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  • 51.
    Philippe, Kaat
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Eating difficulties and parental feeding strategies during and after childhood cancer treatment: The experiences of parents.: A systematic literature review.2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Childhood cancer is a life-threatening disease with a profound impact on the family. Treatment side-effects and accompanied dietary difficulties are for example severe stressors, as appropriate nutrition is important for the treatment success and quality of life. In addition, (unhealthy) dietary patterns established in childhood tend to maintain in survivors. Parents are key players in feeding and establishing these pat-terns, though, systematic research on how parents experience these dietary difficulties is limited. This study aimed at exploring parental experiences of children’s dietary changes and difficulties during cancer treatment and after completion: what feelings do parents experience regarding their child’s dietary changes and difficulties, what feeding strategies to they apply to handle these difficulties, and how did they experience professional support and what are parental support needs. A systematic literature review was conducted and resulted in 21 suitable articles. The children were 0-21 years old, had various types of cancer, and received various types of therapy. Findings showed that parents reported many dietary changes (e.g. increase or decrease in food intake) and associated symptoms (e.g. nausea, changed tastes) during and after the cancer treatment course. Parents reported mainly negative feelings towards these dietary difficulties (e.g. distress and anxiety) and applied a wide range of behavioural feeding strategies, both negative (e.g. pressure to eat) and positive (e.g. provide healthy food) strategies. Parents also used complementary and alternative medicine. A high need for informational support regarding eating and feeding was expressed by parents during treatment, a need for emotional and practical support to a lower extent. These results showed how frequent and profound eating and feeding difficulties are in the childhood cancer and survivor population, and their (negative) impact on parents. Parents consequently need more support: they need oral and written information to set realistic expectations and install appropriate feeding strategies. This is important for the child’s nutritional status and general health both during and after cancer.

  • 52.
    Schmidt, Ingrid
    et al.
    Socialstyrelsen National Board of Health and Welfare, Department of Evaluation and Analysis, Stockholm, Sweden.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Davidson, Thomas
    Linkopings universitet, Department of Management and Engineering, Linkoping, Sweden.
    Nilsson, Fredrik
    Lunds Universitet, Department of Design Sciences, Lund, Sweden.
    Carlsson, Christina
    Lunds Universitet, Department of Clinical Sciences, Lund, Sweden.
    The national program on standardized cancer care pathways in Sweden: Observations and findings half way through2018In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 122, no 9, p. 945-948Article in journal (Refereed)
    Abstract [en]

    In 2015, the Swedish government initiated a national cancer reform program to standardize cancer care pathways. Primary aims included shortened waiting times among patients with suspected cancer, increased patient satisfaction and reduced regional variation. The implementation phase of the program is now more than half way through and both achievements and challenges have been identified. The ongoing evaluation demonstrates that professional engagement and adjustments on the meso- and micro-level of the system are essential to achieving sustainable improvements. Waiting times have shortened for the pathways launched first, and patients are satisfied with a more transparent process. Physicians in primary care are satisfied to inform patients about the pathways but point out problems with comorbidity and complicated diagnostic procedures related to unspecific symptoms. Mechanisms and ethical considerations behind possible crowding-out effects need to be thoroughly highlighted and discussed with staff and management. The results so far appear promising but meso- and micro-levels of the system need to be more involved in the design processes.

  • 53.
    Shamoun, Levar
    et al.
    Division of Medical Diagnostics, Department of Laboratory Medicine, Jönköping County, Jönköping, Sweden.
    Kolodziej, Blanka
    Department of Pathology, Jönköping County, Jönköping, Sweden.
    Andersson, Roland E.
    Department of Surgery, Jönköping County, Jönköping, Sweden.
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Protein expression and genetic variation of IL32 and association with colorectal cancer in Swedish patients2018In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 38, no 1, p. 321-328Article in journal (Refereed)
    Abstract [en]

    Background: Interleukin 32 (IL32) is an intracellular pluripotent cytokine produced by epithelial cells, monocytes, T-lymphocytes and natural killer cells and seems to be involved in the pathogenesis of cancer and inflammatory diseases. Our purpose was to assess the role of protein expression and genetic polymorphisms of IL32 in colorectal cancer (CRC) susceptibility.

    Materials and Methods: To gain insight into clinical significance of IL32 in Swedish patients with CRC, using enzyme-linked immunosorbent assay, we determined whether IL32 protein level is altered in CRC tissue (n=75) compared with paired normal tissue and in plasma from patients with CRC (n=94) compared with controls (n=81). The expression of IL32 protein was confirmed by immunohistochemistry (n=73). We used Luminex technology to investigate protein levels of the cytokines IL6, tumor necrosis factor-a (TNFa) and vascular endothelial growth factor (VEGF) to relate these to IL32 levels in CRC tissue. Three single nucleotide polymorphisms (SNPs) (rs28372698, rs12934561, rs4786370) of the IL32 gene have been proposed as modifiers for different diseases. The present study evaluated the susceptibility of patients possessing these SNPs to CRC. Using TaqMan SNP genotyping assays, these SNPs were screened in Swedish patients with CRC (n=465) and healthy controls (n=331).

    Results: We found no significant differences in the genotypic frequencies between the patients and healthy controls and no relation to survival for any of the SNPs. However, the SNP rs12934561 was statisticalLY significant associated with older patients. IL32 protein was up-regulated in CRC tissue and related to IL6, TNFa, and VEGF, and seems to be modulated by SNP rs28372698. The IL32 protein level in CRC tissue also reflects both disseminated disease and location. Conclusion. Our results suggest that altered IL32 protein concentrations in CRC tissue and genotypic variants of IL32 are related to disseminated CRC.

  • 54.
    Shamoun, Levar
    et al.
    Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden.
    Skarstedt, Marita
    Department of Laboratory Medicine, Division of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden.
    Andersson, Roland E.
    Depatment of Surgery, Region Jönköping County, Jönköping, Sweden.
    Wågsäter, Dick
    Division of Drug Research, Department of Medicine and Health Sciences Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Association study on IL-4, IL-4Rα and IL-13 genetic polymorphisms in Swedish patients with colorectal cancer2018In: Clinica Chimica Acta, ISSN 0009-8981, E-ISSN 1873-3492, Vol. 487, p. 101-106Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Interleukin 4 (IL-4) and interleukin 13 (IL-13) are anti-inflammatory and immunomodulatory cytokines which share a common cellular receptor IL4Rα and are involved in the same signaling pathways. Our purpose was to assess whether genetic variants within IL-4, IL-13 and IL-4Rα are associated with the risk or clinical outcome of colorectal cancer (CRC).

    METHODS: Three single nucleotide polymorphisms (SNPs) were screened in 466 patients with CRC and 445 healthy controls. The selected SNPs were IL-4 SNP rs2243250, IL-4Rα SNP rs1801275 and IL-13 SNP rs1800925.

    RESULTS: We found that the genotype variant T/T in IL-13 gene was associated with a higher risk of CRC. Kaplan-Meier analysis showed that the cancer specific survival differed between C/C and CT + TT for IL-4 SNP. Moreover, the carriers of the T allele were associated with the highest risk of CRC death with a hazard ratio (HR) of 1.57, 95% CI 1.06-2.36, p = .024. The observed effect of the T allele was restricted to stage III patients.

    CONCLUSION: Our results indicate IL-13 SNP rs1800925 as a risk factor for CRC and that IL-4 SNP rs2243250 could be a useful prognostic marker in the follow-up and clinical management of patients with CRC especially in stage III disease.

  • 55.
    Song, Nguyen Van
    et al.
    Department of Medical Laboratory, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam.
    Minh, Nguyen Khac
    Department of Medical Laboratory, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam.
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Matussek, Andreas
    Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden.
    Henningsson, Anna J.
    Clinical Microbiology, Division of Medical Diagnostics, Region Jönköping County, Jönköping, Sweden.
    Prevalence of cervical infection and genotype distribution of human Papilloma virus among females in Da Nang, Vietnam2017In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 37, no 3, p. 1243-1247Article in journal (Refereed)
    Abstract [en]

    Aim: The goal of the present study was to determine the prevalence and distribution of high-risk human papilloma virus (HPV) genotypes in women from two districts in and around Da Nang city, Vietnam.

    Materials and Methods: All participants were randomly selected, 200 from the Hai Chau district and 200 from the Son Tra district. The detection and genotyping of HPV were performed by real-time polymerase chain reaction (PCR) technique.

    Results: Out of a total of 400 women, we found that 38 (9.5%) were infected with a high-risk HPV genotype, the most prevalent genotypes being 16, 18, 58 and 59. By assessment of the HPV findings in relation to sociodemographic characteristics, we found significant differences between the two study districts and between the age groups, as well as differences associated with occupation and the use of contraceptives.

    Conclusion: The proportion of high–risk genotypes other than 16 and 18 was relatively high, and since the HPV genotype distribution is known to vary greatly across populations, the information from this study can be used for planning of screening and vaccination programs in Da Nang.

  • 56.
    Song Van, Nguyen
    et al.
    Da Nang Univ Med Technol & Pharm, Dept Lab Med, Da Nang, Vietnam.
    Skarstedt, Marita
    Ryhov Cty Hosp, Dept Clin Microbiol, Jonkoping, Sweden.
    Löfgren, Sture
    Ryhov Cty Hosp, Dept Clin Microbiol, Jonkoping, Sweden.
    Zar, Niklas
    Ryhov Cty Hosp, Dept Surg, Jonkoping, Sweden.
    Andersson, Roland E
    Ryhov Cty Hosp, Dept Surg, Jonkoping, Sweden.
    Lindh, Mikael
    Ryhov Cty Hosp, Dept Surg, Jonkoping, Sweden.
    Matussek, Andreas
    Ryhov Cty Hosp, Dept Lab Med, Jonkoping, Sweden.
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Gene Polymorphism of Matrix Metalloproteinase-12 and-13 and Association with Colorectal Cancer in Swedish Patients2013In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 33, p. 3247-3250Article in journal (Refereed)
    Abstract [en]

    Background: It has been widely reported that matrix metalloproteinases (MMPs) have fundamental roles in pathological processes in cancer through degradation of basal membranes and extracellular matrix. For MMP12 and MMP13, a functional single nucleotide polymorphism (SNP) has been detected -82A -> G (rs2276109) and -77A -> G (rs2252070), respectively. These SNPs are suggested to have an influence on different diseases. The present study evaluated the association between these SNPs in patients with colorectal cancer (CRC) patients and healthy controls. Patients and Methods: Using the TaqMan system, these SNPs were screened in 385 patients with CRC and 619 controls. Results: No significant difference in genotype distribution or in allelic frequencies was found between the two groups. However, we showed that the AA MMP-12 genotype is connected with a higher risk of disseminated CRC (Odds Ratio=1.77; 95% Confidence Interval=1.11-2.81, p=0.018). Conclusion: The results of this study suggest that the -82A -> G (rs2276109) polymorphism of the MMP12 gene reflects clinical outcome of patients with CRC.

  • 57.
    Svedberg, Petra
    et al.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Einberg, Eva-Lena
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Wärnestål, Pontus
    School of Information Technology, Halmstad University, Halmstad, Sweden.
    Stigmar, Jennie
    Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
    Castor, Anders
    Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Nygren, Jens M.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Support from healthcare services during transition to adulthood – Experiences of young adult survivors of pediatric cancer2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 21, p. 105-112Article in journal (Other academic)
    Abstract [en]

    PURPOSE:

    Improved survival rates of pediatric cancer have drawn attention on how to best facilitate long-term follow up and transition from pediatric to adult care. The transition process is multifactorial and necessitates the joint involvement of the patient, the family and the healthcare providers. The purpose of this study was to explore the experiences of support from healthcare services during the transition from adolescence to adulthood described by young adult survivors of pediatric cancer.

    METHODS:

    A mixed method with a convergent parallel design was used to evaluate the experiences of receiving support from healthcare services (eg pediatric oncology and pediatric clinic) during transition from adolescence to adulthood described by young adult survivors of pediatric cancer (n = 213) in a nation wide cross-sectional survey.

    RESULTS:

    A quantitative assessment of the experienced extent and satisfaction of support from healthcare services to handle physical, mental and social changes to continue life after the disease showed that a majority of the participants had received insufficient support. The qualitative analysis indicated a need for equal roles in healthcare to promote participation, a need to manage and process consequences of the disease, and a need for continuous support.

    CONCLUSIONS:

    During transition to adulthood, there's a need for a personalized care plan that takes a holistic approach towards supporting the young cancer survivor in managing life in the best way. Identifying and handling the individual needs of pediatric cancer survivors is important for providing the resources and support required to increase the likelihood of successful transition to adulthood.

  • 58. Ungerbäck, Jonas
    et al.
    Elander, Nils
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Söderkvist, Peter
    Analysis of VEGF polymorphisms, tumor expression of VEGF mRNA and colorectal cancer susceptibility in a Swedish population2009In: Molecular Medicine Reports, ISSN 1791-2997, Vol. 2, no 3, p. 435-439Article in journal (Refereed)
    Abstract [en]

    Vascular endothelial growth factor (VEGF) plays a significant role in tumor angiogenesis and is found to be overexpressed and involved in the development and progression of colorectal cancer (CRC). The VEGF gene contains several polymorphic sites known to influence VEGF expression. We examined the possible association between five polymorphisms, located in the promoter/5'-untranslated region [-2578 (C/A), -2549 (del/ins 18 bp) -1154 (G/A), -634 (G/C)] or 3'-untranslated region [+936 (C/T)] of the VEGF gene, and CRC Susceptibility and clinicopathological characteristics in 302 Swedish CRC patients and 336 healthy randomly selected controls. Both genotypes and combined haplotypes were analyzed. No significant differences were observed when VEGF genotype/haplotype frequencies in the CRC cases and controls were compared, nor were any associations found between the genotypes/haplotypes and clinicopathological characteristics. However, when the -2578 C and +936 T alleles were combined, a small but significant association with CRC susceptibility was detected (OR=1.6, 95% CI 1.3-1.9, p=0.01). In addition, VEGF mRNA expression was determined in a Subset of patients, revealing a 2-fold VEGF upregulation in CRC tissue compared to normal colonic mucosa, but no association between the genotypes or haplotypes and VEGF mRNA levels. Linkage analysis was performed, revealing that the polymorphisms in the promoter and 5'-untranslated region were in tight linkage disequilibrium (LD) (vertical bar D'vertical bar=0.91-1.00), while the +936 C/T polymorphism was only weakly associated with the others (vertical bar D'vertical bar=0.05-0.19). In conclusion, VEGF is generally upregulated in colorectal tumors. However, the single nucleotide polymorphisms examined do not appear to influence the mRNA expression of VEGF in colorectal tumors, and most likely play a limited role in CRC development and progression.

  • 59.
    Wengström, Y.
    et al.
    Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden / Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Bolam, K. A.
    Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden / School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
    Mijwel, S.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Sundberg, C. J.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden / Unit for Bioentrepreneurship, Karolinska Institutet, Solna, Sweden.
    Backman, M.
    Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden / Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Browall, Maria
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Norrbom, J.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Rundqvist, H.
    Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden.
    Optitrain: a randomised controlled exercise trial for women with breast cancer undergoing chemotherapy2017In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 17, article id 100Article in journal (Refereed)
    Abstract [en]

    Background: Women with breast cancer undergoing chemotherapy suffer from a range of detrimental disease and treatment related side-effects. Exercise has shown to be able to counter some of these side-effects and improve physical function as well as quality of life. The primary aim of the study is to investigate and compare the effects of two different exercise regimens on the primary outcome cancer-related fatigue and the secondary outcomes muscle strength, function and structure, cardiovascular fitness, systemic inflammation, skeletal muscle gene activity, health related quality of life, pain, disease and treatment-related symptoms in women with breast cancer receiving chemotherapy. The second aim is to examine if any effects are sustained 1, 2, and 5 years following the completion of the intervention and to monitor return to work, recurrence and survival. The third aim of the study is to examine the effect of attendance and adherence rates on the effects of the exercise programme.

    Methods: This study is a randomised controlled trial including 240 women with breast cancer receiving chemotherapy in Stockholm, Sweden. The participants are randomly allocated to either: group 1: Aerobic training, group 2: Combined resistance and aerobic training, or group 3: usual care (control group). During the 5-year follow-up period, participants in the exercise groups will receive a physical activity prescription. Measurements for endpoints will take place at baseline, after 16 weeks (end of intervention) as well as after 1, 2 and 5 years.

    Discussion: This randomised controlled trial will generate substantial information regarding the effects of different types of exercise on the health of patients with breast cancer undergoing chemotherapy. We expect that dissemination of the knowledge gained from this study will contribute to developing effective long term strategies to improve the physical and psychosocial health of breast cancer survivors.

  • 60. Wågsater, Dick
    et al.
    Mumtaz, Melad
    Lofgren, Sture
    Hugander, Anders
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Resistin in Human Colorectal Cancer: Increased Expression Independently of Resistin Promoter -420C>G genotype.2008In: Cancer Investigation, ISSN 0735-7907, E-ISSN 1532-4192, Vol. 26, no 10, p. 1008-1014Article in journal (Refereed)
    Abstract [en]

    A single nucleotide polymorphism (SNP) -420C> G of the resistin gene was screened in 248 colorectal cancer (CRC) patients and 256 controls. No significant difference in genotype distribution was found. However, we found an upregulation in 92% of the samples in the levels of resistin protein in cancer tissue (n = 83). Immunohistochemical analysis revealed heterogenous staining of resistin predominantly in the cancer tissue. Further, resistin induced secretion of MMP-2 and MMP-9 from monocytes. The results of this study suggest that resistin may play a partial role in CRC but that the -420C> G resistin polymorphism is not a potential genetic susceptibility factor.

  • 61. Wågsäter, Dick
    et al.
    Dienus, Olaf
    Löfgren, Sture
    Hugander, Anders
    Dimberg, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Quantification of the chemokines CCL17 and CCL22 in human colorectal adenocarcinomas2008In: Molecular Medicine Reports, ISSN 1791-2997, Vol. 1, no 2, p. 211-217Article in journal (Refereed)
    Abstract [en]

    Chemokines are believed to play a crucial role in local immunoresponse by regulating leukocyte movement in various tissues, including the intestinal mucosa. It has been suggested that they are key players in cancer biology, and several studies have identified leukocyte infiltration as a hallmark of most cancers. The chemokines CCL17 and CCL22 attract CCR4-bearing cells, which are especially polarised to Th2-type cells and regulatory T cells (Treg). Recent studies have revealed the participation of the CCL17 and CCL22 proteins in diseases such as atopic dermatitis and lymphoma. The purpose of this study was to assess the role of CCL17 and CCL22 protein expression in colorectal cancer (CRC) and to ascertain whether an association exists between promoter -431C>T CCL17 and -961G>A CCL22 gene polymorphisms in CRC versus non-CRC subjects. Using the ELISA assay, we noted a significantly higher expression of CCL22 in tumour tissue with a 2.3-fold up-regulation (tumour vs. paired normal tissue, n=78) but no significant difference in CCL17 protein expression. Immunohistochemistry revealed protein expression of CCL22 and CCL17 in the epithelial compartment of cancer tissue, in epithelial cells at the resection border that reflects normal tissue, and in some stromal cells such as lymphocytes, macrophages, and fibroblasts. Using a TaqMan system we screened for -431C>T CCL17 and -961G>A CCL22 gene variants in 245 CRC patients and 256 controls, but could not find any significant difference in genotype distribution or in allelic frequencies between the two groups. The genotype and allelic distributions of CRC patients were not related to tissue levels of CCL17 and CCL22 protein, and none of the variables were associated with plasma levels or clinical characteristics. To ascertain whether the tissue expression of CCL17 and CCL22 exerts an influence oil the pathogenesis of CRC, a forthcoming study oil the 5-year survival rate of CRC patients will be conducted.

12 51 - 61 of 61
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