196,244 research outputs found
Introduzione
No full textIntroduzione e Nota al testo del volume 'Botta e risposta. Un dialogo interdisciplinare sulla Commedia' di Massimo Campieri ed Emilio Pasquin
Antibiotic treatment of Crohn's disease:results of a multicentre double blind randomized placebo controlled trial with Rifamixin
No full text1. Aliment Pharmacol Ther. 2006 Apr 15;23(8):1117-25.
Antibiotic treatment of Crohn's disease: results of a multicentre, double blind,
randomized, placebo-controlled trial with rifaximin.
Prantera C, Lochs H, Campieri M, Scribano ML, Sturniolo GC, Castiglione F,
Cottone M.
Operative Unit of Gastroenterology, St Camillo-Forlanini Hospital, Rome, Italy.
[email protected]
BACKGROUND: Clinicians often employ antibiotics in Crohn's disease. Rifaximin is
active against bacteria frequently found in the intestinal mucosa of Crohn's
disease patients.
AIM: To evaluate the difference in efficacy between once and twice/daily oral
administration of rifaximin and placebo in the treatment of active Crohn's
disease.
METHODS: We enrolled 83 patients with mild-to-moderate Crohn's disease and
randomized to three treatments for 12 weeks: Group A (rifaximin 800 mg o.d. +
placebo), Group B (rifaximin 800 mg b.d.) and Group C (placebo b.d.).
RESULTS: Clinical remission was achieved by 52% of Group B, 32% (A) and 33% (C).
Clinical response was seen in 67% (B), 48% (A) and 41% (C), without reaching a
statistically significant difference. Treatment failures were: 4% (B), 12% (A)
and 33% (C), (P = 0.010). Remission and response rates of rifaximin 800 mg b.d.
were significantly higher than those of placebo and rifaximin 800 mg o.d. in
patients with elevated C reactive protein values (P < 0.05).
CONCLUSIONS: Rifaximin 800 mg b.d. was superior to placebo in inducing clinical
remission of active Crohn's disease. Although this difference was not
statistically significant, the number of the failures in the placebo group was
significantly higher than those who received rifaximin 800 mg b.d.
PMID: 16611272 [PubMed - indexed for MEDLINE
Problematic proctitis and distal colitis
No full textAbout two-thirds of patients with ulcerative colitis have an inflammatory involvement distal to the splenic flexure, and therefore may be effectively treated with topical treatment, allowing the delivery of the active drug directly to the site of inflammation and limiting systemic absorption and potential side-effects. Topical aminosalicylate therapy is the most effective approach, and most patients will benefit hugely, provided that the formulation reaches the upper extent of the disease. Therefore, the choice of topical preparation should be based on the proximal extent of the disease and on patient preference. Oral aminosalicylates are less effective than topical therapies; however, a combination of oral and topical aminosalicylates can be successful in refractory patients. Alternatives to aminosalicylates are the new glucocorticoids, budesonide and beclometasone dipropionate, either as enemas or oral formulations (only beclometasone dipropionate). A combination of oral or rectal new glucocorticoids with rectal aminosalicylates should be considered in patients refractory to either approach. When these measures fail, treatment with oral glucocorticoids is necessary. An intensive intravenous steroid regimen is also helpful for patients refractory to oral steroids. Alternative treatments include short-chain fatty acid enemas, nicotine enemas and patches, acetarsol suppositories, ciclosporin enemas and epidermal growth factor enemas. Several factors potentially having a negative impact on therapeutic response include concurrent enteric pathogens, coexistent irritable bowel syndrome, patient nonadherence to therapy, inadequate dosing and duration of therapy, and proximal progression of the disease. Surgical colectomy may be required in those rare patients refractory or intolerant to pharmacotherap
Attachment and mentalizing abilities in patients with inflammatory bowel disease
Get PDFBackground. Inflammatory bowel diseases (IBD) are associated with stress, poor quality of life, and attachment insecurity. Mentalization is the human ability to perceive and reason about feelings and psychological dispositions of one's self and others. The chronic disorders are believed to affect patients' mentalizing abilities and to determine a shift towards attachment insecurity in patients affected. In this study, the attachment dimensions and mentalization were assessed in IBD patients and healthy controls. Further knowledge about the interplay among IBD, mentalization, and attachment might shed more light into the psychopathological mechanisms leading to insecurity and vulnerability to stress in IBD. Methods. A group of 96 IBD patients and 102 healthy controls completed the attachment style questionnaire (ASQ), the reflective functioning questionnaire (RFQ), and the Eyes test, a performance-based measure of mentalization. Results. Compared to controls, IBD patients have shown more pronounced attachment anxiety and lower scores in the Eyes test. Disease activity was negatively correlated with the Eyes test scores. Conclusion. These findings have suggested a plausible impact of IBD on mentalization abilities and have provided new insights into the interplay between IBD, deficits in mentalization, and attachment insecurity. IBD patients are highly vulnerable to disease-related stress that may promote impairments in mentalization. Low mentalization might play a central role in the development of attachment insecurity and emotional disturbances in IBD. The present study's results might open new scenarios for psychodynamic approaches to the treatment of the emotional disturbances in IBD based on attachment and mentalization theory
Comparison of oral with rectal mesalazine in the treatment of ulcerative proctitis
No full textPURPOSE: The aim of our study was to compare the efficacy and safety of oral mesalazine with mesalazine suppositories in patients with active ulcerative proctitis. PATIENTS AND METHODS: A four-week, randomized, single- blind trial was performed in 58 patients with active, histologically confirmed ulcerative proctitis (≤ 15 cm) to evaluate the efficacy and safety of oral 800-mg mesalazine tablets taken three times per day (n = 29) compared with 400 mg of mesalazine suppositories administered three times per day (n = 29). Patients were evaluated at study entry and after two and four weeks. Efficacy evaluations included a disease activity index, which represents a score with four variables: stools frequency, rectal bleeding, mucosal appearance, and physician's assessment of disease severity. Histologic activity was also assessed at study entry and after two and four weeks in accordance with the criteria by Truelove and Richard. Safety assessment included clinical laboratory parameters and adverse event reports. RESULTS: There were no significant differences with regard to baseline comparisons of demographics and severity between the two treatment groups. Improvement in mean disease activity index score was significantly greater with suppositories compared with oral mesalazine, both at two-week and four-week visits (mean disease activity index scores at baseline, two, and four weeks: suppositories = 7.7, 2.59, and 1.48; tablets = 7.42, 5.72, and 3.48, respectively (P < 0.001)). The rate of histologic remission was significantly greater with suppositories compared with tablets both at two and four weeks (P < 0.01). There were no significant differences in adverse events or clinical laboratory results between treatment groups. CONCLUSIONS: Results of this study indicate that treatment with mesalazine suppositories produces earlier and significantly better results than oral mesalazine in the treatment of active ulcerative proctitis
5-Aminosalicylic acid as enemas or suppositories in distal ulcerative colitis?
No full textThirty-nine patients with documented active distal proctitis (<20 cm) received either 5-aminosalicylic acid (5-ASA) enemas (2 g in 100 ml) or suppositories 1 g b.i.d., in a controlled study. Twenty patients received enemas, while 19 patients received suppositories, for 30 days. No difference could be observed in terms of efficacy; however, it was the patients’ opinion that treatment with suppositories was easier than that with enemas (p < 0.01). © Lippincott-Raven Publishers
- …
