1. |
- Hemmingsson, Eva-Stina, et al.
(author)
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Prevalence of pain and pharmacological pain and treatment among old people in nursing homes in 2007 and 2013
- 2018
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In: European Journal of Clinical Pharmacology. - : Springer. - 0031-6970 .- 1432-1041. ; 74:4, s. 483-488
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Journal article (peer-reviewed)abstract
- Purpose: Many elderly people living in nursing homes experience pain and take analgesic medication. The aim of this study was to analyze the prevalence of pain and pharmacological pain treatment among people living in nursing homes in Sweden, in two large, comparable, samples from 2007 to 2013.Methods: Cross-sectional surveys were performed in 2007 and 2013, including all residents in nursing homes in the county of Västerbotten, Sweden. A total of 4933 residents (2814 and 2119 respectively) with a mean age of 84.6 and 85.0 years participated. Of these, 71.1 and 72.4% respectively were cognitively impaired. The survey was completed by the staff members who knew the residents best.Results: The prescription of opioids became significantly more common while the use of tramadol decreased significantly. The staff reported that 63.4% in 2007 and 62.3% in 2013 had experienced pain. Of those in pain, 20.2% in 2007 and 16.8% in 2013 received no treatment and 73.4 and 75.0% respectively of those with pain, but no pharmacological treatment, were incorrectly described by the staff as being treated for pain.Conclusions: There has been a change in the pharmacological analgesic treatment between 2007 and 2013 with less prescribing of tramadol and a greater proportion taking opioids. Nevertheless, undertreatment of pain still occurs and in many cases, staff members believed that the residents were prescribed analgesic treatment when this was not the case.
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2. |
- Gustavsson, Carl Gunnar, et al.
(author)
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Blood viscosity in relation to blood haemoglobin concentration in healthy subjects and in patients with different cardiovascular diseases
- 1994
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In: Clinical Hemorheology. - New York, USA : Pergamon Press. - 0271-5198. ; 14:5, s. 677-683
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Journal article (peer-reviewed)abstract
- Abstract Blood viscosity was measured at different shear rates using a rotational viscometer, and the correlation between blood viscosity and blood haemoglobin concentration was studied. In 10 healthy controls correlation coefficients were: 0,966 at shear rate 40,0 s-1, 0,931 at 19,6 s-l, 0,817 at 2,3 s-1 and 0,816 at 0,8 s-l , p<0,01 to p < 0,001. The regression lines for these relationships were then applied to the patient groups to calculate what blood viscosity should be predicted solely from the individual haemoglobin concentration, "predicted blood viscosity". In 34 patients with cardiovascular diseases (20 patients with coronary artery disease (CAD), 8 patients with idiopathic dilated cardiomyopathy and 6 patients with primary pulmonary hypertension) the correlation between blood viscosity and haemoglobin concentration was less good, for the total patient material 0,748 to 0,613, p < 0,001 at all shear rates, and for the CAD patients 0,664 to 0,428, p < 0,05 at 3 out of 4 shear rates. Apparently the poorer correlation in the patients was due to a larger influence from factors unrelated to haemoglobin concentration/haematocrit, as the quotients between individually measured and predicted blood viscosity correlated with measured blood viscosity when the haematocrit factor had been eliminated by in vitro standardisation of sample haematocrits to 45%. Key words: Blood viscosity; Haemorheology; Haemoglobin concentration; Microcirculation.
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3. |
- Gustavsson, Carl Gunnar, et al.
(author)
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Changed blood rheology in patients with idiopathic dilated cardiomyopathy
- 1994
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In: Angiology. - New York, USA : Westminster Publications, Inc.. - 0003-3197 .- 1940-1574. ; 45:2, s. 107-111
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Journal article (peer-reviewed)abstract
- Abstract Rheologic properties of blood were studied in 8 patients with dilated cardiomyopathy (DCM) and in 10 healthy subjects. Whole-blood viscosity was measured at four different shear rates, by means of a computer-controlled rotational viscometer. The patients had significantly higher blood viscosity at all shear rates, both at their natural hematocrits and after an in vitro adjustment of sample hematocrits to 45%. Erythrocyte filterability (5 μm pore size) was significantly lower, fibrinogen concentration significantly higher, and HDLcholesterol concentration significantly lower in the patient group. No significant differences were found regarding hematocrit, mean corpuscular volume, haemoglobin concentration, leukocyte count and filterability (8 μm pore size), plasma viscosity, and total cholesterol concentration. The measured hemorheologic abnormalities may contribute to the previously reported reduction of coronary blood flow reserve in DCM patients and to myocardial microcirculatory disturbances, which have been suggested as a cause for DCM.
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4. |
- Gustavsson, Carl G, et al.
(author)
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Vein blood rheology alterations immediately after coronary angiography with iohexol, and one month later.
- 1996
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In: Clinical Hemorheology. - New York, USA : Pergamon Press. - 0271-5198. ; 16:6, s. 737-743
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Journal article (peer-reviewed)abstract
- Abstract The effects of coronary angiography with iohexol upon vein blood rheology were studied before, immediately after and one month after angiography. Haematocrit decreased from 40.5 % to 39.0 % immediately after angiography (p < 0.01). When this was compensated for by in vitro standardisation of sample haematocrits to 45% there was a blood viscosity increase by 10.9 - 15.0 %, at the four studied shear rates 0.8 s-1, 2.3 s-1, 19.6 s-1, and 40.0 s-1 (p < 0.05 - p < 0.01). In unadjusted samples, i.e. at the patients natural haematocrits, there was only a slight and statistically non-significant blood viscosity increase. Plasma viscosity decreased immediately after angiography, and was even lower 1 month after angiography. The haematocrit reduction correlated significantly with the iohexol doses (correlation coefficient -0.852, p < 0.001), whereas no significant correlation was found between the contrast volumes and the alterations of blood and plasma viscosity. Except for plasma viscosity, there were no significant differences when the values before angiography and one month later were compared. Key words: Blood viscosity; Contrast media; Iohexol; Coronary angiography; Haematocrit; Haemorheology
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5. |
- Gustavsson, Stig, 1941-
(author)
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IT i lokalsamhället : konsumentmakt eller operatörsdominans
- 2012
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Licentiate thesis (other academic/artistic)abstract
- Abstract Syftet med detta arbete var att studera villkoren för att stärka konsumenten s, den enskilde medborgarens, den boendes inflytande gentemot de kommersiella IT-aktörerna i samband med bredbandsutbyggnad i svenska kommuner. Det har varit konsumentnyttan vid utbyggnad av bredbandsnäten i svenska lokalsamhällen som har varit förem ålet för den föreliggande studien. Utbyggnaden av en IT-infrastruktur påverkar samhällsutvecklingen och därmed också samhällsplaneringen. En övergripande frågeställning var hur kommuner och bostadsföretag medverkar i konsumenternas värdeskapande processer i samband med etableringen av en IT - stödd servi ceinfrastruktur i lokalsamhället. En organiseringsmodell utvecklades och prövades. Operatörsoberoende och konsumentinflytande är viktiga faktorer för att bedöma konsumentens valmöjligheter i det serviceutbud som oftast är tillgängligt, huvudsakligen på teleoperatörernas villkor. En analysmodell för detta togs fram och dess kategorier utgjorde grunden för utformning av frågor i samband med en större enkät och uppföljande intervjuer med företrädare för kommuner och kommunägda bostadsbolag. Organiseringsmodellen , också kallad idealmodellen, utgjorde en grund för en analysmodell. Analysmodellen utgjorde underlag för fallstudierna och avsåg att analysera bredbandsnätens operatörsoberoende/öppenhet (grad av konkurrens) och konsumentens inflytande vid användning av nätet . Sammansättning av tjänsteutbudet, konsumenten s företrädare för bredbandsfrågorna och slag av tjänster på nätet var andra parametrar. Slutligen var också eventuella effekter i lokalsamhället en viktig fråga för studien. Studien ger en en blandad bild av utvecklingen under den tid den genomfördes. Bostadsföretagen visade ett uttalat intresse att för hyresgästernas räkning utforma IT - systemen i fastigheterna för de boendes trygghet, säkerhet, komfort och energihushållning . De underlättade också ofta byte av operatörer. Något längre gående intresse hos bostadsföretagen eller deras ägare kommunerna att utnyttja den nya infrastrukturen till att stärka det lokala samhällets funktioner och stärka medborgarnas/de boendes inflytande över erbjudna tjänster (utöver mer än en internetoperatör) kunde dock inte identifieras. Tjänster, även kommunala tjänster som utvecklas har i praktiken alltid en utgångspunkt i ett producentintresse. Idealmodellen, i den mening som var utgångspunkt för studien, blev inte realiserad någonstans. I idealmodellen har ett lokalt nät (ett slags intranet) en viktig funktion genom att skapa möjlighet till delaktighet och kommunikation mellan lokala aktörer. En mötesplats borde kunna skapas för lokala aktiviteter. Samhällsengagemanget (politiken) borde vara det som drev detta men saknas uppenbarligen. Även kommersiella drivkrafter saknas. Frågan förblir olöst. Kan det möjligen vara så att de värden ett lokalsamhälle av tradition ger åt sina medborgare inte längre är efterfrågade? Skapar IT -samhället i stället helt nya nätverk som är oberoende av lokalsamhället och hur det fungerar? Intresset för det lokala minskar och ingen samlande struktur synes existera som – med IT som hjälpmed el – vill knyta människorna samman i den lokala kontexten. Nya utmanande forskningsfrågor skymtar.
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7. |
- Lindnér, Per, 1956, et al.
(author)
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Biochemical modulation of intraperitoneal fluorouracil by allopurinol-the effect on an experimental adenocarcinoma in the liver.
- 1994
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In: Anticancer research. - 0250-7005. ; 14:3A, s. 847-52
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Journal article (peer-reviewed)abstract
- In a rat liver tumour system with a nitrosoguanidine-induced carcinoma and in an in vitro system with the same tumour, the effect of allopurinol on the toxicity and antitumour effect of 5-fluorouracil (5-FU) was explored. Two doses of 5-FU, 30 and 60 mg/kg b.w. intraperitoneally (i.p.), were tested with a large dose of allopurinol subcutaneously (s.c.( (300 mg) in rats. The drugs were given for three consecutive days. The lethal toxicity of 60 mg 5-FU i.p. could not be counteracted by allopurinol. Allopurinol and 30 mg 5-FU reduced the tumour growth rate more than 5-FU alone. The spleen was smaller, as a sign of increased toxicity, without allopurinol. The concentration of allopurinol and its metabolites in the general circulation was high. In vitro, there was no additive or specific effect of allopurinol. These results indicate some in vivo metabolic modulation of 5-FU efficacy by allopurinol if 5-FU is administered intraperitoneally and allopurinol systemically.
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8. |
- Lindnér, Per, 1956, et al.
(author)
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Hepatic artery occlusion and energy charge in rat liver tumour.
- 1994
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In: Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. - 0923-7534. ; 5:10, s. 961-3
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Journal article (peer-reviewed)abstract
- Hepatic artery ligation (HAL) is a model for inducing a vascular attack on liver tumours which causes a reduction in tumour growth. To determine in an experimental rat liver adenocarcinoma the duration and magnitude of changes in adenonucleotide concentration and energy charge (EC) after HAL, analyses of energy-rich nucleotides were performed at 1, 2, 24 and 168 hours after HAL or a SHAM procedure. There was a significant decrease of the ATP content and energy charge in the tumour one hour after HAL. Two hours after HAL this difference had decreased and with longer observation it was not detectable. Twenty-four hours of starvation did not significantly alter the effects of HAL on the tumour. HAL gives rise to a transient energy depletion of the tumour which is not completely compensated for by glycolysis after 1 hour, but is restored after 2 hours.
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9. |
- Naredi, Peter, 1955, et al.
(author)
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The influence of hepatic artery ligation and of vasopressin on liver tumour blood flow in rats.
- 1992
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In: Journal of surgical oncology. - : Wiley. - 0022-4790 .- 1096-9098. ; 50:2, s. 70-6
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Journal article (peer-reviewed)abstract
- The blood flow in an experimental adenocarcinoma in the rat liver was determined with the 133Xe-washout technique before and after hepatic artery ligation (HAL). There was an initial reduction of the washout of 50%. This was further reduced after 1 day by 50%, which was maintained for 7 days. Seven days after HAL or sham procedures the 133Xe-washout was of similar magnitude in the liver tumours, although after the sham procedure the tumours were larger (3.4 g vs. 1.5 g). The estimated tumour blood flow was then approximately 0.04 ml x min-1 x g-1. The influence on normal liver parenchyma of HAL was a reduction at 30 minutes, which was maintained for 7 days. Postacton--a synthetic vasopressin--did not influence the 133Xe-washout in normal liver parenchyma in non-tumour, as well as in tumour-bearing animals. There was no influence of Postacton on the 133Xe-washout in the liver tumours. Thirty minutes after HAL Postacton gave a reduction of blood flow in normal liver parenchyma of tumour-bearing animals, which is thus only from the portal vein. In tumours Postacton did not significantly reduce the tumour blood flow immediately after HAL.
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10. |
- Persson, Sylvi, et al.
(author)
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Increased blood viscosity and decreased red cell filterability in patients with dilated cardiomyopathy
- 1991
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In: 7th European Conference on Clinical Haemorheology, Southampton, United Kingdom, July 16-19, 1991..
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Conference paper (peer-reviewed)abstract
- Abstract Rheological properties o f blood were studied in eight patients with dilated cardiomyopathy (DCM) and ten healthy controls . Whole blood viscosity was measured at 4 different shear rates, using a computer controlled rotational viscometer. Patients had significantly higher blood viscosity at all shear rates, both at the patients natural hematocrits and after in vitro adjustment of sample hematocrits to 45%. Erythrocyte filterability measured by St George's Filtrometer and expressed as red cell transit time (RCTT) were significantly lower in patients. Hematocrits were higher but not statistically significant. No differences were found regarding plasma viscosity, leucocyte count and leucocyte filterability. The blood rheology changes found in this study may contribute to myocardial perfusion disturbances, which have been suggested a s a cause for DCM. The coronary blood flow reserve is reduced in patients with DCM as well as in patients with angina pectoris, both with and without coronary artery stenosis (Syndrome X). In all three patients cathegories we have found increased blood viscosity but DCM differs by by normal plasma viscosity.
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