1. |
- Holmqvist, F., et al.
(author)
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Pacemaker programming in patients with first-degree AV-block : Programming pattern and possible consequences
- 2018
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In: Health Science Reports. - : Wiley. - 2398-8835. ; 1:6
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Journal article (peer-reviewed)abstract
- Background: The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)–block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization. Methods: The study was a retrospective chart review conducted at Duke University Hospital. Patients receiving a pacemaker due to sinus node dysfunction with coexistent first-degree AV-block were studied. Baseline demographics and characteristics, as well as pacemaker programming parameters and follow-up data, were collected through chart review. Preimplantation and postimplantation electrocardiograms were analyzed. Results: A total of 74 patients were included (mean age, 75 ± 11 y; 53% men). The mean ± SD preimplant PR interval and QRS duration was 243 ± 46 and 110 ± 30 milliseconds, respectively. A history of atrial fibrillation was present in 49% of the patients, and 77% had a normal left ventricular ejection fraction. The majority of patients (65%) had their pacemakers programmed to atrial pacing (AAI/DDD +/−R), whereas 32% and 2.7% of the pacemakers were programmed to AV-sequential pacing (DDD) and ventricular pacing (VVI), respectively. There were no significant differences in baseline characteristics or electrocardiogram measures between patients programmed to the 3 pacing modes. Patients with pacemakers programmed to AAI had a lower ventricular pacing percentage at follow-up (8 vs 55, and 46% [DDD and VVI, respectively]; P <.001). Conclusions: There was no evident association between baseline characteristics and programmed pacing mode in patients with first-degree AV-block. The choice of pacing mode affects long-term pacing burden, which in turn has been shown to influence outcome.
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2. |
- Moen, Ingrid, et al.
(author)
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Development of a novel in situ gelling skin dressing: Deliveringhigh levels of dissolved oxygen at pH 5.5
- 2018
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In: Health Sci Rep.. - : Wiley.
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Journal article (peer-reviewed)abstract
- Background and aims: Wound healing requires appropriate oxygen and pH levels.Oxygen therapy and pH‐modulating treatments have shown positive effects onwound healing. Thus, a dressing, which combines high levels of dissolved oxygen(DO) with the pH of intact skin, may improve wound healing. Our aims were to (1) formulatean in situ gelling dressing with high levels of DO and with the pH level of intactskin, (2) evaluate physical and chemical properties of the dressing, and (3) elucidatebasic effects of elevated levels of DO on human skin cells in vitro.Methods: A dressing was formulated with 15 to 16 wt% poloxamer 407, acetatebuffer, and oxygenated water. Stability of pH and DO, rheology, and shelf life wereanalysed. Furthermore, in vitro studies of the effect of increased levels of DO wereperformed.Results: An in situ gelling wound dressing, with a DO concentration rangingbetween 25 and 35 mg/L and a pH of 5.5, was formulated. The DO concentrationwas stable above 22 mg/L for at least 30 hours when applied on a surface at 35°Cand covered for directed diffusion into the intended wound area. At storage, thedressing had stable pH for 3 months and stable DO concentration over 30 mg/L for7 weeks. Increasing DO significantly enhanced intracellular ATP in human skin cells,without changing reactive oxygen species production, proliferation rate, or viability.Conclusion: The developed dressing may facilitate wound healing by deliveringcontrolled and stable oxygen levels, providing adjustable pH for optimized healing,and increasing intracellular ATP availability.
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3. |
- Nilsen, Tom, et al.
(author)
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Extraction,isolation, and concentration of calprotectin antigen (S100A8/S100A9) fromgranulocytes
- 2018
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In: Health Science Reports. - : Wiley-Blackwell Publishing Inc.. - 2398-8835. ; 1:5
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Journal article (peer-reviewed)abstract
- Background: Calprotectin is a promising biomarker for granulocyte activation. It is mainly measured in faeces as a marker for inflammatory bowel disease. A limitation is that there is no widely accepted calibrator.Aim: To establish a method for purification of calprotectin from human granulocytes that is easily reproducible, reliable, and could contribute to a better agreement between different calprotectin methods.Methods and results: Calprotectin was purified from granulocyte extracts using ion‐exchange chromatography. The granulocytes were separated from blood bags. The purity was analysed by analysing pixel density of a picture of the sodium dodecyl sulfate polyacrylamide gel electrophoresis and by size exclusion chromatography. The calprotectin concentration of the pure antigen solution was determined using Biuret method. The purity was >95% for 3 preparations, and their concentrations were 1079, 1080, and 1813 mg/L.Conclusion: It is possible to reproducibly prepare highly purified calprotectin antigen from human granulocytes. The preparations can be used for preparing calibrators, controls for immunological calprotectin assays, and immunisation for raising antibodies against human calprotectin in hens.
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4. |
- Schildmeijer, Kristina, 1959-, et al.
(author)
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Determinants of patient participation for safer care : a qualitative study of physicians' experiences and perceptions
- 2018
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In: Health Science Reports. - : John Wiley & Sons. - 2398-8835. ; 1:10, s. 1-10
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Journal article (peer-reviewed)abstract
- Objective: There is a paucity of research on physicians' perspectives on involving patients to achieve safer care. This study aims to explore determinants of patient participation for safer care, according to physicians in Swedish health care.Methods: We used a deductive descriptive design, applying qualitative content analysis based on the Capability-Opportunity-Motivation-Behaviour framework. Semi-structured interviews were conducted with 13 physicians in different types of health care units, to achieve a heterogeneous sample. The main outcome measure was barriers and facilitators to patient participation of potential relevance for patient safety.Results: Analysis of the data yielded 14 determinants (ie, subcategories) functioning as barriers and/or facilitators to patient participation of potential relevance for patient safety. These determinants were mapped to five categories: physicians' capability to involve patients in their care; patients' capability to become involved in their care, as perceived by the physicians; physicians' opportunity to achieve patient participation in their care; physicians' motivation to involve patients in their care; and patients' motivation to become involved in their care, as perceived by the physicians.Conclusion: There are many barriers to patient participation to achieve safer care. There are also facilitators, but these tend to depend on initiatives of individual physicians and patients, because organizational-level support may be lacking. Many of the determinants are interdependent, with physicians' perceived time constraints influencing other barriers.
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5. |
- Strömbom, Ylva, 1959-, et al.
(author)
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Cognitive behavioral therapy for frequent attenders in primary care
- 2018
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In: Health Science Reports. - : John Wiley & Sons. - 2398-8835. ; 1:9
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Journal article (peer-reviewed)abstract
- Aim: The aim of the study is to investigate if cognitive behavioral therapy given in a group setting affects anxiety and depression, stress, pain, coping strategies during daily life, and health-related quality of life (HRQoL), among frequent attenders (FAs) in primary care.Methods: Cognitive behavioral therapy was offered to 331 FAs between 18 and 65 years of age, of whom 89 accepted and 54 completed all steps in the protocol; patients were assigned to 1 of 3 groups: 0, 6, and 12-month waiting time. The therapy consisted of 12 sessions administered in group format. Outcome measures were Beck's Anxiety Inventory (BAI), Beck's Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Everyday Life Stress (ELS), Coping Strategy Questionnaire, Multidimensional Pain Inventory-Swedish version, and Short Form-36.Results: Mean age among patients who completed cognitive behavioral therapy was 49.9 years, with a female majority (79.6%). Anxiety and depression scores were reduced after treatment (BAI 16.7 vs 13.6; BDI 16.3 vs 15.7; HADS-Anxiety 8.41 vs 6.05; HADS-Depression 7.09 vs 5.69). Because waiting time itself did not affect symptoms, differences reflect treatment effects. Stress ratings were not affected by treatment. Use of nonadaptive coping strategies like praying and hoping and catastrophizing decreased. Frequent attenders experienced a higher sense of life control. Frequent attenders reported significantly lower HRQoL than general Swedish population norms in all 8 Short Form-36 domains including mental and physical component summary scores (MCS and PCS), and all domains were unaffected by treatment.Conclusion: Cognitive behavioral therapy exerts some beneficial effects in FAs. Content of treatment addressed musculoskeletal pain, stress, anxiety, and depression. This broad approach resulted in reduced anxiety, depression, and impact of pain because of enhanced life control.
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