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  • 1.
    Bergemalm, Per-Olof
    Örebro University, Department of Nursing and Caring Sciences.
    Progress of sensorineural hearing loss after closed head injury: presence of autoantibodies2004In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 2, no 2, p. 92-99Article in journal (Refereed)
    Abstract [en]

    Sensorineural hearing impairment is a common sequel to closed head injury (CHI). In most cases, the impairment subsides within the first post‐traumatic year; in some cases the impairment is permanent and in other cases there will be progress. In most cases the reason for progress is unknown. Substantial research has been carried out to ascertain the aetiology of sudden sensorineural hearing loss (SNHL) and Menière's disease. A number of studies have demonstrated the presence of antibodies against HSP 70 antigen in patients' sera. In accordance with this finding, autoimmunity as an aetiological factor for progressive SNHL has been proposed. There are reports indicating that trauma is a possible mechanism for eliciting an autoimmune response, and the aim of the present study is to study this mechanism. The question of sympathetic cochleolabyrinthitis is highlighted. Sera from 35 subjects with a history of closed head injury three to 13 years prior to the investigation were obtained for Western blot immunoassay in an attempt to identify HSP 70 antibodies. Twenty‐seven of the subjects demonstrated progress of a sensorineural hearing impairment after CHI. Two of 35, both with progress of a SNHL, demonstrated presence of anti‐HSP 70 antibodies. Therefore, a significant role of an HSP 70 related autoimmune mechanism for SNHL progress post CHI could not be confirmed in the present study. Nevertheless, the possible role of autoantibodies in individual cases cannot be ruled out, neither can the presence of other transitory autoimmune reactions after CHI. No conclusive evidence of sympathetic cochleolabyrinthitis was found.

  • 2. Bjerlemo, Berit
    et al.
    Kollén, Lena
    Örebro University, School of Health and Medical Sciences.
    Boderos, Inger
    Kreuter, Margareta
    Möller, Claes
    Örebro University, Department of Clinical Medicine.
    Recovery after early vestibular rehabilitation in patients with acute unilateral vestibular loss2006In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 4, no 3, p. 117-123Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to follow the recovery process, and explore the disease impact on sick leave in patients with acute unilateral vestibular loss (AUVL). Another aim was to investigate whether initial signs of nystagmus, caloric response, and subjective symptoms of vertigo could predict the return to work. Recovery was followed through the reduction in spontaneous and head-shaking nystagmus, evaluated by Video-Frenzel examination, and by caloric response/asymmetry and spontaneous nystagmus, evaluated by bithermal binaural caloric testing. Information regarding employment, sick leave and subjective symptoms of vertigo was collected using a questionnaire. Twenty-seven patients with AUVL participated in a physiotherapy training programme, starting within 48 h of disease onset. Four assessments were performed: at disease onset, in the acute stage, and after one and six months. In most patients a very rapid cessation of spontaneous nystagmus could be observed (14/27 at a median time of two days after disease onset, a further 10 patients after one month and the remaining three patients after six months). A more prolonged persistence of head shaking nystagmus was observed (24/27, 14/27 and 5/21 of the patients showed head-shaking nystagmus at the three assessments). Caloric asymmetry was normalized after six months in 11/27 patients. A positive and significant correlation was observed between long-lasting sick leave and caloric asymmetry, sense of unsteadiness when standing and walking and older age. Unsteadiness when standing and walking, as well as existence of spontaneous nystagmus, were also positively and significantly correlated with the degree of caloric asymmetry. Spontaneous or head-shaking nystagmus, caloric asymmetry and subjective vertigo at disease onset did not, however, predict sick leave after one or six months. Recovery was excellent in most of the patients.

  • 3.
    Carlsson, Per-Inge
    et al.
    Örebro University, Department of Nursing and Caring Sciences.
    Borg, Erik
    Grip, Lars
    Dahl, Niklas
    Bondeson, Marie-Louise
    Variabillity in noise susceptibility in a Swedish population: the role of 35delG mutation in the Connexin 26 (GJB2) gene2004In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 2, no 2, p. 123-130Article in journal (Refereed)
    Abstract [en]

    Although it seems that genetic factors can influence individual susceptibility to noise, still very little is known about the genes or the mechanisms involved. The connexin 26 (Cx26) (GJB2) gene is of particular interest to study in relation to noise, since the gene encodes the gap junction protein Cx26. Noise has a metabolic and mechanical effect on the inner ear and may, therefore, interfere with gap junction channels. In order to investigate whether abnormally high susceptibility to noise induced hearing loss (NIHL) in humans is associated with the common 35delG mutation in the Cx26 gene, 1200 noise‐exposed workers were investigated in Sweden. Using a selection procedure based on audiometric analysis, noise exposure data and questionnaires, noise‐exposed workers were divided into two categories: noise susceptible and noise resistant. There was a correspondence in noise susceptibility between this noise‐exposed population and the international reference ISO Standard 1999. Blood samples were drawn from 245 highly selected male subjects (103 noise susceptible, 112 noise resistant and 30 randomized cases), and genomic DNA was analysed with respect to the Cx26 35delG mutation. The incidence of 35delG carriers among this cohort was determined by multiplex, allele‐specific PCR. Two of the 245 subjects (0.8% ‐ [95% confidence interval 0.1–2.9]) were found to be heterozygous carriers of the 35delG mutation, while the remaining 243 subjects were all non‐carriers. Both the heterozygous carriers were found in the noise susceptible group. Statistical evaluation of the results demonstrated no significant difference in carrier incidence between the noise susceptible and noise resistant individuals in our Swedish noise‐exposed population. In conclusion, there was no support for a major role of Cx26 35delG mutation in explaining the variability in noise susceptibility in this Swedish population.

  • 4. Hederstierna, Christina
    et al.
    Möller, Claes
    Örebro University, Department of Clinical Medicine.
    Åhlman, Henrik
    Lundberg, Rebecca
    von Döbeln, Ulrika
    The prevalence of Connexin 26 mutations in the Swedish population2005In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 3, no 3, p. 154-158Article in journal (Refereed)
    Abstract [en]

    Mutations in GJB2, the gene encoding the protein Connexin 26, have been shown to account for as much as 50% of autosomal recessive, non-syndromic childhood hearing loss (ARNSHL). Early, correct diagnosis and intervention have greatly improved the possibilities for these children in learning and developing language skills. In recent years, many reports from varied parts of the world have described the local scene of mutations in Connexin 26. The prevalence differs with geographic location and assessment procedures. Mutations in Connexin 26 have until recently been identified in very few cases in Sweden, Norway and Denmark, and nationwide population samples have not been studied in the Scandinavian countries. In this study we present the results of a large nationwide and a regional study of the prevalence of the 35delG, L90P and 167delT mutations of the GJB2 gene in Sweden. A total of 2052 samples (dried blood spots) were analysed. 1501 samples were collected representing all of Sweden and 551 samples from northern Sweden. The allele frequencies in Sweden were found to be 35delG, 0.83%; L90P, 0.30%; and 167delT, 0%. The prevalence of mutations in Connexin 26 in Sweden seems to be comparable to that in other northern European countries.

  • 5. Kollén, Lena
    et al.
    Bjerlemo, B
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Long term outcome in acute unilateral vestibular loss2008In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 66, p. 265-270Article in journal (Refereed)
  • 6.
    Kollén, Lena
    et al.
    Örebro University, School of Health and Medical Sciences.
    Bjerlemo, Berit
    Fagervik Olsén, Monika
    Möller, Claes
    Örebro University, School of Health and Medical Sciences.
    Static and dynamic balance and well-being after acute unilateral vestibular loss2008In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 6, no 4, p. 265-270Article in journal (Refereed)
    Abstract [en]

    The aim of this trial was to evaluate long-term (after six months) effects of successful vestibular rehabilitation in patients with acute unilateral vestibular loss (AUVL) in relation to static and dynamic balance, hypertension, headache, disturbed sleep and physical exercise habits. A group of 42 patients were included. For comparison, an age and gender matched healthy reference group was used, consisting of 56 subjects. The assessments were static and dynamic balance performances with the Romberg test, a sharpened Romberg test (SREC), standing on one leg with eyes open/closed (SOLEO/SOLEC) and a 10-m walking test, with and without head movements. A questionnaire concerning the occurrence of hypertension, headache, disturbed sleep and physical exercise habits was also administered. The AUVL group walked significantly slower and took shorter steps (p<0.001) compared to the subjects in the reference group. Significantly impaired performances were also found in the AUVL group in SREC (p<0.01) and SOLEC (p<0.05) compared to the reference group. A significantly larger proportion of patients with AUVL (26%) used anti-hypertensive medication compared to the reference group (4%) (p<0.01). This study demonstrated that AUVL patients, after vestibular rehabilitation and compensation, still have long-term static and dynamic balance problems. We have also found that patients who have suffered from AUVL have a higher prevalence of hypertension compared to a reference group.

  • 7. Sadeghi, Mehdi
    et al.
    Kimberling, William
    Tranebjaerg, Lisbeth
    Möller, Claes
    Örebro University, School of Health and Medical Sciences.
    The prevalence of Usher syndrome in Sweden: a nationwide epidemiological and clinical survey2004In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 2, no 4, p. 220-228Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to estimate the prevalence of Usher syndrome types I, II and III in Sweden and to estimate possible regional differences in the prevalence of different Usher syndrome subtypes within the country. Probands were ascertained through multiple sources and almost complete ascertainment was achieved. A total of 370 subjects with a referring diagnosis of Usher was ascertained. Of those, 77 subjects proved to have an incorrect preliminary diagnosis. Of the remaining 293 individuals, 140 were found to have Usher syndrome type I, 122 subjects were diagnosed as type II, and 27 subjects had Usher syndrome type III. The corresponding prevalence in Sweden was estimated to be 1.6/100,000 for type I, 1.4/100.000 for type II and 0.3/100.000 for type III. The prevalence of Usher I was found to be significantly higher (8.6/100.000) in the two northernmost counties. This is consistent with an earlier report made in the 1950s. Similar geographic concentrations of Usher II and III were not observed. Usher syndrome types IB, ID and IIA were found to be the most common subtypes in Sweden. The age of diagnosis in all 3 types was late and the prevalence was higher at older ages. To our knowledge this is the largest genetic/epidemiological study on patients with Usher syndrome carried out to date. It provides critical information for genetic counselling and public health planning of this important disorder.

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