| 1. |
- Dudas, Kerstin, 1963, et al.
(författare)
-
Implementering av person-centrerad vård i slutenvården
- 2014
-
Ingår i: Personcentrering inom hälso- och sjukvård – från filosofi till praktik. Inger Ekman (red.). - Stockholm : Liber. - 9789147114054 ; , s. 172-206
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 2. |
- Kaczynski, Jerzy, 1951, et al.
(författare)
-
Clinical features in hepatocellular carcinoma and the impact of autopsy on diagnosis. A study of 530 cases from a low-endemicity area
- 2005
-
Ingår i: Hepatogastroenterology. - 0172-6390. ; 52:66, s. 1798-802
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) had been one of the malignancies with the highest reported increase of incidence in Sweden, but during the late 20-year period the incidence has been decreasing. The aims of our study were to state the impact of autopsy on diagnosis and to identify clinical characteristics in HCC. METHODOLOGY: This retrospective study was performed in Goteborg, Sweden and included all cases with a diagnosis of liver cancer from a period with a high autopsy frequency (1958-1979). The cases were reevaluated histopathologically and the autopsy records as well as the case files were scrutinized. RESULTS: The majority (63%) of the 530 biopsy verified cases of HCC were diagnosed unexpectedly at autopsy. Cirrhosis of the liver could be established in 71% of the cases, but was diagnosed or at least clinically suspected before the diagnosis of the tumor only in a minority (19%) of all HCC patients. At presentation, malaise (85%), weight loss (78%), anorexia (67%) and hepatomegaly (84%) were common. The median survival time from diagnosis was one month. In most cases (92%) the cause of death was either directly or indirectly related to HCC and/or underlying liver disease such as advanced tumor disease, hepatic failure and gastrointestinal bleeding. Spontaneous rupture of HCC was the cause of death in 17 cases (3%) CONCLUSIONS: In an unselected population in a low incidence area of HCC, most patients have clinically unknown cirrhosis of the liver and present with vague general paramalignant symptoms. HCC has an extremely poor prognosis. Since HCC, in a majority of cases, remains undiagnosed before death, the autopsy has great impact on the diagnosis. This should be considered in interpretation of results from epidemiological studies.
|
|
| 3. |
- Kaczynski, Jerzy, 1951, et al.
(författare)
-
Diabetes: one of few remarkable differences in clinicopathologic features between cirrhotic and noncirrhotic Swedes with hepatocellular carcinoma
- 2006
-
Ingår i: Dig Dis Sci. - : Springer Science and Business Media LLC. - 0163-2116. ; 51:4, s. 796-802
-
Tidskriftsartikel (refereegranskat)abstract
- The prognosis of hepatocellular carcinoma (HCC) is usually very poor, so increased knowledge of clinicopathologic characteristics and etiologic factors may improve the clinical handling. Because HCC in many patients is unrecognized before death, it is of particular interest to study cases from a period with a high autopsy frequency. The records and liver biopsies from all patients with a diagnosis of primary liver cancer in Goteborg, Sweden, during a 22-year period were scrutinized. Only patients with evaluable non-neoplastic liver tissue were included in the final analysis. The majority (95%) of 478 HCC cases were autopsied and cirrhosis of the liver could be established in 71%. At presentation, general paramalignant symptoms such as malaise, weight loss, anorexia, and hepatomegaly (84%) were common irrespective of cirrhosis. Alcoholism and diabetes mellitus were each significantly more common among cirrhotics (29% and 20%, respectively; P < .001), than among noncirrhotics, in which cholelithiasis was more common (54%; P < .001). The correlation between diabetes and cirrhosis was independent of reported alcoholism. In an unselected population in a low HCC incidence area, there are few differences in clinicopathologic features between cirrhotic and noncirrhotic patients. Diabetes mellitus seems to play an etiologic role in HCC in cirrhotics, and cholelithiasis in noncirrhotics.
|
|
| 4. |
- Kaczynski, Jerzy, 1951, et al.
(författare)
-
Increased porphyrins in primary liver cancer mainly reflect a parallel liver disease
- 2009
-
Ingår i: Gastroenterol Res Pract. - 1687-6121. ; 2009
-
Tidskriftsartikel (refereegranskat)abstract
- Hepatic porphyries have been associated with an increased risk of primary liver cancer (PLC), which on the other hand may cause an increased porphyrin production. To evaluate the role of an underlying liver disorder we analyzed porphyrins in patients with hepatocellular carcinoma (HCC) (n = 65), cholangiocellular carcinoma (n = 3), or suspected PLC, which turned out to be metastases (n = 18) or a benign disorder (n = 11). None of the patients had a family history of porphyry or clinical signs of porphyry. Increased aminolevulinic acid or porphyrin values were common not only in patients with PLC (43%) but also in metastatic (50%) and benign (64%) liver disorders. The corresponding proportion for HCC patients with liver cirrhosis (55%) was higher (P < .05) than in those without cirrhosis (17%). We conclude that symptomatic porphyries are unusual in PLC, whereas elevated urinary and/or faecal porphyrins are common, primarily reflecting a parallel liver disease and not the PLC.
|
|
| 5. |
- Schult, Andreas, 1975, et al.
(författare)
-
Waist-to-hip ratio but not body mass index predicts liver cirrhosis in women.
- 2018
-
Ingår i: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 53:2, s. 212-217
-
Tidskriftsartikel (refereegranskat)abstract
- Being overweight can lead to fatty liver and end-stage liver disease. In men, higher body mass index is associated with higher risk of developing liver cirrhosis. The extent of association between overweight and liver cirrhosis in women is not fully elucidated.This study aimed to investigate the association between overweight and liver cirrhosis in women, taking into account different measures of adipose tissue distribution.A cohort of 1462 middle-aged women was followed over 40years. Cases of liver cirrhosis were identified by linkage to Hospital Discharge and Death Certificate registries. The hazard ratios for different anthropometric measures and liver cirrhosis were obtained by Cox proportional hazard regression, using propensity score methods to adjust for important confounders.During 48,062 person-years of follow-up, 11 cases of liver cirrhosis were identified. The incidence rate in women with waist-to-hip ratio≥0.8 was 131.8 (48.1-287.0), compared to 12.0 (3.9-28.1) in women with a lower ratio. A waist-to-hip ratio≥0.8 was associated with an increased risk of liver cirrhosis, the hazard ratio being 5.8 (95% confidence interval 1.6-21.4). No association between body mass index and liver cirrhosis was found and the hazard ratio for body mass index >25 was 1.8 (0.5-5.8).In women, an unfavorable adipose tissue distribution is more important for development of liver cirrhosis than total body fat per se. When assessing the risk for development of liver cirrhosis in women, waist-to-hip ratio is a better predictor than body mass index.
|
|
