| 1. |
- Andréll, Paulin, 1978, et al.
(författare)
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White matter disease in magnetic resonance imaging predicts cerebral complications after coronary artery bypass grafting
- 2005
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Ingår i: The Annals of thoracic surgery. - 1552-6259. ; 79:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of the present study was to assess neurologic and neuropsychologic complications in 104 patients randomized to coronary artery bypass grafting or spinal cord stimulation. An additional objective of the study was to assess whether preoperative white matter disease might predict cerebral complications, as previous studies have shown that there is a relationship between white matter disease and neuropsychologic decline after coronary artery bypass grafting. METHODS: The patients were subjected to neurologic examination before and six months after intervention. The patients underwent a cerebral magnetic resonance imaging before intervention and the presence of white matter disease was related to development of cerebral complications. RESULTS: More patients in the bypass group than in the spinal cord stimulation group developed focal cerebral ischemia (p < 0.05) and astheno-emotional disorder (p < 0.001). More patients with white matter disease undergoing bypass were affected by focal cerebral ischemia (p < 0.01) and astheno-emotional disorder (p < 0.001) after the intervention compared to patients with white matter disease undergoing spinal cord stimulation. In patients with no white matter disease there were no differences between the bypass group and spinal cord stimulation group with regard to cerebral complications. CONCLUSIONS: Patients undergoing bypass had more neurologic and neuropsychologic complications than patients undergoing spinal cord stimulation. Furthermore, patients with white matter disease were affected by cerebral complications in a higher extent after bypass than after spinal cord stimulation. Thus, preoperative assessment of white matter disease before undergoing coronary artery bypass grafting might predict the patient's risk of developing cerebral injury.
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| 2. |
- Carlson, Tobias, 1976, et al.
(författare)
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Interference of transcutaneous electrical nerve stimulation with permanent ventricular stimulation: a new clinical problem?
- 2009
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Ingår i: Europace. - 1532-2092. ; 11:3, s. 364-9
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To assess the compatibility of thoracic TENS and permanent PM treatment and to identify any signs of interference of TENS with the PM function. METHODS AND RESULTS: Twenty-seven patients treated with PM were tested. Transcutaneous electric nerve stimulation electrodes were placed above each mamilla, and the stimulation intensity was increased to the maximum level tolerated for 30 s or until electrocardiogram revealed signs of interference. Transcutaneous electric nerve stimulation of 2 and 80 Hz was tested with the PM ventricular sensing level set to the clinically chosen level as well as to maximal sensitivity. Interference was detected in 22 of 27 patients (81%). Low-frequency (2 Hz) stimulation was more associated with PM interference (52% at normal vs. 81% at maximal ventricular sensitivity) than high-frequency (80 Hz) stimulation (33% at normal vs. 63% at maximal ventricular sensitivity); although the differences were not statistically significant. CONCLUSION: Transcutaneous electric nerve stimulation frequently induces inhibition of the PM function already at the clinically set ventricular sensitivity. Therefore, individual testing is warranted before TENS treatment is considered in patients with a PM. A test protocol for TENS and PM interaction is proposed.
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| 3. |
- Holmgren, C., et al.
(författare)
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Risk of interference from transcutaneous electrical nerve stimulation on the sensing function of implantable defibrillators
- 2008
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Ingår i: Pacing Clin Electrophysiol. - 1540-8159. ; 31:2, s. 151-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of transcutaneous electrical nerve stimulation (TENS) for pain relief is increasing. At the same time the implantable cardioverter defibrillator (ICD) is a routine treatment for malignant tachyarrhythmias. Today patients often need devices for more than one condition, and consideration must be given to the interaction between them. We studied the risk of interference between TENS and the ICD function. METHODS AND RESULTS: Thirty patients who had received an ICD underwent a test protocol including TENS at the mammilla and hip levels, at two energy levels, and at the highest comfortable stimulation level. The effects of TENS on the electrocardiogram lead II, intracardiac electrograms, and the ICD marker channels were analyzed. Disturbance from TENS on the sensing function was seen at all stimulation attempts. Interference between the systems was observed in 16 patients. In eight patients (27%) the interpretation was VT/VF and in 14 patients (47%) as ventricular premature extra beats. Other kinds of interactions were seen in five patients (16%). Each patient could have more than one kind of interference. CONCLUSIONS: Noise reversion and undersensing might prevent the ICD from delivering shock when it should and the interpretation as VT/VF could result in inappropriate shocks. Because of the potentially serious consequences of interference we do not recommend the use of TENS in patients with ICD.
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| 4. |
- Andréll, Paulin, 1978, et al.
(författare)
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HEALTH-RELATED QUALITY OF LIFE IN FIBROMYALGIA AND REFRACTORY ANGINA PECTORIS: A COMPARISON BETWEEN TWO CHRONIC NON-MALIGNANT PAIN DISORDERS
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 46:4, s. 341-347
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare health-related quality of life in 2 different populations with chronic pain: patients with fibromyalgia and patients with refractory angina pectoris. Previous separate studies have indicated that these patient groups report different impacts of pain on health-related quality of life. Methods: The Short-Form 36 was used to assess health-related quality of life. In order to adjust for age and gender differences between the groups, both patient groups were compared with age- and gender-matched normative controls. The difference in health-related quality of life between the 2 patient groups was assessed by transforming the Short-Form 36 subscale scores to a z-score. Results: The patients with fibromyalgia (n=203) reported poorer health-related quality of life in all the subscale scores of Short-Form 36 (p < 0.05-0.0001) than the patients with refractory angina (n = 146) when both groups were compared with their corresponding normal population (z-score). Conclusion: Patients with fibromyalgia experience greater impairment in health-related quality of life compared with the normal population than do patients with refractory angina pectoris, despite the fact that the latter have a potentially life-threatening disease. The great impairment in health-related quality of life in patients with fibromyalgia should be taken into consideration when planning rehabilitation.
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| 5. |
- Andréll, Paulin, 1978, et al.
(författare)
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Long-term effects of spinal cord stimulation on angina symptoms and quality of life in patients with refractory angina pectoris--results from the European Angina Registry Link Study (EARL)
- 2010
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Ingår i: Heart. - 1355-6037. ; 96:14, s. 1132-1136
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation. METHODS: During 2003-2005, all patients with refractory angina referred for SCS treatment at 10 European centres were consecutively included in the European registry for refractory angina (European Angina Registry Link, EARL), a prospective, 3-year follow-up study. In the present study, the SCS-treated patients were followed-up regarding angina symptoms and quality of life assessed was with a generic (Short Form 36, SF-36) and a disease-specific (Seattle Angina Questionnaire, SAQ) quality of life questionnaire. RESULTS: In total, 235 patients were included in the study. After screening, 121 patients were implanted and followed up 12.1 months after implantation. The implanted patients reported fewer angina attacks (p<0.0001), reduced short-acting nitrate consumption (p<0.0001) and improved Canadian Cardiovascular Society class (p<0.0001). Furthermore, quality of life was significantly improved in all dimensions of the SF-36 and the SAQ. Seven (5.8%) of the implanted patients died within 1 year of follow up. CONCLUSIONS: SCS treatment is associated with symptom relief and improved quality of life in patients with refractory angina pectoris suffering from severe coronary artery disease.
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| 6. |
- Andrell, Paulin, et al.
(författare)
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Smärta vid myokardischemi
- 2021
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Ingår i: Långvarig smärta- smärtmedicin vol 2. - Stockholm : Liber AB. - 9789147112883 ; , s. 673-86
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
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| 8. |
- Börjesson, Mats, 1965, et al.
(författare)
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Chest pain: an update
- 2002
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Ingår i: Curr Opin Anaesthesiol. ; 15:5, s. 569-74
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE OF REVIEW: Chest pain is one of the most common symptoms for seeking acute medical care. Evidence of myocardial ischemia, however, can only be established in a minority of patients. The establishment or ruling out of myocardial ischemia is difficult and the cost is high. An effective rationale for ischemia detection, without unnecessary hospital admission, is needed. The development of chest pain units potentially offers a rapid, effective way of identifying patients at high risk for acute coronary syndromes, as well as those with a low probability of ischemia. Other cardiac or noncardiac causes of chest pain should also be considered. RECENT FINDINGS: Recent developments in chest pain, including the ruling in or out of ischemic pain by triage and different ischemia detection methods, are discussed. Other causes of chest pain such as esophageal, drug related, psychiatric and post-coronary bypass surgery pain are also discussed. Recent findings on syndrome X are reviewed and patients with myocardial infarction presenting without chest pain are discussed. SUMMARY: The possibility of safely and quickly ruling out myocardial ischemia by point-of-care biochemical analyses is reviewed, which might influence our clinical handling of chest pain patients. The importance of biopsychosocial factors, pain perception, esophageal dysfunction, drugs and the coronary artery bypass procedure in itself, is discussed and vital clinical information is provided for the handling of our chest pain patients.
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| 9. |
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| 10. |
- Börjesson, Mats, 1965, et al.
(författare)
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Ischemiska smärttillstånd
- 2010
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Ingår i: Smärta och smärtbehandling. Eds. Werner M, Strang P. 3nd Ed..
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 11. |
- Börjesson, Mats, 1965, et al.
(författare)
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Neurostimulering har god effekt vid svår angina pectoris : Neurostimulation is effective in severe angina pectoris
- 2009
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Ingår i: Läkartidningen. - 0023-7205 .- 0023-7205. ; 106:4, s. 214-7
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Tidskriftsartikel (refereegranskat)abstract
- Svår symtomgivande angina pectoris, trots optimal medikamentell och invasiv terapi, definieras internationellt som refraktär angina pectoris. Ett flertal additiva behandlingsmetoder har utvecklats och visat symtomlindrande effekt i studier av varierande kvalitet. Neurostimulering (spinal cord stimulation, SCS) är mest studerad och har i randomiserade kontrollerade studier visat positiva effekter på symtomlindring, förbättrad funktionell status och höjd livskvalitet.
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| 12. |
- Börjesson, Mats, 1965, et al.
(författare)
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Pain
- 2010
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Ingår i: Physical Activity in the Prevention and Treatment of Disease. - 9789172577152
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Börjesson, Mats, 1965, et al.
(författare)
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Smärta
- 2008
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Ingår i: FYSS. Folkhälsoinstitutet, 2nd Ed. ; , s. 552-70
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 14. |
- Börjesson, Mats, 1965, et al.
(författare)
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Spinal cord stimulation for refractory angina.
- 2010
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Ingår i: In: Evidence-based chronic pain management. Eds. Stannard C, Kelso E, Ballantyne J.. - : Blackwell, Publ, 2010. ; , s. 400-4
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 15. |
- Dyrehag, L E, et al.
(författare)
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Relations between self-rated musculoskeletal symptoms and signs and psychological distress in chronic neck and shoulder pain.
- 1998
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Ingår i: Scandinavian journal of rehabilitation medicine. - 0036-5505. ; 30:4, s. 235-42
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Tidskriftsartikel (refereegranskat)abstract
- The purposes of the present study were to describe physical and psychological characteristics of 55 chronic pain patients with predominantly nociceptive neck and shoulder complaints, and to explore relationships between physical assessment methods, self-reported pain and psychological distress. The physical measures included cervical and shoulder mobility and muscle tenderness. The Pain Severity and Interference subscales from the Multidimensional Pain Inventory (MPI), Becks Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI-Y), and a pain drawing assessed self-reports of pain and psychological distress. The number of tender points (TP score) correlated significantly with pain severity, (p < 0.01) Interference (p < 0.05), pain drawing score (p < 0.05), BDI (p < 0.05) and state anxiety (p < 0.05). No significant correlation was seen between TP score and age, pain duration or trait anxiety. The results suggest that there are relationships between observers' ratings of muscle tenderness (TP score) and self-reports of pain severity, interference of pain and psychological distress in patients with chronic cervico-brachial pain.
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| 16. |
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| 17. |
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| 18. |
- Gordh, Torsten E, et al.
(författare)
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Gabapentin in traumatic nerve injury pain : a randomized, double-blind, placebo-controlled, cross-over, multi-center study
- 2008
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Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 138:2, s. 255-266
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Tidskriftsartikel (refereegranskat)abstract
- A double-blind, randomized, placebo-controlled cross-over multi-center study was conducted to evaluate the efficacy and safety of gabapentin in the treatment of neuropathic pain caused by traumatic or postsurgical peripheral nerve injury, using doses up to 2400 mg/day. The study comprised a run-in period of two weeks, two treatment periods of five weeks separated by a three weeks' washout period. The primary efficacy variable was the change in the mean pain intensity score from baseline to the last week of treatment. Other variables included pain relief, health related quality of life (SF-36), interference of sleep by pain, Clinician and Patient Global Impression of Change, and adverse effects. Nine centers randomized a total of 120 patients, 22 of whom withdrew. There was no statistically significant difference between the treatments for the primary outcome efficacy variable. However, gabapentin provided significantly better pain relief (p=0.015) compared with placebo. More patients had at least a 30% pain reduction with gabapentin compared with placebo (p=0.040) and pain interfered significantly less with sleep during gabapentin treatment compared with placebo (p=0.0016). Both the Patient (p=0.023) and Clinician (p=0.037) Global Impression of Change indicated a better response with gabapentin compared with placebo. Gabapentin was well tolerated. The most common adverse effects were dizziness and tiredness.
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| 19. |
- Hallén, Katarina, et al.
(författare)
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Transcutaneous electrical nerve stimulation induces vasodilation in healthy controls but not in refractory angina patients.
- 2010
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Ingår i: Journal of pain and symptom management. - : Elsevier BV. - 1873-6513 .- 0885-3924. ; 40:1, s. 95-101
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: Transcutaneous electrical nerve stimulation (TENS) is an effective treatment option to relieve ischemic pain in refractory angina pectoris (RAP). In healthy persons, TENS enhances local blood flow, but the mechanism responsible for the anti-ischemic effect in RAP seems to be different. OBJECTIVE: The aim of the present investigation was to compare the difference in blood flow and vasodilatory response to TENS between angina patients and healthy controls and evaluate how vascular response in these groups is affected by amperage dosage above and below motor threshold levels. METHODS: Our study evaluated upper limb vascular responses to low- and high-dose TENS (below and above motor threshold) in RAP patients compared with healthy controls. TENS was applied on the nondominating forearm. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. Forearm vascular resistance (FVR) was determined (mean arterial pressure [MAP]/FBF). Measurements were done during baseline, low-dose TENS, high-dose TENS, and during recovery. RESULTS: A significant dose-dependent increase in FBF in response to TENS stimulation was seen in controls (n=18) but not in RAP (n=23) (P=0.008). There was no significant difference in FVR ratio (FVR(stim)/FVR(ctrl)) between control (n=7) and RAP (n=23) groups at low dose (controls, 5.7+/-21%; RAP, 9.7+/-20%) or recovery (controls, -4.6+19%; RAP, 5.9+25%). High-dose TENS resulted in a significantly reduced FVR ratio (-16.8+/-11%) in controls (n=7) compared with RAP (1.6+/-32%, n=23) (P=0.02). CONCLUSION: High-dose TENS induces forearm vasodilation in healthy subjects but not in patients with RAP. These findings suggest that TENS has different vascular effects in patients with severe coronary artery disease compared with healthy controls.
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| 20. |
- Johansson, Birgitta, 1957, et al.
(författare)
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Evaluation of dosage, safety and effects of methylphenidate on post-traumatic brain injury symptoms with a focus on mental fatigue and pain.
- 2014
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Ingår i: Brain injury : [BI]. - : Informa UK Limited. - 1362-301X .- 0269-9052. ; 28:3, s. 304-310
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: The neurobehavioural symptoms and pain following traumatic brain injury (TBI) can be long-lasting. The condition impairs the persons' ability to function in their work, studies and gatherings with family and friends. The aim of this study was to investigate dosage, safety and effects of methylphenidate on mental fatigue and pain. Methods: Twenty-nine physically-well rehabilitated TBI victims, 28 with a mild TBI and one with TBI and also with pain in the neck, shoulders and head were included in the study. Methylphenidate was tested in each patient using three treatment strategies: no medication, low dose (5mg×3) and normal dose (20mg×3) for 4 weeks using a randomized cross-over design. Results: Twenty-four patients completed the three treatment periods. Five participants discontinued, four females due to adverse reactions and one male due to attenuated motivation. Only minor adverse events were reported. Methylphenidate significantly decreased mental fatigue, as evaluated by the Mental Fatigue Scale (p<0.001), and the effects on mental fatigue were dose-dependent. No effect on pain was detected. Conclusions: Methylphenidate decreased mental fatigue for subjects suffering a traumatic brain injury, the treatment is considered to be safe and is recommended, starting with a low dose.
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| 21. |
- Johansson, Birgitta, 1957, et al.
(författare)
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Hjärntrötthet – ett osynligt gissel : Mental fatigue - possible explanations, diagnostic methods and possible treatments
- 2022
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Ingår i: Läkartidningen. - 0023-7205. ; 119
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Tidskriftsartikel (refereegranskat)abstract
- Mental fatigue or brain fatigue is a pathological and disabling symptom with diminished mental energy. It can be a long-lasting consequence after trauma or disease affecting the brain. The person can do most things in the moment and can be perceived as completely healthy, but the mental energy is insufficient over time and affects the ability to work and participate in social activities. After a conversation, for example, the person can be completely drained of energy and the recovery time is disproportionally long. Here we describe the phenomenon of mental fatigue, provide an explanatory model for how the condition can arise, point out diagnostic methods and possible treatments, which are currently in the research stage but may be implemented in healthcare within the foreseeable future.
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