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Case management for frail older people. Effects on healthcare utilisation, cost in relation to utility, and experiences of the intervention

Popular Abstract in Swedish Dagens vårdsystem står inför många stora utmaningar. Många av dem är relaterade till komplexa vårdbehov hos den allt större andelen sköra äldre personer. Denna andel ökar samtidigt som många vårdorganisationer har krav på sig att minska kostnaderna. Dessa äldre personer har ofta flera sjukdomar samtidigt och de har vanligtvis kontakter med många olika vårdgivare, på fleThe overall aim of this thesis was to investigate healthcare utilisation patterns and to explore the effects of a case management intervention for frail older people on healthcare utilisation and costs in relation to utility. A further aim was to explore the older people’s and case managers’ experiences of the intervention. Study I was a quantitative study comprising ten age cohorts aged between 6

Pain induced by propofol - clinical studies on drug composition and adminstration

Over the last 25 years a number of new anaesthetic drugs have been introduced on the market to allow for better patient satisfaction and faster recovery after anaesthesia and sedation. Propofol (2,6-di-isopropylphenol), one of our most common iv anaesthetics, is associated with pleasant sleep and rapid recovery with little postoperative nausea. When used for anaesthetic induction propofol causes s

Tumor markers in prostate cancer I: Blood-based markers

The introduction of total prostate specific antigen (total PSA) testing in blood has revolutionized the detection and management of men with prostate cancer (PCa). The objective of this review was to discuss the challenges of PCa biomarker research, definition of the type of PCa biomarkers, the statistical considerations for biomarker discovery and validation, and to review the literature regardin

Genetic Variation in KLK2 and KLK3 Is Associated with Concentrations of hK2 and PSA in Serum and Seminal Plasma in Young Men

BACKGROUND: Genetic variants in KLK2 and KLK3 have been associated with increased serum concentrations of their encoded proteins, human kallikrein-related peptidase 2 (hK2) and prostate-specific antigen (PSA), and with prostate cancer in older men. Low PSA concentrations in seminal plasma (SP) have been associated with low sperm motility. To evaluate whether KLK2 and KLK3 genetic variants affect p

Serum markers in prostate cancer detection.

Prostate-specific antigen (PSA) testing provides significant benefits by reducing prostate cancer mortality, but also leads to important harms by detecting clinically insignificant cancers. Hence, there are urgent needs for complementary tools for middle-aged men with modest PSA elevations in blood. This review includes research on prostate cancer biomarkers in blood published from March 2013 thro

Biokinetics Of 18F-Choline Studied In Four Prostate Cancer Patients

Biokinetic data are important when calculating the absorbed dose to the patients and can also be used to find the optimal time between injection and imaging. To the authors' knowledge, there are no published biokinetic data in humans for (18)F-choline, except some distribution data at single time points. Four patients with suspicion of metastases due to biochemical recurrence (measurable prostate-

Serum levels of vitamin D, parathyroid hormone and calcium in relation to survival following breast cancer.

Vitamin D, parathyroid hormone (PTH) and calcium in blood are correlated with each other. Previous studies have suggested vitamin D to have anti-proliferative effects on tumor cells, whereas PTH may have carcinogenic effects. A cancer disease may influence calcium levels in blood, but less is known about calcium and its potential effect on cancer risk and survival. The aim of this study was to exa

The fungal metabolite galiellalactone interferes with the nuclear import of NF-κB and inhibits HIV-1 replication.

Galiellalactone (GL) is a metabolite produced by the fungus Galiella rufa that presents antitumor and immunomodulatory activities. GL interferes with the binding to DNA of signal transducer and activator of transcription (STAT)-3 and also inhibits other signal pathways such as NF-κB, but the mechanism of action in this pathway remains unknown. In this study we report that GL inhibits vesicular sto

A high-density tissue microarray from patients with clinically localized prostate cancer reveals ERG and TATI exclusivity in tumor cells.

Background:Prostate cancer (PCa) is characterized by high tumor heterogeneity. In 2005, the fusion between the androgen-regulated gene TMPRSS2 and members of the ETS family was discovered in prostate cancer. In particular, fusion of TMPRSS2 with ERG was found in approximately 50% of prostate cancers and considered as an early event in the onset of the disease. The prognostic value of this fusion i

Nonsense Mutations in the Shelterin Complex Genes ACD and TERF2IP in Familial Melanoma.

The shelterin complex protects chromosomal ends by regulating how the telomerase complex interacts with telomeres. Following the recent finding in familial melanoma of inactivating germline mutations in POT1, encoding a member of the shelterin complex, we searched for mutations in the other five components of the shelterin complex in melanoma families.

Acoustofluidic, label-free separation and simultaneous concentration of rare tumor cells from white blood cells

Enrichment of rare cells from peripheral blood has emerged as a means to enable noninvasive diagnostics and development of personalized drugs, commonly associated with a prerequisite to concentrate the enriched rare cell population prior to molecular analysis or culture. However, common concentration by centrifugation has important limitations when processing low cell numbers. Here, we report on a

A single inlet two-stage acoustophoresis chip enabling tumor cell enrichment from white blood cells

Metastatic disease is responsible for most cancer deaths, and hematogenous spread through circulating tumor cells (CTC) is a prerequisite for tumor dissemination. CTCs may undergo epithelial–mesenchymal transition where many epithelial cell characteristics are lost. Therefore, CTC isolation systems relying on epithelial cell markers are at risk of losing important subpopulations of cells. Here, a

Cancer-associated Changes in the Expression of TMPRSS2-ERG, PCA3, and SPINK1 in Histologically Benign Tissue From Cancerous vs Noncancerous Prostatectomy Specimens.

To investigate whether messenger ribonucleic acid (mRNA) expression of TMPRSS2-ERG fusion gene, a suggested prostate cancer (PCa) biomarker, was specific to cancerous lesions alone and to study the expression of SPINK1 and PCA3 mRNAs in the same cohort to also explore the proposed mutual exclusivity of TMPRSS2-ERG and SPINK1 expression.

Metagenomic sequencing of "HPV-negative" condylomas detects novel putative HPV types.

Condylomas are caused by human papillomavirus (HPV), but may in rare cases be "negative for HPV" by PCR. Metagenomic sequencing can be used for an unbiased assessment of the presence of virus. Ten swab sample pools, each containing four cases of "HPV-negative" condylomas, were subjected to metagenomic sequencing. One pool contained Molluscum contagiosum. Five pools contained HPV, of which three po

Factors affecting recall rate and false positive fraction in breast cancer screening with breast tomosynthesis - A statistical approach.

In this study, we investigate which factors affect the false positive fraction (FPF) for digital breast tomosynthesis (DBT) compared to digital mammography (DM) in a screening population by using classification and regression trees (C&RT) and binary marginal generalized linear models. The data was obtained from the Malmö Breast Tomosynthesis Screening Trial, which aimed to compare the performa

A Compartmental Model for Biokinetics and Dosimetry of 18F-Choline in Prostate Cancer Patients

PET with F-18-choline (F-18-FCH) is used in the diagnosis of prostate cancer and its recurrences. In this work, biodistribution data from a recent study conducted at Skane University Hospital Malmo were used for the development of a biokinetic and dosimetric model. Methods: The biodistribution of F-18-FCH was followed for 10 patients using PET up to 4 h after administration. Activity concentration

t(14;18) Translocation: A Predictive Blood Biomarker for Follicular Lymphoma

Purpose The (14;18) translocation constitutes both a genetic hallmark and critical early event in the natural history of follicular lymphoma (FL). However, t(14;18) is also detectable in the blood of otherwise healthy persons, and its relationship with progression to disease remains unclear. Here we sought to determine whether t(14;18)-positive cells in healthy individuals represent tumor precurso

Diversity of human papillomaviruses in skin lesions.

Pools of frozen biopsies from patients with squamous cell carcinoma (SCC) (n=29) actinic keratosis (AK) (n=31), keratoacanthoma (n=91) and swab samples from 84 SCCs and 91 AKs were analysed with an extended HPV general primer PCR and high-throughput sequencing of amplimers. We found 273 different HPV isolates (87 known HPV types, 139 previously known HPV sequences (putative types) and 47 sequences