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| 2. |
- Anderot, Maria, et al.
(författare)
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Determination of dissociation constants between polyelectrolytes and proteins by affinity capillary electrophoresis
- 2009
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Ingår i: Journal of chromatography. B. - : Elsevier BV. - 1570-0232 .- 1873-376X. ; 877:10, s. 892-896
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Tidskriftsartikel (refereegranskat)abstract
- In this manuscript we report the binding affinity between two model proteins, human serum albumin (HSA) and ribonuclease A (RNase A), and negatively charged polyelectrolytes, two different heparin fractions and dextran sulfate, by means of partial filling and affinity capillary electrophoresis. The apparent dissociation constants, K-d, obtained by use of the partial-filling method, between HSA and heparin (17 kDa), heparin (3 kDa) and dextran sulfate (8 kDa) were 33 and 307 mu M, respectively. A new method was developed to determine affinities that take in account different migration directions between the protein and the polyelectrolyte, which was required to study RNase A. By use of this affinity capillary electrophoresis two K-d values were observed for the interaction between RNase A and heparin 17 kDa, yielding a high affinity binding with K-d1 0.0075 mu M, and a lower affinity binding with K-d2 8.7 mu M. For dextran sulfate 8 kDa these K-d values were 0.027 and 10.4 mu M, respectively. Heparin 3 kDa only showed a single K-d value of 0.52 mu M. The results show that the magnitude of the binding affinity depends on the type of polyelectrolyte and its molecular weight. (C) 2009 Elsevier B.V. All rights reserved.
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| 3. |
- Arvidsson, Björn, et al.
(författare)
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Online capillary solid phase extraction and liquid chromatographic separation with quantitative tandem mass spectrometric detection (SPE-LC-MS/MS) of ximelagatran and its metabolites in a complex matrix.
- 2009
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Ingår i: Journal of chromatography. B. - : Elsevier BV. - 1570-0232 .- 1873-376X. ; 877:3, s. 291-297
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Tidskriftsartikel (refereegranskat)abstract
- This work presents the development and validation of a fully automated quantitative analysis method of melagatran, its prodrug ximelagatran, and its major metabolites for the study of drug behavior in biofluids. The method involves online sample clean-up and enrichment on a C4 capillary column followed by separation on a capillary C18 column. Electrospray ionization tandem mass spectrometric detection in positive ion mode was performed with multiple reactions monitoring of eight different transients, divided into two time segments with four transients each. The structural similarity, the complexity of the matrix (pig liver extract) and the formation of isobaric fragment ions, made efficient chromatographic separation necessary. The analysis method provides valid accuracy (<9%; RSD%), precision (<8%; RSD%), linearity (<1.2 nM–1 μM; R2 > 0.999), limit of quantitation (<3.6 nM), retention repeatability (<1.2%; RSD%), selectivity, as well as analyte and column stabilities over a wide concentration range.
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| 4. |
- Atwood, C., et al.
(författare)
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Incidence of EMS-treated out-of-hospital cardiac arrest in Europe
- 2005
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Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 67:1, s. 75-80
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The potential impact of efforts in Europe to improve survival from out-of-hospital cardiac arrest is unclear, in part, because estimates of incidence and survival are uncertain. The aim of the investigation was to determine a representative European incidence and survival from cardiac arrest in all-rhythms and in ventricular fibrillation treated by the emergency medical services (EMS). METHODS AND RESULTS: We used Medline to identify peer-reviewed articles published between 1 January 1980 and 30 June 2004 that reported a European community's EMS cardiac arrest experience. Inclusion criteria required the study to include at least 25 cases, report of the total number of all-rhythm and/or ventricular fibrillation arrests, and information about population size and study duration. The incidence was computed by dividing the total number of events by the product of the community's population and the study duration. Reports from 37 communities met the inclusion criteria. A total of 18,105 all-rhythm EMS-treated cardiac arrests occurred during 48 million person-years of observation, resulting in an overall incidence for all-rhythm arrests of 37.72 per 100,000 person-years. Incidence of ventricular fibrillation arrest was 16.84 per 100,000 person-years. Survival was 10.7% for all-rhythm and 21.2% for ventricular fibrillation cardiac arrest. Applying these results to the European population, approximately, 275,000 persons would experience, all-rhythm cardiac arrest treated by the EMS with 29,000 persons surviving to hospital discharge. CONCLUSION: The results provide a framework to assess opportunities and limitations of EMS care with regard to the public health burden of cardiac arrest in Europe.
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| 5. |
- Aune, Solveig, 1957, et al.
(författare)
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Characteristics of patients who die in hospital with no attempt at resuscitation
- 2005
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 65:3, s. 291-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the characteristics, cause of hospitalisation and symptoms prior to death in patients dying in hospital without resuscitation being started and the extent to which these decisions were documented. MATERIALS AND METHODS: All patients who died at Sahlgrenska University Hospital in Goteborg, Sweden, in whom cardiopulmonary resuscitation (CPR) was not attempted during a period of one year. RESULTS: Among 674 patients, 71% suffered respiratory insufficiency, 43% were unconscious and 32% had congestive heart failure during the 24h before death. In the vast majority of patients, the diagnosis on admission to hospital was the same as the primary cause of death. The cause of death was life-threatening organ failure, including malignancy (44%), cerebral lesion (10%) and acute coronary syndrome (10%). The prior decision of 'do not attempt resuscitation' (DNAR) was documented in the medical notes in 82%. In the remaining 119 patients (18%), only 16 died unexpectedly. In all these 16 cases, it was regarded retrospectively as ethically justifiable not to start CPR. CONCLUSION: In patients who died at a Swedish University Hospital, we did not find a single case in which it was regarded as unethical not to start CPR. The patient group studied here had a poor prognosis due to a severe deterioration in their condition. To support this, we also found a high degree of documentation of DNAR. The low rate of CPR attempts after in-hospital cardiac arrest appears to be justified.
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| 6. |
- Axelsson, C, et al.
(författare)
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Characteristics and outcome among patients suffering from out-of-hospital cardiac arrest with the emphasis on availability for intervention trials
- 2007
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Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570.
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe all patients treated for out-of-hospital cardiac arrest (OHCA) according to the Utstein criteria and their characteristics and outcome with emphasis on whether they were available for early intervention trials. DESIGN: Retrospective analysis of a study where data were collected prospectively. SETTING: The Municipality of Goteborg/Molndal in Sweden. PATIENTS: All patients suffering from out-of-hospital cardiac arrest in the Municipality of Goteborg/Molndal in whom cardiopulmonary resuscitation (CPR) was attempted between May 2003 and May 2005. INTERVENTIONS: Part of the study cohort, i.e. patients with a witnessed, non-traumatic, out-of-hospital cardiac arrest were distributed (cluster) to mechanical (LUCAS) or manual chest compression. RESULTS: The overall survival to discharge from hospital among the 508 patients was 8.5%. The corresponding value for non-cardiac cases was 5.1% and for cardiac cases if crew witnessed 16.1%, bystander witnessed 12.7% and non-witnessed 1.4%. Fifty-nine percent of the patients fulfilled the inclusion criteria for the trial and had no exclusion criteria and 9.7% of these survived to discharge. Ten percent of patients fulfilled the inclusion criteria but were excluded and 20.4% survived to discharge. Thirty-one percent of patients did not fulfil the inclusion criteria and 2.5% survived. Among patients included in the LUCAS group, many of the survivors, 10/13 (77%), experienced a rapid return of spontaneous circulation (ROSC) before the application of the device. CONCLUSION: Among patients with OHCA in whom CPR was started 8.5% survived to hospital discharge and 59% were theoretically available for an early intervention trial. These patients have a different outcome compared with patients not available. However, among those available, the majority of survivors had a rapid ROSC before the application of the intervention (LUCAS). This raises concerns about the potential for early intervention trials to improve outcome after OHCA.
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| 7. |
- Axelsson, C, et al.
(författare)
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Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest-a pilot study.
- 2006
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Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 71:1, s. 47-55
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate the outcome among patients suffering from out-of-hospital cardiac arrest (OHCA) after the introduction of mechanical chest compression (MCC) compared with standard cardiopulmonary resuscitation (SCPR) in two emergency medical service (EMS) systems. METHODS: The inclusion criterion was witnessed OHCA. The exclusion criteria were age < 18 years, the following judged etiologies behind OHCA: trauma, pregnancy, hypothermia, intoxication, hanging and drowning or return of spontaneous circulation (ROSC) prior to the arrival of the advanced life support (ALS) unit. Two MCC devices were allocated during six-month periods between four ALS units for a period of two years (cluster randomisation). RESULTS: In all, 328 patients fulfilled the criteria for participation and 159 were allocated to the MCC tier (the device was used in 66% of cases) and 169 to the SCPR tier. In the MCC tier, 51% had ROSC (primary end-point) versus 51% in the SCPR tier. The corresponding values for hospital admission alive (secondary end-point) were 38% and 37% (NS). In the subset of patients in whom the device was used, the percentage who had ROSC was 49% versus 50% in a control group matched for age, initial rhythm, aetiology, bystander-/crew-witnessed status and delay to CPR. The percentage of patients discharged alive from hospital after OHCA was 8% versus 10% (NS) for all patients and 2% versus 4%, respectively (NS) for the patients in the subset (where the device was used and the matched control population). CONCLUSION: In this pilot study, the results did not support the hypothesis that the introduction of mechanical chest compression in OHCA improves outcome. However, there is room for further improvement in the use of the device. The hypothesis that this will improve outcome needs to be tested in further prospective trials
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| 8. |
- Axelsson, C, et al.
(författare)
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Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) versus manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA).
- 2009
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Ingår i: Resuscitation. - : Elsevier BV. - 1873-1570 .- 0300-9572. ; 80:10, s. 1099-103
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Tidskriftsartikel (refereegranskat)abstract
- AIM: In animal and human studies, measuring the pressure of end tidal carbon dioxide (P(ET)CO2) has been shown to be a practical non-invasive method that correlates well with the pulmonary blood flow and cardiac output (CO) generated during cardiopulmonary resuscitation (CPR). This study aims to compare mechanical active compression-decompression (ACD) CPR with standard CPR according to P(ET)CO2 among patients with out-of-hospital cardiac arrest (OHCA), during CPR and with standardised ventilation. METHODS: This prospective, on a cluster level, pseudo-randomised pilot trial took place in the Municipality of Göteborg. During a 2-year period, all patients aged >18 years suffering an out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology were enrolled. The present analysis included only tracheally intubated patients in whom P(ET)CO2 was measured for 15 min or until the detection of a pulse-giving rhythm. RESULTS: In all, 126 patients participated in the evaluation, 64 patients in the mechanical chest compression group and 62 patients in the control group. The group receiving mechanical ACD-CPR obtained the significantly highest P(ET)CO2 values according to the average (p=0.04), initial (p=0.01) and minimum (p=0.01) values. We found no significant difference according to the maximum value between groups. CONCLUSION: In this hypothesis generating study mechanical ACD-CPR compared with manual CPR generated the highest initial, minimum and average value of P(ET)CO2. Whether these data can be repeated and furthermore be associated with an improved outcome after OHCA need to be confirmed in a large prospective randomised trial.
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| 9. |
- Axelsson, Åsa B., 1955, et al.
(författare)
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A nationwide survey of CPR training in Sweden: Foreign born and unemployed are not reached by training programmes.
- 2006
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Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; :70, s. 90-97
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To determine the number of CPR trained adults in Sweden, and the willingness of the non-trained population to attend a CPR course. An additional purpose was to investigate differences related to sex, age, residential area, socio-economic classification and country of origin. METHODS: Five thousand adults in Sweden were surveyed, which yielded 3167 valid responses, a response rate of 63%. The sample was selected at random and stratified to correlate to the geographic distribution of the population. RESULTS: The mean (S.D.) age was 46 (16) years, 54% of the respondents were females and 11% were people of foreign origin. Forty-five percent had participated in some form of CPR training. Younger respondents, those living in rural areas, those born in Sweden, employees, students and military conscripts were trained more frequently in CPR. Of the respondents with no CPR training, 50% expressed a willingness to attend a course. The most common reason for not being trained in CPR was that the respondent did not know such courses existed or that they did not know where to go for training. CONCLUSION: Somewhere between 30 and 45% of the adult population of Sweden had participated in CPR training. Half of the non-trained population was willing to learn CPR but frequently did not know that such courses existed or where they were held. Elderly people, people of foreign origin, or those not included in the workforce were less likely to have participated in CPR training.
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| 10. |
- Bennemo, Mia, et al.
(författare)
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A chromatographic method for determination of supercoiled plasmid DNA concentration in complex solutions.
- 2009
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Ingår i: Journal of chromatography. B. - : Elsevier BV. - 1570-0232 .- 1873-376X. ; 877:24, s. 2530-6
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Tidskriftsartikel (refereegranskat)abstract
- A method for determination of the plasmid DNA concentration with subsequent analysis of the ratio supercoiled to open circular form is presented. The method is suitable for samples from all steps of the manufacturing process, from fermentation to final product. The analysis consists of size exclusion chromatography, followed by analytical thiophilic aromatic chromatography. In the first step, the plasmid DNA concentration is determined by group separation, including removal of RNA and other impurities, within less than 2 min. The limit of detection and quantification was 0.28 and 0.83 microg/ml, respectively. The precision of the method is high, providing a coefficient of variation as low as below 2%. In the second step, the ratio of open circular to supercoiled plasmid DNA is determined following separation of the two plasmid DNA isoforms with a linear salt gradient. The precision of the second step was evaluated using serial injections of aliquots of a sample stock solution. In comparison with the two most commonly used methods, the developed analysis was found to be significantly more accurate than agarose gel electrophoresis and equivalent to capillary gel electrophoresis. The combined methods for quantification and control of homogeneity of plasmid DNA presented here enable reliable and precise analysis at all steps of the manufacturing process.
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