| 1. |
- Bock, David, 1976, et al.
(författare)
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Learning curve for robot-assisted laparoscopic radical prostatectomy in a large prospective multicentre study
- 2022
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 56:3, s. 182-190
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Tidskriftsartikel (refereegranskat)abstract
- Objective Differences in outcome after radical prostatectomy for prostate cancer can partly be explained by intersurgeon differences, where degree of experience is one important aspect. This study aims to define the learning curve of robot-assisted laparoscopic prostatectomy (RALP) regarding oncological and functional outcomes. Materials and methods Out of 4003 enrolled patients in the LAPPRO trial, 3583 met the inclusion criteria, of whom 885 were operated on by an open technique. In total, 2672 patients with clinically localized prostate cancer from seven Swedish centres were operated on by RALP and followed for 8 years (LAPPRO trial). Oncological outcomes were pathology-reported surgical margins and biochemical recurrence at 8 years. Functional outcomes included patient-reported urinary incontinence and erectile dysfunction at 3, 12 and 24 months. Experience was surgeon-reported experience before and during the study. The relationship between surgeon experience and functional outcomes and surgical margin status was analysed by mixed-effects logistic regression. Biochemical recurrence was analysed by Cox regression, with robust standard errors. Results The learning curve for positive surgical margins was relatively flat, with rates of 21% for surgeons who had performed 0-74 cases and 24% for surgeons with > 300 cases. Biochemical recurrence at 4 years was 11% (0-74 cases) and 13% (> 300 cases). Incontinence was stable over the learning curve, but erectile function improved at 2 years, from 38% (0-74 cases) to 53% (> 300 cases). Conclusions Analysis of the learning curve for surgeons performing RALP showed that erectile function improved with increasing number of procedures, which was not the case for oncological outcomes.
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| 2. |
- Carlsson, Gunnar E, 1930, et al.
(författare)
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Attitudes toward dental appearance in 50- and 60-year-old subjects living in Sweden
- 2008
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Ingår i: Journal of Esthetic and Restorative Dentistry. - : Wiley. - 1496-4155 .- 1708-8240. ; 20:1, s. 46-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: Attitudes towards the importance of general appearance has varied much not only over time but also among groups of individuals of different age and other characteristics. Whether the situation is similar regarding dental appearance does not seem to have been studied. Purpose: The aim was to study differences in attitudes towards dental appearance between two large samples of 50- and 60-year-old subjects. Materials and Methods: Identical questionnaires were sent to all subjects born in 1942 and 1952 living in two Swedish counties in 2002 (n=17444; n50=8881; n60=8563). The final response rate was 72.2% (n=12599). In this study, responses to four statements on the importance of dental appearance have been analyzed with respect to gender and age. Results: Many of the responses to the four statements differed with gender and age. To the first statement (“To have beautiful and perfect teeth is very important for how you are treated by other people”), 73 % agreed at age 60 compared to 64 % at age 50 (P < 0.001). Approximately 90 % of the subjects agreed to the second statement (“Minor aesthetic imperfections of the teeth have no importance, only they function well”). Logistic regression indicated that several variables were significantly associated with the statements. Besides age and gender, education and self-assessed dental problems were most important. Conclusion: Attitudes towards the importance of dental appearance differed both between genders and age groups. CLINICAL SIGNIFICANCE The varying attitudes towards dental appearance in the population must be acknowledged in treatment decisions.
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| 3. |
- Carlsson, Gunnar E, 1930, et al.
(författare)
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Is there a trend of decreasing prevalence of TMD-related symptoms with ageing among the elderly?
- 2014
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Ingår i: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 72:8, s. 714-720
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Older adults have not been studied as much as younger ones regarding prevalence of TMD-related symptoms. The aim was to assess the prevalence of TMD-related symptoms in two population samples, 70 and 80 years old.Materials and methods: Identical questionnaires were in 2012 sent to all subjects born in 1932 and 1942 living in two Swedish counties. The response rate was 70.1%, resulting in samples of 5697 70-and 2922 80-year-old subjects. The questionnaire comprised 53 questions. Answers to questions on problems regarding TMD-related symptoms and awareness of bruxism were analysed.Results: Twelve per cent of the women and 7% of the men in the 70-year-old group reported some, rather great or severe problems regarding TMD pain. In the 80-year-olds the prevalence was 8% and 7%, respectively. Subjects who had problems with TMJ sounds reported difficulty to open the jaw wide 6-times and TMJ pain 10-13-times more frequently than subjects without such problems. Changes of taste and awareness of bruxism were the only variables significantly associated with TMD symptoms in both age groups. Number of teeth was not significantly associated with any of the TMD-related symptoms.Conclusions: Most of the elderly subjects had no severe problems with TMD-related symptoms, but 12% of the 70-year-old women reported some, rather great or severe problems. The marked gender difference at age 70 had disappeared in the 80-year-old group. The prevalence was lower among the 80-compared with the 70-year-old subjects of both sexes. The results support the comorbidity between TMD-related symptoms and general health problems.
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| 4. |
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| 5. |
- Carlsson, Leo S., et al.
(författare)
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Fibers of Failure : Classifying Errors in Predictive Processes
- 2020
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Ingår i: Algorithms. - : MDPI. - 1999-4893. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- Predictive models are used in many different fields of science and engineering and are always prone to make faulty predictions. These faulty predictions can be more or less malignant depending on the model application. We describe fibers of failure (FIFA), a method to classify failure modes of predictive processes. Our method uses MAPPER, an algorithm from topological data analysis (TDA), to build a graphical model of input data stratified by prediction errors. We demonstrate two ways to use the failure mode groupings: either to produce a correction layer that adjusts predictions by similarity to the failure modes; or to inspect members of the failure modes to illustrate and investigate what characterizes each failure mode. We demonstrate FIFA on two scenarios: a convolutional neural network (CNN) predicting MNIST images with added noise, and an artificial neural network (ANN) predicting the electrical energy consumption of an electric arc furnace (EAF). The correction layer on the CNN model improved its prediction accuracy significantly while the inspection of failure modes for the EAF model provided guiding insights into the domain-specific reasons behind several high-error regions.
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| 6. |
- CARLSSON, STEFAN, 1987, et al.
(författare)
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Age at surgery, educational level and long-term urinary incontinence after radical prostatectomy
- 2011
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Ingår i: BJU International. - 1464-4096 .- 1464-410X. ; 108:10, s. 1572-1577
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE To identify predictors for long-term urinary leakage after radical prostatectomy. PATIENTS AND METHODS A consecutive series of 1411 patients who underwent radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital between 2002 and 2006 were invited to complete a study-specific questionnaire. Urinary leakage was defined as use of two or more pads per day. RESULTS Questionnaires were received from 1288 (91%) patients with a median follow-up of 2.2 years. Age at surgery predicts in an exponential manner long-term urinary incontinence at follow-up with an estimated relative increase of 6% per year. Among the oldest patients, 19% had urinary incontinence compared with 6% in the youngest age group, translating to a prevalence ratio of 2.4 (95% confidence interval [CI], 1.5-8.1). Low educational level, as compared with high, yielded an increased age-adjusted prevalence ratio of 2.5 (95% CI, 1.7-3.9). Patients who had undergone salvage radiation therapy had an increased prevalence of urinary incontinence (2.5; 95% CI, 1.6-3.8), as did those with respiratory disease (2.4; 95% CI, 1.3-4.4). Body mass index, prostate weight, presence of diabetes or previous transurethral resection did not appear to influence the prevalence of urinary incontinence. CONCLUSIONS In this series, a patient's age at radical prostatectomy influenced, in an exponential manner, his risk of long-term urinary incontinence. Other predictors are low educational level, salvage radiation therapy and respiratory disease. Intervention studies are needed to understand if these data are relevant to the prevalence of urinary leakage if a radical prostatectomy is postponed in an active monitoring programme.
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| 7. |
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| 8. |
- CARLSSON, STEFAN, 1987, et al.
(författare)
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Orgasm-Associated Urinary Incontinence and Sexual Life after Radical Prostatectomy.
- 2011
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Ingår i: The journal of sexual medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Involuntary release of urine during sexual climax, orgasm-associated urinary incontinence, occurs frequently after radical prostatectomy. We know little about its prevalence and its effect on sexual satisfaction. Aim. To determine the prevalence of orgasm-associated incontinence after radical prostatectomy and its effect on sexual satisfaction. Methods. Consecutive series, follow-up at one point in calendar time of men having undergone radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital, Stockholm, Sweden, 2002-2006. Of the 1,411 eligible men, 1,288 (91%) men completed a study-specific questionnaire. Main Outcome Measure. Prevalence rate of orgasm-associated incontinence. Results. Of the 1,288 men providing information, 691 were sexually active. Altogether, 268 men reported orgasm-associated urinary incontinence, of whom 230 (86%) were otherwise continent. When comparing them with the 422 not reporting the symptom but being sexually active, we found a prevalence ratio (with 95% confidence interval) of 1.5 (1.2-1.8) for not being able to satisfy the partner, 2.1 (1.1-3.5) for avoiding sexual activity because of fear of failing, 1.5 (1.1-2.1) for low orgasmic satisfaction, and 1.4 (1.2-1.7) for having sexual intercourse infrequently. Prevalence ratios increase in prostate-cancer survivors with a higher frequency of orgasm-associated urinary incontinence. Conclusion. We found orgasm-associated urinary incontinence to occur among a fifth of prostate cancer survivors having undergone radical prostatectomy, most of whom are continent when not engaged in sexual activity. The symptom was associated with several aspects of sexual life. Nilsson AE, Carlsson S, Johansson E, Jonsson MN, Adding C, Nyberg T, Steineck G, and Wiklund NP. Orgasm-associated urinary incontinence and sexual life after radical prostatectomy. J Sex Med **;**:**-**.
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| 9. |
- Dahlström, Lars, et al.
(författare)
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Comparison of effects of electromyographic biofeedback and occlusal splint therapy on mandibular dysfunction.
- 1982
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Ingår i: Scandinavian journal of dental research. - 0029-845X. ; 90:2, s. 151-6
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Tidskriftsartikel (refereegranskat)abstract
- In order to evaluate and compare the effects of biofeedback and occlusal splint therapy on mandibular dysfunction, 30 patients were randomly divided into two treatment groups. The patients were women aged 20--40 years without any obvious organic reasons for their symptoms. There were no significant differences between the two groups before the start of treatment in respect of signs and symptoms of mandibular dysfunction. One group used full coverage splints at night for 6 weeks. The other group received biofeedback training up to six times, 30 min per session. One month after completion of the therapy the patients were re-examined. Both groups showed a significant reduction in symptoms, both subjectively and clinically. No significant differences between the groups were found. The two treatments were thus equally effective in the short-term perspective in patients with signs and symptoms of mandibular dysfunction.
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| 10. |
- Ekbäck, Gunnar, 1954-, et al.
(författare)
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Changes in dental status and prevalence of symptoms related to temporomandibular disorders in 50- to 70-year-old subjects : longitudinal and cross-sectional results
- 2013
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Ingår i: Journal of craniomandibular function. - Berlin : Quintessenz Verlags_GmbH. - 1868-4149. ; 5:4, s. 317-331
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to assess changes in prevalence of some reported TMD-related symptoms and dental status in 50-year-old subjects who were followed for 20 years. Identical questionnaires were sent to all subjects born in 1942 and living in two Swedish counties every fifth year, from 1992 to 2012. The response rate varied between 71 to 75%, resulting in five cross-sectional samples varying from 5,697 to 6,513 subjects, and a longitudinal sample of 3,585 subjects participating in all examinations. The great majority (80 to 90%) reported no symptoms related to TMD. Prevalence and symptom severity changed only little over time. Less than 3% considered their TMD symptoms to be severe or rather severe. The mean prevalence of TMD-related symptoms and bruxism was greater in women than in men, whereas gender differences in the number of teeth were extremely small. The longitudinal sample had similar prevalence of TMD-related symptoms and reported bruxism, but had more teeth and better chewing ability than the cross-sectional samples. It was concluded that the prevalence of TMD-related symptoms was low but higher in women than in men, whereas there was no gender difference in dental status. The longitudinal sample had more teeth than the cross-sectional samples but there was no difference regarding TMD-related symptoms.
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