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- Andersson, F, et al.
(author)
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The impact of exacerbations on the asthmatic patient's preference scores
- 2003
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In: Journal of Asthma. - 0277-0903. ; 40:6, s. 615-623
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Journal article (peer-reviewed)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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- Buckley, Patrick G, et al.
(author)
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A full-coverage, high-resolution human chromosome 22 genomic microarrayfor clinical and research applications
- 2002
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In: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 11:25, s. 3221-3229
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Journal article (peer-reviewed)abstract
- We have constructed the first comprehensive microarray representing a human chromosome for analysis of DNA copy number variation. This chromosome 22 array covers 34.7 Mb, representing 1.1% of the genome, with an average resolution of 75 kb. To demonstrate the utility of the array, we have applied it to profile acral melanoma, dermatofibrosarcoma, DiGeorge syndrome and neurofibromatosis 2. We accurately diagnosed homozygous/heterozygous deletions, amplifications/gains, IGLV/IGLC locus instability, and breakpoints of an imbalanced translocation. We further identified the 14-3-3 eta isoform as a candidate tumor suppressor in glioblastoma. Two significant methodological advances in array construction were also developed and validated. These include a strictly sequence defined, repeat-free, and non-redundant strategy for array preparation. This approach allows an increase in array resolution and analysis of any locus; disregarding common repeats, genomic clone availability and sequence redundancy. In addition, we report that the application of phi29 DNA polymerase is advantageous in microarray preparation. A broad spectrum of issues in medical research and diagnostics can be approached using the array. This well annotated and gene-rich autosome contains numerous uncharacterized disease genes. It is therefore crucial to associate these genes to specific 22q-related conditions and this array will be instrumental towards this goal. Furthermore, comprehensive epigenetic profiling of 22q-located genes and high-resolution analysis of replication timing across the entire chromosome can be studied using our array.
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- Gunnlaugsson, Adalsteinn, et al.
(author)
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A prospective phase II study of prostate-specific antigen-guided salvage radiotherapy and Ga-68-PSMA-PET for biochemical relapse after radical prostatectomy-The PROPER 1 trial
- 2022
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In: Clinical and Translational Radiation Oncology. - : Elsevier BV. - 2405-6308. ; 36, s. 77-82
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Journal article (peer-reviewed)abstract
- Background and purpose: The treatment of biochemical recurrence (BCR) after prostatectomy is challenging as the site of the recurrence is often undetectable. Our aim was to test a personalised treatment concept for BCR based on PSA kinetics during salvage radiotherapy (SRT) combined with prostate-specific membrane antigen positron emission tomography (PSMA-PET). Materials and methods: This phase II trial included 100 patients with BCR. PSMA-PET was performed at baseline. PSA was measured weekly during SRT. Initially, 70 Gy in 35 fractions was prescribed to the prostate bed. Radiotherapy was adapted after 50 Gy. Non-responders (PSA still >= 0.15 ng/mL) received sequential lymph node irradiation with a boost to PSMA-PET positive lesions, while responders (PSA < 0.15 ng/mL) continued SRT as planned. PET-findings were only taken into consideration for treatment planning in case of PSA non-response after 50 Gy. Results: Data from 97 patients were eligible for analysis. Thirty-four patients were classified as responders and 63 as non-responders. PSMA-PET was positive in 3 patients (9%) in the responder group and in 22 (35%) in the non-responder group (p = 0.007). The three-year failure-free survival was 94% for responders and 68% for non-responders (median follow-up 38 months). There were no significant differences in physician-reported urinary and bowel toxicity. Patient-reported diarrhoea at end of SRT was more common among non-responders. Conclusion: This new personalised treatment concept with intensified SRT based on PSA response demonstrated a high tumour control rate in both responders and non-responders. These results suggest a clinically significant effect with moderate side effects in a patient group with otherwise poor prognosis. PSMA-PET added limited value. The treatment approach is now being evaluated in a phase III trial.
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- Karlsson, Reine, et al.
(author)
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Flervetenskaplig ljusforskning
- 2011
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Reports (pop. science, debate, etc.)abstract
- Den här skriften handlar om ljus och ljusets betydelse för oss människor. Tolv forskare med vitt skilda bakgrunder samlas och diskuterar frågor som skrider över gränserna. Vad är ljus egentligen? Hur kan vi förstå ljus? Hur påverkar det oss? På vilket sätt kan vi använda oss av det? Vilka tekniska möjligheter har vi att skapa och styra olika sorters ljus? Vilka möjligheter ger det oss inför framtiden? I centrum för dialogen står samarbete och nytänkande. Här ges en inblick i perspektiv på ljus från områden som biologi, teknik, material, fysik, estetik, filosofi, medicin och psykologi, vilka sammantaget, på ett åskådligt och lättbegripligt sätt, presenterar den flervetenskapliga ljusrelaterade kompetensen i Lund. Gruppen av experter hoppas att de frågor som ställs och de svar som ges i den här skriften ska inspirera och leda vidare inom fältet ljusforskning. Tillsammans med Pufendorfinstitutet, genom vilket expertgruppens initiativ getts möjlighet att växa och utvecklas, vill de med andra ord att sätta ljuset på...just ”ljuset”!
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- Sirzen, F, et al.
(author)
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A systematic overview of radiation therapy effects in non-small cell lung cancer
- 2003
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In: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 42:5-6, s. 493-515
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Research review (peer-reviewed)abstract
- A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately (Acta Oncol 2003; 42: 357-365). This synthesis of the literature on radiation therapy for non-small cell lung cancer (NSCLC) is based on data from 4 meta-analyses and 31 randomized trials. Moreover, data from 12 prospective studies, 12 retrospective studies and 6 other articles were used. In toal, 65 scientific articles are included, involving 18310 patients. The results were compared with those of a similar overview from 1996 including 28 172 patients. The conclusions reached can be summarized as follows: Extensive clinical experience indicates that radiotherapy for medically inoperable patients or patients refusing surgery with NSCLC stage I/II prolongs survival, 15-20% of these patients reaching long-term (5-year) survival. However, no randomized trials have addressed this issue. There is strong evidence that postoperative radiotherapy in radically resected stage I/II NSCLC does not prolong survival compared with observation alone. There is some evidence that continuous hyperfractionated accelerated radiotherapy (CHART) is associated with increased survival compared to conventional radiotherapy in locally advanced NSCLC and also in medically unfit patients with stage I/II NSCLC. However. the benefit is limited to squamous cell histology. There is strong evidence that combined modality treatment with platinum-based chemotherapy and radiotherapy, either neoadjuvant or concomitant, is superior to radiotherapy alone in terms of survival in locally advanced unresectable NSCLC and should be the standard of care in patients with good performance status. There is some evidence that concomitant chemo-radiotherapy is associated with increased survival compared with sequential chemoradiotherapy, albeit at the price of increased toxicity. Comment: Combined chemo-radiotherapy of primary non-resectable stage III NSCLC followed by surgery in responders lacks evidence from prospective randomized trials and cannot be recommended for routine use. There is strong evidence that radiotherapy can palliate symptoms associated with the intrathoracic tumour burden. There is some evidence that two large fractions may be as effective as conventional schedules consisting of 10-13 smaller fractions in terms of palliation of symptoms. There is some evidence that endobronchial brachytherapy for palliation of symptoms associated with endobronchial tumours is not superior to external beam radiotherapy.
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- Ståhl, Anna, et al.
(author)
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Physiotherapy to prevent hospital-acquired pneumonia in patients undergoing hip fracture surgery
- 2020
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In: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 56:Suppl. 64
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Journal article (other academic/artistic)abstract
- Introduction: Hospital-acquired pneumonia may affect hospitalized patients and results in increased morbidity and mortality. Preventive actions to reduce the incidence are required, especially in patients at a higher risk of postoperative complications, such as the elderly.Purpose: To explore whether an intensified physiotherapy regimen can prevent hospital-acquired pneumonia and reduce hospital length of stay in patients aged 80 and older who have undergone hip fracture surgery.Method: Inclusion criteria were patients aged 80 or older who had undergone hip fracture surgery at a University Hospital in Sweden (n=69). The study has a quasi-experimental design with a historical comparison group (n=64) receiving routine physiotherapy treatment. The intervention group received intensified physiotherapy which included breathing exercises with positive expiratory pressure (PEP) valve. The patients were instructed to take a deep breath, hold their breath for two seconds and then exhale through the valve three sessions of 10 deep breaths, with 30–60 seconds of rest, at least four times daily. Early mobilization to a seated position and walking was advised as soon as possible after surgery.Results: There was a significant difference in number of hospital-acquired pneumonia between the intervention group; 2 patients (3%) and the comparison group; 13 patients (20%) (p=0.002). Patients in the intervention group had a significantly shorter length of stay than those in the comparison group (10.6 ± 4 vs 13.4 ± 9 days, p=0.022).Conclusion: Intensified physiotherapy treatment after hip fracture surgery may be of benefit to reduce the number of hospital-acquired pneumonia in patients over 80 years.
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