| 1. |
- Bill-Axelson, Anna, et al.
(författare)
-
Radical Prostatectomy or Watchful Waiting in Prostate Cancer-29-Year Follow-up
- 2018
-
Ingår i: New England Journal of Medicine. - : Massachussetts Medical Society. - 0028-4793 .- 1533-4406. ; 379:24, s. 2319-2329
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Radical prostatectomy reduces mortality among men with clinically detected localized prostate cancer, but evidence from randomized trials with long-term followup is sparse. METHODS We randomly assigned 695 men with localized prostate cancer to watchful waiting or radical prostatectomy from October 1989 through February 1999 and collected follow-up data through 2017. Cumulative incidence and relative risks with 95% confidence intervals for death from any cause, death from prostate cancer, and metastasis were estimated in intention-to-treat and per-protocol analyses, and numbers of years of life gained were estimated. We evaluated the prognostic value of histopathological measures with a Cox proportional-hazards model. RESULTS By December 31, 2017, a total of 261 of the 347 men in the radical-prostatectomy group and 292 of the 348 men in the watchful-waiting group had died; 71 deaths in the radical-prostatectomy group and 110 in the watchful-waiting group were due to prostate cancer (relative risk, 0.55; 95% confidence interval [CI], 0.41 to 0.74; P<0.001; absolute difference in risk, 11.7 percentage points; 95% CI, 5.2 to 18.2). The number needed to treat to avert one death from any cause was 8.4. At 23 years, a mean of 2.9 extra years of life were gained with radical prostatectomy. Among the men who underwent radical prostatectomy, extracapsular extension was associated with a risk of death from prostate cancer that was 5 times as high as that among men without extracapsular extension, and a Gleason score higher than 7 was associated with a risk that was 10 times as high as that with a score of 6 or lower (scores range from 2 to 10, with higher scores indicating more aggressive cancer). CONCLUSIONS Men with clinically detected, localized prostate cancer and a long life expectancy benefited from radical prostatectomy, with a mean of 2.9 years of life gained. A high Gleason score and the presence of extracapsular extension in the radical prostatectomy specimens were highly predictive of death from prostate cancer.
|
|
| 2. |
- de la Torre, M., et al.
(författare)
-
Elevated expression of estramustine binding protein (EMBP) in prostatic intraepithelial neoplasia (PIN) compared with malignant and benign prostatic epithelia
- 1994
-
Ingår i: The Prostate. - 0270-4137 .- 1097-0045. ; 25:3, s. 125-31
-
Tidskriftsartikel (refereegranskat)abstract
- The expression of estramustine-binding protein (EMBP) was studied immunohistochemically in whole-mount prostate sections. Specimens were taken from the prostates of 15 patients who had undergone total prostatectomy due to localized (TOd-T2 NO MO) prostatic cancer (PC). Almost all the examined whole-mount sections displayed areas with prostatic intraepithelial neoplasia (PIN). PIN is regarded as the main precursor of invasive PC. High- and low-grade PIN expressed EMBP. The average positively stained areas accounted for averages of 69.2% and 48.7%, respectively. High-grade PIN contained the highest EMBP levels of all the investigated (benign and malignant) epithelia, followed by moderately differentiated PC. With regard to areas with PC, the highest levels of EMBP expression (61.3%) were observed in moderately differentiated PC; poorly differentiated PC came second. Of all the examined epithelia, EMBP levels were lowest in well-differentiated PC (25.8%). Normal prostatic epithelia and hyperplasia were characterized by low EMBP expression, although somewhat higher than well-differentiated PC. A moderate expression (45%) was observed in the seminal vesicles. According to these results, EMBP was expressed mainly in the diseased peripheral zone (PZ), where PIN and prostatic cancer have their highest prevalence.
|
|
| 3. |
- Romell, Jenny, et al.
(författare)
-
Virtual histology of dried and mummified biological samples by laboratory phase-contrast tomography
- 2019
-
Ingår i: X-Ray Nanoimaging. - : SPIE - The International Society for Optics and Photonics.
-
Konferensbidrag (refereegranskat)abstract
- Ancient remains from humans, animals and plants hold valuable information about our history. X-ray imaging methods are often, because of their non-destructive nature, used in the analysis of such samples. The classical x-ray imaging methods, radiography and computed tomography (CT), are based on absorption, which works well for radiodense structures like bone, but gives limited contrast for textiles and soft tissues, which exhibit high x-ray transmission. Destructive methods, such as classical histology, have historically been used for analysing ancient soft tissue but the extent to which it is used today is limited because of the fragility and value of many ancient samples. For detailed, non-destructive analysis of ancient biological samples, we instead propose x-ray phase-contrast CT, which like conventional CT gives volume data but with the possibility of better resolution through the detection of phase shift. Using laboratory x-ray sources, we here demonstrate the capabilities of phase-contrast tomography of dried biological samples. Virtual histological analysis of a mummified human hand from ancient Egypt is performed, revealing remains of adipose cells in situ, which would not be possible with classical histology. For higher resolution, a lab-based nano-CT arrangement based on a nanofocus transmission x-ray source is presented. With an x-ray emission spot of 300 nm the system shows potential for sub-micronresolution 3D imaging. For characterisation of the performance of phase-contrast imaging of dried samples a piece of wood is imaged. Finally, we present the first phase-contrast CT data from our nano-CT system, acquired of the dried head of a bee.
|
|
| 4. |
|
|
| 5. |
- Edgren, M, et al.
(författare)
-
Postoperative radiotherapy after prostatectomy can be associated with severe side effects.
- 2001
-
Ingår i: Anticancer research. - 0250-7005. ; 21, s. 2231-
-
Tidskriftsartikel (refereegranskat)abstract
- This retrospective study was initiated to evaluate the efficacy and side effects of post-prostatectomy external beam radiation therapy (XRT) with a short time interval between surgery and irradiation in patients with prostate adenocarcinoma. Sixteen patients were investigated. The overall results in this study were 3 deaths due to recurring disease and two relapses after an average follow-up of 60 months. Severe side effects were observed. Two patients required surgical intervention due to severe post-radiotherapy side effects. The reason for this could be the high dose delivered to peripheral organs and/or a too short time interval between surgery and postoperative XRT. The results of this study confirmed that postoperative XRT can improve local control frequency in prostate carcinomas. It is recommended that the time interval between surgery and postoperative radiotherapy should to be 3-6 month.
|
|
| 6. |
- Häggman Henrikson, Birgitta, et al.
(författare)
-
Pharmacological treatment of oro-facial pain : health technology assessment including a systematic review with network meta-analysis
- 2017
-
Ingår i: Journal of Oral Rehabilitation. - Hoboken : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 44:10, s. 800-826
-
Forskningsöversikt (refereegranskat)abstract
- This health technology assessment evaluated the efficacy of pharmacological treatment in patients with oro-facial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients >= 18 years with chronic (>= 3 months) oro-facial pain. Patients were divided into subgroups: TMD-muscle [ temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment. The scientific quality of the evidence was rated according to GRADE. An electronic search in PubMed, Cochrane Library, and EMBASE from database inception to 1 March 2017 combined with a handsearch identified 1552 articles. After screening of abstracts, 178 articles were reviewed in full text and 57 studies met the inclusion criteria. After risk of bias assessment, 41 articles remained: 15 studies on 790 patients classified as TMD-joint, nine on 375 patients classified as TMD-muscle and 17 on 868 patients with BMS. Of these, eight studies on TMD-muscle, and five on BMS were included in separate network meta-analysis. The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain. The network meta-analysis showed that clonazepam and capsaicin reduced pain intensity in BMS, and the muscle relaxant cyclobenzaprine, for the TMD-muscle group. In conclusion, based on a limited number of studies, evidence provided with network meta-analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine has a positive treatment effect for TMD-muscle pain.
|
|
| 7. |
- Häggman, M, et al.
(författare)
-
Morphometric studies of intra-prostatic volume relationships in localized prostatic cancer
- 1997
-
Ingår i: British Journal of Urology. - : BLACKWELL SCIENCE LTD. - 0007-1331 .- 1365-2176. ; 80:4, s. 612-617
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To further characterize patterns of tumour growth and the distribution of markers for the aggressiveness of prostate cancer by assessing the relationships among the volume of the 'index' tumour and that of the remaining foci, with pathological
|
|
| 8. |
- John, M. T., et al.
(författare)
-
Recommendations for use and scoring of oral health impact profile versions
- 2022
-
Ingår i: Journal of Evidence-Based Dental Practice. - Philadelphia, PA, United States : Elsevier. - 1532-3382 .- 1532-3390. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: OHIP's original seven-domain structure does not fit empirical data, but a psychometrically sound and clinically more plausible structure with the four OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact has emerged. Consequently, use and scoring of available OHIP versions need to be revisited. Aim: We assessed how well the overall construct OHRQoL and its four dimensions were measured with several OHIP versions (20, 19, 14, and 5 items) to derive recommendations which instruments should be used and how to score them. Methods: Data came from the “Dimensions of OHRQoL Project” and used the project's learning sample (5,173 prosthodontic patients and general population subjects with 49-item OHIP data). We computed correlations among OHIP versions’ summary scores. Correlations between OHRQoL dimensions, on one hand, and OHIP versions’ domain scores or OHIP-5′s items, on the other hand, were also computed. OHIP use and scoring recommendations were derived for psychometrically solid but also practical OHRQoL assessment. Results: Summary scores of 5-, 14-, 19- and 49-item versions correlated highly (r = 0.91–0.98), suggesting similar OHRQoL construct measurement across versions. The OHRQoL dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were best measured by the OHIP domain scores for Physical Disability, Physical Pain, Psychological Discomfort, and Handicap, respectively. Conclusion: Recommendations were derived which OHIP should be preferably used and how OHIP versions should be scored to capture the overall construct and the dimensions of OHRQoL. Psychometrically solid and practical OHRQoL assessment in all settings across all oral health conditions can be achieved with the 5-item OHIP.
|
|
