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- Abe, O, et al.
(författare)
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Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials
- 2005
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Ingår i: The Lancet. - 1474-547X. ; 365:9472, s. 1687-1717
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Tidskriftsartikel (refereegranskat)abstract
- Background Quinquennial overviews (1985-2000) of the randomised trials in early breast cancer have assessed the 5-year and 10-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival. Here, we report the 10-year and 15-year effects. Methods Collaborative meta-analyses were undertaken of 194 unconfounded randomised trials of adjuvant chemotherapy or hormonal therapy that began by 1995. Many trials involved CMF (cyclophosphamide, methotrexate, fluorouracil), anthracycline-based combinations such as FAC (fluorouracil, doxombicin, cyclophosphamide) or FEC (fluorouracil, epirubicin, cyclophosphamide), tamoxifen, or ovarian suppression: none involved taxanes, trastuzumab, raloxifene, or modem aromatase inhibitors. Findings Allocation to about 6 months of anthracycline-based polychemotherapy (eg, with FAC or FEC) reduces the annual breast cancer death rate by about 38% (SE 5) for women younger than 50 years of age when diagnosed and by about 20% (SE 4) for those of age 50-69 years when diagnosed, largely irrespective of the use of tamoxifen and of oestrogen receptor (ER) status, nodal status, or other tumour characteristics. Such regimens are significantly (2p=0 . 0001 for recurrence, 2p<0 . 00001 for breast cancer mortality) more effective than CMF chemotherapy. Few women of age 70 years or older entered these chemotherapy trials. For ER-positive disease only, allocation to about 5 years of adjuvant tamoxifen reduces the annual breast cancer death rate by 31% (SE 3), largely irrespective of the use of chemotherapy and of age (<50, 50-69, &GE; 70 years), progesterone receptor status, or other tumour characteristics. 5 years is significantly (2p<0 . 00001 for recurrence, 2p=0 . 01 for breast cancer mortality) more effective than just 1-2 years of tamoxifen. For ER-positive tumours, the annual breast cancer mortality rates are similar during years 0-4 and 5-14, as are the proportional reductions in them by 5 years of tamoxifen, so the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis. These results combine six meta-analyses: anthracycline-based versus no chemotherapy (8000 women); CMF-based versus no chemotherapy (14 000); anthracycline-based versus CMF-based chemotherapy (14 000); about 5 years of tamoxifen versus none (15 000); about 1-2 years of tamoxifen versus none (33 000); and about 5 years versus 1-2 years of tamoxifen (18 000). Finally, allocation to ovarian ablation or suppression (8000 women) also significantly reduces breast cancer mortality, but appears to do so only in the absence of other systemic treatments. For middle-aged women with ER-positive disease (the commonest type of breast cancer), the breast cancer mortality rate throughout the next 15 years would be approximately halved by 6 months of anthracycline-based chemotherapy (with a combination such as FAC or FEC) followed by 5 years of adjuvant tamoxifen. For, if mortality reductions of 38% (age <50 years) and 20% (age 50-69 years) from such chemotherapy were followed by a further reduction of 31% from tamoxifen in the risks that remain, the final mortality reductions would be 57% and 45%, respectively (and, the trial results could well have been somewhat stronger if there had been full compliance with the allocated treatments). Overall survival would be comparably improved, since these treatments have relatively small effects on mortality from the aggregate of all other causes. Interpretation Some of the widely practicable adjuvant drug treatments that were being tested in the 1980s, which substantially reduced 5-year recurrence rates (but had somewhat less effect on 5-year mortality rates), also substantially reduce 15-year mortality rates. Further improvements in long-term survival could well be available from newer drugs, or better use of older drugs.
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| 2. |
- Rothenberg, Elisabet, et al.
(författare)
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Texture-modified meat and carrot products for elderly people with dysphagia : preference in relation to health and oral status
- 2007
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Ingår i: Scandinavian Journal of Food and Nutrition. - : Taylor & Francis. - 1748-2976 .- 1748-2984. ; 51:4, s. 141-147
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reduced taste and smell, chewing problems and swallowing dysfunction are common among elderly people and affect perception, food choice and the ability to eat. Objective: To study the preference for texture-modified carrot and meat products in elderly people aiming to meet the needs of people with impaired chewing and/or swallowing. Design: Data were collected using questionnaires focusing on health, oral status and preference for the products. Altogether, 108 elderly people in ordinary housing (OH) and 50 living in special housing (SH) in Malmö (SH-M) and Göteborg (SH-G) participated. Results: 19% had a body mass index 522, predominantly in SH (24%). Stroke was reported by 20% of the subjects in SH. Among those with subjectively experienced difficulties in swallowing (12%), 58% reported coughing, 21% a gurgly voice in association with food intake and 50% obstruction during swallowing. Only 20% with subjective swallowing difficulties had been specifically examined regarding this problem. All the tested products were easy to masticate and swallow. Compared with OH, people in SH-M found the meatproducts easier to masticate and swallow. Compared with OH, subjects in SH found the carrot products easier to masticate. Conclusions: There is a need to develop tasty texture-modified nutritious food products for people with mastication and/or swallowing problems. Possible factors for differences in preference between groups, in this study OH and SH, may be related to health status in general and specifically mastication and swallowing functions.
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| 4. |
- Nilsson, K. K., et al.
(författare)
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Evolution in the properties of Lyman-α emitters from redshifts z ~ 3 to z ~ 2
- 2009
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 498:1, s. 13-23
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Tidskriftsartikel (refereegranskat)abstract
- Context: Narrow-band surveys to detect Lyα emitters are powerful tools for identifying high, and very high, redshift galaxies. Although samples are increasing at redshifts z = 3 {-} 6, the nature of these galaxies is still poorly known. The number of galaxies detected at redshifts below z ˜ 3 are also small. Aims: We study the properties of z = 2.25 Lyα emitters and compare them with those of z > 3 Lyα emitters. Methods: We present narrow-band imaging made with the MPG/ESO 2.2m telescope and the WFI (Wide Field Imager) detector. Using this data, we have searched for emission-line objects. We find 170 candidate typical Lyα emitters and 17 candidates that we regard as high UV-transmission Lyα emitters. We have derived the magnitudes of these objects in 8 photometric bands from u* to K_s, and studied whether they have X-ray and/or radio counterparts. Results: We demonstrate that there has been significant evolution in the properties of Lyα emitters between redshift z ˜ 3 and z = 2.25. The spread in spectral energy distributions (SEDs) at the lower redshift is larger and we detect a significant AGN contribution in the sample. The distribution of the equivalent widths is narrower than at z ˜ 3, with only a few candidates with rest-frame equivalent width above the predicted limit of 240 Å. The star formation rates derived from the Lyα emission compared to those derived from the UV emission are lower by on average a factor of ˜ 1.8, indicative of a significant absorption by dust. Conclusions: Lyα emitters at redshift z = 2.25 may be more evolved than Lyα emitters at higher redshift. The red SEDs imply more massive, older and/or dustier galaxies at lower redshift than observed at higher redshifts. The decrease in equivalent widths and star formation rates indicate more quiescent galaxies, with in general less star formation than in higher redshift galaxies. At z = 2.25, AGN appear to be more abundant and also to contribute more to the Lyα emitting population. Full Table 2 is only available in electronic form at http://www.aanda.org
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| 7. |
- Midander, K., et al.
(författare)
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Surface characteristics, copper release and toxicity of nano- and micron sized copper and copper(II)oxide particles : A cross-disciplinary study
- 2009
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Ingår i: Small (Weinheim an der Bergstrasse, Germany). - : Wiley. - 1613-6810 .- 1613-6829. ; 5:3, s. 389-399
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Tidskriftsartikel (refereegranskat)abstract
- An interdisciplinary and multianalytical research effort is undertaken to assess the toxic aspects of thoroughly characterized nano- and micrometer-sized particles of oxidized metallic copper and copper(II) oxide in contact with cultivated lung cells, as well as copper release in relevant media. All particles, except micrometer-sized Cu, release more copper in serum-containing cell medium (supplemented Dulbecco's minimal essential medium) compared to identical exposures in phosphate-buffered saline. Sonication of particles for dispersion prior to exposure has a large effect on the initial copper release from Cu nanoparticles. A clear size-dependent effect is observed from both a copper release and a toxicity perspective. In agreement with greater released amounts of copper per quantity of particles from the nanometer-sized particles compared to the micrometer-sized particles, the nanometer particles cause a higher degree of DNA damage (single-strand breaks) and cause a significantly higher percentage of cell death compared to cytotoxicity induced by micrometer-sized particles. Cytotoxic effects related to the released copper fraction are found to be significantly lower than the effects related to particles. No DNA damage is induced by the released copper fraction.
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| 10. |
- Blomstrand, Eva, et al.
(författare)
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Effect of carbohydrate ingestion on brain exchange of amino acids during sustained exercise in human subjects.
- 2005
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Ingår i: Acta Physiologica Scandinavica. - 0001-6772 .- 1365-201X. ; 185:3, s. 203-9
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study investigated the effect of prolonged exercise with and without carbohydrate intake on the brain exchange of amino acids, especially focussing on tryptophan and branched-chain amino acids (BCAA). METHODS: Five male subjects exercised for 3 h on a cycle ergometer at 200 +/- 7 W on two occasions; either supplemented with a 6% carbohydrate solution or with flavoured water (placebo). Catheters were inserted into the right internal jugular vein and the radial artery of the non-dominant arm. The brain exchange of amino acids during exercise was calculated from the arterial-jugular venous concentration difference multiplied by plasma flow. RESULTS: About 106 micromol (22 mg) of tryptophan was taken up by the brain during exercise in the placebo trial, whereas no significant uptake was observed in the carbohydrate trial. In accordance, the arterial concentration of free tryptophan increased from 12 +/- 1 to 20 +/- 2 micromol L(-1) during the placebo trial and was significantly higher compared with the glucose trial (14 +/- 1 micromol L(-1) at the end of exercise). Also, the arterial concentration of total tryptophan (free and albumin-bound) increased during the first 30 min of exercise in both trials, but returned to the basal level at 180 min of exercise. In both trials, BCAA were taken up by the brain while glutamine was released. CONCLUSION: The present data show that both tryptophan and BCAA are taken up by the brain during prolonged exercise, and we suggest that the cerebral uptake of tryptophan may relate to increased synthesis of serotonin (5-HT) in the brain.
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