| 31. |
- Chamalidou, Chaido, 1972, et al.
(författare)
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Survival patterns of invasive lobular and invasive ductal breast cancer in a large population-based cohort with two decades of follow up
- 2021
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Ingår i: Breast. - : Churchill Livingstone. - 0960-9776 .- 1532-3080. ; 59, s. 294-300
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Tidskriftsartikel (refereegranskat)abstract
- Background: Invasive lobular carcinoma (ILC) comprises 8-15 % of all invasive breast cancers and large population-based studies with >10 years of follow-up are rare. Whether ILC has a long-time prognosis different from that of invasive ductal carcinoma, (IDC) remains controversial. Purpose: To investigate the excess mortality rate ratio (EMRR) of patients with ILC and IDC and to correlate survival with clinical parameters in a large population-based cohort. Material and methods: From 1989 through 2006, we identified 17,481 patients diagnosed with IDC (n = 14,583) or ILC (n = 2898), younger than 76 years from two Swedish Regional Cancer Registries. Relative survival (RS) during 20 years of follow up was analysed. Results: ILC was significantly associated with older age, larger tumours, ER positivity and well differentiated tumours. We noticed an improved survival for patients with ILC during the first five years, excess mortality rate ratio (EMRR) 0.64 (CI 95 % 0.53-0.77). This was shifted to a significant decreased survival 10-15 years after diagnosis (EMRR 1.49, CI 95 % 1.16-1.93). After 20 years the relative survival rates were similar, 0.72 for ILC and 0.73 for IDC. Conclusions: During the first five years after surgery, the EMRR was lower for patients with ILC as compared to patients with IDC, but during the years 10-15 after surgery, we observed an increased EMRR for patients with ILC as compared to IDC. These EMRR between ILC and IDC were statistically significant but the absolute difference in excess mortality between the two groups was small. (c) 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 32. |
- Dordlofva, Bengt, et al.
(författare)
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Arrangement for Frequency Planning in Cellular Systems
- 1999
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Patent (populärvet., debatt m.m.)abstract
- The invention relates to an arrangement for frequency planning in cellular systems using a mix of wide and narrow antenna beams. The arrangement employs a dual frequency reuse for the respective wide and narrow antenna beams. According to the invention, a first frequency group is allocated to a cluster with a reuse distance sufficient for narrow beam channels and a second frequency group is allocated to a larger cluster with a reuse distance sufficent for wide beam channels. The second frequency group is a subdivision of and contained in the first frequency group. The second frequency group is the only frequency group available for wide beam channels, while all the frequencies of the two groups are available for the narrow beams channels. Generally, the wide beams are used for control channels and the narrow beams are used for traffic channels. A frequency planning in accordance with the invention makes it possible to use narrow beam traffic channels more efficiently compared to known state of the art methods which results in improved trunking efficiency.
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| 33. |
- Engquist, Bo, et al.
(författare)
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Simplified methods of implant treatment in the edentulous lower jaw. A controlled prospective study. Part I : one-stage versus two-stage surgery.
- 2002
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Ingår i: Clinical Implant Dentistry and Related Research. - 1523-0899 .- 1708-8208. ; 4:2, s. 93-103
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The original protocol for Brσnemark System implants in the mandible was a two-stage procedure with 3 months healing time. With five or six implants and a cast framework of gold, the treatment is rather expensive, and simplified methods would be desirable. PURPOSE: The goal of this controlled serial study was to investigate the outcome of a simplified procedure with one-stage surgery, four Brσnemark implants, shortened healing time, and a new titanium-acrylic fixed full prosthesis. MATERIALS AND METHODS: Eighty-two patients were treated in three different groups at two specialist centers. All patients were provided with four implants, loaded with a Procera All-in-One bridge (Nobel Biocare, Gothenburg, Sweden) after 12 weeks. In group A (n = 30), one-stage surgery was combined with two-piece implants. In group B (n = 30), the control group, two-stage surgery and two-piece implants were used. In group C (n = 22), one-stage surgery was combined with one-piece implants. Marginal bone level was rated from radiographs at implant insertion, at baseline, and after 1 year. RESULTS: The survival rate after 1 year for group A was 93.3%, group B, 97.5%, and group C, 93.2%. The differences were not statistically significant. Between fixture insertion and baseline, the average bone loss for group A was 1.2 mm, group B, 1.3 mm, and group C, 1.3 mm. No complications in the form of bridge loosening or acrylic fractures were recorded during the first year. CONCLUSIONS: The survival rates and the marginal bone changes did not differ significantly between the one-stage groups and the control group. The survival rate and the marginal bone changes were similar for one-piece and two-piece implants. Four implants were sufficient to support full fixed prostheses in the mandibles. The Procera All-in-One bridges proved to be of high quality, and no complications were experienced. key words: endosseous implants, nonsubmerged implants, one-piece implants, prospective clinical study, submerged implants
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| 34. |
- Engquist, Bo, et al.
(författare)
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Simplified methods of implant treatment in the edentulous lower jaw. Part II : Early loading
- 2004
-
Ingår i: Clinical Implant Dentistry and Related Research. - 1523-0899 .- 1708-8208. ; 6:2, s. 90-100
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most implant treatment is performed with a two-stage surgical procedure. A disadvantage of these implant treatments is that they are time-consuming. Purpose: The aim of the present study was to evaluate the results of early loading in the edentulous mandible and to compare those results with treatment results of one-stage surgery followed by a healing period and with two-stage surgery. Material and Methods: The material comprises four treatment groups with a total of 108 patients with edentulous lower jaws and 432 implants. All patients were treated with Brånemark implants (Nobel Biocare AB, Gothenburg, Sweden) with a turned surface and fixed prostheses in the lower jaw, supported by four implants. The patients in group A were treated with a one-stage procedure, a two-piece implant, and a 3-month healing period before loading. Group B (control group) had a two-stage procedure, a two-piece implant, and a 3-month healing period. Group C had a one-stage procedure, a one-piece implant, and a 3-month healing period. Group D was treated with a one-stage surgical procedure, a two-piece implant, and early loading (within 3 weeks). All patients were provided with a Procera® Implant Bridge (Nobel Biocare) with a framework made by computer-assisted milling of one piece of pure titanium. All patients have been followed up for 1 year. Results: The survival rates were 93.2 to 93.3% in the experimental groups and 97.5% in the control group. The difference was not statistically significant. The measurements of the marginal bone level demonstrated a mean bone loss of 0.8 mm between fixture insertion and the 1-year examination in patients with early loading (group D) whereas the bone loss in patients who underwent a healing period before loading was 1.3 to 1.6 mm. The difference between the control group and the group with early loading was significant. Conclusions: Survival rates for patients treated with a one-stage procedure were lower than survival rates for patients treated according to a "classical concept," but the differences were not statistically significant. There was no difference between treatment results with one-piece and two-piece implants. The implant loss in patients with early loading was probably caused by overloading, and careful supervision of occlusal loading is recommended. Early loading gave significantly less marginal bone loss when compared with two-stage surgery.
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| 35. |
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| 36. |
- Fransson, Per, et al.
(författare)
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Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer (HYPO-RT-PC) : patient-reported quality-of-life outcomes of a randomised, controlled, non-inferiority, phase 3 trial
- 2021
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Ingår i: The Lancet Oncology. - : Elsevier. - 1470-2045 .- 1474-5488. ; 22:2, s. 235-245
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The HYPO-RT-PC trial compared conventionally fractionated radiotherapy with ultra-hypofractionated radiotherapy in patients with localised prostate cancer. Ultra-hypofractionation was non-inferior to conventional fractionation regarding 5-year failure-free survival and toxicity. We aimed to assess whether patient-reported quality of life (QOL) differs between conventional fractionation and ultra-hypofractionation up to 6 years after treatment in the HYPO-RT-PC trial.METHODS: HYPO-RT-PC is a multicentre, open-label, randomised, controlled, non-inferiority, phase 3 trial done in 12 centres (seven university hospitals and five county hospitals) in Sweden and Denmark. Inclusion criteria were histologically verified intermediate-to-high-risk prostate cancer (defined as T1c-T3a with one or two of the following risk factors: stage T3a; Gleason score ≥7; and prostate-specific antigen 10-20 ng/mL with no evidence of lymph node involvement or distant metastases), age up to 75 years, and WHO performance status 0-2. Participants were randomly assigned (1:1) to conventional fractionation (78·0 Gy in 39 fractions, 5 days per week for 8 weeks) or ultra-hypofractionation (42·7 Gy in seven fractions, 3 days per week for 2·5 weeks) via a minimisation algorithm with stratification by trial centre, T-stage, Gleason score, and prostate-specific antigen. QOL was measured using the validated Prostate Cancer Symptom Scale (PCSS) and European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) at baseline, the end of radiotherapy, months 3, 6, 12, and 24 after radiotherapy, every other year thereafter up to 10 years, and at 15 years. The primary endpoint (failure-free survival) has been reported elsewhere. Here we report QOL, a secondary endpoint analysed in the per-protocol population, up to 6 years after radiotherapy. The HYPO-RT-PC trial is registered with the ISRCTN registry, ISRCTN45905321.FINDINGS: Between July 1, 2005, and Nov 4, 2015, 1200 patients were enrolled and 1180 were randomly assigned (conventional fractionation n=591, ultra-hypofractionation n=589); 1165 patients (conventional fractionation n=582, ultra-hypofractionation n=583) were included in this QOL analysis. 158 (71%) of 223 patients in the conventional fractionation group and 146 (66%) of 220 in the ultra-hypofractionation group completed questionnaires at 6 years. The median follow-up was 48 months (IQR 25-72). In seven of ten bowel symptoms or problems the proportion of patients with clinically relevant deteriorations at the end of radiotherapy was significantly higher in the ultra-hypofractionation group than in the conventional fractionation group (stool frequency [p<0·0001], rush to toilet [p=0·0013], flatulence [p=0·0013], bowel cramp [p<0·0001], mucus [p=0·0014], blood in stool [p<0·0001], and limitation in daily activity [p=0·0014]). There were no statistically significant differences in the proportions of patients with clinically relevant acute urinary symptoms or problems (total 14 items) and sexual functioning between the two treatment groups at end of radiotherapy. Thereafter, there were no clinically relevant differences in urinary, bowel, or sexual functioning between the groups. At the 6-year follow-up there was no difference in the incidence of clinically relevant deterioration between the groups for overall urinary bother (43 [33%] of 132 for conventional fractionation vs 33 [28%] of 120 for ultra-hypofractionation; mean difference 5·1% [95% CI -4·4 to 14·6]; p=0·38), overall bowel bother (43 [33%] of 129 vs 34 [28%] of 123; 5·7% [-3·8 to 15·2]; p=0·33), overall sexual bother (75 [60%] of 126 vs 59 [50%] of 117; 9·1% [-1·4 to 19·6]; p=0·15), or global health/QOL (56 [42%] of 134 vs 46 [37%] of 125; 5·0% [-5·0 to 15·0]; p=0·41).INTERPRETATION: Although acute toxicity was higher for ultra-hypofractionation than conventional fractionation, this long-term patient-reported QOL analysis shows that ultra-hypofractionation was as well tolerated as conventional fractionation up to 6 years after completion of treatment. These findings support the use of ultra-hypofractionation radiotherapy for intermediate-to-high-risk prostate cancer.
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| 37. |
- Glimelius, Bengt, et al.
(författare)
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U-CAN : a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden.
- 2018
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 57:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- Background: Progress in cancer biomarker discovery is dependent on access to high-quality biological materials and high-resolution clinical data from the same cases. To overcome current limitations, a systematic prospective longitudinal sampling of multidisciplinary clinical data, blood and tissue from cancer patients was therefore initiated in 2010 by Uppsala and Umeå Universities and involving their corresponding University Hospitals, which are referral centers for one third of the Swedish population.Material and Methods: Patients with cancer of selected types who are treated at one of the participating hospitals are eligible for inclusion. The healthcare-integrated sampling scheme encompasses clinical data, questionnaires, blood, fresh frozen and formalin-fixed paraffin-embedded tissue specimens, diagnostic slides and radiology bioimaging data.Results: In this ongoing effort, 12,265 patients with brain tumors, breast cancers, colorectal cancers, gynecological cancers, hematological malignancies, lung cancers, neuroendocrine tumors or prostate cancers have been included until the end of 2016. From the 6914 patients included during the first five years, 98% were sampled for blood at diagnosis, 83% had paraffin-embedded and 58% had fresh frozen tissues collected. For Uppsala County, 55% of all cancer patients were included in the cohort.Conclusions: Close collaboration between participating hospitals and universities enabled prospective, longitudinal biobanking of blood and tissues and collection of multidisciplinary clinical data from cancer patients in the U-CAN cohort. Here, we summarize the first five years of operations, present U-CAN as a highly valuable cohort that will contribute to enhanced cancer research and describe the procedures to access samples and data.
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| 38. |
- Glise Sandblad, Katarina, 1982, et al.
(författare)
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Prevalence of Cancer in Patients with Venous Thromboembolism: A Retrospective Nationwide Case-Control Study in Sweden.
- 2023
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Ingår i: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. - : SAGE Publications. - 1938-2723. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Cancer is a risk factor for venous thromboembolism (VTE). We aimed to define sex-specific risk of preceding cancer in patients with a first-time VTE by conducting a nationwide Swedish registry-based study including 298172 patients with VTE and 1185079 matched controls. This included 44685 patients with a diagnosis of cancer at/or within 1 year before a VTE diagnosis. Female patients with VTE had a higher multivariable adjusted odds ratios of preceding cancer than male patients with VTE (5.5 [99% confidence interval 5.4-5.7] vs 3.9 [3.8-4.0]). The highest risk of cancer in patients with VTE were found for pancreatic cancer (women: 19.6 [15.8-24.4]; men: 17.2 [13.7-21.6]) and brain cancer (women: 17.4 [12.9-23.4]; men: 17.5 [13.8-22.2]). Weak associations were seen between VTE and bladder/urothelial cancer (women: 1.31 [1.12-1.53]; men: 1.34 [1.23-1.47]), prostate cancer (men: 2.17 [2.07-2.27]), malignant melanoma (women: 2.51 [2.07-3.05]; men: 2.67 [2.23-3.18]), and kidney cancer (women: 3.20 [2.49-4.11]; men: 3.33 [2.79-4.07]). In conclusion, associations with VTE were weak for bladder/urothelial cancer and kidney cancer, and strong for pancreatic, brain, and biliary cancers.
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| 39. |
- Hansen, Karin, et al.
(författare)
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Trender i kvävenedfall över Sverige 1955-2011
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Kvävenedfallet har stor betydning för försurning och övergödning. Uppdraget har finansierats av Naturvårdsverket, med syfte att förbättra underlaget för att följa upp miljökvalitetsmålet Bara naturlig försurning . En ny, unik databas har etablerats, med de flesta mätningar som har skett i Sverige av nederbördsmängder och -kemi på öppet fält från 1955 och fram till idag. Beräkningar av nedfallet av oorganiskt kväve (NO3- + NH4+) med nederbörden (våtdepositionen) vid de sammanlagt 362 mätplatserna visar att nedfallet är högre i hela Sverige idag än när mätningarna startade 1955. Data visar en stor variation i kvävenedfallet mellan mätplatser och år, vilket gör det svårt att detektera statistiskt signifikanta förändringar över tid. Nedfallet av kväve med nederbörden till Sverige ökade signifikant under 20-årsperioden 1970-1989 i sydvästra Sverige, men inte i sydöstra eller norra Sverige. Under 20-årsperioden 1990-2009 skedde ingen förändring av nedfallet i norra eller sydvästra Sverige, men i sydöstra Sverige minskade nedfallet av olika kväveformer med nederbörden signifikant. Parallellt har kvävenedfallet uppskattats med MATCH-modellen med två olika simuleringar. Den ena simuleringen (TRENDMATCH) har använt indata från observerad meteorologi tillsammans med emissioner bestämda inom EMEP-programmet medan den andra (KLIMATMATCH) använder meteorologi från en klimatmodell och emissioner sammanställt för RCP4.5. Den med TRENDMATCH modellerade depositionen visar nedåtgående trender för såväl NO3- som NH4+ från 1990 till 2009 i alla regioner. Resultaten från KLIMATMATCH visar inte lika tydliga trender för NH4+, beroende på att de historiska emissionerna i RCP4.5 databasen både visar upp- och nedåtgående trender för perioden. Trender i kvävenedfall beräknade med MATCH-modellen är till mycket stor del styrda av trender i de emissioner som används av spridningsmodellen. Det kan finnas flera orsaker till att vi inte ser tydliga trender i kvävenedfallet under de senaste decennierna. Trendanalyser kräver data med långa tidsserier, vilket av olika orsaker ofta saknas. Om kvävenedfallet har förändrats, men förändringen är liten, så är det svårt eller omöjligt att urskilja detta ur de stora slumpmässiga mellanårsvariationerna. Det är också möjligt att nedfallet inte har förändrats, trots minskande emissioner i Europa, på grund av ändrade atmosfärskemiska förhållanden (t ex klimat och minskande svavelemissioner), eller om utsläppen av kväve från källor som är av vikt för Sverige inte har minskat i samma utsträckning som emissionerna för Europa som helhet har. Det är också svårt att uppskatta kväveemissioner, vilket i rapporten illustreras av de två emissionsuppskattningar som har använts, där den ena rapporterar minskande emissioner av ammoniak och den andra ökande. För att uppnå precision och statistiskt kunna säkerställa förhållandevis små förändringar i kvävenedfallet, i storleksordningen 20 procent under en period av 20 år, behövs mätningar vid ett stort antal platser runt om i landet. Vi föreslår en genomgång av hur de framtida mätningarna av kvävenedfallet, som utgör basen för övervakningen, bör utformas. En viktig punkt är att existerande stationer med långa tidsserier bör bevaras, något som kräver långsiktig finansiering.
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| 40. |
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