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- Bill-Axelson, Anna, et al.
(författare)
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No increased prostate cancer incidence after negative transrectal ultrasound guided multiple biopsies in men with increased prostate specific antigen and/or abnormal digital rectal examination.
- 2003
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Ingår i: Journal of Urology. - : Ovid Technologies (Wolters Kluwer Health). - 0022-5347 .- 1527-3792. ; 170:4 Pt 1, s. 1180-3
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: We investigated the incidence of prostate cancer after negative transrectal ultrasound (TRUS) guided multiple biopsies. Our secondary aim was to calculate the sensitivity of the extended protocol used.MATERIALS AND METHODS: A cohort of 547 men with elevated prostate specific antigen and/or abnormal digital rectal examination but with results negative for prostate cancer on a mean of 9 TRUS guided biopsies was followed through record linkage to the national cancer Registry. The observed number of prostate cancers was compared with the expected number during the same calendar period in an age matched male population to determine the standardized incidence ratio. The sensitivity of TRUS with multiple biopsies after 5 years of followup was calculated. Relative survival was estimated if there was an excess death rate due to undiagnosed prostate cancer.RESULTS: We found 11 men diagnosed with prostate cancer. The expected number in the age standardized male population was 15, resulting in a standardized incidence ratio of 0.8 (95% CI 0.4 to 1.2). Five-year sensitivity of the extended protocol of TRUS guided biopsies was 95.2% (95% CI 93.5 to 96.4) and relative survival was more than 100%, indicating a selection of men deemed candidates for curative treatment.CONCLUSIONS: Men with clinical suspicion of prostate cancer who are examined by an extended protocol of TRUS guided biopsies negative for cancer do not have an increased incidence of prostate cancer within 6 years compared with an age matched male population. Five-year sensitivity of this protocol was high.
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- Glaessgen, Axel, et al.
(författare)
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Prediction of percent Gleason grade 4/5 by multiple core biopsies
- 2006
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 40:6, s. 465-471
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To evaluate whether percent Gleason grade 4/5 (i.e. the proportion of a tumor occupied by high-grade cancer) can be predicted by multiple needle biopsies. Material and methods. In 115 men, 8-14 (mean 10) biopsies were taken, including eight from standardized positions (apex, mid-medial, mid-lateral and base). Biopsies were reviewed and cancer lengths measured. All men underwent radical prostatectomy. The prostatectomy specimens were totally embedded and tumor volume measured planimetrically. Gleason scores and percent Gleason grade 4/5 were assessed for both biopsy and prostatectomy specimens. Results. Percent Gleason grade 4/5 in prostatectomy specimens was predicted correctly in 34% of cases and within 10%, 20% and 30% in 55%, 64% and 73% of cases, respectively. Biopsies had a sensitivity, specificity and accuracy for Gleason grade 4/5 of 62%, 87% and 69%, respectively. Positive and negative predictive values were 93% and 45%, respectively. The weighted kappa value for agreement was slightly higher for Gleason score (0.685) than for percent Gleason grade 4/5 (0.573). The univariate correlation for percent Gleason grade 4/5 in biopsies and the main tumor was r = 0.62, r(2) = 0.39 (p < 0.001). In univariate logistic regression, percent Gleason grade 4/5 on biopsies predicted the presence of any Gleason grade 4/5 cancer in the main tumor (p = 0.009). Conclusions. Gleason grade 4/5 in prostatectomy specimens correlates with findings in preoperative biopsies. Whether this measure will be used in routine practice remains to be seen.
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- Kihlgren, Mona, 1938-
(författare)
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Integrity promoting care of demented patients
- 1992
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of the thesis was to investigate if integrity promoting care improves functions in demented patients over time. The Erikson (1982) theory of ”eight stages of man” was used as a basis for training of staff in a three-month intervention study (I-VI) at a nursing home ward. A collective living unit where staff had had support in the performance of the delivery of care was also evaluated and compared with a nursing home in a long-term study (VII). Patients, relatives, staff, and the environments were investigated. Cerebrospinal fluid concentrations of somatostatin increased, and reduction of distractability, anxiety and confusion was seen in the intervention group (I) in contrast to controls. In the collective living group (VII) EEG activities indicated a reduction of supposed dementia induced changes. Better motor and social ability, some improved intellectual ability, more alertness and reduced signs of depression were seen (I, II, VII). Patients expressed more autonomy (IV, VII) and initiatives (II-VII) and showed a lot of competence (V) in conversations. Five patients (V) showed patterns of behaviour which seemed to reflect life-long characteristics in spite of their severe dementia. The improvement in the patients' functions can be attributed to the physical environment and the integrity promoting care, since the medical treatment of the patients remained unchanged. In the thesis medical, psychological, and nursing sciences were connected in a complementary process. The results were congruent, and indicate that patients in the care of staff who had had training and support, declined less than controls.
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- Kumblad, Linda, 1974-, et al.
(författare)
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Managing multi-functional peri-urban landscapes : Impacts of horse-keeping on water quality
- 2023
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Ingår i: Ambio. - : Springer. - 0044-7447 .- 1654-7209.
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Tidskriftsartikel (refereegranskat)abstract
- Eutrophication assessments in water management to quantify nutrient loads and identify mitigating measures seldom include the contribution from horse facilities. This may be due to lack of appropriate methods, limited resources, or the belief that the impact from horses is insignificant. However, the recreational horse sector is growing, predominantly in multi-functional peri-urban landscapes. We applied an ecosystem management approach to quantify nutrient loads from horse facilities in the Stockholm Region, Sweden. We found that horses increased the total loads with 30–40% P and 20–45% N, with average area-specific loads of 1.2 kg P and 7.6 kg N ha−1 year−1. Identified local risk factors included manure management practices, trampling severity, soil condition and closeness to water. Comparisons of assessment methods showed that literature standard values of area-specific loads and water runoff may be sufficient at the catchment level, but in small and more complex catchments, measurements and local knowledge are needed.
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- Lilja, Mona, 1971, et al.
(författare)
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Genderized power discourses in Cambodian politics
- 1999
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Ingår i: Schulz, M. (ed.), Peace and development - their interrelationship in the global system: an inventory of peace and development research at PADRIGU: a Festschrift in honour of professor Björn Hettne. - Göteborg : Padrigu Papers, Göteborgs universitet. - 9187380447
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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