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Search Results: 1 - 10 of 199454 matches for " Ulf N?slund "
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Gender differences in trends of acute myocardial infarction events: The Northern Sweden MONICA study 1985 – 2004
Dan Lundblad, Lars Holmgren, Jan-H?kan Jansson, Ulf Nslund, Mats Eliasson
BMC Cardiovascular Disorders , 2008, DOI: 10.1186/1471-2261-8-17
Abstract: Diagnosed MI events in subjects aged 25–64 years in the Counties of Norrbotten and V?sterbotten were validated according to the MONICA protocol. The total number of events registered up to January 1, 2005 was 11,763: 9,387 in men and 2,376 in women.The proportion of male/female events has decreased from 5.5:1 to 3:1. For males the reductions were 30% and 70% for first and recurrent MI, respectively, and for women 0% and 40% in the 55–64 year group. For both sexes a 50% reduction in 28-day case fatality was seen in the 25–64 year-group. Mortality was reduced by 69% and 45% in men and women, respectively.First and recurrent events of myocardial infarction was markedly reduced in men over the 20-year observation period, but for women the reduction was seen only for recurrent infarctions. Case fatality, on the other hand, was markedly reduced for both sexes. As a result of the positive effects on incidence and case fatality a substantial reduction was seen in total mortality, most pronounced for men.Coronary heart disease (CHD) is the leading cause of death in Sweden as well as in most Western European countries and in the United States. Incidence and mortality rates in CHD have decreased substantially during the last decades, and this trend seems to continue [1-4].At the start of the MONICA project in 1985 the incidence of, and mortality due to, myocardial infarction (MI) in the two northernmost counties in Sweden were the highest in the country. However, they have gradually approached the national average indicating a faster reduction in Northern Sweden than in the rest of the country [5]. Generally, in the Western world, the decreased mortality in CHD is due to a combination of declining incidence and improved survival. Better primary prevention and improvements in acute coronary care, including secondary prevention, may explain these impressing achievements [1].Gender differences in both events and case-fatality, and thereby also in mortality due to CHD, have been s
Longer pre-hospital delay in first myocardial infarction among patients with diabetes: an analysis of 4266 patients in the Northern Sweden MONICA Study
?ngerud Karin Hellstr?m,Brulin Christine,Nslund Ulf,Eliasson Mats
BMC Cardiovascular Disorders , 2013, DOI: 10.1186/1471-2261-13-6
Abstract: Background Reperfusion therapy reduces both morbidity and mortality in myocardial infarction, but the effectiveness depends on how fast the patient receives treatment. Despite the time-dependent effectiveness of reperfusion therapy, many patients with myocardial infarction have delays in seeking medical care. The aim of this study was to describe pre-hospital delay in a first myocardial infarction among men and women with and without diabetes and to describe the association between pre-hospital delay time and diabetes, sex, age, symptoms and size of residential area as a proxy for distance to hospital. Methods This population based study was based on data from 4266 people aged 25–74 years, with a first myocardial infarction registered in the Northern Sweden MONICA myocardial infarction registry between 2000 and 2008. Results The proportion of patients with delay times ≥ 2 h was 64% for patients with diabetes and 58% for patients without diabetes. There was no difference in delay time ≥ 2 h between men and women with diabetes. Diabetes, older age and living in a town or rural areas were factors associated with pre-hospital delay times ≥ 2 h. Atypical symptoms were not a predictor for pre-hospital delay times ≥ 2 h, OR 0.59 (0.47; 0.75). Conclusions A higher proportion of patients with diabetes have longer pre-hospital delay in myocardial infarction than patients without diabetes. There are no differences in pre-hospital delay between men and women with diabetes. The largest risk difference for pre-hospital delay ≥ 2 h is between women with and without diabetes. Diabetes, older age and living in a town or rural area are predictors for pre-hospital delay ≥ 2 h.
Better long-term survival in young and middle-aged women than in men after a first myocardial infarction between 1985 and 2006. an analysis of 8630 patients in the Northern Sweden MONICA Study
Rose-Marie Isaksson, Jan-H?kan Jansson, Dan Lundblad, Ulf Nslund, Karin Zingmark, Mats Eliasson
BMC Cardiovascular Disorders , 2011, DOI: 10.1186/1471-2261-11-1
Abstract: The Northern Sweden MONICA Myocardial Infarction Registry was linked to The Swedish National Cause of Death Registry for a total of 8630 patients, 25 to 64 years of age, 6762 men and 1868 women, with a first MI during 1985-2006. Also deaths before admission to hospital were included. Follow-up ended on August 30, 2008.Median follow-up was 7.1 years, maximum 23 years and the study included 70 072 patient-years. During the follow-up 45.3% of the men and 43.7% of the women had died. Median survival for men was 187 months (95% confidence interval (CI) 179-194) and for women 200 months (95% CI 186-214). The hazard ratio (HR) for all cause mortality after adjustment for age group was 1.092 (1.010-1.18, P = 0.025) males compared to females, i.e. 9 percent higher survival in women. After excluding subjects who died before reaching hospital HR declined to 1.017 (95%CI 0.93-1.11, P = 0.7). For any duration of follow-up a higher proportion of women were alive, irrespective of age group. The 5-year survivals were 75.3% and 77.5%, in younger (<57 years) men and women and were 65.5% and 66.3% in older (57-64 years) men and women, respectively. For each of four successive cohorts survival improved. Survival time was longer for women than for men in all age groups.Age-adjusted survival was higher among women than men after a first MI and has improved markedly and equally in both men and women over a 23-year period. This difference was due to lower risk for women to die before reaching hospital.Mortality from myocardial infarction (MI) in Sweden, as in most other developed countries, has decreased markedly during recent decades[1]. The international MONICA collaboration hypothesizes that the decline is mainly due to a decrease in the classical risk factors -- smoking, cholesterol and blood pressure [2], although recent modelling strongly emphasizes the pivotal role of lower cholesterol [3]. However, MI still remains the most common cause of death in Sweden and other western regions
Bone blood flow is influenced by muscle contractions  [PDF]
Jan Erik Nslund, Sofie Nslund, Erik Lundeberg, Lars-G?ran Lindberg, Iréne Lund
Journal of Biomedical Science and Engineering (JBiSE) , 2011, DOI: 10.4236/jbise.2011.47062
Abstract: Forces acting on the skeleton could be divided into those originating from gravitational loading and those originating from muscle loading. Flat bones in a non-weight-baring segment of the skeleton probably experience forces mostly generated by muscle contractions. One purpose of muscle contractions is to generate blood flow within skeletal tissues. The present study aimed to investigate the pulsatile patellar bone blood flow after low and high intensity leg extension exercises. Forty-two healthy individuals volunteered for the study. Dynamic isotonic one leg extension/flexion exercises were performed in a leg extension machine. Randomly, the exercises were performed with the left or right leg with either 10 repetition maximum (10 RM) continuously without any resting periods (high intensity muscle work), or 20 RM with a 2 second rest between contractions (low intensity muscle work). The work load, expressed in kilograms totally lifted, was identical in both legs. The pulsatile patellar blood flow was recorded continuously using a photoplethysmographic technique. Blood pressure was measured continuously during muscle work by a non-invasive method (Finapress). The patellar pulsatile bone blood flow increased significantly more after high intensity muscle work (61%) compared to the same work load performed using a lower intensity (22%), p = 0.000073. Systolic blood pressure changed equally during and after both interventions. Post-exercise bone hyperaemia appears to be correlated to the intensity of muscle contractions in the muscle compartment attached to the bone.
Bone and Soft Tissue Blood Flow during Normobaric and Hyperbaric Oxygen Breathing in Healthy Divers  [PDF]
Agneta C. Larsson, Johan Uusij?rvi, Jan E. Nslund, Iréne Lund, Peter Lindholm
Journal of Biomedical Science and Engineering (JBiSE) , 2014, DOI: 10.4236/jbise.2014.712094
Abstract: Purpose: The study aimed to investigate, using a photoplethysmographic (PPG) technique, how pulsatile blood flow within the patellar bone and skin over the patella reacts to normobaric (NBO) and hyperbaric oxygen breathing (HBO). Methods: Eleven healthy volunteers, breathed air or oxygen. Subjects were blinded to breathing gas. A range of partial pressures of oxygen were administered in 10 minute intervals: 21 kPa, 101 kPa (NBO), 21 kPa, (compression to 280 kPa), 59 kPa, 280 kPa (HBO), 59 kPa, (decompression), and 21 kPa. Changes were measured continuously for each individual. Results: Hyperoxia decreased pulsatile patellar blood flow ~32 resp. 38% and skin blood flow ~36 resp. 42% during the first 2 - 3 minutes of NBO resp. HBO. This decrease was normalized within 5 minutes after exposure. The results were similar when switching from air to NBO (101 kPa) and from air at pressure (59 kPa) to HBO (280 kPa). Conclusions: The study shows that pulsatile patellar skin and bone blood flow, decreases significantly as a reaction to oxygen breathing in healthy subjects. The results suggest that a non-invasive PPG technique could be used to monitor blood flow changes in bone during oxygen treatment.
Is Placebo Acupuncture What It Is Intended to Be?
Thomas Lundeberg,Irene Lund,Audrey Sing,Jan Nslund
Evidence-Based Complementary and Alternative Medicine , 2011, DOI: 10.1093/ecam/nep049
Abstract: Randomized, placebo-controlled clinical trials are recommended for evaluation of a treatment's efficacy with the goal of separating the specific effects (verum) from the non-specific ones (placebo). In order to be able to carry out placebo-controlled acupuncture trials, minimal/sham acupuncture procedures and a sham acupuncture needle has been used with the intention of being inert. However, clinical and experimental results suggest that sham/minimal acupuncture is not inert since it is reported that both verum acupuncture and sham/minimal acupuncture induce a significant alleviation of pain. This alleviation is as pronounced as the alleviation obtained with standard treatment and more obvious than the one obtained with placebo medication or by the use of waiting list controls. These results also suggest that sham acupuncture needles evoke a physiological response. In healthy individuals sham acupuncture results in activation of limbic structures, whereas a deactivation is seen in patients with pain, i.e. results from healthy individuals do not reflect what is seen in clinical conditions. Also, depending on the etiology of pain (or any under clinical condition under investigation), the response to sham acupuncture is varying. The acupuncture ritual may also be seen as an emotional focused therapy allowing for psychological re-orientation. Sham needling in such context may be as powerful as verum acupuncture. We recommend that the evaluated effects of acupuncture could be compared with those of standard treatment, also taking the individual response into consideration, before its use or non-use is established. 1. Introduction During the last decade, a large number of randomized controlled trials (RCT) have been published comparing manual acupuncture or electro-acupuncture with different modes of intended placebo controlled procedures in the treatment of perceived pain. The placebo control procedures most commonly used include minimal or superficial acupuncture (needling of the skin), sham acupuncture (deep or superficial needling of non-acupuncture points) and the use of placebo acupuncture needles (a blunt tip of a needle touches the skin without penetrating it) [1–3]. The intention of these RCTs is to reduce the presence of bias of the results by comparing the size of the interventional specific effects, by means of assumed, specific mechanisms, with the non-specific effects of an inert (placebo) comparator applied in a placebo-controlled procedure. This trial design is considered the gold standard in evaluation of all types of intervention and its
Minimal acupuncture is not a valid placebo control in randomised controlled trials of acupuncture: a physiologist's perspective
Iréne Lund, Jan Nslund, Thomas Lundeberg
Chinese Medicine , 2009, DOI: 10.1186/1749-8546-4-1
Abstract: Randomised placebo-controlled clinical trials (placebo-controlled RCTs) are used to evaluate the efficacy of medical interventions. The ultimate intention of these placebo-controlled RCTs is to eliminate the non-specific placebo effects [1]. This trial design is considered as the gold standard. The results of placebo-controlled RCTs provide evidence for a treatment's efficacy [2]. However, the technical issues in developing valid placebos in acupuncture RCTs are still controversial [1,3-7].The placebo concept was introduced into RCTs as a treatment without curative anticipation [8]. Randomised, double-blind, placebo-controlled trials are generally considered as the best experimental method for separating the 'specific' from the 'non-specific placebo related' effects of a treatment. The placebo is supposed to be inert, inducing only non-specific physiological and emotional changes. If the intervention is a drug, the 'specific' component is the pharmacologically active agent while the placebo is an inert substance. Recent studies have, however, shown that some placebos are sometimes therapeutically effective [9]. The issue of evaluation becomes more complicated especially if the intervention in question is as complex as acupuncture [7,10]. Acupuncture may be viewed from a Chinese medicine perspective whereby each acupoint is associated with specific effects, or from a Western perspective whereby acupuncture is merely what its Latin name suggests – 'acus' (needle) and 'pungere' (to prick), and its effects are explained in Western physiological terms.In Chinese medicine, the correct acupoints are vital in the classical theory of acupuncture to achieve efficacy. A possible control intervention from this perspective is, therefore, needling at incorrect sites. From a physiological perspective, an acupoint is defined by its anatomical innervation. Needling at an incorrect site may affect the correct receptive field in terms of physiology. In such a scenario, the physiologic
Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents
Emelie Condén, Jerzy Leppert, Lisa Ekselius, Cecilia ?slund
BMC Pediatrics , 2013, DOI: 10.1186/1471-2431-13-11
Abstract: A population-based, self-reported cross-sectional study conducted in V?stmanland, Sweden with a cohort of 5012 students in the age between 15–18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in V?stmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA) and social inhibition (SI) were measured as well.There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p?=?< 0.001) were defined as Type D personality. Boys and girls with a Type D personality had an approximately 2-fold increased odds of musculoskeletal pain and a 5-fold increased odds of psychosomatic symptoms. The subscale NA explained most of the relationship between Type D personality and psychosomatic symptoms and musculoskeletal pain. No interaction effect of NA and SI was found.There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents.The high prevalence of musculoskeletal and psychosomatic symptoms among adolescents in the western world is a problem involving significant costs for both individuals and societies [1,2]. Musculoskeletal pain and psychosomatic symptoms that appear during adolescence often persist into adulthood and may partly be explained by psychosocial and lifestyle factors [3-5]. Pain among adolescents has been identified as an important public health problem. Roth-Isigkeit found that 83% of children and adolescents had experienced pain during the preceding three months, with headache, abdominal, limb and back pain being the most prevalent types. Pain caused the respondents of th
The Rift Valley Fever virus protein NSm and putative cellular protein interactions
Engdahl Cecilia,Nslund Jonas,Lindgren Lena,Ahlm Clas
Virology Journal , 2012, DOI: 10.1186/1743-422x-9-139
Abstract: Rift Valley Fever is an infectious viral disease and an emerging problem in many countries of Africa and on the Arabian Peninsula. The causative virus is predominantly transmitted by mosquitoes and high mortality and abortion rates characterize outbreaks in animals while symptoms ranging from mild to life-threatening encephalitis and hemorrhagic fever are noticed among infected humans. For a better prevention and treatment of the infection, an increased knowledge of the infectious process of the virus is required. The focus of this work was to identify protein-protein interactions between the non-structural protein (NSm), encoded by the M-segment of the virus, and host cell proteins. This study was initiated by screening approximately 26 million cDNA clones of a mouse embryonic cDNA library for interactions with the NSm protein using a yeast two-hybrid system. We have identified nine murine proteins that interact with NSm protein of Rift Valley Fever virus, and the putative protein-protein interactions were confirmed by growth selection procedures and β-gal activity measurements. Our results suggest that the cleavage and polyadenylation specificity factor subunit 2 (Cpsf2), the peptidyl-prolyl cis-trans isomerase (cyclophilin)-like 2 protein (Ppil2), and the synaptosome-associated protein of 25 kDa (SNAP-25) are the most promising targets for the NSm protein of the virus during an infection.
Is Platinum Present in Blood and Urine from Treatment Givers during Hyperthermic Intraperitoneal Chemotherapy?
Sara Nslund Andréasson,Helena Anundi,Sig-Britt Thorén,Hans Ehrsson,Haile Mahteme
Journal of Oncology , 2010, DOI: 10.1155/2010/649719
Abstract: Background. In selected patients with peritoneal carcinomatosis (PC) originating from colorectal cancer (CRC) the high dosage of oxaliplatin (460?mg/m2) is recommended for hyperthermic intraperitoneal chemotherapy (HIPEC), which may be a health risk to those administering the drug. The aim of this study was to determine the risk of platinum (Pt) exposure for the two main people handling and administering the cytotoxic agent during HIPEC. Methods. Samples of blood and urine were collected from one male surgeon and one female perfusionist during oxaliplatin-based HIPEC treatment with open abdomen coliseum technique on six consecutive patients with PC from CRC. Results. All blood samples analysed were below the detection limit of ?nmol/L Pt, and the urine samples were all below the detection limit of ?nmol/L Pt. Conclusions. There appears to be little or no risk of Pt exposure during HIPEC when the recommended protective garment is used and the safety considerations are followed. 1. Introduction Peritoneal carcinomatosis (PC) from colorectal cancer (CRC) is often associated with poor prognosis [1–3]. However, growing evidence indicates cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective treatment for patients in this category [4–6]. Oxaliplatin is a third generation platinum (Pt) complex used intravenously, at the dose of 85–100?mg/m2 [7, 8], to treat advanced CRC. With HIPEC, a higher oxaliplatin dose of 460?mg/m2 is recommended [9], and with this dosage, a 65%–75% overall survival rate of two years and an estimated five-year survival rate of 40% are reported [5, 10]. The use of oxaliplatin in the HIPEC setting may be a health risk for those administering the cytotoxic agent, as the heated cytotoxic agents may vaporise and become inhaled by health personnel [11]; thus, the guidelines should be followed to minimise exposure [12]. Although insignificant amounts of oxaliplatin are vaporised during HIPEC [13], the occurrence of Pt in surgeons and perfusionists exposed to oxaliplatin has not been investigated. The aim of this study was to determine, through blood and urine sampling, the risk of Pt exposure for the two main people handling and administering the cytotoxic agent during HIPEC. 2. Material and Methods In 2008, six consecutive patients (4 men and 2 women, mean age 54.2 years (range 43–65)) with PC from CRC, with a mean peritoneal cancer index score 16.3 (range 7–32), underwent CRS and oxaliplatin-based HIPEC treatment at the University Hospital, Uppsala, Sweden. During these treatments, blood
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