检索结果-南通市图书馆

A Single Center Retrospective Analysis of Kraske’s Transsacral Approach: A Review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Surgical Science 2014年第10期5卷 454-466页

作者： Cédric Bouts Kurt Van der Speeten Department of Surgical Oncology Ziekenhuis Oost-Limburg Genk Belgium

Aim: Presacral lesions are uncommon and represent a diagnostic and surgical challenge. The aim of this study is to present our experience with Kraske’s transsacral resection and to review current literature. Methods: Seven patients who had a transsacral resection between 2001 and 2013?were reviewed retrospectively. Results: Two men and five women with a mean age of 39 (range 17?- 60) years were diagnosed with a presacral lesion. The clinical presentation was nonspecific;pain was the most common symptom. All lesions were palpable on digital rectal examination. Magnetic resonance imaging (MRI) was necessary to assess the tumor’s extent, biological behavior and relationship to adjacent structures. MRI predicted malignancy with 100% accuracy. All lesions were located below S3 and underwent a transsacral resection. Pathological examination revealed four tailgut cysts, two epidermoid cysts and one chordoma. Postoperative complications included wound infections (two cases) and spasms of the gluteus muscle (one case). We reported no recurrence or mortality. Conclusion: Clinical awareness, the use of MRI in the routine work-up and avoidance of an incisional biopsy result in a good outcome after surgical resection of presacral lesions. Kraske’s approach can be used for presacral lesions below S3, resulting in low morbidity, no recurrence and no mortality.

关键词： Presacral Tumor Magnetic Resonance Imaging Transsacral Approach Kraske

Eligibility of persons who inject drugs for treatment of hepatitis C virus infection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第36期20卷 12722-12733页

作者： Amber Arain Geert Robaeys Department of Gastroenterology and Hepatology Ziekenhuis Oost-Limburg 3600 Genk Belgium Faculty of Medicine and Life Sciences Hasselt University 3590 Diepenbeek Belgium Department of Hepatology UZ Leuven 3000 Leuven Belgium

In this decade, an increase is expected in end-stageliver disease and hepatocellular carcinoma, most commonly caused by hepatitis C virus(HCV) *** people who inject drugs(PWID) are the ma-jor source for HCV infection, they were excluded fromantiviral treatments until recently. Nowadays there isincontrovertible evidence in favor of treating these patients, and substitution therapy and active substanceuse are no longer contraindications for antiviral treatment. The viral clearance in PWID after HCV antiviraltreatment with interferon or pegylated interferon combined with ribavirin is comparable to the viral clearancein non-substance users. Furthermore, multidisciplinary approaches to delivering treatment to PWID are advised, and their treatment should be considered on anindividualized basis. To prevent the spread of HCV inthe PWID community, recent active PWID are eligiblefor treatment in combination with needle exchange programs and substitution therapy. As the rate of HCV reinfection is low after HCV antiviral treatment, there is no need to withhold HCV treatment due to concerns about reinfection alone. Despite the advances in treatment efficacies and data supporting their success, HCV assessment of PWID and initiation of antiviral treatment remains low. However, the proportion of PWID assessed and treated for HCV is increasing, which can be further enhanced by understanding the barriers to and facilitators of HCV care. Removing stigmatization and implementing peer support and group treatment strategies, in conjunction with greater involvement by nurse educators/practitioners, will promote greater treatment seeking and adherence by PWID. Moreover, screening can be facilitated by noninvasive methods for detecting HCV antibodies and assessing liver fibrosis stages. Recently, HCV clearance has become a major endpoint in the war against drugs for the Global Commission on Drug Policy. This review highlights the most recent evidence concerning HCV infection

关键词： Hepatitis C virus Persons who inject drugs Methadone Sustained viral response Adherence

Pathophysiology of colorectal peritoneal carcinomatosis: Role of the peritoneum

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第34期22卷 7692-7707页

作者： Lieselotte Lemoine Paul Sugarbaker Kurt Van der Speeten Department of Medicine and Life Sciences Hasselt University3500 Hasselt Belglum Department of Surgical Oncology Ziekenhuis Oost-Limburg 3600 Genk Belgium Washington Cancer Institute Washington Hospital Center Washington DC 20010 United States

Colorectal cancer(CRC) is the third most common cancer and the fourth most common cause of cancerrelated death worldwide. Besides the lymphatic and haematogenous routes of dissemination,CRC frequently gives rise to transcoelomic spread of tumor cells in the peritoneal cavity,which ultimately leads to peritoneal carcinomatosis(PC). PC is associated with a poor prognosis and bad quality of life for these patients in their terminal stages of disease. A loco-regional treatment modality for PC combining cytoreductive surgery and hyperthermic intraperitoneal peroperative chemotherapy has resulted in promising clinical results. However,this novel approach is associated with significant morbidity and mortality. A comprehensive understanding of the molecular events involved in peritoneal disease spread is paramount in avoiding unnecessary toxicity. The emergence of PC is the result of a molecular crosstalk between cancer cells and host elements,involving several well-defined steps,together known as the peritoneal metastatic cascade. Individual or clumps of tumor cells detach from the primary tumor,gain access to the peritoneal cavity and become susceptible to the regular peritoneal transport. They attach to the distant peritoneum,subsequently invade the subperitoneal space,where angiogenesis sustains proliferation and enables further metastatic growth. These molecular events are not isolated events but rather a continuous and interdependent process. In this manuscript,we review current data regarding the molecular mechanisms underlying the development of colorectal PC,with a special focus on the peritoneum and the role of the surgeon in peritoneal disease spread.

关键词： Peritoneal carcinomatosis Pathophysiology Peritoneal metastatic cascade Cytoreductive surgery Peritoneum Hyperthermic intraperitoneal peroperative chemotherapy

Evaluation of quality of clinical management of neuroendocrine tumors

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Cancer Innovation 2022年第4期1卷 305-315页

作者： Hannah Bloemen Kristien Kneepkens Karen Deraedt Anna Ivanova Gregory Sergeant Jeroen Mebis Kurt Van der Speeten Department of Medicine Faculty of Medicine and Life Sciences(LCRC)Hasselt UniversityDiepenbeekBelgium Department of Pathology and Department Future Health Ziekenhuis Oost-LimburgGenkBelgium Department of Abdominal Surgery and Department Jessa&Science Jessa HospitalHasseltBelgium Department of Medical Oncology and Department Jessa&Science Jessa HospitalHasseltBelgium Department of Surgical Oncology and Department Future Health Ziekenhuis Oost-LimburgGenkBelgium

Background:Neuroendocrine tumors(NETs)are a group of biologically and clinically heterogeneous neoplasms predominantly found in the gastrointestinal and bronchopulmonary *** a rising incidence,implementation of evidence-based standardized care for this heterogenous group remains *** European Neuroendocrine Tumor Society regularly reviews guidelines regarding diagnostic and treatment strategies for *** aim of this study is to shed light on the care of patients with a NET in Belgian limburg,to provide data as a basis for future studies and to check whether data and results are according to consensus guidelines and outcomes described in ***:Our study concerned a detailed observational data collection of two large Belgian hospitals(Jessa Hospital Hasselt and Hospital oost-limburg Genk)with special interest in patient profile,quality of pathology reports,use of diagnostic imaging,and overall *** on 188 patients were assembled between January 2010 and December 2014 with follow-up until June 2016(median follow-up:33.6 months).Results:Fifty percent of patients were *** were located mainly in the digestive tract(63.8%)and lung(20.2%).Appendiceal NETs were diagnosed at a significantly younger age than other tumors(41.3 vs.64.0 years).Overall,a mean pathology report quality score of 3.0/5 was observed with the highest scores for small bowel *** and nuclear imaging was performed in 74.5%and 29.8%of cases,***-four percent of the population survived until the end of the observation period with highest survival rates for appendiceal and small bowel ***:Overall,epidemiological results were comparable with findings in the *** NETs met most of the requirements of qualitative pathology reporting and diagnostic imaging as listed in the European Neuroendocrine Tumor Society consensus ***,consensus with regard to bronchopulmonary NETs is still scarce

关键词： neuroendocrine tumors epidemiology quality pathology report Ki67 overall survival guidelines

An extremely rare case of delusional parasitosis in a chronic hepatitis C patient during pegylated interferon alpha-2b and ribavirin treatment

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第16期13卷 2379-2380页

作者： Geert Robaeys Jozef De Bie Marc Van Ranst Frank Buntinx Department of Gastroenterology and Hepatology Ziekenhuis Oost Limburg Genk Belgium Department of Psychiatry Ziekenhuis Oost Limburg Genk Belgium Laboratory of Clinical and Epidemiological Virology Department of Microbiology and Immunology Rega Institute and University Hospitals Katholieke Universiteit Leuven Leuven Belgium Department of General Practice Katholieke Universiteit Leuven Leuven Belgium and Department of General Practice Maastricht University The Netherlands

During treatment of chronic hepatitis C patients with interferon and ribavirin, a lot of side effects are described. Twenty-three percent to 44% of patients develop depression. A minority of patients evolve to psychosis. To the best of our knowledge, no cases of psychogenic parasitosis occurring during interferon therapy have been described in the literature. We present a 49-year-old woman who developed a delusional parasitosis during treatment with pegylated interferon alpha-2b weekly and ribavirin. She complained of seeing parasites and the larvae of fleas in her stools. This could not be confirmed by any technical examination. All the complaints disappeared after stopping pegylated interferon alpha-2b and reappeared after restarting it. She had a complete sustained viral response.

关键词： Interferons Ribavirin Hepatitis C Chronic Parasitology Delusions

Chronic total occlusions for intermediate volume operators: An antegrade step-up algorithm allows high success in easy and intermediate difficult CTO lesions

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Cardiovascular Diseases 2013年第9期3卷 536-542页

作者： Joren Maeremans Philippe Selleslagh Luigi Di Serafino Emanuele Barbato Joseph Dens Department of Cardiology Onze-Lieve-Vrouw Ziekenhuis Aalst Belgium Department of Cardiology Ziekenhuis Oost-Limburg Genk Belgium Faculty of Medicine and Life Sciences Hasselt University Diepenbeek Belgium

To improve the success rates of chronic total occlusion (CTO) intervention, a large range of CTO-dedicated guidewires (GWs), devices and techniques have been developed. However, such an abundant choice of materials confuses inexperienced operators. Therefore, the usefulness of a simple antegrade treatment algorithm with a limited set of GWs, for easy to intermediate lesions, was investigated. Between November 2011 and March 2013, 105 patients were included, who underwent CTO PCI following the algorithm. Lesions were classified according to the Multicenter CTO Registry of Japan score. Overall technical success was achieved in 77%. Study endpoint was successful GW crossing within 30 min and was reached in 57%. High success rates were achieved in easy (81%) and intermediate (64%) lesion types. In both types, a soft wire could successfully cross in 57% and 51% respectively, with the Fielder XT®?(Asahi Intecc Co.) capable of crossing most commonly (90%). The proposed treatment algorithm simplifies the percutaneous treatment of easy to intermediate CTO lesions. However, it merits further evaluation, especially for operators/centers who perform a low to intermediate amount of CTO PCI.

关键词： Percutaneous Coronary Intervention Chronic Total Occlusion Interventional Cardiology Coronary Angioplasty Guidewires

Acute heart failure in elderly patients:a review of invasive and non-invasive management

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2021年第7期18卷 560-576页

作者： Gregorio Tersalvi Alessio Gasperetti Marco Schiavone Jeroen Dauw Cecilia Gobbi Marialessia Denora Joel Daniel Krul Giacomo Maria Cioffi Gianfranco Mitacchione Giovanni B.Forleo Department of Internal Medicine Hirslanden Klinik St.AnnaLucerneSwitzerland Cardiology Unit ASST-Fatebenefratelli SaccoLuigi Sacco University HospitalMilanItaly Department of Cardiology Ziekenhuis Oost-LimburgGenkBelgium Doctoral School for Medicine and Life Sciences Hasselt UniversityDiepenbeekBelgium Institut Cardiovasculaire de Caen Hôpital PrivéSaint MartinCaenFrance Division of Cardiology Fondazione Cardiocentro TicinoLuganoSwitzerland Division of Cardiology Heart CenterLuzerner KantonsspitalLucerneSwitzerland

Acute heart failure(AHF)is a major cause of unplanned hospitalisations in the elderly and is associated with high *** prevalence has grown in the last years due to population aging and longer life expectancy of chronic heart failure *** international societies have provided guidelines for the management of AHF in the general population,scientific evidence for geriatric patients is often lacking,as these are underrepresented in clinical *** have a different risk profile with more comorbidities,disability,and frailty,leading to increased morbidity,longer recovery time,higher readmission rates,and higher ***,therapeutic options are often limited,due to unfeasibility of invasive strategies,mechanical circulatory support and cardiac ***,the in-hospital management of AHF should be tailored to each patient's clinical situation,cardiopulmonary condition and geriatric *** care should be considered in some cases,in order to avoid unnecessary diagnostics and/or *** discharge,a strict follow-up through outpatient clinic or telemedicine is can improve quality of life and reduce rehospitalisation *** aim of this review is to offer an insight on current literature and provide a clinically oriented,patient-tailored approach regarding assessment,treatment and follow-up of elderly patients admitted for AHF.

关键词： patients mortality invasive

Early prediction of major depression in chronic hepatitis C patients during peg-interferon α-2b treatment by assessment of vegetative-depressive symptoms after four weeks

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第43期13卷 5736-5740页

作者： Geert Robaeys Jozef De Bie Marieke C Wichers Liesbeth Bruckers Frederik Nevens Peter Michielsen Marc Van Ranst Frank Buntinx Department of Gastroenterology and Hepatology Ziekenhuis Oost Limburg Genk Belgium Department of Psychiatry Ziekenhuis Oost Limburg Genk Belgium Department of Psychiatry and Neuro-psychiatry South Limburg Mental Health Research and Teaching Network EURON Maastricht University Maastricht The Netherlands Center for Statistics Limburgs Universitair Centrum Diepenbeek Belgium Department of Hepatology Katholieke Universiteit Leuven Leuven Belgium Division of Gastroenterology and Hepatology University Hospital Antwerp Belgium Laboratory of Clinical and Epidemiological Virology Department of Microbiology and Immunology Rega Institute and University Hospitals Katholieke Universiteit Leuven Leuven Belgium Department of General Practice Katholieke Universiteit Leuven Leuven Belgium and Department of General Practice Maastricht University The Netherlands

AIM: To study the predictive value of the vegetative- depressive symptoms of the Zung Depression Rating Scale for the occurrence of depression during treatment with peg-interferon α-2b of chronic hepatitis C (CHC) patients. METHODS: The predictive value of vegetative- depressive symptoms at 4 wk of treatment for the occurrence of a subsequent diagnosis of major depressive disorder (MDD) was studied in CHC patients infected after substance use in a prospective, multi- center treatment trial in Belgium. The presence of vegetative-depressive symptoms was assessed using the Zung Scale before and 4 wk after the start of antiviral treatment. RESULTS: Out of 49 eligible patients, 19 (39%) developed MDD. The area under the ROC curve of the vegetative Zung subscale was 0.73, P = 0.004. The sensitivity at a cut-point of > 15/35 was 95% (95% CI: 74-100). The positive predictive value equalled 44% (95% CI: 29-60). CONCLUSION: In this group of Belgian CHC patients infected after substance use, antiviral treatment caused a considerable risk of depression. Seven vegetativedepressive symptoms of the Zung scale at wk 4 of treatment predicted 95% of all emerging depressions, at a price of 56% false positive test results.

关键词： Interferons Hepatitis C Chronic Substance-related disorders Depression Zung self rating scale Prognosis

Pharmacology of cancer chemotherapy drugs for hyperthermic intraperitoneal peroperative chemotherapy in epithelial ovarian cancer

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Obstetrics and Gynecology 2013年第4期2卷 143-152页

作者： Kurt Van der Speeten Anthony O Stuart Paul H Sugarbaker Department of Surgical Oncology Ziekenhuis Oost-Limburg 3600 Genk Belgium University Hasselt Life Sciences Faculty Oncology Research Cluster 3000 Hasselt Belgium Washington Cancer Institute Washington Hospital Center Washington DC 20010United States

The peritoneal parietal and visceral surfaces of the abdomen and pelvis are an important anatomic site for the dissemination of epithelial ovarian cancer(EOC). The transcoelomic spread of cancer cells gives rise to peritoneal carcinomatosis(PC) which, without special treatments, is a fatal manifestation of EOC. In order to control PC cytoreductive surgery to remove macroscopic disease is combined with perioperative intraperitoneal(IP) and perioperative intravenous chemotherapy to eradicate microscopic residual disease. Chemotherapy agents are selected to be administered by the IP or intravenous route based on their pharmacologic properties. A peritoneal-plasma barrier which retards the clearance of high molecular weight chemotherapy from the peritoneal cavity results in a large exposure of small cancer nodules on abdominal and pelvic surfaces. Tissue penetration is facilitated by moderate hyperthermia(41-42 ℃) of the IP chemotherapy solution. Timing of the chemotherapy as a planned part of the surgical procedure to maximize expo-sure of all peritoneal surfaces is crucial to success.

关键词： Intraperitoneal chemotherapy Epithelial ovarian cancer Ifosfamide Cisplatin Carboplatin Taxanes Pharmacokinetics Pharmacodynamics