Publications by authors named "Linda Werner"

5 Publications

  • Page 1 of 1

No Increased Cardiac Mortality or Morbidity of Radiation Therapy in Breast Cancer Patients After Breast-Conserving Surgery: 20-Year Follow-up of the Randomized SweBCGRT Trial.

Int J Radiat Oncol Biol Phys 2020 07 14;107(4):701-709. Epub 2020 Apr 14.

Department of Clinical Sciences, Faculty of Medicine, Lund, Lund University, Sweden; Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.

Purpose: Radiation therapy (RT) after breast-conserving surgery reduces locoregional recurrences and improves survival but may cause late side effects. The main purpose of this paper was to investigate long-term side effects after whole breast RT in a randomized clinical trial initiated in 1991 and to report dose-volume data based on individual 3-dimensional treatment plans for organs at risk.

Methods And Materials: The trial included 1187 patients with T1-2 N0 breast cancer randomized to postoperative tangential whole breast RT or no further treatment. The prescription dose to the clinical target volume was 48 to 54 Gy. We present 20-year follow-up on survival, cause of death, morbidity, and later malignancies. For a cohort of patients (n = 157) with accessible computed tomography-based 3-dimensional treatment plans in Dicom-RT format, dose-volume descriptors for organs at risk were derived. In addition, these were compared with dose-volume data for a cohort of patients treated with contemporary RT techniques.

Results: The cumulative incidence of cardiac mortality was 12.4% in the control group and 13.0% in the RT group (P = .8). There was an increase in stroke mortality: 3.4% in the control group versus 6.7% in the RT group (P = .018). Incidences of contralateral breast cancer and lung cancer were similar between groups. The median D (range) heart dose for left-sided treatments was 3.0 Gy (1.1-8.1), and the corresponding value for patients treated in 2017 was 1.5 Gy (0.4-6.0).

Conclusions: In this trial, serious late side effects of whole breast RT were limited and less than previously reported in large meta-analyses. We observed no increase in cardiac mortality in irradiated patients. Doses to the heart were a median D of 3.0 Gy for left-sided RT. The observed increase in stroke mortality may partly be secondary to cardiac side effects, complications to anticoagulant treatment, or to chance, rather than a direct side effect of tangential whole breast irradiation.
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http://dx.doi.org/10.1016/j.ijrobp.2020.04.003DOI Listing
July 2020

Dyadic Instruction for Middle School Students: Liking Promotes Learning.

Learn Individ Differ 2015 Dec;44:33-39

Research Department, ETR Associates.

This study examines whether friendship facilitates or hinders learning in a dyadic instructional setting. Working in 80 same-sex pairs, 160 (60 girls, 100 boys) middle school students ( = 12.13 years old) were taught a new computer programming language and programmed a game. Students spent 14 to 30 ( = 22.7) hours in a programming class. At the beginning and the end of the project, each participant separately completed (a) computer programming knowledge assessments and (b) questionnaires rating their affinity for their partner. Results support the proposition that liking promotes learning: Greater partner affinity predicted greater subsequent increases in computer programming knowledge for both partners. One partner's initial programming knowledge also positively predicted the other partner's subsequent partner affinity.
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http://dx.doi.org/10.1016/j.lindif.2015.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681000PMC
December 2015

Evaluation of surrogate markers for passive transfer of immunity in kittens.

J Am Vet Med Assoc 2006 Apr;228(7):1038-41

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.

Objective: To identify surrogate markers of passive transfer of immunity in kittens.

Design: Prospective clinical trial.

Animals: 55 kittens from 12 specific-pathogen-free queens.

Procedure: Kittens were allocated at birth into colostrum-fed (n = 27) and colostrum-deprived (28) groups. Blood was collected at birth and on days 1, 2, 4, 7, 14, 28, and 56. Serum samples were analyzed for activities of alkaline phosphatase (ALP), alanine aminotransferase, aspartate aminotransferase, creatine kinase, lactate dehydrogenase, gamma-glutamyltransferase, amylase, and lipase and for concentrations of albumin, total protein, bilirubin, urea nitrogen, creatinine, cholesterol, glucose, calcium, phosphorus, and triglycerides by use of an automated analyzer. Total serum solids concentrations were estimated by use of refractometry. Serum IgG concentrations were quantified by use of radial immunodiffusion.

Results: All kittens were agammaglobulinemic at birth. Colostrum-fed kittens had significantly higher IgG concentrations than did colostrum-deprived kittens from 1 though 28 days of age. Transient significant differences in serum biochemical variables between the colostrum-deprived and colostrum-fed groups were substantially resolved by day 4. Passive transfer of immunity could be reliably determined at 1 day of age and to a lesser extent at 2 days of age only by measurement of serum activity of ALP.

Conclusions And Clinical Relevance: Adequacy of passive transfer in kittens initially correlated with serum activity of ALP, but quantification of serum IgG concentration was necessary after 2 days of age.
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http://dx.doi.org/10.2460/javma.228.7.1038DOI Listing
April 2006

Effect of age on reference intervals of serum biochemical values in kittens.

J Am Vet Med Assoc 2006 Apr;228(7):1033-7

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.

Objective: To determine the effect of age on reference intervals of serum biochemical values in kittens.

Design: Prospective clinical trial.

Animals: 55 kittens from 12 specific-pathogen-free queens.

Procedure: Kittens were allocated at birth into colostrum-fed (n = 27) and colostrum-deprived (28) groups. Blood was collected at birth and on days 1, 2, 4, 7, 14, 28, and 56. Serum samples were analyzed for activities of alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, creatine kinase, lactate dehydrogenase, gamma-glutamyltransferase, amylase, and lipase and for concentrations of albumin, total protein, bilirubin, urea nitrogen, creatinine, cholesterol, glucose, calcium, phosphorus, and triglycerides by use of an automated analyzer. Total serum solids concentrations were determined by use of refractometry. Serum IgG concentrations were quantified by use of radial immunodiffusion.

Results: For several analytes, reference intervals changed rapidly, most notably during the first few days of life. Reference intervals for alkaline phosphatase, creatine kinase, lactate dehydrogenase, and triglycerides were higher from birth to 8 weeks than adult reference intervals. Aspartate aminotransferase, bilirubin, urea nitrogen, and creatinine were higher than in adults at birth but were similar to or lower than adult reference intervals by 8 weeks. Compared with adult reference intervals, reference intervals for calcium and phosphorus concentrations were higher and for albumin and total protein concentrations were lower throughout the study period.

Conclusions And Clinical Relevance: Important differences exist between reference intervals for serum biochemical values of neonatal and adult cats. Age-appropriate reference intervals should be used for accurate assessment of serum biochemical test results in cats.
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http://dx.doi.org/10.2460/javma.228.7.1033DOI Listing
April 2006

Factor X deficiency in a Jack Russell terrier.

Vet Clin Pathol 1993 ;22(3):68-71

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616.

Deficiency in factor X (Stuart-Prower factor) was identified in a 7-month-old spayed female Jack Russell Terrier following recurrent bleeding episodes. Various relatives were screened for factor X deficiency and low and subnormal levels were identified in the father and paternal grandmother, respectively. Factor X deficiency has been previously documented in a family of American Cocker Spaniels, in which the inheritance pattern appeared to be an autosomal dominant trait with variable expression. This is the first report describing this coagulopathy in the Jack Russell Terrier.
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http://dx.doi.org/10.1111/j.1939-165x.1993.tb00655.xDOI Listing
January 1993