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Electrolyte handling in the isolated perfused rat kidney: demonstration of vasopressin V2-receptor-dependent calcium reabsorption. 电解质处理在离体灌注大鼠肾脏:血管加压素v2受体依赖性钙重吸收的证明。
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-11-01 Epub Date: 2020-08-19 DOI: 10.1080/03009734.2020.1804496
Krister Bamberg, Lena William-Olsson, Ulrika Johansson, Anders Arner, Judith Hartleib-Geschwindner, Johan Sällström
{"title":"Electrolyte handling in the isolated perfused rat kidney: demonstration of vasopressin V2-receptor-dependent calcium reabsorption.","authors":"Krister Bamberg, Lena William-Olsson, Ulrika Johansson, Anders Arner, Judith Hartleib-Geschwindner, Johan Sällström","doi":"10.1080/03009734.2020.1804496","DOIUrl":"https://doi.org/10.1080/03009734.2020.1804496","url":null,"abstract":"Abstract Background The most profound effect of vasopressin on the kidney is to increase water reabsorption through V2-receptor (V2R) stimulation, but there are also data suggesting effects on calcium transport. To address this issue, we have established an isolated perfused kidney model with accurate pressure control, to directly study the effects of V2R stimulation on kidney function, isolated from systemic effects. Methods The role of V2R in renal calcium handling was studied in isolated rat kidneys using a new pressure control system that uses a calibration curve to compensate for the internal pressure drop up to the tip of the perfusion cannula. Results Kidneys subjected to V2R stimulation using desmopressin (DDAVP) displayed stable osmolality and calcium reabsorption throughout the experiment, whereas kidneys not administered DDAVP exhibited a simultaneous fall in urine osmolality and calcium reabsorption. Epithelial sodium channel (ENaC) inhibition using amiloride resulted in a marked increase in potassium reabsorption along with decreased sodium reabsorption. Conclusions A stable isolated perfused kidney model with computer-controlled pressure regulation was developed, which retained key physiological functions. The preparation responds to pharmacological inhibition of ENaC channels and activation of V2R. Using the model, the dynamic effects of V2R stimulation on calcium handling and urine osmolality could be visualised. The study thereby provides evidence for a stimulatory role of V2R in renal calcium reabsorption.","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 4","pages":"274-280"},"PeriodicalIF":3.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1804496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38287710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementation of a decision aid for recognition and correction of volume alterations (Recova®) in haemodialysis patients. 血液透析患者识别和纠正体积改变的决策辅助工具(Recova®)的实施。
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-11-01 Epub Date: 2020-08-27 DOI: 10.1080/03009734.2020.1804495
Jenny Stenberg, Magnus Lindberg, Hans Furuland
{"title":"Implementation of a decision aid for recognition and correction of volume alterations (Recova<sup>®</sup>) in haemodialysis patients.","authors":"Jenny Stenberg,&nbsp;Magnus Lindberg,&nbsp;Hans Furuland","doi":"10.1080/03009734.2020.1804495","DOIUrl":"https://doi.org/10.1080/03009734.2020.1804495","url":null,"abstract":"<p><strong>Background: </strong>Fluid overload is associated with mortality in haemodialysis patients, and 30% of patients remain fluid-overloaded after dialysis. The aim of this study was to evaluate if implementation of Recova<sup>®</sup>, a decision aid combining clinical assessment with bioimpedance spectroscopy, facilitates individualization of target weight determination and thereby contributes to improved fluid status in maintenance haemodialysis patients.</p><p><strong>Methods: </strong>The impact of the implementation was measured as the proportion of participants at an adequate target weight at the end of the study, assessed as change in symptoms, hydration status, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Nurses were instructed to use Recova every 2 weeks, and the process of the intervention was measured as frequencies of fluid status assessments, bioimpedance measurements, and target weight adjustments.</p><p><strong>Results: </strong>Forty-nine patients at two haemodialysis units were enrolled. In participants with fluid overload (<i>n</i> = 10), both overhydration and fluid overload symptom score decreased. In fluid-depleted participants (<i>n</i> = 20), target weight adjustment frequency and the estimated target weight increased. The post-dialytic negative overhydration was reduced, but NT-proBNP increased.</p><p><strong>Conclusions: </strong>Implementation of Recova in haemodialysis care increased the monthly frequencies of bioimpedance measurements and target weight adjustments, and it contributed to symptom reduction.</p><p><strong>Trial registration: </strong>The Uppsala County Council Registry of Clinical Trials: FoU 2019-0001-15.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 4","pages":"281-292"},"PeriodicalIF":3.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1804495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38315503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Work at inpatient care units is associated with an increased risk of SARS-CoV-2 infection; a cross-sectional study of 8679 healthcare workers in Sweden. 住院护理部门的工作与SARS-CoV-2感染风险增加有关;对瑞典8679名医护人员的横断面研究。
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-11-01 Epub Date: 2020-07-20 DOI: 10.1080/03009734.2020.1793039
Anna-Karin Lidström, Fredrik Sund, Bo Albinsson, Johan Lindbäck, Gabriel Westman
{"title":"Work at inpatient care units is associated with an increased risk of SARS-CoV-2 infection; a cross-sectional study of 8679 healthcare workers in Sweden.","authors":"Anna-Karin Lidström,&nbsp;Fredrik Sund,&nbsp;Bo Albinsson,&nbsp;Johan Lindbäck,&nbsp;Gabriel Westman","doi":"10.1080/03009734.2020.1793039","DOIUrl":"https://doi.org/10.1080/03009734.2020.1793039","url":null,"abstract":"<p><strong>Background: </strong>During the Covid-19 pandemic, the protection of healthcare workers has been in focus throughout the world, but the availability and quality of personal protective equipment has at times and in some settings been suboptimal.</p><p><strong>Materials and methods: </strong>A total of 8679 healthcare workers and healthcare support staff in the county of Uppsala, north of Stockholm, were included in this cross-sectional study. All subjects were analysed for IgG anti-SARS-CoV-2, and predictors for positive serostatus were analysed in a logistic regression model including demographic parameters and self-reported employment characteristics.</p><p><strong>Results: </strong>Overall, 577 (6.6%) were classified as seropositive, with no statistically significant differences between healthcare workers and support staff. Among healthcare workers, age (OR 0.987 per year, 95% CI 0.980-0.995), time to sampling (OR 1.019 per day, 95% CI 1.004-1.035), and employment at an outpatient care unit (OR 0.620, 95% CI 0.487-0.788) were statistically significantly associated with risk of infection. Covid-19 specific units were not at particular risk, compared to other units with comparable characteristics and staff demography.</p><p><strong>Conclusion: </strong>Our findings indicate that SARS-CoV-2 transmission is related to inpatient healthcare work, and illustrate the need for a high standard of basic hygiene routines in all inpatient care settings.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 4","pages":"305-310"},"PeriodicalIF":3.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1793039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38176015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 25
Distinctive alteration in the expression of autophagy genes in Drosophila models of amyloidopathy and tauopathy. 淀粉样变性和牛头病果蝇模型中自噬基因表达的显著改变。
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-11-01 Epub Date: 2020-07-11 DOI: 10.1080/03009734.2020.1785063
Mehrnaz Haghi, Raheleh Masoudi, Seyed Morteza Najibi
{"title":"Distinctive alteration in the expression of autophagy genes in Drosophila models of amyloidopathy and tauopathy.","authors":"Mehrnaz Haghi,&nbsp;Raheleh Masoudi,&nbsp;Seyed Morteza Najibi","doi":"10.1080/03009734.2020.1785063","DOIUrl":"https://doi.org/10.1080/03009734.2020.1785063","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is one the most common types of dementia. Plaques of amyloid beta and neurofibrillary tangles of tau are two major hallmarks of AD. Metabolism of these two proteins, in part, depends on autophagy pathways. Autophagy dysfunction and protein aggregation in AD may be involved in a vicious circle. The aim of this study was to investigate whether tau or amyloid beta 42 (Aβ42) could affect expression of autophagy genes, and whether they exert their effects in the same way or not.</p><p><strong>Methods: </strong>Expression levels of some autophagy genes, <i>Hook</i>, <i>Atg6</i>, <i>Atg8</i>, and <i>Cathepsin D</i>, were measured using quantitative PCR in transgenic <i>Drosophila melanogaster</i> expressing either Aβ42 or Tau R406W.</p><p><strong>Results: </strong>We found that <i>Hook</i> mRNA levels were downregulated in Aβ42-expressing flies both 5 and 25 days old, while they were increased in 25-day-old flies expressing Tau R406W. Both <i>Atg6</i> and <i>Atg8</i> were upregulated at day 5 and then downregulated in 25-day-old flies expressing either Aβ42 or Tau R406W. <i>Cathepsin D</i> expression levels were significantly increased in 5-day-old flies expressing Tau R406W, while there was no significant change in the expression levels of this gene in 5-day-old flies expressing Aβ42. Expression levels of <i>Cathepsin D</i> were significantly decreased in 25-day-old transgenic flies expressing Tau R406W or Aβ42.</p><p><strong>Conclusion: </strong>We conclude that both Aβ42 and Tau R406W may affect autophagy through dysregulation of autophagy genes. Interestingly, it seems that these pathological proteins exert their toxic effects on autophagy through different pathways and independently.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 4","pages":"265-273"},"PeriodicalIF":3.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1785063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38152681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Complete response with combined BRAF and MEK inhibition in BRAF mutated advanced low-grade serous ovarian carcinoma. BRAF和MEK联合抑制对BRAF突变的晚期低度浆液性卵巢癌的完全应答。
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-11-01 Epub Date: 2020-10-10 DOI: 10.1080/03009734.2020.1826612
Bengt Tholander, Anthoula Koliadi, Johan Botling, Hanna Dahlstrand, Anne Von Heideman, Håkan Ahlström, Kjell Öberg, Gustav J Ullenhag
{"title":"Complete response with combined BRAF and MEK inhibition in BRAF mutated advanced low-grade serous ovarian carcinoma.","authors":"Bengt Tholander,&nbsp;Anthoula Koliadi,&nbsp;Johan Botling,&nbsp;Hanna Dahlstrand,&nbsp;Anne Von Heideman,&nbsp;Håkan Ahlström,&nbsp;Kjell Öberg,&nbsp;Gustav J Ullenhag","doi":"10.1080/03009734.2020.1826612","DOIUrl":"10.1080/03009734.2020.1826612","url":null,"abstract":"<p><p>More effective treatments are needed for low-grade serous ovarian carcinoma (LGSOC). Our patient, who suffers from metastatic LGSOC, had received all established treatments. Sequencing analysis revealed an activating BRAF mutation. Therefore, combined treatment with BRAF and MEK inhibitors, which is the gold standard in malignant melanoma, was initiated. After eight months of therapy, the response was assessed as complete and the treatment is still, 3.5 years after initiation, of benefit. To our knowledge, no complete response on combined BRAF and MEK inhibitor treatment of low-grade serous ovarian cancer has previously been reported.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 4","pages":"325-329"},"PeriodicalIF":3.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1826612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38477560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Natural language processing and machine learning to enable automatic extraction and classification of patients' smoking status from electronic medical records. 通过自然语言处理和机器学习,可以从电子病历中自动提取和分类患者的吸烟状况。
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-11-01 Epub Date: 2020-07-22 DOI: 10.1080/03009734.2020.1792010
Andrea Caccamisi, Leif Jørgensen, Hercules Dalianis, Mats Rosenlund
{"title":"Natural language processing and machine learning to enable automatic extraction and classification of patients' smoking status from electronic medical records.","authors":"Andrea Caccamisi,&nbsp;Leif Jørgensen,&nbsp;Hercules Dalianis,&nbsp;Mats Rosenlund","doi":"10.1080/03009734.2020.1792010","DOIUrl":"https://doi.org/10.1080/03009734.2020.1792010","url":null,"abstract":"<p><strong>Background: </strong>The electronic medical record (EMR) offers unique possibilities for clinical research, but some important patient attributes are not readily available due to its unstructured properties. We applied text mining using machine learning to enable automatic classification of unstructured information on smoking status from Swedish EMR data.</p><p><strong>Methods: </strong>Data on patients' smoking status from EMRs were used to develop 32 different predictive models that were trained using Weka, changing sentence frequency, classifier type, tokenization, and attribute selection in a database of 85,000 classified sentences. The models were evaluated using F-score and accuracy based on out-of-sample test data including 8500 sentences. The error weight matrix was used to select the best model, assigning a weight to each type of misclassification and applying it to the model confusion matrices. The best performing model was then compared to a rule-based method.</p><p><strong>Results: </strong>The best performing model was based on the Support Vector Machine (SVM) Sequential Minimal Optimization (SMO) classifier using a combination of unigrams and bigrams as tokens. Sentence frequency and attributes selection did not improve model performance. SMO achieved 98.14% accuracy and 0.981 F-score versus 79.32% and 0.756 for the rule-based model.</p><p><strong>Conclusion: </strong>A model using machine-learning algorithms to automatically classify patients' smoking status was successfully developed. Such algorithms may enable automatic assessment of smoking status and other unstructured data directly from EMRs without manual classification of complete case notes.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 4","pages":"316-324"},"PeriodicalIF":3.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1792010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38178735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 16
Correlation analysis of coagulation dysfunction and liver damage in patients with novel coronavirus pneumonia: a single-center, retrospective, observational study. 新型冠状病毒肺炎患者凝血功能障碍与肝损害的相关性分析:单中心、回顾性、观察性研究
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-11-01 Epub Date: 2020-09-29 DOI: 10.1080/03009734.2020.1822960
Sai Chen, Hanting Liu, Tie Li, Rong Huang, Rong Gui, Junhua Zhang
{"title":"Correlation analysis of coagulation dysfunction and liver damage in patients with novel coronavirus pneumonia: a single-center, retrospective, observational study.","authors":"Sai Chen,&nbsp;Hanting Liu,&nbsp;Tie Li,&nbsp;Rong Huang,&nbsp;Rong Gui,&nbsp;Junhua Zhang","doi":"10.1080/03009734.2020.1822960","DOIUrl":"https://doi.org/10.1080/03009734.2020.1822960","url":null,"abstract":"<p><strong>Background: </strong>The novel coronavirus disease 2019 (COVID-19) is currently breaking out worldwide. COVID-19 patients may have different degrees of coagulopathy, but the mechanism is not yet clear. We aimed to analyse the relationship between coagulation dysfunction and liver damage in patients with COVID-19.</p><p><strong>Methods: </strong>A retrospective analysis of 74 patients with COVID-19 admitted to the First People's Hospital of Yueyang from 1 January to 30 March 2020 was carried out. According to the coagulation function, 27 cases entered the coagulopathy group and 47 cases entered the control group. A case control study was conducted to analyse the correlation between the occurrence of coagulation dysfunction and liver damage in COVID-19 patients.</p><p><strong>Results: </strong>Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), markers of liver damage, were positively correlated with coagulopathy (<i>p</i> = 0.039, OR 2.960, 95% CI 1.055-8.304; and <i>p</i> = 0.028, OR 3.352, 95% CI 1.137-9.187). Alkaline phosphatase (ALP), γ-glutamyl transpeptidase (γ-GT), and total bilirubin (TBIL) were not statistically correlated with coagulopathy. According to the diagnosis and treatment plan, the included cases were classified into mild, moderate, severe, and critical. The results showed that the occurrence of coagulation dysfunction had no statistical correlation with the severity of COVID-19.</p><p><strong>Conclusion: </strong>Coagulation dysfunction in patients with COVID-19 is closely related to liver damage. A longer course of the disease may cause a vicious circle of coagulopathy and liver damage. Clinicians need to closely monitor coagulation and liver function tests and to give prophylactic or supportive therapy when needed.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 4","pages":"293-296"},"PeriodicalIF":3.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1822960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38431715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Oxygen sensing; a stunningly elegant molecular machinery highjacked in cancer. 氧气传感;一个在癌症中被劫持的极其优雅的分子机器。
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-08-01 Epub Date: 2020-06-24 DOI: 10.1080/03009734.2020.1769231
Lena Claesson-Welsh
{"title":"Oxygen sensing; a stunningly elegant molecular machinery highjacked in cancer.","authors":"Lena Claesson-Welsh","doi":"10.1080/03009734.2020.1769231","DOIUrl":"https://doi.org/10.1080/03009734.2020.1769231","url":null,"abstract":"<p><p>Oxygen is of fundamental importance for most living organisms, and the maintenance of oxygen homeostasis is a key physiological challenge for all large animals. Oxygen deprivation, hypoxia, is a critical component of many human diseases including cancer, heart disease, stroke, vascular disease, and anaemia. The discovery of oxygen sensing provides fundamental knowledge of a stunningly elegant molecular machinery; it also promises development of new therapeutics for serious diseases such as cancer. As a result of their impressive contributions to our understanding of the mechanisms by which cells sense oxygen and signal in hypoxia, Gregg Semenza, Peter Ratcliffe, and William Kaelin were awarded the Nobel Prize in 2019.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 3","pages":"205-210"},"PeriodicalIF":3.4,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1769231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38079233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Dietary advice and oral nutritional supplements do not increase survival in older malnourished adults: a multicentre randomised controlled trial. 饮食建议和口服营养补充剂并不能提高营养不良老年人的存活率:一项多中心随机对照试验。
IF 1.5 4区 医学
Upsala journal of medical sciences Pub Date : 2020-08-01 Epub Date: 2020-05-02 DOI: 10.1080/03009734.2020.1751752
Lisa Söderström, Andreas Rosenblad, Leif Bergkvist, Hanna Frid, Eva Thors Adolfsson
{"title":"Dietary advice and oral nutritional supplements do not increase survival in older malnourished adults: a multicentre randomised controlled trial.","authors":"Lisa Söderström, Andreas Rosenblad, Leif Bergkvist, Hanna Frid, Eva Thors Adolfsson","doi":"10.1080/03009734.2020.1751752","DOIUrl":"10.1080/03009734.2020.1751752","url":null,"abstract":"<p><p><b>Objectives:</b> The study aimed to investigate the effect on survival after 6 months of treatment involving individual dietary advice and oral nutritional supplements in older malnourished adults after discharge from hospital.<b>Methods:</b> This multicentre randomised controlled trial included 671 patients aged 65 years who were malnourished or at risk of malnutrition when admitted to hospital between 2010 and 2014, and followed up after 8.2 years (median 4.1 years). Patients were randomised to receive dietary advice or oral nutritional supplements, separate or in combination, or routine care. The intervention started at discharge from the hospital and continued for 6 months, with survival being the main outcome measure.<b>Results:</b> During the follow-up period 398 (59.3%) participants died. At follow-up, the survival rates were 36.9% for dietary advice, 42.4% for oral nutritional supplements, 40.2% for dietary advice combined with oral nutritional supplements, and 43.3% for the control group (log-rank test <i>p</i> = 0.762). After stratifying the participants according to nutritional status, survival still did not differ significantly between the treatment arms (log-rank test <i>p</i> = 0.480 and <i>p</i> = 0.298 for the 506 participants at risk of malnutrition and the 165 malnourished participants, respectively).<b>Conclusions:</b> Oral nutritional supplements with or without dietary advice, or dietary advice alone, do not improve the survival of malnourished older adults. These results do not support the routine use of supplements in older malnourished adults, provided that survival is the aim of the treatment.<b>Trial registration:</b> ClinicalTrials.gov with ID: NCT01057914.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 3","pages":"240-249"},"PeriodicalIF":1.5,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37896210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reduced 10-year risk of developing cardiovascular disease after participating in a lifestyle programme in primary care. 参与初级保健生活方式规划后,10年内患心血管疾病的风险降低。
IF 3.4 4区 医学
Upsala journal of medical sciences Pub Date : 2020-08-01 Epub Date: 2020-02-20 DOI: 10.1080/03009734.2020.1726533
Lena Lönnberg, Elin Ekblom-Bak, Mattias Damberg
{"title":"Reduced 10-year risk of developing cardiovascular disease after participating in a lifestyle programme in primary care.","authors":"Lena Lönnberg,&nbsp;Elin Ekblom-Bak,&nbsp;Mattias Damberg","doi":"10.1080/03009734.2020.1726533","DOIUrl":"https://doi.org/10.1080/03009734.2020.1726533","url":null,"abstract":"<p><p><b>Background:</b> Despite well-known preventive effects for future cardiovascular disease (CVD) risk through lifestyle changes, scientific evaluations of lifestyle programmes in primary care are scarce. Moreover, structured lifestyle counselling is still not integrated in everyday clinical practice. We aimed to evaluate change in cardiovascular risk factors and Framingham 10-year risk score of developing CVD in men and women at high cardiovascular risk after participation in a structured lifestyle programme over 1 year. A single-group study was carried out with a 1-year follow-up including before and after measurements.<b>Methods:</b> The lifestyle programme comprised five appointments to a district nurse over 1 year, focussing on lifestyle habits based on motivational interviewing. Fasting blood samples and anthropometric measurements were obtained at baseline and 1-year follow-up. The 10-year risk of CVD was calculated according to Framingham general CVD risk score.<b>Results:</b> A total of 404 patients were included in the study. There was a positive change over 1 year in the total study population for all risk factors evaluated. This included improvements in weight, waist circumference, blood pressure, blood lipids, and fasting glucose. The 10-year risk of developing CVD decreased for the total population from 24.8% to 21.4% at 1 year, equivalent to a 14% decrease.<b>Conclusions:</b> A structured lifestyle programme in primary care contributes to significant improvements of cardiovascular risk factors and the reduction of 10-year risk for CVD for both men and women at high cardiovascular risk.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"125 3","pages":"250-256"},"PeriodicalIF":3.4,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/03009734.2020.1726533","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37660980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
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