Biomedical subjects

B Bergman

Publications and source records attributed to B Bergman.

At least 37 records · Page 2Linked to original sources

PubMed2000

Psychosocial support in rehabilitation after orthopedic injuries.

OBJECTIVE: Several studies have shown that psychosocial factors play a significant role in the recovery process after injuries. The aim of this study was to investigate whether psychosocial support would have a beneficial effect on outcome. METHODS: A total of 151 patients with orthopedic injuries were randomized into an intervention group and a control group. The intervention group was offered a psychosocial support program during the early phase of rehabilitation. RESULTS: One year after the injury, patients in the control group had an excess risk of having psychiatric complaints compared with patients in the intervention group (odds ratio = 2.74). They also reported a poorer quality of life according to Short Formula 36 Health Survey subscores for General Health (odds ratio = 2.3) and Vitality (odds ratio = 2.45). The length of the sick leave period did not differ between the groups. CONCLUSION: Psychosocial support during the early phase of rehabilitation after orthopedic injuries may have a beneficial effect on outcome when measured as quality of life.

Adolescent↗

PubMed2000

Self-reported health in relation to medical health and gender-specific problems in women.

Self-reported health was studied in relation to physiological measures, gender-specific problems, and clinical evaluation in 61 middle-aged women employed in a male-dominated industry. Using self-reported somatic health as the dependent variable, 50% of the variability was explained by the dimension workplace culture and the ratio low-density lipoprotein/high-density lipoprotein. Some women who reported good health were diagnosed with distress but showed no ill-health factors. However, they reported experiences of gender-specific problems more often than the women who were diagnosed as being healthy. We concluded that self-report scales seem not to be enough to identify people who look healthy on standard health scales but who use psychological defenses. Differentiating methods such as gender-specific questions, physiological ratio-measures, and clinical judgment seem to be important for distinguishing genuine from illusory mental or physical health.

Adult↗

PubMed2000

Tirapazamine plus cisplatin versus cisplatin in advanced non-small-cell lung cancer: A report of the international CATAPULT I study group. Cisplatin and Tirapazamine in Subjects with Advanced Previously Untreated Non-Small-Cell Lung Tumors.

PURPOSE: A phase III trial, Cisplatin and Tirapazamine in Subjects with Advanced Previously Untreated Non-Small-Cell Lung Tumors (CATAPULT I), was designed to determine the efficacy and safety of tirapazamine plus cisplatin for the treatment of non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with previously untreated NSCLC were randomized to receive either tirapazamine (390 mg/m(2) infused over 2 hours) followed 1 hour later by cisplatin (75 mg/m(2) over 1 hour) or 75 mg/m(2) of cisplatin alone, every 3 weeks for a maximum of eight cycles. RESULTS: A total of 446 patients with NSCLC (17% with stage IIIB disease and pleural effusions; 83% with stage IV disease) were entered onto the study. Karnofsky performance status (KPS) was >/= 60 for all patients (for 10%, KPS = 60; for 90%, KPS = 70 to 100). Sixty patients (14%) had clinically stable brain metastases. The median survival was significantly longer (34.6 v 27. 7 weeks; P =.0078) and the response rate was significantly greater (27.5% v 13.7%; P <.001) for patients who received tirapazamine plus cisplatin (n = 218) than for those who received cisplatin alone (n = 219). The tirapazamine-plus-cisplatin regimen was associated with mild to moderate adverse events, including acute, reversible hearing loss, reversible, intermittent muscle cramping, diarrhea, skin rash, nausea, and vomiting. There were no incremental increases in myelosuppression, peripheral neuropathy, or renal, hepatic, or cardiac toxicity and no deaths related to tirapazamine. CONCLUSION: The CATAPULT I study shows that tirapazamine enhances the activity of cisplatin in patients with advanced NSCLC and confirms that hypoxia is an exploitable therapeutic target in human malignancies.

Adult↗

PubMed2000

Professional skills and frame of work organization in managing borderline personality disorder. Shared philosophy or ambivalence--a qualitative study from the view of caregivers.

Caregivers' experiences and beliefs of working with borderline personality disorder (BPD) in a psychiatric organization were investigated using a qualitative analysis of 29 in-depth interviews. The analysis identified eight characteristics, which were organized in two core concepts. The first of these core concepts, professional skills of mental health work, comprised the categories of empathy for persons with BPD, interest in treating the disorder, feelings of professional frustration and need for a common outlook. The second core concept, frame of work organization, that is categories common to the organization, included ambivalence between the professions of the caregivers, the need for structure in organizing the work, forms of emotional support to the caregivers and the need for a shared philosophy of care. A tentative model was proposed to illustrate the effects of these factors on the type and outcome of work that interact with the care of the patient. It is concluded that ambivalence in the division of labour may be a critical hindrance to the development of cooperation in the care of BPD patients. It is suggested that a shared common philosophy will support corresponding ethical standards by individual practitioners for the benefit of patient outcome.

Adult↗

PubMed1999

Expression and purification of the transcription factor NtcA from the cyanobacterium Anabaena PCC 7120.

The transcription factor NtcA from the cyanobacterium Anabaena PCC 7120 was heterologously expressed in Escherichia coli. In order to optimize the expression of NtcA, random silent mutations were introduced at the 5' end of the DNA encoding the protein. To get as high a yield of pure protein as possible, different strategies of expression as well as purification conditions were used. Under optimal expression conditions, a high-level expression clone of NtcA was coexpressed with GroEL-ES at 37 degrees C. A hexahistidine tag was added to the N-terminus of the protein in order to allow purification on an IMAC affinity column. Expression followed by one purification step using IMAC affinity chromatography gave a yield of 30-40 mg pure NtcA protein per liter of bacterial culture. Gel-shift experiments showed that the recombinant NtcA was active in binding a DNA sequence containing an NtcA-specific site.

Amino Acid Sequence↗

PubMed1999

A European perspective on psychiatric nursing and violent incidents: management, education and service organisation.

The topic of violent incidents and its importance to inpatient psychiatric nursing practice is well recognised in the academic literature. However the awareness and profile of the issue in different European countries is highly variable. In this paper five European countries are compared: Italy, Norway, the Netherlands, Sweden and the UK. Contextual factors are likely to determine the perception, recognition and acknowledgement of the problem. Those described in detail here are the organisation of psychiatric inpatient services, the training of psychiatric nurses, and the methods used by those nurses to control and contain disturbed patients. For each of these factors large variations exist between the countries considered. The conclusion is drawn that there is much scope for useful comparative research.

Antipsychotic Agents↗

PubMed1999

Single-agent gemcitabine: an active and better tolerated alternative to standard cisplatin-based chemotherapy in locally advanced or metastatic non-small cell lung cancer.

This randomized study was designed to determine the response rates, survival and toxicities of single-agent gemcitabine (GEMZAR) and a combination of cisplatin/etoposide in chemonaive patients with non-resectable, locally advanced or metastatic non-small cell lung cancer (NSCLC). Gemcitabine 1000 mg/m2 was given as a 30-min intravenous infusion on days 1, 8, 15 of a 28-day cycle, cisplatin 100 mg/m2 on day 1, and etoposide 100 mg/m2 on days 1 (following cisplatin), 2 and 3. Major eligibility criteria included histologically confirmed non-small cell lung cancer, measurable disease, Zubrod performance status 0-2, no prior chemotherapy, no prior radiation of the measured lesion, and no CNS metastases. One hundred and forty-seven patients were enrolled, 72 in the gemcitabine and 75 in the cisplatin/etoposide arm. Patient characteristics were well-matched across both arms. Sixty-seven gemcitabine and 72 cisplatin/etoposide patients were qualified for efficacy analysis. There were no complete responses, but 12 partial responses in the gemcitabine arm and 11 in the cisplatin/etoposide arm, for protocol-qualified response but 12 partial responses in the gemcitabine arm and 11 in the cisplatin/etoposide arm, for protocol-qualified response rates of 17.9% (95%, CI: 9.6-29.2%,) and 15.3% (95% CI: 7.9-25.7%,), respectively. Median survival times were 6.6 months (95% CI: 4.9-7.3 months) for gemcitabine and 7.6 months (95% CI: 5.4-9.3 months) for cisplatin/etoposide. The 1-year survival probability estimate was 26% for gemcitabine and 24% for cisplatin/etoposide. There were no statistically significant between-group differences in time-to-event measures, but patients in the gemcitabine arm had a greater probability of achieving a tumour response after 2 months (probability estimate: 8 vs. 0%,) and of the response lasting at least 6 months (73 vs. 45%,). Clinical and haematologic toxicity was more pronounced in the cisplatin/etoposide arm. Quality-of-life measures indicated a significant worsening of symptomatology in the cisplatin/etoposide arm for hair loss, nausea and vomiting, and appetite loss. This randomized study provides further evidence that single-agent gemcitabine is an active and effective therapy for patients with non-resectable. locally advanced or metastatic NSCLC and good performance status, and that it is better tolerated than the combination cisplatin/ etoposide.

Adult↗

PubMed1999

Psychotic disorders among inpatients with abuse of cannabis, amphetamine and opiates. Do dopaminergic stimulants facilitate psychiatric illness?

We have studied the occurrence of dual diagnoses (psychoses as well as abuse of either amphetamine, cannabis or opiates) during a 15-year period, among patients treated at Huddinge Hospital, Stockholm, Sweden. The purpose of the study is to evaluate if the different drugs were coupled to different rates of psychiatric co-morbidity. During the period in question, 461, 425 and 371 different patients respectively had been admitted at least once due to dependency on amphetamine, cannabis and opiates. Approximately 30% of the patients with a pure abuse of amphetamine or cannabis and less than 6% of the opiate abusers had been diagnosed at least once with any of the psychoses studied. Comparing the frequency of psychoses among mixed and pure abusers of illegal drugs, with and without a concomitant abuse of alcohol, we found that the co-morbidity rate for mixed opiate abusers increased significantly from 7.2 to 20.2% when alcohol abuse was also present. For abusers of amphetamine and cannabis (both pure and mixed), no differences in co-morbidity rates were seen when an abuse of alcohol was added to that of the drugs. It is difficult to find an explanation for the significant difference between the co-morbidity of pure abuse of amphetamine or cannabis on the one hand and opiates on the other. In conclusion, our findings show that the distribution of psychotic illness is high among abusers of amphetamine and cannabis, in contrast to the generally lower co-morbidity among abusers of opiates. Although these findings are consistent with earlier studies that have shown a propensity for developing psychoses among abusers of amphetamine and cannabis, one should bear in mind that this study is based on inpatients, and is not necessarily representative for all abusers of the drugs in question.

Alcoholism↗

PubMed1999

Megestrol acetate in advanced, progressive, hormone-insensitive cancer. Effects on the quality of life: a placebo-controlled, randomised, multicentre trial.

A randomised double-blind placebo-controlled multicentre trial was performed to investigate the effects of megestrol acetate (MA) on the quality of life (QoL), appetite, weight and survival of patients with advanced, incurable, hormone-insensitive cancer. QoL was assessed at the start of treatment and at 4, 8 and 12 weeks, using the EORTC-QLQ-C30 instrument. 255 patients were randomised to 320 mg of MA daily or placebo for 12 weeks. 244 patients were assessable at baseline, 190 at 4 weeks (placebo 94; MA 96), 150 at 8 weeks (placebo 69; MA 81) and 112 at 12 weeks (placebo 55; MA 57). A beneficial effect of MA on appetite loss was observed at week 4 (P < 0.0001) and possibly at week 8 (P = 0.058). Further weight loss during treatment was significant only in the placebo group. In the first 8 weeks, changes in mean global QoL were small and similar in both groups. By 12 weeks the decrease in mean global QoL was more pronounced in the MA group (P = 0.028), which was related to a deterioration in physical function, while psychosocial function was not affected. Survival was not affected by MA, and side-effects were mild. The results show that MA has a beneficial effect on appetite and that it may retard weight loss with no adverse impact on survival and with mild toxicity. However, MA does not appear to improve global QoL as measured by the EORTC QLQ-C30.

Adult↗

PubMed1999

Longitudinal changes in visual acuity and visual ability in a cohort followed from the age of 70 to 88 years.

PURPOSE: To assess the change in visual acuity (VA) for distance and near and to correlate VA to changes in visual ability in a longitudinal study group followed from 70 to 88 years. METHODS: In the population-based study H70 in Gothenburg, Sweden, 958 subjects from the original cohort were eye examined at age 70 and the surviving subjects were reexamined at age 82 (n=203) and at 88 years (n=129). Evaluation of change in visual function between age 82 and 88 was made in 66 subjects who took part in all three eye examinations. RESULTS: The VA in the subsample (n=66) showed minimal difference compared to the cross-sectional groups. At age 70 nearly 100% of both sexes had VA> or =0.8. At age 82 about 50% and at age 88 about 25% had this VA level. Males retained a slightly better visual acuity compared to women. VA< or =0.3 was found in about 10% at age 82 and in >20% at age 88. Reading ability remained high, but at 82 years 1.6% and at 88 years 10.5% could benefit from adjustment of their near glasses. Visual ability corresponded well to VA at age 82, but not at 88 years. Women lost the ability for most tasks, whereas men showed small changes. CONCLUSIONS: The majority of old people had good distance and near vision. A deterioration in visual acuity did not necessarily mean a negative change in visual ability. This emphasizes the importance of relating objective and subjective findings regarding VA and visual impairment to functional ability of the oldest of the elderly.

Activities of Daily Living↗

PubMed1999

Early death during chemotherapy in patients with small-cell lung cancer: derivation of a prognostic index for toxic death and progression.

Based on an increased frequency of early death (death within the first treatment cycle) in our two latest randomized trials of combination chemotherapy in small-cell lung cancer (SCLC), we wanted to identify patients at risk of early non-toxic death (ENTD) and early toxic death (ETD). Data were stored in a database and logistic regression analyses were performed to identify predictive factors for early death. During the first cycle, 118 out of 937 patients (12.6%) died. In 38 patients (4%), the cause of death was sepsis. Significant risk factors were age, performance status (PS), lactate dehydrogenase (LDH) and treatment with epipodophyllotoxins and platinum in the first cycle (EP). Risk factors for ENTD were age, PS and LDH. Extensive stage had a hazard ratio of 1.9 (P = 0.07). Risk factors for ETD were EP, PS and LDH, whereas age and stage were not. For EP, the hazard ratio was as high as 6.7 (P = 0.0001). We introduced a simple prognostic algorithm including performance status, LDH and age. Using a prognostic algorithm to exclude poor-risk patients from trials, we could minimize early death, improve long-term survival and increase the survival differences between different regimens. We suggest that other groups evaluate our algorithm and exclude poor prognosis patients from trials of dose intensification.

Age Factors↗

PubMed1999

Phase II study of gemcitabine and vindesine in patients with previously untreated non-resectable non-small-cell lung cancer.

Because both vindesine and gemcitabine are active drugs in advanced non-small-cell lung cancer (NSCLC), with different modes of action and only partly overlapping toxicity, a phase II study was performed. Gemcitabine 1000 mg m(-2) was given on days 1, 8 and 15 every 4 weeks, while vindesine 3 mg m(-2) was administered weekly for 7 weeks, then every 2 weeks. A total of 42 patients with nonresectable NSCLC were included. The median age of patients was 56 years; 57% were men, 52% had adenocarcinoma, 31% squamous cell carcinoma and 17% had large-cell carcinoma. The performance status ranged from 0 to 2 with 83% in performance status 1. The majority (55%) had stage IV disease, while 40% had stage III B and 5% stage III A disease. WHO grade 3-4 leucopenia occurred in five patients (12%) and 9% had grade 4 neutropenia. Thrombocytopenia grade 3-4 was observed in six patients (15%). There were no septic death or bleeding episodes. One patient had a transient WHO grade 4 increase in bilirubin, and four patients had a decrease in glomerular filtration rate below the normal limit; one of these patients developed a non-reversible renal insufficiency. Ten patients (24%) complained of dyspnoea of uncertain mechanism, possibly involving bronchoconstriction. There were one complete and seven partial responses among 40 assessable patients (20%, 95% confidence limits 9-36%). Median response duration was 31 weeks (range 11-83 weeks) and median survival time 31 weeks (range 2-171 weeks). The current combination of gemcitabine and vindesine does not appear to be promising for further examination because of the toxicity and somewhat disappointing activity.

Adult↗

PubMed1999

Host specificity in the Richelia-diatom symbiosis revealed by hetR gene sequence analysis.

The filamentous heterocyst-forming cyanobacterium Richelia intracellularis forms associations with diatoms and is very abundant in tropical and subtropical seas. The genus Richelia contains only one species, R. intracellularis Schmidt, although it forms associations with several diatom genera and has considerable variation in size and morphology. The genetic diversity, and possible host specificity, within the genus Richelia is unknown. Using primers against hetR, a gene unique for filamentous cyanobacteria, specific polymerase chain reaction (PCR) products were obtained from natural populations of R. intracellularis filaments associated with three diatom genera. Phylogenetic analyses of these sequences showed that they were all in the same clade. This clade contained only the R. intracellularis sequences. The genetic affiliation of hetR sequences of R. intracellularis to those of other heterocystous cyanobacteria strongly suggests that it was not closely related to endosymbiotic Nostoc spp. hetR sequences. Sequences from R. intracellularis-Hemiaulus membranaceus sampled in the Atlantic and Pacific Oceans were almost identical, demonstrating that the genetic relatedness was not dependent on geographical location. All sequences displayed a deep divergence between symbionts from different genera and a high degree of host specificity.

Bacterial Proteins↗

PubMed1999

A cross-sectional validation study of Self-Evaluation of Communication Experiences after Laryngeal Cancer--a questionnaire for use in the voice rehabilitation of laryngeal cancer patients.

A psychometric evaluation of the questionnaire 'Self-Evaluation of Communication Experiences after Laryngeal Cancer' (S-SECEL) addressing communication dysfunction in patients with laryngeal cancer was carried out. Ninety-three patients with laryngeal cancer were studied. For comparison of response patterns and external validation, 21 patients with non-small cell lung cancer (NSCLC) and 26 patients with hoarseness, caused by benign laryngeal disease, were included in the analysis. The patients completed three questionnaires; the S-SECEL, the Sickness Impact Profile (SIP) and the Hospital Anxiety and Depression scale (HAD). The S-SECEL questionnaire was well-accepted by the patients, compliance was satisfactory, and missing value rates were low. The reliability of the S-SECEL was satisfactory for the Environment and Attitude subscales, whereas the General subscale did not reach the reliability levels recommended for group comparisons. In general, the response pattern in the three diagnostic groups and the pattern of correlations between the S-SECEL scores and the SIP- and HAD-subscales and dimensions lent support to the construct validity of the S-SECEL.

Aged↗

PubMed1999

Total fibronectin in maternal plasma as a predictor for preeclampsia.

OBJECTIVE: To assess the ability of measuring total maternal plasma fibronectin in predicting the risk of developing preeclampsia. METHOD: In a cohort of 657 initially normotensive pregnant nulliparous women blood samples were collected at 26, 30 and 34 weeks of gestation. After delivery 3 groups were selected for measurement of total plasma fibronectin. The first group comprised 24 women who developed preeclampsia; the second 21 women who developed gestational hypertension, and the third 89 age-matched controls who remained normotensive. RESULTS: In women who developed preeclampsia the fibronectin levels were higher at 26 (p < 0.01), 30 (p < 0.001) and 34 weeks of gestation (p < 0.001) than in pregnant controls. In the general population of pregnant nulliparous women the estimated risk of subsequent preeclampsia correlated with the fibronectin level at each measurement. In women with fibronectin levels within the 25th percentile at the 26th week of gestation, the risk was </=1.9% and within the 90th percentile >/=6.2%. The change in fibronectin levels between 26 and 34 weeks of gestation was the only variable that remained statistically associated with preeclampsia (p = 0.0002) in multivariate analysis. In this model the risk figures for the corresponding percentiles were </=1.0 and >/=5.8%, respectively. CONCLUSION: Longitudinal assessment of the change in total fibronectin levels predicted preeclampsia slightly better than cross-sectional analysis of fibronectin at any gestational age. Nevertheless, measurement of total fibronectin in maternal plasma could not be proven to be a useful clinical predictor for preeclampsia in a general obstetric population of nulliparous women.

Adult↗

PubMed1999

Molecular cloning of a pancreatic islet-specific glucose-6-phosphatase catalytic subunit-related protein.

A pancreatic islet-specific glucose-6-phosphatase-related protein (IGRP) was cloned using a subtractive cDNA expression cloning procedure from mouse insulinoma tissue. Two alternatively spliced variants that differed by the presence or absence of a 118-bp exon (exon IV) were detected in normal balb/c mice, diabetic ob/ob mice, and insulinoma tissue. The longer, 1901-bp full-length cDNA encoded a 355-amino acid protein (molecular weight 40,684) structurally related (50% overall identity) to the liver glucose-6-phosphatase and exhibited similar predicted transmembrane topology, conservation of catalytically important residues, and the presence of an endoplasmic reticulum retention signal. The shorter transcript encoded two possible open reading frames (ORFs), neither of which possessed His174, a residue thought to be the phosphoryl acceptor (Pan CJ, Lei KJ, Annabi B, Hemrika W, Chou JY: Transmembrane topology of glucose-6-phosphatase. J Biol Chem 273:6144-6148, 1998). Northern blot and reverse transcription-polymerase chain reaction analysis showed that the mRNA was highly expressed in pancreatic islets and expressed more in beta-cell lines than in an alpha-cell line. It was notably absent in tissues and cell lines of non-islet neuroendocrine origin, and no other major tissue source of the mRNA was found. During development, it was expressed in parallel with insulin mRNA. The mRNA was efficiently translated and glycosylated in an in vitro translation/membrane translocation system and readily transcribed into COS 1, HIT, and CHO cells using cytomegalovirus or Rous sarcoma virus promoters. Whereas the liver glucose-6-phosphatase showed activity in these transfection systems, the IGRP failed to show glucose phosphotransferase or phosphatase activity with p-nitrophenol phosphate, inorganic pyrophosphate, or a range of sugar phosphates hydrolyzed by the liver enzyme. While the metabolic function of the enzyme is not resolved, its remarkable tissue-specific expression warrants further investigation, as does its transcriptional regulation in conditions where glucose responsiveness of the pancreatic islet is altered.

Alternative Splicing↗

PubMed1999

Patients with recurrent injuries--psychosocial characteristics and injury panorama.

Accidents are often considered to be a direct function of exposure to risk, but this study implies that there are subgroups of patients that expose themselves to more risks than others. Based on a consecutive series of moderately injured patients this study aimed to compare patients with repeated trauma episodes with patients with single trauma. The study showed that the former had experienced more violence during their lives, had a less favourable psychosocial situation and more often reported psychiatric problems and alcohol abuse compared with the latter, confirming the clinical knowledge that injury recurrence is associated with risk factors such as alcohol abuse, pre-existing psychopathology and a propensity towards violence.

Accident Proneness↗

PubMed1998

The presence and expression of hetR in the non-heterocystous cyanobacterium Symploca PCC 8002.

The filamentous cyanobacteria Symploca PCC 8002 (Symploca) and Trichodesmium spp. fix nitrogen aerobically in the light in a light/dark cycle, without forming specialized thick-walled cells (heterocysts). Even though they do not form heterocysts, we amplified and sequenced a segment of a key regulatory gene in heterocyst differentiation, the hetR gene, from Symploca, Trichodesmium erythraeum and Leptolyngbya PCC 73110 (which fixes nitrogen anaerobically) using degenerate oligonucleotides. The transcriptional level of hetR in Symploca PCC 8002 was examined in relation to nifH expression during nitrogen step-down. The expression pattern of hetR suggests that it was not induced during removal of combined nitrogen, as is the case with the heterocystous cyanobacteria. This is the first report of sequences corresponding to a portion of hetR from within the group of non-heterocystous cyanobacteria.

Acetylene↗