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- Balogh, Lauren C., et al.
(author)
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Clinical outcomes of head and neck cancer patients who refuse curative therapy in pursuit of alternative medicine
- 2021
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In: Laryngoscope Investigative Otolaryngology. - : Wiley. - 2378-8038. ; 6:5, s. 991-998
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Journal article (peer-reviewed)abstract
- Background: We investigated the alarming trend of curable head and neck cancer (HNC) patients forgoing conventional treatment to pursue alternative medicine (AM). Methods: A prospectively maintained database identified HNC patients with ≥12 weeks from diagnosis to treatment initiation between 2012 and 2017. Reasons for delay were categorized and clinical stages and outcomes of AM patients were assessed through chart review by December 2019. Results: Among 1462 patients with primary HNC, 68 patients (4.7%) were confirmed to delay initiation of potentially curative treatment, and 19 of these patients (28%) delayed treatment to pursue AM. Eleven of 19 AM patients transitioned from curative intent to palliation while exploring AM. Continued treatment rejection was common and outcomes corresponded to patients' degree of treatment adherence. Conclusions: AM caused treatment delay and poor outcomes in potentially curable HNC. Improved knowledge among physicians regarding AM and complementary approaches is urgently needed to improve patient counseling. Level of Evidence: Level 2c outcomes research.
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- Holm, Anna, et al.
(author)
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Mapping of Human Papilloma Virus, p16, and Epstein-Barr Virusin Non-Malignant Tonsillar Disease
- 2019
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In: Laryngoscope Investigative Otolaryngology (LIO). - : Wiley-Blackwell. - 2378-8038. ; 4:3, s. 285-291
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Journal article (peer-reviewed)abstract
- Objectives: Due to their location in the entrance of the aero‐digestive tract, tonsils are steadily exposed to viruses. Human papilloma virus (HPV) and Epstein‐Barr virus (EBV) are two potentially oncogenic viruses that tonsils encounter. The incidence of HPV positive tonsillar cancer is on the rise and it is unknown when infection with HPV occurs.Aim: To investigate if tonsils are infected with HPV and EBV, to study the co‐expression of HPV and its surrogate marker p16, and to evaluate the number of EBV positive cells in benign tonsillar disease.Materials and Methods: Tonsils from 40 patients in a university hospital were removed due to hypertrophy, chronic or recurrent infection. These were analyzed for presence of HPV, its surrogate marker p16, and EBV. HPV was studied using PapilloCheck (a PCR method), while p16 was identified in epithelial and lymphoid tissue with immunohistochemistry and EBV using EBER‐ISH (Epstein‐Barr encoding region–in situ hybridization).Results: HPV was not detected, and p16 was present at low numbers in all epithelial samples as well as in 92.5% of the lymphoid tonsillar samples. At least one EBER‐positive cell was seen in 65% of cases. Larger numbers of EBER‐expressing cells were only seen in two cases.Conclusion: These findings demonstrate that EBV and HPV infect tonsils independently, but further studies are warranted to confirm their infectious relationship.Level of Evidence: Cross‐sectional study
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- Jørgensen, Ole Jakob, et al.
(author)
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Elevated FVIII levels in hereditary hemorrhagic telangiectasia : Implications for clinical management
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In: Laryngoscope Investigative Otolaryngology. - 2378-8038.
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Journal article (peer-reviewed)abstract
- Objectives: The objective of this study was twofold: to determine the prevalence of arterial and venous thromboembolic events in the Norwegian Hereditary Hemorrhagic Telangiectasia (HHT) population, and to explore potential factors linked to such events, with particular emphasis on FVIII. Methods: Patients with an HHT diagnosis attending the Otorhinolaryngology Department at Oslo University Hospital—Rikshospitalet were included consecutively between April 2021 and November 2022. We recorded the participants' medical history with an emphasis on thromboembolic events. Measurements of blood constituents, including FVIII, FIX, vWF, hemoglobin, iron, ferritin, and CRP were performed. Results: One hundred and thirty-four patients were included in the study. The total prevalence of thromboembolic events among the participants was 23.1%. FVIII levels were high (>150 IU/dL) in the majority of HHT patients (n = 84) (68.3%) and were significantly associated with thromboembolic events (p <.001), as was age. Of the patients with high FVIII levels, 28 (33%) had experienced a thromboembolic event. Furthermore, FVIII levels were measured consecutively in 51 patients and were found to fluctuate above or below 150 IU/dL in 25% of these cases. Conclusion: Thromboembolic events are highly prevalent in the Norwegian HHT population and are significantly associated with FVIII levels. FVIII levels can fluctuate, and measurements should be repeated in HHT patients to assess the risk of thromboembolic events. Level of Evidence: 4.
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- Karczewska-Lindinger, Magdalena, 1986, et al.
(author)
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Low physical activity in patients diagnosed with head and neck cancer
- 2021
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In: Laryngoscope Investigative Otolaryngology. - : Wiley. - 2378-8038. ; 6:4, s. 747-755
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Journal article (peer-reviewed)abstract
- Background This pilot study aimed to describe physical activity (PA) and self-perceived function, health and quality of life (QoL) prior to oncological treatment in patients with head and neck cancer (HNC). Methods In a prospective study including 49 patients, self-perceived PA (Saltin-Grimby scale) and health-related QoL (European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 and EQ-5D) were assessed. Further, PA was also measured by an accelerometer attached to the thigh for eight consecutive days. The accelerometer PA was compared to the PA of a reference population assessed with the same method. Results presented are from data collected before start of oncological treatment. Results The patients (44-79 years, 65% males) spent most of their time in sedentary behavior: a median of 555 minutes/day in bed (39% of total) and 606 minutes/day sitting (41%). Only 129 minutes/day were spent moving/walking. Patients with higher education, reduced physical function and higher fatigue were less physically active (P <= .01). Further, the different PA measures demonstrated a pattern of being less physically active compared to the reference population. Conclusions Patients diagnosed for HNC may have low PA level. Assessment of PA from accelerometer data may be an important component of oncological treatment to identify patients in need for PA intervention that may enhance treatment outcome.
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