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  • 1.
    Axelsson, Bertil
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    What is the Place for an Effect of Surgery to Prevent And/or to Treat Cancer Pain2011In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 47, p. S45-S45Article in journal (Other academic)
  • 2.
    Axelsson, Bertil
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Östersund Hospital.
    Stellborn, P
    Palliative Team at Långbro Park, Sweden.
    Ström, G
    Palliative Team at Södertälje, Sweden.
    Analgesic effect of paracetamol on cancer related pain in concurrent strong opioid therapy. A prospective clinical study2008In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 47, no 5, p. 891-895Article in journal (Refereed)
    Abstract [en]

    Introduction. In palliative cancer care, when approaching death, swallowing difficulties and the burden of tablet intake frequently makes us reconsider each individual drug prescribed. Through the last two decades the routine of always combining a strong opioid with paracetamol has been widely spread in Sweden. Clinical experience has challenged this routine as many patients seem to manage equally well without paracetamol. To find out whether this might be of clinical importance, we wanted to perform a more systematic registration. Material and methods. Thirty-four incurable cancer patients with well controlled pain (NRS 4), treated by specialised palliative home care teams, with ongoing medication with the strong opioid paracetamol combination was recruited to this prospective clinical study. The effect of completely stopping paracetamol medication was evaluated four days later at follow-up. Results. At follow-up nine patients (26%) felt more pain compared to when they entered the study, two patients (6%) felt less pain and 23 (68%) felt no difference. When asked about their preference about future paracetamol treatment 18 patients (53%) wanted to stop taking it, six patients (18%) wanted to continue with regular paracetamol medication as before, and ten patients (29%) wanted to take paracetamol as needed. No clinical predictors of paracetamol response could be identified. Discussion. The results of this study indicate that a critical evaluation, in every patient, of the subjective additive analgesic effect of paracetamol in concurrent strong opioid therapy is advisable and that stopping paracetamol medication not necessarily implies increased pain. Rather in some patients the cessation of paracetamol medication is experienced as a relief as pain control is maintained with a lesser tablet burden.

  • 3.
    Bengtsson, Jenny
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Mohlin, Madelene
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Akut lymfatisk leukemi hos barn: Föräldrars upplevelser2010Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: När ett barn får diagnosen akut lymfatisk leukemi drabbas föräldrarna ofta av psykisk ohälsa. Sjukdomen och behandlingen orsakar förändringar i hela familjens tillvaro. Syfte: Syftet med denna litteraturstudie var att belysa föräldrars upplevelser av att ha ett barn som drabbats av akut lymfatisk leukemi. Metod: En litteratursökning gjordes på databaserna PubMed och Cinahl samt genom manuell sökning. Totalt ingår 14 artiklar i litteraturstudien. Resultat: Resultatet redovisades i fyra olika kategorier: känslomässig berg- och dalbana, sjukdomens inverkan på det normala livet, behov av stöd och information samt föräldrars upplevda roller. Diskussion: Föräldrarna upplevde många olika känslor i samband med barnets ALL. Sjuksköterskans kunskap och den information hon ger föräldrarna är viktigt för att minska rädsla och oro. Slutsats: Denna litteraturstudie kan vara till hjälp för sjuksköterskor vid omhändertagandet av föräldrar med ett barn som drabbats av ALL.

  • 4.
    Ervik, B.
    et al.
    Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, N-9037 Tromsø, Norway.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Dealing with a troublesome body: A qualitative interview study of men’s experiences living with prostate cancer treated with endocrine therapy2012In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 16, no 2, p. 103-108Article in journal (Refereed)
    Abstract [en]

    Purpose: Endocrine therapy for prostate cancer causes substantial side effects, and previous studies have focused on the impacts on sexuality and masculinity. Little is known about how men experience bodily alterations in everyday life through the course of the prostate cancer and treatment. The aim of this study was to show how men with prostate cancer experience bodily changes and how these alterations influence daily life. Method: The study was conducted via qualitative interviews with a phenomenological hermeneutic approach. We interviewed ten men (aged 58-83) with prostate cancer who received endocrine therapy as the primary treatment method. Results: The results showed that five themes were important for the men’s experiences of their bodily alterations throughout the course of the illness: "something is ’wrong’", "when the body becomes troublesome", "to be well or to be ill", "dealing with the alterations" and "to talk about cancer and the intimate details" Initially, the shock of receiving a cancer diagnosis and the physical changes in their bodies were at the forefront of many patients’ minds. Eventually, the impact of the side effects became more evident, which caused problems in everyday life. Yet, the men were able to reflect on the impact of treatment on their everyday lives. Conclusion: This study showed that hormone treatment has a significant influence, both directly and indirectly, on the bodies of prostate cancer patients. The experiences of men with prostate cancer may lead to feelings of loss of identity on an existential level. © 2011 Elsevier Ltd.

  • 5.
    Hirsch, J
    et al.
    Akademiska sjukhuset.
    Carlbom, I
    Uppsala universitet.
    Dérand, P
    Skåne universitetssjukhus.
    Nysjö, F
    Uppsala universitet.
    Nyström, I
    Uppsala universitet.
    Olsson, P
    Uppsala universitet.
    Rännar, Lars-Erik
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics.
    Virtual planning, additive manufacturing of biomaterials and real time reconstructive maxillofacial surgery2013Conference paper (Refereed)
  • 6.
    Högberg, Cecilia
    et al.
    Department of Public Health and Clinical Medicine, Unit of Clinical Research Centre - Östersund, Umeå University, Sweden.
    Karling, Pontus
    Department of Public Health and Clinical Medicine, Medicine/Gastroenterology, Umeå University, Sweden .
    Rutegård, Jörgen
    Department of Surgical and Perioperative Sciences, Umeå University, Sweden .
    Lilja, Mikael
    Department of Public Health and Clinical Medicine, Unit of Clinical Research Centre - Östersund, Umeå University, Sweden.
    Ljung, Thomas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Immunochemical faecal occult blood tests in primary care and the risk of delay in the diagnosis of colorectal cancer2013In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 31, no 4, p. 209-214Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the value, risks, and shortcomings of immunochemical faecal occult blood tests (iFOBTs) in the diagnosis of colorectal cancer (CRC) and adenomas with high-grade dysplasia (HGD) in patients initially presenting to primary care. Design. A retrospective population-based study. Setting and subjects. All 495 cases of CRC and adenomas with HGD diagnosed in the county of Jamtland, Sweden from 2005 to 2009. Results. Of 495 patients 323 (65%) initially presented to primary care. IFOBTs were performed in 215 of 323 (67%) patients. The sensitivity of iFOBT for CRC and adenomas with HGD was 88% (83% when patients with a history of rectal bleeding were excluded). Of 34 patients with anaemia found en passant, 10 had negative iFOBTs. Time to diagnosis was longer for patients with negative iFOBTs (p < 0.0005). Conclusion. IFOBT might be helpful in selecting which patients to refer for colonoscopy. However, iFOBT has a limited sensitivity as a diagnostic test for CRC and adenomas with HGD. Relying only on iFOBT for colonoscopy referral could delay diagnosis, especially for patients with anaemia found en passant.

  • 7.
    Knudsen, Anne Kari
    et al.
    NTNU, Univ Trondheim Hosp, European Palliat Care Res Ctr, Dept Canc Res & Mol Med,Fac Med, N-7006 Trondheim, Norway .
    Aass, Nina
    Univ Oslo, Fac Med, N-0315 Oslo, Norway.
    Heitzer, Ellen
    Med Univ Graz, Dept Internal Med, Div Palliat Med, Graz, Austria .
    Klepstad, Pal
    Fac Med, Dept Circulat & Med Imaging, N-7006 Trondheim, Norway .
    Hjermstad, Marianne Jensen
    NTNU, Univ Trondheim Hosp, European Palliat Care Res Ctr, Dept Canc Res & Mol Med,Fac Med, N-7006 Trondheim, Norway .
    Schippinger, Walter
    Med Univ Graz, Dept Internal Med, Div Palliat Med, Graz, Austria .
    Brenne, Elisabeth
    NTNU, Univ Trondheim Hosp, European Palliat Care Res Ctr, Dept Canc Res & Mol Med,Fac Med, N-7006 Trondheim, Norway .
    Kaasa, Stein
    NTNU, Univ Trondheim Hosp, European Palliat Care Res Ctr, Dept Canc Res & Mol Med,Fac Med, N-7006 Trondheim, Norway .
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Interviews with patients with advanced cancer-another step towards an international cancer pain classification system2012In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 20, no 10, p. 2491-2500Article in journal (Refereed)
    Abstract [en]

    Patients' involvement in the development of assessment tools is recommended, and the European Palliative Care Research Collaborative has adhered to this when developing a shared language for cancer pain, an international assessment and classification system. Study objectives were to investigate how patients ranked the relevance of several previously identified pain domains, to investigate patients' perception of the pain experience and to disclose additional, relevant pain domains for cancer pain classification to those identified in the literature. Semistructured interviews with advanced cancer patients treated with opioids were performed and analysed verbatim. Patients scored the relevance of predefined pain domains on an 11-point Numerical Rating Scale. Thirty-three Norwegian and Austrian patients were included (16 females and 17 males); the mean age was 63 years, and the mean Karnofsky performance score was 65. The ranking of domains was as follows etiology (mean Numerical Rating Scale score, 8.5), duration (8.0), intensity (7.4), coping (7.1), physical (5.9) and psychological functioning (5.8). Sleep was identified as a new candidate domain to include in the system. The patients emphasised consequences of having pain, for example, poor physical functioning and psychological distress. Previously identified pain domains were confirmed to be relevant to the patients; however, the ranking differed from the experts' ranking. Sleep disturbances may be added as a domain in a future classification system.

  • 8.
    Koptyug, Andrey
    et al.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Engineering and Sustainable Development.
    Mamontov, Eugen
    Sukhovey, Yury
    Towards personalised medicine: Problems of the drug therapy of cancer2011In: Science First Hand, ISSN 1810-8520, Vol. 38, no 2, p. 91-97Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    During the fall of 2010 headlines like "Aspirin a day helps to keep cancer at bay, say scientists" hit the world media. It appeared that all of these were inspired by a single publication in The Lancet. This research article shows that regular administration of small doses of aspirin reduces the mortality from certain types of cancer (like the bowel, lung and prostate cancers). In the present paper, we consider this phenomenon as well. The widespread reaction of the public and media to these headlines has persuaded us to write this paper without delay.

  • 9.
    Landgren, Annelie M.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Landgren, Ola
    NCI, Med Oncol Branch, Ctr Canc Res, NIH,Dept Hlth & Human Serv, Bethesda, MD 20892, USA .
    Gridley, Gloria
    NCI, Biostat Branch, Div Canc Epidemiol & Genet, NIH,Dept Hlth & Human Serv, Rockville, MD 20852, USA .
    Dores, Grace M.
    NCI, Radiat Epidemiol Branch, Div Canc Epidemiol & Genet, NIH,DHHS, Rockville, MD 20852, USA .
    Linet, Martha S.
    NCI, Radiat Epidemiol Branch, Div Canc Epidemiol & Genet, NIH,DHHS, Rockville, MD 20852, USA .
    Morton, Lindsay M.
    NCI, Radiat Epidemiol Branch, Div Canc Epidemiol & Genet, NIH,DHHS, Rockville, MD 20852, USA .
    Autoimmune Disease and Subsequent Risk of Developing Alimentary Tract Cancers Among 4.5 Million US Male Veterans2011In: Cancer, ISSN 0008-543X, E-ISSN 1097-0142, Vol. 117, no 6, p. 1163-1171Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Autoimmunity is clearly linked with hematologic malignancies, but less is known about autoimmunity and alimentary tract cancer risk, despite the specific targeting of alimentary organs and tissues by several autoimmune diseases. The authors therefore conducted the first systematic evaluation of a broad range of specific autoimmune diseases and risk for subsequent alimentary tract cancer. METHODS: On the basis of 4,501,578 US male veterans, the authors identified 96,277 men who developed alimentary tract cancer during up to 26.2 years of follow-up. By using Poisson regression methods, the authors calculated relative risks (RRs) and 95% confidence intervals. RESULTS: A history of autoimmune disease with localized alimentary tract effects generally increased cancer risks in the organ(s) affected by the autoimmune disease, such as primary biliary cirrhosis and liver cancer (RR, 6.01; 95% confidence interval [Cl], 4.76-7.57); pernicious anemia and stomach cancer (RR, 3.17; 95% Cl, 2.47-4.07); and ulcerative colitis and small intestine, colon, and rectal cancers (RR, 2.53; 95% Cl, 1.05-6.11; RR, 2.06; 95% Cl, 1.70-2.48; and RR, 2.07; 95% Cl, 1.62-2.64, respectively). In addition, a history of celiac disease, reactive arthritis (Reiter disease), and systemic sclerosis all were associated significantly with increased risk of esophageal cancer (RR, 1.86-2.86). Autoimmune diseases without localized alimentary tract effects generally were not associated with alimentary tract cancer risk, with the exception of decreased risk for multiple alimentary tract cancers associated with a history of multiple sclerosis. CONCLUSIONS: These findings support the importance of localized inflammation in alimentary tract carcinogenesis. Future research is needed to confirm the findings and improve understanding of underlying mechanisms by which autoimmune diseases contribute to alimentary tract carcinogenesis. Cancer 2011;117:1163-71. Published 2010 by the American Cancer Society*

  • 10.
    Lindberg, Sandra
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Mid Sweden University.
    Olofsson, Malin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Mid Sweden University.
    Ur patientens synvinkel: att leva med cancerrelaterad fatigue2008Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Fatigue är ett cancerrelaterat symtom och drabbar ca 61- 100 % av cancer patienterna. Det är en långdragen trötthet som gör det svårt för de drabbade att leva ett normalt liv. Syftet med arbetet var att belysa cancerrelaterad fatigue samt se hur patienter anpassar sig till att leva med detta cancerrelaterade symtom. Metod: En litteraturöversikt genomfördes, med artikelsökning i databaserna PubMed och Cinahl. Innehållsanalys gjordes på funna artiklar, totalt inkluderades 14 artiklar i resultatet. Resultat: Patienter fann egna strategier för att handskas med fatigue, det kunde vara att sova en stund eller distrahera sig med något annat. Patienterna ville ha information om fatigue, men kände ofta att de inte fick det av sjukvårdspersonalen, de ville också ha stöd och förståelse från sin omgivning, något som det inte alltid fick. Diskussion: Enligt författarna måste patienterna få sjukdomsinsikt och information om fatigue för att hitta sina egna strategier så inte fatigue tar över vardagen. Sjuksköterskor bör vara insatta i patienternas situation eftersom patienterna hellre vill diskutera sina problem med sjuksköterskor än läkare. Slutsats: Fatigue är ett ämne som det bör forskas mer

  • 11.
    Åkerstedt, Torbjörn
    et al.
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Narusyte, Jurgita
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Svedberg, Pia
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Kecklund, Goran
    Radboud Univ Nijmegen, Behav Sci Inst, NL-6525 ED Nijmegen, Netherlands.
    Alexanderson, Kristina
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Night work and breast cancer in women: a Swedish cohort study2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 4, article id e008127Article in journal (Refereed)
    Abstract [en]

    Objectives: Recent research has suggested a moderate link between night work and breast cancer in women, mainly through case-control studies, but nonsignificant studies are also common and cohort studies are few. The purpose of the present study was to provide new information from cohort data through investigating the association between the number of years with night work and breast cancer among women. Design: Cohort study of individuals exposed to night shift work in relation to incidence of breast cancer in women. Setting: Individuals in the Swedish Twin registry, with follow-up in the Swedish Cancer Registry. Participants: 13 656 women from the Swedish Twin Registry, with 3404 exposed to night work. Outcome measures: Breast cancer from the Swedish Cancer Registry (463 cases) during a follow-up time of 12 years. Results: A Cox proportional hazards regression analysis with control for a large number of confounders showed that the HR was HR=1.68 (95% CI 0.98 to 2.88) for the group with >20 years of night work. When the follow-up time was limited to ages below 60 years, those exposed >20 years showed a HR=1.77 (95% CI 1.03 to 3.04). Shorter exposure to night work showed no significant effects. Conclusions: The present results, together with previous work, suggest that night work is associated with an increased risk of breast cancer in women, but only after relatively long-term exposure.

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