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- Tarstedt, M, et al.
(författare)
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A randomized multicenter study to compare two treatment regimens of topical methyl aminolevulinate (Metvix (R))-PDT in actinic keratosis of the face and scalp
- 2005
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 85:5, s. 424-428
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Tidskriftsartikel (refereegranskat)abstract
- Photodynamic therapy (PDT) with topical methyl aminolevulinate ( MAL) administered in two treatment sessions separated by 1 week is an effective treatment for actinic keratoses. This open prospective study compared the efficacy and safety of MAL-PDT given as a single treatment with two treatments of MAL-PDT 1 week apart. Two hundred and eleven patients with 413 thin to moderately thick actinic keratoses were randomized to either a single treatment with PDT using topical MAL ( regimen I; n=105) or two treatments 1 week apart ( regimen II; n=106). Each treatment involved surface debridement, application of Metvix(R) cream (160 mg/g) for 3 h, followed by illumination with red light using a light-emitting diode system ( peak wavelength 634 +/- 3 nm, light dose 37 J/cm(2)). Thirty-seven lesions (19%) with a non-complete response 3 months after a single treatment were re-treated. All patients were followed up 3 months after the last treatment. A total of 400 lesions, 198 initially treated once and 202 treated twice, were evaluable. Complete response rate for thin lesions after a single treatment was 93% (95% CI = 87 - 97%), which was similar to 89% ( 82 - 96%) after repeated treatment. Response rates were lower after single treatment of thicker lesions (70% ( 60 - 78%) vs 84% ( 77 - 91%)), but improved after repeated treatment (88% ( 82 - 94%)). The conclusion of this study is that single treatment with topical MAL-PDT is effective for thin actinic keratosis lesions; however, repeated treatment is recommended for thicker or non-responding lesions.
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- Wennberg, AM, et al.
(författare)
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Comparison of two different frailty scales in the longitudinal Swedish Adoption/Twin Study of Aging (SATSA)
- 2023
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 51:4, s. 587-594
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Tidskriftsartikel (refereegranskat)abstract
- Although up to 25% of older adults are frail, assessing frailty can be difficult, especially in registry data. This study evaluated the utility of a code-based frailty score in registry data by comparing it to a gold-standard frailty score to understand how frailty can be quantified in population data and perhaps better addressed in healthcare. Methods: We compared the Hospital Frailty Risk Score (HFRS), a frailty measure based on 109 ICD codes, to a modified version of the Frailty Index (FI) Frailty Index (FI), a self-report frailty measure, and their associations with all-cause mortality both cross-sectionally and longitudinally (follow-up = 36 years) in a Swedish cohort study ( n = 1368). Results: The FI and HFRS were weakly correlated (rho = 0.11, p < 0.001). Twenty-two percent ( n = 297) of participants were considered frail based on published cut-offs of either measure. Only 3% ( n = 35) of participants were classified as frail by both measures; 4% ( n = 60) of participants were considered frail by only the HFRS; and 15% ( n = 202) of participants were considered frail based only on the FI. Frailty as measured by the HFRS showed greater variance and no clear increase or decrease with age, while frailty as measured by the FI increased steadily with age. In adjusted Cox proportional hazard models, baseline HFRS frailty (HR = 1.17, 95% CI 0.92, 1.49) was not statistically significantly associated with mortality, while FI frailty was (HR = 2.89, 95% CI 1.61, 2.23). These associations were modified by age and sex. Conclusions: The HFRS may not capture the full spectrum of frailty among community-dwelling individuals, particularly at younger ages, in Swedish registry data.
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| 16. |
- Wennberg, AM, et al.
(författare)
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Frailty Among Breast Cancer Survivors: Evidence From Swedish Population Data
- 2023
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Ingår i: American journal of epidemiology. - : Oxford University Press (OUP). - 1476-6256 .- 0002-9262. ; 192:7, s. 1128-1136
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer is the most common cancer among women, and incidence and survival have been increasing, leaving survivors at risk of aging-related health conditions. In this matched cohort study, we examined frailty risk with the Hospital Frailty Risk Score among breast cancer survivors (n=34900) and age-matched comparison subjects (n=290063). Women born 1935-1975 registered in the Swedish Total Population Register 1/1/1991-12/31/2015 were eligible for inclusion. Survivors had a first breast cancer diagnosis 1991-2005 and survived ≥5 years after initial diagnosis. Death date was determined by linkage to the National Cause of Death Registry until 12/31/2015. In subdistribution hazard models, cancer survivorship was weakly associated with frailty (SHR=1.04, 95% CI 1.00, 1.07). In age-stratified models, those diagnosed at younger ages (<50) had higher risk of frailty (SHR=1.12, 95% CI 1.00, 1.24) than those diagnosed at 50-65 (SHR=1.03, 95% CI 0.98, 1.07) or >65 (SHR=1.09, 95% CI 1.02, 1.17) years. Additionally, there was increased risk of frailty post-2000 (SHR=1.15, 95% CI 1.09, 1.21) compared to pre-2000 (SHR=0.97, 95% CI 0.93, 1.17). This supports work from smaller samples showing that breast cancer survivors have increased frailty risk, particularly when diagnosed at younger ages. Future work further exploring these associations and developing interventions is needed.
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| 17. |
- Wennberg, AM, et al.
(författare)
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Frailty Among Breast Cancer Survivors: Evidence From Swedish Population Data
- 2023
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Ingår i: American journal of epidemiology. - : Oxford University Press (OUP). - 1476-6256 .- 0002-9262. ; 192:7, s. 1128-1136
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer is the most common cancer among women, and incidence and survival have been increasing, leaving survivors at risk of aging-related health conditions. In this matched cohort study, we examined frailty risk with the Hospital Frailty Risk Score among breast cancer survivors (n=34900) and age-matched comparison subjects (n=290063). Women born 1935-1975 registered in the Swedish Total Population Register 1/1/1991-12/31/2015 were eligible for inclusion. Survivors had a first breast cancer diagnosis 1991-2005 and survived ≥5 years after initial diagnosis. Death date was determined by linkage to the National Cause of Death Registry until 12/31/2015. In subdistribution hazard models, cancer survivorship was weakly associated with frailty (SHR=1.04, 95% CI 1.00, 1.07). In age-stratified models, those diagnosed at younger ages (<50) had higher risk of frailty (SHR=1.12, 95% CI 1.00, 1.24) than those diagnosed at 50-65 (SHR=1.03, 95% CI 0.98, 1.07) or >65 (SHR=1.09, 95% CI 1.02, 1.17) years. Additionally, there was increased risk of frailty post-2000 (SHR=1.15, 95% CI 1.09, 1.21) compared to pre-2000 (SHR=0.97, 95% CI 0.93, 1.17). This supports work from smaller samples showing that breast cancer survivors have increased frailty risk, particularly when diagnosed at younger ages. Future work further exploring these associations and developing interventions is needed.
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| 18. |
- Wennberg, AM, et al.
(författare)
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How both positive and burdensome caregiver experiences are associated with care recipient cognitive performance: Evidence from the National Health and Aging Trends Study and National Study of Caregiving
- 2023
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Ingår i: Frontiers in public health. - : Frontiers Media SA. - 2296-2565. ; 11, s. 1130099-
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Tidskriftsartikel (refereegranskat)abstract
- Being an informal caregiver to a person with chronic disease, including persons living with dementia (PLWD), is a big role to take on and many caregivers experience both substantial burden and emotional reward related to caregiving. Care recipient factors (e.g., behavioral symptoms) are associated with caregiver experience. However, the relationship between caregiver and care recipient is bidirectional, so it is likely that caregiver factors impact the care recipient, though few studies have investigated this.MethodsIn the 2017 round of the National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC), we studied 1,210 care dyads-−170 PLWD dyads and 1,040 without dementia dyads. Care recipients completed immediate and delayed word list memory tasks, the Clock Drawing Test, and a self-rated memory rating, while caregivers were interviewed about their caregiving experiences using a 34-item questionnaire. Using principal component analysis, we created a caregiver experience score with three components—Practical Care Burden, Positive Care Experiences, and Emotional Care Burden. We then investigated the cross-sectional association between caregiver experience components and care recipient cognitive test performance using linear regression models adjusted for age, sex, education, race, and depressive and anxiety symptoms.ResultsAmong PLWD dyads, a higher caregiver Positive Care Experiences score was associated with better care recipient performance on the delayed word recall (B = 0.20, 95% CI 0.05, 0.36) and Clock Draw (B = 0.12, 95% CI 0.01, 0.24) tests while higher Emotional Care Burden score was associated with worse self-rated memory score (B = −0.19, 95% CI −0.39, −0.003). Among participants without dementia, higher Practical Care Burden score was associated with poorer care recipient performance on the immediate (B = −0.07, 95% CI −0.12, −0.01) and delayed (B = −0.10, 95% CI −0.16, −0.05) word recall tests.DiscussionThese findings support the concept that caregiving is bidirectional within the dyad and that positive variables can positively impact both members of the dyad. This suggests that caregiving interventions should target the caregiver and recipient both individually and as a unit, with the goal of holistically improving outcomes for both.
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