1,720,973 research outputs found
Azathioprine treatment in inflammatory bowel disease patients: type and time of onset of side effects
No full textBACKGROUND: Azathioprine
(AZA) and 6-mercaptopurine (6-MP), purine analogues,
are the immunosuppressant drugs most
frequently used for inducing and maintaining remission
in inflammatory bowel disease (IBD). The
occurrence of adverse effects is a major drawback
in the use of these drugs, and short- and long-term
toxicity represent a major limitation to their use.
AIM: The present study investigated the prevalence,
type and time of onset of AZA-related adverse
events, in a cohort of IBD patients in a single
referral Centre.
PATIENTS AND METHODS: The records of
consecutive IBD outpatients, referred to our Institution
between 1987-2009, were retrospectively
evaluated.
RESULTS: We reviewed 2014 patients, in
whom AZA was prescribed in 302 of them, 139
(46%) with ulcerative colitis (UC) and 163 (54%)
with Crohn’s disease (CD). Side-effects were
complained by 98 (32.4%) out of 302 patients, 50
UC and 48 CD, (36% UC vs 29.4% CD, p = 0.26).
In 20 (20.4%) patients, 11 UC and 9 CD, side-effects
r
β-Lactamase inhibition with clavulanic acid supplementing standard amoxycillin-based triple therapy does not increase eradication rate
No full textUse of argon plasma coagulation in digestive endoscopy: a concise review.
No full textArgon plasma coagulation (APC) is a non-contact thermal method of hemostasis that has generated much attention in recent years. This endoscopic procedure is used primarily to control bleeding from lesions in the gastrointestinal tract, and also sometimes to debulk tumours in the case of patients for whom surgery is not recommended. APC involves the use of a jet of ionized argon gas (plasma) that is directed through a probe passed through the endoscope. The probe is placed at some distance from the lesion, and tissue damage is limited to superficial layers. The depth of coagulation is usually only a few millimetres. Theoretical advantages of APC include facility application, speedy treatment of multiple lesions in the case of angiodysplasias or wide areas (the base of resected polyps or tumor bleeding), safety due to reduced depth of penetration, and lower cost compared to laser
Benign pneumoperitoneum after percutaneous endoscopic gastrostomy (PEG) feeding tube placement: do not be afraid!
No full textIn order to ensure enteral feeding, placement of a percutaneous endoscopic gastrostomy (PEG) is considered a standard care for patients with oropharyngeal malignancies. Benign pneumoperitoneum is a complication of PEG feeding tube placement and it is usually an incidental finding that arises, generally, immediately following the procedure.
We report a case of a benign pneumoperitoneum, developed 48 hours after the procedure, which was treated conservatively
Schwannoma of the rectum: A case report and literature review.
No full textSchwannomas of the colon and rectum are
tumors that are rarely detected. For achieving a definitive
histopathological diagnosis, the use of an appropriate
immunohistochemical panel is request. Although
schwannomas are considered to be benign tumors,
their risks of recurrence must be not ignored. The
best therapeutic option is complete surgical removal.
In the present study, we describe a case of a rectal
schwannoma occured in a 72-year-old man, presented
as a small sessile polypoid lesion, which was successfully
removed in toto by hot-biopsy, during the same
procedure. No recurrence of the lesion was observed
after 6 mo of follow-up
Quality of life in ulcerative colitis patients treated medically versus patients undergoing surgery.
No full textOBJECTIVES: Approximately one third of patients with ulcerative colitis (UC) require surgery.
AIM: Aim of this study was to assess the quality of life (QoL) of UC patients who have undergone surgery with ileorectal anastomosis (IRA) or ileal pouch-anal anastomosis (IPAA) compared to UC patients not operated.
PATIENTS AND METHODS: Fifty consecutive UC patients for each group observed between 1988-2010 were included. To all patients was administered a self completed questionnaire with four different scores: intestinal symptoms (IS), systemic symptoms (SS), emotional function (EF), social function (SF) and an overall QoL score.
RESULTS: Overall QoL score and three dimensions (SS, EF, SF) resulted not significantly different in the three groups, except for IS that resulted worst in the IRA-Group. According to the activity of disease it appeared that UC and IRA patients with mild activity had an overall QoL score similar to patients with complicated IPAA. A higher statistically different score of overall QoL was observed in patients with UC and IRA with moderate/severe disease.
CONCLUSIONS: Results of the study demonstrate that overall QoL score is poorer in patients with UC and IRA with mild activity and in patients with complicated IPAA and is worst in patients with UC and IRA with moderate/severe activity
Large symptomatic simple hepatic cyst with gastric compression treated with percutaneous drainage.
No full textNonparasitic hepatic cysts consist of a heterogeneous group of disorders, which differ in etiology, prevalence, and manifestations. Simple hepatic cysts are considered nonparasitic ones. These are a result of congenital anomalies of the biliary system, and these may be single or multiple. Generally, hepatic cysts are incidentally found during occasional laparotomy or laparoscopy, necropsy, and even during routine ultrasound or computerized tomography (CT) scan. Nowadays, with improving diagnostic techniques, hepatic cysts are becoming more common. Generally these lesions are asymptomatic. However, if they grow, they may become symptomatic. Symptoms depend on the size and location. When symptoms developed, these must be treated. Compressive complications due to local "liver mass" effect include: portal hypertension, edema due to caval compression, jaundice and arrhythmia and duodenal obstruction. Gastric extrinsic compression by liver cysts has been poorly described. Herein, we present a case of a female in whom percutaneous drainage of a large simple hepatic cysts not complicated was performed in order to reduce signs of gastric compression
Extraintestinal manifestations in a large series of Italian inflammatory bowel disease patients
No full textAIM:
To investigate prevalence, type and time of onset of extraintestinal manifestations (EIMs) in a series of Italian inflammatory bowel disease (IBD) patients.
METHODS:
Data of 811 IBD consecutive patients, first referred to our Centre from 2000 to 2011, were retrospectively evaluated.
RESULTS:
Eight hundred and eleven IBD patients (437 M, 374 F) were studied: 595 ulcerative colitis (UC) (73.4%) and 216 Crohn's disease (CD) (26.6%). Among these, 329 (40.6%) showed EIMs: 210 UC (35.3%) and 119 CD (55.1%) (P < 0.0001). Considering the time of the diagnosis of IBD, 37 EIMs (11.2%) were developed before, 229 (69.6%) after and 63 (19.2%) were simultaneous. The type of EIM were as follows: 240 musculoskeletal (29.6%), in 72 CD patients and in 168 UC (P < 0.0001); 47 mucocutaneous (5.8%), in 26 CD and in 21 UC (P = 0.0049); 26 ocular (3.2%), in 16 CD and in 10 UC (CD 7.4% vs UC 1.7%, P = 0.0093); 6 hepatobiliary (0.8%); 10 endocrinological (1.2%). In particular, with regards to the involvement of the musculoskeletal system, arthritis Type 1 was found in 41 CD (19%) and in 61 UC (10.2%) (P = 0.0012) and Type 2 in 25 CD (11.6%) and in 100 UC (16.8%) (P = 0.0012).
CONCLUSION:
Mucocutaneous manifestations, arthritis Type 1 and uveitis were significantly more frequent in CD than UC. The complications of the musculoskeletal system were the mostly observed ones, often with symptoms more severe than intestinal ones, confirming the need for close cooperation with rheumatologists
Patient with chest pain refractory to proton pump inhibitor: report of a case of eosinophilic esophagitis.
No full textEosinophilic esophagitis (EoE) is the most common form of gastrointestinal disorders associated with eosinophilia. Typically, an inappropriate accumulation of eosinophils is found in the esophageal mucosa. EoE can be well managed and treated with several options that include an elimination diet, drug therapy (oral and topical steroids) and esophageal dilatations. We herein, report a case of a 49-year-old male affected by EoE associated to chest pain, treated with proton pump inhibitor without clinical response. The patient suffered from long lasting postprandial fullness and gastroesophageal reflux disease-like symptoms. He had a history of episodic asthmatic attacks and allergic rhinitis but had not dysphagia or food impaction. The patient recovered completely after an adequate treatment
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