| 1. |
- Andersson, B, et al.
(författare)
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Ökad fysisk aktivitet viktigt för att bromsa sjukfrånvaron
- 2015
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Ingår i: Dagens nyheter, DN.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Försäkringskassans rapport (DN Debatt 27/11 2015) visar att sjukfrånvaron fortsätter att öka och lovar att kraftsamla i sjukförsäkringshandläggningen. Men, precis som Försäkringskassan skriver, kommer det inte att räcka för att nå regeringens mål. Regeringens åtgärdsprograms program i sju punkter för att minska sjukfrånvaron saknar en viktig komponent. Det måste kompletteras med fysisk aktivitet som ett åttonde område för att trenden ska kunna brytas, skriver 13 debattörer.
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| 2. |
- Lindahl, Bertil, 1957-, et al.
(författare)
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Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis
- 2021
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 290:2, s. 359-372
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Tidskriftsartikel (refereegranskat)abstract
- Background: Characteristics and prognosis of patients admitted with strong suspicion of myocardial infarction (MI) but discharged without an MI diagnosis are not well-described. Objectives: To compare background characteristics and cardiovascular outcomes in patients discharged with or without MI diagnosis. Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial compared 6629 patients with strong suspicion of MI randomized to oxygen or ambient air. The main composite end-point of this subgroup analysis was the incidence of all-cause death, rehospitalization with MI, heart failure (HF) or stroke during a follow-up of 2.1 years (median; range: 1–3.7 years) irrespective of randomized treatment. Results: 1619 (24%) received a non-MI discharge diagnosis, and 5010 patients (76%) were diagnosed with MI. Groups were similar in age, but non-MI patients were more commonly female and had more comorbidities. At thirty days, the incidence of the composite end-point was 2.8% (45 of 1619) in non-MI patients, compared to 5.0% (250 of 5010) in MI patients with lower incidences in all individual end-points. However, for the long-term follow-up, the incidence of the composite end-point increased in the non-MI patients to 17.7% (286 of 1619) as compared to 16.0% (804 of 5010) in MI patients, mainly driven by a higher incidence of all-cause death, stroke and HF. Conclusions: Patients admitted with a strong suspicion of MI but discharged with another diagnosis had more favourable outcomes in the short-term perspective, but from one year onwards, cardiovascular outcomes and death deteriorated to a worse long-term prognosis.
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| 6. |
- Husby, A, et al.
(författare)
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Clinical outcomes of myocarditis after SARS-CoV-2 mRNA vaccination in four Nordic countries: population based cohort study
- 2023
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Ingår i: BMJ medicine. - : BMJ. - 2754-0413. ; 2:1, s. e000373-
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the clinical outcomes of myocarditis associated with mRNA vaccines against the SARS-CoV-2 virus compared with other types of myocarditis.DesignPopulation based cohort study.SettingNationwide register data from four Nordic countries (Denmark, Finland, Norway, and Sweden), from 1 January 2018 to the latest date of follow-up in 2022.ParticipantsThe Nordic myocarditis cohort; 7292 individuals aged ≥12 years who had an incident diagnosis of myocarditis as a main or secondary diagnosis, in a population of 23 million individuals in Denmark, Finland, Norway, and Sweden.Main outcome measuresHeart failure, or death from any cause within 90 days of admission to hospital for new onset myocarditis, and hospital readmission within 90 days of discharge to hospital for new onset myocarditis. Clinical outcomes of myocarditis associated with SARS-CoV-2 mRNA vaccination, covid-19 disease, and conventional myocarditis were compared.ResultsIn 2018-22, 7292 patients were admitted to hospital with new onset myocarditis, with 530 (7.3%) categorised as having myocarditis associated with SARS-CoV-2 mRNA vaccination, 109 (1.5%) with myocarditis associated with covid-19 disease, and 6653 (91.2%) with conventional myocarditis. At the 90 day follow-up, 62, nine, and 988 patients had been readmitted to hospital in each group (vaccination, covid-19, and conventional myocarditis groups, respectively), corresponding to a relative risk of readmission of 0.79 (95% confidence interval 0.62 to 1.00) and 0.55 (0.30 to 1.04) for the vaccination type and covid-19 type myocarditis groups, respectively, compared with the conventional myocarditis group. At the 90 day follow-up, 27, 18, and 616 patients had a diagnosis of heart failure or died in the vaccination type, covid-19 type, and conventional myocarditis groups, respectively. The relative risk of heart failure within 90 days was 0.56 (95% confidence interval 0.37 to 0.85) and 1.48 (0.86 to 2.54) for myocarditis associated with vaccination and covid-19 disease, respectively, compared with conventional myocarditis; the relative risk of death was 0.48 (0.21 to 1.09) and 2.35 (1.06 to 5.19), respectively. Among patients aged 12-39 years with no predisposing comorbidities, the relative risk of heart failure or death was markedly higher for myocarditis associated with covid-19 disease than for myocarditis associated with vaccination (relative risk 5.78, 1.84 to 18.20).ConclusionsCompared with myocarditis associated with covid-19 disease and conventional myocarditis, myocarditis after vaccination with SARS-CoV-2 mRNA vaccines was associated with better clinical outcomes within 90 days of admission to hospital.
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| 7. |
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| 8. |
- Jernberg, T., et al.
(författare)
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Long-Term Effects of Oxygen Therapy on Death or Hospitalization for Heart Failure in Patients With Suspected Acute Myocardial Infarction
- 2018
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Ingår i: Circulation. - : Ovid Technologies (Wolters Kluwer Health). - 0009-7322 .- 1524-4539. ; 138:24, s. 2754-2762
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the DETO2X-AMI trial (Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction), we compared supplemental oxygen with ambient air in normoxemic patients presenting with suspected myocardial infarction and found no significant survival benefit at 1 year. However, important secondary end points were not yet available. We now report the prespecified secondary end points cardiovascular death and the composite of all-cause death and hospitalization for heart failure. METHODS: In this pragmatic, registry-based randomized clinical trial, we used a nationwide quality registry for coronary care for trial procedures and evaluated end points through the Swedish population registry (mortality), the Swedish inpatient registry (heart failure), and cause of death registry (cardiovascular death). Patients with suspected acute myocardial infarction and oxygen saturation of >= 90% were randomly assigned to receive either supplemental oxygen at 6 L/min for 6 to 12 hours delivered by open face mask or ambient air. RESULTS: A total of 6629 patients were enrolled. Acute heart failure treatment, left ventricular systolic function assessed by echocardiography, and infarct size measured by high-sensitive cardiac troponin T were similar in the 2 groups during the hospitalization period. All-cause death or hospitalization for heart failure within 1 year after randomization occurred in 8.0% of patients assigned to oxygen and in 7.9% of patients assigned to ambient air (hazard ratio, 0.99; 95% CI, 0.84-1.18; P=0.92). During long-term follow-up (median [range], 2.1 [1.0-3.7] years), the composite end point occurred in 11.2% of patients assigned to oxygen and in 10.8% of patients assigned to ambient air (hazard ratio, 1.02; 95% CI, 0.88-1.17; P=0.84), and cardiovascular death occurred in 5.2% of patients assigned to oxygen and in 4.8% assigned to ambient air (hazard ratio, 1.07; 95% CI, 0.87-1.33; P=0.52). The results were consistent across all predefined subgroups. CONCLUSIONS: Routine use of supplemental oxygen in normoxemic patients with suspected myocardial infarction was not found to reduce the composite of all-cause mortality and hospitalization for heart failure, or cardiovascular death within 1 year or during long-term follow-up.
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| 14. |
- Södergren, Anna, 1977-, et al.
(författare)
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Characteristics and outcome of a first acute myocardial infarction in patients with ankylosing spondylitis
- 2021
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Ingår i: Clinical Rheumatology. - : Springer Science and Business Media LLC. - 0770-3198 .- 1434-9949. ; 40, s. 1321-1329
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To study clinical characteristics, mortality, and secondary prevention, after a first incident acute myocardial infarction (AMI) in patients with ankylosing spondylitis (AS) compared with the general population. Methods In total, 292 subjects with AS and a first AMI between Jan 2006 and Dec 2014 were identified using the Swedish national patient register. Each subject was matched with up to 5 general population comparators per AS-patient (n = 1276). Follow-up started at the date of admission for AMI and extended until death or 365 days of follow-up. Cox regression was used to assess mortality in two time intervals: days 0-30 and days 31-365. For a subgroup with available data, clinical presentation at admission, course, treatment for AMI, and secondary prevention were compared. Results During the 365-day follow-up, 56/292 (19%) AS patients and 184/1276 (14%) comparators died. There were no difference in mortality due to cardiovascular-related causes, although the overall mortality day 31-365 was increased among patients with AS compared with comparators (HR [95% CI] = 2.0 [1.3;3.0]). At admission, AS patients had a higher prevalence of cardiovascular comorbidities compared with comparators. At discharge, patients with AS were less often prescribed lipid-lowering drugs and non-aspirin antiplatelet therapy. Conclusions Patients with AS tend to have a higher comorbidity burden at admission for first AMI. The mortality after a first AMI due to cardiovascular-related causes does not seem to be elevated, despite an increased overall mortality during days 31-365 among patients with AS compared with the general population.
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| 15. |
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| 17. |
- Alnersson, Gustaf, et al.
(författare)
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3D flow and fibre orientation modelling of compression moulding of A-SMC: simulations and experimental validation in squeeze flow
- 2023
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Ingår i: Functional Composite Materials. - : Springer Nature. - 2522-5774. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Sheet Moulding Compound (SMC) based composites have a large potential in industrial contexts due to the possibility of achieving comparatively short manufacturing times. It is however necessary to be able to numerically predict both mechanical properties as well as manufacturability of parts.In this paper a fully 3D, semi-empirical model based on fluid mechanics for the compression moulding of SMC is described and discussed, in which the fibres and the resin are modelled as a single, inseparable fluid with a viscosity that depends on volume fraction of fibres, shear strain rate and temperature. This model is applied to an advanced carbon-fibre SMC with a high fibre volume fraction (35%). Simulations are run on a model of a squeeze test rig, allowing comparison to experimental results from such a rig. The flow data generated by this model is then used as input for an Advani-Tucker type of model for the evolution of the fibre orientation during the pressing process. Numerical results are also obtained from the software 3DTimon. The resulting fibre orientation distributions are then compared to experimental results that are obtained from microscopy. The experimental measurement of the orientation tensors is performed using the Method of Ellipses. A new, automated, accurate and fast method for the ellipse fitting is developed using machine learning. For the studied case, comparison between the experimental results and numerical methods indicate that 3D Timon better captures the random orientation at the outer edges of the circular disc, while 3D CFD show larger agreement in terms of the out-of-plane component. One of the advantages of the new image technique is that less work is required to obtain microscope images with a quality good enough for the analysis.
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| 18. |
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| 19. |
- Alnersson, Gustaf, et al.
(författare)
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Numerical Study of the 3D-Flow Characteristics During Compression Moulding of SMC
- 2019
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Ingår i: Proceedings of the 2019 International Conference on Composite Materials. - : RMIT University. ; , s. 1571-1581
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A numerical model for compression moulding of Sheet Moulding Compound is presented. The model is based on fluid mechanics and the SMC charge is modelled as a fluid with a viscosity that is dependent on the charge temperature, the fibre volume fraction of the material and the shear strain rate. Trends observed in the simulations regarding the shape of the flow front agree with experimental observations in previous studies. The simulations also yield that the type and magnitude of initial heating effects the initial flow to a large extent.
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| 20. |
- Alnersson, Gustaf, et al.
(författare)
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Review of the Numerical Modeling of Compression Molding of Sheet Molding Compound
- 2020
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Ingår i: Processes. - : MDPI. - 2227-9717. ; 8:2
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Forskningsöversikt (refereegranskat)abstract
- A review of the numerical modeling of the compression molding of the sheet molding compound (SMC) is presented. The focus of this review is the practical difficulties of modeling cases with high fiber content, an area in which there is relatively little documented work. In these cases, the prediction of the flows become intricate due to several reasons, mainly the complex rheology of the compound and large temperature gradients, but also the orientation of fibers and the micromechanics of the interactions between the fluid and the fibers play major roles. The details of this during moldings are discussed. Special attention is given to the impact on viscosity from the high fiber volume fraction, and the various models for this. One additional area of interest is the modeling of the fiber orientation.
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| 21. |
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| 22. |
- Antonarakis, S. E., et al.
(författare)
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Factor VIII gene inversions in severe hemophilia A : Results of an international consortium study
- 1995
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Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 86:6, s. 2206-2212
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-two molecular diagnostic laboratories from 14 countries participated in a consortium study to estimate the impact of Factor VIII gene inversions in severe hemophilia A. A total of 2,093 patients with severe hemophilia A were studied; of those, 740 (35%) had a type 1 (distal) factor VIII inversion, and 140 (7%) showed a type 2 (proximal) inversion. In 25 cases, the molecular analysis showed additional abnormal or polymorphic patterns. Ninety-eight percent of 532 mothers of patients with inversions were carriers of the abnormal factor VIII gene; when only mothers of nonfamilial cases were studied, 9 de novo inversions in maternal germ cells ware observed among 225 cases (≃ 1 de novo maternal origin of the inversion in 25 mothers of sporadic cases). When the maternal grandparental origin was examined, the inversions occurred de novo in male germ cells in 69 cases and female germ cells in 1 case. The presence of factor VIII inversions is not a major predisposing factor for the development of factor VIII inhibitors; however, slightly more patients with severe hemophilia A and factor VIII inversions develop inhibitors (130 of 642 [20%]) than patients with severe hemophilia A without inversions (131 of 821 [16%]).
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| 23. |
- Barestrand, Henrik A., et al.
(författare)
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Modeling Convective Heat Transfer of Air in a Data Center Using OpenFOAM : Evaluation of the Boussinesq Buoyancy Approximation
- 2023
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Ingår i: OpenFOAM® Journal. - : OpenCFD Ltd. - 2753-8168. ; 3, s. 146-158
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Tidskriftsartikel (refereegranskat)abstract
- Achieving energy and cooling efficiency in data center convective air flow and heat transfer can be a challenging task. Among different numerical methods to work with such issues is the Finite Volume Method in Computational Fluid Dynamics. This work evaluates the performance of two such solvers provided by OpenFOAM® in solving this type of convective heat-transfer problem, namely BuoyantBoussinesqPimpleFOAM and BuoyantPimpleFOAM. This is done for two different flow configurations of significantly different Richardson number. To sufficiently resolve the flow, grid sizing effects are elucidated by way of the kernel density estimate. It determines the volume distribution of the temperature in the data center configuration. For the k-epsilon turbulence model used here, it was found that the compressible solver performs faster and requires less grid resolution for both flow configurations. This is attributed to the nature of the boundary conditions which are set such that the mass flow conservation per server rack and cooling unit is achieved. Transient solutions are found to provide better iterative convergence for cases that involves buoyancy, compressibility and flow separation. This is, in comparison to steady-state solutions where artificial numerical pressure drop is found, to depend on the momentum relaxation factors for the convective case with a higher Richardson number.
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| 24. |
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| 26. |
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| 27. |
- Blander, M, et al.
(författare)
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Equilibrium Chemistry of Biomass Combustion: A Round-Robin Set of Calculations Using Available Computer Programs and Databases
- 2001
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Ingår i: Energy Fuels. - : American Chemical Society (ACS). - 0887-0624 .- 1520-5029. ; 15:2, s. 344-9
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Tidskriftsartikel (refereegranskat)abstract
- Equilibrium calculations of three problems regarding biomass combustion, at various levels of sophistication, were performed at six laboratories using seven combinations of computer programs and databases. The objective was to test the adequacy of the programs and databases for calculating both condensed and gas-phase behavior. The first problem was a simplified calculation for the combustion of a woodlike material with added sulfur to possibly form an ideal molten salt solution of potassium and calcium sulfate. The second and third problems were to simulate aspen wood and wheat straw combustion, respectively, and required a relatively sophisticated database on high-temperature solutions to describe condensed phases. All the participants performed calculations of the gas phases, which were reasonably accurate when their databases were adequate. For problem I, most of the participants were also able to calculate a reasonable set of condensed phases. However, for problems II and III, only four of the participants, using the two most sophisticated computer programs and databases, had the ability to produce rational results for the condensed phases. This round robin identified two computer programs and their associated databases that could prove useful for calculating the condensed-phase equilibrium chemistry of biomass combustion when coupled with experimental programs and the capability to expand databases as new experimental data become available. Such calculations can greatly enhance our understanding of the total equilibrium chemistry of biomass combustion.
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| 28. |
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| 29. |
- Burström, Per, et al.
(författare)
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Discrete and continuous modelling of convective heat transport in a thin porous layer of mono sized spheres
- 2017
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Ingår i: Heat and Mass Transfer. - : Springer. - 0947-7411 .- 1432-1181. ; 53:1, s. 151-160
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Tidskriftsartikel (refereegranskat)abstract
- Convective heat transport in a relatively thin porous layer of monosized particles is here modeled. The size of the particles is only one order of magnitude smaller than the thickness of the layer. Both a discrete three-dimensional system of particles and a continuous one-dimensional model are considered. The methodology applied for the discrete system is Voronoi discretization with minimization of dissipation rate of energy. The discrete and continuous model compares well for low velocities for the studied uniform inlet boundary conditions. When increasing the speed or for a thin porous layer however, the continuous model diverge from the discrete approach if a constant dispersion is used in the continuous approach. The new result is thus that a special correlation must be used when using a continuous model for flow perpendicular to a thin porous media in order to predict the dispersion in proper manner, especially in combination with higher velocities.
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| 35. |
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| 36. |
- Einarsson, Fredrik, 1968, et al.
(författare)
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Subscapularis muscle mechanics in children with obstetric brachial plexus palsy
- 2008
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Ingår i: The Journal of Hand Surgery (European Volume). - : SAGE Publications. - 1753-1934 .- 2043-6289. ; 33:4, s. 507-12
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates the passive mechanical properties of the subscapularis muscle in children with a contracture as a result of obstetrical brachial plexus palsy. Muscle biopsies were harvested from nine children undergoing open surgery for shoulder contracture. Passive mechanical testing of single cells and muscle bundles was performed. Corresponding comparisons were made using muscle biopsies from seven healthy controls. Single muscle fibres from patients with obstetric brachial plexus palsy displayed a shorter slack sarcomere length, linear deformation of the fibre within a wider zone of sarcomere length and a greater relative increase in stiffness compared with muscle bundles. We conclude that secondary changes in muscle fibre properties will occur as a result of a longstanding lack of sufficient passive stretch, leading to compensatory changes in the extracellular matrix. These results suggest the presence of a dynamic feedback system constituting a muscle-to-extracellular matrix communication interface.
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| 37. |
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| 38. |
- Gerber, M., et al.
(författare)
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Fitness Moderates the Relationship between Stress and Cardiovascular Risk Factors
- 2016
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Ingår i: Medicine and Science in Sports and Exercise. - : Ovid Technologies (Wolters Kluwer Health). - 0195-9131. ; 48:11, s. 2075-2081
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Tidskriftsartikel (refereegranskat)abstract
- Purpose This cross-sectional observational study examined the degree to which cardiorespiratory fitness (CRF) and self-perceived stress are associated with cardiometabolic risk factors and the overall risk score for cardiovascular diseases. The second aim was to determine whether participants' CRF levels moderate the relationships between stress and cardiometabolic risk. Methods A gender-matched stratified sample (N = 197, 51% men, M-age = 39.2 yr) was used to ensure that participants with varying stress levels were equally represented. CRF was assessed with the angstrom strand bicycle test, and perceived stress was assessed with a single-item question. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), glycated hemoglobin, and total cardiometabolic risk score (sum of the z-standardized residuals of the previously mentioned indicators) were assessed as outcomes. Results Higher LDL-C, TG, and total metabolic risk were found in participants with high stress scores (P < 0.05). In addition, lower SBP, DBP, BMI, LDL-C, TG, and total metabolic risk were observed in participants with high CRF (P < 0.05). Two-way ANCOVA provided significant interaction effects for five of the nine outcome variables (P < 0.05, 3.6%-4.8% of explained variance). Participants with high stress who also had high CRF levels had lower SBP, DBP, LDL-C, TG, and total cardiometabolic risk than participants with high stress but low or moderate CRF levels. No significant main or interaction effects occurred for BMI, total cholesterol, high-density lipoprotein cholesterol, and glycated hemoglobin. Conclusion Better CRF is associated with more favorable levels of several cardiometabolic risk factors, specifically in participants experiencing high stress. Higher CRF may provide some protection against the health hazards of high chronic stress by attenuating the stress-related increase in cardiovascular risk factors.
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| 39. |
- Graham, J. B., et al.
(författare)
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The Malmo polymorphism of coagulation factor IX, an immunologic polymorphism due to dimorphism of residue 148 that is in linkage disequilibrium with two other F.IX polymorphisms
- 1988
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Ingår i: American Journal of Human Genetics. - 0002-9297. ; 42:4, s. 573-580
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Tidskriftsartikel (refereegranskat)abstract
- A mouse monoclonal antibody (MAB 9,9) to coagulation factor IX (F.IX) detects a polymorphism in the plasma of normal people. Its epitope has been narrowed down to <6 amino acids in the activation peptide of the X-linked F.IX protein. The activation peptide contains a dimorphism - Thr:Ala - at position 148 of the protein. Using synthetic oligonucleotides, we have demonstrated that (1) the F.IX which reacts with 9.9 has Thr at position 148 and (2) that which does not has Ala. Positive reactors (148(thr)) are designated Malmo A, and negative reactors (148(ala)) are designated Malmo B. The plasma levels of AA women are indistinguishable from those of A men, and both B men and BB women are null against MAB 9.9. The plasma level of Malmo A in AB women is approximately half that of AA women, and 'lyonization' is clearly operating in the heterozygotes. The dimorphism is in strong linkage disequilibrium with two other intragenic RFLPs, TaqI and XmnI. Furthermore, intragenic crossing-over - including double crossing-over - appears to have occurred between the three sites. Seven of the eight possible haplotypes have been identified, five in men and two others in women. The immunoassay that identifies ~50% of the AB women in the pool of Malmo A females with 95% confidence identifies men unambiguously as A or B. The assay would be very useful for population-genetic studies of the Malmo epitope if the studies were limited to men.
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| 46. |
- Hoots, W. K., et al.
(författare)
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Secondary prophylaxis with recombinant activated factor VII improves health-related quality of life of haemophilia patients with inhibitors
- 2008
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Ingår i: Haemophilia. - : Wiley. - 1351-8216 .- 1365-2516. ; 14:3, s. 466-466
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Tidskriftsartikel (refereegranskat)abstract
- Haemophilia patients with inhibitors characteristically have impaired joint function and reduced health-related quality of life (HRQoL). This analysis examined whether secondary prophylaxis with recombinant activated factor VII (rFVIIa) improves HRQoL vs. conventional on-demand therapy in patients with haemophilia with inhibitors and frequent bleeds. After a 3-month preprophylaxis period, 22 patients received daily rFVIIa prophylaxis (90 or 270 mu g kg(-1)) for 3 months, followed by 3 months' postprophylaxis. Days of hospitalization, absence from school/work and mobility aids requirements were recorded. HRQoL was assessed by EuroQoL (EQ-5D) questionnaire, visual analogue scale (VAS), derived Time to Trade-Off (TTO) scores and Quality Adjusted Life Years (QALYs). rFVIIa prophylaxis significantly (P < 0.0001) reduced bleeding frequency vs. prior on-demand therapy. Hospitalization (5.9% vs. 13.5%; P = 0.0026) and absenteeism from school/work (16.7% vs. 38.7%; P = 0.0127) decreased during prophylaxis; these effects tended to be maintained during postprophylaxis. HRQoL (evaluated by EQ-5D) tended to improve during and after rFVIIa prophylaxis. Notably, pain decreased and mobility increased in 40.9% and 27.3% of patients, respectively, at the end of the postprophylaxis period vs. preprophylaxis. Median VAS score increased from 66 to 73 (P = 0.048), and TTO scores suggested better HRQoL (0.62 vs. 0.76; P = 0.054) during postprophylaxis than preprophylaxis. Small to moderate changes in effect sizes were reported for VAS and TTO scores. Median QALYs were 0.68 (VAS) and 0.73 (TTO). Reductions in bleeding frequency with secondary rFVIIa prophylaxis were associated with improved HRQoL vs. on-demand therapy.
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| 47. |
- Hultgren, T., et al.
(författare)
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Structural characteristics of the subscapularis muscle in children with medial rotation contracture of the shoulder after obstetric brachial plexus injury
- 2010
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Ingår i: Journal of Hand Surgery (European Volume). - : SAGE Publications. - 1532-2211 .- 1753-1934 .- 2043-6289. ; 35:1, s. 23-28
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to obtain a better understanding of the cause of the medial rotation contracture of the shoulder after obstetric brachial plexus lesions by studying the morphology of the shortened subscapularis muscle. Muscle biopsy specimens were harvested from 13 children with obstetric brachial plexus palsy who underwent corrective surgery for the rotation contracture. The majority of the subscapularis muscle biopsy samples had an essentially normal morphology and showed a predominance of type I myosin heavy chain isoform, while one biopsy showed signs of marked fibrosis and a predominance of type II myosin heavy chain isoform. The findings support the assumption that shortening of the subscapularis is caused primarily by the nerve injury, which weakens the antagonistic lateral rotators, but that direct injury to the muscle might be a contributory factor.
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| 48. |
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| 49. |
- Izadi, Zara, et al.
(författare)
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Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease : an observational study
- 2022
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Ingår i: The Lancet Rheumatology. - : Elsevier. - 2665-9913. ; 4:9, s. e603-e613
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Tidskriftsartikel (refereegranskat)abstract
- Background: Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally.Methods: In this observational study, we derived individual-level data on adults (aged 18–99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death.Findings: 14 044 patients from 23 countries were included in the analyses. 10 178 (72·5%) individuals were female and 3866 (27·5%) were male, with a mean age of 54·4 years (SD 15·6). Air pollution (odds ratio 1·10 per 10 μg/m3 [95% CI 1·01–1·17]; p=0·0105), proportion of the population aged 65 years or older (1·19 per 1% increase [1·10–1·30]; p<0·0001), and population mobility (1·03 per 1% increase in number of visits to grocery and pharmacy stores [1·02–1·05]; p<0·0001 and 1·02 per 1% increase in number of visits to workplaces [1·00–1·03]; p=0·032) were independently associated with higher odds of mortality. Number of hospital beds (0·94 per 1-unit increase per 1000 people [0·88–1·00]; p=0·046), human development index (0·65 per 0·1-unit increase [0·44–0·96]; p=0·032), government response stringency (0·83 per 10-unit increase in containment index [0·74–0·93]; p=0·0018), as well as follow-up time (0·78 per month [0·69–0·88]; p<0·0001) were independently associated with lower odds of mortality. These factors sufficiently explained country-level variations in death attributable to COVID-19 (intraclass correlation coefficient 1·2% [0·1–9·5]; p=0·14).Interpretation: Our findings highlight the importance of environmental and societal factors as potential explanations of the observed regional disparities in COVID-19 outcomes among people with rheumatic disease and lay foundation for a new research agenda to address these disparities.
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