| 114841. |
- Nejdfors, P, et al.
(författare)
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Intestinal permeability in humans is increased after radiation therapy
- 2000
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Ingår i: Diseases of the Colon & Rectum. - 0012-3706. ; 43:11, s. 1582-1587
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Irradiation inflicts acute injuries to the intestinal mucosa with rapid apoptosis induction and subsequent reduction in epithelial surface area. It may therefore be assumed that the intestinal barrier function is affected. The aim of this study was to compare the mucosal permeability in irradiated rectum and nonirradiated sigmoid colon from patients subjected to radiation therapy before surgical treatment for rectal cancer. METHODS: Segments from sigmoid colon and rectum obtained from irradiated and nonirradiated patients were stripped from the serosa-muscle layer and mounted in Ussing diffusion chambers. The mucosa-to-serosa passage of the marker molecules 14C-mannitol, fluorescein isothiocyanate-dextran 4,400, and ovalbumin was followed for 120 minutes. RESULTS: The permeability to the markers was size-dependent and increased linearly across time in all specimens. The passage of all markers was increased in irradiated rectum compared with nonirradiated sigmoid colon, whereas in specimens from nonirradiated patients there were no differences between rectum and sigmoid colon. Histologic signs of crypt and mucosal atrophy were found in the irradiated rectal specimens. CONCLUSIONS: Early gastrointestinal complications after radiation therapy may be the result of mucosal atrophy in addition to mucosal damage, with a loss of barrier integrity.
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| 114842. |
- Nelis, Sabine, et al.
(författare)
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Greater positive affect change after mental imagery than verbal thinking in a student sample.
- 2012
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Ingår i: Journal of Experimental Psychopathology. - : SAGE Publications. - 2043-8087. ; 3:2, s. 178-188
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Tidskriftsartikel (refereegranskat)abstract
- This study sought to replicate previous work concerning the impact of positive mental imagery on emotion. Previous experimental studies found that imagining positive events was superior to verbally processing the same events in producing positive affect, and further that field rather than observer perspective imagery had a more powerful impact (Holmes, Coughtrey, & Connor, 2008; Holmes, Mathews, Dalgleish, & Mackintosh, 2006). In the current study, 78 students listened to 100 positive events randomly allocated to one of three conditions (between-subjects): imagining them via a field or an observer perspective or listening to the same events while thinking about their verbal meaning. Positive affect was measured before and after the task. Positive affect change was greater after imagery (field and observer) than the verbal condition, replicating previous research. Contrary to predictions, there was no significant difference in affect change between the field and observer conditions. To explain the latter result, we reflect on methodological explanations. In conclusion, there was greater positive affect change after positive mental imagery than positive verbal thinking. If results can be translated from the lab to the clinic then imaging positive situations may help people feel more positive than only discussing them verbally in therapy.
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| 114843. |
- Nelis, Sabine, et al.
(författare)
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Response Styles to Positive Affect and Depression : Concurrent and Prospective Associations in a Community Sample
- 2015
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Ingår i: Cognitive Therapy and Research. - : SPRINGER/PLENUM PUBLISHERS. - 0147-5916 .- 1573-2819. ; 39:4, s. 480-491
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Tidskriftsartikel (refereegranskat)abstract
- We examined the concurrent and prospective relations between response styles to positive affect and depression in a community sample. Participants (n = 345) completed self-report measures of current and past depressive episodes, depressive symptoms, anhedonia, and responses to positive affect (including dampening and positive rumination) at two time points, with a 5-month interval. Higher levels of dampening responses to positive affect were related to higher concurrent levels of depressive symptoms. The tendency to positively ruminate on positive affect was negatively related to concurrent anhedonic symptoms. When controlling for current depressive symptomatology, formerly depressed individuals had a higher tendency to dampen positive affect than never-depressed controls, and did not differ from a currently depressed group. Dampening responses did not predict depressive symptoms prospectively, but lower levels of (self-focused) positive rumination did predict higher levels of future anhedonic symptoms. Results indicate that not only currently but also formerly depressed individuals engage in dysfunctional (dampening) strategies in response to positive affect. It is possible that currently as well as formerly depressed individuals might benefit from interventions that are directed at the remediation of disturbed regulation of positive affect. However, our prospective results make clear that more research is needed to examine the precise conditions under which dampening would be a detrimental (and positive rumination a beneficial) response style in the course of depression.
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| 114844. |
- Nelissen, Rob G H H, et al.
(författare)
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RSA and registries: the quest for phased introduction of new implants.
- 2011
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Ingår i: The Journal of bone and joint surgery. American volume. - 1535-1386. ; 93 Suppl 3, s. 62-5
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Tidskriftsartikel (refereegranskat)abstract
- Although the overall survival of knee and hip prostheses at ten years averages 90%, recent problems with several hip and knee prostheses have illustrated that the orthopaedic community, industry, and regulators can still further improve patient safety. Given the early predictive properties of roentgen stereophotogrammetric analysis (RSA) and the meticulous follow-up of national joint registries, these two methods are ideal tools for such a phased clinical introduction. In this paper, we elaborate on the predictive power of RSA within a two-year follow-up after arthroplasty and its relationship to national joint registries. The association between RSA prosthesis-migration data and registry data is evaluated.The five-year rate of revision of RSA-tested total knee replacements was compared with that of non-RSA-tested total knee replacements. Data were extracted from the published results of the national joint registries of Sweden, Australia, and New Zealand.There was a 22% to 35% reduction in the number of revisions of RSA-tested total knee replacements as compared with non-RSA-tested total knee replacements in the national joint registries. Assuming that the total cost of total knee arthroplasty is $37,000 in the United States, a 22% to 35% reduction in the number of revisions (currently close to 55,000 annually) could lead to an estimated annual savings of over $400 million to the health-care system.The phased clinical introduction of new prostheses with two-year RSA results as a qualitative tool could lead to better patient care and could reduce the costs associated with revision total knee arthroplasty. Follow-up in registries is necessary to substantiate these results and to improve post-market surveillance.
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| 114845. |
- Nellgard, B., et al.
(författare)
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Lack of protection by the N-methyl-D-asparate receptor blocker dizocilpine (MK-801) after transient severe cerebral ischemia in the rat
- 1991
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Ingår i: Anesthesiology. - : Ovid Technologies (Wolters Kluwer Health). - 0003-3022. ; 75:2, s. 279-287
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Tidskriftsartikel (refereegranskat)abstract
- Glutamate is an important factor in the mechanisms of neuronal damage following cerebral ischemia. Blockade of one type of glutamate receptor, the N-methyl-D-aspartate (NMDA) receptor, decreases brain infarct size in experimental models of permanent focal ischemia, but protection in models of transient reversible ischemia is ambiguous. We investigated the effect of the noncompetitive NMDA receptor antagonist dizocipiline (MK-801) on neuronal damage in the CA1 region of the rat hippocampus, using two models of reversible cerebral ischemia: 10 or 15 min of bilateral common carotid occlusion combined with hypotension, or 6-8.5 min of cardiac arrest. Histopathologic evaluation of neuronal damage was performed 7 days after the ischemic insults. Thirteen groups of rats (a total of 129 animals) were treated with saline or dizocilpine in single or multiple doses ranging from 0.1 to 5 mg·kg-1, given intravenously or intraperitoneally prior to and/or after the ischemic insult. In none of the dizocilpine-treated groups could neuronal protection be demonstrated in the CA1 region of the septal as well as dorsotemporal hippocampus, compared to a corresponding saline-treated group. We conclude that systemically administered noncompetitive NMDA receptor antagonists do not provide a marked protection against neuronal damage after a transient period of severe forebrain ischemia.
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| 114846. |
- Nelson, Gregg, et al.
(författare)
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Implementation of Enhanced Recovery After Surgery (ERAS) Across a Provincial Healthcare System : The ERAS Alberta Colorectal Surgery Experience
- 2016
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Ingår i: World Journal of Surgery. - New York, USA : Springer. - 0364-2313 .- 1432-2323. ; 40:5, s. 1092-1103
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Tidskriftsartikel (refereegranskat)abstract
- Enhanced recovery after surgery (ERAS) colorectal guideline implementation has occurred primarily in standalone institutions worldwide. We implemented the guideline in a single provincial healthcare system, and our study examined the effect of the guideline on patient outcomes [length of stay (LOS), complications, and 30-day post-discharge readmissions] across a healthcare system.We compared pre- and post-guideline implementation in consecutive elective colorectal patients, a parts per thousand yen18 years, from six Alberta hospitals between February 2013 and December 2014. Participants were followed up to 30 days post discharge. We used summary statistics, to assess the LOS and complications, and multivariate regression methods to assess readmissions and to estimate cost impacts.A total of 1333 patients (350 pre- and 983 post-ERAS) were analysed. Of this number, 55 % were males. Median overall guideline compliance was 39 % in pre- and 60 % in post-ERAS patients. Median LOS was 6 days for pre-ERAS compared to 4.5 days in post-ERAS patients with the longest implementation (p value < 0.0001). Adjusted risk ratio (RR) was 1.71, 95 % CI 1.09-2.68 for 30-day readmission, comparing pre- to post-ERAS patients. The proportion of patients who developed at least one complication was significantly reduced, from pre- to post-ERAS, difference in proportions = 11.7 %, 95 % CI 2.5-21.0, p value: 0.0139. The net cost savings attributable to guideline implementation ranged between $2806 and $5898 USD per patient.The findings in our study have shown that ERAS colorectal guideline implementation within a healthcare system resulted in patient outcome improvements, similar to those obtained in smaller standalone implementations. There was a significant beneficial impact of ERAS on scarce health system resources.
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| 114847. |
- Nelson, Peter T., et al.
(författare)
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Reply : LATE to the PART-y
- 2019
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Ingår i: Brain. - : Oxford University Press. - 0006-8950 .- 1460-2156. ; 142
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 114848. |
- Nelson, Vivianne S., et al.
(författare)
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Platelets in ITP : Victims in charge of their own fate?
- 2021
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Ingår i: Cells. - : MDPI AG. - 2073-4409. ; 10:11
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Forskningsöversikt (refereegranskat)abstract
- Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder. The pathophysiological mechanisms leading to low platelet levels in ITP have not been resolved, but at least involve autoantibody-dependent and/or cytotoxic T cell mediated platelet clearance and impaired megakary-opoiesis. In addition, T cell imbalances involving T regulatory cells (Tregs) also appear to play an important role. Intriguingly, over the past years it has become evident that platelets not only mediate hemostasis, but are able to modulate inflammatory and immunological processes upon activation. Platelets, therefore, might play an immuno-modulatory role in the pathogenesis and pathophysiology of ITP. In this respect, we propose several possible pathways in which platelets themselves may participate in the immune response in ITP. First, we will elaborate on how platelets might directly promote inflammation or stimulate immune responses in ITP. Second, we will discuss two ways in which platelet microparticles (PMPs) might contribute to the disrupted immune balance and impaired thrombopoiesis by megakaryocytes in ITP. Importantly, from these insights, new starting points for further research and for the design of potential future therapies for ITP can be envisioned.
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| 114849. |
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| 114850. |
- Nelzén, Oskar, 1984-, et al.
(författare)
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Impact on venous haemodynamics after treatment of great saphenous vein incompetence using plethysmography and duplex ultrasound
- 2020
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Ingår i: Phlebology. - : Sage Publications. - 0268-3555 .- 1758-1125. ; 35:7, s. 495-504
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo evaluate postoperative venous haemodynamics and quality of life after treatment of great saphenous vein (GSV) incompetence.MethodsRadiofrequency ablation and high ligation and stripping were performed in 62 patients (65 limbs) and 58 (65 limbs), respectively. Phlebectomies were performed in both modalities. Strain-gauge plethysmography on the foot combined with superficial venous occlusion was used to measure refilling time after knee bends. Strain-gauge plethysmography, duplex ultrasound and quality of life were assessed before and one month after treatment.ResultsDuplex ultrasound displayed successful intervention in all but two limbs. Refilling time increased similar in radiofrequency ablation and high ligation and stripping after treatment (p < 0.001). Postoperatively, strain-gauge plethysmography detected remaining reflux in 71% of the patients. Multivariate analysis showed that two or more incompetent calf branches were associated with remaining reflux (OR 4.82 (95% CI: 1.33–17.5), p = 0.02). No difference in quality of life was seen in patients with remaining reflux.ConclusionsDespite successful treatment, a majority of the limbs showed remaining reflux, in which incompetent calf branches appear to play an important role.Clinicaltials.gov: Lower Limb Venous Insufficiency and the Effect of Radiofrequency Treatment Versus Open Surgery. Nr: NCT02397226
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