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- Lodin, Karin, et al.
(författare)
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Self-rated health is associated with fatigue, but not inflammatory cytokines or fraction of exhaled nitric oxide in men and women with allergic asthma
- 2013
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Ingår i: Brain, behavior, and immunity. - : Elsevier BV. - 0889-1591 .- 1090-2139. ; 32:Suppl., s. e31-e31
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Allergic asthma is a chronic inflammatory disorder with both local and systemic inflammation and is associated with elevated levels of cytokines as well as exhaled fraction of nitric oxide (FeNO). Fatigue is a prominent symptom. Poor self-rated health has previously been associated to fatigue and inflammatory markers. However, it is not known if self-rated health is associated with fatigue and inflammation also in patients with asthma. Here, we investigated the associations between self-rated health, fatigue, inflammatory cytokines and FeNO in patients with asthma. Self-rated health, fatigue, levels of cytokines and FeNO were assessed in 184 (93 men, 91 women) non-smoking patients with allergic asthma aged 18–64 years in a one-year longitudinal study with five repeated measurements, two for cytokine levels. Analyses of associations between repeated measurements were performed using mixed regression models. More fatigue was associated with poor self-rated health in both men and women (p < 0.001). Fatigue was also associated to elevated levels of IL-1beta and TNF-alpha in women (p < 0.01). However, no association between self-rated health, inflammatory cytokines and FeNO were found. In conclusion, fatigue is an important determinant of self-rated health also in patients with asthma. In addition, fatigue was associated to elevated levels of inflammatory cytokines in women. Possibly, variance in inflammation may be of less importance in a chronic inflammatory condition such as asthma in relation to how subjective health is appraised.
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| 4. |
- Syk, Erik, et al.
(författare)
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Factors influencing local failure in rectal cancer : analysis of 2315 patients from a population-based series
- 2010
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Ingår i: Diseases of the Colon & Rectum. - 0012-3706 .- 1530-0358. ; 53:5, s. 744-752
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study aimed to identify risk factors for local failure in an effort to optimize treatment for rectal cancer. METHODS: A total of 154 patients with local failure after abdominal resection were identified from a population-based consecutive series of 2315 patients who underwent operations for rectal cancer in the Stockholm region between January 1995 and December 2004. Surgeons trained in total mesorectal excision performed the surgery, and preoperative radiotherapy was given according to defined protocols. Data from the 9 hospitals in the region, prospectively registered in a database, were reviewed with regard to tumor location and stage, radiation therapy, surgical treatment, and follow-up. RESULTS: In a multivariable analysis, independent risk factors for local failure were distal tumor location and advanced tumor and nodal stage, omission of preoperative radiation, residual disease, and hospitals with lower caseload. Low anterior resection and total mesorectal excision were deployed more often in centers with low failure rates. Discriminators for radiation therapy were patients with male gender, less advanced age, and tumors situated <6 cm from the anal verge. CONCLUSION: The variability of patient outcome according to local failure depends on tumor stage, nodal stage, and location. Omission of radiation therapy and surgical performance are important additional risk factors to consider when optimizing treatment for rectal cancer.
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| 5. |
- Syk, E., et al.
(författare)
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Tumour budding correlates with local recurrence of rectal cancer
- 2011
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Ingår i: Colorectal Disease. - : Wiley. - 1462-8910 .- 1463-1318. ; 13:3, s. 255-262
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Tidskriftsartikel (refereegranskat)abstract
- Aim Predictive tools for local recurrence (LR) of rectal cancer are needed. This study assessed the predictive value of tumour budding detected by MNF-116 and laminin-5 gamma 2 chain (Ln-5 gamma 2). Method In a case-control study, the surgical specimens of 48 patients with LR after from primary resection of rectal carcinoma and 82 control patients matched for gender and preoperative radiation from a population of 1180 patients operated with total mesorectal excison were studied. The presence of budding was examined using immunohistochemistry with Ln-5 gamma 2 and pancytokeratin staining with MNF-116. Results Tumour budding counts ranged from 0 to 106 buds (mean 43, median 38) for all patients. Significantly more tumours with more than 35 buds were seen in the LR than in the control group (67 vs 44%; P = 0.02). The spread of budding was also more extensive in the LR than in the control group (63 vs 49%, P = 0.03). In a multivariate analysis with tumour, node, metastasis stage, MNF-116-stained budding was an independent predictor of local failure (P = 0.02). The budding frequency was higher in irradiated tumours in comparison with tumours that had not received irradiation (mean 53 vs 38, P = 0.03). For Ln-5 gamma 2, more tumours with 10 buds were seen in the group with LR than among the control patients, but this difference was not statistically significant (73 vs 57%; P = 0.09). No additive value was found in the multivariate logistic regression model when Ln-5 gamma 2-stained budding frequency was added to MNF-116 and tumour, node, metastasis stage. The agreement between budding frequency determined by MNF-116 and Ln-5 gamma 2 was moderate, with a kappa-coefficient of 0.34 (0.16-0.51). Conclusion Tumour budding determined by MNF-116 staining may serve as a predictive marker for LR in rectal cancer.
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