Complications after benign gynecologic surgery-How are they captured in register-based research? A national register study in Sweden.

Introduction: The evidence on complication rates after gynecological surgery is based on multiple types of studies, and the level of evidence is generally low. We aimed to validate the registration of complications in the Swedish National Quality Register of Gynecological Surgery (GynOp), by cross-linkage to multiple national registers.

Material And Methods: A national register-based study using prospectively collected data was conducted, including women who had surgery on the uterus or adnexa for benign indications from January 1, 2017, to December 31, 2020.

SALpingectomy for STERilisation (SALSTER): study protocol for a Swedish multicentre register-based randomised controlled trial.

Introduction: Salpingectomy is currently suggested as an alternative to tubal ligation for sterilisation. Precursor lesions of ovarian carcinoma can be found in the fallopian tubes; thus, salpingectomy could possibly reduce the incidence. Most of the existing trials on safety are small, on caesarean section and report on surrogate ovarian function measures.

Physicians' assessment of complications after gynecological surgery in Sweden: The GYNCOM survey.

Introduction: Complications after gynecological surgery in Sweden are registered in the well-established Swedish National Quality Register of Gynecological Surgery, GynOp. The aim of this study was to analyze interrater reliability in assessing complications according to the methods in GynOp, and to explore physicians' perceptions of registering complications.

Material And Methods: A digital survey was sent to gynecologists and residents in gynecology in Sweden.

HOPPSA update: changes in the study protocol of Hysterectomy and OPPortunistic SAlpingectomy, a registry-based randomized controlled trial.

Background: The HOPPSA trial is a multi-center national registry-based randomized controlled trial to test the safety and effectiveness of performing opportunistic salpingectomy at hysterectomy to reduce the risk of epithelial ovarian cancer (EOC). The study protocol was first published in January 2019 and is available at https://trialsjournal.biomedcentral.

Impact of hysterectomy on analgesic, psychoactive and neuroactive drug use in women with endometriosis: nationwide cohort study.

Objective: To evaluate how hysterectomy affects the prescription of analgesic, psychotropic and neuroactive drugs in women with endometriosis using population-based nationwide registers.

Design: Nationwide cohort study.

Setting: Swedish national registers, from 1 January 2009 to 31 December 2018.

Experimentally modeling stochastic processes with less memory by the use of a quantum processor.

Computer simulation of observable phenomena is an indispensable tool for engineering new technology, understanding the natural world, and studying human society. However, the most interesting systems are often so complex that simulating their future behavior demands storing immense amounts of information regarding how they have behaved in the past. For increasingly complex systems, simulation becomes increasingly difficult and is ultimately constrained by resources such as computer memory.

Patient-reported lower urinary tract symptoms after hysterectomy or hysteroscopy: a study from the Swedish Quality Register for Gynecological Surgery.

Introduction And Hypothesis: Hysterectomy is sometimes considered the cause of lower urinary tract symptoms (LUTS). We hypothesized that hysterectomy for abnormal uterine bleeding and/or symptoms of fibroids is more likely to cause LUTS than a hysteroscopic procedure for the same indications.

Methods: Two groups of women were compared: one group comprised 3,618 women who had had a hysterectomy due to abnormal uterine bleeding or symptoms of fibroids and the other group comprised 238 women who had had hysteroscopic treatment for the same indications.

Experimental test of universal complementarity relations.

Complementarity restricts the accuracy with which incompatible quantum observables can be jointly measured. Despite popular conception, the Heisenberg uncertainty relation does not quantify this principle. We report the experimental verification of universally valid complementarity relations, including an improved relation derived here.

Education for dialysis patients lowers long-term phosphate levels and maintains health-related quality of life.

Aims: This study aims at biological, knowledgeable, behavioral and health-related quality of life effects of self-dosing of phosphate binders before and after an education program in patients with CKD.

Material And Methods: The following 12-month study included 43 patients with CKD Stage 4 - 5 and plasma phosphate levels repeatedly above recommended maximum level. Patients underwent a structured educational program regarding calcium and phosphate balance, food intake and phosphate binders comprising a 60-min session, 3 - 5 times during a 2-month period (intervention).

Multivariate methods in the development of a new tablet formulation: optimization and validation.

In a previous study of the development of a tablet formulation approximately 100 excipients were characterized in screening experiments using multivariate design. Acceptable values for important responses were obtained with some of the formulations. The relationships between the properties of the excipients and the responses were evaluated using PLS.

Flowability measurements of pharmaceutical powder mixtures with poor flow using five different techniques.

Four different tablet formulations for direct compression with poor flow properties were tested regarding flowability using five different techniques: Hausner ratio, avalanching behavior, powder rheometer, uniaxial tester, and Jenike tester. In addition, the behavior of three of the formulations during emptying of the mixer and tableting was observed and compared to the results of the flowability measurements. The rank order correlation of the formulations was generally the same with all techniques.

Multivariate methods in the development of a new tablet formulation.

The overall objective of this article is to use an efficient approach to find a suitable tablet formulation for direct compression. By using traditional approaches to statistical experimental design in tablet formulation, the number of experiments quickly grows when many descriptive variables or many excipients are included. To facilitate the screening process, a multivariate design, which allows a systematical evaluation of a large number of excipients with a limited number of experiments, was implemented.

Low density lipoprotein as a carrier of cytostatics in cancer chemotherapy: study of stability of drug-carrier complexes in blood.

Several solid tumour and leukemia cell types have a higher low density lipoprotein (LDL) uptake than the corresponding normal cells. We are investigating the possibilities to use LDL as a drug carrier to increase the selectivity of antineoplastic drugs in cancer chemotherapy. We have developed a method to incorporate lipophilic cytotoxic agents without interfering with the in vitro and in vivo properties of LDL.

Plasma stability and cytotoxicity of lipophilic daunorubicin derivatives incorporated into low density lipoproteins.

The selective targeting of antineoplastic drugs to tumours by incorporation in low density lipoproteins (LDL) is an attractive possibility if the drug-LDL complex remains stable in the circulation and is taken up by the tumour. In previous studies we have shown that vincristine- and N-trifluoroacetyladriamycin-14-valerate-LDL complexes were unstable in vivo. We synthesized five N-substituted lipophilic derivatives of daunorubicin and studied their incorporation into LDL.

Tissue culture surface characteristics influence the expansion of human bone marrow cells.

Human cell therapy applications in tissue engineering, such as the ex vivo production of hematopoietic cells for transplantation, have recently entered the clinic. Although considerable effort has been focused on the development of biological processes to generate therapeutic cells, little has been published on the design and manufacture of devices for implementation of these processes in a robust and reproducible fashion at a clinical scale. In this study, the effect of tissue culture surface chemistry and texture was assessed in human bone marrow (BM) mononuclear cell (MNC) and CD34-enriched cell cultures.

Different measures of human hematopoietic cell culture performance are optimized under vastly different conditions.

Hematopoiesis, the formation of mature blood cells from stem (LTC-IC) and progenitor (CFU-GM) cells in the bone marrow, is a complex tissue-forming process that leads to many important physiological functionalities. Consequently, a functioning ex vivo hematopoietic system has a variety of basic scientific and clinical uses. The design and operation of such a system presents the tissue engineer with challenges and choices.

Burnout, empathy and sense of coherence among Swedish district nurses before and after systematic clinical supervision.

The relationships between, on the one hand, burnout, empathy and sense of cohoerence (SOC) and, on the other, personality traits were investigated, together with the effects of systematic clinical supervision on these phenomena among Swedish district nurses. The results in the supervisory group (n = 21) were compared with those of a comparison group (n = 12) in a quasi-experimental design. Personality traits were assessed by means of the Karolinska Scales of Personality.

Long-term culture-initiating cell expansion is dependent on frequent medium exchange combined with stromal and other accessory cell effects.

Despite considerable effort, the expansion of long-term culture-initiating cells (LTC-ICs) in cultures of purified hematopoietic cells has not yet been achieved. In contrast, LTC-IC expansion has been attained in cultures of bone marrow mononuclear cells (MNC) using frequent medium exchange. The use of frequent medium exchange was, therefore, examined in cultures of CD34-enriched cells.

Bioreactor expansion of human bone marrow: comparison of unprocessed, density-separated, and CD34-enriched cells.

Scale-up of human hematopoietic cultures was previously described in continuously perfused systems with bone marrow mononuclear cells (BMMNC), yielding expansion of both progenitors and long-term culture-initiating cells (LTC-IC). We report here on the use of these systems for expansion of unprocessed whole BM cells (WBMC) and CD34-enriched cells. Density separation recovered 84% of CFU-GM and 65% of LTC-IC from WBMC.

Meeting cancer patients. Interviews with Swedish district nurses.

Objective: To illuminate district nurses' experiences in the home care of cancer patients.

Design: A qualitative approach.

Setting: Primary health care in the south-east of Sweden.

Breast cancer patients' experiences of nursing care with the focus on emotional support: the implementation of a nursing intervention.

Nursing care with the focus on emotional support, aimed at improving breast cancer patients' adjustment to everyday life, was implemented. The women were offered the opportunity to talk about illness-related thoughts and reactions, as well as to express feelings of anxiety, fear and anguish with a nurse who listened, consoled and answered questions. The organizational changes included extensive co-operation between the surgical ward and primary health care, shorter waiting times, and changed routines around information about the diagnosis.

District nurses' stories of difficult care episodes narrated during systematic clinical supervision sessions.

In systematic clinical supervision sessions 23 Swedish district nurses narrated 147 difficult care situations. The aim of the study was to illuminate their lived experiences of those situations. The following themes emerged in the analysis of the stories: coming too close to the patient; keeping and restoring patient's hope; conflicting opinions; feeling powerless; meeting unrealistic demands; patients' trust in alternative medicine; feeling disgust, shame and guilt; relations to patients' families; and communication gaps.

Systematic clinical supervision and its effects for nurses handling demanding care situations. Interviews with Swedish district nurses and hospital nurses in cancer care.

This study reports the findings of how district nurses (n = 23) and hospital nurses (n = 9) in cancer care experienced social support in immediate connection with demanding care situations, as well as the effect of systematic clinical supervision. The study is based on their own accounts. The data were collected by means of semi-structured interviews.

Expansion in bioreactors of human progenitor populations from cord blood and mobilized peripheral blood.

Umbilical cord blood (UCB) and mobilized peripheral blood (MPB) provide an alternate source to bone marrow for transplantation. Expansion in vitro of stem/progenitor cell populations from these sources may provide adult-sized grafts otherwise not attainable because of the limited cell numbers available in the case of UCB or because of numerous rounds of apheresis required for sufficient MPB cells. We asked whether continuous perfusion culture could be employed in ex vivo expansion to produce clinically relevant numbers of stem/progenitor cells from these sources.