Publications by authors named "Lars Dahlin"

Background: Postural instability is considered a late complication of Parkinson's disease (PD). However, growing evidence shows that balance and gait problems may occur early in the disease.

Objective: To describe balance, gait, and falls/near falls in persons with newly diagnosed, untreated PD ("de novo"), and to compare this with persons with mild-moderate PD (Later PD).

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Normative values are lacking regarding intraepidermal nerve fiber density (IENFD) in thin sections of 5 µm. Thus, we aimed to assess IENFD in thin sections in a healthy adult population as well as to investigate whether IENFD is related to age, sex, and site of excision. Archival skin biopsies or excisions at the Department of Pathology, Lund, Sweden, from arm and leg were collected, re-sectioned, and immunohistochemically stained for Protein Gene Product 9.

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  • Knowledge about long-term effects of Complex Regional Pain Syndrome (CRPS) on physical symptoms, disabilities, and psychological health is limited, prompting a study to evaluate these aspects.
  • A cross-sectional survey was conducted with individuals diagnosed with CRPS, using validated questionnaires to assess their physical and psychological conditions, revealing that most respondents experience ongoing pain and significant limitations in daily activities.
  • The findings indicate that many individuals with CRPS face long-term challenges such as anxiety, depression, and sleep issues, with those having low resilience (Sense of Coherence) and high pain catastrophizing showing worse outcomes.
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  • In a study of 962 CTS patients, 23 reported vibration exposure; their outcomes were compared with 23 matched controls.
  • Results showed no significant difference in symptom relief post-surgery between vibration-exposed individuals and non-exposed individuals, indicating similar recovery expectations.
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  • The study investigated the relationship between serum biomarker levels and hand-arm vibration injury in 92 patients, focusing on the severity of Raynaud's phenomenon (RP) and neurosensory issues.
  • It utilized statistical methods, including Jonckheere's trend test and generalized linear models, to analyze associations with biomarker levels, exposure magnitude, and duration.
  • Key findings indicated that certain biomarkers, such as thrombomodulin and CGRP, were positively associated with the severity of RP and neurosensory symptoms, while no correlations with exposure levels were found for some biomarkers.
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Introduction: Proteomic analysis of injured human peripheral nerves, particularly focusing on events occurring in the proximal and distal nerve ends, remains relatively underexplored. This study aimed to investigate the molecular patterns underlying a digital nerve injury, focusing on differences in protein expression between the proximal and distal nerve ends.

Methods: A total of 26 human injured digital nerve samples (24 men; 2 women; median age 47 [30-66] years), harvested during primary nerve repair within 48 h post-injury from proximal and distal nerve ends, were analyzed using mass spectrometry.

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Diabetes mellitus (DM) is a risk factor for the development of ulnar nerve entrapment (UNE). Differences in surgical outcomes for UNE between patients with and without DM have been reported, but studies on presurgical management are scarce. This study aimed to evaluate the presurgical management of UNE in patients with (DM diagnosis < 2 years of UNE diagnosis) and without DM regarding the level of care for diagnosis and the proportion that proceeds to surgery.

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  • Adjunctive pharmacological treatment, specifically the peptide PXL01, was studied for its potential effects on nerve regeneration after sciatic nerve repair in rats.
  • The treatments included PXL01, sodium hyaluronate, or sodium chloride, and were administered near the repair site for comparison.
  • Results showed that PXL01 decreased inflammation-related macrophage activity but did not significantly affect other factors related to nerve regeneration, such as axonal outgrowth and sensory response.
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A correct diagnosis and treatment of fingertip- and nail injuries, commonly seen in the emergency room, is crucial. Insufficient treatment can result in long-term complications, including finger dysfunction and dysaesthesia, nail deformity, infection, or pain. These remaining problems may induce severe impairment of the quality of life of the patient.

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  • - The study investigates the experiences of patients who live with chronic pain after surgery for ulnar nerve entrapment at the elbow, highlighting their challenges and coping strategies.
  • - Through in-depth interviews with 10 participants, the research identifies key themes like physical symptoms, emotional impacts, daily life consequences, self-image struggles, and coping resources.
  • - The findings emphasize the necessity for healthcare providers to adopt a holistic approach that addresses both physical and emotional aspects of patient care, particularly focusing on emotional well-being and sleep issues.
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  • - The study analyzed the prevalence of hand and forearm disorders from vibration exposure by gender in a large population, focusing on conditions like carpal tunnel syndrome and trigger finger linked to using vibrating tools.
  • - Researchers involved 14,342 participants from the Malmö Diet and Cancer Study cohort, where they correlated self-reported vibration exposure with medical treatments documented in national registers across many years.
  • - Results indicated that high exposure to vibrating tools was associated with increased risks of certain disorders in men, like carpal tunnel syndrome and ulnar nerve entrapment, while women had a higher risk of trigger finger; no effects were found for Dupuytren's disease or certain osteoarthritis cases.
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  • Type 2 diabetes (T2D) is linked to increased risks for carpal tunnel syndrome (CTS) and trigger finger (TF), raising concerns about potential pre-existing T2D during these conditions.
  • A study conducted in Sweden analyzed data from nearly 4 million individuals aged 40-85 without previous T2D to explore the association between CTS/TF and T2D risk over four years.
  • Results showed that individuals diagnosed with CTS had a 35% increased risk of developing T2D, while those with TF had a 21% higher risk, suggesting possible undiagnosed T2D in patients with CTS and TF.
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Optimal recovery of muscle function after proximal nerve injuries remains a complex and challenging problem. After a nerve injury, alterations in the affected muscles lead to atrophy, and later degeneration and replacement by fat-fibrous tissues. At present, several different strategies for the preservation of skeletal muscle have been reported, including various sets of physical exercises, muscle massage, physical methods (e.

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Carpal tunnel syndrome (CTS) is the most common nerve entrapment disorder worldwide. The epidemiology and risk factors, including family burden, for developing CTS are multi-factorial. Despite much research, its intricate pathophysiological mechanism(s) are not fully understood.

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  • A study analyzed data from over 35,000 individuals diagnosed with carpal tunnel syndrome (CTS) to see if those with diabetes received surgical treatment at similar rates as those without diabetes.* -
  • Results showed that individuals with diabetes were more likely to undergo surgery for CTS (59%) compared to those without diabetes (49%), with type 1 diabetes patients having an even higher surgical rate (65%).* -
  • The research indicated that diabetes is a significant risk factor for the likelihood of surgical treatment for CTS, with diabetes duration impacting type 2 patients but not correlating with high HbA1c levels.*
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Peripheral nerve injuries in the upper limb can lead to substantial disability and pain. We aimed to assess how socioeconomic factors affect outcomes after repaired or reconstructed digital or major nerve trunk injuries in the upper limb. We identified 670 individuals, who underwent surgical nerve repair or reconstruction using sensory nerve autografts, in the Swedish National Quality Registry for Hand Surgery 2010-2018.

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  • Idiopathic cubital tunnel syndrome is the second most common nerve issue in the arm, primarily affecting the ulnar nerve.
  • The best surgical approach has shifted from anterior or submuscular transposition to simpler in situ release, although there are differing views on the timing and type of surgery needed.
  • Four experienced surgeons were consulted to provide insights and address specific questions related to managing this condition.
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  • - Peripheral nerves are complex structures that require protection and nourishment, making them vulnerable to trauma; ulnar nerve entrapment is a common condition, especially at the elbow, impacting older adults more than adolescents.
  • - Risk factors for this condition include obesity, smoking, diabetes, and exposure to vibrations, with symptoms usually starting as tingling and numbness in the fingers, eventually leading to sensory loss and muscle weakness.
  • - Treatment options range from conservative management for mild to moderate cases to surgery for more severe instances, with the decision to operate being challenging due to unpredictable outcomes and potential complications; simple decompression surgery is generally considered to be safer than transposition.
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  • * A study analyzed serum levels of 17 biomarkers in 92 patients with this injury and found significant differences compared to 51 controls, indicating elevated levels of markers linked to blood vessel damage, inflammation, and nerve protection.
  • * The findings of this research enhance understanding of the disease's mechanisms, potentially aiding the development of more objective diagnostic methods.
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  • The study aimed to evaluate the effectiveness of multi-frequency vibrometry (MFV) in detecting diabetic peripheral neuropathy (DPN) in type 1 diabetes, comparing it to traditional methods like nerve conduction studies (NCS) and neurothesiometer (NT).
  • Researchers examined adults with type 1 diabetes at a Swedish hospital from 2018 to 2020, assessing their nerve function through MFV, NT, and NCS.
  • Results indicated that half of the participants had DPN; strong correlations were found between vibrometry pressure thresholds (VPTs) and NCS parameters, suggesting that fewer frequencies in MFV could still effectively distinguish DPN, simplifying the testing process.
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Background: Individuals with wrist osteoarthritis (OA) can suffer from pain, muscular weakness, and impaired motion of the wrist, which can reduce the quality of life. While there is strong evidence that all patients with OA should receive first-line treatment with education and exercises, this approach has not yet been proposed for individuals with wrist OA. Therefore, this trial aimed to evaluate the effectiveness of a first line neuromuscular joint-protective exercise therapy program compared to a training program with range of motion (ROM) exercises in patients with wrist OA.

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  • - The study aimed to explore how socioeconomic status affects patient-reported outcomes after surgery for trigger finger, using data collected from a national hand surgery registry in Sweden.
  • - The analysis revealed that being born in Sweden and having higher income levels were associated with fewer symptoms and less disability post-surgery, while more sick leave correlated with worse outcomes at all assessed time points.
  • - However, no socioeconomic factors were found to significantly influence the change in patient-reported outcome scores over the year following surgery.
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Introduction: Impaired functioning is seen in patients following replantation surgery to the thumb or fingers. Our aim was to explore long-term consequences and adaptation in daily life after a thumb and/or multiple finger amputation followed by replantation surgery during young age.

Methods: Semi-structured interviews were conducted with nine recruited individuals and analysed using content analysis.

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  • *Studying animal models helps identify key factors for nerve regeneration, such as the roles of Schwann cells, macrophages, and the extracellular matrix in recovery processes.
  • *Advanced technologies and bioinformatics are crucial for analyzing the complex interactions of different cell types at a molecular level, revealing how these interactions differ in peripheral nerves under healthy versus diseased conditions.
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Background: Post-traumatic wrist osteoarthritis (OA) can eventually lead to pain, muscular weakness, and stiffness of the wrist, which can affect the function of the entire upper limb and reduce the quality of life. Although there is strong evidence that all patients with OA should be offered adequate education and exercises as a first-line treatment, an effective self-management program, including structured education and therapeutic exercises, has not yet been introduced for individuals with wrist OA. This trial aims to evaluate the effectiveness of an exercise therapy program with joint protective strategies to improve neuromuscular control (intervention group) compared to a training program with range of motion exercises (control group).

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