Karin Toska

• Ho, Ai Van Thuy; Øvensen, Eirik; Lilja, Didrik; Toska, Karin; Grenager, Odd & Kristiansen, Knut [Show all 7 contributors for this article] (2024). Changes in electrodermal activity following sympathicotomy in hyperhidrosis patients. Frontiers in Surgery. 11. doi: 10.3389/fsurg.2024.1358357. Full text in Research Archive Show summary

  Objectives: The aim of this study was to assess the potential of electrodermal activity (EDA) as a diagnostic tool for preoperative evaluation in hyperhidrosis patients. EDA levels and patterns in different skin areas were investigated before and after endoscopic thoracic sympathicotomy (ETS) and was compared to healthy subjects. Methods: Thirty-seven patients underwent two days of measurements before and after the operation. Twenty-five (67.5%) of the patients also had a third measurement after six months. Non-invasive EDA measurements, involving skin conductance, were sampled from five different skin areas while patients were at rest in supine and sitting positions or when subjected to stimuli such as deep inspirations, mental challenge, and exposure to a sudden loud sound. Results: Prior to the operation, hyperhidrosis patients showed higher spontaneous palm EDA variations at rest and stronger responses to stimuli compared to healthy subjects. Patients with facial blushing/hyperhidrosis or combined facial/palmar hyperhidrosis showed minimal spontaneous activity or responses, particularly during mental challenge and sound stimulus. Notably, palm EDA response was abolished shortly following sympathicotomy, although a minor response was observed after six months. Minimal EDA responses were also observed in the back and abdomen postoperatively. Conclusion: Hyperhidrosis patients showed stronger EDA response to stimuli compared to healthy subjects. Sympathicotomy resulted in the complete elimination of palm EDA responses, gradually returning to a limited extent after six months. These findings suggest that EDA recordings could be utilized in preoperative assessment of hyperhidrosis patients.

• Antonsen, Steen; Amundsen, Erik Koldberg; Ceder, Rebecca; Toska, Karin; Tollånes, Mette Christophersen & Hansen, Young Bae [Show all 7 contributors for this article] (2024). History, implementation and current use of the IFCC-IUPAC’s Nomenclature for Properties and Units (NPU) terminology in Denmark, Norway and Sweden. Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (eJIFCC). 35(3), p. 154–165. Full text in Research Archive Show summary

  Electronic exchange of health care data demands code/terminology systems. In the Scandinavian countries, the IFCC-IUPAC’s Nomenclature for Properties and Units (NPU) terminology is used for results in biochemistry, pharmacology, and immunology. Implementation, use and administration of NPU has differed between the countries despite similar health care and lab sectors. In Norway and in one Swedish region NPU – with supplementary SNOMED CT codes is also used for reporting results in microbiology. In Denmark and to some extent in Norway and Sweden NPU is also used for ordering tests. In Norway NPU (as part of NLK) has since 2018 been mandatory in requesting governmental reimbursement for laboratory tests. The numbers of national codes vary considerably (DAN: 303, NOR: 1612, SWE: 415). Furthermore, in Denmark >3500 local codes are used for requisition and to communicate more details with the analytical result than the NPU terminology allows. Also, in Norway the NPU codes are by many lab professionals considered insufficient for communicating all relevant information with results. However, the Norwegian reimbursement system has been a strong motivator for implementing international NPU codes. We find it necessary to add information about “how” a measurement is done to the information about “what” is measured in the laboratory report. Until this is settled otherwise, we suggest an increased pragmatism towards producing national codes including method specific information. Furthermore, we recommend that organisations responsible for classifications have heavy professional participation and decision-making competencies in order to lead and guide implementation and optimal use of the classifications.

• Hansen, Young Bae Lee; Toska, Karin; Lund, Alice; Flatman, Robert & Ceder, Rebecca (2023). Properties and units in the clinical laboratory sciences. Part XXVII: online dynamic NPU manual (IUPAC Technical Report). Pure and Applied Chemistry. ISSN 0033-4545. 95(2), p. 125–131. doi: 10.1515/pac-2021-1109. Full text in Research Archive
• Elsais, Ahmed; Kerty, Emilia; Russell, Kristoffer & Toska, Karin (2022). Does cardiovascular autonomic dysfunction contribute to fatigue in myasthenia gravis? Physiological Research. ISSN 0862-8408. 71, p. 79–91. doi: 10.33549/physiolres.934660. Full text in Research Archive Show summary

  Myasthenia gravis (MG) is an autoimmune disease characterized by fatigable muscle weakness. Despite full spontaneous or pharmacological remission some MG patients still complain of physical and mental fatigue. Fatigue has been related to autonomic dysregulation. The aim of this study was to assess autonomic responses in a group of MG patients in complete remission but complaining of persistent fatigue. Seventeen well-regulated but persistently fatigued MG patients and 17 individually matched controls underwent echocardiography assessing systolic and diastolic heart function. Beat to beat cardiovascular responses at rest and to 30o head-up tilt, tilt-back, and 2-min static handgrip contraction were recorded. Fatigued MG patients had a statistically significant higher resting HR than their matched controls (p=0.03). The difference in resting heart rate between MG patients not using acetylcholine esterase inhibitors (AChEi) and their matched controls was even more pronounced (p=0.007). The autonomic cardiovascular adjustments to head-up tilt, tilt-back and handgrip contraction were not statistically significant different between patients and controls. We found a higher resting heart rate in all well-regulated but fatigued MG patients compared with controls. The difference was more pronounced between patients not taking AChEi compared to their matched controls. This finding may reflect a disturbed resting sympathovagal balance and this might be a contributing factor to the fatigue symptoms.

• Johannessen, Karl Arne; Wear, Nina Kristin Steen; Toska, Karin; Hansbø, Morten; Berg, Jens Petter & Fosse, Erik (2021). Pathologic Blood Samples Tolerate Exposure to Vibration and High Turbulence in Simulated Drone Flights, but Plasma Samples Should be Centrifuged after Flight. IEEE Journal of Translational Engineering in Health and Medicine. doi: 10.1109/JTEHM.2021.3053172. Full text in Research Archive Show summary

  Objective. Most of the previous studies of drone transport of blood samples examined normal blood samples transported under tranquil air conditions. We studied the effects of 1- and 2-hour drone flights using random vibration and turbulence simulation (10-30 g-force) on blood samples from 16 healthy volunteers and 74 patients with varying diseased. Methods: Thirty-two of the most common analytes were tested. For biochemical analytes, we used plasma collected in lithium heparin tubes with and without separator gel. Gel samples were analyzed for the effect of separation by centrifugation before or after turbulence. Turbulence was simulated in an LDS V8900 high-force shaker using random vibration (range, 5-200 Hz), with samples randomly allocated to 1- or 2-hour flights with 25 or 50 episodes of turbulence from 10 to 30 G. Results: For all hematologic and most biochemical analytes, test results before and after turbulence exposure were similar (bias <; 12%, intercepts <; 10%). However, aspartate aminotransferase, folate, lactate dehydrogenase and lipid index increased significantly in samples separated by gel and centrifugation prior to vibration and turbulence test. These changes increased form 10 G to 30 G, but were not observed when the samples were separated after vibration and turbulence. Conclusions: Whole blood showed little vulnerability to turbulence, whereas plasma samples separated from blood cells by gel may be significantly influenced by turbulence when separated by spinning before the exposure. Centrifugation of plasma samples collected in tubes with separator gel should be avoided before drone flights that could be subject to turbulence.

• Ho, Ai Van Thuy; Toska, Karin & Wesche, Jarlis (2020). Rapid, Large, and Synchronous Sweat and Cardiovascular Responses Upon Minor Stimuli in Healthy Subjects. Dynamics and Reproducibility. Frontiers in Neurology. 11, p. 1–10. doi: 10.3389/fneur.2020.00051. Full text in Research Archive Show summary

  Purpose: The aim of the study was to investigate steady state levels, dynamics and reproducibility of cardiovascular variables and electrodermal activity in different skin areas in response to minor physiological and mental stimuli in healthy subjects in the thermoneutral zone, carried out in high time resolution. Methods: Thirteen healthy subjects underwent experiments on two separate days. Non-invasive electrodermal activity in five different skin areas was measured continuously using a skin conductance method, including resting supine and sitting positions, performing deep inspirations, a mental challenge and being exposed to a sudden loud sound. Blood pressure, heart rate, radial artery blood flow, and skin perfusion were measured simultaneously. Results: Electrodermal activity in the right and left palms was almost identical, with rapid and large increases within a few seconds in response to stimuli, whereas no such significant changes were seen in the face, back, and abdomen. Radial artery blood flow and palmar skin perfusion changed synchronously with electrodermal activity for each stimulus, and were correlated to changes in blood pressure and heart rate. The response patterns in each subject were very similar on the two experimental days. There was very low spontaneous electrodermal activity in the supine position, contrary to the resting sitting position. Conclusion: The electrodermal activity increased rapidly and synchronously in both palms within a few seconds as a response to minor physiological and mental stimuli, synchronous with fluctuations in radial artery blood flow, palmar skin perfusion, and cardiovascular variables. The responses are reproducible from day to day, making them a stable and constant stimuli to be used for studies in patients with hyperhidrosis.

• Holmberg, Anne; Ho, Ai Van Thuy; Fernand, Dmitry; Toska, Karin; Wester, Torjus & Klaastad, Øivind [Show all 8 contributors for this article] (2019). Microcirculation and haemodynamics after infraclavicular brachial plexus block using adrenaline as an adjuvant to lidocaine: a randomised, double-blind, crossover study in healthy volunteers. Anaesthesia. ISSN 0003-2409. p. 1–9. doi: 10.1111/anae.14795. Full text in Research Archive Show summary

  We evaluated the effect of adrenaline on human skin microcirculation (nutritive and sub‐papillary) and systemic cardiovascular variables after it was added to lidocaine in infraclavicular brachial plexus blocks. Twelve healthy, non‐smoking male volunteers were included, each attending two study sessions 2 weeks apart, and they were studied using a crossover design. In both sessions, they received an ultrasound‐guided infraclavicular brachial plexus block in the non‐dominant arm with 0.4 ml.kg−1 lidocaine, 15 mg.ml−1 with or without adrenaline 5 μg.ml−1. Microcirculation was assessed by laser Doppler fluxmetry (sub‐papillary blood flow), capillary video microscopy (nutritive blood flow) and continuous temperature measurements. Heart rate and arterial pressure were recorded continuously and non‐invasively. Median (IQR [range]) sub‐papillary blood flow increased substantially 30 min after the brachial plexus block, from 8.5 (4.4–13.5 [2.9–28.2]) to 162.7 (111.0–197.8 [9.5–206.7]) arbitrary units with adrenaline (p = 0.017), and from 6.9 (5.3–28.5 [1.8–42.1] to 133.7 (16.5–216.7 [1.0–445.0] arbitrary units without adrenaline (p = 0.036). Nutritive blood flow (functional capillary density, capillaries.mm−2, measured at the dorsal side of the hand) decreased in the blocked extremity when adrenaline was used as adjuvant, from median (IQR [range]) 45 (36–52 [26–59]) to 38 (29–41 [26–42]), p = 0.028, whereas no significant change occurred without adrenaline. Median finger skin temperature (°C) increased by 44% (data pooled) with no significant differences between the groups. No significant changes were found in the systemic cardiovascular variables with or without adrenaline. We conclude that lidocaine infraclavicular brachial plexus blocks caused an increase in skin sub‐papillary blood flow. The addition of adrenaline produced stronger and longer lasting blocks, but decreased the nutritive blood flow.

• Urdal, Petter; Amundsen, Erik Koldberg; Toska, Karin & Klingenberg, Olav (2014). Automated alarm to detect antigen excess in serum free immunoglobulin light chain kappa and lambda assays. Scandinavian Journal of Clinical and Laboratory Investigation. ISSN 0036-5513. 74(7), p. 575–581. doi: 10.3109/00365513.2014.915426. Full text in Research Archive
• Bergersen, Tone Kristin; Hoffmann-Vold, Anna-Maria; Midtvedt, Øyvind; Gran, Jan Tore; Mørk, Cato & Toska, Karin [Show all 7 contributors for this article] (2014). Dysfunctional arteriovenous anastomoses in hands of systemic sclerosis patients with digital ulcers. Clinical and Experimental Rheumatology. ISSN 0392-856X. 32(6 Suppl 86), p. 53–59. Full text in Research Archive
• Grindheim, Guro; Estensen, Mette-Lise; Langsæter, Eldrid; Rosseland, Leiv Arne & Toska, Karin (2012). Changes in blood pressure during healthy pregnancy: a longitudinal cohort study. Journal of Hypertension. ISSN 0263-6352. 30(2), p. 342–350. doi: 10.1097/HJH.0b013e32834f0b1c. Full text in Research Archive
• Grindheim, Guro; Toska, Karin; Estensen, Mette-Lise & Rosseland, Leiv Arne (2012). Changes in pulmonary function during pregnancy: a longitudinal cohort study. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. 119(1), p. 94–101. doi: 10.1111/j.1471-0528.2011.03158.x. Full text in Research Archive
• Elstad, Maja; Walløe, Lars; Chon, Ki H. & Toska, Karin (2011). Low-frequency fluctuations in heart rate, cardiac output and mean arterial pressure in humans: what are the physiological relationships? Journal of Hypertension. ISSN 0263-6352. 29(7), p. 1327–1336. doi: 10.1097/HJH.0b013e328347a17a. Full text in Research Archive
• Nådland, Inger Helene; Wesche, Jarlis; Sheriff, Don David & Toska, Karin (2011). Does venous insufficiency impair the exercise-induced rise in arterial leg blood flow? Phlebology. ISSN 0268-3555. 26, p. 326–331. doi: 10.1258/phleb.2011.010092. Full text in Research Archive
• Nådland, Inger Helene; Wesche, Jarlis; Sheriff, DD & Toska, Karin (2011). Does the Great Saphenous Vein Stripping Improve Arterial Leg Blood Flow During Exercise? European Journal of Vascular and Endovascular Surgery. ISSN 1078-5884. 41(5), p. 697–703. doi: 10.1016/j.ejvs.2011.01.022. Full text in Research Archive
• Sheriff, Don; Nådland, Inger Helene & Toska, Karin (2010). Role of sympathetic responses on the hemodynamic consequences of rapid changes in posture in humans. Journal of applied physiology. ISSN 8750-7587. 108(3), p. 523–532. doi: 10.1152/japplphysiol.01185.2009. Full text in Research Archive
• Sheriff, Don; Nådland, Inger Helene & Toska, Karin (2010). Retrograde arterial leg blood flow during tilt-back from a head-up posture: importance of capacitive flows when arterial pressure changes. Journal of applied physiology. ISSN 8750-7587. 108(3), p. 533–537. doi: 10.1152/japplphysiol.01184.2009. Full text in Research Archive
• Toska, Karin (2010). Handgrip contraction induces a linear increase in arterial pressure by peripheral vasoconstriction, increased heart rate and a decrease in stroke volume. Acta Physiologica. ISSN 1748-1708. 200(3), p. 211–221. doi: 10.1111/j.1748-1716.2010.02144.x. Full text in Research Archive
• Elstad, Maja; Nådland, Inger Helene; Toska, Karin & Walløe, Lars (2009). Stroke volume decreases during mild dynamic and static exercise in supine humans. Acta Physiologica. ISSN 1748-1708. 195(2), p. 289–300. doi: 10.1111/j.1748-1716.2008.01887.x. Full text in Research Archive
• Nådland, Inger Helene; Walløe, Lars & Toska, Karin (2009). Effect of the leg muscle pump on the rise in muscle perfusion during muscle work in humans. European Journal of Applied Physiology. ISSN 1439-6319. 105(6), p. 829–841. doi: 10.1007/s00421-008-0965-6. Full text in Research Archive
• Sheriff, DD; Nådland, Inger Helene & Toska, Karin (2007). Hemodynamic consequences of rapid changes in posture in humans. Journal of applied physiology. ISSN 8750-7587. 103, p. 452–458. doi: 10.1152/japplphysiol.01190.2006. Full text in Research Archive
• Medbo, JI; Jebens, E; Noddeland, H; Hanem, S & Toska, Karin (2006). Lactate elimination and glycogen resynthesis after intense bicycling. Scandinavian Journal of Clinical and Laboratory Investigation. ISSN 0036-5513. 66. Full text in Research Archive
• Medbø, Jon Ingulf & Toska, Karin (2001). Lactate Release, Concentration in Blood, and Apparent Distribution Volume after Intense Bicycling. Japanese Journal of Physiology. ISSN 0021-521X. 51(3), p. 312–312. doi: 10.2170/jjphysiol.51.303. Full text in Research Archive

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• Toska, Karin (2011). Letter by Toska regarding article, "Biological basis of therapeutic lymphangiogenesis". Circulation. ISSN 0009-7322. 124(24), p. e895–e895. doi: 10.1161/CIRCULATIONAHA.111.035709. Full text in Research Archive
• Elsais, Ahmed; Kerty, Emilia; Russell, Kristoffer & Toska, Karin (2009). Cardiovascular responses during isometric exercise and low-grade head-up tilt-test in patients with myasthenia gravis. European Journal of Neurology. ISSN 1351-5101. 16, p. 373–373. Full text in Research Archive
• Elstad, Maja & Toska, Karin (2006). Point: Counterpoint: Cardiovascular variability is/is not an index of autonomic control of circulation. Journal of applied physiology. ISSN 8750-7587. 101, p. 687–687. Full text in Research Archive

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