| 1. |
- Fresnais, David, et al.
(författare)
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Apathy as a Predictor for Conversion From Mild Cognitive Impairment to Dementia : A Systematic Review and Meta-Analysis of Longitudinal Studies
- 2023
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Ingår i: Journal of Geriatric Psychiatry and Neurology. - : Sage Publications. - 0891-9887 .- 1552-5708. ; 36:1, s. 3-17
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Apathy is one of the most prevalent neurobehavioral manifestations in mild cognitive impairment (MCI) and is included among the behavioral and psychological symptoms of dementia (BPSD). Studies suggest that the presence of apathy could be associated with increased dementia risk. The role of apathy in conversion from MCI to dementia, and whether apathy could be a relevant predictor for dementia progression, are still matters of investigation.AIM: To study the relationship between apathy and progression to dementia in individuals with MCI.METHODS: A systematic literature search in Medline, Embase, Cochrane Library, Epistemonikos, PsychINFO, and CINAHL was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search included longitudinal studies reporting on the association between apathy and dementia.RESULTS: The main outcome was pooled unadjusted hazard ratios (HR) of apathy in dementia conversion and included 11 studies with 9504 individuals. There was a significant association between apathy and dementia conversion, HR = 1.54; 95% CI, 1.29, 1.84. Subgroup analysis showed a significant association between apathy and progression to AD.CONCLUSION: Apathy was associated with an increased risk of conversion to AD and all-cause dementia in patients with MCI. The role of apathy as a marker for incident dementia needs to be investigated in large, high-quality studies.
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| 2. |
- Fresnais, David, et al.
(författare)
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The Association between Carotid Intima-Media Thickness and Cognitive Impairment : A Systematic Review and Meta-Analysis
- 2021
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger. - 1420-8008 .- 1421-9824. ; 50:4, s. 305-317
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Forskningsöversikt (refereegranskat)abstract
- Background: Emerging evidence suggests that cognitive impairment (CI) and different etiologies of dementia, including Alzheimer's disease (AD), are associated with vascular risk factors and atherosclerosis. In clinical practice, carotid intima-media thickness (CIMT) measured by ultrasonography may be a marker of atherosclerosis. Many studies report increased CIMT in patients with dementia and CI although a firm association has not yet been established.Aim: This systematic review and meta-analysis were conducted to study the relationship between CIMT, dementia, and CI.Methods: The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included the following databases: Medline, Embase, Cochrane Library, and Epistemonikos. The search spanned from 2000 to 2020 and was limited to English and Scandinavian languages.Results: The main analysis of CIMT in subjects with CI compared to subjects with no cognitive impairment (NCI) included 12 studies; 1,089 subjects with CI and 5,223 with NCI. There was no significant difference in CIMT between the CI and NCI groups. However, subgroup analyses revealed significantly higher CIMT in the mild cognitive impairment (MCI) and dementia groups than the NCI group. In addition, patients with dementia had increased CIMT compared to patients with MCI, and patients with AD demonstrated higher CIMT than those with vascular cognitive impairment (VCI).Conclusion: CIMT may be higher in subjects with CI than in cognitively healthy subjects although no significant difference was observed in our main analysis. CIMT was higher in the dementia group than the MCI group and in the AD group compared to the VCI group.
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| 3. |
- Papaioannou, Konstantinos-Georgios, 1983-
(författare)
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Diet and physical activity behaviors for healthy aging
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The process of aging is characterized by physiological changes in various body systems and biological functions, that affect health and functional capacity. Adopting healthy lifestyle behaviors could be an effective, accessible, and lowcost strategy to delay age-related functional changes. Dietary habits, including both patterns and amounts of specific food items, and physical activity (PA)are two lifestyle factors that may have an impact on several age-related health aspects. The overall aim of this thesis was to determine the links between diet, physical activity behaviors, and biological markers of healthy aging, including muscle health, metabolic health, and systemic inflammation in older adults.The findings of the present work collectively highlight the role of diet and physical activity behaviors on biological markers of healthy aging in older adults. Daily amounts of sedentary time were detrimentally associated with the systemic inflammatory environment, with sex-specific alterations in proand anti-inflammatory biomarkers. In term of dietary habits, higher intakes of vegetables were associated with lower levels of the pro-inflammatory biomarker IL-6 in older adults, regardless of intakes of other health-related food groups, physical activity behaviors, and adiposity level. Moreover, lower intakes of fruit and vegetables (FV) in general, and of vegetables in particular, increased the likelihood of having metabolic syndrome (MetS) in older adults, which was evident even after considering time spent in sedentary behavior and adherence to the moderate-to-vigorous physical activity (MVPA) guideline. Finally, healthy eating was beneficially associated with lower sarcopenia risk in physically active older men and women, even when engagement in musclestrengthening activities and adherence to guidelines for protein intake were considered. Overall, the present thesis demonstrates the detrimental impact of excessive amounts of sedentary time on markers of systemic inflammation and highlights the beneficial effects of healthy eating on biological determinants of healthy aging regardless of the potential confounding effects of physical activity behaviors.
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| 4. |
- Meehan, Adrian David, 1973-, et al.
(författare)
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Characterization of Calcium Homeostasis in Lithium-Treated Patients Reveals Both Hypercalcaemia and Hypocalcaemia
- 2020
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Ingår i: World Journal of Surgery. - : Springer. - 0364-2313 .- 1432-2323. ; 44:2, s. 517-525
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Prevalence studies demonstrate that a significant proportion of lithium-treated patients develop hypercalcaemia (3-30%). Lithium-associated hyperparathyroidism (LHPT) is poorly defined, and calcium homeostasis may be affected in a more complicated fashion than purely by elevated PTH secretion. The current study aims to examine in detail calcium homeostasis principally with regard to lithium duration.METHODS: Medical records of 297 lithium-treated patients (193 women, 104 men; median age 58 years) were examined, and information on gender, age, lithium treatment duration and calcium homeostasis was obtained. The median treatment duration with lithium was 16 (1.5-45) years.RESULTS: A total of 8504 calcium values were retrieved. Before initiation of lithium treatment, serum calcium was on average 2.33 mmol/l (2.02-2.60). During the treatment period, 178 patients (60%) remained normocalcaemic, 102 (34%) developed hypercalcaemia or were strongly suspected of LHPT, 17 (6%) had 3 or more intermittent episodes of hypocalcaemia. Forty-one per cent of patients with suspected or confirmed LHPT had low (<4 mmol) 24-h urine calcium levels. The success rate after 33 parathyroidectomies was 35%, hyperplasia being diagnosed in 75% of extirpated glands.CONCLUSIONS: The prevalence of hypercalcaemia during lithium treatment is very high. In addition, hypocalcaemic episodes appear to occur frequently, possibly reflecting a more complicated parathyroid dysfunction than previously known. Long-term surgical results are unsatisfactory. LHPT biochemical profile is different from that of primary hyperparathyroidism and is in some ways similar to familial hypocalciuric hypercalcaemia.
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| 5. |
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| 6. |
- Meehan, Adrian David, 1973-, et al.
(författare)
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Lithium-Associated Hypercalcemia: Pathophysiology, Prevalence, Management
- 2018
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 42:2, s. 415-424
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Tidskriftsartikel (refereegranskat)abstract
- Background Lithium-associated hypercalcemia (LAH) is an ill-defined endocrinopathy. The aim of the present study was to determine the prevalence of hypercalcemia in a cohort of bipolar patients (BP) with and without concomitant lithium treatment and to study surgical outcomes for lithium-associated hyperparathyroidism. Methods Retrospective data, including laboratory results, surgical outcomes and medications, were collected from 313 BP treated with lithium from two psychiatric outpatient units in central Sweden. In addition, data were collected from 148 BP without lithium and a randomly selected control population of 102 individuals. Logistic regression was used to compare odds of hypercalcemia in these respective populations. Results The prevalence of lithium-associated hypercalcemia was 26%. Mild hypercalcemia was detected in 87 out of 563 study participants. The odds of hypercalcemia were significantly higher in BP with lithium treatment compared with BP unexposed to lithium (adjusted OR 13.45; 95% CI 3.09, 58.55; p = 0.001). No significant difference was detected between BP without lithium and control population (adjusted OR 2.40; 95% CI 0.38, 15.41; p = 0.355). Seven BP with lithium underwent surgery where an average of two parathyroid glands was removed. Parathyroid hyperplasia was present in four patients (57%) at the initial operation. One patient had persistent disease after the initial operation, and six patients had recurrent disease at follow-up time which was on average 10 years. Conclusion The high prevalence of LAH justifies the regular monitoring of calcium homeostasis, particularly in high-risk groups. If surgery is necessary, bilateral neck exploration should be considered in patients on chronic lithium treatment. Prospective studies are needed.
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| 7. |
- Meehan, Adrian David, 1973-, et al.
(författare)
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Movement Is the Song of the Body : Reflections on the Evolution of Rhythm and Music and Its Possible Significance for the Treatment of Parkinson’s Disease
- 2017
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Ingår i: Evolutionary Studies in Imaginative Culture. - : Academic Studies Press. - 2472-9884 .- 2472-9876. ; 1:2, s. 73-86
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Tidskriftsartikel (refereegranskat)abstract
- Schooling fish, swarms of starlings, plodding wildebeest, and musicians all display impressive synchronization. To what extent do they use acoustic cues to achieve these feats? Could the acoustic cues used in movement synchronization be relevant to the treatment of movement disorders such as Parkinson’s disease (PD) in humans? In this paper, we build on the emerging view in evolutionary biology that the ability to synchronize movement evolved long before language, in part due to acoustic advantages. We use this insight to explore potential mechanisms explaining why music therapy has beneficial effects for PD patients. We hypothesize that rhythmic auditory cues, particularly music, can stimulate neuronal and behavioral processes that ease the symptoms and potentially the causes of PD because the neural circuits used in auditory entrainment at individual and group levels are associated with dopamine production. We summarize current treatment of PD and outline how new insights from an evolutionary perspective could improve understanding and eventual treatment of movement disorders in humans.
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| 10. |
- Meehan, Adrian David, 1973-, et al.
(författare)
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Unusual case of rosacea fulminans in older man
- 2020
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Ingår i: Journal of Gerontology and Geriatrics. - : Italian Society of Gerontology and Geriatrics (SIGG). - 2499-6564. ; 68:3
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Tidskriftsartikel (refereegranskat)abstract
- Rosacea fulminans (RF) is characterised by the abrupt onset of discomforting and consolidating pustules and nodules, oedema, cysts and erythema. The condition is considered rare, even rarer in men. Controversy exists whether RF should be categorised as rosacea. The aetiopathogenesis of RF remains largely unknown. We present a case of an 87-yr-old man with no previous history of rosacea or acne, admit-ted for a suspected systemic bacterial infection and who rapidly developed tender ocular, facial and extrafacial lesions. The patient had subfebrile temperatures, leukocytosis and moderate anaemia, but also general fatigue. The features of gender, location and extent of lesions, and biochemical response are all atypical with regards RF. The condition was successfully treated with a combination of antibiotics and oral corticosteroids. Specific management guidelines regarding RF are yet to be established, further warranting the need for continued research to determine RF’s aetiology, natural course and its optimal treatment.
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| 11. |
- Oikonomakis, Ioannis, 1977-, et al.
(författare)
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Altered mRNA Expression Due to Rectal Perforation in a Porcine Model-A Pilot Study
- 2022
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Ingår i: Anticancer Research. - : Anticancer Research USA Inc.. - 0250-7005 .- 1791-7530. ; 42:6, s. 2827-2833
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anastomotic leakage is the most serious and unwelcome complication in rectal surgery. It has a great impact on postoperative morbidity and mortality. In this pilot study, changes of mRNA expression in blood were analyzed in an animal model designed to imitate anastomotic leakage. Materials and Methods: Twelve pigs were randomized into two groups: A sham-operated control group and an experimental group in which iatrogenic rectal perforation was performed. The changes in the mRNA expression at 4 hours after creating the perforation were studied. Microarray analysis was performed using Gene Chip whole porcine genome array. mRNA expression of 19,124 genes was investigated. Results: Significantly increased levels of genes with a fold change greater than 2 were found, including 276 coding for unknown proteins and 48 coding for known proteins. Eleven of those which coded for known proteins were up-regulated with a fold change >4. Conclusion: Eleven known genes were highly up-regulated after rectal perforation. These genes were mainly involved in inflammatory response, intracellular signaling and cell membrane regulation. Their corresponding proteins might potentially be clinical biomarkers of anastomotic leakage and should be evaluated in further clinical studies.
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