Neuronal spreading and plaque induction of intracellular Aβ and its disruption of Aβ homeostasis.

The amyloid-beta peptide (Aβ) is thought to have prion-like properties promoting its spread throughout the brain in Alzheimer's disease (AD). However, the cellular mechanism(s) of this spread remains unclear. Here, we show an important role of intracellular Aβ in its prion-like spread.

Pre-plaque conformational changes in Alzheimer's disease-linked Aβ and APP.

Reducing levels of the aggregation-prone Aβ peptide that accumulates in the brain with Alzheimer's disease (AD) has been a major target of experimental therapies. An alternative approach may be to stabilize the physiological conformation of Aβ. To date, the physiological state of Aβ in brain remains unclear, since the available methods used to process brain tissue for determination of Aβ aggregate conformation can in themselves alter the structure and/or composition of the aggregates.

Brain natriuretic peptide is related to diastolic dysfunction whereas urinary albumin excretion rate is related to left ventricular mass in asymptomatic type 2 diabetes patients.

Background: The aims of this study were to estimate the prevalence of left ventricular systolic (LVSD) and diastolic (LVDD) dysfunction, and to test if BNP and urinary albumin excretion rate (AER) are related to LVSD, LVD and left ventricular mass (LVM) in asymptomatic type 2 diabetes patients.

Methods: Presence of LVSD, LVDD and LVM, determined with echocardiography, was related to levels of BNP and AER in 153 consecutive asymptomatic patients with type 2 diabetes.

Results: LVSD was present in 6.

Treatment of sleep apnea in congestive heart failure with a dental device: the effect on brain natriuretic peptide and quality of life.

The aim of the present study was to investigate the effect of a mandibular advancement device (MAD) for the treatment of sleep apnea (SA) on plasma brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), and health-related qualify of life (HRQL) in patients with mild to moderate stable congestive heart failure (CHF). Seventeen male patients aged 68.4+/-5.

Fifteen-year risk of major coronary events predicted by Holter ST-monitoring in asymptomatic middle-aged men.

Background: Ambulatory electrocardiogram monitoring (Holter) with ST-analysis as a measure of myocardial ischemia has in populations with coronary heart disease been shown to predict major coronary events: death, myocardial infarction or coronary revascularization. There has, however, been conflicting evidence regarding the usefulness of this technique in identification of healthy subjects with increased risk for coronary heart disease. The aim of this study was to assess if Holter monitoring with ST-analysis could be used to predict future major coronary events in asymptomatic middle-aged men with a defined aggregation of traditional risk factors for coronary heart disease.

A mandibular advancement device reduces sleep disordered breathing in patients with congestive heart failure.

Sleep disordered breathing (SDB) including obstructive and central sleep apnoea/hypopnoea as well as periodic breathing (PB) is common and is believed to increase risk for mortality in patients with congestive heart failure (CHF). Mandibular advancement device (MAD) has widely been recommended for treatment of obstructive sleep apnoea but the method has never been investigated for treatment of SDB in the patients with CHF. The aim with the present study was to examine the effect of MAD intervention on SDB in patients with CHF.

Elevated plasma levels of Nt-proBNP in patients with type 2 diabetes without overt cardiovascular disease.

Objective: The NH(2)-terminal portion of the precursor of brain natriuretic peptide (Nt-proBNP) has been reported to be elevated in left ventricular dysfunction. This peptide is a split product from the proBNP molecule, and its level in the circulation is not, as the mature BNP peptide, dependent on the peripheral number of BNP receptors. We aimed to test the hypothesis that asymptomatic left ventricular dysfunction (ALVD), as estimated by Nt-proBNP, would be more prevalent in patients with type 2 diabetes without overt cardiovascular disease in comparison with matched control subjects.

Use of a mandibular advancement device in patients with congestive heart failure and sleep apnoea.

Objective: To evaluate the practical use of the mandibular advancement device (MAD) for treatment of sleep apnoea (SA) in patients with congestive heart failure (CHF) over 1 year.

Subjects: Twenty-five patients aged 66 +/- 8 years (mean +/- SD) met the inclusion criteria and were included in the study.

Design: In a prospective, clinical trial, the apnoea-hypopnoea index (AHI), a measure of SA, was determined with a portable device.

The Swedish National Programme for Quality Control of Secondary Prevention of Coronary Artery Disease--results after one year.

Background: Guidelines for the prevention of coronary artery disease (CAD) have been developed both in Europe and in the USA. However, several surveys have shown that these guidelines are poorly implemented in clinical practice.

Design/methods: The Swedish Quality Control Programme on Secondary Prevention of CAD includes patients after myocardial infarction, or having undergone coronary artery surgery or percutaneous coronary intervention.

The effect of mandibular advancement device on pharyngeal airway dimension in patients with congestive heart failure treated for sleep apnoea.

Continues positive airway pressure (CPAP) is recommended for treatment of sleep apnoea (SA) in patients with congestive heart failure (CHF) but is not easily tolerated resulting in poor patient compliance. Mandibular advancement device (MAD) is designed to inhibit pharyngeal airway (PAW) obstruction and may be a valuable alternative. It has been proposed that MAD exerts its effect by increasing PAW dimensions.

Gender differences in secondary prevention of coronary heart disease: reasons to worry or not?

Objective: To analyse potential gender differences in cardiovascular risk factors and treatment patterns, reflecting clinical practice in secondary prevention.

Design: Observational national study during 3 years of patients eligible for secondary prevention of coronary heart disease (CHD).

Setting: Fifty-two healthcare districts in Sweden, involving primary health care and hospitals in collaboration, participating in a national quality assurance programme for the prevention of CHD.

Application of quantitative competitive polymerase chain reaction for measurements of mRNA from antioxidative enzymes in the diabetic rat retina and kidney.

This present study applied quantitative competitive polymerase chain reaction (QC-PCR) in the analyses of mRNA expression of the endogenous antioxidative enzymes CuZn superoxide dismutase (SOD), MnSOD, catalase, and glutathione peroxidase in tissue samples from the retina and kidney cortex of diabetic rats. RNA was extracted from snap-frozen retinas and pieces of the kidney cortex of male Wistar rats with streptozotocin (STZ)-induced diabetes and control rats. The mRNA levels were analyzed using QC-PCR.

[Quality assurance of secondary prevention of coronary artery disease. Ongoing project offers possibilities for improved treatment].

Regional programs for secondary prevention of coronary artery disease have been under development for nearly a decade in Sweden. To achieve maximum adherence these programs were created in close collaboration between hospital and primary care physicians. The programs are local applications of national guidelines and aim to support compliance among both patients and physicians.

Comparison of calculated, measured and self-assessed intelligibility of speech in noise for hearing-aid users.

The Speech Intelligibility Index (SII) was used along with paired-comparison judgements and speech recognition scores to compare the speech intelligibility provided by two hearing-aid frequency responses in two different background noises. The purpose was to validate an SII-based procedure. Test subjects were 26 hearing-aid users representing a wide range of hearing loss configurations.

Long-term effects on cholesterol levels and the utilization of lipid-lowering drugs of a hospital-based programme for secondary prevention of coronary artery disease.

Background: The study was designed to determine whether a 1-year hospital-based secondary prevention programme would have any long-term effects on serum lipid levels and the use of lipid-lowering drugs in patients with coronary artery disease 4 years after referral to primary care facilities for follow-up.

Design/methods: After acute myocardial infarction or coronary bypass surgery, 241 consecutive patients were randomly assigned to conventional care (CC) by the primary health care facilities or to a 1-year hospital-based secondary prevention programme (SPP) with target levels for serum cholesterol (< 5.2 mmol/l) and triglycerides (< 1.

Health care costs of heart failure: results from a randomised study of patient education.

Background: Heart failure is a serious syndrome with a bad prognosis. Hospitalisation is common and readmittance rate is high; factors which influence the cost of care and treatment. Only scarce data on detailed patient materials regarding health care costs are known.

Non-compliance and knowledge of prescribed medication in elderly patients with heart failure.

Aims: To determine the extent of non-compliance to prescribed medication in elderly patients with heart failure and to determine to what extent patients recall information given regarding their medication.

Methods And Results: Non-compliance and knowledge of prescribed medication was studied in 22 elderly heart failure patients [mean age 79 +/- 6 (range 70-97); 14 (64%) male], using in-depth interviews performed 30 days after having been prescribed medication. All patients received standardised verbal and written information regarding their medication.

Effects of systematic education on heart failure patients' knowledge after 6 months. A randomised, controlled trial.

Background: Many procedures for patient education are introduced in clinical practice without proper evaluation in randomised trials.

Aims: To compare systematic nurse and pharmacist led education including an interactive Kodak Photo-CD Portfolio technique with conventional information regarding heart failure patients' knowledge.

Methods: One hundred and thirty heart failure patients discharged from hospital were randomised to receive either conventional information or additional structured education with a follow-up of 6 months.

Health-related quality of life in elderly patients with heart failure.

Objective: To assess health-related quality of life (HRQL) in elderly patients with congestive heart failure (CHF) and correlate these to clinical and demographic variables.

Patients And Methods: HRQL was evaluated in 191 patients with CHF, aged 65-84 years, using a self-administered questionnaire including the Nottingham Health Profile (NHP), Quality of Life Questionnaire in Heart Failure and Patients' Global Self-Assessment.

Results: HRQL was more impaired in women than to men (p < 0.

Alcohol consumption and disability pension among middle-aged men.

Purpose: To analyze the relation between alcohol consumption and the risk of disability pension among middle-aged men.

Methods: In the mid-seventies, complete birth-year cohorts of middle-aged male residents in Malmö, Sweden, were invited to participate in a general health survey. The 3751 men with complete data who constituted the cohort in this study were followed for 11 years.

Left atrioventricular plane displacement is related to both systolic and diastolic left ventricular performance in patients with chronic heart failure.

Aims: Left atrioventricular plane displacement is proposed to reflect left ventricular systolic function and is strongly related to prognosis in patients with heart failure. Left atrioventricular plane displacement is a different measure of left ventricular function compared to ejection fraction, and the factors influencing left atrioventricular plane displacement are insufficiently characterized. We wanted to assess any relationship between left atrioventricular plane displacement and left ventricular diastolic performance.