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- Johansson, Bengt, 1958-, et al.
(författare)
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Phantom study of radiation doses outside the target volume brachytherapy versus external radiotherapy of early breast cancer
- 2003
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Ingår i: Radiotherapy and Oncology. - Amsterdam : Elsevier. - 1879-0887 .- 0167-8140. ; 69:1, s. 107-112
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Brachytherapy is sometimes suggested as an adjuvant treatment after surgery of some tumours. When introducing this, it would be useful to have an estimate of the dose distribution to different body sites, both near and distant to target, comparing conventional external irradiation to brachytherapy. The aim of the present study was to determine radiation doses with both methods at different body sites, near and distant to target, in an experimental situation on an operated left sided breast cancer on a female Alderson phantom. Methods: Five external beam treatments with isocentric tangential fields were given by a linear accelerator. A specified dose of 1.0 Gy was given to the whole left sided breast volume. Five interstitial brachytherapy treatments were given to the upper, lateral quadrant of the left breast by a two plane, 10 needles implant. A dose of 1.0 Gy specified according to the Paris system was administered by a pulsed dose rate afterloading machine. Absorbed dose in different fixed dose points were measured by thermoluminescence dosimeters. Results: Both methods yielded an absorbed dose of the same size to the bone marrow and internal organs distant to target, 1.0-1.4% of the prescribed dose. There was a trend of lower doses to the lower half of the trunk and higher doses to the upper half of the trunk, respectively, by brachytherapy. A 90% reduction of absorbed dose with brachytherapy compared to external irradiation was found in the near-target region within 5 cm from target boundary where parts of the left lung and the heart are situated. If an adjuvant dose of 50 Gy is given with the external radiotherapy and brachytherapy, the absorbed dose in a part of the myocardium could be reduced from 31.8 to 2.1 Gy. Conclusions: Near target, brachytherapy yielded a considerably lower absorbed dose which is of special importance when considering radiation effects on the myocard and lungs. We could not demonstrate any difference of importance, in absorbed dose to dose points distant to target. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
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| 2. |
- Olen, O., et al.
(författare)
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Allergy-related diseases and recurrent abdominal pain during childhood - a birth cohort study
- 2014
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Ingår i: Alimentary Pharmacology & Therapeutics. - : Wiley. - 0269-2813 .- 1365-2036. ; 40:11, s. 1349-1358
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAllergy and immune dysregulation may have a role in the pathophysiology of recurrent abdominal pain of functional origin, but previous studies of allergy-related diseases and abdominal pain have contradictory results. AimTo examine the association between allergy-related diseases or sensitisation during childhood and abdominal pain at age 12years. MethodsIn this birth cohort study of 4089 children, parents answered questionnaires regarding asthma, allergic rhinitis, eczema and food hypersensitivity (allergy-related diseases') at ages 0,1,2,4,8 and 12years. Blood for analyses of allergen-specific IgE was sampled at 4 and 8years. At 12years, the children answered questions regarding abdominal pain. Children with coeliac disease or inflammatory bowel disease were excluded. Associations were examined using multivariable logistic regression. ResultsAmong 2610 children with complete follow-up, 9% (n=237) reported abdominal pain at 12years. All allergy-related diseases were associated with concurrent abdominal pain at 12years and the risk increased with increasing number of allergy-related diseases (P for trend <0.001). Asthma at 1 and 2years and food hypersensitivity at 8years were significantly associated with abdominal pain at 12years. There was an increased risk of abdominal pain at 12years in children sensitised to food allergens at 4 or 8years, but in stratified analyses, this was confined to children whose parents had not reported food hypersensitivity at time of sensitisation. ConclusionAllergy-related diseases as well as sensitisation to food allergens were associated with an elevated risk of abdominal pain, and the risk increased with the number of allergy-related diseases.
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| 3. |
- Westman, Anders E., 1946-, et al.
(författare)
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Fear-avoidance beliefs, catastrophizing, and distress : a longitudinal subgroup analysis on patients with musculoskeletal pain
- 2011
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Ingår i: The Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 0749-8047 .- 1536-5409. ; 27:7, s. 567-577
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the present study was to describe fear-avoidance beliefs, catastrophizing, and emotional distress among musculoskeletal pain patients in primary healthcare and to explore the relationship of psychological risk profiles for pain, function, and sick leave from baseline through 1-year and 3-year follow-ups.Methods: Ratings from 110 musculoskeletal pain patients were collected and cluster analysis was used to identify subgroups with similar patterns on fear-avoidance beliefs, catastrophizing, and emotional distress. The clusters were examined cross-sectionally and prospectively on sick leave, function, and pain.Results: Five distinct profiles were found: “low scores cluster,” “high score cluster,” “fear-avoidance beliefs and catastrophizing cluster,” “distress only cluster,” and “medium catastrophizing cluster.” The “low scores cluster” and “distress only cluster” had the most favorable scores on outcome variables. The analysis of common developmental pathways showed considerable stability over time. Reorganization of clusters in a psychological “high risk cluster” and a “low risk cluster” showed significant differences at 1-year and 3-year follow-ups in functional ability as well as in decreased sick leave. There were no significant differences between the groups on average pain ratings at the 2 measure points.Conclusions: Distinct profiles of catastrophizing, fear-avoidance beliefs, and emotional distress were extracted and meaningfully related to future sick leave and dysfunction outcomes. The structures of the profiles were essentially stable and became more accentuated across a 3-year period. The results underscore the need to address psychological aspects as fear-avoidance beliefs, catastrophizing, and emotional distress in the management of patients with musculoskeletal pain and may open the path for a better tailored treatment approach for this patient group.
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