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  • 201.
    Pandey, Jaya
    et al.
    Physics Department, University of Lucknow.
    Prajapati, Preeti
    Physics Department, University of Lucknow.
    Shimpi, Manishkumar
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Tandon, Poonam
    Physics Department, University of Lucknow.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Srivastava, Anubha
    Physics Department, University of Lucknow.
    Sinha, Kirti
    Physics Department, University of Lucknow.
    Studies of molecular structure, hydrogen bonding and chemical activity of a nitrofurantoin-L-proline cocrystal: a combined spectroscopic and quantum chemical approach2016Inngår i: RSC Advances, ISSN 2046-2069, E-ISSN 2046-2069, Vol. 6, nr 78, s. 74135-74154Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Nitrofurantoin (NTF) has been used as an antibacterial drug to treat bacterial infections of the urinary tract. The purpose of this work is to predict the hydrogen bonds (potential synthons) present in the cocrystal of nitrofurantoin-L-proline (NTF-LP) through a computational approach (DFT calculations) and validate using vibrational spectroscopic studies. The present study illustrates the formation and characterization of the cocrystal of NTF-LP. The molecular structure of the NTF-LP cocrystal has been predicted by forming several models on the basis of the hydrogen bonding patterns observed in other NTF cocrystals. A conformational study and potential energy surface scan have been plotted around three flexible bonds of the cocrystal molecule and two stable conformers have been obtained. NBO analysis of the second order perturbation theory of the Fock matrix suggests that interaction n1O(39) → σ*(N13–H21) is responsible for the stabilization of the molecule. Quantum theory of atoms in molecules (QTAIM) explains that all interactions are medium and partially covalent in nature as ∇2ρBCP > 0, HBCP < 0. The molecular electrostatic potential surface (MEPS) of the cocrystal has been visualized for its most electropositive potential in the region of the NH2+ group and most electronegative potential in the vicinity of the COO− group. The HOMO and LUMO energies and electronic charge transfer (ECT) confirms that charge flows from the co-former (LP) to NTF (API). Local reactivity descriptor parameters have been used to predict the reactive sites of the cocrystal and global reactivity descriptor parameters suggest that the cocrystal is softer thus more reactive in comparison to NTF. The experimental and theoretical results support the formation of the cocrystal through the strong hydrogen bond present between the NH group of NTF and carboxylate COO− group of LP and shows that LP is present in the zwitterionic form.

  • 202.
    Pauelsen, Mascha
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Jacobson, Inger
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Larsson, Agneta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Skadepanorama och riskfaktorer inom Flat Track Roller Derby2014Inngår i: Svensk idrottsmedicin, ISSN 1103-7652, Vol. 2014, nr 1, s. 22-25Artikkel i tidsskrift (Annet vitenskapelig)
  • 203.
    Pauelsen, Mascha
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Gusten
    Department of Radiology, Linköping University Hospital.
    Tegner, Cecilia
    Swedish University of Agricultural Sciences, Uppsala.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Concussion in ice hockey: A Cohort Study Across 29 Seasons2017Inngår i: Clinical Journal of Sports Medicine, ISSN 1050-642X, E-ISSN 1536-3724, Vol. 27, nr 3, s. 283-287Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to analyse the concussion incidence rate ratios (IRR) across 29 seasons in a Swedish Hockey League team.Design: Cohort study over 29 seasons within one Swedish elite series ice hockey team. Participants: All players who were part of one Swedish elite ice hockey team during the research period gave consent for participation in the study.Independent Variables: Exposure to top level Swedish ice hockey. Main Outcome Measures: Incidence rate ratio for concussion as well as rehabilitation periods due to concussion were calculated and analysed.Results: During the research period, 267 players in total were part of the team. A total of 1638 traumatic injuries were registered of which 162 were concussions. Incidence rates ranged from 0/1,000 games during the first season to 118/1,000 games for the final recorded season. The incidence rate ratio was 1.06 (CI = 1.03-1.10) for the entire research period. A shift towards longer rehabilitation periods was discovered.Conclusions: This study showed a significant increase of concussion incidence rate and a trend towards longer rehabilitation periods due to concussion. Possible risk factors were discussed. Risk behaviour and rehabilitation protocols should be prioritized areas in the research of concussion in ice hockey. 

  • 204.
    Pauelsen, Mascha
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Hjärnskakning i hockey: en studie över 29 säsonger2015Konferansepaper (Annet vitenskapelig)
    Abstract [sv]

    Hockey är en intensiv sport med en stor risk för commotio. Syftet med studien var att analysera förändring i incidensen av commotio över en 29-års period i ett svenskt elit hockeylag. Under åren 1985-2013 gjordes en prospektiv skaderegistrering i laget. Alla skador som föranledde avbrytande eller bortovaro från match/träning registrerades. skadeorsak, -tidpunkt, -mekanism etc. och närvaro på match/träning registrerades i ett skaderegistreringsprogram (ISIS). Skadedefinitionen på commotio var - förutom under första året - densamma över hela perioden och alla diagnoser ställdes av en och samma läkare. Under studieperioden var 267 spelare med i laget. Totalt registrerades 1628 traumatiska skador och av dessa var 162 (10%) commotio. Incidensen av commotio varierade från 0/1000 matcher under första säsongen till 118/1000 matcher under den sista säsongen. De flesta (85%) av commotio inträffade under match. Bortovaron pga commotio ökade från 0 dagar till 10 dagar per commotio (p<0,001) under studieperioden. Denna kohortstudie visar på en ökning av commotio incidensen över en 29 års period. Vidare ökar bortovaron från match/träning tydande på att skadorna blir allvarligare.

  • 205.
    Persson, Ann-Sofie
    et al.
    Department of Pharmacy, Uppsala University.
    Ahmed, Hamzah
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Alderborn, Göran
    Department of Pharmacy, Uppsala University.
    Powder compression properties of paracetamol, paracetamol hydrochloride, paracetamol cocrystals and coformers2018Inngår i: Journal of Pharmaceutical Sciences, ISSN 0022-3549, E-ISSN 1520-6017, Vol. 107, nr 7, s. 1920-1927Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective was to study the relationship between crystal structure, particle deformation properties and tablet-forming ability for the monoclinic form of paracetamol (PRA), two cocrystals and a salt crystal of PRA in addition to two coformers (oxalic acid and 4,4’-bipyridine). Thus, the structure – property – performance relationship was investigated. Analytical powder compression was used for determination of effective plasticity, as inferred from the Heckel yield pressure and the Frenning parameter, and the elastic deformation was determined from in-die tablet elastic recovery.

    plasticity could not be linked to the crystal lattice structure as crystals containing zig-zag layers displayed similar plasticity as cThe rystals containing slip planes. In addition, crystals containing slip-planes displayed both high and low plasticity.

    The mechanical properties could neither be linked to the tablet-forming ability as the tablet tensile strength, unexpectedly, displayed a tendency to reduce with increased plasticity stiffness. Furthermore, the elastic deformation could not explain the tablet forming ability.

    It was concluded that no relationship between structure – property – performance for paracetamol and its cocrystals and salt could be established. Thus, it was indicated that to establish such a relationship an improved knowledge of crystallographic structure and inter-particle bonding during compaction is needed.

  • 206.
    Poso, Tomi
    et al.
    Sunderby Hospital, Department of Anaesthesiolofy & Intensive Care.
    Kesek, Doris
    Umea University, Department of Surgery & Perioperative Science, Department fo Cardiothorac Anaesthesia.
    Winso, Ola
    Umea University, Department of Surgery & Perioperative Science, Department fo Cardiothorac Anaesthesia.
    Andersson, Staffan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Volatile rapid sequence induction in morbidly obese patients2011Inngår i: European Journal of Anaesthesiology, ISSN 0265-0215, E-ISSN 1365-2346, Vol. 28, nr 11, s. 781-787Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and objective The interest in bariatric surgery is growing. Morbidly obese patients have an increased risk of hypoxia and decreased blood pressure during rapid sequence induction (RSI). Alternate RSI methods that provide cardiovascular and respiratory stability are required. With this in mind, we evaluated a method for volatile RSI in morbidly obese patients. Design Observational study. Methods Thirty-four patients with mean BMI 42.4 kg m(-2) undergoing bariatric surgery (morbidly obese group) and 22 patients with mean BMI 25.6 kg m(-2) as a control group were included in the study. Anaesthesia was induced with sevoflurane, propofol, suxamethonium and alfentanil, designed to avoid respiratory and haemodynamic adverse events and to minimise depressing effect on the brain respiratory centre under ongoing RSI. Peripheral oxygen saturation (SpO(2)) and mean arterial blood pressure were registered before and after endotracheal intubation. In addition, two time periods were measured during RSI: spontaneous breathing time (SBT) and apnoea time. Results We found no significant differences between the groups. No periods of desaturation were detected. SpO(2) was 100% before and after endotracheal intubation in all patients. Mean arterial pressure was maintained at a stable level in both groups. Mean SBT and apnoea time were 65.6 and 45.8 s in the morbidly obese group, and 70.7 and 47.7 s in the control group, respectively.

  • 207.
    Prajapati, Preeti
    et al.
    Physics Department, University of Lucknow.
    Pandey, Jaja
    Physics Department, University of Lucknow.
    Shimpi, Manishkumar
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Srivastava, Anubha
    Physics Department, University of Lucknow.
    Tandon, Poonam
    Physics Department, University of Lucknow.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Sinha, Kirti
    Physics Department, University of Lucknow.
    Combined spectroscopic and quantum chemical studies of ezetimibe2016Inngår i: Journal of Molecular Structure, ISSN 0022-2860, E-ISSN 1872-8014, Vol. 1125, s. 193-203Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Ezetimibe (EZT) is a hypocholesterolemic agent used for the treatment of elevated blood cholesterol levels as it lowers the blood cholesterol by blocking the absorption of cholesterol in intestine. Study aims to combine experimental and computational methods to provide insights into the structural and vibrational spectroscopic properties of EZT which is important for explaining drug substance physical and biological properties. Computational study on molecular properties of ezetimibe is presented using density functional theory (DFT) with B3LYP functional and 6-311++G(d,p) basis set. A detailed vibrational assignment has been done for the observed IR and Raman spectra of EZT. In addition to the conformational study, hydrogen bonding and molecular docking studies have been also performed. For conformational studies, the double well potential energy curves have been plotted for the rotation around the six flexible bonds of the molecule. UV absorption spectrum was examined in methanol solvent and compared with calculated one in solvent environment (IEF-PCM) using TD-DFT/6-31G basis set. HOMO-LUMO energy gap of both the conformers have also been calculated in order to predict its chemical reactivity and stability. The stability of the molecule was also examined by means of natural bond analysis (NBO) analysis. To account for the chemical reactivity and site selectivity of the molecules, molecular electrostatic potential (MEPS) map has been plotted. The combination of experimental and calculated results provide an insight into the structural and vibrational spectroscopic properties of EZT. In order to give an insight for the biological activity of EZT, molecular docking of EZT with protein NPC1L1 has been done.

  • 208.
    Rani, Komal
    et al.
    Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
    Mukherjee, Ranjan
    Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
    Singh, Ekta
    Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
    Kumar, Sanjeev
    Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
    Sharma, Vaibhav
    Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
    Vishwakarma, Poorvi
    Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
    Bharti, Prahalad Singh
    Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
    Nikolajeff, Fredrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Dinda, Ashok Kumar
    Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
    Goyal, Vinay
    Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
    Kumar, Saroj
    Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
    Neuronal exosomes in saliva of Parkinson's disease patients: A pilot study2019Inngår i: Parkinsonism & Related Disorders, ISSN 1353-8020, E-ISSN 1873-5126, Vol. 67, s. 21-23Artikkel i tidsskrift (Fagfellevurdert)
  • 209.
    Rao Vuddanda, Parameswara
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap. Banaras Hindu University, Institute of Technology, Department of Pharmaceutics, Varanasi .
    Chakraborty, Subhashis
    Department of Pharmaceutics, Institute of Technology, Banaras Hindu University, Varanasi .
    Singh, Sanjay Kumar
    Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanasi, Uttar Pradesh.
    Berberine: A potential phytochemical with multispectrum therapeutic activities2010Inngår i: Expert Opinion on Investigational Drugs, ISSN 1354-3784, E-ISSN 1744-7658, Vol. 19, nr 10, s. 1297-1307Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Importance of the field: The use of traditional medicines of natural origin is being encouraged for the treatment of chronic disorders, as synthetic drugs in such cases may cause unpredictable adverse effects. Berberine, a traditional plant alkaloid, is used in Ayurvedic and Chinese medicine for its antimicrobial and antiprotozoal properties. Interestingly, current clinical research on berberine has revealed its various pharmacological properties and multi-spectrum therapeutic applications. Areas covered in this review: An extensive search in three electronic databases (Unbound Medline, PubMed and ScienceDirect) and internet search engines (Scirus and Google Scholar) were used to identify the clinical studies on berberine, without any time constraints. This review elaborates the recent studies which reveal that with time, the drug has evolved with superior therapeutic activities. In addition, this review will also attract the attention of formulation scientists towards the issues and challenges associated in its drug delivery and the probable approaches that may be explored to help patients reap the maximum benefit of this potentially useful drug. What the reader will gain: A relatively large number of studies discussed here have revealed the possible areas where this phytochemical constituent can exhibit its therapeutic activities in the treatment of chronic ailments or diseases including diabetes, cancer, depression, hypertension and hypercholesterolemia. Take home message: The potential of the drug remains to be harvested by designing a suitable formulation that could overcome its inherent low bioavailability

  • 210.
    Rao Vuddanda, Parameswara
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Montenegro-Nicolini, Miguel
    Department of Pharmaceutical Sciences and Technology, University of Chile, Santiago.
    Morales, Javier O.
    Department of Pharmaceutical Sciences and Technology, University of Chile, Santiago.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Effect of plasticizers on the physico-mechanical properties of pullulan based pharmaceutical oral films2017Inngår i: European Journal of Pharmaceutical Sciences, ISSN 0928-0987, E-ISSN 1879-0720, Vol. 96, s. 290-298Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The effect of different plasticizers (glycerol, vitamin E TPGS and triacetin) and their concentrations on the physico-mechanical properties of pullulan based oral films was studied. A full factorial (32) design of experiments was used. Elastic modulus, tensile strength, elongation at break and disintegration time were selected as response variables. Modulated differential scanning calorimeter (MDSC) was used for determining glass transition temperature (Tg) of pullulan films. The surface morphology of films was evaluated by SEM, while ATR-FTIR was used to obtain a molecular level understanding of polymer-plasticizer interactions. The DoE analysis allowed for the modelling of tensile strength and elongation at break. The highest elongations were observed in glycerol at 20% w/w. Majority of the films disintegrated within one minute without significant differences. ATR-FTIR spectra of pullulan alone and different plasticizer blend films show characteristic molecular interactions. The present study concluded that glycerol is suitable plasticizer compared to others for manufacturing pullulan based oral films.

  • 211.
    Rao Vuddanda, Parameswara
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Montenegro-Nicolini, Miguel
    Department of Pharmaceutical Sciences and Technology, University of Chile.
    Morales, Javier O.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Effect of surfactants and drug load on physico-mechanical and dissolution properties of nanocrystalline tadalafil-loaded oral films2017Inngår i: European Journal of Pharmaceutical Sciences, ISSN 0928-0987, E-ISSN 1879-0720, Vol. 109, s. 372-380Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the present work was to prepare tadalafil (TDF) nanocrystals-loaded oral polymeric films (OFs) and investigate the effect of hydrophilic surfactants and drug loads on the physico-mechanical and dissolution properties. The nanosuspensions of TDF were prepared by high shear homogenization. HPMC based placebo casting film gel was prepared and mixed with TDF nanosuspensions. Films were casted using an automated film applicator and dried at 60 °C for 45 min. Particle size (PS), polydispersity index (PDI), and zeta potential (ZP) of TDF nanosuspensions were measured in a Zetasizer. The films were characterized using SEM, AFM, DSC, TGA and PXRD. The mechanical properties and in vitro drug release were determined using standard methods. TDF existed in crystalline form and the particles remained in the nano-range in redispersed films. TDF nanocrystals were embedded in the polymeric matrix and the drug loaded films were rough on the surface. Mechanical properties of the films varied with changes in drug load and surfactant. Significant changes in the disintegration times were noticed in films containing surfactants compared to surfactant-free films. About 80% of the drug release was observed between 3 and 30 min. TPGS showed better TDF release from the films at different drug loads

  • 212.
    Roos, Eva M.
    et al.
    Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense.
    Engelhart, Luella
    Health Economics & Outcomes Research, DePuy, Inc., Raynham.
    Ranstam, Jonas
    Department of Orthopedics, Clinical Sciences Lund, Lund University.
    Anderson, Allen F.
    Tennessee Orthopaedic Alliance/The Lipscomb Clinic, Nashville.
    Irrgang, Jay J.
    Department of Orthopedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh.
    Marx, Robert G.
    Hospital for Special Surgery, Weill Cornell Medical College, New York.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Davis, Aileen M.
    Division of Health Care and Outcomes Research and Arthritis and Community Research and Evaluation Unit, Toronto Western Research Institute, and Departments of Physical Therapy, Rehabilitation Science and Health Policy Management and Evaluation, University of Toronto.
    ICRS recommendation document: Patient-reported outcome instruments for use in patients with articular cartilage defects2011Inngår i: Cartilage, ISSN 1947-6035, E-ISSN 1947-6043, Vol. 2, nr 2, s. 122-136Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The purpose of this article is to describe and recommend patient-reported outcome instruments for use in patients with articular cartilage lesions undergoing cartilage repair interventions. Methods: Nonsystematic literature search identifying measures addressing pain and function evaluated for validity and psychometric properties in patients with articular cartilage lesions. Results: The knee-specific instruments, titled the International Knee Documentation Committee Subjective Knee Form and the Knee injury and Osteoarthritis and Outcome Score, both fulfill the basic requirements for reliability, validity, and responsiveness in cartilage repair patients. A major difference between them is that the former results in a single score and the latter results in 5 subscores. A single score is preferred for simplicity’s sake, whereas subscores allow for evaluation of separate constructs at all levels according to the International Classification of Functioning. Conclusions: Because there is no obvious superiority of either instrument at this time, both outcome measures are recommended for use in cartilage repair. Rescaling of the Lysholm Scoring Scale has been suggested, and confirmatory longitudinal studies are needed prior to recommending this scale for use in cartilage repair. Inclusion of a generic measure is feasible in cartilage repair studies and allows analysis of health-related quality of life and health economic outcomes. The Marx or Tegner Activity Rating Scales are feasible and have been evaluated in patients with knee injuries. However, activity measures require age and sex adjustment, and data are lacking in people with cartilage repair.

  • 213.
    Röijezon, Ulrik
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Løvoll, Grunde
    Norwegian Institute for Water Research (NIVA), Section for Environmental Data Science .
    Henriksson, Anders
    Department of Sport and Health Sciences, School of Education, Health and Social Sciences, Dalarna University.
    Tonkonogi, Michail
    Department of Sport and Health Sciences, School of Education, Health and Social Sciences, Dalarna University.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    An Initial Study on the Coordination of Rod and Line Hauling Movements in Distance Fly Casting2017Inngår i: Annals of Applied Sport Science, ISSN 2476-4981, Vol. 5, nr 2, s. 61-72Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. The double haul is a unique feature of single-handed fly casting and is used in both fly fishing and fly casting competition. The movement behaviour during the double haul has not been investigated in previous research.

    Objectives. Describe the coordination of the rod and line hauling movements during distance fly casting.

    Methods. Elite fly casters performed distance casting with four different fly rod and fly line set-ups used in fly fishing and fly casting competition. Rod and hauling movements were measured with a 3D motion analysis system.

    Results. The rod and line hauling movements were coordinated in an order whereby peak translational speed of the rod occurs prior to the peak speed of the angular rotation of the rod, and the peak speed of the angular rotation of the rod occurs prior to the peak speed of the line haul. This was consistent for all cast sequences, i.e., the back and forward false casts and the delivery cast, and for all four equipment set-ups, i.e., a shooting-head line cast with a relatively stiff fly rod and a long-belly line cast with three different fly rods with different stiffness and action curves. Results also showed differences in movement coordination between cast sequences and rod and line set-ups.

    Conclusion. Among elite casters, single-handed fly casting with double haul is coordinated in an order of events whereby the peak speed occurs first for the translation of the rod, then for the rotation of the rod and finally for the line haul.

  • 214.
    Shahim, Pashtun
    et al.
    Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Adiutori, Rocco
    Queen Mary University of London.
    Ladenson, Jack H.
    Washington University School of Medicine, St. Louis, Missouri.
    Macy, Elizabeth H.
    Washington University School of Medicine, St. Louis, Missouri.
    Crimmins, Dan
    Washington University School of Medicine, St. Louis, Missouri.
    Mattsson, Niklas
    UCSF, San Francisco, California.
    Giovannoni, Gavin
    Queen Mary University of London.
    Kallberg, Birgitta
    Sahlgrenska University Hospital, Mölndal.
    Blennow, Kaj
    Sahlgrenska Academy, University of Gothenburg, Mölndal.
    Kuhne, Jens
    Blizard Institute, London.
    Zetterberg, Henrik
    Sahlgrenska Academy, University of Gothenburg, Mölndal.
    Serum neurofilament light protein and visin-like protein-1 in concussed professional ICE hockey players2014Inngår i: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 10, nr 4 uppl., s. P655-Artikkel i tidsskrift (Fagfellevurdert)
  • 215.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Gren, Magnus
    Institute of Neuroscience and Physiology / The Sahlgrenska Academy, Gothenburg.
    Liman, Victor
    Institute of Neuroscience and Physiology / The Sahlgrenska Academy, Gothenburg.
    Andreasson, Ulf
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg.
    Norgren, Niklas
    UmanDiagnostics, Umeå.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Mattsson, Niklas
    Clinical Memory Research Unit, Lund University.
    Andreassen, Niels
    Department of NVS, Karolinska Institute, Center for Alzheimer Research.
    Öst, Martin
    Institute of Clinical Sciences / Sahlgrenska Academy, Gothenburg.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal.
    Nellgård, Bengt
    Institute of Clinical Sciences / Sahlgrenska Academy, Gothenburg.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Serum neurofilament light protein predicts clinical outcome in traumatic brain injury2016Inngår i: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 12, nr 7 Suppl., s. P896-P897Artikkel i tidsskrift (Fagfellevurdert)
  • 216.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Gren, Magnus
    Institute of Neuroscience and Physiology / The Sahlgrenska Academy, Gothenburg.
    Liman, Victor
    Institute of Neuroscience and Physiology / The Sahlgrenska Academy, Gothenburg.
    Andreasson, Ulf
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg.
    Norgren, Niklas
    UmanDiagnostics, Umeå.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Mattsson, Niklas
    Clinical Memory Research Unit, Lund University.
    Andreassen, Niels
    Department of NVS, Karolinska Institute, Center for Alzheimer Research.
    Öst, Martin
    Institute of Clinical Sciences / Sahlgrenska Academy, Gothenburg.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal.
    Nellgård, Bengt
    Institute of Clinical Sciences / Sahlgrenska Academy, Gothenburg.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Serum neurofilament light protein predicts clinical outcome in traumatic brain injury2016Inngår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 6, artikkel-id 36791Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Axonal white matter injury is believed to be a major determinant of adverse outcomes following traumatic brain injury (TBI). We hypothesized that measurement of neurofilament light protein (NF-L), a protein found in long white-matter axons, in blood samples, may serve as a suitable biomarker for neuronal damage in TBI patients. To test our hypotheses, we designed a study in two parts: i) we developed an immunoassay based on Single molecule array technology for quantification of NF-L in blood, and ii) in a proof-of-concept study, we tested our newly developed method on serial serum samples from severe TBI (sTBI) patients (n = 72) and controls (n = 35). We also compared the diagnostic and prognostic utility of NF-L with the established blood biomarker S100B. NF-L levels were markedly increased in sTBI patients compared with controls. NF-L at admission yielded an AUC of 0.99 to detect TBI versus controls (AUC 0.96 for S100B), and increased to 1.00 at day 12 (0.65 for S100B). Importantly, initial NF-L levels predicted poor 12-month clinical outcome. In contrast, S100B was not related to outcome. Taken together, our data suggests that measurement of serum NF-L may be useful to assess the severity of neuronal injury following sTBI.

  • 217.
    Shahim, Pashtun
    et al.
    Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Linemann, Thomas
    Nordic Bioscience Biomarkers & Research, Neurodegenerative Diseases, Herlev.
    Inecki, Dilek
    Nordic Bioscience Biomarkers & Research, Neurodegenerative Diseases, Herlev.
    Karsdal, Morten Asser
    Nordic Bioscience Biomarkers & Research, Neurodegenerative Diseases, Herlev.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska Academy, University of Gothenburg, Mölndal.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Zetterberg, Henrik
    Sahlgrenska Academy, University of Gothenburg, Mölndal, Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Henriksen, Kim
    Nordic Bioscience Biomarkers & Research, Neurodegenerative Diseases, Herlev.
    Serum tau fragments predict return to play in concussed professional ice hockey players2016Inngår i: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 33, nr 22, s. 1995-1999Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: The diagnosis of sports-related concussion is mainly based on subjective clinical symptoms and neuropsychological tests. Thus, reliable brain injury biomarkers to assess when it is safe to return to play are highly desirable. The overall objective of this study was to evaluate the utility of two newly described tau fragments for diagnosis and prognosis of sports-related concussions Materials and Methods: This multicenter prospective cohort study involved all 12 teams of the top professional ice hockey league in Sweden. A total of 288 players consented to participate in the study. Thirty-five players sustained concussions, of whom 28 underwent repeated blood samplings at 1, 12, 36, and 144 hours after the trauma, or when the player returned to play (7- > 90 days). RESULTS: There was no significant increase in the levels of tau-A in post-concussion samples compared with preseason values. However, serum levels of tau-C were significantly higher in post-concussion samples compared with preseason. Further, levels of Tau-A correlated with the duration of post-concussive symptoms. DISCUSSION: Tau-A in serum, which is newly discovered biomarker, could be used to predict when it is safe to return to play after a sports-related concussion.

  • 218.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Mattsson, Niklas
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Macy, Elizabeth H.
    Washington University School of Medicine, St. Louis, Missouri.
    Crimmins, Dan
    Washington University School of Medicine, St. Louis, Missouri.
    Ladenson, Jack H.
    Washington University School of Medicine, St. Louis, Missouri.
    Zetterberg, Henrik
    Sahlgrenska Academy, University of Gothenburg, Mölndal, Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska Academy, University of Gothenburg, Mölndal.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Serum visinin-like protein-1 in concussed professional ice hockey players2015Inngår i: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 29, nr 7-8, s. 872-876Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Primary objective: Visinin-like protein-1 (VILIP-1) has shown potential utility as a biomarker for neuronal injury in cerebrospinal fluid. This study investigated serum VILIP-1 as a diagnostic and prognostic marker in sports-related concussion. Methods: This multi-centre prospective cohort study involved the 12 teams of the professional ice hockey league in Sweden. A total of 288 players consented to participate in the study. Thirty-five players sustained concussions, of whom 28 underwent repeated blood samplings at 1, 12, 36 and 144 hours after the trauma or when the player returned to play (7-90 days). Main outcomes and results: The highest levels of VILIP-1 were measured 1 hour after concussion and the levels decreased during rehabilitation, reaching a minimum level at the 36-hour sampling. However, the levels of serum VILIP-1 at 1 hour after concussion were not significantly higher than pre-season baseline values. Serum levels of VILIP-1 1 hour post-concussion did not correlate with the number of days for the concussion symptoms to resolve. Further, serum levels of VILIP-1 increased after a friendly game in players who were not concussed. Conclusions: These results provide evidence that serum VILIP-1 may not be a useful biomarker for diagnosis and prognosis of sports-related concussion.

  • 219.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal.
    Cerebrospinal fluid biomarkers of neuronal injury in chronic traumatic brain injury2016Inngår i: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 12, nr 7 Suppl., s. P1056-Artikkel i tidsskrift (Fagfellevurdert)
  • 220.
    Shahim, Pashtun
    et al.
    Department of Neurology, Washington University School of Medicine, St. Louis, MO.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Broady, David L.
    Washington University School of Medicine, St. Louis, MO.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal.
    Astroglial activation and altered amyloid metabolism in human repetitive concussive traumatic brain injury2017Inngår i: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 13, nr 7 (Suppl), s. P216-P217Artikkel i tidsskrift (Fagfellevurdert)
  • 221.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Gustafsson, Bengt
    Capio Artro Clinic, Stockholm.
    Gren, Magnus
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Ärlig, Johan
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Olsson, Martin
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Lehto, Niklas
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Höglund, Kina
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Portelius, Erik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Neurochemical Aftermath of Repetitive Mild Traumatic Brain Injury2016Inngår i: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 73, nr 11, s. 1308-1315Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Importance:

    Evidence is accumulating that repeated mild traumatic brain injury (mTBI) incidents can lead to persistent, long-term debilitating symptoms and in some cases a progressive neurodegenerative condition referred to as chronic traumatic encephalopathy. However, to our knowledge, there are no objective tools to examine to which degree persistent symptoms after mTBI are caused by neuronal injury.

    Objective:

    To determine whether persistent symptoms after mTBI are associated with brain injury as evaluated by cerebrospinal fluid biochemical markers for axonal damage and other aspects of central nervous system injury.

    Design, Settings, and Participants:

    A multicenter cross-sectional study involving professional Swedish ice hockey players who have had repeated mTBI, had postconcussion symptoms for more than 3 months, and fulfilled the criteria for postconcussion syndrome (PCS) according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) matched with neurologically healthy control individuals. The participants were enrolled between January 2014 and February 2016. The players were also assessed with Rivermead Post Concussion Symptoms Questionnaire and magnetic resonance imaging.

    Main Outcomes and Measures:

    Neurofilament light protein, total tau, glial fibrillary acidic protein, amyloid β, phosphorylated tau, and neurogranin concentrations in cerebrospinal fluid.

    Results:

    A total of 31 participants (16 men with PCS; median age, 31 years; range, 22-53 years; and 15 control individuals [11 men and 4 women]; median age, 25 years; range, 21-35 years) were assessed. Of 16 players with PCS, 9 had PCS symptoms for more than 1 year, while the remaining 7 returned to play within a year. Neurofilament light proteins were significantly increased in players with PCS for more than 1 year (median, 410 pg/mL; range, 230-1440 pg/mL) compared with players whose PCS resolved within 1 year (median, 210 pg/mL; range, 140-460 pg/mL) as well as control individuals (median 238 pg/mL, range 128-526 pg/mL; P = .04 and P = .02, respectively). Furthermore, neurofilament light protein concentrations correlated with Rivermead Post Concussion Symptoms Questionnaire scores and lifetime concussion events (ρ = 0.58, P = .02 and ρ = 0.52, P = .04, respectively). Overall, players with PCS had significantly lower cerebrospinal fluid amyloid-β levels compared with control individuals (median, 1094 pg/mL; range, 845-1305 pg/mL; P = .05).

    Conclusions and Relevance:

    Increased cerebrospinal fluid neurofilament light proteins and reduced amyloid β were observed in patients with PCS, suggestive of axonal white matter injury and amyloid deposition. Measurement of these biomarkers may be an objective tool to assess the degree of central nervous system injury in individuals with PCS and to distinguish individuals who are at risk of developing chronic traumatic encephalopathy.

  • 222.
    Shahim, Pashtun
    et al.
    University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, Gothenburg, Sweden. Sahlgrens University Hospital, Neurochem Lab, Molndal, Sweden.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Marklund, Niklas
    Department of Neurology, Skåne University Hospital, Lund University, Sweden.
    Blennow, Kaj
    University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, Gothenburg, Sweden. Sahlgrens University Hospital, Neurochem Lab, Molndal, Sweden.
    Zetterberg, Henrik
    University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, Gothenburg, Sweden. Sahlgrens University Hospital, Neurochem Lab, Molndal, Sweden. UCL Institute of Neurology, Queen Square. UK Dementia Research Institute.
    Neurofilament light and tau as blood biomarkers for sports-related concussion2018Inngår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 90, nr 20, s. e1780-e1788Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective To compare neurofilament light (NfL) and tau as blood-based biomarkers for acute sports-related concussion (SRC) and determine whether their concentrations at different time points after the injury are associated with prolonged time to return to play (RTP).

    Methods A total of 288 professional hockey players were followed longitudinally from September 1, 2012, to April 30, 2015. Data collection and biomarker analyses were conducted between 2015 and 2017. Associations were tested between blood concentrations of NfL and tau, and RTP time. Serum concentrations of S100B and neuron-specific enolase (NSE) were also measured for comparison.

    Results Of 288 players, 105 sustained an SRC. Of these, 87 underwent blood sampling 1, 12, 36, and 144 hours after SRC and at the RTP time point. Serum NfL concentrations 1, 12, 36, and 144 hours after SRC were related to prolonged RTP time, and could separate players with RTP >10 days from those with RTP ≤10 days (area under the receiver operating characteristic curve [AUROC] 0.82). Also, serum NfL 144 hours after SRC discriminated players who resigned from the game due to persistent postconcussion symptoms (PCS) from those who returned to play (AUROC 0.89). Plasma tau 1 hour after SRC was related to RTP but less strongly than NfL, while S100B and NSE showed no such associations.

    Conclusion Serum NfL outperformed tau, S100B, and NSE as a biomarker for SRC. From a clinical standpoint, serum NfL may be useful to identify individuals at risk of prolonged PCS, and may aid in biomarker-informed decisions with regard to when RTP should be considered.

  • 223.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Marklund, Niklas
    Uppsala university, Department of Neuroscience and Neurosurgery.
    Höglund, Kina
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Portelius, Erik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Astroglial activation and altered amyloid metabolism in human repetitive concussion2017Inngår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 88, nr 15, s. 1400-1407Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To determine whether postconcussion syndrome (PCS) due to repetitive concussive traumatic brain injury (rcTBI) is associated with CSF biomarker evidence of astroglial activation, amyloid deposition, and blood–brain barrier (BBB) impairment.

    Methods: A total of 47 participants (28 professional athletes with PCS and 19 controls) were assessed with lumbar puncture (median 1.5 years, range 0.25–12 years after last concussion), standard MRI of the brain, and Rivermead Post-Concussion Symptoms Questionnaire (RPQ). The main outcome measures were CSF concentrations of astroglial activation markers (glial fibrillary acidic protein [GFAP] and YKL-40), markers reflecting amyloid precursor protein metabolism (Aβ38, Aβ40, Aβ42, sAPPα, and sAPPβ), and BBB function (CSF:serum albumin ratio).

    Results: Nine of the 28 athletes returned to play within a year, while 19 had persistent PCS >1 year. Athletes with PCS >1 year had higher RPQ scores and number of concussions than athletes with PCS <1 year. Median concentrations of GFAP and YKL-40 were higher in athletes with PCS >1 year compared with controls, although with an overlap between the groups. YKL-40 correlated with RPQ score and the lifetime number of concussions. Athletes with rcTBI had lower concentrations of Aβ40 and Aβ42 than controls. The CSF:serum albumin ratio was unaltered.

    Conclusions: This study suggests that PCS may be associated with biomarker evidence of astroglial activation and β-amyloid (Aβ) dysmetabolism in the brain. There was no clear evidence of Aβ deposition as Aβ40 and Aβ42 were reduced in parallel. The CSF:serum albumin ratio was unaltered, suggesting that the BBB is largely intact in PCS.

  • 224.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Wilson, David H.
    Quanterix Corp, Lexington, MA.
    Randall, Jeffrey
    Quanterix Corp, Lexington, MA.
    Skillbäck, Tobias
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Pazooki, David
    Department of Surgery, Sahlgrenska University Hospital.
    Kallberg, Birgitta
    Clinical Chemistry Laboratory, Sahlgrenska University Hospital.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Blood biomarkers for brain injury in concussed professional ice hockey players2014Inngår i: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 71, nr 6, s. 684-692Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    IMPORTANCE Lack of objective biomarkers for brain damage hampers acute diagnosis and clinical decision making about return to play after sports-related concussion. OBJECTIVES To determine whether sports-related concussion is associated with elevated levels of blood biochemical markers of injury to the central nervous system and to assess whether plasma levels of these biomarkers predict return to play in professional ice hockey players with sports-related concussion. DESIGN, SETTING, AND PARTICIPANTS Multicenter prospective cohort study involving all 12teams of the top professional ice hockey league in Sweden, the Swedish Hockey League. Two hundred eighty-eight professional ice hockey players from 12 teams contesting during the 2012-2013 season consented to participate. All players underwent clinical preseason baseline testing regarding concussion assessment measures. Forty-seven players from 2 of the 12 ice hockey teams underwent blood sampling prior to the start of the season. Thirty-five players had a concussion from September 13, 2012, to January 31, 2013; of these players, 28 underwent repeated blood sampling at 1, 12, 36, and 144 hours and when the players returned to play. MAIN OUTCOMES AND MEASURES Total tau, S-100 calcium-binding protein B, and neuron-specific enolase concentrations in plasma and serum were measured.

  • 225.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Wilson, David H.
    Quanterix Corp, Lexington, MA.
    Randall, Jeffrey
    Quanterix Corp, Lexington, MA.
    Skillbäck, Tobias
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Pazooki, David
    Department of Surgery, Sahlgrenska University Hospital.
    Kallberg, Birgitta
    Clinical Chemistry Laboratory, Sahlgrenska University Hospital.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Blood biomarkers for brain injury in concussed professional ice hockey players: correction2016Inngår i: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 73, nr 9, s. 1160-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Reports an error in 'Blood biomarkers for brain injury in concussed professional ice hockey players' by Pashtun Shahim, Yelverton Tegner, David H. Wilson, Jeffrey Randall, Tobias Skillbäck, David Pazooki, Birgitta Kallberg, Kaj Blennow and Henrik Zetterberg (JAMA Neurology, 2014[Jun], Vol 71[6], 684-692). In the original article, there were errors in Table 1 and Figure 2A. The corrections are present in the erratum. (The following abstract of the original article appeared in record 2014-24656-005). Importance: Lack of objective biomarkers for brain damage hampers acute diagnosis and clinical decision making about return to play after sports-related concussion. Objectives: To determine whether sports-related concussion is associated with elevated levels of blood biochemical markers of injury to the central nervous system and to assess whether plasma levels of these biomarkers predict return to play in professional ice hockey players with sports-related concussion. Design, Setting, and Participants: Multicenter prospective cohort study involving all 12 teams of the top professional ice hockey league in Sweden, the Swedish Hockey League. Two hundred eighty-eight professional ice hockey players from 12 teams contesting during the 2012-2013 season consented to participate. All players underwent clinical preseason baseline testing regarding concussion assessment measures. Forty-seven players from 2 of the 12 ice hockey teams underwent blood sampling prior to the start of the season. Thirty-five players had a concussion from September 13, 2012, to January 31, 2013; of these players, 28 underwent repeated blood sampling at 1, 12, 36, and 144 hours and when the players returned to play. Main Outcomes and Measures: Total tau, S-100 calcium-binding protein B, and neuron-specific enolase concentrations in plasma and serum were measured. Results: Concussed players had increased levels of the axonal injury biomarker total tau(median, 10.0 pg/mL; range, 2.0-102 pg/mL) compared with preseason values (median, 4.5pg/mL; range, 0.06-22.7 pg/mL) (P < .001). The levels of the astroglial injury biomarker S-100 calcium-binding protein B were also increased in players with sports-related concussion(median, 0.075 μg/L; range, 0.037-0.24 μg/L) compared with preseason values (median,0.045 μg/L; range, 0.005-0.45 μg/L) (P < .001). The highest biomarker concentrations of total tau and S-100 calcium-binding protein B were measured immediately after a concussion, and they decreased during rehabilitation. No significant changes were detected in the levels of neuron-specific enolase from preseason values (median, 6.5 μg/L; range,3.45-18.0 μg/L) to postconcussion values (median, 6.1 μg/L; range, 3.6-12.8 μg/L) (P = .10). Conclusions and Relevance: Sports-related concussion in professional ice hockey players is associated with acute axonal and astroglial injury. This can be monitored using blood biomarkers, which may be developed into clinical tools to guide sport physicians in the medical counseling of athletes in return-to-play decisions

  • 226.
    Shahim, Pashtun
    et al.
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Zetterberg, Henrik
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospita.
    Serum neurofilament light as a biomarker for mild traumatic brain injury in contact sports2017Inngår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 88, nr 19, s. 1788-1794Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To evaluate whether the axonal protein neurofilament light (NFL) in serum is a sensitive biomarker to detect subtle brain injury or concussion in contact sports athletes.

    Methods: Two prospective cohort studies involving (1) 14 Swedish amateur boxers who underwent fluid biomarker assessments at 7–10 days after bout and after 3 months of rest from boxing and (2) 35 Swedish professional hockey players who underwent blood biomarker assessment at 1, 12, 36, and 144 hours after concussion and when the players returned to play were performed. Fourteen healthy nonathletic controls and 12 athletic controls were also enrolled. Serum NFL was measured using ultrasensitive single molecule array technology.

    Results: Serum NFL concentrations were increased in boxers 7–10 days after bout as compared to the levels after 3 months rest as well as compared with controls (p = 0.0007 and p < 0.0001, respectively). NFL decreased following 3 months of rest, but was still higher than in controls (p < 0.0001). Boxers who received many (>15) hits to the head or were groggy after bout had higher concentrations of serum NFL as compared to those who received fewer hits to the head (p = 0.0023). Serum NFL increased over time in hockey players, and the levels returned to normal at return to play. Importantly, serum NFL could separate players with rapidly resolving postconcussion symptoms (PCS) from those with prolonged PCS.

    Conclusions: The results from these 2 independent cohort studies suggest that serum NFL is a highly sensitive biomarker for concussion.

  • 227.
    Shayanfar, Ali
    et al.
    Drug Applied Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Jouyban, Abolghasem
    Drug Applied Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences.
    Solubility of carbamazepine, nicotinamide and carbamazepine-nicotinamide cocrystal in ethanol-water mixtures2014Inngår i: Fluid Phase Equilibria, ISSN 0378-3812, E-ISSN 1879-0224, Vol. 363, s. 97-105Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Solubility is an important physiochemical property of pharmaceutical compounds, and cocrystallization is one method used to improve the solubility of drugs. Carbamazepine is a drug from class II, according to the biopharmaceutical classification system, and it forms a cocrystal with nicotinamide. Carbamazepine cocrystallized with nicotinamide was synthesized using the solvent evaporation approach, and its characteristics were determined using differential scanning calorimetry and powder X-ray diffractometry. The solubility of various solid phases in ethanol. +. water mixtures was investigated at different temperatures using the shake-flask method, and the resulting precipitates were characterized. The solubility of carbamazepine was increased with the addition of ethanol up to a mass fraction of 0.8. Nevertheless, maximum solubility of NIC is observed in neat solvent (water). While the solubility of a cocrystal depends on the concentration of the coformer and its stability in the solution.

  • 228.
    Shimpi, Manishkumar
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Childs, Scott L.
    Renovo Research, Atlanta, GA.
    Boström, Dan
    Umeå universitet, Energy Technology and Thermal Process Chemistry, Umeå University.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    New cocrystals of ezetimibe with l-proline and imidazole2014Inngår i: CrystEngComm, ISSN 1466-8033, E-ISSN 1466-8033, Vol. 16, nr 38, s. 8984-8993Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objectives of the study were to screen and prepare cocrystals of anti-cholesterol drug ezetimibe (EZT) with the aim of increasing its solubility and dissolution rate. Thermodynamic phase diagram based high throughput screening was performed using wet milling/grinding or solution crystallization methods. A large number of coformers were tested and the resulting solids were preliminarily characterized using X-ray powder diffraction (PXRD) and Raman spectroscopy. Potential cocrystals of EZT with l-proline and imidazole and a solvate formamide were identified in the screening experiments. The cocrystal hits were further characterized by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), solution Proton nuclear magnetic resonance spectroscopy (1H-NMR) and single crystal XRD. The dissolution properties and stability of cocrystals were determined. Single-crystal X-ray diffraction data were obtained for EZT, EZT-IMI cocrystal and formamide solvate of ezetimibe. All three systems were crystallized in non-centrosymmetric orthorhombic space group P212121with Z = 4. Robust O-H⋯O, O-H⋯N, N-H⋯O and C-H⋯O hydrogen bonds played an important role in all these crystal structures. EZT-PRO cocrystal showed improved apparent solubility and solid state stability

  • 229.
    Shimpi, Manishkumar R.
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap. Luleå tekniska universitet, Institutionen för samhällsbyggnad och naturresurser, Kemiteknik.
    Al-Hayali, Amani
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Cavanagh, Katie L.
    Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor.
    Rodríguez- Hornedo, Nair
    Department of Pharmaceutical Sciences, University of Michigan, Ann Arbor.
    Velaga, Sitaram P.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Tadalafil-malonic acid cocrystal: Physicochemical characterization, pH-solubility and supersaturation studies2018Inngår i: Crystal Growth & Design, ISSN 1528-7483, E-ISSN 1528-7505, Vol. 18, nr 8, s. 4378-4387Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to enhance the solubility and dissolution of a poorly water-soluble drug, tadalafil (TDF), by cocrystal formation with malonic acid (MOA), to characterize the cocrystal structure, and to quantify the cocrystal solution behavior. The crystal structure revealed a 1:1 stoichiometry wherein the TDF molecules form a double layered structure through N–H…O=C interactions linked to a catemeric chain of MOA molecules via O-H…O hydrogen bonds. Cocrystal solubility advantage (SA defined as Scocrystal/Sdrug) or supersaturation index was determined from eutectic point measurements to be 102 to 129 in the pH range of 1 to 3. Cocrystal dissolution generated supersaturation levels (Cmax/Sdrug) of 30 in buffer and 120 in the presence of a nucleation inhibitor, HPMC. The amorphous form of TDF generated supersaturation 3 times lower than cocrystal in buffer, and not significantly different from cocrystal in the presence of HPMC. Thus, supersaturation index is a valuable metric for assessing the risk of cocrystal conversion during kinetic studies and for predicting conditions when the usage of a precipitation inhibitor may significantly increase cocrystal exposure levels.

  • 230.
    Shimpi, Manishkumar
    et al.
    Luleå tekniska universitet, Institutionen för samhällsbyggnad och naturresurser, Kemiteknik.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Shah, Faiz Ullah
    Luleå tekniska universitet, Institutionen för samhällsbyggnad och naturresurser, Kemiteknik.
    Antzutkin, Oleg
    Luleå tekniska universitet, Institutionen för samhällsbyggnad och naturresurser, Kemiteknik.
    Pharmaceutical Crystal Engineering Using Ionic Liquid Anion–Solute Interactions2017Inngår i: Crystal Growth & Design, ISSN 1528-7483, E-ISSN 1528-7505, Vol. 17, nr 4, s. 1729-1734Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The main purpose of this work was to investigate the potential of ionic liquids (ILs) in crystal engineering. We have employed ILs with different combinations of cations and anions to study their role in directing crystal structure formation of a nicotinamide (NIC) and oxalic acid (OXA) system. A new crystal form of NIC–OXA salt (2:1) was identified and characterized using standard solid state tools such as powder X-ray diffraction, differential scanning calorimetry, thermogravimetric analysis, and Raman and infrared spectroscopy. The crystal structure of the 2:1 salt was elucidated using single-crystal X-ray diffraction. The NIC–OXA 2:1 salt form revealed a two-dimensional layered structure, while the known 1:1 salt had a perpendicular “tape-like” structure. The 2:1 salt form could only be crystallized from the ILs possessing hydrogen bond acceptor functionality. We demonstrated that specific ILs could be selected as solvents for altering the solid-state structure of organic and inorganic materials.

  • 231.
    Siman, Robert
    et al.
    University of Pennsylvania School of Medicine, Neurosurgery.
    Shahim, Pashtun
    Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Blennow, Kaj
    Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska Academy, University of Gothenburg, Mölndal.
    Zetterberg, Henrik
    Sahlgrenska Academy, University of Gothenburg, Mölndal, Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg.
    Smith, Douglas H.
    University of Pennsylvania School of Medicine, Neurosurgery.
    Serum SNTF Increases in Concussed Professional Ice Hockey Players and Relates to the Severity of Post-Concussion Symptoms2015Inngår i: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 32, nr 17, s. 1294-1300Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Biomarkers for diffuse axonal injury could have utilities for the acute diagnosis and clinical care of concussion, including those related to sports. The calpain-derived alpha-spectrin N-terminal fragment SNTF accumulates in axons after traumatic injury, and increases in human blood following mild traumatic brain injury (mTBI) in relation to white matter abnormalities and persistent cognitive dysfunction. However, SNTF has never been evaluated as a biomarker for sports-related concussion. Here, we conducted longitudinal analysis of serum SNTF in professional ice hockey players, 28 of whom had a concussion, along with 45 players evaluated during the preseason, 17 of whom were also tested after a concussion-free training game. Compared to preseason levels, serum SNTF increased at 1 hour after concussion and remained significantly elevated from 12 hours to 6 days, before declining to preseason baseline. In contrast, serum SNTF levels were unchanged after training. In eight players, post-concussion symptoms resolved within a few days, and in these cases serum SNTF levels were at baseline. On the other hand, for the 20 players withheld from play for 6 days or longer, serum SNTF levels rose from 1 hour to 6 days post-concussion, and at 12-36 hours differed significantly from the less severe concussions (p=.004). Serum SNTF exhibited diagnostic accuracy for concussion, especially so with delayed return to play (AUC = 0.87). Multivariate analyses of serum SNTF and tau improved the diagnostic accuracy, the relationship with the delay in return to play, and the temporal window beyond tau alone. These results provide evidence that blood SNTF, a biomarker for axonal injury after mTBI, may be useful for diagnosis and prognosis of sports-related concussion, and for guiding neurobiologically-informed decisions on return to play

  • 232.
    Singh, Sanjay Kumar
    et al.
    Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanas.
    Dadhania, Parth
    Pharma Research, Lupin Limited (Research Park), Pune.
    Vuddanda, Parameswara Rao
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Jain, Achint K.
    Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanas.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Singh, Sanjay
    Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanas.
    Intranasal delivery of asenapine loaded nanostructured lipid carriers: formulation, characterization, pharmacokinetic and behavioural assessment2016Inngår i: RSC Advances, ISSN 2046-2069, E-ISSN 2046-2069, Vol. 6, nr 3, s. 2032-2045Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the present research work was to develop asenapine (ASM) loaded nanostructured lipid carriers (ANLC) for the delivery of drugs in the brain by an intranasal route to enhance therapeutic efficacy. A quality by design approach was used for development and optimization of ANLC. A total of five independent variables were selected, in which three were compositions and two were process variables, while particle size and entrapment efficiency were selected as response variables. The final optimized batch was evaluated by various in vitro characterizations as well as in vivo brain and plasma pharmacokinetic studies. Finally, the ANLC was assessed for efficacy and safety profiling for upto three weeks by a behavior model viz. catalepsy, induced locomotor and paw test in Charles Foster rats. The observed particle size, entrapment efficiency and zeta potential of ANLC was found to be 167.30 +/- 7.52 nm, 83.50 +/- 2.48% and -4.33 +/- 1.27 mV, respectively. Surface characterization studies demonstrated a spherical shape with a smooth surface of ANLC which follows the Korsmeyer-Peppas in vitro release kinetic model (r(2) = 0.9911, n = 0.53). A brain pharmacokinetic study indicated a significantly higher (p < 0.05) peak drug concentration (C-max: 74.13 +/- 6.73 ng mL(-1)), area under the drug concentration-time curve (AUC(0-24) (h): 560.93 +/- 27.85 h ng mL(-1)) and mean residence time (MRT: 7.1 +/- 0.13 h) of ANLC compared to ASM in the brain via an intranasal route. The results of behaviour studies of ANLC showed a significant decrease in extra-pyramidal side effects with increasing antipsychotic effect after 1-2 week(s) of treatment. These findings demonstrate that nanostructured lipid carriers could be a new promising drug delivery system for intranasal delivery of asenapine in the treatment of schizophrenia

  • 233.
    Sngh, Yuvraj N.
    et al.
    Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanas.
    Vuddanda, Parameswara Rao
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Jain, Achint K.
    Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanas.
    Parihar, Sarita
    Department of Orthodontics, Institute of Medical Sciences, Banaras Hindu University, Varaansi.
    Chaturvedi, Thakur P.
    Department of Orthodontics, Institute of Medical Sciences, Banaras Hindu University, Varaansi.
    Singh, Sanjay Kumar
    Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanas.
    Mucoadhesive gel containing immunotherapeutic nanoparticulate satranidazole for treatment of periodontitis: Development and its clinical implications2015Inngår i: RSC Advances, ISSN 2046-2069, E-ISSN 2046-2069, Vol. 5, nr 59, s. 47659-47670Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to alleviate shortcomings in periodontal treatment by utilizing a mucoadhesive gel containing immunotherapeutic ganglioside coated polymeric nanoparticles (G-PNP) bearing satranidazole (SZ). Nanoprecipitation was used to fabricate SZ loaded G-PNP. In our previous deliberations aqueous dispersibility of conventional SZ had raised dose consistency issues. Usage of G-PNP allayed those fears as DSC and XRD data showed that SZ was rendered amorphous (more water dispersible than crystalline SZ) when captured in a polymeric matrix of nanoparticles. G-PNP were added to sodium carboxy methyl cellulose (SCMC 30 NP) gels and compared against SCMC 30 (gel containing conventional SZ) for texture, mucoadhesion, drug release and inhibitory susceptibility of Aggregatibacter actinomycetomicans. Subsequently a 21 day single blind clinical trial comparing the efficacy of SCMC 30 NP and SCMC 30 was conducted. SCMC 30 NP showed a maximum mucoadhesion force (43.27 ± 4.10 gf), low hardness (12.28 ± 0.17 N), moderate gel strength (8.53 ± 0.21 N) and elasticity (5.50 ± 0.03 mm). 'Well' diffusion data revealed qualitatively greater antibacterial activity of SCMC 30 NP. Dissolution studies demonstrated diffusion controlled release of SZ at concentrations above MIC. SCMC 30 NP caused a significant (P < 0.05) decrease in clinical markers of periodontitis, i.e. gingival index and pocket depth as compared to SCMC 30. Also reduction in the plaque index produced by SCMC 30 NP was highly significant (P < 0.01) as compared to SCMC 30 at the end of the 21st day of clinical study. Amelioration of disease was improved due to Th-2 biased immuno shifting mediated by G-PNPs, which increased secretion of anti-inflammatory cytokines like IL-4 and TGF-β from J774 macrophages. Clinical benefits incurred along with ease of application calls for a scaled up investigation of SCMC 30 NP

  • 234.
    Sojka, Peter
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Stålnacke, Britt-Marie
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå univesity.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Playing soccer increases serum concentrations of the biochemical markers of brain damage S-100B and neuron-specific enolase in elite players: a pilot study2004Inngår i: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 18, nr 9, s. 899-909Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PRIMARY OBJECTIVE: To analyse serum concentrations of two biochemical markers of brain tissue damage, S-100B and NSE (neurone-specific enolase), in male soccer players in connection to the game. METHODS: Blood samples were taken in players before and after a competitive game and the numbers of headers and of trauma events during soccer play were assessed. RESULTS: Both S-100B and NSE were significantly raised in serum samples obtained after the game in comparison with the pre-game values (S-100B: 0.118 +/- 0.040 microg L(-1) vs 0.066 +/- 0.025 microg L(-1), p < 0.001; NSE: 10.29 +/- 2.16 microg L(-1) vs 8.57 +/- 2.31 microg L(-1), p < 0.001). Only changes in S-100B concentrations (post-game minus pre-gae values) were statistically significantly correlated to the number of headers (r = 0.428, p = 0.02) and to the number of other trauma events (r = 0.453, p = 0.02). CONCLUSION: Playing competitive elite soccer was found to cause increase in serum concentrations of S-100B and NSE. Increases in S-100B were significantly correlated to the number of headers, and heading may accordingly have contributed to these increases.

  • 235.
    Sojka, Peter
    et al.
    Umeå universitet, Institutionen för Rehabiliteringsmedicin.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Stålnacke, Britt-Marie
    Umeå universitet, Institutionen för Rehabiliteringsmedicin.
    S-100B, a marker of brain damage: a useful tool in the managment of mild traumatic brain injuries in sport2002Inngår i: Neurological rehabilitation: proceedings of the 3rd world congress, Venice, Italy, April 2-6, 2002, Bologna: ISPRM , 2002Konferansepaper (Annet vitenskapelig)
  • 236.
    Srivastava, K.
    et al.
    Physics Department, University of Lucknow, Lucknow, India.
    Khan, E.
    Physics Department, University of Lucknow, Lucknow, India.
    Shimpi, Manishkumar
    Luleå tekniska universitet, Institutionen för samhällsbyggnad och naturresurser, Kemiteknik.
    Tandon, P.
    Physics Department, University of Lucknow, Lucknow, India.
    Sinha, K.
    Physics Department, University of Lucknow, Lucknow, India.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Molecular structure and hydrogen bond interactions of a paracetamol-4,4′-bipyridine cocrystal studied using a vibrational spectroscopic and quantum chemical approach2018Inngår i: CrystEngComm, ISSN 1466-8033, E-ISSN 1466-8033, Vol. 20, nr 2, s. 213-222Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of the current study is to perform the structural and spectroscopic characterization of paracetamol-4,4′-bipyridine (PRA-BPY) cocrystal using infrared, Raman spectroscopy and density functional theory (DFT) calculations. To reveal the interactions between PRA and BPY, two models (monomer and dimer + PRA) of a cocrystal are designed and optimized using DFT with a 6-311G (d, p) basis set. An atoms in molecule study shows that the non-covalent interactions in particular hydrogen bonds involved in forming the cocrystal are moderate in nature. Natural bond orbital analysis of the second order perturbation theory of the Fock matrix suggests that interactions LP (1) N13 → π∗(C15-O16) and LP (1) N56 → σ∗(N13-H14) are responsible for the stabilization of the molecule. 

  • 237.
    Srivastava, Karnica
    et al.
    Physics Department, University of Lucknow.
    Shimpi, Manishkumar
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Srivastava, Anubha
    Physics Department, University of Lucknow.
    Tandon, Poonam
    Physics Department, University of Lucknow.
    Sinha, Kirti
    Physics Department, University of Lucknow.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vibrational analysis and chemical activity of paracetamol-oxalic acid cocrystal based on monomer and dimer calculations: DFT and AIM approach2016Inngår i: RSC Advances, ISSN 2046-2069, E-ISSN 2046-2069, Vol. 6, nr 12, s. 10024-10037Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The study of structural and spectral characteristics of a paracetamol-oxalic acid (PRA-OXA) cocrystal has been carried out using two models (monomer and dimer), with the aim to understand the supramolecular structure and intramolecular interactions within the cocrystal. The cocrystal has been characterized by infrared and Raman spectroscopy combined with quantum chemical calculations molecular electrostatic potential surface (MEPS), frontier orbital analysis and electronic reactivity descriptors were used to understand the role of interactions involved in affecting the chemical reactivity of individual molecules in the cocrystal. It is observed that the C=O, N-H and O-H groups of paracetamol are involved in hydrogen bonds to form cocrystals. NBO analysis suggests that the two types of interactions LP(1)(N8) -> pi*(C9-O10) and LP(2)(O10) -> sigma*(O25-H28) are responsible for the stability of the molecule. AIM analysis suggested that the non-covalent interactions are moderate in nature. The calculated HOMO-LUMO energies reveal that the charge transfer occurs within the cocrystal. Chemical reactivity parameters show that the cocrystal is more active than paracetamol.

  • 238.
    Srivastava, Karnica
    et al.
    Physics Department, University of Lucknow, Lucknow, India.
    Shukla, Anuradha
    Physics Department, University of Lucknow, Lucknow, India.
    Karthick, T.
    Physics Department, University of Lucknow, Lucknow, India;Institute of Organic Chemistry and Biochemistry, Academy of Sciences, Prague, Czech Republic.
    Velaga, Sitaram
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Tandon, Poonam
    Physics Department, University of Lucknow, Lucknow, India.
    Sinha, Kirti
    Physics Department, University of Lucknow, Lucknow, India.
    Shimpi, Manishkumar R.
    Luleå tekniska universitet, Institutionen för samhällsbyggnad och naturresurser, Kemiteknik.
    Molecular structure, spectroscopic signature and reactivity analyses of paracetamol hydrochloride monohydrate salt using density functional theory calculations2019Inngår i: CrystEngComm, ISSN 1466-8033, E-ISSN 1466-8033, Vol. 21, nr 5, s. 857-865Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to understand the role of the intermolecular hydrogen bond interactions present in paracetamol hydrochloride monohydrated salt. Paracetamol hydrochloride monohydrate salt (PRA-HCl) and paracetamol (form I) were investigated via vibrational (FT-IR and FT-Raman) spectroscopy and density functional theory (DFT) to gain insight into the hydrogen bond patterns present in these crystalline materials. Two different density functionals, wB97X-D and M062X, were used for the comparison of the results. The geometrical parameters of PRA-HCl and form I obtained using these functional were compared with the crystallographic data, which proved the existence of intra-molecular and intermolecular hydrogen bonds. The C10O2 group of form I forms an intramolecular hydrogen bond, while the O1–H18 group of PRA-HCl forms an intermolecular hydrogen bond with a chloride ion (Cl), resulting in the elongation of the bond length and shift to a lower wavenumber for the O1–H18 group. To examine the potency of hydrogen bonding, quantum theory of atoms in molecules (QTAIM) calculations were performed and the results suggested that O1–H18⋯Cl22 is a strong intermolecular hydrogen bond. The chemical reactivity parameters reveal that the PRA-HCl and PRA-OXA cocrystals are more reactive and softer (low HOMO–LUMO energy gap) in comparison to paracetamol (form I).

  • 239.
    Stattin, Eva-Lena
    et al.
    Umeå University, Department of Medical Biosciences, Medical and Clinical Genetics.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Domellöf, Magnus
    Umeå University, Department of Clinical Sciences, Paediatrics.
    Dahl, Niklas
    Uppsala university, Department of Genetics and Pathology, The Rudbeck laboratory.
    Familial osteochondritis dissecans associated with early osteoarthritis and disproportionate short stature2008Inngår i: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 16, nr 8, s. 890-896Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Familial osteochondritis dissecans (OCD) is a rare disorder characterised by disturbed chondro-skeletal development, disproportionate growth and deformation of the skeleton.Design: We identified a five-generation family with 15 living affected members from Northern Sweden. The disorder was diagnosed with a case definition of OCD in at least one joint. Results: Main clinical findings consisted of OCD in knees and/or hips and/or elbows, disproportionate short stature and early osteoarthritis (OA). There were no radiological indications of epiphyseal dysplasia. Anthropometric measurements of affected individuals showed short stature, a high ratio between sitting height and total height, a relatively normal arm span and head circumference. In 12 of 15 cases, onset was during late childhood or adolescence and OA had developed in seven of those patients.Conclusions: Our observation suggests that OA is a frequent complication in familial OCD even though the lesions appear before closure of physis.

  • 240.
    Stattin, Eva-Lena
    et al.
    Umeå universitetssjukhus.
    WIklund, Fredrik
    Karolinska Institutet.
    Lindblom, Karin
    Lund University.
    Önnerfjord, Patrik
    Lund University.
    Jonsson, Björn-Anders
    Umeå universitetssjukhus.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Sasaki, Takako
    University of Erlangen-Nuernberg.
    Struglics, André
    Lund University.
    Lohmander, Stefan
    Lund University.
    Dahl, Niklas
    Uppsala University.
    Heinegård, Dick
    Lund University.
    Aspberg, Anders
    University of Copenhagen.
    A missense mutation in the aggrecan C-type lectin domain disrupts extracellular matrix interactions and causes dominant familial osteochondritis dissecans2010Inngår i: American Journal of Human Genetics, ISSN 0002-9297, E-ISSN 1537-6605, Vol. 86, nr 2, s. 126-137Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Osteochondritis dissecans is a disorder in which fragments of articular cartilage and subchondral bone dislodge from the joint surface. We analyzed a five-generation family in which affected members had autosomal-dominant familial osteochondritis dissecans. A genome-wide linkage analysis identified aggrecan (ACAN) as a prime candidate gene for the disorder. Sequence analysis of ACAN revealed heterozygosity for a missense mutation (c.6907G > A) in affected individuals, resulting in a p.V2303M amino acid substitution in the aggrecan G3 domain C-type lectin, which mediates interactions with other proteins in the cartilage extracellular matrix. Binding studies with recombinant mutated and wild-type G3 proteins showed loss of fibulin-1, fibulin-2, and tenascin-R interactions for the V2303M protein. Mass spectrometric analyses of aggrecan purified from patient cartilage verified that V2303M aggrecan is produced and present in the tissue. Our results provide a molecular mechanism for the etiology of familial osteochondritis dissecans and show the importance of the aggrecan C-type lectin interactions for cartilage function in vivo.

  • 241.
    Stattin, Eva-Lena
    et al.
    Umeå University, Department of Medical Biosciences, Medical and Clinical Genetics.
    Wiklund, Fredrik
    Karolinska institutet, Medical Epidemiology and Biostatistics.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Dahl, Niklas
    Uppsala university, Department of Genetics and Pathology, The Rudbeck laboratory.
    AGC1 gene missense mutation associated with familial osteochondritis dissecans and early osteoarthritis2007Inngår i: 8th Meeting of the International Skeletal Dysplasia Society: Albi, France July 19-22, 2007, International Skeletal Dysplasia Society , 2007, s. 6-Konferansepaper (Annet vitenskapelig)
  • 242.
    Stridsman, Caroline
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Skär, Lisa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Hedman, Linnea
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Rönmark, Eva
    Norrbottens Läns Landsting.
    Lindberg, Anne
    OLIN studies, Norrbotten County Council.
    Fatigue affects health status and predicts mortality among subjects with COPD-report from the population-based OLIN COPD study2015Inngår i: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563, Vol. 12, nr 2, s. 199-206Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: COPD is associated to increased fatigue, decreased health status and mortality. However, these relationships are rarely evaluated in population-based studies. Aims: To describe the relationship between health status, respiratory symptoms and fatigue among subjects with and without COPD. Further, to evaluate whether fatigue and/or health status predicts mortality in these groups. Methods: Data were collected in 2007 from the population-based OLIN COPD study. Subjects participated in lung function tests and structured interviews, and 434 subjects with and 655 subjects without COPD were identified. Fatigue was assessed by FACIT-Fatigue and health status by the generic SF-36 questionnaire including physical (PCS) and mental (MCS) components. Mortality data until February 2012 were collected. Results: Fatigue greatly impacts the physical and mental dimensions of health status, both among subjects with and without COPD. Among subjects with clinically significant fatigue, COPD subjects had significantly lower PCS-scores compared to non-COPD subjects. Fairly strong correlations were found between FACIT-F, SF-36 PCS and MCS, respectively. In multivariate models adjusting for covariates, increased fatigue, decreased physical and mental dimensions of health status were all associated to mortality in subjects with COPD (OR 1.06, CI 1.02-1.10, OR 1.04, CI 1.01-1.08 and OR 1.06, CI 1.02-1.10), but not in non-COPD. Conclusions: Fatigue and decreased health status were closely related among subjects with and without COPD. Not only physical health status, but also fatigue and mental health predicted mortality among subjects with COPD. Fatigue assessed by FACIT-F, can be a useful instrument of prognostic value in the care of subjects with COPD.

  • 243.
    Stridsman, Caroline
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Zingmark, Karin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lindberg, Anne
    NLL.
    Skär, Lisa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Creating a balance between breathing and viability: Experiences of well-being when living with chronic obstructive pulmonary disease2015Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 16, nr 1, s. 42-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim To describe experiences of well-being among people with moderate to very severe chronic obstructive pulmonary disease (COPD). BACKGROUND: Living with COPD is related to a complex life situation, and quality of life (QOL) is shown to decrease because of respiratory symptoms and fatigue. However, studies describing well-being in COPD as a subjective description of QOL are rare. METHODS: Ten participants with moderate to very severe COPD from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD study were interviewed about their experiences of well-being. A latent qualitative content analysis was used to analyse the data. Findings To achieve well-being despite breathlessness, the participants had to adapt to their limitations and live towards the future. They created a balance between breathing and viability by adjusting to a lifelong limitation, handling variations in illness, relying on self-capacity and accessibility to a trustful care. The participants adjusted to lifelong limitations through acceptance and replacement of former activities. They handled variations in illness by taking advantage of the good days and using emotional adaptation strategies. The participants relied on their own self-capacity, feeling that smoking cessation, physical activity and breathing fresh air increased their well-being. They requested accessibility to a trustful care and highlighted the need for continuous care relationships and access to medications. These findings can enhance health-care professionals' understanding of the possibilities for increased well-being for people living with COPD.

  • 244.
    Strömbäck, Ulrica
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    The second myocardial infarction: A known but different experience2018Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim of this thesis was to explore the second myocardial infarction (MI) and describe experiences of the second myocardial infarction from the perspectives of patients and personnel in cardiac rehabilitation (CR).

    This thesis includes four studies. Studies using quantitative method (I, II) and qualitative method (III, IV) were performed. Studies I and II were retrospective cohort studies based on data from the Northern Sweden’s MONICA myocardial infarction registry. A paired design was used. Study I included 1017 participants, and the corresponding figure for Study II was 820 participants. The participants had at least two MI events recorded in the MONICA MI registry from 1990 – 2009 (I) and 1986 – 2009 (II). The two MI events studied were the first and second events. Study III included eight patients who suffered two MIs. The data were collected through interviews about the experience of suffering a second MI. In Study IV, personnel working with CR were interviewed about the experience of working with patients suffering from a second MI and data from study III were used for describing the patients expressed needs during CR. Data were analysed by descriptive and analytic statistics (I, II) and by qualitative content analysis (III, IV).

    Both men and women had higher risk factor burdens when suffering the second MI compared when they suffered the first MI. Women had a higher risk factor burden at both first and second MI compared with men. Women also suffered the second MI with a shorter time interval than men did (I). The most common symptom reported in men and women at both MI events were typical symptoms. In men, 10.6 % reported different types of symptoms at first and second MI, and the corresponding figure for women was 16.2 % (II). The number of patients with a prehospital delay < 2 hours increased at the second MI. Furthermore, the results showed that patients with a prehospital delay ≥ 2 hours at the first MI were more likely to have a prehospital delay ≥ 2 hours at the second MI (II). Suffering a second MI is a known but different event compared to the first MI, it makes afflicted people realise the seriousness and the importance of making lifestyle changes (III). People express they are more affected after having the second MI, both physically and psychologically (III). In the analysis of congruence between the needs patients expressed linked to CR and personnel’s description of how they worked, a theme emerged: “Be seen as a unique person” 2(IV). The patients expressed a need of customised care, and the personnel described that it was important for them to individualise the care given to these patients.

    Suffering a second MI is experienced as a different and more serious event that the first one. The patients had gained valuable knowledge due to their previous experience and the second MI was a wake-up call for life style changes. A majority of the patients had typical symptoms at both MI events and an increased number of patients had a prehospital delay < 2 hours at the second MI. We suggest that the personnel in CR pay attention to first-time MI patients’ illness representation to enhance the patient’s awareness of the seriousness of the illness and the fact that they suffer from a chronic illness. The care given after an MI, including cardiac rehabilitation should be person-centred to involve the patient as an active participator in the care and were the patient’s resources and needs are in focus.

  • 245.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå, Sweden.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?2018Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, nr 7, s. 652-659Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Knowledge is limited concerning the type of symptoms and the time from onset of symptoms to first medical contact at first and second myocardial infarction in the same patient.

    AIM:

    This study aimed to describe the type of symptoms and the time from onset of symptoms to first medical contact in first and second myocardial infarctions in men and women affected by two myocardial infarctions. Furthermore, the aim was to identify factors associated with prehospital delays ≥2 h at second myocardial infarction.

    METHODS:

    A retrospective cohort study with 820 patients aged 31-74 years with a first and a second myocardial infarction from 1986 through 2009 registered in the Northern Sweden MONICA registry.

    RESULTS:

    The most common symptoms reported among patients affected by two myocardial infarctions are typical symptoms at both myocardial infarction events. Significantly more women reported atypical symptoms at the second myocardial infarction compared to the first. Ten per cent of the men did not report the same type of symptoms at the first and second myocardial infarctions; the corresponding figure for women was 16.2%. The time from onset of symptoms to first medical contact was shorter at the second myocardial infarction compared to the first myocardial infarction. Patients with prehospital delay ≥2 h at the first myocardial infarction were more likely to have a prehospital delay ≥2 h at the second myocardial infarction.

    CONCLUSIONS:

    Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient's behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.

  • 246.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Wälivaara, Britt-Marie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Realising the seriousness – the experience of suffering a second myocardial infarction: A qualitative study2019Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 51, s. 1-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives

    The aim of this study was to describe people’s experiences of suffering a second myocardial infarction.

    Research methodology

    A descriptive qualitative design. Interviews were conducted with eight persons afflicted by two myocardial infarctions. Data were analysed with qualitative content analysis.

    Findings

    The analysis resulted in one theme and four categories. The theme was ‘Realising the seriousness’ and the categories were: 1) Knowledge from previous experience; 2) A wake-up call for lifestyle changes; 3) The future becomes unpredictable; 4) Trying to find balance in life. The participant’s previous experience contributed to a better understanding of the symptoms of myocardial infarction and how to act when suffering a second myocardial infarction. After their second myocardial infarction, the participants became really aware of the need to implement a healthier lifestyle, as doing so might avoid a third myocardial infarction. The risk of suffering or even dying due to yet another myocardial infarction felt more tangible after their second one.

    Conclusion

    A second myocardial infarction is a different event in comparison to the first one, which makes afflicted people realise the seriousness and importance of making life style changes. They are more affected both physically and psychologically.

  • 247.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men2017Inngår i: EuroHeartCare 2017, 2017Konferansepaper (Annet vitenskapelig)
  • 248.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Lundblad, Dan
    Department of Public Health and Clinical Medicine, Sunderby Research Unit, Umeå University.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Time from onset of symptoms to medical presence at the first and at the second myocardial infarction: a comparative study2013Inngår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 57, nr Suppl. 120, s. 27-Artikkel i tidsskrift (Annet vitenskapelig)
  • 249.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared to men : The Northern Sweden MONICA study2017Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr 5, s. 418-424Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Several studies have examined various parameters and experiences when patients suffer their first myocardial infarction (MI), but knowledge about when they suffer their second MI is limited.

    AIM:

    To compare risk factors for MI, that is, diabetes, hypertension and smoking, for the first and second MI events in men and women affected by two MIs and to analyse the time intervals between the first and second MIs.

    METHODS:

    A retrospective cohort study of 1017 patients aged 25-74 years with first and second MIs from 1990 through 2009 registered in the Northern Sweden MONICA registry.

    RESULTS:

    More women than men have diabetes and hypertension and are smokers at the first MI. Similar differences between the genders remain at the time of the second MI for diabetes and hypertension, although both risk factors have increased. Smoking decreased at the second MI without any remaining difference between genders. Women suffer their second MI within a shorter time interval than men do. Within 16 months of their first MI, 50% of women had a second MI. The corresponding time interval for men was 33 months.

    CONCLUSION:

    Patients affected by an MI should be made aware of their risk of recurrent MI and that the risk of recurrence is highest during the first few years after an MI. In patients affected by two MIs, women have a higher risk factor burden and suffer their second MI earlier than men do and thus may need more aggressive and more prompt secondary prevention.

  • 250.
    Strömbäck, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundblad, Dan
    Sunderby Research Unit, Department of Public Health and Clinical Medicine, Umeå University.
    Lundqvist, Robert
    Department of Research, Norrbotten County Council, Luleå.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The second myocardial infarction: Women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study2017Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S62-S63, artikkel-id 165Artikkel i tidsskrift (Fagfellevurdert)
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