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  • 401.
    Ustun, Celalettin
    et al.
    Rush Univ, Div Hematol Oncol Cell Therapy, Chicago, IL 60612 USA.
    Kim, Soyoung
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Inst Hlth & Equ, Div Biostat, Milwaukee, WI 53226 USA.
    Chen, Min
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Beitinjaneh, Amer M.
    Univ Miami, Dept Hematol, Miami, FL USA.
    Brown, Valerie, I
    Penn State Hershey Childrens Hosp & Coll Med, Div Pediat Oncol Hematol, Dept Pediat, Hershey, PA USA.
    Dahi, Parastoo B.
    Mem Sloan Kettering Canc Ctr, Dept Med, Adult Bone Marrow Transplant Serv, 1275 York Ave, New York, NY 10021 USA.
    Daly, Andrew
    Tom Baker Canc Clin, Calgary, AB, Canada.
    Diaz, Miguel Angel
    Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain.
    Freytes, Cesar O.
    Texas Transplant Inst, San Antonio, TX USA.
    Ganguly, Siddhartha
    Univ Kansas Hlth Syst, Div Hematol Malignancy & Cellular Therapeut, Kansas City, KS USA.
    Hashmi, Shahrukh
    Mayo Clin, Dept Internal Med, Rochester, MN USA;King Faisal Specialist Hosp & Res Ctr, Oncol Ctr, Riyadh, Saudi Arabia.
    Hildebrandt, Gerhard C.
    Univ Kentucky, Markey Canc Ctr, Lexington, KY USA.
    Lazarus, Hillard M.
    Case Western Reserve Univ, Dept Med, Stem Cell Transplant Program, Univ Hosp Cleveland,Div Hematol & Oncol, Cleveland, OH 44106 USA.
    Nishihori, Taiga
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA.
    Olsson, Richard
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Stockholm, Sweden.
    Page, Kristin M.
    Duke Univ, Med Ctr, Div Pediat Blood & Marrow Transplantat, Durham, NC USA.
    Papanicolaou, Genovefa
    Mem Sloan Kettering Canc Ctr, Infect Dis Serv, New York, NY 10021 USA.
    Saad, Ayman
    Ohio State Univ, Div Hematol, Columbus, OH 43210 USA.
    Seo, Sachiko
    Dokkyo Med Univ, Dept Haematol & Oncol, Mibu, Tochigi, Japan.
    William, Basem M.
    Ohio State Univ, Div Hematol, Columbus, OH 43210 USA.
    Wingard, John R.
    Univ Florida, Dept Med, Div Hematol & Oncol, Gainesville, FL USA.
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA.
    Yared, Jean A.
    Univ Maryland, Blood & Marrow Transplantat Program, Div Hematol Oncol, Dept Med,Greenebaum Comprehens Canc Ctr, Baltimore, MD 21201 USA.
    Perales, Miguel-Angel
    Mem Sloan Kettering Canc Ctr, Dept Med, Adult Bone Marrow Transplant Serv, 1275 York Ave, New York, NY 10021 USA.
    Auletta, Jeffery J.
    Nationwide Childrens Hosp, Blood & Marrow Transplant Program, Columbus, OH USA;Nationwide Childrens Hosp, Host Def Program, Div Hematol Oncol & Blood Marrow & Transplant, Columbus, OH USA;Nationwide Childrens Hosp, Div Infect Dis, Columbus, OH USA.
    Komanduri, Krishna, V
    Univ Miami, Dept Hematol, Miami, FL USA.
    Lindemans, Caroline A.
    Univ Utrecht, Univ Med Ctr Utrecht, Pediat Blood & Marrow Transplantat Program, Utrecht, Netherlands;Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands.
    Riches, Marcie L.
    Univ North Carolina Chapel Hill, Div Hematol Oncol, Chapel Hill, NC USA.
    Increased overall and bacterial infections following myeloablative allogeneic HCT for patients with AML in CR12019Ingår i: BLOOD ADVANCES, ISSN 2473-9529, Vol. 3, nr 17, s. 2525-2536Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Presumably, reduced-intensity/nonmyeloablative conditioning (RIC/NMA) for allogeneic hematopoietic cell transplantation (alloHCT) results in reduced infections compared with myeloablative conditioning (MAC) regimens; however, published evidence is limited. In this Center for International Blood and Marrow Transplant Research study, 1755 patients (aged >= 40 years) with acute myeloid leukemia in first complete remission were evaluated for infections occurring within 100 days after T-cell replete alloHCT. Patients receiving RIC/NMA (n = 777) compared with those receiving MAC (n = 978) were older and underwent transplantation more recently; however, the groups were similar regarding Karnofsky performance score, HCT-comorbidity index, and cytogenetic risk. One or more infections occurred in 1045 (59.5%) patients (MAC, 595 [61%]; RIC/NMA, 450 [58%]; P = .21) by day 100. The median time to initial infection after MAC conditioning occurred earlier (MAC, 15 days [range, <1-99 days]; RIC/NMA, 21 days [range, <1-100 days]; P < .001). Patients receiving MAC were more likely to experience at least 1 bacterial infection by day 100 (MAC, 46% [95% confidence interval (CI), 43-49]; RIC/NMA, 37% [95% CI, 34-41]; P = .0004), whereas at least a single viral infection was more prevalent in the RIC/NMA cohort (MAC, 34% [95% CI, 31-37]; RIC/NMA, 39% [95% CI, 36-42]; P = .046). MAC remained a risk factor for bacterial infections in multivariable analysis (relative risk, 1.44; 95% CI, 1.23-1.67; P < .0001). Moreover, the rate of any infection per patient-days at risk in the first 100 days (infection density) after alloHCT was greater for the MAC cohort (1.21; 95% CI, 1.11-1.32; P < .0001). RIC/NMA was associated with reduced infections, especially bacterial infections, in the first 100 days after alloHCT.

  • 402.
    Uy, G. L.
    et al.
    Washington Univ, Sch Med, Dept Med, St Louis, MO 63110 USA..
    Costa, L. J.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Hari, P. N.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Zhang, M-J
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
    Huang, J-X
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Anderson, K. C.
    Dana Farber Canc Inst, Hematol Oncol Treatment Ctr, Boston, MA 02115 USA..
    Bredeson, C. N.
    Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada.;Ottawa Hosp, Res Inst, Ottawa, ON, Canada..
    Callander, N. S.
    Univ Wisconsin, Carbone Canc Ctr, Madison, WI USA..
    Cornell, R. F.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Perez, M. A. D.
    Univ Nino Jesus, Serv Oncohematol, Hosp Infantil, Madrid, Spain..
    Dispenzieri, A.
    Mayo Clin, Dept Hematol, Rochester, MN USA..
    Freytes, C. O.
    South Texas Vet Hlth Care Syst, San Antonio, TX USA.;Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA..
    Gale, R. P.
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Garfall, A.
    Univ Penn, Abramson Canc Ctr, Perelman Ctr Adv Med, Div Hematol Oncol, Philadelphia, PA 19104 USA..
    Gertz, M. A.
    Mayo Clin, Dept Hematol, Rochester, MN USA..
    Gibson, J.
    Royal Prince Alfred Hosp, Dept Haematol, Inst Haematol, Camperdown, NSW 2050, Australia..
    Hamadani, M.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Lazarus, H. M.
    Univ Hosp, Seidman Canc Ctr, Case Med Ctr, Cleveland, OH USA..
    Kalaycio, M. E.
    Cleveland Clin, Hematol Oncol & Blood Disorders, Cleveland, OH 44106 USA..
    Kamble, R. T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Dept Hematol & Oncol, Houston, TX 77030 USA..
    Kharfan-Dabaja, M. A.
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
    Krishnan, A. Y.
    City Hope Natl Med Ctr, Dept Hematol Oncol, Duarte, CA 91010 USA..
    Kumar, S. K.
    Mayo Clin, Dept Hematol, Rochester, MN USA..
    Kyle, R. A.
    Mayo Clin, Dept Hematol, Rochester, MN USA..
    Landau, H. J.
    Mem Sloan Kettering Canc Ctr, Bone Marrow Transplant Serv, New York, NY 10021 USA..
    Lee, C. H.
    Royal Adelaide Hosp, SA Pathol, Haematol & Bone Marrow Transplant Unit, Adelaide, SA 5000, Australia..
    Maiolino, A.
    Univ Fed Rio de Janeiro, Hosp Univ Clementinio Fraga Filho, Rio De Janeiro, Brazil..
    Marks, D. I.
    Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England..
    Mark, T. M.
    New York Presbyterian Hosp Cornell, Dept Med, New York, NY USA..
    Munker, R.
    Louisiana State Univ Hlth Shreveport, Dept Internal Med, Hematol Oncol Sect, Shreveport, LA USA..
    Nishihori, T.
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
    Olsson, R. F.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Ramanathan, M.
    UMass Mem Med Ctr, Dept Med, Div Hematol Oncol, Worcester, MA USA..
    Rodriguez, T. E.
    Loyola Univ, Med Ctr, Bone Marrow Transplant Program, Chicago, IL 60611 USA..
    Saad, A. A.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Savani, B. N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Schiller, G. J.
    Univ Calif Los Angeles, Ctr Hlth Sci, Bone Marrow Transplant Program, Los Angeles, CA 90024 USA..
    Schouten, H. C.
    Acad Ziekenhuis, Dept Hematol, Maastricht, Netherlands..
    Schriber, J. R.
    Virginia G Piper Canc Ctr, Canc Transplant Inst, Scottsdale, AZ USA.;Arizona Oncol, Scottsdale, AZ USA..
    Scott, E.
    Oregon Hlth & Sci Univ, Ctr Hematol Malignancies, Portland, OR 97201 USA..
    Seo, S.
    Fred Hutchinson Canc Res Ctr, Dept Vaccine & Infect Dis, Seattle, WA 98104 USA..
    Sharma, M.
    Thomas Jefferson Univ, Dept Hematol Oncol, Philadelphia, PA 19107 USA..
    Ganguly, S.
    Univ Kansas, Med Ctr, Div Hematol & Oncol, Blood & Marrow Transplantat, Kansas City, KS 66103 USA..
    Stadtmauer, E. A.
    Univ Penn, Abramson Canc Ctr, Perelman Ctr Adv Med, Div Hematol Oncol, Philadelphia, PA 19104 USA..
    Tay, J.
    Univ Ottawa, Dept Med, Ottawa, ON, Canada..
    To, L. B.
    Royal Adelaide Hosp, SA Pathol, Haematol & Bone Marrow Transplant Unit, Adelaide, SA 5000, Australia..
    Vesole, D. H.
    Hackensack Univ, Med Ctr, Hackensack, NJ USA..
    Vogl, D. T.
    Univ Penn, Abramson Canc Ctr, Perelman Ctr Adv Med, Div Hematol Oncol, Philadelphia, PA 19104 USA..
    Wagner, J. L.
    Thomas Jefferson Univ, Dept Hematol Oncol, Philadelphia, PA 19107 USA..
    Wirk, B.
    Seattle Canc Care Alliance, Seattle, WA USA..
    Wood, W. A.
    Univ N Carolina, Dept Med, Div Hematol Oncol, Chapel Hill, NC USA..
    D'Souza, A.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation2015Ingår i: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 50, nr 12, s. 1513-1518Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In patients with multiple myeloma (MM) undergoing autologous hematopoietic cell transplantation (auto-HCT), peripheral blood progenitor cells may be collected following mobilization with growth factor alone (GF) or cytotoxic chemotherapy plus GF (CC+GF). It is uncertain whether the method of mobilization affects post-transplant outcomes. We compared these mobilization strategies in a retrospective analysis of 968 patients with MM from the Center for International Blood and Marrow Transplant Research database who received an auto-Ha in the US and Canada between 2007 and 2012. The kinetics of neutrophil engraftment (>= 0.5 x 10(9)/L) was similar between groups (13 vs 13 days, P=0.69) while platelet engraftment (>= 20 x 10(9)/L) was slightly faster with CC+GF (19 vs 18 days, P=0.006). Adjusted 3-year PFS was 43% (95% confidence interval (CI) 38-48) in GF and 40% (95% CI 35-45) in CC+GF, P=0.33. Adjusted 3-year OS was 82% (95% CI 78-86) vs 80% (95% CI 75-84), P=0.43 and adjusted 5-year OS was 62% (95% CI 54-68) vs 60% (95% CI 52-67), P=0.76, for GF and CC+GF, respectively. We conclude that MM patients undergoing auto-Ha have similar outcomes irrespective of the method of mobilization and found no evidence that the addition of chemotherapy to mobilization contributes to disease control.

  • 403.
    Vahlberg, Birgit
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Holmbäck, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Eriksson, Staffan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Cederholm, Tommy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Protocol and pilot study of a short message service-guided training after acute stroke/transient ischemic attack to increase walking capacity and physical activity2018Ingår i: Preventive medicine reports, ISSN 2211-3355, Vol. 11, s. 109-114Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Physical activity in community-living individuals after a stroke is usually scarce. This protocol describes a study that will evaluate a method to increase physical activity by performing a 3-month outdoor walking and muscle strengthening program and will examine the 3-month and 1-year effects of this program on individuals with acute stroke (AS) or transient ischemic attack (TIA). In a prospective randomized controlled trial in Uppsala, Sweden, 80 individuals with AS or TIA who maintained cognitive and motor function will be randomized into groups for continuous training for three months or for regular standard care. The training will be supervised by daily cellphone-delivered messages (short message services; SMS), and the intensity, duration and workload will be gradually increased. The primary outcome is a change in walking capacity according to the 6-Minute Walk Test and chair-rising at three months. Secondary outcomes include mobility, gait speed, handgrip strength, body composition (fat mass and muscle mass), biochemical risk-markers, health-related quality of life, and cardiovascular events. Adherence to the training program will be documented with a self-reported diary and step counts over two weeks. The major study started in November 2016, and results are expected in 2019. In a pilot study of 15 subjects post-stroke (mean-age 65 years), we observed improved walking capacity (increasing from 23 to 255 m) and chair-rising (decreasing 2.42 s) from baseline to three months. SMS-guided outdoor training will be tested as a potential therapeutic strategy to increase physical activity and thereby improve walking capacity and physical function following a stroke.

  • 404.
    Valachis, Antonis
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Garmo, Hans
    Kings Coll London, Sch Med, Div Canc Studies, Canc Epidemiol Unit, London, England..
    Weinman, John
    Kings Coll London, Inst Pharmaceut Sci, London SE1 9NH, England..
    Fredriksson, Irma
    Karolinska Inst, Karolinska Univ Hosp, Dept Mol Med & Surg, Stockholm, Sweden..
    Ahlgren, Johan
    Univ Orebro, Fac Med & Hlth, Dept Oncol, Orebro, Sweden..
    Sund, Malin
    Umea Univ, Dept Surg & Perioperat Sci, S-90185 Umea, Sweden..
    Holmberg, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Endokrinkirurgi. Kings Coll London, Sch Med, Div Canc Studies, Canc Epidemiol Unit, London, England..
    Effect of selective serotonin reuptake inhibitors use on endocrine therapy adherence and breast cancer mortality: a population-based study2016Ingår i: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 159, nr 2, s. 293-303Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the study was to investigate whether the concomitant use of selective serotonin reuptake inhibitors (SSRI) with tamoxifen influences the risk of death due to breast cancer, and we also investigated the association between SSRI use and adherence to oral endocrine therapy (ET). We analyzed data from BCBaSe Sweden, which is a database created by the data linkage of Registries from three different regions of Sweden. To investigate the association between ET adherence and SSRI use, we included all women who were diagnosed with non-distant metastatic ER-positive invasive breast cancer from July 2007 to July 2011 and had at least one dispensed prescription of oral tamoxifen or aromatase inhibitor. To investigate the role of concurrent administration of SSRI and tamoxifen on breast cancer prognosis, we performed a nested case-control study. In the adherence cohort, 9104 women were included in the analyses. Women who received SSRI, either before or after breast cancer diagnosis, were at higher risk for low adherence to ET. However, when the overlapping period between SSRI use and ET was > 50 %, no excess risk for low adherence was observed. Non-adherence (< 80 %) to ET was significantly associated with worse breast cancer survival (OR 4.07; 95 % CI 3.27-5.06). In the case-control study, 445 cases and 11125 controls were included. The concomitant administration of SSRI and tamoxifen did not influence breast cancer survival, neither in short-term (OR 1.41; 95 % CI 0.74-2.68) nor in long-term SSRI users (OR 0.85; 95 % CI 0.35-2.08). Concomitant SSRI and tamoxifen use does not seem to increase risk for death due to breast cancer. Given the positive association between continuing antidepressive pharmacotherapy for a longer period of time and adherence to ET, it is essential to capture and treat depression in breast cancer patients to secure adherence to ET.

  • 405.
    Valachis, Antonis
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Mamounas, Eleftherios P.
    Univ Florida, Hlth Canc Ctr Orlando Hlth, Comprehens Breast Program, Orlando, FL USA.
    Mittendorf, Elizabeth A.
    Univ Texas MD Anderson Canc Ctr, Dept Breast Surg Oncol, Houston, TX 77030 USA.
    Hayashi, Naoki
    St Lukes Int Hosp, Dept Breast Surg, Tokyo, Japan.
    Ishitobi, Makoto
    Osaka Int Canc Inst, Dept Breast Surg, Osaka, Japan;Osaka Int Canc Inst, Dept Endocrine Surg, Osaka, Japan.
    Natoli, Clara
    Univ G DAnnunzio, Dept Oral Med & Biotechnol Sci, Chieti, Italy.
    Fitzal, Florian
    Med Univ Vienna, Dept Surg, Breast Hlth Ctr, Vienna, Austria.
    Rubio, Isabel T.
    Univ Hosp VAll dHebron, Breast Canc Ctr, Breast Surg Oncol, Barcelona, Spain.
    Tiezzi, Daniel G.
    Univ Sao Paulo, Ribeirao Preto Med Sch, Breast Dis Div, Dept Gynecol & Obstet, Sao Paulo, Brazil.
    Shin, Hee-Chul
    Chung Ang Univ Hosp, Dept Surg, Seoul, South Korea.
    Anderson, Stewart J.
    Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Natl Surg Adjuvant Breast & Bowel Project,Biostat, Pittsburgh, PA 15261 USA.
    Hunt, Kelly K.
    Univ Texas MD Anderson Canc Ctr, Dept Breast Surg Oncol, Houston, TX 77030 USA.
    Matsuda, Naoko
    St Lukes Int Hosp, Dept Breast Surg, Tokyo, Japan.
    Ohsumi, Shozo
    NHO Shikoku Canc Ctr, Dept Breast Oncol, Matsuyama, Ehime, Japan.
    Totomi, Athina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Nilsson, Cecilia
    Vastmanlands Cty Hosp, Ctr Clin Res, Vasteras, Sweden.
    Risk factors for locoregional disease recurrence after breast‐conserving therapy in patients with breast cancer treated with neoadjuvant chemotherapy: An international collaboration and individual patient meta‐analysis2018Ingår i: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 124, nr 14, s. 2923-2930Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Several studies have reported a high risk of local disease recurrence (LR) and locoregional disease recurrence (LRR) in patients with breast cancer after neoadjuvant chemotherapy (NCT) and breast-conserving therapy (BCT). The objective of the current study was to identify potential risk factors for LR and LRR after NCT and BCT. METHODS: Individual patient data sets from 9 studies were pooled. The outcomes of interest were the occurrence of LR and/or LRR. A 1-stage meta-analytic approach was used. Cox proportional hazards regression models were applied to identify factors that were predictive of LR and LRR, respectively. RESULTS: A total of 9 studies (4125 patients) provided their data sets. The 10-year LR rate was 6.5%, whereas the 10-year LRR rate was 10.3%. Four factors were found to be associated with a higher risk of LR: 1) estrogen receptor-negative disease; 2) cN+disease; 3) a lack of pathologic complete response in axilla (pN0); and 4) pN2 to pN3 disease. The predictive score for LR determined 3 risk groups: a low-risk, intermediate-risk, and high-risk group with 10-year LR rates of 4.0%, 7.9%, and 20.4%, respectively. Two additional factors were found to be associated with an increased risk of LRR: cT3 to cT4 disease and a lack of pathologic complete response in the breast. The predictive score for LRR determined 3 risk groups; a low-risk, intermediate-risk, and high-risk group with 10-year LRR rates of 3.2%, 10.1%, and 24.1%, respectively. CONCLUSIONS: BCT after NCT appears to be an oncologically safe procedure for a large percentage of patients with breast cancer. Two easy-to-use clinical scores were developed that can help clinicians to identify patients at higher risk of LR and LRR after NCT and BCT and individualize the postoperative treatment plan and follow-up.

  • 406.
    Valachis, Antonis
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Samonis, George
    Kofteridi, Diamantis R.
    The Role of Aerosolized Colistin in the Treatment of Ventilator-Associated Pneumonia: A Systematic Review and Metaanalysis2015Ingår i: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 43, nr 3, s. 527-533Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The present meta-analysis and systematic review evaluated the efficacy and safety of aerosolized colistin as adjunctive therapy to IV antimicrobials or as monotherapy in the treatment of ventilator-associated pneumonia. Design: The databases of MEDLINE and Cochrane Library up to June 2013 and all reference lists of the included studies and relevant reviews were searched. Studies were eligible if the efficacy and safety of aerosolized colistin in the treatment of ventilator-associated pneumonia was evaluated. An overall effect estimate for all dichotomous data as an odds ratio with 95% CI was calculated by the Mantel-Haenszel or the DerSimonian and Laird method depending on the statistical heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to interpret the findings. Interventions: None. Measurements and Main Results: Sixteen studies fulfilled the inclusion criteria: eight were comparing adjunctive aerosolized versus IV colistin (seven observational cohort or case-control studies and one randomized trial) and were meta-analyzed, and eight were single arm and were only systematically reviewed. The Grading of Recommendations Assessment, Development, and Evaluation approach showed limitations of the study design and presence of inconsistency in most of the outcomes, but no obvious indirectness or imprecision of results reporting. Based on the above assessments, the quality of evidence presented for each outcome ranged from "very low" to "low:" A significant improvement in clinical response (odds ratio, 1.57; 95% CI, 1.14-2.15; p = 0.006; = 37%), microbiological eradication (odds ratio, 1.61; 95% CI, 1.11-2.35; p = 0.01; I-2= 0%), and infection-related mortality (odds ratio, 0.58; 95% CI, 0.34-0.96; p = 0.04; I-2 = 46%) was observed with the addition of aerosolized colistin to IV treatment, whereas the addition of aerosolized colistin did not affect overall mortality (odds ratio, 0.74; 95% CI, 0.54-1.01; p = 0.06; I-2 = 25%) or nephrotoxicity (odds ratio, 1.18; 95% CI, 0.76-1.83; p= 0.45; I-2= 0%). Conclusion: Based on the present results and awaiting further evidence from randomized trials, aerosolized colistin is associated with improved outcome in the treatment of ventilator-associated pneumonia although the level of evidence was low.

  • 407.
    Valachis, Antonis
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Ullenhag, Gustav
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi.
    Discrepancy in BRAF status among patients with metastatic malignant melanoma: A meta-analysis2017Ingår i: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 81, s. 106-115Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The incidence of malignant melanoma is growing rapidly. Approximately half of the cases are BRAF mutated, making treatment with kinase inhibitors a (MEK and BRAF inhibitors) preferred choice in the advanced setting. The vast majority of these patients will benefit from the treatment. It is therefore of vital importance that the BRAF analysis is reliable and reflects the true nature of the tumour. Intraindividual tumour BRAF heterogeneity may exist, and changes of BRAF status over time might occur. We reviewed the literature by searching the PubMed database and 630 potentially relevant studies were identified. Thereafter, studies that investigated intralesional heterogeneity only, studies with <= 10 patients and studies that did not include adequate data to calculate discrepancy rates were excluded. Twenty-two studies met our inclusion criteria and were included in the meta-analysis. The pooled discrepancy rate between primary and metastatic lesions was 13.4% (95% confidence interval [CI]: 9.2-18.2%) while it was 7.3% (95% CI: 3.3-12.6) between two metastatic lesions. The number of patients whose tumoural BRAF status was changed from mutation to wild type and from wild type to mutation, respectively, was comparable. We conclude that a clinically meaningful discrepancy rate in BRAF status both between primary-metastatic and metastatic-metastatic melanoma lesions exists. Our results support the polyclonal model of melanomas in which subclones with different BRAF status co-exist in the same melanoma lesion. In addition, the results indicate a need for biopsy of a metastatic lesion for subsequent BRAF analysis when treatment with kinase inhibitors is considered.

  • 408.
    Valdimarsdottir, Ragnheidur
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Valgeirsdóttir, Heiddis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.
    Wikström, Anna-Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.
    Kallak, Theodora Kunovac
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Elenis, Evangelia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Axelsson, Ove
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Ubhayasekera, Kumari
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för kemi - BMC, Analytisk kemi.
    Bergquist, Jonas
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för kemi - BMC, Analytisk kemi.
    Piltonen, Terhi T
    Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit Oulu, Finland.
    Pigny, Pascal
    Laboratoire de Biochimie & Hormonologie, Centre de Biologie Pathologie, Centre Hospitalier Régional Universitaire, CHU de Lille, Lille, France;Jean-Pierre Aubert Research Center (JPArc), Laboratory of Development and Plasticity of the Neuroendocrine Brain, Inserm, UMR-S 1172 Lille, France.
    Giacobini, Paolo
    Jean-Pierre Aubert Research Center (JPArc), Laboratory of Development and Plasticity of the Neuroendocrine Brain, Inserm, UMR-S 1172 Lille, France;University of Lille, FHU 1,000 Days for Health, School of Medicine Lille, France.
    Sundström Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Pregnancy and neonatal complications in women with polycystic ovary syndrome in relation to second-trimester anti-Müllerian hormone levels2019Ingår i: Reproductive Biomedicine Online, ISSN 1472-6483, E-ISSN 1472-6491, Vol. 39, nr 1, s. 141-148Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    RESEARCH QUESTION: An association has been found between high anti-Müllerian hormone (AMH) levels during pregnancy and the development of polycystic ovary syndrome (PCOS)-like phenotypic traits in mouse offspring. The aim of this study was to determine whether AMH levels are associated with maternal testosterone levels, and whether high AMH concentration influences the risk of developing PCOS-related adverse pregnancy outcomes.

    DESIGN: Maternal serum AMH, testosterone and sex hormone binding globulin levels were measured in blood samples taken in early second-trimester pregnancies from women with PCOS (n = 159) and healthy controls matched for body mass index (n = 320). Possible associations with preeclampsia, gestational hypertension, gestational diabetes, preterm birth and birthweight was explored by logistic and linear regression models.

    RESULTS: Women with PCOS had higher AMH, higher total testosterone levels and higher free androgen index than controls (P < 0.001 for all three parameters). Among women with PCOS, high testosterone levels (B = 2.7; β = 0.26; P = 0.001) and low first trimester body mass index (B = -0.5; β = -0.17; P = 0.043) remained independently associated with AMH. High AMH levels were associated with decreased risk of gestational hypertension (adjusted OR 0.55; 95% CI 0.34 to 0.87), but no association was found with other adverse pregnancy outcomes or birthweight.

    CONCLUSIONS: Women with PCOS had higher AMH levels during pregnancy compared with controls, but high AMH was not associated with increased risk of adverse pregnancy outcomes or birthweight.

  • 409. van Schaarenburg, Rosanne A.
    et al.
    Schejbel, Lone
    Truedsson, Lennart
    Topaloglu, Rezan
    Al-Mayouf, Sulaiman M.
    Riordan, Andrew
    Simon, Anna
    Kallel-Sellami, Maryam
    Arkwright, Peter D.
    Ahlin, Anders
    Hagelberg, Stefan
    Nielsen, Susan
    Shayesteh, Alexander
    Morales, Adelaida
    Tam, Schuman
    Genel, Ferah
    Berg, Stefan
    Ketel, Arnoldus G.
    van den Berg, J. Merlijn
    Kuijpers, Taco W.
    Olsson, Richard F.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Huizinga, Tom W. J.
    Lankester, Arjan C.
    Trouw, Leendert A.
    Marked variability in clinical presentation and outcome of patients with C1q immunodeficiency2015Ingår i: Journal of Autoimmunity, ISSN 0896-8411, E-ISSN 1095-9157, Vol. 62, s. 39-44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Globally approximately 60 cases of C1q deficiency have been described with a high prevalence of Systemic Lupus Erythematosus (SLE). So far treatment has been guided by the clinical presentation rather than the underlying C1q deficiency. Recently, it was shown that C1q production can be restored by allogeneic hematopoietic stem cell transplantation. Current literature lacks information on disease progression and quality of life of C1q deficient persons which is of major importance to guide clinicians taking care of patients with this rare disease. Methods: We performed an international survey, of clinicians treating C1q deficient patients. A high response rate of >70% of the contacted clinicians yielded information on 45 patients with C1q deficiency of which 25 are published. Results: Follow-up data of 45 patients from 31 families was obtained for a median of 11 years after diagnosis. Of these patients 36 (80%) suffer from SLE, of which 16 suffer from SLE and infections, 5 (11%) suffer from infections only and 4(9%) have no symptoms. In total 9 (20%) of the C1q deficient individuals had died. All except for one died before the age of 20 years. Estimated survival times suggest 20% case-fatality before the age of 20, and at least 50% of patients are expected to reach their middle ages. Conclusion: Here we report the largest phenotypic data set on C1q deficiency to date, revealing high variance; with high mortality but also a subset of patients with an excellent prognosis. Management of C1q deficiency requires a personalized approach.

  • 410. Venkatesan, Meera
    et al.
    Gadalla, Nahla B
    Stepniewska, Kasia
    Dahal, Prabin
    Nsanzabana, Christian
    Moriera, Clarissa
    Price, Ric N
    Mårtensson, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Rosenthal, Philip J
    Dorsey, Grant
    Sutherland, Colin J
    Guérin, Philippe
    Davis, Timothy M E
    Ménard, Didier
    Adam, Ishag
    Ademowo, George
    Arze, Cesar
    Baliraine, Frederick N
    Berens-Riha, Nicole
    Björkman, Anders
    Borrmann, Steffen
    Checchi, Francesco
    Desai, Meghna
    Dhorda, Mehul
    Djimdé, Abdoulaye A
    El-Sayed, Badria B
    Eshetu, Teferi
    Eyase, Frederick
    Falade, Catherine
    Faucher, Jean-François
    Fröberg, Gabrielle
    Grivoyannis, Anastasia
    Hamour, Sally
    Houzé, Sandrine
    Johnson, Jacob
    Kamugisha, Erasmus
    Kariuki, Simon
    Kiechel, Jean-René
    Kironde, Fred
    Kofoed, Poul-Erik
    LeBras, Jacques
    Malmberg, Maja
    Mwai, Leah
    Ngasala, Billy
    Nosten, Francois
    Nsobya, Samuel L
    Nzila, Alexis
    Oguike, Mary
    Otienoburu, Sabina Dahlström
    Ogutu, Bernhards
    Ouédraogo, Jean-Bosco
    Piola, Patrice
    Rombo, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Schramm, Birgit
    Somé, A Fabrice
    Thwing, Julie
    Ursing, Johan
    Wong, Rina P M
    Zeynudin, Ahmed
    Zongo, Issaka
    Plowe, Christopher V
    Sibley, Carol Hopkins
    Polymorphisms in Plasmodium falciparum chloroquine resistance transporter and multidrug resistance 1 genes: parasite risk factors that affect treatment outcomes for P. falciparum malaria after artemether-lumefantrine and artesunate-amodiaquine.2014Ingår i: The American journal of tropical medicine and hygiene, ISSN 1476-1645, Vol. 91, nr 4, s. 833-43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Adequate clinical and parasitologic cure by artemisinin combination therapies relies on the artemisinin component and the partner drug. Polymorphisms in the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance 1 (pfmdr1) genes are associated with decreased sensitivity to amodiaquine and lumefantrine, but effects of these polymorphisms on therapeutic responses to artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) have not been clearly defined. Individual patient data from 31 clinical trials were harmonized and pooled by using standardized methods from the WorldWide Antimalarial Resistance Network. Data for more than 7,000 patients were analyzed to assess relationships between parasite polymorphisms in pfcrt and pfmdr1 and clinically relevant outcomes after treatment with AL or ASAQ. Presence of the pfmdr1 gene N86 (adjusted hazards ratio = 4.74, 95% confidence interval = 2.29 - 9.78, P < 0.001) and increased pfmdr1 copy number (adjusted hazards ratio = 6.52, 95% confidence interval = 2.36-17.97, P < 0.001 : were significant independent risk factors for recrudescence in patients treated with AL. AL and ASAQ exerted opposing selective effects on single-nucleotide polymorphisms in pfcrt and pfmdr1. Monitoring selection and responding to emerging signs of drug resistance are critical tools for preserving efficacy of artemisinin combination therapies; determination of the prevalence of at least pfcrt K76T and pfmdr1 N86Y should now be routine.

  • 411.
    von Celsing, Anna-Sophia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Wallman, Thorne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Predicting return to work among sickness-certified patients in general practice: Properties of two assessment tools2014Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 119, nr 3, s. 268-277Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract Aim. The purpose was to analyse the properties of two models for the assessment of return to work after sickness certification, a manual one based on clinical judgement including non-measurable information ('gut feeling'), and a computer-based one. Study population. All subjects aged 18 to 63 years, sickness-certified at a primary health care centre in Sweden during 8 months (n = 943), and followed up for 3 years. Methods. Baseline information included age, sex, occupational status, sickness certification diagnosis, full-time or part-time current sick-leave, and sick-leave days during the past year. Follow-up information included first and last day of each occurring sick spell. In the manual model all subjects were classified, based on baseline information and gut feeling, into a high-risk (n = 447) or a low-risk group (n = 496) regarding not returning to work when the present certificate expired. It was evaluated with a Cox's analysis, including time and return to work as dependent variables and risk group assignment as the independent variable, while in the computer-based model the baseline variables were entered as independent variables. Results. Concordance between actual return to work and return to work predicted by the analysis model was 73%-76% during the first 28-180 days in the manual model, and approximately 10% units higher in the computer-based model. Based on the latter, three nomograms were constructed providing detailed information on the probability of return to work. Conclusion. The computer-based model had a higher precision and gave more detailed information than the manual model.

  • 412.
    von Dobeln, Gabriella Alexandersson
    et al.
    Karolinska Inst, Dept Oncol & Pathol, Stockholm, Sweden..
    Nilsson, Magnus
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Adell, Gunnar
    Linkoping Univ, Dept Oncol, Linkoping, Sweden.;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden..
    Johnsen, Gjermund
    Univ Trondheim Hosp, St Olavs Hosp, Dept Gastrointestinal Surg, Trondheim, Norway..
    Hatlevoll, Ingunn
    Univ Trondheim Hosp, St Olavs Hosp, Dept Oncol, Trondheim, Norway..
    Tsai, Jon
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Lundell, Lars
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Lund, Mikael
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Lind, Pehr
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Oncol & Pathol, Stockholm, Sweden..
    Pulmonary function and cardiac stress test after multimodality treatment of esophageal cancer2016Ingår i: Practical Radiation Oncology, ISSN 1879-8500, E-ISSN 1879-8519, Vol. 6, nr 3, s. E53-E59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Curative treatment of esophageal cancer is accompanied by frequent and sometimes severe side effects. However, prospectively collected data on side effects are scarce. The aim of this study was to evaluate if pulmonary function and exercise capacity were affected in the acute setting after neoadjuvant treatment and if there were long-lasting effects after neoadjuvant treatment and surgery. We also aimed to investigate whether the addition of radiation therapy to chemotherapy would aggravate side effects. Methods and materials: A cohort of 97 patients enrolled in the randomized NeoRes trial was used for the present analysis. The patients had been randomized to receive 3 cycles of cisplatin and fluorouracil with or without concurrent radiation therapy to 40 Gy. A cardiac stress test on a stationary bicycle and a spirometry were performed before and after neoadjuvant treatment and 1 to 2 years later after surgery provided that the cancer had not recurred. Results: We found impairment in pulmonary function measured as vital capacity and forced expiratory volume in 1 second and a decrease in exercise capacity after neoadjuvant treatment and 1 to 2 years later after surgery. We did not detect any differences between patients treated with chemoradiation therapy and those treated with chemotherapy alone. Conclusions: Multimodality treatment of esophageal cancer caused short-term and lasting impairments in pulmonary function and exercise capacity. The reductions were not aggravated by the addition of radiation therapy to neoadjuvant chemotherapy.

  • 413. von Holst, S
    et al.
    Picelli, S
    Edler, D
    Lenander, C
    Dalén, J
    Hjern, F
    Lundqvist, N
    Lindforss, U
    Påhlman, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Kolorektalkirurgi.
    Smedh, K
    Törnqvist, A
    Holm, J
    Janson, M
    Andersson, M
    Ekelund, S
    Olsson, L
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Ghazi, S
    Papadogiannakis, N
    Tenesa, A
    Farrington, S M
    Campbell, H
    Dunlop, M G
    Lindblom, A
    Association studies on 11 published colorectal cancer risk loci2010Ingår i: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 103, nr 4, s. 575-580Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Recently, several genome-wide association studies (GWAS) have independently found numerous loci at which common single-nucleotide polymorphisms (SNPs) modestly influence the risk of developing colorectal cancer. The aim of this study was to test 11 loci, reported to be associated with an increased or decreased risk of colorectal cancer: 8q23.3 (rs16892766), 8q24.21 (rs6983267), 9p24 (rs719725), 10p14 (rs10795668), 11q23.1 (rs3802842), 14q22.2 (rs4444235), 15q13.3 (rs4779584), 16q22.1 (rs9929218), 18q21.1 (rs4939827), 19q13.1 (rs10411210) and 20p12.3 (rs961253), in a Swedish-based cohort. METHODS: The cohort was composed of 1786 cases and 1749 controls that were genotyped and analysed statistically. Genotype-phenotype analysis, for all 11 SNPs and sex, age of onset, family history of CRC and tumour location, was performed. RESULTS: Of eleven loci, 5 showed statistically significant odds ratios similar to previously published findings: 8q23.3, 8q24.21, 10p14, 15q13.3 and 18q21.1. The remaining loci 11q23.1, 16q22.1, 19q13.1 and 20p12.3 showed weak trends but somehow similar to what was previously published. The loci 9p24 and 14q22.2 could not be confirmed. We show a higher number of risk alleles in affected individuals compared to controls. Four statistically significant genotype-phenotype associations were found; the G allele of rs6983267 was associated to older age, the G allele of rs1075668 was associated with a younger age and sporadic cases, and the T allele of rs10411210 was associated with younger age. CONCLUSIONS: Our study, using a Swedish population, supports most genetic variants published in GWAS. More studies are needed to validate the genotype-phenotype correlations.

  • 414.
    Vrooman, Lynda M.
    et al.
    Dana Farber Boston Childrens Canc & Blood Disorde, Dept Pediat, 450 Brookline Ave, Boston, MA 02215 USA.
    Millard, Heather R.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Brazauskas, Ruta
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA.
    Majhail, Navneet S.
    Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA.
    Battiwalla, Minoo
    NHLBI, Hematol Branch, Bethesda, MD 20892 USA.
    Flowers, Mary E.
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA.
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Div Hematol Oncol, Dept Med, Nashville, TN 37235 USA.
    Akpek, Gorgun
    Rush Univ, Med Ctr, Dept Internal Med, Stem Cell Transplantat & Cell Therapy, Chicago, IL 60612 USA.
    Aljurf, Mahmoud
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia.
    Bajwa, Rajinder
    Nationwide Childrens Hosp, Div Hematol Oncol BMT, Columbus, OH USA.
    Baker, K. Scott
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA.
    Beitinjaneh, Amer
    Univ Miami, Div Hematol & Oncol, Miami, FL USA.
    Bitan, Menachem
    Tel Aviv Sourasky Med Ctr, Dept Pediat Hematol Oncol, Tel Aviv, Israel.
    Buchbinder, David
    Childrens Hosp Orange Cty, Div Hematol, Orange, CA 92668 USA.
    Chow, Eric
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA.
    Dandoy, Christopher
    Cincinnati Childrens Hosp Med Ctr, Div Bone Marrow Transplant & Immune Deficiency, Cincinnati, OH 45229 USA.
    Dietz, Andrew C.
    Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol Oncol, Blood & Marrow Transplantat, Los Angeles, CA USA.
    Diller, Lisa
    Dana Farber Boston Childrens Canc & Blood Disorde, Dept Pediat, 450 Brookline Ave, Boston, MA 02215 USA.
    Gale, Robert Peter
    Imperial Coll London, Hematol Res Ctr, Dept Med, Div Expt Med, London, England.
    Hashmi, Shahrukh K.
    Mayo Clin, Div Hematol, Dept Internal Med, Rochester, MN USA.
    Hayashi, Roberti
    Washington Univ, Sch Med, Div Pediat Hematol Oncol, Dept Pediat, St Louis, MO USA.
    Hematti, Peiman
    Univ Wisconsin Hosp & Clin, Div Hematol Oncol Bone Marrow Transplantat, Dept Med, Madison, WI 53792 USA.
    Kamble, Rammurti T. f
    Baylor Coll Med, Div Hematol & Oncol, Ctr Cell & Gene Therapy, Houston, TX 77030 USA.
    Kasow, Kimberly A.
    Univ North Carolina Chapel Hill, Div Hematol Oncol, Dept Pediat, Chapel Hill, NC USA.
    Kletzel, Morris
    Ann & Robert H Lurie Childrens Hosp Chicago, Div Hematol Oncol & Stem Cell Transplant, Dept Pediat, Chicago, IL 60611 USA.
    Lazarus, Hillard M.
    Univ Hosp Cleveland, Med Ctr, Div Hematol & Oncol, Seidman Canc Ctr, Cleveland, OH 44106 USA.
    Malone, Adriana K.
    Icahn Sch Med Mt Sinai, Div Hematol Oncol, Tisch Canc Inst, New York, NY 10029 USA.
    Marks, David I.
    Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England.
    O'Brien, Tracey A.
    Sydney Childrens Hosp, Kids Canc Ctr, Blood & Marrow Transplant Program, Sydney, NSW, Australia.
    Olsson, Richard
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden.
    Ringden, Olle
    Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden.
    Seo, Sachiko
    East Hosp, Natl Canc Res Ctr, Kashiwa, Chiba, Japan.
    Steinberg, Amir
    Icahn Sch Med Mt Sinai, Div Hematol Oncol, Tisch Canc Inst, New York, NY 10029 USA.
    Yu, Lolie C.
    Louisiana State Univ, Childrens Hosp, Med Ctr, Div Hematol Oncol,Ctr Canc & Blood Disorders, New Orleans, LA USA.
    Warwick, Anne
    Uniformed Serv Univ Hlth Sci, Dept Pediat, Bethesda, MD 20814 USA.
    Shaw, Bronwen
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Duncan, Christine
    Dana Farber Boston Childrens Canc & Blood Disorde, Dept Pediat, 450 Brookline Ave, Boston, MA 02215 USA.
    Survival and Late Effects after Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancy at Less than Three Years of Age2017Ingår i: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 23, nr 8, s. 1327-1334Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Very young children undergoing hematopoietic cell transplantation (HCT) are a unique and vulnerable population. We analyzed outcomes of 717 patients from 117 centers who survived relapse free for year after allogeneic myeloablative HCT for hematologic malignancy at <3 years of age, between 1987 and 2012. The median follow-up was 8.3 years (range, 1.0 to 26.4 years); median age at follow-up was 9 years (range, 2 to 29 years). Ten-year overall and relapse-free survival were 87% (95% confidence interval [CI], 85% to 90%) and 84% (95% CI, 81% to 87%). Ten-year cumulative incidence of relapse was 11% (95% CI, 9% to 13%). Of 84 deaths, relapse was the leading cause (43%). Chronic graft-versus-host-disease 1 year after HCT was associated with increased risk of mortality (hazard ratio [HR], 2.1; 95% CI, 1.3 to 3.3; P=.0018). Thirty percent of patients experienced >= 1 organ toxicity/late effect >1 year after HCT. The most frequent late effects included growth hormone deficiency/growth disturbance (10-year cumulative incidence, 23%; 95% CI, 19% to 28%), cataracts (18%; 95% CI, 15% to 22%), hypothyroidism (13%; 95% CI, 10% to 16%), gonadal dysfunction/infertility requiring hormone replacement (3%; 95% CI, 2% to 5%), and stroke/seizure (3%; 95% CI, 2% to 5%). Subsequent malignancy was reported in 3.6%. In multivariable analysis, total body irradiation (TBI) was predictive of increased risk of cataracts (HR, 17.2; 95% CI, 7.4 to 39.8; P <.001), growth deficiency (HR, 3.5; 95% CI, 2.2 to 5.5; P <.001), and hypothyroidism (HR, 5.3; 95% CI, 3.0 to 9.4; P <.001). In summary, those who survived relapse free year after HCT for hematologic malignancy at <3 years of age had favorable overall survival. Chronic graft-versus host-disease and TBI were associated with adverse outcomes. Future efforts should focus on reducing the risk of relapse and late effects after HCT at early age.

  • 415.
    Vrooman, Lynda
    et al.
    Dana Farber Canc Inst, Boston, MA 02115 USA..
    Millard, Heather
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Brazauskas, Ruta
    Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
    Majhail, Navneet S.
    Cleveland Clin, Blood & Marrow Transplant Program, Taussig Canc Inst, Cleveland, OH 44106 USA..
    Battiwallas, Minoo
    NHLBI, Hematol Branch, NIH, Bethesda, MD 20892 USA..
    Flowers, Mary E. D.
    Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA..
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Akpek, Goerguen
    Banner MD Anderson Canc Ctr, Gilbert, AZ USA..
    Aljurf, Mahmoud D.
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia..
    Bajwa, Rajinder
    Nationwide Childrens, Bone Marrow Transplantat, Columbus, OH USA..
    Baker, K. Scott
    Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA..
    Beitinjaneh, Amer
    Univ Virginia, Sch Med, Hematol Oncol, Charlottesville, VA 22908 USA..
    Bitan, Menachem
    Tel Aviv Sourasky Med Ctr, Pediat Hematol Oncol & BMT, Tel Aviv, Israel..
    Buchbinder, David
    Childrens Hosp Orange Cty, Div Pediat Hematol, Orange, CA 92668 USA..
    Dandoy, Christopher E.
    Cincinnati Childrens Hosp Med Ctr, Bone Marrow Transplantat & Immune Deficiency, Cincinnati, OH 45229 USA..
    Gale, Robert Peter
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Hayashi, Robert J.
    Washington Univ, Sch Med, Dept Pediat, Div Pediat Hematol Oncol, St Louis, MO 63110 USA..
    Hematti, Peiman
    Univ Wisconsin Hosp & Clin, Dept Med, Div Hematol Oncol Bone Marrow Transplantat, Madison, WI 53792 USA..
    Kamble, Rammurti T.
    Baylor Coll Med, Div Hematol & Oncol, Ctr Cell & Gene Therapy, Houston, TX 77030 USA..
    Kasow, Kimberly A.
    Univ N Carolina, Div Hematol Oncol, Dept Pediat, Chapel Hill, NC USA..
    Kletzel, Morris
    Northwestern Univ, Ann & Robert H Lurie Childrens Hosp Chicago, Feinberg Sch Med, Div Hematol Oncol & Stem Cell Transplantat, Chicago, IL 60611 USA..
    Lazarus, Hillard M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Adult Hematol Malignancies & Stem Cell Transplant, Cleveland, OH USA..
    Malone, Adriana K.
    Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY 10029 USA..
    O'Brien, Tracey
    Sydney Childrens Hosp, Kids Canc Ctr, Blood & Marrow Transplant Program, Sydney, NSW, Australia..
    Olsson, Richard
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Reddy, Vijay
    Univ Cent Florida, Dept Internal Med, Gainesville, FL USA..
    Willert, Jennifer Reikes
    Univ Calif San Diego, Rady Childrens Hosp, Pediat Hematol Oncol BMT, San Diego, CA USA..
    Ringden, Olle
    Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.;Karolinska Univ Hosp, Ctr Allogene Stem Cell Transplantat, Stockholm, Sweden..
    Schears, Raquel M.
    Mayo Clin, Rochester, MN USA..
    Seo, Sachiko
    Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA..
    Steinberg, Amir
    Mt Sinai Hosp, Dept Hematol Oncol, New York, NY 10029 USA..
    Yu, Lolie C.
    Louisiana State Univ, Med Ctr, Childrens Hosp, Div Hematol Oncol, New Orleans, LA USA.;Louisiana State Univ, Med Ctr, Childrens Hosp, Ctr Canc & Blood Disorders,HSCT, New Orleans, LA USA..
    Shaw, Bronwen E.
    CIBMTR, Dept Med, Milwaukee, WI USA.;Med Coll Wisconsin, Milwaukee, WI 53226 USA..
    Duncan, Christine
    Boston Childrens Hosp, Dept Pediat Oncol, Boston, MA USA.;Dana Farber Canc Inst, Boston, MA 02115 USA..
    Survival and Late Effects of Children Undergoing Myeloablative Allogeneic HCT at Less Than Three Years of Age: A Report from the Center for International Blood and Marrow Transplant Research2016Ingår i: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 22, nr 3, s. S28-S29Artikel i tidskrift (Övrigt vetenskapligt)
  • 416.
    Wackernagel, Dirk
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Department of Pediatrics, Mälarsjukhuset Hospital, 63349 Eskilstuna, Sweden;Karolinska Institutet and University Hospital, Huddinge, 14186 Stockholm, Sweden.
    Brückner, Albrecht
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Department of Pediatrics, Mälarsjukhuset Hospital, 63349 Eskilstuna, Sweden;Department of Pediatrics, Marien-Hospital, 58452 Witten, Germany.
    Ahlsson, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Computer-aided nutrition - Effects on nutrition and growth in preterm infants < 32 weeks gestation2015Ingår i: Clinical Nutrition ESPEN, ISSN 2405-4577, Vol. 10, nr 6, s. e234-e241Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background & aims

    Preterm infants are often discharged from the NICU with suboptimal growth. The aim of our intervention study was to determine if a computer-aided nutrition calculation program could help to optimise the nutrition and secondary improve the growth of preterm infants.

    Methods

    Intake of macro- and micronutrients and anthropometric data was collected in 78 preterm infants with GA ≤32+0 from birth to postnatal week 7. The nutrition of 43 preterm infants was ordinated with help of the program Nutrium™​ (IG). Before the introduction of the program 35 consecutive preterm infants served as control group (CG). Their data were collected in retrospect.

    Results

    Amino acid, carbohydrate, fluid intake and total energy intake were statistically different at all time points. Fatty acid intake was statistically different expect for week 2 and 4. Similar differences were found for magnesium, calcium and phosphorus, zinc, copper and selenium. In contrast vitamin intake was higher in the control group.

    At birth there were no differences between the groups with respect to anthropometric data. Weight, length and head circumference (HC) SDS decreased in both groups from birth to day 28 of life (CG −1.2 SDS; −1.2 SDS; −0.8 SDS vs IG −0.9 SDS; −0.8 SDS; −0.4 SDS). The infants in the CG showed until discharge a partial catch-up but remained below birth SDS for weight and length (−0.5 SDS; −0.9 SDS). In the IG, infants reached birth values for weight and length (−0.1 SDS; 0 SDS). For HC both groups showed similar values at the time point for birth and discharge (CG +0.3 SDS vs IG +0.5 SDS).

    Conclusion

    By using a computer-aided nutrition calculation program better postnatal growth was achieved. Nutritional intake was increased in respect to nearly all micro- and macronutrients. There were no adverse effects. In contrast there was a tendency of decreased incidence of BPD, infection rate and PDA.

  • 417.
    Wackernagel, Dirk
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Institutet and University Hospital Huddinge, Stockholm, Sweden.
    Dube, Martina
    Malarsjukhuset Hosp, Dept Paediat, Eskilstuna, Sweden.
    Blennow, Mats
    Karolinska Inst, Stockholm, Sweden; Huddinge Univ Hosp, Stockholm, Sweden.
    Tindberg, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Continuous subcutaneous glucose monitoring is accurate in term and near-term infants at risk of hypoglycaemia2016Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, nr 8, s. 917-923Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: Postnatal hypoglycaemia increases the risk of adverse neurological outcomes in newborn infants, and adequate glucose control requires repetitive and painful blood sampling. This study evaluated a continuous glucose monitoring system (CGMS) that aims to improve glucose control and decrease the frequency of blood samples taken from neonates.

    METHODS: CGMS sensors, which measure glucose values every five minutes and require calibration twice a day, were placed on 20 infants at risk of hypoglycaemia. The infants also underwent blood glucose sampling, and the blood glucose values were compared with CGMS values six times during the first 30 minutes after sampling.

    RESULTS: We used 97/264 (37%) of the blood glucose values taken for the CGMS calibration. The highest accuracy, a mean of 0.22 (95% confidence interval 0.13-0.30 mmol/L), was found 15-19 minutes after sampling, due to the calibration process. No significant subcutaneous glucose time lag was detectable.

    CONCLUSION: The CGMS system was an accurate and feasible method for glucose control, provided earlier detection of hypoglycaemia in newborn infants and reduced their exposure to procedural pain. The delay in calibration in infants was a new finding and needs to be taken into account when comparing CGMS readings to blood glucose values.

  • 418.
    Wang, Eugen Y-H
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Eriksson, Hans G
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Quality of life and functional outcomes 10 years after laparoscopic radical prostatectomy2014Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 119, nr 1, s. 32-37Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background.

    Minimally invasive laparoscopic radical prostatectomy (LRP) has proven equally effective as open surgery in terms of cancer control and peroperative complication rate with less bleeding and postoperative pain. However, long-term follow-up data after LRP are scarce, especially as related to quality of life (QoL).

    Aim.

    To compare QoL and functional outcomes at least 10 years after LRP with a population-based control group matched for age and region.

    Methods.

    Follow-up data were obtained by mailed questionnaires from patients who responded anonymously to five international questionnaires (EQ-5D, QLQ-C30, QLQ-PR25, IPSS, and IIEF). We collected self-reported outcome data directly from 49 patients who underwent LRP more than 10 years ago in our centre. The results of the patients' overall QoL and urinary continence rates were compared with 918 controls matched for region and age.

    Results.

    Forty-two patients (86%) and 808 (88%) controls reported having no urinary leakage. Only 11 patients (24%) still had sexual activities 10 years after LRP, and three were without erectile dysfunction. There was no difference in four of five statements of the self-assessed QoL questionnaires between the LRP and control group. Anxiety level was higher in the LRP group (44%) than in the control group (23%).

    Conclusion.

    Patients reported high self-assessed QoL, although they also reported low sexual activity 10 years after LRP. Prevalence of urinary leakage was similar in both groups. However, anxiety was more common in LRP patients.

  • 419.
    Wickman, Magnus
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Inst Environm Med, Stockholm, Sweden; Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden.
    Lupinek, Christian
    Med Univ Vienna, Ctr Pathophysiol Infectiol & Immunol, Dept Pathophysiol & Allergy Res, Div Immunopathol, Vienna, Austria.
    Andersson, Niklas
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden; Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden.
    Belgrave, Danielle
    Imperial Coll, Dept Paediat, London, England.
    Asarnoj, Anna
    Karolinska Inst, Dept Med, Immunol & Allergy Unit, Stockholm, Sweden; Karolinska Univ Hosp, Stockholm, Sweden; Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden; Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
    Benet, Marta
    Ctr Res Environm Epidemiol CREAL, ISGlobal, Barcelona, Spain.
    Pinart, Mariona
    Ctr Res Environm Epidemiol CREAL, ISGlobal, Barcelona, Spain.
    Wieser, Sandra
    Med Univ Vienna, Ctr Pathophysiol Infectiol & Immunol, Dept Pathophysiol & Allergy Res, Div Immunopathol, Vienna, Austria.
    Garcia-Aymerich, Judith
    Ctr Res Environm Epidemiol CREAL, ISGlobal, Barcelona, Spain.
    Baar, Alexandra
    Med Univ Vienna, Ctr Pathophysiol Infectiol & Immunol, Dept Pathophysiol & Allergy Res, Div Immunopathol, Vienna, Austria.
    Pershagen, Göran
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden; Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden.
    Simpson, Angela
    Univ Manchester, Div Infect Immun & Resp Med, Fac Biol Med & Hlth, Manchester, Lancs, England.
    Kull, Inger
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden; Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden; Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden.
    Bergström, Anna
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden; Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden.
    Melén, Erik
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden; Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden; Sachs Children & Youth Hosp, Dept Paediat, Stockholm, Sweden.
    Hamsten, Carl
    Karolinska Inst, Dept Med, Immunol & Allergy Unit, Stockholm, Sweden; Karolinska Univ Hosp, Stockholm, Sweden.
    Antó, Josep M.
    Ctr Res Environm Epidemiol CREAL, ISGlobal, Barcelona, Spain; UPF, Hosp del Mar, Med Res Inst, IMIM, Barcelona, Spain; CIBERESP, Barcelona, Spain; UPF, Barcelona, Spain.
    Bousquet, Jean
    Univ Hosp, Montpellier, France; INSERM, VIMA Ageing & Chron Dis, Paris, France; U1168, Epidemiol & Publ Hlth Approaches, Paris, France; Univ Versailles St Quentin En Yvelines, UVSQ, Versailles, France.
    Custovic, Adnan
    Imperial Coll, Dept Paediat, London, England.
    Valenta, Rudolf
    Med Univ Vienna, Ctr Pathophysiol Infectiol & Immunol, Dept Pathophysiol & Allergy Res, Div Immunopathol, Vienna, Austria.
    van Hage, Marianne
    Karolinska Inst, Dept Med, Immunol & Allergy Unit, Stockholm, Sweden; Karolinska Univ Hosp, Stockholm, Sweden.
    Detection of IgE Reactivity to a Handful of Allergen Molecules in Early Childhood Predicts Respiratory Allergy in Adolescence2017Ingår i: EBioMedicine, ISSN 0360-0637, E-ISSN 2352-3964, Vol. 26, s. 91-99Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Sensitization in early childhood may precede respiratory allergy in adolescence.

    Methods: IgE reactivity against 132 allergen molecules was evaluated using the MeDALL microarray in sera obtained from a random sample of 786 children at the age of 4, 8 and 16 years in a population based birth cohort (BAMSE). Symptoms were analyzed by questionnaire at ages 4, 8 and 16 years. Clinically and independent relevant allergen molecules accounting for ≥ 90% of IgE reactivities in sensitized individuals and at all time-points were identified as risk molecules and used to predict respiratory allergy. The data was replicated in the Manchester Asthma and Allergy Study (MAAS) birth cohort by studying IgE reactivity with the use of a commercial IgE microarray. Sera were obtained from children at the ages of 3, 5, 8 and 11 years (N = 248) and the outcome was studied at 11 years.

    Findings: In the BAMSE cohort 4 risk molecules could be identified, i.e.: Ara h 1 (peanut), Bet v 1 (birch), Fel d 1 (cat), Phl p 1 (grass). For MAAS the corresponding number of molecules was 5: Der p 1 (dust mite), Der f 2 (dust mite), Phl p 1 (grass), Phl p 5 (grass), Fel d 1 (cat). In BAMSE, early IgE reactivity to ≥ 3 of 4 allergen molecules at four years predicted incident and persistent asthma and/or rhinitis at 16 years (87% and 95%, respectively). The corresponding proportions in the MAAS cohort at 16 years were 100% and 100%, respectively, for IgE reactivity to ≥ 3 of 5 risk molecules.

    Interpretations: IgE reactivity to a few allergen molecules early in life identifies children with a high risk of asthma and/or rhinitis at 16 years. These findings will be of importance for developing preventive strategies for asthma and rhinitis in children.

  • 420.
    Wilkinson, Tom M. A.
    et al.
    Univ Southampton, Southampton Gen Hosp, Clin & Expt Sci, Fac Med, Southampton, Hants, England;Southampton Gen Hosp, Southampton NIHR Resp Biomed Res Unit, Southampton, Hants, England;Univ Southampton, Southampton Gen Hosp, Wessex Invest Sci Hub, Fac Med, Southampton, Hants, England.
    Schembri, Stuart
    Univ Dundee, Scottish Ctr Resp Res, Dundee, Scotland.
    Brightling, Christopher
    Univ Leicester, Inst Lung Hlth, Dept Infect Immun & Inflammat, Leicester, Leics, England.
    Bakerly, Nawar D.
    Salford Royal NHS Fdn Trust, Salford, Lancs, England.
    Lewis, Keir
    Univ Swansea, Sch Med, Swansea, W Glam, Wales.
    MacNee, William
    Univ Edinburgh, MRC Ctr Inflammat Res, Edinburgh, Midlothian, Scotland.
    Rombo, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Hedner, Jan
    Sahlgrens Univ Hosp, Dept Internal Med, Pulm Med, Gothenburg, Sweden.
    Allen, Martin
    Univ Hosp North Midlands, Royal Stoke Hosp, Dept Resp Med, Stoke On Trent, Staffs, England.
    Walker, Paul P.
    Aintree Univ Hosp NHS Fdn Trust, Dept Resp Med, Liverpool, Merseyside, England.
    De Ryck, Iris
    GSK, Siena, Italy.
    Tasciotti, Annaelisa
    GSK, Siena, Italy.
    Casula, Daniela
    GSK, Siena, Italy.
    Moris, Philippe
    GSK, Rixensart, Belgium.
    Testa, Marco
    GSK, Siena, Italy.
    Arora, Ashwani K.
    GSK, Siena, Italy.
    Non-typeable Haemophilus influenzae protein vaccine in adults with COPD: A phase 2 clinical trial2019Ingår i: Vaccine, ISSN 0264-410X, E-ISSN 1873-2518, Vol. 37, nr 41, s. 6102-6111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Loss of airway microbial diversity is associated with non-typeable Haemophilus influenzae (NTHi) infection and increased risk of exacerbation in chronic obstructive pulmonary disease (COPD). We assessed the safety and immunogenicity of an investigational vaccine containing NTHi antigens, recombinant protein D (PD) and combined protein E and Pilin A (PE-PilA), and AS01 adjuvant in adults with moderate/-severe COPD and prior exacerbations. In this phase 2, observer-blind, controlled trial (NCT02075541), 145 COPD patients aged 40-80 years randomly (1:1) received two doses of NTHi vaccine or placebo 60 days apart, on top of standard care. Reactogenicity in the 7-day post-vaccination period was higher following NTHi vaccine than placebo. Most solicited adverse events (AEs) were mild/moderate. At least one unsolicited AE was reported during the 30-day post-vaccination period by 54.8% of NTHi vaccine and 51.4% of placebo recipients. One serious AE (placebo group) was assessed by the investigator as vaccine-related. Anti-PD, anti-PE and anti-PiIA geometric mean antibody concentrations increased up to 30 days after each NTHi vaccine dose, waned thereafter, but remained higher than baseline (non-overlapping confidence intervals) up to 13 months post-dose 2. The frequency of specific CD4(+) T cells increased following two doses of NTHi vaccine and remained higher than baseline. Exploratory analysis showed a statistically non-significant lower yearly rate of moderate/severe exacerbations in the NTHi vaccine group than following placebo (1.49 versus 1.73) in the one-year period post-dose 2, with estimated vaccine efficacy of 13.3% (95% confidence interval -24.2 to 39.5; p = 0.44). The NTHi vaccine had an acceptable safety and reactogenicity profile and good immunogenicity in adults with COPD.

  • 421.
    Wilkinson, Tom
    et al.
    Southampton Univ, Fac Med, Southampton, Hants, England.
    Schembri, Stuart
    Univ Dundee, Scottish Ctr Resp Res, Dundee, Scotland.
    Brightling, Christopher
    Univ Leicester, Inst Lung Hlth, Leicester, Leics, England.
    Bakerly, Nawar Diar
    Salford Royal NHS Fdn Trust, Salford, Lancs, England.
    Macnee, William
    Univ Edinburgh, Edinburgh, Midlothian, Scotland.
    Rombo, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Hedner, Jan
    Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Allen, Martin
    Univ Hosp North Midlands NHS Trust, Stoke On Trent, Staffs, England.
    Walker, Paul
    Aintree Univ Hosp NHS Fdn Trust, Liverpool, Merseyside, England.
    De Ryck, Iris
    GSK, Siena, Italy.
    Tasciotti, Annaelisa
    GSK, Siena, Italy.
    Casula, Daniela
    GSK, Siena, Italy.
    Testa, Marco
    GSK, Siena, Italy.
    Arora, Ashwani Kumar
    GSK, Siena, Italy.
    Late Breaking Abstract - Safety and immunogenicity of non-typeable H. influenzae (NTHi) adjuvanted vaccine in older adults with chronic obstructive pulmonary disease (COPD)2018Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Artikel i tidskrift (Övrigt vetenskapligt)
  • 422.
    Wleklik, Marta
    et al.
    Wroclaw Med Univ, Dept Clin Nursing, Wroclaw, Poland.
    Lisiak, Magdalena
    Wroclaw Med Univ, Dept Clin Nursing, Wroclaw, Poland.
    Andreae, Christina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Uchmanowicz, Izabella
    Wroclaw Med Univ, Dept Clin Nursing, Wroclaw, Poland.
    Psychometric Evaluation Of Appetite Questionnaires In Elderly Polish Patients With Heart Failure2019Ingår i: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 13, s. 1751-1759Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Loss of appetite is caused by multifaceted disorders and affects an average of 40% of patients with heart failure (HF). The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are designed to assess appetite among older adults. We aimed to assess the psychometric properties of both CNAQ and SNAQ questionnaires in elderly Polish patients with HF.

    Methods: The study sample involved 103 patients aged >= 65 years with HF diagnosed according to the New York Heart Association (NYHA) functional classes II-IV. The study was conducted among hospitalized patients with HF. In the study, the Mini Nutritional Assessment (MNA) questionnaire was used to assess the validity of the questionnaire. The evaluation of the following psychometric values was taken into account: data quality and homogeneity, factor structure, construct validity and internal consistency.

    Results: Parallel analysis confirmed the unidimensional structure of both CNAQ and SNAQ. The adjusted eigenvalues for CNAQ were 3.50 for the first factor and 0.62 for the second factor, and for SNAQ they were 2.2 and 0.31, respectively. For CNAQ, the desired CFA values were obtained after modification (RMSEA <0.06, CFI, TLI> 0.95), for SNAQ without modification (RMSEA <0.06, CFI, TLI> 0.95). The correlation between CNAQ and SNAQ and MNA was strong (rs = 0.8 and rs = 0.81, p <0.001, respectively). The internal consistency of the CNAQ and SNAQ tools was 0.88 and 0.86, respectively.

    Conclusion: The CNAQ and SNAQ questionnaires have positive psychometric properties and can be used to evaluate appetite among elderly Polish patients with HF.

  • 423.
    Wood, William A.
    et al.
    Univ N Carolina, Div Hematol Oncol, Dept Med, Chapel Hill, NC 27515 USA.
    Brazauskas, Ruta
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA.
    Hu, Zhen-Huan
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Abdel-Azim, Hisham
    Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Keck Sch Med, Los Angeles, CA USA.
    Ahmed, Ibrahim A.
    Childrens Mercy Hosp & Clin, Dept Hematol Oncol & Bone Marrow Transplantat, Kansas City, MO USA.
    Aljurf, Mahmoud
    King Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh, Saudi Arabia.
    Badawy, Sherif
    Ann & Robert H Lurie Childrens Hosp Chicago, Div Hematol Oncol & Stem Cell Transplantat, Chicago, IL 60611 USA.
    Beitinjaneh, Amer
    Univ Miami, Dept Hematol Oncol, Miami, FL USA.
    George, Biju
    Christian Med Coll & Hosp, Vellore, Tamil Nadu, India.
    Buchbinder, David
    Childrens Hosp Orange Cty, Div Pediat Hematol, Orange, CA 92668 USA.
    Cerny, Jan
    UMass Mem Med Ctr, Div Hematol Oncol, Worcester, MA USA.
    Dedeken, Laurence
    Hop Univ Enfants Reine Fabiola, Dept Hematol Oncol, Brussels, Belgium.
    Angel Diaz, Miguel
    Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain.
    Freytes, Cesar O.
    Texas Transplant Inst, San Antonio, TX USA.
    Ganguly, Siddhartha
    Univ Kansas, Med Ctr, Blood & Marrow Transplantat, Div Hematol & Oncol, Kansas City, KS 66103 USA.
    Gergis, Usama
    Presbyterian Hosp, Hematolg Malignancies & Bone Marrow Transplant, Dept Med Oncol, Weill Cornell Med Ctr, New York, NY USA.
    Gomez Almaguer, David
    Hosp Univ Autonoma Nuevo Leon, Monterrey, Mexico.
    Gupta, Ashish
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    Hale, Gregory
    Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL USA.
    Hashmi, Shahrukh K.
    Mayo Clin, Dept Internal Med, Rochester, MN USA;King Faisal Specialist Hosp & Res Ctr, Oncol Ctr, Riyadh, Saudi Arabia.
    Inamoto, Yoshihiro
    Natl Canc Ctr, Div Hematopoiet Stem Cell Transplantat, Tokyo, Japan.
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA.
    Adekola, Kehinde
    Northwestern Univ, Div Hematol Oncol, Dept Med, Chicago, IL 60611 USA;Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Feinberg Sch Med, Chicago, IL 60611 USA.
    Kindwall-Keller, Tamila
    Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA USA.
    Knight, Jennifer
    Med Coll Wisconsin, Dept Psychol, Milwaukee, WI 53226 USA.
    Kumar, Lalit
    All India Inst Med Sci, Inst Rotary Canc Hosp, Dept Med Oncol, New Delhi, India.
    Kuwatsuka, Yachiyo
    Nagoya Univ, Ctr Adv Med & Clin Res, Grad Sch Med, Nagoya, Aichi, Japan.
    Law, Jason
    Floating Hosp Children, Tufts Med Ctr, Dept Pediat, Boston, MA USA.
    Lazarus, Hillard M.
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    LeMaistre, Charles
    Sarah Cannon, Hematol & Bone Marrow Transplant, Nashville, TN USA.
    Olsson, Richard
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Pulsipher, Michael A.
    Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol & Blood & Marrow Transplantat, Keck Sch Med, Los Angeles, CA USA.
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA.
    Schultz, Kirk R.
    Univ British Columbia, British Columbias Childrens Hosp, Dept Pediat Hematol Oncol & Bone Marrow Transplan, Vancouver, BC, Canada.
    Saad, Ayman A.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA.
    Seftel, Matthew
    CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada.
    Seo, Sachiko
    Natl Canc Res Ctr East, Dept Hematol & Oncol, Chiba, Japan.
    Shea, Thomas C.
    Univ N Carolina, Div Hematol Oncol, Dept Med, Chapel Hill, NC 27515 USA.
    Steinberg, Amir
    Mt Sinai Hosp, Dept Hematol Oncol, New York, NY 10029 USA.
    Sullivan, Keith
    Duke Univ, Med Ctr, Durham, NC USA.
    Szwajcer, David
    CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada.
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA.
    Yared, Jean
    Univ Maryland, Dept Med, Greenebaum Canc Ctr, Blood & Marrow Transplantat Program,Div Hematol O, Baltimore, MD 21201 USA.
    Yong, Agnes
    Univ Adelaide, Royal Adelaide Hosp, SA Pathol, Adelaide, SA, Australia;Univ Adelaide, Sch Med, Adelaide, SA, Australia.
    Dalal, Jignesh
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    Hahn, Theresa
    Roswell Pk Canc Inst, Dept Med, Buffalo, NY 14263 USA.
    Khera, Nandita
    Mayo Clin, Dept Hematol Oncol, Phoenix, AZ USA.
    Bonfim, Carmem
    Hosp Clin Fed Univ Parana, Curitiba, Parana, Brazil.
    Atsuta, Yoshiko
    Nagoya Univ, Ctr Adv Med & Clin Res, Grad Sch Med, Nagoya, Aichi, Japan.
    Saber, Wael
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Country-Level Macroeconomic Indicators Predict Early Post-Allogeneic Hematopoietic Cell Transplantation Survival in Acute Lymphoblastic Leukemia: A CIBMTR Analysis2018Ingår i: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, nr 9, s. 1928-1935Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    For patients with acute lymphoblastic leukemia (ALL), allogeneic hematopoietic cell transplantation (alloHCT) offers a potential cure. Life-threatening complications can arise from alloHCT that require the application of sophisticated health care delivery. The impact of country-level economic conditions on post-transplantation outcomes is not known. Our objective was to assess whether these variables were associated with outcomes for patients transplanted for ALL. Using data from the Center for Blood and Marrow Transplant Research, we included 11,261 patients who received a first alloHCT for ALL from 303 centers across 38 countries between the years of 2005 and 2013. Cox regression models were constructed using the following macroeconomic indicators as main effects: Gross national income per capita, health expenditure per capita, and Human Development Index (HDI). The outcome was overall survival at 100 days following transplantation. In each model, transplants performed within lower resourced environments were associated with inferior overall survival. In the model with the HDI as the main effect, transplants performed in the lowest HDI quartile (n = 697) were associated with increased hazard for mortality (hazard ratio, 2.42; 95% confidence interval, 1.64 to 3.57; P < .001) in comparison with transplants performed in the countries with the highest HDI quartile. This translated into an 11% survival difference at 100 days (77% for lowest HDI quartile versus 88% for all other quartiles). Country-level macroeconomic indices were associated with lower survival at 100 days after alloHCT for ALL. The reasons for this disparity require further investigation.

  • 424. Xu, Weiping
    et al.
    Morris, Ulrika
    Aydin-Schmidt, Berit
    Msellem, Mwinyi I.
    Shakely, Deler
    Petzold, Max
    Bjorkman, Anders
    Mårtensson, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    SYBR Green Real-Time PCR-RFLP Assay Targeting the Plasmodium Cytochrome B Gene - A Highly Sensitive Molecular Tool for Malaria Parasite Detection and Species Determination2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 3, artikel-id e0120210Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A prerequisite for reliable detection of low-density Plasmodium infections in malaria pre-elimination settings is the availability of ultra-sensitive and high-throughput molecular tools. We developed a SYBR Green real-time PCR restriction fragment length polymorphism assay (cytb-qPCR) targeting the cytochrome b gene of the four major human Plasmodium species (P. falciparum, P. vivax, P. malariae, and P. ovale) for parasite detection and species determination with DNA extracted from dried blood spots collected on filter paper. The performance of cytb-qPCR was first compared against four reference PCR methods using serially diluted Plasmodium samples. The detection limit of the cytb-qPCR was 1 parasite/mu l (p/mu l) for P. falciparum and P. ovale, and 2 p/mu l for P. vivax and P. malariae, while the reference PCRs had detection limits of 0.5-10 p/mu l. The ability of the PCR methods to detect low-density Plasmodium infections was then assessed using 2977 filter paper samples collected during a cross-sectional survey in Zanzibar, a malaria pre-elimination setting in sub-Saharan Africa. Field samples were defined as 'final positive' if positive in at least two of the five PCR methods. Cytb-qPCR preformed equal to or better than the reference PCRs with a sensitivity of 100% (65/65; 95% CI 94.5-100%) and a specificity of 99.9%(2910/2912; 95% CI 99.7-100%) when compared against 'final positive' samples. The results indicate that the cytb-qPCR may represent an opportunity for improved molecular surveillance of low-density Plasmodium infections in malaria pre-elimination settings.

  • 425.
    Zander, Viktoria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Univ Hosp Solna, Dept Womens & Childrens Hlth, Karolinska Inst, S-17176 Stockholm, Sweden..
    Eriksson, Henrik
    Swedish Red Cross Univ Coll, Dept Nursing & Care, S-11428 Stockholm, Sweden..
    Christensson, Kyllike
    Karolinska Univ Hosp Solna, Dept Womens & Childrens Hlth, Karolinska Inst, S-17176 Stockholm, Sweden..
    Mullersdorf, Maria
    Malardalen Univ, Sch Hlth Care & Social Welf, S-63105 Eskilstuna, Sweden..
    Development of an Interview Guide Identifying the Rehabilitation Needs of Women from the Middle East Living with Chronic Pain2015Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 12, nr 10, s. 12043-12056Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to develop an interview guide for use by primary healthcare professionals to support them in identifying the rehabilitation needs of forced resettled women from the Middle East living with chronic pain. Previous findings together with the existing literature were used as the basis for developing the interview guide in three steps: item generation, cognitive interviews, and a pilot study. The study resulted in a 16-item interview guide focusing on patients' concerns and expectations, with consideration of pre-migration, migration, and post-migration factors that might affect their health. With the help of the guide, patients were also invited to identify difficulties in their daily activities and to take part in setting goals and planning their rehabilitation. The current interview guide provides professional guidance to caretakers, taking a person-centered participative point of departure when meeting and planning care, for and together, with representatives from dispersed ethnic populations in Sweden. It can be used together with the patient by all staff members working in primary healthcare, with the aim of contributing to continuity of care and multi-professional collaboration.

  • 426.
    Zander, Viktoria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.
    Eriksson, Henrik
    Swedish Red Cross Univ Coll, Dept Nursing & Care, Stockholm, Sweden.
    Christensson, Kyllike
    Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.
    Müllersdorf, Maria
    Sch Hlth Care & Social Welf, Eskilstuna, Vasteras, Sweden.
    Rehabilitation of Women From the Middle East Living With Chronic Pain-Perceptions From Health Care Professionals.2014Ingår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 11, s. 1194-1207Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Meeting patients from other countries constitutes a challenge for health care. The purpose of this study was to increase knowledge about tacit understandings of treatment in practice by determining the perceptions of chronic pain and rehabilitation directed to resettled women from the Middle East, from a variety of health care professionals within primary care. Based on the results, we find a need to support and increase knowledge among health care professionals to involve the patient and consider her beliefs, expectations, background, current life situation, and spirituality, and to involve family in rehabilitation.

  • 427.
    Zavos, A.
    et al.
    Senol Hellen Soc, Athens, Greece..
    Valachis, Antonis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi. Malarsjukhuset, Dept Oncol, S-63188 Eskilstuna, Sweden..
    Risk of chemotherapy-induced amenorrhea in patients with breast cancer: a systematic review and meta-analysis2016Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 55, nr 6, s. 664-670Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: The aim of the study was to calculate the rate of chemotherapy-induced amenorrhea (CIA) after treatment with different adjuvant therapies in patients with breast cancer and to evaluate the risk factors for CIA based on the quality of evidence.Patient and methods: A search of PubMed and ISI Web of Science was performed. All published trials with female breast cancer patients who received adjuvant chemotherapy and presented data on the rate of CIA were considered eligible. The pooled rates of CIA were calculated by random effects model. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each potential risk factor for CIA by using the generic inverse weighted method.Results: We identified 580 potentially relevant studies, of which 75 were included in the analysis. Among 75 eligible studies, 19 different definitions of CIA have been used. The pooled rate of CIA was 55% (95% CI 50-60%) including 23 673 patients from 74 studies. The rate of CIA was increased by age with an estimate of 26% (95% CI 12-43%), 39% (95% CI 31-58%), and 77% (95% CI 71-83%) for women<35, 35-40, and>40 years old, respectively. Two risk factors were associated with the occurrence of CIA and were supported by strong level of evidence: older age (>40 years old), and the use of tamoxifen.Conclusions: This meta-analysis summarized the updated evidence on the impact of different adjuvant treatment regimens for breast cancer in menstruation and could serve as a helpful guide for oncologists during the discussion with their patients on fertility issues before decision on adjuvant therapy is made. A uniform definition of CIA is essential in future studies to make the interpretation of results more reliable.

  • 428.
    Zewenghiel, Luwam
    et al.
    Orebro Univ, Inst Med Sci, Campus USO, S-70182 Orebro, Sweden.
    Lindman, Henrik
    Akad Univ Hosp, Dept Oncol, Uppsala, Sweden.
    Valachis, Antonis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Malarsjukhuset, Dept Oncol, Eskilstuna, Sweden.
    Impact of body mass index on the efficacy of endocrine therapy in patients with metastatic breast cancer - A retrospective two-center cohort study2018Ingår i: Breast, ISSN 0960-9776, E-ISSN 1532-3080, Vol. 40, s. 136-140Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Bakground: The aim of this study was to investigate the impact of body mass index (BMI) on the efficacy of endocrine therapy in postmenopausal women with metastatic hormone receptor breast cancer (HR+BC) as well as to identify if the potential difference in efficacy was associated with Fulvestrant only or both aromatase inhibitors (AIs) and Fulvestrant. Methods: A consecutive cohort of postmenopausal women with HR+metastatic breast cancer that have received endocrine therapy including Fulvestrant as a metastatic treatment strategy at the Departments of Oncology in Eskilstuna and Uppsala, Sweden, between 2008 and 2016 were identified. The primary outcome of the study was time to disease progression (TTP) during the treatment with Fulvestrant in overweight and obese women compared to patient with normal BMI. Results: In total, 173 patients were enrolled in the study cohort, amongst these, 141 patients received both Fulvestrant and Als and 32 received only Fulvestrant. No statistical significant association was observed between the three BMI categories and TTP, during Fulvestrant treatment (p = 0.136). The rates of objective response and clinical benefit due to Fulvestrant were similar among patients with normal weight, overweight and obesity, respectively. Conclusions: No difference in treatment efficacy was seen between normal, overweight and obese women with metastatic HR+BC, when treated with Fulvestrant. Until further research with prospective studies is available, there is no evidence to support any modification in how Fulvestrant treatment is used in patients with metastatic breast cancer in regard to BMI.

  • 429.
    Åhman, Annika
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Axelsson, Ove
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Maras, Gordan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Sarkadi, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Lindgren, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Ultrasonographic fetal soft markers in a low-risk population: prevalence, association with trisomies and invasive tests2014Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 93, nr 4, s. 367-373Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To investigate the prevalence of soft markers identified at second trimester ultrasound in a low-risk population and the association of these markers with trisomies and invasive testing.

    Design

    Prospective observational study.

    Setting

    Swedish University Hospital.

    Population

    All women with fetuses examined by ultrasound at 15+0–22+0 weeks gestation between July 2008 and March 2011.

    Methods

    Cases with soft markers were compared with non-cases with regard to trisomies and invasive testing.

    Main outcome measures

    Prevalence of soft markers, likelihood ratio for trisomies and risk ratio for invasive tests after detection of soft markers.

    Results

    Second trimester ultrasound was performed on 10 710 fetuses. Markers were detected in 5.9% of fetuses. 5.1% were isolated, 0.7% were multiple and 0.1% were combined with an anomaly. Presence of markers showed a positive likelihood ratio for Down syndrome, but the association (likelihood ratio = 7.1) was only statistically significant for the combined category of any marker (isolated, multiple or combined with anomaly). The risk ratio for invasive testing after the second trimester ultrasound was 24.0 in pregnancies with isolated soft markers compared with those without markers.

    Conclusion

    In a low-risk population, soft markers were found in 5.9% of fetuses at second trimester ultrasound. The likelihood ratio for Down syndrome was significant only for any marker (isolated, multiple or combined with anomaly). The presence of soft markers increased the incidence of invasive procedures substantially. Soft markers should be noted when information on second trimester ultrasound is formulated, and all units performing fetal ultrasound examinations should have established routines concerning information management when soft markers are identified.

  • 430.
    Ångerud, Katja
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Annerbäck, Eva-Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Boddeti, Santosh
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Kristiansson, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Adverse childhood experiences and depressive symptomatology among pregnant women2018Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 97, nr 6, s. 701-708Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Adverse childhood experiences (ACE) result in somatic and mental health disturbances. Its influence on antenatal depression is scarcely studied. This study examined the association between experience of ACE and antenatal depressive symptomatology.

    MATERIAL AND METHODS: 1257 women from 172 antenatal clinics in Sweden were surveyed during pregnancy and one year after delivery. Demographics, previous medical history and Edinburgh Postpartum Depression Scale (EPDS) were collected in pregnancy and postpartum and ACE one year postpartum. ACEs were partitioned into 10 categories. Statistical analyses used linear and logistic regression with EPDS score as main outcome measure.

    RESULTS: 736 (58.6%) women reported at least one ACE category and 88 women (7%) reported five or more ACE categories. An EPDS score of ≥13, which qualifies for a probable depression diagnosis, was reported by 277 (23%) women. In simple regression analyses the EPDS score was positively associated with the number of ACEs, cigarette smoking before pregnancy, body mass index and psychiatric disorders while education level was inversely associated. In a multiple regression analysis ACEs, education level and psychiatric disorder remained associated to the EPDS score. Among women with an ACE score ≥5 the odds ratio of having an EPDS score indicating probable depression was 4.2 (CI; 2.5-7.0).

    CONCLUSIONS: ACE was commonly reported. ACE and depressive symptomatology in late pregnancy were strongly associated in a dose-response manner. Women with several ACEs had high odds of depressive symptomatology in late pregnancy and were more likely to report depressive symptoms both in late pregnancy and postpartum.

  • 431.
    Österberg, Annika
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Kvist, Joanna
    Dahlgren, Madeleine Abrandt
    Ways of experiencing participation and factors affecting the activity level after nonreconstructed anterior cruciate ligament injury: a qualitative study2013Ingår i: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 43, nr 3, s. 172-183Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN:

    Phenomenographic, cross-sectional.

    OBJECTIVES:

    To describe ways of experiencing participation in activities of individuals with a nonreconstructed anterior cruciate ligament injury and to describe the emotional aspects related to participation. Further, the objective was to explore factors affecting the activity level.

    BACKGROUND:

    The importance of assessing different factors (knee status, muscle performance, psychological factors, performance-based tests, and subjective rating of knee function) after an anterior cruciate ligament injury has been emphasized. However, the results of these assessments do not answer the question of how the individuals themselves experience their participation in activities.

    METHODS:

    Semi-structured interviews were conducted with 19 strategically selected informants (age range, 18-43 years) who had sustained an anterior cruciate ligament injury 18 to 67 months previously. A phenomenographic approach, which describes individuals' ways of experiencing a phenomenon, was used.

    RESULTS:

    Five qualitatively different categories were identified: (A) unconditioned participation, (B) participation as conditioned by risk appraisal, (C) participation as conditioned by experienced control of the knee, (D) participation as conditioned by experienced knee impairment, and (E) participation as conditioned by neglecting the knee injury. Within each category, 5 interrelated aspects were discerned: focus, level of performance, activities, strategies, and feelings. Categories A, C, and E reflected experiences of full participation, whereas categories B and D reflected experiences of modified participation. There were mostly positive feelings regarding participation. Negative feelings were expressed in category D. Factors affecting the activity level were grouped according to the framework of the International Classification of Functioning, Disability and Health and described as facilitating or hindering the activity level. Facilitating factors included regaining and maintaining physical function, regaining confidence in knee function, and learning/relearning movement patterns. Hindering factors included fear of injury/reinjury, uncontrollable giving way, and loss of motivation.

    CONCLUSION:

    With different strategies, most of the informants achieved a satisfactory activity level, despite impairments and decreased activity level. Both physical and psychological factors were described to affect the activity level, as well as time since injury.

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