| 1. |
|
|
| 2. |
- Jedel, Elizabeth, 1962
(author)
-
Acupuncture in xerostomia--a systematic review.
- 2005
-
In: Journal of oral rehabilitation. - : Wiley. - 0305-182X .- 1365-2842. ; 32:6, s. 392-6
-
Journal article (peer-reviewed)abstract
- The aim of this systematic review was to assess the efficacy of acupuncture in the management of xerostomia. Assessing quality of studies aim to efficiently integrate valid information and provide a basis for sound decision making based on the best available evidence. Articles of controlled clinical trials evaluating the efficacy of acupuncture in the management of xerostomia were obtained by searching through the databases MEDLINE and Cochrane Central Register of Controlled Trials to September 2003. Three articles met the criteria for inclusion and a criteria list was used to assess the quality of these studies. The studies were considered to be of high quality or low quality in accordance with the criteria list utilized. The results of the trials were considered positive, negative or indifferent based on statistically significant between group differences. The criteria list utilized indicate that one of the three studies was of high quality and it presents indifferent results. One of the two studies of low quality presents positive results and one presents indifferent results. An analysis of the results degree of evidence resulted in no evidence for the efficacy of acupuncture in the management of xerostomia. This systematic review shows that there is no evidence for the efficacy of acupuncture in the management of xerostomia. There is a need for future high quality randomized controlled trials.
|
|
| 3. |
- Jedel, Elizabeth, 1962, et al.
(author)
-
Anxiety and depression symptoms in women with polycystic ovary syndrome compared with controls matched for body mass index.
- 2010
-
In: Human reproduction. - : Oxford University Press (OUP). - 1460-2350 .- 0268-1161. ; 25:2, s. 450-456
-
Journal article (peer-reviewed)abstract
- BACKGROUND Anxiety and depression are more prevalent in women with polycystic ovary syndrome (PCOS) than in those without this disorder. Possible confounding effects of overweight and obesity are suggested. The aim was to compare symptoms of anxiety and depression in women with PCOS and controls matched for age, body weight and body mass index (BMI). METHODS Women with PCOS (n = 30) and controls (n = 30) were recruited from the community. Persons with ongoing psychotropic medication were excluded. All potential participants underwent gynecological examination to confirm case-control status. Participants completed the self-reported versions of the Brief Scale for Anxiety (BSA-S) and Montgomery Asberg Depression Rating Scale (MADRS-S). RESULTS Women with PCOS had a higher BSA-S score compared with controls (median, range: 10.5, 1-24 versus 5.0, 0-28, P < 0.001). They scored higher on the following four individual symptoms: reduced sleep (2.0, 0-5 versus 0, 0-2, P < 0.001), worry (1.5, 0-4 versus 0, 0-6, P = 0.004), phobias (1, 0-4 versus 0, 0-3, P < 0.001), and pain (1, 0-3 versus 0, 0-2, P < 0.001). No statistical difference was demonstrated regarding MADRS-S scores (10.0, 0-27 versus 5.5, 0-24, P = 0.053). Only one of the nine MADRS-S symptoms, reduced sleep, which is also included in the BSA-S, differed between cases and controls. CONCLUSIONS Several anxiety symptoms distinguished women with PCOS from a control group matched on BMI. A better understanding of the symptoms is needed to identify and alleviate anxiety symptoms in this vulnerable group.
|
|
| 4. |
- Jedel, Elizabeth, 1962, et al.
(author)
-
Assessment of health-related quality of life: Swedish version of polycystic ovary syndrome questionnaire.
- 2008
-
In: Acta obstet et Gynecologica. - : Wiley. - 1600-0412 .- 0001-6349. ; 87:12, s. 1329-35
-
Journal article (peer-reviewed)abstract
- Objective. Polycystic ovary syndrome questionnaire (PCOSQ) was developed in USA to ascertain specific health-related quality of life (HRQL) in polycystic ovary syndrome (PCOS). The Swedish version of PCOSQ should be tested prior to its use in research and clinical practice and the aims of the study were as follows: (a) determine the test-retest reliability and (b) confirm the domain structure of the Swedish version of PCOSQ; a 26-item questionnaire, divided into the five domains: emotions, body hair, weight concerns, infertility concerns and menstrual irregularities. Methods. PCOSQ translation from English to Swedish was followed by a test-retest and a factor analysis of obtained PCOSQ completed twice by 69 women with PCOS. Results. The median age was 30 (21-37) years. The Kappa (kappa) statistic for the five domains ranged from 0.29 to 0.69 demonstrating fair to good agreement among items. The Intra-class Correlation Coefficient (ICC) for the five domains was high to excellent ranging from 0.79 to 0.96. The factor analysis presented six domains and the original domain structure was partly confirmed. Conclusions. The Swedish version of PCOSQ is reliable and can be used to measure HRQL in PCOS. Researchers and clinicians should be aware of the benefits of PCOSQ.
|
|
| 5. |
- Jedel, Elizabeth, et al.
(author)
-
Differences in personality, perceived stress and physical activity in women with burning mouth syndrome compared to controls.
- 2021
-
In: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 21:1, s. 183-190
-
Journal article (peer-reviewed)abstract
- Objectives Burning mouth syndrome (BMS) is a long-lasting pain condition which is commonly associated with anxiety symptoms and experience of adverse, stressful life events have been reported by those diagnosed with the syndrome. Stress-related biomarkers have been related to personality traits in BMS and a personality with high stress susceptibility and perceived stress may be of importance. Although biopsychosocial approaches are suggested to manage long-lasting orofacial pain, to date little is known about physical activity in women with BMS. The aim of this study was to investigate if personality, perceived stress and physical activity distinguish women with BMS from controls. Methods Fifty-six women with BMS and 56 controls matched on age and gender completed Swedish universities Scales of Personality (SSP), Perceived Stress Questionnaire (PSQ) and a general questionnaire with an item on weekly physical activity frequency. In addition, health-related quality of life was explored by additional questionnaires and reported in a companion article (Jedel et al. Scand J Pain. 2020. PubMed PMID: 32853174). Results SSP subscales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Verbal Trait Aggression differed between women with BMS and controls and the personality factor scores for Neuroticism and Aggressiveness were higher. Perceived stress measured by PSQ index was higher for women with BMS compared to controls. Women with BMS reported lower physical activity frequency compared to controls and those reporting physical activity <4 days/week scored higher on PSQ compared to those with weekly physical activity ≥4 days/week. Conclusions Personality distinguished women with BMS from controls in this study. Perceived stress was higher and weekly physical activity was lower in women with BMS compared to controls. Our findings suggest physical activity should be more comprehensively measured in future BMS studies and, by extension, physical activity may be a treatment option for women with BMS. Pain management aiming to restore function and mobility with stress reduction should be considered in clinical decision making for women with BMS who have a personality with stress susceptibility, especially if reporting high perceived stress and insufficient physical activity.
|
|
| 6. |
- Jedel, Elizabeth, 1962, et al.
(author)
-
Health-related quality of life in child patients with temporomandibular disorder pain.
- 2007
-
In: European journal of pain (London, England). - : Wiley. - 1090-3801. ; 11:5, s. 557-63
-
Journal article (peer-reviewed)abstract
- Temporomandibular disorders (TMDs) occurs frequently in children and measuring health-related quality of life (HRQL) can complement efficacy measures, offering a complete picture of the impact of disease and treatment on overall well-being. AIM: To compare HRQL, pain threshold (PT) and range of motion (ROM) in child patients with temporomandibular disorder (TMD) pain and an age and gender matched control group. METHODS: The study design was a controlled cross-sectional study. Forty-two children participated in the study. Twenty-one child patients referred to a dental pediatric clinic for specialist treatment because of TMD pain and an age and gender matched control group completed the Child health questionnaire-child form 87 (CHQ-CF87). PT was measured with Pain matcher and ROM in terms of maximum unassisted mandibular opening was measured with a ruler. RESULTS: The child patients with pain more than once a week had a pain duration ranging from 3 months to almost 6 years. The median for pain intensity measured with visual analogue scale (VAS) was 47 ranging from 5 to 80 and the median for behavioral rating scale (BRS) was 3 ranging from 1 to 4. Child patients with TMD pain more than once a week reported significantly lower scores in CHQ-CF87 when compared with a control group. The results for PT and ROM were non-significant. CONCLUSION: CHQ-CF87 could be used for measuring health and to evaluate the efficacy of treatment in child patients with TMD pain.
|
|
| 7. |
- Jedel, Elizabeth, 1962, et al.
(author)
-
Impact of electroacupuncture and exercise on hyperandrogenism and oligo/amenorrhoea in women with polycystic ovary syndrome: A randomized controlled trial.
- 2011
-
In: American Journal of Physiology - Endocrinology and Metabolism. - : American Physiological Society. - 1522-1555 .- 0193-1849. ; 300:1, s. E37-45
-
Journal article (peer-reviewed)abstract
- Background: Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is characterized by hyperandrogenism, oligo/amenorrhea, and polycystic ovaries. We aimed to determine whether low-frequency electro-acupuncture (EA) decreases hyperandrogenism and improves oligo/amenorrhea more effectively than physical exercise or no intervention. Methods: We randomized 84 women with PCOS, aged 18-37 years, to 16 weeks of low-frequency EA, physical exercise, or no intervention. The primary outcome measure-changes in the concentration of total testosterone (T) at week 16 determined by gas and liquid chromatography/mass spectrometry-was analyzed by intention-to treat. Secondary outcome measures were changes in menstrual frequency; concentrations of androgens, estrogens, androgen precursors, glucuronidated androgen metabolites; and acne and hirsutism. Outcomes were assessed at baseline, after 16 weeks of intervention, and after a 16-week follow-up. Results: After 16 weeks of intervention, circulating T decreased by -25%, androsterone glucuronide by -30%, and androstane-3α, 17β-diol-3glucuronide by -28% in the EA group (P=0.038, 0.030, and 0.047, respectively vs. exercise); menstrual frequency increased to 0.69/month from 0.28 at baseline in the EA group (P=0.018 vs. exercise). After the 16-week follow-up, the acne score decreased by -32% in the EA group (P=0.006 vs. exercise). Both EA and exercise improved menstrual frequency and decreased the levels of several sex steroids at week 16 and at the 16-week follow-up, compared to no intervention. Conclusion/Significance: Low-frequency EA and physical exercise improved hyperandrogenism and menstrual frequency more effectively than no intervention in women with PCOS. Low-frequency EA was superior to physical exercise and may be useful for treating hyperandrogenism and oligo/amenorrhea.
|
|
| 8. |
- Jedel, Elizabeth
(author)
-
Polycystic ovary syndrome : studies of affective symptoms in association with sex steroids and evaluation of electroacupuncture and physical exercise
- 2010
-
Doctoral thesis (other academic/artistic)abstract
- Polycystic ovary syndrome (PCOS) is a common heterogeneous condition in women of reproductive age, relating to both physical and mental health. Thoughts on primary pathological origins shift from the ovary to the adrenal gland. Insulin signaling pathways and sympathetic nerve activity are thought to be involved. PCOS features include signs of high androgen concentrations and oligo/amenorrhea. Affective symptoms such as depression and anxiety are prevalent among women with the syndrome and have been associated with body mass index (BMI). PCOS interventions are symptom-oriented and should include physical exercise as part of lifestyle management. Effective pharmacological interventions have side-effects to be taken in consideration. Previous studies suggest electroacupunture (EA) to modulate features commonly observed in women with PCOS. The general aims of this thesis were to explore self-reported depression and anxiety-related symptoms in women with PCOS; and to evaluate low-frequency EA and physical exercise on muscle sympathetic nerve activity (MSNA), biochemical hyperandrogenism and oligo/amenorrhea. Study I investigated depression and anxiety-related symptoms in women with PCOS and noted several anxiety symptoms to distinguish women with PCOS from controls matched on age, body weight and BMI. Symptoms of worry, phobias and sleep disturbances were overrepresented among women with PCOS and may be an indication of an increased arousal. Study II explored associations between depression and anxiety symptoms, and estrogens, sex steroid precursors, androgens, glucuronidated androgen metabolites, sex hormone-binding globulin (SHBG) and insulin sensitivity in drug-naïve women with PCOS. Women with depression-related symptoms had lower testosterone (T), free testosterone (FT) and androstane-3α 17β-diol-3glucuronide (3G). There were inverse associations between circulating FT, 3G and symptoms of depression. Study III aimed to evaluate low-frequency EA and physical exercise on MSNA in women with PCOS. Twenty women with PCOS were allocated to low-frequency EA, physical exercise, or no intervention. From baseline to week 16, MSNA burst frequency decreased by -39.4% for low-frequency EA; -39.0 % for physical exercise; and -8.7% for no intervention. Study IV investigated if low-frequency EA would decrease hyperandrogenism and improve oligo/amenorrhea more effectively than physical exercise or no active intervention in women with PCOS. Eighty four women with PCOS were randomized to 16 weeks of low-frequency EA, physical exercise, or no intervention. Circulating T, androsterone glucuronide (ADT-G) and 3G decreased from baseline measurements to week 16 for low-frequency EA compared to physical exercise. Circulating T, FT, estrone-sulfate (E1-S), ADT-G, 3G and androstane-3α 17β-diol-17glucuronide (17G) decreased from baseline measurements to week 16 for low-frequency EA compared to no intervention. The monthly menstrual bleeding frequency increased for low-frequency EA compared to physical exercise and no intervention from baseline measurements to week 16. Conclusions: This thesis supports the effects of low-frequency EA and physical exercise to be partly mediated via the sympathetic nervous system. Low-frequency EA may be a complement for treatment of hyperandrogenism in women with PCOS. With few minor adverse events of short duration for repeated low-frequency EA and no adverse events for physical exercise, a combination of low-frequency EA and physical exercise is recommended for treatment of oligo/amenorrhea in women with PCOS. With an unmet need for assessment and treatment of affective symptoms in women with PCOS further studies are warranted.
|
|
| 9. |
- Jedel, Elizabeth, 1962, et al.
(author)
-
Sex steroids, insulin sensitivity and sympathetic nerve activity in relation to affective symptoms in women with polycystic ovary syndrome.
- 2011
-
In: Psychoneuroendocrinology. - : Elsevier BV. - 1873-3360 .- 0306-4530. ; 36:10, s. 1470-9
-
Journal article (peer-reviewed)abstract
- CONTEXT: Affective symptoms are poorly understood in polycystic ovary syndrome (PCOS). Clinical signs of hyperandrogenism and high serum androgens are key features in PCOS, and women with PCOS are more likely to be overweight or obese, as well as insulin resistant. Further, PCOS is associated with high sympathetic nerve activity. OBJECTIVE: To elucidate if self-reported hirsutism, body mass index (BMI) and waistline, circulating sex steroids, sex hormone-binding globulin (SHBG), insulin sensitivity and sympathetic nerve activity are associated with depression and anxiety-related symptoms in women with PCOS. DESIGN AND METHODS: Seventy-two women with PCOS, aged 21-37 years, were recruited from the community. Hirsutism was self-reported using the Ferriman-Gallway score. Serum estrogens, sex steroid precursors, androgens and glucuronidated androgen metabolites were analyzed by gas and liquid chromatography/mass spectroscopy (GC-MS/LC-MS/MS) and SHBG by chemiluminiscent microparticle immunoassay (CMIA). Insulin sensitivity was measured with euglycemic hyperinsulinemic clamp. Sympathetic nerve activity was measured with microneurography. Symptoms of depression and anxiety were self-reported using the Montgomery Åsberg Depression Rating Scale (MADRS-S) and the Brief Scale for Anxiety (BSA-S). RESULTS: Circulating concentrations of testosterone (T) (P=0.026), free T (FT) (P=0.025), and androstane-3α 17β-diol-3glucuronide (3G) (P=0.029) were lower in women with depression symptoms of potential clinical relevance (MADR-S≥11). The odds of having a MADRS-S score ≥11 were higher with lower FT and 3G. No associations with BSA-S were noted. CONCLUSION: Lower circulating FT and 3G were associated with worse self-reported depression symptoms. The relationship between mental health, sex steroids and corresponding metabolites in PCOS requires further investigation.
|
|
| 10. |
- Stener-Victorin, Elisabet, 1964, et al.
(author)
-
Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical Evidence.
- 2008
-
In: Journal of Neuroendocrinology. - : Wiley. - 0953-8194 .- 1365-2826. ; 20:3, s. 290-298
-
Journal article (peer-reviewed)abstract
- This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity. PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity. Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system. Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation.
|
|
