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| 212. |
- Malm, J, et al.
(författare)
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Cognitive impairment in young adults with infratentorial infarcts.
- 1998
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Ingår i: Neurology. - 0028-3878 .- 1526-632X. ; 51:2, s. 433-40
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe cognitive functions and functional outcome in young patients with isolated infratentorial infarcts.BACKGROUND: Contemporary knowledge implies a cerebellar contribution to cognitive behavior. Neuropsychological examination of patients with selective cerebellar lesions provides an opportunity to document the existence and nature of clinically relevant cognitive manifestations from lesions of the cerebellum.METHODS: Prospective case series. The patients were assessed acutely and at 4 and 12 months after onset. Twenty-four patients from a consecutive series of 105 patients aged 18 to 44 years with cerebral infarction had a brain stem or cerebellar infarction. Fourteen age-matched controls were used for neuropsychological comparisons. Evaluation included MRI, angiography, and transesophageal echocardiography. Disability and neurologic dysfunction were assessed by the modified Rankin scale, NIH stroke scale, and maximal working capacity. A comprehensive neuropsychological battery was performed at baseline in 20 of the 24 patients.RESULTS: Eighteen patients had a cerebellar infarct. Two patients had lateral medullary infarcts, and two isolated pontine infarcts. Twenty-two patients had a favorable outcome according to the modified Rankin scale (grade 0-2) and the NIH scale. In contrast, 12 patients were granted full or partial sick leave at the 4 months follow-up, and 10 patients at 12 months. Patients generally performed worse than controls in various aspects of cognitive function, especially in tasks concerning working memory, the temporary storage of complex information, and cognitive flexibility. Measures of verbal IQ (r = -0.74) and performance IQ (r = -0.78) were related to the size of the infarct. The block design task performance in the early poststroke period predicted maximal working capacity at 12 months.CONCLUSIONS: Cerebellar damage impairs central aspects of attention and visuospatial skills. In contrast, intelligence and episodic memory remain unchanged. When the lesion involves large portions of the cerebellar hemispheres, changes concerning broad areas of intelligence may occur. The prognosis is favorable for neurologic dysfunction, but cognitive deficits may prevent return to work.
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| 213. |
- Marklund, Marie, et al.
(författare)
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The effect of mandibular advancement device on apneas and sleep in patients with obstructive sleep apnea
- 1998
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Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 113, s. 707-713
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the effects of a mandibular advancement device on apneas and sleep in, mild, moderate and severe obstructive sleep apnea. Design: Prospective study. Subjects: Forty-four of 47 patients included. Intervention: Individually adjusted mandibular advancement devices. Measurements: Polysomnographic sleep recordings for 1 night without the device and 1 night with it, with a median of 1 day and no changes in weight, medication, or sleep position between the recordings. Results: The device reduced the median apnea-hypopnea index from 11 (range, 7 to 19) to 5 (range, 0 to 17) (p<0.001) in 21 patients with mild sleep apnea, from 27 (range, 20 to 38) to 7 (range 1 to 19) (p<0.001) in 15 patients with moderate sleep apnea, and from 53 (range 44 to 66) to 14 (range, 2 to 32) (p=<0.05) in 8 patients with severe sleep apnea. The arousal index decreased and the sleep stage patterns improved in all severity groups. Twenty-eight of 44 patients were successfully treated with an obstructive apnea-hypopnea index of below 10 and a subjective reduction in snoring. Nine of 16 patients with treatment failure still reported a reduction in snoring. The success rate correlated inversely to the disease severity (r=-0.41; p<0.01). Conclusions: A mandibular advancement device reduces apnea and improves sleep quality in patients with obstructive sleep apnea, especially in those with mild and moderate disease. A follow-up sleep recording during treatment is necessary because of the risk of silent obstructive apneas without subjective snoring with the device.
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| 214. |
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| 215. |
- Marner, Anders, 1949-
(författare)
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Multimodalitet - medier, kognition och semiotik
- 1998
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Ingår i: Lärarutbildning och forskning i Umeå. - Umeå : Utbildnings- och forskningsnämnden för lärarutbildning i Umeå. - 1104-523X. ; :2, s. 23-39
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Tidskriftsartikel (refereegranskat)
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| 216. |
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| 217. |
- Mårtensson, Johan, et al.
(författare)
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Chromium-51-EDTA clearance in adults with a single-plasma sample
- 1998
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Ingår i: Journal of Nuclear Medicine. - 0161-5505 .- 1535-5667. ; 39:12, s. 2131-2137
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Tidskriftsartikel (refereegranskat)abstract
- In 1996, a committee on renal clearance recommended a mean sojourn time-based methodology for single-sample determination of plasma clearance of 99mTc-diethylenetriamine pentaacetic acid (DTPA) to be used on adults if the patient's glomerular filtration rate (GFR) is suspected to be >30 ml/min. The main purpose of this study was to derive a mean sojourn time-based formula for calculation of 51Cr-ethylenediamine tetraacetic acid (EDTA) clearance in adults. Methods: Two groups of patients with 51Cr-EDTA clearance (CI) between 16 and 172 ml/min were studied. In Group I (n = 46), reference CI was determined as a multi plasma sample, single-injection method (CISM). Sixteen blood samples were drawn from 0 until 5 hr after a single intravenous injection of 51Cr-EDTA. In Group II (n = 1046), reference CI was determined by the Brøchner-Mortensen four-sample clearance method (CIBM). The plasma timeactivity curves of Group I were used to derive two mean sojourn time-based formulas (Formulas 1 and 2) for calculation of a single sample clearance. Formula 1 was derived from the entire time activity curve, whereas the derivation of Formula 2 used only the final slope of the time-activity curve. The accuracy of the two formulas and the Christensen and Groth 99mTc-DTPA formula was tested on Group II. Results: Chromium-51-EDTA CI calculated by Formula 1 was almost identical to the CI calculated by the reference CI method (r = 0.982; SDdiff = 5.82 ml/min). Both 51Cr-EDTA CI calculated by Formula 2 and by the 99mTc-DTPA formula showed close correlation with the reference method (r = 0.976, r = 0.985, respectively) but systematically overestimated GFR for the whole range of clearance values by 3.5 and 3.2 ml/min (p < 0.001), respectively. Conclusion: It is possible to get an accurate determi nation of 51Cr-EDTA CI from a single-plasma sample in adults by the mean sojourn time methodology. The determination is marginally more accurate (p < 0.001) if using a formula derived from the entire plasma time-activity curve than from only the final slope. The single-sample formula derived for determination of 99mTc-DTPA CI tends slightly to overestimate GFR if used to calculate 51Cr-EDTA CI.
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