| 21. |
- Emdin, Stefan, et al.
(författare)
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SweDCIS: Radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomised trial in a population offered mammography screening.
- 2006
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 45:5, s. 536-43
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Tidskriftsartikel (refereegranskat)abstract
- We studied the effect of postoperative radiotherapy (RT) after breast sector resection for ductal carcinoma in situ (DCIS). The study protocol stipulated radical surgery but microscopically clear margins were not mandatory. We randomised 1,046 operated women to postoperative RT or control between 1987 and 1999. The primary endpoint was ipsilateral local recurrence. Secondary endpoints were contralateral breast cancer, distant metastasis and death. After a median follow-up of 5.2 years (range 0.1-13.8) there were 44 recurrences in the RT group corresponding to a cumulative incidence of 0.07 (95% confidence interval (CI) 0.05-0.10). In the control group there were 117 recurrences giving a cumulative incidence of 0.22 (95% CI 0.18-0.26) giving an overall hazard ratio of 0.33 (95% CI 0.24-0.47, p < 0.0001). Twenty two percent of the patients had microscopically unknown or involved margins. We found no evidence for different effects of RT on the relative risk of invasive or in situ recurrence. Secondary endpoints did not differ. Women undergoing sector resection for DCIS under conditions of population based screening mammography benefit from postoperative RT to the breast. Seven patients needed RT-treatment to prevent one recurrence.
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| 22. |
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| 23. |
- Hellquist, Björn, et al.
(författare)
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Structures of Solvated Cations of Palladium(II) and Platinum(II) in Dimethyl Sulfoxide, Acetonitrile and Aqueous Solution Studied by EXAFS and LAXS
- 1991
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Ingår i: Acta Chemica Scandinavica. - : Danish Chemical Society. - 0904-213X. ; 45:5, s. 449-455
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Tidskriftsartikel (refereegranskat)abstract
- X-Ray absorption edge and EXAFS spectra of the solvated cations of platinum(II) in water, dimethyl sulfoxide and acetonitrile and of palladium(II) in dimethyl sulfoxide have been recorded and analyzed. The cations are four-coordinated. Pt-O in Pt(H2O)4(2+) is 2.01(1) angstrom and Pt-N in Pt(CH3CN)4(2+) is 2.00(1) angstrom. The dimethyl sulfoxide solvated cations of both platinum and palladium contain two sulfur- and two oxygen-bonded ligands with Pt-O 2.07(2), Pt-S 2.21(2), Pd-O 2.04(2), and Pd-S 2.23(2) angstrom, probably in a square-planar cis-arrangement, as in the solid state. Large-angle X-ray scattering (LAXS) studies of the platinum(II) dimethyl sulfoxide solvated cation in a solution of the triflate salt gave Pt-O 2.07(1) and Pt-S 2.20(1) angstrom and in a solution of the tetrafluoroborate salt Pt-O 2.07(2) and Pt-S 2.21(5) angstrom, in good agreement with the EXAFS results. Neither technique gave any support for axially bound solvent molecules in addition to the four in the assumed square coordination plane.
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| 24. |
- Hellström, Vivan, et al.
(författare)
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Malignancies in transplanted patients : Multidisciplinary evaluation and switch to mTOR inhibitors after kidney transplantation - experiences from a prospective, clinical, observational study
- 2016
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Ingår i: Acta Oncologica. - Uppsala : Acta Universitatis Upsaliensis. - 0284-186X .- 1651-226X. ; 55:6, s. 774-781
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Tidskriftsartikel (refereegranskat)abstract
- Background Solid organ transplant recipients are at increased risk of developing malignancies. The objective of this prospective, observational, one-armed study was to study the feasibility to add a mammalian target of rapamycin (mTOR) inhibitor to the immunosuppressive regimen in transplanted patients with post-transplant malignancies. During the trial the need to improve identification of post-transplant malignancies and to reassure adequate oncological treatment of these patients became evident. Multidisciplinary team (MDT) evaluation of oncological and immunosuppressive treatments was implemented for all patients with malignancies after renal or combined renal and pancreas transplantation because of the trial.Material and methods At Uppsala University Hospital, Sweden, a MDT consisting of transplant surgeons, nephrologists, oncologists and dermatologists evaluated 120 renal or combined renal and pancreas-transplanted recipients diagnosed with malignancies from September 2006 to July 2012. To identify all malignancies, the population was linked to the Regional Tumor Registry (RTR). We recorded to which extent a switch to mTOR inhibitors was possible and how often the originally planned oncological managements were adjusted. All patients were followed for three years. (ClinicalTrials.gov: NCT02241564).Results In 76 of 120 patients (63%) a switch to mTOR inhibitors was possible. Immunosuppression was interrupted in seven patients (6%), reduced in three patients (2%) and remained unchanged in 34 of 120 patients (28%). Identification of post-transplant malignancies increased significantly after linkage to RTR (p=0.015). The initially recommended oncological treatment was adjusted in 23 of 44 patients (52%) with solid or hematological malignancies; 36 of these patients (82%) were treated according to national guidelines.Conclusion In two thirds of the patients the immunosuppressive treatment could be changed to an mTOR inhibitor with anti-tumor effects in transplanted patients with post-transplant malignancies. The use of regional tumor registers considerably improved the identification of patients with post-transplant malignancies indicating that post-transplant malignancies might be timely underreported in transplant registers.
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| 25. |
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| 26. |
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| 27. |
- Holmberg, Lars I, 1944-
(författare)
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Health, Risk-Taking Behavior and Sexuality in Swedish Adolescents
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aims of this research were to develop methods of identifying adolescents with unhealthy and/or risk-taking behavior with special reference to sexuality, and to evaluate support measures for young people in need of such interventions. A further aim was to assess strategies for preventing unhealthy and/or risk-taking behavior. Data were obtained by questionnaires (studies I, III, IV and V) and interviews (study II).The results showed that young men involved in unintended pregnancies would benefit from active participation in the decision making regarding continuation or termination of the pregnancy, and from support at Outpatient Clinics for Adolescents in Sweden, including information together with the partner (I).It was also concluded that consideration should be paid to questions and problems, e.g. feelings, apprehensions, moral issues and psychosocial factors, that require individual support from personnel with knowledge and resources to help young men in this difficult situation (II).Among the most important findings regarding young men who had been involved in an unplanned pregnancy were that in this group a high percentage had previously considered suicide and that anabolic steroids were frequently used, compared with young men without experience of pregnancy (III).The finding that unprotected intercourse occurred in a fairly high frequency among 13- to 18-year-olds, despite massive education and easy access to contraceptives, gives reason for further considerations regarding appropriate ways of providing information to young people (IV).Girls and boys in vocational programs in Swedish high schools exhibit more risk-taking behaviors than those in theoretical programs and these two groups differ in clustering and accumulation of these behaviors. This means that preventive interventional strategies need to be elaborated with regard to these differences, with the aim of improving health maintenance among adolescents (V).Child-and-youth centers with a developmental and research capacity need to be established with the broad purpose of drawing up health prevention programs for children and young people.
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| 28. |
- Holmberg, Lars, et al.
(författare)
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Mammography casting-type calcification and risk of local recurrence in DCIS: analyses from a randomised study
- 2013
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Ingår i: British Journal of Cancer. - : Cancer Research UK. - 0007-0920 .- 1532-1827. ; 108:4, s. 812-819
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Tidskriftsartikel (refereegranskat)abstract
- Background: We studied the association between mammographic calcifications and local recurrence in the ipsilateral breast. less thanbrgreater than less thanbrgreater thanMethods: Case-cohort study within a randomised trial of radiotherapy in breast conservation for ductal cancer in situ of the breast (SweDCIS). We studied mammograms from cases with an ipsilateral breast event (IBE) and from a subcohort randomly sampled at baseline. Lesions were classified as a density without calcifications, architectural distortion, powdery, crushed stone-like or casting-type calcifications. less thanbrgreater than less thanbrgreater thanResults: Calcifications representing necrosis were found predominantly in younger women. Women with crushed stone or casting-type microcalcifications had higher histopathological grade and more extensive disease. The relative risk (RR) of a new IBE comparing those with casting-type calcifications to those without calcifications was 2.10 (95% confidence interval (Cl) 0.92-4.80). This risk was confined to in situ recurrences; the RR of an IBE associated with casting-type calcifications on the mammogram adjusted for age and disease extent was 16.4 (95% Cl 2.20-140). less thanbrgreater than less thanbrgreater thanConclusion: Mammographic appearance of ductal carcinoma in situ of the breast is prognostic for the risk of an in situ IBE and may also be an indicator of responsiveness to RT in younger women.
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| 29. |
- Holmberg, Martin, et al.
(författare)
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Evaluation of human seroreactivity to Bartonella species in Sweden
- 1999
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Ingår i: Journal of Clinical Microbiology. - 0095-1137 .- 1098-660X. ; 37:5, s. 1381-1384
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Tidskriftsartikel (refereegranskat)abstract
- Among the species that compose the expanding genus Bartonella, thus far only B. henselae and B. quintana have reportedly been isolated from humans in Europe. To evaluate the prevalence of Bartonella infection in Sweden,we conducted a retrospective serological examination of 126 human serum samples. These samples were analyzed for antibodies to B. henselae, B. quintana, and B. elizabethae, Serum samples from 100 blood donors, who spanned the ages of 20 to 60 and had no apparent clinical signs of illness, were also studied as a control group. An immunoglobulin G indirect fluorescence antibody assay revealed 4 and 8.3% Bartonella positivity rates for the blood donor and patient group, respectively, when a cutoff titer of greater than or equal to 64 was chosen. Among the blood donors, four were seropositive to B, elizabethae; one of these also had concordant positive titer to B. henselae, In the patient group, 14 serum samples were positive against Bartonella spp, These serum specimens represented nine patients. In three of these seropositive patients, paired serum samples displayed a fourfold increase in antibody titer to at least one of the three antigens, These three patients are discussed. In this report we also present a case study of a 60-year-old Swedish male with fatal myocarditis, Postmortem serological analysis revealed a high titer against B. elizabethae, PCR and nucleotide sequencing of the myocardial tissue from this patient, and of Liver tissue from one of the other three patients, showed sequences similar to B. quintana, The age, geographical origin, animal contacts, and serological response pattern to the different Bartonella antigens differed among the four patients. This study substantiates the presence of Bartonella spp, in Sweden, documents the seroreactivity to three Bartonella antigens in Swedish patients, and reports the first two cases of B. quintana-like infections in Sweden.
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| 30. |
- Håkansson, Anna, 1978, et al.
(författare)
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Cyclooxygenase-2 polymorphisms in Parkinson's disease.
- 2007
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Ingår i: American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. - : Wiley. - 1552-4841. ; 144:3, s. 367-9
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Tidskriftsartikel (refereegranskat)abstract
- Accumulating evidence indicate that cyclooxygenase-2 (COX-2) is of pathophysiological importance for the neurodegeneration in Parkinson's disease (PD). For example, in a large epidemiological study, use of NSAIDs was associated with a lower risk of PD. Genetic variants of the COX-2 gene might therefore influence the risk of developing the disease. The genotype distribution of four common single nucleotide polymorphisms (SNPs) in the COX-2 gene (rs689466:A496G, rs20417:G926C, rs5277:G3050C, rs5275:C8473T) was analyzed in PD patients and control subjects in a Swedish population. No differences could be seen between the PD-patient and controls regarding the A496G, G926C, and G3050C SNPs, but the allele frequency of the C8473T SNP was found to differ when male patients were compared to controls (P = 0.007). In females no difference could be seen between PD-patients and controls. In conclusion, the results suggest a possible influence of the COX-2 C8473T SNP in PD, although it only seems to be of importance in men.
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