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- Jakubowska, A, et al.
(författare)
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Association of PHB 1630 C andgt; T and MTHFR 677 C andgt; T polymorphisms with breast and ovarian cancer risk in BRCA1/2 mutation carriers: results from a multicenter study
- 2012
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Ingår i: British Journal of Cancer. - : Cancer Research UK / Nature Publishing Group. - 0007-0920 .- 1532-1827. ; 106:12, s. 2016-2024
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The variable penetrance of breast cancer in BRCA1/2 mutation carriers suggests that other genetic or environmental factors modify breast cancer risk. Two genes of special interest are prohibitin (PHB) and methylene-tetrahydrofolate reductase (MTHFR), both of which are important either directly or indirectly in maintaining genomic integrity. less thanbrgreater than less thanbrgreater thanMETHODS: To evaluate the potential role of genetic variants within PHB and MTHFR in breast and ovarian cancer risk, 4102 BRCA1 and 2093 BRCA2 mutation carriers, and 6211 BRCA1 and 2902 BRCA2 carriers from the Consortium of Investigators of Modifiers of BRCA1 and BRCA2 (CIMBA) were genotyped for the PHB 1630 Candgt;T (rs6917) polymorphism and the MTHFR 677 Candgt;T (rs1801133) polymorphism, respectively. less thanbrgreater than less thanbrgreater thanRESULTS: There was no evidence of association between the PHB 1630 Candgt;T and MTHFR 677 Candgt;T polymorphisms with either disease for BRCA1 or BRCA2 mutation carriers when breast and ovarian cancer associations were evaluated separately. Analysis that evaluated associations for breast and ovarian cancer simultaneously showed some evidence that BRCA1 mutation carriers who had the rare homozygote genotype (TT) of the PHB 1630 Candgt;T polymorphism were at increased risk of both breast and ovarian cancer (HR 1.50, 95% CI 1.10-2.04 and HR 2.16, 95% CI 1.24-3.76, respectively). However, there was no evidence of association under a multiplicative model for the effect of each minor allele. less thanbrgreater than less thanbrgreater thanCONCLUSION: The PHB 1630TT genotype may modify breast and ovarian cancer risks in BRCA1 mutation carriers. This association need to be evaluated in larger series of BRCA1 mutation carriers.
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- Hillert, J., et al.
(författare)
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Expert opinion on the use of contraception in people with multiple sclerosis
- 2022
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Ingår i: Multiple Sclerosis Journal. - : Sage Publications. - 1352-4585 .- 1477-0970. ; 28:Suppl. 3, s. 187-188
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The most appropriate use, type, and timing of contraception in people with multiple sclerosis (PwMS) is poorly understood, and specific guidance is absent.Aims and Objectives: To provide insight into potential clinical guidelines for the use of contraception by PwMS through development of recommendations by a consensus-based program led by international clinical experts.Methods: A multidisciplinary steering committee (SC) of 13 international expert healthcare professionals (HCPs) identified 15 key clinical questions on the use of contraception in PwMS, which addressed issues relating to patient-centred care, selection of contraception for PwMS, and time needed to use contraception since the last dose of disease modifying therapies (DMTs). Twenty-five clinical recommendations addressing the questions were drafted using evidence obtained from a comprehensive systematic literature review combined with expert opinion from the SC. An extended faculty of 32 HCPs from 18 countries including a patient association representative, and the SC members (n=12), voted on the recommendations. Consensus on recommendations was achieved when ⩾75% of respondents expressed an agreement score of 7–9, on a 9-point scale.Results: Overall, consensus was achieved on 24 out of 25 clinical recommendations. In detail, consensus in the range of 90–100% was achieved on 11 recommendations, 12 recommendations achieved 80–89% consensus, and 1 recommendation achieved 75–79% consensus (n=44). The strength of recommendations ranged from 7–9. The one statement failing to achieve consensus scored 74.1%. Clinical recommendations are provided on the process of prescribing contraception for PwMS, including the recommended types of HCPs involved and optimal topics to discuss; the range of contraceptive options and the key considerations involved in selecting an appropriate method of contraception; and the timing of starting and stopping contraception in relation to the use of DMTs.Conclusions: These expert recommendations were based on a robust consensus approach, providing timely and practical guidance on the use of contraception for HCPs treating PwMS and will form the basis of further publications and clinical tools.
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- Berg, Malin, 1976, et al.
(författare)
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Fatigue in Long-Term Head and Neck Cancer Survivors From Diagnosis Until Five Years After Treatment
- 2023
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Ingår i: Laryngoscope. - : Wiley. - 0023-852X.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Fatigue due to cancer is a challenging symptom that might be long-lasting after cancer treatment. The aim of this study was to follow the development of fatigue among head and neck cancer (HNC) patients prospectively and longitudinally and to analyze predictors for acute and chronic fatigue. Methods: HNC patients treated with curative intent were included at diagnosis and completed the following questionnaires multiple times, up to 5 years after treatment: the EORTC QLQ-FA12 for fatigue, EORTC QLQ-C30, and HNC-specific EORTC QLQ-H&N35 together with an anxiety and depression questionnaire. Predictors of fatigue were evaluated at 3 months and 5 years after treatment. Results: Of the 311 study participants, 74% responded at the 5-year follow-up. Physical fatigue was significantly worse 3 months after treatment, while emotional and cognitive fatigue were the worst at diagnosis and at 3 months. All fatigue domains were significantly better after 1 year, and the fatigue scores remained stable from 1 until 5 years after treatment. Three months after chemoradiotherapy, physical fatigue was more significant, but no long-term differences due to treatment modalities were found. Depression and anxiety were predictors for chronic emotional fatigue, and local HN pain and swallowing problems were predictors for chronic physical fatigue. Better global quality of life at diagnosis was associated with less physical and emotional fatigue. Conclusion: Fatigue was worst in the short term for HNC patients and improved after 1 year, and long-term fatigue remained stable up to 5 years after treatment. A few predictors for chronic fatigue were found. Level of Evidence: 3 Laryngoscope, 2023. © 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
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| 11. |
- Berg, Malin, 1976, et al.
(författare)
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The effect of age on health-related quality of life for head and neck cancer patients up to 1 year after curative treatment
- 2022
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Ingår i: Journal of Geriatric Oncology. - : Elsevier BV. - 1879-4068. ; 13:1, s. 60-66
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to evaluate the effect of age on health-related quality of life (HRQOL) for patients with head and neck cancer (HNC), treated with curative intent, in the Western healthcare region of Sweden. Materials and Methods: In this prospective observational study, 311 HNC patients completed quality of life questionnaires for cancer (EORTC QLQ-C30 and EORTC QLQ-H&N35) and for older patients with cancer (EORT QLQELD14) at diagnosis and 3, 6, and 12 months after start of treatment. Mean scores for patients >_70 years old were compared to younger patients (50 to 69 years old) to assess differences in HRQOL. Results: Of the 311 study participants, 105 patients were >_70 years old (median age 76.7), of which 32 were >_80 years of age. Most HRQOL scores were equal or better for older adult patients at 3 months after treatment, but physical function was better for younger adult patients up to 12 months after treatment. At 6 months the HRQOL was similar (older patients had less appetite loss and financial difficulties), while the oldest patients (>_80 years) had worse fatigue, role function, and feeling ill at 12 months. For the EORTC-ELD-14 questionnaire, older patients scored better for worries at diagnosis and reported more difficulties in maintaining purpose at 12 months after treatment. Conclusion: When curative treatment is administered, older adult patients with HNC have similar or even better HRQOL compared to younger adult patients, except for physical function, during the first year. (c) 2021 Elsevier Ltd. All rights reserved.
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| 12. |
- Bergqvist, Joel, et al.
(författare)
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Non-infectious rhinitis is more strongly associated with early-rather than late-onset of COPD: data from the European Community Respiratory Health Survey (ECRHS)
- 2020
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 277, s. 1353-1359
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Chronic obstructive pulmonary disease (COPD) is associated with several co-morbidities and non-infectious rhinitis (NIR) has emerged as a new possible co-morbidity. The primary aim of this study is to confirm a previously reported association between NIR and COPD in a multicentre population over time. The secondary aim is to investigate the course over time of such an association through a comparison between early- and late-onset COPD. Methods This study is part of the European Community Respiratory Health Survey (ECRHS). A random adult population from 25 centres in Europe and one in Australia was examined with spirometry and answered a respiratory questionnaire in 1998-2002 (ECRHS II) and in 2008-2013 (ECRHS III). Symptoms of non-infectious rhinitis, hay fever and asthma, and smoking habits were reported. Subjects reporting asthma were excluded. COPD was defined as a spirometry ratio of FEV1/FVC < 0.7. A total of 5901 subjects were included. Results Non-infectious rhinitis was significantly more prevalent in subjects with COPD compared with no COPD (48.9% vs 37.1%, p < 0.001) in ECRHS II (mean age 43) but not in ECHRS III (mean age 54). In the multivariable regression model adjusted for COPD, smoking, age, BMI, and gender, non-infectious rhinitis was associated with COPD in both ECRHS II and III. Conclusion Non-infectious rhinitis was significantly more common in subjects with COPD at a mean age of 43. Ten years later, the association was weaker. The findings indicate that NIR could be associated with the early onset of COPD.
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- Michaud, Dominique S., et al.
(författare)
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Anthropometric Measures, Physical Activity, and Risk of Glioma and Meningioma in a Large Prospective Cohort Study
- 2011
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Ingår i: Cancer Prevention Research. - Philadelphia, PA : American Association for Cancer Research, Inc.. - 1940-6207 .- 1940-6215. ; 4:9, s. 1385-1392
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Tidskriftsartikel (refereegranskat)abstract
- Body fatness has been associated with increased risk of a number of hormone-dependent cancers. Recent studies suggest that body mass index (BMI) may be related to meningiomas, which are more common in women than men, and for which estrogens are believed to play a role. Using data from a large European propective cohort, 203 incident cases of meningioma and 340 cases of glioma were included in the analysis for measures of body fat, height, and physical activity among 380,775 participants. All analyses were conducted using Cox proportional hazards model and controlling for age, sex, country, and education. A 71% increase in risk of meningioma was observed among men and women in the top quartile of waist circumference (HR = 1.71, 95% CI = 1.08-2.73, P-trend = 0.01). A positive association was also observed for BMI and meningioma (HR = 1.48, 95% CI = 0.98-2.23, for BMI >= 30 compared with a BMI of 20-24.9, P-trend = 0.05). An association with height and meningioma was also suggestive (HR = 1.24, 95% 0.96-1.51, for each 10 cm increase). In contrast, no associations were observed for height and different measures of body fat and risk of glioma. Physical activity was not related to either type of brain tumors. Results from this study support an increase in risk of meningioma with higher body fatness among both men and women. No association was observed between anthropometric measures and risk of glioma. Cancer Prev Res; 4(9); 1385-92. (C) 2011 AACR.
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| 21. |
- Abel, Edvard, 1970, et al.
(författare)
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Impact on quality of life of IMRT versus 3-D conformal radiation therapy in head and neck cancer patients: A case control study
- 2017
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Ingår i: Advances in Radiation Oncology. - : Elsevier BV. - 2452-1094. ; 2:3, s. 346-353
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Tidskriftsartikel (refereegranskat)abstract
- Objective The purpose of this study was to prospectively and longitudinally compare the health-related quality of life (HRQOL) outcomes between head and neck (HN) cancer patients treated with parotid-sparing intensity modulated radiation therapy (IMRT) and patients treated with 3-dimensional conventional radiation therapy (3D-CRT). Methods and materials Before and up to 12 months after treatment, HRQOL was recorded in patients with HN cancer who were referred to the Department of Oncology at Sahlgrenska University Hospital for curative IMRT. The study group's HRQOL was compared with a matched group of patients from previous descriptive HRQOL studies treated with 3D-CRT. Both groups' HRQOL was measured by the European Organization for Research and Treatment for Cancer QLQ-C30 and European Organization for Research and Treatment for Cancer QLQ-HN35 at 6 time points in the first year after diagnosis. Results Two hundred and seven patients were included, 111 treated with IMRT and 96 matched controls treated with 3D-CRT. Both groups' HRQOL deteriorated during and after treatment. Just after treatment, worse HRQOL scores were observed in the IMRT group regarding insomnia (38 vs 27; P = .032), appetite loss (64 vs 50; P = .019), senses (54 vs 41; P = .017), and coughing (39 vs 26, P = .009). At 12 months, however, significantly better HRQOL scores were observed in the IMRT group regarding problems with dry mouth (72 vs 62; P = .018), pain (28 vs 20; P = .018), sexuality (37 vs 23; P = .016), social contacts (10 vs 6; P = .026), cognitive functioning (79 vs 87; P = .0057), and financial difficulties (12 vs 20; P = .0019). Conclusions This study further supports the hypothesis that the introduction of IMRT has improved the long-term quality of life of HN cancer patients who have been treated with radiation therapy, but might cause more acute side effects. Longer follow-up is needed to study late complications.
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| 23. |
- Axelsson, Lars, et al.
(författare)
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Effect of prophylactic percutaneous endoscopic gastrostomy tube on swallowing in advanced head and neck cancer: A randomized controlled study.
- 2017
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Ingår i: Head & neck. - : Wiley. - 1097-0347 .- 1043-3074. ; 39:5, s. 908-915
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Tidskriftsartikel (refereegranskat)abstract
- Dysphagia is common in head and neck cancer. A percutaneous endoscopic gastrostomy (PEG) tube is used to facilitate nutrition; however, some retrospective studies have indicated that the PEG tube causes dysphagia.A randomized study of patients with head and neck cancer was conducted with up to 10 years of follow-up. Patients were randomized to either the prophylactic PEG tube group (study group) or the common clinical nutritional support group (control group). At each follow-up, a dietician assessed the oral intake, noted the patients' weight, and if the patients used a PEG tube. Dysphagia was also assessed by the quality of life questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Head and Neck 35-questions (EORTC-QLQ-H&N35).One hundred thirty-four patients were included in this study. There was no significant difference in swallowing function between the groups after 12 months, 24 months, and 8 years based on the EORTC-QLQ-H&N35, the oral intake scale, tube dependence, esophageal intervention, weight, body mass index (BMI), and overall survival.A prophylactic PEG tube can be used without an increased risk of long-term dysphagia in patients with head and neck cancer. © 2017 Wiley Periodicals, Inc. Head Neck, 2017.
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| 24. |
- Axelsson, Lars, et al.
(författare)
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Prognostic factors for head and neck cancer of unknown primary including the impact of human papilloma virus infection
- 2017
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Ingår i: Journal of Otolaryngology-Head & Neck Surgery. - : Springer Science and Business Media LLC. - 1916-0216. ; 46
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Tidskriftsartikel (refereegranskat)abstract
- Background: Head and neck cancer of unknown primary (HNCUP) is rare and prospective studies are lacking. The impact of different prognostic factors such as age and N stage is not completely known, the optimal treatment is not yet established, and the reported survival rates vary. In the last decade, human papilloma virus (HPV) has been identified as a common cause of and important prognostic factor in oropharyngeal cancer, and there is now growing interest in the importance of HPV for HNCUP. The aim of the present study on curatively treated HNCUP was to investigate the prognostic importance of different factors, including HPV status, treatment, and overall survival. Methods: A search for HNCUP was performed in the Swedish Cancer Registry, Western health district, between the years 1992-2009. The medical records were reviewed, and only patients with squamous cell carcinoma or undifferentiated carcinoma treated with curative intent were included. The tumor specimens were retrospectively analyzed for HPV with p16 immunostaining. Results: Sixty- eight patients were included. The mean age was 59 years. The majority were males, and had N2 tumors. Sixty-nine percent of the tumors were HPV positive using p16 staining. Patients who were older than 70 years, patients with N3-stage tumors, and patients with tumors that were p16 negative had a significantly worse prognosis. The overall 5-year survival rate for patients with p16-positive tumors was 88% vs 61% for p16- negative tumors. Treatment with neck dissection and postoperative radiation or (chemo) radiation had 81 and 88% 5- year survival rates, respectively. The overall and disease- free 5-year survival rates for all patients in the study were 82 and 74%. Conclusions: Curatively treated HNCUP had good survival. HPV infection was common. Independent prognostic factors for survival were age over 70 years, HPV status and N3 stage. We recommend that HPV analysis should be performed routinely for HNCUP. Treatment with neck dissection and postoperative radiation or (chemo) radiation showed similar survival rates.
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| 25. |
- Berg, Malin, 1976, et al.
(författare)
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A randomized study comparing the nutritional effects of radiotherapy with cetuximab versus cisplatin in patients with advanced head and neck cancer
- 2024
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Ingår i: HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK. - 1043-3074 .- 1097-0347. ; 46:4, s. 760-771
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHead and neck cancer (HNC) patients have a high risk of developing malnutrition. This randomized study aimed to compare the effect of weekly cisplatin or cetuximab combined with radiotherapy on weight loss at 3 months after treatment was started. Secondary outcomes were the prevalence of malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria, feeding tube dependence and health related quality of life from a nutritional perspective.MethodsPatients from the ARTSCAN III study with advanced HNC were assessed for weight, body composition, enteral tube dependence and selected quality-of-life scores (EORTC QLQ-C30 and QLQ-H&N35) at diagnosis and 6 weeks 3, 6 and 12 months after treatment initiation.ResultsOf the 80 patients, 38 and 42 were randomized to receive cetuximab and cisplatin treatment, respectively. There was no significant difference in weight loss at 3 months between the two study groups. However, the cetuximab group had significantly less weight loss, fewer enteral feeding tubes and better physical functioning at the end of treatment but more pain-related problems 3 months after treatment initiation. No differences between the groups were found at 6 and 12 months. The prevalence of malnutrition was not significantly different at any time point.ConclusionThe hypothesized benefit of concomitant treatment with cetuximab over cisplatin regarding the prevalence of malnutrition was not supported by this study.
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| 26. |
- Bergqvist, Joel, et al.
(författare)
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Chronic rhinosinusitis associated with chronic bronchitis in a five-year follow-up: the Telemark study
- 2022
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Ingår i: Bmc Pulmonary Medicine. - : Springer Science and Business Media LLC. - 1471-2466. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Chronic rhinosinusitis (CRS) is associated with generalised airway inflammation. Few studies have addressed the relationship between CRS and chronic bronchitis (CB). Methods This prospective study over a five-year period aims to investigate the risk of developing CB in subjects reporting CRS at the beginning of the study. A random sample of 7393 adult subjects from Telemark County, Norway, answered a comprehensive respiratory questionnaire in 2013 and then 5 years later in 2018. Subjects reporting CB in 2013 were excluded from the analyses. New cases of CB in 2018 were analysed in relation to having CRS in 2013 or not. Results The prevalence of new-onset CB in 2018 in the group that reported CRS in 2013 was 11.8%. There was a significant increase in the odds of having CB in 2018 in subjects who reported CRS in 2013 (OR 3.8, 95% CI 2.65-5.40), adjusted for age, sex, BMI, smoking and asthma. Conclusion In this large population sample, CRS was associated with increased odds of developing CB during a five-year follow-up. Physicians should be aware of chronic bronchitis in patients with CRS.
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| 27. |
- Bove, Mogens, 1949, et al.
(författare)
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Acid challenge to the esophageal mucosa: effects on local nitric oxide formation and its relation to epithelial functions
- 2005
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Ingår i: Dig Dis Sci. - : Springer Science and Business Media LLC. - 0163-2116 .- 1573-2568. ; 50:4, s. 640-8
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the effect of esophageal acid exposure on epithelial function, transmucosal potential, histopathological markers of acute tissue damage, and local nitric oxide production were examined in healthy volunteers treated with proton pump inhibitors (group I), patients with treated reflux disease (group II), and patients with untreated erosive reflux disease (group III). The participants were randomized to esophageal perfusion with either saline or HCl. Denominators of acute acid exposure were balloon cells in superficial layers and superficial densification. The nitric oxide concentrations in groups I to III increased from < 1, 10.0+/-10.0, and 20.6+/-19.9 ppb, respectively, to 300+/-80, 1360+/-1080, and 920+/-700 ppb after HCl infusion (P < 0.001). Inducible nitric oxide synthase was consistently expressed in the epithelium. Blood flow was lower among reflux patients but did not correlate with acid exposure or nitric oxide. Nitric oxide is formed following acid perfusion and predominantly in gastroesophageal reflux disease.
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| 28. |
- Bove, Mogens, 1949, et al.
(författare)
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Acid challenge to the human esophageal mucosa: effects on epithelial architecture in health and disease
- 2005
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Ingår i: Dig Dis Sci. - : Springer Science and Business Media LLC. - 0163-2116 .- 1573-2568. ; 50:8, s. 1488-96
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Tidskriftsartikel (refereegranskat)abstract
- The histological changes that occur in the squamous epithelium in response to acute acid challenge was examined in healthy controls and proton pump inhibitor-treated gastroesophageal reflux disease (GERD) patients and related to the state of untreated erosive GERD in a saline-controlled, randomized perfusion study. In the basal state a stepwise significant increase in the thickness of the basal cell layer, papillary length, and dilatation of intercellular spaces (DIS) was seen when the three groups were compared. Acid perfusion induced a slight increase in the height of the basal cell layer mainly in healthy volunteers; this layer appears to be reactive to acute acid challenge as well as to acid suppressive therapy. DIS increases promptly in response to acute acid exposure in the healthy epithelium but no changes were seen in the lengths of the papillae or regarding DIS in the GERD patients. A protective effect of luminal nitric oxide on DIS development is suggested.
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| 29. |
- Dencker, Nils, et al.
(författare)
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The solvability and subellipticity of systems of pseudodifferential operators
- 2009
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Ingår i: Advances in Phase Space Analysis of Partial Differential Equations - In Honor of Ferruccio Colombini's 60th Birthday. - Boston : Birkhäuser Boston. - 2374-0280 .- 1421-1750. - 9780817648602 ; 78, s. 73-94
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Konferensbidrag (refereegranskat)abstract
- The paper studies the local solvability and subellipticity for square systems of principal type. These are the systems for which the principal symbol vanishes of first order on its kernel. For systems of principal type having constant characteristics, local solvability is equivalent to condition (Ψ) on the eigenvalues. This is a condition on the sign changes of the imaginary part along the oriented bicharacteristics of the real part of the eigenvalue. In the generic case when the principal symbol does not have constant characteristics, condition (Ψ) is not sufficient and in general not well defined. Instead we study systems which are quasi-symmetrizable, these systems have natural invariance properties and are of principal type. We prove that quasi-symmetrizable systems are locally solvable. We also study the subellipticity of quasi-symmetrizable systems in the case when principal symbol vanishes of finite order along the bicharacteristics. In order to prove subellipticity, we assume that the principal symbol has the approximation property, which implies that there are no transversal bicharacteristics.
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| 31. |
- Silander, Ewa M, 1952, et al.
(författare)
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Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer - a randomized study.
- 2011
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Ingår i: Head & neck. - : Wiley. - 1097-0347 .- 1043-3074.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The purpose of this randomized study was to examine if a prophylactic percutaneous endoscopic gastrostomy (PEG) for enteral nutrition could prevent malnutrition, reduce hospital stay, and improve health-related quality of life (HRQOL). METHODS: One hundred thirty-four patients with advanced head and neck cancer were randomized to either prophylactic PEG (study group) or clinical praxis (control group). Patients' weight, body mass index (BMI), need for hospitalization, and HRQOL were noted at 7 occasions during 2 years. RESULTS: No difference in hospital stay was found. After 6 months, HRQOL was significantly better and the weight loss was significantly less in the study group. The number of malnourished patients were consistently about 10% lower in the study group during the first study year. The study group started to use enteral feeding significantly earlier and for a significantly longer time period (p < .0001). CONCLUSION: Prophylactic PEG was associated with significantly earlier start and longer use of enteral nutrition, fewer malnourished patients over time, and improved HRQOL at 6 months posttreatment start. © 2011 Wiley Periodicals, Inc. Head Neck, 2011.
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| 32. |
- Tytor, J., et al.
(författare)
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Topically applied mometasone furoate improves dysphagia in adult eosinophilic esophagitis - results from a double-blind, randomized, placebo-controlled trial
- 2021
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 56:6, s. 629-634
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Topical corticosteroids are considered a cornerstone in the treatment of patients with eosinophilic esophagitis. The aim of this study was to evaluate the benefit of using mometasone furoate spray versus placebo on dysphagia and health-related quality of life in these patients. Material and Methods Consecutive, newly diagnosed adult patients with eosinophilic esophagitis were randomized and treated with either 200 micrograms of orally administered topical mometasone furoate or placebo 4 times daily for 8 weeks. Symptoms and quality of life were evaluated using questionnaires including the Watson Dysphagia Scale, the European Organization for Research and Treatment of Cancer Quality of Life-Oesophageal Module 18 and the Short Form-36 before and after treatment. Results In the intention-to-treat analysis (n = 36) the Watson Dysphagia Scale score after mometasone treatment was reduced by 6.5 (median, p < .01) compared with 0 (median, ns) in the placebo group. The benefit of mometasone over placebo was significant (p < .05). In the per-protocol analysis (n = 33) the Watson Dysphagia Scale score was reduced by 5 (median, p = .01) after mometasone treatment compared with 0 (median, ns) in the placebo group. The advantage of mometasone over the placebo was significant (p < .05). The benefit of using mometasoneas evaluated by the two quality of life questionnaires was, however, insignificant. Conclusions Our finding suggests that in adult patients with eosinophilic esophagitis, topical mometasone furoate exerts a beneficial effect compared with placebo regarding the main symptom, i.e., dysphagia. A corresponding benefit could not be verified regarding the various quality of life measurements.
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