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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.

Livskvalitet hos stomiopererade patienter : En litteraturstudie

Gillström, Sara, Ekbo, Sofie January 2007 (has links)
<p>Abstract</p><p>The aim of this literature review was to describe the quality of life in stoma patients after stomasurgery. Different combinations of the keywords “stoma”, “Quality of Life”, “stomasurgery” were used when searching in the databases Medline, Cinahl, Academic Search Elite and PubMed. A total of nineteen articles were used in the result. Fifteen studies had comparing design and four studies had describing design. Eighteen studies used questionnaires and one study used interviews for data collecting. Five studies did not concern the instruments' validity or reliability, fourteen studies referred to previously performed reliability's/validity tests. The sample sizes varied from 7 to 704 patients. Long-term quality of life in stoma patients shows contradictory results. Four studies showed that a brook uniting reservoir/pouch more or less did not change the quality of life. But that the body perception became better. One study showed that men´s Quality of Life was not effected by having a stoma, while women were effected to a greater extent, which led to a changed lifestyle and self-image among the women. Three studies showed that patients that are fecal incontinent has better social quality of life if they undergo stomasurgery. Four studies showed that patients with colon or rectal cancer and stoma had poorer quality of life than non-stoma cancer patients. Four studies showed that more therapy such as colostomy irrigation and relaxation gives better quality of life.</p><p>Keywords; “Quality of Life”, “stoma” and “stomasurgery”</p> / <p>Sammanfattning</p><p>Syftet med litteraturstudien var att beskriva människors upplevelse av livskvalitet efter en stomioperation. Olika kombinationer av sökorden ”stoma”, ”quality of life”, ”stomasurgery” användes vid sökning i databaserna Medline, Cinahl, Academic Search Elite och Pub Med. Totalt användes 19 artiklar i resultatet. Resultatet visade att samtliga studier hade som syfte att undersöka livskvaliteten hos stomiopererade patienter. Femton studier hade jämförande design och fyra studier hade beskrivande design. Arton studier använde sig av enkäter och en studie använde sig av intervjuer för datainsamling. Fem studier berörde inte instrumentens validitet eller reliabilitet, fjorton studier refererade till tidigare utförda reliabilitets/validitetstester. Undersökningsgruppernas storlek varierade från 7 till 704 patienter. Resultatet var motstridigt inom långsiktig livskvalitet hos stomiopererade. Fyra studier visade att en bäckenreservoar/pouch i stort sett inte förändrade livskvaliteten, men att kroppsuppfattningen blev bättre. En studie visade att mäns livskvalitet inte påverkades av att ha stomi, medan kvinnor påverkades i större utsträckning, vilket ledde till en förändrad livsstil och självbild hos kvinnorna. Tre studier visade att patienter som är avföringsinkontinenta får bättre social livskvalitet om de genomgår en stomioperation. Fyra studier visade att patienter med tjock eller ändtarmscancer och stomi hade sämre livskvalitet än de med endast cancer. Fyra studier visade att mer terapi i form av tarmsköljning eller avslappning ger bättre livskvalitet.</p><p>Nyckelord; ”livskvalitet”, ”stomi” och ”stomioperation”</p>

A qualitative exploration of the transmission of knowledge and skills by specialist stoma care nurses to facilitate the needs of patients adapting to a newly formed stoma

Williams, Julia Margaret January 2016 (has links)
Aim: To identify the knowledge and skills required by the specialist stoma care nurse to facilitate the needs of patients adapting to a newly formed stoma in order to inform specialist nurse education. Background: Advances in surgical techniques, drug therapies, bowel screening and patient recovery programmes have offered those with colorectal disorders, a potential increased life expectancy and improved disease management. For the specialist nurse, there is the constant challenge to keep abreast of these advances and provide more formal, precise and accurate information, facilitating individualised patient need. In response, an education curriculum needs to foster a comprehensive knowledge base in order to equip and support the nurse to become confident and competent in clinical practice. How knowledge is translated from the classroom into clinical practice is a key feature of this study; in particular the role of the specialist stoma care nurse in facilitating the adaptation of patients following stoma surgery. Method: A qualitative approach was chosen to fulfil the aim and objectives of this two-staged study. Phase one took a phenomenological approach and phase two a focus group methodology approach. Eight patients were interviewed in phase one. This offered insight into the experiences of living with a newly formed stoma. Vignettes (total 18) were created from the patients’ narratives. These were used to stimulate discussion among nurses at the focus groups within phase two of the study. The complexities of translating specialist knowledge and skills among thirty-nine specialist stoma care nurses were explored through one of a series of seven focus groups. The analysis for this study was undertaken in 3 stages; stage 1, thematic analysis of phase 1, stage 2, thematic analysis of phase 2 and stage 3, further analysis of phase 2 using Mayer and Salovey (1997) emotional intelligence theoretical framework. Findings: Phase one highlighted a variety of challenges faced by patients and recognised their coping strategies as they adapted to a newly formed stoma. Six themes emerged from the thematic analysis; seeking assurances, permanence versus reversibility of stoma, anticipated stigma, psychological projection, worthwhile sacrifice and sense of achievement. The thematic analysis of phase two identified five comparable themes; skilled know-how, understanding self, hurdles to accommodate, communication skills and uncertain ground. A further examination through an alternative lens was considered to distil the pedagogy. Mayer and Salovey (1997) emotional intelligence framework guided the third stage of analysis. Five key concepts emerged, forming the essential components to specialist nursing practice; the influence of emotions on critical thinking and clinical decision-making, the use of empathetic and intuitive skills in clinical judgements, the ability to balance true self alongside professional self, the need to foster cognitive activity, good communication and creativity and preserving a conscious awareness of self so to develop personal growth. Conclusion: Individual experiences of patients adapting to a newly formed stoma evidently differed. Both the challenges faced and coping strategies of the patients were revealed. The specialist stoma care nurse is ideally placed to facilitate meeting the patients’ needs as they adapt. The five essential components to specialist practice are identified. Educational strategies for cultivating critical thinking and communication skills, developing self and emotional conscious awareness and nurturing personal growth need to be considered for integration into specialist nurse educational curriculum.

Agentes infecciosos enteroparasitários associados a indivíduos estomizados / Infectious agents of enteric parasites associated with individuals ostomates

Santos, Cibele Velleda dos 31 March 2011 (has links)
Made available in DSpace on 2014-08-20T14:31:33Z (GMT). No. of bitstreams: 1 dissertacao_cibele_velleda_dos_santos.pdf: 1881403 bytes, checksum: 9dda1568c045e6dba2f90387205d8397 (MD5) Previous issue date: 2011-03-31 / The intestinal parasitoses or enteroparasitoses are a serious public health problem particularly in developing countries. Meantime, there are several studies that wrap the prevalence and the incidence of parasitoses in several populations, lacking parasitological investigations involving individuals with a intestinal ostomy. This study aimed to investigate the presence of infectious nature of parasitic diseases in individuals with ostomy enrolled in an Ostomy Program of the Department of Health and Management of the SUS in the city of Pelotas, RS. A questionnaire was given to patients for epidemiological evaluation of demographic, social, and cultural issues that would limit the subjects' knowledge about the parasites. Totaled to 71 individuals also submitted to parasitological tests using the methods of Faust and Ritchie modified Baermann-Moraes. Were collected and analyzed 03 samples per individual. The prevalence of carriers was 5.6%, all by monoparasitism. Among pacients positives were detected in the same proportion (25%), larvae of Enterobius vermicularis eggs of Taenia sp. eggs Enterobius vermicularis and larvae of Strongyloides stercoralis. Among participants, 49.3% were being female and 50.7% male. 76.1% had colostomy and 23.9% had ileostomy. Of the operations for stoma intestinal was necessary 37.1% due to the rectum cancer, 24,3 % for cancer of colon and 15.7% resulting from other intestinal diseases. As to knowledge about parasitic diseases, 69 % of the interviewed ones revealed to know the subject, 56.3% of the individuals showed up the importance of the hygiene of the hands, nails, sets of cutlery and foods, including his appropriate cooking.Meantime, 33.8% of the interviewed ones did not know how will be careful to prevent the intestinal parasitoses, and, even so, 50.7% of the individuals not feel to miss bigger of explanation regarding the approach in question. / As parasitoses intestinais ou enteroparasitoses representam um grave problema de saúde pública particularmente nos países subdesenvolvidos. Entretanto, existem vários estudos que envolvem a prevalência e a incidência de parasitoses em diversas populações, inexistindo investigações parasitológicas que envolvam indivíduos com estomia intestinal. Este estudo objetivou investigar a presença de agentes infecciosos de natureza enteroparasitária em indivíduos estomizados cadastrados em um Programa de Ostomizados da Secretaria de Saúde e Gestão do SUS da cidade de Pelotas/RS. Foi aplicado um questionário epidemiológico aos pacientes para avaliação das variáveis demográficas, sociais e culturais, além de questões que balizavam o conhecimento dos sujeitos sobre as parasitoses. Totalizaram-se 71 indivíduos, também, submetidos a exames coproparasitológicos segundo os métodos de Faust, Ritchie e Baermann-Moraes modificado. Foram recolhidas e analisadas 03 amostras por sujeito. A prevalência de parasitados foi 5,6%, sendo todos por monoparasitismo. Dentre os positivos detectou-se, na mesma proporção (25%), larvas de Enterobius vermiculares, ovos de Taenia sp., ovos de Enterobius vermiculares e larvas de Strongyloides stercoralis. Dentre os participantes, 49,3% eram pertencentes ao sexo feminino e 50,7% ao masculino. 76,1% possuíam colostomias e 23,9% ileostomias. Das intervenções cirúrgicas para estomização intestinal 37,1% foram necessárias devido ao câncer de reto, 24,3% por câncer de cólon e 15,7% decorrentes de outras doenças intestinais. Quanto aos conhecimentos sobre parasitoses, 69% dos entrevistados revelaram conhecer o assunto, 56,3% dos indivíduos evidenciaram a importância da higiene das mãos, unhas, talheres e alimentos, incluindo seu cozimento adequado. Entretanto, 33,8% dos entrevistados não sabiam como tomar os cuidados necessários para prevenir as parasitoses intestinais, e, ainda assim, 50,7% dos indivíduos consideram não sentirem falta de maiores explicações quanto a abordagem em questão.

Perioperacinis pacientų stomos priežiūros apmokymo ir informavimo įvertinimas / Evaluation of training and informing about handling perioperational stoma

Spornaja, Liudmila 09 July 2011 (has links)
Stomos suformavimo operacija – viena labiausiai traumuojančių asmenį psichologiškai, todėl labai svarbu, kad būsimas stomuotas pacientas būtų tinkamai paruoštas pokyčiams, įvyksiantiems po operacijos bei gyvenimui su stoma. Lietuvoje stomuotų pacientų priežiūra vis dar yra nepakankama. Ši darbo tema pasirinkta siekiant atkreipti dėmesį į tai, kad reikalinga organizuota ir kvalifikuota pagalba stomą turintiems pacientams. Darbo tikslas – įvertinti perioperacinį pacientų stomos priežiūros apmokymą ir informavimą. Darbo uždaviniai: 1. Įvertinti pacientų apmokymą bei informavimą prieš stomos suformavimo operaciją. 2. Įvertinti pacientų apmokymą bei informavimą po stomos suformavimo operacijos. 3. Nustatyti slaugytojos veiklos svarbą bei kokybę perioperaciniu laikotarpiu. 4. Palyginti pacientų su kolostomom ir ileostomom apmokymą ir informavimą. Tyrimo objektas – pacientų stomos priežiūros apmokymas ir informavimas. Tyrimas atliktas Vilniaus universiteto Onkologijos instituto abdominaliniame chirurgijos skyriuje. Tirti pacientai, kuriems per 2005 metus (2005m. sausio 1d. – 2005 m. gruodžio 31d.) dėl tiesiosios žarnos vėžio buvo suformuota kolostoma arba ileostoma. Duomenys buvo renkami apklausos būdu, anonimiškai anketuojant stomuotus pacientus priešpaskutinę arba paskutinę jų gulėjimo stacionare dieną. Sudarytoje anketoje reikėjo atsakyti į 25 klausimus. Tokiu būdu buvo surinkta 110 anketų iš galimų 137 anketų per 2005 metus. Remiantis atlikto tyrimo duomenimis, priešoperacinis... [toliau žr. visą tekstą] / Operation on stoma formation is one of the most psychologically traumatic so it is of vital importance to ensure that would-be patient with stoma is prepared for changes after operation and life with stoma. The attendance of such patients is still insufficient in Lithuania. This subject was chosen with intention to spotlight the need for organized and qualified help for people with stoma. Objective - assessment of preoperative care and induction of patients with stoma. Tasks: 1. Evaluate the induction and training of patients before operation on stoma formation; 2. Evaluate the induction and training of patients after operation on stoma formation; 3. Estimate the importance and quality of nursing during preoperative care; 4. Compare the induction and training of patients with Colostoma and Ileostoma. Research objective – training and induction of patients on stoma care. Research was conducted in the Abdominal Surgery Department of Oncological Institute of Vilnius University. Patients who due to rectum cancer had colostoma and ileostoma formed during 2005 (the 1st of January 2005 – the 31st of December 2005) were examined. An anonymous questionnaire of 25 questions was given for in-patients during their last days in hospital to gather data. Thus, 110 forms of 137 possible were collected during year 2005. According to research preoperative induction of patients on care of stoma is much lesser (28,2 %) compared to induction after operation (90,9 %). In 78 % of cases the optimal... [to full text]

Defunctioning stoma in low anterior resection of the rectum for cancer : Aspects of stoma reversal, anastomotic leakage, anorectal function, and cost-effectiveness

Floodeen, Hannah January 2016 (has links)
Rectal cancer is a common malignancy treated with surgical resection and curative intent in the majority of cases. One treatment option is low anterior resection (LAR) with preserved bowel continuity, often involving the formation of a temporary defunctioning stoma (DS). The general aim of this thesis was to improve understanding of the role of DS in rectal cancer surgery with regard to timing of stoma reversal and development of anastomotic leakage (AL), impact on long-term anorectal function (AF), as well as aspects of cost-effectiveness. Study I addressed the timing of stoma reversal following LAR. We found that 19% of reversed patients were reversed within 4 months of LAR, while 81% of reversals were delayed. In 58% of delayed reversals the delay was due to low priority on surgical waiting lists. Studies II-IV were based on 234 patients randomized to receive a DS or no DS following LAR. Study II compared patients with AL following LAR diagnosed during the initial hospital stay (early leakage, EL) with patients diagnosed after hospital discharge (late leakage, LL). LL was more common in females, and originated more frequently from the transverse stapler line. EL was more common in males, and originated more frequently from the circular stapler line. Study III assessed AF 5 years after LAR with regard to whether patients initially had a DS or no DS. We found no difference in AF between the two randomized groups. When comparing with a 1-year follow-up in the same patient cohort, there were no further changes in AF over time. Study III assessed necessary healthcare resources and cost within 5 years of LAR, depending on whether patients initially had a DS or no DS. The overall cost analysis revealed a higher cost for patients randomized to DS, regardless of the cost-savings associated with a reduced frequency of anastomotic leakage.

Problematika uspokojování potřeb klienta se stomií / Problems of satisfying the needs of stoma clients

MICHÁLKOVÁ, Helena January 2010 (has links)
No description available.

Vzužití volného času u osob se stomií / Leisure time utilisation of persons with stomy

VLČKOVÁ, Šárka January 2009 (has links)
I this thesis anatomical, physiological and functional information of certain parts of the human body organ systems after the damage of which a stoma must be performed is given. A stoma is indicated either after an injury, an illness or a loss of functionality and patency, It constitutes management of a life threatening situation and facilitates life restoration. Basic types of stoma are described, and since the most common type are colostomy and ileostomy, a greater attention is given to the disease and its treatment in the small and large intestine at the ends of which the stoma is created. The thesis also deals with the stoma aids, leisure time activities, psychological aspects of the disease, social problems and awareness of patients with a stoma. One of the objectives was to find out how patients with a stoma spend their leisure time and if they tend to isolate themselves from society because of their handicap. Another objective was to determine if persons with a stoma are sufficiently informed about leisure time activities they could pursue and where to get the information. The data needed to carry out this survey were obtained through studying professional materials available. The quantitative research method of interviewing was chosen, the data collection technique was an anonymous questionnaire aimed at a certain set of respondents as well as semi-standardized interviews with professionals who were given questionnaires for the respondents. The research set was formed by respondents with a type of a stoma mentioned in the questionnaire. It has been found out that the most common type of a stoma is ileostomy, predominantly in men. The research has shown that persons with a stoma isolate themselves from society and are not sufficiently informed about leisure time activities they could pursue. The research results should bring a better cooperation among professionals and thus enhance awareness and improve care not only for persons with a stoma. The outcomes of the thesis could make professionals produce literature concerning the life of persons with a stoma and update the existing information with new experience, advice and recommendations.

Využití NIC, NOC klasifikace u pacientů se stomií / Use NIC, NOC classification of patients with a stoma.

JEDLIČKOVÁ, Eva January 2014 (has links)
The thesis deals with the application of NIC, NOC classifications in patients with stoma. Every nurse uses a classification system of health care which describes activities or interventions done by nurses as a part of planning phase of nursing process in connection with creation of nursing care plan. These classifications also focus on developement of nursing care objectives and evaluating of the effect of nursing care results. Due to these classifications, the nursing care results are mesurable. In the theoretical part of the thesis, we focus on classification systems of nursing care, then on GIT diseases which lead to insertion of stoma, its care, care of patients with stoma and last but not least, on nursing documentation. Several objectives were set to meet the main target of the thesis. Firstly, to map nurses' opinion on nursing classifications; secondly, to find out which NOC indicators are usually judged by nurses in the care of patients with stoma; thirdly, to find out which activities are usually used by nurses in the care of patients with stoma; fourthly, to check up on application of NIC, NOC classification in the care of patients with stoma. The qualitative reserch was hold in two phases. In the first phase of the qualitative research, a nursing documentation was created on the basis of NIC and NOC classification related to care of the patients with stoma. In the second phase of the qualitative research, we interviewed ten nurses who had worked with the particular nursing documentation.

Gör mig delaktig och hjälp mig lära. : Delaktighetens betydelse vid stomiträning för personers lärande - En fenomenografisk studie.

Kolesnikova, Elena, Lilja, Maria January 2015 (has links)
Tidigare studier visar att delaktighet är en förutsättning för lärande. Det finns olika sätt att främja delaktighet men mest framträdande är inverkan av personal och individuell anpassning. Syftet med denna studie var att identifiera och beskriva olika sätt som personer som fått en stomi uppfattar egen delaktighet under stomiträning på sjukhus. Syftet kunde besvaras med hjälp av intervjuer med öppna frågor och fenomenografisk analys av insamlat data. Elva personer som har fått stomi och stomitränat intervjuades. I analysen framkom fyra olika kategorier som beskriver uppfattning av delaktighet under stomiträning: A) Att få vara med och se, B) Att få göra själv, C) Att bli handledd av en kunnig personal, D) Att ha möjlighet att få bestämma själv. De olika sätten att uppfatta delaktighet på visar en variation från att vilja inta en passiv roll i stomiträningen till att vara aktiv och själv fatta beslut om hur stomiträningen skall planeras. Resultatet visar också att personen själv kan ha ett eller flera sätt att uppfatta sig delaktig på men där ett av dem är mer dominant än de andra. / Previous studies showed that participation is a prerequisite for learning. There are various ways to promote participation but the most prominent is the influence of caregivers and individual adaptation.The aim of this study was to identify and describe different ways which persons who underwent a surgery resulting into a stoma to understand theirs own participation during training with the stoma in a hospital. Interviews with open questions and phenomenography analysis was used to answer the aim. Eleven persons who have got an ostomy and stoma trained was interviewed.The analyse resulted in four different categories of describing understanding of participation during training with a stoma: A) To participate by watching, B) To do it myself, C) To be supervised by competent caregivers, D) To have the possibility to decide for myself. These different ways to understand participation shows a variety from wanting to have a passive role in the training with a stoma till being active and make own decisions in planning for the training. The result also shows that one person can have one or more ways of understanding participation but one of those ways is more dominant than other.

Surgery and immuno modulation in Crohn’s disease

Myrelid, Pär January 2009 (has links)
Crohn’s disease is a chronic inflammatory bowel disease with unknown origin. This study investigates the combined use of surgery and immuno modulation in Crohn’s disease. The outcome of medication and surgery in 371 operations on 237 patients between 1989 and 2006 were evaluated. Moreover the effects of prednisolone, azathioprine and infliximab on the healing of colo-colonic anastomosis in 84 mice with or without colitis were evaluated. The use of thiopurines after abdominal surgery in selected cases of severe Crohn’s disease was found to prolong the time to clinical relapse of the disease from 24 to 53 months. Patients on postoperative maintenance therapy with azathioprine had a decreased symptomatic load over time and needed fewer steroid courses. The use of thiopurines was found to be a risk factor of anastomotic complications in abdominal surgery for Crohn’s disease together with pre-operative intra-abdominal sepsis and colo-colonic anastomosis. The risk for anastomotic complications increased from 4 % in those without any of these risk factors to 13 % in those with any one and 24 % if two or three risk factors were present. In patients with two or more of these, or previously established, risk factors prior to surgery one should consider refraining from anastomosis or doing a proximal diverting stoma. Another possibility is to use a split stoma in which both ends of a future delayed anastomosis are brought out in the same ostomy hole of the abdominal wall. This method was found to significantly decrease the number of risk factors prior to the actual anastomosis as well as decreasing the risk of anastomotic complications, without increasing the number of operations or the time spent in hospital. In the animal model all three medications had an ameliorating effect on the colitis compared with placebo. Only prednisolone was found to interfere with the healing of the colo-colonic anastomoses with significantly decreased bursting pressure compared with placebo as well as azathioprine and infliximab. The association between azathioprine therapy and anastomotic complications may be due to a subgroup of patients with a more severe form of the disease who have an increased risk of such complications and also are more prone to receive intense pharmacological therapy. / Crohns sjukdom är en kronisk inflammatorisk tarmsjukdom av oklar orsak. Huvudsyftet med denna avhandling var att undersöka den kombinerade behandlingen med kirurgi och immunhämmare vid Crohns sjukdom. Utfallet av medicinsk och kirurgisk behandling vid 371 operationer på 237 patienter mellan 1989 och 2006 utvärderades. Därutöver studerades effekterna av kortison, immunhämmare och behandling med inflammationsdämpande antikroppar på läkning av tjocktarms-skarv på 84 möss med eller utan inflammation i tarmen. Vid utvalda fall med svårare form av Crohns sjukdom visade sig förebyggande behandling med immunhämmare efter kirurgi förlänga tiden till återfall av symptom från 24 till 53 månader. Patienter med immunhämmare som underhållsbehandling hade också minskade symptom under uppföljningstiden med ett minskat behov av kortison. Immunhämmande behandling inför kirurgi visade sig, liksom pågående infektion i bukhålan och sydd skarv på tjocktarmen, vara en riskfaktor för att drabbas av komplikationer vid bukkirurgi på grund av Crohns sjukdom. Risken för infektionskomplikationer i bukhålan ökade från 4 % hos dem utan någon av dessa riskfaktorer till 13 % hos dem med någon och 24 % hos dem med två eller tre riskfaktorer inför operationen. Hos patienter med två eller fler kända riskfaktorer bör man överväga att avstå från att sy en skarv på tarmen vid kirurgi eller möjligen skydda skarven med en avlastande stomi. Ett alternativ till detta är att anlägga en delad stomi där bägge ändarna av den framtida skarven tas ut genom en och samma stomiöppning i bukväggen. Denna metod med en fördröjd skarv på tarmen visade sig minska antalet kirurgiska riskfaktorer inför själva skarvningen och dessutom minska risken för tidiga infektiösa komplikationer i bukhålan, utan att vare sig öka antalet kirurgiska ingrepp eller förlänga vårdtiden på sjukhus. I en djurmodell visade sig alla tre läkemedlen ha en lindrande effekt på tarminflammation jämfört med placebo. Endast kortison visade sig påverka läkningen negativt med en sänkning av bristningstrycket i den sydda skarven på tjocktarmen, jämfört med placebo såväl som med immunhämmare och antikropps-behandling. Kopplingen mellan immunhämmare och komplikationer efter sydda skarvar på tarmen behöver alltså inte vara en direkt läkemedelseffekt. Orsaken kan istället vara att en undergrupp av Crohnpatienter har en svårare sjukdomsform som ger både ökad komplikationsrisk och större behov av intensiv medicinsk behandling.

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