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Träfflista för sökning "WFRF:(Thorlacius Henrik) srt2:(2015-2019)"

Sökning: WFRF:(Thorlacius Henrik) > (2015-2019)

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  • Föregående 123[4]56Nästa
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31.
  • Sternby, Hanna, et al. (författare)
  • IL-6 and CRP are superior in early differentiation between mild and non-mild acute pancreatitis
  • 2017
  • Ingår i: Pancreatology. - Karger. - 1424-3903. ; 17:4, s. 550-554
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The revised Atlanta classification on acute pancreatitis (AP) presents distinct criteria for severity categorization. Due to the lack of reliable prognostic markers, a majority of patients with AP are currently hospitalized and initially managed identically. As incidence and financial costs are rising the need for early severity differentiation will increase. This study aimed to investigate the capacity of biomarkers to stratify AP patients during the initial course of the disease. Methods Patients with AP were prospectively enrolled and dichotomized into mild or non-mild (moderately severe and severe AP) according to the revised Atlanta classification. Serum samples taken within 13–36 h after onset of disease were analyzed for 20 biomarkers. Through receiver operating curves cut-off levels were set for 5 biomarkers whose stratifying ability was further analyzed. Additionally, the patients were classified according to the harmless acute pancreatitis score (HAPS). Results Among the 175 patients, 70.9% had mild and 29.1% non-mild AP. CRP and IL-6 combined, with cut-off levels 57.0 and 23.6 respectively, demonstrated superior discriminative capacity with an area under the curve of 0.803, sensitivity 98%, specificity 54% and a positive and negative likelihood ratio of 2.1 and 0.06 for the non-mild group. Regarding the mild group likelihood ratios were positive 26.5 and negative 0.48. The identification potential of the HAPS was generally inferior when compared to CRP plus IL-6. Conclusions In this study CRP and IL-6 demonstrate a clinically relevant capacity to differentiate mild from non-mild AP early in the course of AP.
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32.
  • Sternby, Hanna, et al. (författare)
  • Predictive Capacity of Biomarkers for Severe Acute Pancreatitis.
  • 2016
  • Ingår i: European Surgical Research. - Karger. - 0014-312X. ; 56:3-4, s. 154-163
  • Tidskriftsartikel (refereegranskat)abstract
    • Early prediction of severe acute pancreatitis (SAP) substantially improves treatment of patients. A large amount of biomarkers have been studied with this objective. The aim of this work was to study predictive biomarkers using preset cut-off levels in an unselected population of patients with acute pancreatitis (AP).
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35.
  • Thorlacius, Henrik, et al. (författare)
  • En framgångssaga inom gastroenterologisk endoskopi
  • 2018
  • Ingår i: Läkartidningen. - Swedish Medical Association. - 0023-7205. ; 115:24
  • Tidskriftsartikel (refereegranskat)abstract
    • Endoscopic retrograde cholangiopancreatography (ERCP) was introduced 5 decades ago in 1968. Since then ERCP has redefined treatment of pancreatic and biliary tract diseases. The modern duodenoscopy was invented in 1970. Initially, ERCP was mainly used for diagnostic purposes. Sphincterotomy was introduced 1974, which made surgery obsolete in the management of cholodocholitiasis. In 1980 were the first cases of successful decompression of malignant bile duct obstruction using endostents reported. In modern time, efforts have been devoted to scientifically investigate the role of ERCP in the treatment of diseases in the pancreas and bile ducts and to secure high quality in ERCP.
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36.
  • Thorlacius, Henrik, et al. (författare)
  • Endoskopins historia : Från spekulum till kamerakapsel
  • 2017
  • Ingår i: Läkartidningen. - Swedish Medical Association. - 0023-7205. ; 114:42, s. 1782-1782
  • Tidskriftsartikel (övrigt vetenskapligt)abstract
    • Endoscopy is not a modern invention but the history of endoscopy goes back to ancient times in Egypt and Greece when speculums were used to inspect the nose cavity, vagina and anorectum. The modern era of endoscopy started in the 19th century with the development of straight metallic tubes with primitive light sources, such as Bozzini´s »lichtleiter« and Desormeaux´s »endoscope«. The first gastroscopy was conducted by Kussmaul in 1868 when he attempted to inspect the inside of the stomach by intubating a sword swallower with a 48 cm long straight metallic tube. During this time Bruck placed galvanised wire threads at the tip of the endoscope which markedly improved illumination (»galvanoscope«). In 1888, Nitze successfully made an endoscope with a miniaturized light bulb at the tip of the instrument. The first practical semi-flexible instrument was developed by Schindler in 1932 allowing deeper intubation into the gastrointestinal tract. Hopkins invention in 1954 of glass fiber bundles transmitting high quality images even if bent made the way for the flexible fiberscope developed by Hirschowitz in 1957. The fiberscope made it possible to use external high intensity light sources »cold light« improving illumination further. In parallel, Uri and Tasaka developed the »gastrocamera« allowing routine endoscopic photography, which remained standard until the incorporation of the CCD camera in the endoscope in 1983. The development of of videoendoscopy in the 1990s revolutionized endoscopy and made the fiberscopes obsolete. The first capsule endoscopy performed in 1999, which opened up the door to wireless endoscopy. It is interesting that most improvements of endoscopy are the result of an innovative use of inventions from other scientific fields, such as optics, mechanics and photography. How future endoscopy will shape is difficult to guess but, as stated by someone, »the best way to predict the future is to invent it yourself.
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37.
  • Thorlacius, Henrik, et al. (författare)
  • European experience of colorectal endoscopic submucosal dissection : a systematic review of clinical efficacy and safety
  • 2019
  • Ingår i: Acta Oncologica. - Taylor & Francis. - 0284-186X. ; 58:sup1, s. 10-14
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Endoscopic submucosal dissection (ESD) is an advanced method allowing en bloc resection of large and complex lesions in colon and rectum. Herein, the European experience of colorectal ESD was systematically reviewed in the medical literature to determine the clinical efficacy and safety of colorectal ESD in Europe. Material and methods: A systematic search of PubMed for full-text studies including more than 20 cases of colorectal ESD emanating from European centres was performed. Data were independently extracted by two authors using predefined data fields, including efficacy and safety. Results: We included 15 studies containing a total of 1404 colorectal ESD cases (41% in the colon) performed between 2007 and 2018. Lesion size was 40 mm (range 24–59 mm) and procedure time was 102 min (range 48–176 min). En bloc resection rate was 83% (range 67–93%) and R0 resection rate was 70% (range 35–91%). Perforation rate was 7% (range 0–19%) and bleeding rate was 5% (range 0–12%). The percentage of ESD cases undergoing emergency surgery was 2% (range 0–6%). Additional elective surgery was performed in 3% of all cases due to histopathological findings showing deep submucosal invasion or more advanced cancer. The recurrence rate was 4% (range 0–12%) after a median follow-up time of 12 months (range 3–24 months). Conclusions: This review shows that ESD is effective and safe for treating large and complex colorectal lesions in Europe although there is room for improvement. Thus, it is important to develop standardized and high-quality educational programs in colorectal ESD in Europe.
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38.
  • Thorlacius, Henrik, et al. (författare)
  • Koloskopier måste kvalitetssäkras : Verksamheterna bör registrera och följa upp specifika indikatorer för högkvalitetskoloskopi
  • 2017
  • Ingår i: Läkartidningen. - Swedish Medical Association. - 0023-7205. ; 114:20-21
  • Tidskriftsartikel (övrigt vetenskapligt)abstract
    • Colonoscopy plays a key role in the work-up of digestive diseases and constitutes the cornerstone in colorectal cancer diagnosis and prevention. Data suggest that the quality of colonoscopy varies widely between different endoscopists. This article summarizes current evidence and expert consensus on quality indicators, along with the evidence supporting their use in benchmarking, quality reporting, and continuous quality improvement in order to secure high quality colonoscopy. In particular, four quality indicators, i.e. adenoma detection rate, compliance with guidelines on intervals for endoscopic surveillance, cecal intubation rate and complications, should be monitored in endoscopy units to ensure that colonoscopy practice is of high quality. Proper performance and documentation of high quality colonoscopy is critical for reducing colorectal cancer incidence and mortality.
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39.
  • Thorlacius, Henrik, et al. (författare)
  • Riktlinjer för endoskopisk kontroll efter kolorektal polypektomi
  • 2017
  • Ingår i: Läkartidningen. - Swedish Medical Association. - 0023-7205. ; 114:20-21
  • Tidskriftsartikel (övrigt vetenskapligt)abstract
    • These guidelines for endoscopic surveillance after colorectal polypectomy are based on the recommendations published by European Society of Gastrointestinal Endoscopy (ESGE) in 2013. A precondition for the guidelines is that patients have undergone a high-quality colonoscopy, including complete removal and histopathological evaluation of all detected neoplastic lesions. Current research has made it possible to stratify patients into a low-risk and a high-risk group in terms of metachronous cancer. Low-risk group patients (1-2 tubular adenomas <10 mm in size) are recommended a surveillance colonoscopy 10 years after the index colonoscopy if the patient is less than 50 years old, otherwise not. High-risk group patients (adenomas with villous histology or high grade dysplasia or ≥10 mm in size, or ≥ 3 adenomas), should undergo a repetition colonoscopy 3 years after the index colonoscopy. If high-risk adenomas are detected at first or subsequent surveillance colonoscopy, a 3-year repetition of the next endoscopic examination is recommended. If a high-risk patient has no high-risk adenomas at the first surveillance colonoscopy, a 5-year period is recommended until the second surveillance colonoscopy. ESGE recommends termination of the follow-up at 80 years of age although individualised recommendations should consider general health and comorbidity of the patients as well as findings at previous colonoscopies.
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40.
  • Thorlacius, Henrik, et al. (författare)
  • Screening för kolorektal cancer - Evidensläge, metoder och utmaningar : Implementeringen varierar stort mellan olika länder
  • 2018
  • Ingår i: Läkartidningen. - Swedish Medical Association. - 0023-7205. ; 115:22-23
  • Tidskriftsartikel (refereegranskat)abstract
    • Convincing data demonstrate that screening reduces mortality in colorectal cancer. International organizations and national authorities recommend implementation of colorectal cancer screening programs. There are several different primary methods for screening, including tests of blood in feces, sigmoidoscopy and colonoscopy, all with their inherent advantages and disadvantages. The majority of programs utilizes fecal occult blood test as primary screening method followed by colonoscopy. Colonoscopy as a primary screening method has the advantage of directly removing precancerous lesions and ongoing studies evaluates the role of colonoscopy as a primary screening method for colorectal cancer. Challenges for implementation of screening in Sweden include limited access to colonoscopy resources and problems to reassure quality control. This article summarizes current evidence for colorectal cancer screening, as well as methods and requirements for implementation.
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  • Resultat 31-40 av 57
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