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5. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

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Kirmeier, E, Eriksson, L, Lewald, H, Jonsson Fagerlund, M, Hoeft, A, Hollmann, M, Meistelman, C, Hunter, J, Ulm, K, Blobner, M, Abad Gurumeta, A, Abernethy, C, Abigail, P, Achaibar, K, Adam, E, Afshari, A, Agudelo Montoya, M, Akgun, F, Aletti, G, Alkis, N, Allan, K, Allan, A, Allaouchiche, B, Allcock, C, Almasy, E, Amey, I, Amigoni, M, Andersen, E, Andersson, P, Anipchenko, N, Antunes, P, Armstrong, E, Aslam, T, Aslin, B, Assuncao, J, Ausserer, J, Avvai, M, Awad, N, Ayas Montero, B, Ayuso, M, Azevedo, P, Badarau, V, Badescu, R, Baiardo Redaelli, M, Baird, C, Baird, Y, Baker, T, Balaji, P, Balan, C, Balandin, A, Balescu-Arion, C, Baliuliene, V, Baltasar Isabel, J, Baluch, S, Bandrabur, D, Bankewitz, C, Barber, K, Barbera, F, Barcraft-Barnes, H, Barletti, V, Barnett, G, Baron, K, Barros, A, Barsan, V, Bartlett, P, Batistaki, C, Baumgarten, G, Baytas, V, Beauchamp, N, Becerra Cayetano, I, Bell, S, Bellandi, M, Belletti, A, Belmonte Cuenca, J, Benitez-Cano, A, Beretta, L, Berger, M, Bergmann, N, Bergmark, K, Bermudez Lopez, M, Bernotaite, M, Beurskens, C, Bidd, H, Bifulco, F, Bignami, E, Bilic, A, Bilskiene, D, Bischoff, P, Bishop, L, Bjonness, T, Blaylock, H, Blethyn, K, Blincoe, T, Blokhin, I, Blunt, N, Boer, C, Bois, G, Bonicolini, E, Booth, J, Borecka-Kedzierska, M, Borstnar, K, Borys, M, Boselli, E, Bouvet, L, Bouwman, A, Bowen, L, Bowrey, S, Boxall, L, Bozic, T, Bradley, T, Branco, T, Brazzi, L, Brazzoni, M, Brear, T, Brogly, N, Brohi, F, Broms, J, Bubliauskas, A, Bucolo, G, Buerkle, H, Buggy, D, Buhre, W, Bukauskas, T, Butturini, F, Byttner, A, Cabrera Diaz, I, Calderon, A, Calhau, R, Callejo, A, Cammu, G, Campesato, M, Can, O, Candeias, M, Cantor, A, Carise, E, Carmona, C, Carreteiro, J, Carrieri, C, Carter, A, Casal, M, Casanova, I, Cascella, M, Casero, L, Casiraghi, G, Castelo-Branco, L, Castro Arranz, C, Cernea, D, Cervantes, J, Chandler, B, Charnock, R, Chatzimicali, A, Chinery, E, Chishti, A, Chondhury, P, Christie, E, Christodoudiles, G, Ciardo, S, Cimpeanu, L, Cindea, I, Cinnella, G, Clark, S, Clayton, M, Cocu, S, Collyer, T, Colvin, C, Cope, S, Copeta, F, Copotoiu, S, Correia de Barros, F, Corso, R, Cortegiani, A, Costa, G, Cowton, A, Cox, N, Craig, J, Cricca, V, Cronin, J, Cunha, M, Cuomo, A, Curley, K, Czuczwar, M, Dabrowska, D, Damster, S, Danguy des Deserts, M, Daniliuc, A, Danninger, T, Darwish, I, Dascalu, C, Davies, K, Davies, S, De Boer, H, De Flaviis, A, De Selincourt, G, Deana, C, Debaene, B, Debreceni, G, Dedhia, J, Delgado Garcia, I, Della Rocca, G, Delroy-Buelles, L, Desai, T, Dhillon, P, Di Giacinto, I, Di Mauro, P, Diaz Gomez, T, Dimitrovski, A, Dinic, V, Dirzu, D, Divander, M, Dolinar, J, Domingues, S, Doolan, J, Downes, C, Dragoescu, N, Droc, G, Dum, E, Dumitrescu, A, Duncan, L, Dzurnakova, P, Eberl, S, Edwards, J, Edwards, M, Ekelund, K, Ekengren, P, Elghouty, E, Ellerkmann, R, Ellis, H, Elme, A, Ernst, T, Errando, C, Estenes, S, Ewaldsson, C, Farid, N, Featherstone, J, Febres, D, Fedorov, S, Feggeler, J, Feijten, P, Fellmann, T, Fernandez Candil, J, Fernandez Castineira, A, Fernandez Castineira, J, Fernando, A, Ferrando, C, Ferreira, L, Ferreira, P, Feyling, A, Filipescu, D, Fleischer, A, Floris, L, Foerster, U, Fox, B, Franke, U, Frasca, D, Frey, C, Frost, V, Fullin, G, Fumagalli, J, Furneval, J, Fusari, M, Gallacher, S, Galushka, S, Gambale, G, Gambino, I, Garcia-Perez, M, Garg, S, Garlak, J, Gavranovic, Z, Gavrilov, R, Gaynor, L, Gecaj Gashi, A, Georghiou, M, Gerjevic, B, Gferer, G, Giarratano, A, Gibson, A, Gievski, V, Giles, J, Gillberg, L, Gilowska, K, Gilsanz Rodriguez, F, Gioia, A, Giovannoni, C, Girotra, V, Gkinas, D, Gkiokas, G, Godoroja, D, Goebel, U, Goel, V, Gonzalez, M, Goranovic, T, Gornik-Wlaszczuk, E, Gosavi, S, Gottfridsson, P, Gottschalk, A, Granell, M, Granstrom, A, Grassetto, A, Greenwood, A, Grigoras, I, Grintescu, I, Gritsan, A, Gritsan, G, Grynyuk, A, Guadagnin, G, Guarnieri, M, Guclu, C, Guerrero Diez, M, Gunenc, F, Gunther, U, Gupta, P, Guttenthaler, V, Hack, Y, Hafisayena, A, Hagau, N, Haldar, J, Hales, D, Hanci, V, Hanna-Jumma, S, Harazim, H, Harlet, P, Harper, D, Harris, B, Harvey, O, Hashimi, M, Hawkins, L, Hayes, C, Heaton, J, Heier, T, Helliwell, L, Hemmes, S, Henderson, K, Hermanides, J, Hermanns, H, Herrera Hueso, B, Hestenes, S, Hettiarachchi, R, Highgate, J, Hodgson, K, Hoelbling, D, Holland, J, Horhota, L, Hormis, A, Hribar, R, Hua, A, Humphreys, S, Humphries, R, Humplikova, S, Hunt, J, Husnain, A, Hussein, A, Hyams, B, Iannuccelli, F, Ilette, K, Ilyas, C, Inan, T, India, I, Ionitav, V, Irwin, F, Jain, V, Janez, B, Jankovic, R, Jenkins, S, Jenko, M, Jimenez, R, Jimenez Gomez, B, Joachim, S, Joelsson-Alm, E, John, J, Jonikaite, L, Jovic, M, Jungwirth, B, Junke, E, Kabakov, B, Kadaoui, S, Kanski, A, Karadag, S, Karbonskiene, A, Karjagin, J, Kasnik, D, Katanolli, F, Katsika, E, Kaufmann, K, Keane, H, Kelly, M, Kent, M, Keraitiene, G, Khudhur, A, Khuenl-Brady, K, Kidd, L, King, S, Kirchgassner, K, Klancir, T, Klucniks, A, Knotzer, J, Knowlden, P, Koers, L, Kompan, J, Koneti, K, Kooij, F, Koolen, E, Koopman - van Gemert, A, Kopp, K, Korfiotis, D, Korolkov, O, Kosinova, M, Kostenberger, M, Kotzinger, O, Kovacevic, M, Kranke, P, Kranke, E, Kraus, C, Kraus, S, Kubitzek, C, Kucharski, R, Kucukguclu, S, Kudrashou, A, Kumar, V, Kummen, L, Kunit, C, Kushakovsky, V, Kuvaki, B, Kuzmanovska, B, Kyttari, A, Landoni, G, Lau, G, Lazarev, K, Legett, S, Legrottaglie, A, Leonardi, S, Leong, M, Lercher, H, Leuvrey, M, Leva, B, Levstek, M, Limb, J, Lindholm, E, Linton, F, Liperi, C, Lipski, F, Lirk, P, Lisi, A, Liskova, K, Lluch Oltra, A, Loganathan, V, Lombardi, S, Lopez, E, Lopez Rodriguez, M, Lorenzini, L, Lowicka, M, Lugovoy, A, Luippold, M, Lumb, A, Macas, A, Macgregor, M, Machado, H, Maciariello, M, Madeira, I, Maitan, S, Majewski, J, Maldini, B, Malewski, G, Manfredini, L, Manner, O, Marchand, B, Marcu, A, Margalef, J, Margarson, M, Marinheiro, L, Markic, A, Markovic Bozic, J, Marrazzo, F, Martin, J, Martin Ayuso, M, Martinez, E, Martino, E, Martinson, V, Marusic-Gaser, K, Mascarenhas, C, Mathis, C, Matsota, P, Mavrommati, E, Mazul Sunko, B, Mccourt, K, Mcgill, N, Mckee, R, Meco, B, Meier, S, Melbourne, S, Melbybrathen, G, Meli, A, Melia, A, Melotti, R, Menga, M, Mercer, P, Merotra, S, Mescolini, S, Metterlein, T, Michalov, M, Michlig, S, Midgley, S, Milic, M, Milojevic, M, Minana, A, Minto, G, Mirabella, L, Mirea, L, Mittelstadt, L, Moeglen, A, Moise, A, Mokini, Z, Molin, A, Molto, L, Monea, M, Montalto, F, Montgomery, J, Montgomery, C, Montillo, G, Moore, S, Moore, F, Moreira, Z, Moreno, T, Moreno, R, Moret, E, Moreton, S, Morgan, M, Moro Velasco, C, Morri, D, Moull, A, Moura, F, Mraz, P, Mrozek, K, Mukhtar, K, Muniyappa, S, Murray, H, Murthy, B, Mushambi, M, Nadolski, M, Nardelli, P, Nardin, G, Navarro Perez, R, Naveiro, A, Negri, M, Nesek Adam, V, Neskovic, V, Neuwersch, S, Neves, M, Nguyen, B, Ni Eochagain, A, Nicholas, C, Nightingale, J, Norrie, K, Novak-Jankovic, V, Novakova, A, Novillo, M, Numan, S, Oduro-Dominah, L, Oldner, A, Oliveira, I, Ologoiu, D, Oloktsidou, I, O'Reilly, R, Orlando, A, Ovezov, A, Ozbilgin, S, Paal, P, Padin Barreiro, L, Palugniok, R, Papaioannou, A, Papapostolou, K, Paranthaman, P, Pardey Bracho, G, Parente, S, Parfeni, A, Pasin, L, Passey, S, Pastor, E, Patch, S, Patil, A, Paunescu, M, Pehboeck, D, Pereira, M, Pereira, C, Perez Caballero, P, Perez Garcia, A, Perez Soto, A, Perez Tejero, G, Perez-Cerda, F, Pesenti, A, Petta, R, Philippe, S, Pickering, D, Pico Veloso, J, Pina, P, Pinho-Oliveira, V, Pinol, S, Pinto, R, Pistidda, L, Pitterle, M, Piwowarczyk, P, Plotnikova, O, Pohl, H, Poldermann, J, Polkovicova, L, Pompei, L, Popescu, M, Popovic, R, Pota, V, Potocnik, M, Potrec, B, Potter, A, Pramod, N, Prchalova, M, Preckel, B, Pugh, R, Pulletz, M, Radoeshki, A, Rafi, A, Ragazzi, R, Raineri Santi, M, Rajamanickam, T, Rajput, Z, Ramachandran, R, Ramasamy, R, Ramessur, S, Rao, R, Rasmussen, A, Rato, A, Razaque, U, Real Navacerrada, M, Reavley, C, Reid, J, Reschreiter, H, Rial, E, Ribas Carrasco, P, Ribeiro, S, Rich, N, Richardson, L, Rimaitis, K, Rimaitis, M, Ringvold, E, Ripke, F, Ristescu, I, Ritchie, K, Rodenas, F, Rodrigues, P, Rogers, E, Rogerson, D, Romagnoli, S, Romero, E, Rondovic, G, Rose, B, Roth, W, Rotter, M, Rousseau, G, Rudjord, A, Rueffert, H, Rundgren, M, Rupprecht, K, Rushton, A, Russotto, V, Rypulak, E, Ryszka, M, Sa, J, Sa Couto, P, Saby, S, Sagic, J, Saleh, O, Sales, G, Sanchez Sanchez, Y, Sanghera, S, Sanli Karip, C, Santiveri Papiol, F, Santos, S, Sarno, S, Saul, D, Saunders, D, Savic, N, Scalco, L, Scanlon, D, Schaller, S, Schax, C, Scheffer, G, Schening, A, Schiavone, V, Schmidt-Ehrenberg, F, Schmidt-Mutter, C, Schonberg, C, Schopflin, C, Schreiber, J, Schultz, M, Schurig, M, Scott, C, Sebestian, S, Sehgal, S, Sem, V, Semenas, E, Serafini, E, Serchan, P, Shields, M, Shobha, R, Shosholcheva, M, Siamansour, T, Siddaiah, N, Siddiqi, K, Sinclair, R, Singh, P, Singh, R, Sinha, A, Skinner, A, Smee, E, Smekalova, O, Smith, N, Smith, T, Smitz, C, Smole, D, Sojcic, N, Soler Pedrola, M, Somanath, S, Sonksen, J, Sorella, M, Sormus, A, Soro, M, Soto, C, Spada, A, Spadaro, S, Spaeth, J, Sparr, H, Spielmann, A, Spindler-Vesel, A, Stamelos, M, Stancombe L, L, Stanculescu, A, Standl, T, Standley, T, Stanek, O, Stanisavljevic, S, Starczewska, M, Stauble, C, Steen, J, Stefan, O, Stell, E, Stera, C, Stevens, M, Stoerckel, M, Stosic, B, Stourac, P, Stroumpoulis, K, Struck, R, Suarez de la Rica, A, Sultanpori, A, Sundara Rajan, R, Suying, O, Svensen, C, Swan, L, Syrogianni, P, Sysiak, J, Szederjesi, J, Taddei, S, Tan Hao, E, Tanou, V, Tarabova, K, Tardaguila Sancho, P, Tarroso, M, Tartaglione, M, Taylor, E, Tbaily, L, Telford, R, Terenzoni, M, Theodoraki, K, Thornley, H, Tiganiuc, L, Toim, H, Tomescu, D, Tommasino, C, Toni, J, Toninelli, A, Toretti, I, Townley, S, Trepenaitis, D, Trethowan, B, Tsaousi, G, Tsiftsi, A, Tudor, A, Turan, G, Turhan, S, Unic-Stojanovic, D, Unterbuchner, C, Unzueta, C, Uranjek, J, Ursic, T, Vaida, S, Valldeperas Ferrer, S, Valldeperas Hernandez, M, Valsamidis, D, Van Beek, R, Van dasselaer, N, Van Der Beek, T, Van Duivenvoorde, Y, van Klei, W, Van Poorter, F, Van Zaane, B, Van Zundert, T, Van Zyl, R, Vargas Munoz, A, Varsani, N, Vasconcelos, P, Vassilakis, G, Vecchiatini, T, Vecera, L, Vercauteren, M, Verdouw, B, Verheyen, V, Verri, M, Vicari Sottosanti, L, Vico, M, Vidal Mitjans, P, Vilardi, A, Vissicchio, D, Vitale, G, Vitkovic, B, Vizcaychipi, M, Voicu, A, Voje, M, Volfova, I, Volta, C, Von Lutterotti, T, von Tiesenhausen, A, Vrecic-Slabe, S, Vukcevic, D, Vukovic, R, Vullo, P, Wade, A, Wallberg, H, Wallden, J, Wallner, J, Walther Sturesson, L, Watson, D, Weber, S, Wegiel Leskiewiq, A, Weller, D, Wensing, C, Werkmann, M, Westberg, H, Wikstrom, E, Williams, B, Wilson, R, Wirth, S, Wittmann, M, Wood, L, Wright, S, Zachoval, C, Zambon, M, Zampieri, S, Zampone, S, Zangrillo, A, Zani, G, Zavackiene, A, Zieglerder, R, Zonneveldt, H, Zsisku, L, Zucker, T, Zukowski, M, Zuleika, M, Zupaneie, D, Kirmeier E., Eriksson L. I., Lewald H., Jonsson Fagerlund M., Hoeft A., Hollmann M., Meistelman C., Hunter J. M., Ulm K., Blobner M., Abad Gurumeta A., Abernethy C., Abigail P., Achaibar K., Adam E., Afshari A., Agudelo Montoya M. E., Akgun F. N., Aletti G., Alkis N., Allan K., Allan A., Allaouchiche B., Allcock C., Almasy E., Amey I., Amigoni M., Andersen E., Andersson P., Anipchenko N., Antunes P., Armstrong E., Aslam T. N., Aslin B., Assuncao J. P., Ausserer J., Avvai M., Awad N., Ayas Montero B., Ayuso M., Azevedo P., Badarau V., Badescu R., Baiardo Redaelli M., Baird C., Baird Y., Baker T., Balaji P., Balan C., Balandin A., Balescu-Arion C., Baliuliene V., Baltasar Isabel J., Baluch S. N., Bandrabur D., Bankewitz C., Barber K., Barbera F., Barcraft-Barnes H., Barletti V., Barnett G., Baron K., Barros A., Barsan V., Bartlett P., Batistaki C., Baumgarten G., Baytas V., Beauchamp N., Becerra Cayetano I. A., Bell S., Bellandi M., Belletti A., Belmonte Cuenca J., Benitez-Cano A., Beretta L., Berger M., Bergmann N., Bergmark K., Bermudez Lopez M., Bernotaite M., Beurskens C., Bidd H., Bifulco F., Bignami E., Bilic A., Bilskiene D., Bischoff P., Bishop L., Bjonness T., Blaylock H., Blethyn K., Blincoe T., Blokhin I., Blunt N., Boer C., Bois G., Bonicolini E., Booth J., Borecka-Kedzierska M., Borstnar K., Borys M., Boselli E., Bouvet L., Bouwman A., Bowen L., Bowrey S., Boxall L., Bozic T., Bradley T., Branco T., Brazzi L., Brazzoni M., Brear T., Brogly N., Brohi F., Broms J., Bubliauskas A., Bucolo G. E., Buerkle H., Buggy D., Buhre W., Bukauskas T., Butturini F., Byttner A., Cabrera Diaz I., Calderon A., Calhau R., Callejo A., Cammu G., Campesato M., Can O. S., Candeias M., Cantor A., Carise E., Carmona C., Carreteiro J., Carrieri C., Carter A., Casal M., Casanova I., Cascella M., Casero L. M., Casiraghi G. M., Castelo-Branco L., Castro Arranz C., Cernea D. D., Cervantes J., Chandler B., Charnock R., Chatzimicali A., Chinery E., Chishti A., Chondhury P., Christie E., Christodoudiles G., Ciardo S., Cimpeanu L., Cindea I., Cinnella G., Clark S., Clayton M., Cocu S., Collyer T., Colvin C., Cope S., Copeta F., Copotoiu S. -M., Correia de Barros F., Corso R. M., Cortegiani A., Costa G., Cowton A., Cox N., Craig J., Cricca V., Cronin J., Cunha M., Cuomo A., Curley K., Czuczwar M., Dabrowska D., Damster S., Danguy des Deserts M., Daniliuc A., Danninger T., Darwish I., Dascalu C., Davies K., Davies S., De Boer H., De Flaviis A., De Selincourt G., Deana C., Debaene B., Debreceni G., Dedhia J., Delgado Garcia I., Della Rocca G., Delroy-Buelles L., Desai T., Dhillon P., Di Giacinto I., Di Mauro P., Diaz Gomez T. V., Dimitrovski A., Dinic V., Dirzu D. -S., Divander M. B., Dolinar J., Domingues S., Doolan J., Downes C., Dragoescu N. A., Droc G., Dum E., Dumitrescu A., Duncan L., Dzurnakova P., Eberl S., Edwards J., Edwards M., Ekelund K., Ekengren P., Elghouty E., Ellerkmann R., Ellis H., Elme A., Ernst T., Errando C. L., Estenes S., Ewaldsson C., Farid N., Featherstone J., Febres D., Fedorov S., Feggeler J., Feijten P., Fellmann T., Fernandez Candil J., Fernandez Castineira A., Fernandez Castineira J., Fernando A., Ferrando C., Ferreira L., Ferreira P., Feyling A., Filipescu D., Fleischer A., Floris L., Foerster U., Fox B., Franke U., Frasca D., Frey C., Frost V., Fullin G., Fumagalli J., Furneval J., Fusari M., Gallacher S., Galushka S., Gambale G., Gambino I., Garcia-Perez M. L., Garg S., Garlak J., Gavranovic Z., Gavrilov R., Gaynor L., Gecaj Gashi A., Georghiou M., Gerjevic B., Gferer G., Giarratano A., Gibson A., Gievski V., Giles J., Gillberg L., Gilowska K., Gilsanz Rodriguez F., Gioia A., Giovannoni C., Girotra V., Gkinas D., Gkiokas G., Godoroja D., Goebel U., Goel V., Gonzalez M., Goranovic T., Gornik-Wlaszczuk E., Gosavi S., Gottfridsson P., Gottschalk A., Granell M., Granstrom A., Grassetto A., Greenwood A., Grigoras I., Grintescu I., Gritsan A., Gritsan G., Grynyuk A., Guadagnin G. M., Guarnieri M., Guclu C., Guerrero Diez M., Gunenc F., Gunther U., Gupta P., Guttenthaler V., Hack Y., Hafisayena A., Hagau N., Haldar J., Hales D., Hanci V., Hanna-Jumma S., Harazim H., Harlet P., Harper D., Harris B., Harvey O., Hashimi M., Hawkins L., Hayes C., Heaton J., Heier T., Helliwell L., Hemmes S., Henderson K., Hermanides J., Hermanns H., Herrera Hueso B., Hestenes S., Hettiarachchi R., Highgate J., Hodgson K., Hoelbling D., Holland J., Horhota L., Hormis A., Hribar R., Hua A., Humphreys S., Humphries R., Humplikova S., Hunt J., Husnain A., Hussein A., Hyams B., Iannuccelli F., Ilette K., Ilyas C., Inan T., India I., Ionitav V., Irwin F., Jain V., Janez B., Jankovic R., Jenkins S., Jenko M., Jimenez R., Jimenez Gomez B., Joachim S., Joelsson-Alm E., John J., Jonikaite L., Jovic M., Jungwirth B., Junke E., Kabakov B., Kadaoui S. -D., Kanski A., Karadag S., Karbonskiene A., Karjagin J., Kasnik D., Katanolli F., Katsika E., Kaufmann K., Keane H., Kelly M., Kent M., Keraitiene G., Khudhur A., Khuenl-Brady K., Kidd L., King S., Kirchgassner K., Klancir T., Klucniks A., Knotzer J., Knowlden P., Koers L., Kompan J., Koneti K. K., Kooij F., Koolen E., Koopman - van Gemert A. W. M. M., Kopp K., Korfiotis D., Korolkov O., Kosinova M., Kostenberger M., Kotzinger O., Kovacevic M., Kranke P., Kranke E., Kraus C., Kraus S., Kubitzek C., Kucharski R., Kucukguclu S., Kudrashou A., Kumar V., Kummen L., Kunit C., Kushakovsky V., Kuvaki B., Kuzmanovska B., Kyttari A., Landoni G., Lau G., Lazarev K., Legett S., Legrottaglie A. M., Leonardi S., Leong M., Lercher H., Leuvrey M., Leva B., Levstek M., Limb J., Lindholm E., Linton F., Liperi C., Lipski F., Lirk P., Lisi A., Liskova K., Lluch Oltra A., Loganathan V., Lombardi S., Lopez E., Lopez Rodriguez M., Lorenzini L., Lowicka M., Lugovoy A., Luippold M., Lumb A., Macas A., Macgregor M., Machado H., Maciariello M., Madeira I., Maitan S., Majewski J., Maldini B., Malewski G., Manfredini L., Manner O., Marchand B., Marcu A., Margalef J., Margarson M., Marinheiro L., Markic A., Markovic Bozic J., Marrazzo F., Martin J., Martin Ayuso M., Martinez E., Martino E. A., Martinson V., Marusic-Gaser K., Mascarenhas C., Mathis C., Matsota P., Mavrommati E., Mazul Sunko B., McCourt K., McGill N., McKee R., Meco B. C., Meier S., Melbourne S., Melbybrathen G., Meli A., Melia A., Melotti R. M., Menga M. R., Mercer P., Merotra S., Mescolini S., Metterlein T., Michalov M., Michlig S., Midgley S., Milic M., Milojevic M., Minana A., Minto G., Mirabella L., Mirea L., Mittelstadt L., Moeglen A., Moise A., Mokini Z., Molin A., Molto L., Monea M. C., Montalto F., Montgomery J., Montgomery C., Montillo G., Moore S., Moore F., Moreira Z., Moreno T., Moreno R., Moret E., Moreton S., Morgan M., Moro Velasco C., Morri D., Moull A., Moura F., Mraz P., Mrozek K., Mukhtar K., Muniyappa S., Murray H., Murthy B. V., Mushambi M., Nadolski M., Nardelli P., Nardin G., Navarro Perez R., Naveiro A., Negri M., Nesek Adam V., Neskovic V., Neuwersch S., Neves M., Nguyen B., Ni Eochagain A., Nicholas C., Nightingale J., Norrie K., Novak-Jankovic V., Novakova A., Novillo M., Numan S., Oduro-Dominah L., Oldner A., Oliveira I., Ologoiu D., Oloktsidou I., O'Reilly R., Orlando A., Ovezov A., Ozbilgin S., Paal P., Padin Barreiro L., Palugniok R., Papaioannou A., Papapostolou K., Paranthaman P., Pardey Bracho G., Parente S., Parfeni A., Pasin L., Passey S., Pastor E., Patch S., Patil A., Paunescu M. -A., Pehboeck D., Pereira M., Pereira C., Perez Caballero P., Perez Garcia A., Perez Soto A., Perez Tejero G., Perez-Cerda F., Pesenti A., Petta R., Philippe S., Pickering D., Pico Veloso J., Pina P., Pinho-Oliveira V., Pinol S., Pinto R., Pistidda L., Pitterle M., Piwowarczyk P., Plotnikova O., Pohl H., Poldermann J., Polkovicova L., Pompei L., Popescu M., Popovic R., Pota V., Potocnik M., Potrec B., Potter A., Pramod N., Prchalova M., Preckel B., Pugh R., Pulletz M., Radoeshki A., Rafi A., Ragazzi R., Raineri Santi M., Rajamanickam T., Rajput Z., Ramachandran R., Ramasamy R., Ramessur S., Rao R., Rasmussen A., Rato A., Razaque U., Real Navacerrada M. I., Reavley C., Reid J., Reschreiter H., Rial E., Ribas Carrasco P., Ribeiro S., Rich N., Richardson L., Rimaitis K., Rimaitis M., Ringvold E. -M., Ripke F., Ristescu I., Ritchie K., Rodenas F., Rodrigues P., Rogers E., Rogerson D., Romagnoli S., Romero E., Rondovic G., Rose B. O., Roth W., Rotter M. -T., Rousseau G., Rudjord A., Rueffert H., Rundgren M., Rupprecht K., Rushton A., Russotto V., Rypulak E., Ryszka M., Sa J., Sa Couto P., Saby S., Sagic J., Saleh O., Sales G., Sanchez Sanchez Y., Sanghera S., Sanli Karip C., Santiveri Papiol F. J., Santos S., Sarno S., Saul D., Saunders D., Savic N., Scalco L., Scanlon D., Schaller S., Schax C., Scheffer G. J., Schening A., Schiavone V., Schmidt-Ehrenberg F., Schmidt-Mutter C., Schonberg C., Schopflin C., Schreiber J. -U., Schultz M., Schurig M., Scott C., Sebestian S., Sehgal S., Sem V., Semenas E., Serafini E., Serchan P., Shields M., Shobha R., Shosholcheva M., Siamansour T., Siddaiah N., Siddiqi K., Sinclair R., Singh P., Singh R., Sinha A., Skinner A., Smee E., Smekalova O., Smith N., Smith T., Smitz C., Smole D., Sojcic N., Soler Pedrola M., Somanath S., Sonksen J., Sorella M. C., Sormus A., Soro M., Soto C., Spada A., Spadaro S., Spaeth J., Sparr H., Spielmann A., Spindler-Vesel A., Stamelos M., Stancombe L L., Stanculescu A., Standl T., Standley T., Stanek O., Stanisavljevic S., Starczewska M., Stauble C., Steen J., Stefan O. M., Stell E., Stera C., Stevens M., Stoerckel M., Stosic B., Stourac P., Stroumpoulis K., Struck R., Suarez de la Rica A., Sultanpori A., Sundara Rajan R., Suying O., Svensen C., Swan L., Syrogianni P., Sysiak J., Szederjesi J., Taddei S., Tan Hao E., Tanou V., Tarabova K., Tardaguila Sancho P., Tarroso M., Tartaglione M., Taylor E., Tbaily L., Telford R., Terenzoni M., Theodoraki K., Thornley H., Tiganiuc L., Toim H., Tomescu D., Tommasino C., Toni J., Toninelli A., Toretti I., Townley S., Trepenaitis D., Trethowan B., Tsaousi G., Tsiftsi A., Tudor A., Turan G., Turhan S. C., Unic-Stojanovic D., Unterbuchner C., Unzueta C., Uranjek J., Ursic T., Vaida S., Valldeperas Ferrer S., Valldeperas Hernandez M. I., Valsamidis D., Van Beek R., Van dasselaer N., Van Der Beek T., Van Duivenvoorde Y., van Klei W. A., Van Poorter F., Van Zaane B., Van Zundert T., Van Zyl R., Vargas Munoz A. M., Varsani N., Vasconcelos P., Vassilakis G., Vecchiatini T., Vecera L., Vercauteren M., Verdouw B., Verheyen V., Verri M., Vicari Sottosanti L. G., Vico M., Vidal Mitjans P., Vilardi A., Vissicchio D., Vitale G., Vitkovic B., Vizcaychipi M. P., Voicu A., Voje M., Volfova I., Volta C. A., Von Lutterotti T., von Tiesenhausen A., Vrecic-Slabe S., Vukcevic D., Vukovic R., Vullo P. A., Wade A., Wallberg H., Wallden J., Wallner J., Walther Sturesson L., Watson D., Weber S., Wegiel Leskiewiq A., Weller D., Wensing C., Werkmann M., Westberg H., Wikstrom E., Williams B., Wilson R., Wirth S., Wittmann M., Wood L., Wright S., Zachoval C., Zambon M., Zampieri S., Zampone S., Zangrillo A., Zani G., Zavackiene A., Zieglerder R., Zonneveldt H., Zsisku L., Zucker T. -P., Zukowski M., Zuleika M., Zupaneie D., Kirmeier, E, Eriksson, L, Lewald, H, Jonsson Fagerlund, M, Hoeft, A, Hollmann, M, Meistelman, C, Hunter, J, Ulm, K, Blobner, M, Abad Gurumeta, A, Abernethy, C, Abigail, P, Achaibar, K, Adam, E, Afshari, A, Agudelo Montoya, M, Akgun, F, Aletti, G, Alkis, N, Allan, K, Allan, A, Allaouchiche, B, Allcock, C, Almasy, E, Amey, I, Amigoni, M, Andersen, E, Andersson, P, Anipchenko, N, Antunes, P, Armstrong, E, Aslam, T, Aslin, B, Assuncao, J, Ausserer, J, Avvai, M, Awad, N, Ayas Montero, B, Ayuso, M, Azevedo, P, Badarau, V, Badescu, R, Baiardo Redaelli, M, Baird, C, Baird, Y, Baker, T, Balaji, P, Balan, C, Balandin, A, Balescu-Arion, C, Baliuliene, V, Baltasar Isabel, J, Baluch, S, Bandrabur, D, Bankewitz, C, Barber, K, Barbera, F, Barcraft-Barnes, H, Barletti, V, Barnett, G, Baron, K, Barros, A, Barsan, V, Bartlett, P, Batistaki, C, Baumgarten, G, Baytas, V, Beauchamp, N, Becerra Cayetano, I, Bell, S, Bellandi, M, Belletti, A, Belmonte Cuenca, J, Benitez-Cano, A, Beretta, L, Berger, M, Bergmann, N, Bergmark, K, Bermudez Lopez, M, Bernotaite, M, Beurskens, C, Bidd, H, Bifulco, F, Bignami, E, Bilic, A, Bilskiene, D, Bischoff, P, Bishop, L, Bjonness, T, Blaylock, H, Blethyn, K, Blincoe, T, Blokhin, I, Blunt, N, Boer, C, Bois, G, Bonicolini, E, Booth, J, Borecka-Kedzierska, M, Borstnar, K, Borys, M, Boselli, E, Bouvet, L, Bouwman, A, Bowen, L, Bowrey, S, Boxall, L, Bozic, T, Bradley, T, Branco, T, Brazzi, L, Brazzoni, M, Brear, T, Brogly, N, Brohi, F, Broms, J, Bubliauskas, A, Bucolo, G, Buerkle, H, Buggy, D, Buhre, W, Bukauskas, T, Butturini, F, Byttner, A, Cabrera Diaz, I, Calderon, A, Calhau, R, Callejo, A, Cammu, G, Campesato, M, Can, O, Candeias, M, Cantor, A, Carise, E, Carmona, C, Carreteiro, J, Carrieri, C, Carter, A, Casal, M, Casanova, I, Cascella, M, Casero, L, Casiraghi, G, Castelo-Branco, L, Castro Arranz, C, Cernea, D, Cervantes, J, Chandler, B, Charnock, R, Chatzimicali, A, Chinery, E, Chishti, A, Chondhury, P, Christie, E, Christodoudiles, G, Ciardo, S, Cimpeanu, L, Cindea, I, Cinnella, G, Clark, S, Clayton, M, Cocu, S, Collyer, T, Colvin, C, Cope, S, Copeta, F, Copotoiu, S, Correia de Barros, F, Corso, R, Cortegiani, A, Costa, G, Cowton, A, Cox, N, Craig, J, Cricca, V, Cronin, J, Cunha, M, Cuomo, A, Curley, K, Czuczwar, M, Dabrowska, D, Damster, S, Danguy des Deserts, M, Daniliuc, A, Danninger, T, Darwish, I, Dascalu, C, Davies, K, Davies, S, De Boer, H, De Flaviis, A, De Selincourt, G, Deana, C, Debaene, B, Debreceni, G, Dedhia, J, Delgado Garcia, I, Della Rocca, G, Delroy-Buelles, L, Desai, T, Dhillon, P, Di Giacinto, I, Di Mauro, P, Diaz Gomez, T, Dimitrovski, A, Dinic, V, Dirzu, D, Divander, M, Dolinar, J, Domingues, S, Doolan, J, Downes, C, Dragoescu, N, Droc, G, Dum, E, Dumitrescu, A, Duncan, L, Dzurnakova, P, Eberl, S, Edwards, J, Edwards, M, Ekelund, K, Ekengren, P, Elghouty, E, Ellerkmann, R, Ellis, H, Elme, A, Ernst, T, Errando, C, Estenes, S, Ewaldsson, C, Farid, N, Featherstone, J, Febres, D, Fedorov, S, Feggeler, J, Feijten, P, Fellmann, T, Fernandez Candil, J, Fernandez Castineira, A, Fernandez Castineira, J, Fernando, A, Ferrando, C, Ferreira, L, Ferreira, P, Feyling, A, Filipescu, D, Fleischer, A, Floris, L, Foerster, U, Fox, B, Franke, U, Frasca, D, Frey, C, Frost, V, Fullin, G, Fumagalli, J, Furneval, J, Fusari, M, Gallacher, S, Galushka, S, Gambale, G, Gambino, I, Garcia-Perez, M, Garg, S, Garlak, J, Gavranovic, Z, Gavrilov, R, Gaynor, L, Gecaj Gashi, A, Georghiou, M, Gerjevic, B, Gferer, G, Giarratano, A, Gibson, A, Gievski, V, Giles, J, Gillberg, L, Gilowska, K, Gilsanz Rodriguez, F, Gioia, A, Giovannoni, C, Girotra, V, Gkinas, D, Gkiokas, G, Godoroja, D, Goebel, U, Goel, V, Gonzalez, M, Goranovic, T, Gornik-Wlaszczuk, E, Gosavi, S, Gottfridsson, P, Gottschalk, A, Granell, M, Granstrom, A, Grassetto, A, Greenwood, A, Grigoras, I, Grintescu, I, Gritsan, A, Gritsan, G, Grynyuk, A, Guadagnin, G, Guarnieri, M, Guclu, C, Guerrero Diez, M, Gunenc, F, Gunther, U, Gupta, P, Guttenthaler, V, Hack, Y, Hafisayena, A, Hagau, N, Haldar, J, Hales, D, Hanci, V, Hanna-Jumma, S, Harazim, H, Harlet, P, Harper, D, Harris, B, Harvey, O, Hashimi, M, Hawkins, L, Hayes, C, Heaton, J, Heier, T, Helliwell, L, Hemmes, S, Henderson, K, Hermanides, J, Hermanns, H, Herrera Hueso, B, Hestenes, S, Hettiarachchi, R, Highgate, J, Hodgson, K, Hoelbling, D, Holland, J, Horhota, L, Hormis, A, Hribar, R, Hua, A, Humphreys, S, Humphries, R, Humplikova, S, Hunt, J, Husnain, A, Hussein, A, Hyams, B, Iannuccelli, F, Ilette, K, Ilyas, C, Inan, T, India, I, Ionitav, V, Irwin, F, Jain, V, Janez, B, Jankovic, R, Jenkins, S, Jenko, M, Jimenez, R, Jimenez Gomez, B, Joachim, S, Joelsson-Alm, E, John, J, Jonikaite, L, Jovic, M, Jungwirth, B, Junke, E, Kabakov, B, Kadaoui, S, Kanski, A, Karadag, S, Karbonskiene, A, Karjagin, J, Kasnik, D, Katanolli, F, Katsika, E, Kaufmann, K, Keane, H, Kelly, M, Kent, M, Keraitiene, G, Khudhur, A, Khuenl-Brady, K, Kidd, L, King, S, Kirchgassner, K, Klancir, T, Klucniks, A, Knotzer, J, Knowlden, P, Koers, L, Kompan, J, Koneti, K, Kooij, F, Koolen, E, Koopman - van Gemert, A, Kopp, K, Korfiotis, D, Korolkov, O, Kosinova, M, Kostenberger, M, Kotzinger, O, Kovacevic, M, Kranke, P, Kranke, E, Kraus, C, Kraus, S, Kubitzek, C, Kucharski, R, Kucukguclu, S, Kudrashou, A, Kumar, V, Kummen, L, Kunit, C, Kushakovsky, V, Kuvaki, B, Kuzmanovska, B, Kyttari, A, Landoni, G, Lau, G, Lazarev, K, Legett, S, Legrottaglie, A, Leonardi, S, Leong, M, Lercher, H, Leuvrey, M, Leva, B, Levstek, M, Limb, J, Lindholm, E, Linton, F, Liperi, C, Lipski, F, Lirk, P, Lisi, A, Liskova, K, Lluch Oltra, A, Loganathan, V, Lombardi, S, Lopez, E, Lopez Rodriguez, M, Lorenzini, L, Lowicka, M, Lugovoy, A, Luippold, M, Lumb, A, Macas, A, Macgregor, M, Machado, H, Maciariello, M, Madeira, I, Maitan, S, Majewski, J, Maldini, B, Malewski, G, Manfredini, L, Manner, O, Marchand, B, Marcu, A, Margalef, J, Margarson, M, Marinheiro, L, Markic, A, Markovic Bozic, J, Marrazzo, F, Martin, J, Martin Ayuso, M, Martinez, E, Martino, E, Martinson, V, Marusic-Gaser, K, Mascarenhas, C, Mathis, C, Matsota, P, Mavrommati, E, Mazul Sunko, B, Mccourt, K, Mcgill, N, Mckee, R, Meco, B, Meier, S, Melbourne, S, Melbybrathen, G, Meli, A, Melia, A, Melotti, R, Menga, M, Mercer, P, Merotra, S, Mescolini, S, Metterlein, T, Michalov, M, Michlig, S, Midgley, S, Milic, M, Milojevic, M, Minana, A, Minto, G, Mirabella, L, Mirea, L, Mittelstadt, L, Moeglen, A, Moise, A, Mokini, Z, Molin, A, Molto, L, Monea, M, Montalto, F, Montgomery, J, Montgomery, C, Montillo, G, Moore, S, Moore, F, Moreira, Z, Moreno, T, Moreno, R, 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Piwowarczyk, P, Plotnikova, O, Pohl, H, Poldermann, J, Polkovicova, L, Pompei, L, Popescu, M, Popovic, R, Pota, V, Potocnik, M, Potrec, B, Potter, A, Pramod, N, Prchalova, M, Preckel, B, Pugh, R, Pulletz, M, Radoeshki, A, Rafi, A, Ragazzi, R, Raineri Santi, M, Rajamanickam, T, Rajput, Z, Ramachandran, R, Ramasamy, R, Ramessur, S, Rao, R, Rasmussen, A, Rato, A, Razaque, U, Real Navacerrada, M, Reavley, C, Reid, J, Reschreiter, H, Rial, E, Ribas Carrasco, P, Ribeiro, S, Rich, N, Richardson, L, Rimaitis, K, Rimaitis, M, Ringvold, E, Ripke, F, Ristescu, I, Ritchie, K, Rodenas, F, Rodrigues, P, Rogers, E, Rogerson, D, Romagnoli, S, Romero, E, Rondovic, G, Rose, B, Roth, W, Rotter, M, Rousseau, G, Rudjord, A, Rueffert, H, Rundgren, M, Rupprecht, K, Rushton, A, Russotto, V, Rypulak, E, Ryszka, M, Sa, J, Sa Couto, P, Saby, S, Sagic, J, Saleh, O, Sales, G, Sanchez Sanchez, Y, Sanghera, S, Sanli Karip, C, Santiveri Papiol, F, Santos, S, Sarno, S, Saul, D, Saunders, D, Savic, N, Scalco, L, Scanlon, D, Schaller, S, Schax, C, Scheffer, G, Schening, A, Schiavone, V, Schmidt-Ehrenberg, F, Schmidt-Mutter, C, Schonberg, C, Schopflin, C, Schreiber, J, Schultz, M, Schurig, M, Scott, C, Sebestian, S, Sehgal, S, Sem, V, Semenas, E, Serafini, E, Serchan, P, Shields, M, Shobha, R, Shosholcheva, M, Siamansour, T, Siddaiah, N, Siddiqi, K, Sinclair, R, Singh, P, Singh, R, Sinha, A, Skinner, A, Smee, E, Smekalova, O, Smith, N, Smith, T, Smitz, C, Smole, D, Sojcic, N, Soler Pedrola, M, Somanath, S, Sonksen, J, Sorella, M, Sormus, A, Soro, M, Soto, C, Spada, A, Spadaro, S, Spaeth, J, Sparr, H, Spielmann, A, Spindler-Vesel, A, Stamelos, M, Stancombe L, L, Stanculescu, A, Standl, T, Standley, T, Stanek, O, Stanisavljevic, S, Starczewska, M, Stauble, C, Steen, J, Stefan, O, Stell, E, Stera, C, Stevens, M, Stoerckel, M, Stosic, B, Stourac, P, Stroumpoulis, K, Struck, R, Suarez de la Rica, A, Sultanpori, A, Sundara Rajan, R, Suying, O, Svensen, C, Swan, L, Syrogianni, P, Sysiak, J, Szederjesi, 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I., Lewald H., Jonsson Fagerlund M., Hoeft A., Hollmann M., Meistelman C., Hunter J. M., Ulm K., Blobner M., Abad Gurumeta A., Abernethy C., Abigail P., Achaibar K., Adam E., Afshari A., Agudelo Montoya M. E., Akgun F. N., Aletti G., Alkis N., Allan K., Allan A., Allaouchiche B., Allcock C., Almasy E., Amey I., Amigoni M., Andersen E., Andersson P., Anipchenko N., Antunes P., Armstrong E., Aslam T. N., Aslin B., Assuncao J. P., Ausserer J., Avvai M., Awad N., Ayas Montero B., Ayuso M., Azevedo P., Badarau V., Badescu R., Baiardo Redaelli M., Baird C., Baird Y., Baker T., Balaji P., Balan C., Balandin A., Balescu-Arion C., Baliuliene V., Baltasar Isabel J., Baluch S. N., Bandrabur D., Bankewitz C., Barber K., Barbera F., Barcraft-Barnes H., Barletti V., Barnett G., Baron K., Barros A., Barsan V., Bartlett P., Batistaki C., Baumgarten G., Baytas V., Beauchamp N., Becerra Cayetano I. A., Bell S., Bellandi M., Belletti A., Belmonte Cuenca J., Benitez-Cano A., Beretta L., Berger M., Bergmann N., Bergmark K., Bermudez Lopez M., Bernotaite M., Beurskens C., Bidd H., Bifulco F., Bignami E., Bilic A., Bilskiene D., Bischoff P., Bishop L., Bjonness T., Blaylock H., Blethyn K., Blincoe T., Blokhin I., Blunt N., Boer C., Bois G., Bonicolini E., Booth J., Borecka-Kedzierska M., Borstnar K., Borys M., Boselli E., Bouvet L., Bouwman A., Bowen L., Bowrey S., Boxall L., Bozic T., Bradley T., Branco T., Brazzi L., Brazzoni M., Brear T., Brogly N., Brohi F., Broms J., Bubliauskas A., Bucolo G. E., Buerkle H., Buggy D., Buhre W., Bukauskas T., Butturini F., Byttner A., Cabrera Diaz I., Calderon A., Calhau R., Callejo A., Cammu G., Campesato M., Can O. S., Candeias M., Cantor A., Carise E., Carmona C., Carreteiro J., Carrieri C., Carter A., Casal M., Casanova I., Cascella M., Casero L. M., Casiraghi G. M., Castelo-Branco L., Castro Arranz C., Cernea D. D., Cervantes J., Chandler B., Charnock R., Chatzimicali A., Chinery E., Chishti A., Chondhury P., Christie E., Christodoudiles G., Ciardo S., Cimpeanu L., Cindea I., Cinnella G., Clark S., Clayton M., Cocu S., Collyer T., Colvin C., Cope S., Copeta F., Copotoiu S. -M., Correia de Barros F., Corso R. M., Cortegiani A., Costa G., Cowton A., Cox N., Craig J., Cricca V., Cronin J., Cunha M., Cuomo A., Curley K., Czuczwar M., Dabrowska D., Damster S., Danguy des Deserts M., Daniliuc A., Danninger T., Darwish I., Dascalu C., Davies K., Davies S., De Boer H., De Flaviis A., De Selincourt G., Deana C., Debaene B., Debreceni G., Dedhia J., Delgado Garcia I., Della Rocca G., Delroy-Buelles L., Desai T., Dhillon P., Di Giacinto I., Di Mauro P., Diaz Gomez T. V., Dimitrovski A., Dinic V., Dirzu D. -S., Divander M. B., Dolinar J., Domingues S., Doolan J., Downes C., Dragoescu N. A., Droc G., Dum E., Dumitrescu A., Duncan L., Dzurnakova P., Eberl S., Edwards J., Edwards M., Ekelund K., Ekengren P., Elghouty E., Ellerkmann R., Ellis H., Elme A., Ernst T., Errando C. L., Estenes S., Ewaldsson C., Farid N., Featherstone J., Febres D., Fedorov S., Feggeler J., Feijten P., Fellmann T., Fernandez Candil J., Fernandez Castineira A., Fernandez Castineira J., Fernando A., Ferrando C., Ferreira L., Ferreira P., Feyling A., Filipescu D., Fleischer A., Floris L., Foerster U., Fox B., Franke U., Frasca D., Frey C., Frost V., Fullin G., Fumagalli J., Furneval J., Fusari M., Gallacher S., Galushka S., Gambale G., Gambino I., Garcia-Perez M. L., Garg S., Garlak J., Gavranovic Z., Gavrilov R., Gaynor L., Gecaj Gashi A., Georghiou M., Gerjevic B., Gferer G., Giarratano A., Gibson A., Gievski V., Giles J., Gillberg L., Gilowska K., Gilsanz Rodriguez F., Gioia A., Giovannoni C., Girotra V., Gkinas D., Gkiokas G., Godoroja D., Goebel U., Goel V., Gonzalez M., Goranovic T., Gornik-Wlaszczuk E., Gosavi S., Gottfridsson P., Gottschalk A., Granell M., Granstrom A., Grassetto A., Greenwood A., Grigoras I., Grintescu I., Gritsan A., Gritsan G., Grynyuk A., Guadagnin G. M., Guarnieri M., Guclu C., Guerrero Diez M., Gunenc F., Gunther U., Gupta P., Guttenthaler V., Hack Y., Hafisayena A., Hagau N., Haldar J., Hales D., Hanci V., Hanna-Jumma S., Harazim H., Harlet P., Harper D., Harris B., Harvey O., Hashimi M., Hawkins L., Hayes C., Heaton J., Heier T., Helliwell L., Hemmes S., Henderson K., Hermanides J., Hermanns H., Herrera Hueso B., Hestenes S., Hettiarachchi R., Highgate J., Hodgson K., Hoelbling D., Holland J., Horhota L., Hormis A., Hribar R., Hua A., Humphreys S., Humphries R., Humplikova S., Hunt J., Husnain A., Hussein A., Hyams B., Iannuccelli F., Ilette K., Ilyas C., Inan T., India I., Ionitav V., Irwin F., Jain V., Janez B., Jankovic R., Jenkins S., Jenko M., Jimenez R., Jimenez Gomez B., Joachim S., Joelsson-Alm E., John J., Jonikaite L., Jovic M., Jungwirth B., Junke E., Kabakov B., Kadaoui S. -D., Kanski A., Karadag S., Karbonskiene A., Karjagin J., Kasnik D., Katanolli F., Katsika E., Kaufmann K., Keane H., Kelly M., Kent M., Keraitiene G., Khudhur A., Khuenl-Brady K., Kidd L., King S., Kirchgassner K., Klancir T., Klucniks A., Knotzer J., Knowlden P., Koers L., Kompan J., Koneti K. K., Kooij F., Koolen E., Koopman - van Gemert A. W. M. M., Kopp K., Korfiotis D., Korolkov O., Kosinova M., Kostenberger M., Kotzinger O., Kovacevic M., Kranke P., Kranke E., Kraus C., Kraus S., Kubitzek C., Kucharski R., Kucukguclu S., Kudrashou A., Kumar V., Kummen L., Kunit C., Kushakovsky V., Kuvaki B., Kuzmanovska B., Kyttari A., Landoni G., Lau G., Lazarev K., Legett S., Legrottaglie A. M., Leonardi S., Leong M., Lercher H., Leuvrey M., Leva B., Levstek M., Limb J., Lindholm E., Linton F., Liperi C., Lipski F., Lirk P., Lisi A., Liskova K., Lluch Oltra A., Loganathan V., Lombardi S., Lopez E., Lopez Rodriguez M., Lorenzini L., Lowicka M., Lugovoy A., Luippold M., Lumb A., Macas A., Macgregor M., Machado H., Maciariello M., Madeira I., Maitan S., Majewski J., Maldini B., Malewski G., Manfredini L., Manner O., Marchand B., Marcu A., Margalef J., Margarson M., Marinheiro L., Markic A., Markovic Bozic J., Marrazzo F., Martin J., Martin Ayuso M., Martinez E., Martino E. A., Martinson V., Marusic-Gaser K., Mascarenhas C., Mathis C., Matsota P., Mavrommati E., Mazul Sunko B., McCourt K., McGill N., McKee R., Meco B. C., Meier S., Melbourne S., Melbybrathen G., Meli A., Melia A., Melotti R. M., Menga M. R., Mercer P., Merotra S., Mescolini S., Metterlein T., Michalov M., Michlig S., Midgley S., Milic M., Milojevic M., Minana A., Minto G., Mirabella L., Mirea L., Mittelstadt L., Moeglen A., Moise A., Mokini Z., Molin A., Molto L., Monea M. C., Montalto F., Montgomery J., Montgomery C., Montillo G., Moore S., Moore F., Moreira Z., Moreno T., Moreno R., Moret E., Moreton S., Morgan M., Moro Velasco C., Morri D., Moull A., Moura F., Mraz P., Mrozek K., Mukhtar K., Muniyappa S., Murray H., Murthy B. V., Mushambi M., Nadolski M., Nardelli P., Nardin G., Navarro Perez R., Naveiro A., Negri M., Nesek Adam V., Neskovic V., Neuwersch S., Neves M., Nguyen B., Ni Eochagain A., Nicholas C., Nightingale J., Norrie K., Novak-Jankovic V., Novakova A., Novillo M., Numan S., Oduro-Dominah L., Oldner A., Oliveira I., Ologoiu D., Oloktsidou I., O'Reilly R., Orlando A., Ovezov A., Ozbilgin S., Paal P., Padin Barreiro L., Palugniok R., Papaioannou A., Papapostolou K., Paranthaman P., Pardey Bracho G., Parente S., Parfeni A., Pasin L., Passey S., Pastor E., Patch S., Patil A., Paunescu M. -A., Pehboeck D., Pereira M., Pereira C., Perez Caballero P., Perez Garcia A., Perez Soto A., Perez Tejero G., Perez-Cerda F., Pesenti A., Petta R., Philippe S., Pickering D., Pico Veloso J., Pina P., Pinho-Oliveira V., Pinol S., Pinto R., Pistidda L., Pitterle M., Piwowarczyk P., Plotnikova O., Pohl H., Poldermann J., Polkovicova L., Pompei L., Popescu M., Popovic R., Pota V., Potocnik M., Potrec B., Potter A., Pramod N., Prchalova M., Preckel B., Pugh R., Pulletz M., Radoeshki A., Rafi A., Ragazzi R., Raineri Santi M., Rajamanickam T., Rajput Z., Ramachandran R., Ramasamy R., Ramessur S., Rao R., Rasmussen A., Rato A., Razaque U., Real Navacerrada M. I., Reavley C., Reid J., Reschreiter H., Rial E., Ribas Carrasco P., Ribeiro S., Rich N., Richardson L., Rimaitis K., Rimaitis M., Ringvold E. -M., Ripke F., Ristescu I., Ritchie K., Rodenas F., Rodrigues P., Rogers E., Rogerson D., Romagnoli S., Romero E., Rondovic G., Rose B. O., Roth W., Rotter M. -T., Rousseau G., Rudjord A., Rueffert H., Rundgren M., Rupprecht K., Rushton A., Russotto V., Rypulak E., Ryszka M., Sa J., Sa Couto P., Saby S., Sagic J., Saleh O., Sales G., Sanchez Sanchez Y., Sanghera S., Sanli Karip C., Santiveri Papiol F. J., Santos S., Sarno S., Saul D., Saunders D., Savic N., Scalco L., Scanlon D., Schaller S., Schax C., Scheffer G. J., Schening A., Schiavone V., Schmidt-Ehrenberg F., Schmidt-Mutter C., Schonberg C., Schopflin C., Schreiber J. -U., Schultz M., Schurig M., Scott C., Sebestian S., Sehgal S., Sem V., Semenas E., Serafini E., Serchan P., Shields M., Shobha R., Shosholcheva M., Siamansour T., Siddaiah N., Siddiqi K., Sinclair R., Singh P., Singh R., Sinha A., Skinner A., Smee E., Smekalova O., Smith N., Smith T., Smitz C., Smole D., Sojcic N., Soler Pedrola M., Somanath S., Sonksen J., Sorella M. C., Sormus A., Soro M., Soto C., Spada A., Spadaro S., Spaeth J., Sparr H., Spielmann A., Spindler-Vesel A., Stamelos M., Stancombe L L., Stanculescu A., Standl T., Standley T., Stanek O., Stanisavljevic S., Starczewska M., Stauble C., Steen J., Stefan O. M., Stell E., Stera C., Stevens M., Stoerckel M., Stosic B., Stourac P., Stroumpoulis K., Struck R., Suarez de la Rica A., Sultanpori A., Sundara Rajan R., Suying O., Svensen C., Swan L., Syrogianni P., Sysiak J., Szederjesi J., Taddei S., Tan Hao E., Tanou V., Tarabova K., Tardaguila Sancho P., Tarroso M., Tartaglione M., Taylor E., Tbaily L., Telford R., Terenzoni M., Theodoraki K., Thornley H., Tiganiuc L., Toim H., Tomescu D., Tommasino C., Toni J., Toninelli A., Toretti I., Townley S., Trepenaitis D., Trethowan B., Tsaousi G., Tsiftsi A., Tudor A., Turan G., Turhan S. C., Unic-Stojanovic D., Unterbuchner C., Unzueta C., Uranjek J., Ursic T., Vaida S., Valldeperas Ferrer S., Valldeperas Hernandez M. I., Valsamidis D., Van Beek R., Van dasselaer N., Van Der Beek T., Van Duivenvoorde Y., van Klei W. A., Van Poorter F., Van Zaane B., Van Zundert T., Van Zyl R., Vargas Munoz A. M., Varsani N., Vasconcelos P., Vassilakis G., Vecchiatini T., Vecera L., Vercauteren M., Verdouw B., Verheyen V., Verri M., Vicari Sottosanti L. G., Vico M., Vidal Mitjans P., Vilardi A., Vissicchio D., Vitale G., Vitkovic B., Vizcaychipi M. P., Voicu A., Voje M., Volfova I., Volta C. A., Von Lutterotti T., von Tiesenhausen A., Vrecic-Slabe S., Vukcevic D., Vukovic R., Vullo P. A., Wade A., Wallberg H., Wallden J., Wallner J., Walther Sturesson L., Watson D., Weber S., Wegiel Leskiewiq A., Weller D., Wensing C., Werkmann M., Westberg H., Wikstrom E., Williams B., Wilson R., Wirth S., Wittmann M., Wood L., Wright S., Zachoval C., Zambon M., Zampieri S., Zampone S., Zangrillo A., Zani G., Zavackiene A., Zieglerder R., Zonneveldt H., Zsisku L., Zucker T. -P., Zukowski M., Zuleika M., and Zupaneie D.

Abstract

Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary

Published
2019

10. Participation in water-exercising long-term after breast cancer surgery: Experiences of significant factors for continuing exercising as a part of cancer rehabilitation

Author

Enblom, Anna, Lindquist, H., Bergmark, K., Enblom, Anna, Lindquist, H., and Bergmark, K.

Abstract

Although physical exercising has great benefits, little is known regarding factors of significance for cancer survivors to continue exercising within their rehabilitation. The objective was to describe factors experienced to be of significance for cancer survivors to continue with water-exercising long-term after breast cancer surgery. Women (n=29) who had undergone breast cancer surgery (mastectomy 79%, axillary surgery 86%, and radiotherapy 86%) for median (md) 13 (25th-75th percentile 3-21.5) was followed up regarding their rehabilitation, arm function Disabilities of Arm Shoulder and Hand (md 14, IQR 7-32), EQ-5D score (md 0.8, IQR 0.73-1.0) and quality of life EQ health barometer (md 80, IQR 64-95). We performed qualitative focus-group interviews regarding the womens views (n=24). The women had participated in water-exercising 1-46 semesters, md 8 (25th-75th percentile 3-21.5) semesters. Nearly all, 97%, participated in the water-exercising group every week, and 21 (72%) had participated in the water-exercising group at least half of the time since their breast cancer surgery, without complications. The women experienced that factors of significance to continue with water-exercising were the convenience of easily modified weightless exercising in the water, social interaction, and access to a private dressing room. These factors would be important to consider to encourage continuing in exercising., Funding Agencies|Division of Clinical Cancer Epidemiology, Gothenburg; Linkoping University; Region of Ostergotland, Sweden

Published
2018
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13. WATER EXERCISE COMPARED TO LAND EXERCISE OR STANDARD CARE IN FEMALE CANCER SURVIVORS WITH SECONDARY LYMPHEDEMA

Author

Lindquist, H., Enblom, A., Dunberger, G., Tommy Nyberg, and Bergmark, K.

Subjects
Adult, Aged, 80 and over, Sweden, Time Factors, Genital Neoplasms, Female, Health Status, Water, Breast Neoplasms, Recovery of Function, Middle Aged, Biomechanical Phenomena, Exercise Therapy, Upper Extremity, Treatment Outcome, Surveys and Questionnaires, Immersion, Body Image, Humans, Female, Lymphedema, Aged
Abstract

There are few studies showing that physical exercise can improve secondary lymphedema. We hypothesized that water exercise would be more effective than land exercise in reducing limb volume. Secondary objectives were joint movement, BMI, daily function, well-being, and body image. Limb volume was measured with circumference or was volumetric. Well-being and body image were measured with a study-specific questionnaire and daily function with DASH and HOOS questionnaires. Eighty-eight eligible patients with secondary lymphedema after breast or gynecological cancer participated in this controlled clinical intervention study. There was a higher proportion of women who participated in water exercises who reduced their secondary arm limb volume (p = 0.029), and there were also significant differences for BMI (p = 0.047) and self-reported frequency of swelling (p = 0.031) in the water exercise group after intervention. Women with arm lymphedema in the land exercise group improved DASH scores (p = 0.047) and outer rotation in the shoulder (p = 0.001). Our results suggest that to reduce objective and self-reported swelling, lymphedema patients may be offered water exercise training while to improve daily shoulder function, land exercises are preferred. To guide female cancer survivors with lymphedema to effective exercise resulting in reduced limb volume and improved function, adequate evidenced-based programs are needed.

Published
2015

17. Psychometric validation of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24)

Author

Greimel, E., Nordin, A., Lanceley, A., Creutzberg, C.L., Poll-Franse, L.V. van de, Radisic, V.B., Galalae, R., Schmalz, C., Barlow, E., Jensen, P.T., Waldenstrom, A.C., Bergmark, K., Chie, W.C., Kuljanic, K., Costantini, A., Singer, S., Koensgen, D., Menon, U., Daghofer, F., and EORTC Quality Life Grp

Subjects
Adult, Questionnaires, Cancer Research, medicine.medical_specialty, Psychometrics, medicine.medical_treatment, Sensitivity and Specificity, Quality of life Endometrial cancer Questionnaire development EORTC Psychometric properties mrc astec radiotherapy health trial irradiation survivors, Cronbach's alpha, Quality of life, Surveys and Questionnaires, medicine, Humans, Karnofsky Performance Status, Aged, Gynecology, Aged, 80 and over, business.industry, Endometrial cancer, Discriminant validity, Cancer, Reproducibility of Results, social sciences, Middle Aged, medicine.disease, humanities, Endometrial Neoplasms, Radiation therapy, Clinical trial, Oncology, Socioeconomic Factors, Patient Satisfaction, Physical therapy, Quality of Life, Female, business
Abstract

Aim: A validation study was conducted to evaluate the psychometric properties of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24). This module was designed to assess disease and treatment specific aspects of the quality of life (QoL) of patients with endometrial cancer. Methods: Two hundred and sixty-eight women with endometrial cancer were recruited in different phases of treatment: after pelvic surgery (Group 1); during adjuvant chemotherapy and/or radiotherapy (Group 2); after completion of treatment (Group 3). Patients completed the EORTC QLQ-C30, the endometrial cancer module and a short debriefing questionnaire. Results: Multi-trait scaling analyses confirmed the hypothesised scale structure of the QLQ-EN24. Internal consistency reliability was good with Cronbach's alpha coefficients ranging from 0.74 to 0.86 (lymphoedema 0.80, urological symptoms 0.75, gastrointestinal symptoms 0.74, body image problems 0.86 and sexual/vaginal problems 0.86). Convergent and discriminant validity did not show any scaling errors for the subscales. The QLQ-EN24 module discriminated well between clinically different groups of patients. All items exhibited a high completion rate with less than 2% missing values except for the sexuality items (19%). Conclusion: The validation study supports the reliability, the convergent and divergent validity of the EORTC QLQ-EN24. This newly developed QLQ-EN24 module is a useful instrument for the assessment of the QoL in patients treated for endometrial cancer in clinical trials. (C) 2010 Elsevier Ltd. All rights reserved.

Published
2011
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20. Lymphedema and bladder-emptying difficulties after radical hysterectomy for early cervical cancer and among population controls.

Author

Bergmark, K, Åvall-Lundqvist, Elisabeth, Dickman, P W, Henningsohn, L, Steineck, G, Bergmark, K, Åvall-Lundqvist, Elisabeth, Dickman, P W, Henningsohn, L, and Steineck, G

Abstract

The aim of the study was to acquire knowledge that can be used to refine radical hysterectomy to improve quality-of-life outcome. Data were collected in 1996-1997 by means of an anonymous postal questionnaire in a follow-up study of two cohorts (patients and population controls). We attempted to enroll all 332 patients with stage IB-IIA cervical cancer registered in 1991-1992 at the seven departments of gynecological oncology in Sweden and 489 population controls. Ninety three (37%) of the 256 women with a history of cervical cancer who answered the questionnaire (77%) were treated with surgery alone. Three-hundred fifty population controls answered the questionnaire (72%). Women treated with radical hysterectomy, as compared with controls, had an 8-fold increase in symptoms indicating lymphedema (25% reported distress due to lymphedema), a nearly 9-fold increase in difficult emptying of the bladder, and a 22-fold increase in the need to strain to initiate bladder evacuation. Ninety percent of the patients were not willing to trade off survival for freedom from symptoms. Avoiding to induce long-term lymphedema or bladder-emptying difficulties would probably improve quality of life after radical hysterectomy (to cure cervical cancer). Few women want to compromise survival to avoid long-term symptoms.

Published
2006
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22. Time after surgery, symptoms and well-being in survivors of urinary bladder cancer

Author

Henningsohn, L, Wijkström, H, Pedersen, J, Ahlstrand, Christer, Aus, G, Bergmark, K, Onelöv, E, Steineck, G, Henningsohn, L, Wijkström, H, Pedersen, J, Ahlstrand, Christer, Aus, G, Bergmark, K, Onelöv, E, and Steineck, G

Abstract

OBJECTIVE: To evaluate how an increasing burden of symptoms influences well-being, anxiety and depression at different intervals after a radical cystectomy with urostomy for bladder cancer, as this therapy can induce long-term distressful symptoms. PATIENTS AND METHODS: Patients with bladder cancer undergoing radical cystectomy in Stockholm between 1969 and 1995 were matched with 434 controls from the normal population, all 404 patients operated on between 1985 and 1995 at three other hospitals in Sweden were invited to enter the study. The final analysis included 306 patients and 310 controls, all assessed for symptoms and well-being. RESULTS: A low or moderate level of well-being was reported by 35% of the patients having none or one of the symptoms studied, by 39% with two symptoms, by 45% with three symptoms and by 66% of those with four or more symptoms. The values, irrespective of symptom burden, were 45% after 2-5 years of follow-up, 58% after 6-10 years and 38% at > 10 years after surgery. The total symptom burden also influenced the risk of anxiety and depression. Symptom prevalence remained largely unaffected by the duration of follow-up, except for defecation urgency. CONCLUSIONS: The number of long-term symptoms after radical surgery with a urostomy for urinary bladder cancer affects the risk of anxiety, depression and low or moderate well-being.

Published
2003
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23. Relative importance of sources of symptom-induced distress in urinary bladder cancer survivors

Author

Henningsohn, L, Wijkstrom, H, Steven, K, Pedersen, J, Ahlstrand, Christer, Aus, G, Kallestrup, EB, Bergmark, K, Onelov, E, Steineck, G, Henningsohn, L, Wijkstrom, H, Steven, K, Pedersen, J, Ahlstrand, Christer, Aus, G, Kallestrup, EB, Bergmark, K, Onelov, E, and Steineck, G

Abstract

Objective: The influence of specific symptoms on emotions and social activities in the individual patient vanes. Little is known about this variation in urinary bladder cancer survivors (in other words, about the relative importance of sources of symptom-induced distress). Methods: We attempted to enrol 404 surgical patients treated with cystectomy and a conduit or reservoir in four Swedish towns (Stockholm, Orebro, Jonkoping, Linkoping), 101 surgical patients treated with cystectomy and orthotopic neobladder at the Herlev Hospital in Copenhagen, Denmark, and 71 patients treated with radical radiotherapy for bladder cancer, as well as 581 men and women controls in Stockholm and Copenhagen. An anonymous postal questionnaire was used to collect the information. Results: A total of 503 out of 576 (87%) treated patients and 422 out of 581 (73%) controls participated but 59 patients were excluded. The primary source of self-assessed distress among cystectomised patients was compromised sexual function, reduced intercourse frequency caused great distress in 19% of the conduit patients, 20% of the reservoir patients and 19% of the bladder substitute patients. The primary source of self-assessed distress in patients treated with radical radiotherapy was symptoms from the bowel, 17% reported great distress due to diarrhoea, 16% due to abdominal pain, 14% due to defecation urgency and 14% due to faecal leakage. The highest proportion of subjects being distressed was 93% (substantial: 43%, moderate: 29% and little: 21%) for treated upper or lower urinary retention (indwelling catheter or nephrostomy). Conclusion: The distress caused by a specific symptom varies considerably and the prevalence of symptoms causing great distress differs between treatments in bladder cancer survivors. It is possible that patient care and clinical research can be made more effective by focusing on important sources of symptom-induced distress. (C) 2003 Elsevier Science B.V. All rights reserved.

Published
2003
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24. Marriage, cohabitation and alcohol consumption in young adults: an international exploration

Author

Plant, M., primary, Miller, P., additional, Plant, M., additional, Kuntsche, S., additional, Gmel, G., additional, Ahlström, with S., additional, Allamani, A., additional, Beck, F., additional, Bergmark, K., additional, Bloomfield, K., additional, Csémy, L., additional, Elekes, Z., additional, Knibbe, R., additional, Kraus, L., additional, Ólafsdóttir, H., additional, Rossow, I., additional, and Vidal, A., additional

Published
2008
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25. A Swedish study of women treated for cervix cancer. Gynecologic cancer often affects sexuality

Author

Bergmark, K, Åvall Lundqvist, Elisabeth, Steineck, G, Bergmark, K, Åvall Lundqvist, Elisabeth, and Steineck, G

Abstract

Gynecological cancer and its treatments are often associated with physical, psychological and social consequences that affect the woman's and the couple's sexuality. Especially due to their impact on sexuality, physical changes distress the women considerably, and warrant consideration for women of all ages. Women with gynecological cancer ask for information about possible side-effects of the disease and treatment that can affect the sexual function. At follow-up visits these issues can be attended to through information, with specific suggestions including advice about topical estrogen and dilators, to alleviate possible long-term sequelae.

Published
2000

31. [A Swedish study of women treated for cervix cancer. Gynecologic cancer often affects sexuality]

Author

Bergmark K, Ea, Lundqvist, and Gunnar Steineck

Subjects
Adult, Male, Libido, Coitus, Social Support, Uterine Cervical Neoplasms, Middle Aged, Sexual Dysfunction, Physiological, Patient Education as Topic, Humans, Female, Sexual Dysfunctions, Psychological, Orgasm, Spouses, Sexuality, Aged
Abstract

Gynecological cancer and its treatments are often associated with physical, psychological and social consequences that affect the woman's and the couple's sexuality. Especially due to their impact on sexuality, physical changes distress the women considerably, and warrant consideration for women of all ages. Women with gynecological cancer ask for information about possible side-effects of the disease and treatment that can affect the sexual function. At follow-up visits these issues can be attended to through information, with specific suggestions including advice about topical estrogen and dilators, to alleviate possible long-term sequelae.

32. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Author

Kirmeier E. a, Eriksson L. I. c, Lewald H. a, Jonsson Fagerlund, M. c Hoeft, A. f Hollmann, M. g Meistelman, C. e Hunter, J. M. d Ulm, K. b Blobner, M. aEmail Author, Abad Gurumeta, A. Abernethy, C. Abigail, P. Achaibar, K. Adam, E. Afshari, Agudelo Montoya, M. E. Akgün, F. N. Aletti, G. Alkış, N. Allan, K. Allan, A. Allaouchiche, B. Allcock, C. Almasy, E. Amey, I. Amigoni, M. Andersen, E. Andersson, P. Anipchenko, N. Antunes, P. Armstrong, E. Aslam, T. N. Aslin, B. Assunção, J. P. Ausserer, J. Avvai, M. Awad, Ayas Montero, B. Ayuso, M. Azevedo, P. Badarau, V. Badescu, Baiardo Redaelli, M. Baird, C. Baird, Y. Baker, T. Balaji, P. Bălan, C. Balandin, A. Balescu-Arion, C. Baliuliene, Baltasar Isabel, J. Baluch, S. N. Bandrabur, D. Bankewitz, C. Barber, K. Barbera, F. Barcraft-Barnes, H. Barletti, V. Barnett, G. Baron, K. Barros, A. Barsan, V. Bartlett, P. Batistaki, C. Baumgarten, G. Baytas, V. Beauchamp, Becerra Cayetano, I. A. Bell, S. Bellandi, M. Belletti, Belmonte Cuenca, J. Benitez-Cano, A. Beretta, L. Berger, M. Bergmann, N. Bergmark, Bermudez Lopez, M. Bernotaite, M. Beurskens, C. Bidd, H. Bifulco, F. Bignami, E. Bilic, A. Bilskiene, D. Bischoff, P. Bishop, L. Bjonness, T. Blaylock, H. Blethyn, K. Blincoe, T. Blokhin, I. Blunt, N. Boer, C. Bois, G. Bonicolini, E. Booth, J. Borecka-Kedzierska, M. Borstnar, K. Borys, M. Boselli, E. Bouvet, L. Bouwman, A. Bowen, L. Bowrey, S. Boxall, L. Božić, T. Bradley, T. Branco, T. Brazzi, L. Brazzoni, M. Brear, T. Brogly, N. Brohi, F. Broms, J. Bubliauskas, A. Bucolo, G. E. Buerkle, H. Buggy, D. Buhre, W. Bukauskas, T. Butturini, F. Byttner, Cabrera Díaz, I. Calderon, A. Calhau, R. Callejo, A. Cammu, G. Campesato, M. Can, Ö. S. Candeias, M. Cantor, A. Carise, E. Carmona, C. Carreteiro, J. Carrieri, C. Carter, A. Casal, M. Casanova, I. Cascella, M. Casero, L. M. Casiraghi, G. M. Castelo-Branco, Castro Arranz, C. Cernea, D. D. Cervantes, J. Chandler, B. Charnock, R. Chatzimicali, A. Chinery, E. Chishti, A. Chondhury, P. Christie, E. Christodoudiles, G. Ciardo, S. Cimpeanu, L. Cindea, I. Cinnella, G. Clark, S. Clayton, M. Cocu, S. Collyer, T. Colvin, C. Cope, S. Copeta, F. Copotoiu, S. -M., Correia de Barros, F. Corso, R. M. Cortegiani, A. Costa, G. Cowton, A. Cox, N. Craig, J. Cricca, V. Cronin, J. Cunha, M. Cuomo, A. Curley, K. Czuczwar, M. Dabrowska, D. Damster, Danguy des Déserts, M. Daniliuc, A. Danninger, T. Darwish, I. Dascalu, C. Davies, K. Davies, De Boer, De Flaviis, De Selincourt, G. Deana, C. Debaene, B. Debreceni, G. Dedhia, Delgado Garcia, Della Rocca, G. Delroy-Buelles, L. Desai, T. Dhillon, Di Giacinto, Di Mauro, Diaz Gomez, T. V. Dimitrovski, A. Dinic, V. Dîrzu, D. -S., Divander M. B., Dolinar J., Domingues S., Doolan J., Downes C., Dragoescu N. A., Droc G., Dum E., Dumitrescu A., Duncan L., Dzurňáková P., Eberl S., Edwards J., Edwards M., Ekelund K., Ekengren P., Elghouty E., Ellerkmann R., Ellis H., Elme A., Ernst T., Errando C. L., Estenes S., Ewaldsson C., Farid N., Featherstone J., Febres D., Fedorov S., Feggeler J., Feijten P., Fellmann T., Fernandez Candil, Fernandez Castineira, Fernández Castineira, J. Fernando, A. Ferrando, C. Ferreira, L. Ferreira, P. Feyling, A. Filipescu, D. Fleischer, A. Floris, L. Foerster, U. Fox, B. Franke, U. Frasca, D. Frey, C. Frost, V. Fullin, G. Fumagalli, J. Furneval, J. Fusari, M. Gallacher, S. Galushka, S. Gambale, G. Gambino, I. Garcia-Perez, M. L. Garg, S. Garlak, J. Gavranovic, Z. Gavrilov, R. Gaynor, Gecaj Gashi, A. Georghiou, M. Gerjevic, B. Gferer, G. Giarratano, A. Gibson, A. Gievski, V. Giles, J. Gillberg, L. Gilowska, Gilsanz Rodriguez, F. Gioia, A. Giovannoni, C. Girotra, V. Gkinas, D. Gkiokas, G. Godoroja, D. Goebel, U. Goel, V. Gonzalez, M. Goranovic, T. Gornik-Wlaszczuk, E. Gosavi, S. Gottfridsson, P. Gottschalk, A. Granell, M. Granstrom, A. Grassetto, A. Greenwood, A. Grigoras, I. Grintescu, I. Gritsan, A. Gritsan, G. Grynyuk, A. Guadagnin, G. M. Guarnieri, M. Güçlü, Guerrero Diez, M. Gunenc, F. Günther, U. Gupta, P. Guttenthaler, V. Hack, Y. Hafisayena, A. Hagau, N. Haldar, J. Hales, D. Hancı, V. Hanna-Jumma, S. Harazim, H. Harlet, P. Harper, D. Harris, B. Harvey, O. Hashimi, M. Hawkins, L. Hayes, C. Heaton, J. Heier, T. Helliwell, L. Hemmes, S. Henderson, K. Hermanides, J. Hermanns, Herrera Hueso, B. Hestenes, S. Hettiarachchi, R. Highgate, J. Hodgson, K. Hoelbling, D. Holland, J. Horhota, L. Hormis, A. Hribar, R. Hua, A. Humphreys, S. Humphries, R. Humpliková, S. Hunt, J. Husnain, A. Hussein, A. Hyams, B. Iannuccelli, F. Ilette, K. Ilyas, C. Inan, T. India, I. Ionițăv, V. Irwin, F. Jain, V. Janez, B. Jankovic, R. Jenkins, S. Jenko, M. Jimenez, Jiménez Gomez, B. Joachim, S. Joelsson-Alm, E. John, J. Jonikaite, L. Jovic, M. Jungwirth, B. Junke, E. Kabakov, B. Kadaoui, S. -D., Kanski A., Karadag S., Karbonskiene A., Karjagin J., Kasnik D., Katanolli F., Katsika E., Kaufmann K., Keane H., Kelly M., Kent M., Keraitiene G., Khudhur A., Khuenl-Brady K., Kidd L., King S., Kirchgäßner K., Klancir T., Klucniks A., Knotzer J., Knowlden P., Koers L., Kompan J., Koneti K. K., Kooij F., Koolen E., Koopman - van Gemert, A. W. M. M. Kopp, K. Korfiotis, D. Korolkov, O. Kosinová, M. Köstenberger, M. Kotzinger, O. Kovačević, M. Kranke, P. Kranke, E. Kraus, C. Kraus, S. Kubitzek, C. Kucharski, R. Kucukguclu, S. Kudrashou, A. Kumar, V. Kummen, L. Kunit, C. Kushakovsky, V. Kuvaki, B. Kuzmanovska, B. Kyttari, A. Landoni, G. Lau, G. Lazarev, K. Legett, S. Legrottaglie, A. M. Leonardi, S. Leong, M. Lercher, H. Leuvrey, M. Leva, B. Levstek, M. Limb, J. Lindholm, E. Linton, F. Liperi, C. Lipski, F. Lirk, P. Lisi, A. Lišková, Lluch Oltra, A. Loganathan, V. Lombardi, S. Lopez, Lopez Rodríguez, M. Lorenzini, L. Lowicka, M. Lugovoy, A. Luippold, M. Lumb, A. Macas, A. Macgregor, M. Machado, H. Maciariello, M. Madeira, I. Maitan, S. Majewski, J. Maldini, B. Malewski, G. Manfredini, L. Männer, O. Marchand, B. Marcu, A. Margalef, J. Margarson, M. Marinheiro, L. Markic, Markovic Bozic, J. Marrazzo, F. Martin, Martin Ayuso, M. Martinez, E. Martino, E. A. Martinson, V. Marusic-Gaser, K. Mascarenhas, C. Mathis, C. Matsota, P. Mavrommati, Mazul Sunko, B. McCourt, K. McGill, N. McKee, R. Meço, B. C. Meier, S. Melbourne, S. Melbybråthen, G. Meli, A. Melia, A. Melotti, R. M. Menga, M. R. Mercer, P. Merotra, S. Mescolini, S. Metterlein, T. Michalov, M. Michlig, S. Midgley, S. Milić, M. Milojevic, M. Miñana, A. Minto, G. Mirabella, L. Mirea, L. Mittelstädt, L. Moeglen, A. Moise, A. Mokini, Z. Molin, A. Moltó, L. Monea, M. C. Montalto, F. Montgomery, J. Montgomery, C. Montillo, G. Moore, S. Moore, F. Moreira, Z. Moreno, T. Moreno, R. Moret, E. Moreton, S. Morgan, Moro Velasco, C. Morri, D. Moull, A. Moura, F. Mráz, P. Mrozek, K. Mukhtar, K. Muniyappa, S. Murray, H. Murthy, B. V. Mushambi, M. Nadolski, M. Nardelli, P. Nardin, Navarro Pérez, R. Naveiro, A. Negri, Nesek Adam, V. Neskovic, V. Neuwersch, S. Neves, M. Nguyen, Ní Eochagáin, A. Nicholas, C. Nightingale, J. Norrie, K. Novak-Jankovic, V. Novakova, A. Novillo, M. Numan, S. Oduro-Dominah, L. Oldner, A. Oliveira, I. Ologoiu, D. Oloktsidou, I. O'Reilly, R. Orlando, A. Ovezov, A. Ozbilgin, S. Paal, Padin Barreiro, L. Palugniok, R. Papaioannou, A. Papapostolou, K. Paranthaman, Pardey Bracho, G. Parente, S. Parfeni, A. Pasin, L. Passey, S. Pastor, E. Patch, S. Patil, A. Paunescu, M. -A., Pehboeck D., Pereira M., Pereira C., Perez Caballero, Pérez García, Pérez Soto, Perez Tejero, G. Perez-Cerda, F. Pesenti, A. Petta, R. Philippe, S. Pickering, Pico Veloso, J. Pina, P. Pinho-Oliveira, V. Pinol, S. Pinto, R. Pistidda, L. Pitterle, M. Piwowarczyk, P. Plotnikova, O. Pohl, H. Poldermann, J. Polkovicová, L. Pompei, L. Popescu, M. Popović, Pota V, Potocnik M., Potręć B., Potter A., Pramod N., Prchalova M., Preckel B., Pugh R., Pulletz M., Radoeshki A., Rafi A., Ragazzi R., Raineri Santi, M. Rajamanickam, T. Rajput, Z. Ramachandran, R. Ramasamy, R. Ramessur, S. Rao, R. Rasmussen, A. Rato, A. Razaque, Real Navacerrada, M. I. Reavley, C. Reid, J. Reschreiter, H. Rial, Ribas Carrasco, P. Ribeiro, S. Rich, N. Richardson, L. Rimaitis, K. Rimaitis, M. Ringvold, E. -M., Ripke F., Ristescu I., Ritchie K., Ródenas F., Rodrigues P., Rogers E., Rogerson D., Romagnoli S., Romero E., Rondovic G., Rose B. O., Roth W., Rotter, M. -T., Rousseau G., Rudjord A., Rueffert H., Rundgren M., Rupprecht K., Rushton A., Russotto V., Rypulak E., Ryszka M., Sà J., Sà Couto, P. Saby, S. Sagic, J. Saleh, O. Sales, Sánchez Sánchez, Y. Sanghera, Şanli Karip, Santiveri Papiol, F. J. Santos, S. Sarno, S. Saul, D. Saunders, D. Savic, N. Scalco, L. Scanlon, D. Schaller, S. Schax, C. Scheffer, G. J. Schening, A. Schiavone, V. Schmidt-Ehrenberg, F. Schmidt-Mutter, C. Schönberg, C. Schopflin, C. Schreiber, J. -U., Schultz M., Schurig M., Scott C., Sebestian S., Sehgal S., Sem V., Semenas E., Serafini E., Serchan P., Shields M., Shobha R., Shosholcheva M., Siamansour T., Siddaiah N., Siddiqi K., Sinclair R., Singh P., Singh R., Sinha A., Skinner A., Smee E., Smekalova O., Smith N., Smith T., Smitz C., Smole D., Sojčić N., Soler Pedrola, M. Somanath, S. Sonksen, J. Sorella, M. C. Sörmus, A. Soro, M. Soto, C. Spada, A. Spadaro, S. Spaeth, J. Sparr, H. Spielmann, A. Spindler-Vesel, A. Stamelos, Stancombe L, L. Stanculescu, A. Standl, T. Standley, T. Stanek, O. Stanisavljević, S. Starczewska, M. Stäuble, C. Steen, J. Stefan, O. M. Stell, E. Stera, C. Stevens, M. Stoerckel, M. Stošić, B. Stourac, P. Stroumpoulis, K. Struck, Suarez de la Rica, A. Sultanpori, Sundara Rajan, R. Suying, O. Svensen, C. Swan, L. Syrogianni, P. Sysiak, J. Szederjesi, J. Taddei, Tan Hao, E. Tanou, V. Tarabová, Tardaguila Sancho, P. Tarroso, M. Tartaglione, M. 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P., Ausserer, J., Avvai, M., Awad, Ayas, Montero, B., Ayuso, M., Azevedo, P., Badarau, V., Badescu, Baiardo, Redaelli, M., Baird, C., Baird, Y., Baker, T., Balaji, P., Bălan, C., Balandin, A., Balescu-Arion, C., Baliuliene, Baltasar, Isabel, J., Baluch, S. N., Bandrabur, D., Bankewitz, C., Barber, K., Barbera, F., Barcraft-Barne, H., Barletti, V., Barnett, G., Baron, K., Barro, A., Barsan, V., Bartlett, P., Batistaki, C., Baumgarten, G., Bayta, V., Beauchamp, Becerra, Cayetano, I. 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A., Droc, G., Dum, E., Dumitrescu, A., Duncan, L., Dzurňáková, P., Eberl, S., Edwards, J., Edwards, M., Ekelund, K., Ekengren, P., Elghouty, E., Ellerkmann, R., Ellis, H., Elme, A., Ernst, T., Errando, C. L., Estenes, S., Ewaldsson, C., Farid, N., Featherstone, J., Febres, D., Fedorov, S., Feggeler, J., Feijten, P., Fellmann, T., Fernandez, Candil, Fernandez, Castineira, Fernández, Castineira, J., Fernando, A., Ferrando, C., Ferreira, L., Ferreira, P., Feyling, A., Filipescu, D., Fleischer, A., Flori, L., Foerster, U., Fox, B., Franke, U., Frasca, D., Frey, C., Frost, V., Fullin, G., Fumagalli, J., Furneval, J., Fusari, M., Gallacher, S., Galushka, S., Gambale, G., Gambino, I., Garcia-Perez, M. 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M., Guarnieri, M., Güçlü, Guerrero, Diez, M., Gunenc, F., Günther, U., Gupta, P., Guttenthaler, V., Hack, Y., Hafisayena, A., Hagau, N., Haldar, J., Hale, D., Hancı, V., Hanna-Jumma, S., Harazim, H., Harlet, P., Harper, D., Harri, B., Harvey, O., Hashimi, M., Hawkin, L., Haye, C., Heaton, J., Heier, T., Helliwell, L., Hemme, S., Henderson, K., Hermanide, J., Hermann, Herrera, Hueso, B., Hestene, S., Hettiarachchi, R., Highgate, J., Hodgson, K., Hoelbling, D., Holland, J., Horhota, L., Hormi, A., Hribar, R., Hua, A., Humphrey, S., Humphrie, R., Humpliková, S., Hunt, J., Husnain, A., Hussein, A., Hyam, B., Iannuccelli, F., Ilette, K., Ilya, C., Inan, T., India, I., Ionițăv, V., Irwin, F., Jain, V., Janez, B., Jankovic, R., Jenkin, S., Jenko, M., Jimenez, Jiménez, Gomez, B., Joachim, S., Joelsson-Alm, E., John, J., Jonikaite, L., Jovic, M., Jungwirth, B., Junke, E., Kabakov, B., Kadaoui, S., -D., Kanski, A., Karadag, S., Karbonskiene, A., Karjagin, J., Kasnik, D., Katanolli, F., Katsika, E., Kaufmann, K., Keane, H., Kelly, M., Kent, M., Keraitiene, G., Khudhur, A., Khuenl-Brady, K., Kidd, L., King, S., Kirchgäßner, K., Klancir, T., Klucniks, A., Knotzer, J., Knowlden, P., Koers, L., Kompan, J., Koneti, K. 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Damster, Sabrine, Danguy des Déserts, Marc, Daniliuc, Aura, Danninger, Thoma, Darwish, Imad, Dascalu, Corina, Davies, Kirsty, Davies, Simon, De Boer, Han, De Flaviis, Adelisa, De Selincourt, Gabrielle, Deana, Cristian, Debaene, Bertrand, Debreceni, Gabor, Dedhia, Jatin, Delgado Garcia, Isabel, Della Rocca, Giorgio, Delroy-Buelles, Llana, Desai, Tejal, Dhillon, Parveen, Di Giacinto, Ida, Di Mauro, Piero, Diaz Gomez, Tamara V., Dimitrovski, Aleksandar, Dinic, Vesna, Dîrzu, Dan-Sebastian, Divander, Mona Britt, Dolinar, Janez, Domingues, Susana, Doolan, Jame, Downes, Charlotte, Dragoescu, Nicoleta Alice, Droc, Gabriela, Dum, Elisabeth, Dumitrescu, Alexandra, Duncan, Louise, Dzurňáková, Paul, Eberl, Susanne, Edwards, Jayne, Edwards, Mark, Ekelund, Kim, Ekengren, Patrik, Elghouty, Eyad, Ellerkmann, Richard, Ellis, Helen, Elme, Andrea, Ernst, Thoma, Errando, Carlos Lui, Estenes, Simao, Ewaldsson, Calli, Farid, Nahla, Featherstone, Jame, Febres, Daniela, Fedorov, Sergey, Feggeler, Johanna, Feijten, Prisca, Fellmann, Tobia, Fernandez Candil, Juan, Fernandez Castineira, Ana, Fernández Castineira, Juan, Fernando, Aruna, Ferrando, Carlo, Ferreira, Leonia, Ferreira, Patrick, Feyling, Ander, Filipescu, Daniela, Fleischer, Andrea, Floris, Leda, Foerster, Ur, Fox, Benjamin, Franke, Uwe, Frasca, Deni, Frey, Christian, Frost, Victoria, Fullin, Giorgio, Fumagalli, Jacopo, Furneval, Julie, Fusari, Maurizio, Gallacher, Stuart, Galushka, Svetlana, Gambale, Giorgio, Gambino, Irene, Garcia-Perez, Maria Luisa, Garg, Sanjeev, Garlak, Justyna, Gavranovic, Zeljka, Gavrilov, Roman, Gaynor, Lame, Gecaj Gashi, Agreta, Georghiou, Maria, Gerjevic, Bozena, Gferer, Gudrun, Giarratano, Antonino, Gibson, Andy, Gievski, Vanja, Giles, Julian, Gillberg, Lar, Gilowska, Katarzyna, Gilsanz Rodriguez, Fernando, Gioia, Antonio, Giovannoni, Cecilia, Girotra, Vandana, Gkinas, Dimitrio, Gkiokas, George, Godoroja, Daniela, Goebel, Ulrich, Goel, Vandana, Gonzalez, Matilde, Goranovic, Tatjana, Gornik-Wlaszczuk, Ewa, Gosavi, Smita, Gottfridsson, peter, Gottschalk, André, Granell, Manuel, Granstrom, Anna, Grassetto, Alberto, Greenwood, Anna, Grigoras, Ioana, Grintescu, Ioana, Gritsan, Alexey, Gritsan, Galina, Grynyuk, Andriy, Guadagnin, Giovanni Maria, Guarnieri, Marcello, Güçlü, Çiğdem, Guerrero Diez, Maria, Gunenc, Ferim, Günther, Ulf, Gupta, Pawan, Guttenthaler, Vera, Hack, Yvonne, Hafisayena, Ade, Hagau, Natalia, Haldar, Jagannath, Hales, Dawn, Hancı, Volkan, Hanna-Jumma, Sameer, Harazim, Hana, Harlet, Pierre, Harper, Daniel, Harris, Benjamin, Harvey, Orla, Hashimi, Medita, Hawkins, Lesley, Hayes, Conrad, Heaton, Jame, Heier, Tom, Helliwell, Laurence, Hemmes, Sabrine, Henderson, Kate, Hermanides, Jeroen, Hermanns, Henning, Herrera Hueso, Berta, Hestenes, Siv, Hettiarachchi, Roshane, Highgate, Judith, Hodgson, Keith, Hoelbling, Daniel, Holland, Jonathan, Horhota, Lucian, Hormis, Anil, Hribar, Renata, Hua, Alina, Humphreys, Sally, Humphries, Ryan, Humpliková, Simona, Hunt, Janez, Husnain, Ali, Hussein, Ahmed, Hyams, Benjamin, Iannuccelli, Fabrizio, Ilette, Katie, Ilyas, Carl, Inan, Turgay, India, Immaculada, Ionițăv, Victor, Irwin, Foo, Jain, Vipul, Janez, Benedikt, Jankovic, Radmilo, Jenkins, Sarah, Jenko, Matej, Jimenez, Raquel, Jiménez Gomez, Bárbara, Joachim, Sugganthi, Joelsson-Alm, Eva, John, John, Jonikaite, Lina, Jovic, Miomir, Jungwirth, Bettina, Junke, Etienne, Kabakov, Bory, Kadaoui, Salah-Din, Kanski, Andrzej, Karadag, Süheyla, Karbonskiene, Aurika, Karjagin, Juri, Kasnik, Darja, Katanolli, Fato, Katsika, Eleni, Kaufmann, Kai, Keane, Helen, Kelly, Martin, Kent, Melanie, Keraitiene, Grazina, Khudhur, Ahmed, Khuenl-Brady, Karin, Kidd, Laurie, King, Siobhan, Kirchgäßner, Katharina, Klancir, Tino, Klucniks, Andri, Knotzer, Johann, Knowlden, Peter, Koers, Lena, Kompan, Janez, Koneti, Kiran K, Kooij, Fabian, Koolen, Eric, Koopman - van Gemert, Anna Wilhelmina Margaretha Maria, Kopp, Kristen, Korfiotis, Dimitrio, Korolkov, Oleg, Kosinová, Martina, Köstenberger, Marku, Kotzinger, Oskar, Kovačević, Marko, Kranke, Peter, Kranke, Eva, Kraus, Christiane, Kraus, Stephanie, Kubitzek, Christiane, Kucharski, Rafal, Kucukguclu, Semih, Kudrashou, Allaksandr, Kumar, Vinayak, Kummen, Live, Kunit, Cornelia, Kushakovsky, Vlad, Kuvaki, Bahar, Kuzmanovska, Biljana, Kyttari, Aikaterina, Landoni, Giovanni, Lau, Gary, Lazarev, Konstantin, Legett, Samantha, Legrottaglie, Anna Maria, Leonardi, Silvia, Leong, Maria, Lercher, Helene, Leuvrey, Matthieu, Leva, Brigitte, Levstek, Meta, Limb, Jame, Lindholm, Espen, Linton, Fiona, Liperi, Corradero, Lipski, Fabian, Lirk, Philipp, Lisi, Alberto, Lišková, Katarina, Lluch Oltra, Aitana, Loganathan, Vinothan, Lombardi, Stefania, Lopez, Eloisa, Lopez Rodríguez, Maria, Lorenzini, Laura, Lowicka, Malgorzata, Lugovoy, Alexander, Luippold, Madeleine, Lumb, Andrew, Macas, Andriu, Macgregor, Mark, Machado, Humberto, Maciariello, Maria, Madeira, Isabel, Maitan, Stefan, Majewski, Jacek, Maldini, Branka, Malewski, Georgia, Manfredini, Livia, Männer, Olja, Marchand, Bahareh, Marcu, Alexandra, Margalef, Jordi, Margarson, Michael, Marinheiro, Lucia, Markic, Ana, Markovic Bozic, Jasmina, Marrazzo, Francesco, Martin, Jane, Martin Ayuso, Maria, Martinez, Esteher, Martino, Enrico Antonio, Martinson, Victoria, Marusic-Gaser, Katarina, Mascarenhas, Catia, Mathis, Cindy, Matsota, Paraskevi, Mavrommati, Eleni, Mazul Sunko, Branka, McCourt, Killian, McGill, Neil, McKee, Raymond, Meço, Başak Ceyda, Meier, Sonja, Melbourne, Susan, Melbybråthen, Grethe, Meli, Andrea, Melia, Aiden, Melotti, Rita Maria, Menga, Maria Rosaria, Mercer, Pauline, Merotra, Susan, Mescolini, Silvia, Metterlein, Thoma, Michalov, Martin, Michlig, Sam, Midgley, Susan, Milić, Morena, Milojevic, Milan, Miñana, Amanda, Minto, Gary, Mirabella, Lucia, Mirea, Liliana, Mittelstädt, Ludger, Moeglen, Aude, Moise, Alida, Mokini, Zhirajr, Molin, Anna, Moltó, Lui, Monea, Maria Concetta, Montalto, Francesca, Montgomery, Jane, Montgomery, Claire, Montillo, Gerardo, Moore, Sally, Moore, Faye, Moreira, Zelia, Moreno, Tania, Moreno, Ricardo, Moret, Enrique, Moreton, Sarah, Morgan, Marianne, Moro Velasco, Concepción, Morri, Davide, Moull, Alice, Moura, Fernando, Mráz, Peter, Mrozek, Katarzyna, Mukhtar, Karim, Muniyappa, Sudeshkumar, Murray, Heather, Murthy, Burra VS, Mushambi, Mary, Nadolski, Maria, Nardelli, Pasquale, Nardin, Giordano, Navarro Pérez, Rosalía, Naveiro, Andrea, Negri, Manuela, Nesek Adam, Visnja, Neskovic, Vojislava, Neuwersch, Stefan, Neves, Miriam, Nguyen, Bavinh, Ní Eochagáin, Aisling, Nicholas, Caroline, Nightingale, Jeremy, Norrie, Kylie, Novak-Jankovic, Vesna, Novakova, Andrea, Novillo, Marta, Numan, Sandra, Oduro-Dominah, Louise, Oldner, Ander, Oliveira, Isabel, Ologoiu, Daniela, Oloktsidou, Irini, O'Reilly, Rosalind, Orlando, Alessandro, Ovezov, Alexey, Ozbilgin, Sule, Paal, Peter, Padin Barreiro, Lidia, Palugniok, Ryszard, Papaioannou, Alexandra, Papapostolou, Konstantino, Paranthaman, Prabhakar, Pardey Bracho, Gilda, Parente, Suzana, Parfeni, Alexandru, Pasin, Laura, Passey, Samuel, Pastor, Ernesto, Patch, Sarah, Patil, Andan, Paunescu, Marilena-Alina, Pehboeck, Daniel, Pereira, Manuela, Pereira, Carla, Perez Caballero, Paula, Pérez García, Aníbal, Pérez Soto, Antonia, Perez Tejero, Gisela, Perez-Cerda, Francisco, Pesenti, Antonio, Petta, Rocco, Philippe, Simon, Pickering, David, Pico Veloso, Jandro, Pina, Pedro, Pinho-Oliveira, Vítor, Pinol, Santiago, Pinto, Rita, Pistidda, Laura, Pitterle, Manuela, Piwowarczyk, Paweł, Plotnikova, Olga, Pohl, Holger, Poldermann, Jorinde, Polkovicová, Lucia, Pompei, Livia, Popescu, Mihai, Popović, Radmila, Pota, Vincenzo, Potocnik, Miriam, Potręć, Beata, Potter, Alison, Pramod, Nalwaya, Prchalova, Martina, Preckel, Benedikt, Pugh, Richard, Pulletz, Mark, Radoeshki, Aleksandar, Rafi, Amir, Ragazzi, Riccardo, Raineri Santi, Maurizio, Rajamanickam, Tamiselvan, Rajput, Zahra, Ramachandran, Rajeskar, Ramasamy, Radhika, Ramessur, Suneil, Rao, Roshan, Rasmussen, Ander, Rato, André, Razaque, Usman, Real Navacerrada, M. Isabel, Reavley, Caroline, Reid, Jame, Reschreiter, Henrik, Rial, Erick, Ribas Carrasco, Patricia, Ribeiro, Sandy, Rich, Nathalie, Richardson, Lydia, Rimaitis, Kestuti, Rimaitis, Mariu, Ringvold, Else-Marie, Ripke, Fabian, Ristescu, Irina, Ritchie, Keith, Ródenas, Frederic, Rodrigues, Patrícia, Rogers, Emma, Rogerson, David, Romagnoli, Stefano, Romero, Esther, Rondovic, Goran, Rose, Bernd Oliver, Roth, Winfried, Rotter, Marie-Therese, Rousseau, Guy, Rudjord, Ander, Rueffert, Henrik, Rundgren, Malin, Rupprecht, Korbinian, Rushton, Andrew, Russotto, Vincenzo, Rypulak, Elżbieta, Ryszka, Maciej, Sà, Jacinta, Sà Couto, Paula, Saby, Sandrine, Sagic, Jelena, Saleh, Omar, Sales, Gabriele, Sánchez Sánchez, Yván, Sanghera, Sumayer, Şanli Karip, Ceren, Santiveri Papiol, Francisco Javier, Santos, Sofia, Sarno, Stephen, Saul, Daniel, Saunders, David, Savic, Nenad, Scalco, Loïc, Scanlon, Deborah, Schaller, Stefan, Schax, Christoph, Scheffer, Gert Jan, Schening, Anna, Schiavone, Vincenzo, Schmidt-Ehrenberg, Florian, Schmidt-Mutter, Catherine, Schönberg, Christina, Schopflin, Christian, Schreiber, Jan-Uwe, Schultz, Marcu, Schurig, Marlen, Scott, Carmen, Sebestian, Siby, Sehgal, Selena, Sem, Victoria, Semenas, Egidiju, Serafini, Elena, Serchan, Pashalitsa, Shields, Martin, Shobha, Ramakrishnan, Shosholcheva, Mirjana, Siamansour, Tanja, Siddaiah, Narendra, Siddiqi, Khalid, Sinclair, Rhona, Singh, Permendra, Singh, Rajendra, Sinha, Aneeta, Sinha, Ashok, Skinner, Amanda, Smee, Elizabeth, Smekalova, Olga, Smith, Neil, Smith, Thoma, Smitz, Carine, Smole, Daniel, Sojčić, Nataša, Soler Pedrola, Maria, Somanath, Sameer, Sonksen, Julian, Sorella, Maria Christina, Sörmus, Alar, Soro, Marina, Soto, Carmen, Spada, Anna, Spadaro, Savino, Spaeth, Johanne, Sparr, Harald, Spielmann, Annika, Spindler-Vesel, Alenka, Stamelos, Matthaio, Stancombe L, Liucia, Stanculescu, Andreea, Standl, Thoma, Standley, Tom, Stanek, Ondrej, Stanisavljević, Snežana, Starczewska, Malgorzata, Stäuble, Christiane, Steen, Julie, Stefan, Oana Maria, Stell, Elizabeth, Stera, Caterina, Stevens, Marku, Stoerckel, Marlène, Stošić, Biljana, Stourac, Petr, Stroumpoulis, Konstantino, Struck, Rafael, Suarez de la Rica, Alejandro, Sultanpori, Altaf, Sundara Rajan, Rajinikanth, Suying, Ong, Svensen, Christer, Swan, Louise, Syrogianni, Paulina, Sysiak, Justyna, Szederjesi, Jano, Taddei, Stefania, Tan Hao, Ern, Tanou, Virginia, Tarabová, Katarina, Tardaguila Sancho, Paula, Tarroso, Maria, Tartaglione, Marco, Taylor, Emma, Tbaily, Lee, Telford, Richard, Terenzoni, Massimo, Theodoraki, Kassiani, Thornley, Helen, Tiganiuc, Liviu, Toim, Hardo, Tomescu, Dana, Tommasino, Concezione, Toni, Jessica, Toninelli, Arturo, Toretti, Ilaria, Townley, Stephen, Trepenaitis, Dariu, Trethowan, Brian, Tsaousi, Georgia, Tsiftsi, Aikaterini, Tudor, Adrada, Turan, Güldem, Turhan, Sanem Çakar, Unic-Stojanovic, Dragana, Unterbuchner, Christoph, Unzueta, Carmen, Uranjek, Jasna, Ursic, Tomaz, Vaida, Simona, Valldeperas Ferrer, Silvia, Valldeperas Hernandez, Maria Inmaculada, Valsamidis, Dimitri, Van Beek, Rienk, Van dasselaer, Nick, Van Der Beek, Tim, Van Duivenvoorde, Yoni, van Klei, Wilton A., Van Poorter, Fran, Van Zaane, Ba, Van Zundert, Tom, Van Zyl, Rebekka, Vargas Munoz, Ana Milena, Varsani, Nimu, Vasconcelos, Pedro, Vassilakis, Georgio, Vecchiatini, Tommaso, Vecera, Lubomir, Vercauteren, Marcel, Verdouw, Ba, Verheyen, Veerle, Verri, Marco, Vicari Sottosanti, Luigi Giancarlo, Vico, Manuel, Vidal Mitjans, Patricia, Vilardi, Anna, Vissicchio, Daniela, Vitale, Giovanni, Vitković, Bibiana, Vizcaychipi, Marcela Paola, Voicu, Alexandra, Voje, Minca, Volfová, Ivana, Volta, Carlo Alberto, Von Lutterotti, Theresa, von Tiesenhausen, Anna, Vrecic-Slabe, Simona, Vukcevic, Dejan, Vukovic, Rade, Vullo, P. Agostina, Wade, Andrew, Wallberg, Hanna, Wallden, Jakob, Wallner, Johann, Walther Sturesson, Louise, Watson, Davina, Weber, Stefan, Wegiel Leskiewiq, Anna, Weller, Debbie, Wensing, Carine, Werkmann, Marku, Westberg, Henrik, Wikström, Erik, Williams, Benedict, Wilson, Robin, Wirth, Steffen, Wittmann, Maria, Wood, Laura, Wright, Stella, Zachoval, Christian, Zambon, Massimo, Zampieri, Silvia, Zampone, Salvatore, Zangrillo, Alberto, Zani, Gianluca, Zavackiene, Asta, Zieglerder, Raphael, Zonneveldt, Harry, Zsisku, Lajo, Zucker, Tom-Philipp, Żukowski, Maciej, Zuleika, Mehrun, and Zupanĕiĕ, Darja

Subjects
Pulmonary and Respiratory Medicine, pulmonary complications, muscle relaxants, Post-anaesthesia complications, Neuromuscular Blockade, pulmonary complication, muscle relaxant, neuromuscular block, postoperative pulmonary complication, business.industry, Retrospective cohort study, post-operative pulmonary complications, Neuromuscular monitoring, Neuromuscular Blocking Agents, Sugammadex, NO, Anaesthesia, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Anesthesia, Medicine, General anaesthesia, Neuromuscular Agents, 030212 general & internal medicine, MED/41 - ANESTESIOLOGIA, Prospective cohort study, business, medicine.drug
Abstract

Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj −0·3%, 95% CI −2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; −0·4%, −3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation: We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications. Funding: European Society of Anaesthesiology.

Published
2019
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33. The effect of tinzaparin on biomarkers in FIGO stages III-IV ovarian cancer patients undergoing neoadjuvant chemotherapy - the TABANETOC trial: study protocol for a randomized clinical multicenter trial.

Author

Karlsson A, Lindahl G, Spetz Holm AC, Bergmark K, Dahm Kähler P, Fekete B, Ottander U, Öfverman C, Israelsson P, Falknäs L, Rosenmüller A, Tiefenthal Thrane M, Halili S, Lindahl TL, Jenmalm MC, and Kjølhede P

Subjects
Adult, Aged, Female, Humans, Middle Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chemotherapy, Adjuvant methods, Heparin, Low-Molecular-Weight therapeutic use, Heparin, Low-Molecular-Weight administration & dosage, Neoplasm Staging, Pilot Projects, Prognosis, Randomized Controlled Trials as Topic, Biomarkers, Tumor blood, CA-125 Antigen blood, Carcinoma, Ovarian Epithelial drug therapy, Carcinoma, Ovarian Epithelial pathology, Carcinoma, Ovarian Epithelial blood, Neoadjuvant Therapy methods, Ovarian Neoplasms drug therapy, Ovarian Neoplasms pathology, Ovarian Neoplasms blood, Tinzaparin administration & dosage
Abstract

Background: Tinzaparin, a low-molecular weight heparin (LMWH), has shown anti-neoplastic properties in animal models and in in vitro studies of human cancer cell lines. The reduction of CA-125 levels during neoadjuvant chemotherapy (NACT) in patients with epithelial ovarian cancer (EOC) co-varies with the prognosis; the larger the decrease in CA-125, the better the prognosis., Purpose: This study aims to evaluate the potential anti-neoplastic effects of tinzaparin by investigating changes in serum CA-125 levels in advanced EOC patients who receive NACT., Material and Methods: This is an open randomized multicenter pilot trial. Forty patients with EOC selected to receive NACT will be randomized 1:1 to receive daily addition of tinzaparin or no tinzaparin. The processing and treatment of the patients will otherwise follow the recommendations in the Swedish National Guidelines for Ovarian Cancer. Before every cycle of chemotherapy, preoperatively, and 3 weeks after the last cycle of chemotherapy, a panel of biomarkers, including CA-125, will be measured., Patients: Inclusion criteria are women aged 18 years or older, World Health Organization performance status 0-1, histologically confirmed high-grade serous, endometrioid or clear cell EOC, International Federation of Gynecology and Obstetrics (FIGO) stages III-IV. In addition, a CA-125 level of ≥ 250 kIE/L at diagnosis. Exclusion criteria are contraindications to LMWH, ongoing or recent treatment with unfractionated heparin, LMWH, warfarin or non-vitamin K antagonist oral anticoagulants., Interpretation: This study will make an important contribution to the knowledge of the anti-neoplastic effects of tinzaparin in EOC patients and may thus guide the planning of a future study on the impact of tinzaparin on survival in EOC.

Published
2024
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34. Remarkable effects of infliximab on severe radiation-induced side effects in a patient with uterine cervical cancer: a case report.

Author

Toft Morén A, Bull C, and Bergmark K

Subjects
Female, Humans, Quality of Life, Rectum, Infliximab therapeutic use, Radiation Injuries drug therapy, Radiation Injuries etiology, Uterine Cervical Neoplasms drug therapy, Uterine Cervical Neoplasms radiotherapy, Uterine Cervical Neoplasms complications
Abstract

Pelvic radiotherapy is a powerful treatment for a broad range of cancers, including gynecological, prostate, rectal, and anal cancers. Despite improvements in the delivery of ionizing beams, damage to non-cancerous tissue can cause long-term effects that are potentially severe, affecting quality of life and daily function. There is an urgent need for new strategies to treat and reverse the side effects of pelvic radiotherapy without compromising the antitumor effect. A woman with severe radiation-induced intestinal side effects was treated with the tumor necrosis factor-alpha inhibitor infliximab with a dose of 3 mg/kg every 4 to 6 weeks. With infliximab treatment, a remarkable improvement in her bowel health was observed. The patient's late bowel toxicity was reduced from Grade 2 to Grade 0 (RTOG/EORTC Late Radiation Morbidity Scale). Although it is necessary to proceed cautiously because of the risk of serious side effects from immunosuppressants, our case suggests that infliximab can be used to treat symptoms of chronic bowel dysfunction after radiotherapy., Competing Interests: Declaration of conflicting interestsThe authors declare that there is no conflict of interest.

Published
2023
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35. Low-grade intestinal inflammation two decades after pelvic radiotherapy.

Author

Devarakonda S, Thorsell A, Hedenström P, Rezapour A, Heden L, Banerjee S, Johansson MEV, Birchenough G, Toft Morén A, Gustavsson K, Skokic V, Pettersson VL, Sjöberg F, Kalm M, Al Masri M, Ekh M, Fagman H, Wolving M, Perkins R, Morales RA, Castillo F, Villablanca EJ, Yrlid U, Bergmark K, Steineck G, and Bull C

Abstract

Background: Radiotherapy is effective in the treatment of cancer but also causes damage to non-cancerous tissue. Pelvic radiotherapy may produce chronic and debilitating bowel symptoms, yet the underlying pathophysiology is still undefined. Most notably, although pelvic radiotherapy causes an acute intestinal inflammation there is no consensus on whether the late-phase pathophysiology contains an inflammatory component or not. To address this knowledge gap, we examined the potential presence of a chronic inflammation in mucosal biopsies from irradiated pelvic cancer survivors., Methods: We biopsied 24 cancer survivors two to 20 years after pelvic radiotherapy, and four non-irradiated controls. Using tandem mass tag (TMT) mass spectrometry and mRNA sequencing (mRNA-seq), we charted proteomic and transcriptomic profiles of the mucosal tissue previously exposed to a high or a low/no dose of radiation. Changes in the immune cell populations were determined with flow cytometry. The integrity of the protective mucus layers were determined by permeability analysis and 16S rRNA bacterial detection., Findings: 942 proteins were differentially expressed in mucosa previously exposed to a high radiation dose compared to a low radiation dose. The data suggested a chronic low-grade inflammation with neutrophil activity, which was confirmed by mRNA-seq and flow cytometry and further supported by findings of a weakened mucus barrier with bacterial infiltration., Interpretation: Our results challenge the idea that pelvic radiotherapy causes an acute intestinal inflammation that either heals or turns fibrotic without progression to chronic inflammation. This provides a rationale for exploring novel strategies to mitigate chronic bowel symptoms in pelvic cancer survivors., Funding: This study was supported by the King Gustav V Jubilee Clinic Cancer Foundation (CB), The Adlerbertska Research Foundation (CB), The Swedish Cancer Society (GS), The Swedish State under the ALF agreement (GS and CB), Mary von Sydow's foundation (MA and VP)., Competing Interests: Declaration of interests M Kalm is an employee at AstraZeneca. The other authors have nothing to disclose., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Published
2023
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36. Intra-abdominal Surgery and Intestinal Syndromes After Pelvic Radiation Therapy.

Author

Bull C, Morén AT, Skokic V, Wilderäng U, Malipatlolla D, Alevronta E, Dunberger G, Sjöberg F, Bergmark K, and Steineck G

Abstract

Purpose: To determine the effects of intra-abdominal surgery on the intensities of 5 radiation-induced intestinal syndromes in survivors of pelvic cancer., Methods and Materials: The analysis included 623 women born in 1927 or later who had survived cancer. They all had received external radiation therapy toward the pelvic area to treat gynecologic cancers. Information from 344 women who did not undergo irradiation, matched for age and residency, was also included. Main outcome measures after the surgical procedures were the intensity scores for 5 radiation-induced intestinal syndromes: urgency-tenesmus syndrome, fecal-leakage syndrome, excessive mucus discharge, excessive gas discharge, and blood discharge. The scores were based on symptom frequencies obtained from patient-reported outcomes and on factor loadings obtained from a previously reported factor analysis. Follow-up was 2 to 15 years after radiation therapy., Results: Among survivors of cancer, intra-abdominal surgery increased the intensity of the urgency-tenesmus syndrome, the fecal-leakage syndrome, excessive gas discharge, and blood discharge but had a negligible effect on mucus discharge. Intra-abdominal surgery had an especially negative effect on the urgency-tenesmus syndrome. Although the combination of appendectomy with 1 or more other intra-abdominal surgeries resulted in the highest score for all syndromes, appendectomy alone had weak to no effect. In women who did not undergo irradiation, a similar pattern was seen, albeit with much lower scores., Conclusions: We found intra-abdominal surgery to be a risk factor among survivors of gynecologic cancer, increasing the intensity score of 4 out of 5 radiation-induced intestinal syndromes. During radiation therapy, it may be worthwhile to pay extra attention to the dose of unwanted ionizing radiation to the intestines if the patient previously has undergone intra-abdominal surgery., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Published
2023
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37. Barriers to and strategies for dealing with vaginal dilator therapy - Female pelvic cancer survivors' experiences: A qualitative study.

Author

Åkeflo L, Elmerstig E, Bergmark K, and Dunberger G

Subjects
Female, Humans, Vagina, Qualitative Research, Survivors, Cancer Survivors, Sexual Dysfunction, Physiological, Neoplasms
Abstract

Purpose: Vaginal changes, a frequently reported late effect among women treated with pelvic radiotherapy, can result in sexual dysfunction and distress. Women are recommended vaginal dilator therapy after completed radiotherapy; however, low adoption has been recognized. This study aims to provide insight into women's difficulties with carrying out vaginal dilator therapy and their experiences of information., Methods: Face-to-face, semi-structured interviews were undertaken with 12 pelvic cancer survivors in a selected sample of women with difficulties adopting the therapy. Interviews were audio-recorded, transcribed and analyzed using qualitative content analysis., Results: One overarching theme, Being unprepared, emerged from three identified categories relating to Experience of received information, Experience of performing the therapy, and Motivation to perform the therapy. The women experienced the information as unrealistic and insufficient, and requested clearer and earlier information. Bleeding, pain, fear of cancer recurrence, and recalling memories from treatments were experienced. Women described intestinal symptoms, fatigue, and feeling that the therapy was self-harm as barriers to performing the therapy. They described creating routines, breathing exercises, relaxation, pre-warming the dilator and performing therapy together with their partner as helpful strategies., Conclusions: Careful discussion, early and clear communication, psychoeducation and supportive follow-up of vaginal changes should be integrated into cancer treatment and follow up. Healthcare professionals should be aware of potential difficulties with vaginal dilator therapy and identify women in need of extended support. Research is required to investigate interventions that suit the needs of female pelvic cancer survivors., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2023
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38. Astatine-211 based radionuclide therapy: Current clinical trial landscape.

Author

Albertsson P, Bäck T, Bergmark K, Hallqvist A, Johansson M, Aneheim E, Lindegren S, Timperanza C, Smerud K, and Palm S

Abstract

Astatine-211 ( 211 At) has physical properties that make it one of the top candidates for use as a radiation source for alpha particle-based radionuclide therapy, also referred to as targeted alpha therapy (TAT). Here, we summarize the main results of the completed clinical trials, further describe ongoing trials, and discuss future prospects., Competing Interests: PA, TB, KS, SP, EA, and SL are co-founders of Aprit Biotech AB. EA and SL are the co-founders of Atley Solutions AB. KS is the founder of Smerud Medical Research Group. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Albertsson, Bäck, Bergmark, Hallqvist, Johansson, Aneheim, Lindegren, Timperanza, Smerud and Palm.)

Published
2023
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39. Sexual health and wellbeing among female pelvic cancer survivors following individualized interventions in a nurse-led clinic.

Author

Åkeflo L, Dunberger G, Elmerstig E, Skokic V, Steineck G, and Bergmark K

Subjects
Female, Humans, Quality of Life, Pain, Cancer Survivors, Sexual Health, Practice Patterns, Nurses', Pelvic Neoplasms radiotherapy
Abstract

Purpose: Treatment-induced sexual and intestinal dysfunctions coexist among women after pelvic radiotherapy. We aimed to explore if sexual health and wellbeing may be improved after radiotherapy following nurse-led interventions and if an association exists between improved intestinal health and sexual health., Methods: A population-based cohort of women treated with pelvic radiotherapy underwent interventions at a nurse-led clinic at Sahlgrenska University Hospital, Sweden, from 2011 to 2017. Self-reported questionnaires were used, pre- and post-intervention, to compare self-reported changes in sexual health and wellbeing. A regression model was performed to explore the association between intestinal and wellbeing variables., Results: Among the 260 female pelvic cancer survivors included in the study, more women reported increased than decreased satisfaction with overall sexual health post-intervention (26.0% vs. 15.3%, p = 0.035). They also reported significantly reduced superficial genital pain (25.8% vs. 13.1%, p ≤ 0.025), reduced deep genital pain (23.1% vs. 8.0%, p ≤ 0.001), increased QoL (42.7% vs. 22.4%, p < 0.001), and reduced levels of depression (43.1% vs. 28.0%, p = 0.003) or anxiety (45.9% vs. 24.4%, p < 0.001) post-intervention. We found a significant association between reduced urgency to defecate and improved satisfaction with overall sexual health (RR 3.12, CI 1.27-7.68, p = 0.004) and between reduced urgency to defecate with fecal leakage and reduced anxious mode (RR 1.56, CI 1.04-2.33, p = 0.021)., Conclusion: Sexual health and wellbeing can be improved by interventions provided in a nurse-led clinic focusing on physical treatment-induced late effects. Further research to optimize treatment strategies in female pelvic cancer survivors is needed., (© 2022. The Author(s).)

Published
2022
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40. Decreasing the Adverse Effects in Pelvic Radiation Therapy: A Randomized Controlled Trial Evaluating the Use of Probiotics.

Author

Ahrén IL, Bjurberg M, Steineck G, Bergmark K, and Jeppsson B

Abstract

Purpose: The aim of this randomized controlled trial was to evaluate the potential benefit from 2 probiotic bacteria of the species Lactiplantibacillus plantarum against radiation therapy-induced comorbidities., Methods and Materials: Women (>18 years of age) scheduled for radiation therapy because of gynecologic cancer were randomly allocated to consume placebo or either low-dose probiotics (1 × 10 10 colony-forming unit/capsule twice daily) or high-dose probiotics (5 × 10 10 colony-forming unit/capsule twice daily). The intervention started approximately 1 week before the onset of radiation therapy and continued until 2 weeks after completion. During this period the participants were daily filling in a study diary documenting the incidence and severity of symptoms, intake of concomitant medication, and stool consistency. The primary endpoint was the probiotic effect on the mean number of loose stools during radiation therapy., Results: Of the 97 randomized women, 75 provided data for the analysis of the results. The mean number of loose stools (sum of Bristol stool type 6 and 7) was not significantly reduced in the probiotic groups, but there was a significant reduction in the mean number of days with >1 loose stool with 15.04 ± 8.92 days in the placebo and 8.65 ± 5.93 days in the high-dose probiotics group ( P  = .014). The benefit was even more pronounced in the 2 weeks following the end of radiation therapy ( P  = .005). Moreover, intake of the probiotics resulted in a reduced severity of the symptoms grinding abdominal pain ( P  = .041) and defecation urgency ( P  = .08) and a reduced percentage of days with these symptoms ( P  = .023 and P  = .042, respectively), compared with placebo. There were no differences regarding reported adverse events., Conclusions: Intake of the 2 probiotic bacteria was beneficial and reduced many measures or symptoms of the radiation-induced toxicity in women treated for gynecologic cancer., (© 2022 The Authors.)

Published
2022
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41. A Preparatory Study for a Randomized Controlled Trial of Dietary Fiber Intake During Adult Pelvic Radiotherapy.

Author

Ahlin R, Bergmark K, Bull C, Devarakonda S, Landberg R, Sigvardsson I, Sjöberg F, Skokic V, Steineck G, and Hedelin M

Abstract

Background: Patients undergoing pelvic radiotherapy are often advised to omit fiber-rich foods from their diet to reduce the adverse effects of treatment. Scientific evidence supporting this recommendation is lacking, and recent studies on animals and humans have suggested that there is a beneficial effect of dietary fiber for the alleviation of symptoms. Randomized controlled studies on dietary fiber intake during pelvic radiotherapy of sufficient size and duration are needed. As preparation for such a large-scale study, we evaluated the feasibility, compliance, participation rate, and logistics and report our findings here in this preparatory study. Methods: In this preparatory study of a fiber intervention trial, Swedish gynecological cancer patients scheduled for radiotherapy were recruited between January 2019 and August 2020. During the intervention, the participants filled out questionnaires and used an application. They also consumed a fiber supplement at first in powder form, later in capsules. Blood- and fecal samples were collected. The study is registered in clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT04534075?cond=fidura&draw=2&rank=1). Results: Among 136 approached patients, 57 started the study and the participation rate for primary outcomes was 63% (third blood sample) and 65% (third questionnaire). Barely half of the participants provided fecal samples. Providing concise and relevant information to the patients at the right time was crucial in getting them to participate and stay in the study. The most common reasons for declining participation or dropping out were the expected burden of radiotherapy or acute side effects. Tailoring the ambition level to each patient concerning the collection of data beyond the primary endpoints was an important strategy to keep the dropout rate at an acceptable level. Using capsules rather than psyllium in powder form made it much easier to document intake and to create a control group. During the course of the preparatory study, we improved the logistics and for the last 12 participants included, the participation rate was 100% for the earliest primary outcome. Conclusion: A variety of adjustments in this preparatory study resulted in an improved participation rate, which allowed us to set a final protocol and proceed with the main study., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Ahlin, Bergmark, Bull, Devarakonda, Landberg, Sigvardsson, Sjöberg, Skokic, Steineck and Hedelin.)

Published
2021
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42. Sexual health and wellbeing after pelvic radiotherapy among women with and without a reported history of sexual abuse: important issues in cancer survivorship care.

Author

Åkeflo L, Elmerstig E, Dunberger G, Skokic V, Arnell A, and Bergmark K

Subjects
Female, Humans, Surveys and Questionnaires, Survivorship, Neoplasms, Sex Offenses, Sexual Dysfunction, Physiological epidemiology, Sexual Dysfunction, Physiological etiology, Sexual Health
Abstract

Aims: Sexual abuse is a women's health concern globally. Although experience of sexual abuse and cancer may constitute risk factors for sexual dysfunction and low wellbeing, the effects of sexual abuse have received little attention in oncology care. This study aims to explore sexual health and wellbeing in women after pelvic radiotherapy and to determine the relationship between sexual abuse and sexual dysfunction, and decreased wellbeing., Methods: Using a study-specific questionnaire, data were collected during 2011-2017 from women with gynaecological, anal, or rectal cancer treated with curative pelvic radiotherapy in a population-based cohort and a referred patient group. Subgroup analyses of data from women with a reported history of sexual abuse were conducted, comparing socio-demographics, diagnosis, aspects of sexual health and wellbeing., Results: In the total sample of 570 women, 11% reported a history of sexual abuse and among these women the most common diagnosis was cervical cancer. More women with than without a history of sexual abuse reported feeling depressed (19.4% vs. 9%, p = 0.007) or anxious (22.6% vs. 11.8%, p = 0.007) and suffering genital pain during sexual activity (52% vs. 25.1%, p = 0.011, RR 2.07, CI 1.24-3.16). In the total study cohort, genital pain during sexual activity was associated with vaginal shortness (68.5% vs. 31.4% p ≤ 0.001) and inelasticity (66.6% vs. 33.3%, p ≤ 0.001)., Conclusions: Our findings suggest that a history of both sexual abuse and pelvic radiotherapy in women are associated with increased psychological distress and sexual impairment, challenging healthcare professionals to take action to prevent retraumatisation and provide appropriate interventions and support., (© 2021. The Author(s).)

Published
2021
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43. Cohort profile: an observational longitudinal data collection of health aspects in a cohort of female cancer survivors with a history of pelvic radiotherapy-a population-based cohort in the western region of Sweden.

Author

Åkeflo L, Dunberger G, Elmerstig E, Skokic V, Steineck G, and Bergmark K

Subjects
Adolescent, Adult, Cohort Studies, Data Collection, Female, Humans, Prospective Studies, Sweden epidemiology, Cancer Survivors, Neoplasms
Abstract

Purpose: The study 'Health among women after pelvic radiotherapy' was conducted in response to the need for more advanced and longitudinal data concerning long-term radiotherapy-induced late effects and chronic states among female cancer survivors. The objective of this paper is to detail the cohort profile and the study procedure in order to provide a sound basis for future analyses of the study cohort., Participants: Since 2011, and still currently ongoing, participants have been recruited from a population-based study cohort including all female patients with cancer, over 18 years of age, treated with pelvic radiotherapy with curative intent at Sahlgrenska University Hospital in Gothenburg, in the western region of Sweden, which covers 1.7 million of the Swedish population. The dataset presented here consists of baseline data provided by 605 female cancer survivors and 3-month follow-up data from 260 individuals with gynaecological, rectal or anal cancer, collected over a 6-year period., Findings to Date: Data have been collected from 2011 onwards. To date, three studies have been published using the dataset reporting long-term radiation-induced intestinal syndromes and late adverse effects affecting sexuality, the urinary tract, the lymphatic system and physical activity. These projects include the evaluation of interventions developed by and provided in a nurse-led clinic., Future Plans: This large prospective cohort offers the possibility to study health outcomes in female pelvic cancer survivors undergoing a rehabilitation intervention in a nurse-led clinic, and to study associations between demographics, clinical aspects and long-term late effects. Analysis focusing on the effect of the interventions on sexual health aspects, preinterventions and postinterventions, is currently ongoing. The cohort will be expanded to comprise the entire data collection from 2011 to 2020, including baseline data and data from 3-month and 1-year follow-ups after interventions. The data will be used to study conditions and treatment-induced late effects preintervention and postintervention., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2021
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44. Dose-response relationships of intestinal organs and excessive mucus discharge after gynaecological radiotherapy.

Author

Alevronta E, Skokic V, Dunberger G, Bull C, Bergmark K, Jörnsten R, and Steineck G

Subjects
Aged, Area Under Curve, Colon, Sigmoid radiation effects, Dose-Response Relationship, Radiation, Female, Humans, Intestine, Small radiation effects, Middle Aged, Organs at Risk, ROC Curve, Radiation, Ionizing, Radiotherapy Dosage, Rectum radiation effects, Colon, Sigmoid metabolism, Genital Neoplasms, Female radiotherapy, Intestine, Small metabolism, Mucus metabolism, Rectum metabolism
Abstract

Background: The study aims to determine possible dose-volume response relationships between the rectum, sigmoid colon and small intestine and the 'excessive mucus discharge' syndrome after pelvic radiotherapy for gynaecological cancer., Methods and Materials: From a larger cohort, 98 gynaecological cancer survivors were included in this study. These survivors, who were followed for 2 to 14 years, received external beam radiation therapy but not brachytherapy and not did not have stoma. Thirteen of the 98 developed excessive mucus discharge syndrome. Three self-assessed symptoms were weighted together to produce a score interpreted as 'excessive mucus discharge' syndrome based on the factor loadings from factor analysis. The dose-volume histograms (DVHs) for rectum, sigmoid colon, small intestine for each survivor were exported from the treatment planning systems. The dose-volume response relationships for excessive mucus discharge and each organ at risk were estimated by fitting the data to the Probit, RS, LKB and gEUD models., Results: The small intestine was found to have steep dose-response curves, having estimated dose-response parameters: γ50: 1.28, 1.23, 1.32, D50: 61.6, 63.1, 60.2 for Probit, RS and LKB respectively. The sigmoid colon (AUC: 0.68) and the small intestine (AUC: 0.65) had the highest AUC values. For the small intestine, the DVHs for survivors with and without excessive mucus discharge were well separated for low to intermediate doses; this was not true for the sigmoid colon. Based on all results, we interpret the results for the small intestine to reflect a relevant link., Conclusion: An association was found between the mean dose to the small intestine and the occurrence of 'excessive mucus discharge'. When trying to reduce and even eliminate the incidence of 'excessive mucus discharge', it would be useful and important to separately delineate the small intestine and implement the dose-response estimations reported in the study., Competing Interests: No authors have competing interests.

Published
2021
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45. Intraperitoneal α-Emitting Radioimmunotherapy with 211 At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations.

Author

Hallqvist A, Bergmark K, Bäck T, Andersson H, Dahm-Kähler P, Johansson M, Lindegren S, Jensen H, Jacobsson L, Hultborn R, Palm S, and Albertsson P

Subjects
Adult, Aged, Alpha Particles, Animals, Antibodies, Monoclonal chemistry, Carcinoma, Ovarian Epithelial mortality, Catheters, Disease Progression, Female, Follow-Up Studies, Humans, Immunoglobulin Fab Fragments, Infusions, Parenteral, Maximum Tolerated Dose, Mice, Middle Aged, Neoplasm, Residual, Ovarian Neoplasms mortality, Radiation Dosage, Radiometry, Recurrence, Reproducibility of Results, Treatment Outcome, Astatine, Carcinoma, Ovarian Epithelial immunology, Carcinoma, Ovarian Epithelial radiotherapy, Neoplasm Recurrence, Local, Ovarian Neoplasms immunology, Ovarian Neoplasms radiotherapy, Radioimmunotherapy methods
Abstract

Eliminating microscopic residual disease with α-particle radiation is theoretically appealing. After extensive preclinical work with α-particle-emitting 211 At, we performed a phase I trial with intraperitoneal α-particle therapy in epithelial ovarian cancer using 211 At conjugated to MX35, the antigen-binding fragments-F(ab') 2 -of a mouse monoclonal antibody. We now present clinical outcome data and toxicity in a long-term follow-up with individual absorbed dose estimations. Methods: Twelve patients with relapsed epithelial ovarian cancer, achieving a second complete or nearly complete response with chemotherapy, received intraperitoneal treatment with escalating (20-215 MBq/L) activity concentrations of 211 At-MX35 F(ab') 2. Results: The activity concentration was escalated to 215 MBq/L without any dose-limiting toxicities. Most toxicities were low-grade and likely related to the treatment procedure, not clearly linked to the α-particle irradiation, with no observed hematologic toxicity. One grade 3 fatigue and 1 grade 4 intestinal perforation during catheter implantation were observed. Four patients had a survival of more than 6 y, one of whom did not relapse. At progression, chemotherapy was given without signs of reduced tolerability. Overall median survival was 35 mo, with a 1-, 2-, 5-, and 10-y survival of 100%, 83%, 50%, and 25%, respectively. Calculations of the absorbed doses showed that a lower specific activity is associated with a lower single-cell dose, whereas a high specific activity may result in a lower central dose in microtumors. Individual differences in absorbed dose to possible microtumors were due to variations in administered activity and the specific activity. Conclusion : No apparent signs of radiation-induced toxicity or decreased tolerance to relapse therapy were observed. The dosimetric calculations show that further optimization is advisable to increase the efficacy and reduce possible long-term toxicity., (© 2019 by the Society of Nuclear Medicine and Molecular Imaging.)

Published
2019
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46. Sex steroid hormone receptor expression in the vaginal wall in cervical cancer survivors after radiotherapy.

Author

Hofsjö A, Bohm-Starke N, Bergmark K, Masironi B, and Sahlin L

Subjects
Adult, Biopsy, Cancer Survivors statistics & numerical data, Chemoradiotherapy adverse effects, Chemoradiotherapy methods, Connective Tissue Growth Factor metabolism, Dose-Response Relationship, Radiation, Drug Resistance, Estradiol pharmacology, Estradiol therapeutic use, Estrogen Replacement Therapy methods, Female, Humans, Hysterectomy, Neoadjuvant Therapy adverse effects, Neoadjuvant Therapy methods, Progestins pharmacology, Progestins therapeutic use, Radiotherapy Dosage, Treatment Outcome, Vagina radiation effects, Vaginal Diseases etiology, Vaginal Diseases therapy, Estrogen Receptor alpha metabolism, Receptors, Androgen metabolism, Uterine Cervical Neoplasms therapy, Vagina pathology, Vaginal Diseases pathology
Abstract

Background: Sex steroid hormones and their receptors are important in female sexual function. The aim of this study was to investigate the expression and distribution of estrogen receptor (ER)α, ERβ, G-protein-coupled ER-1 (GPER), androgen receptor (AR), progesterone receptor (PR)A, PRB and connective tissue growth factor (CTGF) in the vaginal wall among women who had been treated for cervical cancer with radiotherapy. Material and methods: We included cervical cancer survivors treated with radiotherapy and premenopausal control women of the same age scheduled for benign gynecological surgery. We analyzed the expression and distribution of sex steroid hormone receptors and CTGF in biopsies from the vaginal wall, by real-time PCR and immunohistochemistry (IHC). Serum samples were analyzed for hormone levels and radiation dose at biopsy site were calculated and correlated to levels of the sex steroid hormone receptors. Results: In the cervical cancer survivors ( n  = 34), we found a lower expression of ERα at both mRNA and protein levels, compared to the control women ( n  = 37). In the survivors with high radiation dose at biopsy site, the immunostaining of ERα and AR was lower in the epithelium and the stroma, compared to survivors with minimal radiation dose. The later group showed expression of ERα comparable to the control women. The cancer survivors were sufficiently substituted with systemic estradiol with no difference in the serum estradiol levels compared to control women. Conclusions: We found that external radiation reduces the ERα and AR protein expression in the vaginal mucosa, indicating that the vaginal changes in irradiated cervical cancer survivors and the lack of response to hormonal treatment could be due to the decreases in sex steroid hormone receptor expression.

Published
2019
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47. Long-term fertility, oncological, and quality-of-life outcomes after trachelectomy in early stage cervical cancer.

Author

Malmsten C, Hellberg P, Bergmark K, and Dahm-Kähler P

Subjects
Adult, Female, Humans, Neoplasm Staging, Pregnancy, Treatment Outcome, Uterine Cervical Neoplasms pathology, Young Adult, Fertility physiology, Quality of Life psychology, Trachelectomy methods, Uterine Cervical Neoplasms surgery
Abstract

Purpose: Our aim was to evaluate fertility-sparing surgery of early stage cervical cancer after the introduction of vaginal trachelectomy (VT) and pelvic lymph node dissection (PLND). The objectives were to assess surgical, long-term oncological, fertility, and obstetric outcomes together with self-assessed quality of life (QoL)., Methods: All women ≤ 40 years diagnosed with early stage cervical cancers IA1-IB1 and ≤ 2 cm treated by VT and PLND between 2000 and 2014 were included. All successful fertility-sparing surgeries were identified. Medical records were reviewed and analyzed for surgical, oncological, fertility, and obstetric outcomes. Postal questionnaires were collected to further evaluate and validate the fertility and obstetric outcomes and QoL was assessed using the QLQ-C30 and QLQ-CX24 instruments., Results: Thirty-nine patients fulfilled the inclusion criteria, where 28 patients (71.8%) had successful VT performed with preserved fertility according to the oncological guidelines. Mean follow-up after VT was 95.0 months (range 26.5-182.4). There were 2 recurrences (7.1%) registered. All together, 24 pregnancies were identified and 17 children born; 76.5% after gestational week (gw) ≥ 34 + 0 and 23.5% preterm (gw < 34 + 0). The questionnaires revealed an overall high level of self-assessed QoL with global health status scores of 91.7 (median) and physical, role, emotional, cognitive, and social functioning all had median scores of 100 and a low incidence of "symptom experience scores" of urogynecological morbidity, although 38.9% experienced lymphedema., Conclusions: Early stage cervical cancers treated by VT and PLND are associated with acceptable long-term oncological outcomes, relatively high rate of successful pregnancies, and a high long-term QoL.

Published
2019
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48. Intake of citrus fruits and vegetables and the intensity of defecation urgency syndrome among gynecological cancer survivors.

Author

Hedelin M, Skokic V, Wilderäng U, Ahlin R, Bull C, Sjöberg F, Dunberger G, Bergmark K, Stringer A, and Steineck G

Subjects
Adult, Aged, Aged, 80 and over, Case-Control Studies, Female, Genital Neoplasms, Female radiotherapy, Humans, Middle Aged, Mucus metabolism, Statistics, Nonparametric, Syndrome, Cancer Survivors, Citrus, Defecation physiology, Feeding Behavior, Fruit, Genital Neoplasms, Female physiopathology, Vegetables
Abstract

Background: Despite the experimental evidence that certain dietary compounds lower the risk of radiation-induced damage to the intestine, clinical data are missing and dietary advice to irradiated patients is not evidence-based., Materials and Methods: We have previously identified 28 intestinal health-related symptoms among 623 gynaecological-cancer survivors (three to fifteen years after radiotherapy) and 344 matched population-based controls. The 28 symptoms were grouped into five radiation-induced survivorship syndromes: defecation-urgency syndrome, fecal-leakage syndrome, excessive mucus discharge, excessive gas discharge and blood discharge. The grouping was based on factor scores produced by Exploratory Factor Analysis in combination with the Variable Cutoff Method. Frequency of food intake was measured by a questionnaire. We evaluated the relationship between dietary intake and the intensity of the five syndromes., Results: With the exception of excessive mucus discharge, the intensity of all syndromes declined with increasing intake of citrus fruits. The intensity of defecation-urgency and fecal-leakage syndrome declined with combined intake of vegetables and citrus fruits. The intensity of excessive mucus discharge was increased with increasing intake of gluten., Conclusion: In this observational study, we found an association between a high intake of citrus fruits and vegetables and a lower intensity of the studied radiation-induced cancer survivorship syndromes. Our data suggest it may be worthwhile to continue to search for a role of the diet before, during and after radiotherapy to help the cancer survivor restore her or his intestinal health after irradiation., Competing Interests: Gunnar Steineck is PI for a study of probiotics sponsored by Probi AB. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There exist no other competing interests.

Published
2019
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49. A comparison of two imaging modalities for detecting lymphatic nodal spread in radiochemotherapy of locally advanced cervical cancer.

Author

Waldenström AC, Bergmark K, Michanek A, Hashimi F, Norrlund RR, Olsson CE, Gjertsson P, and Leonhardt H

Abstract

Background and Purpose: In uterine cervical cancer tumour spread reaching the para-aortic lymph nodes is the most significant independent pre-treatment predictor of progression-free survival. When introducing [ 18 F]fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) in our clinic for patients with advanced cervical cancer planned for definitive radiochemotherapy, the purpose of this study was to quantify to what extent the added information lead to changes in radiotherapy planning., Material and Methods: We included 25 consecutive patients with cervical cancer stages IB2 - IIIB planned for definitive radiochemotherapy between November 2010 and May 2012. The patients were examined both with magnetic resonance imaging (MRI) and FDG-PET/CT before treatment and after four weeks of treatment., Results: In 11/24 (46%) of the patients the FDG-PET/CT before treatment provided additional diagnostic information leading to changes in treatment planning compared to information from MRI. Seven of these eleven patients (64%) were alive and without evidence of disease at four-year follow-up. The MRI detected pelvic tumour spread not seen on the FDG-PET/CT in 2/24 patients. The disease-free four-year survival was 59%., Conclusions: Additional diagnostic information from FDG-PET/CT changed treatment strategy in almost half of the patients and may have increased chances of survival in this limited group of patients with locally advanced uterine cervical cancer. We recommend both modalities for nodal detection., (© 2018 The Authors.)

Published
2018
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50. Dose-response relationships of the sigmoid for urgency syndrome after gynecological radiotherapy.

Author

Alevronta E, Skokic V, Wilderäng U, Dunberger G, Sjöberg F, Bull C, Bergmark K, Jörnsten R, and Steineck G

Subjects
Aged, Dose-Response Relationship, Radiation, Female, Humans, Intestine, Small radiation effects, Middle Aged, Organs at Risk, Radiotherapy Dosage, Colon, Sigmoid radiation effects, Genital Neoplasms, Female radiotherapy, Radiation Injuries etiology, Rectum radiation effects
Abstract

Purpose: To find out what organs and doses are most relevant for 'radiation-induced urgency syndrome' in order to derive the corresponding dose-response relationships as an aid for avoiding the syndrome in the future., Material and Methods: From a larger group of gynecological cancer survivors followed-up 2-14 years, we identified 98 whom had undergone external beam radiation therapy but not brachytherapy and not having a stoma. Of those survivors, 24 developed urgency syndrome. Based on the loading factor from a factor analysis, and symptom frequency, 15 symptoms were weighted together to a score interpreted as the intensity of radiation-induced urgency symptom. On reactivated dose plans, we contoured the small intestine, sigmoid colon and the rectum (separate from the anal-sphincter region) and we exported the dose-volume histograms for each survivor. Dose-response relationships from respective risk organ and urgency syndrome were estimated by fitting the data to the Probit, RS, LKB and gEUD models., Results: The rectum and sigmoid colon have steep dose-response relationships for urgency syndrome for Probit, RS and LKB. The dose-response parameters for the rectum were D 50 : 51.3, 51.4, and 51.3 Gy, γ 50  = 1.19 for all models, s was 7.0e -09 for RS and n was 9.9 × 10 7 for LKB. For Sigmoid colon, D 50 were 51.6, 51.6, and 51.5 Gy, γ 50 were 1.20, 1.25, and 1.27, s was 2.8 for RS and n was 0.079 for LKB., Conclusions: Primarily the dose to sigmoid colon as well as the rectum is related to urgency syndrome among gynecological cancer survivors. Separate delineation of the rectum and sigmoid colon in order to incorporate the dose-response results may aid in reduction of the incidence of the urgency syndrome.

Published
2018
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