| 1. |
- Levine, Hagai, et al.
(författare)
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Male reproductive health statement (XIIIth international symposium on Spermatology, may 9th-12th 2018, Stockholm, Sweden
- 2018
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Ingår i: Basic and Clinical Andrology. - : Springer Science and Business Media LLC. - 2051-4190. ; 28:1
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Tidskriftsartikel (refereegranskat)abstract
- On the occasion of the XIIIth International Symposium on Spermatology held from 9 to 13 May 2018 in Stockholm (Sweden), participants (guest speakers and audience) collectively felt the need to make a public statement on the general issue of male reproductive health. Our intention is to raise awareness of what we believe is a neglected area of research despite alarming situations around the world. The disclosure strategy desired by the co-authors is to bring it to the attention of the greatest number partly by considering co-publication in the various periodicals dealing with Reproductive Biology and Andrology. BaCA's editorial office accepted this mission and found it natural that our periodical, the official journal of the French Andrology Society (SALF), should carry this message.
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| 2. |
- Axén, Elin, et al.
(författare)
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Biochemical recurrence after radical prostatectomy - a large, comprehensive, population-based study with long follow-up
- 2022
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 56:4, s. 287-292
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Tidskriftsartikel (refereegranskat)abstract
- Objective We evaluated long-term risk for biochemical recurrence and subsequent prognosis in a population-based cohort. Material and Methods We used register-based data to evaluate 6 675 consecutive patients having radical prostatectomy in Vastra Gotaland county in Sweden during 1995-2014. Patients were followed until death or end of study, 31 December 2014. Data were collected from registers on national, regional and local level and linked by means of the Swedish personal identity number. Biochemical recurrence was defined as PSA >= 0.2 ng/ml; failure as hormonal treatment, metastasis or prostate cancer death. Survival analysis was used to estimate time to biochemical recurrence and time to failure after biochemical recurrence for patients with 0 - 2 years, 2-5 years, 5-10 years and >10 years interval to biochemical recurrence, respectively. Results A total of 1214 men had biochemical recurrence during follow-up. Biochemical recurrence-free survival was 83% (95% confidence interval [CI] 82-84%), 75% (95% CI 74-77%) and 69% (95% CI 67-71%) at 5, 10 and 15 years, respectively. Cumulative incidence of failure for all patients 15 years after biochemical recurrence was 50% (95% CI 43-55%) in competing risk analysis .The risk of failure after biochemical recurrence was highest among patients having biochemical recurrence within 2 years from surgery. Incomplete data on PSA-history is a limitation. Conclusions The risk for biochemical recurrence persists 15 years after surgery. Follow-up should continue as long as treatment would be considered in case of recurrent disease.
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| 3. |
- Frånlund, Maria, et al.
(författare)
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Results from 22 years of Followup in the Göteborg Randomized Population-Based Prostate Cancer Screening Trial
- 2022
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Ingår i: Journal of Urology. - 0022-5347 .- 1527-3792. ; 208:2, s. 292-300
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:Our goal was to analyze results from 22 years of followup in the Göteborg randomized prostate cancer (PC) screening trial.Materials and Methods:In December 1994, 20,000 men born 1930-1944 were randomly extracted from the Swedish population register and were randomized (1:1) into either a screening group (SG) or to a control group (CG). Men in the SG were repeatedly invited for biennial prostate specific antigen testing up to an average age of 69 years. Main endpoints were PC incidence and mortality (intention-to-screen principle).Results:After 22 years, 1,528 men in the SG and 1,124 men in the CG had been diagnosed with PC. In total, 112 PC deaths occurred in the SG and 158 in the CG. Compared with the CG, the SG showed a PC incidence rate ratio (RR) of 1.42 (95% CI, 1.31-1.53) and a PC mortality RR of 0.71 (95% CI, 0.55-0.91). The 22-year cumulative PC mortality rate was 1.55% (95% CI, 1.29-1.86) in the SG and 2.13% (95% CI, 1.83-2.49) in the CG. Correction for nonattendance (Cuzick method) yielded a RR of PC mortality of 0.59 (95% CI, 0.43-0.80). Number needed to invite and number needed to diagnose was estimated to 221 and 9, respectively. PC death risk was increased in the following groups: nontesting men, men entering the program after age 60 and men with >10 years of followup after screening termination.Conclusions:Prostate specific antigen-based screening substantially decreases PC mortality. However, not attending, starting after age 60 and stopping at age 70 seem to be major pitfalls regarding PC death risk.
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| 4. |
- Godtman, Rebecka Arnsrud, 1981, et al.
(författare)
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High accuracy of Swedish death certificates in men participating in screening for prostate cancer: A comparative study of official death certificates with a cause of death committee using a standardized algorithm.
- 2011
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Ingår i: Scandinavian journal of urology and nephrology. - : Informa UK Limited. - 1651-2065 .- 0036-5599.
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. Recently, the first mortality data from the Göteborg Randomized Population-based Prostate Cancer Screening Trial showed a 44% reduction in prostate cancer (PC)-specific mortality as a result of screening with prostate-specific antigen (PSA). As death of PC is the main endpoint, an accurate determination of the cause of death (COD) is crucial. The aim of this study was therefore to investigate the accuracy of death certificates of men in the Göteborg Randomized Population-based Prostate Cancer Screening Trial. Material and methods. Men with a PC diagnosis and who died within the study period (1995-2008) were included. Relevant medical information, including death certificate, was collected. An independent COD committee reviewed the material following a flowchart to classify the COD. The committee's decision was compared with the COD on the death certificate. Results. Of the 285 men included in the study, 278 men were eligible for a comparative analysis. The committee and the death certificates agreed on PC as the underlying COD in 116 men and causes other than PC in 151. There were 11 discordant cases, for an overall agreement of 96%. Men with PC in the screening group had, compared with the control group, a significantly lower PC-specific mortality but did not differ in non-PC-specific mortality. Conclusion. This study concludes that Swedish death certificates are of high accuracy and can be used for endpoint evaluation in screening studies for PC.
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| 5. |
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| 6. |
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| 7. |
- Godtman, Rebecka Arnsrud, 1981, et al.
(författare)
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Outcome Following Active Surveillance of Men with Screen-detected Prostate Cancer. Results from the Göteborg Randomised Population-based Prostate Cancer Screening Trial.
- 2013
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Ingår i: European urology. - : Elsevier BV. - 1873-7560 .- 0302-2838. ; 63:1, s. 101-107
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Active surveillance (AS) has emerged as a treatment strategy for reducing overtreatment of screen-detected, low-risk prostate cancer (PCa). OBJECTIVE: To assess outcomes following AS of men with screen-detected PCa. DESIGN, SETTING, AND PARTICIPANTS: Of the 968 men who were diagnosed with screen-detected PCa between 1995 and 2010 in the Göteborg randomised, population-based PCa screening trial, 439 were managed with AS and were included in this study. Median age at diagnosis was 65.4 yr of age, and median follow-up was 6.0 yr from diagnosis. INTERVENTION: The study participants were followed at intervals of 3-12 mo and were recommended to switch to deferred active treatment in case of a progression in prostate-specific antigen, grade, or stage. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The end points-overall survival (OS), treatment-free survival, failure-free (no relapse after radical treatment) survival, and cancer-specific survival-were calculated for various risk groups (very low, low, intermediate, and high) with Kaplan-Meier estimates. A Cox proportional hazards model as well as a competing risk analysis were used to assess whether risk group or age at diagnosis was associated with failure after AS. RESULTS AND LIMITATIONS: Forty-five per cent of all screen-detected PCa were managed with AS, and very low-risk and low-risk PCa constituted 60% of all screen-detected PCa. Thirty-seven per cent (162 of 439) switched from surveillance to deferred active treatment, and 39 men failed AS. The 10-yr OS, treatment-free survival, and failure-free survival were 81.1%, 45.4%, and 86.4%, respectively (Kaplan-Meier estimates). Men with low-, intermediate-, and high-risk tumours had a hazard ratio for failure of 2.1 (p=0.09), 3.6 (p=0.002), and 4.6 (p=0.15), respectively, compared to very low-risk tumours (Cox regression). Only one PCa death occurred, and one patient developed metastasis (both in the intermediate-risk group). The main limitation of this study is the relatively short follow-up. CONCLUSIONS: A large proportion of men with screen-detected PCa can be managed with AS. AS appears safe for men with low-risk PCa.
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| 9. |
- Holmberg, Rebecka, et al.
(författare)
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Antiviral treatments reduce severity of diabetes in Ljungan virus-infected CD-1 mice and delay onset in diabetes-prone BB rats
- 2009
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Ingår i: Microbiology and immunology. - : Wiley. - 0385-5600 .- 1348-0421. ; 53:10, s. 567-572
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Tidskriftsartikel (refereegranskat)abstract
- The effects of LV in two different species, CD-1 mice, without a genetic disposition for diabetes, and BB rats prone to T1D were examined. Male CD-1 mice that had been exposed to LV in utero developed a type 2-like diabetes with increased blood glucose, insulin levels and epididymal fat at the age of 10-15 weeks. Combination therapy including LV-antiserum and an antiviral drug, Pleconaril, significantly reduced the levels of blood glucose and insulin and the amount of abdominal fat. In BB rats, LV has been found in both prediabetic- and diabetic diabetes-prone rats, as well as in diabetes-resistant rats. To evaluate whether the presence of LV has any influence on the onset of T1D, prediabetic BB rats were treated with an antiserum against LV or a combination of the antiviral drugs Pleconaril and Ribavirin. In the group treated with antiviral drugs, the onset was significantly delayed. These results indicate that the presence of LV can be involved in the pathogenesis of diabetes in these animal models.
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| 10. |
- Holmberg, Rebecka
(författare)
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Apolipoprotein CIII and Ljungan virus in diabetes
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- It has been shown that there are patients with type 1 diabetes (T1D), whose sera induce an increased activity of voltage-gated Ca2+-channels in pancreatic beta-cells, resulting in increased cytoplasmic free Ca2+ concentration ([Ca2+]i) and apoptosis. Purification of the protein in the active fraction of T1D sera revealed that the observed effects were mediated by apolipoprotein CIII (apoCIII), and this protein was shown to be increased in serum from T1D patients. To be able to evaluate the importance of apoCIII in vivo for the development of T1D there is a need for a suitable animal model. We used the animal model diabetes-prone BB rat (DPBB) that spontaneously, at the age of around 60 days, develops a human-like T1D. Isolated islet cells cultured overnight in the presence of 10% sera from 60 days old prediabetic BB rats had a higher increase in [Ca2+]i upon depolarization with K+, an impaired glucose-induced insulin secretion and a decreased viability, compared to cells exposed to age-matched control sera. The prediabetic sera with this effect are referred to as positive (pos). The effect on [Ca2+]i was abolished when an antibody against apoCIII was present during culture. The relative amounts of apoCIII in pos, neg and control sera from 60 days old rats were evaluated and the content in pos sera was significantly higher. To investigate the effects of apoCIII in vivo, DPBB rats were treated with either active or inactive antisense against apoCIII between the age of 12 to 40 days. The apoCIII antisense treatment significantly delayed the onset of diabetes. Wild bank voles (Myodes glareolus) develop T1D and a picornavirus, named Ljungan virus (LV), has been isolated from these animals. If CD-1 mice, that normally do not carry LV, are infected with this virus in utero and exposed to stress after birth, the male offspring get type 2 diabetes. In BB rats LV was found in both prediabetic- and diabetic DPBB rats, as well as in diabetes-resistant rats. To evaluate if the presence of virus influences the onset of T1D, prediabetic rats were given antiviral treatments, which prolonged the prediabetic phase with approximately one week. The interplay between LV and diabetes is complicated and still not understood, and our data does not exclude a role of this virus in the development of diabetes.
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