| 1. |
- Feresiadou, Amalia, et al.
(författare)
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Measurement of sCD27 in the cerebrospinal fluid identifies patients with neuroinflammatory disease
- 2019
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Ingår i: Journal of Neuroimmunology. - : Elsevier BV. - 0165-5728 .- 1872-8421. ; 332, s. 31-36
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Laboratory tests to assist in the diagnosis and monitoring of neuroinflammatory diseases are scarce. The soluble form of the CD27 molecule (sCD27) is shed in high concentrations by activated T cells and can be detected in the cerebrospinal fluid. The aim of this study was to investigate whether CSF quantitation of sCD27 could discriminate between inflammatory and non-inflammatory neurological diseases.METHODS: The concentration of sCD27 was measured using a commercially available ELISA in 803 well-defined subjects from a study cohort comprised of 338 patients with neuroinflammatory disease, 338 with non-inflammatory neurological disease and 127 controls without neurological disease.RESULTS: The median value of cerebrospinal fluid sCD27 was 64 pg/mL (IQR 0-200) in controls, 58 pg/mL (IQR 0-130) in patients with non-inflammatory disease and 740 pg/mL (IQR 230-1800) in patients with inflammatory disease. The likelihood ratio of having an inflammatory disease was 10 (sensitivity 74% and specificity 93%) if the sCD27 concentration was >250 pg/mL. In patients with a known inflammatory condition, the likelihood ratio of having an infection was 10 (sensitivity 40% and specificity 96%) if the sCD27 concentration was >2500 pg/mL.CONCLUSIONS: The likelihood of having an inflammatory neurological condition is increased with elevated concentrations of sCD27 in cerebrospinal fluid. Rapid tests of sCD27 should be developed to assist clinicians in diagnosis of neuroinflammatory disease.
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| 2. |
- Nygren, Anders, et al.
(författare)
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Swedish children with hereditary angioedema report good overall health and quality of life despite symptoms
- 2016
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Ingår i: Acta Paediatrica. - : WILEY-BLACKWELL. - 0803-5253 .- 1651-2227. ; 105:5, s. 529-534
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Tidskriftsartikel (refereegranskat)abstract
- AimFew studies have been published on children with hereditary angioedema (HAE), an autosomal dominant disease caused by mutations on chromosome 11. This study explored various aspects of the disease in the Swedish paediatric population. MethodsA retrospective questionnaire was sent to all 36 Swedish children known to have HAE, and a physician carried out follow-up telephone interviews. ResultsMost of the questionnaires were completed by the parents of 31 (86%) children with HAE, with or without their input, at a median age of nine years (range 1-17), and the physician also interviewed 29. HAE symptoms were experienced by 23 children, including abdominal attacks (96%), skin swelling (78%) and swelling in the mouth and/or upper airways (52%). Psychological stress was the most common trigger for abdominal attacks and trauma and sports triggered skin swelling. The majority (n = 19) had access to complement-1 esterase inhibitor concentrate at home. Current health and quality of life were generally rated as good, independent of whether the child had experienced HAE symptoms or not. ConclusionMost children with HAE had experienced abdominal attacks and skin swelling, but their overall health and quality of life were generally perceived to be good.
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| 3. |
- Alenius Dahlqvist, Jenny, 1972-, et al.
(författare)
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Pacemaker treatment after Fontan surgery-A Swedish national study
- 2019
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Ingår i: Congenital Heart Disease. - : Computers, Materials and Continua (Tech Science Press). - 1747-079X .- 1747-0803. ; 14:4, s. 582-589
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveFontan surgery is performed in children with univentricular heart defects. Previous data regarding permanent pacemaker implantation frequency and indications in Fontan patients are limited and conflicting. We examined the prevalence of and risk factors for pacemaker treatment in a consecutive national cohort of patients after Fontan surgery in Sweden. MethodsWe retrospectively reviewed all Swedish patients who underwent Fontan surgery from 1982 to 2017 (n=599). ResultsAfter a mean follow-up of 12.2years, 13% (78/599) of the patients with Fontan circulation had received pacemakers. Patients operated with the extracardiac conduit (EC) type of total cavopulmonary connection had a significantly lower prevalence of pacemaker implantation (6%) than patients with lateral tunnel (LT; 17%). Mortality did not differ between patients with (8%) and without pacemaker (5%). The most common pacemaker indication was sinus node dysfunction (SND) (64%). Pacemaker implantation due to SND was less common among patients with EC. Pacemaker implantation was significantly more common in patients with mitral atresia (MA; 44%), double outlet right ventricle (DORV; 24%) and double inlet left ventricle (DILV; 20%). In contrast, patients with pulmonary atresia with intact ventricular septum and hypoplastic left heart syndrome were significantly less likely to receive a pacemaker (3% and 6%, respectively). ConclusionsThirteen percent of Fontan patients received a permanent pacemaker, most frequently due to SND. EC was associated with a significantly lower prevalence of pacemaker than LT. Permanent pacemaker was more common in patients with MA, DORV, and DILV.
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| 4. |
- Alenius Dahlqvist, Jenny, 1972-, et al.
(författare)
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Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
- 2019
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Ingår i: Pediatric Cardiology. - : Springer Science and Business Media LLC. - 0172-0643 .- 1432-1971. ; 40:4, s. 685-693
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Tidskriftsartikel (refereegranskat)abstract
- Sinus node dysfunction (SND) causes significant morbidity in patients after Fontan surgery. Heart rate variability (HRV) reflects the autonomic regulation of the heart, and changes in HRV have been associated with SND in adults. We aimed to study whether changes in HRV could be detected in 24-h electrocardiographic (ECG) recordings in Fontan patients with SND. We compared HRV results from two patient groups; patients with Fontan circulation who later required a pacemaker due to severe SND (n = 12) and patients with Fontan circulation and SND, without indication for pacemaker treatment (n = 11), with two control groups; patients with Fontan circulation without SND (n = 90) and healthy controls (n = 66). The Poincare plot index SD2 (representing changes in heart rate over 24-h) and the very low-frequency (VLF) HRV component were significantly higher in both SND groups, both compared with healthy controls and patients with Fontan circulation without SND. In SND patients with pacemakers, SD2 and VLF were slightly reduced compared to SND patients without pacemaker (p = 0.06). In conclusion, in Fontan patients with SND the HRV is significantly higher compared to healthy controls and Fontan patients without SND. However, in patients with severe SND requiring pacemaker, SD2 and VLF tended to be lower than in patients with SND without pacemaker, which could indicate a reduced diurnal HRV in addition to the severe bradycardia. This is a small study, but our results indicate that HRV analysis might be a useful method in the follow-up of Fontan patients regarding development of SND.
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| 5. |
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| 6. |
- Andersson, Katarina, et al.
(författare)
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Governance, Accountability, and Organizational Development : Eldercare Unit Managers' and Local Politicians' Experiences of and Responses to State Supervision of Swedish Eldercare
- 2018
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Ingår i: Journal of Aging & Social Policy. - : Routledge. - 0895-9420 .- 1545-0821. ; 30:5, s. 419-439
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Tidskriftsartikel (refereegranskat)abstract
- This article explores how local politicians and care unit managers in Swedish eldercare experience and respond to state supervision. Twelve politicians and 12 managers in 15 previously inspected municipalities were interviewed about their experiences of and reactions to state supervision (SSV) in relation to their views of care quality and routines in eldercare practice. The findings indicate that local managers and political chairs perceived SSV in eldercare positively at a superficial level, but were critical of and disappointed with specific aspects of it: in terms of a) governance—chairs and managers said SSV strengthened implementation of national policies via local actors, but were critical of SSV’s narrow focus on control and flaws in eldercare practice; b) accountability—SSV was seen as limited to accountability for finances and systemic performance; and c) organizational development—SSV was seen as limited to improving routines and compliance with legislation, while local definitions of quality are broader than that. In general, local actors regarded SSV as improving administrative aspects and routines in practice but ignoring the relational content of eldercare quality.
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| 7. |
- Andersson, Katarina, 1963-, et al.
(författare)
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Statlig tillsyn
- 2019
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Ingår i: Perspektiv på granskning inom offentlig sektor. - Malmö : Gleerups Utbildning AB. - 9789151100654 ; , s. 55-70
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Baban, Bayar, 1973-, et al.
(författare)
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Determination of insulin resistance in surgery : the choice of method is crucial
- 2015
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Ingår i: Clinical Nutrition. - : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 34:1, s. 123-128
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: In elective surgery, postoperative hyperglycaemia and insulin resistance are independent risk factors for complications. Since the simpler HOMA method has been used as an alternative to the hyperinsulinemic normoglycemic clamp in studies of surgery induced insulin resistance, we compared the two methods in patients undergoing elective surgery.METHODS: Data from 113 non-diabetic patients undergoing elective surgery were used. Insulin sensitivity, both before and after surgery, was quantified by the clamp and HOMA. Pre- and postoperatively, the results of the clamp were compared to HOMA using regression- and correlation analysis. Degree of agreement between the methods was studied using weighted linear kappa and the Bland-Altman test.RESULTS: Both the clamp and HOMA recorded a mean relative reduction in insulin sensitivity of 39 ± 24% and 39 ± 61% respectively after surgery; with significant correlations (p < 0.01) for pre- and post-operative measures as well as for relative changes. However r(2) values were low: 0.04, 0.07 and 0.03 respectively. The degree of agreement for the relative change in insulin sensitivity using the Bland-Altman test gave a mean of difference 0% but "limits of agreement" (±2SD) was ±125%. This poor inter-method agreement was consolidated by a weighted linear kappa value of 0.18.CONCLUSION: While the hyperinsulinemic euglycemic clamp measures the postoperative changes in insulin sensitivity, HOMA measures something different. Data using the HOMA method must therefore be interpreted cautiously and is not interchangeable with data obtained from the clamp.
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| 9. |
- Bang, Peter, et al.
(författare)
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Free dissociable IGF-I : Association with changes in IGFBP-3 proteolysis and insulin sensitivity after surgery
- 2016
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Ingår i: Clinical Nutrition. - : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 35:2, s. 408-413
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients receiving a carbohydrate drink (CHO) before major abdominal surgery display improved insulin sensitivity postoperatively and increased proteolysis of IGFBP-3 (IGFBP-3-PA) compared to patients undergoing similar surgery after overnight fasting. Aims: We hypothesized that serum IGFBP-3-PA increases bioavailability of circulating IGF-I and preserves insulin sensitivity in patients given CHO. Design: Matched control study. Methods: At Karolinska University Hospital, patients given CHO before major elective abdominal surgery (CHO,n = 8) were compared to patients undergoing similar surgical procedures after overnight fasting (FAST,n = 10). Results from two different techniques for determination of free-dissociable IGF-I (fdIGF-I) were compared with changes in IGFBP-3-PA and insulin sensitivity. Results: Postoperatively, CHO displayed 18% improvement in insulin sensitivity (hyperinsulinemic clamp) and increased IGFBP-3-PA vs. FAST. As determined by IRMA, fdIGF-I increased by 48 +/- 25% in CHO while fdIGF-I decreased by 13 +/- 18% in FAST (p < 0.01 vs. CHO, when corrected for duration of surgery). However, fdIGF-I determined by ultra-filtration decreased similarly in both groups (-22 +/- 8% vs. -25 +/- 8%, p = 0.8) and IGFBP-1 increased similarly in both groups. Patients with less insulin resistance after surgery demonstrated larger increases in fdIGF-I by IRMA (r = 0.58, p < 0.05). Fifty-three % of the variability of the changes in fdIGF-I by IRMA could be explained by changes in IGFBP-3-PA and total IGF-I levels (p < 0.05), while IGFBP-1 did not contribute significantly. Conclusion: During conditions when serum IGF-I bioavailability is regulated by IGFBP-3 proteolysis, measurements of fdIGF-I by IRMA is of physiological relevance as it correlates with the associated changes in insulin sensitivity.
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| 10. |
- Berglund, Åke, et al.
(författare)
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First-in-human, phase I/IIa clinical study of the peptidase potentiated alkylator melflufen administered every three weeks to patients with advanced solid tumor malignancies
- 2015
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Ingår i: Investigational new drugs. - : Springer Science and Business Media LLC. - 0167-6997 .- 1573-0646. ; 33:6, s. 1232-1241
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Melflufen (melphalan flufenamide, previously designated J1) is an optimized and targeted derivative of melphalan, hydrolyzed by aminopeptidases overexpressed in tumor cells resulting in selective release and trapping of melphalan, and enhanced activity in preclinical models. Methods This was a prospective, single-armed, open-label, first-in-human, dose-finding phase I/IIa study in 45 adult patients with advanced and progressive solid tumors without standard treatment options. Most common tumor types were ovarian carcinoma (n = 20) and non-small-cell lung cancer (NSCLC, n = 11). Results In the dose-escalating phase I part of the study, seven patients were treated with increasing fixed doses of melflufen (25-130 mg) Q3W. In the subsequent phase IIa part, 38 patients received in total 115 cycles of therapy at doses of 30-75 mg. No dose-limiting toxicities (DLTs) were observed at 25 and 50 mg; at higher doses DLTs were reversible neutropenias and thrombocytopenias, particularly evident in heavily pretreated patients, and the recommended phase II dose (RPTD) was set to 50 mg. Response Evaluation Criteria In Solid Tumors (RECIST) evaluation after 3 cycles of therapy (27 patients) showed partial response in one (ovarian cancer), and stable disease in 18 patients. One NSCLC patient received nine cycles of melflufen and progressed after 7 months of therapy. Conclusions In conclusion, melflufen can safely be given to cancer patients, and the toxicity profile was as expected for alkylating agents; RPTD is 50 mg Q3W. Reversible and manageable bone marrow suppression was identified as a DLT. Clinical activity is suggested in ovarian cancer, but modest activity in treatment of refractory NSCLC.
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| 11. |
- Biel, Anders, et al.
(författare)
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The use of MgO-paste as a biodegradeable bone cement
- 2016
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Ingår i: Materials Today. - : Elsevier. - 2214-7853. ; 3:2, s. 556-561
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Tidskriftsartikel (refereegranskat)abstract
- The use of MgO-paste as bone cement was tested on titanium cylinders implanted into rat tibia. The evaluation of bone healingwas made with the retention force (pull-out) test, light microscopy and ESEM/ EDX. Preimplantation of the MgO-paste into drillperforations of rat tibia increased the retention of the titanium implant 6-fold. The error was expressed as the 95% confidenceinterval of means (n=10 bones in each group). The observed difference between 3.46+/-0.71 N/mm2 for Ti-cylinders implantedwith MgO-paste and 0.56+/-0.26 N/mm2 for Ti-cylinders implanted directly into the bone, is statistically significant (p<0.01).The increase of retention force, caused by MgO is parallel to an increased thickness of the compact bone surrounding the implantand closer contact between bone and implant.Histological examination of the implant-related bone showed that the MgO-induced bone growth is mediated by the formation ofa bone-inducing matrix. The matrix contains organic substance, most likely proteins.
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| 12. |
- Fahlgren, Siv, et al.
(författare)
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Having Your Cake and Eating It? : The “Painful Cake” Incident of 2012 Examined
- 2015
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Ingår i: Konsthistorisk Tidskrift. - : Routledge. - 0023-3609 .- 1651-2294. ; 84:1, s. 55-70
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Tidskriftsartikel (refereegranskat)abstract
- On the 15th of April, 2012, The Modern Museum (Modernamuseet) in Stockholm celebrated the World Art Day by having a reception with the Swedish cultural minister present, at which an artwork in the form of a cake made in the likeness of the body of a caricatured black woman was served, cut up and eaten, while the artist, masked as the cakes head, screamed. This conceptual, relational, and contextualizing artwork, which leads to a much heated debate in Sweden and which was also internationally picked up on, was made by the explicitly anti-racist artist Makode Linde. In this article, we explore the problem of this event in terms of its sociocultural significance. How did we react upon the drama that we were following from a distance? What did it make us see? What questions did the incident raise about the Swedish society of today? These are examples of the questions we as gender researchers working in Sweden will discuss in the form of a triptych. We use the triptych metaphor as a tool for opening dialogue. By opening its panels it becomes possible to decommodify the single image of the artwork and make relations between agents traceable, visible, and readable.
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| 13. |
- Fahlgren, Siv, et al.
(författare)
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Utmaningar : feminismens (o)möjlighet under nyliberalismen
- 2016
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- När individen på en marknad blivit den alltigenom dominerande modellen för att organisera samhällen och organisationer har det också påverkat hur en ser på betydelsen av kön. Den här boken utforskar hur normalisering går till under nyliberalism, hur det görs på sätt som både utmanar feministiska perspektiv och kan utmanas av feministiska läsningar. Om vi alla i nyliberal anda sägs göra fria, individualistiska val kring alla frågor i våra liv, val som var och en av oss själva samtidigt står ansvariga för, blir en feministisk kritisk position svår att se. Måste vi då kunna tänka i sociala kollektiv för att komma förbi föreställningar om och erfarenheter av ett privatiserat och personligt förtryck, förenklingar och individuell moralism? Så ställer boken frågor om feminismens (o)möjlighet under nyliberalism. Boken avslutas med att skissa möjliga feministiska positioner och strategier för förändring, för att slutligen visionärt diskutera vad ett feministiskt samhälle skulle kunna vara.
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| 14. |
- Giritli Nygren, Katarina, et al.
(författare)
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Inledande ord
- 2016
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Ingår i: Ko. - Sundsvall : Mid Sweden University. - 9789188025739
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 15. |
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| 16. |
- Giritly Nygren, Katarina, et al.
(författare)
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(Re)assembling the ‘Normal’ in Neoliberal Policy Discourses : Tracing Gender Relations in the Age of Risk
- 2015
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Ingår i: Nordic Journal of Social Research. - : Scandinavian University Press / Universitetsforlaget AS. - 1892-2783. ; 6, s. 24-43
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is to explore through a reading of an official Swedish policy document what questions and challenges such a document poses for feminist theory by the way the 'normal' is (re)assembled in accordance with what others have called the risk politics of advanced liberalism. The intensified focus on risk in neoliberalism has seen responsibility move from the state to individuals, and old divisions between society and market as well as between civil society and state are being refigured. The argument put forward here is that current modes of governance tend to neglect the complexities of present-day life courses when using a gender-'neutral' approach to social policy that is in fact the work of a gender regime.
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| 17. |
- Glimelius, Bengt, et al.
(författare)
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U-CAN : a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden.
- 2018
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 57:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- Background: Progress in cancer biomarker discovery is dependent on access to high-quality biological materials and high-resolution clinical data from the same cases. To overcome current limitations, a systematic prospective longitudinal sampling of multidisciplinary clinical data, blood and tissue from cancer patients was therefore initiated in 2010 by Uppsala and Umeå Universities and involving their corresponding University Hospitals, which are referral centers for one third of the Swedish population.Material and Methods: Patients with cancer of selected types who are treated at one of the participating hospitals are eligible for inclusion. The healthcare-integrated sampling scheme encompasses clinical data, questionnaires, blood, fresh frozen and formalin-fixed paraffin-embedded tissue specimens, diagnostic slides and radiology bioimaging data.Results: In this ongoing effort, 12,265 patients with brain tumors, breast cancers, colorectal cancers, gynecological cancers, hematological malignancies, lung cancers, neuroendocrine tumors or prostate cancers have been included until the end of 2016. From the 6914 patients included during the first five years, 98% were sampled for blood at diagnosis, 83% had paraffin-embedded and 58% had fresh frozen tissues collected. For Uppsala County, 55% of all cancer patients were included in the cohort.Conclusions: Close collaboration between participating hospitals and universities enabled prospective, longitudinal biobanking of blood and tissues and collection of multidisciplinary clinical data from cancer patients in the U-CAN cohort. Here, we summarize the first five years of operations, present U-CAN as a highly valuable cohort that will contribute to enhanced cancer research and describe the procedures to access samples and data.
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| 18. |
- Gustafsson, Ulf O., et al.
(författare)
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Adherence to the ERAS protocol is Associated with 5-Year Survival After Colorectal Cancer Surgery : A Retrospective Cohort Study
- 2016
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Ingår i: World Journal of Surgery. - New York, USA : Springer. - 0364-2313 .- 1432-2323. ; 40:7, s. 1741-1747
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Tidskriftsartikel (refereegranskat)abstract
- Background: Surgical stress can influence oncological outcome and survival. The enhanced recovery after surgery (ERAS) protocol is designed to reduce perioperative stress and has been shown to reduce postoperative morbidity. We studied if adherence to ERAS is associated with increased long-term survival.Methods: Between the years 2002 and 2007, 911 consecutive patients, operated with major colorectal cancer surgery at Ersta Hospital, Stockholm, Sweden were analyzed. The histopathological reports of the resected specimen, date, and cause of death of the patients as well as postoperative CRP levels were obtained. The relation between the rate of adherence to the ERAS protocol at the time of surgery, and the short-term outcomes in relation to 5-year overall and colorectal cancer-specific survival was determined in this retrospective cohort study.Results: In patients with ≥70 % adherence to ERAS interventions (N = 273,), the risk of 5-year cancer-specific death was lowered by 42 %, HR 0.58 (0.39-0.88, cox regression) compared to all other patients (<70 % adherence). Significant independent perioperative predictors of increased 5-year survival were avoiding overload of intravenous fluids, HR 0.53 (0.32-0.86); oral intake on the day of operation, HR 0.55 (0.34-0.78); and low CRP levels on postoperative day 1.Conclusion: High adherence to the ERAS protocol may be associated with improved 5-year cancer-specific survival after colorectal cancer surgery.
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| 19. |
- Hanberger, Anders, et al.
(författare)
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Audit and Accountability
- 2017
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Ingår i: Blom, B., Evertsson, L. & Perlinski, M. (Eds.) Social and Caring Professions in European Welfare States.. - Bristol, UK. : Policy Press. - 9781447327196
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Bokkapitel (refereegranskat)
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| 20. |
- Hanberger, Anders, 1953-, et al.
(författare)
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Auditing and accountability
- 2017
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Ingår i: Social and caring professions in European welfare states. - Bristol : Policy Press. - 9781447327196 ; , s. 83-97
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Bokkapitel (refereegranskat)abstract
- This chapter consists of two parts. First, two accountability dilemmas are identified, key concepts are defined, and a framework for exploring the interplay among democratic governance, audit systems, and accountability is presented. Second, two different but dominant audit systems used in Swedish eldercare are described and analysed in light of this framework, and consequences of auditing and accountability for key actors involved are discussed, as well as possible ways of resolving the two accountability dilemmas. In relation to the volume, this chapter explores conditions, trends, and challenges in today's audit society and their implications for welfare professions and other key actors. Swedish eldercare is an illustrative case of a phenomenon occurring in most policy sectors.
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| 21. |
- Hanberger, Anders, 1953-, et al.
(författare)
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Can state supervision improve eldercare? : An analysis of the soundness of the Swedish supervision model
- 2018
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Ingår i: British Journal of Social Work. - Oxford : Oxford University Press. - 0045-3102 .- 1468-263X. ; 48:2, s. 371-389
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Tidskriftsartikel (refereegranskat)abstract
- This article examines the assumptions regarding how Swedish state supervision (SSV) ofeldercare is to achieve its intended effects. It explores how SSV is intended to work toensure and improve eldercare quality, and theoretically and empirically assesses the validityof its guiding assumptions with programme theory methodology. The theoreticalassessment suggests that most intended effects are partly achieved, though the qualityenhancingassumption finds little support in caring research. The assumption that thesupervised parties will improve their compliance with laws and regulations has some validity,but this compliance is temporary and confined to the aspects of eldercare beingsupervised. Twenty-four interviews with the chairs of Social Welfare Committees andcare unit managers provide empirical support for all but two intended effects. SSV hasnot increased ‘awareness of national regulative demands in eldercare’ or contributed to‘general quality improvement in eldercare’. Four unintended effects of SSV were also recognisedin the interviews—for example, unsupervised caring activities were less prioritised.The authors conclude that, although SSV does little to improve eldercare quality, itis needed for transparency and accountability as well as to hold local governments andpublic and private service providers to account for compliance with national statutes.
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| 22. |
- Hanberger, Anders, 1953-, et al.
(författare)
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Can state supervision improve eldercare? An analysis of the assumptions of the Swedish supervision model
- 2015
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Konferensbidrag (refereegranskat)abstract
- Can state supervision improve eldercare? An analysis of the assumptions of the Swedish supervision modelBackground: Lately the supervision of Swedish eldercare has been reinforced to ensure better compliance with laws and regulations. Policy-makers express high expectation that this reform will improve quality in eldercare, and ensure older citizens a good and equal distribution of eldercare.Purpose: The aim of this paper is to unfold the underlying assumptions of how the supervision model (inspectorate) is intended to work to ensure and improve quality in Swedish eldercare, and to probe the validity of the assumptions.Method: A program theory analysis is carried out to describe how state supervision is assumed to work to achieve intended effects. These assumptions are referred to as the supervision’s program theory. A policy scientific method is applied to reconstruct the program theory. Once the program theory is described its consistence is analyzed and the validity is assessed against supervision theory and caring theory.Results: The assumption that the supervised will improve compliance with laws and regulations has some validity but confined to aspects of eldercare being supervised. The theories we used provide no support that supervision is an effective tool for improving quality in eldercare.Conclusions: Reinforced supervision cannot be justified with reference to supervision being an effective tool or mechanism to enhance quality in eldercare. However, some kind of supervision is necessary for transparency and holding local governments, and public and private service providers to account for compliance with the statues. Supervision also reinforce the national objectives and standards that should guide social service committees and eldercare service providers.
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| 23. |
- Hanberger, Anders, 1953-, et al.
(författare)
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Hur kan granskning av äldreomsorg studeras?
- 2019. - 1
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Ingår i: Perspektiv på granskning inom offentlig sektor. - Malmö : Gleerups Utbildning AB. - 9789151100654 ; , s. 39-54
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 24. |
- Hanberger, Anders, et al.
(författare)
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Hur kan granskning av äldreomsorgen studeras?
- 2018
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Ingår i: Perspektiv på granskning inom offentlig sektor : Med äldreomsorgen som exempel. - Malmö : Gleerups Utbildning AB. - 9789151100654
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 25. |
- Hanberger, Anders, 1953-, et al.
(författare)
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Tillsyn och öppna jämförelser : exemplet äldreomsorgen
- 2015
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Konferensbidrag (populärvet., debatt m.m.)abstract
- Äldreomsorg har genom olika former av utvärdering fått avsevärt ökad uppmärksamhet i media och politisk debatt. I denna session diskuteras vilka konsekvenser som två dominerande former av utvärdering – tillsyn och öppna jämförelser – har för äldreomsorgens styrning, ansvarsutkrävande och verksamhetsutveckling. Sessionen utgår från resultat från ett Forte-finansierat forskningsprojekt om användning av utvärdering i äldreomsorgen.
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| 26. |
- Hjelm, Linnea C., et al.
(författare)
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Lysis of Staphylococcal Cells by Modular Lysin Domains Linked via a n-covalent Barnase-Barstar Interaction Bridge
- 2019
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Ingår i: Frontiers in Microbiology. - : Frontiers Media SA. - 1664-302X. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Bacteriophage endolysins and bacterial exolysins are capable of enzymatic degradation of the cell wall peptidoglycan layer and thus show promise as a new class of antimicrobials. Both exolysins and endolysins often consist of different modules, which are responsible for enzymatic functions and cell wall binding, respectively. Individual modules from different endo- or exolysins with different binding and enzymatic activities, can via gene fusion technology be re-combined into novel variants for investigations of arrangements of potential clinical interest. The aim of this study was to investigate if separately produced cell wall binding and enzyme modules could be assembled into a functional lysin via a non-covalent affinity interaction bridge composed of the barnase ribonuclease from Bacillus amyloliquefaciens and its cognate inhibitor barstar, known to form a stable heterodimeric complex. In a proof-of-principle study, using surface plasmon resonance, flow cytometry and turbidity reduction assays, we show that separately produced modules of a lysin cysteine/histidine-dependent amidohydrolase/peptidase (CHAP) from Staphylococcus aureus bacteriophage K endolysin (LysK) fused to barnase and a cell wall binding Src homology 3 domain (SH3b) from the S. simulans exolysin lysostaphin fused to barstar can be non-covalently assembled into a functional lysin showing both cell wall binding and staphylolytic activity. We hypothesize that the described principle for assembly of functional lysins from separate modules through appended hetero-dimerization domains has a potential for investigations of also other combinations of enzymatically active and cell wall binding domains for desired applications.
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| 27. |
- Hordoir, Robinson, et al.
(författare)
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Nemo-Nordic 1.0 : a NEMO-based ocean model for the Baltic and North seas - research and operational applications
- 2019
-
Ingår i: Geoscientific Model Development. - : Copernicus GmbH. - 1991-959X .- 1991-9603. ; 12:1, s. 363-386
-
Tidskriftsartikel (refereegranskat)abstract
- We present Nemo-Nordic, a Baltic and North Sea model based on the NEMO ocean engine. Surrounded by highly industrialized countries, the Baltic and North seas and their assets associated with shipping, fishing and tourism are vulnerable to anthropogenic pressure and climate change. Ocean models providing reliable forecasts and enabling climatic studies are important tools for the shipping infrastructure and to get a better understanding of the effects of climate change on the marine ecosystems. Nemo-Nordic is intended to be a tool for both short-term and long-term simulations and to be used for ocean forecasting as well as process and climatic studies. Here, the scientific and technical choices within Nemo-Nordic are introduced, and the reasons behind the design of the model and its domain and the inclusion of the two seas are explained. The model's ability to represent barotropic and baroclinic dynamics, as well as the vertical structure of the water column, is presented. Biases are shown and discussed. The short-term capabilities of the model are presented, especially its capabilities to represent sea level on an hourly timescale with a high degree of accuracy. We also show that the model can represent longer timescales, with a focus on the major Baltic inflows and the variability in deep-water salinity in the Baltic Sea.
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| 28. |
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| 29. |
- Månsson, Christopher, Läkarexamen, 1977-, et al.
(författare)
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Percutaneous Irreversible Electroporation as First Line Treatment of Locally Advanced Pancreatic Cancer
- 2019
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Ingår i: Anticancer Research. - : Anticancer Research USA Inc.. - 0250-7005 .- 1791-7530. ; 39:5, s. 2509-2512
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aim:Irreversible electroporation (IRE) has recently been used as an experimental ablation treatment following systemic chemotherapy in locally advanced pancreatic cancer (LAPC). The primary aim of this study was to evaluate survival of LAPC patients after IRE prior to chemotherapy. The secondary aim was to examine the complication rates.Patients and Methods:Twenty-four patients with LAPC were included and treated with percutaneous ultrasound-guided IRE under general anesthesia. Survival data from the National Quality Registry for Pancreatic and Periampullary Cancer for LAPC during the same period were used for comparison.Results:The median survival after diagnosis was 13.3 months in the IRE group compared to 9.9 months in the registry group (p=0.511). Six patients had a severe complication after IRE treatment.Conclusion:No obvious gain in survival was observed with IRE as the first line treatment of LAPC and IRE was associated with severe complications. This study does not support percutaneous IRE in this setting.
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| 30. |
- Månsson, Christopher, et al.
(författare)
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Percutaneous irreversible electroporation for treatment of locally advanced pancreatic cancer following chemotherapy or radiochemotherapy
- 2016
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Ingår i: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 42:9, s. 1401-1406
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Tidskriftsartikel (refereegranskat)abstract
- Background: Irreversible electroporation (IRE) is a non-thermal based tumor ablation method used close to vessels and ducts and has the potential of treating locally advanced pancreatic cancer (LAPC). The aim of this study was to evaluate the efficacy and safety of IRE in patients with LAPC after chemo- and/or radio-chemotherapy.Method: Twenty-four patients with biopsy proven LAPC and who had received chemo- and/or radio-chemotherapy with no signs of metastases were included and treated with ultrasound guided percutaneous IRE under general anesthesia.Results: The median overall survival from diagnosis of LAPC was 17.9 months; this included 7.0 months after IRE. Median time from IRE was 6.1 months to local progression and 2.7 months to observation of metastases. Local control was observed in nine patients. IRE related complications were observed in 11 patients, three of which were serious complications. There was no IRE related mortality.Conclusion: Percutaneous IRE is reasonably safe in LAPC after chemo-/radio-chemotherapy and with promising results regarding efficacy.
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| 31. |
- Norhammar, Anna, et al.
(författare)
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Undetected Dysglycemia Is an Important Risk Factor for Two Common Diseases, Myocardial Infarction and Periodontitis : A Report From the PAROKRANK Study
- 2019
-
Ingår i: Diabetes Care. - : NLM (Medline). - 0149-5992 .- 1935-5548. ; 42:8, s. 1504-1511
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Information on the relationship among dysglycemia (prediabetes or diabetes), myocardial infarction (MI), and periodontitis (PD) is limited. This study tests the hypothesis that undetected dysglycemia is associated with both conditions. RESEARCH DESIGN AND METHODS: The PAROKRANK (Periodontitis and Its Relation to Coronary Artery Disease) study included 805 patients with a first MI and 805 matched control subjects. All participants without diabetes (91%) were examined with an oral glucose tolerance test. Abnormal glucose tolerance (AGT) (impaired glucose tolerance or diabetes) was categorized according to the World Health Organization. Periodontal status was categorized from dental X-rays as healthy (≥80% remaining alveolar bone height), moderate (79-66%), or severe (<66%) PD. Odds ratios (ORs) and 95% CIs were calculated by logistic regression and were adjusted for age, sex, smoking, education, marital status, and explored associated risks of dysglycemia to PD and MI, respectively. RESULTS: AGT was more common in patients than in control subjects (32% vs. 19%; P < 0.001) and was associated with MI (OR 2.03; 95% CI 1.58-2.60). Undetected diabetes was associated with severe PD (2.50; 1.36-4.63) and more strongly in patients (2.35; 1.15-4.80) than in control subjects (1.80; 0.48-6.78), but not when categorized as AGT (total cohort: 1.07; 0.67-1.72). Severe PD was most frequent in subjects with undetected diabetes, and reversely undetected diabetes was most frequent in patients with severe PD. CONCLUSIONS: In this large case-control study previously undetected dysglycemia was independently associated to both MI and severe PD. In principal, it doubled the risk of a first MI and of severe PD. This supports the hypothesis that dysglycemia drives two common diseases, MI and PD.
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| 32. |
- Nygren, Andreas, 1990, et al.
(författare)
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Validation of the VSB2 Spray Model for Ethanol under Diesel like Conditions
- 2017
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Ingår i: SAE Technical Papers. - 400 Commonwealth Drive, Warrendale, PA, United States : SAE International. - 0148-7191 .- 2688-3627. ; 2017-October
-
Tidskriftsartikel (refereegranskat)abstract
- When developing new combustion concepts, CFD simulations is a powerful tool. The modeling of spray formation is a challenging but important part when it comes to CFD modelling of non-premixed combustion. There is a large difference in the accuracy and robustness among different spray models and their implementation in different CFD codes. In the work presented in this paper a spray model, designated as VSB2 has been implemented in OpenFOAM. VSB2 differ from traditional spray models by replacing the Lagrangian parcels with stochastic blobs. The stochastic blobs consists of a droplet size distribution rather than equal sized droplets, as is the case with the traditional parcel. The VSB2 model has previously been thoroughly validated for spray formation and combustion of n-heptane. The aim of this study was to validate the VSB2 spray model for ethanol spray formation and combustion as a step in modelling dual-fuel combustion with alcohol and diesel. This was done by comparing spray penetration with data obtained from experiments with ethanol in a high-temperature high pressure spray chamber. The spray turbulence interaction is also investigated by the usage of different turbulence models. The study showed that the VSB2 model can be used to predict the formation of an ethanol spray. It was also concluded that the standard k - ε performed better than the realizable k - ε model, and that it is necessary to fix the turbulent length scale in the injector cell to produce accurate results
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| 33. |
- Nygren, Christer, et al.
(författare)
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Dilemmas in service transformation : a service strategy implementation case
- 2018
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Ingår i: The 28th International RESER Conference – Services in the age of contested globalization RESER2018.
-
Konferensbidrag (refereegranskat)abstract
- This paper study a service strategy implementation case using an inductive method to catch informant-centric perspectives and create theory-centric categories leading to the findings of three dilemmas: not really service but only services, waste of potential value and no one owns services. These dilemmas can be used in servitization implementation work from a practical viewpoint and can be of value for the discussion around service strategy implementation within an industrial organisation, working with software development apart from more traditional manufacturing.
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| 34. |
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| 35. |
- Nygren, Ingrid, et al.
(författare)
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Arbogaåns avrinningsområde : Recipientkontroll 2015
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Institutionen för vatten och miljö vid SLU har på uppdrag av Arbogaåns vattenförbund varit utförare av recipientkontrollprogrammet för Arbogaåns avrinningsområde under 2015. Prov för vattenkemiska och biologiska analyser har tagits på 27 platser i rinnande vattendrag, samt i 16 sjöar inom Arbogaaåns vattensystem. Denna rapport redovisar resultaten från dessa undersökningar och klassning av ekologisk status, avseende analyserade parametrar vid stationerna, enligt Naturvårdsverkets bedömningsgrunder 2007 (NV 2007:4, Bilaga A: Bedömningsgrunder för sjöar och vattendrag) och Havs- och vattenmyndighetens föreskrifter om klassificering och miljökvalitetsnormer avseende ytvatten (HVMFS 2013:19). Väder och vattenföring Året 2015 hamnade på tredje plats bland de varmaste åren i Sverige. Det var framförallt i början och slutet av året som man hade de största temeraturöverskotten medan för årstiden ovanligt kyligt väder under maj, juni och delar av juli drog ner årsmedeltemperaturen. När det gäller nederbörd så var det stora variationer så att i princip varannan månad gav nederbörd över eller mycket över det normala medan övriga månader låg under eller mycket under. Vattenföringen vid pegelstationerna i området låg mestadels nära medel för perioden 1978-2015. Vattenkemi De lägsta halterna av näringsämnen i både sjöar och vattendrag uppmättes liksom tidigare år i de norra och västra delarna av Arbogaåns avrinningsområde där andelen skog är stor. Halten av fosfor i sjöarna var 2015 högst i Väringen (6070) medan den högsta kvävehalten uppmättes i Vikern (6310). Transporten av näringsämnen i vattendragen ökar successivt mot Arbogåns mynning. Anledningen är att vattenföringen ökar nedåt i systemet samt att halterna av kväve och fosfor också ökar i och med att andelen jordbruksmark är större i den nedre delen. Det tillkommer också punktkällor från ett antal avloppsreningsverk vilket ökar belastningen nedåt i systemet. Belastningen av kväve och fosfor på Mälaren från Arbogaån varierar mellan åren, till stor del beroende på variationer i vattenföringen (figur A). En viss trend kan dock anas att efter en nedgång runt år 2000 så ökar transporten av näringsämnen åter långsamt. Efter 2012 och 2014 års toppnoteringar är 2015 års transport åter lägre men fortfarande den femte högsta noteringen sedan 1997. De högsta siktdjupen och lägsta klorofyllhalterna återfanns i de norra och västra delarna av avrinningsområdet (område E och D) medan de lägsta siktdjupen uppmättes i de södra och östra delarna (område A, B och C). De högsta klorofyllhalterna var inte lika tydligt associerade till delområde utan återfanns i princip spridda över alla områden. Biologi De biologiska provtagningarna fokuserade i år helt på bottenfauna i vattendrag. Den ekologiska statu-sen bedömd med hjälp av bottenfauna var vid alla provpunkter utom Hagbyåns inflöde till Norasjön (6330) och Arbogaåns inflöde i Väringen (6065) oförändrat hög eller god 2015 (figur B). Stationen vid inflödet till Norasjön visar en fortsatt sjunkande trend men bibehåller måttlig ekologisk status. Även status vid inflödet till Väringen har försämrats till måttlig. Sammanställning av statusklassningVi sammanvägning av alla analyserade kvalitetselement är statusen generellt hög eller god i merparten av sjöarna och vattendragen i norra och västra delen av avrinningsområdet med några undantag (figur B). Statusklassningarna kring och nedströms Väringen visar mestadels på måttlig till god status.
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| 36. |
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| 37. |
- Nygren, Ingrid, et al.
(författare)
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Eskilstunaåns avrinningsområde : Recipientkontroll 2015
- 2016
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- -Institutionen för vatten och miljö vid SLU har på uppdrag av Hjälmarens vattenvårdsförbund varit utförare av recipientkontrollprogrammet för Eskilstunaåns avrinningsområde under 2015. Prov för vattenkemiska och biologiska analyser har tagits på 29 platser i rinnande vattendrag, samt i 13 sjöar (figur A) inom Eskilstunaåns vattensystem. Denna rapport redovisar en sammanfattning av resultaten från dessa undersökningar och klassning av den ekologiska statusen vid stationerna enligt Naturvårdsverkets bedömningsgrunder 2007 (NV 2007:4 Bilaga A) samt Havs- och vattenmyndighetens föreskrifter om klassificering och miljökvalitetsnormer avseende ytvatten (HVMFS 2013:19). Väder och vattenföring Året 2015 hamnade på tredje plats bland de varmaste åren i Sverige. Det var framförallt i början och slutet av året som man hade de största temperaturöverskotten medan för årstiden ovanligt kyligt väder under maj, juni och delar av juli drog ner årsmedeltemperaturen.I princip gav varannan månad nederbörd över eller mycket över det normala medan övriga månader låg under eller mycket under. Vattenföringen låg nära eller under medel för mätperioden under de flesta av årets månader. Vattenkemi Halterna av näringsämnen är högst i Hjälmaren och Öljaren där andelen jordbruksmark i området är större än längre upp i avrinningsområdet. Högst halt av totalfosfor erhölls 2015 liksom tidigare år i Öljaren (4010) men Hemfjärden (9010) i Hjälmaren låg nästan lika högt. Den högsta kvävehalten återfanns i Hemfjärden med Öljaren och Mellanfjärden (9020) strax under. Belastningen av kväve och fosfor på Mälaren från Eskilstunaån visar inte på någon tydlig monoton trend sedan mätningarna startade 1997. Ett visst mönster kan man emellertid se. Efter en kraftig minskning av både fosfor och kväve i början av 2000-talet tycks halterna öka igen. Skillnaden mellan åren är dock stor och den beror till stor del på variationer i vattenföringen (figur A). Lägst klorofyllhalt och störst siktdjup finner man i sjöar i de västra delarna av avrinningsområdet. Störst siktdjup uppmättes även detta år i Östra Laxsjön där också klorofyllhalten var lägst. De högsta klorofyllhalterna återfanns i Öljaren och Hjälmaren där också de lägsta siktdjupen uppmättes. Vid årets provtagning var klorofyllhalten i Hjälmaren betydligt lägre än de två föregående åren vid alla provplatser. Detta till trots är det inga stora skillnader i siktdjup mellan åren. Biologi Samtliga stationer i Hjälmaren är av växtplanktonutvecklingen att döma mer eller mindre tydligt på- verkade av fosforbelastning (jämför rapporten SLU 2014:10). En statusklassning baserad på de senaste tre årens sammanvägda värden ger vid handen att status 2015 är fortsatt otillfredsställande men svagt stigande i Hemfjärden och Mellanfjärden, otillfredsställande och oförändrade i Östra Hjälmaren samt måttlig och fortsatt stigande i Storhjälmaren. Liksom 2014 hade alla vattendragsstationer även 2015 en bottenfauna med litet antal arter och låg biologisk mångfald. Surhetsindexet MISA har indikerat nära neutrala förhållanden i alla stationer i Eskilstunaåns nedströms Hjälmaren. Den ekologiska statusen avseende bottenfauna vid undersökningspunkterna är 2015 god till hög. Liksom året innan visar Frommestabäcken-Ekeby sämre resultat än tidigare under 10-talet och erhåller bara god status. I Eskils-tunaån vid vattenverket samt nedströms Torshälla är den ekologiska statusen oförändrat hög. Indexen för Eskiltunaån nedströms avloppsverket har fluktuerat men visar i år liksom 2014 på god status. Sammanställning av statusklassningar Statusklassningen av vattendragen i den västra delen (delområde A), visade alla detta år på god eller hög status (figur B). I de södra delarna (delområde C och E), samt i Svartåns nedre del (delområde B), var statusen i vattendragen med några undantag måttlig. Lillån från Logsjön (2410) erhöll otillfredsställande status medan Vibysjöns utlopp (3010, Svartån, Karlslund (2070) och Frommestabäcken vid Ekeby (3210) erhöll god status. Vattendragen öster om Hjälmaren (delområde G) erhöll alla god status. Avseende sjöarna så visade Toften och Storhjälmaren och Näshultasjön måttlig status, medan övriga fjärdar i Hjälmaren visade otillfredsställande och Öljaren dålig status. Övriga sjöar visade på god eller hög status. Till viss del beror skillnader mellan åren på att olika antal kvalitetselement ingått olika år eftersom den biologiska provtagningen på många stationer bara sker vissa år. För en fullständig klassning av ekologisk status ska även hydromorfologiska kvalitetsfaktorer beaktas, men dessa ingår inte i uppdraget.
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| 38. |
- Nygren, Jonas, et al.
(författare)
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Preoperative oral carbohydrate therapy
- 2015
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Ingår i: Current Opinion in Anaesthesiology. - 0952-7907 .- 1473-6500. ; 28:3, s. 364-369
-
Forskningsöversikt (refereegranskat)abstract
- Purpose of review: Management of the postoperative response to surgical stress is an important issue in major surgery. Avoiding preoperative fasting using preoperative oral carbohydrates (POC) has been suggested as a measure to prevent and reduce the extent to which such derangements occur. This review summarizes the current evidence and rationale for this treatment.Recent findings: A recent review from the Cochrane Collaboration reports enhanced gastrointestinal recovery and shorter hospital stay with the use of POC with no effect on postoperative complication rates. Multiple randomized controlled trials demonstrate improved postoperative metabolic response after POC administration, including reduced insulin resistance, protein sparing, improved muscle function and preserved immune response. Cohort studies in patients undergoing major abdominal surgery have shown that the use of POC as part of an enhanced recovery after surgery protocol is a significant predictor for improved clinical outcomes.Summary: Avoiding preoperative fasting with POC is associated with attenuated postoperative insulin resistance, improved metabolic response, enhanced perioperative well-being, and better clinical outcomes. The impact is greatest for patients undergoing major surgeries.
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| 39. |
- Nygren, Jim, et al.
(författare)
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Variation in Susceptibility to Wheat dwarf virus among Wild and Domesticated Wheat
- 2015
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10
-
Tidskriftsartikel (refereegranskat)abstract
- We investigated the variation in plant response in host-pathogen interactions between wild (Aegilops spp., Triticum spp.) and domesticated wheat (Triticum spp.) and Wheat dwarf virus (WDV). The distribution of WDV and its wild host species overlaps in Western Asia in the Fertile Crescent, suggesting a coevolutionary relationship. Bread wheat originates from a natural hybridization between wild emmer wheat (carrying the A and B genomes) and the wild D genome donor Aegilops tauschii, followed by polyploidization and domestication. We studied whether the strong selection during these evolutionary processes, leading to genetic bottlenecks, may have resulted in a loss of resistance in domesticated wheat. In addition, we investigated whether putative fluctuations in intensity of selection imposed on the hostpathogen interactions have resulted in a variation in susceptibility to WDV. To test our hypotheses we evaluated eighteen wild and domesticated wheat taxa, directly or indirectly involved in wheat evolution, for traits associated with WDV disease such as leaf chlorosis, different growth traits and WDV content. The plants were exposed to viruliferous leafhoppers (Psammotettix alienus) in a greenhouse trial and evaluated at two time points. We found three different plant response patterns: i) continuous reduction in growth over time, ii) weak response at an early stage of plant development but a much stronger response at a later stage, and iii) remission of symptoms over time. Variation in susceptibility may be explained by differences in the intensity of natural selection, shaping the coevolutionary interaction between WDV and the wild relatives. However, genetic bottlenecks during wheat evolution have not had a strong impact on WDV resistance. Further, this study indicates that the variation in susceptibility may be associated with the genome type and that the ancestor Ae. tauschii may be useful as genetic resource for the improvement of WDV resistance in wheat.
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| 40. |
- Ryden, Lars, et al.
(författare)
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Periodontitis Increases the Risk of a First Myocardial Infarction A Report From the PAROKRANK Study
- 2016
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Ingår i: Circulation. - : Lippincott Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 133:6, s. 576-583
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Tidskriftsartikel (refereegranskat)abstract
- Background The relationship between periodontitis (PD) and cardiovascular disease is debated. PD is common in patients with cardiovascular disease. It has been postulated that PD could be causally related to the risk for cardiovascular disease, a hypothesis tested in the Periodontitis and Its Relation to Coronary Artery Disease (PAROKRANK) study. Methods and Results Eight hundred five patients (<75 years of age) with a first myocardial infarction (MI) and 805 age- (mean 628), sex- (male 81%), and area-matched controls without MI underwent standardized dental examination including panoramic x-ray. The periodontal status was defined as healthy (80% remaining bone) or as mild-moderate (from 79% to 66%) or severe PD (<66%). Great efforts were made to collect information on possibly related confounders (approximate to 100 variables). Statistical comparisons included the Student pairwise t test and the McNemar test in 2x2 contingency tables. Contingency tables exceeding 2x2 with ranked alternatives were tested by Wilcoxon signed rank test. Odds ratios (95% confidence intervals) were calculated by conditional logistic regression. PD was more common (43%) in patients than in controls (33%; P<0.001). There was an increased risk for MI among those with PD (odds ratio, 1.49; 95% confidence interval, 1.21-1.83), which remained significant (odds ratio, 1.28; 95% confidence interval, 1.03-1.60) after adjusting for variables that differed between patients and controls (smoking habits, diabetes mellitus, years of education, and marital status). Conclusions In this large case-control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confounding factors. These findings strengthen the possibility of an independent relationship between PD and MI.
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| 41. |
- Singh, Sukhi, 1990, et al.
(författare)
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Adrenaline Improves Platelet Reactivity in Ticagrelor-Treated Healthy Volunteers
- 2019
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Ingår i: Thrombosis and Haemostasis. - : Georg Thieme Verlag KG. - 0340-6245 .- 2567-689X. ; 119:5, s. 735-743
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Administration of agents that enhance platelet reactivity may reduce the perioperative bleeding risk in patients treated with the adenosine diphosphate (ADP)-receptor antagonist ticagrelor. Adrenaline potentiates ADP-induced aggregation and activation in blood samples from ticagrelor-treated patients, but it has not previously been evaluated in vivo.METHODS: Ten healthy male subjects were included in an interventional study. A loading dose of ticagrelor (180 mg) was administered, followed 2 hours later by a gradually increased intravenous adrenaline infusion (0.01, 0.05, 0.10 and 0.15 µg/kg/min; 15 minutes at each step). Blood pressure, heart rate, platelet aggregation (impedance aggregometry), platelet activation (flow cytometry), clot formation (rotational thromboelastometry) and adrenaline plasma concentration were determined before and after ticagrelor administration and at the end of each adrenaline step.RESULTS: = 0.007).CONCLUSION: Infusion of adrenaline at clinically relevant doses improves in vivo platelet reactivity and clot formation in ticagrelor-treated subjects. Adrenaline could thus potentially be used to prevent perioperative bleeding complications in ticagrelor-treated patients. Studies in patients are necessary to determine the clinical importance of our observations.TRIAL REGISTRY NUMBER: ClinicalTrials.gov NCT03441412.
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| 42. |
- Singh, Sukhi, 1990, et al.
(författare)
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Intraoperative infusion of noradrenaline improves platelet aggregation in patients undergoing coronary artery bypass grafting: a randomized controlled trial
- 2019
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Ingår i: Journal of Thrombosis and Haemostasis. - : Elsevier BV. - 1538-7933 .- 1538-7836. ; 17:4, s. 657-665
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Tidskriftsartikel (refereegranskat)abstract
- Background New approaches to prevent bleeding complications during cardiac surgery are needed. Objective To investigate if noradrenaline (NA) enhances platelet aggregation in patients undergoing coronary artery bypass grafting (CABG). Patients/Methods Twenty-four patients undergoing coronary artery bypass grafting (CABG) were included in a prospective parallel-group randomized study. All patients but one were treated with acetylsalicylic acid (ASA). In the treatment group (n = 12), mean arterial blood pressure (MAP) was maintained at pre-induction levels by NA infusion. In the control group (n = 12), NA was administered only if MAP decreased below 60 mmHg. Platelet aggregation (impedance aggregometry with ADP, arachidonic acid [AA] and thrombin-receptor activating peptide [TRAP] as initiators) and clot formation (clotting time, clot formation time and maximum clot firmness by EXTEM, INTEM and FIBTEM tests with thromboelastometry) were assessed before and 50 min after anesthesia induction (before cardiopulmonary bypass was initiated). Results All patients in the treatment group received NA (median dose after 50 min 0.09 (range 0-0.26) mu g kg(-1) min(-1)). Four patients in the control group also received NA (0.03-0.12 mu g kg(-1) min(-1)). There were differences between the treatment group and the control group in ADP- and AA-induced aggregation changes (ADP, +16 [25th-75th percentiles, 5-26] vs. -7 [-19 to -1] U; AA, +12 [-4 to 16] vs. -9 [-13 to 1] U). INTEM maximum clot firmness increased in the treatment group but not in the control group. Conclusion Infusion of clinically relevant doses of NA enhanced platelet aggregation and clot firmness in ASA-treated CABG patients. NA infusion is hence a potential new method to acutely improve platelet reactivity in patients on antiplatelet therapy undergoing surgery.
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| 43. |
- Svedberg, Petra, et al.
(författare)
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Support from healthcare services during transition to adulthood : experiences of young adult survivors of pediatric cancer
- 2016
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Ingår i: European Journal of Oncology Nursing. - 1462-3889 .- 1532-2122. ; 21, s. 105-112
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:Improved survival rates of pediatric cancer have drawn attention on how to best facilitate long-term follow up and transition from pediatric to adult care. The transition process is multifactorial and necessitates the joint involvement of the patient, the family and the healthcare providers. The purpose of this study was to explore the experiences of support from healthcare services during the transition from adolescence to adulthood described by young adult survivors of pediatric cancer.METHODS:A mixed method with a convergent parallel design was used to evaluate the experiences of receiving support from healthcare services (eg pediatric oncology and pediatric clinic) during transition from adolescence to adulthood described by young adult survivors of pediatric cancer (n = 213) in a nation wide cross-sectional survey.RESULTS:A quantitative assessment of the experienced extent and satisfaction of support from healthcare services to handle physical, mental and social changes to continue life after the disease showed that a majority of the participants had received insufficient support. The qualitative analysis indicated a need for equal roles in healthcare to promote participation, a need to manage and process consequences of the disease, and a need for continuous support.CONCLUSIONS:During transition to adulthood, there's a need for a personalized care plan that takes a holistic approach towards supporting the young cancer survivor in managing life in the best way. Identifying and handling the individual needs of pediatric cancer survivors is important for providing the resources and support required to increase the likelihood of successful transition to adulthood.
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| 44. |
- Svedberg, Petra, 1973-, et al.
(författare)
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Support from healthcare services during transition to adulthood – Experiences of young adult survivors of pediatric cancer
- 2016
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Ingår i: European Journal of Oncology Nursing. - London : Elsevier. - 1462-3889 .- 1532-2122. ; 21, s. 105-112
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Improved survival rates of pediatric cancer have drawn attention on how to best facilitate long-term follow up and transition from pediatric to adult care. The transition process is multifactorial and necessitates the joint involvement of the patient, the family and the healthcare providers. The purpose of this study was to explore the experiences of support from healthcare services during the transition from adolescence to adulthood described by young adult survivors of pediatric cancer.Methods: A mixed method with a convergent parallel design was used to evaluate the experiences of receiving support from healthcare services (eg pediatric oncology and pediatric clinic) during transition from adolescence to adulthood described by young adult survivors of pediatric cancer (n = 213) in a nation wide cross-sectional survey.Results: A quantitative assessment of the experienced extent and satisfaction of support from healthcare services to handle physical, mental and social changes to continue life after the disease showed that a majority of the participants had received insufficient support. The qualitative analysis indicated a need for equal roles in healthcare to promote participation, a need to manage and process consequences of the disease, and a need for continuous support.Conclusions: During transition to adulthood, there's a need for a personalized care plan that takes a holistic approach towards supporting the young cancer survivor in managing life in the best way. Identifying and handling the individual needs of pediatric cancer survivors is important for providing the resources and support required to increase the likelihood of successful transition to adulthood. © 2016 Elsevier Ltd.
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| 45. |
- Thålin, Charlotte, et al.
(författare)
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Elevated Troponin Levels in Acute Stroke Patients Predict Long-term Mortality
- 2015
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Ingår i: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1052-3057 .- 1532-8511. ; 10, s. 285-286
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Forskningsöversikt (refereegranskat)abstract
- Background: Elevated plasma levels of troponin in acute stroke patients are common and have in several studies been shown to predict in-hospital and short-term mortality. Little is, however, known about the long-term prognosis of these patients. The aim of this study was to determine patient characteristics and 5-year mortality in patients with acute stroke and troponin elevation on admission. Methods: A retrospective cohort study of all consecutive patients with acute stroke and a plasma troponin I (TnI) analyzed on admission to Danderyd Hospital between January 1, 2005, and January 1, 2006 (n = 247). Patient characteristics were obtained from the Swedish National Stroke Register, Riksstroke, as well as hospital records. Mortality data were obtained from the Swedish Cause of Death Register. Results: There were 133 patients (54%) with TnI less than .03 mu g/L (normal), 74 patients (30%) with TnI .03-.11 mu g/L (low elevation), and 40 patients (16%) with TnI greater than .11 mu g/L (high elevation). TnI elevations were associated with a higher age, prior ischemic stroke, chronic heart failure, renal insufficiency, stroke severity, and ST segment elevation or depression on admission. The rate of hyperlipidemia decreased with increasing TnI. Adjusted for age and comorbidity, elevated TnI values on admission had a significantly and sustained increased mortality over the 5-year follow-up, with a hazard ratio of 1.90 (95% confidence interval, 1.33-2.70). Conclusions: Troponin elevation in patients with acute stroke, even when adjusted for several possible confounders, is associated with an almost 2-fold increased risk of 5-year mortality.
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