| 1. |
- Andersson, Bodil, et al.
(författare)
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Gemcitabine Treatment in Pancreatic Cancer – Prognostic Factors and Outcome.
- 2007
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Ingår i: Annals of Gastroenterology. - 1108-7471. ; 20:2, s. 130-137
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pancreatic cancer is generally associated with a poor prognosis and often diagnosed in an advanced stage. The aim of the present study was to evaluate gemcitabine treatment concerning prognostic factors, clinical benefit, tolerance/ toxicity and survival. Methods: Patients with surgically nonresectable, locally advanced or metastatic pancreatic cancer treated with gemcitabine were included. Different parameters, including clinical benefit, toxicity (WHO΄s criteria) and survival were registered. Kaplan-Meier and Cox regression analysis were performed. Results: Forty-two consecutive patients were included. Median age was 62.5 years, 42% were men. Gemcitabine treatment lasted in median for 5 months (0.5-29 months). Median survival from diagnosis was 9.4 months and from start of treatment 8.1 months. Thirteen patients (32%) were alive 12 months after treatment start. The treatment was overall well tolerated concerning toxicity. Seven patients had transient grade 4 reactions. Of 8 parameters selected from the univariate analysis, 3 were identified as independent predictors for longer survival: age >60 years, ≤5 % weight loss at diagnosis and absence of metastases. Conclusions: Gemcitabine treatment in locally advanced and metastatic pancreatic cancer showed to be of potential benefit and well tolerated. Age, weight loss and metastases were independent prognostic factors for survival. The median survival time was longer than previously reported. Keywords: pancreatic cancer; locally advanced; gemcitabine; treatment outcome; prognostic factors
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| 2. |
- Axelsson, Jakob B, et al.
(författare)
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Intestinal bacteria and permeability during experimental acute pancreatitis in rats
- 2006
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Ingår i: Annals of Gastroenterology. - 1108-7471. ; 19:3, s. 276-284
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Tidskriftsartikel (refereegranskat)abstract
- Background: An increase in intestinal permeability and subsequent bacterial translocation has been demonstrated in critical illness. Cellulose derivatives have in the past been shown to reduce gut leakage following liver resection. Aims: The aim of the present study was to evaluate changes in microbial counts in experimental acute pancreatitis and the effect of pre-treatment with cellulose derivatives and N-acetyl cysteine. Subjects: 92 male Sprague Dawley rats. Methods: Acute pancreatitis was induced by intraductal taurodeoxycholic acid infusion. Animals received oral pretreatment and were randomized to either sham operation or the pancreatitis groups, with or without pre-treatment with cellulose derivatives, the antioxidant or their combinations. Intestinal bacterial populations and permeability were evaluated using bacterial counts and Ussing chamber, respectively. Results: The number of E. coli increased in the luminal content and ileal and colonic mucosa, but levels were restored to almost those seen in controls in all pre-treatment groups except for N-acetyl cysteine. When intestinal permeability was measured, none of the treatment groups showed significant differences compared to challenge, except for Nacetyl cysteine, which significantly increased permeability. Conclusion: Pre-treatment with cellulose derivatives was more efficient against disturbances in intestinal permeability and microbial populations than the antioxidant Nacetyl cysteine.
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| 3. |
- Tingstedt, Bobby, et al.
(författare)
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Improved diagnostic accuracy in patients with suspected appendicitis
- 2005
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Ingår i: Annals of Gastroenterology. - 1108-7471. ; 18:1, s. 65-69
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies during the 1990s showed that it was possible to reduce the rate of negative appendectomies by using various diagnostic methods. The present study aims to evaluate the effect on diagnostic accuracy of implementation of repeated clinical examination and blood tests in a small county hospital without possibilities of radiological assistance on a 24-hour basis. Methodology: Prospective study of all appendectomies performed at Ystad General Hospital, Sweden. Leukocyte count and C-reactive protein levels were analysed in all patients. Patients with suspicion of acute appendicitis were admitted for active observation, repeated clinical examination and analyses of leukocyte counts and CRP levels. Results: 533 appendectomies were performed during 1996- 2000 and compared with the index year 1995. Diagnostic accuracy increased from 73% to 90% (p<0.01). The rates of perforations and complications did not change during the study period, being 12.4% and 5.1%, respectively. Coinciding with the increased accuracy, a drop in the number of appendectomies performed and a longer time interval from admittance to the start of operation was seen. Conclusion: Through repeated clinical examinations and blood tests it was prospectively possible to achieve an increase in diagnostic accuracy in patients with suspicion of acute appendicitis without any noticeable side effects.
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