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| 3. |
- Källén, Kristina, et al.
(författare)
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Behandling av terapiresistent epilepsi - ett multiprofessionellt samarbete
- 2007
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Ingår i: Incitament : för en hälso- & sjukvård i förvandling. - 1103-503X. ; 16:1, s. 25-25
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Epilepsi är den vanligaste neurologiska sjukdomen efter stroke och huvudvärk, ca 60 000 personer har aktiv epilepsi i Sverige. Vi har idag tillgång till en rad mycket effektiva läkemedel, bara sedan 1989 har åtta nya epilepsimediciner registrerats. Trots den utvidgade behandlingsarsenalen bli bara två av tre patienter anfallsfria av läkemedel, för en tredjedel fortsätter anfallen att komma. Vid farmakologiskt terapiresistent epilepsi finns andra behandlingsalternativ.
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| 4. |
- Lorant, Tomas, 1975-, et al.
(författare)
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Safety, immunogenicity, pharmacokinetics, and efficacy of degradation of anti-HLA antibodies by IdeS (imlifidase) in chronic kidney disease patients
- 2018
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Ingår i: American Journal of Transplantation. - : Elsevier BV. - 1600-6135 .- 1600-6143. ; 18:11, s. 2752-2762
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Tidskriftsartikel (refereegranskat)abstract
- Safety, immunogenicity, pharmacokinetics, and efficacy of the IgG-degrading enzyme of Streptococcus pyogenes (IdeS [imlifidase]) were assessed in a single-center, open-label ascending-dose study in highly sensitized patients with chronic kidney disease. Eight patients with cytotoxic PRAs (median cytotoxic PRAs of 64%) at enrollment received 1 or 2 intravenous infusions of IdeS on consecutive days (0.12 mg/kg body weight ×2 [n = 3]; 0.25 mg/kg ×1 [n = 3], or 0.25 mg/kg ×2 [n = 2]). IgG degradation was observed in all subjects after IdeS treatment, with <1% plasma IgG remaining within 48 hours and remaining low up to 7 days. Mean fluorescence intensity values of HLA class I and II reactivity were substantially reduced in all patients, and C1q binding to anti-HLA was abolished. IdeS also cleaved the IgG-type B cell receptor on CD19+ memory B cells. Anti-IdeS antibodies developed 1 week after treatment, peaking at 2 weeks. A few hours after the second IdeS infusion, 1 patient received a deceased donor kidney offer. At enrollment, the patient had a positive serum crossmatch (HLA-B7), detected by complement-dependent cytotoxicity, flow cytometry, and multiplex bead assays. After IdeS infusion (0.12 mg/kg ×2) and when the HLA-incompatible donor (HLA-B7+) kidney was offered, the HLA antibody profile was negative. The kidney was transplanted successfully.
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| 5. |
- Sonesson, Ulf, et al.
(författare)
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Paths to a sustainable food sector: integrated design and LCA of future food supply chains : the case of pork production in Sweden
- 2016
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Ingår i: The International Journal of Life Cycle Assessment. - : Springer Ferlag. - 0948-3349 .- 1614-7502. ; 21:5, s. 664-676
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe a more sustainable food sector, a supply chain approach is needed. Changing a supply chain inevitably means that various attributes of the product and its system will change. This project assumed this challenge and delivered detailed descriptions, life cycle assessment (LCA) evaluations, and consequence assessments of the supply chains of six commodities, i.e., milk, cheese, beef, pork, chicken, and bread, from a Swedish region. This paper presents results for the pork supply chain. Methods: In the project setup, experts on production along supply chains designed three scenarios for environmentally improved systems. These scenarios, i.e., the ecosystem, plant nutrients, and climate scenarios, were intended to address different clusters of environmental goals. The next step was to challenge these scenarios by considering their possible consequences for products and systems from the food safety, sensory quality, animal welfare, consumer appreciation, and (for primary production only) cost perspectives. This led to changes in production system design to prevent negative consequences. The final supply chains were quantified using LCA and were again assessed from the three perspectives. Results and discussion: The scenario design approach worked well, thoroughly and credibly describing the production systems. Assessment of consequences bolstered the credibility and quality of the systems and results. The LCA of pig production and smoked ham identified large potentials for improvement by implementing available knowledge: global warming potential (GWP) could be reduced 21–54 % and marine eutrophication by 14–45 %. The main reason for these improvements was improved productivity (approaching the best producers’ current performance), though dedicated measures were also important, resulting in increased nitrogen efficiency, more varied crop rotations for crop production and better production management, and improved animal health and manure management for animal production. Reduced post-farm wastage contributed as did reduced emissions from fertilizer production. Conclusions: The working approach applied was successful in integrating LCA research with food system production expertise to deliver results relevant to supply chain decision-makers. The consequence assessments brought considerable value to the project, giving its results greater credibility. By introducing constraints in the form of “no negative consequences and no increased costs,” the work was “guided” so that the scenario design avoided being hampered by too many opportunities.
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- Stenberg, Johan, et al.
(författare)
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Clinical Outcome 3 Years After Autologous Chondrocyte Implantation Does Not Correlate With the Expression of a Predefined Gene Marker Set in Chondrocytes Prior to Implantation but Is Associated With Critical Signaling Pathways
- 2014
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Ingår i: The Orthopaedic Journal of Sports Medicine. - : Sage Publications. - 2325-9671. ; 2:9, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a need for tools to predict the chondrogenic potency of autologous cells for cartilage repair.PURPOSE: To evaluate previously proposed chondrogenic biomarkers and to identify new biomarkers in the chondrocyte transcriptome capable of predicting clinical success or failure after autologous chondrocyte implantation.STUDY DESIGN: Controlled laboratory study and case-control study; Level of evidence, 3.METHODS: Five patients with clinical improvement after autologous chondrocyte implantation and 5 patients with graft failures 3 years after implantation were included. Surplus chondrocytes from the transplantation were frozen for each patient. Each chondrocyte sample was subsequently thawed at the same time point and cultured for 1 cell doubling, prior to RNA purification and global microarray analysis. The expression profiles of a set of predefined marker genes (ie, collagen type II α1 [COL2A1], bone morphogenic protein 2 [BMP2], fibroblast growth factor receptor 3 [FGFR3], aggrecan [ACAN], CD44, and activin receptor-like kinase receptor 1 [ACVRL1]) were also evaluated.RESULTS: No significant difference in expression of the predefined marker set was observed between the success and failure groups. Thirty-nine genes were found to be induced, and 38 genes were found to be repressed between the 2 groups prior to autologous chondrocyte implantation, which have implications for cell-regulating pathways (eg, apoptosis, interleukin signaling, and β-catenin regulation).CONCLUSION: No expressional differences that predict clinical outcome could be found in the present study, which may have implications for quality control assessments of autologous chondrocyte implantation. The subtle difference in gene expression regulation found between the 2 groups may strengthen the basis for further research, aiming at reliable biomarkers and quality control for tissue engineering in cartilage repair.CLINICAL RELEVANCE: The present study shows the possible limitations of using gene expression before transplantation to predict the chondrogenic and thus clinical potency of the cells. This result is especially important as the chondrogenic potential of the chondrocytes is currently part of quality control measures according to European and American legislations regarding advanced therapies.
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| 7. |
- Andersson Granberg, Tobias, et al.
(författare)
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Tåla : Trygghetsskapande åtgärder för landsbygden
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I april 2010 gav regeringen i uppdrag till Myndigheten för samhällsskydd och beredskap (MSB) att i ett projekt öka säkerheten på landsbygden genom nya former för räddning och respons. Inom ramen för ovanstående uppdrag, vilket benämns ”Samhällsviktig samverkan i landsbygd” har CARER – Centrum för respons- och räddningssystem – vid Linköpings universitet fått i uppdrag av MSB att inventera vilka behov och resurser för säkerhet och trygghet som existerar på lands- och glesbygd, samt undersöka vilka andra projekt och initiativ som föregått detta, nationellt och internationellt. CARERs projekt, som görs inom ramen för regeringsuppdraget, benämns Trygghetshöjande åtgärder för landsbygden (TÅLA).TÅLA har genomförts som fyra sammanhängande delstudier där de två första delstudierna använder kvalitativ metodik, främst intervjuer, och syftar till att skapa en förståelse för den upplevda tryggheten på lands- och glesbygden, samt utröna vad den består i och hur den kan stärkas. Delstudie 3 syftar till att kvantitativt uttrycka behov och resurser för säkerhet och trygghet på landsoch glesbygd genom ett urval av indikatorer. Delstudie 4 syftar till att ge en överblick över tidigare forskning och utveckling på området.Några generella slutsatser som kan dras från TÅLA-projektets olika delstudier är att det finns en god medvetenhet hos boende i land- och glesbygd för att det kan ta tid innan hjälp kan fås ifrån de traditionella räddningssystemen (som till exempel polis eller räddningstjänst), ett faktum som också kan bekräftas numerärt. Vissa indikatorer tyder dessutom på att boende på lands- och glesbygden är mer drabbade av olyckor än boende i tätort, vilket ger ett ökat behov av de aktuella resurserna. Detta har lett till att nya typer av lösningar har utvecklats, oftast av de boende, för att bistå vid olyckor, många baserade på självhjälp och frivillighet.Tydligt är också att trygghet omfattar mer än bara blåljusverksamheter och stöd från det allmänna. Här inkluderas också behov som el, vatten och möjligheten att handla mat. En stor del av den upplevda tryggheten hos befolkningen kommer från det sociala nätverk som finns i respektive by. Möjligheter till kommunikation är centralt och det är när individen är ensam utan möjlighet till kontakt med omvärlden som den största otryggheten infinner sig.Det framkom under projektet flera exempel på samverkan och de som medverkar framhåller vikten av att känna varandra innan insatsen, för att bästa möjliga resultat ska uppnås. Såväl de båda kvalitativa studierna som kunskapsöversikten pekar på att en trolig väg till framgång för en ökad säkerhet och trygghet på landsbygden bygger på att de lokala resurserna och strukturerna nyttjas i samverkan med de traditionella räddningsresurserna. Detta innebär att det bör vara möjligt att stärka dels de boendes möjligheter att hjälpa sig själva och att hjälpa varandra, men också att nyttja organisationer som idag inte tillhör blåljusmyndigheterna för att i samverkan med räddningstjänsten, sjukvården och polisen kunna bistå vid olyckor, akuta sjukdomsförlopp och andra relevanta händelser. Viktigt att beakta i detta sammanhang är då att använda de befintliga strukturer som existerar bland såväl boende som olika organisationer, för att på bästa sätt kunna dra nytta av den lokala kunskap, de resurser och det engagemang som existerar.
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| 8. |
- Andersson, Linus, et al.
(författare)
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Brain responses to olfactory and trigeminal exposure in idiopathic environmental illness (IEI) attributed to smells : An fMRI study
- 2014
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Ingår i: Journal of Psychosomatic Research. - : Elsevier. - 0022-3999 .- 1879-1360. ; 77:5, s. 401-408
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Idiopathic environmental intolerance (IEI) to smells is a prevalent medically unexplained illness. Sufferers attribute severe symptoms to low doses of non-toxic chemicals. Despite the label, IEI is not characterized by acute chemical senses. Theoretical models suggest that sensitized responses in the limbic system of the brain constitute an important mechanism behind the symptoms. The aim was to investigate whether and how brain reactions to low-levels of olfactory and trigeminal stimuli differ in individuals with and without IEI. METHODS: Brain responses to intranasally delivered isoamyl acetate and carbon dioxide were assessed in 25 women with IEI and 26 non-ill controls using functional magnetic resonance imaging. RESULTS: The IEI group had higher blood-oxygenated-level-dependent (BOLD) signal than controls in the thalamus and a number of, mainly, parietal areas, and lower BOLD signal in the superior frontal gyrus. The IEI group did not rate the exposures as more intense than the control group did, and there were no BOLD signal differences between groups in the piriform cortex or olfactory regions of the orbitofrontal cortex. CONCLUSIONS: The IEI reactions were not characterized by hyper-responsiveness in sensory areas. The results can be interpreted as a limbic hyperreactivity and speculatively as an inability to inhibit salient extemal stimuli.
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| 9. |
- Anna Karin, Hedström, et al.
(författare)
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The impact of bariatric surgery on disease activity and progression of multiple sclerosis : A nationwide matched cohort study
- 2022
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Ingår i: Multiple Sclerosis Journal. - : Sage Publications. - 1352-4585 .- 1477-0970. ; 28:13, s. 2099-2105
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Surgical outcomes in patients with multiple sclerosis (MS) following metabolic surgery appear to be similar compared to those of the general bariatric population.OBJECTIVE: To study the impact of metabolic surgery on the clinical course of MS.METHODS: Using data from the Scandinavian Obesity Surgery Registry and the Swedish Multiple Sclerosis register, we compared disease outcomes in 122 cases of MS who had undergone metabolic surgery with those of 122 cases of MS without surgery, matched by a two-staged Propensity score match, including age at disease onset, sex, MS phenotype, body mass index, and preoperative severity of MS as measured by the Expanded Disability Status Scale.RESULTS: The time to 6-month confirmed disability progression during the first five years postbaseline was shorter among the surgical patients (hazard ratio (HR) = 2.31, 95% confidence interval (CI) = 1.09-4.90; p = 0.03). No differences were observed regarding postoperative annual relapse rate (p = 0.24) or time to first postoperative relapse (p = 0.52).CONCLUSION: Although metabolic surgery appears to be a safe and efficient treatment of obesity in patients with MS, the clinical course of the disease might be negatively affected. Long-term nutritional follow-up after surgery and supplementation maintenance are crucial, particularly among those with preoperative deficits.
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