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- Hagell, Peter, et al.
(författare)
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Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson's disease
- 2020
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Ingår i: Journal of Neurology. - 0340-5354 .- 1432-1459. ; 267:11, s. 3411-3417
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Tidskriftsartikel (refereegranskat)abstract
- Continuous subcutaneous (s.c.) apomorphine infusion is an effective therapy for Parkinson's disease (PD), but a limitation is the formation of troublesome s.c. nodules. Various chemically non-identical apomorphine formulations are available. Anecdotal experiences have suggested that shifting from one of these (Apo-Go PumpFill®; apoGPF) to another (Apomorphine PharmSwed®; apoPS) may influence the occurrence and severity of s.c. nodules. We, therefore, followed 15 people with advanced PD (median PD-duration, 15 years; median "off"-phase Hoehn and Yahr, IV) on apoGPF and with troublesome s.c. nodules who were switched to apoPS. Data were collected at baseline, at the time of switching, and at a median of 1, 2.5, and 7.3 months post-switch. Total nodule numbers (P < 0.001), size (P < 0.001), consistency (P < 0.001), skin changes (P = 0.058), and pain (P ≤ 0.032) improved over the observation period. PD severity and dyskinesias tended to improve and increase, respectively. Apomorphine doses were stable, but levodopa doses increased by 100 mg/day. Patient-reported apomorphine efficacy tended to increase and all participants remained on apoPS throughout the observation period; with the main patient-reported reason being improved nodules. These observations suggest that patients with s.c. nodules caused by apoGPF may benefit from switching to apoPS in terms of s.c. nodule occurrence and severity. Alternatively, observed benefits may have been due to the switch itself. As nodule formation is a limiting factor in apomorphine treatment, a controlled prospective study comparing local tolerance with different formulations is warranted.
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- Höglund, Arja, et al.
(författare)
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Associations between fluctuations in daytime sleepiness and motor and non-motor symptoms in Parkinson's disease
- 2021
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Ingår i: Movement Disorders Clinical Practice. - 2330-1619. ; 8:1, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Non-motor fluctuations (NMF) are a major concern in Parkinson's disease (PD), and they have been categorised into neuropsychiatric, autonomic and sensory fluctuations. However, this categorisation does not include sleep and sleep-related features, and the association between daytime sleepiness and other motor and/or non-motor fluctuations in PD remains to be elucidated. Objective To investigate the relationship between daytime sleepiness and other non-motor and motor fluctuations in people with PD. Methods A three-day home diary recording daytime sleepiness, mood, anxiety, and motor symptoms was used along with the Karolinska Sleepiness Scale (KSS) and six days of accelerometer (Parkinson's KinetiGraph?; PKG?) registration to detect motor fluctuations among people with a DaTSCAN verified clinical PD diagnosis (32 men; mean PD duration, 8.2?years). Participants were categorised as motor fluctuators or non-fluctuators according to the UPDRS part IV and/or the presence of motor and non-motor fluctuations. Results Fifty-two people with PD participated. Daytime sleepiness correlated significantly with motor symptoms, mood and anxiety among those classified as motor fluctuators (n = 28). Motor fluctuators showed stronger correlations between the individual mean level of all diary variables (daytime sleepiness, anxiety, mood and motor symptoms) when compared to the non-fluctuators (n = 24). Stronger positive within-individual correlations were found among fluctuators in comparison to non-fluctuators. In general, PKG data did not correlate with diary data. Conclusion Episodes of daytime sleepiness, as reported by home diaries, were associated with other self-reported non-motor and motor fluctuations, but were not supported by PKG data.
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| 5. |
- Hedin, G, et al.
(författare)
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Measuring Insomnia Among Adolescents : Analysis of the Minimal Insomnia Symptom Scale (miss) with the Rasch Measurement Model
- 2022
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457.
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Konferensbidrag (refereegranskat)abstract
- Introduction : The Minimal Insomnia Symptom Scale (MISS) is a three-item screening instrument that has been found to be psychometrically sound and capable of screening for insomnia among adults and older people. This study aimed to test the measurement properties of the MISS together with an additional item focusing on daytime functioning among adolescents using the Rasch measurement model. Materials and Methods : A cross-sectional design were used, and data from adolescents (age 13-17 years, n=3022) was analyzed using the Rasch measurement model. Results : The MISS had good measurement properties. When replacing the original MISS item “not rested by sleep” with the item “daytime disturbance”, the measurement properties slightly improved. We label this new scale the MISS-Revised (MISS-R). The reliability was significantly better for the MISS-R (0.55) compared to the MISS (0.50). The optimal cut-off was found to be >6 points, both for the MISS and the MISS-R. Conclusions : This study provides general support that both the MISS as well as the MISS-R have good fit to the Rasch model. At this stage, neither the MISS nor the MISS-R can be advocated over the other for use among adolescents, although the MISS-R had slightly better reliability than the MISS. Additional studies are needed to determine the clinically optimal cut-off score for identification of insomnia.
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| 6. |
- Newby, H, et al.
(författare)
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A Scoping Review of Adolescent Health Indicators
- 2021
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Ingår i: The Journal of adolescent health : official publication of the Society for Adolescent Medicine. - : Elsevier BV. - 1879-1972. ; 69:3, s. 365-374
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Bolejko, A., et al.
(författare)
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Effects of an information booklet on patient anxiety and satisfaction with information in magnetic resonance imaging : A randomized, single-blind, placebo-controlled trial
- 2021
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Ingår i: Radiography. - : Elsevier BV. - 1078-8174 .- 1532-2831. ; 27:1, s. 162-167
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Magnetic resonance imaging (MRI) is an important modality in diagnostics and treatment follow-up. However, MRI can be perceived as unpleasant even though the examination is non-invasive. Patients' knowledge of the MRI procedure is usually scarce, which may enhance patient anxiety at examination. We investigated the effects on anxiety and satisfaction with an information booklet on MRI compared to a placebo booklet delivered to adult patients prior to their first MRI examination. Methods: This randomized, single-blind, placebo-controlled trial included 197 patients. The intervention group (n = 95) received a booklet about MRI prior to the examination, whereas the control group (n = 102) received a placebo booklet of the same size and layout but containing general information. The State Trait Anxiety Inventory with supplementary questions from the Quality from the Patient's Perspective questionnaire were used as patient-reported outcome measures. Results: Anxiety did not differ between the groups, either prior to MRI or during the examination, but those who received the placebo booklet were at higher risk of experiencing high anxiety prior to the MRI examination (odds ratio 2.64; P = 0.029). The intervention group was more satisfied with the information received (P = 0.044), and a majority of participants in both groups (≥87%) considered it important to obtain information on the MRI procedure. Conclusion: Written MRI information decreases the risk of high anxiety levels before MRI and improves patient satisfaction with the information. Further research is needed to investigate whether written information prior to MRI is beneficial not only from the perspective of the patient but may also be cost-effective. Implications for practice: Written MRI information prior to the examination is recommended in radiography care.
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| 8. |
- Hedin, G., et al.
(författare)
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Measuring insomnia among adolescents : Analysis of the Minimal Insomnia Symptom Scale (MISS) with the Rasch measurement model
- 2022
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 100:Suppl. 1, s. S130-S131
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The Minimal Insomnia Symptom Scale (MISS) is a three-item screening instrument that has been found to be psychometrically sound and capable of screening for insomnia among adults and older people. This study aimed to test the measurement properties of the MISS together with an additional item focusing on daytime functioning among adolescents using the Rasch measurement model.
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