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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 60 (2005), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A prospective study using neuropsychological testing explored cognitive performance, and specifically executive function, in survivors of critical illness during the first year of recovery. Fifty-one patients who had survived 3 days or more in the intensive care unit were studied approximately 3 months after discharge; 45 of them were studied again 6 months later. General health was assessed using the Short-Form 36. Cognitive and executive functions were measured using Raven's Progressive Matrices, the Hayling Sentence completion test and the Six-Element Test. Three months after discharge from intensive care, all eight domains of Short-Form 36 were impaired among survivors; by 9 months, four of the eight domains showed significant improvement. At 3 months, 35% of patients scored at or below a level equivalent to the lowest performing 5% of a normal population (i.e. the fifth percentile) on two or more tests of cognitive function; by 9 months only 4% of patients were impaired to this extent. Although cognitive performance improved with time, it remained below normal.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The number of hospital admissions for acute and chronic pancreatitis increased in Britain from the 1960s to the 1980s.Aims: To determine time trends in acute and chronic pancreatitis for hospital admissions from 1989/90 to 1999/2000, mortality from 1979 to 1999, and various indices of alcohol consumption.Methods: Hospital Episode Statistics for admissions were obtained from the Department of Health and mortality data from the Office for National Statistics. Alcohol consumption data were obtained from the General Household Survey.Results: Between 1989/90 and 1999/2000, age-standardized hospital admission rates for acute pancreatitis increased by 43%, whilst those for chronic pancreatitis rose by 100%. The proportions of admissions requiring surgical operations increased for acute pancreatitis, but declined for chronic pancreatitis. Case fatality rates for acute pancreatitis declined, but mortality statistics showed no significant change. The proportion of women who drank more than 14 units of alcohol a week also increased.Conclusions: There has been a steady increase in admission rates for both acute and chronic pancreatitis over the study period, and these conditions will become an increasingly important part of the workload of the gastroenterologist.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : The number of operations for cholelithiasis increased from the 1950s to the 1990s.Aims : To determine the time trends in cholelithiasis for hospital admissions, operations and in-hospital case fatalities in England between 1989/1990 and 1999/2000, and population mortality rates between 1979 and 1999.Methods : Hospital Episode Statistics for admissions were obtained from the Department of Health and mortality data were obtained from the Office for National Statistics.Results : Between 1989/1990 and 1999/2000, age-standardized hospital admission rates for cholelithiasis increased by 30% for males and 64% for females. The proportions of admissions undergoing an operation declined progressively over the study period. In 1999/2000, the frequency of operation was approximately 50–60% for most age groups, but decreased progressively with advancing age at ≥ 65 years. The proportions of admissions undergoing therapeutic endoscopy increased several-fold, especially amongst older individuals. Case fatality rates declined. Mortality rates declined from 1979 to 1988, but showed no further change from 1989 to 1999.Conclusions : There has been a steady increase in admission rates for cholelithiasis over the study period. Whilst the frequency of operation has declined, the proportion of patients undergoing therapeutic endoscopy has increased.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of hepato-biliary-pancreatic surgery 1 (1994), S. 355-366 
    ISSN: 1436-0691
    Keywords: pancreatoduodenectomy ; pancreatic cancer ; chronic pancreatitis ; ampullary carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Whipple's pancreatoduodenectomy was the standard operation for diseases of the head of the pancreas for more than 40 years, but the results were vitiated in part by poor gastrointestinal function and malnutrition. Reintroduced in 1978, pylorus-preserving proximal pancreatoduodenectomy (PPPP) has had an increasing impact on pancreatic surgery as its benefits have been recognized: improved nutritional status, decreased incidence of postgastrectomy syndromes, and a technically easier operation. Postoperative mortality rates and 5-year survival rates are comparable with those of the classic Whipple procedure. PPPP is indicated for most patients with chronic pancreatitis of the pancreatic head. It is also appropriate for patients with periampullary cancer and for those with pancreatic cancer arising from the lower part of ‘the head and the uncinate process. More than 650 patients have now undergone PPPP: 31% for chronic pancreatitis and 66% for periampullary and pancreatic cancers. We assess the indications for PPPP, outline the operation, and review the results.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    International journal of colorectal disease 1 (1986), S. 186-187 
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A radioimmunoassay was used for the detection of the human carcinoma-associated antigen CA-50 in the serum of 50 normal subjects, 16 patients with inflammatory bowel diseases and 77 patients with primary and secondary colorectal carcinomas. Serum levels in all normal patients and those with benign disease were below 17 U/ml, while 40 of 77 (51%) patients with carcinoma had levels above 17 U/ml. The sensitivity of this test was 22% for Dukes' A carcinoma, 29% for Dukes' B, 59% for Dukes' C and 73% for metastatic disease. The CA-50 levels were elevated in 7 of 9 (78%) patients who developed tumour recurrence following curative surgery compared with 15 of 43 (35%) patients who are alive and tumour free (p〈0.05). Therefore, this test may prove useful in the diagnosis and prognosis of patients with colorectal carcinomas.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 9 (1985), S. 876-886 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'ulcération de l'intestin grÊle est une affection rare et difficile à diagnostiquer. Le plus souvent, les malades sont opérés pour une complication: perforation, hémorragie, occlusion. Les causes sont multiples et doivent Être soigneusement recherchées. Dans quelques cas, aucune cause ne peut Être trouvée; l'ulcération dépourvue de spécificité revÊt un caractère idiopathique. Dix cas inhabituels d'ulcère du grÊle sont présentés pour illustrer la démarche du diagnostic et la conduite thérapeutique à suivre.
    Abstract: Resumen La ulceración del intestino delgado es poco comün y difícil de diagnosticar. Un gran numéro de pacientes requieren operación para complicaciones tales como perforación, hemorragia y obstrucción. El diagnóstico diferencial es amplio, y en algunos casos de ulceración entérica (no específica, idiopática) no es posible definir una causa etiológica. Se presentan diez casos inusitados de ulceración entérica complicada con el propósito de ilustrar los métodos de diagnóstico y de manejo de estas oscuras entidades clínicas.
    Notes: Abstract Ulceration of the small bowel is uncommon and difficult to diagnose. Many patients require operation for the complications of perforation, hemorrhage, and obstruction. There is a wide differential diagnosis, and in a few cases of enteric ulceration (nonspecific, idiopathic) no etiological cause can be defined. Ten unusual cases of complicated small bowel ulceration are presented to illustrate the investigation and management of these obscure conditions.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 9 (1985), S. 914-920 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'intestin grÊle représente 75% de la longueur du tractus gastro-intestinal, cependant il est rarement le siège d'une formation tumorale. De 1969 à 1983 une revue rétrospective sans sélection des malades observés pendant cette période a permis de retrouver 25 cancers du grÊle ce qui représente 1 cas de cancer par an pour 450,000 personnes. Ces tumeurs malignes siègeaient respectivement au niveau du duodénum, 10 cas; du jéjunum, 6 cas; de l'iléon, 9 cas. Vingt-et-un des malades furent traités par une résection; 17 survécurent à l'intervention (mortalité opératoire: 19%). La survie à 1 an fut de 60%, à 2 ans de 40%, aucun malade ne survécut plus de 5 ans bien que 3 opérés soient actuellement vivants et en bonne santé. Cinq autres malades étaient porteurs d'une tumeur bénigne: 3 adénomes duodénaux et 3 adénomes jéjunaux. Les adénomes duodénaux furent traités par résection endoscopique et les adénomes jéjunaux par résection chirurgicale sans aucune complication.
    Abstract: Resumen El intestino delgado comprende el 75% de la longitud y el 90% de la superficie del tracto gastrointestinal, pero es un lugar infrecuente de neoplasia. Una revisión general y retrospectiva de los patientes de los hospitales de la ciudad de Bristol (Gran Bretaña) entre 1969 y 1983 reveló sólo 25 carcinomas del intestino delgado, lo cual significa una incidencia anual de 1 por 450,000 personas, o sea 0.2 por 100,000, comparada con 51.2/100,000 para carcinoma gástrico y 87.5/100,000 para carcinoma colorrectal en la misma población. La distribución de estos carcinomas señaló 10 duodenales, 6 yeyunales y 9 ileales; 5 pacientes presentaron otras enfermedades asociadas. Veintiuno de los 25 pacientes fueron sometidos a resección quirÚrgica, con 17 sobrevivientes (mortalidad operatoria 19%). La supervivencia fue de 60% a 1 año, y de 40% a 2 años; ningÚn paciente ha sobrevivido 5 años, aunque 3 permanecen vivos y aparentemente libres de recurrencia. Otros 5 pacientes presentaron adenomas benignos: 3 duodenales y 2 yeyunales. Las lesiones duodenales fueron tratadas endoscópicamente, en tanto que los adenomas yeyunales fueron resecados mediante enterotomía. No se presentaron complicaciones como resultado del tratamiento.
    Notes: Abstract The small bowel comprises 75% of the length of the gastrointestinal tract but is a rare site of neoplasia. An unselected retrospective review of Bristol patients between 1969 and 1983 revealed only 25 small bowel carcinomas: an incidence of 1 per 450,000 of population per annum. Distribution was 10 duodenal, 6 jejunal, and 9 ileal carcinomas; 5 patients had other associated diseases. Twenty-one of the 25 patients underwent a surgical resection, of whom 17 survived (operative mortality 19%). Survival was 60% at 1 year and 40% at 2 years; no patient has survived 5 years although 3 remain alive and well. A further 5 patients were found to have benign adenomas in the absence of malignancy: 3 duodenal and 2 jejunal. Duodenal lesions were treated endoscopically while the jejunal adenomas were removed by enterotomy. There were no complications of treatment.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1573-6865
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Two new histochemical procedures for detecting sulphated and non-sulphated sialomucin in colonic mucosa were assessed: the saponification—Alcian Blue pH 1—periodic acid—phenylhydrazine—Schiff method (KOH—AB pH 1—PAPS) and the mild periodic acid modification of this (KOH—AB pH 1—mPAS). Using normal colonic mucosa obtained from 11 non-cancer patients, the mPAS and PAPS techniques were tested for specificity and reproducibility for staining sialic acid, either alone or in combination with Alcian Blue. A spectrophotometric method was devised to quantify the uptake of both Schiff and Alcian Blue stain by sections. At low temperature and pH5.5, the mPAS procedure had improved specificity over the PAPS procedure, and after saponification it could be used to stainO-acetyl-substituted sialic acid. When used in combination with Alcian Blue at pH 1, however, underestimation of the sialic acid content occurred owing to interference between Alcian Blue and Schiff dyes. Interference was even greater with KOH—AB pH1—PAPS procedure for both sialic acid and sulphate components. We conclude that caution must be exercised in interpretation of the staining results obtained with these new combination methods and that more accurate information on the sialic acid and sulphate content of colonic mucin is obtained by staining serial sections with the mPAS technique and Alcian Blue pH 1 alone.
    Type of Medium: Electronic Resource
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