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3. Breakthrough cancer pain: An observational study of 1000 european oncology patients

Author

Davies, A. Buchanan, A. Zeppetella, G. Porta-Sales, J. Likar, R. Weismayr, W. Slama, O. Korhonen, T. Filbet, M. Poulain, P. Mystakidou, K. Ardavanis, A. O'Brien, T. Wilkinson, P. Caraceni, A. Zucco, F. Zuurmond, W. Andersen, S. Damkier, A. Vejlgaard, T. Nauck, F. Radbruch, L. Sjolund, K.-F. Stenberg, M.

Abstract

Context: Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients. Objectives: The aim of this study was to characterize breakthrough pain in a diverse population of cancer patients. Methods: The study involved 1000 cancer patients from 13 European countries. Patients were screened for breakthrough pain using a recommended diagnostic algorithm and then questioned about the characteristics and management of their pain. Results: Of the 1000 patients, 44% reported incident pain, 41.5% spontaneous pain, and 14.5% a combination. The median number of episodes was three a day. The median time to peak intensity was 10 minutes, with the median for patients with incident pain being five minutes (P < 0.001). The median duration of untreated episodes was 60 minutes, with the median for patients with incident pain being 45 minutes (P = 0.001). Eight hundred six patients stated that pain stopped them doing something, 66 that it sometimes stopped them doing something, and only 107 that it did not interfere with their activities. Patients with incident pain reported more interference with walking ability and normal work, whereas patients with spontaneous pain reported more interference with mood and sleep. As well, 65.5% of patients could identify an intervention that improved their pain (29.5%, pharmacological; 23%, nonpharmacological; 12%, combination). Regarding medications, 980 patients were receiving an opioid to treat their pain, although only 191 patients were receiving a transmucosal fentanyl product licensed for the treatment of breakthrough pain. Conclusion: Breakthrough cancer pain is an extremely heterogeneous condition. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Published
2013

4. Nutritional aspects in patients with functional gastrointestinal disorders and motor dysfunction in the gut Working team report of the Swedish Motility Group (SMoG)

Author

Simren, M., Abrahamsson, H., Bosaeus, I., Brummer, R.J., Dolk, A., Lindberg, G., Nyhlin, H., Ohlsson, B., Sjolund, K., Tornblom, H., Interne Geneeskunde, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, and RS: NUTRIM - R2 - Gut-liver homeostasis

Abstract

In reviews regarding the management of patients with functional gastrointestinal disorders and motility disturbances within the gut nutritional aspects and dietary advice is often put forward as being of great importance. However, there are relatively few high-quality, interventional studies in the literature supporting an important role for general dietary advice to improve symptoms in these patients. Nutritional supplementation to patients with malnutrition due to severe dysfunction of the gastrointestinal tract is of course less controversial, even though different views on how this should be performed exist. The content of this article is based on presentations given by the authors during the second meeting of the Swedish Motility Group held in Gothenburg in March 2005, and aims to give an overview on the role of dietary advice and nutritional supplementation to patients with gastrointestinal dysfunction of different severity.

Published
2007

10. Effects of anti-secretory factor (ASF) on irritable bowel syndrome (IBS): a double-blind, randomized study.

Author

Ekesbo R, Nilsson PM, and Sjolund K

Abstract

Objective. To evaluate the role of the endogenous protein anti-secretory factor (ASF) on the symptoms, especially loose stools, in irritable bowel ayndrome (IBS). Design. A diet with specially processed cereals (SPC) known to induce ASF production was used in patients with IBS, in an eight-week randomized, placebo-controlled study. Subjects. Eighty-two patients with IBS were randomized to a diet with either SPC or placebo. Main outcome measures. The overall clinical condition and the quality of life were measured by VAS and SF-36 questionnaire, respectively. The plasma levels of ASF were determined in 14 patients with dominating loose stools before and after diet. Results. All patients significantly (p<0.001) improved in IBS-related symptoms irrespective of active or placebo diet. In an active-diet sub-group with diarrhoea (n=11) there was a significant (p<0.05) correlation between the increase of plasma ASF level and the improvement on the VAS. Conclusion. Both study groups improved significantly on the VAS but no additive effect was seen for the active treatment. In the sub-group with loose stools, the SPC diet induced ASF plasma levels in IBS patients and was correlated to significant symptom improvement in the individual patient. [ABSTRACT FROM AUTHOR]

Published
2008
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14. Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report

Author

Malfertheiner, P., Megraud, F., Omorain, C., Bell, D., Bianchi, Pg, Deltenre, M., Forman, D., Gasbarrini, G., Jaup, B., Misiewicz, G., Pajares, J., Quina, M., Rauws, E., Andersen, L., Arenas, Mi, Bazzoli, F., Berstad, A., Bianchi, P., Birkner, B., Brun, J., Buckley, M., Jan Bures, Butruk, E., Cadranel, S., Casas, Rj, Caspary, F., Cottrill, M., Culhane, A., Dekoster, E., Dite, P., Farkkila, M., Fujioka, T., Fukuda, T., Glupczynski, Y., Hirschl, A., Hunt, R., Johannessen, T., Krejs, G., Labenz, J., Lamers, C., Lind, T., Mccoll, K., Nuesch, H., Odonoghue, D., Offer, G., Peura, D., Pombal, R., Pounder, R., Pretolani, P., Rokkas, T., Romaozinho, J., Rune, S., Sandelowsky, H., Seifert, B., Shimoyama, T., Sjolund, K., Stockbrugger, R., Thomson, A., Ubaldi, E., Unge, P., Vancutsem, E., Wadstrom, T., Weber, J., Sipponen, P., and Price, A.

18. Inflammation as a cause of functional bowel disorders

Author

Hans Törnblom, Hasse Abrahamsson, Giovanni Barbara, Per M Hellström, Greger Lindberg, Henry Nyhlin, Bodil Ohlsson, Magnus Simrèn, Kristina Sjölund, Henrik Sjövall, Peter Thelin Schmidt, Lena Öhman, THE SWEDISH MOTILITY GROUP, Tornblom H, Abrahamsson H, Barbara G, Hellstrom PM, Lindberg G, Nyhlin H, Ohlsson B, Simren M, Sjolund K, Sjovall H, Schmidt PT, Ohman L, and SWEDISH MOTILITY GROUP

Subjects
Intestinal pseudo-obstruction, medicine.medical_specialty, business.industry, Visceral Afferents, Intestinal Pseudo-Obstruction, Neuropeptides, Gastroenterology, Inflammatory Bowel Diseases, Inflammation, medicine.disease, Pathophysiology, Visceral afferent, Irritable Bowel Syndrome, Internal medicine, Medicine, Animals, Humans, medicine.symptom, business, Gastrointestinal Motility, Irritable bowel syndrome
Published
2005

19. Chronic atrophic fundic gastritis diagnosed by a modified Congo red test.

Author

Toth E, Sjolund K, Fork FT, and Lindstrom C

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Female, Gastric Fundus, Gastritis, Atrophic pathology, Gastroscopes, Humans, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, Video Recording, Congo Red, Gastritis, Atrophic diagnosis, Gastroscopy methods
Abstract

Background and Study Aims: Chronic atrophic fundic gastritis (CAFG) is associated with several diseases, such as gastric cancer, gastric ulcer, pernicious anemia, and bacterial overgrowth. In spite of recent technical improvements, the gastroscopic diagnosis of CAFG remains uncertain. Congo red chromogastroscopy is capable of visualizing acid-producing normal fundic mucosa, but has hitherto not been suitable for routine use. The aim of our study was to establish a reliable endoscopic technique with which to diagnose CAFG., Patients and Methods: This prospective study comprises 124 consecutive patients (71 women, 53 min) with a mean age of 65 years (range 36-92). Macroscopic evaluation of the gastric fundic mucosa in routine endoscopy using video techniques was compared with evaluation by means of a modified endoscopic Congo red test (MCRT). In routine gastroscopy, CAFG was recognized by the thin, friable mucosa, with a marked visible vascular pattern and fold atrophy. With MCRT, the diagnosis of CAFG was made within five minutes' observation when no red-to-blue color shift in the fundic mucosa could be induced by 0.2 mu g/kg intravenous pentagastrin. The results were then compared with the histological examination of biopsies from the fundic mucosa., Results: CAFG was confirmed by histology in 40 of 124 cases. The diagnostic sensitivity of MCRT was 1.0 (40/40), with a positive predictive value of 0.90, whereas the values for macroscopic gastroscopic evaluation were 0.25 (10/40) and 0.50, respectively., Conclusions: We conclude that MCRT is a sensitive, fast, and cost-effective method of identifying patients with CAFG, and well suited for use in routine gastroscopy.

Published
1995

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