| 1. |
- Apelqvist, G, et al.
(author)
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Dynamic and kinetic effects of chronic citalopram treatment in experimental hepatic encephalopathy
- 2000
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In: Clinical neuropharmacology. - : Ovid Technologies (Wolters Kluwer Health). - 0362-5664 .- 1537-162X. ; 23:6, s. 304-317
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Journal article (peer-reviewed)abstract
- Chronic hepatic encephalopathy (HE) is a neuropsychiatric syndrome that arises in liver-impaired subjects. Patients with HE display various neuropsychiatric symptoms including affective disturbances and may therefore likely receive treatment with novel thymoleptics like citalopram (CIT). The simultaneous pharmacokinetic and pharmacodynamic outcome of the commonly used serotonin-selective thymoleptic drugs in liver-impaired subjects with pending chronic HE is far from understood today. We therefore investigated the effects of chronic, body-weight-adjusted (10 mg ╖ kg-1 ╖ day-1), treatment with CIT in rats with and without portacaval shunts (PCS). Open-field activity was monitored. The 5-HT, 5-HIAA, noradrenaline (NA), and dopamine (DA) output were assessed in the frontal neocortex. The racemic levels of CIT and its metabolites DCIT and DDCIT, including the S- and R-enantiomers, were determined in serum, brain parenchyma, and extracellular fluid. The rats with PCS showed higher (2-3-fold) levels of CIT than rats undergoing a sham treatment with CIT in all compartments investigated. The PCS rats also showed elevated levels of DCIT and DDCIT. No major differences in the S/R ratios between PCS rats and control rats could be detected. The CIT treatment resulted in neocortical output differences between PCS rats and control rats mainly within the 5-HT and DA systems but not within the NA system. For the 5-HT system, this change was further evidenced by outspoken elevation in 5-HT output after KCl-depolarizing challenges. Moreover, the CIT treatment to PCS rats was shown to "normalize" the metabolic turnover of 5-HT, measured as a profound lowering of a basal elevation in the 5-HIAA levels. The CIT treatment resulted in an increased or "normalized" behavioral activity in the PCS group. Therefore, a dose-equal chronic treatment with CIT in PCS rats produced pharmacokinetic and pharmacodynamic changes not observed in control rats. The results further support the contention of an altered 5-HT neurotransmission prevailing in the chronic HE condition. However, the tentatively beneficial behavioral response also seen following chronic CIT treatment to PCS rats in this study has to be viewed in relation to both the pharmacokinetic and pharmacodynamic changes observed.
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| 2. |
- Bjordal, Kristin, et al.
(author)
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A prospective study of quality of life in head and neck cancer patients. Part II: Longitudinal data
- 2001
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In: Laryngoscope. - 1531-4995. ; 111:8, s. 1440-1452
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To evaluate the health-related quality of life (HRQL) of patients with head and neck cancer during and after treatment with radiotherapy, surgery, and chemotherapy. STUDY DESIGN: Prospective, descriptive study. METHODS: All new patients in four institutions in Norway and Sweden were asked to participate. Health-related quality of life was assessed at baseline and at 1, 2, 3, 6, and 12 months after start of treatment by means of the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC head and neck cancer-specific questionnaire. Baseline results are described elsewhere; longitudinal results are presented in the current article. Three hundred fifty-seven patients with cancer in the oral cavity, pharynx, larynx, nose, sinuses, and salivary glands and neck node metastases from unknown primaries filled in the questionnaires at baseline. RESULTS: Seventy-eight percent of the patients who were alive after 12 months filled in all questionnaires (218/280). The general trend was that HRQL deteriorated significantly during treatment, followed by a slow recovery until the 12-month follow-up with few exceptions (senses, dry mouth, and sexuality). Patients who later died reported worse HRQL at each assessment point compared with patients who filled in all six questionnaires, whereas those who dropped out of the study for other reasons were quite similar to patients who filled in all questionnaires. The patients with pharyngeal cancer in general reported worse HRQL compared with the other groups and did not reach pretreatment values in several domains. Stage was also an important factor for HRQL in patients with head and neck cancer. CONCLUSION: Detailed knowledge about the differences between groups and changes over time may aid us in the communication with patients and in the design of intervention studies focusing on improvement of the support and rehabilitation of patients with head and neck cancer.
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| 3. |
- Hammerlid, Eva, 1957, et al.
(author)
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A prospective study of quality of life in head and neck cancer patients. Part I: At diagnosis
- 2001
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In: Laryngoscope. - : Wiley. - 0023-852X. ; 111:4 Pt 1, s. 669-680
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Journal article (peer-reviewed)abstract
- Purpose: A Swedish and Norwegian study was designed to examine health-related quality of life (HQL) in patients with head and neck cancer (head and neck) at diagnosis and during treatment and rehabilitation. The overall aim was to examine the impact on HQL at diagnosis depending on tumor location, stage, sex, and age (part I) and to describe HQL longitudinally and determine for which patients and during which period HQL deteriorated most (part II), This article presents the results at diagnosis. Method Patients with head and neck cancer at five hospitals in Sweden and Norway were consecutively requested to participate, They were asked to answer the EORTC QLQ-C30 and QLQ-H&N35 (the European Organization for Research and Treatment of Cancer, Core 30 questionnaire and head and neck cancer module) repeatedly during I year. A total of 357 patients (mean age, 63 y; 72% males) were included, Results: Patients with different tumor locations all had their special problems at diagnosis, for example, those with tumors in the larynx with communication, those with oral tumors with pain, and those with pharyngeal tumors with nutrition and pain. The patients with hypopharyngeal cancer reported the worst HQL. Stage appeared to have the strongest impact on HQL. Patients with a more advanced tumor stage reported significantly worse HQL scores for 24 of 32 variables reflecting functioning or problems. The females scored worse than the males for some areas, in particular, emotional functioning. The older patients scored significantly better for emotional and social functioning than patients <65 years but worse for physical functioning and various symptoms. The traditional way of grouping the tumor locations into oral, pharyngeal, laryngeal, and "other" tumors (salivary gland, sinus and nose, and unknown primary) was tested from a HQL point of view and found to be consistent. Conclusions: The chosen questionnaires differentiated between different sites of head and neck cancer at diagnosis. Tumor stage had the most powerful impact on HQL score.
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| 4. |
- Prochazka, J, et al.
(author)
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Inter- and intraindividual pharmacokinetic variations of mirtazapine and its N-demethyl metabolite in patients treated for major depressive disorder - A 6-month therapeutic drug monitoring study
- 2005
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In: Therapeutic Drug Monitoring. - 0163-4356. ; 27:4, s. 469-477
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Journal article (peer-reviewed)abstract
- Mirtazapine pharmacokinctic (PK) data from patients on long-term treatment for major depression have never been investigated. For this reason, in a large naturalistic outpatient study (prospective, multicenter, open-labeled, and noncomparative) conducted in Sweden in the period 2000 2002, one of the main objectives was to outline the inter- as well as intraindividual PK variance of mirtazapine and demethylmirtazapine serum concentrations in a patient cohort treated up to 6 (optionally 12) months. A total of 192 male and female outpatients aged 18 years or older were included. Serum samples of mir-tazapine and demethylmirtazapine were collected, by the means of therapeutic drug monitoring, at weeks 1, 4, 8, and 24 (52). Altogether 683 serum samples were analyzed. A pronounced interindividual variability of mirtazapine and demethylmirtazapine, and the demethylmirtazapine/mirtazapine ratio was seen. The coefficient of variation was about 38%, 33%, and 36%, respectively. The intraindividual variation over time was low, about 20% on all variables. At the population level, no accumulation of mirtazapine, demethylmirtazapine, or change of the demethylmirtazapine/mirtazapine ratio was observed over time. Women had significantly higher dose-corrected concentrations of mirtazapine and demethylmirtazapine and demethylmirtazapine/mirtazapine ratio than men. Patients above 65 years of age had higher concentrations than their younger counterparts. Among patients with adverse events, lower demethylmirtazapine concentrations were observed than in patients with no adverse events. Patients on multiple drug treatment had higher dose-corrected mirtazapine and demethylmirtazapine serum concentrations than patients taking only mirtazapine. Weight and BMI had a significant negative correlation with demethylmirtazapine concentrations and with the demethylmirtazapine/mirtazapine ratio. Continued efforts are warranted to perform PK studies in a natural clinical setting to team and understand inter- and intraindividual PK variances in real patients treated for longer periods of time. For mirtazapine as well as for most antidepressant drugs only relatively short term PK is available. To help clinicians improve their treatment of patients with major depressive disorder, the possible implications on the PK with a long-term treatment are important to study.
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| 6. |
- Rothenberg, Elisabet, 1960-, et al.
(author)
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Alcohol and dietary intake among 70-year-olds : Results from the Gothenburg H70 birth cohort studies
- 2018
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In: Abstracts of the 40th ESPEN Congress, Madrid, Spain, 1-4 September 2018. - Madrid.
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Conference paper (peer-reviewed)abstract
- ESPEN 2018 Abstract Submission Topic: Nutritional epidemiology Abstract Submission Identifier: ESPEN18-ABS-1511 ALCOHOL AND DIETARY INTAKE AMONG 70-YEAR-OLDS – RESULTS FROM THE GOTHENBURG H70 BIRTH COHORT STUDIES J. Samuelsson*, 1, A. Zettergren 1, E. Rothenberg 2, F. Ahlner 1, I. Skoog 1 1Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, 2Food and Meal Science, Kristianstad University, Kristianstad, Sweden Rationale: A higher intake of alcohol has been associated with a lower quality of diet. There are indications that alcohol consumption is increasing in older adults, but studies examining the relation between alcohol and dietary patterns in older adults are limited. We aim to investigate the relation between diet quality and alcohol intake in two samples of 70-year-olds examined 2000-02 and 2014-16. Methods: Data was derived from the Gothenburg H70 Birth Cohort Studies and the Population Study of Women in Gothenburg, Sweden. A total of 1415 individuals participated in the dietary examinations (56% women). Alcohol and dietary intake was determined by the diet history method, estimating total food intake during the preceding three months. Determinants of a high quality diet and values of high and low alcohol intake were based on the Nordic Nutrition Recommendations 2012. Relations between alcohol consumption and dietary intake were investigated, within each birth cohort stratified by sex, using linear regressions adjusted for energy and BMI. Results: Alcohol intake has increased (p=< 0, 05), 15% of the women and 21% of the men had a higher alcohol intake in the 2000-02 examination and 33% of the women and 32% of the men had a higher intake in the 2014- 16 examination. There were less dietary intake differences in women within both birth cohorts, but the results indicate that men and women with a higher intake of alcohol had a higher intake of energy and fish/shellfish, but a lower intake of carbohydrates, fibre, fruits and vegetables, sweets and snacks (p=<0,05). Conclusions: Preliminary results support the notion that alcohol intake in older adults has increased, but results do not indicate that dietary intake overall is of lower quality in those with a higher intake of alcohol. Further analyses will be conducted and longitudinal data will be added. Disclosure of Interest: None Declared Keywords: alcohol, dietary pattern
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| 7. |
- Rothenberg, Elisabet, et al.
(author)
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Alcohol and dietary intake among 70-year-olds : Results from the Gothenburg H70 birth cohort studies
- 2018
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In: Clinical Nutrition. - : Elsevier BV. - 0261-5614.
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Conference paper (other academic/artistic)abstract
- ESPEN 2018 Abstract Submission Topic: Nutritional epidemiology Abstract Submission Identifier: ESPEN18-ABS-1511 ALCOHOL AND DIETARY INTAKE AMONG 70-YEAR-OLDS – RESULTS FROM THE GOTHENBURG H70 BIRTH COHORT STUDIES J. Samuelsson*, 1, A. Zettergren 1, E. Rothenberg 2, F. Ahlner 1, I. Skoog 1 1Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, 2Food and Meal Science, Kristianstad University, Kristianstad, Sweden Rationale: A higher intake of alcohol has been associated with a lower quality of diet. There are indications that alcohol consumption is increasing in older adults, but studies examining the relation between alcohol and dietary patterns in older adults are limited. We aim to investigate the relation between diet quality and alcohol intake in two samples of 70-year-olds examined 2000-02 and 2014-16. Methods: Data was derived from the Gothenburg H70 Birth Cohort Studies and the Population Study of Women in Gothenburg, Sweden. A total of 1415 individuals participated in the dietary examinations (56% women). Alcohol and dietary intake was determined by the diet history method, estimating total food intake during the preceding three months. Determinants of a high quality diet and values of high and low alcohol intake were based on the Nordic Nutrition Recommendations 2012. Relations between alcohol consumption and dietary intake were investigated, within each birth cohort stratified by sex, using linear regressions adjusted for energy and BMI. Results: Alcohol intake has increased (p=< 0, 05), 15% of the women and 21% of the men had a higher alcohol intake in the 2000-02 examination and 33% of the women and 32% of the men had a higher intake in the 2014- 16 examination. There were less dietary intake differences in women within both birth cohorts, but the results indicate that men and women with a higher intake of alcohol had a higher intake of energy and fish/shellfish, but a lower intake of carbohydrates, fibre, fruits and vegetables, sweets and snacks (p=<0,05). Conclusions: Preliminary results support the notion that alcohol intake in older adults has increased, but results do not indicate that dietary intake overall is of lower quality in those with a higher intake of alcohol. Further analyses will be conducted and longitudinal data will be added. Disclosure of Interest: None Declared Keywords: alcohol, dietary pattern
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| 10. |
- Bjordal, K, et al.
(author)
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- 1999
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In: Journal of Clinical Oncology. - 1527-7755. ; 17:3, s. 1008-1019
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Journal article (peer-reviewed)abstract
- PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and sensitivity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-H&N35, a questionnaire designed to assess the quality of life of head and neck (H&N) cancer patients in conjunction with the general cancer-specific EORTC QLQ-C30. PATIENTS AND METHODS: Questionnaires were given to 500 H&N cancer patients from Norway, Sweden, and the Netherlands as part of two prospective studies. The patients completed the questionnaires before, during (Norway and Sweden only), and after treatment, yielding a total of 2070 completed questionnaires. RESULTS: The compliance rate was high, and the questionnaires were well accepted by the patients. Seven scales were constructed (pain, swallowing, senses, speech, social eating, social contact, sexuality). Scales and single items were sensitive to differences between patient subgroups with relation to site, stage, or performance status. Most scales and single items were sensitive to changes, with differences of various magnitudes according to the site in question. The internal consistency, as assessed by Cronbach's alpha coefficient, varied according to assessment point and within subsamples of patients. A low overall alpha value was found for the speech and the senses scales, but values were higher in assessments of patients with laryngeal cancer and in patients with nose, sinus, and salivary gland tumors. Scales and single items in the QLQ-H&N35 seem to be more sensitive to differences between groups and changes over time than do the scales and single items in the core questionnaire. CONCLUSION: The QLQ-H&N35, in conjunction with the QLQ-C30, provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&N cancer patients before, during, and after treatment with radiotherapy, surgery, or chemotherapy.
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