Strukturelle und quantitative Identifizierung der Einzelkomponenten in Lipidgemischen

Lipidomics aims to qualitatively and quantitatively define lipid classes, including their molecular species, in biological systems. Continuous technical advances in instrumentation enable a high level of sensitivity and precision. Due to the broad diversity of chemical structures of lipids, different methods and strategies are being applied for the investigation of lipids. In this study lipophilic extracts of pig brain (liver, kidney, heart and human blood plasma) were examined with Nuclear Magnetic Resonance (NMR) spectroscopy and Mass Spectrometry (MS) after separation with solid phase extraction (SPE) in different lipid fractions. The aim of this work was the identification and quantification of the individual components in lipid mixtures. After the class separation the individual components of phosphatidylethanolamine and galactosylcerebroside were further separated with an isocratic High Performance Liquid Chromatography(HPLC)method. At first an optimized dual phase extraction procedure for tissues was developed in this thesis which enables a quantitative isolation of analytes under mild conditions. The focus of this work was the SPE method development. The SPE technique is easy, rapid, and reliable. The growing popularity of SPE is in part due to the operational simplicity and cost reduction in solvents and because it is easy to automate. The developed SPE method for phospholipid class separation with the use of silica gel cartridge allowed the separation of neutral lipids, galactocerebroside, sulfatide, cardiolipin, phosphatidylethanolamine and plasmalogen, as well as the approximately separation of phosphatidylcholine and sphingomyeline. The method proved to be reproducible and showed recoveries higher 73%. The individual components of the phosphatidylethanolamine fraction from each tissue were analyzed with the separation by RP-HPLC-MS. A total of 25 phosphatidylethanolamine components were baseline separated in a period of 20 min (eluting 6.8 min - 18.6 min). Here also the differences of the lipid components of the various organs were analyzed and discussed in relation to their functions. With the same method 19 galactocerebroside were separated. This confirms the potential of the method developed in this work for the detailed characterization of heterogeneous lipid compositions

Trends in caesarean section and instrumental deliveries in relation to Body Mass Index: a clinical survey during 1978 - 2001

<p>Abstract</p> <p>Background</p> <p>During the last 20 years the rate of CS has increased in Sweden as it has in many other countries. The proportion of pregnant women suffering from a high BMI has also increased rapidly during the same time period. It would therefore be of interest to study both how and if these two observations are related to each other. The aim was therefore to study trends in mode of caesarean section (CS) and instrumental deliveries among women in three BMI groups over a time span of almost 25 years with special focus on the observed body weight of pregnant women.</p> <p>Method</p> <p>The design is a retrospective cohort study using medical records of consecutively delivered women at two delivery wards in South East Sweden during the years 1978, 1986, 1992, 1997 and 2001.</p> <p>Results</p> <p>No significant time-trends were found for CS and instrumental delivery within each BMI-group for the time period studied. The proportion of women with BMI ≥ 25 delivered by means of CS or instrumental delivery increased quite dramatically from 1978 to 2001 (χ²test for trend; p < 0.001 for both CS and instrumental deliveries). The mean birth weight in relation to BMI and year of study among women delivered by means of CS decreased, a trend that was most evident between 1997 and 2001 (F-test; p = 0.005, p = 0.004, and p = 0.003 for BMI < 20, 20-24.9, and ≥ 25, respectively).</p> <p>Conclusion</p> <p>Overweight and obese pregnant women constitute a rapidly growing proportion of the total number of CS and instrumental deliveries. Planning and allocation of health resources must be adjusted to this fact and its implications.</p

Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden

BACKGROUND: Reduction in costs of hormonal contraceptives is often proposed to reduce rates of induced abortion among young women. This study investigates the relationship between rates of induced abortion and reimbursement of dispensed hormonal contraceptives among young women in Sweden. Comparisons are made with the Nordic countries Finland, Norway and Denmark. METHODS: Official statistics on induced abortion and numbers of prescribed and dispensed hormonal contraceptives presented as "Defined Daily Dose/thousand women" (DDD/T) aged 15-19 years were compiled and related to levels of reimbursement in all Swedish counties by using public official data. The Swedish numbers of induced abortion were compared to those of Finland, Norway and Denmark. The main outcome measure was rates of induced abortion and DDD/T. RESULTS: No correlation was observed between rates of abortion and reimbursement among Swedish counties. Nor was any correlation found between sales of hormonal contraceptives and the rates of abortion. In a Nordic perspective, Finland and Denmark, which have no reimbursement at all, and Norway all have lower rates of induced abortion than Sweden. CONCLUSIONS: Reimbursement does not seem to be enough in order to reduce rates of induced abortion. Evidently, other factors such as attitudes, education, religion, tradition or cultural differences in each of Swedish counties as well as in the Nordic countries may be of importance. A more innovative approach is needed in order to facilitate safe sex and to protect young women from unwanted pregnancies

Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden

BACKGROUND: Reduction in costs of hormonal contraceptives is often proposed to reduce rates of induced abortion among young women. This study investigates the relationship between rates of induced abortion and reimbursement of dispensed hormonal contraceptives among young women in Sweden. Comparisons are made with the Nordic countries Finland, Norway and Denmark. METHODS: Official statistics on induced abortion and numbers of prescribed and dispensed hormonal contraceptives presented as "Defined Daily Dose/thousand women" (DDD/T) aged 15-19 years were compiled and related to levels of reimbursement in all Swedish counties by using public official data. The Swedish numbers of induced abortion were compared to those of Finland, Norway and Denmark. The main outcome measure was rates of induced abortion and DDD/T. RESULTS: No correlation was observed between rates of abortion and reimbursement among Swedish counties. Nor was any correlation found between sales of hormonal contraceptives and the rates of abortion. In a Nordic perspective, Finland and Denmark, which have no reimbursement at all, and Norway all have lower rates of induced abortion than Sweden. CONCLUSIONS: Reimbursement does not seem to be enough in order to reduce rates of induced abortion. Evidently, other factors such as attitudes, education, religion, tradition or cultural differences in each of Swedish counties as well as in the Nordic countries may be of importance. A more innovative approach is needed in order to facilitate safe sex and to protect young women from unwanted pregnancies

La doctrina de la ilicitud probatoria y sus efectos revisada

Conferència a càrrec de Jordi Ferrer de la Universitat de Girona sobre la prova il·lícita i el seu tractament en el procés penal des d'un punt de vista diferent al de Manuel Miranda Estrampes i al de la resta de ponents de la Jornad

A Comparison Between Swedish Midwives and Obstetricians and Gynecologists Opinions on Cesarean Section

To compare Swedish obstetricians/gynecologists and midwives attitudes and opinions on different aspects of cesarean section (CS). In total 330 midwives from the south east of Sweden and 1280 Swedish obstetricians/gynecologists were asked to answer a study-specific questionnaire anonymously about their opinions on different issues concerning CS. The majority of obstetricians/gynecologists and midwives had more than 10 years of experience in their professions (75.2% vs. 73.6%). The midwives thought that a reasonable CS rate would be 11.5% whereas the corresponding figures for the obstetricians/gynecologists was 13.8% (P andlt; 0.001). There are differences in opinions and attitudes concerning both CS rates and other aspects in connection with CS. There are evident differences in attitudes towards CS and mode of delivery between midwives and obstetricians/gynecologists. These need to be explored and discussed in relation to state-of-the-art knowledge and should become a part of the curriculum for both groups of professionals both in training as well as on a regular clinical basis.The original publication is available at www.springerlink.com:Ann Josefsson, Christina Gunnervik, Adam Sydsjö and Gunilla Sydsjö, A Comparison Between Swedish Midwives and Obstetricians and Gynecologists Opinions on Cesarean Section, 2011, MATERNAL AND CHILD HEALTH JOURNAL, (15), 5, 555-560.http://dx.doi.org/10.1007/s10995-010-0630-7Copyright: Springer Science Business Mediahttp://www.springerlink.com

Trends in induced abortion among Nordic women aged 40-44 years.

OBJECTIVES: Women aged 40-44 years in 2005 ought to have been subjected to much more influence on attitudes and knowledge on contraceptive methods during their fertile period than women who were in the same age span in 1975 when the abortion laws were introduced. MATERIAL: From official statistics, the rates of induced abortion and birth rates in women aged 40-44 years were collected for Sweden, Denmark, Norway and Finland for each five-year during the period 1975-2005. RESULTS: With the exception of Sweden all other studied Scandinavian countries have lowered their abortion rates since 1975 (p&lt;0.001) and reduced the proportion of induced abortions in relation to birth rate (p&lt;0.001). In 2005 these countries also had lower rates of induced abortion than Sweden in the age group 40-44 years (p&lt;0.001). CONCLUSION: There is a significant change in rates of induced abortion in women aged 40-44 years in Finland, Norway, Denmark, and at status quo in Sweden. 40-44 years in Finland, Norway, Denmark, and at status quo in Sweden. This indicates that family planning programs works well in the Nordic countries. The differences found may be assumed to possible diverging focus on attitudes or ethical considerations

Attitudes towards mode of birth among Swedish midwives

Objective: to investigate midwives attitudes and opinions on mode of birth. Design: exploratory descriptive study. Data were collected via study-specific questionnaires during 2006. Setting: southeastern Sweden. Participants: all midwives working in two counties. Findings: regardless of age, experience and working field, the midwives considered a reasonable caesarean rate to be around 11.5 per cent. None of the participants thought that the caesarean rate was too low. Midwives younger than 50 years tended to consider the current caesarean rate to be too high (p = 0.059). Midwives working on labour wards stated that they thought the current caesarean rate was too high compared with midwives working at antenatal care clinics (ACCs)(pandlt;0.001). Midwives working at ACCs agreed with the statements one should agree to a womans right to have an elective caesarean (pandlt;0.001) and elective caesarean is the best choice for a woman with fear of birth (p = 0.046) more often than midwives working on labour wards, regardless of age or working experience. Key conclusions and implications for practice: midwives working at ACCs are more willing to accept caesarean section at the womans request and for women with fear of birth. It is of importance that ACC caregivers and professionals on labour wards increase their collaboration and have continuous discussions with one another in an attempt to reach consensus about the appropriate caesarean rates on evidence-based grounds.Original Publication:Christina Gunnervik, Ann Josefsson, Adam Sydsjö and Gunilla Sydsjö, Attitudes towards mode of birth among Swedish midwives, 2010, MIDWIFERY, (26), 1, 38-44.http://dx.doi.org/10.1016/j.midw.2008.04.006Copyright: Elsevier Science B.V., Amsterdamhttp://www.elsevier.com

Attitudes towards mode of birth among Swedish midwives

Objective: to investigate midwives attitudes and opinions on mode of birth. Design: exploratory descriptive study. Data were collected via study-specific questionnaires during 2006. Setting: southeastern Sweden. Participants: all midwives working in two counties. Findings: regardless of age, experience and working field, the midwives considered a reasonable caesarean rate to be around 11.5 per cent. None of the participants thought that the caesarean rate was too low. Midwives younger than 50 years tended to consider the current caesarean rate to be too high (p = 0.059). Midwives working on labour wards stated that they thought the current caesarean rate was too high compared with midwives working at antenatal care clinics (ACCs)(pandlt;0.001). Midwives working at ACCs agreed with the statements one should agree to a womans right to have an elective caesarean (pandlt;0.001) and elective caesarean is the best choice for a woman with fear of birth (p = 0.046) more often than midwives working on labour wards, regardless of age or working experience. Key conclusions and implications for practice: midwives working at ACCs are more willing to accept caesarean section at the womans request and for women with fear of birth. It is of importance that ACC caregivers and professionals on labour wards increase their collaboration and have continuous discussions with one another in an attempt to reach consensus about the appropriate caesarean rates on evidence-based grounds.Original Publication:Christina Gunnervik, Ann Josefsson, Adam Sydsjö and Gunilla Sydsjö, Attitudes towards mode of birth among Swedish midwives, 2010, MIDWIFERY, (26), 1, 38-44.http://dx.doi.org/10.1016/j.midw.2008.04.006Copyright: Elsevier Science B.V., Amsterdamhttp://www.elsevier.com