Tidsskrift for Den Norske Laegeforening, May 15, 2008
Background: Acute myocarditis is a serious condition that is challenging to diagnose. Recent deve... more Background: Acute myocarditis is a serious condition that is challenging to diagnose. Recent developments in contrast-enhanced cardiac magnetic resonance imaging (ce-MRI) enable visualization of myocardial damage in patients with myocarditis. The objective of this study was to identify patients in whom ce-MRI could be useful to reach such a diagnosis. Methods: We reviewed data from 37 patients referred to ce-MRI with suspected acute myocarditis at Stavanger University Hospital from July 2004 to May 2007. Result: 20 patients had epicardial contrast enhancement compatible with myocarditis. The contrast enhancement was focal and most frequently localized to the inferolateral wall (n = 12). No patient with Troponin T < 0.1 microg/L (n = 7) showed epicardial contrast enhancement. It was not possible to distinguish patients with acute myocarditis from the other patients on the basis of clinical signs, symptoms, C-reactive protein levels, ECG- or echocardiography. Interpretation: Ce-cardiac MRI is important in the diagnosis of acute myocarditis. If troponin T levels are < 0.1 microg/L during the acute phase, it is unlikely that a contrast enhancement pattern will be compatible with myocarditis.
Background: We investigated whether the prevalence of primary headaches was higher in patients wi... more Background: We investigated whether the prevalence of primary headaches was higher in patients with primary Sjøgren's syndrome (PSS) than in healthy individuals. Methods: This retrospective cohort study included 71 patients with PSS (patients) based on the American European Consensus Classification criteria, and 71 age-and gender-matched healthy subjects (controls). Headaches were classified according to the International Classification of Headache Disorders. We measured depression with the Beck Depression Inventory, and fatigue with the Fatigue Severity Scale. Results: Fifty-one patients and 42 controls had headaches in the previous 12 months (71.8% vs. 59.2%, P = 0.10). Thirty-eight patients and 28 controls had tension type headaches (TTHs) (53.5% vs. 39.4%, P = 0.12). Eight patients (11.3%) and one control had chronic TTHs (P = 0.05). Migraines and migraines with aura were equally prevalent in patients (26.8% and 11.3%, respectively) and controls (28.2% and 15.5%, respectively; P = 0.61). Conclusions: In general, patients did not have more migraines or headaches than controls. However, patients had more chronic TTHs than controls. Chronic TTHs were not associated with PSS-related autoantibodies, fatigue, depression, abnormalities on magnetic resonance imaging or abnormalities in the cerebrospinal fluid. Patients with PSS did, however, have higher depression and fatigue scores than controls.
This author takes responsibility for all aspects of the reliability and freedom from bias of the ... more This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
Stavanger universitetssjukehus Han har bidratt med utarbeiding av manuskriptet og godkjent den in... more Stavanger universitetssjukehus Han har bidratt med utarbeiding av manuskriptet og godkjent den innsendte manusversjonen. Jens Vikse (f. 1989) er turnuslege. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. STEIN ØRN Kardiologisk avdeling Stavanger universitetssjukehus og Det teknisk-naturvitenskapelige fakultet Universitetet i Stavanger
Background/Objectives: White matter hyperintensities (WMH) in magnetic resonance imaging (MRI) sc... more Background/Objectives: White matter hyperintensities (WMH) in magnetic resonance imaging (MRI) scans of the brain, and orthostatic hypotension (OH) are both common in older people. We tested the hypothesis that OH is associated with WMH.
ysis. J Clin Ultrasound 1987;15:567–90. 2. Torp-Pedersen ST, Terslev L. Settings and artefacts re... more ysis. J Clin Ultrasound 1987;15:567–90. 2. Torp-Pedersen ST, Terslev L. Settings and artefacts relevant in colour/power Doppler ultrasound in rheumatology. Ann Rheum Dis 2008;67:143–9. 3. Bude RO, Rubin JM, Adler RS. Power versus conventional color Doppler sonography: comparison in the depiction of normal intrarenal vasculature. Radiology 1994;192:777–80. 4. Rubin JM, Bude RO, Carson PL, Bree RL, Adler RS. Power Doppler US: a potentially useful alternative to mean frequencybased color Doppler US. Radiology 1994;190:853–6. 5. Jensen JA. Estimation of blood velocities using ultrasound: a signal processing approach. Cambridge University Press; 1996. URL: http://orbit.dtu.dk/en/publications/estimation-of-blood-velocitiesusing-ultrasound%28a0816561-f101-4aac-b724-d8973050df4e% 29.html.
was associated with a reduced risk for CVEs. Conclusion: The increased risk for CVEs in the first... more was associated with a reduced risk for CVEs. Conclusion: The increased risk for CVEs in the first 6 months after HF diagnosis and additional risk factors identified may help to better define the prothrombotic phenotype in HF.
Objective A prevailing hypothesis for neuropsychiatric involvement in systemic lupus erythematosu... more Objective A prevailing hypothesis for neuropsychiatric involvement in systemic lupus erythematosus (SLE) and primary Sjögren’s syndrome is that brain reactive autoantibodies enter the brain through a disrupted blood–brain barrier. Our aim was to investigate whether TNF-like weak inducer of apoptosis (TWEAK) plays a role in cerebral involvement in human SLE and primary Sjögren’s syndrome, and whether an impaired blood–brain barrier is a prerequisite for neuropsychiatric manifestations. Methods TWEAK was measured in the cerebrospinal fluid and serum and compared with markers of blood–brain barrier permeability (Q-albumin and MRI contrast-enhanced lesions) and S100B, an astrocyte activation marker in 50 SLE and 52 primary Sjögren’s syndrome patients. Furthermore, we estimated the general intrathecal B-cell activation (IgG index), measured anti-NR2 antibodies in cerebrospinal fluid, and explored whether these variables were associated with neuropsychiatric manifestations. Results No ass...
OP0215-Table 1. Number (N), proportion of females (%), and mean ages at baseline of incident pati... more OP0215-Table 1. Number (N), proportion of females (%), and mean ages at baseline of incident patients with inflammatory arthritides between 2010 and 2014 in Finland. RA+ n=6186 RA-n=2970 UA n=2959 SpA n=3577 PsA n=2670 Age, mean (SD) 58 (15) 57 (17) 49 (17) 38 (12) 49 (13) Proportion of females (%) 66.4 67.2 67.4 52.3 48.8 Abstract OP0215-Figure 1. Proportion of opioid purchasers among patients with incident A) seropositive rheumatoid arthritis (RA+), B) seronegative rheumatoid arthritis (RA-), C) unspecified arthritis (UA), D) spondyloarthritis [(SpA), including ankylosing spondylitis and non-radiographic axial spondyloarthritis], and E) psoriatic arthritis (PsA) and their controls one year before and after the index date. F) Odds ratio for long-term opioid use among incident RA+, RA-, UA, SpA, and PsA patients versus controls after the index date. Conclusions: IA patients are more likely to buy opioids one year before and one year after the diagnosis and presciption of antirheumatic medication than controls from the general population. The opioid purchases peak just before the index date in most IA patients. Long-term opioid use is also more common among patients with newly-onset IA, especially among those with SpA.
Journal of Neurology, Neurosurgery & Psychiatry, 2008
Fatigue is a disabling phenomenon in many patients who have systemic lupus erythematosus (SLE). T... more Fatigue is a disabling phenomenon in many patients who have systemic lupus erythematosus (SLE). The pathophysiological processes are unknown, and no known biological disease factors influence the phenomenon. Because depressive mood is consistently associated with fatigue, and drug treatment for SLE does not ameliorate fatigue, a psychological explanation could be an alternative. In search of a somatic basis for fatigue, we looked for alternative markers of biologic activity associated with fatigue. Cerebral white matter hyperintensities (WMHs) represent biochemical changes of brain tissue and are frequently encountered in patients with SLE, and are associated with cognitive impairment in patients with multiple sclerosis. Presence of such an association between fatigue and WMHs in SLE would favour a biological axis to fatigue. A cross-sectional, case-control study with 62 unselected patients with SLE and 62 age- and gender-matched healthy subjects. Fatigue was evaluated using the Fatigue Severity Scale (FSS) and a fatigue visual analogue scale (VAS). WMHs were rated using Scheltens&#39; method. Greater fatigue and more WMHs appeared in patients with SLE versus healthy subjects. In the full group of patients (n = 62), fatigue VAS was associated with total WMH score (p = 0.009). In subgroup analysis of patients without clinical depression (n = 40), the association with total WMH remained (p = 0.035), whereas this was not the case in the depressed group (n = 18) (p = 0.211). Increased cerebral WMH load is associated with increased fatigue, indicating a biological origin for some portion of fatigue in patients with SLE.
Background Contrast enhancement is measured in the aorta at set intervals of time during the test... more Background Contrast enhancement is measured in the aorta at set intervals of time during the test-bolus series of a coronary computed tomography angiography [CCTA]. Its primary purpose is to ascertain the timing delay of the main scan after contrast administration to ensure optimal image acquisition. The change in contrast enhancement over time correlates directly with contrast medium concentration in the vessel. If the complete time density curve [TDC] is known and corrected for contrast enhancement due to recirculation it can be used to estimate the cardiac output [CO], by e.g. a modified Stewart-Hamilton equation, as shown by Mahnken et al. Purpose The current study aims to explore ways to improve the mathematical estimation of CO. In practical applications only part of the TDC is known. By integrating patient factors, contrast factors and scanning factors with a mathematical compartment model, the CO can be estimated. Estimated CO is subsequently used to simulate the distributio...
Acta Obstetricia et Gynecologica Scandinavica, 2009
A scar pregnancy is an ectopic pregnancy implanted in a previous lower segment cesarean scar, and... more A scar pregnancy is an ectopic pregnancy implanted in a previous lower segment cesarean scar, and the incidence of this complication may be expected to rise along with increasing cesarean section rates. Arteriovenous malformation of the uterus may be congenital, associated with early pregnancy loss, trophoblastic disease, or surgical procedures. We describe a case of uterine arteriovenous malformation as a consequence of a scar pregnancy, complicated by recurrent, serious bleeding. The condition was diagnosed using three‐dimensional ultrasound with color Doppler and magnetic resonance imaging and appears not to have been described before. Selective embolization was performed, but eventually surgical intervention with resection of the affected uterine segment was necessary, and the patient recovered. The diagnosis was confirmed by pathologic‐anatomical diagnosis showing trophoblastic cells in the resected area. Because of collateral formation, non‐surgical options may be limited and not successful.
section (CS) rate worldwide. No general treatment guidelines have been established to date. The p... more section (CS) rate worldwide. No general treatment guidelines have been established to date. The purpose of this study was to describe our experience with the diagnosis and treatment of a Cesarean scar pregnancy and to formulate our optimal treatment policy for Cesarean scar pregnancies. Methods: Four women were diagnosed with a Cesarean scar pregnancy in our hospital between 1996 and 2007. Three women were treated with ultrasound guided transcervical aspiration of the gestational sac, followed by intra-amniotic injection of methotrexate. One woman was treated with systemic injection of methotrexate. Results: All women had a steady decline of the serum β-hCG level. Because of persistence of pregnancy tissue, two women underwent laparotomy with good results. The uterus was preserved in all women and 3 of them had an uneventful subsequent pregnancy and delivery. Conclusions: We suggest that transcervical needle aspiration of amniotic fluid followed by intra-amniotic injection of methotrexate should be the treatment of preference, only followed by surgical treatment if methotrexate fails.
ysis. J Clin Ultrasound 1987;15:567–90. 2. Torp-Pedersen ST, Terslev L. Settings and artefacts re... more ysis. J Clin Ultrasound 1987;15:567–90. 2. Torp-Pedersen ST, Terslev L. Settings and artefacts relevant in colour/power Doppler ultrasound in rheumatology. Ann Rheum Dis 2008;67:143–9. 3. Bude RO, Rubin JM, Adler RS. Power versus conventional color Doppler sonography: comparison in the depiction of normal intrarenal vasculature. Radiology 1994;192:777–80. 4. Rubin JM, Bude RO, Carson PL, Bree RL, Adler RS. Power Doppler US: a potentially useful alternative to mean frequencybased color Doppler US. Radiology 1994;190:853–6. 5. Jensen JA. Estimation of blood velocities using ultrasound: a signal processing approach. Cambridge University Press; 1996. URL: http://orbit.dtu.dk/en/publications/estimation-of-blood-velocitiesusing-ultrasound%28a0816561-f101-4aac-b724-d8973050df4e% 29.html.
Background To test the hypothesis that neurofilament light (NfL) in CSF is a biomarker of CNS inv... more Background To test the hypothesis that neurofilament light (NfL) in CSF is a biomarker of CNS involvement in patients with systemic lupus erythematosus (SLE) and primary Sjögren’s syndrome (pSS), we measured NfL in CSF from 52 patients with lupus and 54 with pSS and explored associations with clinical, structural, immunological and biochemical abnormalities. Methods In CSF, we measured NfL, anti-P antibodies, protein S100B and TWEAK by ELISA and anti-NR2 antibodies by electrochemiluminescence. Anti-phospholipid antibodies and routine immunological tests were performed in blood. IgG and albumin were measured in CSF and serum for assessment of the blood–brain barrier function (Q-albumin) and intrathecal IgG production (IgG index). Cerebral MRI and neuropsychological testing were performed. Results A multivariable regression model showed that increasing CSF anti-NR2 antibody levels were associated with increasing NfL levels in patients with SLE (B 1.27, 95% CI 0.88–1.65, p
Tidsskrift for Den Norske Laegeforening, May 15, 2008
Background: Acute myocarditis is a serious condition that is challenging to diagnose. Recent deve... more Background: Acute myocarditis is a serious condition that is challenging to diagnose. Recent developments in contrast-enhanced cardiac magnetic resonance imaging (ce-MRI) enable visualization of myocardial damage in patients with myocarditis. The objective of this study was to identify patients in whom ce-MRI could be useful to reach such a diagnosis. Methods: We reviewed data from 37 patients referred to ce-MRI with suspected acute myocarditis at Stavanger University Hospital from July 2004 to May 2007. Result: 20 patients had epicardial contrast enhancement compatible with myocarditis. The contrast enhancement was focal and most frequently localized to the inferolateral wall (n = 12). No patient with Troponin T < 0.1 microg/L (n = 7) showed epicardial contrast enhancement. It was not possible to distinguish patients with acute myocarditis from the other patients on the basis of clinical signs, symptoms, C-reactive protein levels, ECG- or echocardiography. Interpretation: Ce-cardiac MRI is important in the diagnosis of acute myocarditis. If troponin T levels are < 0.1 microg/L during the acute phase, it is unlikely that a contrast enhancement pattern will be compatible with myocarditis.
Background: We investigated whether the prevalence of primary headaches was higher in patients wi... more Background: We investigated whether the prevalence of primary headaches was higher in patients with primary Sjøgren's syndrome (PSS) than in healthy individuals. Methods: This retrospective cohort study included 71 patients with PSS (patients) based on the American European Consensus Classification criteria, and 71 age-and gender-matched healthy subjects (controls). Headaches were classified according to the International Classification of Headache Disorders. We measured depression with the Beck Depression Inventory, and fatigue with the Fatigue Severity Scale. Results: Fifty-one patients and 42 controls had headaches in the previous 12 months (71.8% vs. 59.2%, P = 0.10). Thirty-eight patients and 28 controls had tension type headaches (TTHs) (53.5% vs. 39.4%, P = 0.12). Eight patients (11.3%) and one control had chronic TTHs (P = 0.05). Migraines and migraines with aura were equally prevalent in patients (26.8% and 11.3%, respectively) and controls (28.2% and 15.5%, respectively; P = 0.61). Conclusions: In general, patients did not have more migraines or headaches than controls. However, patients had more chronic TTHs than controls. Chronic TTHs were not associated with PSS-related autoantibodies, fatigue, depression, abnormalities on magnetic resonance imaging or abnormalities in the cerebrospinal fluid. Patients with PSS did, however, have higher depression and fatigue scores than controls.
This author takes responsibility for all aspects of the reliability and freedom from bias of the ... more This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
Stavanger universitetssjukehus Han har bidratt med utarbeiding av manuskriptet og godkjent den in... more Stavanger universitetssjukehus Han har bidratt med utarbeiding av manuskriptet og godkjent den innsendte manusversjonen. Jens Vikse (f. 1989) er turnuslege. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. STEIN ØRN Kardiologisk avdeling Stavanger universitetssjukehus og Det teknisk-naturvitenskapelige fakultet Universitetet i Stavanger
Background/Objectives: White matter hyperintensities (WMH) in magnetic resonance imaging (MRI) sc... more Background/Objectives: White matter hyperintensities (WMH) in magnetic resonance imaging (MRI) scans of the brain, and orthostatic hypotension (OH) are both common in older people. We tested the hypothesis that OH is associated with WMH.
ysis. J Clin Ultrasound 1987;15:567–90. 2. Torp-Pedersen ST, Terslev L. Settings and artefacts re... more ysis. J Clin Ultrasound 1987;15:567–90. 2. Torp-Pedersen ST, Terslev L. Settings and artefacts relevant in colour/power Doppler ultrasound in rheumatology. Ann Rheum Dis 2008;67:143–9. 3. Bude RO, Rubin JM, Adler RS. Power versus conventional color Doppler sonography: comparison in the depiction of normal intrarenal vasculature. Radiology 1994;192:777–80. 4. Rubin JM, Bude RO, Carson PL, Bree RL, Adler RS. Power Doppler US: a potentially useful alternative to mean frequencybased color Doppler US. Radiology 1994;190:853–6. 5. Jensen JA. Estimation of blood velocities using ultrasound: a signal processing approach. Cambridge University Press; 1996. URL: http://orbit.dtu.dk/en/publications/estimation-of-blood-velocitiesusing-ultrasound%28a0816561-f101-4aac-b724-d8973050df4e% 29.html.
was associated with a reduced risk for CVEs. Conclusion: The increased risk for CVEs in the first... more was associated with a reduced risk for CVEs. Conclusion: The increased risk for CVEs in the first 6 months after HF diagnosis and additional risk factors identified may help to better define the prothrombotic phenotype in HF.
Objective A prevailing hypothesis for neuropsychiatric involvement in systemic lupus erythematosu... more Objective A prevailing hypothesis for neuropsychiatric involvement in systemic lupus erythematosus (SLE) and primary Sjögren’s syndrome is that brain reactive autoantibodies enter the brain through a disrupted blood–brain barrier. Our aim was to investigate whether TNF-like weak inducer of apoptosis (TWEAK) plays a role in cerebral involvement in human SLE and primary Sjögren’s syndrome, and whether an impaired blood–brain barrier is a prerequisite for neuropsychiatric manifestations. Methods TWEAK was measured in the cerebrospinal fluid and serum and compared with markers of blood–brain barrier permeability (Q-albumin and MRI contrast-enhanced lesions) and S100B, an astrocyte activation marker in 50 SLE and 52 primary Sjögren’s syndrome patients. Furthermore, we estimated the general intrathecal B-cell activation (IgG index), measured anti-NR2 antibodies in cerebrospinal fluid, and explored whether these variables were associated with neuropsychiatric manifestations. Results No ass...
OP0215-Table 1. Number (N), proportion of females (%), and mean ages at baseline of incident pati... more OP0215-Table 1. Number (N), proportion of females (%), and mean ages at baseline of incident patients with inflammatory arthritides between 2010 and 2014 in Finland. RA+ n=6186 RA-n=2970 UA n=2959 SpA n=3577 PsA n=2670 Age, mean (SD) 58 (15) 57 (17) 49 (17) 38 (12) 49 (13) Proportion of females (%) 66.4 67.2 67.4 52.3 48.8 Abstract OP0215-Figure 1. Proportion of opioid purchasers among patients with incident A) seropositive rheumatoid arthritis (RA+), B) seronegative rheumatoid arthritis (RA-), C) unspecified arthritis (UA), D) spondyloarthritis [(SpA), including ankylosing spondylitis and non-radiographic axial spondyloarthritis], and E) psoriatic arthritis (PsA) and their controls one year before and after the index date. F) Odds ratio for long-term opioid use among incident RA+, RA-, UA, SpA, and PsA patients versus controls after the index date. Conclusions: IA patients are more likely to buy opioids one year before and one year after the diagnosis and presciption of antirheumatic medication than controls from the general population. The opioid purchases peak just before the index date in most IA patients. Long-term opioid use is also more common among patients with newly-onset IA, especially among those with SpA.
Journal of Neurology, Neurosurgery & Psychiatry, 2008
Fatigue is a disabling phenomenon in many patients who have systemic lupus erythematosus (SLE). T... more Fatigue is a disabling phenomenon in many patients who have systemic lupus erythematosus (SLE). The pathophysiological processes are unknown, and no known biological disease factors influence the phenomenon. Because depressive mood is consistently associated with fatigue, and drug treatment for SLE does not ameliorate fatigue, a psychological explanation could be an alternative. In search of a somatic basis for fatigue, we looked for alternative markers of biologic activity associated with fatigue. Cerebral white matter hyperintensities (WMHs) represent biochemical changes of brain tissue and are frequently encountered in patients with SLE, and are associated with cognitive impairment in patients with multiple sclerosis. Presence of such an association between fatigue and WMHs in SLE would favour a biological axis to fatigue. A cross-sectional, case-control study with 62 unselected patients with SLE and 62 age- and gender-matched healthy subjects. Fatigue was evaluated using the Fatigue Severity Scale (FSS) and a fatigue visual analogue scale (VAS). WMHs were rated using Scheltens&#39; method. Greater fatigue and more WMHs appeared in patients with SLE versus healthy subjects. In the full group of patients (n = 62), fatigue VAS was associated with total WMH score (p = 0.009). In subgroup analysis of patients without clinical depression (n = 40), the association with total WMH remained (p = 0.035), whereas this was not the case in the depressed group (n = 18) (p = 0.211). Increased cerebral WMH load is associated with increased fatigue, indicating a biological origin for some portion of fatigue in patients with SLE.
Background Contrast enhancement is measured in the aorta at set intervals of time during the test... more Background Contrast enhancement is measured in the aorta at set intervals of time during the test-bolus series of a coronary computed tomography angiography [CCTA]. Its primary purpose is to ascertain the timing delay of the main scan after contrast administration to ensure optimal image acquisition. The change in contrast enhancement over time correlates directly with contrast medium concentration in the vessel. If the complete time density curve [TDC] is known and corrected for contrast enhancement due to recirculation it can be used to estimate the cardiac output [CO], by e.g. a modified Stewart-Hamilton equation, as shown by Mahnken et al. Purpose The current study aims to explore ways to improve the mathematical estimation of CO. In practical applications only part of the TDC is known. By integrating patient factors, contrast factors and scanning factors with a mathematical compartment model, the CO can be estimated. Estimated CO is subsequently used to simulate the distributio...
Acta Obstetricia et Gynecologica Scandinavica, 2009
A scar pregnancy is an ectopic pregnancy implanted in a previous lower segment cesarean scar, and... more A scar pregnancy is an ectopic pregnancy implanted in a previous lower segment cesarean scar, and the incidence of this complication may be expected to rise along with increasing cesarean section rates. Arteriovenous malformation of the uterus may be congenital, associated with early pregnancy loss, trophoblastic disease, or surgical procedures. We describe a case of uterine arteriovenous malformation as a consequence of a scar pregnancy, complicated by recurrent, serious bleeding. The condition was diagnosed using three‐dimensional ultrasound with color Doppler and magnetic resonance imaging and appears not to have been described before. Selective embolization was performed, but eventually surgical intervention with resection of the affected uterine segment was necessary, and the patient recovered. The diagnosis was confirmed by pathologic‐anatomical diagnosis showing trophoblastic cells in the resected area. Because of collateral formation, non‐surgical options may be limited and not successful.
section (CS) rate worldwide. No general treatment guidelines have been established to date. The p... more section (CS) rate worldwide. No general treatment guidelines have been established to date. The purpose of this study was to describe our experience with the diagnosis and treatment of a Cesarean scar pregnancy and to formulate our optimal treatment policy for Cesarean scar pregnancies. Methods: Four women were diagnosed with a Cesarean scar pregnancy in our hospital between 1996 and 2007. Three women were treated with ultrasound guided transcervical aspiration of the gestational sac, followed by intra-amniotic injection of methotrexate. One woman was treated with systemic injection of methotrexate. Results: All women had a steady decline of the serum β-hCG level. Because of persistence of pregnancy tissue, two women underwent laparotomy with good results. The uterus was preserved in all women and 3 of them had an uneventful subsequent pregnancy and delivery. Conclusions: We suggest that transcervical needle aspiration of amniotic fluid followed by intra-amniotic injection of methotrexate should be the treatment of preference, only followed by surgical treatment if methotrexate fails.
ysis. J Clin Ultrasound 1987;15:567–90. 2. Torp-Pedersen ST, Terslev L. Settings and artefacts re... more ysis. J Clin Ultrasound 1987;15:567–90. 2. Torp-Pedersen ST, Terslev L. Settings and artefacts relevant in colour/power Doppler ultrasound in rheumatology. Ann Rheum Dis 2008;67:143–9. 3. Bude RO, Rubin JM, Adler RS. Power versus conventional color Doppler sonography: comparison in the depiction of normal intrarenal vasculature. Radiology 1994;192:777–80. 4. Rubin JM, Bude RO, Carson PL, Bree RL, Adler RS. Power Doppler US: a potentially useful alternative to mean frequencybased color Doppler US. Radiology 1994;190:853–6. 5. Jensen JA. Estimation of blood velocities using ultrasound: a signal processing approach. Cambridge University Press; 1996. URL: http://orbit.dtu.dk/en/publications/estimation-of-blood-velocitiesusing-ultrasound%28a0816561-f101-4aac-b724-d8973050df4e% 29.html.
Background To test the hypothesis that neurofilament light (NfL) in CSF is a biomarker of CNS inv... more Background To test the hypothesis that neurofilament light (NfL) in CSF is a biomarker of CNS involvement in patients with systemic lupus erythematosus (SLE) and primary Sjögren’s syndrome (pSS), we measured NfL in CSF from 52 patients with lupus and 54 with pSS and explored associations with clinical, structural, immunological and biochemical abnormalities. Methods In CSF, we measured NfL, anti-P antibodies, protein S100B and TWEAK by ELISA and anti-NR2 antibodies by electrochemiluminescence. Anti-phospholipid antibodies and routine immunological tests were performed in blood. IgG and albumin were measured in CSF and serum for assessment of the blood–brain barrier function (Q-albumin) and intrathecal IgG production (IgG index). Cerebral MRI and neuropsychological testing were performed. Results A multivariable regression model showed that increasing CSF anti-NR2 antibody levels were associated with increasing NfL levels in patients with SLE (B 1.27, 95% CI 0.88–1.65, p
Uploads
Papers by Ole Greve