Browsing Artikler, rapporter og annet (klinisk medisin) by Author
DSpace/Manakin Repository
- Home
- Det helsevitenskapelige fakultet
- Institutt for klinisk medisin
- Artikler, rapporter og annet (klinisk medisin)
- Browsing Artikler, rapporter og annet (klinisk medisin) by Author
Browsing Artikler, rapporter og annet (klinisk medisin) by Author
Previous Page
Now showing items 186-192 of 192
-
Zanaboni, Paolo; Wootton, Richard (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. URI: http://hdl.handle.net/10037/4427 File(s) in this item: 1
article.pdf (467.5Kb) -
Øiesvold, Terje; Nivison, Mary; Hansen, Vidje; Skre, Ingunn; Østensen, Line; Sørgaard, Knut (Journal article; Tidsskriftartikkel; Peer reviewed, 2013)[+][-]
Abstract: Background This study will explore the validity of psychiatric diagnoses in administrative registers with special emphasis on comorbid anxiety and substance use disorders. Methods All new patients admitted to psychiatric hospital in northern Norway during one year were asked to participate. Of 477 patients found eligible, 272 gave their informed consent. 250 patients (52%) with hospital diagnoses comprised the study sample. Expert diagnoses were given on the basis of a structured diagnostic interview (M.I.N.I.PLUS) together with retrospective checking of the records. The hospital diagnoses were blind to the expert. The agreement between the expert’s and the clinicians’ diagnoses was estimated using Cohen’s kappa statistics. Results The expert gave a mean of 3.4 diagnoses per patient, the clinicians gave 1.4. The agreement ranged from poor to good (schizophrenia). For anxiety disorders (F40-41) the agreement is poor (kappa = 0.12). While the expert gave an anxiety disorder diagnosis to 122 patients, the clinicians only gave it to 17. The agreement is fair concerning substance use disorders (F10-19) (kappa = 0.27). Only two out of 76 patients with concurrent anxiety and substance use disorders were identified by the clinicians. Conclusions The validity of administrative registers in psychiatry seems dubious for research purposes and even for administrative and clinical purposes. The diagnostic process in the clinic should be more structured and treatment guidelines should include comorbidity. URI: http://hdl.handle.net/10037/5038 File(s) in this item: 1
article.pdf (148.8Kb) -
Øiesvold, Terje; Bakkejord, Tony Thørring; Hansen, Vidje; Nivison, Mary; Sørgaard, Knut (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: The epidemiology of suicidality shows considerable variation across sites. However, one of the strongest predictors of suicide is a suicidal attempt. Knowledge of the epidemiology of suicidal ideas and attempts in the general population as well as in the health care system is of importance for designing preventive strategies. In this study, we will explore the role of the psychiatric hospital in suicide prevention by investigating treated incidence of suicidal ideation and attempt, and further, discern whether sociodemographic, clinical and service utilization factors differ between these two groups at admission. The study was a prospective cohort study on treated incidence in a 1-year period and 12-month follow-up. The two psychiatric hospitals in northern Norway, serving a population of about 500,000 people, participated in the study. A total of 676 first-time admissions were retrospectively checked for suicidality at the time of admission. A study sample of 168 patients was found eligible for logistic regression analysis to elucidate the risk profiles of suicidal ideators versus suicidal attempters. GAF, HoNOS and SCL-90-R were used to assess symptomatology at baseline. 52.2% of all patients admitted had suicidal ideas at admission and 19.7% had attempted suicide. In the study sample, there were no differences in risk profile between the two groups with regard to sociodemographic and clinical factors. Males who had made a suicide attempt were less likely to have been in contact with an out-patient clinic before the attempt. The rating scales not measuring suicidality directly showed no differences in symptomatology. The findings provide evidence for the importance of the psychiatric hospital in suicide prevention. About half of the admissions were related to suicidality and the similar risk profiles found in suicidal ideators and suicidal attempters indicate that it is the ideators who mostly need treatment that get admitted to the hospital, and should be evaluated and treated with equal concern as those who have attempted suicide. URI: http://hdl.handle.net/10037/4973 File(s) in this item: 1
article.pdf (200.2Kb) -
Øiesvold, Terje; Nivison, Mary; Hansen, Vidje; Sørgaard, Knut; Østensen, Line; Skre, Ingunn (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)[+][-]
Abstract: Background This study has explored the classification of bipolar disorder in psychiatric hospital. A review of the literature reveals that there is a need for studies using stringent methodological approaches. Methods 480 first-time admitted patients to psychiatric hospital were found eligible and 271 of these gave written informed consent. The study sample was comprised of 250 patients (52%) with hospital diagnoses. For the study, expert diagnoses were given on the basis of a structured diagnostic interview (M.I.N.I.PLUS) and retrospective review of patient records. Results Agreement between the expert's and the clinicians' diagnoses was estimated using Cohen's kappa statistics. 76% of the primary diagnoses given by the expert were in the affective spectrum. Agreement concerning these disorders was moderate (kappa ranging from 0.41 to 0.47). Of 58 patients with bipolar disorder, only 17 received this diagnosis in the clinic. Almost all patients with a current manic episode were classified as currently manic by the clinicians. Forty percent diagnosed as bipolar by the expert, received a diagnosis of unipolar depression by the clinician. Fifteen patients (26%) were not given a diagnosis of affective disorder at all. Conclusions Our results indicate a considerable misclassification of bipolar disorder in psychiatric hospital, mainly in patients currently depressed. The importance of correctly diagnosing bipolar disorder should be emphasized both for clinical, administrative and research purposes. The findings questions the validity of psychiatric case registers. There are potential benefits in structuring the diagnostic process better in the clinic. URI: http://hdl.handle.net/10037/4436 File(s) in this item: 1
article.pdf (250.5Kb) -
Øie, Cristina Ionica; Appa, Rupa Shree; Hilden, Ida; Petersen, Helle Heibroch; Gruhler, Albrecht; Smedsrød, Bård; Hansen, John-Bjarne (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)[+][-]
Abstract: The low density lipoprotein receptor-related protein-1 (LRP-1) is a large, multifunctional endocytic receptor from the LDL receptor family, highly expressed in liver parenchymal cells (PCs), neurons, activated astrocytes, and fibroblasts. The aim of the study was to investigate if liver sinusoidal endothelial cells (LSECs), highly specialized scavenger cells, express LRP-1. To address this question, experiments were performed in vivo and in vitro to determine if receptor associated protein (RAP) and trypsin-activated α2-macroglobulin (α2M∗) were endocytosed in LSECs. Both ligands were cleared from the circulation mainly by the liver. Hepatocellular distribution of intravenously administered ligands, assessed after magnetic bead cell separation using LSEC- and KC-specific antibodies, showed that PCs contained 93% and 82% of liver-associated 125I-RAP and 125I-α2M∗, whereas 5% and 11% were associated with LSECs. Uptake of RAP and α2M∗ in the different liver cell population in vitro was specific and followed by degradation. The uptake of 125I-RAP was not inhibited by ligands to known endocytosis receptors in LSECs, while uptake of 125I-α2M∗ was significantly inhibited by RAP, suggesting the involvement of LRP-1. Immunofluorescence using LRP-1 antibody showed positive staining in LSECs. Ligand blot analyses using total cell proteins and 125I-RAP followed by mass spectrometry further confirmed and identified LRP-1 in LSECs. LSECs express functional LRP-1. An important implication of our findings is that LSECs contribute to the rapid removal of blood borne ligands for LRP-1 and may thus play a role in lipid homeostasis. Description: This paper is part of Cristina Ionica Øie's doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/2910 URI: http://hdl.handle.net/10037/4078 File(s) in this item: 1
article.pdf (2.615Mb) -
Øie, Cristina Ionica; Appa, Rupa Shree; Hilden, Ida; Brodin, Ellen; Smedsrød, Bård; Hansen, John-Bjarne (Preprint; Manuskript; Peer reviewed, 2010)[+][-]
Abstract: Background: Tissue factor pathway inhibitor (TFPI) plays an important role for the anticoagulant effect of heparin. Depletion of intravascular TFPI by treatment with unfractionated heparin (UFH), and not by low molecular weight heparin (LMWH), has been suggested to explain the superiority of LMWH in treatment of both arterial and venous thrombosis. The present study was undertaken to investigate the impact of UFH on clearance kinetics, and organs and cells responsible for the clearance of recombinant human full length TFPI purified from baby hamster kidney cells (TFPIBHK) and from E.Coli (TFPIE.Coli).
Methods: Male Sprague-Dawley rats were used as research animals. TFPIBHK and TFPIE.Coli were labelled with 125I, and used to study clearance in vivo.
Results: Surface Plasmon Resonance (SPR) analysis revealed that both types of TFPI bound to UFH in vitro, but TFPIE.Coli exhibited a faster association rate and a much slow dissociation rate. Intravenous administration of 100 IU/kg UFH immediately prior to TFPI decreased the circulatory survival (t1/2α) of TFPIBHK from 1.99 ± 0.10 min to 1.17 ± 0.13 min (p<0.001) without affecting the fast clearance of TFPIE.Coli. Presence of UFH significantly increased the circulatory survival during the slow t1/2β phase of TFPIE.Coli from 27.44 ± 1.91 min to 36.88 ± 1.87 min (p<0.05) without affecting the t1/2β of TFPIBHK. Hepatocellular distribution of radiolabeled ligands showed that both forms of TFPI were mainly taken up by PCs in the absence of UFH (≥ 90%). UFH administration switched the hepatocellular distribution of TFPIE.Coli from PCs towards LSECs, without affecting the distribution of TFPIBHK.
Conclusions: Our findings revealed a specific increase in the elimination of TFPIBHK during UFH treatment. This observation may represent the underlying mechanism for depletion of endogenous TFPI in humans during UFH treatment.Description: This paper is part of Cristina Ionica Øie's doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/2910 URI: http://hdl.handle.net/10037/2913 File(s) in this item: 1
article.pdf (247.6Kb) -
Øie, Cristina Ionica; Appa, Rupa Shree; Brodin, Ellen; Hansen, John-Bjarne; Smedsrød, Bård (Preprint; Manuskript; Peer reviewed, 2010)[+][-]
Abstract: We here report on a study carried out to determine the early clearance kinetics, and organ, cell(s) and receptor(s) responsible for the clearance of full length TFPI purified from BHK cells (TFPIBHK). Following intravenous administration, 125I-TFPIBHK was cleared with a biphasic elimination curve, and with a significantly slower t1/2α compared to recombinant human TFPI from E.Coli (TFPIE.Coli) (1.95±0.10 versus 1.42±0.07 min, respectively, p<0.001). Studies on organ and cell distribution revealed that liver parenchymal cells (PCs) were responsible for 96% of the uptake of TFPIBHK and 81% of TFPIE.Coli, whereas the nonparenchymal cells (NPCs) were responsible for 4% and 19%, respectively. Pre-administration of excessive amounts of unlabeled TFPIBHK prolonged blood clearance of 125I-TFPIBHK. Unlabelled TFPIBHK inhibited endocytosis of 125I-TFPIBHK in PCs in vitro, whereas blocking of LDL-receptor related protein-1 (LRP-1) by receptor-associated protein (RAP) affected neither blood clearance nor endocytosis of 125I-TFPIBHK in PCs. In addition, TFPIBHK was also found in the kidneys and this could be reduced in the presence of RAP. Asialoorosomucoid (ASOR), a potent inhibitor of the asialoglycoprotein receptor (ASGP-R), prolonged the circulatory survival of 125I-m-TFPI by 1.5-fold (p<0.001). In vitro, ASOR and other ASGP-R antagonists significantly inhibited endocytosis of 125I-TFPIBHK in PCs. Moreover, unlabelled TFPIBHK markedly decreased endocytosis of 125I-asialofetuin. In conclusion, our findings suggest that ASGP-R mediated endocytosis in the liver is involved in the clearance of TFPIBHK. Description: This article is part of Cristina Ionica Øie's doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/2910 URI: http://hdl.handle.net/10037/2912 File(s) in this item: 1
article.pdf (655.0Kb)
Previous Page
Now showing items 186-192 of 192
Search Munin
Browse
-
All of Munin
-
This Collection
Help
Munin is powered by DSpace 1.8.2
The University Library of Tromsø, N-9037 Tromsø
Tel: +47 77 64 40 00, E-mail: munin@ub.uit.no