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Sökning: WFRF:(Maly Sundgren P)

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1.
  • Maly, P, et al. (författare)
  • Neural tolerance of the non-ionic dimers iodixanol and iotrolan and the non-ionic monomer iopamidol during myelography in non-anaesthetised rabbits
  • 1995
  • Ingår i: Acta Radiologica. - 0284-1851. ; 36:6, s. 8-644
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The neural tolerance of the recently introduced dimer iodixanol (320 g I/l) was compared with that of the dimer iotrolan (300 g I/l) and of the monomer iopamidol (300 g I/l), both used in clinical myelography.MATERIAL AND METHODS: Non-anaesthetised rabbits were injected into the cisterna magna with Ringer's solution (control) or contrast media (CM) at doses of 1.0 or 0.5 ml/kg b.w. The behaviour of the animals (10 in each of 7 groups) was evaluated for signs of excitation and depression during the first 3 hours after injection.RESULTS: At the dose level of 1.0 ml/kg b.w., iodixanol produced no seizures but did cause focal twitching in 4/10 rabbits. Iopamidol produced grand mal seizures in 2/10 and hyperexcitability in 4/10 rabbits. Iotrolan produced generalised grand mal seizures in 8/10 rabbits, an incidence of excitation significantly greater than that of iodixanol (p < 0.01) and iopamidol (p < 0.05). The excitative effects of iodixanol were not significantly different from those of iopamidol and Ringer's solution. All 3 CM produced similar depressive effects on rabbit behaviour. Ringer's solution caused no depressive effects (p < 0.01). A clear dose response was produced with all 3 CM after treatment with a lower dose of 0.5 ml/kg b.w.CONCLUSION: The results indicate that the neural tolerance in the rabbit of iodixanol is higher than that of iotrolan, and is at least equal to that of iopamidol.
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2.
  • Nilsson, P, et al. (författare)
  • Predicting the Outcome of Optic Neuritis Evaluation of risk factors after 30 years of follow-up.
  • 2005
  • Ingår i: Journal of Neurology. - : Springer Science and Business Media LLC. - 1432-1459 .- 0340-5354. ; 252:4, s. 396-402
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Multiple sclerosis ( MS) is a common disease with considerable risk for disability. Optic neuritis ( ON) is a common first symptom of MS but it can also remain an isolated episode. Therefore, predicting the outcome of ON has gained in importance, particularly in light of current discussions of early disease modifying treatments in individuals at risk of developing MS. We reported previously on our cohort of 86 patients with acute monosymptomatic unilateral ON of whom 33 had progressed to MS after up to 18 years. Three patients had died. The present study extends the observation period to 31 years. Methods Patients were followed for up to 31 years or until a diagnosis of MS was made. Cerebrospinal fluid (CSF) was examined at onset. HLA class I and II antigens were determined. Magnetic Resonance Imaging (MRI) was performed during follow up. Findings Only one of 50 patients at risk developed clinical manifestations of MS during the extended follow up period. The estimated 15-year-risk of MS was 40% ( confidence interval [CI] 31% - 52%). Most cases, 20 of 34 or 60%, occurred within three years. Among factors present at onset, CSF with mononuclear pleocytosis and/or oligoclonal Ig increased the risk for subsequent MS significantly, 49% (CI 38% - 65%) compared with 23% ( CI 12% - 44%) for those with normal CSF, p= 0.02. Younger patients and those with winter onset also had greater risk. Recurrence of ON similarly elevated the risk significantly, p< 0.001. After 19 - 31 years MRI lesions suggestive of demyelinating disease were detected in 20 of 30 individuals although no clinical manifestations of MS had occurred. Conclusion The risk of MS in this large population-based prospective ON patient series was 40% and significantly higher in those with inflammatory CSF abnormalities at onset. Clinically silent MRI lesions suggestive of MS were detected in a majority of those with "ON-only". This finding should be taken into account when discussing prognosis and early intervention in patients with clinically isolated ON.
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3.
  • Sundgren, P C, et al. (författare)
  • Value of radiography in the management of possible fishbone ingestion
  • 1994
  • Ingår i: Annals of Otology, Rhinology & Laryngology. - : SAGE Publications. - 0003-4894 .- 1943-572X. ; 103:8 Pt 1, s. 31-628
  • Tidskriftsartikel (refereegranskat)abstract
    • A retrospective study was performed on 42 consecutive patients to examine the value of radiography in the management of complaints of fishbone ingestion. All patients underwent an oral examination followed by radiographic examination with plain films, barium swallows, barium and water swallows, and an endoscopic examination. All radiographs were reviewed by two unbiased, experienced radiologists. Of the 7 cases with fishbone found at endoscopic examination, only two (29%) bones were seen by the primary radiologist and 5 (71%) by the reviewing radiologists. Except for one case in which all three radiologists detected a fishbone that passed during the examination, and thereby was not found on endoscopy, no fishbones were found at the radiographic examination that were not seen on the endoscopic examination. Thus, radiography added no valuable information but only delayed the endoscopic examination with ensuing removal of the foreign body, which had to be performed regardless of the outcome of the radiographic examination. Therefore, we suggest that patients with a short history of complaints of fishbone ingestion, ie, 48 hours or less, should first be evaluated with oral and endoscopic examination.
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4.
  • Sundgren, P, et al. (författare)
  • Elevation of the larynx on normal and abnormal cineradiogram
  • 1993
  • Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 66:789, s. 72-768
  • Tidskriftsartikel (refereegranskat)abstract
    • The relationship between bolus volume (2.5, 5, 10 and 20 ml) and larynx elevation during swallowing was assessed in 10 non-dysphagic and 10 dysphagic individuals without pharyngeal dysfunction. Laryngeal elevation in different types of pharyngeal dysfunction was assessed in 60 non-dysphagic and 75 dysphagic patients. All subjects were examined with liquid barium and cineradiography at 50 frames/s. The laryngeal elevation was measured at the moment when the bolus reached the level of the valleculae and at maximum elevation. Elevation of the larynx, both the initial and maximal, was not influenced by sex, age or presence of dysphagia. Elevation of the larynx at the moment when the bolus reached the valleculae, when expressed in per cent of maximum elevation, was lower with 10 and 20 ml bolus volumes compared with 2.5 ml bolus volume (p < 0.05) in the 10 dysphagic individuals. Pharyngeal dysfunction was associated with significantly lower initial elevation of the larynx, at the moment when the bolus reached the level of the valleculae, although the maximal laryngeal elevation was normal. Initial elevation was 30% lower (p = 0.03) in patients with aspiration of bolus material into the trachea, 22% lower (p = 0.007) in those with defective closure of the laryngeal vestibule without aspiration and 16% lower (p = 0.06) in those with incoordination of the cricopharyngeal muscle compared with patients without dysfunction.
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6.
  • Owolabi, M.O., et al. (författare)
  • Global synergistic actions to improve brain health for human development
  • 2023
  • Ingår i: Nature Reviews Neurology. - 1759-4758. ; 19:6, s. 371-383
  • Tidskriftsartikel (refereegranskat)abstract
    • The global burden of neurological disorders is substantial and increasing, especially in low-resource settings. The current increased global interest in brain health and its impact on population wellbeing and economic growth, highlighted in the World Health Organization’s new Intersectoral Global Action Plan on Epilepsy and other Neurological Disorders 2022–2031, presents an opportunity to rethink the delivery of neurological services. In this Perspective, we highlight the global burden of neurological disorders and propose pragmatic solutions to enhance neurological health, with an emphasis on building global synergies and fostering a ‘neurological revolution’ across four key pillars — surveillance, prevention, acute care and rehabilitation — termed the neurological quadrangle. Innovative strategies for achieving this transformation include the recognition and promotion of holistic, spiritual and planetary health. These strategies can be deployed through co-design and co-implementation to create equitable and inclusive access to services for the promotion, protection and recovery of neurological health in all human populations across the life course. © 2023, Springer Nature Limited.
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