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Blood and tissue velocities are measured and analysed in cardiac, vascular and other applications of diagnostic ultrasound. Errors in system performance might give invalid measurements. We developed two moving string test targets (“Doppler phantoms”) to characterise ultrasound Doppler systems. These phantoms were initially used to measure such variables as sample volume dimensions, location of the sample volume, and the performance of the spectral analysis. Specific tests were done to detect errors in signal processing causing time delays and inaccurate velocity estimation. Even time delays as short as 30 ms in cardiac motion pattern may have clinical relevance. These delays can be measured with echocardiography, by using techniques such as flow and tissue Doppler and M-mode together with external signals (e.g., ECG and phonocardiography). If one or more of these signals are delayed in relation to the other signals (asynchronous), an incorrect definition of cardiac time intervals can occur. To determine if this time delay in signal processing is a problem, we tested three commercial ultrasound systems. We used a digital ECG simulator and a Doppler string phantom to obtain test signals. We found time delays of up to 90 ms in one system, whereas delays were mostly short in the other two systems. Further, the time delays varied relative to system settings. To determine the accuracy in velocity calibration, we tested the same three ultrasound systems using the Doppler phantom to obtain test signals for flow and tissue pulsed Doppler and for continuous wave Doppler. The ultrasound systems were tested with settings and transducers commonly used in cardiac applications. In two systems the observed errors were mostly close to zero, whereas one system systematically overestimated velocity by an average of 4.6%. The detected errors can be considered small in clinical applications but might be serious in certain research applications. It is important to know the velocity error of the used ultrasound system and to judge it in relation to the application in which it is used.

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Introduktion: Läkemedelsinteraktion uppstår vid samtidig behandling med flera läkemedel som påverkar varandras effekter. Interaktioner uppkommer inte endast vid samtidig behandling av flera receptbelagda läkemedel. Även natur- och receptfria läkemedel, vissa födoämnen exempelvis grapefruktjuice och kalkhaltiga livsmedel som mjölkprodukter samt alkohol kan ge upphov till interaktioner. Läkemedel påverkar varandras effekter genom farmakokinetiska och farmakodynamiska processer. Läkemedelupplysningen är en upplysningstjänst på Läkemedelverket och har som uppdrag att förmedla information om läkemedelsanvändning till allmänheten. Frågorna varierar och handlar ofta om läkemedels möjliga säkerhetsrisker t.ex. interaktioner och biverkningar. Syfte: Syftet med denna studie var att sortera och analysera inkomna frågor till LMU för att ta reda på vilken information som efterfrågas om interaktioner.Metod: Undersökning genomfördes utifrån kvalitativa och kvantitativa perspektiv och Microsoft Excel-dokument innehållande all information om bland annat läkemedelsinteraktioner inkomma till LMU användes. Resultat: Undersökningen visade att 25% av alla frågor inkomna till LMU handlade om läkemedelsinteraktioner. Resultatet visade att de flesta frågor handlade om läkemedelsinteraktioner mellan läkemedel för nervsystemet blodtrycks- och blodförtunnade mediciner. Kategorisering för egenvårdsprodukter resulterade i att frågeställarna i de flesta fall frågar om deras receptbelagda läkemedel fungerar ihop med receptfria produkter som smärtstillande NSAID, paracetamol protonpumpshämmare samt vitaminkosttillkott. Validering av ett antal frågor visade i stort sett rätt kategorisering. Konklusion: Resultatet visar att allmänheten har stora behov av information om läkemedelsinteraktioner om läkemedel för nervsystemet, blodtrycks- och blodförtunnade mediciner och egenvårdsprodukter bl.a. smärtstillande läkemedel.

Sepsis is a medical emergency and it arises from extreme response of the host to an infection. Current diagnosis in sepsis relies on nonspecific clinical signs and culture-based analysis, which is time-consuming. It is critically important for clinicians to follow a protocol to identify sepsis and administer antibiotic therapy without any delay. Sepsis-specific biomarkers are being assessed for early diagnosis and thus improving the outcome of the sepsis patient. Many cellular molecules have been proposed to be sepsis-specific biomarkers. However, these molecules lack specificity and sensitivity. MicroRNA expression in biological fluids, particularly plasma and other tissues is very specific to disease state and are found to be promising diagnostic biomarkers in sepsis. Therefore, it is essential to extract qualitative and sufficient amount of microRNAs from human plasma for the downstream application of two-tailed RT-qPCR method microRNA needed for detection of sepsis patients. The aim of this study was to find optimal volume of plasma required to measure microRNA as sepsis biomarker. The study also included isolating exosomal microRNA from blood samples to check whether blood can be used for extraction. The study was conducted with healthy donor samples and the extraction is performed using Plasma/Serum Exosome Purification (product 58300, Norgen Biotek Corporation, Canada) and RNA Isolation Mini Kit and Total RNA Purification Kit (product 37500, Norgen Biotek Corporation, Canada). The samples were assessed for its quantity and quality by Qubit® and Nanodrop™ technology. Based on the comparison of amount of exosomal microRNA extracted from different plasma volumes, it can be concluded, that increasing volume of plasma may not give higher quantity of microRNA.

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Abstract Introduction: Polypharmacy and inappropriate medication are common issues in elderly patients. Older people are more likely to suffer from adverse drug reactions and other drug-related problems due to the increased presence of multimorbidity, inappropriate polypharmacy, age related impairments in the hepatic metabolism and renal clearance of medication and enhanced pharmacodynamic sensitivity to specific drugs. Aim: The aim of this study was to analyze, compare and describe medication use in the MedBridge study population, in total and for different patient groups. Materials and Methods: Medication data from approximately 700 patients from Uppsala University Hospital and the hospital of Enköping was extracted from the medical record system and stored in an electronic data capture system. This data was joined together with the collected data from the other 1939 study participants and exported to Microsoft excel for analyses. Results: The mean value of prescribed medicines was 9.2. Women had significantly higher (p<0.05) number of prescribed medicines. Participants aged 85 or older had the highest number of prescribed medicines and participant between 65-74 had the least prescribed medicines. The mean value was significantly higher (p<0.05) for women aged 85 years or older and women between 75-85 years compared with women aged 65- 74. In this population 461 patients (17.4%) used at least one inappropriate medicine. Of all the women 18.8% used at least one inappropriate medicine and 15.7% of all the men. Women aged 85 years or older used the most inappropriate medicines and men between 65-74 used the least. Women aged 85 or older used significantly (p<0.05) higher amount of inappropriate medicines than women aged 65-74 years did. Conclusion: In conclusion, this report shows that many of our elderly haves’ polypharmacy and that women are using more medicines than men and more inappropriate medicines than men. It also indicates that the older you get, the more medicines you use.