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- Henderson, Audrey J., et al.
(författare)
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Skin colour changes during experimentally-induced sickness
- 2017
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Ingår i: Brain, behavior, and immunity. - : Elsevier BV. - 0889-1591 .- 1090-2139. ; 60, s. 312-318
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Tidskriftsartikel (refereegranskat)abstract
- Skin colour may be an important cue to detect sickness in humans but how skin colour changes with acute sickness is currently unknown. To determine possible colour changes, 22 healthy Caucasian participants were injected twice, once with lipopolysaccharide (LPS, at a dose of 2ng/kg body weight) and once with placebo (saline), in a randomised cross-over design study. Skin colour across 3 arm and 3 face locations was recorded spectrophotometrically over a period of 8h in terms of lightness (L(∗)), redness (a(∗)) and yellowness (b(∗)) in a manner that is consistent with human colour perception. In addition, carotenoid status was assessed as we predicted that a decrease it skin yellowness would reflect a drop in skin carotenoids. We found an early change in skin colouration 1-3h post LPS injection with facial skin becoming lighter and less red whilst arm skin become darker but also less red and less yellow. The LPS injection also caused a drop in plasma carotenoids from 3h onwards. However, the timing of the carotenoid changes was not consistent with the skin colour changes suggesting that other mechanisms, such as a reduction of blood perfusion, oxygenation or composition. This is the first experimental study characterising skin colour associated with acute illness, and shows that changes occur early in the development of the sickness response. Colour changes may serve as a cue to health, prompting actions from others in terms of care-giving or disease avoidance. Specific mechanisms underlying these colour changes require further investigation.
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- Janszky, I, et al.
(författare)
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Inflammatory markers and heart rate variability in women with coronary heart disease
- 2004
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 256:5, s. 421-428
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. Both heart rate variability (HRV) and inflammatory markers are carrying prognostic information in coronary heart disease (CHD), however, we know of no studies examining their relation in CHD. The aim of this study, therefore, was,to assess the association between HRV and inflammatory activity, as reflected by the levels of interleukin-6 (IL-6), IL-1 receptor antagonist (IL-1ra) and C-reactive protein (CRP). Subjects and methods. Consecutive women patients who survived hospitalization for acute myocardial infarction, and/or underwent a percutaneous transluminal coronary angioplasty or a coronary artery bypass grafting were included and evaluated in a stable condition 1 year after the index events. An ambulatory 24-h ECG was recorded during normal activities. SDNN index (mean of the standard deviations of all normal to normal intervals for all 5-min segments of the entire recording) and the following frequency domain parameters were assessed: total power, high frequency (HF) power, low frequency (LF) power and very low frequency (VLF) power. Levels of high-sensitivity CRP were measured by nephelometry, IL-6 and IL-1ra concentrations were determined by enzyme immunoassay. Results. Levels of IL-6 showed an inverse relation with HRV measures even after controlling for potential confounding factors. The P-values were 0.02, 0.04, 0.01, 0.03, 0.18 for the multivariate association with SDDN index, total power, VLF power, LF power and HF power respectively. In contrast, the inverse relationship between HRV measures and CRP or IL-1ra levels were weak and nonsignificant. Correlation coefficients for the relationship between IL-6 and HRV measures were both uni- and multivariately higher than for the relationship between HRV measures and any other factors evaluated in this study. Conclusion. Concentration of IL-6 showed a negative, independent association with HRV in women with CHD. Thus, increased inflammatory activity, as reflected by IL-6 levels, may represent a new auxiliary mechanism linking decreased HRV to poor prognosis in CHD.
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- Lekander, I, et al.
(författare)
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Cost-effectiveness of hormone replacement therapy for menopausal symptoms in the UK
- 2009
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Ingår i: Menopause international. - : SAGE Publications. - 1754-0453. ; 15:1, s. 19-25
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Tidskriftsartikel (refereegranskat)abstract
- To estimate the cost-effectiveness of five-year treatment of hormone replacement therapy (HRT) compared with no treatment for women with menopausal symptoms in the UK. Method A Markov cohort simulation model with tunnel techniques was used to assess the cost-effectiveness of HRT in women aged 50 years. For the clinical effects of HRT we used, where possible, results taken from the Women's Health Initiative (WHI). The model had a life-time horizon with cycle lengths of one year and contained the following disease states: hip fracture, vertebral fracture, wrist fracture, breast cancer, colorectal cancer, coronary heart disease, stroke and venous thromboembolic events. An intervention was modelled by its impact on the disease risks during and after stopping treatment. The model was populated with UK-specific data on risks, mortality rates, quality-of-life weights and costs. The main outcome of the model was cost per quality-adjusted life year (QALY) gained of HRT compared with no treatment. Results The results indicated that it was cost-effective to treat women with menopausal symptoms with HRT in the UK. The severity of menopausal symptoms was the single most important determinant of cost-effectiveness, but HRT remained cost-effective even where symptoms were mild or effects on symptom relief were small. Conclusions Treatment of women with menopausal symptoms with HRT is cost-effective.
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- Mozaffari, F, et al.
(författare)
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NK-cell and T-cell functions in patients with breast cancer : effects of surgery and adjuvant chemo- and radiotherapy
- 2007
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Ingår i: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 97:1, s. 105-111
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer is globally the most common malignancy in women. Her2-targeted monoclonal antibodies are established treatment modalities, and vaccines are in late-stage clinical testing in patients with breast cancer and known to promote tumour-killing through mechanisms like antibody-dependent cellular cytotoxicity. It is therefore increasingly important to study immunological consequences of conventional treatment strategies. In this study, functional tests and four-colour flow cytometry were used to detect natural killer (NK)-cell functions and receptors as well as T-cell signal transduction molecules and intracellular cytokines in preoperative breast cancer patients, and patients who had received adjuvant radiotherapy or adjuvant combined chemo-radiotherapy as well as in age-matched healthy controls. The absolute number of NK cells, the density of NK receptors as well as in vitro quantitation of functional NK cytotoxicity were significantly higher in preoperative patients than the post-treatments group and controls. A similar pattern was seen with regard to T-cell signalling molecules, and preoperative patients produced significantly higher amounts of cytokines in NK and T cells compared to other groups. The results indicate that functions of NK and T cells are well preserved before surgery but decrease following adjuvant therapy, which may speak in favour of early rather than late use of immunotherapeutic agents such as trastuzumab that may depend on intact immune effector functions.
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- Olesen, J, et al.
(författare)
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Funding of headache research in Europe
- 2007
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Ingår i: Cephalalgia : an international journal of headache. - : SAGE Publications. - 0333-1024. ; 27:9, s. 995-999
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Tidskriftsartikel (refereegranskat)abstract
- Migraine costs European Society ¬27 billion per year. Other headaches may account for a similar amount. Given this enormous impact, the question arises as to whether the funding of research efforts in this field are sufficient. A recent European study called the Resource Allocation to Brain Research in Europe (RABRE) examined funding of brain research. Identified charities and Government agencies in Europe filled out a questionnaire regarding their funding of brain diseases. Industry spending was evaluated by three different previously validated methods. In the present report, detailed results are presented for migraine and other headaches. In 2004, migraine research was funded by nearly €315 million. Of this, €308 million was invested by the pharmaceutical industry, whereas public funding was estimated at €7 million. No funding was identified for non-migraine headache disorders. Of the public spending, €714 000 came from private foundations. There was a very large difference between different European countries in the funding of headache research. When public funding was compared with the cost of different brain disorders, migraine funding was in the middle range. This was due to relatively large industry funding. Compared with societal costs, migraine received the least public funds amongst all brain disorders, i.e. 0.025%. We conclude that migraine attracts reasonable interest from the pharmaceutical industry, but Governmental and charity funding is extremely low and no funding was identified for non-migraine headache disorders. Considering the huge economic impact of these disorders, public funding of research into migraine and other headaches should be greatly increased in the future.
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- Sobocki, P., et al.
(författare)
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Resource allocation to brain research in Europe (RABRE)
- 2006
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Ingår i: The European journal of neuroscience. - : Blackwell Publishing Ltd. - 1460-9568 .- 0953-816X. ; 24:10, s. 2691-2693
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Tidskriftsartikel (refereegranskat)abstract
- This article is a markedly condensed summary of a longer report [Resource allocation to brain research in Europe (RABRE), part 2] that is simultaneously published on line: (i) as supplementary material linked to this European Journal of Neuroscience article (http://www.blackwell-synergy.com/loi/ejn) and (ii) on the website of the European Brain Council (http://www.europeanbraincouncil.org/ publications). We have recently shown that brain diseases account for 35% of the overall disease burden and cost European society almost €400 billion per year (a billion is understood to mean one thousand million throughout this report). The aim of the present study was to estimate funding for brain research in Europe and the cost-benefit of further investments in this area of research. The assessment of funding included public sources (governmental agencies plus charities) and industry funding. The assessment of publicly financed research support for brain research was based on a comprehensive survey, and industry investment in brain research was assessed based on published data on pharmaceutical development. The total funding of brain research in Europe was estimated at €4.1 billion in 2005, of which public grants amounted to <€900 million. Thus, industry funding accounted for 79%. Although cancer only incurred 50% of the cost of brain diseases in 2005, public grants for cancer research were almost twice as high as the public financial support of brain research. US-based funding of brain research was almost four times higher than European funding. We assessed the cost-benefit of further investment in brain research using different methods. They all showed that increased investment in brain research is likely to be highly cost-effective. We conclude that European spending on brain research, particularly public spending, is low compared to other fields of research and to the US, and that increased investment in brain research seems warranted.
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| 23. |
- Sobocki, P, et al.
(författare)
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The economic burden of depression in Sweden from 1997 to 2005
- 2007
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Ingår i: European psychiatry : the journal of the Association of European Psychiatrists. - : Cambridge University Press (CUP). - 0924-9338. ; 22:3, s. 146-152
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDepression is one of the most common causes of disability and is associated with substantial reductions in the individual's quality of life. The aim of this study was to estimate the economic burden of depression to Swedish society from 1997 to 2005.Materials and MethodsThe study was conducted in a cost-of-illness framework, measuring both the direct cost of providing health care to depressive patients, and the indirect costs as the value of production that is lost due to morbidity or mortality. The costs were estimated by a prevalence and top-down approach.ResultsThe cost of depression increased from a total of €1.7 billion in 1997 to €3.5 billion in 2005, representing a doubling of the burden of depression to society. The main reason for the cost increase is found in the significant increase in indirect costs due to sick leave and early retirement during the past decade, whereas direct costs were relatively stable over time. In 2005, indirect costs were estimated at €3 billion (86% of total costs) and direct costs at €500 million (16%). Cost of drugs was estimated at €100 million (3% of total cost).ConclusionThe cost of depression is substantial to society and the main cost driver is indirect costs due to sick leave and early retirement. The cost of depression has doubled during the past eight years making it a major public health concern for the individuals afflicted, carers and decision makers.
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| 26. |
- Willers, C., et al.
(författare)
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The Association of Pre-stroke Psychosis and Post-stroke Levels o Health, Resource Utilization, and Care Process: A Register-Based Study
- 2018
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Ingår i: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: While approximately one percent of the global population is formally diagnosed with psychosis or schizophrenia, the actual number is expected to be significantly higher. These patients often consume more healthcare resources and have poorer somatic health. In this study, we analyze potential differences in health, resources, and care process between stroke patients with and without a previous diagnosis of psychosis or schizophrenia. Methods: Ischemic stroke patients from seven regions in Sweden were identified via ICD-10 codes (163.0-9) in regional administrative systems and the Swedish Stroke Register, and approximately 70% of all ischemic stroke cases in Sweden during 2008-2011 were included (n = 46,350). Relevant patient-level data from national registries were linked to enable multivariate regression analysis, including data on socioeconomics, mortality, municipality services, and filled prescriptions. History of psychosis or schizophrenia was defined via ICD-10 codes F20-29 (n = 389). Results: Patient-reported functional outcomes at 3 months and 1 year were significantly lower in the psychosis subgroup, and stroke recurrence was higher. Patients with pre-stroke psychosis did not receive the same levels of reperfusion treatment as the non-psychosis group. Time at the stroke unit was the same, as were first-year levels of somatic care, but dispensation of antihypertensives was less common. Conclusion: Our findings emphasize the importance of taking mental comorbidity into account during stroke treatment as well as when evaluating indicators for health, resources, and the care process, since mental comorbidity such as psychosis or schizophrenia may have a significant impact the year preceding and the year succeeding the stroke event.
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