A total of 154 patients were recruited: 79 G17DT and 75 placebo. A final analysis of the intention-to-treat population, using a proportional hazards model, stratifying by disease stage and adjusting for interim analysis, gave a hazard ratio for mortality of 0.75 (95% confidence interval, 0.51-1.10, P = 0.138; G17DT/placebo). A conventional analysis without adjustment for disease stage or interim analysis, censoring for chemotherapy and excluding protocol violators, gave median survival periods of 151 (G17DT) and 82 days (placebo) (log-rank test, P = 0.03).Patients developing anti-G17DT responses (73.8%) survived longer than nonresponders or those on placebo (median survival, 176 vs 63 vs 83; log-rank test, P = 0.003). G17DT was well tolerated.
Systematic culturing of perioperative intra-abdominal samples allowed us to recognize the presence of Streptococcus pneumoniae in infectious complications of chronic pancreatitis in 9 male patients. In 8 of 10 of the intra- or peripancreatic samples, S. pneumoniae was the single isolate identified. All but one of the S. pneumoniae isolates were sensitive to penicillin. The patients had predisposing underlying conditions such as alcoholism and diabetes mellitus. All patients were cured due to adequate surgery and antibiotic treatment. Analysis of the case histories suggests that S. pneumoniae may have been a relevant organism causing the infectious complications of pancreatitis in these patients.
The indication circle of enteral nutrition is continuously enlarging. Looking after this increasing group of patients, is now an everyday practice. Enteral nutrition has more advantages than intravenous. Amongst this, jejunal feeding is most widely applied, but it requires nasojejunal tube. Positioning the tube is possible by the guide of X-ray, endoscope, ultrasound, or simply "blind". Authors present the fluoroscopic technique, as their everyday practice. It does not demand special expertise, skilled endoscopist, or premedication, and can be performed in any hospital. It is fast, cheap, and tolerable. It's disadvantages are that only conscious, cooperating, spontaneously breathing patients can be treated such, and it involves irradiation. Authors have used this method 34 times in the past 3 years and had no major complications. Every patient suffered acute necrotising pancreatitis. Considering cost-benefit principles, they recommend this procedure as safe for all levels of in-patient departments.
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