| 1. |
- Gallo, Valentina, et al.
(författare)
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Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study
- 2016
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 31:3, s. 255-266
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Tidskriftsartikel (refereegranskat)abstract
- Previous case-control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected through standardised questionnaires. Total PA was expressed by the Cambridge Physical Activity Index (CPAI) and analysed in relation to ALS mortality, using Cox hazard models. Interactions with age, sex, and anthropometric measures were assessed. Total PA was weakly inversely associated with ALS mortality with a borderline statistically significant trend across categories (p = 0.042), with those physically active being 33 % less likely to die from ALS compared to those inactive: HR = 0.67 (95 % CI 0.42-1.06). Anthropometric measures, sex, and age did not modify the association with CPAI. The present study shows a slightly decreased-not increased like in case-control studies-risk of dying from ALS in those with high levels of total PA at enrolment. This association does not appear confounded by age, gender, anthropometry, smoking, and education. Ours was the first prospective cohort study on ALS and physical activity.
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| 2. |
- Bondemark, Lars, et al.
(författare)
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Funktionsstörningar och smärta
- 2008
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Ingår i: Tandläkartidningen. - 0039-6982. ; 100:9-10, s. 64-68
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Orofaciala funktionsstörningar och smärta är en sammanfattning av kliniska problem och sjukdomar som involverar bett, käkar, tuggmuskulatur, käkleder och omgivande strukturer. Orsakerna är oftast multifaktoriella för de barn, ungdomar och vuxna som drabbas.
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| 3. |
- Pigg, Maria, et al.
(författare)
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A comparative analysis of MRI, CBCT and conventional radiography in patients with atypical odontalgia and symptomatic apical periodontitis : preliminary results
- 2006
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 30:4, s. 173-174
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: Atypical odontalgia(AO) is a chronic pain condition located in the teeth and jaws. It has been suggested, that AO is best regarded as a neuropathic pain condition, but knowledge regarding the etiology, diagnostics, and management of AO is not yet satisfactory. This pilot study evaluates the clinical usefulness of more recently developed imaging methods for intraoral pain conditions. The aim is to compare the diagnostic findings using magnetic resonance imaging(MRI) and cone beam computed tomography(CBCT) with the findings from conventional radiography in patients with atypical odontalgia(AO) and symptomatic apical periodontitis(SAP). Material and methods: 12 patients (9 F, 3 M) mean age 50,25 years, range 36 - 63 years participated in the study. The patients were referred to the Orofacial Pain Unit or the Department of Endodontics, Faculty of Odontology, Malmö University. Inclusion criteria for AO were chronic pain (>6 months) located in a region where a tooth had been endodontically or surgically treated, pain with no pathological cause detectable in clinical or radiological examinations. For SAP, the inclusion criteria were recurrent pain from a tooth diagnosed with apical periodontitis in a clinical and radiographic examination. Ten of the patients in the study were diagnosed with AO and two with SAP. The patients were clinically assessed with a qualitative somatosensory examination, a dental examination, an examination of the masticatory system(RDC/TMD), and panoramic and intraoral radiographs. A questionnaire was used to gather information about pain characteristics, psychosocial status(SCL-90), and quality of life. Besides these measures, each patient underwent a CBCT(3D-Accuitomo, J Morita Co) examination and a MRI(Siemens Sonata Vision 1.5 T) examination with and without contrast enhancement. Contrast was enhanced by injections of Magnevist (469 mg/ml, Schering Nordiska). Bone destruction, sclerosis, and signs of inflammation were the main parameters studied. Results: In the preliminary results, average pain intensity was 6.3 on a numerical rating scale(NRS) and average pain duration was 3,6 years. 83% exhibited somatosensory abnormalities. Bone destruction not visible in the intraoral and panoramic radiographs was detected with CBCT in 40% (4/10) of the patients diagnosed with AO, and signs of inflammation were detected in the MRIs of 20% (2/10) of the patients diagnosed with AO. Conclusion: Preliminary findings indicate that CBCT and MRI can provide additional information to conventional radiography in the diagnosis of intraoral orofacial pain. Further studies with larger sample sizes of AO and SAP patients are necessary to determine the clinical relevance of these findings.
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| 4. |
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| 5. |
- Pigg, Maria, et al.
(författare)
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Diagnostic yield of conventional radiographic and cone-beem computed tomographic images in patients with atypical odontalgia
- 2011
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Ingår i: International Endodontic Journal. - : John Wiley & Sons. - 0143-2885 .- 1365-2591. ; 12:44, s. 1092-1101
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Tidskriftsartikel (refereegranskat)abstract
- Abstract AIM: To investigate whether the additional diagnostic yield of a cone-beam computed tomography (CBCT) examination over conventional radiographs in patients primarily suspected of having atypical odontalgia (AO) improves differentiation between AO and symptomatic apical periodontitis (SAP) in patients with severe chronic intraoral pain. METHODOLOGY: In this clinical study, 25 patients (mean age 54 ± 11 years, range 34-72) participated; 20 were diagnosed with AO and 5 with SAP. All patients were recruited from the clinics of the Faculty of Odontology, Malmö University. AO inclusion criteria were chronic pain (>6 months) in a region where a tooth had been endodontically or surgically treated, with no pathological cause detectable in clinical or radiologic examinations. SAP inclusion criteria were recurrent pain from a tooth diagnosed with apical periodontitis in clinical and radiographic examinations. Assessments comprised a self-report questionnaire on pain characteristics, a comprehensive clinical examination and a radiographic examination including panoramic and intraoral radiographs and CBCT images. The main outcome measure was periapical bone destruction. RESULTS: Sixty per cent of patients with AO had no periapical bone destructions detectable with any radiographic method. Overall, CBCT rendered 17% more periapical bone destructions than conventional radiography. Average pain intensity in patients with AO was 5.6 (± 1.8) on a 0-10 numerical rating scale, and average pain duration was 4.3 (± 5.2) years. CONCLUSION: Cone-beam computed tomography improves identification of patients without periapical bone destruction, which may facilitate differentiation between AO and SAP.
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| 6. |
- Wikberg, Carl, et al.
(författare)
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Comparison Between the Montgomery-Asberg Depression Rating Scale–Self and the Beck Depression Inventory II in Primary Care
- 2015
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Ingår i: The Primary Care Companion for CNS Disorders. - 0160-6689 .- 1555-2101 .- 2155-7772. ; 17:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The Montgomery-Asberg Depression Rating Scale–Self (MADRS-S) and the Beck Depression Inventory II (BDI-II) are commonly used self-assessment instruments for screening and diagnosis of depression. The BDI-II has 21 items and the MADRS-S has 9 items. These instruments have been tested with psychiatric inpatients but not in outpatient primary care, where most patients with symptoms of depression initially seek treatment. The purpose of this study was to compare these 2 instruments in the primary care setting. Method: Data were collected from 2 primary care randomized controlled trials that were performed from 2010 to 2013 in Sweden: the Primary Care Self-Assessment MADRS-S Study and Primary Care Internet-Based Cognitive Behavioral Therapy Study. There were 146 patients (73 patients each from both trials) who had newly diagnosed mild or moderate depression (per DSM-IV recommendations) and who had assessment with both the MADRS-S and BDI-II at primary care centers. Comparability and reliability of the instruments were estimated by Pearson product moment correlation and Cronbach α. Results: A good correlation was observed between the 2 instruments: 0.66 and 0.62 in the 2 study cohorts. The reliability within the 2 study cohorts was good for both MADRS-S (Cronbach α: 0.76 for both cohorts) and BDI-II items (Cronbach α: 0.88 and 0.85). Conclusions: The 2 instruments showed good comparability and reliability for low, middle, and high total depression scores. The MADRS-S may be used as a rapid, easily administered, and inexpensive tool in primary care and has results comparable to the BDI-II in all domains.
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| 7. |
- Wolf, Eva, et al.
(författare)
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Long-term follow-up by means of a questionnaire of 109 patients with long-lasting orofacial pain.
- 2002
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 26:3, s. 125-34
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Tidskriftsartikel (refereegranskat)abstract
- The aims were to follow-up, analyse and compare the pain status after 4-9 years with that at the baseline examination of 109 consecutive patients referred to the Pain Group at the Faculty of Odontology in Malmö, Sweden during the period 1988-1993 due to long-lasting orofacial pain. A further aim was to identify predictive factors of significance for pain alteration. 85 (78%) women with a median age of 51 years and 24 (22%) men with a median age of 60 years were included in the study. A survey of the pain status at the follow-up was conducted by means of a mailed questionnaire. The questionnaire covered the following aspects: pain alteration, pain intensity, pain location, medication and education. After one reminder, the non-responding patients were called for a telephone interview. A response level of 85% was obtained. Significant improvements were noted by the patients in the answers of the questionnaire in mainly three areas; the patients answered individually that pain relief had occurred, pain intensity rated on the VAS was lower at follow-up compared to the baseline examination and a decrease in drug use was reported. The responses indicated pain relief for 75% of the patients. However, only 27% of the patients experienced total disappearance of pain. Medication at baseline with opioids, muscle relaxants with central effect, antidepressants, neuroleptics, hypnotics or sedatives was found to be a predictive factor for persistent pain.
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| 8. |
- Karlsson, Therese, 1979, et al.
(författare)
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Effect of the New Nordic Diet compared with usual care on glucose control in gestational diabetes mellitus: Study protocol for the randomized controlled trial intervention with new Nordic DIet in women with GestatiOnal diabetes mellitus (iNDIGO)
- 2022
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Ingår i: Contemporary Clinical Trials. - : Elsevier BV. - 1559-2030 .- 1551-7144. ; 115
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gestational diabetes mellitus (GDM) is a pregnancy complication associated with short- and long-term health consequences for mother and child. First line treatment is diet and exercise but there is a recognized knowledge gap as to what diet treatment is optimal. A healthy Nordic diet has been associated with improved health but no studies in women with GDM exist. The New Nordic Diet (NND) is an initiative with the purpose to develop a healthy Nordic diet including foods with the potential to grow in Nordic countries; including fruit, berries, vegetables, whole-grain cereal products, nuts, fish, and rapeseed oil. The purpose of the intervention with new Nordic DIet in women with GestatiOnal diabetes mellitus (iNDIGO) is to test if the NND compared with usual care improves glucose control in women with GDM. Methods: The iNDIGO study is a randomized parallel controlled trial where 50 women with GDM will be randomized to either an NND or usual care for 14 days (30–32 weeks of gestation). Participants in the NND group will receive menus and food bags containing foods to be consumed. Primary outcome is glycemic control (time in target) measured using continuous glucose monitoring. Compliance to the dietary intervention will be tested using dietary biomarkers and adherence questionnaires. Conclusion: Diet treatment represents first line treatment in GDM but it remains unclear what type of diets are effective. iNDIGO is an efficacy study and will provide evidence as to whether a healthy Nordic diet can improve glucose control in women with GDM. Trial registration: ClinicalTrials.gov registration Number: NCT04169243. Registered 19 November 2019, https://clinicaltrials.gov/ct2/show/NCT04169243.
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| 9. |
- Uvnäs-Moberg, Kerstin, et al.
(författare)
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Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact - With a particular focus on the oxytocinergic system
- 2020
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Ingår i: Infant Behavior and Development. - : Elsevier. - 0163-6383 .- 1879-0453 .- 1934-8800. ; 61:November
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Forskningsöversikt (refereegranskat)abstract
- The positive clinical effects caused by skin-to-skin contact immediately after birth or after repeated skin-to-skin contact of premature infants (kangaroo care) or fullterm infants are well documented in the literature. However, information regarding the physiological mechanisms mediating these effects are surprisingly scarce and incomplete. In this article the oxytocinergic system and the cutaneous sensory pathways by which the oxytocinergic system is activated in response to skin-to-skin contact are presented in more detail. In addition, we discuss how the effects of skin-to-skin treatment can be attributed to different aspects of the effect spectrum of the oxytocinergic or calm and connection system.The structure of the oxytocinergic system, comprising the peripheral (circulating, hormonal) and the central (neurotransmitter) components, as well as, the pathways and mechanisms by which these functions are coordinated are described. Also the various effects induced by the oxytocinergic system (the calm and connection system) are reviewed.The sensory pathways, which include visual, auditory, olfactory and tactile stimuli, given and received by both mother and newborn and which activate the oxytocinergic system in response to skin-to-skin contact, are reviewed. A special emphasis is placed on the role of cutaneous sensory nerves and their activation by touch, light pressure and in particular warmth. The important role of the rise and the pulsatility of maternal temperature in mediating the positive effects of skin-to-skin contact in the newborn is highlighted. The concept of maternal giving of warmth and its possible link to the experience of trust and safety in the newborn is discussed from an evolutionary perspective.The effects induced by skin-to-skin contact can be attributed to the different functions of the oxytocinergic system. Ameliorated social interaction (e.g., more tactile and auditory interaction, more sensitive and synchronous interaction between mother and baby, the baby’s crawling behavior) are expressions of oxytocin’s ability to stimulate social interaction. The decreased levels of fear and stress are expressions of oxytocin’s ability to reduce the activity of the amygdala and of the stress system, e.g. the activity in the HPA-axis and the sympathetic nervous system. Increased HRV, increased activity in endocrine system of the gastrointestinal tract as well as stimulation of growth and maturation are examples of oxytocin’s ability to stimulate the activity of the parasympathetic nervous system and other peripheral and central mechanisms related to restoration and growth.The propensity of different types of treatment with skin-to-skin contact to induce long-term effects is also highlighted. We propose that the sustained effects caused by skin-to-skin contact are induced by an enduring shift in the balance between the oxytocinergic system (the calm and connection system) and the stress system (fight flight reaction) in favor of the oxytocinergic system. This shift leads to a sustained decrease in the HPA-axis and the sympathetic nervous system probably involving alpha 2-adrenoceptors.It is of clinical importance to be aware of the mechanisms by which skin-to-skin contact induces short and longterm positive effects in parents and newborns. If ward routines are adapted to ascertain a maximal stimulation of these mechanisms, the function of the oxytocinergic system will be optimized, which will be linked to a better clinical outcome for parents and newborns.
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| 10. |
- Uvnäs-Moberg, Kerstin, et al.
(författare)
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Oxytocin is a principal hormone that exerts part of its effects by active fragments
- 2019
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Ingår i: Medical Hypotheses. - : Elsevier. - 0306-9877 .- 1532-2777. ; 133, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Oxytocin is a nonapeptide consisting of a cyclic six amino-acid structure and a tail of three amino acids. It was originally known for its ability to induce milk ejection and to stimulate uterine contractions. More recently, oxytocin has been shown to stimulate social behaviors, and exert pain-relieving, anti-stress/anti-inflammatory and restorative effects. We hypothesize that oxytocin is a principal hormone that, in part, exerts its effects after degradation to active fragments with more specific effect profiles. Experimental findings on rats show that administered oxytocin exerts biphasic effects. For example, after an initial increase in pain threshold, a second more long-lasting increase follows. Blood pressure and cortisol levels initially increase and then reverse into a long-lasting decrease in blood pressure and cortisol. Whereas the initial effects are, the second-phase effects are not blocked by an oxytocin antagonist, but by an opioid mu-antagonist and by an alpha 2-adrenoreceptor antagonist, respectively, suggesting that other receptors are involved. Repeated administration of oxytocin induces multiple anti-stress effects, which are mediated by alpha 2-adrenoreceptors. Repeated administration of linear oxytocin and linear oxytocin fragments with a retained C-terminal reduce spontaneous motor activity, a sedative or anti-stress effect, suggesting that alpha 2-adrenoreceptors have been activated. In contrast, linear mid-fragments stimulate motor activity. Low-intensity stimulation of cutaneous nerves in rats, as well as breastfeeding and skin-to-skin contact between mothers and babies, trigger immediate anti-stress effects. Some of these effects are likely caused by open ring/linear C-terminal fragments activating alpha 2-adrenoreceptors. Oxytocin fragments may be pre-formed and released in the brain or created by metabolic conversion of the principal hormone oxytocin in the central nervous system. Oxytocin and its fragments may also be released from peripheral sites, such as peripheral nerves, the gastrointestinal tract, and blood vessels in response to decreased sympathetic or increased parasympathetic nervous tone. Smaller fragments of oxytocin produced in the periphery may easily pass the blood-brain barrier to induce effects in the brain. In conclusion, oxytocin is linked to many different, sometimes opposite effects. The intact cyclic molecule may act to initiate social interaction and associated psychophysiological effects, whereas linear oxytocin and C-terminal fragments may induce relaxation and anti-stress effects following social interaction. In this way, the principal hormone oxytocin and its fragments may take part in a behavioral sequence, ranging from approach and interaction to calm and relaxation. Linear fragments, with an exposed cysteine-residue, may exert anti-inflammatory and antioxidant effects and thereby contribute to the health-promoting effects of oxytocin.
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