| 1. |
- Sonoo, Masahiro, et al.
(författare)
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Appropriate window width for the "clustering index method" in the tibialis anterior muscle
- 2021
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Ingår i: Muscle and Nerve. - : John Wiley & Sons. - 0148-639X .- 1097-4598. ; 63:1, s. 89-95
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Tidskriftsartikel (refereegranskat)abstract
- We previously reported a new quantitative analysis of single-channel surface electromyography (EMG), the "clustering index method" (CI method), in the tibialis anterior muscle, which achieved sufficiently good sensitivity to detect neurogenic or myogenic abnormalities. The window width is a fundamental parameter of the CI method, and was arbitrarily set at 15 ms in that study. In this study, we searched for the most appropriate window width using expanded patient data. The data from our previous study were reanalyzed, and new patients were enrolled. Window width in the CI method was changed from 5 to 27.5 ms with a step of 2.5 ms. For each window width, Z-score values of individual subjects were calculated and the diagnostic yield was investigated. We enrolled 67 controls, 29 subjects with neurogenic disorders, and 39 with myogenic disorders. When the window width was set at 22.5 ms, the highest sensitivity was achieved both for neurogenic (97%) and myogenic (72%) disorders, with a specificity of 97%. Seven of 10 patients with inclusion body myositis were also abnormal. Reliable results were obtained by collecting 15 epochs per subject. There are two conflicting effects that appear to be best balanced at a window width of 22.5 ms: a wider width decreases the chance that a motor unit potential (MUP) is divided into two adjacent windows, and a narrower width reduces the possibility that an MUP firing at a low-frequency is counted twice by the differential sequences. CI is promising as a non-invasive method to diagnose neuromuscular disorders.
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| 2. |
- Stålberg, Stefan, et al.
(författare)
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Analysis of electromyographic activity
- 2004
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Ingår i: Clinical Neurophysiology of Disorders of Muscle and Neuromuscular Junction, including fatigue. - : Elsevier Science B.V. (Ed: E Stålberg).
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Alix, James J. P., et al.
(författare)
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Assessment of the reliability of the motor unit size index (MUSIX) in single subject "round-robin" and multi-centre settings
- 2019
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Ingår i: Clinical Neurophysiology. - : ELSEVIER IRELAND LTD. - 1388-2457 .- 1872-8952. ; 130:5, s. 666-674
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The motor unit size index (MUSIX) is incorporated into the motor unit number index (MUNIX). Our objective was to assess the intra-/inter-rater reliability of MUSIX in healthy volunteers across single subject "round robin" and multi-centre settings.Methods: Data were obtained from (i) a round-robin assessment in which 12 raters (6 with prior experience and 6 without) assessed six muscles (abductor pollicis brevis, abductor digiti minimi, biceps brachii, tibialis anterior, extensor digitorum brevis and abductor hallucis) and (ii) a multi-centre study with 6 centres studying the same muscles in 66 healthy volunteers. Intrafinter-rater data were provided by 5 centres, 1 centre provided only intra-rater data. Intrafinter-rater variability was assessed using the coefficient of variation (COV), Bland-Altman plots, bias and 95% limits of agreement.Results: In the round-robin assessment intra-rater COVs for MUSIX ranged from 7.8% to 28.4%. Inter-rater variability was between 7.8% and 16.2%. Prior experience did not impact on MUSIX values. In the multi-centre study MUSIX was more consistent than the MUNIX. Abductor hallucis was the least reliable muscle.Conclusions: The MUSIX is a reliable neurophysiological biomarker of reinnervation.Significance: MUSIX could provide insights into the pathophysiology of a range of neuromuscular disorders, providing a quantitative biomarker of reinnervation.
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| 4. |
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| 5. |
- Annebäck, Matilda
(författare)
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Hypoparathyroidism after thyroid surgery- rates, risks, prevention and consequences
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hypoparathyroidism is the most common complication after thyroid surgery and associated with short- and long-term consequences. The lack of a consensus on the definition of hypoparathyroidism has led to a broad range in the rates reported in the literature. The overall aim of this thesis was to study different aspects of hypoparathyroidism, in terms rates, risks and long-term impact. Paper I is a case control study, investigating prophylactic, preoperative treatment with active vitamin D and early hypocalcemia after total thyroidectomy. The study showed that patients with preoperative treatment had a lower risk of early hypocalcemia and a reduced length of stay in hospital, compared to patients without treatment. No adverse outcomes were found. Paper II is a population-based retrospective cohort study on the rate and risks for permanent hypoparathyroidism after total thyroidectomy for benign thyroid disease. Data was retrieved from The Swedish National Patient Register, The Swedish Quality Register for Thyroid, Parathyroid and Adrenal Surgery and The Swedish Prescribed Drug Registry. Permanent hypoparathyroidism was defined as dispensation of calcium and/or active vitamin D >12 months after surgery. Among 7852 patients, 12.5% developed permanent hypoparathyroidism. Surgery at low volume centers, parathyroid autotransplantation, female gender and high age were independent risk factors. In Paper III the aim was to validate the high rate of permanent hypoparathyroidism found in Paper II. A regional cohort was extrapolated from the national cohort. A retrospective chart review, of 1636 patients, was performed. Using a strict definition, 6.2 % were found to have definitive permanent hypoparathyroidism. Additionally, 2.5 % were found to have possible permanent hypoparathyroidism. Of these, at least 1.7 % might have been overtreated due to lacking attempts to unwind the treatment. The study also proposed that the rate of low early PTH in a cohort might be useful to predict the rate of permanent hypoparathyroidism. Paper IV investigated health related quality of life (HRQoL) in patients with and without permanent hypoparathyroidism using the same cohort as in Paper III and SF-36 v.2. No impact of definitive hypoparathyroidism on HRQoL could be found. In conclusion, the use of preoperative active vitamin D may be useful as a tool to lower the risk of early hypocalcemia. The risk of permanent hypoparathyroidism after total thyroidectomy is high and there is a need for improved follow up. Permanent hypoparathyroidism may not have a negative effect on HRQoL in most patients.
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| 6. |
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| 7. |
- Aprile, I, et al.
(författare)
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Double peak sensory responses: effects of capsaicin
- 2007
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Ingår i: Neurological Sciences. - : Springer Science and Business Media LLC. - 1590-1874 .- 1590-3478. ; 28:5, s. 264-269
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to verify whether degeneration of skin receptors or intradermal nerve endings by topical application of capsaicin modifies the double peak response obtained by submaximal anodal stimulation. Five healthy volunteers topically applied capsaicin to the finger-tip of digit III (on the distal phalanx) four times daily for 4–5 weeks. Before and after local capsaicin applications, we studied the following electrophysiological findings: compound sensory action potential (CSAP), double peak response, sensory threshold and double peak stimulus intensity. Local capsaicin application causes disappearance or decrease of the second component of the double peak, which gradually increases after the suspension of capsaicin. Conversely, no significant differences were observed for CSAP, sensory threshold and double peak stimulus intensity. This study suggests that the second component of the double peak may be a diagnostic tool suitable to show an impairment of the extreme segments of sensory nerve fibres in distal sensory axonopathy in the early stages of damage, when receptors or skin nerve endings are impaired but undetectable by standard nerve conduction studies.
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| 9. |
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| 10. |
- Bjurberg, Maria, et al.
(författare)
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Primary treatment patterns and survival of cervical cancer in Sweden : A population-based Swedish Gynecologic Cancer Group Study
- 2019
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Ingår i: Gynecologic Oncology. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0090-8258 .- 1095-6859. ; 155:2, s. 229-236
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Survival in cervical cancer has improved little over the last decades. We aimed to elucidate primary treatment patterns and survival. Methods: Population-based study of patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed 2011-2015. Main outcome was 5-year relative survival (RS). Age-standardised RS (AS-RS) was estimated for the total cohort and for the pooled study population of squamous, adenosquamous-, adenocarcinoma. Results: Median follow-up time was 4.6 years. The study population consisted of 2141 patients; 97% of the 2212 patients in the total cohort and the 5-year AS-RS was 71% and 70%, respectively. RS stage IB1: surgery alone 95% vs. 72% for definitive chemoradiotherapy (CT-RT) (p < 0.001). In stage IIA1 74% had CTRL, and 47% of operated patients received adjuvant (CT)-RT. RS stage IB2: surgically treated 81% (69% received adjuvant (CT)-RT) vs. 76% for (CT)-RT (p = 0.73). RS stage IIB: 77% for CT-RT + brachytherapy BT), 37% for RT + BT (p = 0.045) and 27% for RT-BT (p < 0.001). Stages III-IVA; <40% received CT-RT + BT, RS 45% vs. 18% for RT-BT (RR 4.1, p < 0.001). RS stage IVB 7%. Conclusion: Primary treatment of cervical cancer in Sweden adhered to evidence-based standard of care. Areas of improvement include optimising treatment for stages III-IVA, and avoiding combining surgery and radiotherapy. (C) 2019 Elsevier Inc. All rights reserved.
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