liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Berg, Sören
Publications (10 of 33) Show all publications
Zilg, B., Alkass, K., Berg, S. & Druid, H. (2016). Interpretation of postmortem vitreous concentrations of sodium and chloride. Forensic Science International, 263, 107-113
Open this publication in new window or tab >>Interpretation of postmortem vitreous concentrations of sodium and chloride
2016 (English)In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 263, p. 107-113Article in journal (Refereed) Published
Abstract [en]

Vitreous fluid can be used to analyze sodium and chloride levels in deceased persons, but it remains unclear to what extent such results can be used to diagnose antemortem sodium or chloride imbalances. In this study we present vitreous sodium and chloride levels from more than 3000 cases. We show that vitreous sodium and chloride levels both decrease with approximately 2.2 mmol/L per day after death. Since potassium is a well-established marker for postmortem interval (PMI) and easily can be analyzed along with sodium and chloride, we have correlated sodium and chloride levels with the potassium levels and present postmortem reference ranges relative the potassium levels. We found that virtually all cases outside the reference range show signs of antemortem hypo- or hypernatremia. Vitreous sodium or chloride levels can be the only means to diagnose cases of water or salt intoxication, beer potomania or dehydration. We further show that postmortem vitreous sodium and chloride strongly correlate and in practice can be used interchangeably if analysis of one of the ions fails. It has been suggested that vitreous sodium and chloride levels can be used to diagnose drowning or to distinguish saltwater from freshwater drowning. Our results show that in cases of freshwater drowning, vitreous sodium levels are decreased, but that this mainly is an effect of postmortem diffusion between the eye and surrounding water rather than due to the drowning process, since the decrease in sodium levels correlates with immersion time. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2016
Keywords
Postmortem; Vitreous; Sodium; Chloride; Hypernatremia; Hyponatremia
National Category
Forensic Science
Identifiers
urn:nbn:se:liu:diva-129143 (URN)10.1016/j.forsciint.2016.04.006 (DOI)000375944700016 ()27105154 (PubMedID)
Note

Funding Agencies|Swedish National Board of Forensic Medicine; Swedish Medical Society

Available from: 2016-06-13 Created: 2016-06-13 Last updated: 2017-11-28
Olsson, A., Alfredsson, J., Håkansson, E., Svedjeholm, R., Berglund, J. & Berg, S. (2016). Protamine reduces whole blood platelet aggregation after cardiopulmonary bypass. Scandinavian Cardiovascular Journal, 50(1), 58-63
Open this publication in new window or tab >>Protamine reduces whole blood platelet aggregation after cardiopulmonary bypass
Show others...
2016 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 50, no 1, p. 58-63Article in journal (Refereed) Published
Abstract [en]

Platelet dysfunction is an important cause of postoperative bleeding after cardiac surgery. Protamine is routinely used for reversal of heparin after cardiopulmonary bypass (CBP), but may affect platelet aggregation. We assessed changes in platelet function in relation to protamine administration. Design: Platelet aggregation was analyzed by impedance aggregometry before and after protamine administration in 25 adult cardiac surgery patients. Aggregation was also studied after in vitro addition of heparin and protamine. The activators adenosine diphosphate (ADP), thrombin receptor activating peptide-6 (TRAP), arachidonic acid (AA) and collagen (COL) were used.Results: Platelet aggregation was reduced by approximately 50% after in vivo protamine administration; ADP 640 +/- 230 (AU*min, mean +/- SD) to 250 +/- 160, TRAP 939 +/- 293 to 472 +/- 260, AA 307 +/- 238 to 159 +/- 143 and COL 1022 +/- 350 to 506 +/- 238 (all p<0.001). Aggregation was also reduced after in vitro addition of protamine alone with activators ADP from 518 +/- 173 to 384 +/- 157 AU*min p<0.001, and AA 449 +/- 311 to 340 +/- 285 (p<0.01) and protamine combined with heparin (1:1 ratio) with activators ADP to 349 +/- 160 and AA to 308 +/- 260 (both p<0.001); and COL from 586 +/- 180 to 455 +/- 172 (p<0.05). Conclusions: Protamine given after CPB markedly reduces platelet aggregation. Protamine added in vitro also reduces platelet aggregation, by itself or in combination with heparin.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2016
Keywords
Cardiopulmonary bypass; platelet aggregation; platelet function tests; protamine
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-124094 (URN)10.3109/14017431.2015.1099720 (DOI)000365693900009 ()26402229 (PubMedID)
Note

Funding Agencies|Blekinge Institute of Technology, Karlskrona; Department of Cardiothoracic Anaesthesiology and Intensive Care, County Council of Ostergotland [LIO-284621]

Available from: 2016-01-25 Created: 2016-01-19 Last updated: 2018-04-03
Zilg, B., Bernard, S., Alkass, K., Berg, S. & Druid, H. (2015). A new model for the estimation of time of death from vitreous potassium levels corrected for age and temperature. Forensic Science International, 254, 158-166
Open this publication in new window or tab >>A new model for the estimation of time of death from vitreous potassium levels corrected for age and temperature
Show others...
2015 (English)In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 254, p. 158-166Article in journal (Refereed) Published
Abstract [en]

Analysis of potassium concentration in the vitreous fluid of the eye is frequently used by forensic pathologists to estimate the postmortem interval (PMI), particularly when other methods commonly used in the early phase of an investigation can no longer be applied. The postmortem rise in vitreous potassium has been recognized for several decades and is readily explained by a diffusion of potassium from surrounding cells into the vitreous fluid. However, there is no consensus regarding the mathematical equation that best describes this increase. The existing models assume a linear increase, but different slopes and starting points have been proposed. In this study, vitreous potassium levels, and a number of factors that may influence these levels, were examined in 462 cases with known postmortem intervals that ranged from 2 h to 17 days. We found that the postmortem rise in potassium followed a non-linear curve and that decedent age and ambient temperature influenced the variability by 16% and 5%, respectively. A long duration of agony and a high alcohol level at the time of death contributed less than 1% variability, and evaluation of additional possible factors revealed no detectable impact on the rise of vitreous potassium. Two equations were subsequently generated, one that represents the best fit of the potassium concentrations alone, and a second that represents potassium concentrations with correction for decedent age and/or ambient temperature. The former was associated with narrow confidence intervals in the early postmortem phase, but the intervals gradually increased with longer PMIs. For the latter equation, the confidence intervals were reduced at all PMIs. Therefore, the model that best describes the observed postmortem rise in vitreous potassium levels includes potassium concentration, decedent age, and ambient temperature. Furthermore, the precision of these equations, particularly for long PMIs, is expected to gradually improve by adjusting the constants as more reference data are added over time. A web application that facilitates this calculation process and allows for such future modifications has been developed. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2015
Keywords
Postmortem; Potassium; Vitreous; Postmortem interval; PMI; Time of death
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-121755 (URN)10.1016/j.forsciint.2015.07.020 (DOI)000360974500025 ()26232848 (PubMedID)
Note

Funding Agencies|Swedish National Board of Forensic Medicine; Swedish Medical Society

Available from: 2015-10-06 Created: 2015-10-05 Last updated: 2017-12-01
Ågren, S., Berg, S., Svedjeholm, R. & Strömberg, A. (2015). Psychoeducational support to post cardiac surgery heart failure patients and their partners: A randomised pilot study. Intensive & Critical Care Nursing, 31(1), 10-18
Open this publication in new window or tab >>Psychoeducational support to post cardiac surgery heart failure patients and their partners: A randomised pilot study
2015 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, no 1, p. 10-18Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Postoperative heart failure is a serious complication that changes the lives of both the person who is critically ill and family in many ways. The purpose of this study was to evaluate the effects of an intervention in postoperative heart failure patient-partner dyads regarding health, symptoms of depression and perceived control.

RESEARCH METHODOLOGY/DESIGN: Pilot study with a randomised controlled design evaluating psychosocial support and education from an interdisciplinary team.

SETTING: Patients with postoperative heart failure and their partners.

MAIN OUTCOME MEASURES: SF-36, Beck Depression Inventory, Perceived Control at baseline, 3 and 12 months.

RESULTS: A total of 42 patient-partner completed baseline assessment. Partners in the intervention group increased health in the role emotional and mental health dimensions and patients increased health in vitality, social function and mental health dimensions compared with the control group. Patients' perceived control improved significantly in the intervention group over time.

CONCLUSION: Psychoeducational support to post cardiac surgery heart failure dyads improved health in both patients and partners at short term follow-up and improved patients' perceived control at both short and long-term follow-up. Psychoeducational support appears to be a promising intervention but the results need to be confirmed in larger studies.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Education; Family; Heart failure; Intervention; Postoperative complications; Psychosocial support; Quality of life
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-109501 (URN)10.1016/j.iccn.2014.04.005 (DOI)000349930300002 ()24969363 (PubMedID)
Available from: 2014-08-20 Created: 2014-08-20 Last updated: 2017-12-05Bibliographically approved
Olsson, A., Alfredsson, J. & Berg, S. (2014). Improved quality of retransfused residual blood from the cardio-pulmonary bypass circuit with Ringer wash-in technique. In: Sixth Joint Scandinavian Conference in Cardiothoracic Surgery 2014.: Abstract O35.. Paper presented at Sixth Joint Scandinavian Conference in Cardiothoracic Surgery 2014, Gothenburg, Sweden, September 3-5, 2014.
Open this publication in new window or tab >>Improved quality of retransfused residual blood from the cardio-pulmonary bypass circuit with Ringer wash-in technique
2014 (English)In: Sixth Joint Scandinavian Conference in Cardiothoracic Surgery 2014.: Abstract O35., 2014Conference paper, Oral presentation only (Other academic)
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-112573 (URN)
Conference
Sixth Joint Scandinavian Conference in Cardiothoracic Surgery 2014, Gothenburg, Sweden, September 3-5, 2014
Available from: 2014-12-03 Created: 2014-12-03 Last updated: 2014-12-08
Tynngård, N., Berlin, G., Samuelsson, A. & Berg, S. (2014). Low dose of hydroxyethyl starch impairs clot formation as assessed by viscoelastic devices. Scandinavian Journal of Clinical and Laboratory Investigation, 74(4), 344-350
Open this publication in new window or tab >>Low dose of hydroxyethyl starch impairs clot formation as assessed by viscoelastic devices
2014 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 74, no 4, p. 344-350Article in journal (Refereed) Published
Abstract [en]

Objective. High doses of the synthetic colloid hydroxyethyl starch (HES) used for plasma expansion have been associated with impaired haemostasis and hypocoagulation. Less is known about effects on clot formation in the low haemodilutional range (less than 40%). This study evaluated the effects of low haemodilution with HES and albumin on coagulation using two different viscoelastic methods. Methods. Clot formation was studied in vitro in healthy donor blood after 10% and 30% haemodilution with 60 g/L HES 130/0.4 or 50 g/L albumin with free oscillation rheometry (FOR) and rotational thromboelastography. Results. Clotting time was not significantly affected at 10% haemodilution but was prolonged with both substances at 30% dilution (p less than 0.01-0.001). The effect was significantly more pronounced with HES than with albumin. The elasticity of the clot was slightly reduced at 10% dilution with albumin, more pronounced at 10% dilution with HES (p less than 0.05), further reduced at 30% dilution with albumin and to a still greater extent at 30% dilution with HES (p less than 0.05). With albumin the functional activity of fibrinogen was not reduced in excess of the dilutional effect. HES in contrast produced a further reduction in clot elasticity than caused by mere dilution at both 10% and 30% dilutions (p less than 0.001). Conclusions. There is an adverse effect on clot formation even at low grade haemodilution with both albumin and HES. The effect on coagulation is significantly more pronounced with HES than with albumin.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keywords
Coagulation; colloids; fibrinogen; haemodilution; platelets
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-108934 (URN)10.3109/00365513.2014.891259 (DOI)000337084600011 ()
Available from: 2014-07-15 Created: 2014-07-13 Last updated: 2018-01-11
Hammarskjöld, F., Berg, S., Hanberger, H., Taxbro, K. & Malmvall, B.-E. (2014). Sustained low incidence of central venous catheter-related infections over six years in a Swedish hospital with an active central venous catheter team. American Journal of Infection Control, 42(2), 122-128
Open this publication in new window or tab >>Sustained low incidence of central venous catheter-related infections over six years in a Swedish hospital with an active central venous catheter team
Show others...
2014 (English)In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296, Vol. 42, no 2, p. 122-128Article in journal (Refereed) Published
Abstract [en]

Background: There are limited data on the long-term effects of implementing a central venous catheter (CVC) program for prevention of CVC infections. The aims of this study were to evaluate the incidence of CVC colonization, catheter-related infections (CRI), catheter-related bloodstream infections (CRBSI), and their risk factors over a 6-year period in a hospital with an active CVC team. Methods: We conducted a continuous prospective study aiming to include all CVCs used at our hospital during the years 2004 to 2009, evaluating colonization, CRI, CRBSI, and possible risk factors. Results: A total of 2,772 CVCs was used during the study period. Data on culture results and catheterization time were available for 2,045 CVCs used in 1,674 patients. The incidences of colonization, CRI, and CRBSI were 7.0, 2.2, and 0.6 per 1,000 CVC-days, respectively. Analysis of quarterly incidences revealed 1 occasion with increasing infection rates. Catheterization time was a risk factor for CRI but not for CRBSI. Other risk factors for CRI were hemodialysis and CVC use in the internal jugular vein compared with the subclavian vein. Hemodialysis was the only risk factor for CRBSI. Conclusion: We found that a CRI prevention program led by an active CVC team and adhered to by the entire staff at a county hospital is successful in keeping CVC infections at a low rate over a long period of time.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Central venous catheter-related bloodstream infection; Intravascular catheter; Nosocomial infection; Statistical process control
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-105238 (URN)10.1016/j.ajic.2013.09.023 (DOI)000330952500009 ()
Available from: 2014-03-14 Created: 2014-03-14 Last updated: 2017-12-05
Taxbro, K., Berg, S., Hammarskjold, F., Hanberger, H. & Malmvall, B.-E. (2013). A prospective observational study on 249 subcutaneous central vein access ports in a Swedish county hospital. Acta Oncologica, 52(5), 893-901
Open this publication in new window or tab >>A prospective observational study on 249 subcutaneous central vein access ports in a Swedish county hospital
Show others...
2013 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 52, no 5, p. 893-901Article in journal (Refereed) Published
Abstract [en]

Background. Reliable central vein access is a fundamental issue in modern advanced oncological care. The aim of this study was to determine the incidence of complications and patient perception regarding central vein access ports. Methods. We prospectively studied 249 single lumen access ports implanted between 1 July 2008 and 15 March 2010 in a mixed patient population at a 500-bed secondary level hospital in Sweden. We determined the number of catheter days, infection rate and mechanical complications, as well as patient satisfaction regarding the access port, over a six-month follow-up period. Results. Two hundred and forty-four different patients received 249 ports yielding a total of 37 763 catheter days. Ultrasound and fluoroscopic guidance was used in 98% of procedures. Vein access was obtained percutanously by an anaesthesiologist in all cases. There was no case of pneumo- or haemothorax. The incidence of catheter-related bloodstream infection, was 0.05/1000 catheter days and the incidence of pocket/tunnel infection was 0.39/1000 catheter days. Clinically apparent deep vein thrombosis occurred in four patients (1.6%). Patient satisfaction was overall high. Conclusion. These results confirm that our team-based approach with written easily accessible evidence-based guidelines and a structured education programme leads to a very low complication rate and a high degree of patient satisfaction.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-93959 (URN)10.3109/0284186X.2013.770601 (DOI)000318655300003 ()
Note

Funding Agencies|Futurum - the Academy for Healthcare, Jonkoping County Council, Jonkoping, Sweden||

Available from: 2013-06-13 Created: 2013-06-13 Last updated: 2019-07-23
Berg, S. (2013). Akut handläggning av svår sepsis och septisk chock (2ed.). In: Håkan Hanberger (Ed.), Sepsis på akuten & IVA: diagnostik och antibiotikaterapi (pp. 14-25). Linköping: Linköpings universitet
Open this publication in new window or tab >>Akut handläggning av svår sepsis och septisk chock
2013 (Swedish)In: Sepsis på akuten & IVA: diagnostik och antibiotikaterapi / [ed] Håkan Hanberger, Linköping: Linköpings universitet , 2013, 2, p. 14-25Chapter in book (Other academic)
Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2013 Edition: 2
Keywords
Sepsis -- drug therapy, Anti-Bacterial Agents -- administration & dosage, Sepsis -- behandling
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-102322 (URN)978-91-7519-605-3 (ISBN)
Available from: 2013-12-05 Created: 2013-12-05 Last updated: 2014-03-20Bibliographically approved
Szabó, Z., Sjökvist, S., Gustavsson, T., Carleberg, P., Uppsäll, M., Wren, J., . . . Smedby, Ö. (2013). Intraoperativ visualisering av myokardiell perfusion i realtidmeaugmented reality temperatur monitorering-en experimentellstudie. In: : . Paper presented at Thoraxmötet, 16-18 oktober 2013, Linköping (pp. O2-O2).
Open this publication in new window or tab >>Intraoperativ visualisering av myokardiell perfusion i realtidmeaugmented reality temperatur monitorering-en experimentellstudie
Show others...
2013 (Swedish)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-99977 (URN)
Conference
Thoraxmötet, 16-18 oktober 2013, Linköping
Available from: 2013-10-24 Created: 2013-10-24 Last updated: 2013-11-05
Organisations

Search in DiVA

Show all publications