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Kekki H, Montoya Perez I, Taimen P, Boström PJ, Gidwani K, Pettersson K. Lectin-nanoparticle concept for free PSA glycovariant providing superior cancer specificity. Clin Chim Acta 2024; 559:119689. [PMID: 38677453 DOI: 10.1016/j.cca.2024.119689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Using lectins to target cancer-associated modifications of PSA glycostructure for identification of clinically significant prostate cancers, e.g., Gleason score (GS) ≥ 7, from benign and indolent cancers (GS 6), is highly promising yet technically challenging. From previous findings to quantify increased PSA fucosylation in urine, we set out to construct a robust, specific test concept suitable for plasma samples. METHODS Macrophage galactose-binding lectin (MGL) coupled to 100 nm Eu3 + -nanoparticles was used to probe PSA captured from cancer cell lines, seminal plasma, and plasma samples from 249 patients with a clinical suspicion of prostate cancer onto 3 mm dense spots of free PSA antibody fab fragments. Results were compared to four kallikrein tests: tPSA, fPSA, iPSA and hK2. RESULTS The fPSAMGLglycovariant provided superior discrimination of the GS ≥ 7 and benign + GS 6 groups (p 0.0003) compared to fPSA (NS). The corresponding AUC in ROC analysis was 0.70 compared to 0.66 for tPSA. In contrast to all four kallikrein tests, the fPSAMGLGV was independent of prostate gland volume. Using a logistic regression analysis the fPSAMGLGV significantly improved on the four-kallikrein model. CONCLUSIONS Due to Eu-nanoparticles and a dense fPSA capture spot, the fPSAMGL glycovariant identifies an fPSA subform with the highest cancer specificity compared to the four conventional kallikreins.
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Affiliation(s)
- H Kekki
- Biotechnology Unit, Department of Life Technologies, University of Turku, Finland.
| | - I Montoya Perez
- Department of Diagnostic Radiology, University of Turku, Turku, Finland; Department of Computing, University of Turku, Turku, Finland
| | - P Taimen
- Institute of Biomedicine, Department of Pathology, University of Turku, Turku University Hospital, Turku, Finland
| | - P J Boström
- Department of Urology, University of Turku and Turku University Hospital, Turku, Finland
| | - K Gidwani
- Biotechnology Unit, Department of Life Technologies, University of Turku, Finland
| | - K Pettersson
- Biotechnology Unit, Department of Life Technologies, University of Turku, Finland
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Pettersson K, Liedgren P, Lyon AR, Hasson H, von Thiele Schwarz U. Fidelity-consistency and deliberateness of modifications in parenting programs. Implement Sci Commun 2024; 5:13. [PMID: 38351018 PMCID: PMC10865709 DOI: 10.1186/s43058-024-00545-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/07/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Evidence-based interventions (EBIs) are frequently modified in practice. It is recommended that decisions to modify EBIs should be made deliberately to ensure fidelity-consistency, yet the relationship between fidelity-consistency and deliberateness is not well understood. This study aims to explore modifications in a sample of practitioners delivering evidence-based parenting programs (i.e., interventions to strengthen parent-child relationships, reduce harmful interactions, and improve child health and well-being). The study investigated three research questions: (1) What kind of modifications are made during the delivery of parenting programs? (2) To what degree are the identified modifications consistent with the core functions of each program? and (3) Is deliberateness associated with the fidelity-consistency of the identified modifications? METHODS In total, 28 group leaders of five widely disseminated parenting programs in Sweden participated in five focus groups, and two participants from each group also participated in individual interviews (n = 10). A content analysis approach was used where the identification of modifications was directed by the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) and then assessed for fidelity-consistency and four levels of deliberateness (universal, situational, conditional, and unintentional). Chi-square tests were performed to compare consistent and inconsistent modifications, and logistic regression was performed to explore whether deliberateness predicted consistency. RESULTS A total of 137 content modifications were identified, covering most of the content modification categories in FRAME. The most common were tailoring/tweaking/refining, adding elements, shortening/condensing, lengthening/extending, and integrating another treatment. Modifications were mostly fidelity-consistent but consistency varied greatly among categories. Furthermore, modifications made unintentionally or situationally were more likely to be fidelity-inconsistent. CONCLUSIONS These results indicate that explicit consideration of modifications and their impact could be essential for sustaining the fidelity-consistent use of EBIs, even as such interventions are continuously modified.
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Affiliation(s)
| | - Pernilla Liedgren
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Henna Hasson
- Procome Research Group, Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, 171 77, Stockholm, SE, Sweden
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine (CES), Stockholm County Council, 171 29, Stockholm, SE, Sweden
| | - Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Procome Research Group, Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, 171 77, Stockholm, SE, Sweden
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Ivert A, Lindblad Wollmann C, Pettersson K. A Case Series on Pregnant Patients with Mild Covid-19 Infection and Signs of Severe Placental Insufficiency. Case Rep Obstet Gynecol 2023; 2023:2018551. [PMID: 37025388 PMCID: PMC10072962 DOI: 10.1155/2023/2018551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/24/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023] Open
Abstract
In this case series, we present five cases of pregnant women who sought medical attention for reduced fetal movements with an ongoing mild maternal Covid-19 infection at a Stockholm hospital in Spring of 2021. At the time of admission, the patients were in gestational week between
and
. Abdominal ultrasound at the hospital showed no fetal movements, and cardiotocography (CTG) was pathological. All women delivered via cesarean section within 24 hours after admission. Placental pathology in all cases showed massive perivillous fibrin deposition and extensive histiocytic intervillositis. All placentas were Covid-19 polymerase chain reaction (PCR) positive. The infants were Covid-19 PCR negative. Consistent with other published case reports, we hypothesize that Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect the placenta resulting in massive perivillous fibrin deposition and histiocytic intervillositis leading to acute placental insufficiency and fetal hypoxia. The absence of intrauterine growth restriction also augments the theory of an acute onset of placental insufficiency due to the Covid-19 infection.
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Li T, Vazakidou P, Leonards P, Damdimopoulou A, Panagiotou E, Arnelo C, Jansson K, Pettersson K, Duursen M, Damdimopoulou P. SOC-I-04 Identification of biomarkers and outcomes of endocrine disruption in adult human ovarian cortex. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Birrer DL, Kuemmerli C, Obwegeser A, Liebi M, von Felten S, Pettersson K, Horisberger K. INSPIRA: study protocol for a randomized-controlled trial about the effect of spirometry-assisted preoperative inspiratory muscle training on postoperative complications in abdominal surgery. Trials 2022; 23:473. [PMID: 35672861 PMCID: PMC9172146 DOI: 10.1186/s13063-022-06254-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/29/2022] [Indexed: 11/28/2022] Open
Abstract
Background Rehabilitation strategies after abdominal surgery enhance recovery and improve outcome. A cornerstone of rehabilitation is respiratory physiotherapy with inspiratory muscle training to enhance pulmonary function. Pre-habilitation is the process of enhancing functional capacity before surgery in order to compensate for the stress of surgery and postoperative recovery. There is growing interest in deploying pre-habilitation interventions prior to surgery. The aim of this study is to assess the impact of preoperative inspiratory muscle training on postoperative overall morbidity. The question is, whether inspiratory muscle training prior to elective abdominal surgery reduces the number of postoperative complications and their severity grade. Methods We describe a prospective randomized-controlled single-centre trial in a tertiary referral centre. The primary outcome is the Comprehensive Complication Index (CCI) at 90 days after surgery. The CCI expresses morbidity on a continuous numeric scale from 0 (no complication) to 100 (death) by weighing all postoperative complications according to the Clavien-Dindo classification for their respective severity. In the intervention group, patients will be instructed by physiotherapists to perform inspiratory muscle training containing of 30 breaths twice a day for at least 2 weeks before surgery using Power®Breathe KHP2. Depending on the surgical schedule, training can be extended up to 6 weeks. In the control group, no preoperative inspiratory muscle training will be performed. After the operation, both groups receive the same physiotherapeutic support. Discussion Existing data about preoperative inspiratory muscle training on postoperative complications are ambiguous and study protocols are often lacking a clear design and a clearly defined endpoint. Most studies consist of multi-stage concepts, comprehensively supervised and long-term interventions, whose implementation in clinical practice is hardly possible. There is a clear need for randomized-controlled studies with a simple protocol that can be easily transferred into clinical practice. This study examines the effortless adjustment of the common respiratory physiotherapy from currently postoperative to preoperative. The external measurement by the device eliminates the diary listing of patients’ performances and allows the exercise adherence and thus the effect to be objectively recorded. Trial registration ClinicalTrials.govNCT04558151. Registered on September 15, 2020.
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Affiliation(s)
- D L Birrer
- Department of Transplantation and Surgery, University Hospital of Zurich, Zurich, Switzerland.
| | - C Kuemmerli
- Department of Surgery, Clarunis-University Centre for Gastrointestinal and Liver Diseases Basel, Basel, Switzerland
| | - A Obwegeser
- Department of Physiotherapy and Occupational Therapy, University Hospital of Zurich, Zurich, Switzerland
| | - M Liebi
- Department of Physiotherapy and Occupational Therapy, University Hospital of Zurich, Zurich, Switzerland
| | - S von Felten
- Department of Biostatistics, Epidemiology and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - K Pettersson
- Department of Transplantation and Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - K Horisberger
- Department of Transplantation and Surgery, University Hospital of Zurich, Zurich, Switzerland.,Department of Surgery and Transplantation, University Hospital Mainz, Mainz, Germany
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Lampi K, Papadogiannakis N, Sirotkina M, Pettersson K, Ajne G. Massive perivillous fibrin deposition of the placenta and pregnancy outcome: A retrospective observational study. Placenta 2022; 117:213-218. [DOI: 10.1016/j.placenta.2021.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/10/2021] [Accepted: 12/09/2021] [Indexed: 01/05/2023]
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Pettersson K, Liedgren P, Giannotta F, von Thiele Schwarz U. Eleven Reasons for Adaptation of Swedish Parenting Programs. Front Health Serv 2022; 2:923504. [PMID: 36925861 PMCID: PMC10012651 DOI: 10.3389/frhs.2022.923504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022]
Abstract
While questions about adaptation and fidelity are of great concern in many implementation projects, less attention has been paid to reasons for adaptations that remain when evidence-based interventions (EBIs) are used in clinical and community settings. This study aims to explore reasons for adaptations that can arise when using parenting programs in a community setting. Seventeen individual interviews with providers were conducted and analyzed thematically, resulting in 11 reasons for adaptations organized into four separate areas: characteristics of group leaders (supplementary skills and knowledge, preferred ways of working), characteristics of families (problem complexity, diverse or limited educational experience, non-parenting needs for support, colliding value systems), group incidents (criticism and challenges, excessive questions or discussions), and didactic challenges (lack of focus or engagement, limitations of the material, language differences). The study shows that factors triggering adaptation and fidelity decisions continuously reappear in the provision of parenting programs in community settings. Knowledge about reasons for adaptation can be used to inform decision-making during implementation planning, as well as the sustainment of implemented interventions.
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Affiliation(s)
| | - Pernilla Liedgren
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Fabrizia Giannotta
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Procome Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Stockholm, Sweden
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von Thiele Schwarz U, Lyon AR, Pettersson K, Giannotta F, Liedgren P, Hasson H. Understanding the value of adhering to or adapting evidence-based interventions: a study protocol of a discrete choice experiment. Implement Sci Commun 2021; 2:88. [PMID: 34380575 PMCID: PMC8356451 DOI: 10.1186/s43058-021-00187-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/11/2021] [Indexed: 12/20/2022] Open
Abstract
Background Whereas the value of an evidence-based intervention (EBI) is often determined by its effect on clinical outcomes, the value of implementing and using EBIs in practice is broader, reflecting qualities such as appropriateness, equity, costs, and impact. Reconciling these value conflicts involves a complicated decision process that has received very limited scholarly attention. Inspired by studies on decision-making, the objective of this project is to explore how practitioners appraise the values of different outcomes and to test how this appraisal influences their decisions surrounding the so-called fidelity–adaptation dilemma. This dilemma is related to the balance between using an EBI as it was designed (to ensure its effectiveness) and making appropriate adaptations (to ensure alignment with constraints and possibilities in the local context). Methods This project consists of three sub-studies. The participants will be professionals leading evidence-based parental programs in Sweden and, in Sub-study 1, parents and decision-makers. Sub-study 1 will use sequential focus groups and individual interviews to explore parameters that influence fidelity and adaptation decisions—the dilemmas encountered, available options, how outcomes are valued by practitioners as well as other stakeholders, and value trade-offs. Sub-study 2 is a discrete choice experiment that will test how value appraisals influence decision-making using data from Sub-study 1 as input. Sub-study 3 uses a mixed-method design, with findings from the two preceding sub-studies as input in focus group interviews to investigate how practitioners make sense of findings from optimal decision situations (experiment) and constrained, real-world decision situations. Discussion The project will offer unique insights into decision-making processes that influence how EBIs are used in practice. Such knowledge is needed for a more granular understanding of how practitioners manage the fidelity–adaptation dilemma and thus, ultimately, how the value of EBI implementation can be optimized. This study contributes to our knowledge of what happens once EBIs are adopted—that is, the gap between the way in which EBIs are intended to be used and the way in which they are used in practice.
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Affiliation(s)
- Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden. .,Procome, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Kristoffer Pettersson
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Fabrizia Giannotta
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Pernilla Liedgren
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Henna Hasson
- Procome, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.,Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
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de Vries MR, Ewing MM, de Jong RCM, MacArthur MR, Karper JC, Peters EAB, Nordzell M, Karabina SAP, Sexton D, Dahlbom I, Bergman A, Mitchell JR, Frostegård J, Kuiper J, Ninio E, Jukema JW, Pettersson K, Quax PHA. Identification of IgG1 isotype phosphorylcholine antibodies for the treatment of inflammatory cardiovascular diseases. J Intern Med 2021; 290:141-156. [PMID: 33342002 PMCID: PMC8359267 DOI: 10.1111/joim.13234] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Phosphorylcholine (PC) is an important pro-inflammatory damage-associated molecular pattern. Previous data have shown that natural IgM anti-PC protects against cardiovascular disease. We aimed to develop a monoclonal PC IgG antibody with anti-inflammatory and anti-atherosclerotic properties. METHODS Using various techniques PC antibodies were validated and optimized. In vivo testing was performed in a femoral artery cuff model in ApoE3*Leiden mice. Safety studies are performed in rats and cynomolgus monkeys. RESULTS A chimeric anti-PC (PC-mAb(T15), consisting of a human IgG1 Fc and a mouse T15/E06 Fab) was produced, and this was shown to bind specifically to epitopes in human atherosclerotic tissues. The cuff model results in rapid induction of inflammatory genes and altered expression of genes associated with ER stress and choline metabolism in the lesions. Treatment with PC-mAb(T15) reduced accelerated atherosclerosis via reduced expression of endoplasmic reticulum stress markers and CCL2 production. Recombinant anti-PC Fab fragments were identified by phage display and cloned into fully human IgG1 backbones creating a human monoclonal IgG1 anti-PC (PC-mAbs) that specifically bind PC, apoptotic cells and oxLDL. Based on preventing macrophage oxLDL uptake and CCL2 production, four monoclonal PC-mAbs were selected, which to various extent reduced vascular inflammation and lesion development. Additional optimization and validation of two PC-mAb antibodies resulted in selection of PC-mAb X19-A05, which inhibited accelerated atherosclerosis. Clinical grade production of this antibody (ATH3G10) significantly attenuated vascular inflammation and accelerated atherosclerosis and was tolerated in safety studies in rats and cynomolgus monkeys. CONCLUSIONS Chimeric anti-PCs can prevent accelerated atherosclerosis by inhibiting vascular inflammation directly and through reduced macrophage oxLDL uptake resulting in decreased lesions. PC-mAb represents a novel strategy for cardiovascular disease prevention.
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Affiliation(s)
- M. R. de Vries
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
| | - M. M. Ewing
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
- Deptartment of CardiologyLUMCLeidenThe Netherlands
| | - R. C. M. de Jong
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
| | - M. R. MacArthur
- Department of Molecular MetabolismHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - J. C. Karper
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
| | - E. A. B. Peters
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
| | | | - S. A. P. Karabina
- INSERM UMR_S 933Hôpital Armand‐TrousseauSorbonne UniversitéParisFrance
| | | | - I. Dahlbom
- Dept. of MedicineKarolinska University Hospital Huddinge and Karolinska InstitutetStockholmSweden
| | | | - J. R. Mitchell
- Department of Molecular MetabolismHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - J. Frostegård
- Dept. of MedicineKarolinska University Hospital Huddinge and Karolinska InstitutetStockholmSweden
| | - J. Kuiper
- Division of BioTherapeuticsLACDRLeidenThe Netherlands
| | - E. Ninio
- INSERM UMR_S 1166‐ICANGenomics and Pathophysiology of Cardiovascular DiseasesInstitute of Cardiometabolism and NutritionPitié‐Salpêtrière HôpitalSorbonne UniversitéParisFrance
| | - J. W. Jukema
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
- Deptartment of CardiologyLUMCLeidenThe Netherlands
| | | | - P. H. A. Quax
- From theDeptartment of SurgeryLUMCLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLUMCLeidenThe Netherlands
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Akselsson A, Lindgren H, Georgsson S, Pettersson K, Steineck G, Skokic V, Rådestad I. Mindfetalness to increase women's awareness of fetal movements and pregnancy outcomes: a cluster-randomised controlled trial including 39 865 women. BJOG 2020; 127:829-837. [PMID: 31971325 DOI: 10.1111/1471-0528.16104] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine whether a method for raising women's awareness of fetal movements, Mindfetalness, can affect pregnancy outcomes. DESIGN Cluster-randomised controlled trial. SETTING Sixty-seven maternity clinics in Stockholm, Sweden. POPULATION Women with singleton pregnancy with birth from 32 weeks' gestation. METHODS Women registered at a clinic randomised to Mindfetalness were assigned to receive a leaflet about Mindfetalness (n = 19 639) in comparison with routine care (n = 20 226). Data were collected from a population-based register. MAIN OUTCOME MEASURES Apgar score <7 at 5 minutes after birth, visit to healthcare due to decrease in fetal movements. Other outcomes: Apgar score <4 at 5 minutes after birth, small-for-gestational-age and mode of delivery. RESULTS No difference (1.1 versus 1.1%, relative risk [RR] 1.0; 95% CI 0.8-1.2) was found between the Mindfetalness group and the Routine care group for a 5-minute Apgar score <7. Women in the Mindfetalness group contacted healthcare more often due to decreased fetal movements (6.6 versus 3.8%, RR 1.72; 95% CI 1.57-1.87). Mindfetalness was associated with a reduction of babies born small-for-gestational-age (RR 0.95, 95% CI 0.90-1.00), babies born after gestational week 41+6 (RR 0.91, 95% CI 0.83-0.98) and caesarean sections (19.0 versus 20.0%, RR 0.95; 95% CI 0.91-0.99). CONCLUSIONS Mindfetalness did not reduce the number of babies born with an Apgar score <7. However, Mindfetalness was associated with the health benefits of decreased incidence of caesarean section and fewer children born small-for-gestational-age. TWEETABLE ABSTRACT Introducing Mindfetalness in maternity care decreased caesarean sections but had no effect on the occurrence of Apgar scores <7.
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Affiliation(s)
- A Akselsson
- Department of Women and Children's Health, Karolinska Institutet, Sophiahemmet University, Stockholm, Sweden
| | - H Lindgren
- Department of Women and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - S Georgsson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, The Swedish Red Cross University College, Stockholm, Sweden
| | - K Pettersson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - G Steineck
- Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - V Skokic
- Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - I Rådestad
- Sophiahemmet University, Stockholm, Sweden
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Sagerfors M, Niklasson J, Pettersson K. Pulp-to-palm distance is associated with inferior short-term outcome after combined plating for distal radius fractures. Hand Surg Rehabil 2019; 38:369-374. [PMID: 31568863 DOI: 10.1016/j.hansur.2019.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/29/2019] [Accepted: 09/18/2019] [Indexed: 10/25/2022]
Abstract
Distal radius fractures (DRF) are the most common fracture in adults. A tool is needed to identify patients who may need extra attention from the physical therapist during the rehabilitation process. The purpose of the study was to examine if pulp-to-palm distance (PTP) 4 weeks postoperatively is associated with wrist function 3 months postoperatively in patients undergoing combined plating for a complex DRF. This prospective study involved 53 patients. PTP was assessed by a physical therapist at the second visit, 4 weeks postoperatively. The 3-month follow-up visit consisted of evaluating the following outcomes: PRWE (Patient-Rated Wrist Evaluation), QuickDASH (Disabilities of the Arm, Shoulder and Hand), VAS pain scores, hand grip strength and wrist range of motion. All patients received the same amount of hand therapy. Patients with zero PTP at 4 weeks postoperative had a significantly better range of motion in wrist extension, flexion, radial deviation, ulnar deviation, hand grip strength and QuickDASH scores compared to patients with a PTP>0cm. VAS pain scores did not differ between the two groups. Patients with zero PTP at 4 weeks postoperative were more likely to have a better wrist function at 3 months postoperative compared to patients with measurable PTP. Based on this study's findings, measuring the PTP distance at 4 weeks postoperative could be useful for identifying patients in need of support during the rehabilitation process after DRF surgery. This could potentially improve the allocation of hand rehabilitation resources; screening patients postoperatively could help to begin relevant interventions.
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Affiliation(s)
- M Sagerfors
- Department of Hand Surgery, Faculty of Medicine and Health, Örebro University, Södra Grev Rosengatan, 70182 Örebro, Sweden.
| | - J Niklasson
- Department of Hand Surgery, Faculty of Medicine and Health, Örebro University, Södra Grev Rosengatan, 70182 Örebro, Sweden.
| | - K Pettersson
- Department of Hand Surgery, Faculty of Medicine and Health, Örebro University, Södra Grev Rosengatan, 70182 Örebro, Sweden.
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Nadeem N, Gidwani K, Huhtinen K, Kekki H, Hynninen J, Poutanen M, Carpen O, Lamminmäki U, Pettersson K. Europium nanoparticle-conjugated Sialyl-TN monoclonal antibody discriminates epithelial ovarian cancer-based CA125 from benign sources. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bayoumy S, Juntunen E, Pettersson K, Talha S. Detection of antibodies to the hepatitis C virus using up-converting nanoparticles − Based lateral flow immunoassay. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jain S, Nadeem N, Huhtinen K, Pettersson K, Gidwani K. Glycoprofiling of epithelial ovarian cancer CA125 with lectin coated europium nanoparticles. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Botti O, Terävä J, Gidwani K, Pettersson K. Anti-Tn antibody coated fluorescent nanoparticle-based immunoassay for the detection of mucin 1 in breast cancer patients. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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Syed P, Kekki H, Terävä J, Gidwani K, Lamminmäki U, Boström P, Pettersson K. Potential role of glycovariants of urinary MUC1 and CEA in sensitive detection of urothelial bladder cancer. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Bjork I, Pettersson K, Lindqvist P. O008: Stillbirth and factor V Leiden: a regional-based prospective evaluation. Thromb Res 2019. [DOI: 10.1016/s0049-3848(19)30088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Abrahamsson T, Nerme V, Strömqvist M, Åkerblom B, Legnehed A, Pettersson K, Westin Eriksson A. Anti-thrombotic Effect of a PAI-1 Inhibitor in Rats Given Endotoxin. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1650231] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThe aim of this study was to investigate the anti-thrombotic effects of an inhibitor of the plasminogen activator inhibitor-1 (PAI-1) in rats given endotoxin. In studies in vitro, PRAP-1, a Fab-fragment of a polyclonal antibody against human PAI-1, was shown to inhibit PAI-1 activity in rat plasma as well as to stimulate clot-lysis of the euglobulin fraction derived from rat plasma. Endotoxin administered to anaesthetised rats produced a marked increase in plasma PAI-1 activity. To study fibrin formation and lysis in vivo after intravenous (i. v.) injection of the coagulant enzyme batroxobin, 125I-fibrinogen was administered to the animals. The thrombi formed by batroxobin were rapidly lysed in control animals, while the rate of lysis was markedly attenuated in rats given endotoxin. PRAP-1 was administered i.v. (bolus + infusion) to rats given endotoxin and batroxobin and the PAI-1 inhibitor caused a dose-dependent decrease in the 125I-fibrin deposition in the lungs. An immunohistochemical technique was used to confirm this decrease in density of fibrin clots in the tissue. Furthermore, PRAP-1 decreased plasma PAI-1 activity in the rats and this reduction was correlated to the decrease in lung 125I-fibrin deposition at the corresponding time point. It is concluded that in this experimental model the PAI-1 antibody PRAP-1 may indeed inhibit thrombosis in animals exposed to endotoxin.
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Affiliation(s)
- T Abrahamsson
- The Department of Pharmacology CV, Astra Hässle AB, Mölndal, Sweden
| | - V Nerme
- The Department of Pharmacology CV, Astra Hässle AB, Mölndal, Sweden
| | - M Strömqvist
- The Department of Pharmacology CV, Astra Hässle AB, Mölndal, Sweden
| | - B Åkerblom
- The Department of Pharmacology CV, Astra Hässle AB, Mölndal, Sweden
| | - A Legnehed
- The Department of Pharmacology CV, Astra Hässle AB, Mölndal, Sweden
| | - K Pettersson
- The Department of Pharmacology CV, Astra Hässle AB, Mölndal, Sweden
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Pettersson K, Ahonen L, Sokka L, Müller K, Pakarinen S. 0950 Simulated Knowledge Work Decreases Alertness in Job-burnout. Sleep 2018. [DOI: 10.1093/sleep/zsy061.949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Pettersson
- Finnish Institution of Occupational Health, Helsinki, FINL
| | - L Ahonen
- Finnish Institution of Occupational Health, Helsinki, FINL
| | - L Sokka
- Finnish Institution of Occupational Health, Helsinki, FINL
| | - K Müller
- Department of Neurology, University of Helsinki, Helsinki, FINL
| | - S Pakarinen
- Finnish Institution of Occupational Health, Helsinki, FINL
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21
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Pluijmert NJ, De Jong RCM, De Vries MR, Pettersson K, Jukema JW, Quax PHA. P515Phosphorylcholine antibodies preserve cardiac function and reduce infarct size by attenuation of the inflammatory response following myocardial ischemia-reperfusion injury. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- N J Pluijmert
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands
| | - RCM De Jong
- Leiden University Medical Center, Department of Surgery, Leiden, Netherlands
| | - M R De Vries
- Leiden University Medical Center, Department of Surgery, Leiden, Netherlands
| | | | - J W Jukema
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands
| | - P H A Quax
- Leiden University Medical Center, Department of Surgery, Leiden, Netherlands
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22
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Reinebrant HE, Leisher SH, Coory M, Henry S, Wojcieszek AM, Gardener G, Lourie R, Ellwood D, Teoh Z, Allanson E, Blencowe H, Draper ES, Erwich JJ, Frøen JF, Gardosi J, Gold K, Gordijn S, Gordon A, Heazell A, Khong TY, Korteweg F, Lawn JE, McClure EM, Oats J, Pattinson R, Pettersson K, Siassakos D, Silver RM, Smith G, Tunçalp Ö, Flenady V. Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG 2017; 125:212-224. [PMID: 29193794 DOI: 10.1111/1471-0528.14971] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD-PM) aims to improve data on stillbirth to enable prevention. OBJECTIVES To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD-PM. SEARCH STRATEGY We searched CINAHL, EMBASE, Medline, Global Health, and Pubmed from 2009 to 2016. SELECTION CRITERIA Reports of stillbirth causes in unselective cohorts. DATA COLLECTION AND ANALYSIS Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD-PM. Data are presented by income setting (low, middle, and high income countries; LIC, MIC, HIC). MAIN RESULTS Eighty-five reports from 50 countries (489 089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage, and Other (all settings); Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD-PM. All stillbirth causes mapped to ICD-PM. In a subset from HIC, mapping obscured major causes. CONCLUSIONS There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well-resourced settings. Implementation of the WHO Perinatal Mortality Audit and Review guide is needed, particularly across high burden settings. FUNDING HR, SH, SHL, and AW were supported by an NHMRC-CRE grant (APP1116640). VF was funded by an NHMRC-CDF (APP1123611). TWEETABLE ABSTRACT Urgent need to improve data on causes of stillbirths across all settings to meet global targets. PLAIN LANGUAGE SUMMARY Background and methods Nearly three million babies are stillborn every year. These deaths have deep and long-lasting effects on parents, healthcare providers, and the society. One of the major challenges to preventing stillbirths is the lack of information about why they happen. In this study, we collected reports on the causes of stillbirth from high-, middle-, and low-income countries to: (1) Understand the causes of stillbirth, and (2) Understand how to improve reporting of stillbirths. Findings We found 85 reports from 50 different countries. The information available from the reports was inconsistent and often of poor quality, so it was hard to get a clear picture about what are the causes of stillbirth across the world. Many different definitions of stillbirth were used. There was also wide variation in what investigations of the mother and baby were undertaken to identify the cause of stillbirth. Stillbirths in all income settings (low-, middle-, and high-income countries) were most frequently reported as Unexplained, Other, and Haemorrhage (bleeding). Unexplained and Other are not helpful in understanding why a baby was stillborn. In low-income countries, stillbirths were often attributed to Infection and Complications during labour and birth. In middle- and high-income countries, stillbirths were often reported as Placental complications. Limitations We may have missed some reports as searches were carried out in English only. The available reports were of poor quality. Implications Many countries, particularly those where the majority of stillbirths occur, do not report any information about these deaths. Where there are reports, the quality is often poor. It is important to improve the investigation and reporting of stillbirth using a standardised system so that policy makers and healthcare workers can develop effective stillbirth prevention programs. All stillbirths should be investigated and reported in line with the World Health Organization standards.
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Affiliation(s)
- H E Reinebrant
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - S H Leisher
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - M Coory
- Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - S Henry
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - A M Wojcieszek
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - G Gardener
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - R Lourie
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,Translational Research Institute, Brisbane, QLD, Australia
| | - D Ellwood
- Griffith University School of Medicine, Gold Coast, QLD, Australia.,Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Z Teoh
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,Department of Medicine-Pediatrics, University of Louisville, Louisville, KY, USA
| | - E Allanson
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.,School of Women's and Infants' Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, WA, Australia
| | - H Blencowe
- London School of Hygiene & Tropical Medicine, London, UK
| | - E S Draper
- MBRRACE-UK, Department of Health Sciences, University of Leicester Centre for Medicine, Leicester, UK
| | - J J Erwich
- International Stillbirth Alliance, Bristol, UK.,University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - J F Frøen
- Norwegian Institute of Public Health, Oslo, Norway.,Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway
| | | | - K Gold
- International Stillbirth Alliance, Bristol, UK.,Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - S Gordijn
- International Stillbirth Alliance, Bristol, UK.,University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - A Gordon
- University of Sydney, Sydney, NSW, Australia
| | - Aep Heazell
- Division of Developmental Biomedicine, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.,St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - T Y Khong
- SA Pathology, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - F Korteweg
- Department of Obstetrics and Gynecology, Martini Hospital, Groningen, the Netherlands
| | - J E Lawn
- London School of Hygiene & Tropical Medicine, London, UK
| | - E M McClure
- International Stillbirth Alliance, Bristol, UK.,Department of Social, Statistical and Environmental Health Sciences, Research Triangle Institute, Research Triangle Park, NC, USA
| | - J Oats
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia.,Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM), Melbourne, Vic., Australia
| | - R Pattinson
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - K Pettersson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - D Siassakos
- International Stillbirth Alliance, Bristol, UK.,Obstetrics and Gynaecology, School of Social and Community Medicine, Southmead Hospital, University of Bristol, Bristol, UK
| | - R M Silver
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Gcs Smith
- Department of Obstetrics and Gynaecology, NIHR Cambridge Comprehensive Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Ö Tunçalp
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
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Wojcieszek AM, Boyle FM, Belizán JM, Cassidy J, Cassidy P, Erwich JJHM, Farrales L, Gross MM, Heazell AEP, Leisher SH, Mills T, Murphy M, Pettersson K, Ravaldi C, Ruidiaz J, Siassakos D, Silver RM, Storey C, Vannacci A, Middleton P, Ellwood D, Flenady V. Care in subsequent pregnancies following stillbirth: an international survey of parents. BJOG 2016; 125:193-201. [DOI: 10.1111/1471-0528.14424] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 12/01/2022]
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24
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Pettersson K, Ajne J, Yousaf K, Sturm D, Westgren M, Ajne G. Traction force during vacuum extraction: a prospective observational study. BJOG 2015; 122:1809-16. [DOI: 10.1111/1471-0528.13222] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2014] [Indexed: 11/29/2022]
Affiliation(s)
- K Pettersson
- Department of Obstetrics and Gynaecology; The Karolinska Institute; Karolinska University Hospital; Stockholm Sweden
| | - J Ajne
- Department of Obstetrics and Gynaecology; The Karolinska Institute; Karolinska University Hospital; Stockholm Sweden
| | - K Yousaf
- Department of Obstetrics and Gynaecology; The Karolinska Institute; Karolinska University Hospital; Stockholm Sweden
| | - D Sturm
- KTH Royal Institute of Technology; School of Technology and Health; Stockholm Sweden
| | - M Westgren
- Department of Obstetrics and Gynaecology; The Karolinska Institute; Karolinska University Hospital; Stockholm Sweden
| | - G Ajne
- Department of Obstetrics and Gynaecology; The Karolinska Institute; Karolinska University Hospital; Stockholm Sweden
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25
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Lindqvist PG, Pettersson K, Morén A, Kublickas M, Nordström L. Routine ultrasound examination at 41 weeks of gestation and risk of post-term severe adverse fetal outcome: a retrospective evaluation of two units, within the same hospital, with different guidelines. BJOG 2014; 121:1108-15; discussion 1116. [DOI: 10.1111/1471-0528.12654] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 11/28/2022]
Affiliation(s)
- PG Lindqvist
- Department of Obstetrics and Gynaecology; Clintec; Karolinska Institute; Karolinska University Hospital, Huddinge; Stockholm Sweden
| | - K Pettersson
- Department of Obstetrics and Gynaecology; Clintec; Karolinska Institute; Karolinska University Hospital, Huddinge; Stockholm Sweden
| | - A Morén
- Department of Obstetrics and Gynaecology; Clintec; Karolinska Institute; Karolinska University Hospital, Huddinge; Stockholm Sweden
| | - M Kublickas
- Department of Obstetrics and Gynaecology; Clintec; Karolinska Institute; Karolinska University Hospital, Huddinge; Stockholm Sweden
| | - L Nordström
- Department of Mothers and Childrens Health; Karolinska University Hospital, Solna; Stockholm Sweden
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26
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Gustås P, Pettersson K, Honkavaara S, Lagerstedt AS, Byström A. Kinematic and temporospatial assessment of habituation of Labrador retrievers to treadmill trotting. Vet J 2013; 198 Suppl 1:e114-9. [PMID: 24360755 DOI: 10.1016/j.tvjl.2013.09.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigated differences in kinematic and temporospatial variables in treadmill-naïve dogs when introduced to treadmill trotting and the time required to for them to become habituated to the treadmill. Twenty-four healthy Labrador retrievers, with an age range of 22-36 months and with no history of orthopaedic disease, were included in the study. A motion capture system registered kinematic variables of the carpus, elbow, tarsus and stifle, along with stride time and stance duration, at 240 Hz. Six sessions, each lasting 8-10 min, walking and trotting on the treadmill were performed with each dog, with three sessions on each of two consecutive days. The between-stride variability of total angular displacement of the carpus, elbow, stifle and tarsus, as well as the stride and stance time, was higher during the day 1 trotting sessions than in the last session of day 2. These stabilised to non-significant levels before the second session on the second day of measurements and thus habituation was achieved.
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Affiliation(s)
- P Gustås
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, Box 7054, 750 07 Uppsala, Sweden.
| | - K Pettersson
- University Animal Hospital, Swedish University of Agricultural Sciences, Box 7040, 750 07 Uppsala, Sweden
| | - S Honkavaara
- Västra Djursjukhuset, August Barks Gata 8, 421 32 Västra Frölunda, Sweden
| | - A-S Lagerstedt
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, Box 7054, 750 07 Uppsala, Sweden
| | - A Byström
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, Box 7011, 750 07 Uppsala, Sweden
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Ewing MM, Karper J, De Vries MR, De Jong RCM, Pettersson K, Quax P. Optimized anti-phosphorylcholine IgG for therapeutic inhibition of inflammatory vascular disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pluijmert NJ, Pettersson K, De Jong RCM, Schutte CI, Atsma DE, Quax PHA. Anti-phosphorylcholine therapy restricts left ventricular remodeling after myocardial ischemia-reperfusion injury in hypercholesterolemic APOE*3-Leiden mice. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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29
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Ewing MM, Karper JC, Sampietro ML, de Vries MR, Pettersson K, Jukema JW, Quax PHA. Annexin A5 prevents post-interventional accelerated atherosclerosis development in a dose-dependent fashion in mice. Atherosclerosis 2012; 221:333-40. [PMID: 22341596 DOI: 10.1016/j.atherosclerosis.2012.01.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 01/17/2012] [Accepted: 01/24/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND Activated cells in atherosclerotic lesions expose phosphatidylserine (PS) on their surface. Annexin A5 (AnxA5) binds to PS and is used for imaging atherosclerotic lesions. Recently, AnxA5 was shown to inhibit vascular inflammatory processes after vein grafting. Here, we report a therapeutic role for AnxA5 in post-interventional vascular remodeling in a mouse model mimicking percutaneous coronary intervention (PCI). METHODS AND RESULTS Associations between the rs4833229 (OR = 1.29 (CI 95%), p(allelic) = 0.011) and rs6830321 (OR = 1.35 (CI 95%), p(allelic) = 0.003) SNPs in the AnxA5 gene and increased restenosis-risk in patients undergoing PCI were found in the GENDER study. To evaluate AnxA5 effects on post-interventional vascular remodeling and accelerated atherosclerosis development in vivo, hypercholesterolemic ApoE(-/-) mice underwent femoral arterial cuff placement to induce intimal thickening. Dose-dependent effects were investigated after 3 days (effects on inflammation and leukocyte recruitment) or 14 days (effects on remodeling) after cuff placement. Systemically administered AnxA5 in doses of 0.1, 0.3 and 1.0mg/kg compared to vehicle reduced early leukocyte and macrophage adherence up to 48.3% (p = 0.001) and diminished atherosclerosis development by 71.2% (p = 0.012) with a reduction in macrophage/foam cell presence. Moreover, it reduced the expression of the endoplasmic reticulum stress marker GRP78/BiP, indicating lower inflammatory activity of the cells present. CONCLUSIONS AnxA5 SNPs could serve as markers for restenosis after PCI and AnxA5 therapeutically prevents vascular remodeling in a dose-dependent fashion, together indicating clinical potential for AnxA5 against post-interventional remodeling.
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Affiliation(s)
- M M Ewing
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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Pettersson K, Carlsson G, Holmberg C, Sporrong KK. 3640 POSTER Cost Identification of Nordic-FLIRI, Nordic- FLOX, XELIRI and XELOX in Palliative Colorectal Cancer in Sweden-a Clinical Practice Model Approach. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71237-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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31
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Alviggi C, Clarizia R, Pettersson K, Mollo A, Humaidan P, Strina I, Coppola M, Ranieri A, D'Uva M, De Placido G. Suboptimal response to GnRHa long protocol is associated with a common LH polymorphism. Reprod Biomed Online 2011; 22 Suppl 1:S67-72. [PMID: 21575852 DOI: 10.1016/s1472-6483(11)60011-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 12/21/2007] [Accepted: 08/28/2008] [Indexed: 10/18/2022]
Abstract
The aim of this observational preliminary trial was to estimate the association between the most common polymorphism of LH (LH-β variant: v-βLH), with different profiles of ovarian response to recombinant human FSH (rhFSH). A total of 60 normogonadotrophic patients undergoing a gonadotrophin-releasing hormone analogue long down-regulation protocol followed by stimulation with recombinant human FSH (rhFSH) for IVF/intracytoplasmic sperm injection, and in whom at least five oocytes were retrieved were retrospectively included. On the basis of the total rhFSH consumption, patients were divided into three groups: Group A: 22 women requiring a cumulative dose of rhFSH >3500 IU; Group B: 15 patients requiring 2000-3500 IU; Group C (control): 23 women requiring <2000 IU. The presence of v-βLH was evaluated using specific immunoassays. Peak oestradiol concentrations were significantly lower in Group A when compared with both groups B (P < 0.05) and C (P < 0.001). Group A had a significantly lower (P < 0.05) number of oocytes retrieved (7.3 ± 1.5, 11.7 ± 2.4 and 14.7 ± 4.1 in the three groups, respectively). Seven carriers (31.8%) of v-βLH were found in Group A, whereas only one variant (6.7%) was observed in Group B; no variant was detected in Group C. These preliminary results suggest that v-βLH is more frequent in women with ovarian resistance to rhFSH.
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Affiliation(s)
- C Alviggi
- Dipartimento Universitario di Scienze Ostetriche Ginecologiche e Medicina della Riproduzione, Area Funzionale di Medicina della Riproduzione ed Endoscopia Ginecologica, Universitá degli Studi di Napoli Federico ll, Naples, Italy.
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32
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Gupta A, Roobol MJ, Savage CJ, Peltola M, Pettersson K, Scardino PT, Vickers AJ, Schröder FH, Lilja H. A four-kallikrein panel for the prediction of repeat prostate biopsy: data from the European Randomized Study of Prostate Cancer screening in Rotterdam, Netherlands. Br J Cancer 2010; 103:708-14. [PMID: 20664589 PMCID: PMC2938258 DOI: 10.1038/sj.bjc.6605815] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: Most men with elevated levels of prostate-specific antigen (PSA) do not have prostate cancer, leading to a large number of unnecessary biopsies. A statistical model based on a panel of four kallikreins has been shown to predict the outcome of a first prostate biopsy. In this study, we apply the model to an independent data set of men with previous negative biopsy but persistently elevated PSA. Methods: The study cohort consisted of 925 men with a previous negative prostate biopsy and elevated PSA (⩾3 ng ml−1), with 110 prostate cancers detected (12%). A previously published statistical model was applied, with recalibration to reflect the lower positive biopsy rates on rebiopsy. Results: The full-kallikrein panel had higher discriminative accuracy than PSA and DRE alone, with area under the curve (AUC) improving from 0.58 (95% confidence interval (CI): 0.52, 0.64) to 0.68 (95% CI: 0.62, 0.74), P<0.001, and high-grade cancer (Gleason ⩾7) at biopsy with AUC improving from 0.76 (95% CI: 0.64, 0.89) to 0.87 (95% CI: 0.81, 0.94), P=0.003). Application of the panel to 1000 men with persistently elevated PSA after initial negative biopsy, at a 15% risk threshold would reduce the number of biopsies by 712; would miss (or delay) the diagnosis of 53 cancers, of which only 3 would be Gleason 7 and the rest Gleason 6 or less. Conclusions: Our data constitute an external validation of a previously published model. The four-kallikrein panel predicts the result of repeat prostate biopsy in men with elevated PSA while dramatically decreasing unnecessary biopsies.
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Affiliation(s)
- A Gupta
- Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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Katrukha A, Bereznikova A, Pettersson K. New approach to standardisation of human cardiac Troponin I (cTnI). Scandinavian Journal of Clinical and Laboratory Investigation 2010. [DOI: 10.1080/00365519909168335] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Latva-Hirvelä J, Kytö V, Saraste A, Eriksson S, Vuorinen T, Pettersson K, Saukko P. Development of troponin autoantibodies in experimental coxsackievirus B3 myocarditis. Eur J Clin Invest 2009; 39:457-62. [PMID: 19397694 DOI: 10.1111/j.1365-2362.2009.02113.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Autoantibodies against various endogenous proteins are found in myocarditis. Troponin autoantibodies are detected in patients with chronic dilated cardiomyopathy, but their presence in myocarditis remains unknown. We set out to study the presence of troponin autoantibodies in experimental viral myocarditis. MATERIALS AND METHODS BALB/c mice infected with coxsackievirus B3 Nancy strain were followed-up at days 1-7 and 2, 4, 8 and 12 weeks after infection. Levels of circulating cardiac troponin I and circulating troponin autoantibodies were measured. Transthoracic echocardiography was performed. Myocarditis was histopathologically graded and cardiomyocyte apoptosis was quantified (TUNEL). RESULTS Histopathologically relatively mild acute myocarditis followed by persistent cardiomyocyte damage was observed. Rate of cardiomyocyte apoptosis was the highest on day 5 (0.16 +/- 0.01% vs. 0.03 +/- 0.01% in controls, P < 0.001). Circulating troponin I levels were increased to day 5 (45.2 +/- 6.5 ng mL(-1), P < 0.005 vs. controls). Troponin autoantibodies were detected from 2 weeks after infection (20% of animals had autoantibodies at 2 weeks, 60% at 4 and 8 weeks and 20% at 12 weeks, P < 0.05 vs. controls). Fractional shortening remained decreased after acute myocarditis (0.36 +/- 0.02 at 4 weeks, 0.30 +/- 0.02 at 8 and 12 weeks vs. 0.41 +/- 0.01 before infection, P < 0.01) parallel to development of troponin autoantibodies. CONCLUSION Troponin autoantibodies are formed in experimental virus induced myocarditis following troponin I release and cardiomyocyte apoptosis. The definite role of these autoantibodies remains to be further characterized.
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Oskarsson E, Piehl Aulin K, Gustafsson BE, Pettersson K. Improved intramuscular blood flow and normalized metabolism in lateral epicondylitis after botulinum toxin treatment. Scand J Med Sci Sports 2009; 19:323-8. [DOI: 10.1111/j.1600-0838.2008.00804.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Caidahl K, Hartford M, Karlsson T, Pettersson K, deFaire U, Frostegård J. Abstract: P779 LOW TITERS OF NATURAL ANTI-PHOSPHORYLCHOLINE IGM ANTIBODIES PREDICT INCREASED MORTALITY AND MORBIDITY IN ACUTE CORONARY SYNDROMES. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70935-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Keros V, Xella S, Hultenby K, Pettersson K, Sheikhi M, Volpe A, Hreinsson J, Hovatta O. Vitrification versus controlled-rate freezing in cryopreservation of human ovarian tissue. Hum Reprod 2009; 24:1670-83. [DOI: 10.1093/humrep/dep079] [Citation(s) in RCA: 247] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Alviggi C, Clarizia R, Pettersson K, Mollo A, Humaidan P, Strina I, Coppola M, Ranieri A, D'Uva M, De Placido G. Suboptimal response to GnRHa long protocol is associated with a common LH polymorphism. Reprod Biomed Online 2009; 18:9-14. [DOI: 10.1016/s1472-6483(10)60418-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bursztyka J, Perdu E, Pettersson K, Pongratz I, Fernández-Cabrera M, Olea N, Debrauwer L, Zalko D, Cravedi J. Biotransformation of genistein and bisphenol A in cell lines used for screening endocrine disruptors. Toxicol In Vitro 2008; 22:1595-604. [DOI: 10.1016/j.tiv.2008.06.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Revised: 05/05/2008] [Accepted: 06/24/2008] [Indexed: 02/07/2023]
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Windahl SH, Lagerquist MK, Andersson N, Jochems C, Kallkopf A, Håkansson C, Inzunza J, Gustafsson JA, van der Saag PT, Carlsten H, Pettersson K, Ohlsson C. Identification of target cells for the genomic effects of estrogens in bone. Endocrinology 2007; 148:5688-95. [PMID: 17761761 DOI: 10.1210/en.2007-0508] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Estrogen has bone protective effects, but the exact mechanism behind these effects remains unclear. The aim of the present study was to identify the primary target cells in bone for the classical genomic effects of estrogens in vivo. For this purpose we have used reporter mice with a luciferase gene under the control of three estrogen-responsive elements (EREs), enabling detection of in vivo activation of gene transcription. Three-month-old ovariectomized mice were treated with a single dose (50 mug/kg) 17beta-estradiol (E2). Luciferase activity was analyzed in several tissues and in different bone marrow-derived lymphocyte enriched/depleted preparations using MacsMouse CD19 (for B lymphocytes) or CD90 (for T lymphocytes) MicroBeads (Miltenyi Biotec GmbH, Bergisch Gladbach, Germany). Histological characterization of cells with high luciferase content was performed using immunohistochemistry. Both cortical bone and bone marrow displayed a rapid (within 1 h) and pronounced E2-induced increase in luciferase activity. The luciferase activity in total bone marrow and in bone marrow depleted of lymphocytes was increased six to eight times more than in either B-lymphocyte or T-lymphocyte enriched cell fractions 4 h after the E2 injection, demonstrating that mature lymphocytes are not major direct targets for the genomic effect of estrogens in bone. Immunohistochemistry identified clear luciferase staining in hypertrophic growth plate chondrocytes, megakaryocytes, osteoblasts, and lining cells, whereas no staining was seen in proliferative chondrocyte. Although most of the osteocytes did not display any detectable luciferase staining, a subpopulation of osteocytes both in cortical and trabecular bone stained positive for luciferase. In conclusion, hypertrophic growth plate chondrocytes, megakaryocytes, osteoblasts, lining cells, and a subpopulation of osteocytes were identified to respond to estrogen via the classical ERE-mediated genomic pathway in bone. Furthermore, our findings indicate that possible direct estrogenic effects on the majority of osteocytes, not staining positive for luciferase, on proliferative chondrocytes and on mature lymphocytes are mediated by non-ERE actions.
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Affiliation(s)
- S H Windahl
- Department of Internal Medicine, Division of Endocrinology, Gröna Stråket 8, Gothenburg, Sweden
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Abstract
The purpose of this pilot study was to investigate intramuscular microcirculation in extensor carpi radialis brevis (ECRB) in patients with lateral epicondylitis. Ten patients with unilateral epicondylitis, mean duration of symptoms of 39 (12-96) months participated. The diagnosis was based on clinical examination and none was under treatment for the last 6 months. Isometric handgrip strength, 2-pinch grip strength and muscle strength during radial deviation and dorsal extension were determined. Functional perceived pain was evaluated by a modified behaviour rating scale and perceived pain during contraction by visual analogue scale. Intramuscular and skin blood flow was recorded by a laser-Doppler flowmetry system technique (LDF) during stable temperature condition. Intramuscular blood flow was significantly lower in the affected side, 22.7+/-9.8 perfusion units (PU), as compared with 35.2+/-11.9 PU in the control side (P=0.01). There was no difference in skin blood flow or temperature between the affected and the control side. A positive correlation was found between the duration of symptoms and the difference in intramuscular blood flow between the affected and the control arm (r=0.65, P=0.06). The present data indicate that decreased microcirculation and anaerobic metabolism in ECRB may contribute to the lateral epicondylitis symptoms.
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Affiliation(s)
- E Oskarsson
- Department of Clinical Medicine, Orebro University, Orebro, Sweden.
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Ylikotila J, Välimaa L, Vehniäinen M, Takalo H, Lövgren T, Pettersson K. A sensitive TSH assay in spot-coated microwells utilizing recombinant antibody fragments. J Immunol Methods 2005; 306:104-14. [PMID: 16154584 DOI: 10.1016/j.jim.2005.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2005] [Revised: 07/07/2005] [Accepted: 08/08/2005] [Indexed: 11/29/2022]
Abstract
We have developed a novel TSH immunoassay based on a simplified test protocol suitable for point-of-care testing yet providing 3rd generation TSH assay sensitivity. The antibody density and the functional solid phase capacity were improved up to six-fold by capturing the site-specifically biotinylated recombinant Fab fragment or single chain antibody fragment onto the surface of immobilized streptavidin. An important mechanism for obtaining a low limit of detection (0.003 mIU/l) was the reduction of the coated area to a size ("spot") more closely coinciding with the excitation beam. The reporter technology was based on time-resolved fluorometric detection of inherently fluorescent europium chelates of high quantum yield. The ready-to-use assay concept employed the all-in-one (Aio!) principle--holding all assay components in a dry form in the microtitration well--to provide a simple assay protocol. Direct signal measurement from the surface was done after the washing step without a separate development step. It is concluded that size reduction and site-specific labeling of the antibodies to create a surface with high functional capacity provides a rapid, highly sensitive immunoassay.
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Affiliation(s)
- J Ylikotila
- University of Turku, Department of Biotechnology, Tykistökatu 6A, FIN-20520 Turku, Finland.
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Abstract
OBJECTIVE Degeneration and death of cardiomyocytes contribute to the genesis of heart failure (HF) in aortic valve stenosis (AS). We studied whether the ongoing myocyte damage in AS can be detected from circulating cardiac troponin I (cTnI) concentrations. DESIGN AND SETTING A cross-sectional cohort study in a university hospital. SUBJECTS AND METHODS We examined 131 adult patients undergoing echocardiography and cardiac catheterization for isolated AS. Blood was sampled from the aortic root and, in a subset of 49 patients, also from the coronary sinus for the determination of cTnI using a sensitive immunoanalysis. RESULTS Seventy-three patients (56%) had detectable aortic cTnI (> or =5 ng L(-1)) with 30 of them (23% of the total group) having cTnI above the reference limit in healthy subjects (>14 ng L(-1)). Patients with detectable cTnI had a higher prevalence of HF than those with undetectable cTnI (42% vs. 19%, P = 0.004). Plasma cTnI rose from the aorta to the coronary sinus by > or =5 ng L(-1) in 13 of 49 patients with AS (27%) versus in none of 12 control patients free of structural heart disease (P = 0.044). AS patients with transcardiac cTnI gradients > or =5 ng L(-1) had lower left ventricular (LV) ejection fractions than AS patients with gradients <5 ng L(-1) (mean +/- SD, 52 +/- 14% vs. 61 +/- 11%; P = 0.011). CONCLUSIONS Detectable circulating cTnI is not uncommon in AS and shows a moderate association with the presence of HF. Leakage of cTnI into the coronary sinus associates with impairment of LV systolic function. Monitoring cTnI could provide a means to expose incipient clinical deterioration in AS.
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Affiliation(s)
- M Kupari
- Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
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Ilva T, Eriksson S, Lund J, Porela P, Mustonen H, Pettersson K, Pulkki K, Voipio-Pulkki LM. Improved early risk stratification and diagnosis of myocardial infarction, using a novel troponin I assay concept. Eur J Clin Invest 2005; 35:112-6. [PMID: 15667582 DOI: 10.1111/j.1365-2362.2005.01466.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND We evaluated the clinical performance of a novel cardiac troponin I (cTnI) assay specifically designed to improve the very early risk stratification in acute coronary syndromes. SUBJECTS AND METHODS Serum and plasma samples (taken 0, 6-12 h and 24 h after admission) from 531 patients with suspected acute coronary syndrome were studied using a novel investigational cTnI assay, reference cTnI assay and myoglobin. The lowest cTnI concentration giving a total assay imprecision of 10% was used as the positive myocardial infarction (MI) cut-off value. RESULTS At the time of admission, the investigational assay was positive in 27.9% of the patients, the reference cTnI assay was positive in only 17.5% (P < 0.001) and myoglobin in 24.1% (P = 0.067). Receiver operating characteristic (ROC) curve analysis for the detection of myocardial injury on admission gave area-under-curve (AUC) values of 0.937, 0.775 and 0.762, respectively (P < 0.001). Of those MI patients who presented within 3 h of symptom onset, 50.0% were identified by the investigational assay at the time of presentation, compared with 44.2% by myoglobin (P = 0.791) but only 11.5% by the reference assay (P < 0.001). CONCLUSIONS The novel cTnI assay considerably improves the performance of cTnI as an early rule-in biomarker for MI.
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Affiliation(s)
- T Ilva
- Department of Medicine, University of Turku, FIN-20520 Turku, Finland.
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Hänni M, Edvardsson H, Wågberg M, Pettersson K, Smedby O. Quantification of Atherosclerosis with MRI and Image Processing in Spontaneously Hyperlipidemic Rabbits. J Cardiovasc Magn Reson 2004; 6:675-84. [PMID: 15347132 DOI: 10.1081/jcmr-120038087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The need for a quantitative method to assess atherosclerosis in vivo is well known. This study tested, in a familiar animal model of atherosclerosis, a combination of magnetic resonance imaging (MRI) and image processing. Six spontaneously hyperlipidemic (Watanabe) rabbits were examined with a knee coil in a 1.5-T clinical MRI scanner. Inflow angio (2DI) and proton density weighted (PDW) images were acquired to examine 10 cm of the aorta immediately cranial to the aortic bifurcation. Examination of the thoracic aorta was added in four animals. To identify the inner and outer boundary of the arterial wall, a dynamic contour algorithm (Gradient Vector Flow snakes) was applied to the 2DI and PDW images, respectively, after which the vessel wall area was calculated. The results were compared with histopathological measurements of intima and intima-media cross-sectional area. The correlation coefficient between wall area measurements with MRI snakes and intima-media area was 0.879 when computed individual-wise for abdominal aortas, 0.958 for thoracic aortas, and 0.834 when computed segment-wise. When the algorithm was applied to the PDW images only, somewhat lower correlations were obtained. The MRI yielded significantly higher values than histopathology, which excludes the adventitia. Magnetic resonance imaging, in combination with dynamic contours, may be a suitable technique for quantitative assessment of atherosclerosis in vivo. Using two sequences for the measurement seems to be superior to using a single sequence.
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Affiliation(s)
- Mari Hänni
- Department of Radiology, University Hospital, Uppsala, Sweden.
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Törneke K, Ingvast-Larsson C, Pettersson K, Bergvall K, Hedeland M, Bondesson U, Broström H. Pharmacokinetics and pharmacodynamics of clemastine in healthy horses. J Vet Pharmacol Ther 2003; 26:151-7. [PMID: 12667185 DOI: 10.1046/j.1365-2885.2003.00460.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Clemastine is an H1 antagonist used in certain allergic disorders in humans and tentatively also in horses, although the pharmacology of the drug in this species has not yet been investigated. In the present study we determined basic pharmacokinetic parameters and compared the effect of the drug measured as inhibition of histamine-induced cutaneous wheal formation in six horses. The most prominent feature of drug disposition after intravenous dose of 50 microg/kg bw was a very rapid initial decline in plasma concentration, followed by a terminal phase with a half-life of 5.4 h. The volume of distribution was large, Vss = 3.8 L/kg, and the total body clearance 0.79 L/h kg. Notably, oral bioavailability was only 3.4%. There was a strong relationship between plasma concentrations and effect. The effect maximum (measured as reduction in histamine-induced cutaneous wheal formation) was 65% (compared with controls where saline was injected) and the effect duration after i.v. dose was approximately 5 h. The effect after oral dose of 200 microg/kg was minor. The results indicate that clemastine is not appropriate for oral administration to horses because of low bioavailability. When using repeated i.v. administration, the drug has to be administered at least three to four times daily to maintain therapeutic plasma concentrations because of the short half-life. However, if sufficient plasma concentrations are maintained the drug is efficacious in reducing histamine-induced wheal formations.
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Affiliation(s)
- K Törneke
- Department of Pharmacology and Toxicology, SLU, BMC, SE-75123, Uppsala, Sweden.
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hlund C, Pettersson K, Lind L. 2P-0537 Pulse wave analysis (PWA) and experimental stressors can be used to study vascular reactivity. ATHEROSCLEROSIS SUPP 2003. [DOI: 10.1016/s1567-5688(03)90676-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Consecutive adult patients (n = 70) referred for investigation of suspected asthma were reinvestigated after 5 years with the same diagnostic procedures (airway symptom score, spirometry, methacholine test) as used at the initial investigation. The same diagnostic criteria for asthma, asthma-like disorder (current asthma-like symptoms but negative asthmatests)and chronicobstructive pulmonary disease (COPD) were used at both visits. At the first visit 39/70 patients (56%) fulfilled the asthma criteria, 21/70 (27%) fulfilled the asthma-like criteria and 5/70 (7%) the COPD criteria. Due to lack of current symptoms 5/70 (7%) could not be classified. 5/70 patients (7%) were smokers, however, in the majority (72%) smoke was not tolerated as it induced asthma-like symptoms. At the investigation, 5 years later, 30/39 patients (76%) still fulfilled the asthma criteria and 12/21 patients (57%) still fulfilled the asthma-like criteria. At the 5-year investigation, 10% of patients in the asthma group now fulfilled the asthma-like criteria and 10% of patients in the asthma-like group fulfilled the asthma criteria. It is concluded that asthma as well an asthma-like syndrome may persist for 5 years or more. It is also concluded thatthe two disorders are closely related as patients in the asthma group over time could move into the diagnostic criteria ofthe asthma-like disorder and vice versa.
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Affiliation(s)
- O Löwhagen
- Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergy, Sahlgrenska University Hospital, Göteborg, Sweden.
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Abstract
The aim of this study was to identify the prevalence of brain/brainstem dysfunction after acute whiplash trauma (grades II and III according to the Quebec Task Force Classification on whiplash-associated disorders) and to investigate a possible correlation between the development of chronic symptoms and objective findings from auditory brainstem response (ABR) and eye motility tests. We used ABR and oculomotor tests and a thorough clinical, subjective and psychological evaluation in a sample of prospective whiplash trauma patients who were followed up for 2 years after the trauma. The initial test results did not reveal any prognostic clinical signs for the tested group as a whole, but we could discriminate some patients with clinical symptoms and signs paired with pathologic test results. Over time, some patients normalized clinically and their test results improved while others deteriorated clinically and their test results were worse at the 2-year investigation. Our findings of moderate derangements in the tests could be the effects of pain and/or changed cervical afferent activity at the brain/brainstem level, while eye motility dysfunction, in addition to pathological neuro-otological findings in a small proportion of the patients with severe symptoms, could be explained by lesions to the brain/brainstem.
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Affiliation(s)
- B I Wenngren
- Department of Otorhinolaryngology, University of Umeå, Sweden.
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Faulds MH, Pettersson K, Gustafsson JA, Haldosén LA. Cross-talk between ERs and signal transducer and activator of transcription 5 is E2 dependent and involves two functionally separate mechanisms. Mol Endocrinol 2001; 15:1929-40. [PMID: 11682624 DOI: 10.1210/mend.15.11.0726] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Steroid hormone receptors and signal transducers and activators of transcription (STAT) factors constitute two distinct families of transcription factors activated by different signaling pathways. In previous reports, cross-talk between STAT5 and several steroid receptors has been demonstrated. We investigated putative cross-talk between ERalpha and ERbeta and STAT5. ERalpha and ERbeta were found to potently repress PRL-induced STAT5 transcriptional activity on a beta-casein promoter construct in a ligand-dependent manner. This down-regulation was found to rely on direct physical interaction between the ERs and STAT5, mediated via the ER DNA-binding domain (DBD). The contact between the ER DBD and STAT5 is highly specific; the interaction is abolished if the ERalpha DBD is replaced with the DBD of a closely related steroid receptor. The physical interaction, however, is insufficient to confer the repression of STAT5 activity, which in addition requires the ligand-activated C-terminal part of the ERs, although these domains are not in direct contact with STAT5. Negative cross-talk between ERs and STAT5 is thus mediated via several functionally separated domains of the ERs. Our findings may enhance the understanding of mechanisms of regulation of the different hormonal signaling pathways occurring during different functional events in tissues coexpressing ERs and STAT5.
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Affiliation(s)
- M H Faulds
- Department of Medical Nutrition, Karolinska Institute, NOVUM, S-14186 Huddinge, Sweden
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