226 results on '"L. Rosengren"'
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2. POSB197 Impact of Immune Checkpoint Inhibitors (ICIS) on the Management of Advanced Non-Small Cell Lung Cancer (NSCLC) in Real-World Practice at Karolinska University Hospital, Stockholm between 2012 and 2018
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S Ekman, OT Brustugun, JB Sørensen, AM Kejs, Q Ann, M Bortolini, A Calleja, L Rosengren, P Huetson, MJ Daumont, JR Penrod, HC Jacobs, L Lacoin, and H Koyi
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Health Policy ,Public Health, Environmental and Occupational Health - Published
- 2022
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3. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants
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Zhou, Bin Carrillo-Larco, Rodrigo M. Danaei, Goodarz Riley, Leanne M. Paciorek, Christopher J. Stevens, Gretchen A. and Gregg, Edward W. Bennett, James E. Solomon, Bethlehem and Singleton, Rosie K. Sophiea, Marisa K. Iurilli, Maria L. C. and Lhoste, Victor P. F. Cowan, Melanie J. Savin, Stefan and Woodward, Mark Balanova, Yulia Cifkova, Renata Damasceno, Albertino Elliott, Paul Farzadfar, Farshad He, Jiang and Ikeda, Nayu Kengne, Andre P. Khang, Young-Ho Kim, Hyeon Chang Laxmaiah, Avula Lin, Hsien-Ho Margozzini Maira, Paula and Miranda, J. Jaime Neuhauser, Hannelore Sundstrom, Johan and Varghese, Cherian Widyahening, Indah S. Zdrojewski, Tomasz and Ezzati, Majid Abarca-Gomez, Leandra Abdeen, Ziad A. Rahim, Hanan F. Abdul Abu-Rmeileh, Niveen M. Acosta-Cazares, Benjamin and Adams, Robert J. Aekplakorn, Wichai Afsana, Kaosar and Afzal, Shoaib Agdeppa, Imelda A. Aghazadeh-Attari, Javad and Aguilar-Salinas, Carlos A. Agyemang, Charles Ahmad, Noor Ani and Ahmadi, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadizar, Fariba and Ahmed, Soheir H. Ahrens, Wolfgang Ajlouni, Kamel and Al-Raddadi, Rajaa Alarouj, Monira AlBuhairan, Fadia and AlDhukair, Shahla Ali, Mohamed M. Alkandari, Abdullah and Alkerwi, Ala'a Allin, Kristine Aly, Eman Amarapurkar, Deepak N. Amougou, Norbert Amouyel, Philippe Andersen, Lars Bo and Anderssen, Sigmund A. Anjana, Ranjit Mohan Ansari-Moghaddam, Alireza Ansong, Daniel Aounallah-Skhiri, Hajer Araujo, Joana and Ariansen, Inger Aris, Tahir Arku, Raphael E. Arlappa, Nimmathota Aryal, Krishna K. Aspelund, Thor Assah, Felix K. and Assuncao, Maria Cecilia F. Auvinen, Juha Avdicova, Maria and Azevedo, Ana Azimi-Nezhad, Mohsen Azizi, Fereidoun Azmin, Mehrdad Babu, Bontha V. Bahijri, Suhad Balakrishna, Nagalla and Balanova, Yulia Bamoshmoosh, Mohamed Banach, Maciej and Banadinovic, Maja Bandosz, Piotr Banegas, Jose R. Baran, Joanna Barbagallo, Carlo M. Barcelo, Alberto Barkat, Amina and Barreto, Marta Barros, Aluisio J. D. Gomes Barros, Mauro Virgilio Bartosiewicz, Anna Basit, Abdul Bastos, Joao Luiz D. Bata, Iqbal Batieha, Anwar M. Batyrbek, Assembekov and Baur, Louise A. Beaglehole, Robert Belavendra, Antonisamy and Ben Romdhane, Habiba Benet, Mikhail Bennett, James E. and Benson, Lowell S. Berkinbayev, Salim Bernabe-Ortiz, Antonio and Bettiol, Heloisa Bezerra, Jorge Bhagyalaxmi, Aroor Bhargava, Santosh K. Bia, Daniel Biasch, Katia Lele, Elysee Claude Bika Bikbov, Mukharram M. Bista, Bihungum Bjerregaard, Peter and Bjertness, Espen Bjertness, Marius B. Bjorkelund, Cecilia and Bloch, Katia V. Blokstra, Anneke Bo, Simona Bobak, Martin Boeing, Heiner Boggia, Jose G. Boissonnet, Carlos P. and Bojesen, Stig E. Bongard, Vanina Bonilla-Vargas, Alice and Bopp, Matthias Borghs, Herman Bovet, Pascal Boyer, Christopher B. Braeckman, Lutgart Brajkovich, Imperia and Branca, Francesco Breckenkamp, Juergen Brenner, Hermann and Brewster, Lizzy M. Briceno, Yajaira Brito, Miguel Bruno, Graziella Bueno-de-Mesquita, H. Bas Bueno, Gloria Bugge, Anna Burns, Con Bursztyn, Michael Cabrera de Leon, Antonio and Cacciottolo, Joseph Cameron, Christine Can, Gunay and Candido, Ana Paula C. Capanzana, Mario V. Capkova, Nadezda and Capuano, Eduardo Capuano, Vincenzo Cardoso, Viviane C. and Carlsson, Axel C. Carvalho, Joana Casanueva, Felipe F. and Censi, Laura Cervantes-Loaiza, Marvin Chadjigeorgiou, Charalambos A. Chamukuttan, Snehalatha Chan, Angelique W. and Chan, Queenie Chaturvedi, Himanshu K. Chaturvedi, Nish Chee, Miao Li Chen, Chien-Jen Chen, Fangfang Chen, Huashuai and Chen, Shuohua Chen, Zhengming Cheng, Ching-Yu Cheraghian, Bahman Dekkaki, Imane Cherkaoui Chetrit, Angela Chien, Kuo-Liong Chiolero, Arnaud Chiou, Shu-Ti Chirita-Emandi, Adela Chirlaque, Maria-Dolores Cho, Belong Christensen, Kaare Christofaro, Diego G. Chudek, Jerzy Cifkova, Renata and Cinteza, Eliza Claessens, Frank Clarke, Janine Clays, Els Cohen, Emmanuel Concin, Hans Cooper, Cyrus and Coppinger, Tara C. Costanzo, Simona Cottel, Dominique and Cowell, Chris Craig, Cora L. Crampin, Amelia C. Crujeiras, Ana B. Cruz, Juan J. Csilla, Semanova Cui, Liufu Cureau, Felipe V. Cuschieri, Sarah D'Arrigo, Graziella d'Orsi, Eleonora Dallongeville, Jean Damasceno, Albertino Danaei, Goodarz Dankner, Rachel Dantoft, Thomas M. Dauchet, Luc and Davletov, Kairat De Backer, Guy De Bacquer, Dirk De Curtis, Amalia de Gaetano, Giovanni De Henauw, Stefaan de Oliveira, Paula Duarte De Ridder, David De Smedt, Delphine Deepa, Mohan Deev, Alexander D. DeGennaro, Vincent Jr Delisle, Helene Demarest, Stefaan Dennison, Elaine Deschamps, Valerie and Dhimal, Meghnath Di Castelnuovo, Augusto F. Dias-da-Costa, Juvenal Soares Diaz, Alejandro Dickerson, Ty T. Dika, Zivka and Djalalinia, Shirin Do, Ha T. P. Dobson, Annette J. and Donfrancesco, Chiara Donoso, Silvana P. Doering, Angela and Dorobantu, Maria Doerr, Marcus Doua, Kouamelan Dragano, Nico and Drygas, Wojciech Duante, Charmaine A. Duboz, Priscilla and Duda, Rosemary B. Dulskiene, Virginija Dushpanova, Anar and Dzakula, Aleksandar Dzerve, Vilnis Dziankowska-Zaborszczyk, Elzbieta Eddie, Ricky Eftekhar, Ebrahim Eggertsen, Robert and Eghtesad, Sareh Eiben, Gabriele Ekelund, Ulf El-Khateeb, Mohammad El Ati, Jalila Eldemire-Shearer, Denise Eliasen, Marie Elliott, Paul Elosua, Roberto Erasmus, Rajiv T. and Erbel, Raimund Erem, Cihangir Eriksen, Louise Eriksson, Johan G. Escobedo-de la Pena, Jorge Eslami, Saeid Esmaeili, Ali Evans, Alun Faeh, David Fakhretdinova, Albina A. and Fall, Caroline H. Faramarzi, Elnaz Farjam, Mojtaba and Farzadfar, Farshad Fattahi, Mohammad Reza Fawwad, Asher and Felix-Redondo, Francisco J. Felix, Stephan B. Ferguson, Trevor S. Fernandes, Romulo A. Fernandez-Berges, Daniel Ferrante, Daniel Ferrao, Thomas Ferrari, Marika Ferrario, Marco M. and Ferreccio, Catterina Ferreira, Haroldo S. Ferrer, Eldridge and Ferrieres, Jean Figueiro, Thamara Hubler Fink, Gunther and Fischer, Krista Foo, Leng Huat Forsner, Maria Fouad, Heba M. and Francis, Damian K. Franco, Maria do Carmo Frikke-Schmidt, Ruth Frontera, Guillermo Fuchs, Flavio D. Fuchs, Sandra C. and Fujita, Yuki Fumihiko, Matsuda Furdela, Viktoriya Furer, Ariel Furusawa, Takuro Gaciong, Zbigniew Galbarczyk, Andrzej and Galenkamp, Henrike Galvano, Fabio Gao, Jingli Gao, Pei and Garcia-de-la-Hera, Manoli Garcia, Pablo Gareta, Dickman and Garnett, Sarah P. Gaspoz, Jean-Michel Gasull, Magda and Gazzinelli, Andrea Gehring, Ulrike Geleijnse, Johanna M. and George, Ronnie Ghanbari, Ali Ghasemi, Erfan Gheorghe-Fronea, Oana-Florentina Ghimire, Anup Gialluisi, Alessandro and Giampaoli, Simona Gieger, Christian Gill, Tiffany K. and Giovannelli, Jonathan Gironella, Glen Giwercman, Aleksander and Gkiouras, Konstantinos Goldberg, Marcel Goldsmith, Rebecca A. and Gomez, Luis F. Gomula, Aleksandra Cordeiro da Silva, Bruna Goncalves Goncalves, Helen Goncalves, Mauer Gonzalez-Chica, David A. Gonzalez-Gross, Marcela Gonzalez-Rivas, Juan P. and Gonzalez-Villalpando, Clicerio Gonzalez-Villalpando, Maria-Elena and Gonzalez, Angel R. Bonet Gorbea, Mariano Gottrand, Frederic and Graff-Iversen, Sidsel Grafnetter, Dusan Grajda, Aneta and Grammatikopoulou, Maria G. Gregor, Ronald D. Grodzicki, Tomasz and Grosso, Giuseppe Gruden, Gabriella Gu, Dongfeng Guan, Ong Peng Gudmundsson, Elias F. Gudnason, Vilmundur Guerrero, Ramiro Guessous, Idris Guimaraes, Andre L. Gulliford, Martin C. Gunnlaugsdottir, Johanna Gunter, Marc J. Gupta, Prakash C. Gupta, Rajeev Gureje, Oye Gurzkowska, Beata and Gutierrez, Laura Gutzwiller, Felix Ha, Seongjun Hadaegh, Farzad Haghshenas, Rosa Hakimi, Hamid Halkjaer, Jytte and Hambleton, Ian R. Hamzeh, Behrooz Hange, Dominique Hanif, Abu A. M. Hantunen, Sari Hao, Jie Hardman, Carla Meneses and Kumar, Rachakulla Hari Hashemi-Shahri, Seyed Mohammad Hata, Jun and Haugsgjerd, Teresa Hayes, Alison J. He, Jiang He, Yuna and Heier, Margit Hendriks, Marleen Elisabeth Henrique, Rafael dos Santos Henriques, Ana Cadena, Leticia Hernandez Herrala, Sauli Heshmat, Ramin Hill, Allan G. Ho, Sai Yin Ho, Suzanne C. Hobbs, Michael Holdsworth, Michelle Homayounfar, Reza Dinc, Gonul Horasan Horimoto, Andrea R. V. R. Hormiga, Claudia M. Horta, Bernardo L. Houti, Leila Howitt, Christina and Htay, Thein Thein Htet, Aung Soe Htike, Maung Maung Than and Hu, Yonghua Huerta, Jose Maria Huhtaniemi, Ilpo Tapani and Huiart, Laetitia Huisman, Martijn Husseini, Abdullatif S. and Huybrechts, Inge Hwalla, Nahla Iacoviello, Licia Iannone, Anna G. Ibrahim, Mohsen M. Wong, Norazizah Ibrahim Ikeda, Nayu Ikram, M. Arfan Iotova, Violeta Irazola, Vilma E. and Ishida, Takafumi Isiguzo, Godsent C. Islam, Muhammad Islam, Sheikh Mohammed Shariful Iwasaki, Masanori Jackson, Rod T. and Jacobs, Jeremy M. Jaddou, Hashem Y. Jafar, Tazeen James, Kenneth Jamrozik, Konrad Janszky, Imre Janus, Edward and Jarvelin, Marjo-Riitta Jasienska, Grazyna Jelakovic, Ana and Jelakovic, Bojan Jennings, Garry Jha, Anjani Kumar Jiang, Chao Qiang Jimenez, Ramon O. Joeckel, Karl-Heinz Joffres, Michel Johansson, Mattias Jokelainen, Jari J. Jonas, Jost B. and Jorgensen, Torben Joshi, Pradeep Joukar, Farahnaz and Jozwiak, Jacek Juolevi, Anne Jurak, Gregor Juresa, Vesna and Kaaks, Rudolf Kafatos, Anthony Kajantie, Eero O. and Kalmatayeva, Zhanna Kalpourtzi, Natasa Kalter-Leibovici, Ofra and Kampmann, Freja B. Kannan, Srinivasan Karaglani, Eva and Karhus, Line L. Karki, Khem B. Katibeh, Marzieh Katz, Joanne and Kauhanen, Jussi Kaur, Prabhdeep Kavousi, Maryam and Kazakbaeva, Gyulli M. Keil, Ulrich Boker, Lital Keinan and Keinanen-Kiukaanniemi, Sirkka Kelishadi, Roya Kemper, Han C. G. and Kengne, Andre P. Keramati, Maryam Kerimkulova, Alina and Kersting, Mathilde Key, Timothy Khader, Yousef Saleh and Khalili, Davood Khang, Young-Ho Khaw, Kay-Tee Kheiri, Bahareh Kheradmand, Motahareh Khosravi, Alireza and Kiechl-Kohlendorfer, Ursula Kiechl, Stefan Killewo, Japhet and Kim, Dong Wook Kim, Hyeon Chang Kim, Jeongseon Klakk, Heidi and Klimek, Magdalena Klumbiene, Jurate Knoflach, Michael and Kolle, Elin Kolsteren, Patrick Kontto, Jukka P. Korpelainen, Raija Korrovits, Paul Kos, Jelena Koskinen, Seppo Kouda, Katsuyasu Kowlessur, Sudhir Koziel, Slawomir Kratenova, Jana and Kriaucioniene, Vilma Kristensen, Peter Lund Krokstad, Steiner Kromhout, Daan Kruger, Herculina S. Kubinova, Ruzena and Kuciene, Renata Kujala, Urho M. Kulaga, Zbigniew Kumar, R. Krishna Kurjata, Pawel Kusuma, Yadlapalli S. Kutsenko, Vladimir Kuulasmaa, Kari Kyobutungi, Catherine Laatikainen, Tiina Lachat, Carl Laid, Youcef Lam, Tai Hing Landrove, Orlando Lanska, Vera Lappas, Georg Larijani, Bagher and Latt, Tint Swe Laxmaiah, Avula Le Coroller, Gwenaelle Khanh Le Nguyen Bao Le, Tuyen D. Lee, Jeannette Lee, Jeonghee and Lehmann, Nils Lehtimaki, Terho Lemogoum, Daniel Levitt, Naomi S. Li, Yanping Lilly, Christa L. Lim, Wei-Yen and Lima-Costa, M. Fernanda Lin, Hsien-Ho Lin, Xu Lin, Yi-Ting and Lind, Lars Lingam, Vijaya Linneberg, Allan Lissner, Lauren Litwin, Mieczyslaw Lo, Wei-Cheng Loit, Helle-Mai and Lopez-Garcia, Esther Lopez, Tania Lotufo, Paulo A. Lozano, Jose Eugenio Lovrencic, Iva Lukacevic Lukrafka, Janice L. and Luksiene, Dalia Lundqvist, Annamari Lundqvist, Robert Lunet, Nuno Lustigova, Michala Luszczki, Edyta Ma, Guansheng and Ma, Jun Machado-Coelho, George L. L. Machado-Rodrigues, Aristides M. Macia, Enguerran Macieira, Luisa M. Madar, Ahmed A. Maggi, Stefania Magliano, Dianna J. Magriplis, Emmanuella Mahasampath, Gowri Maire, Bernard Majer, Marjeta and Makdisse, Marcia Malekzadeh, Fatemeh Malekzadeh, Reza and Malhotra, Rahul Mallikharjuna, Kodavanti Malyutina, Sofia K. and Maniego, Lynell V. Manios, Yannis Mann, Jim I. and Mansour-Ghanaei, Fariborz Manzato, Enzo Marcil, Anie and Margozzini, Paula Marild, Staffan B. Glavic, Mihalea Marinovic and Marques-Vidal, Pedro Marques, Larissa Pruner Marrugat, Jaume and Martorell, Reynaldo Mascarenhas, Luis P. Matasin, Marija and Mathiesen, Ellisiv B. Mathur, Prashant Matijasevich, Alicia and Matlosz, Piotr Matsha, Tandi E. Mavrogianni, Christina and Mbanya, Jean Claude N. Mc Donald Posso, Anselmo J. McFarlane, Shelly R. McGarvey, Stephen T. McLachlan, Stela McLean, Rachael M. McLean, Scott B. McNulty, Breige A. Benchekor, Sounnia Mediene Medzioniene, Jurate Mehdipour, Parinaz and Mehlig, Kirsten Mehrparvar, Amir Houshang Meirhaeghe, Aline and Meisinger, Christa Mendoza Montano, Carlos Menezes, Ana Maria B. and Menon, Geetha R. Mereke, Alibek Meshram, Indrapal I. and Metspalu, Andres Meyer, Haakon E. Mi, Jie Michels, Nathalie and Mikkel, Kairit Milkowska, Karolina Miller, Jody C. and Minderico, Claudia S. Mini, G. K. Miranda, J. Jaime and Mirjalili, Mohammad Reza Mirrakhimov, Erkin Misigoj-Durakovic, Marjeta Modesti, Pietro A. Moghaddam, Sahar Saeedi Mohajer, Bahram Mohamed, Mostafa K. Mohamed, Shukri F. Mohammad, Kazem Mohammadi, Mohammad Reza Mohammadi, Zahra and Mohammadifard, Noushin Mohammadpourhodki, Reza Mohan, Viswanathan Mohanna, Salim Yusoff, Muhammad Fadhli Mohd and Mohebbi, Iraj Mohebi, Farnam Moitry, Marie Mollehave, Line T. Molnar, Denes Momenan, Amirabbas Mondo, Charles K. and Monterrubio-Flores, Eric Monyeki, Kotsedi Daniel K. Moon, Jin Soo Moosazadeh, Mahmood Moreira, Leila B. Morejon, Alain and Moreno, Luis A. Morgan, Karen Moschonis, George Mossakowska, Malgorzata Mostafa, Aya Mostafavi, Seyed-Ali Mota, Jorge and Motlagh, Mohammad Esmaeel Motta, Jorge Andre Moura-dos-Santos, Marcos Mridha, Malay K. Msyamboza, Kelias P. Mu, Thet Thet and Muhihi, Alfa J. Muiesan, Maria L. Muller-Nurasyid, Martina and Murphy, Neil Mursu, Jaakko Musa, Kamarul Imran and Milanovic, Sanja Music Musil, Vera Mustafa, Norlaila and Nabipour, Iraj Naderimagham, Shohreh Nagel, Gabriele Naidu, Balkish M. Najafi, Farid Nakamura, Harunobu Namesna, Jana and Nang, Ei Ei K. Nangia, Vinay B. Narake, Sameer Ndiaye, Ndeye Coumba Neal, William A. Nejatizadeh, Azim Nenko, Ilona and Neovius, Martin Neuhauser, Hannelore K. Nguyen, Chung T. and Nguyen, Nguyen D. Nguyen, Quang V. Quang Ngoc Nguyen and Nieto-Martinez, Ramfis E. Niiranen, Teemu J. Nikitin, Yury P. and Ninomiya, Toshiharu Nishtar, Sania Njelekela, Marina A. and Noale, Marianna Noboa, Oscar A. Noorbala, Ahmad Ali Norat, Teresa Nordendahl, Maria Nordestgaard, Borge G. Noto, Davide and Nowak-Szczepanska, Natalia Al Nsour, Mohannad Nunes, Baltazar O'Neill, Terence W. O'Reilly, Dermot Ochimana, Caleb Oda, Eiji Odili, Augustine N. Oh, Kyungwon Ohara, Kumiko Ohtsuka, Ryutaro Olie, Valerie Olinto, Maria Teresa A. Oliveira, Isabel O. Omar, Mohd Azahadi Onat, Altan and Ong, Sok King Ono, Lariane M. Ordunez, Pedro Ornelas, Rui and Ortiz, Pedro J. Osmond, Clive Ostojic, Sergej M. and Ostovar, Afshin Otero, Johanna A. Overvad, Kim Owusu-Dabo, Ellis Paccaud, Fred Michel Padez, Cristina Pahomova, Elena and de Paiva, Karina Mary Pajak, Andrzej Palli, Domenico and Palmieri, Luigi Pan, Wen-Harn Panda-Jonas, Songhomitra and Panza, Francesco Paoli, Mariela Papandreou, Dimitrios Park, Soon-Woo Park, Suyeon Parnell, Winsome R. Parsaeian, Mahboubeh Pasquet, Patrick Patel, Nikhil D. Pavlyshyn, Halyna Pecin, Ivan Pednekar, Mangesh S. Pedro, Joao M. and Peer, Nasheeta Peixoto, Sergio Viana Peltonen, Markku and Pereira, Alexandre C. Peres, Karen G. D. A. Peres, Marco A. and Peters, Annette Petkeviciene, Janina Peykari, Niloofar Son Thai Pham Pichardo, Rafael N. Pigeot, Iris Pikhart, Hynek and Pilav, Aida Pilotto, Lorenza Pitakaka, Freda Piwonska, Aleksandra Pizarro, Andreia N. Plans-Rubio, Pedro Polasek, Ozren Porta, Miquel Poudyal, Anil Pourfarzi, Farhad and Pourshams, Akram Poustchi, Hossein Pradeepa, Rajendra Price, Alison J. Price, Jacqueline F. Providencia, Rui Puhakka, Soile E. Puiu, Maria Punab, Margus Qasrawi, Radwan F. and Qorbani, Mostafa Queiroz, Daniel Tran Quoc Bao Radic, Ivana and Radisauskas, Ricardas Rahimikazerooni, Salar Rahman, Mahfuzar Raitakari, Olli Raj, Manu Rakhimova, Ellina M. and Rao, Sudha Ramachandra Ramachandran, Ambady Ramos, Elisabete and Rampal, Lekhraj Rampal, Sanjay Rangel Reina, Daniel A. and Rarra, Vayia Rech, Cassiano Ricardo Redon, Josep Reganit, Paul Ferdinand M. Regecova, Valeria Revilla, Luis and Rezaianzadeh, Abbas Ribeiro, Robespierre Riboli, Elio and Richter, Adrian Rigo, Fernando de Wit, Tobias F. Rinke and Ritti-Dias, Raphael M. Robitaille, Cynthia Rodriguez-Artalejo, Fernando del Cristo Rodriguez-Perez, Maria Rodriguez-Villamizar, Laura A. Roggenbuck, Ulla Rojas-Martinez, Rosalba Romaguera, Dora Romeo, Elisabetta L. Rosengren, Annika Roy, Joel G. R. and Rubinstein, Adolfo Ruidavets, Jean-Bernard Sandra Ruiz-Betancourt, Blanca Ruiz-Castell, Maria Rusakova, Iuliia A. and Russo, Paola Rutkowski, Marcin Sabanayagam, Charumathi and Sabbaghi, Hamideh Sachdev, Harshpal S. Sadjadi, Alireza and Safarpour, Ali Reza Safi, Sare Safiri, Saeid Saidi, Olfa and Sakarya, Sibel Saki, Nader Salanave, Benoit Salazar Martinez, Eduardo Salmeron, Diego Salomaa, Veikko Salonen, Jukka T. Salvetti, Massimo Sanchez-Abanto, Jose Sans, Susana and Santos, Diana A. Santos, Ina S. Santos, Lelita C. and Santos, Maria Paula Santos, Rute Saramies, Jouko L. and Sardinha, Luis B. Sarganas, Giselle Sarrafzadegan, Nizal and Sathish, Thirunavukkarasu Saum, Kai-Uwe Savva, Savvas and Sawada, Norie Sbaraini, Mariana Scazufca, Marcia Schaan, Beatriz D. Schargrodsky, Herman Schipf, Sabine Schmidt, Carsten O. Schnohr, Peter Schoettker, Ben Schramm, Sara and Schultsz, Constance Schutte, Aletta E. Sebert, Sylvain Sein, Aye Aye Sen, Abhijit Senbanjo, Idowu O. Sepanlou, Sadaf G. and Servais, Jennifer Shalnova, Svetlana A. Shamah-Levy, Teresa and Shamshirgaran, Morteza Shanthirani, Coimbatore Subramaniam and Sharafkhah, Maryam Sharma, Sanjib K. Shaw, Jonathan E. and Shayanrad, Amaneh Shayesteh, Ali Akbar Shi, Zumin Shibuya, Kenji Shimizu-Furusawa, Hana Shin, Dong Wook Shirani, Majid and Shiri, Rahman Shrestha, Namuna Si-Ramlee, Khairil Siani, Alfonso Siantar, Rosalynn Sibai, Abla M. de Moura Silva, Caroline Ramos Santos Silva, Diego Augusto Simon, Mary and Simons, Judith Simons, Leon A. Sjostrom, Michael and Slowikowska-Hilczer, Jolanta Slusarczyk, Przemyslaw Smeeth, Liam and So, Hung-Kwan Soares, Fernanda Cunha Sobngwi, Eugene and Soderberg, Stefan Soemantri, Agustinus Sofat, Reecha and Solfrizzi, Vincenzo Somi, Mohammad Hossein Sonestedt, Emily and Song, Yi Sorensen, Thorkild I. A. Sorgjerd, Elin P. Soric, Maroje Jerome, Charles Sossa Soumare, Aicha Sparboe-Nilsen, Bente Sparrenberger, Karen Staessen, Jan A. Starc, Gregor and Stavreski, Bill Steene-Johannessen, Jostein Stehle, Peter and Stein, Aryeh D. Stergiou, George S. Stessman, Jochanan and Stieber, Jutta Stoeckl, Doris Stocks, Tanja Stokwiszewski, Jakub Stronks, Karien Strufaldi, Maria Wany Suka, Machi and Sun, Chien-An Sundstrom, Johan Sung, Yn-Tz Suriyawongpaisal, Paibul Sy, Rody G. Syddall, Holly E. Sylva, Rene Charles and Szklo, Moyses Tai, E. Shyong Tammesoo, Mari-Liis Tamosiunas, Abdonas Tan, Eng Joo Tang, Xun Tanser, Frank Tao, Yong and Tarawneh, Mohammed Rasoul Tarqui-Mamani, Carolina B. Taylor, Anne Taylor, Julie Tebar, William R. Tell, Grethe S. and Tello, Tania Tham, Yih Chung Thankappan, K. R. Theobald, Holger Theodoridis, Xenophon Thijs, Lutgarde Thinggaard, Mikael Thomas, Nihal Thorand, Barbara Thuesen, Betina H. and Timmermans, Erik J. Tjandrarini, Dwi H. Tjonneland, Anne and Toft, Ulla Tolonen, Hanna K. Tolstrup, Janne S. Topbas, Murat Topor-Madry, Roman Jose Tormo, Maria Tornaritis, Michael J. Torrent, Maties Torres-Collado, Laura Touloumi, Giota Traissac, Pierre Triantafyllou, Areti Trichopoulos, Dimitrios Trichopoulou, Antonia Trinh, Oanh T. H. Trivedi, Atul Tshepo, Lechaba Tsugane, Shoichiro Tuliakova, Azaliia M. Tulloch-Reid, Marshall K. Tullu, Fikru Tuomainen, Tomi-Pekka Tuomilehto, Jaakko Turley, Maria L. Twig, Gilad and Tynelius, Per Tzourio, Christophe Ueda, Peter Ugel, Eunice Ulmer, Hanno Uusitalo, Hannu M. T. Valdivia, Gonzalo and Valvi, Damaskini van Dam, Rob M. van den Born, Bert-Jan and Van der Heyden, Johan van der Schouw, Yvonne T. Van Herck, Koen and Hoang Van Minh Van Schoor, Natasja M. van Valkengoed, Irene G. M. van Zutphen, Elisabeth M. Vanderschueren, Dirk and Vanuzzo, Diego Varbo, Anette Vasan, Senthil K. Vega, Tomas and Veidebaum, Toomas Velasquez-Melendez, Gustavo Veronesi, Giovanni Verschuren, W. M. Monique Verstraeten, Roosmarijn and Victora, Cesar G. Viet, Lucie Villalpando, Salvador Vineis, Paolo Vioque, Jesus Virtanen, Jyrki K. Visvikis-Siest, Sophie Viswanathan, Bharathi Vlasoff, Tiina Vollenweider, Peter Voutilainen, Ari Wade, Alisha N. Walton, Janette and Wambiya, Elvis O. A. Bebakar, Wan Mohamad Wan Mohamud, Wan Nazaimoon Wan Wanderley Junior, Rildo de Souza Wang, Ming-Dong and Wang, Ningli Wang, Qian Wang, Xiangjun Wang, Ya Xing and Wang, Ying-Wei Wannamethee, S. Goya Wareham, Nicholas Wei, Wenbin Weres, Aneta Werner, Bo Whincup, Peter H. and Widhalm, Kurt Widyahening, Indah S. Wiecek, Andrzej Wilks, Rainford J. Willeit, Johann Willeit, Peter Williams, Emmanuel A. Wilsgaard, Tom Wojtyniak, Bogdan Wong-McClure, Roy A. Wong, Andrew Wong, Tien Yin Woo, Jean Woodward, Mark Wu, Frederick C. Wu, Shouling Wyszynska, Justyna and Xu, Haiquan Xu, Liang Yaacob, Nor Azwany Yan, Weili and Yang, Ling Yang, Xiaoguang Yang, Yang Yasuharu, Tabara and Ye, Xingwang Yiallouros, Panayiotis K. Yoosefi, Moein and Yoshihara, Akihiro You, San-Lin Younger-Coleman, Novie O. and Yusoff, Ahmad Faudzi Zainuddin, Ahmad A. Zakavi, Seyed Rasoul and Zamani, Farhad Zambon, Sabina Zampelas, Antonis Elisa Zapata, Maria Zaw, Ko Ko Zdrojewski, Tomasz Zejglicova, Kristyna Vrkic, Tajana Zeljkovic Zeng, Yi Zhang, Luxia and Zhang, Zhen-Yu Zhao, Dong Zhao, Ming-Hui Zhen, Shiqi and Zheng, Yingfeng Zholdin, Bekbolat Zhu, Dan Zins, Marie and Zitt, Emanuel Zocalo, Yanina Zoghlami, Nada Zuniga Cisneros, Julio NCD Risk Factor Collaboration
- Abstract
Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier.
- Published
- 2021
4. Modeling of ground-shock wave propagation in soil using FLAC
- Author
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S.-O Olofsson, L Rosengren, and G Svedbjork
- Subjects
Current (stream) ,Vibration ,Shock wave ,Source code ,Explosive material ,media_common.quotation_subject ,Calibration ,Process (computing) ,Point (geometry) ,Mechanics ,Geology ,media_common - Abstract
The impact of explosive load must be considered in the design of civil defense structures. An explosion occurring below ground level generates a ground-shock wave that affects buried structures in the proximity of the explosion point. Current knowledge about the spectrum of induced vibrations in buried structures is limited. The computer code FLAC offers an opportunity to model the propagation of ground shock waves as well as the interaction between soil and structures. This paper present the procedure employed to calibrate a numerical model against idealized field data for a buried exploding charge. Some of the results during the calibration process are also presented. A FLAC model was calibrated that can reproduce the idealized field data with relatively good accuracy. To make the calibrated model successful a material model exhibiting volumetric yield had to be used.
- Published
- 2020
- Full Text
- View/download PDF
5. PND58 - COST-EFFECTIVENESS ANALYSIS OF TREATMENT WITH ABOBOTULINUMTOXINA COMPARED TO BEST SUPPORTIVE CARE IN PATIENTS WITH UPPER LIMB SPASTICITY IN SWEDEN
- Author
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J Lundkvist, A Forsmark, N Danchenko, P Ertzgaard, and L Rosengren
- Subjects
medicine.medical_specialty ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Physical therapy ,medicine ,In patient ,Cost-effectiveness analysis ,Upper limb spasticity ,business - Published
- 2018
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- View/download PDF
6. Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) Farm Program: Results from Finisher Pig Surveillance
- Author
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Brent P. Avery, L. Dutil, Anne E. Deckert, Danielle Daignault, Rebecca Irwin, Sheryl P. Gow, Richard J. Reid-Smith, David F. Léger, and L. Rosengren
- Subjects
Veterinary medicine ,Antiinfective agent ,General Veterinary ,General Immunology and Microbiology ,Epidemiology ,medicine.drug_class ,business.industry ,animal diseases ,Public Health, Environmental and Occupational Health ,Drug resistance ,Antimicrobial ,Macrolide Antibiotics ,Infectious Diseases ,Antibiotic resistance ,medicine ,Virginiamycin ,Veterinary drug ,business ,Ceftiofur ,medicine.drug - Abstract
Summary In 2006, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) Farm Program was implemented in sentinel grower-finisher swine herds in Quebec, Ontario, Manitoba, Saskatchewan and Alberta. Herds were visited 1–3 times annually. Faecal samples were collected from pens of close-to-market (CTM) weight (>80 kg) pigs and antimicrobial use (AMU) data were collected via questionnaires. Samples were cultured for generic Escherichia coli and Salmonella and tested for antimicrobial susceptibility. This paper describes the findings of this program between 2006 and 2008. Eighty-nine, 115 and 96 herds participated in this program in 2006, 2007 and 2008 respectively. Over the 3 years, antimicrobial resistance (AMR) levels remained consistent. During this period, resistance to one or more antimicrobials was detected in 56–63% of the Salmonella spp. isolates and 84–86% of E. coli isolates. Resistance to five or more antimicrobials was detected in 13–23% of Salmonella and 12–13% of E. coli. Resistance to drugs classified as very important to human health (Category I) by the Veterinary Drug Directorate (VDD), Health Canada, was less than or equal to 1% in both organisms. AMU data were provided by 100 herds in 2007 and 95 herds in 2008. Nine herds in 2007 and five herds in 2008 reported no AMU. The most common route of antimicrobial administration (75–79% of herds) was via feed, predominantly macrolides/lincosamides (66–68% of herds). In both 2007 and 2008, the primary reasons given for macrolide/lincosamide use were disease prevention, growth promotion and treatment of enteric disease. The Category I antimicrobials, ceftiofur and virginiamycin were not used in feed or water in any herds in 2008, but virginiamycin was used in feed in two herds in 2007. Parenteral ceftiofur was used in 29 herds (29%) in 2007 and 20 herds (21%) in 2008. The reasons for ceftiofur use included treatment of lameness, respiratory disease and enteric disease.
- Published
- 2010
- Full Text
- View/download PDF
7. Genotyping of the platelet-specific alloantigen HPA-5 (Bra/Brb) using polymerase chain reaction with sequence-specific primers (PCR-SSP)
- Author
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Ming Hou, Jack Kutti, A Elmgren, B. Forsberg, Lennart Rydberg, Hans Wadenvik, and L Rosengren-Kogan
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Adult ,Male ,Isoantigens ,endocrine system ,Genotype ,Population ,Biology ,Polymerase Chain Reaction ,law.invention ,Restriction map ,law ,Humans ,Antigens, Human Platelet ,education ,Genotyping ,Polymerase chain reaction ,Aged ,DNA Primers ,Genetics ,education.field_of_study ,Base Sequence ,Nucleic acid sequence ,Hematology ,General Medicine ,Middle Aged ,Molecular biology ,genomic DNA ,Female ,sense organs ,Primer (molecular biology) - Abstract
A DNA-based one-stage technique, polymerase chain reaction with sequence-specific primers (PCR-SSP) was developed for genotyping of the platelet specific alloantigen HPA-5 (Bra/Brb). Sequence-specific primers, matching the wild type and the point mutation responsible for the HPA-5 (Bra/Brb) phenotype, were constructed. Conjointly a fragment of the gene coding for glycoprotein (GP) IIIa was amplified as an internal control of the enzyme reaction. Using these HPA-5 (Bra/Brb) sequence-specific primers the correct fragment of the GPIa gene was amplified, as evidenced by the PCR product size, the restriction map and by the nucleotide sequence. This assay was applied on 187 Swedish blood donors; 157 individuals were found to have a homozygous HPA-5a (Bra/Brb) genotype and 30 individuals a heterozygous HPA-5a,b (Bra/Brb) genotype. None of the donors was found to display a homozygous HPA-5b (Bra/Brb) genotype. Thus, the (HPA-5b) Bra antigen frequency in this population will be approximately 16.0% with a gene frequency of 8.0%. It is concluded that this assay is an attractive technique for genotyping of the HPA-5 (Bra/Brb) alloantigens on genomic DNA. The technique can replace serological alloantigen typing, especially in cases where platelets and rare human alloantisera are not available.
- Published
- 2009
- Full Text
- View/download PDF
8. Bradycardic response during submersion in infant swimming
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E Goksör, L Rosengren, and G Wennergren
- Subjects
Pediatrics, Perinatology and Child Health ,General Medicine - Published
- 2007
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- View/download PDF
9. The DECOVALEX test—Case one
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Jonny Rutqvist, A. Makurat, L. Rosengren, M.P. Ahola, K. Khair, and J. Noorishad
- Subjects
musculoskeletal diseases ,Engineering ,Computer simulation ,business.industry ,General Engineering ,Experimental data ,Mechanics ,Test method ,Shear (geology) ,Rock mechanics ,Shear stress ,Geotechnical engineering ,business ,Material properties ,Shear flow - Abstract
This test case is based on experimental data from a study of the mechanical and hydraulic reaction of a natural rough joint upon normal and shear stress loading. The test was conducted in NGI's Coupled Shear Flow Test apparatus, which allows large diameter jointed rock cores to be tested under controlled boundary stresses with multiple loading-unloading cycles. Five teams have modelled two joints, using finite and discrete element codes with different joint constitutive laws. The simulation results agree well with the experimental data during pure normal stress loading, and less well for shear displacement induced joint dilation.
- Published
- 1995
- Full Text
- View/download PDF
10. Fabrication of 45° mirrors together with well-defined v-grooves using wet anisotropic etching of silicon
- Author
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L. Rosengren, Ylva Bäcklund, C. Strandman, and Hakan Elderstig
- Subjects
Fabrication ,Materials science ,Silicon ,business.industry ,Mechanical Engineering ,Single-mode optical fiber ,chemistry.chemical_element ,Isotropic etching ,Surface micromachining ,Optics ,chemistry ,Etching (microfabrication) ,Wafer ,Electrical and Electronic Engineering ,business ,Groove (music) - Abstract
The most commonly used microstructure for passive fiber alignment is the ordinary v-groove, defined by {111} planes on a (100) silicon wafer. The plane at the end of the groove, having a 54.7/spl deg/ angle to the surface, can be used as a reflecting mirror. For single-mode fiber applications, a 45/spl deg/ mirror is advantageous together with high accuracy in the position of the fiber, i.e. a smooth mirror and good control of the groove geometry is needed. Two techniques are presented to form 45/spl deg/ mirrors along with well-defined grooves in silicon, using the wet anisotropic etchants EDP and KOH. These techniques are used: (1) to reveal {110} planes on (100) silicon and (2) to make {111} mirrors on wafers that are cut 9.7/spl deg/ off the [100] axis. On (100) silicon, EDP without pyrazine gave the best result. The best mirror and groove reproducibility was found on off-axis cut silicon, using 36 wt.% KOH, with isopropyl alcohol added.
- Published
- 1995
- Full Text
- View/download PDF
11. Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) Farm Program: results from finisher pig surveillance
- Author
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A, Deckert, S, Gow, L, Rosengren, D, Léger, B, Avery, D, Daignault, L, Dutil, R, Reid-Smith, and R, Irwin
- Subjects
Swine Diseases ,Canada ,Swine ,Microbial Sensitivity Tests ,Anti-Bacterial Agents ,Feces ,Salmonella ,Drug Resistance, Multiple, Bacterial ,Population Surveillance ,Salmonella Infections ,Escherichia coli ,Animals ,Humans ,Escherichia coli Infections - Abstract
In 2006, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) Farm Program was implemented in sentinel grower-finisher swine herds in Québec, Ontario, Manitoba, Saskatchewan and Alberta. Herds were visited 1-3 times annually. Faecal samples were collected from pens of close-to-market (CTM) weight (80 kg) pigs and antimicrobial use (AMU) data were collected via questionnaires. Samples were cultured for generic Escherichia coli and Salmonella and tested for antimicrobial susceptibility. This paper describes the findings of this program between 2006 and 2008. Eighty-nine, 115 and 96 herds participated in this program in 2006, 2007 and 2008 respectively. Over the 3 years, antimicrobial resistance (AMR) levels remained consistent. During this period, resistance to one or more antimicrobials was detected in 56-63% of the Salmonella spp. isolates and 84-86% of E. coli isolates. Resistance to five or more antimicrobials was detected in 13-23% of Salmonella and 12-13% of E. coli. Resistance to drugs classified as very important to human health (Category I) by the Veterinary Drug Directorate (VDD), Health Canada, was less than or equal to 1% in both organisms. AMU data were provided by 100 herds in 2007 and 95 herds in 2008. Nine herds in 2007 and five herds in 2008 reported no AMU. The most common route of antimicrobial administration (75-79% of herds) was via feed, predominantly macrolides/lincosamides (66-68% of herds). In both 2007 and 2008, the primary reasons given for macrolide/lincosamide use were disease prevention, growth promotion and treatment of enteric disease. The Category I antimicrobials, ceftiofur and virginiamycin were not used in feed or water in any herds in 2008, but virginiamycin was used in feed in two herds in 2007. Parenteral ceftiofur was used in 29 herds (29%) in 2007 and 20 herds (21%) in 2008. The reasons for ceftiofur use included treatment of lameness, respiratory disease and enteric disease.
- Published
- 2010
12. Light subunit of neurofilament triplet protein in the cerebrospinal fluid after subthalamic nucleus stimulation for Parkinson's disease
- Author
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R, Constantinescu, B, Holmberg, L, Rosengren, O, Corneliusson, B, Johnels, and H, Zetterberg
- Subjects
Male ,Neurofilament Proteins ,Subthalamic Nucleus ,Deep Brain Stimulation ,Nerve Degeneration ,Humans ,Female ,Parkinson Disease ,Middle Aged ,Biomarkers ,Time - Abstract
Cerebrospinal fluid (CSF) levels of neurofilament triplet protein (NFL), a non-specific marker of neuronal damage, are normal in Parkinson's disease (PD) but increased after brain trauma and in several neurological disorders. Using longitudinal CSF-NFL measurements as an indicator of neuronal damage, this study investigated the impact of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on the brain, directly following the surgical intervention and in chronically treated patients with PD.CSF-NFL levels were measured consecutively in eight patients with PD before and after STN-DBS treatment.CSF-NFL levels were normal prior to STN-DBS and increased sharply during the first 2 weeks post-operatively, but normalized after 12 months or more.The STN-DBS procedure leads to an acute but limited neuronal damage, as expected. However, normal CSF-NFL levels at 12 months post-operatively and beyond suggest the absence of any long-term neuronal damage caused by long-term STN-DBS stimulation.
- Published
- 2010
13. No neurochemical evidence of brain injury after blast overpressure by repeated explosions or firing heavy weapons
- Author
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K, Blennow, M, Jonsson, N, Andreasen, L, Rosengren, A, Wallin, P A, Hellström, and H, Zetterberg
- Subjects
Adult ,Male ,Blast Injuries ,Brain Injuries ,Explosions ,Humans ,Female ,Weapons - Abstract
Psychiatric and neurological symptoms are common among soldiers exposed to blast without suffering a direct head injury. It is not known whether such symptoms are direct consequences of blast overpressure.To examine if repeated detonating explosions or firing if of heavy weapons is associated with neurochemical evidence of brain damage.Three controlled experimental studies. In the first, army officers were exposed to repeated firing of a FH77B howitzer or a bazooka. Cerebrospinal fluid (CSF) was taken post-exposure to measure biomarkers for brain damage. In the second, officers were exposed for up to 150 blasts by firing a bazooka, and in the third to 100 charges of detonating explosives of 180 dB. Serial serum samples were taken after exposure. Results were compared with a control group consisting of 19 unexposed age-matched healthy volunteers.The CSF biomarkers for neuronal/axonal damage (tau and neurofilament protein), glial cell injury (GFAP and S-100b), blood-brain barrier damage (CSF/serum albumin ratio) and hemorrhages (hemoglobin and bilirubin) and the serum GFAP and S-100b showed normal and stable levels in all exposed officers.Repeated exposure to high-impact blast does not result in any neurochemical evidence of brain damage. These findings are of importance for soldiers regularly exposed to high-impact blast when firing artillery shells or other types of heavy weapons.
- Published
- 2010
14. Cerebrospinal fluid biomarkers of white matter lesions - cross-sectional results from the LADIS study
- Author
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M, Jonsson, H, Zetterberg, E, van Straaten, K, Lind, S, Syversen, A, Edman, K, Blennow, L, Rosengren, L, Pantoni, D, Inzitari, and A, Wallin
- Subjects
Aged, 80 and over ,Male ,Brain Diseases ,Sulfoglycosphingolipids ,Brain ,Receptors, Cell Surface ,tau Proteins ,Nerve Fibers, Myelinated ,Severity of Illness Index ,Spinal Puncture ,Protease Nexins ,Amyloid beta-Protein Precursor ,Cross-Sectional Studies ,Neurofilament Proteins ,Albumins ,Humans ,Female ,Longitudinal Studies ,Phosphorylation ,Biomarkers ,Aged - Abstract
White matter lesions (WMLs) caused by small vessel disease are common in elderly people and contribute to cognitive impairment. There are no established biochemical markers for WMLs. We aimed to study the relation between degree of WMLs rated on magnetic resonance imaging of the brain and cerebrospinal fluid (CSF) levels of structural biomarkers associated with Alzheimer's disease (AD) and subcortical vascular dementia.Fifty-three non-demented elderly individuals with WMLs were subjected to lumbar puncture. Degree of WMLs was rated using the Fazekas scale. Volumetric assessment of WMLs was performed. CSF samples were analyzed for the 40 and 42 amino acid fragments of amyloid beta, alpha- and beta-cleaved soluble amyloid precursor protein, total tau (T-tau), hyperphosphorylated tau (P-tau(181)), neurofilament light protein (NFL), sulfatide and CSF/Serum-albumin ratio.Fifteen subjects had mild, 23 had moderate and 15 had severe degree of WMLs. CSF-NFL levels differed between the groups (P0.001) and correlated with the volume of WMLs (r = 0.477, P0.001). CSF sulfatide concentration displayed similar changes but less strongly. T-tau, P-tau(181) and the different amyloid markers as well as CSF/S-albumin ratio did not differ significantly between the groups.The association of increased CSF-NFL levels with increasing severity of WMLs in non-demented subjects suggests that NFL is a marker for axonal damage in response to small vessel disease in the brain. This manifestation may be distinct from or earlier than the neurodegenerative process seen in AD, as reflected by the lack of association between WMLs and AD biomarkers.
- Published
- 2009
15. Apolipoprotein E polymorphism and gender difference in outcome after severe traumatic brain injury
- Author
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M, Ost, K, Nylén, L, Csajbok, K, Blennow, L, Rosengren, and B, Nellgård
- Subjects
Adult ,Aged, 80 and over ,Male ,Polymorphism, Genetic ,Adolescent ,Genotype ,Middle Aged ,Prognosis ,Polymerase Chain Reaction ,Cohort Studies ,Survival Rate ,Young Adult ,Apolipoproteins E ,Sex Factors ,Double-Blind Method ,Brain Injuries ,Humans ,Female ,Prospective Studies ,Child ,Aged - Abstract
Traumatic brain injury (TBI) is one of the most common causes of death and dismal outcome among children and young adults. The morbidity and mortality differ but more aggressive monitoring and more designated neuro intensive care units have improved the results. Studies have demonstrated a connection between apolipoprotein E (APOE) genotype and outcome after TBI, but few are prospective and none is from northern Europe. APOE has three alleles: epsilon2, epsilon3 and epsilon4.A total of 96 patients with Glasgow coma score (GCS)or =8 were prospectively and consecutively included. APOE genotypes were all analyzed at the same laboratory from blood samples by polymerase chain reaction-restriction fragment length polymorphism.All patients were assessed at 1 year with Glasgow outcome scale extended (GOSE), National Institute of Health Stroke Scale (NIHSS) and the Barthel daily living index. The genotype was available in all patients. Twenty-six patients expressed APOE epsilon4 while 70 patients did not. Outcome demonstrated that patients with APOE epsilon4 had worse outcome vs. those lacking this allele. When subdividing patients into gender, males with APOE epsilon4 did worse, a difference not detected among female patients.APOE epsilon4 correlated to worse outcome in TBI patients. We also found that males with APOE epsilon4 had poor outcome while females did not. Thus, the results indicate that genetic polymorphism may influence outcome after TBI.
- Published
- 2008
16. Mid-life adiposity factors relate to blood-brain barrier integrity in late life
- Author
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D R, Gustafson, C, Karlsson, I, Skoog, L, Rosengren, L, Lissner, and K, Blennow
- Subjects
Aged, 80 and over ,Leptin ,Middle Aged ,Overweight ,Blood-Brain Barrier ,Albumins ,Sex Hormone-Binding Globulin ,Linear Models ,Humans ,Female ,Obesity ,Biomarkers ,Serum Albumin ,Aged ,Retrospective Studies - Abstract
We explored the relationship between adiposity factors measured during mid-life and blood-brain barrier (BBB) integrity measured via the cerebrospinal fluid/serum (CSF/S) albumin ratio in late life. Adiposity factors included body mass index and blood levels of sex hormone binding globulin (SHBG) and leptin. Design. Retrospective analyses over 24 years within a longitudinal study.Population-based sample. Subjects. Eighty-one women.CSF/S albumin ratio.The CSF/S albumin ratio measured at age 70-84 years was higher amongst women who were overweight or obese (6.50 +/- 2.79 vs. 5.23 +/- 1.61, age-adjusted P = 0.012), and was inversely correlated with SHBG (age-adjusted r = -0.321, P0.005) at age 46-60 years. In stepwise regression models, SHBG predicted the CSF/S albumin ratio (beta = -0.017, R2 = 0.107, P = 0.007). The best model (R2 = 0.187) predicting CSF/S albumin ratio included SHBG, age group (age 46 years versus46), overweight or obesity, and an age group by SHBG interaction.Lower levels of SHBG in mid-life were related to worse BBB integrity in women after 24 years in late life, even considering other adiposity factors. SHBG may be important for understanding sex hormone-mediated mechanisms in brain health or as an independent marker of adipose tissue, the largest endocrine organ.
- Published
- 2007
17. Cerebrospinal fluid neurofilament light levels in amyotrophic lateral sclerosis: impact of SOD1 genotype
- Author
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H, Zetterberg, J, Jacobsson, L, Rosengren, K, Blennow, and P M, Andersen
- Subjects
Adult ,Aged, 80 and over ,Central Nervous System ,Male ,Genotype ,Superoxide Dismutase ,Amyotrophic Lateral Sclerosis ,Middle Aged ,Prognosis ,Sensitivity and Specificity ,Superoxide Dismutase-1 ,Neurofilament Proteins ,Predictive Value of Tests ,Humans ,Female ,Biomarkers ,Aged ,Cerebrospinal Fluid - Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative syndrome with familial and sporadic forms. Most ALS-associated mutations are found in the superoxide dismutase 1 (SOD1) gene. We conducted a study including 60 sporadic and 19 familial ALS patients, 206 reference patients with other neurological disorders and 40 age- and sex-matched healthy controls to test the hypothesis that cerebrospinal fluid (CSF) levels of neurofilament light (NF-L) protein, a marker of axonal degeneration, might provide diagnostic and prognostic information on the disease. All ALS patients were screened for SOD1 mutations. Ten of the familial and five of the sporadic cases carried SOD1 mutations. NF-L concentration [median (range)] was strongly elevated in ALS [2110 (255-10 800) ng/l] compared with reference patients and healthy controls [277 (125-15 506) and 175 (125-710) ng/l, respectively, P0.001] and correlated inversely with disease duration (Spearman R = -0.518, P = 0.001). NF-L levels were lower in SOD1 mutation-associated ALS compared with SOD1 wild-type (wt) ALS (P = 0.03). In conclusion, CSF NF-L levels may provide both diagnostic and prognostic information, particularly in SOD1 wt ALS.
- Published
- 2007
18. Piezoelectric shear force detection: A geometry avoiding critical tip/tuning fork gluing
- Author
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M. Spajer, K. Hjort, S. Davy, J. Salvi, P. Chevassus, D. Courjon, A. Mouflard, and L. Rosengren
- Subjects
Materials science ,Microscope ,business.industry ,Shear force ,Piezoelectricity ,law.invention ,Amplitude ,Optics ,Optical microscope ,law ,Adhesive ,Dither ,Tuning fork ,business ,Instrumentation - Abstract
A technique for controlling the tip–sample distance in near-field optical microscopes is presented. It consists of mechanically exciting a fiber tip inserted without any adhesive between the two prongs of a high Q-piezoelectric tuning fork. The detection of the shear forces is classically achieved by measuring the decrease of the dithering amplitude when the tip approaches the surface. This simple setup greatly simplifies tip replacement and its resonance frequency tuning.
- Published
- 1998
- Full Text
- View/download PDF
19. Increased levels of GFAP in the cerebrospinal fluid in three subtypes of genetically confirmed Alexander disease
- Author
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L. Rosengren, L.-M. Wiklund, Mårten Kyllerman, and E. Holmberg
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Screening test ,DNA Mutational Analysis ,macromolecular substances ,Gene mutation ,medicine.disease_cause ,Central nervous system disease ,Cerebrospinal fluid ,Degenerative disease ,Albumins ,Glial Fibrillary Acidic Protein ,medicine ,Humans ,Child ,Mutation ,Glial fibrillary acidic protein ,biology ,business.industry ,Tomography, X-Ray ,S100 Proteins ,Brain ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Alexander disease ,nervous system ,Pediatrics, Perinatology and Child Health ,biology.protein ,Female ,Neurology (clinical) ,Alexander Disease ,business - Abstract
GFAP levels in the CSF were highly elevated in three genetically confirmed cases of Alexander disease clinically conforming with infantile, early and late juvenile forms. No other CSF abnormalities were detected. Assay of CSF-GFAP may prove to be a rapid and cost-effective screening test in clinical variants of Alexander disease and an indicator of GFAP gene mutations.
- Published
- 2005
20. Fabrication of 45° optical mirrors on
- Author
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C. Strundman, L. Rosengren, and Y. Backlund
- Subjects
Fabrication ,Materials science ,business.industry ,Optoelectronics ,business - Published
- 2005
- Full Text
- View/download PDF
21. Neurofilament light protein and glial fibrillary acidic protein as biological markers in MS
- Author
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J. R. Avasarala, J. N. Lycke, C. Malmestrom, S. Haghighi, L. Rosengren, and O. Andersen
- Subjects
Multiple Sclerosis ,S100 Proteins ,Confounding Factors, Epidemiologic ,S100 Calcium Binding Protein beta Subunit ,Sensitivity and Specificity ,Rats ,Adrenal Cortex Hormones ,Neurofilament Proteins ,Phosphopyruvate Hydratase ,Glial Fibrillary Acidic Protein ,Animals ,Humans ,Female ,Neurology (clinical) ,Nerve Growth Factors ,Biomarkers ,Menstrual Cycle - Published
- 2004
22. Cerebrospinal fluid markers in MS patients and their healthy siblings
- Author
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S, Haghighi, O, Andersen, A, Odén, and L, Rosengren
- Subjects
Adult ,Male ,Multiple Sclerosis ,Phenotype ,Neurofilament Proteins ,Case-Control Studies ,Siblings ,Glial Fibrillary Acidic Protein ,Humans ,Female ,Middle Aged ,Biomarkers - Abstract
In a previous study we found that nine of 47 siblings to multiple sclerosis (MS) patients with a normal neurological examination carry an intrathecal oligoclonal immunopathy with limited specificity, a condition we termed MS immunopathic trait. The purpose of this study is to further characterize the MS immunopathic trait phenotype. We found that the neurofilament light protein (NFL) and glial fibrillary acidic protein (GFAp) concentrations were increased in the group of patients with clinically definite MS (n = 47) in latent or slowly progressive phases. There was no increase in GFAp and NFL in cerebrospinal fluid in the healthy siblings of MS patients (n = 47), nor in the subgroup of these siblings with MS immunopathic trait (n = 9) compared with a group of healthy control subjects (n = 50). Thus, there was no indication of presymptomatic CNS parenchymal involvement in MS immunopathic trait.
- Published
- 2004
23. Neurofilament protein in cerebrospinal fluid: a marker of white matter changes
- Author
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M, Sjögren, M, Blomberg, M, Jonsson, L O, Wahlund, A, Edman, K, Lind, L, Rosengren, K, Blennow, and A, Wallin
- Subjects
Cerebral Cortex ,Male ,Amyloid beta-Peptides ,Dementia, Vascular ,Apolipoprotein E4 ,tau Proteins ,Middle Aged ,Magnetic Resonance Imaging ,Nerve Fibers, Myelinated ,Peptide Fragments ,Diagnosis, Differential ,Apolipoproteins E ,Sex Factors ,Alzheimer Disease ,Neurofilament Proteins ,Predictive Value of Tests ,Disease Progression ,Humans ,Female ,Wallerian Degeneration ,Biomarkers ,Serum Albumin ,Aged - Abstract
The objective of this study was to compare cerebrospinal fluid (CSF) levels of the light subtype of the neurofilament proteins (NFL), tau, and beta-amyloid42 (Abeta42) in individuals with moderate or severe white matter changes (WMC) and in those with mild or no WMC. Twenty-two patients with Alzheimer's disease (AD), nine patients with subcortical vascular dementia (SVD), and 20 normal controls were included in the study. The occurrence of WMC was evaluated by a neuroradiologist using the Blennow-Wallin scale. Thirty-seven subjects had no or only punctate WMC; 14 had moderate to severe WMC. Both diagnostic group and WMC, but not gender or apolipoproteinE E4 inheritance, contributed to the variance in the CSF levels of tau, NFL, and Abeta42. In patients with moderate to severe WMC, CSF NFL (P0.01), but not CSF tau or CSF Abeta42, was increased also after correction for age, gender, and degree of cognitive impairment. A comparison between patients and controls with any signs of WMC and those without such signs yielded a similar result: CSF NFL (P0.001) was increased in the group with signs of WMC. As in numerous previous studies, we found that CSF tau was increased in AD (P0.001) compared with controls. Furthermore, CSF NFL was increased in both AD and SVD compared with controls (P0.001 for both). Although diagnostic group seems to be a stronger predictor of the variance found in CSF NFL, a clear association between the presence of WMC and increased CSF NFL was found. Because NFL is located mainly in large myelinated axons, increased CSF NFL in individuals with WMC probably reflects axonal degeneration.
- Published
- 2001
24. Antisense inhibition of BCL-2 expression induces retinoic acid-mediated cell death during differentiation of human NT2N neurons
- Author
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S, Wang, L, Rosengren, A, Hamberger, and K, Haglid
- Subjects
Neurons ,DNA, Complementary ,Dose-Response Relationship, Drug ,Gene Expression ,Apoptosis ,Cell Differentiation ,Tretinoin ,Oligonucleotides, Antisense ,Proto-Oncogene Mas ,Clone Cells ,Up-Regulation ,Proto-Oncogene Proteins c-bcl-2 ,Neoplastic Stem Cells ,Humans ,Cell Division - Abstract
Changes in expression of the proto-oncogene Bcl-2 are well known in the developing brain, with a high expression level in young post-mitotic neurons that are beginning the outgrowth of processes. The physiological significance of the Bcl-2 up-regulation in these neurons is not fully understood. We used a differentiation model for human CNS neurons to study the expression and function of Bcl-2. NT2/D1 human neuronal precursor cells differentiated into a neuronal phenotype in the presence of 10 microM retinoic acid for 3-5 weeks. This concentration of retinoic acid was not toxic to undifferentiated NT2/D1 cells but was sufficient to up-regulate the BCL-2 protein in 6 days. The BCL-2 levels increased further after 3 weeks, i.e. when the cells started to show neuronal morphology. Inhibition of the accumulation of endogenous BCL-2 with vectors expressing the antisense mRNA of Bcl-2 caused extensive apoptosis after 3 weeks of the retinoic acid treatment. The loss of neuron-like cells from differentiating cultures indicated that the dead cells were those committed to neuronal differentiation. Death was related to the presence of retinoic acid since withdrawal of retinoic acid after 16 days of treatment dramatically increased cell surviving. The ability of BCL-2 to prevent retinoic acid-induced cell death was also confirmed in undifferentiated NT2/D1 cells that were transfected with a vector containing Bcl-2 cDNA in sense orientation and exposed to toxic doses (40-80 microM) of retinoic acid. Furthermore, down-regulation of BCL-2 levels by an antisense oligonucleotide in neuronally differentiated NT2/D1 cells increased their susceptibility to retinoic acid-induced apoptosis. These results indicate that one function of the up-regulation of endogenous BCL-2 during neuronal differentiation is to regulate the sensitivity of young post-mitotic neurons to retinoic acid-mediated apoptosis.
- Published
- 2001
25. Growth hormone increases connexin-43 expression in the cerebral cortex and hypothalamus
- Author
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N D, Aberg, B, Carlsson, L, Rosengren, J, Oscarsson, O G, Isaksson, L, Rönnbäck, and P S, Eriksson
- Subjects
Cerebral Cortex ,Hypothalamus ,Recombinant Proteins ,Rats ,Rats, Sprague-Dawley ,Reference Values ,Connexin 43 ,Growth Hormone ,Glial Fibrillary Acidic Protein ,Animals ,Humans ,Cattle ,Female ,Insulin-Like Growth Factor I ,Hypophysectomy - Abstract
Several studies indicate that systemic GH influences various brain functions. Connexin-43 forms gap junctions that mediate intercellular communication and establish the astroglial syncytium. We investigated the effects of peripheral administration of bovine GH (bGH) and recombinant human insulin-like growth factor I (rhIGF-I) on the expression of connexin-43 in the rat brain. Hypophysectomized female Sprague Dawley rats were substituted with cortisol (400 microg/kg x day) and L-T4 (10 microg/kg x day) and treated with either bGH (1 mg/kg x day) or rhIGF-I (0.85 mg/kg x day) for 19 days. The abundance of connexin-43 messenger RNA (mRNA) and protein in the brainstem, cerebral cortex, hippocampus, and hypothalamus was quantified by means of ribonuclease protection assays and Western blots. Treatment with bGH increased the amounts of connexin-43 mRNA and protein in the cerebral cortex and hypothalamus. No changes were found in the brainstem or hippocampus. Infusion of rhIGF-I did not affect connexin-43 mRNA or protein levels in any of the brain regions studied. These results show that administration of bGH increases the abundance of cx43 in specific brain regions, suggesting that GH may influence gap junction formation and thereby intercellular communication in the brain.
- Published
- 2000
26. Extracellular glial fibrillary acidic protein and amino acids in brain regions of patients with subarachnoid hemorrhage--correlation with level of consciousness and site of bleeding
- Author
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L. Rosengren, Hamberger A, Runnerstam M, C von Essen, and Nyström B
- Subjects
Adult ,Male ,medicine.medical_specialty ,Microdialysis ,Taurine ,Subarachnoid hemorrhage ,Consciousness ,Brain Edema ,Biology ,Aneurysm, Ruptured ,chemistry.chemical_compound ,Internal medicine ,Extracellular fluid ,Glial Fibrillary Acidic Protein ,medicine ,Extracellular ,Humans ,Amino Acids ,chemistry.chemical_classification ,Glial fibrillary acidic protein ,Vasospasm ,Intracranial Aneurysm ,General Medicine ,Cerebral Infarction ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Temporal Lobe ,Amino acid ,Endocrinology ,Neurology ,chemistry ,Anesthesia ,Cerebrovascular Circulation ,biology.protein ,Female ,Neurology (clinical) ,Extracellular Space - Abstract
The extracellular fluid of two cortical regions was investigated in eight patients who underwent surgery for subarachnoid hemorrhage within 7-96 h after the rupture of an arterial aneurysm. Microdialysis samples, collected from the cortex of the ipsilateral gyrus rectus and temporal lobe for 52-127 h, were analyzed with respect to amino acids and the glial fibrillary acidic protein. In agreement with a previous study, an inverse relation was observed between total amino acid concentration and the level of consciousness. We also found that the concentration of glial fibrillary acidic protein was higher close to the bleeding site. Furthermorel we observed specific changes in the concentration of the protein and certain amino acids which coincided with clinical events such as increased intracranial pressure, vasospasm, ischemia and infarction. Finally, the concentrations of taurine may corroborate its function as an osmoequivalent. [Neural Res 1997; 19: 361-368]
- Published
- 1997
27. Analysis of glial fibrillary acidic protein in the cerebrospinal fluid of children investigated for encephalopathy
- Author
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S. Ehlers, L. Rosengren, and M. Kyllerman
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Adolescent ,Encephalopathy ,Enzyme-Linked Immunosorbent Assay ,Epilepsies, Myoclonic ,Glutaric aciduria type 1 ,Central nervous system disease ,Epilepsy ,Cerebrospinal fluid ,Neuronal Ceroid-Lipofuscinoses ,Internal medicine ,Glial Fibrillary Acidic Protein ,medicine ,Rett Syndrome ,Humans ,Child ,Dominance (genetics) ,Pantothenate Kinase-Associated Neurodegeneration ,Brain Diseases ,Glial fibrillary acidic protein ,biology ,business.industry ,Infant, Newborn ,General Medicine ,medicine.disease ,Endocrinology ,Huntington Disease ,El Niño ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,biology.protein ,Female ,Neurology (clinical) ,business - Abstract
The clinical application of a newly developed highly sensitive ELISA method (20) to assay glial fibrillary acidic protein (GFAP) in the cerebrospinal fluid (CSF) was investigated in children and adolescents with neurological disorders. GFAP analysis was explored as a tool to differentiate disorders with ongoing astrocytosis. A consecutive series of 34 subjects, 17 boys and 17 girls, with nonprogressive and progressive neurological encephalopathies was compared to 10 healthy controls. The mean CSF GFAP concentration of the controls was 60.6 ± 54 ng/l (SD). The group of 24 subjects (12 boys and 12 girls) with progressive neurologic disorders had higher mean CSF GFAP levels than the group of 10 subjects (5 boys and 5 girls) with non-progressive disorders, 222.6 ± 186 and 127.5 ± 86 ng/l, respectively. The progressive encephalopathies differed significantly from controls (p < 0.01) while the non-progressive did not. The mean GFAP concentration of the epilepsy cases (n = 18) and non-epilepsy cases (n = 16) was 212.9 ± 196 and 174.0 ± 132 ng/l, respectively. The epilepsy cases differed significantly from controls which could be explained by the dominance of progressive cases (15 out of 18). Six subjects with known gliotic progressive disorders (glutaric aciduria Type 1, Unverricht-Lundborg disease, Hallervorden-Spatz disease, Jansky-Bielschowsky disease and juvenile Huntington disease) differed significantly, as expected, from controls with a mean CSF GFAP concentration of 326.2 ± 132.5 ng/l, p < 0.001. The group with Lennox-Gastaut syndrome (3 boys and 3 girls) also differed significantly from controls (205.0 ± 107.6, p
- Published
- 1994
28. Brain specific proteins in posthaemorrhagic ventricular dilatation
- Author
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L Rosengren, Mats Blennow, and A Whitelaw
- Subjects
Pathology ,medicine.medical_specialty ,Neurofilament ,Glial fibrillary acidic protein ,biology ,business.industry ,Obstetrics and Gynecology ,Original Articles ,General Medicine ,medicine.disease ,Central nervous system disease ,White matter ,Pathogenesis ,Cerebrospinal fluid ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Parenchyma ,Cerebral ventricle ,medicine ,biology.protein ,business - Abstract
Median neurofilament and glial fibrillary acidic protein concentrations in the cerebrospinal fluid of 18 infants with posthaemorrhagic ventricular dilatation were 20-200 times higher than control values. S-100 protein in cerebrospinal fluid was four times higher than control values. Glial fibrillary acidic protein concentrations correlated with death or disability and with parenchymal lesions but not with shunt dependence.
- Published
- 2001
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- View/download PDF
29. Brain specific proteins in the cerebrospinal fluid: markers of damage to the periventricular white matter and prognosis after intraventricular haemorrhage
- Author
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Andrew Whitelaw, L Rosengren, and Mats Blennow
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,Pathology ,medicine.medical_specialty ,Cerebrospinal fluid ,nervous system ,business.industry ,Pediatrics, Perinatology and Child Health ,Medicine ,cardiovascular diseases ,Periventricular white matter ,business ,nervous system diseases - Abstract
Brain specific proteins in the cerebrospinal fluid: markers of damage to the periventricular white matter and prognosis after intraventricular haemorrhage
- Published
- 1999
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30. Increased Levels of Brain Specific Proteins in the Cerebrospinal Fluid after Full Term Asphyxia 1854
- Author
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M Blennow, K Sävman, P Ilves, M Thoresen, H Hagberg, and L Rosengren
- Subjects
Pediatrics, Perinatology and Child Health - Published
- 1998
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- View/download PDF
31. Immunohistochemical distribution of S-100 antigen in the urinary system of man and rat
- Author
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Steno Sentinelli, D. Cocchia, Vito M. Stolfi, K. Haglid, Fabrizio Michetti, L. Rosengren, Libero Lauriola, and Nicola Maggiano
- Subjects
Pathology ,medicine.medical_specialty ,Urinary system ,Urinary Bladder ,Biology ,Kidney ,Immunoenzyme Techniques ,Species Specificity ,Urethra ,Antigen ,medicine ,Animals ,Humans ,Distribution (pharmacology) ,Urinary Tract ,Electron microscopic ,S100 Proteins ,Rats, Inbred Strains ,Cell Biology ,Anatomy ,Rats ,Staining ,Microscopy, Electron ,medicine.anatomical_structure ,Thin limbs ,Immunohistochemistry ,Ureter - Abstract
The immunohistochemical distribution of S-100, a protein originally isolated from the brain, has been investigated at the light and electron microscopic levels in rat and man urinary systems. In both species the antigen essentially exhibited the same location, restricted, with different degrees of staining, to certain cells in the kidney, i.e. collecting tubules, thin limbs of Henle's loop and renal papillae.
- Published
- 1985
- Full Text
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32. Successful transplantation of a human midgut carcinoid tumour to the anterior eye chamber of the rat
- Author
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L. Rosengren, Ola Nilsson, G. Skolnik, Annica Dahlström, K. O. Grönstad, Håkan Ahlman, and C. Briving
- Subjects
Male ,Serotonin ,Pathology ,medicine.medical_specialty ,Anterior Chamber ,Physiology ,Transplantation, Heterologous ,Cyclosporins ,Rats, Inbred Strains ,Carcinoid Tumor ,Anatomy ,Biology ,Models, Biological ,Rats ,Transplantation ,Intestinal Neoplasms ,medicine ,Animals ,Immunosuppressive Agents ,Neoplasm Transplantation ,Midgut carcinoid - Published
- 1984
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33. Decreased morphine intake by opiate addicted rats administered zimelidine, a 5-HT uptake inhibitor
- Author
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L. Rönnbäck, J. Zeuchner, Sven-Ove Ögren, A. Wronski, and L. Rosengren
- Subjects
Male ,medicine.medical_specialty ,Pharmacology ,5 ht uptake ,Internal medicine ,medicine ,Ingestion ,Animals ,Humans ,Receptor ,5-HT receptor ,Zimelidine ,Dose-Response Relationship, Drug ,Morphine ,Quinine ,Zimeldine ,Rats, Inbred Strains ,Feeding Behavior ,Rats ,Dose–response relationship ,Endocrinology ,Receptors, Serotonin ,Female ,Opiate ,Psychology ,Morphine Dependence ,medicine.drug - Abstract
Zimelidine, a specific 5-HT uptake inhibitor, reduced peroral morphine consumption by morphine-addicted adult male and female Sprague-Dawley rats and old male rats in choice tests. The effect was dose dependent in male rats. Thus, the availability of central 5-HT appears to be important for the regulation of morphine preference in rat. The results are discussed in relation to recent literature where ethanol preference has been found to be attenuated by zimelidine. The results may provide insights into the complex cellular mechanisms underlying opiate addiction.
- Published
- 1984
34. The connection between Uveitis and pulp infection
- Author
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M, Gjotterberg and L, Rosengren
- Subjects
Uveitis ,Dental Pulp Diseases ,Humans - Published
- 1989
35. Dopaminergic terminals in the rat locus coeruleus: an immunocytochemical investigation
- Author
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L. Rosengren, I. Augustsson, K. Haglid, Amanda McRae-Degueurce, and Annica Dahlström
- Subjects
medicine.medical_specialty ,Physiology ,Dopamine ,Central nervous system ,Biology ,Receptors, Dopamine ,Midbrain ,chemistry.chemical_compound ,Biogenic amine ,Internal medicine ,medicine ,Animals ,Neurotransmitter ,chemistry.chemical_classification ,Nerve Endings ,Dopaminergic ,Rats, Inbred Strains ,Immunohistochemistry ,Rats ,Endocrinology ,medicine.anatomical_structure ,chemistry ,Catecholamine ,Locus coeruleus ,Locus Coeruleus ,Neuroscience ,medicine.drug - Published
- 1988
36. Amino acid incorporation into total protein and levels of S-100 protein in discrete rat brain areas after prolonged protein or amino acid restriction
- Author
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L, Rosengren, A, Wroński, K G, Haglid, J, Jarlstedt, and L, Rönnbäck
- Subjects
Male ,Immune Sera ,Protein Deficiency ,S100 Proteins ,Animals ,Brain ,Nerve Tissue Proteins ,Amino Acids ,Immunoelectrophoresis ,Rats - Abstract
Young adult rats were fed an isocaloric diet for 28 days. The diet consisted of either 22% casein, or protein-restricted food consisting of a 5% mixture of soy and whey protein, or a synthetic amino acid mixed diet devoid of the essential amino acids tryptophan, valine, lysine, and threonine. The level of the nervous tissue-specific S-100 protein was quantified immunoelectrophoretically in 9 different brain areas. A marked decrease of S-100 was observed in hippocampus and posterior part of the cerebellar vermis per g wet weight in protein-restricted rats. An additional lowering was noticed in sensory motor cortex per mg soluble protein. This effect was potentiated with the amino acid-deficient diet. The in vitro incorporation of 3H-leucine into cerebellar proteins was slightly decreased in the low-protein-fed rats, and more markedly decreased in those receiving an amino acid-restricted diet.
- Published
- 1977
37. Self-reported sleep disturbances and its determinants in people 1 year or more after stroke: A cross-sectional study.
- Author
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Nilsson HM, Kähler M, Rosengren L, Jacobsson L, and Lexell J
- Abstract
Background: Survivors of stroke commonly report sleep disturbances. Studies of sleep disturbances after stroke are mostly performed in the acute phase. An increased knowledge of sleep disturbances and its determinants a longer time after stroke is needed to improve treatment and rehabilitation., Objective: To assess survivors of stroke more than 1 year after stroke onset and (1) investigate self-reported sleep disturbances and (2) explore the association between self-reported sleep disturbances, gender, age, time since stroke, other stroke characteristics, and sociodemographic data., Design: Cross-sectional survey., Setting: Community setting., Participants: Participants (n = 160) in the Life After Stroke In Northern Sweden Study (LASINS) (46% women, mean age 73 years, mean time since stroke 35 months)., Interventions: Not applicable., Main Outcome Measurements: Pittsburgh Sleep Quality Index (PSQI), stroke characteristics (time since stroke, first time stroke, type of stroke, location of stroke, stroke treatment and comorbidities) and sociodemographic data (gender, age, marital status, vocational situation, need for home help, and use of mobility devices)., Results: A total of 84 participants (53%) rated 6 points or more on the PSQI (mean 6.5 points, SD: ±4.2, min-max 0-18), indicating sleep disturbances. Gender (p = .002) and use of mobility devices (p = .036) explained 9.5% of the variance in PSQI., Conclusion: Survivors of stroke report sleep disturbances even several years after stroke onset. Women and those using mobility devices, indicating less recovery after stroke, report sleep disturbances to a higher degree, regardless of chronological age, time since stroke onset, other stroke characteristics, comorbidities, and sociodemographic data. Further studies with a longitudinal design are needed to gain a comprehensive understanding of how stroke-related factors and other reasons account for poststroke sleep disturbances in order to improve treatment and rehabilitation., (© 2025 The Author(s). PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.)
- Published
- 2025
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38. Self-reported physical activity more than 1 year after stroke and its determinants in relation to the WHO recommendations.
- Author
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Kähler M, Nilsson HM, Rosengren L, Jacobsson L, and Lexell J
- Abstract
Background: Physical activity (PA) after stroke has significant health benefits if it is conducted regularly, with sufficient intensity and duration. Because of the health benefits, it is important to identify those below the World Health Organization (WHO) recommended level of PA. However, few studies have assessed the level of PA after stroke in relation to the WHO recommendations and which sociodemographic factors and stroke characteristics are associated with those below the WHO recommendations., Objective: To assess survivors of stroke at least 1 year after onset and (1) describe their self-reported level of PA; (2) explore the association between PA, sociodemographics, and stroke characteristics, and (3) determine the characteristics of those below the WHO recommended level of PA., Design: Cross-sectional descriptive survey., Setting: Community settings., Participants: Data were collected from 160 survivors of stroke (mean age 73 years, 46% women, mean time since stroke onset 35 months)., Interventions: Not applicable., Main Outcome Measures: The Swedish National Board of Health and Welfare Physical Activity Questionnaire and the following sociodemographics and stroke characteristics: gender, age, marital status, vocational situation, need for home help, use of mobility devices, time since stroke onset, first-time stroke, type of stroke, location of stroke, and stroke treatment., Results: Two thirds (66.3%) of the participants were below the WHO recommendations. The hierarchical regression analysis explained 13% of the variance in PA with need for home help as a single significant contributor. Those who did not meet the WHO recommendations were significantly older, more likely to live alone, and in need of home help and mobility devices., Conclusions: A majority of survivors of stroke do not meet the WHO recommended level of PA. Future studies should assess how other factors characterize those who are physically inactive. This knowledge could help rehabilitation professionals to target interventions and self-management programs to promote PA among survivors of stroke., (© 2025 The Author(s). PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.)
- Published
- 2025
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39. Video support for prehospital stroke consultation: implications for system design and clinical implementation from prehospital simulations.
- Author
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Candefjord S, Andersson Hagiwara M, Sjöqvist BA, Karlsson JE, Nordanstig A, Rosengren L, and Söderholm HM
- Subjects
- Humans, Patient Simulation, Remote Consultation, Referral and Consultation, Neurologists, Emergency Medical Services standards, Stroke therapy, Video Recording
- Abstract
Background: Video consultations between hospital-based neurologists and Emergency Medical Services (EMS) have potential to increase precision of decisions regarding stroke patient assessment, management and transport. In this study we explored the use of real-time video streaming for neurologist-EMS consultation from the ambulance, using highly realistic full-scale prehospital simulations including role-play between on-scene EMS teams, simulated patients (actors), and neurologists specialized in stroke and reperfusion located at the remote regional stroke center., Methods: Video streams from three angles were used for collaborative assessment of stroke using the National Institutes of Health Stroke Scale (NIHSS) to assess symptoms affecting patient's legs, arms, language, and facial expressions. The aim of the assessment was to determine appropriate management and transport destination based on the combination of geographical location and severity of stroke symptoms. Two realistic patient scenarios were created, with severe and moderate stroke symptoms, respectively. Each scenario was simulated using a neurologist acting as stroke patient and an ambulance team performing patient assessment. Four ambulance teams with two nurses each all performed both scenarios, for a total of eight cases. All scenarios were video recorded using handheld and fixed cameras. The audio from the video consultations was transcribed. Each team participated in a semi-structured interview, and neurologists and actors were also interviewed. Interviews were audio recorded and transcribed., Results: Analysis of video-recordings and post-interviews (n = 7) show a more thorough prehospital patient assessment, but longer total on-scene time, compared to a baseline scenario not using video consultation. Both ambulance nurses and neurologists deem that video consultation has potential to provide improved precision of assessment of stroke patients. Interviews verify the system design effectiveness and suggest minor modifications., Conclusions: The results indicate potential patient benefit based on a more effective assessment of the patient's condition, which could lead to increased precision in decisions and more patients receiving optimal care. The findings outline requirements for pilot implementation and future clinical tests., (© 2024. The Author(s).)
- Published
- 2024
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40. Real-World Treatment Patterns and Survival Outcomes for Patients with Non-Metastatic Non-Small-Cell Lung Cancer in Sweden: A Nationwide Registry Analysis from the I-O Optimise Initiative.
- Author
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Oskarsdottir GN, Lampa E, Berglund A, Rosengren L, Ulvestad M, Boros M, Daumont MJ, Rault C, Emanuel G, Leal C, Schoemaker MJ, and Wagenius G
- Abstract
Non-small-cell lung cancer (NSCLC) is the leading cause of cancer-related death worldwide, with ~40-50% of patients diagnosed with non-metastatic disease (stages IA-IIIC). The treatment landscape is evolving rapidly as immunotherapies and targeted therapy are introduced in the non-metastatic setting, creating a need to assess patient outcomes prior to their introduction. This real-world study using Swedish National Lung Cancer Registry data examined outcomes (overall survival (OS) and time to next treatment or death (TTNTD)) and treatment patterns for adults diagnosed with non-metastatic NSCLC. Baseline characteristics and OS from diagnosis were described for all patients; OS, treatment patterns, and TTNTD from treatment start were described for the treatment subgroup (patients diagnosed from 2014 onwards), stratified by disease stage and initial treatment. OS and TTNTD were described using the Kaplan-Meier estimator. The overall population (2008-2019) included 17,433 patients; the treatment subgroup included 5147 patients. Median OS (interquartile range) overall ranged from 83.3 (31.6-165.3) months (stage I patients) to 10.4 (4.3-24.2) months (stage IIIB patients). Among the treatment subgroup, median OS and TTNTD were longest among patients receiving surgery versus other anticancer treatments. These findings provide a baseline upon which to evaluate the epidemiology of non-metastatic NSCLC as newer treatments are introduced.
- Published
- 2024
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41. The In Vivo Fate of Polycatecholamine Coated Nanoparticles Is Determined by a Fibrinogen Enriched Protein Corona.
- Author
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Emilsson G, Liu K, Höök F, Svensson L, Rosengren L, Lindfors L, and Sigfridsson K
- Subjects
- Polyethylene Glycols chemistry, Fibrinogen, Protein Corona chemistry, Hemostatics, Nanoparticles chemistry
- Abstract
Polycatecholamine coatings have attracted significant attention in the past 10 years owing to their ability to functionalize a wide range of materials. Here we apply the use of such coatings to drug nanocrystals, made from a poorly soluble drug compound, to postfunctionalize the nanocrystal surface with the aim of providing steric stabilization and extending their circulation time after intravenous injection. We show that both polydopamine and polynorepinephrine can be used to successfully modify drug nanocrystals and subsequently incorporate end-functionalized PEG to the surface. Even though high grafting densities of PEG were achieved, we observed rapid clearance and increased liver uptake for polycatecholamine functionalized drug nanocrystals. Using both surface sensitive model systems and protein corona profiling, we determine that the rapid clearance was correlated with an increase in adsorption of proteins involved in coagulation to the polycatecholamine surface, with fibrinogen being the most abundant. Further analysis of the most abundant proteins revealed a significant increase in thiol-rich proteins on polycatecholamine coated surfaces. The observed interaction with coagulation proteins highlights one of the current challenges using polycatecholamines for drug delivery but might also provide insights to the growing use of these materials in hemostatic applications.
- Published
- 2023
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42. Evaluation in pig of an intestinal administration device for oral peptide delivery.
- Author
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Berg S, Uggla T, Antonsson M, Nunes SF, Englund M, Rosengren L, Fahraj M, Wu X, Govender R, Söderberg M, Janzén D, Van Zuydam N, Hugerth A, Larsson A, Abrahmsén-Alami S, Abrahamsson B, Davies N, and Bergström CAS
- Subjects
- Animals, Swine, Peptides chemistry, Intestinal Absorption, Administration, Oral, Tablets, Biological Availability, Intestines, Intestinal Mucosa metabolism
- Abstract
The bioavailability of peptides co-delivered with permeation enhancers following oral administration remains low and highly variable. Two factors that may contribute to this are the dilution of the permeation enhancer in the intestinal fluid, as well as spreading of the released permeation enhancer and peptide in the lumen by intestinal motility. In this work we evaluated an Intestinal Administration Device (IAD) designed to reduce the luminal dilution of drug and permeation enhancer, and to minimize movement of the dosage form in the intestinal lumen. To achieve this, the IAD utilizes an expanding design that holds immediate release mini tablets and places these in contact with the intestinal epithelium, where unidirectional drug release can occur. The expanding conformation limits movement of the IAD in the intestinal tract, thereby enabling drug release at a single focal point in the intestine. A pig model was selected to study the ability of the IAD to promote intestinal absorption of the peptide MEDI7219 formulated together with the permeation enhancer sodium caprate. We compared the IAD to intestinally administered enteric coated capsules and an intestinally administered solution. The IAD restricted movement of the immediate release tablets in the small intestine and histological evaluation of the mucosa indicated that high concentrations of sodium caprate were achieved. Despite significant effect of the permeation enhancer on the integrity of the intestinal epithelium, the bioavailability of MEDI7219 was of the same order of magnitude as that achieved with the solution and enteric coated capsule formulations (2.5-3.8%). The variability in plasma concentrations of MEDI7219 were however lower when delivered using the IAD as compared to the solution and enteric coated capsule formulations. This suggests that dosage forms that can limit intestinal dilution and control the position of drug release can be a way to reduce the absorptive variability of peptides delivered with permeation enhancers but do not offer significant benefits in terms of increasing bioavailability., (Copyright © 2022. Published by Elsevier B.V.)
- Published
- 2023
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43. Investigating effective testing strategies for the control of Johne's disease in western Canadian cow-calf herds using an agent-based simulation model.
- Author
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Johnson P, McLeod L, Qin Y, Osgood N, Rosengren L, Campbell J, Larson K, and Waldner C
- Abstract
Johne's disease is an insidious infectious disease of ruminants caused by Mycobacterium avium subspecies paratuberculosis (MAP). Johne's disease can have important implications for animal welfare and risks causing economic losses in affected herds due to reduced productivity, premature culling and replacement, and veterinary costs. Despite the limited accuracy of diagnostic tools, testing and culling is the primary option for controlling Johne's disease in beef herds. However, evidence to inform specific test and cull strategies is lacking. In this study, a stochastic, continuous-time agent-based model was developed to investigate Johne's disease and potential control options in a typical western Canadian cow-calf herd. The objective of this study was to compare different testing and culling scenarios that included varying the testing method and frequency as well as the number and risk profile of animals targeted for testing using the model. The relative effectiveness of each testing scenario was determined by the simulated prevalence of cattle shedding MAP after a 10-year testing period. A second objective was to compare the direct testing costs of each scenario to identify least-cost options that are the most effective at reducing within-herd disease prevalence. Whole herd testing with individual PCR at frequencies of 6 or 12 months were the most effective options for reducing disease prevalence. Scenarios that were also effective at reducing prevalence but with the lowest total testing costs included testing the whole herd with individual PCR every 24 months and testing the whole herd with pooled PCR every 12 months. The most effective method with the lowest annual testing cost per unit of prevalence reduction was individual PCR on the whole herd every 24 months. Individual PCR testing only cows that had not already been tested 4 times also ranked well when considering both final estimated prevalence at 10 years and cost per unit of gain. A more in-depth economic analysis is needed to compare the cost of testing to the cost of disease, taking into account costs of culling, replacements and impacts on calf crops, and to determine if testing is an economically attractive option for commercial cow-calf operations., Competing Interests: Author LR is the owner of the company Rosengren Epidemiology Consulting. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Johnson, McLeod, Qin, Osgood, Rosengren, Campbell, Larson and Waldner.)
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- 2022
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44. Social Belonging as the Main Concern for Achieving Life Satisfaction When Adapting to Parkinson's Disease.
- Author
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Rosengren L, Forsberg A, Brogårdh C, and Lexell J
- Subjects
- Adaptation, Physiological, Female, Health Personnel, Humans, Male, Middle Aged, Personal Satisfaction, Time, Parkinson Disease
- Abstract
Parkinson's disease (PD) is a complex, progressive neurological condition that impacts daily life and reduces life satisfaction (LS). To achieve and maintain high LS, persons with PD (PwPD) must go through a process of change to adapt to their new life situation. However, our knowledge about this process is very limited. The aim of this study was to investigate the process of change, and the main concern in this process, in PwPD. To study the transitional experience of PwPD, an inductive qualitative approach, using Grounded Theory (GT), was employed. Thirteen participants (9 women, 3 men and 1 non-binary), with a mean age of 54 years (range from 47-62 years), participated in in-depth interviews. Data showed that social belonging is the main concern in the process of change for PwPD. In this process of change, they use strategies to comprehend, accept, adapt, and balance in their strive for social belonging, which in turn can enhance LS. Health care professionals can use this model with an interdisciplinary approach to support PwPD through a successful process of change to achieve social belonging, and thereby achieving and maintaining LS.
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- 2021
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45. Life Satisfaction and Adaptation in Persons with Parkinson's Disease-A Qualitative Study.
- Author
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Rosengren L, Forsberg A, Brogårdh C, and Lexell J
- Subjects
- Adaptation, Psychological, Female, Humans, Male, Middle Aged, Personal Satisfaction, Qualitative Research, Time, Persons with Disabilities, Parkinson Disease
- Abstract
Persons with Parkinson's disease (PD) need to adapt to their progressive disability to achieve and maintain a high degree of life satisfaction (LS), but little is known about the meaning of LS and adaptation. This study aimed to gain an in-depth understanding of the meaning of LS and adaptation in persons with PD. Open-ended in-depth interviews were performed with 13 persons diagnosed with PD, 9 women, 3 men, and one non-binary person (mean age 54 years, mean time since diagnosis 3.4 years). The interviews were analyzed using a phenomenological-hermeneutic approach. The participants were in the process of adapting to their new health situation. There were two quite distinct groups: one that adapted through acceptance and one that struggled to resist the disease and the profound impact it had on their lives. The thematic structural analysis covers eight themes illustrating the meaning of LS and adaptation, through either acceptance or resistance. Adaptation to PD involves a transitional process characterized by either acceptance or resistance, which influences a person's LS. Acceptance makes LS possible, whereas resistance constitutes a behavioral barrier to adaptation and LS. Rehabilitation professionals need to understand this individual process to be able to support a person with PD to reach and maintain a high level of LS. Understanding the link between LS and adaptation can support rehabilitation professionals to provide targeted interventions for people with PD.
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- 2021
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46. Difficulties in the prehospital assessment of patients with TIA/stroke.
- Author
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Magnusson C, Lövgren E, Alfredsson J, Axelsson C, Andersson Hagiwara M, Rosengren L, Herlitz J, and Jood K
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Retrospective Studies, Emergency Medical Services methods, Ischemic Attack, Transient diagnosis, Stroke diagnosis
- Abstract
Background: In patients with TIA/stroke, early assessment is critical., Aim: To describe patients who were not directly transported to hospital by ambulance after prehospital assessment., Methods: Patients hospitalized with TIA/stroke in Gothenburg, Data were obtained from the EMS and hospital case record system., Results: There were 7,812 patients with TIA/stroke, of which 4,853 (62%) were candidates for EMS transport. Among them, 176 (3.6%) were not directly transported to hospital by ambulance. In 45% of them, delay from symptom onset to calling for EMS was ≤24 hours. On EMS arrival, common symptom was dizziness (28%), followed by weakness in arm or leg (21%), loss of sensibility (13%), speech disturbances (7%), and facial numbness (4%). The modified National Institute of Health Stroke Score (mNIHSS) was 0 in 80% and >1 in two per cent. The NIHSS at the emergency department was 1-4 in 39% and 5-15 in six per cent. The EMS clinician made the decision not to transport the patient to hospital by the EMS in 84%, the dispatcher in 12% and the patient or relatives in four per cent. Patients were involved in the decision in 51%. Final diagnosis was stroke in 74% and the proportion who were independent in normal daily activities at hospital discharge decreased by 15% compared with before event., Conclusion: About 3%-4% of patients with TIA/stroke were not directly transported to hospital by EMS after prehospital assessment. The most common symptom was dizziness. Decision-support tools for EMS to identify time-sensitive conditions are required., (© 2020 The Authors. Acta Neurologica Scandinavica published by John Wiley & Sons Ltd.)
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- 2021
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47. Do patients with large vessel occlusion ischemic stroke harboring prestroke disability benefit from thrombectomy?
- Author
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Larsson A, Karlsson C, Rentzos A, Schumacher M, Abrahamson M, Allardt A, Brederlau A, Ceder E, Davidson M, Dunker D, Gunnarsson T, Holmegaard L, Jerndal M, Karlsson JE, Nordanstig A, Redfors P, Rosengren L, Tatlisumak T, and Jood K
- Subjects
- Female, Humans, Retrospective Studies, Thrombectomy, Treatment Outcome, Brain Ischemia complications, Brain Ischemia surgery, Endovascular Procedures, Ischemic Stroke, Stroke complications, Stroke surgery
- Abstract
Objectives: Evidence of endovascular treatment (EVT) for acute large vessel occlusion (LVO) ischemic stroke in patients harboring substantial prestroke disability is lacking due to their exclusion from randomized trials. Here, we used routine care observational data to compare outcomes in patients with and without prestroke disability receiving EVT for LVO ischemic stroke., Methods: Consecutive patients undergoing EVT for acute LVO ischemic stroke at the Sahlgrenska University Hospital from January 1st, 2015 to March 31st, 2018 were registered in the Sahlgrenska Stroke Recanalization Registry. Pre- and poststroke functional levels were assessed by the modified Rankin Scale (mRS). Outcomes were recanalization rate (mTICI = 2b/3), symptomatic intracranial hemorrhage [sICH], complications during hospital stay, and return to prestroke functional level and mortality at 3 months., Results: Among 591 patients, 90 had prestroke disability (mRS ≥ 3). The latter group were older, more often female, had more comorbidities and higher NIHSS scores before intervention compared to patients without prestroke disability. Recanalization rates (80.0% vs 85.0%, p = 0.211), sICH (2.2% vs 6.3% p = 0.086) and the proportion of patients returning to prestroke functional level (22.7% vs 14.8% p = 0.062) did not significantly differ between those with and without prestroke disability. Patients with prestroke disability had higher complication rates during hospital stay (55.2% vs 40.1% p < 0.01) and mortality at 3 months (48.9% vs 24.3% p < 0.001)., Conclusion: One of five with prestroke disability treated with thrombectomy for a LVO ischemic stroke returned to their prestroke functional level. However, compared to patients without prestroke disability, mortality at 3 months was higher.
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- 2020
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48. Acute symptomatic seizures and epilepsy after mechanical thrombectomy.
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Eriksson H, Löwhagen Hendén P, Rentzos A, Pujol-Calderón F, Karlsson JE, Höglund K, Blennow K, Zetterberg H, Rosengren L, and Zelano J
- Subjects
- Acute Disease, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Male, Prospective Studies, Risk Factors, Stroke complications, Stroke diagnostic imaging, Stroke surgery, Treatment Outcome, Epilepsy diagnostic imaging, Epilepsy etiology, Seizures diagnostic imaging, Seizures etiology, Thrombectomy adverse effects
- Abstract
Purpose: The purpose of this study was to assess the incidence of acute symptomatic seizures and poststroke epilepsy (PSE) in a well-characterized cohort of patients treated with mechanical thrombectomy. In addition, we aimed to describe the dynamics of blood markers of brain injury in patients that developed PSE., Methods: Participants of the prospective AnStroke Trial of anesthesia method during mechanical thrombectomy were included and acute symptomatic seizures and PSE ascertained by medical records review. Blood markers neurofilament light (NFL), tau, glial fibrillary acidic protein (GFAP), S100 calcium-binding protein B (S100B), and neuron-specific enolase (NSE) were assessed., Results: A total of 90 patients with acute anterior ischemic stroke were included. Median National Institutes of Health Stroke Scale (NIHSS) at admission to hospital was 18 (IQR 15-22). Recanalization was achieved in 90%. No patients had epilepsy prior to the ischemic stroke. Four patients (4.4%) had acute symptomatic seizures and four patients (4.4%) developed PSE during the follow-up time (to death or last medical records review) of 0-4.5 years (median follow-up 1070 days IQR 777-1306), resulting in a two-year estimated PSE risk of 5.3% (95%CI: 0.2-10.4%). Blood markers of brain injury (NFL, tau, GFAP, S100B, and NSE) were generally above the cohort median in patients that developed PSE., Conclusions: The incidence of PSE after mechanical thrombectomy was low in our cohort. All blood biomarkers displayed interesting sensitivity and specificity. However, the number of PSE cases was small and more studies are needed on risk factors for PSE after mechanical thrombectomy. The potential of blood markers of brain injury markers to contribute to assessment of PSE risk should be explored further. This article is part of the Special Issue "Seizures & Stroke"., Competing Interests: Declaration of competing interest HZ has served at scientific advisory boards for Roche Diagnostics, Wave, Samumed and CogRx, has given lectures in symposia sponsored by Biogen and Alzecure, and is a cofounder of Brain Biomarker Solutions in Gothenburg AB, a GU Ventures-based platform company at the University of Gothenburg (all outside submitted work). KB has served as a consultant or at advisory boards for Alector, Alzheon, CogRx, Biogen, Lilly, Novartis and Roche Diagnostics, and is a cofounder of Brain Biomarker Solutions in Gothenburg AB, a GU Venture-based platform company at the University of Gothenburg, all unrelated to the work presented in this paper. JZ reports consultancy fee from the Swedish Medical Products agency, and has been investigator/sub-investigator without personal compensation in clinical trials at Sahlgrenska university hospital sponsored by Bial, SK Life science, and GW Pharma., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2020
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49. Inequalities in pharmacologic treatment of spasticity in Sweden - health economic consequences of closing the treatment gap.
- Author
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Forsmark A, Rosengren L, and Ertzgaard P
- Abstract
Background: The Swedish Healthcare Act states that patients should have equal access to healthcare. This study addresses at how this translates to pharmacological treatment of adult spasticity, including injections with botulinum toxin A (BoNT-A) and pumps for intrathecal baclofen (ITB). To address potential economic incentives for treatment differences, the results are also set into a health economic perspective. Thus, the current study provides a detailed and comprehensive overview for informed decision- and policymaking., Methods: Botulinum toxin use was retrieved from sales data. Clinical practice regarding mean BoNT-A treatment dose and proportion used for spasticity indication were validated in five county councils, while the number of ITB pumps were mapped for all county councils. Published costs and quality of life data was used for estimating required responder rates for cost-balance or cost-effectiveness., Results: The proportion of patients treated with BoNT-A varied between 5.8% and 13.6% across healthcare regions, with a mean of 9.2% on a national level. The reported number of ITB pumps per 100,000 inhabitants varied between 3.6 and 14.1 across healthcare regions, with a national mean of 6/100,000. The estimated incremental cost for reaching treatment equity was EUR 1,976,773 per year for BoNT-A and EUR 3,326,692 for ITB pumps. Based on expected cost-savings, responder rates ranging between 4% and 15% cancelled out the incremental cost for BoNT-A. Assuming no cost-savings, responder rates of 14% or 36% was required for cost-effectiveness., Conclusions: There is a marked variation in pharmacologic treatment of adult spasticity in Sweden. Overall, the results indicate an underuse of treatment and need for harmonisation of clinical practice. Furthermore, the incremental cost for reaching treatment equity is likely to be offset by spasticity-associated cost-savings.
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- 2020
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50. Evaluation of the Swedish National Stroke Campaign: A population-based time-series study.
- Author
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Nordanstig A, Palaszewski B, Asplund K, Norrving B, Wahlgren N, Wester P, Jood K, and Rosengren L
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Endovascular Procedures, Female, Health Education methods, Humans, Interrupted Time Series Analysis, Male, Middle Aged, Sweden, Time Factors, Young Adult, Health Promotion methods, Stroke therapy, Thrombectomy statistics & numerical data, Thrombolytic Therapy statistics & numerical data, Time-to-Treatment statistics & numerical data
- Abstract
Background: Time delay from stroke onset to hospital arrival is an important obstacle to recanalization therapy. To increase knowledge about stroke symptoms and potentially reduce delayed hospital arrival, a 27-month national public information campaign was conducted in Sweden., Aim: To assess the effects of a national stroke campaign in Sweden., Methods: This nationwide study included 97,840 patients with acute stroke, admitted to hospital and registered in the Swedish Stroke Register from 1 October 2010 to 31 December 2014 (one year before the campaign started to one year after the campaign ended). End points were (1) proportion of patients arriving at hospital within 3 h of stroke onset and (2) the proportion < 80 years of age receiving recanalization therapy., Results: During the campaign, both the proportion of patients arriving at hospital within 3 h (p < 0.05) and the proportion receiving recanalization therapy (p < 0.001) increased. These proportions remained stable the year after the campaign, and no significant improvements with respect to the two end points were observed during the year preceding the campaign. In a multivariable logistic regression model comparing the last year of the campaign with the year preceding the campaign, the odds ratio of arriving at hospital within 3 h was 1.05 (95% confidence interval (CI): 1.00-1.09) and that of receiving recanalization was 1.34 (95% CI: 1.24-1.46)., Conclusion: The Swedish National Stroke Campaign was associated with a sustained increase in the proportion of patients receiving recanalization therapy and a small but significant improvement in the proportion arriving at hospital within 3 h.
- Published
- 2019
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