| 1. |
- Stegmayr, B G, et al.
(författare)
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Wegener granulomatosis in children and young adults. A case study of ten patients.
- 2000
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Ingår i: Pediatric nephrology (Berlin, West). - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X. ; 14:3, s. 208-13
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Tidskriftsartikel (refereegranskat)abstract
- This retrospective study reports seven children and three young adults (aged 11-30 years) who suffered from Wegener granulomatosis. Nine represent consecutive patients admitted to the Division of Nephrology over a period of 23 years. All patients had respiratory tract symptoms and renal involvement on admission. In several patients infiltrates on chest X-ray developed within 2 weeks of onset of symptoms. All patients survived. The median observation period was 9 years (range 13 months to 23 years). One patient progressed to end-stage renal disease. Nine patients initially received cyclophosphamide and steroids. After a median period of 9 months (range 6-31 months) the cyclophosphamide was replaced by azathioprine. Relapses occurred after a median of 28 months (range 4-120 months) in 80% of patients, in six of the eight patients causing a definite decrease in kidney function. We believe that early diagnosis and initiation of therapy reduce the extent of organ damage. Since relapses are frequent, these patients should be evaluated frequently.
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| 2. |
- Malm, J., et al.
(författare)
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Three-year survival and functional outcome of patients with idiopathic adult hydrocephalus syndrome
- 2000
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Ingår i: Neurology. - : Wolters Kluwer. - 0028-3878 .- 1526-632X. ; 55:4, s. 576-578
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Tidskriftsartikel (refereegranskat)abstract
- The functional outcome of 42 patients with idiopathic adult hydrocephalus syndrome (IAHS) was followed over a 3-year period after shunting. Survival curves were compared with those of age-matched healthy elderly subjects and patients with first-ever ischemic stroke. Twenty-seven patients with IAHS were improved 3 months after the operation and 11 remained improved at the 3-year follow-up. The case fatality in patients with stroke and those with IAHS was similar (32% versus 28%), but the relative risk of death among IAHS patients compared to a general elderly population was 3.3.
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| 3. |
- Mogren, I, et al.
(författare)
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Fetal exposure, heredity and risk indicators for cardiovascular disease in a Swedish welfare cohort.
- 2001
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Ingår i: International Journal of Epidemiology. - 0300-5771 .- 1464-3685. ; 30:4, s. 853-62
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Tidskriftsartikel (refereegranskat)abstract
- Our interpretation is that the 'fetal origins' hypothesis' is valid for middle-age subjects who grow up in a welfare society. The population attributable proportions that result from different exposures to LBW were relatively small overall; from a public health perspective, heredity was more important than LBW for elevated SBP.
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| 4. |
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| 5. |
- Vanholder, R, et al.
(författare)
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Uremic toxicity: present state of the art
- 2001
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Ingår i: The International journal of artificial organs. - : SAGE Publications. - 0391-3988 .- 1724-6040. ; 24:10, s. 695-725
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Tidskriftsartikel (refereegranskat)abstract
- The uremic syndrome is a complex mixture of organ dysfunctions, which is attributed to the retention of a myriad of compounds that under normal condition are excreted by the healthy kidneys (uremic toxins). In the area of identification and characterization of uremic toxins and in the knowledge of their pathophysiologic importance, major steps forward have been made during recent years. The present article is a review of several of these steps, especially in the area of information about the compounds that could play a role in the development of cardiovascular complications. It is written by those members of the Uremic Toxins Group, which has been created by the European Society for Artificial Organs (ESAO). Each of the 16 authors has written a state of the art in his/her major area of interest.
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| 6. |
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| 7. |
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| 8. |
- Hallmans, Göran, et al.
(författare)
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Cardiovascular disease and diabetes in the Northern Sweden Health and Disease Study Cohort : evaluation of risk factors and their interactions.
- 2003
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Ingår i: Scandinavian Journal of Public Health. Supplement Links. - : SAGE Publications. - 1403-4956 .- 1403-4948 .- 1651-1905. ; 61, s. 18-24
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this paper is, first, to describe the organization, sampling procedures, availability of samples/database, ethical considerations, and quality control program of the Northern Sweden Health and Disease Study Cohort. Secondly, some examples are given of studies on cardiovascular disease and diabetes with a focus on the biomarker programme. The cohort has been positioned as a national and international resource for scientific research.
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| 9. |
- Norda, R., et al.
(författare)
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Adverse events and problems in therapeutic hemapheresis. A report from the Swedish registry
- 2001
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Ingår i: Transfusion and apheresis science. - 1473-0502 .- 1878-1683. ; 25:1, s. 33-41
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Tidskriftsartikel (refereegranskat)abstract
- Background: Since 1996 adverse events (AE) in therapeutic apheresis (TA) have been more extensively registered in Sweden. This report analyzes the extent and relation of AEs to procedures and diagnoses. Materials and methods: Reporting of TA performed in Sweden was centralized. A separate system for the registration of AE in TA was established and the data received were entered into a central database for registration and analyses. Fifteen of all 35 apheresis units reported both TA and AE during 1996-1999. These centers performed 75% of all TA procedures. Adverse events included medical symptoms, vascular access problems, technical and other problems. Results: More than 14,000 procedures were registered during the observation period. No fatalities occurred. AEs occurred in 3.7% (1996), 4.6% (1997), 4.2% (1998) and 4.4% (1999) of procedures. Interventions during the adverse event were performed in about 65% of the events. Apheresis procedures were interrupted due to an adverse event in about 1%. Adverse events occurred in 5.6% of plasma exchanges, 1.9% of plasma modulations and 6.8% of cytapheresis procedures. Paresthesia was registered in 22% and hypotensive events in 20.5%. Other more frequent symptoms were urticaria (14.4%), shivering (7.4%) and nausea (7.4%). AEs were most frequent in patients with Goodpasture's syndrome (12.5%), TTP/HUS (10.5%) and GuillainBarré syndrome (11.0%). Conclusion: AEs are few, often mild and less common in plasma modulation than plasma exchange. AEs are more frequent during TA of patients with certain diagnoses such as TTP/HUS. Copyright © 2001 Elsevier Science Ltd.
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| 10. |
- Rydvall, A., et al.
(författare)
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Plasma cortisol is often decreased in patients treated in an intensive care unit
- 2000
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Ingår i: Intensive Care Med. ; 26:5, s. 545-51
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the prevalence of adrenal hypofunction, as assessed by plasma cortisol (p-cortisol) and its relationship to clinical events. DESIGN: Prospective, consecutive. SETTING: General intensive care unit in a university hospital. PATIENTS: Fifty-five patients (34 men and 21 women) were studied (surgery 40 patients, hemodialysis 5, ventilator treatment 45, sepsis 21). METHODS: Morning basal levels of p-cortisol were determined. Previous reports define adrenal insufficiency to be present if p-cortisol under stressful conditions is lower than either 400 or 500 nmol/l. The tetracosactoid test (250 microg Synacthen) was performed in 16 patients and urinary 24-h excretion of cortisol in 24 (none on corticosteroid treatment). RESULTS: Median p-cortisol was 550 nmol/l (range 20-1764). In 36% of patients p-cortisol was lower than 400 nmol/l and in 47% lower than 500 nmol/l. There was a significantly increased probability (P < 0.05) of p-cortisol being below 400 nmol/l in patients admitted due to trauma or cerebral disorder and in patients on ventilator therapy or on mannitol. Thirty minutes after tetracosactoid administration p-cortisol response was lower than 200 nmol/l in 56% of the patients. CONCLUSIONS: Several patients had low p-cortisol and attenuated responses to tetracosactoid, indicative of adrenal insufficiency. There seem to be certain risk factors for adrenal hypofunction which may justify more frequent use of physiological doses of corticosteroid in selected patients.
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| 11. |
- Stegmayr, B. G., et al.
(författare)
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Plasma exchange as rescue therapy in multiple organ failure including acute renal failure
- 2003
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Ingår i: Crit Care Med. ; 31:6, s. 1730-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the outcome of using a rescue therapy including plasma exchange given to patients with a progressive acute disseminated intravascular coagulation and multiple organ dysfunction syndrome. STUDY DESIGN: Retrospective study. SETTING: University and county hospital. PATIENTS: Included were 76 consecutive patients (41 men and 35 women) treated with plasma exchange as rescue therapy besides optimal conventional therapy during a progressive course of disseminated intravascular coagulation and multiple organ dysfunction syndrome, including acute renal failure. Of the 76 patients, 66% needed dialysis. The distribution was hemodialysis in 76%, continuous arteriovenous hemofiltration in 36%, continuous venovenous hemodialysis in 12%, and peritoneal dialysis in 24%. The median organ-failure score was 5 (range, 1-6). Seventy-two percent required mechanical ventilation; septic shock was present in 88%. The median septic shock score was 4 (range, 2-4). Nine patients had another reason than sepsis for the multiple organ dysfunction syndrome. INTERVENTION: Plasma exchange (centrifugation technique) was performed until disseminated intravascular coagulation was reversed (median, two times; range, 1-14). Besides antibiotics and fluid administration, most patients received heparin or low molecular weight heparin (77%), steroids (87%), and inotropes (88%). More than one vasoactive drug was used in 57% of the patients. MEASUREMENTS AND MAIN RESULTS: Eighty-two percent of the patients survived and could leave the hospital. The previously observed survival rates by others for this category of patients would be <20%, and thus, the outcome in this study is significantly better. CONCLUSION: Plasma exchange using plasma as replacement may, in addition to conventional intensive care, help to reverse severe progressive disseminated intravascular coagulation and multiple organ dysfunction syndrome and improve survival.
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| 12. |
- Stegmayr, Bernd, et al.
(författare)
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World apheresis registry
- 2004
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Ingår i: International Journal of Artificial Organs. - Milano : Wichtig Editore. - 0391-3988 .- 1724-6040. ; 27:7, s. 589-
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Tidskriftsartikel (refereegranskat)
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| 13. |
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