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| 3. |
- Fransson, Per, et al.
(författare)
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Quality of life in patients with locally advanced prostate cancer given endocrine treatment with or without radiotherapy: 4-year follow-up of SPCG-7/SFUO-3, an open-label, randomised, phase III trial.
- 2009
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Ingår i: The lancet oncology. - : Elsevier. - 1474-5488 .- 1470-2045. ; 10:4, s. 370-80
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Androgen treatment for prostate cancer can adversely affect functional domains of quality of life. We aimed to assess quality of life in men with locally advanced prostate cancer in an open-label phase III randomised comparison between lifelong endocrine treatment with and without radiotherapy. METHODS: We obtained quality-of-life information from 872 (99%) of 875 eligible men with locally advanced prostate cancer (T3; 78%) who were randomly assigned, between 1996 and 2002, to 3 months of total androgen blockade followed by continuous endocrine treatment (439 patients) or the same hormonal treatment with radiotherapy 3 months after randomisation (436 patients). Prospective outcomes included patient-reported symptoms and quality of life assessed with questionnaires from baseline to 4 years after randomisation. Analysis was by intention to treat. This study is registered as an international standard randomised controlled trial, number ISRCTN01534787. FINDINGS: 438 of 439 men assigned endocrine treatment and 434 of 436 assigned endocrine plus radiotherapy completed at least one questionnaire. Missing data at baseline and during follow-up was equally distributed between groups. At 4 years, 64 (18%) of 353 patients on combined therapy and 39 (12%) of 337 on endocrine-alone therapy had moderate to severe urinary bother (p=0.005), and 16 (4%) of 355 on combined therapy and five (2%) of 338 on endocrine treatment alone had pain while urinating (p=0.024). 37 (11%) of 350 in the combined group and 23 (7%) of 35 in the endocrine-only group had overall bother from all bowel symptoms (p=0.022). 281 (85%) of 332 in the combined-treatment group and 227 (72%) of 313 in the endocrine-only group had erectile dysfunction (p=0.0002). Quality of life at 4 years was similar, with the exception of decreased social function in patients receiving endocrine treatment plus radiotherapy. INTERPRETATION: Although addition of radiotherapy to endocrine treatment significantly increased some treatment-related symptoms, none were serious. Given the substantial survival benefit of combined treatment, the increase of symptoms seems acceptable and has little extra effect on quality of life after 4 years compared with endocrine treatment alone.
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- Hafström, Anna, et al.
(författare)
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Increased visual dependence and otolith dysfunction with alcohol intoxication
- 2007
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Ingår i: NeuroReport. - 1473-558X. ; 18:4, s. 391-394
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Tidskriftsartikel (refereegranskat)abstract
- dAlcohol intoxication affects the vestibular system and balance control in many ways. We have investigated how acute, moderate (blood alcohol concentrations of 0.06 +/- 0.01%), and high (0.10 +0.02%) alcohol intoxication affects the ability to perceive the visual horizontal and vertical and the visual field dependence measured with the rod and frame tests in 24 healthy participants. Alcohol ingestion impaired the ability to use gravitational vestibular cues when determining the visual vertical and horizontal, and caused increased visual field dependence. With conflicting gravitational and visual information, alcohol seems to promote a reweighting in balance control from a vestibular to a more visual dependency. Furthermore, the results indicate that alcohol intoxication at these levels start instigating a decompensation of minute subdinical vestibular asymmetries.
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- Holmberg, Johan, et al.
(författare)
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Reduced postural differences between phobic postural vertigo patients and healthy subjects during a postural threat.
- 2009
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Ingår i: Journal of Neurology. - : Springer Science and Business Media LLC. - 1432-1459 .- 0340-5354. ; 256, s. 1258-1262
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Tidskriftsartikel (refereegranskat)abstract
- Phobic postural vertigo is characterized by subjective imbalance and dizziness while standing or walking, despite normal values for clinical balance tests. Patients with phobic postural vertigo exhibit an increased high-frequency sway in posturographic tests. Their postural sway, however, becomes similar to the sway of healthy subjects during difficult balance tasks. Posturographic recordings of 30 s of quiet stance was compared to recordings of 30 s of quiet stance during a postural threat, which consisted of the knowledge of forthcoming vibratory calf muscle stimulation, in 37 consecutive patients with phobic postural vertigo and 24 healthy subjects. During quiet stance without the threat of forthcoming vibratory stimulation, patients with phobic postural vertigo exhibited a postural sway containing significantly more high-frequency sway than the healthy subjects. During the quiet stance with forthcoming vibratory stimulation, i.e., anticipation of a postural threat, the significant differences between groups disappeared for all variables except sagittal high-frequency sway. During postural threat, healthy subjects seemed to adopt a postural strategy that was similar to that exhibited by phobic postural vertigo patients. The lack of additional effects facing a postural threat among phobic postural vertigo patients may be due to an already maximized postural adaptation. Deviant postural reactions among patients with phobic postural vertigo may be considered as an avoidant postural response due to a constant fear of losing postural control.
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- Tjernström, Fredrik, et al.
(författare)
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Decreased postural adaptation in patients with phobic postural vertigo-An effect of an "anxious" control of posture?
- 2009
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Ingår i: Neuroscience Letters. - : Elsevier BV. - 0304-3940. ; 454:3, s. 198-202
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Tidskriftsartikel (refereegranskat)abstract
- Postural adaptability and responses elicited by vibratory stimulation to the calf muscles recorded on a force platform with eyes open or closed were analyzed in 39 patients suffering from Postural Phobic Vertigo (PPV) (17 men and 22 women, mean age 49 years) and 24 healthy subjects (14 men, 10 women, mean age 38 years). The vibration induced increased body sway in both groups, but the adaptation pattern differed significantly. With eyes open the PPV patients decreased their induced body sway over time (-32%, p < 0.01), which the controls did not. With eyes closed the PPV patients reduced their induced body sway over time to a much lesser extent than the controls (PPV: -28%, p < 0.05, controls: -57%, p < 0.001). These new findings show that PPV patients adapt to proprioceptive perturbation to a lesser extent than normal subjects and that PPV patients do not use visual information as efficiently to modulate postural control. The results support the hypothesis that a cognitive set of posture, an "anxious control", may underlie the symptoms of PPV, i.e. an increased readiness to react to any perturbation or deviation. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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| 9. |
- Tjernström, Fredrik, et al.
(författare)
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Vestibular PREHAB and gentamicin before schwannoma surgery may improve long-term postural function
- 2009
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ. - 1468-330X .- 0022-3050. ; 80:11, s. 1254-1260
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Tidskriftsartikel (refereegranskat)abstract
- Background: Unilateral vestibular deafferentation (uVD), as performed in vestibular schwannoma surgery, results in a chronic vestibular deficit, though most of the insufficiency can be compensated by other sensory input. By vestibular training (prehabituation) performed before surgery, motor adaptation processes can be instigated before the actual lesion. The adaptation processes of the altered sensory input could be affected if the vestibular ablation and surgery were separated in time, by pretreating patients who have remaining vestibular function with gentamicin. Objective: To determine whether presurgical deaf-ferentation would affect postsurgery postural control also in a long-term perspective (6 months). Method: 41 patients subjected to trans-labyrinthine schwannoma surgery were divided into four groups depending on the vestibular activity before surgery (with no clinical significant remaining function n = 17; with remaining function n = 8), whether signs of central lesions were present (n = 10), and if patients with remaining vestibular activity were treated with gentamicin with the aim to produce uVD before surgery (n = 6). The vibratory posturography recordings before surgery and at the follow-up 6 months after surgery were compared. Results: The subjects pretreated with gentamicin had significantly less postural sway at the follow-up, both compared with the preoperative recordings and compared with the other groups. Conclusion: The results indicate that by both careful sensory training and separating the surgical trauma and the effects of uVD in time, adaptive processes can develop more efficiently to resolve sensory conflicts, resulting in a reduction of symptoms not only directly after surgery but also perhaps up to 6 months afterwards.
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| 11. |
- Wigenius, Jens, et al.
(författare)
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Protein biochips patterned by microcontact printing or by adsorption-soft lithography in two modes
- 2008
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Ingår i: Biointerphases. - : American Vacuum Society. - 1934-8630 .- 1559-4106. ; 3:3, s. 75-82
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Tidskriftsartikel (refereegranskat)abstract
- Patterning of proteins is critical to protein biochips. Printing of layers of proteins is well established, as is adsorption of proteins to surfaces properly modified with surface chemical functionalities. The authors show that simple methods based on soft lithography stamps can be used to prepare functional antibody chips through both these routes. Both methods incorporate transfer of the stamp material poly(dimethylsiloxane) (PDMS) to the biochip, whether intended or not intended. The results indicate that microcontact printing of proteins always includes PDMS transfer, thereby creating a possibility of unspecific adsorption to a hydrophobic domain. © 2008 American Vacuum Society.
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