| 1. |
- Schaufelberger, Maria, 1954, et al.
(författare)
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Intestinal paracellular permeability is not affected in chronic congestive heart failure
- 2007
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Ingår i: Eur J Heart Fail. - : Wiley. - 1388-9842. ; 9:6-7, s. 574-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In chronic heart failure (CHF) it has been proposed that a dysfunction of the gastrointestinal barrier could lead to translocation of endotoxin into the systemic circulation. A secondary inflammatory reaction, observed as increased levels of cytokines, could negatively affect cardiac function. The aims of this paper were therefore to determine whether patients with CHF have a disturbed mucosal barrier and whether it was possible to detect endotoxin in venous blood. METHODS: Nineteen stable patients with CHF (New York Heart Association II-III, EF40% and earlier hospitalisation for heart failure) were investigated. Twenty healthy subjects (HS group) and 25 patients, who were admitted for bone marrow transplantation (BMT group), served as controls. Gastrointestinal permeability was assessed by a (51)Cr-EDTA absorption test. RESULTS: Eleven patients with and eight without peripheral oedema were included. Median age was 76.5 years. Intestinal permeability was 1.82+/-1.96% in the CHF patients and 1.54+/-.59% and 1.9+/-.9% in HS and BMT groups, respectively (p=0.4 and p=0.7, CHF vs HS and BMT, respectively). No difference was found between patients with and without oedema and endotoxins were below the detection limit in all patients. DISCUSSION: This study does not support the hypothesis that patients with CHF have a dysfunctional gastrointestinal barrier, at least as assessed by the (51)Cr-EDTA resorbtion test.
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| 2. |
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| 3. |
- Abel, Edvard, 1970, et al.
(författare)
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Early disturbance of microvascular function precedes chemotherapy-induced intestinal injury
- 2005
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Ingår i: Dig Dis Sci. - : Springer Science and Business Media LLC. - 0163-2116. ; 50:9, s. 1729-33
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Tidskriftsartikel (refereegranskat)abstract
- Intestinal injury 4-48 hr after cytotoxic therapy (etoposide phosphate, 100 mg/kg body weight [bw], intravenously [i.v.]) was studied in rats using ligated intestinal loops. Chromium-51 ethylenediaminetetraacetic acid ((51)Cr-EDTA) and rubidium-86 chloride ((86)RbCl) were deposited intraluminally to determine the extent of the increase in intestinal permeability and ion channel disruption. Evans Blue (EB) was used for detection of endothelial leakage. Intestinal morphology was documented. Endothelial dysfunction, as observed by an increased extravasation of EB, was evident already 4 hr after cytotoxic therapy. Intestinal epithelial injury, as observed by an increase in (51)Cr-EDTA permeation and a decrease in (86)Rb absorption, occurred after 48 hr. Finally, histology disclosed a reduced crypt cell proliferation, displayed as a decrease in Ki67-positive cells. The findings suggest that, in the development of intestinal injury after cytotoxic therapy, endothelial disruption is an early event, whereafter epithelial dysfunction and crypt stem cell arrest occur. This knowledge could be of importance in the design of future intervention trials.
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| 4. |
- Adde, Magdalena, 1960-
(författare)
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Aggressive B-cell Lymphomas : Studies of Treatment, FDG-PET Evaluation and Prognostic Factors
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- To improve outcome in young, high-risk lymphoma patients, treatment was intensified, adding etoposide and rituximab to standard CHOP treatment. Granulocyte-colony stimulating factor (G-CSF) enabled treatment bi-weekly. Results were promising: overall (OS) and event-free survival (EFS) 79% and 60% respectively, median follow up 27 months. Single infusion Ara-C, contrary to expectations, did not prevent relapse in CNS. DLBCL were classified as germinal center (GC) or non-GC derived, using immunohistochemical markers, CD10, BCL6 and MUM1. We investigated the outcome for both phenotypes after adding rituximab to chemotherapy. For 106 patients treated with CHOP alone, the GC phenotype displayed significantly better OS and EFS. In contrast, GC phenotype did not predict outcome in 95 patients treated with immunochemotherapy . Thus, addition of rituximab seems to eliminate the prognostic value of immunohistochemically defined GC phenotypes in DLBCL. To improve evaluation and find non-responders, mid-treatment FDG-PET CT was incorporated into clinical routine for patients with high-risk aggressive lymphoma. For those with positive PET, biopsy followed by treatment intensification was recommended. Twenty-five patients were examined, five with positive PET. Two of these had lymphoma in the biopsy. Two had a negative biopsy, and one had a false positive investigation. Seven patients had increased uptake of uncertain significance. Two patients with uncertain PET, and two with negative PET have relapsed, giving a negative predictive value of 85%. In case of relapse of aggressive lymphoma or if not obtaining CR, high dose chemotherapy with autologous stem cell support (HDT) is standard treatment. HDT outcome for 38 patients with transformed follicular lymphoma was compared to outcome for 79 patients with de novo B-cell lymphoma. At median follow-up of 11.5 years both OS and EFS were superior in the transformed group, OS 67% and 33%, EFS 55% and 27% respectively. Treatment related mortality was less than reported in other studies.
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| 5. |
- Ahlberg, Karin, 1965, et al.
(författare)
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Fatigue, psychological distress, coping resources, and functional status during radiotherapy for uterine cancer.
- 2005
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Ingår i: Oncology nursing forum. - 1538-0688. ; 32:3, s. 633-40
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To evaluate how patients diagnosed with uterine cancer experience fatigue, psychological distress, coping resources, and functional status before, during, and after treatment with radiation therapy and to study whether significant correlations exist among these variables. DESIGN: Longitudinal, descriptive, and correlational. SETTING: The Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden. SAMPLE: 60 women diagnosed with uterine cancer who were receiving curative external radiation therapy. Typical participants were 64 years old, married, and on sick leave or retired from work. METHODS: Data were collected through self-report instruments. Demographic and clinical data were extracted from the patients' records. Main Research Variables: Cancer-related fatigue, psychological distress, coping resources, and functional status. FINDINGS: Patients' fatigue scores increased significantly during and after completion of radiotherapy. The participants reported normal levels of anxiety and depression, and their coping resources changed over time. After completing therapy, all dimensions of function had decreased; for social function, the decrease was significant. The correlation over time was significant among fatigue and physical function, role function, and cognitive function. The variation of the change in fatigue after therapy was completed was explained only by the level of fatigue experienced at baseline. CONCLUSIONS: Fatigue is a symptom that increases in connection with radiotherapy. Functional status is influenced by the variation in fatigue levels. Fatigue level before treatment may be an important variable when trying to find a risk factor for the development of fatigue over the course of treatment. IMPLICATIONS FOR NURSING: Nurses must inform patients receiving radiotherapy about the expected changes in fatigue and functional status. Pretreatment screening for fatigue is needed to identify patients at risk for developing fatigue.
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| 6. |
- Ahlberg, Karin, 1965, et al.
(författare)
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The experience of fatigue, other symptoms and global quality of life during radiotherapy for uterine cancer.
- 2005
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Ingår i: International journal of nursing studies. - : Elsevier BV. - 0020-7489. ; 42:4, s. 377-86
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports on how patients with uterine cancer, receiving radiotherapy, experience fatigue, other symptoms and global quality of life. The results showed that fatigue increased significantly during the therapy. Also the other symptoms; loss of appetite, nausea/vomiting and diarrhoea increased significantly and were significantly correlated to general fatigue. Global quality of life decreased significantly during treatment compared to baseline. The variation of the level in general fatigue after completed therapy was only explained by the level of general fatigue experienced at baseline. The result can lead to a better understanding of the severity of symptoms experienced by patients with uterine cancer treated with radiotherapy.
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| 7. |
- Berggren, Malin, 1975, et al.
(författare)
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Alternative EBNA1 expression in organ transplant patients.
- 2005
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Ingår i: Journal of medical virology. - : Wiley. - 0146-6615 .- 1096-9071. ; 76:3, s. 378-85
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Tidskriftsartikel (refereegranskat)abstract
- In order to identify patients at risk for developing post-transplant lymphoproliferative disease (PTLD), a sensitive nested RT-PCR method for detection of EBNA1 gene expression in peripheral blood cells was used. EBNA1 expression in peripheral blood samples from 60 organ recipients was analyzed and compared with 24 healthy controls in a retrospective study. Overall, EBNA1-positive samples were detected at least once in 43% of the transplant patients with post-transplant lymphoproliferative disease, in 18% of the other transplant patients and in none of the healthy controls. The odds ratio for EBNA1 expression in patients with post-transplant lymphoproliferative disease was 3.42 (95% CI=1.02-11.54) compared to other transplant recipients. Together with normal EBV Q promoter initiated EBNA1 transcripts, an alternatively spliced form was expressed in peripheral blood cells in the above-mentioned transplant patients. This transcript lacks the U leader exon in the 5'-untranslated region (UTR). We have previously identified and characterized a functional internal ribosome entry site, the EBNA IRES, in the untranslated U leader exon of EBNA1. Transfection experiments with EBNA1 coding plasmids followed by Western blot showed that the EBNA IRES promotes cap-independent translation and increases the EBNA1 protein level. The alternative EBNA1 transcript lacking this function is expressed in the majority of the investigated EBNA1-positive patient samples as well as in some EBV-positive B-cell lines. Alternative splicing in this form gives EBV potential to regulate the translation of EBNA1 by modifying the 5' UTR. These findings indicate a new mechanism for EBNA1 expression in vivo.
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| 8. |
- Jakobsson, Sofie, 1968, et al.
(författare)
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Components that influence assessment and management of cancer-related symptoms: an interdisciplinary perspective.
- 2008
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Ingår i: Oncology nursing forum. - 1538-0688. ; 35:4, s. 691-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To describe, from an interdisciplinary perspective, how cancer-related symptoms are assessed and managed in a cancer care setting and to describe the components that influence symptom management. DESIGN: Descriptive, qualitative, and cross-sectional. SETTING: An oncology and hematology department in a university hospital in western Sweden. SAMPLE: 31 nurses, physicians, physical therapists, dietitians, occupational therapists, and a medical social worker who all cared for patients with cancer-related symptoms. METHODS: Data were collected in focus groups and analyzed using content analysis. MAIN RESEARCH VARIABLES: Cancer-related symptoms and symptom management. FINDINGS: Symptom management, from a clinician's perspective, is a process involving different components. Four themes emerged from the data analysis: creating a relationship with the patient, understanding the patient, assessing the symptoms, and cooperating as a team. CONCLUSIONS: This study highlights several components that should be discussed in an effort to enhance symptom management. Discussion will help ensure that barriers to effective symptom management are acknowledged and addressed when implementing clinical routines designed to enhance management of different symptoms. In addition, these components should be acknowledged in the interest of facilitating adherence to symptom management strategies. Whether these components are important factors from patients' perspectives remains unknown. IMPLICATIONS FOR NURSING: Enhancing symptom management is not only a matter of implementing clinical guidelines; it must be preceded by teamwork, assessment, and evaluation method discussions and the ability to create a relationship with the patient. Nurses should be aware that their understanding of a patient affects their assessment of that patient's symptom experience.
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| 9. |
- Johansson, Jan-Erik, et al.
(författare)
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Gut toxicity during hemopoietic stem cell transplantation may predict acute graft-versus-host disease severity in patients.
- 2007
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Ingår i: Digestive diseases and sciences. - : Springer Science and Business Media LLC. - 0163-2116 .- 1573-2568. ; 52:9, s. 2340-5
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Tidskriftsartikel (refereegranskat)abstract
- Graft-versus-host disease (GVHD) is the primary complication of allogeneic, hemopoietic, stem cell transplantation (HSCT). Murine models suggest that gut toxicity, induced by the intensive chemotherapy preceding hematopoietic stem cell infusion, aggravates systemic GVHD. In HSCT patients gut toxicity correlates with chemotherapy intensity. The present study investigates acute GVHD severity and intestinal toxicity in patients undergoing allogeneic HSCT. In 38 patients intestinal permeability was assessed before and after chemotherapy (on days -1, +4, +7 and +14 as related to the stem cell infusion). Cumulative acute GVHD (days 0-100) and clinical intestinal toxicity (days 0-14) were evaluated in parallel. Patients with mild, acute GVHD (grades 0-I) had better-preserved intestinal barrier function (P=0.04) and less pronounced cumulative clinical intestinal toxicity (P=0.02) compared with patients with more severe acute GVHD (grades II-IV). Gut toxicity predicts acute GVHD severity. Therefore, gut protective strategies may diminish GVHD severity in allogeneic HSCT patients.
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| 11. |
- Spribille, Toby, et al.
(författare)
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Contributions to an epiphytic lichen flora of northwest North America: I. Eight new species from British Columbia inland rain forests
- 2009
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Ingår i: The Bryologist. - 0007-2745 .- 1938-4378. ; 112:1, s. 109-137
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Tidskriftsartikel (refereegranskat)abstract
- Recent surveys of the inland rain forests of British Columbia and adjacentregions have brought to light an unexpectedly rich epiphytic lichen flora, including severalspecies apparently new to science. In the first of a series of papers, we describe eight speciesdiscovered during these surveys as new: Absconditella amabilis T. Sprib. (Ostropales),Bacidina contecta S. Ekman & T. Sprib., Biatora aureolepra T. Sprib. & Tønsberg, Biatoraligni-mollis T. Sprib. & Printzen (all Lecanorales), Collema coniophilum Goward(Peltigerales), Pertusaria diluta C. Bjo¨rk, G. Thor & T. Wheeler (Pertusariales), Schaereriabrunnea C. Bjo¨rk, T. Sprib. & T. Wheeler (Ostropomycetidae incertae sedis) andScoliciosporum abietinum T. Sprib. (Lecanorales). We also call attention to a ninth species,Bacidina sp. A, a poorly known and possibly undescribed colonizer of moribundcyanolichens. A majority of the above species appear to be confined to old-growth forests,while two (Biatora ligni-mollis and Schaereria brunnea) are currently known only from‘‘antique’’ forests older than about 500 years. Many additional undescribed epiphyticlichens are known from inland rain forests, underscoring the need for further baselinebiodiversity research in light of its ongoing disappearance as a result of resource extraction.In addition to the eight new species, we report Absconditella celata as new to NorthAmerica, Absconditella lignicola as new to Canada and Montana, Bacidina chloroticula asnew to British Columbia and Gyalideopsis piceicola as new to Montana.
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