| 1. |
- Pillai, Rajath S, et al.
(författare)
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Assessment of Somatosensory and Psychosocial Function of Patients With Trigeminal Nerve Damage
- 2020
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Ingår i: Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 1536-5409 .- 0749-8047. ; 36:5, s. 321-335
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The present study assessed somatosensory changes related to trigeminal nerve damage using extensive evaluation tools and assessed the effect of such damage on the patients' psychosocial status and quality of life compared with healthy participants.METHODS: In 37 patients with intraorally or extraorally presenting trigeminal nerve damage diagnosed as painful or nonpainful posttraumatic trigeminal neuropathy, psychophysical tests like quantitative sensory testing (QST) and qualitative sensory testing and the electrophysiological "nociceptive-specific" blink reflex were performed. The patients and 20 healthy participants completed a set of questionnaires assessing their psychosocial status and quality of life.RESULTS: A loss or gain of somatosensory function was seen in at least 1 QST parameter in >88.9% of the patients. Patients in whom extraoral QST was performed showed an overall loss of somatosensory function, whereas intraoral QST showed a general gain of somatosensory function. Qualitative sensory testing identified a side-to-side difference in the tactile and pinprick stimulation in >77% of the patients. An abnormal "nociceptive-specific" blink reflex response was seen in 42.1% to 71.4% of patients dependent on the trigeminal branch stimulated, though comparisons with healthy reference values showed ambiguous results. Compared with the healthy participants, patients showed higher scores for pain catastrophizing, symptoms of depression and anxiety, limited jaw function, more somatic symptoms, and significantly impaired oral health-related quality of life (all P<0.038).DISCUSSION: The results from the present study showed presence of varied somatosensory abnormalities when assessed using psychophysical and electrophysiological investigations and a significantly impaired psychosocial status.
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| 2. |
- Andersson, Henrik, 1968-, et al.
(författare)
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Competency requirements for the assessment of patients with mental illness in somatic emergency care : A modified Delphi study from the nurses’ perspective
- 2020
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 40:3, s. 162-170
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Tidskriftsartikel (refereegranskat)abstract
- Patients suffering from mental illness are vulnerable, and they do not always have access to proper emergency care. The aim of this study was to identify competency requirements for the assessment of patients with mental illness by soliciting the views of emergency care nurses. A modified Delphi method comprising four rounds was used. Data were collected in Sweden between October 2018 and March 2019. The data were analyzed using content analysis and descriptive statistics. The panel of experts reached the highest level of consensus regarding basic medical knowledge: the capability to listen and show respect to the patient are essential competency requirements when assessing patients with mental illness in emergency care. Awareness of these competency requirements will enhance teaching and training of emergency care nurses.
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| 3. |
- Broesby-Olsen, Sigurd, et al.
(författare)
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Multidisciplinary Management of Mastocytosis : Nordic Expert Group Consensus
- 2016
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 96:5
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Tidskriftsartikel (refereegranskat)abstract
- Mastocytosis is a heterogeneous group of diseases defined by an increased number and accumulation of mast cells, and often also by signs and symptoms of mast cell activation. Disease subtypes range from indolent to rare aggressive forms. Mastocytosis affects people of all ages and has been considered rare; however, it is probably underdiagnosed with potential severe implications. Diagnosis can be challenging and symptoms may be complex and involve multiple organ-systems. In general it is advised that patients should be referred to centres with experience in the disease offering an individualized, multidisciplinary approach. We present here consensus recommendations from a Nordic expert group for the diagnosis and general management of patients with mastocytosis.
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| 4. |
- Eklund Karlsson, Leena, 1956-, et al.
(författare)
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Are universal measures sufficient in reducing child poverty in the Nordic countries? : An analysis of policies and political commitments
- 2022
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Ingår i: Scandinavian Journal of Public Health. - London : Sage Publications. - 1403-4948 .- 1651-1905. ; 50:7, s. 892-902
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Tidskriftsartikel (refereegranskat)abstract
- Background: The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have long traditions of social welfare policies that have eradicated poverty as part of their goals. The purpose of this study was to increase our understanding of why child poverty is still significant in the Nordic countries despite existing strategies. Methods: A qualitative analysis of Nordic government documents and reports between 2007 and 2019 was carried out to track changes in public health priorities and political measures and to determine the similarities and differences between the five countries. Results: In all countries, most of the measures were universal, such as benefits during pregnancy, paid parental leave before and after the child was born, paid parental leave related to children’s sickness, child allowances, day care, free health care for children and support for disabled children. National policies aimed to reduce social inequalities and child poverty exist in all five countries, but unaffordable housing, unequal disposable family income distribution and unequal income distribution at local municipality levels seem to be obstacles to reaching national policy goals. Conclusions: Despite comprehensive universal measures to eradicate child poverty, inequalities are significant and increasing in some of the Nordic countries. This might be due to a lack of proportional universalism, where universal measures are in place in all Nordic countries, but with a lack of scale and intensity proportional to the children and families at risk. The significance of eliminating social inequalities needs to be emphasised at the local level.
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| 5. |
- Hjorth, Martin, et al.
(författare)
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Thalidomide and dexamethasone vs. bortezomib and dexamethasone for melphalan refractory myeloma: a randomized study.
- 2012
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Ingår i: European journal of haematology. - : Wiley. - 0902-4441 .- 1600-0609. ; 88:6, s. 485-496
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Thalidomide and bortezomib have been frequently used for second-line therapy in patients with myeloma relapsing after or refractory to initial melphalan-based treatment, but no randomized trials have been published comparing these two treatment alternatives. Methods: Thalidomide- and bortezomib-naïve patients with melphalan refractory myeloma were randomly assigned to low-dose thalidomide + dexamethasone (Thal-Dex) or bortezomib + dexamethasone (Bort-Dex). At progression on either therapy, the patients were offered crossover to the alternative drug combination. An estimated 300 patients would be needed for the trial to detect a 50% difference in median PFS between the treatment arms. Results: After inclusion of 131 patients, the trial was prematurely closed because of low accrual. Sixty-seven patients were randomized to Thal-Dex and 64 to Bort-Dex. Progression-free survival was similar (median, 9.0 months for Thal-Dex and 7.2 for Bort-Dex). Response rate was similar (55% for Thal-Dex and 63% for Bort-Dex), but time to response was shorter (P < 0.05) and the VGPR rate higher (P < 0.01) for Bort-Dex. Time-to-other treatment after crossover was similar (median, 13.2 months for Thal-Dex and 11.2 months for Bort-Dex), as was overall survival (22.8 months for Thal-Dex and 19.0 for Bort-Dex). Venous thromboembolism was seen in seven patients and cerebrovascular events in four patients in the Thal-Dex group. Severe neuropathy, reactivation of herpes virus infections, and mental depression were more frequently observed in the Bort-Dex group. In the quality-of-life analysis, no difference was noted for physical function, pain, and global quality of life. Fatigue and sleep disturbances were significantly more prevalent in the Bort-Dex group. Conclusions: Thalidomide (50–100 mg daily) in combination with dexamethasone seems to have an efficacy comparable with that of bortezomib and dexamethasone in melphalan refractory myeloma. However, the statistical strength of the results in this study is limited by the low number of included patients.
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| 6. |
- Karlsson, Lene, et al.
(författare)
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Characteristics and outcome of primary resistant disease in paediatric acute myeloid leukaemia
- 2023
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Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 201:4, s. 757-765
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Tidskriftsartikel (refereegranskat)abstract
- A significant proportion of events in paediatric acute myeloid leukaemia (AML) are caused by resistant disease (RD). We investigated clinical and biological characteristics in 66 patients with RD from 1013 children with AML registered and treated according to the NOPHO-AML 93, NOPHO-AML 2004, DB AML-01 and NOPHO-DBH AML 2012 protocols. Risk factors for RD were age10 years or older and a white-blood-cell count (WBC) of 100 x 10(9)/L or more at diagnosis. The five-year overall survival (OS) was 38% (95% confidence interval [CI]: 28%-52%). Of the 63 children that received salvage therapy with chemotherapy, 59% (N = 37) achieved complete remission (CR) with OS 57% (95% CI: 42%-75%) compared to 12% (95% CI: 4%-35%) for children that did not achieve CR. Giving more than two salvage chemotherapy courses did not increase CR rates. OS for all 43 patients receiving allogeneic haematopoietic stem cell transplantation (HSCT) was 49% (95% CI: 36%-66%). Those achieving CR and proceeding to HSCT had an OS of 56% (95% CI: 41%-77%, N = 30). This study showed that almost 40% of children with primary resistant AML can be cured with salvage therapy followed by HSCT. Children that did not achieve CR after two salvage courses with chemotherapy did not benefit from additional chemotherapy.
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| 7. |
- Karlsson, Lene, et al.
(författare)
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Fusion transcript analysis reveals slower response kinetics than multiparameter flow cytometry in childhood acute myeloid leukaemia
- 2022
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Ingår i: International Journal of Laboratory Hematology. - : Wiley. - 1751-5521 .- 1751-553X. ; 44:6, s. 1094-1101
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Analysis of measurable residual disease (MRD) is increasingly being implemented in the clinical care of children and adults with acute myeloid leukaemia (AML). However, MRD methodologies differ and discordances in results lead to difficulties in interpretation and clinical decision-making. The aim of this study was to compare results from reverse transcription quantitative polymerase chain reaction (RT-qPCR) and multiparameter flow cytometry (MFC) in childhood AML and describe the kinetics of residual leukaemic burden during induction treatment. Methods In 15 children who were treated in the NOPHO-AML 2004 trial and had fusion transcripts quantified by RT-qPCR, we compared MFC with RT-qPCR for analysis of MRD during (day 15) and after induction therapy. Eight children had RUNX1::RUNX1T1, one CBFB::MYH11 and six KMT2A::MLLT3. Results When >= 0.1% was used as cut-off for positivity, 10 of 22 samples were discordant. The majority (9/10) were MRD positive with RT-qPCR but MRD negative with MFC, and several such cases showed the presence of mature myeloid cells. Fusion transcript expression was verified in mature cells as well as in CD34 expressing cells sorted from diagnostic samples. Conclusions Measurement with RT-qPCR suggests slower response kinetics than indicated from MFC, presumably due to the presence of mature cells expressing fusion transcript. The prognostic impact of early measurements with RT-qPCR remains to be determined.
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| 8. |
- Karlsson, Lene
(författare)
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Treatment failure in pediatric acute myeloid leukemia: factors associated with frequency and outcome of resistant disease and relapse.
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although the prognosis for childhood acute myeloid leukemia (AML) has improved over the last decades to a survival of over 70%, still 30-40 % relapse and 5-10% experience resistant disease with poor prognosis. The aim of this thesis was to perform a detailed analysis of disease characteristics and treatment in children with relapsed and resistant AML to provide means to improve prognosis. Also, since early response to therapy is one of the strongest prognostic factors for outcome, kinetics of the reduction in fusion transcript levels during induction was investigated. The thesis consists of three population-based studies and one descriptive study. Paper I included 208 children with relapsed AML treated on two consecutive NOPHO protocols, 1993 and 2004. In the second paper fusion transcript levels were measured in fifteen children during induction. The third paper included all 66 children with resistant AML treated on the NOPHO93, NOPHO2004, DB AML-01 and NOPHO2012 protocols. The fourth paper included 326 children with relapsed AML treated on the NOPHO2004, DB AML-01 and the NOPHO2012 protocols. Reinduction therapy, followed by stem cell transplant gave the best outcome in both relapsed AML and resistant AML. In children with relapse, we found that time to relapse has been constant over the last decades and that 90% of relapses occur within 2 years from end of therapy. Children <2 years had shorter time to relapse. Given that the overall survival for children with relapsed and resistant AML continues to be poor, increased enrollment of these patients in collaborative trials are needed. Additional refinement of risk stratification, especially for standard and intermediate risk patients could prevent relapses.
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| 9. |
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| 10. |
- Lange, Lene, et al.
(författare)
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Nordic Bioeconomy : NCM reporting: Test centers for green energy solutions – Biorefineries and business needs
- 2016
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Bok (refereegranskat)abstract
- In 2014 the Nordic Council of Ministers initiated a new bioeconomy project: “Test centers for green energy solutions – Biorefineries and Business needs”. The purpose was to strengthen green growth in the area of the bioeconomy by analyzing and mapping the current status of the bioeconomy in the Nordic countries and identify potentials and obstacles, needs and opportunities. Based on this a set of policy recommendations was formulated. The project group participants were prominent scientists within the field of bioeconomy as well as government officials from all the Nordic countries. The project was headed by Professor Lene Lange, DTU, Denmark. The resulting Nordic Bioeconomy NCM Report consists of three parts: 1.Executive summary chapters (Introduction, Background, Scoping, Conclusions, Trends, Actions, and Recommendations, supplemented by highlights of the reporting from each of the Nordic countries).2. Full country reports on the bioeconomy, activities and available infrastructures from each of the Nordic countries, including Greenland and the Faroe Islands.3. A consultancy report (authored by Matis, Iceland) on business needs and opportunities within the bioeconomy, upgrading biological resources from agriculture, forestry, and fishery, as well as from industrial organic side streams and household waste.
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