| 1. |
- Sarwar, Nadeem, et al.
(författare)
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Interleukin-6 receptor pathways in coronary heart disease : a collaborative meta-analysis of 82 studies
- 2012
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Ingår i: The Lancet. - New York, NY, USA : Elsevier. - 0140-6736 .- 1474-547X. ; 379:9822, s. 1205-1213
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Tidskriftsartikel (refereegranskat)abstract
- Background: Persistent inflammation has been proposed to contribute to various stages in the pathogenesis of cardiovascular disease. Interleukin-6 receptor (IL6R) signalling propagates downstream inflammation cascades. To assess whether this pathway is causally relevant to coronary heart disease, we studied a functional genetic variant known to affect IL6R signalling. Methods: In a collaborative meta-analysis, we studied Asp358Ala (rs2228145) in IL6R in relation to a panel of conventional risk factors and inflammation biomarkers in 125 222 participants. We also compared the frequency of Asp358Ala in 51 441 patients with coronary heart disease and in 136 226 controls. To gain insight into possible mechanisms, we assessed Asp358Ala in relation to localised gene expression and to postlipopolysaccharide stimulation of interleukin 6. Findings: The minor allele frequency of Asp358Ala was 39%. Asp358Ala was not associated with lipid concentrations, blood pressure, adiposity, dysglycaemia, or smoking (p value for association per minor allele >= 0.04 for each). By contrast, for every copy of 358Ala inherited, mean concentration of IL6R increased by 34.3% (95% CI 30.4-38.2) and of interleukin 6 by 14.6% (10.7-18.4), and mean concentration of C-reactive protein was reduced by 7.5% (5.9-9.1) and of fibrinogen by 1.0% (0.7-1.3). For every copy of 358Ala inherited, risk of coronary heart disease was reduced by 3.4% (1.8-5.0). Asp358Ala was not related to IL6R mRNA levels or interleukin-6 production in monocytes. Interpretation: Large-scale human genetic and biomarker data are consistent with a causal association between IL6R-related pathways and coronary heart disease.
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| 2. |
- Ovesen, C., et al.
(författare)
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Feasibility of endovascular and surface cooling strategies in acute stroke
- 2013
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 127:6, s. 399-405
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Tidskriftsartikel (refereegranskat)abstract
- Background Therapeutic hypothermia (TH) is a promising treatment of stroke, but limited data are available regarding the safety and effectiveness of cooling methodology. We investigated the safety of TH and compared the cooling capacity of two widely used cooling strategies endovascular and surface cooling. Methods COOLAID Oresund is a bicentre randomized trial in Copenhagen (Denmark) and Malmo (Sweden). Patients were randomized to either TH (33 degrees C for 24h) in a general intensive care unit (ICU) or standardized stroke unit care (control). Cooling was induced by a surface or endovascular-based strategy. Results Thirty-one patients were randomized. Seven were cooled using endovascular and 10 using surface-based cooling methods and 14 patients received standard care (controls). 14 (45%) patients received thrombolysis. Pneumonia was recorded in 6 (35%) TH patients and in 1 (7%) control. 4 TH patients and 1 control developed massive infarction. 1 TH patient and 2 control suffered asymptomatic haemorrhagic transformation. Mortality was comparable with 2 (12%) in the TH group and 1 (7%) among controls. Mean (SD) duration of hospital stay was 25.0days (24, 9) in TH and 22.5days (20.6) in control patients (P=0.767). Mean (SD) induction period (cooling onset to target temperature) was 126.3min (80.6) with endovascular cooling and 196.3min (76.3) with surface cooling (P=0.025). Conclusions Therapeutic hypothermia with general anaesthesia is feasible in stroke patients. We noticed increased rates of pneumonia, while the length of hospital stay remained comparable. The endovascular cooling strategy provides a faster induction period than surface cooling.
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| 3. |
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| 4. |
- Broman, T, et al.
(författare)
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Molecular Detection of Persistent Francisella tularensis Subspecies holarctica in Natural Waters
- 2011
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Ingår i: International Journal of Microbiology. - : Hindawi Publishing Corporation. - 1687-918X .- 1687-9198. ; 2011, s. Article ID 851946-
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Tidskriftsartikel (refereegranskat)abstract
- Tularemia, caused by the bacterium Francisella tularensis, where F. tularensis subspecies holarctica has long been the cause of endemic disease in parts of northern Sweden. Despite this, our understanding of the natural life-cycle of the organism is still limited. During three years, we collected surface water samples (n = 341) and sediment samples (n = 245) in two areas in Sweden with endemic tularemia. Real-time PCR screening demonstrated the presence of F. tularenis lpnA sequences in 108 (32%) and 48 (20%) of the samples, respectively. The 16S rRNA sequences from those samples all grouped to the species F. tularensis. Analysis of the FtM19InDel region of lpnA-positive samples from selected sampling points confirmed the presence of F. tularensis subspecies holarctica-specific sequences. These sequences were detected in water sampled during both outbreak and nonoutbreak years. Our results indicate that diverse F. tularensis-like organisms, including F. tularensis subsp. holarctica, persist in natural waters and sediments in the investigated areas with endemic tularemia.
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| 5. |
- Cornell, David H., 1948, et al.
(författare)
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Evidence from Dwyka tillite cobbles of Archean basement beneath the Kalahari sands of southern Africa
- 2011
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Ingår i: Lithos. - 0024-4937. ; 125, s. 482-502
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Tidskriftsartikel (refereegranskat)abstract
- We have found a new source of information about what lies beneath the Kalahari sands. The Kheis and Rehoboth Provinces of southern Africa were thought to be underlain by either an ~1800 Ma orogenic belt, or a northern branch of the ~1200 Ma Namaqua–Natal Province. Glacial diamictites of the Permocarboniferous Dwyka Group exposed at Rietfontein west of the Kalahari sands carry cobbles plucked from the bedrock by the ice sheet which covered the Gondwana supercontinent about 300 Ma ago. Despite altered mineralogy, the cobbles are not severely altered geochemically. Their normative mineral compositions give classifications as trondhjemites and granites, supported by rare earth element diagrams. Microbeam U–Pb zircon dating of the granitic cobbles shows that they contain no evidence of crustal growth or orogeny at either 1800 or 1200 Ma. Rather they testify to the presence of 2500 to 2900 Ma Archaean trondhjemitic and granitic crust beneath the Kalahari, with a lesser ~2050 Ma granite component. The pebble assemblages from the diamictites we sampled lack the diagnostic banded iron formation (BIF), stromatolitic limestone and other supracrustal pebbles which characterise diamictites derived from the Kaapvaal Craton, thus we envisage shorter transport distances and derivation from the region now beneath the Kalahari sands. Three of the Archaean granite cobbles have unusual less-than-mantle zircon oxygen isotope values around +3 (δ18O VSMOW), which may reflect interaction of their source with high-temperature, originally meteoric water before melting to produce the granites. The mafic cobbles described in a companion paper are much younger and are related to intrusions of the 1.1 Ga Umkondo Large Igneous Province, probably located on the Kalahari Line or Rehoboth Province. Five trondhjemitic granites from the westernmost outcrops of the Kaapvaal Craton were dated, the oldest being 3061±9 Ma and four others between 2882±7 Ma and 2854±7 Ma, reflecting the cratonisation of the Kimberley Terrane. Four of the Archaean Dwyka cobbles we dated are younger than the 2.7 Ga Kaapvaal cover sequence and are thus too young to be derived from the craton. All the Dwyka cobbles described here are most likely derived from either the Rehoboth Province or the Kalahari Line with origins from the Kheis Province, Kaapvaal Craton, or further afield considered unlikely. We envisage the Rehoboth Province to consist of an Archaean core supplemented by Palaeoproterozoic granitoids, which was joined to the Kaapvaal Craton at an early stage of crustal development and played an important role during later tectonic events. This has important implications not only for the tectonic framework and assembly of Southern Africa, but also for exploration for diamonds and other ore deposits.
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| 6. |
- Goransson, H., et al.
(författare)
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The adoption of nickel-titanium rotary instrumentation increases root-filling quality amongst a group of Swedish general dental practitioners
- 2014
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 38:1, s. 15-22
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was testing the hypothesis that the adoption of nickel-titanium rotary instrumentation (NTRI) will improve the technical quality of root-fillings.The investigation was carried out within a mandatory continuing education program (CEP) for general dental practitioners (GDPs). The study was conducted amongst GDPs employed by the Public Dental Health Service in the County of Stockholm. Identical questionnaires were distributed before the CEP (Pre-Q) and 9 to 12 months after the course (Post-Q).The CEP consisted of two parts: lectures and hands-on training. From each GDP, radiographs of two cases completed before the course and two cases treated 9-12 months after the course were randomly selected. Primarily molars were selected for evaluation.The radiographs were individually evaluated by two endodontists.Teeth treated before and after training were presented in random order. Adoption rate of NTRI increased from 35% to 75%. Cases from 124 GDPs were included in the final analysis.The rate of good quality root-fillings increased from 27% to 49% (p<.001). A significantly increased radiographic quality was found between GDPs adopting NTRI and those who did not.The GDPs produced root-fillings of very poor quality before as well as after the training period. However, the rate decreased from 29% to 12% amongst adopters and from 46% to 28% amongst non-adopters. Dentists considering canal preparation and root-filling as "easy" produced more frequently good quality root-fillings than the others (p
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| 7. |
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| 8. |
- Jakobsson, H E, et al.
(författare)
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Short-term antibiotic treatment has differing long-term impacts on the human throat and gut microbiome
- 2010
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 5:3, s. e9836-
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Tidskriftsartikel (refereegranskat)abstract
- Antibiotic administration is the standard treatment for the bacterium Helicobacter pylori, the main causative agent of peptic ulcer disease and gastric cancer. However, the long-term consequences of this treatment on the human indigenous microbiota are relatively unexplored. Here we studied short- and long-term effects of clarithromycin and metronidazole treatment, a commonly used therapy regimen against H. pylori, on the indigenous microbiota in the throat and in the lower intestine. The bacterial compositions in samples collected over a four-year period were monitored by analyzing the 16S rRNA gene using 454-based pyrosequencing and terminal-restriction fragment length polymorphism (T-RFLP). While the microbial communities of untreated control subjects were relatively stable over time, dramatic shifts were observed one week after antibiotic treatment with reduced bacterial diversity in all treated subjects in both locations. While the microbiota of the different subjects responded uniquely to the antibiotic treatment some general trends could be observed; such as a dramatic decline in Actinobacteria in both throat and feces immediately after treatment. Although the diversity of the microbiota subsequently recovered to resemble the pre treatment states, the microbiota remained perturbed in some cases for up to four years post treatment. In addition, four years after treatment high levels of the macrolide resistance gene erm(B) were found, indicating that antibiotic resistance, once selected for, can persist for longer periods of time than previously recognized. This highlights the importance of a restrictive antibiotic usage in order to prevent subsequent treatment failure and potential spread of antibiotic resistance.
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| 9. |
- Johansson, Helena, 1981, et al.
(författare)
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High serum adiponectin predicts incident fractures in elderly men: Osteoporotic fractures in men (MrOS) Sweden
- 2012
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Ingår i: Journal of Bone and Mineral Research. - : Wiley. - 1523-4681 .- 0884-0431. ; 27:6, s. 1390-1396
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Tidskriftsartikel (refereegranskat)abstract
- Adipocytes and osteoblasts share a common progenitor, and there is, therefore, potential for both autocrine and endocrine effects of adiponectin on skeletal metabolism. The aim of the present study was to determine whether high serum adiponectin was associated with an increased risk of fracture in elderly men. We studied the relationship between serum adiponectin and the risk of fracture in 999 elderly men drawn from the general population and recruited to the Osteoporotic Fractures in Men (MrOS) study in Gothenburg, Sweden. Baseline data included general health questionnaires, lifestyle questionnaires, body mass index (BMI), bone mineral density (BMD), serum adiponectin, osteocalcin, and leptin. Men were followed for up to 7.4 years (average, 5.2 years). Poisson regression was used to investigate the relationship between serum adiponectin, other risk variables and the time-to-event hazard function of fracture. Median levels of serum adiponectin at baseline were 10.4 mu g/mL (interquartile range, 7.714.3). During follow-up, 150 men sustained one or more fractures. The risk of fracture increased in parallel with increasing serum adiponectin (hazard ratio [HR]/SD, 1.46; 95% confidence interval [CI], 1.231.72) and persisted after multivariate-adjusted analysis (HR/SD, 1.30; 95% CI, 1.091.55). Serum adiponectin shows graded stepwise association with a significant excess risk of fracture in elderly men that was independent of several other risk factors for fracture. Its measurement holds promise as a risk factor for fracture in men. (C) 2012 American Society for Bone and Mineral Research.
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| 10. |
- Jonsson, Joakim H, et al.
(författare)
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Internal fiducial markers and susceptibility effects in MRI : simulation and measurement of spatial accuracy
- 2012
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Ingår i: International Journal of Radiation Oncology, Biology, Physics. - : Elsevier BV. - 0360-3016 .- 1879-355X. ; 82:5, s. 1612-1618
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is well-known that magnetic resonance imaging (MRI) is preferable to computed tomography (CT) in radiotherapy target delineation. To benefit from this, there are two options available: transferring the MRI delineated target volume to the planning CT or performing the treatment planning directly on the MRI study. A precondition for excluding the CT study is the possibility to define internal structures visible on both the planning MRI and on the images used to position the patient at treatment. In prostate cancer radiotherapy, internal gold markers are commonly used, and they are visible on CT, MRI, x-ray, and portal images. The depiction of the markers in MRI are, however, dependent on their shape and orientation relative the main magnetic field because of susceptibility effects. In the present work, these effects are investigated and quantified using both simulations and phantom measurements.METHODS AND MATERIALS: Software that simulated the magnetic field distortions around user defined geometries of variable susceptibilities was constructed. These magnetic field perturbation maps were then reconstructed to images that were evaluated. The simulation software was validated through phantom measurements of four commercially available gold markers of different shapes and one in-house gold marker.RESULTS: Both simulations and phantom measurements revealed small position deviations of the imaged marker positions relative the actual marker positions (<1 mm).CONCLUSION: Cylindrical gold markers can be used as internal fiducial markers in MRI.
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| 11. |
- Jonsson, Joakim H, et al.
(författare)
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Registration accuracy for MR images of the prostate using a subvolume based registration protocol
- 2011
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Ingår i: Radiation Oncology. - 1748-717X. ; 6:1, s. 73-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In recent years, there has been a considerable research effort concerning the integration of magnetic resonance imaging (MRI) into the external radiotherapy workflow motivated by the superior soft tissue contrast as compared to computed tomography. Image registration is a necessary step in many applications, e.g. in patient positioning and therapy response assessment with repeated imaging. In this study, we investigate the dependence between the registration accuracy and the size of the registration volume for a subvolume based rigid registration protocol for MR images of the prostate.METHODS: Ten patients were imaged four times each over the course of radiotherapy treatment using a T2 weighted sequence. The images were registered to each other using a mean square distance metric and a step gradient optimizer for registration volumes of different sizes. The precision of the registrations was evaluated using the center of mass distance between the manually defined prostates in the registered images. The optimal size of the registration volume was determined by minimizing the standard deviation of these distances.RESULTS: We found that prostate position was most uncertain in the anterior-posterior (AP) direction using traditional full volume registration. The improvement in standard deviation of the mean center of mass distance between the prostate volumes using a registration volume optimized to the prostate was 3.9 mm (p < 0.001) in the AP direction. The optimum registration volume size was 0 mm margin added to the prostate gland as outlined in the first image series.CONCLUSIONS: Repeated MR imaging of the prostate for therapy set-up or therapy assessment will both require high precision tissue registration. With a subvolume based registration the prostate registration uncertainty can be reduced down to the order of 1 mm (1 SD) compared to several millimeters for registration based on the whole pelvis.
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| 12. |
- Ringnér, Anders, 1975-
(författare)
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Information till föräldrar som har barn med cancer
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund. Föräldrar till barn som har cancer upplever en livssituation som präglas av osäkerhet och oro och de ställs inför sociala och känslomässiga utmaningar. Jämfört med föräldrar till friska barn, upplever de också högre stress och drabbas i större utsträckning av posttraumatiska stressymptom. Trots att information om barnets sjukdom är ett centralt behov för föräldrarna, upplever de otillfredsställelse med den information som ges.Syfte. Syftet med denna avhandling var att inom barnonkologisk vård beskriva vårdares och föräldrars upplevelser av information, studera deras inbördes interaktion samt beskriva upplevelser och effekter av en intervention för personcentrerad information till föräldrar.Metod. I delstudie I–III användes fokusgruppintervjuer (I, II), individuella intervjuer (II, III) och deltagande observationer (III). Deltagarna bestod av 20 vårdare (I), 14 föräldrar till barn med cancer (II) respektive 25 vårdare och 25 föräldrar (III). Data analyserades med kvalitativ innehållsanalys (I, II) och diskurspsykologi (III). I delstudie IV testades en intervention för personcentrerad information på åtta föräldrar med hjälp av en experimentell single-case-design. Data samlades in med kvalitativa intervjuer och internetenkäter. Upplevd stress, kroppsliga symptom på stress, ångest, nedstämdhet och tillfredsställelse med information var utfallsmått.Resultat. I delstudie I bestod resultatet av två teman: anpassa mängden information till föräldrarnas behov, som handlade om skillnader i hur mycket information som gavs till föräldrarna utifrån vårdarnas bedömning av föräldrarnas behov, och navigera i en vag struktur, som handlade om brister i ansvar, miljö, tajming och språk när informationen lämnades.I delstudie II konstruerades två teman. Känna sig bekräftad som en viktig person handlade om att föräldrarna kände sig trygga, kunde hålla hoppet uppe och fick stöd från andra föräldrar. Temat var mer framträdande under behandlingens tidiga skeden. Det andra temat var känna sig som en objuden gäst vilket handlade om att kännas övergiven vid viktiga milstolpar, att tvingas tjata sig till information och att belastas av att själv behöva informera andra inom sjukvården.I delstudie III använde vårdarna tolkningsrepertoarer som var barn-, föräldra- eller familjeorienterade, vilket avspeglade deras primära fokus i interaktionen. Föräldrarna använde tolkningsrepertoarer som talesperson, observatör eller familjemedlem. Hur dessa kombinerades inbördes påverkade interaktionen.I delstudie IV erfor föräldrarna stor tillfredsställelse med den personcentrerade informationen och upplevde att de hade nytta av att på egen hand få diskutera barnets sjukdom och ställa frågor de annars inte skulle ställt. Interventionen visade ingen effekt på stress eller kroppsliga symptom på stress, ångest och nedstämdhet.Slutsatser. För att förbättra information till föräldrar som har barn med cancer är det en central uppgift att bedöma hur mycket och vilken information som ska ges vid varje tillfälle, att uppmärksamma att föräldrarna kan ha andra informationsbehov än barnet och att möten med föräldrarna ska ske i lugn och ro samt att organisera vården så att ansvaret är tydligt. I synnerhet bör det ske förbättringar kring det som föräldrarna upplever som viktiga milstolpar under barnets sjukdomstid. Interventionen för personcentrerad information uppskattades av föräldrar som har barn med cancer men effekten på föräldrarnas psykosociala välbefinnande behöver utforskas ytterligare.
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| 13. |
- Svanborg, Per, 1978, et al.
(författare)
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Marginal and internal fit of cobalt-chromium fixed dental prostheses generated from digital and conventional impressions
- 2014
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Ingår i: International Journal of Dentistry. - : Hindawi Limited. - 1687-8728 .- 1687-8736. ; 2014
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Digital impressions are increasingly used and have the potential to avoid the problem of inaccurate impressions. Only a few studies to verify the accuracy of digital impressions have been performed. The purpose of this study was to compare the marginal and internal fit of 3-unit tooth supported fixed dental prostheses (FDPs) fabricated from digital and conventional impressions. Methods. Ten FDPs were produced from digital impressions using the iTero system and 10 FDPs were produced using vinyl polysiloxane (VPS) impression material. A triple-scan protocol and CAD software were used for measuring and calculating discrepancies of the FDPs at 3 standard areas: mean internal discrepancy, absolute marginal gap, and cervical area discrepancy. The Mann-Whitney U test was used for analyzing the results. Results. For conventional and digital impressions, respectively, FDPs had an absolute marginal gap of 147 μm and 142 μm, cervical area discrepancy of 69 μm and 44 μm, and mean internal discrepancy of 117 μm and 93 μm. The differences were statistically significant in the cervical and internal areas (P < 0.001). Significance. The results indicated that the digital impression technique is more exact and can generate 3-unit FDPs with a significantly closer fit compared to the VPS technique. © 2014 Per Svanborg et al.
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