St. John?s wort extract is composed of a large number of components, about 150, but the most studied and interesting substance are hyperforin and hypericin. The herb is very popular and it is known for its pharmacological efficacy in numerous disorders. It is used for treatment of mild to moderated depression as an alternative to synthetic antidepressants.

During the last years, meticillin resistant Staphylococcus pseudintermedius (MRSP) have caused an increasing number of infections in Swedish dogs. MRSP is resistant against a majority of the antimicrobials available for dogs in Sweden, making it difficult to treat the infection. Our knowledge of the bacterium is limited, making it hard to handle infected dogs in a proper way. The aim of this study was to investigate for how long time dogs, who have an infection caused by MRSP, become carriers of the bacterium. Other factors like treatment with antimicrobials, the correlation between clinical symptoms and carriage, common diagnoses and institutionalization where also looked upon.

The Bovine respiratory syncytial virus (BRSV) causes bronchiolitis and interstitial pneumonia, predominantly in calves, and is a major cause of bovine respiratory disease worldwide. In humans, BRSV is paralleled by the closely related Human respiratory syncytial virus (HRSV), an important cause of respiratory disease, most severe in infants.The clinical signs and pathology during RSV infection is caused, not only by the direct effects of viral replication, but also by the response of the host immune system. The immunopathology of RSV has long obfuscated our understanding of the disease, and development of effective treatment and vaccines will be very difficult until greater knowledge is gained.One of the components of the immune system that has come into focus in RSV research the last few years, is the Toll-like receptor 4 (TLR4). The TLR4 receptor is well known as the receptor that binds lipopolysaccaride (LPS), and initiates the host response to bacterial infection. Recently, it has been shown that the fusion protein of RSV also interacts with, and up-regulates the expression of, the TLR4 receptor.

The aim of this study was to conduct an instrument test of the Canadian questionnaire Alberta Context Tool (ACT) version Long-Term care for Swedish conditions. ACT is designed in order to measure the context in the care environment and different behaviours related to the changes in clinical practice. In total, 159 Licensed Practical Nurses (LPNs) and Registered Nurses (RNs) within municipality care of the elderly were included in the survey. The test included the instrument's reliability and face validity.The reliability test was implemented through calculation of Cronbach´s Alpha, and showed internal consistency for five of the scales of the ACT-instrument with Cronbach´s Alpha values ranging between 0,728 and 0,873. However, three dimensions got lower values (0,558 - 0,683).The analysis was carried out with content analysis and carried out for LPNs and RNs in separate groups.

The Bovine respiratory syncytial virus (BRSV) causes bronchiolitis and interstitial pneumonia, predominantly in calves, and is a major cause of bovine respiratory disease worldwide. In humans, BRSV is paralleled by the closely related Human respiratory syncytial virus (HRSV), an important cause of respiratory disease, most severe in infants.The clinical signs and pathology during RSV infection is caused, not only by the direct effects of viral replication, but also by the response of the host immune system. The immunopathology of RSV has long obfuscated our understanding of the disease, and development of effective treatment and vaccines will be very difficult until greater knowledge is gained.One of the components of the immune system that has come into focus in RSV research the last few years, is the Toll-like receptor 4 (TLR4). The TLR4 receptor is well known as the receptor that binds lipopolysaccaride (LPS), and initiates the host response to bacterial infection. Recently, it has been shown that the fusion protein of RSV also interacts with, and up-regulates the expression of, the TLR4 receptor.

The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

Sahlgrenska AcademyAt University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: The obesity paradox, myth or truth in adults with cardiovascular disease.Author: Louise Svensson och Amanda NilssonSupervisor: Fredrik BertzExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 30, 2013Background: It has long been generally accepted that obesity is a risk factor for many diseases. Despite this, new research indicates that a higher BMI could be a protective factor for those with a chronic cardiovascular disease. This discovery is called the obesity paradox and could change the perception of patients' BMI in both public health and clinical work.Objective: The objective of this systematic review article is to examine the scientific evidence for the existence of the obesity paradox in chronic cardiovascular disease, i.e. if a BMI >25 kg/m2 is associated with lower mortality among adults with chronic cardiovascular disease.Search strategy: The databases used in the literature study were PubMed, Summon, Scopus and Cochrane. The keywords were: obesity paradox, cardiovascular, heart, male, BMI, intentional weight loss, cardiovascular mortality and mortality heart failure.Selection criteria: Studies, which had an adult population classified after BMI that suffered from chronic cardiovascular disease and had all-cause mortality and cardiovascular mortality as endpoints, were included.Data collection and analysis: Ten studies were included.

Renal dysplasi (RD) is a congenital chronic renal disease affecting young dogs. It is a rather common disease that occurs in a large number of dogs and in some breeds there is a familiar incidence or suspected hereditary background. Both the etiology and pathogenesis are still unknown, but a theory about the cause of RD is that the two components that form the kidney, the uretheric bud and the metanephrogenic blastema, don´t interact normally in the embryo. Kidneys affected by RD contain fetal (immature) structures that are inappropriate for the state of development/age of the dog and abnormal structures caused by an abnormal differentiation. Affected dogs usually are under .

Every year 300 children in Sweden are diagnosed with cancer, but through research and successful clinical work 70 % of the children survive their cancer. Aim: To illuminate nursing care of children with cancer. Method: The study was carried out as a general literature study through systematic review and analyse of 18 scientific articles. Result: The analysis resulted in five themes: Support, play as a psychological assistance, alternatives to alleviation of pain, nutrition and relieving symptoms of fatigue.Conclusion: It is important that the nurse has knowledge about the children and their family?s experiences when dealing with a cancer illness to provide the children with adequate care.

ABSTRACTChlamydia and Chlamydophila are species of a family of bacteria (Chlamydiaceae) that cause a range of diseases, including conjunctivitis, in a variety of animals including pigs and humans. Some species cause zoonotic disease. This study examined the occurrence of Chlamydiaceae in samples taken from the lower eyelid conjunctiva in pigs with and without conjunctivitis. The study was initiated based on a herd investigation aimed to examine the experienced increase of conjunctivitis in some finisher herds. This study was conducted as a case-control study, by collecting samples from 62 case pigs (16-26 weeks old) and an equal number of controls, from three herds in Uppland, Sweden.

Canine parvovirus is associated with two disorders: enteritis, which is common, and myocarditis, which is rare. Prominent clinical signs of parvovirus enteritis are vomiting, diarrhea and rapid dehydration. Canine parvovirus type 2 (CPV-2) is very contagious. When CPV-2 first emerged it had high rates of mortality, but later studies have shown that most infections are self-limiting and do not require veterinary care. Mortality rates vary greatly, and therefore it is important to determine risk factors for developing severe canine parvovirus enteritis.

Back problems are well noticed in horses, especially in horses used for riding. Kissing spines (impingement of the dorsal spinous processes) are often found at radiographic examinations of the thoracic spine. Kissing spines is a radiological diagnosis, indicating that parts of at least two adjacent dorsal spinous processes are in contact with each other. It is not uncommon that horses without clinical signs of back problems have some degree of kissing spines. It is therefore not sufficient with a radiographic examination to say that the cause of pain is kissing spines.

Background: It is required that health care professionals continuously work with patient safety and quality improvements, and the skills of registered nurses are significant in this work. However, quality improvement also requires commitment and knowledge about how to improve health care and ensure patient safety. There is a lack of studies that highlights the importance of supportive functions for this work. Nurses in clinical settings can be utilized as facilitators that make things easier for other health care professionals who are engaged in quality improvement and patient safety. In order to gain understanding about the significance and needs of nurses with a role of facilitator, it is urgent to learn from their experiences of facilitating quality improvement in health care.Aim: The aim was to study nurses? experiences of facilitating quality improvement of nursing care, patient safety and multi-professional collaboration in health care.Method: Semi-structured qualitative interviews were performed with ten registered nurses who had experience of being in the role of facilitators.

Dairy farming in Uganda provides a source of food, employment and income. Previous studies have revealed high frequencies of bovine mastitis, a costly disease for the dairy farmer. The aims of this study were to investigate the bacteriological panorama in milk from udder quarters with clinical (CM) and subclinical mastitis (SCM) and to determine the antimicrobial susceptibility in staphylococcal isolates. Further, we intended to establish the prevalence of subclinical mastitis and to investigate some environmental factors and animal properties that might influence the frequency of mastitis. For CM, farmers made contact with the members of this study when recognizing an animal with CM.

Peritonitis is a potentially life-threatening disease in horses. With no published work from Sweden, the objective of the study was to describe the occurrence and demographics of horses with peritonitis and to evaluate the outcome of treatment in terms of short-term survival during a ten-year period in a large clinic in Sweden. Data were examined in a retrospective manner in 69 horses diagnosed with and treated for peritonitis at Universitetsdjursjukhuset (UDS) in Uppsala between 2002-2012. Demographic data examined included age, breed, gender, history, duration of illness before arriving at UDS, reason for seeking veterinary care, initial clinical findings (general state of health, heart rate, respiratory rate, mucous membrane appearance, rectal temperature, abdominal sounds, rectal examination, nasogastric tube results), abdominocentesis results (abdominal fluid analysis including visual inspection, leukocytes and protein, cytology, bacterial culture and sensitivity pattern), complete blood count (CBC), Serum amyloid-A (SAA) upon presentation and a follow up, plasma fibrinogen, plasma protein and albumin, treatments, length of hospitalisation and outcome. All medical records with the diagnosis of peritonitis were extracted from the medical records system Trofast. All records with any other diagnosis code referring to trauma such as rectal tear or ruptured uterus, recent abdominal surgery, external trauma or rupture in the gastrointestinal tract were excluded. To be included in the study, the peritoneal fluid should contain more than 20.000 cells/?L, have a peritoneal protein value of >30 g/L; or have a significantly changed peritoneal fluid sample (orange with increased turbidity or worse) in cases where no data on cells or protein were available. The horses were divided into two groups; one where the peritonitis was deemed to have an idiopathic aetiology (primary peritonitis) and the other group where the peritonitis had a possible aetiology such as intestinal parasites, impaction etc.