Biomedical subjects
Publications and source records attributed to M Persson.
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This paper describes a development process concerning the active involvement of staff of different professions in developing and implementing methods for assessment of activities of daily living (ADL) in home-based geriatric rehabilitation. Although a variety of established ADL instruments exist, at the time for this study no I-ADL (Instrumental Activities of Daily Living) instrument suitable for communication among staff members of different professions was available. The specific aim was to test a new I-ADL instrument for interrater reliability. The developmental process resulting in the Measure of Instrumental Daily Activity (MIDA) is described. The instrument comprises 12 I-ADL items, defined on the basis of practical home rehabilitation experience. The study involved 36 clients with impairments, aged 65+ years. Multi-disciplinary interrater reliability was tested by 67 parallel independent assessments during a 3-month period, performed by pairs of raters of different professions. Overall agreement was very good (mean weighted kappa=0.89). The MIDA fulfils the basic requirements necessary for valid I-ADL assessment of elderly clients in community health care. An important quality is the active involvement of all staff in the assessment procedure, facilitating and stimulating the implementation of a general rehabilitative attitude in everyday practice.
The purpose of the present study was to investigate personality traits and platelet monoamine oxidase (MAO) activity, as well as occurrence of personality disorder criteria, family characteristics, and criminal activity as related to misuse pattern in a sample of female in-patients with severe alcohol dependence. In accordance with theoretical assumptions and empirical findings of underlying neurobiological correlates of disinhibition in individuals with double or multiple misuse patterns, the female alcoholics were divided into subgroups with: (1) alcohol as their single drug of misuse (ALC; n = 16); (2) a history of additional substance misuse (ALC-DRUG; n = 11). Platelet MAO activity of the female subgroups was studied in comparison to a control group of non-clinical female subjects. Marked differences were obtained between the two subgroups. The ALC-DRUG females scored significantly higher with regard to Karolinska Scales of Personality (KSP) impulsiveness, anxiety-related traits, and non-conformity, displayed higher frequency of depression in first degree relatives, were more frequently involved in criminal activity, and more frequently diagnosed for any personality disorder according to DSM-IV, axis II. Finally, the ALC-DRUG females displayed significantly lower platelet MAO activity than controls. In conclusion, the results support the usefulness of a classification of severe alcoholic female subjects according to having/not having a history of additional substance misuse. The present female alcoholics with a history of additional misuse formed a group of individuals fulfilling the criteria similar for male type 2 alcoholism.
OBJECTIVE: Giant cell arteritis (GCA) is a chronic form of vasculitis which predominantly affects women over 50 years of age. The aim of this study was to analyse the presence of estrogen receptor alpha (ER) in the temporal arteries of patients with GCA. METHODS: Inflamed temporal artery biopsies from 43 GCA patients were stained with monoclonal antibodies to two different segments of the ER and compared with non-inflamed arteries from age- and sex-matched controls who had not received a clinical diagnosis of GCA. The protein that was extracted from 4 GCA-positive biopsies and 4 non-GCA controls was analysed using the Western blot method with a monoclonal antibody to ER. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis using primer pairs specific to ER-cDNA was performed on the total RNA from 4 GCA-positive biopsies and 4 non-GCA controls. RESULTS: The inflamed arteries expressed distinct cytoplasmic immunoreactivity to ER in activated mononuclear inflammatory cells and in giant cells. Biopsies from GCA patients and controls displayed cytoplasmic ER positivity in smooth muscle cells. Western blot analysis revealed two bands corresponding to approximately 64 and 54 kDa, respectively, in the inflamed arteries and controls. In the inflamed biopsies and non-GCA controls, RT-PCR analysis revealed a strong band corresponding to approximately 670 bp, as expected, and a weaker band corresponding to approximately 440 bp. CONCLUSION: In inflamed arteries from GCA patients, smooth muscle cells, activated mononuclear inflammatory cells and giant cells express cytoplasmic ER. Non-inflamed control arteries also express cytoplasmic ER in smooth muscle cells. The accumulation of cytoplasmic ER may suggest the involvement of estrogen not only in GCA but also in normal vascular aging. The results justify further investigations into the pathogenetic roles of estrogen metabolism in GCA.
OBJECTIVE: Giant cell arteritis (GCA) predominantly affects postmenopausal women. Estrogen receptor alpha (ER alpha) accumulates in the cytoplasm of smooth muscle cells, activated mononuclear inflammatory cells and giant cells in the temporal arteries of GCA patients, as well as in smooth muscle cells in arteries from non-GCA controls. The aim of this study was to analyse whether this accumulation is related to structural aberrations in the ER alpha mRNA leading to a change in protein structure. METHODS: Total RNA was extracted from inflamed temporal artery tissue in two GCA patients and from non-inflamed arteries in two non-GCA controls. Products from the nested RT-PCR of the cDNA were cloned and plasmid inserts of 20 different clones from each case were investigated using nucleotide sequence analysis. RESULTS: A total of eight different types of transcripts lacking parts of the ER alpha mRNA were detected. Seven of these could be explained by alternative splicing. There were no significant differences between the GCA patients and the non-GCA controls in terms of the number of transcript variants. CONCLUSION: The accumulated cytoplasmic ER alpha in temporal arterial tissue from elderly persons appears mainly to be of wild type. The main structural changes in the ER alpha mRNA may be due to alternative splicing. Somatic mutations of the ER alpha gene appear to be rare and it is therefore unlikely that they are involved in the pathogenesis of GCA.
Neuromotor handicaps and mental retardation have been associated with various types of dental malocclusions and oral dysfunction. In this study the specific role of mental status on oral functions was examined. For this, oral function capacity was compared between two groups of physically handicapped children and young adults, one with a physical handicap alone, the other with mental retardation. The latter were found not only to be significantly more motor-impaired in general, but also were found to have significantly more deficient oral functions (speech, swallowing and chewing). Mentally retarded also showed significantly more frequent involvement with regard to some other characteristics of oral function and oral conditions, such as lip seal, tongue posture and drooling. As oral dysfunction may cause dental malocclusion, it seems likely that the deviating or immature oral functions in the mentally retarded group may explain earlier observations of a higher prevalence and often more severe malocclusion in these individuals, compared to those who are handicapped.