Bruk av supplerende oksygen ved akutt innsettende høyde

Abstract Background: All over the world, people are increasingly spending time at high altitude for scientific, military, personal or commercial reasons. When otherwise healthy individuals are exposed to altitude, certain physiological reactions occur, ranging from light headache, dyspnea, nausea and subjective discomfort, to life threatening diseases such as cerebral or pulmonary edema. The medical problems associated with ascent to altitude, are mainly caused by lack of oxygen in the inspired air. Method: The material is based on litterature searches based on a selection of articles from PubMed and Cochrane Library, using the terms “Supplemental oxygen” AND “Altitude”. Results: Use of supplemental oxygen during exposure of high altitude can prevent the damaging effects caused by the hypoxia that occurs in these environments. Supplemental oxygen improves exercise performance, arterial oxygen saturation, sleep quality, general well-being, mental performance, and work-efficiency. However, potential disadvantages concerning the use of oxygen needs to be considered when planning a stay at high altitude. Regarding the effects of supplemental oxygen in exposure of acute altitude, more research is needed to establish further knowledge on the subject

Risk and Interdependencies in Critical Infrastructures: A Guideline for Analysis

Today’s society is completely dependent on critical networks such as  water supply, sewage, electricity, ICT and transportation. Risk and vulnerability analyses are needed to grasp the impact of threats and hazards. However, these become quite complex as there are strong interdependencies both within and between infrastructure systems. Risk and Interdependencies in Critical Infrastructures: A  guideline for analysis provides methods for analyzing risks and interdependencies of critical infrastructures.  A number of analysis approaches are described and are adapted to each of these infrastructures. Various approaches are also revised, and all are supported by several examples and illustrations. Particular emphasis is given to the analysis of various interdependencies that often exist between the infrastructures.  Risk and Interdependencies in Critical Infrastructures: A  guideline for analysis provides a good tool to identify the hazards that are threatening your infrastructures, and will enhance the understanding on how these threats can propagate throughout the system and also affect other infrastructures, thereby identifying useful risk reducing measures. It is essential reading  for municipalities and infrastructure owners  that are obliged to know about and prepare for the risks and vulnerabilities of the critical infrastructures for which they are responsible.

Stamming forekommer hyppig hos barn med Down syndrom: Resultater fra en landsomfattende empirisk studie

Barn med Down syndrom har risiko for vansker med språk og kommunikasjon, og vanligvis er det ekspressive språket og talen betydelig affisert. Det finnes få studier av taleflyt hos barn med Down syndrom, og det er omdiskutert hvorvidt deres taleflytbrudd kan karakteriseres som stamming, hvor mange som faktisk stammer og hvilke variabler som er assosiert med stamming. For å få mer kunnskap om stamming hos barn med Down syndrom, har vi i denne studien analysert typer taleflytbrudd, frekvens av taleflytbrudd, samt sammenheng mellom frekvens av taleflytbrudd og ekspressivt vokabular hos en nasjonal alderskohort med barn med Down syndrom. Til sammen kan dette gi oss indikasjoner om behovet for behandling

Tumor necrosis factor inhibitors are associated with reduced complement activation in spondylarthropathies: An observational study

Background The complement system is involved in pathogenesis of cardiovascular disease, and might play a role in accelerated atherogenesis in spondylarthropathies (SpA). Hence, we examined complement activation in SpA, and its relationship to antirheumatic treatment, inflammatory and cardiovascular markers. Methods From PSARA, a prospective observational study, we examined 51 SpA patients (31 psoriatic arthritis (PsA), and 20 ankylosing spondylitis (AS)), starting tumor necrosis factor (TNF) inhibitor alone (n = 25), combined with methotrexate (MTX) (n = 10), or MTX monotherapy (n = 16). Complement activation was determined by the soluble terminal complement complex (sC5b-9), inflammation by erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and endothelial function by finger plethysmography (Endopat) at baseline, after 6 weeks and 6 months of treatment. Results SpA patients had sC5b-9 levels at (PsA) or above (AS) the upper limit of the estimated reference range. Median sC5b-9 levels decreased significantly from baseline to 6 weeks, with no significant difference between the AS and PsA group. Notably, a significant reduction in sC5b-9 was observed after administration of TNF inhibitor ± MTX, whereas no significant changes were observed in patients treated with MTX alone. Between 6 weeks and 6 months, sC5b-9 remained stable across all subgroups. Reduction in sC5b-9 was independently related to decreased ESR and CRP, and to increased high density cholesterol and total cholesterol. Reduction in sC5b-9 from baseline to 6 weeks was associated with improved EF in age and gender adjusted analyses. Conclusion TNF-inhibition, but not MTX monotherapy, led to rapid and sustained reduction of complement activation in SpA. Thus, the observed decrease in cardiovascular morbidity in patients treated with TNF-inhibitors might be partly due to its beneficial effect on complement. Trial registration Clinical Trials (NCT00902005), retrospectively registered on the 14th of May 2009

Høyt nivå av tungmetaller i krabbe

Krabber er populær sjømat, men kan inneholde til dels store mengder miljøgifter. Innholdet er mange steder i Norge så høyt at inntak av brunmaten generelt bør frarådes

Antirheumatic therapy is associated with reduced complement activation in rheumatoid arthritis

Background The complement system plays an important role in pathophysiology of cardiovascular disease (CVD), and might be involved in accelerated atherogenesis in rheumatoid arthritis (RA). The role of complement activation in response to treatment, and in development of premature CVD in RA, is limited. Therefore, we examined the effects of methotrexate (MTX) and tumor necrosis factor inhibitors (TNFi) on complement activation using soluble terminal complement complex (TCC) levels in RA; and assessed associations between TCC and inflammatory and cardiovascular biomarkers. Methods We assessed 64 RA patients starting with MTX monotherapy (n = 34) or TNFi with or without MTX co-medication (TNFi±MTX, n = 30). ELISA was used to measure TCC in EDTA plasma. The patients were examined at baseline, after 6 weeks and 6 months of treatment. Results Median TCC was 1.10 CAU/mL, and 57 (89%) patients had TCC above the estimated upper reference limit (<0.70). Compared to baseline, TCC levels were significantly lower at 6-week visit (0.85 CAU/mL, p<0.0001), without significant differences between the two treatment regimens. Notably, sustained reduction in TCC was only achieved after 6 months on TNFi±MTX (0.80 CAU/mL, p = 0.006). Reductions in TCC after treatment were related to decreased C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and interleukin 6, and increased levels of total, high and low-density lipoprotein cholesterol. Similarly, baseline TCC was significantly related to baseline CRP, ESR and interleukin 6. Patients with endothelial dysfunction had higher baseline TCC than those without (median 1.4 versus 1.0 CAU/mL, p = 0.023). Conclusions Patients with active RA had elevated TCC, indicating increased complement activation. TCC decreased with antirheumatic treatment already after 6 weeks. However, only treatment with TNFi±MTX led to sustained reduction in TCC during the 6-month follow-up period. RA patients with endothelial dysfunction had higher baseline TCC compared to those without, possibly reflecting involvement of complement in the atherosclerotic process in RA

Methotrexate and anti-tumor necrosis factor treatment improves endothelial function in patients with inflammatory arthritis

Background: Inflammatory arthritis (IA), including rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA), leads to increased cardiovascular disease occurrence probably due to atherosclerosis. One of the first stages in atherogenesis is endothelial dysfunction (ED). Therefore, we aimed to compare endothelial function (EF) in patients with IA, and to examine the effects of methotrexate (MTX) monotherapy and antitumor necrosis factor (anti-TNF) treatment with or without MTX comedication (anti-TNF±MTX) on EF. Methods: From the PSARA observational study, all patients with RA (n=64), PsA (n=29), and AS (n=20) were evaluated for EF. In patients with ED at baseline (n=40), we evaluated changes in the Reactive Hyperemic Index (RHI) after 6 weeks and 6 months of antirheumatic therapy. Results: In IA patients with ED, RHI significantly improved after 6 weeks (p<0.001) and 6 months (p<0.001) of treatment, independent of changes in disease activity parameters. After 6 months, RHI had improved more in the MTX group than in the anti-TNF±MTX group, and the difference remained statistically significant after adjustments for potential confounders. Among patients with active RA, AS, and PsA, those with AS appeared to have the worst endothelial function, although they were the youngest. Conclusion: Treatment with MTX and anti-TNF±MTX was associated with a relatively fast improvement of EF in IA patients with ED, independent of change in disease activity. Therefore, modes of action other than the antiinflammatory effect may contribute to the EF improvement. After 6 months, the EF improvement was more pronounced in the MTX group than in the anti-TNF±MTX group