Læknaneminn


Læknaneminn - 01.04.2016, Qupperneq 32

Læknaneminn - 01.04.2016, Qupperneq 32
Ri trý nt e fn i 32 hjá samsvarandi þýði (e. matched population) og hefur haldist nokkuð stöðug undanfarna áratugi þrátt fyrir talsverða framþróun í aðgerðartækni47,63. Aðeins 10-18% sjúklinga lifa af rof á ósæð. Aðrir deyja ýmist samstundis, í flutningi, fyrir aðgerð, í aðgerð eða innan 30 daga eftir aðgerð5,7,64,65. Lokaorð Ósæðargúll í kviðarholi er lífshættulegur sjúkdómur og vegur rof þungt sem orsök dauðsfalla á Vesturlöndum, sér í lagi hjá eldri karlmönnum. Því er til mikils að vinna að draga úr breytanlegum áhættuþáttum ósæðargúla, einkum reykingum sem auka algengi sjúkdómsins, rofhættu og minnka lífslíkur í kjölfar aðgerðar. Undanfarna áratugi hefur verið mikil framþróun í greiningu og meðferð og hafa rannsóknir stutt ávinning af skimun áhættuhópa. Auk þess hefur ósæðarfóðring komið fram á sjónarsviðið sem góð viðbót við meðferðarúrræði. Mikilvægt er að læknar og annað heilbrigðisstarfsfólk muni eftir einkennagefandi ósæðargúlum sem mismunagreiningu kviðverks enda geta afleiðingar rofs verið voveiflegar. Sérstakar þakkir fá Kristbjörn Reynisson og Áskell Löve röntgenlæknar. Fengið var upplýst, skriflegt samþykki sjúklings og birting tilkynnt Persónuvernd. Heimildaskrá 1. Johnston KW, Rutherford RB, Tilson MD, Shah DM, Hollier L, Stanley JC. Suggested standards for reporting on arterial aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery. J Vasc Surg. 1991;13:452-458. 2. Wassef M, Baxter BT, Chisholm RL, Dalman RL, Fillinger MF, Heinecke J, et al. Pathogenesis of abdominal aortic aneurysms: a multidisciplinary research program supported by the National Heart, Lung, and Blood Institute. J Vasc Surg. 2001;34(4):730- 738. 3. Lijnen HR. Metalloproteinases in development and progression of vascular disease. Pathophysiol Haemost Thromb. 2003;33:275-281. 4. Morris DR, Biros E, Cronin O, Kuivaniemi H, Golledge J. The association of genetic variants of matrix metalloproteinases with abdominal aortic aneurysm: a systematic review and meta-analysis. Heart. 2014;100(4):295-302. 5. Lederle FA, Johnson GR, Wilson SE, Gordon IL, Chute EP, Littooy FN, et al. Relationship of age, gender, race, and body size to infrarenal aortic diameter. The Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Investigators. J Vasc Surg. 1997;26(4):595- 601. 6. Kuivaniemi H, Ryer EJ, Elmore JR, Tromp G. Understanding the pathogenesis of abdominal aortic aneurysms. Expert Rev Cardiovasc Ther. 2015;13(9):975-987. 7. Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA, Sicard GA, et al. The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. J Vasc Surg. 2009;50(4 Suppl):S2-49. 8. Singh K, Bønaa KH, Jacobsen BK, Bjørk L, Solberg S. Prevalence of and risk factors for abdominal aortic aneurysms in a population- based study: The Tromsø Study. Am J Epidemiol. 2001;154(3):236-244. 9. Lederle FA, Johnson GR, Wilson SE. Abdominal aortic aneurysm in women. J Vasc Surg. 2001;34:122-126. 10. Pleumeekers HJ, Hoes AW, van der DE, van UH, Hofman A, de Jong PT, et al. Aneurysms of the abdominal aorta in older adults. The Rotterdam Study. Am J Epidemiol. 1995;142:1291-1299. 11. Eickhoff JH. Incidence of diagnosis, operation and death from abdominal aortic aneurysms in Danish hospitals: results from a nation-wide survey, 1977-1990. Eur J Surg. 1993;159:619-623.  12. Drott C, Arfvidsson B, Ortenwall P, Lundholm K. Age-standardized incidence of ruptured aortic aneurysm in a defined Swedish population between 1952 and 1988: mortality rate and operative results. Br J Surg. 1992;79:175-79.  13. Svensjö S, Björck M, Gürtelschmid M, Djavani Gidlund K, Hellberg A, Wanhainen A. Low prevalence of abdominal aortic aneurysm among 65-year-old Swedish men indicates a change in the epidemiology of the disease. Circulation. 2011;124(10):1118-1123. 14. Anjum A, von Allmen R, Greenhalgh R, Powell JT. Explaining the decrease in mortality from abdominal aortic aneurysms rupture. Br J Surg. 2012;99(5):637-645. 15. Kent KC, Zwolak RM, Egorova NN, Riles TS, Manganaro A, Moskowitz AJ, et al. Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals. J Vasc Surg. 2010;52(3):539-548. 16. Vardulaki KA, Walker NM, Day NE, Duffy SW, Ashton HA, Scott RA. Quantifying the risks of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. Br J Surg. 2000;87(2):195-200. 17. De Rango P, Farchioni L, Fiorucci B, Lenti M. Diabetes and abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2014;47(3):243- 261. 18. Larsson E, Granath F, Swedenborg J, Hultgren R. A population-based case-control study of the familial risk of abdominal aortic aneurysm. J Vasc Surg. 2009;49(1):47. 19. Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, et al. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg. 2011;41 Suppl 1:S1-S58. 20. Bhak RH, Wininger M, Johnson GR, Lederle FA, Messina LM, Ballard DJ, et al. Factors associated with small abdominal aortic aneurysm expansion rate. JAMA Surg. 2015;150(1):44-50. 21. Lederle FA, Wilson SE, Johnson GR, Reinke DB, Littooy FN, Acher CW, et al. Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med. 2002;346(19):1437-1444. 22. Sweeting MJ, Thompson SG, Brown LC, Powell JT, et al. Meta-analysis of individual patient data to examine factors affecting growth and rupture of small abdominal aortic aneurysms. Br J Surg. 2012;99(5):655-665. 23. The United Kingdom Small Aneurysm Trial Participants. Long-Term Outcomes of Immediate Repair Compared with Surveillance of Small Abdominal Aortic Aneurysms. N Engl J Med. 2002;346:1445- 1452. 24. Salomaa V, Riley W, Kark JD, Nardo C, Folsom AR. Non-insulin-dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes: the ARIC Study. Circulation. 1995;91(5):1432-1443. 25. Chervu A, Clagett GP, Valentine RJ, Myers SI, Rossi PJ. Role of physical examination in detection of abdominal aortic aneurysms. Surgery. 1995;117(4):454-457.
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