Maria Helde-Frankling's research while affiliated with Karolinska University Hospital and other places

Publications (8)

Article
Background: Fatigue is one of the most distressing symptoms in patients with advanced cancer. Previous studies have shown an association between low vitamin D levels and fatigue. Objectives: The aim of this study was to investigate the association between vitamin D levels and self-assessed fatigue in cancer patients admitted to palliative care, wi...
Article
Objectives The aim of this study was to investigate factors predictive for ‘death at home’ for patients admitted to an advanced medical home care unit in Stockholm, Sweden, with a focus on possible gender differences. In addition, place of death in relation to the patient’s wishes was studied. Method A retrospective review of medical records of al...
Article
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Background Statins are often discontinued in patients with advanced cancer since the net effect of treatment is considered negative. However, guidelines concerning discontinuation of statin treatment are lacking. The aim of this study was to investigate any differences in time of discontinuation of statin treatment between men and women with advanc...
Article
Full-text available
Vitamin D is a hormone synthesized in the skin in the presence of sunlight. Like other hormones, vitamin D plays a role in a wide range of processes in the body. Here we review the possible role of vitamin D in nociceptive and inflammatory pain. In observational studies, low vitamin D levels have been associated with increased pain and higher opioi...
Article
Background According to a small pilot study on palliative cancer patients at our ward, vitamin D supplementation had beneficial effects on pain (measured as opioid consumption), infections and quality of life (QoL) without having any significant side effects. Objective The primary objective of the ‘Palliative-D’ study is to test the hypothesis tha...
Article
Full-text available
Background We previously showed an association between low vitamin D levels and high opioid doses to alleviate pain in palliative cancer patients. The aim of this case-controlled study was to investigate if vitamin D supplementation could improve pain management, quality of life (QoL) and decrease infections in palliative cancer patients. Methods...
Article
Full-text available
Background: The aim of this study was to elucidate whether palliative cancer patients benefit from antibiotic treatment in the last two weeks of life when an infection is suspected. Method: We reviewed medical records from 160 deceased palliative cancer patients that had been included in previous studies on vitamin D and infections. Patients tre...

Citations

... The Palliative-D study was not powered for any subgroup analyses between men and women [17]. However, in the screening cohort (n = 530), an association between low 25-OHD levels and more severe fatigue was evident in men, while 25-OHD levels did not correlate to fatigue scores in women [18]. These findings encouraged further studies on possible sex differences in the effect of vitamin D. ...
... Both patients and their families are very satisfied with the symptom control and support offered by such home care services [15]. In most cases, the home care teams can offer inpatient palliative care at special units outside the acute hospitals when needed for palliation of symptoms or at end of life, but a majority of patients prefer to die at home, provided they receive adequate medical and other support [16,17]. ...
... There are no clear guidelines to support when statins should be terminated in end-oflife patients [17]. However, studies from palliative care show that statins are generally safe to discontinue in cancer patients with an expected survival time of 1 year or less [18,19]. In addition, geriatric patients with life-limiting diseases seem to be more susceptible to statin induced myalgia and pain [20]. ...
... Here, we adjusted the models for several variables not included in the main analyses, to check for residual confounding or mediation, where appropriate. The candidate variables were: (1) calcium intake, as vitamin D increases intestinal calcium absorption and both nutrients play a joint role on bone health [14,23]; (2) sleep quantity and quality, because vitamin D acts in sleep regulatory mechanisms, whose malfunction may lead to hyperalgesia [17]; (3) baseline use of pain medications, given that some mechanisms of action of painkillers may overlap with those of vitamin D (i.e., modulation of pain signaling pathways [15] and anti-inflammatory effects [16]); and (4) vitamin D supplement use, as vitamin D pills' dosing likely outweighs foods' [24,39]. For this same reason, we ran a final analysis excluding those subjects taking said supplements. ...
... Inclusion criteria were men and women, ≥18 years old, diagnosed with advanced and/or metastatic cancer in the palliative phase, and with a life expectancy >3 months. More details about the study design can be found elsewhere [30][31][32]. In these analyses, we used baseline data collected at the screening visit, i.e., data collected before any intervention had been performed [32]. ...
... Mechanistic studies suggesting anti-proliferative and anti-inflammatory effects of vitamin D [4,5,9,10], have spiked interest in epidemiological vitamin D research in cancer patients. Studies on cancer incidence and mortality indicate that vitamin D supplementation may reduce cancer specific, but not overall, mortality [11][12][13][14][15]. Prospective clinical studies investigate the possible potentiating effect of vitamin D on oncologic treatment effect [16,17], as well as its possible role in the management of pain [18][19][20][21][22], fatigue, and quality of life [20,21,[23][24][25]. In a recent US study, 56% of cancer survivors took vitamin D supplementation compared to 37% in the general population [26]. ...
... Previous reports indicate that 17% to 90% of patients receive antimicrobials near the end of life, with wide variability due to differences in patient populations, study setting (inpatient vs outpatient; hospice vs acute care), and period of assessment before death [2][3][4][5][6][7][8][9][10][11][12][13]. Antimicrobial use at end of life tends to be higher among patients with cancer (58%-87%) [14][15][16][17][18][19]. Patients with cancer experience a high rate of infectious complications and often experience symptoms of malignancy, such as fever, pain, or dyspnea, that can be mistaken for infection. ...