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6 results on '"Arkkila, P."'

1. Ruokatorvi- ja mahasyövän riskiin voidaan vaikuttaa

Author

Arkkila, P. (Perttu) and Saarnio, J. (Juha)

Abstract

Tiivistelmä Ruokatorvisyöpä on lisääntynyt Suomessa jo kahdenkymmenen vuoden ajan. Mahasyövän ilmaantuvuus pienenee. Näille syöville altistavat tupakanpoltto, ruoka-aineet ja etenkin mahasyövälle infektiot. Perinnöllisillä tekijöillä on myös merkitystä. Runsaasti tuoreita vihanneksia ja hedelmiä sisältävä ruokavalio todennäköisesti vähentää ruokatorven ja mahalaukun syöpien riskiä. Laadukas endoskopia on edellytys syöpien esiasteiden diagnostiikalle ja hoidolle.

Published
2022

2. Maha-suolikanavan yläosan tähystystoimenpiteet

Author

Tyrväinen, T. (Tuula), Saarnio, J. (Juha), and Arkkila, P. (Perttu)

Abstract

Tiivistelmä Maha-suolikanavan yläosan ahtaumia, puhkeamia ja leikkaussauman pettämisiä voidaan hoitaa endoskooppisesti itsestään laajenevilla metalliverkkoproteeseilla. Puhkeamien tai leikkaussauman pettämisten uudempana hoitovaihtoehtona on endoluminaalinen alipaineimuhoitojärjestelmä. Kaikutähystystä käytetään sekä diagnostiikkaan että toimenpiteiden tekemiseen. Limakalvoon rajoittuvat muutokset voidaan valikoidusti poistaa endoskopiassa. Toimenpiteiden haasteellisuus ja komplikaatioriskit puoltavat vaativien toimenpiteiden keskittämistä. Abstract Oesophageal obstructions, perforations and leaks have been successfully treated with self-expanding metal stents (SEMS). In gastric outlet obstruction, stenting also provides efficient and fast palliation of symptoms, with low morbidity and short hospital stay. Especially for terminally ill patients, stenting is the therapy of choice. Pancreatic cancer and gastric cancer are the most common reasons for gastric outlet obstruction. Endoscopic vacuum therapy (EVT) has become a useful option to treat perforations and leaks in the upper gastrointestinal tract. A sponge is introduced transorally into the leakage cavity or oesophageal lumen and is connected via a drainage tube to a continuous negative pressure up to 125 mmHg. The sponge is replaced every 3–5 days. However, more comparative studies are needed to compare EVT and SEMS therapy. EVT has been used longer to treat low rectal anastomotic leaks. Use of endoscopic ultrasound has been extended from diagnostic use to EUS-guided therapeutic endoscopies. Many superficial mucosal dysplastic or neoplastic lesions can be treated by mucosal resection in the upper gastrointestinal tract, too. Endoscopic mucosal resection (EMR) is used for piecemeal resection of mucosal lesions, for example a nodular dysplastic lesion in Barrett’s oesophagus. Endoscopic submucosal dissection (ESD) has been developed for dissection of larger mucosal lesions to achieve en bloc resection and to obtain a single larger specimen for histologic examination. ESD is technically quite demanding and requires a longer operation time compared to EMR. For treatment of Barrett’s oesophagus (BO) with non-granular dysplasia, radiofrequency ablation is a safe and effective mucosal eradication method.

Published
2020

3. [Fecal transfusion as treatment of Clostridium difficile infection].

Author

Arkkila P, Mattila E, and Anttila VJ

Subjects
Anti-Infective Agents therapeutic use, Finland, Humans, Intubation, Gastrointestinal, Metronidazole therapeutic use, Therapeutic Irrigation, Vancomycin therapeutic use, Enterocolitis, Pseudomembranous therapy, Feces
Abstract

Clostridium difficile is the major identified cause of antibiotic-associated diarrhea. Metronidazole has been applied as the first-line treatment, while vancomycin has been used in recurring cases of the disease. Fecal transfusion has already long been applied as experimental therapy in the treatment of recurring C. difficile infection. The aim of fecal transfusion is normalization of the intestinal microbial flora. An only recently published extensive Finnish patient series and a randomized study have confirmed fecal transfusion as a highly efficient and safe form of treatment in recurrent C. difficile infection.

Published
2013

4. [Prolonged abdominal discomfort, ascites and pleural fluid].

Author

Nuutinen H, Timonen T, Numminen K, Arkkila P, and Färkkilä M

Subjects
Abdominal Pain diagnosis, Aged, Ascites diagnosis, Blood Sedimentation, Diagnosis, Differential, Humans, Male, Pleural Effusion diagnosis, Time Factors, Weight Loss, Mesothelioma diagnosis, Peritoneal Neoplasms diagnosis, Rare Diseases diagnosis
Abstract

A 67-year-old man had been examined for 1.5 years for hypersedimentation, abdominal discomfort and pleural effusion, but the cause had remained unclear. With progressive weight loss the patient was admitted to the ward for examinations, whereupon the diagnosis of a rare disease began to unravel.

Published
2011

5. [Dysphagia--a multidisciplinary challenge].

Author

Aaltonen LM, Saarela M, Jousimaa J, Aherto A, and Arkkila P

Subjects
Deglutition Disorders therapy, Humans, Patient Care Team, Deglutition Disorders diagnosis, Deglutition Disorders etiology
Abstract

Difficulty in swallowing, i.e. dysphagia should be distinguished from the sensation of a lump in the throat and the pain on swallowing. A careful anamnesis will help in determining the ailment as a problem of oral, pharyngeal or esophageal stage of swallowing. Videofluorography, FEES investigation and transnasal esophagoscopy as well as gastroscopy are helpful for the diagnosis. Cerebral infarction is the most significant cause of oropharyngeal dysphagia. Esophageal causes include reflux disease, tumors and achalasia. Diagnostics, treatment and rehabilitation of dysphagia patients require multidisciplinary collaboration. In addition, surgical therapy may be required.

Published
2009

6. [Short bowel syndrome and muscle weakness].

Author

Arkkila P and Vuorte J

Subjects
Catheterization, Central Venous, Humans, Hypophosphatemia blood, Hypophosphatemia drug therapy, Hypophosphatemia physiopathology, Male, Middle Aged, Parenteral Nutrition, Total, Short Bowel Syndrome diet therapy, Crohn Disease surgery, Hypophosphatemia diagnosis, Muscle Weakness diagnosis, Postoperative Complications diet therapy, Short Bowel Syndrome diagnosis
Published
1998

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