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- Aesoy, M. S., et al.
(författare)
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Epidemiology of persistent iatrogenic spinal cord injuries in Western Norway
- 2016
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279. ; 6:10
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Iatrogenic spinal cord injuries (SCIs) caused by invasive procedures or surgical interventions have previously been reported as case studies. The primary objective of this study was to investigate and analyze the incidence, etiology, and prognosis of iatrogenic SCI in Western Norway. Methods: Medical records of all 183 patients admitted to the SCU between 01.01.2004 and 31.12.2013 were reviewed. Gender, age, diagnosis, iatrogenic medical procedure, symptoms and findings before and after injury, mechanism of injury, level of injury, and ASIA Impairment Scale (AIS) score prior iatrogenic SCI, at admittance and discharge were recorded, as were the length of the period prior to admittance and the length of stay. Results: Twenty-three (12.5%; 14 men, nine women) of 183 patients met the criteria for iatrogenic SCI. The annual incidence rate was estimated 2,3 per 1,000,000 (SD +/-1.0). Mean age at iatrogenic SCI was 55.5 years (range 16-79 years). Intervention for cervical spinal stenosis was the leading cause of iatrogenic SCI, followed by operations on the aorta and spine. Iatrogenic SCIs was most frequently located on the thoracic level. The patients suffered from clinical incomplete injuries (AIS score C and D) both at admittance and discharge from the SCU. Most patients improved, but no patient recovered completely after SCI. Conclusion: Although the annual incidence rate of iatrogenic SCI is low in Norway, individual consequences are serious. Increased awareness of the causes of SCI may decrease the risk of iatrogenic SCI.
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| 4. |
- Franzén, Erika, et al.
(författare)
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Depressive symptoms associated with concerns about falling in Parkinson's disease
- 2016
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279. ; 6:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Concerns about falling, a construct related to fear of falling, is increased in people with Parkinson's disease (PD) and is recognized as a barrier for exercise, negatively affecting health-related quality of life and participation. Aim: To investigate modifiable factors associated with concerns about falling in elderly with mild-to-moderate PD. Methods: Eighty-nine elderly (39 females, mean age 73 years) with mild-to-moderate PD were recruited. Concerns about falling were assessed with the Falls Efficacy Scale-international, that is, the dependent variable in multiple linear regression analysis. Independent variables included both motor (e.g., objective measures of physical activity and gait) and nonmotor aspects such as depressive symptoms. Results: A model with three significant independent variables explained 33% of the variance in concerns about falling. According to the standardized regression coefficients (β), the strongest contributing factor was depressive symptoms (0.40), followed by balance performance (−0.25), and use of mobility devices (0.24). Conclusions: The findings imply that factors associated with concerns about falling are a multifactorial phenomenon. For its management in elderly with mild-to-moderate PD, one should consider depressive symptoms, balance deficits, and mobility devices.
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| 5. |
- Håglin, Lena, et al.
(författare)
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Covariation between plasma phosphate and daytime cortisol in early Parkinson's disease
- 2016
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279 .- 2162-3279. ; 6:12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Disturbed phosphate homeostasis in early Parkinson′s disease (PD) may originate from a stress-related condition and nutritional status among other risk factors, age, and gender.Methods: Risk of malnutrition using Mini-nutritional assessment (MNA score) and plasma levels of protein markers and daytime cortisol at the time of diagnosis in PD (n = 75) were compared with a control group (n = 24). Cognition was assessed using the Mini-Mental State Examination (MMSE score) and motor function using Unified Parkinson′s Disease Rating Scale (UPDRS-part III scale).Results: The patients with PD had significantly lower MNA score than controls which correlated with plasma phosphate levels. The logistic regression revealed that increasing MNA protected from low plasma phosphate, final score (OR = 0.399; 95% CI = 0.196–0.816; p = .012) and total score (OR = 0.656; 95% CI = 0.422–1.018; p = .060). Phosphate correlated with albumin (r = .315; p < .006), transferrin (r = .331; p < .004) and cortisol (r = −0.355; p < .002) confirmed by logistic regressions. Increasing albumin protects from low phosphate after adjusting in logistic regression (OR = 0.806; 95% CI = 0.682–0.952; p = .011) and after including variables from Table 1 in backwards elimination, final step (OR = 0.800; 95% CI = 0.660–0.969; p = .022). MNA total score and cortisol correlated inversely, confirmed in logistic regression for MNA total score (OR = 0.786; 95% CI = 0.627–0.985; p = .037) and for MNA initial score (OR = 0.650; 95% CI = 0.453–0.930; p = .020).Conclusion: This study highlights the importance of phosphate for optimal nutritional status by association with MNA score and albumin in plasma. An inverse relationship between phosphate and cortisol indicate, in addition, that low phosphate levels may affect cognition and motor function in PD.
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| 6. |
- Kleggetveit, Inge P., et al.
(författare)
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Pathological nociceptors in two patients with erythromelalgia-like symptoms and rare genetic Nav 1.9 variants
- 2016
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279 .- 2162-3279. ; 6:10
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The sodium channel Nav 1.9 is expressed in peripheral nociceptors and has recently been linked to human pain conditions, but the exact role of Nav 1.9 for human nociceptor excitability is still unclear. Methods: C-nociceptors from two patients with late onset of erythromelalgia-like pain, signs of small fiber neuropathy, and rare genetic variants of Nav 1.9 (N1169S, I1293V) were assessed by microneurography. Results: Compared with patients with comparable pain phenotypes (erythromelalgia-like pain without Nav-mutations and painful polyneuropathy), there was a tendency toward more activity-dependent slowing of conduction velocity in mechanoinsensitive C-nociceptors. Hyperexcitability to heating and electrical stimulation were seen in some nociceptors, and other unspecific signs of increased excitability, including spontaneous activity and mechanical sensitization, were also observed. Conclusions: Although the functional roles of these genetic variants are still unknown, the microneurography findings may be compatible with increased C-nociceptor excitability based on increased Nav 1.9 function.
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