Publications by authors named "J H Kappen"

Article Synopsis
  • Patients with peritoneal metastasis from colorectal cancer have a poor prognosis, but cytoreductive surgery is a key treatment to remove large tumors, though micrometastases often remain.
  • Systemic chemotherapy is a standard treatment for these micrometastases, but intraperitoneal therapy can deliver higher doses directly to the affected area while reducing side effects.
  • The review suggests more research is needed to establish the effectiveness of hyperthermic intraperitoneal chemotherapy (HIPEC) combined with surgery, and explores emerging therapies like oncolytic viruses and small-molecule inhibitors for treating peritoneal metastasis.
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The concept of pre-diabetes has led to provision of measures to reduce disease progression through identification of subjects at risk of diabetes. We previously considered the idea of pre-asthma in relation to allergic asthma and considered that, in addition to the need to improve population health via multiple measures, including reduction of exposure to allergens and pollutants and avoidance of obesity, there are several possible specific means to reduce asthma development in those most at risk (pre- asthma). The most obvious is allergen immunotherapy (AIT), which when given for allergic rhinitis (AR) has reasonable evidence to support asthma prevention in children (2) but also needs further study as primary prevention.

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Background: Asthma is a common disease characterized by chronic inflammation of the lower airways, bronchial hyperactivity, and (reversible) airway obstruction. The Global Initiative of Asthma Guideline recommends a flowchart to diagnose asthma with first-step spirometry with reversibility and a bronchial challenge test (BPT) with histamine or methacholine as a second step [1]. The BPT is considered burdensome, time-consuming for patients and staff, can cause side effects, and is expensive.

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