52 results on '"Johansson, Jan-Erik"'
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2. The European landscape on allogeneic haematopoeietic cell transplantation in Chronic Lymphocytic Leukaemia between 2009 and 2019: a perspective from the Chronic Malignancies Working Party of the EBMT
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Tournilhac, Olivier, van Gelder, Michel, Eikema, Dirk-Jan, Zinger, Nienke, Dreger, Peter, Bornhäuser, Martin, Vucinic, Vladan, Scheid, Christof, Cornelissen, Jan J., Schroeder, Thomas, Jindra, Pavel, Sengeloev, Henrik, Nguyen Quoc, Stephanie, Stelljes, Matthias, Blau, Igor Wolfgang, Mayer, Jiri, Paneesha, Shankara, Chevallier, Patrice, Forcade, Edouard, Kröger, Nicolaus, Blaise, Didier, Gribben, John, Nielsen, Bendt, Johansson, Jan-Erik, Kyriakou, Charalampia, Beguin, Yves, Pioltelli, Pietro, Sampol, Antònia, McLornan, Donal P., Schetelig, Johannes, Hayden, Patrick J., and Yakoub-Agha, Ibrahim
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Allogeneic transplantation (allo-HCT) is a curative treatment in CLL whose efficacy including the most severe forms had led to the 2006 EBMT recommendations. The advent after 2014 of targeted therapies has revolutionized CLL management, allowing prolonged control to patients who have failed immunochemotherapy and/or have TP53 alterations. We analysed the pre COVID pandemic 2009–2019 EBMT registry. The yearly number of allo-HCT raised to 458 in 2011 yet dropped from 2013 onwards to an apparent plateau above 100. Within the 10 countries who were under the EMA for drug approval and performed 83.5% of those procedures, large initial differences were found but the annual number converged to 2–3 per 10 million inhabitants during the 3 most recent years suggesting that allo-HCT remains applied in selected patients. Long-term follow-up on targeted therapies shows that most patients relapse, some early, with risk factors and resistance mechanisms being described. The treatment of patients exposed to both BCL2 and BTK inhibitors and especially those with double refractory disease will become a challenge in which allo-HCT remains a solid option in competition with emerging therapies that have yet to demonstrate their long-term effectiveness.
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- 2023
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3. Risk factors for a severe disease course in children with SARS-COV-2 infection following hematopoietic cell transplantation in the pre-Omicron period: a prospective multinational Infectious Disease Working Party from the European Society for Blood and Marrow Transplantation group (EBMT) and the Spanish Group of Hematopoietic Stem Cell Transplantation (GETH) study
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Averbuch, Dina, de la Camara, Rafael, Tridello, Gloria, Knelange, Nina Simone, Bykova, Tatiana A., Ifversen, Marianne, Dobsinska, Veronika, Ayas, Mouhab, Hamidieh, Amir Ali, Pichler, Herbert, Perez-Martinez, Antonio, Cesaro, Simone, Sundin, Mikael, Badell, Isabel, Bader, Peter, Johansson, Jan-Erik, Mirci-Danicar, Oana, Sedlacek, Petr, Paillard, Catherine, Gibson, Brenda, Lawson, Sarah, Kroeger, Nicolaus, Corbacioglu, Selim, Mikulska, Malgorzata, Piñana, Jose Luis, Styczynski, Jan, and Ljungman, Per
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Risk factors for severe SARS-Cov-2 infection course are poorly described in children following hematopoietic cell transplantation (HCT). In this international study, we analyzed factors associated with a severe course (intensive care unit (ICU) admission and/or mortality) in post-HCT children. Eighty-nine children (58% male; median age 9 years (min-max 1–18)) who received an allogeneic (85; 96%) or an autologous (4; 4%) HCT were reported from 28 centers (18 countries). Median time from HCT to SARS-Cov-2 infection was 7 months (min-max 0–181). The most common clinical manifestations included fever (37; 42%) and cough (26; 29%); 37 (42%) were asymptomatic. Nine (10%) children following allo-HCT required ICU care. Seven children (8%) following allo-HCT, died at a median of 22 days after SARS-Cov-2 diagnosis. In a univariate analysis, the probability of a severe disease course was higher in allo-HCT children with chronic GVHD, non-malignant disease, immune suppressive treatment (specifically, mycophenolate), moderate immunodeficiency score, low Lansky score, fever, cough, coinfection, pulmonary radiological findings, and high C-reactive protein. In conclusion, SARS-Cov-2 infection in children following HCT was frequently asymptomatic. Despite this, 10% needed ICU admission and 8% died in our cohort. Certain HCT, underlying disease, and SARS-Cov-2 related factors were associated with a severe disease course.
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- 2023
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4. Allogeneic hematopoietic stem cell transplantation for adult HLH: a retrospective study by the chronic malignancies and inborn errors working parties of EBMT
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Machowicz, Rafal, Suarez, Felipe, Wiktor-Jedrzejczak, Wieslaw, Eikema, Diderik-Jan, de Wreede, Liesbeth C., Blok, Henric-Jan, Isaksson, Cecilia, Einsele, Hermann, Poiré, Xavier, van Dorp, Suzanne, Nikolousis, Emmanouil, Johansson, Jan-Erik, Kobbe, Guido, Zecca, Marco, Arnold, Renate, Gerbitz, Armin, Finke, Jürgen, Díez-Martín, Jose Luis, Bonifazi, Francesca, McQuaker, Grant, Lenhoff, Stig, Rohrlich, Pierre-Simon, Theobald, Matthias, Ljungman, Per, Collin, Matthew, Albert, Michael H., Ehninger, Gerhard, Carlson, Kristina, Halaburda, Kazimierz, Lehmberg, Kai, Schönland, Stefan, Yakoub-Agha, Ibrahim, Gennery, Andrew R., Lankester, Arjan C., and Kröger, Nicolaus
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Hemophagocytic lymphohistiocytosis (HLH; hemophagocytic syndrome) is a rare syndrome of potentially fatal, uncontrolled hyperinflammation. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is indicated in primary, recurrent or progressive HLH, but information about its outcomes in the adult population is limited. We obtained data about 87 adult (≥18 years of age) patients retrospectively reported to the EBMT. The median survival time was 13.9 months. The three and five-year overall survival (OS) was 44% (95% CI 33–54%). Among 39 patients with a follow-up longer than 15 months, only three died. Relapse rate was 21% (95% CI 13–30%), while NRM reached 36% (95% CI 25–46%). Younger patients (<30 years of age) had better prognosis, with an OS of 59% (95% CI 45–73%) at three and five years vs 23% (95% CI 8–37%) for older ones. No difference in survival between reduced and myeloablative conditioning was found. To our knowledge, this is the largest report of adult HLH patients who underwent allo-HSCT. Patients who survive the first period after this procedure can expect a long disease-free survival. Both reduced intensity and myeloablative conditioning have therapeutic potential in adult HLH.
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- 2022
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5. Cancer incidence in healthy Swedish peripheral blood stem cell donors
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Pahnke, Simon, Nygell, Ulla Axdorph, Johansson, Jan-Erik, Kisch, Annika, Ljungman, Per, Sandstedt, Anna, Hägglund, Hans, and Larfors, Gunnar
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Granulocyte colony-stimulating factor (G-CSF) has been used for over 20 years to obtain peripheral blood stem cells from healthy donors for allogeneic stem cell transplantation. Concerns have been raised about a potentially increased cancer incidence in donors after donation, especially regarding haematological malignancies. In a prospective Swedish national cohort study, we studied the cancer incidence after donation in 1082 Swedish peripheral blood stem cell donors, donating between 1998 and 2014. The primary objective was to evaluate if the cancer incidence increased for donors treated with G-CSF. With a median follow-up time of 9.8 years, the incidence of haematological malignancies was 0.85 cases per 1000 person-years, and did not significantly differ from the incidence in age-, sex- and residence-matched population controls (hazard ratio 1.70, 95% confidence interval (CI) 0.79–3.64, pvalue 0.17), bone marrow donors or non-donating siblings. The total cancer incidence for peripheral blood stem cell donors was 6.0 cases per 1000 person-years, equal to the incidence in matched population controls (hazard ratio 1.03, 95% CI 0.78–1.36, pvalue 0.85), bone marrow donors or non-donating siblings. In this study of healthy peripheral blood stem cell donors, the cancer incidence was not increased after treatment with G-CSF.
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- 2022
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6. Multivariate modeling of eosinophil markers and other cellular immune parameters associated with the development of chronic graft-versus-host disease
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Lingblom, Christine, Andersson, Kerstin, Johansson, Jan-Erik, and Wennerås, Christine
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- 2022
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7. Umbilical Cord Blood Transplantation for Fanconi Anemia With a Special Focus on Late Complications: a Study on Behalf of Eurocord and SAAWP-EBMT
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Rafii, Hanadi, Volt, Fernanda, Bierings, Marc, Dalle, Jean-Hugues, Ayas, Mouhab, Rihani, Rawad, Faraci, Maura, de Simone, Giuseppina, Sengeloev, Henrik, Passweg, Jakob, Cavazzana, Marina, Costello, Regis, Maertens, Johan, Biffi, Alessandra, Johansson, Jan-Erik, Montoro, Juan, Guepin, Gabrielle Roth, Diaz, Miguel Angel, Sirvent, Anne, Kenzey, Chantal, Rivera Franco, Monica M., Cappelli, Barbara, Scigliuolo, Graziana Maria, Rocha, Vanderson, Ruggeri, Annalisa, Risitano, Antonio, De Latour, Regis Peffault, and Gluckman, Eliane
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•Results of umbilical cord blood transplantation in patients with Fanconi anemia have improved.•The rates of organ-specific complications and subsequent neoplasms are relatively low.•The incidence of subsequent neoplasm, mostly squamous cell carcinoma, increases with time.•Rigorous follow-up and life-long screening are crucial for survivors of transplantation for Fanconi anemia.
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- 2024
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8. Consumption of whole grain/bran rye instead of refined wheat decrease concentrations of TNF-R2, e-selectin, and endostatin in an exploratory study in men with prostate cancer.
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Zamaratskaia, Galia, Mhd Omar, Nor Adila, Brunius, Carl, Hallmans, Göran, Johansson, Jan-Erik, Andersson, Sven-Olof, Larsson, Anders, Åman, Per, and Landberg, Rikard
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Rye consumption has shown beneficial effects on prostate cancer tumors, as indicated by slower initial tumor growth in animal models and lowering of prostate-specific antigen (PSA) in humans. This study evaluated the effects of whole grain/bran rye consumption on low-grade inflammation and endothelial function biomarkers in men with prostate cancer. Seventeen men with untreated, low-grade prostate cancer consumed 485 g rye whole grain and bran products (RP) per day or refined wheat products with added cellulose (WP) in a randomized crossover design. Fasting blood samples were taken before and after 2, 4, and 6 weeks of treatment. Concentrations of tumor nuclear factor-receptor 2 (TNF-R2), e-selectin, and endostatin were significantly lower after consumption of the RP diet compared with WP (p < 0.05). Cathepsin S concentration was positively correlated to TNF-R2 and endostatin concentrations across all occasions. Strong correlations were consistently found between intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) and between interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1RA). No effect of intervention was found in 92 inflammation-related protein biomarkers measured in a proximity extension assay. RP diet lowered TNF-R2, e-selectin, and endostatin, compared with WP in men with prostate cancer. These effects were accompanied by a reduction in PSA. [ABSTRACT FROM AUTHOR]
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- 2020
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9. Cryotherapy as prophylaxis against oral mucositis after high-dose melphalan and autologous stem cell transplantation for myeloma: a randomised, open-label, phase 3, non-inferiority trial
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Johansson, Jan-Erik, Bratel, John, Hardling, Mats, Heikki, Lena, Mellqvist, Ulf-Henrik, and Hasséus, Bengt
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The conditioning therapy used in connection with haematopoietic stem cell transplantation (HSCT) can induce painful oral mucositis, which has negative impacts on patient quality of life and survival, as well as on health-care costs. While cooling of the oral mucosa (cryotherapy) is regarded as standard prophylaxis against oral mucositis, the long duration of the treatment affects compliance owing to side effects. In this prospective, randomised trial, 94 patients (62 males/32 females; median age 59 years, range 34–69) with a diagnosis of myeloma who were undergoing autologous HSCT were randomised 1:1 to receive cryotherapy for 7 h (N= 46) or 2 h (N= 48). Oral mucositis was evaluated prospectively. No significant difference was observed with respect to the proportion of patients who showed grades 3 and 4 toxicity according to the WHO scale (2.1 and 4.3% for 2 and 7 h, respectively; 95% CI −0.09 to 0.049; p= 0.98) as between the groups. Two hours of cryotherapy was as effective as 7 h in terms of protecting against severe oral mucositis in connection with autologous HSCT for myeloma. This trial is registered with ClinicalTrials.gov (NCT03704597).
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- 2019
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10. Upfront Unrelated Donor Hematopoietic Stem Cell Transplantation in Patients with Idiopathic Aplastic Anemia: A Study on Behalf of the Saawp of EBMT
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Petit, Audrey Françoise, Eikema, Dirk-Jan, Maschan, Alexey, Adjaoud, Dalila, Kulagin, Aleksander, Rambaldi, Alessandro, Fagioli, Franca, Griškevičius, Laimonas, Snowden, John A, Johansson, Jan-Erik, Dalle, Jean-Hugues, Byrne, Jenny, Risitano, Antonio, and Peffault De Latour, Regis
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IntroductionYoung patients with idiopathic aplastic anemia (AA) respond better to immunosuppressive therapy (IST) but the long-term outcome is suboptimal with non-response in 30% of patients as well as significant risks of relapse, ciclosporine (CSA) dependence and clonal evolution. Excellent results of up-front unrelated donor (UD) hematopoietic stem cell transplantation (HSCT) have been reported in a cohort of 29 children with idiopathic AA using an Alemtuzumab-based regimen, with low Graft versus Host Disease (GvHD) rates and only 1 death (Dufour C, BJH 2015). We took advantage of the SAAWP registry of the European Blood and Marrow Transplantation (EBMT) to analyze the outcomes of 65 young patients who received up-front UD HSCT in Europe.
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- 2020
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11. Quality of Life after Radical Prostatectomy or Watchful Waiting With or Without Androgen Deprivation Therapy: The SPCG-4 Randomized Trial
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Johansson, Eva, Steineck, Gunnar, Holmberg, Lars, Johansson, Jan-Erik, Nyberg, Tommy, and Bill-Axelson, Anna
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Men with prostate cancer experience adjuvant androgen deprivation therapy (ADT) differently.
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- 2018
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12. Outcome of Primary Versus Deferred Radical Prostatectomy in the National Prostate Cancer Register of Sweden Follow-Up Study.
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Holmström, Benny, Holmberg, Erik, Egevad, Lars, Adolfsson, Jan, Johansson, Jan-Erik, Hugosson, Jonas, and Stattin, Pär
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PROSTATECTOMY ,HEALTH outcome assessment ,PROSTATE cancer treatment ,PATHOLOGY ,FOLLOW-up studies (Medicine) ,CANCER radiotherapy ,MEDICAL statistics - Abstract
Purpose: We assessed outcomes in terms of adverse pathology and prostate cancer specific mortality in men who underwent primary or deferred radical prostatectomy. Materials and Methods: In the National Prostate Cancer Register of Sweden Follow-Up Study men 70 years old or younger at diagnosis with localized low to intermediate risk prostate cancer diagnosed from 1997 to 2002 were identified. Outcome in terms of adverse pathology, namely upgrading of Gleason score, positive surgical margins and extraprostatic extension, as well as prostate cancer specific mortality, was assessed in 2,344 men who underwent primary radical prostatectomy and 222 who underwent deferred radical prostatectomy after an initial period of surveillance. Results: Upgrading of Gleason score in surgical specimens vs core biopsies was less frequent after primary (25%) vs deferred radical prostatectomy (38%), p <0.001. There was no significant difference in the percentage of men who underwent primary vs deferred radical prostatectomy for positive surgical margins (33% vs 24%) or extraprostatic extension (27% vs 25%), and there was no difference in any 1 or more of the 3 adverse pathology features (55% vs 56%). After a median followup of 8 years 0.7% of men in the primary radical prostatectomy group and 0.9% in the deferred radical prostatectomy group had died of prostate cancer. Conclusions: There was no significant difference in the presence of any 1 or more adverse pathology features or in prostate cancer specific mortality after primary compared to deferred radical prostatectomy. However, longer followup is needed to conclusively evaluate the role of deferred radical prostatectomy. [Copyright &y& Elsevier]
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- 2010
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13. Two Independent Prostate Cancer Risk–Associated Loci at 11q13.
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Zheng, S. Lilly, Stevens, Victoria L., Wiklund, Fredrik, Isaacs, Sarah D., Jielin Sun, Smith, Shelly, Pruett, Kristen, Wiley, Kathleen E., Seong-Tae Kim, Yi Zhu, Zheng Zhang, Fang-Chi Hsu, Turner, Aubrey R., Johansson, Jan-Erik, Wennuan Liu, Jin Woo Kim, Bao-Li Chang, Duggan, David, Carpten, John, and Rodriguez, Carmen
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The article discusses a study which genotypes single nucleotide polymorphisms (SNP) in a region in a Swedish case-control study. Researchers discover evidence of prostate cancer association for the implicated SNP, including the locus 1 and multiple SNP on the centromeric side of the region are associated with the prostate cancer risk called the locus 2. They concluded that additional studies are needed to advance their knowledge on the etiology of prostate cancer.
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- 2009
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14. Surveillance and Deferred Treatment for Localized Prostate Cancer. Population Based Study in the National Prostate Cancer Register of Sweden.
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Stattin, Pär, Holmberg, Erik, Bratt, Ola, Adolfsson, Jan, Johansson, Jan-Erik, and Hugosson, Jonas
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PROSTATE cancer treatment ,CANCER risk factors ,COHORT analysis ,PROSTATE-specific antigen ,PUBLIC health surveillance ,HORMONE therapy ,CANCER radiotherapy - Abstract
Purpose: To what extent active surveillance and deferred treatment for localized risk prostate cancer are used is unclear. We assessed the use of surveillance and of deferred treatment in a population based, nationwide cohort in Sweden. Materials and Methods: In the National Prostate Cancer Register of Sweden, with a 98% coverage vs the compulsory Swedish Cancer Registry, we identified 8,304 incident cases of prostate cancer in 1997 to 2002 with age younger than 70 years, clinical local stage T1 or 2, N0 or Nx, M0 or Mx and serum prostate specific antigen less than 20 ng/ml. Data were extracted from medical charts for 7,782 of these men (94%) at a median of 4 years after diagnosis. Results: Primary treatment was surveillance for 2,065 men (26%), radical prostatectomy for 3,722 (48%), radiotherapy for 1,632 (21%) and hormonal treatment for 363 (5%). Men on surveillance had lower local tumor stage, grade and prostate specific antigen, and were older than those who received active primary treatment (p <0.001). After a median surveillance of 4 years 711 men (34%) on surveillance had received deferred treatment, which was radical prostatectomy for 279 (39%), radiotherapy for 212 (30%) and hormonal treatment for 220 (30%). Conclusions: Surveillance was a common treatment for patients younger than 70 years with localized prostate cancer in Sweden in 1997 to 2002, 26% of men with localized prostate cancer started surveillance and after a median followup of 4 years, 66% of these men remained on surveillance. [Copyright &y& Elsevier]
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- 2008
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15. Fruit and Vegetable Consumption and Risk of Bladder Cancer: A Prospective Cohort Study.
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Larsson, Susanna C., Andersson, Swen-Olof, Johansson, Jan-Erik, and Wolk, Alicja
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The article discusses the result of a study concerning fruit and vegetable consumption and risk of bladder cancer. No associations were observed for citrus fruits, cruciferous vegetables or green leafy vegetables and the associations found did not differ by sex or smoking status. It was concluded that fruit and vegetable intakes are not likely to be appreciably associated with the risk of bladder cancer.
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- 2008
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16. Testing a Multigene Signature of Prostate Cancer Death in the Swedish Watchful Waiting Cohort.
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Mucci, Lorelei A., Pawitan, Yudi, Demichelis, Francesca, Fall, Katja, Stark, Jennifer R., Adami, Hans-Olov, Andersson, Swen-Olof, Andrén, Ove, Eisenstein, Anna, Holmberg, Lars, Wei Huang, Kantoff, Philip W., Kim, Robert, Perner, Sven, Stampfer, Meir J., Johansson, Jan-Erik, and Rubin, Mark A.
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The article examines the prognostic value of a previously identified multigene signature of prostate cancer progression to predict cancer-specific death in Sweden. The authors quantified protein expression of the markers in tumor tissue by immunohistochemistry. They explained that the hazard ratio of prostate cancer death increased with increasing risk classification by the multigene model and molecular tumor markers can help distinguish lethal and indolent prostate cancer.
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- 2008
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17. Birth Weight, Abdominal Obesity and the Risk of Lower Urinary Tract Symptoms in a Population Based Study of Swedish Men.
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Laven, Brett A., Orsini, Nicola, Andersson, Swen-Olof, Johansson, Jan-Erik, Gerber, Glenn S., and Wolk, Alicja
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BIRTH weight ,OBESITY ,BODY mass index ,DIABETES complications - Abstract
Purpose: Lower urinary tract symptoms and obesity are prominent health problems. Low birth weight increases the adult risk of adiposity and insulin resistance, which may increase sympathetic activity and potentially lower urinary tract symptoms. Results of obesity and lower urinary tract symptoms studies are conflicting, and low birth weight and lower urinary tract symptoms relationships have not been investigated. Materials and Methods: This cross-sectional study examines lower urinary tract symptoms, body measures, activity, birth weight and lifestyle data collected by questionnaire from 1997 to 1998. Overall 27,858 men were analyzed and odds ratios calculated after excluding those with cancer, cerebrovascular accident, diabetes and incomplete information. Results: After adjustment for age, activity level, smoking, alcohol, coffee intake and body mass index, a significant positive association was seen between abdominal obesity (waist-to-hip ratio) and moderate to severe lower urinary tract symptoms. The risks of moderate to severe and severe lower urinary tract symptoms were 22% (95% CI 1.09–1.37) and 28% (95% CI 1.01–1.63) higher, respectively, for the top vs the lowest abdominal obesity quartile. The risk of nocturia (twice or more per night) was 1.16 (95% CI 1.02–1.33) in men in the top compared to the bottom waist-to-hip ratio quartile. Men with low birth weight (less than 2,500 gm) had a 61% (95% CI 1.12–2.30) higher risk of severe lower urinary tract symptoms compared to men with normal birth weight (2,500 to 3,999 gm). Men in the top waist-to-hip ratio quartile who had low birth weight had twice the risk of severe lower urinary tract symptoms (95% CI 1.29–3.02) compared to men with normal birth weight and in the lowest waist-to-hip ratio quartile. Conclusions: Low birth weight and abdominal adiposity are associated with increased risk of moderate to severe lower urinary tract symptoms in adults. Further investigations are needed to determine if decreases in obesity can ameliorate lower urinary tract symptoms. [Copyright &y& Elsevier]
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- 2008
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18. Long-Term Physical Activity and Lower Urinary Tract Symptoms in Men.
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Orsini, Nicola, RashidKhani, Bahram, Andersson, Swen-Olof, Karlberg, Lars, Johansson, Jan-Erik, and Wolk, Alicja
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HYPERPLASIA ,URINATION disorders ,ENDOCRINE diseases ,MALE reproductive organs - Abstract
Purpose: We assessed the association between physical activity, and the risk of moderate and severe lower urinary tract symptoms. Materials and Methods: A cross-sectional representative sample of 30,377 men 45 to 79 years old in central Sweden who completed a self-administered life-style questionnaire, including International Prostate Symptom Score questions, physical activity currently and recalled at age 30 years (total, work/occupation, walking/bicycling, inactivity and exercise) and demographic data. A total of 6,905 men (23%) who scored 8 or more points on International Prostate Symptom Score questions were considered to have moderate or severe lower urinary tract symptoms. Results: After controlling for subject age, waist-to-hip ratio, diabetes, smoking and drinking status, and educational level total physical activity was significantly inversely related to moderate and severe lower urinary tract symptoms (highest vs lowest quartile OR 0.72, 95% CI 0.66 to 0.79, p trend <0.001). Men who were physically active at work as well as during leisure time were at half the risk of lower urinary tract symptoms compared to inactive men (OR 0.49, 95% CI 0.40 to 0.60). Long-term high inactivity (5 hours daily at age 30 years plus currently) was associated with a 2-fold increased risk compared with the risk in men who were more active at the 2 periods (OR 1.90, 95% CI 1.41 to 2.59). Conclusions: Our results suggest that physical activity in young and late adulthood may be associated with a lower risk of moderate and severe lower urinary tract symptoms. [Copyright &y& Elsevier]
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- 2006
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19. How Well Does the Gleason Score Predict Prostate Cancer Death? A 20-Year Followup of a Population Based Cohort in Sweden.
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Andrén, Ove, Fall, Katja, Franzén, Lennart, Andersson, Swen-Olof, Johansson, Jan-Erik, and Rubin, Mark A.
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CANCER treatment ,CANCER patients ,PROSTATE cancer ,MALE reproductive organs - Abstract
Purpose: Adenocarcinoma of the prostate is the most common cancer among men in Western countries. Although the prognostic heterogeneity of prostate cancer is enormous, clinically insignificant aggressive prostate cancers cannot be reliably distinguished. Therefore, identifying prognostic factors is increasingly important, notably among men diagnosed with localized prostate cancer, because many of them may not require aggressive treatment. Materials and Methods: We analyzed a population based cohort of 253 men with early stage (T1a-b, Nx, M0) initially untreated prostate cancer diagnosed between 1977 and 1991, before PSA screening was available. Tissue samples were available for 240 patients diagnosed with transurethral resection. During complete followup through September 2003, standardized criteria were used to classify histopathological characteristics, progression and causes of death. Results: Higher Gleason grade, higher nuclear grade and larger tumor volume were independent predictors of death in prostate cancer with monotonous and statistically significant trends (p <0.05). In contrast, the level of Ki-67 – strongly correlated to Gleason score – was not an independent predictor of prostate cancer death. Given a Gleason score of 7 or greater, the probability of dying of prostate cancer was 29%. The corresponding predictive value for Gleason score 8 or greater was 48%. Conclusions: Although a high Gleason score is a determinant of prostate cancer death, its PPV is relatively low. Thus, further efforts in finding other or complementary indicators of prostate cancer outcome are needed. [Copyright &y& Elsevier]
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- 2006
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20. Dietary Phytoestrogen, Serum Enterolactone and Risk of Prostate Cancer: The Cancer Prostate Sweden Study (Sweden)
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Hedelin, Maria, Klint, Åsa, Chang, Ellen, Bellocco, Rino, Johansson, Jan-Erik, Andersson, Swen-Olof, Heinonen, Satu-Maarit, Adlercreutz, Herman, Adami, Hans-Olov, Grönberg, Henrik, and Bälter, Katarina
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- 2006
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21. BICALUTAMIDE (150 MG) VERSUS PLACEBO AS IMMEDIATE THERAPY ALONE OR AS ADJUVANT TO THERAPY WITH CURATIVE INTENT FOR EARLY NONMETASTATIC PROSTATE CANCER: 5.3-YEAR MEDIAN FOLLOWUP FROM THE SCANDINAVIAN PROSTATE CANCER GROUP STUDY NUMBER 6
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IVERSEN, PETER, JOHANSSON, JAN-ERIK, LODDING, PÄR, LUKKARINEN, OLAVI, LUNDMO, PER, KLARSKOV, PETER, TAMMELA, TEUVO L.J., TASDEMIR, ILKER, MORRIS, TOM, and CARROLL, KEVIN
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We evaluated the benefits of adding 150 mg bicalutamide to standard care, that is radical prostatectomy, radiotherapy or watchful waiting (WW), in patients with localized or locally advanced prostate cancer.
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- 2004
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22. Prostate carcinoma risk subsequent to diagnosis of benign prostatic hyperplasia<FNR HREF="fn1"></FNR><FN ID="fn1">This article is a US Government work and, as such, is in the public domain in the United States of America.</FN>
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Chokkalingam, Anand P., Nyrén, Olof, Johansson, Jan-Erik, Gridley, Gloria, McLaughlin, Joseph K., Adami, Hans-Olov, and Hsing, Ann W.
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Pathologically, benign prostatic hyperplasia (BPH) is not considered a precursor for prostate carcinoma. However, because the two conditions share not only a similar hormonal environment within the prostate but also several common risk factors, it is possible that men with BPH may be at increased risk of prostate carcinoma due to these shared factors. To elucidate this further, the authors used Swedish nationwide population-based record-linkage data to assess prostate carcinoma risk up to 26 years after the diagnosis of BPH among 86,626 men. Overall, relative to the general population, patients with BPH experienced little, if any, excess risk of prostate carcinoma (2% excess incidence after 10 years of follow-up). However, patients with BPH with and without surgical intervention experienced different prostate carcinoma risk patterns. Those undergoing transvesicular adenomectomy had a significant 22% lower incidence and a 23% lower mortality after the first 5 years of follow-up and those undergoing transurethral resection had a significant 10% higher incidence but a 17% lower mortality. In contrast, after the first 5 years, patients with BPH who did not receive surgical intervention experienced significant excesses of both prostate carcinoma incidence (18%) and mortality (77%). The differences in prostate carcinoma incidence and mortality by BPH treatment type suggest that factors related to treatment or health reasons underlying the selection of treatment influence subsequent prostate carcinoma risk. Further studies are needed to confirm the minimal excess risk of prostate carcinoma among BPH patients overall and the possible impact of BPH treatment methods on subsequent prostate carcinoma risk. Cancer 2003. Published 2003 by the American Cancer Society. DOI 10.1002/cncr.11710
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- 2003
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23. Kinetics of minimal residual disease and chimerism in patients with chronic myeloid leukemia after nonmyeloablative conditioning and allogeneic stem cell transplantation
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Uzunel, Mehmet, Mattsson, Jonas, Brune, Mats, Johansson, Jan-Erik, Aschan, Johan, and Ringdén, Olle
- Abstract
The kinetics of minimal residual disease (MRD) and chimerism were studied in 15 patients with chronic myeloid leukemia (CML) receiving nonmyeloablative stem cell transplantation (NST) and in 10 patients receiving conventional stem cell transplantation (CST). All NST patients showed T-cell mixed chimerism (MC) while granulocyte and B-cell MC occurred in 80% and 60% of the NST patients, respectively. In CST patients, T-cell MC was detected in 5 patients, of whom 3 were mixed only during the first month. MRD was detected in all NST patients. During the first 3 months the median BCR-ABL/ABL ratio was 0.2% in NST patients compared with 0.01% in CST patients (P < .01). However, 12 months after transplantation, the percentage of reverse transcriptase–polymerase chain reaction (RT-PCR)–positive patients was 20% in NST patients and 50% in CST patients. In conclusion, molecular remission can be induced in most patients after NST, albeit with different kinetics from CST.
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- 2003
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24. Kinetics of minimal residual disease and chimerism in patients with chronic myeloid leukemia after nonmyeloablative conditioning and allogeneic stem cell transplantation
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Uzunel, Mehmet, Mattsson, Jonas, Brune, Mats, Johansson, Jan-Erik, Aschan, Johan, and Ringdén, Olle
- Abstract
The kinetics of minimal residual disease (MRD) and chimerism were studied in 15 patients with chronic myeloid leukemia (CML) receiving nonmyeloablative stem cell transplantation (NST) and in 10 patients receiving conventional stem cell transplantation (CST). All NST patients showed T-cell mixed chimerism (MC) while granulocyte and B-cell MC occurred in 80% and 60% of the NST patients, respectively. In CST patients, T-cell MC was detected in 5 patients, of whom 3 were mixed only during the first month. MRD was detected in all NST patients. During the first 3 months the median BCR-ABL/ABL ratio was 0.2% in NST patients compared with 0.01% in CST patients (P< .01). However, 12 months after transplantation, the percentage of reverse transcriptase–polymerase chain reaction (RT-PCR)–positive patients was 20% in NST patients and 50% in CST patients. In conclusion, molecular remission can be induced in most patients after NST, albeit with different kinetics from CST.
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- 2003
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25. 5α-Reductase 2 polymorphisms as risk factors in prostate cancer
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Söderström, Torbjörn, Wadelius, Mia, Andersson, Swen-Olov, Johansson, Jan-Erik, Johansson, Sara, Granath, Fredrik, and Rane, Anders
- Abstract
Prostate cancer is a significant cause of death in Western countries and is under the strong influence of androgens. The steroid 5α-reductase 2 catalyzes the metabolism of testosterone into the more potent androgen dihydrotestosterone in the prostate gland. The enzyme is a target in pharmacological treatment of benign prostatic hyperplasia using specific inhibitors such as finasteride. Makridakis et al.have characterized the V89L and A49T polymorphisms in recombinant expression systems. The L allelic variant has a lower Vmax/ Kmratio than the V variant. In the A49T polymorphism, the T variant has an increased Vmax/ Kmratio. We performed a population-based case–control study of the impact of the SRD5A2V89L and A49T polymorphisms on the risk of prostate cancer. We also studied the relation between the genotypes and age at diagnosis, tumor, node, metastasis stage, differentiation grade, prostate specific antigen and heredity. The study included 175 prostate cancer patients and 159 healthy controls that were matched for age. There was an association with SRD5A2V89L LL genotype and metastases at the time of diagnosis, OR 5.67 (95 CI 1.44–22.30) when adjusted for age, differentiation grade, T-stage and prostate specific antigen. Heterozygous prostate cancer cases that carried the SRD5A2A49T AT genotype were significantly younger than cases that carried the AA genotype, (mean age 66 years vs 71, P0.038). The SRD5A2V89L and A49T polymorphisms were, however, not associated with altered prostate cancer risk. Further studies of the V89L polymorphism may lead to better understanding of the etiology of prostate cancer metastases.
- Published
- 2002
26. Disturbance of Purine Nucleotide Metabolism
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Johansson, Jan-Erik, Soussi, Bassam, Bagge, Ulf, and Ekman, Tor
- Abstract
Protective strategies to minimize the hematological toxicity in connection with bone marrow transplantation (BMT) have been successful, but toxicity to the gastrointestinal tract prevents further dose escalation and therefore limits the application of the treatment. As it is known that chemotherapy leads to disruption of the intestinal barrier and morphological changes of mitochondria in enterocytes, this study was conducted in order to investigate intestinal energy metabolism and permeability after intensive cytotoxic therapy in rats. Intestinal damage was produced by intraperitoneal administration of the cytostatic etoposide. Intestinal permeability was assessed by a [51Cr]EDTA absorption test and intestinal purine nucleotide content by a high-performance liquid chromatography (HPLC) technique. Four hours after the administration of etoposide, and the next 48 hr, there was a significant increase in the intestinal permeability (P < 0.05) and a significant reduction of the purine nucleotide content in the intestinal epithelial cells (P < 0.01) as compared to control animals. This early disturbance in enterocyte energy metabolism may be a key event in the development of the intestinal damage, induced by chemotherapy, and an explanation for the early disruption of the intestinal barrier demonstrable before morphological changes are evident.
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- 2001
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27. Polymorphisms in NAT2 CYP2D6 CYP2C19 and GSTP1 and their association with prostate cancer
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Wadelius, Mia, Autrup, Judith L., Stubbins, Michael J., Andersson, Swen-Olof, Johansson, Jan-Erik, Wadelius, Claes, Wolf, C. Roland, Autrup, Herman, and Rane, Anders
- Abstract
The development of prostate cancer is dependent on heredity, androgenic influences, and exposure to environmental agents. A high intake of dietary fat is associated with an increased risk of prostate cancer, either through influence on steroid hormone profiles or through production of carcinogenic compounds that require biotransformation by enzymes. The polymorphic glutathione S-transferase (GST), N-acetyltransferase (NAT), and cytochrome P450 (CYP) enzymes are of particular interest in prostate cancer susceptibility because of their ability to metabolize both endogenous and exogenous compounds, including dietary constituents. Association between different NAT2, CYP2D6, CYP2C19 and GSTP1 genotypes and prostate cancer was studied in a Swedish and Danish case-control study comprising 850 individuals. The combined Swedish and Danish study population was analysed by polymerase chain reaction for the NAT2 alleles 4, 5A, 5B, 5C, 6 and 7, and for the CYP2D6 alleles 1, 3 and 4. The Swedish subjects were also analysed for the CYP2C19 alleles 1 and 2, and the GSTP1 alleles A, B and C. No association was found between prostate cancer and polymorphisms in NAT2, CYP2D6, CYP2C19 or GSTP1. An association between CYP2D6 poor metabolism and prostate cancer was seen among smoking Danes; odds ratio 3.10 (95 confidence interval 1.07; 8.93), P = 0.03, but not among smoking Swedes; odds ratio 1.19 (95 confidence interval 0.41; 3.42), P = 0.75. Smoking is not a known risk factor for prostate cancer, and the association between CYP2D6 poor metabolism and prostate cancer in Danish smokers may have arisen by chance.
- Published
- 1999
28. Prostate cancer associated with CYP17 genotype
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Wadelius, Mia, Andersson, Swen-Olof, Johansson, Jan-Erik, Wadelius, Claes, and Rane, Anders
- Abstract
Androgens play an important role in the development of prostate cancer. Androgen regulating genes that show allelic variation may be susceptibility factors for the disease. One of these genes, CYP17, encodes the cytochrome P450c17α enzyme. It catalyses steroid 17α-hydroxylase/17,20 lyase activities at key points in testosterone biosynthesis. We investigated the association between a polymorphism in the CYP17gene and prostate cancer in a population-based case-control study. All individuals studied were Caucasians born in Sweden, 178 were consecutive clinical prostate cancer patients, and 160 were age-matched control individuals randomly selected from the same catchment area. DNA was extracted from blood samples. A CYP17gene fragment was amplified by polymerase chain reaction. The MspAll restriction enzyme, which recognizes the base pair substitution, was used to identify the allelic variants CYP17A1and CYP17A2.Significantly more men homozygous for the CYP17A1allele were found among prostate cancer patients compared with control individuals; odds ratio 1.61 (95 confidence interval 1.02; 2.53), P= 0.04. According to a preliminary report, the CYP17A1/A1genotype leads to higher circulating androgen levels, possibly by encoding for a more active androgen synthesizing CYP17 enzyme. Consequently, the CYP17A1/A1genotype, which was found in a higher frequency among prostate cancer patients, may prove to be one of the important susceptibility factors for prostate cancer. If verified, this genotype is likely to convey a larger risk on a population basis, than the rare hereditary prostate cancer genes do.
- Published
- 1999
29. Nine-Gene Molecular Signature Is Not Associated with Prostate Cancer Death in a Watchful Waiting Cohort.
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Mucci, Lorelei A., Pawitan, Yudi, Demichelis, Francesca, Fall, Katja, Stark, Jennifer R., Adami, Hans-Olov, Anderson, Swen-Olof, Andrén, Ove, Eisenstein, Anna S., Holmberg, Lars, Wei Huang, Kantoff, Philip W., Perner, Sven, Stampfer, Meir J., Johansson, Jan-Erik, and Rubin, Mark A.
- Abstract
The article focuses on a study which examined the relationship between nine-gene molecular signature and prostate cancer death. The study examined 172 men who were initially diagnosed with localized disease. It measured the protein expression of the genes in tumors. It concluded that the nine-gene molecular model did not predict lethal and indolent prostate cancer.
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- 2008
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30. Level of dental disease and differences in dental treatment in stem cell transplant recipients: the OraStem study.
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Napodano, Lara, Von Bültzingslöwen, Inger, Hovan, Allan, Huysmans, Marie Charlotte, Raber-Durlacher, Judith E., Hasseus, Bengt, Blijlevens, Nicole, Laheij, Alexa, Legert, Karen Garming, Rozario, Nigel, Osipoff, Anna, Johansson, Jan-Erik, Howard, Waylon, and Brennan, Michael T.
- Abstract
There is a lack of an accepted standard of care for dental treatment before hematopoietic stem cell transplantation (HSCT). Therefore, in this international, prospective multicenter study (OraStem), we evaluated the differences in dental diseases, oral hygiene practices, and dental treatments before HSCT. Enrollment sites included Vancouver, BC (Canada); Gothenburg and Huddinge (Sweden); Nijmegen and Amsterdam (The Netherlands); and Charlotte, NC (USA). The frequency of dental diseases, oral hygiene practices, and dental treatments before HSCT are reported here. Data on the number, mean age, and gender (%) of the cohort included the following: Overall: n = 269, age 53.6 years, males 56%; Vancouver: n = 58, age 52.3 years, males 57%; Sweden: n = 29, age 57.2 years, males 56%; Nijmegen: n = 81, age 55.1 years, males 54%; Amsterdam: n = 43, age 55.2 years, males 59%; and Charlotte: n = 58, age 49.6 years, males 57%. Overall, the most frequent medical diagnoses necessitating HSCT were as follows: myeloma = 74 (27%), acute myelogenous leukemia = 67 (24%); lymphoma = 37 (13%), myelodysplastic syndrome = 19 (7%); and acute lymphoblastic leukemia = 17 (6%). Overall, most transplants were allogeneic (61%) versus autologous (36%). The numbers of patients reporting brushing 2 or more times per day were as follows: overall = 200 (73%); Vancouver = 40 (67%); Sweden = 27 (87%); Nijmegen = 63 (78%); Amsterdam = 34 (77%); and Charlotte = 36 (59%). The numbers of patients reporting seeing a dentist or dental therapist routinely were as follows: overall = 202 (73%); Vancouver = 41 (71%); Sweden = 24 (77%); Nijmegen = 70 (86%); Amsterdam = 37 (84%); and Charlotte = 30(49%). Conditions of teeth were recorded before and after dental treatment provided before HSCT. Upon enrollment, mean numbers of teeth with a natural root (with or without crown) were as follows: overall = 24.2; Vancouver = 23.2; Sweden = 26.3; Amsterdam = 23.5; Nijmegen = 23.8; and Charlotte = 25.5. The numbers of people who underwent tooth extraction and the numbers of dental extractions (% of existing teeth) before transplantation were as follows: overall: n = 44, 126 teeth (0.5%); Vancouver: n = 4, 5 teeth (0.1%); Sweden: n = 5, 28 teeth (0.32%); Nijmegen: n = 10, 41 teeth (0.5%); Amsterdam: n = 8, 14 teeth (0.3%); and Charlotte: n = 17, 59 teeth (1%). The numbers of teeth with periodontal pocketing greater than 5 mm left untreated were as follows: overall = 102 (0.4%); Vancouver = 23 (0.5%); Sweden = 25 (0.3%); Nijmegen = 25 (0.3%); Amsterdam = 12 (0.3%); and Charlotte = 35 (0.8%). The numbers of teeth with 1 or more carious lesions to dentin left untreated were as follows: overall = 246 (1.0%); Vancouver = 11 (0.2%); Sweden = 27 (0.3%); Nijmegen = 118 (1.5%); Amsterdam = 11 (0.3%); and Charlotte = 99 (1.7%). This baseline report reveals variations in dental diseases, oral hygiene practices, and dental treatments rendered before HSCT among different study centers. Establishment of an international standard of care for dental treatment before HSCT is needed. Prospective OraStem study data will increase the understanding of risk factors related to oral complications during HSCT. [ABSTRACT FROM AUTHOR]
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- 2020
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31. NATURAL HISTORY OF LOCALISED PROSTATIC CANCER
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Johansson, Jan-Erik, Andersson, Swen-Olof, Brith Krusemo, Ulla, Adami, Hans-Olov, Bergström, Reinhold, and Kraaz, Wolfgang
- Abstract
In a population-based study, disease progression and survival were evaluated in untreated patients with newly diagnosed cancer of the prostate without distant metastases. Complete follow-up was achieved in 223 of 227 (98%) consecutively diagnosed, eligible patients of all ages. After 5 years, the cumulative progression-free survival (with 95% confidence interval) was 71·8 (65·5-78·1)% and survival corrected for causes of death other than prostatic cancer was 93·8 (88·3-97·6)%. Univariate and multivariate analyses showed no association between age at diagnosis and the natural course. Local progression was less common in localised, non-palpable tumours than in larger tumours. The rate of progression was 18·7 (6·1-57·1) times higher and that of disease-specific death 216·0 (31·2-1496) times higher in patients with poorly than in those with highly differentiated tumours. It is concluded that tumour grade at diagnosis is an excellent predictor of local and distant progression. The low death rate, especially in patients with highly and moderately differentiated tumours, means that any local or systemic therapy intended for patients with early prostatic cancer must be evaluated in clinical trials with untreated controls for comparison.
- Published
- 1989
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32. Primary Orchiectomy Versus Estrogen Therapy in Advanced Prostatic Cancer—A Randomized Study: Results After 7 to 10 Years of Followup
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Johansson, Jan-Erik, Andersson, Swen-Olof, Holmberg, Lars, and Bergstrom, Reinhold
- Abstract
Of 163 new consecutively diagnosed cases of advanced (T3-4 M0 or T04M1) prostatic cancer 13 had contraindications for estrogen treatment, and the remainder were randomized to orchiectomy (76) or to estrogen treatment (74), consisting of 150μg. ethinyl estradiol daily and 80mg. polyestradiol monthly. During the followup period of 7 to 10 years disease progression was noted in 27 patients (36%) treated with estrogen and 39 (51%) orchiectomized patients. The free of progression survival rate was significantly better (<0.05) among the estrogen treated patients but the over-all survival rates after orchiectomy and estrogen treatment were almost identical. A significantly higher frequency of cardiovascular side effects was noted in the estrogen group (23 cases) compared to the orchiectomy group (4 cases). Therefore, estrogen treatment in this form cannot be recommended for the palliative treatment of prostate cancer.
- Published
- 1991
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33. Clinical Experience with Recombinant Factor VIla in Patients with Thrombocytopenia
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Kristensen, Jörgen, Killander, Andreas, Hippe, Erik, Helleberg, Carsten, Ellegård, Jörgen, Holm, Mette, Kutti, Jack, Mellqvist, Ulf-Henrik, Johansson, Jan Erik, Glazer, Steven, and Hedner, Ulla
- Abstract
Platelets play a central role in primary hemostasis. The role of the coagulation mechanism during early stages of hemostasis is less clear, although increasing evidence is emerging indicating the ultimate importance of the factor VII (FVII)-tissue factor-dependent coagulation system in providing the first thrombin molecules necessary for the platelet activation to occur. Supporting this, early fibrin formation has been reported to occur within the bleeding time wound and infusion of recombinant FVIIa (rFIIa) has been shown to shorten the bleeding time in rabbits. We have investigated whether infusion of rFVIIa would enhance fibrin formation in bleeding time wounds in patients with thrombocytopenia as reflected by a shortening of the bleeding time. A reduction of the bleeding time was found in 55/105 cases (52%). The decrease was significantly more pronounced when the platelet count exceeded 20 × 10
9 /l. With the exception of an anaphylactoid reaction in 1 patient, no major adverse reactions related to the study drug were observed. Nine infusions of rFVIIa were given to 8 thrombocytopenic patients with overt bleeding. One patient received two infusions. Bleeding decreased in all patients and stopped in 6 patients.- Published
- 1996
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34. Knowledge Traditions in the Education of Pre-school Teachers [Sweden]
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Johansson, Jan-Erik
- Abstract
The purpose of this project, which forms part of the NBUC [National Board of Universities and Colleges] program "Research into Higher Education," is to describe and analyse the "pre-school methods" in Swedish pre-school teacher education. We plan to investigate how this subject has been perceived by the teachers of pre-school methods. Pre-school teacher training programs have expanded during the past twenty years as a result of the expansion of pre-school education itself. These programs are also examples of a non-academic education which was made a part of the higher education system in the reform of 1977. The subject now termed "pre-school methods" (and previously known, for example as "infant education") has traditionally been the focal point of these programs.
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- 1984
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35. Expectant Management of Early Stage Prostatic Cancer: Swedish Experience
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Johansson, Jan-Erik
- Abstract
To learn about the natural history of untreated early stage prostatic cancer (stage T0-2NXM0) progression-free, disease specific, overall survival and the need for palliative care were evaluated in a population-based and regionally well defined cohort from Sweden. Complete followup, with a mean observation of 12.5 years, was achieved in 223 consecutively diagnosed, eligible patients (98%) of all ages. Patients with progression were hormonally treated (orchiectomy or estrogens) if they had symptoms. After a mean of 12.5 years only 23 patients (10%) had died of prostate cancer and 125 of 148 deaths (84%) were of other causes. The 10-year disease specific survival rate was 85% (95% confidence interval 79 to 91%) and was equally high (89%) in a subgroup of 58 patients who met current indications for radical prostatectomy. The progression-free 10-year survival rate was 55% (95% confidence interval 46 to 63%) but in 49 of 77 patients local growth provided the only evidence of progression and endocrine treatment was generally successful in these cases. Following an initial increase, the rate of disease progression and death from prostate cancer decreased during the last years of followup.
- Published
- 1994
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36. Prognostic Factors in Progression-Free Survival and Corrected Survival in Patients with Advanced Prostatic Cancer: Results from a Randomized Study Comprising 150 Patients Treated with Orchiectomy or Estrogens
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Johansson, Jan-Erik, Andersson, Swen-Olof, Holmberg, Lars, and Bergström, Reinhold
- Abstract
In a population-based randomized study comparing 150 patients with advanced prostatic cancer treated with orchiectomy or estrogen, some possible prognostic factors were analyzed. The observation period was 78 to 114 months. M category, T category, tumor grade, performance status, pain, prostatic acid phosphatase, sedimentation rate, hemoglobin and serum creatinine level were all statistically significantly related to the interval to progression and to disease-specific death on univariate analyses. Variables that were statistically significant on multivariate analyses were M category, T category, sedimentation rate and patient age. The sedimentation rate predicted the intervals to progression and to disease-specific death, with the relative hazard and 95% confidence interval for the latter end point being 1.018 (range 1.010 to 1.027) for each millimeter increase in sedimentation rate per hour. An analysis that was stratified according to the extent of the disease as measured on a bone scan showed that the sedimentation rate was the only prognostic factor of statistical significance with an estimate of relative hazard of 1.52 if the sedimentation rate was elevated 20mm. per hour. Progression-free survival but not disease-specific survival was statistically significantly better in the estrogen group (relative hazard 0.47), as assessed by multivariate analysis in which all variables were taken into account.
- Published
- 1991
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37. Outcome of Allogeneic Haematopoietic Stem Cell Transplantation in Myeloproliferative Neoplasms-Unclassifiable: A Retrospective Study By the Chronic Malignancies Working Party of EBMT
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McLornan, Donal P., Malpassuti, Vittoria, Iacobelli, Simona, Lippinkhof-Kozijn, Anne, Koster, Linda, Robin, Marie, Chalandon, Yves, Bunjes, Donald, Beelen, Dietrich W., Potter, Victoria, Sengeloev, Henrik, Radujkovic, Aleksandar, Passweg, Jakob R., Kröger, Nicolaus, Wulf, Gerald, Johansson, Jan Erik, Ciceri, Fabio, Bornhäuser, Martin, Holler, Ernst, Beguin, Yves, Lioure, Bruno, Martin, Sonja, Milojkovic, Dragana, Hayden, Patrick, Hernandez Boluda, Juan Carlos, Czerw, Tomasz, and yakoub-Agha, Ibrahim
- Abstract
McLornan: Novartis: Honoraria; Jazz Pharmaceuticals: Honoraria, Speakers Bureau. Robin:Novartis Neovii: Research Funding. Chalandon:Novartis: Consultancy, Honoraria; Bristol-Myers Squibb: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria; Incyte Biosciences: Consultancy, Honoraria. Beelen:Medac GmbH Wedel Germany: Consultancy, Honoraria. Kröger:Sanofi-Aventis: Honoraria; Riemser: Research Funding; Novartis: Honoraria, Research Funding; Neovii: Honoraria, Research Funding; Medac: Honoraria; JAZZ: Honoraria; DKMS: Research Funding; Celgene: Honoraria, Research Funding. Milojkovic:Novartis: Honoraria, Speakers Bureau; Incyte: Honoraria, Speakers Bureau; Pfizer: Honoraria, Speakers Bureau; BMS: Honoraria, Speakers Bureau. Hernandez Boluda:Incyte: Other: Travel expenses paid.
- Published
- 2019
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38. Outcome of Allogeneic Haematopoietic Stem Cell Transplantation in Myeloproliferative Neoplasms-Unclassifiable: A Retrospective Study By the Chronic Malignancies Working Party of EBMT
- Author
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McLornan, Donal P., Malpassuti, Vittoria, Iacobelli, Simona, Lippinkhof-Kozijn, Anne, Koster, Linda, Robin, Marie, Chalandon, Yves, Bunjes, Donald, Beelen, Dietrich W., Potter, Victoria, Sengeloev, Henrik, Radujkovic, Aleksandar, Passweg, Jakob R., Kröger, Nicolaus, Wulf, Gerald, Johansson, Jan Erik, Ciceri, Fabio, Bornhäuser, Martin, Holler, Ernst, Beguin, Yves, Lioure, Bruno, Martin, Sonja, Milojkovic, Dragana, Hayden, Patrick, Hernandez Boluda, Juan Carlos, Czerw, Tomasz, and yakoub-Agha, Ibrahim
- Abstract
Introduction
- Published
- 2019
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39. Impact of Oral Side Effects from Conditioning Therapy Before Hematopoietic Stem Cell Transplantation: Protocol for a Multicenter Study.
- Author
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Brennan, Michael T, Hasséus, Bengt, Hovan, Allan J, Raber-Durlacher, Judith E, Blijlevens, Nicole MA, Huysmans, Marie-Charlotte, Legert, Karin Garming, Johansson, Jan-Erik, Moore, Charity G, and Bültzingslöwen, Inger von
- Subjects
HEMATOPOIETIC stem cell transplantation ,CHEMOTHERAPY complications ,RADIOTHERAPY complications ,IMMUNE response ,XEROSTOMIA ,GRAFT versus host disease - Abstract
Background: The oral cavity is a common site of complications related to the cytotoxic effect of high-dose chemotherapy and radiation therapy. Considering our limited understanding of the burden of illness in the oral cavity from various cytotoxic therapies, it is difficult to produce evidence-based, preventive and management protocols. A prospective multicenter study is necessary to collect data on the burden of illness from various cytotoxic regimens. Objective: The objectives of this prospective international observational multicenter study in hematopoietic stem cell transplant (HSCT) patients are to establish the nature, incidence and temporal relationship of oral complications related to conditioning regimens (chemotherapy with or without total body irradiation), stem cell transplantation and the immunologic reactions (mainly graft-vs-host-disease) that may follow, and to determine what subjective and objective oral complications related to treatment can predict negative clinical and economic outcomes and reduced quality of life. Methods: Adult patients at six study sites receiving full intensity conditioning, reduced intensity conditioning or nonmyeloablative conditioning, followed by autologous or allogeneic hematopoietic stem cell infusion, are included. A pre-treatment assessment includes medical conditions, planned chemo- and radiation therapy regimen, medications, allergies, social history, patient report of oral problems, dental history, subjective oral complaints, objective measures of oral conditions, current laboratory values, dental treatment recommended and untreated dental disease. Starting 1-3 days after hematopoietic stem cell infusion, a bedside assessment is completed 3 days per week until resolution of neutropenia. A patient questionnaire is also completed during hospitalization. Beyond this time, patients with continued oral mucositis or other oral problems are followed 1 day per week in an inpatient or outpatient setting. Additional visits for urgent care for acute oral problems after hospitalization are documented. Autologous transplant patients are being followed up at 100 days (SD 30 days) and at 1 year (SD 30 days) post-transplantation to identify any long-term side effects. Patients treated with allogeneic transplantation are being followed at 100 days (SD 30 days), 6 months (SD 30 days), and 12 months (SD 30 days). The follow-up assessments include cancer response to therapy, current medical conditions, medications, subjective and objective oral findings, quality of life measures and laboratory values. The targeted enrollment is 254 patients who have received HSCT. Results: A total of 260 participants have been enrolled, with 233 (91%) who have received HSCT. We anticipate enrollment of 20-30 additional participants to obtain the sample size of 254 enrolled participants who have received HSCT. Conclusions: The results of the ongoing prospective study will provide a unique dataset to understand the impact of oral complications on patients undergoing HSCT and provide needed evidence for guidelines regarding the management of this patient cohort. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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40. Outcome of Third Salvage Autologous Stem Cell Transplantation in Multiple Myeloma
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Garderet, Laurent, Iacobelli, Simona, van Biezen, Anja, Koster, Linda, Dreger, Peter, Johansson, Jan-Erik, Leleu, Xavier, Potter, Michael, Krejci, Marta, Peschel, Christian, Radocha, Jakub, Ganser, Arnold, Metzner, Bernd, Paoli, Nicoli, Schäfer-Eckart, Kerstin, Pohlreich, David, Lenain, Pascal, Grasso, Mariella, Caillot, Denis, Einsele, Hermann, Sengeloev, Henrik, Meuleman, Nathalie, Ciceri, Fabio, Schönland, Stefan, and Kröger, Nicolaus
- Abstract
Garderet: Takeda: Consultancy; Amgen: Consultancy; BMS: Consultancy, Honoraria; Novartis: Consultancy. Dreger:Janssen: Consultancy; Gilead: Speakers Bureau; Novartis: Speakers Bureau; Novartis: Consultancy; Gilead: Consultancy; Roche: Consultancy. Leleu:TEVA: Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria; LeoPharma: Honoraria; Pierre Fabre: Honoraria; Amgen: Honoraria; Bristol-Myers Squibb: Honoraria; Takeda: Honoraria; Celgene: Honoraria; Janssen: Honoraria. Peschel:MophoSys: Honoraria. Meuleman:Bristol-Myers-Squibb: Consultancy; Celgene: Consultancy; Amgen: Consultancy; Takeda: Consultancy. Ciceri:MolMed SpA: Consultancy. Schönland:Janssen, Prothena, GSK: Consultancy, Employment, Equity Ownership, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, accommations, Patents & Royalties, Research Funding, Speakers Bureau. Kröger:Sanofi: Honoraria, Research Funding; Neovii: Honoraria, Research Funding; Riemser: Honoraria, Research Funding; Novartis: Honoraria, Research Funding.
- Published
- 2016
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41. Allogeneic Hematopoietic Stem Cell Transplantation in Hemophagocytic Lymphohistiocytosis (HLH) in Adults: A Retrospective Study of the Chronic Malignancies and Inborn Errors Working Parties (CMWP and IEWP) of the EBMT
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Machowicz, Rafal, Suarez, Felipe, Jedrzejczak, Wieslaw W, Eikema, Dirk-Jan, de Wreede, Liesbeth C, Blok, Henric-Jan, Isaksson, Cecilia, Einsele, Hermann, Poiré, Xavier, Nikolousis, Manos, Johansson, Jan-Erik, Kobbe, Guido, Zecca, Marco, Arnold, Renate, Diez-Martin, Jose L., Schönland, Stefan, Lankester, Arjan C, Gennery, Andrew, and Kroeger, Nicolaus
- Abstract
Hemophagocytic lymphohistiocytosis (HLH; hemophagocytic syndrome) is a rare syndrome of potentially fatal, uncontrolled hyperinflammation. Allogeneic stem cell transplantation (alloSCT) is indicated in familial, recurrent or progressive HLH. Additional recommendations include central nervous system involvement and unknown triggering factor. While data for alloSCT outcome are available for the pediatric setting, information for adults is very limited.
- Published
- 2016
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42. Allogeneic Hematopoietic Stem Cell Transplantation in Hemophagocytic Lymphohistiocytosis (HLH) in Adults: A Retrospective Study of the Chronic Malignancies and Inborn Errors Working Parties (CMWP and IEWP) of the EBMT
- Author
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Machowicz, Rafal, Suarez, Felipe, Jedrzejczak, Wieslaw W, Eikema, Dirk-Jan, de Wreede, Liesbeth C, Blok, Henric-Jan, Isaksson, Cecilia, Einsele, Hermann, Poiré, Xavier, Nikolousis, Manos, Johansson, Jan-Erik, Kobbe, Guido, Zecca, Marco, Arnold, Renate, Diez-Martin, Jose L., Schönland, Stefan, Lankester, Arjan C, Gennery, Andrew, and Kroeger, Nicolaus
- Abstract
Jedrzejczak: Celgene: Consultancy; Roche: Consultancy, Research Funding; Jansen-Cilag: Consultancy; Novartis: Consultancy, Research Funding; Amgen: Research Funding; BMS: Research Funding; Angelini: Consultancy; Sandoz: Consultancy. Kobbe:Jansen: Honoraria, Other: travel support; Celgene: Honoraria, Other: travel support, Research Funding. Kroeger:Sanofi: Honoraria, Research Funding.
- Published
- 2016
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43. Statistics reveal UK's reliance on landfill.
- Author
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Johansson, Jan Erik
- Abstract
The article discusses the report "Plastics: The Facts 2011" by the European plastics industry. It shows the steady reduction in the amount of plastics buried in European landfill despite an increase in post-consumer waste in 2010. Some of the factors attributed to the reduced amount of plastics are continuous improvement in plastics end-of-life management performance and growing public awareness. It cites the disappointing recovery of plastics rate of Great Britain.
- Published
- 2011
44. Outcome of Third Salvage Autologous Stem Cell Transplantation in Multiple Myeloma
- Author
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Garderet, Laurent, Iacobelli, Simona, van Biezen, Anja, Koster, Linda, Dreger, Peter, Johansson, Jan-Erik, Leleu, Xavier, Potter, Michael, Krejci, Marta, Peschel, Christian, Radocha, Jakub, Ganser, Arnold, Metzner, Bernd, Paoli, Nicoli, Schäfer-Eckart, Kerstin, Pohlreich, David, Lenain, Pascal, Grasso, Mariella, Caillot, Denis, Einsele, Hermann, Sengeloev, Henrik, Meuleman, Nathalie, Ciceri, Fabio, Schönland, Stefan, and Kröger, Nicolaus
- Published
- 2016
- Full Text
- View/download PDF
45. VARIED APPROACHES TO PLASTICS PROBLEM.
- Author
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Johansson, Jan-Erik
- Abstract
The article provides information about several issues related to the plastic industry in Great Britain. According to a report, nine of the 29 countries studied already recover more than 80 percent of their plastics waste through a combination of recycling and energy recovery. The European collection rate for mechanical recycling of post-consumer plastics waste has shown an increment of 20.1 percent in 2007 from 11 percent in 2006. This increase is a result of higher polymer prices and improved collection and sorting technology. Several graphs are also presented providing information about the decoupling of plastic waste and landfill, and growth of recycling and energy recovery.
- Published
- 2009
46. 1783 INDIVIDUALIZED ESTIMATION OF THE BENEFIT OF RADICAL PROSTATECTOMY: DATA FROM SPCG4, THE SCANDINAVIAN RANDOMIZED TRIAL OF RADICAL PROSTATECTOMY.
- Author
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Vickers, Andrew, Savage, Caroline, Steineck, Gunnar, Adami, Hans-Olov, Johansson, Jan-Erik, Bill-Axelson, Anna, Garmo, Hans, and Holmberg, Lars
- Published
- 2011
- Full Text
- View/download PDF
47. ESTIMATION OF ABSOLUTE RISK FOR PROSTATE CANCER FROM BLOOD DNA.
- Author
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Xu, Jianfeng, Sun, Jielin, Kader, A. Karim, Lindström, Sara, Wiklund, Fredrik, Hsu, Fang-Chi, Kim, Seong-Tae, Johansson, Jan-Erik, Zheng, S. Lilly, Platz, Elizabeth A., Isaacs, William B, and Grönberg, Henrik
- Published
- 2009
- Full Text
- View/download PDF
48. SURVEILLANCE, RADICAL PROSTATECTOMY, OR RADIOTHERAPY FOR PROSTATE CANCER: POPULATION-BASED, NATION-WIDE COHORT STUDY ON IN THE NATIONAL PROSTATE CANCER REGISTER (NPCR).
- Author
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Stattin, Pär, Holmberg, Erik, Johansson, Jan-Erik, Holmberg, Lars, Adolfsson, Jan, and Hugosson, Jonas
- Published
- 2009
- Full Text
- View/download PDF
49. Results From the Scandinavian Prostate Cancer Group Trial Number 4: A Randomized Controlled Trial of Radical Prostatectomy Versus Watchful Waiting
- Author
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Holmberg, Lars, Bill-Axelson, Anna, Steineck, Gunnar, Garmo, Hans, Palmgren, Juni, Johansson, Eva, Adami, Hans-Olov, and Johansson, Jan-Erik
- Abstract
In the Scandinavian Prostate Cancer Group Trial Number 4 (SPCG-4), 347 men were randomly assigned to radical prostatectomy and 348 to watchful waiting. In the most recent analysis (median follow-up time = 12.8 years), the cumulative mortality curves had been stable over the follow-up. At 15 years, the absolute risk reduction of dying from prostate cancer was 6.1% following randomization to radical prostatectomy, compared with watchful waiting. Hence, 17 need to be randomized to operation to avert one death. Data on self-reported symptoms, stress from symptoms, and quality of life were collected at 4 and 12.2 years of median follow-up. These questionnaire studies show an intricate pattern of symptoms evolving after surgery, hormonal treatments, signs of tumor progression, and also from natural aging. This article discusses some of the main findings of the SPCG-4 study.
- Published
- 2012
- Full Text
- View/download PDF
50. The Gut-Mucosa-Barrier-Function during Hematopoietic Stem-Cell Transplantation Predicts Acute Graft-Versus-Host Disease Severity.
- Author
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Johansson, Jan-Erik and Ekman, Tor
- Abstract
Background Graft-versus-host disease (GVHD) is the primary complication of allogeneic, haemopoietic, stem-cell transplantation (HSCT). From murine models, it has been revealed that gut toxicity increases the translocation of inflammatory mediators through the impaired intestinal barrier, which aggravates systemic GVHD. In patients, the intestinal barrier is disrupted after myeloablative conditioning but preserved after reduced intensity conditioning (RIC). The present study investigates, in a clinical situation, whether the severity of acute GVHD depends on intestinal-barrier function. Methods In 38 patients (21 myeloablative, 17 RIC), intestinal permeability was assessed before transplant and during the transplantation course (day −1 to +14). Blood levels of cytokines were assessed in parallel. Results Intestinal barrier integrity was preserved in RIC patients but disrupted in myeloablatively conditioned on day 4 (p = 0.0091) and on day 7 (p = 0.0014) compared with RIC patients. Patients with mild, acute GVHD (grades 0–1) had a significantly better preserved intestinal-barrier function (p = 0.042 on day 4) and lower TNF-a levels (p = 0.013 and 0.025 on day −1 and day +7 respectively), compared with patients with more pronounced GVHD (grades 2–4). Conclusion Intestinal barrier function predicts the severity of acute GVHD in patients and gives support to the assumption that gut protective strategies may diminish acute GVHD.
- Published
- 2004
- Full Text
- View/download PDF
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