| 1. |
- Möller, Peter, et al.
(författare)
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Unga vuxna i Dalarna 2008 : En regional kartläggning av unga vuxnas livsvillkor
- 2008
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Unga vuxna är en mycket viktig men också sårbar grupp. Unga representerar på ett mycket påtagligt sätt framtiden, samtidigt som det faktum att de ännu inte hunnit etablera sig fullt ut i samhället gör dem särskilt utsatta. Flera nationella undersökningar visar att åldersgruppen 19-25 år upplevt försämringar under senare tid, bland annat i form av ökad psykisk ohälsa och försämrad ekonomi. Mest utsatta vad gäller ökad psykisk ohälsa och stress är unga kvinnor. Unga kvinnor uttrycker också i högre grad än unga män en känsla av otrygghet i offentliga miljöer, och då i synnerhet kvällstid. Kön är dock inte den enda faktor som bidrar till att skapa skillnader mellan olika kategorier av unga. Social bakgrund, etnicitet, personliga förutsättningar och tidigare erfarenheter bidrar på olika sätt till att forma unga människors möte med arbetsmarknaden och steget in i vuxenlivet. Den fysiska plats där man bor påverkar också i stor utsträckning hur ens sociala parametrar kommer att samspela med samhället. Vi vet att gruppen unga vuxna lever under andra villkor än för bara ett par decennier sedan. Kunskap har dock saknats om hur det ser ut i Dalarna. För att kunna stärka unga vuxnas position och ta vara på dem som den resurs de är för regionens utveckling behöver vi veta mera. Under 2006 tog Dalarnas forskningsråd initiativ till att samla en rad organisationer med särskilt intresse för gruppen unga vuxna. En arbetsgrupp bildades och ett samtal om unga vuxnas förändrade livsvillkor inleddes. Diskussionerna mynnade ut i ett beslut att låta göra en postenkät för att kartlägga unga vuxnas livsvillkor i Dalarna. Under hösten 2007 skickades enkäter ut till 3000 slumpmässigt utvalda 19–25-åringar i Dalarna; omkring 200 i var och en av Dalarnas 15 kommuner. Det är resultatet av den kartläggningen som presenteras i den här rapporten.
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| 2. |
- Lind, Lisbet K, et al.
(författare)
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EDAR mutation in autosomal dominant hypohidrotic ectodermal dysplasia in two Swedish families
- 2006
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Ingår i: BMC Medical Genetics. - : BioMed Central. - 1471-2350. ; 7, s. 80-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hypohidrotic ectodermal dysplasia (HED) is a genetic disorder characterized by defective development of teeth, hair, nails and eccrine sweat glands. Both autosomal dominant and autosomal recessive forms of HED have previously been linked to mutations in the ectodysplasin 1 anhidrotic receptor (EDAR) protein that plays an important role during embryogenesis.METHODS: The coding DNA sequence of the EDAR gene was analyzed in two large Swedish three-generational families with autosomal dominant HED.RESULTS: A non-sense C to T mutation in exon 12 was identified in both families. This disease-specific mutation changes an arginine amino acid in position 358 of the EDAR protein into a stop codon (p.Arg358X), thereby truncating the protein. In addition to the causative mutation two polymorphisms, not associated with the HED disorder, were also found in the EDAR gene.CONCLUSION: The finding of the p.Arg358X mutation in the Swedish families is the first corroboration of a previously described observation in an American family. Thus, our study strengthens the role of this particular mutation in the aetiology of autosomal dominant HED and confirms the importance of EDAR for the development of HED.
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| 3. |
- Lind, Marcus, 1976, et al.
(författare)
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A systematic review of HbA1c variables used in the study of diabetic complications
- 2008
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Ingår i: Diabetes and Metabolic Syndrome: Clinical Research and Reviews. - : Elsevier BV. - 1871-4021. ; 2:4, s. 282-293
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The predictive power of different HbA1c variables is of importance in prognosis of diabetic complications, clinical guidelines, health-economical analyses and in the design of clinical trials of antidiabetic agents. The aim was to review the literature with regard to the HbA1c variables used, and determine how the predictive power of these relates to diabetic complications. Method: We reviewed 97 full-text articles on HbA1c and diabetic complications. Results: The most commonly used HbA1c variables were: the baseline value, the mean and the "updated" mean HbA1c. Other variables used were the logarithm of the updated mean, the standard deviation, the slope (annual average change), the initial decline (change during the first year), the final value, and the change in HbA1c between baseline and the fourth year. The updated mean, logarithm of the updated mean and mean HbA1c were found to have greater predictive power than baseline HbA1c. The slope, final value, S.D., initial decline and change of HbA1c did not add any further information. The predictive power of the mean or updated mean HbA1c became stronger with longer study lengths. There was a persistent effect over several years between HbA1c values and diabetic complications. Measurements of HbA1c varied from a single value to measurements each month. Conclusions: The use of a mean or the updated mean HbA1c is recommended in the study design. HbA1c values several years old also influence the prognosis of diabetic complications. The possibility of finding a true effect of an antidiabetic agent increases with longer study length. © 2008 Diabetes India.
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| 4. |
- Lind, Marcus, et al.
(författare)
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[Deep venous thrombosis]
- 2006
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Ingår i: Lakartidningen. - 0023-7205. ; 103:13, s. 1031-4
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Tidskriftsartikel (refereegranskat)
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| 5. |
- Lind, Marcus, 1976
(författare)
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Glycaemic control: evaluation of HbA1c as a risk factor and the effect of modern insulins in clinical practice
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- One of the ultimate goals of diabetes care is to minimise diabetic complications. When evaluating insulins it is important to understand what extent of improvements in glycaemic control is clinically relevant in preventing diabetic complications. We have thus both studied the effects on glycaemic control of the most commonly used insulins and the relations between glycaemic control and diabetic complications. In analyses electronical tracking of patient record systems and data from the landmark study Diabetes Control and Complications Trial (DCCT) were used. Research and statistical models were developed to estimate time-dependent effects between HbA1c and diabetic complications. Patients receiving insulin glargine in clinical practice have decreased on average 0.18% in HbA1c compared to patients continuing with NPH insulin. Lean men had the greatest reductions in HbA1c. In corresponding analyses of insulin lispro reductions of HbA1c by 0.19% were achieved compared to patients continuing with regular insulin. Patients with high HbA1c experienced the greatest reductions in HbA1c. When relating HbA1c to diabetic complications we introduced the term HbA1c-variable describing different weightings and combinations of HbA1c values. In a systematic review we found that the baseline value was most common to use in studies of HbA1c and diabetic complications, but a mean value of many HbA1c values had greater predictive ability. By simulations we showed that HbA1c-variables comprising time-dependent effects of HbA1c could have 100% greater predictive power than a mean value. In the DCCT we could confirm these results and describe the temporal relationship between HbA1c and retinopathy. Over 6 years an HbA1c-level of 8% instead of 7% predicted 92% greater risk of retinopathy when time-dependent effects were considered instead of 50% with a mean value. HbA1c values 2.4 years ago had the largest deleterious effects on current risk of retinopathy and historical values up to 5 years ago were more harmful than present values. The current salutary effect of a constant lower level of HbA1c increased steadily with time since both present and previous values reduce the current risk of retinopathy. When lowering HbA1c from 9% to 7% 274 patients had to be treated during the first 3 years after diagnosis, but only 2 patients during the period 9-12 years to prevent retinopathy. With time also relatively small HbA1c changes of 0.3% showed a low NNTof 13. In conclusion good glycemic control is more important than earlier recognised in preventing retinopathy. Insulin lispro and insulin glargine improve glycaemic control in clinical practice and the reductions obtained in HbA1c are clinically relevant. In medicine time-dependent effects of treatments and risk factors should be regarded in epidemiologic and clinical trials to understand the magnitude of the effects. Electronical tracking of data in clinical research and quality improvement is more efficient than manual collection, extensive information is retrieved and costs are reduced substantially.
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| 6. |
- Lind, Marcus, 1976, et al.
(författare)
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The effect of insulin lispro on glycemic control in a large patient cohort.
- 2009
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Ingår i: Diabetes technology & therapeutics. - : Mary Ann Liebert Inc. - 1520-9156 .- 1557-8593. ; 11:1, s. 51-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of rapid-acting insulin analogs and regular insulin differs considerably in countries throughout the world. We therefore studied how glycemic control has been affected by using insulin lispro in clinical practice over 5 years in 14 hospitals in Sweden. METHODS: We used a time period when most patients had not changed the basal insulin, but only the mealtime insulin. Accordingly the most recent years were not suitable since many patients had changed basal insulin from NPH to glargine or determir. We therefore analyzed the metabolic consequences on glycosylated hemoglobin (HbA1c) when changing from regular insulin to insulin lispro from 1997 and during the following 5 years. We studied 1,069 patients with diabetes taking NPH insulin as basal insulin and at least three daily injections of regular insulin, of whom 423 changed their mealtime insulin to insulin lispro and 646 controls who continued with regular insulin. RESULTS: Patients changing to insulin lispro on average decreased by 0.19% units more in HbA1c than those remaining on regular insulin. The effect was most pronounced in patients with high HbA1c even after controlling for regression to the mean. A beneficial effect of insulin lispro was also indicated since patients had the same level of HbA1c during a long period of time with regular insulin but then dropped when changing to insulin lispro. CONCLUSIONS: This study indicates that insulin lispro has had a beneficial and persisting effect on glycemic control when used in patients with diabetes on multiple daily injections of insulin in clinical practice.
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| 7. |
- Lind, Marcus, 1976, et al.
(författare)
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The true value of HbA1c as a predictor of diabetic complications: simulations of HbA1c variables
- 2009
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- Aim The updated mean HbA1c has been used in risk estimates of diabetic complications, but it does not take into account the temporal relationship between HbA1c and diabetic complications. We studied whether the updated mean HbA1c underestimated the risk of diabetic complications. Method Continuous HbA1c curves for 10,000 hypothetical diabetes patients were simulated over an average of 7 years. Simulations were based on HbA1c values encountered in clinical practice. We assumed that each short time interval of the continuous HbA1c curves had a long-lasting effect on diabetic complications, as evidenced by earlier studies. We tested several different HbA1c variables including various profiles, e.g. different duration, of such a long-lasting effect. The predictive power of these variables was compared with that of the updated mean HbA1c. Results The predictive power of the constructed HbA1c variables differed considerably compared to that of the updated mean HbA1c. The risk increase per standard deviation could be almost 100% higher for a constructed predictor than the updated mean HbA1c. Conclusions The importance of good glycemic control in preventing diabetic complications could have been underestimated in earlier hallmark studies by not taking the time-dependent effect of HbA1c into account.
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| 8. |
- Lind, Marcus, et al.
(författare)
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Thrombomodulin as a marker for bleeding complications during warfarin treatment
- 2009
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Ingår i: Archives of Internal Medicine. - : American Medical Association (AMA). - 0003-9926 .- 1538-3679. ; 169:13, s. 1210-1215
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The major adverse effect of warfarin treatment is hemorrhage. Several risk factors for bleeding complications are also risk factors for thromboembolic events, making the clinical decision to initiate or withhold anticoagulant treatment difficult. Specific markers that solely identify patients at high risk of bleeding would have great clinical impact. This study aimed to test if thrombomodulin (TM) concentrations were associated with bleeding complications, cardiovascular events, or mortality in long-term anticoagulant-treated patients. METHODS: In a longitudinal cohort study we followed up 719 patients receiving warfarin treatment for a mean duration of 4.2 years. All bleeding complications causing hospitalization were registered and classified. Soluble TM antigen (sTM) concentration in plasma was measured with an enzyme-linked immunosorbent assay method. RESULTS: During the follow-up time, 113 clinically relevant bleeding events and 73 major bleeding events occurred. Increased concentration of sTM was associated with both clinically relevant bleeding and major bleeding events after adjustment for age. In the multivariable models, hazard ratios for the highest tertiles compared with the lowest were 2.29 (95% confidence interval, 1.35-3.89) and 2.33 (95% confidence interval, 1.21-4.48), respectively. No association between sTM concentration and nonfatal ischemic cardiovascular events or all-cause mortality was found. CONCLUSIONS: Increased levels of sTM are associated with bleeding complications during warfarin treatment but not with cardiovascular events or all-cause mortality. Soluble TM antigen concentration has potential as a new specific marker to identify patients at high risk of bleeding during warfarin treatment.
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| 9. |
- Lind, Per, et al.
(författare)
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Structural, photophysical, and nonlinear absorption properties of trans-di-arylalkynyl Platinum(II) Complexes with Phenyl and Thiophenyl Groups
- 2007
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Ingår i: Journal of Physical Chemistry A. - : American Chemical Society (ACS). - 1089-5639 .- 1520-5215. ; 111:9, s. 1598-1609
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Tidskriftsartikel (refereegranskat)abstract
- Optical power limiting and luminescence properties of two Pt(II) complexes with thiophenyl and phenyl groups in the ligands, trans-Pt(P(n-Bu)3)2(C[triple bond]C-Ar)2, where Ar = -C4H2S-C[triple bond]C-p-C6H4-n-C5H11 (1) and -p-C6H4-C[triple bond]C-C4H3S (2), have been investigated. The fluorescence lifetimes were found to be on the sub-nanosecond time scale, and the quantum yields were low, in accord with fast intersystem crossing from the excited singlet to triplet manifold. The phosphorescence lifetimes of 1 and 2 were shorter than that of a Pt(II) complex having two phenyl groups in the ligands. In order to elucidate the C-Pt bonding nature in the ground state, the 13C NMR chemical shift of the carbon directly bonded to Pt, the coupling constants 1JPtC, 2JPtC, and 1JPtP, and IR νC[triple bond]C wavenumbers were obtained for 1, 2, and three other trans-diarylalkynyl Pt(II) complexes. X-ray diffraction data of 1 and 2 and density functional theory calculated geometries of models of 1, 2, and trans-Pt(P(n-Bu)3)2(C[triple bond]C-p-C6H4-C[triple bond]C-C6H5)2 (3) show that 1 preferably exists in a different conformation from that of 2 and 3. The variations in photophysical, NMR, and IR data can be rationalized by differences in geometry and pi-backbonding from Pt to the alkynyl ligand.
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| 10. |
- Sahlén, Anders, et al.
(författare)
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Magnitude, reproducibility, and association with baseline cardiac function of cardiac biomarker release in long-distance runners aged > or =55 years
- 2008
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Ingår i: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 102:2, s. 218-222
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Tidskriftsartikel (refereegranskat)abstract
- Cardiac biomarker release after endurance exercise has been described in young athletes. Although older athletes are increasingly active in such sports, they have not previously been studied. Therefore, the aim of this study was to assess the magnitude and reproducibility of biomarker release in athletes aged > or =55 years. Forty-three healthy athletes (mean age 61 +/- 3.6 years) were assessed before and immediately after a 30-km cross-country race and studied with echocardiography at rest. The median N-terminal pro-brain natriuretic peptide (NT-proBNP; normal <194 ng/L) level was 42 ng/L (interquartile range 30 to 95) at baseline and 191 ng/L (interquartile range 114 to 308) after the race. Troponin T (normal <0.03 microg/L) was elevated in 19 subjects (44%) after the race. Twenty-two subjects had also been studied 3 years before at the same race, using an identical test protocol. Between the 2 races, strong correlations were seen for individual runners' postrace biomarker levels (NT-proBNP: r = 0.82, log transformed data; troponin T: Spearman's rho = 0.84; p <0.001 for both). The coefficient of variation for NT-proBNP release was 8.1%. Levels of NT-proBNP after the race were correlated with levels at baseline (r = 0.93, p <0.001) and with left ventricular mass index (r = 0.32, p = 0.03). Moreover, participants with elevated postrace NT-proBNP were significantly older (62.0 vs 59.8 years, p = 0.04). In conclusion, long-distance runners aged > or =55 years released NT-proBNP and troponin T in a reproducible fashion. The magnitude of NT-proBNP release during the race was correlated strongly with NT-proBNP baseline levels and was associated with left ventricular mass and age. These findings may suggest a potential adverse effect of long-distance running on cardiac function in certain participants in this age group.
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