| 11. |
- Ahle, Margareta, 1966-, et al.
(författare)
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Maternal, fetal and perinatal factors associated with necrotizing enterocolitis in Sweden. A national case-control study
- 2018
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Ingår i: Plos One. - San Francisco, United States : Public Library of Science (PLoS). - 1932-6203. ; 13:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective To analyze associations of maternal, fetal, gestational, and perinatal factors with necrotizing enterocolitis in a matched case-control study based on routinely collected, nationwide register data. Study design All infants born in 1987 through 2009 with a diagnosis of necrotizing enterocolitis in any of the Swedish national health care registers were identified. For each case up to 6 controls, matched for birth year and gestational age, were selected. The resulting study population consisted of 720 cases and 3,567 controls. Information on socioeconomic data about the mother, maternal morbidity, pregnancy related diagnoses, perinatal diagnoses of the infant, and procedures in the perinatal period, was obtained for all cases and controls and analyzed with univariable and multivariable logistic regressions for the whole study population as well as for subgroups according to gestational age. Results In the study population as a whole, we found independent positive associations with necrotizing enterocolitis for isoimmunization, fetal distress, cesarean section, neonatal bacterial infection including sepsis, erythrocyte transfusion, persistent ductus arteriosus, cardiac malformation, gastrointestinal malformation, and chromosomal abnormality. Negative associations were found for maternal weight, preeclampsia, maternal urinary infection, premature rupture of the membranes, and birthweight. Different patterns of associations were seen in the subgroups of different gestational age. Conclusion With some interesting exceptions, especially in negative associations, the results of this large, population based study, are in keeping with earlier studies. Although restrained by the limitations of register data, the findings mirror conceivable pathophysiological processes and underline that NEC is a multifactorial disease. © 2018 Ahle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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| 12. |
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| 13. |
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| 14. |
- Andersson, Roland E.
(författare)
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The Role of Antibiotic Therapy in the Management of Acute Appendicitis
- 2013
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Ingår i: Current Infectious Disease Reports. - : Current Medicine Group. - 1523-3847 .- 1534-3146. ; 15:1, s. 10-13
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Tidskriftsartikel (refereegranskat)abstract
- Nonsurgical treatment with antibiotics has recently been proposed as the first line of treatment for noncomplicated appendicitis. This has met with considerable interest, illustrated by the number of reviews and meta-analyses, which exceed the number of original reports of the issue. The results in these studies are seriously biased due to inclusion of patients with resolving appendicitis. At a time when we need to reduce inappropriate use of antibiotics in the struggle against the increasing rate of antibiotics resistance, there must be strong requirements of a proven effect and an improved cost-benefit ratio before antibiotics treatment is introduced for a new group of patients. These requirements have not yet been met for nonsurgical treatment with antibiotics for assumed uncomplicated appendicitis. Due to the high rate of spontaneous resolution, a randomized placebo-controlled trial is needed that can compare the efficiency of antibiotics treatment and expectant management in this group of patients. Antibiotics treatment, however, remains indicated for treatment of perforated appendicitis with localized abscess or phlegmone and in selected surgical high-risk patients.
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| 15. |
- Ansaloni, Luca, et al.
(författare)
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Guidelines in the management of obstructing cancer of the left colon : consensus conference of the world society of emergency surgery (WSES) and peritoneum and surgery (PnS) society
- 2010
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Ingår i: World Journal of Emergency Surgery. - London, UK : BioMed Central (BMC). - 1749-7922. ; 5, s. 29-
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Forskningsöversikt (refereegranskat)abstract
- Background: Obstructive left colon carcinoma (OLCC) is a challenging matter in terms of obstruction release as well of oncological issues. Several options are available and no guidelines are established. The paper aims to generate evidenced based recommendations on management of OLCC. Methods: The PubMed and Cochrane Library databases were queried for publications focusing on OLCC published prior to April 2010. A extensive retrieval, analyses, and grading of the literature was undertaken. The findings of the research were presented and largely discussed among panellist and audience at the Consensus Conference of the World Society of Emergency Surgery (WSES) and Peritoneum and Surgery (PnS) Society held in Bologna July 2010. Comparisons of techniques are presented and final committee recommendation are enounced. Results: Hartmann's procedure should be preferred to loop colostomy (Grade 2B). Hartmann's procedure offers no survival benefit compared to segmental colonic resection with primary anastomosis (Grade 2C+); Hartmann's procedure should be considered in patients with high surgical risk (Grade 2C). Total colectomy and segmental colectomy with intraoperative colonic irrigation are associated with same mortality/morbidity, however total colectomy is associated with higher rates impaired bowel function (Grade 1A). Segmental resection and primary anastomosis either with manual decompression or intraoperative colonic irrigation are associated with same mortality/morbidity rate (Grade 1A). In palliation stent placement is associated with similar mortality/morbidity rates and shorter hospital stay (Grade 2B). Stents as a bridge to surgery seems associated with lower mortality rate, shorter hospital stay, and a lower colostomy formation rate (Grade 1B). Conclusions: Loop colostomy and staged procedure should be adopted in case of dramatic scenario, when neoadjuvant therapy could be expected. Hartmann's procedure should be performed in case of high risk of anastomotic dehiscence. Subtotal and total colectomy should be attempted when cecal perforation or in case of synchronous colonic neoplasm. Primary resection and anastomosis with manual decompression seems the procedure of choice. Colonic stents represent the best option when skills are available. The literature power is relatively poor and the existing RCT are often not sufficiently robust in design thus, among 6 possible treatment modalities, only 2 reached the Grade A.
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| 16. |
- Di Saverio, Salomone, et al.
(författare)
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Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines
- 2020
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Ingår i: World Journal of Emergency Surgery. - : BMC. - 1749-7922. ; 15:1
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Forskningsöversikt (refereegranskat)abstract
- Background and aims Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospital delay, (4) surgical treatment, (5) intra-operative grading of AA, (6) ,management of perforated AA with phlegmon or abscess, and (7) peri-operative antibiotic therapy.
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| 17. |
- Dimberg, Jan, et al.
(författare)
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Gene polymorphism in DNA repair genes XRCC1 and XRCC6 and association with colorectal cancer in Swedish patients
- 2016
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : WILEY-BLACKWELL. - 0903-4641 .- 1600-0463. ; 124:9, s. 736-740
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Tidskriftsartikel (refereegranskat)abstract
- The DNA repair genes XRCC1 and XRCC6 have been proposed to participate in the pathological process of cancer by modulating the DNA repair capacity. This study evaluated the susceptibility of the single-nucleotide polymorphisms (SNPs) XRCC1 (rs25487, G amp;gt; A) and XRCC6 (rs2267437, C amp;gt; G) to colorectal cancer (CRC) and their association with clinical parameters in Swedish patients with CRC. Using the TaqMan system, these SNPs were screened in 452 patients and 464 controls. No significant difference in genotype distribution was found between the patients and controls, or any significant association with cancer-specific or disease-free survival in patients. However, we showed that the carriers of allele A in XRCC1 (rs25487, G amp;gt; A) were connected with a higher risk of disseminated CRC (Odds Ratio = 1.64; 95% Confidence Interval = 1.12-2.41, p = 0.012).
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| 18. |
- Isaksson, Karolin, et al.
(författare)
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Small bowel obstruction: early parameters predicting the need for surgical intervention
- 2011
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Ingår i: European Journal of Trauma and Emergency Surgery. - : Springer Science and Business Media LLC. - 1863-9933 .- 1863-9941. ; 37:2, s. 155-159
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Tidskriftsartikel (refereegranskat)abstract
- To study and identify early clinical and radiological findings that could help to predict operative intervention for small bowel obstruction. One hundred and nine consecutive patients with small bowel obstruction who underwent small bowel follow-through examination with Gastrografin(A (R)) during 2005-2006. The patients were divided into an operative group and a non-operative group, n = 44 and 65, respectively. Findings primarily noted were those which were possible to register within 1-4 h from hospital arrival. In univariate analyses, factors found to be significantly associated with surgical intervention were no prior abdominal surgery, the presence of radiological differential air fluid levels, and absence of flatulence 24 h prior to admission, CRP > 10 mg/L and dehydration at admission. In multivariate analyses, the presence of dehydration and radiological differentiated air fluid levels were independent predictive factors of significance. Absence of all factors significantly favored non-operative treatment, while operative treatment was significantly favored when two or more factors were present. The presence of two or more early predictive factors as defined above, available at admission, significantly correlates with a likelihood of complete obstruction and the need of surgical intervention.
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| 19. |
- Jansson, Roland, 1967-, et al.
(författare)
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Effects of river regulation on river-margin vegetation : A comparison of eight boreal rivers
- 2000
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Ingår i: Ecological Applications. - 1051-0761 .- 1939-5582. ; 10:1, s. 203-224
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Tidskriftsartikel (refereegranskat)abstract
- Regulation and fragmentation by dams belong to the most widespread deliberate impacts of humans on the world's rivers, especially in the Northern Hemisphere. We evaluated the effects of hydroelectric development by comparing the flora of vascular plants in 200-m-long reaches of river margin distributed along eight entire rivers in northern Sweden. Four of these rivers were free-flowing, and four were strongly regulated for hydroelectric purposes. First, we compared species diversity per site between entire free-flowing and regulated rivers. To reduce the effects of natural, between-river variation, we compared adjacent rivers. One regulated river had lower plant species richness and cover than two adjacent free-flowing ones, whereas two other parallel rivers, one regulated and another free-flowing, did not differ significantly. Second, river-margin vegetation responded differently to different types of regulated water-level regimes. Both along run-of-river impoundments, with small but daily water-level fluctuations, and along storage reservoirs, with large fluctuations between low water levels in spring and high levels in late summer and fall, the number of species and their cover per site were lower than along the free-flowing rivers. Regulated but unimpounded reaches were most similar to free-flowing rivers, having lower plant cover per site, but similar numbers of species. For reaches with reduced discharge, evidence was mixed; some variables were lower compared to free-flowing rivers whereas others were not. However, for the last two types of regulation, statistical power was low due to small sample sizes. Third, we classified all plant species according to their dispersal mechanisms and tested whether they respond differently to different types of regulated water-level regimes. Three out of four types of regulation had higher proportions of wind-dispersed species, and two out of four had lower proportions of species without specific mechanisms for dispersal, compared to free-flowing rivers, suggesting that dispersal ability is critical for persistence following regulation. Run-of-river impoundments had higher proportions of long-floating species and species with mechanisms for vegetative dispersal, suggesting that water dispersal may still be important despite fragmentation by dams. Fourth, plant species richness and cover varied with both local factors, such as water-level regime, and regional factors, such as length of the growing season. Presence of clay and silt in the river-margin soil, preregulation position of the contemporary river margin, non-reservoir sites, low altitudes, and long growing seasons were associated with high plant species richness and cover.
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| 20. |
- Jarfors, Anders E.W. 1963-, et al.
(författare)
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Build strategy and impact strength of slm produced maraging steel (1.2709)
- 2021
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Ingår i: Metals. - : MDPI. - 2075-4701. ; 11:1, s. 1-20
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Tidskriftsartikel (refereegranskat)abstract
- The current paper aimed to study the impact properties of additively manufactured maraging steel (1.2709) using laser powder bed fusion (PBF-L) processing. The specimens were fabricated using 3D Systems ProX 300 equipment under constant specific power input, or Andrew number. The interactions between the build strategy and parameters such as hatch spacing and scan speed was, and the impact strength and fracture were investigated. The impact energy anisotropy was also investigated in parallel and perpendicular to the build direction. Instrumented impact testing was performed, and the fractography supported that the fusion zone geometry dictated the fracture behavior. The influence from gaseous elements such as nitrogen, oxygen, and hydrogen was found insignificant at the levels found in the printed material.
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