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- Muller-Lissner, S A, et al.
(författare)
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Interobserver agreement in defecography--an international study
- 1998
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Ingår i: Zeitschrift für Gastroenterologie. - 0044-2771. ; 36:4, s. 273-279
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Defecography is considered to be an essential investigation in the evaluation of functional anorectal disorders, but the agreement between observers from different clinical centers has never been evaluated. METHODS: 14 defecographic studies were selected aimed to cover the most relevant defecographic findings responsible for disordered defecation. Eight studies were considered unequivocal, but six were thought to be controversial. All were sent to the ten participants in Europe and the US (five proctosurgeons, three radiologists, two gastroenterologists). They evaluated the studies using a previously agreed upon questionnaire. Interobserver agreement was quantified by kappa statistics and by the proportions of positive and negative agreement as compared to chance agreement, respectively. RESULTS: Overall, only the completeness of rectal emptying and the presence of a rectocele achieved acceptable kappa values above 0.4. When restricting the evaluation to the studies considered to be unequivocal, agreement improved considerably and was moderate to good for all items describing the images (kappa 0.43-0.63). However, whether proctosurgery should be performed and whether defecography contributed to the management of the particular patient remained controversial with very low kappa. CONCLUSIONS: It is doubtful whether defecography contributes substantially to the management of patients with disordered defecation.
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- Ekberg, H, et al.
(författare)
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Similar treatment success rate after renal transplantation in diabetic and nondiabetic patients due to improved short- and long-term diabetic patient survival
- 1996
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Ingår i: Transplant international : official journal of the European Society for Organ Transplantation. - 0934-0874. ; 9:6, s. 64-557
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Tidskriftsartikel (refereegranskat)abstract
- In the early era of transplantation, it was common practice to exclude diabetic patients since the outcome in such cases was usually poor. At our center in Malmö, Sweden, diabetic nephropathy was never regarded as a contraindication. During the 22-year period from 1972 to 1993, 223 renal allografts were transplanted in 189 uremic diabetics, representing 24% of all renal transplant recipients (n = 788). The two subgroups - patients with and without diabetes - did not differ significantly in graft survival rates for the 22-year period, which was characterized by a successive improvement in the success rate that was especially striking in the diabetic nephropathy subgroup. Among transplantations performed before 1988, the overall patient survival rate was significantly lower in the diabetic subgroup than in the remainder. After 1988 (when a series of new procedures had been adopted), the patient survival rate in the diabetic subgroup was similar to that in the nondiabetic subgroup, a similarity that persisted for at least 5 years. The 1st year post-transplant mortality rate was reduced in diabetic patients from 24% before 1988 to 0% in those transplanted after 1988. In the 22-year period as a whole, cardiovascular or cerebrovascular events were the most common cause of death in both subgroups; the risk of cardiovascular or cerebrovascular death was reduced after 1988, and the rates were similar in both subgroups. The improved success rate of renal transplantation in patients with diabetic nephropathy supports continuation of the renal transplant program, which is based on careful management of the early stages of the disease.
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- Ekberg-Jansson, A, et al.
(författare)
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A comparison of the expression of lymphocyte activation markers in blood, bronchial biopsies and bronchoalveolar lavage: evidence for an enrichment of activated T lymphocytes in the bronchoalveolar space
- 1999
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Ingår i: Respiratory Medicine. - 1532-3064. ; 93:8, s. 563-570
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Tidskriftsartikel (refereegranskat)abstract
- In this study healthy never-smoking subjects (n = 18) were recruited from a population study. Bronchoalveolar lavage (BAL), blood lymphocytes and bronchial biopsies, analysed both in the epithelium and lamina propria, were stained for T and B lymphocytes, natural killer (NK) cells and different subpopulations of T lymphocytes. In BAL, significantly higher proportions of T lymphocytes (CD3), T lymphocyte activation markers; HLA-DR, CD26+, CD49a+, CD54+ and CD69+, helper T (CD3+4+) and memory helper T lymphocytes (CD4+45RO+29+) and memory T lymphocytes (CD3+45RO+) were found, compared to blood. However, the proportion of IL-2 receptor-positive T lymphocytes (CD25+) was lower in BAL than in blood. A previously described higher ratio of CD3+4+/CD3+8+ in BAL than in blood (3.4 vs 1.7; P = 0.001) was confirmed. In bronchial biopsies, we found significantly higher numbers of CD8+ cell profiles per mm2 in the epithelial compared to the lamina propria compartment. We conclude that healthy never-smoking men have higher levels of activated memory T lymphocytes in BAL than in blood, and that the T-cell subpopulations differ in the epithelial compared to the lamina propria compartment in the bronchial mucosa and these compartments should be analysed separately. It is reasonable to think that there is a gradient from blood to the airway lumen where T cells are recruited from blood to take part in the defense towards damaging agents.
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