Journal: Upsala journal of medical sciences
Abstract There has been only one reported case of neuromuscular scoliosis following chronic inflammatory demyelinating polyneuropathy (CIDP). However, no cases of scoliosis that were treated with surgery secondary to CIDP have been previously described. A 16-year-old boy with CIDP was consultant due to the progression of scoliosis with the coronal curve of 86° from T8 to T12. Posterior correction and fusion with segmental pedicle screws were performed under intraoperative spinal cord monitoring with transcranial electric motor-evoked potentials. Although the latency period was prolonged and amplitude was low, the potential remained stable. Coronal curve was corrected from 86° to 34° without neurological complications. We here describe scoliosis associated with CIDP, which was successfully treated with surgery under intraoperative spinal cord monitoring.
Abstract Objective. We studied the relationship between systolic blood pressure and hemodynamics using impedance cardiography in elderly Han residents in order to evaluate how different hemodynamic variables are altered with normal aging and with hypertension superimposed on aging. Methods. A total of 670 subjects, aged 60-93 years, were evaluated with impedance cardiography for non-invasive hemodynamic variables. The subjects were categorized as hypertensives or normotensives, and then they were also divided into six subgroups according to actual systolic blood pressure values. Results. Hypertensive patients had significantly lower values of cardiac output (4.4 ± 1.5 L/min) and cardiac index (2.6 ± 1.0 L/min/m(2)) than those in the normotensive group (4.7 ± 1.5 L/min, and 2.8 ± 0.8 L/min/m(2), respectively; P < 0.05 for both). Compared to the normotensive group, stroke volume and stroke index values were also lower and systemic vascular resistance and systemic vascular resistance index were higher in the hypertensive group. There were no significant differences in left ventricular stroke work and left ventricular stroke work index between the two groups. When all 670 subjects were stratified to actual blood pressure, cardiac output of group 6 patients (systolic blood pressure ≥180 mmHg) was 19% lower than that of group 1 subjects (SBP <140 mmHg; P < 0.05). Similarly, systemic vascular resistance of group 6 patients was 56% higher than that of group 1 subjects (P < 0.05). Conclusion. With aging, arterial systolic blood pressure is elevated as a result of increased arterial stiffness and increased systemic vascular resistance. With hypertension, these values are further elevated. Non-invasive impedance cardiography helps to characterize the hemodynamic mechanisms, which can improve hypertension management.
This commentary examines how specific sustainable development goals (SDGs) are affected by antimicrobial resistance and suggests how the issue can be better integrated into international policy processes. Moving beyond the importance of effective antibiotics for the treatment of acute infections and health care generally, we discuss how antimicrobial resistance also impacts on environmental, social, and economic targets in the SDG framework. The paper stresses the need for greater international collaboration and accountability distribution, and suggests steps towards a broader engagement of countries and United Nations agencies to foster global intersectoral action on antimicrobial resistance.
Research about pregnancy-planning behaviour mostly focuses on women, even though pregnancy planning usually also concerns men. The purpose of this study was to investigate how men plan for family, and to measure their fertility knowledge after having become fathers.
To investigate the associations between gambling frequency, attention-deficit hyperactivity disorder (ADHD) symptoms, and problem gambling among adolescent boys and girls. One hypothesis was that adolescents with increased ADHD symptoms have a higher frequency of gambling compared to adolescents with fewer ADHD symptoms.
Abstract Introduction. Our knowledge about atopy as a longitudinal predictor of asthma is limited. The purpose of this study was to investigate the prognosis of asthma and risk factors for asthma onset, especially sensitization of specific allergens in a population sample. Material and methods. A cohort responded to a respiratory questionnaire in 1990 and 2003. At baseline, 2,060 subjects who, in the screening questionnaire, reported respiratory symptoms and 482 controls were investigated with interviews, spirometry, and skin-prick test. A total of 721 asthmatics and 976 subjects without respiratory disease were clinically verified. At follow-up in 2003, 340 subjects with persistent asthma and 186 subjects with asthma remission were identified, while 76 subjects reported new asthma onset. Results. Sensitization to pets and a high symptom score were significant determinants of persistent asthma (odds ratio (OR) 3.2 (95% CI 1.9-5.6) and 5.7 (2.5-13.3), respectively) and onset of asthma (OR 2.6 (1.1-6.0), and 1.7 (1.2-2.3)). A high self-reported responsiveness to airway irritants (OR 1.6 (1.1-2.2)), and more asthma medications (OR 2.0 (1.3-2.9)) were additional indicators of persistent asthma at the follow-up. Belonging to the older age group decreased the risk both of having persistent asthma and asthma onset. Discussion. Asthmatics sensitized to pets have a more severe outcome than asthmatics not sensitized to pets. Sensitization to pets was also a strong predictor for onset of asthma. Special attention should be given to asthmatics who report having severe symptoms and problems with airway irritants as such patients are more likely to have persistent problems.
In an increasingly globalized and interlinked world it becomes ever more important to find strategies to prevent, detect, and respond to emerging public health threats. Local communities have a central role in this effort and need to be empowered and strengthened to be able to meet the challenge, and local knowledge and participation are key. This paper outlines a theoretical framework for community intervention dynamics and explores perceptions, priorities, and perspectives of stakeholders involved in community interventions.
The natural ovarian stimulation is mediated by four gonadotrophin glycoforms: FSHtri with three, FSHtetra with four, LHdi with two, and LHtri with three N-glycans. The aim of the study was to determine the serum concentrations of the four glycoforms and their contents of anionic monosaccharides (AMS), i.e. sialic acid (SA) and sulfonated N-acetylgalactosamine (SU) residues throughout the menstrual cycle.
To compare low-density lipoprotein cholesterol (LDL-C) values calculated by the Friedewald equation with direct LDL-C in patient samples and assess the possible impact on re-classification of LDL-C target values for primary prevention or high cardiovascular disease (CVD) risk (<2.5 mmol/L) and secondary prevention or very high CVD risk (<1.8 mmol/L). LDL-C is an important CVD risk factor. Over the last decade, there has been a change in laboratory methodology from indirectly calculated LDL-C with the Friedewald equation to direct LDL-C measurements (dLDL-C).
Despite the growing body of evidence on growth differentiation factor 15 (GDF-15) reference values for patients with existing cardiovascular disease, limited investigation has been dedicated to characterizing the distribution and prognostic impact of GDF-15 in predominantly healthy populations. Furthermore, current cutoff values for GDF-15 fail to account for the well-documented age-dependence of circulating GDF-15.