| 1. |
- Sackey, Peter, et al.
(författare)
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Short- and long-term follow-up of intensive care unit patients after sedation with isoflurane and midazolam : A pilot study
- 2008
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Ingår i: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 36:3, s. 801-806
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare memories from the intensive care unit (ICU) and short- and long-term psychological morbidity in patients after sedation with intravenous midazolam or inhaled isoflurane. DESIGN: Prospective long-term follow-up after randomized controlled trial. SETTING: General ICU at Karolinska University Hospital, Solna, Stockholm. PATIENTS: Forty patients in need of sedation during ventilator treatment. INTERVENTIONS: Patients were randomized to receive isoflurane or midazolam for goal-directed sedation until extubation or for a maximum of 96 hrs. MEASUREMENTS AND MAIN RESULTS: For short-term follow-up, doctors', nurses', and physiotherapists' notes from the 4 days following exposure to the study drugs were reviewed for words indicating adequate or pathologic cognitive and psychological recovery. For long-term follow-up, all 6-month survivors received questionnaires including the ICU Memory Tool (ICU-MT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), and Well-Being Index. Additionally, several screening questions for previous posttraumatic stress symptoms were included. In the short term follow-up, no significant differences were found between groups. In the long-term follow-up, a trend toward fewer hallucinations/delusions after isoflurane sedation than after midazolam (two of ten isoflurane patients vs. five of seven midazolam patients) was found (p = .06). None of the five solely isoflurane-sedated patients reported hallucinations/delusions from the ICU. There was no difference in groups in long-term psychological morbidity as measured with HADS and IES. Memories of negative feelings in the ICU (ICU-MT) were associated with high HADS and IES scores (Fisher's exact test, p = .02 and p = .01, respectively). CONCLUSIONS: Sedation of ICU patients with isoflurane may result in fewer delusional memories or hallucinations from the ICU compared with more commonly used intravenous sedation. Memories of negative feelings from the ICU were associated with symptoms of depression or anxiety or symptoms indicating posttraumatic stress disorder. Further study of memory and cognitive/psychological recovery after prolonged isoflurane sedation beyond 96 hrs is warranted.
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| 2. |
- Bailey, Leslie, et al.
(författare)
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Small molecule inhibitors of type III secretion in Yersinia block the Chlamydia pneumoniae infection cycle
- 2007
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Ingår i: FEBS Letters. - : Elsevier. - 0014-5793 .- 1873-3468. ; 581:4, s. 587-595
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Tidskriftsartikel (refereegranskat)abstract
- Intracellular parasitism by Chlamydiales is a complex process involving transmission of metabolically inactive particles that differentiate, replicate, and re-differentiate within the host cell. A type three secretion system (T3SS) has been implicated in this process. We have here identified small molecules of a chemical class of acylated hydrazones of salicylaldehydes that specifically blocks the T3SS of Chlamydia. These compounds also affect the developmental cycle showing that the T3SS has a pivotal role in the pathogenesis of Chlamydia. Our results suggest a previously unexplored avenue for development of novel anti-chlamydial drugs.
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| 3. |
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| 4. |
- Byström, Per, et al.
(författare)
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Early prediction of response to first-line chemotherapy by sequential [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography in patients with advanced colorectal cancer
- 2009
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Ingår i: Annals of Oncology. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 20:6, s. 1057-1061
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To evaluate [(18)F]-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), for early evaluation of response to palliative chemotherapy and for prediction of long-term outcome, in patients with metastatic colorectal cancer (mCRC). PATIENTS AND METHODS: In a randomized trial, patients with mCRC received irinotecan-based combination chemotherapy. FDG-PET was carried out before treatment and after two cycles in 51 patients at two centers. Visual changes in tumor FDG uptake and changes measured semi-automatically, as standard uptake values (SUVs), were compared with radiological response after four and eight cycles. RESULTS: The mean baseline SUV for all tumor lesions per patient was higher in nonresponders than in responders (mean 7.4 versus 5.6, P = 0.02). There was a strong correlation between metabolic response (changes in SUV) and objective response (r = 0.57, P = 0.00001), with a sensitivity of 77% and a specificity of 76%. There was no significant correlation between metabolic response and time to progression (P = 0.5) or overall survival (P = 0.1). CONCLUSIONS: Although metabolic response assessed by FDG-PET reflects radiological tumor volume changes, the sensitivity and specificity are too low to support the routine use of PET in mCRC. Furthermore, PET failed to reflect long-term outcome and can, thus, not be used as surrogate end point for hard endpoint benefit.
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| 5. |
- Cantillana, Tatiana, 1969-
(författare)
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Toxicologically important DDT metabolites : Synthesis, enantioselective analysis and kinetics
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- DDT was extensively and globally used as a pesticide in agriculture and for malaria vector control from the 1940’s until the 1970’s. Due to its heavy use, DDT became ubiquitously distributed throughout the environment. DDT and several DDT metabolites are persistent organic pollutants. Two DDT metabolites, 3-MeSO2-DDE and o,p’-DDD have been proved to be tissue specific toxicants in the adrenal cortex. They are bioactivated to reactive intermediates which bind covalently to the adrenal cortex causing cell death. Due to its tissue specific toxicity o,p’-DDD has been used as a chemotherapy drug for adrenal cancer in humans. The efficacy and potency is however low and o,p’-DDD treatment is associated with serious side effects. 3-MeSO2-DDE has been suggested as a potential alternative therapeutic agent. A key aim of this thesis has been to improve the understanding of the kinetics of the two adrenocorticolytic compounds o,p’-DDD, its two enantiomers and 3-MeSO2-DDE. To meet this objective chemical synthesis and enantioselective analysis were required. Furthermore, in vitro toxicity of o,p’-DDD enantiomers and diastereomers were performed. An 11 step synthesis of 3-SH-DDE has been developed to promote both labelled and unlabelled synthesis of 3-alkylsulfonyl-DDE. Toxicokinetic studies showed that 3-MeSO2-DDE and o,p’-DDD were accumulated in tissues and retained in adipose tissue in minipigs. 3-MeSO2-DDE however had a twice as long biological t1/2 and a considerably lower Vd compared to o,p’-DDD. Suckling offspring were more exposed to 3-MeSO2-DDE than their mothers who were given 3-MeSO2-DDE orally. Interindividual differences in enantiomer kinetics in minipigs were observed suggesting polymorphism among the minipigs. Preparative isolation of the o,p’-DDD enantiomers is presented allowing determination of the absolute structures of the o,p’-DDD enantiomers by X-ray. The pure enantiomer of o,p’-DDD showed significant differences in toxicity in human adrenocortical cells.
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| 6. |
- Eskilsson, Anna, 1977-
(författare)
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På plats i historien : Studier av hembygsföreningar på 2000-talet
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Local heritage societies were established in Sweden for about a hundred years ago. The societies responded to the large changes of industrialisation, emigration and urbanisation during that time. Today there are about 2 000 societies with almost half a million members altogether. Why do people turn to local heritage societies today? The image of them, associated with folklore costumes and quaint old cottages, is not consistent with the extensive activity in the 21st century. That raises questions that have not been clarified in previous research. The aim of this thesis is to find out what today's local heritage societies do, as well as to investigate what their meanings are for people and the local society. Thereby the intention is to contribute to an understanding of their present extent and endurance over time.The activities of three local heritage societies in and around the city of Linköping are mapped out in this thesis. The survey shows extensive and very broad activities that are well adjusted to present time. The traditional image has become rigid, but in parts it is accurate since the activities are still dominated by local use of history., which also contributes to their extent and continuity. Place and history as common ground is something universal: The need for people to be oriented in time and space contributes to the persistence of the local heritage societies. At the same time there seems to be something strong in society today which contributes to their extent.The thesis shows that the societies can have knowledge-generating, ideological, existential and social meaning. Through the local heritage society people can learn about, evaluate and gain feelings for the place. The society also contributes to strengthening the power of togetherness in the local community as a part of the civilian society. The multifaceted meaning of the activities makes it possible for the societies to keep or even strengthen their attraction, especially among the large group of retired people.
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| 7. |
- Hessman, Ola, et al.
(författare)
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High success rate of parathyroid reoperation may be achieved with improved localization diagnosis
- 2008
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 32:5, s. 774-81; discussion 782
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Because of the difficulty of reoperative parathyroid surgery, preoperative imaging studies have been increasingly adopted. We report the use of consistently applied localization diagnosis to yield high success rates in parathyroid reoperations. METHODS: Parathyroid reoperation was performed after previous parathyroid surgery in 144 patients with nonmalignant hyperparathyroidism (HPT) between 1962 and 2007. From the year 2000, 46 patients who underwent parathyroid reoperation and 14 patients who were subjected to thyroid surgery before primary parathyroid operation were investigated with sestamibi scintigraphy (MIBI), 11C-methionine PET/CT (met-PET), surgeon-performed ultrasound (US), US-guided fine-needle aspiration biopsy (US-FNA), and selective venous sampling (SVS) with rapid PTH (Q-PTH) analyses. When imaging was considered adequate, additional studies were generally not obtained. RESULTS: Reversal of hypercalcemia was achieved by reoperation in 134 of 144 (93%) of all patients with previous parathyroid surgery. In patients operated from year 2000, MIBI had 90% sensitivity and 88% predictive value, met-PET 79% sensitivity and 87% predictive value, and US 72% sensitivity and 93% predictive value. SVS with Q-PTH analyses provided accurate localization or regionalization in 11 of 11 recently selected patients. Q-PTH analyses in fine-needle aspirations verified parathyroid origin of excised specimens, and intraoperative Q-PTH helped decide when operations could be terminated. In patients subjected to the algorithm of imaging procedures, reversal of hypercalcemia and apparent cure was obtained after the reoperation in 45 of 46 patients with previous parathyroid surgery, implying a success rate of 98%, and in all patients with previous thyroid surgery. CONCLUSIONS: Reoperative parathyroid surgery is challenging. Results can be improved by consistently applied sensitive methods of preoperative imaging, and reoperative procedures may then achieve nearly the same success rates as primary operations.
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| 8. |
- Lundmark, Peter, 1982-, et al.
(författare)
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Industrial Challenges within the Remanufacturing System
- 2009
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Ingår i: Proceedings of the 3rd Swedish Production Symposium, Stockholm, Sweden. - 9789163360060 ; , s. 132-138
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Konferensbidrag (refereegranskat)abstract
- This paper is a literature review of challenges within the remanufacturing system. Thechallenges in the remanufacturing system has been categorised in a collection phase, aremanufacturing process phase and a redistribution phase which the challenges havebeen presented according to. The causes and effects of each challenge have beenexplored and are presented in this paper. The final result is a compilation figure with thechallenges for the whole remanufacturing system. In general uncertainties and complexitycan be seen as the main characteristics for the challenges within the remanufacturingsystem.
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| 9. |
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| 10. |
- Sundin, Peter, et al.
(författare)
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International Science Programme : Annual Report for 2008
- 2009
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Rapport (populärvet., debatt m.m.)abstract
- ISP provides long-term support for the development of active and sustainable research environments within these basic sciences in developing countries. The support is directed to research groups and regional networks. The work is carried out in close cooperation with research groups at more advanced host institutions. Although Uppsala Univ. is the base of the operation, ISP functions as a national programme and host laboratories may be located at other Swedish universities, in other Nordic and European countries, and in the regions. This is to meet the requests from developing countries on their own terms.ISP support includes equipment, spare parts consumables, technical services, literature, computer hard- and software, and all costs associated with participating in meetings, exchange visits, training, etc. Besides what has been achieved in terms of development and maintenance of resources, contacts, etc., the outcome of ISP support in 2008 can be summarized by the following figures (assuming that one € equals 10 SEK):19 PhD graduations per M€ invested.54 MSc/MPhil graduations per M€ invested.80 international publications per M€ invested.27 regional or national publications per M€ invested.129 conference contributions (> 40% of which international) per M€ invested.
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