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| 2. |
- Regnér, Sara, et al.
(författare)
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Nya nationella riktlinjer för handläggning av akut pankreatit
- 2021
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Ingår i: Läkartidningen. - 0023-7205. ; 118
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Tidskriftsartikel (refereegranskat)abstract
- This is a short report of the recently published Swedish guidelines for acute pancreatitis, which are based on international guidelines as well as original publications. The report covers diagnosis, classification, treatment and follow up for patients with acute pancreatitis. Early rehydration and goal-based fluid therapy is recommended as well as oral intake of food on demand. Risk factors for development of severe disease and organ failure should be considered already in the emergency unit. Abdominal computer tomography is generally not recommended the first 5-7 days from onset of symptoms. Antibiotic therapy is only recommended when there is suspicion of or a confirmed infection. If intervention is needed for patients with moderate or severe disease a minimal-invasive step-up approach is recommended. Endoscopic Retrograde Cholangiography is generally not recommended as a treatment in the acute phase of the disease. Identification and treatment of the etiology causing acute pancreatitis is essential to prevent new episodes of the disease.
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| 3. |
- Villabona Lisa Villabona, Lisa, et al.
(författare)
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Immunrelaterade biverkningari tarm, lever, lungor och njurar : BIVERKNINGAR I SAMBAND MED IMMUNTERAPI MOT CANCER, DEL 1 [Overview of immune-related side effects from immune checkpoint inhibitors. Part 1: Gastrointestinal, lung and kidney toxicity]
- 2021
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Ingår i: Läkartidningen. - : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 118
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Forskningsöversikt (refereegranskat)abstract
- In the past decade, immunotherapy with checkpoint inhibitors has revolutionized the field of oncology. Checkpoint inhibitors have been approved for several types of cancer and thousands of patients in Sweden now receive oncological immunotherapy annually. Immune-related side effects are common and can occur in almost any organ. These side effects are different from those that occur with traditional oncological treatments. The side effects are usually mild, but can be serious and even lethal. In a short time, health care providers have had to readjust to be able to handle these side effects. Early and correct diagnosis of immune-related side effects, proper management and a multidisciplinary approach is crucial. Here, we give an overview of the presentation, diagnosis and treatment of immune-related side effects, with emphasis of those occurring in gastrointestinal organs, lungs and kidneys.
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| 4. |
- Espes, Daniel, 1985-, et al.
(författare)
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[Amyloid from insulin treatment : a pitfall for the pathologist and the diabetologist]
- 2020
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 117
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Tidskriftsartikel (refereegranskat)abstract
- Biopsies from six diabetic patients with subcutaneous amyloid deposits formed by injected insulin have been sent to our laboratory during the last year. In all but one of the six patients a subcutaneous adipose tissue biopsy was taken due to suspicion of systemic amyloidosis. Four of these patients had renal insufficiency, with monoclonal gammopathy of undetermined significance (MGUS) in three while the fifth had heredity for transthyretin amyloidosis. In the sixth patient a biopsy was taken due to subcutaneous nodules at insulin injection sites. In all biopsies, large amounts of amyloid were present and their biochemical nature was elucidated by immunohistochemistry or western blot. The risk of incorrect interpretation with misdiagnosis of systemic amyloidosis is underlined. The consequences this may have on insulin treatment are insufficiently studied.
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| 5. |
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| 6. |
- Regnér, Sara, et al.
(författare)
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Nya riktlinjer för kronisk pankreatit
- 2020
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Ingår i: Lakartidningen. - 0023-7205. ; 117
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Patients with chronic pancreatitis have an impaired quality of life and are at risk for several long-term complications. It is important to diagnose and treat these patients to minimize the effects of the disease. Clinical manifestations of chronic pancreatitis include a wide range of symptoms and patients are managed differenth between medical centers. In recent years, there have been improvements in knowledge about treatment and management of patients with chronic pancreatitis. This is a short report of the recently published Swedish guidelines for chronic pancreatitis, which are based on international guidelines as well as original publications and are related to the Swedish healthcare system.
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| 7. |
- Ringström, Gisela, 1964, et al.
(författare)
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Patientutbildning
- 2020
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Ingår i: IBS: irritabel tarm. - Lund : Studentlitteratur. - 9789144130132
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Thorell, Anders, et al.
(författare)
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Diagnos, behandling, risk och kontroll vid Barretts esofagus : [Barrett's esophagus: Diagnosis, treatment and minimizing of risk]
- 2023
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Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 120
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Forskningsöversikt (refereegranskat)abstract
- Gastroesophageal reflux disease (GERD) is characterized by regurgitation of gastric juices into the esophagus. This has an erosive effect on the mucosa with accompanying symptoms, such as heartburn, acid regurgitation and positional-/exertion–induced chest pain. The associated inflammation in the multi-layered squamous epithelium of the esophagus (esophagitis) can usually be seen macroscopically at gastroscopy and is always possible to demonstrate microscopically as well-characterized changes. GERD is abundant in the adult population in the Western world, and the incidence appears to be increasing. Serious manifestations of GERD include the appearance of esophageal injury (esophagitis) and columnar lined esophagus (Barrett’s esophagus) and, in rare cases, peptic stricture. The glandular-transformed (metaplastic) mucosa carries its clinical significance by constituting the basis for continued cell transformation (development of dysplasia), which eventually might lead to esophageal adenocarcinoma (EAC). EAC is an aggressive form of cancer whose incidence continues to increase in particular in the Western part of the world. In this article the potential mechanisms for the development of the metaplastic glandular epithelium and its progression to dysplasia and cancer is reviewed. In addition, recommendations are given on how important signals about future risks can be captured and managed and how these risks can be minimized and preferably prevented.
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| 9. |
- Törnblom, H., et al.
(författare)
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Gastroesofageal refluxsjukdom – gammal bekant med nya ansikten : Management of patients with gastroesophageal reflux disease can be optimized
- 2022
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Ingår i: Läkartidningen. - 0023-7205. ; 119
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Tidskriftsartikel (refereegranskat)abstract
- Gastroesophageal reflux disease (GERD) often requires lifelong treatment to return to and maintain a normal quality of life. Proton pump inhibitors (PPIs) offer effective medical treatment and can be used for a long time with good safety margins. The diagnostic criteria for GERD must be strictly based on current guidelines and the need for maintained treatment must be regularly evaluated. When medical treatment fails (> 20%), the patient should be offered a consultation with a specialist in the field. Too many patients who are currently treated with PPI for suspected GERD ultimately require treatment with a completely different diagnosis in focus. The investigation and treatment options are several and well-defined in the event of PPI failure in patients with well documented GERD. The indications for surgical treatment are well established, but this treatment option is likely underused today.
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