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- Berg, Thomas, 1975-
(författare)
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Medical Treatment and Grading of Bell's Palsy
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aim of this thesis was to evaluate the effect of prednisolone and valaciclovir in a large number of Bell's palsy patients. The incidence and intensity of pain around the ear, in the face or in the neck during the first two months of palsy, and its prognostic value, was also assessed. We also investigated how study design and choice of analysis method affect the rate of facial recovery. Furthermore, the agreement between the Sunnybrook, House-Brackmann and Yanagihara facial grading systems was evaluated. From May 2001 to September 2007, a prospective, randomised, double-blind, placebo-controlled, multicentre trial with 12-month follow-up was performed in patients with Bell's palsy. Of 839 randomised patients, 829 were included in the intention-to-treat analysis; 206 received placebo plus placebo, 210 prednisolone plus placebo, 207 valaciclovir plus placebo, and 206 prednisolone plus valaciclovir. Time to recovery was significantly shorter in the 416 patients who received prednisolone compared with the 413 who did not (p<0.0001). At 12 months, 300 of 416 patients (72%) in the prednisolone group had recovered compared with 237 of 413 patients (57%) in the no prednisolone group (p<0.0001). Valaciclovir was not found to affect time to facial recovery or outcome at 12 months. Prednisolone and/or valaciclovir did not affect the incidence or intensity of pain. Presence of pain at day 11 to 17 indicated a worse prognosis for facial recovery at 12 months. We also found that recovery rates in a Bell's palsy trial are substantially affected by the choice of analysis method and definition of facial recovery. We used weighted Kappa statistics in 100 examinations of patients with facial palsy to assess the agreement between the Sunnybrook, House-Brackmann and Yanagihara scales. The highest agreement was found between the regional Sunnybrook and Yanagihara scales. An evaluative difference between the Sunnybrook and House-Brackmann systems was observed.
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| 2. |
- Lindkvist, Jesper, 1986-
(författare)
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Plasma Interactions with Icy Bodies in the Solar System
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Here I study the “plasma interactions with icy bodies in the solar system”, that is, my quest to understand the fundamental processes that govern such interactions. By using numerical modelling combined with in situ observations, one can infer the internal structure of icy bodies and their plasma environments.After a broad overview of the laws governing space plasmas a more detailed part follows. This contains the method on how to model the interaction between space plasmas and icy bodies. Numerical modelling of space plasmas is applied to the icy bodies Callisto (a satellite of Jupiter), the dwarf planet Ceres (located in the asteroid main belt) and the comet 67P/Churyumov-Gerasimenko.The time-varying magnetic field of Jupiter induces currents inside the electrically conducting moon Callisto. These create magnetic field perturbations thought to be related to conducting subsurface oceans. The flow of plasma in the vicinity of Callisto is greatly affected by these magnetic field perturbations. By using a hybrid plasma solver, the interaction has been modelled when including magnetic induction and agrees well with magnetometer data from flybys (C3 and C9) made by the Galileo spacecraft. The magnetic field configuration allows an inflow of ions onto Callisto’s surface in the central wake. Plasma that hits the surface knocks away matter (sputtering) and creates Callisto’s tenuous atmosphere.A long term study of solar wind protons as seen by the Rosetta spacecraft was conducted as the comet 67P/Churyumov-Gerasimenko approached the Sun. Here, extreme ultraviolet radiation from the Sun ionizes the neutral water of the comet’s coma. Newly produced water ions get picked up by the solar wind flow, and forces the solar wind protons to deflect due to conservation of momentum. This effect of mass-loading increases steadily as the comet draws closer to the Sun. The solar wind is deflected, but does not lose much energy. Hybrid modelling of the solar wind interaction with the coma agrees with the observations; the force acting to deflect the bulk of the solar wind plasma is greater than the force acting to slow it down.Ceres can have high outgassing of water vapour, according to observations by the Herschel Space Observatory in 2012 and 2013. There, two regions were identified as sources of water vapour. As Ceres rotates, so will the source regions. The plasma interaction close to Ceres depends greatly on the source location of water vapour, whereas far from Ceres it does not. On a global scale, Ceres has a comet-like interaction with the solar wind, where the solar wind is perturbed far downstream of Ceres.
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| 3. |
- Svensson, Malin, 1965-
(författare)
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Snoring and Sleep Apnea in Women : Risk Factors, Signs and Consequences
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Obstructive sleep apnea syndrome (OSAS) is characterized by snoring, apneas and excessive daytime sleepiness (EDS). Obesity is a risk factor for snoring and sleep apnea, but data on other factors in relation to obesity are ambiguous. Symptoms of sleep apnea in women have not been fully elucidated. OSAS is an important risk factor for cardiovascular disease (CVD). A common feature in patients with CVD and sleep apnea is an increase in systemic inflammation.From the general population 7,051 women ≥ 20 years answered a questionnaire on snoring and sleep disturbances. Habitual snoring was found in 8% of the total population, and influenced by age, obesity and smoking. The highest prevalence (14%) was found in women 50-59 years. In lean women, alcohol dependence was associated with snoring, while physical inactivity was a risk factor for snoring in obese women.Further, 230 snoring women and 170 women regardless of snoring status were investigated with polysomnography, blood sampling and anthropometric measurements. Of these, 132 participants underwent an ocular and endoscopic examination of their upper airways. Several findings in the upper airways characterised normal-weight women with an apnea-hypopnea index (AHI) ≥ 10. In women with BMI of > 25, no pharyngeal characteristics predicted sleep apnea.When adjusting for age, obesity, smoking, AHI and sleep parameters, several aspects of daytime sleepiness correlated to snoring independently of AHI (EDS, falling asleep involuntarily during day, waking up unrefreshed and fatigue). No symptoms correlated to AHI independently of snoring.Blood samples were analysed for systemic inflammation (CRP, TNFα, IL-6, myeloperoxidase (MPO) and lysozyme). Strong correlations were found between obesity and inflammatory markers. AHI and nocturnal hypoxia correlated to all markers except MPO. When adjusting for age, obesity and smoking, only IL-6 and TNFα were independently associated with nocturnal hypoxia.In conclusion, age and obesity influence the prevalence of snoring and sleep apnea in women from the general population. Other risk factors differ according to BMI. Daytime symptoms are independently related to snoring per se. Despite a strong correlation between obesity and inflammation, an independent relationship between sleep apnea and inflammatory markers was found.
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