| 1. |
- Osmancevic, Amra, 1968, et al.
(författare)
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Size of the exposed body surface area, skin erythema and body mass index predict skin production of vitamin D
- 2015
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Ingår i: Journal of Photochemistry and Photobiology B-Biology. - : Elsevier BV. - 1011-1344. ; 149, s. 224-229
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cholecalciferol (vitamin D-3), produced in the skin by UVB irradiation (290-315 nm) of 7-dehydrocholesterol, is metabolized in the liver into 25-hydroxyvitamin D [25(OH)D] which is a major circulating metabolite. Aim: To examine changes in serum concentrations of cholecalciferol and its metabolites after UVB exposure of different skin areas. Methods: 21 healthy Caucasians (skin type II and III, aged 23-47 years) were exposed to broadband UVB (290-320 nm) and randomized to either exposure to one minimal erythema dose given as a single dose, or a suberythemic dose given for 3 subsequent days. The following areas were exposed: face and back of hands, upper half of the body and the whole body, respectively. Serum cholecalciferol and 25(OH)D were measured immediately before start and 24 h after the 1st and last exposure, respectively. Results: Subjects with whole body exposure had an average S-cholecalciferol increase per dose unit of 0.18 ng m1(-1) mJ(-1) cm(2), 0.95 CI: (0.16, 0.20), upper body treatment 0.13 ng ml(-1) mJ(-1) cm(2), 0.95 CI: (0.10, 0.15) and face and hands exposure 0.013 ng ml(-1) mJ(-1) cm(2), 0.95 CI: (-0.012, 0.037). The increase in cholecalciferol correlated positively to the UVB dose and skin erythema and negatively to body mass index (BMI) when controlling for other factors. Exposure of face and hands induces smaller cholecalciferol production in comparison with exposure of larger skin areas. Conclusion: Size of the exposed skin area, UVB dose, skin erythema and BMI were the major determinants for serum levels of skin synthesized cholecalciferol. Exposure of hands and face induces smaller cholecalciferol production in comparison with exposure of larger skin areas.
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| 2. |
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| 3. |
- Berglind, Mari, 1953-, et al.
(författare)
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Uppskattning av antal patienter med basalcellscancer i Sverige under 2003 samt kostnader för diagnostik och behandling
- 2006
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- SSI:s vetenskapliga UV-råd skall ge myndigheten råd om det vetenskapliga underlaget beträffande sambandet UV-strålning och biologiska effekter. Vidare ligger i uppdraget att ge vägledning inför SSI:s ställningstagande i frågor av policykaraktär. Rådet har under året haft följande ledamöter: docent Harry Beitner, docent Yvonne Brandberg, meteorolog Weine Josefsson, professor Olle Larkö, professor Ulrik Ringborg (ordförande), docent Bernt Lindelöf, professor Per Söderberg, professor Rune Toftgård, docent Johan Hansson och docent Johan Westerdahl. Till rådet har adjungerats myndighetsspecialist Lars-Erik Paulsson.Alla tre hudcancerformer - malignt melanom, skivepitelcancer och basalcellscancer – ökar i Sverige och internationellt. Gemensamt för alla tre formerna är att ökningen sammanhänger med exposition av solens UV-strålning, den viktigaste yttre riskfaktorn. Av detta följer att modifiering av UV-exposition, framför allt genom ändrade solvanor i befolkningen, bör kunna leda till en minskning av förekomsten av hudcancer. Primär prevention genom förebyggande insatser med syfte minskad UV-exposition, bedöms vara ett betydelsefullt sätt att motverka uppkomsten av alla tre formerna av hudcancer.Ett annat gemensamt drag hos dessa tre tumörformer är nyttan av tidig diagnostik. Ett tidigt avlägsnande av en hudcancer innebär mindre sjukvårdsinsatser och, för framför allt malignt melanom, minskad risk för tumörspridning. Tumörutvecklingen sker ofta via förstadier och ökad kunskap om dessa leder till möjligheter att avlägsna förstadier innan dessa har hunnit bli elakartade tumörer. Denna form av tidigdiagnostik gränsar till den primära preventionen.Av de tre formerna hudcancer är det i första hand malignt melanom som kan förorsaka död i sjukdomen. Ett väsentligt mål med förebyggande insatser är därför att minska dödligheten. För alla tre formerna kan insjuknande förorsaka betydande besvär för patienten. På grund av den rikliga förekomsten av maligna hudtumörer är sjukvårdskostnader betydande. Därför är mål för förebyggande insatser också minskad morbiditet och sjukvårdskostnader. Förutom hudcancer orsakar solens UV-strålning betydande problem i form av ögonskador.I årets rapport redovisas (1) epidemiologiska aspekter av malignt hudmelanom, som under senare år uppvisar en stegrad ökningstakt; (2) maligna melanom hos barn och ungdomar; (3) förslag till studier av skivepitelcancer och yrke; (4) förekomst och kostnader för medicinsk handläggning av patienter med basalcellscancer, som visar höga incidenssiffror och höga kostnader; (5) lymfom och UV-strålning; (6) UV-strålning och katarakt, betydelsefullt med förebyggande åtgärder; (7) förslag till workshop om cellulära effekter av UV-strålning; (8) rekommendation att använda den uppgraderade versionen av European Code Against Cancer; (9) UV-strålning och vitamin D, viss UV-dos är av nytta; (10) dosrat och fraktioner av UV-strålning i relation till utveckling av hudcancer och hos möss, påverkar ej preventiva strategier; (11) debatt om ökad solexposition eventuellt skulle leda till förbättrad överlevnad för melanompatienter ändrar ej preventiva strategier; (12) synpunkter på primär prevention från 6th World Conference on Melanoma, Vancouver, 2005.
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| 4. |
- Ekman, Inger, 1952, et al.
(författare)
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The person-centred approach to an ageing society
- 2013
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Ingår i: European Journal for Person Centered Healthcare. - : University of Buckingham Press. - 2052-5656 .- 2052-5648. ; 1:1, s. 132-137
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Tidskriftsartikel (refereegranskat)abstract
- Modern care is often based on investigations such as laboratory markers and imaging - for example, x-ray or ultrasound. The results contribute to a diagnosis and, if judged necessary, treatment is initiated. This diseased-oriented approach is the prevailing mode of management in modern medicine. In contrast, person-centered care (PCC) takes the point of departure from each person´s subjective experience of illness and its impact on daily life. A patient is considered as a person with emotions and feelings. PCC is considered present within clinical care according to a definition articulated by the Centre for Person Centred Care at the University of Gothenburg (GPCC) when three core components are present: elicitation of a detailed patient narrative; formulated partnership between caregiver and patient and documentation of the partnership in the patient record. Accordingly, when there is an illness requiring care and the person is attended using these components, PCC is being applied. In most situations today, PCC is not applied as the narrative is not fully elicited or the partnership and/or the documentation are not included. It is proposed that the challenge to Society arising from changing demographics can be addressed by implementing PCC and creating an alternative to existing healthcare. The importance and benefits of such an approach on a wider scale is not yet clear as research has been limited to date. Studies in selected patient populations (heart failure and hip fractures), however, have shown promising results. As the population ages, there will be a dramatic increase in healthcare consumption. Even with technological developments, there will be a need for tremendous resources to be dedicated to care. A new organization and attitude from healthcare policymakers and providers above and beyond the present model appears required in order to respond to this demand. As part of such change, person-centred care, with the interaction between healthcare providers and the person of the patient, can facilitate, compensate and develop more effective healthcare services for the future.
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| 5. |
- Ericson, Marica B, 1974, et al.
(författare)
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A spectroscopic study of the photobleaching of protoporphyrin IX in solution
- 2003
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Ingår i: Lasers in Medical Science. - 0268-8921. ; 18:1, s. 56-62
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Tidskriftsartikel (refereegranskat)abstract
- Photodynamic therapy (PDT) has developed into an important new clinical treatment for cancer during the past 30 years. The method is non-invasive and based on the photochemical activity of a photosensitising agent present in cells and tissues. In so-called ALA-PDT, protoporphyrin IX (Pp IX) is induced from aminolaevulinic acid (ALA) applied topically or systemically. It has been shown that Pp IX is photodegraded by a photo-oxidation process and that its photoproducts have a characteristic absorption band around 670 nm, as observed both in solution and in cells incubated with ALA. In this study, the involvement of oxygen in the photobleaching process was verified by studying the effect of oxygen depletion using the freeze-pump-thaw (FPT) method. A solution of Pp IX in dimethylformamide (DMF) was exposed to light in the wavelength region 600-700 nm (peak centred at 620 (+/-25) nm) both in the presence and in the absence of oxygen. The bleaching process was observed by absorbance and fluorescence measurements. Photobleaching was observed in the presence of oxygen, as verified by the build-up of a photoproduct absorbing at 670 nm. When the sample was deoxygenated with the FPT method, the photoproduct absorption peak at 670 nm was missing. These results confirm that the formation of photo-protopor-phyrin is a photo-oxidation process and that no photobleaching takes place in the absence of oxygen. When comparing our results to the studies carried out by N-2 bubbling, the N-2 bubbling seems to be insufficient to remove the oxygen completely from the solution.
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| 6. |
- Ericson, Marica B, 1974, et al.
(författare)
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Bispectral fluorescence imaging combined with texture analysis and linear discrimination for correlation with histopathologic extent of basal cell carcinoma
- 2005
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Ingår i: Journal of Biomedical Optics. - : SPIE-Intl Soc Optical Eng. - 1083-3668 .- 1560-2281. ; 10:3
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Tidskriftsartikel (refereegranskat)abstract
- Fluorescence imaging has been shown to be a potential complement to visual inspection for demarcation of basal cell carcinoma (BCC), which is the most common type of skin cancer. Earlier studies have shown promising results when combining autofluorescence with protoporphyrin IX (Pp IX) fluorescence, induced by application of delta-5-aminolaevulinic acid (ALA). In this work, we have tried to further improve the ability of this technique to discriminate between areas of tumor and normal skin by implementing texture analysis and Fisher linear discrimination (FLD) on bispectral fluorescence data of BCCs located on the face. Classification maps of the lesions have been obtained from histopathologic mapping of the excised tumors. The contrast feature obtained from co-occurrence matrices was found to provide useful information, particularly for the ALA-induced Pp IX fluorescence data. Moreover, the neighborhood average features of both autofluorescence and Pp IX fluorescence were preferentially included in the analysis. The algorithm was trained by using a training set of images with good agreement with histopathology, which improved the discriminability of the validation set. In addition, cross validation of the training set showed good discriminability. Our results imply that FLD and texture analysis are preferential for correlation between bispectral fluorescence images and the histopathologic extension of the tumors.
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| 7. |
- Ericson, Marica B, 1974, et al.
(författare)
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Fluorescence contrast and threshold limit: implications for photodynamic diagnosis of basal cell carcinoma
- 2003
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Ingår i: Journal of Photochemistry and Photobiology. B: Biology. - 1011-1344. ; 69:2, s. 121-7
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Tidskriftsartikel (refereegranskat)abstract
- This study was designed to evaluate what application time of delta-5-aminolaevulinic acid (ALA) results in highest contrast between tumour and normal skin, in the interval 1-4 h, when using photodynamic diagnosis (PDD) of basal cell carcinomas (BCC) located on the face. Moreover, a value of the demarcation limit has been derived based on the fluorescence variation in normal skin adjacent to the tumour. Forty patients were included in the study, randomly allocated to four different groups with varying ALA application time in the range 1-4 h. The contrast, defined as the ratio between the fluorescence intensity in ALA-treated tumour tissue and normal skin, was calculated for each patient, and the mean values in each group were evaluated as a function of ALA application time. In addition, the fluorescence intensity variation in ALA-treated normal skin adjacent to the tumour was assessed. The results from this study show a peak of the mean contrast values after 3 h ALA application, but due to large interpatient variation, the mean contrast did not differ significantly in the interval 2-4 h. After 2 h ALA application, the fluorescence intensity variation in the normal ALA-treated skin was found to be at a maximum, which suggests that 2 h ALA application is not preferable when using PDD. Based on data of the fluorescence variation in ALA-treated normal skin after 3 and 4 h ALA application, a tolerance interval was calculated implying that values above 1.4 times the mean normal fluorescence indicate an abnormal condition. This tolerance limit agrees well with results obtained in a former study.
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| 8. |
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| 9. |
- Ericson, Marica B, 1974, et al.
(författare)
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Review of photodynamic therapy in actinic keratosis and basal cell carcinoma
- 2008
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Ingår i: Therapeutics and Clinical Risk Management. - 1178-203X. ; 4:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- The number of non-melanoma skin cancers is increasing worldwide, and so also the demand for effective treatment modalities. Topical photodynamic therapy (PDT) using aminolaevulinic acid or its methyl ester has recently become good treatment options for actinic keratosis and basal cell carcinoma; especielly when treating large areas and areas with field cancerization. The cure rates are usually good, and the cosmetic outcomes excellent. The only major side effect reported is the pain experienced by the patients during treatment. This review covers the fundamental aspects of topical PDT and its application for treatment of actinic keratosis and basal cell carcinoma. Both potentials and limitations will be reviewed, as well as some recent development within the field.
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