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- Wu, W. H., et al.
(author)
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Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence
- 2004
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In: Eur Spine J. - : Springer Science and Business Media LLC. - 0940-6719. ; 13:7, s. 575-89
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Journal article (peer-reviewed)abstract
- Pregnancy-related lumbopelvic pain has puzzled medicine for a long time. The present systematic review focuses on terminology, clinical presentation, and prevalence. Numerous terms are used, as if they indicated one and the same entity. We propose "pregnancy-related pelvic girdle pain (PPP)", and "pregnancy-related low back pain (PLBP)", present evidence that the two add up to "lumbopelvic pain", and show that they are distinct entities (although underlying mechanisms may be similar). Average pain intensity during pregnancy is 50 mm on a visual analogue scale; postpartum, pain is less. During pregnancy, serious pain occurs in about 25%, and severe disability in about 8% of patients. After pregnancy, problems are serious in about 7%. The mechanisms behind disabilities remain unclear, and constitute an important research priority. Changes in muscle activity, unusual perceptions of the leg when moving it, and altered motor coordination were observed but remain poorly understood. Published prevalence for PPP and/or PLBP varies widely. Quantitative analysis was used to explain the differences. Overall, about 45% of all pregnant women and 25% of all women postpartum suffer from PPP and/or PLBP. These values decrease by about 20% if one excludes mild complaints. Strenuous work, previous low back pain, and previous PPP and/or PLBP are risk factors, and the inclusion/exclusion of high-risk subgroups influences prevalence. Of all patients, about one-half have PPP, one-third PLBP, and one-sixth both conditions combined. Overall, the literature reveals that PPP deserves serious attention from the clinical and research communities, at all times and in all countries.
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| 3. |
- Look, M, et al.
(author)
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Pooled analysis of prognostic impact of uPA and PAI-I in breast cancer patients
- 2003
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In: Thrombosis and Haemostasis. - 0340-6245. ; 90:3, s. 538-548
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Journal article (peer-reviewed)abstract
- In this report we present an extension of the pooled analysis of the prognostic impact of urokinase-type plasminogen activator (uPA) and its inhibitor PAI-I in breast cancer patients. We analyzed a different endpoint, metastasis-free survival (MFS). We checked the consistency of the estimates for uPA and PAI-I for relapse-free survival (RFS) and MFS exploring possible sources of heterogeneity. Nodal status, the most important prognostic factor for breast cancer, introduced heterogeneity in the uPA/PAI-I survival analyses, reflecting the interaction between nodal status and uPA/PAI-I. The estimates for uPA and PAI-I were found to be consistent, even when a different transformation of their values was used. The heterogeneity of the separate data sets decreased if the levels of uPA and PAI-I were ranked, data sets were pooled, and the analyses corrected for the base model that included all traditional prognostic factors, and stratified by data set. We conclude that uPA and PAI-I are ready to be used in the clinic to help classify breast cancer patients into high and low risk groups.
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| 4. |
- Look, MP, et al.
(author)
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Pooled analysis of prognostic impact of urokinase-type plasminogen activator and its inhibitor PAI-1 8377 breast cancer patients
- 2002
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In: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 94:2, s. 116-128
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Journal article (peer-reviewed)abstract
- Background: Urokinase-type plasminogen activator (uPA) and its inhibitor (PAI-1) play essential roles in tumor invasion and metastasis. High levels of both uPA and PAT-1 are associated with poor prognosis in breast cancer patients. To confirm the prognostic value of uPA and PAI-1 in primary breast cancer, we reanalyzed individual patient data provided by members of the European Organization for Research and Treatment of Cancer-Receptor and Biomarker Group (EORTC-RBG). Methods: The study included 18 datasets involving 8377 breast cancer patients. During follow-up (median 79 months), 35% of the patients relapsed and 27% died. Levels of uPA and PAI-1 in tumor tissue extracts were determined by different immunoassays; values were ranked within each dataset and divided by the number of patients in that dataset to produce fractional ranks that could be compared directly across datasets. Associations of ranks of uPA and PAI-1 levels with relapse-free survival (RFS) and overall survival (OS) were analyzed by Cox multivariable regression analysis stratified by dataset, including the following traditional prognostic variables: age, menopausal status, lymph node status, tumor size, histologic grade, and steroid hormone-receptor status. All P values were two-sided. Results: Apart from lymph node status, high levels of uPA and PAI-1 were the strongest predictors of both poor RFS and poor OS in the analyses of all patients. Moreover, in both lymph node-positive and lymph nodenegative patients, higher uPA and PAI-1 values were independently associated with poor RFS and poor OS. For (untreated) lymph node-negative patients in particular, uPA and PAI-1 included together showed strong prognostic ability (all P<.001). Conclusions: This pooled analysis of the EORTC-RBG datasets confirmed the strong and independent prognostic value of uPA and PAI-1 in primary breast cancer. For patients with lymph node-negative breast cancer, uPA and PAI-1 measurements in primary tumors may be especially useful for designing individualized treatment strategies.
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| 6. |
- Pohjola, V, et al.
(author)
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Effect of periodic melting on geochemical and isotopic signals in an ice core from Lomonosovfonna, Svalbard
- 2002
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In: J.Geophys.Res.. ; 107:D4, s. ACL 1-14
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Journal article (peer-reviewed)abstract
- In this work we examine the quality of the atmospherically deposited signals in an ice core taken from a periodically melting ice field, Lomonosovfonna on central Spitsbergen, Svalbard. The aim is to investigate how much the atmospheric deposited signals in the stratigraphy of ice pack are changed by periodic melting of the ice. To determine the impact of this melting on the stratigraphy found in the ice core, we use three diagnostics: 1) Association between peak values in the ice chemical and isotopic record and ice facies type; 2) Number of “annual” cycles in these records compared with independently-determined number of years represented in the ice core; 3) Statistical comparison between the isotopic record in the ice core and the isotope records from coastal stations from the same region. We find that during warm summers as much as 50% of the annual accumulation may melt and percolate into the firn, and in a median year this decreases to ca. 25 %. As a consequence of percolation the most mobile acids show upto 50 % higher concentrations in bubble poor ice facies compared with facies that are less affected by melt. Most of the other chemical species are less affected than the strong acids, and the stable water isotopes show little evidence of mobility Annual, or bi-annual cycles are detected in most parameters, and the water isotope record has a comparable statistical distribution to isotopic records from coastal stations. We conclude that ice cores from sites like Lomonosovfonna preserve an useful environmental record despite melt events and percolation, where most parameters displays an annual, or in poor cases a bi-annual atmospheric signal.
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| 7. |
- Pohjola, V, et al.
(author)
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Reconstruction of three centuries of annual accumulation rates based on the record of stable isotopes of water from Lomonosovfonna, Svalbard
- 2002
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In: Annals of glaciology. ; 35, s. 57-62
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Journal article (peer-reviewed)abstract
- We use the upper 81 m of the record of stable isotopes of water from a 122 m long ice core from Lomonosovfonna, central Spitsbergen, to construct an ice core chronology and the annual accumulation rates over the ice field. The isotope cycles are counted in the ice core record using a model that neglects short wavelength and low amplitude cycles. We find approximately the same number of ä18O cycles as years between known reference horizons, and assume these cycles represent annual cycles. Testing the validity of this assumption using cycles in äD shows that both records give similar numbers of cycles. Using the ä18O chronology, and de-compressing the accumulation records using the Nye flow model, we calculate the annual accumulation for the ice core site back to 1715 AD. We find that the average accumulation rate from 1715 to 1950 o was on average 0.30 m w.e. Accumulation rates increased ca. 25% during the later part of the 20th century to an average of 0.41 m w.e. for the period 1950 – 1997. The accumulation rates show highly significant 2.1 and 21 year periodicities, which gives credibility to our time scale.
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| 8. |
- Veldkamp, R., et al.
(author)
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Laparoscopic resection of colon Cancer: consensus of the European Association of Endoscopic Surgery (EAES)
- 2004
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In: Surgical endoscopy. - : Springer Science and Business Media LLC. - 1432-2218 .- 0930-2794. ; 18:8, s. 1163-85
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Journal article (peer-reviewed)abstract
- BACKGROUND: The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference on the laparoscopic resection of colon cancer during the annual congress in Lisbon, Portugal, in June 2002. METHODS: A systematic review of the current literature was combined with the opinions, of experts in the field of colon cancer surgery to formulate evidence-based statements and recommendations on the laparoscopic resection of colon cancer. RESULTS: Advanced age, obesity, and previous abdominal operations are not considered absolute contraindications for laparoscopic colon cancer surgery. The most common cause for conversion is the presence of bulky or invasive tumors. Laparoscopic operation takes longer to perform than the open counterpart, but the outcome is similar in terms of specimen size and pathological examination. Immediate postoperative morbidity and mortality are comparable for laparoscopic and open colonic cancer surgery. The laparoscopically operated patients had less postoperative pain, better-preserved pulmonary function, earlier restoration of gastrointestinal function, and an earlier discharge from the hospital. The postoperative stress response is lower after laparoscopic colectomy. The incidence of port site metastases is <1%. Survival after laparoscopic resection of colon cancer appears to be at least equal to survival after open resection. The costs of laparoscopic surgery for colon cancer are higher than those for open surgery. CONCLUSION: Laparoscopic resection of colon cancer is a safe and feasible procedure that improves short-term outcome. Results regarding the long-term survival of patients enrolled in large multicenter trials will determine its role in general surgery.
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