Search PubMed⌕ Search

Biomedical subjects

A Gad

Publications and source records attributed to A Gad.

At least 55 records · Page 3Linked to original sources
PubMed1991

Breast screening, prognostic factors and survival--results from the Swedish two county study.

The results of the Swedish two-county study are analysed with respect to tumour size, nodal status and malignancy grade, and the relationship of these prognostic factors to screening and to survival. It is shown that these factors can account for much of the differences in survival between incidence screen detected, interval and control group cancers but to a lesser extent for cancers detected at the prevalence screen where length bias is greatest. Furthermore, examination of the relationships among the prognostic factors and mode of detection indicates that malignancy grade, as a measure of inherent malignant capacity, evolves as a tumour grows. The proportion of cancers with poor malignancy grade is several fold lower for cancers of diameter less than 15 cm than for cancers greater than 30 cm, independent of the length bias of screening. The implications of these findings for screening frequency are briefly discussed.

Adult↗
PubMed1989

The diagnosis of gastroduodenal Crohn's disease by endoscopic biopsy.

Forceps endoscopic biopsy under direct vision is a useful tool in the diagnosis of gastroduodenal Crohn's disease. The presence of the characteristic microgranuloma is conclusive for diagnosis and was found in 33.3% of the cases. Biopsies should be taken from endoscopically pathologic and normal mucosa. The value of repeated endoscopic biopsy and serial sections in increasing the yield of granuloma is still uncertain. In the absence of granuloma the constellation of histopathologic changes such as mucosal oedema, inflammation, crypt abscess, erosion, ulceration, attenuated deformed duodenal villi and lymphangiectasia should be consistent with the diagnosis of Crohn's disease.

Adolescent↗
PubMed1989

Campylobacter pylori and non-ulcer dyspepsia. 1. The final results of a double-blind multicentre trial for treatment with pirenzepine in Italy.

In a double-blind multicentre trial to study the effect of pirenzepine in the treatment of non-ulcer dyspepsia, 104 of 128 patients, 52 in each of the study and control groups, completed the 4 weeks of the investigation. There was improvement of the endoscopic and clinical findings but no change of the degree of the mucosal inflammation or the extent of colonisation by campylobacter pylori. The mode of action of pirenzepine in patients with non-ulcer dyspepsia associated with campylobacter related gastroduodenitis remains obscure. Further studies are needed to investigate the possibility of a causal relationship between mucosal colonisation with campylobacter pylori and gastroduodenitis specially in cases of non-ulcer dyspepsia.

Adult↗
PubMed1989

Campylobacter pylori and non-ulcer dyspepsia. 2. A prospective study in a Swedish population.

In a consecutive prospective series of 186 Swedish persons with the diagnosis of non-ulcer dyspepsia 71.5% were found to have gastritis and/or bulbar duodenitis in endoscopic biopsies. Gastroduodenitis was associated with campylobacter pylori (CP) in 83.5% of the cases. The double therapeutic approach using an antibiotic and a preparation containing bismuth in an uncontrolled therapeutic pilot trial resulted in improvement of the histological picture, disappearance of CP and amelioration of symptoms. It is concluded that CP-infection plays a central role in the pathogenesis of gastroduodenitis associated NUD.

Adult↗
PubMed1989

Does omeprazole improve antimicrobial therapy directed towards gastric Campylobacter pylori in patients with antral gastritis? A pilot study.

This double-blind pilot study has been undertaken in order to investigate the effect of amoxicillin and pronounced suppression of gastric acid secretion on mucosal colonisation with Campylobacter pylori (CP). Twenty four CP-positive patients were included in the study and assigned to 14 days of treatment in either one of the following three therapy groups: Group 1: Omeprazole 40 mg o.m. + Amoxicillin 750 mg b.i.d (9 pat); Group 2: Omeprazole 40 mg o.m. (8 pat); Group 3: Amoxicillin 750 mg b.i.d (7 pat). Gastroscopy with biopsy for culture and histology was performed pre-entry, at cessation of therapy and four weeks later. In the group receiving omeprazole and amoxicillin in combination 5 out of 8 patients were negative for CP four weeks after stopping treatment, while in the amoxicillin and the omeprazole groups respectively one (1/7) and none (0/8) were negative. Except for one patient who was withdrawn because of severe diarrhoea, only minor adverse effects occurred.

Adult↗
PubMed1989

Campylobacter pylori and gastroduodenal ulcer disease. A prospective study in a Swedish population.

In a consecutive prospective series of 208 Swedish primary peptic ulcer patients, 146 gastric, 55 duodenal and 7 in both sites, gastroduodenitis was found in 97.6% of the cases. The mucosal inflammation was associated with CP in 87% and 91% of the gastric and duodenal ulcer cases respectively. No significant correlation was found between CP colonisation and the type or severity of mucosal inflammation. Gastric metaplasia was present in only 8% of 48 bulbar ulcer cases. Ulcer healing and eradication of CP was achieved in 52% of patients treated with bismuth subnitrate in combination with erythromycin or according to the triple approach.

Adult↗
PubMed1989

Aortoduodenal fistula revisited.

Two new cases of primary aortoduodenal fistula (ADF), one associated with an arteriosclerotic aneurysm and the other without, are presented and 4 cases of primary ADF without aneurysm published between 1972 and 1985 are reviewed. The anatomic relationship of the distal part of the duodenum to the infrarenal segment of the aorta, arteriosclerosis, mechanical trauma, infection and sepsis are prominent factors in the pathogenesis of ADF irrespective of its type. Intermittent haematemesis and/or melaena are the main presenting symptoms in all variants of ADF and awareness of the existence of this condition is essential for its early detection. Upper gastrointestinal endoscopy including examination of the distal part of the duodenum and explorative laparotomy are important tools in the preoperative diagnostic workup specially in primary ADF without previous knowledge of the presence of an aneurysm.

Aged↗
PubMed1989

Rapid diagnosis of Campylobacter pylori by brush cytology.

Campylobacter pylori (CP) was demonstrated in 67.2% of 67 patients using cytology as compared to 65.7% by histology. Brush cytology is thus found to be superior to all other methods available to date for the detection of CP. It is rapid, simple, and has a high specificity.

Adult↗
PubMed1987

Conservative management of the abnormal smear during pregnancy. A long-term follow-up.

One hundred and thirty-two pregnant women who had a smear suggestive of cervical intra-epithelial neoplasia (CIN) II or more during the 10th to 12th gestational week, were followed with repeated smears and colposcopy every month and, when indicated, a colposcopically guided biopsy. Post-partum follow-up included cytology, colposcopy, portio biopsies and endocervical curettage. Seventy-nine women with normal findings post partum were checked once a year in a long-term study. A close correlation (71% of CINIII) was found between cytological and histological diagnoses in cases of persistent (three or more) abnormal smears. However, in women with regression of the cytological diagnosis, high frequencies of histologically verified CIN were found. Thus, 37.5% (18/48) of normal or CINI smears were histologically still CINIII. Histologically verified CIN during pregnancy, on the other hand, showed a post partum progression of two degrees or more of CIN in only two cases. Cytology seemed to be inappropriate post partum, with 23.3% smears which were normal or suggestive of CINI, when histology showed CINIII. In a long-term follow-up, 24% of women with a normal post partum follow-up for at least one year had a subsequent recurrence of CIN. It is concluded that follow-up of abnormal smears during pregnancy with repeated smears is not a reliable method. Post-partum follow-up should include at least colposcopy and a biopsy when indicated by the colposcopical examination. Women with a normal post partum follow-up constitute a high risk group for future recurrence of CIN and should be carefully followed for at least 5 years.

Adult↗
PubMed1986

Erosion: a correlative endoscopic histopathologic multicenter study.

This multicenter study was conducted in 6 gastroenterology units, two each in Germany and Italy and one each in Sweden and Czechoslovakia. The diagnosis of erosion was made on endoscopic examination of 166 patients presenting with symptoms of upper gastrointestinal disease. Only 78 out of 172 (42%) lesions diagnosed endoscopically as gastroduodenal erosions were confirmed as such histologically. The discrepancy between the endoscopic and histologic diagnosis varied from one centre to another, and ranged from 15 to 100%. The lack of agreement between the endoscopic and morphologic diagnosis in 94 biopsies (55%) is attributed to such histopathological changes as: foci of acute gastritis with or without mucopurulent surface exudate, small islands of intestinal metaplasia, subepithelial stromal capillary hyperemia, pseudovillous formations of the surface epithelium, microcarcinoid tumor and lipid islands. It is recommended that the term erosion should be reserved for histologically verified lesions, and the need for a descriptive endoscopic terminology is emphasized.

Adolescent↗
PubMed1985

Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare.

A randomised controlled trial to investigate the efficacy of mass screening with single-view mammography in reducing mortality from breast cancer was started in Sweden in 1977. 162 981 women aged 40 years or more and living in the counties of Kopparberg and Ostergötland were enrolled in the study and divided at random into 2 groups. Each woman in the study group was offered screening every 2 or 3 years depending on age. Women in the control group were not offered screening. This report is confined to the 134 867 women aged 40-74 years at date of entry. The results to the end of 1984 show a 31% reduction in mortality from breast cancer and a 25% reduction in the rate of stage II or more advanced breast cancers in the group invited to screening. 7 years after the start of the study the excess of stage I cancers in the study group largely outweighs the deficit of advanced cancers.

Aged↗
PubMed1985

Significant reduction in advanced breast cancer. Results of the first seven years of mammography screening in Kopparberg, Sweden.

A population-based, randomized, controlled breast cancer screening trial with single-view mammography as the only means of primary detection has been under way in Kopparberg county, Sweden, since October 1977. The 7-year results of the study show (1) a significant change in the stage distribution of breast cancers in the cohort invited to undergo screening (ASP) as compared to the control group. (2) This change is seen as an initial decrease in the proportion of advanced (stage II and more advanced) cancers in the ASP as compared to the control population, followed in the second and third round of screening by a significant decrease in the absolute number of these advanced cancers in the ASP relative to the control group. (3) A thorough follow-up of both populations will answer whether these preliminary findings will result in decreased breast cancer mortality in the population invited to screening.

Adult↗
PubMed1984

Screening for breast cancer in Europe: achievements, problems, and future.

Several breast cancer screening programmes are being carried out in Europe. Clinical examination in combination with mammography is the screening method used in Guildford and Edinburgh (United Kingdom) as well as in Utrecht (Netherlands). Mammography is the only screening modality in the Swedish programmes of Falun (Kopparberg County), Linköping (Ostergötland county), and Malmö and in Nijmegen (Netherlands). Clinical examination is the initial screening method in Turku (Finland). The Swedish programmes are population-based, controlled, and randomised. They are designed to assess the impact of screening on the mortality of breast carcinoma. Comparing the results of all the European screening programmes is expected to give some answers to the hitherto unanswered questions concerning the screening method and ideal interval in different age groups. The results achieved so far indicate that although mammography is a sensitive method for the detection of early breast cancer, clinical examination and an aggressive biopsy policy may be necessary to reduce mortality from breast cancer in certain age groups. It is also evident that there is no universally applicable ideal screening method or rescreening interval for all age groups.

Adult↗