1,721,110 research outputs found

    Perforating Crohn's disease: conservative and surgical treatment

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    Surgery is a part of the clinical history of patients with Crohn's disease (CD) since nearly all the patients receive at least one surgical procedure. The main indication for surgery is obstruction, but 50-60% of patients present a concomitant perforating disease at surgery, and 10% of patients have a primary indication for abscess or fistula. Generally, fistulas are classified on an anatomical basis, indicating the site of origin followed by the target (i.e. ileocolic, ileovesical, etc.). Enteroenteric fistulas are frequently asymptomatic and are not always considered an indication for surgery. However, in case of bypass with severe malnutrition or bacterial overgrowth (i.e. duodenal involvement), surgery is the only option. Enterovesical, enteroureteral and enterobiliary fistulas, due to their potential for septic complications, are a definite indication for surgery. Enterogenital fistulas have an indication mainly for their impact on the quality of life. Enterocutaneous fistulas are, in most cases, a late surgical complication, and the indication and timing for treatment are due to their output volume. Abscesses may be present alone or in association with enteric fistulas. The initial approach is conservative, and a percutaneous drainage should be a good treatment or a bridge to elective surgery. Since a modern surgical approach to CD has to be minimally invasive and highly conservative whenever possible, the presence of perforating disease should be well characterized in order to plan a laparoscopic approach and to reduce the amount of resected bowel, in case combining resection and strictureplasty. Perforating CD necessitates a multidisciplinary approach involving, behind the gastroenterologist and the surgeon, the radiologist, the urologist, the gynecologist and the nutritionist in order to obtain the best tailored treatment

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    INHIBITION OF INFLAMMATORY ANGIOGENESIS IN RATS BY LOCO-REGIONAL ADMINISTRATION OF HYDROCORTISONE AND PROTAMINE

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    We have studied the antiangiogenetic effects of hydrocortisone and protamine given intra-arterially. The cornea of male, Sprague-Dawley rats were cauterized with silver nitrate. The following treatments were given : 30 mu g hydrocortisone topical (t.p.), b.i.d., 50 mg/kg/day intraperitoneally (i.p.) or intra-arterially (i.a.), 10 mg/kg/day protamine i.p. or i.a. Saline was administered to the control groups. In separate experiments we also evaluated the anti-inflammatory effects of hydrocortisone, i.p., on the cauterized corneas. Five days after cauterization, the animals were killed, exsanguinated and India ink was injected to show the network of neovessels. The percentage area of the cornea covered by neovessels was measured morphometrically and evaluated statistically. Hydrocortisone t.p. (-84%), i.a. (-60%) and protamine i.a. (-44%) significantly inhibited angiogenesis in the cauterized cornea. Either drugs, i.p., had any antiangiogenetic effects, but hydrocortisone significantly reduced cell infiltration of the corneas. The results suggest that locoregional administration of antiangiogenetic drugs might be clinically useful
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