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| 13. |
- Pálsdóttir, K, et al.
(författare)
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Inter-observer agreement of transvaginal ultrasound and magnetic resonance imaging in local staging of cervical cancer.
- 2021
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Ingår i: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 58:5, s. 773-779
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the inter-observer agreement in relation to observer experience for the assessment of local tumor extension in women with cervical cancer, using transvaginal ultrasound (US) and magnetic resonance imaging (MRI).METHODS: The observers comprised six US specialists with, and seven without previous experience of cervical cancer assessment, five experienced radiologists in pelvic MRI, and four less experienced radiology residents without previous MRI experience. The less experienced US observers, and all MRI observers underwent comprehensive training on assessment of cervical tumor extension while experienced US observers received written directives. All observers were assigned the same images from cervical cancer patients of all stages (n=60) for off-line evaluation on tumor detection, cervical stromal- (>1/3), and parametrial invasion. Inter-observer agreement was measured using Fleiss kappa, with 95% CI.RESULTS: Experienced and less experienced US observers had moderate agreement regarding tumor detection Fleiss κ [95% CI] (0.46 [0.40-0.53], and 0.46 [0.41-0.52]), stromal invasion (0.45 [0.38-0.51] and 0.53 [0.40-0.58]) and parametrial invasion (0.57 [0.51-0.64], and 0.44 [0.39-0.50]), respectively. Experienced and less experienced MRI observers had good κ [95% CI] (0.70 [0.62-0.78]) and moderate agreement (0.51 [0.41-0.62]), regarding tumor detection, good agreement regarding stromal invasion (0.80 [0.72-0.88] and 0.71 [0.61-0.81]) and parametrial invasion (0.69 [0.61-0.77] and 0.71[0.61-0.81]), respectively.CONCLUSION: The inter-observer agreement was moderate for US, and moderate - good for MRI regarding the assessment of local tumor extension. The level of inter-observer agreement was only associated with experience among US observers regarding parametrial invasion. This article is protected by copyright. All rights reserved.
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| 14. |
- Pavel, M., et al.
(författare)
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Gastroenteropancreatic neuroendocrine neoplasms : ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
- 2020
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Ingår i: Annals of Oncology. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 31:7, s. 844-860
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Tidskriftsartikel (refereegranskat)abstract
- Neuroendocrine neoplasms (NENs) arise from the diffuse neuroendocrine cell system and may occur at many different disease sites. Most frequently, these neoplasms occur in the digestive system, followed by the lung. The term NEN encompasses well-differentiated neuroendocrine tumours (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). NECs represent only 10%–20% of all NENs. The main focus of these guidelines is on sporadic small intestinal (SI)-NENs and pancreatic NENs (Pan-NENs) since these are the most prevalent NENs at advanced disease stages. In general, the management of other gastrointestinal NENs follows the same principles as in SI- or Pan-NENs taking into consideration key features of NENs such as proliferative activity, somatostatin receptor (SSTR) expression, tumour growth rate and extent of the disease.
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| 16. |
- Sundin, Johanna, et al.
(författare)
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Evidence of altered mucosa-associated and fecal microbiota composition in patients with Irritable Bowel Syndrome
- 2020
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Altered bacterial composition and small intestinal bacterial overgrowth (SIBO) may be associated with irritable bowel syndrome (IBS). This study aimed to determine the fecal and mucosa-associated bacterial composition along the gastrointestinal (GI) tract and to assess SIBO in IBS. Bacterial composition of feces, and mucosa of the duodenum and sigmoid colon was determined by 16S rRNA-amplicon-sequencing. SIBO was evaluated by bacterial culture of duodenal aspirate, glucose and lactulose breath tests. Mucosal antibacterial gene expression was assessed by PCR Array. The bacterial profiles of feces and the mucosa of sigmoid colon, but not duodenum, differed between IBS patients (n = 17) and HS (n = 20). The IBS specific bacterial profiles were linked to the colonic antibacterial gene expression. Fecal bacterial profile differed between IBS subtypes, while the mucosa-associated bacterial profile was associated with IBS symptom severity and breath tests results at baseline (H-2 and/or CH4 >= 15 ppm). The prevalence of SIBO was similar between IBS patients and HS. This study demonstrates that alterations in the bacterial composition of the sigmoid colon of IBS patients were linked to symptoms and immune activation. While breath tests reflected the mucosa-associated bacterial composition, there was no evidence for high prevalence of SIBO or small intestinal bacterial alterations in IBS.
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| 17. |
- Versluys, A. B., et al.
(författare)
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Hematopoietic cell transplant in pediatric acute myeloid leukemia after similar upfront therapy; a comparison of conditioning regimens
- 2021
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Ingår i: Bone Marrow Transplantation. - : Springer Science and Business Media LLC. - 0268-3369 .- 1476-5365. ; 56:6, s. 1426-1432
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Tidskriftsartikel (refereegranskat)abstract
- The impact of conditioning regimen prior to hematopoietic cell transplant (HCT) in pediatric AML-patients is not well studied. We retrospectively analyzed the impact of Busulfan-Cyclophosphamide (BuCy), Busulfan-Cyclophosphamide-Melphalan (BuCyMel) and Clofarabine-Fludarabine-Busulfan (CloFluBu) in pediatric AML-patients, with similar upfront leukemia treatment (NOPHO-DBHconsortium), receiving an HCT between 2010 and 2015. Outcomes of interest were LFS, relapse, TRM and GvHD. 103 patients were included; 30 received BuCy, 37 BuCyMel, and 36 CloFluBu. The 5-years LFS was 43.3% (SE +/- 9.0) in the BuCy group, 59.2 % (SE +/- 8.1) after BuCyMel, and 66.7 % (SE +/- 7.9) after CloFluBu. Multivariable Cox regression analysis showed a trend to lower LFS after BuCy compared to CloFluBu (p = 0.07). BuCy was associated with a higher relapse incidence compared to the other regimens (p = 0.06). Younger age was a predictor for relapse (p = 0.02). A strong correlation between Busulfan Therapeutic Drug Monitoring (TDM) and lower incidence of aGvHD (p < 0.001) was found. In conclusion, LFS after BuCyMel and CloFluBu was comparable, lower LFS was found after BuCy, due to higher relapse incidence. CloFluBu was associated with lower incidence of aGvHD, suggesting lower toxicity with this type of conditioning. This finding is also explained by the impact of Busulfan monitoring.
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