| 1. |
- Andersson, Swen-Olof, et al.
(författare)
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Managing localized prostate cancer by radical prostatectomy or watchful waiting: Cost analysis of a randomized trial (SPCG-4)
- 2011
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Ingår i: SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY. - : Informa Healthcare. - 0036-5599 .- 1651-2065. ; 45:3, s. 177-183
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The cost of radical prostatectomy (RP) compared to watchful waiting (WW) has never been estimated in a randomized trial. The goal of this study was to estimate long-term total costs per patient associated with RP and WW arising from inpatient and outpatient hospital care. Material and methods. This investigation used the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial, comparing RP to WW, and included data from 212 participants living in two counties in Sweden from 1989 to 1999 (105 randomized to WW and 107 to RP). All costs were included from randomization date until death or end of follow-up in July 2007. Resource use arising from inpatient and outpatient hospital costs was measured in physical units and multiplied by a unit cost to come up with a total cost per patient. Results. During a median follow-up of 12 years, the overall cost in the RP group was 34% higher (p andlt; 0.01) than in the WW group, corresponding to euroa,not sign6123 in Sweden. The difference was driven almost exclusively by the cost of the surgical procedure. The cost difference between RP and WW was two times higher among men with low (2--6) than among those with high (7--10) Gleason score. Conclusion. In this economic evaluation of RP versus WW of localized prostate cancer in a randomized study, RP was associated with 34% higher costs. This difference, attributed exclusively to the cost of the RP procedure, was not overcome during extended follow-up.
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| 2. |
- Carlsson Tedgren, Åsa, et al.
(författare)
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Comparison of high-dose-rate Ir-192 source strength measurements using equipment with traceability to different standards
- 2014
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Ingår i: Brachytherapy. - : Elsevier. - 1538-4721 .- 1873-1449. ; 13:4, s. 420-423
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:According to the American Association of Physicists in Medicine Task Group No. 43 (TG-43) formalism used for dose calculation in brachytherapy treatment planning systems, the absolute level of absorbed dose is determined through coupling with the measurable quantity air-kerma strength or the numerically equal reference air-kerma rate (RAKR). Traceability to established standards is important for accurate dosimetry in laying the ground for reliable comparisons of results and safety in adoption of new treatment protocols. The purpose of this work was to compare the source strength for a high-dose rate (HDR) (192)Ir source as measured using equipment traceable to different standard laboratories in Europe and the United States.METHODS AND MATERIALS:Source strength was determined for one HDR (192)Ir source using four independent systems, all with traceability to different primary or interim standards in the United States and Europe.RESULTS:The measured HDR (192)Ir source strengths varied by 0.8% and differed on average from the vendor value by 0.3%. Measurements with the well chambers were 0.5% ± 0.1% higher than the vendor-provided source strength. Measurements with the Farmer chamber were 0.7% lower than the average well chamber results and 0.2% lower than the vendor-provided source strength. All of these results were less than the reported source calibration uncertainties (k=2) of each measurement system.CONCLUSIONS:In view of the uncertainties in ion chamber calibration factors, the maximum difference in source strength found in this study is small and confirms the consistency between calibration standards in use for HDR (192)Ir brachytherapy.
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| 3. |
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| 4. |
- Erlinge, David, et al.
(författare)
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Rapid Endovascular Catheter Core Cooling Combined With Cold Saline as an Adjunct to Percutaneous Coronary Intervention for the Treatment of Acute Myocardial Infarction The CHILL-MI Trial : A Randomized Controlled Study of the Use of Central Venous Catheter Core Cooling Combined With Cold Saline as an Adjunct to Percutaneous Coronary Intervention for the Treatment of Acute Myocardial Infarction
- 2014
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 63:18, s. 1857-1865
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to confirm the cardioprotective effects of hypothermia using a combination of cold saline and endovascular cooling. Background Hypothermia has been reported to reduce infarct size (IS) in patients with ST-segment elevation myocardial infarctions. Methods In a multicenter study, 120 patients with ST-segment elevation myocardial infarctions (<6 h) scheduled to undergo percutaneous coronary intervention were randomized to hypothermia induced by the rapid infusion of 600 to 2,000 ml cold saline and endovascular cooling or standard of care. Hypothermia was initiated before percutaneous coronary intervention and continued for 1 h after reperfusion. The primary end point was IS as a percent of myocardium at risk (MaR), assessed by cardiac magnetic resonance imaging at 4 +/- 2 days. Results Mean times from symptom onset to randomization were 129 +/- 56 min in patients receiving hypothermia and 132 +/- 64 min in controls. Patients randomized to hypothermia achieved a core body temperature of 34.7 degrees C before reperfusion, with a 9-min longer door-to-balloon time. Median IS/MaR was not significantly reduced (hypothermia: 40.5% [interquartile range: 29.3% to 57.8%; control: 46.6% [interquartile range: 37.8% to 63.4%]; relative reduction 13%; p = 0.15). The incidence of heart failure was lower with hypothermia at 45 +/- 15 days (3% vs. 14%, p < 0.05), with no mortality. Exploratory analysis of early anterior infarctions (0 to 4 h) found a reduction in IS/MaR of 33% (p < 0.05) and an absolute reduction of IS/left ventricular volume of 6.2% (p = 0.15). Conclusions Hypothermia induced by cold saline and endovascular cooling was feasible and safe, and it rapidly reduced core temperature with minor reperfusion delay. The primary end point of IS/MaR was not significantly reduced. Lower incidence of heart failure and a possible effect in patients with early anterior ST-segment elevation myocardial infarctions need confirmation. (Efficacy of Endovascular Catheter Cooling Combined With Cold Saline for the Treatment of Acute Myocardial Infarction [CHILL-MI]; NCT01379261)
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| 5. |
- Goldkuhl, Renée, et al.
(författare)
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Impact of Surgical Severity and Analgesic Treatment on Plasma Corticosterone in Rats during Surgery
- 2010
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Ingår i: European Surgical Research. - : S. Karger AG. - 0014-312X .- 1421-9921. ; 44:2, s. 117-123
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Tidskriftsartikel (refereegranskat)abstract
- Tissue injury and anaesthesia during surgery induce a stress response associated with increased glucocorticoid secretion from the adrenal glands. This response alters the normal physiology and may cause postoperative morbidity, as well as affect the results during acute experiments. The aim of the present investigation was to study the effect of surgical severity and analgesic treatment on circulating corticosterone in male Sprague-Dawley rats. Male rats were treated with either lidocaine infiltrated during surgery, buprenorphine (0.05 or 0.1 mg/kg subcutaneously) or saline subcutaneously. Each treatment group was subjected to either arterial catheterisation or arterial catheterisation and laparotomy. A catheter was inserted in the common carotid artery and blood was collected during surgery and during anaesthesia 6 h after surgery. Lidocaine treatment reduced the corticosterone levels compared to saline treatment after catheterisation but not after laparotomy. Buprenorphine treatment reduced the corticosterone levels during the first hour after surgery after both catheterisation and laparotomy. The higher buprenorphine dose led to an earlier and more pronounced reduction, especially after laparotomy. In the present study, the corticosterone response during surgery in laboratory rats is correlated with the severity of the procedure, and buprenorphine reduces the surgical stress response more effectively than lidocaine treatment.
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| 6. |
- Hugosson, Jonas, 1955, et al.
(författare)
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Mortality results from the Göteborg randomised population-based prostate-cancer screening trial.
- 2010
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Ingår i: The lancet oncology. - 1474-5488. ; 11:8, s. 725-32
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Tidskriftsartikel (refereegranskat)abstract
- Prostate cancer is one of the leading causes of death from malignant disease among men in the developed world. One strategy to decrease the risk of death from this disease is screening with prostate-specific antigen (PSA); however, the extent of benefit and harm with such screening is under continuous debate.
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| 7. |
- Kavoi, Boniface, et al.
(författare)
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Comparative functional structure of the olfactory mucosa in the domestic dog and sheep
- 2010
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Ingår i: Annals of Anatomy. - : Elsevier BV. - 0940-9602 .- 1618-0402. ; 192:5, s. 329-337
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Tidskriftsartikel (refereegranskat)abstract
- Olfactory acuity differs among animal species depending on age and dependence on smell However the attendant functional anatomy has not been elucidated We sought to determine the functional structure of the olfactory mucosa in suckling and adult dog and sheep Mucosal samples harvested from ethmoturbinates were analyzed qualitatively and quantitatively In both species the olfactory mucosa comprised olfactory supporting and basal cells and a lamina propria containing bundles of olfactory cell axons Bowman s glands and vascular elements The olfactory cells terminated apically with an expanded knob from which cilia projected in a radial fashion from its base and in form of a tuft from its apex in the dog and the sheep respectively Olfactory cilia per knob were more numerous in the dog (19 +/- 3)compared to the sheep (7 +/- 2) (p<0 05) In the dog axonal bundles exhibited one to two centrally located capillaries and the bundles were of greater diameters (73 3 +/- 103 mu m) than those of the sheep (50 6 +/- 6 8 mu m) which had no capillaries From suckling to adulthood in the dog the packing density of the olfactory and supporting cells increased by 22 5% and 126% respectively Surprisingly in the sheep the density of the olfactory cells decreased by 262% while that of the supportive cells showed no change Overall epithelial thickness reached 72 5 +/- 2 9 mu m in the dog and 56 8 +/- 3 1 mu m in the sheep These observations suggest that the mucosa is better structurally refined during maturation in the dog than in the sheep.
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| 8. |
- Maamun, Jeneby, et al.
(författare)
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Prevalence of Babesia microti in free-ranging Baboons and African Green Monkeys
- 2011
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Ingår i: Journal of Parasitology. - 0022-3395 .- 1937-2345. ; 97:1, s. 63-67
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Tidskriftsartikel (refereegranskat)abstract
- Babesia microti-like parasites have been reported to infect captive non-human primates (NHPs). However, studies on the prevalence of Babesia spp. in free-ranging NHPs are lacking. This investigation aimed at determining the prevalence of B. microti in wild-caught Kenyan NHPs. In total, 125 animals were studied, including 65 olive baboons (Papio cynocephalus anubis) and 60 African green monkeys ([AGMs] Chlorocebus aethiops). Nested polymerase chain reaction targeting Babesia β-tubulin genes was used to diagnose infection prevalence. Results indicated a prevalence of 22% (27/125) B. microti infection in free-ranging NHPs in Kenya. There was no statistically significant difference in B. microti infection prevalence between baboons and AGMs or male and female animals. This is the first report of the presence and prevalence of B. microti in free-ranging Kenyan NHPs.
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| 9. |
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| 10. |
- Wirén, Sara, 1981-, et al.
(författare)
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Fatherhood status and risk of prostate cancer : nationwide, population-based case-control study
- 2013
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Ingår i: International Journal of Cancer. - : John Wiley & Sons. - 0020-7136 .- 1097-0215. ; 133:4, s. 937-943
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have shown a decreased risk of prostate cancer for childless men; however, the cause of the association remains to be elucidated. The aim of our study was to assess the risk of prostate cancer by fatherhood status, also considering potential confounding factors. In a case–control study in Prostate Cancer data Base Sweden 2.0, a nationwide, population-based cohort, data on number of children, marital status, education, comorbidity and tumor characteristics obtained through nationwide healthcare registers and demographic databases for 117,328 prostate cancer cases and 562,644 controls, matched on birth year and county of residence, were analyzed. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for prostate cancer overall and by risk category, adjusting for marital status and education. Childless men had a decreased risk of prostate cancer compared to fathers, OR = 0.83 (95% CI = 0.82–0.84), and risk was lower for low-risk prostate cancer, OR = 0.74 (95% CI = 0.72–0.77), than for metastatic prostate cancer, OR = 0.93 (95% CI = 0.90–0.97). Adjustment for marital status and education attenuated the association in the low-risk category, adjusted OR = 0.87 (95% CI = 0.84–0.91), whereas OR for metastatic cancer remained virtually unchanged, adjusted OR = 0.92 (95% CI = 0.88–0.96). Our data indicate that the association between fatherhood status and prostate cancer to a large part is due to socioeconomic factors influencing healthcare-seeking behavior including testing of prostate-specific antigen levels.
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