| 1. |
- Lindström, Björn E., et al.
(författare)
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Borrelia Ocular Infection : A Case Report and a Systematic Review of Published Cases
- 2022
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Ingår i: Ophthalmic Research. - : S. Karger. - 0030-3747 .- 1423-0259. ; 65:2, s. 121-130
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Forskningsöversikt (refereegranskat)abstract
- INTRODUCTION: Lyme borreliosis can cause many diverse manifestations, also ocular disease where the diagnosis of ocular borreliosis is challenging. The primary aim was to report on the evidence of Borrelia spirochetes in the ocular tissue in presumed ocular borreliosis.METHODS: A systematic review of pathological eye conditions was performed where Borrelia has been suspected in relevant ocular tissue, together with a case report of diagnosed uveitis with polymerase chain reaction (PCR)-confirmed Borrelia afzelii in the vitreous. The evidence for clinical and laboratory diagnosis was evaluated systematically. As a secondary aim, the treatment of ocular Borrelia infection was also evaluated for confirmed cases.RESULTS: Thirteen includable studies were found, and after the removal of case duplicates, eleven unique cases were extracted. Apart from the present case report, 4 other cases reported strong evidence for the detection of B. spirochetes in ocular tissue. Four cases presented reasonable evidence for assumed detected Borrelia, while three additional cases showed only weak diagnostic credibility that Borrelia was detected.CONCLUSION: This systematic review, including all reported cases and our case report, supports evidence of ocular infection of Borrelia species. Furthermore, in case of suspicion of infection and seronegativity, it is justified to look for Borrelia in eye tissue samples. In addition, microscopy without using PCR is not sufficient to confirm the diagnosis of borreliosis on ocular tissue. In the articles studied, there was no unambiguous recommendation of treatment.
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| 2. |
- Lindström, Annika K, 1953-, et al.
(författare)
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Correlation between LRIG1 and LRIG2 expressions and expression of 11 tumor markers, with special reference to tumor suppressors, in CIN and normal cervical epithelium
- 2011
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Ingår i: Gynecologic Oncology. - : Elsevier BV. - 0090-8258 .- 1095-6859. ; 122:2, s. 372-376
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Novel biological markers LRIG1 and LRIG2 have been associated with favorable as well as poor prognosis, respectively, in different cancer types, including cervical cancer. The aim of this study was to investigate possible interactions between these proteins and other tumor markers, and as diagnostic adjuncts in CIN. Methods. Cervical biopsies from 171 women, with normal epithelium, and low-grade and high-grade CIN were stained for LRIG1 and LRIG2, and 11 additional tumor markers. The tumor markers were chosen to be relevant in cervical neoplasms. Staining was evaluated semiquantitatively. Results. Expression of LRIG1 and LRIG2 was found to correlate with increasing CIN grade, as well as with expression of tumor suppressor FHIT, independent of histological grade. In addition, tumor promoter LRIG2 expression correlated negatively with expression of tumor suppressor retinoblastoma protein and positively with IL-10. The latter correlation did not however remain after adjustment for CIN grade. p53 and p16 expressions correlated positively with LRIG1 expression in univariate analyses, but significance did not hold after adjustment for CIN grade. Conclusion. LRIG1 and LRIG2 expressions were seen in precancerous cervical epithelium and found to increase with increasing grade. There was an association between expression of these glycoproteins and FHIT tumor suppressor protein, independently of histological grade.
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| 3. |
- Lindström, Annika K, 1953-, et al.
(författare)
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Immunohistochemical LRIG3 expression in cervical intraepithelial neoplasia and invasive squamous cell cervical cancer : association with expression of tumor markers, hormones, high-risk HPV-infection, smoking and patient outcome
- 2014
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Ingår i: European journal of histochemistry. - : PAGEPress Publications. - 1121-760X .- 2038-8306. ; 58:2, s. 83-87
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Tidskriftsartikel (refereegranskat)abstract
- The novel biomarker LRIG3 is a member of the LRIG family (LRIG1-3). While LRIG1 has been associated with favorable prognosis and LRIG2 with poor prognosis in invasive cervical cancer, little is known about the role of LRIG3. The aim of this study was to investigate the expression of LRIG3 in invasive cancer and cervical intraepithelial neoplasia (CIN) for possible correlation with other tumor markers, to hormones and smoking, as a diagnostic adjunct in CIN, and prognostic value in invasive cancer. Cervical biopsies from 129 patients with invasive squamous cell carcinoma and 170 biopsies showing low grade and high grade CIN, or normal epithelium were stained for LRIG3 and 17 additional tumor markers. Among other variables the following were included: smoking habits, hormonal contraceptive use, serum progesterone, serum estradiol, high-risk HPV-infection, meno pausal status and ten-year survival. In CIN, high expression of the tumor suppressors retinoblastoma protein, p53, and p16, and Ecadherin (cell-cell interaction), or low expression of CK10, correlated to LRIG3 expression. In addition, progestogenic contraceptive use correlated to high expression of LRIG3. In invasive cancer there was a correlation between expression of the major tumor promoter c-myc and high LRIG3 expression. High LRIG3 expression correlated significantly to presence of high-risk HPV infection in patients with normal epithelium and CIN. There was no correlation between LRIG3 expression and 10-year survival in patients with invasive cell cervical cancer. LRIG3 expression is associated with a number of molecular events in CIN. Expression also correlates to hormonal contraceptive use. The results on expression of other tumor markers suggest that LRIG3 is influ-markers in cancer and precancerous cells. Further studies are needed to elucidate if LRIG3 expression might be clinically useful.
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| 4. |
- Lindström, B. E., et al.
(författare)
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Urethral instillations of clobetasol propionate and lidocaine : a promising treatment of urethral pain syndrome
- 2016
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Ingår i: Clinical and Experimental Obstetrics & Gynecology. - : I. R. O. G. Canada, Inc.. - 0390-6663. ; 43:6, s. 803-807
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate topical treatment with clobetasol propionate and lidocaine in women with urethral pain syndrome (UPS) in a retrospective pilot study.Materials and Methods: Urethral instillations of two ml clobetasol propionate cream and two ml lidocaine gel in 30 Caucasian women age 15-74 years with UPS between 1999 and 2006 were evaluated retrospectively. Instillations were given approximately once a week until the patient improved. Between one and 15 (median three) instillations were given. In substudy I a review was undertaken of the medical records to register the treatment effect at the end of the treatment (the last instillation) and any relapses six months thereafter. Substudy II was a follow-up at least five years after last instillation based on medical records and a written questionnaire.Results: Substudy I (n=30): By the end of the treatment 18 women had no symptoms and 12 were improved. Five patients had relapsed within six months. Substudy II (n=28): Twenty-eight women responded to the questionnaire. Four women remained with no symptoms, 18 remained improved, and six had the same symptoms as before treatment. Twenty women thought the treatment was very effective, five rather effective, and three women reported poor effect. Twenty-six women would ask for retreatment if a relapse occurred, two patients would not. No side effects, except transient pain, were reported.Conclusions: This retrospective study and long-term follow-up suggests that urethral instillation of clobetasol propionate and lidocaine is effective in treating women with UPS. Randomized control studies are warranted.
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| 8. |
- Hermansson, Ruth S., et al.
(författare)
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Elderly women's experiences of self-sampling for HPV testing.
- 2020
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Self-sampling for HPV testing, as an alternative to the conventional speculum based sampling, is highly acceptable to women of screening ages. The aim of this study was to describe older women's (60 to 75 years) experiences of self-sampling.METHODS: In Sweden a descriptive study with quantitative and qualitative methods was designed to collect data from a survey of women who participated in self-sampling for HPV testing. Individual interviews were done with women who tested positive in the first self-sampling, and were either negative in their second HPV test or were positive in their second HPV test, but without precancerous lesions or cancer.RESULTS: Of 893 eligible women, 868 (97.2%) answered the survey. Among the surveyed women, 49.2% reported it was very easy to perform self-sampling, 46.8% answered it was easy and 2.0% answered it was not easy. A majority (58.9%) answered that they prefer self-sampling, 16.5% that they prefer sample collection by a healthcare provider, 23.7% did not have any preference and 0.9% did not answer the question. In the interviews, 13 of 16 invited women participated. Most of them reported that they prefer self-sampling because it was easy to perform, less embarrassing and less time consuming than a visit to a clinic. The majority of women reported that they were not worried when informed about having an HPV positive test. Overall, participating women with better knowledge about the significance of an HPV infection were more worried about having a positive HPV test.CONCLUSION: Cervical cancer remains a highly preventable disease through screening and early treatment. Our results indicated that vaginal self-sampling for HPV testing was a well-accepted method for cervical cancer prevention in this group of older women.TRIAL REGISTRATION: https://www.researchweb.org/is/en/fouckfuu/project/272587. Registered 24 June 2019-retrospectively registered. www.researchweb.org.
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| 9. |
- Hermansson, Ruth S., et al.
(författare)
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HPV prevalence and HPV-related dysplasia in elderly women
- 2018
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Ingår i: PLOS ONE. - San Francisco, USA : Public Library of Science. - 1932-6203. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: In Sweden, where screening ends at the age of 60, about 30% of the cervical cancer cases occur in women older than 60. The aim of the present study was to investigate the prevalence of HPV and cervical dysplasia in women of 60 years and above.PATIENTS AND METHODS: From September 2013 until June 2015, 1051 women aged 60-89 years (mean 68 years) were sampled for an HPV test when attending an outpatient gynecology clinic. Women with positive results had a second HPV test and liquid based cytology (LBC), after 3.5 months on average. Those with a positive second HPV test were examined by colposcopy, and biopsy and a sample for LBC was obtained.RESULTS: The prevalence of HPV was 4.1%, (95%CI 3.0-5.5, n = 43) at the first test, and at the second test 2.6% remained positive (95%CI 1.7-3.8, n = 27). The majority of women positive in both HPV tests, had dysplasia in histology, 81.5% (22/27) (4 CIN 2-0.4%, 18 CIN 1-1.7%). HPV-related dysplasia was found in 2.1%, (95%CI 1.3-3.2, n = 22) of the 1051 women. Four of the 22 women with positive HPV tests also had abnormal cytology, one ASCUS and three CIN 1. No cancer or glandular dysplasia was detected.CONCLUSION: A significant proportion of elderly women were found to have a persistent cervical HPV infection. Among them there was a high prevalence of CIN diagnosed by histology. The HPV test showed high sensitivity and specificity in detecting CIN in elderly women, while cytology showed extremely low sensitivity.
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| 10. |
- Hermansson, Ruth S., et al.
(författare)
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Incidence of oncogenic HPV and HPV-related dysplasia five years after a negative HPV test by self-sampling in elderly women
- 2022
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Ingår i: Infectious Agents and Cancer. - : Springer Nature. - 1750-9378. ; 17:42
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Cervical cancer prevention for older women can be challenging since there are no specific guidelines for this group. This study aimed to determine the incidence of oncogenic HPV and HPV-related dysplasia in elderly women 5 years after being HPV negative.Methods: Invited women participated five years earlier in a study where self-sampling for HPV testing was applied, at this time, they were all HPV negative. The women were now, five years later invited to perform self-sampling for HPV testing. Women with a positive result performed a repeat HPV test. Those with a positive repeat HPV test were examined by colposcopy, biopsy and cytology.Results: Of the 804 invited women, 634 (76.9%) agreed to participate in the study and a self-sampling kit was sent to them. Of these, 99.6% (632/634) sent a sample to the HPV laboratory. The participation rate in each age group was 93.3% at age 65, 74.0% at age 70, 80.7% at age 75 and 64.6% at age 80. Overall 18 women (2.8%, 95% CI 3.2 to 6.0) were HPV positive in the first test and 8 (1.3%, 95% CI 0.6 to 2.6) in the second test. Sampling for the second test was done on average 5.4 months after the first test. Fifty per cent (4/8) of the women with a positive repeat test had dysplasia in histology.Conclusions: The incidence of HPV in previously HPV-negative elderly women was low. Among women who were HPV positive in a repeat test, there was a high prevalence of low grade dysplasia.
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| 11. |
- Lannér, Lars, et al.
(författare)
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Incidence of HPV and HPV related dysplasia in elderly women in Sweden
- 2020
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Ingår i: PLOS ONE. - : PLOS. - 1932-6203. ; 15:3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: About one-third of the cervical cancer cases in Sweden occur in women over the age of 60. The primary aim of this study was to analyze the incidence of HPV, and HPV related dysplasia, in elderly women who had an HPV negative test at the age of 60 years or older.METHODS: From October 2004 to June 2019, 1784 women aged 60-90 years were sampled for an HPV test when attending an outpatient gynecology clinic. Of these women, 827 HPV-negative women had two or more HPV tests at intervals of three months to eleven years (mean 3.2 years). The women with positive results had a repeat HPV test and cytology after 2.5 months on average. Those with a positive repeat HPV test were examined by colposcopy and biopsy.FINDINGS: The overall prevalence of HPV was 5.4%, (95%CI 4.4-6.6, 96/1784). The incidence of HPV in the 827 women, who were HPV negative in their first test, was 2.4% (95%CI 1.5-3.8, n = 20). At the repeat test 1.2% remained positive (95%CI 0.6-2.3, n = 10). HPV-related dysplasia diagnosed by histology was found in 1.2% (95%CI 0.6-2.3, n = 10) of the 827 women. CIN2+ was found in 0.5% (95%CI 0.2-1.3, n = 4). In the repeat HPV test 52.6% 10/19) were HPV positive. The time between an HPV negative test and an HPV positive test and CIN2+ was on average 45.5 months (range 10-85 months). The positive predictive value (PPV) for CIN2+ was 20.0% in the first positive HPV test and 40.0% in the repeat HPV test. The women with CIN2+ had normal cytology. No cancer or glandular dysplasia was detected.INTERPRETATION: In this study older HPV-negative women were at risk of becoming HPV positive. Among the women who were HPV positive in a repeat test, there was a high risk of dysplasia.
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| 12. |
- Lindström, Annika K., 1953-, et al.
(författare)
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Cervical dysplasia in elderly women performing repeated self-sampling for HPV testing
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 13:12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: About 30% of the cervical cancer cases in Sweden occur in women older than 60. The primary aim was to evaluate the acceptability of repeated self-sampling at home for HPV-testing in elderly women. The prevalence of HPV and HPV related dysplasia as well as the sensitivity of cytology was evaluated.METHODS: Repeated self-sampling at home for HPV testing was offered 375 women in each of the four age groups 60, 65, 70 and 75 years. Women with two consecutive positive HPV tests were examined with sampling for histology and cytology.FINDINGS: A self-sample was provided by 59.5% (893/1500) of the invited women. The overall prevalence of HPV was 4.4% (95% CI 3.2-6.0, n = 39) in the first test, and 2.5% were persistent positive in the second test (95% C 1.6-3.8, n = 22) collected on average 5.5 months later. Dysplasia, was found in 1.8% (16/893) (95% CI 1.1-3.0) and CIN 2+ in 1.0% (9/893) (95%CI 0.5-2.0) of the women. Of the 16 women with dysplasia in histology, 13 (81.2%) had a normal cytology.INTERPRETATION: Repeated self-sampling at home combined with HPV testing was well accepted among elderly women. A high prevalence of CIN was diagnosed by histology. Cytology showed extremely low sensitivity and should not be recommended for this age group.
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| 13. |
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| 14. |
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| 15. |
- Lindström, Annika K., 1953-, et al.
(författare)
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Screening history of elderly women diagnosed with cervical cancer
- 2018
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Ingår i: International Journal of Gynecology & Obstetrics. - : Wiley-Blackwell Publishing Inc.. - 0020-7292 .- 1879-3479. ; 143:S3, s. 927-927
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Cervical cancer in elderly women is often discovered at advanced stages and the prognosis is poor. In Sweden, where the screening program ends at the age of 60 in most counties, approximately 30% of the women diagnosed with cervical cancer are older than 60. The aim of this study was to investigate the cytological screening history in women diagnosed with cervical cancer at the age of 61 years and older.Method: This is a retrospective study including women from the counties of Örebro, Dalarna, and Gävleborg, (Sweden,) diagnosed with cervical cancer at the age of 61 years and older between 2001 and 2016. Screening history was obtained from 1967.Results: Out of the 223 women, 142 (63.7%) had participated in the screening program at least once and 95 (42.6%) had participated in the screening five times or more. Of the 142 women with at least one screening sample, 76 (53.5%) had a benign screening history. Of all women 76 (34.1%) had benign screening history, 66 (29.6%) had had dysplasia and 19 (8.5%) high-grade dysplasia. It was more common with a benign screening history among women diagnosed with adenocarcinomas compared to squamous cell carcinomas (p=0.002).Conclusions: In elderly women diagnosed with cervical cancer, more than one third had not participated in the screening program, nearly one third had a benign screening history and one-third of the women had dysplasia in their screening history. Continuing screening past the age of 60 can decrease the incidence of cervical cancer.
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| 16. |
- Lindström, Annika K., 1953-
(författare)
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Självprovtagning hos 60
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 17. |
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| 18. |
- Lindström, Annika, 1953-, et al.
(författare)
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LRIG1 and squamous epithelial uterine cervical cancer : correlation to prognosis, other tumor markers, sex steroid hormones, and smoking
- 2008
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Ingår i: International Journal of Gynecological Cancer. - : BMJ. - 1048-891X .- 1525-1438. ; 18:2, s. 312-317
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Tidskriftsartikel (refereegranskat)abstract
- The aim is to evaluate LRIG1 as a prognosis predictor and correlations to cofactors in squamous cell cervical cancer. LRIG1 expression was studied in 128 cervical carcinomas and was compared with expression of nine other tumor markers. Smoking history was registered and pretreatment serum estradiol and progesterone levels were evaluated in 79 women. At clinical stage IB, 58% of the tumors showed LRIG1 expression, but there was a decline by increasing stage (33% in stage IV). Ninety percent of women with stage IB cancer and LRIG1 positivity survived, as compared to 64% without expression (P = 0.02). LRIG1 expression did not predict prognosis in advanced stages, but in stage IIA there was a marked relative difference, with 75% survival in tumors expressing LRIG1, as compared to 43% in those without. No correlation was found between LRIG1 and the other nine tumor markers studied. A high serum progesterone and smoking correlated to absent LRIG1 expression. We conclude that LRIG1 appears to be a significant prognosis predictor in early-stage cervical cancer, independent of the other tumor markers that were studied. Diminished expression in advanced stages and the inverse correlation to serum progesterone and smoking indicates that LRIG1 is a tumor suppressor in cervix.
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