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- Darsalia, V, et al.
(författare)
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The DPP-4 inhibitor linagliptin counteracts stroke in the normal and diabetic mouse brain: a comparison with glimepiride
- 2013
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Ingår i: Diabetes. - : American Diabetes Association. - 1939-327X .- 0012-1797. ; 62:4, s. 1289-1296
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Tidskriftsartikel (refereegranskat)abstract
- Type 2 diabetes is a strong risk factor for stroke. Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor in clinical use against type 2 diabetes. The aim of this study was to determine the potential antistroke efficacy of linagliptin in type 2 diabetic mice. To understand whether efficacy was mediated by glycemia regulation, a comparison with the sulfonylurea glimepiride was done. To determine whether linagliptin-mediated efficacy was dependent on a diabetic background, experiments in nondiabetic mice were performed. Type 2 diabetes was induced by feeding the mice a high-fat diet for 32 weeks. Mice were treated with linagliptin/glimepiride for 7 weeks. Stroke was induced at 4 weeks into the treatment by transient middle cerebral artery occlusion. Blood DPP-4 activity, glucagon-like peptide-1 (GLP-1) levels, glucose, body weight, and food intake were assessed throughout the experiments. Ischemic brain damage was measured by determining stroke volume and by stereologic quantifications of surviving neurons in the striatum/cortex. We show pronounced antistroke efficacy of linagliptin in type 2 diabetic and normal mice, whereas glimepiride proved efficacious against stroke in normal mice only. These results indicate a linagliptin-mediated neuroprotection that is glucose-independent and likely involves GLP-1. The findings may provide an impetus for the development of DPP-4 inhibitors for the prevention and treatment of stroke in diabetic patients.
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- Egge, A, et al.
(författare)
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Outcome 1 year after aneurysmal subarachnoid hemorrhage: relation between cognitive performance and neuroimaging
- 2005
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 112:2, s. 76-80
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Tidskriftsartikel (refereegranskat)abstract
- Objective - To assess the cognitive impairment and the association between neuropsychological measures and neuroimaging 1 year after aneurysmal subarachnoid hemorrhage (SAH). Method - Forty-two patients were examined clinically according to Glasgow Outcome Scale (GOS). Computed tomography (CT), single photon emission computed tomography (SPECT) and neuropsychological examination were performed. Results - There were no association between GOS and cognitive impairment index based on the neuropsychological examination. CT showed no sign of cerebral ischemia in 17 (40%) and low attenuating areas indicating cerebral infarction(s) in 25 (60%) patients. A significant correlation (P = 0.01) was observed between the cognitive impairment index and the SPECT index (r = 0.6). SPECT measurement was the only independent predictor for cognitive impairment. Conclusion - GOS is a crude outcome measure and patients classified with good recoveries may have significant cognitive deficits. Neuropsychological examination is the preferred method for outcome evaluation as this method specifically addresses the disabilities affecting patients' everyday life.
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- Egge, A, et al.
(författare)
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Serial single-photon emission computed tomographic and transcranial doppler measurements for evaluation of vasospasm after aneurysmal subarachnoid hemorrhage
- 2005
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Ingår i: Neurosurgery. - 0148-396X. ; 57:2, s. 237-248
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the clinical value of serial single photon-emission computed tomographic (SPECT) measurements after aneurysmal subarachnoid hemorrhage (SAH). Methods: Thirty-two patients were studied prospectively during the first 26 days after SAH with repeated SPELT measurements; clinical examinations, and transcranial Doppler recordings. Time trends were analyzed with a general linear model. A final SPECT measurement was performed after 1 year. Results: A mean of 2.6 (range, 1-5) SPECT measurements revealed a significant (P=0.001) quadratic curve consistent with initial hypoperfusion and then with hyperperfusion during the acute stage. SPELT findings were significantly associated with transcranial Doppler recordings (P=0.016) and clinical assessments (P=0.008). Patients fulfilling clinical and transcranial Doppler criteria for vasospasm demonstrated a more pronounced relative hypoperfusionj hyperperfusion time course. A multivariate logistic regression analysis identified SPECT measurements obtained during Days 7 to 14 after the SAH as the only independent predictor (beta=0.042, P=0.02) for impaired perfusion after 1 year. Conclusion: Serial SPECT measurements after aneurysmal SAH demonstrate that regional changes in cerebral perfusion follow a nonlinear time trend, and repeated measurements are necessary. This observation, as well as the low feasibility of SPECT, restricts the clinical value of such measurements.
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- Sjoholm, B, et al.
(författare)
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Impact of digital imaging on radiation doses to the patient during X-ray examination of the urinary tract
- 2005
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Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 46:6, s. 657-661
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare radiation doses given to patients undergoing IVU (intravenous urography) before and after digitalization of our X-ray department. Material and Methods: IVU examinations were monitored with dose area product meters before and after the X-ray department changed to digital techniques. The first step was a change from film-screen to storage phosphor plates, while the second step involved changing to a flat panel detector. Forty-two patients were included for the film-screen situation, 69 when using the storage phosphor plates, and 70 using the flat panel detector. Results: A dose reduction from 41.8 Gycm(2) to 31.5 Gycm(2) was achieved with the first step when the film-screen system was replaced with storage phosphor plates. A further reduction to 12.1 Gycm(2) was achieved using the flat panel detector. Conclusion: The introduction of the flat panel detectors made a considerable dose reduction possible.
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