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- Sandström, Caroline, et al.
(författare)
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An association between Type 2 diabetes and alpha(1)-antitrypsin deficiency
- 2008
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Ingår i: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 25:11, s. 1370-1373
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Tidskriftsartikel (refereegranskat)abstract
- Aims alpha(1)-Antitrypsin (AAT) is a serine protease inhibitor which recently has been shown to prevent Type 1 diabetes development, to prolong islet allograft survival and to inhibit pancreatic B-cell apoptosis in vivo. It has also been reported that Type 1 diabetic patients have significantly lower plasma concentrations of AAT, suggesting the potential role of AAT in the pathogenesis of Type 1 diabetes. We have investigated whether plasma AAT levels are altered in Type 2 diabetes. Methods The study included patients with Type 2 diabetes (n = 163) and non-diabetic control subjects matched for age, sex and smoking habits (n = 158) derived from the population-based Malmo Diet and Cancer study. Plasma samples were analysed for AAT concentration and phenotype and serum glucose, insulin, C-reactive protein and lipid levels were measured. Glycated haemoglobin was also measured. Results In the diabetic group, the women had higher mean plasma AAT levels than men ( P < 0.05). The mean plasma AAT levels did not differ between diabetic and control subjects. However, the number of individuals with low AAT levels (< 1.0 mg/ml) was 50% higher in the diabetic group (P < 0.05) and the frequency of AAT deficiency genotypes was 50% higher (NS) in diabetic compared with control subjects. In the group of diabetic patients with AAT < 1 mg/ml, AAT directly correlated with systolic blood pressure (P = 0.048) and inversely correlated with waist-hip ratio (P = 0.031). Conclusions Our results provide evidence that deficiency of AAT may be associated with an increased risk of developing Type 2 diabetes.
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- Sandström, Ulla, et al.
(författare)
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Variation in views on clients in interprofessional work for vocational rehabilitation in Sweden
- 2007
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Ingår i: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 21:5, s. 479-489
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Tidskriftsartikel (refereegranskat)abstract
- To deal with long-term sickness absence, inter-organizational and interprofessional projects for rehabilitation were established in Sweden in the late 1990s. This study explores the different views about the clients of such a project from the professionals of the organizations involved. Twenty-one key informants were interviewed in 1999 and 22 in 2002. The interviews were semi-structured and analysed with a phenomenographic approach. Four descriptive categories emerged: (A) the individual as consisting of components, (B) the individual in his/her context, (C) the individual as part of a group, and (D) the individual as part of the population. Category A included a paternalistic view and B included a maternalistic as well as an autonomous view. Both paternalism and maternalism imply an inequality in the relationship between the professional and the client. Category C had an organizational perspective, whereas category D had a community perspective. Both of these perspectives included an abstract view of the client. The conclusions were that the professionals had qualitatively different views on clients, which might lead to unequal encounters as well as differences in opportunities for rehabilitation. The results stress the importance of discussing what ethical values are desirable, not least in inter-organizational and interprofessional projects.
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