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- Ståhl, Elisabeth
(författare)
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Health-Related Quality of Life in COPD and Asthma - Discriminative and evaluative aspects
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background - The effects of intervention can be evaluated in different ways, and objective measurements of changes in lung function are commonly used as the outcome measure. Patient-reported outcome (PRO) is an umbrella term used for all patient-based assessments. One important PRO is health-related quality of life (HRQL), which may be used as an evaluative or discriminative measure. Objectives - To examine COPD subjects' completion of self-administered questionnaires. To study the evaluative effects with HRQL assessments after pulmonary interventions in COPD and asthma. Finally, to explore the discriminative possibility of using HRQL with regard to its relationship to other clinical indices and to disease severity in both COPD and asthma. Results - Most COPD subjects find it easy to complete questionnaires; however, the correlation of age with difficulty in completing questionnaires needs to be considered. Furthermore, it was shown that assessments of HRQL may be useful for evaluative purposes in COPD and asthma, although in COPD longer studies will be needed. The discriminative possibility of using HRQL data in COPD and asthma was shown. Symptoms correlated with HRQL, whereas between lung function and HRQL the relationship was weaker. HRQL seems to deteriorate with disease severity in COPD and asthma, as measured by lung function, or with age. However, great individual variation was noticed. Conclusions - The completion of up to five PRO questionnaires was well accepted by subjects with COPD. HRQL questionnaires might be used for evaluative purposes. HRQL questionnaires appear to have a possibility to be used for discriminative purposes in COPD and asthma, and for comparison of these diseases; however, this needs to be further explored. In homogeneous populations, used in evaluative studies, assessment of HRQL is valuable. In heterogeneous populations, a great variation in HRQL is likely to be seen and therefore there may be a chance to show a relationship between HRQL and lung function measures. However, within severity stages there is a great individual variation.
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| 2. |
- Andersson, F, et al.
(författare)
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The impact of exacerbations on the asthmatic patient's preference scores
- 2003
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Ingår i: Journal of Asthma. - 0277-0903. ; 40:6, s. 615-623
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to examine the effect of exacerbations on mild to moderate asthmatic patients' preference-based, health-related, quality of life scores and also to describe the effect of these exacerbations on daily life. In a survey, 100 mild to moderate asthmatic patients in the United Kingdom were asked to rate three different health marker states on a scale between 0 (death) and 100 (perfect health), defined as: your asthma of today, a mild exacerbation, and a severe exacerbation of asthma. They were also asked to describe their symptoms and what they did when experiencing an exacerbation. During exacerbations the vast majority of asthmatic patients have significant symptoms and consume a considerable amount of health care resources, which often overlap. The health marker state "your asthma of today" was given a mean score of 81.0, a mild exacerbation a score of 62.1, and a severe exacerbation a score of 25.6, indicating a large impact on patients' daily life and their health-related quality of life. In conclusion, asthmatic patients are severely affected in their health and daily living by mild and severe exacerbations. Considerable effort should be made to reduce the number and severity of exacerbations.
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| 3. |
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| 4. |
- Villman, Kenneth, et al.
(författare)
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Topoisomerase II-α expression in different cell cycle phases in fresh human breast carcinomas
- 2002
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Ingår i: Modern Pathology. - Baltimore : Lippincott Williams & Wilkins. - 0893-3952 .- 1530-0285. ; 15:5, s. 486-491
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Tidskriftsartikel (refereegranskat)abstract
- Topoisomerase II-alfa (topo IIalfa) is the key target enzyme for the topoisomerase inhibitor class of anti-cancer drugs. In normal cells, topo IIalfa is expressed predominantly in the S/G2/M phase of the cell cycle. In malignant cells, in vitro studies have indicated that the expression of topo IIalfa is both higher and less dependent on proliferation state in the cell. We studied fresh specimens from 50 cases of primary breast cancer. The expression of topo IIalfa in different cell cycle phases was analyzed with two-parameter flow cytometry using the monoclonal antibody SWT3D1 and propidium iodide staining. The expression of topo IIalfa was significantly higher in the S/G2/M phase of the cell cycle than in the G0/G1 phase in both DNA diploid and DNA nondiploid tumors. In 18 of 21 diploid tumors, and in 25 of 29 nondiploid tumors, >50% of the topo IIalfa–positive cells were in the G0/G1 phase. This significant expression of topo IIalfa in the G0/G1 phase of the cell cycle may have clinically important implications for treatment efficacy of topoisomerase II inhibitors.
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| 5. |
- Uggla, Bertil, 1962-, et al.
(författare)
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Expression of topoisomerase IIalpha in the G0/G1 cell cycle phase of fresh leukemic cells
- 2001
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Ingår i: Leukemia research. - Oxford, United Kingdom : Elsevier. - 0145-2126 .- 1873-5835. ; 25:11, s. 961-966
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Tidskriftsartikel (refereegranskat)abstract
- Topoisomerase IIalpha (topoII alpha) is the target enzyme for several antineoplastic drugs. Correlation between low expression of topo IIalpha and drug resistance has been shown in vitro, but there is limited evidence of a correlation to initial response to treatment or to overall prognosis. Normal cells express topo IIalpha in S/G2/M phase of the cell cycle but not in G0/G1 phase. However, some data suggest that topo IIalpha could be expressed in G0/G1 phase in malignant cells. We have investigated the expression of topo IIalpha in leukemic cells from 25 patients with acute leukemia by flow cytometry, separating cells of different cell cycle phases. We demonstrated that 9/25 samples showed >50% positive cells in G0/G1, and another five samples showed >20%. This finding could possibly provide an explanation to previous difficulties in correlating topo IIalpha expression with clinical outcome. Six of eight patients, where >20% of the cells in G0/G1 were positive for topo IIalpha, entered CR, compared to one of five patients with <20% topo IIalpha positive cells in G0/G1. We suggest that topo IIalpha expression in G0/G1 in leukemic cells may be of predictive value for clinical response to cytostatic drugs.
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