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- Eriksson, B. K., et al.
(författare)
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Liver embolizations of patients with malignant neuroendocrine gastrointestinal tumors
- 1998
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Ingår i: Cancer. - 0008-543X .- 1097-0142. ; 83:11, s. 2293-2301
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Patients with neuroendocrine gastrointestinal tumors usually present with inoperable metastatic disease and severe hormonal symptoms. Specific chemotherapy, interferon-alpha (IFN), and somatostatin analogs are established therapies for these patients, but all of them eventually fail. Hepatic arterial embolization can provide reduction of both hormonal symptoms and tumor burden in these patients. METHODS Between 1981 and 1995, a total of 55 liver embolizations with gel foam powder were performed on 41 patients with histopathologically verified neuroendocrine tumors; 29 had carcinoid tumors and 12 had endocrine pancreatic tumors (EPTs). All patients had received medical treatment, including chemotherapy (n = 18), IFN (n = 31), and octreotide (n = 19), and were experiencing treatment failure when liver embolization was performed at a median of 37 months after diagnosis of liver metastases. Medical treatment was continued after embolization. RESULTS An overall objective response was noted in 15 of 29 patients with carcinoid tumors (52%). The median duration of effect was 12 months in patients with midgut carcinoid tumors. An overall objective response was observed in 6 of 12 patients with EPTs (50%), with a median duration of effect of 10 months. Adverse events were observed, and, in agreement with earlier reports, the rate of serious complications was 10%. Survival analyses showed a median survival of 80 months and a 5-year survival rate of 60% from the performance of embolization on patients with midgut carcinoid tumors, whereas for patients with EPTs the median survival from embolization was only 20 months. CONCLUSIONS Liver embolizations performed relatively late in the clinical course in our series appeared to be as effective as "early" embolizations in other series of patients with carcinoid tumors. The results for those with EPTs were poorer, and earlier embolizations may result in better outcomes for these patients. Considering the morbidity associated with the procedure, it is imperative to select patients according to extent of liver involvement, severity of carcinoid heart disease, and somatostatin receptor status.
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- Torén, A, et al.
(författare)
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Tractor-driving hours and their relation to self-reported low-back and hip symptoms.
- 2002
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Ingår i: Appl Ergon. - 0003-6870 .- 1872-9126. ; 33:2, s. 139-46
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Tractor driving might be one causal risk factor in the incidence of low-back and hip symptoms among farmers. Information on the annual exposure to tractor driving and its distribution among different work operations is scarce. The purpose of this study was to quantify the total and the annual time driving tractors among Swedish farmers and its distribution into different work operations, and to investigate the risk of low-back and hip symptoms in relation to tractor driving within different work operations. The data were collected from a questionnaire study sent to all farms with acreage more than 10 ha in a county in Sweden. Farmers having farming and/or forestry as their main occupation in 1995 were included in the analysis. The annual tractor-driving time and the percentage distribution within different work operations were calculated for females, males, the total group and four production groups. The risk calculations for low-back and hip symptoms from the variables related to tractor driving were performed on the total group. The results showed that the mean annual tractor-driving time was 472 h. Ploughing was the single most time-consuming work operation but it had no influence on the risk for low-back or hip pain. The results showed that some of the variables investigated related to tractor driving influenced the risk for low-back and hip symptoms.
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