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  1. Book ; Online: Legitimate Interest is the New Consent -- Large-Scale Measurement and Legal Compliance of IAB Europe TCF Paywalls

    Morel, Victor / Santos, Cristiana / Fredholm, Viktor / Thunberg, Adam

    2023  

    Abstract: Cookie paywalls allow visitors of a website to access its content only after they make a choice between paying a fee or accept tracking. European Data Protection Authorities (DPAs) recently issued guidelines and decisions on paywalls lawfulness, but it ... ...

    Abstract Cookie paywalls allow visitors of a website to access its content only after they make a choice between paying a fee or accept tracking. European Data Protection Authorities (DPAs) recently issued guidelines and decisions on paywalls lawfulness, but it is yet unknown whether websites comply with them. We study in this paper the prevalence of cookie paywalls on the top one million websites using an automatic crawler. We identify 431 cookie paywalls, all using the Transparency and Consent Framework (TCF). We then analyse the data these paywalls communicate through the TCF, and in particular, the legal grounds and the purposes used to collect personal data. We observe that cookie paywalls extensively rely on legitimate interest legal basis systematically conflated with consent. We also observe a lack of correlation between the presence of paywalls and legal decisions or guidelines by DPAs.

    Comment: Accepted for publication at WPES2023, minor modifications following feedback from the community
    Keywords Computer Science - Computers and Society
    Subject code 340
    Publishing date 2023-09-20
    Publishing country us
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: "It's ok that I feel like this": a qualitative study of adolescents' and parents' experiences of facilitators, mechanisms of change and outcomes in a joint emotion regulation group skills training.

    Holmqvist Larsson, K / Thunberg, M / Münger, A-C / Andersson, G / Falkenström, F / Zetterqvist, M

    BMC psychiatry

    2023  Volume 23, Issue 1, Page(s) 591

    Abstract: Background: Emotion regulation difficulties underlie several psychiatric conditions, and treatments that focus on improving emotion regulation can have an effect on a broad range of symptoms. However, participants' in-depth experiences of participating ... ...

    Abstract Background: Emotion regulation difficulties underlie several psychiatric conditions, and treatments that focus on improving emotion regulation can have an effect on a broad range of symptoms. However, participants' in-depth experiences of participating in emotion regulation treatments have not been much studied. In this qualitative study, we investigated participants' experiences of a joint emotion regulation group skills training in a child and adolescent psychiatric outpatient setting.
    Methods: Twenty-one participants (10 adolescents and 11 parents) were interviewed about their experiences after they had participated in a seven-session transdiagnostic emotion regulation skills training for adolescents and parents. The aim of the skills training was to decrease emotion regulation difficulties, increase emotional awareness, reduce psychiatric symptoms, and enhance quality of life. The skills training consisted of psychoeducation about emotions and skills for regulating emotions. The interviews were transcribed and analysed using reflexive thematic analysis.
    Results: The analysis resulted in three overarching themes: Parent - Child processes, Individual processes, and Group processes. The result showed that participants considered an improved parent-child relationship to be the main outcome. Increased knowledge, emotion regulation skills and behavioural change were conceptualised as both mechanisms of change and outcomes. The group format, and the fact that parents and adolescents participated together, were seen as facilitators. Furthermore, the participants experienced targeting emotions in skills training as meaningful and helpful.
    Conclusion: The results highlight the potential benefits of providing emotion regulation skills training for adolescents and parents together in a group format to improve the parent-child relationship and enable the opportunity to learn skills.
    MeSH term(s) Humans ; Adolescent ; Emotional Regulation ; Quality of Life ; Parents/psychology ; Emotions ; Parent-Child Relations
    Language English
    Publishing date 2023-08-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2050438-X
    ISSN 1471-244X ; 1471-244X
    ISSN (online) 1471-244X
    ISSN 1471-244X
    DOI 10.1186/s12888-023-05080-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Direct and indirect effects of Puumala hantavirus on platelet function.

    Schrottmaier, Waltraud C / Schmuckenschlager, Anna / Thunberg, Therese / Wigren-Byström, Julia / Fors-Connolly, Anne-Marie / Assinger, Alice / Ahlm, Clas / Forsell, Mattias N E

    Thrombosis research

    2023  Volume 233, Page(s) 41–54

    Abstract: Thrombocytopenia is a cardinal symptom of hantavirus-induced diseases including Puumala virus (PUUV)-induced hemorrhagic fever with renal syndrome (HFRS), which is associated with impaired platelet function, bleeding manifestations and augmented ... ...

    Abstract Thrombocytopenia is a cardinal symptom of hantavirus-induced diseases including Puumala virus (PUUV)-induced hemorrhagic fever with renal syndrome (HFRS), which is associated with impaired platelet function, bleeding manifestations and augmented thrombotic risk. However, the underlying mechanisms causing thrombocytopenia and platelet hypo-responsiveness are unknown. Thus, we investigated the direct and indirect impact of PUUV on platelet production, function and degradation. Analysis of PUUV-HFRS patient blood revealed that platelet hypo-responsiveness in PUUV infection was cell-intrinsic and accompanied by reduced platelet-leukocyte aggregates (PLAs) and upregulation of monocyte tissue factor (TF), whereas platelet vasodilator-stimulated phosphoprotein (VASP) phosphorylation was comparable to healthy controls. Plasma CXCL4 levels followed platelet count dynamics throughout disease course. PUUV activated both neutrophils and monocytes in vitro, but platelet desialylation, degranulation and GPIIb/IIIa activation as well as PLA formation and endothelial adhesion under flow remained unaltered in the presence of PUUV. Further, MEG-01 megakaryocytes infected with PUUV displayed unaltered polyploidization, expression of surface receptors and platelet production. However, infection of endothelial cells with PUUV significantly increased platelet sequestration. Our data thus demonstrate that although platelet production, activation or degradation are not directly modulated, PUUV indirectly fosters thrombocytopenia by sequestration of platelets to infected endothelium. Upregulation of immunothrombotic processes in PUUV-HFRS may further contribute to platelet dysfunction and consumption. Given the pathophysiologic similarities of hantavirus infections, our findings thus provide important insights into the mechanisms underlying thrombocytopenia and highlight immune-mediated coagulopathy as potential therapeutic target.
    MeSH term(s) Humans ; Puumala virus ; Hemorrhagic Fever with Renal Syndrome/diagnosis ; Hemorrhagic Fever with Renal Syndrome/therapy ; Endothelial Cells ; Orthohantavirus ; Thrombocytopenia
    Language English
    Publishing date 2023-11-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/j.thromres.2023.11.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Machine learning slice-wise whole-lung CT emphysema score correlates with airway obstruction.

    Lidén, Mats / Spahr, Antoine / Hjelmgren, Ola / Bendazzoli, Simone / Sundh, Josefin / Sköld, Magnus / Bergström, Göran / Wang, Chunliang / Thunberg, Per

    European radiology

    2023  Volume 34, Issue 1, Page(s) 39–49

    Abstract: Objectives: Quantitative CT imaging is an important emphysema biomarker, especially in smoking cohorts, but does not always correlate to radiologists' visual CT assessments. The objectives were to develop and validate a neural network-based slice-wise ... ...

    Abstract Objectives: Quantitative CT imaging is an important emphysema biomarker, especially in smoking cohorts, but does not always correlate to radiologists' visual CT assessments. The objectives were to develop and validate a neural network-based slice-wise whole-lung emphysema score (SWES) for chest CT, to validate SWES on unseen CT data, and to compare SWES with a conventional quantitative CT method.
    Materials and methods: Separate cohorts were used for algorithm development and validation. For validation, thin-slice CT stacks from 474 participants in the prospective cross-sectional Swedish CArdioPulmonary bioImage Study (SCAPIS) were included, 395 randomly selected and 79 from an emphysema cohort. Spirometry (FEV1/FVC) and radiologists' visual emphysema scores (sum-visual) obtained at inclusion in SCAPIS were used as reference tests. SWES was compared with a commercially available quantitative emphysema scoring method (LAV950) using Pearson's correlation coefficients and receiver operating characteristics (ROC) analysis.
    Results: SWES correlated more strongly with the visual scores than LAV950 (r = 0.78 vs. r = 0.41, p < 0.001). The area under the ROC curve for the prediction of airway obstruction was larger for SWES than for LAV950 (0.76 vs. 0.61, p = 0.007). SWES correlated more strongly with FEV1/FVC than either LAV950 or sum-visual in the full cohort (r =  - 0.69 vs. r =  - 0.49/r =  - 0.64, p < 0.001/p = 0.007), in the emphysema cohort (r =  - 0.77 vs. r =  - 0.69/r =  - 0.65, p = 0.03/p = 0.002), and in the random sample (r =  - 0.39 vs. r =  - 0.26/r =  - 0.25, p = 0.001/p = 0.007).
    Conclusion: The slice-wise whole-lung emphysema score (SWES) correlates better than LAV950 with radiologists' visual emphysema scores and correlates better with airway obstruction than do LAV950 and radiologists' visual scores.
    Clinical relevance statement: The slice-wise whole-lung emphysema score provides quantitative emphysema information for CT imaging that avoids the disadvantages of threshold-based scores and is correlated more strongly with reference tests than LAV950 and reader visual scores.
    Key points: • A slice-wise whole-lung emphysema score (SWES) was developed to quantify emphysema in chest CT images. • SWES identified visual emphysema and spirometric airflow limitation significantly better than threshold-based score (LAV950). • SWES improved emphysema quantification in CT images, which is especially useful in large-scale research.
    MeSH term(s) Humans ; Pulmonary Disease, Chronic Obstructive ; Prospective Studies ; Cross-Sectional Studies ; Pulmonary Emphysema/diagnostic imaging ; Lung/diagnostic imaging ; Tomography, X-Ray Computed/methods ; Emphysema/diagnostic imaging ; Airway Obstruction/diagnostic imaging
    Language English
    Publishing date 2023-08-08
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-023-09985-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Clinical and genomic characterisation of a fatal Puumala orthohantavirus case with low levels of neutralising antibodies.

    Tuiskunen Bäck, Anne / Rasmuson, Johan / Thunberg, Therese / Rankin, Gregory / Wigren Byström, Julia / Andersson, Charlotta / Sjödin, Andreas / Forsell, Mattias / Ahlm, Clas

    Infectious diseases (London, England)

    2022  Volume 54, Issue 10, Page(s) 766–772

    Abstract: Background: Orthohantaviruses are rodent-borne emerging viruses that cause haemorrhagic fever with renal syndrome (HFRS) in Eurasia and hantavirus pulmonary syndrome in America. Transmission between humans have been reported and the case-fatality rate ... ...

    Abstract Background: Orthohantaviruses are rodent-borne emerging viruses that cause haemorrhagic fever with renal syndrome (HFRS) in Eurasia and hantavirus pulmonary syndrome in America. Transmission between humans have been reported and the case-fatality rate ranges from 0.4% to 40% depending on virus strain. There is no specific and efficient treatment for patients with severe HFRS. Here, we characterised a fatal case of HFRS and sequenced the causing Puumala orthohantavirus (PUUV).
    Methods: PUUV RNA and virus specific neutralising antibodies were quantified in plasma samples from the fatal case and other patients with non-fatal PUUV infection. To investigate if the causing PUUV strain was different from previously known strains, Sanger sequencing was performed directly from the patient's plasma. Biopsies obtained from autopsy were stained for immunohistochemistry.
    Results: The patient had approximately tenfold lower levels of PUUV neutralising antibodies and twice higher viral load than was normally seen for patients with less severe PUUV infection. We could demonstrate unique mutations in the S and M segments of the virus that could have had an impact on the severity of infection. Due to the severe course of infection, the patient was treated with the bradykinin receptor inhibitor icatibant to reduce bradykinin-mediated vessel permeability and maintain vascular circulation.
    Conclusions: Our data suggest that bradykinin receptor inhibitor may not be highly efficient to treat patients that are at an advanced stage of HFRS. Low neutralising antibodies and high viral load at admission to the hospital were associated with the fatal outcome and may be useful for future predictions of disease outcome.
    MeSH term(s) Antibodies, Neutralizing ; Antibodies, Viral ; Bradykinin Receptor Antagonists ; Genomics ; Orthohantavirus/genetics ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Puumala virus/genetics
    Chemical Substances Antibodies, Neutralizing ; Antibodies, Viral ; Bradykinin Receptor Antagonists
    Language English
    Publishing date 2022-06-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 2839775-7
    ISSN 2374-4243 ; 2374-4235
    ISSN (online) 2374-4243
    ISSN 2374-4235
    DOI 10.1080/23744235.2022.2076904
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Hypoxemia, hypoglycemia and IMCI danger signs in pediatric outpatients in Malawi.

    Thunberg, André / Zadutsa, Beatiwel / Phiri, Everlisto / King, Carina / Langton, Josephine / Banda, Lumbani / Makwenda, Charles / Hildenwall, Helena

    PLOS global public health

    2022  Volume 2, Issue 4, Page(s) e0000284

    Abstract: Hypoxemia and hypoglycemia are known risks for mortality in children in low-income settings. Routine screening with pulse oximetry and blood glucose assessments for outpatients could assist in early identification of high-risk children. We assessed the ... ...

    Abstract Hypoxemia and hypoglycemia are known risks for mortality in children in low-income settings. Routine screening with pulse oximetry and blood glucose assessments for outpatients could assist in early identification of high-risk children. We assessed the prevalence of hypoglycemia and hypoxemia, and the overlap with Integrated Management of Childhood Illness (IMCI) general danger signs, among children seeking outpatient care in Malawi. A cross-sectional study was conducted at 14 government primary care facilities, four rural hospitals and one district referral hospital in Mchinji district, Malawi from August 2019-April 2020. All children aged 0-12 years seeking care with an acute illness were assessed on one day per month in each facility. Study research assistants measured oxygen saturation using Lifebox LB-01 pulse oximeter and blood glucose was assessed with AccuCheck Aviva glucometers. World Health Organization definitions were used for severe hypoglycemia (<2.5mmol/l) and hypoxemia (SpO2 <90%). Moderate hypoglycemia (2.5-4.0mmol/l) and hypoxemia (SpO2 90-93%) were also calculated and prevalence levels compared between those with and without IMCI danger signs using chi2 tests. In total 2,943 children were enrolled, with a median age of 41 (range: 0-144) months. The prevalence of severe hypoxemia was 0.6% and moderate hypoxemia 5.4%. Severe hypoglycemia was present in 0.1% of children and moderate hypoglycemia in 11.1%. IMCI general danger signs were present in 29.3% of children. All severely hypoglycemic children presented with an IMCI danger sign (p <0.001), but only 23.5% of the severely hypoxemic and 31.7% of the moderately hypoxemic children. We conclude that while the prevalence of severe hypoxemia and hypoglycemia were low, moderate levels were not uncommon and could potentially be useful as an objective tool to determine referral needs. IMCI danger signs identified hypoglycemic children, but results highlight the challenge to detect hypoxemia. Future studies should explore case management strategies for moderate hypoxemia and hypoglycemia.
    Language English
    Publishing date 2022-04-26
    Publishing country United States
    Document type Journal Article
    ISSN 2767-3375
    ISSN (online) 2767-3375
    DOI 10.1371/journal.pgph.0000284
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Modulation of lytic molecules restrain serial killing in γδ T lymphocytes.

    Sandoz, Patrick A / Kuhnigk, Kyra / Szabo, Edina K / Thunberg, Sarah / Erikson, Elina / Sandström, Niklas / Verron, Quentin / Brech, Andreas / Watzl, Carsten / Wagner, Arnika K / Alici, Evren / Malmberg, Karl-Johan / Uhlin, Michael / Önfelt, Björn

    Nature communications

    2023  Volume 14, Issue 1, Page(s) 6035

    Abstract: γδ T cells play a pivotal role in protection against various types of infections and tumours, from early childhood on and throughout life. They consist of several subsets characterised by adaptive and innate-like functions, with Vγ9Vδ2 being the largest ... ...

    Abstract γδ T cells play a pivotal role in protection against various types of infections and tumours, from early childhood on and throughout life. They consist of several subsets characterised by adaptive and innate-like functions, with Vγ9Vδ2 being the largest subset in human peripheral blood. Although these cells show signs of cytotoxicity, their modus operandi remains poorly understood. Here we explore, using live single-cell imaging, the cytotoxic functions of γδ T cells upon interactions with tumour target cells with high temporal and spatial resolution. While γδ T cell killing is dominated by degranulation, the availability of lytic molecules appears tightly regulated in time and space. In particular, the limited co-occurrence of granzyme B and perforin restrains serial killing of tumour cells by γδ T cells. Thus, our data provide new insights into the cytotoxic arsenal and functions of γδ T cells, which may guide the development of more efficient γδ T cell based adoptive immunotherapies.
    MeSH term(s) Child, Preschool ; Humans ; Antineoplastic Agents ; Perforin ; Immunotherapy, Adoptive ; Receptors, Antigen, T-Cell, gamma-delta ; Cytotoxicity, Immunologic
    Chemical Substances Antineoplastic Agents ; Perforin (126465-35-8) ; Receptors, Antigen, T-Cell, gamma-delta
    Language English
    Publishing date 2023-09-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-023-41634-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Positive Expiratory Pressure Therapy on Oxygen Saturation and Ventilation After Abdominal Surgery: A Randomized Controlled Trial.

    Spyckerelle, Iris / Jonsson Fagerlund, Malin / Holmgren, Erik / Johansson, Göran / Sahlin, Carin / Thunberg, Johan / Franklin, Karl A

    Annals of surgery open : perspectives of surgical history, education, and clinical approaches

    2021  Volume 2, Issue 4, Page(s) e101

    Abstract: Objective: To evaluate the immediate effects of positive expiratory pressure therapy on oxygen saturation and ventilation after abdominal surgery.: Background: Positive expiratory pressure therapy to treat postoperative hypoxia is widespread, despite ...

    Abstract Objective: To evaluate the immediate effects of positive expiratory pressure therapy on oxygen saturation and ventilation after abdominal surgery.
    Background: Positive expiratory pressure therapy to treat postoperative hypoxia is widespread, despite a lack of evidence of effect.
    Methods: This randomized, sham-controlled, crossover trial investigated adults 1-2 days after abdominal surgery at Umeå University Hospital, Sweden. The intervention was positive expiratory pressure of 10-15 cm H
    Results: Eighty patients were included and randomized and 76 patients were analyzed. Oxygen saturation increased from a baseline mean of 92% to 95%,
    Conclusions: Positive expiratory pressure breathing after abdominal surgery improves oxygen saturation during the maneuver because of hyperventilation, but it is followed by apnea, hypoventilation, and oxygen desaturation. The effect is not different from the expiration to a sham device or hyperventilation. It is time to stop positive expiratory pressure therapy after abdominal surgery, as there is no evidence of effect in previous trials, apart from the adverse effects reported here.
    Language English
    Publishing date 2021-10-01
    Publishing country United States
    Document type Journal Article
    ISSN 2691-3593
    ISSN (online) 2691-3593
    DOI 10.1097/AS9.0000000000000101
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Ustekinumab treatment in ulcerative colitis: Real-world data from the Swedish inflammatory bowel disease quality register.

    Thunberg, Joel / Björkqvist, Olle / Hedin, Charlotte R H / Forss, Anders / Söderman, Charlotte / Bergemalm, Daniel / Olén, Ola / Hjortswang, Henrik / Strid, Hans / Ludvigsson, Jonas F / Eriksson, Carl / Halfvarson, Jonas

    United European gastroenterology journal

    2022  Volume 10, Issue 7, Page(s) 631–639

    Abstract: Background: Real-world data on clinical outcomes of ustekinumab in ulcerative colitis are lacking.: Objective: To assess short- and long-term clinical outcomes of ustekinumab in ulcerative colitis.: Methods: Adult ulcerative colitis patients ... ...

    Abstract Background: Real-world data on clinical outcomes of ustekinumab in ulcerative colitis are lacking.
    Objective: To assess short- and long-term clinical outcomes of ustekinumab in ulcerative colitis.
    Methods: Adult ulcerative colitis patients without previous colectomy starting ustekinumab treatment up until 11 December 2020 were identified through the Swedish Inflammatory Bowel Disease Register (SWIBREG). Prospectively recorded data were extracted from the SWIBREG. The primary outcome was persistence to ustekinumab 16 weeks after treatment initiation. Secondary outcomes included drug persistence beyond week 16, clinical remission (defined as a patient-reported Mayo rectal bleeding subscore = 0 and stool frequency subscore ≤1), biochemical remission (defined as faecal-calprotectin <250 μg/g) and changes in health-related quality of life (HRQoL), as measured by the Short Health Scale (SHS). Logistic regression was used to identify potential predictors of ustekinumab persistence at 16 weeks.
    Results: Of the 133 patients with ulcerative colitis, only three were naïve to biologics and tofacitinib. The persistence rates of ustekinumab were 115/133 (86%) at 16 weeks and 89/133 (67%) at last follow-up, that is, after a median follow-up of 32 (interquartile range 19-56) weeks. The clinical remission rates were 17% at 16 weeks and 32% at the last follow-up. The corresponding rates for biochemical remission were 14% and 23%. The median faecal-calprotectin concentration decreased from 740 μg/g at baseline to 98 μg/g at the last follow-up (p < 0.01, n = 37). Improvement was seen in each dimension of the SHS between baseline and last follow-up (p < 0.01 for each dimension, n = 46). Male sex was associated with ustekinumab persistence at 16 weeks (adjusted odds ratio = 4.00, 95% confidence interval: 1.35-11.83).
    Conclusion: In this nationwide real-world cohort of ulcerative colitis patients with prior drug failures, including other biologics and tofacitinib, ustekinumab was associated with high drug persistence rates and improvements in clinical, biochemical and HRQoL measures.
    MeSH term(s) Adult ; Biological Products/therapeutic use ; Colitis, Ulcerative/diagnosis ; Colitis, Ulcerative/drug therapy ; Humans ; Inflammatory Bowel Diseases/drug therapy ; Leukocyte L1 Antigen Complex ; Male ; Quality of Life ; Sweden/epidemiology ; Ustekinumab/therapeutic use
    Chemical Substances Biological Products ; Leukocyte L1 Antigen Complex ; Ustekinumab (FU77B4U5Z0)
    Language English
    Publishing date 2022-07-14
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2728585-6
    ISSN 2050-6414 ; 2050-6406
    ISSN (online) 2050-6414
    ISSN 2050-6406
    DOI 10.1002/ueg2.12275
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Inhaled therapy for the management of perioperative pulmonary hypertension.

    Thunberg, C A / Morozowich, S T / Ramakrishna, Harish

    Annals of cardiac anaesthesia

    2015  Volume 18, Issue 3, Page(s) 394–402

    Abstract: Patients with pulmonary hypertension (PH) are at high risk for complications in the perioperative setting and often receive vasodilators to control elevated pulmonary artery pressure (PAP). Administration of vasodilators via inhalation is an effective ... ...

    Abstract Patients with pulmonary hypertension (PH) are at high risk for complications in the perioperative setting and often receive vasodilators to control elevated pulmonary artery pressure (PAP). Administration of vasodilators via inhalation is an effective strategy for reducing PAP while avoiding systemic side effects, chiefly hypotension. The prototypical inhaled pulmonary-specific vasodilator, nitric oxide (NO), has a proven track record but is expensive and cumbersome to implement. Alternatives to NO, including prostanoids (such as epoprostenol, iloprost, and treprostinil), NO-donating drugs (sodium nitroprusside, nitroglycerin, and nitrite), and phosphodiesterase inhibitors (milrinone, sildenafil) may be given via inhalation for the purpose of treating elevated PAP. This review will focus on the perioperative therapy of PH using inhaled vasodilators.
    MeSH term(s) Administration, Inhalation ; Antihypertensive Agents/administration & dosage ; Antihypertensive Agents/therapeutic use ; Humans ; Hypertension, Pulmonary/drug therapy ; Intraoperative Complications/drug therapy ; Perioperative Care/methods ; Postoperative Complications/drug therapy ; Vasodilator Agents/administration & dosage ; Vasodilator Agents/therapeutic use
    Chemical Substances Antihypertensive Agents ; Vasodilator Agents
    Language English
    Publishing date 2015-07
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2106866-5
    ISSN 0974-5181 ; 0971-9784
    ISSN (online) 0974-5181
    ISSN 0971-9784
    DOI 10.4103/0971-9784.159811
    Database MEDical Literature Analysis and Retrieval System OnLINE

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