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  • 1. Bath, Philip M W
    et al.
    Lindenstrom, Ewa
    Boysen, Gudrom
    De Deyn, Peter
    Friis, Pal
    Leys, Didier
    Marttila, Reijo
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    O´Neill, Desmond
    Orgagozo, Jean-Marc
    Ringelstein, Bernd
    van der Sande, Jan-Jacob
    Turpie, Alexander G G
    Tinzaparin in acute ischaemic stroke (TAIST): A randomised aspirin-controlled trial2001Ingår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 358, nr 9283, s. 702-710Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Low-molecular-weight heparins and heparinoids are superior to unfractionated heparin in the prevention and treatment of venous thromboembolism, but their safety and efficacy in acute ischaemic stroke are inadequately defined. Methods: This randomised, double-blind, aspirin-controlled trial tested the safety and efficacy of treatment with high-dose tinzaparin (175 anti-Xa IU/kg daily, 487 patients), medium-dose tinzaparin (100 anti-Xa IU/kg daily, 508 patients), or aspirin (300 mg daily, 491 patients) started within 48 h of acute ischaemic stroke and given for up to 10 days. Primary intracerebral haemorrhage was excluded by computed tomography. Outcome was assessed, with treatment allocation concealed, by the modified Rankin scale at 6 months (independence [scores 0-2] vs dependence or death [scores 3-6]). Findings: Of 1486 randomised patients, two did not receive treatment and 46 were lost to follow-up. The proportions independent at 6 months were similar in the groups assigned high-dose tinzaparin (194/468 [41.5%]), medium-dose tinzaparin (206/486 [42.4%]), or aspirin (205/482 [42.5%]). There was no difference in effect in any predefined subgroup, including patients with presumed cardioembolic stroke. Other outcome measures were similar between the treatment groups (disability, case-fatality, and neurological deterioration rates). During the in-hospital treatment period no patient assigned high-dose tinzaparin developed a symptomatic deep-vein thrombosis compared with nine assigned aspirin. Conversely, seven patients assigned high-dose tinzaparin developed symptomatic intracerebral haemorrhage compared with one in the aspirin group. Interpretation: Treatment with tinzaparin, at high or medium dose, within 48 h of acute ischaemic stroke did not improve functional outcome compared with aspirin. Although high-dose tinzaparin was superior in preventing deep-vein thrombosis, it was associated with a higher rate of symptomatic intracranial haemorrhage.

  • 2.
    Dizdar (Dizdar Segrell), Nil
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Granerus, Ann-Kathrine
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Geriatrik. Linköpings universitet, Hälsouniversitetet.
    Hannestad, Ulf
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Kullman, Anita
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Ljungdahl, Å.
    Department of Neurology, Huddinge Hospital, Stockholm.
    Olsson, Jan-Edvin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Kågedal, Bertil
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    L-dopa pharmacokinetics studied with microdialysis in patients with Parkinson's disease and a history of malignant melanoma1999Ingår i: Acta neurologica Scandinavica, ISSN 0001-6314, Vol. 100, nr 4, s. 231-237Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The pharmacokinetics of free L-dopa in blood and tissue of five parkinsonian patients with malignant melanoma was studied with microdialysis. In one case the effect of L-dopa treatment on 5-S-cysteinyldopa and the melanoma was studied. Gastric emptying and its effects on free L-dopa in blood were also investigated in one of the patients.

    METHODS: Five patients were given 100 mg L-dopa with 25 mg benserazide. Blood and dialysates from the circulation and fatty tissue were collected for analysis. [13C]-Octanoic breath test was used for analyzing gastric half-emptying time.

    RESULTS: Four of the patients had similar pharmacokinetic patterns for L-dopa and a significant (P < 0.05) increase of serum 5-S-cysteinyldopa occurring 30 min after L-dopa intake. Delayed L-dopa peaks and slow gastric half-emptying time were found in 1 patient. A dose-dependent increase of 5-S-cysteinyldopa occurred but no melanoma metastases were seen during long-term L-dopa therapy.

    CONCLUSION: L-dopa therapy increases 5-S-cysteinyldopa levels but does not seem to cause progress of melanomas. Gastric emptying impacts L-dopa pharmacokinetics.

  • 3.
    Dizdar (Dizdar Segrell), Nil
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Kullman, Anita
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Norlander, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Olsson, Jan-Edvin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Kågedal, Bertil
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Human pharmacokinetics of L-3,4-dihydroxyphenylalanine studied with microdialysis1999Ingår i: Clinical Chemistry, ISSN 0009-9147, E-ISSN 1530-8561, Vol. 45, nr 10, s. 1813-1820Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Intravenous and subcutaneous microdialysis was performedto compare the free concentrations and pharmacokinetics of L-3,4-dihyroxyphenylalanine(L-dopa) in blood and tissue in healthy subjects and in patientswith Parkinson disease.

    Methods: Nine healthy volunteers and 10 patients with Parkinson disease, stage 1.5–2 according to the Hoehn-Yahr rating scale, took part of the study. In the patient group subcutaneous microdialysis and ordinary blood sampling were performed, whereas in the control group intravenous microdialysis was also performed. Microdialysis samples were collected in fractions of 15 min. The first two fractions were collected for analysis of basal concentrations. A blood sample was also taken. The patients were then given one tablet of Madopar® (100 mg of L-dopa and 25 mg of benserazide),and the microdialysis was continued for another 210 min. Bloodsamples were obtained at 30-min intervals.

    Results: The serum samples gave a significantly higher meanarea under the curve (AUC; 491 ± 139 µmol ·min/L) than that for intravenous dialysates (235 ± 55.3µmol · min/L), suggesting a protein binding of50%. The L-dopa concentrations from the subcutaneous dialysatesmatched those from the intravenous dialysates, indicating rapiddistribution of L-dopa to the tissues.

    Conclusions: Parkinsonian patients in early stages of the disease have a pharmacokinetic pattern of free L-dopa similar to that of healthy subjects. Comparison of AUCs from microdialysis with ordinary serum analysis revealed data indicating significant protein binding. Microdialysis is a suitable and easily applied tool in pharmacokinetic studies.

  • 4. Ekbom, Karl
    et al.
    Leissner, Lena
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Widner, Håkan
    Restless legs - vanligt sjukdomstillstånd som ofta missas. Möjligheter till framgångsrik behandling finns idag2006Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, s. 207-211Artikel i tidskrift (Övrigt vetenskapligt)
  • 5.
    Eriksson, Sven-Erik
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan.
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Survival and recurrent strokes in patients with different subtypes of stroke: A fourteen-year follow-up study2001Ingår i: Cerebrovascular Diseases, ISSN 1015-9770, E-ISSN 1421-9786, Vol. 12, nr 3, s. 171-180Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this study, 339 patients (154 men, 185 women) with a median age of 74 years (range 23-97) admitted to the Stroke Unit, Department of Neurology in 1986, have been followed up for 14 years. The diagnoses were intra-cerebral hemorrhage (ICH, 30, 8.8%), cardioembolic cerebral infarction (CE, 71, 20.9%), lacunar infarction (LI, 47, 13.9%) and atherosclerotic cerebral infarction (ACI, 191, 56.3%). The cumulative probabilities of recurrent stroke rates at 1-, 5- and 10-year follow-ups were 13.5% (95% confidence interval, CI, 9.6-17.4), 38.7% (95% CI 32.6-44.8) and 53.9% (95% CI 46.7-61.1). According to Cox proportional hazard regression analysis, age, severity of stroke, previous stroke and systolic blood pressure are each of importance in predicting recurrent stroke. During the observation period, 290 patients (85.5%) died. The mortality rate of 24.5% during the first year was 4.5 times higher compared to the normal population of the same age and gender. Patients with LI had lower mortality rates compared to ICH by the log rank test (p =0.0275), to CE (p =0.000) and to ACI (p =0.049). Thirty-nine percent of all vascular deaths after the first year were caused by recurrent strokes. Fatal index/recurrent stroke occurred statistically more frequently in the CE group versus the non-CE one (p =0.005). Cox proportional hazard regression analysis indicated that age, severity of stroke, previous stroke, heart failure and fasting blood glucose exceeding 6 mmol/l or history of diabetes were each predictors of mortality. In conclusion, this study has shown the worse outcomes for all subtypes of stroke compared to the normal population and also clearly pointed out independent predictors of recurrent stroke or death at the time of diagnosis. Copyright

  • 6.
    Fall, Per-Arne
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Geriatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Geriatriska kliniken.
    Axelson, Olav
    Linköpings universitet, Institutionen för molekylär och klinisk medicin.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Hansson, Gunilla
    Lindvall, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Olsson, Jan-Edvin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet.
    Granérus, Ann-Kathrine.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Geriatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Geriatriska kliniken.
    Age standardised incidence and prevalence of Parkinson´s disease in a Swedish community1996Ingår i: Journal of Clinical Epidemiology, ISSN 0895-4356, Vol. 49, nr 6, s. 637-641Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Parkinson's disease (PD) shows a geographical variation. All prescriptions for anti-parkinsonian drugs were recorded for a half-year in a region with low -dopa consumption. Hospital and outpatient records were studied and physicians were asked to supply details of PD patients in the region, with 147,777 inhabitants. The crude prevalence was 115 PD per 100,000 inhabitants, based on 170 cases. In contrast to other studies we report an age-standardized prevalence, which was 76 per 100,000, using the European Standard Population as reference. The corresponding approximate incidences were 11.0 (crude) and 7.9 (age-standardized) per 100,000 person-years. Male preponderance appeared in all age groups. Mean age at onset was 65.6 years, the highest figure reported. Variation between studies for age at onset, differences in prevalence, and male preponderance suggest environmental risk factors to be of importance for PD.

  • 7.
    Fall, Per-Arne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Geriatrik. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Geriatriska kliniken.
    Saleh, Avin
    Fredrikson, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Yrkes- och miljömedicin.
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Granerus, Ann-Kathrine
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Geriatrik. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Geriatriska kliniken.
    Survival time, mortality, and cause of death in elderly patients with Parkinson's disease: A 9-year follow-up2003Ingår i: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 18, nr 11, s. 1312-1316Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This community-based study of Parkinson's disease (PD) investigated age at death and cause of death in a cohort of 170 previously studied patients. The current study is a 9-year follow-up, and the results are compared to 510 sex- and age-matched controls from the same area. A total of 170 patients were diagnosed with PD on August 31, 1989, within a defined area of Sweden. A control group of 510 persons from the same area and with the same age and sex distribution was also examined regarding age at death and cause of death. After 9.4 years, 121 cases (71.1%) and 229 controls (44.9%) were no longer alive. Thus, the mortality rate ratio was 1.6 (95% confidence interval [CI], 1.3-1.8) when comparing PD patients with controls. The all-cause hazard ratio for cases compared to controls was 2.4 (95% CI, 1.9-3.0). The mean age at death for the cases was 81.9 (95% CI, 80.3-83.0) years and for the controls 82.9 (95% CI, 82.0-83.7) years. Survival analysis also showed a shorter survival time (P < 0.001) for PD patients. Only 53% of the death certificates for the deceased patients recorded PD as an underlying or contributory cause of death. Many PD patients reached a high age but had a shorter survival than the controls. There was a significant increase in deaths from pneumonia.

  • 8. Gray, L J
    et al.
    Sprigg, N
    Bath, P M W
    Sörensen, P
    Lindenström, E
    Boysen, G
    De Deyn, P P
    Friis, P
    Leys, D
    Marttila, R
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    O´Neill, D
    Ringelstein, B
    van der Sande, J-J
    Turpie, A G G
    Significant variation in mortality and functional outcome after acute ischaemic stroke between western countries: Data from the tinzaparin in acute ischaemic stroke trial (TAIST)2006Ingår i: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 77, nr 3, s. 327-333Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The medical care of patients with acute stroke varies considerably between countries. This could lead to measurable differences in mortality and functional outcome. Objective: To compare case mix, clinical management, and functional outcome in stroke between 11 countries. Methods: All 1484 patients from 11 countries who were enrolled into the tinzaparin in acute ischaemic stroke trial (TAIST) were included in this substudy. Information collected prospectively on demographics, risk factors, clinical features, measures of service quality (for example, admission to a stroke unit), and outcome were assessed. Outcomes were adjusted for treatment assignment, case mix, and service relative to the British Isles. Results: Differences in case mix (mostly minor) and clinical service (many of prognostic relevance) were present between the countries. Significant differences in outcome were present between the countries. When assessed by geographical region, death or dependency were lower in North America (odds ratio (OR) adjusted for treatment group only = 0.52 (95% confidence interval, 0.39 to 0.71) and north west Europe (OR = 0.54 (0.37 to 0.78)) relative to the British Isles, similar reductions were found when adjustments were made for 11 case mix variables and five service quality measures. Similarly, case fatality rates were lower in North America (OR = 0.44 (0.30 to 0.66)) and Scandinavia (OR = 0.50 (0.33 to 0.74)) relative to the British Isles, whether crude or adjusted for case mix and service quality. Conclusions: Both functional outcome and case fatality vary considerably between countries, even when adjusted for prognostic case mix variables and measures of good stroke care. Differing health care systems and the management of patients with acute stroke may contribute to these findings.

  • 9.
    Murray, V
    et al.
    Danderyd Hosp, Div Med, Stockholm, Sweden Reg Hosp, Dept Geriatr Med, Orebro, Sweden Linkoping Univ Hosp, Dept Neurol, S-58185 Linkoping, Sweden Acad Hosp, Dept Med, Uppsala, Sweden Reg Hosp, Dept Neurol, Orebro, Sweden Karolinska Hosp, Dept Clin Neurosci, S-10401 Stockholm, Sweden Danderyd Hosp, Dept Rehabil Med, Stockholm, Sweden Linkoping Univ Hosp, Dept Psychiat, S-58185 Linkoping, Sweden.
    Von Arbin, M
    Danderyd Hosp, Div Med, Stockholm, Sweden Reg Hosp, Dept Geriatr Med, Orebro, Sweden Linkoping Univ Hosp, Dept Neurol, S-58185 Linkoping, Sweden Acad Hosp, Dept Med, Uppsala, Sweden Reg Hosp, Dept Neurol, Orebro, Sweden Karolinska Hosp, Dept Clin Neurosci, S-10401 Stockholm, Sweden Danderyd Hosp, Dept Rehabil Med, Stockholm, Sweden Linkoping Univ Hosp, Dept Psychiat, S-58185 Linkoping, Sweden.
    Varelius, R
    Danderyd Hosp, Div Med, Stockholm, Sweden Reg Hosp, Dept Geriatr Med, Orebro, Sweden Linkoping Univ Hosp, Dept Neurol, S-58185 Linkoping, Sweden Acad Hosp, Dept Med, Uppsala, Sweden Reg Hosp, Dept Neurol, Orebro, Sweden Karolinska Hosp, Dept Clin Neurosci, S-10401 Stockholm, Sweden Danderyd Hosp, Dept Rehabil Med, Stockholm, Sweden Linkoping Univ Hosp, Dept Psychiat, S-58185 Linkoping, Sweden.
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Terent, A
    Danderyd Hosp, Div Med, Stockholm, Sweden Reg Hosp, Dept Geriatr Med, Orebro, Sweden Linkoping Univ Hosp, Dept Neurol, S-58185 Linkoping, Sweden Acad Hosp, Dept Med, Uppsala, Sweden Reg Hosp, Dept Neurol, Orebro, Sweden Karolinska Hosp, Dept Clin Neurosci, S-10401 Stockholm, Sweden Danderyd Hosp, Dept Rehabil Med, Stockholm, Sweden Linkoping Univ Hosp, Dept Psychiat, S-58185 Linkoping, Sweden.
    Samuelsson, M
    Berggren, AL
    Landtblom, Anne-Marie
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Asberg, M
    Bartfai, A
    Danderyd Hosp, Div Med, Stockholm, Sweden Reg Hosp, Dept Geriatr Med, Orebro, Sweden Linkoping Univ Hosp, Dept Neurol, S-58185 Linkoping, Sweden Acad Hosp, Dept Med, Uppsala, Sweden Reg Hosp, Dept Neurol, Orebro, Sweden Karolinska Hosp, Dept Clin Neurosci, S-10401 Stockholm, Sweden Danderyd Hosp, Dept Rehabil Med, Stockholm, Sweden Linkoping Univ Hosp, Dept Psychiat, S-58185 Linkoping, Sweden.
    Bengtsson, F
    Martensson, B
    Sertraline in poststroke depression - A controlled study2002Ingår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 33, nr 1, s. P292-Konferensbidrag (Övrigt vetenskapligt)
  • 10. Murray, Veronica
    et al.
    von Arbin, Magnus
    Bartfai, Aniko
    Berggren, Anna-Lena
    Landtblom, Anne-Marie
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Lundmark, Jöns
    Näsman, Per
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Samuelsson, Margareta
    Terént, Andreas
    Varelius, Riitta
    Åsberg, Marie
    Mårtensson, Björn
    Double-blind comparison of sertraline and placebo in stroke patients with minor depression and less severe major depression2005Ingår i: Journal of Clinical Psychiatry, ISSN 0160-6689, E-ISSN 1555-2101, Vol. 66, nr 6, s. 708-716Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Poststroke depression is a frequent condition and important to treat. The aim of this trial was to study the efficacy and tolerability of sertraline. Method: In 4 Swedish stroke centers, 123 patients (aged 70.7 ± 9.9 years) were enrolled during the period September 1998 to January 2001 in a randomized, double-blind, placebo-controlled 26-week trial, at a mean of 128 ± 97 days (range, 3-375 days) after stroke, if they fulfilled DSM-IV criteria of major depressive episode (N = 76) or minor depressive disorder (N = 47). The primary efficacy variable was a change in depression assessed by the Montgomery-Åsberg Depression Rating Scale. The Emotional Distress Scale (EDS) was administered and the occurrence of emotionalism and quality of life (QoL) were assessed, as well as neurologic recovery. Efficacy analyses were intention-to-treat, short-term (week 6) and long-term (week 26). Results: Of the 123 patients, 62 were treated with sertraline (50-100 mg/day) and 61 with placebo. Both groups improved substantially, with no differences between the treatments, either for major depressive episode or minor depressive disorder, or for short- or long-term antidepressant effect and neurologic outcome. EDS revealed a better outcome with sertraline at week 6 (p < .05). At week 26, the improvement in QoL was better in sertraline patients (p < .05) and there was a trend for emotionalism (p = .07). No serious side effects were seen. Conclusion: Poststroke depression as measured by a conventional depression rating scale improved over time irrespective of treatment. Positive effects specific to sertraline were identified in emotional distress, emotionalism, and QoL. The study indicates that poststroke emotional reactions comprise depression and other domains susceptible to pharmacologic therapy.

  • 11.
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Lipidsänkning och cerebrovaskulär sjukdom - nytta och risker?2002Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 99, s. 1967-1969Artikel i tidskrift (Övrigt vetenskapligt)
  • 12.
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Ny MAO-hämmare vid behandling av Parkinsons sjukdom2005Ingår i: Transmittorn, Vol. 1Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 13.
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Några reflektioner från American Academy of Neurology, 55th Annual Meeting, 2003, Honolulu, Hawaii2003Ingår i: Parkinson-journalen, ISSN 1104-2435, Vol. 4, s. 22-23Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 14.
    Olsson, Jan-Edvin
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Ohrvik, J
    Palhagen, S
    "The Swedish Parkinson Kohort Study" : an Interim Analysis after 7 years2005Ingår i: XVIII World Congress of Neurology,2005, 2005, s. 45-45Konferensbidrag (Refereegranskat)
  • 15. Paviour, Dominic C
    et al.
    Revesz, Tamas
    Holton, Janice L
    Evans, Andrew
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Lees, Andrew J
    Neuronal intranuclear inclusion disease: Report on a case originally diagnosed as dopa-responsive dystonia with lewy bodies2005Ingår i: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 20, nr 10, s. 1345-1349Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disorder with a heterogeneous clinical picture characterized by the presence of eosinophilic intranuclear inclusions in neuronal and glial cells. We describe a case, reported 12 years ago as dopa-responsive dystonia (DRD) with Lewy body pathology. Pathological re-examination has led to a revised diagnosis of neuronal intranuclear inclusion disease. This rare condition, which may be diagnosed in life with a full thickness rectal biopsy, needs to be considered in the differential diagnosis of any case presenting as progressive juvenile parkinsonism (JP) or dystonia. © 2005 Movement Disorder Society.

  • 16.
    Sprigg, N.
    et al.
    Institute of Neuroscience, University of Nottingham, United Kingdom.
    Gray, L.J.
    Institute of Neuroscience, University of Nottingham, United Kingdom.
    Bath, P.M.W.
    Institute of Neuroscience, University of Nottingham, United Kingdom.
    Lindenstrom, E.
    Lindenstrøm, E., Leo Pharma A/S, Ballerup, Denmark.
    Boysen, G.
    Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark.
    De, Deyn P.P.
    De Deyn, P.P., Department of Neurology, A. Z. Middelheim, ZNA, Belgium.
    Friis, P.
    Vest-Agder Sentralsykehus, Kristiansand, Norway.
    Leys, D.
    Clinique Neurologique, CHRU de Lille, France.
    Marttila, R.
    Department of Neurology, Turku University Central Hospital, Finland.
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    O'Neill, D.
    Department of Age Related Health Care, Adelaide and Meath Hospital, Dublin, Ireland.
    Ringelstein, E.B.
    Klinik für Neurologie, Universität Münster, Germany.
    van, der Sande J.-J.
    van der Sande, J.-J., Slotervaartziekenhuis, Amsterdam, Netherlands.
    Turpie, A.G.G.
    Hamilton General Hospital, Hamilton, Ont., Canada.
    Early Recovery and Functional Outcome are Related with Causal Stroke Subtype: Data from the Tinzaparin in Acute Ischemic Stroke Trial2007Ingår i: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 16, nr 4, s. 180-184Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Baseline severity and causal subtype are predictors of outcome in ischemic stroke. We used data from the Tinzaparin in Acute Ischemic Stroke Trial (TAIST) to further assess the relationship among stroke subtype, early recovery, and outcome. Methods: Patients with ischemic stroke (<48 hours ictus) and enrolled into TAIST were included. Severity was measured prospectively as the Scandinavian Neurological Stroke Scale (SNSS) at days 0, 4, 7, and 10. Causal subtype as large artery atherosclerosis (LAA), cardioembolism (CE), or small vessel occlusion (SVO) was assigned after standard investigations. The rate of recovery was calculated as the change in SNSS at each time point. Functional outcome was assessed using the modified Rankin Scale (mRS) and Barthel Index at day 90. Results: Analyses were performed on the 1190 patients in TAIST who met criteria for LAA, CE, and SVO. The largest change in SNSS score occurred between baseline and day 4 and was greatest in SVO (median improvement 4 U), compared with LAA (median improvement 2 U) and CE (median improvement 2 U) (P < .0001). If no improvement in SNSS had occurred by day 4, irrespective of subgroup, then early recovery (median SNSS improvement by day 10: 2) and functional outcome (mRS 4) tended to be limited, patients who recovered early tended to continue to improve (median SNSS improvement by day 10: 11) and had a better outcome at day 90 (median, mRS 2). Conclusions: Recovery is related to causal subtype. In all subtypes most recovery occurred by day 4, and was predictive of longer-term functional outcome. © 2007 National Stroke Association.

  • 17.
    Sprigg, N.
    et al.
    Institute of Neuroscience, University of Nottingham, Nottingham, United Kingdom.
    Gray, L.J.
    Institute of Neuroscience, University of Nottingham, Nottingham, United Kingdom.
    Bath, P.M.W.
    Institute of Neuroscience, University of Nottingham, Nottingham, United Kingdom.
    Lindenstrom, E.
    Lindenstrøm, E., Leo Pharma A/S, Ballerup, Denmark.
    Boysen, G.
    Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark.
    De, Deyn P.P.
    De Deyn, P.P., Department of Neurology, A. Z. Middelheim, ZNA, Antwerpen, Belgium.
    Friis, P.
    Vest-Agder Sentralsykehus, Kristiansand, Norway.
    Leys, D.
    Clinique Neurologique, CHRU de Lille, Lille, France.
    Marttila, R.
    Department of Neurology, Turku University Central Hospital, Turku, Finland.
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    O'Neill, D.
    Department of Age Related Health Care, Adelaide and Meath Hospital, Dublin, Ireland.
    Ringelstein, E.B.
    Klinik für Neurologie, Universität Münster, Münster, Germany.
    van, der Sande J.-J.
    van der Sande, J.-J., Slotervaartziekenhuis, Amsterdam, Netherlands.
    Turpie, A.G.G.
    Hamilton General Hospital, Hamilton, Canada.
    Stroke severity, early recovery and outcome are each related with clinical classification of stroke: Data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST)2007Ingår i: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 254, nr 1-2, s. 54-59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Baseline severity and clinical stroke syndrome (Oxford Community Stroke Project, OCSP) classification are predictors of outcome in stroke. We used data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST) to assess the relationship between stroke severity, early recovery, outcome and OCSP syndrome. Methods: TAIST was a randomised controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1484 patients with acute ischaemic stroke. Severity was measured as the Scandinavian Neurological Stroke Scale (SNSS) at baseline and days 4, 7 and 10, and baseline OCSP clinical classification recorded: total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) and posterior circulation infarction (POCI). Recovery was calculated as change in SNSS from baseline at day 4 and 10. The relationship between stroke syndrome and SNSS at days 4 and 10, and outcome (modified Rankin Scale at 90 days) were assessed. Results: Stroke severity was significantly different between TACI (most severe) and LACI (mildest) at all four time points (p < 0.001), with no difference between PACI and POCI. The largest change in SNSS score occurred between baseline and day 4, improvement was least in TACI (median 2 units), compared to other groups (median 3 units) (p < 0.001). If SNSS did not improve by day 4, then early recovery and late functional outcome tended to be limited irrespective of clinical syndrome (SNSS, baseline: 31, day 10: 32, mRS, day 90: 4), patients who recovered early tended to continue to improve and had better functional outcome irrespective of syndrome (SNSS, baseline: 35, day 10: 50, mRS, day 90: 2). Conclusions: Although functional outcome is related to baseline clinical syndrome (best with LACI, worst with TACI), patients who improve early have a more favourable functional outcome, irrespective of their OCSP syndrome. Hence, patients with a TACI syndrome may still achieve a reasonable outcome if early recovery occurs. © 2007 Elsevier B.V. All rights reserved.

  • 18. Sprigg, Nikola
    et al.
    Gray, Laura J
    Bath, Philip M W
    Boysen, Gudrun
    De Deyn, Peter Paul
    Friis, Pal
    Leys, Didier
    Marttila, Reijo
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    O´Neill, Desmond
    Ringelstein, Bernd
    van der Sande, Jan- Jacob
    Lindenström, Ewa
    elationship between outcome and baseline blood pressure and other haemodynamic measures in acute ischaemic stroke: Data from the TAIST trial2006Ingår i: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 24, nr 7, s. 1413-1417Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: A poor outcome after stroke is associated independently with high blood pressure during the acute phase, however, relationships with other haemodynamic measures [heart rate (HR), pulse pressure (PP), rate-pressure product (RPP)] remain less clear. METHODS: The Tinzaparin in Acute Ischaemic Stroke Trial is a randomised, controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1484 patients with acute ischaemic stroke. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR measurements taken immediately prior to randomization were averaged, and the mid-blood pressure (MBP), PP, mean arterial pressure (MAP), pulse pressure index, and RPP were calculated. The relationship between these haemodynamic measures and functional outcome (death or dependency, modified Rankin Scale > 2) and early recurrent stroke, were studied with adjustment for baseline prognostic factors and treatment group. Odds ratios (OR) and 95% confidence intervals (CI) refer to a change in haemodynamic measure by 10 points. RESULTS: A poor functional outcome was associated with SBP (adjusted OR, 1.11, 95% CI, 1.03-1.21), HR (adjusted OR, 1.15, 95% CI, 1.00-1.31), MBP (adjusted OR, 1.15, 95% CI, 1.03-1.29), PP (adjusted OR, 1.14, 95% CI, 1.02-1.26), MAP (adjusted OR, 1.15, 95% CI, 1.02-1.31) and RPP (adjusted OR, 1.01, 95% CI, 1.00-1.02). Early recurrent stroke was associated with SBP, DBP, MBP and MAP. CONCLUSIONS: A poor outcome is independently associated with elevations in blood pressure, HR and their derived haemodynamic variables, including PP and the RPP. Agents that modify these measures may improve functional outcome after stroke. © 2006 Lippincott Williams & Wilkins.

  • 19. Sprigg, Nikola
    et al.
    Gray, Laura J
    Bath, Philip MS
    Lindenström, Ewa
    Boysen, Gudrun
    De Deyn, Peter Paul
    Friis, Pal
    Leys, Didier
    Marttila, Reijo
    Olsson, Jan-Edvin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    ONeil, Desmond
    Ringelstein, Erich Bernd
    van der Sande, Jan-Jacob
    Turpie, Alexander GG
    Early recovery and functional outcome are related with causal stroke subtype: Data from the tinzaparin in acute ischemic stroke trial.2007Ingår i: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 16, nr 4, s. 180-184Artikel i tidskrift (Refereegranskat)
    Abstract [en]

        

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