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- Ashizawa, T., et al.
(author)
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Consensus-based care recommendations for adults with myotonic dystrophy type 1
- 2018
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In: Neurology-Clinical Practice. - : Ovid Technologies (Wolters Kluwer Health). - 2163-0402 .- 2163-0933. ; 8:6, s. 507-520
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Research review (peer-reviewed)abstract
- Purpose of review Myotonic dystrophy type 1 (DM1) is a severe, progressive genetic disease that affects between 1 in 3,000 and 8,000 individuals globally. No evidence-based guideline exists to inform the care of these patients, and most do not have access to multidisciplinary care centers staffed by experienced professionals, creating a clinical care deficit. Recent findings The Myotonic Dystrophy Foundation (MDF) recruited 66 international clinicians experienced in DM1 patient care to develop consensus-based care recommendations. MDF created a 2-step methodology for the project using elements of the Single Text Procedure and the Nominal Group Technique. The process generated a 4-page Quick Reference Guide and a comprehensive, 55-page document that provides clinical care recommendations for 19 discrete body systems and/or care considerations. The resulting recommendations are intended to help standardize and elevate care for this patient population and reduce variability in clinical trial and study environments.
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- Castro, JP, et al.
(author)
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A Call to Use the Multicomponent Exercise Tai Chi to Improve Recovery From COVID-19 and Long COVID
- 2022
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In: Frontiers in public health. - : Frontiers Media SA. - 2296-2565. ; 10, s. 827645-
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Journal article (peer-reviewed)abstract
- Approximately 10% of all COVID patients develop long COVID symptoms, which may persist from 1 month up to longer than 1 year. Long COVID may affect any organ/system and manifest in a broad range of symptoms such as shortness of breath, post-exercise malaise, cognitive decline, chronic fatigue, gastrointestinal disorders, musculoskeletal pain and deterioration of mental health. In this context, health institutions struggle with resources to keep up with the prolonged rehabilitation for the increasing number of individuals affected by long COVID. Tai Chi is a multicomponent rehabilitation approach comprising correct breathing technique, balance and neuromuscular training as well as stress- and emotional management. In addition, practicing Tai Chi elicits the relaxation response and balances the autonomic nervous system thus regulating respiration, heart rate, blood pressure and vitality in general. Moreover, Tai Chi has been shown to increase lung capacity, improve cognitive status and mental health, and thereby even the quality of life in diseases such as chronic obstructive pulmonary disease (COPD). Hence, we advocate Tai Chi as potent and suitable rehabilitation tool for post-COVID-19-affected individuals.
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- Buser, Andreas M., et al.
(author)
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Concentrations in Ambient Air and Emissions of Cyclic Volatile Methylsiloxanes in Zurich, Switzerland
- 2013
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In: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 47:13, s. 7045-7051
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Journal article (peer-reviewed)abstract
- Tens of thousands of tonnes of cyclic volatile methylsiloxanes (cVMS) are used each year globally, which leads to high and continuous cVMS emissions to air. However, field measurements of cVMS in air and empirical information about emission rates to air are still limited. Here we present measurements of decamethylcyclopentasfloxane (D-5) and dodecamethylcyclohexasiloxane (D-6) in air for Zurich, Switzerland. The measurements were performed in January and February 2011 over a period of eight days and at two sites (city center and background) with a temporal resolution of 6-12 h. Concentrations of Ds and D-6 are higher in the center of Zurich and range from 100 to 650 ng m(-3) and from 10 to 79 ng m(-3), respectively. These values are among the highest levels of D-5 and D-6 reported in the literature. In a second step, we used a multimedia environmental fate model parametrized for the region of Zurich to interpret the levels and time trends in the cVMS concentrations and to back calculate the emission rates of D-5 and D-6 from the city of Zurich. The average emission rates obtained for D-5 and D-6 are 120 kg d(-1) and 14 kg d(-1), respectively, which corresponds to per capita emissions of 310 mg capita(-1) d(-1) for D-5 and 36 mg capita(-1) d(-1) for D-6.
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- Helmerson, Birgitta, et al.
(author)
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A pilot study of the feasibility of a Swedish multimodal group intervention for severe migraine - The migraine patient school
- 2021
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In: Cephalalgia Reports. - : SAGE. - 2515-8163. ; 4, s. 1-9
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Journal article (peer-reviewed)abstract
- Objectives: To evaluate a multidisciplinary group intervention, the migraine patient school (MPS), for patients with severe, mostly chronic migraine. Method: A 13-week group intervention program including seven sessions of patient education, practical body awareness and relaxation exercises, and home assignments was performed in small groups with 5–11 participants. Four groups were consecutively included from spring 2014 to fall 2015. Headache diaries and standardized and study-specific questionnaires were used for evaluation at baseline before MPS (pre-interventional phase), and at follow-up. Results: Twenty-four of 30 included patients completed the study, i.e. attended ≥ four sessions. Most participants found it rewarding to participate in the MPS and easy to take part in, understand and complete home assignments. Validated standardized questionnaires delivered before, and after (follow-up) MPS showed that the impact on life (HIT-6) and avoidance behavior (PIPS-A) were significantly improved whereas quality of life (MSQL), anxiety and depression (HAD) and perceived stress (PSS-14) did not show a statistically significant change. Conclusion: The Migraine patient school with a multimodal educational and behavioral group intervention program was feasible to perform and seem to benefit patients with severe (high-frequency or chronic) migraine. © The Author(s) 2021.
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- Kierkegaard, Amelie, et al.
(author)
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Bioconcentration of Several Series of Cationic Surfactants in Rainbow Trout
- 2021
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In: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 55:13, s. 8888-8897
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Journal article (peer-reviewed)abstract
- Cationic surfactants have a strong affinity to sorb to phospholipid membranes and thus possess an inherent potential to bioaccumulate, but there are few measurements of bioconcentration in fish. We measured the bioconcentration of 10 alkylamines plus two quaternary ammonium compounds in juvenile rainbow trout at pH 7.6, and repeated the measurements at pH 6.2 for 6 of these surfactants. The BCF of the amines with chain lengths <= C-14 was positively correlated with chain length, increasing similar to 0.5 log units per carbon. Their BCF was also pH dependent and approximately proportional to the neutral fraction of the amine in the water. The BCFs of the quaternary ammonium compounds showed no pH dependence and were >2 orders of magnitude less than for amines of the same chain length at pH 7.6. This indicates that systemic uptake of permanently charged cationic surfactants is limited. The behavior of the quaternary ammonium compounds and the two C-16 amines studied was consistent with previous observations that these surfactants accumulate primarily to the gills and external surfaces of the fish. At pH 7.6 the BCF exceeded 2000 L kg(-1) for 4 amines with chains >= C-13, showing that bioconcentration can be considerable for some longer chained cationic surfactants.
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- Kierkegaard, Amelie, et al.
(author)
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Tissue Distribution of Several Series of Cationic Surfactants in Rainbow Trout (Oncorhynchus mykiss) Following Exposure via Water
- 2020
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In: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 54:7, s. 4190-4199
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Journal article (peer-reviewed)abstract
- Bioaccumulation assessment is important for cationic surfactants in light of their use in a wide variety of consumer products and industrial processes. Because they sorb strongly to natural surfaces and to cell membranes, their bioaccumulation behavior is expected to differ from other classes of chemicals. Divided over two mixtures, we exposed rainbow trout to water containing 10 alkyl amines and 2 quaternary alkylammonium surfactants for 7 days, analyzed different fish tissues for surfactant residues, and calculated the tissues' contribution to fish body burden. Mucus, skin, gills, liver, and muscle each contributed at least 10% of body burden for the majority of the test chemicals. This indicates that both sorption to external surfaces and systemic uptake contribute to bioaccumulation. In contrast to the analogue alkylamine bases, the permanently charged quaternary ammonium compounds accumulated mostly in the gills and were nearly absent in internal tissues, indicating that systemic uptake of the charged form of cationic surfactants is very slow. Muscle-blood distribution coefficients were close to 1 for all alkyl amines, whereas liver-blood distribution coefficients ranged from 13 to 90, suggesting that the dominant considerations for sorption in liver are different from those in blood and muscle. The significant fraction of body burden on external surfaces can have consequences for bioaccumulation assessment.
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- Kierkegaard, M, et al.
(author)
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The relationship between walking, manual dexterity, cognition and activity/participation in persons with multiple sclerosis
- 2012
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In: Multiple sclerosis (Houndmills, Basingstoke, England). - : SAGE Publications. - 1477-0970 .- 1352-4585. ; 18:5, s. 639-646
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Journal article (peer-reviewed)abstract
- Background: Multiple sclerosis has a vast impact on health, but the relationship between walking, manual dexterity, cognition and activity/participation is unclear. Objective: The specific aims were to explore the discriminative ability of measures of walking, manual dexterity and cognition, and to identify cut-off values in these measures, for prediction of independence in personal and instrumental activities of daily living (ADL) and activity/participation in social and lifestyle activities. Methods: Data from 164 persons with multiple sclerosis were collected during home visits with the following measures: the 2 × 5 m walk test, the Nine-hole Peg Test, the Symbol Digit Modalities Test, the Katz Personal and Instrumental ADL Indexes, and the Frenchay Activities Index (measuring frequency in social and lifestyle activities). Results: The 2 × 5 m walk test and the Nine-hole Peg Test had high and better discriminative and predictive ability than the Symbol Digit Modalities Test. Cut-off values were identified. The accuracy of predictions was increased above all by combining the 2 × 5 m walk test and the Nine-hole Peg Test. Conclusion: The proposed cut-off values in the 2 × 5 m walk test and the Nine-hole Peg Test may be used as indicators of functioning and to identify persons risking activity limitations and participation restrictions. However, further studies are needed to confirm the usefulness in clinical practice.
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- Krogseth, Ingjerd S., et al.
(author)
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Occurrence and seasonality of cyclic volatile methyl siloxanes in arctic air
- 2013
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In: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 47:1, s. 502-509
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Journal article (peer-reviewed)abstract
- Cyclic volatile methyl siloxanes (cVMS) are present in technical applications and personal care products. They are predicted to undergo long-range atmospheric transport, but measurements of cVMS in remote areas remain scarce. An active air sampling method for decamethylcyclopentasiloxane (D5) was further evaluated to include hexamethylcyclotrisiloxane (D3), octamethylcyclotetrasiloxane (D4), and dodecamethylcyclohexasiloxane (D6). Air samples were collected at the Zeppelin observatory in the remote Arctic (79 degrees N, 12 degrees E) with an average sampling time of 81 +/- 23 h in late summer (August-October) and 25 +/- 10 h in early winter (November-December) 2011. The average concentrations of D5 and D6 in late summer were 0.73 +/- 0.31 and 0.23 +/- 0.17 ng/m(3), respectively, and 2.94 +/- 0.46 and 0.45 +/- 0.18 ng/m(3) in early winter, respectively. Detection of D5 and D6 in the Arctic atmosphere confirms their long-range atmospheric transport. The D5 measurements agreed well with predictions from a Eulerian atmospheric chemistry-transport model, and seasonal variability was explained by the seasonality in the OH radical concentrations. These results extend our understanding of the atmospheric fate of D5 to high latitudes, but question the levels of D3 and D4 that have previously been measured at Zeppelin with passive air samplers.
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- Longinetti, Elisa, et al.
(author)
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The Swedish motor neuron disease quality registry
- 2018
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In: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration. - : Taylor & Francis. - 2167-8421 .- 2167-9223. ; 19:7-8, s. 528-537
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Journal article (peer-reviewed)abstract
- Objective: We set up the Swedish Motor Neuron Disease (MND) Quality Registry to assure early diagnosis and high-quality health care for all MND patients (mainly amyotrophic lateral sclerosis, ALS), and to create a research base by prospectively following the entire MND population in Sweden. Methods: Since 2015, the MND Quality Registry continuously collects information about a wide range of clinical measures, biological samples, and quality of life outcomes from all MND patients recruited at the time of MND diagnosis in Sweden and followed at each clinic visit approximately every 12 weeks. The Registry includes an Internet based patient own reporting portal that involves patients in the registration of their current symptoms and health status. Results: As of 20th January 2017, the MND Quality Registry included 99% of the MND patients of the Stockholm area (N = 194), consisting mostly of ALS patients (N = 153, 78.9%), followed by patients labeled as MND due to a neurophysiology finding but not fulfilling the criteria for ALS (N = 20, 10.3%), primary lateral sclerosis (N = 13, 6.7%), and progressive spinal muscular atrophy patients (N = 8, 4.1%). A higher proportion of these patients were women (N = 100, 52%), and women and men had a similar age at symptoms onset (59 years). Conclusions: Main strengths of the MND Quality Registry are its clinical, quantitative, qualitative, and prospective nature, providing the researchers potential means of identifying appropriate candidates for clinical trials and other research projects, as well as assuring to the patients an effective and adequate time spent on-site with the healthcare professionals.
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- McLachlan, Michael S., et al.
(author)
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Concentrations and Fate of Decamethylcyclopentasiloxane (D-5) in the Atmosphere
- 2010
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In: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 44:14, s. 5365-5370
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Journal article (peer-reviewed)abstract
- Decamethylcyclopentasiloxane (D-5) is a volatile compound used in personal care products that is released to the atmosphere in large quantities. Although D-5 is currently under consideration for regulation, there have been no field investigations of its atmospheric fate. We employed a recently developed, quality assured method to measure D-5 concentration in ambient air at a rural site in Sweden. The samples were collected with daily resolution between January and June 2009. The 05 concentration ranged from 0.3 to 9 ng m(-3), which is 1-3 orders of magnitude lower than previous reports. The measured data were compared with D-5 concentrations predicted using an atmospheric circulation model that included both OH radical and D-5 chemistry. The model was parametrized using emissions estimates and physical chemical properties determined in laboratory experiments. There was good agreement between the measured and modeled D-5 concentrations. The results show that D-5 is clearly subject to long-range atmospheric transport, but that it is also effectively removed from the atmosphere via phototransformation. Atmospheric deposition has little influence on the atmospheric fate. The good agreement between the model predictions and the field observations indicates that there is a good understanding of the major factors governing D-5 concentrations in the atmosphere.
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- Ricklund, N., 1979-, et al.
(author)
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Bioaccumulation of decabromodiphenyl ethane (dbdpe) in the Western Scheldt estuary
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Other publication (other academic/artistic)abstract
- Decabromodiphenyl ethane (dbdpe) is a brominated flame retardant (BFR) with both a similar chemical structure and similar technical applications to a chemical of recognized environmental concern, decabromodiphenyl ether (decaBDE). Bioaccumulation has been one of the most controversial issues in the risk assessment of decaBDE, but it has not been measured for dbdpe. During the last several years, dbdpe has been detected in a variety of biota, which suggests that it is bioavailable. In this work, dbdpe was analyzed together with decaBDE in a benthic and pelagic food web in the Western Scheldt estuary, an environment known to be contaminated with the two BFRs. The biota-sediment accumulation factors for benthic invertebrates were low (0.0008-0.005) for both chemicals. This weak bioaccumulation into the lowest trophic levels of the food web may have been due to a poor bioavailability of the BFRs into the estuary. Both chemicals were transferred up through the food web, but biodilution was observed, not biomagnification (BMFs 0.2-0.8). The bioaccumulation behavior of dbdpe was similar to that of decaBDE.
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- Risberg, May Arna, et al.
(author)
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Arthroscopic surgical procedures versus sham surgery for patients with femoroacetabular impingement and/or labral tears : Study protocol for a randomized controlled trial (HIPARTI) and a prospective cohort study (HARP)
- 2018
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In: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 48:4, s. 325-335
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Journal article (peer-reviewed)abstract
- STUDY DESIGN: Study protocol for a randomized controlled trial and a prospective cohort. BACKGROUND: The number of arthroscopic surgical procedures for patients with femoroacetabular impingement syndrome (FAIS) has significantly increased worldwide, but high-quality evidence of the effect of such interventions is lacking. OBJECTIVES: The primary objective will be to determine the efficacy of hip arthroscopic procedures compared to sham surgery on patient-reported outcomes for patients with FAIS (HIP ARThroscopy International [HIPARTI] Study). The secondary objective will be to evaluate prognostic factors for long-term outcome after arthroscopic surgical interventions in patients with FAIS (Hip ARthroscopy Prospective [HARP] Study). METHODS: The HIPARTI Study will include 140 patients and the HARP Study will include 100 patients. The international Hip Outcome Tool-33 will be the primary outcome measure at 1 year. Secondary outcome measures will be the Hip disability and Osteoarthritis Outcome Score, Arthritis Self-Efficacy Scale, fear of movement (Tampa Scale of Kinesiophobia), Patient-Specific Functional Scale, global rating of change score, and expectations. Other outcomes will include active hip range of motion, hip muscle strength tests, functional performance tests, as well as radiological assessments using radiographs and magnetic resonance imaging. CONCLUSION: To determine the true effect of surgery, beyond that of placebo, double-blinded placebo-controlled trials including sham surgery are needed. The HIPARTI Study will direct future evidence-based treatment of FAIS. Predictors for long-term development and progression of degenrative changes in the hip are also needed for this young patient group with FAIS; hence, responders and nonresponders to treatment could be determined.
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