| 1. |
- Erlandsson, Soly, 1942-, et al.
(författare)
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A longitudinal study investigating the contribution of mental illness in chronic tinnitus patients
- 2006
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Ingår i: Audiological Medicine. - : Informa UK Limited. - 1651-386X .- 1651-3835. ; 4:3, s. 124-133
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Tidskriftsartikel (refereegranskat)abstract
- The nature of affective components seen in relation to tinnitus suffering was investigated in 70 patients consulting at an audiological clinic. They were interviewed and answered the Spielberger's State and Trait Anxiety Inventory (STAI) and the Beck's Depression Inventory (BDI). It was hypothesized that an anxious and depressed mood might be a sign of a serious psychiatric illness and, therefore, diagnostic interviews including the Structural Clinical Interview for DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders), Axis II (personality) disorders (SCID-II), the BDI, the Montgomery A?sberg Depression Rating Scale (MADRS) and the Hopelessness Scale (HS), as well as biomedical tests, were conducted in a subgroup of 18 individuals. Fifty per cent (two women and seven men) were diagnosed as suffering from a personality disorder. No significant relationships were revealed when various biochemical markers were analysed. One and a half years later, 16 subjects were interviewed a third time and answered the STAI and the BDI. There was a clear trend in the data showing that patients having a personality disorder did not change their distress profile from the first to the third period of assessment. In these patients, a vicious circle caused by pronounced intolerance to life stress seems to operate in a more serious way than in patients who do not suffer from a personality disorder. © 2006 Taylor & Francis.
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| 2. |
- Johansson, Magnus, et al.
(författare)
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Prevalence of dizziness in relation to psychological factors and general health in older adults
- 2006
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Ingår i: Audiological Medicine. - : Informa UK Limited. - 1651-386X .- 1651-3835. ; 4:3, s. 144-150
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Tidskriftsartikel (refereegranskat)abstract
- The present study examined the point prevalence of dizziness among older adults in the Swedish population. It also explored the relationship between dizziness and general health and psychological factors, and the impact of dizziness on daily life. Data were obtained by means of a postal survey, administrated to 2000 randomly selected adults. Among the responders, 247 were aged 65-79 years. Dizziness was defined as being at least slightly annoyed by dizziness or unsteadiness at present. Results showed that the point prevalence of dizziness was estimated at 25.2%. Dizziness increased significantly with age among the women, but not among the men. Statistically significant associations were found between dizziness and anxiety, anxiety sensitivity, depression, hearing problems, tinnitus, pain in neck or shoulder and muscle tension. Almost 10% of the sample had visited a physician during the last 12 months concerning their dizziness and more than 10% reported having been prevented from working or performing normal activities for at least a day due to dizziness. In conclusion, the present study suggests that, at present, more than 25% of the older adults in Sweden are suffering from dizziness. It also suggests that a large proportion of the older adults in the country visit a physician concerning their problems with dizziness each year, and that there are associations between dizziness and factors in multiple domains in this population. © 2006 Taylor & Francis.
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| 3. |
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| 4. |
- Aljassim, Obaid, et al.
(författare)
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Inflammatory response and platelet activation after off-pump coronary artery bypass surgery.
- 2006
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Ingår i: Scandinavian cardiovascular journal : SCJ. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 40:1, s. 43-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cardiac surgery induces a systemic inflammatory activation and alterations in the hemostatic cascade. The responses contribute to postoperative complications but may also have protective effects. We investigated the relationship between inflammation, hemostasis and bleeding after off-pump coronary artery bypass surgery (OPCAB). METHODS: Ten OPCAB patients were included in a prospective descriptive study. Selected markers of inflammation (IL-6, IL-8, PMN-elastase, C3a, and SC5b-9), and hemostasis (platelet count, ss-thromboglobulin, anti-thrombin, D-dimer and fibrinogen) were measured before and immediately after surgery. Postoperative bleeding was registered. RESULTS: Inflammatory variables did not alter significantly during surgery while ss-thromboglobulin concentrations increased and anti-thrombin and fibrinogen decreased. There were significant postoperative correlations between PMN-elastase and ss-thromboglobulin (r=0.82, p=0.004), between PMN-elastase and fibrinogen (r=0.69, p=0.03) and between C3a and ss-thromboglobulin (r=0.71, p=0.02). In addition, there were significant inverse correlations between postoperative bleeding and pre- and postoperative fibrinogen levels (r=-0.76, p=0.011 and r=-0.84, p=0.002 respectively), between bleeding and postoperative ss-thromboglobulin levels (r=-0.66, p=0.04) and between bleeding and postoperative PMN-elastase (r=-0.75, p=0.01). CONCLUSIONS: The results give further evidence for an association between the inflammatory response and hemostasis after cardiac surgery.
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| 5. |
- Berg, K., et al.
(författare)
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Oxidative stress during coronary artery bypass operations : Importance of surgical trauma and drug treatment
- 2006
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 40:5, s. 291-297
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate oxidative stress and myocardial injury at different stages of coronary artery bypass grafting (CABG). Design. Twenty patients underwent CABG with use of cardiopulmonary bypass (CPB) and with intermittent sampling of plasma and urine. Main markers were: 8-iso-PGF(2 alpha) (oxidative stress); troponin T (myocardial injury); and 15-keto-dihydro-PGF2 alpha and hsCRP (inflammation). Results. Plasma 8-iso-PGF2 alpha increased after start of surgery, but there was no further rise during CPB or after aortic cross-clamp release and no significant myocardial arterio-venous differences. An increase in troponin T was seen early after the operation, but no relationship was established between 8-iso-PGF2 alpha and troponin T. 8-iso-PGF2 alpha levels were elevated by preoperative withdrawal of acetylsalicylic acid (ASA) but reduced by intraoperative use of heparin. 15-keto-dihydro-PGF2 alpha was elevated during operation and hsCRP following operation. Conclusions. In the present study oxidative stress was multifactorial in origin with main impacts from surgical trauma, less from CPB and little if any from myocardial ischemia-reperfusion events. In addition, cardiovascular drugs in common use like ASA and heparin seemed to influence the pro- and antioxidant balance, a finding that has to be confirmed in future studies.
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| 6. |
- Bjerlemo, Berit, et al.
(författare)
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Recovery after early vestibular rehabilitation in patients with acute unilateral vestibular loss
- 2006
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Ingår i: Audiological Medicine. - : Informa UK Limited. - 1651-386X .- 1651-3835. ; 4:3, s. 117-123
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to follow the recovery process, and explore the disease impact on sick leave in patients with acute unilateral vestibular loss (AUVL). Another aim was to investigate whether initial signs of nystagmus, caloric response, and subjective symptoms of vertigo could predict the return to work. Recovery was followed through the reduction in spontaneous and head-shaking nystagmus, evaluated by Video-Frenzel examination, and by caloric response/asymmetry and spontaneous nystagmus, evaluated by bithermal binaural caloric testing. Information regarding employment, sick leave and subjective symptoms of vertigo was collected using a questionnaire. Twenty-seven patients with AUVL participated in a physiotherapy training programme, starting within 48 h of disease onset. Four assessments were performed: at disease onset, in the acute stage, and after one and six months. In most patients a very rapid cessation of spontaneous nystagmus could be observed (14/27 at a median time of two days after disease onset, a further 10 patients after one month and the remaining three patients after six months). A more prolonged persistence of head shaking nystagmus was observed (24/27, 14/27 and 5/21 of the patients showed head-shaking nystagmus at the three assessments). Caloric asymmetry was normalized after six months in 11/27 patients. A positive and significant correlation was observed between long-lasting sick leave and caloric asymmetry, sense of unsteadiness when standing and walking and older age. Unsteadiness when standing and walking, as well as existence of spontaneous nystagmus, were also positively and significantly correlated with the degree of caloric asymmetry. Spontaneous or head-shaking nystagmus, caloric asymmetry and subjective vertigo at disease onset did not, however, predict sick leave after one or six months. Recovery was excellent in most of the patients.
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| 7. |
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| 8. |
- Ekman, Mattias, et al.
(författare)
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Cost-effectiveness of the Taxus paclitaxel-eluting stent in the Swedish healthcare system
- 2006
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 40:1, s. 17-24
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To analyse the cost-effectiveness of Taxus compared to a bare-metal stent in patients with coronary artery disease in the Swedish healthcare setting. DESIGN: A decision-analytic model combining clinical data on revascularization rates with Swedish unit costs for medical resources and utility data from the literature. RESULTS: For patients of moderate risk, the average cost per patient at 12 months is 72,200 SEK for Taxus and 66,900 SEK for a bare-metal stent, while the average cost for high risk patients is nearly equivalent (73,000 vs. 71,700 SEK). The cost per revascularization avoided is generally favourable, while the incremental cost per QALY gained varies depending on the assumptions made; from 2,351,000 SEK for patients of moderate risk at 12-months to cost saving at 24 months for high risk patients. Budget impact scenarios at 12 months are cost-neutral. CONCLUSION: The Taxus stent is cost-effective in high risk patients, particularly at 24 months. Although it may be less cost-effective for the general population, there is still a substantial offset of initial procedure costs through lower rate of repeat revascularizations.
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| 9. |
- Friberg, Örjan, et al.
(författare)
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Cost effectiveness of local collagen-gentamicin as prophylaxis for sternal wound infections in different risk groups
- 2006
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 40:2, s. 117-125
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: In a randomized trial addition of local collagen-gentamicin in the sternal wound reduced the rate of sternal wound infection (SWI) to about 50% compared to intravenous prophylaxis alone. The aim of the present study was to evaluate the economic rationale for its use in every-day clinical practice. This includes the question whether high-risk groups that may have particular benefit should be identified. DESIGN: For each patient with SWI in the trial the costs attributable to the SWI were calculated. Risk factors for SWI were identified and any heterogeneity of the effect of the prophylaxis examined. RESULTS: The mean cost of a SWI was about 14500 Euros. A cost effectiveness analysis showed that the prophylaxis was cost saving. The positive net balance was even higher in risk groups. Assignment to the control group, overweight, diabetes, younger age, mammarian artery use, left ventricular ejection fraction <35% and longer operation time were independent risk factors for infection. CONCLUSION: The addition of local collagen-gentamicin to intravenous antibiotic prophylaxis was dominant, i.e. resulted in both lower costs and fewer wound infections.
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| 10. |
- Hannuksela, Matias, et al.
(författare)
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Thoracic aorta : dilated or not?
- 2006
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 40:3, s. 175-178
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Knowledge of normal aortic diameters is important in the assessment of aortic disease. The aim of this study was to determine normal thoracic aortic diameters.Design: 77 patients undergoing computed tomography of the thorax were studied. The diameter of the thoracic aorta was measured at three levels in the ascending aorta and at three levels in the descending aorta. The diameter was studied in relation to age, sex, weight and height.Results: We found that aortic diameter is increasing with increasing age. Even sex and BMI influence the aortic diameter but to a lesser extent than age. The upper normal limit for ascending aorta can be calculated with the formula D(mm) = 31 + 0.16*age and for descending aorta with the formula D(mm) = 21 + 0.16*age. Thus a 20-year-old person has an upper normal limit for ascending aorta of 34 mm and an 80-year-old person has a limit of 44 m.Conclusions: The thoracic aortic diameter varies with age, sex and body weight and height. The strongest correlation can be seen with age. Age should therefore be taken into consideration when determining whether the thoracic aorta is dilated or not.
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