| 1. |
- Ahmad, Irma, et al.
(författare)
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High prevalence of persistent symptoms and reduced health-related quality of life 6 months after COVID-19
- 2023
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The long-term sequelae after COVID-19 constitute a challenge to public health and increased knowledge is needed. We investigated the prevalence of self-reported persistent symptoms and reduced health-related quality of life (HRQoL) in relation to functional exercise capacity, 6 months after infection, and explored risk factors for COVID-19 sequalae.METHODS: This was a prospective, multicenter, cohort study including 434 patients. At 6 months, physical exercise capacity was assessed by a 1-minute sit-to-stand test (1MSTST) and persistent symptoms were reported and HRQoL was evaluated through the EuroQol 5-level 5-dimension (EQ-5D-5L) questionnaire. Patients with both persistent symptoms and reduced HRQoL were classified into a new definition of post-acute COVID syndrome, PACS+. Risk factors for developing persistent symptoms, reduced HRQoL and PACS+ were identified by multivariable Poisson regression.RESULTS: Persistent symptoms were experienced by 79% of hospitalized, and 59% of non-hospitalized patients at 6 months. Hospitalized patients had a higher prevalence of self-assessed reduced overall health (28 vs. 12%) and PACS+ (31 vs. 11%). PACS+ was associated with reduced exercise capacity but not with abnormal pulse/desaturation during 1MSTST. Hospitalization was the most important independent risk factor for developing persistent symptoms, reduced overall health and PACS+.CONCLUSION: Persistent symptoms and reduced HRQoL are common among COVID-19 survivors, but abnormal pulse and peripheral saturation during exercise could not distinguish patients with PACS+. Patients with severe infection requiring hospitalization were more likely to develop PACS+, hence these patients should be prioritized for clinical follow-up after COVID-19.
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| 8. |
- Bergentall, Martina, et al.
(författare)
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Malolactic fermentation in lingonberry juice and its use as a preservative
- 2024
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Ingår i: Food microbiology (Print). - 0740-0020 .- 1095-9998. ; 121
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Tidskriftsartikel (refereegranskat)abstract
- Lingonberry is a common wild berry that is often sold as jams and beverages. It naturally contains high amounts of the weak acid preservative benzoic acid making it an interesting ingredient for shelf-life extension. Despite this, their use as a raw ingredient is limited by the inherently intense sour taste. This study aimed to improve the taste of lingonberry juice by subjecting it to malolactic fermentation in order to reduce the sourness, and to investigate the benzoic acid in lingonberries as a natural preservative in juice blends by determining the microbial stability. After initial screening of lactic acid bacteria, a Lactiplantibacillus plantarum strain was used as the starter for subsequent investigations. Upon raising the pH, all malic acid was completely converted to lactic acid after seven days. The fermented juice was mixed with blackcurrant juice in different proportions. Challenge tests of the blends showed Listeria monocytogenes could not grow in any juice samples, while Candida albicans only grew in the pure blackcurrant juice. Aspergillus brasiliensis growth was delayed in all samples containing benzoic acid in a concentration-dependent manner. The sourness and astringency were substantially reduced in the juice with added L. plantarum compared to the unfermented juice. © 2024 The Authors
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| 9. |
- Bodén, Robert, 1973-, et al.
(författare)
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Suppressing visual hallucinations in an adolescent by occipital transcranial magnetic stimulation: A single-case experimental research design.
- 2021
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Ingår i: Neuropsychological rehabilitation. - : Informa UK Limited. - 1464-0694 .- 0960-2011. ; 33:2, s. 346-55
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Tidskriftsartikel (refereegranskat)abstract
- Visual hallucinations after central or peripheral impairment, commonly called Charles Bonnet syndrome, are often highly distressing and with few available treatment options. Here we report a case where an adolescent developed severely distressing visual hallucinations after hypoxic damage to the occipital cortex following a suicide attempt. The patient received active and sham occipital continuous theta-burst stimulation (cTBS) in a single-case experimental research design and a subsequent open phase, to evaluate cTBS as a Charles Bonnet treatment. The visual hallucinations seemed to decrease more during active than sham cTBS in the blind phase, and in the following week of repeated five daily treatments they almost disappeared. A normalization of increased activity in the lateral visual network after cTBS was observed on a functional magnetic resonance imaging resting-state analysis compared with 42 healthy controls. Visual evoked potentials stayed largely unchanged both in the sham-controlled blind phase and the subsequent open phase. During the two weeks after the open phase with repeated cTBS sessions, the visual hallucinations gradually reappeared and almost returned to the baseline level. Our findings suggest that active cTBS over the primary visual cortex can reduce visual hallucinations through modulation of downstream visual regions, though the effect is temporally limited.
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| 10. |
- Bäckström, Ingela, 1963-, et al.
(författare)
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Experiences with and causes of work interruptions and fragmentation in academia - How can they be managed?
- 2023
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Ingår i: 26th Excellence In Services International Conference (EISIC). - 9791221039054
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Konferensbidrag (refereegranskat)abstract
- Purpose: The purpose of this research is to explore experiences with and causes of the work interruptions and fragmentation that occur in the daily work of academic staff. This research also aims to explore strategies for managing these issues.Methodology: As part of a research project, data were collected from a workshop featuring academics to investigate their experiences of workfragmentation and the strategies they used to manage this issue. These academics were asked to individually write down ways of creating coherent time and their perceptions of the reasons underlying the fragmentation of work. They were then asked to discuss and reflect on this topic in groups based on their work roles, after which the groups’ answers were summarized. The written answers were analysed by a total of four researchers working on this project in two separate rounds.Findings: The analysis resulted in fourteen group labels of experiences and causes of work interruptions and fragmentation, including Knowledge, Resources, Communication, Unplanned tasks, Planning, Digital systems, Processes, Job duties, Administration, (Over)ambition, Meetings, Set-up time, Quality work and Help and support. In the analysis of the strategies used to manage work interruptions and fragmentation, seven groups were identified: Conscious planning to create space for coherent time, Need for knowledge that offers the ability to create coherent time, Control the communication, Support/lead, Working hours, Prioritize, and Respect others and their time.Research limitations/implications: The research was conducted by reference to a group of heads of subjects drawn from one university.Originality/Value: Qualitative research on interruptions and fragmentation in higher education institutes (HEI) is rare.
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| 11. |
- Delfin, Ingela, et al.
(författare)
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Does physical activity affect risk of revision of total hip arthroplasty? A matched pairs study
- 2017
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 19:3, s. 124-130
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to investigate differences in level of physical activity between patients who underwent revision after surgery with total hip arthroplasty and those who did not. Secondary purposes were to study if level of physical activity, frequency of physical activity, body mass index, sex or age could predict the risk of revision an to find out if patients were sufficiently active. Methods: The patients who had surgery with total hip arthroplasty at any time and required a revision were identified (n = 27) and matched with controls. The primary outcome measure was the University of California Los Angeles activity scale. Secondary outcome measures were risk prediction including body mass index, age, year between total hip arthroplasty and revision, frequency of physical activity, and level of physical activity. Results and conclusions: There were no statistical significant differences for University of California Los Angeles activity scale score between samples (p = .914). 44% Of the participants in the revision group and 33% in the control group were insufficiently active. Level or frequency of physical activity did not increase the risk of revision (OR 0.96 and 0.46), nor did body mass index, age or sex (OR 1.00, 0.98 and 1.00).
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| 12. |
- Fridberg, Marie, et al.
(författare)
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Immunohistochemical analyses of phosphatases in childhood B-cell lymphoma : lower expression of PTEN and HePTP and higher number of positive cells for nuclear SHP2 in B-cell lymphoma cases compared to controls
- 2008
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Ingår i: Pediatric Hematology & Oncology. - : Taylor & Francis. - 0888-0018 .- 1521-0669. ; 25, s. 528-540
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Tidskriftsartikel (refereegranskat)abstract
- Although many pediatric B-cell lymphoma patients are being cured today, much is still unknown about the pathogenesis of this disease. Protein tyrosine phosphatases are involved in the control of survival, growth, and differentiation of cells. The authors have analyzed 26 pediatric B-cell lymphoma cases for the expression of a panel of phosphatases and report a statistically significant lower expression intensity of PTEN and HePTP and higher nuclear SHP2 expression in B-cell lymphoma cases compared to lymphoid tissue. Knowledge about the expression of key regulatory proteins in pediatric B-cell lymphomas is necessary for revealing the complex molecular background of this disease.
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| 13. |
- Huang, F, et al.
(författare)
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Proteomics of Synechocystis sp strain PCC 6803 - Identification of plasma membrane proteins
- 2002
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Ingår i: Molecular & Cellular Proteomics. - 1535-9476 .- 1535-9484. ; 1:12, s. 956-966
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Tidskriftsartikel (refereegranskat)abstract
- Cyanobacteria are unique prokaryotes since they in addition to outer and plasma membranes contain the photosynthetic membranes (thylakoids) The plasma membranes of Synechocystis 6803, which can be completely purified by density centrifugation and polymer two-phase partitioning, have been found to be more complex than previously anticipated, i. e they appear to be essential for assembly of the two photosystems. A proteomic approach for the characterization of cyanobacterial plasma membranes using two-dimensional gel electrophoresis and mass spectrometry analysis revealed a total of 57 different membrane proteins of which 17 are integral membrane spanning proteins. Among the 40 peripheral proteins 20 are located on the periplasmic side of the membrane, while 20 are on the cytoplasmic side. Among the proteins identified are subunits of the two photosystems as well as Vipp1, which has been suggested to be involved in vesicular transport between plasma and thylakoid membranes and is thus relevant to the possibility that plasma membranes are the initial site for photosystem biogenesis. Four subunits of the Pilus complex responsible for cell motility were also identified as well as several subunits of the TolC and TonB transport systems. Several periplasmic and ATP-binding proteins of ATP-binding cassette transporters were also identified as were two subunits of the F-0 membrane part of the ATP synthase
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| 14. |
- Krantz, Ingela, et al.
(författare)
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Screening for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS) : An ethical analysis
- 2008
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Ingår i: Scandinavian Journal of Public Health. - London : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:2, s. 211-216
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To assess the Edinburgh Postnatal Depression Scale (EPDS), a self-administered questionnaire created to screen for symptoms of postpartum depression in the community, from an epidemiological and ethical perspective. Screening, as the practice of investigating apparently healthy individuals to detect unrecognised disease or its precursors, has interpretation problems and is complicated by deliberations on probabilities for something to occur, on which the scientific community is unanimous. Methods: Our ethical analysis is made using a framework with two different dimensions, the ethical principles autonomy and beneficence and the affected persons. To balance the ethical costs and the ethical benefits of EPDS an analogy with the assessment of pharmaceutics is used. Results: In this article we argue that routine EPDS screening of Swedish postpartum women would lead to considerable ethical problems due to the weak scientific foundation of the screening instrument. Despite a multitude of published studies, the side-effects in terms of misclassifications have not been considered carefully. The EPDS does not function very well as a routine screening instrument. The dualism created is too reductive and fails to recognize the plurality of difference that exists in the social word. Conclusions: Public health authorities should not advocate screening of unproved value. Screening is not just a medical issue but also an ethical one.
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| 15. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
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Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: A pilot study
- 2010
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Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 9:3, s. 168-174
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Tidskriftsartikel (refereegranskat)abstract
- Background: As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required. Aims:The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.Methods:A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions. Results:Two separate factor analyses each revealed a two-factor structure on both occasions: “Sexual appetite” and “Sexual expectations ”with gender-neutral questions and “Sexual sensitiveness” and “Sexual ability” with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test – retest values for all but one question exceeded 0.70.Conclusions:The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.
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| 18. |
- Nätterdahl, Carolina, et al.
(författare)
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Risk Factors for Complicated Mohs Surgery in the South Sweden Mohs Cohort
- 2022
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 1468-3083 .- 0926-9959. ; 36:7, s. 1113-1117
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mohs micrographic surgery (MMS) is a precise, tissue-sparing surgical technique that offers superior cure rates compared to traditional surgical excision. However, the degree of difficulty of MMS depends on many variables, and consequently, the number of surgical stages required for each case is quite unpredictable.Objectives: To identify risk factors for complicated MMS, defined as MMS requiring ≥3 stages.Methods: In a cohort study design, data were prospectively collected from 612 patients that underwent MMS for basal cell carcinoma (BCC) at the Department of Dermatology, Skåne University Hospital, Lund, between 2009 and 2020. Univariate and multivariate logistic regression were used to estimate the risk of MMS requiring ≥3 stages. Due to the risk of multicollinearity between recurrent or incompletely excised BCC and previous treatments, a partially and a fully adjusted multivariate logistic regression model were constructed.Results: In fully adjusted multivariate analyses, age (odds ratio (OR) 1.02; confidence interval (CI) 95% 1.00-1.04), previous cryotherapy (OR 2.3; CI 95% 1.1-4.8), and >1 previous surgery (OR 3.4; CI 95% 1.5-7.7) were significantly associated with risk of complicated MMS. Recurrent BCC was associated with the risk of complicated MMS in partially adjusted multivariate analyses, but not in the fully adjusted analyses. In this highly selected cohort, histopathological subtype, and tumour localization were not associated with the risk of complicated MMS.Conclusions: Older age and tumours previously treated with cryotherapy or multiple prior surgeries increased the risk of MMS requiring ≥3 stages. Whether recurrent BCC is an independent risk factor for complicated MMS needs further evaluation. Knowledge of these risk factors may ameliorate the planning of Mohs surgeries.
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| 19. |
- Persson, Hans, et al.
(författare)
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Fine root dynamics in a Norway spruce forest (Picea abies (L.) Karst) in eastern Sweden
- 2010
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Ingår i: Plant and Soil. - : Springer Science and Business Media LLC. - 0032-079X .- 1573-5036. ; 330, s. 329-344
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Tidskriftsartikel (refereegranskat)abstract
- The annual dynamics of live and dead fine roots for trees and the field layer species and live/dead ratios were investigated at a coniferous fern forest (Picea abies L. Karts) in Sweden. Our methods of estimating the average amount of fine roots involved the periodic sampling of fine roots in sequential cores on four sampling occasions. The highest live/dead ratio was found in the upper part of the humus layer for both tree and field-layer species and decreased with depth. Most tree fine roots on the four sampling occasions were found in the mineral soil horizon, where 86, 81, 85 and 89% of < 1 mm and 89, 88, 89 and 92% of < 2 mm diameter of the total amounts of live fine roots in the soil profile were found. The mean amounts of live fine roots of tree species for the total soil profile on the four sampling occasions was 317, 150, 139 and 248 g m(-2) for < 1 mm and 410, 225, 224 and 351 g m(-2) for < 2 mm diameter fine roots. The related amount of dead fine roots was 226, 321, 176 and 299 g m(-2) and 294, 424, 282 and 381 g m(-2), respectively. Average amounts of live and dead fine-roots and live/dead ratios from other Picea abies forest ecosystems were within the range of our estimates. The production of fine roots, < 1 and < 2 mm in diameter, estimated from the annual increments in live fine roots, was 207 and 303 g m(-2). The related accumulation of dead fine roots was 257 and 345 g m(-2), The turnover rate of tree fine roots < 1 mm in diameter in the total soil profile amounted to 0.7 yr(-1) for live and 0.8 yr(-1) for dead fine roots. The related turnover rates for tree fine roots < 2 mm were 0.4 yr(-1) and 0.7 yr(-1). Our data, although based on minimum estimates of the annual fluxes of live and dead fine roots, suggests a carbon flow to the forest soil from dead fine-roots even more substantial than from the needle litter fall. Fine-root data from several Picea abies forest ecosystems, suggest high turnover rates of both live and dead tree fine-roots.
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| 20. |
- Persson, Hans, et al.
(författare)
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Spatial distribution of fine-roots in boreal forests in eastern Sweden
- 2009
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Ingår i: Plant and Soil. - : Springer Science and Business Media LLC. - 0032-079X .- 1573-5036. ; 318, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- Investigations were carried out in six forest types in areas surrounding two Swedish nuclear power plants (Forsmark and Laxemar). The aim of the investigation was to determine the spatial distribution of fine-root biomass (live), necromass (dead) and standing crop (live + dead) and to test the use of the live/dead ratio as a vitality criterion. Soil cores were taken to depths with insignificant amounts of roots. The total amount of fine-root biomass (< 1 mm in diameter) of tree species in the soil profile was 267, 317 and 235 g m(-2) for the Forsmark and 137, 371 and 50 g m(-2) for the Laxemar sites. The related necromass was 119, 226 and 184 g m(-2) and 87, 245 and 271 g m(-2). The biomass in the humus layer was 47, 7 and 48% for the Forsmark and 34, 26 and 7% for the Laxemar sites, as a percentage of the total live + dead fine roots in the soil profile. The related necromass in the humus layer was 13, 2 and 30% for the Forsmark and 13, 2 and 28% for the Laxemar sites. The live/dead ratio decreased with depth for both tree- and field-layer species and seems to be a most powerful vitality criterion of fine roots.
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| 21. |
- Persson, Jessica, et al.
(författare)
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Aspects of Expansive Learning in the Context of Healthy Ageing—A Formative Intervention between Dental Care and Municipal Healthcare
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:3
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Tidskriftsartikel (refereegranskat)abstract
- There are great risks of diseases in the ageing population, and oral diseases are no exception. Poor oral health has profound negative impacts on the quality of life. It is therefore crucial to include the oral health perspective in the care for older adults. To meet the challenges associated with oral health in the ageing population, a formative intervention was launched. The intervention, called the TAIK project (=“Dental hygienist in a municipality organization”, in Swedish: Tandhygienist i kommunal verksamhet), meant that six dental hygienists served non-clinically as oral health consultants in five Swedish municipal organizations. The intervention formed an infrastructure and platform for work that benefits the ageing population and created a new basis for decisions regarding oral health in homecare. The aim of this paper is to explore how aspects of collaboration in an interprofessional and interorganizational intervention may lead to expansive learning. Expansive learning forms the theoretical framework of this study. The dental hygienists and the local head nurses were interviewed individually in-depth. Reflection documents from the dental hygienists were also part of the analyzed data. The conclusion is that the formative intervention was reliant of change which created a foundation for reciprocal understanding that led to expansive learning between dental care and municipal healthcare, with resilience and empowerment as crucial factors. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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| 22. |
- Persson, Lena, 1951-, et al.
(författare)
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A new model for dealing with patients who frequently arrive spontaneously at hospital emergency departments requiring health care : a pilot study
- 2014
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Ingår i: International Journal of Nursing & Clinical Practices. ; 1, s. 103-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients who repeatedly seek care directly at hospital based somatic emergencydepartments take up a large proportion of health care resources, at the same time they appear to experience low satisfaction with the care they receive. The purposes of this pilot study were to describe: I) the development of a team model for taking care of frequent visitors to a somatic hospital based ED; II) Eventual changes, over six months, in costs and patients’ health care utilization related to pilot testing the model and III), the team’s experiences of implementing the model.Methods: A mixed method convergent parallel design was used.Results: The development of the model began as a top-down process and later on into a bottom-up approach once the inter-professional team became involved. The new model functioned as a support for all 12 patients included in the study and collectively their visits decreased by a total of 73 visits (55%).Conclusion: The inference quality description is that a management induced project may be accepted and actively applied when those involved experience freedom to structure the project. Increased communication between different professionals within the hospital and between different caregivers such as ED, primary health care and community social- and health-care, increases the possibility for the patients to be cared for in a sustainable and non-fragmented way.
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| 23. |
- Persson, Lena, 1951-, et al.
(författare)
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A new model for dealing with patients who frequently arrive spontaneously at hospital emergency departments requiring health care : A pilot study
- 2014
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Ingår i: International Journal of Nursing & Clinical Practices. - : Graphyonline Publications PVT, Ltd.. - 2394-4978. ; 1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients who repeatedly seek care directly at hospital based somatic emergency departments take up a large proportion of health care resources, at the same time they appear to experience low satisfaction with the care they receive. The purposes of this pilot study were to describe: I) the development of a team model for taking care of frequent visitors to a somatic hospital based ED; II) Eventual changes, over six months, in costs and patients’ health care utilization related to pilot testing the model and III), the team’s experiences of implementing the model.Methods: A mixed method convergent parallel design was used.Results: The development of the model began as a top-down process and later on into a bottom-up approach once the inter-professional team became involved. The new model functioned as a support for all 12 patients included in the study and collectively their visits decreased by a total of 73 visits (55%).Conclusion: The inference quality description is that a management induced project may be accepted and actively applied when those involved experience freedom to structure the project. Increased communication between different professionals within the hospital and between different caregivers such as ED, primary health care and community social- and health-care, increases the possibility for the patients to be cared for in a sustainable and non-fragmented way.
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| 24. |
- Pettersson, Anna, 1979-, et al.
(författare)
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Assessing patients’ perceived bother from the gastrointestinal side effects of radiotherapy for localized prostate cancer : initial questionnaire development and validation
- 2014
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 53:3, s. 368-377
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe present study reports on the development and first steps of validation of the Gastrointestinal Side Effects Questionnaire (GISEQ), a measure of patient-reported gastrointestinal symptoms following local radiotherapy to the prostate. The questionnaire design provides a novel approach of assessment of side effects of prostate radiotherapy, by enabling measurement of patient-perceived change in symptoms.Material and methodsThe eight-item GISEQ was administered to 130 prostate cancer patients referred to radiotherapy. Patients completed the GISEQ at four, eight and 15 weeks after start of radiotherapy. The psychometric properties including validity, reliability, responsiveness and feasibility were evaluated. The EORTC QLQ-C30 and QLQ-PR25 were chosen as comparative measures.ResultsExpert opinion supported content validity. For concurrent validity, correlation between the GISEQ and matching items in the EORTC questionnaires was moderate but significant (r > 0.41, p < 0.001). The responsiveness was adequate, indicated by changes in GISEQ scores over time corresponding to the effects of radiation. Internal consistency was satisfactory (overall Cronbach's α> 0.70). Sensitivity and specificity for items diarrhea, constipation and blood in stools ranged from 50% to 100% and from 68% to 100%, respectively. All items had a floor effect above 15%. The response rates ranged from 85% to 92% and missing items was < 0.8%, indicating good feasibility.ConclusionsThe GISEQ showed satisfactory internal consistency and adequate content validity, concurrent validity and responsiveness. It is brief, easy to use and can be quickly evaluated, making it useful not only for research but possibly also for clinical settings. Modification of response scale and extension of items are potential improvements. Further work is needed to strengthen the psychometric qualities of the GISEQ and to evaluate its clinical use and potential effects of response shift and recall bias.
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| 25. |
- Pettersson, Anna, 1979-
(författare)
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Diet and Gastrointestinal Symptoms in Patients with Prostate Cancer Treated with Radiotherapy
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective The main objective of this thesis was to explore the effects of diet on gastrointestinal symptoms in prostate cancer patients treated with local curative radiotherapy, by evaluating dietary intake prior to treatment (Study I), the psychometric properties of a new questionnaire on patient-reported gastrointestinal side effects (Study II), and the effect of a dietary intervention on acute and long-term gastrointestinal symptoms up to 2 years after radiotherapy completion (Study III-IV).Methods A total of 130 men with localized prostate cancer referred to dose-escalated radiotherapy (ED2 87-102 Gy, α/β=3 Gy) were recruited to a dietary intervention trial. Patients were randomized to receive either standard care plus the dietary intervention of a fibre- and lactose-restricted diet (intervention group, IG; n=64) or standard care alone (standard care group, SCG; n=66). Data on gastrointestinal symptoms and dietary intake were collected pre-treatment and at seven time points during a follow-up period of 26 months.Results Prior to treatment, grain products and milk products were major sources of energy. Unbalanced fatty acid intake and low intake of selenium were observed (Study I). Validation of the Gastrointestinal Side Effects Questionnaire (GISEQ) revealed satisfactory internal consistency, moderate concurrent validity and adequate responsiveness (Study II). There were no significant effects of the intervention on acute or long-term gastrointestinal symptoms, but a tendency towards lower prevalence and severity of bloating and diarrhoea in the IG compared to the SCG during radiotherapy. Gastrointestinal symptoms were predominantly mild, and the frequency of clinically relevant symptoms was merely a few percent. Dietary adherence in the IG was initially good, but tended to decline beyond 12 months post-radiotherapy (Study III-IV).Conclusions A fibre- and lactose-restricted diet was not superior to the habitual diet in reducing gastrointestinal symptoms in patients undergoing high-dose, small-volume radiotherapy for localized prostate cancer. The GISEQ enables assessment of patient-perceived change in symptoms, but further work is needed to strengthen its psychometric qualities. It is suggested that continued research in this area target patient categories referred to irradiation of larger pelvic volumes with a higher risk of gastrointestinal symptoms, and that dietary interventions incorporate established strategies to enhance adherence and effectiveness.
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