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Colonic perforation in a child with crohn’s disease: successful medical treatment can rescue from colectomy.
No full textBackground: The challenging treatment of penetrating paediatric
Crohn’s disease (CD) involves pharmacological and surgical
approaches [1−2]. Despite a proved efficacy of anti-TNF agents
for treatment of complex fistula, a large number of patients cannot
achieve a complete healing and relapses during the follow-up [3].
Specific aim: We report a paediatric case with CD and colonic
perforation who was successfully treated with medical therapy only,
including anti-TNFa.
Case Report: During a colonoscopy performed on a 9 year old girl
with CD, a perforation occurred in correspondence of the splenic flexure.
A laparoscopic suture of the colonic wall was required. The formation
of a peri-splenic and retro-colonic collection was then detected
(US, enteric-CT), with concomitant appearance of fever and severe
increase in the inflammation markers. Images also demonstrated a
fistula connecting the colon to the collection. The girl was kept fasting
and treated with total parenteral nutrition and antibiotic therapy. The
dimensions of the collection decreased progressively at control images
within two months. Treatment with infliximab was started according
to the standard schedule, and after the third dose a US control showed
disappearance of the collection and complete healing of the enteric
fistula. Parenteral nutrition was progressively substituted with enteral
feeding and no surgical treatments have been needed as yet. The girl
is gaining weight and is maintaining good general conditions.
Discussion: In pubertal children with CD, the option of an efficacious
medical treatment to avoid a major surgical approach on the bowel
(colectomy, ileostomy) is to be aimed for growth improvement. This
approach requires a strictly monitored long-term follow-up.
Reference(s)
[1] Vermeire S, Van Assche G, Rutgeerts P. Review article: altering the natural
histoty of Crohn’s disease − evidence for and against current therapies.
Aliment Pharmacol Ther 2006; 25: 3−12.
[2] Gupta N, Bostrom AG, Kirschner BS, Ferry GD, Gold BD, Cohen SA,
Winter HS, Baldassano RN, Abramson O, Smith T, Heyman MB.
Incidence of stricturing and penetrating complications of Crohn’s disease
diagnosed in pediatric patients. Inflamm Bowel Dis 2010; 16(4): 638−44.
[3] Gupta N, Cohen SA, Bostrom AG, Kirschner BS, Baldassano RN,
Winter HS, Ferry GD, Smith T, Abramson O, Gold BD, Heyman MB.
Risk factors for initial surgery in pediatric patients with Crohn’s disease.
Gastroenterology 2006; 130(4): 1069−77
Colonic perforation in a child with Crohn's disease: successful medical treatment rescues from colectomy.
No full textAbstract
Background. The challenging treatment of penetrating paediatric Crohn's disease (CD) involves pharmacological and surgical approaches. Despite a proved efficacy of anti-TNF agents for treatment of complex fistula, a large number of patients cannot achieve a complete healing and relapse during the followup. Aim. We report a paediatric case with CD and colonic perforation who was successfully treated with medical therapy only, including anti-TNFα. Case Presentation. During a colonoscopy performed on a 9-year-old girl with CD, a perforation occurred in correspondence of a fistula at the colonic splenic flexure. The formation of a collection was then detected (US, enteric-CT), as well as a fistula connecting the colon to the collection. The girl was kept fasting and treated with total parenteral nutrition and antibiotic therapy. Treatment with Infliximab was also started, and after the third dose a US control showed disappearance of the collection and healing of the enteric fistula. Parenteral nutrition was progressively substituted with enteral feeding, and no surgical treatments were needed. Discussion. In pubertal children with penetrating CD, the option of an efficacious medical treatment to avoid a major surgical approach on the bowel is to be aimed for growth improvement. This approach requires a strictly monitored long-term followup
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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