| 1. |
- Thompson, B.A., et al.
(författare)
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Application of a 5-tiered scheme for standardized classification of 2,360 unique mismatch repair gene variants in the InSiGHT locus-specific database
- 2014
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 46:2, s. 107-115
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Tidskriftsartikel (refereegranskat)abstract
- The clinical classification of hereditary sequence variants identified in disease-related genes directly affects clinical management of patients and their relatives. The International Society for Gastrointestinal Hereditary Tumours (InSiGHT) undertook a collaborative effort to develop, test and apply a standardized classification scheme to constitutional variants in the Lynch syndrome-associated genes MLH1, MSH2, MSH6 and PMS2. Unpublished data submission was encouraged to assist in variant classification and was recognized through microattribution. The scheme was refined by multidisciplinary expert committee review of the clinical and functional data available for variants, applied to 2,360 sequence alterations, and disseminated online. Assessment using validated criteria altered classifications for 66% of 12,006 database entries. Clinical recommendations based on transparent evaluation are now possible for 1,370 variants that were not obviously protein truncating from nomenclature. This large-scale endeavor will facilitate the consistent management of families suspected to have Lynch syndrome and demonstrates the value of multidisciplinary collaboration in the curation and classification of variants in public locus-specific databases. © 2014 Nature America, Inc.
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| 2. |
- Gyllenberg, A, et al.
(författare)
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Variability in the CIITA gene interacts with HLA in multiple sclerosis.
- 2014
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Ingår i: Genes and immunity. - Stockholm : Springer Science and Business Media LLC. - 1476-5470 .- 1466-4879. ; 15, s. 162-167
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Tidskriftsartikel (refereegranskat)abstract
- The human leukocyte antigen (HLA) is the main genetic determinant of multiple sclerosis (MS) risk. Within the HLA, the class II HLA-DRB1*15:01 allele exerts a disease-promoting effect, whereas the class I HLA-A*02 allele is protective. The CIITA gene is crucial for expression of class II HLA molecules and has previously been found to associate with several autoimmune diseases, including MS and type 1 diabetes. We here performed association analyses with CIITA in 2000 MS cases and up to 6900 controls as well as interaction analysis with HLA. We find that the previously investigated single-nucleotide polymorphism rs4774 is associated with MS risk in cases carrying the HLA-DRB1*15 allele (P=0.01, odds ratio (OR): 1.21, 95% confidence interval (CI): 1.04-1.40) or the HLA-A*02 allele (P=0.01, OR: 1.33, 95% CI: 1.07-1.64) and that these associations are independent of the adjacent confirmed MS susceptibility gene CLEC16A. We also confirm interaction between rs4774 and HLA-DRB1*15:01 such that individuals carrying the risk allele for rs4774 and HLA-DRB1*15:01 have a higher than expected risk for MS. In conclusion, our findings support previous data that variability in the CIITA gene affects MS risk, but also that the effect is modulated by MS-associated HLA haplotypes. These findings further underscore the biological importance of HLA for MS risk.Genes and Immunity advance online publication, 16 January 2014; doi:10.1038/gene.2013.71.
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| 3. |
- Ancelle-Park, R., et al.
(författare)
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Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet
- 2012
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Ingår i: Journal of Medical Screening. - : SAGE Publications. - 0969-1413 .- 1475-5793. ; 19, s. 5-13
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women. Methods From the studies reviewed, the primary benefit of screening, breast cancer mortality reduction, was compared with the main harms, over-diagnosis and false-positive screening results (FPRs). Results Pooled estimates of breast cancer mortality reduction among invited women were 25% in incidence-based mortality studies and 31% in case-control studies (38% and 48% among women actually screened). Estimates of over-diagnosis ranged from 1% to 10% of the expected incidence in the absence of screening. The combined estimate of over-diagnosis for screened women, from European studies correctly adjusted for lead time and underlying trend, was 6.5%. For women undergoing 10 biennial screening tests, the estimated cumulative risk of a FPR followed by non-invasive assessment was 17%, and 3% having an invasive assessment. For every 1000 women screened biennially from age 50-51 until age 68-69 and followed up to age 79, an estimated seven to nine lives are saved, four cases are over-diagnosed, 170 women have at least one recall followed by non-invasive assessment with a negative result and 30 women have at least one recall followed by invasive procedures yielding a negative result. Conclusions The chance of saving a woman's life by population-based mammographic screening of appropriate quality is greater than that of over-diagnosis. Service screening in Europe achieves a mortality benefit at least as great as the randomized controlled trials. These outcomes should be communicated to women offered service screening in Europe.
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| 4. |
- Sun, Chengjun, et al.
(författare)
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CRYAB-650 C>G (rs2234702) affects susceptibility to type 1 diabetes and IAA-positivity in Swedish population
- 2012
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Ingår i: Human Immunology. - : Elsevier. - 0198-8859 .- 1879-1166. ; 73:7, s. 759-766
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Single nucleotide polymorphisms (SNPs) in the promoter region of CRYAB gene have been associated with in multiple sclerosis. CRYAB gene, which encodes alpha B-crystallin (a member of small heat shock protein), was reported as a potential autoimmune target. In this study we investigated whether SNPs in the promoter region of CRYAB gene were also important in the etiology of Type 1 diabetes (T1D).METHODS: Genotyping of SNPs in the promoter region of CRYAB gene was performed in a Swedish cohort containing 444 T1D patients and 350 healthy controls. Three SNPs were included in this study: CRYAB-652 A>G (rs762550), -650 C>G (rs2234702) and -249 C > G (rs14133). Two SNPs (CRYAB-652 and -650) were not included in previous genome wide association studies.RESULTS: CRYAB-650 (rs2234702)*C allele was significantly more frequent in patients than in controls (OR = 1.48, Pc = 0.03). CRYAB-650*C allele was associated with IAA positivity (OR = 8.17, Pc < 0.0001) and IA-2A positivity (OR = 2.14, Pc = 0.005) in T1D patients. This association with IAA was amplified by high-risk HLA carrier state (OR = 10.6, P < 0.0001). No association was found between CRYAB-650 and other autoantibody positivity (GADA and ICA). CRYAB haplotypes were also associated with IAA and IA-2A positivity (highest OR = 2.07 and 2.11, respectively), these associations remain in high HLA-risk T1D patients.CONCLUSIONS: CRYAB-650 was associated with T1D in the Swedish cohort we studied. CRYAB-650*C allele might confers susceptibility to the development of T1D. CRYAB-650 was also associated with the development of IAA-positivity in T1D patients, especially in those carrying T1D high-risk HLA haplotypes.
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| 5. |
- Steele, K M, et al.
(författare)
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Characteristics associated with improved knee extension after strength training for individuals with cerebral palsy and crouch gait.
- 2012
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Ingår i: Journal of pediatric rehabilitation medicine. - 1875-8894. ; 5:2, s. 99-106
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Tidskriftsartikel (refereegranskat)abstract
- Muscle weakness may contribute to crouch gait in individuals with cerebral palsy, and some individuals participate in strength training programs to improve crouch gait. Unfortunately, improvements in muscle strength and gait are inconsistent after completing strength training programs. The purpose of this study was to examine changes in knee extensor strength and knee extension angle during walking after strength training in individuals with cerebral palsy who walk in crouch gait and to determine subject characteristics associated with these changes. A literature review was performed of studies published since January 2000 that included strength training, three-dimensional motion analysis, and knee extensor strength measurements for individuals with cerebral palsy. Three studies met these criteria and individual subject data was obtained from the authors for thirty crouch gait subjects. Univariate regression analyses were performed to determine which of ten physical examination and motor performance variables were associated with changes in strength and knee extension during gait. Change in knee extensor strength ranged from a 25% decrease to a 215% increase, and change in minimum knee flexion angle during gait ranged from an improvement of 9° more knee extension to 15° more knee flexion. Individuals without hamstring spasticity had greater improvement in knee extension after strength training. Hamstring spasticity was associated with an undesired increase in knee flexion during walking. Subject-specific factors such as hamstring spasticity may be useful for predicting which subjects will benefit from strength training to improve crouch gait.
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| 6. |
- Avelin, Benny, 1984-, et al.
(författare)
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Boundary estimates for solutions to operators of p-Laplace type with lower order terms
- 2011
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Ingår i: Journal of Differential Equations. - : Elsevier BV. - 0022-0396 .- 1090-2732. ; 250:1, s. 264-291
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we study the boundary behavior of solutions to equations of the form∇⋅A(x,∇u)+B(x,∇u)=0, in a domain Ω⊂Rn, assuming that Ω is a δ-Reifenberg flat domain for δ sufficiently small. The function A is assumed to be of p-Laplace character. Concerning B, we assume that |∇ηB(x,η)|⩽c|η|p−2, |B(x,η)|⩽c|η|p−1, for some constant c, and that B(x,η)=|η|p−1B(x,η/|η|), whenever x∈Rn, η∈Rn∖{0}. In particular, we generalize the results proved in J. Lewis et al. (2008) [12] concerning the equation ∇⋅A(x,∇u)=0, to equations including lower order terms.
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| 7. |
- Avelin, Benny, et al.
(författare)
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Optimal doubling, reifenberg flatness and operators of p-laplace type
- 2011
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Ingår i: Nonlinear Analysis. - : Elsevier BV. - 0362-546X .- 1873-5215. ; 74:17, s. 5943-5955
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, we consider equations of p-Laplace type of the form ∇⋅A(x,∇u)=0. Concerning A we assume, for p∈(1,∞) fixed, an appropriate ellipticity type condition, Hölder continuity in x and that A(x,η)=|η|p−1A(x,η/|η|) whenever x∈Rn and η∈Rn∖{0}. Let Ω⊂Rn be a bounded domain, let D be a compact subset of Ω. We say that is the A-capacitary function for D in Ω if on D, on ∂Ω in the sense of and in Ω∖D in the weak sense. We extend to Rn∖Ω by putting on Rn∖Ω. Then there exists a unique finite positive Borel measure on Rn, with support in ∂Ω, such that In this paper, we prove that if Ω is Reifenberg flat with vanishing constant, then for every τ, 0<τ≤1. In particular, we prove that is an asymptotically optimal doubling measure on ∂Ω.
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| 8. |
- Barbosa, Edna J L, 1961, et al.
(författare)
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Extracellular water and blood pressure in adults with growth hormone (GH) deficiency: a genotype-phenotype association study.
- 2014
-
Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 9:8
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Tidskriftsartikel (refereegranskat)abstract
- Growth hormone deficiency (GHD) in adults is associated with decreased extracellular water volume (ECW). In response to GH replacement therapy (GHRT), ECW increases and blood pressure (BP) reduces or remains unchanged. Our primary aim was to study the association between polymorphisms in genes related to renal tubular function with ECW and BP before and 1 year after GHRT. The ECW measures using bioimpedance analysis (BIA) and bioimpedance spectroscopy (BIS) were validated against a reference method, the sodium bromide dilution method (Br(-)).
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| 9. |
- Barbosa, Edna J L, 1961, et al.
(författare)
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Genotypes associated with lipid metabolism contribute to differences in serum lipid profile of GH-deficient adults before and after GH replacement therapy.
- 2012
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Ingår i: European journal of endocrinology / European Federation of Endocrine Societies. - 1479-683X .- 0804-4643. ; 167:3, s. 353-62
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Tidskriftsartikel (refereegranskat)abstract
- bjective: GH deficiency (GHD) in adults is associated with an altered serum lipid profile that responds to GH replacement therapy (GHRT). This study evaluated the influence of polymorphisms in genes related to lipid metabolism on serum lipid profile before and after 1 year of GHRT in adults. Design and methods: In 318 GHD patients, total cholesterol (TC) serum concentrations, LDL-C, HDL-C, and triglycerides (TG) were assessed. Using a candidate gene approach, 20 single nucleotide polymorphisms (SNPs) were genotyped. GH dose was individually titrated to obtain normal serum IGF1 concentrations. Results: At baseline, the minor alleles of cholesteryl ester transfer protein (CETP) gene SNPs rs708272 and rs1800775 were associated with higher serum TC and apolipoprotein E (APOE) gene SNP rs7412 with lower TC concentrations; CETP SNPs rs708272, rs1800775, and rs3764261 and apolipoprotein B (APOB) gene SNP rs693 with higher serum HDL-C; APOE SNP rs7412, peroxisome proliferator-activated receptor gamma (PPARG) gene SNP rs10865710 with lower LDL-C, and CETP SNP rs1800775 with higher LDL-C; and APOE/C1/C4/C2 cluster SNP rs35136575 with lower serum TG. After treatment, APOB SNP rs676210 GG genotype was associated with larger reductions in TC and LDL-C and PPARG SNP rs10865710 CC genotype with greater TC reduction. All associations remained significant when adjusted for age, sex, and BMI. Conclusions: In GHD adults, multiple SNPs in genes related to lipid metabolism contributed to individual differences in baseline serum lipid profile. The GH treatment response in TC and LDL-C was influenced by polymorphisms in the APOB and PPARG genes.
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| 10. |
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| 11. |
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| 12. |
- Glad, Camilla A M, 1981, et al.
(författare)
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SNPs within the GH-signaling pathway are associated with the early IGF1 response to GH replacement therapy in GHD adults.
- 2014
-
Ingår i: European journal of endocrinology / European Federation of Endocrine Societies. - 1479-683X .- 0804-4643. ; 170:1, s. 101-7
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Tidskriftsartikel (refereegranskat)abstract
- GH-deficient (GHD) adults have reduced serum concentrations of IGF1. GH replacement therapy increases serum IGF1 concentrations, but the interindividual variation in treatment response is large and likely influenced by genetic factors. This study was designed to test the hypothesis that single-nucleotide polymorphisms (SNPs) in genes within the GH signaling pathway influence the serum IGF1 response to GH replacement.
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| 13. |
- Hunter, Amanda, et al.
(författare)
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Effect of wood smoke exposure on vascular function and thrombus formation in healthy fire fighters
- 2014
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Ingår i: Particle and Fibre Toxicology. - : BioMed Central (BMC). - 1743-8977. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Myocardial infarction is the leading cause of death in fire fighters and has been linked with exposure to air pollution and fire suppression duties. We therefore investigated the effects of wood smoke exposure on vascular vasomotor and fibrinolytic function, and thrombus formation in healthy fire fighters. Methods: In a double-blind randomized cross-over study, 16 healthy male fire fighters were exposed to wood smoke (~1 mg/m3 particulate matter concentration) or filtered air for one hour during intermittent exercise. Arterial pressure and stiffness were measured before and immediately after exposure, and forearm blood flow was measured during intra-brachial infusion of endothelium-dependent and -independent vasodilators 4–6 hours after exposure. Thrombus formation was assessed using the ex vivo Badimon chamber at 2 hours, and platelet activation was measured using flow cytometry for up to 24 hours after the exposure. Results: Compared to filtered air, exposure to wood smoke increased blood carboxyhaemoglobin concentrations (1.3% versus 0.8%; P < 0.001), but had no effect on arterial pressure, augmentation index or pulse wave velocity (P > 0.05 for all). Whilst there was a dose-dependent increase in forearm blood flow with each vasodilator (P < 0.01 for all), there were no differences in blood flow responses to acetylcholine, sodium nitroprusside or verapamil between exposures (P > 0.05 for all). Following exposure to wood smoke, vasodilatation to bradykinin increased (P = 0.003), but there was no effect on bradykinin-induced tissue-plasminogen activator release, thrombus area or markers of platelet activation (P > 0.05 for all). Conclusions: Wood smoke exposure does not impair vascular vasomotor or fibrinolytic function, or increase thrombus formation in fire fighters. Acute cardiovascular events following fire suppression may be precipitated by exposure to other air pollutants or through other mechanisms, such as strenuous physical exertion and dehydration.
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| 14. |
- Högberg, K, et al.
(författare)
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Prerequisites required for the provision and use of web-based communication for psychosocial support in haematologic care
- 2013
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Ingår i: European Journal of Oncology Nursing. - : Elsevier Sci LTD. - 1462-3889 .- 1532-2122. ; 17:5, s. 596-602
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to describe the prerequisites required for the provision and use of web-based communication for psychosocial support within a haematology clinic, from a patient and family perspective. Method: A qualitative design using content analysis was used. A strategically selected sample of patients ( n ¼ 11) and family members ( n ¼ 6) were offered access to a web-based communication capability with a nurse. After four months, individual interviews were conducted with all participants, in order to identify necessary prerequisites. Results: Preferences and characteristics of the individual patient or family member are crucial as to whether web-based communication for support is perceived as useful. To feel comfortable with writing and to self-identify the need for support are fundamental in getting motivated to use web-based com- munication. An effective organization around psychosocial support in general is another prerequisite. Goals and responsibilities must be clearly de fi ned for patients and family members to understand their rights and enable the transformation of opportunities into practice. The use of web-based communi- cation must also be a convenient and naturally incorporated part of both individual and organizational use of the web in general. Conclusions: Prerequisites of taking into account caretakers ’ different preferences and needs, providing highly structured psychosocial support activities and providing a congruent range of web services, are necessary for successful provision and use of web-based communication for psychosocial support.
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| 15. |
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| 16. |
- Lewis, John L, et al.
(författare)
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New results for p harmonic functions
- 2011
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Ingår i: Pure and Applied Mathematics Quarterly. - : International Press of Boston. - 1558-8599 .- 1558-8602. ; 7:2, s. 345-363
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we first discuss new results of the authors concerning a boundary Harnack inequality and Holder continuity up to the boundary for the ratio of two positive pharmonic functions, 1 < p < infinity, which vanish on a portion of a Lipschitz domain. Second we discuss applications of these results to the Martin boundary problem for p harmonic functions and to certain boundary regularity-free boundary problems.
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| 17. |
- Lewis, John L., et al.
(författare)
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New results for $p$ harmonic functions
- 2011
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Ingår i: Pure and Applied Mathematics Quarterly. - 1558-8599 .- 1558-8602. ; 7, s. 345-363
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Tidskriftsartikel (refereegranskat)
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| 18. |
- Lewis, John L, et al.
(författare)
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On the dimension of p-harmonic measure in space
- 2013
-
Ingår i: Journal of the European Mathematical Society (Print). - 1435-9855 .- 1435-9863. ; 15:6, s. 2197-2256
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Tidskriftsartikel (refereegranskat)abstract
- Let Omega subset of R-n, n >= 3, and let p, 1 < p < infinity, p not equal D 2, be given. In this paper we study the dimension of p-harmonic measures that arise from nonnegative solutions to the p-Laplace equation, vanishing on a portion of partial derivative Omega, in the setting of delta-Reifenberg flat domains. We prove, for p >= n, that there exists (delta) over tilde = (delta) over tilde (p, n) > 0 small such that if Omega is a delta-Reifenberg flat domain with delta < <(delta)over tilde>, then p-harmonic measure is concentrated on a set of sigma-finite Hn-1-measure. We prove, for p >= n, that for sufficiently flat Wolff snowflakes the Hausdorff dimension of p-harmonic measure is always less than n - 1. We also prove that if 2 < p < n, then there exist Wolff snowflakes such that the Hausdorff dimension of p-harmonic measure is less than n - 1, while if 1 < p < 2, then there exist Wolff snowflakes such that the Hausdorff dimension of p-harmonic measure is larger than n - 1. Furthermore, perturbing off the case p = 2; we derive estimates for the Hausdorff dimension of p-harmonic measure when p is near 2.
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| 19. |
- Lewis, John L., et al.
(författare)
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p Harmonic Measure in Simply Connected Domains
- 2011
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Ingår i: Annales de l'Institut Fourier. - : Annales de L'Institut Fourier. - 0373-0956 .- 1777-5310. ; 61:2, s. 689-715
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Tidskriftsartikel (refereegranskat)abstract
- Let Omega be a bounded simply connected domain in the complex plane, C. Let N be a neighborhood of partial derivative Omega, let p be fixed, 1 < p < infinity, and let (u) over cap be a positive weak solution to the p Laplace equation in Omega boolean AND N. Assume that (u) over cap has zero boundary values on partial derivative Omega in the Sobolev sense and extend (u) over cap to N \ Omega by putting 11 E 0 on N Then there exists a positive finite Borel measure (mu) over cap on C with support contained in partial derivative Omega and such that integral vertical bar del(u) over cap vertical bar(p-2) dA = - integral phi d (mu) over cap whenever phi is an element of C(0)(infinity)(N). If p = 2 and if (u) over cap is the Green function for Omega with pole at x is an element of Omega\(N) over bar then the measure (mu) over cap coincides with harmonic measure at x, omega = omega(x), associated to the Laplace equation. In this paper we continue the studies initiated by the first author by establishing new results, in simply connected domains, concerning the Hausdorff dimension of the support of the measure (mu) over cap. In particular, we prove results, for 1 < p < infinity, p not equal 2, reminiscent of the famous result of Makarov concerning the Hausdorff dimension of the support of harmonic measure in simply connected domains.
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| 20. |
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| 21. |
- Lewis, John L., et al.
(författare)
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Regularity of flat free boundaries in two-phase problems for the p-Laplace operator
- 2012
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Ingår i: Annales de l'Institut Henri Poincare. Analyse non linéar. - : European Mathematical Society - EMS - Publishing House GmbH. - 0294-1449 .- 1873-1430. ; 29:1, s. 83-108
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we continue the study in Lewis and Nystrom (2010) [19], concerning the regularity of the free boundary in a general two-phase free boundary problem for the p-Laplace operator, by proving regularity of the free boundary assuming that the free boundary is close to a Lipschitz graph.
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| 22. |
- Lewis, John L, et al.
(författare)
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Regularity of Lipschitz free boundaries in two-phase problems for the p-Laplace operator
- 2010
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Ingår i: Advances in Mathematics. - : Academic Press. - 0001-8708 .- 1090-2082. ; 225:5, s. 2565-2597
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we study the regularity of the free boundary in a general two-phase free boundary problem for the p-Laplace operator and we prove, in particular, that Lipschitz free boundaries are C(1,gamma)-smooth for some gamma is an element of (0, 1). As part of our argument, and which is of independent interest, we establish a Hopf boundary type principle for non-negative p-harmonic functions vanishing on a portion of the boundary of a Lipschitz domain.
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| 23. |
- Litorp, Helena, 1980-, et al.
(författare)
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Increasing caesarean section rates among low-risk groups : a panel study classifying deliveries according to Robson at a university hospital in Tanzania
- 2013
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Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 13, s. Article nr 107-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Rising caesarean section (CS) rates have been observed worldwide in recent decades. This study sought to analyse trends in CS rates and outcomes among a variety of obstetric groups at a university hospital in a low-income country. Methods: We conducted a hospital-based panel study at Muhimbili National Hospital, Dar es Salaam, Tanzania. All deliveries between 2000 and 2011 with gestational age >= 28 weeks were included in the study. The 12 years were divided into four periods: 2000 to 2002, 2003 to 2005, 2006 to 2008, and 2009 to 2011. Main outcome measures included CS rate, relative size of obstetric groups, contribution to overall CS rate, perinatal mortality ratio, neonatal distress, and maternal mortality ratio. Time trends were analysed within the ten Robson groups, based on maternal and obstetric characteristics. We applied the chi(2) test for trend to determine whether changes were statistically significant. Odds ratios of CS were evaluated using multivariate logistic regression, accounting for maternal age, referral status, and private healthcare insurance. Results: We included 137,094 deliveries. The total CS rate rose from 19% to 49%, involving nine out of ten groups. Multipara without previous CS with single, cephalic pregnancies in spontaneous labour had a CS rate of 33% in 2009 to 2011. Adjusted analysis explained some of the increase. Perinatal mortality and neonatal distress decreased in multiple pregnancies (p < 0.001 and p = 0.003) and nullipara with breech pregnancies (p < 0.001 and p = 0.024). Although not statistically significant, there was an increase in perinatal mortality (p = 0.381) and neonatal distress (p = 0.171) among multipara with single cephalic pregnancies in spontaneous labour. The maternal mortality ratio increased from 463/100, 000 live births in 2000 to 2002 to 650/100, 000 live births in 2009 to 2011 (p = 0.031). Conclusion: The high CS rate among low-risk groups suggests that many CSs might have been performed on questionable indications. Such a trend may result in even higher CS rates in the future. While CS can improve perinatal outcomes, it does not necessarily do so if performed routinely in low-risk groups.
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| 24. |
- Litorp, Helena, 1980-, et al.
(författare)
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Maternal near-miss and death and their association with caesarean section complications : a cross-sectional study at a university hospital and a regional hospital in Tanzania
- 2014
-
Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 14:1, s. 244-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The maternal near-miss (MNM) concept has been developed to assess life-threatening conditions during pregnancy, childhood, and puerperium. In recent years, caesarean section (CS) rates have increased rapidly in many low- and middle-income countries, a trend which might have serious effects on maternal health. Our aim was to describe the occurrence and panorama of maternal near-miss and death in two low-resource settings, and explore their association with CS complications.METHODS: We performed a cross-sectional study, including all women who fulfilled the WHO criteria for MNM or death between February and June 2012 at a university hospital and a regional hospital in Dar es Salaam, Tanzania. Cases were assessed individually to determine their association with CS. Main outcome measures included MNM ratio; maternal mortality ratio; proportion of MNM and death associated with CS complications; and the risk for such outcomes per 1,000 operations. The risk ratio of life-threatening CS complications at the university hospital compared to the regional hospital was calculated.RESULTS: We identified 467 MNM events and 77 maternal deaths. The MNM ratio was 36 per 1,000 live births (95% CI 33-39) and the maternal mortality ratio was 587 per 100,000 live births (95% CI 460-730). Major causes were eclampsia and postpartum haemorrhage, but we also detected nine MNM events and five deaths from iatrogenic complications. CS complications accounted for 7.9% (95% CI 5.6-11) of the MNM events and 13% (95% CI 6.4-23) of the maternal deaths. The risk of experiencing a life-threatening CS complication was three times higher at the regional hospital (22/1,000 operations, 95% CI 12-37) compared to the university hospital (7.0/1,000 operations, 95% CI 3.8-12) (risk ratio 3.2, 95% CI 1.5-6.6).CONCLUSIONS: The occurrence of MNM and death at the two hospitals was high, and many cases were associated with CS complications. The maternal risks of CS in low-resource settings must not be overlooked, and measures should be taken to avoid unnecessary CSs. More comprehensive training of staff, improved postoperative surveillance, and a more even distribution of resources within the health care system might reduce the risks of CS.
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| 25. |
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| 26. |
- Lundström, Niklas L P, et al.
(författare)
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Systems of variational inequalities in the context of optimal switching problems and operators of Kolmogorov type
- 2014
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Ingår i: Annali di Matematica Pura ed Applicata. - : Springer. - 0373-3114 .- 1618-1891. ; 193:4, s. 1213-1247
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we study the system where . A special case of this type of system of variational inequalities with terminal data occurs in the context of optimal switching problems. We establish a general comparison principle for viscosity sub- and supersolutions to the system under mild regularity, growth, and structural assumptions on the data, i.e., on the operator and on continuous functions , , and . A key aspect is that we make no sign assumption on the switching costs and that is allowed to depend on as well as . Using the comparison principle, the existence of a unique viscosity solution to the system is constructed as the limit of an increasing sequence of solutions to associated obstacle problems. Having settled the existence and uniqueness, we subsequently focus on regularity of beyond continuity. In this context, in particular, we assume that belongs to a class of second-order differential operators of Kolmogorov type of the form: where . The matrix is assumed to be symmetric and uniformly positive definite in . In particular, uniform ellipticity is only assumed in the first coordinate directions, and hence, may be degenerate.
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| 27. |
- Lundström, Niklas L.P., et al.
(författare)
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The Boundary Harnack Inequality for Solutions to Equations of Aronsson type in the Plane
- 2011
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Ingår i: Annales Academiae Scientiarum Fennicae Mathematica. - : Academia Scientiarum Fennica. - 1239-629X .- 1798-2383. ; 36, s. 261-278
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we prove a boundary Harnack inequality for positive functions which vanish continuously on a portion of the boundary of a bounded domain \Omega \subset R2 and which are solutions to a general equation of p-Laplace type, 1 < p < \infty. We also establish the same type of result for solutions to the Aronsson type equation \nabla (F(x,\nabla u)) \cdot F\eta(x,\nabla u) = 0. Concerning \Omega we only assume that \partial\Omega is a quasicircle. In particular, our results generalize the boundary Harnack inequalities in [BL] and [LN2] to operators with variable coefficients.
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| 28. |
- Murphy, MP, et al.
(författare)
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Unraveling the Biological Roles of Reactive Oxygen Species
- 2011
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Ingår i: Cell Metabolism. - 1550-4131. ; 13:4, s. 361-366
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Tidskriftsartikel (refereegranskat)abstract
- Reactive oxygen species are not only harmful agents that cause oxidative damage in pathologies, they also have important roles as regulatory agents in a range of biological phenomena. The relatively recent development of this more nuanced view presents a challenge to the biomedical research community on how best to assess the significance of reactive oxygen species and oxidative damage in biological systems. Considerable progress is being made in addressing these issues, and here we survey some recent developments for those contemplating research in this area.
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| 29. |
- Nash, Kirsty L., et al.
(författare)
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Discontinuities, cross-scale patterns, and the organization of ecosystems
- 2014
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Ingår i: Ecology. - : Wiley. - 0012-9658 .- 1939-9170. ; 95:3, s. 654-667
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Tidskriftsartikel (refereegranskat)abstract
- Ecological structures and processes occur at specific spatiotemporal scales, and interactions that occur across multiple scales mediate scale-specific (e.g., individual, community, local, or regional) responses to disturbance. Despite the importance of scale, explicitly incorporating a multi-scale perspective into research and management actions remains a challenge. The discontinuity hypothesis provides a fertile avenue for addressing this problem by linking measureable proxies to inherent scales of structure within ecosystems. Here we outline the conceptual framework underlying discontinuities and review the evidence supporting the discontinuity hypothesis in ecological systems. Next we explore the utility of this approach for understanding cross-scale patterns and the organization of ecosystems by describing recent advances for examining nonlinear responses to disturbance and phenomena such as extinctions, invasions, and resilience. To stimulate new research, we present methods for performing discontinuity analysis, detail outstanding knowledge gaps, and discuss potential approaches for addressing these gaps.
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| 30. |
- Nash, Kirsty L., et al.
(författare)
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Habitat structure and body size distributions : cross-ecosystem comparison for taxa with determinate and indeterminate growth
- 2014
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Ingår i: Oikos. - : Wiley. - 0030-1299 .- 1600-0706. ; 123:8, s. 971-983
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Tidskriftsartikel (refereegranskat)abstract
- Habitat structure across multiple spatial and temporal scales has been proposed as a key driver of body size distributions for associated communities. Thus, understanding the relationship between habitat and body size is fundamental to developing predictions regarding the influence of habitat change on animal communities. Much of the work assessing the relationship between habitat structure and body size distributions has focused on terrestrial taxa with determinate growth, and has primarily analysed discontinuities (gaps) in the distribution of species mean sizes (species size relationships or SSRs). The suitability of this approach for taxa with indeterminate growth has yet to be determined. We provide a cross-ecosystem comparison of bird (determinate growth) and fish (indeterminate growth) body mass distributions using four independent data sets. We evaluate three size distribution indices: SSRs, species size-density relationships (SSDRs) and individual size-density relationships (ISDRs), and two types of analysis: looking for either discontinuities or abundance patterns and multi-modality in the distributions. To assess the respective suitability of these three indices and two analytical approaches for understanding habitat-size relationships in different ecosystems, we compare their ability to differentiate bird or fish communities found within contrasting habitat conditions. All three indices of body size distribution are useful for examining the relationship between cross-scale patterns of habitat structure and size for species with determinate growth, such as birds. In contrast, for species with indeterminate growth such as fish, the relationship between habitat structure and body size may be masked when using mean summary metrics, and thus individual-level data (ISDRs) are more useful. Furthermore, ISDRs, which have traditionally been used to study aquatic systems, present a potentially useful common currency for comparing body size distributions across terrestrial and aquatic ecosystems.
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| 31. |
- Nyström, Helena Filipsson, 1966, et al.
(författare)
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Detection of genetic hypopituitarism in an adult population of idiopathic pituitary insufficiency patients with growth hormone deficiency.
- 2011
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Ingår i: Pituitary. - : Springer Science and Business Media LLC. - 1573-7403 .- 1386-341X. ; 14:3, s. 208-216
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Tidskriftsartikel (refereegranskat)abstract
- Idiopathic pituitary insufficiency (IPI) is diagnosed in 10% of all hypopituitary patients. There are several known and unknown aetiologies within the IPI group. The aim of this study was to investigate an adult IPI population for genetic cause according a screening schedule. From files of 373 GH deficient (GHD) patients on GH replacement 50 cases with IPI were identified. Of the 39 patients that approved to the study, 25 patients were selected for genetic investigation according to phenotype and 14 patients were not further tested, as sporadic isolated GHD (n=9) and GHD with diabetes insipidus (n=5) have low probability for a known genetic cause. Genotyping of all coding exons of HESX1, LHX4, PROP1, POU1F1 and GH1 genes were performed according to a diagnostic algorithm based on clinical, hormonal and neuroradiological phenotype. Among the 25 patients, an overall rate of 8% of mutations was found, and a 50% rate in familial cases. Among two sibling pairs, one pair that presented with complete anterior pituitary insufficiency, had a compound heterozygous PROP1 gene mutation (codons 117 and 120: exon 3 p Phe 117 Ile (c349 T>A) and p Arg 120 Cys (c358 C>T)) with a phenotype of very late onset ACTH-insufficiency. In the other sibling pair and in the sporadic cases no mutation was identified. This study suggests that currently known genetic causes are rare in sporadic adult IPI patients, and that systematic genetic screening is not needed in adult-onset sporadic cases of IPI. Conversely, familial cases are highly suspect for genetic causes.
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| 32. |
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| 33. |
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| 34. |
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| 35. |
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| 36. |
- Nyström, Sofie, et al.
(författare)
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Evidence for Age-Dependent in Vivo Conformational Rearrangement within A beta Amyloid Deposits
- 2013
-
Ingår i: ACS Chemical Biology. - : American Chemical Society. - 1554-8929 .- 1554-8937. ; 8:6, s. 1128-1133
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Tidskriftsartikel (refereegranskat)abstract
- Deposition of aggregated A beta peptide in the brain is one of the major hallmarks of Alzheimers disease. Using a combination of two structurally different, but related, hypersensitive fluorescent amyloid markers, LCOs, reporting on separate ultrastructural elements, we show that conformational rearrangement occurs within A beta plaques of transgenic mouse models as the animals age. This important mechanistic insight should aid the design and evaluation of experiments currently using plaque load as readout.
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| 37. |
- Ofverholm, I. Ivanov, et al.
(författare)
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PROGNOSTIC IMPACT OF IKZF1 DELETIONS IN PEDIATRIC B-CELL PRECURSOR ACUTE LYMPHOBLASTIC LEUKEMIA TREATED ACCORDING TO NOPHO PROTOCOLS - THE SWEDISH EXPERIENCE
- 2014
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Ingår i: Haematologica. - 0390-6078 .- 1592-8721. ; 99:Suppl 1, s. 9-9
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Recently, IKZF1 deletions have been shown to be associated notonly with the leukemogenic process but also to confer a poor prognosis in allrisk groups of B-cell precursor ALL. In a previous study, we used Multiplex Ligation-dependentProbe Amplification (MLPA) to investigate the presence ofIKZF1 deletions in bone marrow DNA from 116 children diagnosed with BCPALL in a single center and treated according to NOPHO protocols. Deletionswere detected in 16% of cases; both event free survival and overall survivalwere significantly reduced in the IKZF1-deleted group compared to the groupwith intact IKZF1.
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| 38. |
- Ording, Anne Gulbech, et al.
(författare)
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Comorbid Diseases Interact with Breast Cancer to Affect Mortality in the First Year after Diagnosis-A Danish Nationwide Matched Cohort Study
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:10, s. e76013-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Survival of breast cancer patients with comorbidity, compared to those without comorbidity, has been well characterized. The interaction between comorbid diseases and breast cancer, however, has not been well-studied. Methods: From Danish nationwide medical registries, we identified all breast cancer patients between 45 and 85 years of age diagnosed from 1994 to 2008. Women without breast cancer were matched to the breast cancer patients on specific comorbid diseases included in the Charlson comorbidity Index (CCI). Interaction contrasts were calculated as a measure of synergistic effect on mortality between comorbidity and breast cancer. Results: The study included 47,904 breast cancer patients and 237,938 matched comparison women. In the first year, the strongest interaction between comorbidity and breast cancer was observed in breast cancer patients with a CCI score of >= 4, which accounted for 29 deaths per 1000 person-years. Among individual comorbidities, dementia interacted strongly with breast cancer and accounted for 148 deaths per 1000 person-years within one year of follow-up. There was little interaction between comorbidity and breast cancer during one to five years of follow-up. Conclusions: There was substantial interaction between comorbid diseases and breast cancer, affecting mortality. Successful treatment of the comorbid diseases or the breast cancer can delay mortality caused by this interaction in breast cancer patients.
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| 39. |
- Ording, Anne Gulbech, et al.
(författare)
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Hospital Recorded Morbidity and Breast Cancer Incidence : A Nationwide Population-Based Case-Control Study
- 2012
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:10
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Chronic diseases and their complications may increase breast cancer risk through known or still unknown mechanisms, or by shared causes. The association between morbidities and breast cancer risk has not been studied in depth. Methods: Data on all Danish women aged 45 to 85 years, diagnosed with breast cancer between 1994 and 2008 and data on preceding morbidities were retrieved from nationwide medical registries. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression associating the Charlson comorbidity score (measured using both the original and an updated Charlson Comorbidity Index (CCI)) with incident breast cancer. Furthermore, we estimated associations between 202 morbidity categories and incident breast cancer, adjusting for multiple comparisons using empirical Bayes (EB) methods. Results: The study included 46,324 cases and 463,240 population controls. Increasing CCI score, up to a score of six, was associated with slightly increased breast cancer risk. Among the Charlson diseases, preceding moderate to severe renal disease (OR = 1.25, 95% CI: 1.06, 1.48), any tumor (OR = 1.17, 95% CI: 1.10, 1.25), moderate to severe liver disease (OR = 1.86, 95% CI: 1.32, 2.62), and metastatic solid tumors (OR = 1.49, 95% CI: 1.17, 1.89), were most strongly associated with subsequent breast cancer. Preceding myocardial infarction (OR = 0.89, 95% CI: 0.81, 0.99), connective tissue disease (OR = 0.87, 95% CI: 0.80, 0.94), and ulcer disease (OR = 0.91, 95% CI: 0.83, 0.99) were most strongly inversely associated with subsequent breast cancer. A history of breast disorders was associated with breast cancer after EB adjustment. Anemias were inversely associated with breast cancer, but the association was near null after EB adjustment. Conclusions: There was no substantial association between morbidity measured with the CCI and breast cancer risk.
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| 40. |
- Ording, Anne Gulbech, et al.
(författare)
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Impact of comorbidity on risk of venous thromboembolism in patients with breast cancer : a Danish population-based cohort study
- 2014
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 4:6
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To assess the interaction between comorbidity and breast cancer (BC) on the rate of venous thromboembolism (VTE) beyond what can be explained by the independent effects of BC and comorbidity. Design: Population-based matched cohort study. Setting: Denmark. Participants: Danish patients with BC (n=62 376) diagnosed in 1995-2010 and a comparison cohort of women without BC (n=304 803) from the general population were matched to the patients with BC on year of birth in 5-year intervals and on the specific diseases included in the Charlson Comorbidity Index (CCI) and atrial fibrillation and obesity. Measures: The rate ratios of VTE per 1000 person-years (PY) were computed by comorbidity levels using the CCI, and interaction contrasts (IC) were calculated as a measure of the excess or deficit VTE rate not explained by the independent effects of BC and comorbidity. Results: Among patients with BC with a CCI score of 1, the 0-1 year VTE rate was 12/1000 PY, and interaction accounted for 10% of the rate (IC=3.2, 95% CI 0.5 to 5.9). Among patients with BC with CCI >= 4, the VTE rate was 17, and interaction accounted for 8% of the rate (IC=1.2, 95% CI -1.8 to 4.2). There was no interaction during 2-5 years of follow-up. Conclusions: There was only little interaction between BC and the CCI score on the rate of VTE.
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| 41. |
- Pelaseyed, Thaher, 1979, et al.
(författare)
-
The mucus and mucins of the goblet cells and enterocytes provide the first defense line of the gastrointestinal tract and interact with the immune system
- 2014
-
Ingår i: Immunological Reviews. - : Wiley. - 0105-2896 .- 1600-065X. ; 260:1, s. 8-20
-
Forskningsöversikt (refereegranskat)abstract
- The gastrointestinal tract is covered by mucus that has different properties in the stomach, small intestine, and colon. The large highly glycosylated gel-forming mucins MUC2 and MUC5AC are the major components of the mucus in the intestine and stomach, respectively. In the small intestine, mucus limits the number of bacteria that can reach the epithelium and the Peyer's patches. In the large intestine, the inner mucus layer separates the commensal bacteria from the host epithelium. The outer colonic mucus layer is the natural habitat for the commensal bacteria. The intestinal goblet cells secrete not only the MUC2 mucin but also a number of typical mucus components: CLCA1, FCGBP, AGR2, ZG16, and TFF3. The goblet cells have recently been shown to have a novel gate-keeping role for the presentation of oral antigens to the immune system. Goblet cells deliver small intestinal luminal material to the lamina propria dendritic cells of the tolerogenic CD103+ type. In addition to the gel-forming mucins, the transmembrane mucins MUC3, MUC12, and MUC17 form the enterocyte glycocalyx that can reach about a micrometer out from the brush border. The MUC17 mucin can shuttle from a surface to an intracellular vesicle localization, suggesting that enterocytes might control and report epithelial microbial challenge. There is communication not only from the epithelial cells to the immune system but also in the opposite direction. One example of this is IL10 that can affect and improve the properties of the inner colonic mucus layer. The mucus and epithelial cells of the gastrointestinal tract are the primary gate keepers and controllers of bacterial interactions with the host immune system, but our understanding of this relationship is still in its infancy.
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| 42. |
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| 43. |
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| 44. |
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| 45. |
- Slavica, Lucija, et al.
(författare)
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Indoleamine 2,3-dioxygenase Expression and Functional Activity in Dendritic Cells Exposed to Cholera Toxin
- 2012
-
Ingår i: Scandinavian Journal of Immunology. - : Wiley. - 0300-9475. ; 76:2, s. 113-122
-
Tidskriftsartikel (refereegranskat)abstract
- Indoleamine 2,3-dioxygenase (IDO), a tryptophan-metabolizing enzyme expressed by dendritic cells (DC), has the potential to inhibit T cell responses and to promote tolerance. In contrast, cholera toxin (CT), the enterotoxin produced by Vibrio cholerae, promotes T cell responses, partly through its ability to induce DC maturation and promote antigen presentation. We hypothesized that the adjuvant activity of CT is associated with a lack of induction of IDO in DC. To test this hypothesis, monocyte-derived DC were pulsed with CT, and the IDO mRNA expression, IDO functional activity and cytokine production were measured as well as the ability of DC to induce T cell responses in vitro. Cholera toxin exposure induced enhanced levels of IDO mRNA in DC but no functional IDO protein activity. Cholera toxin pulsing however primed DC for CD40L-induced IDO protein activity. CD40L stimulation of CT-pulsed DC induced a modest IL-12p40 production, but not IL-12p70 or IL-23 secretion. Furthermore, CT-pulsed DC induced strong allogeneic and autologous T cell responses in vitro, which were not affected by the IDO-specific inhibitor 1-methyl tryptophan. Our results show that CT per se does not induce the expression of functional IDO protein, although it primes DC for CD40L-mediated IDO production and IL-12p40 secretion. Furthermore, CT-treated DC were equally powerful in their T cell stimulatory capacity as cytokine-matured DC.
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| 46. |
- Sundqvist, E., et al.
(författare)
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Cytomegalovirus seropositivity is negatively associated with multiple sclerosis
- 2014
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Ingår i: Multiple Sclerosis. - : SAGE Publications. - 1352-4585 .- 1477-0970. ; 20:2, s. 165-173
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Tidskriftsartikel (refereegranskat)abstract
- Background: Epidemiological data suggest a role for common viruses in the pathogenesis of multiple sclerosis (MS), and recent data showed a negative association of past cytomegalovirus (CMV) infection on pediatric MS risk. Objective: Our aim was to analyze the association of CMV infection with MS risk in an adult case-control material. A meta-analysis was performed to validate our findings. Methods: Epidemiological Investigation in MS (EIMS) is a case-control study with incident cases and population-based controls. Anti-CMV antibody titers were measured with ELISA, and HLA-A and DRB1 genotyping was performed with SSP-PCR, in 658 MS cases, who all fulfilled the McDonald criteria for MS, and 786 controls. Results: CMV seropositivity was associated with a decreased MS risk, OR = 0.73 (0.58-0.92 95% CI), p = 0.005, adjusted for index age, gender, smoking, sun exposure, EBNA1 IgG titer and HLA-A*02 and DRB1*15. When we removed all cases and controls younger than 18 years at index, the protective effect was still apparent. Conclusions: CMV is negatively associated with adult-onset MS pathology, consistent with results from a study on pediatric MS cases. It remains to be shown whether this negative association is due to a true protective effect of CMV infection on MS risk. © 2013 The Author(s).
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| 47. |
- Svensson, K. E., et al.
(författare)
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Effects of mother-infant skin-to-skin contact on severe latch-on problems in older infants : A randomized trial
- 2013
-
Ingår i: International Breastfeeding Journal. - : Springer Science and Business Media LLC. - 1746-4358. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Infants with latch-on problems cause stress for parents and staff, often resulting in early termination of breastfeeding. Healthy newborns experiencing skin-to-skin contact at birth are pre-programmed to find the mother's breast. This study investigates if skin-to-skin contact between mothers with older infants having severe latching on problems would resolve the problem.Methods: Mother-infant pairs with severe latch-on problems, that were not resolved during screening procedures at two maternity hospitals in Stockholm 1998-2004, were randomly assigned to skin-to-skin contact (experimental group) or not (control group) during breastfeeding. Breastfeeding counseling was given to both groups according to a standard model. Participants were unaware of their treatment group. Objectives were to compare treatment groups concerning the proportion of infants regularly latching on, the time from intervention to regular latching on and maternal emotions and pain before and during breastfeeding.Results: On hundred and three mother-infant pairs with severe latch-on problems 1-16 weeks postpartum were randomly assigned and analyzed. There was no significant difference between the groups in the proportion of infants starting regular latching-on (75% experimental group, vs. 86% control group). Experimental group infants, who latched on, had a significantly shorter median time from start of intervention to regular latching on than control infants, 2.0 weeks (Q1 = 1.0, Q3 = 3.7) vs. 4.7 weeks (Q1 = 2.0, Q3 = 8.0), (p-value = 0.020). However, more infants in the experimental group (94%), with a history of " strong reaction" during " hands-on latch intervention" , latched-on within 3 weeks compared to 33% in the control infants (Fisher Exact test p-value = 0.0001). Mothers in the experimental group (n = 53) had a more positive breastfeeding experience according to the Breastfeeding Emotional Scale during the intervention than mothers in the control group (n = 50) (p-value = 0.022).Conclusions: Skin-to-skin contact during breastfeeding seems to immediately enhance maternal positive feelings and shorten the time it takes to resolve severe latch-on problems in the infants who started to latch. An underlying mechanism may be that skin-to-skin contact with the mother during breastfeeding may calm infants with earlier strong reaction to " hands on latch intervention" and relieve the stress which may have blocked the infant's inborn biological program to find the breast and latch on.Trial registration: Karolinska Clinical Trial Registration number CT20100055.
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| 48. |
- Torkzad, Michael R, et al.
(författare)
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Manifestations of small bowel disease in pediatric Crohn's disease on magnetic resonance enterography
- 2012
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Ingår i: Inflammatory Bowel Diseases. - : Oxford University Press (OUP). - 1078-0998 .- 1536-4844. ; 18:3, s. 520-528
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We report the manifestations of Crohn's disease (CD) observed on magnetic resonance enterography (MRE) in a pediatric population at the time of CD diagnosis. METHODS: MRE of 95 consecutive pediatric patients with inflammatory bowel disease (IBD) examined in 2006-2009 were retrospectively analyzed, with documentation of findings based on type and location of the small bowel (SB) disease. RESULTS: In all, 51 were boys and 44 girls. 54 had CD, 31 non-CD IBD, and 10 no IBD. The most common site of SB involvement in CD was the terminal ileum seen in 29 (53.7%) patients, followed by ileum in 10 (18.5%) and jejunum in 9 (16.7%) patients. Solitary jejunal inflammation (3.7%), SB stenoses (1.9%), fistula formation (0.95%), and abscess (0.95%) were much less common. Perienteric lymphadenopathy was seen in 30 (55.6%) patients and fatty proliferation in 9 (16.7%). The most common manifestation of SB inflammation was increased contrast enhancement of bowel wall (93.5%), thickening of the bowel wall (90.3%), and derangement of bowel shape with saccular formations (25.8%). CONCLUSIONS: MRE in the pediatric population often demonstrates increased contrast uptake, bowel wall thickening, and perienteral lymphadenopathy in CD. More chronic small bowel changes seen commonly in adults and solitary jejunal involvements are less commonly seen.
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| 49. |
- Unosson, Jon, et al.
(författare)
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Exposure to wood smoke increases arterial stiffness and decreases heart rate variability in humans
- 2013
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Ingår i: Particle and Fibre Toxicology. - London, England : Springer Science and Business Media LLC. - 1743-8977. ; 10, s. 20-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Emissions from biomass combustion are a major source of indoor and outdoor air pollution, and are estimated to cause millions of premature deaths worldwide annually. Whilst adverse respiratory health effects of biomass exposure are well established, less is known about its effects on the cardiovascular system. In this study we assessed the effect of exposure to wood smoke on heart rate, blood pressure, central arterial stiffness and heart rate variability in otherwise healthy persons. Methods: Fourteen healthy non-smoking subjects participated in a randomized, double-blind crossover study. Subjects were exposed to dilute wood smoke (mean particle concentration of 314 +/- 38 mu g/m(3)) or filtered air for three hours during intermittent exercise. Heart rate, blood pressure, central arterial stiffness and heart rate variability were measured at baseline and for one hour post-exposure. Results: Central arterial stiffness, measured as augmentation index, augmentation pressure and pulse wave velocity, was higher after wood smoke exposure as compared to filtered air (p < 0.01 for all), and heart rate was increased (p < 0.01) although there was no effect on blood pressure. Heart rate variability (SDNN, RMSSD and pNN50; p = 0.003, p < 0.001 and p < 0.001 respectively) was decreased one hour following exposure to wood smoke compared to filtered air. Conclusions: Acute exposure to wood smoke as a model of exposure to biomass combustion is associated with an immediate increase in central arterial stiffness and a simultaneous reduction in heart rate variability. As biomass is used for cooking and heating by a large fraction of the global population and is currently advocated as a sustainable alternative energy source, further studies are required to establish its likely impact on cardiovascular disease.
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| 50. |
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