There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury.Inclusion of manageable routines for valid assessment o...There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury.Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma.The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders(WADs)with both a qualitative method and quantitative sensory testing(QST).Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women.Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits.Seven test sites in the facial skin(overlying each trigeminal branch bilaterally,and the midpoint of the chin)were examined.The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds.For the WAD patients,the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy,whereas QST systematically showed significantly higher detection thresholds(i.e.,decreased sensitivity)for both cold and warm stimuli.For the individuals who were assessed as having increased sensitivity in the qualitative assessment,the QST displayed either normal or higher thresholds,i.e.,decreased sensitivity.The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method.The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.展开更多
Introduction: Insomnia and depressive symptoms are common among patients with chronic heart failure (HF). Aim: The aim was to describe the prevalence of insomnia and depressive symptoms, as well as to examine the asso...Introduction: Insomnia and depressive symptoms are common among patients with chronic heart failure (HF). Aim: The aim was to describe the prevalence of insomnia and depressive symptoms, as well as to examine the association between insomnia and depressive symptoms in patients with HF. Method: A crosssectional descriptive study including 212 patients with HF. All patients responded to questionnaires regarding sleeping difficulties (Uppsala Sleep Inventory-Chronic Heart Failure), daytime sleepiness (Epworth Sleepiness Scale) and depressive symptoms (The Mental Health Scale). Results: Patients with depressive symptoms (34%) had, compared to those without, significantly more major complaints of insomnia as indicated by the sub-types;non-restorative sleep (66% vs. 32%, p < 0.0001), difficulty in maintaining sleep (35% vs. 16%, p = 0.003), difficulty in initiating sleep (29% vs. 14%, p = 0.009) and early morning awakenings (25% vs. 10%, p = 0.004). The odds ratio (OR) to suffer from depressive symptoms;were for;non-restorative sleep 5.2 (CI 95%, 2.2 - 12.3), difficulties maintaining sleep 2.5 (CI 95%, 1.2 - 4.9), difficulties in initiating sleep 2.2 (CI 95%, 1.1 - 4.4) and early morning awakenings 2.4 (CI 95%, 1.1 - 5.4). When categorising insomnia into three severity groups, 1) non insomnia, 2) mild insomnia, and 3) severe insomnia, the OR for depressive symptoms for the mild insomnia and severe insomnia group were 2.2 (CI 95%, 1.1 - 4.2) and 7.4 (CI 95%, 2.4 - 22.8) respectively, compared to the non insomnia group. Conclusion: Insomnia is independently associated to depressive symptoms. Assessment of depressive symptoms and insomnia in patients with HF is important since treatment could be targeted to depressive symptoms only and/or to the sleep disturbance.展开更多
Pediatric cardiac surgery with cardiopulmonary bypass (CPB)-is frequently associated with neurologic deficits. We describe the postoperative EEG changes, assess their possible causes, and evaluate their relevance to n...Pediatric cardiac surgery with cardiopulmonary bypass (CPB)-is frequently associated with neurologic deficits. We describe the postoperative EEG changes, assess their possible causes, and evaluate their relevance to neurologic outcome. Thirty-one children and five neonates with congenital heart disease were included. EEG recording started after intubation and continued until 22-96 h after CPB. In addition to conventional analysis, spectral analysis was performed for occipital and frontal electrodes, and differences between pre-and postoperative delta power (delta-δP) were calculated. Maximum values of occipital delta-δP that occurred within 48 h after CPB were correlated with clinical variables and with perioperative markers of oxidative stress and inflammation. Occipital delta-δP correlated with frontal delta-δP, and maximum delta-δP correlated with conventional rating. Distinct rise of δP was detected in 18 of 21 children without any acute or long-term neurologic deficits but only in five of 10 children with temporary or permanent neurologic deficits. Furthermore, maximally registered delta-δP was inversely associated with duration of CPB and postoperative ventilation. Maximal delta-δP was also inversely associated with the loss of plasma ascorbate (as an index of oxidative stress) and plasma levels of IL-6 and IL-8. Slow wave activity frequently occurs within 48 h after CPB. However, our data do not support the notion that EEG slowing is associated with adverse neurologic outcome. This is supported by the fact that EEG slowing was associated with less oxido-inflammatory stress.展开更多
Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjectiv...Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.展开更多
Temporal lobe seizures generate a large pool of new hippocampal neurons in the adult brain.Their role within the hyperexcitable neuronal network and how they are regulated by the immune response is unclear.Fractalkine...Temporal lobe seizures generate a large pool of new hippocampal neurons in the adult brain.Their role within the hyperexcitable neuronal network and how they are regulated by the immune response is unclear.Fractalkine and its receptor CX3CR1 constitute a chemokine pathway known to modulate the immune response in temporal lobe epilepsy.Here,6 weeks of intracerebroventricular infusion of anti-CX3CR1 antibody,starting 1 week after electrically induced prolonged seizures in the temporal lobe(status epilepticus(SE)),reduced microglial activation within the hippocampus.展开更多
In the present study, we demonstrate that adult mice lacking interleukin- 1 receptor 1 (IL- 1R1) exhibit increased express- ion of both the excitatory scaffolding protein postsynaptic density-95 (PSD-95) and inhib...In the present study, we demonstrate that adult mice lacking interleukin- 1 receptor 1 (IL- 1R1) exhibit increased express- ion of both the excitatory scaffolding protein postsynaptic density-95 (PSD-95) and inhibitory scaffolding proteinge- phyrin, respectively, in the hippocampus. The morphology of hippocampal microglia is also altered towards a more activated phenotype. These results indicate an important role for IL-1 signaling in maintaining physiological conditions in both neurons and microglia.展开更多
基金supported by the Department of Odontology and the Faculty of Medicine,Umea University,the Folksam Research Foundation and grants from Vasterbotten County Council(TUA)
文摘There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury.Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma.The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders(WADs)with both a qualitative method and quantitative sensory testing(QST).Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women.Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits.Seven test sites in the facial skin(overlying each trigeminal branch bilaterally,and the midpoint of the chin)were examined.The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds.For the WAD patients,the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy,whereas QST systematically showed significantly higher detection thresholds(i.e.,decreased sensitivity)for both cold and warm stimuli.For the individuals who were assessed as having increased sensitivity in the qualitative assessment,the QST displayed either normal or higher thresholds,i.e.,decreased sensitivity.The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method.The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.
基金Health Research Council in the South- East of Sweden Grant no F2004-233
文摘Introduction: Insomnia and depressive symptoms are common among patients with chronic heart failure (HF). Aim: The aim was to describe the prevalence of insomnia and depressive symptoms, as well as to examine the association between insomnia and depressive symptoms in patients with HF. Method: A crosssectional descriptive study including 212 patients with HF. All patients responded to questionnaires regarding sleeping difficulties (Uppsala Sleep Inventory-Chronic Heart Failure), daytime sleepiness (Epworth Sleepiness Scale) and depressive symptoms (The Mental Health Scale). Results: Patients with depressive symptoms (34%) had, compared to those without, significantly more major complaints of insomnia as indicated by the sub-types;non-restorative sleep (66% vs. 32%, p < 0.0001), difficulty in maintaining sleep (35% vs. 16%, p = 0.003), difficulty in initiating sleep (29% vs. 14%, p = 0.009) and early morning awakenings (25% vs. 10%, p = 0.004). The odds ratio (OR) to suffer from depressive symptoms;were for;non-restorative sleep 5.2 (CI 95%, 2.2 - 12.3), difficulties maintaining sleep 2.5 (CI 95%, 1.2 - 4.9), difficulties in initiating sleep 2.2 (CI 95%, 1.1 - 4.4) and early morning awakenings 2.4 (CI 95%, 1.1 - 5.4). When categorising insomnia into three severity groups, 1) non insomnia, 2) mild insomnia, and 3) severe insomnia, the OR for depressive symptoms for the mild insomnia and severe insomnia group were 2.2 (CI 95%, 1.1 - 4.2) and 7.4 (CI 95%, 2.4 - 22.8) respectively, compared to the non insomnia group. Conclusion: Insomnia is independently associated to depressive symptoms. Assessment of depressive symptoms and insomnia in patients with HF is important since treatment could be targeted to depressive symptoms only and/or to the sleep disturbance.
文摘Pediatric cardiac surgery with cardiopulmonary bypass (CPB)-is frequently associated with neurologic deficits. We describe the postoperative EEG changes, assess their possible causes, and evaluate their relevance to neurologic outcome. Thirty-one children and five neonates with congenital heart disease were included. EEG recording started after intubation and continued until 22-96 h after CPB. In addition to conventional analysis, spectral analysis was performed for occipital and frontal electrodes, and differences between pre-and postoperative delta power (delta-δP) were calculated. Maximum values of occipital delta-δP that occurred within 48 h after CPB were correlated with clinical variables and with perioperative markers of oxidative stress and inflammation. Occipital delta-δP correlated with frontal delta-δP, and maximum delta-δP correlated with conventional rating. Distinct rise of δP was detected in 18 of 21 children without any acute or long-term neurologic deficits but only in five of 10 children with temporary or permanent neurologic deficits. Furthermore, maximally registered delta-δP was inversely associated with duration of CPB and postoperative ventilation. Maximal delta-δP was also inversely associated with the loss of plasma ascorbate (as an index of oxidative stress) and plasma levels of IL-6 and IL-8. Slow wave activity frequently occurs within 48 h after CPB. However, our data do not support the notion that EEG slowing is associated with adverse neurologic outcome. This is supported by the fact that EEG slowing was associated with less oxido-inflammatory stress.
基金The Swedish Heart Lung Foundation, Grant 20090547
文摘Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.
基金supported by Swedish Research Council,ALF Grant,Zoega’s,Tore Nilson’s Foundation,and EU’s Seventh Framework Programme(FP7/20072013)(602102).
文摘Temporal lobe seizures generate a large pool of new hippocampal neurons in the adult brain.Their role within the hyperexcitable neuronal network and how they are regulated by the immune response is unclear.Fractalkine and its receptor CX3CR1 constitute a chemokine pathway known to modulate the immune response in temporal lobe epilepsy.Here,6 weeks of intracerebroventricular infusion of anti-CX3CR1 antibody,starting 1 week after electrically induced prolonged seizures in the temporal lobe(status epilepticus(SE)),reduced microglial activation within the hippocampus.
文摘In the present study, we demonstrate that adult mice lacking interleukin- 1 receptor 1 (IL- 1R1) exhibit increased express- ion of both the excitatory scaffolding protein postsynaptic density-95 (PSD-95) and inhibitory scaffolding proteinge- phyrin, respectively, in the hippocampus. The morphology of hippocampal microglia is also altered towards a more activated phenotype. These results indicate an important role for IL-1 signaling in maintaining physiological conditions in both neurons and microglia.