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Articles by H Bergman
Total Records ( 3 ) for H Bergman
  H Syddall , H. C Roberts , C Cooper , H Bergman and A. A. Sayer
 

Background: frailty, a multi-dimensional geriatric syndrome, confers a high risk for falls, disability, hospitalisation and mortality. The prevalence and correlates of frailty in the UK are unknown.

Methods: frailty, defined by Fried, was examined among community-dwelling young-old (64–74 years) men (n = 320) and women (n = 318) who participated in the Hertfordshire Cohort Study, UK.

Results: the prevalence of frailty was 8.5% among women and 4.1% among men (P = 0.02). Among men, older age (P = 0.009), younger age of leaving education (P = 0.05), not owning/mortgaging one's home (odds ratio [OR] for frailty 3.45 [95% confidence interval {CI} 1.01–11.81], P = 0.05, in comparison with owner/mortgage occupiers) and reduced car availability (OR for frailty 3.57 per unit decrease in number of cars available [95% CI 1.32, 10.0], P = 0.01) were associated with increased odds of frailty. Among women, not owning/mortgaging one's home (P = 0.02) was associated with frailty. With the exception of car availability among men (P = 0.03), all associations were non-significant (P > 0.05) after adjustment for co-morbidity.

Conclusions: frailty is not uncommon even among community-dwelling young-old men and women in the UK. There are social inequalities in frailty which appear to be mediated by co-morbidity.

  A. J Watson , H Bergman , C. M Williams and J. C. Kvedar
 

Objective  To evaluate whether delivering acne follow-up care via an asynchronous, remote online visit (e-visit) platform produces equivalent clinical outcomes to office care.

Design  A prospective, randomized controlled study.

Setting  Two teaching hospitals in Boston between September 2005 and May 2007.

Participants  A total of 151 patients with mild to moderate facial acne.

Interventions  Subjects were asked to carry out 4 follow-up visits using either an e-visit platform or conventional office care. At 6-week intervals, subjects in the e-visit group were prompted to send images of their skin and an update, via a secure Web site, to their dermatologist. Dermatologists responded with advice and electronic prescriptions.

Main Outcome Measures  The primary outcome measure was change in total inflammatory lesion count between the first and last visit. The major secondary outcomes were subject and dermatologist satisfaction with care and length of time to complete visits.

Results  The mean age of subjects was 28 years; most were female (78%), white (65%), and college educated (69%). One hundred twenty-one of the initial 151 subjects completed the study. The decrease in total inflammatory lesion count was similar in the e-visit and office visit groups (6.67 and 9.39, respectively) (P = .49). Both subjects and dermatologists reported comparable satisfaction with care regardless of visit type (P = .06 and P = .16, respectively). Compared with office visits, e-visits were time saving for subjects and time neutral for dermatologists (4 minutes, 8 seconds vs 4 minutes, 42 seconds) (P = .57).

Conclusion  Delivering follow-up care to acne patients via an e-visit platform produced clinical outcomes equivalent to those of conventional office visits.

Trial Registration  clinicaltrials.gov Identifier: NCT00417456

  A Zaidel , A Spivak , B Grieb , H Bergman and Z. Israel
 

The significance of oscillations that characterize the subthalamic nucleus in Parkinson’s disease is still under debate. Here, we analysed the spectral and spatial characteristics of 314 microelectrode trajectories from 128 patients undergoing subthalamic nucleus deep brain stimulation surgery for Parkinson’s disease. We correlated the subthalamic nucleus pathophysiology with the outcome of surgery, as evaluated by the third section of the Unified Parkinson’s Disease Rating Scale (motor score), which was subdivided into tremor, rigidity, limb-bradykinesia and axial-bradykinesia subscores. β-oscillatory activity (13–30 Hz) comprised a continuous stretch within the subthalamic nucleus, and was limited to a distinctly-bounded dorsolateral oscillatory region. Although less consistent and more sporadic, low-frequency (3–7 Hz) power was also increased in the dorsolateral oscillatory region. In contrast, the more ventral subthalamic nucleus was characterized by consistently reduced β and increased gamma (30–100 Hz) activity. Neuronal responses to passive arm movement (analysed by their alignment to goniometer tracing of the joints’ angular displacement) were significantly more common in the dorsolateral oscillatory region than the ventral subthalamic nucleus region (62 versus 25% of sites tested respectively, P < 0.01). The length of the dorsolateral oscillatory region recorded in the macroelectrode-implanted trajectory predicted a favourable response to subthalamic nucleus deep brain stimulation (R = 0.67, P < 0.0001). This correlation was also evident for improvement in the specific symptom subscores of rigidity, limb-bradykinesia and axial-bradykinesia (P < 0.05). Similarly, increased subthalamic nucleus β power was associated with postoperative improvement. In contrast, the preoperative response to levodopa did not correlate with dorsolateral oscillatory region length (P = 0.33), however, it did tend to be associated with increased β (and decreased low frequency) subthalamic nucleus power. Finally, the active macroelectrode contact, independently selected by optimal clinical outcome, coincided with the dorsolateral oscillatory region centre. On average, the location of the active contact was not significantly different from the dorsolateral oscillatory region centre (P = 0.10), but was significantly different from the subthalamic nucleus centre (P < 0.0001). We conclude that the spatial extent of the dorsolateral oscillatory region, which overlaps the motor territories of the subthalamic nucleus, predicts the outcome of subthalamic nucleus deep brain stimulation. Thus the frequency and spatial characteristics of the subthalamic nucleus trajectory may be used for deep brain stimulation outcome optimization.

 
 
 
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