| 1. |
- Bobjer, Johannes, et al.
(författare)
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Location of retroperitoneal lymph node metastases in upper tract urothelial carcinoma : results from a prospective lymph node mapping study
- 2023
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Ingår i: European Urology Open Science. - : Elsevier. - 2666-1691 .- 2666-1683. ; 57, s. 37-44
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is limited information on the distribution of retroperitoneal lymph node metastases (LNMs) in upper tract urothelial carcinoma (UTUC).Objective: To investigate the location of LNMs in UTUC of the renal pelvis or proximal ureter and short-term complications after radical nephroureterectomy (RNU) with lymph node dissection (LND).Design, setting, and participants: This was a prospective Nordic multicenter study (four university hospitals, two county hospitals). Patients with clinically suspected locally advanced UTUC (stage >T1) and/or clinical lymph node–positive (cN+) disease were invited to participate. Participants underwent RNU and fractionated retroperitoneal LND using predefined side-specific templates.Outcome measurements and statistical analysis: The location of LNMs in the LND specimen and retroperitoneal lymph node recurrences during follow-up was recorded. Postoperative complications within 90 d of surgery were ascertained from patient charts. Descriptive statistics were used.Results and limitations: LNMs were present in the LND specimen in 23/100 patients, and nine of 100 patients experienced a retroperitoneal recurrence. Distribution per side revealed LNMs in the LND specimen in 11/38 (29%) patients with right-sided tumors, for whom the anatomically larger, right-sided template was used, in comparison to 12/62 (19%) patients with left-sided tumors, for whom a more limited template was used. High-grade complications (Clavien grade ≥3) within 90 d of surgery were registered for 13/100 patients. The study is limited in size and not powered to assess survival estimates.Conclusions: The suggested templates that we prospectively applied for right-sided and left-sided LND in patients with advanced UTUC included the majority of LNMs. High-grade complications directly related to the LND part of the surgery were limited.Patient summary: This study describes the location of lymph node metastases in patients with cancer in the upper urinary tract who underwent surgery to remove the affected kidney and ureter. The results show that most metastases occur within the template maps for lymph node surgery that we investigated, and that this surgery can be performed with few severe complications.
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| 2. |
- Karlmark, Bertil, et al.
(författare)
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Hans R Ulfendahl (1927-2021) : Obituary
- 2021
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Ingår i: Acta Physiologica. - : John Wiley & Sons. - 1748-1708 .- 1748-1716. ; 232:2
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 3. |
- Rhodin, Annica, 1949-
(författare)
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Long-term Effects of Opioids in the Treatment of Chronic Pain : Investigation of Problems and Hazards on Clinical, Biochemical, Cellular and Genetic Levels
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- After two decades of liberal prescribing of opioids, there has been an increasing recognition of problems connected to the prolonged use of opioids for chronic pain. The aim of my thesis was to explore some consequences of long-term opioid treatment for chronic pain such as problematic opioid use, endocrine disorders, tolerance and genetic variations in pain and opioid response. Sixty patients with severe pain and problematic opioid use were treated with a structured methadone programme. Risk factors were musculoskeletal pain, psychiatric co-morbidity and previous addiction. Treatment resulted in good pain relief and improved quality of life, but function was impaired by side effects indicating endocrine dysregulation. The possibility of opioid-induced endocrine dysfunction was explored in the second paper, where 40 pain patients treated with strong opioids and 20 pain patients without treatment of strong opioids were investigated. The opioid-treated patients had significantly higher incidence of endocrine disturbance affecting gonadal and adrenal function and prolactin levels. The functionality of the μ-receptor after long-term treatment with morphine, saline and naloxone was explored in a cell-line expressing the μ-receptor. After one and four weeks of treatment the binding was tested with morphine, methadone, fentanyl and DAMGO and function measured by GTP γ-assay. The binding of DAMGO was significantly diminished after 4 weeks in cells treated with morphine compared with saline and naloxone. Genetic variation in three genes with functional impact on opioid response and pain sensitivity was investigated in 80 patients with chronic low-back pain and differential opioid sensitivity and in 56 healthy controls. The results indicated a higher incidence of opioid-related side effects and gender differences in patients with the minor allele of the ABCB1 gene, a correlation between increased opioid sensitivity and the major CACNA2D2 allele and a possible relationship between intrinsic protection against chronic pain and the minor allele of OPRM1.
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| 4. |
- Yngman, Gunnar, et al.
(författare)
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An introduction of the full random effects model
- 2022
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Ingår i: CPT. - : John Wiley & Sons. - 2163-8306. ; 11:2, s. 149-160
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Tidskriftsartikel (refereegranskat)abstract
- The full random-effects model (FREM) is a method for determining covariate effects in mixed-effects models. Covariates are modeled as random variables, described by mean and variance. The method captures the covariate effects in estimated covariances between individual parameters and covariates. This approach is robust against issues that may cause reduced performance in methods based on estimating fixed effects (e.g., correlated covariates where the effects cannot be simultaneously identified in fixed-effects methods). FREM covariate parameterization and transformation of covariate data records can be used to alter the covariate-parameter relation. Four relations (linear, log-linear, exponential, and power) were implemented and shown to provide estimates equivalent to their fixed-effects counterparts. Comparisons between FREM and mathematically equivalent full fixed-effects models (FFEMs) were performed in original and simulated data, in the presence and absence of non-normally distributed and highly correlated covariates. These comparisons show that both FREM and FFEM perform well in the examined cases, with a slightly better estimation accuracy of parameter interindividual variability (IIV) in FREM. In addition, FREM offers the unique advantage of letting a single estimation simultaneously provide covariate effect coefficient estimates and IIV estimates for any subset of the examined covariates, including the effect of each covariate in isolation. Such subsets can be used to apply the model across data sources with different sets of available covariates, or to communicate covariate effects in a way that is not conditional on other covariates.
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| 5. |
- af Geijerstam, Agnes, et al.
(författare)
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Fitness, strength and severity of COVID-19: a prospective register study of 1 559 187 Swedish conscripts
- 2021
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the possible connection between cardiorespiratory fitness (CRF) and muscle strength in early adulthood and severity of COVID-19 later in life. Design Prospective registry-based cohort study. Participants 1 559 187 Swedish men, undergoing military conscription between 1968 and 2005 at a mean age of 18.3 (SD 0.73) years. Main outcome measures Hospitalisation, intensive care or death due to COVID-19 from March to September 2020, in relation to CRF and muscle strength. Results High CRF in late adolescence and early adulthood had a protective association with severe COVID-19 later in life with OR (95% CI) 0.76 (0.67 to 0.85) for hospitalisation (n=2 006), 0.61 (0.48 to 0.78) for intensive care (n=445) and 0.56 (0.37 to 0.85) for mortality (n=149), compared with the lowest category of CRF. The association remains unchanged when controlled for body mass index (BMI), blood pressure, chronic diseases and parental education level at baseline, and incident cardiovascular disease before 2020. Moreover, lower muscle strength in late adolescence showed a linear association with a higher risk of all three outcomes when controlled for BMI and height. Conclusions Physical fitness at a young age is associated with severity of COVID-19 many years later. This underscores the necessity to increase the general physical fitness of the population to offer protection against future viral pandemics.
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| 7. |
- Alfredsson, Ylvi, et al.
(författare)
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Electronic structure of a vapor-deposited metal-free phthalocyanine thin film
- 2005
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Ingår i: Journal of Chemical Physics. - : AIP Publishing. - 0021-9606 .- 1089-7690. ; 122:21
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Tidskriftsartikel (refereegranskat)abstract
- The electronic structure of a vapor-sublimated thin film of metal-free phthalocyanine (H2Pc) is studied experimentally and theoretically. An atom-specific picture of the occupied and unoccupied electronic states is obtained using x-ray-absorption spectroscopy (XAS), core- and valence-level x-ray photoelectron spectroscopy (XPS), and density-functional theory (DFT) calculations. The DFT calculations allow for an identification of the contributions from individual nitrogen atoms to the experimental N1s XAS and valence XPS spectra. This comprehensive study of metal-free phthalocyanine is relevant for the application of such molecules in molecular electronics and provides a solid foundation for identifying modifications in the electronic structure induced by various substituent groups.
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