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Sökning: WFRF:(Jansson S E) > (2000-2004)

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  • Svenmarker, S., et al. (författare)
  • Neurological and general outcome in low-risk coronary artery bypass patients using heparin coated circuits
  • 2001
  • Ingår i: European Journal of Cardio-Thoracic Surgery. - Oxford : Oxford University Press. - 1010-7940 .- 1873-734X. ; 19:1, s. 47-53
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The clinical significance of heparin coating in cardiopulmonary bypass has previously been investigated. However, few studies have addressed the possible influence on brain function and memory disturbances. Methods: Three hundred low-risk patients exposed to coronary bypass surgery were randomised into three groups according to type of heparin coating: Carmeda Bioactive Surface, Baxter Duraflo II and a control group. Outcome was determined from a number of clinically oriented parameters, including a detailed registry of postoperative deviations from the normal postoperative course. Brain damage was assessed through S100 release and memory tests, including a questionnaire follow-up. Results: Clinical outcome was similar for all groups. Blood loss (Duraflo only), transfusion requirements and postoperative creatinine elevation were reduced in the heparin-coated groups. A lower incidence of atrial fibrillation was noted in the Duraflo group. Heparin coating did not uniformly attenuate the release of S100 or the degree of memory impairment. Conclusions: Cardiopulmonary bypass (CPB) with heparin coating and a reduced dose of heparin seems to be safe. Clinical outcome and neurological injury seem not to be associated with type of heparin coating used for CPB. However, blood loss and transfusion requirements may be reduced.
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  • Svenmarker, S., et al. (författare)
  • Use of heparin-bonded circuits in cardiopulmonary bypass improves clinical outcome
  • 2002
  • Ingår i: Scand Cardiovasc J. ; 36:4, s. 241-6
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The use of heparin-coated surfaces in cardiopulmonary bypass has been shown to decrease the inflammatory response imposed by the contact between blood and artificial surfaces. One would expect this reaction to improve clinical outcome. However, this has been difficult to verify. This investigation is based on an aggregation of two randomized studies from our institution and highlights possible effects of heparin coating on a number of clinically oriented parameters. DESIGN: Departmental analysis of patients subjected to coronary artery bypass surgery using heparin-coated circuits. Cardiopulmonary bypass was employed using either the Carmeda or Duraflo heparin coatings compared with a control. The systemic heparin dose was reduced in the heparin-coated groups (ACT > 250 s) vs control group patients (ACT > 480 s). The effects of heparin coating related to clinical outcome were studied. RESULTS: The use of heparin-coated circuits reduced the mean length of stay in hospital from 7.8 +/- 2.5 to 7.3 +/- 1.8 days (p = 0.040) and postoperative ventilation time from 9.7 +/- 9.2 to 8.2 +/- 8.5 h (p = 0.018), blood loss 8 h post surgery from 676 +/- 385 to 540 +/- 245 ml (p = 0.001), individual perioperative change of haemoglobin loss (p = 0.001), leukocyte count (p = 0.000) and creatinine elevation (p = 0.000), proportion of patients exposed to allogenous blood transfusions 39.2 vs 23.9% (p = 0.001), postoperative coagulation disturbances 4.4 vs 0.4% (p = 0.006), postoperative deviations from the normal postoperative course 47.2 vs 36.7% (p = 0.035), neurological deviations 9.4 vs 3.9% (p = 0.021) and atrial fibrillation 26.4 vs 18.0% (p = 0.041). No effects were found with respect to perioperative platelet count, postoperative fever reaction and 5-year survival. CONCLUSION: Based on several indicators, the use of heparin coating in cardiopulmonary bypass is associated with improved clinical results.
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  • Jansson, S. E. A., et al. (författare)
  • Packaging materials for fermented milk : Effects of material crystallinity and polarity on food quality
  • 2001
  • Ingår i: Packaging technology & science. - : Wiley. - 0894-3214 .- 1099-1522. ; 14:3, s. 119-127
  • Tidskriftsartikel (refereegranskat)abstract
    • The ability of a packaging material to protect the food product and extend its shelf-life depends on several material properties. In this work the effects of material crystallinity and polarity on the quality of fermented milk were studied. The fermented milk is a high-quality Swedish product, similar to yoghurt. The quality of the food product was determined as a function of storage time by containing the liquid in pouches of different materials. The material crystallinity was varied by using very low-density polyethylene, high-density polyethylene and aluminium laminate as packaging materials. Aluminium was used on account of its '100%' gas-tightness. The polarity was varied by comparing an aliphatic polyketone with polyethylene of similar crystallinity. The carbon dioxide (CO2) and oxygen (O-2) contents in the headspace of the pouches were determined. The food quality was determined by measuring whey syneresis, viscosity and the content of desired Bifidobacteria, as well as of undesired yeast and mould. A trained taste panel determined the degree of acidity and of the sparkling taste. It was found that the content of CO2 increased and that of O-2 decreased in the pouches with increasing degree of crystallinity and increasing polarity. The sparkling taste of fermented milk was a clear function of the headspace CO2 content. The data presented here could thus be used to 'design' a package for a desired sparkling taste of the fermented milk by selecting a certain material crystallinity. Whey syneresis, viscosity and content of Bifidobacteria were found to be independent of pouch material. While the degree of whey syneresis and the viscosity increased with increasing storage time, the content of Bifidobacteria slowly decreased. The content of yeast and mould in the liquid was below the existing limit values for foodstuffs. The degrees of acidity and sparkling taste were highest for the liquids contained in aluminium and polyketone pouches, although the differences in acidulous taste between the various pouch materials were small.
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  • Jansson, S. E. A., et al. (författare)
  • Packaging materials for fermented milk Part 2 : Solute-induced changes and effects of material polarity and thickness on food quality
  • 2002
  • Ingår i: Packaging technology & science. - : Wiley. - 0894-3214 .- 1099-1522. ; 15:6, s. 287-300
  • Tidskriftsartikel (refereegranskat)abstract
    • This work is a continuation of the application of a developed methodology for the selection of packaging material for a specific food product, in this case the 'demanding' food product. fermented milk. The effects of different packaging material parameters on the quality of fermented milk were studied. Food quality after storage was determined as a function of material polarity and pouch thickness by storing the liquid in pouches of different materials. The material polarity was varied by using laminates with polyethylene, poly(ethylene-co-vinyl alcohol) with two different ethylene contents and an aliphatic polyketone. The effects of pouch thickness were studied using high-density polyethylene films of different thicknesses between 25 mum and 200 mum. The interactions between the milk product and the pouch material were analysed by oxygen and water permeability, gas chromatography-mass spectrometry and tensile testing. The CO2 and O-2 contents in the headspace of the pouches were determined. The food quality was determined by measuring whey syneresis and the contents of Bifidobacteria, Enterobacteriaceae, yeast and mould. A trained taste panel determined the sensory properties. The content of CO2, and consequently the sparkling taste, increased with increasing polarity and/or pouch thickness. The CO2 content was affected more easily by changes in material polarity than by changes in pouch thickness. The increase in whey syneresis and the decrease in Bifidobacteria content with time were independent Of material polarity and pouch thickness. The contents Of Enterobacteriaceae, yeast and mould in the liquid were always below existing limits for foodstuffs. A newly developed method was used by which the CO2 and 02 permeabilities of the pouch/packaging could be estimated, using the kinetics of the gas composition in the pouch headspace. Permeability values, as estimated by the method, revealed that the CO2 production and the O-2 consumption rates of the fermented milk were dependent on the CO2 and O-2 headspace concentrations. An increase in permeability, determined by conventional methods, suggested that both the non-polar and the polar polymers were plasticized by fermented milk. The plasticization was, however, modest and undetectable when the polyethylene tensile test data were analysed.
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  • Andersson, F, et al. (författare)
  • The costs of exacerbations in chronic obstructive pulmonary disease (COPD)
  • 2002
  • Ingår i: Respiratory Medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 96:9, s. 700-708
  • Tidskriftsartikel (refereegranskat)abstract
    • Exacerbations are the key drivers in the costs of chronic obstructive pulmonary disease (COPD). The objective was to examine the costs of COPD exacerbations in relation to differing degrees of severity of exacerbations and of COPD. We identified 202 subjects with COPD, defined according to the BTS and ERS criteria. Exacerbations were divided into mild (self-managed), mild/moderate (telephone contact with a health-care centre and/or the use of anti biotics/systemic corticosteroids), moderate (health-care centre visits) and severe (emergency care visit or hospital admission). Exacerbations were identified by sending the subjects a letter inquiring whether they had any additional respiratory problems or influenza the previous winter. At least one exacerbation was reported by 61 subjects, who were then interviewed about resource use for these events. The average health-care costs per exacerbation were SEK 120(95% CI = 39-246), SEK 354 (252-475), SEK 2111 (1673-2612) and SEK 21852 (14436-29825) for mild, mild/moderate, moderate and severe exacerbations, respectively. Subjects with impaired lung function experienced more severe exacerbations, which was also reflected in the cost of exacerbations per severity of the disease during the 41 month study period (ranging from SEK 224 for mild to SEK 13708 for severe cases, median SEK 940). Exacerbations account for 35-45% of the total per capita health-care costs for COPD. In conclusion, costs varied considerably with the severity of the exacerbation as well as with the severity of COPD. The prevention of moderate-to-severe exacerbations could be very cost-effective and improve the quality of life.
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  • Jansson, D. S., et al. (författare)
  • Brachyspira hyodysenteriae and other strongly beta-haemolytic and indole-positive spirochaetes isolated from mallards (Anas platyrhynchos)
  • 2004
  • Ingår i: Journal of Medical Microbiology. - : Microbiology Society. - 0022-2615 .- 1473-5644. ; 53:4, s. 293-300
  • Tidskriftsartikel (refereegranskat)abstract
    • The aims of the current study were to collect intestinal spirochaetes (genus Brachyspira) from farmed and wild mallards (Anas platyrhynchos) and to identify and classify those isolates that phenotypically resembled Brachyspira hyodysenteriae, an enteric pathogen of pigs. The isolation rate of Brachyspira spp. was high from both farmed (93%) and wild mallards (78%). In wild mallards, it appeared that Brachyspira spp. were more likely to be found in migratory birds (multivariate analysis: RR = 1(.)8, 95% Cl 1(.)1-3(.)1) than in mallards sampled in a public park. Pure cultures of putative B. hyodysenteriae were obtained from 22 birds. All five isolates from farmed mallards and ten randomly selected isolates with this phenotype were used for further studies. All isolates from farmed mallards and two of the isolates from wild mallards were PCR-positive for the tlyA gene of B. hyodysenteriae. Two isolates from farmed mallards were selected for pulsed field gel electrophoresis (PFGE) and randomly amplified polymorphic DNA (RAPD) analysis. These isolates clustered with the type and reference strains of B. hyodysenteriae. 16S rDNA sequence analysis performed on 11 of the strains showed that they were all closely related to each other and to the B. hyodysenteriae-Brachyspira intermedia cluster. Three of the mallard isolates had 16S rDNA sequences that were identical to those of B. hyodysenteriae strains R1 and NIV-1 previously isolated from common rheas (Rhea americana). To conclude, the isolates from farmed mallards and two isolates from wild mallards were classified as B. hyodysenteriae based on the factthat they could not be differentiated by any of the applied methods from type, reference and field strains of B. hyodysenteriae. The remaining isolates could not be assigned irrefutably to any of the presently recognized Brachyspira species. These results point to a broader host spectrum of B. hyodysenteriae than is generally recognized, and to the presence in mallards of strongly haemolytic and indole-producing spirochaetes that possess many, but not all, of the currently recognized characteristics of B. hyodysenteriae.
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  • Jansson, M, et al. (författare)
  • Gender differences in heritability of depressive symptoms in the elderly
  • 2004
  • Ingår i: PSYCHOLOGICAL MEDICINE. - 0033-2917 .- 1469-8978. ; 34:3, s. 471-479
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The present study aimed to investigate the relative importance of genetic and environmental influences on depressive symptoms in the elderly. METHOD: Depressive symptoms were assessed through the Center for Epidemiological Studies-Depression (CES-D) scale. The CES-D scale was administered to 959 twin pairs (123 female MZs, 90 male MZs, 207 same-sex female DZs, 109 same-sex male DZs and 430 opposite-sex DZs) aged 50 years or older (mean age 72 years). A dichotomous depressed state variable was constructed based on CES-D cut-offs and self-reported use of antidepressant medication. Structural equation models were fitted to the data to dissect genetic and environmental variance components. RESULTS: The sex-specific heritability estimates for depressive symptoms were 14% for males and 29% for females and 23% when constrained to be equal for men and women. The prevalence of clinically significant depressive symptoms was 16% for men and 24% for women. Heritability estimates for the dichotomous depressed state measure were 7% for males and 49% for females in the full model and 33% when constrained to be equal. CONCLUSION: Our results suggest that depressive symptoms in the elderly are moderately heritable, with a higher heritability for women than men, although differences in heritability estimates were not statistically significant.
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  • Lee, S. K., et al. (författare)
  • Electrical characterization of TiC ohmic contacts to aluminum ion implanted 4H-silicon carbide
  • 2000
  • Ingår i: Applied Physics Letters. - : AIP Publishing. - 0003-6951 .- 1077-3118. ; 77:10, s. 1478-1480
  • Tidskriftsartikel (refereegranskat)abstract
    • We report on the investigation of epitaxial TiC ohmic contacts to Al ion implanted 4H-SiC. TiC ohmic contacts were formed by coevaporation of Ti and C-60 at low temperature (< 500 degrees C). A sacrificial silicon nitride (Si3N4) layer was deposited on the silicon carbide substrate prior to Al implantation in order to reach a high Al dopant concentration at the surface while maintaining a low dose. The combination of epitaxially grown TiC and the silicon nitride layer resulted in a promising scheme to make low resistivity ohmic contacts. The lowest contact resistivity (rho(C)) and sheet resistance (R-s) of the implanted layer at 25 degrees C were as low as 2 x 10(-5) Ohm cm(2) and 0.6 k Ohm/square, respectively.
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20.
  • Lindskog, Stefan, et al. (författare)
  • [Phenotypic expression of a mutation in MEN 2A documented in a family in the western part of Sweden]. : Fenotypiskt uttryck av mutation vid MEN 2A kartlagd i västsvensk familj.
  • 2001
  • Ingår i: Lakartidningen. - 0023-7205. ; 98:35
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • A missense mutation at codon 618 of the RET proto-oncogene is a rather unusual cause of multiple endocrine neoplasia 2A. We report the phenotypic expression of this specific RET mutation in a large Swedish family. The family was mapped back to the 18th century. Since 1971 the family has been included in a biochemical screening program, and since 1994 has undergone genetic screening. Twenty-seven individuals were found to have medullary thyroid carcinoma (MTC). Eighteen were detected by screening. The incidence of pheochromocytoma (4%) and hyperparathyroidism (7%) was low. Five individuals died of MTC, but of these none had been included in the screening program. One patient underwent prophylactic thyroidectomy after positive genetic screening. MTC tumor aggressivity differed markedly between gene carriers. The screening program shows that the clinical aggressivity of MTC can be mitigated by early and adequate surgical intervention.
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  • Nilsson, B, et al. (författare)
  • Effects of preoperative parathyroid localisation studies on the cost of operations for persistent hyperparathyroidism.
  • 2001
  • Ingår i: The European journal of surgery = Acta chirurgica. - : Oxford University Press (OUP). - 1102-4151. ; 167:8, s. 587-91
  • Tidskriftsartikel (refereegranskat)abstract
    • To find out whether preoperative parathyroid localisation studies are cost-effective in patients with persistent hyperparathyroidism (HPT).Retrospective study.University hospital, Sweden.29 consecutive patients with persistent HPT who were reoperated on with or without localisation studies. 15 other patients had initial operations for HPT without localisation studies.Initial or repeat operation for HPT, localisation studies with 99mTc sestamibi scintigraphy, and catheterisation of large cervical and mediastinal veins with measurements of serum concentrations of parathyroid hormone.Operative time. Cost of operations, frozen section biopsy and localisation studies.The mean durations of reoperation with localisation studies and for the initial operation without them, were 124 and 135 minutes, respectively, while it was 269 minutes for reoperation without studies. For patients who had localisation studies the mean total cost of the investigations, operating time, and frozen section biopsy was 28% less than for patients who were reoperated on without such studies.Preoperative localisation studies before repeat operations for HPT were cost-effective. Even if it has not been shown in this series, the reduction in operating time and the extent of dissection by localisation studies has the potential to decrease morbidity.
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