Örebro University Hospital (Swedish: Universitetssjukhuset Örebro, USÖ) is a university hospital in Örebro, Sweden.The hospital is operated by Örebro County Council and took its current name in 2000, having previously been called Örebro Regional Hospital. Örebro University, which was awarded full university status in 1999, and the County Council have long tried to establish a governmentally funded medical school in Örebro in collaboration with the hospital. On 30 March 2010, the university was granted the right to award medical degrees, making it the 7th medical school in Sweden..
MGMT promoter methylation is a key predictive biomarker for response to alkylating agents in glioblastoma. However, there is no consensus regarding optimal analytical method or cut-off. This study aimed to define a clinically relevant survival-based cut-off value for MGMT using a standardized pyrosequencing assay. Patients from five Swedish university hospitals with MGMT promoter methylation status analyzed using the Therascreen MGMT Pyro Kit, investigating CpGs 76–79, were identified. Glioblastoma patients treated with radiotherapy and concomitant temozolomide were selected from the Swedish CNS Tumor Registry. Quantitative MGMT status, both mean value and percentage of methylation for each individual CpG, was analyzed using an unsupervised bimodal normal mixture model and a survival-informed approach adjusted for established prognostic factors. A total of 451 patients were included. The unsupervised model identified a cut-off at ≥ 11
Summary:. Large language models and text-to-image systems offer value for surgical education, counseling, and decision support. Yet, European teams frequently face legal barriers that US investigators do not, especially when patient images or other sensitive health data are processed by third-country artificial intelligence (AI) services. Europe’s General Data Protection Regulation explains this divergence, and the European Union (EU) AI Act imposes strict rules on special-category health data, whereas US frameworks (Health Insurance Portability and Accountability Act/the Common Rule) allow broader use of de-identified data and pose no cross-border transfer constraints. We use a recent Plastic and Reconstructive Surgery study on AI-generated lip-lift counseling images as a concrete example of work that is straightforward in the United States but risky in the EU if done via public, non-EU AI services. We then present legal and practical ways for EU researchers, when using EU–US Data Privacy Frameworks or an EU-hosted enterprise service with a data-processing agreement, to keep data in EU regions on Microsoft Azure/Google Cloud Platform or run on open-source models on your own servers and apply strict de-identification/anonymization. We conclude with policy recommendations for regulators to clarify research exceptions, set up supervised “sandboxes,” and publish practical healthcare guidance under the AI Act.
BACKGROUND:HYPO-RT-PC is a phase 3 trial comparing ultra-hypofractionated and conventionally fractionated radiotherapy in intermediate-to-high-risk localised prostate cancer. This 10-year update reports long-term efficacy and toxicity outcomes. METHODS:In this open-label, randomised, phase 3, non-inferiority trial done in ten centres in Sweden and two in Denmark, we recruited men aged 75 years or younger with intermediate-risk or high-risk prostate cancer and a WHO performance status between 0 and 2. Previous or current androgen deprivation therapy was not permitted. Patients were randomly assigned (1:1) to ultra-hypofractionated radiotherapy (42·7 Gy in seven fractions, 3 days per week for 2·5 weeks) or conventionally fractionated radiotherapy (78·0 Gy in 39 fractions, 5 days per week for 8 weeks). Randomisation was performed with a minimisation algorithm balancing T stage, Gleason score, prostate-specific antigen, and trial centre. The primary endpoint was failure-free survival, defined as time from randomisation to the first occurrence of biochemical failure, evidence of clinical progression, initiation of androgen deprivation therapy, or death from prostate cancer, analysed in the per-protocol population. The non-inferiority margin was 4% at 5 years and had previously been met, corresponding to a critical hazard ratio (HR) limit of 1·338. Toxicity was assessed using the Radiation Therapy Oncology Group morbidity scale. Here, we report long-term efficacy and safety results at 10 years. The trial is registered with the ISRCTN registry, ISRCTN45905321, and is closed. FINDINGS:Between July 1, 2005, and Nov 4, 2015, 1200 patients were randomly assigned to conventional fractionated radiotherapy (n=602) or ultra-hypofractionated radiotherapy (n=598). Ten patients withdrew consent, eight were found to be ineligible, and two died of reasons unrelated to prostate cancer. 1180 patients constituted the per-protocol population (591 in the conventional fractionation group and 589 in the ultra-hypofractionation group). After a median follow-up of 10·6 years (IQR 9·0-13·0) in the conventional fractionation group and 10·7 years (9·1-12·7) in the ultra-hypofractionation group, 205 and 178 primary events were observed, respectively. 10-year failure-free survival was 65% (95% CI 61-69) in the conventionally fractionated group and 72% (68-76) in the ultra-hypofractionated group. The adjusted HR for the primary endpoint was 0·84 (95% CI 0·69-1·03; Cox regression analysis), confirming non-inferiority. The 10-year cumulative incidence of late grade 2 or worse genitourinary toxic effects was 30% (95% CI 26-34) in the conventional fractionation group and 28% (24-32) in the ultra-hypofractionated group (HR 1·01, 95% CI 0·81-1·25; p=0·95). For late grade 2 or worse gastrointestinal toxic effects, the corresponding figures were 14% (95% CI 11-18) and 14% (11-17; HR 0·94, 95% CI 0·70-1·28; p=0·72). INTERPRETATION:This 10-year follow-up confirms the non-inferiority of the ultra-hypofractionated radiotherapy regimen compared with the conventionally fractionated, with similar toxicity profiles. The findings support the seven-fraction schedule as a safe, effective, and practical standard-of-care option for patients with intermediate-risk prostate cancer. FUNDING:The Nordic Cancer Union, the Swedish Cancer Society, the Swedish Research Council, the Swedish Prostate Cancer Association, and Cancerforskningsfonden i Norrland.
Background Cosmetic surgery tourism continues to grow, but the evidence on postoperative complications and healthcare costs remains fragmented. This systematic review synthesized the published literature on complications after cosmetic procedures performed abroad, with focus on clinical outcomes and financial repercussions, comparing European and non-European settings. Methods The review was conducted according to PRISMA guidelines and was pre-registered in PROSPERO, including PubMed, Embase, Scopus and the Cochrane Library. Eligible studies included adults who underwent cosmetic procedures abroad and later required treatment in their home countries. Risk of bias was assessed and for commonly reported binary outcomes a random-effects meta-analysis was performed. Results Fifty-eight studies were included, comprising 1249 patients. Thirty-six articles originated from Europe and 22 from elsewhere. Infection was the most frequently reported complication, followed by wound dehiscence, implant-related complications and systemic complications. Turkey was the most commonly reported destination in European studies, whereas the Dominican Republic dominated in non-European studies. Quantitative synthesis was feasible for infection, wound dehiscence, hospital admission, implant-related complications and systemic complications. Heterogeneity was present across all pooled outcomes and continuous outcome meta-analysis for cost and length of stay was not feasible. Conclusion Complications after cosmetic surgery abroad represent a substantial treatment burden for healthcare systems. The available evidence supports recurring patterns in reported procedures, complications, microbiology and destinations. Quantitative synthesis supported infection as the dominant reported complication, but regional comparisons remain observational and hypothesis-generating rather than epidemiological estimates.
In patients with stable coronary artery disease (CAD), the long-term benefits of revascularization over medical therapy remain unclear. In the Fractional Flow Reserve versus Angiography for Multivessel Evaluation 2 trial, patients with hemodynamically significant stenoses (fractional flow reserve (FFR) ≤ 0.80) were randomized to receive FFR-guided percutaneous coronary intervention (PCI) plus medical therapy (n = 447) or medical therapy alone (n = 441). At 5 years, FFR-guided PCI reduced the risk of the primary composite outcome of time to death, myocardial infarction or urgent revascularization, largely because of fewer urgent revascularizations. We now report the long-term clinical outcomes from this trial. Sixteen hospitals, contributing 748 randomized patients (161 women, 21.5 NCT06159231 . In a long-term follow-up of the FAME 2 trial, fractional flow reserve-guided percutaneous coronary intervention plus medical therapy in patients with stable coronary artery disease reduced cardiovascular events compared to medical therapy alone, primarily due to a decrease in urgent revascularization events.
