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- Preinbergs, Julia, 1989-
(författare)
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Testosterone Analysis in Hair
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The effects of testosterone in the body are dependent on the concentrations at the target organs, as well as the susceptibility of the androgen receptor. Steroid hormones circulate in the bloodstream bound to proteins, and only a small part is unbound and free to exert its effect at the receptors. Due to the diurnal variation in testosterone levels, the measured concentrations can change rapidly. Thus, a kind of "long-term measure" of the average free testosterone concentration would facilitate the understanding of the hormones' long-term effects on target organs.Hair seems at first sight to be a suitable matrix. The current theory is that only the free, unbound fraction of hormones passively diffuse from the bloodstream into the hair matrix as the hair grows. In this thesis, we have developed an analysis capable of analysing testosterone in the hair of men and women. We have systematically explored potential confounding factors and the pattern of testosterone concentrations in different hair segments. Furthermore, we have sought to confirm biological differences such as sex, age and BMI which affect hormone concentrations in the blood. Finally, we have investigated how hair testosterone concentrations change in relation to treatment with oral contraceptives and before an acute myocardial infarction.Our conclusions are that it is possible to measure testosterone in extracts from hair in very low concentrations. The choice of measurement method needs to balance between high specificity, which mass spectrometry can offer, and adequate detection limits, which can be achieved with immunoassays. Hair testosterone concentrations correlate significantly with testosterone concentrations in saliva, which suggests that hair testosterone reflects the average hormone concentrations in the body. The significant variation in hair growth rate within and between individuals impedes the theoretical relationship between certain hair segments and a specific time in the past. Hair testosterone concentrations are affected by the frequency of hair washing, cosmetic hair treatment, natural hair colour and the biological sex. In hair samples taken shortly after a patient was admitted to hospital due to a myocardial infarction, lower concentrations of testosterone can be seen in hair compared to individuals of the same age who have not had an acute heart attack. This suggests that a reduction in testosterone concentrations occurs shortly before the heart attack, independently of other cardiovascular risk factors. Reduced testosterone concentrations could thus be an independent risk factor for developing an acute myocardial infarction.
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| 2. |
- Lööv, Anna, 1990-, et al.
(författare)
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Diagnostic accuracy for colorectal cancer of a quantitative faecal immunochemical test in symptomatic primary care patients : a study protocol
- 2022
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Ingår i: Diagnostic and prognostic research. - : BioMed Central (BMC). - 2397-7523. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is increasing evidence supporting the use of faecal immunochemical tests (FIT) in patients reporting symptoms associated with colorectal cancer (CRC), but most studies until now have focused on selected subjects already referred for investigation. We therefore set out to determine the accuracy and predictive values of FIT in a primary care population.METHOD: A prospective, multicentre, single-gated comparative diagnostic study on quantitative FIT in patients aged 40 years and above presenting in primary care with symptoms associated with CRC will be conducted. Patients representing the whole spectrum of severity of such symptoms met with in primary care will be eligible and identified by GPs. Participants will answer a short form on symptoms during the last month. They will provide two faecal samples from two separate days. Analyses will be performed within 5 days (QuikRead go®, Aidian Oy). The analytical working range is 10-200 μg Hb/g faeces. Reference test will be linked to the Swedish Colorectal Cancer Registry up to 2 years after inclusion. Accuracy, area under ROC curves, and predictive values will be calculated for one FIT compared to the highest value of two FIT and at cutoff < 10, 10-14.9, 15-19.9 and ≥ 20 μg Hb/g faeces. Subgroup analyses will be conducted for patients with anaemia and those reporting rectal bleeding. A model-based cost-effectiveness analysis based on the clinical accuracy study will be performed. Based on previous literature, we hypothesized that the sensitivity of the highest value of two FIT at cutoff 10 μg Hb/g faeces will be 95% (95% CI + / - 15%). The prevalence of CRC in the study population was estimated to be 2%, and the rate of non-responders to be 1/6. In all, 3000 patients will be invited at 30 primary care centres.DISCUSSION: This study will generate important clinical real-life structured data on accuracy and predictive values of FIT in the most critical population for work-up of CRC, i.e. patients presenting with at times ambiguous symptoms in primary care. It will help establish the role of FIT in this large group.
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| 3. |
- Martinez, Cristina A., et al.
(författare)
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Prenatal stress, anxiety and depression alter transcripts, proteins and pathways associated with immune responses at the maternal-fetal interface
- 2022
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Ingår i: Biology of Reproduction. - : Oxford University Press. - 0006-3363 .- 1529-7268. ; 106:3, s. 449-462
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Tidskriftsartikel (refereegranskat)abstract
- During pregnancy, the immune system is modified to allow developmental tolerance of the semi-allogeneic fetus and placenta to term. Pregnant women suffering from stress, anxiety, and depression show dysfunctions of their immune system that may be responsible for fetal and/or newborn disorders, provided that placental gene regulation is compromised. The present study explored the effects of maternal chronic self-perceived stress, anxiety, and depression during pregnancy on the expression of immune-related genes and pathways in term placenta. Pregnancies were clinically monitored with the Beck Anxiety Inventory (BAI) and Edinburgh Postnatal Depression Scale (EPDS). A cutoff threshold for BAI/EPDS of 10 divided patients into two groups: Index group (>10, n = 11) and a Control group (<10, n = 11), whose placentae were sampled at delivery. The placental samples were subjected to RNA-Sequencing, demonstrating that stress, anxiety, and depression during pregnancy induced a major downregulation of placental transcripts related to immune processes such as T-cell regulation, interleukin and cytokine signaling, or innate immune responses. Expression differences of main immune-related genes, such as CD46, CD15, CD8 alpha & beta ILR7 alpha, and CCR4 among others, were found in the Index group (P < 0.05). Moreover, the key immune-like pathway involved in humoral and cellular immunity named "Primary immunodeficiency" was significantly downregulated in the Index group compared with Controls. Our results show that mechanisms ruling immune system functions are compromised at the maternal-fetal interface following self-perceived depressive symptoms and anxiety during pregnancy. These findings may help unveil mechanisms ruling the impact of maternal psychiatric symptoms and lead to new prevention/intervention strategies in complicated pregnancies. Summary Sentence Mechanisms ruling immune system functions are compromised at the maternal-fetal interface following self-perceived depressive symptoms and anxiety during pregnancy.
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| 4. |
- Sjödahl, Rune, 1938-, et al.
(författare)
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Robotassisterad bäcken- och njurkirurgi – en utvärdering
- 2022
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Ingår i: Läkartidningen. - Stockholm, Sweden : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 119
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Forskningsöversikt (refereegranskat)abstract
- Current studies indicate that robotic-assisted surgery is not inferior to laparoscopic or open surgery regarding oncologic or functional outcomes. An exception may be uterine cervix cancer, where the survival after minimal invasive surgery might not be as good as after open surgery. There is less bleeding and need for blood transfusion after robotic-assisted surgery, and postoperative complications are similar to open or laparoscopic surgery. Robotic-assisted surgery offers ergonomic advantages compared to laparoscopic surgery. The effect of the surgical learning curve is not sufficiently studied. Presently robotic-assisted surgery is not cost-effective due to high costs of investments. The operation is more time consuming than laparoscopic or open surgery with risks of delaying and cancellation of other operations.
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