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| 12. |
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| 13. |
- Analatos, Apostolos, et al.
(författare)
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Tension-free mesh versus suture-alone cruroplasty in antireflux surgery : a randomized, double-blind clinical trial
- 2020
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Ingår i: British Journal of Surgery. - : John Wiley & Sons. - 0007-1323 .- 1365-2168. ; 107:13, s. 1731-1740
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAntireflux surgery is effective for the treatment of gastro-oesophageal reflux disease (GORD) but recurrence of hiatal hernia remains a challenge. In other types of hernia repair, use of mesh is associated with reduced recurrence rates. The aim of this study was to compare the use of mesh versus sutures alone for the repair of hiatal hernia in laparoscopic antireflux surgery.MethodsPatients undergoing laparoscopic Nissen fundoplication for GORD between January 2006 and December 2010 were allocated randomly to closure of the diaphragmatic hiatus with crural sutures or non-absorbable polytetrafluoroethylene mesh (CruraSoft®). The primary outcome was recurrence of hiatal hernia, as determined by barium swallow study 12 months after surgery. Secondary outcomes were: intraoperative and postoperative complications, use of antireflux medication, postoperative oesophageal acid exposure, quality of life, dysphagia and duration of hospital stay.ResultsSome 77 patients were randomized to the suture technique and 82 patients underwent mesh repair. At 1 year, the hiatal hernia had recurred in six of 64 patients (9 per cent) in the mesh group and two of 64 (3 per cent) in the suture group (P = 0·144). Reflux symptoms, use of proton pump inhibitors and oesophageal acid exposure did not differ between the groups. At 3 years, recurrence rates were 13 and 10 per cent in the mesh and suture groups respectively (P = 0·692). Dysphagia scores decreased in both groups, but more patients had dysphagia for solid food after mesh closure (P = 0·013). Quality-of-life scores were comparable between the groups.ConclusionTension-free crural repair with non-absorbable mesh does not reduce the incidence of recurrent hiatal hernia compared with use of sutures alone in patients undergoing laparoscopic fundoplication. NCT03730233 (http://www.clinicaltrials.gov).
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| 15. |
- Ellebæk, SB, et al.
(författare)
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Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC)-directed treatment of peritoneal metastasis in end-stage colo-rectal cancer patients
- 2020
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Ingår i: Pleura and peritoneum. - : Walter de Gruyter GmbH. - 2364-768X .- 2364-7671. ; 5:2, s. 20200109-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) represents a novel approach to intraperitoneal chemotherapy. Hereby results, obtained with PIPAC in patients with advanced peritoneal metastasis (PM) from colorectal cancer (CRC), are presented.MethodsData from CRC patients (n = 24) included in the prospective PIPAC-OPC1 and PIPAC-OPC2 trials are reported. Oxaliplatin 92 mg/m2 was administered at 4-6-week intervals. A CE certified nebulizer was used to aerosolize the chemotherapeutics. Outcome criteria were objective tumor response, survival and adverse events.ResultsRetrospective analysis of 74 PIPAC procedures carried out in 24 consecutive patients with PM from CRC included from October 2015 to February 2019. Five patients had still the primary tumor in situ, and 22 patients had received palliative systemic chemotherapy. Nineteen patients completed more than two PIPAC procedures, and objective tumor response according to the histological Peritoneal Regression Grading Score (PRGS) was observed in 67% of the patients, while 21% had stable disease. Four patients (21%) had complete response (mean PRGS = 1 and negative cytology). We recorded a median survival of 37.6 (range 7.3–48.9) months from the time of PM diagnosis, whereas it was 20.5 (range 0.13–34.7) months following the first PIPAC session. Minor postoperative complications were noted, and few were considered causally related to the PIPAC treatment. However, two cases of severe postoperative complications were recorded (urosepsis and iatrogenic bowel perforation).ConclusionsPIPAC with low-dose oxaliplatin can induce objective tumor regression in selected patients with advanced PM from colorectal cancer.
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| 17. |
- Fuaad, P. A., et al.
(författare)
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Simulation of slot-coating of nanocellulosic material subject to a wall-stress dependent slip-velocity at die-walls
- 2022
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Ingår i: JCT Research. - : Springer Nature. - 1547-0091 .- 2168-8028. ; 19:1, s. 111-120
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Tidskriftsartikel (refereegranskat)abstract
- Bio-based nanocellulosic materials are non-toxic, renewable, exhibit excellent barrier properties, and are suitable candidates for sustainable food packaging applications. Sizing and designing coating parameters for slot-coating process using nanocellulose suspensions is challenging due to complex shear-thinning rheology and the presence of a water-rich boundary layer, effecting significant apparent slip at the wall. Previous studies have shown that the flow inside the coating bead can be complex, with occasional stagnation regions and a rheological model incorporating yield stress which should be considered while analyzing slot coating of nanocellulosic flows. This work extends earlier investigations by including the effects of the particle depleted water-rich boundary layer. The suspension is modeled as a Casson fluid with a shear-thinning viscosity, and the particle depletion at the wall is represented by an infinitely thin layer modeled as a local shear-dependent nonlinear slip law. The resulting two-phase flow equations are solved using a Finite Volume Method (FVM) coupled with the Volume of Fluid (VoF) method for tracking the free surface interface. It is observed that slip alters the flow’s dynamics in the coating bead, and the effect of slip cannot be ignored, especially at high shear rates. For thin films, the presence of slip enhances the flow, leading to more material coated on the substrate. In contrast, for thicker coatings, apparent slip leads to an augmentation in stagnant, non-yielded regions, potentially generating uneven surfaces.
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| 18. |
- Harris, M., et al.
(författare)
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The Kumbis and Nagatis Formations and the Helmeringhausen Gabbro: Oldest undeformed rocks of the Sinclair Supergroup in Namibia
- 2020
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Ingår i: Journal of African Earth Sciences. - : Elsevier BV. - 1464-343X. ; 165
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Tidskriftsartikel (refereegranskat)abstract
- The Mesoproterozoic rocks of the Kumbis and Nagatis Formations and Helmeringhausen Gabbro in Southern Namibia are now recognised as the oldest rocks in the sedimentary and volcanic Sinclair Supergroup. The stratigraphic subdivision and plate tectonic setting are still debated and reliable ages are sparse. This work investigates the relatively undeformed felsic and mafic lava of the Kumbis Formation, rhyolitic lava of the Nagatis Formation and the intrusive Helmeringhausen Gabbro. Microscopic and field investigation reveals no evidence of regional metamorphism in these units. Ion probe U-Pb zircon dating yields ages of 1374 +/- 7 Ma to 1358 +/- 5 Ma (2 sigma) for the Kumbis Formation, 1363 +/- 11 Ma for the Nagatis Formation and 1372 +/- 12 Ma for the Helmeringhausen Gabbro. These dates are in contrast to the published stratigraphy in which the Helmeringhausen Gabbro was regarded as much older than the Kumbis Formation and both were excluded from the Sinclair Supergroup, whereas the Nagatis Formation was considered to be younger and was included as the oldest unit of the Sinclair Supergroup. Lu-Hf data on zircon indicates different magma sources for the Kumbis and Nagatis Formations, implying that although they are time equivalent, they are not co-magmatic. The geochemical data suggests that the most felsic rocks contain large amounts of older crustal material, from which their apparent subduction signatures were inherited. The more mafic rocks also contain minor crustal components mixed with material derived from depleted mantle. The Helmeringhausen Gabbro is similar to coeval hybrid gabbros at Neuhof Valley 150 Km to the north and they are grouped in the intrusive Helmering Suite. Taking the regional context into account, these oldest rocks of the Sinclair Supergroup probably formed in a rift environment which split the Rehoboth Province apart at the beginning of the Mesoproterozoic Namaqua-Natal Wilson Cycle.
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| 19. |
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| 20. |
- Jeremiasen, Martin, et al.
(författare)
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Improvements in esophageal and gastric cancer care in Sweden-population-based results 2007-2016 from a national quality register
- 2020
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Ingår i: Diseases of the esophagus. - : Oxford University Press (OUP). - 1120-8694 .- 1442-2050. ; 33:3
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish National Register for Esophageal and Gastric cancer was launched in 2006 and contains data with adequate national coverage and of high internal validity on patients diagnosed with these tumors. The aim of this study was to describe the evolution of esophageal and gastric cancer care as reflected in a population-based clinical registry. The study population was 12,242 patients (6,926 with esophageal and gastroesophageal junction (GEJ) cancers and 5,316 with gastric cancers) diagnosed between 2007 and 2016. Treatment strategies, short- and long-term mortality, gender aspects, and centralization were investigated. Neoadjuvant oncological treatment became increasingly prevalent during the study period. Resection rates for both esophageal/GEJ and gastric cancers decreased from 29.4% to 26.0% (P=0.022) and from 38.8% to 33.3% (P=0.002), respectively. A marked reduction in the number of hospitals performing esophageal and gastric cancer surgery was noted. In gastric cancer patients, an improvement in 30-day mortality from 4.2% to 1.6% (P=0.005) was evident. Overall 5-year survival after esophageal resection was 38.9%, being higher among women compared to men (47.5 vs. 36.6%; P<0.001), whereas no gender difference was seen in gastric cancer. During the recent decade, the analyses based on the Swedish National Register for Esophageal and Gastric cancer database demonstrated significant improvements in several important quality indicators of care for patients with esophagogastric cancers. The Swedish National Register for Esophageal and Gastric cancer offers an instrument not only for the control and endorsement of quality of care but also a unique tool for population-based clinical research.
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