| 1. |
- Aad, G, et al.
(författare)
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- 2015
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swepub:Mat__t
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| 9. |
- Andrae, Bengt, et al.
(författare)
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Screening and cervical cancer cure: population based cohort study.
- 2012
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Ingår i: BMJ (Clinical research ed.). - : BMJ. - 1756-1833 .- 0959-8138 .- 1468-5833. ; 344
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Tidskriftsartikel (refereegranskat)abstract
- To determine whether detection of invasive cervical cancer by screening results in better prognosis or merely increases the lead time until death.
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| 11. |
- Dahlberg, Leif, et al.
(författare)
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Proteoglycan fragments in joint fluid : Influence of arthrosis and inflammation
- 1992
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 63:4, s. 417-423
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Tidskriftsartikel (refereegranskat)abstract
- We determined the concentration of proteoglycan fragments in knee joint fluid collected from knee-ligament injured patients more than 6 months after the trauma and from patients with acute pyrophosphate arthritis and arthrosis or with arthrosis only. Injured patients with normal or only mildly altered cartilage at arthroscopy and with normal radiographs, had twice the average concentration of healthy volunteers. Other injured patients with advanced, radiographic signs of arthrosis, had synovial fluid proteoglycan fragment concentrations within the range of healthy volunteers. Patients with pyrophosphate arthritis had the highest concentrations, substantially increased compared with both arthrosis patients, with or without knee injury and healthy volunteers. Likewise, there was an inverse relation between the degree of arthrosis and the concentration of proteoglycan fragments in the joint fluid in patients with pyrophosphate arthritis and arthrosis or with arthrosis only. We conclude that synovial fluid levels of proteoglycan fragments are influenced by the mass of cartilage matrix remaining in the joint, the inflammatory activity in the joint, and the metabolic activity of the cartilage cells.
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| 12. |
- de Boniface, J., et al.
(författare)
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The generalisability of randomised clinical trials: an interim external validity analysis of the ongoing SENOMAC trial in sentinel lymph node-positive breast cancer
- 2020
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Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 0167-6806 .- 1573-7217. ; 180:1, s. 167-176
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Tidskriftsartikel (refereegranskat)abstract
- Purpose None of the key randomised trials on the omission of axillary lymph node dissection (ALND) in sentinel lymph-positive breast cancer have reported external validity, even though results indicate selection bias. Our aim was to assess the external validity of the ongoing randomised SENOMAC trial by comparing characteristics of Swedish SENOMAC trial participants with non-included eligible patients registered in the Swedish National Breast Cancer Register (NKBC). Methods In the ongoing non-inferiority European SENOMAC trial, clinically node-negative cT1-T3 breast cancer patients with up to two sentinel lymph node macrometastases are randomised to undergo completion ALND or not. Both breast-conserving surgery and mastectomy are eligible interventions. Data from NKBC were extracted for the years 2016 and 2017, and patient and tumour characteristics compared with Swedish trial participants from the same years. Results Overall, 306 NKBC cases from non-participating and 847 NKBC cases from participating sites (excluding SENOMAC participants) were compared with 463 SENOMAC trial participants. Patients belonging to the middle age groups (p = 0.015), with smaller tumours (p = 0.013) treated by breast-conserving therapy (50.3 versus 47.1 versus 65.2%, p < 0.001) and less nodal tumour burden (only 1 macrometastasis in 78.8 versus 79.9 versus 87.3%, p = 0.001) were over-represented in the trial population. Time trends indicated, however, that differences may be mitigated over time. Conclusions This interim external validity analysis specifically addresses selection mechanisms during an ongoing trial, potentially increasing generalisability by the time full accrual is reached. Similar validity checks should be an integral part of prospective clinical trials. Trial registration: NCT 02240472, retrospective registration date September 14, 2015 after trial initiation on January 31, 2015
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| 13. |
- Flivik, Gunnar, et al.
(författare)
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Positive effect of removal of subchondral bone plate for cemented acetabular component fixation in total hip arthroplasty: a randomised RSA study with ten-year follow-up.
- 2015
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Ingår i: The Bone & Joint Journal. - 2049-4408. ; 97B:1, s. 35-44
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Tidskriftsartikel (refereegranskat)abstract
- We hypothesised that the removal of the subchondral bone plate (SCBP) for cemented acetabular component fixation in total hip arthroplasty (THA) offers advantages over retention by improving the cement-bone interface, without jeopardising implant stability. We have previously published two-year follow-up data of a randomised controlled trial (RCT), in which 50 patients with primary osteoarthritis were randomised to either retention or removal of the SCBP. The mean age of the retention group (n = 25, 13 males) was 70.0 years (sd 6.8). The mean age in the removal group (n = 25, 16 males) was 70.3 years (sd 7.9). Now we have followed up the patients at six (retention group, n = 21; removal group, n = 20) and ten years (retention group: n = 17, removal group: n = 18), administering clinical outcome questionnaires and radiostereometric analysis (RSA), and determining the presence of radiolucent lines (RLLs) on conventional radiographs. RSA demonstrated similar translation and rotation patterns up to six years. Between six and ten years, proximal acetabular component migration and changes of inclination were larger in the retention group, although the mean differences did not reach statistical significance. Differences in migration were driven by two patients in the SCBP retention group with extensive migration versus none in the SCBP removal group. The significant difference (p < 0.001) in the development of radiolucent lines in the retention group, previously observed at two years, increased even further during the course of follow-up (p < 0.001). While recognising SCBP removal is a more demanding technique, we conclude that, wherever possible, the SCBP should be removed to improve the cement-bone interface in order to maximise acetabular component stability and longevity. Cite this article: Bone Joint J 2015;97-B:35-44.
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| 14. |
- Forslund, Ola, et al.
(författare)
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Population-based type-specific prevalence of high-risk human papillomavirus infection in middle-aged Swedish Women.
- 2002
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Ingår i: Journal of Medical Virology. - : Wiley. - 1096-9071 .- 0146-6615. ; 66:4, s. 535-541
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Tidskriftsartikel (refereegranskat)abstract
- Human papillomavirus (HPV) DNA testing can be used to identify women at risk of the development of cervical cancer. The cost-effectiveness of HPV screening is dependent on the type-specific HPV prevalence in the general population. The present study describes the prevalence and spectrum of high-risk HPV types found in a large real-life population-based HPV screening trial undertaken entirely within the cervical screening program offered to middle-aged Swedish women. Cervical brush samples from 6,123 women aged 32-38 years were analyzed using a general HPV primer (GP5(+)/6(+)) polymerase chain reaction-enzyme immunoassay (PCR-EIA) combined with reverse dot-blot hybridization for confirmation and HPV typing by a single assay. In this study, 6.8% (95% CI 6.2-7.5) (417/6,123) were confirmed as high-risk HPV positive. Infections with 13 different high-risk HPV types were detected, of which HPV 16 was the most prevalent type (2.1%; 128/6,123), followed by HPV 31 (1.1%; 67/6,123). Any one of the HPV types 18, 33, 35, 39, 45, 51, 52, 56, 58, 59, or 66 was detected in 3.6% (223/6,123) of the women. Infection with two, three, and five types simultaneously was identified in 32, 5, and 1 women, respectively. The combination of PCR-EIA as a screening test and reverse dot-blot hybridization as a confirmatory test, was found to be readily applicable to a real-life population-based cervical screening. The type-specific HPV prevalence found support in previous modeling studies suggesting that HPV screening may be a favorable cervical screening strategy.
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- Kiernan, Sverrir, et al.
(författare)
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The importance of adequate stem anteversion for rotational stability in cemented total hip replacement: A radiostereometric study with ten-year follow-up.
- 2013
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Ingår i: The Bone & Joint Journal. - 2049-4408. ; 95B:1, s. 23-30
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Tidskriftsartikel (refereegranskat)abstract
- Progressive retroversion of a cemented stem is predictive of early loosening and failure. We assessed the relationship between direct post-operative stem anteversion, measured with CT, and the resulting rotational stability, measured with repeated radiostereometric analysis over ten years. The study comprised 60 cemented total hip replacements using one of two types of matt collared stem with a rounded cross-section. The patients were divided into three groups depending on their measured post-operative anteversion (< 10°, 10° to 25°, > 25°). There was a strong correlation between direct post-operative anteversion and later posterior rotation. At one year the < 10° group showed significantly more progressive retroversion together with distal migration, and this persisted to the ten-year follow-up. In the < 10° group four of ten stems (40%) had been revised at ten years, and an additional two stems (20%) were radiologically loose. In the 'normal' (10° to 25°) anteversion group there was one revised (3%) and one loose stem (3%) of a total of 30 stems, and in the > 25° group one stem (5%) was revised and another loose (5%) out of 20 stems. This poor outcome is partly dependent on the design of this prosthesis, but the results strongly suggest that the initial rotational position of cemented stems during surgery affects the subsequent progressive retroversion, subsidence and eventual loosening. The degree of retroversion may be sensitive to prosthetic design and stem size, but < 10° of anteversion appears deleterious to the long-term outcome for cemented hip prosthetic stems.Cite this article: Bone Joint J 2013;95-B:23-30.
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| 19. |
- Lohmander, L. Stefan, et al.
(författare)
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Intra-articular hyaluronan injections in the treatment of osteoarthritis of the knee : A randomised, double blind, placebo controlled multicentre trial
- 1996
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967. ; 55:7, s. 424-431
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Tidskriftsartikel (refereegranskat)abstract
- Objective - To assess the effects of intraarticular injections of hyaluronan on symptoms of knee osteoarthritis (OA). Methods - Two hundred and forty patients with symptomatic, radiological knee OA were randomly assigned to treatment with weekly injections for five weeks with either 25 mg of high molecular weight hyaluronan or vehicle. Results were evaluated at weeks 1, 2, 3, 4, 5, 13, and 20 by visual analogue scales (pain, function, motion, activity), algofunctional index, and global evaluation by patient and investigator. Analysis was by 'intention to treat', 'per protocol), and area under the curve principles on unstratified patient groups and for patients stratified into four groups of equal size by age and baseline algofunctional index. Results - No serious side effects were reported. At 20 weeks both treatment groups were improved compared with baseline, with no difference between unstratified groups treated with placebo or hyaluronan. Comparison of treatment-groups stratified by age and baseline algofunctional index revealed a significant-difference in favour of hyaluronan over placebo (pain, activity, algofunctional index, global evaluations by patient-and investigator) for patients older than 60 years and with a baseline algofunctional index greater than 10. There was no clinically relevant difference between the two treatments for the other three stratified subgroups of younger age or fewer symptoms. Similar results were obtained by area under the curve, intention to treat, and per protocol analysis. Conclusions-Patients older than 60 years with knee osteoarthritis and with significant symptoms corresponding to an index of severity of knee disease of 10 or more, comprise the group most likely to benefit from treatment with intra-articular hyaluronan injections.
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| 20. |
- Lundgren-Eriksson, L., et al.
(författare)
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Radio-and chemotoxicity in mice during hypothermia
- 2001
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Ingår i: Anticancer Res. - 0250-7005. ; 21:5, s. 3269-74
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The influence of hypothermia induced by chlorpromazine (10-15 mg/kg given intra-peritoneally) on the survival from radiation and chemotherapy exposure in C57B1-mice, with or without tumour inoculation, was studied. MATERIALS AND METHODS: The mice were exposed to either whole body irradiation (8 Gy), or doxorubicin (15 or 17.5 mg/kg i.p.), or cisplatin (20 mg/kg i. p.) and followed to ensuing death. The control mice maintained a rectal temperature of 38 degres C while those receiving chlorpromazine developed moderate hypothermia of 28 degrees C or 36 degrees C, dependent on the ambient temperature. RESULTS: Hypothermia of 28 degrees C protected the mice from radiation-induced death and acute doxorubicin toxicity, with males gaining more protection than females. The effects appeared dependent on temperature, not on chlorpromazine. Hypothermia protected the mice from acute cisplatin toxicity and increased the anti-tumour effects in both genders. Chlorpromazine itself did not cause toxicity, neither did it change the natural course of tumour progression. CONCLUSION: Hypothermia of 28 degrees C induced by chlorpromazine profoundly reduces radiation, doxorubicin-and cisplatin-induced toxicity in mice with males benefiting more than females. The hypothermia itself, not the chlorpromazine, was responsible for these effects. The anti-neoplastic activity was not compromised; rather, it was enhanced, particularly for cisplatin.
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- Molt, M, et al.
(författare)
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Strategy for RSA migration thresholds
- 2016
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 87:4, s. 432-433
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 27. |
- Olsson, O, et al.
(författare)
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A biomechanical study on fixation stability with twin hook or lag screw in artificial cancellous bone
- 2002
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Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 1432-5195 .- 0341-2695. ; 26:6, s. 349-355
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Tidskriftsartikel (refereegranskat)abstract
- The twin hook has been developed as an alternative to the conventional lag screw to be combined with a barrelled side-plate in the treatment of trochanteric hip fractures. With two oppositely directed apical hooks introduced into the subchondral bone of the femoral head, the twin hook provides different stabilising properties to the lag screw. The femoral head purchase of the twin hook and the lag screw were compared in a biomechanical study using artificial cancellous bone, and responses to axial and torsional loading was determined. A distinct yield point in load and torque was noted for the lag screw, representing failure of the laminas supporting the threads. For the twin hook, gradual increase of load and torque occurred during impaction of the bone supporting the hooks. The peak loads and torques were higher for the lag screw, but were similar for both devices after 8 rum deformation. The stiffness was higher for the lag screw, but in counter-clockwise rotation the stiffness for the lag screw was negligible. The twin hook appeared to provide fixation stability comparable to that offered by the lag screw, but with conceivable advantages in terms of a deformation response involving bone impaction and gradually increasing stability.
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- Roos, Ewa M., et al.
(författare)
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Substantial disability 3 months after arthroscopic partial meniscectomy: : A prospective study of patient-relevant outcomes
- 2000
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Ingår i: Arthroscopy. - : Elsevier BV. - 0749-8063. ; 16:6, s. 619-626
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Tidskriftsartikel (refereegranskat)abstract
- To our knowledge, this is the first prospective study using validated questionnaires to assess patient-relevant outcomes after arthroscopic partial meniscectomy. Data from the Knee Injury and Osteoarthritis Outcome Score (KOOS), the SF-36 Medical Outcomes Study Short-Form Health Survey, and the Lysholm Knee Scoring Scale were available for 74 consecutive patients (50 males, 24 females; mean age, 45 years) with isolated meniscus tear (n = 47) or meniscus tear combined with cartilage damage (n = 27). At postoperative follow-up (mean, 14.4 weeks) significant improvement was seen, but despite only minor pain and other symptoms postoperatively, significant physical disability and handicap were reported. Postoperatively, 30% of patients were active in sports compared with 63% before injury. A sedentary lifestyle was reported by 38% compared with 9% before injury. We conclude that patient-relevant outcomes provide additional information and should be assessed after arthroscopic partial meniscectomy. We further suggest that preoperative information for the meniscectomy patient should include a realistic expected functional outcome.
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| 30. |
- Ryd, L., et al.
(författare)
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Pre-Osteoarthritis: Definition and Diagnosis of an Elusive Clinical Entity
- 2015
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Ingår i: Cartilage. - : SAGE Publications. - 1947-6035 .- 1947-6043. ; 6:3, s. 156-165
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Tidskriftsartikel (refereegranskat)abstract
- Objective. An attempt to define pre-osteoarthritis (OA) versus early OA and definitive osteoarthritis. Methods. A group of specialists in the field of cartilage science and treatment was formed to consider the nature of OA onset and its possible diagnosis. Results. Late-stage OA, necessitating total joint replacement, is the end stage of a biological process, with many previous earlier stages. Early-stage OA has been defined and involves structural changes identified by arthroscopy or radiography. The group argued that before the "early-stage OA" there must exist a stage where cellular processes, due to the presence of risk factors, have kicked into action but have not yet resulted in structural changes. The group suggested that this stage could be called "pre-osteoarthritis" (pre-OA). Conclusions. The group suggests that defining points of initiation for OA in the knee could be defined, for example, by traumatic episodes or surgical meniscectomy. Such events may set in motion metabolic processes that could be diagnosed by modern MRI protocols or arthroscopy including probing techniques before structural changes of early OA have developed. Preventive measures should preferably be applied at this pre-OA stage in order to stop the projected OA epidemic.
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