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| 8. |
- Andersson, Agneta, et al.
(författare)
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Domiciliary liquid oxygen versus concentrator treatment in chronic hypoxaemia: a cost-utility analysis
- 1998
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Ingår i: European Respiratory Journal. - 1399-3003. ; 12:6, s. 1284-1289
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Tidskriftsartikel (refereegranskat)abstract
- Whether long-term oxygen therapy (LTOT) improves quality of life in chronic hypoxaemia has been questioned. LTOT with an oxygen concentrator (C/C) and gas cylinders for ambulation is considered cumbersome compared to mobile liquid oxygen equipment (L). The hypothesis for this study was that LTOT with liquid oxygen treatment (L) improves patients' health-related quality of life, but that it is also more expensive compared to concentrator (C/C) treatment. A prospective, randomized multicentre trial comparing C/C with L for LTOT was conducted during a six-month period. Fifty-one patients (29 on L and 22 on C/C) with chronic hypoxaemia, regularly active outside the home, participated in the study initially. Costs for oxygen were obtained from the pharmacies. Patient diaries and telephone contacts with members of the healthcare sector were used to estimate costs. Health-related quality of life was measured by the Sickness Impact Profile (SIP) and the EuroQol, instruments at the start and after 6 months. The average total cost per patient for group C/C for the six-month period was US$1,310, and for group L it was US$4,950. Health-related quality of life measured by the SIP instrument showed significant differences in favour of group L in the categories/dimensions of physical function, body care, ambulation, social interaction and total SIP score. In conclusion, liquid-oxygen treatment was more expensive compared to concentrator treatment. However, treatment effects showed that liquid oxygen had a better impact on quality of life.
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- Grängsjö, A., et al.
(författare)
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Different pathways in irritant contact eczema? Early differences in the epidermal elemental content and expression of cytokines after application of 2 different irritants
- 1996
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Ingår i: Contact Dermatitis. - 0105-1873 .- 1600-0536. ; 35:6, s. 355-360
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Tidskriftsartikel (refereegranskat)abstract
- The epidermal response to 2 different irritants, nonanoic acid (NAA) and sodium lauryl sulfate (SLS), was investigated with 2 different methods. NAA 80% and SLS 4% were applied under occlusion for up to 24 h. Elemental changes were determined in cryosections by x-ray microanalysis. Compared to unexposed skin a significantly higher sodium/potassium ratio was found after 6 h in NAA-exposed skin and a lower ratio in SLS-exposed. At 24 h both substances had induced similar changes, compatible with a cell injury. The findings demonstrate a time-dependent NAA and SLS response. With reverse transcription polymerase chain reaction, the mRNA expression of interleukin-1 alpha (IL-1 alpha), -1 beta (IL-1 beta), -6 (IL-6), and -8 (IL-8), tumor necrosis factor alpha (TNF alpha) and granulocyte macrophage colony stimulating factor (GM-CSF) in shave biopsies from irritated and unexposed skin was studied at 0. 4. 8 and 24 h. NAA, but not SLS, induced an increase in mRNA expression for IL-6 mRNA-expression for GM-CSF was increased after SLS exposure, but not after NAA. These findings indicate a time and substance dependent difference in the up-regulation of mRNA for different cytokines in epidermis during the first 24 h of the irritant reaction. This might be the effect of differences in the irritants action on the cell membranes, which is also reflected by the differences found in the elemental content at 6 h.
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| 24. |
- Lundberg, Lena, et al.
(författare)
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Quality of life, health-state utilities and willingness to pay in patients with psoriasis and atopic eczema
- 1999
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Ingår i: British Journal of Dermatology. - : Blackwell Science Ltd. - 1365-2133 .- 0007-0963. ; 141:6, s. 1067-1075
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Tidskriftsartikel (refereegranskat)abstract
- Skin diseases have been shown to have a significant adverse impact on the health-related quality of life of patients that may be underestimated by objective assessments of clinical severity. The main aim of this study was to measure the health-state utilities on a scale between 0 (dead) and 1 (full health) of patients with psoriasis and atopic eczema, and to measure the willingness to pay for a cure for psoriasis and atopic eczema. A second aim was to analyse how these measures are related to different dimensions of health-related quality of life, as measured by general and disease-specific quality of life instruments and a subjective measure of disability activity. This study was based on data from a questionnaire administered to, and interviews conducted with, 366 patients with psoriasis and atopic eczema aged 17-73 years, attending the dermatology outpatient clinic in Uppsala, Sweden from November 1996 to December 1997. The survey included: a rating scale question, a time trade-off question, a standard gamble question, a dichotomous choice willingness to pay question, a bidding-game willingness to pay question, a generic quality of life instrument (SF-36), a disease-specific quality of life instrument (the Dermatology Life Quality Index) and a subjective measure of disease activity (on a visual analogue scale). The mean health-state utility was 0.69 (rating scale), 0.88 (time trade-off) and 0.97 (standard gamble) for patients with psoriasis. The corresponding health-state utilities for patients with atopic eczema were 0.73, 0.93 and 0.98. On average, patients were willing to pay between 1253 and 1956 Swedish crowns (SEK) per month for a psoriasis cure and between SEK 960 and 1083 per month for an atopic eczema cure ($1 = SEK 8.25 and £1 = SEK 13.23). The health-state utilities were related to SF-36, the Dermatology Life Quality Index and disease activity in the expected direction and the correlations were strongest for rating scale and weakest for standard gamble. The willingness to pay was correlated with the Dermatology Life Quality Index and disease activity, but not with SF-36. The study indicates that it is feasible to measure health-state utilities and willingness to pay in this patient population, and the sizeable willingness to pay suggests that skin diseases are associated with substantial reductions in quality of life.
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- Andersen, Tonny, et al.
(författare)
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[New documentation routines in psychiatry in Västerbotten : unified structure for better quality of care].
- 1999
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 96:17, s. 2102-6
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Tidskriftsartikel (refereegranskat)abstract
- During recent decades psychiatric health care has become increasingly complex due to substantial clinical improvements and to the growing need of integrating psychiatric services with other health and welfare services in the community. The traditional psychiatric record format is incompatible both with these requirements and with the practical advantages and difficulties of modern computer technology. In a collaborative effort involving most professional categories at three psychiatric units in the county of Västerbotten in northern Sweden, a new structured format for medical records was developed. The basic feature is a structured summary of background factors, social situation, drug habits, and general health, which is reviewed and updated as necessary. The psychiatric condition is described in some detail, including onset and course, symptomatology, personality factors, diagnosis, treatment results, suicidality, etc. Day to day treatment is outlined in in- and out-patient treatment plans, which are evaluated and revised at regular intervals. The new record format, which is used by all categories of health care professionals, is intended to promote goal-directed treatment and professional collaboration, and is easily adapted to computer technology.
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| 30. |
- Beland, Marie-Claude, et al.
(författare)
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Optical measurement and perception of gloss quality of printed matte-coated paper
- 1998
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Ingår i: Proceedings of the International Printing and Graphic Arts Conference. - : CPPA, Montreal, Canada. ; , s. 187-191
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Konferensbidrag (refereegranskat)abstract
- A set of 32 commercially produced and printed matte-coated papers were rated for gloss quality by a panel of 13 expert judges and light scattering distributions, gloss, and gloss variation measured. Fitting the light scattering distributions to Von Mises distributions, we obtain a factor, kappa, related to the width of the distribution and sensitive to small changes in surface roughness, which relates very well with the subjective rating. Gloss variation in certain surface spatial wavelength bands also correlates well with the gloss quality rating. The topography of the samples was also measured using confocal microscopy and the relationship between light scattering and paper topography is discussed.
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| 31. |
- Bergh, C, et al.
(författare)
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A new treatment of anorexia nervosa
- 1996
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Ingår i: Lancet (London, England). - 0140-6736. ; 348:9027, s. 611-612
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- BOHLIN, Gunilla, et al.
(författare)
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EARLY FEEDING PROBLEMS - IDENTIFICATION BY PARENTS AND HEALTH-CARE PERSONNEL
- 1995
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Ingår i: SCANDINAVIAN JOURNAL OF SOCIAL WELFARE. - : MUNKSGAARD INT PUBL LTD. - 0907-2055. ; 4:4, s. 238-245
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the discrepancy between parental reports indicating a high prevalence of feeding problems during infancy and the relatively low identification rate of such cases at child health care centers. Thirty nurses were interviewed about d
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| 39. |
- Carlsson, Annelie, et al.
(författare)
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Prevalence of IgA-antiendomysium and IgA-antigliadin autoantibodies at diagnosis of insulin-dependent diabetes mellitus in Swedish children and adolescents
- 1999
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 103:6 I, s. 1248-1252
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Tidskriftsartikel (refereegranskat)abstract
- Objective. This study was conducted to investigate the prevalence of celiac disease (CD) in children and adolescents at diagnosis of insulin- dependent diabetes mellitus (IDDM) before insulin treatment was started. Material and Methods. At diagnosis of IDDM, and before treatment was started, 115 children and adolescents were screened for IgA-antiendomysium (EMA) and IgA-antigliadin antibodies (AGA). Those found to be EMA-positive and/or AGA- positive were investigated further with intestinal biopsy. Results. Of the 115 patients, 2 had known CD at diagnosis of IDDM; of the remainder of patients, 6% (7/113) were found to be EMA-positive and 9% (10/113) were found to have AGA levels above normal. Of the 6 patients who underwent biopsy, 5 manifested villous atrophy. In addition, 2 patients with high EMA and AGA antibody titers refused biopsy, and 4 patients with low EMA and/or AGA titers were found to have normal titers at control before biopsy decision. Conclusion. Because the prevalence of CD at diagnosis of IDDM would seem to be 6% to 8%, screening for CD seems to be justified among patients with newly diagnosed IDDM.
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| 43. |
- DAHLQUIST, GG, et al.
(författare)
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Maternal enteroviral infection during pregnancy as a risk factor for childhood IDDM. A population-based case-control study
- 1995
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Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 44:4, s. 408-413
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Tidskriftsartikel (refereegranskat)abstract
- Using the nationwide childhood-onset diabetes register in Sweden, we were able to trace children who contracted diabetes before the age of 15 years and who were born at a specific hospital in Sweden where maternal sera from delivery had been stored during the years 1969-1989. Sera obtained at delivery from 57 mothers of diabetic children were compared with sera from 203 mothers of control subjects who were delivered at the same hospital during the same time period. The sera were analyzed blindly using a group-specific enzyme-linked immunosorbent assay for enteroviral IgG and IgM antibodies before and after urea wash as an avidity test. On the same plates, IgG antibodies to herpes, mumps, and toxoplasmosis were analyzed. The mean absorbance values of enteroviral IgG antibodies against enteroviral antigens (echo30, coxsackie B5, and echo9) were significantly higher among mothers whose children later developed diabetes (P = 0.002, P = 0.02, and P = 0.04, respectively). When reduction in activity after urea wash, indicating recently formed antibodies, was compared, the differences were even more pronounced (P < 0.001 for all three antigens). No significant differences were found for antibodies against herpes (all types), herpes type 2, mumps, or toxoplasmosis. When IgM activity and/or a significant decrease in avidity index, an indication of recent enterovirus infection, was used as a risk exposure, the odds ratio standardized for year of birth (95% confidence interval) was 3.19 (1.39–7.30). We conclude that the results of this study indicate that enteroviral infection during pregnancy is a risk factor for childhood-onset diabetes in the offspring. Whether one or several viruses in the enterovirus group are responsible remains to be discovered.
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| 45. |
- Ericson, M.L., et al.
(författare)
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A method of measuring energy dissipation during crack propagation in polymers with an instrumented ultramicrotome
- 1996
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Ingår i: Journal of Materials Science. - 0022-2461 .- 1573-4803. ; 31:3, s. 655-662
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Tidskriftsartikel (refereegranskat)abstract
- In order to characterize very local energy dissipation during crack propagation in polymers, an ultramicrotome was instrumented to measure the energy dissipated during sectioning. The work to section per unit area, W s, was measured for five different amorphous polymers [polymethyl methacrylate (PMMA), polystyerene (PS), polycarbonate (PC) and two epoxy resins] in the glassy state. When the section thickness was varied between 60 and 250 nm, W s varied between 15 and 100 Jm-2, depending on the material and section thickness. The method and the results are compared with other methods used for determining the energy dissipation at a local level as well as at a macroscopic level in polymers. The differences between different polymers were found to be contradictory to macroscopic fracture toughness, G lc, measurements. The material that showed the highest W s had the lowest G lc values reported. Possible mechanisms for energy dissipation during sectioning are also discussed.
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| 46. |
- FALT, IC, et al.
(författare)
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Expression of Shigella dysenteriae serotype 1 O-antigenic polysaccharide by Shigella flexneri aroD vaccine candidates and different S. flexneri serotypes
- 1995
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Ingår i: Journal of bacteriology. - : American Society for Microbiology. - 0021-9193 .- 1098-5530. ; 177:18, s. 5310-5315
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Tidskriftsartikel (refereegranskat)abstract
- The potential utility of Shigella flexneri aroD vaccine candidates for the development of bi- or multivalent vaccines has been explored by the introduction of the genetic determinants rfp and rfb for heterologous O antigen polysaccharide from Shigella dysenteriae serotype 1. The serotype Y vaccine strain SFL124 expressed the heterologous antigen qualitatively and quantitatively well, qualitatively in the sense of the O antigen polysaccharide being correctly linked to the S. flexneri lipopolysaccharide R3 core oligosaccharide and quantitatively in the sense that typical yields were obtained, with ratios of homologous to heterologous O antigen being 4:1 for one construct and 1:1 for another. Moreover, both polysaccharide chains were shown to be linked to position O-4 of the subterminal D-glucose residue of the R3 core. In contrast to the hybrid serotype Y SFL124 derivatives, analogous derivatives of serotype 2a vaccine strain SFL1070 did not elaborate a complete heterologous O antigen. Such derivatives, and analogous derivatives of rough, O antigen-negative mutants of SFL1070, formed instead a hybrid lipopolysaccharide molecule consisting of the S. flexneri lipid A R3 core with a single repeat unit of the S. dysenteriae type 1 O antigen. Introduction of the determinants for the S. dysenteriae type 1 O antigen into a second serotype 2a strain and into strains representing other serotypes of S. flexneri, revealed the following for the expression of the heterologous O antigen: serotypes 1a, 1b, 2a, and 5a did not produce the heterologous O antigen, whereas serotypes 2b, 3a, 3b, 4a, 4b, 5b, and X did.
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| 48. |
- Forslind, Bo, et al.
(författare)
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Aspects on the physiology of human skin : studies using particle probe analysis
- 1997
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Ingår i: Microscopy research and technique (Print). - 1059-910X .- 1097-0029. ; 38:4, s. 373-386
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Tidskriftsartikel (refereegranskat)abstract
- The cellular part of the skin, the epidermis, is a very thin structure, approximately 120 microns thick, a fact which has hindered the exploration of the physiology of the epidermis in normal and pathological conditions. An additional complication is the fact that the epidermis contains layers of cells at different stages of differentiation. Therefore, conventional physiological capillary probes cannot, with any satisfactory precision, be located within a specified cell of a specified layer of the skin in vivo. Hence, alternative ways for the exploration of skin physiology have been sought for. In the past, analysis of the elemental content of skin was done was done as bulk measurements, and surprisingly wide ranges of elemental content were recorded. The width of these ranges was most certainly due to the sampling methods used rather than the sensitivity of the chosen method of analysis. Also, these older measurements did not discriminate between the different strata, and therefore the information provided little if any substance for a functional analysis of processes involved in normal and pathological differentiation of the epidermis. Particle probes, however, have been able to overcome such methodological problems. Over a period of 15 years we have studied normal human skin, normal-looking, paralesional skin from psoriatics, and skin from persons suffering from atopic dermatitis using PIXE analysis. In recent years, trace elements have been shown to work as secondary messengers or regulatory substances. As an example, calcium (Ca2+) has proven to be a very important signalling substance in a great variety of cellular systems. Studies with the transmission electron microscope (TEM) as well as histochemical methods have allowed an understanding of the role of Ca2+ in the differentiation process of the epidermis. Ca2+ has also been shown to play an important role in apoptosis (programmed cell death), which is currently a hot subject for the obvious reason that the final differentiation step between the stratum granulosum level and the stratum corneum represents a particular aspect of programmed cell death. The importance of the balance between calcium and zinc in apoptosis has been clearly demonstrated in a number of cellular systems, but we have still to clarify the validity of topical treatment with Zn ointments in different skin conditions. Substantial iron (Fe) losses via psoriatic lesions were demonstrated more than two decades ago, and these data were given new meaning when we found that a more discrete loss occurs in clinically normal-looking psoriatic skin. Obviously, such findings stress the importance of understanding the relation between the elemental content and normal and abnormal physiology. The ultimate goal of particle probe studies is to provide an understanding of the formation of a mature stratum corneum with a functional barrier reflected in physiological/biochemical mechanisms behind the properties of changed skin in patients afflicted with skin disorders of genetic or constitutional origin. This paper aims to give an overview of the state of the art in skin physiology made possible through the use of particle probes.
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| 50. |
- Forslind, Bo, et al.
(författare)
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Human skin physiology studied by particle probe microanalysis
- 1995
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Ingår i: Scanning Microscopy. - 0891-7035. ; 9:4, s. 1011-1025
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Tidskriftsartikel (refereegranskat)abstract
- Particle probe methods (electron probe and proton probe X-ray microanalysis) have been applied to investigate the distribution of elements and water over the different layers of the epidermis. For major elements, electron probe X-ray microanalysis (XRMA) provides the advantage of superior spatial resolution, but for trace element analysis the more sensitive proton probe (particle induced X-ray emission, PIXE) analysis has to be used. On a dry weight basis, the concentration of S is rather constant across the epidermis, whereas the concentrations of P, K, Cl and Na show gradients with high levels in stratum germinativum (basale) and stratum spinosum but low levels in the stratum granulosum and stratum corneum. Essentially, Fe and Zn are confined to the basal region in normal skin. The concentration of Ca, however, increased steadily from the basal region to the stratum corneum. The probe technique allows quantitative analysis of stratum-specific changes in elemental content in a variety of pathological conditions, e.g., changes induced by nickel, detergents and other chemicals, or in psoriatic skin. Of particular interest are findings of increased Fe and Zn in non-involved psoriatic skin. Since the different layers of the skin have different elemental concentrations and react differently under pathological conditions, the probe techniques are far superior to bulk chemical analysis in elucidating physiological and pathological processes in the skin.
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