| 1. |
- Andersson, Bodil, et al.
(författare)
-
Fatal Acute Pancreatitis Occurring Outside of the Hospital: Clinical and Social Characteristics.
- 2010
-
Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; Jul 1, s. 2286-2291
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mortality caused by acute pancreatitis in patients admitted to the hospital has been thoroughly investigated, but knowledge regarding outpatient fatalities is far from complete. The purpose of this study was to assess the incidence and clinical characteristics of patients who have died due to acute pancreatitis occurring outside the hospital. METHODS: Deaths caused by acute pancreatitis in the southern part of Sweden during 1994-2008 were identified at the Department of Forensic Medicine, Lund. A retrospective review of all cases was performed. RESULTS: A total of 50 patients were included, representing approximately 50 of 292 (17%) of all deaths due to acute pancreatitis in the region during this period of time. Median age was 54 (47-69) years and the majority-37 (74%)-were men. The main etiology was alcohol, seen in at least 35 (70%) patients. Twelve (24%) patients were obese. The duration of abdominal pain, in evaluable cases, was 3.0 (1.6-6.2) days. Profound signs of pancreatitis were seen in all patients; 35 (70%) had a necrotising disease according to histopathological examination. Pulmonary changes were common, e.g., bronchopneumonia, pleural effusion, or edema, and all but four had fatty liver. Massive intra-abdominal bleeding was seen in one patient. At least eight patients had a mental disorder, and three were homeless. CONCLUSIONS: Fatal acute pancreatitis occurring outside the hospital accounts for a substantial part of all deaths due to the disease. The incidence seems to decline, and no variation in season was seen. Alcohol was the predominant etiology. Many of the patients lived alone and in poor social conditions.
|
|
| 2. |
- Andersson, Roland, et al.
(författare)
-
Acute pancreatitis - from cellular signalling to complicated clinical course.
- 2007
-
Ingår i: HPB. - : Elsevier BV. - 1477-2574 .- 1365-182X. ; 9:6, s. 414-420
-
Tidskriftsartikel (refereegranskat)abstract
- Acute pancreatitis (AP) is a common disease that has a mild to moderate course in most cases. During the last decade, a change in diagnostic facilities as well as improved intensive care have influenced both morbidity and mortality in AP. Still, however, a number of controversies and unresolved questions remain regarding AP. These include prognostic factors and how these may be used to improve outcome, diagnostic possibilities, their indications and optimal timing, and the systemic inflammatory reaction (systemic inflammatory response syndrome - SIRS) and its effect on the concomitant course of the disease and potential development of organ failure. The role of the gut has been suggested to be important in severe AP, but has recently been somewhat questioned. Despite extensive research, pharmacological and medical intervention of proven clinical value is scarce. Various aspects on surgical interventions, including endoscopic sphincterotomy, cholecystectomy and necrosectomy, as regards indications and timing, will be reviewed. Last, but not least, are the management of late complications and long-term outcome for patients with especially severe AP.
|
|
| 3. |
- Andersson, Roland, et al.
(författare)
-
Akut buk
- 2004
-
Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 102-102
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 4. |
- Andersson, Roland, et al.
(författare)
-
Appendicit
- 2004
-
Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 144-144
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 5. |
- Andersson, Roland, et al.
(författare)
-
Bråck
- 2004
-
Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 156-156
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 6. |
- Andersson, Roland, et al.
(författare)
-
Bukhålan - peritonit, abscess och ileus
- 2004
-
Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 107-107
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 7. |
- Andersson, Roland, et al.
(författare)
-
Gallvägssjukdomar
- 2004
-
Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 119-119
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 8. |
- Andersson, Roland, et al.
(författare)
-
Immunomodulation in surgical practise
- 2006
-
Ingår i: HPB. - : Elsevier BV. - 1477-2574 .- 1365-182X. ; 8:2, s. 116-123
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Immunomodulation may represent a potential way to improve surgical outcome. These types of interventions should be based on detailed knowledge of the underlying mechanisms involved. The aim of the present review is to summarize some experience on the acute phase response, potential ways of intervention and experiences from critical illness and HPB disease. Discussion. Mechanisms of the acute phase response are discussed including the individual parameters and local changes that take part. Mechanisms involved in failure of the gut barrier are presented and include changes in gut barrier permeability, effects on gut-associated immunocompetent cells, and systemic implications. As examples of HPB disease, mechanisms of the acute phase response and potential ways of intervention in obstructive jaundice and acute pancreatitis are discussed. Nutritional pharmacology and lessons learned from immunomodulation and immunonutrition in critical illness and major abdominal surgery, including upper GI and HPB surgery, are referred to. Overall, immunomodulation represents a potential tool to improve results but requires a thorough mapping of underlying mechanisms in order to achieve individualized treatment or prevention based on patients' specific needs.
|
|
| 9. |
- Andersson, Roland, et al.
(författare)
-
Inflammation
- 2004
-
Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 29-29
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 10. |
- Andersson, Roland, et al.
(författare)
-
Interventionell radiologi
- 2004
-
Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 78-78
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
