| 1. |
- Skoogh, Johanna, 1975, et al.
(författare)
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Testicular-cancer survivors experience compromised language following chemotherapy: Findings in a Swedish population-based study 3-26 years after treatment.
- 2012
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Ingår i: Acta oncologica. - 0284-186X .- 1651-226X. ; 51:2, s. 185-197
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background. Studies suggest an increased risk for compromised cognitive function among cancer survivors. It is unclear to what extent chemotherapy is the cause and how the dysfunction, when present, affects everyday life. The objective was to study self-reported behaviours that may depend on cognitive function, among testicular-cancer survivors who received various cycles of cisplatin-based chemotherapy by comparing them with those who did not. Material and methods. We identified 1173 eligible men diagnosed with non-seminomatous testicular cancer treated according to the national cancer-care programs SWENOTECA I-IV between 1981 and 2004. During an 18-month qualitative phase we constructed a study-specific questionnaire including questions about specific activities and behaviour in everyday life. Results. We obtained information from 960 of 1173 (82%) testicular-cancer survivors diagnosed on average 11 years previously. The prevalence of "saying similar but incorrect words" at least once a week was 5% among those having received no chemotherapy versus 16% among those having received five or more cycles, giving a prevalence ratio ("relative risk", RR) of 3.3 with a 95% confidence interval of 1.5 to 7.1. The corresponding figure for "saying words in the wrong order" was 3.1 (1.7-5.8), for "difficulties understanding what other people mean" 3.1 (1.3-7.7), for "saying words other than planned" 2.2 (1.1-4.5) and for "difficulties completing sentences" 2.0 (1.0-3.6). The relative risks for those with a low level of education ranged between 4.9 (1.6-14.9) and 15.3 (1.9-120.5). Conclusion. Testicular-cancer survivors in Sweden who have received five or more cycles of cisplatin-based chemotherapy experience an increased incidence of long-term compromised language; the effect is primarily seen among men with a low level of education.
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| 2. |
- Akner, Gunnar, 1953-, et al.
(författare)
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Glucocorticoid receptor inhibits microtubule assembly in vitro.
- 1995
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Ingår i: Molecular and cellular endocrinology. - : Elsevier BV. - 0303-7207 .- 1872-8057. ; 110:1-2, s. 49-54
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Tidskriftsartikel (refereegranskat)abstract
- The effect of glucocorticoid hormones, purified glucocorticoid receptor (GR) and purified heat shock protein M(r) 90,000 (hsp90) on microtubule (MT) assembly in vitro was tested by a spectrophotometric MT assembly assay and electron microscopy. GR significantly prolonged the nucleation phase, slowed down the assembly rate and reduced the maximal amplitude of MT assembly compared with control. The effects were partially reversed by the addition of glucocorticoid hormone. GR associated with MTs. These results indicate that GR affects MT assembly in vitro, which may be a functional correlate to the structural association of GR with MTs. This implies that factors affecting GR may affect MT assembly in vivo.
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| 3. |
- Berg, Marie, 1955, et al.
(författare)
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Early random capillary glucose level screening and multidisciplinary antenatal teamwork to improve outcome in gestational diabetes mellitus
- 2007
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Ingår i: Acta Obstet Gynecol Scand. ; 86:3, s. 283-90
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study describes maternal and neonatal characteristics and delivery outcome in women with gestational diabetes mellitus [GDM], compared to a control group. METHODS: A retrospective observational study of 719 women with GDM was undertaken in a Swedish urban district. All other parturients at the same hospital served as the control group. GDM was diagnosed using random capillary glucose levels at fixed intervals, beginning early in pregnancy. An oral glucose tolerance test was performed at glucose levels>or=7.0 mmol/l (127.8 mg/dl). Data was analysed according to glucose levels at diagnosis, ie, mild or severe GDM. RESULTS: GDM was diagnosed in 2.28% of the women who were older and had higher Body Mass Index [BMI]. A high proportion was of non-Nordic origin (44.5%); they had severe GDM more often (49.1%) than the Nordic group (33.1%). The GDM-mild group had less complications and abnormalities, compared to the GDM-severe group, although both groups differed from the control group in this respect. Delivery was spontaneous in 70.2% of GDM-mild, 65.7% of GDM-severe and 81.0% of the control group. LGA (+2 SD) was found in 4.8, 10.5 and 3.2%, respectively. CONCLUSION: Early non-fasting random universal screening and multidisciplinary antenatal teamwork intervention seems to be favourable, with low rates of excessive fetal growth, instrumental vaginal delivery and caesarean section.
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| 4. |
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| 5. |
- Bergh, Ingrid, 1956, et al.
(författare)
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Comparison of the PainMatcher and the Visual Analogue Scale for assessment of labour pain following administered pain relief treatment.
- 2011
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Ingår i: Midwifery. - : Elsevier BV. - 1532-3099 .- 0266-6138. ; 27:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: during childbirth, it is necessary to assess and monitor experienced pain and to evaluate the effect of pain relief treatment. The aim of this study was to compare the PainMatcher((R)) (PM) with the Visual Analogue Scale (VAS) for the assessment of labour pain and the effect of pain relief treatment. DESIGN: randomised controlled trial. SETTING: labour ward with approximately 2500 childbirths per year in western Sweden. PARTICIPANTS: 57 women with labour pain treated with acupuncture or sterile water injections scored their electrical pain threshold and pain intensity with the PM. Pain intensity was also assessed with the VAS. Electrical pain threshold and pain intensity were assessed immediately after a uterine contraction before and 30, 60, 90, 120, 150 and 180minutes after treatment. MEASUREMENTS AND FINDINGS: the results showed a weak correlation (r=0.13, p<0.05) between the pain intensity scores on the PM and the VAS. The PM detected changes (decrease) in pain intensity to a lower degree than the VAS. Surprisingly, in over 10% of sessions, women scored their pain intensity during a uterine contraction lower than their electrical pain threshold with the PM. However, electrical pain thresholds with the PM correlated well throughout all measurements. CONCLUSIONS: the PM is a reliable tool for the assessment of electrical pain threshold; however, the VAS is more sensitive than the PM for recording changes in pain intensity when assessing the effects of treatment on labour pain. IMPLICATIONS FOR PRACTICE: the PM and the VAS are not interchangeable in the case of labour pain, and there is still a need for research in this area to find a more suitable assessment instrument for the evaluation of labour pain.
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| 6. |
- Eckerström, Marie, 1981, et al.
(författare)
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Sahlgrenska Academy Self-reported Cognitive Impairment Questionnaire (SASCI-Q) - a research tool discriminating between subjectively cognitively impaired patients and healthy controls.
- 2013
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Ingår i: International psychogeriatrics / IPA. - 1741-203X. ; 25:3, s. 420-430
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT Background: Subjective cognitive impairment (SCI) is a potential early marker for actual cognitive decline. The cognitive manifestation of the SCI stage is, however, largely unknown. Self-report instruments developed especially for use in the SCI population are lacking, and many SCI studies have not excluded mild cognitive impairment and dementia. We developed and tested a patient-based questionnaire on everyday cognitive function aiming to discriminate between patients with subjective, but not objective, cognitive impairment and healthy controls. Methods: Individuals experiencing cognitive impairment were interviewed to generate a pool of items. After condensing to 97 items, we tested the questionnaire in 93 SCI patients seeking care at a memory clinic (age M = 64.5 years, Mini-Mental State Examination (MMSE) M = 29.0) and 50 healthy controls (age M = 69.6 years, MMSE M = 29.3). Further item reduction was conducted to maximize that remaining items would discriminate between SCI patients and controls, using a conservative α level and requiring medium to high effect sizes. Internal consistency reliability and convergent validity was subsequently examined. Results: Forty-five items discriminated between the groups, resulting in the Sahlgrenska Academy Self-reported Cognitive Impairment Questionnaire (SASCI-Q). Internal consistency was high and correlations to a single question on memory functioning were of medium to large sizes. Most remaining items were related to the memory domain. Conclusion: The SASCI-Q discriminates between SCI patients and healthy controls and demonstrates satisfying psychometric properties. The instrument provides a research method for examining SCI and forms a foundation for future examining which SCI symptoms predict objective cognitive decline. The cognitive manifestation of the SCI stage is mostly related to experiences of memory deficits.
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| 7. |
- Eilegård Wallin, Alexandra, 1975-, et al.
(författare)
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Bereaved siblings' perception of participating in research : a nationwide study
- 2013
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Ingår i: Psycho-Oncology. - : John Wiley & Sons. - 1057-9249 .- 1099-1611. ; 22:2, s. 411-416
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe objective of the present study is to examine bereaved siblings' perception of research participation.MethodsA Swedish nationwide study on avoidable and modifiable health care‐related factors in paediatric oncology among bereaved siblings who lost a brother or sister to cancer between the years 2000 and 2007 was conducted. Data are presented as proportions, and the differences between groups were statistically tested at the 5% significant level using Fisher's exact test.ResultsOut of 240 eligible siblings, 174 responded (73 %). None of the siblings (0/168) thought their participation would affect them negatively in the long term. However, 13% (21/168) stated it was a negative experience to fill out the questionnaire, whereas 84% (142/169) found it to be a positive experience. Women were more likely to report their participation as positive in a long‐term perspective compared with men (p = 0.018).ConclusionsNone of the bereaved siblings in this Swedish nationwide study anticipated any long‐term negative effect from their research participation. A majority reported it as positive to revisit their needs and experiences throughout their brother or sister's illness and death 2–9 years following the loss. We believe that the stepwise approach used in this study contributed to the high acceptance.
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| 8. |
- Eilegård Wallin, Alexandra, 1975-, et al.
(författare)
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Insufficient communication and anxiety in cancer-bereaved siblings : a nationwide long-term follow-up
- 2016
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Ingår i: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; October, s. 488-494
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of this study was to examine siblings’ long-term psychological health in relation to their perception of communication with their family, friends, and healthcare professionals during a brother or sister's last month of life.Method: A nationwide questionnaire study was conducted during 2009 in Sweden of individuals who had lost a brother or sister to cancer within the previous two to nine years. Of the 240 siblings contacted, 174 (73%), participated. The Hospital Anxiety and Depression Scale (HADS) was employed to assess psychological health (anxiety). The data are presented as proportions (%) and relative risks (RR) with a 95% confidence interval (CI 95%).Results: Siblings who were not satisfied with the amount they talked about their feelings with others during their brother or sister's last month of life were more likely to report anxiety (15/58, 26%) than those who were satisfied (13/115, 11%; RR = 2.3(1.2–4.5)). The same was true for those who had been unable to talk to their family after bereavement (RR = 2.5(1.3–4.8)). Avoiding healthcare professionals for fear of being in their way increased siblings’ risk of reporting anxiety at follow-up (RR = 2.2(1.1–4.6)), especially avoidance in the hospital setting (RR = 6.7(2.5–18.2)). No such differences were seen when the ill brother or sister was cared for at home.Significance of results: Long-term anxiety in bereaved siblings might be due to insufficient communication. Avoiding healthcare professionals, especially when the brother or sister is cared for at the hospital, may also increase the risk of anxiety.
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| 9. |
- Eilegård Wallin, Alexandra, 1975-, et al.
(författare)
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Psychological health in siblings who lost a brother or sister to cancer 2 to 9 years earlier
- 2013
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Ingår i: Psycho-Oncology. - : Wiley-Blackwell. - 1057-9249 .- 1099-1611. ; 22:3, s. 683-691
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The objective of this study was to assess long-term psychological distress in siblings who lost a brother or sister to cancer 2 to 9 years earlier, as compared with a control group of non-bereaved siblings from the general population.METHODS: During 2009, we conducted a nationwide follow-up study in Sweden by using an anonymous study-specific questionnaire. Siblings who had lost a brother or sister to cancer between the years 2000 and 2007 and also a control group of non-bereaved siblings from the general population were invited to participate. The Hospital Anxiety and Depression Scale (HADS) was used to measure psychological distress, and to test for differences in the ordinal outcome responses between the groups, we used Wilcoxon-Mann-Whitney rank-sum test.RESULTS: Among the bereaved siblings, 174/240 (73%) participated and 219/293 (75%) among the non-bereaved. Self-assessed low self-esteem (p = 0.002), difficulties falling asleep (p = 0.005), and low level of personal maturity (p = 0.007) at follow-up were more prevalent among bereaved siblings. However, anxiety (p = 0.298) and depression (p = 0.946), according to HADS, were similar.CONCLUSION: Bereaved siblings are at increased risk of low self-esteem, low level of personal maturity and difficulties falling asleep as compared with non-bereaved peers. Yet, the bereaved were not more likely to report anxiety or depression.
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| 10. |
- Eilertsen, M. E. B., et al.
(författare)
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Impact of Social Support on Bereaved Siblings' Anxiety: A Nationwide Follow-Up
- 2013
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Ingår i: Journal of Pediatric Oncology Nursing. - : SAGE Publications. - 1043-4542 .- 1532-8457. ; 30:6, s. 301-310
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:To assess adolescent and young adult siblings' perception of social support prior to and following the loss of their brother or sister to cancer, 2 to 9 years earlier, and their anxiety at follow-up. Method: In 2009, 174 (73%) bereaved siblings (12-25 years) participated in a nationwide, long-term follow-up study in Sweden using an anonymous study-specific questionnaire. The Hospital Anxiety and Depression Scale was used to measure self-assessed anxiety. Results: Siblings had a higher risk of anxiety if they perceived their need for social support was unsatisfied during their brother or sisters' last month before death, relative risk (RR) = 3.6 (95% confidence interval [CI] = 1.8-7.3); time after death, RR = 2.9 (95% CI = 1.5-5.6); and at follow-up, RR = 3.8 (95% CI = 2.0-7.2). Furthermore, a higher risk for anxiety was shown for siblings if they did not perceive that their parents and neighbors cared for them after their brother or sisters' death, RR = 2.7 (95% CI = 1.3-5.5), RR = 5.4 (95% CI = 1.3-21.9), respectively. Conclusion: Bereaved siblings had a greater probability to report self-assessed anxiety if they perceived that their need for social support was not satisfied prior to and following death. Information from both nurses and other health care professionals to families about the impact of social support may contribute to lessen the siblings' risk of anxiety.
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| 11. |
- Hart, E. C., et al.
(författare)
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Recording sympathetic nerve activity in conscious humans and other mammals: guidelines and the road to standardization
- 2017
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Ingår i: American Journal of Physiology-Heart and Circulatory Physiology. - : American Physiological Society. - 0363-6135 .- 1522-1539. ; 312:5
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Tidskriftsartikel (refereegranskat)abstract
- Over the past several decades, studies of the sympathetic nervous system in humans, sheep, rabbits, rats, and mice have substantially increased mechanistic understanding of cardiovascular function and dysfunction. Recently, interest in sympathetic neural mechanisms contributing to blood pressure control has grown, in part because of the development of devices or surgical procedures that treat hypertension by manipulating sympathetic outflow. Studies in animal models have provided important insights into physiological and pathophysiological mechanisms that are not accessible in human studies. Across species and among laboratories, various approaches have been developed to record, quantify, analyze, and interpret sympathetic nerve activity (SNA). In general, SNA demonstrates "bursting" behavior, where groups of action potentials are synchronized and linked to the cardiac cycle via the arterial baroreflex. In humans, it is common to quantify SNA as bursts per minute or bursts per 100 heart beats. This type of quantification can be done in other species but is only commonly reported in sheep, which have heart rates similar to humans. In rabbits, rats, and mice, SNA is often recorded relative to a maximal level elicited in the laboratory to control for differences in electrode position among animals or on different study days. SNA in humans can also be presented as total activity, where normalization to the largest burst is a common approach. The goal of the present paper is to put together a summary of "best practices" in several of the most common experimental models and to discuss opportunities and challenges relative to the optimal measurement of SNA across species.
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| 12. |
- Lövgren, Malin, et al.
(författare)
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Care at end of life influences grief : A nationwide long-term follow-up among young adults who lost a brother or sister to childhood cancer
- 2018
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Ingår i: Journal of Palliative Medicine. - Larchmont, New York : Mary Ann Liebert Inc. - 1096-6218 .- 1557-7740. ; 21:2, s. 156-162
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A majority of cancer-bereaved siblings report long-term unresolved grief, thus it is important to identify factors that may contribute to resolving their grief.OBJECTIVE: To identify modifiable or avoidable family and care-related factors associated with unresolved grief among siblings two to nine years post loss.DESIGN: This is a nationwide Swedish postal survey.MEASUREMENTS: Study-specific questions and the standardized instrument Hospital Anxiety and Depression Scale. Primary outcome was unresolved grief, and family and care-related factors were used as predictors.SETTING/PARTICIPANTS: Cancer-bereaved sibling (N = 174) who lost a brother/sister to childhood cancer during 2000-2007 in Sweden (participation rate 73%). Seventy-three were males and 101 females. The age of the siblings at time of loss was 12-25 years and at the time of the survey between 19 and 33 years.RESULTS: Several predictors for unresolved grief were identified: siblings' perception that it was not a peaceful death [odds ratio (OR): 9.86, 95% confidence interval (CI): 2.39-40.65], limited information given to siblings the last month of life (OR: 5.96, 95% CI: 1.87-13.68), information about the impending death communicated the day before it occurred (OR: 2.73, 95% CI: 1.02-7.33), siblings' avoidance of the doctors (OR: 3.22, 95% CI: 0.75-13.76), and lack of communication with family (OR: 2.86, 95% CI: 1.01-8.04) and people outside the family about death (OR: 5.07, 95% CI: 1.64-15.70). Depressive symptoms (OR: 1.27, 95% CI: 1.12-1.45) and time since loss (two to four years: OR: 10.36, 95% CI: 2.87-37.48 and five to seven years: OR: 8.36, 95% CI: 2.36-29.57) also predicted unresolved grief. Together, these predictors explained 54% of the variance of unresolved grief.CONCLUSION: Siblings' perception that it was not a peaceful death and poor communication with family, friends, and healthcare increased the risk for unresolved grief among the siblings.
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| 13. |
- Mårtensson, Lena, 1958, et al.
(författare)
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Acupuncture versus subcutaneous injections of sterile water as treatment for labour pain
- 2008
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Ingår i: Acta Obstetricia et Gynecologica. - : Wiley. - 0001-6349 .- 1600-0412. ; 87, s. 171-177
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Tidskriftsartikel (refereegranskat)abstract
- Background. Two methods for pain relief and relaxation during labour are sterile water injections and acupuncture. In several studies, sterile water injections have been shown to provide good pain relief, particularly for low back pain during labour. The acupuncture studies for pain relief during labour are not as concordant. Therefore, the aim of this study was to explore if there were any differences between acupuncture and sterile water injections regarding pain relief and relaxation during labour. Methods. A randomised controlled trial. Some 128 pregnant women at term were randomly assigned to receive acupuncture (no 62) sterile water injections (no. 66). The primary endpoint was to compare the differences between pre-treatment pain levels and maximum pain in the 2 groups. Results. The main results of this study were that sterile water injections yielded greater pain relief (pB0.001) during childbirth compared to acupuncture. The secondary outcome showed that women in the sterile water group had a higher degree of relaxation (pB0.001) compared to the acupuncture group. The women’s own assessment of the effects also favoured sterile water injections (pB0.001). There were no significant differences regarding requirements for additional pain relief after treatment between the 2 groups. Conclusions. Women given sterile water injection experience less labour pain compared to women given acupuncture.
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| 14. |
- Mårtensson, Lena, et al.
(författare)
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Sterile water injections as treatment for low-back pain during labour : A review
- 2008
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Ingår i: Australian and New Zealand journal of obstetrics and gynaecology. - : Blackwell Publishing. - 0004-8666 .- 1479-828X. ; 48:4, s. 369-374
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Forskningsöversikt (refereegranskat)abstract
- Background: Some women have severe low-back pain during childbirth. It has been shown that sterile water injections reduce this pain. This method, which is easy to learn and very cheap can be a good pain relief alternative primarily in countries with limited available pain relief options. Aims: The aim of this article was to describe published research concerning sterile water injections for treatment of low-back pain during labour. Methods: Three databases were searched from their inception until February, 2008. The inclusion criteria were trials elucidating the pain relief effect of sterile water injections during childbirth. The search terms were labour, birth, obstetrics, parturient, pregnancy, pain relief, analgesia, injection, papules, blocks and sterile water. The computerised literature searches yielded 64 trials, 55 of which failed to meet our inclusion criteria. We used the Jadad Score Instrument to assess the quality of the remaining nine articles, of which six were of adequate quality. Results: All studies in this review had similar alms, designs and measurement instruments and they reported good pain relief particularly, for low-back pain during childbirth. In all studies the pain score reduction is approximately, 60% and the effect remains up to two hours. Conclusions: Sterile water injections seem to be a good alternative for low-back pain during childbirth.
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| 15. |
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| 16. |
- Nilsson, Erik, 1983-, et al.
(författare)
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Evaluating humidity and sea salt disturbances on CO2 flux measurements
- 2018
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Ingår i: Journal of Atmospheric and Oceanic Technology. - 0739-0572 .- 1520-0426. ; 35, s. 859-875
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Tidskriftsartikel (refereegranskat)abstract
- Global oceans are an important sink of atmospheric carbon dioxide (CO2). Therefore, understanding the air-sea flux of CO2 is a vital part in describing the global carbon balance. Eddy covariance (EC) measurements are often used to study CO2 fluxes from both land and ocean. CO2 are usually measured with infrared absorption sensors, which at the same time measure water vapor. Studies have shown that presence of water vapor fluctuations in the sampling air potentially result in erroneous CO2 flux measurements due to cross-sensitivity of the sensor. Here we compare measured CO2 fluxes from both enclosed path Li-Cor 7200 sensors and open-path Li-Cor 7500 instruments from an inland measurement site and a marine site. We also introduce new quality control criteria based upon a Relative Signal Strength Indicator (RSSI). The sampling gas in one of the Li-Cor 7200 instruments was dried by means of a multi-tube diffusion dryer so that the water vapor fluxes were close to zero. With this setup we investigated the effect that cross-sensitivity of the CO2 signal to water vapor can have on the CO2 fluxes. The dryer had no significant effect on the CO2 fluxes. We tested the hypothesis that the cross-sensitivity effect is caused by hygroscopic particles such as sea salt by spraying a saline solution on the windows of the Li-Cor 7200 instruments during the inland field test. Our results confirm earlier findings that sea salt contamination can affect CO2 fluxes significantly and confirm earlier findings, that drying the sampling air for the gas analyzer is an effective method to reduce this signal contamination.
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| 17. |
- Selin, Lotta, et al.
(författare)
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Dystocia in labour - risk factors, management and outcome: a retrospective observational study in a Swedish setting
- 2008
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 87:2, s. 216-221
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Tidskriftsartikel (refereegranskat)abstract
- Background. Labour dystocia (LD) is associated with adverse maternal and child outcomes. This study investigated obstetric risk factors, frequency of interventions and delivery outcomes for LD. Methods. A retrospective, observational, study of 1,480 deliveries was undertaken in a Swedish district hospital during 2000 and 2001. Results. LD was identified in 21% of deliveries, 16.7% of which ended in caesarean section (CS) compared to 1.7% of deliveries without LD. Multiparity with no previous vaginal delivery (OR = 6.0), epidural analgesia (EDA) at cervical dilation ≤5 cm (OR = 4.6), primiparity (OR = 4.5), gestational age ≥42 weeks (OR = 3.1), birth weight >4,000 g (OR = 2.7) and EDA at cervical dilation >5 cm (OR = 2.0) were major independent risk factors for LD. Conclusions. In delivery management, special attention should be directed to primiparous women and multiparous women with no previous vaginal delivery. Women given EDA, especially at cervical dilation ≤5 cm are also of particular interest. Furthermore, rigorous routines for LD diagnosis and oxytocin augmentation are important.
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| 18. |
- Selin, Lotta, et al.
(författare)
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High dose versus low dose oxytocin for augmentation of delayed labour, a randomized controlled trial
- 2014
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Ingår i: Optimizing childbirth across Europe - an intedisciplinary maternity care conference. 9-10 April 2014, Brussels. Part of COST Action IS0907: Childbirth Cultures, Concerns & Consequences: Creating a dynamic EU framework for Optimal maternity care..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Delay in labour due to ineffective uterine contractions is a major problem in obstetric care and a main reason for the increased rate of caesarean deliveries, particularly among nulliparous women. Infusion with synthetic oxytocin is a commonly used treatment of hypotonic uterine contractions however there is a gap of knowledge concerning which dosage of oxytocin should be used, both starting dose and increment dose of oxytocin. Aim of the study: The aim is to compare starting dose and increment of amount of oxytocin for augmentation of delayed labour to determine whether augmentation by high dose of oxytocin improves labour outcomes compared with a low dose of oxytocin, without affecting neonatal or maternal outcomes including birth experiences negatively. Research methodology: In a randomized double-blind controlled trial conducted in three labour wards in Sweden, consenting nulliparous women in active labour and with a defined delayed progress are randomized to receive a regimen of either high dose or low dose of oxytocin (33.2 respectively 16,6 microgram oxytocin in 1000 ml isotone saline solution). randomization will be computer-generated, with allocation concealment by a coding system. Primary outcome is caesarean delivery rate. Based on a sample size calculation (α=0.05, β=0.80), a minimum of 688 women will be included in each group in order to reduce caesarean section rate from 17.5 % to 12 %. Ethical approval: The study is approved by the regional Ethics Board in Gothenburg (dnr: 090-12), and by the medical Products Agency –Sweden (Eudra-CTnr:2012-000356-33). Study finding: This poster will describe the study protocol and the first period of data collection. Results will concern: 1) maternal and fetal outcomes in randomized groups, and 2) maternal overall childbirth experience including labour pain. Conclusion: The study will contribute to establishment of evidencebased routines regarding oxytocin treatment of delayed labour progress.
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| 19. |
- Selin, Lotta, et al.
(författare)
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High Dose versus Low Dose Oxytocin for Augmentation of Delayed Labour: a randomized controlled trial
- 2016
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Ingår i: NJF (Nordiskt Jordemoderförbund) Congress. Programme and abstracts. Gothenburg, May 12-14, 2016. - 9789163742699
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Delay in labour due to ineffective uterine contractions is a major problem in obstetric care and a main reason for the increased rate of caesarean deliveries, particularly among nulliparous women. Infusion with synthetic oxytocin is a commonly used treatment of hypotonic uterine contractions however there is a gap of knowledge concerning which dosage of oxytocin should be used, both starting dose and increment dose of oxytocin. Aim To compare dosage of oxytocin treatment in nulliparous women with delayed labour progress in active phase of labour. The hypothesis is that augmentation by high dose of oxytocin improves labour outcomes compared with a low dose of oxytocin, without affecting neonatal or maternal outcomes including birth experiences negatively. Methods In a randomized double-blind controlled trial conducted in six labour wards in Sweden, consenting nulliparous women in active labour and with a defined delayed progress are randomized to receive a regimen of either high dose or low dose of oxytocin (33.2 respectively 16,6 microgram oxytocin in 1000 ml isotone saline solution). Randomization is computergenerated, with allocation concealment by a coding system. Primary outcome is caesarean delivery rate. Based on a sample size calculation (α=0.05, β=0.80), a minimum of 1 045 women will be included in each group in order to reduce caesarean section rate from 17.5 % to 13 %. The study is approved by the regional Ethics Board in Gothenburg (dnr: 090-12), by the Medical Products Agency –Sweden (Eudra-CTnr:2012-00035633) and registered at ClinicalTrials.gov. Identifier: NCT01587625. Results Data collection started 15th of August 2013 and data is still under collection. This presentation will describe the study protocol and the first half period of the data collection. Conclusion The study will contribute to establishment of evidence based routines regarding oxytocin treatment of delayed labour progress.
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| 20. |
- Selin, Lotta, et al.
(författare)
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Use and abuse of oxytocin for augmentation of labor.
- 2009
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 88:12, s. 1352-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the use of oxytocin for augmentation of labor and its relation to labor progress and delivery outcome. DESIGN AND SETTING: A retrospective observational study undertaken in a Swedish hospital during 2000-2001. SAMPLE: Singleton pregnancies at > or = 37 weeks of gestation with cephalic presentation and spontaneous onset of labor. METHODS: Data were collected from 1,263 clinical records. The partogram was used to diagnose labor dystocia (LD). MAIN OUTCOME MEASURES: Prevalence of oxytocin administration, LD and operative delivery. RESULTS: Oxytocin was administered to 55% of the women (75% of primiparas and 38.1% of multiparas); a majority did not meet LD criteria. LD frequency was 19.8% (32.7% in primiparas and 7.4% in multiparas). Oxytocin was started both 'too early' and 'too late' in relation to the diagnosis of LD. Cesarean section (CS) was performed on 17.1% of primiparous and 2.4% of multiparous oxytocin recipients with LD, compared to 2.3 and 1.5%, respectively, of oxytocin recipients without diagnosed LD. CONCLUSIONS: Oxytocin augmentation was undertaken in an unstructured manner; some women were inadequately treated and others were treated unnecessarily. Oxytocin recipients with LD underwent operative delivery to a higher extent than oxytocin recipients without LD, suggesting that the main reason for CS was the underlying problem of LD rather than the oxytocin augmentation itself.
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| 21. |
- Sveen, Josefin, et al.
(författare)
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They still grieve : a nationwide follow‐up of young adults 2–9 years after losing a sibling to cancer
- 2014
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Ingår i: Psycho-Oncology. - : John Wiley & Sons. - 1057-9249 .- 1099-1611. ; 23:6, s. 658-664
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aims of this study were to assess the prevalence of unresolved grief in bereaved young adult siblings and examine possible contributing factors.Methods: The study was a Swedish population-based study of young adults who had lost a brother or sister to cancer, 2-9 years earlier. Of 240 eligible siblings, 174 (73%) completed a study-specific questionnaire. This study focused on whether the respondents had worked through their grief over the sibling's death and to what extent.Results: A majority (54%) of siblings stated that they had worked through their grief either 'not at all' or 'to some extent' at the time of investigation. In multiple regression analyses with unresolved grief as the dependent variable, 21% of the variance was explained by lack of social support and shorter time since loss.Conclusion: The majority of bereaved young adults had not worked through their grief over the sibling's death. A small group of siblings reported that they had not worked through their grief at all, which may be an indicator of prolonged grief. Lack of social support and more recent loss were associated with not having worked through the grief over the sibling's death. Keywords: bereavement; cancer; grief; oncology; sibling loss; young adult loss.
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| 22. |
- von Otter, Malin, 1978, et al.
(författare)
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Kinesin Light Chain 1 Gene Haplotypes in Three Conformational Diseases
- 2010
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Ingår i: NeuroMolecular Medicine. - : Springer Science and Business Media LLC. - 1535-1084 .- 1559-1174. ; 12:3, s. 229-236
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Tidskriftsartikel (refereegranskat)abstract
- A functional intracellular transport system is essential to maintain cell shape and function especially in elongated cells, e.g. neurons and lens fibre cells. Impaired intracellular transport has been suggested as a common pathological mechanism for age-related diseases characterised by protein aggregation. Here, we hypothesise that common genetic variation in the transport protein kinesin may influence the risk of Parkinson's disease (PD), Alzheimer's disease (AD) and age-related cataract. This case-control study involves a PD material (165 cases and 190 controls), an AD material (653 cases and 845 controls) and a cataract material (495 cases and 183 controls). Genetic variation in the kinesin light chain 1-encoding gene (KLC1) was tagged by six tag single nucleotide polymorphisms (SNPs). Single SNPs and haplotypes were analysed for associations with disease risk, age parameters, mini-mental state examination scores and cerebrospinal fluid biomarkers for AD using logistic or linear regression. Genetic variation in KLC1 did not influence risk of PD. Weak associations with risk of AD were seen for rs8007903 and rs3212079 (P (c) = 0.04 and P (c) = 0.02, respectively). Two SNPs (rs8007903 and rs8702) influenced risk of cataract (P (c) = 0.0007 and P (c) = 0.04, respectively). However, the allele of rs8007903 that caused increased risk of AD caused reduced risk of cataract, speaking against a common functional effect of this particular SNP in the two diseases. Haplotype analyses did not add significantly to the associations found in the single SNP analyses. Altogether, these results do not convincingly support KLC1 as a major susceptibility gene in any of the studied diseases, although there is a small effect of KLC1 in relation to cataract.
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| 23. |
- Wallerstedt Lantz, Anna, et al.
(författare)
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90-Day readmission after radical prostatectomy—a prospective comparison between robot-assisted and open surgery
- 2019
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 53:1, s. 26-33
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: All types of surgery are associated with complications. The debate is ongoing whether robot-assisted radical prostatectomy can lower this risk compared to open surgery. The objective of the present study was to evaluate post-operative adverse events leading to readmissions, using clinical records to classify these adverse events systematically. Materials and methods: A prospective controlled trial of men who underwent robot-assisted laparoscopic (RALP) or retropubic radical prostatectomy (RRP) at 14 departments of Urology (LAPPRO) between 2008 and 2011. Data on all readmissions within 3 months of surgery were collected from the Patient registry, Swedish Board of Health and Welfare. For each readmission the highest Clavien-Dindo grade was listed. Results: A total of 4003 patients were included in the LAPPRO trial and, after applying exclusion criteria, 3706 patients remained for analyses. The results showed no statistically significant difference in the overall readmission rates (8.1 vs. 7.1%) or readmission due to major complications (Clavien-Dindo ≥3b, 1.7 vs. 1.9%) between RALP and RRP within 90 days after surgery. Patients subjected to lymph-node dissection (LND) had twice the risk for readmission as men not undergoing LND, irrespective RALP or RRP technique. Blood transfusion was significantly more frequent during and within 30 days of RRP surgery (16 vs. 4%). Abdominal symptoms were more common after RALP. Conclusions: There is a substantial risk for hospital readmission after prostate-cancer surgery, regardless of technique; although major complications are rare. Regardless of surgical technique, attention should be focused on specific types of complications.
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