The relationship between periodontitis (PD) and cardiovascular disease is debated. PD is common in patients with cardiovascular disease. It has been postulated that PD could be causally related to ...the risk for cardiovascular disease, a hypothesis tested in the Periodontitis and Its Relation to Coronary Artery Disease (PAROKRANK) study.
Eight hundred five patients (<75 years of age) with a first myocardial infarction (MI) and 805 age- (mean 62±8), sex- (male 81%), and area-matched controls without MI underwent standardized dental examination including panoramic x-ray. The periodontal status was defined as healthy (≥80% remaining bone) or as mild-moderate (from 79% to 66%) or severe PD (<66%). Great efforts were made to collect information on possibly related confounders (≈100 variables). Statistical comparisons included the Student pairwise t test and the McNemar test in 2×2 contingency tables. Contingency tables exceeding 2×2 with ranked alternatives were tested by Wilcoxon signed rank test. Odds ratios (95% confidence intervals) were calculated by conditional logistic regression. PD was more common (43%) in patients than in controls (33%; P<0.001). There was an increased risk for MI among those with PD (odds ratio, 1.49; 95% confidence interval, 1.21-1.83), which remained significant (odds ratio, 1.28; 95% confidence interval, 1.03-1.60) after adjusting for variables that differed between patients and controls (smoking habits, diabetes mellitus, years of education, and marital status).
In this large case-control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confounding factors. These findings strengthen the possibility of an independent relationship between PD and MI.
The psychological assessment of chronic pain is often accomplished using questionnaires such as the (West Haven-Yale) Multidimensional Pain Inventory ((WHY)MPI) which is constructed to capture the ...multidimensionality of chronic pain. The (WHY)MPI theoretically originates from behavioural and cognitive behavioural theories of pain. It is divided into three parts and measures psychosocial and behavioural consequences of pain. This questionnaire has displayed satisfactory psychometric properties and translations of the original English version into German and Dutch have been demonstrated to be reliable and valid. The aim of this study was to test the reliability and factor structure of a Swedish translation of the (WHY)MPI, the MPI-S, and also to test the generalisability of the factor structure found for the (WHY)MPI. We performed analyses of internal consistency using Cronbach's alpha, and carried out a confirmatory factor analysis (CFA) employing LISREL-8 on a population of 682 patients suffering from chronic musculoskeletal pain. Test-retest analysis was accomplished on a sub-sample of 54 individuals taken from the aforementioned population. For sections 1 and 2 of the MPI-S the overall reliability and stability were good, and after the exclusion of four items, the factor structure was similar to other versions of the MPI. For section 3, despite removal of five questions, the proposed factor structure could not be replicated. This part of the inventory is designed to measure the extent of different types of activities, and our results suggest that this section may only be used for assessing general activity level. We conclude that, with a few adjustments, the analyses yielded satisfactory results for sections 1 and 2 of the MPI-S regarding its factor structure, reliability and generalisability. For section 3 the hypothesised factor structure could not be confirmed.
Background
We present the work conducted to arrive at deriving behavioural indicators that could be used to guide clinical judgement in determining the presence and severity of deficits in ...intellectual functioning and adaptive behaviour for the purpose of making a diagnosis of disorders of intellectual development.
Methods
An interdisciplinary expert panel provided guidance in developing behavioural indicators for intellectual functioning. A national dataset of adaptive behaviour on a sample of individuals with a diagnosis of intellectual disability was used to develop the behavioural indicators for the adaptive behaviour. The adaptive behaviour data were analysed using a cluster analysis procedure to define the different severity groupings by chronological age groups.
Results
We present a series of tables containing behavioural indicators across the lifespan for intellectual functioning and adaptive behaviour, including conceptual, social and practical skills. These tables of behavioural indicators have been proposed for use in the clinical version of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD‐11) to be published by the World Health Organization.
Conclusions
The proposed behavioural indicators for disorders of ID described in the present article and to be included in the ICD‐11 Clinical Descriptions and Diagnostic Guidelines are put forth to assist professionals in making an informed clinical decision regarding an individual's level of intellectual functioning and adaptive behaviour for the purpose of making a determination about the presence and severity of disorders of ID.
. Sarkar N, Rück A, Källner G, Y‐Hassan S, Blomberg P, Islam KB, van der Linden J, Lindblom D, Nygren AT, Lind B, Brodin L‐Å, Drvota V, Sylvén C (Karolinska Institute, Huddinge University Hospital, ...Novum, Stockholm, Sweden). Effects of intramyocardial injection of phVEGF‐A165 as sole therapy in patients with refractory coronary artery disease: 12‐month follow‐up. Angiogenic gene therapy. J Intern Med 2001; 250: 373–381.
Objective. To test the safety and bioactivity of phVEGF‐A165 after intramyocardial injection during 12‐month follow‐up.
Design. Open‐labelled study.
Subjects. Inclusion criteria were angina pectoris, Canadian Cardiovascular Society (CCS) class III–IV, unamenable to further revascularization, ejection fraction (EF) >30%, perfusion defects extending over >10% of the anterolateral left ventricle wall detectable with adenosine single photon emission computerized tomography (SPECT) and at least one patent vessel visible by coronary angiography. Seven of 39 patients referred for gene therapy were included.
Intervention. Via a mini‐thoracotomy under general anaesthesia, phVEGF‐A165 was injected directly into the myocardium at four sites in the anterolateral region of the left ventricle.
Results. Operative procedures were uneventful. Perioperative release of myocardial markers and electrocardiogram (ECG) changes were detected in two patients. There were no perioperative deaths but one patient died 7 months postoperatively because of myocardial infarction. Plasma vascular endothelial growth factor (VEGF)‐A levels increased two to threefold peaking 6 days postoperatively (P < 0.004) and returning to baseline by day 30. A significant reduction in angina pectoris was reported. The CCS class improved from 3.3 ± 0.2 to 1.9 ± 0.3 (P < 0.01) and nitroglycerine intake decreased from 39 ± 15 to 12 ± 5 tablets week–1 (P < 0.001) 2 months after gene transfer. Improvements remained after 12 months when nitroglycerine consumption approached zero. Improved myocardial function in the phVEGF‐A165 injection region was documented in all patients (P < 0.016) by tissue velocity imaging (TVI). Reduced reversible ischaemia was detected by adenosine SPECT in four patients. Improved collateralization was detected in four patients with coronary angiography.
Conclusion. Intramyocardial injection of phVEGF‐A165 is safe and may lead to improved myocardial perfusion and function with longstanding symptomatic relief in end‐stage angina pectoris. Based on these results this therapeutic potential is being tested in a double‐blind placebo controlled multicentre trial, EUROINJECT ONE.
Background
Media coverage can play an important part in energy transitions. It creates awareness of landscape-level megatrends affecting energy systems. It influences and is influenced by public and ...policy agendas on a regime level. On a niche level, it can spread or screen out information and motivate or discourage actors to adopt new technologies and practices. However, relatively few studies have specifically addressed the role of media in energy transitions. Newspaper coverage of biogas is studied here as a case of media framing of a potential renewable energy solution.
Methods
This article examines the long-term development of newspaper coverage of biogas in Finland. The aim of the quantitative content analysis is to draw an overall picture of the main phases of biogas coverage of a widely read newspaper focusing on agriculture and forestry, actors using discursive power in this coverage and key framings of the discussion. The results are discussed from the perspective of energy transition studies. In particular, future expectations created by the media are explored.
Results
The results show a lack of newspaper coverage on biogas in the early 2000s, followed by a rapid increase and stabilisation of the volume of newspaper coverage. Biogas was most often mentioned as a secondary topic of broader discussions related to renewable energy. The core discussion focusing on biogas was characterised by very positive framings of biogas as a preferable energy solution fully compatible with the principle of circular economy. The news stories often had a strong future orientation, and examples of enthusiastic forerunners were frequently presented. However, the coverage also emphasised the poor economic profitability of biogas technologies and a need for considerable public subsidies that are inherently unpredictable.
Conclusions
The future of niche-level energy technologies such as biogas can be strongly shaped by information flows, public perceptions and expectations created in part by media coverage. The analysed newspaper coverage in Finland was ambivalent from the perspective of energy transition. On the one hand, biogas production was represented as a preferable, environmentally friendly niche-level energy technology that should be encouraged. On the other hand, by emphasising the economic unviability of biogas technologies, the analysed newspaper coverage did not promote the adoption of biogas.
Different symptoms, together with neck pain, have been attributed to persons with persistent complaints after a previous motor vehicle crash (MVC) and are sometimes referred to as the “late whiplash ...syndrome.” A cohort study was conducted to determine whether exposure to a rear-end collision, with or without whiplash injury, is associated with future health complaints. The results regarding future neck or shoulder pain have previously been described, and the objective of the present report was to focus on outcomes other than neck pain. Included in the study were persons 18 to 65 years of age and covered by traffic insurance at one of the largest insurance companies in Sweden. Claim reports were collected from the period November 1987 to April 1988. Drivers exposed to a rear-end collision were divided into two subgroups: those with reported whiplash injury (
n = 232) and those without reported whiplash injury (
n = 204). For comparison, 3688 subjects who were unexposed to MVCs were selected, with consideration taken to the age and gender distribution in the exposed subgroups. The prevalence of different health complaints among the study subjects was estimated according to a mailed questionnaire at follow-up in 1994, 7 years after the rear-end collision. When exposed subjects with whiplash injury were compared to unexposed subjects, increased relative risks in the range of 1.6–3.7 were seen for headache, thoracic and low back pain, as well as for fatigue, sleep disturbances and ill health. No corresponding increased risks were found among the exposed subjects without reported whiplash injury. We conclude that rear-end collisions resulting in reported whiplash injuries seem to have a substantial impact on health complaints, even a long time after the collision. There is a need to identify factors that predict a non-favorable outcome in order to improve clinical management.
An imaging system suitable for recordings from Langendorff-perfused rat hearts using the voltage-sensitive dye 4-beta-2-(di-n-butylamino)-6-naphthylvinylpyridinium (di-4-ANEPPS) has been developed. ...Conduction velocity was measured under hyper- and hypokalemic conditions, as well as at physiological and reduced temperature. Elevation of extracellular K(+) to 9 mM from 5.9 mM caused a slowing of conduction velocity from 0.66 +/- 0.08 to 0.43 +/- 0.07 mm/ms (35%), and reduction of the temperature to 32 degrees C from 37 degrees C caused a slowing from 0.64 +/- 0.07 to 0.46 +/- 0.05 mm/ms (28%). Ventricular activation patterns in sinus rhythm showed areas of early activation (breakthrough) in both the right and left ventricle, with breakthrough at a site near the apex of the right ventricle usually occurring first. The effects of mechanically immobilizing the preparation to reduce motion artifact were also characterized. Activation patterns in epicardially paced rhythm were insensitive to this procedure over the range of applied force tested. In sinus rhythm, however, a relatively large immobilizing force caused prolonged PQ intervals as well as altered ventricular activation patterns. The time-dependent effects of the dye on the rat heart were characterized and include 1) a transient vasodilation at the onset of dye perfusion and 2) a long-lasting prolongation of the PQ interval of the electrocardiogram, frequently resulting in brief episodes of atrioventricular block.
No single U.S. health surveillance system adequately describes the health of people with intellectual and developmental disabilities (IDD). Researchers and policy makers have sought to understand the ...potential of state and local administrative and survey data to produce a local as well as a national picture of the health of the population with IDD. Analyses of these secondary data sources have significant appeal because of the potential to derive new information without the burden and expense of new data collection. The authors examined the potential for data collected by states and territories to inform health surveillance in the population with IDD, including data from the administration of eligibility-based supports, health insurance claims, and surveys administered for monitoring and quality improvement. Although there are opportunities to align and harmonize datasets to enhance the available information, there is no simple path to use state and local data to assess and report on the health of the population with IDD. Recommendations for policy, practice, and research include the development and use of consistent operational definitions in data collection, and research to fill knowledge gaps.
Display of proteins on bacteria Samuelson, Patrik; Gunneriusson, Elin; Nygren, Per-Åke ...
Journal of Biotechnology,
06/2002, Letnik:
96, Številka:
2
Book Review, Journal Article
Recenzirano
Display of heterologous proteins on the surface of microorganisms, enabled by means of recombinant DNA technology, has become an increasingly used strategy in various applications in microbiology, ...biotechnology and vaccinology. Gram-negative, Gram-positive bacteria, viruses and phages are all being investigated in such applications. This review will focus on the bacterial display systems and applications. Live bacterial vaccine delivery vehicles are being developed through the surface display of foreign antigens on the bacterial surfaces. In this field, ‘second generation’ vaccine delivery vehicles are at present being generated by the addition of mucosal targeting signals, through co-display of adhesins, in order to achieve targeting of the live bacteria to immunoreactive sites to thereby increase immune responses. Engineered bacteria are further being evaluated as novel microbial biocatalysts with heterologous enzymes immobilized as surface exposed on the bacterial cell surface. A discussion has started whether bacteria can find use as new types of whole-cell diagnostic devices since single-chain antibodies and other type of tailor-made binding proteins can be displayed on bacteria. Bacteria with increased binding capacity for certain metal ions can be created and potential environmental or biosensor applications for such recombinant bacteria as biosorbents are being discussed. Certain bacteria have also been employed for display of various poly-peptide libraries for use as devices in in vitro selection applications. Through various selection principles, individual clones with desired properties can be selected from such libraries. This article explains the basic principles of the different bacterial display systems, and discusses current uses and possible future trends of these emerging technologies.
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