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Biomedical subjects

L Räf

Publications and source records attributed to L Räf.

At least 55 records · Page 3Linked to original sources
PubMed1985

Ulceration of the small intestine due to slow-release potassium chloride tablets.

A retrospective study at surgical clinics in Stockholm County disclosed 22 cases of small-bowel ulceration in which a connection with use of slow-release potassium chloride tablets was probable. Most ulcers had caused stenosis of 1-2 cm of gut, and in four of these cases there was also perforation of the bowel wall. Five patients had perforation without signs of stenosis. The pathology of the ulcers was similar to that described after use of enteric-coated potassium chloride tablets. Since 1970 the frequency of potassium-induced ulceration has been low--3 cases per 100 000 patient-years of slow-release tablet use. On the other hand, this complication of drug therapy can be serious--the mortality in the present series was 27%. Other types of potassium chloride preparations should therefore be tested. Microencapsulated potassium chloride tablets have been reported to be less irritating to the gastrointestinal tract.

Aged↗
PubMed1984

Nontraumatic perforation of the small intestine.

Nontraumatic perforation of the small intestine is very rare in western countries, while typhoid fever is the most common cause of such perforation in other parts of the world. A series spanning 24 years is reviewed, comprising 112 adults with perforation of the small intestine resulting in peritonitis. Perforations due to Crohn's disease, strangulation, postoperative complications and malignancy are not included. Causes of perforation were ingested foreign body (24 cases), radiotherapy (18), potassium chloride medication (13), diverticula of the small bowel (10), Zollinger-Ellison syndrome (2), and tuberculosis, actinomycosis and intrauterine contraceptive device (each in 1 case). The etiology could only be suspected in 13 cases and in 31 it was unknown. Difficulties in making the preoperative diagnosis contributed to lateness of surgical intervention. Mortality (23%) was related to patient age and cause of the perforation. The series permitted no conclusions concerning relationship between surgical method and mortality rate, but it is recommended that the method be adapted from case to case, depending on the etiology of the perforation.

Adult↗
PubMed1978

Preoperative radiotherapy in operable breast cancer: results in the Stockholm Breast Cancer Trial.

A randomized trial of preoperative radiotherapy in operable breast cancer was conducted from 1971 to 1976. The diagnosis was established by fine-needle aspiration biopsy. A dose of 4500 rad over five weeks was given to the chest wall, the breast and the lymph nodes of the axilla, the supraclavicular fossa and the internal mammary chain. Modified radical mastectomy was performed six weeks or more after completed radiotherapy. In control patients the same operation was performed without prior radiotherapy. By random allocation, one control group received no further treatment and postoperative irradiation was given to the other controls. Preoperative radiotherapy reduced the incidence of local and regional recurrence and of distant metastases, and also the mortality, as compared with the surgery only group. Postoperative radiotherapy as given in this trial gave almost equal reduction of local and regional recurrence but did not diminish the frequency of distant metastases or the mortality.

Adult↗