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- Claesson, K, et al.
(författare)
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Role of endovascular intervention in patients with diabetic foot ulcer and concomitant peripheral arterial disease.
- 2011
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Ingår i: International Angiology. - 1827-1839. ; 30:4, s. 349-358
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to evaluate wound healing, major amputation and mortality in patients with diabetic foot ulcer and peripheral arterial disease (PAD), and to compare the group decided to have an endovascular intervention with groups referred to conservative treatment or to those judged as unreconstructable. METHODS: A retrospective two-year review of all patients with diabetic foot ulcers and PAD presented at an interdisciplinary diabetic foot round 2006-2007 at Malmö University Hospital, Sweden, was performed. Independent predictive factors of insufficient ulcer healing, amputation and mortality during follow-up were analysed according to treatment decisions at the diabetic foot round. RESULTS: A total of 135 limbs in 115 consecutive diabetic patients with foot ulcers were included. Median age was 73 years and 41% were women. During a median follow-up time of 17 months, 44% of the ulcers did not heal, 15% of the limbs underwent major amputation and 42% died. Ulcer depth with a Wagner grade ≥3 (hazard ratio [HR] 5.8; 95% confidence interval [CI] 2.6-12.9), CRP (HR 1.007; 95% CI 1.002-1.012, and impaired run-off (HR 3.0; 95% CI 1.03-8.9) were independent risk factors for incomplete wound healing. The three treatment decision groups: attempt for endovascular leg revascularization (N.=75), conservative (N.=42) and unreconstructable (N.=18) showed no significant difference in terms of wound healing, major amputation or death. CONCLUSION: Patients with diabetic foot ulcers and concomitant PAD are at high risk for limb loss and premature death. Ulcer depth, CRP and impaired run-off are independent risk factors for incomplete wound healing. There is an apparent need for prospective controlled studies to better define the role of endovascular therapy in this subset of diabetic foot ulcer patients.
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- Claesson, Maria, 1985, et al.
(författare)
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Meso-ordered soft hydrogels
- 2012
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Ingår i: Soft Matter. - : Royal Society of Chemistry (RSC). - 1744-6848 .- 1744-683X. ; 8:31, s. 8149-8156
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Tidskriftsartikel (refereegranskat)abstract
- Many factors such as cross-link density are known to dictate the properties of hydrogels; however, less is known about the microstructure and how it can be tailored to control the properties. Here we demonstrate a method of forming microstructured hydrogels using a soft template that allows us to control and modify the microstructure. Meso-ordered hydrogels were formed by chemically cross-linking poly(ethylene glycol)-diacrylate (PEG-DA) segments via photopolymerization in the presence of poly(ethylene glycol)-poly(propylene glycol)-poly(ethylene glycol) (EOxPOyEOx) block copolymers. The results showed that hydrogels with lamellar mesostructured regions were formed when high concentrations of PEG-DA segments (50%) were used in combination with block co-polymers having certain ratios of the hydrophilic and hydrophobic blocks (P123, EO20PO70EO20). Only lamellar mesostructures were observed, independent of the PEG molecular weight (1500 or 3400 g mol(-1)) or block co-polymer concentration (10-50%). This finding demonstrates that it is possible to form soft meso-ordered hydrogels using block co-polymers as templates, and they do not follow the same mesophase behavior as the purely self-assembled block co-polymers.
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- Glader, A, et al.
(författare)
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Byggnadsrelaterad ohälsa : Kompetensutveckling inom hälsovården
- 2014
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Rapport (refereegranskat)abstract
- Det finns ett stort behov av utbildning om inomhusmiljö och byggnadsrelaterad ohälsa, både inom ramen för grundläggande yrkesutbildningar och som fortbildningskurser för yrkesverksamma. Hälsoproblem som beror på dålig inomhusluft på arbetsplatsen utreds av företagshälsovården. Dock har de som jobbar inom företagshälsovård idag inte alltid tillräcklig kunskap om inomhusmiljö och byggnadsrelaterad ohälsa och saknar ofta beredskap att som sakkunniga delta i utredningar på arbetsplatser. För att förbättra vården bör personalen utbildas om bl.a. riskfaktorer för dålig inomhusluft, vanliga hälsobesvär och inverkan på arbetsförmåga och produktivitet, de psykosociala faktorernas betydelse samt ansvarsfrågor och hälsoekonomiska konsekvenser. Öppna digitala lärresurser (OER) och kurser på nätet (MOOCs) kan med fördel användas vid fortbildning av vårdpersonal. Nätbaserad utbildning underlättar för vårdpersonalen att själv kunna välja tidpunkt och målsättning. Därtill utgör OER även ett hjälpmedel för att utveckla kunskapsöverföringen mellan Sverige och Finland.
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- Kraemer, Bernhard K., et al.
(författare)
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Tacrolimus-Based, Steroid-Free Regimens in Renal Transplantation : 3-Year Follow-Up of the ATLAS Trial
- 2012
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Ingår i: Transplantation. - 0041-1337 .- 1534-6080. ; 94:5, s. 492-498
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Tidskriftsartikel (refereegranskat)abstract
- Background. Long-term use of corticosteroids is associated with considerable morbidity, including cardiovascular and metabolic adverse effects. Methods. This study evaluated the long-term efficacy and safety of two steroid-free regimens compared with a triple immunosuppressive therapy in renal transplant recipients. This was a 3-year follow-up to a 6-month, open-label, randomized, multicenter study. Results. Data from 3 years were available for 421 (93.3%) of 451 patients in the original intent-to-treat population (143 tacrolimus/basiliximab [Tac/Bas], 139 tacrolimus/mycophenolate mofetil [Tac/MMF], and 139 tacrolimus/MMF/steroids [triple therapy]). In the time interval from 6 months to 3 years after transplantation, the incidence of biopsy-proven acute rejection was low and similar (Tac/Bas, 2.1%; Tac/MMF, 2.2%; triple therapy, 2.2%); Most rejection episodes occurred during the first 6 months of the study. Graft survival was high (Kaplan-Meier estimates: 92.7%, 92.5%, and 92.5%), as was patient survival (93.1%, 96.4%, and 97.0%). There were 10 graft losses (n=2, 4, and 4) and 12 patient deaths (n=5, 2, and 5). Renal function was well preserved throughout the study and similar between groups. There was a trend toward improved cardiovascular risk factors in the Tac/Bas group, including reduced total and low-density lipoprotein cholesterol and lower new-onset insulin use. There were no between-group differences in the incidence or type of adverse events. Conclusion. Higher rates of acute rejection early in treatment were seen with the steroid-free regimens, but this did not translate into poorer long-term outcomes, such as graft and patient survival and renal function. A trend for a more favorable cardiovascular risk profile was observed for steroid-free immunosuppression with Tac/Bas.
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- Krämer, Bernhard K., et al.
(författare)
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Tacrolimus combined with two different corticosteroid-free regimens compared with a standard triple regimen in renal transplantation : one year observational results
- 2010
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Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 24:1, s. E1-E9
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Tidskriftsartikel (refereegranskat)abstract
- Side effects of steroid use have led to efforts to minimize their use in transplantation. Two corticosteroid-free regimens were compared with a triple immunosuppressive therapy. Data from the original intent-to-treat (ITT) population (153 tacrolimus/basiliximab [Tac/Bas], 151 tacrolimus/MMF [Tac/MMF], and 147 tacrolimus/MMF/steroids [control]) were analyzed in a 12-month follow-up. Percentage of graft survival were 92.8%, 95.4%, and 95.9% (KM estimates 89.9%, 95.3%, 95.9%), percentage of surviving patients were 98.7%, 98.0%, and 100% (KM estimates 95.9%, 92.8%, and 100%). During months 7-12, graft loss occurred in 3 Tac/Bas, 2 Tac/MMF, and zero control patients, patient deaths in 1 Tac/Bas, 2 Tac/MMF, and zero control, and biopsy-proven acute rejection episodes in 4 Tac/Bas, 3 Tac/MMF, and zero control. Mean serum creatinine at month 12 was 141.9 +/- 69.6 muM, 144.0 +/- 82.1 muM, and 134.5 +/- 71.2 muM (ns). New-onset insulin use in previously non-diabetic patients at month 12 was 1/138, 6/127, and 4/126. Patient and graft survival as well as renal function at 12 months were not different between patient groups, despite considerably higher rates of acute rejection occurring within the first six months after transplantation in both steroid-free patient groups. Tac/Bas therapy might offer benefits in terms of a trend for a more favorable cardiovascular risk profile.
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- Lundgren, Sarah M., et al.
(författare)
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The influence of water on the adsorption and the tribological properties of unsaturated fatty acids in alkane solution
- 2011
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Ingår i: Proceedings of the Institution of mechanical engineers. Part J, journal of engineering tribology. - : SAGE Publications. - 1350-6501 .- 2041-305X. ; 225:10, s. 1048-1055
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Tidskriftsartikel (refereegranskat)abstract
- The moisture uptake of the three unsaturated fatty acids, oleic acid, linoleic acid, and linolenic acid has been investigated. The amount of water absorbed by the fatty acids increased with increasing degree of unsaturation. The influence of the water on the adsorption onto steel and lubricating properties of the fatty acid in hexadecane was investigated. The adsorption, as determined with quartz crystal microbalance of 0.1 and 1 wt% of oleic acid onto steel was not affected by the presence of water (1.5 mole% water in fatty acid) while 5.6 mole% water enhanced the adsorbed amount of linolenic acid. Even though this amount of water had a large influence on the adsorption of linolenic acid, it did not affect the friction and wear measured with high frequency reciprocating rig using oleic acid or linolenic acid in hexadecane.
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- Saigal, Trishna, et al.
(författare)
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Poly(ethylene oxide) star polymer adsorption at the silica/aqueous interface and displacement by linear poly(ethylene oxide)
- 2013
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Ingår i: Langmuir. - : American Chemical Society (ACS). - 0743-7463 .- 1520-5827. ; 29:12, s. 3999-4007
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Tidskriftsartikel (refereegranskat)abstract
- Multiarm star copolymers with approximately 460 poly(ethylene oxide) (PEO) arms that have a degree of polymerization N = 45 were synthesized via atom transfer radical polymerization (ATRP) of PEO-methacrylate macromonomers in the presence of divinyl benzene cross-linkers. These are an example of molecular or nanoparticulate brushes that are of interest as steric stabilizers or boundary lubrication agents when adsorbed from solution to a solid/aqueous interface. We use ellipsometry to measure adsorption isotherms at the silica/aqueous interface for PEO star polymers and linear PEO chains having molecular weights comparable either to the star polymer or to the individual arms. The compactness of the PEO star polymers (molecular weight 1.2 × 106) yields a saturation surface excess concentration that is approximately 3.5 times greater than that of the high molecular weight (1 × 106) linear PEO. Adsorption of low molecular weight (6000) linear PEO was below the detection limit. Competitive adsorption experiments were conducted with ellipsometry, complemented by independent quartz crystal microbalance with dissipation (QCM-D) measurements. Linear PEO (high molecular weight) displaced preadsorbed PEO star polymers over the course of approximately 1.5 h, to form a mixed adsorbed layer having not only a significantly lower overall polymer surface excess concentration, but also a significantly greater amount of hydrodynamically entrapped water. Challenging a preadsorbed linear PEO (high molecular weight) layer with PEO star polymers produced no measurable change in the overall polymer surface excess concentration, but changes in the QCM-D energy dissipation and resonance frequency suggested that the introduction of PEO star polymers caused a slight swelling of the layer with a correspondingly small increase in entrapped water content.
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