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Träfflista för sökning "WFRF:(Graf Wilhelm) srt2:(2005-2009)"

Sökning: WFRF:(Graf Wilhelm) > (2005-2009)

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1.
  • Andersson, Magnus V., et al. (författare)
  • Kirurgi - Omistligt komplement till medicinsk behandling
  • 2009
  • Ingår i: Läkartidningen. - 0023-7205. ; 106:45, s. 3003-3009
  • Tidskriftsartikel (refereegranskat)abstract
    • Kirurgi på rätt indikation och vid rätt tidpunkt är ett omistligt komplement till medicinsk behandling vid inflammatorisk tarmsjukdom, som förebygger sjukdomskomplikationer, förbättrar patienternas livskvalitet och ibland är livräddande. Kirurgi för ulcerös kolit görs oftast som ett tvåstegsförfarande: först kolektomi plus ileostomi med rektum lämnad intakt och i senare skede, med optimerad patient, tarmrekonstruktion anpassad efter patientens individuella livssituation. Kirurgi vid Crohns sjukdom korrigerar komplikationer (stenoser och fistlar) och sparar tarm genom begränsade resektioner och strikturplastiker. Laparoskopisk kir­urgi verkar ha viktiga fördelar vid primära tarmresektioner. Modern medicinsk behandling har förändrat indikationerna men ännu inte minskat behovet av kirurgi. Pågående antiinflammatorisk och immunmodulerande behandling är viktig att beakta i samband med kirurgi. Ett nära samspel mellan gastroenterolog och kolorektalkirurg är nödvändigt för att uppnå bästa möjliga långtidsprognos för de individer som lever med IBD.
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  • Danielson, Johan, et al. (författare)
  • Submucosal injection of stabilized nonanimal hyaluronic acid with dextranomer : a new treatment option for fecal incontinence
  • 2009
  • Ingår i: Diseases of the Colon & Rectum. - 0012-3706 .- 1530-0358. ; 52:6, s. 1101-1106
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: NASHA Dx gel has been used extensively for treatments in the field of urology. This study was performed to evaluate NASHA Dx gel as an injectable anal canal implant for the treatment of fecal incontinence. METHODS: Thirty-four patients (5 males, 29 females; median age, 61 years; range, 34 to 80) were injected with 4 x 1 ml of NASHA Dx gel, just above the dentate line in the submucosal layer. The primary end point was change in the number of incontinence episodes and a treatment response was defined as a 50 percent reduction compared with pretreatment. All patients were followed up at 3, 6, and 12 months. RESULTS: The median number of incontinence episodes during four weeks was 22 (range, 2 to 77) before treatment, at 6 months it was 9 (range, 0 to 46), and at 12 months it was 10 (range, 0 to 70, P = 0.004). Fifteen patients (44 percent) were responders at 6 months, compared with 19 (56 percent) at 12 months. No long-term side effects or serious adverse events were reported. CONCLUSIONS: Submucosal injection of NASHA Dx gel is an effective treatment for fecal incontinence. The effect is sustained for at least 12 months. The treatment is associated with low morbidity.
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4.
  • Franck-Larsson, Karin, et al. (författare)
  • Lower gastrointestinal symptoms and quality of life in patients with systemic sclerosis : a population-based study
  • 2009
  • Ingår i: European Journal of Gastroenterology and Hepathology. - 0954-691X .- 1473-5687. ; 21:2, s. 176-182
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To investigate the frequency and nature of bowel symptoms in a population-based cohort of patients with systemic sclerosis (SSc), compared with healthy controls, and to relate these symptoms to health-related quality of life (HR-QOL). METHOD: Seventy-nine SSc patients and 158 matched controls answered a validated questionnaire on gastrointestinal (GI) symptoms and Medical Outcomes Study Short Form Health Survey (SF-36). Modified Miller Score, a composite score measuring faecal incontinence, was computed. RESULTS: Abnormal stool consistency, bloating, a feeling of incomplete evacuation, faecal incontinence and rectal bleeding were more frequently reported by SSc patients than controls. The ability for anorectal discrimination, and deferring defecation was diminished in SSc patients. Bowel function affected general well being in 30% of patients and social life in 20%. Patients had lower SF-36 scores, that is, worse HR-QOL than controls. Modified Miller Score did not correlate to the SF-36 scores in patients, but other lower GI symptoms, especially abdominal pain and bloating, were associated with diminished HR-QOL. CONCLUSION: Lower GI symptoms, including faecal incontinence, are more common in patients with SSc than in healthy controls and are of consequence to the individual patient's life. The lower prevalence of anorectal discrimination in the SSc patients suggests a neuronal defect in these patients. Increased awareness of these symptoms might stimulate a search for new diagnostic and therapeutic strategies.
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5.
  • Gerdin, Eva, et al. (författare)
  • The role of maternal age and episiotomy in the risk of anal sphincter tears during childbirth
  • 2007
  • Ingår i: Australian and New Zealand journal of obstetrics and gynaecology. - 0004-8666 .- 1479-828X. ; 47:4, s. 286-290
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Many women who experience anal sphincter tear will suffer from anal incontinence. The most important tool to avoid this is to recognise the obstetric risk factors involved and thereby prevent injury. AIMS: The aim of this study was to analyse and evaluate the risk factors of anal sphincter tear during delivery. METHODS: Of a total of 57,943 vaginal deliveries, we identified 565 women with partial or total rupture of the anal sphincter and compared these women with 565 controls without sphincter tear with respect to possible risk factors. RESULTS: Several factors were significantly associated with sphincter tears, including nulliparity, birthweight, instrumental delivery, episiotomy, malpresentation, maternal age and epidural analgesia. The importance of these variables was further confirmed in a stepwise logistic regression analysis. Age was found to be a significant risk factor only when the birthweight was less than 4000 g. Episiotomy more than doubled the risk of sphincter tear when delivery was non-instrumental. CONCLUSION: There are several independent risk factors that should be considered when making decisions regarding delivery mode. Maternal age and episiotomy in non-instrumental delivery are two of these.
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6.
  • Graf, Wilhelm (författare)
  • Anorektala sjukdomar
  • 2009
  • Ingår i: Läkemedelsboken. - Stockholm : Apoteket AB. - 91-85574-59-7 ; s. 142-149
  • Bokkapitel (övrigt vetenskapligt)
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7.
  • Gustafsson, Ulla Maria, et al. (författare)
  • Randomized clinical trial of local gentamicin-collagen treatment in advancement flap repair for anal fistula
  • 2006
  • Ingår i: British Journal of Surgery. - 0007-1323 .- 1365-2168. ; 93:10, s. 1202-1207
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Endoanal advancement flap repair is widely used in sphincter-preserving surgery for anal fistula, but the high recurrence rate is a major problem. A possible cause of non-healing is local infection of the flap. The aim of this study was to evaluate whether local antibiotic treatment with gentamicin-collagen improves healing after endoanal advancement flap repair for anal fistula.Methods: Eighty-three patients (52 men and 31 women; mean age 47 (range 17-71) years) who had endoanal advancement flap repair for anal fistula between September 1998 and January 2004 were randomized to surgery with (42 patients) or without (41 patients) application of gentamicin-collagen beneath the flap. Patients were evaluated at 1-3 and 12 months after surgery for healing and/or recurrence.Results: The overall healing rate with no recurrence at 1 year after surgery was 57 per cent (47 of 83). Twenty-six of 42 patients randomized to gentamicin-collagen healed primarily compared with 21 of 41 patients randomized to surgery only. There were no overall differences in healing rate according to sex, previous fistula surgery, complexity of fistula, smoking habit or body mass index.Conclusion: Endoanal advancement flap repair for anal fistula has a fairly high primary recurrence rate. Healing was not significantly improved by local application of gentamicin-collagen.
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8.
  • Hansson, Johan, et al. (författare)
  • Postoperative adverse events and long-term survival after cytoreductive surgery and intraperitoneal chemotherapy
  • 2009
  • Ingår i: European Journal of Surgical Oncology. - 0748-7983 .- 1532-2157. ; 35:2, s. 202-208
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Peritoneal carcinomatosis (PC) is fatal without special combined cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC). This study was designed to identify factors that may increase the risk of postoperative morbidity and mortality from combined CRS and IPC interventions for PC. Survival based on primary tumour type and extent of surgery is reported. METHODS: Between May 1991 and November 2004, 123 patients were treated with CRS and IPC for PC. Based on the National Cancer Institute Common Toxicity Criteria for grade 3 and 4, data on 30 days postoperative morbidity and 90 days mortality were analysed. RESULTS: Grade 3-4 adverse events were observed in 51 patients (41%) and were associated with stoma formation, duration of surgery, peroperative blood loss and peritoneal cancer index (PCI). Excision, or electrocautery evaporation, of tumour from small bowel surface was correlated to bowel morbidity. Five patients had treatment-related mortality (4%) within 90 days. Survival was associated with macroscopic radical surgery, prior surgical score, PCI and primary tumour type. CONCLUSIONS: CRS and IPC for PC are associated with high morbidity and mortality. However, in light of the potential benefit indicated by long-term survival, the adverse event from this treatment is considered acceptable.
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  • Resultat 1-10 av 18
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