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- Erik, Stålberg
(författare)
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Between genetics and biology. Is ENMG useful in peripheral neuropathy diagnosis and management?
- 2016
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Ingår i: Revue neurologique (Paris). - : Elsevier BV. - 0035-3787 .- 2213-0004. ; 172:10, s. 627-631
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Tidskriftsartikel (refereegranskat)abstract
- Neurography and EMG are complementary techniques used in the diagnosis and monitoring of neuropathies. Both assess function of the peripheral nervous system and provide clinically useful information regarding the functional status of peripheral nerves. This information is not readily obtainable using biochemical, genetic or imaging techniques. I will discuss the role of these techniques in the diagnosis and management of neuropathies and some limitations of these techniques. These methods are routinely used in an EMG lab. These are most useful when used in conjunction with clinical examination to answer a well-defined clinical question. Reference values are required for interpretation of the data.
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| 2. |
- Feasson, L., et al.
(författare)
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Exercise therapy and myopathies
- 2010
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Ingår i: Revue neurologique (Paris). - : Elsevier BV. - 0035-3787 .- 2213-0004. ; 166:3, s. 269-278
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Forskningsöversikt (refereegranskat)abstract
- Since the first consensus papers published early in the 2000s, a growing number of recent publications has shown that adapted physical activity is not only safe in the context of myopathy but also potentially effective as a therapeutic tool. After a short recall of the different exercise modalities, the mechanical strain they induce and the expected muscular benefits, the present paper reviews the different studies related to exercise therapy in myopathic patients and provides a critical analysis of the topic. Myopathies are rare diseases with many different etiologies and a large number of training modalities which could be useful for the different muscular challenges have been proposed. We have chosen to focus on several specific training modalities and to discuss the results from the most recent papers. The purpose of this review is to, firstly, update physical training guidelines for patients with myopathy and, secondly, highlight some common pitfalls associated with this strategy. This is particularly important for medical and allied professionals involved in prescribing and managing exercise therapy protocols. (C) 2009 Elsevier Masson SAS. All rights reserved.
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| 3. |
- Landtblom, Anne-Marie, et al.
(författare)
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Organic solvent exposure as a risk factor for multiple sclerosis : An updated review
- 2019
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Ingår i: Revue neurologique (Paris). - Issy les Moulineaux Cedex, France : Elsevier BV. - 0035-3787 .- 2213-0004. ; 175:10, s. 625-630
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Forskningsöversikt (refereegranskat)abstract
- Organic solvents exposure has for a long time been suspected as a risk factor for developing multiple sclerosis. The evidence, containing case reports, case-control studies and cohort studies has been contradictory. An early meta-analysis, however, pointed to a doubled risk for MS. Recent major case-control studies confirm this, but also have elucidated the risk pattern, being dependent on another risk factor, i.e. smoking.
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| 4. |
- Savarese, Gianluigi, et al.
(författare)
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Incidence, Predictors, and Outcome Associations of Dyskalemia in Heart Failure With Preserved, Mid-Range, and Reduced Ejection Fraction
- 2019
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Ingår i: JACC. Heart failure. - : ELSEVIER SCI LTD. - 2213-1779 .- 2213-1787. ; 7:1, s. 65-76
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES This study investigated 1-year incidence and predictors of dyskalemia (dysK) and its outcome associations in heart failure with preserved ejection fraction (HFpEF), HF with mid-range EF (HFmrEF), and HF with reduced EF (HFrEF). BACKGROUND DysK in real-world HF is insufficiently characterized. Fear of dyskalemia may lead to underuse or underdosing of renin-angiotensin-aldosterone system inhibitors. METHODS Patients enrolled in the SwedeHF (Swedish Heart Failure) Registry from 2006 to 2011 in Stockholm, Sweden were included in the analyses. Multivariate Cox regression analysis identified independent predictors of dysK within 1 year. Time-dependent Cox models assessed outcomes associated with incident dysK (all-cause death, HF, and other cardiovascular disease [CVD] hospitalizations) within 1 year from baseline. RESULTS Of 5,848 patients, 24.4% experienced hyperkalemia (hyperK [K amp;gt; 5.0 mmol/l]) at least once, and 10.2% had moderate or severe hyperK (K amp;gt; 5.5 mmol/l). Adjusted risk of moderate or severe hyperK was highest in HFpEF and HFmrEF. Similarly, 20.3% of patients had at least one episode of hypokalemia (hypoK [amp;lt;3.5 mmol/l]), and 3.7% had severe hypoK (amp;lt;3.0 mmol/l). Adjusted risk of any hypoK was highest in HFpEF. Independent predictors of both hyperK and hypoK were sex, baseline potassium and estimated glomerular filtration rate, low hemoglobin, chronic obstructive pulmonary disease (COPD), inpatient status, and higher New York Heart Association functional class. Incident dysK was associated with increased risk of mortality. Furthermore, hypoK was associated with increased CVD hospitalizations (HF-related excluded). There was no association between dysK and HF hospitalization risk, regardless of EF. CONCLUSIONS DysK is common in HF and is associated with increased mortality. Risk of moderate or severe hyperK was highest in HFpEF and HFmrEF, whereas risk of hypoK was highest in HFpEF. HF severity, low hemoglobin, COPD, baseline high and low potassium, and low eGFR were relevant predictors of dysK occurrence. (C) 2019 by the American College of Cardiology Foundation.
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| 7. |
- Norrving, Bo
(författare)
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Leucoaraiosis and silent subcortical infarcts.
- 2008
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Ingår i: Revue Neurologique. - : Elsevier BV. - 0035-3787. ; Aug 27, s. 801-804
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Tidskriftsartikel (refereegranskat)abstract
- Silent brain infarcts and leucoaraiosis are frequently observed in patients with transient ischemic attack (TIA) and ischemic stroke. Patients with silent brain infarcts and leucoaraiosis at baseline are a high-risk group with an increased long-term risk for recurrent stroke, cognitive decline, and dementia. Effects on short-term outcomes are less clear, but leucoaraiosis appear to increase the risk of early infarct growth as determined by MRI in mismatch areas of the brain. After acute thrombolytic therapy, presence of silent cerebrovascular disease increases the risk of intracerebral hemorrhage, but the increased risk does not negate the overall benefit of this therapy. Similarly, presence of leucoaraiosis is associated with an increased risk of intracerebral bleeding during long-term anticoagulant therapy, but because the risk-benefit ratio has not been well delineated, degree of leucoaraiosis should not influence clinical decision-making at present. Carotid endarterectomy for symptomatic carotid stenosis appears equally effective across different degrees of baseline leucoaraiosis, despite an increased perioperative risk in those with moderate to severe leucoaraiosis. Long-term blood pressure lowering appears equally effective in patients with silent cerebrovascular disease at baseline, and there is some support that blood pressure lowering may decrease the risk of progression of leucoaraiosis.
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| 8. |
- Wu, Yuanjue, et al.
(författare)
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Stair climbing, genetic predisposition, and the risk of incident type 2 diabetes : A large population-based prospective cohort study
- 2023
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Ingår i: Journal of Sport and Health Science. - : Elsevier. - 2095-2546 .- 2213-2961. ; 12:2, s. 158-166
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCross-sectional evidence and small-scale trials suggest positive effects of stair climbing on cardiometabolic disease and glucose regulation. However, few studies have examined the long-term association between stair climbing and the incidence of type 2 diabetes (T2D). We aimed to prospectively evaluate the association of stair climbing with T2D and assess modifications by genetic predisposition to T2D.MethodsWe included 451,699 adults (mean age = 56.3 ± 8.1 years, mean ± SD; 55.2% females) without T2D at baseline in the UK Biobank and followed up to March 31, 2021. Stair climbing information was collected through the touchscreen questionnaire. Genetic risk score for T2D consisted of 424 single nucleotide polymorphisms.ResultsDuring a median follow up of 12.1 years, 14,896 T2D cases were documented. Compared with participants who reported no stair climbing, those who climbed stairs regularly had a lower risk of incident T2D (10–50 steps/day: hazard ratio (HR) = 0.95, 95% confidence interval (95%CI): 0.89–1.00; 60–100 steps/day: HR = 0.92, 95%CI: 0.87–0.98; 110–150 steps/day: HR = 0.86, 95%CI: 0.80–0.91; >150 steps/day: HR = 0.93, 95%CI: 0.87–0.99, p for trend = 0.0007). We observed a significant interaction between stair climbing and genetic risk score on the subsequent T2D risk (p for interaction = 0.0004), where the risk of T2D showed a downward trend in subjects with low genetic risk and those who reported stair climbing activity of 110–150 steps/day appeared to have the lowest overall T2D risk among those with intermediate to high genetic risk.ConclusionA higher number of stairs climbed at home was associated with lower T2D incidence risk, especially among individuals with a low genetic predisposition to T2D. These findings highlight that stair climbing, as incidental physical activity, offers a simple and low-cost complement to public health interventions for T2D prevention.
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| 9. |
- Matsushita, Kunihiro, et al.
(författare)
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Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes : a collaborative meta-analysis of individual participant data
- 2015
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Ingår i: LANCET DIABETES & ENDOCRINOLOGY. - 2213-8587. ; 3:7, s. 514-525
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Tidskriftsartikel (refereegranskat)abstract
- Background The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a meta-analytic approach. Methods We meta-analysed individual-level data for 637 315 individuals without a history of cardiovascular disease from 24 cohorts (median follow-up 4.2-19.0 years) included in the Chronic Kidney Disease Prognosis Consortium. We assessed C statistic difference and reclassification improvement for cardiovascular mortality and fatal and non-fatal cases of coronary heart disease, stroke, and heart failure in a 5 year timeframe, contrasting prediction models for traditional risk factors with and without creatinine-based eGFR, albuminuria (either albumin-to-creatinine ratio [ACR] or semi-quantitative dipstick proteinuria), or both. Findings The addition of eGFR and ACR significantly improved the discrimination of cardiovascular outcomes beyond traditional risk factors in general populations, but the improvement was greater with ACR than with eGFR, and more evident for cardiovascular mortality (C statistic difference 0.0139 [95% CI 0.0105- 0.0174] for ACR and 0.0065 [0.0042-0.0088] for eGFR) and heart failure (0.0196 [0.0108-0.0284] and 0.0109 [0.0059-0.0159]) than for coronary disease (0.0048 [0.0029-0.0067] and 0.0036 [0.0019-0.0054]) and stroke (0.0105 [0.0058-0.0151]and 0.0036 [0.0004-0.0069]). Dipstick proteinuria showed smaller improvement than ACR. The discrimination improvement with eGFR or ACR was especially evident in individuals with diabetes or hypertension, but remained significant with ACR for cardiovascular mortality and heart failure in those without either of these disorders. In individuals with chronic kidney disease, the combination of eGFR and ACR for risk discrimination outperformed most single traditional predictors; the C statistic for cardiovascular mortality fell by 0.0227 (0.0158-0.0296) after omission of eGFR and ACR compared with less than 0.007 for any single modifiable traditional predictor. Interpretation Creatinine-based eGFR and albuminuria should be taken into account for cardiovascular prediction, especially when these measures are already assessed for clinical purpose or if cardiovascular mortality and heart failure are outcomes of interest. ACR could have particularly broad implications for cardiovascular prediction. In populations with chronic kidney disease, the simultaneous assessment of eGFR and ACR could facilitate improved classification of cardiovascular risk, supporting current guidelines for chronic kidney disease. Our results lend some support to also incorporating eGFR and ACR into assessments of cardiovascular risk in the general population.
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