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Sökning: WFRF:(Olsson Daniel S 1983 )

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  • Föregående 123[4]
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  • Olsson, Daniel S, 1983, et al. (författare)
  • Incidence of malignant tumours in patients with a non-functioning pituitary adenoma.
  • 2017
  • Ingår i: Endocrine-related cancer. - : BioScientifica Ltd.. - 1479-6821 .- 1351-0088. ; 24:5, s. 227-235
  • Tidskriftsartikel (refereegranskat)abstract
    • Whether patients with non-functioning pituitary adenoma (NFPA) are at increased risk of developing malignant tumours has been sparsely studied and is a matter of debate. In this study, we have investigated the incidence of malignant tumours in a large and unselected group of patients with NFPA. The study was nationwide and included all patients diagnosed with NFPA between 1987-2011 (n=2,795) in Sweden, identified in the National Patient Register. Malignant tumours, occurring after the NFPA diagnosis, were identified in the Swedish Cancer Register between 1987-2014. Standardised incidence ratios (SIRs) for malignant tumours with 95% confidence intervals (CI) were calculated using the Swedish population as reference. In total, 448 malignant tumours were detected in 386 patients with NFPA, as compared to 368 expected malignancies in the general population [SIR 1.22 (95% CI 1.11-1.33)]. The incidence of neoplasms of the brain was increased [SIR 5.83 (95% CI 4.03-8.14)]. When analysing the total incidence of malignancies excluding neoplasms of the brain, the overall SIR was still increased [SIR 1.14 (95% CI 1.03-1.26)]. The incidence of malignant neoplasm of skin other than malignant melanoma [SIR 1.99 (95% CI 1.55-2.52)] and malignant melanoma [SIR 1.62 (95% CI 1.04-2.38)] were increased, whereas the incidence of breast cancer [SIR 0.65 (95% CI 0.42-0.97)] was decreased. The incidence of other types of malignancies did not differ significantly from the expected incidence in the general population. In conclusion, patients with NFPA have an increased over-all risk of developing malignancies. To what extent these findings are due to more frequent medical surveillance, genetic predisposition, or endocrine changes, remains unknown.
  • Olsson, Daniel S, 1983, et al. (författare)
  • Life expectancy in patients with pituitary adenoma receiving growth hormone replacement.
  • 2017
  • Ingår i: European journal of endocrinology. - 1479-683X. ; 176:1, s. 67-75
  • Tidskriftsartikel (refereegranskat)abstract
    • Hypopituitarism has been associated with increased mortality. The excess mortality may be due to untreated growth hormone (GH) deficiency but also due to various underlying disorders. We therefore analysed mortality in patients with only one underlying disorder, non-functioning pituitary adenoma (NFPA), with and without GH replacement therapy (GHRT).Patients with NFPA in the western region of Sweden, 1997-2011, were identified through the National Patient Registry and cross-referenced with several National Health Registries. All patient records were reviewed. Standardised mortality ratios (SMRs) with 95% confidence intervals (CIs) were calculated using the general population as reference. Cox-regression models were performed to identify predictors of mortality.A total of 426 NFPA patients with 4599 patient-years were included, of whom 207 had used GHRT and 219 had not received GHRT. Median (range) follow-up in patients with and without GHRT was 12.2 (0-25) and 8.2 (0-27) years, respectively. Other pituitary hormone deficiencies were more frequent in the GHRT group than those in the non-GHRT group. SMR was 0.65 (95% CI, 0.44-0.94; P = 0.018) for the GHRT group and 1.16 (0.94-1.42; P = 0.17) for the non-GHRT group. Direct comparison between the groups showed reduced mortality among those who were GH replaced (P = 0.0063). The SMR for malignant tumours was reduced in the GHRT-group (0.29; 0.08-0.73; P = 0.004) but not in untreated patients.Selection bias explaining some of the results cannot be excluded. However, NFPA patients with GHRT had reduced overall mortality compared with the general population, and death due to malignancy was not increased. This suggests that long-term GHRT is safe in adult patients selected for treatment.
  • Olsson, Daniel S, 1983, et al. (författare)
  • Tumour recurrence and enlargement in patients with craniopharyngioma with and without GH replacement therapy during more than 10 years of follow-up.
  • 2012
  • Ingår i: European journal of endocrinology. - 1479-683X. ; 166:6, s. 1061-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Most patients who have been treated for craniopharyngioma (CP) are GH deficient (GHD). GH replacement therapy (GHRT) may stimulate tumour regrowth; and one of the concerns with long-term GHRT is the risk of tumour progression. Therefore, the objective was to study tumour progression in CP patients on long-term GHRT.Case-control study.The criteria for inclusion of cases were: i) GHD caused by CP; ii) GHRT >3 years; and iii) regular imaging. This resulted in 56 patients (mean age at diagnosis 25±16 years) with a mean duration of GHRT of 13.6±5.0 years. As controls, 70 CP patients who had not received GHRT were sampled with regard to follow-up, gender, age at diagnosis and initial radiation therapy (RT).The 10-year tumour progression-free survival rate (PFSR) for the entire population was 72%. There was an association (hazard ratio, P value) between PFSR and initial RT (0.13, 0.001) and residual tumour (3.2, 0.001). The 10-year PFSR was 88% for the GHRT group and 57% for the control group. Substitution with GHRT resulted in the following associations to PFSR: GHRT (0.57, 0.17), initial RT (0.16, <0.001), residual tumour (2.6, <0.01) and gender (0.57, 0.10). Adjusted for these factors, the 10-year PFSR was 85% for the GHRT group and 65% for the control group.In patients with CP, the most important prognostic factors for the PFSR were initial RT and residual tumour after initial treatment. Long-term GHRT did not affect the PFSR in patients with CP.
  • Trimpou, Penelope, 1973, et al. (författare)
  • Diagnostic value of the water deprivation test in the polyuria-polydipsia syndrome.
  • 2017
  • Ingår i: Hormones. - 2520-8721. ; 16:4, s. 414-422
  • Tidskriftsartikel (refereegranskat)abstract
    • Diabetes insipidus (DI) and primary polydipsia (PP) are characterised by polyuria and polydipsia. It is crucial to differentiate between these two disorders since the treatment is different. The aim of this study was to evaluate the diagnostic value of the short and an extended variant of the water deprivation test (WDT) and of measuring urinary vasopressin (AVP) in patients with polyuria and polydipsia.A retrospective, single-centre study based on WDTs performed between 2004 and 2014 including 104 consecutive patients with the polyuria-polydipsia syndrome. During a strict water deprivation, weight, urinary osmolality, urinary vasopressin and specific gravity were collected until one of the following was reached: i) >3% weight reduction, ii) Urinary specific gravity >1.020 or, urinary osmolality >800 mOsm/L, iii) Intolerable adverse symptoms such as excessive thirst.Out of 104 patients (67 women, 37 men), 21 (20%) were diagnosed with DI and 83 (80%) with PP. The median (interquartile range; range) test duration was 14 hours (10-16; 3-36) in patients with DI and 18 hours (14-24; 7-48) in patients with PP (P=0.011). Of those diagnosed with PP, 22 (26%) did not reach urinary specific gravity >1.020 nor urine osmolality >800 mOsm/L. Urine AVP did not overlap between patients with PP and patients with central DI.The short WDT is of limited value in the diagnostic work-up of polydipsia and polyuria and a partial DI may have been missed in every fourth patient diagnosed with PP. Urinary AVP has excellent potential in discriminating PP from central DI.
  • van Bunderen, Christa C, et al. (författare)
  • Growth hormone deficiency and replacement therapy in adults: Impact on survival.
  • 2020
  • Ingår i: Reviews in endocrine & metabolic disorders. - 1573-2606.
  • Forskningsöversikt (refereegranskat)abstract
    • In a seminal paper from 1990, Rosen and Bengtsson suggested that hypopituitary patients with a presumed growth hormone (GH) deficiency (GHD) have an excess mortality. Later studies have confirmed this finding but have also shown that the cause of the increased risk of death in these patients is multifactorial, including unreplaced GHD as well as non-physiological replacement therapy of other deficiencies, the etiology of hypopituitarism, and the side effects of tumor treatment. Only a few studies have investigated mortality in hypopituitary patients with GHD receiving GH replacement therapy (GHRT): these studies are retrospective observational studies with a wide range of underlying diseases but most of them show a mortality that is not different from the general population. Even though the research field of survival in GHD patients with and without GHRT is lacking prospective randomized trials, the evidence suggests that GHD in hypopituitary patients contributes to an excess mortality and modern replacement therapy including GHRT will result in a mortality that is approaching normal. Herein, we review the literature in the field of survival in GHD patients with and without GHRT. In addition, we outline the most important issues when evaluating studies in this area.
  • van Bunderen, Christa C, et al. (författare)
  • Personalized approach to growth hormone replacement in adults.
  • 2019
  • Ingår i: Archives of endocrinology and metabolism. - 2359-4292. ; 63:6, s. 592-600
  • Forskningsöversikt (refereegranskat)abstract
    • Growth hormone (GH) deficiency (GHD) in adults is well-characterized and includes abnormal body composition, reduced bone mass, an adverse cardiovascular risk profile, and impaired quality of life. In the early 1990s, it was also shown that patients with hypopituitarism without GH replacement therapy (GHRT) had excess mortality. Today, GHRT has been shown to decrease or reverse the negative effects of GHD. In addition, recent papers have shown that mortality and morbidity are approaching normal in hypopituitary patients with GHD who receive modern endocrine therapy including GHRT. Since the first dose-finding studies, it has been clear that efficacy and side effects differ substantially between patients. Many factors have been suggested as affecting responsiveness, such as sex, age, age at GHD onset, adherence, and GH receptor polymorphisms, with sex and sex steroid replacement having the greatest impact. Therefore, the individual tailoring of GH dose is of great importance to achieve sufficient efficacy without side effects. One group that stands out is women receiving oral estrogen replacement, who needs the highest dose. Serum insulin-like growth factor-1 (IGF-1) is still the most used biochemical biomarker for GH dose titration, although the best serum IGF-1 target is still debated. Patients with GHD due to acromegaly, Cushing's disease, or craniopharyngioma experience similar effects from GHRT as others. Arch Endocrinol Metab. 2019;63(6):592-600.
  • van Santen, Selveta Sanne, et al. (författare)
  • Diagnosing Metabolic Syndrome in Craniopharyngioma Patients: Body Composition versus BMI.
  • 2019
  • Ingår i: European journal of endocrinology. - 1479-683X. ; 181:2, s. 173-183
  • Tidskriftsartikel (refereegranskat)abstract
    • Craniopharyngioma patients often have poor metabolic profiles due to hypothalamic-pituitary damage. Previously, using body mass index (BMI) as obesity marker, the occurrence of the metabolic syndrome in these patients was estimated at 46%. Our aim was to determine if Dual X-ray Absorptiometry (DXA-) scan in evaluation of obesity and metabolic syndrome would be superior.Retrospective study of craniopharyngioma patients for whom DXA-scan results were available.BMI, fat percentage and fat mass index were used to evaluate obesity and as components for obesity in metabolic syndrome.Ninety-five craniopharyngioma patients were included (51% female, 49% childhood-onset disease). Metabolic syndrome occurred in 34-53 (45-51%) subjects (depending on the definition of obesity, although all definitions occurred in higher frequency than in the general population). Metabolic syndrome frequency was higher if obesity was defined by fat percentage (52% vs. 42%) or fat mass index (51% vs. 43%) compared to BMI. Misclassification appeared in 9% (fat percentage vs. BMI) and 7% (fat mass index vs. BMI) for metabolic syndrome and 29% and 13% for obesity itself, respectively. For metabolic syndrome, almost perfect agreement was found for BMI compared with fat percentage or fat mass index. For obesity, agreement was fair to moderate (BMI vs. fat percentage).Using BMI to evaluate obesity underestimates the true prevalence of metabolic syndrome in patients with craniopharyngioma. Furthermore, fat percentage contributes to a better evaluation of obesity than BMI. The contribution of DXA-scan might be limited for identification of the metabolic syndrome.
  • Wijnen, Mark, et al. (författare)
  • Excess morbidity and mortality in patients with craniopharyngioma: a hospital-based retrospective cohort study.
  • 2018
  • Ingår i: European journal of endocrinology. - 1479-683X. ; 178:1, s. 95-104
  • Tidskriftsartikel (refereegranskat)abstract
    • Most studies in patients with craniopharyngioma did not investigate morbidity and mortality relative to the general population nor evaluated risk factors for excess morbidity and mortality. Therefore, the objective of this study was to examine excess morbidity and mortality, as well as their determinants in patients with craniopharyngioma.Hospital-based retrospective cohort study conducted between 1987 and 2014.We included 144 Dutch and 80 Swedish patients with craniopharyngioma identified by a computer-based search in the medical records (105 females (47%), 112 patients with childhood-onset craniopharyngioma (50%), 3153 person-years of follow-up). Excess morbidity and mortality were analysed using standardized incidence and mortality ratios (SIRs and SMRs). Risk factors were evaluated univariably by comparing SIRs and SMRs between non-overlapping subgroups.Patients with craniopharyngioma experienced excess morbidity due to type 2 diabetes mellitus (T2DM) (SIR: 4.4, 95% confidence interval (CI): 2.8-6.8) and cerebral infarction (SIR: 4.9, 95% CI: 3.1-8.0) compared to the general population. Risks for malignant neoplasms, myocardial infarctions and fractures were not increased. Patients with craniopharyngioma also had excessive total mortality (SMR: 2.7, 95% CI: 2.0-3.8), and mortality due to circulatory (SMR: 2.3, 95% CI: 1.1-4.5) and respiratory (SMR: 6.0, 95% CI: 2.5-14.5) diseases. Female sex, childhood-onset craniopharyngioma, hydrocephalus and tumour recurrence were identified as risk factors for excess T2DM, cerebral infarction and total mortality.Patients with craniopharyngioma are at an increased risk for T2DM, cerebral infarction, total mortality and mortality due to circulatory and respiratory diseases. Female sex, childhood-onset craniopharyngioma, hydrocephalus and tumour recurrence are important risk factors.
  • Wijnen, Mark, et al. (författare)
  • The metabolic syndrome and its components in 178 patients treated for craniopharyngioma after 16 years of follow-up.
  • 2018
  • Ingår i: European journal of endocrinology. - 1479-683X. ; 178:1, s. 11-22
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with craniopharyngioma are at an increased risk for cardio- and cerebrovascular mortality. The metabolic syndrome (MetS) is an important cardiometabolic risk factor, but barely studied in patients with craniopharyngioma. We aimed to investigate the prevalence of and risk factors for the MetS and its components in patients with craniopharyngioma.Cross-sectional study with retrospective data.We studied the prevalence of and risk factors for the MetS and its components in 110 Dutch (median age 47 years, range 18-92) and 68 Swedish (median age 50 years, range 20-81) patients with craniopharyngioma with ≥3 years of follow-up (90 females (51%); 83 patients with childhood-onset craniopharyngioma (47%); median follow-up after craniopharyngioma diagnosis 16 years (range 3-62)). In Dutch patients aged 30-70 years and Swedish patients aged 45-69 years, we examined the prevalence of the MetS and its components relative to the general population.Sixty-nine (46%) of 149 patients with complete data demonstrated the MetS. Prevalence of the MetS was significantly higher in patients with craniopharyngioma compared with the general population (40% vs 26% (P < 0.05) for Dutch patients; 52% vs 15% (P < 0.05) for Swedish patients). Multivariable logistic regression analysis identified visual impairment as a borderline significant predictor of the MetS (OR 2.54, 95% CI 0.95-6.81; P = 0.06) after adjustment for glucocorticoid replacement therapy and follow-up duration. Age, female sex, tumor location, radiological hypothalamic damage, 90Yttrium brachytherapy, glucocorticoid replacement therapy and follow-up duration significantly predicted components of the MetS.Patients with craniopharyngioma are at an increased risk for the MetS, especially patients with visual impairment.
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