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- Thörn, Magnus, et al.
(författare)
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Predictors of late mortality in cutaneous malignant melanoma : A population-based study in Sweden
- 1996
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Ingår i: International Journal of Cancer. - : Springer Science and Business Media LLC. - 0020-7136 .- 1097-0215. ; 73:2, s. 255-259
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Tidskriftsartikel (refereegranskat)abstract
- We determined risk factors for late deaths from cutaneous malignant melanoma (CMM) based on clinical characteristics at diagnosis, initial surgical treatment, histopathologic features of the primary tumor and type of eventual recurrences during follow-up. We examined deaths from CMM 8 or more completed years after the initial diagnosis in a case-control study nested in a nationwide cohort comprising all 8,838 patients with CMM diagnosed in Sweden during 1960-1978 with complete follow-up through 1986. There were 285 case patients and 285 control patients, individually matched by sex, age and follow-up time. Conditional logistic regression was used to obtain odds ratios (OR) as estimates of the relative risk. The risk of late mortality increased stepwise, almost 19-fold, with increasing tumor thickness from < or = 0.75 to > or = 7.00 mm. Besides the thickest tumors (> or = 7.00 mm), those of intermediate thickness (1.50-2.49 mm) had the highest risk (OR 8.5). After adjustment for tumor thickness, non-radical primary surgical treatment increased the risk of late mortality almost 3-fold while prophylactic lymph node dissection entailed a significantly reduced risk of late mortality (OR 0.5); the histopathologic features increasing level of invasion and vertical growth phase also remained significantly associated with a poor outcome. In a multivariate model, non-radical primary surgical treatment, prophylactic lymph node dissection, vertical growth phase, level of invasion and lymphocyte reaction were independent predictors of late mortality.
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- Carlsson, A., et al.
(författare)
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Prevalence of coeliac disease in Turner syndrome
- 1999
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Ingår i: Acta Pædiatrica. - 1651-2227 .- 0803-5253. ; 88, s. 933-
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Tidskriftsartikel (refereegranskat)abstract
- This study was undertaken to investigate the prevalence of coeliac disease in children and adolescents with Turner syndrome. Eighty-seven children and adolescents with Turner syndrome were screened for IgA- antiendomysium antibodies (EMA) and IgA-antigliadin antibodies (AGA), 5% (4/87) being found to be EMA-positive, and 15% (13/87) to have AGA levels above normal. Of the 10 patients who were either AGA- or EMA-positive and further investigated with intestinal biopsy, four manifested villous atrophy (i.e. all three of the EMA-positive patients, but only one of the seven AGA- positive patients). The results suggest EMA-positivity to be a good immunological marker for use in screening for coeliac disease, and such screening to be justified in patients with Turner syndrome.
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- Weiland, O, et al.
(författare)
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Efficacy of human leucocyte alpha-interferon treatment for chronic hepatitis C virus infection
- 1995
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 1651-1980 .- 0036-5548. ; 27:5, s. 319-324
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Tidskriftsartikel (refereegranskat)abstract
- A total of 42 Swedish patients with biopsy-proven chronic hepatitis C virus (HCV) infection were treated with a natural human leucocyte alpha-interferon (HuIFN-alpha-Le), Alfanative (BioNative AB, Umeå, Sweden) in an open uncontrolled study. Two patients were withdrawn from treatment within 2 weeks due to non-compliance and were omitted from further analysis, and 40 patients (17 females), mean age 39 years (range 24-71) completed the study. All patients were HCV RNA-positive in serum prior to treatment, with raised alanine aminotransferase (ALT) levels > 1.5 times the upper normal limit known for more than 6 months. Interferon was given at a dose of 3 MU t.i.w. for an intended 24 weeks and follow-up was a further 24 weeks after treatment. Biochemical non-responders were withdrawn from treatment within 12-16 weeks but continued follow-up. Overall 21/40 (52.5%) patients had a complete biochemical response with normal ALT levels at the end of treatment. Sustained response during follow-up was seen in 8 (20%) whereas 13 (32.5%) had a non-sustained response. At the end of treatment 23 (58%) patients had undetectable serum HCV RNA and 9 (23%) at follow-up. Patients with sustained, non-sustained and non-response had a mean pretreatment HCV RNA level of 3.2 x 10(5), 2.5 x 10(6) and 3.2 x 10(6) genomes/ml, respectively, differences that did not reach statistical significance. Of the patients 3, 9, 10 and 14 had genotype 1b, 3a, 1a, and 2b, respectively, and 4 had mixed genotypes. Of the 23 patients with genotype 2b or 3a, 7 had a sustained response vs. none of the 13 patients with genotype 1a or 1b (p = 0.03). No patients with cirrhosis had a sustained response whereas 4/18 with chronic persistent and 4/18 with chronic active hepatitis had such a response. It is concluded that some 50% of patients treated with HuIFN-alpha-Le responded with normalisation of ALT levels but that only 20% had a durable response 24 weeks post-treatment, and that patients with genotypes 3a or 2b seem to respond better than patients with other genotypes.
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- Anderzén, Ingrid, 1952-, et al.
(författare)
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Psychophylogcal reactions during the first year of a foreign assignment: result from a controlled longitudinal study.
- 1997
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Ingår i: Work & Stress. - : Taylor & Francis. - 0267-8373 .- 1464-5335. ; 11, s. 304-
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies reveal that employees are exposed to several potential stressors during foreign assignments. This prospective multidisciplinary study followed managers (expatriate group) before and during their first year of an international work assignment. Concurrently, a matched reference group that did not relocate was observed. The secretion of the stress-sensitive hormone prolactin increased in the expatriate group during the first year abroad, compared to the reference group. Selfesteem, family relations, language skills, decreased internal locus of control and job promotion explained 32% of the variance in serum prolactin levels. Lower self-esteem and sense of coherence was related to increased serum prolactin. Increased working hours were associated with decreased work satisfaction. Job promotion was not related to work satisfaction. Mental well-being decreased in the expatriate group, compared to the reference group. Individual factors such as a strong sense of coherence and social provision attenuated decreases in mental well-being. A significant increase in cigarette and alcohol consumption was found in the expatriate group during the first year abroad. This study indicates that there are important psychosocial determinants influencing psychophysiological response patterns in expatriates. The present results put into question the generalizability of the ‘culture shock’ syndrome. The results have practical implications for guiding expatriates on time-limited assignments.
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