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J Wind

Publications and source records attributed to J Wind.

At least 19 recordsLinked to original sources
PubMed2006

A systematic review on the significance of extracapsular lymph node involvement in gastrointestinal malignancies.

AIMS: The impact of extracapsular lymph node involvement (LNI) has been studied for several malignancies, including gastrointestinal malignancies. Aim of this study was to assess the current evidence on extracapsular LNI as a prognostic factor for recurrence in gastrointestinal malignancies. METHODS: The Cochrane Database of systematic reviews, the Cochrane central register of controlled trials, and MEDLINE databases were searched using a combination of keywords relating to extracapsular LNI in gastrointestinal malignancies. Primary outcome parameters were incidence of extracapsular LNI and overall five-year survival rates. FINDINGS: Fourteen manuscripts were included, concerning seven oesophageal, three gastric, one colorectal, and three rectal cancer series with a total of 1528 node positive patients. The pooled incidence of extracapsular LNI was 57% (95% CI: 53-61%) for oesophageal cancer, 41% (95% CI: 36-47%) for gastric cancer, and 35% (95% CI: 31-40%) for rectal cancer. In nine of the 14 studies a multivariate analysis was performed. In eight of these nine studies extracapsular LNI was identified as an independent risk factor for recurrence. CONCLUSION: Extracapsular LNI is a common phenomenon in patients with gastrointestinal malignancies. It identifies a subgroup of patients with a significantly worse long-term survival. This systematic review highlights the importance of assessing extracapsular LNI as a valuable prognostic factor. Pathologists and clinicians should be aware of this important feature.

Chi-Square Distribution↗
PubMed2006

[Elective colon surgery according to a 'fast-track' programme].

In fast-track surgical programmes, a variety ofperioperative elements are combined in an intensive multidisciplinary approach for the purpose of preserving the preoperative body composition and organ functions and actively stimulating functional recovery. Such programmes have already been introduced in several surgical procedures. The essence of fast-track colon surgery consists of extensive preoperative counselling, adequate preoperative nutrition with the avoidance of prolonged fasting, a minimum of invasive procedures and anaesthesia, no routine use of drains and nasogastric tubes, adequate perioperative analgesia encompassing high thoracic epidural anaesthesia, rapid mobilisation, rapid resumption of postoperative feeding, and medicinal support with prokinetics and laxatives. A systematic review shows that this programme accelerates recovery and hence shortens the primary and total hospital stay.

Colectomy↗
PubMed2006

Systematic review of enhanced recovery programmes in colonic surgery.

BACKGROUND: Fast track (FT) programmes optimize perioperative care in an attempt to accelerate recovery, reduce morbidity and shorten hospital stay. The aim of this review was to assess FT programmes for elective segmental colonic resections. METHODS: A systematic review was performed of all randomized controlled trials and controlled clinical trials on FT colonic surgery. The main endpoints were number of applied FT elements, hospital stay, readmission rate, morbidity and mortality. Quality assessment and data extraction were performed independently by three observers. RESULTS: Six papers were eligible for analysis (three randomized controlled and three controlled clinical trials), including 512 patients. FT programmes contained a mean of nine (range four to 12) of the 17 FT elements as defined in the literature. Primary hospital stay (weighted mean difference - 1.56 days, 95 per cent confidence interval (c.i.) - 2.61 to - 0.50 days) and morbidity (relative risk 0.54, 95 per cent c.i. 0.42 to 0.69) were significantly lower for FT programmes. Readmission rates were not significantly different (relative risk 1.17, 95 per cent c.i. 0.73 to 1.86). No increase in mortality was found. CONCLUSIONS: FT appears to be safe and shortens hospital stay after elective colorectal surgery. However, as the evidence is limited, a multicentre randomized trial seems justified.

Aged↗
PubMed2002

[Acute respiratory distress syndrome more frequently diagnosed in intensive care patients in the Netherlands than would occur according to internationally established criteria].

OBJECTIVE: To determine the agreement of the diagnosis 'acute respiratory distress syndrome' (ARDS) established by intensive care (IC) specialists, with that according to internationally accepted objective criteria. DESIGN: Descriptive inventory. METHOD: All 119 hospitals in the Netherlands with an IC department were asked to participate; 34 did (29%). On 3 consecutive days, IC specialists completed a case-record form concerning the respiratory status and additional treatment of all of their patients. In the case of mechanical ventilation, the specialist could indicate whether ARDS or another condition was the cause of the respiratory insufficiency. In addition to this, objective data were requested so that the investigators could establish whether there was ARDS on the basis of the North American-European Consensus Conference (NAECC) criteria and the less generally accepted 'Lung injury score' (LIS > or = 2.5). RESULTS: Of the 266 patients about whom a case record form was returned, 151 were mechanically ventilated. ARDS was diagnosed in 36 of these patients according to the IC specialists, in 24 according to the NAECC and in 20 according to the LIS criteria (p < 0.05 versus IC specialists). The chance-corrected agreement (kappa) between the diagnoses by IC specialists and the NAECC criteria was 0.34 (p < 0.001) and between the IC specialists and the LIS 0.44 (p < 0.001). The kappa between the NAECC and the LIS diagnoses was 0.42 (p < 0.001). Using NAECC and/or LIS criteria as the golden standard, a correct ARDS diagnosis was made by the IC specialists in the case of 20 patients, a false-positive diagnosis in the case of 16 patients and a false-negative diagnosis in the case of 13 patients. CONCLUSION: In this investigation, the diagnosis of ARDS was more frequently established than would occur according to the NAECC criteria.

APACHE↗
PubMed2000

What kind of patients and physicians value direct-to-consumer advertising of prescription drugs.

Direct-to-consumer (DTC) advertising of prescription drugs can enhance the physician-patient relationship, as well as benefiting its sponsor. However, overall benefits can only occur if the patients value the information enough to discuss it with their physicians and the physicians are not predisposed against the DTC information. We investigate the impact of demographics and exposure to marketing on consumers' and physicians' receptiveness to DTC advertising of prescription drugs, using data from two nationwide surveys. We find that consumers who have an ongoing need for health care, that is, those with children or with a chronic condition requiring medication, value prescription drug advertising more highly, while older consumers, consumers who have been sick recently, or more educated consumers are more likely to trust their physicians instead. We find that more experienced physicians, physicians who see more patients, or those who have more exposure to pharmaceutical advertisements are more accepting of DTC advertising of prescription drugs.

Advertising↗
PubMed1985

Ring-like perilimbic pigment deposits in dark-skinned children. An oculo-aural syndrome?

A description is given of a perilimbic ring-like pigment deposit which the author found in East Africa. It appears that the rings were more frequently present among deaf than among non-deaf children in Tanzania and Kenya, and in both more frequently in these countries than in Ethiopia, Florida, India, Malawi and South Africa. In the absence of a satisfactory explanation being found in the previous literature, it is hypothesized, on the basis of data gathered in 1748 children, that the occurrence of the rings is negatively correlated with the level of the regions' general health conditions as well as with an unfavourable individual case history, and positively with a genetically determined pigment proneness and the individual's age.

Adolescent↗