| 1. |
- Ozanne, Anneli, 1978, et al.
(författare)
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Symptom relief during last week of life in neurological diseases
- 2019
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279. ; 9:8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to investigate symptom prevalence, symptom relief, and palliative care indicators during the last week of life, comparing them for patients with motor neuron disease (MND), central nervous system tumors (CNS tumor), and other neurological diseases (OND). Material & Methods Data were obtained from the Swedish Register for Palliative Care, which documents care during the last week of life. Logistic regression was used to compare patients with MND (n = 419), CNS tumor (n = 799), and OND (n = 1,407) as the cause of death. Results The most prevalent symptoms for all neurological disease groups were pain (52.7% to 72.2%) and rattles (58.1% to 65.6%). Compared to MND and OND, patients with CNS tumors were more likely to have totally relieved pain, shortness of breath, rattles, and anxiety. They were also more likely to have their pain assessed with a validated tool; to receive symptom treatment for anxiety, nausea, rattles, and pain; to have had family members receive end-of-life discussions; to have someone present at death; and to have had their family members offered bereavement support. Both patients with CNS tumor and MND were more likely than patients with OND to receive consultation with a pain unit and to have had end-of-life discussions. Conclusions The study reveals high symptom burden and differences in palliative care between the groups during the last week of life. There is a need for person-centered care planning based on a palliative approach, focused on improving symptom assessments, relief, and end-of-life conversations.
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| 2. |
- Hansson, Per-Olof, 1958, et al.
(författare)
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Prehospital identification of factors associated with death during one-year follow-up after acute stroke
- 2018
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279. ; 8:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In acute stroke, the risk of death and neurological sequelae are obvious threats. The aim of the study was to evaluate the association between various clinical factors identified by the emergency medical service (EMS) system before arriving at hospital and the risk of death during the subsequent year among patients with a confirmed stroke. Material and Methods: All patients with a diagnosis of stroke as the primary diagnosis admitted to a hospital in western Sweden (1.6 million inhabitants) during a four-month period were included. There were no exclusion criteria. Results: In all, 1,028 patients with a confirmed diagnosis of stroke who used the EMS were included in the analyses. Among these patients, 360 (35%) died during the following year. Factors that were independently associated with an increased risk of death were as follows: (1) high age, per year OR 1.07; 95% CI 1.05-1.09; (2) a history of heart failure, OR 2.08; 95% CI 1.26-3.42; (3) an oxygen saturation of < 90%, OR 8.05; 95% CI 3.33-22.64; and (4) a decreased level of consciousness, OR 2.19; 95% CI 1.61-3.03. Conclusions: Among patients with a stroke, four factors identified before arrival at hospital were associated with a risk of death during the following year. They were reflected in the patients' age, previous clinical history, respiratory function, and the function of the central nervous system.
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| 3. |
- Alsholm, Linda, et al.
(författare)
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Interrupted transport by the emergency medical service in stroke/transitory ischemic attack : A consequence of changed treatment routines in prehospital emergency care.
- 2019
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279 .- 2162-3279.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The discovery that not all patients who call for the emergency medical service (EMS) require transport to hospital has changed the structure of prehospital emergency care. Today, the EMS clinician at the scene already distinguishes patients with a time-critical condition such as stroke/transitory ischemic attack (TIA) from patients without. This highlights the importance of the early identification of stroke/TIA.AIM: To describe patients with a final diagnosis of stroke/TIA whose transport to hospital was interrupted either due to a lack of suspicion of the disease by the EMS crew or due to refusal by the patient or a relative/friend.METHODS: Data were obtained from a register in Gothenburg, covering patients hospitalised due to a final diagnosis of stroke/TIA. The inclusion criterion was that patients were assessed by the EMS but were not directly transported to hospital by the EMS.RESULTS: Among all the patients who were assessed by the EMS nurse and subsequently diagnosed with stroke or TIA in 2015, the transport of 34 of 1,310 patients (2.6%) was interrupted. Twenty-five of these patients, of whom 20 had a stroke and five had a TIA, are described in terms of initial symptoms and outcome. The majority had residual symptoms at discharge from hospital. Initial symptoms were vertigo/disturbed balance in 11 of 25 cases. Another three had symptoms perceived as a change in personality and three had a headache.CONCLUSION: From this pilot study, we hypothesise that a fraction of patients with stroke/TIA who call for the EMS have their direct transport to hospital interrupted due to a lack of suspicion of the disease by the EMS nurse at the scene. These patients appear to have more vague symptoms including vertigo and disturbed balance. Instruments to identify these patients at the scene are warranted.
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| 4. |
- Jonsson, Bo H, et al.
(författare)
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Serum concentration of zinc is elevated in clinically stable bipolar disorder patients.
- 2022
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Ingår i: Brain and behavior. - : Wiley. - 2162-3279. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Bipolar disorder (BD) is a chronic psychiatric disorder characterized by recurrent mood episodes interspersed with euthymic periods. A growing number of studies have indicated that zinc plays an important role in coordinating immune responses, as well as being involved in synaptic transmission. In the current study, we set out to measure serum levels of zinc in a meticulously phenotyped cohort of 121 euthymic BD subjects and 30 matched controls.Serum levels of zinc were measured by photometry. To assess the interplay between zinc levels and immune activation in BD, we measured serum levels of high-sensitive C-reactive protein (hsCRP) levels by immunoturbidimetric assay, and serum levels of monocyte chemoattractant protein-1 (MCP-1), chitinase 3-like protein 1 (YKL-40), and soluble cluster of differentiation 14 (sCD14) by electrochemiluminescence enzyme-linked immunosorbent assays. The baseline clinical diagnostic instrument for BD was the Affective Disorder Evaluation, and executive functioning was assessed by using the Delis-Kaplan Executive Function System.Controlling for potential confounding factors, BD patients displayed increased serum levels of zinc unrelated to hsCRP, MCP-1, YKL-40, and sCD14 levels. Serum levels of zinc did not associate with executive functioning or measurements of disease severity.This study suggests that the zinc homeostasis is disturbed in BD and that this dyshomeostasis is not related to ongoing mood symptoms or immune activation. Of note, serum levels were increased and hence do not support continuous zinc supplementation in BD.
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| 5. |
- Mohseni, Simin, et al.
(författare)
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Longitudinal study of neuropathy, microangiopathy, and autophagy in sural nerve : Implications for diabetic neuropathy
- 2017
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Ingår i: Brain and Behavior. - : Wiley Online Library. - 2162-3279 .- 2162-3279. ; 7:8
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Tidskriftsartikel (refereegranskat)abstract
- The progression and pathophysiology of neuropathy in impaired glucose tolerance (IGT) and type 2 diabetes (T2DM) is poorly understood, especially in relation to autophagy. This study was designed to assess whether the presence of autophagy-related structures was associated with sural nerve fiber pathology, and to investigate if endoneurial capillary pathology could predict the development of T2DM and neuropathy. Sural nerve physiology and ultrastructural morphology were studied at baseline and 11 years later in subjects with normal glucose tolerance (NGT), IGT, and T2DM. Subjects with T2DM had significantly lower sural nerve amplitude compared to subjects with NGT and IGT at baseline. Myelinated and unmyelinated fiber, endoneurial capillary morphology, and the presence and distribution of autophagy structures were comparable between groups at baseline, except for a smaller myelinated axon diameter in subjects with T2DM and IGT compared to NGT. The baseline values of the subjects with NGT and IGT who converted to T2DM 11 years later demonstrated healthy smaller endoneurial capillary and higher g-ratio versus subjects who remained NGT. At follow-up, T2DM showed a reduction in nerve conduction, amplitude, myelinated fiber density, unmyelinated axon diameter, and autophagy structures in myelinated axons. Endothelial cell area and total diffusion barrier was increased versus baseline. We conclude that small healthy endoneurial capillary may presage the development of T2DM and neuropathy. Autophagy occurs in human sural nerves and can be affected by T2DM. Further studies are warranted to understand the role of autophagy in diabetic neuropathy.
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| 6. |
- Vadlin, Sofia, et al.
(författare)
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A longitudinal study of the individual- and group-level problematic gaming and associations with problem gambling among Swedish adolescents
- 2018
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279 .- 2162-3279. ; 8:4
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aims of the present study were to investigate the long-term stability of problematic gaming among adolescents and whether problematic gaming at wave 1 (W1) was associated with problem gambling at wave 2 (W2), three years later.Methods: Data from the SALVe cohort, including adolescents in Västmanland born in 1997 and 1999, were accessed and analyzed in two waves W2, N = 1576; 914 (58%) girls). At W1 the adolescents were 13 and 15 years old, and at W2 they were 16 and 18 years old. Adolescents self-rated on the Gaming Addiction Identification Test (GAIT), Problem Gambling Severity Index (PGSI), and gambling frequencies. Stability of gaming was determined using Gamma correlation, Spearman’s rho, and McNemar. Logistic regression analysis and General linear model (GLM) analysis were performed and adjusted for sex, age, and ethnicity, frequency of gambling activities and gaming time at W1, with PGSI as the dependent variable, and GAIT as the independent variable, to investigate associations between problematic gaming and problem gambling.Results: Problematic gaming was relative stable over time, g = 0.739, P £ 0.001, r = 0.555, P £ 0.001, and McNemar P £ 0.001. Furthermore, problematic gaming at W1 increased the probability of having problem gambling three years later, logistic regression OR = 1.886 (95% CI 1.125-3.161), P = 0.016, GLM F = 10.588, h2 = 0.007, P = 0.001. Conclusions: Problematic gaming seems to be relatively stable over time. Although associations between problematic gaming and later problem gambling were found, the low explained variance indicate that problematic gaming in an unlikely predictor for problem gambling within this sample.
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| 7. |
- Adebäck, Petra, et al.
(författare)
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Children or adolescents who lost someone close during the Southeast Asia tsunami 2004 – The life as young
- 2022
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Ingår i: Brain and Behavior. - Oxford, United Kingdom : John Wiley & Sons. - 2162-3279 .- 2162-3279. ; 12:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: To lose a person close suddenly, during childhood or adolescence, can be devastating. Many children or adolescents experienced the 2004 Indonesian tsunami when they were between 10- and 15-years-old. This study, from Stockholm, Sweden, describes the long-term effects of loss, eight- or nine-years post disaster, in young adulthood.Method: A mixed-method approach was used including statistical analyses (n = 210) and interpretative phenomenological analysis (IPA).Results: It was shown that there was a significant difference between bereaved (n=34) and nonbereaved (n = 176) respondents concerning, psychological distress, posttraumatic stress symptoms, and self-rated health. Three themes were found by using the IPA approach (n=9): Living in traumas, carrying heavy baggage, and living with change.Conclusion: The respondents described personal feelings of grief that are not expressed in their outward appearance or behavior in their daily living. When meeting young adults that have lost someone close in childhood or adolescence, this is important to have in mind.
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| 8. |
- Aniszewska, Agata, et al.
(författare)
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Modeling Parkinson's disease-related symptoms in alpha-synuclein overexpressing mice
- 2022
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Ingår i: Brain and Behavior. - : John Wiley & Sons. - 2162-3279 .- 2162-3279. ; 12:7
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Forskningsöversikt (refereegranskat)abstract
- Background: Intracellular deposition of alpha-synuclein (alpha-syn) as Lewy bodies and Lewy neurites is a central event in the pathogenesis of Parkinson's disease (PD) and other alpha-synucleinopathies. Transgenic mouse models overexpressing human alpha-syn, are useful research tools in preclinical studies of pathogenetic mechanisms. Such mice develop alpha-syn inclusions as well as neurodegeneration with a topographical distribution that varies depending on the choice of promoter and which form of alpha-syn that is overexpressed. Moreover, they display motor symptoms and cognitive disturbances that to some extent resemble the human conditions.Purpose: One of the main motives for assessing behavior in these mouse models is to evaluate the potential of new treatment strategies, including their impact on motor and cognitive symptoms. However, due to a high within-group variability with respect to such features, the behavioral studies need to be applied with caution. In this review, we discuss how to make appropriate choices in the experimental design and which tests that are most suitable for the evaluation of PD-related symptoms in such studies.Methods: We have evaluated published results on two selected transgenic mouse models overexpressing wild type (L61) and mutated (A30P) alpha-syn in the context of their validity and utility for different types of behavioral studies.Conclusions: By applying appropriate behavioral tests, alpha-syn transgenic mouse models provide an appropriate experimental platform for studies of symptoms related to PD and other alpha-synucleinopathies.
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| 9. |
- Atalan, Pelin, et al.
(författare)
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Influence of mobility restrictions on post-stroke pain
- 2021
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Ingår i: Brain and behavior. - : Wiley. - 2162-3279. ; 11:5
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate the role of mobility limitations and vitality, as well as additional factors such as comorbidities, to predict post-stroke pain.This study included cross-sectional data from 214 participants living in varied settings in different parts of Sweden. Participants were asked to complete the Stroke Impact Scale, Medical Outcomes Study Short Form 36, and Self-administered Comorbidity Questionnaire to evaluate mobility, vitality, comorbidities, and pain. Descriptive statistics were used for demographic and clinical characteristics. Binary logistic regression analysis was performed to predict the pain domain score on Medical Outcomes Study Short Form 36.The mean age of all participants in the sample was 66 years (SD 14); 43.4% of the study population were women. After analyses, "standing without losing balance and vitality'' were found to be significant predictors in the model which explained the pain score on Medical Outcomes Study Short Form 36.In conclusion, the results suggest that restrictions in mobility and low vitality have an important role on the occurrence of post-stroke pain. Having post-stroke pain could be due to not able to stand without losing balance and low vitality. Thus, rehabilitation professionals may consider the importance of these factors, especially mobility restrictions, in preventing post-stroke pain.
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| 10. |
- Bendt, Martina, et al.
(författare)
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Adults with spina bifida : A cross-sectional study of health issues and living conditions
- 2020
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Ingår i: Brain and Behavior. - : John Wiley & Sons. - 2162-3279 .- 2162-3279. ; 10:8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe health issues and living conditions in a cohort of adults living with Spina bifida.MATERIAL AND METHODS: A cross-sectional study was conducted by a multidisciplinary team. Adults with spina bifida (n = 219) were invited to participate. One-hundred-and-ninety-six persons (104 women and 92 men; 18-73 years, median age 33 years) were included. Structured interviews, questionnaires, and clinical assessments for medical, social, physical, and cognitive functions were used.RESULTS: There was large variation among participants as regards the consequences of their spina bifida. Individuals < 46 years seemed to have more secondary conditions such as hydrocephalus, Chiari II malformation, tethered cord symptoms, and latex allergy. A higher proportion of the individuals >46 years and older was able to walk, and they had performed better in primary school and on tests of psychomotor speed and executive function.CONCLUSIONS: This study demonstrates that adults with spina bifida have a complex set of physical, cognitive, and social needs that need to be addressed in order to improve their health issues and living conditions. The high prevalence of urinary and fecal incontinence, pain, and overweight underline that these issues need much attention during follow-up. The future generations of older adults may need more attention in many ways, since they at a younger age do have more complex medical conditions, lower physical and cognitive functions, and lower prerequisites for independent living and participation in society than those > 46 years today. This elucidates that adults with spina bifida need systematic follow-up services and social support throughout life.
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