| 1. |
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| 2. |
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| 3. |
- Löfberg, Anne-Marie, et al.
(author)
-
The use of below-knee percutaneous transluminal angioplasty in arterial occlusive disease causing chronic critical limb ischemia
- 1996
-
In: Cardiovascular and Interventional Radiology. - 0174-1551 .- 1432-086X. ; 19:5, s. 317-322
-
Journal article (peer-reviewed)abstract
- PURPOSE: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). METHODS: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n = 39) or in combination with PTA of the superficial and/or popliteal artery (n = 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs. RESULTS: A technically successful PTA with at least one crural level was achieved in 88% of cases (n = 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. CONCLUSION: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions.
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| 4. |
- Ahlborg, Liv, et al.
(author)
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Visuospatial ability correlates with performance in simulated gynecological laparoscopy
- 2011
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 157:1, s. 73-77
-
Journal article (peer-reviewed)abstract
- Objective: To analyze the relationship between visuospatial ability and simulated laparoscopy performed by consultants in obstetrics and gynecology (OBGYN). Study design: This was a prospective cohort study carried out at two community hospitals in Sweden. Thirteen consultants in obstetrics and gynecology were included. They had previously independently performed 10-100 advanced laparoscopies. Participants were tested for visuospatial ability by the Mental Rotations Test version A (MRT-A). After a familiarization session and standardized instruction, all participants subsequently conducted three consecutive virtual tubal occlusions followed by three virtual salpingectomies. Performance in the simulator was measured by Total Time, Score and Ovarian Diathermy Damage. Linear regression was used to analyze the relationship between visuospatial ability and simulated laparoscopic performance. The learning curves in the simulator were assessed in order to interpret the relationship with the visuospatial ability. Results: Visuospatial ability correlated with Total Time (r = -0.62; p = 0.03) and Score (r = 0.57; p = 0.05) in the medium level of the virtual tubal occlusion. In the technically more advanced virtual salpingectomy the visuospatial ability correlated with Total Time (r = -0.64; p = 0.02), Ovarian Diathermy Damage (r = -0.65; p = 0.02) and with overall Score (r = 0.64; p = 0.02). Conclusions: Visuospatial ability appears to be related to the performance of gynecological laparoscopic procedures in a simulator. Testing visuospatial ability might be helpful when designing individual training programs.
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| 5. |
- Andersson, Pehr, et al.
(author)
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Working memory and virtual endoscopy simulation
- 2004
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In: Proceedings of the twenty-sixth annual conference of the cognitive science society. - Mahwah : Lawrence Erlbaum Associates. - 9780805854640 ; , s. 1519-1519
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Conference paper (peer-reviewed)
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| 6. |
- Bergqvist, David, et al.
(author)
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Paediatric arterial trauma
- 1998
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In: European Journal of Surgery. - : Oxford University Press (OUP). - 1102-4151 .- 1741-9271. ; 164:10, s. 723-731
-
Journal article (peer-reviewed)
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| 7. |
- Borgqvist, Martin, 1980-, et al.
(author)
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Certifierad energikonsult livsmedelsbutiker
- 2017
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Reports (other academic/artistic)abstract
- Denna förstudie har undersökt förutsättningarna för en frivillig, ej ackrediterad certifiering av energikonsulter för livsmedelsbutiker. Det långsiktiga målet är att butiker med hjälp av certifierade energikonsulter skall få effektiva och kvalitativa energikartläggningar som innefattar såväl fastighetens som verksamhetens energianvändning och hur de olika delarna kan samverka för största möjliga energieffektivisering.Det finns en mycket stor potential att spara energi i butiker. Dagens genomsnittsbutik kan minska sin energianvändning med en tredjedel. Idag finns också en ökad miljömedvetenhet hos svenska livsmedelsbutiker, och med ett större behov av kyld mat har energifrågorna fått en allt större betydelse. Medlemmar i BELIVS Innovationskluster har länge efterfrågat en certifiering av energikonsulter för livmedelsbutiker, som utgår ifrån beställarnas behov. Detta för att öka andelen butiker med låg energianvändning, säker drift och liten miljöpåverkan.Förstudiens resultat består av; identifierade behov ur ett beställarperspektiv, en kravspecifikation som beskriver certifieringens kompetenskrav, en beskrivning av hur en certifiering är tänkt att gå till, samt ett exempel på hur ett certifieringsprov kan se ut. Dessutom har fyra stycken testcertifieringar genomförts, där exempelprovet har testats av energikonsulter. Tanken är att förstudiens resultat skall kunna användas som underlag för att ta fram ett färdigt certifieringsprogram.Den generella slutsatsen från förstudien är att certifieringen av energikonsulter för livsmedelsbutiker är genomförbar, men beställarna behöver efterfråga certifieringen i sina upphandlingar av konsulter om denna skall slå på marknaden. Baserat på diskussioner med representanter från konsultsidan, bedömer projektgruppen att det finns ett intresse för certifieringen så länge beställarna kommer att efterfråga detta. Att få fler beställare bakom den föreslagna certifieringen är den viktigaste åtgärden i ett nästa steg.RISE har drivit projektet tillsammans med INCERT, ICA Fastigheter, Coop och Hållbar Miljö & Strategi. Projektgruppen har haft kontakt med Bergendahls och Axfood vilka har deltagit vid enstaka arbetsmöten.Finansiärer av förstudien är Energimyndigheten, INCERT, ICA Fastigheter, Coop samt Bergendahls.
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| 8. |
- Bostner, Josefine, et al.
(author)
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Activation of Akt, mTOR, and the estrogen receptor as a signature to predict tamoxifen treatment benefit
- 2013
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In: Breast Cancer Research and Treatment. - : Springer Verlag (Germany). - 0167-6806 .- 1573-7217. ; 137:2, s. 397-406
-
Journal article (peer-reviewed)abstract
- The frequent alterations of the PI3K/Akt/mTOR-growth signaling pathway are proposed mechanisms for resistance to endocrine therapy in breast cancer, partly through regulation of estrogen receptor alpha (ER) activity. Reliable biomarkers for treatment prediction are required for improved individualized treatment. We performed a retrospective immunohistochemical analysis of primary tumors from 912 postmenopausal patients with node-negative breast cancer, randomized to either tamoxifen or no adjuvant treatment. Phosphorylated (p) Akt-serine (s) 473, p-mTOR-s2448, and ER phosphorylations-s167 and -s305 were evaluated as potential biomarkers of prognosis and tamoxifen treatment efficacy. High expression of p-mTOR indicated a reduced response to tamoxifen, most pronounced in the ER+/progesterone receptor (PgR) + subgroup (tamoxifen vs. no tamoxifen: hazard ratio (HR), 0.86; 95 % confidence interval (CI), 0.31-2.38; P = 0.78), whereas low p-mTOR expression predicted tamoxifen benefit (HR, 0.29; 95 % CI, 0.18-0.49; P = 0.000002). In addition, nuclear p-Akt-s473 as well as p-ER at -s167 and/or -s305 showed interaction with tamoxifen efficacy with borderline statistical significance. A combination score of positive pathway markers including p-Akt, p-mTOR, and p-ER showed significant association with tamoxifen benefit (test for interaction; P = 0.029). Cross-talk between growth signaling pathways and ER-signaling has been proposed to affect tamoxifen response in hormone receptor-positive breast cancer. The results support this hypothesis, as an overactive pathway was significantly associated with reduced response to tamoxifen. A clinical pre-treatment test for cross-talk markers would be a step toward individualized adjuvant endocrine treatment with or without the addition of PI3K/Akt/mTOR pathway inhibitors.
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| 9. |
- Cunningham, Janet, et al.
(author)
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Antibody Responses to Severe Acute Respiratory Syndrome Coronavirus 2 in the Serum and Cerebrospinal Fluid of Patients With Coronavirus Disease 2019 and Neurological Symptoms
- 2022
-
In: Journal of Infectious Diseases. - : Oxford University Press (OUP). - 0022-1899 .- 1537-6613. ; 225:6, s. 965-970
-
Journal article (peer-reviewed)abstract
- Antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in serum and cerebrospinal fluid (CSF) samples from 16 patients with coronavirus disease 2019 and neurological symptoms were assessed using 2 independent methods. Immunoglobulin G (IgG) specific for the virus spike protein was found in 81% of patients in serum and in 56% in CSF. SARS-CoV-2 IgG in CSF was observed in 2 patients with negative serological findings. Levels of IgG in both serum and CSF were associated with disease severity (P < .05). All patients with elevated markers of central nervous system damage in CSF also had CSF antibodies (P = .002), and CSF antibodies had the highest predictive value for neuronal damage markers of all tested clinical variables.
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| 10. |
- Cunningham, Janet L, et al.
(author)
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Anti-SARS-CoV2 antibody responses in serum and cerebrospinal fluid of COVID-19 patients with neurological symptoms.
- 2022
-
In: The Journal of infectious diseases. - : Oxford University Press (OUP). - 1537-6613 .- 0022-1899. ; 225:6, s. 965-970
-
Journal article (peer-reviewed)abstract
- Antibody responses to SARS-CoV-2 in serum and CSF from 16 COVID-19 patients with neurological symptoms were assessed using two independent methods. IgG specific for the virus spike protein was found in 81% of cases in serum and in 56% in CSF. SARS-CoV-2 IgG in CSF was observed in two cases with negative serology. Levels of IgG in both serum and CSF were associated with disease severity (p<0.05). All patients with elevated markers of CNS damage in CSF also had CSF antibodies (p=0.002), and CSF antibodies had the highest predictive value for neuronal damage markers of all tested clinical variables.
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| 11. |
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| 12. |
- Gullö, Jan-Olof, 1961-, et al.
(author)
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A hundred years of pop music : similarities and differences between Irving Berlin and Max Martin
- 2020
-
Conference paper (pop. science, debate, etc.)abstract
- As previous research clearly shows, a variety of competencies are used and needed among artists, musicians, music producers and others active in the art of popular music production. We chose to focus on two very successful persons in popular music: Irving Berlin (1888-1989) and Martin Sandberg (1971-), also known as Max Martin. In this study we present an analysis of core aspects of Irving Berlin and Martin Sandberg's songs and creative work. Although there are of course great differences in the surrounding culture in which they were and are active, it is still evident which similarities they both show. The analysis is based on a comprehensive interview with Irving Berlin by Frank Ward O'Malley (1875-1932), originally published in 'The American Magazine', Volume 90, October 1920, where he presented "Nine Rules for Writing Popular Songs" and on an interview we conducted ourselves with Martin Sandberg in November 2019. For the analysis we also used a music production and song writing model based on strategies that were used by the successful Swedish music producer Dag Volle (1963–1998), also known as Denniz PoP. Volle lacked formal music education, but he had some unique music-producer skills and also developed new innovative music-production methods. Today Volle probably is most well-known as the mentor of Max Martin. This study is part of the research project Searching for Sophia in music production where we study how various aspects linked to music production have contributed to the Swedish music industry's international achievements. The term Sophia [wisdom] refers to ancient Greek knowledge typology and is used to summarize the theoretical framework of the project. In the project a team of researchers study various formal and informal learning processes connected to education in music production in higher education.
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| 13. |
- Gullö, Jan-Olof, 1961-, et al.
(author)
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Searching for “Sophia” in Music Production : Challenges for Future Higher Education in Music
- 2019
-
In: AEC Pop & Jazz Platform Meeting. - Trondheim.
-
Conference paper (pop. science, debate, etc.)abstract
- Although Sweden is a small country, the Swedish music exports have been very successful for many years. This has resulted in a growing interest among students in Sweden to study music and not at least to study music production. Therefore, the aim of this presentation is to highlight and discuss our analyze of the motives that exist among young people who choose to study music in higher education and to compare such motives with perceptions among leading music professionals. Firstly, we have chose to study various formal and informal learning processes relevant to music production and secondly, we have focused on artistic aspects. The empirical data in this study consists of qualitative interviews with successful professionals and focus group interviews with students in higher education in music and music production. Learning theories as well as entrepreneurial theories were used to analyze the collected data. The results indicate some clear differences between what the students and the professionals value as most important. The term Sophia [wisdom] refers to ancient Greek knowledge typology and is used to summarize the theoretical framework of the project.
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| 14. |
- Gullö, Jan-Olof, 1961-, et al.
(author)
-
Towards a stronger focus on entrepreneurial skills in future higher education in music
- 2019
-
In: INTED2019 Proceedings. - Valencia : IATED. - 9788409086191 ; , s. 9639-9646
-
Conference paper (peer-reviewed)abstract
- The profound changes, in recent years, in Swedish design and cultural industries are the backdrop tothis research project. Such changes includes the music industry where digitalization and online musicdistribution as well as new music production methods has led to that production traditions as well asthe competences among the professionals in are challenged. Many Swedish design-intensivecompanies have been internationally successful for several years. And the international success of bigcompanies in the music industry, like Spotify, as well as smaller companies, like Cheiron andMaratone and individuals like Max Martin and Shellback, has resulted in a growing interest amongstudents in higher education to study music in combination with design and new media technology.Therefore, the aim of this study is to analyze the motives that exist among young people who chooseto study music in combination with design and new media technology and to compare such motiveswith perceptions among leading music industry professionals. The collected data are analyzed in atheoretical perspective including learning theories as well as entrepreneurial theory. The study isexpected to lead to new knowledge that is valuable in developing future education in music incombination with design and new media technology. The empirical data consists of qualitativeinterviews with industry professionals and focus group interviews with students in higher education inmusic. In addition, the collected data also include analyses of selected music industry magazines andjournals 1988-2018 as well as analyses of several curricula for higher education in music productionand music related to new media. The results firstly indicate that there is a clear discrepancy betweenthe content in the analyzed educational programs and what the students value as important. Secondly,there are also differences between what successful music industry representatives highlight asvaluable and what is offered in the courses and study programs included in the analysis. One clearsuch difference is that entrepreneurial skills are valued much higher by the interviewed music industryrepresentatives compared with what has been offered in the courses included in the analysis. A keyconclusion is that expanding entrepreneurial aspects in future curricula, in order to strengthen practicalas well as theoretical entrepreneurial skills, should reasonably lead to increased employability forfuture students.
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| 15. |
- Horm, Peeter, et al.
(author)
-
Zambia
- 1972
-
Reports (pop. science, debate, etc.)
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| 16. |
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| 17. |
- Lidström, Anna-Karin, et al.
(author)
-
Work at inpatient care units is associated with an increased risk of SARS-CoV-2 infection; a cross-sectional study of 8679 healthcare workers in Sweden.
- 2020
-
In: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 125:4, s. 305-310
-
Journal article (peer-reviewed)abstract
- BACKGROUND: During the Covid-19 pandemic, the protection of healthcare workers has been in focus throughout the world, but the availability and quality of personal protective equipment has at times and in some settings been suboptimal.MATERIALS AND METHODS: A total of 8679 healthcare workers and healthcare support staff in the county of Uppsala, north of Stockholm, were included in this cross-sectional study. All subjects were analysed for IgG anti-SARS-CoV-2, and predictors for positive serostatus were analysed in a logistic regression model including demographic parameters and self-reported employment characteristics.RESULTS: Overall, 577 (6.6%) were classified as seropositive, with no statistically significant differences between healthcare workers and support staff. Among healthcare workers, age (OR 0.987 per year, 95% CI 0.980-0.995), time to sampling (OR 1.019 per day, 95% CI 1.004-1.035), and employment at an outpatient care unit (OR 0.620, 95% CI 0.487-0.788) were statistically significantly associated with risk of infection. Covid-19 specific units were not at particular risk, compared to other units with comparable characteristics and staff demography.CONCLUSION: Our findings indicate that SARS-CoV-2 transmission is related to inpatient healthcare work, and illustrate the need for a high standard of basic hygiene routines in all inpatient care settings.
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| 18. |
- Löfberg, Anne-Marie, et al.
(author)
-
Percutaneous transluminal angioplasty of the femoropopliteal arteries in limbs with chronic critical lower limb ischemia
- 2001
-
In: Journal of vascular surgery. - : Elsevier BV. - 0741-5214. ; 34:1, s. 114-121
-
Journal article (peer-reviewed)abstract
- PURPOSE: The aim of the study was to evaluate the results of percutaneous transluminal angioplasty (PTA) of femoropopliteal arteries in patients with subcritical or critical lower limb ischemia. Materials and Methods: Ninety-two patients underwent 121 PTA procedures, 68 were of the superficial femoral artery (SFA), 13 of the popliteal and 40 of both arteries. Fifty-seven procedures were performed for treatment of occlusions. Eighty-four patients (94 procedures) were monitored with duplex scanning. RESULTS: Technical success rate was 88%. Primary success rates at 12 and 60 months in the whole series were 40% and 27%, respectively. The primary success rate in limbs with SFA occlusion of longer than 5 cm was only 12% after 5 years compared with 32% if the occlusion was CONCLUSION: The results of femoropopliteal PTA performed for treatment of subcritical or critical lower limb ischemia seemed to be inferior to the results of infrainguinal bypass grafting reported in literature. However, because the PTA procedure does not preclude the performance of bypass grafting, it might be an alternative to surgical intervention in limbs with stenotic femoropopliteal lesions. PTA might also be considered in patients with high surgical risk and limited life expectancy, having short occlusive lesions (< 5 cm).
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| 19. |
- Lökk, Johan, et al.
(author)
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Controversies around vitamin B12 in Sweden. : Attitudes and values behind clinical decision-making in primary health care 1996
- 1997
-
In: Hematology. - 1024-5332 .- 1607-8454. ; 2:4, s. 341-350
-
Journal article (peer-reviewed)abstract
- Over a five-year period, 1991-1995, the vitamin B12 market in Sweden increased three-fold, from approximatelyy 2 million U.S. dollars to approximately 6 million U.S. dollars. Most prescriptions, approximately 60%, originated from primary health care. The attitudes, values and knowledge of the family physicians/general practitioners were elucidated by a questionnaire study with visuo-analogue opinion scales, evaluating 24 basic statements on problems associated with the management of vitamin B12 deficiency. The questionnaire was sent to a representative sample of 506 family physicians/general practitioners. Response rate was 74%. Dropout analysis supported the view that responders provided a representative sample of Swedish FP/GPs. Analysis of the answers was compatible with the hypothesis that the mentioned increase in Swedish B12 market reflected increased awareness in primary health care about the biochemical, pathophysiological and social problems associated with vitamin B12 deficiency.
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| 20. |
- Lökk, Johan, et al.
(author)
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Shifts in B12 opinions in primary health care of Sweden.
- 2001
-
In: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905. ; 29:2, s. 122-128
-
Journal article (peer-reviewed)abstract
- AIMS: The diagnosis and management of vitamin B12 deficiency varies between countries and within countries. The aim of the study was to map current attitudes and values behind clinical decision-making in Swedish primary health care, which has a unique B12 tradition: two patients out of three are treated with oral high-dose cyanocobalamin. Most patients with B12-associated problems are managed in primary health care by general practitioners (GPs). METHODS: The study was designed to elucidate possible opinion shifts among GPs during the period 1996-1998. GPs (n=499), stratified and randomized, received a questionnaire with 24 statements on B12-associated clinical and laboratory problems, to be evaluated by a visuo-analogue scale. RESULTS: The majority of GPs in primary health care in Sweden accepted homocysteine and methylmalonic acid (MMA) as markers for functional deficiency of vitamin B12. The evaluation of classical markers of B12 deficiency was wary and balanced. There was a consensus of the need for B12 therapy to risk groups such as patients with atrophic gastritis or previous gastric surgery. The answers also appeared to reflect an improvement of professional knowledge and competence concerning B12-associated problems among Swedish GPs between 1996 and 1998. CONCLUSIONS: The overriding conclusion was that B12-associated opinions of Swedish GPs were stable within the period studied, with marginal improvements of knowledge and competence.
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| 21. |
- Lökk, Johan, et al.
(author)
-
Vitamin B12 in primary health care and geriatrics - attitudes, knowledge, competence.
- 2001
-
In: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 16:10, s. 987-992
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: The objective of the study was to test attitudes, knowledge and competence of Swedish general practitioners and geriatricians concerning B12-associated problems in 1998. METHODS: Postal questionnaires were sent to a random sample of 485 GPs and a total sample of 613 geriatricians. The response rates were 70% in the GP group and 69% in the geriatrician group. The questionnaire contained 24 statements to be evaluated by a visuo-analogue scale. RESULTS: There were small numerical differences between the two physician groups. The geriatricians were more aware of risk groups for B12 deficiency. GPs were less categorical concerning low hit rate in the laboratory testing of clinical conclusions. There were statistical differences in both directions for statements on pitfalls in laboratory diagnostics. GPs were somewhat less prone to give risk groups prophylactic B12 therapy. CONCLUSIONS: GPs and geriatricians appeared to be familiar with the current debate on B12-associated problems, suggesting that health care quality will be unaffected by patient transfer from hospital care to primary health care. Copyright 2001 John Wiley & Sons, Ltd.
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| 22. |
- Nilsson, Mats, 1954-
(author)
-
Cobalamin communication in Sweden 1990 – 2000 : views, knowledge and practice among Swedish physicians
- 2005
-
Doctoral thesis (other academic/artistic)abstract
- Cobalamin (vitamin B12) is one of several essential micronutrients needed by the human organism. Other important micronutritients, which interplay with vitamin B12, are folate and iron. During the last ten years, the attention has been drawn to different forms of neurological disorders supposed to be caused by vitamin B12 deficiency. Vitamin B12 deficiency states are common among elderly patients in primary health care and sometimes in hospital care, especially in geriatric practice. This is a study to define the cobalamin treatment traditions, among Swedish physicians in the period 1990 – 2000. The period was distinguished by an intense debate on the issue by the physicians, an increase of cobalamin consumption, and a shift from parenteral therapy towards oral high-dose therapy. It had been known that symptoms of cobalamin deficiency could start in the nervous system. This knowledge was reinforced by the application of homocysteine and methyl-malonic acid (MMA) in deficiency diagnosis. Introduction of homocysteine and MMA in deficiency diagnosis changed the view on deficiency prevalence, by identifying persons at risk to develop B12 deficiency prior to established symptoms. In this study, Swedish physicians are regarded mainly as receivers of communication about the markers homocysteine and MMA, and deficiency states of cobalamin and folate. The main senders were scientists from North America, Norway, Denmark, and Sweden. This study sets the senders and the receivers of cobalamin communication on a collegial level and quantifies and evaluates the feed-back from the receivers. The receivers, gen¬eral practitioners and geriatricians, appeared to be familiar with old knowledge and frontier concepts in the field. Thus, it is suggested that the increase of B12 prescriptions in Sweden 1990 – 2000 reflected an increased awareness of B12-associated clinical problems among the physicians managing the majority of deficiency patients, although a possible overconsumption of pharmaceutical drugs must be kept in mind.
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| 23. |
- Nilsson, Mats, et al.
(author)
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Medical intelligence in Sweden. Vitamin B12 : oral compared with parenteral?
- 2005
-
In: Postgraduate medical journal. - : Oxford University Press (OUP). - 0032-5473 .- 1469-0756. ; 81:953, s. 191-193
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Sweden is the only country in which oral high dose vitamin B12 has gained widespread use in the treatment of deficiency states. OBJECTIVE: The aim of the study was to describe prescribing patterns and sales statistics of vitamin B12 tablets and injections in Sweden 1990-2000.Design, setting, and sources: Official statistics of cobalamin prescriptions and sales were used. RESULTS: The use of vitamin B12 increased in Sweden 1990-2000, mainly because of an increase in the use of oral high dose vitamin B12 therapy. The experience, in statistical terms a "total investigation", comprised 1,000,000 patient years for tablets and 750,000 patient years for injections. During 2000, 13% of residents aged 70 and over were treated with vitamin B12, two of three with the tablet preparation. Most patients in Sweden requiring vitamin B12 therapy have transferred from parenteral to oral high dose vitamin B12 since 1964, when the oral preparation was introduced. CONCLUSION: The findings suggest that many patients in other post-industrial societies may also be suitable for oral vitamin B12 treatment.
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| 24. |
- Nilsson, Mats, et al.
(author)
-
Sex differences in cobalamin (vitamin B12) opinions of Swedish physicians.
- 2002
-
In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 56:4, s. 299-303
-
Journal article (peer-reviewed)abstract
- The aim of the study was to elucidate possible sex differences in knowledge, competence and attitudes behind decision-making on cobalamin-associated problems (vitamin B(12)). The study was conducted by postal questionnaires to Swedish physicians in 1996-98. The participants were recruited by random sampling of general practitioners (1996, 1998), and a total sampling of geriatricians (1998). The overall response rate was 71%. The study group comprised 480 female physicians and 526 male physicians. The responses to 24 statements in the questionnaire were measured by means of visual analogue scales. Group differences were evaluated by medians and shapes of distributions. The female doctors appeared to value patient-related symptoms and signs more than male doctors. Conversely, male doctors relied on laboratory tests more than female doctors. As reflected by questionnaire answers, female doctors appeared to be more informed than male doctors on cobalamin-associated clinical problems. Group differences between the sexes were marginal from a numerical point of view. It is suggested that the statistical differences observed should be regarded as negligible until confirmed by further studies.
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| 25. |
- Odén, Bertil, et al.
(author)
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Tanzania
- 1972
-
Book (other academic/artistic)
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| 26. |
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| 27. |
- Suppiah, Ravi, et al.
(author)
-
A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis.
- 2011
-
In: Rheumatology (Oxford, England). - : Oxford University Press (OUP). - 1462-0332 .- 1462-0324. ; 50, s. 899-905
-
Journal article (peer-reviewed)abstract
- Objective. Assessment of disease activity in vasculitis can be achieved using the BVAS, a clinical checklist of relevant symptoms, signs and features of active disease. The aim of this study was to revalidate the BVAS version 3 (BVAS v. 3) in a cohort of patients with systemic vasculitis. Methods. A total of 238 patients with vasculitis from seven countries in Europe were evaluated at a single time point. Spearman's correlation coefficients were calculated between BVAS v. 3 scores, vasculitis activity index (VAI), physician's global assessment (PGA), the physician's treatment decision, CRP and the vasculitis damage index (VDI) to demonstrate that the BVAS v. 3 measures disease activity. Results. WG (63%), Churg-Strauss syndrome (9%) and microscopic polyangiitis (9%) were the most common diagnoses. The BVAS v. 3 showed convergent validity with the VAI [ρ = 0.82 (95% CI 0.77, 0.85)], PGA [ρ = 0.85 (95% CI 0.81, 0.88)] and the physician's treatment decision [ρ = 0.54 (95% CI 0.44, 0.62)]. There was little or no correlation between BVAS v. 3 and the CRP level [ρ = 0.18 (95% CI 0.05, 0.30)] or with the VDI [ρ = -0.10 (95% CI 0.22, 0.03)]. The inter-observer reliability was very high with an intra-class correlation coefficient (ICC) of 0.996 (95% CI 0.990, 0.998) for the total BVAS v. 3 score. Conclusion. The BVAS v. 3 has been evaluated in a large cohort of patients with vasculitis and the important properties of the tool revalidated. This study increases the utility of the BVAS v. 3 in different populations of patients with systemic vasculitis.
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| 28. |
- Suppiah, Ravi, et al.
(author)
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Measurement of damage in systemic vasculitis: a comparison of the Vasculitis Damage Index with the Combined Damage Assessment Index
- 2011
-
In: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 70:1, s. 80-85
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Journal article (peer-reviewed)abstract
- Objectives To compare the Vasculitis Damage Index (VDI) with the Combined Damage Assessment Index (CDA) as measures of damage from vasculitis. Methods A total of 283 patients with vasculitis from 11 European centres were evaluated in a cross-sectional study using the VDI and CDA. Results Wegener's granulomatosis (58.4%) and microscopic polyangiitis (11.0%) were the most common diagnoses. Agreement between VDI and CDA scores (Spearman's correlation) was 0.90 (95% CI 0.87 to 0.92). There was good correlation between individual comparably evaluated organ systems (Spearman's correlation 0.70-0.94). Interobserver reliability (assessed by intraclass correlation coefficient (ICC)) was 0.94 (95% CI 0.89 to 0.98) for VDI and 0.78 (95% CI 0.63 to 0.93) for CDA. Intraobserver reliability was 0.92 (95% CI 0.83 to 1.00) for VDI and 0.87 (95% CI 0.75 to 1.00) for CDA. A total of 13 items were not used in the VDI compared to 23 in the CDA. Observers agreed that the CDA covered the full spectrum of damage attributable to vasculitis but was more time consuming and thus possibly less feasible for clinical and research purposes. Conclusions The VDI and CDA capture reliable data on damage among patients with vasculitis. The CDA captures more detail but is more complex and less practical than the VDI. Further evolution of damage assessment in vasculitis is likely to include key elements from both instruments.
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| 29. |
- Westman, Bo, et al.
(author)
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Effects on skeletal muscle glutathione status of ischemia and reperfusion following abdominal aortic aneurysm surgery.
- 2006
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In: Annals of Vascular Surgery. - : Elsevier BV. - 0890-5096 .- 1615-5947. ; 20:1, s. 99-105
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Journal article (peer-reviewed)abstract
- Glutathione (GSH) is an important endogenous scavenger against reactive oxygen species. Elective abdominal surgery without ischemia and reperfusion leads to decreased muscle GSH concentrations 4-72 hr postoperatively without altering GSH redox status. In the present study, we investigated to what extent muscle GSH status was affected during and following elective abdominal aortic aneurysm repair. From patients (n = 10) undergoing abdominal aortic repair, thigh muscle specimens were taken preoperatively, at maximal ischemia, and at 10 min and 4, 24, and 48 hr of reperfusion. Specimens were analyzed for GSH, amino acids, and energy-rich compounds. At maximal ischemia, phosphocreatine decreased by 37% (p < 0.05) and lactate and creatine increased by 274% and 57% (p < 0.001 and 0.05), respectively, indicating ischemia during the clamping of aorta. Adenosine triphosphate, on the other hand, remained unaltered during the entire study period. Total GSH (tGSH) decreased by 46% at 24 hr and by 43% at 48 hr of reperfusion (p < 0.001), while reduced GSH decreased by 48% at 24 hr and by 44% at 48 hr (p < 0.001). The redox status (GSH/tGSH) of GSH and oxidized GSH remained unaltered. Among the constituent amino acids of GSH, glycine and cysteine remained unaltered while glutamine and glutamate decreased by 55% and 55%, respectively (p < 0.001). Abdominal aortic aneurysm repair induces metabolic alterations characteristic for ischemia. The antioxidative capacity in terms of muscle levels of GSH was decreased. However, the oxidative stress during reperfusion did not change GSH status more than what has been reported following abdominal surgery without ischemia and reperfusion. The results indicate that the oxidative stress elicited by elective abdominal aortic aneurysm repair is outbalanced by a compensated GSH metabolism not giving rise to an increased amount of oxidized GSH or an altered GSH redox status.
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| 30. |
- Westman, Bo
(author)
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Studies of ischemia and reperfusion in muscle and liver on glutathione and amino acid metabolism in man
- 2007
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Doctoral thesis (other academic/artistic)abstract
- Oxidative stress increases the formation of reactive oxygen species (ROS), which can induce damage and breakdown of enzymes and lipoproteins. This leads to impaired cellular function and ultimately to death of cells and eventually organ failure. ROS are thought to be responsible for the damage during reperfusion following ischemia. ROS are counteracted by scavengers (anti-oxidants) among which glutathione is one of the most important. Glutathione and oxidative stress during ischemia and reperfusion have been extensively investigated in animal models earlier. However, the relevance for human physiology especially during disease is not clear. The aim of the present studies was to characterise glutathione and amino acid metabolism in human skeletal muscle and liver during ischemia and reperfusion using surgical interventions as potential human models. In the first study abdominal aneurysm surgery with an ischemia time of about 65 minutes was used. Biopsies from the thigh muscle were obtained before ischemia, at maximal ischemia and after 10 min, 4, 24 and 48 hours of reperfusion. In a second study aorto bi-femoral surgery patients were studied because of the longer ischemia times up to 120 minutes with this procedure. Biopsies from both legs were obtained before ischemia, at maximal ischemia and at 10 min. and 24 h of reperfusion. In the third study knee replacement surgery was used as a model since the obtained ischemia is more complete than in the first 2 studies and because no severe metabolic stress due to abdominal surgery is present in this model. Muscle biopsies were taken before ischemia, at maximal ischemia and 24 h into reperfusion. In the last study the effect of ischemia and reperfusion on human liver was studied during liver resection surgery. In this study biopsies were obtained before ischemia, at maximal ischemia and at 5, 10, 15, 20, 25 and 30 minutes of reperfusion. Results from the first two studies show that both reduced and total glutathione are decreased at 24 and 48 hours of reperfusion. No changes were observed at maximal ischemia or in oxidised glutathione at any point. The changes were however very similar to those previously obtained in muscle following abdominal surgery without ischemia to the muscle. And therefore the observed changes are mainly due to the surgical trauma. In the knee surgery model reduced and total glutathione were also only decreased after 24h of reperfusion. However in this model a complete ischemia is obtained without the metabolic stress of abdominal surgery. The decrease here is therefore more likely to be due to ischemia and reperfusion in combination with a minor surgical trauma. Ischemia of the human liver had no effect on glutathione levels at all. Changes in amino acid levels during reperfusion were very similar as those seen in skeletal muscle following surgery without ischemia reperfusion. However the changes in amino acids seen at maximal ischemia are specific for the ischemia. Alanine is increased and glutamate decreased most likely to remove pyruvate to maintain the flux in the glycolysis. The branched chain amino acids behave differently in liver and muscle during maximal ischemia with and increase in liver and a slight decrease in muscle. Glutamate is decreased at ischemia in both muscle and liver, and decreases in reperfusion in muscle, while an increase is seen in liver at reperfusion. Glutamine is not affected by ischemia but decreases in muscle and increases in liver at reperfusion. In conclusion, ischemia times of up to 120 minutes for skeletal muscle and about 30 minutes for liver do not affect glutathione levels in humans. During early reperfusion phase in the liver no changes are seeneither. In skeletal muscle at 1 to 2 days after reperfusion decreases in glutathione can be observed which seem to a large extend to be caused by the surgical stress rather then the ischemic insult. However in a human model with minimal surgical stress also a decrease is observed suggesting a contribution of the IR. Amino acids are used during the ischemia to maintain the energy status of both skeletal muscle and liver in humans.
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| 31. |
- Westman, Kerstin W.A., et al.
(author)
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Clinical evaluation of a capture ELISA for detection of proteinase-3 antineutrophil cytoplasmic antibody : Technical note
- 1998
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In: Kidney International. - : Elsevier BV. - 0085-2538. ; 53:5, s. 1230-1236
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Journal article (peer-reviewed)abstract
- Detection of antineutrophil cytoplasmic antibodies (ANCA) has become a useful tool in the diagnosis of Wegener's granulomatosis and microscopic polyangiitis. However, the results obtained with indirect immunofluorescence (IIF) and by ELISA for ANCA demonstration do not always correlate. A possible explanation for this finding could be that proteins are denatured during the process of antigen purification or during coating onto the solid phase. To avoid this possibility, a monoclonal antibody to PR3 that is precoated on the plate can be used. In the present study we have used the monoclonal antibody (MoAb) 4A3 for the capture of PR3 in an ELISA, and a clinical evaluation of the diagnostic properties of the new capture ELISA has been made. The sensitivity of the capture PR3-ANCA ELISA was 85% in a material of c-ANCA positive sere. A specificity of 90% was obtained in analyses from patients having various forms of glomerulonephritis. There was a significantly higher diagnostic sensitivity of the capture PR3-ANCA ELISA (85%) compared to c- ANCA by IIF (58%) in patients with Wegener's granulomatosis with renal involvement. Capture PR3-ANCA and direct ELISA for MPO-ANCA together gave a diagnostic sensitivity of 98%, versus 75% using IIF. In conclusion, the capture PR3-ANCA ELISA seems to be a valuable tool in the diagnosis of Wegener's granulomatosis with renal involvement. Preliminary data suggest that the technique may have an advantage over direct ELISA for PR3-ANCA, as well as in the follow-up of c-/PR3-ANCA associated vasculitides. However, further prospective studies are needed to clarify this premise.
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