| 1. |
- Westman, Jeanette, et al.
(författare)
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The influences of place of birth and socioeconomic factors on attempted suicide in a defined population of 4.5 million people.
- 2003
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Ingår i: Archives of general psychiatry. - : American Medical Association (AMA). - 0003-990X. ; 60:4, s. 409-14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Our knowledge of the influence of place of birth and socioeconomic status on attempted suicide in a defined national population is limited. METHODS: The study population at baseline in 1993 included approximately 4.5 million Swedish persons aged 25 to 64 years, of whom 570 000 had been born abroad. Each individual was tracked until attempted suicide, remigration, death, or the end of the study on December 31, 1998. The Cox regression was used in the analysis. RESULTS: Labor migrants from Finland and other OECD (Organisation for Economic Cooperation and Development) countries and refugees from Poland and Iran had higher hazard ratios of attempted suicide than Swedish-born control subjects. Women born in Latin America, Asia, and Eastern Europe had significantly higher hazard ratios of attempted suicide than Swedish-born women. In contrast, men born in southern Europe and Asia had significantly lower hazard ratios of attempted suicide. The hazard ratios of attempted suicide among women from Iran, Asia, southern Europe, Latin America, and eastern Europe considerably exceeded those of men from the same country of origin. When socioeconomic status was included in the final model, the hazard ratios remained high for women, while the risk of attempted suicide among men declined sharply with increased income. CONCLUSIONS: Place of birth, socioeconomic status, and sex are associated with attempted suicide. Socioeconomic status explains only part of the association between place of birth and attempted suicide.
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| 2. |
- Basu, Samar, et al.
(författare)
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Biomarkers of free radical injury during spinal cord ischemia
- 2001
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Ingår i: FEBS Letters. - 0014-5793 .- 1873-3468. ; 508:1, s. 36-38
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Tidskriftsartikel (refereegranskat)abstract
- Plasma and urinary levels of 8-iso-PGF(2alpha) and 15-keto-dihydro-PGF(2alpha) were analysed at baseline and during the ischemia-reperfusion period in experimental spinal cord ischemia. A significant and immediate increase of 8-iso-PGF(2alpha) in plasma at the start and up to 60 min, and in the urine at 90-150 min following ischemia indicate an association of oxidative injury. The inflammatory response indicator 15-keto-dihydro-PGF(2alpha) in plasma increased significantly at the start and up to 60 min after ischemia. No such increase was seen in animals with no spinal cord ischemia. Thus, free radical mediated and cyclooxygenase catalysed products of arachidonic acid are increased during spinal cord ischemia as a consequence of oxidative injury and inflammation.
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| 3. |
- Hellberg, Anders, et al.
(författare)
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Monitoring of intrathecal oxygen tension during experimental aortic occlusion predicts ultrastructural changes in the spinal cord
- 2001
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Ingår i: Journal of Thoracic and Cardiovascular Surgery. - : Elsevier BV. - 0022-5223 .- 1097-685X. ; 121:2, s. 316-323
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the correlation between intrathecal PO2 and ultrastructural changes in the spinal cord during thoracic aortic occlusion in pigs. MATERIAL AND METHODS: In 18 pigs, online intrathecal oxygenation was monitored by a multiparameter Paratrend catheter (Biomedical Sensors, High Wycombe, United Kingdom) during 60 minutes' clamping of the proximal and distal descending thoracic aorta. The animals were randomly divided into 2 groups (A and B) depending on the level of distal aortic clamping. Distal aortic perfusion was restored through an aorto-iliac shunt, which also maintained low thoracic segmental perfusion of the spinal cord in group B. Perfusion-fixation technique was used before harvesting the spinal cord specimens, which later were evaluated with light and electron microscopy by an independent observer. Intrathecal parameters were interpreted as normal if PO2 was more than 0.8 kPa and PCO2 was less than 12 kPa, as intermediate ischemia if PO2 was 0.8 or less or PCO (2) was more than 12 kPa, and as absolute ischemia if PO2 was 0.8 or less and PCO2 was more than 12 kPa. RESULTS: Among 6 animals with ultrastructural changes of absolute spinal cord ischemia-reperfusion injury, 5 also had absolute ischemia according to variables derived by the Paratrend catheter. The 2 methods were in agreement in 3 of 5 animals with intermediate ischemia-reperfusion changes and in 5 of 6 animals with normal findings. The accuracy of cerebrospinal fluid PO2 and PCO2 to predict electron microscopy-verified intermediate or absolute ischemia-reperfusion injury was 94%. CONCLUSIONS: Monitoring of intrathecal PO2 after clamping of the descending aorta correlated with ultrastructural changes in the spinal cord in this pig model.
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| 4. |
- Jayne, David, et al.
(författare)
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A randomized trial of maintenance therapy for vasculitis associated with antineutrophil cytoplasmic autoantibodies
- 2003
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Ingår i: New England Journal of Medicine. - 0028-4793. ; 349:1, s. 36-44
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The primary systemic vasculitides usually associated with autoantibodies to neutrophil cytoplasmic antigens include Wegener's granulomatosis and microscopic polyangiitis. We investigated whether exposure to cyclophosphamide in patients with generalized vasculitis could be reduced by substitution of azathioprine at remission. METHODS: We studied patients with a new diagnosis of generalized vasculitis and a serum creatinine concentration of 5.7 mg per deciliter (500 micromol per liter) or less. All patients received at least three months of therapy with oral cyclophosphamide and prednisolone. After remission, patients were randomly assigned to continued cyclophosphamide therapy (1.5 mg per kilogram of body weight per day) or a substitute regimen of azathioprine (2 mg per kilogram per day). Both groups continued to receive prednisolone and were followed for 18 months from study entry. Relapse was the primary end point. RESULTS: Of 155 patients studied, 144 (93 percent) entered remission and were randomly assigned to azathioprine (71 patients) or continued cyclophosphamide (73 patients). There were eight deaths (5 percent), seven of them during the first three months. Eleven relapses occurred in the azathioprine group (15.5 percent), and 10 occurred in the cyclophosphamide group (13.7 percent, P=0.65). Severe adverse events occurred in 15 patients during the induction phase (10 percent), in 8 patients in the azathioprine group during the remission phase (11 percent), and in 7 patients in the cyclophosphamide group during the remission phase (10 percent, P=0.94 for the comparison between groups during the remission phase). The relapse rate was lower among the patients with microscopic polyangiitis than among those with Wegener's granulomatosis (P=0.03). CONCLUSIONS: In patients with generalized vasculitis, the withdrawal of cyclophosphamide and the substitution of azathioprine after remission did not increase the rate of relapse. Thus, the duration of exposure to cyclophosphamide may be safely reduced.
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| 6. |
- Johansson, Bengt, 1958-, et al.
(författare)
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Phantom study of radiation doses outside the target volume brachytherapy versus external radiotherapy of early breast cancer
- 2003
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Ingår i: Radiotherapy and Oncology. - Amsterdam : Elsevier. - 1879-0887 .- 0167-8140. ; 69:1, s. 107-112
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Brachytherapy is sometimes suggested as an adjuvant treatment after surgery of some tumours. When introducing this, it would be useful to have an estimate of the dose distribution to different body sites, both near and distant to target, comparing conventional external irradiation to brachytherapy. The aim of the present study was to determine radiation doses with both methods at different body sites, near and distant to target, in an experimental situation on an operated left sided breast cancer on a female Alderson phantom. Methods: Five external beam treatments with isocentric tangential fields were given by a linear accelerator. A specified dose of 1.0 Gy was given to the whole left sided breast volume. Five interstitial brachytherapy treatments were given to the upper, lateral quadrant of the left breast by a two plane, 10 needles implant. A dose of 1.0 Gy specified according to the Paris system was administered by a pulsed dose rate afterloading machine. Absorbed dose in different fixed dose points were measured by thermoluminescence dosimeters. Results: Both methods yielded an absorbed dose of the same size to the bone marrow and internal organs distant to target, 1.0-1.4% of the prescribed dose. There was a trend of lower doses to the lower half of the trunk and higher doses to the upper half of the trunk, respectively, by brachytherapy. A 90% reduction of absorbed dose with brachytherapy compared to external irradiation was found in the near-target region within 5 cm from target boundary where parts of the left lung and the heart are situated. If an adjuvant dose of 50 Gy is given with the external radiotherapy and brachytherapy, the absorbed dose in a part of the myocardium could be reduced from 31.8 to 2.1 Gy. Conclusions: Near target, brachytherapy yielded a considerably lower absorbed dose which is of special importance when considering radiation effects on the myocard and lungs. We could not demonstrate any difference of importance, in absorbed dose to dose points distant to target. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
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| 7. |
- Link, Katarina, et al.
(författare)
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Low individualized growth hormone (GH) dose increased renal and cardiac growth in young adults with childhood onset GH deficiency
- 2001
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Ingår i: Clinical Endocrinology. - : Wiley. - 1365-2265 .- 0300-0664. ; 55:6, s. 741-748
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE In childhood onset GH deficiency (GHD) a reduction in left ventricular mass (LV-mass) and impairment of systolic function as well an impairment in glomerular filtration rate (GFR) has been shown. The aim of the present study was to assess if a low GH dose resulted in an improvement in morphological and functional parameters of these organs. DESIGN AND PATIENTS Eleven patients with childhood onset GHD were investigated before and after 10 months of GH treatment at a dose of 1.5 IU/day (range 1-2), corresponding to 0.02 IU/kg/day or 7 mug/kg/day. The GH dose resulted in a serum IGF-I level in the normal range in all but one patient. MEASUREMENTS Doppler echocardiography of the heart and ultrasound examination of the kidneys was performed. Glomerular filtration rate (GFR) was estimated with iohexol clearance and urinary proteinuria was measured with 24-h urinary samples collected for analyses of albumin, alpha-1-microglobulin, IgG and albumin/creatinine clearance ratio. Body composition was measured by bioelectric impedance analysis. RESULTS L V-mass index increased significantly after GH treatment (P = 0.04), and there was a clear trend for a positive correlation between the increase in serum IGF-I and the increase in LV-mass index, although it did not reach significance (r = 0.57, P = 0.07). GH treatment did not increase cardiac fractional shortening. Kidney length increased significantly (P = 0.02) with an average increase of 1 cm (range -0.5-1.5 cm). No significant changes in median GFR or serum creatinine were recorded. Three patients with subnormal GFR before GH treatment normalized after 10 months of treatment. Urine analysis showed no abnormalities before or after GH treatment. A significant decrease in percentage fat mass was recorded (P = 0.03). CONCLUSION A low individualized GH dose to adults with childhood onset GHD resulted in an increase in LV-mass index and kidney length. Re-establishing GH treatment with a low dose in this patient group can lead to a further somatic maturation of these organs, probably not accomplished previously.
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| 10. |
- Yin, Hong, et al.
(författare)
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Complete nucleotide sequence of a Coxsackievirus B-4 strain capable of establishing persistent infection in human pancreatic islet cells : effects on insulin release, proinsulin synthesis, and cell morphology
- 2002
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Ingår i: Journal of Medical Virology. - : Wiley. - 0146-6615 .- 1096-9071. ; 68:4, s. 544-57
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present investigation was to study the effect of infection of human pancreatic islet cells with a strain (VD2921) of Coxsackie B virus serotype 4 capable of establishing persistent infection in these cells, as well as to sequence the strain, to study the determinants of virulence and persistence. Groups of islets were infected and assessments of proinsulin, insulin content, and virus replication were made. Insulin release in response to high glucose was measured. Infected and control islets displayed a strong insulin response to high glucose 3-4 days as well as 7-8 days post-infection (dpi). At 11-17 dpi, the infected islets did not respond at all to high glucose, and the response of the control islets was at this late time point somewhat reduced. The insulin and proinsulin content of the infected islets did not differ significantly from that of the control islets. TCID(50) titrations showed that the VD2921 strain replicated in the islet cells during the whole study. Electron microscopic examination of infected islets did not reveal any virus-induced changes of cell morphology compared with the controls, although higher magnifications of the infected beta-cells showed virus-like particles in the cytoplasm. These results show that certain strains of Coxsackievirus B-4 in vitro can establish a persistent infection that might mimic, the more gradual loss of beta-cell function seen during the clinical course of autoimmune diabetes. The ability of this Coxsackievirus B-4 strain to establish a persistent infection might be due to substitution of 11 amino acids located at the surface of the structural protein VP1, adjacent to the predicted receptor binding canyon of the virus.
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