| 1. |
- Bill-Axelson, Anna, et al.
(författare)
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Radical prostatectomy versus watchful waiting in localized prostate cancer : the Scandinavian prostate cancer group-4 randomized trial
- 2008
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Ingår i: Journal of the National Cancer Institute. - : Oxford University Press. - 0027-8874 .- 1460-2105. ; 100:16, s. 1144-1154
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The benefit of radical prostatectomy in patients with early prostate cancer has been assessed in only one randomized trial. In 2005, we reported that radical prostatectomy improved prostate cancer survival compared with watchful waiting after a median of 8.2 years of follow-up. We now report results after 3 more years of follow-up.METHODS: From October 1, 1989, through February 28, 1999, 695 men with clinically localized prostate cancer were randomly assigned to radical prostatectomy (n = 347) or watchful waiting (n = 348). Follow-up was complete through December 31, 2006, with histopathologic review and blinded evaluation of causes of death. Relative risks (RRs) were estimated using the Cox proportional hazards model. Statistical tests were two-sided.RESULTS: During a median of 10.8 years of follow-up (range = 3 weeks to 17.2 years), 137 men in the surgery group and 156 in the watchful waiting group died (P = .09). For 47 of the 347 men (13.5%) who were randomly assigned to surgery and 68 of the 348 men (19.5%) who were not, death was due to prostate cancer. The difference in cumulative incidence of death due to prostate cancer remained stable after about 10 years of follow-up. At 12 years, 12.5% of the surgery group and 17.9% of the watchful waiting group had died of prostate cancer (difference = 5.4%, 95% confidence interval [CI] = 0.2 to 11.1%), for a relative risk of 0.65 (95% CI = 0.45 to 0.94; P = .03). The difference in cumulative incidence of distant metastases did not increase beyond 10 years of follow-up. At 12 years, 19.3% of men in the surgery group and 26% of men in the watchful waiting group had been diagnosed with distant metastases (difference = 6.7%, 95% CI = 0.2 to 13.2%), for a relative risk of 0.65 (95% CI = 0.47 to 0.88; P = .006). Among men who underwent radical prostatectomy, those with extracapsular tumor growth had 14 times the risk of prostate cancer death as those without it (RR = 14.2, 95% CI = 3.3 to 61.8; P < .001).CONCLUSION: Radical prostatectomy reduces prostate cancer mortality and risk of metastases with little or no further increase in benefit 10 or more years after surgery.
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| 2. |
- Liljegren, Göran, et al.
(författare)
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10-year Results After Sector Resection With or Without Postoperative Radiotherapy for Stage I Breast Cancer : a Randomized Trial
- 1999
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Ingår i: Journal of Clinical Oncology. - 0732-183X .- 1527-7755. ; 17:8, s. 2326-2333
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study the long-term effectiveness of postoperative radiotherapy after sector resection for breast cancer in a randomized trial in which mammography is a major pathway to diagnosis. PATIENTS AND METHODS: Three hundred eighty-one women with a unifocal breast cancer < or = 20 mm in diameter on the preoperative mammogram and without histopathologic signs of axillary metastases were treated by sector resection plus axillary dissection. Of these patients, 184 women were randomized to receive postoperative radiotherapy to the breast (XRT group), and 197 women received no further treatment (non-XRT group). RESULTS: The local recurrence rate was 8.5% (95% confidence interval [CI], 3.9% to 13.1%) in the XRT group and 24.0% (95% CI, 17.6% to 30.4%) in the non-XRT group (P =.0001). Survival free from regional and distant recurrence was 83. 3% in the XRT group (95% CI, 77.5% to 89.1%) and 80.0% in the non-XRT group (95% CI, 73.9% to 86.1%) (P =.23). Overall survival was 77.5% in the XRT group (95% CI, 70.9% to 84.1%) and 78% in the non-XRT group (95% CI, 71.7% to 84.3%) (P =.99). A subgroup analysis suggested that women older than 55 years of age without comedo or lobular carcinomas had a low risk of local recurrence of 6.1% (95% CI, 0.1% to 9.1%) in the XRT-group and 11.0% (4.0% to 18.0%) in the non-XRT group (P =.16). CONCLUSION: Sector resection plus radiotherapy resulted in an absolute reduction in local recurrence of 16% at 10 years compared with surgery alone. Women older than 55 years of age without comedo or lobular carcinomas may have a low risk of local recurrence. Postoperative radiotherapy was not shown to reduce distant recurrences or improve overall survival.
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| 3. |
- Shungin, Dmitry, et al.
(författare)
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New genetic loci link adipose and insulin biology to body fat distribution.
- 2015
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 518:7538, s. 187-378
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Tidskriftsartikel (refereegranskat)abstract
- Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms.
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| 4. |
- Smith, Jennifer A, et al.
(författare)
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Genome-wide association study identifies 74 loci associated with educational attainment
- 2016
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Ingår i: Nature (London). - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 533:7604, s. 539-542
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Tidskriftsartikel (refereegranskat)abstract
- Educational attainment is strongly influenced by social and other environmental factors, but genetic factors are estimated to account for at least 20% of the variation across individuals. Here we report the results of a genome-wide association study (GWAS) for educational attainment that extends our earlier discovery sample of 101,069 individuals to 293,723 individuals, and a replication study in an independent sample of 111,349 individuals from the UK Biobank. We identify 74 genome-wide significant loci associated with the number of years of schooling completed. Single-nucleotide polymorphisms associated with educational attainment are disproportionately found in genomic regions regulating gene expression in the fetal brain. Candidate genes are preferentially expressed in neural tissue, especially during the prenatal period, and enriched for biological pathways involved in neural development. Our findings demonstrate that, even for a behavioural phenotype that is mostly environmentally determined, a well-powered GWAS identifies replicable associated genetic variants that suggest biologically relevant pathways. Because educational attainment is measured in large numbers of individuals, it will continue to be useful as a proxy phenotype in efforts to characterize the genetic influences of related phenotypes, including cognition and neuropsychiatric diseases.
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| 5. |
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| 6. |
- Allvin, Kerstin, 1970, et al.
(författare)
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Elevated serum levels of estradiol, dihydrotestosterone, and inhibin B in adult males born small for gestational age
- 2008
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Ingår i: Journal of Clinical Endocrinology & Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 93:4, s. 1464-9
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: Prenatal growth restriction may affect future fertility in both females and males. Studies have shown that growth-retarded male rats have different sexual behavior and disturbed steroidogenesis. OBJECTIVE: We hypothesized that adult human males born small for gestational age (SGA) have an altered sex hormone profile. DESIGN, SETTING, AND PATIENTS: Twenty-five adult males born SGA with median birth weight -2.2 sd scores (SDS) and birth length -2.4 SDS were studied. Median age was 23.1 yr and final height -0.5 SDS. They were compared with 44 male controls with median age 20.5 yr and final height 0.4 SDS. MAIN OUTCOME MEASURE: The primary outcome before the study started was 17beta-estradiol (E(2)) levels in SGA males. RESULTS: The SGA group showed significantly higher median levels of E(2), 17.9 pg/ml (P < 0.001), and dihydrotestosterone (DHT), 0.543 ng/ml (P < 0.05), compared with controls, 12.6 pg/ml and 0.423 ng/ml, respectively. Testosterone (T) levels did not differ between groups. E(2) to T ratio correlated negatively to birth weight (r = -0.40, P < 0.01) and birth length (r = -0.44, P < 0.001). DHT to T ratio correlated negatively to birth weight (r = -0.51, P < 0.001) and birth length (r = -0.38, P < 0.01). Males born SGA also had significantly higher median levels of inhibin B, 164 pg/ml (P < 0.05), compared with controls, 137 pg/ml. Inhibin B correlated negatively to birth length (r = -0.34, P < 0.01). CONCLUSION: SGA males of normal stature have higher levels of E(2), DHT, and inhibin B than controls, indicating a disturbed steroid synthesis or metabolism. Aromatase activity, calculated as E(2) to T ratio, and 5alpha-reductase activity, calculated as DHT to T ratio, is negatively correlated to size at birth.
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| 7. |
- Andersson, Anders S, et al.
(författare)
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Vitamin supplementation normalizes total plasma homocysteine concentration but not plasma homocysteine redox status in patients with acute coronary syndromes and hyperhomocysteinemia.
- 2002
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Ingår i: Clinical Chemistry and Laboratory Medicine. - 1434-6621. ; 40:6, s. 554-558
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Tidskriftsartikel (refereegranskat)abstract
- Despite the growing evidence that elevated total homocysteine (tHcy) in plasma is a cardiovascular risk factor, the mechanism underlying the vascular injury is still unknown. Studies are difficult due to the fact that little is known about the formation of different homocysteine species in vivo. In the present study we have investigated the different fractions of tHcy in 21 patients with acute coronary syndromes and elevated concentration of plasma tHcy. A subgroup of the patients (n=16) was investigated before and after a 3 months study period with or without vitamin supplementation (folic acid 5 mg, pyridoxine 40 mg and cyanocobalamin 1 mg once daily). A major finding is that these patients had a lowered ratio (0.95%) between the concentration of reduced homocysteine (HcyH) and tHcy compared to controls (1.38%). A low ratio HcyH/tHcy in plasma in combination with elevated plasma tHcy concentrations might reflect increased oxidative activity or decreased reducing capacity in plasma from the patients. Another main finding in the present study is that, although vitamin supplementation of these patients normalized plasma tHcy, the ratio between HcyH and tHcy did not normalize. Since substantial evidence indicates that progression of arteriosclerosis is related to enhanced oxidant activity, the premature vascular disease associated with increased plasma tHcy concentration might be due to increased oxidative activity and the elevated plasma tHcy concentration may only reflect the increased oxidative stress.
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| 8. |
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| 9. |
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| 10. |
- Andersson, Lisa, et al.
(författare)
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The same ELA class II risk factors confer equine insect bite hypersensitivity in two distinct populations
- 2012
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Ingår i: Immunogenetics. - : Springer Science and Business Media LLC. - 0093-7711 .- 1432-1211. ; 64:3, s. 201-208
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Tidskriftsartikel (refereegranskat)abstract
- Insect bite hypersensitivity (IBH) is a chronic allergic dermatitis common in horses. Affected horses mainly react against antigens present in the saliva from the biting midges, Culicoides ssp, and occasionally black flies, Simulium ssp. Because of this insect dependency, the disease is clearly seasonal and prevalence varies between geographical locations. For two distinct horse breeds, we genotyped four microsatellite markers positioned within the MHC class II region and sequenced the highly polymorphic exons two from DRA and DRB3, respectively. Initially, 94 IBH-affected and 93 unaffected Swedish born Icelandic horses were tested for genetic association. These horses had previously been genotyped on the Illumina Equine SNP50 BeadChip, which made it possible to ensure that our study did not suffer from the effects of stratification. The second population consisted of 106 unaffected and 80 IBH-affected Exmoor ponies. We show that variants in the MHC class II region are associated with disease susceptibility (p(raw)=2.34x10(-5)), with the same allele (COR112:274) associated in two separate populations. In addition, we combined microsatellite and sequencing data in order to investigate the pattern of homozygosity and show that homozygosity across the entire MHC class II region is associated with a higher risk of developing IBH (p=0.0013). To our knowledge this is the first time in any atopic dermatitis suffering species, including man, where the same risk allele has been identified in two distinct populations.
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| 11. |
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| 12. |
- Andersson, Pia, 1968, et al.
(författare)
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Building Perspective Awareness as a Workplace Practice
- 2022
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Ingår i: Journal of Workplace Learning. - 1366-5626. ; 34:4, s. 373-387
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Tidskriftsartikel (refereegranskat)abstract
- The present study aims to describe the implementation of a facilitated dialogue model intended to improve communication across professional logics and knowledge boundaries in two units of a large health-care organization in Sweden. This is a mixed-methods study with interviews, field observations and follow- up questionnaires that were conducted during the implementation process. The conclusion drawn in this study is that it is possible to change and improve the dialogue between health-care professionals with the help of a tailored, facilitated dialogue model. The authors found that different professional logics can indeed meet and share perspectives if the right conditions are provided. Moreover, an improved dialogue between different professional groups may contribute to work satisfaction, engagement, social cohesion and communication between professionals. This study shows that the right organizational conditions, such as support from managers, must exist if the model’s inherent possibilities are to be used. Inhouse facilitation may be a sustainable model for facilitated workplace dialogue when its implementation is supported by the overall organization. The contribution is an empirically based analysis of a new form of model for mediating perspectives within an organization with distinct professional roles. This study shows how, under the right conditions, the model can contribute to a perspective awareness and thus a more mature work organization.
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| 13. |
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| 14. |
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| 15. |
- Askling, Berit, et al.
(författare)
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Introduktionsperioden i förskollärarutbildningen.
- 1977
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Rapport (populärvet., debatt m.m.)abstract
- Avsikten med projektgruppens arbete har varit att sprida information om och erfarenheter av några olika modeller för introduktionsperioden i förskollärarutbildningen. De modeller, som presenteras i rapporten, är hämtade från förskoleseminarierna i Gävle och Södertälje samt lärarhögskolan i Växjö,
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| 16. |
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| 17. |
- Bergenfeldt, Henrik, et al.
(författare)
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Pseudoaneurysm Development after Drug-Eluting Balloon (DEB) Angioplasty of a Venous Femoropopliteal Bypass Graft
- 2021
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Ingår i: Annals of Vascular Surgery. - : Elsevier BV. - 0890-5096. ; 72, s. 5-665
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Tidskriftsartikel (refereegranskat)abstract
- Endovascular recanalization of occluded venous femoropopliteal bypass grafts is widely used because of easy access. This case report describes pseudoaneurysm developing 4 weeks after endovascular recanalization of an occluded in situ venous femoropopliteal graft. The patient was treated for a popliteal aneurysm with a venous femoropopliteal bypass graft, which subsequently occluded. Four weeks after DEB PTA, the occluded graft developed 3 pseudoaneurysms. Impaired vessel wall healing after intraluminal paclitaxel administration could have contributed to this. This case adds a perspective to the choice of treatment of occluded venous femoropopliteal bypass grafts.
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| 18. |
- Bergman, Peter, et al.
(författare)
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Safety and efficacy of the mRNA BNT162b2 vaccine against SARS-CoV-2 in five groups of immunocompromised patients and healthy controls in a prospective open-label clinical trial
- 2021
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Ingår i: EBioMedicine. - : Elsevier BV. - 2352-3964. ; 74
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with immunocompromised disorders have mainly been excluded from clinical trials of vaccination against COVID-19. Thus, the aim of this prospective clinical trial was to investigate safety and efficacy of BNT162b2 mRNA vaccination in five selected groups of immunocompromised patients and healthy controls.Methods: 539 study subjects (449 patients and 90 controls) were included. The patients had either primary (n=90), or secondary immunodeficiency disorders due to human immunodeficiency virus infection (n=90), allogeneic hematopoietic stem cell transplantation/CAR T cell therapy (n=90), solid organ transplantation (SOT) (n=89), or chronic lymphocytic leukemia (CLL) (n=90). The primary endpoint was seroconversion rate two weeks after the second dose. The secondary endpoints were safety and documented SARS-CoV-2 infection.Findings: Adverse events were generally mild, but one case of fatal suspected unexpected serious adverse reaction occurred. 72.2% of the immunocompromised patients seroconverted compared to 100% of the controls (p=0.004). Lowest seroconversion rates were found in the SOT (43.4%) and CLL (63.3%) patient groups with observed negative impact of treatment with mycophenolate mofetil and ibrutinib, respectively.Interpretation: The results showed that the mRNA BNT162b2 vaccine was safe in immunocompromised patients. Rate of seroconversion was substantially lower than in healthy controls, with a wide range of rates and antibody titres among predefined patient groups and subgroups. This clinical trial highlights the need for additional vaccine doses in certain immunocompromised patient groups to improve immunity.
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| 19. |
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| 20. |
- Berntson, Erik, et al.
(författare)
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Improving Organizational Prerequisites for Public Sector Managers – a Follow-up Study With Long-term Effects
- 2014
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Ingår i: Book of Proceedings, 11th Conference of the European Academy of Occupational Health Psychology. - Nottingham, UK : European Academy of Occupational Health Psychology. - 9780992878603 ; , s. 345-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Organizational interventions have been suggested to be important instruments in order to improve working conditions as well as employee health and well-being. Even though such studies are relevant the effects are difficult to measure (Nielsen, 2013; Nielsen & Abildgaard, 2013). There is an ongoing discussion on why it is difficult to measure and how to do it. One aspect of this is when the effects are prevalent. In the present study we focus on long-term effects of an intervention. The study is a survey-feedback intervention directed at managers in public sector authorities. The purpose of the intervention, which was a participatory intervention, was to improve organizational prerequisites for the managers in the study.In a previous investigation of the effects of the intervention, the short-term effects where studied, implying mixed results. There was a tendency of a positive effect among those intervention organizations that also had a successful implementation process. On the other hand, in those organizations with an unsuccessful implementation process, the results came out negative. In the present study, the aim is to investigate long-term effects of the participatory intervention, regarding work conditions among public sector managers.In this study 720 managers participated. There were six intervention organizations and 22 controls, located in seven local authorities in Western Sweden. Questionnaires were answered pre and post intervention (in 2009 and 2011). In addition, register data were used and interviews made, providing a multi-method approach. During the intervention year, process support was provided. The focus of the quantitative measures was to investigate if working conditions improved as a result of the intervention. Variables such as resource problems, conflicts of logics, illegitimate tasks, supporting structures, hindrance, managerial problems but also factors such as span of control, performance and perceived stress were measured. In the present study, a follow-up questionnaire will be answered by one of the intervention organizations. Results from this third questionnaire will be analyzed and presented.
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| 21. |
- Björklund, Erik, et al.
(författare)
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Postdischarge major bleeding, myocardial infarction, and mortality risk after coronary artery bypass grafting
- 2023
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Ingår i: HEART. - 1355-6037 .- 1468-201X.
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the incidence and mortality risk associated with postdischarge major bleeding after coronary artery bypass grafting (CABG), and relate this to the incidence of, and mortality risk from, postdischarge myocardial infarction.Methods All patients undergoing first-time isolated CABG in Sweden in 2006-2017 and surviving 14 days after hospital discharge were included in a cohort study. Individual patient data from the SWEDEHEART Registry and five other mandatory nationwide registries were merged. Piecewise Cox proportional hazards models were used to investigate associations between major bleeding, defined as hospitalisation for bleeding, with subsequent mortality risk. Similar Cox proportional hazards models were used to investigate the association between postdischarge myocardial infarction and mortality risk.Results Among 36 633 patients, 2429 (6.6%) had a major bleeding event and 2231 (6.1%) had a myocardial infarction. Median follow-up was 6.0 (range 0-11) years. Major bleeding was associated with higher mortality risk <30 days (adjusted HR (aHR)=20.2 (95% CI 17.3 to 23.5)), 30-365 days (aHR=3.8 (95% CI 3.4 to 4.3)) and >365 days (aHR=1.8 (95% CI 1.7 to 2.0)) after the event. Myocardial infarction was associated with higher mortality risk <30 days (aHR=20.0 (95% CI 16.7 to 23.8)), 30-365 days (aHR=4.1 (95% CI 3.6 to 4.8)) and >365 days (aHR=1.8 (95% CI 1.7 to 2.0)) after the event.Conclusions The increase in mortality risk associated with a postdischarge major bleeding after CABG is substantial and is similar to the mortality risk associated with a postdischarge myocardial infarction.
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| 22. |
- Björkman, Per, et al.
(författare)
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GB virus C/hepatitis G virus infection in patients investigated for chronic liver disease and in the general population in southern Sweden
- 2001
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 1651-1980 .- 0036-5548. ; 33:8, s. 611-617
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Tidskriftsartikel (refereegranskat)abstract
- Serum samples from patients referred for liver biopsy for investigation of suspected chronic liver disease (n = 286) and from healthy middle-aged volunteers (n = 445) were analyzed for markers of exposure to GB virus C/hepatitis G virus (GBV-C/HGV), hepatitis B virus and hepatitis C virus. GBV-C/HGV analyses included GBV-C/HGV PCR for detection of viremia and GBV-C/HGV enzyme-linked immunosorbent assay for anti-GBV-C/HGV E2 antibodies. Liver biopsies were re-evaluated by a hepatopathologist. GBV-C/HGV markers were detected in 97/286 (34%) patients (GBV-C/HGV RNA = 26; anti-GBV-C/HGV E2 antibodies = 74) compared to 86/445 (19%; p < 0.0001) controls (GBV-C/HGV RNA = 7, anti-GBB-C/HGV E2 antibodies = 79). A significantly higher proportion of GBV-C/HGV-exposed subjects in the patient group were viremic compared to controls (27% vs. 8.1%; p = 0.0015). GBV-C/HGV markers were more commonly found in patients with chronic hepatitis B and C. In patients with GBV-C/HGV viremia, a higher occurrence of bile duct degeneration was detected than in non-viremic patients. Markers of GBV-C/HGV infection were over-represented among patients investigated for chronic liver disease, and ongoing GBV-C/HGV viremia was more common in this group than in controls. Apart from a higher prevalence of bile duct degeneration in viremic patients, infection with GBV-C/HGV did not confer any specific histological characteristics.
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| 23. |
- Björkström, Niklas K, et al.
(författare)
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Rapid expansion and long-term persistence of elevated NK cell numbers in humans infected with hantavirus
- 2011
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Ingår i: Journal of Experimental Medicine. - : Rockefeller University Press. - 0022-1007 .- 1540-9538. ; 208:1, s. 13-21
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Tidskriftsartikel (refereegranskat)abstract
- Natural killer (NK) cells are known to mount a rapid response to several virus infections. In experimental models of acute viral infection, this response has been characterized by prompt NK cell activation and expansion followed by rapid contraction. In contrast to experimental model systems, much less is known about NK cell responses to acute viral infections in humans. We demonstrate that NK cells can rapidly expand and persist at highly elevated levels for >60 d after human hantavirus infection. A large part of the expanding NK cells expressed the activating receptor NKG2C and were functional in terms of expressing a licensing inhibitory killer cell immunoglobulin-like receptor (KIR) and ability to respond to target cell stimulation. These results demonstrate that NK cells can expand and remain elevated in numbers for a prolonged period of time in humans after a virus infection. In time, this response extends far beyond what is considered normal for an innate immune response.
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| 24. |
- Blomstedt, Mats, et al.
(författare)
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Innovative starting procedure of Siemens SGT-600 in cold climate conditions
- 2011
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Ingår i: ASME 2011 Turbo Expo:Turbine Technical Conference and Exposition. - : The American Society of Mechanical Engineers (ASME). - 9780791854648 ; , s. 1021-1026
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Konferensbidrag (refereegranskat)abstract
- A start-up of a gas turbine means that stress and forces are put on the machine. A start-up in cold climate conditions means that the forces are more critical since the material in the machine becomes more brittle. At a certain temperature the material is utilized to its limits (with appropriate margins applied) and for the SGT-600 ambient temperatures below -30°C (-22°F) become critical. In earlier installations in an arctic climate, an electric pre- heater has been utilized to prevent the critical components from becoming too brittle. This additional hardware costs money, is consuming auxiliary power and may contribute to unavailability. Another way to solve this issue may be to install material that is less brittle, but this will also increase the cost of the installation. Siemens is now applying an improved control logic during start-up, solving this issue in the software, without any additional hardware and avoiding unnecessary material changes. This new innovative start-up procedure is performing an automatic check of the stress levels before loading the machine, resulting in a safe and reliable start at temperatures below -30°C (-22°F).
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| 25. |
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| 26. |
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| 27. |
- Bybrant, Mara Cerqueiro, et al.
(författare)
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The prevalence of having coeliac disease in children with type 1 diabetes was not significantly higher during the Swedish coeliac epidemic
- 2023
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 112:10, s. 2175-2181
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Tidskriftsartikel (refereegranskat)abstract
- Aim: From 1986 to 1996, there was a four-fold increase in coeliac disease among young Swedish children, known as the Swedish coeliac epidemic. Children with type 1 diabetes have an increased risk of developing coeliac disease. We studied whether the prevalence of coeliac disease differed in children with type 1 diabetes born during and after this epidemic.Methods: We compared national birth cohorts of 240 844 children born in 1992–1993 during the coeliac disease epidemic and 179 530 children born in 1997–1998 after the epidemic. Children diagnosed with both type 1 diabetes and coeliac disease were identified by merging information from five national registers.Results: There was no statistically significant difference in the prevalence of coeliac disease among children with type 1 diabetes between the two cohorts: 176/1642 (10.7%, 95% confidence interval 9.2%–12.2%) in the cohort born during the coeliac disease epidemic versus 161/1380 (11.7%, 95% confidence interval 10.0%–13.5%) in the post-epidemic cohort.Conclusion: The prevalence of having both coeliac disease and type 1 diabetes was not significantly higher in children born during, than after, the Swedish coeliac epidemic. This may support a stronger genetic disposition in children who develop both conditions.
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| 28. |
- Cardinale, M, et al.
(författare)
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CES. 2009. Report of the Workshop on Combining Climatic Scenarios and Medium‐Term Predictions for Baltic Herring and Sprat stocks (WKCSMPB), 13–16 October 2009, Ponza, Italy. ICES CM 2009/BCC:03. : ICES WKCSMPB REPORT 2009
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The direct and indirect effects of density dependence (i.e. parental stock effects) and climate‐induced hydrographic change on five different Baltic herring stocks and on Baltic sprat, investigated by WKHRPB and WKSSRB (ICES 2007b and 2008) to develop stock specific recruitment‐environment relationships, were revisited and updated. The predictors to be included in the final recruitment models were selected on the basis of the parsimonious principle, statistical significance of the predictors and the ecological criterion being fulfilled simultaneously (Cardinale et al. 2009). In previous work, temperature was detected to be an important predictor for several stocks of clupeids. Weight at age (WAA) was the major factor explaining recruitment for Main Basin herring (MBH) while spawning stock biomass (SSB) was important for Baltic sprat (BS) and Gulf of Riga herring (GRH). For MBH, food supply was also a significant predictor, suggesting that a part of the changes in climate and hydrographic conditions may affect herring indirectly via prey availability. The best recruitment model for Baltic sprat (BS) linked recruitment success to its spawning stock biomass (SSB), sea surface temperature in August (NASA8), predation mortality by cod (PM), and Bottom Depth Anomaly (BDA) which is a proxy of drift/retention of sprat larvae (ICES 2008). The final recruitment models provided by Cardinale et al. (2009) were tested with updated data series only for MBH, GRH and BS as no satisfactory final model was found for the other stocks (Cardinale et al. 2009). Further, as the main aim was to include climatic scenarios for recruitment predictions, number of recruits (thereafter referred also as recruitment) was used for all stocks instead of recruitment success. Thus, models developed for MBH, GRH and BS were re‐fitted with updated input data and with number of recruits as response variable using both a linear and a GAM model to allow for medium‐term recruitment predictions under different climatic scenarios. SSB time series were generated using the BALMAR food‐web model (Lindegren et al. 2009), a linear state‐space model based on a theoretical approach for predicting longterm responses of populations to environmental change (Ives 1995; Ives et al. 2003). SSB time series were generated assuming two different levels of fishing mortalities (Fmed, Fmsy or Fmp). Predictions of SST were generated using higher resolution Regional Climate Models (RCMs). The results show that in the next 30 years recruitment of herring stocks will generally increase or stay relatively stable at values observed in the last decade for any of the scenarios considered. This is likely to be mainly an effect of a predicted increase in SST. On the other hand, the effect of SSB is small for MBH mainly due to the narrow range of predicted SSB values over the next 3 decades. In the case of GRH, a similar pattern was observed although the increase in recruitment is not as large as for MBH. For sprat, a satisfactory model was not found for predicting recruitment and further analysis are needed.
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| 29. |
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| 30. |
- Dahlström, Mia, et al.
(författare)
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Evidence for different pharmacological targets for imidazoline compounds inhibiting settlement of the barnacle Balanus improvisus
- 2005
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Ingår i: Journal of Experimental Zoology. - : Wiley. - 0022-104X .- 1097-010X. ; 303A:7, s. 551-562
-
Tidskriftsartikel (refereegranskat)abstract
- We describe the effect of eight different imidazoline/guanidinium compounds on the settlement and metamorphosis of larvae of the barnacle Balanus improvisus. These agents were chosen on the basis of their similar pharmacological classification in vertebrates and their chemical similarity to medetomidine and clonidine, previously described as highly potent settlement inhibitors (nanomolar range). Seven of the tested compounds were found to inhibit settlement in a dose-dependent manner in concentrations ranging from 100 nM to 10 microM without any significant lethal effects. In vertebrate systems these substances have overlapping functions and interact with both alpha-adrenoceptors as well as imidazoline binding sites. Antagonizing experiments using the highly specific alpha(2)-antagonist methoxy-idazoxan or agmatine (the putative endogenous ligand at imidazoline receptors) were performed to discriminate between putative pharmacological mechanisms involved in the inhibition of cyprid settlement. Agmatine was not able to reverse the effect of any of the tested compounds. However, methoxy-idazoxan almost completely abolished the settlement inhibition mediated by guanabenz (alpha(2)-agonist, I(2) ligand), moxonidine (alpha(2)-agonist, I(1) ligand) and tetrahydrozoline (alpha-agonist, I(2) ligand). The actions of cirazoline (alpha(1)-agonist, I(2) ligand) BU 224 (I(2) ligand) and metrazoline (I(2) ligand) were not reversed by treatment with methoxy-idazoxan. These results suggest that the settlement inhibition evoked by the I(2) ligands and alpha(2)-agonists used in this study of the neurologically simple but well-organized barnacle larva is mediated through different physiological targets important in the overall settlement process.
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| 31. |
- Danielsson Borssén, Åsa, et al.
(författare)
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Hepatocellular and extrahepatic cancer in patients with autoimmune hepatitis : a long-term follow-up study in 634 Swedish patients
- 2015
-
Ingår i: Scandinavian Journal of Gastroenterology. - : Informa Healthcare. - 0036-5521 .- 1502-7708. ; 50:2, s. 217-223
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives. Cirrhosis is a well-known risk factor for hepatocellular cancer, but the true risk in autoimmune hepatitis (AIH) is scarcely studied. Other cancers may arise after prolonged use of immune-modulating drugs. The aim of this study was to investigate the cancer risk in a large cohort of AIH patients.Material and methods. Six hundred and thirty-four Swedish patients in a well-defined cohort were matched to the Cause of Death Registry and the Cancer Registry. Standard incidence ratios were calculated by relating the incidences in the cohort to an age-matched material from the Swedish background population.Results. A higher overall incidence of malignancies than the background population was found, counting from the date of diagnosis (standard incidence ratio (SIR) 2.08, 95% CI 1.68-2.55). The highest risk was found for hepatocellular carcinoma (HCC). We found 10 cases (4.0%) in 248 patients with cirrhosis, which gives an incidence rate of 0.3%. Standard incidence ratio for developing hepatobiliary cancer was 54.55 (95% CI 19.92-99.99). HCC only occurred in cirrhotic patients. There was also an increased risk for non-melanoma skin cancer (SIR 9.87, 95% CI 6.26-14.81).Conclusion. A slightly enhanced risk for malignancies in general compared to the background population was found. The risk of hepatobiliary cancer was increased, but the annual risk over the observational period was well under the postulated 1.5% when surveillance in cirrhotic patients is considered to be cost-effective.
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| 32. |
- Deleskog, Viktor, et al.
(författare)
-
Robust NLS Sensor Localization using MDS Initialization
- 2014
-
Ingår i: 17th International Conference on Information Fusion (FUSION), 2014. - : Institute of Electrical and Electronics Engineers (IEEE). - 9788490123553 ; , s. 1-7
-
Konferensbidrag (refereegranskat)abstract
- Before a sensor network can be used for target localization, the locations of the sensors need to be determined. We approach this calibration step by moving a source to distinct positions around the network. At each position, the range to each sensor is measured,and from these range measurements the sensor locations can be estimated by solving a nonlinear least squares (NLS) problem. Here we formulate the NLS problem and describe how to robustly initialize it by the use of multidimensional scaling. The method is evaluated on both simulations and real data from an acoustic sensor network. Withas few as six source positions, a robust calibration is demonstrated that gives a position error about the same size as the range error. In the acoustic example this RMSE is less than 40 cm.
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| 33. |
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| 34. |
- Djerf, Henrik, et al.
(författare)
-
Editor's Choice - Cost Effectiveness of Primary Stenting in the Superficial Femoral Artery for Intermittent Claudication: Two Year Results of a Randomised Multicentre Trial
- 2021
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884. ; 62:4, s. 576-582
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Invasive treatment of intermittent claudication (IC) is commonly performed, despite limited evidence of its cost effectiveness. IC symptoms aremainly caused by atherosclerotic lesions in the superficial femoral artery (SFA), and endovascular treatment is performed frequently. The aimof this studywas to investigate its cost effectiveness vs. noninvasive treatment. Methods: One hundred patients with IC due to lesions in the SFA were randomised to treatment with primary stenting, best medical treatment (BMT) and exercise advice (stent group), or to BMT and exercise advice alone (control group). Patients were recruited at seven hospitals in Sweden. For this analysis of cost effectiveness after 24 months, 84 patients with data on quality adjusted life years (QALY; based on the EuroQol Five Dimensions EQ5D 3L (TM) questionnaire) were analysed. Patient registry and imputed cost data were used for accumulated costs regarding hospitalisation and outpatient visits. Results: The mean cost per patient was (SIC)11 060 in the stent group and (SIC)4 787 in the control group, resulting in a difference of (SIC)6 273 per patient between the groups.The difference in mean QALYs between the groups was 0.26, in favour of the stent group, which resulted in an incremental cost effectiveness ratio (ICER) of (SIC)23 785 per QALY. Conclusion: The costs associated with primary stenting in the SFA for the treatment of IC were higher than for exercise advice and BMT alone. With concurrent improvement in health related quality of life, primary stenting was a cost effective treatment option according to the Swedish national guidelines (ICER < (SIC)50 000 - (SIC)70 000) and approaching the UK's National Institute for Health and Care Excellence threshold for willingness to pay (ICER < 20 pound 000 - 30 pound 000). From a cost effectiveness standpoint, primary stenting of the SFA can, in many countries, be used as an adjunct to exercise training advice, but it must be considered that successful implementation of structured exercise programmes and longer follow up may alter these findings.
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| 35. |
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| 36. |
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| 37. |
- Ekman, Björn, et al.
(författare)
-
Utilization of digital primary care in Sweden : Descriptive analysis of claims data on demographics, socioeconomics, and diagnoses
- 2019
-
Ingår i: International Journal of Medical Informatics. - : Elsevier. - 1386-5056 .- 1872-8243. ; 127, s. 134-140
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: As digital technologies for health continue to develop, the ability to provide primary care services to patients with new symptoms will grow. In Sweden, two providers of digital primary care have expanded rapidly over the past years giving rise to a heated debate with clear policy implications. The purpose of the study is to present a descriptive review of digital primary care as currently under development in Sweden.Methods: Descriptive analysis of national coverage data on the utilization of digital care by sex, age, place of residence, socioeconomic status, and most common diagnoses. The data are compared with samples of corresponding data on traditional, office-based primary care, out-of-hours care, and on non-emergency telephone consultations to obtain a comparative analysis of digital care.Results: Digital primary care in Sweden has increased rapidly over the past two years. Currently, more than 30,000 digital consultations are made per month, equivalent to around two percent of all physician-led primary care. Digital care differs in some ways to that of traditional care as users are generally younger and seek for different conditions compared with office-based primary care. Digital care is also similar to traditional care as utilization is higher in metropolitan areas compared with rural areas. Similar to general health care use, there is a negative correlation between use of digital care and socioeconomic status. User profiles by age and sex of digital care are also similar to those of out-of-hours care and non-emergency telephone medical consultations.Conclusions: By providing a detailed description of the development of digital primary care the study contributes to a growing understanding of the contributions that digital technologies can make to health care. Based on current trends digital primary care is likely to continue to increase in frequency over the coming years. As technologies develop and the public becomes more familiar to interacting with medical providers over the Internet also the scope of digital care is likely to expand. As the provision of digital primary care expands across Europe and beyond, policy makers will need to develop regulating capacities to ensure its safe, effective and equitable integration into existing health systems.
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| 38. |
-
Electronic Government : 18th IFIP WG 8.5 International Conference, EGOV 2019, San Benedetto Del Tronto, Italy, September 2–4, 2019, Proceedings
- 2019
-
Proceedings (redaktörskap) (refereegranskat)abstract
- This book constitutes the proceedings of the 18th IFIP WG 8.5 International Conference on Electronic Government, EGOV 2019, held in San Benedetto del Tronto, Italy, in September 2019, in conjunction with the IFIP WG 8.5 IFIP International Conference on Electronic Participation (ePart 2019) and the International Conference for E-Democracy and Open Government Conference (CeDEM 2019).The 27 revised full papers presented were carefully reviewed and selected from 64 submissions. The papers are clustered under the following topical sections: E-Government Foundations; E-Government Services and Open Government; Open Data: Social and Technical Aspects; AI, Data Analytics and Automated Decision Making; and Smart Cities.
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| 39. |
-
Electronic Government : 19th IFIP WG 8.5 International Conference, EGOV 2020 Linköping, Sweden, August 31 - September 2, 2020 Proceedings
- 2020
-
Proceedings (redaktörskap) (refereegranskat)abstract
- This book constitutes the proceedings of the 19th IFIP WG 8.5 International Conference on Electronic Government, EGOV 2020, held in Linköping, Sweden, in August/September 2020, in conjunction with the IFIP WG 8.5 IFIP International Conference on Electronic Participation (ePart 2020) and the International Conference for E-Democracy and Open Government Conference (CeDEM 2020). The conference was held virtually due to the COVID-19 pandemic.The 30 full papers presented were carefully reviewed and selected from 118 submissions. The papers are clustered under the following topical sections: e-government foundations; e-government services and open government; open data: social and technical aspects; AI, data analytics, and automated decision making; and smart cities.
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| 40. |
-
Electronic Government : 20th IFIP WG 8.5 International Conference, EGOV 2021, Granada, Spain, September 7–9, 2021, Proceedings
- 2021
-
Proceedings (redaktörskap) (refereegranskat)abstract
- This book constitutes the proceedings of the 20th IFIP WG 8.5 International Conference on Electronic Government, EGOV 2021, held in Granada, Spain, in September 2021, in conjunction with the IFIP WG 8.5 IFIP International Conference on Electronic Participation (ePart 2021) and the International Conference for E-Democracy and Open Government Conference (CeDEM 2021).The 23 full papers presented were carefully reviewed and selected from 63 submissions. The papers are clustered under the following topical sections: digital transformation; digital services and open government; open data: social and technical perspectives; smart cities; and data analytics, decision making, and artificial intelligence.
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| 41. |
- Elzouki, Abdul-Nasser, et al.
(författare)
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Serine protease inhibitors in patients with chronic viral hepatitis
- 1997
-
Ingår i: Journal of Hepatology. - 0168-8278. ; 27:1, s. 42-48
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: This study aimed to determine whether deficiency of the major serine protease inhibitors (alpha1-antitrypsin (AAT) or alpha1-antichymotrypsin (ACT)) is associated with increased risk for chronic hepatitis B or C virus (HBV or HCV) infection. METHODS: We studied 709 adults with chronic liver disease who had undergone liver biopsy during the 14-year period 1978-92. Anti-HCV testing was carried out with second-generation ELISA and immunoblot assays (RIBA 2). HBV markers were tested with commercially available radioimmunoassays. ACT and AAT concentrations in plasma were measured with electroimmunoassay and immune nephelometry. Plasma samples were screened for the AAT PiZ deficiency with ELISA technique and phenotyped by isoelectric focusing. The 229Pro-->Ala mutation for ACT deficiency was identified by PCR techniques. RESULTS: Of the 709 patients, 132 (18.6%) were positive for anti-HCV according to RIBA 2. PiZ AAT deficiency was found in 44 (6.2%) of patients (one PiZZ, 38 PiMZ, and PiSZ), while subnormal ACT levels were found in 33 (4.6%) patients, frequencies that were higher than expected in the general population (p=0.0375 and p<0.0001, respectively). Of the PiZ-carriers, 8/44 (18%) were found to be anti-HCV positive according to RIBA 2, as compared to 123/662 (19%) non-PiZ-carriers (p>0.05). One of these patients had cirrhosis, four chronic active hepatitis, and three chronic persistent hepatitis. In contrast, 17/33 (51.5%) of the patients with subnormal ACT were anti-HCV positive (OR=5.2, CI=2.6-10.6; p<0.0001). No relationship was found between HBV infection and AAT deficiency or subnormal ACT levels. Only one patient with subnormal ACT levels was heterozygous for the 229Pro-->Ala mutation of ACT deficiency. There was no significant difference in the histological findings when the patients with subnormal ACT levels or PiZ allele were subgrouped according to HCV status. CONCLUSIONS: There is no overrepresentation of chronic HBV or HCV in heterozygous AAT deficiency, although an association with more severe liver disease in such patients cannot be excluded. In contrast, low plasma levels of ACT that may be acquired or hereditary, due to mutations other than 229Pro-->Ala, are frequent in HCV infection.
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| 42. |
- Engberg, Morten, et al.
(författare)
-
Learning insertion of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) catheter : Is clinical experience necessary? A prospective trial
- 2023
-
Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 54:5, s. 1321-1329
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging and po-tentially life-saving procedure, necessitating qualified operators in an increasing number of centres. The procedure shares technical elements with other vascular access procedures using the Seldinger technique, which is mastered by doctors not only in endovascular specialties but also in trauma surgery, emergency medicine, and anaesthesiology. We hypothesised that doctors mastering the Seldinger technique (expe-rienced anaesthesiologist) would learn the technical aspects of REBOA with limited training and remain technically superior to doctors unfamiliar with the Seldinger technique (novice residents) given similar training.Methods: This was a prospective trial of an educational intervention. Three groups of doctors were en-roled: novice residents, experienced anaesthesiologists, and endovascular experts. The novices and the anaesthesiologists completed 2.5 h of simulation-based REBOA training. Their skills were tested before and 8-12 weeks after training using a standardised simulated scenario. The endovascular experts, con-stituting a reference group, were equivalently tested. All performances were video recorded and rated by three blinded experts using a validated assessment tool for REBOA (REBOA-RATE). Performances were compared between groups and with a previously published pass/fail cutoff.Results: Sixteen novices, 13 board-certified specialists in anaesthesiology, and 13 endovascular experts participated. Before training, the anaesthesiologists outperformed the novices by 30 percentage points of the maximum REBOA-RATE score (56% (SD 14.0) vs 26% (SD 17%), p < 0.01). After training, there was no difference in skills between the two groups (78% (SD 11%) vs 78 (SD 14%), p = 0.93). Neither group reached the endovascular experts' skill level (89% (SD 7%), p < 0.05).Conclusion: For doctors mastering the Seldinger technique, there was an initial inter-procedural transfer of skills advantage when performing REBOA. However, after identical simulation-based training, novices performed equally well to anaesthesiologists, indicating that vascular access experience is not a prerequi-site to learning the technical aspects of REBOA. Both groups would need more training to reach technical proficiency.
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| 43. |
- Engberg, Morten, et al.
(författare)
-
Reliable and valid assessment of procedural skills in resuscitative endovascular balloon occlusion of the aorta
- 2021
-
Ingår i: Journal of Trauma and Acute Care Surgery. - : Lippincott Williams & Wilkins. - 2163-0755 .- 2163-0763. ; 91:4, s. 663-671
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Valid and reliable assessment of skills is essential for improved and evidence-based training concepts. In a recent study, we presented a novel tool to assess procedural skills in resuscitative endovascular balloon occlusion of the aorta (REBOA), REBOA-RATE, based on international expert consensus. Although expert consensus is a strong foundation, the performance of REBOA-RATE has not been explored. The study aimed to examine the reliability and validity of REBOA-RATE.METHODS: This was an experimental simulation-based study. We enrolled doctors with three levels of expertise to perform two REBOA procedures in a simulated scenario of out-of-hospital cardiac arrest. Procedures were video-recorded, and videos were blinded and randomized. Three clinical experts independently rated all procedures using REBOA-RATE. Data were analyzed using Messick's framework for validity evidence, including generalizability analysis of reliability and determination of a pass/fail standard.RESULTS: Forty-two doctors were enrolled: 16 novices, 13 anesthesiologists, and 13 endovascular experts. They all performed two procedures, yielding 84 procedures and 252 ratings. The REBOA-RATE assessment tool showed high internal consistency (Cronbach's alpha = 0.95) and excellent interrater reliability (intraclass correlation coefficient, 0.97). Assessment using one rater and three procedures could ensure overall reliability suitable for high-stakes testing (G-coefficient >0.80). Mean scores (SD) for the three groups in the second procedure were as follows: novices, 32% (24%); anesthesiologists, 55% (29%); endovascular experts, 93% (4%) (p < 0.001). The pass/fail standard was set at 81%, which all experts but no novices passed.CONCLUSION: Data strongly support the reliability and validity of REBOA-RATE, which successfully discriminated between all experience levels. The REBOA-RATE assessment tool requires minimal instruction, and one rater is sufficient for reliable assessment. Together, these are strong arguments for the use of REBOA-RATE to assess REBOA skills, allowing for competency-based training and certification concepts.
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| 44. |
- Eriksson, Mats, 1963-, et al.
(författare)
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Drinking water monitoring with voltammetric sensors
- 2011
-
Ingår i: Procedia Engineering. - : Elsevier. - 1877-7058. ; 25, s. 1165-1168
-
Tidskriftsartikel (refereegranskat)abstract
- Pulsed voltammetry has been applied to drinking water monitoring. This non-selective technique facilitates detection of several different threats to the drinking water. A multivariate algorithm shows that anomaly detection is possible with a minimum of false alarms. Multivariate analysis can also be used to classify different types of substances added to the drinking water. Low concentrations of sewage water contaminating the drinking water can be detected. A network of such sensors is envisaged to facilitate real-time and on-line monitoring of drinking water distribution networks.
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| 45. |
- Eriksson, Mats, et al.
(författare)
-
Event Detection in Crisis Management Systems
- 2009
-
Ingår i: Procedia Chemistry. - : Elsevier. - 1876-6196. ; 1:1, s. 1055-1058
-
Tidskriftsartikel (refereegranskat)abstract
- The EVENT project concerns drinking water surveillance and includes sensors and algorithms that detect anomalies in the drinking water properties, communication of the evaluated sensor data to a crises management system and presentation of information that is relevant for the end users of the crises management system. We have chosen to focus on a sensor technique based on an "electronic tongue", since this robust type of non-selective sensor, can detect a plurality of anomalies without the need of a specific sensor for each type of event. Measurements of natural variations and contamination events are presented and discussed.
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| 46. |
- Eskelinen, M., et al.
(författare)
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Preoperative serum levels of follicle stimulating hormone (FSH) and prognosis in invasive breast cancer
- 2004
-
Ingår i: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 30:5, s. 495-500
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS: We investigated the association between preoperative serum levels of follicle stimulating hormone (FSH) and the prognosis in women with invasive breast cancer. METHODS: Serum levels of FSH were measured in 182 premenopausal and 581 peri- or postmenopausal women with invasive breast cancer. They were followed for a mean time of 84 months. The study endpoint was death from breast cancer (182 events). Analyses were stratified on menopausal status. RESULTS: None of the estimates showed a statistically significant result. In both pre- and postmenopausal women there was a nominally higher probability of survival with a higher FSH level. Point estimates in multivariate analysis incorporating age, tumour diameter, axillary lymph status, estrogen and progesterone receptor content and year of treatment indicated a stronger association with FSH levels in premenopausal than postmenopausal women (relative hazard 0.63 or 0.85, respectively in the highest compared with the lowest quartile). CONCLUSION: We did not find any statistically significant association between preoperative serum level of FSH and prognosis. Today, FSH is not a clinical target for intervention or a clinically useful prognostic factor and the results of clinical studies up to date can only be used for motivation of further experimental laboratory research.
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| 47. |
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| 48. |
- Garkavij, Michael, et al.
(författare)
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Enhanced radioimmunotargeting of 125I-labeled L6-biotin monoclonal antibody (MAb) by combining preload of cold L6 MAb and subsequent immunoadsorption in rats
- 1995
-
Ingår i: Cancer Research. - 1538-7445. ; 55:23 Suppl, s. 5874-5880
-
Tidskriftsartikel (refereegranskat)abstract
- The present study investigates whether tumor:normal tissue uptake ratios of radiolabeled monoclonal antibodies can be further improved by a combination of extracorporeal immunoadsorption (ECIA) and preload with unlabeled idiotypic monoclonal antibody. Athymic rats, heterotransplanted with human lung carcinoma under the kidney capsule (SR tumor) and i.m. (IM tumor), were divided into four study groups: controls, ECIA, preload, and combined preload+ECIA. The preload+ECIA procedure reduced the whole-body and plasma activity by 48 and 89%, respectively. After such combined procedure, the uptake of 125I-labeled L6-biotin in SR tumors was unchanged, while the uptake in normal tissues was considerably reduced. Tumor (T):bone marrow ratio was then increased by 17.5 times (after ECIA) and by 4.5 times (24 h after ECIA). Similar enhancements were achieved for T:liver and T:kidney ratios. For the IM tumors, the ratios were not as high as for SR tumors. The effects on T:normal ratios of preload+ECIA in combination were synergistic. The combined procedure resulted both in an increased uptake and prolonged persistence of 125I-labeled L6-biotin in the SR tumors and also in a reduction of corresponding uptake values in organs critical for radiation.
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| 49. |
- Garkavij, Michael, et al.
(författare)
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Extracorporeal immunoadsorption from whole blood based on the avidin-biotin concept. Evaluation of a new method
- 1996
-
Ingår i: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 35:3, s. 309-312
-
Tidskriftsartikel (refereegranskat)abstract
- This study of 36 rats with rat colon adenocarcinoma transplants was carried out to investigate the efficacy of a new method of whole blood immunoadsorption (WBIA) in removing biotinylated monoclonal antibodies (MAbs) directly from unseparated blood, in order to increase 'the tumor/normal-tissue uptake ratio', as compared with extracorporeal immunoadsorption (ECIA) of antibodies from plasma. Compared with the ECIA system, the overall volume of the WBIA system (comprising only a pump, an adsorption column, a drop-chamber and tubings) was less (3.6 vs. 6.2 ml), and procedure duration 2 h less. The 17 rats undergoing the WBIA procedure, started 12 h after i.v. injection of 4.0-4.5 MBq 125I-BR96-biotin, manifested neither hemolysis nor any other complication; no signs of organ edema were found at dissection; whole body and blood radioactivity values were reduced by 51% and 89.5%, respectively. The WBIA method was as effective as ECIA, but technically simpler, safer and more reliable.
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| 50. |
- Garkavij, Michael, et al.
(författare)
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Improving radioimmonotargeting of tumors. Variation in the amount of L6 MAb administered, combined with an immunoadsorption system (ECIA)
- 1993
-
Ingår i: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 32:7-8, s. 853-859
-
Tidskriftsartikel (refereegranskat)abstract
- Extracorporeal immunoadsorption (ECIA) is a new method for the selective removal of circulating radiolabeled monoclonal antibodies (MAb) from plasma to increase the uptake in tumor versus normal tissues (T/N-ratio). To ascertain whether the amount of MAb affects T/N ratios immediately and 24 h after ECIA, we used a rat model with two tumor sites--one intramuscular (im) and one below the subrenal capsule (SR). Extracorporeal immunoadsorption was done with an avidin-agarose column after injection of 125I-labeled biotinylated L6 MAb. The animals received 10, 50 or 250 micrograms of L6 only (controls), or followed by ECIA. The efficacy of the procedure in removing plasma activity was 80-95%. For both tumor sites, the highest T/N-ratios were obtained with 10 micrograms L6. All T/N-ratios significantly improved for SR tumors by a factor ranging from 3.2 (lung) to 12.6 (bone marrow). The T/N-ratios were still elevated 24 h after ECIA. Injection of larger amounts of MAb, probably causing a higher degree of tumor saturation, will not necessarily improve the T/N ratio after ECIA.
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