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1.
  • Eskafi, Mahmoud, et al. (författare)
  • Treatment of sleep apnea in congestive heart failure with a dental device - The effect on brain natriuretic peptide and quality of life
  • 2006
  • Ingår i: Sleep and Breathing. - Springer. - 1520-9512. ; 10:2, s. 90-97
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to investigate the effect of a mandibular advancement device (MAD) for the treatment of sleep apnea (SA) on plasma brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), and health-related qualify of life (HRQL) in patients with mild to moderate stable congestive heart failure (CHF). Seventeen male patients aged 68.4 +/- 5.5 with an apnea-hypopnea index (AHI) = 10 were equipped with an individually fitted MAD. SA was evaluated using a portable respiratory multirecording system before and after the initiation of treatment. Eleven patients completed follow-up and were evaluated after 6 months of treatment. The AHI reduced from 25.4 +/- 10.3 to 16.5 +/- 10.0 (p = 0.033) compared to baseline and mean plasma BNP levels decreased from 195.8 +/- 180.5 pg/ml to 148.1 +/- 139.9 pg/ml (p = 0.035). SA-related symptoms, e. g., excessive daytime sleepiness, were also reduced (p = 0.003). LVEF and HRQL were unchanged. We conclude that SA treatment with a MAD on patients with mild to moderate stable CHF appears to result in the reduction of plasma BNP levels. Further studies to investigate if the observed reduction in BNP concentrations also result in improved prognosis are warranted.
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2.
  • Limchaichana, Napat, et al. (författare)
  • Clinical diagnoses and MRI findings in patients with TMD pain
  • 2007
  • Ingår i: Journal of Oral Rehabilitation. - Blackwell Publishing Ltd. - 0305-182X. ; 34:4, s. 237-245
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to compare the findings on magnetic resonance imaging (MRI) in temporomandibular disorders (TMD) pain patients with clinical diagnoses of myofascial pain or arthralgia/osteoarthritis in combination with myofascial pain according to the Research Diagnostic Criteria for TMD. The temporomandibular joints of 60 consecutive patients, 19 with myofascial pain and 41 patients with arthralgia/osteoarthritis in combination with myofascial pain were examined clinically and with MRI. Overall the most common MRI findings were different kinds of disc displacements and structural bone changes, which were found in both pain groups. However, disc displacements were found significantly (P = 0.002) more often in the group arthralgia/osteoarthritis in combination with myofascial pain. One hundred and four joints were found to have no clinical diagnosis of disc displacements, but 64 of these joints had findings of disc displacements on MRI. Joint fluid was found in both pain groups Patients having a combination of disc displacement and joint fluid were significantly (P = 0.047) more common in the pain group arthralgia/osteoarthritis in combination with myofascial pain. In conclusion, the MRI findings of different kinds of disc displacement and structural bone changes were common in TMD patients. The clinical diagnoses for subdivision into myogenous only or combined arthrogenous and myogenous pain groups were not confirmed by MRI
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3.
  • Eskafi, Mahmoud, et al. (författare)
  • Use of a mandibular advancement device in patients with congestive heart failure and sleep apnoea.
  • 2004
  • Ingår i: Gerodontology. - Blackwell Publishing. - 0734-0664. ; 21:2, s. 100-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To evaluate the practical use of the mandibular advancement device (MAD) for treatment of sleep apnoea (SA) in patients with congestive heart failure (CHF) over 1 year. Subjects: Twentyfive patients aged 66 ± 8 years (mean ± SD) met the inclusion criteria and were included in the study. Design: In a prospective, clinical trial, the apnoea-hypopnoea index (AHI), a measure of SA, was determined with a portable device. Failure to enter treatment and compliance, adverse events and signs and symptoms of temporomandibular disorders (TMD) were examined before intervention and 4-6 weeks, 6 months and 1 year after intervention. Results: Six patients had removable dentures of whom four had complete dentures. Before treatment, eight patients reported minor symptoms of TMD. The AHI fell from 19.3 ± 12.1 to 11.8 ± 9.5 (p = 0.004) with use of the device. In most patients, use of the MAD had no severe effects on the signs and symptoms of TMD. Adverse events such as pain in the temporomandibular joints, soreness in the teeth, and tiredness in the jaws were reported by ten patients. Dental complications were observed in two patients. Sixtyfour per cent of the patients were still using the MAD at the 1-year follow-up. Conclusion: both the general and oral health of CHF patients were important in treatment with a MAD. The MAD therapy had no severe effect on the masticatory system and edentulous patients could be treated.
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4.
  • Wolf, Eva, et al. (författare)
  • Nonspecific Chronic Orofacial Pain: Studying Patient Experiences and Perspectives with a Qualitative Approach
  • 2008
  • Ingår i: Journal Of Orofacial Pain. - Quintessence Publishing Co Inc. - 1064-6655. ; 22:4, s. 349-358
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To analyze the nonspecific chronic orofacial pain patient's experience of the pain condition and to gain knowledge on the complexity of the problem. Methods: Fourteen patients (1 I female, 3 male) aged 21 to 77 years were selected among those referred to a specialist clinic. All selected patients agreed to participate. Data were obtained through thematic in-depth interviews that exposed the context of the orofacial pain condition. The 2 interviews with each patient were audiotaped and transcribed verbatim. The text material was analyzed using a qualitative research strategy based on phenomenology. Results: The essence of the chronic orofacial pain was expressed by the patients as something that eludes perception and comprehension. The pain was difficult to grasp and to communicate, The consequence of the pain was experienced by the patients as to be stricken by the pain and was expressed as living a life permeated by hopelessness, resignation, and a lack of faith. Conclusion: The patients in this study experienced their chronic orofacial pain to have no limits and to repressively permeate all aspects of their existence: social, practical, and emotional. J OROFAC PAIN 2008;22:349-358
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5.
  • Wolf, Eva, et al. (författare)
  • Patients' experiences of consultations for nonspecific chronic orofacial pain: A phenomenological study
  • 2006
  • Ingår i: Journal of Orofacial Pain. - Quintessence Publishing. - 1064-6655. ; 20:3, s. 226-233
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To use a qualitative research study to analyze the experiences of patients with nonspecific chronic orofacial pain with respect to consultations for their pain condition. Methods: Fourteen patients (11 women and 3 men; age range, 21 to 77 years) were strategically selected through a purposive sampling of the chronic orofacial pain patients referred to the Orofacial Pain Unit at the Faculty of Odontology, Malmo University, Malmo, Sweden. A qualitative research strategy based on phenomenological philosophy was chosen. Thematic in-depth interviews were conducted twice with each patient in order to expose the context of the orofacial pain condition. The interviews were audiotaped and transcribed verbatim. The text material was analyzed to determine the attitude of the patients concerning their experience from the consultations. Results: All selected patients consented to participate. The patients expressed dissatisfaction with the consultations and related many examples of poor communication and understanding. The patients also felt a great need to be taken care of and expressed contradictory statements concerning pain improvement. Conclusion: The results suggest that the communication between the patients and the care providers was unsatisfactory and that the patients were limited in their ability to develop a personal coping strategy.
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