| 1. |
- Bucin, Dragan, et al.
(författare)
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Heart transplantation across the antibodies against HLA and ABO
- 2006
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Ingår i: Transplant International. - : Frontiers Media SA. - 1432-2277 .- 0934-0874. ; 19:3, s. 239-244
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Tidskriftsartikel (refereegranskat)abstract
- We have intentionally performed heart transplantation in a 5-year-old child, despite the most unfavourable risk factors for patient survival; the presence of high level of antibodies against donor's human leucocyte antigen (HLA) class I/II and blood group antigens. Pretransplant treatment by mycophenolate mofetil, prednisolone, tacrolimus, intravenous immunoglobulin, rituximab, protein-A immunoadsorption (IA) and plasma exchange reduced antibody titres against the donor's lymphocytes from 128 to 16 and against the donor's blood group antigen from 256 to 0. The patient was urgently transplanted with a heart from an ABO incompatible donor (A(1) to O). A standard triple-drug immunosuppressive protocol was used. No hyperacute rejection was seen. Antibodies against the donor's HLA antigens remained at a low level despite three acute rejections. Rising anti-A(1) blood group antibodies preceded the second rejection and were reduced by two blood group-specific IAs and remained at a low level. The patient is doing well despite the persistence of donor-reactive antibodies.
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| 2. |
- Lindberg, Magnus, et al.
(författare)
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Fluid Intake Appraisal Inventory : Development and psychometric evaluation of a situation-specific measure for haemodialysis patients' self-efficacy to low fluid intake
- 2007
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 63:2, s. 167-173
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Tidskriftsartikel (refereegranskat)abstract
- Self-efficacy is an important determinant of health behaviour and reflects a person's belief about their capability to complete a given task. The relationship between self-efficacy and fluid adherence has been investigated, although limited attention has been given to measurement issues. The purpose of this study was to develop a measure of situation-specific self-efficacy for constructive fluid intake behaviour in haemodialysis patients, the Fluid Intake Appraisal Inventory (FIAI). METHODS: Items were generated from an analysis of empirical studies available in the literature and exposed to an interpretability critique before haemodialysis patients confirmed sufficiency of each item. In a multi-centre study, data from 144 haemodialysis patients were collected regarding general self-efficacy, situation-specific self-efficacy, and estimated fluid consumption. Internal consistency, criterion-related validity, and structural validity were tested. RESULTS: The FIAI was found to have high internal consistency (Cronbach alpha 0.96) and the theoretical assumptions for criterion-related validity and known-group validity were supported. Structural validity was not confirmed, however, because the theoretically hypothesized four-factor model was not the prime structure. CONCLUSION: The FIAI was revealed to have satisfactory psychometric properties. The scale may be used in research or in clinical settings to study the mediating effects of self-efficacy or to modify haemodialysis patients' fluid-intake behaviour. Although this first validity study is promising, further validation focusing on reliability and cultural validity is needed.
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| 3. |
- Lindberg, Magnus, et al.
(författare)
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Interdialytic weight gain and ultrafiltration rate in hemodialysis : lessons about fluid adherence from a national registry of clinical practice
- 2009
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Ingår i: Hemodialysis International. - : Wiley. - 1492-7535 .- 1542-4758. ; 13:2, s. 181-188
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Tidskriftsartikel (refereegranskat)abstract
- Excessive interdialytic weight gain (IWG) and ultrafiltration rates (UFR) above 10 mL/h/kg body weight imply higher morbidity and mortality. This study aimed to estimate the prevalence of high fluid consumers, describe UFR patterns, and describe patient characteristics associated with IWG and UFR. The Swedish Dialysis DataBase and The Swedish Renal Registry of Active Treatment of Uremia were used as data sources. Data were analyzed from patients aged >/=18 on regular treatment with hemodialysis (HD) and registered during 2002 to 2006. Interdialytic weight gain and dialytic UFR were examined in annual cohorts and the records were based on 9693 HD sessions in 4498 patients. Differences in proportions were analyzed with the chi-square test and differences in means were tested using the ANOVA or the t test. About 30% of the patients had IWG that exceed 3.5% of dry body weight and 5% had IWG >/=5.7%. The volume removed during HD was >10 mL/h/kg for 15% to 23% of the patients, and this rate increased during the first dialytic year. Patient characteristics associated with fluid overload were younger age, lower body mass index, longer dialytic vintage, and high blood pressure. By studying IWG and dialytic UFR as quality indicators, it is shown that there is a potential for continuing improvement in the care of patients in HD settings, i.e., to enhanced adherence to fluid restriction or alternatively to extend the frequency of dialysis for all patients, e.g., by providing daily treatment.
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| 4. |
- Lindberg, Magnus, et al.
(författare)
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Medication discrepancy : A concordance problem between dialysis patients and caregivers
- 2007
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 41:6, s. 546-552
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Extensive drug utilization, and non-concordance between the patient and the caregiver about prescriptions and actual medicine intake, are associated with the risk of non-adherence to medication as well as medication-related illness. To achieve reliable estimates of drug use, it is important to consider the patient's self-reported drug utilization as well as to consult his/her medical record. The present multicentre study was conducted with the aim of examining the self-reported drug consumption of dialysis patients and its congruence with medical records. Material and methods. Consumption of pharmaceutical agents was recorded by 204 patients undergoing haemo- or peritoneal dialysis at 10 Swedish clinics. Drug record discrepancies were identified by comparing the self-reported use of prescribed medicines with the subsequently obtained medication lists. Results. The median drug intake was 11 prescribed medicines and by including on-demand drugs this increased to 12. Discrepancies between the self-reported use of prescribed drugs and the medical record were prevalent in 80.4% of cases, with a median of three discrepancies per patient. Conclusions. Dialysis patients have an extensive need for medication but there is an undesirable deviation between consumption and prescription. A single medication list, accessible for the patient and for all prescribers, is a possible solution to achieve concordance but other measures, such as analysis of the reasons for discrepancy and tailored measures, would also benefit concordant medicine-taking.
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| 5. |
- Angdal, Henrik, et al.
(författare)
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Trends in Service Sourcing Practices
- 2007
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Ingår i: Journal of Business Market Management. - : Springer Science and Business Media LLC. - 1864-0753 .- 1864-0761. ; 1:3, s. 187-207
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Björn, Catrine, 1961-, et al.
(författare)
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Theatre Nurses Understanding of their Work : A phenomenographic study at a hospital theatre
- 2008
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Ingår i: Journal of Advanced Perioperative Care. - Harrogate, UK : Associations for Perioperative Practice. - 1470-5664. ; 3:4, s. 149-155
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Tidskriftsartikel (refereegranskat)abstract
- The operating theatre is a place where people work together in a multidisciplinary team. It has a very high patient through-put, and use of advanced technology and surgical routine. Working in an operating theatre has been described as dynamic and challenging. The nurse’s perspective of her/his practice role in the operating theatre department is poorly identified, a fact that makes it necessary for the theatre nurses themselves to define their role as nurses in the multidisciplinary team.The aim of this study was to begin the work of describing the theatre nurses’ work using a qualitative descriptive design with a phenomenographic approach. A purposeful sample from two hospitals in Sweden was employed to select the 15 theatre nurses, the interviews formed the basis of this study.As in several other phenomenographic studies three specific questions guided the data collection: What aspect of your practice do you find the easiest? What aspect of your practice do you find the most challenging? What do you think is the most important aspect of your practice? To deepen the interview, what and how questions were used to probe the responses.The interviews were audio-taped and transcribed verbatim. The interviews were read several times, after which an analysis was undertaken.The analysis revealed the following three understandings of the phenomenon of “the work of the theatre nurse”: Theatre nurses achieve control of the situation referred to having the appropriate equipment prepared in advance for the operation, the hygienic aspect, for example keeping the operation area, surgical instruments and people involved sterile, and to control patient, instrument and implant logistics by advance planning and being one step ahead.The possibility of good teamwork is enhanced by being attentive to the spoken and unspoken wishes and needs of the patient as well as all members of the team, especially the surgeon; and Theatre nurses develop their professional practice through practical experience.All three understandings that emerged in present study are useful for both competence development and quality improvement.
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| 7. |
- Elfving, Maria, et al.
(författare)
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Maternal enterovirus infection during pregnancy as a risk factor in Offspring Diagnosed with Type 1 Diabetes between 15 and 30 years of age
- 2008
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Ingår i: Experimental Diabetes Research. - : Hindawi Limited. - 1687-5214 .- 1687-5303. ; , s. 271958-
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Tidskriftsartikel (refereegranskat)abstract
- Maternal enterovirus infections during pregnancy may increase the risk of offspring developing type 1 diabetes during childhood. The aim of this study was to investigate whether gestational enterovirus infections increase the offspring's risk of type 1 diabetes later in life. Serum samples from 30 mothers without diabetes whose offspring developed type 1 diabetes between 15 and 25 years of age were analyzed for enterovirus-specific immunoglobulin M (IgM) antibodies and enterovirus genome (RNA), and compared to a control group. Among the index mothers, 9/30 (30%) were enterovirus IgM-positive, and none was positive for enterovirus RNA. In the control group, 14/90 (16%) were enterovirus IgM-positive, and 4/90 (4%) were positive for enterovirus RNA (n.s.). Boys of enterovirus IgM-positive mothers had approximately 5 times greater risk of developing diabetes (OR 4.63; 95% CI 1.22-17.6), as compared to boys of IgM-negative mothers (P < .025). These results suggest that gestational enterovirus infections may be related to the risk of offspring developing type 1 diabetes in adolescence and young adulthood.
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| 8. |
- Fick, Jerker, et al.
(författare)
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Antiviral Oseltamivir is not removed or degraded in normal sewage water treatment : Implications for development of resistance by influenza A virus
- 2007
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 2:10, s. e986-
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Tidskriftsartikel (refereegranskat)abstract
- Oseltamivir is the main antiviral for treatment and prevention of pandemic influenza. The increase in oseltamivir resistance reported recently has therefore sparked a debate on how to use oseltamivir in non pandemic influenza and the risks associated with wide spread use during a pandemic. Several questions have been asked about the fate of oseltamivir in the sewage treatment plants and in the environment. We have assessed the fate of oseltamivir and discuss the implications of environmental residues of oseltamivir regarding the occurrence of resistance. A series of batch experiments that simulated normal sewage treatment with oseltamivir present was conducted and the UV-spectra of oseltamivir were recorded. Findings: Our experiments show that the active moiety of oseltamivir is not removed in normal sewage water treatments and is not degraded substantially by UV light radiation, and that the active substance is released in waste water leaving the plant. Our conclusion is that a ubiquitous use of oseltamivir may result in selection pressures in the environment that favor development of drug-resistance.
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| 9. |
- Fosså, Jan Helg, et al.
(författare)
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Mapping of Lophelia reefs in Norway: experiences and survey methods
- 2005
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Ingår i: In Freiwald A, Roberts JM (eds), Cold-water Corals and Ecosystems. Springer-Verlag, Berlin Heidelberg. ; , s. 337-370
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Tidskriftsartikel (refereegranskat)abstract
- The Institute of Marine Research commenced a program for mapping and assessment of Lophelia reefs in 1997. It was initiated by reports from fishermen claiming that bottom trawling damaged deep-water coral reefs. The strategy was to survey coral sites reported in the literature and by the fishermen. This has provided an extensive database of coral occurrences, both damaged and undamaged sites. A number of major coral reefs have been identified, which has provided a better understanding of the morphology of Lophelia reefs and where they are likely to occur. We are now able to identify potential coral areas by analysing seafloor topography on maps. Fast and reliable ground-truthing methods using simple and inexpensive systems have been developed. Mapping and quantification of corals demand more advanced instrumentation, such as singlebeam and multibeam echo sounders in combination with data processing software allowing coral reefs to be detected in real time. Systems providing real time presentation of multibeam data are especially useful in combination with Remotely Operated Vehicle (ROV) positioned with acoustic navigation systems. We suggest the following mapping procedure: 1) acoustical reef detection followed by multibeam mapping, preferably along with collection of seismic reflection data. 2) ground-truthing with a tethered video camera platform or an ROV. The position of the observation platform is plotted online and draped on the multibeam maps, either in 2D or 3D mode. Examples from the reefs on Sula, Røst, Træna and Fugløya are given.
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| 10. |
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| 11. |
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| 12. |
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| 13. |
- Jönsson, Björn, 1951-, et al.
(författare)
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A new probe for ankle systolic pressure measurement using Photoplethysmography (PPG)
- 2005
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Ingår i: Annals of Biomedical Engineering. - : Springer Science and Business Media LLC. - 0090-6964 .- 1573-9686. ; 33:2, s. 232-239
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Tidskriftsartikel (refereegranskat)abstract
- An automated method for ankle systolic pressure measurement, less operator dependent than the standard continuous wave (CW) Doppler technique, would imply an advantage both in patient measurements and in epidemiological studies. We present a new photoplethysmographic (PPG) probe that uses near-infrared light (880 nm) to detect pulsatory blood flow underneath the distal end of a standard pneumatic cuff. The probe is adapted to the anatomical conditions at the ankle, permitting recording of pressures in both ankle arteries separately. The validity of the equipment was tested with CW Doppler-derived systolic pressures and invasive blood pressure measurements for reference. In 20 healthy subjects, visual analysis of the PPG curves revealed a mean difference between CW Doppler and PPG measurements of –0.5 mmHg (SD 6.9). Corresponding results for the anterior and posterior tibial arteries separately were –1.8 mmHg (SD 6.2) and 0.9 mmHg (SD 7.3), respectively. A correct probe position was essential for the results. In direct recordings from the dorsalis pedis artery in 10 intensive care patients, PPG underestimated systolic pressure in the anterior tibial artery by 4.5 mmHg (SD 12.1). With further development, the PPG probe, integrated in the pneumatic cuff, may simplify measurements of ankle systolic pressures.
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| 14. |
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| 15. |
- Jönsson, Björn, 1951-, et al.
(författare)
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Automatic ankle pressure measurements using PPG in ankle-brachial pressure index determination
- 2005
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 30:4, s. 395-401
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo evaluate a new technique using a photoplethysmographic (PPG) probe for automatic ankle pressure measurements.DesignComparative study on two techniques for ankle pressure measurement.SettingUniversity hospital.MaterialThirty-five patients with leg arterial disease and eight healthy volunteers. Ankle-brachial indices (ABPI) were measured using conventional CW Doppler technique and PPG-based prototype equipment for the ankle pressure recordings.Chief outcome measuresABPIs calculated from CW Doppler and PPG ankle pressure measurements. The PPG signals were analysed both by visual judgement and by a software based, automatic algorithm.Main resultsThe mean difference between ABPIs calculated from CW Doppler recordings and PPG (visual analysis) was −0.01 (limits of agreement (±two standard deviations) +0.16 to −0.19). The correlation coefficient was 0.93. When the algorithm was used, the mean difference (CW Doppler−PPG) was 0.05 (limits of agreement 0.28 to −0.18, r=0.89).ConclusionsThe PPG method is a promising technique with an inherent potential for automatisation of the ankle pressure measurements, thereby reducing the observer-dependency in ABPI recordings.
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| 16. |
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| 17. |
- Kindblom, Jenny, 1971, et al.
(författare)
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Increased adipogenesis in bone marrow but decreased bone mineral density in mice devoid of thyroid hormone receptors.
- 2005
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Ingår i: Bone. - : Elsevier BV. - 8756-3282. ; 36:4, s. 607-16
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Tidskriftsartikel (refereegranskat)abstract
- Mice deficient for all known thyroid hormone receptors, TRalpha1-/-beta-/- mice, display a clear skeletal phenotype characterized by growth retardation, delayed maturation of long bones and decreased trabecular and total bone mineral density (BMD; -14.6 +/- 2.8%, -14.4 +/- 1.5%). The aim of the present study was to investigate the molecular mechanisms behind the skeletal phenotype in TRalpha1-/-beta-/- mice. Global gene expression analysis was performed on total vertebrae from wild-type (WT) and TRalpha1-/-beta-/- mice using DNA microarray and the results were verified by real-time PCR. The mRNA levels of six genes (AdipoQ, Adipsin, Fat-Specific Protein 27 (FSP 27), lipoprotein lipase (LPL), retinol-binding protein (RBP) and phosphoenolpyruvate carboxykinase (PEPCK)) expressed by mature adipocytes were increased in TRalpha1-/-beta-/- compared with WT mice. An increased amount of fat (225% over WT) due to an increased number but unchanged mean size of adipocytes in the bone marrow of TRalpha1-/-beta-/- mice was revealed. Interestingly, the mRNA levels of the key regulator of osteoclastogenesis, receptor activator of NF-varkappab ligand (RANKL), were dramatically decreased in TRalpha1-/-beta-/- mice. In conclusion, TRalpha1-/-beta-/- mice demonstrated increased expression of adipocyte specific genes and an increased amount of bone marrow fat. Thus, these mice have increased adipogenesis in bone marrow associated with decreased trabecular bone mineral density (BMD). One may speculate that these effects either could be caused by an imbalance in the differentiation of the osteoblast and the adipocyte lineages at the expense of osteoblastogenesis, or by independent effects on the regulation of both osteoblastogenesis and adipogenesis.
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| 18. |
- Koenig, Thomas, et al.
(författare)
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Bicameral conflict resolution in the European Union : An empirical analysis of conciliation committee bargains
- 2007
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Ingår i: British Journal of Political Science. - 0007-1234 .- 1469-2112. ; 37:2, s. 281-312
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Tidskriftsartikel (refereegranskat)abstract
- This article is a study of bicameral conflict resolution between the Council and the European Parliament in the European Union, which has established a bicameral conciliation process under the co-decision procedure. Scholars commonly agree that the European Parliament has gained power under the co-decision procedure, but the impact of the conciliation process on the power distribution between the Council and the European Parliament remains unclear. The scholarly debate suggests that the power of the institutional actors depends on their proximity to the status quo, the (im-)patience and the specific preference distribution of the institutional actors, although most analyses assume that the Commission plays an insignificant role. Using an ordered probit model, this study examines the power distribution between the two institutional actors, the factors for their bargaining success and the role of the Commission in the period between 1999 and 2002. The findings show that the European Parliament wins most conflicts, but that the Council is more successful in multi-dimensional disputes. The results confirm some theoretical claims made in the literature, such as the importance of the status quo location and of preference cohesiveness. However, they also reject a major assumption in the literature on the irrelevance of the Commission in the conciliation process, which we show to have an influential informational position for parliamentary success.
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| 19. |
- Laurent, Claes, 1958-, et al.
(författare)
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Non-invasive measurement of systolic blood pressure on the arm utilising photoplethysmography : development of the methodology
- 2005
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Ingår i: Medical and Biological Engineering and Computing. - 0140-0118 .- 1741-0444. ; 43:1, s. 131-135
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Tidskriftsartikel (refereegranskat)abstract
- Photoplethysmography (PPG) can be used to measure systolic blood pressure at the brachial artery. With a specially designed probe, positioned in the most distal position beneath a pressure cuff on the upper arm, this is possible. The distance between the light source (880 nm) and the photodetector was 20 mm. A test was performed on neuro-intensive care patients by determining blood pressure from the PPG curves, and, when it was compared with systolic blood pressure obtained from inserted indwelling arterial catheters, a correlation factor of r=0.95 was achieved. The difference between blood pressure obtained using PPG and invasive blood pressure measurement was 3.9±9.1 mmHg (mean±SD), n=19. The depth to the brachial artery was 13.9±4.1 mm (mean±SD), n=18. A digital PPG system utilising pulsating light was also developed.
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| 20. |
- Lindberg, Björn
(författare)
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Are political parties controlling legislative decision-making in the European Parliament? : The case of the services directive
- 2008
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Ingår i: Journal of European Public Policy. - : Informa UK Limited. - 1350-1763 .- 1466-4429. ; 15:8, s. 1184-1204
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Tidskriftsartikel (refereegranskat)abstract
- This case study analyses the efforts of the transnational party groups in controlling the legislative decision-making process inside the European Parliament. The case study focuses on one of the most important and contested pieces of European legislation: the services directive. The study addresses the choice of the rapporteurship for the legislative proposal through comparing the trade-offs between policy preferences, party loyalty and expertise in the nomination process. Further, the study analyses the party group internal conflict patterns, which emerged in the first reading of the proposal. The results show that party group voting loyalty and preference proximity to the party might have been a decisive factor in the nomination of the rapporteur for the services directive. The two largest party groups were also able to secure a compromise solution, which determined the final outcome of the intra-institutional decision-making process.
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| 21. |
- Lindberg, Björn, 1975-
(författare)
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Fit for European Democracy? : Party Discipline in the European Parliament
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study evaluates the fitness of political parties for the democratisation of the European Union. At the national level political parties have successfully functioned as transmission belts between voter’s preferences and political outcomes in representative democracies. Some scholars have therefore argued that an increase in party competition at the European level could make the European Union more democratic; other scholars claim that European political parties are too weak to fend off public pressure, which would arise from an increase in political competition. Since cohesive voting behaviour of political parties is the basic prerequisite for a functioning representative democracy, this study analyses how the transnational party groups of the European Parliament are able to generate voting cohesion. Drawing on rational institutionalist theories of political parties and theories of collective action, the study outlines two competitive scenarios for explaining party group voting cohesion in the European Parliament. In the party group disciplinary scenario, the party group leadership is able to enforce voting cohesion through its disciplinary powers. The national party discipline scenario predicts that party group voting cohesion is dependent on the voluntary cooperation of the national party delegations. The empirical analysis of party disciplinary effects in the European Parliament corroborates the party group disciplinary scenario. The party group leadership of the two largest party groups is able to discipline it is members for disloyal voting behaviour. The findings do, however, also show that the party group leadership is not able to sanction national party delegations if they fail to toe the party group line. The study concludes that it will be difficult for the party groups to maintain voting cohesion, if public pressure on Members of the European Parliament increases through a more open form of political contestation at the European level. The responsibility for a successful democratisation of the European Union through party competition, therefore, lies in the hands of national political parties.
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| 22. |
- Lindberg, Björn, et al.
(författare)
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Party politics as usual? : The role of political parties in EU legislative decision-making
- 2008
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Ingår i: Journal of European Public Policy. - : Informa UK Limited. - 1350-1763 .- 1466-4429. ; 15:8, s. 1107-1126
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Tidskriftsartikel (refereegranskat)abstract
- Scholars have raised doubts about the ability of political parties to fulfil their traditional role as 'transmission belts' between citizens and legislators in the EU. We discuss how the different institutional environment of the EU affects the assumptions and predictions of theories of political parties developed for the national context and discuss how political parties can influence EU legislative decision-making. We distinguish between partisan effects in the electoral and legislative arena, and argue for a clear distinction between the effects of national parties, national party delegations and transnational party groups when studying EU party politics. The empirical literature shows that, whereas parties play a role in most institutions, they are not always the dominant players, and their effect varies both across and within these institutions.
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| 23. |
- Lindberg, Fredrik, 1974, et al.
(författare)
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SOLWEIG 1.0 – Modelling spatial variations of 3D radiant fluxes and mean radiant temperature in complex urban settings
- 2008
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Ingår i: International Journal of Biometeorology. ; 52, s. 697-713
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Tidskriftsartikel (refereegranskat)abstract
- The mean radiant temperature, Tmrt, which sums up all shortwave and longwave radiation fluxes (both direct and reflected) to which the human body is exposed is one of the key meteorological parameters governing human energy balance and the thermal comfort of man. In this paper, a new radiation model (SOLWEIG 1.0), which simulates spatial variations of 3D radiation fluxes and Tmrt in complex urban settings, is presented. The Tmrt is derived by modelling shortwave and longwave radiation fluxes in six directions (upward, downward and from the four cardinal points) and angular factors. The model requires a limited number of inputs, such as direct, diffuse and global shortwave radiation, air temperature, relative humidity, urban geometry and geographical information (latitude, longitude and elevation). The model was evaluated using 7 days of integral radiation measurements at two sites with different building geometries – a large square and a small courtyard in Göteborg, Sweden (57°N) – across different seasons and in various weather conditions. The evaluation reveals good agreement between modelled and measured values of Tmrt, with an overall good correspondence of R 2=0.94, (p<0.01, RMSE=4.8 K). SOLWEIG 1.0 is still under development. Future work will incorporate a vegetation scheme, as well as an improvement of the estimation of fluxes from the four cardinal points.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Ludovica Saccà, Maria, et al.
(författare)
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Environmental fate of the antiviral drug Tamiflu in two aquatic ecosystems
- 2009
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Ingår i: Chemosphere. - : Elsevier Ltd. - 0045-6535 .- 1879-1298. ; 75:1, s. 28-33
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Tidskriftsartikel (refereegranskat)abstract
- The antiviral drug Tamiflu (Oseltamivir Phosphate, OP), has been indicated by the World Health Organization as a first-line defense in case of an avian influenza pandemic. Recent studies have demonstrated that Oseltamivir Carboxylate (OC), the active metabolite of the prodrug OP, has the potential to be released into water bodies. The present laboratory study focused on basic processes governing the environmental fate of OC in surface water from two contrasting aquatic ecosystems of northern Italy, the River Po and the Venice lagoon.Results of this study confirmed the potential of OC to persist in surface water. However, addition of 5% of sediments resulted in rapid OC degradation. Estimated half-life of OC in water/sediment of the River Po was 15 days. After three weeks of incubation at 20 °C, more than 8% of 14C-OC evolved as 14CO2 from water/sediment samples of the River Po and Venice lagoon. At the end of the 21-day incubation period, more than 65% of the 14C-residues were recovered from the liquid phase of both Po and Venice water/sediment samples. OC was moderately retained onto coarse sediments from the two sites. In water/sediment samples of the River Po and Venice lagoon treated with 14C-OC, more than 30% of the 14C-residues remained water-extractable after three weeks of incubation. The low affinity of OC to sediments suggests that presence of sediments would not reduce its bioavailability to microbial degradation.
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| 28. |
- Löfström, Björn, et al.
(författare)
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Myeloid leukaemia in systemic lupus erythematosus--a nested case-control study based on Swedish registers
- 2009
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Ingår i: Rheumatology. - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 48:10, s. 1222-1226
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the risk factors for leukaemic transformation and myeloid leukaemia in patients with SLE. METHODS: A national SLE cohort identified through SLE discharge diagnoses in the Swedish hospital discharge register during 1964 to 1995 (n = 6438) was linked to the national cancer register. A nested case-control study in SLE patients who developed acute or chronic myeloid leukaemia was performed with SLE patients without malignancy as controls. Medical records from cases and controls were reviewed and bone marrow specimens were re-evaluated. A Medline search of previously published cases of SLE and myeloid leukaemia was performed. RESULTS: After confirmation of SLE diagnosis according to the ACR criteria, eight patients with SLE and myeloid leukaemia and 18 SLE controls were included in the study. Preceding leucopenia was significantly associated with leukaemia development, whereas other SLE manifestations were not. Two cases had a preceding bone marrow confirming myelodysplastic syndrome (MDS). Only two cases were significantly treated with cyclophosphamide or AZA. A Medline search resulted in only 15 previously published cases of coincident SLE and myeloid leukaemia. Preceding MDS was reported in five of these, whereas only eight had been treated with cytotoxic drugs. CONCLUSION: Low-dose chemotherapy was not a major cause of myeloid malignancy in our population-based cohort of SLE patients nor in the reported cases from literature. Leucopenia was a risk factor for myeloid leukaemia development and an MDS was frequently seen. Therefore bone marrow investigation should be considered in SLE patients with long-standing leucopenia and anaemia.
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| 29. |
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| 30. |
- Sandberg, Margareta, et al.
(författare)
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Different patterns of blood flow response in the trapezius muscle following needle stimulation (acupuncture) between healthy subjects and patients with fibromyalgia and work-related trapezius myalgia
- 2005
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801. ; 9:5, s. 497-510
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Tidskriftsartikel (refereegranskat)abstract
- Needle stimulation (acupuncture) has recently been shown to increase blood flow in the tibialis anterior muscle and overlying skin in healthy subjects (HS) and patients with fibromyalgia (FM). The aim of the present study was to examine the effect of needle stimulation on local blood flow in the trapezius muscle and overlying skin in HS and two groups of patients suffering from chronic pain in the trapezius muscle, i.e., FM and work-related trapezius myalgia (TM) patients. Two modes of needling, deep muscle stimulation (Deep) and subcutaneous needle insertion (SC), were performed at the upper part of the shoulder and blood flow was monitored for 60 min post-stimulation. Blood flow changes were measured non-invasively by using a new application of photoplethysmography. Increased blood flow in the trapezius muscle and overlying skin was found in all three groups following both Deep and SC. In HS, Deep was superior to SC in increasing skin and muscle blood flow, whereas in FM, SC was as effective as, or even more effective, than Deep. In the severely affected TM patients, no differences were found between the stimuli, and generally, a lesser blood flow response to the stimuli was found. At Deep, the muscle blood flow increase was significantly larger in HS, compared to the two patient groups. Positive correlations were found between muscle blood flow at Deep and pressure pain threshold in the trapezius muscle, neck movement and pain experienced at the stimulation, and negative correlations were found with spontaneous pain-related variables, symptom duration and age, pointing to less favorable results with worsening of symptoms, and to the importance of nociceptor activation in blood flow increase. It was hypothesized that the different patterns of muscle blood flow response to the needling may mirror a state of increased sympathetic activity and a generalized hypersensitivity in the patients. The intensity of stimulation should be taken into consideration when applying local needle stimulation (acupuncture) in order to increase the trapezius muscle blood flow in chronic pain conditions. (c) 2004 European Federation of Chapters of the International Association for the Study of Pain.
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| 31. |
- Sandberg, Margareta, et al.
(författare)
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Non-invasive monitoring of muscle blood perfusion by photoplethysmography: evaluation of a new application
- 2005
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Ingår i: Acta Physiol Scand. - 0001-6772 .- 1365-201X. ; 183:4, s. 335-43
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate a specially developed photoplethysmographic (PPG) technique, using green and near-infrared light sources, for simultaneous non-invasive monitoring of skin and muscle perfusion. METHODS: Evaluation was based on assessments of changes in blood perfusion to various provocations, such as post-exercise hyperaemia and hyperaemia following the application of liniment. The deep penetrating feature of PPG was investigated by measurement of optical radiation inside the muscle. Simultaneous measurements using ultrasound Doppler and the new PPG application were performed to elucidate differences between the two methods. Specific problems related to the influence of skin temperature on blood flow were highlightened, as well. RESULTS: Following static and dynamic contractions an immediate increase in muscle perfusion was shown, without increase in skin perfusion. Liniment application to the skin induced a rapid increase in skin perfusion, but not in muscle. Both similarities and differences in blood flow measured by Ultrasound Doppler and PPG were demonstrated. The radiant power measured inside the muscle, by use of an optical fibre, showed that the near-infrared light penetrates down to the vascular depth inside the muscle. CONCLUSIONS: The results of this study indicate the potentiality of the method for non-invasive measurement of local muscle perfusion, although some considerations still have to be accounted for, such as influence of temperature on blood perfusion.
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| 32. |
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| 33. |
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| 34. |
- Söderström, Hanna, et al.
(författare)
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Detection of the antiviral drug oseltamivir in aquatic environments
- 2009
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 4:6, s. e6064-
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Tidskriftsartikel (refereegranskat)abstract
- Oseltamivir (Tamiflu) is the most important antiviral drug available and a cornerstone in the defence against a future influenza pandemic. Recent publications have shown that the active metabolite, oseltamivir carboxylate (OC), is not degraded in sewage treatment plants and is also persistent in aquatic environments. This implies that OC will be present in aquatic environments in areas where oseltamivir is prescribed to patients for therapeutic use. The country where oseltamivir is used most is Japan, where it is used to treat seasonal flu. We measured the levels of OC in water samples from the Yodo River system in the Kyoto and Osaka prefectures, Japan, taken before and during the flu-season 2007/8. No OC was detected before the flu-season but 2-58 ng L(-1) was detected in the samples taken during the flu season. This study shows, for the first time, that low levels of oseltamivir can be found in the aquatic environment. Therefore the natural reservoir of influenza virus, dabbling ducks, is exposed to oseltamivir, which could promote the evolution of viral resistance.
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| 35. |
- Thorsson, Sofia, 1972, et al.
(författare)
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Different methods for estimating the mean radiant temperature in an outdoor setting
- 2007
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Ingår i: International Journal of Climatology. - : Wiley. - 0899-8418 .- 1097-0088. ; 27:14, s. 1983-1993
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Tidskriftsartikel (refereegranskat)abstract
- The mean radiant temperature (Tmrt) is one of the most important meteorological parameters governing human energy balance. In this paper, three different methods of obtaining the Tmrt in an outdoor urban setting are compared. Method A is based on integral radiation measurements and angular factors, method B is based on measurements with a 38-mm flat grey globe thermometer and in method C makes use of the Rayman 1.2 software is used. Measurements were performed in a large open square in a high latitude city - Göteborg, Sweden - during clear to overcast weather conditions in October 2005 and in July and August 2006. Results show that the difference between Method A and Method B was generally relatively small. Most of the discrepancy, caused by rapid changes in radiation, temperature and wind speed was smoothed out using 5 min mean values. By systematically and empirically changing the mean convection coefficient, the accuracy of Method B was improved and a new equation expressing the Tmrt was obtained. With this new equation the 38 mm flat grey globe thermometer could successfully be used to estimate the Tmrt in an outdoor urban setting provided that the wind speed and the air and globe temperatures are measured accurately. The study also shows that the flat grey colour of the globe thermometer slightly underestimates the level of short-wave radiation (i.e. sunshine). Method C works very well during the middle of the day in July, i.e. at high sun elevations. However, the model considerably underestimates the Tmrt in the morning and evening in July and during the whole day in October, i.e. at low sun elevations. In outdoor urban settings where thermal comfort researchers or urban planners and designers require an easy and reliable method of estimating mean radiant temperature, the 38 mm flat grey globe thermometer provides a good and cheap solution.
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| 36. |
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| 37. |
- Tolf, Conny, et al.
(författare)
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Molecular characterization of a novel Ljungan virus (Parechovirus; Picornaviridae) reveals a fourth genotype and indications of ancestral recombination
- 2009
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Ingår i: Journal of General Virology. - : Microbiology Society. - 0022-1317 .- 1465-2099. ; 90, s. 843-853
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Tidskriftsartikel (refereegranskat)abstract
- Ljungan virus (LV) was discovered 20 years ago in Swedish bank voles (Myodes glareolus, previously referred to as Clethrionomys glareolus) during the search for an infectious agent causing lethal myocarditis in young athletes. To date, the genomes of four LV isolates, including the prototype 87-012 strain, have been characterized. Three of these LV strains were isolated from bank voles trapped in Sweden. Sequence analysis of an American virus (M1146), isolated from a montane vole (Microtus montanus) in western USA, indicates that this strain represents a genotype that is different from the Swedish strains. Here, we present genomic analyses of a fifth LV strain (64-7855) isolated from a southern red-backed vole (Myodes gapperi) trapped during arbovirus studies in New York state in the north-eastern USA in the 1960s. Sequence analysis of the 64-7855 genome showed an LV-like genome organization and sequence similarity to other LV strains. Genetic and phylogenetic analyses of the evolutionary relationship between the 64-7855 strain and other viruses within the family Picornaviridae, including previously published LV strains, demonstrated that the 64-7855 strain constitutes a new genotype within the LV species. Analyses also showed that different regions of the 64-7855 genome have different phylogenetic relationships with other LV strains, indicating that previous recombination events have been involved in the evolution of this virus.
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| 38. |
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| 39. |
- Åsenlöf, Pernilla, 1967-
(författare)
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Individually Tailored Treatment in the Management of Musculoskeletal Pain : Development and Evaluation of a Behavioural Medicine Intervention in Primary Health Care
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis deals with clinical pain intervention research from a behavioural medicine perspective. The general aim was to develop and evaluate an individually tailored treatment protocol focused on pain management in everyday life in people who experience persistent musculoskeletal pain. Another aim was to develop and incorporate an idiographic outcome measure for behavioural goal assessment in the formal evaluation of the clinical significance of treatment outcomes. The studies were conducted in a primary health care setting demonstrating a contribution from physical therapists in the field of behavioural medicine. Two separate samples of patients with musculoskeletal pain with a duration exceeding one month, n = 197 (Study I, descriptive and correlational design), and n = 97/82 (Study III/IV, randomized group-study) were included. In addition, four women were recruited for a series of experimental single-case studies (Study II).The treatment protocol that was individually tailored to each participant’s behavioural treatment goals and assumed determinants of pain-related disability was more effective in reducing pain-related disability, pain intensity, fear-avoidance, and in increasing pain control when compared to an intervention including physical exercises. The individually tailored treatment was generally more beneficial for resumption of everyday life activity, increasing satisfaction, fulfilling pre-treatment expectations, and in preparing individuals for self-management of pain. The Patient Goal Priority Questionnaire that was elaborated over the course of the project can be used to a) identify and assess behavioural treatment goals, b) elaborate individual functional behavioural analyses relevant for everyday life functioning, and c) determine the clinical significance of treatment outcomes – that is, whether interventions produce outcomes of relevance for each individual’s everyday life. The inclusion of idiographic outcome measures in clinical pain intervention research is necessary and improves the ecological validity of the evaluation of clinical significance.
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