| 1. |
- Lewerin, Catharina, 1961, et al.
(författare)
-
Low holotranscobalamin and cobalamins predict incident fractures in elderly men: the MrOS Sweden.
- 2014
-
Ingår i: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 25:1, s. 131-140
-
Tidskriftsartikel (refereegranskat)abstract
- In a population-based study on cobalamin status and incident fractures in elderly men (n=790) with an average follow-up of 5.9years, we found that low levels of metabolically active and total cobalamins predict incident fractures, independently of body mass index (BMI), bone mineral density (BMD), plasma total homocysteine (tHcy), and cystatin C.
|
|
| 2. |
- Lewerin, Catharina, 1961, et al.
(författare)
-
Serum estradiol associates with blood hemoglobin in elderly men; The MrOS Sweden Study
- 2014
-
Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 99:7, s. 2549-56
-
Tidskriftsartikel (refereegranskat)abstract
- Context: Blood hemoglobin (Hb) declines with age in healthy elderly men, in whom decreasing testosterone has been regarded as part of normal ageing. However, the association between Hb and serum estradiol is incompletely known. Objective: To determine whether estradiol is associated with anemia/Hb and established determinants of Hb in elderly men without prostate cancer. Design, Setting and Participants: The MrOS (Osteoporotic Fractures in Men) is a population-based study (n=918, median age 75.3 years, range 70-81 years). Main Outcome Measures: We evaluated total estradiol in relation to Hb and adjusted for potential confounders (i.e. age, body mass index (BMI), erythropoietin (EPO), total testosterone, cystatin C, iron- and B-vitamin status). Results: Estradiol correlated negatively with age (r=-0.14, p<0.001). Hb correlated (age adjusted) positively with estradiol (r=0.21, p<0.001) and testosterone (r=0.10, p<0.01). Independent predictors for Hb in multivariate analyses were estradiol, EPO, BMI, transferrin saturation, cystatin C and free T4 but not testosterone. After exclusion of subjects with Hb <130g/L and/or testosterone <8 nmol/L (n=99), the correlation between Hb and testosterone was no longer significant, whereas the associations between Hb and estradiol remained. After adjusting for age, BMI and EPO, men with lower estradiol levels were more likely to have Hb in the lowest quartile of values [OR per SD decrease in estradiol = 1.61 (95% CI 1.34-1.93)]. Anemic subjects (Hb <130 g/L) had lower mean estradiol than non-anemic (67.4 vs 79.4 pmol/L, p<0.001). Conclusions: Estradiol correlated, positively and independently, with Hb. Decreased estradiol might partly explain the age-related Hb decline observed in healthy elderly men.
|
|
| 3. |
- Bergman, Birgitta, 1941, et al.
(författare)
-
Ocular changes, risk markers for eye disorders and effects of cataract surgery in elderly people: a study of an urban Swedish population followed from 70-97 years of age
- 2004
-
Ingår i: Acta Ophthalmologica Scandinavica. - : Wiley. - 1395-3907. ; 82, s. 166-74
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate the prevalence of and potential risk factors for ocular disorders and the effects of timing of cataract surgery from age 70–97 years. Population: A representative population sample taken from within the Gerontological and Geriatric Population Studies (H 70) in Gothenburg, Sweden (n = 958). All subjects underwent eye examinations at age 70 years in 1971 and subsequently at ages 82, 88, 95 and 97 years. All inhabitants of Gothenburg aged 95 and 97 years were invited to participate in the study. Results: Decreased vision (visual acuity ≤ 0.5) was found in 20% and 80% of subjects at ages 82 and 97 years, respectively. Blood folate and physical activity at age 70 years correlated positively and body mass index (BMI) negatively to visual acuity (VA) ≥ 0.8 at ages 82 and 88 years. Smoking at age 70 years correlated to early age-related maculopathy (ARM). Cataract surgery had been performed in 40% of subjects at age 97 years. Surgery 2 years earlier led to a 15% increase in time spent with improved vision. Conclusions: The deterioration of vision in elderly people is a major health problem, for which ‘low’ folate status, smoking, ‘high’ BMI and low physical activity are potential risk factors. Early cataract surgery is also beneficial in very old patients.
|
|
| 4. |
- Bram Ednersson, Susanne, et al.
(författare)
-
Expression of ribosomal and actin network proteins and immunochemotherapy resistance in diffuse large B cell lymphoma patients
- 2018
-
Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 181:6, s. 770-781
-
Tidskriftsartikel (refereegranskat)abstract
- Diffuse large B cell lymphoma (DLBCL) patients with early relapse or refractory disease have a very poor outcome. Immunochemotherapy resistance will probably, also in the era of targeted drugs, remain the major cause of treatment failure. We used proteomic mass spectrometry to analyse the global protein expression of micro-dissected formalin-fixed paraffin-embedded tumour tissues from 97 DLBCL patients: 44 with primary refractory disease or relapse within 1year from diagnosis (REF/REL), and 53 who were progression-free more than 5years after diagnosis (CURED). We identified 2127 proteins: 442 were found in all patients and 102 were differentially expressed. Sixty-five proteins were overexpressed in REF/REL patients, of which 46 were ribosomal proteins (RPs) compared with 2 of the 37 overexpressed proteins in CURED patients (P=76x10(-10)). Twenty of 37 overexpressed proteins in CURED patients were associated with actin regulation, compared with 1 of 65 in REF/REL patients (P=14x10(-9)). Immunohistochemical staining showed higher expression of RPS5 and RPL17 in REF/REL patients while MARCKS-like protein, belonging to the actin network, was more highly expressed in CURED patients. Even though functional studies aimed at individual proteins and protein interactions to evaluate potential clinical effect are needed, our findings suggest new mechanisms behind immunochemotherapy resistance in DLBCL.
|
|
| 5. |
- Bram Ednersson, Susanne, et al.
(författare)
-
Proteomic analysis in diffuse large B-cell lymphoma identifies dysregulated tumor microenvironment proteins in non-GCB/ABC subtype patients
- 2021
-
Ingår i: Leukemia & Lymphoma. - : Informa UK Limited. - 1042-8194 .- 1029-2403. ; 62:10, s. 2360-2373
-
Tidskriftsartikel (refereegranskat)abstract
- The complexity of the activated B-cell like (ABC) diffuse large B-cell lymphoma (DLBCL) subtype is probably not only explained by genetic alterations and methods to measure global protein expression could bring new knowledge regarding the pathophysiology. We used quantitative proteomics to analyze the global protein expression of formalin-fixed paraffin-embedded (FFPE) tumor tissues from 202 DLBCL patients. We identified 6430 proteins and 498 were significantly regulated between the germinal center B-cell like (GCB) and non-GCB groups. A number of proteins previously not described to be upregulated in non-GCB or ABC DLBCL was found, e.g. CD64, CD85A, guanylate-binding protein 1 (GBP1), interferon-induced proteins with tetratricopeptide repeat (IFIT)2, and mixed lineage kinase domain-like protein (MLKL) and immunohistochemical staining showed higher expression of GBP1 and MLKL. A cluster analysis revealed that the most prominent cluster contained proteins involved in the tumor microenvironment and regulation of the immune system. Our data suggest that the therapeutic focus should be expanded toward the tumor microenvironment in non-GCB/ABC subtype patients.
|
|
| 6. |
- Bram Ednersson, Susanne, et al.
(författare)
-
TBLR1 and CREBBP as potential novel prognostic immunohistochemical biomarkers in diffuse large B-cell lymphoma
- 2020
-
Ingår i: Leukemia & Lymphoma. - : Informa UK Limited. - 1042-8194 .- 1029-2403. ; 61:11, s. 2595-2604
-
Tidskriftsartikel (refereegranskat)abstract
- Recent studies have identified prognostic mutational clusters for diffuse large B-cell lymphoma (DLBCL) patients, both within and outside the original cell-of-origin (COO) classification. For many of these mutations, there is limited information regarding the corresponding protein expression. With the aim to determine the relationship of protein expression and intensity to COO and prognosis, we used digital image analysis to quantitate immunohistochemical staining of CREBBP, IRF8, EZH2, and TBLR1 in 209 DLBCL patients. We found that patients with strong nuclear expression of TBLR1 had inferior progression-free survival (PFS) and overall survival (OS) in univariable analysis and inferior PFS in multivariable analysis. Patients with higher proportion of intermediate to strong nuclear CREBBP expression had a worse PFS and OS in univariable analysis. CREBBP was expressed with stronger intensity in non-GCB patients and the prognostic impact was restricted to this subgroup. These findings suggest that high nuclear protein expression of TBLR1 and CREBBP is negatively associated with prognosis in DLBCL.
|
|
| 7. |
- Ekberg, Sara, et al.
(författare)
-
Trends in the prevalence, incidence and survival of non-Hodgkin lymphoma subtypes during the 21st century - a Swedish lymphoma register study
- 2020
-
Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 189:6, s. 1083-1092
-
Tidskriftsartikel (refereegranskat)abstract
- Non-Hodgkin lymphoma (NHL) prognosis has improved in recent years, yet the number of patients living with the diagnosis, i.e. the prevalence, has seldom been reported. The prevalence provides a measure of the burden of disease, useful for healthcare planning and to optimise resource allocation. We provide a systematic presentation of temporal trends in absolute numbers of prevalent patients by NHL subtypes, linking them to trends in incidence, survival and mortality. Patients diagnosed 2000-2016 were identified in the national Swedish lymphoma register. Incidence and mortality rates, relative survival and prevalence were estimated for NHL overall and for major clinical and morphological subtypes. Poisson regression was used to test for temporal trends. Increasing incidence and improved survival have led to a 47% increase in the five-year prevalence of NHL overall in 2016 compared to 2004. An increasing prevalence was observed for all investigated subtypes during the study period, but most notably for diffuse large B cell lymphomas among aggressive subtypes (66%), and marginal zone lymphomas among indolent subtypes (135%). This dramatic increase in NHL prevalence underscores the need to develop and evaluate alternative follow-up schemes to use resources efficiently and still ensure optimal care of lymphoma survivors.
|
|
| 8. |
- Hagberg, Hans, et al.
(författare)
-
Follicular lymphoma in Sweden: nationwide improved survival in the rituximab era, particularly in elderly women: a Swedish Lymphoma Registry Study
- 2015
-
Ingår i: Leukemia. - : Springer Science and Business Media LLC. - 0887-6924 .- 1476-5551. ; 29:3, s. 668-676
-
Tidskriftsartikel (refereegranskat)abstract
- Treatment for follicular lymphoma (FL) improved with rituximab. In Sweden, first-line rituximab was gradually introduced between 2003 and 2007, with regional differences. The first national guidelines for FL were published in November 2007, recommending rituximab in first-line therapy. Using the population-based Swedish Lymphoma Registry, 2641 patients diagnosed with FL from 2000 to 2010 were identified and characterized by year and region of diagnosis, age (median, 65 years), gender (50% men), first-line therapy and clinical risk factors. Overall and relative survivals were estimated by calendar periods (2000-2002, 2003-2007 and 2008-2010) and region of diagnosis. With each period, first-line rituximab use and survival increased. Survival was superior in regions where rituximab was quickly adopted and inferior where slowly adopted. These differences were independent in multivariable analyses. Ten-year relative survival for patients diagnosed 2003-2010 was 92%, 83%, 78% and 64% in the age groups 18-49, 50-59, 60-69 and ≥70, respectively. With increasing rituximab use, male sex emerged as an adverse factor. Survival improved in all patient categories, particularly in elderly women. The introduction and the establishment of rituximab have led to a nationwide improvement in FL survival. However, rituximab might be inadequately dosed in younger women and men of all ages. © 2015 Macmillan Publishers Limited. All rights reserved.
|
|
| 9. |
- Junevik, Katarina, 1965, et al.
(författare)
-
The expression of NK cell inhibitory receptors on cytotoxic T cells in B-cell chronic lymphocytic leukaemia (B-CLL).
- 2007
-
Ingår i: Annals of hematology. - : Springer Science and Business Media LLC. - 1432-0584 .- 0939-5555. ; 86:2, s. 89-94
-
Tidskriftsartikel (refereegranskat)abstract
- Immune surveillance of tumours is mediated by cytotoxic T cells (CTL) that recognise tumour antigen. Reduced reactivity of CTL towards tumour cells could thus lead to disease progression and loss of tumour control. In B-cell chronic lymphocytic leukaemia (B-CLL), the function of tumour-reactive CTL seems to correlate inversely to disease stage. Inhibitory NK cell receptors are known to suppress the CTL response upon interaction with major histocompatibility complex (MHC) class I and increased expression of such receptors on CTL may inhibit the anti-tumour response. So, the aim of this study was to investigate the expression of NK cell inhibitory receptors on CTL in B-CLL patients and if such expression correlated to disease stage. CD8+ T cells from B-CLL patients in Binet stage A (n = 26) and stage C (n = 14) and healthy controls (n = 14) were analysed for the expression of killer immunoglobulin-like receptors (KIR) CD158a (KIR2DL1), CD158b (KIR2DL2), CD158e (KIR3DL1) and the C-type lectin receptor CD94, by flow cytometry analysis. Patients with advanced disease (Binet stage C) had a significantly greater percentage of CTL expressing CD158b, CD158e and CD94 than patients with non-progressive disease (Binet stage A) and healthy controls. Stage C patients also had a significantly higher percentage of CTL expressing CD158a than stage A patients. No statistically significant differences were found between Binet A patients and healthy controls. Our results suggest that increased expression of KIR and CD94 on CTL in advanced stage B-CLL may potentially contribute to the impaired anti-tumour immune response in these patients.
|
|
| 10. |
- Lewerin, Catharina, 1961, et al.
(författare)
-
Glomerular filtration rate as measured by serum cystatin C is an important determinant of plasma homocysteine and serum methylmalonic acid in the elderly
- 2007
-
Ingår i: J Intern Med. - 0954-6820. ; 261:1, s. 65-73
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore the dependence of glomerular filtration rate (GFR) on plasma total homocysteine (tHcy) and serum methylmalonic acid (MMA), as well as the consequences for the diagnosis of cobalamin and/or folic acid deficiency in an elderly community-dwelling population. DESIGN AND SETTING: Population-based study of 209 community-dwelling subjects, mean age 76 years. INTERVENTIONS: Four months' treatment study with oral vitamin B(12), folic acid and B(6) or placebo. MAIN OUTCOME MEASURES: Determinants of tHcy and MMA: cystatin C as a marker of GFR and serum/plasma concentrations of vitamin B(12) and folate, age and sex. RESULTS: Elevated cystatin C (>1.55 mg L(-1)) was found in 31.3% (men) and 13.0% (women). Elevated tHcy (> or = 16 micromol L(-1)) occurred in 53% and elevated MMA (> or = 0.34 micromol L(-1)) in 11% of all subjects. When GFR was taken into consideration, the proportion of elevated tHcy was reduced to 10% (20/209), whilst the proportion of elevated MMA was unchanged. Cystatin C was correlated with tHcy (r = 0.45, P < 0.001) and with MMA (r =0.28, P < 0.001), independently of vitamin B(12)- and folate status. According to multiple regression, independent predictors for tHcy were plasma folate (15%), cystatin C (11%) and vitamin B(12) (4%), and for MMA, cystatin C (8%) and vitamin B(12) (2%). CONCLUSIONS: The prevalence of elevated tHcy may be overestimated in elderly populations unless GFR is taken into account. Nomograms for evaluation of tHcy and MMA in relation to both cystatin C and serum creatinine are presented.
|
|
| 11. |
- Lewerin, Catharina, 1961, et al.
(författare)
-
Holotranscobalamin is not influenced by decreased renal function in elderly men: the MrOS Sweden study
- 2013
-
Ingår i: Annals of Clinical Biochemistry. - : SAGE Publications. - 0004-5632 .- 1758-1001. ; 50:6, s. 585-594
-
Tidskriftsartikel (refereegranskat)abstract
- Background Subclinical cobalamin deficiency is common in the elderly, but the sensitivity and specificity of serum total cobalamin for this diagnosis is poor. Serum holotranscobalamin (holoTC), a measure of biologically available cobalamin, is considered a better marker for early cobalamin depletion than total cobalamin. However, in elderly populations, health-related reference intervals for holoTC and correlations to renal function are not entirely clear. Methods HoloTC was determined with an automated microparticle enzyme immunoassay (AxSYM (R)) in 790 elderly non-vitamin-supplemented Swedish men, median age 75.3 years. Renal function was assessed with creatinine, cystatin C and estimated glomerular filtration rate (eGFR calculated from creatinine). Results Median holoTC was 51.8pmol/L, the health-related reference interval 19.6-132.3pmol/L. There was no significant difference in mean holoTC in probands with normal compared to high creatinine (P=0.80) and cystatin C (P=0.82). No significant differences between the quartiles of creatinine or cystatin C in mean of log holoTC were seen. HoloTC correlated strongly with total cobalamin (r=0.69, P<0.001), weaker with eGFR(creatinine) (r=-0.09, P<0.05) and creatinine (r=0.09, P<0.05), the latter correlation was only seen in subjects with creatinine <100 mu mol/L. HoloTC correlated negatively with plasma total homocysteine (r=-0.24, P<0.001), but not with cystatin C and age. Conclusions Serum holoTC in healthy elderly men shows the same distribution as earlier described for a younger reference population. In this group of elderly subjects, holoTC did not correlate to reduced renal function. Thus, holoTC appears to be a promising tool for evaluating cobalamin status also in elderly populations.
|
|
| 12. |
- Lewerin, Catharina, 1961, et al.
(författare)
-
Low serum iron is associated with high serum intact FGF23 in elderly men: The Swedish MrOS study
- 2017
-
Ingår i: Bone. - : Elsevier BV. - 8756-3282 .- 1873-2763. ; 98, s. 1-8
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Fibroblast growth factor (FGF23) is a protein that is produced by osteoblasts and osteocytes. Increased serum levels of FGF23 have been associated with increased risks of osteoporotic fractures and cardiovascular disease, particularly in participants with poor renal function. Serum iron (Fe) has been suggested as a regulator of FGF23 homeostasis. Objective: To determine whether Fe and iron status are determinants of the levels of intact FGF23 (iFGF23) in elderly men. Methods: The MrOS study is a population-based study of elderly men (N = 1010; mean age, 75.3 years; range, 69-81 years). The levels of Fe, transferrin saturation (TS), and ferritin were evaluated in relation to the serum concentrations of iFGF23 before and after adjustments for confounders. Results: TS<15% was found in 3.5% (34/977) of the participants, who had a higher median level iFGF23 compared with the remaining subjects (47.4 mu rnol/L vs. 41.9 mu mol/L, p = 0.008). The levels of iFGF23 correlated negatively (un-adjusted) with the levels of Fe (r = -0.17, p < 0.001), TS (r = -0.16, p < 0.001) and serum ferritin (r = -0.07, p = 0.022). In addition, in participants with estimated glomerular filtration rate eGFRCystatin C > 60 mL/min, the levels of iFGF23 correlated (age-adjusted) negatively with the levels of Fe (r = -0.15, p < 0.001) and TS (r = -0.17, p < 0.001). The level of iFGF23 correlated positively (un-adjusted) with lumbar spine bone mineral density (BMD) (r = 0.14, p < 0.001), total body BMD (r = 0.11, p = 0.001), and total hip BMD (r = 0.09, p = 0.004). The corresponding correlations, when adjusted for age, weight, and height were: r = 0.08, p = 0.018; r = 0.05, p = 0.120; and r = 0.02, p = 0.624, respectively. No associations were found between BMD and the levels of Fe or TS. Multiple step-wise linear regression analyses [adjusting for age, body mass index (BMI), comorbidity index, cystatin C, C-reactive protein (hs-CRP), serum vitamin D 25-OH (25OHD), phosphate, calcium, parathyroid hormone (PTH), erythropoietin, hemoglobin, lumbar spine BMD, apolipoprotein B/A1 ratio] were performed in three separate models with Fe, TS or ferritin as potential explanatory variables. Fe and TS, but not ferritin, were independent predictors of iFGF23 level (standardized beta-values: -0.10, p <0.001; 0.10, p <0.001; and -0.05, p = 0.062, respectively). Conclusion: Low levels of Fe in elderly men are associated with high levels of iFGF23, independently of markers of inflammation and renal function, suggesting an iron-related pathway for FGF23 regulation. (C) 2017 Elsevier Inc. All rights reserved.
|
|
| 13. |
|
|
| 14. |
- Lewerin, Catharina, 1961, et al.
(författare)
-
Significant correlations of plasma homocysteine and serum methylmalonate with movement and cognitive performance in elderly subjects but no improvement from short-term vitamin therapy: a placebo controlled randomized study
- 2005
-
Ingår i: American Journal of Clinical Nutrition. - 0002-9165. ; 81:5, s. 1155-1162
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Deficiencies of vitamin B-12, folic acid, and vitamin B-6-as de-fined by laboratory measures-occur in 10-20% of elderly subjects. The clinical significance remains unresolved. OBJECTIVE: The objective was to explore any association between vitamin status and vitamin treatment and movement and cognitive performance in elderly subjects. DESIGN: Community-dwelling sub-jects (n = 209) with a median age of 76 y were randomly assigned to daily oral treatment with 0.5 mg cyanocobalamin, 0.8 mg folic acid, and 3 mg vitamin B-6 or placebo (double blind) for 4 mo. Movement and cognitive performance tests were performed before and after treatment. RESULTS: A high plasma total ho-mocysteine (tHcy) concentration (> or =16 micromol/L) was found in 64% of men and in 45% of women, and a high serum methylmalonic acid (MMA) concentra-tion (> or =0.34 micromol/L) was found in 11% of both sexes. Movement time, digit symbol, and block design (adjusted for age, sex, smoking, and creatinine) correlated independently with plasma tHcy (P < 0.01, < 0.05, and < 0.01, respec-tively); the simultaneity index and block design correlated with serum MMA (P < 0.05 for both). Vitamin therapy significantly decreased plasma tHcy (32%) and serum MMA (14%). No improvements were found in the movement or cognitive tests compared with placebo. Neither vitamin therapy nor changes in plasma tHcy, serum MMA, serum vitamin B-12, plasma folate, or whole-blood folate cor-related with changes in movement or cognitive performance. CONCLUSIONS: High plasma tHcy and serum MMA were prevalent and correlated inversely with movement and cognitive performance. Oral B vitamin treatment normalized plasma tHcy and serum MMA concentrations but did not affect movement or cognitive performance. This might have been due to irreversible or vitamin-independent neurocognitive decline or to an insufficient dose or duration of vita-mins.
|
|
| 15. |
|
|
| 16. |
- Nilsson-Ehle, Herman, 1950, et al.
(författare)
-
Vitaminer och spårämnen.
- 2012
-
Ingår i: Laurells Klinisk kemi i praktisk medicin. - 2012 - 9., [rev. och utök.] uppl. / redaktion: Peter Nilsson-Ehle, Maria Berggren Söderlund, Elvar Theodorsson ; redaktionskommitté: Charlotte Becker, Kjell Grankvist, Anders Grubb, Göran Lindstedt, Per Simonsson.. - Lund : Studentlitteratur AB. - 9789144047874
-
Bokkapitel (refereegranskat)
|
|
| 17. |
- Rüetschi, Ulla, 1962, et al.
(författare)
-
SILAC-Based Quantitative Proteomic Analysis of Diffuse Large B-Cell Lymphoma Patients.
- 2015
-
Ingår i: International journal of proteomics. - : Hindawi Limited. - 2090-2166 .- 2090-2174. ; 2015
-
Tidskriftsartikel (refereegranskat)abstract
- Diffuse large B-cell lymphoma (DLBCL), the most common lymphoma, is a heterogeneous disease where the outcome for patients with early relapse or refractory disease is very poor, even in the era of immunochemotherapy. In order to describe possible differences in global protein expression and network patterns, we performed a SILAC-based shotgun (LC-MS/MS) quantitative proteomic analysis in fresh-frozen tumor tissue from two groups of DLBCL patients with totally different clinical outcome: (i) early relapsed or refractory and (ii) long-term progression-free patients. We could identify over 3,500 proteins; more than 1,300 were quantified in all patients and 87 were significantly differentially expressed. By functional annotation analysis on the 66 proteins overexpressed in the progression-free patient group, we found an enrichment of proteins involved in the regulation and organization of the actin cytoskeleton. Also, five proteins from actin cytoskeleton regulation, applied in a supervised regression analysis, could discriminate the two patient groups. In conclusion, SILAC-based shotgun quantitative proteomic analysis appears to be a powerful tool to explore the proteome in DLBCL tumor tissue. Also, as progression-free patients had a higher expression of proteins involved in the actin cytoskeleton protein network, such a pattern indicates a functional role in the sustained response to immunochemotherapy.
|
|
| 18. |
- Sjövall, Henrik, 1954, et al.
(författare)
-
»Stopp, frys, vad är det som händer? Hjälp er kollega!« : - Scenkonst och läkekonst i samverkan för bättre patientmöten
- 2019
-
Ingår i: Läkartidningen. ; :43
-
Tidskriftsartikel (refereegranskat)abstract
- »Stopp, frys, vad är det som händer? Hjälp er kollega!« Scenkonst och läkekonst i samverkan för bättre patientmöten. I ett projekt som kombinerar läkarutbildning, fallstudier och scenkonst samarbetar läkare, skådespelare och regissör i kreativ gestaltning och analys av patientmöten. Victoria Brattström arbetar som frilansade regissör och som lektor i scenisk gestaltning på Högskolan för scen och musik i Göteborg. Hon är också knuten som doktorand till Centrum för person-centrerad vård, GPCC, med ett projekt som undersöker roller och förhållningssätt i teater och sjukvård och där ett av syftena är att utveckla nya pedagogiska verktyg. Henrik Sjövall är professor emeritus, universitetsöverläkare i medicinsk gastroenterologi vid Sahlgrenska universitetssjukhuset och har lång erfarenhet av att arbeta med läkarutbildning. På ett seminarium arrangerat av Svensk förening för narrativ medicin möttes Brattström och Sjövall. De började samtala om pedagogiska frågor inom deras respektive professionsområden. Med grund i verktyg utvecklade inom ramen för Brattströms avhandlingsarbete och utifrån ett antal pedagogiskt relevanta fallbeskrivningar, beslöt de sig för att skapa en utbildningsmodell med växelverkan mellan gestaltning och reflektion: Läkarstudenter och skådespelare prövar fallen praktiskt uppe på scengolvet. Studenter och erfarna kliniker analyserar sedan de gestaltade situationerna tillsammans. Läkaren själv inkluderas som både aktiv och i efterförloppet reflekterande part. Inom det sceniska gestaltningsområdet vilar utbildningsmodellen på en sammanställning och utveckling av verktyg från olika traditioner inom teatern. Mer specifikt har man tagit avstamp i en tradition skapad av teaterpersonen Konstantin Stanislavsky [1863- 1938]. I linje med Brattströms avhandlingsarbete har man här utvecklat och applicerat Stanislavskys »magiska Om« som analys- och gestaltningsverktyg i kontexter utanför teaterns mer traditionella spelrum. Principerna är att regissör och skådespelare använder sig av sin expertis inom den så kallade aktion-aktivitetsmetoden under förberedelsearbetet och för att sedan analysera och aktivt sceniskt undersöka situationerna. På det sättet omvandlas de autentiska fallen till spelbara och pedagogiskt aktiva improvisationssituationer. Skådespelarens och regissörens gestaltningsförmåga blir på detta sätt ett kraftfullt verktyg för läkarstudenternas lärande. Workshopsmodellen prövades för första gången skarpt 2018 och blev en succé. Såhär uttryckte sig t.ex. en av de deltagande studenterna efter workshopen: ”Det är konstigt, det var som att bli vaccinerad mot det man är mest rädd för! Här blir vi immuniserade och nästa gång när vi ställs inför det där vet vi hur vi skall göra! ”.
|
|
| 19. |
- Smith, Frida, 1973, et al.
(författare)
-
Evaluating the implementation and use of the regional cancer plan in Western Sweden through concept mapping
- 2019
-
Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1464-3677 .- 1353-4505. ; 31:7, s. G44-G52
-
Tidskriftsartikel (refereegranskat)abstract
- Quality problem or issue: Within healthcare, policy documents are often used to strategically standardize, streamline or change how general health issues are managed for a specific patient group or treatment. Despite significant effort in developing policy and strategic planning documents, these may not have the intended impact and their value has long been questioned by practitioners. Choice of solution: To identify barriers and affordances for the implementation and use of a strategic plan for cancer care in the Western Sweden Healthcare Region, we used Concept Mapping; a participatory mixed method approach to inquiry consisting of both qualitative and quantitative tasks intended to elicit and integrate the diverse perspectives of multiple stakeholders. Implementation: The study was carried out between April and October 2017 and consisted of several sequential data collection steps: idea generation, sorting and rating ideas for importance and feasibility. Stakeholders from different levels and professions in cancercare participated, but the number varied in the separate steps of data collection: idea generation (n = 112), sorting (n = 16) and rating (n = 38). Evaluation: A concept map visualized seven areas that stakeholders throughout the cancer-care process considered necessary to address in order to enable the implementation of the plan. Skills provision was considered the most important cluster but also rated as least feasible. A consistent theme emerged that information, or lack thereof, might be a barrier for the plan being put into action to a greater extent in the cancer-care units. Nine actionable ideas rated highly on both importance and feasibility were presented as a go-zone. Lessons learned: Our results suggest that efforts might be better spent on ensuring information about and accessibility to strategic documents throughout the organization, rather than frequently updating them or producing new ones. Having sufficient skills provision seems to be the prerequisite for successful implementation.
|
|
| 20. |
- Stenson, Martin, et al.
(författare)
-
Serum nuclear magnetic resonance-based metabolomics and outcome in diffuse large B-cell lymphoma patients - a pilot study
- 2016
-
Ingår i: Leukemia and Lymphoma. - : Informa UK Limited. - 1042-8194 .- 1029-2403. ; 57:8, s. 1814-1822
-
Tidskriftsartikel (refereegranskat)abstract
- The prognosis for diffuse large B-cell lymphoma (DLBCL) patients with early relapse or refractory disease is dismal. To determine if clinical outcome correlated to diverse serum metabolomic profiles, we used H-1 nuclear magnetic resonance (NMR) spectroscopy and compared two groups of DLBCL patients treated with immunochemotherapy: i) refractory/early relapse (REF/REL; n=27) and ii) long-term progression-free (CURED; n=60). A supervised multivariate analysis showed a separation between the groups. Among discriminating metabolites higher in the REF/REL group were the amino acids lysine and arginine, the degradation product cadaverine and a compound in oxidative stress (2-hydroxybutyrate). In contrast, the amino acids aspartate, valine and ornithine, and a metabolite in the glutathione cycle, pyroglutamate, were higher in CURED patients. Together, our data indicate that NMR-based serum metabolomics can identify a signature for DLBCL patients with high-risk of failing immunochemotherapy, prompting for larger validating studies which could lead to more individualized treatment of this disease.
|
|
| 21. |
- Wahlin, Björn Engelbrekt, et al.
(författare)
-
T Cells in Tumors and Blood Predict Outcome in Follicular Lymphoma Treated with Rituximab
- 2011
-
Ingår i: Clinical Cancer Research. - : American Association for Cancer Research. - 1078-0432 .- 1557-3265. ; 17:12, s. 4136-4144
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: T cells influence outcome in follicular lymphoma, but their contributions seem to be modified by therapy. Their impact in patients receiving rituximab without chemotherapy is unknown. EXPERIMENTAL DESIGN: Using flow cytometry, we evaluated the T cells in tumors and/or blood in a total of 250 follicular lymphoma patients included in two Nordic Lymphoma Group randomized trials that compared single rituximab with IFN-α2a-rituximab combinations. RESULTS: In univariate analysis, higher levels of CD3(+), CD4(+), and CD8(+) T cells in both tumors and blood correlated with superior treatment responses, and in multivariate analysis, tumor-CD3(+) (P = 0.011) and blood-CD4(+) (P = 0.029) cells were independent. CD4(+) cells were favorable regardless of treatment arm, but CD8(+) cells were favorable only in patients treated with single rituximab, because IFN-α2a improved responses especially in patients with low CD8(+) cell levels. Higher levels of blood-CD3(+) (P = 0.003) and blood-CD4(+) (P = 0.046) cells predicted longer overall survival, and higher levels of blood-CD8(+) cells longer times to next treatment (P = 0.046). CONCLUSIONS: We conclude that therapeutic effects of rituximab are augmented by tumor-associated T cells for rapid responses and by systemic T cells for sustained responses. CD4(+) and CD8(+) cells are both favorable in patients treated with rituximab. IFN-α2a abrogates the negative impact of few CD8(+) cells.
|
|
| 22. |
|
|
