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Sample records for anal por colitis

  1. Anal transition zone in the surgical management of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Jennifer Holder-Murray; Alessandro Fichera

    2009-01-01

    Preservation of the anal transition zone has long been a significant source of controversy in the surgical management of ulcerative colitis. The two techniques for restorative proctocolectomy and ileal pouch anal anastomosis (RPC IPAA) in common practice are a stapled anastomosis and a handsewn anastomosis;these techniques differ in the amount of remaining rectal mucosa and therefore the presence of the anal transition zone following surgery. Each technique has advantages and disadvantages in long-term functional outcomes, operative and postoperative complications, and risk of neoplasia. Therefore, we propose a selective approach to performing a stapled RPC IPAA based on the presence of dysplasia in the preoperative endoscopic evaluation.

  2. Open versus laparoscopic (assisted) ileo pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis

    NARCIS (Netherlands)

    Ali, Usama Ahmed; Keus, Frederik; Heikens, Joost T.; Bemelman, Willem A.; Berdah, Stephane V.; Gooszen, H. G.; van Laarhoven, Cees J. H. M.

    2009-01-01

    Background Restorative proctocolectomy with ileo pouch anal anastomosis (IPAA) is the main surgical treatment for patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP). With the advancements of minimal-invasive surgery this demanding operation is increasingly being performed

  3. Proctocolectomy and ileal J-pouch anal anastomosis on the surgical treatment of familial adenomatous polyposis and ulcerative colitis: analysis of 49 cases

    Directory of Open Access Journals (Sweden)

    Bruno Amaral Medeiros

    2012-09-01

    Full Text Available OBJECTIVE: To evaluate the results of ileal J-pouch anal anastomosis in ulcerative colitis and familial adenomatous polyposis. METHOD: Retrospective analysis of medical records of 49 patients submitted to ileal J-pouch anal anastomosis. RESULTS: Ulcerative colitis was diagnosed in 65% and familial adenomatous polyposis in 34%. Mean age was 39.5 years. 43% were male. Among familial adenomatous polyposis, 61% were diagnosed with colorectal cancer. Thirty-one percent of patients with ulcerative colitis was submitted to a previous surgical approach and 21% of these had toxic megacolon. Average hospital stay was 10 days. Post-operative complications occurred in 50% of patients with ulcerative colitis and 29.4% with familial adenomatous polyposis. Intestinal diversion was performed in 100% of ulcerative colitis and 88% of familial adenomatous polyposis. Pouchitis occurred in eight cases (seven ulcerative colitis and one FAP, requiring excision of the pouch in three ulcerative colitis. Mortality rate was 7.6%: two cases of carcinoma on the pouch and two post-operative complications. Late post-operative complications occurred in 22.4%: six familial adenomatous polyposis and five ulcerative colitis. Two patients had erectile dysfunction, and one retrograde ejaculation. One patient with severe perineal dermatitis was submitted to excision of the pouch. Incontinence occurred in four patients and two reported soil. Mean bowel movement was five times a day. CONCLUSION: Ileal J-pouch anal anastomosis is a safe surgery with acceptable morbidity and good functional results, if well indicated and performed in referral centers.OBJETIVO: Avaliar resultados da anastomose íleo-anal com bolsa ileal em J na colite ulcerativa e na polipose adenomatosa familiar. MÉTODO: Análise retrospectiva dos prontuários de 49 pacientes submetidos a anastomose íleo-anal com bolsa ileal em J. RESULTADOS: 65% de colite ulcerativa e 34% de polipose adenomatosa familiar. Idade m

  4. Pouchitis-Associated Iritis (Uveitis Following Total Proctocolectomy and Ileal Pouch-to-Anal Anastomosis in Ulcerative Colitis

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    Hugh James Freeman

    2001-01-01

    Full Text Available A 26-year-old woman with ulcerative colitis treated with a proctocolectomy and ileal pouch-to-anal anastomosis developed an erosive and ulcerative pouchitis. Although no ophthalmological manifestations were present before the staged surgical procedures, iritis developed after appearance of the pouchitis. Both conditions subsequently resolved with oral corticosteroids and metronidazole.

  5. Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis: A narrative review.

    Science.gov (United States)

    Sofo, Luigi; Caprino, Paola; Sacchetti, Franco; Bossola, Maurizio

    2016-08-27

    Restorative proctocolectomy with ileal pouch-anal anastomosis (RP-IPAA) is the gold standard surgical treatment for ulcerative colitis. However, despite the widespread use of RP-IPAA, many aspects of this treatment still remain controversial, such as the approach (open or laparoscopic), number of stages in the surgery, type of pouch, and construction type (hand-sewn or stapled ileal pouch-anal anastomosis). The present narrative review aims to discuss current evidence on the short-, mid-, and long-term results of each of these technical alternatives as well as their benefits and disadvantages. A review of the MEDLINE, EMBASE, and Ovid databases was performed to identify studies published through March 2016. Few large, randomized, controlled studies have been conducted, which limits the conclusions that can be drawn regarding controversial issues. The available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected cases. Regarding 2- and 3-stage RP-IPAA, patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables, making any comparisons extremely difficult. The long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly, although the J pouch is generally preferred by surgeons. Hand-sewn and stapled ileal pouch-anal anastomoses have their own advantages, and there is no clear benefit of one technique over the other. PMID:27648159

  6. Clinical outcome of ileal pouch-anal anastomosis for chronic ulcerative colitis in China

    Institute of Scientific and Technical Information of China (English)

    Liu Gang; Han Hongqiu; Liu Tong; Fu Qiang; Lyu Yongcheng

    2014-01-01

    Background The incidence of chronic ulcerative colitis (CUC) in China is remarkably increasing,while little information on surgical treatment has been reported.This study aimed to completely describe and analyze the clinical outcome of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for CUC in China.Methods Ninety-five consecutive patients,who suffered CUC and had surgical indications,were carefully selected.All patients underwent IPAA.Data on patient characteristics,surgical indications,surgical details,postoperative complications,functional outcome,and quality of life were collected.Results The mean patient age at the time of the operation was 32 years.Twenty-nine (31%) patients underwent an emergency operation,and 66 (69%) underwent elective procedures.Four patients with severe dysplasia underwent operations,but no carcinoma was histologically confirmed.A two-stage operation was performed in 87 (92%) patients,and a hand-sewn technique was applied in 88 (93%) patients.Sixteen patients (17.0%) experienced early complications,and there was a significant difference between the emergency surgery group and the elective group (31.0% vs.10.6%,respectively; P <0.01).Five (5.3%) patients developed pouchitis as a late complication.The mean stool frequency after the operation was 4.6 (2-11) during the first 24 hours and 1.5 (0-4) overnight.According to the Kirwan grading scale,87 (91.8%) patients showed satisfactory anal continence function.The quality of life improved significantly from a preoperative mean value of 0.28-0.61 before ileostomy closure to 0.78 after ileostomy closure (P <0.01) according to the Cleveland Global Quality of Life index.Conclusions IPAA is an effective and safe surgical procedure for patients with CUC in China.However,some characteristics,such as the low incidence of pouchitis,require further study.

  7. O papel do óxido nítrico na pressão anal esfincteriana de ratos submetidos à colite experimental The role of nitric oxide in sphincteric anal pressure of rats with experimental colitis

    Directory of Open Access Journals (Sweden)

    Henrique Sarubbi Fillmann

    2006-12-01

    Full Text Available O óxido nítrico (NO é um radical livre sintetizado endogenamente por várias células do nosso organismo. Apresenta um amplo espectro de ações fisiológicas, sendo as mais importantes o seu mecanismo de ação parácrino no relaxamento da musculatura lisa, sua atividade neurotransmissora em vários sistemas e seu envolvimento no processo inflamatório. O NO é sintetizado em diferentes tecidos através da conversão da L-arginina em L-citrulina pela ação da enzima óxido nítrico sintase (NOS. OBJETIVOS: Este estudo tem por objetivo demonstrar o envolvimento do óxido nítrico no processo intestinal inflamatório de ratos Wistar submetidos à colite experimental com ácido acético. MATERIAL E MÉTODOS: Foram utilizados 20 ratos machos Wistar, com peso entre 250 e 350 gramas divididos em dois grupos de 10 animais. Os animais do grupo em estudo foram submetidos à administração intracolônica, por enema, de uma solução de ácido acético diluído a 7% e com volume de 3 ml. O grupo controle recebeu apenas enema de solução salina. Foram avaliados os índices histológicos, a expressão da enzima óxido nítrico sintase (iNOS e a pressão anal esfincteriana. RESULTADOS: Os índices histológicos apresentaram uma significativa elevação no grupo colite quando comparados ao grupo controle, tanto na avaliação macroscópica quanto na microscópica. A expressão da enzima iNOS também foi significativamente maior no grupo colite quando comparada ao grupo controle. A pressão anal esfincteriana foi significativamente mais baixa no grupo colite na comparação ao grupo controle. CONCLUSÃO: Os animais submetidos à colite experimental apresentam um aumento da expressão da enzima óxido nítrico sintase induzível (i-NOS. Este aumento, associado ao conseqüente aumento do nível de óxido nítrico, ocasiona uma diminuição dos níveis de pressão anal esfincteriana.The nitric oxide (NO is a free radical synthesized from some cells of our

  8. Intraperitoneal injection (IP), Intravenous injection (IV) or anal injection (AI)? Best way for mesenchymal stem cells transplantation for colitis

    Science.gov (United States)

    Wang, Min; Liang, Cong; Hu, Hao; Zhou, Lin; Xu, Bing; Wang, Xin; Han, Ying; Nie, Yongzhan; Jia, Shuyun; Liang, Jie; Wu, Kaichun

    2016-01-01

    Stem cell transplantation showed promising results in IBD management. However, the therapeutic impacts of cell delivery route that is critical for clinical translation are currently poorly understood. Here, three different MSCs delivery routes: intraperitoneal (IP), intravenous (IV), and anal injection (AI) were compared on DSS-induced colitic mice model. The overall therapeutic factors, MSCs migration and targeting as well as local immunomodulatory cytokines and FoxP3+ cells infiltration were analyzed. Colitis showed varying degrees of alleviation after three ways of MSCs transplantation, and the IP injection showed the highest survival rate of 87.5% and displayed the less weight loss and quick weight gain. The fecal occult blood test on the day 3 also showed nearly complete absence of occult blood in IP group. The fluorescence imaging disclosed higher intensity of engrafted cells in inflamed colon and the corresponding mesentery lymph nodes (MLNs) in IP and AI groups than the IV group. Real time-PCR and ELISA also demonstrate lower TNF-α and higher IL-10, TSG-6 levels in IP group. The immunohistochemistry indicated higher repair proliferation (Ki-67) and more FoxP3+ cells accumulation of IP group. IP showed better colitis recovery and might be the optimum MSCs delivery route for the treatment of DSS-induced colitis. PMID:27488951

  9. Possible role of human cytomegalovirus in pouchitis after proctocolectomy with ileal pouch-anal anastomosis in patients with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Damian Casadesus; Tatsuo Tani; Toshifumi Wakai; Satoshi Maruyama; Tsuneo Iiai; Haruhiko Okamoto; Katsuyoshi Hatakeyama

    2007-01-01

    AIM:To detect the presence of human cytomegalovirus(HCMV)proteins and genes on the ileal pouch of patients with ulcerative colitis who have undergone proctocolectomy with ileal pouch-anal anastomosis(IPAA).METHODS:Immunohistochemistry,polymerase chain reaction(PCR)and PCR sequencing methods were utilized to test the presence of HCMV in pouch specimens taken from 34 patients in 86 endoscopies.RESULTS:HCMV genes and proteins were detected in samples from 12(35.2%)patients.The rate of detection was significant in the endoscopies from patients diagnosed with pouchitis(5 of 12,41.6%),according to the Japanese classification of pouchitis,in comparison to patients with normal pouch(7 of 62,11.2%;P = 0.021).In all patients with pouchitis in which the HCMV was detected,it was the first episode of pouchitis.The virus was not detected in previous biopsies taken in normal endoscopies of these patients.During the followup,HCMV was detected in one patient with recurrent pouchitis and in 3 patients whose pouchitis episodes improved but whose positive endoscopic findings persisted.CONCLUSION:HCMV can take part in the inflammatory process of the pouch in some patients with ulcerative colitis who have undergone proctocolectomy with IPAA.

  10. Pseudomembranous colitis

    Science.gov (United States)

    Antibiotic-associated colitis; Colitis - pseudomembranous; Necrotizing colitis; C difficile - pseudomembranous ... this bacteria from 1 person to another. Pseudomembranous colitis is uncommon in children, and rare in infants. ...

  11. Verificación analítica para las determinaciones de cromo hexavalente en aguas por espectrofotometría

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    Carlos Alberto Severiche Sierra

    2013-06-01

    Full Text Available En la actualidad la prestación de servicios analíticos de laboratorios, toma de forma ascendente más auge y utilidad. El efecto de un análisis de aguas es forjar resultados correctos y confiables, siendo la verificación de ensayos uno de los aspectos más importantes y factor clave para conseguir este propósito. La determinación de cromo hexavalente en aguas por colorimetría con la difenilcarbazida es la metodología analítica más usada y útil que se conoce en el ámbito científico técnico, principalmente, por su alta selectividad y también debatida por su reacción a las interferencias. En el presente estudio se hizo la valoración analítica del método espectrofotométrico para la determinación de cromo hexavalente en aguas; el objetivo de este trabajo fue confirmar correctamente la aplicación del método para el análisis de aguas. Se trabajaron muestras de diferentes tipos de agua: potable, residual y superficial, siguiéndose estrictamente los protocolos de verificación. Se encontraron resultados satisfactorios en precisión y exactitud con el fin de emitir resultados confiables y reales de la muestra analizada.

  12. La administración de Carditrofina-1 mejora la colitis ulcerosa inducida por dextrano sulfato de sodio

    OpenAIRE

    Prieto Vicente, Vanessa

    2015-01-01

    [ES] La enfermedad inflamatoria intestinal crónica (EIIC) surge de la interacción entre las bacterias de la luz intestinal y la mucosa y comprende la colitis ulcerosa (CU), la enfermedad de Crohn (EC) y la colitis inclasificable (CI) . Aunque la etiopatogenia de la EIIC no ha sido claramente dilucidada, se atribuye a una compleja interacción entre factores genéticos, ambientales, microbianos y diversos factores inmunes que incluyen péptidos quimiotácticos y citocinas proinflamatorias. La dis...

  13. Cytomegaloviral colitis in HIV positive patients: endoscopic findings Colite por citomegalovírus em pacientes HIV positivo: aspectos endoscópicos

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    Oswaldo Marques Jr

    2007-12-01

    Full Text Available BACKGROUND: Diarrhea in seropositive human immunodeficiency virus patients is one of the most important and disabling symptoms, and often decreases their quality of life. Cytomegalovirus colitis is among the principal causes of this symptom and colonoscopy is the gold standard examination to diagnose it. AIM: To define the main endoscopic findings in seropositive human immunodeficiency virus patients with cytomegalovirus colitis. METHODS: Two hundred and forty-three colonoscopies were performed in 200 seropositive human immunodeficiency virus patients with diarrhea associated or not to abdominal pain or gastrointestinal bleeding, over 10-year period, whom 51 patients were diagnosed with cytomegalovirus colitis. Full length colonoscopy with ileum intubation was always tried and multiple biopsies of all segments examined, including endoscopically normal segments, were attempted. All diagnoses were confirmed by histologic and immunohistochemical studies. RESULTS: Total colonoscopy was possible in 98.03% and ileum intubation in 88.23% of these cytomegalovirus colitis patients. At colonoscopy, a heterogeneous ulcerative pattern was presented in 72.54%, an inflammatory process of the mucosa in 21.56% and 5.88% of the patients mucosa was endoscopically normal. CONCLUSION: Full length colonoscopy with ileum intubation and multiples biopsies of all segments, even when they are endoscopically normal, have always to be attempted in cases of seropositive human immunodeficiency virus patient with diarrhea.RACIONAL: Diarréia em pacientes soropositivos para o vírus da imunodeficiência adquirida é um dos sintomas mais importantes e debilitantes e freqüentemente reduz sua qualidade de vida. Colite por citomegalovírus está entre as principais causas desse sintoma e a colonoscopia é o exame padrão-ouro para seu diagnóstico. OBJETIVO: Definir os principais achados endoscópicos em pacientes HIV+ com colite por citomegalovírus. MÉTODO: Duzentas e

  14. Surgery for Crohn's anal fistulas.

    Science.gov (United States)

    Sugita, A; Koganei, K; Harada, H; Yamazaki, Y; Fukushima, T; Shimada, H

    1995-11-01

    The aim of this study was to analyze the features of Crohn's anal fistulas and to evaluate the efficacy of seton treatment. In 119 patients with Crohn's disease, the incidence of anal fistula was 56% (67/119), with no significant difference in the incidence among patients with ileitis, colitis, and ileocolitis. "Intractable" anal fistulas were found in 17% of patients with ileitis, compared to 64% of those with colitis (P = 0.051) and 68% of those with ileocolitis (P = 0.014). Seton treatment, i.e., non-cutting, long-term seton drainage, was performed for 21 patients (5 with intersphincteric, and 16 with transsphincteric fistulas). In the 16-month follow up, 9 patients required redrainage for recurrent fistulous abscess, mainly because of progressive colorectal disease. Finally, a good result was obtained in 17 of the 21 patients (81%) and no recurrent fistulous abscess developed in the 8 patients in whom all setons were removed. Anal continence was preserved in all the patients. These results indicate that anal fistulas with Crohn's ileitis were cured more easily than those with colitis or ileocolitis, and that seton treatment was effective for intersphincteric fistula with multiple fistula openings and for transphincteric fistulas in patients exhibiting remission of intestinal Crohn's disease. PMID:8563879

  15. Determinação analítica da performance da irrigação por sulcos abertos e em declive

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    Aristides Fraga Lima Filho

    2015-06-01

    Full Text Available Uma solução analítica foi desenvolvida, para avaliar sulcos abertos e em declive, com base na teoria de Balanço de Volume de Walker e Skogerboe (1987. Essa metodologia é capaz de obter, matematicamente, a performance de um sistema, dispensando a construção de gráficos que definem os parâmetros de avaliação. A solução matemática é baseada no ajuste de equações ao modelo potencial, no cálculo das áreas sob as curvas definidas no ajuste e na intercessão de curvas, obtendo-se, assim, a performance de sistemas de irrigação por sulcos abertos e em declive. Para validação da metodologia, foi realizado um experimento de campo, na Fazenda Experimental da Universidade Federal do Ceará, situada no município de Pentecoste, pertencente ao Centro de Ciências Agrárias. Os dados de campo foram submetidos à análise pelas duas metodologias. Os resultados mostraram que a metodologia analítica pode ser usada para avaliar a irrigação por sulcos abertos e em declive.

  16. Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis Resultado precoce e tardio da anastomose íleoanal com reservatório ileal na retocolite ulcerativa

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    Magaly Gemio Teixeira

    2003-01-01

    Full Text Available Ileal pouch-anal anastomosis was an important advancement in the treatment of ulcerative colitis. The aim of this study was to determine whether early complications of ileal pouch-anal anastomosis in patients with ulcerative colitis are associated with poor late functional results. PATIENTS AND METHODS: Eighty patients were operated on from 1986 to 2000, 62 patients with ileostomy and 18 without. The early and late complications were recorded. Specific emphasis has been placed on the incidence of pouchitis with prolonged follow-up. RESULTS: The ileostomy was closed an average of 9.2 months after the first operation. Fourteen patients were excluded from the long-term evaluation; 6 patients were lost to regular follow-up, 4 died, and 4 patients still have the ileostomy. Of the 4 patients that died, 1 died from surgical complications. Early complications after operation (41 occurred in 34 patients (42.5%. Late complications (29 occurred in 25 patients as follows: 16 had pouchitis, 3 associated with stenosis and 1 with sexual dysfunction; 5 had stenosis; and there was 1 case each of incisional hernia, ileoanal fistula, hepatic cancer, and endometriosis. Pouchitis occurred in 6 patients (9.8% 1 year after ileal pouch-anal anastomosis, 9 (14.8% after 3 years, 13 (21.3% after 5 years, and 16 (26.2% after more than 6 years. The mean daily stool frequency was 12 before and 5.8 after operation. One pouch was removed because of fistulas that appeared 2 years later. CONCLUSIONS: Ileal pouch-anal anastomosis is associated with a considerable number of early complications. There was no correlation between pouchitis and severe disease, operation with or without ileostomy, or early postoperative complications. The incidence of pouchitis was directly proportional to duration of time of follow-up.A anastomose íleo-anal com reservatório ileal foi um importante avanço no tratamento da retocolite ulcerativa. O objetivo deste trabalho foi determinar se os maus

  17. Las transformaciones empresariales en la industria de artes gráficas. Los retos analíticos de las historias por contar

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    Florentino Malaver Rodríguez

    2002-06-01

    Full Text Available Este artículo se compone de dos partes. En la primera se identifican las tendencias que enmarcan las transformaciones ocurridas en la industria de artes gráficas, imprentas y editoriales en las dos últimas décadas del siglo XX. Entre estas se destacan la conformación de grupos empresariales en medio de un notable impacto del cambio técnico impulsado por la digitalización de la producción gráfica y una acelerada convergencia tecnológica que propicia la integración de la industria gráfica con las de la información, la comunicación y el entretenimiento. A causa de ello esta industria está inmersa en una reconfiguración que afecta su morfología. En la segunda parte, se intentan dilucidar los retos analíticos que se desprenden de las transformaciones detectadas, y se plantea que para interpretar la dinámica de las transformaciones empresariales detectadas y el papel vital que en ellas juega el cambio técnico se pueden integrar los aportes de la teoría de los costos de transacción, la perspectiva evolutiva del cambio técnico y el enfoque de los recursos y las capacidades. Se sugiere, igualmente, que síntesis analíticas como la propuesta reclaman una apertura disciplinaria concordante con los desafíos que abren transformaciones empresariales como la descrita en la primera parte del artículo y que poco se han estudiado en el país.

  18. Ulcerative colitis - discharge

    Science.gov (United States)

    Inflammatory bowel disease - ulcerative colitis - discharge; Ulcerative proctitis - discharge; Colitis - discharge ... were in the hospital because you have ulcerative colitis. This is a swelling of the inner lining ...

  19. Microscopic colitis

    DEFF Research Database (Denmark)

    Münch, A; Aust, D; Bohr, Jakob;

    2012-01-01

    Microscopic colitis (MC) is an inflammatory bowel disease presenting with chronic, non-bloody watery diarrhoea and few or no endoscopic abnormalities. The histological examination reveals mainly two subtypes of MC, lymphocytic or collagenous colitis. Despite the fact that the incidence in MC has...... been rising over the last decades, research has been sparse and our knowledge about MC remains limited. Specialists in the field have initiated the European Microscopic Colitis Group (EMCG) with the primary goal to create awareness on MC. The EMCG is furthermore a forum with the intention to promote...

  20. [Collagenous colitis].

    Science.gov (United States)

    Lindström, C G

    1991-05-01

    Collagenous colitis is now regarded by an overwhelming majority of authors as a clinicopathological entity and has been taken up as a such in many text-books and diagnostic atlases (Morson & Dawson, 1990, Fenoglio-Preiser et al., 1989, Whitehead 1985, Whitehead 1989). A good, detailed review of cases of collagenous colitis published up to 1988 was performed by Perri et al. Collagenous colitis was also presented to a wider medical public through a clinicopathological conference case at Massachusetts General Hospital (Case 29-1988). Finally it may be added that collagenous colitis has been included in the new fourth edition of Robbins Pathologic Basis of Disease (Cotran, Kumar, Robbins, 1989), where the possibility of an autoimmune disease is stressed.

  1. Microscopic colitis

    Institute of Scientific and Technical Information of China (English)

    Gianluca Ianiro; Giovanni Cammarota; Luca Valerio; Brigida Eleonora Annicchiarico; Alessandro Milani; Massimo Siciliano; Antonio Gasbarrini

    2012-01-01

    Microscopic colitis may be defined as a clinical syndrome,of unknown etiology,consisting of chronic watery diarrhea,with no alterations in the large bowel at the endoscopic and radiologic evaluation.Therefore,a definitive diagnosis is only possible by histological analysis.The epidemiological impact of this disease has become increasingly clear in the last years,with most data coming from Western countries.Microscopic colitis includes two histological subtypes [collagenous colitis (CC) and lymphocytic colitis (LC)] with no differences in clinical presentation and management.Collagenous colitis is characterized by a thickening of the subepithelial collagen layer that is absent in LC.The main feature of LC is an increase of the density of intra-epitll lial lymphocytes in the surface epithelium.A number of pathogenetic theories have been proposed over the years,involving the role of luminal agents,autoimmunity,eosinophils,genetics (human leukocyte antigen),biliary acids,infections,alterations of pericryptal fibroblasts,and drug intake; drugs like ticlopidine,carbamazepine or ranitidine are especially associated with the development of LC,while CC is more frequently linked to cimetidine,non-steroidal antiinflammatory drugs and lansoprazole.Microscopic colitis typically presents as chronic or intermittent watery diarrhea,that may be accompanied by symptoms such as abdominal pain,weight loss and incontinence.Recent evidence has added new pharmacological options for the treatment of microscopic colitis:the role of steroidal therapy,especially oral budesonide,has gained relevance,as well as immunosuppressive agents such as azathioprine and 6-mercaptopurine.The use of anti-tumor necrosis factor-α agents,infliximab and adalimumab,constitutes a new,interesting tool for the treatment of microscopic colitis,but larger,adequately designed studies are needed to confirm existing data.

  2. La administración preventiva de cardiotrofina-1 disminuye la gravedad de la colitis ulcerosa inducida por dextrano sulfato de sodio

    OpenAIRE

    Sánchez Garrido, Ana Isabel

    2015-01-01

    [ES]La enfermedad inflamatoria intestinal crónica (EIIC) surge de la interacción entre las bacterias de la luz intestinal y la mucosa y comprende la colitis ulcerosa (CU), la enfermedad de Crohn (EC) y la colitis inclasificable (CI) . Aunque la etiopatogenia de la EIIC no ha sido claramente dilucidada, se atribuye a una compleja interacción entre factores genéticos, ambientales, microbianos y diversos factores inmunes que incluyen péptidos quimiotácticos y citocinas proinflamatorias. La disr...

  3. Colitis ulcerosa

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Jess, Tine; Bjerrum, Jacob Tveiten;

    2013-01-01

    Ulcerative colitis (UC) is a prevalent inflammatory bowel disease of the colonic mucosa affecting approximately 20,000-25,000 Danes. Apart from subgroups with early onset, extensive and long-standing inflammation, or primary sclerosing cholangitis the risk of developing colorectal cancer is of th......Ulcerative colitis (UC) is a prevalent inflammatory bowel disease of the colonic mucosa affecting approximately 20,000-25,000 Danes. Apart from subgroups with early onset, extensive and long-standing inflammation, or primary sclerosing cholangitis the risk of developing colorectal cancer...

  4. CMV - gastroenteritis/colitis

    Science.gov (United States)

    Colitis - cytomegalovirus; Gastroenteritis - cytomegalovirus; Gastrointestinal CMV disease ... or after bone marrow or organ transplant Ulcerative colitis or Crohn disease Rarely, serious CMV infection involving ...

  5. Desarrollo de metodología analítica para la determinación de contaminantes basada en el cálculo por deconvolución de perfiles isotópicos

    OpenAIRE

    Fabregat Cabello, Neus

    2015-01-01

    El análisis por dilución isotópica y espectrometría de masas (IDMS) es reconocido como una de las técnicas más potentes para obtener resultados altamente fiables y de gran calidad metrológica en el campo de la química analítica. IDMS destaca como la forma de cuantificación más adecuada ante determinaciones realizadas en matrices de alta complejidad, siendo por ello ampliamente utilizado durante el acoplamiento de las técnicas de cromatografía a la espectrometría de masas. Además IDMS también ...

  6. Anal acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J;

    2011-01-01

    Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new technique of assessing anal sphincter function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, the opening and closing elastance, and hysteresis....

  7. Eosinophilic colitis

    Institute of Scientific and Technical Information of China (English)

    Nnenna Okpara; Bassam Aswad; Gyorgy Baffy

    2009-01-01

    Eosinophilic colitis (EC) is a rare form of primary eosinophilic gastrointestinal disease with a bimodal peak of prevalence in neonates and young adults. EC remains a little understood condition in contrast to the increasingly recognized eosinophilic esophagitis. Clinical presentation of EC is highly variable according to mucosal, transmural, or serosal predominance of inflammation. EC has a broad differential diagnosis because colon tissue eosinophilia often occurs in parasitic infection, drug-induced allergic reactions,inflammatory bowel disease, and various connective tissue disorders, which require thorough searching for secondary causes that may be specifically treated with antibiotics or dietary and drug elimination.Like eosinophilic gastrointestinal disease involving other segments of the gastrointestinal tract, EC responds very well to steroids that may be spared by using antihistamines, leukotriene inhibitors and biologics.

  8. Perfil clínico da Enterocolite por Citomegalovírus (CMV na síndrome da imunodeficiência adquirida (Aids Clinical profile of Cytomegalovirus Colitis in AIDS

    Directory of Open Access Journals (Sweden)

    D.B. de Lima

    2000-03-01

    Full Text Available Múltiplos agentes estão envolvidos na etiopatogenia da diarréia em Aids. O exame de fezes e a colonoscopia são elementos decisivos para o diagnóstico específico. A enterocolite por CMV pode cursar com febre, emagrecimento, diarréia intermitente e hematoquesia. Outros agentes causadores de diarréia podem ter o mesmo espectro de apresentação. OBJETIVO: Definir o perfil clínico da enterocolite por CMV em pacientes com Aids, comparando os parâmetros clínicos, endoscópicos e de tempo de sobrevida entre dois grupos com diarréia crônica, grupo A com CMV e grupo B sem CMV. MÉTODOS: Foram acompanhados 48 pacientes com Aids e diarréia de duração maior que 30 dias, sendo 27 do grupo A e 21 do grupo B. Os parâmetros analisados foram idade, situação de risco, duração da diarréia, hematoquesia, intervalo de tempo entre diagnóstico da infecção por HIV e início de diarréia, achados endoscópicos e sobrevida. Foram realizados exames parasitológicos, culturas e colonoscopia com biópsias. Foi utilizado o teste "t-student" para amostras não pareadas e o teste Qui-Quadrado com correção de Yates para variáveis não paramétricas. Foram construídas curvas de sobrevida pelo método descrito por Kaplan-Meier e aplicado o teste de Mantel - Haenszel. Foi assumido como nível de significância estatística o valor de P menor que 0.05. RESULTADOS: O padrão endoscópico da infecção por CMV correspondeu a ulcerações associadas a hemorragia de submucosa 14 (51.8% P P > 0.001. Os outros parâmetros estudados não mostraram significância estatística. CONCLUSÕES: A presença de enterocolite por CMV em Aids é marcador de mau prognóstico e menor sobrevida. Existe um padrão endoscópico sugestivo da infecção por CMV.OBJECTIVE: To determine the clinical profile of CMV colitis in AIDS patients, comparing clinical, endoscopic parameters and survival time between 2 groups of AIDS patients having chronic diarrhea. Group A being CMV

  9. Complications of collagenous colitis

    OpenAIRE

    Freeman, Hugh James

    2008-01-01

    Microscopic forms of colitis have been described, including collagenous colitis. This disorder generally has an apparently benign clinical course. However, a number of gastric and intestinal complications, possibly coincidental, may develop with collagenous colitis. Distinctive inflammatory disorders of the gastric mucosa have been described, including lymphocytic gastritis and collagenous gastritis. Celiac disease and collagenous sprue (or collagenous enteritis) may occur. Colonic ulceration...

  10. Ileal pouch surgery for ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Simon P Bach; Neil J Mortensen

    2007-01-01

    Ulcerative colitis (UC) is a relapsing and remitting disease characterised by chronic mucosal and submucosal inflammation of the colon and rectum.Treatment may vary depending upon the extent and severity of inflammation. Broadly speaking medical treatments aim to induce and then maintain remission.Surgery is indicated for inflammatory disease that is refractory to medical treatment or in cases of neoplastic transformation. Approximately 25% of patients with UC ultimately require colectomy. Ileal pouch-anal anastomosis (IPAA) has become the standard of care for patients with ulcerative colitis who ultimately require colectomy. This review will examine indications for IPAA, patient selection, technical aspects of surgery,management of complications and long term outcome following this procedure.

  11. El Modelo Analítico Tridimensional obtenido por fotogrametría. Descomposición, manipulación y aplicaciones en el campo de la restauración arquitectónica

    Directory of Open Access Journals (Sweden)

    Cámara, Leandro

    2003-12-01

    permite situar cada línea en su posición real en el espacio. Estos modelos de líneas son transparentes, lo que impide ocultar las líneas que su sitúan en un segundo plano, y ocupan gran cantidad de memoria, lo que dificulta su manipulación informática. Para resolver ese problema es necesario descomponer el modelo 3D por archivos y capas de dibujo. Cada archivo de dibujo incluye las líneas restituidas de un elemento constructivo y se identifica por la tipología del elemento y su posición en el espacio del edificio. Las líneas se separan en capas según su orientación geográfica y su tipología (arista, contorno, fisura, etc.. La gestión del conjunto de archivos que componen el modelo 3D se realiza directamente por designación o gráficamente mediante un plano guía simplificado en el que cada línea es una llamada a un archivo. El modelo 3D analítico en una maqueta informática del monumento que nos permite visualizaciones y análisis métricos, geométricos, constructivos y estructurales imposibles sin esta herramienta. Al conectar informáticamente cada una de las entidades dibujadas con un sistema de bases de datos externo de los estudios del monumento se establecerá lo que conocemos como «Monument Information System», MIS.

  12. Sulfate-reducing bacteria colonize pouches formed for ulcerative colitis but not for familial adenomatous polyposis.

    LENUS (Irish Health Repository)

    Duffy, M

    2012-02-03

    PURPOSE: Ileal pouch-anal anastomosis remains the "gold standard" in surgical treatment of ulcerative colitis and familial adenomatous polyposis. Pouchitis occurs mainly in patients with a background of ulcerative colitis, although the reasons for this are unknown. The aim of this study was to characterize differences in pouch bacterial populations between ulcerative colitis and familial adenomatous pouches. METHODS: After ethical approval was obtained, fresh stool samples were collected from patients with ulcerative colitis pouches (n = 10), familial adenomatous polyposis (n = 7) pouches, and ulcerative colitis ileostomies (n = 8). Quantitative measurements of aerobic and anaerobic bacteria were performed. RESULTS: Sulfate-reducing bacteria were isolated from 80 percent (n = 8) of ulcerative colitis pouches. Sulfate-reducing bacteria were absent from familial adenomatous polyposis pouches and also from ulcerative colitis ileostomy effluent. Pouch Lactobacilli, Bifidobacterium, Bacteroides sp, and Clostridium perfringens counts were increased relative to ileostomy counts in patients with ulcerative colitis. Total pouch enterococci and coliform counts were also increased relative to ileostomy levels. There were no significant quantitative or qualitative differences between pouch types when these bacteria were evaluated. CONCLUSIONS: Sulfate-reducing bacteria are exclusive to patients with a background of ulcerative colitis. Not all ulcerative colitis pouches harbor sulfate-reducing bacteria because two ulcerative colitis pouches in this study were free of the latter. They are not present in familial adenomatous polyposis pouches or in ileostomy effluent collected from patients with ulcerative colitis. Total bacterial counts increase in ulcerative colitis pouches after stoma closure. Levels of Lactobacilli, Bifidobacterium, Bacteroides sp, Clostridium perfringens, enterococci, and coliforms were similar in both pouch groups. Because sulfate-reducing bacteria are

  13. Crohn's & Colitis Foundation of America

    Science.gov (United States)

    ... enabled to enjoy the full interactive experience. Crohn's & Colitis Foundation of America Find a Doctor Find a ... Local Chapters News Events Search: What are Crohn's & Colitis? What is Crohn's Disease What is Ulcerative Colitis ...

  14. Intractable colitis associated with chronic granulomatous disease in a young girl.

    Science.gov (United States)

    Yaman, Aytaç; Kuloğlu, Zarife; Doğu, Figen; İkincioğulları, Aydan; Ensari, Arzu; Çiftçi, Ergin; Kansu, Aydan

    2015-01-01

    Chronic granulomatous disease (CGD) is an autosomal recessive or X-linked disorder caused by NADPH oxidase deficiency leading to an impaired ability of reactive superoxide anion and metabolite formation and recurring severe bacterial and fungal infections, with a high mortality rate. Diarrhea, colitis, ileus, perirectal abscess formation and anal fissures are reported gastrointestinal findings in these patients. We report a case of intractable colitis associated with CGD in a young girl.

  15. Validação de métodos analíticos por espectrofotometria de absorção atómica

    OpenAIRE

    Almeida, Marina Margarida Pereira de

    2013-01-01

    O presente relatório, inserido no Trabalho Final de Mestrado em Tecnologia Química, foi desenvolvido no âmbito do estágio realizado no Centro Tecnológico da Cerâmica e do Vidro (CTCV), empresa vocacionada para aprovisionar apoio técnico e promoção tecnológica às indústrias nacionais da cerâmica, vidro e outros sectores. Possui uma estrutura técnica organizada em Centros de Competência, cada um composto por diversas unidades. O estágio realizou-se no Centro de Competência Medição e Ensaio no L...

  16. Rigidez do papelão ondulado: comparação entre resultados experimentais e os obtidos por cálculo analítico Bending stiffness evaluation of cardboard: comparison between experimental and analytically results

    Directory of Open Access Journals (Sweden)

    Paulo G. Magalhães

    2006-04-01

    Full Text Available Embalagens de papelão ondulado para produtos hortícolas têm como função principal a proteção do produto. O dimensionamento de uma embalagem de papelão requer o conhecimento da rigidez à flexão, que depende dos módulos de elasticidade dos elementos que o constituem. Este trabalho teve por objetivo calcular, a partir da caracterização física do papelão em laboratório, o módulo de elasticidade por diferentes métodos, comparando os resultados com os valores obtidos experimentalmente. Dez corpos de prova de cada um dos papéis selecionados para este estudo foram testados na direção de fabricação e na direção transversal. A resistência à tração dos papéis, capa e miolo, utilizada para calcular a rigidez, foi determinada em máquina universal de ensaios. Para a obtenção da rigidez à flexão, foi realizado o teste de quatro pontos. Foi observada expressiva variação entre os métodos pelos quais se obtêm os módulos de elasticidade que reflete nos valores de rigidez da estrutura. Os valores de rigidez obtidos experimentalmente foram sempre superiores aos valores obtidos por cálculos analíticos. Essa diferença pode ser atribuída a dois fatores conjugados: o processo de fabricação que confere maior rigidez do que os componentes isoladamente, e o outro componente é a adição de camada adesiva que não é levada em consideração nos cálculos analíticos.Cardboard packing for horticultural products has as main function to protect them. The design of a cardboard packing request the knowledge of the bending stiffens which is depending on the modulus of elasticity. The objective of this work was to calculate the cardboard modulus of elasticity from data obtained in laboratory using physical characterization test, with different methods, and comparing the results with the values obtained experimentally. Ten samples of each cardboard selected for this study were tested in the paper fabrication direction and in its

  17. Complications of collagenous colitis.

    Science.gov (United States)

    Freeman, Hugh-James

    2008-03-21

    Microscopic forms of colitis have been described, including collagenous colitis. This disorder generally has an apparently benign clinical course. However, a number of gastric and intestinal complications, possibly coincidental, may develop with collagenous colitis. Distinctive inflammatory disorders of the gastric mucosa have been described, including lymphocytic gastritis and collagenous gastritis. Celiac disease and collagenous sprue (or collagenous enteritis) may occur. Colonic ulceration has been associated with use of nonsteroidal anti-inflammatory drugs, while other forms of inflammatory bowel disease, including ulcerative colitis and Crohn's disease, may evolve from collagenous colitis. Submucosal "dissection", colonic fractures or mucosal tears and perforation from air insufflation during colonoscopy may occur and has been hypothesized to be due to compromise of the colonic wall from submucosal collagen deposition. Similar changes may result from increased intraluminal pressure during barium enema contrast studies. Finally, malignant disorders have also been reported, including carcinoma and lymphoproliferative disease. PMID:18350593

  18. Complications of collagenous colitis

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2008-01-01

    Microscopic forms of colitis have been described, including collagenous colitis. This disorder generally has an apparently benign clinical course. However, a number of gastric and intestinal complications, possibly coincidental, may develop with collagenous colitis. Distinctive inflammatory disorders of the gastric mucosa have been described, including lymphocytic gastritis and collagenous gastritis. Celiac disease and collagenous sprue (or collagenous enteritis) may occur. Colonic ulceration has been associated with use of nonsteroidal anti-inflammatory drugs, while other forms of inflammatory bowel disease, including ulcerative colitis and Crohn's disease, may evolve from collagenous colitis. Submucosal "dissection", colonic fractures or mucosal tears and perforation from air insufflation during colonoscopy may occur and has been hypothesized to be due to compromise of the colonic wall from submucosal collagen deposition. Similar changes may result from increased intraluminal pressure during barium enema contrast studies. Finally, malignant disorders have also been reported, including carcinoma and lymphoproliferative disease.

  19. The Artificial Anal Sphincter

    OpenAIRE

    Christiansen, John

    2000-01-01

    The artificial anal sphincter as treatment for end stage anal incontinence was first described in 1987. Published series concern a total of 42 patients, with a success rate of approximately 80%. Infection has been the most serious complication, but a number of technical complications related to the device have also occurred and required revisional procedures in 40% to 60% of the patients. The artificial anal sphincter may be used for the same indications as dynamic graciloplasty except in pat...

  20. Surgery for Crohn's Disease and Ulcerative Colitis

    Science.gov (United States)

    ... Crohn's Disease & Ulcerative Colitis Go Back Surgery for Crohn's Disease & Ulcerative Colitis Email Print + Share ( Disclaimer: Surgery information ... helps you to learn what to expect. About Crohn’s disease and ulcerative colitis Crohn’s disease and ulcerative colitis ...

  1. Anal condyloma acuminatum.

    Science.gov (United States)

    McCutcheon, Tonna

    2009-01-01

    Anal condyloma acuminatum is a human papillomavirus (HPV) that affects the mucosa and skin of the anorectum and genitalia. Anal condyloma acuminatum is the most commonly diagnosed sexually transmitted disease in the United States. To date, there are more than 100 HPV types, with HPV-6, HPV-10, and HPV-11 predominately found in the anogenital region and causing approximately 90% of genital warts. Risk factors for anal condyloma acuminatum include multiple sex partners, early coital age, anal intercourse, and immunosuppression. Transmission occurs by way of skin-to-skin contact through sexual intercourse, oral sex, anal sex, or other contact involving the genital area. The virus may remain latent for months to years until specific mechanisms cause production of viral DNA, leading to the presentation of anal condyloma acuminatum.Patients with anal condyloma acuminatum may be asymptomatic or present with presence of painless bumps, itching, and discharge or bleeding. It is not uncommon to have involvement of more than one area, and multiple lesions may also be present and extend into the anal canal or rectum. To date, there is no serologic testing or culture to detect anal condyloma acuminatum; therefore, diagnosis is made clinically or by detection of HPV DNA. Multiple factors determine the choice of treatment, which may range from patient-applied medications to surgical intervention. Despite treatment choice, recurrence rates are high, indicating the importance of patient education on prevention of HPV infection and reinfection. Unfortunately, at this time, no cure exists for anal condyloma acuminatum; however, recently Gardasil and Cervarix (in Australia only) vaccines have become available and are showing promising results. PMID:19820442

  2. Omega 3 fatty acids supplementation has an ameliorative effect in experimental ulcerative colitis despite increased colonic neutrophil infiltration Los suplementos de ácidos grasos omega 3 tienen efectos beneficiosos en colitis ulcerosa a pesar del aumento de la infiltracción por neutrófilos del colon

    Directory of Open Access Journals (Sweden)

    Ioannis Varnalidis

    2011-10-01

    Full Text Available Purpose: omega 3 polyunsaturated fatty acids have anti-inflammatory properties and can be beneficial in the treatment of inflammatory diseases, such as ulcerative colitis. Dextran sodium sulphate (DSS colitis in rats appears to mimic nearly all of the morphological characteristics and lesion distributions of ulcerative colitis. The purpose of the current study was to investigate the efficacy of omega 3 fatty acids in the treatment of experimental ulcerative colitis. Methods: thirty-six Wistar rats were randomly assigned to group A or group B receiving 5% dextran sulfate sodium (DSS in their drinking water for eight days. For the next eight days post-DSS, group A animals received tap-water, and group B animals were fed a nutritional solution containing high levels of omega 3 polyunsaturated fatty acids (ProSure®, Abbott Laboratories, Zwolle, Netherlands once per day, administrated with a orogastric feeding tube. Results: animals fed an omega 3 rich diet exhibited a statistically significant increase in hematocrit and hemoglobin levels, compared to animals drinking tap water, and a trend towards histopathological and clinical improvement, with the administration of omega 3 fatty acids ameliorating epithelial erosion by day 8 post-DSS, but no statistically significant difference was observed between group A and group B animals at 4 or 8 days post-DSS. Also, a statistically significant increase in neutrophil infiltration was observed, as depicted by myelohyperoxidase activity. Conclusion: our findings support a positive role of omega 3 polyunsaturated fatty acids supplementation in an experimental model of ulcerative colitis despite the increased colonic neutrophil infiltration. Further studies are needed in order to investigate the role of increased neutrophils in colonic mucosa.

  3. Genetics Home Reference: ulcerative colitis

    Science.gov (United States)

    ... my area? Other Names for This Condition colitis gravis idiopathic proctocolitis inflammatory bowel disease, ulcerative colitis type ... for professional medical care or advice. Users with questions about a personal health condition should consult with ...

  4. Non-IBD and noninfectious colitis

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Vainer, Ben; Rask-Madsen, Jørgen

    2008-01-01

    A wide range of etiologies and pathogenic mechanisms underlie colitis. This Review provides an overview of the pathophysiology, epidemiology, histopathology, and clinical characteristics of noninfectious and non-IBD forms of colitis: microscopic colitis, Behçet's syndrome, diversion colitis......, diverticular colitis, eosinophilic colitis, ischemic colitis, and radiation colitis. These more recently characterized and rare forms of colitis occur as either primary conditions or complications of other diseases. Most of these diseases are uncommon; therefore, epidemiologic data and data from controlled...... trials are not readily available. Practical guidelines for the diagnosis and therapy of these more recently characterized and rarer forms of colitis are given where possible....

  5. Non-IBD and noninfectious colitis

    DEFF Research Database (Denmark)

    Nielsen, O.H.; Vainer, B.; Rask-Madsen, J.

    2008-01-01

    A wide range of etiologies and pathogenic mechanisms underlie colitis. This Review provides and overview of the pathophysiology, epidemiology, histopathology, and clinical characteristics of noninfectious and non-IBD forms of colitis: microscopic colitis, Behcet's syndrome, diversion colitis......, diverticular colitis, eosinophilic colitis, ischemic colitis, and radiation colitis. These more recently characterized and rare forms of colitis occur as either primary conditions or complications of other diseases. Most of these diseases are uncommon; therefore, epidemiologic data and data from controlled...... trials are not readily available. Practical guidelines for the diagnosis and therapy of these more recently characterized and rarer forms of colitis are given where possible Udgivelsesdato: 2008/1...

  6. HIV-associated anal cancer

    OpenAIRE

    Newsom-Davis, Thomas; Bower, Mark

    2010-01-01

    HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50. Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiqui...

  7. Anal cancer; Cancer du canal anal

    Energy Technology Data Exchange (ETDEWEB)

    Fesneau, M.; Champeaux-Orange, E. [Service de radiotherapie, Centre regional universitaire de cancerologie Henry-S.-Kaplan CHU de Tours, Hopital Bretonneau, 37 - Tours (France); Champeaux-Orange, E. [Service d' oncologie-radiotherapie, Centre hospitalier regional d' Orleans, 45 - Orleans (France); Hennequin, C. [Service de cancerologie-radiotherapie, hopital Saint-Louis, 75 - Paris (France)

    2010-07-01

    Anal canal epidermoid carcinomas represent 1.2% of digestive cancers and 6% of ano-rectal cancers. For localized diseases, the treatment is based on radiotherapy with or without chemotherapy (5-FU and cisplatin or mitomycin), according to tumour and nodal extension. The recommended treatment dose is 45 Gy in the anal canal, the mesorectum, para-rectal lymph nodes, and inguinal lymph nodes. An additional dose of 15 to 20 Gy is delivered in the initial tumour for good responders. Salvage surgery is necessary in case of poor response. The organs at risk to be considered are bladder, femur heads, small intestine and vulva. The objective of this work is to summarize the epidemiological and radio-anatomic and prognostic characteristics of this tumour. The conformal radiotherapy technique is illustrated by a case report. (authors)

  8. Eosinophilic colitis in infants

    Directory of Open Access Journals (Sweden)

    Adriana Chebar Lozinsky

    2014-01-01

    Full Text Available OBJECTIVE: To review the literature for clinical data on infants with allergic or eosinophilic colitis. DATA SOURCE: MEDLINE search of all indexes was performed using the words ''colitis or procto-colitis and eosinophilic'' or ''colitis or proctocolitis and allergic'' between 1966 and February of 2013. All articles that described patients' characteristics were selected. DATA SYNTHESIS: A total of 770 articles were identified, of which 32 met the inclusion criteria. The 32 articles included a total of 314 infants. According to the available information, 61.6% of infants were male and 78.6% were younger than 6 months. Of the 314 patients, 49.0% were fed exclusively breast milk, 44.2% received cow's milk protein, and 6.8% received soy protein. Diarrheal stools were described in 28.3% of patients. Eosinophilia was found in 43.8% (115/263 of infants. Colonic or rectal biopsy showed infiltration by eosinophils (between 5 and 25 perhigh-power field in 89.3% (236/264 of patients. Most patients showed improvement with theremoval of the protein in cow's milk from their diet or the mother's diet. Allergy challenge tests with cow's milk protein were cited by 12 of the 32 articles (66 patients. CONCLUSIONS: Eosinophilic colitis occurs predominantly in the first six months of life and in males. Allergy to cow's milk was considered the main cause of eosinophilic colitis. Exclusion of cow'smilk from the diet of the lactating mother or from the infant's diet is generally an effective therapeutic measure.

  9. Desenvolvimento e validação de método analítico para quantificação de diclofenaco de dietilamônio em pele humana por cromatografia líquida de alta eficiência

    OpenAIRE

    JOSé ALEXSANDRO SILVA; Bedor, Danilo C. G.; Sousa, Carlos E.M.; DAVI P. SANTANA; Egito, Eryvaldo S. T.

    2010-01-01

    Foi desenvolvido e validado neste estudo um método analítico para quantificação de diclofenaco de dietilamônio em pele humana por cromatografia líquida de alta eficiência, segundo a Resolução 899/2003 da Agência Nacional de Vigilância Sanitária (ANVISA). Empregou-se cromatografia em fase reversa com coluna C18 150 x 4,6 mm, 5 µm Shimpack®, à temperatura de 40 ºC e fase móvel, constituída por mistura de acetonitrila e tampão fosfato de sódio 20 mM pH 3,0 (70:30, v/v) com fluxo de 1,2 mL min-1....

  10. Common carotid arterial thrombosis associated with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Hitoshi Nogami; Tsuneo Iiai; Satoshi Maruyama; Tatsuo Tani; Katsuyoshi Hatakeyama

    2007-01-01

    A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient's bowel disease.

  11. Megacólon tóxico fatal por cytomegalovirus em paciente com retocolite ulcerativa idiopática: relato de caso e revisão de literatura Fatal toxic megacolon due to cytomegalovirosis in a patient with ulcerative colitis: case report and review

    Directory of Open Access Journals (Sweden)

    Sérgio Ossamu IOSHII

    2002-04-01

    Full Text Available Racional - O megacólon tóxico é complicação grave e pouco freqüente na retocolite ulcerativa idiopática. Ocorre, geralmente, em pacientes cuja doença ativa é resistente ao tratamento clínico e, em algumas situações, o fator desencadeante é desconhecido. A infecção pelo cytomelogalovirus em seres humanos em geral é evento subclínico; entretanto, em pacientes imunocomprometidos a primoinfecção ou mesmo a reativação de infecção latente pode ter amplas repercussões clínicas, uma das quais o desencadeamento de megacólon tóxico. Objetivo - Descrever um caso de megacólon tóxico fatal por cytomegalovirose em paciente com retocolite ulcerativa idiopática. Paciente - Masculino, 38 anos, com clínica de diarréia e perda ponderal cuja investigação mostrou tratar-se de retocolite ulcerativa idiopática e para a qual foi instituída terapêutica imunossupressora vigorosa. Resultados - Evoluiu com quadro clínico de megacólon tóxico, sendo submetido a colectomia total. Complicações clínicas culminaram no óbito pós-operatório e o estudo anatomopatológico do cólon revelou doença ativa, associada a ulcerações confluentes na base das quais foram observadas células com alterações características da cytomegalovirose. Conclusão - A cytomegalovirose deve ser considerada como um dos agentes causadores de megacólon tóxico em retocolite ulcerativa.Background - The toxic megacolon is a rare and severe complication of ulcerative colitis. In general it complicates patients with active colitis that are resistant to clinical treatment and, in some cases, the developing factor is unknown. Cytomegalovirus infection in humans in general is a subclinical condition. However, in patients with immunodeficiency the primary infection or the reactivation of latent infection could have enormous clinical effects. One of these effects is the toxic megacolon. Aim - To report a case of fatal toxic megacólon due to cytomegalovirosis in a

  12. Obstetric anal sphincter injuries

    Institute of Scientific and Technical Information of China (English)

    Remon Keriakos; Deepa Gopinath

    2015-01-01

    Obstetric anal sphincter injuries can be associated with significant short and long term consequences causing devastating impacts on the quality of lives of young, otherwise healthy women. The major consequence is anal incontinence which may be short or long term and vary in severity. The other consequences include pain, infection, dyspareunia and sexual dysfunction. This may in turn result in considerable economic burden to health care providers and patients. It also has an implication on future deliveries. Although it can never be eliminated, it can be reduced by improving practice, training and provision of high quality multidisciplinary care in order to reduce long-term morbidity. Obstetric anal sphincter injuries are also a source of litigation which can be distressing to both patients and clinicians. The aim of this review article is to explore the available evidence on epidemiology, strategies for preventions, prognosis and also how to deal with governance issues.

  13. [Anal intraepithelial neoplasia].

    Science.gov (United States)

    de Parades, Vincent; Fathallah, Nadia; Barret, Maximilien; Zeitoun, Jean-David; Lemarchand, Nicolas; Molinié, Vincent; Weiss, Laurence

    2013-01-01

    Anal intraepithelial lesions are caused by chronic infection with oncogenic types of human papillomavirus. Their incidence and prevalence are increasing, especially among patients with HIV infection. Their natural history is not well known, but high-grade intraepithelial lesions seem to have an important risk to progress to squamous cell carcinoma. Their treatment can be achieved by many ways (surgery, coagulation, imiquimod, etc.) but there is a high rate of recurrent lesions. Pretherapeutic evaluation should benefit from high-resolution anoscopy. Periodic physical examination and anal cytology may probably be interesting for screening the disease among patients with risk factors. Vaccine against oncogenic types of papillomavirus may prevent the development of anal intraepithelial neoplasia. PMID:23122632

  14. Crohn's Disease and Ulcerative Colitis: Emotional Factors

    Science.gov (United States)

    ... Ulcerative Colitis: Emotional Factors Q & A Go Back Crohn’s Disease and Ulcerative Colitis: Emotional Factors Q & A Email ... WHAT IS THE CAUSE OF ULCERATIVE COLITIS AND CROHN’S DISEASE? The origin of IBD is still unknown. It ...

  15. Straight ileo-anal anastomosis with myectomy as an alternative to ileal pouch-anal anastomosis in restorative proctocolectomy.

    Science.gov (United States)

    Landi, E; Landa, L; Fianchini, A; Marmorale, C; Piloni, V

    1994-04-01

    Restorative proctocolectomy with various types of reservoir is widely used in the elective surgery of ulcerative colitis and familial adenomatous polyposis. Both, advantages and disadvantages of this procedure are well known and documented. Straight ileo-anal anastomosis (IAA) yields unsatisfactory clinical results due to the lack of storage capacity of the distal ileum and the frequency of bowel movements related to high pressure ileal waves. In an attempt to create an alternative to the above procedures, we have performed a straight ileo-anal anastomosis with two rectangular (10 cm x 1 cm) myectomies down to 2 cm, above the anastomotic line. The two myectomies are spaced at 120 degrees to each other and to the mesenteric border of the ileal loop. The rationale of this approach is to reduce the peristaltic drive of the ileum by weakening the muscular wall. This study presents the results in three patients operated on with this new method in the last year.

  16. Clostridium difficile Colitis

    OpenAIRE

    Trudel, Judith L.

    2007-01-01

    Clostridium difficile enterocolitis is endemic in most modern hospitals. The spectrum of clinical presentation varies from the asymptomatic carrier state to fulminant colitis with toxic megacolon and perforation. Highly toxigenic and lethal strains of C. difficile have emerged worldwide. Medical treatment consists of discontinuing the precipitating antibiotic, supportive measures and bowel rest, and antibiotic treatment with metronidazole or vancomycin. Surgical treatment may be necessary in ...

  17. A case of interstitial pneumonitis in a patient with ulcerative colitis treated with azathioprine

    Institute of Scientific and Technical Information of China (English)

    Ferenc Nagy; Tamas Molnar; Eva Makula; Ildiko Kiss; Peter Milassin; Eva Zollei; Laszlo Tiszlavicz; Janos Lonovics

    2007-01-01

    The early hypersensitivity reaction and late bone marrow depression are well-known side-effects of azathioprine,whereas interstitial pneumonia is a rare complication.A 40-year old male patient had been treated with azathioprine in consequence of extensive ulcerative colitis for 10 years. He then complained of 7 d of fever,cough and catarrhal signs, without symptoms of active colitis. Opportunistic infections were ruled out. The chest X-ray, CT and lung biopsy demonstrated the presence of interstitial inflammation. Azathioprine therapy was discontinued as a potential source of the pulmonary infiltrate. In response to steroid therapy, and intensive care, the pulmonary infiltrate gradually decreased within 4 wk. Three months later, his ulcerative colitis relapsed,and ileo-anal pouch surgery was performed. In cases of atypical pneumonia, without a proven infection,azathioprine-associated interstitial pneumonitis may be present, which heals after withdrawal of the drug.

  18. Desenvolvimento e validação de um método analítico por espectrofotometria no UV para determinação quantitativa do anti-neoplásico β-lapachona

    OpenAIRE

    Presmich, Geisiane M.A.; Larissa A. Rolim; Cavalcanti, Otávio R.B.R.; Silva, Keyla E.R. da; Rolim Neto, Pedró José

    2010-01-01

    A β-lapachona é uma ortonaftoquinona natural extraída de plantas da família Bignoniaceae, como o Ipê Roxo (Tabebuia avellanedae Lor), árvore nativa do Brasil, ou sintetizada a partir de seu isômero lapachol. A β-lapachona têm demonstrado uma série de ações farmacológicas incluindo antibacteriana, antifúngica, tripanossomicida, antiviral e antineoplásica. Não há relatos na literatura de um método analítico espectrofotométrico para a quantificação de β-lapachona. Assi...

  19. Tofacitinib in ulcerative colitis.

    Science.gov (United States)

    Archer, Thomas P; Moran, Gordon W; Ghosh, Subrata

    2016-05-01

    Cytokines orchestrate immune and inflammatory responses involved in the pathogenesis of ulcerative colitis (UC). Protein kinases are essential for signal transduction in eukaryotic cells. Janus kinases (JAKs) are a family of protein tyrosine kinases that play a pivotal role in cytokine receptor signaling. Indeed, a major subgroup of cytokines use Type I and II cytokine receptors which signal via the activation of JAKs. Tofacitinib is an oral JAK inhibitor that has been studied in autoimmune pathologies, including UC and rheumatoid arthritis with good overall efficacy and acceptable safety profile. This literature review was performed with the goal of summarizing the knowledge on JAK inhibitors in UC treatment. PMID:27140405

  20. Anal anatomy and normal histology.

    Science.gov (United States)

    Pandey, Priti

    2012-12-01

    The focus of this article is the anatomy and histology of the anal canal, and its clinical relevance to anal cancers. The article also highlights the recent histological and anatomical changes to the traditional terminology of the anal canal. The terminology has been adopted by the American Joint Committee on Cancer, separating the anal region into the anal canal, the perianal region and the skin. This paper describes the gross anatomy of the anal canal, along with its associated blood supply, venous and lymphatic drainage, and nerve supply. The new terminology referred to in this article may assist clinicians and health care providers to identify lesions more precisely through naked eye observation and without the need for instrumentation. Knowledge of the regional anatomy of the anus will also assist in management decisions.

  1. Anal incontinence in women with recurrent obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

    2015-01-01

    UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...

  2. Serial Fecal Calprotectin and Lactoferrin Measurements for Early Diagnosis of Pouchitis After Proctocolectomy for Ulcerative Colitis: Is Pouchoscopy No Longer Needed?

    Science.gov (United States)

    Schoepfer, Alain; Reinisch, Walter

    2015-06-01

    This editorial discusses the role of serial measurements of fecal calprotectin or fecal lactoferrin for the early detection of pouchitis in patients with ulcerative colitis having undergone procto-colectomy with ileo-pouch-anal anastomosis. Furthermore, the role of fecal calprotectin and fecal lactoferrin for the monitoring of pouchitis is highlighted. PMID:26052770

  3. Apontamentos sobre a psicologia analítica de Carl Gustav Jung

    OpenAIRE

    Luís Marcelo Alves Ramos

    2002-01-01

    O texto faz uma introdução à Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung: define o conceito de Psicologia Analítica, traz uma biografia resumida de Carl Gustav Jung, indica as principais diferenças entre a Psicologia Analítica e a Psicanálise, descreve a estrutura e o funcionamento da psique e, por fim, apresenta sinteticamente as características dos tipos de personalidades traçadas por Jung. The text makes an introduction to the Analytical Psychology of the psycholo...

  4. Hypertrophied anal papillae and fibrous anal polyps, should they be removed during anal fissure surgery?

    Institute of Scientific and Technical Information of China (English)

    Pravin J. Gupta

    2004-01-01

    AIM: Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice.They are mostly ignored being considered as normal structures. The present study was aimed to demonstrate that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic fissure in anus.METHODS: Two groups of patients were studied. A hundred patients were studied in group A in which the associated fibrous polyp or papillae were removed by radio frequency surgical device after a lateral subcutaneous sphincterotomy for relieving the sphincter spasm. Another group of a hundred patients who also had papillae or fibrous polyps, were treated by lateral sphincterotomy alone. They were followed up for one year.RESULTS: Eighty-nine percent patients from group A expressed their satisfaction with the treatment in comparison to only 64% from group B who underwent sphincterotomy alone with the papillae or anal polyps left untreated. Group A patients showed a marked reduction with regard to pain and irritation during defecation (P= 0.0011),pricking or foreign body sensation in the anus (P = 0.0006)and pruritus or wetness around the anal verge (P = 0.0008).CONCLUSION: Hypertrophied anal papillae and fibrous anal polyps should be removed during treatment of chronic anal fissure. This would add to effectiveness and completeness of the procedure.

  5. Management of pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Turner, Dan; Levine, Arie; Escher, Johanna C;

    2012-01-01

    Pediatric ulcerative colitis (UC) shares many features with adult-onset disease but there are some unique considerations; therefore, therapeutic approaches have to be adapted to these particular needs. We aimed to formulate guidelines for managing UC in children based on a systematic review (SR......) of the literature and a robust consensus process. The present article is a product of a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)....

  6. Validación del método analítico para la determinación de valsartán en plasma humano por HPLC/UV con adición de estándar empleando losartán como estándar interno

    Directory of Open Access Journals (Sweden)

    Milena Pérez

    2007-03-01

    Full Text Available Introducción: El concepto de validación se refiere a la evaluación estadística de los resultados obtenidos en la aplicación de técnicas analíticas, mediante pruebas convenientemente documentadas y demostrativas de que un método es lo suficientemente fiable a fin de producir el resultado previsto bajo condiciones definidas, como son: sistema analítico, intervalo de concentración, infraestructura y talento humano. Objetivo: Describir el proceso de validación del método analítico para la cuantificación de valsartán en plasma humano por HPLC-UV y su aplicación en estudios farmacocinéticos, de biodisponibilidad y bioequivalencia de medicamentos que contengan valsartán como principio activo.Metodología: Se desarrolló un método para la detección y cuantificación de valsartán en plasma humano, con elución isocrática por cromatografía líquida de fase reversa, con detección ultravioleta a 265 nm, mediante el método de adición de estándar. Se utilizó losartán como estándar interno. El método implica una extracción en fase sólida de los principios activos ( valsartán y losartán con cartuchos C8. La separación se realizó en una columna C18 en fase reversa y la fase móvil fue una mezcla de acetonitrilo: buffer fosfato (45:55 v/v ajustado a pH 2.7±0.1 con ácido fosfórico concentrado. El método se validó en el rango de concentraciones de 0.05 a 20 µg/ml con adición de estándar de valsartán de 2.5 µg/ml. Resultados y conclusiones: La curva de calibración fue lineal en el rango de concentraciones establecido. Se evaluó la reproducibilidad, estabilidad y porcentaje de recuperación del método. El método para determinar el valsartán en plasma humano por HPLC/UV fue preciso y exacto con un límite de cuantificación de 1.485 µg/ml. Este método fue suficientemente sensible para su aplicación en estudios farmacocinéticos de valsartán.

  7. [Surgery of anal fistulas].

    Science.gov (United States)

    Ricchi, E; Carriero, A; Spallanzani, A; Fundarò, S; Heydari, A; Piccoli, M; Gelmini, R

    1997-06-01

    The authors report a study on 120 patients with anal fistula (111 males and 9 females). The average age was 44.3 years (median 44, SD +/- 14.807). 64.1% of patients had an intersphincteric fistula, 23.3% hanal transphincteric fistula, 1.6% a suprasphincteric fistula, 7.5% a horseshoe fistula and the 3.3% an extrasphincteric fistula. We treated 14 patients (11.66%) with direct surgical treatment. The other 106 had various types of treatment depending on the localisation and the involvement of the anorectal sphincter. We had 11 cases (9.1%) of complications, such as recurrence in 5 patients (4.1%) transitory incontinence in 2 cases (1.6%) and finally postoperative bleeding in 3 patients (2.5%). PMID:9324655

  8. Activos y estructuras de oportunidades de movilidad: Una propuesta analítica para el estudio de la accesibilidad por transporte público, el bienestar y la equidad

    Directory of Open Access Journals (Sweden)

    Diego Hernández

    2012-09-01

    Full Text Available Uno de los desafíos actuales para los estudios sobre movilidad y transporte en América Latina es adoptar un enfoque multidimensional de la movilidad que trascienda la noción más estrecha de desplazamiento o viaje y que, a la vez, permita integrar este tema a la discusión más general acerca del efecto de la movilidad sobre la pobreza y la exclusión social. Este artículo aborda el desafío y propone un marco analítico que recoja la -aún incipiente en nuestra región- experiencia teórico-empírica sobre estos fenómenos. Luego de revisar la literatura y argumentar a favor de la adopción de diversos postulados, se propone el enfoque de activos y estructuras de oportunidades para el estudio de la accesibilidad. Esta es concebida como el grado de ajuste entre las estructuras de oportunidades de movilidad, y los recursos y activos con que cuentan los hogares para aprovecharlas. El esquema propuesto permite maximizar la comprensión del efecto de la movilidad sobre el bienestar y el rol del transporte público.One of the major current challenges for mobility and transport studies in Latin America is the adoption of a multidimensional approach that goes beyond the narrower notion of trip and that does not neglect a broader discussion about mobility's effect on po verty and social exclusion. This article seeks to tackle this challenge and posits an analyticalframework that takes into account the theoretical and empirical regional background on these phenomena. After reviewing existing literature and affiliating to some necessary assumptions, it proposes the assets and opportunities structures approach as a useful device to study accessibility. This concept is defined as the level of adjustment between the structures of opportunity for mobility and household's resource and assets to take advantagefrom them. I argue that thisframework is adequate in order to maximize understanding of mobility's effect on welfare and the role of public transport.

  9. Atypical disease phenotypes in pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Levine, Arie; de Bie, Charlotte I; Turner, Dan;

    2013-01-01

    Definitive diagnosis of pediatric ulcerative colitis (UC) may be particularly challenging since isolated colitis with overlapping features is common in pediatric Crohn's disease (CD), while atypical phenotypes of UC are not uncommon. The Paris classification allows more accurate phenotyping...

  10. Intracolonic Vancomycin for Severe Clostridium difficile Colitis

    OpenAIRE

    Kim, Peter K.; Huh, Heesun C.; Cohen, Hillel W.; Feinberg, Elyssa J.; Ahmad, Salman; Coyle, Christina; Teperman, Sheldon; Boothe, Hugh

    2013-01-01

    Background: Clostridium difficile colitis is associated with increased age, antibiotic usage, and hospitalization. Severe C. difficile colitis refractory to medical therapy may require surgical intervention including subtotal colectomy. We initiated an adjuvant intracolonic vancomycin (ICV) enema protocol for inpatients with severe C. difficile colitis and compared the response to this therapy in patients from the community and nursing homes.

  11. CT evaluation of infectious colitis

    International Nuclear Information System (INIS)

    Computed tomography (CT) is useful for evaluating the diagnosis of gastrointestinal disease, such as infectious colitis, in patients with severe pain and bloody diarrhea. During the 7 years between November 1993 and October 2000, 34 patients with infectious colitis (18 male, 16 female; mean age 42±19 yrs), received emergency CT and colonoscopy because of severe abdominal pain and dysentery. The following organisms were isolated: pathogenic Escherichia coli (12), 6 of which were O157: H7 (O-157), Salmonella species (11), Campylobacter species (5), Vibrio parahaemolyticus (3), Yersinia enterocolotica (2) and Shigella species (1). Thickening of the intestinal wall greater than 10 mm was seen in the ascending colon in the 6 cases with E. coli O157, in 5/11 cases with Salmonella, 4/5 with Campylobacter and 1/6 with non-O157 pathogenic E. Coli. marked intestinal wall thickening, greater than 20 mm, was seen in the ascending colon of the 4 of the patients with an O-157 infection. In all patients with O-157 colitis, slight ascites was noted in the pelvic space. In additions, ascites was also seen in 3/13 patients with Salmonella and 1/5 patients with Campylobacter colitis. The CT findings, in the patients with infectious colitis, are non-specific but knowledge and recognition of the findings will help in patient evaluation and proper treatment. (author)

  12. Comparative study of anal acoustic reflectometry and anal manometry in the assessment of faecal incontinence

    DEFF Research Database (Denmark)

    Hornung, B R; Mitchell, P J; Carlson, G L;

    2012-01-01

    Anal acoustic reflectometry (AAR) is a reproducible technique providing a novel physiological assessment of anal sphincter function. It may have advantages over conventional anal manometry. The aims of this study were to determine the ability of AAR and anal manometry to identify changes in anal...

  13. Electrocautery for Precancerous Anal Lesions

    Science.gov (United States)

    Results from a randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at treating potentially precancerous anal lesions in HIV-positive men who have sex with men.

  14. Brachyspira murdochii colitis in pigs

    DEFF Research Database (Denmark)

    Jensen, Tim Kåre; Christensen, A. S.; Boye, Mette

    2010-01-01

    The weakly beta-hemolytic porcine spirochete Brachyspira murdochii is considered a normal intestinal commensal. In the present study, however, a field case of B murdochii–associated catarrhal colitis was identified in a pig, as characterized by extensive spirochetal colonization of the surface...... epithelium. Experimentally, 8 weaned pigs were challenged with the B murdochii isolate, reproducing catarrhal colitis in 2 animals. By applying fluorescent in situ hybridization using a species-specific oligonucleotide probe targeting 23S rRNA, B murdochii organisms were found in high numbers and were...... closely associated with the surface epithelium in the pigs with catarrhal colitis. The results indicate that, when present in high numbers, B murdochii is low pathogenic for pigs....

  15. Modern management of anal fistula.

    Science.gov (United States)

    Limura, Elsa; Giordano, Pasquale

    2015-01-01

    Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract, whilst preserving the sphincters and the mechanism of continence. For the simple and most distal fistulae, conventional surgical options such as laying open of the fistula tract seem to be relatively safe and therefore, well accepted in clinical practise. However, for the more complex fistulae where a significant proportion of the anal sphincter is involved, great concern remains about damaging the sphincter and subsequent poor functional outcome, which is quite inevitable following conventional surgical treatment. For this reason, over the last two decades, many sphincter-preserving procedures for the treatment of anal fistula have been introduced with the common goal of minimising the injury to the anal sphincters and preserving optimal function. Among them, the ligation of intersphincteric fistula tract procedure appears to be safe and effective and may be routinely considered for complex anal fistula. Another technique, the anal fistula plug, derived from porcine small intestinal submucosa, is safe but modestly effective in long-term follow-up, with success rates varying from 24%-88%. The failure rate may be due to its extrusion from the fistula tract. To obviate that, a new designed plug (GORE BioA®) was introduced, but long term data regarding its efficacy are scant. Fibrin glue showed poor and variable healing rate (14%-74%). FiLaC and video-assisted anal fistula treatment procedures, respectively using laser and electrode energy, are expensive and yet to be thoroughly assessed in clinical practise. Recently, a therapy using autologous adipose-derived stem cells has been described. Their properties of regenerating tissues and suppressing inflammatory response must be better investigated on anal fistulae, and studies remain in progress. The aim of this present article is to review the pertinent literature, describing the advantages and limitations of

  16. Inter-Rater Agreement of Anal Cytology

    OpenAIRE

    Darragh, Teresa M.; Tokugawa, Diane; Castle, Philip E.; Follansbee, Stephen; Borgonovo, Sylvia; LaMere, Brandon J.; Schwartz, Lauren; Gage, Julia C.; Fetterman, Barbara; Lorey, Thomas; Wentzensen, Nicolas

    2012-01-01

    Most anal cancers are caused by persistent infections with carcinogenic human papillomaviruses (HPV). Similar to cervical carcinogenesis, the progression from HPV infection to anal cancer goes through precancerous lesions that can be treated to prevent invasion. In analogy to cervical cytology, anal cytology has been proposed as a screening tool for anal cancer precursors in high-risk populations. We analyzed the inter-observer reproducibility of anal cytology in a population of 363 HIV-infec...

  17. Development and validation of the analytical method by high performance liquid chromatography (HPLC for Lamotrigine raw material = Desenvolvimento e validação do método analítico por cromatografia líquida de alta eficiência (CLAE para a matéria prima Lamotrigina

    Directory of Open Access Journals (Sweden)

    Guilherme Nobre Lima do Nascimento

    2011-07-01

    Full Text Available Currently when all roads lead to the pursuit of total quality in production of drugs, it is essential to fully understand each phase of a production process. In this case, validation is the appropriate tool to ensure reliability of a production process involving new equipment and the analytical methodology, either in the pharmaceutical, food, computer, microelectronics area or any other area where the quality of the manufactured product is one of the main reasons for the existence of a given company. This study aimed to analyze the main aspects of the validation of analytical methods for Lamotrigine, new drug for bipolar disorder with wide use today. In conclusion, the proposed analytical method for determination of the lamotrigine content in raw materials is adequate, effective and capable of reproducing reliable results during analysis. This method is fast (running time of 10 minutes, selective, accurate, precise and robust for the determination of the drug, with no observedinterfering substances in the optimum wavelength. It could be concluded that this may be a routine method for quality control laboratories to certify the quality of Lamotrigine. Atualmente quando todos os caminhos levam à busca da qualidade total na produção de medicamentos, torna-se indispensável conhecer perfeitamente cada fase de um processo produtivo. Neste caso, a validação é a ferramenta adequada para garantir a confiabilidade de instalação de um processo produtivo, de equipamento novo e, inclusive, da metodologia analítica, seja do setor farmacêutico, alimentício, informática microeletrônico ou qualquer outra área onde a qualidade do produto fabricado é uma das principais razões da existência da empresa. O presente trabalho teve por objetivo analisar os principais aspectos da validação de métodos analíticos para Lamotrigina, fármaco novo para transtorno bipolar com amplo usoatualmente. Em conclusão, o método analítico proposto para determina

  18. Treatment of experimental ulcerative colitis.

    Science.gov (United States)

    Lazebnik, L B; Lychkova, A E; Knyazev, O V

    2012-10-01

    The effects of infliximab, an anticytokine drug, on the course of inflammatory process was studied on the model of ulcerative colitis induced by injection of picrylsulfonic acid. Infliximab prevented the development of toxic dilatation and a drop of bioelectric activity of smooth muscles via maintenance of activity of the intramural nervous system neurons. PMID:23113311

  19. Kolorektal cancerudvikling ved colitis ulcerosa

    DEFF Research Database (Denmark)

    Kallesøe, Jane; Langholz, E.; Frisch, Morten;

    2010-01-01

    Ulcerative colitis (UC) is believed to carry a predisposition to colorectal cancer (CRC) development. International clinical guidelines suggest that UC patients should have a colonoscopy performed every year or up to every third year from approximately eight years after diagnosis for early...

  20. Mucosal healing in ulcerative colitis

    DEFF Research Database (Denmark)

    Seidelin, Jakob Benedict; Coskun, Mehmet; Nielsen, Ole Haagen

    2013-01-01

    Ulcerative colitis (UC) is a colonic inflammatory condition with a substantial impact on the quality of life of affected persons. The disease carries a cumulative risk of need of colectomy of 20-30% and an estimated cumulative risk of colorectal cancer of 18% after 30 years of disease duration...

  1. Anorexia nervosa and necrotizing colitis.

    OpenAIRE

    Kaye, J. C.; Madden, M V; Leaper, D J

    1985-01-01

    Anorexia nervosa is associated with a mortality approaching 5% in patients severely enough affected to warrant hospital care (Hsu, 1980). The main causes of death are inanition, electrolyte disturbances or suicide. We report here a case of necrotizing colitis associated with anorexia nervosa, an association which has not been described previously.

  2. Desenvolvimento e validação de método analítico para quantificação de diclofenaco de dietilamônio em pele humana por cromatografia líquida de alta eficiência

    Directory of Open Access Journals (Sweden)

    JOSé ALEXSANDRO SILVA

    2010-06-01

    Full Text Available Foi desenvolvido e validado neste estudo um método analítico para quantificação de diclofenaco de dietilamônio em pele humana por cromatografia líquida de alta eficiência, segundo a Resolução 899/2003 da Agência Nacional de Vigilância Sanitária (ANVISA. Empregou-se cromatografia em fase reversa com coluna C18 150 x 4,6 mm, 5 µm Shimpack®, à temperatura de 40 ºC e fase móvel, constituída por mistura de acetonitrila e tampão fosfato de sódio 20 mM pH 3,0 (70:30, v/v com fluxo de 1,2 mL min-1. Os analitos foram detectados por UV a 280 nm e o método foi especifico, preciso, exato, robusto e linear no intervalo de 0,05 a 20 µg mL-1 (R2 = 0,998, mostrando que pode ser utilizado em estudos de penetração cutânea in vitro tendo como modelo de membrana a pele humana. Palavras-chave: Diclofenaco dietilamônio. Retenção cutânea. Validação. ABSTRACT Development and validation of an analytical method for quantitation of diclofenac diethylamine in human skin by high performance liquid chromatography An analytical method has been developed and validated for the quantitation of diclofenac diethylamine (DDA in human skin by high performance liquid chromatography (HPLC, in accordance with Regulation 899/2003 of the National Sanitary Surveillance Agency (ANVISA. The HPLC column was a reversed-phase Shimpack® C18, with a 5 µm particle bed, measuring 150 x 4.6 mm i.d., eluted isocratically at 40C with 20 mM sodium phosphate buffer (pH 3.0:acetonitrile (30:70, v/v, the mobile phase flowing at 1.2 mL min-1. Analytes were measured by a UV detector set at 280 nm. The results revealed that the method was specific, precise, accurate, robust and linear (R2=0.998 in the range from 0.05 to 20 µg mL-1. Therefore, it can safely be used to assess DDA in vitro penetration of human skin in kinetic studies. Keywords: Diclofenac diethylamine. Human skin retention. Validation.

  3. Effect of calcium polycarbophil on bowel function after restorative proctocolectomy for ulcerative colitis: a randomized controlled trial.

    Science.gov (United States)

    Shibata, Chikashi; Funayama, Yuji; Fukushima, Kouhei; Takahashi, Ken-Ichi; Ogawa, Hitoshi; Haneda, Sho; Watanabe, Kazuhiro; Kudoh, Katsuyoshi; Kohyama, Atsushi; Hayashi, Kei-Ichi; Sasaki, Iwao

    2007-06-01

    The aim of the present study was to determine if calcium polycarbophil ameliorates diarrhea after ileal J-pouch anal anastomosis for ulcerative colitis. Twenty-one randomized patients were given either bifidobacterium (3 g/day) plus calcium polycarbophil (3 g/day), in the polycarbophil group (11 patients), or bifidobacterium (3 g/day), in the control group (10 patients), p.o. for 6 months. Anal manometry was performed and bowel function (stool frequency, stool consistency, and nighttime soiling) was assessed via a questionnaire before and 1, 3, and 6 months after drug administration. Eight patients were deemed eligible in each group; five patients were excluded from the study, including two patients whose stool consistency was too firm and who experienced difficulty in defecating attributed to polycarbophil. Anal manometry and stool consistency did not change with time and did not differ between the polycarbophil and the control groups. Stool frequency decreased with time in both groups and did not differ between the groups. Nighttime soiling improved with time in the polycarbophil group but did not change in the control subjects. These results suggest that polycarbophil might be able to improve nighttime soiling without obviously affecting stool frequency and consistency after ileal J-pouch anal anastomosis for ulcerative colitis.

  4. Influência da administração da Plantago ovata (fibra dietética na proteção da parede colônica em colite inflamatória induzida por ácido acético: estudo estereológico experimental em ratos The influence of Plantago ovata (dietetic fiber admininstration on the colonic wall protection in the acetic acid induced inflammatory colitis: an experimental stereologic study in rats

    Directory of Open Access Journals (Sweden)

    Eduardo Cortez Vassallo

    2007-12-01

    benéfico na proteção do intestino submetido à colite inflamatória induzida por ácido acético a 8%.BACKGROUND: The objective of this paper was to study the role of the dietetic fiber (Plantago ovata in the protection and recovery of the intestinal wall of rats submitted to acetic acid induced inflammatory colitis. METHODS: 30 Wistar male rats were studied, weighing between 260 and 300g, divided in three groups of 10 individuals. The distribution of the groups was made as follows: Group I (n 10, named control group, received a standard diet during the whole experiment. Group II (n 10, named colitis group, received an equally standard diet during the whole experiment and 8% acetic acid that induced inflammatory colitis. Group III (n 10, named colitis + fiber, received a standard diet with addition of dietetic fiber ( 10 g of seeds and peels of Plantago ovata for each 90 g of standard diet and 8% acetic acid that induced inflammatory colitis. The experiment lasted 21 days and the inflammatory colitis induction was introduced on the fourteenth day in groups II and III. Twenty-one days after the start of the experiment the animals were sacrificed and total colectomies were performed. The specimens were submitted to stereologic and histological analysis, and they statistically evaluated by the Mann-Whitney test. The weight variation of the animals was also measured during the experiment. The studied parameters were: mucosa, muscularis mucosa, submucosa, lamina propria, epithelial and proper epithelial layer partial volumes. CONCLUSION: The results, through stereologic, histological and weight analysis, lead us to conclude that the addition of Plantago ovata (dietetic fiber prevents the alterations caused by the 8% acetic acid induced colitis in the experimental animals.

  5. CD3 immunohistochemical staining in diagnosis of lymphocytic colitis

    DEFF Research Database (Denmark)

    Fiehn, Anne-Marie Kanstrup; Engel, Ulla; Holck, Susanne;

    2016-01-01

    Microscopic colitis (MC) is a common cause of chronic watery diarrhea. Traditionally, MC encompasses the 2 subgroups lymphocytic colitis (LC) and collagenous colitis, but recently, an additional subgroup, MC incomplete, has been introduced. Distinguishing between the subgroups relies exclusively...

  6. La Contabilidad Analítica en los Hospitales Públicos

    OpenAIRE

    Ma Silvia Fresneda Fuentes

    1998-01-01

    La confección de presupuestos públicos austeros para la consecución de los criterios de convergencia impuestos por el Tratado de Maastricht ha originado una preocupación en todo el Sector Público en general, y en el hospitalario en particular, por la contención de los costes. Esta situación ha puesto de manifiesto la necesidad de introducir sistemas de Contabilidad para la Gestión interna de las organizaciones hospitalarias públicas. Así, la Contabilidad Analítica o de Costes se constituye co...

  7. Validación del método analítico para la determinación de valsartán en plasma humano por HPLC/UV con adición de estándar empleando losartán como estándar interno

    OpenAIRE

    Milena Pérez; Gloria Ramírez; Mauricio Pérez; Piedad Restrepo

    2007-01-01

    Introducción: El concepto de validación se refiere a la evaluación estadística de los resultados obtenidos en la aplicación de técnicas analíticas, mediante pruebas convenientemente documentadas y demostrativas de que un método es lo suficientemente fiable a fin de producir el resultado previsto bajo condiciones definidas, como son: sistema analítico, intervalo de concentración, infraestructura y talento humano. Objetivo: Describir el proceso de validación del método analítico para la cuantif...

  8. Validación de la metodología analítica para la cuantificación de hierro por espectroscopia de absorción atómica de llama en alimentos de la canasta básica costarricense

    Directory of Open Access Journals (Sweden)

    Paulina Silva Trejos

    2009-01-01

    Full Text Available Se validó la metodología analítica para la determinación de hierro en alimentos de la canasta básica del costarricense por espectroscopia de absorción atómica con llama. La digestión de las muestras se realizó en recipientes cerrados, con horno de microondas con HNO3 al 65% m/m, para muestras de 0,5 g, dependiendo del tipo de alimento; las cantidades óptimas de ácido nítrico variaron de 6 a 10 mL, obteniéndose porcentajes de recuperación que variaron de 90,0±0,5% a 106,0±0,5%. El ámbito de linealidad óptimo que se obtuvo fue de 0,05 m/L a 6,0 mg/L, con un coeficiente de correlación de 0,9991. Los límites de detección y cuantificación reportados fueron de 0,006 mg/L y 0,009 mg/L, respectivamente. La veracidad se determinó utilizando un patrón certificado de la NIST, SRM 1846 Infant Formula, con un valor reportado para hierro de 63,1±4,0 mg/kg, el valor obtenido fue de 63,8 mg/L, con un porcentaje de error de 1,1%.

  9. Clear cell colitis: A form of microscopic colitis in children

    Institute of Scientific and Technical Information of China (English)

    Jan J(o)zefczuk; Bogdan Marian Wozniewicz

    2008-01-01

    AIM: To describe a new clinical and pathological subtype of microscopic colitis in children.METHODS: A selected group of children with abdominal pain, constipation and/or diarrhoea showing discrete or no macroscopic abnormalities on endoscopy was described.RESULTS: Multiple biopsies of colon showed large mononuclear clear cells in lamina propria of mucous membrane provided that good quality histological sections were performed and observed under a higher magnification. Otherwise, they could be misinterpreted as artefacts. Their presence in routine histology might suggest a systemic storage disease (Whipple's disease), and neuronal intestine dysplasia.Using immunohistochemical staining and electron microscopy we confirmed their origin from CD68 positive mononuclear macrophages.CONCLUSION: The presence of large clear cells is a constant microscopic feature. Failure of transient large bowel stationary macrophages plays a role in the pathogenesis of this benign microscopic clear cell colitis,sometimes coexisting with allergy.

  10. β-lactam-associated eosinophilic colitis.

    Science.gov (United States)

    Mogilevski, Tamara; Nickless, David; Hume, Sam

    2015-01-01

    A 42-year-old man with a history of childhood asthma presented with a 2-week history of watery diarrhoea and marked peripheral eosinophilia in the setting of recent use of cephalexin. His colonoscopy revealed patchy colitis. Biopsies were consistent with eosinophilic colitis. Two months later he received a course of amoxicillin resulting in recurrence of peripheral eosinophilia. Given the time-frame of β-lactam administration to symptom onset and elimination of all other precipitating causes, he was diagnosed with β-lactam-associated eosinophilic colitis. The patient's symptoms resolved and peripheral eosinophil count decreased with no specific treatment. Eosinophilic colitis is a rare heterogeneous condition, the pathogenesis of which is likely to be an interplay between environmental and genetic factors. It can be secondary to a helminthic infection or a drug reaction and has been associated with ulcerative colitis. If secondary causes of eosinophilic colitis have been excluded, the mainstay of treatment is with corticosteroids. PMID:26106168

  11. Surveillance for colitis-associated colon neoplasia

    Institute of Scientific and Technical Information of China (English)

    Hugh; James; Freeman

    2010-01-01

    The risk of developing colon cancer is increased in colitis patients, particularly if the disease is extensive and its duration long-standing. Endoscopic guidelines have been developed with the goal of detecting early neoplastic changes prior to development of advanced malignancy. Unfortunately, the natural history of this superimposed neoplastic process in colitis appears to be very heterogeneous and poorly understood. Moreover, there are numerous confounding variables in colitis patients that limit accura...

  12. Delay in diagnosis of congenital anal stenosis

    OpenAIRE

    Weledji, Elroy P; Motaze Sinju

    2016-01-01

    Although a minor anorectal malformation the delay in diagnosis and treatment of anal stenosis may result in significant early or late complications. Early inspection of the perineum in the neonate to pick up and correct anorectal malformation improves long term outcome but this requires proper anal examination or it could be missed. We present and discuss a case of delayed diagnosis of congenital anal stenosis (a low anorectal anomaly) with an imminent colonic perforation. Severe anal stenosi...

  13. Cyclooxygenase-2 immunoreactivity in collagenous colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Rumessen, Jüri J; Csillag, Claudio;

    2009-01-01

    Collagenous colitis (CC) is an inflammatory bowel disease of unknown aetiology and pathogenesis. In ulcerative colitis and Crohn's disease, prostaglandins may be involved in the pathogenesis of inflammation, and increased expression of cyclo-oxygenase-2 (COX-2) has been detected. The purpose...... with samples from eight normal controls, and samples from eight patients with ulcerative colitis or Crohn's disease. Specimens from patients with CC expressed COX-2 protein in increased amounts compared with controls, but similar to patients with ulcerative colitis and Crohn's disease. COX-2 expression...

  14. Autoimmune hepatitis in association with lymphocytic colitis.

    LENUS (Irish Health Repository)

    Cronin, Edmond M

    2012-02-03

    Autoimmune hepatitis is a rare, chronic inflammatory disorder which has been associated with a number of other auto-immune conditions. However, there are no reports in the medical literature of an association with microscopic (lymphocytic) colitis. We report the case of a 53-year-old woman with several autoimmune conditions, including lymphocytic colitis, who presented with an acute hepatitis. On the basis of the clinical features, serology, and histopathology, we diagnosed autoimmune hepatitis. To our knowledge, this is the first report of autoimmune hepatitis in association with lymphocytic colitis, and lends support to the theory of an autoimmune etiology for lymphocytic colitis.

  15. Desempenho de uma escala analógica visual legendada na determinação do grau de dispneia durante teste de broncoespasmo induzido por exercício em crianças e adolescentes asmáticos Performance of a word labeled visual analog scale in determining the degree of dyspnea during exercise-induced bronchoconstriction in children and adolescents with asthma

    OpenAIRE

    Patrícia Bueno Lima; Ilka Lopes Santoro; Lilian Ballini Caetano; Anna Lúcia de Barros Cabral; Ana Luisa Godoy Fernandes

    2010-01-01

    OBJETIVO: Existe uma relação indireta entre a obstrução das vias aéreas em asma e a intensidade de falta de ar (dispneia). Uma escala visual analógica legendada de dispneia com escore de 0-3 pontos tem sido amplamente utilizada na avaliação da broncoconstrição, embora a percepção de tal obstrução seja muito variável. O objetivo deste estudo foi determinar se crianças e adolescentes são capazes de perceber a broncoconstrição aguda induzida por exercício (BAIE), bem como medir o poder discrimin...

  16. Determinación de esteroles y dialcoholes triterpénicos en aceite de oliva mediante separación de la fracción por cromatografía líquida de alta eficacia y análisis por cromatografía de gases. Estandarización del método analítico.

    Directory of Open Access Journals (Sweden)

    Cert, Arturo

    1997-08-01

    Full Text Available A method is developed for the analysis of sterols together with triterpenic alcohols (erythrodiol and uvaol in vegetable oils. The method involves obtention of the unsaponifiable matter, isocratic HPLC separation with refractive index detector, preparation of silylderivatives, and analysis by capillary GC. Four procedures involving GC analysis of sterol and sterol+dialcohol fractions obtained by HPLC and CCF separations are compared. A collaborative trial comparing HPLC-sterols+dialcohols and CCF-sterols (official methods is carried out. For Δ7-sterols, higher values and better repeatability and reproducibility were observed in the first method, but no differences for the remainder sterols were found. The erythrodiol+uvaol determinations by HPLC-sterols+dialcohols and CCF-sterols+dialcohols (official methods resulted in similar precision.

    Se presenta un método para la determinación conjunta de esteróles y dialcoholes triterpénicos (eritrodiol y uvaol en aceites de oliva que consta de las etapas siguientes: obtención del insaponificable, fraccionamiento mediante cromatografía líquida de alta eficacia (CLAE en régimen isocrático con detector de índice de refracción, preparación de derivados sililados y análisis por cromatografía de gases en columna capilar. Se comparan cuatro procedimientos que utilizan el análisis por cromatografía de gases de las fracciones de esteroles y de esteroles + dialcoholes obtenidas tanto por CLAE como por CCF. Se lleva a cabo un análisis colaborativo para la determinación de esteroles comparando los métodos CLAE-esteroles+dialcoholes y CCFesteroles (método oficial. Los resultados mostraron que por el primer procedimiento la determinación de Δ7-esteroles se realiza con mayor repetibilidad y reproducibilidad, aunque los valores resultantes son más altos. No se encontraron diferencias en los parámetros de precisión ni en los valores de los restantes esteroles. Las determinaciones de

  17. The misdiagnosis of ischaemic colitis

    Energy Technology Data Exchange (ETDEWEB)

    Rudd, Joanne [Department of Radiology, West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ (United Kingdom)]. E-mail: joanne.rudd@wsh.nhs.uk

    2006-11-15

    This case study followed the pathway taken by an elderly patient who presented as an emergency with rectal bleeding. Views obtained of the colon by flexible sigmoidoscopy suggested an initial diagnosis of colorectal carcinoma but this proved to be incorrect. It was a combination of the histology obtained from the initial and subsequent endoscopies, barium enema and the clinical history that finally gave rise to the correct diagnosis of ischaemic colitis. Opinion is currently divided as to whether sigmoidoscopy or colonoscopy is the most appropriate test for those patients presenting with rectal bleeding. Ischaemic colitis is a disease that can present with many differing symptoms depending on the degree of severity of the ischaemia.

  18. Turner Syndrome with Ulcerative Colitis

    OpenAIRE

    Hyodo, Hiromi; TOMITA, Yuichiro; Hirai, Kohta; HIRAKAWA, Hitoshi; Ueno, Shigeru; Ishiguro, Hiroyuki

    2009-01-01

    Turner syndrome is a chromosomal disease frequently associated with autoimmune disorders including diabetes mellitus, thyroid disease and inflammatory bowel disease (IBD). Although the etiology of IBD has not been fully elucidated, genetic analysis has recently revealed several susceptibility genes. Recently, cases with Turner syndrome associated with IBD have been reported. We report here a 13-yr-old girl with Turner syndrome associated with ulcerative colitis. The patient was undergoing gro...

  19. Ulcerative colitis after Cytomegalovirus Infection

    Directory of Open Access Journals (Sweden)

    Mohammad Aminianfar

    2014-06-01

    Full Text Available A 21 years old man has been complained of bloody diarrhea, liquid stool containing blood, pus, and fecal matter and crampy abdominal pain from four monthes ago. Ulcerative colitis relies upon the patient's history, clinical symptoms, sigmoidoscopic appearance and histology of colonic biopsy specimens. Treatment of patient started with high dose dexamethasone and prednisolone, asacole, suppository, metronidazole. Patient’s condition not improved and patient admitted in hospital. High dose prednisolone, azathioprine, sulfasalazine and folic acid were given.

  20. Colitis after polytrauma: Case report

    OpenAIRE

    William E. Carter, MD, MPH; Isaac A. Darko, MD; Priya Chandan, MD, MPH; Ajit B. Pai, MD

    2014-01-01

    Across the medical literature, delayed diagnosis and treatment leads to more costly and worse outcomes. Rehabilitation patients, especially those with polytrauma, often have a complex mixture of medical, social, and psychological health problems that can impair effective diagnosis and treatment. The case presentation describes the procession toward the diagnosis of ulcerative colitis in a preinjury asymptomatic male, suggesting a potential mechanism for its emergence and describing the effect...

  1. Current treatment of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    JohannesMeier; AndreasSturm

    2011-01-01

    Ulcerative colitis (UC) is a chronic disease featuring re- current inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complica- tions of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice-orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.

  2. Current treatment of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Johannes Meier; Andreas Sturm

    2011-01-01

    Ulcerative colitis (UC) is a chronic disease featuring recurrent inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complications of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice- orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.

  3. Delay in diagnosis of congenital anal stenosis

    Directory of Open Access Journals (Sweden)

    Elroy P. Weledji

    2016-03-01

    Full Text Available Although a minor anorectal malformation the delay in diagnosis and treatment of anal stenosis may result in significant early or late complications. Early inspection of the perineum in the neonate to pick up and correct anorectal malformation improves long term outcome but this requires proper anal examination or it could be missed. We present and discuss a case of delayed diagnosis of congenital anal stenosis (a low anorectal anomaly with an imminent colonic perforation. Severe anal stenosis will always require examination under anesthesia with graded Hegar's dilatation followed by postoperative maintenance. The Hegar dilator is thus both diagnostic and therapeutic in congenital anal stenosis.

  4. Pancreatitis aguda recidivante con enteropatía por gluten asociada: Características clínico-analíticas y evolutivas en 34 pacientes Relapsing acute pancreatitis associated with gluten enteropathy: Clinical, laboratory, and evolutive characteristics in thirty-four patients

    Directory of Open Access Journals (Sweden)

    L. Rodrigo

    2008-12-01

    Full Text Available Objetivos: describir la frecuencia y características clínico-analíticas de la pancreatitis aguda (PA recidivante con enteropatía por gluten (EG asociada. Pacientes y métodos: estudiamos de forma prospectiva los casos de pancreatitis agudas ingresados en nuestro Servicio durante el año 2006. Registramos un total de 185 pacientes. A las formas recurrentes que fueron 40 en total (22%, les aplicamos un protocolo clínico-analítico consistente en la determinación de marcadores serológicos, genéticos y biopsias duodenales, para descartar una EG asociada. Resultados: un total de 34 pacientes (18% cumplían criterios clínico-biológicos de EG asociada (grupo 1 y se compararon con el resto de las PA no-EG (n = 161 (grupo 2. La edad media en la EG fue de 54 ± 25 años, ligeramente inferior al grupo 2, (61 ± 14 (NS. Existía un ligero predominio de mujeres (50% en el grupo 1, respecto al grupo 2 (38,5% (NS. Siete pacientes del grupo 1 (20% presentaron una PA grave, frente a 27 (17% en el grupo 2 (NS. La presencia de colelitiasis en el grupo 1, fue de 6 casos (18%, significativamente inferior a la del grupo 2, de 72 casos (45% (p Objectives: to describe the frequency and the clinical and laboratory characteristics of relapsing acute pancreatitis (AP associated with gluten enteropathy (GE. Patients and methods: we prospectively examined all acute pancreatitis cases admitted to our Department in 2006. We recorded a total of 185 patients. With recurring forms, 40 (22% in all, we used a clinical-lab protocol including serologic and genetic markers, and duodenal biopsy to rule out GE. Results: a total of 34 patients (18% met clinical-biological criteria for GE (group 1, and were compared to the remaining non-GE AP cases (n = 161 (group 2. Mean age in the GE group was 54 ± 25 years, slightly younger than group 2 (61 ± 14 (NS. There was a mild predominance of women (50% in group 1 versus group 2 (38.5% (NS. Seven patients in group 1 (20% had severe

  5. Diagnóstico de HPV anal em mulheres com NIC: prevenção de câncer do ânus? Anal HPV diagnosis in women with NIC: anal cancer prevention?

    Directory of Open Access Journals (Sweden)

    Alice Capobiango

    2009-12-01

    Full Text Available Os objetivos deste estudo foram avaliar a frequência de HPV anal em pacientes com neoplasia intraepitelial cervical (NIC, verificar a concordância entre os subtipos encontrados nos dois locais e investigar os fatores que influenciaram a ocorrência de HPV anal em mulheres com NIC sem evidências clínicas de imunodepressão. Foram avaliadas 52 mulheres com idades entre 16 e 72 anos e diagnóstico de neoplasia intraepitelial cervical graus I, II e III. A identificação do DNA (ácido desoxirribonucleico do HPV e de sete subtipos dos vírus foi realizada por meio da reação em cadeia da polimerase (PCR em material colhido no ânus e colo uterino. Foram pesquisados fatores que poderiam contribuir para a infecção anal, como paridade, número de parceiros, tabagismo, manipulação e coito anal e o tipo de doença ginecológica. Das 52 mulheres, foi diagnosticado HPV na região anal em 25 (48%, das quais 23 (44% também apresentavam HPV no colo uterino - resultado significativo para existência do HPV em portadoras de NIC. Em 16 (31% o HPV foi diagnosticado somente no colo uterino e em 11 (21% não foi identificado em colo ou ânus. Houve associação significativa nas variáveis paridade (p=0,02 e número de parceiros (p=0,04. Concluiu-se que: as mulheres com HPV genital têm mais probabilidade de serem acometidas por HPV anal; não há concordância unânime entre os subtipos do HPV do colo do útero e do ânus e a paridade e o número de parceiros contribuem para aumentar a incidência de HPV anal nas mulheres sem imunodeficiência e com HPV cervical.This study aims were to assess the frequency of HPV anal infection in patients with cervical intra-epithelial neoplasia (CIN, to find out the relation between the found subtypes, when present in both regions, and investigate factors that influenced the occurrence of anal HPV in women with CIN. Fifty two women with age between 16 and 72 years and cervical intra-epithelial neoplasia (CIN diagnosis

  6. Crohn's colitis and idiopathic thrombocytopenic purpura

    OpenAIRE

    Boyne, M.; Dye, K.

    2000-01-01

    A 17 year old girl with active Crohn's colitis developed idiopathic thrombocytopenic purpura that was managed with intravenous immune globulins and cyclosporin A. The possible association between Crohn's disease and immune thrombocytopenia is explored.


Keywords: Crohn's disease; colitis; thrombocytopenia

  7. Microscopic colitis : an unfamiliar but treatable disease

    NARCIS (Netherlands)

    van der Wouden, E. J.; Karrenbeld, A.; Kleibeuker, J. H.; Dijkstra, G.

    2009-01-01

    Chronic diarrhoea is a frequent complaint in clinical practice. Microscopic colitis is the cause of this symptom in 10% of these cases and the prevalence is rising. To exclude microscopic colitis a colonoscopy with multiple biopsies of different regions of the colon is mandatory. A sigmoidoscopy alo

  8. Kalium kanalers rolle i inflammation i Colitis Ulcerosa

    DEFF Research Database (Denmark)

    Hansen, Lars Koch

    2011-01-01

    Gennemgang af T-cellers kalium kanaler og deres mulige rolle i Colitis Ulcerosa. Artiklen skrevet til Den danske Colitis-Crohn Forenings Medlemsblad.......Gennemgang af T-cellers kalium kanaler og deres mulige rolle i Colitis Ulcerosa. Artiklen skrevet til Den danske Colitis-Crohn Forenings Medlemsblad....

  9. Internal anal sphincter: an anatomic study.

    Science.gov (United States)

    Uz, A; Elhan, A; Ersoy, M; Tekdemir, I

    2004-01-01

    The anatomy of the internal anal sphincter and surrounding structures was investigated in 24 cadavers using a surgical microscope (6-25 x magnification). An understanding of the anatomy of the internal anal sphincter is helpful in avoiding complications during surgical procedures in the anorectal region. The external anal sphincter was composed of three ellipsoid rings of skeletal muscle (subcutaneous, superficial, and deep) that encircle the anal canal; in contrast, we found that the internal anal sphincter was composed of flat rings of smooth muscle bundles stacked one on top of the other, like the slats of a Venetian blind. In each anal canal, the average number of ring-like slats observed was 26.33 +/- 2.93 (range = 20-30) and each was covered by its own fascia. The smooth muscle fibers and fascia coalesced at three equidistant points around the anal canal to form three columns that extended distally into the lumen and differed in form from the other anal columns. When viewed from an anterior position, the columns were located anteriorly at the observer's right (5 o'clock position), posteriorly at the right (1 o'clock position), and laterally at the left (9 o'clock position). This heretofore unreported anatomy of the internal anal sphincter may play an important role in closing off the lumen of the anal canal and maintaining bowel continence. PMID:14695582

  10. Nitric oxide and chronic colitis

    Directory of Open Access Journals (Sweden)

    Matthew B Grisham

    1996-01-01

    Full Text Available Nitric oxide (NO is thought to play an important role in modulating the inflammatory response by virtue of its ability to affect bloodflow, leukocyte function and cell viability. The objective of this study was to assess the role that NO may play in mediating the mucosal injury and inflammation in a model of chronic granulomatous colitis using two pharmacologically different inhibitors of nitric oxide synthase (NOS. Chronic granulomatous colitis with liver and spleen inflammation was induced in female Lewis rats via the subserosal (intramural injection of peptidoglycan/polysaccharide (PG/PS derived from group A streptococci. Chronic NOS inhibition by oral administration of NG-nitro-L-arginine methyl ester (L-NAME (15 µmol/kg/day or amino-guanidine (AG (15 µmol/ kg/day was found to attenuate the PG/PS-induced increases in macroscopic colonic inflammation scores and colonic myeloperoxidase activity. Only AG -- not L-NAME – attenuated the PG/PS-induced increases in colon dry weight. Both L-NAME and AG significantly attenuated the PG/PS-induced increases in spleen weight whereas neither was effective at significantly attenuating the PG/PS-induced increases in liver weight. Although both L-NAME and AG inhibited NO production in vivo, as measured by decreases in plasma nitrite and nitrate levels, only AG produced significantly lower values (38±3 versus 83±8 µM, respectively, P<0.05. Finally, L-NAME, but not AG, administration significantly increased mean arterial pressure from 83 mmHg in colitic animals to 105 mmHg in the PG/PS+ L-NAME-treated animals (P<0.05. It is concluded that NO may play an important role in mediating some of the pathophysiology associated with this model of chronic granulomatous colitis.

  11. O terapêutico e o analítico em Freud

    Directory of Open Access Journals (Sweden)

    Vinicius Anciães Darriba

    2013-06-01

    Full Text Available Este artigo tem como objetivo investigar, na obra de Freud, a demarcação que se institui entre o terapêutico e o analítico. Tal investigação enfoca, primeiramente, a passagem da hipnose à associação livre e o direcionamento do autor à questão da causa, o que estabelece uma visada para a cura analítica em confluência com o que se desdobra da exploração do campo do inconsciente e da consideração de um domínio pulsional. Delimitados por esta via os objetivos terapêuticos e analíticos, interroga-se, em seguida, como a dimensão do terapêutico se veria reintroduzida nos termos da nova direção de cura proposta por Freud.

  12. Apontamentos sobre a psicologia analítica de Carl Gustav Jung

    Directory of Open Access Journals (Sweden)

    Luís Marcelo Alves Ramos

    2002-01-01

    Full Text Available O texto faz uma introdução à Psicologia Analítica do psicólogo e psiquiatra suíço Carl Gustav Jung: define o conceito de Psicologia Analítica, traz uma biografia resumida de Carl Gustav Jung, indica as principais diferenças entre a Psicologia Analítica e a Psicanálise, descreve a estrutura e o funcionamento da psique e, por fim, apresenta sinteticamente as características dos tipos de personalidades traçadas por Jung. The text makes an introduction to the Analytical Psychology of the psychologist and swiss psychiatrist Carl Gustav Jung: it defines the concept of Analytical Psychology, brings a summarized biography of Carl Gustav Jung, indicates the main differences between Analytical Psychology and the Psychoanalysis, describes the structure and the functioning of psyche and, finally, presents synthetically the characteristics of the types of personalities traced by Jung.

  13. Colitis ulserosaa sairastavan potilaan ohjaus

    OpenAIRE

    Södervik, Satu; Liimatainen, Erja

    2011-01-01

    Opinnäytetyön toimeksiantajana olivat Keski-Suomen Sairaanhoitopiirin sisätautiosasto 11 ja sisätau-tien poliklinikka. Opinnäytetyön tarkoituksena oli selvittää, miten Colitis ulcerosa potilaat kokevat saa-mansa ohjauksen riittävyyden ja ajankohdan, sekä mitä asioita hoitajat ohjaavat potilaille ja millä taval-la hoitajat haluavat kehittää jo annettavaa ohjausta. Opinnäytetyön tavoitteena oli, että tutkimustuloksia voidaan hyödyntää sisätautien osastoilla ja polikli-nikoilla annettavassa C...

  14. Colitis after polytrauma: Case report

    Directory of Open Access Journals (Sweden)

    William E. Carter, MD, MPH

    2014-07-01

    Full Text Available Across the medical literature, delayed diagnosis and treatment leads to more costly and worse outcomes. Rehabilitation patients, especially those with polytrauma, often have a complex mixture of medical, social, and psychological health problems that can impair effective diagnosis and treatment. The case presentation describes the procession toward the diagnosis of ulcerative colitis in a preinjury asymptomatic male, suggesting a potential mechanism for its emergence and describing the effect of delayed diagnosis on the efficiency of rehabilitative care. As such, the differential diagnosis for early posttraumatic diarrhea should remain broad, particularly if unexplained or ineffectively controlled.

  15. Sulphasalazine-Induced Pseudomembranous Colitis

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    1991-01-01

    Full Text Available An 18-year-old female with ankylosing spondylitis developed fever, abdominal pain and diarrhea on two occasions after starting sulphasalazine therapy. Flexible sigmoidoscopy revealed pseudomembranous colitis; fecal cultures were positive for Clostridium difficile; and C difficile toxin assay was positive. Despite the frequent use of sulphasalazine in the management of inflammatory bowel disease, this complication has been apparently rare. Clinicians should be wary of the onset of diarrhea in patients receiving sulphasalazine, whether for inflammatory bowel disease or other conditions.

  16. Elements of an anal dysplasia screening program.

    Science.gov (United States)

    Jay, Naomi

    2011-01-01

    The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is highly elevated compared to the general population, as is the incidence of its precursor lesion, high-grade anal intraepithelial neoplasia (HGAIN). MSM in general and other immunocompromised populations are also at higher risk. Treatment of HGAIN may prevent development of cancer, similar to the decrease in cervical cancers that has occurred since the advent of cervical cancer screening programs in women. Cervical cancer screening tools have been adapted and validated for screening, diagnosis, and treatment of anal HGAIN. Anal cancer screening programs have now been available for more than a decade, although they are not yet standards of care. Incorporating screening procedures into practice depends on the available resources in a particular community. This article discusses the procedures for anal cancer screening including cytology, digital anal rectal examinations, high-resolution anoscopy, and biopsy. PMID:22035526

  17. ¿que es una función analítica?

    OpenAIRE

    Takahashi, Alonso

    2012-01-01

    1. El plano complejo Si designamos por ℝ el conjunto de los números reales entonces el plano cartesiano o plano de la geometría analítica es el conjunto ℝ2 = {(x,y): x ϵ ℝ , y ϵ ℝ}. Es bien conocida su representación

  18. Cytomegalovirus-colitis hos immunkompetent ung mand

    DEFF Research Database (Denmark)

    Rasmussen, Eva; Grønbaek, Karin; Linnemann, Dorte

    2009-01-01

    haematochezia remained present after six months. Development of IBD subsequent to CMV colitis has previously been described, and is now suspected in our patient. CMV colitis is a rare but possible differential diagnosis in immunocompetent patients with fever, elevated liver enzymes and bloody stools......A healthy young man was hospitalized due to fever, malaise and bloody stools for three weeks. The patient had a primary CMV infection based on biochemical, serological and ultrasonic results, and a colonoscopy was consistent with left-sided CMV colitis. He recovered spontaneously, though...

  19. Left Ventricular Thrombosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Tarek Saleh

    2010-07-01

    Full Text Available Left ventricular thrombi usually occur in the setting of an acute myocardial infarction, left ventricular aneurysm, or dilated cardiomyopathy. In the absence of ventricular wall motion abnormalities, they are rare. This report describes a patient with ulcerative colitis in whom two-dimensional echocardiography revealed a left intraventricular mass. Thrombosis in ulcerative colitis is a serious condition and can occur in a very young population. This case also shows that left ventricular thrombi can occur in the active setting of ulcerative colitis.

  20. [Simultaneous occurrence of lymphocytic gastritis and lymphocytic colitis with transition to collagenous colitis].

    Science.gov (United States)

    Christ, A D; Meier, R; Bauerfeind, P; Wegmann, W; Gyr, K

    1993-07-31

    Lymphocytic gastritis and lymphocytic colitis are two rare disorders of unknown etiology, only diagnosable by histology. Simultaneous occurrence of lymphocytic colitis and lymphocytic gastritis has not been described up to now. A 69-year-old female patient was examined because of crampy abdominal pain and watery diarrhea. Laboratory tests did not reveal an etiology and in colonoscopy the colon and terminal ileum were normal. Histology disclosed lymphocytic colitis. Esophagogastroduodenoscopy showed erosive bulbitis. Biopsies of the stomach revealed lymphocytic gastritis. A second colonoscopy one year later showed the development of collagenous colitis. PMID:8367708

  1. Future targets for immune therapy in colitis?

    DEFF Research Database (Denmark)

    Kristensen, Nanna Ny; Claesson, M H

    2008-01-01

    Crohn's disease and Ulcerative Colitis, collectively termed inflammatory bowel disease (IBD), are chronic inflammatory disorders of the bowel. It is generally accepted that the pathology associated with IBD is characterized by a hyper-reactive immune response in the gut wall directed against...... cells to the inflamed bowel of IBD patients, making the chemokine/receptor system appealing as new therapeutic targets to sustain remission in these patients. In the severe combined immunodeficiency transfer model of colitis, which histopathologically resembles human IBD, low numbers of CD4+CD25- T...... cells from congenic normal mice are transplanted into immune deficient mice, which in turn develop a chronic lethal colitis within 1-2 months. By simultaneous transplantation of CD4+CD25+ regulatory T cells (Tregs) it is possible to hinder development of colitis. Thus the model is well suited...

  2. Intestinal microecology in rats with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    韩晓霞

    2013-01-01

    Objective To study the abundance and diversity ofthe gut flora in rats with dextran sulfate sodium(DSS)-induced ulcerative colitis(UC)to provide new knowledge about the pathogenesis of this disease.Methods Twenty-six

  3. Resultados do exame anátomo-patológico e "Polymerase Chain Reaction (PCR)" na forma clinica e subclinica da infecção anal pelo Papilomavirus Humano (HPV): estudo em quatro grupos de pacientes Histopathological and PCR results for clinical and subclinical forms of HPV anal infection: study of four groups of patients

    OpenAIRE

    João Carlos Magi; Marcos Ricardo da Silva Rodrigues; Geanna Mara Lino e Silva de Resende Guerra; Maria Cecília Costa; Anderson da Costa Lino Costa; Luisa Lina Villa; Galdino José Sitonio Formiga

    2006-01-01

    O Papilomavírus Humano tem alta incidência na população. O objetivo deste trabalho é o estudo dos resultados encontrados no exame anatomo-patológico e no PCR das formas clínica e subclínica da infecção anal por HPV em quatro grupos de pacientes. MÉTODO: Foram estudados 10 pacientes com prurido anal idiopático, seis com infecção genital pelo HPV, tratada, seis com condiloma anal tratado e oito com condiloma anal. As verrugas foram biopsiadas nos oito pacientes com condiloma e feito exame de an...

  4. Intestinal microbiota and ulcerative colitis.

    Science.gov (United States)

    Ohkusa, Toshifumi; Koido, Shigeo

    2015-11-01

    There is a close relationship between the human host and the intestinal microbiota, which is an assortment of microorganisms, protecting the intestine against colonization by exogenous pathogens. Moreover, the intestinal microbiota play a critical role in providing nutrition and the modulation of host immune homeostasis. Recent reports indicate that some strains of intestinal bacteria are responsible for intestinal ulceration and chronic inflammation in inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD). Understanding the interaction of the intestinal microbiota with pathogens and the human host might provide new strategies treating patients with IBD. This review focuses on the important role that the intestinal microbiota plays in maintaining innate immunity in the pathogenesis and etiology of UC and discusses new antibiotic therapies targeting the intestinal microbiota.

  5. Viscoelastic assessment of anal canal function using acoustic reflectometry

    DEFF Research Database (Denmark)

    Mitchell, Peter J; Klarskov, Niels; Telford, Karen J;

    2012-01-01

    Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis.......Anal acoustic reflectometry is a new reproducible technique that allows a viscoelastic assessment of anal canal function. Five new variables reflecting anal canal function are measured: the opening and closing pressure, opening and closing elastance, and hysteresis....

  6. Colitis associated with biological agents

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2012-01-01

    In the past,there has been considerable focus on a host of drugs and chemicals that may produce colonic toxicity.Now,a variety of new biological monoclonal antibody agents,usually administered by infusion,have appeared in the clinical realm over the last decade or so to treat different chronic inflammatory or malignant disorders.For some of these agents,adverse effects have been documented,including apparently new forms of immune-mediated inflammatory bowel disease.In some,only limited symptoms have been recorded,but in others,severe colitis with serious complications,such as bowel perforation has been recorded.In others,adverse effects may have a direct vascular or ischemic basis,while other intestinal effects may be related to a superimposed infection.Some new onset cases of ulcerative colitis or Crohn's disease may also be attributed to the same agents used to treat these diseases,or be responsible for disease exacerbation.Dramatic and well documented side effects have been observed with ipilimumab,a humanized monoclonal antibody developed to reduce and overcome cytotoxic T-lymphocyte antigen 4,a key negative feedback regulator of the T-cell anti-tumor response.This agent has frequently been used in the treatment of different malignancies,notably,malignant melanoma.Side effects with this agent occur in up to 40% and these are believed to be largely immune-mediated.One of these is a form of enterocolitis that may be severe,and occasionally,fatal.Other agents include rituximab (an antiCD20 monoclonal antibody),bevacizumab (a monoclonal antibody against the vascular endothelial growth factor) and anti-tumor necrosis factor agents,including infliximab,adalimumab and etanercept.

  7. Nocturnal faecal soiling and anal masturbation.

    OpenAIRE

    A. F. Clark; Tayler, P J; Bhate, S R

    1990-01-01

    Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised.

  8. Desenvolvimento e validação de método analítico para nistatina creme vaginal por cromatografia líquida de alta eficiência Development and validation of an analytical method for Nystatin vaginal cream by high performance liquid chromatography

    Directory of Open Access Journals (Sweden)

    Zênia Maria Maciel Lavra

    2008-12-01

    Full Text Available A nistatina é um antibiótico poliênico, com características fungistáticas e fungicidas, que age desestruturando a membrana celular de fungos e leveduras. O creme vaginal de nistatina é usado para o tratamento da candidíase vaginal. Até recentemente, os compêndios oficiais preconizavam o ensaio microbiológico para doseamento deste antibiótico, método este considerado inviável na rotina de centros de controle de qualidade, devido ao tempo excessivo para liberação dos resultados. Visando obter um método alternativo para o doseamento do creme vaginal de nistatina, procurou-se desenvolver e validar um método cromatográfico (CLAE. O método desenvolvido utilizou como fase estacionária uma coluna de fase reversa, C18, 3,9 x 150 mm, 4 mm, à temperatura de 30 ºC. A fase móvel foi constituída por tampão fosfato de sódio 0,25 mM e EDTA 0,025 mM, pH 6,00, metanol e acetonitrila (40:30:30, vazão de 1,0 mL/minuto e comprimento de onda 305 nm. O método validado revelou-se exato, preciso, robusto, linear e específico, além de rápido e prático, podendo ser utilizado para o doseamento analítico de creme vaginal de nistatina.Nystatin is a polyenic antibiotic with fungistatic and fungicide characteristics that acts by de-structuring the cellular membrane of fungi and yeast. The nystatin vaginal cream is used for the treatment of vaginal candidiasis. Until recently, the official compendia professed the microbiological trial for dosing this antibiotic, method considered as non-feasible in the routine of quality control centers due to the excessive time for release of results. Aiming at obtaining an alternative method for dosing nystatin vaginal cream, a chromatographic method (HPLC was developed and validated. The method developed used a reversible phase column of C18, 3.9 x 150 mm, 4 mm, at 30 ºC. The mobile phase was made up of a 0.25 mM sodium phosphate buffer and 0.025 mM EDTA, pH 6.00, methanol and acetonitrile (40:30:30, rate of

  9. Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    GU Jin; LI Jiyou; YAO Yunfeng; LU Aiping; WANG Hongyi

    2007-01-01

    It is difficult to distinguish a tectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas.The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified.Here,we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma.Five months after resection,he developed an adenocarcinoma in the anal canal.The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins(CKs)7 and 20 were performed.The index tumor demonstrated CK 7-/CK 20+and the second showed CK7+/CK20+.For this reason,we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately.It is very important to difierentiate the anorectal lesions pathologically because of the impact on the therapeutic options available,especially for the lesion arising in the anal canal.

  10. Colonic production of nitric oxide gas in ulcerative colitis, collagenous colitis and uninflamed bowel

    DEFF Research Database (Denmark)

    Perner, Anders; Lassen, Inge Nordgaard; Matzen, Peter;

    2002-01-01

    ulcerative colitis, 10 patients with collagenous colitis and 20 controls with uninflamed mucosa. METHODS: The tip of a Teflon tube was placed in the caecum during colonoscopy. Subsequently, argon was infused at a constant rate for 70-180 min. Argon and NO in gas sampled from the rectum were measured by...

  11. Lansoprazole-associated collagenous colitis: Diffuse mucosal cloudiness mimicking ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Mitsuro Chiba; Takeshi Sugawara; Haruhiko Tozawa; Hidehiko Tsuda; Toru Abe; Takuo Tokairin; Iwao Ono; Eriko Ushiyama

    2009-01-01

    There have only been a few reports on lansoprazoleassociated collagenous colitis. Colonic mucosa of collagenous colitis is known to be endoscopically normal. We present a case of collagenous colitis where the mucosa showed diffuse cloudiness mimicking ulcerative colitis. A 70-year-old woman developed watery diarrhea four to nine times a day. She had interstitial pneumonia at 67 and reflux esophagitis at 70 years. Lansoprazole 30 mg/d had been prescribed for reflux esophagitis for nearly 6 mo. Lansoprazole was withdrawn due to its possible side effect of diarrhea. Colonoscopy disclosed diffuse cloudiness of the mucosa which suggested ulcerative colitis. Consequently sulfasalazine 2 g/d was started. The patient's diarrhea dramatically disappeared on the following day. However, biopsy specimens showed subepithelial collagenous thickening and infiltration of inflammatory cells in the lamina propria, confirming the diagnosis of collagenous colitis. One month after sulfasalazine therapy was initiated, colonoscopic and histological abnormalities resolved completely. Five months later the diarrhea recurred. The findings on colonoscopy and histology were the same as before, confirming a diagnosis of collagenous colitis relapse. We found that the patient had begun to take lansoprazole again 3 mo ahead of the recent diarrhea. Withdrawal of lansoprazole promptly resolved the diarrhea. Endoscopic and histological abnormalities were also completely resolved, similar to the first episode. Retrospectively, the date of commencement of sulfasalazine and discontinuation of lansoprazole in the first episode was found to be the same. We conclude that this patient had lansoprazole-associated collagenous colitis.

  12. Anal intraepithelial neoplasia: review and recommendations for screening and management.

    Science.gov (United States)

    Smyczek, Petra; Singh, Ameeta E; Romanowski, Barbara

    2013-11-01

    Anal cancer is a rare malignancy of the distal gastrointestinal tract, often associated with human papillomavirus, the most common sexually transmitted infection worldwide. Currently available screening methods for anal intraepithelial neoplasia, a precursor for anal cancer, combine anal Papanicolaou cytology and high resolution anoscopy with biopsy of suspicious lesions. Significant barriers to establishing anal cancer screening programmes include the small number of healthcare professionals performing high resolution anoscopy and the lack of data showing that anal cancer screening can reduce morbidity and mortality related to anal carcinoma. Despite several controversies surrounding anal cancer screening, the rising incidence of this disease in some groups supports routine screening programmes in high-risk populations, especially in HIV-positive men who have sex with men. This review outlines the epidemiology of anal intraepithelial neoplasia and anal cancer and summarizes issues related to the introduction of anal cancer screening programmes. PMID:23970583

  13. Sensibilidad, especificidad y valores predictivos del nivel de hemoglobina, hematócrito y cuenta plaquetariacomo índices de actividad en colitis ulcerativa

    OpenAIRE

    J. Jesús Ibarra-Rodríguez; Ernesto Santiago-Luna; Gabriela Abigail Velázquez-Ramírez; María Karina Lizbeth López-Ramírez; Clotilde Fuentes-Orozco; Ana Olivia Cortés-Flores; Alejandro González-Ojeda

    2005-01-01

    ntroducción: la colitis ulcerativa es una enfermedad caracteri-zada por inflamación no infecciosa de la mucosa colorrectal, asícomo por recaídas y remisiones. Su heterogeneidad hace que laevaluación de la actividad sea un requisito para elegir el trata-miento.Objetivo: determinar sensibilidad, especificidad, valor predictivopositivo y negativo de la hemoglobina, hematócrito y cuentaplaquetaria para desarrollar un índice simplificado de actividadde la colitis ulcerativa.Material y métodos: se ...

  14. Ischemic colitis due to vigorous physical exercise Colitis isquémica en relación con ejercicio físico extenuante

    Directory of Open Access Journals (Sweden)

    Natalia Z. Rosado-Dawid

    2013-01-01

    Full Text Available Physical exercise has been related with both beneficial effects on the gastrointestinal tract as with adverse effects on the latter. Gastrointestinal bleeding is one of these. In general, gastrointestinal bleeding is transient and mild. However, some cases caused by intestinal ischemia can sometimes be more serious due to the amount of bleeding and the presence of mucosal lesions. We present the case of a patient with abdominal pain and rectal bleeding caused by an extensive ischemic colitis due to vigorous physical exercise.El ejercicio físico se ha relacionado con beneficios sobre el tracto digestivo así como efectos adversos sobre el mismo. El sangrado gastrointestinal es una de las complicaciones descritas asociadas al mismo. Por lo general, la hemorragia digestiva en estos casos es transitoria y leve. Sin embargo, algunos casos ocasionados por isquemia intestinal tienen una repercusión más grave por la cuantía de la hemorragia y la propia alteración de la mucosa intestinal. Presentamos el caso de un paciente con dolor abdominal y rectorragia causada por colitis isquémica extensa secundaria a la práctica de un entrenamiento intenso.

  15. Vedolizumab as induction and maintenance therapy for ulcerative colitis

    DEFF Research Database (Denmark)

    Feagan, Brian G; Rutgeerts, Paul; Sands, Bruce E;

    2013-01-01

    Gut-selective blockade of lymphocyte trafficking by vedolizumab may constitute effective treatment for ulcerative colitis.......Gut-selective blockade of lymphocyte trafficking by vedolizumab may constitute effective treatment for ulcerative colitis....

  16. Infliximab and complications after colectomy in patients with ulcerative colitis

    DEFF Research Database (Denmark)

    Bregnbak, David; Mortensen, Christian; Bendtsen, Flemming

    2012-01-01

    Infliximab treatment may increase the risk of subsequent postoperative complications in patients with ulcerative colitis. The main purpose of the present study therefore was to assess postoperative complications in patients who have undergone colectomy for ulcerative colitis with and without...

  17. Anal cancer and intraepithelial neoplasia screening: Areview

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. Anumber of risk-stratification strategies as well as screeningtechniques have been suggested, and currently littleconsensus exists among national societies. Much ofthe current clinical rationale for the prevention of analcancer derives from the similar tumor biology of cervicalcancer and the successful use of routine screening toidentify cervical cancer and its precursors early in thedisease process. It is thought that such a strategy ofidentifying early anal intraepithelial neoplasia will reducethe incidence of invasive anal cancer. The low prevalenceof anal cancer in the general population prevents theuse of routine screening. However, routine screeningof selected populations has been shown to be a morepromising strategy. Potential screening modalities includedigital anorectal exam, anal Papanicolaou testing, humanpapilloma virus co-testing, and high-resolution anoscopy.Additional research associating high-grade dysplasiatreatment with anal cancer prevention as well as directcomparisons of screening regimens is necessary todevelop further anal cancer screening recommendations.

  18. Prophylactic HPV vaccination and anal cancer.

    Science.gov (United States)

    Stier, Elizabeth A; Chigurupati, Nagasudha L; Fung, Leslie

    2016-06-01

    The incidence of anal cancer is increasing. High risk populations include HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive women and heterosexual men and women with a history of cervical cancer. HPV has been detected in over 90% of anal cancers. HPV16 is the most common genotype detected in about 70% of anal cancers. The quadrivalent HPV (qHPV) vaccine has been demonstrated to prevent vaccine associated persistent anal HPV infections as well as anal intraepithelial neoplasia grades 2-3 (AIN2+) in young MSM not previously infected. A retrospective analysis also suggests that qHPV vaccination of older MSM treated for AIN2+ may significantly decrease the risk of recurrence of the AIN2+. The HPV types detected in anal cancer are included in the 9-valent vaccine. Thus, the 9-valent HPV vaccine, when administered to boys and girls prior to the onset of sexual activity, should effectively prevent anal cancer. PMID:26933898

  19. Antiviral treatment in patients with cytomegalovirus positive ulcerative colitis

    OpenAIRE

    Kadir OZTURK

    2014-01-01

    Cytomegalovirus (CMV) is a common virus in patients with ulcerative colitis receiving immunosuppressive drugs. Many studies suggested that CMV infection is an exacerbating factor in patients with ulcerative colitis. The role of CMV in exacerbations of ulcerative colitis has been discussed. One of studies starting this discussion is an article entitled “CMV positive ulcerative colitis: A single center experience and literature review” by Kopylov et al. However, we think that there are some poi...

  20. Anal erogeneity: the goose and the rat.

    Science.gov (United States)

    Shengold, L

    1982-01-01

    A case is presented in which the patient's traumatically derived intense anal erogeneity (associated with traumatic anxiety as well as with castration anxiety) inhibited his phallic sensations and potency and also his power to sustain productive thought. His passive cravings were disguised and reacted against in his compulsive-exhibitionistically phallic role of a Don Juan. He described at least two levels of anal feelings: a dangerous but exciting, tolerable or even pleasurable tension associated with the imago of the goose; and an unbearable, terrifying overcharged level embodied in the imago of the rat. (He had read of, and had felt himself identified with, Freud's Rat Man.) Contrasts are presented with François Rabelais' account of the instinctual development and anal training of Gargantua, in which the connotations of the goose lead to a happy anal, phallic and intellectual control. Generalizations are ventured about the crucial attainment of command over the anal sphincter for the taming of 'primal affect'(Fliess). With early psychopathology there is a defensive overcathexis of anal control (and of anal mechanisms and character traits) to try to contain over-stimulation. In contrast true anal mastery contributes to the acquisition of optimal genital feelings and functioning and to the capacity for sustaining integrative thinking so necessary for 'owning' one's affects and impulses, and therefore for a feeling of identity. Finally, some remarks of Freud on Rabelais are reviewed in relation to levels of urethral erogeneity, seen as developmental way stations between the anal and the phallic, and partaking of both.

  1. VERJETNOSTNE VARNOSTNE ANALIZE JEDRSKE ELEKTRARNE V ZAUSTAVITVI

    OpenAIRE

    Antončič, Mitja

    2016-01-01

    Pričujoča magistrska naloga obravnava verjetnostne varnostne analize jedrske elektrarne v zaustavitvenih stanjih. Verjetnostne varnostne analize so namenjene ocenjevanju in izboljšanju varnosti kompleksnih sistemov, tudi jedrskih elektrarn. Skozi analizo izvemo možne neželene dogodke, do katerih lahko pride v sistemu, verjetnost nastopa teh dogodkov, način njihovega razvoja in končne posledice. Na podlagi analize lahko določimo pomembnost posameznih komponent, kar je koristna informacija pri ...

  2. Collagenous colitis as a possible cause of toxic megacolon.

    LENUS (Irish Health Repository)

    Fitzgerald, S C

    2009-03-01

    Collagenous colitis is a microscopic colitis characterized by normal appearing colonic mucosa on endoscopy. It is regarded as a clinically benign disease which rarely results in serious complications. We report a case of toxic megacolon occurring in a patient with collagenous colitis. This is the first reported case of toxic megacolon occurring in this subset of patients.

  3. Sonographic and Endoscopic Findings in Cocaine-Induced Ischemic Colitis

    DEFF Research Database (Denmark)

    Leth, Thomas; Wilkens, Rune; Bonderup, Ole Kristian

    2015-01-01

    Cocaine-induced ischemic colitis is a recognized entity. The diagnosis is based on clinical and endoscopic findings. However, diagnostic imaging is helpful in the evaluation of abdominal symptoms and prior studies have suggested specific sonographic findings in ischemic colitis. We report...... sonographic and endoscopic images along with abdominal computed tomography in a case of cocaine-induced ischemic colitis....

  4. Radiologic evaluation of the continent (S-pouch) ileal reservoir with anal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Hennild, V.; Kjaergaard, H.; Kuld Hansen, L.

    A radiologic investigation was performed in 26 patients subjected to colectomy, mucosal proctectomy and endorectal ileo-anal anastomosis after the creation of an ileal reservoir. The patients had suffered from ulcerative colitis or familial polyposis. The reservoir and its efferent leg was best demonstrated by contrast enema. The size and position of the reservoir and the efferent leg was demonstrated, and stenoses, abscesses and fistulae could be identified. Examination of the small bowel with a contrast medium showed slight dilatation of the ileum orally to the reservoir in all instances and one patient had a stenosis at the junction of the afferent leg of the reservoir. Erect and supine projections of the abdomen showed gas in the intestine and fluid levels in the reservoir. These radiographic findings should not be confused with ileus or pelvic abscess. Radiology was of great value in disclosing postoperative complications.

  5. Golimumab in unresponsive ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Lippert E

    2014-05-01

    Full Text Available Elisabeth Lippert, Martina Müller, Claudia Ott University Hospital Regensburg, Department of Internal Medicine I, Regensburg, Germany Abstract: Ulcerative colitis (UC is a chronic inflammation mainly affecting the colon mucosa. It predominantly occurs in younger patients. Until recently, the main goals in the treatment of UC were to temper the symptoms, such as diarrhea, pain, and weight loss, by using mesalazine and steroids. With newer medications, such as immunomodulators (thiopurines and the biologics providing blockade of tumor necrosis factor (TNF, the goals of the therapy in UC have changed to long-term remission and mucosal healing. The first available anti-TNF therapy in UC included infusion therapy with infliximab every few weeks. In 2012, subcutaneously administered adalimumab gained approval for the treatment of UC in Germany. In patients with a mild disease, therapy with mesalazine, orally or topically, can be sufficient. In patients with moderate to severe disease, therapy with azathioprine or anti-TNF is often required to reach disease control; however, this is only efficient in about two-thirds of patients. Some patients either show no response or a lost response while on treatment. So, further medical options are warranted in the treatment of UC. With golimumab, a new approach in the treatment of mild to moderate UC recently became available in Germany and is a promising new option in the therapy regimen for patients with UC. Keywords: anti-TNF, biological therapy, inflammatory bowel disease

  6. Relation between electromyography and anal manometry of the external anal sphincter.

    OpenAIRE

    Sørensen, M; Tetzschner, T; Rasmussen, O O; Christiansen, J

    1991-01-01

    Thirteen patients with faecal incontinence and 26 control subjects were studied to investigate whether a quantitative electromyographic (EMG) signal could be correlated to anal manometry. Three different electrodes were used--a concentric needle electrode, a disposable sponge electrode, and a hard anal plug electrode. The maximum amplitude of the EMG recording was used as a quantitative parameter. Linear regression showed significant correlation between EMG and anal manometry with the sponge ...

  7. Anal Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Anal Disorders URL of this page: https://medlineplus.gov/languages/analdisorders.html Other topics A-Z A B ...

  8. Amyloid Goiter Secondary to Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Bunyamin Aydin

    2016-01-01

    Full Text Available Diffuse amyloid goiter (AG is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn’s disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis.

  9. Diagnosis and management of microscopic colitis

    Institute of Scientific and Technical Information of China (English)

    Curt Tysk; Johan Bohr; Nils Nyhlin; Anna Wickbom; Sune Eriksson

    2008-01-01

    Microscopic colitis,comprising collagenous and lymphocytic colitis,is characterized clinically by chronic watery diarrhea,and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination.The annual incidence of each disorder is 4-6/100000 inhabitants,with a peak incidence in 60-70-year-old individuals and a noticeable female predominance for collagenous colitis.The etiology is unknown.Chronic diarrhea,abdominal pain,weight loss,fatigue and fecal incontinence are common symptoms,which impair the health-related quality of life of the patient.There is an association with other autoimmune disorders such as celiac disease,diabetes mellitus,thyroid disorders and arthritis.Budesonide is the best-documented shortterm treatment,but the optimal long-term strategy needs further study.The long-term prognosis is good and the risk of complications including colonic cancer is low.

  10. Amyloid Goiter Secondary to Ulcerative Colitis.

    Science.gov (United States)

    Aydin, Bunyamin; Koca, Yavuz Savas; Koca, Tugba; Yildiz, Ihsan; Gerek Celikden, Sevda; Ciris, Metin

    2016-01-01

    Diffuse amyloid goiter (AG) is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn's disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis. PMID:27051538

  11. Collagenous gastritis associated with lymphocytic colitis.

    Science.gov (United States)

    Groisman, G M; Meyers, S; Harpaz, N

    1996-03-01

    Collagenous sprue and collagenous colitis are two well-recognized idiopathic enteritides whose defining histologic attribute is fibrous thickening of the subepithelial basement membrane. Analogous changes in gastric mucosa seem to be quite rare. The term "collagenous gastritis" was recently applied for the first time to an isolated case of refractory gastritis in which distinctive subepithelial gastric fibrosis was noted. We report an additional case of this entity in a 35-year-old woman with refractory dyspepsia. In contrast to the earlier case of collagenous gastritis, our patient also had lymphocytic colitis, a type of colitis associated with watery diarrhea. Collagenous gastritis appears to be a distinct clinicopathologic entity, the histologic changes of which should be sought in patients with unexplained dyspepsia. Increased awareness of this condition and its possible clinical correlates may provide clues to its etiology and pathogenesis. PMID:8742654

  12. Infliximab to treat severe ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Dídia Bisamra Cury; Marcelo de Souza Cury; Geraldo Vinicius Hemerly Elias; Sender Jankiel Mizsputen

    2009-01-01

    A 48-year-old female with severe ulcerative colitis refractory to conventional therapy was referred to our facility for management. The patient showed extensive ulcerative colitis since the age of 20 years and had failed therapy with 5-aminosalicylic acid agents and azathioprine. The disease remained active despite treatment with steroids and cyclosporine. The clinical and endoscopic parameters were consistent with severe disease. Infectious precipitants were ruled out. Given the severity of the disease and in order to avoid a colectomy, we started the patient on infliximab therapy. A dramatic clinical and endoscopic response was observed and she remained in remission at the end of a 1-year follow-up period. We discuss findings in the literature regarding the use of infliximab therapy in patients with ulcerative colitis who have failed steroids and cyclosporine.

  13. Anal intraepitelial neoplasia: a narrative review

    OpenAIRE

    Garazi Elorza; Yolanda Saralegui; José María Enríquez-Navascués; Carlos Placer; Leyre Velaz

    2016-01-01

    Anal intraepitelial neoplasia (AIN) constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV) infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal ca...

  14. Análise tensional e morfológica da anastomose colônica na colite induzida por ácido acético a 10%, em ratos Wistar, tratados com extrato aquoso de aroeira-do-sertão a 10% (Myracrodruon urundeuva fr. all. Tensional and morphologic analysis of the colonic anastomosis on 10% acetic acid induced colitis, in Wistar rats, treated with 10% aroeira-do-sertão (Myracrodruon urundeuva fr. all. aqueous extract

    Directory of Open Access Journals (Sweden)

    Antonio Rubens Soares Martins Cavalcante

    2005-04-01

    Full Text Available OBJETIVO: Verificar, do ponto de vista tensional e morfológico, o efeito do extrato aquoso de aroeira-do-sertão a 10% na anastomose colônica, na vigência de colite induzida por ácido acético a 10%, em ratos Wistar. MÉTODOS: Foram utilizados 48 ratos da linhagem Wistar, distribuídos em dois grupos. Todos os animais foram submetidos à indução da colite por solução aquosa de ácido acético a 10%. Vinte e quatro horas após, os animais foram submetidos à laparotomia, colotomia transversa total e anastomose término-terminal com fio de polipropileno 5-0. Grupo A (veículo, animais tratados com veículo à base de carboximetilcelulose. Grupo B (aroeira, animais tratados com extrato aquoso de aroeira a 10%. Ambos tratamentos foram sob a forma de enema. Os grupos A e B foram distribuídos em subgrupos A3, A7, A14 e A21; B3, B7, B14 e B21, respectivamente, conforme a data prevista para a eutanásia (3, 7, 14 e 21 dias. Nas respectivas datas, os animais foram relaparotomizados, o segmento colônico contendo a anastomose foi ressecado, submetido ao teste de pressão e em seguida à análise histológica. Para o estudo morfológico, as lâminas foram coradas com hematoxilina-eosina e avaliou-se a condição de cicatrização baseado numa tabela de escores que variava de 0 a 16. Quanto maior o escore melhor o grau de cicatrização. RESULTADOS: Na avaliação do estudo morfológico, que quantifica a evolução e o grau de cicatrização, como resultado final do processo cicatricial, o grupo aroeira foi superior ao grupo veículo (pPURPOSE: Verify, from a morphologic and tensional view point, the effect of the 10% aqueous extract of aroeira-do-sertão on the colonic anastomosis, during the occurrence of 10% acetic acid induced colitis, in Wistar rats. METHODS: There were used 48 Wistar rats, distributed in two groups. All animals were subjected to induction of colitis by aqueous solution of 10% acetic acid. Twenty-four hours later, the animals

  15. Substance P Modulates Colitis-Asscociated Fibrosis

    OpenAIRE

    Koon, Hon Wai; Shih, David; Karagiannides, Iordanes; Zhao, Dezheng; Fazelbhoy, Zafeer; Hing, Tressia; Xu, Hua; Lu, Bao; Gerard, Norma; Pothoulakis, Charalabos

    2010-01-01

    Substance P (SP) and the neurokinin-1 receptor (NK-1R) are involved in the development of colitis and mucosal healing after colonic inflammation. We studied whether SP modulates colonic fibrosis by using a chronic model of trinitrobenzenesulfonic acid (TNBS)-induced colitis in wild-type (WT) and NK-1R-deficient (NK-1R KD) mice. We found increased mRNA expression levels of collagen, vimentin, and the fibrogenic factors transforming growth factor β1 and insulin-like growth factor 1 in the chron...

  16. Small-bowel permeability in collagenous colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Madsen, Jan L; Rumessen, Jüri J

    2006-01-01

    OBJECTIVE: Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestin......OBJECTIVE: Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small...

  17. Drug therapy for ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Chang-Tai Xu; Shu-Yong Meng; Bo-Rong Pan

    2004-01-01

    Ulcerative colitis (UC) is an inflammatory destructive disease of the large intestine occurred usually in the rectum and lower part of the colon as well as the entire colon. Drug therapy is not the only choice for UC treatment and medical management should be as a comprehensive whole.Azulfidine, Asacol, Pentasa, Dipentum, and Rowasa all contain 5-aminosalicylic acid (5-ASA), which is the topical anti-inflammatory ingredient. Pentasa is more commonly used in treating Crohn's ileitis because Pentasa capsules release more 5-ASA into the small intestine than Asacol tablets. Pentasa can also be used for treating mild to moderate UC. Rowasa enemas are safe and effective in treating ulcerative proctitis and proctosigmoiditis. The sulfafree 5-ASA agents (Asacol, Pentasa, Dipentum and Rowasa) have fewer side effects than sulfa-containing Azulfidine. In UC patients with moderate to severe disease and in patients who failed to respond to 5-ASA compounds,systemic (oral) corticosteroids should be used. Systemic corticosteroids (prednisone, prednisolone, cortisone, etc.)are potent and fast-acting drugs for treating UC, Crohn's ileitis and ileocolitis. Systemic corticosteroids are not effective in maintaining remission in patients with UC.Serious side effects can result from prolonged corticosteroid treatment. To minimize side effects, corticosteroids should be gradually reduced as soon as the disease remission is achieved. In patients with corticosteroid-dependent or unresponsive to corticosteroid treatment, surgery or immunomodulator is considered. Immunomodulators used for treating severe UC include azathioprine/6-MP,methotrexate, and cyclosporine. Integrated traditional Chinese and Western medicine is safe and effective in maintaining remission in patients with UC.

  18. Surgical treatment of anal stenosis: assessment of 77 anoplasties Tratamento cirúrgico da estenose anal: resultados de 77 anoplastias

    Directory of Open Access Journals (Sweden)

    Angelita Habr-Gama

    2005-02-01

    temporária em outro. Um paciente necessitou reoperação precoce por deiscência de linha de sutura. Os resultados tardios foram classificados como bons em 67 (87%. Não houve reoperação por recorrência de estenose. CONCLUSÃO: A facilidade técnica, os bons resultados funcionais e a ausência de complicações graves demonstraram que as técnicas de avanço de retalho de Sarner e Musiari são efetivas e seguras para correção de estenose anal, particularmente nos casos em que a fibrose cutânea é o principal fator etiológico.

  19. Fecal calprotectin and ulcerative colitis endoscopic activity index as indicators of mucosal healing in ulcerative colitis.

    Science.gov (United States)

    Taghvaei, Tarang; Maleki, Iradj; Nagshvar, Farshad; Fakheri, Hafez; Hosseini, Vahid; Valizadeh, Seyed Mohammad; Neishaboori, Hassan

    2015-04-01

    Ulcerative colitis (UC) is a chronic, idiopathic, inflammatory large bowel disease with recurrent variable periods of exacerbation. The aim of the current study is to evaluate the correlation of UCEIS with fecal calprotectin (FC) level to assess disease activity in UC patients in order to determine whether FC can prognosticate clinical outcome and disease activity of UC instead of colonoscopic evaluation. Our endoscopic investigations revealed the extension of UC as the following: proctitis (11.6%), procto-sigmoiditis (18.5%), left-sided colitis (15.8%), extensive colitis (11.7%), and normal endoscopy (42.4%). Conclusively, we suggest that FC can be used as a reliable tool to evaluate disease activity in ulcerative colitis patients. Moreover, our findings indicate a significant correlation between FC level and mucosal healing. PMID:25366383

  20. Infliximab induces clinical, endoscopic and histological responses in refractory ulcerative colitis Infliximab induce respuesta clínica, endoscópica e histológica en la colitis ulcerosa refractaria

    Directory of Open Access Journals (Sweden)

    F. Bermejo

    2004-02-01

    Full Text Available Background: infliximab is a monoclonal antiTNF-α antibody that has repeatedly shown to be effective in the management of Crohn's disease. However, data are scarce about its efficacy in ulcerative colitis. Aim: to describe the joint experience of three Spanish hospitals in the use of infliximab in patients with active refractory ulcerative colitis. Patients and methods: we present seven cases of ulcerative colitis (6 with chronic active disease despite immunosuppressive therapy, and one with acute steroid-refractory ulcerative colitis treated with infliximab 5 mg/kg of body weight. Clinical response was evaluated by means of the Clinical Activity Index at 2, 4 and 8 weeks after initial infusion. Biochemical (erythrocyte sedimentation rate and C-reactive protein, endoscopic, and histological changes were also assessed. Results: mean age of patients was 45.8 ± 17 years (range 23-77; 4 were female. No adverse effects were recorded. Inflammatory activity diminished significantly in 6 of 7 patients (85.7%; CI 95%: 42-99% both from a clinical (p = 0.01 and biochemical (p Introducción: infliximab, un anticuerpo monoclonal quimérico antiTNF-α ha demostrado su eficacia en pacientes con enfermedad de Crohn. Sin embargo, son escasos los datos sobre su efectividad en el tratamiento de la colitis ulcerosa. Objetivo: describir la experiencia conjunta de 3 hospitales españoles en el uso de infliximab en enfermos con CU activa resistente a otros tratamientos. Pacientes y métodos: se presentan 7 casos de colitis ulcerosa (6 con enfermedad crónicamente activa a pesar de tratamiento con inmunosupresor y 1 con colitis aguda grave refractaria a esteroides tratados con infliximab a dosis de 5 mg/kg de peso. Se evaluó la respuesta clínica mediante un Índice de Actividad Clínica trascurridas 2, 4 y 8 semanas de la infusión inicial. Así mismo, se estudiaron los cambios analíticos (velocidad de sedimentación y proteína C reactiva, endoscópicos e histol

  1. Anal acoustic reflectometry: a new technique for assessing anal sphincter function

    DEFF Research Database (Denmark)

    Mitchell, P J; Klarskov, N; Hosker, G;

    2010-01-01

    Anal acoustic reflectometry (AAR) is a new technique that offers an assessment of anal sphincter function by the measurement of additional parameters not available with conventional manometry. The aim of this study is to describe the technique, methodology and initial pilot study results....

  2. Epistemología de la hermenéutica analógica para los estudios sociales de la ciencia

    OpenAIRE

    Mauricio Hardie Beuchot Puentes

    2014-01-01

    En estas páginas trataré de abordar algunos de los problemas epistemológicos que surgen de una hermenéutica analógica; o, si se prefiere, me esforzaré por esbozar la epistemología de la hermenéutica analógica, viendo su aplicación para los estudios sociales de la ciencia.

  3. Golimumab for the treatment of ulcerative colitis

    NARCIS (Netherlands)

    Lowenberg, M.; Boer, N. de; Hoentjen, F.

    2014-01-01

    The introduction of therapeutic antibodies against tumor necrosis factor (TNF) had a major impact on the treatment of ulcerative colitis (UC). Infliximab and adalimumab are powerful agents that are used for remission induction and maintenance therapy in UC and have an acceptable safety profile. Howe

  4. Colitis following fecal diversion: still a challenge

    Directory of Open Access Journals (Sweden)

    Castro Leonaldson dos Santos

    2000-01-01

    Full Text Available After fecal diversion, nonspecific colitis may be seen in the defunctionalized colon. The purpose of this prospective study is to identify specific findings that could help in the differential diagnosis between diversion colitis and other inflammatory bowel diseases in order to avoid inappropriate diagnosis and therapy. It was studied, prospectively, thirteen consecutive patients from two public hospitals of Rio de Janeiro who had undergone temporary colostomy for indications other than inflammatory bowel disease. They were submitted to endoscopy with biopsy of both proximal and distal colorectal segments, and prospectively evaluated before and after restoration of intestinal continuity. Endoscopy with biopsy of both proximal and distal excluded colorectal segments showed a nonspecific mucosal and submucosal inflammation, resembling ulcerative colitis ( p < 0.01. There was endoscopic resolution in all patients once restoration of intestinal continuity was established (p < 0.01 and also histologic improvement after the stoma closure. In conclusion there are no specific findings that make possible an unequivocal distinction between diversion colitis and other nonspecific inflammatory diseases. Diagnosis should be achieved if after stoma closure occur remission of endoscopic large bowel inflammatory signs with improvement in mucosal histologic appearance and prompt relief of clinical complaints.

  5. Selenoprotein P in colitis-associated carcinoma

    Science.gov (United States)

    Short, Sarah P.; Whitten-Barrett, Caitlyn; Williams, Christopher S.

    2016-01-01

    ABSTRACT Patients with inflammatory bowel disease are often deficient in micronutrients such as selenium and have an increased risk of colon cancer. We tested whether the selenium transport protein, selenoprotein P, could modify colitis-associated cancer. Our results indicate that global SEPP1 haploinsufficiency augments tumorigenesis and mediates oxidative damage in the intestine. PMID:27314080

  6. Cerebral Arterial Thrombosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Giovanni Casella

    2013-01-01

    Full Text Available Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD. We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

  7. Ulcerative colitis flare with splenic ven thrombosis.

    Science.gov (United States)

    Bozkurt, Huseyin Sancar; Kara, Banu; Citil, Serdal

    2015-01-01

    Patients with ulcerative colitis (UC) have an increased risk of thromboembolic events. Here, we present a 28-year-old man with active ulcerative pancolitis presenting via splenic vein thrombosis and left renal superior infarct that was not associated with a surgical procedure.

  8. Neutrophil Extracellular Traps in Ulcerative Colitis

    DEFF Research Database (Denmark)

    Bennike, Tue Bjerg; Carlsen, Thomas Gelsing; Ellingsen, Torkell;

    2015-01-01

    BACKGROUND: The etiology of the inflammatory bowel diseases, including ulcerative colitis (UC), remains incompletely explained. We hypothesized that an analysis of the UC colon proteome could reveal novel insights into the disease etiology. METHODS: Mucosal colon biopsies were taken by endoscopy...

  9. Small-bowel permeability in collagenous colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Madsen, Jan L; Rumessen, Jüri J

    2006-01-01

    Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestinal biopsies...

  10. Manipulation of enteric flora in ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Mario Guslandi

    2005-01-01

    @@ TO THE EDITOR Reviewing the available therapeutic options in the medical treatment of ulcerative colitis, Xu et al.[1], have omitted to mention an important aspect in the pharmacological management of the disease, namely the possibility to promote clinical and endoscopic improvement by manipulating the enteric flora.

  11. Microarray Assisted Gene Discovery in Ulcerative Colitis

    DEFF Research Database (Denmark)

    Brusgaard, Klaus

    Inflammatory Bowel disease (IBD) is a condition characterised by chronic recidivous inflammation of the bowel and intestine. IBD includes chron´s disease (CD) and ulcerative colitis (UC). The combined prevalence of CD and UC are app. 1 in 500 in the general Caucasian population. In 25% of the cases...

  12. La Contabilidad Analítica en los Hospitales Públicos

    Directory of Open Access Journals (Sweden)

    Ma Silvia Fresneda Fuentes

    1998-06-01

    Full Text Available La confección de presupuestos públicos austeros para la consecución de los criterios de convergencia impuestos por el Tratado de Maastricht ha originado una preocupación en todo el Sector Público en general, y en el hospitalario en particular, por la contención de los costes. Esta situación ha puesto de manifiesto la necesidad de introducir sistemas de Contabilidad para la Gestión interna de las organizaciones hospitalarias públicas. Así, la Contabilidad Analítica o de Costes se constituye como un componente más de dichos sistemas y está llamada a alcanzar dos objetivos muy claros, por un lado, la determinación del coste del producto hospitalario para en base a él realizar una presupuestación prospectiva, y por otro, suministrar información interna que permita llevar a cabo un verdadero Control de Gestión. Con este trabajo se pretenden describir los modelos de costes alternativos propuestos por la literatura especializada, señalando su idoneidad en base a la consecución de los objetivos que la Contabilidad Analítica debe satisfacer. Se pondrá de manifiesto la tendencia actual a establecer modelos basados en la nueva definición de producto hospitalario, los cuales tienen como finalidad la determinación de los costes totales de dicho producto, dejando a un lado el objetivo del control de la eficacia y eficiencia de la gestión.The development of strict Public Budgets in order to reach the goals settled by Maastricht agreements have caused a deep concern in the Public Sector and mostly in hospitals in order to brake the growth of costs. Such a situation has stated clearly the necessity of implementing Management Accounting Systems in Public Hospitals organizations. Therefore, costs accounting cames to be a part of such systems, which is to reach two very clear objetives. In one hand, the definition of the hospital product cost using it as the base to develop the hospital budget. On the other hand, to supply internal

  13. Role of surgery in severe ulcerative colitis in the era of medical rescue therapy

    Institute of Scientific and Technical Information of China (English)

    Bosmat Dayan; Dan Turner

    2012-01-01

    Despite the growing use of medical salvage therapy,colectomy has remained a cornerstone in managing acute severe ulcerative colitis (ASC) both in children and in adults.Colectomy should be regarded as a life saving procedure in ASC,and must be seriously considered in any steroid-refractory patient.However,colectomy is not a cure for the disease but rather the substitution of a large problem with smaller problems,including fecal incontinence,pouchitis,irritable pouch syndrome,cuffitis,anastomotic ulcer and stenosis,missed or de-novo Crohn's disease and,in young females,reduced fecundity.This notion has led to the widespread practice of offering medical salvage therapy before colectomy in most patients without surgical abdomen or toxic megacolon.Medical salvage therapies which have proved effective in the clinical trial setting include cyclosporine,tacrolimus and infliximab,which seem equally effective in the short term.Validated predictive rules can identify a subset of patients who will eventually fail corticosteroid therapy after only 3-5 d of steroid therapy with an accuracy of 85%-95%.This accuracy is sufficiently high for initiating medical therapy,but usually not colectomy,early in the admission without delaying colectomy if required.This approach has reduced the colectomy rate in ASC from 30%-70% in the past to 10%-20% nowadays,and the mortality rate from over 70% in the 1930s to about 1%.In general,restorative proctocolectomy (ileoanal pouch or ileal pouch-anal anastomosis),especially the J-pouch,is preferred over straight pullthrough (ileo-anal) or ileo-rectal anastomosis,which may still be considered in young females concerned about infertility.Colectomy in the acute severe colitis setting,is usually performed in three steps due to the severity of the inflammation,concurrent steroid treatment and the generally reduced clinical condition.The first surgical step involves colectomy and constructing an ileal stoma,the second-constructing the

  14. Lymphocytic colitis: A clue to bacterial etiology

    Institute of Scientific and Technical Information of China (English)

    Thanaa EA Helal; Naglaa S Ahmed; Osama Abo El Fotoh

    2005-01-01

    AIM: To find out the role of bacteria as a possible etiological factor in lymphocytic colitis.METHODS: Twenty patients with histopathological diagnosis of lymphocytic colitis and 10 normal controls were included in this study. Colonoscopic biopsies were obtained from three sites (hepatic and splenic flexures and rectosigmoid region). Each biopsy was divided into two parts. A fresh part was incubated on special cultures for bacterial growth. The other part was used for the preparation of histologic tissue sections that were examined for the presence of bacteria with the help of Giemsa stain.RESULTS: Culture of tissue biopsies revealed bacterial growth in 18 out of 20 patients with lymphocytic colitis mostly Escherichia coli(14/18), which was found in all rectosigmoid specimens (14/14), but only in 8/14 and 6/14 of splenic and hepatic flexure specimens respectively. In two of these cases, E coliwas associated with proteus. Proteus was found only in one case, Klebsiella in two cases, and Staphylococcus aureus in one case. In the control group, only 2 out of 10 controls showed the growth of E coliin their biopsy cultures.Histopathology showed rod-shaped bacilli in the tissue sections of 12 out of 14 cases with positive E coliin their specimen's culture. None of the controls showed these bacteria in histopathological sections.CONCLUSION: This preliminary study reports an association between E coliand lymphocytic colitis, based on histological and culture observations. Serotyping and molecular studies are in process to assess the role of E coliin the pathogenesis of lymphocytic colitis.

  15. Influencia de los factores emocionales en la colitis ulcerosa

    Directory of Open Access Journals (Sweden)

    Leonor I. Lega

    2014-11-01

    Full Text Available Los resultados del análisis estadístico sugieren una diferencia entre los dos grupos de enfermos en cuanto a manifestaciones psíquicas. El patrón de la personalidad de los enfermos con colitis ulcerativa idiopática es bien definido, y lo encontrado en el grupo del presente estudio, no difiere de lo escrito en la literatura mundial. En estos pacientes se han encontrado circunstancias psíquicas o físicas, que han tenido estrecha relación con la exacerbación y persistencia de la enfermedad, así como también la remisión de los síntomas aun por períodos muy largos, cuando el enfermo logra superar sus problemas emocionales serios. En conclusión, los resultados de esta investigación parecen confirmar que existe una relación estrecha entre las recurrencias de la enfermedad, los estados emocionales y la mejoría marcada, a veces por muchos años, al solucionar sus problemas.

  16. Desempenho de uma escala analógica visual legendada na determinação do grau de dispneia durante teste de broncoespasmo induzido por exercício em crianças e adolescentes asmáticos Performance of a word labeled visual analog scale in determining the degree of dyspnea during exercise-induced bronchoconstriction in children and adolescents with asthma

    Directory of Open Access Journals (Sweden)

    Patrícia Bueno Lima

    2010-10-01

    Full Text Available OBJETIVO: Existe uma relação indireta entre a obstrução das vias aéreas em asma e a intensidade de falta de ar (dispneia. Uma escala visual analógica legendada de dispneia com escore de 0-3 pontos tem sido amplamente utilizada na avaliação da broncoconstrição, embora a percepção de tal obstrução seja muito variável. O objetivo deste estudo foi determinar se crianças e adolescentes são capazes de perceber a broncoconstrição aguda induzida por exercício (BAIE, bem como medir o poder discriminatório de uma escala visual analógica legendada de dispneia em relação à intensidade de BAIE. MÉTODOS: Estudo transversal com 134 crianças e adolescentes asmáticos que foram submetidos a um teste de broncoespasmo induzido por seis minutos de exercício em um cicloergômetro. A intensidade da dispneia foi determinada utilizando-se uma escala visual analógica legendada de dispneia antes de cada determinação de VEF1. A escala tem um escore de 0-3 pontos, com desenhos em uma sequência lógica variando entre "sem sintomas" e "dispneia grave". As variáveis foram determinadas no momento basal, assim como em 5, 10 e 20 minutos após o término do teste de exercício. A acurácia da escala de dispneia em detectar o grau de BAIE foi determinada através de curvas ROC para a queda de VEF1 após o exercício, usando pontos de corte de 10%, 20%, 30% e 40%. RESULTADOS: Dos pacientes selecionados, 111 completaram o estudo, e 52 (46,8% apresentaram BAIE. A área sob a curva ROC progressivamente aumentou com o aumento do grau de broncoconstrição. CONCLUSÕES: Em crianças e adolescentes asmáticos, a acurácia desta escala de dispneia melhora com o aumento do percentual de queda em VEF1 após o exercício. Entretanto, o valor preditivo da escala é subótimo quando a porcentagem de queda em VEF1é menor.OBJECTIVE: There is an indirect relationship between airway obstruction in asthma and the intensity of breathlessness (dyspnea. A word

  17. Proctology - diseases of the anal region.

    Science.gov (United States)

    Kreuter, Alexander

    2016-04-01

    Proctology is a medical subspecialty that encompasses diseases of the perianal region, anal canal, and rectum. Dermatologists play a pivotal role in this realm, as inflammatory perianal disorders, infectious and sexually transmitted diseases, as well as perianal tumors and their precursor lesions fall within the core competency of dermatology. In a concise manner, the present article highlights all relevant disease groups in the field of proctology. With a particular focus on aspects pertinent to dermatologists, this includes inflammatory disorders, "classic" proctologic diseases, sexually transmitted diseases, malignancies of the anal region, as well as pathogen-induced diseases. Despite the wide variety of disorders, there are only five key symptoms prompting patients to consult a proctologist, including anal pruritus and burning, discharge, bleeding, pain, and foreign body sensation. A simple algorithm, which incorporates these symptoms as well as key clinical features, may assist in quickly establishing the correct diagnosis in everyday clinical practice. PMID:27027745

  18. Nicotine alleviates colitis-induced damage in rats via its anti-oxidative activity

    OpenAIRE

    ÖZDEMİR, Zarife Nigar; TAZEGÜL, Gökhan; Kuru, Pınar; BİLGİN, Şeyda; MENTEŞE, Semih Tiber; ERZIK, Can; Sirvanci, Serap; YEGEN, Berrak C

    2014-01-01

    Objective: Previous studies have demonstrated a higher incidence of ulcerative colitis in non-smokers. We investigated the beneficial effects of nicotine treatment on colitis-induced anxiety and oxidative colonic damage on rats.Materials and Methods: Wistar Albino (250-300 g) rats (n=40) were randomly divided into 5 groups as saline-treated colitis group, nicotine pre-treated colitis group, nicotine post-treated colitis group, continuously nicotine-treated colitis group and control group. Gro...

  19. Dextran sulfate sodium (DSS)-induced colitis in mice.

    Science.gov (United States)

    Chassaing, Benoit; Aitken, Jesse D; Malleshappa, Madhu; Vijay-Kumar, Matam

    2014-02-04

    Inflammatory bowel diseases (IBD), mainly comprising ulcerative colitis and Crohn's Disease, are complex and multifactorial diseases with unknown etiology. For the past 20 years, to study human IBD mechanistically, a number of murine models of colitis have been developed. These models are indispensable tools to decipher underlying mechanisms of IBD pathogenesis as well as to evaluate a number of potential therapeutics. Among various chemically induced colitis models, the dextran sulfate sodium (DSS)-induced colitis model is widely used because of its simplicity and many similarities with human ulcerative colitis. This model has both advantages and disadvantages that must be considered when employed. This protocol describes the DSS-induced colitis model, focusing on details and factors that could affect DSS-induced pathology.

  20. Contemporary methods for the diagnosis and treatment of microscopic colitis.

    Science.gov (United States)

    Jauregui-Amezaga, Aranzazu; Vermeire, Séverine; Geboes, Karel

    2016-01-01

    Microscopic colitis is a common cause of chronic diarrhea. It is characterized by non-bloody watery diarrhea with macroscopically normal colonic mucosa. Its specific histological characteristics confirm the diagnosis. Two distinct histological forms can be identified, namely, collagenous colitis and lymphocytic colitis. In collagenous colitis, a thick colonic subepithelial collagenous deposit can be observed, whereas in lymphocytic colitis, a pronounced intraepithelial lymphocytic inflammation in the absence of a thickened collagen band can be identified. Microscopic colitis occurs more frequently in elderly females and its etiology is believed to be multifactorial, although smoking and consumption of several drugs have been identified as risks factors for the development of the disease. The treatment is based on avoiding the risks factors and administration of oral budesonide. PMID:26470823

  1. Seoseid loov kunstiteose analüüs / Anneli Porri

    Index Scriptorium Estoniae

    Porri, Anneli, 1980-

    2013-01-01

    Kunstiteose analüüsi seosest riikliku õppekavaga, ülevaade kunstiteose analüüsimeetoditest kunstiteaduses ning metoodilistest tähelepanekutest kunsti ja visuaalkultuuri kujutiste vaatamise kohta gümnaasiumi kunstitunnis

  2. PRIMENA SWOT ANALIZE NA SISTEM INTEGRALNOG TRANSPORTA VOJSKE SRBIJE

    OpenAIRE

    Dragan Pamučar

    2008-01-01

    U radu je prikazana primena SWOT analize na sistem integralnog transporta Vojske Srbije. Kao rezultat analize predstavljeni su ciljevi daljeg usavršavanja integralnog transporta, kao i mogući problemi generisani strateškim upravljanjem.

  3. Quality of life in patients with ulcerative colitis treated surgically

    OpenAIRE

    Kozłowska, Katarzyna A.; Bączyk, Grażyna; Krokowicz, Piotr

    2014-01-01

    Introduction Ulcerative colitis belongs to the group of inflammatory bowel diseases. The specific symptoms and chronic nature of the disease significantly affect the quality of patients’ lives. Quality-of-life assessment helps to define its determining factors as well as the efficiency of surgical procedures. Aim Quality-of-life evaluation of patients with ulcerative colitis treated surgically. Material and methods A retrospective review was carried out on 35 patients with ulcerative colitis,...

  4. Update in the treatment of paediatric ulcerative colitis.

    Science.gov (United States)

    Greifer, Melanie K; Markowitz, James F

    2006-10-01

    Ulcerative colitis is an important disease in the paediatric population. Ulcerative colitis is one of the chronic inflammatory bowel diseases, and is medically incurable. However, the arsenal of medications has grown as knowledge of the pathogenesis of this disease advances. This review looks at the classical treatments for children with ulcerative colitis, including the 5-aminosalicylates, corticosteroids and imunomodulators, as well as biological therapy and other, newer modalities. PMID:17020417

  5. Cytomegalovirus-associated colitis causing diarrhea in an immunocompetent patient

    Institute of Scientific and Technical Information of China (English)

    Dan Carter; David Olchovsky; Russell Pokroy; David Ezra

    2006-01-01

    Cytomegalovirus (CMV) colitis rarely occurs in immunocompetent patients. We report a case of disabling and life threatening diarrhea in an immunocompetent elderly woman due to CMV colitis. The diagnosis of CMV was based on histological examination of tissues biopsied at colonoscopy, positive CMV antigen and high CMV-IgM titer in peripheral blood samples and a good response to systemic gancyclovir treatment.We conclude that CMV should be considered in the differential diagnosis of colitis in elderly immunocompetent patients.

  6. Evaluation of dairy allergy among ulcerative colitis patients

    OpenAIRE

    judaki, Arezo; Hafeziahmadi, Mohamadreza; Yousefi, Atefe; Havasian, Mohamad Reza; Panahi, Jafar; Sayehmiri, Koroush; Alizadeh, Sajjad

    2014-01-01

    The intestine is the largest mucosal organ of the body and also the first line immune homeostasis. Inflammatory bowel disease or IBD is divided into ulcerative colitis and Crohn's disease. One of the problems that can occur with UC is dietary allergy to some foods. This study aimed to evaluated the dairy allergy among patients with ulcerative colitis. This study is a Case - control study, that studied 72 patients with Ulcerative Colitis, after recording history of the disease, colonoscopy and...

  7. Nuevas perspectivas en la evaluación cognitiva : inteligencia analítica y práctica

    OpenAIRE

    Llor Zaragoza, Laura

    2014-01-01

    El objetivo general de la tesis doctoral es estudiar las propiedades psicométricas de fiabilidad y validez de la Batería Aurora, concretamente los subtests de la inteligencia analítica y práctica. Los objetivos específicos son: 1. Estudiar las características psicométricas de fiabilidad de los instrumentos de evaluación de la inteligencia analítica y práctica (subtests y total) de la Batería Aurora diseñada por Sternberg y colaboradores. 2. Estudiar la estructura interna de la prueba, p...

  8. The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions

    OpenAIRE

    Arain Shehla; Walts Ann; Thomas Premi; Bose Shikha

    2005-01-01

    Abstract Background Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs). This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs. Methods The cytomorphological features of 200 consecutive anal smears collected in liquid medium from 198 patients were studied and findings were correlated with results of surgical biopsies and/or repeat smears that became available for 71 patients within six...

  9. Ulcerative colitis six years after colon cancer: only a coincidence?

    Science.gov (United States)

    Sakellakis, Minas; Makatsoris, Thomas; Gkermpesi, Maria; Peroukidis, Stavros; Kalofonos, Haralabos

    2014-01-01

    The association between inflammatory bowel disease and colorectal cancer is well known. Ulcerative colitis is a risk factor for the development of colorectal cancer, and this risk increases with the activity and duration of bowel inflammation. Here we describe the case of a 52-year-old man who developed ulcerative colitis 6 years after the diagnosis and treatment of colon cancer. Although this could be a coincidence, there could be additional possibilities, like pre-existence of quiescent colitis, late effect of therapy, or maybe the existence of common pathogenetic factors contributing to the development of ulcerative colitis and colorectal cancer. PMID:24855393

  10. Pseudomembranous Colitis: Not Always Caused by Clostridium difficile

    Directory of Open Access Journals (Sweden)

    Derek M. Tang

    2014-01-01

    Full Text Available Although classically pseudomembranous colitis is caused by Clostridium difficile, it can result from several etiologies. Certain medications, chemical injury, collagenous colitis, inflammatory bowel disease, ischemia, and other infectious pathogens can reportedly cause mucosal injury and subsequent pseudomembrane formation. We present the case of a middle-aged woman with vascular disease who was incorrectly diagnosed with refractory C. difficile infection due to the presence of pseudomembranes. Further imaging, endoscopy, and careful histopathology review revealed chronic ischemia as the cause of her pseudomembranous colitis and diarrhea. This case highlights the need for gastroenterologists to consider non-C. difficile etiologies when diagnosing pseudomembranous colitis.

  11. Ulcerative Colitis: Update on Medical Management.

    Science.gov (United States)

    Iskandar, Heba N; Dhere, Tanvi; Farraye, Francis A

    2015-11-01

    Ulcerative colitis (UC) is a chronic inflammatory bowel disease whose pathogenesis is multifactorial and includes influences from genes, the environment, and the gut microbiome. Recent advances in diagnosis and treatment have led to significant improvement in managing the disease. Disease monitoring with the use of therapeutic drug monitoring, stool markers, and assessment of mucosal healing have garnered much attention. The recent approval of vedolizumab for treatment of moderate to severe UC has been a welcome addition. Newer biologics, including those targeting the Janus tyrosine kinase (JAK) pathway, are on the horizon to add to the current armamentarium of anti-TNF alpha and anti-integrin therapies. The recent publication of the SCENIC consensus statement on surveillance and management of dysplasia in UC patients supports the use of chromoendoscopy over random biopsies in detecting dysplasia. This review highlights these recent advances along with others that have been made with ulcerative colitis.

  12. Teaching Men's Anal Pleasure: Challenging Gender Norms with "Prostage" Education

    Science.gov (United States)

    Branfman, Jonathan; Ekberg Stiritz, Susan

    2012-01-01

    To help students critique sex/gender norms, sexuality educators should address men's anal pleasure. Men's anal receptivity blurs accepted binaries like male/female, masculine/feminine, and straight/queer. By suppressing men's receptivity, the taboo against men's anal pleasure helps legitimize hegemonic sex/gender beliefs--and the sexism,…

  13. KRAS and BRAF mutations in anal carcinoma

    DEFF Research Database (Denmark)

    Serup-Hansen, Eva; Linnemann, Dorte; Høgdall, Estrid;

    2015-01-01

    The EGF receptor (EGFR) is expressed in most cases of anal carcinomas. Anecdotal benefit from EGFR-targeted therapy has been reported in anal cancer and a negative correlation with Kirsten Ras (KRAS) mutation status has been proposed. The purpose of this retrospective study was to investigate...... the frequency and the prognostic value of KRAS and BRAF mutations in a large cohort of patients with anal cancer. One hundred and ninety-three patients with T1-4N0-3M0-1 anal carcinoma were included in the study. Patients were treated with curative (92%) or palliative intent (8%) between January 2000...... and January 2010. KRAS mutations were detected using Therascreen(®)KRAS real-time PCR assay (Qiagen) and V600E or V600D/K BRAF mutations were uncovered using Pyrosequencing. The frequency of KRAS and BRAF mutations was low; KRAS mutations were detected in 1.6% and BRAF mutations in 4.7% of the biopsies...

  14. [Diagnostics and conservative treatment of anal incontinence].

    Science.gov (United States)

    Geile, Dorothea; Osterholzer, Georg; Rosenberg, Robert

    2004-01-01

    Anal incontinence is diagnosed primarily by clinical and proctologic examination. Etiological factors of the disease are found in 85% of the patients by additional examinations. Motility dysfunction of colon and rectum has to be excluded (stenosis, dyschezia, internal hernias). Because anal incontinence is a multifactorial disease as a rule, the single compounds have to be diagnosed and have to undergo therapy. Accordingly, useful investigations are: endorectal ultrasound (defect of muscle, inflammatory or tumour infiltration), manometry (alteration of either anal resting pressure and/or anal squeezing pressure) and surface electromyography (ability of contraction, duration of contraction, strength). Neurophysiological examinations are: needle electromyography, pudendal nerve latency time measurement (PNLT). The occurrence of nerve damage determines the outcome of operative intervention! Conservative treatment is indicated in 80 to 90% of all patients, even higher when one includes all patients in the perioperative period. Possible therapy modalities are: nutrition consultation, physiotherapy, pelvic floor training, biofeedback training of pelvic floor and sphincter muscles, electrostimulation and the combination of both (EMG-triggered electrostimulation). Short-term results are satisfying in up to 85% of patients, but later, successful results depend on the patient's willingness or ability to continue training, and on his/her age.

  15. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter;

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should be ...

  16. Animal Models of Colitis-Associated Carcinogenesis

    Directory of Open Access Journals (Sweden)

    Manasa Kanneganti

    2011-01-01

    Full Text Available Inflammatory bowel disease (IBD is a group of chronic inflammatory disorders that affect individuals throughout life. Although the etiology and pathogenesis of IBD are largely unknown, studies with animal models of colitis indicate that dysregulation of host/microbial interactions are requisite for the development of IBD. Patients with long-standing IBD have an increased risk for developing colitis-associated cancer (CAC, especially 10 years after the initial diagnosis of colitis, although the absolute number of CAC cases is relatively small. The cancer risk seems to be not directly related to disease activity, but is related to disease duration/extent, complication of primary sclerosing cholangitis, and family history of colon cancer. In particular, high levels and continuous production of inflammatory mediators, including cytokines and chemokines, by colonic epithelial cells (CECs and immune cells in lamina propria may be strongly associated with the pathogenesis of CAC. In this article, we have summarized animal models of CAC and have reviewed the cellular and molecular mechanisms underlining the development of carcinogenic changes in CECs secondary to the chronic inflammatory conditions in the intestine. It may provide us some clues in developing a new class of therapeutic agents for the treatment of IBD and CAC in the near future.

  17. Novel topical therapies for distal colitis

    Institute of Scientific and Technical Information of China (English)

    Ian; Craig; Lawrance

    2010-01-01

    Distal colitis(DC) can be effectively treated with topical 5ASA agents.Suppositories target the rectum while enemas can reliably reach the splenic flexure.Used in combination with oral 5ASAs,the control of the inflammation is even more effective.Unfortunately,resistant DC does occur and can be extremely challenging to manage.In these patients,the use of steroids,immunosuppressants and the anti-tumor necrosis factor α agents are often required.These,however,can be associated with systemic side effects and are not always effective.The investigation of new topical therapeutic agents is thus required as they are rarely associated with significant blood drug levels and side effects are infrequent.Some of the agents that have been proposed for use in resistant distal colitis include butyrate,cyclosporine and nicotine enemas as well as tacrolimus suppositories and tacrolimus,ecabet sodium,arsenic,lidocaine,rebamipide and Ridogrel enemas.Some of these agents have demonstrated impressive results but the majority of the agents have only been assessed in small open-labelled patient cohorts.Further work is thus required with the investigation of promising agents in the context of randomized double-blinded placebo controlled trials.This review aims to highlight those potentially effective therapies in the management of resistant distal colitis and to promote interest in furthering their investigation.

  18. Prevalência de papilomavirus humano (HPV anal, genital e oral, em ambulatório geral de coloproctologia Prevalence of anal, genital and oral human papillomavirus (HPV in general ambulatory for diseases of colon and rectum

    Directory of Open Access Journals (Sweden)

    João Carlos Magi

    2006-09-01

    Full Text Available O Papilomavirus Humano (HPV anal tem alta prevalência e incidência na população. O objetivo deste trabalho é verificar a prevalência de HPV anal, bucal e genital em ambulatório público de Coloproctologia, com base no exame de captura hibrida. Foram estudados 64 pacientes atendidos no ambulatório geral de Coloproctologia do Hospital Heliópolis, no período de 22/11/2005 a 20/12/2005, onde foram levantados, de forma prospectiva, dados clínicos, pessoais e comportamentais, identificando o perfil do grupo como não sendo de risco para HPV. Nenhum paciente deste grupo veio à consulta com queixa ou apresentando sinais de HPV ou outra doença sexualmente transmissível. Foram colhidos para cada paciente um esfregaço com escova de boca, outro de vulva/pênis e outro do ânus. O resultado mostrou que 15,62% dos pacientes apresentaram HPV anal, bucal ou genital, sendo que 4,68% do total de pacientes apresentavam HPV anal, um paciente de alto risco associado ao HPV genital, outro misto e outro de baixo risco. Trinta por cento dos pacientes HPV+ apresentavam dor anal como queixa principal. A conclusão é que a prevalência de HPV anal, genital e bucal é elevada, sendo que 4,68% apresentavam HPV anal e daqueles HPV positivos 30% apresentavam dor anal na queixa principal.Anal Human Papilomavirus (HPV has a high prevalence and incidence in the population. The purpose of this project is to verify the prevalence of anal, oral and genital HPV at the Coloproctology Clinic, based on the hybrid capture exam. Sixty four patients were assisted at the clinic from November 22nd to December 20th 2005. Clinical, personal and behavioral data of the patients were set up in a prospective way. The group profile was identified as not being a risky one to HPV. No patient of this group, when was assisted, had complained of or had presented any symptoms of HPV or any other sexually transmitted disease (STD. From each patient it was collected a mouth sample, a vulva

  19. Una manera sencilla para probar un teorema de geometría analítica

    OpenAIRE

    Vilchez, Enrique

    2003-01-01

    La razón de esta propuesta, está fundamentada en brindar una exposición simple de una prueba de un teorema de geometría analítica, utilizado por nuestros estudiantes en la educación media y la educación media superior. Mi idea nació de la iniciativa de postular una demostración a un nivel básico, de tal forma que cualquier estudiante que conozca algunos principios generales de álgebra de polinomios, geometría analítica y trigonometría, pueda comprenderla sin mayor complicación.

  20. Long-Term Natural History and Complications of Collagenous Colitis

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    2012-01-01

    Full Text Available Microscopic forms of colitis have been described, including collagenous colitis, a possibly heterogeneous disorder. Collagenous colitis most often appears to have an entirely benign clinical course that usually responds to limited treatment. Sometimes significant extracolonic disorders, especially arthritis, spondylitis, thyroiditis and skin disorders, such as pyoderma gangrenosum, dominate the clinical course and influence the treatment strategy. However, rare fatalities have been reported and several complications, some severe, have been attributed directly to the colitis. Toxic colitis and toxic megacolon may develop. Concomitant gastric and small intestinal inflammatory disorders have been described including celiac disease and more extensive collagenous inflammatory disease. Colonic ulceration has been associated with the use of nonsteroidal anti-inflammatory drugs, while other forms of inflammatory bowel disease, including ulcerative colitis and Crohn disease, may evolve directly from collagenous colitis. Submucosal ‘dissection’, colonic fractures, or mucosal tears and perforation, possibly from air insufflation during colonoscopy, have been reported. Similar changes may result from increased intraluminal pressures that may occur during radiological imaging of the colon. Neoplastic disorders of the colon may also occur during the course of collagenous colitis, including colon carcinoma and neuroendocrine tumours (ie, carcinoids. Finally, lymphoproliferative disease has been reported.

  1. Acupuncture Treatment for 76 Cases of Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Ulcerative colitis is also called nonspecific chronic ulcerative colitis. The author of this essay has treated 76 such cases with acupuncture and obtained satisfactory therapeutic effect. Meanwhile, the results were compared with 45 cases treated with azulfidine.A report follows.

  2. Samtidig debut af kollagen colitis og mb. Crohn

    DEFF Research Database (Denmark)

    Nøjgaard, Camilla; Nielsen, Preben Løvgreen; Rumessen, Jüri J

    2002-01-01

    A case report of a 69-year-old man with synchronous onset and diagnosis of collagenous colitis and Crohn's disease is discussed.......A case report of a 69-year-old man with synchronous onset and diagnosis of collagenous colitis and Crohn's disease is discussed....

  3. Dr.Dong Demao's Experience in Treating Chronic Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    徐凌云

    2004-01-01

    @@ Chronic ulcerative colitis (chronic non-specific ulcerative colitis) is a kind of non-specific inflammation occurred in the colonic mucosa layers. As a lingering and troublesome condition that often attacks people aged 20-40, it is characterized by recurrent diarrhea, abdominal pain, pus- and mucus-stained stools in clinic.

  4. Metabolic and inflammatory faecal markers in collagenous colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Lassen, Inge Nordgaard; Bendtsen, Flemming;

    2007-01-01

    To evaluate the excretion of the inflammatory and metabolic faecal markers calprotectin, lactoferrin, and short-chain fatty acids in symptomatic and quiescent collagenous colitis.......To evaluate the excretion of the inflammatory and metabolic faecal markers calprotectin, lactoferrin, and short-chain fatty acids in symptomatic and quiescent collagenous colitis....

  5. Prevalence of anal human papillomavirus infection and anal HPV-related disorders in women: a systematic review.

    Science.gov (United States)

    Stier, Elizabeth A; Sebring, Meagan C; Mendez, Audrey E; Ba, Fatimata S; Trimble, Debra D; Chiao, Elizabeth Y

    2015-09-01

    The aim of this study was to systematically review the findings of publications addressing the epidemiology of anal human papillomavirus (HPV) infection, anal intraepithelial neoplasia, and anal cancer in women. We conducted a systematic review among publications published from Jan. 1, 1997, to Sept. 30, 2013, to limit to publications from the combined antiretroviral therapy era. Three searches were performed of the National Library of Medicine PubMed database using the following search terms: women and anal HPV, women anal intraepithelial neoplasia, and women and anal cancer. Publications were included in the review if they addressed any of the following outcomes: (1) prevalence, incidence, or clearance of anal HPV infection, (2) prevalence of anal cytological or histological neoplastic abnormalities, or (3) incidence or risk of anal cancer. Thirty-seven publications addressing anal HPV infection and anal cytology remained after applying selection criteria, and 23 anal cancer publications met the selection criteria. Among HIV-positive women, the prevalence of high-risk (HR)-HPV in the anus was 16-85%. Among HIV-negative women, the prevalence of anal HR-HPV infection ranged from 4% to 86%. The prevalence of anal HR-HPV in HIV-negative women with HPV-related pathology of the vulva, vagina, and cervix compared with women with no known HPV-related pathology, varied from 23% to 86% and from 5% to 22%, respectively. Histological anal high-grade squamous intraepithelial lesions (anal intraepithelial neoplasia 2 or greater) was found in 3-26% of the women living with HIV, 0-9% among women with lower genital tract pathology, and 0-3% for women who are HIV negative without known lower genital tract pathology. The incidence of anal cancer among HIV-infected women ranged from 3.9 to 30 per 100,000. Among women with a history of cervical cancer or cervical intraepithelial neoplasia 3, the incidence rates of anal cancer ranged from 0.8 to 63.8 per 100,000 person-years, and in

  6. Colonic production of nitric oxide gas in ulcerative colitis, collagenous colitis and uninflamed bowel

    DEFF Research Database (Denmark)

    Perner, A; Nordgaard, I; Matzen, P;

    2002-01-01

    Nitric oxide (NO) produced in excess by the inflamed human colon is generally considered a pathway of mucosal damage. In an attempt to quantify colonic mucosal production of NO in various forms of colitis we performed 'steady-state' gas perfusion of whole colon in 11 patients with ulcerative coli...

  7. Ulcerative colitis six years after colon cancer: only a coincidence?

    Directory of Open Access Journals (Sweden)

    Sakellakis M

    2014-04-01

    Full Text Available Minas Sakellakis,1 Thomas Makatsoris,1 Maria Gkermpesi,2 Stavros Peroukidis,1 Haralabos Kalofonos11Division of Oncology, Department of Medicine, 2Department of Pathology, University, Hospital of Patras, Patras, GreeceAbstract: The association between inflammatory bowel disease and colorectal cancer is well known. Ulcerative colitis is a risk factor for the development of colorectal cancer, and this risk increases with the activity and duration of bowel inflammation. Here we describe the case of a 52-year-old man who developed ulcerative colitis 6 years after the diagnosis and treatment of colon cancer. Although this could be a coincidence, there could be additional possibilities, like pre-existence of quiescent colitis, late effect of therapy, or maybe the existence of common pathogenetic factors contributing to the development of ulcerative colitis and colorectal cancer.Keywords: ulcerative, colitis, colorectal, cancer, inflammation

  8. Antiviral treatment in patients with cytomegalovirus positive ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Kadir; Ozturk

    2014-01-01

    Cytomegalovirus(CMV) is a common virus in patients with ulcerative colitis receiving immunosuppressive drugs. Many studies suggested that CMV infection is an exacerbating factor in patients with ulcerative colitis. The role of CMV in exacerbations of ulcerative colitis has been discussed. One of studies starting this discussion is an article entitled "CMV positive ulcerative colitis: A single center experience and literature review" by Kopylov et al. However, we think that there are some points that should be emphasized about the study. Especially, the small number of patients in the study has led to meaningless results. Large controlled prospective trials are needed to clarify the benefit of antiviral therapy for active ulcerative colitis patients.

  9. Pathogenesis and biomarkers of carcinogenesis in ulcerative colitis

    DEFF Research Database (Denmark)

    Thorsteinsdottir, Sigrun; Gudjonsson, Thorkell; Nielsen, Ole Haagen;

    2011-01-01

    One of the most serious complications of ulcerative colitis is the development of colorectal cancer. Screening patients with ulcerative colitis by standard histological examination of random intestinal biopsy samples might be inefficient as a method of cancer surveillance. This Review focuses...... on the current understanding of the pathogenesis of ulcerative colitis-associated colorectal cancer and how this knowledge can be transferred into patient management to assist clinicians and pathologists in identifying patients with ulcerative colitis who have an increased risk of colorectal cancer. Inflammation....... Although progress has been made in the understanding of inflammation-driven carcinogenesis, markers based on these findings possess insufficient sensitivity or specificity to be usable as reliable biomarkers for risk of colorectal cancer development in patients with ulcerative colitis. However, screening...

  10. Risk factors of recurrent anal sphincter ruptures

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen;

    2012-01-01

    Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective  To determine the incidence and risk factors of recurrent anal sphincter...... were used to determine risk factors of recurrent ASR. Main outcome measures  The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...... augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...

  11. Squamous cell carcinoma of the anal canal.

    LENUS (Irish Health Repository)

    Martin, F T

    2012-01-31

    Squamous cell carcinoma ofthe anal canal represents 1.5% of all malignancies affectingthe gastrointestinal tract. Over the past 20 years dramatic changes have been seen in both the epidemiological distribution of the disease and in the therapeutic modalities utilised to manage it. CLINICAL MANAGEMENT: Historically abdominoperineal resection had been the treatment of choice with local resection reserved for early stage disease. Work by Nigro et al. has revolutionised how we currently manage carcinoma of the anal canal, demonstrating combined modality chemoradiotherapy as an appropriate alternative to surgical resection with the benefit of preserving sphincter function. Surgery is then reserved for recurrent disease with salvage abdominoperineal resection. This article reviews current literature and highlights the changing therapeutic modalities with selected clinical cases

  12. Management of Anal Squamous Intraepithelial Lesions

    OpenAIRE

    Pineda, Carlos E.; Welton, Mark L.

    2009-01-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is ...

  13. Update on medical and surgical options for patients with acute severe ulcerative colitis: What is new?

    Science.gov (United States)

    Andrew, Rachel E; Messaris, Evangelos

    2016-01-01

    Acute severe ulcerative colitis (UC) is a highly morbid condition that requires both medical and surgical management through the collaboration of gastroenterologists and colorectal surgeons. First line treatment for patients presenting with acute severe UC consists of intravenous steroids, but those who do not respond require escalation of therapy or emergent colectomy. The mortality of emergent colectomy has declined significantly in recent decades, but due to the morbidity of this procedure, second line agents such as cyclosporine and infliximab have been used as salvage therapy in an attempt to avoid emergent surgery. Unfortunately, protracted medical therapy has led to patients presenting for surgery in a poorer state of health leading to poorer post-operative outcomes. In this era of multiple medical modalities available in the treatment of acute severe UC, physicians must consider the advantages and disadvantages of prolonged medical therapy in an attempt to avoid surgery. Colectomy remains a mainstay in the treatment of severe ulcerative colitis not responsive to corticosteroids and rescue therapy, and timely referral for surgery allows for improved post-operative outcomes with lower risk of sepsis and improved patient survival. Options for reconstructive surgery include three-stage ileal pouch-anal anastomosis or a modified two-stage procedure that can be performed either open or laparoscopically. The numerous avenues of medical and surgical therapy have allowed for great advances in the treatment of patients with UC. In this era of options, it is important to maintain a global view, utilize biologic therapy when indicated, and then maintain an appropriate threshold for surgery. The purpose of this review is to summarize the growing number of medical and surgical options available in the treatment of acute, severe UC.

  14. Comparison between anal endosonography and digital examination in the evaluation of anal fistulae.

    Science.gov (United States)

    Choen, S; Burnett, S; Bartram, C I; Nicholls, R J

    1991-04-01

    A prospective trial was performed comparing the accuracy of digital examination and anal endosonography in defining the anatomy of anal fistulae. Before operation 38 consecutive patients were assessed by the consultant in charge of the case, by a research fellow and by anal endosonography involving two radiologists. These findings were compared with the operative findings. Consultants correctly identified 26 of 33 internal openings, 29 of 34 primary tracks and 15 of 21 secondary tracks. The research fellow correctly identified 26 internal openings, 24 primary tracks and 10 secondary tracks. There was no significant difference between the accuracy of consultants and the research fellow. Anal endosonography identified 10 internal openings based on initial criteria. This rose to 24 when revised ultrasonographic criteria were applied. There was no statistical difference between consultant assessment and anal ultrasonography in correctly identifying intersphincteric and transphincteric tracks. Ultrasonography is unable to assess primary superficial, suprasphincteric and extrasphincteric tracks or secondary supralevator and infralevator tracks. Consultant assessment of secondary supralevator and infralevator tracks was correct in 78 per cent of cases. PMID:2032103

  15. Development of a pulse height analizer

    International Nuclear Information System (INIS)

    The development of a Pulse Height Analizer is described. This equipment is essential to analize data coming from detectors producing information codified in pulse amplitudes. The system developed consist of a Signal Input Module connected to a Controller Module based on a 8085A microprocessor capable to memorize pulses up to 1 uS in 256 channels with a resolution better than 20 mV. A Communication Module with a serial interface is used for data transfer to a host computer using RS232c protocol. The Monitoring and Operation Module consist of a hexadecimal Keybord, a 6 digit 7-segment display and a XY analog output enabling real time visualization of data on a XY monitor. The hardware and the software designed for this low cost system were optimized to obtain a typical dead time of approximately 100 uS. As application, this device was used to adquire curves at the Small Angle X-ray Scattering Laboratory in this Department. The apparatus performance was tested by comparing its data with a Northern Pulse Height Analizer model NS633 output, with favorable results. (Author)

  16. Anal intraepitelial neoplasia: a narrative review

    Directory of Open Access Journals (Sweden)

    Garazi Elorza

    2016-01-01

    Full Text Available Anal intraepitelial neoplasia (AIN constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.

  17. Anal intraepitelial neoplasia: A narrative review.

    Science.gov (United States)

    Elorza, Garazi; Saralegui, Yolanda; Enríquez-Navascués, Jose María; Placer, Carlos; Velaz, Leyre

    2016-01-01

    Anal intraepitelial neoplasia (AIN) constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV) infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population. PMID:26765233

  18. Substance P modulates colitis-associated fibrosis.

    Science.gov (United States)

    Koon, Hon Wai; Shih, David; Karagiannides, Iordanes; Zhao, Dezheng; Fazelbhoy, Zafeer; Hing, Tressia; Xu, Hua; Lu, Bao; Gerard, Norma; Pothoulakis, Charalabos

    2010-11-01

    Substance P (SP) and the neurokinin-1 receptor (NK-1R) are involved in the development of colitis and mucosal healing after colonic inflammation. We studied whether SP modulates colonic fibrosis by using a chronic model of trinitrobenzenesulfonic acid (TNBS)-induced colitis in wild-type (WT) and NK-1R-deficient (NK-1R KD) mice. We found increased mRNA expression levels of collagen, vimentin, and the fibrogenic factors transforming growth factor β1 and insulin-like growth factor 1 in the chronically inflamed colons of WT mice treated with repeated intracolonic TNBS administrations. Fibrosis in TNBS-treated mice was also evident immunohistochemically by collagen deposition in the colon. Treatment of TNBS-exposed WT mice with the NK-1R antagonist CJ-12255 reduced colonic inflammation, colonic fibrosis, fibroblast accumulation, and expression levels of the fibrogenic factors. NK-1R knockout mice chronically exposed to TNBS had similar colonic inflammation compared with WT, but reduced colonic fibrosis, fibroblast accumulation, and expression levels of fibrogenic factors. Immunohistochemical staining also showed co-localization of NK-1R with fibroblasts in inflamed colons of mice and in colonic mucosa of patients with Crohn's disease. Exposure of human colonic CCD-18Co fibroblasts to SP (10 nmol/L) increased cell migration. SP stimulated collagen synthesis in CCD-18Co fibroblasts in the presence of transforming growth factor β1 and insulin-like growth factor 1, and this effect was reduced by Akt inhibition. Thus, SP, via NK-1R, promotes intestinal fibrogenesis after chronic colitis by stimulating fibrotic responses in fibroblasts. PMID:20889569

  19. Mechanism of diarrhea in microscopic colitis

    Institute of Scientific and Technical Information of China (English)

    Marijana Protic; Njegica Jojic; Daniela Bojic; Svetlana Milutinovic; Dusanka Necic; Bozidar Bojic; Petar Svorcan; Miodrag Krstic; Obren Popovic

    2005-01-01

    AIM: To search the pathophysiological mechanism of diarrhea based on daily stool weights, fecal electrolytes,osmotic gap and pH.METHODS: Seventy-six patients were included: 51 with microscopic colitis (MC) [40 with lymphocytic colitis (LC);11 with collagenous colitis (CC)]; 7 with MC without diarrhea and 18 as a control group (CG). They collected stool for 3 d. Sodium and potassium concentration were determined by flame photometry and chloride concentration by titration method of Schales. Fecal osmotic gap was calculated from the difference of osmolarity of fecal fluid and double sum of sodium and potassium concentration.RESULTS: Fecal fluid sodium concentration was significantly increased in LC 58.11±5.38 mmol/L (P<0.01)and CC 54.14±8.42 mmol/L (P<0.05) than in CG 34.28±2.98 mmol/L. Potassium concentration in LC 74.65±5.29 mmol/L (P<0.01) and CC 75.53±8.78 mmol/L (P<0.05) was significantly less compared to CG 92.67±2.99 mmol/L.Chloride concentration in CC 36.07±7.29 mmol/L was significantly higher than in CG 24.11±2.05 mmol/L (P<0.05).Forty-four (86.7%) patients had a secretory diarrhea compared to fecal osmotic gap. Seven (13.3%) patients had osmotic diarrhea.CONCLUSION: Diarrhea in MC mostly belongs to the secretory type. The major pathophysiological mechanism in LC could be explained by a decrease of active sodium absorption. In CC, decreased Cl/HCO3 exchange rate and increased chloride secretion are coexistent pathways.

  20. Colonic biogeography in health and ulcerative colitis.

    Science.gov (United States)

    Lavelle, Aonghus; Lennon, Grainne; Winter, Desmond C; O'Connell, P Ronan

    2016-09-01

    The relevance of biogeography to the distal gut microbiota has been investigated in both health and inflammatory bowel disease (IBD), however multiple factors, including sample type and methodology, microbiota characterization and interpersonal variability make the construction of a core model of colonic biogeography challenging. In addition, how phylogenetic classification relates to immunogenicity and whether consistent alterations in the microbiota are associated with ulcerative colitis (UC) remain open questions. This addendum seeks to review the human colonic microbiota in health and UC as currently understood, in the broader context of the human microbiome. PMID:27662587

  1. Turner Syndrome Associated with Ulcerative Colitis

    OpenAIRE

    Takaya, Junji; Teraguchi, Masayuki; Ikemoto, Yumiko; Yoshimura, Ken; Yamato, Fumiko; Higashino, Hirohiko; Kobayashi, Yohnosuke; Kaneko, Kazunari

    2006-01-01

    We report the case of a 7-yr-old girl with Turner syndrome, ulcerative colitis (UC) and coarctation of the aorta. The diagnosis of Turner syndrome was made in early infancy (karyotype analysis 45, X). Growth hormone treatment was started at 3 yr and 2 mo of age. From the age of 4 yr and 5 mo, the patient suffered from persistent diarrhea with traces of blood and intermittent abdominal discomfort. As these symptoms gradually deteriorated, she was referred to our clinic at the age of 7 yr for f...

  2. Cellular and Molecular Immunopathogenesis of Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    Suzhen Zhang; Xuhui Zhao; Dechun Zhang

    2006-01-01

    Ulcerative colitis (UC) is an inflammatory disease of the rectal and colonic mucosa and seems to result from a complex series of interactions between susceptibility genes, the environment and the immune system. Various components of the mucosal immune system are implicated in the immunopathogenesis of UC. Evidence from animal models also suggests that an altered immune response to the commensal microflora of the host plays a central role in the development of UC. So in this review, we elucidate the cells and molecules which are implicated in the immunopathogenesis of the disease from four aspects: antigens in the intestine, dendritic cells, toll like receptors and NF-κB in the UC.

  3. por valores

    Directory of Open Access Journals (Sweden)

    Jazmín Díaz-Barrios

    2005-01-01

    Full Text Available La era actual se caracteriza por una búsqueda de la identidad del hombre, donde el pivote del cambio organizacional es el individuo; cambiar en este entorno depende, en gran medida, de los valores que imperen en la cultura de la organización. Este trabajo documental intenta identificar aquellos valores, condición sine-qua-non, para el logro de los objetivos de cambio y analizarlos a fin de determinar sus indicadores, con el objeto de presentar una herramienta a las organizaciones que les facilite adaptarse a los nuevos tiempos. Se encontró que los valores: Delegación, Comunicación, Colaboración, Participación y Aprendizaje, son esenciales en los cambios integrales de esta era. Se determinaron 20 indicadores de su presencia. Se concluye que con esta información cada ente puede elaborar instrumentos que le permitan saber si los valores requeridos están presentes y en caso contrario tomar decisiones que alineen a la organización alrededor de los valores humanistas planteados, incrementando así las posibilidades de éxito en el proceso de cambio y por ende, las posibilidades de supervivencia en esta nueva época.

  4. Utilidad de la ecografía en la valoración de la extensión de la colitis ulcerosa Usefulness of digestive ultrasonography in assessment of ulcerative colitis extent

    Directory of Open Access Journals (Sweden)

    D. Martínez Ares

    2007-07-01

    Full Text Available Introducción: el hallazgo de lesiones endoscópicas severas en un paciente con colitis ulcerosa desaconseja la realización de una exploración completa del colon. No obstante el conocimiento de la extensión precisa de la enfermedad tiene gran importancia en las decisiones terapéuticas a tomar y también en el pronóstico de la enfermedad. Por todo ello, la validación de una técnica no invasiva para el estudio de extensión de la colitis ulcerosa cobra gran interés e importancia. Material y método: se incluyen en el estudio pacientes con diagnóstico previo de colitis ulcerosa o en el debut de la enfermedad y, de forma prospectiva y ciega se evalúa la precisión de la ecografía digestiva en la valoración de la extensión de la colitis ulcerosa. Las exploraciones ecográficas son realizadas todas ellas por el mismo explorador y siempre con anterioridad al estudio endoscópico completo, que se usa como patrón oro. No se emplea la técnica hidrocolónica en ningún caso. Resultados: han sido incluidos en el estudio 20 pacientes, 13 varones (65% y 7 mujeres (35%, con una edad media de 51,7 años (rango de 24 a 82 años. Los estudios endoscópicos mostraron una afectación severa en 5 casos (25%, moderada en 12 pacientes (60% y lesiones leves en los 3 casos restantes (15%. El estudio ecográfico del colon fue considerado satisfactorio en 18 casos (90% y la extensión de la enfermedad establecida en el estudio ecográfico coincide en todos los casos con la determinada por la colonoscopia: 3 pacientes (16,6% presentaban una proctitis ulcerosa, 9 (50% una colitis izquierda y 6 (33,3% una colitis extensa. Conclusiones: la ecografía digestiva permite el estudio del marco colónico en la mayoría de los pacientes, especialmente si existe actividad inflamatoria, permitiendo establecer con gran precisión la extensión de la colitis ulcerosa, independientemente del grado de actividad de la misma.Introduction: a full examination of the colon

  5. Intraepithelial lymphocytosis is a frequent finding in biopsies from ileal pouch-anal anastomoses.

    Science.gov (United States)

    Schaeffer, David F; Walsh, Joanna C; Tyler, Andrea D; Ben-Bassat, Ofer; Silverberg, Mark S; Riddell, Robert H; Kirsch, Richard

    2016-08-01

    Following restorative proctocolectomy with an ileal pouch-anal anastomosis, the small bowel mucosa undergoes several specific histologic adaptions, which may be unrelated to the underlying disease or symptoms of pouchitis. An increase in intraepithelial lymphocytes (IELs) has not been described as part of this spectrum. Mucosal biopsies of the ileal pouch and afferent limb of 230 patients (mean age: 45.7y [18.3-74.7], gender [female/male]: 117/113) with a functioning ileal pouch-anal anastomosis (mean time since ileostomy closure: 10.8months) and associated clinically annotated outcome data were assessed for IELs/100 enterocytes. Forty-two patients (18.3%) showed an increase in IELs (≥20 IELs/100 enterocytes [range 20-39]), in pouch and/or afferent limb biopsies. Intraepithelial lymphocytosis was more commonly observed in afferent limb compared to pouch biopsies (18.8% vs 8.3%; P = .42) and in familial adenomatous polyposis compared to ulcerative colitis patients (16% vs 8%; P = 0.36), but neither difference reached statistical significance. No cases with increased IELs displayed severe villous blunting. Increased IELs were not significantly associated with age, sex, ethnicity, smoking history, time since ileostomy, use of antibiotics, biologic agents, anti-diarrheal agents or probiotics, C-reactive protein levels or differential white cell count. None of the 42 patients with increased IELs had positive celiac serology (anti-human tissue transglutaminase IgA [ELISA] with corresponding total serum IgA). Intraepithelial lymphocytosis in pouch biopsies may represent a subclinical response to an altered bacterial microenvironment. Pathologists should be aware that intraepithelial lymphocytosis is part of the spectrum of changes in pouch biopsies, and only rarely is due to celiac disease. PMID:27063473

  6. Evaluation of topical n-acetylcysteine in diversion colitis

    Directory of Open Access Journals (Sweden)

    Marcos Gonçalves de Almeida

    2012-09-01

    Full Text Available INTRODUCTION: Diversion colitis (DC is a benign condition characterized by the appearance of inflammation in the mucosa of the colon or rectum devoid of fecal stream. Oxidative stress has been associated with the etiopathogenesis of the disease. N-acetylcysteine (NAC is a substance with antioxidant properties, used in different treatments of inflammatory diseases. The purpose of this study was to evaluate the effects of topical applications of NAC in an experimental model of DC. METHODS: Thirty-six Wistar rats were submitted to deviation of fecal stream by proximal colostomy and a distal mucosal fistula. They were distributed into 3 experimental groups of 12 animals according to the daily application of enemas containing 0.9% saline or 2 doses of NAC, 25 mg/kg and 100 mg/kg, respectively. In each group, half of the animals were sacrificed after two weeks of irrigation and half after four weeks of irrigation. The diagnosis of colitis was assessed by histopathological analysis and the grade of inflammation by inflammatory grading scale. The results were evaluated with the Mann-Whitney test, adopting significance level of 5% (pINTRODUÇÃO: Colite de exclusão (CE é uma condição benigna caracterizada pelo desenvolvimento de inflamação na mucosa do cólon desprovida de trânsito fecal. O estresse oxidativo tem sido implicado na patogênese da doença. A n-acetilcisteína (NAC é uma substância com efeitos antioxidantes, sendo utilizada no tratamento de várias doenças inflamatórias. OBJETIVO: Avaliar os efeitos da aplicação tópica de NAC em modelo de CE. MÉTODO: Trinta e seis ratos Wistar foram submetidos ao desvio do trânsito por meio de colostomia proximal e fístula mucosa distal. Os animais foram distribuídos em três grupos experimentais de igual tamanho segundo a aplicação de enemas diários contendo soro fisiológico 0,9% ou NAC nas concentrações de 25 mg/kg ou 100 mg/kg. Em cada grupo, metade dos animais foi sacrificada ap

  7. Grim19 Attenuates DSS Induced Colitis in an Animal Model.

    Science.gov (United States)

    Kim, Jae-Kyung; Lee, Seung Hoon; Lee, Seon-Young; Kim, Eun-Kyung; Kwon, Jeong-Eun; Seo, Hyeon-Beom; Lee, Han Hee; Lee, Bo-In; Park, Sung-Hwan; Cho, Mi-La

    2016-01-01

    DSS induced colitis is a chronic inflammatory disease characterized by inflammation in the gastrointestinal tract, which destabilizes the gut and induces an uncontrolled immune response. Although DSS induced colitis is generally thought to develop as a result of an abnormally active intestinal immune system, its pathogenesis remains unclear. Gene associated with retinoid interferon induced mortality (Grim) 19 is an endogenous specific inhibitor of STAT3, which regulates the expression of proinflammatory cytokines. In this study, we investigated the influence of GRIM19 in a DSS induced colitis mouse model. We hypothesized that Grim19 would ameliorate DSS induced colitis by altering STAT3 activity and intestinal inflammation. Grim19 ameliorated DSS induced colitis severity and protected intestinal tissue. The expression of STAT3 and proinflammatory cytokines such as IL-1β and TNF-α in colon and lymph nodes was decreased significantly by Grim19. Moreover, DSS induced colitis progression in a Grim19 transgenic mouse line was inhibited in association with a reduction in STAT3 and IL-17 expression. These results suggest that Grim19 attenuates DSS induced colitis by suppressing the excessive inflammatory response mediated by STAT3 activation.

  8. Microheterogeneity of acute phase proteins in patients with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Marian Grzymis(l)awski; Katarzyna Derc; Magdalena Sobieska; Krzysztof Wiktorowicz

    2006-01-01

    AIM: To estimate the serum α1-antichymotrypsin (ACT),α1-acid glycoprotein (AGP) and transferrin (Tf) concentrations and to evaluate the microheterogeneity of these acute phase proteins in patients with ulcerative colitis. METHODS: Twenty-seven patients with ulcerative colitis (UC) and 17 healthy control subjects were studied. The patients were categorised as severe (n = 9), moderate (n = 10) and mild groups (n = 8) using Truelove and Witts'classification of ulcerative colitis. Microheterogeneity of ACT, AGP and Tf was analysed by crossed immunoaffinity electrophoresis (CIAE) with concanavalin A. In all serum samples standard electrophoresis of serum proteins was performed, iron (Fe) concentration, total iron binding capacity (TIBC) and C-reactive protein (CRP) were also measured.RESULTS: Our patients suffering from ulcerative colitis had significantly higher serum ACT and AGP concentrations and lower serum transferrin concentration in comparison to healthy subjects. Changes in concentrationsof acute phase proteins were dependent on the activityof the inflammatory process. The glycosylation patterns of transferrin were related to the inflammation status. We also observed the correlation between ACT and AGP concentrations, patterns of transferrin glycosylation and changes in standard protein electrophoresis or blood cell count.CONCLUSION: The glycosylation patterns of transferrin obtained from patients suffering from ulcerative colitis are highly branched and sialylated compared with those obtained from healthy subjects. In contrast, the glycosylation patterns of transferrin do not differ according to the activity index of ulcerative colitis. The microheterogeneity patterns of AGP and ACT are similar in ulcerative colitis patients and healthy subjects.

  9. Grim19 Attenuates DSS Induced Colitis in an Animal Model

    Science.gov (United States)

    Kim, Jae-kyung; Lee, Seung Hoon; Lee, Seon-Young; Kim, Eun-Kyung; Kwon, Jeong-Eun; Seo, Hyeon-Beom; Lee, Han Hee; Lee, Bo-In; Park, Sung-Hwan; Cho, Mi-La

    2016-01-01

    DSS induced colitis is a chronic inflammatory disease characterized by inflammation in the gastrointestinal tract, which destabilizes the gut and induces an uncontrolled immune response. Although DSS induced colitis is generally thought to develop as a result of an abnormally active intestinal immune system, its pathogenesis remains unclear. Gene associated with retinoid interferon induced mortality (Grim) 19 is an endogenous specific inhibitor of STAT3, which regulates the expression of proinflammatory cytokines. In this study, we investigated the influence of GRIM19 in a DSS induced colitis mouse model. We hypothesized that Grim19 would ameliorate DSS induced colitis by altering STAT3 activity and intestinal inflammation. Grim19 ameliorated DSS induced colitis severity and protected intestinal tissue. The expression of STAT3 and proinflammatory cytokines such as IL-1β and TNF-α in colon and lymph nodes was decreased significantly by Grim19. Moreover, DSS induced colitis progression in a Grim19 transgenic mouse line was inhibited in association with a reduction in STAT3 and IL-17 expression. These results suggest that Grim19 attenuates DSS induced colitis by suppressing the excessive inflammatory response mediated by STAT3 activation. PMID:27258062

  10. Golimumab for the treatment of ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Löwenberg M

    2014-03-01

    Full Text Available Mark Löwenberg,1 Nanne KH de Boer,2 Frank Hoentjen3 1Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands; 2Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, the Netherlands; 3Inflammatory Bowel Disease Center, Radboud University Medical Center, Nijmegen, the Netherlands Abstract: The introduction of therapeutic antibodies against tumor necrosis factor (TNF had a major impact on the treatment of ulcerative colitis (UC. Infliximab and adalimumab are powerful agents that are used for remission induction and maintenance therapy in UC and have an acceptable safety profile. However, a proportion of UC patients for whom therapy with anti-TNF agents is indicated fail or become intolerant to treatment with infliximab or adalimumab. Hence, there remains an unmet need for novel anti-TNF agents. Golimumab (Simponi®, a human anti-TNF antibody that is administered by monthly subcutaneous injections, is the most recently introduced TNF blocker for the treatment of UC. Here, we will discuss recent literature on clinical efficacy and safety of golimumab induction and maintenance treatment in patients with UC. Furthermore, we will discuss the positioning of golimumab for UC in current treatment algorithms. Keywords: ulcerative colitis, UC, antitumor necrosis factor, TNF, antibodies, golimumab

  11. Management and treatment of distal ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Andrea Calafiore

    2013-12-01

    Full Text Available Ulcerative colitis (UC is a chronic inflammatory condition that is confined to the colonic mucosa. Its main symptoms include diarrhea, rectal bleeding and abdominal pain. Approximately two-thirds of UC patients have disease confined distal to the splenic flexure, which can be treated effectively with topical therapy. This means the active drug can be delivered directly to the site of inflammation, limiting the systemic absorption and potential side effects. Topical treatment with aminosalicylates is the most effective approach in the treatment of these forms, provided that the formulation reaches the upper margin of the disease. Given this, the suppository formulation is the treatment of choice for proctitis and distal sigmoiditis. Thanks to their proximal spread, enemas, foams and gels represent the treatment of choice for proctosigmoiditis and for distal ulcerative colitis. Oral aminosalicylates are less effective than topical therapies in patients with active disease, while the combination of topical and oral treatment is more effective in patients refractory to topical or oral mono-therapy. Topically administered aminosalicylates play an important role in the maintenance of remission, but the long-term adhesion to therapy is poor. For this reason, the oral formulation is the first-line therapy in the maintenance of remission. Refractory patients can be treated with topical steroids or systemic steroids and TNF-alpha inhibitors in severe forms.

  12. Diagnosis and classification of ulcerative colitis.

    Science.gov (United States)

    Conrad, Karsten; Roggenbuck, Dirk; Laass, Martin W

    2014-01-01

    Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease (IBD) characterised by superficial mucosal ulceration, rectal bleeding, diarrhoea, and abdominal pain. In contrast to Crohn's disease (CrD), UC is restricted to the colon and the inflammation is limited to the mucosal layer. Classic UC affects the colon in a retrograde and continuous fashion starting from the rectum and extending proximally. Dependent on the anatomic extent of involvement, UC can be classified as proctitis, left-sided colitis, or pancolitis. Inflammatory arthropathies and primary sclerosing cholangitis (PSC) are the most common and clinically most important extraintestinal manifestations of UC. The aetiopathogenesis of UC is incompletely understood, but immune-mediated mechanisms are responsible for dysregulated immune responses against intraluminal antigens in genetically predisposed individuals. The diagnosis is based on the history, as well as clinical, radiological, endoscopic and histological features. Autoantibodies, mainly antineutrophil cytoplasmic antibodies (ANCA) and anti-goblet cell antibodies (GAB) may be helpful in the early diagnosis of UC and in differentiating it from CrD.

  13. Obstructive ileus caused by phlebosclerotic colitis

    Science.gov (United States)

    Lee, Seung Hyun; Park, Se Jin; Heo, Ju Yeol; Paik, Woo Hyun; Bae, Won Ki; Kim, Nam-Hoon; Kim, Kyung-Ah; Lee, June Sung

    2016-01-01

    A 57-year-old man with chronic kidney disease and a history of using numerous herbal medications visited Inje University Ilsan Paik Hospital for abdominal pain and vomiting. An abdominal radiograph showed diffuse small bowel distension containing multiple air-fluid levels and extensive calcifications along the colon. Computed tomography showed colon wall thickening with diffuse calcification along the colonic mesenteric vein and colonic wall. Colonoscopy, performed without bowel preparation, showed bluish edematous mucosa from the transverse to the distal sigmoid colon, with multiple scar changes. At the mid transverse colon, a stricture was noted and the scope could not pass through. A biopsy of the stricture site revealed nonspecific changes. The patient was diagnosed with phlebosclerotic colitis. After the colonoscopy, the obstructive ileus spontaneously resolved, and the patient was discharged without an operation. Currently, after 2 months of follow-up, the patient has remained asymptomatic. Herein, we report the rare case of an obstructive ileus caused by phlebosclerotic colitis with a colon stricture. PMID:27799889

  14. (phoenicopterus roseus por intoxicación aguda por plomo

    Directory of Open Access Journals (Sweden)

    D Romero

    2007-01-01

    Full Text Available La presencia de plomo en el medio ambiente es un hecho indiscutible. Ello es objeto de gran interés sanitario pues repercute tanto en la salud de los animales como en la del ser humano. El plumbismo es una intoxicación que puede afectar a cualquier especie animal. En el ámbito de la fauna silvestre se asocia principalmente a la actividad cinegética en los humedales y a la ingestión de plomo metálico por parte de las aves que frecuentan estos ecosistemas. En España cada año mueren decenas de miles de aves acuáticas como consecuencia de la ingesta de perdigones de plomo. En los individuos capturados enfermos se pueden observar signos clínicos, mientras que a partir de muestras de cadáveres se obtienen datos sobre niveles tisulares de plomo. Sin embargo la evaluación de lesiones anatomopatológicas en animales de vida silvestre es difícil de realizar por la dificultad de encontrar animales recién muertos o afectados de un cuadro agudo mortal. La reproducción de esta patología en animales de experimentación se suele realizar en cisnes, palomas o patos, pero no en flamencos, por lo que no es usual disponer de datos histológicos en esta especie. En este trabajo presentamos la clínica, analítica y estudio microscópico de diferentes tejidos de un flamenco común (Phoenicopterus roseus muerto por plumbismo.

  15. Electrophysiological observations on the human pudendo-anal reflex.

    OpenAIRE

    Varma, J S; Smith, A N; McInnes, A

    1986-01-01

    A reproducible electrophysiological technique is described to determine the latency of reflex contraction of the external anal sphincter in response to stimulation of the dorsal genital nerve: the pudendo-anal reflex. This was studied in 38 asymptomatic control subjects and 20 women with neurogenic faecal incontinence, supplemented by determination of the mean motor unit potential duration (MUPD) of the external anal sphincter and anorectal manometry. The reflex latency in the control group w...

  16. Current treatment options for management of anal intraepithelial neoplasia

    OpenAIRE

    Weis SE

    2013-01-01

    Stephen E Weis1,2 1Division of Dermatology, Department of Internal Medicine, University of North Texas Health Science Center at Fort Worth, 2Preventive Medicine Clinic, Tarrant County Public Health, Fort Worth, TX, USA Abstract: Anal squamous cell cancer is an uncommon malignancy caused by infection with oncogenic strains of Human papilloma virus. Anal cancer is much more common in immunocompromised persons, including those infected with Human immunodeficiency virus. High-grade anal intraepi...

  17. Environmental scan of anal cancer screening practices: worldwide survey results

    OpenAIRE

    Patel, Jigisha; Salit, Irving E.; Berry, Michael J.; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey ...

  18. Acute Onset Collagenous Colitis with Unique Endoscopic Findings

    Directory of Open Access Journals (Sweden)

    Rintaro Moroi

    2014-01-01

    Full Text Available We experienced a rare case of 72-year-old woman with acute onset collagenous colitis (CC induced by lansoprazole. The patient developed acute abdominal pain, watery diarrhea, and melena that are quite rare in usual CC. We could find the characteristic colonoscopic findings such as active long liner ulcers in the patient. We also observed the healing courses of these unique findings. Our case indicates two important points of view. (1 CC sometimes develops with acute onset symptoms which resemble those of ischemic colitis. (2 Colonoscopy would be useful and necessary to distinguish acute onset CC and ischemic colitis.

  19. Golimumab: clinical update on its use for ulcerative colitis.

    Science.gov (United States)

    Gilardi, D; Fiorino, G; Allocca, M; Bravatà, I; Danese, S

    2015-03-01

    Monoclonal antibodies directed against tumor necrosis factor alpha (anti-TNF-α agents) have dramatically changed the therapeutical approach to inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis. A new anti-TNF drug, golimumab, has recently been approved for patients with moderate to severe ulcerative colitis. Its efficacy has been demonstrated by preclinical and clinical studies and the drug showed an efficacy and safety profile in line with the other anti-TNF agents, such as infliximab and adalimumab. This review gives an overview on golimumab in the treatment of moderate to severe ulcerative colitis.

  20. Extraintestinal manifestations in Crohn's disease and ulcerative colitis

    DEFF Research Database (Denmark)

    Isene, Rune; Bernklev, Tomm; Høie, Ole;

    2015-01-01

    BACKGROUND: In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal manifest......BACKGROUND: In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal......, skin, and liver) manifestations: 20.1% versus 10.4% (p colitis compared to proctitis in UC increased the risk of EIM. CONCLUSION: In a European inception cohort, EIMs in IBD...

  1. Impact of probiotics on colonic microflora in patients with colitis

    DEFF Research Database (Denmark)

    Reddy, B. S.; Ahmed, J.; Macfie, J.;

    2010-01-01

    Background: Probiotics colonise the gut and may exert beneficial effects. The aim of this study was to assess if probiotics change the spectrum of colonic microflora in patients with colitis when taken daily for a period of one month Methods: This is a prospective double blind randomised crossover...... of study. Terminal-restriction fragment length polymorphism technique (T-RFLP) and principal component analysis (PCA) on the bacterial community were used to study the faecal mircoflora. Results: Sixteen patients completed the study, 8 had Crohn’s disease and 8 had ulcerative colitis. Median age was 62...... in patients with colitis. This observation might have clinical implications....

  2. Analýza vybrané firmy

    OpenAIRE

    Křemečková, Tereza

    2013-01-01

    Tato bakalářská práce obsahuje celkovou analýzu firmy Pegas NONWOVENS. Práce se zabývá analýzami SWOT a SLEPTE, Porterovým pětifaktorovým modelem, Kralickovým Quick testem a vybranými ukazateli finanční analýzy. Na základě zpracování těchto analýz jsou navržena doporučení, která by mohla zlepšit situaci firmy.

  3. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  4. Environmental scan of anal cancer screening practices: worldwide survey results.

    Science.gov (United States)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-08-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening. PMID:24740973

  5. Notas para un modelo analítico de la acción educativa

    OpenAIRE

    Trilla, Jaime

    2009-01-01

    El propósito de las páginas siguientes es desarrollar algunas distinciones conceptuales que puedan servir para la elaboración de un modelo analítico de la acción educativa. No constituyen, ni mucho menos, la propuesta de un modelo con pretensiones de globalidad, sino tan sólo algunas indicaciones que puedan resultar pertinentes para su confección. Así, por ejemplo, aspectos tan importantes en una acción educativa como los procesos de retroalimentación no serán ni mencionados en este trabajo. ...

  6. Risk of Anal Cancer in People Living with HIV: Addressing Anal Health in the HIV Primary Care Setting.

    Science.gov (United States)

    Walker, Crystal Martin; Likes, Wendy; Bernard, Marye; Kedia, Satish; Tolley, Elizabeth

    2016-01-01

    Anal health and anal cancer are rarely addressed in HIV primary care. We sought to understand factors that impeded or promoted addressing anal health in HIV primary care from providers' perspectives. In this exploratory study, HIV primary care providers from the Mid-South region of the United States participated in brief individual interviews. We analyzed transcribed data to identify barriers and facilitators to addressing anal health. Our study sample included five physicians and four nurse practitioners. The data revealed a number of barriers such as perception of patient embarrassment, provider embarrassment, external issues such as time constraints, demand of other priorities, lack of anal complaints, lack of resources, and gender discordance. Facilitators included awareness, advantageous circumstances, and the patient-provider relationship. Anal health education should be prioritized for HIV primary care providers. Preventive health visits should be considered to mitigate time constraints, demands for other priorities, and unequal gender opportunities. PMID:27080925

  7. Concomitant herpes simplex virus colitis and hepatitis in a man with ulcerative colitis

    Science.gov (United States)

    Phadke, Varun K.; Friedman-Moraco, Rachel J.; Quigley, Brian C.; Farris, Alton B.; Norvell, J. P.

    2016-01-01

    Abstract Background: Herpesvirus infections often complicate the clinical course of patients with inflammatory bowel disease; however, invasive disease due to herpes simplex virus is distinctly uncommon. Methods: We present a case of herpes simplex virus colitis and hepatitis, review all the previously published cases of herpes simplex virus colitis, and discuss common clinical features and outcomes. We also discuss the epidemiology, clinical manifestations, diagnosis, and management of herpes simplex virus infections, focusing specifically on patients with inflammatory bowel disease. Results: A 43-year-old man with ulcerative colitis, previously controlled with an oral 5-aminosalicylic agent, developed symptoms of a colitis flare that did not respond to treatment with systemic corticosteroid therapy. One week later he developed orolabial ulcers and progressive hepatic dysfunction, with markedly elevated transaminases and coagulopathy. He underwent emergent total colectomy when imaging suggested bowel micro-perforation. Pathology from both the colon and liver was consistent with herpes simplex virus infection, and a viral culture of his orolabial lesions and a serum polymerase chain reaction assay also identified herpes simplex virus. He was treated with systemic antiviral therapy and made a complete recovery. Conclusions: Disseminated herpes simplex virus infection with concomitant involvement of the colon and liver has been reported only 3 times in the published literature, and to our knowledge this is the first such case in a patient with inflammatory bowel disease. The risk of invasive herpes simplex virus infections increases with some, but not all immunomodulatory therapies. Optimal management of herpes simplex virus in patients with inflammatory bowel disease includes targeted prophylactic therapy for patients with evidence of latent infection, and timely initiation of antiviral therapy for those patients suspected to have invasive disease. PMID:27759636

  8. Spectrum of non-inflammatory bowel disease and non-infectious colitis

    Institute of Scientific and Technical Information of China (English)

    Ioannis E Koutroubakis

    2008-01-01

    A variety of inflammatory diseases of the colon,which can be differentiated from inflammatory bowel disease (IBD) and infectious colitis by their clinical,endoscopic and histological characteristics,are reported as nonIBD and non-infectious colitis.These diseases include microscopic colitis,ischemic colitis,segmental colitis associated with diverticula,radiation colitis,diversion colitis,eosinophilic colitis and Behcet's colitis.The etiopathogenesis of most of these diseases remains obscure and the epidemiological data are rather limited.These conditions are often troublesome for the patient and are associated with diagnostic difficulties for the physician.In many cases the treatment is empirical and there is a need for future research using randomized controlled trials.

  9. Papilomavírus Humano (HPV e sua associação entre lesões cervical e anal em mulheres

    Directory of Open Access Journals (Sweden)

    Luciane Maria Oliveira Brito

    2016-09-01

    Full Text Available Introdução: Entre as doenças virais sexualmente transmissíveis, a infecção pelo Papilomavírus Humano (HPV configura-se como a mais comum, e sua incidência vem aumentando acentuadamente nos últimos trinta anos. A infecção anal por subtipos específicos do HPV predispõe o indivíduo à neoplasia intraepitelial anal, que pode evoluir para o câncer de forma similar ao colo uterino. Objetivo: avaliar a associação tipo-específica entre infecções anais e cervicais, assim como os aspectos citopatológicos das lesões anais pelo vírus HPV em mulheres de São Luís, Maranhão. Métodos: Estudo analítico transversal com 27 mulheres atendidas no Centro de Pesquisa Clínica da UFMA, entre agosto de 2012 e julho de 2015, mediante entrevista e realização de exames complementares. Resultados: As mulheres tinham, em média, 32 anos. Em relação ao resultado do PCR, 77,7% das pacientes apresentaram resultado positivo para HPV anal, sendo o subtipo 16 o mais frequente (47,6%. Na região cervical, 88,8% apresentaram PCR positivo, sendo o mais comum o subtipo 16 (47,8%. A coinfecção anal e cervical pelo HPV foi observada em 74% das mulheres. 93,3% dos resultados de citologia anal não apresentaram alteração, assim como 72,2% das anuscopias realizadas. Conclusões: A infecção cervical por HPV é um fator sugestivo de risco para o desenvolvimento da infecção na região anal.

  10. Faecal mucus degrading glycosidases in ulcerative colitis and Crohn's disease.

    Science.gov (United States)

    Rhodes, J M; Gallimore, R; Elias, E; Allan, R N; Kennedy, J F

    1985-08-01

    Because the normal faecal flora includes bacteria which can produce mucus-digesting glycosidases, it follows that increased digestion of colonic mucus by these bacterial enzymes could be important in the pathogenesis of ulcerative colitis. Faecal activities of potential mucus-degrading glycosidases have therefore been assayed in samples from patients with inflammatory bowel disease and normal controls. The enzymes alpha-D-galactosidase, beta-D-galactosidase, beta-NAc-D-glucosaminidase alpha-L-fucosidase and neuraminidase were assayed. Considerable glycosidase activity was present in most faecal samples. Similar activities of all the enzymes assayed were found in faeces from patients with ulcerative colitis, Crohn's disease and normal controls and there was no significant correlation with disease activity. These results imply that relapse of ulcerative colitis is not initiated by increased degradation of colonic mucus by faecal glycosidases but do not exclude a role for bacterial mucus degradation in the pathogenesis of ulcerative colitis.

  11. Clostridium difficile Infection Worsens the Prognosis of Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    María E Negrón

    2014-01-01

    Full Text Available BACKGROUND: The impact of Clostridium difficile infections among ulcerative colitis (UC patients is well characterized. However, there is little knowledge regarding the association between C difficile infections and postoperative complications among UC patients.

  12. Faecal mucus degrading glycosidases in ulcerative colitis and Crohn's disease.

    Science.gov (United States)

    Rhodes, J M; Gallimore, R; Elias, E; Allan, R N; Kennedy, J F

    1985-08-01

    Because the normal faecal flora includes bacteria which can produce mucus-digesting glycosidases, it follows that increased digestion of colonic mucus by these bacterial enzymes could be important in the pathogenesis of ulcerative colitis. Faecal activities of potential mucus-degrading glycosidases have therefore been assayed in samples from patients with inflammatory bowel disease and normal controls. The enzymes alpha-D-galactosidase, beta-D-galactosidase, beta-NAc-D-glucosaminidase alpha-L-fucosidase and neuraminidase were assayed. Considerable glycosidase activity was present in most faecal samples. Similar activities of all the enzymes assayed were found in faeces from patients with ulcerative colitis, Crohn's disease and normal controls and there was no significant correlation with disease activity. These results imply that relapse of ulcerative colitis is not initiated by increased degradation of colonic mucus by faecal glycosidases but do not exclude a role for bacterial mucus degradation in the pathogenesis of ulcerative colitis. PMID:2991089

  13. A Review of Qingchang Shuan for Treatment of Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    DAI Yan-cheng; TANG Zhi-peng; MA Gui-tong; GONG Yu-ping; LIU Wen; ZHANG Ya-li; WANG Xin-zhong

    2010-01-01

    @@ Qingchang Shuan(清肠栓)is a commonly used Chinese herbal suppository for treatment of ulcerative colitis(UC).It has the effects of clearing away heat and toxic materials, and promoting tissue regeneration by removing blood stasis.

  14. Rastreamento e seguimento dos portadores das lesões anais induzidas pelo papilomavírus humano como prevenção do carcinoma anal Screening and follow-up of patients with anal HPV induced lesions for anal carcinoma prevention

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2009-06-01

    Full Text Available O Papilomavírus humano (HPV é o agente sexualmente transmissível mais comum na região perianal. O vírus provoca lesões clínicas e subclínicas que podem evoluir para carcinoma anal. É descrito o aumento da incidência desse tipo de tumor naqueles que praticam sexo anal; nos portadores, de ambos os sexos, de lesões genitais HPV induzidas; nas pessoas com neoplasias intraepiteliais anais de alto grau, o precursor do carcinoma, com maior incidência nos infectados pelo vírus da imunodeficiência humana (HIV, e com outras causas de supressão imunológica. Outra característica das lesões HPV induzidas é a elevada incidência de recidivas. Daí, a importância do seguimento por longo prazo e da pesquisa de meios terapêuticos para reduzir essa ocorrência. A possibilidade da detecção das lesões precursoras indica que programas padronizados de rastreamento para a prevenção do câncer anal deveriam ser instituídos. Os esfregaços anais para citologia vêm sendo realizados, com eficácia semelhante a das coletas cervicais e a colposcopia anal tem sido indicada para biópsias dirigidas quando a citologia mostrou-se alterada, embora muitos recomendam-na, também, como método de rastreamento. Nesse artigo, descrevemos a padronização da coleta de material para citologia anal e o método de realização da colposcopia anal, bem como a periodicidade com que devem ser repetidos.The human papillomavirus is the most frequent sexually transmitted agent in anorectal area. This virus provokes clinical and sub-clinical lesions that can evolve to anal carcinoma. Its incidence is increasing among those who practice anal receptive sex; in both gender patients with genital HPV induced lesions; in those with high grade anal intra-epithelial neoplasia, anal carcinoma precursor, mainly among HIV infected persons or with other causes of immunodeficiency. Another HPV induced lesions characteristic is their elevated incidence of recurrences. Therefore

  15. Pouchitis and pre-pouch ileitis developed after restorative proctocolectomy for ulcerative colitis: A case report

    Institute of Scientific and Technical Information of China (English)

    Takashi Iwata; Takayuki Yamamoto; Satoru Umegae; Koichi Matsumoto

    2007-01-01

    We report a case of pouchitis and pre-pouch ileitis, and inflammation in the neo-terminal ileum proximal to the pouch, developed after restorative proctocolectomy for ulcerative colitis. A 35-year old female presented with fever and abdominal pain five weeks after ileostomy closure following proctocolectomy. Computed tomography showed collection of feces in the pouch and proximal ileum. A drainage tube was placed in the pouch perianally,and purulent feces were discharged. With antibiotic treatment, her symptoms disappeared, but two weeks later, she repeatedly developed fever and abdominal pain along with anal bleeding. Pouchscopy showed mucosal inflammation in both the pouch and the pre-pouch ileum. The mucosal cytokine production was elevated in the pouch and pre-pouch ileum. With antibiotic and corticosteroid therapy, her symptoms were improved along with improvement of endoscopic inflammation and decrease of mucosal cytokine production. The fecal stasis with bacterial overgrowth is the major pathogenesis of pouchitis and pre-pouch ileitis in our case.

  16. Budesonide for ulcerative colitis Budesonida en el tratamiento de la colitis ulcerosa

    Directory of Open Access Journals (Sweden)

    I. Marín-Jiménez

    2006-05-01

    Full Text Available In this review, we examined studies published on oral and topical formulations of budesonide (Entocort® and Budenofalk®, in Spain: Entocord® and Intestifalk® for the treatment of ulcerative colitis. This glycocorticosteroid has a potent local action and an important first-pass liver metabolism. It has proven successful over the last years as a controlled-release formulation. It obtained results similar to prednisolone, without the latter's significant suppression of plasma cortisol. Many publications exist on the effects of oral budesonide for the treatment of Crohn's disease (CD. These have led to the registration of this drug for the treatment of CD. Studies on oral formulations of budesonide for the treatment of ulcerative colitis (UC are scarce. After reviewing published evidence, we suggest the conduction of controlled trials for the treatment of UC to obtain evidence-based efficacy and safety results in order to benefit patients with this form of inflammatory bowel disease (IBD.En esta revisión repasamos los estudios publicados hasta la fecha con las formulaciones orales y las preparaciones tópicas rectales de budesonida (Entocort® y Budenofalk®, en España Entocord® e Intestifalk® para el tratamiento de la colitis ulcerosa. Este glucocorticosteroide de una elevada acción tópica y un importante metabolismo de primer paso hepático se ha utilizado en los últimos años como una formulación de liberación controlada, proporcionando resultados similares a la prednisolona pero sin suprimir de forma apreciable los niveles de cortisol plasmático. Aunque se han publicado muchos estudios sobre los efectos de la budesonida oral para el tratamiento de la enfermedad de Crohn, los estudios sobre esta misma forma galénica de administración de budesonida para el tratamiento de los pacientes con colitis ulcerosa son escasos. Después de revisar los trabajos publicados al respecto, se sugiere la necesidad de realizar un estudio controlado

  17. "Cat scratch colon" in a patient with ischemic colitis.

    Science.gov (United States)

    Park, Eui Ju; Lee, Joon Seong; Lee, Tae Hee; Choi, Dae Han; Kim, Eui Bae; Jeon, Seong Ran; Hong, Su Jin; Kim, Jin-Oh

    2015-03-01

    "Cat scratch colon" is a gross finding characterized by hemorrhagic mucosal scratches on colonoscopy. It is usually associated with a normal colon and is rarely associated with collagenous colitis. In a previous report, cat scratch colon was noted in the cecum and ascending colon, but has also been observed in the distal transverse colon. The patient in this study was also diagnosed with ischemic colitis that may have played a role in the development of cat scratch colon.

  18. Temporal Comorbidity of Mental Disorder and Ulcerative Colitis

    OpenAIRE

    Cawthorpe, David; Davidson, Marta

    2015-01-01

    The authors used physician diagnoses from Calgary, Alberta, for patient visits from fiscal years 1994 to 2009 for treatment of any presenting concern (763,449 patients) to identify 5113 patients with a diagnosis of ulcerative colitis, and found 4192 patients also had a diagnosis of a mental disorder. Patients with mental disorder had a significantly higher annual prevalence. The mental disorder grouping neuroses/depression was most likely to arise before diagnosis of ulcerative colitis.

  19. Predictive Factors for Severe Outcomes in Ischemic Colitis

    OpenAIRE

    Choi, Seok Reyol; Jee, Sam Ryong; Song, Geun Am; Park, Seun Ja; Lee, Jong Hun; Song, Chul Soo; Park, Hee Ug

    2015-01-01

    Background/Aims Ischemic colitis includes a wide clinical spectrum ranging from mild to severe forms. This study aimed to determine the factors that are related to the occurrence of severe ischemic colitis. Methods This multicenter study was conducted retrospectively in Korea. The patients were divided into mild and severe groups. This study surveyed clinical characteristics, blood tests, endoscopic findings, and imaging studies. Results In the comparison of comorbidities, the severe group ha...

  20. Benign retroperitoneal schwannoma presenting as colitis: A case report

    OpenAIRE

    Fass, Gary; Hossey, Didier; Nyst, Michel; Smets, Dirk; Saligheh, Esmail Najar; Duttmann, Ruth; Claes, Kathleen; da Costa, Pierre Mendes

    2007-01-01

    We report a case of a patient presenting with clinical , radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed, which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma. These neural sheath tumors rarely occur in the retroperitoneum. They are usually asymptomatic but as they enlarge they may compress adjacent structures, which leads to a ...

  1. Hydrophobic adhesin of E coli in ulcerative colitis.

    OpenAIRE

    Burke, D A; Axon, A T

    1988-01-01

    Pathogenic E coli have adhesive properties which are mirrored by an increase in their surface hydrophobicity. E coli isolated from patients with ulcerative colitis possess a mannose resistant adhesin similar to that found in pathogenic E coli. In this study 42 E coli isolates from patients with colitis have been compared with 15 from controls to assess hydrophobicity and cellular adherence. The salting out method and the buccal epithelial cell technique were used respectively. E coli isolated...

  2. Fulminant ulcerative colitis in late pregnancy and the puerperium.

    OpenAIRE

    Anderson, J. B.; Turner, G. M.; Williamson, R C

    1987-01-01

    Four patients underwent emergency colectomy during pregnancy or the puerperium for complications of ulcerative proctocolitis. Three had inactive colitis at conception, while in the fourth the disease started during pregnancy. Three patients required subtotal colectomy and ileostomy for toxic dilatation during the third trimester or within 5 days of delivery, and the fourth underwent proctocolectomy postpartum for intractable colitis. There were no maternal deaths but 2 of 4 infants died. One ...

  3. Dipeptidyl peptidase expression during experimental colitis in mice

    DEFF Research Database (Denmark)

    Yazbeck, Roger; Sulda, Melanie L; Howarth, Gordon S;

    2010-01-01

    We have previously demonstrated that inhibition of dipeptidyl peptidase (DP) activity partially attenuates dextran sulfate sodium (DSS) colitis in mice. The aim of this study was to further investigate the mechanisms of this protection.......We have previously demonstrated that inhibition of dipeptidyl peptidase (DP) activity partially attenuates dextran sulfate sodium (DSS) colitis in mice. The aim of this study was to further investigate the mechanisms of this protection....

  4. Acute respiratory distress syndrome associated with severe ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Shiho; Sagara; Yasuo; Horie; Yumiko; Anezaki; Hideaki; Miyazawa; Masahiro; Iizuka

    2010-01-01

    Various extraintestinal manifestations including pulmonary abnormalities have been reported in patients with ulcerative colitis. Acute respiratory distress syndrome (ARDS) is a serious and fatal pulmonary manifestation. We have experienced a 67-year-old male patient with ARDS associated with a severe type of ulcerative colitis (UC). Severe dyspnea symptoms occurred during the treatment of UC in a previous hospital and the patient was transferred to our hospital on June 27, 2007. Both blood and sputa culture...

  5. Ulcerative colitis Presenting as leukocytoclastic vasculitis of skin

    Institute of Scientific and Technical Information of China (English)

    Sabiye Akbulut; Ersan Ozaslan; Firdevs Topal; Levent Albayrak; Burcak Kayhan; Cumali Efe

    2008-01-01

    A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD),including pyoderma gangrenosum, erythema nodosum,perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions.

  6. Desulfovibrio bacterial species are increased in ulcerative colitis.

    LENUS (Irish Health Repository)

    Rowan, Fiachra

    2012-02-01

    BACKGROUND: Debate persists regarding the role of Desulfovibrio subspecies in ulcerative colitis. Combined microscopic and molecular techniques enable this issue to be investigated by allowing precise enumeration of specific bacterial species within the colonic mucous gel. The aim of this study was to combine laser capture microdissection and quantitative polymerase chain reaction to determine Desulfovibrio copy number in crypt-associated mucous gel in health and in acute and chronic ulcerative colitis. METHODS: Colonic mucosal biopsies were harvested from healthy controls (n = 19) and patients with acute (n = 10) or chronic (n = 10) ulcerative colitis. Crypt-associated mucous gel was obtained by laser capture microdissection throughout the colon. Pan-bacterial 16S rRNA and Desulfovibrio copy number\\/mm were obtained by polymerase chain reaction at each locus. Bacterial copy numbers were interrogated for correlation with location and disease activity. Data were evaluated using a combination of ordinary linear methods and linear mixed-effects models to cater for multiple interactions. RESULTS: Desulfovibrio positivity was significantly increased in acute and chronic ulcerative colitis at multiple levels within the colon, and after normalization with total bacterial signal, the relative Desulfovibrio load was increased in acute colitis compared with controls. Desulfovibrio counts did not significantly correlate with age, disease duration, or disease activity but interlevel correlations were found in adjacent colonic segments in the healthy control and chronic ulcerative colitis groups. CONCLUSION: The presence of Desulfovibrio subspecies is increased in ulcerative colitis and the data presented suggest that these bacteria represent an increased percentage of the colonic microbiome in acute ulcerative colitis.

  7. Reactive arthritis induced by recurrent Clostridium difficile colitis

    Directory of Open Access Journals (Sweden)

    Allison Marr

    2012-01-01

    Full Text Available Clostridium difficile colitis is a common infection that can be difficult to resolve and may result in recurrent infections. Reactive arthritis is a rare presentation of this disease and its treatment is not well differentiated in the literature. We describe a case of reactive arthritis occurring in a patient with a history of recurrent Clostridium difficile colitis while currently receiving a taper of oral vancomycin. His arthritis symptoms resolved with corticosteroids and continued treatment with anticlostridial antibiotics.

  8. Technická analýza

    OpenAIRE

    NĚMEC, Ondřej

    2014-01-01

    Předmětem diplomové práce je technická analýza – vytvoření investičních strategií. V teoretické části jsou popsána teoretická východiska vztahující se k technické analýze a indikátorům. V praktické části je zmapována současná situace v prostředí investování na forexu – porovnání brokerů, výběr platformy apod. Vlastní řešení potom obsahuje popis investičních strategií, které byly naprogramovány v jazyku Meta Quotes Language 4 a testovány a optimalizovány pomocí genetických algoritmů v prostřed...

  9. Segmental colitis associated with diverticulosis syndrome

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2008-01-01

    An inflammatory process that involves the sigmoid colonic segment associated with diverticular disease (SCAD) appears to be a distinct clinical and pathological disorder. It has been described in older adults, often presenting with rectal bleeding. Host of the patients seem to respond to treatment only with a 5-aminosalicylate, but some spontaneously resolve with no treatment. Endoscopic evaluation usually shows a non-specific inflammatory process localized in the sigmoid colon alone that may resolve completely with histologically normal colonic mucosa. Repeated symptomatic events with discrete episodes of segmental colitis may occur, but most patients have an entirely benign clinical course. Definition of the underlying molecular events that occur with SCAD may be critically important in understanding the critical elements present in a colonic inflammatory process that can completely resolve without pharmacological or biological treatment.

  10. Atresia anal, fístula uretrorretal congênita, bolsa escrotal acessória e pseudo-hermafroditismo em bezerro mestiço Anal atresia, congenital urethrorectal fistula, accessory scrotum and pseudohermafroditism in a crossbred calf

    Directory of Open Access Journals (Sweden)

    Thaís Gomes Rocha

    2010-05-01

    Full Text Available Neste trabalho, é descrito o caso de um bezerro mestiço recém-nascido que apresentava atresia anal tipo 2, fístula uretrorretal congênita, bolsa escrotal bífida e pseudo-hermafroditismo masculino. O principal sinal clínico era a eliminação de fezes por meio do óstio prepucial, uma apresentação incomum em casos de fístula uretrorretal em animais machos. Apesar de o quadro de atresia anal ser relativamente comum nessa espécie, os outros defeitos congênitos encontrados são pouco frequentes.In this study, the case of a newborn calf, which presented type 2 anal atresia, congenital urethrorectal fistula, bifid scrotum and male pseudohermafroditism is described. The main clinical sign was the elimination of feces by the prepucial ostium, an unusual finding in cases of urethrorectal fistula in male animals. Although anal atresia is relatively common in bovines, the other congenital defects found in this case are uncommon.

  11. Resíduo da semente de urucum (Bixa orellana L. como corante da gema, pele bico e ovário de poedeiras avaliado por dois métodos analíticos Evaluating of annatto (Bixa orellana L. seeds by-product as yolk, skin, beak and ovary coloring of hens using two analytical methods

    Directory of Open Access Journals (Sweden)

    José Humberto Vilar da Silva

    2006-10-01

    Full Text Available O experimento foi realizado com o objetivo de avaliar o resíduo da semente de urucum (RSU como ingrediente e aditivo corante de diferentes tecidos de 125 poedeiras Lohmann-LSL, com 22 semanas de idade e 1,65 kg de peso vivo, distribuídas num delineamento inteiramente ao acaso em cinco tratamentos com cinco repetições de cinco aves. O tratamento 1 (T1 = ração à base de milho+farelo de soja (M+FS; T2 = ração à base de sorgo (40% + FS; T3 = T2 + 4% RSU; T4 = T2 + 8% RSU e T5 = T2 + 12% RSU. Foram fornecidos 110 g de ração/ave/dia e água à vontade. As coletas foram realizadas em três períodos de 28 dias. A pigmentação dos diferentes tecidos foi avaliada pelo método 1 (M1 do leque colorimétrico da Roche® e, pelo método 2 (M2 do escore "b+", que mede a cor amarela, pelo cromatográfo Minolta® CR-10. Excetuando-se os T1 e T2 da análise de variância, o aumento do RSU na ração com 40% de sorgo melhorou, linearmente, o consumo, produção, massa, conversão alimentar por massa e por dúzia de ovos. A pigmentação da gema analisada pelos M1 e M2, do bico pelo M2 e do ovário pelo M1 melhoraram com o aumento do RSU. Alta correlação (r = 0,72; P A experiment was carried out in the poultry science station of CFT/UFPB with the objective to evalluate the annatto seeds bran (ASB as an ingredient and as an additive colouring of several tissue in 125 hens Lohmann LSL with twenty-two weeks of age, 1.65 kg of live weight, allocated in the completely randomized design, with five treatments and five replication of five hens. The treatment 1 (T1 = diet based on corn and soybean meal; T2 = diet + 40% of sorghum; T3 = T2 + 4% ASB; T4 = T2 + 8% ASB; e T5 = T2 + 12% ASB. The birds were fed 110 g of diet/day and water ad libitum. The collect were obtained in three periods of twenty-eight days. Collor changes were measured with yolk the Roche® collor fan method (M1 and score calculated from "b+" (yellowness of Minolta® CR-10 instrument (M2

  12. Treatment of severe steroid refractory ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Gert Van Assche; Séverine Vermeire; Paul Rutgeerts

    2008-01-01

    Although systemic steroids are highly efficacious in ulcerative colitis (UC),failure to respond to steroids sUll poses an important challenge to the surgeon and physician alike. Even if the life Lime risk of a fulminant UC flare is only 20%, this condition is potentially life threatening and should be managed in hospital. If patients fail 3 to 5 d of intravenous corticosteroids and optimal supportive care, they should be considered for any of three options: intravenous cyclosporine (2 mg/kg for 7 d, and serum level controlled),infliximab (5 mg/kg N,0-2-6 wk) or total colectomy.The choice between these three options is a medicalsurgical decision based on clinical signs, radiological and endoscopic findings and blood analysis (CRP, serum albumin).Between 65 and 85% of patients will initially respond to cyclosporine and avoid colectomy on the short term. Over 5 years only 50% of initial responders avoid colectomy and outcomes are better in patients naive to azathioprine (bridging strategy).The data on infliximab as a medical rescue in fulminant colitis are more limited although the efficacy of this anti tumor necrosis factor (TNF) monoclonal antibody has been demonstrated in a controlled trial. Controlled data on the comparative efficacy of cyclosporine and infliximab are not available at this moment. Both drugs are immunosuppressants and are used in combination with steroids and azathioprine, which infers a risk of serious, even fatal, opportunistic infections. Therefore,patients not responding to these agents within 5-7 d should be considered for colectomy and responders should be closely monitored for infections.

  13. Treatment of severe steroid refractory ulcerative colitis

    Science.gov (United States)

    Assche, Gert Van; Vermeire, Séverine; Rutgeerts, Paul

    2008-01-01

    Although systemic steroids are highly efficacious in ulcerative colitis (UC), failure to respond to steroids still poses an important challenge to the surgeon and physician alike. Even if the life time risk of a fulminant UC flare is only 20%, this condition is potentially life threatening and should be managed in hospital. If patients fail 3 to 5 d of intravenous corticosteroids and optimal supportive care, they should be considered for any of three options: intravenous cyclosporine (2 mg/kg for 7 d, and serum level controlled), infliximab (5 mg/kg IV, 0-2-6 wk) or total colectomy. The choice between these three options is a medical-surgical decision based on clinical signs, radiological and endoscopic findings and blood analysis (CRP, serum albumin). Between 65 and 85% of patients will initially respond to cyclosporine and avoid colectomy on the short term. Over 5 years only 50% of initial responders avoid colectomy and outcomes are better in patients naive to azathioprine (bridging strategy). The data on infliximab as a medical rescue in fulminant colitis are more limited although the efficacy of this anti tumor necrosis factor (TNF) monoclonal antibody has been demonstrated in a controlled trial. Controlled data on the comparative efficacy of cyclosporine and infliximab are not available at this moment. Both drugs are immunosuppressants and are used in combination with steroids and azathioprine, which infers a risk of serious, even fatal, opportunistic infections. Therefore, patients not responding to these agents within 5-7 d should be considered for colectomy and responders should be closely monitored for infections. PMID:18810767

  14. Colitis detection on abdominal CT scans by rich feature hierarchies

    Science.gov (United States)

    Liu, Jiamin; Lay, Nathan; Wei, Zhuoshi; Lu, Le; Kim, Lauren; Turkbey, Evrim; Summers, Ronald M.

    2016-03-01

    Colitis is inflammation of the colon due to neutropenia, inflammatory bowel disease (such as Crohn disease), infection and immune compromise. Colitis is often associated with thickening of the colon wall. The wall of a colon afflicted with colitis is much thicker than normal. For example, the mean wall thickness in Crohn disease is 11-13 mm compared to the wall of the normal colon that should measure less than 3 mm. Colitis can be debilitating or life threatening, and early detection is essential to initiate proper treatment. In this work, we apply high-capacity convolutional neural networks (CNNs) to bottom-up region proposals to detect potential colitis on CT scans. Our method first generates around 3000 category-independent region proposals for each slice of the input CT scan using selective search. Then, a fixed-length feature vector is extracted from each region proposal using a CNN. Finally, each region proposal is classified and assigned a confidence score with linear SVMs. We applied the detection method to 260 images from 26 CT scans of patients with colitis for evaluation. The detection system can achieve 0.85 sensitivity at 1 false positive per image.

  15. Plasma interleukin-18 reflects severity of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Alicja Wiercinska-Drapalo; Robert Flisiak; Jerzy Jaroszewicz; Danuta Prokopowicz

    2005-01-01

    AIM: The aim of this study was to evaluate the association between ulcerative colitis activity and plasma or mucosal concentrations of interleukin (IL)-18.METHODS:Il-18 concentrations were measured in plasma and mucosal samples from 15 patients with active ulcerative colitis (UC).RESULTS: The mean plasma concentration of IL-18 measured in all patients (422±88 pg/mL) doubled the mean value in healthy controls (206±32 pg/mL); however,the difference was not statistically significant. Plasma IL-18 levels revealed a significant positive correlation with scored endoscopic degree of mucosal injury, disease activity index, clinical activity index and C-reactive protein concentration. The mean concentration of plasma IL-18 was significantly higher in patients with severe ulcerative colitis (535±115 pg/mL) than in patients with mild ulcerative colitis (195±41 pg/mL), and in healthy controls.Although the mucosal mean IL-18 concentration in severe ulcerative colitis (2 523±618 pg/mg protein) doubled values observed in mild one (1 347±308 pg/mg protein), there was no statistically significant difference.CONCLUSION: Plasma IL-18 can be considered as a surrogate marker helpful in evaluation of ulcerative colitis activity.

  16. Survey of anal sphincter dysfunction using anal manometry in patients with fecal incontinence: a possible guide to therapy

    Science.gov (United States)

    Mandaliya, Rohan; DiMarino, Anthony J.; Moleski, Stephanie; Rattan, Satish; Cohen, Sidney

    2015-01-01

    Background Despite the surge of new medical and surgical approaches to treat fecal incontinence, the types of sphincter abnormalities in patients with incontinence have not been well characterized. We aimed to categorize anal sphincter dysfunction using anorectal manometry in patients with fecal incontinence as a potential guide for improved treatment. Methods A retrospective review of 162 consecutive patients with fecal incontinence referred for anorectal manometry was performed. Resting anal pressure and maximal squeeze pressure were considered as measures of internal anal sphincter and external anal sphincter function respectively. Results Mean age of the patients was 63 years (13-89); females (81.5%) and males (18.5%). 74% of the patients had sphincter dysfunction on anorectal manometry. Internal anal sphincter dysfunction was present in 62% patients vs. external anal sphincter dysfunction present in 44% patients. 80% females had abnormal manometry vs. 44% in males (P<0.0001). Internal anal sphincter dysfunction was present in 68% females vs. 37% in males (P=0.0026). Conclusions Overall, abnormal anorectal manometry studies revealed that internal anal sphincter dysfunction is the most common finding, alone or in combination with external anal sphincter dysfunction. We suggest that anorectal manometry may be important to delineate anal sphincter function prior to using newer therapeutic mechanical devices. Future studies using pharmacological agents to increase internal anal sphincter tone may be of clinical importance. Finally, the classification of fecal incontinence based on the type of sphincter dysfunction may be an improved guide in the selection of newer agents in treating fecal incontinence. PMID:26423466

  17. [The anal incontinence-- study on 20 operated cases].

    Science.gov (United States)

    Iusuf, T; Sârbu, V; Grasa, C; Cristache, C; Botea, F

    2001-01-01

    The authors present 20 cases operated for anal incontinence. Two techniques were performed: direct repair (18 cases) and Musset-Cottrell procedure (2 cases). The results were excellent in 12 cases, good in 5 cases and satisfactory in 3 cases. The method of choice seems to be the direct repair of the anal sphincter after a proper local and general preparation. PMID:12731180

  18. Kirurgisk behandling af anale fistler ved Crohns sygdom

    DEFF Research Database (Denmark)

    Heyckendorff-Diebold, Tina; Maeda, Yasuko; Buntzen, Steen;

    2012-01-01

    The treatment of transsphincteric anal fistulas in Crohn's disease is a balance between the elimination of the sepsis and the functional outcome. Loose setons can be used as a preoperative drainage or chronic treatment. Fibrin glue and the anal fistula plug are methods with excellent functional o...

  19. Obstetrical anal sphincter injuries and outcome of primary repair

    Directory of Open Access Journals (Sweden)

    Gauri J. Desai

    2016-10-01

    Conclusions: Nulliparity, instrumental delivery, increasing birth weight were high risk factors for obstetrical anal sphincter injuries. Obstetrician needs to be more careful while delivering a patient with multiple risk factors for OASIs. Primary suturing of anal sphincter injury with good post-operative care has a favorable outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3568-3571

  20. Anal cancer and intraepithelial neoplasia screening: A review.

    Science.gov (United States)

    Leeds, Ira L; Fang, Sandy H

    2016-01-27

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors early in the disease process. It is thought that such a strategy of identifying early anal intraepithelial neoplasia will reduce the incidence of invasive anal cancer. The low prevalence of anal cancer in the general population prevents the use of routine screening. However, routine screening of selected populations has been shown to be a more promising strategy. Potential screening modalities include digital anorectal exam, anal Papanicolaou testing, human papilloma virus co-testing, and high-resolution anoscopy. Additional research associating high-grade dysplasia treatment with anal cancer prevention as well as direct comparisons of screening regimens is necessary to develop further anal cancer screening recommendations. PMID:26843912

  1. Sotsiaalvõrgustike analüüs / Innar Liiv

    Index Scriptorium Estoniae

    Liiv, Innar, 1982-

    2005-01-01

    Sotsiaalvõrgustike analüüs (social network analys - SNA) on tehnikate, meetodite ning vahendite kogum, mis aitab avastada mustreid sotsiaalsetes struktuurides. Analüüsi kasutamisest energeetikaettevõtte Enron ja kohalike ettevõtete võrgustike näitel. Skeemid

  2. Overexpression of Elastin Affects the Protease to Anti-Protease Balance and Protects Mice from Colitis. : Elafin protects from colitis

    OpenAIRE

    Motta*, Jean-Paul; Magne, Laurent; Descamps, Delphyne; Rolland, Corinne; Squarzoni-Dale, Camila; Rousset, Perrine; Balloy, Viviane; Huerre, Michel; Jenne, Dieter; Wartelle, Julien; Belaaouaj, Azzaq; Mas, Emmanuel; Vinel, Jean-Pierre; Alric, Laurent; Chignard, Michel

    2010-01-01

    BACKGROUND & AIMS:: Colon tissues of patients with inflammatory bowel disease (IBD) have been reported to have increased proteolytic activity, but no studies have clearly addressed the protease to anti-protease balance in the pathogenesis of colitis. We investigated the role of Elafin, a serine protease inhibitor expressed by skin and mucosal surfaces in human inflammatory conditions, and the proteases neutrophil elastase (NE) and proteinase-3 (PR-3), in mice with colitis. METHODS:: We studie...

  3. Quantification by computerized morphometry of tissue levels of sulfomucins and sialomucins in diversion colitis in rats Quantificação por morfometria computadorizada dos níveis teciduais de sulfomucinas e sialomucinas na colite de exclusão em ratos

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Real Martinez

    2010-06-01

    Full Text Available PURPOSE: To quantify the intensity of sulfomucin and sialomucin expression in the colon mucosa, by means of computer-assisted image processing, comparing segments with and without fecal stream and correlating with the duration of fecal transit exclusion. METHODS: Forty-five Wistar rats were subjected to diversion of the fecal stream in the left colon by means of constructing a proximal colostomy and distal mucosal fistula. They were distributed randomly into three experimental groups of 15 animals, of which 10 were subjected to colon diversion (experimental subgroup and five were only subjected to laparotomy, without colon diversion (control subgroup. The three experimental groups were formed according to the sacrifice date, which was to be performed six weeks after the surgical procedure (Group A, 12 weeks (Group B and 18 weeks (Group C. The sulfomucin and sialomucin expression in the colon mucosa was evaluated using the histochemical technique of high iron diamine-alcian blue (HID-AB. The tissue expression was quantified for each animal, in the segments with and without fecal stream, at a location where there were four complete contiguous crypts in two random fields, with the aid of the computer-assisted image analysis software. The final value was taken to be the mean reading from the two fields selected, in the segments with and without fecal stream. To compare the expressions of the two mucin subtypes in the segments with and without fecal stream, the paired Student t test was used. To analyze variance according to duration of exclusion, ANOVA with the Newman-Keuls post-test was used, setting the significance level at 5% (pOBJETIVO: Quantificar, por meio de processamento de imagem assistida por computador, a intensidade de expressão de sulfomucinas e sialomucinas na mucosa cólica comparando segmentos com e sem trânsito e relacionando-a ao tempo de exclusão de trânsito fecal. MÉTODOS: Quarenta e cinco ratos Wistar machos foram

  4. Chronic anal fissure: new approaches to chemical sphincterotomy

    Directory of Open Access Journals (Sweden)

    Mohammad hassan Emami

    2008-06-01

    Full Text Available

    • An anal fissure is a split in the mucosa extending from the anal verge towards the dentate line. It currently affects 10% of patients attending proctology clinics. Recent studies have highlighted the role of increased internal anal sphincter pressure and decreased anodermal blood flow in the pathogenesis of chronic anal fissures. Acute fissures usually heal with conservative management. Fissures lasting greater than two months with features of chronicity, are unlikely to heal with conservative management. Lateral internal sphincterotomy has been the treatment of choice for chronic anal fissures. Because of the disability associated with surgery for healing anal fissure and the risk of incontinence, medical alternatives for surgery have been sought. Among different chemical agents, Glyceryl trinitrate (GTN has been shown to be the first line treatment for chronic anal fissure but the transient sphincteric relaxation effect of pharmacologic agents such as GTN, makes them less effective than surgery. Although we have different forms of GTN products, they do not show a long acting effect on relaxing and enhancing the perfusion of anal sphincter, because they are soon metabolized. Most difficulties with current usage of drugs are due to poor compliance of patients. It can be taken into consideration that new formulation and novel combination of GTN with other treatments, in slow releasing forms may lead to acceptable strategies in the management of chronic anal fissure. As authors’ experience in this field, other clinical trials on the drug combination and slow releasing formulations are warranted to generate new data on the subject.
    • Key word: chronic anal fissure, review, chemical sphincterotomy 

  5. Trends in incidence of anal cancer and high-grade anal intraepithelial neoplasia in Denmark, 1978-2008

    DEFF Research Database (Denmark)

    Nielsen, Ann; Plum, Christian Edinger Munk; Kjaer, Susanne K

    2012-01-01

    The aim of the study was to determine the incidences of anal cancer and high-grade anal intraepithelial neoplasia (AIN2/3) over time in Danish women and men. Describing the burden of anal cancer and AIN may be valuable in future evaluations of the human papillomavirus (HPV) vaccine. We included all......-associated histological types levelled out or even declined during the 30 years of observation. In women, the increase in HPV-associated cancers was more pronounced among those under 60 years of age. Our findings indicate that vaccines against HPV might play an important role in the prevention of anal cancer and its...... cases of AIN2/3 during the study period. The average annual percentage change of 5% between 1998 and 2008 represents a steep increase in the incidence of AIN in both genders. Furthermore, the incidence rate of HPV-associated anal cancers increased significantly, whereas that of non-HPV...

  6. Anales del Museo del Pueblo Español y Anales del Museo Nacional de Antropología. Aproximación bibliométrica

    Directory of Open Access Journals (Sweden)

    Carretero Pérez, Andrés

    2002-06-01

    Full Text Available The author presents a preliminary bibliometric discussion of the journal Anales, originally published by the National Museum of the Spanish People and in recent years by the National Museum of Anthropology after the incorporation of the former museum into the latter. Though at the service of this museum, Anales is open to contributions from outside, which address an increasingly wide range of topics as the importance of the journal for Spanish researchers grows.

    El texto presenta una primera aproximación bibliométrica a las revistas publicadas por el Museo Nacional del Pueblo Español, y por el Museo Nacional de Antropología tras la integración de aquél en éste. Aunque cumple su tarea de órgano de expresión del Museo, Anales es una revista abierta y la mayor parte del contenido se debe a colaboraciones externas, de temática cada vez más variada a medida que su presencia en el panorama investigador español se consolida.

  7. Loss of n-6 fatty acid induced pediatric obesity protects against acute murine colitis

    Science.gov (United States)

    Dietary influences may affect microbiome composition and host immune responses, thereby modulating propensity toward inflammatory bowel diseases: Crohn disease and ulcerative colitis. Dietary n-6 fatty acids have been associated with ulcetative colitis in prospective studies. However, the critical d...

  8. Spontaneous colitis in Muc2-deficient mice reflects clinical and cellular features of active ulcerative colitis.

    Directory of Open Access Journals (Sweden)

    Ulf A Wenzel

    Full Text Available The colonic mucus layer plays a critical role in intestinal homeostasis by limiting contact between luminal bacteria and the mucosal immune system. A defective mucus barrier in animal models allows bacterial contact with the intestinal epithelium and results in spontaneous colitis. A defective mucus barrier is also a key feature of active ulcerative colitis (UC. Alterations in the immune compartment due to intestinal bacterial breach in mice lacking the colon mucus barrier have not been characterized and correlated to active UC.To characterize alterations in the immune compartment due to intestinal bacterial breach in Muc2-/- mice, which lack the colon mucus barrier, and correlate the findings to active UC.Bacterial contact with colon epithelium and penetration into colon tissue was examined in Muc2-/- mice and colon biopsies from patients with active UC using fluorescence microscopy and qPCR. Neutrophils, lymphocytes, CD103+ dendritic cell subsets and macrophages in colon from Muc2-/- mice and biopsies from UC patients were quantitated by flow cytometry.Inflamed UC patients and Muc2-/- mice had bacteria in contact with the colon epithelium. Bacterial rRNA was present in colonic mucosa in humans and Muc2-/- mice and in the draining lymph nodes of mice. Inflamed Muc2-/- mice and UC patients had elevated colon neutrophils, T cells and macrophages while a reduced frequency of CD103+ DCs was present in the inflamed colon of both mice and humans.The parallel features of the colon immune cell compartment in Muc2-/- mice and UC patients supports the usefulness of this model to understand the early phase of spontaneous colitis and will provide insight into novel strategies to treat UC.

  9. Aspectos psicopatológicos en la enfermedad de Crohn y en la colitis ulcerosa

    Directory of Open Access Journals (Sweden)

    Stefano Vinaccia

    2007-06-01

    Full Text Available son trastornos crónicos que inflaman y destruyen el tejido intestinal de forma periódica y recurrente. Las EII se clasifican en dos tipos: enfermedad de Crohn (EC y colitis ulcerosa (CU. La etiología tanto de la EC como de la CU es poco conocida y el curso está influido por múltiples factores de tipo biopsicosocial. Al respecto, diversas investigaciones están aportando evidencia de la implicación de factores psicológicos en el curso de las EII, tales como el estrés psicosocial, las estrategias de afrontamiento, las características de personalidad, los síntomas psicopatológicos y el apoyo social

  10. Electroacupuntura en el tratamiento de la colitis ulcerosa experimental en ratas Sprague Dawley - Electro acupuncture in the treatment of experimental ulcerous colitis in Sprague Dawley rats

    Directory of Open Access Journals (Sweden)

    Molina Martínez, José L.

    2010-08-01

    Full Text Available ResumenSe realizó un estudio sobre la efectividad terapéutica de la electroacupuntura (EA en la colitis ulcerosa (CU provocada experimentalmente en ratas Sprague Dawley por administración intracolónica de una disolución de ácido acético al 4%. El experimento se realizó en 57 ratas distribuidas en tres grupos: Grupo I (control placebo, al que se administró solución salina fisiológica mediante instilación intracolónica, Grupo II (control no tratado y Grupo III (estudio, integrado ambos por animales en que se reprodujo artificialmente la colitis ulcerosa. El estudio histopatológico de muestras tomadas mediante biopsias permitió corroborar la instauración de la entidad. Los acupuntos seleccionados fueronLI-4 (Hegu y ST-36 (Zusanli y la aplicación de la EA se realizó a las 24, 48 y 72 horas posteriores a la reproducción experimental de la CU. En las condiciones del estudio se comprobó que una sesión de EA a las 24 horas posteriores a la reproducción de la entidad, posee efecto anti inflamatorio y mejora notablemente la lesión tisular, no siendo eficaz en los tratamientos realizados a las 48 y 72 horas, influyendo en ello el mecanismo de transducción. Mediante el estudio histopatológico de muestras tomadas mediante biopsias se puede evaluar el estado de la mucosa en la CU y su respuesta al tratamiento mediante EA, sin necesidad de acudir a otros procedimientos más sofisticados y costosos. Se comprobó que el modelo experimental utilizado es adecuado para estudios sobre esta afección.SummaryA study was carried out on the therapeutic effectiveness ofelectroacupuncture (EA in the ulcerous colitis (UC experimentally provoked in Sprague Dawley rats by intracolonic administration of a 4 % acetic acid dissolution. The experiment was realized in 57 rats distributed in three groups: Group I (placebo control, to which physiological saline solution was administered by intracolonic instillation, Group II (not treated control and Group

  11. Analýza vybrané firmy

    OpenAIRE

    Žahourek, Martin

    2010-01-01

    V dnešní nelehké situaci musí organizace obzvlášť pečlivě sledovat svoje hospodaření a plánovat. Cílem této práce je zhodnotit aktuální situace společnosti Centropen a.s.. Použitými nástroji jsou finanční analýza, fundamentální analýza, SLEPTE analýza a Porterova analýza pěti sil. Výsledky těchto analýz jsou dále zpracovány ve SWOT analýza, ta je potom porovnána se SWOT analýzou k situaci z roku 2006. Today, in the hard situation, must organization very carefully observe its economy and pl...

  12. Clostridium difficile associated infection, diarrhea and colitis

    Institute of Scientific and Technical Information of China (English)

    Perry Hookman; Jamie S Barkin

    2009-01-01

    A new, hypervirulent strain of Clostridium difficile, called NAP1/BI/027, has been implicated in C. difficile outbreaks associated with increased morbidity and mortality since the early 2000s. The epidemic strain is resistant to fluoroquinolones in vitro, which was infrequent prior to 2001. The name of this strain reflects its characteristics, demonstrated by different typing methods: pulsed-field gel electrophoresis (NAP1), restriction endonuclease analysis (BI) and polymerase chain reaction (027). In 2004 and 2005, the US Centers for Disease Control and Prevention (CDC) emphasized that the risk of C. difficile-associated diarrhea (CDAD) is increased, not only by the usual factors, including antibiotic exposure, but also gastrointestinal surgery/manipulation, prolonged length of stay in a healthcare setting, serious underlying illness, immune-compromising conditions, and aging. Patients on proton pump inhibitors (PPIs) have an elevated risk, as do peripartum women and heart transplant recipients. Before 2002, toxic megacolon in C. difficile-associated colitis (CDAC), was rare, but its incidence has increased dramatically. Up to twothirds of hospitalized patients may be infected with C. difficile. Asymptomatic carriers admitted to healthcare facilities can transmit the organism to other susceptible patients, thereby becoming vectors. Fulminant colitis is reported more frequently during outbreaks of C. difficile infection in patients with inflammatory bowel disease (IBD). C. difficile infection with IBD carries a higher mortality than without underlying IBD. This article reviews the latest information on C. difficile infection, including presentation, vulnerable hosts and choice of antibiotics, alternative therapies, and probiotics and immunotherapy. We review contact precautions for patients with known or suspected C. difficileassociated disease. Healthcare institutions require accurate and rapid diagnosis for early detection of possible outbreaks, to initiate

  13. Observer variability in the histopathologic diagnosis of microscopic colitis and subgroups

    DEFF Research Database (Denmark)

    Fiehn, Anne-Marie Kanstrup; Bjørnbak, Camilla; Warnecke, Mads;

    2013-01-01

    The diagnosis of microscopic colitis (MC) is based on histologic findings and includes collagenous colitis (CC) and lymphocytic colitis (LC). Incomplete MC (MCi) denotes patients with chronic diarrhea and a normal endoscopy and morphological changes that do not completely meet the histologic crit...

  14. Microscopic colitis : prevalence and distribution throughout the colon in patients with chronic diarrhoea

    NARCIS (Netherlands)

    Thijs, WJ; van Baarlen, J; Kleibeuker, JH; Kolkman, JJ

    2005-01-01

    Background: Microscopic colitis presents with chronic diarrhoea with or without abdominal pain. Microscopic colitis is an important cause of chronic diarrhoea. It can be distributed throughout the colon, as well as limited to the right colon. Microscopic colitis is associated with coeliac disease. W

  15. Metachronous tubulovillous and tubular adenomas of the anal canal

    OpenAIRE

    NOZAWA, HIROAKI; ISHIHARA, SOICHIRO; Morikawa, Teppei; Tanaka, Junichiro; YASUDA, KOJI; Ohtani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Hata, Keisuke; Kazama, Shinsuke; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji

    2015-01-01

    Anal canal adenoma is an extremely rare disease that has the potential to transform into a malignant tumor. We herein presented a rare case of metachronous multiple adenomas of the anal canal. A 48-year-old woman underwent total colonoscopy following a positive fecal blood test. A 9-mm villous polyp arising from the posterior wall of the anal canal was removed by snare polypectomy. Histologically, the tumor was tubulovillous adenoma with high-grade dysplasia and the cut end was negative for t...

  16. Surgical Management of Severe Colitis in the Intensive Care Unit.

    Science.gov (United States)

    Halaweish, Ihab; Alam, Hasan B

    2015-12-01

    Severe colitis, an umbrella encompassing several entities, is one of the most common acute gastrointestinal disorders resulting in critical illness. Clostridium difficile infection is responsible for the majority of nosocomial diarrhea with fulminant C difficile colitis (CDC) carrying a high mortality. Optimal outcomes can be achieved by early identification and treatment of fulminant CDC, with appropriate surgical intervention when indicated. Ischemic colitis, on the other hand, is uncommon with a range of etiological factors including abdominal aortic surgery, inotropic drugs, rheumatoid diseases, or often no obvious triggering factor. Most cases resolve with nonsurgical management; however, prompt recognition of full-thickness necrosis and gangrene is crucial for good patient outcomes. Fulminant colitis is a severe disease secondary to progressive ulcerative colitis with systemic deterioration. Surgical intervention is indicated for hemorrhage, perforation, or peritonitis and failure of medical therapy to control the disease. Although, failure of medical management is the most common indication, it can be difficult to define objectively and requires a collaborative multidisciplinary approach. This article proposes some simple management algorithms for these clinical entities, with a focus on critically ill patients.

  17. Interleukin 19 reduces inflammation in chemically induced experimental colitis.

    Science.gov (United States)

    Matsuo, Yukiko; Azuma, Yasu-Taka; Kuwamura, Mitsuru; Kuramoto, Nobuyuki; Nishiyama, Kazuhiro; Yoshida, Natsuho; Ikeda, Yoshihito; Fujimoto, Yasuyuki; Nakajima, Hidemitsu; Takeuchi, Tadayoshi

    2015-12-01

    Inflammatory bowel disease results from chronic dysregulation of the mucosal immune system and aberrant activation of both the innate and adaptive immune responses. Interleukin (IL)-19, a member of the IL-10 family, functions as an anti-inflammatory cytokine. Here, we investigated the contribution of IL-19 to intestinal inflammation in a model of T cell-mediated colitis in mice. Inflammatory responses in IL-19-deficient mice were assessed using the 2,4,6-trinitrobenzene sulfonic acid (TNBS) model of acute colitis. IL-19 deficiency aggravated TNBS-induced colitis and compromised intestinal recovery in mice. Additionally, the exacerbation of TNBS-induced colonic inflammation following genetic ablation of IL-19 was accompanied by increased production of interferon-gamma, IL-12 (p40), IL-17, IL-22, and IL-33, and decreased production of IL-4. Moreover, the exacerbation of colitis following IL-19 knockout was also accompanied by increased production of CXCL1, G-CSF and CCL5. Using this model of induced colitis, our results revealed the immunopathological relevance of IL-19 as an anti-inflammatory cytokine in intestinal inflammation in mice.

  18. Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review

    Science.gov (United States)

    Shirley, Debbie-Ann; Moonah, Shannon

    2016-01-01

    Background Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high mortality and morbidity. We conducted a review of the English literature to describe cases of fulminant amebic colitis associated with exposure to corticosteroid medications in order to identify the risk factors for poor outcome and determine difficulties in diagnosis and treatment. Methodology and Principal Findings Articles reporting severe and fulminant forms of amebic colitis between 1991 and 2016 were collected. 525 records were screened to identify 24 cases for qualitative analysis associated with corticosteroid use. Cases arose from areas of high endemicity or travel to such areas. Most cases (14 of 24, 58%) were given corticosteroids for initially misdiagnosed colitis, mainly inflammatory bowel, resulting in rapid progression of disease. Nearly half of all cases underwent surgical intervention, and 25% of cases died, despite all patients eventually receiving treatment with metronidazole. The odds of death did not differ significantly by prior misdiagnosis, co-morbidities, bowel perforation or need for surgery. Conclusions and Significance Infection with E. histolytica should be considered prior to the administration of corticosteroids, in particular for patients residing in endemic areas or those with appropriate travel history, especially prior to the diagnosis of inflammatory bowel disease. The development of preventative and treatment interventions are needed to improve outcomes of fulminant disease. PMID:27467600

  19. DO CHANGES IN ANAL SPHINCTER ANATOMY CORRELATE WITH ANAL FUNCTION IN WOMEN WITH A HISTORY OF VAGINAL DELIVERY?

    Directory of Open Access Journals (Sweden)

    Sthela Maria MURAD-REGADAS

    2014-09-01

    Full Text Available Objectives To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Methods Female with fecal incontinence and vaginal delivery were assessed with Wexner’s score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS, the anterior and posterior internal anal sphincter (IAS, the EAS + puborectal and the gap were measured and correlated with score. Results Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Conclusions Avaliar a anatomia do esfíncter anal usando ultra-sonografia tridimensional (3D-US em mulheres incontinentes com parto vaginal, correlacionar os achados anatômicos com sintomas de incontinência fecal e, determinar o efeito do parto vaginal sobre a anatomia e função do canal anal.

  20. Pseudomembranous colitis: CT findings in children

    International Nuclear Information System (INIS)

    A spectrum of nodular haustral thickening and an 'accordion' pattern have been reported as specific features of pseudomembranous colitis (PMC) in adults. A retrospective review of nine patients with PMC was performed to assess whether this spectrum of CT findings also occurred in children. In four girls and five boys, CT scans were performed within 3 days of a positive stool toxin assay for Clostridium difficile. Documented CT abnormalities included nodular haustral thickening, the 'accordion' pattern, colonic wall thickening, ascites, and pericolonic edema. These results were then correlated as to their impact on the clinical outcome. Circumferential colon wall thickening was identified in 7/9 (78%) patients (mean thickening 14.5 mm). Nodular haustral thickening was identified in 4/9 (44%) and the 'accordion' pattern in 2/9 (22%). Other findings included pericolonic edema in 3/9 (33%) and ascites in 1/9 (11%). Wall thickening was confined to the left colon and rectum in 2/9 (22%), to the right colon in 2/9 (22%), and involved the whole colon in 3/9 (33%). Although CT findings associated with PMC in children may be suggestive for this diagnosis, CT is less specific than laboratory and clinical findings. (orig.)

  1. Antineutrophil cytoplasmic autoantibodies in ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Vodjgani M

    2000-10-01

    Full Text Available Antineutrophil cytoplasmic autoanibodies (ANCA were detecte in patients with certain autoimmune vascular disease such as Wegner’s granulomatosis, polyarthrits nodosa and systemic luuc erythematous. Indirect immunofluorescence (IIF technique was employed to detec these autoantibodies.ANCA have been recently detected in some forms of inflammatory bowel disease (IBD, ulcerative colitis (U.C. Crohn’s disease (C.D and primary sclerosing cholangitis (PSC. By IIF method, two general patterns of ANCA were seen: a cytoplasmic (C-ANCA and perinuclear form (P-ANCA. In this study we evaluated the presece of ANCA in 52 U.C. patients and 69 matched normal control group by IIF technique, and it’s relationship with disease activity. Site of colon involvement and, lesion extent. The results showed that all control group were ANCA negative, but 58% of patients had ANCA, and most cases (70% had C- ANCA. The obtained results also revealed that there was no relationship between ANCA and disease activity

  2. Relapsing and refractory ulcerative colitis in children.

    Science.gov (United States)

    Turner, Dan

    2014-01-01

    Approximately half of the children with ulcerative colitis (UC) have refractory, relapsing or steroid-dependent disease. UC in children is more extensive than in adults, presents more often with severe attacks and carries a more aggressive disease course. Therefore, although a step-up approach is usually recommended in UC, aggressive therapy will often be indicated in children since steroid dependency should never be tolerated. It is vital to ensure that in every resistant case, the symptoms are truly related to the inflammatory disease activity and not to other conditions such as poor adherence to treatment, infections, adverse reactions to drugs, irritable bowel syndrome, lactose intolerance, celiac disease and bacterial overgrowth. The clinician should be ready to escalate therapy in a timely manner but only after ensuring optimization of current treatments. Optimization may include, among others, appropriate dosage, utilization of assays that determine thiopurine, calcineurin inhibitors and anti-tumor necrosis factor levels, introduction of combination therapy when indicated (enemas and immunomodulators) and a long enough time for treatment to become effective. Colectomy is always a valid option and should be discussed before major treatment escalations. Experimental therapies can be considered when all else fails and the family prefers to avoid colectomy. The management of refractory and relapsing disease is particularly challenging in children, and this review summarizes the available evidence to guide treatment decisions in this setup. PMID:24969290

  3. Relationship between Ulcerative Colitis and Lung Injuries

    Institute of Scientific and Technical Information of China (English)

    Zhi-peng Tang; Jia-wei Wu; Yan-cheng Dai; Ya-li Zhang; Rong-rong Bi

    2015-01-01

    Objective To explore the relationship between ulcerative colitis (UC) and lung injuries by assessing their clinical manifestations and characteristics. Methods From July 2009 to April 2012, 91 UC patients presenting to Longhua Hospital who met the established inclusion and exclusion criteria were enrolled in this retrospective study. According to the scores of disease activity index, the patients were divided into the mild, moderate, and severe groups. Meanwhile, the records of pulmonary symptoms, chest X-ray image, and pulmonary function were reviewed. Results Sixty-eight (74.7%) patients had at least 1 pulmonary symptom, such as cough (38.5%), shortness of breath (27.5%), and expectoration (17.6%). And 77 (84.6%) had at least 1 ventilation abnormality. Vital capacity value was significantly lower in the severe group than that in the mild group (91.82%±10.38%vs. 98.92%±12.12%, P Conclusions Lung injury is a common extraintestinal complication of UC. According to the theory in Traditional Chinese Medicine that the lung and large intestine are related, both the lungs and large intestine should be treated simultaneously.

  4. Cytomegalovirus Colitis in a Burn Patient.

    Science.gov (United States)

    Gibbs, Jeff T; Zieger, Madeline; Sood, Rajiv

    2016-01-01

    The prevalence of cytomegalovirus in the burn population is high. However, its role in the clinical management of burn patients is still being defined. This report documents a 41-year-old man who developed cytomegalovirus (CMV) colitis after being admitted with a 72% burn. Before the administration of ganciclovir, the authors had difficulty controlling his quantitative wound cultures with serial debridements, topical agents, and systemic antibiotics for known pathogens, which led to graft loss. After the ganciclovir was given, his quantitative wound cultures improved without changing the authors' topical agents or systemic antibiotics and had improved graft take. Whether CMV infection alone contributed to an increased morbidity in this patient or the combination of bacteria/fungal infection with CMV led to a synergistic effect is still not clearly understood. CMV may have contributed to a dysfunction in his cell mediated immunity, which, in turn, lowered the bacterial and fungal load necessary to cause graft loss. Patients who continue to do poorly despite adequate treatment for known pathogens may need to be screened for CMV and treated. PMID:26056763

  5. Radical induction theory of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Jay Pravda

    2005-01-01

    To propose a new pathogenesis called Radical Induction to explain the genesis and progression of ulcerative colitis (UC). UC is an inflammatory bowel disease. Colonic inflammation in UC is mediated by a buildup of white blood cells (WBCs) within the colonic mucosal lining; however,to date there is no answer for why WBCs initially enter the colonic mucosa to begin with. A new pathogenesis termed "Radical Induction Theory" is proposed to explain this and states that excess un-neutralized hydrogen peroxide, produced within colonic epithelial cells as a result of aberrant cellular metabolism, diffuses through cell membranes to the extracellular space where it is converted to the highly damaging hydroxyl radical resulting in oxidative damage to structures comprising the colonic epithelial barrier. Once damaged, the barrier is unable to exclude highly immunogenic fecal bacterial antigens from invading the normally sterile submucosa. This antigenic exposure provokes an initial immune response of WBC infiltration into the colonic mucosa. Once present in the mucosa,WBCs are stimulated to secrete toxins by direct exposure to fecal bacteria leading to mucosal ulceration and bloody diarrhea characteristic of this disease.

  6. Pseudomembranous colitis: CT findings in children

    Energy Technology Data Exchange (ETDEWEB)

    Blickman, J.G. [Massachusetts General Hospital, Boston, MA (United States); Boland, G.W.L. [Massachusetts General Hospital, Boston, MA (United States); Cleveland, R.H. [The Children`s Hospital, Boston, MA (United States); Bramson, R.T. [Massachusetts General Hospital, Boston, MA (United States); Lee, M.J. [Massachusetts General Hospital, Boston, MA (United States)

    1995-11-01

    A spectrum of nodular haustral thickening and an `accordion` pattern have been reported as specific features of pseudomembranous colitis (PMC) in adults. A retrospective review of nine patients with PMC was performed to assess whether this spectrum of CT findings also occurred in children. In four girls and five boys, CT scans were performed within 3 days of a positive stool toxin assay for Clostridium difficile. Documented CT abnormalities included nodular haustral thickening, the `accordion` pattern, colonic wall thickening, ascites, and pericolonic edema. These results were then correlated as to their impact on the clinical outcome. Circumferential colon wall thickening was identified in 7/9 (78%) patients (mean thickening 14.5 mm). Nodular haustral thickening was identified in 4/9 (44%) and the `accordion` pattern in 2/9 (22%). Other findings included pericolonic edema in 3/9 (33%) and ascites in 1/9 (11%). Wall thickening was confined to the left colon and rectum in 2/9 (22%), to the right colon in 2/9 (22%), and involved the whole colon in 3/9 (33%). Although CT findings associated with PMC in children may be suggestive for this diagnosis, CT is less specific than laboratory and clinical findings. (orig.)

  7. Management of acute severe ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Saurabh; Kedia; Vineet; Ahuja; Rakesh; Tandon

    2014-01-01

    The management strategy of acute severe ulcerative colitis has evolved over the past decade from being entirely restricted to twin choices of intravenous steroids or colectomy to include colon rescue therapies like cyclosporin as well as infliximab. However it still remains a medical emergency requiring hospitalization and requires care from a multidisciplinary team comprising of a gastroenterologist and a colorectal surgeon. The frame shift in management has been the emphasis on time bound decision making with an attempt to curtail the mortality rate to below 1%. Intravenous corticosteroids are the mainstay of therapy. Response to steroids should be assessed at day 3 of admission and partial/non-responders should be considered for alternative medical therapy/surgery. Medical rescue therapies include intravenous cyclosporin and infliximab. Cyclosporin is administered in a dose of 2 mg/kg per day and infliximab is administered as a single dose intravenous infusion of 5 mg/kg. Approximately 75% patients have short term and 50% patients have long term response to cyclosporin. Long term response to cyclosporin is improved in patients who are thiopurine na?ve and are started on thiopurines on day 7. Infliximab also has a response rate of approximately 70% in short term and 50% in long term. Both cyclosporin and infliximab are equally efficacious medical rescue therapies as demonstrated in a recent randomized control trial. Patientsnot responding to infliximab or cyclosporin should be considered for colectomy.

  8. The classification and staging of cancerous growths of the anal canal

    International Nuclear Information System (INIS)

    In this chapter authors give information about frequency of cancerous growths of the anal canal, general analysis of observations the classification and staging of cancerous growths of the anal canal, clinical-anatomy classification of cancerous growths of the anal canal and staging of cancerous growths of anal canal

  9. MRI in evaluating atrophy of the external anal sphincter in patients with fecal incontinence

    NARCIS (Netherlands)

    M.P. Terra; R.G.H. Beets-Tan; V.P.M. van der Hulst; M. Deutekom; M.G.W. Dijkgraaf; P.M.M. Bossuyt; A.C. Dobben; C.G.M.I. Baeten; J. Stoker

    2006-01-01

    OBJECTIVE. External anal sphincter atrophy seen at endoanal MRI may predict poor outcome of surgical anal sphincter repair for an external anal sphincter defect. The purposes of this study were to compare external phased-array MRI to endoanal MRI for depicting external anal sphincter atrophy in pati

  10.  Surgical excision of extensive anal condylomata is a safe operation without risk of anal stenosis

    Directory of Open Access Journals (Sweden)

    Konrad Wroński

    2012-03-01

    Full Text Available  Introduction:Anal condylomata acuminata was a well-known disease in ancient times but in recent years there has been a rapidly increasing number of people who suffer from this disease. The main cause of this disease is infection of human papilloma virus (HPV which occurs through sexual contact.Currently there are three different ways to treat anal condylomata. Small changes of anal condylomata can be treated with local therapeutic agents, but the best results of treatment of extensive changes are obtained by surgical techniques.Material/Methods:The study group consisted of 30 patients with diagnosed extensive anal condylomata who underwent surgery in Mikolaj Pirogow High Specialized Hospital in Lodz. The survey was conducted from 2007 to 2011. Patients had been directed to the surgical ward by general surgeons and practitioners, proctologists and urologists. The diagnosis was made after proctological assessment in the knee-chest position.Results:All patients underwent surgery and had complete macroscopic electroexcision of anal condylomata. In the research group there was no mortality. Postoperative complications occurred in 4 (13.3�20patients – postoperative bleeding. Strong pain was present in 14 (46.7�20patients but only in the postoperative period. During postoperative follow-up there was no observed infection in the anal region or recurrence of disease. In the operated group there were no observed cosmetic deformations of the anus and/or the anal canal, narrow anal canal or functional fecal incontinence symptoms.Conclusions:Surgical treatment of anal condylomata is an effective and safe method for the patient. In our research there were no serious postoperative complications or recurrence of the disease during the follow-up period.

  11. Indicação da anuscopia de alta resolução e citologia anal na prevenção de HPV e câncer colorretal em pacientes portadores de HIV Indication of high resolution anoscopy and anal cytology for prevention of HPV and colorectal cancer in HIV patients

    OpenAIRE

    Hugo Leonardo Madeiro Arcanjo Silva; Leandro Valério Costa Batista; Luciane de Lima Moura; Luís Carlos Vieira Tavares Júnior; Juliana Aroucha; Sandra Gico Belo; Manoel Álvaro Lins Neto

    2010-01-01

    OBJETIVO: Rastreamento do papilomavírus humano (HPV) assim como sua correlação com a neoplasia anorretal nos pacientes portadores do vírus da imunodeficiência humana (HIV) por meio da anuscopia de alta resolução (AAR) e da citologia anal. MÉTODOS: Desenvolvemos um estudo observacional, transversal e duplo-cego em que participaram 31 pacientes portadores do HIV independente de queixas proctológicas. Os pacientes foram submetidos à AAR e citologia anal cujas lâminas foram enviadas ao setor de a...

  12. Computed tomography of Crohn`s disease and ulcerative colitis; Computertomographische Morphologie von Morbus Crohn und Colitis ulcerosa

    Energy Technology Data Exchange (ETDEWEB)

    Klein, H.M. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Wein, B. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Adam, G. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Ruppert, D. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany); Guenther, R.W. [Klinik fuer Radiologische Diagnostik der RWTH, Aachen (Germany)

    1995-07-01

    We analysed the CT examinations of 109 patients with 197 involved bowel locations. 81 patients suffered from Crohn`s disease, 28 from ulcerative colitis. Diagnosis was based on the combination of clinical, endoscopic and histopathologic findings. Three radiologists evaluated the CT series concerning the presence of morphologic changes analogous to conventional radiographic findings. In Crohn`s disease, we found irregular outer contours in 26% of cases. The bowel wall was thickened in 82%. In acute phases, the bowel wall was thickened in 100%. Abscess and fistula as complications of inflammatory disease were present in 26 and 14% respectively. In ulcerative colitis, a target sign of the bowel wall was present in 40%, whereas in Crohn`s disease a homogeneous wall density was present in all but two cases. Reduced attenuation due to submucosal fat deposits was found in 16% and mucosal tunneling in 27% of cases with ulcerative colitis. Even if severe mucosal destructions were found, the outer contour of the gut was smooth and regular in 95% of the ulcerative colitis cases. CT can provide additional information on acuity, extent and complications in inflammatory bowel disease. In combination with conventional radiographic findings a three-step classification for Crohn`s disease and ulcerative colitis (early changes, acute and chronic phase) can be proposed. (orig./MG) [Deutsch] Wir untersuchten computertomographisch 109 Patienten mit 197 erkrankten Darmsegmenten. 81 Patienten litten an M. Crohn und 28 an Colitis ulcerosa. Die Diagnose wurde durch Kombination klinischer, endoskopischer, radiologischer und bioptischer Befunde gesichert. Drei Radiologen bewerteten die Computertomographien und verglichen die Ergebnisse mit den konventionell-radiologischen Befunden. Bei den Patienten mit M. Crohn fanden wir in 26% der Faelle eine irregulaere aeussere Darmwand. Eine Darmwandverdickung lag in 82% vor und fand sich regelmaessig in Darmabschnitten mit floriden Veraenderungen

  13. Angelica acutiloba Kitagawa Extract Attenuates DSS-Induced Murine Colitis.

    Science.gov (United States)

    Jang, Jong-Chan; Lee, Kang Min; Ko, Seong-Gyu

    2016-01-01

    We examined the protective effects of Angelica acutiloba Kitagawa (AAK) extract on a murine model of acute experimental colitis. Colitis was induced by 4% dextran sulfate sodium (DSS) in the drinking water of male C57BL/6 mice, for 7 consecutive days. Oral administration of AAK extract (500 mg/kg/day) significantly alleviated DSS-induced symptoms such as anorexia, weight loss, events of diarrhea or bloody stools, and colon shortening. Histological damage was also ameliorated, as evidenced by the architectural preservation and suppression of inflammatory cell infiltration in colonic samples. Treatment improved the colonic mRNA expression of different inflammatory markers: cytokines, inducible enzymes, matrix metalloproteinases, and tight junction-related proteins. In the isolated serum, IgE levels were downregulated. Collectively, these findings indicate the therapeutic potentials of AAK as an effective complementary or alternative modality for the treatment of ulcerative colitis.

  14. [Ulcerative colitis and proctitis in two Swiss Braunvieh cows].

    Science.gov (United States)

    Braun, U; Hilbe, M; Gerspach, C; Ruetten, M

    2015-04-01

    Two Swiss Braunvieh cows were referred to our clinic because of narrowing of the rectum and difficult rectal examination attributable to restricted arm movement within the pelvic cavity. Cow 1 also had perforation of the cranial rectum and cow 2 had multiple small funnel-shaped depressions in the rectal mucosa. Both cows had ultrasonographic evidence of peritonitis with thickening of the intestinal wall and fibrin and fluid accumulation in the abdominal cavity. A diagnosis of peritonitis was made in both cows, most likely caused by rectal perforation; they were euthanized and a post-mortem examination was carried out. Both cows had proctitis and ulcerative colitis with three or four perforated ulcers which were associated with fibrinopurulent peritonitis. The final diagnosis was ulcerative colitis and proctitis of unknown aetiology. Infectious causes of colitis and proctitis, including bovine viral diarrhoea, adenovirus infection and salmonellosis, and trauma and poisoning were ruled out.

  15. Surveillance issues in inflammatory bowel disease: ulcerative colitis.

    Science.gov (United States)

    Provenzale, D; Onken, J

    2001-02-01

    This review article on the surveillance of patients with ulcerative colitis provides an overview of the criteria for evaluating screening and surveillance programs and applies the criteria to the available evidence to determine the effectiveness of the surveillance of patients with ulcerative colitis. We examine the clinical outcomes associated with surveillance, the additional clinical time required to confirm the diagnosis of dysplasia and cancer, compliance with surveillance and follow-up, and the effectiveness of the individual components of a surveillance program, including colonoscopy and pathologist's interpretation. The disability associated with colectomy is considered, as are the cost and acceptability of surveillance programs. Patients with long-standing ulcerative colitis are at risk for developing colorectal cancer. Recommended surveillance colonoscopy should be supported. New endoscopic and histopathologic techniques to improve the identification of high-risk patients may enhance the effectiveness and cost-effectiveness of surveillance practices.

  16. Ischemic colitis:Clinical practice in diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    Angeliki Theodoropoulou; Ioannis E Koutroubakis

    2008-01-01

    Ischemic colitis is the most common form of ischemic injury of the gastrointestinal tract and can present either as an occlusive or a non-occlusive form.It accounts for 1 in 1000 hospitalizations but its incidence is underestimated because it often has a mild and transient nature.The etiology of ischemic colitis is multifactorial and the clinical presentation variable.The diagnosis is based on a combination of clinical suspicion,radiographic,endoscopic and histological findings.Therapy and outcome depends on the severity of the disease.Most cases of the non-gangrenous form are transient and resolve spontaneously without complications.On the other hand,high morbidity and mortality and urgent operative intervention are the hallmarks of gangrenous ischemic colitis.

  17. Inherited determinants of Crohn's disease and ulcerative colitis phenotypes

    DEFF Research Database (Denmark)

    Cleynen, Isabelle; Boucher, Gabrielle; Jostins, Luke;

    2016-01-01

    BACKGROUND: Crohn's disease and ulcerative colitis are the two major forms of inflammatory bowel disease; treatment strategies have historically been determined by this binary categorisation. Genetic studies have identified 163 susceptibility loci for inflammatory bowel disease, mostly shared...... between Crohn's disease and ulcerative colitis. We undertook the largest genotype association study, to date, in widely used clinical subphenotypes of inflammatory bowel disease with the goal of further understanding the biological relations between diseases. METHODS: This study included patients from 49...... centres in 16 countries in Europe, North America, and Australasia. We applied the Montreal classification system of inflammatory bowel disease subphenotypes to 34,819 patients (19,713 with Crohn's disease, 14,683 with ulcerative colitis) genotyped on the Immunochip array. We tested for genotype...

  18. [Meloxicam-induced colitis revealed by acute abdominal pain].

    Science.gov (United States)

    Seddik, H; Rabhi, M

    2013-03-01

    Whether intestinal toxicity of preferential or selective COX-2 inhibitors is reduced compared with that of standard NSAIDs is controversial. A 26-year-old woman presented with acute abdominal pain and bloody diarrhoea a few days after beginning meloxicam treatment. Endoscopic examination of the colon showed erythematous and ulcerative lesions involving 15 cm of the left colon. No aetiology has been found for colitis. Diarrhea disappeared 1 week after meloxicam was stopped. Total colonoscopy 3 months and 2 years later was normal. The role of meloxicam in the etiology of colitis was considered plausible. This report and a few other cases in the literature suggest that cyclooxygenase-2 selective non-steroidal anti-inflammatory drug inhibitor toxicity should be investigated in case of unexplained acute colitis. PMID:23537413

  19. Analýza vybrané firmy

    OpenAIRE

    Jandová, Jana

    2010-01-01

    Tato bakalářská práce utváří celkový obraz o vybrané firmě pomocí SWOT analýzy, SLEPTE analýzy, Porterovy analýzy konkurence a analyzuje její finanční situaci od roku 2006 do roku 2008 prostřednictvím soustav poměrových ukazatelů. Z výsledků všech analýz jsou navržena doporučení ke zlepšení stávající situace firmy. This bachelor’s thesis presents a picture of a selected firm by applying SWOT and SLEPTE analysis and Porter´s Five Forces analysis. Next follows an analysis of the financial st...

  20. Softwarová podpora analýzy rizik

    OpenAIRE

    Psota, Michal

    2013-01-01

    Tato práce se zabývá teoretickým popisem možností řízení rizik především v oblasti informačních technologií a popisuje metody sloužící k analýze rizik. Rozebrané metody jsou analýza stromu událostí, analýza stromu poruch, FMEA, HAZOP a Markovova analýza. Praktická část práce zahrnuje návrh a implementaci aplikace, která vizualizuje rozhodovací stromy a určuje pravděpodobnosti jednotlivých prvků.

  1. What Are the Risk Factors for Anal Cancer?

    Science.gov (United States)

    ... have few or no known risk factors. Human papilloma virus (HPV) infection Most squamous cell anal cancers ... to be linked to infection by the human papilloma virus (HPV), the same virus that causes cervical ...

  2. Analýza vybrané firmy

    OpenAIRE

    Peloušková, Tereza

    2013-01-01

    Předmětem bakalářská práce je analýza společnosti MMB Consulting, s.r.o., která se zabývá realizací staveb v Jihomoravském kraji. Obsahem práce je vypracování SLEPTE analýzy, Porterova modelu pěti konkurenčních sil a SWOT analýzy. Na základě provedených analýz jsou nakonec navrženy způsoby zlepšení současné situace společnosti. Subject of this thesis is the analysis the MMB Consulting company, which is engaged in construction of buildings in the South Moravian region. The thesis includes S...

  3. Tubulovillous adenoma of anal canal: A case report

    Institute of Scientific and Technical Information of China (English)

    Bhupinder S Anand; Gordana Verstovsek; George Cole

    2006-01-01

    Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery.Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma.

  4. Quality of life after ileal pouch-anal anastomosis: an evaluation of diet and other factors using the Cleveland Global Quality of Life instrument.

    LENUS (Irish Health Repository)

    Coffey, J C

    2012-02-03

    PURPOSE: Although functional results after ileal pouch-anal anastomosis are excellent, imperfections of function do occur. In this setting, quality-of-life assessment is an invaluable tool in determining overall therapeutic efficacy. We evaluated the impact of dietary restrictions, preoperative diagnosis (ulcerative colitis vs. familial adenomatous polyposis), and pregnancy (after pouch insertion) on quality of life. METHODS: After ethical approval, 64 patients were reviewed (mean age, 31 (range, 15-54) years). Long-term quality of life in patients after ileal pouch-anal anastomosis was assessed using the Cleveland Global Quality of Life instrument or Fazio score. The Cleveland Global Quality of Life score is a novel quality-of-life instrument specifically designed for patients with ileal pouches. Stool frequency and continence were recorded to establish the functional status of this group. RESULTS: Sixty-one patients (95.3 percent) complained of some form of dietary restriction and adopted a fixed dietary regimen. All such patients felt that a breach of this regimen would impinge significantly on their quality of life. Late eating and alcohol were associated with diarrhea, whereas smoking was not. Constipation was infrequently reported. The mean Cleveland Global Quality of Life score of patients with ulcerative colitis (0.81 +\\/- 0.13) was greater than that of patients with ulcerative colitis and a background of pouchitis (0.78 +\\/- 0.16; P = 0.042). Whereas postoperative stool frequency in patients with familial adenomatous polyposis was always higher than the preoperative level (4 vs. 2 movements per day; P = 0.04), the Cleveland Global Quality of Life score of this group was lower than that of ulcerative colitis patients (0.77 vs. 0.81; P = 0.047). The Cleveland Global Quality of Life score of females who had had pregnancies after pouch formation was 0.70, significantly lower (P = 0.039) than that of ulcerative colitis patients, although pouch function was

  5. Is there an association of microscopic colitis and irritable bowel syndrome-A subgroup analysis of placebo-controlled trials

    Institute of Scientific and Technical Information of China (English)

    Ahmed Madisch; Birgit Bethke; Manfred Stolte; Stephan Miehlke

    2005-01-01

    @@ TO THE EDITOR With great interest we read the recent retrospectice study by Barta et al (1) dealing with the clinical presentation of patients with microscopic colitis. They investigated in a cohort of 53 patients with microscopic colitis (46 with collagenous colitis, 7 with lymphocytic colitis)the relationship between microscopic colitis and both constipation and diarrhea. One of their mean finding was that abdominal pain, diarrhea and constipation was a common symptom complex of patients with microscopic colitis, thus the face of microcopic colitis resembles the subgroups of irritable bowel syndrome (IBS).

  6. Matrine ameliorates spontaneously developed colitis in interleukin-10-deficient mice.

    Science.gov (United States)

    Wu, Cong; Xu, Zheng; Gai, Renhua; Huang, Kehe

    2016-07-01

    Interleukin-10 (IL-10)-deficient mice spontaneously develop T cell-mediated colitis. Previous reports have shown that Matrine may reduce the symptoms of acute colitis induced by trinitrobenzene sulfonic acid (TNBS). However, whether Matrine impacts chronic colitis remains unknown. In this study, we investigated whether Matrine could limit the symptoms of spontaneously developed colitis and its potential molecular mechanisms. IL-10 deficient mice were given Matrine or a PBS control by oral gavage daily for 4weeks and were euthanized at week 2 or week 4. We measured body weight, colon length and weight, and histological scores. We also evaluated the spontaneous secretion of IL-12/23p40, IFN-γ and IL-17 in colon explant cultures as well as IFN-γ and IL-17 secretion in unseparated mesenteric lymph node (MLN) cells, and assessed IFN-γ, IL-17, IL-1β and IL-6 mRNA expression in colon tissue. In addition, we analyzed the proportions of CD4-positive and CD8-positive cells in unseparated MLN cells. Our results show that Matrine-treated mice exhibited better body weight recovery than controls and that histological scores and spontaneously secreted IL-12/23p40, IFN-γ and IL-17 in colon tissue were significantly decreased in treated mice compared with controls. The proportion of CD4-positive cells of MLNs in treated mice was significantly smaller than that in controls at week 4. Both cytokine production and mRNA expression of IFN-γ and IL-17 were significantly reduced in treated mice compared with controls. Taken together, our results indicate that Matrine may ameliorate spontaneously developed chronic colitis and could be considered as a therapeutic alternative for chronic colitis.

  7. Recent advances in the management of radiation colitis

    Institute of Scientific and Technical Information of China (English)

    Jannis Kountouras; Christos Zavos

    2008-01-01

    Radiation colitis,an insidious,progressive disease of increasing frequency,develops 6 mo to 5 years after regional radiotherapy for malignancy,owing to the deleterious effects of the latter on the colon and the small intestine.When dealing with radiation colitis and its complications,the most conservative modality should be employed because the areas of intestinal injury do not tend to heal.Acute radiation colitis is mostly selflimited,and usually,only supportive management is required.Chronic radiation colitis,a poorly predictable progressive disease,is considered as a precancerous lesion;radiation-associated malignancy has a tendency to be diagnosed at an advanced stage and to bear a dismal prognosis.Therefore,management of chronic radiation colitis remains a major challenge owing to the progressive evolution of the disease,including development of fibrosis,endarteritis,edema,fragility,perforation,partial obstruction,and cancer.Patients are commonly managed conservatively.Surgical intervention is difficult to perform because of the extension of fibrosis and alterations in the gut and mesentery,and should be reserved for intestinal obstruction,perforation,fistulas,and severe bleeding.Owing to the difficulty in managing the complications of acute and chronic radiation colitis,particular attention should be focused onto the prevention strategies.Uncovering the fibrosis mechanisms and the molecular events underlying radiation bowel disease could lead to the introduction of new therapeutic and/or preventive approaches.A variety of novel,mostly experimental,agents have been used mainly as a prophylaxis,and improvements have been made in radiotherapy delivery,including techniques to reduce the amount of exposed intestine in the radiation field,as a critical strategy for prevention.

  8. Anal sphincter EMG in the diagnosis of parkinsonian syndromes

    DEFF Research Database (Denmark)

    Winge, K; Jennum, Poul Jørgen; Løkkegaard, Annemette;

    2010-01-01

    The role of electromyography (EMG) recorded from the external anal sphincter (EAS) in the diagnosis of atypical parkinsonian syndromes is a matter for continuous debate. Most studies addressing this issue are retrospective.......The role of electromyography (EMG) recorded from the external anal sphincter (EAS) in the diagnosis of atypical parkinsonian syndromes is a matter for continuous debate. Most studies addressing this issue are retrospective....

  9. Innovations in chronic anal fissure treatment: A systematic review

    OpenAIRE

    2010-01-01

    A chronic anal fissure is a common perianal condition. This review aims to evaluate both existing and new therapies in the treatment of chronic fissures. Pharmacological therapies such as glyceryl trinitrate (GTN), Diltiazem ointment and Botulinum toxin provide a relatively non-invasive option, but with higher recurrence rates. Lateral sphincterotomy remains the gold standard for treatment. Anal dilatation has no role in treatment. New therapies include perineal support devices, Gonyautoxin i...

  10. Anal cancer and intraepithelial neoplasia screening: A review

    OpenAIRE

    Leeds, Ira L.; Fang, Sandy H

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors earl...

  11. Two for One: Coexisting Ulcerative Colitis and Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Grant I Chen

    2002-01-01

    Full Text Available Three cases of coexisting ulcerative colitis and Crohn’s disease are presented. In the first case, the patient had a long-standing history of ulcerative proctitis before developing Crohn’s colitis. In the two remaining cases, the patients presented initially with Crohn’s disease of the ileum and, subsequent to resection, developed ulcerative colitis. Well-documented cases of patients diagnosed with both ulcerative colitis and Crohn’s disease are rare. The literature on such cases is reviewed, and the controversy over whether ulcerative colitis and Crohn’s disease are two distinct diseases is explored.

  12. Mesalamine treatment mimicking relapse in a child with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Iva Hojsak; Ana M Pavić; Sanja Kolaček

    2014-01-01

    Background: There are reports on mesalamine-induced bloody diarrhea mimicking ulcerative colitis (UC) relapse, mostly in adults. Methods: Herein we present a case of a child with UC who developed relapse of hemorrhagic colitis related to mesalamine. Results: A 10-year-old girl developed severe symptoms mimicking UC relapse 3 weeks after introduction of mesalamine therapy. After mesalamine was withdrawn, her symptoms improved, but deteriorated again during the challenge of mesalamine despite concomitant use of corticosteroids. Conclusion: This is the fi rst case report on such a young child during the concomitant use of corticosteroids.

  13. Activation of the Renin-Angiotensin System Promotes Colitis Development

    OpenAIRE

    Yongyan Shi; Tianjing Liu; Lei He; Urszula Dougherty; Li Chen; Sarbani Adhikari; Lindsay Alpert; Guolin Zhou; Weicheng Liu; Jiaolong Wang; Deb, Dilip K.; John Hart; Liu, Shu Q.; John Kwon; Joel Pekow

    2016-01-01

    The renin-angiotensin system (RAS) plays pathogenic roles in renal and cardiovascular disorders, but whether it is involved in colitis is unclear. Here we show that RenTgMK mice that overexpress active renin from the liver developed more severe colitis than wild-type controls. More than 50% RenTgMK mice died whereas all wild-type mice recovered. RenTgMK mice exhibited more robust mucosal TH17 and TH1/TH17 responses and more profound colonic epithelial cell apoptosis compared to wild-type cont...

  14. Clinical Observations on Acupuncture Treatment of Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    YANG Shun-yi

    2003-01-01

    Purpose To observe the curative effect of acupuncture on ulcerative colitis. Methods and Results Sixty-two patients with ulcerative colitis were treated mainly by needle-warming moxibustion at Lower He-Sea points and Front-mu points, with the cooperation of syndomic differentiation-based selection of acupoints and oral administration of patent Chinese medicine. After treatment the total effective rate was 91.94% and T cell subgroups returned nearly to normal. Conclusion This treatment method can help the internal environment of human immune system to tend to balance.

  15. Review article: colitis-associated cancer -- time for new strategies.

    LENUS (Irish Health Repository)

    Shanahan, F

    2012-02-03

    Colorectal cancer (CRC) remains a feared and potentially life-threatening complication of both ulcerative colitis and Crohn\\'s colitis. Currently, the main preventive strategy is a secondary one, i.e. surveillance colonoscopy usually after 8 years of disease duration, when the risk for neoplasia begins to increase. Despite its widespread acceptance, dysplasia and cancer surveillance is unproven in terms of reducing mortality or morbidity and there is a remarkable lack of uniformity in the manner in which it is practised. In this review article, the pitfalls of dysplasia surveillance are summarized and the need for novel chemopreventive and perhaps pharmabiotic approaches for prevention are highlighted.

  16. Faecal Bacterial Communities in Healthy Controls and Ulcerative Colitis Patients

    DEFF Research Database (Denmark)

    Vigsnæs, Louise Kristine; Wilcks, Andrea; Brynskov, Jørn;

    Ulcerative colitis (UC) is an idiopathic inflammatory bowel disease (IBD) that is characterized by chronic inflammation of the colonic mucosa. The aetiology of IBD is not well understood, however the commensal intestinal microbiota is thought to play an important pathogenetic role. Hence, a detai......Ulcerative colitis (UC) is an idiopathic inflammatory bowel disease (IBD) that is characterized by chronic inflammation of the colonic mucosa. The aetiology of IBD is not well understood, however the commensal intestinal microbiota is thought to play an important pathogenetic role. Hence...

  17. Ischemic colitis after mesotherapy combined with anti-obesity medications

    Institute of Scientific and Technical Information of China (English)

    Jong; Bin; Kim; Won; Moon; Seun; Ja; Park; Moo; In; Park; Kyu-Jong; Kim; Jae; Nam; Lee; Seong; Joo; Kang; Lee; La; Jang; Hee; Kyung; Chang

    2010-01-01

    Mesotherapy and anti-obesity medications are gradually gaining worldwide popularity for purposes of body contouring and weight loss.Their adverse effects are various,but there is a tendency to disregard them.Ischemic colitis is one of the most common diseases associated with non-obstructive blood vessel disorders.However,there have been no case reports about the adverse effects resulting from mesotherapy only or in combination with anti-obesity medications.We report on an interesting case of ischemic coliti...

  18. Fulminant amoebic colitis during chemotherapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Noboru Hanaoka; Katsuhiko Higuchi; Satoshi Tanabe; Tohru Sasaki; Kenji Ishido; Takako Ae; Wasaburo Koizumi; Katsunori Saigenji

    2009-01-01

    A 52-year-old man had bloody stools during chemotherapy for gastric cancer. A colonoscopy revealed necrotizing ulcer-like changes. A biopsy confirmed the presence of amoebic trophozoites. Subsequently,peritonitis with intestinal perforation developed, and emergency peritoneal lavage and colostomy were performed. After surgery, endotoxin adsorption therapy was performed and metronidazole was given. Symptoms of peritonitis and colonitis resolved.with the progression of gastric cancer. The patient died 50 d after surgery. Fulminant amoebic colitis is very rarely associated with chemotherapy. Amoebic colitis should be considered in the differential diagnosis of patients who have bloody stools during chemotherapy.

  19. Botulinum toxin A in the treatment of anal fissure

    Directory of Open Access Journals (Sweden)

    Stanković Nebojša

    2004-01-01

    Full Text Available Background. This paper presents our first experience in the treatment of primary anal fissure by injection of botulinum A toxin into the internal sphincter. Methods. The study group of the retrospective study included 12 outpatients (8 females and 4 males, mean age 42 (range 18-60. During the period 2000-2003, after unsuccessful conservative treatment, patients were treated with the injections of botulinum A toxin, 100 units on both sides of the anal fissure laterally into the internal anal sphincter (50 units on either side. The patients were clinically evaluated 3, 7, and 30 days, and 3 and 6 months after the treatment. Results. Three fissures had healed after a month, and seven after 3 months. Two remained unhealed, but asymptomatic. There was no incontinence of flatus or faeces after 3 months of the treatment. After temporary healing, two fissures relapsed after 6 months, and these patients had the adequate tonus of the anal sphincter muscles. Except for the temporary incontinence, there were neither other side-efects, nor serious complications. Conclusion. Injection of botulinum A toxin achieved good results in the treatment of anal fissure. The appropriate use makes this method safe as an alternative to surgical treatment of anal fissure.

  20. Reflexo pudendo-anal em mulheres normais Pudendo-anal reflex in normal women

    Directory of Open Access Journals (Sweden)

    Geraldo de Aguiar Cavalcanti

    2004-09-01

    Full Text Available São descritas observações do registro do reflexo pudendo-anal em mulheres sem queixas de incontinência urinária. Foram estudadas 31 voluntárias adultas, com estimulação elétrica bilateral e independente do clitóris e registros de superfície em ambos os lados do músculo esfíncter externo do ânus (EEA. As respostas foram obtidas com pulsos duplos de 0,2 ms de duração e intervalos de 5 ms, aplicados a uma freqüência menor que 0,5 Hz. Foram medidas as latências iniciais das respostas. Não foram evidenciadas diferenças entre as respostas obtidas de cada lado do EEA e nem entre os lados, com relação aos estímulos. Uma das voluntárias não apresentou respostas após estimulação de um dos lados. Não foram observadas diferenças relacionadas a paridade total e nem com a presença de partos vaginais. A idade e o índice de massa corpórea não se correlacionaram com as respostas. Em 12% das respostas, a medida das latências foi dificultada pela baixa relação sinal-ruído.The pudendo-anal reflex was studied in a sample of 31 normal women. Responses were obtained after bilateral independent stimulation of the clitoris, with surface recordings from both sides of the external anal sphincter. Reponses were elicited with double-pulses of 0,2 ms duration with a interstimulus interval of 5 ms, frequency of stimulation was lower than 0,5 Hz. A minimal of four responses were recorded after supramaximal stimulation. In one volunteer no response was recorded after unilateral stimulation. Latencies of the responses from the right and left sides of the anal sfincter after right and left stimulation were 36.35±6.37, 36.28±6.23, 35.88±4.68, 36.44±4.45ms, respectively. No relation was detected between latencies and age, body mass index and parity (considering either total parity or vaginal delivery only. In 12% of the recordings uncertainty was introduced in the latency measurements related to a poor signal-noise ratio.

  1. [Epithelium and anal glands in rectal pouches and fistula. Histologic studies of swine with congenital anal atresia].

    Science.gov (United States)

    Lambrecht, W; Kluth, D; Lierse, W

    1989-02-01

    The epithelial coating of the rectal pouch and fistula was studied morphologically in 33 newborn piglets with high and low forms of anal atresia and was found to be similar to the epithelial coating of the anal canal in normal piglets: the typical epithelium of the rectum changed its character into transitional epithelium at the region of the internal sphincter which surrounded the fistulae in all animals. In the caudal part of the fistula the transitional epithelium was followed by squamous epithelium. Only in male piglets with deformities and recto-urethral fistulae no squamous epithelium was found. In these cases transitional epithelium covered all parts of the fistula and the region of the internal sphincter. Anal glands were found in all animals, with or without anorectal malformations. They always invaded the internal sphincter. According to our morphological studies the fistula in anorectal malformations represents an ectopic anal canal.

  2. High prevalence of high grade anal intraepithelial neoplasia in HIV-infected women screened for anal cancer.

    Science.gov (United States)

    Hou, June Y; Smotkin, David; Grossberg, Robert; Suhrland, Mark; Levine, Rebecca; Smith, Harriet O; Negassa, Abdissa; McAndrew, Thomas C; Einstein, Mark H

    2012-06-01

    There is no consensus on optimal screening for anal cancer (AC) in HIV+ women. Seven hundred fifteen unique asymptomatic women in a high-prevalence HIV+ community were screened for AC with anal cytology and triage to high-resolution anoscopy after routine screening was implemented in a large urban hospital system. Of these, 75 (10.5%) had an abnormal anal cytology and 29 (38.7%) of those with an abnormality had high-grade anal intraepithelial neoplasia (AIN). Women with poorly controlled HIV were significantly more likely to have high-grade AIN (P = 0.03). Given the high rate of AIN in screened HIV-infected women, routine AC screening in all HIV-infected women should be strongly considered. PMID:22466085

  3. Primary biliary cirrhosis and ulcerative colitis: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Wen-Bin Xiao; Yu-Lan Liu

    2003-01-01

    AIM: To summarize the characteristics of patients suffered from primary biliary cirrhosis associated with ulcerative colitis.METHODS: To report a new case and review the literature.RESULTS: There were 18 cases (including our case) of primary biliary cirrhosis complicated with ulcerative colitis reported in the literature. Compared with classical primary biliary cirrhosis, the patients were more often males and younger similar. The bowel lesions were usually mild with proctitis predominated. While ulcerative colitis was diagnosed before primary biliary cirrhosis in 13 cases, the presentation of primary biliary cirrhosis was earlier than that of ulcerative colitis in our new case reported here. The prevalence of primary biliary cirrhosis among patients of ulcerative colitis was almost 30 times higher than in general population.CONCLUSION: Association of primary biliary cirrhosis with ulcerative colitis is rare. It should be considered in the differential diagnosis of hepatobiliary disease in patients with ulcerative colitis, and vice versa.

  4. Efficacy of topical imiquimod in HIV-positive patients with recurrent anal condylomata acuminata

    Directory of Open Access Journals (Sweden)

    Sidney Roberto Nadal

    2012-03-01

    Full Text Available INTRODUCTION: Imiquimod is a topical chemotherapic and immunostimulant agent with antitumoral and antiviral activities, used for anal condylomata acuminata treatment, mainly in recurrences. OBJECTIVE: Evaluate the imiquimod efficiency in chronic and recurrent anal condylomata acuminata in HIV-infected persons. METHOD: A prospective study that analyzed 61 patients with recurrent anal condylomata treated with topic 5% imiquimod, for at least 8 weeks. These patients had already been submitted to other topical and surgical treatments for anal warts. We evaluated the efficiency of this agent, through wart remission, with clinical examination and high-resolution anoscopy, CD4+ T lymphocyte count and side effects. The patients were 55 males and 6 females, from 22 to 63 years old. RESULTS: Remission was seen in 90%, being 46% complete remission and 44% partial remission. Other 10% did not respond to the treatment with imiquimod within the 16th week. Recurrences were observed in 11% of patients in 24-week follow-up. Statistics showed no differences in CD4+ T cell scores when groups with and without complete remission were compared. Adverse effects were reported by 45% of patients. They were mild to moderate burning (25%, intense burning (7%, ulcerative dermatitis (8% and systemic symptoms (5%. CONCLUSION: Imiquimod was effective in controlling recurrent anal condylomata acuminata in HIV-positive patients, regardless of CD4+ T cell count.INTRODUÇÃO: O imiquimode é agente tópico quimioterápico e imunoestimulante, com atividades antitumoral e antiviral, usado para tratamento dos condilomas acuminados perianais, principalmente os recidivantes. OBJETIVO: Avaliar a eficácia do imiquimode nos condilomas acuminados perianais crônicos e multirrecidivantes dos doentes soropositivos para o vírus da imunodeficiência adquirida (HIV. CASUÍSTICA E MÉTODO: Estudo clínico prospectivo por 12 meses em que observamos o uso tópico de imiquimode creme 5%, por no

  5. Desarrollo de un método analítico aplicable al control de la calidad de tabletas de Clonazepam

    OpenAIRE

    García Peña, Caridad M.; Fernández Serret, Alfredo; Garciga, María R.; Martínez Espinosa, Vivian

    2006-01-01

    Se desarrolló y validó un método analítico alternativo para el control de la calidad de las tabletas de clonazepam 2 mg sin lactosa por espectrofotometría UV, el cual no es aplicable a los estudios de estabilidad, ya que este método resulta más rápido, más sencillo y económico. Además se validó el método analítico reportado para el estudio de estabilidad por cromatografía líquida de alta resolución (CLAR), comparándose ambos métodos estadísticamente. Ambos métodos resultaron específicos, line...

  6. Current treatment options for management of anal intraepithelial neoplasia.

    Science.gov (United States)

    Weis, Stephen E

    2013-01-01

    Anal squamous cell cancer is an uncommon malignancy caused by infection with oncogenic strains of Human papilloma virus. Anal cancer is much more common in immunocompromised persons, including those infected with Human immunodeficiency virus. High-grade anal intraepithelial neoplasia (HGAIN), the precursor of anal cancer, is identified by clinicians providing care for patients with anorectal disease, and is increasingly being identified during screening of immunosuppressed patients for anal dysplasia. The traditional treatment for HGAIN has been excision of macroscopic disease with margins. This approach is effective for patients with small unifocal HGAIN lesions. Patients with extensive multifocal HGAIN frequently have recurrence of HGAIN after excision, and may have postoperative complications of anal stenosis or fecal incontinence. This led to the suggestion by some that treatment for HGAIN should be delayed until patients developed anal cancer. Alternative approaches in identification and treatment have been developed to treat patients with multifocal or extensive HGAIN lesions. High-resolution anoscopy combines magnification with anoscopy and is being used to identify HGAIN and determine treatment margins. HGAIN can then be ablated with a number of modalities, including infrared coagulation, CO2 laser, and electrocautery. These methods for HGAIN ablation can be performed with local anesthesia on outpatients and are relatively well tolerated. High-resolution anoscopy-directed HGAIN ablation is evolving into a standard approach for initial treatment and then subsequent monitoring of a disease which should be expected to be recurrent. Another treatment approach for HGAIN is topical treatment, principally with 5-fluorouracil or imiquimod. Topical therapies have the advantage of being nonsurgical and are well suited for treating widespread multifocal disease. Topical treatments have the disadvantage of requiring extended treatment courses and causing a symptomatic

  7. AOM/DSS Model of Colitis-Associated Cancer.

    Science.gov (United States)

    Parang, Bobak; Barrett, Caitlyn W; Williams, Christopher S

    2016-01-01

    Our understanding of colitis-associated carcinoma (CAC) has benefited substantially from mouse models that faithfully recapitulate human CAC. Chemical models, in particular, have enabled fast and efficient analysis of genetic and environmental modulators of CAC without the added requirement of time-intensive genetic crossings. Here we describe the Azoxymethane (AOM)/Dextran Sodium Sulfate (DSS) mouse model of inflammatory colorectal cancer.

  8. Impact of probiotics on colonic microflora in patients with colitis

    DEFF Research Database (Denmark)

    Reddy, B. S.; Ahmed, J.; Macfie, J.;

    2010-01-01

    Background: Probiotics colonise the gut and may exert beneficial effects. The aim of this study was to assess if probiotics change the spectrum of colonic microflora in patients with colitis when taken daily for a period of one month Methods: This is a prospective double blind randomised crossover...

  9. [Ischemic colitis after renal transplantation:etiology and pathogenesis].

    Science.gov (United States)

    Alperovich, G; Idiarte, L; Besasso, O; Avagnina, A

    2003-01-01

    Ischemic colitis is a well-recognized complication occurring in renal transplant recipients. It has often been associated with cytomegalovirus (CMV) vasculitis. However, the diagnosis of this pathology in the absence of CMV suggests that other etiological factors might be involved. Drugs inducing mesenteric vasoconstriction, such as non-steroidal anti-inflamatory drugs (NSAIDs) and cyclosporine could be related to this entity.

  10. REGULATION OF INDUCIBLE NITRIC OXIDE SYNTHASE IN COLLAGENOUS COLITIS

    DEFF Research Database (Denmark)

    Andresen, Lars

    2004-01-01

    ulcerøs colitis, der er karakteriseret ved en kronisk recidiverende, sårdannende inflammation af kolorektalslimhinden. I nærværende sammenlignende studie er ekspressionen af iNOS og aktiviteten af enzymets transkriptionsfaktor, nukleær faktor-kappa B (NF-B), i slimhindebiopsier fra colonslimhinden hos...

  11. Automated image analysis in the study of collagenous colitis

    DEFF Research Database (Denmark)

    Fiehn, Anne-Marie Kanstrup; Kristensson, Martin; Engel, Ulla;

    2016-01-01

    PURPOSE: The aim of this study was to develop an automated image analysis software to measure the thickness of the subepithelial collagenous band in colon biopsies with collagenous colitis (CC) and incomplete CC (CCi). The software measures the thickness of the collagenous band on microscopic...

  12. Microscopic colitis is a common cause of chronic diarrhoea

    DEFF Research Database (Denmark)

    Munck, Lars Kristian; Wildt, Signe; Engell, Peter Johan Heiberg;

    2014-01-01

    Microscopic colitis (MC) is a common cause of chronic, non-bloody diarrhoea in the elderly population. In Denmark the incidence has been rising for the last decades. Sufficient biopsy material from colon mucosa is essential for the diagnosis. Treatment is important to improve the patient's quality...

  13. Ischemic Colitis of the Left Colon in a Diabetic Patient

    Directory of Open Access Journals (Sweden)

    Anastasios J. Karayiannakis

    2011-04-01

    Full Text Available Diabetes mellitus may affect the gastrointestinal tract possibly as a result of autonomic neuropathy. Here we present a 68-year-old male with non-insulin-dependent diabetes mellitus who presented with prolonged watery diarrhea and in whom imaging studies demonstrated ischemic colitis of the left colon. Resection of the affected colon resulted in sustained disappearance of symptoms.

  14. Epithelial IL-18 Equilibrium Controls Barrier Function in Colitis

    NARCIS (Netherlands)

    Nowarski, Roni; Jackson, Ruaidhrí; Gagliani, Nicola; de Zoete, Marcel R; Palm, Noah W; Bailis, Will; Low, Jun Siong; Harman, Christian C D; Graham, Morven; Elinav, Eran; Flavell, Richard A

    2015-01-01

    The intestinal mucosal barrier controlling the resident microbiome is dependent on a protective mucus layer generated by goblet cells, impairment of which is a hallmark of the inflammatory bowel disease, ulcerative colitis. Here, we show that IL-18 is critical in driving the pathologic breakdown of

  15. Scintigraphic evaluation of pouch function in patients with ulcerative colitis

    DEFF Research Database (Denmark)

    Kjær, Mie Dilling; Simonsen, Jane Angel; Hvidsten, Svend;

    scintigraphic intestinal transit time, scintigraphic defecography and any association with QoL, and pouch function. Method A cross-sectional study including 20 patients with ulcerative colitis and an IPAA. Scintigraphic transit time was determined after oral administration of a Tc-99m-labelled omelette...

  16. HLA-DR expression and disease activity in ulcerative colitis

    DEFF Research Database (Denmark)

    Poulsen, L O; Elling, P; Sørensen, Flemming Brandt;

    1986-01-01

    In 12 patients with active ulcerative colitis (UC) the rectal epithelial cells were analyzed for HLA-DR antigens by an immunohistochemical technique. The clinical, rectoscopic, and histologic stages were also determined. The investigations were carried out at the beginning of the study and 2 weeks...

  17. IL-33 is upregulated in colonocytes of ulcerative colitis

    DEFF Research Database (Denmark)

    Seidelin, J.B.; Bjerrum, J.T.; Coskun, Mehmet;

    2010-01-01

    , airway inflammation and arthritis in animal models. We now report IL-33 to be produced by colonic epithelial cells in humans and it is highly upregulated in ulcerative colitis (UC). Little mRNA expression was found in control subjects (N=9), whereas patients with UC in remission (N=7) and active UC (N=9...

  18. Ischemic colitis complicating reconstruction of the abdominal aorta

    DEFF Research Database (Denmark)

    Schroeder, T V; Christoffersen, J K; Andersen, J;

    1985-01-01

    A review of 23 patients with ischemic colitis after surgical treatment of the abdominal aorta disclosed a pathogenetic heterogeneous finding. Ligation of the inferior mesenteric artery, abolished collateral blood supply or nonocclusive low flow state, or both, was a common feature. An incidence...

  19. Scintigrapfic evaluation of pouch function in patients with ulcerative colitis

    DEFF Research Database (Denmark)

    Kjær, Mie Dilling; Hvidsten, Svend; Simonsen, Jane Angel;

    with QoL and pouch function. Method It is a cross-sectional study including 20 patients with ulcerative colitis and an IPAA. Scintigraphic transit time was determined after oral administration of a Tc-99m-labelled omelette. Defecography was performed with instillation of a radioactive labelled paste...

  20. Fungal Colitis by Paracoccidioides brasiliensis: a case report

    Directory of Open Access Journals (Sweden)

    Carlos José Galeazzi

    2011-12-01

    Full Text Available Paracoccidioidomycosis (PBM is an infection caused by a dimorphic fungus called Paracoccidioides brasiliensis. It occurs in Latin America, with incidence of 1 to 3 per 100,000 inhabitants in endemic areas. The digestive tract is usually not affected, but when it occurs, it may lead to events similar to colorectal neoplasm and inflammatory bowel disease (IBD. This is a case report of a 68-year-old female patient, with diarrhea without blood or mucus for 6 months, weight loss of 8 kg over the period. Abdominal ultrasonography showed some mass in the right colon, suggestive of cancer and liver perihilar lymph node. Colonoscopy showed lesions suggestive of Crohn's disease. Biopsy showed chronic granulomatous colitis of fungal etiology: Paracoccidioidomycosis. The patient did not tolerate oral treatment with itraconazole and subsequently sulfadiazine, requiring hospital admission for the treatment with amphotericin B. The presence of Paracoccidioidomycosis in the digestive tract may be associated with bloody diarrhea, mucus, rectal hemorrhage, abdominal pain, malabsorption syndrome. Histopathological studies show the fungus and a chronic inflammatory infiltrate and granulation tissue. The differential diagnoses are tuberculosis, colorectal cancer and inflammatory bowel disease. The treatment is oral antifungal (itraconazole, sulfadiazine or intravenous (amphotericin B based. The case has caused diagnostic confusion between colon cancer (clinical and US and Crohn's disease (colonoscopy.Paracoccidioidomicose (PBM é uma infecção causada por um fungo dimórfico: Paracoccidioides brasiliensis. Ocorre na América Latina, com incidência de 1 a 3 por 100.000 habitantes em áreas endêmicas. O acometimento do trato digestivo é infrequente, sendo que pode levar a manifestações semelhantes à neoplasia colorretal e doença inflamatória intestinal (DII. Relatamos o caso da paciente feminina, 68 anos, com diarreia sem sangue ou muco há seis meses, com

  1. Altered response to hydrogen sulphide during experimental colitis in rats.

    Science.gov (United States)

    Steidle, J; Würner, L; Diener, M

    2012-09-10

    Hydrogen sulphide (H(2) S) is produced in the intestine by sulphate-reducing bacteria and during metabolism of L-cysteine within the mucosa. This gasotransmitter induces anion secretion by stimulating enteric neurons and by a direct effect on epithelial cells. As H(2) S is discussed to exert both pro- and anti-inflammatory actions, we aimed to investigate the role of H(2) S during experimental colitis by comparing the effects of blockade of H(2) S-forming endogenous enzymes with the effect of a S-reduced diet to diminish microbial production of H(2) S. Rectal application of trinitrobenzenesulfonic acid (TNBS) was used to induce chronic colitis. The level of inflammation was assessed macroscopically and histologically. In Ussing chamber experiments, colonic specimens from TNBS-treated animals exhibited a higher tissue conductance, that is, a higher epithelial permeability, and a slightly reduced basal short-circuit current (a measure of net ion transport) in relation to non-inflamed control tissue. Analgetic treatment with flupirtine, a central antinociceptive analgetic, did not interfere with the induction of the inflammatory response so that all animals were treated with flupirtine to reduce pain and distress during the development of colitis. The secretory response evoked by an exogenous H(2) S donor, NaHS, was significantly decreased after induction of colitis, whereas the response to Ca(2+) - or cAMP-dependent secretagogues was unaltered. This downregulation was not observed in the colitis group fed on a S-reduced diet. The decreased NaHS response indicates a desensitization of the tissue by inflammation, which might be explained by an upregulation of colonic H(2) S production as described in some models of inflammation. PMID:22963333

  2. Differential effects of energy balance on experimentally-induced colitis

    Institute of Scientific and Technical Information of China (English)

    Sarah J McCaskey; Elizabeth A Rondini; Ingeborg M Langohr; Jenifer I Fenton

    2012-01-01

    AIM:To characterize the influence of diet-induced changes in body fat on colitis severity in SMAD3-/-mice.METHODS:SMAD3-/-mice (6-8 wk of age) were randomly assigned to receive a calorie restricted (30%of control; CR),control (CON),or high fat (HF) diet for 20 wk and were gavaged with sterile broth or with Helicobacter hepaticus (H.hepaticus) to induce colitis.Four weeks after infection,mice were sacrificed and the cecum and colons were processed for histological evaluation.RESULTS:Dietary treatment significantly influenced body composition prior to infection (P < 0.05),with CR mice having less (14% ± 2%) and HF-fed mice more body fat (32% ± 7%) compared to controls (22% ±4%).Differences in body composition were associated with alterations in plasma levels of leptin (HF > CON > CR) and adiponectin (CON > HF ≥ CR) (P < 0.05).There were no significant differences in colitis scores between CON and HF-fed mice 4 wk post-infection.Consistent with this,differences in proliferation and inflammation markers (COX-2,iNOS),and infiltrating cell types (CD3+ T lymphocytes,macrophages) were not observed.Unexpectedly,only 40% of CR mice survived infection with H.hepaticus,with mortality observed as early as 1 wk following induction of colitis.CONCLUSION:Increased adiposity does not influence colitis severity in SMAD3-/-mice.Importantly,caloric restriction negatively impacts survival following pathogen challenge,potentially due to an impaired immune response.

  3. Current treatment options for management of anal intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    Weis SE

    2013-06-01

    Full Text Available Stephen E Weis1,2 1Division of Dermatology, Department of Internal Medicine, University of North Texas Health Science Center at Fort Worth, 2Preventive Medicine Clinic, Tarrant County Public Health, Fort Worth, TX, USA Abstract: Anal squamous cell cancer is an uncommon malignancy caused by infection with oncogenic strains of Human papilloma virus. Anal cancer is much more common in immunocompromised persons, including those infected with Human immunodeficiency virus. High-grade anal intraepithelial neoplasia (HGAIN, the precursor of anal cancer, is identified by clinicians providing care for patients with anorectal disease, and is increasingly being identified during screening of immunosuppressed patients for anal dysplasia. The traditional treatment for HGAIN has been excision of macroscopic disease with margins. This approach is effective for patients with small unifocal HGAIN lesions. Patients with extensive multifocal HGAIN frequently have recurrence of HGAIN after excision, and may have postoperative complications of anal stenosis or fecal incontinence. This led to the suggestion by some that treatment for HGAIN should be delayed until patients developed anal cancer. Alternative approaches in identification and treatment have been developed to treat patients with multifocal or extensive HGAIN lesions. High-resolution anoscopy combines magnification with anoscopy and is being used to identify HGAIN and determine treatment margins. HGAIN can then be ablated with a number of modalities, including infrared coagulation, CO2 laser, and electrocautery. These methods for HGAIN ablation can be performed with local anesthesia on outpatients and are relatively well tolerated. High-resolution anoscopy-directed HGAIN ablation is evolving into a standard approach for initial treatment and then subsequent monitoring of a disease which should be expected to be recurrent. Another treatment approach for HGAIN is topical treatment, principally with 5

  4. Condiloma acuminado anal com ovos de Schistosoma mansoni em paciente HIV-positivo Condilomata acuminata with Schistosoma eggs in HIV-positive patient

    Directory of Open Access Journals (Sweden)

    Fabiana Pirani Carneiro

    2007-06-01

    Full Text Available Condiloma acuminado e ovos de Schistosoma são freqüentemente encontrados na região anal, mas não há nenhum caso descrito de associação dessas doenças nessa região. No colo uterino a associação de infecção por HPV (vírus do papiloma humano e ovos de Schistosoma em paciente HIV (vírus da imunodeficiência humana-positivo já foi relatada e há evidências de que essa associação possa alterar a história natural dessas doenças. Assim como no colo uterino, é possível que essa interação também ocorra na região anal. Nosso objetivo, portanto, é relatar um caso de condiloma anal em paciente HIV-positivo, que foi submetido a ressecção cirúrgica e que apresentou no exame histopatológico numerosos ovos de Schistosoma mansoni.Condilomata acuminata and Schistosoma eggs are frequently found in the anal region, but there is no report about the association of these diseases in this region. The association of HPV infection and Schistosoma eggs in an HIV-positive patient was found in uterine cervix and there is evidence suggesting that this association can alters the natural history of these diseases. Like in the cervix, it is possible that this interaction also occurs in the anal region. So, we report a case of anal Condilomata acuminata, in an HIV-positive patient, that was ressected and contained on histopathologic examination, multiple Schistosoma eggs.

  5. Analýza vybrané firmy

    OpenAIRE

    Ligurská, Pavlína

    2014-01-01

    Bakalářská práce je zaměřena na analýzu vybrané firmy. Práce je rozdělena na teoretickou a praktickou část. V teoretické části jsou popsány metody, které byly použity pro analyzování firmy. V praktické části jsou aplikovány jednotlivé metody, Pro analýzu vnějšího prostředí byla použita analýza SLEPTE, pro analýzu odvětví byl použit Porterův model pěti konkurenčních sil, v další části se práce zabývá identifikací silných a slabých stránek firmy. V závěru práce jsou zhodnoceny výsledky analýz a...

  6. Analýza vybrané firmy

    OpenAIRE

    Rysková, Diana

    2013-01-01

    Bakalářská práce se zabývá zhodnocením situace vybraného podniku prostřednictvím analýz vnějšího a vnitřního okolí, mezi které patří SLEPTE analýza, SWOT analýza a Porterův model pěti konkurenčních sil. Teoretická část vystihuje podstatu jednotlivých analýz, které jsou následně aplikovány v praktické části bakalářské práce. Na základě výsledků z analýz jsou navržena řešení zjištěných problémových oblastí, směřující k upevnění postavení společnosti na trhu a jejího možného růstu. The bachel...

  7. The Anal Pap Smear: Cytomorphology of squamous intraepithelial lesions

    Directory of Open Access Journals (Sweden)

    Arain Shehla

    2005-01-01

    Full Text Available Abstract Background Anal smears are increasingly being used as a screening test for anal squamous intraepithelial lesions (ASILs. This study was undertaken to assess the usefulness and limitations of anal smears in screening for ASILs. Methods The cytomorphological features of 200 consecutive anal smears collected in liquid medium from 198 patients were studied and findings were correlated with results of surgical biopsies and/or repeat smears that became available for 71 patients within six months. Results Adequate cellularity was defined as an average of 6 or more nucleated squamous cells/hpf. A glandular/transitional component was not required for adequacy. Dysplastic cells, atypical parakeratotic cells and bi/multinucleated cells were frequent findings in ASIL while koilocytes were infrequent. Smears from LSIL cases most frequently showed mildly dysplastic and bi/multinucleate squamous cells followed by parakeratotic cells (PK, atypical parakeratotic cells (APK, and koilocytes. HSIL smears contained squamous cells with features of moderate/severe dysplasia and many APKs. Features of LSIL were also found in most HSIL smears. Conclusions In this study liquid based anal smears had a high sensitivity (98% for detection of ASIL but a low specificity (50% for predicting the severity of the abnormality in subsequent biopsy. Patients with cytologic diagnoses of ASC-US and LSIL had a significant risk (46–56% of HSIL at biopsy. We suggest that all patients with a diagnosis of ASC-US and above be recommended for high resolution anoscopy with biopsy.

  8. Metachronous tubulovillous and tubular adenomas of the anal canal.

    Science.gov (United States)

    Nozawa, Hiroaki; Ishihara, Soichiro; Morikawa, Teppei; Tanaka, Junichiro; Yasuda, Koji; Ohtani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Hata, Keisuke; Kazama, Shinsuke; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Fukayama, Masashi; Watanabe, Toshiaki

    2015-01-01

    Anal canal adenoma is an extremely rare disease that has the potential to transform into a malignant tumor. We herein presented a rare case of metachronous multiple adenomas of the anal canal. A 48-year-old woman underwent total colonoscopy following a positive fecal blood test. A 9-mm villous polyp arising from the posterior wall of the anal canal was removed by snare polypectomy. Histologically, the tumor was tubulovillous adenoma with high-grade dysplasia and the cut end was negative for tumor cells. Six years later, an elevated lesion, macroscopically five millimeters in size, was detected in the left wall of the anal canal in a follow-up colonoscopy. Local excision of the tumor was performed, and the lesion was pathologically confirmed to be tubular adenoma with high-grade dysplasia limited to the mucosa. The patient is currently alive without any evidence of recurrence for six months after surgery. Although she had a past history of cervical cancer, the multiple tumors arising in the anal canal were unlikely to be related to human papilloma virus infection. Our case report underscores the importance of careful observations throughout colonoscopy to detect precancerous lesions, particularly in anatomically narrow segments. PMID:26249723

  9. All's Well That Ends Well: Shakespeare's treatment of anal fistula.

    Science.gov (United States)

    Cosman, B C

    1998-07-01

    Textual and contextual evidence suggests that the French king's fistula, a central plot device in Shakespeare's play All's Well That Ends Well, is a fistula-in-ano. Anal fistula was known to the lay public in Shakespeare's time. In addition, Shakespeare may have known of the anal fistula treatise of John Arderne, an ancestor on Shakespeare's mother's side. Shakespeare's use of anal fistula differs from all previous versions of the story, which first appeared in Boccaccio's Decameron and from its possible historical antecedent, the fistula of Charles V of France. This difference makes sense given the conventions of Elizabethan comedy, which included anal humor. It is also understandable when one looks at what wounds in different locations mean in European legend. In this light, it is not surprising that subsequent expurgations treat Boccaccio's and Shakespeare's fistulas differently, censoring only Shakespeare's. This reading has implications for the staging of All's Well That Ends Well, and for our view of the place of anal fistulas in cultural history.

  10. Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer.

    Science.gov (United States)

    Zhong, Min-Er; Niu, Bei-Zhan; Ji, Wu-Yang; Wu, Bin

    2016-06-14

    We report on a patient diagnosed with Peutz-Jeghers syndrome (PJS) with synchronous rectal cancer who was treated with laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). PJS is an autosomal dominant syndrome characterized by multiple hamartomatous polyps in the gastrointestinal tract, mucocutaneous pigmentation, and increased risks of gastrointestinal and nongastrointestinal cancer. This report presents a patient with a 20-year history of intermittent bloody stool, mucocutaneous pigmentation and a family history of PJS, which together led to a diagnosis of PJS. Moreover, colonoscopy and biopsy revealed the presence of multiple serried giant pedunculated polyps and rectal adenocarcinoma. Currently, few options exist for the therapeutic management of PJS with synchronous rectal cancer. For this case, we adopted an unconventional surgical strategy and ultimately performed laparoscopic restorative proctocolectomy with IPAA. This procedure is widely considered to be the first-line treatment option for patients with ulcerative colitis or familial adenomatous polyposis. However, there are no previous reports of treating PJS patients with laparoscopic IPAA. Since the operation, the patient has experienced no further episodes of gastrointestinal bleeding and has demonstrated satisfactory bowel control. Laparoscopic restorative proctocolectomy with IPAA may be a safe and effective treatment for patients with PJS with synchronous rectal cancer. PMID:27298573

  11. Analýza vybrané firmy

    OpenAIRE

    Peš, Martin

    2010-01-01

    Hlavním cílem diplomové práce je analyzovat skutečný a aktuální stav společnosti Laufen CZ, s.r.o. a navržení opatření. Jedná se o analýzu vnitřního a vnějšího prostředí společnosti. Jak se firma vyrovnala s dopady finanční a hospodářské krize nám sdělí analýzy SWOT, SLEPT, Quick test, Fundamentální analýza a Porterův model 5 sil.

  12. Hrvatsko nazivlje u analitičkoj kemiji

    OpenAIRE

    Kaštelan-Macan (ur.), M.

    2008-01-01

    U radu je prikazan povijesni razvoj prirodoslovnoga nazivlja s naglaskom na nazivlje u analitičkoj kemiji te današnje stanje i nastojanja da se to nazivlje ujednači i normira u skladu s hrvatskom jezičnom normom. Konačni cilj znanstvenoga projekta Hrvatsko nazivlje u analitičkoj kemiji, koji Ministarstvo znanosti, obrazovanja i športa podupire unutar znanstvenoga programa Hrvatska standardnojezična leksikologija i leksikografija jest izraditi cjeloviti enciklopedijski rječnik hrvatskoga anali...

  13. Empaatia kogemus kunstiteoses kujutatud subjekti suhtes: fenomenoloogiline analüüs / Marge Paas

    Index Scriptorium Estoniae

    Paas, Marge, 1976-

    2015-01-01

    Analüüsitakse vaataja esteetilist kogemust kunstiteose suhtes. Autor tugineb Edith Steini empaatia kogemuse uurimusele ja fenomenoloogilisele uurimismeetodile. Vaataja empaatia kogemuse analüüs Maarit Murka maalisarjas "Hairpower" kujutatud subjekti suhtes

  14. Modifiable risk factors of obstetric anal sphincter injury in primiparous women

    DEFF Research Database (Denmark)

    Jango, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne;

    2014-01-01

    To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women.......To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women....

  15. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    OpenAIRE

    Newton Sérgio de Carvalho; Aliana Meneses Ferreira; Camila Caroline Tremel Bueno

    2011-01-01

    In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN) and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be us...

  16. CXCR2 knockout mice are protected against DSS-colitis-induced acute kidney injury and inflammation.

    Science.gov (United States)

    Ranganathan, Punithavathi; Jayakumar, Calpurnia; Manicassamy, Santhakumar; Ramesh, Ganesan

    2013-11-15

    Organ cross talk exists in many diseases of the human and animal models of human diseases. A recent study demonstrated that inflammatory mediators can cause acute kidney injury and neutrophil infiltration in a mouse model of dextran sodium sulfate (DSS)-colitis. However, the chemokines and their receptors that may mediate distant organ effects in colitis are unknown. We hypothesized that keratinocyte chemoattractant (KC)/IL-8 receptor chemokine (C-X-C motif) ligand 2 (CXCL2) mediates DSS-colitis-induced acute kidney injury. Consistent with our hypothesis, wild-type (WT) mice developed severe colitis with DSS treatment, which was associated with inflammatory cytokine and chemokine expression and neutrophil infiltration in the colon. DSS-colitis in WT was accompanied by acute kidney injury and enhanced expression of inflammatory cytokines in the kidney. However, CXCR2 knockout mice were protected against DSS-colitis as well as acute kidney injury. Moreover, the expression of cytokines and chemokines and neutrophil infiltration was blunted in CXCR2 knockout mice in the colon and kidney. Administration of recombinant KC exacerbated DSS-colitis-induced acute kidney injury. Our results suggest that KC/IL-8 and its receptor CXCR2 are critical and major mediators of organ cross talk in DSS colitis and neutralization of CXCR2 will help to reduce the incidence of acute kidney injury due to ulcerative colitis and Crohn's disease in humans.

  17. Prevalence of microscopic colitis in patients with diarrhea of unknown etiology in Turkey

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To investigate the prevalence and demography of microscopic colitis in patients with diarrhea of unknown etiology and normal colonoscopy in Turkey. METHODS: Between March, 1998 to July, 2005, 129 patients with chronic non-bloody diarrhea of unexplained etiology who had undergone full colonoscopy with no obvious abnormalities were included in the study. Two biopsies were obtained from all colonic segments and terminal ileum for diagnosis of microscopic colitis. On histopathologic examination, criteria for lymphocytic colitis (intraepithelial lymphocyte ≥ 20 per 100 intercryptal epithelial cells, change in surface epithelium, mononuclear infiltration of the lamina propria) and collagenous colitis (subepithelial collagen band thickness ≥ 10 μm) were explored. RESULTS: Lymphocytic colitis was diagnosed in 12 (9%) patients (Female/Male: 7/5, mean age: 45 year, range: 27-63) and collagenous colitis was diagnosed in only 3 (2.5%) patients (all female, mean age: 60 years, range: 54-65). CONCLUSION: Biopsy of Turkish patients with the diagnosis of chronic non-bloody diarrhea of unexplained etiology and normal colonoscopic findings will reveal microscopic colitis in approximately 10% of the patients. Lymphocytic colitis is 4 times more frequent than collagenous colitis in these patients

  18. Treatment tactics in patient with rectal cancer complicating ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Yu. A. Barsukov

    2012-01-01

    Full Text Available A successful treatment of a young patient with a 15-year anamnesis of ulcerative colitis, who has been diagnosed with rectal cancer, is presented in this case report. A non-standard surgical intervention has been performed following all principles of oncologic surgery. A subtotal colectomy has been performed with ultra-low anterior resection of rectum. Ascendoanal anastomosis has been performed forming the neo-rectum. There were no complications in postoperative period. Considering disease stage (T3N1M0 adjuvant XELOX was administered for 6 months along with 2 cycles of prophylactic treatment with 5-aminosalycilic acid. During 2-years follow-up there are no signs of rectal cancer and ulcerative colitis progression. After pelvic electrostimulation defecation frequency decreased to 3–4 times per day, a patient has complete social rehabilitation.

  19. [Recent advances in medical and surgical treatment of ulcerative colitis].

    Science.gov (United States)

    Sugita, Akira; Koganei, Kazutaka; Tatsumi, Kenji; Futatsuki, Ryo; Kuroki, Hirosuke; Yamada, Kyoko; Arai, Katsuhiko; Fukushima, Tsuneo

    2015-03-01

    Recent advances in both medical and surgical treatment of ulcerative colitis have been remarkable. Changes in medical treatment are mainly good results of therapy with the anti-TNF-α antibody, tacrolimus, and those in surgical treatment are an expansion of the surgical indications to include patients with intractable disease, such as treatment refractoriness and chronic corticosteroid dependence, by a better postoperative clinical course after pouch surgery, improred selection of surgical procedures and the timing of surgery in elderly patients. To offer the optimal treatment for patients with ulcerative colitis, new medical therapies should be analyzed from the standpoint of the efficacy and limitations of effect. Long postoperative clinical course of surgical patients including colitic cancer, prevention of postoperative complications should be also analyzed.

  20. Sobre la mediatización: revisión conceptual y propuesta analítica

    Directory of Open Access Journals (Sweden)

    Fernández, Mariano

    2014-01-01

    Full Text Available [es] El propósito de este artículo es someter a una revisión analítica el concepto de “mediatización”, con especial énfasis en lo que podría considerarse una sub-variante, “la mediatización de la política”, pero que considerada desde el punto de vista de la constitución de un campo problemático, es en realidad un antecedente antes que un derivado. La tarea que nos proponemos ha sido realizada, con alcances desiguales y diverso esfuerzo de sistematización, por otros investigadores.Nos sumamos, pues, a una larga fila, pero no para actualizar un estado del arte sino para recortar las propiedades teóricas del concepto (y por lo tanto, para valorar su potencial heurístico, a la vez que nos permitimos sugerir una distinción de niveles analíticos que pueden ser útiles para orientar futuras investigaciones empíricas.

  1. Cause-Specific Colostomy Rates After Radiotherapy for Anal Cancer: A Danish Multicentre Cohort Study

    DEFF Research Database (Denmark)

    Sunesen, Kåre G; Nørgaard, Mette; Lundby, Lilli;

    2011-01-01

    In anal cancer, colostomy-free survival is a measure of anal sphincter preservation after treatment with radiotherapy or chemoradiotherapy. Failure to control anal cancer and complications of treatment are alternative indications for colostomy. However, no data exist on cause-specific colostomy...

  2. Pythium insidiosum colitis in a dog: treatment and clinical outcome

    OpenAIRE

    Mahyumi Fujimori; Erika Rondon Lopes; Samara Rosolem Lima; Daphine Ariadne Jesus de Paula; Arleana do Bom Parto Ferreira de Almeida; Edson Moleta Colodel; Caroline Argenta Pescador; Pedro Eduardo Brandini Néspoli; Luciano Nakazato; Valéria Dutra; Roberto Lopes de Souza; Valéria Régia Franco Sousa

    2016-01-01

    ABSTRACT: The aim of this report is to describe the clinical, pathological and imaging findings and treatment of colitis caused by Pythium insidiosum in a canine presenting haematochezia and progressive weight loss. Through imaging, a thickening of the transverse and descending colon was observed. Histopathological analysis of the large intestine fragment revealed the presence of hyphae, confirmed by immunohistochemistry and PCR as P. insidiosum. Antifungal treatment with itraconazole impleme...

  3. Pythium insidiosum colitis in a dog: treatment and clinical outcome

    Directory of Open Access Journals (Sweden)

    Mahyumi Fujimori

    2016-03-01

    Full Text Available ABSTRACT: The aim of this report is to describe the clinical, pathological and imaging findings and treatment of colitis caused by Pythium insidiosum in a canine presenting haematochezia and progressive weight loss. Through imaging, a thickening of the transverse and descending colon was observed. Histopathological analysis of the large intestine fragment revealed the presence of hyphae, confirmed by immunohistochemistry and PCR as P. insidiosum. Antifungal treatment with itraconazole implemented after partial surgical resection, resulted in control of the disease.

  4. Managing Ulcerative Colitis – The Guidelines and Beyond

    Directory of Open Access Journals (Sweden)

    Mitchell RKL Lie

    2013-11-01

    Full Text Available Management guidelines offer clinicians clear, evidence-based and often succinct treatment advice. For ulcerative colitis these guidelines describe the use of 5-ASA, corticosteroids, thiopurines, cyclosporine, and anti-TNFα therapies. However, guidelines do have some drawbacks, mainly a lack of concrete advice concerning patients resistant to these aforementioned therapies. This review gives a short overview of current guidelines and addresses treatment alternatives for conventional therapies.

  5. Pseudomembranous collagenous colitis: an unusual cause of chronic diarrhoea.

    Science.gov (United States)

    Khan-Kheil, Ayisha Mehtab; Disney, Benjamin; Ruban, Ernie; Wood, Gordon

    2014-02-13

    An 81-year-old woman presented with a history of severe chronic diarrhoea resulting in an admission with syncope and electrolyte abnormalities. Imaging studies of the bowel were normal. However, biopsies taken during colonoscopy enabled a diagnosis to be made and effective treatment to be initiated. This case report details the presentation, diagnosis and management of a rare injury pattern affecting the bowel: pseudomembranous collagenous colitis.

  6. Pseudomembranous colitis: an unusual cause of neutrocytic ascites.

    Science.gov (United States)

    Spahr, L; de Saussure, P; Felley, C; Pugin, J; Hadengue, A

    1999-07-01

    Severe cases of pseudomembranous colitis (PMC) may be associated with intraperitoneal fluid accumulation. However, the characteristics of the liquid are seldom described. Specifically, neutrocytic ascites has only been reported once. We report a case of a severe PMC complicated by a highly neutrocytic ascites which remained culture-negative. We discuss the possible mechanisms leading to ascites formation in this condition and review ascitic fluid characteristics in patients with PMC. PMID:10445802

  7. Diagnostic Value of Fecal Calprotectin in Patient with Ulcerative Colitis

    OpenAIRE

    Zamani, Hamed; Barzin, Gilda; Yousefinia, Mahsa; Mohammadkhani, Ashraf; Ostovaneh, Mohammad Reza; Sharifi, Amir Houshang; Tayebi, Sirous; Malekzadeh, Reza; Ansari, Reza

    2013-01-01

    BACKGROUND Ulcerative colitis (UC) is characterized by recurrent episodes of inflammation limited to the mucosal layer of the colon. Calprotectin is a zinc and calcium binding protein derived from neutrophils and monocytes. It is easily detectable in tissue samples, body fluids, and stools, which makes it a potentially valuable marker of inflammation. The aim of the current study is to evaluate the value of fecal calprotectin (FC) as a marker of disease activity in patients with UC. METHODS S...

  8. The Role of Fecal Calprotectin in Investigating Pediatric Ulcerative Colitis

    OpenAIRE

    Fatih Ünal; Evren Semizel; Muhittin Serdar; Çiğdem Ömür Ecevit; Yılmaz Karaca; Emine Mert Yılmaz; Hasan Kocaefe; Hasan Erhun Kasırga

    2012-01-01

    Introduction: Fecal calprotectin (FCP) can be found in high concentrations in inflammatory bowel disease due to the increase in leucocyte turnover in intestinal wall or increase of migration of neutrophils into the lumen. In this study, we aimed to determine the FCP values of the ulcerative colitis (UC) patients at the time of diagnosis and to investigate the applicability and effectiveness of this non-invasive method in the diagnosis of the disease, routinely.Materials and Methods: A total o...

  9. Colitis is associated with a loss of intestinofugal neurons

    OpenAIRE

    Linden, David R.

    2012-01-01

    Intestinofugal neurons sense and receive information regarding mechanical distension of the bowel and transmit this information to postganglionic sympathetic neurons in the prevertebral ganglia. Previous studies have demonstrated that trinitrobenzene sulfonic acid (TNBS)-induced colitis is associated with a loss of myenteric neurons that occurs within the first 12 h following the inflammatory insult. The purpose of this study was to test the hypothesis that intestinofugal neurons are among th...

  10. Norovirus Gastroenteritis Accompanied by Ischemic Colitis : A Case Report

    OpenAIRE

    Zenda, Takahiro; Kaneko, Shuichi; Noriki, Sakon

    2010-01-01

    A 57-year-old woman was admitted to our hospital because of frequent bloody diarrhea, vomiting, and abdominal cramps. While the patient was diagnosed with norovirus gastroenteritis based on the presence by chance of positive norovirus antigen in the stool samples, endoscopic as well as pathological examinations demonstrated left-sided ischemic colitis. The patient soon recovered solely by supportive treatment. Although it is believed that patients with viral gastroenteritis do not develop blo...

  11. Inflammatory cells′ role in acetic acid-induced colitis

    Directory of Open Access Journals (Sweden)

    Mohammad H Sanei

    2014-01-01

    Full Text Available Background: Free radicals are the known mechanisms responsible for inducing colitis with two origins: Inflammatory cells and tissues. Only the inflammatory cells can be controlled by corticosteroids. Our aim was to assess the importance of neutrophils as one of the inflammatory cells in inducing colitis and to evaluate the efficacy of corticosteroids in the treatment of inflammatory bowel disease (IBD. Materials and Methods: Thirty-six mice were divided into six groups of six mice each. Colitis was induced in three groups by exposing them to acetic acid through enema (group 1, ex vivo (group 3, and enema after immune suppression (group 5. Each group had one control group that was exposed to water injection instead of acetic acid. Tissue samples were evaluated and compared based on macroscopic damages and biochemical and pathological results. Results: Considering neutrophilic infiltration, there were significant differences between groups 1, 3, 5, and the control of group 1. Groups 3, 5, and their controls, and group 1 and the control of group 3 had significant differences in terms of goblet depletion. Based on tissue originated H 2 O 2 , we found significant differences between group 1 and its control and group 3, and also between groups 5 and the control of group 3. All the three groups were significantly different from their controls based on Ferric Reducing Ability of Plasma (FRAP and such differences were also seen between group 1 with two other groups. Conclusion: Neutrophils may not be the only cause of oxidation process in colitis, and also makes the effectiveness of corticosteroids in the treatment of this disease doubtful.

  12. Damage to the Enteric Nervous System in Experimental Colitis

    OpenAIRE

    Sanovic, Srdan; Lamb, Damian P.; Blennerhassett, Michael G

    1999-01-01

    Inflammation of the intestine causes pain and altered motility, at least in part through effects on the enteric nervous system. While these changes may be reversed with healing, permanent damage may contribute to inflammatory bowel disease (IBD) and post-enteritis irritable bowel syndrome. Since little information exists, we induced colitis in male Sprague-Dawley rats with dinitrobenzene sulfonic acid and used immunocytochemistry to examine the number and distribution of enteric neurons at ti...

  13. Immunomodulators and Immunosuppressants for Japanese Patients with Ulcerative Colitis

    OpenAIRE

    Shigeki Bamba; Tomoyuki Tsujikawa; Masaya Sasaki; Yoshihide Fujiyama; Akira Andoh

    2011-01-01

    Ulcerative colitis (UC) is characterized by a long-standing chronic course with remissions and exacerbations. Previously, patients do not respond to 5-aminosalicylic acid compounds and corticosteroids are considered for colectomies, however, in recent years, alternative treatments emerged for steroid-refractory or steroid-dependent UC. In this review article, we focus on immunomodulators (such as azathioprine [AZA] and 6-mercaptopurine [6-MP]) and immunosuppressants (such as cyclosporine A [C...

  14. Pseudomembranous collagenous colitis: an unusual cause of chronic diarrhoea

    Science.gov (United States)

    Khan-Kheil, Ayisha Mehtab; Disney, Benjamin; Ruban, Ernie; Wood, Gordon

    2014-01-01

    An 81-year-old woman presented with a history of severe chronic diarrhoea resulting in an admission with syncope and electrolyte abnormalities. Imaging studies of the bowel were normal. However, biopsies taken during colonoscopy enabled a diagnosis to be made and effective treatment to be initiated. This case report details the presentation, diagnosis and management of a rare injury pattern affecting the bowel: pseudomembranous collagenous colitis. PMID:24526204

  15. Two Cases of Diffuse Duodenitis Associated with Ulcerative Colitis

    OpenAIRE

    Katsuya Endo; Masatake Kuroha; Hisashi Shiga; Yoichi Kakuta; Seiichi Takahashi; Yoshitaka Kinouchi; Tooru Shimosegawa

    2012-01-01

    The upper gastrointestinal tract is not generally considered a target organ in ulcerative colitis (UC). However, several cases showing upper gastrointestinal involvement in UC have been reported. In this report, we present 2 rare cases of diffuse duodenitis accompanying pancolonic UC. Case patient 1 was a 44-year-old man who developed diffuse duodenitis shortly after colectomy and was successfully treated with mesalazine. Case patient 2 was a 25-year-old woman who developed diffuse duodenitis...

  16. Specific endoscopic features of ulcerative colitis complicated by cytomegalovirus infection

    Institute of Scientific and Technical Information of China (English)

    Hideyuki; Suzuki; Jun; Kato; Motoaki; Kuriyama; Sakiko; Hiraoka; Kenji; Kuwaki; Kazuhide; Yamamoto

    2010-01-01

    AIM:To identify specific colonoscopic findings in patients with ulcerative colitis (UC) complicated by cyto-megalovirus (CMV) infection.METHODS: Among UC patients who were hospitalized due to exacerbation of symptoms, colonoscopic findings were compared between 15 CMV-positive patients and 58 CMV-negative patients. CMV infection was determined by blood test for CMV antigenemia. Five aspects of mucosal changes were analyzed (loss of vascular pattern, erythema, mucosal edema, easy bleeding, and mucinous exuda...

  17. Microscopic colitis as a missed cause of chronic diarrhea

    Institute of Scientific and Technical Information of China (English)

    Nooroudien Mohamed; Monique Marais; Juanita Bezuidenhout

    2011-01-01

    AIM: To determine the prevalence of increased in-traepithelial lymphocytes, using immunohistochemistry in patients with normal colonoscopy and near normal biopsy. METHODS: We retrospectively reviewed all non-malig-nant colon mucosal biopsies between 2005 and 2007, reported as normal, chronic inflammation or melanosis coli in patients who were undergoing routine colonos-copy. Immunohistochemistry using CD3 was performed on all mucosal biopsies and an intraepithelial lympho-cyte count (IEL) was determined. Cases with an IEL count of ≥ 20 IELs per 100 surface epithelial cells were correlated with demographic, clinical and follow-up data. A further subgroup was evaluated for lymphocytic colitis.RESULTS: Twenty (8.3%) of 241 cases revealed an IEL count ≥ 20. Six (2.5%) patients were identified as having lymphocytic colitis (P < 0.001), of whom, five were missed on initial evaluation (P = 0.01). Four of these five patients were labeled with diarrhea-predom-inant irritable bowel syndrome (IBS). On follow-up, three of the remaining 20 cases were diagnosed with malignancy (renal cell carcinoma and myelodysplastic syndrome) and one had an unknown primary tumor with multiple liver metastases. Two cases of collag-enous colitis with an IEL count < 10 were included in this study. Increased IELs were not confined to pa-tients with diarrhea as a primary presenting symptom, but were also present in patients with abdominal pain (n = 7), constipation (n = 3) and loss of weight (n = 1). CONCLUSION: Immunohistochemistry using CD3 is of value in identifying and quantifying IELs for the pres-ence of microscopic colitis in patients with diarrhea-predominant IBS.

  18. Primary radiation therapy in the treatment of anal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cantril, S.T. (Children' s Hospital of San Francisco, CA); Green, J.P.; Schall, G.L.; Schaupp, W.C.

    1983-09-01

    From 1966 to 1981, 47 patients with a diagnosis of anal carcinoma were irradiated. This group was composed of 23 males and 24 females, with age ranging from 38 to 84 years (average 64.4 years). Five patients were treated preoperatively and 34 were treated definitively with cancericidal doses of irradiation. Acute radiation reactions requiring a rest-break were noted in 28% of patients, but all were managed as outpatients without untoward chronic sequelae. Chronic complications were noted in 13 patients, including two patients who required colostomy for severe anal stenosis and two who required A-P resection for large painful ulcers. Twenty-eight of 35 patients (80%) treated with irradiation alone have remained locally controlled without further treatment. An additional four have been salvaged by surgery. Only three patients had interstitial implants as part of their treatment course. Actuarial survival at five years for the N/sub 0/ patients and the group as a whole are 95.6 and 79.3%, respectively. It is concluded that external beam irradiation alone, properly fractionated to cancericidal doses, can control anal carcinoma with acceptable morbidity rates and without the use of either chemotherapy or interstitial implants in most cases. There is also a strong correlation suggesting that anal intercourse and male homosexuality play a significant role in the etiology of this disease.

  19. Aspectos funcionales de la psicoterapia analítico funcional.

    Directory of Open Access Journals (Sweden)

    Javier Virués Ortega

    2003-01-01

    Full Text Available Se considera una nueva psicoterapia de orientación conductual: la Psicoterapia Analítico Funcional. Se describen brevemente sus fundamentos teóricos, metodológicos y aplicados. Se discuten sus aspectos funcionales desde un punto de vista contextual.

  20. Analýza vybrané firmy

    OpenAIRE

    Zavoralová, Eva

    2012-01-01

    Diplomová práce je zaměřena na analýzu realitní společnosti M&M reality holding, a.s.. V rámci mapování společnosti se zaměřuji na rozbor oborového okolí pomocí PEST analýzy, Porterův model pěti konkurenčních sil, SWOT analýzu a finanční analýzu. V závěru práce navrhuji doporučení, která by měla vést ke zlepšení současné situace. The master´s thesis is focused on the analysis of real estate company M&M reality holding, a.s.. The mapping of the analysis focuses on the professional environme...

  1. Anal endosonographic findings in women after vaginal delivery

    Energy Technology Data Exchange (ETDEWEB)

    Kolodziejczak, Malgorzata [Department of Proctology, Hospital at Solec, Warsaw (Poland); Sudol-Szopinska, Iwona, E-mail: iwsud@ciop.pl [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Stefanski, Robert [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Panorska, Anna K. [Department of Mathematics and Statistics, University of Nevada, Reno (United States); Gardyszewska, Agnieszka [Second Clinic of Obstetrics and Gynecology, Warsaw (Poland); Krasnodebski, Ireneusz [Department of General and Gastroenterological Surgery and Nutrition, Medical University, Warsaw (Poland)

    2011-04-15

    Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery. Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years). 28 women had perineal lacerations of 3rd and 4th degree. 22 women had instrumental delivery. Anal endosonography was performed on all participants using BK Medical scanner Pro focus with a 3D endoprobe during the first week after delivery. Starck's classification was used to score sphincters defects. Results: The endosonographic images were abnormal in 8 out of 102 women (7.8%). Follow-up examinations after 6 weeks confirmed defects in 6 out of 102 women (5.8%). Five women had external anal sphincter torn, and 1 woman had both sphincters, internal and external, defected. Discordance between endosonographic diagnosis of defect and clinical assessment of sphincters continuity was demonstrated in 6 (5.9%) out of 8 initially found, including 2 (1.9%) false endosonographic results and 4 (3.9%) false clinical diagnosis (occult sphincter defects). The endosonography sensitivity and accuracy in sphincter defect diagnostic amounted to 100% and 98%, respectively. Conclusions: (1) Anal sphincters' tears in symptomatic women are not as frequent as it was believed. (2) The defect diagnosis in the first week after delivery should be verified by a follow-up endosonography in 6 weeks, after regression of the edema and hematoma.

  2. Increased Production of Lysozyme Associated with Bacterial Proliferation in Barrett's Esophagitis, Chronic Gastritis, Gluten-induced Atrophic Duodenitis (Celiac Disease), Lymphocytic Colitis, Collagenous Colitis, Ulcerative Colitis and Crohn's Colitis.

    Science.gov (United States)

    Rubio, Carlos A

    2015-12-01

    The mucosa of the esophagus, the stomach, the small intestine, the large intestine and rectum are unremittingly challenged by adverse micro-environmental factors, such as ingested pathogenic and non-pathogenic bacteria, and harsh secretions with digestive properties with disparate pH, as well as bacteria and secretions from upstream GI organs. Despite the apparently inauspicious mixture of secretions and bacteria, the normal GI mucosa retains a healthy state of cell renewal. To by-pass the tough microenvironment, the epithelia of the GI react by speeding-up cell exfoliation, by increasing peristalsis, eliminating bacteria through secretion of plasma cell-immunoglobulins and by increasing production of natural antibacterial enzymes (lysozyme) and host defense peptides (defensin-5). Lysozyme was recently found up-regulated in Barrett's esophagitis, in chronic gastritis, in gluten-induced atrophic duodenitis (celiac disease), in collagenous colitis, in lymphocytic colitis and in Crohn's colitis. This up-regulation is a response directed towards the special types of bacteria thriving in the microenvironment in each of the aforementioned clinical inflammatory maladies. The purpose of that up-regulation is to protect the mucosa affected by the ongoing chronic inflammation. Bacterial antibiotic resistance continues to exhaust our supply of effective antibiotics. The future challenge is how to solve the increasing menace of bacterial resistance to anti-bacterial drugs. Further research on natural anti-bacterial enzymes such as lysozyme, appears mandatory. PMID:26637845

  3. Protective Effect of Laminaria japonica with Probiotics on Murine Colitis

    Directory of Open Access Journals (Sweden)

    Seok-Jae Ko

    2014-01-01

    Full Text Available Inflammatory bowel disease (IBD is a chronically relapsing inflammatory disorder of the gastrointestinal tract. Most IBD treatments are unsatisfactory; therefore, various dietary supplements have emerged as promising interventions. Laminaria japonica (LJ is an edible seaweed used to regulate digestive symptoms. Probiotics have been reported to improve digestive problems and their simultaneous administration with seaweeds has been shown to produce synergistic therapeutic effects. Here, we investigated the effect of LJ combination with probiotics on dextran sodium sulfate-induced colitis model in mice. Aqueous LJ extracts (LJE at doses from 100 to 300 mg/kg and probiotics at a dose of 300 mg/kg were orally administered for 7 days. Body weight, colon length, histological score, macroscopic damage, and the levels of cytokines IFN-γ, IL-1β, IL-6, IL-10, IL-12 (P40, IL-12 (P70, IL-17, and TNF-α were assessed. LJE alone caused a significant improvement of colitis signs such as colon length, histological score, and IL-1β and IL-6 production. LJE and probiotics demonstrated a synergistic effect by the histological score and levels of IL-1β, IL-6, and IL-12 (P40 but not IFN-γ, IL-10, and IL-12 (P70. In conclusion, LJE was effective in inducing protection against colitis in mice and acted synergistically with probiotics.

  4. HSF2 expression in ulcerative colitis lesion tissue

    Institute of Scientific and Technical Information of China (English)

    Li-Rong Zeng; Peng-Fei Chen; Wen-Bin Wei

    2016-01-01

    Objective:To study the expression of HSF2 in ulcerative colitis lesion tissue and its value for diagnosis and assessment of the disease.Methods:A total of 40 cases with ulcerative colitis were included for study and divided into remission stage, mild activity stage, moderate activity stage and severe activity stage by Sutherland disease activity index. Lesion tissue and normal tissue were collected to detect HSFs, NOX1, ROS, COX2, PGE2, IL-6, JAK2, STAT3, TLRs and SOCSs contents.Results: HSF2 contents in lesion tissue were higher than those in normal tissue, and HSF1, HSF3 and HSF4 contents were not different from those of normal tissue; TLR2, TLR4, TLR5, MyD88, NF-kB, NOX1, ROS, COX2, PGE2, IL-6, JAK2 and STAT3 contents in lesion tissue were higher than those in normal tissue and positively correlated with HSF2 content; SOCS2 and SOCS3 contents in lesion tissue were lower than those in normal tissue and negatively correlated with HSF2 content, and SOCS1, SOCS4, SOCS5, SOCS6 and SOCS7 contents were not different from those of normal tissue.Conclusions:HSF2 expression abnormally increases in ulcerative colitis lesion tissue and is closely related to the activity of the disease, and HSF2 can regulate the expression of inflammatory signal molecules, TLRs and SOCSs to enhance inflammatory response.

  5. Histo-topographic study of the longitudinal anal muscle.

    Science.gov (United States)

    Macchi, Veronica; Porzionato, Andrea; Stecco, Carla; Vigato, Enrico; Parenti, Anna; De Caro, Raffaele

    2008-07-01

    The longitudinal anal muscle (LAM) has been described as a vertical layer of muscular tissue interposed between the circular layers of the internal (IAS) and external (EAS) anal sphincters. There is, however, no general agreement in the literature on its composition and attachments. The aim of this study was to investigate the histological structure, attachments, and topography of the LAM in order to evaluate its role in continence and defecation, thus enhancing knowledge of the surgical anatomy of this region. After in situ formalin fixation, the pelvic viscera were removed from eight male and eight female cadavers (age range: 52-72 years). Serial macrosections of the bladder base, lower rectum and anal canal, cervix and pelvic floor complex, cut in the transverse (six specimens) and coronal (six specimens) planes, underwent histological and immunohistochemical studies. Four specimens were studied using the E12 sheet plastination technique. The LAM was identified in 10/12 specimens (83%). Transverse and coronal sections made clear that it is a longitudinal layer of muscular tissue, marking the boundary between the internal and external anal sphincters. From the anorectal junction it extends along the anal canal, receives fibers from the innermost part of the puborectalis and the puboanalis muscles, and terminates with seven to nine fibro-elastic septa, which traverse the subcutaneous part of the external anal sphincter, reaching the perianal dermis. In the transverse plane, the mean thickness of the LAM was 1.68 +/- 0.27 mm. Immunohistochemical staining showed that the LAM consists of predominantly outer striated muscle fibers and smaller numbers of inner smooth muscle fibers, respectively coming from the levator ani muscle and from the longitudinal muscular layer of the rectum. The oblique fibers suggest that the LAM may represent the intermediate longitudinal course of small bridging muscle bundles going reciprocally from the striated EAS to the smooth IAS and

  6. A Cytosolic Multiprotein Complex Containing p85α Is Required for β-Catenin Activation in Colitis and Colitis-associated Cancer.

    Science.gov (United States)

    Goretsky, Tatiana; Bradford, Emily M; Ryu, Hyunji; Tahir, Maryam; Moyer, Mary Pat; Gao, Tianyan; Li, Linheng; Barrett, Terrence A

    2016-02-19

    Wnt/β-catenin signaling is required for crypt structure maintenance. We previously observed nuclear accumulation of Ser-552 phosphorylated β-catenin (pβ-Cat(Ser-552)) in intestinal epithelial cells (IEC) during colitis and colitis-associated cancer. Data here delineate a novel multiprotein cytosolic complex (MCC) involved in β-catenin signaling in the intestine. The MCC contains p85α, the class IA subunit of PI3K, along with β-catenin, 14-3-3ζ, Akt, and p110α. MCC levels in IEC increase in colitis and colitis-associated cancer patients. IEC-specific p85α-deficient (p85(ΔIEC)) mice develop more severe dextran sodium sulfate colitis due to delayed ulcer healing and reduced epithelial β-catenin activation. In colonic IEC, p85α deficiency did not alter PI3K signaling. In vitro shRNA depletion of individual complex members disrupts the MCC and reduces β-catenin signaling. Despite worse colitis, p85(ΔIEC) mice have reduced tumor burden after azoxymethane/dextran sodium sulfate treatment. Together the data indicate that the β-catenin MCC is needed for mucosal repair and carcinogenesis. This novel MCC may be an attractive therapeutic target in preventing cancer in colitis patients.

  7. Assessment of risks of stenosis of the anal canal during a prostatic radiotherapy; evaluation des risques de stenose du canal anal lors de la radiotherapie prostatique

    Energy Technology Data Exchange (ETDEWEB)

    Almokhles, H.; Pan, Q.; Calitchi, E.; Diana, C.; Muresan, M.; Jiang, M.W.; Wu, J.F.; Wang, X.W.; Lu, H.J.; Lagrange, J.L. [Hopital Henri-Mondor, Creteil (France)

    2011-10-15

    The authors report a study which aimed at assessing the late tolerance of a prostatic irradiation at the rectum and anal canal level. They assessed the length of the rectum and of the anal canal after prostate irradiation or surgery in patients who suffered from a prostate adenocarcinoma. Data of 154 patients have been analyzed regarding the number of cases of stenosis of rectum or anal canal. They highlight the importance of the irradiated length and dose level. Short communication

  8. Autoimmunity in ulcerative colitis: humoral and cellular immune response bytropomyosin in ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Xin Geng; Masato Taniguchi; Hui Hui Dai; JJ-C Lin; Jim Lin; Kiron Moy Das

    2000-01-01

    AIM Autoimmunity has been emphasized in the pathogenesis of ulcerative colitis (UC). We reported thattropomyosin (TM) or TM related protein is a putative autoantigen in UC. In human fibroblast, at least 8isoforms of TM have been identified with molecular weight range from 30kD to 40kD, depending upon theisoforms, and human TM isoforms (hTM5) has been found the main isoform in human intestinal epithelialcells. In this study, hTM5 was used as a putative auto-antigen for the humoral and T cell immune responses inpatients with UC, Crohn's disease (CD) and healthy subjects (HS) as controls.METHODS Anti-bTM antibody was examined by enzyme-linked immunosorbent assay using human sera(UC 59, CD 28, HS 26) against hTM isoforms. The IFN-γ production by peripheral blood T cells followingstimulation by recombinant hTM5 was analyzed by ELISPOT assay.RESULTS Anti-hTM5 antibody (IgG1) was detected in 15/59 (25.4%) patients with UC, 3/28 (10.γ%)with CD, and 3/26 (11.5%) of HS. The OD value in UC was significantly higher than in CD and HS groups(P < 0.05; P < 0.01 respectively). Western blot analysis demonstrated immunoreactivity against hTM5 inseveral UC sera. ELISPOT assay demonstrated that IFN-γ production is significantly higher in UC (7/18),39.0%), compared with CD (0/8, 0%) and HS (0/7, 0%), (P<0.05).CONCLUSION A significantly higher immune response to hTM5 was present in UC compared to CD andHS. Further studies of the hTM5/peptides may provide immuno-biochemical mechanism of autoimmuneprocess in UC.

  9. Usefulness of colonoscopy in ischemic colitis Utilidad de la colonoscopia en la colitis isquémica

    Directory of Open Access Journals (Sweden)

    M. Lozano Maya

    2010-08-01

    Full Text Available Background: the ischemic colitis is intestinal the most frequent cause of ischemia. With this work we determine the demographic and clinical characteristics, and the usefulness of the colonoscopy in the patients with ischemic colitis diagnosed in our centre in relation to a change of therapeutic attitude. Method: retrospective study in which were selected 112 patients diagnosed with ischemic colitis by colonoscopy and biopsy, in a period of five years. It was analyzed: age, sex, reason for examination, factors of cardiovascular risk, endoscopic degree of ischemia, change in the therapeutic attitude, treatment and outcome. Results: the average age was of 73.64 ± 12.10 years with an equal incidence in women (50.9% and the men (49.1%. The associated factors were the HTA (61.1%, tobacco (37.2% and antecedents of cardiovascular episode (52.2%. The most frequent reason for colonoscopy was rectorrhagia (53.6% followed of the abdominal pain (30.4%, being urgent the 65.3%. Colonoscopy allowed a change in the therapeutic attitude in the 50 increasing in the urgent one to the 65.75%. Global mortality was of 27.67%. The serious ischemic colitis (25% was more frequent in men (64.3% in urgent indication (85.71% and attends with high mortality (53.57%. Surgical treatment in the 57.14% was made with a good evolution in the 50%, whereas the patients with mild or moderate ischemic colitis had a better prognosis (favourable evolution in 80.95% with smaller requirement of the surgical treatment (4.76%, p Introducción: la colitis isquémica es la causa más frecuente de isquemia intestinal. Realizamos un estudio con el objetivo de analizar las características demográficas, clínicas y la utilidad de la colonoscopia en los pacientes diagnosticados de colitis isquémica en nuestro centro en relación a un cambio de actitud terapéutica. Método: estudio retrospectivo en el que se seleccionaron 112 pacientes diagnosticados de colitis isquémica mediante

  10. Diffuse large B cell lymphoma presenting as a peri-anal abscess.

    Science.gov (United States)

    Jayasekera, Hasanga; Gorissen, Kym; Francis, Leo; Chow, Carina

    2014-01-01

    A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a peri-anal abscess is rare. A high degree of suspicion must be maintained for an anal abscess which does not resolve with conservative management. PMID:24898408

  11. Influência da administração da Plantago ovata (fibra dietética) na proteção da parede colônica em colite inflamatória induzida por ácido acético: estudo estereológico experimental em ratos The influence of Plantago ovata (dietetic fiber) admininstration on the colonic wall protection in the acetic acid induced inflammatory colitis: an experimental stereologic study in rats

    OpenAIRE

    Eduardo Cortez Vassallo; Andréa Povedano; João de Aguiar Pupo Neto; Francisco Lopes Paulo

    2007-01-01

    OBJETIVO: Estudo do papel da fibra dietética (Plantago ovata) na proteção e recuperação da parede intestinal de ratos submetidos a colite inflamatória induzida por ácido acético. MÉTODO: Utilizados 30 ratos Wistar machos, com peso variando entre 260 - 300g, distribuidos em três Grupos de 10 indivíduos: O Grupo I (n10) ou Grupo Controle, recebeu dieta padrão durante todo o experimento. O Grupo II (n10) ou Grupo Colite, recebeu igualmente, dieta padrão durante todo o experimento. O Grupo III (n...

  12. Human papillomavirus, anal cancer, and screening considerations among HIV-infected individuals.

    Science.gov (United States)

    Cachay, Edward R; Mathews, William Christopher

    2013-01-01

    Invasive anal cancer has become an important cause of non AIDS-related cancer among HIV-infected individuals. Human papillomavirus is the main etiological agent. This review explains the pathophysiologic role of human papillomavirus in the development of invasive anal cancer, summarizes recent epidemiological trends of invasive anal cancer, and reviews the evidence to address common clinical questions posed when screening for anal cancer in HIV-infected patients. The effect of highly active antiretroviral therapy on human papillomavirus oncogenesis is still unclear, but given the increased clinical burden of invasive anal cancer among HIV-infected patients, many clinics have implemented screening programs for anal cancer and its precursors. Despite the availability of several modalities for treatment of precursors of anal cancer, evidence that current treatment modalities favorably alter the natural history of human papillomavirus oncogenesis in the anal and perianal regions is still inconclusive. However, there is sufficient evidence to state that the accuracy of anal cancer screening procedures (cytology and high-resolution anoscopy directed biopsy) is comparable to the accuracy of those used in screening for cervical cancer precursors. Studies that systematically assess the efficacy of these anal cancer screening programs in reducing the incidence of and morbidity and mortality from invasive anal cancer among HIV-infected patients are needed. PMID:23681437

  13. Obestatin Accelerates the Healing of Acetic Acid-Induced Colitis in Rats

    Directory of Open Access Journals (Sweden)

    Aleksandra Matuszyk

    2016-01-01

    Full Text Available Obestatin, a 23-amino acid peptide derived from the proghrelin, has been shown to exhibit some protective and therapeutic effects in the gut. The aim of present study was to determine the effect of obestatin administration on the course of acetic acid-induced colitis in rats. Materials and Methods. Studies have been performed on male Wistar rats. Colitis was induced by a rectal enema with 3.5% acetic acid solution. Obestatin was administered intraperitoneally twice a day at a dose of 8 nmol/kg, starting 24 h after the induction of colitis. Seven or 14 days after the induction of colitis, the healing rate of the colon was evaluated. Results. Treatment with obestatin after induction of colitis accelerated the healing of colonic wall damage and this effect was associated with a decrease in the colitis-evoked increase in mucosal activity of myeloperoxidase and content of interleukin-1β. Moreover, obestatin administration significantly reversed the colitis-evoked decrease in mucosal blood flow and DNA synthesis. Conclusion. Administration of exogenous obestatin exhibits therapeutic effects in the course of acetic acid-induced colitis and this effect is related, at least in part, to the obestatin-evoked anti-inflammatory effect, an improvement of local blood flow, and an increase in cell proliferation in colonic mucosa.

  14. Can colonoscopy diagnose transmural ischaemic colitis after abdominal aortic surgery? An evidence-based approach

    DEFF Research Database (Denmark)

    Houe, T; Thorböll, J E; Sigild, U;

    2000-01-01

    to assess the diagnostic value of colonoscopy in ischaemic colitis following abdominal aortic surgery, based on a literature review, and to introduce the concept of evidence-based medicine.......to assess the diagnostic value of colonoscopy in ischaemic colitis following abdominal aortic surgery, based on a literature review, and to introduce the concept of evidence-based medicine....

  15. Systemic lupus erythematosus in association with ulcerative colitis: related autoimmune diseases.

    Science.gov (United States)

    Stevens, H P; Ostlere, L S; Rustin, M H

    1994-03-01

    We report a patient who developed urticaria, angio-oedema and polyarthropathy secondary to the hypocomplementaemic urticarial vasculitis syndrome, a year prior to the onset of ulcerative colitis. Ten years later, primary sclerosing cholangitis and the antiphospholipid syndrome developed concomitantly. We believe this patient represents only the second reported case of idiopathic systemic lupus erythematosus (SLE) occurring in association with ulcerative colitis. PMID:8148283

  16. Retrospective analysis of old-age colitis in the Dutch inflammatory bowel disease population

    OpenAIRE

    Hadithi, M. al; Cazemier, M.; Meijer, G. A.; Bloemena, E.; Felt-Bersma, R.J.F.; Mulder, C. J. J.; Meuwissen, S G M; Pena, A S; Bodegraven, van, A.A.

    2008-01-01

    AIM: To describe the characteristics of Dutch patients with chronic inflammatory bowel disease (IBD) first diagnosed above 60 years of age-a disease also known as old-age colitis (OAC) and to highlight a condition that has a similar appearance to IBD, namely segmental colitis associated with diverticular disease (SCAD).

  17. Efficacy of Adalimumab as a long term maintenance therapy in ulcerative colitis.

    LENUS (Irish Health Repository)

    McDermott, Edel

    2013-03-01

    Adalimumab is a recombinant human IgG1 monoclonal antibody to TNF-alpha. There are limited data with regard to its efficacy in ulcerative colitis. We report experience of adalimumab in ulcerative colitis in a single centre with a focus on the ability of this agent to maintain response and avoid colectomy in the medium to long-term.

  18. Obestatin Accelerates the Healing of Acetic Acid-Induced Colitis in Rats.

    Science.gov (United States)

    Matuszyk, Aleksandra; Ceranowicz, Piotr; Warzecha, Zygmunt; Cieszkowski, Jakub; Bonior, Joanna; Jaworek, Jolanta; Kuśnierz-Cabala, Beata; Konturek, Peter; Ambroży, Tadeusz; Dembiński, Artur

    2016-01-01

    Obestatin, a 23-amino acid peptide derived from the proghrelin, has been shown to exhibit some protective and therapeutic effects in the gut. The aim of present study was to determine the effect of obestatin administration on the course of acetic acid-induced colitis in rats. Materials and Methods. Studies have been performed on male Wistar rats. Colitis was induced by a rectal enema with 3.5% acetic acid solution. Obestatin was administered intraperitoneally twice a day at a dose of 8 nmol/kg, starting 24 h after the induction of colitis. Seven or 14 days after the induction of colitis, the healing rate of the colon was evaluated. Results. Treatment with obestatin after induction of colitis accelerated the healing of colonic wall damage and this effect was associated with a decrease in the colitis-evoked increase in mucosal activity of myeloperoxidase and content of interleukin-1β. Moreover, obestatin administration significantly reversed the colitis-evoked decrease in mucosal blood flow and DNA synthesis. Conclusion. Administration of exogenous obestatin exhibits therapeutic effects in the course of acetic acid-induced colitis and this effect is related, at least in part, to the obestatin-evoked anti-inflammatory effect, an improvement of local blood flow, and an increase in cell proliferation in colonic mucosa.

  19. Critical appraisal of the current practice in murine TNBS-induced colitis

    NARCIS (Netherlands)

    A.A.T. Velde; M.I. Verstege; D.W. Hommes

    2006-01-01

    There is no standard practice in the induction of colitis by 2,4,6-trinitrobenzene sulfonic acid. In this review the current practice in 2,4,6-trinitrobenzene sulfonic acid colitis is studied using 20 recently published articles. We compare the different protocols, discuss the mechanism of disease a

  20. Safety and efficacy of Profermin(R) to induce remission in ulcerative colitis

    DEFF Research Database (Denmark)

    Krag, Aleksander; Israelsen, Hans; von Ryberg, Bjørn;

    2012-01-01

    AIM: To test the efficacy and safety of Profermin(R) in inducing remission in patients with active ulcerative colitis (UC). METHODS: The study included 39 patients with mild to moderate UC defined as a Simple Clinical Colitis Activity Index (SCCAI) > 4 and < 12 (median: 7.5), who were treated ope...

  1. Valoración de la región anal en el delito sexual en la medicina forense clínica

    Directory of Open Access Journals (Sweden)

    Pablo Navarro

    2001-09-01

    Full Text Available La región anal tiene una gran importancia en la vida sexual de los individuos. Se dice que es utilizada por el 10% de las mujeres heterosexuales como área genital y en el 80% de los varones homosexuales en USA, de ahi la importancia de conocer el tipo de lesiones y hallazgos médico forenses en las agresiones y delitos de este tipo.The anal area has a great meaning in peopels sexual live. In U S A 10% of heterosexual women and 80% of guy men use it like a genital area Here is the reazon to know the kind of legal medicine injuries and findings in this type of cases.

  2. Sonda para la medida de transistorios radiados en campo cercano con transmisión por fibra optica

    OpenAIRE

    Gras Andreu, Isabel

    2013-01-01

    [ANGLÈS] Design and characterization of a probe with analog transmission by optical fiber for the simultaneous measure of the electrical and magnetic components of a transient radiated interference. [CASTELLÀ] Diseño y caracterización de una sonda con transmisión analógica por fibra óptica para la medida simultanea de los componentes eléctricos y magnéticos de una interferencia radiada transitoria. [CATALÀ] Disseny i caracterització d'una sonda amb transmissió analògica per fibra òptica...

  3. The importance of ultrasound findings in the study of anal pain Importancia de los hallazgos ecográficos en el dolor anal

    Directory of Open Access Journals (Sweden)

    A. M. Vieira

    2010-05-01

    Full Text Available Objective: endoanal ultrasonography can detect organic causes of anal pain without pathology on physical examination. The aim of this study is to evaluate the importance of endoanal ultrasonography in the diagnosis and therapeutic management of idiopathic and functional anal pain. Material and methods: retrospective study, between 15 March 2005 and 15 June 2008, of all patients with proctalgia and normal examination or with alterations not responsible for anal pain at proctologic exam that have undergone an endoanal ultrasonography. Results: a total of 90 patients were analyzed, with a mean age of 50.5 years, 58% were female. Twenty-three patients had functional anal pain clinic criteria. Endoanal ultrasonography revealed alterations in 49% of patients. The primary findings were changes in sphincters in 14 patients, followed by anal sepsis in 12 patients, anal fissure in 10 patients, perirectal lesions in 6 patients and ulcer of the anal canal in 2 patients. Of the patients with sphincter defects, 5 patients had criteria of chronic anal pain. In this group of patients, no differences were found in manometric and defecographic results between the different ultrasound abnormalities. Conclusions: the endoanal ultrasonography detected occult organic lesions to proctologic examination, in half the patients with anal pain. Ultrasound abnormalities were found in 22% of patients with functional anal pain. However, there was no correlation between ultrasound findings and physiological studies, and therefore could not find etiological or pathogenic factors of functional anal pain.Objetivo: la ecografía endoanal puede detectar causas orgánicas en el dolor anal sin patología en la exploración física. El objetivo de este estudio es evaluar la importancia de la ecografía endoanal en el diagnóstico y en el abordaje terapéutico del dolor anal idiopática y funcional. Material y métodos: estudio retrospectivo realizado entre el 15 de marzo de 2005 y el

  4. Cellular localization, binding sites, and pharmacologic effects of TFF3 in experimental colitis in mice

    DEFF Research Database (Denmark)

    Kjellev, Stine; Thim, Lars; Pyke, Charles;

    2007-01-01

    the effect of TFF3 on dextrane sulfate sodium (DSS)-induced colitis in mice. Expression of endogenous TFF1-3 was examined by in situ hybridization and immunohistochemistry, and the distribution of intravenously, intraperitoneally, and subcutaneously administered (125)I-TFF3 by autoradiography and gamma......-counting. The effect of systemically administered TFF3 on DSS-induced colitis was assessed. We found increased expression of endogenous TFF3 and increased binding of injected (125)I-TFF3 in the colon of animals with DSS-induced colitis. The distribution of intraperitoneally and subcutaneously administered (125)I-TFF3...... was comparable. Systemic administration of the peptides reduced the severity of colitis. Expression of endogenous TFF3 and binding of systemically administered TFF3 are increased in DSS-induced colitis. Systemic administration of TFF3 attenuates the disease. These findings suggest a role of TFF3 in mucosal...

  5. Relationship between Mast Cells and the Colitis with Relapse Induced by Trinitrobenzesulphonic Acid in Wistar Rats

    Directory of Open Access Journals (Sweden)

    Ana Carolina Luchini

    2009-01-01

    Full Text Available The present study aimed to clarify the role of mast cells in colitis with relapse induced in Wistar rats by trinitrobenzenosulphonic acid. Colitis induction increased the histamine concentration in the colon, which peaked on day 26. The number of mast cells, probably immature, was ten times higher on day 8. Different from animals infected with intestinal parasites, after colitis remission, mast cells do not migrate to the spleen, showing that mast cell proliferation presents different characteristics depending on the inflammation stimuli. Treatment with sulfasalazine, doxantrazole, quercetin, or nedocromil did not increase the histamine concentration or the mast cell number in the colon on day 26, thereby showing absence of degranulation of these cells. In conclusion, although mast cell proliferation is associated with colitis, these cells and their mediators appear to play no clear role in the colitis with relapses.

  6. Anal high-risk human papillomavirus infection and high-grade anal intraepithelial neoplasia detected in women and heterosexual men infected with human immunodeficiency virus

    Directory of Open Access Journals (Sweden)

    Gandra S

    2015-01-01

    Full Text Available Sumanth Gandra, Aline Azar, Mireya WessolosskyDivision of Infectious Disease and Immunology, University of Massachusetts Medical School, Worcester, MA, USABackground: Although anal high-risk human papillomavirus (HR-HPV infection and anal cytological abnormalities are highly prevalent among human immunodeficiency virus (HIV-infected men who have sex with men (MSM, there are insufficient data on these abnormalities among HIV-infected heterosexual men (HSM and women. In this study, we evaluated the prevalence of anal HR-HPV, cytological abnormalities, and performance of these screening tests in detecting high-grade anal intraepithelial neoplasia (AIN2+ among our cohort of HIV-infected MSM and non-MSM (HSM and women.Methods: A single-center, retrospective cohort study was conducted with HIV-infected individuals who underwent anal cancer screening with anal cytology and HR-HPV testing from January 2011 to January 31, 2013.Results: Screening of 221 HIV-infected individuals for both HR-HPV and anal cytology showed the presence of HR-HPV in 54% (abnormal anal cytology 48% of MSM, 28% (abnormal anal cytology 28% of HSM, and 27% (abnormal anal cytology 34% of women. Among 117 (53% individuals with abnormal results (HR-HPV-positive and/or cytology was atypical squamous cells of undetermined significance or above, 67 underwent high resolution anoscopy. Of these 67 individuals, 22 individuals had AIN2+ (17 MSM, four women, and one HSM. HR-HPV correlated better with AIN2+ than with anal cytology on biopsy in both MSM (r=0.29 versus r=0.10; P=0.05 versus P=0.49 and non-MSM (r=0.36 versus r=-0.34; P=0.08 versus P=0.09.Conclusion: Given the presence of AIN2+ in screened HIV-infected HSM and women, routine anal cancer screening in all HIV-infected individuals should be considered. HR-HPV merits further evaluation for anal cancer screening among non-MSM.Keywords: human immunodeficiency virus, anal human papillomavirus, heterosexual men, women, anal cancer

  7. Modelo analítico del efecto de PRS sobre satélites GPS

    Science.gov (United States)

    Meza, A.; Brunini, C.; Usandivaras, J. C.

    El sistema GPS (Global Position System) es, hoy en día, la herramienta de navegación y posicionamiento más potente y lo será sin duda en la próxima década. Gran parte de su valiosa utilidad se debe a la alta precisión que permite lograr y ésta, a su vez, depende, entre otras causas, de la precisión con que se conocen las órbitas de los satélites. La presión de radiación solar (PRS) fija el límite de la precisión con que pueden calcularse en la actualidad las efemérides satelitarias. El objetivo de este trabajo es proponer una mejor resolución de este fenómeno. El modelo analítico aquí presentado, se basa en el análisis del comportamiento de los residuos de un ajuste por mínimos cuadrados en el que se utiliza el modelo de PRS propuesto por Beutler. El mismo consiste en un modelo determinista del fenómeno con dos parámetros libres. Los resultados obtenidos ponen de manifiesto que, aún después de aplicar dichos parámetros, prevalecen en los residuos efectos semidiurnos en las componentes radial,tangencial y normal. Estos resultados obtenidos se comparan con los de un trabajo desarrollado por el Instituto de Berne (Beutler et al., 1994), en el que se utilizaron como pseudo-observaciones las órbitas precisas del IGS (CODE). El intervalo de integración escogido por este centro fueron las semanas 680 y 681. En resumen se tienen arcos de 14 días para todos los satélites, donde las efemérides precisas de los mismos para los 14 días fueron utilizados como pseudo-observaciones. El modelo de fuerza que empleó dicho centro fue básicamente el tradicional en lo que respecta al modelo de las fuerzas gravitacionales, y para la PRS utilizo el modelo standard de Beutler. Los parámetros de este modelo junto con las 6 condiciones iniciales (posición y velocidad) fueron ajustados por el método general de mínimos cuadrados. Los residuos en la componente radial, tangencial y normal, para los satélites con un buen comportamiento, presentan una

  8. Intestine-Specific Mttp Deletion Increases the Severity of Experimental Colitis and Leads to Greater Tumor Burden in a Model of Colitis Associated Cancer

    OpenAIRE

    Yan Xie; Hitoshi Matsumoto; Ilke Nalbantoglu; Kerr, Thomas A.; Jianyang Luo; Rubin, Deborah C; Susan Kennedy; Davidson, Nicholas O.

    2013-01-01

    Background Gut derived lipid factors have been implicated in systemic injury and inflammation but the precise pathways involved are unknown. In addition, dietary fat intake and obesity are independent risk factors for the development of colorectal cancer. Here we studied the severity of experimental colitis and the development of colitis associated cancer (CAC) in mice with an inducible block in chylomicron secretion and fat malabsorption, following intestine-specific deletion of microsomal t...

  9. Light-emitting diodes at 940nm attenuate colitis-induced inflammatory process in mice.

    Science.gov (United States)

    Belém, Mônica O; de Andrade, Giovana M M; Carlos, Thalita M; Guazelli, Carla F S; Fattori, Victor; Toginho Filho, Dari O; Dias, Ivan F L; Verri, Waldiceu A; Araújo, Eduardo J A

    2016-09-01

    Inflammatory bowel disease (IBD) presents intense inflammatory infiltrate, crypt abscesses, ulceration and even loss of function. Despite the clinical relevance of IBD, its current therapy remains poorly effective. Infrared wavelength phototherapy shows therapeutic potential on inflammation. Our goal was to evaluate whether light-emitting diodes (LED) at 940nm are capable of mitigating the colitis-induced inflammatory process in mice. Forty male Swiss mice were assigned into five groups: control; control treated with LED therapy; colitis without treatment; colitis treated with LED therapy; colitis treated with Prednisolone. Experimental colitis was induced by acetic acid 7.5% (pH2.5) rectal administration. LED therapy was performed with light characterized by wavelength of 940nm, 45nm bandwidth, intensity of 4.05J/cm(2), total power of 270mW and total dose of 64.8J for 4min in a single application. Colitis-induced intestinal transit delay was inhibited by LED therapy. Colitis caused an increase of colon dimensions (length, diameter, total area) and colon weight (edema), which were inhibited by LED therapy. LED therapy also decreased colitis-induced tissue gross lesion, myeloperoxidase activity, microscopic tissue damage score and the presence of inflammatory infiltrate in all intestinal layers. Furthermore, LED therapy inhibited colitis-induced IL-1β, TNF-α, and IL-6 production. We conclude LED therapy at 940nm inhibited experimental colitis-induced colon inflammation in mice, therefore, rendering it a promising therapeutic approach that deserves further investigation. PMID:27424097

  10. Celulitis por citomegalovirus

    Directory of Open Access Journals (Sweden)

    A. Ruiz Lascano

    2002-12-01

    Full Text Available Las lesiones cutáneas por citomegalovirus (CMV son infrecuentes y a menudo una manifestación tardía de una enfermedad sistémica, que generalmente anuncia un curso fatal. Comunicamos un caso de celulitis por CMV: una mujer de 70 años con trasplante renal efectuado 1 mes antes de la consulta, terapia inmunosupresora con ciclosporina A y metilprednisona. La paciente ingresó por fiebre, dolor e impotencia funcional en pierna derecha. Comprobamos la existencia de una placa de 8 por 4 cm eritematoedematosa. La tratamos con antibióticos sin mejoría, por lo que realizamos un estudio histopatológico de piel que mostró cambios citopáticos compatibles con infección por CMV. Los cultivos bacteriológicos y micológicos fueron negativos. La inmunohistoquímica específica para CMV y el estudio de reacción en cadena de la polimerasa (PCR de la biopsia de piel fueron positivas, al igual que la antigenemia. El tratamiento con ganciclovir produjo la mejoría del cuadro clínico. En la literatura revisada no hemos encontrado la celulitis como manifestación de enfermedad cutánea por CMV.

  11. Open lateral internal anal sphincterotomy under local anesthesia as the gold standard in the treatment of chronic anal fissures: A prospective clinical and manometric study Esfinterotomía lateral interna abierta con anestesia local como gold standard en el tratamiento de la fisura anal crónica: Estudio prospectivo clínico y manométrico a largo plazo

    Directory of Open Access Journals (Sweden)

    A. Sánchez Romero

    2004-12-01

    hipertonía esfinteriana (mecanismo etiopatogénico fundamental de la fisura, permitiendo por tanto, disminuir la proctalgia y así la curación de la fisura. Material y métodos: realizamos un estudio prospectivo de 120 pacientes intervenidos por fisura anal crónica con esfinterotomía lateral interna abierta con anestesia local (20 cc mepivacaína al 2% tratados ambulatoriamente en la consulta de la Unidad de Proctología entre los años 1998-2001. No se requirió estudios preoperatorios, preparación con enemas, profilaxis antibiótica, accesos venosos, ingreso ni observación hospitalaria. Los pacientes fueron revisados a la 1ª semana, 2º mes, 6º mes y al año. Resultados: complicaciones precoces (1ª semana: 3 hematoma-equimosis de la herida (2,5%, 3 hemorragias autolimitadas (2,5%. No encontramos trombosis hemorroidales, fístulas, abscesos perianales ni mortalidad. Complicaciones tardías (2º mes: 9 pacientes con incontinencia (7,5% y 3 pacientes (2,5% con recurrencia de la fisura. Al 6º mes, la incontinencia disminuyó al 5% (6 pacientes, y aparecieron 3 pacientes más con recurrencia de la fisura (2,5%. Al año se mantuvo la tasa de incontinencia del 5% (a gases y líquidos y aparecieron otros 3 pacientes con recurrencia de la fisura (2,5%. Recurrencia global del 7,5%. Los hallazgos en la manometría fueron, PMB (presión máxima basal pre-tratamiento similar a la PMB en pacientes con recurrencia de la fisura, así como la PMB del grupo control similar a la PMB de pacientes con curación. La PMB en pacientes incontinentes fue más baja que la PMB en pacientes continentes (55 ± 7 frente a 80,7 ± 21. La diferencia entre la PMCV (presión máxima de contracción voluntaria en pacientes incontinentes y pacientes continentes no fue estadísticamente significativa. Conclusiones: la esfinterotomía lateral interna abierta con anestesia local tiene una tasa de curación a largo plazo y unos índices de morbilidad equiparables a otras técnicas, por lo que puede

  12. Anal metastasis from recurrent breast lobular carcinoma: A case report

    Institute of Scientific and Technical Information of China (English)

    Maria Puglisi; Emanuela Varaldo; Michela Assalino; Gianluca Ansaldo; Giancarlo Torre; Giacomo Borgonovo

    2009-01-01

    We report a case of isolated gastrointestinal metastasis from breast lobular carcinoma, which mimicked primary anal cancer. In July 2000, an 88-year-old woman presented with infiltrating lobular cancer (pT1/G2/N2). The patient received postoperative radiotherapy and hormonal therapy. Four years later,she presented with an anal polypoid lesion. The mass was removed for biopsy. Immunohistochemical staining suggested a breast origin. Radiotherapy was chosen for this patient, which resulted in complete regression of the lesion. The patient died 3 years after the first manifestation of gastrointestinal metastasis.According to the current literature, we consider the immunohistochemistry features that are essential to support the suspicion of gastrointestinal breast metastasis, and since we consider the gastrointestinal involvement as a sign of systemic disease, the therapy should be less aggressive and systemic.

  13. Nástroj pro shlukovou analýzu

    OpenAIRE

    Hezoučký, Ladislav

    2010-01-01

    Diplomová práce se věnuje shlukové analýze dat. Jsou v ní vysvětleny základní pojmy a metody z této oblasti. Výsledkem práce je Nástroj pro shlukovou analýzu dat. Implementovány byly metody K-Medoids a DBSCAN. Součástí práce je i srovnání dosažených výsledků na reálných datech s programy Rapid Miner a SAS Enterprise Miner. The master' s thesis deals with cluster data analysis. There are explained basic concepts and methods from this domain. Result of the thesis is Cluster an...

  14. Pelvic floor ultrasound and anal incontinence in primiparous women

    DEFF Research Database (Denmark)

    Sakse, Abelone Elisabeth

    2010-01-01

    Afhandlingen havde til formål at undersøge muskulære forandringer på bækkenbundsmuskulaturen i relation til første fødsel, med særligt fokus på anal inkontinens. Forsvaret fandt sted d. 10. september 2010 kl. 14:00 i Auditoriet på Hvidovre Hospital.   ...

  15. Endosonographic appearance of the anal sphincters in patients following colostomy

    International Nuclear Information System (INIS)

    Background. The aim of the study was to visualize, by anal ultrasound (AUS), the suspected defects of the anal sphincters in the patients after colostomy and to analyze possible factors that could have led to such defects. Patients and methods. AUS, using a 7.0 MHz endorectal probe, was performed in a group of 25 patients with colostomy. The internal anal sphincter (IAS), external anal sphincter (EAS) and puborectalis muscle (PR) were visualized and the defects within them were qualified and quantified. For statistical analysis, the analysis of variance (ANOVA) was used. Results. The IAS was thin in all but three patients (22 patients; 88 %) with the mean thickness of 1.62 mm. A circular reduction of the thickness along the entire length of the IAS was seen in 20 patients (90.9 %). The echogenicity of the IAS was increased in 15 patients (60 %), and in 10 of them (66.6%), this defect embraced the whole length and circumference of the IAS. The margins of the IAS were not well-defined in 10 patients (40%). A significant correlation was found between the length of the patient's life with the stoma and the IAS echogenicity defect (p-value = 0.0001). No significant correlation was found between the dynamic examination, the IAS thickness and the IAS borders definition. Conclusion. The reduced thickness, increased echogenicity and borders definition defect of the IAS are seen in the patients after colostomy. The only significant correlation was confirmed between the length of the patient's life with the stoma and the IAS echogenicity defect. (author)

  16. Andrographis paniculata Extract (HMPL-004) for Active Ulcerative Colitis

    Science.gov (United States)

    Sandborn, William J; Targan, Stephan R; Byers, Vera S; Rutty, Dean A; Mu, Hua; Zhang, Xun; Tang, Tom

    2013-01-01

    OBJECTIVES: Andrographis paniculata has in vitro inhibitory activity against TNF-α, IL-1β and NF-κB. A pilot study of A. paniculata extract (HMPL-004) suggested similar efficacy to mesalamine for ulcerative colitis. METHODS: A randomized, double-blind, placebo-controlled trial evaluated the efficacy of A. paniculata extract (HMPL-004) in 224 adults with mild-to-moderate ulcerative colitis. Patients were randomized to A. paniculata extract (HMPL-004) 1,200 mg or 1,800 mg daily or placebo for 8 weeks. RESULTS: In total, 45 and 60% of patients receiving A. paniculata 1,200 mg and 1,800 mg daily, respectively, were in clinical response at week 8, compared with 40% of those who received placebo (P=0.5924 for 1,200 mg vs. placebo and P=0.0183 for 1,800 mg vs. placebo). In all, 34 and 38% of patients receiving A. paniculata 1,200 mg and 1,800 mg daily, respectively, were in clinical remission at week 8, compared with 25% of those who received placebo (P=0.2582 for 1,200 mg vs. placebo and P=0.1011 for 1,800 mg vs. placebo). Adverse events developed in 60 and 53% of patients in the A. paniculata 1,200 mg and 1,800 mg daily groups, respectively, and 60% in the placebo group. CONCLUSIONS: Patients with mildly to moderately active ulcerative colitis treated with A. paniculata extract (HMPL-004) at a dose of 1,800 mg daily were more likely to achieve clinical response than those receiving placebo. PMID:23044768

  17. Carcinoma of the anal sac glands in ranch mink.

    Science.gov (United States)

    Hadlow, W J

    1985-05-01

    During a 14-year period, carcinoma of the anal sac apocrine glands was found in 52 pastel and 8 sapphire mink (Mustela vison) kept for studies on slow viral diseases. The pastel mink varied in age from 72 to 135 months (mean age 108 months), the sapphire mink from 63 to 100 months (mean age 81 months). All but one pastel mink were females. The primary tumor varied in size from masses that caused bulges in the perineum to those that were found only after microscopic examination of the anal sac glands. Although the primary tumor grew mainly by expansion with little local infiltration, 41 of the 60 tumors had metastasized to the regional lymph nodes and sometimes also to more distant sites. The striking propensity of the carcinoma to metastasize while still small, even microscopic, often resulted in massive secondary growths, notably in the iliac lymph nodes. Hypercalcemia did not accompany the carcinoma. Its varied microscopic appearance included solid, glandular, squamous cell, and spindle or round cell components. Combinations of them formed mixed or complex histologic patterns, no doubt largely attributable to neoplastic proliferation of myoepithelial cells and squamous metaplasia of the apocrine gland epithelium. Although its cause remains obscure, the carcinoma appeared to arise from small foci of hyperplastic apocrine glands, sometimes in relation to both anal sacs. The tumor is a common and distinctive expression of neoplasia in older ranch mink.

  18. Heterosexual anal intercourse among men in Long Beach, California.

    Science.gov (United States)

    Hess, Kristen L; Reynolds, Grace L; Fisher, Dennis G

    2014-01-01

    Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions. PMID:24024565

  19. Fractal dimension and image statistics of anal intraepithelial neoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Ahammer, H., E-mail: helmut.ahammer@medunigraz.a [Institute of Biophysics, Center of Physiological Medicine, Medical University of Graz, Harrachgasse 21, A-8010 Graz (Austria); Kroepfl, J.M. [Human Performance Research Graz (HPR Graz), Karl-Franzens and Medical University of Graz, Max-Mell Allee 11, A-8010 Graz (Austria); Hackl, Ch. [Research Group of Applied Theoretical Pathology, Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria); Sedivy, R. [Research Group of Applied Theoretical Pathology, Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria); Department of Pathology, Country Medical Centre St.Poelten, Propst Fuehrer Strasse 4, A-3100 St.Poelten (Austria)

    2011-01-15

    Research Highlights: Human papillomaviruses cause anal intraepithelial neoplasia (AIN). Digital image processing was carried out to classify the grades of AIN quantitatively. The fractal dimension as well as grey value statistics was calculated. Higher grades of AIN yielded higher values of the fractal dimension. An automatic detection system is feasible. - Abstract: It is well known that human papillomaviruses (HPV) induce a variety of tumorous lesions of the skin. HPV-subtypes also cause premalignant lesions which are termed anal intraepithelial neoplasia (AIN). The clinical classification of AIN is of growing interest in clinical practice, due to increasing HPV infection rates throughout human population. The common classification approach is based on subjective inspections of histological slices of anal tissues with all the drawbacks of depending on the status and individual variances of the trained pathologists. Therefore, a nonlinear quantitative classification method including the calculation of the fractal dimension and first order as well as second order image statistical parameters was developed. The absolute values of these quantitative parameters reflected the distinct grades of AIN very well. The quantitative approach has the potential to decrease classification errors significantly and it could be used as a widely applied screening technique.

  20. Analýza signálů AVG

    OpenAIRE

    Mikauš, Jakub

    2008-01-01

    MIKAUŠ, J. Analýza signálů AVG. Brno: Vysoké učení technické v Brně, Fakulta elektrotechniky a komunikačních technologií, 2008. 33 s., 1 příl. Vedoucí bakalářské práce doc. Ing. Jiří Rozman, CSc. Práce se zabývá analýzou signálů AVG (arteriovelocitogram), který je získán neinvazivním měřením pomocí ultrazvukových lékařských přístrojů. Získaná data z těchto signálů jsou využívána pro stanovení diagnózy pacientů postižených ischemickou chorobou. Pro danou analýzu je využit algoritmus používajíc...

  1. Analýza AVG signálu

    OpenAIRE

    Matušek, Adam

    2010-01-01

    Bakalářská práce se zabývá analýzou signálu AVG (arteriovelocitogramu). Naměřená data vypovídají o rychlosti a charakteristice průtoku krve tepnami lidského těla. Signál je získáván ultrazvukovým měřením, využívá se odrazu mechanického vlnění od pohybující se tkáně a následné změny frekvence. Tento fenomén nazýváme Dopplerův jev. Na základě provedené analýzy určujeme přítomnost a stupeň ischemické choroby. K samotné klasifikaci dat byla použita metoda shlukové analýzy. Vyhodnocovací algoritmu...

  2. Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia.

    Science.gov (United States)

    Long, Kevin C; Menon, Raman; Bastawrous, Amir; Billingham, Richard

    2016-03-01

    The prevalence of anal intraepithelial neoplasia has been increasing, especially in high-risk patients, including men who have sex with men, human immunodeficiency virus positive patients, and those who are immunosuppressed. Several studies with long-term follow-up have suggested that rate of progression from high-grade squamous intraepithelial lesions to invasive anal cancer is ∼ 5%. This number is considerably higher for those at high risk. Anal cytology has been used to attempt to screen high-risk patients for disease; however, it has been shown to have very little correlation to actual histology. Patients with lesions should undergo history and physical exam including digital rectal exam and standard anoscopy. High-resolution anoscopy can be considered as well, although it is of questionable time and cost-effectiveness. Nonoperative treatments include expectant surveillance and topical imiquimod or 5-fluorouracil. Operative therapies include wide local excision and targeted ablation with electrocautery, infrared coagulation, or cryotherapy. Recurrence rates remain high regardless of treatment delivered and surveillance is paramount, although optimal surveillance regimens have yet to be established. PMID:26929753

  3. Anal intraepithelial neoplasia--is treatment better than observation?

    Science.gov (United States)

    Orchard, M; Roman, A; Parvaiz, A C

    2013-01-01

    Anal Intraepithelial Neoplasia (AIN) is an increasingly common condition for which the best treatment has not been well established. Traditional management was based on a 'watch and wait' strategy, but as the natural history of AIN and its progression to anal cancer is becoming better understood, more active treatment strategies are warranted. A best evidence topic in surgery was written according to a structured protocol to address the question whether treatment is indicated in patients with AIN. A total of 169 papers were identified using the defined search criteria. This included only one randomised controlled trial. Case series were therefore also included to help answer the question. The details of the papers were tabulated including relevant outcomes and study weaknesses. We conclude that treatment of high grade AIN, particularly in high risk groups is recommended to try to avoid progression to anal cancer. Treatment options that have shown some benefit include topical use of imiquimod cream or ablation directed by high resolution anoscopy. PMID:23643642

  4. Conceptualizations of heterosexual anal sex and HIV risk in five East African communities.

    Science.gov (United States)

    Duby, Zoe; Colvin, Christopher

    2014-01-01

    Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered "sex" and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.

  5. Anal squamous carcinoma: a new AIDS-defining cancer? Case report and literature review

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2012-12-01

    Full Text Available Squamous anal cell carcinoma is a rare malignancy that represents the 1.5% to 2% of all the lower digestive tract cancers. However, an increased incidence of invasive anal carcinoma is observed in HIV-seropositive population since the widespread of highly active antiretroviral therapy. Human papillomavirus is strongly associated with the pathogenesis of anal cancer. Anal intercourse and a high number of sexual partners appear to be risk factors to develop anal cancer in both sexes. Anal pain, bleeding and a palpable lesion in the anal canal are the most common clinical features. Endo-anal ultrasound is the best diagnosis method to evaluate the tumor size, the tumor extension and the infiltration of the sphincter muscle complex. Chemoradiotherapy plus antiretroviral therapy are the recommended treatments for all stages of localized squamous cell carcinoma of the anal canal in HIV-seropositive patients because of its high rate of cure. Here we present an HIV patient who developed a carcinoma of the anal canal after a long time of HIV infection under highly active antiretroviral therapy with a good virological and immunological response.

  6. A novel artificial anal sphincter system based on transcutaneous energy transmission

    Institute of Scientific and Technical Information of China (English)

    Zan Peng; Yan Guozheng; Liu Hua

    2008-01-01

    For controlling anal incontinence, a new artificial anal sphincter system (AASS) with sensor feedback based on transcutaneous energy transmission is developed. The device mainly comprises an artificial anal sphincter (AAS), a wireless power supply subsystem, and a communication subsystem. The artificial anal sphincter comprises a front cuff and a sensor cuff placed around the rectum, a reservoir sited in abdominal cavity and a micropump controlling inflation and deflation of the front cuff. There are two pressure sensors in the artificial anal sphincter. One can measure the pressure in the front cuff to clamp the rectum, the other in the sensor cuff can measure the pressure of the rectum. Wireless power supply subsystem includes a resonance transmit coil to transmit an alternating magnetic field and a secondary coil to receive the power. Wireless communication subsystem can transmit the pressure information of the artificial anal sphincter to the monitor, or send the control commands to the artificial anal sphincter. A prototype is designed and the basic function of the artificial anal sphincter system has been tested through experiments. The results demonstrate that the artificial anal sphincter system can control anal incontinence effectively.

  7. Increased levels of homocysteine in patients with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Sabiye; Akbulut; Emin; Altiparmak; Firdevs; Topal; Ersan; Ozaslan; Metin; Kucukazman; Ozlem; Yonem

    2010-01-01

    AIM: To investigate serum levels of homocysteine (Hcys) and the risk that altered levels carry for thrombosis development in ulcerative colitis (UC) patients. METHODS: 55 UC patients and 45 healthy adults were included. Hcys, vitamin B12 and folic acid levels were measured in both groups. Clinical history and thrombo- embolic events were investigated. RESULTS: The average Hcys level in the UC patients was 13.3 ± 1.93 μmmol/L (range 4.60-87) and was higher than the average Hcys level of the control group whi...

  8. Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

    OpenAIRE

    Kaija-Leena Kolho; Dan Turner

    2013-01-01

    Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values 1000  μ g/g). The best cut-off value for calprotectin for predicting poor outcome was 800  μ g/g (sensitivity...

  9. Fatty Acid Synthase Inhibitor C75 Ameliorates Experimental Colitis

    OpenAIRE

    Matsuo, Shingo; Yang, Weng-Lang; Aziz, Monowar; Kameoka, Shingo; Wang, Ping

    2013-01-01

    Abnormalities of lipid metabolism through overexpression of fatty acid synthase (FASN), which catalyzes the formation of long-chain fatty acids, are associated with the development of inflammatory bowel disease (IBD). C75 is a synthetic α-methylene-γ-butyrolactone compound that inhibits FASN activity. We hypothesized that C75 treatment could effectively reduce the severity of experimental colitis. Male C57BL/6 mice were fed 4% dextran sodium sulfate (DSS) for 7 d. C75 (5 mg/kg body weight) or...

  10. Processed coffee alleviates DSS-induced colitis in mice

    Directory of Open Access Journals (Sweden)

    Bernd L. Fiebich

    2013-05-01

    Full Text Available ABSTRACTBackground: Coffee is one of the most widely consumed beverages in the world and it has been demonstrated that it has important therapeutic activities not only because of its caffeine content but also owing to the presence of other biologically active small molecules such as chlorogenic acid, trigonelline and cyclopentadiones. However, chlorogenic acid is degraded into catechol, pyrogallol and hydroxyhydroquinone, which are thought to induce irritation of the gastric mucosa. To reduce the content of irritant compounds processing methods have been developed prior to roasting the coffee beans.Objectives: The aim of this study was to study the anti-inflammatory and gastro-protective effects of processed coffee (Idee-Kaffee on in LPS-treated human primary monocytes and in a murine model of colon inflammation (IBD model.Results: In this study we have analyzed the effects on inflammatory events in cultured cells and in mice drinking a commercially available processed coffee. The processed coffee inhibited lipopolysaccharide (LPS-induced proinflammatory cytokines such as interleukin (IL-1, tumor necrosis factor (TNF, IL-6 and IL-8, and other inflammatory mediators such as prostaglandin (PGE2 and 8-isoprostane in cultured human primary monocytes. Oral administration of dissolved processed coffee, i.e., in its usual beverage form, improved greatly the adverse macroscopic and histological features of dextran sodium sulfate (DSS-induced colitis in mice in a dose-dependent manner. Processed coffee not only largely prevented DSS-induced colitis but also dramatically suppressed in vivo NF-B and STAT3 activities through inhibition of IB and STAT3 phosphorylation. Furthermore, this solubleFunctional Foods in Health and Disease 2013; 3(5:133-145coffee bean extract reduced the expression of proinflammatory cytokines TNF, IL-11, and IL-6 and the expression of cyclooxygenase (COX-2 in colonic tissues.Conclusions: This work identified

  11. Translabial ultrasound assessment of the anal sphincter complex: normal measurements of the internal and external anal sphincters at the proximal, mid-, and distal levels.

    Science.gov (United States)

    Hall, Rebecca J; Rogers, Rebecca G; Saiz, Lori; Qualls, C

    2007-08-01

    The purpose of this study was to measure the internal and external anal sphincters using translabial ultrasound (TLU) at the proximal, mid, and distal levels of the anal sphincter complex. The human review committee approval was obtained and all women gave written informed consent. Sixty women presenting for gynecologic ultrasound for symptoms other than pelvic organ prolapse or urinary or anal incontinence underwent TLU. Thirty-six (60%) were asymptomatic and intact, 13 symptomatic and intact, and 11 disrupted. Anterior-posterior diameters of the internal anal sphincter at all levels and the external anal sphincter at the distal level were measured in four quadrants. Mean sphincter measurements are given for symptomatic and asymptomatic intact women and are comparable to previously reported endoanal MRI and ultrasound measurements. PMID:17221149

  12. Câncer ano-reto-cólico - aspectos atuais: I - câncer anal Anal canal and colorectal cancer - current features: I - anal canal cancer

    Directory of Open Access Journals (Sweden)

    Júlio César M. Santos Jr.

    2007-06-01

    Full Text Available A inclusão do tema - câncer anal - nessa revisão, apesar de sua relativa raridade, responde, em parte, ao propósito de chamar atenção para o significativo aumento dessa lesão e sua estreita relação com doenças sexualmente transmissíveis, principalmente causadas pelo vírus do papiloma humano (HPV; seus aspectos nosológicos, sua epidemiologia, sua etiologia multifatorial, seus fatores de riscos, sua prevenção e, em parte, para revelar a definição atual do tratamento.The inclusion of the theme - anal cancer - in this revision, in spite of its relative rarity, it answers, partly, to the purpose of calling attention for the significant increase of that lesion and its narrow relationship with sexually transmissible diseases mainly caused by the human papilloma virus (HPV; its nosologic aspects, epidemiology, etiology, and the multifactorial nature of risk that is associated to the disease, its prevention, and, partly, to reveal the current definition of the treatment.

  13. Identifying the best therapy for chronic anal fissure

    Institute of Scientific and Technical Information of China (English)

    Mariusz; H; Madalinski

    2011-01-01

    Chronic anal fissure(CAF)is a painful tear or crack which occurs in the anoderm.The optimal algorithm of therapy for CAF is still debated.Lateral internal sphincterotomy(LIS)is a surgical treatment,considered as the’gold standard’therapy for CAF.It relieves CAF symptoms with a high rate of healing.Chemical sphincterotomy(CS)with nitrates,calcium blockers or botulinum toxin(BTX)is safe,with the rapid relief of pain,mild sideeffects and no risk of surgery or anesthesia,but is a statistically less effective therapy for CAF than LIS.This article considers if aggressive treatment should only be offered to patients who fail pharmacological sphincterotomy.Aspects of anal fissure etiology,epidemiology and pathophysiology are considered with their meaning for further management of CAF.A molecular model of chemical interdependence significant for the chemistry of CAF healing is examined.Its application may influence the development of optimal therapy for CAF.BTX is currently considered the most effective type of CS and discussion in this article scrutinizes this method specifically.Although the effectiveness of BTXvs LIS has been discussed,the essential focus of the article concerns identifying the best therapy application for anal fissure.Elements are presented which may help us to predict CAF healing.They provide rationale for the expansion of the CAF therapy algorithm.Ethical and economic factors are also considered in brief.As long as the patient is willing to accept the potential risk of fecal incontinence,we have grounds for the’gold standard’(LIS)as the first-line treatment for CAF.The author concludes that,when the diagnosis of the anal fissure is established,CS should be considered for both ethical and economic reasons.He is convinced that a greater understanding and recognition of benign anal disorders by the GP and a proactive involvement at the point of initial diagnosis would facilitate the consideration of CS at an earlier,more practical stage with

  14. Progression of anal high-grade squamous intraepithelial lesions to invasive anal cancer among HIV-infected men who have sex with men.

    Science.gov (United States)

    Berry, J Michael; Jay, Naomi; Cranston, Ross D; Darragh, Teresa M; Holly, Elizabeth A; Welton, Mark L; Palefsky, Joel M

    2014-03-01

    The incidence of anal cancer is elevated in human immunodeficiency virus (HIV)-infected men-who-have-sex-with-men (MSM) compared to the general population. Anal high-grade squamous intraepithelial lesions (HSIL) are common in HIV-infected MSM and the presumed precursors to anal squamous cell cancer; however, direct progression of HSIL to anal cancer has not been previously demonstrated. The medical records were reviewed of 138 HIV-infected MSM followed up at the University of California, San Francisco, who developed anal canal or perianal squamous cancer between 1997 and 2011. Men were followed up regularly with digital anorectal examination (DARE), high-resolution anoscopy (HRA) and HRA-guided biopsy. Although treatment for HSIL and follow-up were recommended, not all were treated and some were lost to follow-up. Prevalent cancer was found in 66 men. Seventy-two HIV-infected MSM developed anal cancer while under observation. In 27 men, anal cancer developed at a previously biopsied site of HSIL. An additional 45 men were not analyzed in this analysis due to inadequate documentation of HSIL in relation to cancer location. Of the 27 men with documented progression to cancer at the site of biopsy-proven HSIL, 20 men progressed from prevalent HSIL identified when first examined and seven men from incident HSIL. Prevalent HSIL progressed to cancer over an average of 57 months compared to 64 months for incident HSIL. Most men were asymptomatic, and cancers were detected by DARE. Anal HSIL has clear potential to progress to anal cancer in HIV-infected MSM. Early diagnosis is facilitated by careful follow-up. Carefully controlled studies evaluating efficacy of screening for and treatment of HSIL to prevent anal cancer are needed. PMID:23934991

  15. Derivación analítica del tiempo de llegada en modelos de canal basados en geometría para sistemas inalámbricos

    Directory of Open Access Journals (Sweden)

    M.R. Arias

    2007-11-01

    Full Text Available Este artículo presenta una propuesta analítica para derivar la función de densidad de probabilidad de potencia (PDF, por sus siglas en ingles del tiempo de llegada (TOA, por sus siglas en inglés y su aplicación en los modelos de canal estadísticos basados en geometría para ambientes urbanos. En éste artículo proponemos un modelo de canal utilizando el método por agrupamiento, y lo empleamos para derivar la PDF del tiempo de llegada de la señal de multitrayectorias. Para evaluar la PDF teórica propuesta por agrupamiento en el dominio del tiempo, hacemos simulaciones por computadora del modelo de canal basado en geometría propuesto y lo comparamos con los resultados experimentales publicados en la literatura. La comparación con los resultados experimentales revelan una buena aproximación. La PDF por agrupamiento derivada se puede utilizar para simular la dispersión temporal de la señal de multitrayectorias agrupadas para una variedad de condiciones de propagación en ambientes urbanos para cuantificar parámetros estadísticos de segundo orden, es decir, la difusión de retardo para una forma elíptica específica dada por el grupo de señales de multitrayectorias.

  16. The Rhizome Mixture of Anemarrhena asphodeloides and Coptis chinensis Attenuates Mesalazine-Resistant Colitis in Mice

    Directory of Open Access Journals (Sweden)

    Su-Min Lim

    2016-01-01

    Full Text Available We investigated the effect of DWac on the gut microbiota composition in mice with 2,3,6-trinitrobenzenesulfonic acid- (TNBS- induced colitis. Treatment with DWac restored TNBS-disturbed gut microbiota composition and attenuated TNBS-induced colitis. Moreover, we examined the effect of DWac in mice with mesalazine-resistant colitis (MRC. Intrarectal injection of TNBS in MRC mice caused severe colitis, as well as colon shortening, edema, and increased myeloperoxidase activity. Treatment with mesalazine (30 mg/kg did not attenuate TNBS-induced colitis in MRC mice, whereas treatment with DWac (30 mg/kg significantly attenuated TNBS-induced colitis. Moreover, treatment with the mixture of mesalazine (15 mg/kg and DWac (15 mg/kg additively attenuated colitis in MRC mice. Treatment with DWac and its mixture with mesalazine inhibited TNBS-induced activation of NF-κB and expression of M1 macrophage markers but increased TNBS-suppressed expression of M2 macrophage markers. Furthermore, these inhibited TNBS-induced T-bet, RORγt, TNF-α, and IL-17 expression but increased TNBS-suppressed Foxp3 and IL-10 expression. However, Th2 cell differentiation and GATA3 and IL-5 expression were not affected. These findings suggest that DWac can ameliorate MRC by increasing the polarization of M2 macrophage and correcting the disturbance of gut microbiota and Th1/Th17/Treg, as well as additively attenuating MRC along with mesalazine.

  17. NKT cells mediate the recruitment of neutrophils by stimulating epithelial chemokine secretion during colitis.

    Science.gov (United States)

    Huang, Enyu; Liu, Ronghua; Lu, Zhou; Liu, Jiajing; Liu, Xiaoming; Zhang, Dan; Chu, Yiwei

    2016-05-27

    Ulcerative colitis (UC) is a kind of inflammatory bowel diseases characterized by chronic inflammation and ulcer in colon, and UC patients have increased risk of getting colorectal cancer. NKT cells are cells that express both NK cell markers and semi-invariant CD1d-restricted TCRs, can regulate immune responses via secreting a variety of cytokines upon activation. In our research, we found that the NKT cell-deficient CD1d(-/-) mice had relieved colitis in the DSS-induced colitis model. Further investigations revealed that the colon of CD1d(-/-) mice expressed less neutrophil-attracting chemokine CXCL 1, 2 and 3, and had decreased neutrophil infiltration. Infiltrated neutrophils also produced less reactive oxygen species (ROS) and TNF-α, indicating they may cause less epithelial damage. In addition, colitis-associated colorectal cancer was also relieved in CD1d(-/-) mice. During colitis, NKT cells strongly expressed TNF-α, which could stimulate CXCL 1, 2, 3 expressions by the epithelium. In conclusion, NKT cells can regulate colitis via the NKT cell-epithelium-neutrophil axis. Targeting this mechanism may help to improve the therapy of UC and prevent colitis-associated colorectal cancer. PMID:27063801

  18. Involvement of lymphocytes in dextran sulfate sodium-induced experimental colitis

    Institute of Scientific and Technical Information of China (English)

    Tae Woon Kim; Jae Nam Seo; Young Ho Suh; Hyo Jin Park; Ju Hyun Kim; Ji Young Kim; Kwon Tk Oh

    2006-01-01

    AIM: To investigate the roles of lymphocytes in the development of dextran sulfate sodium-induced colitis.METHODS: Using various doses of dextran sulfate sodium (DSS), we induced colitis in wild-type B6control and Rag-1 knockout (H-2b haplotype) mice,and evaluated the colitis in terms of symptomatic and histologic parameters, such as weight loss, survival,severity of diarrhea, shortage of colon length and histological changes. Symptomatic parameters were checked daily and histological changes were scored.RESULTS: Although development of colitis in Rag-1knockout mice treated with high dose (5%) of DSS was comparable to that in B6 control mice, colitis progression was much more tolerable in Rag-1 knockout mice compared to than in B6 mice treated with low dose (1.5%)DSS. Symptomatic parameters as well as histopathologic changes were improved in Rag-1 knockout mice.CONCLUSION: These results indicate that the presence of lymphocytes contributes to colitis progression at low dose of DSS stimulation. Lymphocytes may play roles as an aggravating factor in DSS-induced colitis.

  19. Hypoxia-inducible factor 1 alpha and vascular endothelial growth factor overexpression in ischemic colitis

    Institute of Scientific and Technical Information of China (English)

    Tomoyuki Okuda; Takeshi Azuma; Masahiro Ohtani; Ryuho Masaki; Yoshiyuki Ito; Yukinao Yamazaki; Shigeji Ito; Masaru Kuriyama

    2005-01-01

    AIM: To examine the etiology and pathophysiology in human ischemic colitis from the viewpoint of ischemic favors such as hypoxia-inducible factor 1 alpha (HIF-1alpha and vascular endothelial growth factor (VEGF).METHODS: Thirteen patients with ischemic colitis and 21 normal controls underwent colonoscopy. The follow-up colonoscopy was performed in 8 patients at 7 to 10 d after theoccurrence of ischemic colitis. Biopsy samples were subjected to real-time RT-PCR and immunohistochemistry to detect the expression of HIF-1 alpha and VEGF.RESULTS: HIF-1 alpha and VEGF expression were found in the normal colon tissues by RT-PCR and immunohistochemistry.HIF-1 alpha and VEGF were overexpressed in the lesions of ischemic colitis. Overexpressed HIF-1 alpha and VEGF RNA quickly decreased to the normal level in the scar regions at 7 to 10 d after the occurrence of ischemic colitis.CONCLUSION: Constant expression of HIF-1 alpha and VEGF in normal human colon tissue suggested that HIF-1alpha and VEGF play an important role in maintaining tissue integrity. We confirmed the ischemic crisis in ischemic colitis at the molecular level, demonstrating overexpression of HIF-1 alpha and VEGF in ischemic lesions. These ischemic factors may play an important role in the pathophysiology of ischemic colitis.

  20. Effects of appendectomy and oral tolerance on dextran sulfate sodium colitis

    Institute of Scientific and Technical Information of China (English)

    Min Yue; Zhe Shen; Chao-Hui Yu; Hua Ye; Yue-Fang Ye; You-Ming Li

    2011-01-01

    AIM: To evaluate the concomitant effects of appendectomy and oral tolerance on colitis. METHODS: Delayed-type hypersensitivity (DTH) was investigated at a 7-d interval after ovalbumin (OVA) administration and immunization under normal and colitis conditions in appendectomized or sham-operated mice. Pathological scores for the colon were graded after ingestion of colon-extracted protein (CEP) and induction of dextran sulfate sodium (DSS) colitis in appendectomized or sham-operated mice. Thereafter, Th1 and Th2 in Peyer's patches and spleen lymphocytes were detected in CEP-treated and bovine serum albumin (BSA)-treated control mice. RESULTS: In appendectomized mice, DTH was not inhibited at day 7 after OVA administration and at the initial phase of DSS colitis, whereas it was inhibited at day 14 and day 21. However, in sham-operated mice, it was inhibited during the whole procedure and the onset of DSS colitis. The protective role of CEP against DSS colitis was present in sham-operated mice, with predominant improvement of colonic pathological changes, while vanished in the appendectomized mice. A shift from Th1 to Th2 in Peyer's patches resulted from a decrease of Th1 cells with the ingestion of CEP. Compared with BSA in the sham-operated group, no predominant changes were observed in the appendectomized mice. CONCLUSION: Appendectomy interferes with the protective role of CEP in DSS colitis via a shift from Th2 to Th1 during oral tolerance induction.

  1. Hospitalized ulcerative colitis patients have an elevated risk of thromboembolic events

    Institute of Scientific and Technical Information of China (English)

    Jennifer Y Wang; Jonathan P Terdiman; Eric Vittinghoff; Tracy Minichiello; Madhulika G Varma

    2009-01-01

    AIM: To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between patients with ulcerative colitis undergoing a colorectal operation and other patients undergoing colorectal operations. METHODS: Data from the National Hospital Discharge Survey was used to compare thromboembolism rates between (1) hospitalized patients with a discharge diagnosis of ulcerative colitis and those with diverticulitis or acute respiratory failure, and (2) hospitalized patients with a discharge diagnosis of ulcerative colitis who underwent colectomy and those with diverticulitis or colorectal cancer who underwent colorectal operations. RESULTS: Patients diagnosed with ulcerative colitis had similar or higher rates of combined venous thromboembolism (2.03%) than their counterparts with diverticulitis (0.76%) or respiratory failure (1.99%), despite the overall greater prevalence of thromboembolic risk factors in the latter groups. Discharged patients with colitis that were treated surgically did not have significantly different rates of venous or arterial thromboembolism than those with surgery for diverticulitis or colorectal cancer. CONCLUSION: Patients with ulcerative colitis who do not undergo an operation during their hospitalization have similar or higher rates of thromboembolism than other medical patients who are considered to be high risk for thromboembolism.

  2. Exogenous Ghrelin Accelerates the Healing of Acetic Acid-Induced Colitis in Rats.

    Science.gov (United States)

    Matuszyk, Aleksandra; Ceranowicz, Piotr; Warzecha, Zygmunt; Cieszkowski, Jakub; Ceranowicz, Dagmara; Gałązka, Krystyna; Bonior, Joanna; Jaworek, Jolanta; Bartuś, Krzysztof; Gil, Krzysztof; Olszanecki, Rafał; Dembiński, Artur

    2016-01-01

    Previous studies have shown that ghrelin reduces colonic inflammation induced by trinitrobenzene sulfonic acid and dextran sodium sulfate. In the present study we determined the effect of treatment with ghrelin on the course of acetic acid-induced colitis in rats. Rectal administration of 3% acetic acid solution led to induction of colitis in all animals. Damage of the colonic wall was accompanied by an increase in mucosal concentration of pro-inflammatory interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), as well mucosal activity of myeloperoxidase. Moreover, induction of colitis led to a reduction in colonic blood flow and DNA synthesis. Administration of ghrelin after induction of colitis led to faster regeneration of the colonic wall and reduction in colonic levels of IL-1β, TNF-α, and myeloperoxidase. In addition, treatment with ghrelin improved mucosal DNA synthesis and blood flow. Our study disclosed that ghrelin exhibits a strong anti-inflammatory and healing effect in acetic acid-induced colitis. Our current observation in association with previous findings that ghrelin exhibits curative effect in trinitrobenzene sulfonic acid- and dextran sodium sulfate-induced colitis suggest that therapeutic effect of ghrelin in the colon is universal and independent of the primary cause of colitis. PMID:27598133

  3. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    Directory of Open Access Journals (Sweden)

    Newton Sérgio de Carvalho

    2011-10-01

    Full Text Available In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy.

  4. HPV infection and intraepithelial lesions from the anal region: how to diagnose?

    Science.gov (United States)

    Carvalho, Newton Sérgio de; Ferreira, Aliana Meneses; Bueno, Camila Caroline Tremel

    2011-01-01

    In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN) and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy. PMID:22230855

  5. Negative regulation of DSS-induced experimental colitis by PILRα.

    Science.gov (United States)

    Kishida, Kazuki; Kohyama, Masako; Kurashima, Yosuke; Kogure, Yuta; Wang, Jing; Hirayasu, Kouyuki; Suenaga, Tadahiro; Kiyono, Hiroshi; Kunisawa, Jun; Arase, Hisashi

    2015-06-01

    Inflammatory bowel disease is thought to be a complex multifactorial disease, in which an increased inflammatory response plays an important role. Paired immunoglobulin-like type 2 receptor α (PILRα), well conserved in almost all mammals, is an inhibitory receptor containing immunoreceptor tyrosine-based inhibitory motifs in the cytoplasmic domain. PILRα is mainly expressed on myeloid cells and plays an important role in the regulation of inflammation. In the present study, we investigated the function of PILRα in inflammatory bowel disease using PILRα-deficient mice. When mice were orally administered dextran sulfate sodium (DSS), colonic mucosal injury and inflammation were significantly exacerbated in DSS-treated PILRα-deficient mice compared with wild-type (WT) mice. Flow cytometric analysis revealed that neutrophil and macrophage cell numbers were higher in the colons of DSS-treated PILRα-deficient mice than in those of WT mice. Blockade of CXCR2 expressed on neutrophils using a CXCR2 inhibitor decreased the severity of colitis observed in PILRα-deficient mice. These results suggest that PILRα negatively regulates inflammatory colitis by regulating the infiltration of inflammatory cells such as neutrophils and macrophages.

  6. Optimal management of steroid-dependent ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Khan HMW

    2015-11-01

    Full Text Available Hafiz M Waqas Khan,1 Faisal Mehmood,1 Nabeel Khan2 1Department of Medicine, King Edward Medical University, Lahore, Pakistan; 2Section of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia VA Medical Center, Philadelphia, PA, USA Abstract: Ulcerative colitis (UC is a chronic inflammatory condition that is variable in both extent and severity of disease as well as response to therapy. Corticosteroids (CSs were the first drugs used in the management of UC and are still used for induction of remission. However, because of their extensive side-effect profile, they are not utilized for maintenance of remission. In view of this, CS-free remission has become an important end point while evaluating therapeutic agents used in the management of UC. This review highlights the results of various studies conducted to evaluate the efficacy of different medications to attain CS-free remission in the setting of active UC. The drugs reviewed include established agents such as thiopurines, methotrexate, infliximab, adalimumab, vedolizumab, golimumab, and newer experimental agents, and if all else fails, colectomy will be performed. The efficacy of these drugs is evaluated individually. Our aim is to provide a synopsis of the work done in this field to date. Keywords: ulcerative colitis, steroid dependent, thiopurines, MTX, adalimumab, infliximab

  7. Benign retroperitoneal schwannoma presenting as colitis: A case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We report a case of a patient presenting with clinical, radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed, which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma. These neural sheath tumors rarely occur in the retroperitoneum. They are usually asymptomatic but as they enlarge they may compress adjacent structures, which leads to a wide spectrum of nonspecific symptoms, including lumbar pain, headache, secondary hypertension, abdominal pain and renal colicky pain. CT and MR findings show characteristic features, but none are specific. Schwannoma can be isolated sporadic lesions, or associated with schwannomatosis or neurofibromatosis type Ⅱ (NF2). Although they vary in biological and clinical behavior, their presence is, in nearly every case, due to alterations or absence of the NF2 gene, which is involved in the growth regulation of Schwann cells. Both conditions were excluded by thorough mutation analysis. Diagnosis is based on histopathological examination and immunohistochemistry. Total excision is therapeutic and has a good prognosis. Schwannomatosis and NF2 should be excluded through clinical diagnostic criteria. Genetic testing of NF2 is probably not justified in the presence of a solitary retroperitoneal schwannoma.

  8. A case of reactive arthritis due to Clostridium difficile colitis

    Science.gov (United States)

    Essenmacher, Alex C.; Khurram, Nazish; Bismack, Gregory T.

    2016-01-01

    Reactive arthritis is an acute, aseptic, inflammatory arthropathy following an infectious process but removed from the site of primary infection. It is often attributed to genitourinary and enteric pathogens, such as Chlamydia, Salmonella, Shigella, Campylobacter, and Yersinia, in susceptible individuals. An uncommon and less recognized cause of this disease is preceding colonic infection with Clostridium difficile, an organism associated with pseudomembranous colitis and diarrhea in hospitalized patients and those recently exposed to antibiotics. Recognition of this association may be complicated by non-specific presentation of diarrhea, the interval between gastrointestinal and arthritic symptoms, and the wide differential in mono- and oligoarthritis. We present the case of a 61-year-old, hospitalized patient recently treated for C. difficile colitis who developed sudden, non-traumatic, right knee pain and swelling. Physical examination and radiographs disclosed joint effusion, and sterile aspiration produced cloudy fluid with predominant neutrophils and no growth on cultures. Diagnostic accuracy is enhanced by contemporaneous laboratory investigations excluding other entities such as gout and rheumatoid arthritis and other infections that typically precede reactive arthritis. Contribution of Clostridium infection to reactive arthritis is an obscure association frequently difficult to prove, but this organism is warranted inclusion in the differential of reactive arthritis. PMID:26908381

  9. Diagnostic Value of Fecal Calprotectin in Patient with Ulcerative Colitis

    Science.gov (United States)

    Zamani, Hamed; Barzin, Gilda; Yousefinia, Mahsa; Mohammadkhani, Ashraf; Ostovaneh, Mohammad Reza; Sharifi, Amir Houshang; Tayebi, Sirous; Malekzadeh, Reza; Ansari, Reza

    2013-01-01

    BACKGROUND Ulcerative colitis (UC) is characterized by recurrent episodes of inflammation limited to the mucosal layer of the colon. Calprotectin is a zinc and calcium binding protein derived from neutrophils and monocytes. It is easily detectable in tissue samples, body fluids, and stools, which makes it a potentially valuable marker of inflammation. The aim of the current study is to evaluate the value of fecal calprotectin (FC) as a marker of disease activity in patients with UC. METHODS Seventy three eligible subjects underwent ileocolonoscopy and multiple biopsies were obtained from different parts of the colon and terminal ileum. All patients underwent blood and stool sampling as well as an interview to assess the disease severity utilizing ulcerative colitis activity index (UCAI), subjectively. The diagnostic value of the FC in comparison with Mayo disease activity index as the gold standard technique, was then evaluated. RESULTS Mean FC level increased linearly according to Mayo disease activity index (r=0.44, p 21.4 ng/ml was able to discriminate between active and inactive phases of UC according to Mayo disease activity index>2 with 72.3% sensitivity and 73.1% specificity. The combination of FC > 21.4 ng/ml and UCAI score of 7 had a 46.8% sensitivity and 88% specificity to diagnose Mayo disease activity index >2. Furthermore, FC level 2. PMID:24829673

  10. [Association between ulcerative colitis and primary esclerosing cholangitis].

    Science.gov (United States)

    Aguilar Sanchez, Victor; Guzman Rojas, Patricia; Bravo Paredes, Eduar; Rios Perez, Cristian

    2016-01-01

    Ulcerative Colitis (UC) is associated to Primary Sclerosing Cholangitis (PSC) in 80% of cases, and this association is more common than the one with Crohn’s disease. Nevertheless, the prevalence of PSC in patients with UC is only 2.9% in Latin America. We present the case of a female patient who presents a clinical history characterized for chronic diarrhea of one year of evolution, associated to fever, oral ulcers and loss of weight. In the laboratory results there is an elevation in the following: alkaline phosphatase, GGT, ALT and AST, for that reason we decide to do an abdominal ultrasound finding a hepatomegaly. In the colonoscopy we found an ulcerative colitis. Later, we do a magnetic resonance cholangiopancreatography, because of the diagnosis of UC and the abnormalities at the liver function tests, diagnosing PSC associated to UC. At that moment, the patient starts treatment with sulfasalazine that is stopped because of an adverse effect, starting prednisone and azathioprine. The patient then is discharged with the medication already mentioned and has a favorable clinical outcome. We decide to report the case because is the second reported case in Peru, being this association not commonly found in the South hemispheric. PMID:27409097

  11. Two cases of rectal cancer accompanied with radiation colitis

    International Nuclear Information System (INIS)

    This paper presents two cases of rectal cancer accompanied with radiation colitis. Case 1 was a 53-year-old woman, who had a history of undergoing radiation therapy for a uterine cervical cancer 11 years before. She was seen at the hospital because of constipation and pointed out a IIa-like lesion on the rectum by colonoscopy. Abdominoperineal resection was performed. The surgical specimen showed the IIa-like lesion on the rectum. Pathological findings revealed well-differentiated adenocarcinoma. Immunohistochemical staining of p53 showed positive cells in atrophic glands. Case 2 was a 62-year-old woman complaining of diarrhea. There was a previous history of receiving radiation therapy for a uterine cancer 20 years before. Colonoscopy showed a Borrmann type 2 cancer on the rectum. Abdominoperineal resection was performed. Histological findings revealed moderately differentiated adenocarcinoma invading to the propria muscle. The features of radiation colitis were observed around the cancer in the two cases which provided a clue to diagnose the lesions with radiation-induced cancer. (author)

  12. Eosinophilic Colitis: University of Minnesota Experience and Literature Review

    Directory of Open Access Journals (Sweden)

    Wolfgang B. Gaertner

    2011-01-01

    Full Text Available Eosinophilic colitis is a rare form of primary eosinophilic gastrointestinal disease that is poorly understood. Neonates and young adults are more frequently affected. Clinical presentation is highly variable depending on the depth of inflammatory response (mucosal, transmural, or serosal. The pathophysiology of eosinophilic colitis is unclear but is suspected to be related to a hypersensitivity reaction given its correlation with other atopic disorders and clinical response to corticosteroid therapy. Diagnosis is that of exclusion and differential diagnoses are many because colonic tissue eosinophilia may occur with other colitides (parasitic, drug-induced, inflammatory bowel disease, and various connective tissue disorders. Similar to other eosinophilic gastrointestinal disorders, steroid-based therapy and diet modification achieve very good and durable responses. In this paper, we present our experience with this rare pathology. Five patients (3 pediatric and 2 adults presented with diarrhea and hematochezia. Mean age at presentation was 26 years. Mean duration of symptoms before pathologic diagnosis was 8 months. Mean eosinophil count per patient was 31 per high-power field. The pediatric patients responded very well to dietary modifications, with no recurrences. The adult patients were treated with steroids and did not respond. Overall mean followup was 22 (range, 2–48 months.

  13. Cellulose supplementation early in life ameliorates colitis in adult mice.

    Directory of Open Access Journals (Sweden)

    Dorottya Nagy-Szakal

    Full Text Available Decreased consumption of dietary fibers, such as cellulose, has been proposed to promote the emergence of inflammatory bowel diseases (IBD: Crohn disease [CD] and ulcerative colitis [UC] where intestinal microbes are recognized to play an etiologic role. However, it is not known if transient fiber consumption during critical developmental periods may prevent consecutive intestinal inflammation. The incidence of IBD peaks in young adulthood indicating that pediatric environmental exposures may be important in the etiology of this disease group. We studied the effects of transient dietary cellulose supplementation on dextran sulfate sodium (DSS colitis susceptibility during the pediatric period in mice. Cellulose supplementation stimulated substantial shifts in the colonic mucosal microbiome. Several bacterial taxa decreased in relative abundance (e.g., Coriobacteriaceae [p = 0.001], and other taxa increased in abundance (e.g., Peptostreptococcaceae [p = 0.008] and Clostridiaceae [p = 0.048]. Some of these shifts persisted for 10 days following the cessation of cellulose supplementation. The changes in the gut microbiome were associated with transient trophic and anticolitic effects 10 days following the cessation of a cellulose-enriched diet, but these changes diminished by 40 days following reversal to a low cellulose diet. These findings emphasize the transient protective effect of dietary cellulose in the mammalian large bowel and highlight the potential role of dietary fibers in amelioration of intestinal inflammation.

  14. Isotretinoína y colitis ulcerosa Isotretinoin and ulcerous colitis

    OpenAIRE

    E. Borobio; A. Arín; A. Valcayo; M. Iñarrairaegui; O. Nantes; Prieto, C.

    2004-01-01

    La isotretinoína (Roacután®), fármaco derivado del ácido retinoico, es utilizado en dermatología como tratamiento para diversos tipos de acné. Su mecanismo de acción a nivel dermo-epidérmico aún no ha sido completamente esclarecido. Existen en la literatura actual diversos estudios en los que se ha documentado una relación, proporcional o inversa, entre la toma de isotretinoína y el debut o reactivación de una enfermedad inflamatoria intestinal. Aunque se han propuesto diversas hipótesis por ...

  15. Investigation of pulmonary involvement in inflammatory bowel disease in an experimental model of colitis

    Science.gov (United States)

    Aydin, Bunyamin; Songur, Yıldıran; Songur, Necla; Aksu, Oğuzhan; Senol, Altug; Ciris, I. Metin; Sutcu, Recep

    2016-01-01

    Background/Aims: Inflammatory bowel disease (IBD) may also involve various extra-intestinal organs. Clinical studies have found asymptomatic/symptomatic pulmonary involvement in 1% to 6% of patients with IBD. The present study histopathologically investigated pulmonary involvement in an experimental model of colitis in order to demonstrate pulmonary tissue involvement in IBD and to expose potential etiological factors. It also explored the relation between inflammation and tissue concentrations of vascular endothelial growth factor (VEGF) and tumor necrosis factor α (TNF-α). Methods: The study comprised 24 male Wistar albino rats. The rats were divided into four groups of six rats each. Acute colitis was induced in two separate groups using either the dextran sulphate sodium (DSS) or trinitrobenzene sulfonic acid (TNBS) method, while the other two groups were used as controls for each model of colitis. Wallace scoring was used for macroscopic assessment of colitis, and the lungs were histopathologically examined. Concentrations of VEGF and TNF-α in pulmonary tissue were measured by the enzyme-linked immunosorbent assay method. Results: The number of animals that had alveolar hemorrhage was significantly higher in the TNBS-induced colitis and DSS-induced colitis groups compared to their own control groups (p = 0.015 and p = 0.015, respectively). VEGF and TNF-α concentrations in pulmonary tissues were significantly increased in both the TNBS colitis and DSS colitis groups compared to their own control groups (p = 0.002 and p = 0.004, respectively; and p = 0.002 and p = 0.002, respectively). Conclusions: The present study demonstrated that significant and serious histopathological changes directly associated with colitis occur in the lungs in IBD. PMID:27539446

  16. La indemnización por clientela en el contrato de agencia y en el contrato de concesión

    OpenAIRE

    Torrego Porro, Álvaro

    2015-01-01

    La indemnización por clientela es una compensación a la que tiene derecho el agente cuando se extingue la relación contractual con el empresario y siempre que se cumpla una serie de presupuestos. ¿Es extensible analógicamente a los contratos de concesión? ¿Qué requisitos se exigen?.

  17. Human papillomavirus in anal squamous cell carcinoma: an angel rather than a devil?

    OpenAIRE

    Ravenda, Paola Simona; Zampino, Maria Giulia; Fazio, Nicola; Barberis, Massimo; Bottiglieri, Luca; Chiocca, Susanna

    2015-01-01

    Anal cancer is a rare disease with an increasing incidence worldwide but, unfortunately, even today the scientific community still has a limited knowledge and limited options of treatment. More than 50% of patients with anal cancer presenting at diagnosis with locoregional disease have good chances of cure with chemoradiotherapy (CT–RT). However, once patients develop metastatic spread, the prognosis is very poor. Human papillomavirus (HPV) is present in more than 80% of anal cancers and whil...

  18. Incidence of obstetric anal sphincter injuries after training to protect the perineum: cohort study

    OpenAIRE

    Laine, Katariina; Skjeldestad, Finn Egil; Sandvik, Leiv; Staff, Anne Cathrine

    2012-01-01

    Objective To compare the incidence of obstetric anal sphincter injuries (OASIS) in two time periods, before and after implementing a training programme for improved perineal support aimed at reducing the incidence of obstetric anal sphincter injuries. The secondary aim was to study incidence of obstetric anal sphincter injuries in subgroups defined by risk factors for OASIS. Design Population-based cohort study. Setting University hospital setting in Oslo, Norway. Participants Two...

  19. Effects of serotonin on the internal anal sphincter: in vivo manometric study in rats.

    OpenAIRE

    Goldberg, M; Hanani, M.; Nissan, S

    1986-01-01

    The effects of serotonin (5-hydroxytryptamine, 5-HT) on the internal anal sphincter were studied in anaesthesized rats. Serotonin induced a dose dependent relaxation of the internal anal sphincter. Methysergide blocked this relaxation, but did not affect the rectoanal reflex. Methysergide did not antagonise the actions of cholinergic and adrenergic agonists on the internal anal sphincter. Other 5-HT antagonists such as cyproheptadine, ketanserin, chlorpromazine, amitriptyline and ergotamine f...

  20. Efficacy of topical imiquimod in HIV-positive patients with recurrent anal condylomata acuminata

    OpenAIRE

    Sidney Roberto Nadal; Carmen Ruth Manzione; Fernanda Bellotti Formiga; Sérgio Henrique Couto Horta; Victor Edmond Seid

    2012-01-01

    INTRODUCTION: Imiquimod is a topical chemotherapic and immunostimulant agent with antitumoral and antiviral activities, used for anal condylomata acuminata treatment, mainly in recurrences. OBJECTIVE: Evaluate the imiquimod efficiency in chronic and recurrent anal condylomata acuminata in HIV-infected persons. METHOD: A prospective study that analyzed 61 patients with recurrent anal condylomata treated with topic 5% imiquimod, for at least 8 weeks. These patients had already been submitted to...

  1. Anti-Inflammatory Effects of Inonotus obliquus in Colitis Induced by Dextran Sodium Sulfate

    OpenAIRE

    Se Young Choi; Sun Jin Hur; Chi Sun An; Yun Hui Jeon; Young Jun Jeoung; Jong Phil Bak; Beong Ou Lim

    2010-01-01

    A total of 28 male BALB/c mice (average weight 20.7 ± 1.6 g) were divided into 4 treatment groups and fed a commercial diet (A), a commercial diet + induced colitis by dextran sodium sulfate (DSS) (B), Inonotus obliquus (IO) administration (C), and IO administration + induced colitis by DSS (D). IO treatment (C, D) decreased the expression of tumor necrosis factor (TNF)-α and signal transducers and activators of transcription (STAT)1 compared to those of the colitis induced group (B). The exp...

  2. Ischemic colitis associated with intestinal vasculitis: Histological proof in systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    Jeong Rok Lee; Chang Nyol Paik; Jin Dong Kim; Woo Chul Chung; Kang-Moon Lee; Jin Mo Yang

    2008-01-01

    Ischemic colitis is an uncommon complication in patients with systemic lupus erythematosus (SIE). In previously reported cases of colitis caused by SLE, intestinal vasculitis is implicated as the causative process, but is rarely confirmed histologically. We described a case of a 32-year-old man with increased activity of SLE, who presented with hematochezia and abdominal pain due to ischemic colitis with small vessel vasculitis which was proven by sigmoidoscopic biopsy. The clinical course of the patient was improved after steroid and conservative management.

  3. A unique case of collagenous colitis presenting as protein-losing enteropathy successfully treated with prednisolone

    Institute of Scientific and Technical Information of China (English)

    Soichi Sano; Katsunobu Yoshioka; Keiko Yamagami; Ayako Tanaka; Minako Nishio; Tomoyuki Nakamura; Yuki Kubo; Takeshi Inoue; Wataru Ueda; Kiyotaka Okawa

    2008-01-01

    A 76-year-old woman with a 5-mo history of recurrent diarrhea and generalized edema was admitted to our hospital. Colonoscopy revealed edematous mucosa, and histopathological examination was compatible with collagenous colitis. Protein leakage from the colon, particularly in the ascending portion, was identified on 99mTc-human serum albumin scintigraphy. Collagenous colitis associated with protein-losing enteropathy (PLE) without small bowel disease was diagnosed. Prednisolone treatment ameliorated diarrhea and hypoproteinemia. Collagenous colitis should be included in the differential diagnosis of chronic diarrhea with hypoproteinemia for appropriate management.

  4. Anti-inflammatory efficiency of levobupivacaine in an experimental colitis model

    Institute of Scientific and Technical Information of China (English)

    Ugur; Duman; Aysun; Yilmazlar; Ersin; Ozturk; Sibel; Aker

    2010-01-01

    AIM:To investigate the efficiency of levobupivacaine in treating experimentally induced colitis in rats.METHODS:Colitis was induced by trinitrobenzene sulfonic acid and ethanol in 30 rats under general anesthesia,and 10 rats were used as a sham group.Subsequent to induction of colitis,rats were divided into three groups;budesonide group received 0.1 mg/kg budesonide,levobupivacaine group received 10 mg/kg levobupivacaine and saline group received 1 mL saline solution via rectal route for 7 d.In the sham gro...

  5. Anal Pap Screening for HIV-infected Men Who Have Sex With Men: Practice Improvement.

    Science.gov (United States)

    Welbeck, Monique

    2016-01-01

    HIV-infected men who have sex with men (MSM) have the highest rates of anal dysplasia and anal cancer when compared to HIV-uninfected MSM and when compared to HIV-infected heterosexual men and women. Despite significantly increasing rates of anal dysplasia and anal cancer in HIV-infected MSM, in many settings, no standard protocol is in place to screen for anal dysplasia in this high-risk group. A practice improvement project was conducted at a primary care health center to educate the HIV health care team about anal Pap screening in an effort to increase provider knowledge and rates of anal Pap screening performed as part of primary comprehensive care for HIV-infected MSM. Increased health care provider knowledge of anal Pap screening within this setting resulted in increased anal Pap screening for HIV-infected MSM. Routine screening leads to improved surveillance and treatment of precancerous lesions, decreasing morbidity and mortality in HIV-infected MSM.

  6. Método de diferencias finitas en mallas irregulares con soluciones analíticas parciales aplicado al flujo hidrodinámico

    OpenAIRE

    Fuentes R., Ricardo; Carvajal G., L. Fernando

    2005-01-01

    Se investiga la aplicación de diferencias finitas en mallas irregulares con funciones interpoladoras que son soluciones analíticas de las ecuaciones de Navier-Stokes para el flujo hidrodinámico. El dominio se divide en regiones y en cada una de ellas la solución se aproxima por una serie de funciones que cumplen con la ecuación diferencial. Para la solución del flujo hidrodinámico se utiliza el método de proyección usando las citadas funciones para la evaluación de las derivadas d...

  7. Desarrollo teórico de la Resiliencia y su aplicación en situaciones adversas: Una revisión analítica

    OpenAIRE

    Elsy Dominguez-de la Ossa; María Cristina García-Vesga

    2013-01-01

    En este artículo hacemos una revisión analítica acerca de las teorías surgidas en las últimas tres décadas alrededor de la capacidad que poseen los niños y las niñas para afrontar situaciones adversas. Realizamos un recorrido por las definiciones del concepto, clasificándolas según la relación que hacen los distintos autores y autoras con los conceptos de adaptabilidad, capacidad y competencia. Identificamos dos momentos en la evolución teórica del enfoque y analizamos los fundamentos psicoló...

  8. deseo del analista, la transferencia y la interpretación: una perspectiva analítica

    Directory of Open Access Journals (Sweden)

    Viana Ángela Bustos Arcón

    2016-01-01

    Full Text Available Este documento es una revisión teórica de los conceptos deseo del analista, transferencia e interpretación como elementos técnicos del psicoanálisis. La pregunta central de este tra- bajo es ¿Cómo se organizan el deseo del analista, la transferencia y la interpretación en la clínica psicoanalítica? Se entiende que la transferencia y la interpretación son los elementos que por excelencia definen el análisis propiamente dicho, sin embargo, el deseo del analista constituye un elemento que antecede la función clínica analítica y que conjuntamente con la transferencia habilitan un dispositivo que permite la interpretación.

  9. Contribuciones al estudio analítico del movimiento de rotación de una Tierra deformable

    OpenAIRE

    Baenas Tormo, Tomás

    2014-01-01

    Esta memoria para optar al grado de doctor por la Universidad de Alicante, en el área de Matemática Aplicada, se divide en ocho capítulos. En los cuatro primeros se lleva a cabo una revisión del problema de la rotación de la Tierra rígida y elástica, en formalismo hamiltoniano, y se introducen algunas alternativas originales a la construcción de ciertos elementos de la teoría. En los otros cuatro se presentan nuevas contribuciones al estudio analítico de los movimientos de precesión y nutació...

  10. Inteligencia de negocios en la banca nacional: Un enfoque basado en herramientas analíticas

    Directory of Open Access Journals (Sweden)

    Arlenys Roo Huerta

    2012-01-01

    Full Text Available Desde el punto de vista tecnológico, la inteligencia de negocios implica el proceso de conversión de datos relevantes en información útil para la toma de decisiones estratégicas. El objetivo central del presente artículo es analizar la inteligencia de negocios en la banca nacional, desde la perspectiva de las herramientas analíticas, representadas por los servicios de transformación de datos, los procesos de análisis en línea, los servicios de explotación y el almacén de datos. Este estudio se basa en una metodología descriptiva, con un diseño de campo, se emplea la estadística descriptiva para el análisis de los resultados. Los hallazgos encontrados indican que las herramientas utilizadas con mayor frecuencia son los servicios de explotación, teniendo una notoria debilidad en la definición de los procesos realizados. Esto genera un gran impacto en la toma de decisiones, para proporcionar respuestas a interrogantes del negocio. Se concluye el uso de la inteligencia de negocios como un sistema de apoyo a los procesos llevados a cabo en las instituciones estudiadas.

  11. El significado de las malformaciones anorectales y de las dilataciones anales

    Directory of Open Access Journals (Sweden)

    Aguinaga Benítez Oscar William

    1996-12-01

    Full Text Available

    Es un estudio investigativo de tipo cualitativo, dentro del enfoque hermenéutico, en donde se busca conocer el significado que los padres asignan a las malformaciones anorectales o enfermedad de Hirschprung y el tratamiento en sus hijos, incluyendo las dilataciones anales; con el propósito de encontrar aproximaciones a sus sentidos y construir estrategias de atención que beneficien el estado físico del niño y apunten a un mayor equilibrio psicosocial de los padres. Es por ello, que las categorías de análisis están insertas en la actitud, entendida ésta como la síntesis de lo afectivo, lo cognitivo y lo práxico. Mediante la historia clínica hospitalaria, se seleccionaron a los padres a quienes se les hizo la entrevista y se les observó la actitud frente a las malformaciones y su tratamiento en más de una ocasión, obteniéndose la información que condujo a las conclusiones. Se entrevistaron y observaron 25 padres de familia y sus respectivos hijos, no sin antes señalar que se trató de recoger una experiencia de 4 años atrás, con otros padres con similar problemática.

  12. Concurrent Chemoradiotherapy Results in Patients with Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Weon Kuu; Kim, Soo Kon [Presbyterian Medical Center, Chonju (Korea, Republic of); Lee, Chang Geol; Seong, Jin Sil; Kim, Gwi Eon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-02-15

    Among the 63 patients with histopathologically proven primary squamous cell anal cancer who were managed in Presbyterian Medical Center and Yonsei University Cancer from Jan. 1971 to Dec. 1991, 34 patients, who were managed with surgery alone (abdominoperineal resection) or post-operative radiotherapy and concurrent chemoradiotherapy were analyzed. With mean follow up time of 81.3 months, 30 patients (88%) were followed up from 17 to 243 months. In methods, 10 patients were treated with surgery alone. 9 patients were treated with combined surgery and postoperative radiotherapy (59{approx}60 Gy in 28{approx}30 fractions). 15 patients were treated with concurrent chemoradiotherapy. Chemotherapy (Mitomycin C 15 mg/squ, bolus injection day 1;5-FU, 750 mg/squ, 24hr infusion, day 1 to 5) and radiotherapy started the same day. A dose of 30 Gy was given to the tumor and to the pelvis including inguinal nodes, in 15 fractions. After 2 weeks a boost of radiotherapy (20 Gy) to the ano-perineal area and second cycle of chemotherapy completed the treatment. The overall 50 year survival rate was 56.2%. concurrent chemoradiotherapy group was 70% and surgery alone group was 16.7%. According to the cox proportional harzard model, there was significant different between survival with concurrent chemoradiotherapy and surgery alone (p=0.0129), but post-operative radiotherapy was 64.8%, which was not statically significant (p=0.1412). In concurrent chemoradiotherapy group, the anal function preservation rate was 87% and the severe complication rate (grade 3 stenosis and incontinence) was 13.3%. In conclusion, we conclude that the concurrent chemoradiotherapy may be effective treatment modality in patients with anal cancer.

  13. Role of intracellular calcium in contraction of internal anal sphincter

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    @@ INTRODUCTION Internal anal sphincter (IAS) is a continuation of the smooth circular muscle layer thickened at the rectum, innervated by vegetative nerve. IAS is a special smooth muscle, which is different from colonic smooth muscle in physiology and pharmaology[1]. It was found that contraction of gastric smooth muscle depends on the influx of extracellular calcium and release of intracellular calcium[2]. In present study, we observed and compared the effects of extra- and intracellular calcium on the contraction of IAS and colonic smooth muscle.

  14. [The time of proctectomy during ileo-anal anastomosis].

    Science.gov (United States)

    Hautefeuille, P

    1993-01-01

    Proctectomy is one of the most important operative phases of ileal pouch-anal anastomosis. It allows complete resection of the rectal mucosa and determines the quality of the postoperative course and the functional results. Two procedures are described, either with a distal rectal mucosectomy or complete resection of the rectal wall as far as the pectinate line. Functional results are identical. The second procedure leads to a complete resection of the rectal mucosa and therefore will be indicated in cases of low rectal cancer of dysplasia when the anus can be preserved. PMID:8161140

  15. Tailgut cyst in a neonate with anal stenosis.

    Science.gov (United States)

    Antao, B; Lee, A C H; Gannon, C; Arthur, R; Sugarman, I D

    2004-06-01

    Tailgut cysts, embryological remnants of the hindgut, are rare retrorectal tumours. They have been described in adults but are rare in children, especially neonates. We report a case of a neonate, who presented with anal stenosis and an incidental ultrasonographic finding of a presacral mass. Excision and histological examination of the mass confirmed the appearance of a tailgut cyst. There were no postoperative complications and no evidence of recurrence of the presacral mass over one year after excision. The clinical, pathological, and radiological findings of the tailgut cyst are described with a review of the literature. PMID:15211416

  16. Hrvatski studentski pokret – pokušaj teorijske analize

    OpenAIRE

    Mesić, Milan

    2010-01-01

    Postoje različite ocjene, prigodne i djelomične analize, pa i empirijska istraživanja nedavnog protestnog kolektivnog djelovanja hrvatskih studenata. No teško da je bilo pokušaja njegova teorijskoga objašnjenja i razumijevanja. Imajući u vidu vrlo raznovrsna određenja društvenoga pokreta, autorovo je stajalište da se zahtjevi pobunjenih studenata, blokade fakulteta i plenumsko odlučivanje te drugi oblici kolektivnoga studentskog djelovanja mogu teorijski najbolje sagledati k...

  17. Analítica de datos en Twitter

    OpenAIRE

    Mir Montserrat, Dani; López Vicario, José

    2015-01-01

    Aquest document conté originàriament altre material i/o programari només consultable a la Biblioteca de Ciència i Tecnologia. Als últims anys, les xarxes socials han esdevingut una eina empresarial indispensable amb la que, en definitiva, augmentar les vendes a les companyies. El present treball fa front al repte de realitzar analítica a Twitter, mitjançant la comparativa entre dues grans marques com son adidas i Nike, i experimentant amb l'algorisme k-menas i tècniques Natural Language Pr...

  18. Lentes progressivas x lentes multifocais: um estudo baseado na geometria analítica do cone

    Directory of Open Access Journals (Sweden)

    Araújo Marília Cavalcante

    2004-01-01

    Full Text Available OBJETIVO: Compreender, por meio de figuras e funções matemáticas do cone, as lentes progressivas e mostrar que elas não são lentes multifocais porque, nelas, a refração da luz não obedece as leis da geometria euclidiana. MÉTODOS: Foi feito um estudo da geometria analítica do cone, com o programa de computador Auto-CAD 14, dando enfoque óptico às figuras geométricas obtidas com a sua secção. RESULTADOS: Pela análise das figuras obtidas da secção do cone, pudemos observar as superfícies que compõem as lentes progressivas. Estas superfícies são compostas de elipse, círculo, parábola e hipérbole. Diferente do que é dito na literatura, encontramos as elipses com diâmetro maior nas ordenadas e de mesmo sentido seguida por duas superfícies inferiores que são parábola e hipérbole e não o contrário. CONCLUSÕES: As lentes progressivas diferentemente das lentes multifocais apresentam prismas nos centros ópticos como decorrência da sua estrutura. No final, fizemos análise das suas formas mostrando o limite teórico da sua evolução.

  19. Isotretinoína y colitis ulcerosa Isotretinoin and ulcerous colitis

    Directory of Open Access Journals (Sweden)

    E. Borobio

    2004-08-01

    Full Text Available La isotretinoína (Roacután®, fármaco derivado del ácido retinoico, es utilizado en dermatología como tratamiento para diversos tipos de acné. Su mecanismo de acción a nivel dermo-epidérmico aún no ha sido completamente esclarecido. Existen en la literatura actual diversos estudios en los que se ha documentado una relación, proporcional o inversa, entre la toma de isotretinoína y el debut o reactivación de una enfermedad inflamatoria intestinal. Aunque se han propuesto diversas hipótesis por las cuales este fármaco podría actuar sobre la mucosa intestinal en la patogénesis de la enfermedad, ninguna de ellas ha sido concluyente. Presentamos aquí un nuevo caso en el que pudo evidenciarse la mencionada relación, por lo que creemos conveniente recordar que ante un paciente con síntomas sospechosos de enfermedad inflamatoria intestinal en tratamiento activo con este isómero, debe realizarse un procedimiento endoscópico para descartarla.Isotretinoin is a drug obtained from retinoid acid, often used for the treatment of different types of acne. The way it acts on the dermo-epidermis has not been clearly described. Different studies reporting a relation, proportional or inverse, between isotretinoin and the occurrence or reactivation of an inflammatory bowel disease (IBD have been found in the literature. Although there are several hypotheses about how this substance can affect the bowel mucous in the pathogenesis of the disease, none of them are definitive. We present a new case where the mentioned relation was evident. Therefore we suggest that when a patient treated with this isomer presents symptoms suggesting IBD, an endoscopic procedure should be performed in order to rule out inflammatory mucous changes.

  20. Topical Rosiglitazone Treatment Improves Ulcerative Colitis by Restoring Peroxisome Proliferator-Activated Receptor-gamma Activity

    DEFF Research Database (Denmark)

    Pedersen, G.; Brynskov, Jørn

    2010-01-01

    and functional activity in human colonic epithelium and explored the potential of topical treatment with rosiglitazone (a PPAR gamma ligand) in patients with ulcerative colitis. METHODS: Spontaneous and rosiglitazone-mediated PPAR gamma and adipophillin expression (a gene transcriptionally activated by PPAR...... gamma) were measured by reverse transcriptase PCR in colonic biopsies and isolated epithelial cells from patients with ulcerative colitis and controls. Fourteen patients with active distal ulcerative colitis were randomized to either rosiglitazone (4 mg) or mesalazine (1 g) enema treatment once daily...... in epithelial cells from inflamed mucosa in vitro. Rosiglitazone enema treatment was well tolerated and reduced the Mayo ulcerative colitis score from 8.9 to 4.3 (P