| 1. |
- Rådegran, Göran, et al.
(author)
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Characteristics and survival of adult Swedish PAH and CTEPH patients 2000-2014
- 2016
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In: Scandinavian Cardiovascular Journal. - : Taylor & Francis. - 1401-7431 .- 1651-2006. ; 50:4, s. 243-250
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The Swedish Pulmonary Arterial Hypertension Register (SPAHR) is an open continuous register, including pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) patients from 2000 and onwards. We hereby launch the first data from SPAHR, defining baseline characteristics and survival of Swedish PAH and CTEPH patients.DESIGN: Incident PAH and CTEPH patients 2008-2014 from all seven Swedish PAH-centres were specifically reviewed.RESULTS: There were 457 PAH (median age: 67 years, 64% female) and 183 CTEPH (median age: 70 years, 50% female) patients, whereof 77 and 81%, respectively, were in functional class III-IV at diagnosis. Systemic hypertension, diabetes, ischaemic heart disease and atrial fibrillation were common comorbidities, particularly in those >65 years. One-, 3- and 5-year survival was 85%, 71% and 59% for PAH patients. Corresponding numbers for CTEPH patients with versus without pulmonary endarterectomy were 96%, 89% and 86% versus 91%, 75% and 69%, respectively. In 2014, the incidence of IPAH/HPAH, associated PAH and CTEPH was 5, 3 and 2 per million inhabitants and year, and the prevalence was 25, 24 and 19 per million inhabitants.CONCLUSION: The majority of the PAH and CTEPH patients were diagnosed at age >65 years, in functional class III-IV, and exhibiting several comorbidities. PAH survival in SPAHR was similar to other registers.
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| 2. |
- Bergh, Claes-Håkan, 1951, et al.
(author)
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Intravenous levosimendan vs. dobutamine in acute decompensated heart failure patients on beta-blockers
- 2010
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In: European Journal of Heart Failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 12:4, s. 404-410
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Journal article (peer-reviewed)abstract
- The aim of this study is to compare the effects of a 24 h intravenous infusion of levosimendan and a 48 h infusion of dobutamine on invasive haemodynamics in patients with acutely decompensated chronic NYHA class III-IV heart failure. All patients were receiving optimal oral therapy including a beta-blocker. METHODS AND RESULTS: This was a multinational, randomized, double-blind, phase IV study in 60 patients; follow-up was 1 month. There was a significant increase in cardiac index and a significant decrease in pulmonary capillary wedge pressure (PCWP) at 24 and 48 h for both dobutamine and levosimendan. The improvement in cardiac index with levosimendan was not significantly different from dobutamine at 24 h (P = 0.07), but became significant at 48 h (0.44 +/- 0.56 vs. 0.66 +/- 0.63 L/min/m(2); P = 0.04). At 24 h, the reduction in the mean change in PCWP from baseline was similar for levosimendan and dobutamine, however, at 48 h the difference was more marked for levosimendan (-3.6 +/- 7.6 vs. -8.3 +/- 6.7 mmHg; P = 0.02). No difference was observed between the groups for change in NYHA class, beta-blocker use, hospitalizations, treatment discontinuations or rescue medication use. Reduction in B-type natriuretic peptide (BNP) was significantly greater with levosimendan at 48 h (P = 0.03). According to physician's assessment, the improvement in fatigue (P = 0.01) and dyspnoea (P = 0.04) was in favour of dobutamine treatment, and hypotension was significantly more frequent with levosimendan (P = 0.007). No increase in atrial fibrillation or ventricular tachycardia was seen in either group. CONCLUSION: A 24 h levosimendan infusion achieved haemodynamic and neurohormonal improvement that was at least comparable at 24 h and superior at 48 h to a 48 h dobutamine infusion.
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| 3. |
- Boman, Bengt, et al.
(author)
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Anaerob-aerob drift av luftade dammar för skogsindustriell avloppsvattenrening
- 1989
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Reports (other academic/artistic)abstract
- Möjligheter att åstadkomma elenergibesparingar inom skogsindustrin genom modifiering av luftade dammar till anaerob-aerob drift har studerats i laboratorieskala. I tre parallella system behandlades avloppsvatten från tillverkning av såväl oblekt som blekt sulfatmassa samt avloppsvatten från CTMP-tillverkning. I samtliga 7 genomförda försök var den totala uppehållstiden 7 dygn. Behandlingen genomfördes vid rumstemperatur (20-22ºC) efter pH-justering, men utan tillsats av närsalter. Inverkan av avloppsvattnets uppehållstid under anaeroba betingelser liksom inverkan av slamrecirkulering undersöktes. Uppehållstiden i det anaeroba steget var härvid antingen 2,3 eller 4,6 dygn, dvs antingen 33 eller 66% av dammens totalvolym utgjorde ett anaerobt behandlingssteg. Ett kontrollförsök drevs under betingelser motsvarande de som upprätthålls sommartid i konventionella luftade dammar, dvs med hela volymen luftad. Försöksresultaten visar att för avloppsvatten från såväl oblekt som blekt sulfatmassa kan samma eller bättre behandlingsresultat erhållas vid övergång från helt anaerob till kombinerad anaerob-aerob drift
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| 4. |
- Gustafsson, Birgitta, E., 1950-
(author)
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Att sätta sig själv på spel : Om språk och motspråk i pedagogisk praktik
- 2008
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Doctoral thesis (other academic/artistic)abstract
- In order to change and to think in new ways boundaries of thought and action must be dislodged or crossed. To do this, something needs to disrupt the conceptual world. Counter-language is therefore a recurring concept in this dissertation. Art can be seen as counter-language, but also pedagogical processes can have this characteristic. Counter-language is that which provokes, that which calls into question the language people use to interpret their life experiences. In this dissertation I examine two pedagogical chains of events that challenge the participants' "world view", and in which the participants meet a counter-language aimed at the type of learning that involves the confirmation of knowledge. How do the participants in these two arenas describe these events, and how do they approach the pedagogical "game”? The goal is to organize in theoretical themes and to put into words the concrete images of the pedagogical context where individuals' world view and self-image are confronted, and to interpret and analyze them. The empirical part of this study involves two arenas. The first arena is an encounter between the school and the theatre. An analysis of group interviews shows how teachers talk about theatre and its potential in educational contexts. The second arena is a university course in cultural pedagogy in which the participants' written assignments comprise the empirical material. What happens when the participants experience counter-language? When conceptual worlds are confronted or challenged, we can react in different ways. We are faced with the choice to choose, to either look at or to look away. In encounters with counter-language, teachers and course participants are confronted with these choices. Should they engage in the pedagogical "game"? The results show what happens when the participants are confronted with counter-language. Three different action strategies are formulated: "to go into," "to stay put," and "to flee from." People strive to create order, to create meaning, in everything that happens. This involves both cognitive and existential meaning-making. In this perspective learning involves meaning-making processes in which pupils' understandings of themselves and the world are provoked and challenged. A frequently occurring notion about learning is that it is a linear process in which new knowledge is added to previously learned knowledge in a summative process. However, learning is more complex than this. Less frequently do people speak of challenging and provoking existing knowledge. It is my intention to problematize this. By way of conclusion, didactic issues concerning the school, and the teacher education are discussed in light of this study’s findings.
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| 5. |
- Lauten, Alexander, et al.
(author)
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Percutaneous Left-Ventricular Support With the Impella-2.5-Assist Device in Acute Cardiogenic Shock Results of the Impella-EUROSHOCK-Registry
- 2013
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In: Circulation Heart Failure. - 1941-3289 .- 1941-3297. ; 6:1, s. 23-30
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Journal article (peer-reviewed)abstract
- Background-Acute cardiogenic shock after myocardial infarction is associated with high in-hospital mortality attributable to persisting low-cardiac output. The Impella-EUROSHOCK-registry evaluates the safety and efficacy of the Impella-2.5-percutaneous left-ventricular assist device in patients with cardiogenic shock after acute myocardial infarction. Methods and Results-This multicenter registry retrospectively included 120 patients (63.6 +/- 12.2 years; 81.7% male) with cardiogenic shock from acute myocardial infarction receiving temporary circulatory support with the Impella-2.5-percutaneous left-ventricular assist device. The primary end point evaluated mortality at 30 days. The secondary end point analyzed the change of plasma lactate after the institution of hemodynamic support, and the rate of early major adverse cardiac and cerebrovascular events as well as long-term survival. Thirty-day mortality was 64.2% in the study population. After Impella-2.5-percutaneous left-ventricular assist device implantation, lactate levels decreased from 5.8 +/- 5.0 mmol/L to 4.7 +/- 5.4 mmol/L (P=0.28) and 2.5 +/- 2.6 mmol/L (P=0.023) at 24 and 48 hours, respectively. Early major adverse cardiac and cerebrovascular events were reported in 18 (15%) patients. Major bleeding at the vascular access site, hemolysis, and pericardial tamponade occurred in 34 (28.6%), 9 (7.5%), and 2 (1.7%) patients, respectively. The parameters of age >65 and lactate level >3.8 mmol/L at admission were identified as predictors of 30-day mortality. After 317 +/- 526 days of follow-up, survival was 28.3%. Conclusions-In patients with acute cardiogenic shock from acute myocardial infarction, Impella 2.5-treatment is feasible and results in a reduction of lactate levels, suggesting improved organ perfusion. However, 30-day mortality remains high in these patients. This likely reflects the last-resort character of Impella-2.5-application in selected patients with a poor hemodynamic profile and a greater imminent risk of death. Carefully conducted randomized controlled trials are necessary to evaluate the efficacy of Impella-2.5-support in this high-risk patient group.
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| 6. |
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| 7. |
- Olofson, Jan, 1947, et al.
(author)
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Prediction of COPD and Related Events Improves by Combining Spirometry and the Single Breath Nitrogen Test
- 2018
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In: Copd-Journal of Chronic Obstructive Pulmonary Disease. - : Informa UK Limited. - 1541-2555 .- 1541-2563. ; 15:5, s. 424-431
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Journal article (peer-reviewed)abstract
- Chronic obstructive pulmonary disease (COPD) develops in small airways. Severity of small airway pathology relates to progression and mortality. The present study evaluated the prediction of COPD of a validated test for small airway disease, i.e. a slope of the alveolar plateau of the single breath nitrogen test (N-2-slope). The N-2-slope, spirometry, age, smoking habits, and anthropometric variables at baseline were obtained in a population-based sample (n = 592). The cohort was followed for first COPD events (first hospital admission of COPD or related conditions or death from COPD) during 38 years. During follow-up, 52 subjects (8.8%) had a first COPD event, of which 18 (3.0%) died with a first COPD diagnosis. In the proportional hazard regression analysis adjusted for age and smoking habits, the cumulative COPD event incidence increased from 5% among those with high forced expired volume in one second (FEV1) to 25% among those with low FEV1, while increasing from 4% among those with the lowest N-2-slope to 26% among those with the highest. However, combining the N-2-slope and FEV1 resulted in considerable synergy in the prediction of first COPD event and even more so when taking account of smoking habits. The cumulative COPD event incidence rate was 75% among heavy smokers with the highest N-2-slope and lowest FEV1, and less than 1% among never smokers with the lowest N-2-slope and highest FEV1. Thus, combining the results of the single breath N-2-slope and FEV1 considerably improved the prediction of COPD events as compared to either test alone.
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