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- Berntsson, Matilda, et al.
(författare)
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Två fall av pellagra : 4D-sjukdomen - bortglömd men dödlig sjukdom
- 2012
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 109:5, s. 228-229
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Tidskriftsartikel (refereegranskat)abstract
- Epidemics of pellagra, the dreaded “4D disease”, still occur in wars and disasters. It also remains endemic in parts of the world, even though prevention with nicotinic acid is known to be remarkably efficient. Elsewhere, there are sporadic cases. Timely diagnosis and treatment are essential to avoid permanent functional impairment and even death. Two cases are presented here.A 31-year-old autistic woman with a history of eating disorder suffered from gastrointestinal and neurological symtoms. Upon examination erythematous, weeping, thickened and desquamating skin lesions were found on sun-exposed areas. The patient’s diet consisted mostly of Greek salad. A 44-year-old woman suffered from disabling weakness of the lower limbs after a period of weight loss and high alcohol consumption. Cobalamine and folic acid supplementation was ineffective. Dermatological examination revealed pellagrous skin lesions on the back of her hands. Both patients responded rapidly to nicotinic acid replacement therapy.
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- Botling, Johan, et al.
(författare)
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High-grade progression confers poor survival in pancreatic neuroendocrine tumors
- 2020
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Ingår i: Neuroendocrinology. - : S. Karger AG. - 0028-3835 .- 1423-0194. ; 110:11-12, s. 891-898
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Little is known about how Pancreatic Neuroendocrine Tumors (PanNETs) evolve over time and if changes towards a more aggressive biology correlates with prognosis. The purpose of this study was to characterize changes PanNET differentiation and proliferation over time, and to correlate findings to overall survival (OS).PATIENTS AND METHODS: In this retrospective cohort study we screened 475 PanNET patients treated at Uppsala University Hospital, Sweden. Sporadic patients with baseline and follow-up tumor samples were included. Pathology reports and available tissue sections were re-evaluated with regard to tumor histopathology and Ki-67 index.RESULTS: Forty-six patients with 106 tumor samples (56 available for pathology re-evaluation) were included. Median Ki-67 index at diagnosis was 7% (range 1-38%), grade 1 n=8, grade 2 n=36, and grade 3 n=2. The median change in Ki-67 index (absolute value; follow-up - baseline) was +14% (range -11 to +80%). Increase in tumor grade occurred in 28 patients (63.6%), the majority from grade 1/2 to grade 3 (n=24, 54.5%). The patients with a high-grade progression had a median OS of 50.2 months compared to 115.1 months in patients without such progression (HR 3.89, 95% CI 1.91-7.94, P<0.001).CONCLUSIONS: A longitudinal increase in Ki-67 index and increase in tumor grade were observed in a majority of PanNETs included in this study. We propose that increase in Ki-67 index and high-grade progression should be investigated further as important biomarkers in PanNET.
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| 6. |
- Lönngren, Vincent, 1977-, et al.
(författare)
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Neutrophilic and Eosinophilic Dermatitis Caused by Contact Allergic Reaction to Paraphenylenediamine in Hair Dye
- 2012
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Ingår i: Archives of Dermatology. - : American Medical Association (AMA). - 0003-987X .- 1538-3652. ; 148:11, s. 1299-1301
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Tidskriftsartikel (refereegranskat)abstract
- Background: Paraphenylenediamine (PPD) in hair dyes can cause systemic as well as cutaneous allergic reactions such as neutrophilic and eosinophilic dermatitis. The symptoms are often severe. The acute lesion is normally histologically indistinguishable from any eczematous reaction with marked spongiosis. Observations: We report a case of allergic contact dermatitis caused by the use of hair dye containing PPD that developed in a patient who had been using the same hair dye for many years. Her symptoms included scalp dermatitis and widespread skin lesions as well as lymphadenopathy and quite possibly dyspnea resembling asthma. What is most remarkable about this case is the histopathologic finding of neutrophilic cellulitis and a marked neutrophilic infiltrate with variable spongiosis. This unique finding was confirmed by histologic analysis of a patch test lesion specimen. Conclusion: It is always important to consider contact allergic dermatitis as a cause of dermatitis because of the variable presentation of the disease, including unique histologic findings that do not fit the conventional picture, as in the present case. Arch Dermatol. 2012;148(11):1299-1301
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| 8. |
- Sundbeck, Mats, et al.
(författare)
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Snuff use associated with abdominal obesity in former smokers.
- 2009
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:5, s. 487-93
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity. Participants and METHODS: Tobacco use was explored in 834 men aged 30-75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination. RESULTS: Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08-3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08-2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05-2.36) (p = 0.041) waist circumference and 0.01 (0.00-0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users. CONCLUSIONS: Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.
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