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Biomedical subjects

M Claesson

Publications and source records attributed to M Claesson.

16 recordsLinked to original sources

Cognitive-behavioural stress management does not improve biological cardiovascular risk indicators in women with ischaemic heart disease: a randomized-controlled trial.

OBJECTIVES: Psychosocial factors, such as stress and vital exhaustion, are associated with an increased risk of cardiovascular events, and women report more psychosocial ill-being after an acute myocardial infarction than men. We have earlier shown that a cognitive-behavioural intervention in women with ischaemic heart disease (IHD) improved psychosocial well-being. In the present study, we tested the hypothesis that the improvement in psychosocial well-being is associated with an improvement in biochemical indicators of cardiovascular risk. DESIGN: Randomized-controlled trial in northern Sweden. SETTING: Outpatient care. SUBJECTS: Women with IHD were randomized to either a 1-year cognitive-behavioural stress management programme or usual care. Of the 159 women who completed the study, 77 were in the intervention group, and 82 in the control group. INTERVENTIONS: A 1-year cognitive-behavioural stress management programme versus conventional care. RESULTS: Group assignment was not found to be a determinant of waist circumference, high sensitive C-reactive protein (hs-CRP), fibrinogen, von Willebrand factor (vWF), plasminogen activator inhibitor type 1 (PAI-1) activity, tissue plasminogen activator (tPA) activity, tPA antigen, tPA-PAI-1 complex, leptin, or HOMA2 insulin resistance index (HOMA2-IR) at follow up. Changes in psychosocial variables were not associated with changes in any of the biological risk indicators. CONCLUSIONS: Even if our cognitive-behavioural stress management programme had effects on proximal targets, such as stress behaviour and vital exhaustion, we found no improvement in intermediate biochemical targets related to the metabolic syndrome and IHD. Our results challenge the proposition that the relationship between psychological well-being and biological cardiovascular risk indicators is a direct cause-effect phenomenon.

Biomarkers↗

Corneal grafts at St John Eye Hospital, Jerusalem, January 2001-November 2002.

AIM: To compare a cohort of corneal graft patients in east Jerusalem with one in Sweden, concerning diagnosis, sex, patient age, preoperative visual acuity in both eyes, and type of operation. METHODS: Standard forms developed for the Swedish Corneal Transplant Register were used for data collection at the time of operation. RESULTS: In east Jerusalem, keratoconus accounted for 51% of the grafts compared with only 27% in Sweden and the male:female ratio was reversed. There were very few patients with endothelial disease. The Palestinian patients had overall worse visual acuity both in the eye to be operated and the fellow eye compared with patients in Sweden. CONCLUSION: Significant differences were found between the Palestinian and Swedish cohorts in the distribution of indications for transplantation and preoperative visual acuity.

Adult↗

Visual outcome in corneal grafts: a preliminary analysis of the Swedish Corneal Transplant Register.

AIM: To assess visual outcome and the incidence of complications at 2 years postoperatively in corneal grafts reported to the Swedish Corneal Transplant Register. METHODS: Preoperative and 2 year follow up data were submitted to the Swedish Corneal Transplant Register by surgeons in eight corneal transplant clinics in Sweden. Preoperative data on 1957 grafts and 520 grafts with 2 year follow up were included in the analysis. Data were analysed by multiple linear and logistic regression methods, as appropriate. RESULTS: The major diagnostic categories were keratoconus (29%), bullous keratopathy (21%), and "other diagnosis" (32%). Fuchs' endothelial dystrophy and stromal dystrophies accounted for 15% and 3% of grafts, respectively. At 2 years the overall incidence of complications, other than rejection and regrafting, was 26%, with an increasing frequency from keratoconus < Fuchs' dystrophy < bullous keratopathy < "other diagnosis." Rejection was observed in 15% of grafts and was more likely in the bullous keratopathy (OR 3.1, 95% CI 1.1 to 9.0, p=0.04) and "other diagnosis" (OR 2.6, 95% CI 1.1 to 5.9, p=0.03) groups. Regrafting, which occurred in 10% of cases, was not influenced by diagnosis, but it was related to the incidence of rejection (OR 14.8, 95% CI 6.1 to 35.9, p<0.001) and other complications (OR 4.4, 95% CI 1.9 to 10.4, p=0.001), and to the presence of other sight threatening pathology in the eye (OR 3.6, 95% CI 1.3 to 9.9, p=0.01). Visual acuity was improved in a high proportion of the patients, especially those with keratoconus and Fuchs' dystrophy where, respectively, 86% and 54% of grafts achieved a visual acuity of > or =0.5 at 2 years, compared with only 31% with bullous keratopathy and 35% in the "other diagnosis" group. 60% of grafts for keratoconus and Fuchs' dystrophy achieved a visual acuity equal to or better than the other eye. Postoperative astigmatism was higher in the bullous keratopathy (p=0.01) group. Patients with high astigmatism benefited from refractive surgery, showing a reduction from 7.9 (95%CI 6.9, 8.7) to 3.2 (95% CI 2.6, 3.9) dioptres (p<0.001). A centre effect was evident in visual outcome. CONCLUSION: The overall incidence of complications was related to diagnosis. Complications other than rejection and regrafting were most likely in the "other diagnosis" group, and further analysis of this group is therefore planned. The best improvement in visual acuity and the lowest astigmatism were achieved in the keratoconus and Fuchs' dystrophy groups; but the influence of diagnosis on astigmatism was small and, overall, the statistical model accounted for only 8% of the variability in astigmatism. Refractive surgery was, however, effective in reducing astigmatism. It is hoped that a better understanding of the factors that determine the visual outcome of grafts will emerge from future analyses of the Swedish Corneal Transplant Register, helping to refine the criteria for patient selection and to guide clinical practice.

Adolescent↗

Enteric bacterial antigens activate CD4(+) T cells from scid mice with inflammatory bowel disease.

Scid mice transplanted with CD4(+) T cells from congenic donor mice develop a chronic and lethal inflammatory bowel disease (IBD) 2-3 months post-transplantation. In the present study we have investigated the response of CD4(+) T cells from scid mice with colitis against fecal extracts. Our results show that in contrast to CD4(+) T cells from normal BALB/c mice, CD4(+) T cells from scid mice with colitis proliferate strongly in response to antigen-presenting cells (APC) pulsed with fecal extracts. The IBD-associated T cells did not respond to either extracts from food antigens or fecal extracts from germ-free mice, which indicates that they recognize bacterial antigens in the fecal extracts. CD4(+) T cells isolated from the colonic lamina propria of scid mice 3 weeks post transplantation also responded vigorously to fecal extracts, demonstrating that reactive CD4(+) T cells are present in the gut mucosa of transplanted scid mice prior to clinical manifestations of IBD. CD4(+) T cells activated by fecal extracts produced high amounts of IL-2 and IFN-gamma, intermediate amounts of IL-4 and low amounts of IL-10, consistent with a Th1 profile. The proliferative reactivity towards fecal extracts was restricted by MHC class II molecules and dependent on antigen processing, as the response could be blocked by anti-MHC class II antibodies or a short fixation of the APC. This study demonstrates that class II-restricted CD4(+) Th1 cells, which recognize enteric bacterial antigens, infiltrate the gut mucosa and spleen of transplanted scid mice prior to and during the course of colitis.

Animals↗

Predictors of developmental delay at 18 months and later school achievement problems.

The aim of the study was to examine the predictive value of the variables of parental assessment score, pre-, peri-, and postpartum optimality, sex, socioeconomic status (SES), and maternal education with respect to developmental delay at 18 months, and intellectual disability and school achievement problems at 8 and 14 years. The sample studied comprised 101 children (53 low scorers and 48 controls) originally from a total population of 2783 children assessed by their parents at 18 months using a screening instrument. Data were analysed by logistic regression. The results yielded moderate but statistically significant correlations between predictor and outcome variables. Optimality score and maternal education were the best predictors of developmental delay at 18 months. At 8 years, parental assessment score and maternal education constituted the best predictors of school achievement problems. At 14 years, SES together with parental assessment score were included in the model, when school achievement problems were predicted. Parental assessment score showed the strongest association with school achievement problems at both 8 and 14 years, when children with intellectual disability were included in the analysis. The exclusion of children with intellectual disability from the analyses yielded a stronger association between maternal education (at 8 years) and SES (at 14 years) and school achievement problems. The overall classification accuracy of the models varied between 67% and 88%. Specificity varied from 65% at 18 months to 95% at 14 years. Sensitivity varied from 70% at 18 months and 55% (all cases) and 42% (children with intellectual disability excluded) at 14 years.

Adolescent↗

Classification, prevalence, prevention and rehabilitation of intellectual disability: an overview of research in the People's Republic of China.

The People's Republic of China is a developing country with all the problems and challenges that face such countries all over the world. Progress has been hampered by scarcity of resources, and a lack of relevant information and appropriate skills, as well as by the stigma traditionally attached to people with intellectual disability. The present rapid economic development has made possible further improvement and expansion of educational opportunities, and health and rehabilitation services. According to a recent census and sample surveys conducted in the People's Republic of China, the overall prevalence rate of people with disabilities was estimated to 4.9%. Thus, China has more individuals with disabilities than any other country in the world. According to these figures, the prevalence of intellectual disability in the population is approximately 1%. For children younger than 14 years of age, the prevalence is around 2%, which accounts for 66% of all handicapped children, making it the most frequent childhood disability. Today, the existing medical facilities, and educational and social welfare organizations cannot meet the tremendous need of care and services. The problems of the large number of disabled children and adults are a major challenge for contemporary Chinese society. This paper is devoted to research pertinent to intellectual disability in China. With a few exceptions, only publications in the English language were included in this review, which makes the overview selective rather than comprehensive. Publications on classification systems and diagnostic criteria, screening methods and assessment instruments, prevalence rates, aetiology and risk factors, prevention and intervention efforts, special education, and families with children with intellectual disability are presented.

Adaptation, Psychological↗

A method for separation and staining of flat mounts of human corneal endothelium.

A technique is described in which sheets of corneal endothelium are removed from human donor corneo-scleral discs. Celloidin solution was applied to the endothelial surface, allowed to dry, peeled off with the attached endothelial cell layer and mounted on a glass slide. Following removal of the celloidin with acetone, this endothelial cell flat mount was then stained with H&E and monoclonal antibodies to cell adhesion molecules. A pilot study of endothelial cell adhesion molecule expression in flat mount preparations of 14 corneas showed constitutive neural cell adhesion molecule (NCAM) expression, but a lower degree of focal expression of intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VACM)-1, P/E-selectin and HLA-DR.

Cell Separation↗

Glare and contrast sensitivity before and after Nd:YAG laser capsulotomy.

The benefits of Nd:YAG laser capsulotomy on visual performance were evaluated in 13 patients with after-cataract following extracapsular cataract extraction. Besides clinical evaluation we measured: visual acuity, letter contrast sensitivity with and without the presence of a circular glare source (glare angle: 8 degrees). Finally, the patients were asked to evaluate their subjective glare problems. In all patients, visual acuity had decreased markedly compared to measurements 2 months after cataract surgery. Before capsulotomy we observed impaired letter contrast sensitivity and increased intraocular light scatter compared to normals. Following capsulotomy, VA and contrast sensitivity both improved by a factor of 2. The subjective glare problems diminished, although most patients showed minor decreases in intraocular light scatter. The limited glare induced loss of letter contrast sensitivity, present before capsulotomy, remained after treatment. Our study indicates that after-cataract impairs resolution and contrast sensitivity without necessarily causing a marked increase in light scatter as measured at a large angle.

Adolescent↗

Narrowing of the retinal arterioles in descending optic atrophy. A quantitative clinical study.

Measurements were made on fundus photographs of the diameters of retinal arterioles in a series of cases with various nonvascular lesions of the anterior visual pathways, before and after the development of fundus signs of optic atrophy. A simple method was devised for reliable estimation of the diameter of the central retinal artery whenever this vessel could not be measured directly: this allowed comparisons to be made between different eyes, irrespective of individual variations in arteriolar branching patterns. Atrophy was consistently associated with a decrease in central retinal artery caliber, averaging 24% in eyes developing total optic atrophy, and 17% in eyes with hemi-atrophy. Normal controls showed a maximum side difference of 8%.

Adolescent↗

Lancet with less pain.

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Blood Specimen Collection↗

Effect of chronic treatment with imipramine on interleukin 1 and interleukin 2 production by splenocytes obtained from rats subjected to a chronic mild stress model of depression.

A depression-like state was induced by chronic (3-week) exposure of Wistar rats to a very mild, unpredictable stress which is a model of depression, developed by Willner's group. Five-week daily administration of imipramine reversed the stress-induced deficit in sucrose consumption. Eight-week stress induced an increase in the ability of splenocytes to produce interleukin 1 (IL-1) and interleukin 2 (IL-2) and to proliferate after stimulation with concanavalin A. Antidepressant effects of imipramine were accompanied by a decrease in the ability of splenocytes to produce IL-1 and IL-2 and to proliferate. Administration of imipramine alone did not modify the activity of those cells.

Animals↗