Schweizerische Rundschau für Medizin Praxis = Revue suisse de médecine Praxis
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There are very few observations on the occurrence of stroke after general surgery; the incidence lies between 0.2 and 0.7%. On the other hand, cerebrovascular accidents are mainly seen after cardiac and carotid surgery, where the incidence is high (5%). Strokes are also an important cause of morbidity and mortality following orthotopic transplantations, particularly heart, heart/lung and liver transplantations.
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Severe liver disease complicates pregnancy in only 0.1% of the cases. Viral hepatitis is the most common cause (40%). (Liver cirrhosis usually results in amenorrhea). Liver disease unique to pregnancy comprises "intrahepatic cholestasis of pregnancy" (Increased fetal risk), "acute fatty liver of pregnancy" (AFLP) and "HELLP-syndrome", both with high maternal and fetal risk when untreated. ⋯ Imaging methods like ultrasound are invaluable in the differential diagnosis and detection of complications like subcapsular hematoma in the liver patients with HELLP-syndrome. Fulminant hepatic failure requires intensive care, liver transplantation is an additional therapeutic option. Recurrent AFLP has been reported recently.
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Schweiz. Rundsch. Med. Prax. · Jul 1992
[Chemotherapy in solid tumors of the gastrointestinal tract?].
Chemotherapy in disseminated stages of gastro-intestinal tumor only causes remission rates of 20 to 40% in a reproducible manner. Treatment is clearly palliative and does not influence median time of survival in these patients. In limited stages of esophageal or gastric cancer remission rates above 50% are achieved. ⋯ Based on prospectively randomized studies, for stage-III colon carcinoma adjuvant chemotherapy using Fluorouracil and Levamisole is recommended. In resected carcinoma of rectum the adjuvant combination of chemotherapy and radiation improves local control of the tumor as well as survival of the patients. This modality of treatment is recommended.