| 1. |
- Baad-Hansen, L, et al.
(författare)
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Blink reflexes in patients with atypical odontalgia
- 2005
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Ingår i: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 19:3, s. 239-247
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To use the human blink reflex (BR) to explore possible neuropathic pain mechanisms in patients with atypical odontalgia (AO). Methods: In 13 AO patients, the BR was elicited using a concentric electrode and recorded bilaterally with surface electromyographic (EMG) electrodes on both orbicularis oculi muscles. Electrical stimuli were applied to the skin above branches of the V1, V2, and V3 nerves and to the V branch contralateral to the painful branch. Sensory and pain thresholds were determined. The BR examination of the painful V branch was repeated during a capsaicin pain-provocation test. The data were analyzed with nonparametric statistics. Results: The BR responses (R2 and R3) evoked by stimulation of V3 were significantly smaller than the BR responses evoked by stimulation of V1 and V2 (P < .004). There were no differences in BR (R2 or R3) between the painful and nonpainful sides (P > .569), and the BR (R2 and R3) was not significantly modulated by experimental pain (P > .080). The sensory thresholds were significantly lower on the painful side compared to the nonpainful side (P = .014). The pain thresholds were not different between sides (P > .910). Conclusion: No major differences between the V nociceptive pathways on the right and left sides were found in a relatively small group of AO patients. Future studies that compare BRs in AO patients and healthy volunteers are needed to provide further knowledge on the pain mechanisms in AO.
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| 2. |
- Baad-Hansen, Lene, et al.
(författare)
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Blink reflexes in patients with atypical odontalgia
- 2005
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 19:3, s. 223-247
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To examine the blink reflex (BR) evoked by stimulation of the trigeminal (V) nerve branches, to examine the painful V branch before and during a pain provocation test, and to compare the painful and the contra lateral non-painful branch in patients with atypical odon-talgia (AO). Methods: In thirteen patients with AO, the BR was elicited with the use of a concentric electrode and recorded bilaterally with surface EMG electrodes on both orbicularis oculi muscles. Electrical stimuli were applied to the skin above the V1, V2 and V3 nerve branches and to the V branch contralateral to the painful branch. The sensory and pain thresholds were determined. The BR examination of the painful V branch was repeated during a capsaicin pain provocation test. The data were analysed with use of non-parametric statistics. Results: The BR responses evoked by stimulation of the V3 were significantly lower than the BR responses evoked by stimulation of the V1 and V2 (P < 0.004). There were no differences in BR between the painful and non-painful side (P > 0.569), and the BR was not significantly modulated by experimental pain (P > 0.080). The sensory thresholds were significantly lower on the painful side compared to the non-painful side (P = 0.017). The pain thresholds were not different between sides (P > 0.910). Conclusion: These preliminary findings did not indicate major differences in the V nociceptive pathways between sides in AO patients. Future studies comparing the BR in AO patients with healthy volunteers are needed to provide further knowledge on the pain mechanisms in AO.
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| 3. |
- Baad-Hansen, Lene, et al.
(författare)
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Comparison of clinical findings and psychosocial factors in patients with atypical odontalgia and temporomandibular disorders
- 2008
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To systematically compare clinical findings and psychosocial factors between patients suffering from atypical odontalgia (AO) and an age- and gender-matched group of patients with temporomandibular disorders (TMD).Methods: Forty-six AO patients (7 men and 39 women, mean age, 56 years) were compared with 41 TMD patients (8 men and 33 women, mean age, 58 years). Results: Mean pain intensity at the time of inclusion in the study was similar between the groups (TMD: 5.3 ± 0.4, AO: 5.0 ± 0.3), but pain duration was longer in AO patients (AO: 7.7 ± 1.1 years, TMD: 4.5 ± 0.1 years). Eighty-three percent of the AO patients and 15% of TMD patients reported pain onset in relation to dental/surgical procedures. Episodic tension-type headache (TTH) occurred equally in both groups (TMD: 46%, AO: 46%), but TMD patients more frequently experienced chronic TTH (TMD: 35%, AO: 18%), myofascial TMD (TMD: 93%, AO: 50%), and temporomandibular joint disorders (TMD: 66%, AO: 2%). Overall, TMD patients had lower pressure pain thresholds and poorer jaw function than AO patients. Mean depression and somatization scores were moderate to severe in both groups, and widespread pain was most common in TMD patients.Conclusion: AO and TMD share some characteristics but differ significantly in report of dental trauma, jaw function, pain duration, and pain site.
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| 4. |
- Baron, Ralf, et al.
(författare)
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5% lidocaine medicated plaster versus pregabalin in post-herpetic neuralgia and diabetic polyneuropathy : an open-label, non-inferiority two-stage RCT study
- 2009
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Ingår i: CURRENT MEDICAL RESEARCH AND OPINION. - : Informa Healthcare. - 0300-7995 .- 1473-4877. ; 25:7, s. 1663-1676
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare efficacy and safety of 5% lidocaine medicated plaster with pregabalin in patients with post-herpetic neuralgia (PHN) or painful diabetic polyneuropathy (DPN). Study design and methods: This was a two-stage adaptive, randomized, open-label, multicentre, non-inferiority study. Data are reported from the initial 4-week comparative phase, in which adults with PHN or painful DPN received either topical 5% lidocaine medicated plaster applied to the most painful skin area or twice-daily pregabalin capsules titrated to effect according to the Summary of Product Characteristics. The primary endpoint was response rate at 4 weeks, defined as reduction averaged over the last three days from baseline of greater than= 2 points or an absolute value of less than= 4 points on the 11-point Numerical Rating Scale (NRS-3). Secondary endpoints included 30% and 50% reductions in NRS-3 scores; change in allodynia severity rating; quality of life (QoL) parameters EQ-5D, CGIC, and PGIC; patient satisfaction with treatment; and evaluation of safety (laboratory parameters, vital signs, physical examinations, adverse events [AEs], drug-related AEs [DRAEs], and withdrawal due to AEs). Results: Ninety-six patients with PHN and 204 with painful DPN were analysed (full analysis set, FAS). Overall, 66.4% of patients treated with the 5% lidocaine medicated plaster and 61.5% receiving pregabalin were considered responders (cor-responding numbers for the per protocol set, PPS: 65.3% vs. 62.0%). In PHN more patients responded to 5% lidocaine medicated plaster treatment than to pregabalin (PPS: 62.2% vs. 46.5%), while response was comparable for patients with painful DPN (PPS: 66.7% vs 69.1%). 30% and 50% reductions in NRS-3 scores were greater with 5% lidocaine medicated plaster than with pregabalin. Both treatments reduced allodynia severity. 5% lidocaine medicated plaster showed greater improvements in QoL based on EQ-5D in both PHN and DPN. PGIC and CGIC scores indicated greater improvement for 5% lidocaine medicated plaster treated patients with PHN. Improvements were comparable between treatments in painful DPN. Fewer patients administering 5% lidocaine medicated plaster experienced AEs (safety set, SAF: 18.7% vs. 46.4%), DRAEs (5.8% vs. 41.2%) and related discontinuations compared to patients taking pregabalin. Conclusion: 5% lidocaine medicated plaster showed better efficacy compared with pregabalin in patients with PHN. Within DPN, efficacy was comparable for both treatments. 5% lidocaine medicated plaster showed a favourable efficacy/safety profile with greater improvements in patient satisfaction and QoL compared with pregabalin for both indications, supporting its first line position in the treatment of localized neuropathic pain.
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| 5. |
- Baron, R., et al.
(författare)
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Efficacy and safety of 5% lidocaine (lignocaine) medicated plaster in comparison with pregabalin in patients with postherpetic neuralgia and diabetic polyneuropathy : Interim analysis from an open-label, two-stage adaptive, randomized, controlled trial
- 2009
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Ingår i: Clinical Drug Investigation. - : Springer Science and Business Media LLC. - 1173-2563. ; 29:4, s. 231-241
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Tidskriftsartikel (refereegranskat)abstract
- Background and objective: Postherpetic neuralgia (PHN) and diabetic polyneuropathy (DPN) are two common causes of peripheral neuropathic pain. Typical localized symptoms can include burning sensations or intermittent shooting or stabbing pains with or without allodynia. Evidence-based treatment guidelines recommend the 5% lidocaine (lignocaine) medicated plaster or pregabalin as first-line therapy for relief of peripheral neuropathic pain. This study aimed to compare 5% lidocaine medicated plaster treatment with pregabalin in patients with PHN and patients with DPN. Methods: The study was a two-stage, adaptive, randomized, controlled, open-label, multicentre trial that incorporated a drug wash-out phase of up to 2 weeks prior to the start of the comparative phase. At the end of the enrolment phase, patients who fulfilled the eligibility criteria were randomized to either 5% lidocaine medicated plaster or pregabalin treatment and entered the 4-week comparative phase. The interim analysis represents the first stage of the two-stage adaptive trial design and was planned to include data from the comparative phase for the first 150 randomized patients of the 300 total planned for the trial. Patients aged =18 years with PHN or DPN were recruited from 53 investigational centres in 14 European countries. For this interim analysis, 55 patients with PHN and 91 with DPN (full-analysis set [FAS}), randomly assigned to the treatment groups, were available for analysis. Topical 5% lidocaine medicated plaster treatment was administered by patients to the area of most painful skin. A maximum of three or four plasters were applied for up to 12 hours within each 24-hour period in patients with PHN or DPN, respectively. Pregabalin capsules were administered orally, twice daily. The dose was titrated to effect: all patients received 150 mg/day in the first week and 300 mg/day in the second week of treatment. After 1week at 300 mg/day, the dose of pregabalin was further increased to 600 mg/day in patients with high pain intensity scores. The pre-planned primary study endpoint was the rate of treatment responders, defined as completing patients experiencing a reduction from baseline of =2 points or an absolute value of =4 points on the 11-item numerical rating scale of recalled average pain intensity over the last 3 days (NRS-3), after 4 weeks of treatment. Secondary endpoints included =30% and =50% reductions in NRS-3 scores, changes in neuropathic pain symptom inventory (NPSI) scores and allodynia severity ratings. Results: Overall, 65.3% of patients treated with the 5% lidocaine medicated plaster and 62.0% receiving pregabalin responded to treatment with respect to the primary endpoint. A higher proportion of PHN patients responded to plaster treatment compared with pregabalin (63.0% vs 37.5%), whereas in the larger DPN group treatments were comparable. Both treatments improved NPSI scores and reduced allodynia severity. Patients administering lidocaine plaster experienced fewer drug-related adverse events (3.9% vs 39.2%) and there were substantially fewer discontinuations due to drug-related adverse events (1.3% vs 20.3%). Conclusion: After 4 weeks, 5% lidocaine medicated plaster treatment was associated with similar levels of analgesia in patients with PHN or DPN but substantially fewer frequent adverse events than pregabalin.
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| 6. |
- Baron, Ralf, et al.
(författare)
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Efficacy and safety of combination therapy with 5% lidocaine medicated plaster and pregabalin in post-herpetic neuralgia and diabetic polyneuropathy
- 2009
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Ingår i: CURRENT MEDICAL RESEARCH AND OPINION. - : Informa Healthcare. - 0300-7995 .- 1473-4877. ; 25:7, s. 1677-1687
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Neuropathic pain is often difficult to treat due to a complex pathophysiology. This study evaluated the efficacy, tolerability and safety of combination therapy with 5% lidocaine medicated plaster and pregabalin for neuropathic pain in patients with post-herpetic neuralgia (PHN) or painful diabetic polyneuropathy (DPN). Methods: Patients completing 4-week monotherapy with 5% lidocaine medicated plaster or pregabalin were enrolled in an 8-week combination phase. Patients with adequate response to monotherapy (recalled average pain intensity of 4 or less on 11-point numeric rating scale in the previous 3 days [NRS-3 score]) continued their previous therapy, whereas those with insufficient response received combination therapy. Efficacy endpoints included change in NRS-3 from combination phase baseline, Patient and Clinical Global Impression of Change (PGIC/CGIC), and patients satisfaction with treatment. Safety evaluation included adverse events (AEs), drug-related AEs (DRAEs), and withdrawal due to AEs. Clinical trial registration: EudraCT No. 2006-003132-29. Results: Of 229 patients in the per-protocol set(PPS: 68 PHN and 161 DPN), 71 received 5% lidocaine medicated plaster monotherapy, 57 had pregabalin added to 5% lidocaine medicated plaster, 57 pregabalin monotherapy and 44 received 5% lidocaine medicated plaster in addition to continued pregabalin treatment. There were no meaningful differences in demographic data between the treatment groups. Patients continuing on monotherapy demonstrated additional decreases in NRS-3 scores. Patients receiving combination therapy achieved clinically relevant reduction in NRS-3 values in addition to improvement achieved during the 4 weeks of monotherapy. Improvement was similar between the two combination therapy groups. Considerable improvements in patients treatment satisfaction were reported. Incidences of AEs were in line with previous reports for the two treatments and combination therapy was generally well tolerated. Conclusions: In patients with PHN and painful DPN failing to respond to monotherapy, combination therapy with 5% lidocaine medicated plaster and pregabalin provides additional clinically relevant pain relief and is safe and well-tolerated.
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| 7. |
- Behrens, Anders, et al.
(författare)
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The Computerized General Neuropsychological INPH Test (CoGNIT) revealed improvement in Idiopathic Normal Pressure Hydrocephalus (INPH) after shunt surgery
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundWe have developed the COmputerized General Neuropsychological INPH Test (CoGNIT) dedicated for patients with idiopathic normal pressure hydrocephalus (INPH). Previously, validity and reliability of included tests have been established. The aim was to evaluate the battery’s sensitivity to detect cognitive changes after shunt surgery in INPH patients.MethodsPreoperatively, thirty-one INPH patients were given CoGNIT, which includes tests assessing memory, executive functions, attention, manual dexterity and psychomotor speed. CoGNIT also includes the Geriatric Depression Scale (GDS). Re-examination was done four months after shunt surgery. Scores and test completion were examined and compared to healthy elderly (n=44).ResultsPreoperative INPH test results were significantly lower in all tests compared to healthy. Improvements after shunt surgery were seen in all cognitive domains: memory (Ten-word list test, p<0,01), executive functions (Stroop incongruent, (p<0.05), attention (Two choice reaction test, p<0.01), psychomotor speed (Stroop congruent, p<0.05) and manual dexterity (Four- finger tapping, p<0.01). No ceiling effects were observed. Depressive symptoms were more common in INPH versus healthy and did not change postoperatively. Preoperatively 81 % of INPH patients completed at least eight of the nine included test.ConclusionsCoGNIT is sensitive to cognitive impairment and to investigate changes after shunt surgery in INPH. Completion rates are good. CoGNIT has a potential to be useful in the cognitive assessment of INPH.
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| 8. |
- Behrens, Anders, et al.
(författare)
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The Computerized General Neuropsychological INPH Test revealed improvement in idiopathic normal pressure hydrocephalus after shunt surgery
- 2020
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Ingår i: Journal of Neurosurgery. - : AMER ASSOC NEUROLOGICAL SURGEONS. - 0022-3085 .- 1933-0693. ; 132:3, s. 733-740
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE The Computerized General Neuropsychological INPH Test (CoGNIT) provides the clinician and the researcher with standardized and accessible cognitive assessments in patients with idiopathic normal pressure hydrocephalus (INPH). CoGNIT includes tests of memory, executive functions, attention, manual dexterity, and psychomotor speed. Investigations of the validity and reliability of CoGNIT have been published previously. The aim of this study was to evaluate CoGNIT's sensitivity to cognitive change after shunt surgery in patients with INPH.METHODS Forty-one patients with INPH (median Mini-Mental State Examination score 26) were given CoGNIT preoperatively and at a postoperative follow-up 4 months after shunt surgery. Scores were compared to those of 44 healthy elderly control volunteers. CoGNIT was administered by either a nurse or an occupational therapist.RESULTS Improvement after shunt surgery was seen in all cognitive domains: memory (10-word list test, p < 0.01); executive functions (Stroop incongruent color and word test, p < 0.01); attention (2-choice reaction test, p < 0.01); psychomotor speed (Stroop congruent color and word test, p < 0.01); and manual dexterity (4-finger tapping, p < 0.01). No improvement was seen in the Mini-Mental State Examination score. Preoperative INPH test scores were significantly impaired compared to healthy control subjects (p < 0.001 for all tests).CONCLUSIONS In this study the feasibility for CoGNIT to detect a preoperative impairment and postoperative improvement in INPH was demonstrated. CoGNIT has the potential to become a valuable tool in clinical and research work.
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| 9. |
- Danielsson, Oskar, 1975-
(författare)
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Wave Energy Conversion : Linear Synchronous Permanent Magnet Generator
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis studies the electric aspects of a linear synchronous permanent magnet generator. The generator is designed for use in a wave energy converter, which determines the fundamental requirements of the generator. The electromagnetic properties of the generator are investigated with a finite element based simulation tool. These simulations formed the base of the design and construction of a laboratory prototype. Several experiments where conducted on the prototype generator. The results verify at large the simulation tool. However, a difference between the measured and simulated air gap flux was discovered. This was attributed to the longitudinal ends of the generator, which are ignored in the simulation tool. Experiences from the construction, and further finite element studies, led to a significant change in the support structure of the first offshore prototype generator. A complete wave energy converter was constructed and launched, the 13th of March, on the west coast of Sweden. A study of the load resistance impact on the power absorption has been carried out. An optimal load interval, with regard to power absorption, has been identified. Furthermore, the generator has proofed to withstand short term overload several times larger than the nominal load. Finally, the longitudinal ends’ influence on the flux distribution was investigated with an analytical model, as well as finite element simulations. A possible problem with large induction of eddy currents in the actuator back steel was identified.This work is a part of a larger project, which aims do develop a viable wave energy conversion system.
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| 10. |
- Hai, Ling
(författare)
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Hydrodynamic Modelling of Wave Power using Electrical Equivalent Circuit Theory
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Ocean wave energy can be harnessed and converted into electric energy nowadays. This provides a possibility for populations that live on islands or along coastlines to utilize the renewable and safe power produced by ocean waves. Point absorbing wave energy converter (WEC) is one example of such devices for electrical power production from ocean waves. It is composed of a floating buoy on the water surface, and a linear generator that sits on seabed and is connected with the buoy via a line. Electricity is generated when the buoy moves up and down in the waves.The geometry and dimensions of the floating buoy have dominant influences on the energy absorption. This thesis introduces an equivalent electric circuit for modelling the hydrodynamic interaction between the wave and a cylindrical buoy. The model allows a rapid assessment of the velocity, force in the connection line and output power, by which the system design and optimization can be performed faster and easier.The electric circuit model is based on the WEC's dynamic force analysis, and the electric components' parameters are determined from analytical approximations of the hydrodynamic coefficients. The simulation results of the equivalent circuit for one typical wave climate in Lysekil has been presented, and the results indicate a good fitting with former experimental results.The thesis also includes a hydrodynamic study for a torus shaped buoy, which aims at applying a theoretical background for a force measurement experiment. A comparison has been conducted between the torus buoy and two similar cylindrical buoys. Preliminary WAMIT simulation results demonstrate that the force in the connection line will be 5% bigger by using the torus buoy. It is also found that the torus buoy is advantageous for its larger excitation force and smaller added mass. A brief introduction of the 500kN force measurement system and the communication test have been introduced as well.
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