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- Sahlstrom, T., et al.
(författare)
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Workforce participation and activities in Parkinson's disease patients receiving device-aided therapy
- 2018
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 138:1, s. 78-84
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Many countries have an aging population, and it is thus likely that Parkinson's disease (PD) will become an increasing health problem. It is important to ensure this group can use their resources in the best way possible, including remaining in the work market. This study aimed to investigate workforce participation and daily activities among patients with PD receiving device-aided therapy to provide new knowledge that may be used to inform decisions about these therapy options.Materials and Methods:This was a retrospective, descriptive quantitative pilot study, including 67 patients with PD from 3 centers in Sweden and Denmark. Included patients were younger than 67years at the time of introduction of device-aided therapy. Eligible patients were identified by the Swedish national Parkinson patient registry or by the treating neurologist. Quantitative interviews were made by telephone.Results:A majority of the patients could perform the same, or more, amount of activities approximately 5years after the introduction of device-aided therapy. A small number of patients receiving deep brain stimulation (DBS) and levodopa-carbidopa intestinal gel (LCIG) were able to increase their work capacity within 1year of initiating device-aided therapy and a remarkably high share could still work at the end-point of this study, approximately 15years since the diagnosis of PD.Conclusions:Device-aided therapy may sustain or increase daily activities and workforce participation in patients with PD who have not yet reached retirement age. There is need for prospective studies, both quantitative and qualitative, to confirm these results.
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- Daniel, M., et al.
(författare)
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Impact of androgen deprivation therapy on apparent diffusion coefficient and T2w MRI for histogram and texture analysis with respect to focal radiotherapy of prostate cancer
- 2019
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Ingår i: Strahlentherapie und Onkologie (Print). - : Springer Berlin/Heidelberg. - 0179-7158 .- 1439-099X. ; 195:5, s. 402-411
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Accurate prostate cancer (PCa) detection is essential for planning focal external beam radiotherapy (EBRT). While biparametric MRI (bpMRI) including T2-weighted (T2w) and diffusion-weighted images (DWI) is an accurate tool to localize PCa, its value is less clear in the case of additional androgen deprivation therapy (ADT). The aim of this study was to investigate the value of a textural feature (TF) approach on bpMRI analysis in prostate cancer patients with and without neoadjuvant ADT with respect to future dose-painting applications.Methods: 28 PCa patients (54–80 years) with (n = 14) and without (n = 14) ADT who underwent bpMRI with T2w and DWI were analyzed retrospectively. Lesions, central gland (CG), and peripheral zone (PZ) were delineated by an experienced urogenital radiologist based on localized pre-therapeutic histopathology. Histogram parameters and 20 Haralick TF were calculated. Regional differences (i. e., tumor vs. PZ, tumor vs. CG) were analyzed for all imaging parameters. Receiver-operating characteristic (ROC) analysis was performed to measure diagnostic performance to distinguish PCa from benign prostate tissue and to identify the features with best discriminative power in both patient groups.Results: The obtained sensitivities were equivalent or superior when utilizing the TF in the no-ADT group, while specificity was higher for the histogram parameters. However, in the ADT group, TF outperformed the conventional histogram parameters in both specificity and sensitivity. Rule-in and rule-out criteria for ADT patients could exclusively be defined with the aid of TF.Conclusions: The TF approach has the potential for quantitative image-assisted boost volume delineation in PCa patients even if they are undergoing neoadjuvant ADT.
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- Nyholm, Anders, 1985-, et al.
(författare)
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The bumpy light curve of Type IIn supernova iPTF13z over 3 years
- 2017
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 605
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Tidskriftsartikel (refereegranskat)abstract
- A core-collapse (CC) supernova (SN) of Type IIn is dominated by the interaction of SN ejecta with the circumstellar medium (CSM). Some SNe IIn (e.g. SN 2006jd) have episodes of re-brightening (''bumps'') in their light curves. We present iPTF13z, a Type IIn SN discovered on 2013 February 1 by the intermediate Palomar Transient Factory (iPTF). This SN showed at least five bumps in its declining light curve between 130 and 750 days after discovery. We analyse this peculiar behaviour and try to infer the properties of the CSM, of the SN explosion, and the nature of the progenitor star. We obtained multi-band optical photometry for over 1000 days after discovery with the P48 and P60 telescopes at Palomar Observatory. We obtained low-resolution optical spectra during the same period. We did an archival search for progenitor outbursts. We analyse the photometry and the spectra, and compare iPTF13z to other SNe IIn. In particular we derive absolute magnitudes, colours, a pseudo-bolometric light curve, and the velocities of the different components of the spectral lines. A simple analytical model is used to estimate the properties of the CSM. iPTF13z had a light curve peaking at Mr <~ -18.3 mag. The five bumps during its decline phase had amplitudes ranging from 0.4 to 0.9 mag and durations between 20 and 120 days. The most prominent bumps appeared in all the different optical bands, when covered. The spectra of this SN showed typical SN IIn characteristics, with emission lines of Hα (with broad component FWHM ~ 103 - 104 km s-1 and narrow component FWHM ~ 102 km s-1) and He I, but also with Fe II, Ca II, Na I D and Hβ P Cygni profiles (with velocities of ~ 103 km s-1). A pre-explosion outburst was identified lasting >~ 50 days, with Mr -15 mag around 210 days before discovery. Large, variable progenitor mass-loss rates (>~ 0.01 MSun yr-1) and CSM densities (>~ 10-16 g cm-3) are derived. The SN was hosted by a metal-poor dwarf galaxy at redshift z = 0.0328. We suggest that the light curve bumps of iPTF13z arose from SN ejecta interacting with denser regions in the CSM, possibly produced by the eruptions of a luminous blue variable progenitor star.
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- Nyholm, Tufve, et al.
(författare)
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A national approach for automated collection of standardized and population-based radiation therapy data in Sweden
- 2016
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Ingår i: Radiotherapy and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 119:2, s. 344-350
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To develop an infrastructure for structured and automated collection of interoperable radiation therapy (RT) data into a national clinical quality registry. Materials and methods: The present study was initiated in 2012 with the participation of seven of the 15 hospital departments delivering RT in Sweden. A national RT nomenclature and a database for structured unified storage of RT data at each site (Medical Information Quality Archive, MIQA) have been developed. Aggregated data from the MIQA databases are sent to a national RT registry located on the same IT platform (INCA) as the national clinical cancer registries. Results: The suggested naming convention has to date been integrated into the clinical workflow at 12 of 15 sites, and MIQA is installed at six of these. Involvement of the remaining 3/15 RT departments is ongoing, and they are expected to be part of the infrastructure by 2016. RT data collection from ARIA (R), Mosaiq (R), Eclipse (TM), and Oncentra (R) is supported. Manual curation of RT-structure information is needed for approximately 10% of target volumes, but rarely for normal tissue structures, demonstrating a good compliance to the RT nomenclature. Aggregated dose/volume descriptors are calculated based on the information in MIQA and sent to INCA using a dedicated service (MIQA2INCA). Correct linkage of data for each patient to the clinical cancer registries on the INCA platform is assured by the unique Swedish personal identity number. Conclusions: An infrastructure for structured and automated prospective collection of syntactically inter operable RT data into a national clinical quality registry for RT data is under implementation. Future developments include adapting MIQA to other treatment modalities (e.g. proton therapy and brachytherapy) and finding strategies to harmonize structure delineations. How the RT registry should comply with domain-specific ontologies such as the Radiation Oncology Ontology (ROO) is under discussion.
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- van Laar, T, et al.
(författare)
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Transcutaneous port for levodopa/carbidopa intestinal gel administration in Parkinson's disease
- 2016
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 133:3, s. 208-215
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the safety and tolerability of the T-Port(®) for intestinal infusion of levodopa/carbidopa gel in patients with advanced Parkinson's disease (PD).METHODS: This prospective study was carried out in 24 patients with PD (15 males, mean age 61.8 years, mean duration PD 18.7 years). All adverse device effects were evaluated at 2 weeks, 3 months and 6 months and until explantation or death.RESULTS: Post-operative complications were similar to endoscopic gastrojejunostomy placement (four peritoneal irritation, one pocket pain). Eight patients with prior experience with the endoscopic gastrojejunostomy preferred the T-Port. The total device experience was 83.6 years, and the average survival time was 3.6 (range 1.1-5.2) years. Six T-Ports were still in use, and two patients had died due to non-device-related reasons. Sixteen T-Ports had been explanted due to 15 stoma reactions (14 inflammations and one infection) and one tilting of the T-Port. The T-Ports were replaced with endoscopic gastrojejunostomy system as replacements with T-Ports were not part of the study. Only two device malfunctions occurred (one catheter breakage at 3 year post-implant and one T-Port leakage of levodopa/carbidopa gel). No tube kinking, dislocation or blockage occurred. The number of adverse device effects proved to be significantly lower as compared to the endoscopic gastrojejunostomy literature data.CONCLUSIONS: The T-Port is safe and well tolerated, and the low number of tube problems is a potential advantage compared with the endoscopic gastrojejunostomy system. Proper cleaning and local treatment of the stoma site around the T-Port are essential to prolong its longevity.
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