Paciente con esquizofrenia tratado con ziprasidona + clozapina

Directory of Open Access Journals (Sweden)

Pol Yanguas E.

2013-05-01

Full Text Available P es un paciente diagnosticado de esquizofrenia, sigue en un piso tutelado un programa de rehabilitación, está medicado con clozapina 500 mg/día y ziprasidona 280 mg/ día. Padece hipercolesterolemia, tabaquismo y sus hábitos alimenticios no son buenos. La medicación que utiliza desde 2007 hasta ahora se refleja en la tabla 1. El último tratamiento se le introdujo el 7 de agosto de 2012, habiendo presentado un electro cardiograma (ECG normal, pero con ligera taquicardia ventricular y prolactinemia de 44,8 ng/ml (valores normales: 2-18 ng/ml.

Prevalencia y factores asociados de la automonitorización glucémica en pacientes diabéticos tipo 2 no tratados con insulina en la Comunidad Valenciana

OpenAIRE

Cano-Blanquer, Diego; Cervera-Casino, Pedro; Peiró-Moreno, Salvador; Mateu-García, Mónica; Barreda-Aznar, Amparo

2013-01-01

Fundamentos: La utilidad de la automonitorización de la glucemia (AMGS) en pacientes con diabetes tipo 2 (DM2) no tratados con insulina (NTI) es objeto de controversia. Los objetivos de este trabajo son describir la prevalencia de AMGS en sujetos con DM2 NTI en la Comunidad Valenciana y analizar los factores asociados a su a su uso. Método: Estudio transversal en 83 consultas de atención primaria mediante revisión de la historia clínica electrónica y entrevista a 573 sujetos con DM2-NTI. Se a...

La importancia de una estrategia de comercializaci?n y negociaci?n del sectorfloricultor colombiano en el marco del Tratado de Libre Comercio (TLC) con losEstados Unidos

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Vargas Su?rez, Carlos Andr?s

2005-01-01

Por esto, la intenci?n de esta investigaci?n es plantear una estrategia de comercializaci?n y negociaci?n para el sector floricultor colombiano m?s acorde, que le haga frente a esta nueva oportunidad que se le presenta al pa?s, como lo es el Tratado de Libre Comercio con Estados Unidos.

La Salud y el Tratado de Libre Comercio (TLC.

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Gustavo Malagón Londoño

2004-09-01

Se pregunta uno si con el espectro proyectado las pretensiones de obligar a normas rígidas de patentes, propiedad intelectual y otras inherentes se lograría un tratado justo o mas bien se agravaría la situación de los países en serios problemas actualmente...

Función adrenal y metabolismo lipídico en niños asmáticos tratados con budesonida

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Paoli-de Valeri Mariela

1999-01-01

Full Text Available Objetivo. Evaluar el efecto de bajas dosis de budesonida inhalado sobre la función adrenal y el metabolismo lipídico en niños asmáticos. Material y métodos. Se estudiaron: 10 niños asmáticos (edad promedio, 8.6 años tratados con budesonida inhalado (200-300 µg/día por un lapso mayor a tres meses (grupo A; 15 niños asmáticos (edad promedio, 7.8 años sin tratamiento esteroideo (grupo B, y 10 niños no asmáticos (grupo C. Se determinaron los niveles de cortisol basal y postestímulo con ACTH, andrógenos adrenales, lípidos y cortisol urinario. Resultados. Entre los grupos A y B no hubo diferencias significativas en las variables estudiadas. En los niños asmáticos (grupo A-B el cortisol urinario fue significativamente mayor en relación con el grupo C. Los niveles de triglicéridos, colesterol total, colesterol de la lipoproteína de baja densidad e índices aterogénicos fueron mayores en el grupo de niños asmáticos, con y sin budesonida, comparados con el grupo C. Conclusiones. El tratamiento con dosis bajas de budesonida inhalado en niños asmáticos no modificó la función del eje adrenal ni el metabolismo lipídico. Los pacientes asmáticos presentaron un perfil lipídico aterogénico que podría incrementar el riesgo de enfermedad cardiovascular.

Factores de riesgo para la recanalización de los aneurismas cerebrales tratados con coils desprendibles

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Carlos Mario Jiménez Yepes

2008-11-01

Full Text Available INTRODUCCIÓN: la efectividad de la embolización con coils de los aneurismas cerebrales se apoya en última instancia en su capacidad para lograr la exclusión del flujo sanguíneo del interior del aneurisma, que a su vez es el mecanismo por medio del cual se previene el resangrado. Los buenos resultados a corto y mediano plazo de la terapia endovascular con coils para la oclusión de aneurismas cerebrales no están discusión, siempre y cuando sean medidos en términos de complicaciones y prevención del resangrado, e incluso son mejores que con cirugía abierta, como lo han demostrado estudios tanto retrospectivos como prospectivos El problema aparece cuando se evalúa la persistencia de la oclusión de los aneurismas a largo plazo. A pesar de las ventajas de la terapia endovascular con coils, los aneurismas embolizados con este método en ocasiones se recanalizan y se requieren intervenciones adicionales, hecho que se constituye en la principal desventaja de esta modalidad de tratamiento. Este fenómeno, llamado recanalización, se ha reportado hasta en, aproximadamente, un tercio de los pacientes. Se han reportado frecuencias de recanalización del 28% en el primer año, 20% entre el primer y segundo años y 14% entre el segundo y tercer años, mostrando un patrón de recanalización que declina progresivamente hasta el tercer año, después del cual ya prácticamente no se presenta. Cognard y colaboradores (Radiology 1999,212;384-356 encontraron una frecuencia de recanalización del 14% en los aneurismas totalmente ocluidos y del 30% en los parcialmente ocluidos, con una frecuencia continua de recurrencia del 5% a los 3 meses, 9% a los 18 meses y 8% a los 38 meses luego de la embolización. En la serie reportada por Hayakawa (J Neurosurgery 2000, 193;561- 568 49% de los aneurismas tratados por medio de coils se hicieron recurrentes debido a recanalización de la luz meses o años después del tratamiento inicial. Como se puede ver a partir

Mycobacterium avium subsp. paratuberculosis: presencia en los alimentos y su relación con la enfermedad de Crohn Mycobacterium avium subsp. paratuberculosis in food and its relationship with Crohn's disease

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K. Cirone

2007-03-01

Full Text Available La paratuberculosis o enfermedad de Johne es una enteritis crónica producida por Mycobacterium avium subsp. paratuberculosis, que afecta a bovinos y a otras especies. En la Argentina se ha caracterizado en rodeos bovinos y de ciervos, con aislamientos tipificados en distintos patrones genéticos. M. avium subsp. paratuberculosis ha sido vinculado en humanos con una inflamación crónica del intestino, denominada enfermedad de Crohn. Existen evidencias clínicas y experimentales que relacionan a M. avium subsp. paratuberculosis con la enfermedad en el humano, mediante su detección por PCR y por cultivo a partir de biopsias de órganos, de leche materna y de sangre de pacientes afectados. La leche y sus subproductos serían posibles fuentes de infección y se ha sugerido que M. avium subsp. paratuberculosis resistiría las condiciones de pasteurización. Diversos trabajos de investigación demostraron que esta micobacteria podría estar presente en leches comercializadas en diversos países, como Reino Unido, Estados Unidos, República Checa, y también en la Argentina. La presencia de M. avium subsp. paratuberculosis en productos lácteos y agua de consumo ha sido relacionada con la resistencia del microorganismo tanto a los procesos de elaboración como a los factores climáticos adversos, lo que enfatiza el rol de los alimentos y del agua como vías de transmisión al humano. Las investigaciones en curso podrían ratificar el riesgo y las implicancias de la exposición del humano a M. avium subsp. paratuberculosis a través de los alimentos y del agua contaminados, para determinar la importancia de la paratuberculosis como enfermedad zoonótica.Paratuberculosis or Johne's disease is a chronic enteritis of the cattle and other small ruminant animals caused by Mycobacterium avium subsp. paratuberculosis. In Argentina, the strains were characterized in beef and dairy cattle and deer in different genetic patterns by molecular tools. M. avium

Viabilidad de la aplicación de materiales reciclados y cenizas de biomasa en la fabricación de materiales tratados con cemento

OpenAIRE

Cabrera Montenegro, Manuel

2016-01-01

La presente Tesis Doctoral es una contribución al conocimiento y la investigación sobre el uso de áridos reciclados y cenizas de fondo procedentes de la combustión de biomasa para su uso en ingeniería civil. El interés en el uso de áridos reciclados procedentes de residuos de construcción y demolición (RCD) están en continuo crecimiento debido a su potencial frente a diversos usos, entre ellos como material tratado con cemento para capas estructurales de carretera. Por ot...

Bilateral pulmonary thromboembolism and Budd-Chiari syndrome in a patient with Crohn's disease on oral contraceptives Tromboembolismo de pulmón bilateral y síndrome de Budd-Chiari en paciente con enfermedad de Crohn y toma de anticonceptivos orales

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M. Valdés Mas

2009-09-01

Full Text Available Budd-Chiari syndrome can be defined as an interruption or diminution of the normal blood flow out of the liver. Patients with Budd-Chiari syndrome present with varying degrees of symptomatology that can be divided into the following categories: fulminant, acute, subacute and chronic. The subacute form is the most common presentation. A majority of patients with Budd-Chiari syndrome have an underlying hypercoagulability state. We present the case of a young woman with Crohn's disease on oral contraceptives who developed bilateral pulmonary thromboembolism and Budd-Chiari syndrome.El síndrome de Budd-Chiari consiste en la interrupción o disminución de flujo de las venas suprahepáticas. Tiene una gran variabilidad clínica en cuanto a su forma de presentación siendo la más frecuente la forma subaguda. La gran mayoría de los pacientes responden a estados de hipercoagulabilidad. Presentamos el caso de una paciente joven con enfermedad de Crohn que estaba en tratamiento con anticonceptivos orales y desarrolló un cuadro clínico de tromboembolismo de pulmón bilateral y síndrome de Budd-Chiari.

Estandarización de una prueba de ELISA para detectar anticuerpos IgE en pacientes con equinococosis quistica y su utilidad en el diagnóstico y seguimiento de pacientes tratados con albendazol: reporte preliminar

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Herman Vildózola

2012-01-01

Full Text Available Objetivos: Determinar las diluciones y concentraciones optimas de una prueba de ELISA para detectar anticuerpos IgE, así como su sensibilidad, espécificidad y valor predictivo en pacientes con equinococosis quistica. Analizar si los niveles de anticuerpos IgE especificos se correlacionan con la respuesta al tratamiento médico con albendazol en un periodo mayor a un año de finalizado el tratamiento. Diseño: Estudio cuasiexperimental con grupo control. Institución: Instituto de Medicina Tropical Daniel A. Carrión, Facultad de Medicina, UNMSM, Lima, Perú. Material de estudio: Prueba de ELISA para anticuerpo IgE. Intervenciones: Estandarizacion de la prueba de ELISA para anticuerpo IgE y diseño preexperimento con preprueba y posprueba en un solo grupo, para evaluar su valor en el diagnóstico y seguimiento postratamiento de pacientes con quiste hidatidico hepatico tratados con albendazol. Para la estandarizacion de la prueba de ELISA, se utilizó suero de cinco pacientes con diagnóstico clínico de equinococosis quistica, y la sensibilidad y especificidad de la prueba se usó suero de 30 pacientes aparentemente sanos. Para determinar las reacciones cruzadas, se utilizó 16 muestras de suero de pacientes con otras helmintiasis (ascariasis, strongiloidiasis, toxocariosis, trichuriasis, himenolepiasis, cisticercosis y teniasis. Para el diagnóstico y seguimiento postratamiento de equinocococosis quística, se utilizó el suero de 17 pacientes. Principales medidas de resultados: Sensibilidad y especificidad de prueba estandarizada de ELISA para detectar anticuerpos IgE. Resultados: La prueba estandarizada de ELISA para detectar anticuerpos IgE tuvo una sensibilidad de 95,6% y una especificidad de 100%. En los pacientes con quiste hidatídico hepático considerados curados, uniformemente disminuyeron los niveles de anticuerpo tipo IgE hasta la negativización. Se obtuvo elevación de los niveles de IgE en los pacientes que presentaron

Un tratado sobre la extranjería de lo propio (El uruguayo de Copi

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María Negroni

2006-09-01

Full Text Available El uruguayo de Copi es un tratado sobre la lengua, una descripción desopilante de un país, un ácido comentario político, una burla impiadosa de los valores culturales, una pesadilla personal, un golpe de teatro donde cualquier versión de la realidad se vuelve precaria y se trastoca al compás de una imaginación afiebrada que no hace más que dar rienda suelta a los materiales del inconsciente. Pero sobre todo, es la visión desnuda de la relación imposible de un escritor con el país que ha dejado atrás. Un tratado sobre el horror de confrontarse con la realidad carcelaria del pasado. Un intento de "calmar" los fantasmas, es decir, de hacerlos hablar y moverse y morir y resucitar en una trama que transita en medio de cadáveres y mares desaparecidos y un territorio que se achica constantemente. Un texto fundamental para indagar cuestiones relacionadas con la "identidad" nacional y con las maneras en que los desplazamientos culturales (con su concomitante tránsito entre lenguas y visiones del mundo, tan comunes en el mundo actual, afectan la escritura.

Implicaciones para el Ecuador del Tratado de Libre Comercio con Estados Unidos en relación a los medicamentos y a la salud.

OpenAIRE

Logroño Barrionuevo, Milton Efraín

2006-01-01

1. LEGISLACION DE PROPIEDAD INTELECTUAL 2.EL TRATADO DE LIBRE COMERCIO: MEDICAMENTOS Y SALUD 3. IMPACTO DEL TRATADO DE LIBRE COMERCIO EN MEDICINAS Y SALUD.4. IMPLICACIONES SOCIALES DEL TRATADO DE LIBRE COMERCIO EN MEDICAMENTOS Y SALUD 5. PROPUESTA DE NEGOCIACIÓN EQUITATIVA DEL ECUADOR EN EL TRATADO DE LIBRE COMERCIO EN MEDICAMENTOS Y SALUD.6. CONCLUSIONES Y RECOMENDACIONES

Tratamiento de la anorexia urémica con acetato de megestrol

OpenAIRE

Fernández Lucas, M.; Teruel, J.L.; Burguera, V.; Sosa, H.; Rivera, M.; Rodríguez Palomares, J.R.; Marcén, R.; Quereda, C.

2010-01-01

Introducción: La anorexia es un trastorno frecuente en el enfermo tratado con hemodiálisis periódica, y factor contribuyente de la malnutrición. El objetivo del presente trabajo es comprobar la eficacia del acetato de megestrol, un estimulador del apetito utilizado en enfermos con cáncer, como tratamiento de la anorexia del enfermo sometido a diálisis. Material y métodos: En el año 2009, 16 enfermos de nuestra unidad de hemodiálisis, tres de ellos con diabetes mellitus, fueron tratados con ac...

Crohn's disease.

LENUS (Irish Health Repository)

Shanahan, Fergus

2012-02-03

Crohn\\'s disease is a disorder mediated by T lymphocytes which arises in genetically susceptible individuals as a result of a breakdown in the regulatory constraints on mucosal immune responses to enteric bacteria. Regulation of immune reactivity to enteric antigens has improved understanding of the pathophysiological mechanisms of Crohn\\'s disease, and has expanded therapeutic options for patients with this disorder. Disease heterogeneity is probable, with various underlying defects associated with a similar pathophysiological outcome. Although most conventional drug treatments are directed at modification of host response, therapeutic manipulation of the enteric flora is becoming a realistic option.

El leasing financiero internacional en el tratado UNIDROIT

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Flores Doña, Mª Sierra

1998-01-01

El Tratado UNIDROIT se refiere al contrato de leasing financiero internacional, esto es, al celebrado entre una Sociedad de leasing y un empresario con establecimientos (principal o secundario) situados en el territorio de dos Estados contratantes y caracterizado porque la primera adquiere elementos integrantes del patrimonio empresarial a un fabricante, según las instrucciones recibidas por su cliente y a quien se le entregará para su uso a cambio del pago de cuotas períodicas, al margen de ...

Análisis de la producción y comercialización del banano, su aceptación y evolución frente al Tratado de Libre Comercio con la Unión Europea

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Rojas, Miguel Angel; Rodríguez, María Vanessa

2015-01-01

Colombia ha sido tradicionalmente un país exportador de banano, incluso éste producto es uno de los que conforman la canasta de los tradicionales. Ahora bien, con el Tratado de Libre Comercio con la Unión Europea es factible que su posición mejore en este mercado de más de 500 millones de habitantes, sin embargo, y bajo el supuesto que a futuro Ecuador ( el primer productor mundial) y Costa Rica suscriban TLC´S con la Unión Europea . El país ha emprendido una etapa de transformación que ...

Oxidation kinetics of hazelnut oil treated with ozone; Cinética de oxidación del aceite de avellana tratado con ozono

Energy Technology Data Exchange (ETDEWEB)

Uzun, H.; Ibanoglu, E.

2017-07-01

libres de todas las muestras. Ea y ΔH‡ de los aceites tratados con ozono mostraron una tendencia reductora que refleja una mayor sensibilidad a la oxidación de los aceites después del tratamiento con ozono. Consistentemente, un aumento de ΔS‡ indicó una reacción de oxidación más rápida con un aumento del tiempo de exposición al ozono. Sin embargo, no se observó diferencia significativa en k, Ea, ΔH‡, ΔS‡ (p <0.05) en función del período de almacenamiento, después de que el aceite de avellana fue tratado con ozono durante 1 min.

Composición química, digestibilidad y cinética ruminal de la digestión de residuos agrícolas tratados con explosión de vapor

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Ricardo Basurto Gutiérrez

2012-01-01

Full Text Available Para determinar el efecto de la explosión de vapor (EXPV en la composición y digestibilidad de forrajes toscos (F se condujeron dos experimentos. En el Exp 1, con un diseño factorial de presión (P; 10.3, 13.8 y 17.2 kg cm2 y tiempo (T; 5, 10 y 15 min, se determinaron los cambios en pH, fracciones de fibra (FF y la digestibilidad in vitro (DIVMS del rastrojo de sorgo (RS, rastrojo de maíz (RM y bagazo de caña (BZC por efecto de EXPV. En el Exp 2, se comparó la cinética de la digestión in situ (CDI de forrajes sin tratar y tratados con EXPV, RS y RM fueron tratados con 13.8 kg/cm2 por 10 min y BZC con 17.2 kg/cm2 por 15 min. Se incubaron muestras de forraje en rumen hasta por 120 h. Los datos fueron ajustados a un modelo no lineal. P y T no interactuaron en pH o FF. El aumento en P o T redujeron el pH, FDN y la hemicelulosa. La lignina y FDA no cambiaron dentro los niveles de P o T. En DIVMS, P*F y T*F fueron significativas. EXPV incrementó las fracciones soluble y potencialmente digestible y extensión de digestión de FF de los tres forrajes. Exceptuando para BCZ, el tiempo de retraso no cambió para FF. La respuesta de la tasa de digestión fue variable para FF o forraje. Se concluye que la EXPV mejora la calidad nutritiva de los forrajes toscos por solubilizar parte de la pared celular, acelerar la tasa de digestión e incrementar la extensión de la digestión.

Efectos de inhibidores de colinesterasa en pacientes con enfermedad asociada a cuerpos de Lewy

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Nilton Custodio

2008-09-01

Full Text Available Objetivos: Analizar los efectos de los inhibidores de colinesterasas (ICE donepezilo, rivastigmina y galantamina en el tratamiento de demencia con cuerpos de Lewy (DCL y demencia de la enfermedad de Parkinson (DEP. Diseño: Estudio tipo ensayo abierto. Lugar: Servicio de Neurología, Hospital Militar Central (HMC, y Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Clínica Internacional. Participantes: Pacientes con demencia asociada a cuerpos de Lewy y demencia de la enfermedad de Parkinson. Intervenciones: Las mediciones de eficacia en 33 pacientes con diagnóstico de DCL y DEP se realizó con el Mini-Mental State Examination (MMSE, Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog, Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC, Alzheimer’s Disease Cooperative Study-Activities of Daily Living Inventory (ADCS-ADL, Neuro-Psychiatry Inventory (NPI, Prueba de dibujo de Reloj de Manos (PDR-M y la Unified Parkinson´s Disease Rating Scale-motor subscale (UPDRS-part III. Principales medidas de resultados: Síntomas cognitivos, funcionamiento global y actividades de vida diaria de los pacientes. Resultados: Diecisiete pacientes fueron tratados con rivastigmina, 9 con galantamina y 7 con donepezilo. Luego de 6 meses de tratamiento, los pacientes en tratamiento con rivastigmina mejoraron en 1,39 puntos en ADAS-cog respecto de su medición basal, mientras que los pacientes tratados con donepezilo y galantamina no mostraron cambios (cambios <0,2 puntos. Respecto al ADCS-ADL, los pacientes tratados con rivastigmina, donepezilo y galantamina demostraron disminución de 0,42, 0,58 y 0,75 puntos, respectivamente. En el MMSE, los pacientes tratados con rivastigmina y donepezilo no mostraron cambios y los pacientes tratados con galantamina tuvieron una disminución promedio de 1,19 puntos. No hubo diferencias significativas en la incidencia de síntomas parkinsonianos en los tres

Meeting the Challenge of Crohn's Disease

Science.gov (United States)

... page please turn JavaScript on. Feature: Crohn's Disease Meeting the Challenge of Crohn's Disease Past Issues / Winter ... Living with Crohn's Disease / What Is Crohn's Disease / Meeting the Challenge of Crohn's Disease Winter 2016 Issue: ...

Las indicaciones geográficas en el TLC firmado por Colombia y Perú con EUA frente al TLC con Chile.

Directory of Open Access Journals (Sweden)

Juan Andrés Zarama Medina

2007-06-01

Full Text Available El propósito de este trabajo es hacer un análisis crítico del tratamiento que se ha dado a las Indicaciones Geográficas y mas específicamente a las Denominaciones de Origen en el Tratado de Libre Comercio que firmaron recientemente por Colombia y Perú, con los Estados Unidos (TLC, al que en adelante denominaremos TLC CAN, y compararlo con el TLC firmado con Chile (En adelante TLC CHILE. Para efectos de este trabajo, centraremos nuestra atención de manera específica en la tendencia de estos tratados a tratar las indicaciones geográficas y en especial las denominaciones de origen, como marcas colectivas y de certificación o garantía.

Crohn's disease.

Science.gov (United States)

von Roon, Alexander C; Reese, George E; Orchard, Timothy R; Tekkis, Paris P

2007-11-07

Crohn's disease is a long-term chronic condition of the gastrointestinal tract. It is characterised by transmural, granulomatous inflammation that occurs in a discontinuous pattern, with a tendency to form fistulae. The cause is unknown but may depend on interactions between genetic predisposition, environmental triggers, and mucosal immunity. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical treatments in adults to induce remission in Crohn's disease? What are the effects of lifestyle interventions in adults with Crohn's disease to maintain remission? What are the effects of surgical interventions in adults with small-bowel Crohn's disease to induce remission? What are the effects of surgical interventions in adults with colonic Crohn's disease to induce remission? What are the effects of medical interventions to maintain remission in adults with Crohn's disease; and to maintain remission following surgery? We searched: Medline, Embase, The Cochrane Library and other important databases up to March 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 60 systematic reviews, RCTs, or observational studies that met our inclusion criteria. In this systematic review we present information relating to the effectiveness and safety of the following interventions: aminosalicylates, antibiotics, azathioprine/mercaptopurine, ciclosporin, corticosteroids (oral), enteral nutrition, fish oil, infliximab, methotrexate, probiotics, resection, segmental colectomy, smoking cessation, and strictureplasty.

Efecto de los Tratados de Libre Comercio, Acuerdos Comerciales y Tratados Bilaterales de Inversión sobre los Flujos de Inversión Extranjera Directa: un análisis para América Latina entre 2001-2014

OpenAIRE

Dávila Barragán, Jimena Alejandra; Orozco Jaramillo, Camilo

2015-01-01

Este documento investiga los efectos que tienen los Tratados de Libre Comercio (TLC), demás Acuerdos Comerciales (AC) y Tratados Bilaterales de Inversión (TBI) sobre los flujos de Inversión Extranjera Directa (IED), por medio de un pseudo - panel conformado por un total de total de 960 individuos (construidos con país de origen y de destino) para 15 países de América Latina durante el período 2001-2014 -- Los resultados sugieren que los TLC no incluyen en los flujos de IED que ingresan a Amér...

Impacto del síndrome metabólico en la resistencia a la recanalización arterial y en el pronóstico de los pacientes con oclusión aguda de la arteria cerebral media tratados con activador tisular del plasminógeno

OpenAIRE

Dorado Bouix, Laura

2012-01-01

La recanalización arterial precoz es un punto clave para alcanzar un buen pronóstico funcional tras un ictus isquémico. El síndrome metabólico (SM) podría jugar un papel en la evolución de los pacientes con ictus isquémico tratados con activador tisular del plasminógeno (tPA) por vía sistémica (a) por su asociación a un estado protrombótico que podría interferir en la recanalización arterial inducida por tPA y (b) porque varias de las alteraciones metabólicas que acompañan al SM podrían contr...

Tratado de libre comercio entre Colombia e Israel. Perspectivas generales y oportunidades para el sector agrícola colombiano

OpenAIRE

Triviño Ortega, Sebastián; Prada Vanegas, Harold Sebastián

2015-01-01

Las estrategias tendientes a la diversificación de los mercados de exportación e internacionalización de la economía por parte del gobierno colombiano y sus políticas gubernamentales han incluido la firma de una serie de Tratados de Libre Comercio, entre ellos el TLC de última generación firmado con El Estado de Israel. Estos tratados además de abordar temas tradicionales de comercio, tratan nuevos capítulos en inversiones y servicios. Así mismo se analizan las principales políticas por parte...

Valor predictor del cociente saturación hemoglobina/fio2 en pacientes pediátricos con insuficiencia respiratoria aguda debida a neumonía tratados con ventilación no invasiva. Predictive value of the pulse oximetric saturation/fraction of inspired oxygen ratio in pediatric patients with acute respiratory failure due to pneumonia treated with non-invasive ventilation

OpenAIRE

Palanca Arias, Daniel

2014-01-01

RESUMEN: El uso de la ventilación no invasiva (VNI) en pacientes con fracaso respiratorio hipoxémico debido a neumonía es controvertido, alcanzando elevadas tasas de fracaso en el Síndrome de Distrés Respiratorio Agudo (SDRA). Recientemente, el cociente SpO2/FiO2 (SF) se ha equiparado al cociente paO2/FiO2 (PF) para la valoración del SDRA. Determinamos en una cohorte de pacientes, diagnosticados de neumonía y tratados con VNI, si el cociente SF es una variable con valor predictor de fraca...

Defectos del dorso nasal tratados con injerto autólogo

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Ángel Soto Fernández

2005-08-01

Full Text Available Se operaron 10 pacientes con defectos del dorso nasal, 9 catalogados de grandes (4 mm o más y uno con menos de 1 mm. En la mayoría predominó el sexo masculino y el defecto fue adquirido. En 9 de los pacientes con defectos grandes se utilizó injerto de hueso de cresta ilíaca en forma de L descansando en huesos propios y espina nasal, y en uno con defecto pequeño se utilizó cartílago. El resultado es evaluado después de 8 años como satisfactorio estética y funcionalmente, sin evidencia clínica de reabsorción.

PREVALENCIA Y FACTORES ASOCIADOS DE LA AUTOMONITORIZACIÓN GLUCÉMICA EN PACIENTES DIABÉTICOS TIPO 2 NO TRATADOS CON INSULINA EN LA COMUNIDAD VALENCIANA

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Diego Cano-Blanquer

2013-01-01

Full Text Available Fundamentos: La utilidad de la automonitorización de la glucemia (AMGS en pacientes con diabetes tipo 2 (DM2 no tratados con insulina (NTI es objeto de controversia.. Los objetivos de este trabajo son describir la prevalencia de AMGS en sujetos con DM2 NTI en la Comunidad Valenciana y analizar los factores asociados a su a su uso. Método: Estudio transversal en 83 consultas de atención primaria mediante revisión de la historia clínica electrónica y entrevista a 573 sujetos con DM2-NTI. Se analizó la asociación entre la indicación de AMGS y las características del paciente, médico y organizativas. Resultados: 289 (50,4% de los pacientes con DM2-NTI utilizaban AMGS. En el análisis multivariante el uso de AMGS se asoció a la menor edad (OR:2,3 para 65-84 y 6,0 para 8, vs <7, número de antidiabéticos orales prescritos (ADO (OR:2,5, 4,1 y 5,7 para 1, 2 ó 3+ ADO vs no tratamiento farmacológico, tipo de ADO (mayor en sulfonilureas y glitazonas y enfermedad respiratoria crónica (OR:0,5. Controlando el efecto de estos factores, el uso de AMGS se asoció adicionalmente a los años de ejercicio profesional del médico y a la asistencia en algunos departamentos sanitarios. Conclusiones: La mitad de los pacientes con DM-NTI utilizan AMGS. Su uso se asoció fuertemente a las características clínicas de los pacientes, aunque algunos factores no clínicos explican parte de la variabilidad en su utilización.

Denervación renal percutánea mediante el uso de catéter con balón en pacientes con hipertensión arterial resistente

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Isabel C. Marín-Orozco

2015-11-01

El objetivo del presente reporte es describir detalladamente dos casos de hipertensión arterial resistente, tratados mediante ablación con radiofrecuencia con el nuevo dispositivo Vessix® de la compañía Boston Scientific.

Vinos, carnes, ferrocarriles y el Tratado de Libre Comercio entre Argentina y Chile (1905-1910)

OpenAIRE

Lacoste, Pablo

2004-01-01

Entre 1905 y 1910 Chile y Argentina negociaron la firma de un Tratado de Comercio con vistas a suprimir los aranceles aduaneros y consagrar el principio de "Cordillera Libre". El centro de atracción eran las exportaciones de ganado argentino a Chile y de vino chileno a Argentina. Pero en ambos países se produjo una fuerte reacción de los intereses creados con vistas a frustrar las tratativas diplomáticas. Tanto la Sociedad Nacional de Agricultura (Chile) como el Centro Vitivinícola Nacional (...

Emergency surgery for Crohn's disease.

Science.gov (United States)

Smida, Malek; Miloudi, Nizar; Hefaiedh, Rania; Zaibi, Rabaa

2016-03-01

Surgery has played an essential role in the treatment of Crohn's disease. Emergency can reveal previously unknown complications whose treatment affects prognosis. Indicate the incidence of indications in emergent surgery for Crohn's disease. Specify the types of procedures performed in these cases and assess the Results of emergency surgery for Crohn's disease postoperatively,  in short , medium and long term. Retrospective analysis of collected data of 38 patients, who underwent surgical resection for Crohn's disease during a period of 19 years from 1992 to 2011 at the department of surgery in MONGI SLIM Hospital, and among them 17 patients underwent emergency surgery for Crohn's disease. In addition to socio-demographic characteristics and clinical presentations of our study population, we evaluated the indications, the type of intervention, duration of evolution preoperative and postoperative complications and overall prognosis of the disease. Of the 38 patients with Crohn's disease requiring surgical intervention, 17/38 patients underwent emergency surgery. Crohn's disease was inaugurated by the complications requiring emergency surgery in 11 patients. The mean duration of symptoms prior to surgery was 1.5 year. The most common indication for emergency surgery was acute intestinal obstruction (n=6) followed by perforation and peritonitis (n=5). A misdiagnosis of appendicitis was found in 4 patients and a complicated severe acute colitis for undiagnosed Crohn's disease was found in 2 cases. The open conventional surgery was performed for 15 patients. Ileocolic resection was the most used intervention. There was one perioperative mortality and 5 postoperative morbidities. The mean of postoperative hospital stay was 14 days (range 4-60 days). Six patients required a second operation during the follow-up period. The incidence of emergency surgery for Crohn's disease in our experience was high (17/38 patients), and is not as rare as the published estimates

Avaliação de parâmetros antioxidantes em ratos tratados com sevoflurano Evaluación de parámetros antioxidantes en ratones tratados con sevoflurano Evaluation of antioxidant parameters in eats treated with sevoflurane

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Francisco J. L Bezerra

2010-04-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: O sevoflurano é um éter halogenado com flúor que sofre biotransformação hepática através do citocromo P450 2E1. Éteres halogenados que sofrem biotransformação pelo P450 2E1 podem produzir espécies reativas do oxigênio (ERO e promover enfraquecimento do sistema de defesa antioxidante. O objetivo deste trabalho foi investigar a relação entre a atividade das enzimas antioxidantes eritrocitárias e o sevoflurano. MÉTODO: Os animais foram distribuídos em quatro grupos: Grupo 1 controle: apenas oxigênio a 100% (1 L.min-1 por 60 minutos durante 5 dias consecutivos; Grupo 2 - sevoflurane 4,0% em oxigênio a 100% (1 L.min-1 por 60 minutos durante 5 dias consecutivos; Grupo 3 - isoniazida (i.p., 50 mg.kg-1 de peso corporal /dia, durante 4 dias e em seguida tratados apenas com oxigênio a 100% (1 L.min-1 por 60 minutos durante 5 dias consecutivos; Grupo 4 - isoniazida por via intraperitoneal na dose de 50 mg.kg-1 de peso corporal, diariamente durante 4 dias, seguido da administração do sevoflurane a 4,0% em oxigênio a 100% (1 L.min-1 por 60 minutos durante 5 dias. Após 12 horas da última exposição ao sevoflurane, os animais foram sacrificados e o sangue foi coletado através da veia porta para análise da atividade das enzimas antioxidantes. RESULTADOS: Aumento da atividade específica da glicose-6-fosfato desidrogenase, diminuição da atividade específica da catalase, principalmente no grupo de animais pré-tratados com isoniazida e, em seguida, tratados com sevoflurano. A glutationa peroxidase não apresentou alteração na sua atividade. CONCLUSÕES: A interação do sevoflurano com indutores enzimáticos do citocromo P450 2E1 pode propiciar a instalação do estresse oxidativo caso a exposição se torne prolongada e repetitiva.JUSTIFICATIVA Y OBJETIVOS: El sevoflurano es un éter halogenado con flúor que sufre una biotransformación hepática a través del citocromo P450 2E1. Los �

El tratado secreto del Barón de Río Branco: la alianza entre Brasil y Ecuador, 1904

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Luís Cláudio Villafañe G. Santos

2016-06-01

Full Text Available Es casi desconocida en las historiografías de Brasil y Ecuador la existencia de un tratado militar secreto entre ambos países, rmado el 5 de mayo de 1904, dirigido contra las pretensiones territoriales de Perú. El artículo estudia una creciente tensión entre Brasil y Perú, que disputaban un área de 442 mil kilómetros cuadrados en la Amazonía. Por iniciativa del Barón de Río Branco, se rmó un tratado secreto de alianza militar entre Brasil y Ecuador. Si bien este acuerdo no fue raticado por los países rmantes, fue de suma importancia para forzar al gobierno peruano a iniciar negociaciones con Brasil, que años más tarde resultaron en el tratado de límites entre los dos países.

Proceso de negociación del tratado sobre el comercio de armas: tensiones y dinámicas de poder

OpenAIRE

del Castillo Briceño, Paula Johana

2014-01-01

El interés del presente estudio de caso es analizar la articulación de las dinámicas de poder y estrategias de negociación detrás de un proceso tan complejo como el de la creación del Tratado sobre el Comercio de Armas.El estudio examina la evolución de las tensiones principales entre los Estados participantes frente al Tratado y resalta las lógicas de poder al interior de las negociaciónes, así como los factores externos que influyeron para solucionar o agravar dichas tensiones. Con el apoyo...

Adición de residuos de yeso laminado tratado, en el yeso de construcción.

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Rodriguez Orejón, Agustín

2011-01-01

Este trabajo tiene por objeto analizar la posibilidad de utilización de los RCD’s derivados de las placas de yeso laminado (PYL) de forma específica por mezcla de una matriz de yeso o escayola en polvo de nueva producción, con diferentes proporciones de estos residuos, previamente tratados. Por otro lado estudiar la cuantificación de la minoración de resistencia mecánica, sufrida por matrices de diferentes tipos de yeso con agregados, en distintas proporciones, a base de RCD`s de paneles ...

El tratado de Derecho Administrativo del Profesor Rodolfo Carlos Barra

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Daniel Hugo Martins

2014-06-01

Full Text Available En el "Tratado" cuyos primeros dos tomos han sido públicados recientemente, Barra se propone aplicar la "tesis cuatripartita" al derecho administrativo, con base en la "filosofía perenne" y la interpretación tomista del derecho."Este trabajo -dice- propugna la sistematización y mediatización del Derecho Administrativo, como rama del derecho público que garantiza el cumplimiento del acto justo en las relaciones de justicia distributiva y está referido a la regulación de la relación jurídica Estado (Administración Pública - administrado"

Los tratados silogísticos de Boecio: sus fuentes, historia e influencia en la cristiandad latina

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Manuel Correia

2007-01-01

Full Text Available En este artículo se describen los contenidos de un tratado sobre lógica aristotélica escrito por Boecio en el VI d. C, llamado por nuestras ediciones modernas De syllogismo categórico (=DSC. A través de sus contenidos, es posible mostrar: (i la importancia de este tratado en el proceso de transmisión de la lógica de Aristóteles al medioevo latino; (ii su relación con otro tratado monográfico similar, titulado por la crítica moderna Introductio ad syllogismos categóricos (ISC y su relación temática con DSC; (iii las fuentes más probables de ambos tratados; y, finalmente, (iv su influencia en el medioevo latino. La hipótesis que se defiende en este artículo es que los contenidos lógicos de este tratado, en particular la clasificación de las proposiciones categóricas, contenida en el corazón del DSC, entregan no solo el objeto temático al tratado, sino también coherencia argumentativa y unidad. En especial, el estudio de esta clasificación permite demostrar la unidad de DSC y en particular que el segundo libro de DSC es genuino y no espurio como sostuvieron, no hace mucho, los estudiosos Murari y McKinlay; además, esta misma clasificación permite apreciar su diferencia con ISC, por el hecho de que este último tratado posee una clasificación diferente a la de DSC. La base de la hipótesis propuesta se halla en que la clasificación mencionada es un intento por generar, a partir de los elementos preposicionales, las principales operaciones lógicas definidas por Aristóteles en sus escritos lógicos, asunto que en la revisión de De Rijk (1964 no quedó totalmente establecidoIn this article, the author describes the contents of a treatise on Aristotelian logic, written by Boethius in the sixth century A.D., titled in our modern editions as De syllogismo categórico (DSC. It is possible to show, through the contents: (i the importance of this treatise for the transmission process of Aristotle's logic to the Latin medieval

Colorectal cancer complicating Crohn's disease.

Science.gov (United States)

Freeman, H J

2001-04-01

Some earlier studies have indicated that patients with inflammatory bowel disease, especially those with long-standing and extensive ulcerative colitis, have an increased risk of colorectal cancer. Moreover, others in tertiary care centres have suggested that patients with Crohn's disease also have a higher risk of colorectal cancer. Canadian data on colorectal cancer in Crohn's disease appear to be limited. For this investigation, a single clinician database of 877 patients with Crohn's disease was used. Altogether, there were six patients with colorectal cancer (ie, overall rate of 0.7%). All of these patients were men with an initial diagnosis of Crohn's disease established at a mean age of approximately 28 years, with either ileocolonic disease or colonic disease alone, but not with ileal disease alone. Although there was a predominance of women in the overall study population (ie, 56.1%), no women developed colorectal cancer. The clinical behaviour of Crohn's disease was classified as nonstricturing in all six patients with colorectal cancer, but in two patients, Crohn's disease was complicated by a perirectal abscess or a fistula. All cancers were located in the rectum and were diagnosed 30 years, 22 years, seven years, 18 years, 20 years and 40 years after Crohn's disease was initially diagnosed. In three patients, the cancer was detected in a residual rectal stump after a partial colon resection at least 10 years earlier. In five patients, localized extension of disease through the serosa, nodal or distant metastases (ie, liver, lung) was found at the time of cancer diagnosis; two patients have since died. The present study confirms that Crohn's disease involving the colon may be a possible risk factor for the development of colorectal cancer, at least in younger men, but, in this study, not in women. However, part of this increased risk in men may have been related to the presence of a rectal stump, rather than to Crohn's disease per se.

Colorectal Cancer Complicating Crohn's Disease

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Hugh J Freeman

2001-01-01

Full Text Available Some earlier studies have indicated that patients with inflammatory bowel disease, especially those with long-standing and extensive ulcerative colitis, have an increased risk of colorectal cancer. Moreover, others in tertiary care centres have suggested that patients with Crohn's disease also have a higher risk of colorectal cancer. Canadian data on colorectal cancer in Crohn's disease appear to be limited. For this investigation, a single clinician database of 877 patients with Crohn's disease was used. Altogether, there were six patients with colorectal cancer (ie, overall rate of 0.7%. All of these patients were men with an initial diagnosis of Crohn's disease established at a mean age of approximately 28 years, with either ileocolonic disease or colonic disease alone, but not with ileal disease alone. Although there was a predominance of women in the overall study population (ie, 56.1%, no women developed colorectal cancer. The clinical behaviour of Crohn's disease was classified as nonstricturing in all six patients with colorectal cancer, but in two patients, Crohn's disease was complicated by a perirectal abscess or a fistula. All cancers were located in the rectum and were diagnosed 30 years, 22 years, seven years, 18 years, 20 years and 40 years after Crohn's disease was initially diagnosed. In three patients, the cancer was detected in a residual rectal stump after a partial colon resection at least 10 years earlier. In five patients, localized extension of disease through the serosa, nodal or distant metastases (ie, liver, lung was found at the time of cancer diagnosis; two patients have since died. The present study confirms that Crohn's disease involving the colon may be a possible risk factor for the development of colorectal cancer, at least in younger men, but, in this study, not in women. However, part of this increased risk in men may have been related to the presence of a rectal stump, rather than to Crohn's disease per se.

Fistole retto-vaginali Crohn-relate trattate mediante trasposizione del muscolo gracile: risultati a lungo termine e qualità della vita

OpenAIRE

Tassone, Daniela

2015-01-01

OBIETTIVO: Le fistole retto-vaginali Crohn-relate hanno un impatto significativo sulla qualità della vita. Quando il canale anale è alterato da ulcerazioni e stenosi o in pazienti con difetti estesi del perineo, la chirurgia locale produce risultati insoddisfacenti. Lo scopo di questo studio è quello di valutare l'efficacia della trasposizione del muscolo gracile nelle fistole retto-vaginali Crohn-relate e determinare i suoi effetti sulla qualità della vita. MATERIALI E METODI: Da gennaio...

El Tratado de Versalles y el huevo de la serpiente

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Cruset, María Eugenia

2009-01-01

Si algo enseña la historia es que no hay verdadero y pacífico desarrollo sin verdad, justicia y reparación. O, dicho en sentido negativo, nada hay más explosivo y destructivo para cualquier país que las arbitrariedades e inequidades. Este año se cumplen 90 años de uno de los episodios más gráficos de lo que estamos diciendo: el Tratado de Versalles, que firmado el 28 de junio de 1919 significó el fin de la Primer Guerra Mundial con la humillante derrota de Alemania. Flagrante situación de arb...

Tratado de Libre Comercio de América del Norte, territorio financiero del libre comercio

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Margarita Camarena Luhrs

2014-09-01

Full Text Available A veinte años de la firma del Tratado de Libre Comercio de Norteamérica, posiblemente ha agotado sus posibilidades. De sus objetivos, los que resultaron viables, fue la constitución de un territorio financiero de libre comercio, libre y continuo en Norteamérica. Con este proceso destaca el imperativo financiero de la expansión comercial trilateral; pero también, tal como se muestra con esta reflexión, que tras esos resultados comerciales opera una inteligencia financiera y territorial, realmente geoestratégica, promotora de extrema “liberalización proteccionista” que traspasa y supera las capacidades nacionales de Estados.

Isolated Crohn's disease of the stomach

International Nuclear Information System (INIS)

Traxler, M.; Weiss, W.; Rohrmoser, G.

1988-01-01

The spectrum of this disease has undergone major changes since 1932 when Crohn, Ginzberg and Oppenheimer differentiated Ileitis terminalis from nonspecific inflammations of the bowels. Initially, Crohn assumed an inflammation restricted to the terminal ileum. Today, Crohn's disease has been verified to affect the total gastro-intestinal tract from the cavity of the mouth to the anus. In 1949 Ross et al. were the first to report Crohn's disease in the region of the stomach and duodenum. Its localization in the upper intestinal tract, however, is a rare occurrence on the whole. (orig.) [de

El Sistema del Tratado Antártico, Posición de Chile como País Puente

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Javier Urbina Paredes

2009-10-01

Full Text Available El artículo presenta al Tratado Antártico y al sistema y régimen internacional a que da lugar, a cincuenta años de su firma en Washington, Estados Unidos, el 1 de diciembre de 1959. Los retos de la época y los propósitos del Tratado fueron satisfactoriamente superados, pero hoy se enfrenta a nuevos problemas y desafíos, no tanto de carácter político, sino científico, derivados sobre todo del cambio climático, la creciente actividad turística, el daño al medio ambiente y la seguridad de la navegación marítima y aérea. Chile es un actor clave en la Antártida y en el sistema del Tratado Antártico y ofrece sus potencialidades como país puente al ser el más cercano al continente para el desarrollo de las actividades antárticas en general. En su vinculación internacional sobre la materia, lo hace bajo el marco del Tratado Antártico, pero más aún, desarrolla capacidades concretas de acuerdo con las mayores y nuevas demandas que el sistema antártico deberá enfrentar para ponerlas a disposición de la comunidad internacional.

MRI of vulvar Crohn disease

Energy Technology Data Exchange (ETDEWEB)

Pai, Deepa; Dillman, Jonathan R.; Mahani, Maryam Ghadimi; Strouse, Peter J. [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, F3503, Ann Arbor, MI (United States); Adler, Jeremy [University of Michigan Health System, Department of Pediatrics and Communicable Diseases, Division of Pediatric Gastroenterology, C. S. Mott Children' s Hospital, Ann Arbor, MI (United States)

2011-04-15

Crohn disease is a chronic granulomatous inflammatory disorder that most commonly affects the gastrointestinal tract, particularly the distal small bowel and colon. While certain extraintestinal manifestations of Crohn disease are relatively common and well-known, others, such as metastatic cutaneous involvement, are quite rare and may be difficult to recognize, particularly in the pediatric population. This case report illustrates the magnetic resonance imaging (MRI) appearance of vulvar region cutaneous Crohn disease in an 11-year-old girl. (orig.)

Eficacia del tratamiento acupuntural en pacientes con epicondilitis humeral externa

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Ida Pantoja Fornés

2015-07-01

Full Text Available Se realizó una intervención terapéutica en 100 pacientes de 20-59 años, con epicondilitis humeral externa, atendidos en la Sala de Rehabilitación del Policlínico Comunitario Docente “Eduardo Mesa Llull”, del municipio de II Frente, de la provincia Santiago de Cuba, desde septiembre de 2013 hasta marzo de 2014, para evaluar la eficacia del tratamiento acupuntural en ellos. La muestra fue dividida en 2 grupos de 50 integrantes cada uno, seleccionados de forma aleatoria. Los del grupo de estudio fueron tratados con acupuntura más corriente Trabert y los del control con corriente Trabert solamente. Como principales resultados predominaron: el grupo etario de 40-49 años (64,0 %, el sexo femenino (66,0 % y los obreros de servicio (56,0 %. Se obtuvo que los tratados con acupuntura tuvieron una mejor evolución, de donde se infiere que la terapia empleada resultó efectiva para aliviar el dolor en quienes se aplicó

Diferencias conductuales y cognitivas en dos grupos de escolares con TDAH intervenidos con Arteterapia -vsMetilfenidato y un grupo control

OpenAIRE

M. Aurora G. Gallardo Saavedra; Ana Lucía Padrón García; M. del Consuelo Martínez-Wbaldo

2018-01-01

Introducción: El trastorno de défcit de atención e hiperactividad TDAH es una entidad neuropsiquiátrica, con prevalencia en la infancia entre 2% y 20%, su tratamiento actual asocia medicamentos y psicoterapia. El arteterapia en salud mental ha sido utilizado para tratar de cambiar el comportamiento y potenciar la cognición. Objetivo: comparar los cambios cognitivo-conductuales en escolares con TDAH tratados con arteterapia-vs-metilfenidato y un grupo control. Método: Ensayo clínico aleatoriza...

Estudio comparativo de las medidas transitorias de protección al sector agrícola en los tratados de libre comercio suscritos entre Estados Unidos de América (EEUU) – Colombia y Estados Unidos de América (EEUU) – Chile

OpenAIRE

Barón Martín, Erika Andrea; Vargas Pulido, Wiiliam Ernesto

2016-01-01

La suscripción de tratados de libre comercio (TLC) por parte de Estados Unidos (EEUU) durante la última década con países suramericanos ha correspondido a una estrategia implementada por este país para acercase al continente y mantener relaciones comerciales más estrechas con sus aliados estratégicos. Sin embargo, las negociaciones de estos tratados de libre comercio, suscritos con países suramericanos como Chile y Colombia han incluido medidas transitorias de protección, en especial en el s...

Linfoma hepático primario: Evolución favorable con quimioterapia combinada con rituximab Primary hepatic lymphoma: favorable outcome with chemotherapy plus rituximab

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I. Serrano-Navarro

2008-11-01

Full Text Available Comunicamos el caso de una paciente con un linfoma hepático primario tratado con éxito con quimioterapia combinada con rituximab. Utilizando los "encabezamientos estándar para búsquedas bibliográficas informatizadas" (Medical Subject Heading revisamos los casos publicados hasta la fecha de esta infrecuente entidad.This article describes the case of a patient with a non-Hodgkin primary hepatic lymphoma who was successfully treated with chemotherapy combined with rituximab. Using the Medical Subject Headings the published reports of this rare entity were reviewed.

Altered potassium homeostasis in Crohn's disease

International Nuclear Information System (INIS)

Schober, O.; Hundeshagen, H.; Bosaller, C.; Lehr, L.

1983-01-01

The total body potassium (TBK), serum potassium, and the number of red blood cell ouabain-binding sites was studied in 94 patients with Crohn's diease. TBK was measured by counting the endogenous 40 K in a whole body counter. TBK was 87%+-13% in 94 patients was Crohn's disease, while in control subjects, it was 97%+-12% (n=24). This significant reduction in TBK was accompanied by normal serum potassium levels (4.4+-0.5 mM). TBK was significantly correlated with the Crohn's disease activity index (r=0.79, n=113, P 3 H-ouabain showed a significant increse in the number of Na-K pumps in Crohn's disease (396+-65, n=27) compared with the control group. 290+-45 (n=24). These results support the suggestion that changes in TBK may regulate the synthesis of Na-K pump molecules. The total body potassium depletion and the need for a preoperative nutritional support in Crohn's disease are discussed. (orig.)

ANÁLISIS DEL PERFIL DE COMPUESTOS VOLÁTILES DEL MANGO (Mangifera indica L. Var. Tommy Atkins) TRATADO POR MÉTODOS COMBINADOS

OpenAIRE

Angélica Moreno; David F. León; Germán A. Giraldo; Eunice Ríos

2010-01-01

Se evaluó el perfil de compuestos volátiles del mango (Mangifera indica L. Var. Tommy Atkins) al ser tratado con la combinación de los métodos de deshidratación osmótica con o sin pulso de vacío (DOPV y DO) y con secado por aire caliente o con vacío (SAC y VAC). El tiempo utilizado en la cinética del proceso de DO fue de 42 horas y la DOPV de 30 horas; en los procesos de secado, el SAC se realizó durante 24 horas y el VAC requirió 40 horas. En el perfil de compuestos volátiles del mango fresc...

Embarazo cornual: tratamiento médico con dosis única de metotrexato

OpenAIRE

Ricci A,Paolo; Troncoso J,José Luis; Avilés L,Guillermo; Avilés D,Raimundo

2013-01-01

Presentamos un caso de embarazo cornual o intersticial diagnosticado en forma precoz a través de ecografía transvaginal, tratado exitosamente, en forma conservadora, con dosis única sistémica de metotrexato.

El comercio electrónico en los tratados de libre comercio de México

OpenAIRE

Sigmond, Karen

2018-01-01

Resumen: Este artículo iniciará con los antecedentes del desarrollo del régimen del derecho commercial internacional, desde el Acuerdo General sobre Aranceles Aduaneros y Comercio a la Organización Mundial del Comercio. Se definirá al comercio electrónico o E-commerce y se hará una referencia de las tendencias de crecimiento actuales, seguida de la manera en la que se regula esta materia en México. Se estudiará la cobertura del comercio electrónico en los Tratados de Libre Comercio de México,...

Ana?lisis cinemático de la marcha en pacientes con pie zambo tratados mediante el me?todo de Ponseti frente a la te?cnica quiru?rgica de liberacio?n posterior

OpenAIRE

Ferrando, A.; Salom Taverner, M.; Page, A.

2018-01-01

El objetivo principal de este proyecto consiste en valorar la evolución de la marcha en niños en edad preadolescente tratados mediante el método de Ponseti frente a los tratados mediante liberación posterior a partir de técnicas de valoración de la marcha mediante análisis biomecánico. Material y Métodos Estudio retrospectivo de casos y controles aprobado por el comité de ética. Grupo 1: 28 niños (39 pies) tratados mediante liberación posterior. Grupo 2: 18 pacientes (31 pies) tratados median...

IMPACTO DEL TRATADO DE LIBRE COMERCIO ENTRE COLOMBIA Y EEUU, SOBRE EL ACCESO A LOS MEDICAMENTOS EN COLOMBIA

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José David Millán Cano

2012-12-01

Full Text Available Este artículo, más que pretender continuar con la franca crítica al Tratado de Libre Comercio (TLC entre Colombia y EE.UU, busca dar una aproximación a las posibles repercusiones que este acuerdo tendrá sobre el acceso a los medicamentos de los afiliados al Sistema General de Seguridad Social en Salud (SGSSS colombiano en  mediano y largo plazo.Para lograr esto, se definirá qué se entiende por Tratado de Libre Comercio, para luego realizar una breve reseña histórica de su evolución. Luego, y para entender un poco la relación que ha unido a Colombia y a EEUU en términos comerciales, se intentará dar un panorama histórico sobre el tema. Se continuará con una descripción de cómo fue el proceso de negociación sin perder de vista los antecedentes y causas de tipo político, económico, y social que motivaron un TLC entre Colombia y EEUU, teniendo en cuenta qué sectores quedaron incluidos en la negociación, qué servicios y con qué condiciones, para luego, evaluar cómo se ve afectado el derecho a la salud y sobre todo el acceso a los medicamentos para los afiliados al SGSSS colombiano a mediano y largo plazo.

La ruptura de las relaciones diplomáticas: Una aproximación sistemática con una referencia especial a las consecuencias de la entrada en vigor del tratado de Lisboa en la praxis diplomática

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Carles Pérez-Desoy i Fages

2013-12-01

Full Text Available Este trabajo tiene por objeto ofrecer un análisis sistemático de las distintas formas en que puede producirse la ruptura de relaciones diplomáticas entre dos estados soberanos, así como de las diversas fases en que puede descomponerse un proceso de este tipo, caracterizadas por la adopción de distintos tipos de medidas diplomáticas y la combinación de unas con otras (llamada a consultas, retirada de Embajadores, etc. lo que constituye un lenguaje de signos decodificable en términos diplomáticos, que ha sido poco estudiado desde un punto de vista sistemático. El elemento casuístico es, necesariamente, muy importante, máxime cuando las referencias a esta cuestión dentro de las normas codificadas del Derecho Diplomático son muy limitadas, y la jurisprudencia es con frecuencia inexistente. Por otra parte, la entrada en vigor del Tratado de Lisboa, y la puesta en marcha del Servicio de Acción Exterior Europeo (SEAE abre la posibilidad de que, en caso de crisis diplomática, acciones características de la diplomacia clásica puedan ser aplicadas también en el marco del proceso de toma de decisiones colectivas de la UE, ampliando así significativamente la panoplia de posibles medidas a adoptar. La entrada en vigor del Tratado de Lisboa abre también nuevas opciones teóricas de gran interés en el caso de ruptura de relaciones diplomáticas de un Estado Miembro de la UE con un tercer Estado, como por ejemplo la posible creación de una "sección de intereses" de ese Estado en el seno de la Delegación de la UE en ese país

Concanavalin A-binding cholesterol crystallization inhibiting and promoting activity in bile from patients with Crohn's disease compared to patients with ulcerative colitis.

Science.gov (United States)

Keulemans, Y C; Mok, K S; Slors, J F; Brink, M A; Gouma, D J; Tytgat, G N; Groen, A K

1999-10-01

Crohn's disease is a risk factor for gallstone formation. In contrast, patients with ulcerative colitis have an incidence of gallstone formation comparable to the general population. The reason for this difference is not known. The aim of this study was to elucidate the factors controlling cholesterol crystallization in gallbladder bile of Crohn's disease and ulcerative colitis patients. Gallbladder bile was obtained by aspiration during bowel resections (26 Crohn's disease patients, 20 ulcerative colitis patients). Biliary lipid composition, crystal detection time and the effect of extraction of the concanavalin A-binding fraction on crystal formation were determined. Cholesterol crystals were present in seven of the 26 bile samples of Crohn's disease-patients and one of the 20 ulcerative colitis patients. Four of the bile samples of Crohn's disease patients were fast nucleating. None of the 20 ulcerative colitis patients had fast nucleating bile. Lipid composition, total lipid concentration and CSI were not significantly different between the two groups. In Crohn's disease patients extraction of concanavalin A-binding fraction decreased crystallization in 10 bile samples but accelerated crystallization in one bile sample. In eight bile samples from ulcerative colitis patients crystallization increased after concanavalin A-binding fraction extraction. Compared to ulcerative colitis patients, gallbladder bile of Crohn's disease patients showed increased cholesterol crystallization despite comparable lipid composition and cholesterol saturation index. This difference is caused by increased cholesterol crystallization-promoting activity. Bile from ulcerative colitis patients contains a Con A-binding factor which inhibits cholesterol crystallization.

Efecto coadyuvante del extracto liofilizado de Passiflora edulis (maracuyá en la reducción de la presión arterial en pacientes tratados con enalapril

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Juan Rojas

2009-06-01

Full Text Available Objetivos: Determinar el efecto coadyuvante antihipertensivo y la seguridad del jugo del fruto de maracuyá en pacientes hipertensos en tratamiento con enalapril. Diseño: Ensayo clínico prospectivo piloto, de fase II, aleatorizado, a doble ciego, de grupos paralelos, controlado, de búsqueda de dosis y evaluación del producto. Institución: Instituto de Investigaciones Clínicas, Facultad de Medicina, UNMSM; Hospital Nacional Dos de Mayo en Lima; Hospital Belén de Trujillo y Centros de Salud de Moche y Laredo, en la ciudad de Trujillo. Participantes: Pacientes hipertensos. Intervenciones: Los pacientes fueron asignados aleatoriamente a 4 grupos. Todos recibieron enalapril 10 mg/día y, además, el primer grupo recibió placebo y los demás 2, 3 y 4 cápsulas de 500 mg de liofilizado de jugo de maracuyá/día, respectivamente. Principales medidas de resultados: Disminución de la presión arterial. Resultados: Los grupos que recibieron enalapril más maracuyá tuvieron una mejor reducción de la presión sanguínea en comparación con el grupo que recibió enalapril más placebo. El grupo tratado con enalapril más 4 cápsulas de jugo liofilizado de maracuyá/día produjo al final del experimento una reducción de la presión sistólica de 6,73 mmHg y de la presión diastólica de 5,33 mmHg (p<0,05, en comparación con el grupo enalapril más placebo. No se observó efectos adversos por el tratamiento. Conclusiones: El jugo del fruto de P. edulis fue coadyuvante efectivo del enalapril en la disminución de la presión arterial en pacientes con hipertensión estadio 1, y demostró ser seguro.

Diagnosis and management of Crohn's disease.

Science.gov (United States)

Wilkins, Thad; Jarvis, Kathryn; Patel, Jigneshkumar

2011-12-15

Crohn's disease is a chronic inflammatory condition affecting the gastrointestinal tract at any point from the mouth to the rectum. Patients may experience diarrhea, abdominal pain, fever, weight loss, abdominal masses, and anemia. Extraintestinal manifestations of Crohn's disease include osteoporosis, inflammatory arthropathies, scleritis, nephrolithiasis, cholelithiasis, and erythema nodosum. Acute phase reactants, such as C-reactive protein level and erythrocyte sedimentation rate, are often increased with inflammation and may correlate with disease activity. Levels of vitamin B12, folate, albumin, prealbumin, and vitamin D can help assess nutritional status. Colonoscopy with ileoscopy, capsule endoscopy, computed tomography enterography, and small bowel follow-through are often used to diagnose Crohn's disease. Ultrasonography, computed axial tomography, scintigraphy, and magnetic resonance imaging can assess for extraintestinal manifestations or complications (e.g., abscess, perforation). Mesalamine products are often used for the medical management of mild to moderate colonic Crohn's disease. Antibiotics (e.g., metronidazole, fluoroquinolones) are often used for treatment. Patients with moderate to severe Crohn's disease are treated with corticosteroids, azathioprine, 6-mercaptopurine, or anti-tumor necrosis factor agents (e.g., infliximab, adalimumab). Severe disease may require emergent hospitalization and a multidisciplinary approach with a family physician, gastroenterologist, and surgeon.

Crohn's disease limited to the vermiform appendix

DEFF Research Database (Denmark)

Bak, Martin; Andersen, J C

1987-01-01

Thirteen cases of Crohn's disease confined to the vermiform appendix were seen during a 12-year period. They constituted 16.9% of patients with primary resection of the bowel for Crohn's disease in the same period, but only 0.4% of the cases of acute appendicitis. In 10 of the 13 cases there was ......Thirteen cases of Crohn's disease confined to the vermiform appendix were seen during a 12-year period. They constituted 16.9% of patients with primary resection of the bowel for Crohn's disease in the same period, but only 0.4% of the cases of acute appendicitis. In 10 of the 13 cases...... to approach that of recurrence after resection in other parts of the intestines. Collective review of this and three other relatively large case series gave an estimated recurrence rate of 3.5%. We conclude that in Crohn's disease initially confined to the appendix the course appears to be indolent....

Las indicaciones geográficas en el TLC firmado por Colombia y Perú con EUA frente al TLC con Chile.

OpenAIRE

Zarama Medina, Juan Andrés

2007-01-01

El propósito de este trabajo es hacer un análisis crítico del tratamiento que se ha dado a las Indicaciones Geográficas y mas específicamente a las Denominaciones de Origen en el Tratado de Libre Comercio que firmaron recientemente por Colombia y Perú, con los Estados Unidos (TLC), al que en adelante denominaremos TLC CAN, y compararlo con el TLC firmado con Chile (En adelante TLC CHILE). Para efectos de este trabajo, centraremos nuestra atención de manera específica en la tendencia de estos ...

Osteomalacia in Crohn's disease.

Science.gov (United States)

Dedeoglu, Meryem; Garip, Yesim; Bodur, Hatice

2014-01-01

Osteomalacia is a metabolic bone disorder characterized by impaired mineralization of the bone matrix. Vitamin D deficiency due to malabsorption syndromes may cause osteomalacia. This is a case of a patient with a 6-year history of seronegative spondyloarthropathy associated with Crohn's disease who was admitted to our outpatient clinic with symptoms of osteomalacia. Osteomalacia is a metabolic bone disease characterized by an impaired mineralization of the bone matrix, frequently caused by disorders in vitamin D or phosphate metabolism. Vitamin D deficiency due to malabsorption syndromes (e.g., Crohn's disease, ulcerative colitis, celiac disease, and jejuno-ileal bypass for obesity) may cause osteomalacia. A 43-year-old male presented with fatigue, low back pain, and morning stiffness. He had a 6-year history of seronegative spondyloarthropathy associated with Crohn's disease. Laboratory findings revealed low serum calcium, low 25-hydroxy vitamin D3, normal phosphorus, elevated parathyroid hormone, and alkaline phosphatase levels. Radiographs revealed grade IV sacroiliitis and Looser zones. He was diagnosed with osteomalacia due to the malabsorption of vitamin D. His symptoms and signs were relieved with supplements of vitamin D and calcium. Osteomalacia should be considered in differential diagnosis when assessing low back pain in the patients with chronic inflammatory bowel disease. Vitamin D deficiency should be treated with vitamin D supplementation in patients with Crohn's disease to prevent osteomalacia.

Aceros sinterizados tratados al vapor para la fabricación de componentes de amortiguadores bitubo

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Cambronero, L. E. G.

2000-06-01

Full Text Available In this work, properties of three sintered and steam treated alloyed irons were analysed. These materials were Fe+2Cu, Fe+0.6C+0.5Cu, and Fe+0.45P+2.5Cu, which were obtained by powder mixing. Once pressed and sintered, samples were steam treated (surface treatment which is characteristic of sintered irons. Density, hardness and tensile strength were obtained on sintered and steam treated samples, within their microstructure analysis. Also, a tribological study was carried out since some parts of shock absorbers are working under friction.

En este trabajo se analizan las propiedades de tres hierros aleados sintetizados y tratados al vapor. Los materiales seleccionados son el Fe+2Cu, Fe+0.6C+0.5Cu, y Fe+0.45P+2.5Cu, obtenidos por mezcla elemental de polvos. Una vez compactados y sintetizados, se sometieron a un tratamiento de recubrimiento característico de los hierros, como es el tratamiento al vapor. En los materiales sintetizados y tratados al vapor, se determinaron su densidad, dureza y resistencia a tracción, junto con su análisis microestructural. Así mismo dado que algunos de los componentes de los amortiguadores bitubo están sometidos a esfuerzos de fricción, se analizaron el comportamiento tribologíco de los materiales obtenidos tanto en estado sintetizado como tratados al vapor.

Evolución oftalmológica en pacientes hipertiroideos tratados con yodo radiactivo Ophthalmological evolution in hyperthyroid patients treated with radioactive iodine

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María Teresa Marrero Rodríguez

2005-08-01

Full Text Available El objetivo del presente estudio fue realizar un análisis de la evolución oftalmológica en pacientes hipertiroideos tratados con yodo radiactivo. Se estudiaron 100 casos (88 mujeres y 12 hombres procedentes de la consulta de tiroides del Instituto Nacional de Endocrinología, con diagnóstico clínico y bioquímico de hipertiroidismo y con una edad media de 40 ± 10 años. Estos pacientes fueron sometidos a un tratamiento con yodo radiactivo a una dosis de 80 µCi/g de tejido tiroideo. A cada uno de ellos se le realizó una oftalmometría bilateral antes del tratamiento y 12 meses después de este. La oftalmometría media del ojo derecho antes del tratamiento fue de 14,51 ± 2,86 mm y posterior al tratamiento de 13,92 ± 2,83 mm, mientras que para el ojo izquierdo fue de 14,98 ± 2,91 mm y 14,27 ± 2,83 mm, respectivamente. Teniendo en cuenta los resultados de la oftalmometría, concluimos que el uso del yodo radiactivo en el tratamiento de pacientes hipertiroideos no tuvo efectos negativos sobre la evolución oftalmológica de los pacientes estudiados.This study was aimed at analyzing the ophthalmolgical evolution in hyperthyroid patients treated with radioactive iodine. 100 patients (88 females and 12 males from the thyroid department of the National Institute of Endocrinology with clinical and biochemical diagnosis of hyperthyroidism and with a mean age of 40 ± 10 years old, were studied. These patients underwent a treatment with radioactive iodine at a dose of 80 m Ci/g of thyroid tissue. A bilateral ophthalmometry was performed to each patient before the treatment and 12 months after it. Mean ophthalmometry of the right eye was 14.51 ± 2.86 mm before the treatment and 13.92 ± 2.83 mm after the treatment, whereas for the left eye it was 14.98 ± 2.91 mm and 14.27 ± 2.83 mm , respectively. Taking into account the results of the ophthalmometry, we concluded that the use of radioactive iodine in the treatment of hyperthyroid patients had

Paediatric Crohn's disease: a radiological review

International Nuclear Information System (INIS)

Ali, S.I.; Carty, H.M.L.

2000-01-01

Paediatric Crohn's disease can be a serious and complex condition which is not always easy to diagnose if it presents in an atypical manner. Although the pathological processes are the same in adults and children, the clinical presentation and disease distribution can be different in children. The impact of the disease can also be much more significant in a growing and developing child than in an adult. Numerous investigations are available to establish the diagnosis, define the complications and to demonstrate the extra-intestinal manifestations. Close co-operation is required between the clinician and radiologist when investigating a child suspected of having Crohn's disease or its symptoms to minimise the radiation dose and the psychological and physical trauma. We review the clinical and radiological aspects of Crohn's disease and discuss the imaging modalities available in diagnosing Crohn's disease and its complications and suggest an investigation pathway as used in our institution. (orig.)

US contribution in Crohn's disease

Energy Technology Data Exchange (ETDEWEB)

Alessi, V; Bianco, S; Traina, G

1986-01-01

The authors report their experience in 40 patients with intestinal Crohn's disease, who underwent both abdominal ultrasound scanning and double-contrast small bowel enema. The various echographic patterns are described, found in the different phases during the evolution of Crohn's disease, underlying the importance of ultrasound in evaluating the real degree of bowel wall thickening and the esoenteric space, only indirectly appreciated with X-ray examination.

Surgical management of Crohn's disease.

Science.gov (United States)

Lu, Kim C; Hunt, Steven R

2013-02-01

Although medical management can control symptoms in a recurring incurable disease, such as Crohn's disease, surgical management is reserved for disease complications or those problems refractory to medical management. In this article, we cover general principles for the surgical management of Crohn's disease, ranging from skin tags, abscesses, fistulae, and stenoses to small bowel and extraintestinal disease. Copyright © 2013 Elsevier Inc. All rights reserved.

Análisis del perfil de compuestos volátiles del mango (mangifera indica l. var. tommy atkins) tratado por métodos combinados

OpenAIRE

Moreno, Angélica; León, David F.; Giraldo, Germán A.; Ríos, Eunice

2010-01-01

Se evaluó el perfil de compuestos volátiles del mango (Mangifera indica L. Var. Tommy Atkins) al ser tratado con la combinación de los métodos de deshidratación osmótica con o sin pulso de vacío (DOPV y DO) y con secado por aire caliente o con vacío (SAC y VAC). El tiempo utilizado en la cinética del proceso de DO fue de 42 horas y la DOPV de 30 horas; en los procesos de secado, el SAC se realizó durante 24 horas y el VAC requirió 40 horas. En el perfil de compuestos volátiles del mango fresc...

[Socioprofessional consequences of Crohn disease].

Science.gov (United States)

Duclos, B; Planchon, F; Jouin, H; Chamouard, P; Schieber, J P; Ubrich-Leuilliot, M; Baumann, R; Weill, J P

1990-01-01

To evaluate evolutivity and social repercussions of Crohn's disease, the same gastroenterologist interviewed 151 out of 197 patients with Crohn's disease (77.5 percent) who had been hospitalized from 1964 to 1986 in our unit. The other 46 could not be traced or refused to participate. There was no difference regarding age, sex, duration of illness, pattern of lesions and operations between the two groups. At the time of observation, mean follow-up was 7.8 years and two thirds of the patients had inactive disease. During the previous year, the course of the disease was quiescent in 50 percent of all patients; this rate increased with duration of follow-up and time from surgery. A constant rate of stable course was observed (20 percent) irrespective of duration of disease and time of surgery. The interviews were compared with those obtained from an age and sex-matched group of 70 previously healthy subjects admitted to the hospital for less than one month. The education and socioeconomic levels were higher in patients with Crohn's disease than in controls, in spite of the fact that 25 percent of patients whose disease begun during scholarship complained of difficulties at school, and nearly 20 percent of all patients were partially or totally unable to work. Sports and cultural activities were the same in Crohn's disease and in the control group. Tobacco intake was slightly higher at time of diagnosis but it was equal in both groups at the time of the interview. Non allopathic advice or treatment were sought by 48 percent of Crohn's disease patients (7 percent in controls).(ABSTRACT TRUNCATED AT 250 WORDS)

CON EL TRATADO DE LIBRE COMERCIO PERDIMOS TOD@S

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Mario Rodríguez

2008-12-01

Full Text Available Resumen El objetivo principal de este artículo es analizar la inserción de la economía guatemalteca al proceso del desarrollo global del sistema capitalista. El trabajo sustenta la idea de que la estructura productiva se fue configurando a partir de los procesos de ajuste estructural y que la misma tuvo un sesgo marcadamente neoliberal. Esto permitió generar una plataforma política y económica que facilito la imposición de un modelo dependiente con la instauración de un Acuerdo Comercial con Estados Unidos. Este mecanismo es la última fase de la implantación del modelo económico de acumulación, que permite una inserción del capital nacional al gran mercado capitalista mundial y reconfigura la estructura productiva agrícola del país adaptándola a las nuevas necesidades del capital global.   Abstract The Objective of this article is analyzing the insertion of the Guatemalan economy to process of world development of capitalist system. The work support the idea of the productive structure was forming to begin of structures adjustments process and had a slant markedly neoliberal. It allowed produce a politic platform and economic that made easy the imposition of a dependent model with the establishment of one trade agreement with United States. It mechanism is the last stage of the implantation of economic model of accumulation, that allow a insertion of national working capital to big world capitalist market and reforming the farming productive structure of Guatemala; adjustmenting the country to the new necessities of world working capital.

Surgical care of the pediatric Crohn's disease patient.

Science.gov (United States)

Stewart, Dylan

2017-12-01

Despite the significant advances in the medical management of inflammatory bowel disease over the last decade, surgery continues to play a major role in the management of pediatric Crohn's disease (CD). While adult and pediatric Crohn's disease may share many clinical characteristics, pediatric Crohn's patients often have a more aggressive phenotype, and the operative care given by the pediatric surgeon to the newly diagnosed Crohn's patient is very different in nature to the surgical needs of adult patients after decades of disease progression. Children also have the unique surgical indication of growth failure to consider in the overall clinical decision making. While surgery is never curative in CD, it has the ability to transform the disease process in children, and appropriately timed operations may have tremendous impact on a child's physical and mental maturation. This monograph aims to address the surgical care of Crohn's disease in general, with a specific emphasis on the surgical treatment of small intestinal and ileocecal involvement. Copyright © 2017 Elsevier Inc. All rights reserved.

Hipnosis clínica en un caso de enfermedad inflamatoria intestinal

Directory of Open Access Journals (Sweden)

J. C. FERNÁNDEZ MÉNDEZ

2000-01-01

Full Text Available Un sujeto de veinte años con una enfermedad inflamatoria intestinal fue tratado con hipnosis. Hasta donde sabemos es el primer informe que documenta el empleo de la hipnosis clínica en un paciente con enfermedad de Crohn, para reducir el estrés y afrontar las demandas originadas por la patología digestiva. Además, otro aspecto importante en el presente trabajo, es el registro exhaustivo y consecutivo de la sintomatología gastrointestinal, un punto débil en la gran mayoría de los trabajos precedentes. Al finalizar la intervención psicológica disminuyó notablemente el nivel de intensidad del estrés, el número de deposiciones diarias así como la intensidad del dolor abdominal. Estos resultados se mantuvieron a lo largo del seguimiento.

Disease outcome for children who present with oral manifestations of Crohn's disease.

LENUS (Irish Health Repository)

Hussey, S

2011-06-01

To describe the outcome for children with oral Crohn\\'s disease (OCD) at diagnosis, and to determine if there was a difference in the Paediatric Crohn\\'s Disease Activity Index (PCDAI) scores between those with and those without oral lesions at follow-up.

Crohn Disease: Epidemiology, Diagnosis, and Management.

Science.gov (United States)

Feuerstein, Joseph D; Cheifetz, Adam S

2017-07-01

Crohn disease is a chronic idiopathic inflammatory bowel disease condition characterized by skip lesions and transmural inflammation that can affect the entire gastrointestinal tract from the mouth to the anus. For this review article, we performed a review of articles in PubMed through February 1, 2017, by using the following Medical Subject Heading terms: crohns disease, crohn's disease, crohn disease, inflammatory bowel disease, and inflammatory bowel diseases. Presenting symptoms are often variable and may include diarrhea, abdominal pain, weight loss, nausea, vomiting, and in certain cases fevers or chills. There are 3 main disease phenotypes: inflammatory, structuring, and penetrating. In addition to the underlying disease phenotype, up to a third of patients will develop perianal involvement of their disease. In addition, in some cases, extraintestinal manifestations may develop. The diagnosis is typically made with endoscopic and/or radiologic findings. Disease management is usually with pharmacologic therapy, which is determined on the basis of disease severity and underlying disease phenotype. Although the goal of management is to control the inflammation and induce a clinical remission with pharmacologic therapy, most patients will eventually require surgery for their disease. Unfortunately, surgery is not curative and patients still require ongoing therapy even after surgery for disease recurrence. Importantly, given the risks of complications from both Crohn disease and the medications used to treat the disease process, primary care physicians play an important role in optimizing the preventative care management to reduce the risk of complications. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Tránsito del Derecho Penal Internacional desde el Tratado de Versalles y de Nuremberg hasta Roma

OpenAIRE

Castaño, Deissy Motta

2012-01-01

El marco del presente artículo se sustenta en la trascendencia del análisis de las instituciones internacionales en relación con los delitos contemplados como crímenes de guerra en conflagraciones entre Estados y su intervención en la problemática de la violencia interna. El tránsito del derecho penal internacional desde el Tratado de Versalles y de Nuremberg hasta Roma, constituye una aproximación a una genealogía histórica del derecho internacional, relativo a los crímenes de guerra durante...

Responsiveness of Endoscopic Indices of Disease Activity for Crohn's Disease

NARCIS (Netherlands)

Khanna, Reena; Zou, Guangyong; Stitt, Larry; Feagan, Brian G.; Sandborn, William J.; Rutgeerts, Paul; McDonald, John W. D.; Dubcenco, Elena; Fogel, Ronald; Panaccione, Remo; Jairath, Vipul; Nelson, Sigrid; Shackelton, Lisa M.; Huang, Bidan; Zhou, Qian; Robinson, Anne M.; Levesque, Barrett G.; D'Haens, Geert

2017-01-01

The Crohn's Disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's Disease (SES-CD) are commonly used to assess Crohn's disease (CD) activity; however neither instrument is fully validated. We evaluated the responsiveness to change of the SES-CD and CDEIS using data

El lugar de la sátira en la poética: los tratados españoles del siglo XIX

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González Alcázar, Felipe

2008-12-01

Full Text Available This article aims to analyse the satirical genre and its connections with Poetics in the Spanish Poetry and Rhetoric precept treatises of the nineteenth century. Throughout that century, literary theory was subject to major changes, such as the success of Hegel’s postulates on literary genres. Satire faces these changes and its own evolution: it was first identified with the Roman satura and afterwards through its various forms, it became a mixed or transitional genre. Its fragile nature seems to confront directly the normative perpetuity of treatises that, in spite of their rupture with romanticism, may be considered inheritors of the classicist principles.Se propone en este artículo investigar el género satírico y sus relaciones con la Poética a través de los tratados poético-retóricos de preceptiva españoles del siglo XIX. A lo largo de toda esa centuria la teoría literaria estuvo sujeta a grandes transformaciones, entre ellas, el triunfo de los principios hegelianos acerca de los géneros literarios. La sátira se enfrenta a esas mismas transformaciones y a su propia evolución: primero, identificada con la satura romana, y luego, a través de sus numerosas formas, convertida en un género mixto o de transición. Su lábil naturaleza parece enfrentarse directamente con la perennidad normativa de los tratados que, a pesar de la ruptura romántica, pueden considerarse herederos de los principios clasicistas.

Diagnostic and treatment difficulties in Crohn's disease

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Ioana Păunică

2016-11-01

Full Text Available Inflammatory bowel diseases are related to a special pathology having a great psychosocial and economic impact, being represented by chronic diseases which often affects the adult/ active population and that require a long-term treatment. The incidence of Crohn's disease has recorded an increasing trend amongst the general population. However, the incidence of regional enteritis is somewhat lower than in the case of ulcerohemorrhagic rectocolitis. The highest prevalence of Crohn's disease is encountered among the populations with a high standard of living; the onset of the disease occurs between 15 and 35 years, but there are also rare cases with onset in childbirth or over 60 years of age. Men and women are approximate equally affected by Crohn's disease. The main purpose of the treatment is to keep under control the disease, and to increase the quality of life with the following goals: diminishing intestinal inflammatory lesions, relieving symptoms and inducing remission, preventing relapses and complications, as well as maintaining proper nutrition. Appropriate treatment should be adapted to the different clinical-evolutionary forms of Crohn's disease, the succession of different treatment methods being therefore different. Surgical treatment plays a much more limited role in Crohn's disease than in ulcerhemorrhagic rectocolitis. Operational interventions are frequently followed by relapses, and surgical resections should be limited to macroscopically affected segments.

La Unidad de Atención Crohn-Colitis: 3 años de actividad The Crohn-Colitis Care Unit: analysis of the first 3 years of activity

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Gisel Fontanet

2004-12-01

Full Text Available Objetivo: Conocer los primeros datos de actividad de la Unidad de Atención Crohn-Colitis (UACC y su línea virtual, la http://www.ua-cc.org Material y método: La UACC es un servicio de educación y promoción de la salud que se dirige a los enfermos con enfermedad inflamatoria intestinal y a su entorno. Dispone de un centro de coordinación desde donde se gestionan todas las consultas y las resoluciones gestionadas por un equipo multidisciplinario. El acceso telefónico y la web son las principales vías de contacto. Resultados: A los 3 años de funcionamiento, la UACC cuenta con 956 usuarios, el 87% de los cuales son pacientes, que han generado más de 4.500 consultas multitemáticas. Destaca la vía de atención telefónica con un 67% y los más de 500 usuarios registrados en el portal. Conclusiones: Los primeros datos descriptivos expresan un impacto significativo del proyecto, en el que destacan la atención integral y el acceso virtual como las variables más significativas.Objective: To assess the activity of the Crohn-Colitis Care Unit (CCCU and of its web site: http://www.ua-cc.org Material and method: The CCCU is a unit for the education and health promotion of patients with inflammatory bowel disease and their immediate circle. It includes a coordination center with a multidisciplinary team that manages patients' requests. The main means of contact is through telephone and the Web. Results: After 3 years, there are 956 users registered in the CCCU, of which 87% are patients who generated more than 4,500 consultations on multiple topics. Telephone consultations account for 67% of all consultations and there are 500 users registered in the Web. Conclusions: The preliminary results suggest that the integral approach of the CCCU and its web site have had a significant impact on patients with inflammatory bowel disease.

Situaciones especiales en la enfermedad inflamatoria intestinal: primer consenso latinoamericano de la Pan American Crohn's and Colitis Organisation (PANCCO (Segunda parte

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J.K. Yamamoto-Furusho

2017-04-01

Full Text Available Este es el primer Consenso Latinoamericano de la Pan American Crohn's and Colitis Organisation (PANCCO que corresponde a situaciones especiales en pacientes con enfermedad inflamatoria intestinal (EII. El objetivo de este consenso es concientizar a la comunidad médica de todos los países de América Latina acerca del embarazo, la vacunación, las infecciones y las neoplasias, incluyendo el cáncer colorrectal, así como los aspectos pediátricos en pacientes con EII.

Profilaxis primaria para tromboembolismo venoso en pacientes ambulatorios con cáncer sometidos a quimioterapia

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2013-07-01

Conclusiones de los autores: La tromboprofilaxis primaria con HBPM redujo significativamente la incidencia del TEV sintomático en los pacientes ambulatorios con cáncer tratados con quimioterapia. Sin embargo, la ausencia de poder estadístico obstaculiza la posibilidad de establecer conclusiones definitivas sobre los efectos en cuanto a los resultados principales de seguridad, lo cual obliga a la realización de estudios adicionales para determinar el cociente riesgos/beneficios de la HBPM en este contexto.

RELACIÓN DE LA CALIDAD DE VIDA CON DIFERENTES MODELOS DE ATENCIÓN DOMICILIARIA EN ENFERMOS ONCOLÓGICOS TERMINALES DE UN ÁREA SANITARIA DE MADRID

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Yolanda Agra Varela

2003-01-01

Full Text Available Fundamentos: En este trabajo se evalúa la efectividad de los cuidados paliativos a domicilio con el objetivo de determinar si los enfermos con cáncer terminal tratados por Equipos de Soporte de Atención Domiciliaria presentan mejor calidad de vida que los tratados por Equipos de Atención Primaria. Métodos: Estudio prospectivo cuasi experimental realizado en el Área 4 del Imsalud de Madrid con enfermos referidos desde el hospital a Equipos de Soporte de Atención Domiciliaria o a Equipos de Atención Primaria. La variable estudiada fue la calidad de vida medida a través del Rotterdam Symptom Check List y el Hospital Anxiety and Depression Scale. Para el análisis estadístico se utilizó MANOVA, ANOVA de medidas repetidas y el test de Friedman. Resultados: 165 enfermos fueron tratados por Equipos de Soporte de Atención Domiciliaria y 56 por Equipos de Atención Primaria. Los primeros presentaron mejor puntuación en las escalas global (diferencia de medias: 9,5; IC 95%: 2,3-16,67 y dolor (diferencia de medias: 6,4; IC 9%: 1,14-11,43 del Rotterdam Symptom Check List en la primera semana del estudio. El tamaño del efecto fue mayor en el grupo Equipos de Soporte de Atención Domiciliaria. La prescripción de fármacos y el lugar de la muerte fue diferente en ambos grupos. Conclusiones:Al principio del estudio los enfermos tratados por Equipos de Soporte de Atención Domiciliaria presentaron una mejor percepción del estado de salud que los tratados por Equipos de Atención Primaria. No obstante, el importante número de pérdidas a lo largo del mismo hace que haya que mirar estos resultados con precaución.

Crohn's disease in adolescence: presentation and treatment.

Science.gov (United States)

Cullen, Mick; Barnes, Claire

2015-05-13

Crohn's disease is a chronic inflammatory bowel condition that affects more than 115,000 people in the UK. This article focuses on Crohn's disease in adolescents. Management of the condition in this group should address adolescent-specific characteristics and treatment goals. Key elements include optimising growth, pubertal development and social functioning, including education. The condition can affect an individual's mental and emotional wellbeing significantly, as well as their physical health. As adolescence is a time of great change, the additional burden of a chronic illness can prove difficult to manage. The authors provide information on the presentation of Crohn's disease in adolescence and insights into the particular issues encountered by this group.

RECONSTRUCCIÓN DEL MAXILAR SUPERIOR POSTERIOR ATRÓFICO CON CÉLULAS MADRE MESENQUIMALES

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Martí Pagès, Carles

2009-01-01

Se realiza un estudio clínico en el lnstituto de Cirugía Maxilofacial e Implantologia tras pasar el comité ético del Centro Medica Teknon. Es un estudio randomizado, controlado utilizando un diseño tipo "split mouth" en el cual cada paciente sirve de propio control. SE realiza a 5 pacientes, con atrofia posterior del maxilar superior sin posibilidad de instalar implantes fueron tratados con reconstrucción mediante la técnica de elevación sinusal bilateral, rellenando un sena con Bio-as...

Tocando a las puertas del cielo. México y la negociación del Tratado de Libre Comercio

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Orozco-Martínez, Carlos E.

1992-01-01

Análisis de la iniciativa de Carlos Salinas de Gortari como presidente de México para la creación de un área libre de comercio con Estados Unidos y Canadá. Se hace una radiografía de lo negociado para el Tratado de Libre Comercio, como acceso a mercados, reglas de comercio, servicios, inversión y propiedad intelectual; se repasa lo visto en materia de aranceles, agricultura, industria automotriz, industria textil y petroquímica, entre otros. Incluye obra visual de Francisco Madrigal, reproduc...

The Structure and Content of Agreements between the Agency and States required in connection with the Treaty on the Non-Proliferation of Nuclear Weapons; Estructura y contenido de los acuerdos entre los Estados y el Organismo requeridos en relacion con el Tratado sobre la no proliferacion de las armas nucleares

Energy Technology Data Exchange (ETDEWEB)

NONE

1971-05-15

The Board of Governors has requested the Director General to use the material reproduced in this booklet as the basis for negotiating safeguards agreements between the Agency and non-nuclear-weapon States party to the Treaty on the Non-Proliferation of Nuclear Weapons [Spanish] El Acuerdo debe contener, de conformidad con el parrafo 1 del Articulo III del Tratado sobre la no proliferacion de las armas nucleares, el compromiso de aceptar salvaguardias por parte del Estado de conformidad con los terminos del Acuerdo, sobre todos los materiales basicos o materiales fisionables especiales en todas las actividades nucleares con fines pacificos realizadas en su territorio, bajo su jurisdiccion, o efectuadas bajo su control en cualquier lugar, a efectos unicamente de verificar que dichos materiales no se desvian hacia armas nucleares u otros dispositivos nucleares explosivos.

Follow up of Crohn's disease under therapy with hydro-MRI

International Nuclear Information System (INIS)

Ganten, M.; Flosdorff, P.; Grueber-Hoffmann, B.; Erb, G.; Hansmann, J.; Encke, J.

2003-01-01

Evaluation of typical MRI-findings in patients with Crohn's disease receiving therapy.Correlation with the course of disease.Patients and methods 81 follow-up MRI-studies in 25 patients conducted within a period of 3 weeks to 4 years were evaluated retrospectively.Therapy consisted in various combinations of antibiotics and immunosuppressive agents and if necessary operation. The findings of the MRI-studies were correlated with clinical data (e.g.operation of Crohn's complications) and the subjective perception during therapy. The morphological substrate of Crohn's disease in the Hydro-MRI images is reliably detected. Especially in a delineation of extraluminal changes MRI is superior to endoscopy and enteroclysis.Independent from clinical symptoms short- and middleterm follow-up showed inflammatory changes of the intestinal wall in all 25 patients. In 24/81 studies there was persistence or even progression of Crohn's disease in the MRI-studies, although patients were free of symptoms by the time of image acquisition. Hydro-MRI is a modality for the evaluation of inflammatory changes in patients with Crohn's disease.Independent from clinical symptoms persistence of Crohn's disease is detectable. (orig.) [de

Los potenciales impactos del tratado de libre comercio Estados Unidos-Ecuador en el sector agrícola

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Calvache Peña, Myriam Patricia; Zambrano Illescas, José Sigifredo

2008-01-01

El presente trabajo analiza las ventajas y desventajas, así como los potenciales impactos de la firma del tratado de libre comercio con Estados Unidos, en el sector agrícola ecuatoriano. Se trata de abordar este tema a través de una exposición técnica de datos y de la experiencia internacional existente, lo que lleva a un enfoque más profundo de las grandes asimetrías que se tiene en el país del norte, en donde los agricultores reciben beneficios tanto en la producción como en la exportación,...

EL TRATADO DE LIBRE COMERCIO EN LOS DISCURSOS DE LOS CULTIVADORES DE TRIGO EN YACUANQUER-NARIÑO

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Burbano Huertas, Luis Felipe; Ortega Vera, César Mauricio

2015-01-01

A finales del siglo XX Colombia ha ingresado paulatinamente en los procesos de libre comercialización con otros países, derivados de las dinámicas del mercado a nivel internacional; entre estos se encuentran el de la apertura económica en la década de los noventa y en la actualidad, el Tratado de Libre Comercio (TLC). El TLC, ha sido objeto de una serie de inconformidades planteadas por parte de algunos sectores económicos, como es el caso de los cultivadores de trigo en todo el país y partic...

Hematologic manifestations of Crohn's disease: two clinical cases

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O. V. Taratina

2017-01-01

Full Text Available Inflammatory bowel diseases (IBD are commonly associated with extraintestinal manifestations, hematological disorders being the most special among them. In some cases, they dominate the clinical picture masking the intestinal manifestations of the underlying disease. Aplastic anemia is an extremely rare extraintestinal IBD manifestation. There are only two clinical cases of aplastic anemia associated with ulcerative colitis and non with Crohn's disease reported in the literature. Combination of Crohn's disease and В₁₂-deficient anemia is more prevalent, but is seen usually only after more than 20 cm of the ileus has been resected. The first clinical case presented in this paper is a  combination of severe fistula-forming Crohn's disease with a constriction in the terminal part of the ileus and profound pancytopenia as an outcome of aplastic anemia. This profound pancytopenia is associated with an extremely high risk of life-threatening complications both of surgical treatment, as well as of several chemotherapeutic agents, which made the management of this patient difficult. The second clinical case demonstrates the manifestation of Crohn's disease as ileocolitis starting from the symptoms of cobalamin deficiency: severe В₁₂-deficient anemia, funicular myelosis and sensory ataxia, with blunted intestinal symptoms. This made the initial diagnosis and timely treatment difficult. Replacement therapy with cobalamin injections and treatment with glucocorticoids and antibacterials led to endoscopically confirmed remission of Crohn's disease and normalization of hematological parameters, with persistent polyneuropathy. Thus, management of patients with Crohn's disease should be multidisciplinary. In the case of anemia, leucopenia and/or thrombocytopenia in IBD patients it is necessary to exclude potential myelodysplasia and bone marrow aplasia. In the event of megaloblastic anemia and/or progressive polyneuropathy one should bear in mind

Evaluación urodinámica con doxazocina en pacientes con hiperplasia prostática benigna (HPB. Hospital Pablo Tobón Uribe (HPTU de 1998-1999

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Juan Aristizábal

2001-04-01

Full Text Available

Tradicionalmente la HPB ha sido tratada quirúrgicamente, pero a
partir de los años 80 ha aparecido una gran variedad de modalidades
terapéuticas diferentes a la cirugía, basadas en medicamentos orales que disminuyen el tamaño de la próstata y/o los síntomas que esto genera.
Se propone estudiar con todos los parámetros urodinámicos, la respuesta de los pacientes con HPB tratados con Doxazocina para evaluar su efecto en las curvas Flujo-Presión.

Crohn's disease in Japan: diagnostic criteria and epidemiology.

Science.gov (United States)

Yao, T; Matsui, T; Hiwatashi, N

2000-10-01

New diagnostic criteria for Crohn's disease and a review of Japanese epidemiologic studies are presented. New diagnostic criteria for Crohn's disease were established by the Research Committee of Inflammatory Bowel Disease, set up by the Japanese Ministry of Health and Welfare. For a definite diagnosis one of the following three conditions is required: 1) longitudinal ulcer or luminal deformity induced by longitudinal ulcer or cobblestone pattern, 2) intestinal small aphthous ulcerations arranged in a longitudinal fashion for at least three months plus noncaseating granulomas, and 3) multiple small aphthous ulcerations in both the upper and lower digestive tract not necessarily with longitudinal arrangement, for at least three months, plus noncaseating granulomas. Moreover, ulcerative colitis, ischemic enterocolitis, and acute infectious enterocolitis should be excluded. Data from the Japanese Ministry of Health and Welfare, in addition to data collected from two study groups, these being the two largest studies in Japan, are reviewed with regard to epidemiology. The number of patients with Crohn's disease has increased remarkably. The prevalence and the annual incidence of patients with Crohn's disease in Japan were estimated to be approximately 2.9 and 0.6 per 10(5) population in 1986, respectively, and 13.5 and 1.2 per 10(5) population in 1998. Characteristic features of Crohn's disease in Japan are that the male-female ratio exceeds 2, and that there is no second peak of incidence in the age group of 55 to 65 years. Clinically, Crohn's disease with only multiple small aphthous ulcerations, which is the earliest stage of the disease that is diagnosable, was found in 5 percent of patients.

Low serum and bone vitamin K status in patients with longstanding Crohn's disease: another pathogenetic factor of osteoporosis in Crohn's disease?

Science.gov (United States)

Schoon, E; Muller, M; Vermeer, C; Schurgers, L; Brummer, R; Stockbrugger, R

2001-01-01

BACKGROUND—A high prevalence of osteoporosis is reported in Crohn's disease. The pathogenesis is not completely understood but is probably multifactorial. Longstanding Crohn's disease is associated with a deficiency of fat soluble vitamins, among them vitamin K. Vitamin K is a cofactor in the carboxylation of osteocalcin, a protein essential for calcium binding to bone. A high level of circulating uncarboxylated osteocalcin is a sensitive marker of vitamin K deficiency.
AIMS—To determine serum and bone vitamin K status in patients with Crohn's disease and to elucidate its relationship with bone mineral density.
METHODS—Bone mineral density was measured in 32 patients with longstanding Crohn's disease and small bowel involvement, currently in remission, and receiving less than 5 mg of prednisolone daily. Serum levels of vitamins D and K, triglycerides, and total immunoreactive osteocalcin, as well as uncarboxylated osteocalcin ("free" osteocalcin) were determined. The hydroxyapatite binding capacity of osteocalcin was calculated. Data were compared with an age and sex matched control population.
RESULTS—Serum vitamin K levels of CD patients were significantly decreased compared with normal controls (p<0.01). "Free" osteocalcin was higher and hydroxyapatite binding capacity of circulating osteocalcin was lower than in matched controls (p<0.05 and p<0.001, respectively), indicating a low bone vitamin K status in Crohn's disease. In patients, an inverse correlation was found between "free" osteocalcin and lumbar spine bone mineral density (r=−0.375, p<0.05) and between "free" osteocalcin and the z score of the lumbar spine (r=−0.381, p<0.05). Multiple linear regression analysis showed that "free" osteocalcin was an independent risk factor for low bone mineral density of the lumbar spine whereas serum vitamin D was not.
CONCLUSIONS—The finding that a poor vitamin K status is associated with low bone mineral density in longstanding Crohn

Cicatrização de feridas: estudo comparativo em ratos hipertensos não tratados e tratados com inibidor da enzima conversora da angiotensina

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Maria de Lourdes Pessole Biondo-Simões

Full Text Available OBJETIVO: Reconhecer a interferência do captopril na cicatrização de feridas cutâneas de ratos hipertensos. MÉTODOS: Distribuíram-se 111 ratos em quatro grupos: controle normotenso (N=30; controle hipertenso (N=30, os quais receberam 1 ml/dia de solução de cloreto de sódio a 0.9% por via oral; grupo experimento (N=31, hipertensos que receberam 7,5mg/kg/dia de captopril e um grupo aferição (N=20, 10 hipertensos e 10 normotensos, nos quais aferiu-se a pressão na aorta abdominal, no último dia de experimento. Após 15 dias de medicação, fez-se uma incisão da pele e da tela subcutânea, na região médio-dorsal dos grupos I, II e III, seguida de síntese. Ressecaram-se as cicatrizes de 10 animais de cada grupo, no 4.º, 7.º e 14.º dias após a operação, que divididas em duas partes foram enviadas para a tensiometria e para análise histológica. RESULTADOS: A pressão arterial média de 83,18 ± 7,51 mmHg nos normotensos e 151,36 ± 10,51 mmHg nos hipertensos. As cicatrizes dos hipertensos tratados e não tratados eram menos resistentes que as dos normotensos, nos tempos iniciais (p<0,05 e que ao 14.º dia as resistências se igualaram. Não houve diferença entre o grupo tratado e o não tratado. A densidade de colágeno total foi maior nos normotensos em todos os tempos (p<0,05 e não houve diferença entre hipertensos tratados e não tratados. A epitelização, a reação inflamatória e a formação do tecido de granulação foi semelhante nos três grupos. CONCLUSÕES: O captopril, em ratos, não modifica a cicatrização, ficando as diferenças relacionadas à hipertensão.

Vinos, carnes, ferrocarriles y el Tratado de Libre Comercio entre Argentina y Chile (1905-1910

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Pablo Lacoste

2004-06-01

Full Text Available Entre 1905 y 1910 Chile y Argentina negociaron la firma de un Tratado de Comercio con vistas a suprimir los aranceles aduaneros y consagrar el principio de "Cordillera Libre". El centro de atracción eran las exportaciones de ganado argentino a Chile y de vino chileno a Argentina. Pero en ambos países se produjo una fuerte reacción de los intereses creados con vistas a frustrar las tratativas diplomáticas. Tanto la Sociedad Nacional de Agricultura (Chile como el Centro Vitivinícola Nacional (Argentina realizaron intensas gestiones para alcanzar sus objetivos; esta última corporación llegó a movilizar miles de personas para oponerse al tratado; y hasta solicitó ayuda a los ferrocarriles británicos para que obstaculizaran el ingreso de los vinos chilenos al mercado argentino. La intensa resistencia de estas corporaciones terminaron por frustrar el proyecto, el cual fue definitivamente archivado en 1911.Between 1905 and 1910, Chile and Argentina negotiated the signature of a Trade Agreement in order to abolish the customs duties and consecrate the principle of "Free Mountain Range". The centre of attraction was the exports of Argentinean cattle to Chile and of Chilean wine to Argentina. But in both countries there aroused a strong reaction of the vested interests, purposely to thwart the diplomatic negotiations. Both, the Sociedad Nacional de Agricultura (Chile as well as the Centro Vitivinícola Nacional (Argentina carried out intense negotiations to reach their objectives; the latter even movilized thousands of people to oppose the treaty and went as far as requesting the help of the British railroads to block the entrance of Chilean wines to the Argentinean market. The stiff opposition of these corporations finally frustrated the project, which was definitively filed away in 1911.

Relación de la calidad de vida con diferentes modelos de atención domiciliaria en enfermos oncológicos terminales de un área sanitaria de Madrid

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Agra Varela Yolanda

2003-01-01

Full Text Available Fundamentos: En este trabajo se evalúa la efectividad de los cuidados paliativos a domicilio con el objetivo de determinar si los enfermos con cáncer terminal tratados por Equipos de Soporte de Atención Domiciliaria presentan mejor calidad de vida que los tratados por Equipos de Atención Primaria. Métodos: Estudio prospectivo cuasi experimental realizado en el Área 4 del Imsalud de Madrid con enfermos referidos desde el hospital a Equipos de Soporte de Atención Domiciliaria o a Equipos de Atención Primaria. La variable estudiada fue la calidad de vida medida a través del Rotterdam Symptom Check List y el Hospital Anxiety and Depression Scale. Para el análisis estadístico se utilizó MANOVA, ANOVA de medidas repetidas y el test de Friedman. Resultados: 165 enfermos fueron tratados por Equipos de Soporte de Atención Domiciliaria y 56 por Equipos de Atención Primaria. Los primeros presentaron mejor puntuación en las escalas global (diferencia de medias: 9,5; IC 95%: 2,3-16,67 y dolor (diferencia de medias: 6,4; IC 9%: 1,14-11,43 del Rotterdam Symptom Check List en la primera semana del estudio. El tamaño del efecto fue mayor en el grupo Equipos de Soporte de Atención Domiciliaria. La prescripción de fármacos y el lugar de la muerte fue diferente en ambos grupos. Conclusiones: Al principio del estudio los enfermos tratados por Equipos de Soporte de Atención Domiciliaria presentaron una mejor percepción del estado de salud que los tratados por Equipos de Atención Primaria. No obstante, el importante número de pérdidas a lo largo del mismo hace que haya que mirar estos resultados con precaución.

Amino acid-responsive Crohn's disease: a case study

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Alvin Stein

2010-12-01

Full Text Available Alvin Stein1, Marty Hinz2, Thomas Uncini31Stein Orthopedic Associates, Plantation, FL, USA; 2Clinical Research, NeuroResearch Clinics Inc., Cape Coral, FL, USA; 3Laboratory, Fairview Regional Medical Center-Mesabi, Hibbing, MN, USAPurpose: This paper reviews the clinical course of a case of severe Crohn's disease and discusses the scientific ramifications of a novel treatment approach.Patients and methods: A case study of a 37-year-old male with a 22-year history of Crohn's disease whose clinical course had experienced no sustained remissions. The patient was treated with a protocol that utilized serotonin and dopamine amino acid precursors administered under the guidance of organic cation transporter assay interpretation.Results: Within 5 days of achieving the necessary balance of serotonin and dopamine, the patient experienced remission of symptoms. This remission has been sustained without the use of any Crohn's disease medications.Conclusion: In Crohn's disease, it is known that there is an increase of both synthesis and tissue levels of serotonin in specific locations. It is asserted that this is prima facie evidence of a significant imbalance in the serotonin–dopamine system, leading to serotonin toxicity. The hypothesis formulated is that improperly balanced serotonin and dopamine transport, synthesis, and metabolism is a primary defect contributing to the pathogenesis of Crohn's disease.Keywords: serotonin, dopamine, organic cation transporters, OCT

The Diagnostic Role of Magnetic Resonance Enterography as a Complementary Test to Colonoscopy in Active Crohn?s Disease

OpenAIRE

Aryan, Arvin; Azizi, Zahra; Teimouri, Azam; Ebrahimi Daryani, Nasser; Aletaha, Najme; Jahanbakhsh, Ali; Nouritaromlou, Mohammad Kazem; Alborzi, Forough; Mami, Masoud; Basirat, Vahid; Javid Anbardan, Sanam

2016-01-01

BACKGROUND According to recent studies comparing magnetic resonance enterography (MRE) with ileocolonoscopy for assessing inflammation of small bowel and colonic segments in adults with active Crohn?s disease (CD), we aimed to compare the accuracy of these two diagnostic methods in Iranian population. METHODS During 2013-2014 a follow-up study was done on 30 patients with active CD in a gastroenterology clinic affiliated to Tehran University of Medical Sciences. MRE and ileocolonoscopy were p...

Evaluación de una crema dental con extracto de cuproclorofila

OpenAIRE

Estela Gispert Abreu; Elena Cantillo Estrada; Aracelys Rivero López; Bertha Oramas Rodríguez; Esther Barreto Banderas

2001-01-01

Se evaluó el efecto del cepillado con crema dental que contiene extracto de cuproclorofila en 23 niños de 10 años (otros 23 niños se tomaron como control). Se observaron reducciones significativas según chi cuadrado en cuanto a la infección por Streptococcus mutans, la acumulación de placa dentobacteriana y en la inflamación gingival del grupo tratado con respecto al control.The effect of tooth brushing with a dentrifice containing cuprochlorophyll extract in 23 children aged 10 (other 23 wer...

Tratado de libre comercio entre Colombia y los Estados Unidos desde el análisis económico del derecho

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Aldana Carrillo, Diego David

2015-01-01

El presente trabajo es una aproximación al Tratado de Libre Comercio entre Colombia y los Estados Unidos desde el Análisis Económico del Derecho. Inicialmente se reconstruye la normativa del acuerdo y sus funciones económicas fundamentales, contextualizando el libre comercio con Estados Unidos desde una perspectiva comparada, y analizando su papel tanto en el ámbito de la economía globalizada como en el ordenamiento jurídico nacional. Posteriormente se realiza una aproximación conceptual al A...

Reconstrucción de lesiones osteocondrales con fibra de carbono

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Carranza Bencano, A.; Armas-Padrón, J. R.; Lozano, Mª A.

1998-01-01

Objetivo: Estudiar a largo plazo la evolución histológica de defectos osteocondrales de la rótula de conejos tratados con fibra de carbono. Material y Método: 18 conejos de raza gigante español, variedad parda, de ambos sexos, con un peso aproximado de 1.5 a 2 Kg y 18 discos Cleveland de fibra de carbono de 8 mm de diámetro (Medicarb®, fabricado por Leyland Medical International). Creación de un defecto de 6 mm. de diámetro en la superficie articular de la rótula, hasta alcanzar el teji...

Tratamiento de la mordida cruzada anterior con plano inclinado anterior. Efecto sobre los arcos dentales

OpenAIRE

Carolina Rodríguez Manjarrés; Jesús Alberto Hernández Silva

2017-01-01

Objetivo: Evaluar los cambios dimensionales de los arcos dentales primarios tratados con plano inclinado anterior como método de corrección de la mordida cruzada anterior. Métodos: Se trataron 10 pacientes con edades entre 3 y 5 años afectados con mordida cruzada anterior completa, se colocó un plano inclinado anterior elaborado en acrílico, que estuvo en posición en promedio 8.5 semanas. Se obtuvieron modelos de estudio en 3 momentos T0: antes del tratamiento; T1: 6 meses después de iniciado...

Optimizing biological therapy in Crohn's disease.

Science.gov (United States)

Gecse, Krisztina Barbara; Végh, Zsuzsanna; Lakatos, Péter László

2016-01-01

Anti-TNF therapy has revolutionized the treatment of inflammatory bowel diseases, including both Crohn's disease and ulcerative colitis. However, a significant proportion of patients does not respond to anti-TNF agents or lose response over time. Recently, therapeutic drug monitoring has gained a major role in identifying the mechanism and management of loss of response. The aim of this review article is to summarize the predictors of efficacy and outcomes, the different mechanisms of anti-TNF/biological failure in Crohn's disease and identify strategies to optimize biological treatment.

Crohn's disease and risk of fracture: does thyroid disease play a role?

Institute of Scientific and Technical Information of China (English)

Nakechand Pooran; Pankaj Singh; Simmy Bank

2003-01-01

AIM: To assess the role of thyroid disease as a risk for fractures in Crohn's patients.METHODS: A cross-sectional study was conducted from 1998 to 2000. The study group consisted of 210 patients with Crohn's disease. A group of 206 patients without inflammatory bowel disease served as controls. Primary outcome was thyroid disorder. Secondary outcomes included use of steroids, immunosuppressive medications, surgery and incidence of fracture.RESULTS: The prevalence of hyperthyroidism was similar in both groups. However, the prevalence of hypothyroidism was lower in Crohn's patients (3.8 % vs 8.2 %, P=0.05).Within the Crohn's group, the use of immunosuppressive agents (0 % vs11 %), steroid usage (12.5 % vs37 %), small bowel surgery (12.5 % vs 28 %) and large bowel surgery (12.5 % vs27 %) were lower in the hypothyroid subset as compared to the euthyroid subset. Seven (3.4 %) Crohn'spatients suffered fracture, all of whom were euthyroid.CONCLUSION: Thyroid disorder was not found to be associated with Crohn's disease and was not found to increase the risk for fractures. Therefore, screening for thyroid disease is not a necessary component in the management of Crohn's disease.

Farmacovigilancia de la sertralina en pacientes cubanos con episodio de depresión mayor

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Leslie Pérez Ruiz

2011-03-01

Full Text Available En la depresión predominan síntomas como: desinterés, fatiga, sentimientos de inutilidad, desconcentración, deseos de muerte e insomnio. Entre los medicamentos para tratarla se encuentra la sertralina. Con el objetivo de evaluar su seguridad, se revisaron 40 historias clínicas y cuadernos de recogida de datos de los pacientes incluidos en ensayo clínico fase III, aletatorizado, controlado y a doble ciegas: "Uso de sertralina en pacientes con episodio de depresión mayor", pertenecientes al Hospital "Dr. Gustavo Aldereguía Lima". Se obtuvieron datos demográficos, clínicos y eventos adversos, con los cuales se realizó un estudio descriptivo, observacional y transversal que clasifica como un estudio de utilización de medicamentos sobre consecuencias prácticas. La información fue analizada mediante SPSS, versión 13.0 para Windows. De los 40 pacientes incluidos, 24 presentaron eventos adversos para un 60 %; de ellos, 16 (67 % en el grupo tratado con sertralina y 8 (33 % en los tratados con placebo. Los eventos adversos más frecuentes fueron: disminución de peso, sequedad bucal, cefalea, diarreas y náuseas. En su mayoría resultaron de intensidad ligera, causalidad probable y sin necesidad de tratamiento. El uso del fármaco se consideró seguro en el tratamiento de estos pacientes.

MR enterography of ileocolovesicular fistula in pediatric Crohn disease

Energy Technology Data Exchange (ETDEWEB)

Sakala, Michelle D. [Wayne State University School of Medicine, Detroit, MI (United States); Dillman, Jonathan R.; Ladino-Torres, Maria F. [University of Michigan Health System, Department of Radiology, C.S. Mott Children' s Hospital, Section of Pediatric Radiology, Ann Arbor, MI (United States); McHugh, Jonathan B. [University of Michigan Health System, Department of Pathology, Ann Arbor, MI (United States); Adler, Jeremy [University of Michigan Health System, Department of Pediatrics and Communicable Diseases, C. S. Mott Children' s Hospital, Division of Pediatric Gastroenterology, Ann Arbor, MI (United States)

2011-05-15

Crohn disease, a form of chronic inflammatory bowel disease is characterized by discontinuous inflammatory lesions of the gastrointestinal tract, has a variety of behavioral patterns, including penetrating or fistulous disease. While magnetic resonance enterography (MRE) excellently depicts inflamed bowel segments, it can also be used to assess for a variety of Crohn-disease-related extraintestinal complications, including fistulae. We present the MRE findings of a complex ileocolovesicular fistula in a 14-year-old boy with Crohn disease, where the fistulous tract to the urinary bladder was best delineated on precontrast T1-W imaging because of the presence of fecal material. (orig.)

Tuberculose ileocecal isolada simulando neoplasia maligna e doença de Crohn Isolated ileocecal tuberculosis simulating malignant neoplasia and Crohn's disease

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S.H. BROMBERG

2001-06-01

Full Text Available OBJETIVO: No Brasil, a tuberculose ileocecal isolada, na ausência de tuberculose pulmonar ativa ou cicatrizada, é rara, sendo freqüentemente confundida com neoplasia e a doença de Crohn. MÉTODOS: Os autores apresentam oito doentes com essas características, tratados por cirurgia, em período de 20 anos. A dor abdominal na fossa ilíaca direita foi o principal sintoma (100%, seguido da presença de perda de peso (62,5%, febre, náuseas e vômitos e fadiga em 50% dos doentes. Sete enfermos (87,5% apresentaram massa palpável na fossa ilíaca direita. A duração média dos sintomas foi de 14,7 meses, variando de 5 a 36 meses. Todas as lesões foram detectadas pelo enema opaco e mimetizavam aspecto neoplásico. A colonoscopia foi realizada em três doentes, evidenciando lesões sub-oclusivas da região íleo-cecal em dois; as biópsias foram sugestivas de tuberculose, não sendo possível diferenciá-las da doença de Crohn. RESULTADOS: Seis enfermos com diagnóstico presuntivo de neoplasia foram submetidos a cirurgia eletiva, realizando-se neles a colectomia direita clássica. Os outros dois, com suspeita de tuberculose, foram operados na vigência de obstrução intestinal, sendo submetidos a ressecção limitada (ileocecectomia. O estudo anatomopatológico estabeleceu o diagnóstico final pelo encontro de necrose caseosa e de bacilos álcool ácido-resistentes no intestino ou nos linfonodos. A evolução pós-operatória foi satisfatória, com pequena morbidade resolvida clinicamente. Posteriormente, todos os doentes receberam o esquema tríplice por 12 meses, variando a droga de acordo com a época do tratamento. CONCLUSÃO: Apesar de rara, a tuberculose hipertrófica ileocecal isolada freqüentemente é confundida com neoplasias e com a doença de Crohn, devendo ser lembrada no diagnóstico diferencial das lesões localizadas no quadrante inferior direito do abdome.BACKGROUND: Isolated ileocecal involvement by tuberculosis in the absence

"La pequeña y mediana empresa ante la apertura comercial y el tratado de libre comercio"

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Beltran Cázares, Graciela

2011-01-01

En México la pequeña y mediana empresa constituye, hoy en día, el contro del sistema económico del país, debido a que más del 95% de las empresas son pequeñas y medianas. Estas proporcionan más de la mitad de todos los empleos de la nación, incluyendo actividades que no son comerciales, ofrecen el campo experimental en donde se generan con frecuencia nuevos productos, nuevas ideas, nuevas técnicas y nuevas formas de hacer las cosas. México firmó el Diecisiete de Diciembre de 1992 un Tratado d...

SUSTANCIAS Y REACCIONES QUÍMICAS. TEMAS DEL CURSO DE INGRESO UNIVERSITARIO TRATADOS CON DIFERENTES RECURSOS

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René O. Güemes

2011-01-01

Full Text Available En esta investigación se buscó detectar y comparar dificultades presentadas en la comprensión de los temas “Sustancias” y “Reacciones Químicas” en alumnos ingresantes a la Universidad Nacional del Litoral (Santa Fe, Argentina implementando dos estrategias didácticas diferentes durante el dictado del “Curso de Ingreso de Química”. Se trabajó con dos grupos de alumnos; uno de los grupos utilizó un libro de texto, mientras que el otro trabajó con material multimedia en un aula de informática. Ambos grupos fueron evaluados al inicio y final del curso con la misma evaluación de opciones múltiples. Pudo comprobarse que el grupo que trabajó con el material multimedia alcanzó una mayor comprensión de los conceptos abstractos.

Active Crohn's disease is associated with low vitamin D levels

DEFF Research Database (Denmark)

Jørgensen, Søren Peter; Hvas, Christian Lodberg; Agnholt, Jørgen

2013-01-01

activity is associated with low vitamin D levels. METHODS: In a cross-sectional study of 182 CD patients and 62 healthy controls, we measured serum 25-OH vitamin D. Stratified analysis was used to compare 25-OH vitamin D levels with Crohn's disease activity index, C-reactive protein, smoking status, intake...... of oral vitamin D supplements and seasonal variation in CD patients and healthy controls. RESULTS: Serum 25-OH vitamin D was inversely associated with disease activity: Median 25-OH vitamin D levels of Crohn's disease in remission, mildly, and moderately active diseases evaluated by Crohn's disease...... D levels (51nmol/l) than patients who did not smoke (76nmol/l), plevels. CONCLUSIONS: Active Crohn's disease was associated with low serum 25-OH vitamin D. Patients who smoked had lower 25-OH...

O Tratado de Tordesilhas e sua projeção

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Héctor José Tanzi

1976-12-01

Full Text Available (primeiro parágrafo do artigo Em fins de 1479, Castela e Portugal derimiam momentaneamente os trâmites de uma cruel contenda, num tratado de paz pelo qual Fernando e Isabel logravam uma efetiva elevação ao trono e Afonso V de Portugal abandonava a idéia de casar-se com a filha bastarda de Henrique IV, chamada a Beltraneja; esse foi o Tratado das Tercerías de Moura. Porém, ao  mesmo tempo que punha fim ao pleito dinástico, regulamentava-se a questão africana do Reino de Fez e reconhecia-se a Portugal a posse de Guiné, Açores e Cabo Verde, " ... e todas as ilhas que agora se tem descoberto e qualquer outras ilhas que se acharem e se conquistarem das ilhas da Canária para baixo contra Guiné..." no tratado chamado de Alcaçobas.

Sífilis secundaria en un paciente viviendo con VIH

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Mauricio La Rosa

2007-07-01

Full Text Available Se presenta el caso de un paciente varón de 31 años, con diagnóstico de infección por el virus de inmunodeficiencia humana (VIH sin tratamiento antirretroviral, presentó lesiones ulcerativas en la región genital que luego progresaron por todo el cuerpo, se le diagnosticó sífilis secundaria. Fue tratado con penicilina benzatínica, con lo cual las lesiones desaparecieron. Se discute las pruebas diagnósticas realizadas y la terapéutica empleada. La coinfección por Treponema pallidum y por el VIH está presente en la población general y en especial en poblaciones de riesgo, como los hombres que tienen sexo con hombres y clientes de trabajadoras sexuales, esta situación puede afectar la presentación inicial así como el curso de la enfermedad.

Los tratados de arquitectura en los fondos de la Biblioteca Histórica de la Universidad Complutense: una aproximación al estudio de sus procedencias y antiguos poseedores.

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Lizarraga Echaide, Juan Manuel

2009-07-01

Full Text Available La Biblioteca Histórica de la Universidad Complutense de Madrid atesora una importantísima colección de tratados de arquitectura El objeto de este artículo es reconstruir la historia de esta singular colección de libros antiguos de gran riqueza y valor y recuperar la procedencia estos tratados tanto con respecto a las bibliotecas de las instituciones docentes que forman parte de la historia de la Universidad como a las importantes bibliotecas personales que se han ido incorporando a su patrimonio bibliográfico. El conocimiento de las antiguas procedencias constituye una información valiosa que permite nuevas oportunidades de investigación histórica y bibliográfica

Lower extremity necrotizing fasciitis: A unique initial presentation of Crohn's disease

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Anna Weiss

2015-09-01

Full Text Available Crohn's disease is a disease of the bowel, typically presenting with diarrhea, weight loss, and abdominal pain. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease who presented for the first time with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease as the initial presentation.

High frequency of helicobacter negative gastritis in patients with Crohn's disease.

OpenAIRE

Halme, L; Kärkkäinen, P; Rautelin, H; Kosunen, T U; Sipponen, P

1996-01-01

The frequency of gastric Crohn's disease has been considered low. This study was undertaken to determine the prevalence of chronic gastritis and Helicobacter pylori infection in patients with Crohn's disease. Oesophagogastroduodenoscopy was performed on 62 consecutive patients suffering from ileocolonic Crohn's disease. Biopsy specimens from the antrum and corpus were processed for both histological and bacteriological examinations. H pylori antibodies of IgG and IgA classes were measured in ...

Reconocimiento Mapu-Che de Chile: Tratado ante Constitución, Historia frente a Derecho

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Bartolomé CLAVERO SALVADOR

2011-04-01

Full Text Available Desde el año 1991, el compromiso adquirido por los sucesivos gobiernos chilenos para reconocer a nivel constitucional la presencia indígena en el ordenamiento del Estado ha puesto de manifiesto el desconocimiento académico y jurídico mutuo por parte de Chile con respecto a las evidencias para una reposición de Mapu-Che. El presente trabajo hace un recorrido histórico y jurídico por las formas de relación entre el Estado chileno y el Estado Mapu, que hasta la conquista chilena de Mapu en la década de los ochenta del siglo XIX se manifestaron a través de Tratados y Parlamentos que implicaban un reconocimiento mutuo de ambas entidades en una esfera internacional. Las comisiones de estudios, informes oficiales e invocaciones de verdad para un nuevo trato, primero de las Naciones Unidas, y después de la República de Chile, han observado estas evidencias de la significación constitucional e internacional de los Tratados, pero Chile ha convertido su peculiar forma de reconocimiento constitucional de la presencia indígena en un alarde de unidad e indivisibilidad nacional. Este encubrimiento nace del deseo de mantener una Constitución exclusiva, al que se une la certeza de que otra forma de reconocimiento obligaría a un replanteamiento de las propias raíces de los fundamentos constitucionales de la República de Chile.

Eficacia del tratamiento tópico con Vimang® en pacientes con estomatitis subprótesis

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Laritza Coureaux Rojas

2013-10-01

Full Text Available Se efectuó un ensayo clínico terapéutico controlado de fase III en 120 pacientes con estomatitis subprótesis, atendidos en la Clínica Estomatológica Provincial Docente "Mártires del Moncada" de Santiago de Cuba, desde junio de 2010 hasta mayo de 2011, con vistas a evaluar la eficacia del tratamiento tópico con té de Vimang® en dichos pacientes. Se conformaron 2 grupos de 60 integrantes cada uno (de estudio y de control. Los primeros fueron tratados con enjuagatorios fríos de dicho té 4 veces al día y los segundos con el mismo tratamiento más vitaminas. Se utilizaron el porcentaje para variables cualitativas, así como la media aritmética y la desviación estándar para variables cuantitativas. Todos los integrantes del grupo de estudio se curaron y disminuyó el gasto de material, pero el costo-efectividad fue mayor por ser menor el tiempo de curación. El té de Vimang® resultó eficaz para eliminar las manifestaciones clínicas de esa lesión y no hubo reacciones adversas, de manera que se logró la curación de los afectados con ahorro de tiempo y recursos.

Relationship between socio-demographic and clinical variables, and health-related quality of life in patients with inflammatory bowel disease Relación entre variables sociodemográficas y clínicas y calidad de vida relacionada con la salud en pacientes con enfermedad inflamatoria intestinal

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B. López Blanco

2005-12-01

Full Text Available Objective: the principal aim of the present study is to evaluate the influence of socio-demographic and clinical variables on health-related quality of life (HRQL in patients with inflammatory bowel disease. Patients and method: this was a cross-sectional study. health-related quality of life was measured with the Inflammatory Bowel Disease Questionnaire (IBDQ. A total of 120 patients, 60 with ulcerative colitis and 60 with Crohn's disease, participated in the study. Results: no significant differences were observed between ulcerative colitis and Crohn's disease patients in IBDQ dimensions. However, a multivariate analysis revealed that sex, type of treatment, extraintestinal symptoms, number of relapses in previous year, satisfaction with surgery, and need for psychological support were related to HRQL. Conclusions: the identification of these variables associated with HRQL in patients with inflammatory bowel disease shows them to be basically non-disease factors. Knowledge of such elements can turn out to be very useful in order to guide future research and modify specific factors in further interventions.Objetivo: el objetivo principal del presente trabajo consiste en evaluar la influencia de las variables sociodemográficas y clínicas en la calidad de vida relacionada con la salud de los pacientes con enfermedad inflamatoria intestinal. Pacientes y método: se trata de un estudio transversal. La calidad de vida relacionada con la salud se investigó utilizando el "Inflammatory Bowel Disease Questionnaire" (IBDQ. Un total de 120 pacientes, 60 con colitis ulcerosa y 60 con enfermedad de Crohn participaron en el estudio. Resultados: no se apreciaron diferencias significativas en la calidad de vida relacionada con la salud en las dimensiones del IBDQ en función de la enfermedad, sin embargo, tras el análisis multivariante, el sexo, el tipo de tratamiento, las manifestaciones extradigestivas, el número de recaídas anual, la satisfacción con

Retención y Penetración en Estacones de Eucalyptus Saligna. Sometidos a Tratamiento con CuSO4 y Sal CCC, en Baño Caliente y frio y Vacio-Presión

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Escobar C. Oscar

1987-09-01

Full Text Available Este trabajo describe y da los resultados obtenidos con el pretratamiento de estacones de Eucalyptus saligna a tres soluciones de CUS04 y su posterior tratamiento con sales CCA (OSMOSE K-33. El sulfato de cobre se aplicó por el método de baño caliente y frío, seguido por el proceso de difusión durante una semana; para los anteriores tratamientos se usó madera verde o parcialmente seca al aire; las sales CCA se aplicaron a madera seca por el método de vacío-presión. Una de las razones para llevar a cabo este refuerzo de las sales CCA, es haber encontrado postes de eucalipto severamente atacados por hongos, en especial con pudrición blanda. Los estacones fueron tratados inicialmente con soluciones de sulfato de cobre a 1 %, 2% y 3% de concentración; luego los estacones fueron tratados con una solución de sal CCA al 2.5% de concentración por vacío-presión. Se usaron 40 estacones distribuídos en 4 grupos de 10: tres (3 grupos fueron usados para el tratamiento con las soluciones de CUS04 y solución de CCA; el grupo restante fue tratado con la sal CCA únicamente, el cual fue usado como grupo testigo para fines de comparación en los ensayos de campo (cementerios.

Clinical course of Crohn's disease first diagnosed at surgery for acute abdomen.

Science.gov (United States)

Latella, G; Cocco, A; Angelucci, E; Viscido, A; Bacci, S; Necozione, S; Caprilli, R

2009-04-01

The severity of clinical activity of Crohn's disease is high during the first year after diagnosis and decreases thereafter. Approximately 50% of patients require steroids and immunosuppressants and 75% need surgery during their lifetime. The clinical course of patients with Crohn's disease first diagnosed at surgery has never been investigated. To assess the clinical course of Crohn's disease first diagnosed at surgery for acute abdomen and to evaluate the need for medical and surgical treatment in this subset of patients. Hospital clinical records of 490 consecutive Crohn's disease patients were reviewed. Patients were classified according to the Vienna criteria. Sex, extraintestinal manifestations, family history of inflammatory bowel diseases, appendectomy, smoking habit and medical/surgical treatments performed during the follow-up period were assessed. Kaplan-Meier survival method and Cox proportional hazards regression model. Of the 490 Crohn's disease patients, 115 had diagnosis of Crohn's disease at surgery for acute abdomen (Group A) and 375 by conventional clinical, radiological, endoscopic and histologic criteria (Group B). Patients in Group A showed a low risk of further surgery (Log Rank test pacute abdomen showed a low risk for reintervention and less use of steroids and immunosuppressants during follow-up than those not operated upon at diagnosis. Early surgery may represent a valid approach in the initial management of patients with Crohn's disease, at least in the subset of patients with ileal and complicated disease.

Diseño del proceso de obtención de trozos secos de carambola (averroha carambola l.) tratados osmóticamente

OpenAIRE

Castillo Ortiz, Maria Eugenia; Cornejo Z., Fabiola

2009-01-01

En el presente trabajo se diseñó la línea de proceso para obtener trozos secos de carambola tratados osmóticamente, mostrando la utilidad industrial que posee la carambola para la elaboración de productos que puedan ser exportados al mercado extranjero con excelentes características organolépticas y condiciones de estabilidad en percha óptimas. Los experimentos realizados sirvieron para establecer la cinética de deshidratación osmótica, analizada a 3 concentraciones de sacarosa (40 ºBrix,...

Factores pronósticos y predictivos de respuesta en pacientes con carcinoma de vejiga localmente avanzado tratados con quimioterapia neoadyuvante

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Céliz, Pamela

2012-01-01

La cistectomía radical es el tratamiento de elección en pacientes con carcinoma de vejiga localmente avanzado. Sin embargo, más del 50% de los pacientes presentan recurrencias y fallecen por la enfermedad. La quimioterapia neoadyuvante ha demostrado un beneficio modesto en estos pacientes, más significativo en pacientes con respuesta patológica completa tras el tratamiento. Sin embargo, aun no se ha identificado en que pacientes se obtiene un mayor beneficio. El análisis de genes que particip...

Radiological aspects of Crohn's disease in small intestine: iconographic assay; Aspectos radiologicos da doenca de Crohn no intestino delgado: ensaio iconografico

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Barros, Nestor de; Juliano, Adriana G.; Polizini, Jose M.R.; Rejtman, Debora; Cerri, Giovanni Guido; Rocha, Manoel de Souza [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia

1999-12-01

The authors present the radiological features of Crohn's disease in small intestine as ways of differential diagnosis of others diseases of duodenum and adjacent organs. In this differentiation or confirmation of Crohn's disease the US and TC have proven to be clinically efficacious in the identification of lesions.

Os Tratados de Polícia, fundadores da moderna saúde pública (1707-1856 Los Tratados de Policía, fundadores de la salud pública moderna (1707-1856 Treatises on Medical Police, founders of modern public health (1707-1856

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Carlos Lousada Subtil

2012-07-01

Full Text Available A participação dos enfermeiros no movimento higienista é relativamente recente em relação aos momentos fundadores da moderna saúde pública, a que nos vamos referir. Para o enfermeiro de saúde pública contemporâneo é fundamental, no âmbito das suas atribuições e competências, analisar esses momentos à luz dum quadro conceptual que lhe permita esclarecer-se e estruturar a sua identidade profissional na construção do presente e no delinear do futuro. É objetivo deste trabalho fazer uma breve apresentação de alguns estudos sobre o tema e, sobretudo, analisar e discutir o «Tratado de Conservação da Saúde dos Povos», de Ribeiro Sanches (1756 e o «Tratado de Polícia Médica», de Freitas Soares (1818 que refletem os princípios da ciência de Polícia contidos na obra de Nicolas Delamare (1707, com recurso à metodologia de investigação histórica foucauniana. Aquelas obras ilustram bem a lenta passagem do modelo de governação corporativo para o estadualista, que se iniciou nos finais do Antigo Regime, e prosseguiu, com avanços e recuos, ao longo da monarquia constitucional inaugurada pela revolução de 1820.La participación de los enfermeros en el movimiento higienista es relativamente reciente con respecto a los momentos fundadores de la salud pública moderna a la cual vamos a referirnos. Para el enfermero actual de salud pública es fundamental, dentro del ámbito de sus atribuciones y competencias, analizar dichos movimientos a la luz de un marco conceptual que le permita aclarar y estructurar su identidad profesional en su construcción del presente y en el delinear de su futuro. El objetivo de este trabajo es realizar una breve presentación de algunos de los estudios sobre el tema y, sobre todo, analizar y discutir el «Tratado de Conservação da Saúde dos Povos», de Ribeiro Sanches (1756 y el «Tratado de Polícia Médica», de Freitas Soares (1818, que recogen los principios de la ciencia de Pol

ARTRODESIS TIBIOTALOCALCANEA CON PLACA PHILOS: EXPERIENCIA EN EL HOSPITAL MILITAR CENTRAL. ENERO 2007 A DICIEMBRE DE 2009

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MUÑOZ FALLA, GERARDO ALEXI; DELGADO NEIRA, ALEJANDRO; ENRIQUE GAMBA, CESAR; HERNÁNDEZ PERDOMO, EDGAR

2011-01-01

Estudio descriptivo observacional, retrospectivo tipo serie de casos, realizado entre enero de 2007 y diciembre de 2009 en el Hospital Militar Central. Fueron tratados 21 pacientes con artrosis de la articulación tibio talar y subtalar de etiología diversa, con seguimiento mínimo de 6 meses. Se evaluó; la función pre operatoria y post operatoria por medio de la escala AOFAS, el dolor mediante la escala visual análoga, el tiempo de consolidación con controles radiográficos, el tipo de injerto ...

Current status of endoscopic balloon dilation for Crohn's disease

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Fumihito Hirai

2017-04-01

Full Text Available The therapeutic target in Crohn's disease (CD has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery. EBD with a conventional colonoscope for Crohn's strictures of the colon and ileo-colonic anastomosis has established efficacy and safety. In addition, EBD using balloon-assisted enteroscopy has recently been applied for small bowel Crohn's strictures. Although the evidence is not strong, EBD may become an alternative to surgery in small bowel strictures in CD. EBD and other new methods such as self-expanding stent implantation for Crohn's strictures may be useful and safe; however, it is important to address several issues regarding these interventions and to establish a protocol for combined therapies.

Top-down approach to biological therapy of Crohn's disease.

Science.gov (United States)

Hirschmann, Simon; Neurath, Markus F

2017-03-01

Crohn's disease (CD) is a chronic, immune-mediated condition with a potentially disabling and destructive course. Despite growing data on when to use a therapeutic 'top-down' strategy, clinical management of this complex disorder is still challenging. Currently, the discussion of 'top-down' strategy in CD mostly includes biological therapy alone or in combination. Areas covered: This article is based on a review of existing literature regarding the use of biological therapy in a 'top-down' approach for the treatment of Crohn's disease. The authors reviewed all the major databases including MEDLINE as well as DDW and ECCO abstracts, respectively. Expert opinion: A 'top-down' therapeutic approach in Crohn's disease is strongly supported by existing data in patients with several risk factors for a severe course of disease. Moreover, there is an increasing amount of published data recommending a more individualised therapeutic strategy to identify candidates for 'top-down' treatment, based on enhanced diagnostics using biomarkers. Emerging therapeutic approaches besides existing therapy concepts using biologicals may possibly redefine the 'top-down' therapeutic strategy for Crohn's disease in the future.

Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease

NARCIS (Netherlands)

Ziech, M. L. W.; Lavini, C.; Caan, M. W. A.; Nio, C. Y.; Stokkers, P. C. F.; Bipat, S.; Ponsioen, C. Y.; Nederveen, A. J.; Stoker, J.

2012-01-01

Objectives: To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease. Methods: Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of

Rifaximin and Crohn's disease.

Science.gov (United States)

Prantera, Cosimo; Scribano, Maria Lia

2013-11-14

In a recent article, Longman and Swaminath analyzed our paper on the use of rifaximin in patients with moderately active Crohn's disease (CD). Here we report some considerations concerning their article. The exploratory post-hoc subgroup analysis showed that early-stage disease and, differently from that written by Longman and Swaminath, also colonic involvement seemed to be associated with a significant higher efficacy of rifaximin-EIR 800 mg twice daily. Early-stage disease is generally considered as the more easily treatable phase of CD, and the better response to rifaximin in Crohn's colitis is in accordance with the high concentration of bacteria in the colon. In addition, patients with C reactive protein level > 5 mg/L achieved remission more significantly than patients with normal values, thus suggesting that the symptoms were probably caused by inflammation instead of by non-inflammatory causes. We also analyze the role of rifaximin against gut bacteria and the clinical situations that could obtain the best results from antibiotics.

What Is Crohn's Disease?

Science.gov (United States)

... card! You can find the assessment here . Click video below to learn more about Crohn's Disease Get Involved Read the Latest News Attend Upcoming Events Find a Support Group I’ll Be Determined Explore treatment options, learn how to make better choices, and join the community at I'll ...

Nutrition in paediatric Crohn's disease

African Journals Online (AJOL)

Keywords: Crohn's disease; linear growth; Tumour Necrosis Factor-α; nutritional support; enteral ... hormone (GH) stimulation, is the key mediator of GH effects at the ... deficit documented in children with CD seems to be directly linked to.

Tolerancia al ejercicio en pacientes con enfermedad pulmonar obstructiva crónica después de un programa de rehabilitación respiratoria

OpenAIRE

Meneses Terry, Mercedes R.

1999-01-01

Se expusieron los resultados de la aplicación de un programa de rehabilitación respiratoria consistente en la aplicación de ejercicios respiratorios a un grupo de pacientes con asma bronquial, bronquitis crónica y enfisema pulmonar con una duración de 36 sesiones de tratamiento, luego de las cuales se compararon los resultados con los del grupo control que sólo llevó tratamiento con medicamentos. Se observó en los tratados con el programa, un incremento en la tolerancia a los ejercicios. T...

Radiological aspects of Crohn's disease in small intestine: iconographic assay

International Nuclear Information System (INIS)

Barros, Nestor de; Juliano, Adriana G.; Polizini, Jose M.R.; Rejtman, Debora; Cerri, Giovanni Guido; Rocha, Manoel de Souza

1999-01-01

The authors present the radiological features of Crohn's disease in small intestine as ways of differential diagnosis of others diseases of duodenum and adjacent organs. In this differentiation or confirmation of Crohn's disease the US and TC have proven to be clinically efficacious in the identification of lesions

Estabilidad de emulsiones preparadas con proteínas de sueros de soja

Directory of Open Access Journals (Sweden)

Jorge Wagner

2011-12-01

Full Text Available Por precipitación con acetona en frio, se obtuvieron muestras de proteínas aisladas de dos sueros de soja, el suero SS proveniente de la obtención de aislados de soja y el suero de tofu ST. A partir del SS y del mismo suero previamente liofilizado y calentado (SSLC se obtuvieron las proteínas denominadas PSS y PSSLC, respectivamente; a partir de ST se preparó la muestra PST. El objetivo del trabajo fue analizar la estabilidad de emulsiones o/w preparadas con las proteínas de sueros de soja en forma comparativa con un aislado de soja nativo (ASN. Las emulsiones se prepararon por homogeneización de dispersiones proteicas (0,1–1,0 % p/v en buffer fosfato 10 mM pH 7 y aceite de girasol (Φmásico=0,33, empleando un Ultraturrax T-25. La estabilidad fue evaluada por medida del aceite separado, distribución de tamaño de partículas (por difracción láser y los grados de cremado y coalescencia evaluados a través de perfiles de BackScattering. Se observó que en todas las concentraciones ensayadas las emulsiones preparadas con proteínas aisladas (por precipitación con acetona en frío de suero de tofu tratado térmicamente (PST tenían una estabilidad comparable a la de emulsiones preparadas con ASN. Se halló una estabilidad menor en emulsiones con proteínas nativas de suero de soja (PSS obtenido en laboratorio no tratado térmicamente. Las proteínas obtenidas de este suero liofilizado y calentado (PSSLC exhibieron una mejor capacidad emulsionante. Los resultados mostraron que las proteínas de sueros de soja presentan buenas propiedades emulsionantes y estabilizantes dependientes del grado de desnaturalización y glicosilación alcanzado.

Laparoskopiassisteret ileocøkal resektion ved Crohns sygdom

DEFF Research Database (Denmark)

Laursen, Stig Borbjerg; Knudsen, Torben; Poornoroozy, Peiman

2010-01-01

Laparoscopic surgery has become more widely used in the treatment of patients with inflammatory bowel disease. The aim of this study is retrospectively to describe the results of laparoscopy-assisted ileocolic resection of nineteen patients with Crohn's disease.......Laparoscopic surgery has become more widely used in the treatment of patients with inflammatory bowel disease. The aim of this study is retrospectively to describe the results of laparoscopy-assisted ileocolic resection of nineteen patients with Crohn's disease....

The Text of the Agreement between Iran and the Agency for the Application of Safeguards in connection with the Treaty on the Non-Proliferation of Nuclear Weapons; Texto Del Acuerdo Concertado Entre El Iran Y El Organismo Para La Aplicacion De Salvaguardias En Relacion Con El Tratado Sobre La No Proliferacion De Las Armas Nucleares

Energy Technology Data Exchange (ETDEWEB)

NONE

1974-12-17

The text of the agreement between Iran and the Agency for the application of safeguards in connection with the Treaty on the Non-Proliferation of Nuclear Weapons is reproduced in this document for the information of all Members [Spanish] Para informacion de todos los Estados Miembros, en el presente documento se trans cribe el texto del Acuerdo concertado entre el Iran y el Organismo para la aplicacion de salvaguardias en relacion con el Tratado sobre la no proliferacion de las armas nucle ares.

Facial biometrics of peri-oral changes in Crohn's disease.

Science.gov (United States)

Zou, L; Adegun, O K; Willis, A; Fortune, Farida

2014-05-01

Crohn's disease is a chronic relapsing and remitting inflammatory condition which affects any part of the gastrointestinal tract. In the oro-facial region, patients can present peri-oral swellings which results in severe facial disfigurement. To date, assessing the degree of facial changes and evaluation of treatment outcomes relies on clinical observation and semi-quantitative methods. In this paper, we describe the development of a robust and reproducible measurement strategy using 3-D facial biometrics to objectively quantify the extent and progression of oro-facial Crohn's disease. Using facial laser scanning, 32 serial images from 13 Crohn's patients attending the Oral Medicine clinic were acquired during relapse, remission, and post-treatment phases. Utilising theories of coordinate metrology, the facial images were subjected to registration, regions of interest identification, and reproducible repositioning prior to obtaining volume measurements. To quantify the changes in tissue volume, scan images from consecutive appointments were compared to the baseline (first scan image). Reproducibility test was performed to ascertain the degree of uncertainty in volume measurements. 3-D facial biometric imaging is a reliable method to identify and quantify peri-oral swelling in Crohn's patients. Comparison of facial scan images at different phases of the disease revealed precisely profile and volume changes. The volume measurements were highly reproducible as adjudged from the 1% standard deviation. 3-D facial biometrics measurements in Crohn's patients with oro-facial involvement offers a quick, robust, economical and objective approach for guided therapeutic intervention and routine assessment of treatment efficacy on the clinic.

Determinação das substâncias reativas ao ácido tiobarbitúrico como indicador da peroxidação lipídica em ratos tratados com sevoflurano Determinación de las substancias reativas al ácido tiobarbitúrico como indicador de la peroxidación lipídica en ratones tratados con sevoflurano Thiobarbituric acid reactive substances as an index of lipid peroxidation in sevoflurane-treated rats

Directory of Open Access Journals (Sweden)

Francisco José Lucena Bezerra

2004-10-01

biotransformación dos éteres sobre la acción del citocromo P450, uno de los posibles mecanismos de toxicidad hepática y renal promovida por eses compuestos. El objetivo de este estudio fue determinar los niveles de substancias reactivas al ácido tiobarbitúrico (SRAT, como indicador de la peroxidación lipídica, en ratones que recibieron sevoflurano, previamente tratados o no con isoniazida, inductora enzimática del citocromo P450 2E1. MÉTODO: Los animales fueron distribuidos aleatoriamente en 4 grupos que recibieron respectivamente: G1 - oxígeno a 100% 1 l.min-1/60 minutos por 5 días consecutivos; G2 - sevoflurano a 4% en oxígeno a 100%, 1 l.min-1/60 minutos por 5 días consecutivos; G3 - isoniazida (50 mg.kg-1.dia por vía intraperitoneal durante 4 días consecutivos, en seguida fue tratado como el G1, en G4 - isoniazida 50 mg.kg-1.dia por vía intraperitoneal durante 4 días consecutivos, siendo tratado, posteriormente, como el G2. Después de 12 horas del último tratamiento, se sacrificaran los animales y fue colectado el plasma para la análisis de las SRAT, siendo removido el lóbulo izquierdo del hígado y de los riñones para examen histológico. RESULTADOS: Los resultados mostraron aumento en las tasas de SRAT en el G3 y G4, con elevación discreta en G2. El estudio histológico reveló necrosis focal en el hígado de ratones pre-tratados con isoniazida (G3. CONCLUSIONES: El sevoflurano promovió peroxidación lipídica apenas cuando asociado a la isoniazida.BACKGROUND AND OBJECTIVES: Sevoflurane is a fluorinated ether with low blood solubility and biotransformed by an oxidative enzymatic liver system involving cytochrome P450 2E1. Lipid peroxidation occurs during ethers biotransformation process under action of cytochrome P450, a possible mechanism for liver and kidney toxicity promoted by such compounds. This study aimed at determining the levels of substances reactive to thiobarbituric acid (TBARS, as an index for lipid peroxidation in sevoflurane

Técnica dramática y retórica de las pasiones en el Tratado completo del arte del canto de Manuel García

Directory of Open Access Journals (Sweden)

Díaz Marroquín, Lucía

2007-12-01

Full Text Available The history of European singing technique, from the Italian origins of the stile rappresentativo and the early Seicento musical drama to the heights of bel canto, seems inextricably related to the classical rhetorical and philosophical theories, later re-interpreted by the humanist and rationalist authors. Manuel García’s Tratado completo del arte del canto inherits this tradition and contributes to it with every single observation or musical example included in this eminently practical work.

Desde los orígenes italianos del stile rappresentativo y del drama musical, en los últimos años del siglo XVI y primeros del XVII, hasta el esplendor del bel canto, la historia de los tratados de canto europeos se encuentra inseparablemente asociada a las teorías retóricas y filosóficas clásicas, más tarde reinterpretadas por los autores humanistas y preenciclopedistas. Al escribir su Tratado completo del arte del canto, una obra eminentemente práctica, Manuel García hereda esta tradición y contribuye a ella con cada una de las observaciones y ejemplos musicales que propone.

Differentiation between active and chronic Crohn's disease using MRI small-bowel motility examinations — Initial experience

International Nuclear Information System (INIS)

Bickelhaupt, S.; Froehlich, J.M.; Cattin, R.; Patuto, N.; Tutuian, R.; Wentz, K.U.; Culmann, J.L.; Raible, S.; Bouquet, H.; Bill, U.; Patak, M.A.

2013-01-01

Aim: To evaluate the influence of locally active Crohn's disease on systemic small-bowel motility in patients with chronic Crohn's disease compared to healthy individuals. Material and methods: Fifteen healthy individuals (11 men, four women; mean age 37 years) and 20 patients with histopathologically proven active (n = 15; 10 women, 5 men; mean age 45 years) or chronic (n = 5; four women, one man; mean age 48 years) Crohn's disease were included in this institutional review board-approved, retrospective study. Magnetic resonance imaging (MRI; 1.5 T) was performed after standardized preparation. Two-dimensional (2D) cine sequences for motility acquisition were performed in apnoea (27 s). Motility assessment was performed using dedicated software in three randomly chosen areas of the small-bowel outside known Crohn's disease-affected hotspots. The main quantitative characteristics (frequency, amplitude, occlusion rate) were compared using Student's t-test and one-way analysis of variance (ANOVA). Results: Three randomly chosen segments were analysed in each participant. Patients with active Crohn's disease had significantly (p < 0.05) reduced contraction frequencies (active Crohn's disease: 2.86/min; chronic: 4.14/min; healthy: 4.53/min) and luminal occlusion rates (active: 0.43; chronic: 0.70; healthy: 0.73) compared to healthy individuals and patients with chronic Crohn's disease. Contraction amplitudes were significantly reduced during active Crohn's disease (6.71 mm) compared to healthy participants (10.14 mm), but this only reached borderline significance in comparison to chronic Crohn's disease (8.87 mm). Mean bowel lumen diameter was significantly (p = 0.04) higher in patients with active Crohn's disease (16.91 mm) compared to healthy participants (14.79 mm) but not in comparison to patients with chronic Crohn's disease (13.68). Conclusion: The findings of the present study suggest that local inflammatory activity of small-bowel segments in patients with

Asociación de colelitiasis y terapia de reemplazo de testosterona en un paciente con hipogonadismo primario

OpenAIRE

S. Squarza; U.G. Rossi; P. Torcia; M. Cariati

2018-01-01

Resumen: Tratamos a un niño de 16 años de edad con hipogonadismo primario debido a la anorquia bilateral, que presentó cálculos biliares en la vesícula biliar con una leve dilatación del árbol biliar intrahepático. La histología de los cálculos biliares confirmó la naturaleza de colesterol de los mismos. El niño fue tratado desde la infancia con terapia de reemplazo de testosterona. Sugerimos una posible correlación entre la terapia de reemplazo de testosterona y la presencia de cálculos bili...

Comparison of MR enterography and histopathology in the evaluation of pediatric Crohn disease

Energy Technology Data Exchange (ETDEWEB)

Dillman, Jonathan R.; Ladino-Torres, Maria F.; Strouse, Peter J. [University of Michigan Health System, Department of Radiology, C.S. Mott Children' s Hospital, Section of Pediatric Radiology, Ann Arbor, MI (United States); Adler, Jeremy; DeMatos-Malliard, Vera [University of Michigan Health System, Department of Pediatrics and Communicable Diseases, C. S. Mott Children' s Hospital, Division of Pediatric Gastroenterology, Ann Arbor, MI (United States); McHugh, Jonathan B. [University of Michigan Health System, Department of Pathology, Ann Arbor, MI (United States); Khalatbari, S. [University of Michigan Institute for Clinical Health Research (MICHR), Ann Arbor, MI (United States)

2011-12-15

While MR enterography (MRE) is commonly used to identify segments of bowel affected by Crohn disease in children, there is little data to support this practice. To assess the ability of MRE to identify segments of small bowel and colon affected by pediatric Crohn disease using histopathology as the reference standard. Pediatric MRE examinations performed between April 2009 and December 2010 were identified. Subjects were excluded if they did not have Crohn disease, if they had Crohn disease but no correlative histopathology within 2 months of imaging, or if they had undergone prior bowel resection. Pertinent MRE and histopathology reports were reviewed, and normal and abnormal bowel segments were documented. Thirty-two pediatric MRE examinations were identified with correlative histopathology. MRE had an overall sensitivity of 94% for detecting the presence of Crohn disease, in general. At the bowel segmental level, MRE had a sensitivity of 66%, specificity of 90%, positive predictive value of 85% and negative predictive value of 76%. The terminal ileum was abnormal by MRE in 11 of 15 (73%) subjects lacking a diagnostic biopsy of this bowel segment. MRE successfully identifies small bowel and colon segments affected by pediatric Crohn disease. (orig.)

Tumor necrosis factor alpha antibody (infliximab) therapy profoundly down-regulates the inflammation in Crohn's ileocolitis

NARCIS (Netherlands)

Baert, F. J.; D'Haens, G. R.; Peeters, M.; Hiele, M. I.; Schaible, T. F.; Shealy, D.; Geboes, K.; Rutgeerts, P. J.

1999-01-01

Anti-tumor necrosis factor alpha monoclonal antibody treatment (infliximab) reduces clinical signs and symptoms in patients with Crohn's disease. The effects of infliximab on mucosal histopathologic abnormalities in Crohn's ileocolitis were studied. Thirteen patients with steroid-refractory Crohn's

Increasing incidence of Crohn's disease in Victorian children.

Science.gov (United States)

Phavichitr, Nopaorn; Cameron, Donald J S; Catto-Smith, Anthony G

2003-03-01

The incidence of Crohn's disease has been increasing in Western communities, but there are no published studies which have examined this change in children in Australia. The centralization of pediatric gastroenterology services in Victoria provides an opportunity to examine these changes within one state. We undertook a retrospective study over a 31-year period of all children aged 16 years or less initially diagnosed with Crohn's disease at either the Royal Children's Hospital, or Monash Medical Center, Melbourne, Victoria. We identified 351 patients who met the diagnostic criteria between 1971 and 2001. The incidence of Crohn's disease in children aged 16 years or less rose from 0.128 to 2.0 per 100,000 per year over the three decades (r = 0.964, P Victorian children. The pattern of disease has also changed with colonic disease now more frequent, and inflammatory indices less abnormal. The increased use of endoscopy has established the frequent involvement of the upper gastrointestinal tract.

Cryptogenic Organizing Pneumonia With Lung Nodules Secondary to Pulmonary Manifestation of Crohn Disease

Directory of Open Access Journals (Sweden)

Taufiq Zaman

2017-05-01

Full Text Available Crohn disease is an immune-mediated inflammatory condition with gastrointestinal and extraintestinal manifestations in patients. Pulmonary involvement of Crohn disease is one manifestation. There have been case reports which have shown Crohn disease and lung nodules which were noted to be histopathological as cryptogenic organizing pneumonia (COP. In our case, a 22-year-old woman with Crohn disease was seen with complaints of chest pain and cough. Computed tomographic scan of chest showed multiple bilateral lung nodules, for which biopsy was done, which showed COP. The case study is followed by a deeper discussion of COP and the extraintestinal manifestation seen in inflammatory bowel disease.

Síndrome de lisis tumoral en un paciente con cáncer de riñón tratado con sunitinib

Directory of Open Access Journals (Sweden)

Ezequiel Rodríguez-Reimúndes

2011-04-01

Full Text Available El síndrome de lisis tumoral (SLT es un trastorno metabólico que ocurre como consecuencia de una destrucción celular masiva. Se caracteriza por la presencia de hiperuricemia, hiperfosfatemia, hipocalcemia e hiperkalemia, y predispone al desarrollo de insuficiencia renal aguda. En la mayoría de los casos el SLT ocurre luego de instaurarse un tratamiento antitumoral y es más frecuente en tumores de alto grado de malignidad y alta sensibilidad a la quimioterapia. Presentamos el caso de un paciente con diagnóstico de cáncer de riñón recidivado que presenta un SLT e insuficiencia renal aguda luego de iniciar tratamiento con sunitinib.

Perforated Meckel's diverticulitis complicating active Crohn's ileitis: a case report.

Science.gov (United States)

Schwenter, Frank; Gervaz, Pascal; de Saussure, Philippe; McKee, Thomas; Morel, Philippe

2009-01-13

In Crohn's disease, the extension of active terminal ileitis into a Meckel's diverticulum is possible, but usually has no impact on clinical decision-making. We describe an original surgical approach in a young woman presenting with a combination of perforated Meckel's diverticulitis and active Crohn's ileitis. We report the case of a 22-year-old woman with Crohn's disease, who was admitted for abdominal pain, fever and diarrhoea. CT scan demonstrated active inflammation of the terminal ileum, as well as a fluid collection in the right iliac fossa, suggesting intestinal perforation. Laparoscopy was performed and revealed, in addition to extensive ileitis, a 3 x 3 cm abscess in connection with perforated Meckel's diverticulitis. It was therefore possible to avoid ileocaecal resection by only performing Meckel's diverticulectomy; pathological examination of the surgical specimen revealed the presence of transmural inflammation with granulomas and perforation of the diverticulum at its extremity. Crohn's disease of the ileum may be responsible for Meckel's diverticulitis and cause perforation which, in this case, proved to be a blessing in disguise and spared the patient an extensive small bowel resection.

Obliteración de fracturas de seno frontal con colgajos pediculados

Directory of Open Access Journals (Sweden)

J. Pefaure

2014-03-01

Full Text Available El compromiso del seno frontal con fractura de sus paredes es un tipo de lesión infrecuente, en torno al 5-12% de todas las fracturas faciales. Suele asociarse a lesiones intracraneales, oftalmológicas y a otras fracturas máxilofaciales y cuando conlleva fractura de la pared posterior de seno frontal requiere tratamiento inmediato, siendo necesaria la obliteración del seno frontal debido a la comunicación con meninges y lóbulo frontal, con el riesgo infeccioso que ello representa. Tratamos 18 pacientes con traumatismos craneofaciales y fracturas del seno frontal con compromiso de su pared posterior en el periodo comprendido entre 2007 y 2011; 8 mujeres y 10 varones con edades comprendidas entre los 15 y los 64 años. Todos los casos fueron tratados con reducción y osteosíntesis por vía abierta con distintos abordajes y realizamos en todos colgajos pediculados de vecindad. La vitalidad de los colgajos fue del 100% . Certificamos el posicionamiento correcto mediante tomografía axial computarizada. El tratamiento de las fracturas del seno frontal con compromiso de su pared posterior o del conducto nasofrontal requiere obliteración con tejido vascularizado para evitar comunicaciones con la cavidad nasal.

MR enterography findings in abdominopelvic extraintestinal complications of Crohn's disease.

Science.gov (United States)

Mazziotti, Silvio; Blandino, Alfredo; Scribano, Emanuele; Gaeta, Michele; Mileto, Achille; Fries, Walter; Bombaci, Francesco; Ascenti, Giorgio

2013-05-01

MR of the small bowel is a useful technique for the evaluation of both intraluminal and extraluminal pathologic involvement of the small bowel in patients with Crohn's disease. Crohn's disease is associated with a range of extraintestinal complications that sometimes may be the initial presenting symptoms. Some of these extraintestinal complications may not correlate with disease activity, but in general, they tend to follow the clinical course of disease and may have a high impact on life quality, morbidity, and even mortality in these patients. Our purpose is to describe some abdominopelvic extraintestinal complications of Crohn's disease, such as hepatopancreatobiliary, genitourinary, musculoskeletal, peritoneal, and lymph-nodal, detectable at MR enterography. Copyright © 2012 Wiley Periodicals, Inc.

Estudio comparativo de las maloclusiones de clase III tratadas con y sin cirugía

OpenAIRE

Martínez Asúnsolo, Pascual

2014-01-01

El objetivo de la presente tesis fue determinar si existen diferencias en la inclinación de los incisivos superiores e inferiores en pacientes de clase III tratados con cirugía o únicamente con “camuflaje ortodóncico”, así como su repercusión en la relación esquelética final. Para ello se realizó un estudio clínico comparativo y retrospectivo en la unidad docente de Ortodoncia del departamento de Estomatología de la Universidad de Valencia. La muestra consistió en 56 pacientes que cump...

Diagnostic accuracy of computed tomography using lower doses of radiation for patients with Crohn's disease.

LENUS (Irish Health Repository)

Craig, Orla

2012-08-01

Magnetic resonance and ultrasonography have increasing roles in the initial diagnosis of Crohn\\'s disease, but computed tomography (CT) with positive oral contrast agents is most frequently used to identify those with acute extramural complications. However, CT involves exposure of patients to radiation. We prospectively compared the diagnostic accuracy of low-dose CT (at a dose comparable to that used to obtain an abdominal radiograph) with conventional-dose CT in patients with active Crohn\\'s disease.

Pretextos y contextos olvidados : arte, ciencia y técnica en algunos tratados contables de la Inglaterra Tudor

Directory of Open Access Journals (Sweden)

Juan Lanero Fernández

2009-06-01

Full Text Available El presente estudio pretende ver, desde una perspectiva amplia, los dos tratados de James Peele (1553, 1569. The pathe waye (1569, en su conjunto, se aparta de forma considerable de los tratados publicados con anterioridad; y por lo que se refiere a su primer libro (1553, dispone de suficientes rasgos diferenciadores para que en el todo y en las partes sea una pieza bien distinta de tratados anteriores. Algunos detalles de The maner and fourme provienen directamente de Pacioli o a través del primer tratado inglés de partida doble, obra de Hugh Oldcastle (1543, o de Ympyn. La influencia de éste, por su tratado holandés/francés (1543 y la traducción inglesa (1547, se aprecia en The pathe waye en el cierre del Libro Mayor y en la forma que ambos tienen de tratar las operaciones de trueque. Es un hecho que Manzoni (1540 está presente en The moner and fourme en lo tocante a la numeración de las partidas en el Diario y a su referencia en el texto. Por lo que se refiere a la organización de los libros de cuentas, también existen resonancias de Weddington. La excelencia es la cualidad que destaca en los dos tratado, en particular en The pathe waye. Peele supo recoger en sus libros las tendencias más innovadoras de la partida doble provenientes de los autores que le precedieron. Está demostrado que Mellis manejó, aunque no siempre de forma apropiada, los tratados de Peele para su reedición de Oldcastle (1588. Y se puede decir lo mismo de John Carpenter (1632. Pele comprendió los verdaderos principios de la partida doble; pero sus excelentes tratados se quedaron injustamente olvidados en la penumbra de los pretextos, la competencia de los contextos y casi ningún paratexto que los valorara en su justiprecio que fue, y sigue siendo, elevado.The present paper tries to have a look, from a broad perspective, at James Peele's two treatises (1553, 1569. The pathe waye (1569, as a whole, drifts away considerably from the treatises previously

Entrecruzamiento en medio acuoso del biomaterial pericárdico bovino con un prepolímero de poliuretano Entrecruzamiento en medio acuoso del biomaterial pericárdico bovino con un prepolímero de poliuretano

Directory of Open Access Journals (Sweden)

Birzabith Mendoza-Novelo

2012-02-01

Full Text Available Animal tissues used in the manufacture of medical devices require chemical treatments to improve durability. A number of techniques have been proposed to preserve such collagenous biological tissues. This study reports a new strategy for the crosslinking of bovine pericardium with a blocked polyurethane prepolymer (PUP in aqueous medium. The decrease in amino group content (70 % and corresponding increase in shrinkage temperature (13 °C when native tissue was treated with PUP, indicate the participation of tissue-amines in the stabilization process. The resistance toward degradation by collagenase in PUP-treated tissue indicate a in vitro stability similar to the glutaraldehyde-crosslinked tissue. It can conclude that the isocyanate-blocked PUP is effective agent for the aqueous fixation of biological tissues of biomedical interest.Los tejidos animales destinados a la fabricación de dispositivos médicos requieren de tratamientos químicos para mejorar su durabilidad. Varias técnicas se han propuesto para preservar tales tejidos biológicos ricos en colágeno. En este estudio se reporta una nueva estrategia para entrecruzar pericardio bovino (PB con un prepolímero de poliuretano (PUP soluble en agua con grupos isocianato protegidos. La disminución del contenido de grupos amino libres (70 % y el correspondiente incremento de la temperatura de encogimiento (13 °C para PB tratado con PUP, indican la participación de los grupos amino del tejido en el proceso de estabilización. La resistencia a la digestión con colagenasa de PB tratado con PUP indican una estabilidad in vitro similar al tejido entrecruzado con glutaraldehído. Se puede concluir que el PUP bloqueado es un agente efectivo para la fijación en medio acuoso de tejidos biológicos de interés biomédico.

Hepatocellular carcinoma: computed tomography assessment after invasive treatment;Hepatocarcinoma: Evaluacion con tomografia computada luego del tratamiento intervencionista

Energy Technology Data Exchange (ETDEWEB)

Kozima, Shigeru; Larranaga, Nebil; Wulfson, Gabriela [Servicio de Diagnostico por Imagenes Hospital General de Agudos ' Cosme Argerich' , CABA, Buenos Aires (Argentina); Departamento de Imagenes, CEMIC, Buenos Aires (Argentina); Eisele, Guillermo [Departamento de Imagenes, CEMIC, Buenos Aires (Argentina); Ridruejo, Ezequiel; Mando, Oscar [Seccion de Hepatologia. Departamento de Medicina, CEMIC, Buenos Aires (Argentina); Perazzo, Florencia [Seccion Oncologia. Departamento de Medicina, CEMIC, Buenos Aires (Argentina)

2008-07-01

diagnostico de hepatocarcinoma; todas fueron tratadas en forma minimamente invasiva. Para el tratamiento se dividio a los pacientes en dos grupos siguiendo el criterio de Milan. El primer grupo, constituido por 75 pacientes con 109 nodulos, fue tratado con quimioembolizacion. El segundo grupo, de 15 pacientes y 25 nodulos, fue tratado con ablacion por radiofrecuencia. Dentro de nuestra poblacion, hubo un subgrupo de 10 pacientes (14 nodulos) que se trato con ambos metodos. Resultados: De los 90 pacientes tratados, luego de los controles con TC realizados a un mes, 3 meses y cada 3 meses durante dos anios, en 63 casos (70%) se observo acumulacion homogenea del lipiodol, defecto parcial sin realce o ausencia de realce en la lesion tratada. A estos no se les realizo nuevo procedimiento luego del tratamiento inicial. En los 27 pacientes restantes (30%), se practico un nuevo tratamiento por visualizarse defecto parcial o ausencia del lipiodol con realce o realce periferico en la fase arterial de la lesion tratada. En este ultimo grupo, 16 pacientes tratados (17,7%) tuvieron nuevo realce nodular en el parenquima hepatico restante. Conclusion: La TC en las fases sin contraste y arterial, a un mes y cada 3 meses, permite evaluar la efectividad, enfermedad residual y/o la recaida del hepatocarcinoma luego del tratamiento minimamente invasivo. (autores)

MODELADO DE LA CINÉTICA DE SECADO DE MANGO PRE-TRATADAS CON DESHIDRATACIÓN OSMÓTICA Y MICROONDAS

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MARIBEL GARCÍA-PATERNINA

Full Text Available La aplicación de tecnologías complementarias como la deshidratación osmótica y microondas como pre-tratamientos al secado convencional contribuye al desarrollo de nuevos productos y favorece la disminución de los cambios físico-químicos y organolépticos en el mango. El objetivo del trabajo fue evaluar el efecto de la deshidratación osmótica con una solución a 65°Brix de 37 a 40°C por 60 min, tratamiento con microondas a 560 W por 7 min y combinado como pre-tratamientos al secado de hojuelas de mango a 70°C en una estufa tipo bandeja y al sol. Las muestras de mango con 11 a 14°Brix y humedad del 80% fueron dimensionadas a 1x1x0,4 cm. La pérdida de peso y el tiempo de secado en los pre-tratados presentaron diferencias significativas (p0,99 se ajustó para el secado sin pre-tratamiento y el modelo de Vermet et al. (R²>0,99 para los pre-tratados. La De ff para microondas y secado en estufa fue mayor. Las hojuelas de mango pre-tratadas con deshidratación osmótica fueron las que mejor conservaron la apariencia de las hojuelas de mango

Efectividad de la acupuntura con tachuela en afectados por epicondilitis

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Mercedes Gay Muguercia

2014-06-01

Full Text Available Se realizó una intervención terapéutica en 20 pacientes con epicondilitis, remitidos de la consulta de Ortopedia al Departamento de Medicina Natural Tradicional del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, de septiembre a diciembre de 2012, con vistas a determinar la efectividad de la acupuntura con tachuela en ellos. Los afectados fueron valorados y, de forma aleatoria, se les distribuyó en 2 grupos de 10 integrantes cada uno: el de estudio, que recibió acupuntura (agujas de 0,2 mm de forma permanente en los puntos Ashi y en el IG-11, y el de control, tratado convencionalmente con antiinflamatorios y analgésicos. Luego de aplicadas las terapias, los pacientes fueron valorados a los 5, 10 y 15 días, teniendo en cuenta el cuadro clínico dado por dolor, inflamación e impotencia funcional. La regresión de los síntomas se evaluó por la escala visual analógica, y se obtuvo una efectividad marcada del tratamiento con acupuntura en relación con el medicamentoso

Diseñe su interfaz gráfica con Matlab

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Miguel Ramón Ortegón Gutiérrez

1998-05-01

Full Text Available Las aplicaciones de carácter científico o tecnológico cuentan, para su desarrollo, con el apoyo de una poderosa herramienta de cálculo numérico, que permite abordar problemas que demanden variada y compleja manipulación matemática de manera eficiente y con ayudas gráficas. Su diseño funcional le permite usar con facilidad toda la gama de comandos en forma interactiva, o en modo programas que han sido implementados como parte del lenguaje, o los nuevos comandos implementados por el usuario. Problemas tradicionales, relativos al manejo de matrices o álgebra lineal, cálculo diferencial e integral, ecuaciones diferenciales, raíces de funciones, solución de sistemas de ecuaciones, etc., hasta algunos más especializados como el procesamiento digital de señales, redes neuronales, filtros, pueden ser tratados con este lenguaje. Con el presente artículo se desea difundir el uso de interfaces gráficas que provee Matlab, para hacer más modernas, presentables y manejables aplicaciones de ingeniería que con otras herramientas podrían resultar mas complicadas y engorrosas.

Perfil eletrocardiográfico e conteúdo glicogênico muscular de ratos tratados com nandrolona Perfil electrocardiográfico y contenido glicogénico muscular de ratones tratados con nandrolona Electrocardiographic profile and muscle glycogen content of rats treated with nandrolone

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Carlos Alberto da Silva

2010-12-01

áfico, contenido glicogénico y de proteínas totales de los músculos cardíacos y esqueléticos, así como las concentraciones plasmática de albúmina. MÉTODOS: Los animales del grupo tratado recibieron la droga en la concentración 5mg/kg por vía subcutánea, dos veces por semana, durante tres semanas. Una vez por semana, los ratones fueron anestesiados con Pentobarbital sódico (50mg/Kg, ip y sometidos a evaluación por medio de electrocardiograma (ECG. Después del período experimental, muestras de los músculos cardíaco (ventrículo izquierdo - VI, sóleo (S, gastrocnemio blanco (GB, gastrocnemio rojo (GV, pectoral (P, intercostal (IC y diafragma (D fueron colectadas y analizadas. Los datos (media±epm fueron evaluados de acuerdo con ANOVA, segundo test de Tukey (p>0,05. RESULTADOS: Los ratones del grupo tratado presentaron alteraciones en los siguientes parámetros cardíacos: intervalo QRS, intervalo QTc y frecuencia cardíaca, caracterizados por un aumento de estos, teniendo el ápice en el intervalo de la semana de pretratamiento a la primera semana. Las reservas de glicógeno en el VI presentaron aumento de 127%. En relación a la cantidad de proteínas totales, una diferencia significativa fue constatada en el S, GV y D. En cuanto al perfil bioquímico y al hematocrito, fue observado un aumento en el porcentaje de eritrocitos. CONCLUSIÓN: El estudio muestra que importantes alteraciones cardíacas son provocadas precozmente, sugiriendo una jerarquía en la secuencia de modificaciones que comprometen la homeostasia del organismo.BACKGROUND: We considered both the indiscriminate use of steroids by top athletes and by physically active individuals. OBJECTIVE: To evaluate the effects of nandrolone decanoate on the electrocardiographic profile, glycogen content and total-protein profile of skeletal and cardiac muscles, as well as the plasma albumin concentrations. METHODS: The drug was administered subcutaneously, at a concentration of 5 mg/kg, twice a week for three

Rabdomioma cardiaco tratado quirúrgicamente con éxito y revisión de la literatura

OpenAIRE

Cigarroa López,Ángel; García Jiménez,Yoloxóchitl; Yáñez Gutiérrez,Lucelly; Jiménez Arteaga,Santiago; Martínez Sánchez,Arturo; Ortegón Cardeña,José; David Gómez,Felipe; Sánchez Soberanes,Agustín; López Gallegos,Diana; Riera-Kinkel,Carlos; Alva Espinosa,Carlos

2005-01-01

Los tumores cardiacos primarios son raros, con incidencia variable en todas las edades del 0.005 al 0.05%. En pacientes pediátricos, la incidencia es del 0.27%. Los tumores más frecuentes durante la infancia son los rabdomiomas cardiacos, considerados como benignos. Aunque la expresión clínica es amplia, en la mayoría de los casos son asintomáticos y se detectan por la presencia de soplos. En la etapa prenatal se manifiestan con arritmias o hydrops fetalis. En algunos neonatos y lactantes se ...

Immunogenetic markers of Crohn's disease in adults population of the Moscow region

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Stavtsev D.S.

2014-12-01

Full Text Available Aim: to study immunogenetic markers of predisposition to the development and protection for Crohn's disease in adults population of the Moscow region. Material and methods. The study included 53 samples of peripheral blood of patients with Crohn's disease in the Moscow region. The control group was represented by 1,700 samples of umbilical cord blood is healthy newborns. Revealing HLA antigens at low level performed by SSO method on DynalRELI 48 processor. The results received with ambiguous interpretation was using PCR-SSP method (Ivitrogen. Results. Were found the positive and negative associations of groups of HLA alleles with clinical form, the course of Crohn's disease and response to steroid treatment, in particular revealed that, predisposition to the development for Crohn's disease in women and with sensitivity to steroid treatment in this disease associated allele group C*12, to the characteristic restricting markers such as Crohn's disease include the В 38 and A*11 markers nonrestricting, nonpenetrating noninflammatory type groups are alleles B*56 and C*14 and C*14 is also associated with the risk of Crohn's disease in men, characteristic markers of protection to the development of the disease crown with chronic relapsing and severe clinical course are DQB1*02 and DQB1*03, respectively. Conclusion. These results demonstrate the need for studies of gene polymorphism HLA-system, not only in relation to the disease in general, but in selected patients with clinical groups.

Cost of illness of Crohn's disease.

Science.gov (United States)

Bodger, Keith

2002-01-01

Crohn's disease is a chronic inflammatory bowel disease of unknown aetiology which affects around 35,000 people in the UK (population 56.8 million). The potential for onset in early adult life, disease chronicity and a need for hospitalisation and surgery mean that the disease can be associated with substantial healthcare costs. Cost-of-illness studies focusing on direct medical costs have identified that over half the average costs associated with the disease relate to hospital costs. Estimates of the contribution of drug costs to the total direct economic burden have varied between 4.6 and 25%. Figures for average annual direct costs per patient in the US have been put at between US dollars 6561 (1990 values) and US dollars 12,417 (1994 values), whereas European studies have given much lower cost estimates (US dollars 655, 1994 values). However, all studies have highlighted that much of the total cost of illness relates to extensive interventions required by a small proportion of severely affected individuals. Indirect costs associated with reduced productivity in Crohn's disease can be high, with long periods of absenteeism and early disability. However, most patients (90%) remain in the workforce and life expectancy is relatively normal. A variety of drugs are employed for the treatment of Crohn's disease, both in an attempt to induce clinical remission in active disease and to maintain remission once this has been achieved. Comparative data on cost effectiveness is lacking, though crude estimates based on randomised trials suggest that the frequently prescribed aminosalicylates, which have only modest efficacy, are a relatively costly drug option. The costs associated with adverse drug effects, particularly for corticosteroids, have not been formally quantified. Despite high costs, new drug therapies for more severe disease, such as anti-tumour necrosis factor (TNF-alpha) antibodies, may prove a cost-effective option if the need for hospitalisation is reduced

Fistulizing Crohn's disease: Diagnosis and management.

Science.gov (United States)

Gecse, Krisztina; Khanna, Reena; Stoker, Jaap; Jenkins, John T; Gabe, Simon; Hahnloser, Dieter; D'Haens, Geert

2013-06-01

Fistulizing Crohn's disease represents an evolving, yet unresolved, issue for multidisciplinary management. Perianal fistulas are the most frequent findings in fistulizing Crohn's disease. While enterocutaneous fistulas are rare, they are associated with considerable morbidity and mortality. Detailed evaluation of the fistula tract by advanced imaging techniques is required to determine the most suitable management options. The fundamentals of perianal fistula management are to evaluate the complexity of the fistula tract, and exclude proctitis and associated abscess. The main goals of the treatment are abscess drainage, which is mandatory, before initiating immunosuppressive medical therapy, resolution of fistula discharge, preservation of continence and, in the long term, avoidance of proctectomy with permanent stoma. The management of enterocutaneous fistulas comprises of sepsis control, skin care, nutritional optimization and, if needed, delayed surgery.

Tratamiento con inmunoterapia específica en niños con Rinitis Alérgica y/o Asma Bronquial. Área Norte. 2005 - 2007.

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Matilde Iraida Morera Franco

2007-10-01

Full Text Available Se realizó un estudio descriptivo longitudinal durante el período Enero 2005_ Enero 2007 en el Policlínico Norte del municipio Sancti Spíritus. El universo estuvo constituido por el total de niños con edades de 2_15 años con enfermedades alérgicas, a los que se realizó pruebas de alergia e indicó tratamiento con inmunoterapia específica por vía subcutánea, la muestra estuvo formada por 75 pacientes con asma bronquial, rinitis alérgica y/o ambas enfermedades, con el objetivo de determinar el comportamiento del tratamiento con inmunoterapia específica se aplicó el método porcentual para el análisis de resultados, donde el grupo etáreo que predominó fue de 2 _5 años, más del 65 % de los pacientes tratados refirieron mejoría de los síntomas las causas más frecuentes de abandono de tratamiento fue la aparición de infecciones intercurrentes, no ocurrió reacción anafiláctica en ninguno de los casos estudiados, el tratamiento con inmunoterapia puede reducir el uso de otros tratamientos asociados como Intal, antihistamínicos, broncodilatadores y esteroides.

Las convenciones de comercio, navegación y relaciones internacionales firmadas por Colombia con Estados Unidos y Reino Unido en 1825: al rescate de su memoria, a propósito del TLC

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Jorge Enrique Elías Caro

2013-10-01

Full Text Available Colombia en 1825 firmó con Estados Unidos y el Reino Unido un tratado de libre comercio, de navegación y relaciones internacionales. En este trabajo lo que se persigue es explicar las razones que dieron origen a la firma de estos acuerdos. De igual forma analizar las repercusiones que tuvo para la economía, la política y las condiciones sociales el haber suscrito estos pactos. De la misma manera se hace una analogía de los determinantes que versaban estos tratados con el que actualmente vienen  los gobiernos de Colombia y Estados , para ello se hace una comparación de los articulados y sus contenidos

Treaty on the Non-Proliferation of Nuclear Weapons. Notification of the Entry into Force; Tratado Sobre la no Proliferacion de las Armas Nucleares. Notificacion de la Entrada en Vigor

Energy Technology Data Exchange (ETDEWEB)

NONE

1970-04-22

By letters addressed to the Director General on 5, 6 and 20 March 1970 respectively, the Governments of the United Kingdom of Great Britain and Northern Ireland, the United States of America and the Union of Soviet Socialist Republics, which are designated as the Depository Governments in Article IX. 2 of the Treaty on the Non-Proliferation of Nuclear Weapons, informed the Agency that the Treaty had entered into force on 5 March 1970 [Spanish] En sus cartas dirigidas al Director General con fecha 5, 6 y 20 de marzo de 1970, respectivamente, el Reino Unido de Gran Bretana e Irlanda del Norte, los Estados Unidos de America y la Union de Republicas Socialistas Sovieticas, designados Gobiernos depositarios en el parrafo 2 del Articulo IX del Tratado sobre la no proliferacion de las armas nucleares, han comunicado al Organismo que dicho Tratado entro en vigor el 5 de marzo de 1970.

High-utilizing Crohn's disease patients under psychosomatic therapy*

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Jantschek Günther

2008-10-01

Full Text Available Abstract Objective Few studies have been published on health care utilization in Crohn's disease and the influence of psychological treatment on high utilizers. Methods The present sub study of a prospective multi center investigation conducted in 87 of 488 consecutive Crohn's disease (CD patients was designed to investigate the influence of the course of Crohn's disease on health care utilization (hospital days (HD and sick leave days (SLD collected by German insurance companies and to examine the conditions of high-utilizing patients. Predictors of health care utilization should be selected. Based on a standardized somatic treatment, high health care utilizing patients of the psychotherapy and control groups should be compared before and after a one-year treatment. Results Multivariate regression analysis identified disease activity at randomization as an important predictor of the clinical course (r2 = 0.28, p 2 = 0.15, p = 0.09. The patients' level of anxiety, depression and lack of control at randomization predicted their health-related quality of life at the end of the study (r2 = 0.51, p 2 = 0.22, p Among high utilizers, a significantly greater drop in HD (p Conclusion The course of Crohn's disease is influenced by psychological as well as somatic factors; especially depression seems important here. A significant drop of health care utilization demonstrates the benefit of psychological treatment in the subgroup of high-utilizing CD patients. Further studies are needed to replicate the findings of the clinical outcome in this CD subgroup.

Natalizumab for induction of remission in Crohn's disease.

Science.gov (United States)

Macdonald, J K; McDonald, J W D

2006-07-19

The pathogenesis of Crohn's disease involves migration of leukocytes into gut tissue and subsequent inflammation. Natalizumab (Tysabri, Elan Pharmaceuticals and Biogen Idec) a recombinant humanized IgG4 monoclonal antibody that blocks adhesion and subsequent migration of leukocytes into the gut by binding the alpha4 integrin is a member of a new class of molecules known as selective adhesion molecule (SAM) inhibitors. The results of animal studies suggest that alpha4 integrin blockade could be a useful therapy for inflammatory bowel disease. The results of randomized controlled trials suggest that natalizumab may be an effective therapy for active Crohn's disease. This systematic review summarizes the current evidence on the use of natalizumab for the induction of remission in Crohn's disease. To determine the efficacy and safety of natalizumab for induction of remission in Crohn's disease. A computer assisted search of the Cochrane Central Register of Controlled Trials, the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Review Group Specialized Trials Register, MEDLINE and EMBASE was performed to identify relevant publications between 1966 and June 2005. The medical subject heading (MeSH) terms "Crohn disease" or "inflammatory bowel disease", "Natalizumab" or "Antegren" or "Tysabri" and "Antibodies, Monoclonal" were used to perform key word searches of each database. Manual searches of reference lists from potentially relevant papers were performed in order to identify additional studies that may have been missed using the computer-assisted search strategy. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Personal contacts, leaders in the field, and the manufacturers were contacted to identify other studies which may not be published. We included only randomized controlled trials comparing natalizumab to a placebo or control therapy for the induction of remission in Crohn

Mercurius solubilis en el tratamiento de pacientes con estomatitis aftosa recurrente

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María Isabel Aguilar Vallejo

2015-01-01

Full Text Available Se realizó ensayo clinicoterapéutico controlado, de fase II B, de 112 pacientes con estomatitis aftosa recurrente, atendidos en la Clínica Estomatológica "José Luis Tassende" de Santiago de Cuba, desde enero hasta diciembre de 2013, para evaluar la eficacia del Mercurius solubilis en el tratamiento de estos. La muestra fue distribuida de forma aleatoria, mediante orden de llegada, en 2 grupos (uno de estudio y uno control, con 56 integrantes cada uno. Los primeros fueron tratados con Mercurius solubilis y los segundos con los remedios homeopáticos habituales. Para la validación estadística de la información obtenida se emplearon el porcentaje, el test de Ji al cuadrado, con 95 % de confiabilidad, y la probabilidad exacta de Fisher. Entre los grupos estudiados no existieron diferencias significativas en relación con la remisión de la intensidad del dolor, la recuperación de la integridad epitelial y la curación al tercer, quinto y séptimo días de tratamiento. Se demostró que esta terapia alternativa fue tan eficaz como el bórax

Propiedades biomecánicas de la membrana limitante interna tras recibir tratamiento intravítreo con ocriplasmina.

Science.gov (United States)

Vielmuth, Franziska; Schumann, Ricarda G; Spindler, Volker; Wolf, Armin; Scheler, Renate; Mayer, Wolfgang J; Henrich, Paul B; Haritoglou, Christos

2017-01-01

Objetivo: Evaluar la rigidez de la membrana limitante interna (MLI) humana y evaluar los posibles cambios de las propiedades mecánicas tras administrar una inyección intravítrea de ocriplasmina para tratar la tracción vitreomacular. Métodos: Este estudio se compone de una serie de casos intervencionales y comparativos de 12 muestras de MLI extraídas mediante cirugía y obtenidas de forma consecutiva de 9 ojos de 9 pacientes después de someterse sin éxito a vitreólisis farmacológica con ocriplasmina. Durante el mismo periodo de tiempo, 16 muestras de otros 13 ojos sin tratamiento con ocriplasmina se obtuvieron mediante vitrectomía y sirvieron como controles. Todos los pacientes presentaron agujeros maculares o tracción vitreomacular y se sometieron a vitrectomía con disección de la MLI tanto con tinción con azul brillante (AB) como sin ella. Todas las muestras se analizaron con un microscopio de fuerza atómica con imágenes de las regiones de 25 × 25 μm. En todas las muestras, se analizaron tanto la parte de la retina como la del vítreo de la MLI. Resultados: La microscopia de fuerza atómica no reveló diferencias significativas en cuanto a elasticidad de las muestras de MLI extraídas de ojos con o sin tratamiento con ocriplasmina. Las áreas onduladas de la parte de la retina presentaron una mayor rigidez que la parte del vítreo de la MLI. La cartografía topográfica tanto de la parte del vítreo como de la retina de la MLI no mostró ninguna alteración aparente de la morfología en ojos tratados con ocriplasmina en comparación con los ojos no tratados. La tinción con azul brillante conllevó un aumento de la rigidez tisular. Conclusiones: Las inyecciones intravítreas de ocriplasmina no varían las propiedades biomecánicas de la MLI humana. No existen pruebas de un posible efecto enzimático que interfiera con la rigidez de esta membrana basal. © 2017 S. Karger AG, Basel.

Development of the Crohn's disease digestive damage score, the Lémann score

DEFF Research Database (Denmark)

Pariente, Benjamin; Cosnes, Jacques; Danese, Silvio

2011-01-01

is to outline the methods to develop an instrument that can measure cumulative bowel damage. The project is being conducted by the International Program to develop New Indexes in Crohn's disease (IPNIC) group. This instrument, called the Crohn's Disease Digestive Damage Score (the Lémann score), should take...

Tratamiento con miltefosina de la leishmaniosis cutánea diseminada

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Lina María González

2006-10-01

Full Text Available La leishmaniosis cutánea diseminada es una forma escasa de leishmaniosis, que se caracterizapor la diseminación sanguínea del parasito que lleva a la aparición de múltiples nódulos yplacas en la piel de todo el cuerpo y aun de la mucosa nasal. Se diferencia de la leishmaniosiscutánea difusa en que la alteración de la inmunidad celular es menor y las lesiones puedentener una descamación epidérmica, en cambio en la leishmaniosis difusa las lesiones sonnodulares y hay una anergia celular específica contra el parásito. En este artículo se describeel caso de un paciente colombiano con Leishmaniosis cutánea diseminada causada por L(Vpanamensis que inicialmente tuvo falla terapéutica al ser tratado con Glucantime y AnfotericinaB y quien curó de sus lesiones al recibir tratamiento con Miltefosine.

Looking in the mouth for Crohn's disease.

LENUS (Irish Health Repository)

Rowland, Marion

2012-02-01

It is widely acknowledged among gastroenterologists that the oral cavity may be involved in Crohn\\'s disease (CD). However, the specific manifestations are poorly appreciated. Although oral aphthous ulceration is probably not diagnostically useful in patients with suspected CD, disease-specific manifestations do occur and are particularly common in children presenting with CD. These manifestations can be subtle, often are subclinical, yet commonly harbor diagnostically useful material (granulomas). Orofacial granulomatosis (OFG) is conventionally used to describe patients with overt oral disease without obvious involvement of the gastrointestinal tract. However, many patients with OFG have subclinical intestinal CD or will progress to develop overt intestinal CD with time. The management of severe oral disease is challenging and lacks a clear evidence base.

Looking in the mouth for Crohn's disease.

LENUS (Irish Health Repository)

Rowland, Marion

2010-02-01

It is widely acknowledged among gastroenterologists that the oral cavity may be involved in Crohn\\'s disease (CD). However, the specific manifestations are poorly appreciated. Although oral aphthous ulceration is probably not diagnostically useful in patients with suspected CD, disease-specific manifestations do occur and are particularly common in children presenting with CD. These manifestations can be subtle, often are subclinical, yet commonly harbor diagnostically useful material (granulomas). Orofacial granulomatosis (OFG) is conventionally used to describe patients with overt oral disease without obvious involvement of the gastrointestinal tract. However, many patients with OFG have subclinical intestinal CD or will progress to develop overt intestinal CD with time. The management of severe oral disease is challenging and lacks a clear evidence base.

La ventana europea: retos de la negociación del Tratado de Libre Comercio de México con la Unión Europea

OpenAIRE

Jaime Zabludovsky; Sergio Gómez Lora

2004-01-01

Después de más de seis años de gestiones diplomáticas y complejas negociaciones, el primero de julio de 2000 entraron en vigor las disposiciones para liberalizar los flujos de comercio de bienes entre México y la Unión Europea (UE). Estas disposiciones son parte del Tratado de Libre Comercio (TLCUEM) que, a su vez, es uno de los componentes del Acuerdo de Concertación Política, Asociación Económica y Cooperación ("Acuerdo Global").

Impacto psicológico de la enfermedad de Crohn en pacientes en remisión: riesgo de ansiedad y depresión Psychological impact of Crohn's disease on patients in remission: anxiety and depression risks

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M. Iglesias

2009-04-01

Full Text Available Introducción: el papel de la ansiedad y depresión en pacientes con enfermedad de Crohn (EC en remisión es incierto. Objetivo: evaluar la frecuencia de ansiedad y depresión en pacientes con EC en remisión y potenciales factores que pueden influir en el desarrollo de esos síntomas. Métodos: se incluyeron pacientes con EC mayores de 18 años, que estuviesen en remisión durante al menos 6 meses. La remisión se definió como un CDAI Background: the role of anxiety and depression in CD patients in remission has been poorly investigated. Objective: the aim of the study was to evaluate the frequency of anxiety and depression symptoms in CD patients in remission, and potential factors influencing the development of these symptoms. Methods: CD patients older than 18 years in remission for at least 6 months before study entry were included. CD remission was defined as a Crohn's disease Activity Index (CDAI < 150 points together with C-reactive protein < 5 mg/L. A demographic questionnaire was filled in, and all patients were clinically classified. The therapy maintaining remission was also recorded. A Hospital Anxiety and Depression scale (HAD was administered to all patients. Results are shown as OR and 95% CI, and analyzed by logistic regression. Results: 92 consecutive patients were included (48 male, mean age 37 years, range from 18 to 71 years. One patient failed to correctly fill in the questionnaire. Anxiety and depression symptoms were present in 36 (39% and 22 (24% patients, respectively. Infliximab therapy was the only factor associated with anxiety (OR = 3.11; 95% CI: 1.03-9.43; p < 0.05. In contrast, the presence of depressive symptoms is less frequent in patients under infliximab therapy (OR = 0.16; 95% CI: 0.02-0.97; p < 0.05. Conclusions: despite clinical remission, an important number of CD patients present with anxiety or depressive symptoms. Infliximab therapy in CD patients is associated to more anxiety but fewer depressive

Un caso de osteocondritis costal tífica tratado con vacunas y antivirus

OpenAIRE

Lleras Acosta, F.; Rueda H., Alfonso

2011-01-01

Por considerala de importancia práctica, presentamos la historiaclínica de una enferma afectada de osteocondritis costal de origen Eberthiano, tratada con éxito completo por las autovacunas y antivirus, Debemos esta interesante observación al Dr. Juan N. Carpas y al interno de su servicio de mujeres, Sr. Azuero, quienes galantemente nos suministraron los datos clínicos y las observaciones relativas a los efectos producidos por las vacunas.

LA RELACIÓN ENTRE TRATADOS DE INVERSIÓN Y CONVENIOS DE DOBLE TRIBUTACIÓN: el caso chileno

OpenAIRE

Lazo, Rodrigo Polanco; Villanueva, Felipe Yáñez

2016-01-01

El presente artículo examina las relaciones entre los tratados de inversión y los tratados de doble tributación, considerando que, en la actual evolución de ambos tipos de acuerdos, sus disposiciones pueden presentar superposiciones en aspectos tales como estándares de protección, transparencia, trato nacional, cláusula de la nación más favorecida, expropiación y transferencias de capital. Tomando el ejemplo de los tratados suscritos por Chile, en este trabajo se examinan las consecuencias de...

A 5-year prospective observational study of the outcomes of international treatment guidelines for Crohn's disease.

LENUS (Irish Health Repository)

Cullen, Garret

2012-02-01

BACKGROUND & AIMS: Therapeutic strategies for patients with Crohn\\'s disease are based on American and European guidelines. High rates of corticosteroid dependency and low remission rates are identified as weaknesses of this therapy and as justification for early introduction of biologic agents (top-down treatment) in moderate\\/severe Crohn\\'s disease. We reviewed outcomes and corticosteroid-dependency rates of patients with moderate-to-severe disease who were treated according to the international guidelines. METHODS: Consecutive patients (102) newly diagnosed with Crohn\\'s disease in 2000-2002 were identified from a prospectively maintained database. Severity of disease was scored using the Harvey-Bradshaw Index (HBI). Disease was classified by Montreal classification. Five-year follow-up data were recorded. RESULTS: Seventy-two patients had moderate\\/severe disease at diagnosis (HBI >8). Fifty-four (75%) had nonstricturing, nonpenetrating disease (B1). Sixty-four (89%) received corticosteroids, and 44 (61%) received immunomodulators. Twenty-one patients (29%) received infliximab. Thirty-nine patients (54%) required resection surgery. At a median of 5 years, 66 of 72 (92%) patients with moderate\\/severe disease were in remission (median HBI, 1). Twenty-five patients (35%) required neither surgery nor biologic therapy. CONCLUSIONS: When international treatment guidelines are strictly followed, Crohn\\'s disease patients can achieve high rates of remission and low rates of morbidity at 5 years. Indiscriminate use of biologic agents therefore is not appropriate for all patients with moderate-to-severe disease.

Interaccion de promastigotes de Leishmania donovani con celulas de exudado peritonial de ratones mediante la influencia de la quimotripsina

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Lucila Arcay

1986-06-01

Full Text Available Se hace un estudio de la interacción de promastigotes de Leishmania donovani con células de exudado peritoneal de ratón (c e p mediante la influencia de la quimotripsina. La adhesión de los promastigotes a las c e p fue terminal y marginal, y en observaciones hechas a partir de los 10 minutos de enfrentamiento, esta adhesión fue nula hasta los 30 minutos en el grupo tratado, y sólo a las das horas hubo un pequeño incremento (2.4% con respecto al control. Se observa marcada disminución en todos los parámetro medidos, tales como enlace, penetración, multiplicación intracelular, división de formas flageladas, en el grupo tratado. La quimotripsina favorece la formación de formas intermedias flageladas, heciendose el parásito piriforme y esférico, apareciendo una forma aberrante de extremo anterior cilindrico que semeja a una forma coanoflagelada. Se sospecha que la enzima reduce efectivamente fragmentos proteicos o péptidos, los cuales pueden haber sido tan pequeños como para esconder a otros ligandos relacionados con la adhesión macrófago-parásito.

Plain abdominal radiographs in patients with Crohn's disease: radiological findings and diagnostic value.

LENUS (Irish Health Repository)

O'Regan, K

2012-08-01

To determine the diagnostic yield and clinical value of plain film of the abdomen (PFA) in Crohn\\'s disease (CD) patients and to determine whether performance of PFA yields definitive diagnostic information or whether additional imaging examinations are required.

Crohn's Disease Associated with Sweet's Syndrome and Sjögren's Syndrome Treated with Infliximab

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Erina N. Foster

2005-01-01

Full Text Available The association of Crohn's disease (CD and Sweet's syndrome is rare and the presence of Sjögren's syndrome in Crohn's disease is even rarer, with only three reports found in the literature. We describe two cases of Crohn's disease associated with Sweet's syndrome, one of which is the first case of CD and Sweet's concomitantly associated with Sjögren's syndrome. Both cases responded rapidly to Infliximab therapy with complete resolution of the skin lesions.

Leishmaniosis laríngea recidivante: un caso inusual en un paciente inmunocompetente tratado con corticoides Recidivant laryngeal leishmaniosis: an unusual case in an immunocompetent patient treated with corticosteroids

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R. Casero

2010-06-01

Full Text Available La leishmaniosis es una parasitosis de evolución crónica; en Argentina, sus agentes etiológicos principales pertenecen al complejo Leishmania (Viannia braziliensis, habitualmente asociado a lesiones cutáneas y mucocutáneas. Informamos en este trabajo un caso de leishmaniosis laríngea en un hombre de 29 años procedente de Jujuy, quien a raíz de múltiples subdiagnósticos portaba esta parasitosis desde hacía 20 años. En el año 2008 este paciente consulta por disfonía crónica y trastornos en las vías aéreas superiores, refiere que fue sometido a terapias con tuberculostáticos, antifúngicos y corticoides desde 2002. Diferentes biopsias y fibroscopías revelaron los siguientes diagnósticos: laringitis granulomatosa inespecífica, laringitis compatible con tuberculosis, laringitis compatible con histoplasmosis, linfoma Natural Killer extraganglionar a células pequeñas. Finalmente, estudios realizados en nuestro hospital demostraron la presencia de una laringe granulomatosa en toda su extensión, amastigotes intra y extracelulares de Leishmania spp., ausencia de formas compatibles con Micobacterias e Histoplasma, y laringitis crónica vinculable a Leishmania spp. El paciente realizó tratamiento con antimoniato de N-metil-glucamina y demostró una muy buena evolución clínica tras ser examinado 2 meses después. Si bien la leishmaniosis laríngea como lesión única no es la presentación prevalente de esta zoonosis, su estudio amerita especial atención en pacientes tratados con corticoides, pues esto evitará un diagnóstico tardío y las mayores consecuencias asociadas a la morbimortalidad propia de esta parasitosis.Leishmaniosis is a chronic parasitic disease, which in Argentina is mainly caused by protozoa belonging to the Leishmania (Viannia braziliensis complex, leading to cutaneous and mucosal pathologies. We report a rare case of laryngeal leishmaniosis in a 29 year-old man from Jujuy province, Argentina, who had been

La UNASUR y el Protocolo sobre Compromiso con la Democracia

OpenAIRE

Luchetti, Javier Fernando

2012-01-01

En el presente trabajo describiremos brevemente el proceso que llevó a la UNASUR a añadir a su Tratado Constitutivo, el Protocolo Adicional sobre Compromiso con la Democracia, que pretende constituirse en un apéndice importante en la defensa de las instituciones democráticas y el respeto por los derechos humanos en el sur del continente suramericano, más allá que en otras organizaciones regionales también se menciona que la defensa de la democracia es uno de los pilares de dichas organizacion...

Human Embryonic Stem Cell Therapy in Crohn's Disease: A Case Report.

Science.gov (United States)

Shroff, Geeta

2016-02-29

Crohn's disease is a chronic inflammatory disease of the intestines, mainly the colon and ileum, related with ulcers and fistulae. It is estimated to affect 565,000 people in the United States. Currently available therapies, such as antibiotics, thiopurines, and anti-tumor necrosis factor-alpha agents, are only observed to reduce the complications associated with Crohn's disease and to improve quality of life, but cannot cure the disease. Stem cell therapy appears to have certain advantages over conventional therapies. Our study aimed to evaluate the efficacy of human embryonic stem cell therapy in a patient with Crohn's disease. A 21-year-old male with chief complaints of intolerance to specific foods, abdominal pain, and diarrhea underwent human embryonic stem cell therapy for two months. After undergoing human embryonic stem cell therapy, the patient showed symptomatic relief. He had no complaints of back pain, abdominal pain, or diarrhea and had improved digestion. The patient had no signs and symptoms of skin infection, and had improved limb stamina, strength, and endurance. The condition of patient was stable after the therapy. Human embryonic stem cell therapy might serve as a new optimistic treatment approach for Crohn's disease.

Nuestra Experiencia con la técnica de Barcat y Godart en el Torticolis Muscular Congénito

OpenAIRE

Remartínez Rivares, José María; Latorre Sahún, A.; Castiella Muruzabal, Tomás; Aznar Aznarez, J. Mª; Seral Iñigo, Fernando

1990-01-01

Los autores exponen los resultados obtenidos en diez casos de T.M.C. tratados quirúrgicamente con la técnica de Barcat y Godard, tanto estéticos como funcionales. Se analizan los parámetros de sexo, edad de intervención, lado afectado, tipo de parto, anomalías asociadas, y presencia de asimetría facial, movilidad craneal, pérdida de relieve muscular y aparición de bandas laterales postoperatorias. Estos resultados son comparados con los otros autores, mostrándose superiores....

Role of delayed indium-111 labeled leukocyte scan in the management of Crohn's disease

International Nuclear Information System (INIS)

Slaton, G.D.; Navab, F.; Boyd, C.M.; Diner, W.C.; Texter, E.C. Jr.

1985-01-01

Comparison of nine patients with Crohn's disease who had a positive delayed (24 hr) 111 indium leukocyte scan and 10 patients with negative scan showed no significant difference between the two groups for the Crohn's disease activity index, sedimentation rate, survival, complications, number of days in hospital, outpatient visits, or readmissions. Despite the apparent lack of statistical significance in Crohn's disease activity index, the scan was positive in nine of 16 patients with a Crohn's disease activity index more than 150, and none of three patients with Crohn's disease activity index less than 150. In the patients studied, there were no false-positive leukocyte scans. In nine of 10 patients with ileocolonic disease, scanning results correctly predicted the proper management. Six patients with positive scan and enteroclysis responded to medical treatment. Four patients had positive enteroclysis and negative scan; of these, three had radiographic features of chronic ileal stricture which was confirmed at operation. The results suggest that a negative delayed indium-111 leukocyte scan may be useful in diagnosis of chronic fibrotic ileal stricture

Un caso de Osteocondritis costal tífica tratado con vacunas y antivirus

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F. Lleras Acosta

1932-05-01

Full Text Available Por considerala de importancia práctica, presentamos la historia clínica de una enferma afectada de osteocondritis costal de origen Eberthiano, tratada con éxito completo por las autovacunas y antivirus, Debemos esta interesante observación al Dr. Juan N. Carpas y al interno de su servicio de mujeres, Sr. Azuero, quienes galantemente nos suministraron los datos clínicos y las observaciones relativas a los efectos producidos por las vacunas.

Utilização de efluente tratado em complexo industrial automotivo

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Sandro Carlos Pohl

Full Text Available RESUMO Neste trabalho, realizaram-se modificações nos sistemas produtivo e de tratamento de efluentes em um complexo industrial automotivo a fim de possibilitar a utilização do efluente tratado no sistema de torres de resfriamento. Inicialmente, realizou-se um balanço hídrico nos processos industriais para determinar o consumo de água e analisou-se a qualidade do efluente tratado quanto aos parâmetros físico-químicos em dois pontos do sistema de tratamento de efluentes: no decantador secundário (P1 do tratamento físico-químico e na saída da lagoa de polimento (P2. Essas análises mostraram que o efluente tratado no decantador secundário não tem capacidade de atender às especificações da água de circulação das torres de resfriamento sem a realização de muitas alterações em seu tratamento, optando-se pela utilização do efluente tratado na saída da lagoa de polimento após modificações, como: alteração na concentração de ácido fosfórico e de ácido nítrico da solução de limpeza dos tanques de fosfatização, elevação em 50% da capacidade de aeração da lagoa aerada e troca do coagulante sulfato de alumínio pelo cloreto férrico no tratamento físico-químico. Assim, os parâmetros do efluente tratado na lagoa de polimento aproximaram-se aos parâmetros especificados para água de torres de resfriamento. A introdução desse efluente na proporção de 40% do volume da água de circulação na torre de resfriamento resultou em elevação do ciclo de dureza e redução no ciclo de sílica. A utilização de um filtro abrandador na saída da lagoa de polimento proporcionou a redução dos parâmetros de qualidade da água para valores similares aos da água de recirculação nas torres de resfriamento.

Mongersen, an oral SMAD7 antisense oligonucleotide, and Crohn's disease.

Science.gov (United States)

Monteleone, Giovanni; Neurath, Markus F; Ardizzone, Sandro; Di Sabatino, Antonio; Fantini, Massimo C; Castiglione, Fabiana; Scribano, Maria L; Armuzzi, Alessandro; Caprioli, Flavio; Sturniolo, Giacomo C; Rogai, Francesca; Vecchi, Maurizio; Atreya, Raja; Bossa, Fabrizio; Onali, Sara; Fichera, Maria; Corazza, Gino R; Biancone, Livia; Savarino, Vincenzo; Pica, Roberta; Orlando, Ambrogio; Pallone, Francesco

2015-03-19

Crohn's disease-related inflammation is characterized by reduced activity of the immunosuppressive cytokine transforming growth factor β1 (TGF-β1) due to high levels of SMAD7, an inhibitor of TGF-β1 signaling. Preclinical studies and a phase 1 study have shown that an oral SMAD7 antisense oligonucleotide, mongersen, targets ileal and colonic SMAD7. In a double-blind, placebo-controlled, phase 2 trial, we evaluated the efficacy of mongersen for the treatment of persons with active Crohn's disease. Patients were randomly assigned to receive 10, 40, or 160 mg of mongersen or placebo per day for 2 weeks. The primary outcomes were clinical remission at day 15, defined as a Crohn's Disease Activity Index (CDAI) score of less than 150, with maintenance of remission for at least 2 weeks, and the safety of mongersen treatment. A secondary outcome was clinical response (defined as a reduction of 100 points or more in the CDAI score) at day 28. The proportions of patients who reached the primary end point were 55% and 65% for the 40-mg and 160-mg mongersen groups, respectively, as compared with 10% for the placebo group (P<0.001). There was no significant difference in the percentage of participants reaching clinical remission between the 10-mg group (12%) and the placebo group. The rate of clinical response was significantly greater among patients receiving 10 mg (37%), 40 mg (58%), or 160 mg (72%) of mongersen than among those receiving placebo (17%) (P=0.04, P<0.001, and P<0.001, respectively). Most adverse events were related to complications and symptoms of Crohn's disease. We found that study participants with Crohn's disease who received mongersen had significantly higher rates of remission and clinical response than those who received placebo. (Funded by Giuliani; EudraCT number, 2011-002640-27.).

Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease

International Nuclear Information System (INIS)

Ziech, M.L.W.; Lavini, C.; Caan, M.W.A.; Nio, C.Y.; Stokkers, P.C.F.; Bipat, S.; Ponsioen, C.Y.; Nederveen, A.J.; Stoker, J.

2012-01-01

Objectives: To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease. Methods: Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of gadobutrol, single shot fast spin echo sequence and 3D T1-weighted spoiled gradient echo sequence, a dynamic coronal 3D T1-weighted fast spoiled gradient were performed before and after gadobutrol. Maximum enhancement (ME) and initial slope of increase (ISI) were calculated for four colon segments (ascending colon + coecum, transverse colon, descending colon + sigmoid, rectum) and (neo)terminal ileum. C-reactive protein (CRP), Crohn's disease activity index (CDAI), per patient and per segment Crohn's disease endoscopic index of severity (CDEIS) and disease duration were determined. Mean values of the (DCE-)MRI parameters in each segment from each patient were compared between four disease activity groups (normal mucosa, non-ulcerative lesions, mild ulcerative and severe ulcerative disease) with Mann–Whitney test with Bonferroni adjustment. Spearman correlation coefficients were calculated for continuous variables. Results: Thirty-three patients were included (mean age 37 years; 23 females, median CDEIS 4.4). ME and ISI correlated weakly with segmental CDEIS (r = 0.485 and r = 0.206) and ME per patient correlated moderately with CDEIS (r = 0.551). ME was significantly higher in segments with mild (0.378) or severe (0.388) ulcerative disease compared to normal mucosa (0.304) (p < 0.001). No ulcerations were identified at conventional sequences. ME correlated with disease duration in diseased segments (r = 0.492), not with CDAI and CRP. Conclusions: DCE-MRI can be used as a method for detecting Crohn's disease ulcerative lesions.

Eficacia del extracto fluido de Vimang® en el tratamiento de pacientes con alveolitis

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Yolanda Del Toro Gámez

2014-09-01

Full Text Available Se realizó un ensayo clínico de fase III en 118 pacientes con alveolitis, atendidos en la consulta estomatológica del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, para evaluar la eficacia del extracto fluido de Vimang® en el tratamiento de ellos. La muestra se dividió en 2 grupos (experimental y control, distribuidos aleatoriamente; los integrantes del primero, tratados con el mencionado extracto; y los del segundo, con Alvogyl. Los resultados del estudio fueron validados mediante el estadígrafo de Ji al cuadrado. Se concluye que el extracto fluido de Vimang® fue eficaz para eliminar la alveolitis en menor tiempo y sin reacciones adversas, por lo cual se recomendó generalizar su uso

ANÁLISIS DEL PERFIL DE COMPUESTOS VOLÁTILES DEL MANGO (Mangifera indica L. Var. Tommy Atkins TRATADO POR MÉTODOS COMBINADOS

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Angélica Moreno

2010-09-01

Full Text Available Se evaluó el perfil de compuestos volátiles del mango (Mangifera indica L. Var. Tommy Atkins al ser tratado con la combinación de los métodos de deshidratación osmótica con o sin pulso de vacío (DOPV y DO y con secado por aire caliente o con vacío (SAC y VAC. El tiempo utilizado en la cinética del proceso de DO fue de 42 horas y la DOPV de 30 horas; en los procesos de secado, el SAC se realizó durante 24 horas y el VAC requirió 40 horas. En el perfil de compuestos volátiles del mango fresco analizado por cromatografía de gases acoplada a detector de espectrometría de masas (GC-MS se encontraron compuestos tipo mono y sesquiterpénico, además de ácidos y ésteres grasos. El germacreno D (20,49% fue el compuesto terpénico de mayor abundancia encontrado en el análisis realizado. La cantidad de compuestos volátiles en la fruta procesada fue afectada por la aplicación de DOPV y VAC; sin embargo estas pérdidas fueron menores que en las muestras secadas sin pretratamiento osmótico. En el análisis sensorial realizado, las frutas tratadas con DOPV y DO presentaron una menor intensidad calificada en el olor en comparación con la muestra no pretratada.

Desarrollo de panuveítis por tuberculosis en paciente con esclerosis múltiple tratado con interferón beta

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Lucía Echevarría Lucas

2016-09-01

Los linfocitos CD4+ T, leucocitos, macrófagos y granulocitos, con la producción de sus mediadores interferón gamma, IL-12 o TNF-α son fundamentales para controlar al Mycobacterium tuberculosis. Por ello, antes de introducir Interferón beta 1b, convendría realizar técnicas de screening, como la prueba de Mantoux o el interferon gamma release assay–(quantiferon-TB para detectar posibles tuberculosis latentes potencialmente activables.

Misleading pustular plaques of the lower limbs during Crohn's disease: two case reports

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Farhi David

2007-10-01

Full Text Available Abstract Background Extraintestinal manifestations of Crohn's disease may involve the skin, the eyes, the genital mucosa, and the joints. Dermatoses associated with Crohn's disease include neutrophilic dermatoses, erythema nodosum, granulomatous dermatitis, blistering dermatoses, and non-specific skin manifestations. Cutaneous Crohn's disease is characterized by skin non-caseating epithelioid granulomatas with giant cells, remote from the gastrointestinal tract. We report herein two new cases. Observations On both patients, differential diagnosis of neutrophilic dermatoses and infectious disease were evoked, and antimicrobial agents were introduced in one of them. Given the atypical presentation, the final diagnosis of cutaneous Crohn's disease could only be made with histological examination. In patient 1, the plaques decreased in size and infiltration by more than 75% after 3 weeks of treatment with bethametasone dipropionate 0.05% cream. In patient 2, the plaques decreased by more than 50% after 6 weeks of treatment with prednisolone (45 mg/day and azathioprine (100 mg/day. Discussion Cutaneous Crohn's disease may present as dusky, erythematous, infiltrated, and ulcerated plaques and nodules. Female-to-male sex ratio is about 2, and the mean age at onset is 35. Recurrently, the hypothesis of a skin mycobacterial or fungal infection greatly delays proper treatment. Rarity of cutaneous Crohn's disease hampers therapeutic assessment in controlled trials. Thus, available literature is limited to case reports and sparse small series, with contradictory results. These reports are subject to publication bias, and no definite evidence-based recommendations can be made on the most adequate therapeutic strategy.

Effectiveness of infliximab after adalimumab failure in Crohn's disease.

Science.gov (United States)

Chaparro, María; Andreu, Montserrat; Barreiro-de Acosta, Manuel; García-Planella, Esther; Ricart, Elena; Domènech, Eugeni; Esteve, María; Merino, Olga; Nos, Pilar; Peñalva, Mireia; Gisbert, Javier P

2012-10-07

To evaluate the effectiveness of infliximab as a second-line therapy in Crohn's disease patients after adalimumab failure. A historical cohort study in a community-based gastroenterology practice evaluated Crohn's disease patients treated with infliximab (induction plus maintenance) after adalimumab failure. Patients were identified using a large Spanish database (ENEIDA). We included 15 Crohn's disease patients who received infliximab after adalimumab failure. Five patients discontinued adalimumab due to loss of response, 3 due to adverse events and 7 due to partial response. After infliximab therapy was started, all patients who had interrupted adalimumab due to loss of efficacy regained response. All patients who discontinued adalimumab due to adverse events responded to infliximab and maintained this response; one of these patients had an uneventful course on infliximab, but 2 developed adverse events. None of the 7 patients who interrupted adalimumab due to partial response reached remission with infliximab. Switching from adalimumab to infliximab may be useful in patients who develop adverse effects or loss of response, however, the benefit of infliximab in primary nonresponders was not established.

Eficacia del tratamiento acupuntural en pacientes con sacrolumbalgia de causa no neurológica

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Arthur Smith Austin

2013-12-01

Full Text Available Se realizó un ensayo clinicoterapéutico de fase II de 120 pacientes con sacrolumbalgia no neurológica, atendidos en el cuerpo de guardia y en la consulta ambulatoria del Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto" y del Hospital Militar Central "Dr. Carlos J. Finlay", desde enero de 2009 hasta junio de 2010, con vistas a evaluar la eficacia del tratamiento acupuntural. Se conformaron 2 grupos de 60 integrantes cada uno, los cuales fueron comparados con un grupo control con la misma cantidad de pacientes, pero con tratamiento farmacológico. Se obtuvo que los tratados con acupuntura mejoraron en menor tiempo, en particular los del grupo 2, de donde se infiere que esta técnica resultó eficaz para aliviar el dolor lumbar en quienes se aplicó, a la vez que permitió a los enfermos reducir el período de tratamiento, ahorrar medicamentos y lograr una rápida reincorporación a la vida laboral y social.

Características in vivo del epitelio corneal versus magnitud del defecto refractivo, posterior a tratamiento con láser de excímeros

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Eduardo Rojas Álvarez

Full Text Available Objetivo: describir las características in vivo del epitelio corneal y su relación con la magnitud del defecto refractivo tratado posterior al tratamiento quirúrgico de LASIK. Método: estudio descriptivo, prospectivo-longitudinal con 24 pacientes (48 ojos con astigmatismo miópico intervenidos con el ESIRIS (Schwind-Alemania por la técnica quirúrgica LASIK con microquerátomo pendular. Se analizaron los resultados a partir de técnicas de estadística descriptiva. Se utilizó el microscopio confocal ConfoScan 4 de NIDEK para la obtención y estudio de las imágenes in vivo de tejido corneal. Resultados: el grosor epitelial central medio en el preoperatorio fue 34,7 mm, a los 7 días del posoperatorio hubo un incremento del 36 % en pacientes con defectos refractivos inferiores a 4D y un incremento del 44 % en pacientes con defectos refractivos de 4 D o más. El promedio de densidad de células del epitelio basal a los 7 días fue de 5 098,3±1 654 células/mm², tuvo variaciones mínimas inferiores a la unidad porcentual durante la etapa de estudio. Conclusiones: existió incremento del grosor epitelial posterior a LASIK que fue superior en defectos refractivos mayores de 4 dioptrías. La densidad celular del epitelio basal no tuvo variaciones significativas y fue independiente a la magnitud del defecto refractivo tratado.

Linfangioma cervical: manejo terapéutico con OK-432 (Picibanil Cervical lymphangioma: therapeutic management with OK-432 (Picibanil

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E. Valle Rodríguez

2007-12-01

Full Text Available Introducción: El linfangioma es una malformación del sistema linfático. El abordaje clásico ha sido la cirugía. El OK-432 (Picibanil tiene acción esclerosante y se está utilizando cómo primer escalón terapéutico. El objetivo es aportar un nuevo caso de linfangioma tratado con OK-432 y hacer una revisión de la literatura. Material y método: Aportamos un varón de 16 años con un linfangioma cervical macroquístico de 10 x 6 cm tratado con una dosis de OK-432. Resultados: A las 16 semanas del tratamiento, el tamaño del linfangioma era de 6 x 2 cm, siendo clínicamente inapreciable. Discusión: El tratamiento con OK-432 tiene una alta tasa de curación, con una baja tasa de recidiva y una fibrosis circunscrita a la lesión. En relación con la cirugía, se evitan cicatrices y posibles lesiones de estructuras vitales.Introduction: Lymphangioma is a malformation of the lymphatic system. The classic approach is surgery. OK-432 (Picibanil has sclerosing action and is being used as the first therapeutic step. The objective was to report a new case of lymphangioma treated with OK-432 and to review the literature. Material and method: We report the case of a 16-year-old man with a 10x6-cm macrocystic cervical lymphangioma treated with a dose of OK-432. Results: At 16 weeks of treatment, the size of the lymphangioma was 6x2 cm and it was clinically unappreciable. Discussion: OK-432 treatment has a high cure rate, low recurrence rate, and fibrosis circumscribed to the lesion. Compared to surgery, scars and possible harm to vital structures are avoided.

LA RELACIÓN ENTRE TRATADOS DE INVERSIÓN Y CONVENIOS DE DOBLE TRIBUTACIÓN: el caso chileno

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Rodrigo Polanco Lazo

Full Text Available El presente artículo examina las relaciones entre los tratados de inversión y los tratados de doble tributación, considerando que, en la actual evolución de ambos tipos de acuerdos, sus disposiciones pueden presentar superposiciones en aspectos tales como estándares de protección, transparencia, trato nacional, cláusula de la nación más favorecida, expropiación y transferencias de capital. Tomando el ejemplo de los tratados suscritos por Chile, en este trabajo se examinan las consecuencias de las trasposiciones de ambos acuerdos, desde el punto de vista de sus mecanismos de solución de controversias, como en lo referido a los conflictos de jerarquía normativa entre esos dos tipos de tratados. Asimismo, se efectúa un análisis sobre iniciativas de tipo multilateral que afectan a ambas categorías de acuerdos como el Base Erosion and Profit Shifting (BEPS.

Advances in imaging to allow personalized medicine in Crohn's disease.

Science.gov (United States)

Neurath, Markus F

2015-08-01

Crohn's disease is a destructive inflammatory bowel disease of unknown origin that may lead to various complications such as strictures, stenosis, fistulas and colitis-associated neoplasias. However, the course of the disease varies substantially among patients and disease behaviour may also change with time. At diagnosis behaviour is inflammatory in the majority of patients, while penetrating or structuring behaviour become more prominent at later time points. Thus, medication in Crohn's disease needs frequent optimization over time. Therefore, new strategies for prediction of response to therapy are urgently needed. Here, recent advantages in imaging techniques for personalized medicine in Crohn's disease are reviewed. Such advantages include ultrasonography, computed tomography, magnetic resonance imaging and new endoscopic approaches such as molecular endoscopy. It is expected that these novel techniques will lead to marked improvements in the assessment of disease behaviour and the prediction of response to clinical therapy with biologicals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Vedolizumab as a Treatment for Crohn's Disease and Ulcerative Colitis.

Science.gov (United States)

Ha, Christina; Kornbluth, Asher

2014-12-01

The management of Crohn's disease and ulcerative colitis has become increasingly complex. With the current utilization of immunosuppressive therapies earlier in the disease course for patients presenting with moderate to severe disease, there is a great need for additional biologic agents targeting inflammatory mediators other than anti-tumor necrosis factor-α (anti-TNF) agents. Although anti-TNF agents have positively impacted the treatment of inflammatory bowel disease, many patients can lose their response or develop intolerance to these agents over time through the formation of antidrug antibodies. Furthermore, a sizeable percentage of patients are primary nonresponders to anti-TNF drugs. Vedolizumab (Entyvio, Takeda Pharmaceuticals), a monoclonal antibody to the α4β7 integrin, inhibits gut lymphocyte trafficking and has been demonstrated to be an effective and safe agent for the treatment of both Crohn's disease and ulcerative colitis. This article reviews the clinical trial evidence and rationale for the use of vedolizumab in moderate to severe Crohn's disease and ulcerative colitis.

Inherited determinants of Crohn's disease and ulcerative colitis phenotypes: a genetic association study.

Science.gov (United States)

Cleynen, Isabelle; Boucher, Gabrielle; Jostins, Luke; Schumm, L Philip; Zeissig, Sebastian; Ahmad, Tariq; Andersen, Vibeke; Andrews, Jane M; Annese, Vito; Brand, Stephan; Brant, Steven R; Cho, Judy H; Daly, Mark J; Dubinsky, Marla; Duerr, Richard H; Ferguson, Lynnette R; Franke, Andre; Gearry, Richard B; Goyette, Philippe; Hakonarson, Hakon; Halfvarson, Jonas; Hov, Johannes R; Huang, Hailang; Kennedy, Nicholas A; Kupcinskas, Limas; Lawrance, Ian C; Lee, James C; Satsangi, Jack; Schreiber, Stephan; Théâtre, Emilie; van der Meulen-de Jong, Andrea E; Weersma, Rinse K; Wilson, David C; Parkes, Miles; Vermeire, Severine; Rioux, John D; Mansfield, John; Silverberg, Mark S; Radford-Smith, Graham; McGovern, Dermot P B; Barrett, Jeffrey C; Lees, Charlie W

2016-01-09

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. 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-phenotype associations across 156,154 genetic variants. We generated genetic risk scores by combining information from all known inflammatory bowel disease associations to summarise the total load of genetic risk for a particular phenotype. We used these risk scores to test the hypothesis that colonic Crohn's disease, ileal Crohn's disease, and ulcerative colitis are all genetically distinct from each other, and to attempt to identify patients with a mismatch between clinical diagnosis and genetic risk profile. After quality control, the primary analysis included 29,838 patients (16,902 with Crohn's disease, 12,597 with ulcerative colitis). Three loci (NOD2, MHC, and MST1 3p21) were associated with subphenotypes of inflammatory bowel disease, mainly disease location (essentially fixed over time; median follow-up of 10·5 years). Little or no genetic association with disease behaviour (which changed dramatically over time) remained after conditioning on disease location and age at onset. The genetic risk score representing all known risk alleles for inflammatory bowel disease showed strong association with

La inclusión en las clases de educación física con juegos sensibilizadores

OpenAIRE

Navarro Pérez, Micaela E.

2017-01-01

[58 p.] il. 1 CD La presente Investigación se dispone a fin de mejorar la inclusión de niños con discapacidad, en grados de escuelas comunes, trabajando directamente sobre los niños convencionales de la clase; a través de los Juegos Sensibilizadores. La misma se encuentra enmarcada dentro del tipo de investigación básica descriptiva, debido a que el tema tratado está sustentado por un marco teórico, y se caracteriza por la situación real de trabajo con los niños convencionales. Esta ...

Valor nutritivo y utilización para producción de leche del bagazo de alfalfa ensilado con diferentes aditivos

OpenAIRE

Gonzalez, V.; Fernández, E.; González, G.; Remón, J.

2011-01-01

Mediante pruebas de ingestión, digestibilidad de la materia orgánica (DMO) y lactación se ha estudiado el valor nutritivo del bagazo de alfalfa ensilado sin aditivos (BST), tratado con ácido fórmico (BF) y con formaldehído-sulfúrico (BFS). En la prueba de lactación el bagazo de alfalfa se comparó con heno de alfalfa de calidad media.La ingestión de MO en corderos fue mayor para los bagazos BFS y BF, un 16,4 y 9,3 % respectivamente, que la de BST. La DMO fue 54,4; 60,7 y 61,8 % para BST, BF y ...

Modelo conceptual de datos difusos de triaje para emergencia hospitalaria representado con FuzzyEER

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Wuilfredo Rangel

2010-05-01

Full Text Available El triaje de emergencia persigue desarrollar el proceso de valorización clínica preliminar para ordenar los pacientes según el nivel de urgencia o gravedad, antes de la atención médica, de forma que en una condición de saturación del servicio o disminución de recursos, los pacientes más graves sean tratados con prioridad. Un proceso de triaje presenta un alto grado de imprecisión o incertidumbre al momento de expresar el estado de salud de un paciente, en consecuencia puede haber dificultad y riesgo en la clasificación de las urgencias. En los servicios de emergencias de loshospitales públicos venezolanos, en especial el servicio de emergencia del Hospital Universitario de Caracas (HUC, seha evidenciado un incremento en el número de casos que se atienden, siendo una constante la saturación del servicio, lo cual imposibilita que los pacientes con prioridad de atención, sean tratados más rápidamente de forma oportuna y eficaz. En este trabajo se propone un modelo conceptual de datos difuso de triaje para el sector salud venezolano basado en el proceso de triaje hospitalario de la Sociedad Venezolana de Medicina de Emergencia y Desastres (SVMED, ya que un modelo de datos que contemple la representación de atributos difusos puede representar de mejor forma los requerimientos del sistema. El modelo propuesto utiliza la notación Entidad Relación con elementos difusos (FuzzyEER para la representación de las entidades y atributos con imprecisión. Dicho modelo será la base de un sistema automatizado de triaje que hará uso del lenguaje de consultas difusas FSQL (Fuzzy SQL.

Evaluación de una crema dental con extracto de cuproclorofila

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Estela Gispert Abreu

2001-12-01

Full Text Available Se evaluó el efecto del cepillado con crema dental que contiene extracto de cuproclorofila en 23 niños de 10 años (otros 23 niños se tomaron como control. Se observaron reducciones significativas según chi cuadrado en cuanto a la infección por Streptococcus mutans, la acumulación de placa dentobacteriana y en la inflamación gingival del grupo tratado con respecto al control.The effect of tooth brushing with a dentrifice containing cuprochlorophyll extract in 23 children aged 10 (other 23 were selected as controls was evaluated. Significant reductions were observed according to Chi square test as regards the infection caused by Streptococcus mutans, the accumulation of bacterial plaque and the gingival inflammation of the group treated compared with the controls.

Búsquedas web con información de contexto y anotaciones sociales

OpenAIRE

Tolosa, Gabriel Hernán; Bordignon, Fernando Raúl Alfredo

2008-01-01

Una de las tareas más comunes que realizan los usuarios en la Web es la búsqueda de información utilizando motores de búsqueda tradicionales. Generalmente, éstas se basan en un conjunto de términos que son tratados fuera de contexto alguno. La incorporación de información contextual permite obtener resultados más precisos y puede ser presentada al sistema de formas diferentes. Una fuente posible son los sistemas basados en “anotaciones sociales”, los cuales se enriquecen con la participación ...

Effect of childbirth on the course of Crohn's disease; results from a retrospective cohort study in the Netherlands

NARCIS (Netherlands)

Smink, M.; Lotgering, F.K.; Albers, L.; Jong, D.J. de

2011-01-01

BACKGROUND: Pregnant women with Crohn's disease needs proper counselling about the effect of pregnancy and childbirth on their disease. However, Literature about the effect of childbirth on Crohn's disease is limited. This study examined the effect of childbirth on the course of Crohn's disease and

Quality of Life in Crohn's Disease

Czech Academy of Sciences Publication Activity Database

Gabalec, L.; Bureš, J.; Šedová, Michaela; Valenta, Zdeněk

2007-01-01

Roč. 56, Suppl. 3 (2007), A138-A138 ISSN 0017-5749. [United European Gastroenterology Week /15./. 27.10.2007-31.10.2007, Paris] Institutional research plan: CEZ:AV0Z10300504 Keywords : quality of life * Crohn´s disease * inflammatory bowel disease Subject RIV: BB - Applied Statistics, Operational Research

Perfil lipídico sérico de ratos tratados com surfactante

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Karina Ferreira de Castro

2012-06-01

Full Text Available A aterosclerose é uma doença multifatorial, lenta e progressiva e a hiperlipidemia um dos fatores potenciais no desenvolvimento de doenças cardíacas ateroscleróticas. As vantagens da indução das dislipidemias experimentais são a produção de lesões ateromatosas em curto espaço de tempo; adequado controle dietético e fatores ambientais; a possibilidade de estudos sobre a reversibilidade de lesões ateroscleróticas e ensaios pré-clínicos de substâncias hipolipidêmicas. Este estudo visou avaliar o perfil lipídico sérico de ratos tratados com surfactante. Foram utilizados 28 ratos Wistar, machos, albinos, adultos e hígidos. Estes foram distribuídos em quatro grupos experimentais formados por sete animais cada, a saber: Grupo I – (controle; Grupo II – tratado com tyloxapol, na dose de 500 mg/kg de peso corporal, via intraperitoneal a cada 48 horas, durante duas semanas; Grupo III – tratado com tyloxapol na dose de 500 mg/kg de peso corporal, via intraperitoneal a cada 48 horas, durante três semanas; Grupo IV – tratado com tyloxapol na dose de 500 mg/kg de peso corporal, via intraperitoneal a cada 48 horas, durante quatro semanas. Na avaliação do perfil lipídico, os valores de triacilgliceróis e HDL demonstraram que o grupo III diferiu significativamente do grupo I e os valores de colesterol total e LDL indicaram que o grupo I diferiu significativamente dos grupos II, III e IV. Conclui-se que o surfactante tyloxapol foi efetivo na indução da hiperlipidemia.

Análisis jurídico en relación con la aplicación provisional de tratados en Colombia. Una perspectiva de derecho internacional y nacional

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Juan Camilo Rojas-Arias

2015-01-01

Full Text Available Este trabajo discute, desde una perspectiva del derecho internacional y del derecho constitucional, la prerrogativa del Gobierno de Colombia de aplicar provisionalmente un tratado en cumplimiento de las disposiciones legales sobre la materia. Este análisis teórico y práctico, busca examinar los criterios de aplicación de la precitada figura a fin de presentar algunas conclusiones al respecto.

Fracturas de clavícula. Tratamiento quirúrgico con clavos intramedulares flexibles

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Roberto Joaquín Del Gordo D'amato

2014-05-01

Full Text Available Se realizó un estudio de tipo descriptivo en una serie de casos en el cual se presentan los resultados de 12 fracturas de clavícula tratadas en forma quirúrgica mediante clavos intramedulares flexibles. Todos los pacientes fueron tratados por los autores en la Clínica El Prado del D.T.C.H. de la Ciudad de Santa Marta mediante reducción cerrada bajo control radioscópico. Presentando resultados excelentes y buenos en todos los casos. Así mismo, se evidenció consolidación clínica a las cuatro semanas con reintegro a la vida laboral alrededor de las seis semanas. Todos los pacientes mostraron alto grado de satisfacción con el resultado obtenido. Se concluye que el tratamiento empleado es una alternativa terapéutica a tener en cuenta en aquellas fracturas desplazadas, sean estas del tercio externo, medio o interno que permite consolidación sin las complicaciones que con alguna frecuencia se presentan con el tratamiento conservador. (Duazary 2006; 2:115-120

¿Es la resistencia de Mycobacterium leprae a los medicamentos un verdadero motivo de preocupación? Primera aproximación a la vigilancia molecular de pacientes colombianos multibacilares con tratamiento previo para lepra y sin él

Directory of Open Access Journals (Sweden)

Martha Inírida Guerrero

2014-04-01

Full Text Available Introducción. Colombia no dispone de información sobre farmacorresistencia primaria y secundaria de Mycobacterium leprae al esquema de terapia múltiple de la Organización Mundial de la Salud (OMS y las autoridades de salud pública del mundo han emitido varias recomendaciones, entre las cuales está organizar de inmediato la vigilancia a la resistencia empleando métodos moleculares simples. Objetivo. Determinar la prevalencia de la resistencia de M. leprae a rifampicina, ofloxacina y dapsona en pacientes del Centro Dermatológico Federico Lleras Acosta con tratamiento previo y sin él durante el período de 1985 a 2004. Materiales y métodos. Se realizó un estudio retrospectivo. Mediante muestreo electivo se incluyeron biopsias de pacientes multibacilares: 381 de pacientes nuevos y 560 de pacientes previamente tratados. Se obtuvieron con micrótomo seis cortes de cada biopsia de piel incluida en parafina, y se realizó la extracción de ADN de M. leprae. Se llevó a cabo la amplificación de tres blancos moleculares mediante PCR y se obtuvieron los patrones de resistencia a los medicamentos dapsona, rifampicina y ofloxacina por hibridación inversa. Se recolectaron datos epidemiológicos, clínicos y demográficos para llevar a cabo los análisis. Resultados. De las 941 muestras estudiadas, 4,14 % era resistente a uno o más fármacos, y se detectaron 5,77 y 3,04 % con genotipos resistentes en pacientes nuevos y previamente tratados, respectivamente. La resistencia total para cada fármaco fue de 0,43 % a dapsona, 3,19 % a rifampicina y 1,17 % a ofloxacina. Se encontró una diferencia estadísticamente significativa para rifampicina y para la población total al comparar los resultados de los pacientes no tratados con los de los pacientes tratados previamente. Dos tercios de las muestras resistentes lo fueron a rifampicina sola o combinada. Conclusiones. Los esquemas de terapia múltiple estándar siguen siendo efectivos para los casos de

ORAL MANIFESTATIONS OF CROHN'S DISEASE: A CASE REPORT

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Muhvić-Urek Miranda

2015-12-01

Full Text Available Crohn´s disease is a chronic inflammatory bowel disease still with unknown etiology. In 0.5-20 % of patients, extraintestinal lesions in the oral cavity can be presented in forms of orofacial granulomatosis, cobblestone and corrugated oral mucosa, mucosal tags, deep linear ulcerations with hyperplastic folds, pyostomatits vegetans, aphthous ulcers, angular cheilitis, labial/facial edema and gingival erythema/edema. We describe a case of a 28-year-old male who was presented with oral lesions of Crohn´s disease and treatment procedure. The patient was candidate for biologic treatment so dental procedures and preparation of the patient for treatment are described. Good communication and cooperation between the patient's doctor and dentist are important for successful treatment.

B-Cell Dysregulation in Crohn's Disease Is Partially Restored with Infliximab Therapy.

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Wilhelmina M C Timmermans

Full Text Available B-cell depletion can improve a variety of chronic inflammatory diseases, but does not appear beneficial for patients with Crohn's disease.To elucidate the involvement of B cells in Crohn's disease, we here performed an 'in depth' analysis of intestinal and blood B-cells in this chronic inflammatory disease.Patients with Crohn's disease were recruited to study B-cell infiltrates in intestinal biopsies (n = 5, serum immunoglobulin levels and the phenotype and molecular characteristics of blood B-cell subsets (n = 21. The effects of infliximab treatment were studied in 9 patients.Granulomatous tissue showed infiltrates of B lymphocytes rather than Ig-secreting plasma cells. Circulating transitional B cells and CD21low B cells were elevated. IgM memory B cells were reduced and natural effector cells showed decreased replication histories and somatic hypermutation (SHM levels. In contrast, IgG and IgA memory B cells were normally present and their Ig gene transcripts carried increased SHM levels. The numbers of transitional and natural effector cells were normal in patients who responded clinically well to infliximab.B cells in patients with Crohn's disease showed signs of chronic stimulation with localization to granulomatous tissue and increased molecular maturation of IgA and IgG. Therapy with TNFα-blockers restored the defect in IgM memory B-cell generation and normalized transitional B-cell levels, making these subsets candidate markers for treatment monitoring. Together, these results suggest a chronic, aberrant B-cell response in patients with Crohn's disease, which could be targeted with new therapeutics that specifically regulate B-cell function.

Indirect costs of inflammatory bowel diseases: Crohn's disease and ulcerative colitis. A systematic review.

Science.gov (United States)

Kawalec, Paweł

2016-04-01

Crohn's disease and ulcerative colitis are lifelong illnesses which have a significant impact on quality of life and personal burden through a reduction in the ability to work, sick leave and restrictions of leisure time. The aim of this study was to conduct a systematic review of the indirect costs of Crohn's disease and ulcerative colitis. The search was carried out in Medline, EMBASE, the Centre for Reviews and Dissemination, and reference lists of identified articles and reference lists of identified articles were also handsearched. All costs were adjusted to 2013 USD values by using the consumer price index and purchasing power parity. Identified studies were then analysed in order to assess their heterogeneity and possibility of inclusion in the meta-analysis. Eleven of the identified publications presented indirect costs of Crohn's disease or ulcerative colitis. The range of estimated yearly indirect costs per patient was large, from $1 159.09 for loss of earnings to $14 135.64 for lost productivity and sick leave for Crohn's disease. The values for ulcerative colitis ranged from $926.49 to $6 583.17. Because of the imprecise definition of methods of indirect cost calculations as well as heterogeneity of indirect cost components, a meta-analysis was not performed. The indirect costs of ulcerative colitis seem to be slightly lower than in the case of Crohn's disease. A small number of studies referring to indirect costs of Crohn's disease and ulcerative colitis were identified, which indicates the need to conduct further investigations on this problem.

A rare complication of CMV infection in Crohn's disease - hemophagocytic syndrome: a case report.

Science.gov (United States)

Pop, Corina Silvia; Becheanu, Gabriel; Calagiu, Dorina; Jantea, Petruţa-Violeta; Rădulescu, Dragoş Mihai; Pariza, George; Mavrodin, Carmen-Iuliana; Bold, Adriana; Costache, Adrian; Nemeş, Roxana Maria

2015-01-01

We report a case of CMV (cytomegalovirus) infection in a Crohn's disease patient, resulting in severe hemophagocytic syndrome and death. A 63-year-old man with a 10-year history of ileal and colonic Crohn's disease presented with general malaise, loss of appetite and weight loss over the last month. He was in clinical remission for two years, with maintenance therapy 5-Aminosalicylic acid (5-ASA)-derived Mesalamine. The patient had no prior immunomodulators or suppressive treatment. A colonoscopy was performed and we found appearance suggestive of active Crohn's disease, confirmed by histopathological examination. A diagnosis of an exacerbation of Crohn's disease was established. Although the specific treatment was initiated, patient's general condition degraded progressively and diarrheal stools appeared, followed by an episode of massive gastrointestinal bleeding - hematochezia. We performed a new colonoscopy and the pathological examination revealed Crohn's ileocolitis with superimposed CMV infection. Despite the initiation of Ganciclovir alongside with other intensive care measures, he increasingly deteriorated and chest X-ray confirmed multilobar pneumonia. The occurrence of rapidly progressing pancytopenia and evidence for disseminated intravascular coagulopathy as well as hyperferritinemia, raised the suspicion of hemophagocytic syndrome confirmed by bone marrow aspiration. Hence, CMV-associated hemophagocytic syndrome in the context of recent corticotherapy for Crohn's disease was established. There is enough evidence that supports the gravity of the CMV infection in the case of inflammatory bowel disease (IBD) patients, especially the ones on immunomodulator treatment. The hemophagocytic syndrome reactively occurs in patients with infections in cases of immunodeficiency, displaying a hematological aspect of multiple organ dysfunction syndrome.

Simultaneous central retinal artery occlusion and optic nerve vasculitis in Crohn disease

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Razek Georges Coussa

2017-04-01

Conclusions and importance: To our knowledge, this is the first case of unilateral CRAO and bilateral optic nerve occlusive vasculitis in Crohn disease, which should be considered as an etiology of retinal vascular occlusive disorders especially in young patients. It is important for ophthalmologists to be aware of the ophthalmic risks associated with Crohn disease as aggressive treatment with systemic steroids and immunosuppressive agents is often needed.

Mycobacterium avium subsp. Paratuberculosis (MAP) as a modifying factor in Crohn's disease.

LENUS (Irish Health Repository)

Sibartie, Shomik

2010-02-01

Crohn\\'s disease (CD) is a multifactorial syndrome with genetic and environmental contributions. Mycobacterium avium subspecies paratuberculosis (MAP) has been frequently isolated from mucosal tissues of patients with CD but the cellular immune response to this bacterium has been poorly described. Our aim was to examine the influence of MAP on T-cell proliferation and cytokine responses in patients with inflammatory bowel disease (IBD).

Tiempo de excreción de Vibrio cholerae O1 en pacientes con tratamiento

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Elizabeth Castañeda

1992-12-01

Full Text Available El tiempo de excreción del Vibrio cholerae O1 en pacientes con cólera está influenciado por el tratamiento antimicrobiano. Se determinó en un grupo de pacientes con diagnóstico bacteriológico de cólera, que empezaron a recibir tratamiento con antibióticos una vez establecido el diagnóstico clínico, el tiempo de excreción del V. cholerae O1 empleando muestras de materia fecal obtenidas dentro de los cinco días siguientes al diagnóstico clínico inicial. En las 32 muestras obtenidas en ese período de cinco días el porcentaje de negativos fue del 81,2% (26/ 32; en 21 muestras obtenidas 24 horas después de haberse establecido el diagnóstico, se observó negativización en el 81% (17/21. Con nuestros datos podemos confirmar, al compararlos con los datos de la literatura en pacientes no tratados, que el tratamiento acorta el periodo de excreción del V. cholerae O1.

Risk of early surgery for Crohn's disease: implications for early treatment strategies.

Science.gov (United States)

Sands, Bruce E; Arsenault, Joanne E; Rosen, Michael J; Alsahli, Mazen; Bailen, Laurence; Banks, Peter; Bensen, Steven; Bousvaros, Athos; Cave, David; Cooley, Jeffrey S; Cooper, Herbert L; Edwards, Susan T; Farrell, Richard J; Griffin, Michael J; Hay, David W; John, Alex; Lidofsky, Sheldon; Olans, Lori B; Peppercorn, Mark A; Rothstein, Richard I; Roy, Michael A; Saletta, Michael J; Shah, Samir A; Warner, Andrew S; Wolf, Jacqueline L; Vecchio, James; Winter, Harland S; Zawacki, John K

2003-12-01

In this study we aimed to define the rate of early surgery for Crohn's disease and to identify risk factors associated with early surgery as a basis for subsequent studies of early intervention in Crohn's disease. We assembled a retrospective cohort of patients with Crohn's disease diagnosed between 1991 and 1997 and followed for at least 3 yr, who were identified in 16 community and referral-based practices in New England. Chart review was performed for each patient. Details of baseline demographic and disease features were recorded. Surgical history including date of surgery, indication, and procedure were also noted. Risk factors for early surgery (defined as major surgery for Crohn's disease within 3 yr of diagnosis, exclusive of major surgery at time of diagnosis) were identified by univariate analysis. Multiple logistic regression was used to identify independent risk factors. Of 345 eligible patients, 69 (20.1%) required surgery within 3 yr of diagnosis, excluding the 14 patients (4.1%) who had major surgery at the time of diagnosis. Overall, the interval between diagnosis and surgery was short; one half of all patients who required surgery underwent operation within 6 months of diagnosis. Risk factors identified by univariate analysis as significantly associated with early surgery included the following: smoking; disease of small bowel without colonic involvement; nausea and vomiting or abdominal pain on presentation; neutrophil count; and steroid use in the first 6 months. Disease localized to the colon only, blood in the stool, use of 5-aminosalicylate, and lymphocyte count were inversely associated with risk of early surgery. Logistic regression confirmed independent associations with smoking as a positive risk factor and involvement of colon without small bowel as a negative risk factor for early surgery. The rate of surgery is high in the first 3 yr after diagnosis of Crohn's disease, particularly in the first 6 months. These results suggest that

Evaluación de ansiedad y frecuencia cardíaca: ensayo clínico aleatorizado de la remoción químico-mecánica de caries con papacárieDuoTM. Proyecto piloto

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Elisa-Lopes-Craveiro

2013-01-01

Full Text Available Objetivo: Evaluar el grado de ansiedad y frecuencia cardíaca en pacientes infantiles sometidos a tratamiento con PapacárieDuoTM, comparado a un grupo control con el uso del método tradicional (fresa. Métodos: Se desarrolló un ensayo clínico aleatorizado en 7 pacientes infantiles (5 a 11 años. Fueron tratados 2 molares deciduos en cada niño, realizando la aleatorización para los dos grupos (G1= remoción químico-mecánica de la caries con Papacárie DuoTM; G2= remoción de la dentina cariada utilizando fresa con baja velocidad, realizando un procedimiento restaurador similar en ambos (cemento de ionómero de vidrio y control. Se evaluó el tiempo de duración del procedimiento, ansiedad y frecuencia cardíaca. Los datos fueron tabulados con el programa SPSS para Windows (v.17 y analizados estadísticamente mediante el Test Wilcoxon, para los resultados del test VPT; el Test t pareado, para la frecuencia cardíaca, y el Test t para el tiempo de tratamiento, considerándose el nivel de significancia de 5%. Resultados: La media del tiempo para el G1 fue menor (p<0.001, así como la frecuencia cardíaca en el mismo grupo luego de finalizado el tratamiento (p=0.042. No hubo diferencia estadística en las reacciones emocionales antes (p=0.317, durante (p=0.355 y después (p=0.564 de los procedimientos. Conclusión: El tiempo operatorio y la frecuencia cardíaca fueron menores en los niños tratados con el Papacárie DuoTM al ser comparados con los que fueron tratados con tratamiento convencional. Estos hallazgos demuestran las ventajas de los tratamientos conservadores en dientes deciduos.

Respuesta clínica en pacientes mexicanos con síndrome de intestino irritable tratados con dieta baja en carbohidratos fermentables (FODMAP

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N. Pérez y López

2015-07-01

Conclusiones: En este primer estudio en población mexicana con SII se observó mejoría significativa de los principales síntomas incluyendo dolor, distensión y flatulencia tras una dieta baja FODMAP.

COMPORTAMIENTO DE UN MATERIAL GRANULAR NO TRATADO EN ENSAYOS TRIAXIALES CÍCLICOS CON PRESIÓN DE CONFINAMIENTO CONSTANTE Y VARIABLE BEHAVIOR OF AN UNBOUND GRANULAR MATERIAL IN CYCLIC TRIAXIAL TESTS WITH CONSTANT AND VARIABLE CONFINING PRESSURE

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Hugo Alexander Rondón Quintana

2008-12-01

Full Text Available En un pavimento, cada una de las capas de la estructura experimenta bajo una carga vehicular ciclos de esfuerzo con componentes vertical, horizontal y de corte. Para el estudio de materiales granulares no tratados (utilizados para conformar capas de base y subbase, la mayor parte de las investigaciones se realizan empleando equipos triaxiales cíclicos en donde sólo la carga vertical es cíclica y la presión de confinamiento permanece constante durante el ensayo. Un ensayo que reproduce mejor la forma como se distribuyen los esfuerzos en estas capas es el ensayo triaxial cíclico con presión de confinamiento variable. En este ensayo se pueden modelar las componentes cíclicas tanto en el sentido vertical como horizontal. A pesar que son ensayos distintos, la ingeniería de pavimentos supone que la respuesta que experimentan estos materiales en estos ensayos es similar, lo anterior basado en algunos estudios realizados en la década de los setenta. En la presente investigación se diseña y desarrolla un programa experimental más detallado, para comparar el comportamiento que desarrolla un material granular no tratado en estos ensayos. De los resultados se evidencia que sólo para algunas trayectorias de esfuerzo, la dirección y la acumulación de la deformación vertical y volumétrica es similar.In a pavement structure, passing wheel loads impose cyclic stresses consisting of vertical, horizontal and shear components. Studies of the behavior of unbound granular materials (UGM, used for base and sub-base layers under cyclic loading are mostly performed using the axisymmetric triaxial test with constant confining pressure (CCP test and a cyclic variation of the axial stress. However, in this type of test only the vertical component of the cyclic stress path is considered. The oscillation of the horizontal stress can be reproduced by an additional cyclic variation of the confining pressure (VCP test. CCP and VCP tests are sometimes assumed to

Evolución clínica de pacientes asmáticos tratados con inmunoterapia. Municipio Majibacoa, 2008-2013

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Mailin Molina Leyva

2015-11-01

Full Text Available Se realizó un estudio cuasi-experimental de corte longitudinal en 50 pacientes asmáticos con edades  entre 5 y 54 años, atendidos en el Servicio de Alergología del municipio Majibacoa de la provincia de Las Tunas; con el objetivo de determinar la evolución clínica con inmunoterapia, en el período de enero 2008 a febrero de 2013. A los pacientes se les administró inmunoterapia específica de ácaros con extractos estandarizados, durante tres años o más de forma subcutánea. El asma bronquial predominó en el sexo femenino y en las edades comprendidas entre 5 y 14 años. Los antecedentes de atopia familiar fueron referidos por el mayor por ciento de los pacientes analizados. Según severidad de la enfermedad, antes del tratamiento prevalecieron los pacientes en la categoría persistente moderada. Se observó mejoría de los síntomas del asma en una elevada proporción de casos.

Onercept for moderate-to-severe Crohn's disease

DEFF Research Database (Denmark)

Rutgeerts, Paul; Sandborn, William J; Fedorak, Richard N

2006-01-01

BACKGROUND AND AIMS: Onercept is a recombinant, soluble human p55 receptor to tumor necrosis factor-alpha. METHODS: A randomized, double-blind, placebo-controlled, dose-ranging trial was performed to evaluate the efficacy of onercept induction therapy in patients with Crohn's disease (CD). Patien...

Muramyl dipeptide responsive pathways in Crohn's disease

DEFF Research Database (Denmark)

Salem, Mohammad; Seidelin, Jakob Benedict; Rogler, Gerhard

2012-01-01

Crohn's disease (CD) is one of main disease entities under the umbrella term chronic inflammatory bowel disease. The etiology of CD involves alterations in genetic, microbiological, and immunological factors. This review is devoted to the role of the bacterial wall compound muramyl dipeptide (MDP...

Realización y corrección automática de exámenes con hoja de cálculo

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Sánchez García, Juan Francisco

2007-01-01

Full Text Available La forma habitual de realizar exámenes de tipo test es mediante formularios en papel que posteriormente son tratados con un escáner y un software específico que facilita la corrección así como la emisión de informes y la exportación de datos a aplicaciones de hoja de cálculo. En las asignaturas de informática de gestión llama la atención que en algunos casos se hace evaluación de términos informáticos y utilización de aplicaciones informáticas sobre papel, cuando el hacerlo directamente sobre el ordenador permitiría además comprobar los conocimientos prácticos del alumno.Con la idea de facilitar al alumno la cumplimentación de este tipo de exámenes hemos desarrollado una metodología propia utilizando la hoja de cálculo Microsoft Excel. De esta forma el formulario de examen se sustituye por un fichero de hoja de cálculo que posteriormente será tratado para obtener los resultados contenido en el mismo y facilitar su corrección, la cual también se efectuará con la propia hoja de cálculo, utilizando programación en Visual Basic para Aplicaciones (VBA.

Histologic scoring indices for evaluation of disease activity in Crohn's disease.

Science.gov (United States)

Novak, Gregor; Parker, Claire E; Pai, Rish K; MacDonald, John K; Feagan, Brian G; Sandborn, William J; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

2017-07-21

Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and operating characteristics of available histologic disease activity indices in Crohn's disease. Electronic searches of MEDLINE, EMBASE, PubMed, and the Cochrane Library (CENTRAL) databases from inception to 20 July 2016 were supplemented by manual reviews of bibliographies and abstracts submitted to major gastroenterology meetings (Digestive Disease Week, United European Gastroenterology Week, European Crohn's and Colitis Organisation). Any study design (e.g. randomised controlled trial, cohort study, case series) that evaluated a histologic disease activity index in patients with Crohn's disease was considered for inclusion. Study participants included adult patients (> 16 years), diagnosed with Crohn's disease using conventional clinical, radiographic or endoscopic criteria. Two authors independently reviewed the titles and abstracts of the studies identified from the literature search. The full text of potentially relevant citations were reviewed for inclusion and the study investigators were contacted as needed for clarification. Any disagreements regarding study eligibility were resolved by discussion and consensus with a third author.Two authors independently extracted and recorded data using a standard form. The following data were recorded from each eligible study: number of patients enrolled; number of patients per treatment arm; patient characteristics: age and gender distribution; description of histologic disease activity index utilized; and outcomes such as content validity, construct validity, criterion validity, responsiveness, intra-rater reliability, inter-rater reliability, and feasibility. Sixteen reports of 14 studies describing 14 different numerical

Identifying decreased peristalsis of abnormal small bowel segments in Crohn's disease using cine MR enterography: the frozen bowel sign.

Science.gov (United States)

Guglielmo, Flavius F; Mitchell, Donald G; O'Kane, Patrick L; Deshmukh, Sandeep P; Roth, Christopher G; Burach, Ilene; Burns, Aaron; Dulka, Susan; Parker, Laurence

2015-06-01

The purpose of this study was to evaluate whether affected bowel in Crohn's disease patients can be identified by observing decreased peristalsis (frozen bowel sign) using cine balanced steady-state free precession (cine BSSFP) images. 5 radiologists independently reviewed cine BSSFP sequences from randomized MR Enterography (MRE) exams for 30 normal and 30 Crohn's disease patients, graded overall small bowel peristalsis from slowest to fastest, and graded peristalsis for the most abnormal small bowel segment. Sensitivity and specificity of the frozen bowel sign for diagnosing Crohn's disease were calculated. T tests of the peristalsis difference between abnormal segments and overall small bowel were conducted. For 5 readers, the sensitivity and specificity of cine BSSFP of the frozen bowel sign for diagnosing Crohn's disease ranged from 70% to 100% and 87% to 100%, respectively. There were significant differences in peristalsis between abnormal small bowel segments and the overall small bowel for Crohn's patients, but not in the overall small bowel between normal-MRE patients and Crohn's disease patients. Abnormal Crohn's small bowel segments have significantly decreased peristalsis compared to normal small bowel, which can be identified using cine BSSFP sequences as the frozen bowel sign.

Effect of antitumour necrosis factor-alpha therapy on bone turnover in patients with active Crohn's disease: a prospective study.

Science.gov (United States)

Ryan, B M; Russel, M G V M; Schurgers, L; Wichers, M; Sijbrandij, J; Stockbrugger, R W; Schoon, E

2004-10-15

Patients with Crohn's disease are at increased risk of osteoporosis. Disease activity and circulating proinflammatory cytokines are thought to play a role in this process. Infliximab, a chimaeric antitumour necrosis factor-alpha antibody is effective in the treatment of Crohn's disease. The aim of this study was to investigate the impact of treatment with infliximab on bone turnover in Crohn's disease patients. This was a prospective trial. Twenty-four patients with active Crohn's disease were treated with infliximab (5 mg/kg). Bone markers were assayed pre- and post-treatment. Bone formation was measured using serum bone-specific alkaline phosphatase and total osteocalcin and bone resorption using serum N-telopeptide cross-linked type 1 collagen. Infliximab therapy caused a significant increase in both markers of bone formation in patients with active Crohn's disease. No significant change in the bone resorption marker serum N-telopeptide cross-linked type 1 was found. Infliximab therapy had a significant beneficial effect on bone metabolism in patients with active Crohn's disease. These findings further support the theory that active ongoing inflammation and high levels of circulating cytokines play a pivotal role in the pathogenesis of bone loss in patients with Crohn's disease.

Periodontal disease and anemias associated with Crohn's disease. A case report.

Science.gov (United States)

Nagpal, Swati; Acharya, Anirudh B; Thakur, Srinath L

2012-03-01

Crohn's disease (CD) is an inflammatory bowel disease with oral findings, including periodontal manifestations. Anemias, such as iron deficiency and anemia of chronic disease (ACD), are the most common hematologic complications of CD. Periodontitis has systemic effects, and may tend toward anemia, which can be explained by depressed erythropoiesis. In the report presented here, the authors review a case of Crohn's disease diagnosed 10 years previous to the patient presenting with a changing anemic profile and periodontal disease. A discussion of patient and disease management is included.

Tratamiento endovascular de una fuga paraprotésica mitral con dispositivo Amplatzer®

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Alberto Sciegata

2012-10-01

Full Text Available El leak o fuga paraprotésica mitral se presenta entre el 5 y el 17% de los pacientes tratados con cirugía de reemplazo valvular. En general, los defectos son únicos, la mayoría se encuentran localizados en la región postero-medial del anillo valvular y solo la tercera parte produce reflujo de grado grave. El cierre percutáneo por vía endovascular es una alternativa terapéutica válida en pacientes con elevado riesgo para re-operación. La estrategia de abordaje depende de la localización, tamaño, morfología y relaciones adyacentes del o los defectos. El procedimiento debe ser realizado por profesionales con experiencia en el tratamiento de cardiopatías estructurales y en el manejo de estos dispositivos de cierre, y se considera imprescindible la utilización de un ecocardiograma transesofágico tridimensional. Se presenta el caso de un paciente con una fuga paraprotésica valvular mitral que fue cerrada con un dispositivo Amplatzer ® introducido en forma percutánea desde la vena femoral.

Multidrug resistance 1 gene polymorphisms may determine Crohn's disease behavior in patients from Rio de Janeiro

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Ana Teresa P. Carvalho

2014-01-01

Full Text Available OBJECTIVES: Conflicting data from studies on the potential role of multidrug resistance 1 gene polymorphisms in inflammatory bowel disease may result from the analysis of genetically and geographically distinct populations. Here, we investigated whether multidrug resistance 1 gene polymorphisms are associated with inflammatory bowel diseases in patients from Rio de Janeiro. METHODS: We analyzed 123 Crohn's disease patients and 83 ulcerative colitis patients to determine the presence of the multidrug resistance 1 gene polymorphisms C1236T, G2677T and C3435T. In particular, the genotype frequencies of Crohn's disease and ulcerative colitis patients were analyzed. Genotype-phenotype associations with major clinical characteristics were established, and estimated risks were calculated for the mutations. RESULTS: No significant difference was observed in the genotype frequencies of the multidrug resistance 1 G2677T/A and C3435T polymorphisms between Crohn's disease and ulcerative colitis patients. In contrast, the C1236T polymorphism was significantly more common in Crohn's disease than in ulcerative colitis (p = 0.047. A significant association was also found between the multidrug resistance 1 C3435T polymorphism and the stricturing form of Crohn's disease (OR: 4.13; p = 0.009, whereas no association was found with penetrating behavior (OR: 0.33; p = 0.094. In Crohn's disease, a positive association was also found between the C3435T polymorphism and corticosteroid resistance/refractoriness (OR: 4.14; p = 0.010. However, no significant association was found between multidrug resistance 1 gene polymorphisms and UC subphenotypic categories. CONCLUSION: The multidrug resistance 1 gene polymorphism C3435T is associated with the stricturing phenotype and an inappropriate response to therapy in Crohn's disease. This association with Crohn's disease may support additional pathogenic roles for the multidrug resistance 1 gene in regulating gut

Contrast-Enhanced Ultrasonography in Crohn's Disease Diagnostics.

Science.gov (United States)

Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Liebert, Ariel; Kłopocka, Maria; Serafin, Zbigniew

2015-06-01

The chronic nature of Crohn's disease (CD) implicates necessity of multiple control assessments throughout patient's life. It is accepted that in patients with CD requiring disease monitoring, magnetic resonance enterography (MRE) and computed tomography enterography (CTE) are--apart from endoscopy--imaging studies of first choice. In practice, diagnostic imaging of patients with CD is troublesome, since MRE is an expensive and complicated study, and CTE exposes patients to high doses of ionizing radiation. Therefore, there is a need for new, both non-invasive and effective, methods of imaging in CD. Contrast-Enhanced Ultrasonography (CEUS) is a relatively new method using gas-filled microbubbles serving as contrast agent. It allows for detailed assessment of blood perfusion within intestine wall and peri-intestinal tissues, which enables detection and monitoring of inflammation and its qualitative assessment. The purpose of this paper is to describe CEUS examination technique and its clinical applications in patients with Crohn's disease.

Pinworm Infestation Mimicking Crohns' Disease

OpenAIRE

Johansson, Joel; Ignatova, Simone; Ekstedt, Mattias

2013-01-01

We here report a case of a young man who presented to his general practitioner with diarrhea. Inflammatory bowel disease was suspected and a colonoscopy showed aphthous lesions suggestive of Crohns' disease but biopsies revealed eggs of Enterobius vermicularis. When treated for this parasite, his symptoms were alleviated and a followup colonoscopy revealed a normal colon and distal ileum. Enterobius vermicularis is the most common parasite worldwide and has been attributed with many different...

Investigaciones Terapéuticas en la Lepra: Ensayos con “Promín” o “Promanida'”

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J. Ignacio Chala H.

1948-07-01

Full Text Available Con propósitos de observar, comprobar y valorar los resultados del "Promín"  o “Promanida” en la lepra, lo aplicarnos en un grupo de veintisiete enfermos seleccionados con criterio clínico y de investigación terapéutica. Iniciamos el estudio en julio de 1946. Ninguno de estos casos había sido tratado antes con otros medicamentos preconizados contra la enfermedad. Como lo he dicho en varias ocasiones, solamente teniendo esta precaución y seleccionando los pacientes para la investigación, podrá juzgarse científicamente de la eficacia terapéutica que puedan tener en los distintos tipos de lepra, las drogas aconsejadas para tratar esa enfermedad. Prescindimos de aquellos cases en los cuales, por lo avanzado del mal, los organismos no estaban en condiciones de reaccionar favorablemente con ninguna medicación.

Infliximab for the Treatment of Crohn'S Disease: Review and Indications for Clinical Use in Canada

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Remo Panaccione

2001-01-01

Full Text Available Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract. It may affect any portion of the gastrointestinal tract from the mouth to the anus. Symptoms typically include cramping abdominal pain, diarrhea (which may be bloody and nausea. As the severity of the illness worsens, patients may experience constant abdominal pain, vomiting, weight loss and fever. From the perspective of the patient, disease symptoms significantly impair quality of life, and interfere with their work environment and activities of daily living. Unfortunately, there is no cure for Crohn's disease. Patients experience a chronic, relapsing course characterized by recurrent flares of their disease. Conventional medical treatment of Crohn's disease includes the use of non-specific anti-inflammatory drugs (5-aminosalicylic acid agents, prednisone, budesonide, immunosuppressives (6-mercaptopurine, azathioprine, methotrexate and antibiotics. A variable onset of action, incomplete response rates and a significant risk of adverse effects characterize current therapies. Although surgery is frequently used to treat complications or medically refractory disease, postoperative recurrence is a common problem. Infliximab, a murine chimeric monoclonal antibody directed toward tumour necrosis factor-alpha, is a highly effective treatment of active Crohn's disease. In randomized, placebo-controlled clinical trials, 33% of patients treated with infliximab 5 mg/kg achieved remission (Crohn's Disease Activity Index score less than 150, compared with only 4% of those receiving placebo (P<0.001. Additionally, infliximab is the only drug therapy shown to be effective for the treatment of fistulizing Crohn's disease. In studies done to date, infliximab appears to be well tolerated and has a favourable side effect profile.

Inhibition of stress-activated MAP kinases induces clinical improvement in moderate to severe Crohn's disease

NARCIS (Netherlands)

Hommes, Daan; van den Blink, Bernt; Plasse, Terry; Bartelsman, Joep; Xu, Cuiping; Macpherson, Bret; Tytgat, Guido; Peppelenbosch, Mailkel; van Deventer, Sander

2002-01-01

Background & Aims: We investigated if inhibition of mitogen-activated protein kinases (MAPKs) was beneficial in Crohn's disease. Methods: Inhibition of JNK and p38 MAPK activation with CNI-1493, a guanylhydrazone, was tested in vitro. Twelve patients with severe Crohn's disease (mean baseline, CDAI

Computed tomography enterography in assessment of Crohn's ...

African Journals Online (AJOL)

Background: Monitoring the disease activity in Crohn's disease (CD) may be challenging with endoscopic manoeuvers due to difficulties in reaching the affected areas and being restricted to mucosal lesions, so the existence of a more tolerable and reliable technique will be highly warranted. Objectives: This study aims at ...

Outcome of sporadic amyotrophic lateral sclerosis treated With non-invasive ventilation and riluzole Sobrevida en pacientes con esclerosis lateral amiotrófica esporádica tratados con ventilación no invasiva y riluzole

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Martín Sívori

2007-08-01

diagnóstico de sALS, según criterios definidos en El Escorial modificados, y fueron seguidos por 60 meses. Veintinueve pacientes recibieron NIV y 68 no (nNIV. En el grupo NIV la sobrevida media fue de 15.41 ± 7.78 meses vs. 10.88 ± 7.78 meses en nNIV (p= 0.028. La sobrevida media de los pacientes que recibieron riluzole (n=44 no fue diferente de la que no lo recibieron (n=53, aunque en el 4° y 5° mes los pacientes tratados con riluzole mostraron un escaso beneficio. Los pacientes que recibieron NIV y riluzole (n=18 tuvieron una sobrevida media de 16.61 ± 10.97 meses vs. 10.69 ± 7.86 meses para los que sólo recibieron tratamiento sintomático (n=42 (p= 0.021. La NIV prolongó significativamente la sobrevida en este grupo de pacientes. El riluzole, empleado como única terapéutica, no lo hizo. Los pacientes que combinaron los dos tratamientos tuvieron la mayor sobrevida.

Ivermectin-related adverse clinical events in patients treated for Mansonella ozzardi infections Efectos clínicos adversos relacionados con ivermectina en pacientes tratados por infecciones con Mansonella ozzarddi

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Alejandro J. Krolewiecki

2011-03-01

Full Text Available We report the occurrence of serious reactions after treatment with oral ivermectin in two patients with Mansonella ozzardi infections. Both had systemic and respiratory symptoms and recovered without sequelae. Follow-up revealed clearance of microfilaremia in both cases, with relapse in one of them. These reactions are well described in the treatment of other filarial infections, but have not yet been reported in the treatment of M. ozzardi. We are now reporting the first such known reactions with this helminthiasis.Se informa la aparición de reacciones adversas graves con el tratamiento con ivermectina oral en dos pacientes con infección por Mansonella ozzardi. Ambos presentaron síntomas respiratorios y sistémicos y se recuperaron sin secuelas. El seguimiento mostró ausencia de microfilaremia en ambos casos, con recidiva en uno de ellos. Estas reacciones, bien conocidas durante el tratamiento de otras filariosis, se describen por primera vez con esta helmintiasis.

Maduración sexual en niños con diabetes mellitus tipo 1 tratados con dosis múltiples de insulina Sexual maturation in children presenting with Type 1 diabetes mellitus treated with multiple dose of insulin.

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Tania Espinosa Reyes

2007-04-01

Full Text Available Antes de la terapia insulínica, la menarquia y menstruaciones subsecuentes aparecían raramente en niñas con diabetes mellitus tipo 1 (DM 1 desde la infancia, y en los varones se verificaba un importante retraso puberal. El objetivo del presente trabajo es evaluar el inicio de la pubertad, y la influencia de la edad de diagnóstico de la diabetes y el grado de control metabólico, sobre el desarrollo sexual en un grupo de ninos atendidos en consultas de endocrinología pediátrica. Se realizó un estudio prospectivo no concurrente a partir de las historias clínicas de pacientes tratados con dosis múltiples de insulina, de procedencia urbana (32 varones y 28 hembras, seguidos longitudinalmente por examen clínico y determinaciones bioquímicas periódicas desde el inicio de la DM 1 hasta alcanzar su talla final. El control metabólico fue evaluado a través de la hemoglobina glicosilada (HbA1 realizada trimestralmente, y clasificado según criterios de la institución en bueno (B: 10 %. La media de la edad a la que se encontró un volumen testicular de 4 mL fue 12,5 ± 0,8 años; en las niñas el inicio del desarrollo mamario se constató a la edad promedio de 11,4 ± 1,3 años y la menarquia ocurrió a los 12,9 ± 1,2 años. Se comprobó también que 31 pacientes tuvieron un control metabólico B (51,6 %, 22 R (36,7 % y 7 M (11,7 %. Se concluye que el tratamiento con dosis múltiples de insulina tiene una influencia favorable y decisiva sobre el grado de control metabólico, lo cual hace posible un desarrollo puberal adecuado en pacientes con DM 1.Before insulin therapy, menarche and subsequent menstruation rarely appear in girls presenting Type 1 diabetes mellitus (MD 1 from childhood, and in boys a significicant pubertal retardation was confirmed. Aim of present paper is to assess onset of puberty, influence of diagnosis age of diabetes, and degree of metabolic control, on sexual development in a cohort of children seen in service of

Alta precisión relativa en problemas de álgebra lineal numérica en matrices con estructura

OpenAIRE

Ceballos Cañón, Johan Armando

2016-01-01

Esta tesis se enmarca dentro del campo de la Alta Precisión Relativa (HRA) en Álgebra Lineal Numérica (ALN). Sus líneas maestras son dos. Por un lado, el diseño y análisis de algoritmos que permitan resolver problemas de Álgebra Lineal con más precisión de la habitual para matrices con estructura. Y por otro el estudio de la teoría específica de perturbaciones necesaria para tratar los problemas que nos ocupan. En nuestra investigación hemos tratado dos: La obtención de soluciones precisas de...

Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease

Energy Technology Data Exchange (ETDEWEB)

Ziech, M.L.W., E-mail: m.l.ziech@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Lavini, C., E-mail: c.lavini@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Caan, M.W.A., E-mail: m.w.a.caan@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Nio, C.Y., E-mail: C.Y.Nio@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Stokkers, P.C.F., E-mail: p.stokkers@slaz.nl [Academic Medical Center, Department of Gastroenterology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Sint Lucas Andreas Ziekenhuis, Department of Gastroenterology, Jan Tooropstraat 164, 1061 AE, Amsterdam (Netherlands); Bipat, S., E-mail: S.Bipat@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Ponsioen, C.Y., E-mail: c.y.ponsioen@amc.uva.nl [Academic Medical Center, Department of Gastroenterology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Nederveen, A.J., E-mail: a.j.nederveen@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Stoker, J., E-mail: j.stoker@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands)

2012-11-15

Objectives: To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease. Methods: Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of gadobutrol, single shot fast spin echo sequence and 3D T1-weighted spoiled gradient echo sequence, a dynamic coronal 3D T1-weighted fast spoiled gradient were performed before and after gadobutrol. Maximum enhancement (ME) and initial slope of increase (ISI) were calculated for four colon segments (ascending colon + coecum, transverse colon, descending colon + sigmoid, rectum) and (neo)terminal ileum. C-reactive protein (CRP), Crohn's disease activity index (CDAI), per patient and per segment Crohn's disease endoscopic index of severity (CDEIS) and disease duration were determined. Mean values of the (DCE-)MRI parameters in each segment from each patient were compared between four disease activity groups (normal mucosa, non-ulcerative lesions, mild ulcerative and severe ulcerative disease) with Mann-Whitney test with Bonferroni adjustment. Spearman correlation coefficients were calculated for continuous variables. Results: Thirty-three patients were included (mean age 37 years; 23 females, median CDEIS 4.4). ME and ISI correlated weakly with segmental CDEIS (r = 0.485 and r = 0.206) and ME per patient correlated moderately with CDEIS (r = 0.551). ME was significantly higher in segments with mild (0.378) or severe (0.388) ulcerative disease compared to normal mucosa (0.304) (p < 0.001). No ulcerations were identified at conventional sequences. ME correlated with disease duration in diseased segments (r = 0.492), not with CDAI and CRP. Conclusions: DCE-MRI can be used as a method for detecting Crohn's disease ulcerative lesions.

Guidelines for treatment with infliximab for Crohn's disease.

NARCIS (Netherlands)

Hommes, D.W.; Oldenburg, B.; Bodegraven, A.A; Hogezand, R.A. van; Jong, D.J. de; Romberg-Camps, M.; Woude, J. van der; Dijkstra, G.

2006-01-01

Infliximab is an accepted induction and maintenance treatment for patients with Crohn's disease. The effectiveness of infliximab has been demonstrated for both active luminal disease and for enterocutaneous fistulisation. In addition, infliximab can be administered for extraintestinal symptoms of

Guidelines for treatment with infliximab for Crohn's disease

NARCIS (Netherlands)

Hommes, D. W.; Oldenburg, B.; van Bodegraven, A. A.; van Hogezand, R. A.; de Jong, D. J.; Romberg-Camps, M. J. L.; van der Woude, J.; Dijkstra, G.

2006-01-01

Infliximab is an accepted induction and maintenance treatment for patients with Crohn's disease. The effectiveness of infliximab has been demonstrated for both active luminal disease and for enterocutaneous fistulisation. In addition, infliximab can be administered for extraintestinal symptoms of

Experiencia con hipotermia terapéutica en el paro cardíaco extrahospitalario

Directory of Open Access Journals (Sweden)

Ricardo Levin

2016-01-01

Full Text Available Introducción: El paro cardíaco extrahospitalario (PCEH, una de las principales causas de mortalidad en el mundo occidental, se asocia con una muy baja sobrevida hospitalaria y con un número elevado de secuelas neurológicas entre los sobrevivientes, sin modificaciones significativas en el pronóstico en las últimas tres décadas. Estudios clínicos más recientes plantearon la utilidad de la hipotermia terapéutica en la reducción de la mortalidad y el grado de deterioro neurológico en sobrevivientes de un PCEH. Objetivos: Evaluar la mortalidad y el resultado neurológico de pacientes comatosos resucitados de un PCEH tratados con hipotermia terapéutica. Considerar las indicaciones y los hallazgos de la cinecoronariografía y detectar complicaciones asociadas con la hipotermia. Material y métodos: Se incluyeron pacientes resucitados de un PCEH tratados bajo hipotermia terapéutica, que consistió en una fase de enfriamiento a 33 °C, un mantenimiento durante 24 horas y recalentamiento a 0,25 °C/hora. Se analizaron las indicaciones y los hallazgos de la cinecoronariografía. Se evaluaron complicaciones metabólicas, arrítmicas, infecciosas y hemorrágicas. Se consideró significativo valor de p menor de 0,05. Resultados: De los 213 pacientes incluidos, la sobrevida hospitalaria fue de 109 pacientes (51,2%, de los que 96 (46,1% presentaron al egreso buena recuperación neurológica. Se observó mayor sobrevida en pacientes con ritmos pasibles de desfibrilación respecto de aquellos con ritmos no pasibles de desfibrilación (58,2% vs. 37,7%; p = 0,007. Se derivaron (3,5 horas en promedio a cinecoronariografía 147 (69% pacientes, de los cuales 121 (82,3% mostraron enfermedad significativa, observándose en 69 (57% oclusión coronaria completa. Ciento siete pacientes fueron sometidos a angioplastia; 43 (40,2% de ellos fallecieron durante la internación frente a 61 (58,6% óbitos entre los no intervenidos o no estudiados (p = 0,005. Entre

Disease phenotype at diagnosis in pediatric Crohn's disease

DEFF Research Database (Denmark)

de Bie, Charlotte I; Paerregaard, Anders; Kolacek, Sanja

2013-01-01

It has been speculated that pediatric Crohn's disease (CD) is a distinct disease entity, with probably different disease subtypes. We therefore aimed to accurately phenotype newly diagnosed pediatric CD by using the pediatric modification of the Montreal classification, the Paris classification....

Twin studies reveal specific imbalances in the mucosa-associated microbiota of patients with ileal Crohn's disease

Energy Technology Data Exchange (ETDEWEB)

Willing, B.; Halfvarson, J.; Dicksved, J.; Rosenquist, M.; Jarnerot, G.; Engstrand, L.; Tysk, C.; Jansson, J. K

2008-08-15

Large inter-individual variation in the composition of the intestinal microbiota between unrelated individuals has made it challenging to identify specific aspects of dysbiosis that lead to Crohn's disease. To reduce variations in exposure during establishment of the gut flora and influence of genotype, we studied the mucosaassociated microbiota of monozygotic twin pairs that were discordant (n=6) or concordant (n=4) for Crohn's disease. DNA was extracted from biopsies collected from 5 locations between the ileum and rectum. Bacterial 16S ribosomal RNA genes were amplified and community composition assessed by terminal-restriction fragment length polymorphism, cloning and sequencing and quantitative real-time PCR. The microbial compositions at all biopsy locations for each individual were similar, regardless of disease state, but there were differences between individuals. In particular, individuals with predominantly ileal Crohn's had a dramatically lower abundance (P<0.001) of Faecalibacterium prausnitzii and increased abundance (P<0.03) of Escherichia coli compared to healthy co-twins and those with Crohn's localized in the colon. This dysbiosis was significantly correlated to the disease phenotype rather than genotype. The reduced abundance of F. prausnitzii and increased abundance of E. coli are indicative of an ileal Crohn's disease phenotype, distinct from colonic Crohn's disease and the relative abundances of these specific bacterial populations are promising biomarker candidates for differential diagnosis of Crohn's and eventually customized treatment.

The effect of anti-tumor necrosis factor alpha agents on postoperative anastomotic complications in Crohn's disease

DEFF Research Database (Denmark)

El-Hussuna, Alaa Abdul-Hussein H; Krag, Aleksander; Olaison, Gunnar

2013-01-01

Patients with Crohn's disease treated with anti-tumor necrosis factor alpha agents may have an increased risk of surgical complications.......Patients with Crohn's disease treated with anti-tumor necrosis factor alpha agents may have an increased risk of surgical complications....

Análisis e Identificación de las Potenciales Oportunidades Comerciales con Países miembros del TPP en el Sector de Alimentos Frescos

OpenAIRE

Malca Guaylupo, Oscar; Florián Mendo, Samir; Barrantes Rivas, Sofía; Cerdán Torres, Sara; Zhu Gálvez, Eloha

2016-01-01

La estructura de las exportaciones peruanas se ha basado a lo largo de los años en productos tradicionales cuya naturaleza se puede explicar a partir del patrón de ventajas comparativas que posee el Perú. Con el objetivo de intensificar los flujos comerciales hacia un mayor número de mercados, el Perú ha firmado muchos tratados comerciales y, siguiendo con la estrategia, ha concluido negociaciones del Acuerdo Trans-Pacific Partnership (TPP). Sin embargo, las participaciones de mercado del Per...

Análisis e identificación de las potenciales oportunidades comerciales con países miembros del TPP en el sector de alimentos frescos

OpenAIRE

Malca, Oscar; Florián Mendo, Samir; Barrantes Rivas, Sofía; Cerdán Torres, Sara; Zhu Gálvez, Eloha

2016-01-01

La estructura de las exportaciones peruanas se ha basado a lo largo de los años en productos tradicionales cuya naturaleza se puede explicar a partir del patrón de ventajas comparativas que posee el Perú. Con el objetivo de intensificar los flujos comerciales hacia un mayor número de mercados, el Perú ha firmado muchos tratados comerciales y, siguiendo con la estrategia, ha concluido negociaciones del Acuerdo Trans-Pacific Partnership (TPP). Sin embargo, las participaciones de mercado del Per...

Valvuloplastia mitral percutánea de emergencia en un paciente con edema pulmonar refractario

Directory of Open Access Journals (Sweden)

Alejandra I. de Zubiría

2018-01-01

Full Text Available La estenosis mitral usualmente es causada por fiebre reumática. A pesar de ser una patología poco frecuente en los países desarrollados, es prevalente en los países en vía de desarrollo, donde aproximadamente dos tercios de la población mundial vive, haciendo de esta condición, una enfermedad valvular común. Es importante considerar la estenosis mitral en el diagnóstico diferencial de los pacientes con edema agudo de pulmón cardiogénico refractario y la valvuloplastia mitral percutánea de emergencia como el tratamiento definitivo. Se presenta el caso de un paciente femenino de 21 años, con edema agudo de pulmón cardiogénico refractario, secundario a estenosis mitral muy severa de origen reumático, tratado con valvuloplastia percutánea con balón de urgencia. Se realiza una revisión sobre la estenosis mitral y se examina el tratamiento con especial énfasis en los casos publicados en la literatura de valvuloplastia mitral percutánea de emergencia.

Osteosíntesis mini-invasiva con placas bloqueadas en fracturas metafisarias distales de tibia. Resultados clínico-funcionales. [Minimally invasive plate osteosynthesis in distal metaphyseal fractures of tibia. Comparison of results between fractures AO 43A and AO 43C.

OpenAIRE

Juan Manuel Yañez Arauz; Ignacio Arzac Ulla; Javier Del Vecchio; Andres Eksarho; Leandro Civetta; Rodrigo Perez Davila

2015-01-01

Introducción Las fracturas distales de tibia son un desafío para el tratamiento debido a la escasa cobertura y particular vascularización. Los objetivos del presente estudio son analizar los resultados clínicos y funcionales de los pacientes con fractura de tibia distal; tratados con técnica MIPO (minimally invasive plate osteosynthesis) con placas bloqueadas; comparar los resultados del grupo de fracturas tipo AO 43A con las tipo AO 43C1-C2; y comparar los resultados MIPO con el tratamie...

EVALUACIÓN DE LAS TÉCNICAS DE CEPILLADO DE BASS Y VERTICAL EN UN GRUPO DE PACIENTES EN TRATAMIENTO DE ORTODONCIA CON TÉCNICA MBT

Directory of Open Access Journals (Sweden)

Yelitza Ivone Baracaldo Ortíz

2012-12-01

Full Text Available Objetivo: Evaluar la efectividad de las técnicas de Cepillado de Bass y Vertical en pacientes con aparatología ortodóntica fija tratados con la técnica MBT. Materiales y métodos: se realizó un estudio experimental “In vivo” aleatorizado doble ciego; la muestra fue de 100 personas distribuidas en dos grupos, a cada uno se le asignó una Técnica de Cepillado y se dieron instrucciones de higiene oral por medio de charlas personalizadas y por escrito. Se usó el índice de Sillnes y Löe para medir el porcentaje de placa bacteriana, el cual fue realizado por una higienista oral, cada 30 ± 3 días durante 3 meses. A los dos grupos se les realizó profilaxis con el objetivo de tener un índice inicial de placa lo más aproximado a cero. A los participantes se les entregó mensualmente los aditamentos de higiene oral que debían usar. Resultados: antes de dar instrucciones de higiene oral el 73,4% tenían índice de placa moderado, el 16,46% severo y el 10,3% incipiente. El grupo de Técnica Vertical obtuvo mayor reducción de placa en comparación con el grupo de Técnica  Bass durante la primera toma (pConclusiones: La Técnica de Cepillado Vertical es más efectiva que la Técnica Bass para disminuir la placa bacteriana en pacientes tratados ortodónticamente con la técnica MBT.  

Transformation of chenodeoxycholic acid to ursodeoxycholic acid in patients with Crohn's disease

International Nuclear Information System (INIS)

Miwa, H.; Yamamoto, M.; Nishida, T.; Yao, T.

1986-01-01

In vivo 7 beta-epimerization of chenodeoxycholic acid to ursodeoxycholic acid and the role of 7-ketolithocholic acid as an intermediate in this biotransformation were studied in 11 patients with Crohn's disease and in 5 healthy volunteers. The incorporation of deuterium into biliary ursodeoxycholic acid and 7-ketolithocholic acid was determined by computed gas chromatography-mass fragmentography after ingestion of a dideuterated chenodeoxycholic acid, chenodeoxycholic-11,12-d2 acid. The incorporation of deuterium into ursodeoxycholic acid increased to a peak level at 48 h in the patients with Crohn's disease, but was delayed in healthy volunteers. In 8 patients and 2 healthy controls there were small amounts of 7-ketolithocholic acid in bile. The incorporation of deuterium into 7-ketolithocholic acid was confirmed in only 2 patients and the peak level was noted at 48 h. These observations suggest that 7-ketolithocholic acid is an intermediate of this biotransformation in patients with Crohn's disease

The cost of hospitalization in Crohn's disease.

Science.gov (United States)

Cohen, R D; Larson, L R; Roth, J M; Becker, R V; Mummert, L L

2000-02-01

The aim of this study was to evaluate the demographics, resource use, and costs associated with hospitalization of Crohn's disease patients. All patients hospitalized at our institution from 7/1/96 to 6/30/97 with a primary diagnosis of "Crohn's Disease" were analyzed using a computerized database. Data are presented "per hospitalization." A total of 175 hospitalizations (147 patients) were identified. Mean patient age was 36.5 yr; 61% were female; 82% Caucasian. Payer mix was most commonly contracted (57%), commercial (21%), or Medicare (13%). 57% of hospitalizations had a primary surgical procedure; the remainder were medical. Average length of stay was 8.7 days (surgical, 9.6 days; medical, 7.5 days). The average cost of hospitalization, excluding physician fees, was $12,528 (surgical, $14,409; medical, $10,020), whereas average charges were $35,378 (surgical, $46,354; medical, $20,744), including physician fees, which averaged $7,249 (surgical, $11,217; medical, $1,959). Mean reimbursements were $21,968 (surgical, $28,946; medical, $12,666) with average weighted reimbursement rates of 60.17% of hospital charges, 69.57% of physician fees. The distribution of costs across subcategories was: Surgery (39.6%), Pharmacy (18.6%), Laboratory (3.8%), Radiology (2.1%), Pathology (0.8%), Endoscopy (0.3%), and Other Hospital Costs (34.9%). Of the hospitalizations, 87% included treatment with steroids, 23% with immunomodulators, and 14% with aminosalicylates; 27% included the administration of total parenteral nutrition, which accounted for 63% of the total pharmacy costs. Surgery accounts for the majority of hospitalizations, nearly 40% of their total costs, and 75% of overall charges and reimbursements. Therapy that decreases the number of surgical hospitalizations should substantially reduce inpatient Crohn's disease costs, as well as overall costs.

Colorectal cancer in Crohn's disease--review of a 56-year experience in Karolinska Institute University Hospital.

Science.gov (United States)

Rubio, Carlos A; Befrits, Ragnar

2008-01-01

We previously reported that the frequency of colorectal carcinomas (CRC) in Crohn's disease (CD) had increased at this hospital between 1951 and May 1996. The aim was to compare the frequency of CRC in CD between June 1996 and September 2007 to that found between 1951 and May 1996. For that purpose colectomy specimens with an IBD-CRC diagnosis filed during the last 11 years were reviewed. It was found that 29 patients with IBD developed a CRC at this hospital: 21 had CD (or 1.91 cases/year) and the remaining eight, ulcerative colitis (or 0.72 cases/year). At this hospital, the number of cases of CRC in Crohn's colitis increased from 0.28/year between 1951 and the end of 1989, to 1.69 patients/year between 1990 and May 1996, and to 1.91 patients/year between June 1996 and September 2007 (present report). The marginal increase number of patients with CRC in Crohn's colitis/year during the last 11 years at this hospital might be only apparent, considering that the incidence of Crohn's disease in the county has dramatically increased, and that the localization of Crohn's disease has changed in later years, with a predilection for the colon and rectum.

EVOLUCIÓN DE LA PROPIEDAD INTELECTUAL EN LOS TRATADOS DE LIBRE COMERCIO SUSCRITOS POR CANADÁ.

OpenAIRE

Vaccaro, Christian Schmitz

2015-01-01

O esforço para integrar-se economicamente se enquadra em uma ampla tendência de globalização, especialmente econômica e comercial, que impera em nosso mundo há algum tempo. Isso leva ao cumprimento de altas exigências para poder competir nos mercados mundiais. O Canadá tem assinado múltiplos tratados de livre comércio com várias nações. Para os fins do presente trabalho, centrar-nos-emos particularmente na relação entre propriedade intelectual e tratados de livre comércio, examinando as dispo...

Creación de mapas conceptuales con CMapTools versión 4.02

OpenAIRE

Orlando Abril, Diego; Patricia Vivas, Nidia

2005-01-01

El presente artículo resume las principales actividades para elaborar un mapa conceptual con CmapTools, pero no pretende ser una guía completa de creación de mapas conceptuales ni tampoco un tratado de gramática para la definición de las proposiciones representadas en ellos. Aquest article resumeix les principals activitats per a elaborar un mapa conceptual amb CmapTools, però no pretén ser una guia completa de creació de mapes conceptuals ni tampoc un tractat de gramàtica per a la definic...

Via póstero-lateral unilateral para cifoplastia percutánea con balón

OpenAIRE

Ricciardi,Daniel Oscar

2013-01-01

Esta experiencia ha sido realizada en el Hospital Alvarez de Buenos Aires, Argentina en pacientes tratados por el Equipo de Columna Vertebral. El autor ha modificado el método original de punción descrito por Valls y Ottolenghi, lo que permite ubicar al paciente en decúbito lateral y prescinde del instrumental descrito originalmente, como spider y guía que se utilizaban con equipos de rayos X convencionales. El presente trabajo pretende describir en detalle la técnica aplicada para efectuar l...

Focal enhanced gastritis and macrophage microaggregates in the gastric mucosa: potential role in the differential diagnosis between Crohn's disease and ulcerative colitis.

Science.gov (United States)

Magalhães-Costa, Marcia Henriques de; Reis, Beatriz Ribeiro dos; Chagas, Vera Lúcia Antunes; Nunes, Tiago; Souza, Heitor Siffert Pereira de; Zaltman, Cyrla

2014-01-01

Focally enhanced gastritis and macrophage microaggregates are found in the upper gastrointestinal involvement of Crohn's disease, and may reflect an underlying defective innate immunity. These features, however, are also described in patients with Helicobacter pylori infection. The role of these gastric abnormalities in the diagnosis of Crohn's disease was assessed in a population with high prevalence of H. pylori infection. Thirty-seven Crohn's disease, 26 ulcerative colitis, and 30 control patients were included. The H. pylori status was evaluated by the rapid urease test and histology. The presence of focally enhanced gastritis and macrophage microaggregates was recorded. Focally enhanced gastritis was present in 24% of Crohn's disease patients, 4% of ulcerative colitis patients and 11.5% of controls, presenting an overall sensitivity and specificity for Crohn's disease of 24% and 88%, respectively. Macrophage microaggregates were found in all groups, but were only detected in ulcerative colitis and controls in association with H. pylori infection, with an overall sensitivity and specificity for Crohn's disease of 61% and 69%, respectively. In the absence of H. pylori infection, focally enhanced gastritis and macrophage microaggregates were significantly associated with Crohn's disease (Pgastritis and macrophage microaggregates are suggestive of Crohn's disease only in H. pylori-negative specimens.

The glucose breath test: a diagnostic test for small bowel stricture(s) in Crohn's disease.

Science.gov (United States)

Mishkin, Daniel; Boston, Francis M; Blank, David; Yalovsky, Morty; Mishkin, Seymour

2002-03-01

The aim of this study was to determine whether an indirect noninvasive indicator of proximal bacterial overgrowth, the glucose breath test, was of diagnostic value in inflammatory bowel disease. Twenty four of 71 Crohn's disease patients tested had a positive glucose breath test. No statistical conclusions could be drawn between the Crohn's disease activity index and glucose breath test status. Of patients with radiologic evidence of small bowel stricture(s), 96.0% had a positive glucose breath test, while only one of 46 negative glucose breath test patients had a stricture. The positive and negative predictive values for a positive glucose breath test as an indicator of stricture formation were 96.0% and 97.8%, respectively. This correlation was not altered in Crohn's disease patients with fistulae or status postresection of the terminal ileum. The data in ulcerative colitis were nondiagnostic. In conclusion, the glucose breath test appears to be an accurate noninvasive inexpensive diagnostic test for small bowel stricture(s) and secondary bacterial overgrowth in Crohn's disease.

Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review.

Science.gov (United States)

Schlussel, Andrew T; Cherng, Nicole B; Alavi, Karim

2017-11-01

Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the postoperative medical management of Crohn's disease. A systematic literature review of medications administered following respective therapy for Crohn's disease was performed from 1979 through 2016. Twenty-six prospective articles provided directed guidelines for recommendations and these were graded based on the level of evidence. The postoperative management of Crohn's disease faces multiple challenges. Current indicated medications in this setting include: antibiotics, aminosalicylates, immunomodulators, and biologics. Each drug has inherent risks and benefits, and the optimal regimen is still unknown. Initiating therapy in a prophylactic fashion compared to endoscopic findings, or escalating therapy versus treating with the most potent drug first is debated. Although a definitive consensus on postoperative treatment is necessary, aggressive and early endoluminal surveillance is paramount in the treatment of these complicated patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Experiencia de la terapia con lokomat en pacientes portadores de parálisis cerebral y síndromes atáxicos, instituto de rehabilitación infantil teletón concepción Chile

Directory of Open Access Journals (Sweden)

D. Lorena Llorente, DRA.

2014-03-01

En el Instituto de Rehabilitación Infantil Teletón Concepción el Lokomat existe desde 2008. Esto ha permitido recoger experiencias relacionadas con los cambios observados en el desempeño de la marcha de niños con distintos trastornos de la marcha de origen neurológico tratados con esta órtesis robótica. Se presentan resultados preliminares de tres líneas de investigación que se están desarrollando actualmente incluyendo niños con Parálisis Cerebral Hemipléjica, Parálisis Cerebral dipléjica y con Síndromes Atáxicos.

Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children

DEFF Research Database (Denmark)

Hyams, Jeffrey; Crandall, Wallace; Kugathasan, Subra

2006-01-01

BACKGROUND AND AIMS: The REACH study evaluated the safety and efficacy of infliximab in children with moderately to severely active Crohn's disease. METHODS: Patients (n = 112) with a Pediatric Crohn's Disease Activity Index (PCDAI) score >30 received infliximab 5 mg/kg at weeks 0, 2, and 6...

Small bowel carcinomas in celiac or Crohn's disease: distinctive histophenotypic, molecular and histogenetic patterns.

Science.gov (United States)

Vanoli, Alessandro; Di Sabatino, Antonio; Martino, Michele; Klersy, Catherine; Grillo, Federica; Mescoli, Claudia; Nesi, Gabriella; Volta, Umberto; Fornino, Daniele; Luinetti, Ombretta; Fociani, Paolo; Villanacci, Vincenzo; D'Armiento, Francesco P; Cannizzaro, Renato; Latella, Giovanni; Ciacci, Carolina; Biancone, Livia; Paulli, Marco; Sessa, Fausto; Rugge, Massimo; Fiocca, Roberto; Corazza, Gino R; Solcia, Enrico

2017-10-01

Non-familial small bowel carcinomas are relatively rare and have a poor prognosis. Two small bowel carcinoma subsets may arise in distinct immune-inflammatory diseases (celiac disease and Crohn's disease) and have been recently suggested to differ in prognosis, celiac disease-associated carcinoma cases showing a better outcome, possibly due to their higher DNA microsatellite instability and tumor-infiltrating T lymphocytes. In this study, we investigated the histological structure (glandular vs diffuse/poorly cohesive, mixed or solid), cell phenotype (intestinal vs gastric/pancreatobiliary duct type) and Wnt signaling activation (β-catenin and/or SOX-9 nuclear expression) in a series of 26 celiac disease-associated small bowel carcinoma, 25 Crohn's disease-associated small bowel carcinoma and 25 sporadic small bowel carcinoma cases, searching for new prognostic parameters. In addition, non-tumor mucosa of celiac and Crohn's disease patients was investigated for epithelial precursor changes (hyperplastic, metaplastic or dysplastic) to help clarify carcinoma histogenesis. When compared with non-glandular structure and non-intestinal phenotype, both glandular structure and intestinal phenotype were associated with a more favorable outcome at univariable or stage- and microsatellite instability/tumor-infiltrating lymphocyte-inclusive multivariable analysis. The prognostic power of histological structure was independent of the clinical groups while the non-intestinal phenotype, associated with poor outcome, was dominant among Crohn's disease-associated carcinoma. Both nuclear β-catenin and SOX-9 were preferably expressed among celiac disease-associated carcinomas; however, they were devoid, per se, of prognostic value. We obtained findings supporting an origin of celiac disease-associated carcinoma in SOX-9-positive immature hyperplastic crypts, partly through flat β-catenin-positive dysplasia, and of Crohn's disease-associated carcinoma in a metaplastic (gastric and

What is Crohn's Disease | NIH MedlinePlus the Magazine

Science.gov (United States)

... your health care provider about what to expect. Biological therapies. Biological therapies are medicines that are given by an ... the skin. There are currently five FDA-approved biological drugs that treat inflammation in Crohn's disease. Antibiotics. ...

Intestinal APCs of the endogenous nanomineral pathway fail to express PD-L1 in Crohn's disease.

Science.gov (United States)

Robertson, Jack; Haas, Carolin T; Pele, Laetitia C; Monie, Tom P; Charalambos, Charles; Parkes, Miles; Hewitt, Rachel E; Powell, Jonathan J

2016-05-26

Crohn's disease is a chronic inflammatory condition most commonly affecting the ileum and colon. The aetiology of Crohn's disease is complex and may include defects in peptidoglycan recognition, and/or failures in the establishment of intestinal tolerance. We have recently described a novel constitutive endogenous delivery system for the translocation of nanomineral-antigen-peptidoglycan (NAP) conjugates to antigen presenting cells (APCs) in intestinal lymphoid patches. In mice NAP conjugate delivery to APCs results in high surface expression of the immuno-modulatory molecule programmed death receptor ligand 1 (PD-L1). Here we report that NAP conjugate positive APCs in human ileal tissues from individuals with ulcerative colitis and intestinal carcinomas, also have high expression of PD-L1. However, NAP-conjugate positive APCs in intestinal tissue from patients with Crohn's disease show selective failure in PD-L1 expression. Therefore, in Crohn's disease intestinal antigen taken up by lymphoid patch APCs will be presented without PD-L1 induced tolerogenic signalling, perhaps initiating disease.

Quality of life study in a regional group of patients with Crohn disease. A structured interview study

DEFF Research Database (Denmark)

Guassora, A D; Kruuse, Christina; Thomsen, O O

2000-01-01

of 100 consecutive out-patients with Crohn disease, 94 patients accepted to participate together with 94 age- and sex-matched healthy controls. A modified McMaster Inflammatory Bowel Disease Questionnaire (IBDQ23) was used, excluding bowel-related questions. Medical students conducted interviews without...... knowing who were Crohn disease patients and who were controls. The bowel-related questions and Crohn's Disease Activity Index (CDAI) were assessed by gastroenterologists at inclusion in the study. Responses were indicated on a seven-point scale (7 best/1 worst). Mean numeric score was calculated as well...

Role of Doppler ultrasonography evaluation of superior mesenteric artery flow volume in the assessment of Crohn's disease activity

Directory of Open Access Journals (Sweden)

Fabiana Paiva Martins

2013-09-01

Full Text Available Objective To investigate superior mesenteric artery flow measurement by Doppler ultrasonography as a means of characterizing inflammatory activity in Crohn's disease. Materials and Methods Forty patients were examined and divided into two groups – disease activity and remission – according to their Crohn's disease activity index score. Mean superior mesenteric artery flow volume was calculated for each group and correlated with Crohn's disease activity index score. Results The mean superior mesenteric artery flow volume was significantly greater in the patients with active disease (626 ml/min ± 236 × 376 ml/min ± 190; p = 0.001. As a cut off corresponding to 500 ml/min was utilized, the superior mesenteric artery flow volume demonstrated sensitivity of 83% and specificity of 82% for the diagnosis of Crohn's disease activity. Conclusion The present results suggest that patients with active Crohn's disease have increased superior mesenteric artery flow volume as compared with patients in remission. Superior mesenteric artery flow measurement had a good performance in the assessment of disease activity in this study sample.

Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohn's disease

DEFF Research Database (Denmark)

Almen, Sven; Granerus, Göran; Ström, Magnus

2007-01-01

Background: Leukocyte scintigraphy is a noninvasive investigation to assess inflammation. We evaluated the utility of labeled leukocytes to detect small bowel inflammation and disease complications in Crohn's disease and compared it to whole small bowel enteroscopy and laparotomy findings. Methods......: Scintigraphy with technetium-99m exametazime-labeled leukocytes was prospectively performed in 48 patients with Crohn's disease a few days before laparotomy; 41 also had an intraoperative small bowel enteroscopy. The same procedures were performed in 8 control patients. Independent grading of scans...... was compared with the results of enteroscopy and with surgical, histopathologic, and clinical data. Results: In the 8 control patients leukocyte scan, endoscopy, and histopathology were all negative for the small bowel. In patients with Crohn's disease and small bowel inflammation seen at enteroscopy and...

Observatorio de los tratados de libre Comercio en Colombia: oportunidades de exportación para Colombia a los países miembros de la comunidad Andina (Perú, Bolivia, Ecuador)

OpenAIRE

Páez Murcia, Jenniffer Adriana; Parada Suárez, Karen Juliana

2015-01-01

Hoy en día, gracias a la globalización y a los tratados de libre comercio que a través de los años Colombia ha logrado firmar, el país ha conseguido nuevas oportunidades de mercado, y así mismo, ha podido identificar grandes apuestas a futuro,de tal manera que los productos colombianos lleguen a más países y compitan en un mercado donde grandes proveedores mundiales tratan de posicionarse. En este documento se quiere mostrar la relación comercial que mantiene el país Colombiano con los demás ...

Guidelines for treatment with infliximab for Crohn's disease.

Science.gov (United States)

Hommes, D W; Oldenburg, B; van Bodegraven, A A; van Hogezand, R A; de Jong, D J; Romberg-Camps, M J L; van der Woude, J; Dijkstra, G

2006-01-01

Infliximab is an accepted induction and maintenance treatment for patients with Crohn's disease. The effectiveness of infliximab has been demonstrated for both active luminal disease and for enterocutaneous fistulisation. In addition, infliximab can be administered for extraintestinal symptoms of Crohn's disease, such as pyoderma gangrenosum, uveitis and arthropathy. Maintenance treatment with infliximab is effective and is regarded as safe as long as the necessary safety measures are heeded. Infusion reactions occur in 3 to 17% of the patients and are associated with the formation of antibodies to infliximab. A reduction in infusion reactions is possible by the concurrent administration of steroids and the use of immunosuppressants (azathioprine, 6-mercaptopurine, methotrexate). Furthermore, immunosuppressants increase the duration of the response to infliximab. For these reasons, the concomitant use of immunosuppressants with infliximab is recommended. Infections and most specifically tuberculosis need to be ruled out before infliximab is administered. Up to now, there are no indications for a connection between an increased risk for malignancies and treatment with infliximab.

Vitamin D deficiency in Crohn's disease: prevalence, risk factors and supplement use in an outpatient setting.

LENUS (Irish Health Repository)

Suibhne, Treasa Nic

2012-03-01

Vitamin D deficiency impacts on bone health and has potential new roles in inflammation. We aimed to determine the prevalence of and risk factors for vitamin D deficiency and to explore vitamin D supplement usage in patients with Crohn\\'s disease (CD) in an outpatient setting, compared with controls.

Maduración poscosecha de la feijoa (Acca sellowiana Berg tratada con CaCl2 en tres temperaturas de almacenamiento

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Ramírez Juan Manuel

2005-06-01

Full Text Available

Con la finalidad de comprobar los efectos retardantes del calcio en la maduración de los frutos de feijoa (Acca sellowiana Berg, cultivar Quimba, se realizó un estudio sobre la aplicación poscosecha, mediante inmersiones de tres soluciones distintas de cloruro de calcio (5%, 10% y 15% y un testigo. La aplicación de CaCl2 prolongó la vida de almacenamiento de los fru­tos, ya que los tratamientos permitieron a los frutos so­portar las condiciones de almacenamiento. Se observó un efecto importante en la disminución de las pérdidas de peso; los frutos tratados con el porcentaje de calcio más alto (15% presentaron las menores pérdidas de peso en cada temperatura. En las fejioas almacenadas a temperatura ambiente (18° C, se observó que la in­cidencia de enfermedades fue más pequeña en los fru­tos tratados con CaCl2. La velocidad de pérdida de la firmeza de los frutos también se vio fortalecida por la adición de calcio. Con relación a las propiedades quí­micas de los frutos, no se presentaron diferencias sig­nificativas entre los tratamientos con cloruro de calcio para cada temperatura de almacenamiento; las feijoas tratadas con CaCl presentaron niveles superiores de sólidos solubles totales, a pesar de no ser significativos estadísticamente.

Resected Hepatocellular Carcinoma in a Patient with Crohn's Disease on Azathioprine

Science.gov (United States)

Heron, Valérie; Fortinsky, Kyle Joshua; Spiegle, Gillian; Hilzenrat, Nir; Szilagyi, Andrew

2016-01-01

Hepatocellular carcinoma rarely occurs in patients without underlying cirrhosis or liver disease. While inflammatory bowel disease has been linked to certain forms of liver disease, hepatocellular carcinoma is exceedingly rare in these patients. We report the twelfth case of hepatocellular carcinoma in a patient with Crohn's disease. The patient is a 61-year-old with longstanding Crohn's disease who was treated with azathioprine and was found to have elevated liver enzymes and a new 3-cm liver mass on ultrasound. A complete workup for underlying liver disease was unremarkable and liver biopsy revealed hepatocellular carcinoma. The patient underwent a hepatic resection, and there is no evidence of recurrence at the 11-month follow-up. The resection specimen showed no evidence of cancer despite the initial biopsy revealing hepatocellular carcinoma. This case represents the third biopsy-proven complete spontaneous regression of hepatocellular carcinoma. Although large studies have failed to show a definite link between azathioprine and hepatocellular carcinoma, the relationship remains concerning given the multiple case reports suggesting a possible association. Clinicians should exercise a high degree of suspicion in patients with Crohn's disease who present with elevated liver enzymes, especially those on azathioprine therapy. PMID:27403102

An international study of agglutinins to Eubacterium, Peptostreptococcus and Coprococcus species in Crohn's disease, ulcerative colitis and control subjects.

Science.gov (United States)

Wensinck, F; van de Merwe, J P; Mayberry, J F

1983-01-01

The world-wide occurrence of agglutinating antibodies to four coccoid anaerobes belonging to Eubacterium, Peptostreptococcus and Coprococcus spp. was investigated in 937 coded sera from patients suffering from Crohn's disease, ulcerative colitis, various other diseases and from healthy controls. Positive results were found in 59% of patients with Crohn's disease, 29% of patients with ulcerative colitis, and 8% of both diseased and healthy control subjects. Patients with Crohn's disease of the colon had more positive tests (67%) than patients with disease confined to the small bowel (46%). The results show that agglutinating antibodies to the coccoid anaerobes occur more frequently in patients with Crohn's disease than in other subjects in widely varying geographic regions.

O-PRECISION: UNA ALTERNATIVA METODOLÓGICA DE TRABAJO CON PERSONAS CON DISCAPACIDAD FÍSICA E INTELECTUAL

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Victoria Rey Niño

2015-04-01

Full Text Available La Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF define la discapacidad como un término genérico que abarca deficiencias, limitaciones de la actividad y restricciones a la participación. En este caso hablamos de personas con discapacidad física e intelectual por parálisis cerebral, lo que significa que su acceso al mundo de la actividad física se encuentra en la mayoría de los casos muy restringido. Pero existe una modalidad de la orientación llamada Orientación de Precisión u O-Trail que, según la Federación Deportiva de Orientación (FEDO, ha sido adaptada para ofrecer a todos, independientemente de su sexo, edad, capacidad o discapacidad física, la oportunidad de participar en igualdad de condiciones en una típica competición de orientación. Como sugiere Arribas y Sánchez (1998: “En la actividad física podemos encontrar recursos y herramientas de intervención adecuadas a cada contexto y etapa de ciclo vital además, a través de su práctica pueden verse satisfechas determinadas necesidades e intereses personales y grupales, que pueden ser tratados desde un planteamiento educativo” . Este proyecto tiene la intención de ir más allá y pretende utilizar la Orientación de precisión como una herramienta para implementar una alternativa metodológica de trabajo a las actividades que se llevan a cabo con un colectivo de personas con discapacidad física e intelectual en la Asociación Cultural y rehabilitadora de Discapacitados Físicos de Palencia, desarrollando y estimulando sus aspectos intelectuales y sociales mediante una disciplina deportiva desconocida para ellos, con la intención de que aumente su motivación por participar.Objetivo: Implementar la O-Precisión como alternativa metodológica de trabajo con personas con discapacidad física e intelectual con el fin de desarrollar sus capacidades cognitivas y aumentar su autoestima.

Tratamiento conservador en pacientes con retinoblastoma bilateral

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Juan C. Suárez

2008-11-01

Full Text Available OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, entre 1997 y 2007. MÉTODO: se hizo enucleación del ojo con el tumor de mayor tamaño. En el otro ojo se hizo tratamiento con TTT, con el láser diodo (810 nm, spot amplio, solo o combinado con otras terapias. RESULTADOS: se dividió a los pacientes en dos grupos: 16 pacientes (32 ojos en el grupo 1 tratados conservadoramente y 4 pacientes (8 ojos en el grupo 2 con tratamiento convencional. El rango de edad fue de 1-72 meses en el grupo 1 y de 1-12 meses en el grupo 2. El tiempo de seguimiento fue de 7-67 meses para el grupo 1 y de 13-73 meses para el grupo 2. En el grupo 1 se hizo enucleación de 16 ojos (50%, radioterapia externa de uno (3,1%, quimioterapia más termoterapia de 5 (15,6% y quimioterapia más termoterapia más crioterapia de 10 (31,3%. En todos los pacientes se logró preservar al menos un ojo. En el grupo 2, se enuclearon 7 ojos (87,5% y se hizo radioterapia externa más enucleación en un paciente (12.5%. Además, todos los pacientes recibieron quimioterapia. CONCLUSIÓN: la terapia conservadora actual consistente en tratamiento local (termoterapia, crioterapia o braquiterapia y quimiorreducción permite preservar al menos un ojo y en algunos casos de los dos, muchas veces con buena agudeza visual, en niños con retinoblastoma bilateral; se evitan así la enucleación bilateral y la radioterapia externa usada en el tratamiento convencional con todos sus efectos secundarios. La enucleación contin

Updated German S3-guideline regarding the diagnosis of Crohn's disease. Implementation of radiological modalities

International Nuclear Information System (INIS)

Schreyer, A.G.; Ludwig, D.; Koletzko, S.; Hoffmann, J.C.; Preiss, J.C.; Zeitz, M.; Stange, E.; Herrlinger, K.R.

2010-01-01

The recently updated German S3-guideline regarding the diagnosis and treatment of Crohn's disease incorporates several changes concerning the radiological approach compared to the former guideline. This article focuses on guideline-based radiological imaging techniques for patients with Crohn's disease. The new guideline is also compared to former European and German guidelines in the context of recently published radiological literature. (orig.)

Fasting plasma carotenoids concentrations in Crohn's and pancreatic cancer patients compared to control subjects.

Science.gov (United States)

Drai, J; Borel, P; Faure, H; Galabert, C; Le Moël, G; Laromiguière, M; Fayol, V

2009-03-01

Carotenoids are colored molecules that are widespread in the plant kingdom, but animals cannot synthesize them. Carotenes are long, apolar molecules which require fully functioning digestive processes to be absorbed properly. Hence they could be interesting markers of intestinal absorption and digestion. Indeed, only few tests are available to assess these processes and only the D-xylose tolerance test is routinely used. However D-xylose is a sugar that tests only the absorption of water-soluble compounds and it only tests duodenal absorption. In this study, we have evaluated carotenoids as markers of digestion and absorption. We compared fasting plasma carotenoids concentrations in 21 control subjects, 20 patients with Crohn's disease, and 18 patients with pancreatic cancer. Crohn's disease alters intestinal absorption while pancreatic cancer decreases pancreatic enzyme secretion thus impairing digestion. Results show that all carotenoids are significantly lower in Crohn's and cancer patients as compared to control subjects and the multifactorial analysis shows that this decrease is mostly independent of dietary intake. Interestingly, maldigestion as seen in pancreatic cancer more strongly influences plasma lutein and lycopene concentrations while malabsorption in Crohn's disease acts on other carotenoids. Thus carotenoids could be interesting alternatives for testing and following patients that are suspected of having malabsorption or maldigestion syndromes.

Normal villous architecture with increased intraepithelial lymphocytes: a duodenal manifestation of Crohn disease.

Science.gov (United States)

Patterson, Emily R; Shmidt, Eugenia; Oxentenko, Amy S; Enders, Felicity T; Smyrk, Thomas C

2015-03-01

To assess a possible association between inflammatory bowel disease (IBD) and the histologic finding in duodenal biopsy specimens of increased intraepithelial lymphocytes (IELs) with normal villous architecture. We identified all patients with duodenal biopsy specimens obtained between 2000 and 2010 showing increased IELs and normal architecture. Among the 74 such patients who also had IBD, we characterized the clinical features of IBD and reviewed all available upper gastrointestinal biopsy specimens. Fifty-eight patients had Crohn disease, 13 had ulcerative colitis, and three had IBD, type unclassified. No duodenal sample with increased IELs had other histologic features of IBD. Among gastric biopsy specimens from 34 patients with Crohn disease, nearly half (16) had focal gastritis. We propose that Crohn disease be included in the differential diagnosis for increased IELs with normal villous architecture in duodenal biopsy specimens, particularly when gastric biopsy specimens show focal gastritis. Copyright© by the American Society for Clinical Pathology.

Polifarmacia en el anciano con afecciones vasculares periféricas

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José Barnés Domínguez

2017-05-01

Full Text Available Se considera polifarmacia cuando un individuo utiliza cuatro o más medicamentos. Realizamos un estudio descriptivo-retrospectivo de los pacientes ancianos ingresados en el Instituto Nacional de Angiología y Cirugía Vascular (INACV con afecciones vasculares periféricas durante los meses de julio a septiembre de 2016 tratados con polifarmacia. El universo estuvo constituido por 90 pacientes. Se procedió a la revisión de las historias clínicas obteniendo las siguientes variables: grupos de edad, sexo, comorbilidades asociadas, diagnóstico al ingreso, número de fármacos prescritos y grupos farmacológicos más frecuentemente utilizados. Predominó el grupo de edad de 60 a 69 años, 41 pacientes (45,56%, fundamentalmente del sexo masculino. Prevalecieron la hipertensión arterial con 64 casos (71,11%, seguidos de la diabetes mellitus con 47 pacientes (52,22% y la cardiopatía isquémica con 25 casos (27,78%, como comorbilidades asociadas, los principales diagnósticos al ingreso resultaron el pie diabético isquémico infectado con 21 pacientes (23,35%, la aterosclerosis obliterante (AEO grado IV, 16 casos (17,78%, y el pie diabético neuroinfeccioso,14 casos (15,56%. En cuanto a la polifarmacia 16 pacientes recibieron seis fármacos, los grupos farmacológicos más utilizados con frecuencia estuvieron representados por los analgésicos y antiinflamatorios en 81 pa-cientes (90,0%, los antibióticos 73 pacientes (81,11% y los antihipertensivos en 63 casos (70,0%. Se enfatiza en el manejo integral y multidisciplinario de estos pacientes para reducir la polifarmacia y sus consecuencias. Reportar el comportamiento de la polifarmacia en los pacientes ancianos con afecciones vasculares periféricas.

The long-term results of resection and multiple resections in Crohn's disease.

Science.gov (United States)

Krupnick, A S; Morris, J B

2000-01-01

Crohn's disease is a panenteric, transmural inflammatory disease of unknown origin. Although primarily managed medically, 70% to 90% of patients will require surgical intervention. Surgery for small bowel Crohn's is usually necessary for unrelenting stenotic complications of the disease. Fistula, abscess, and perforation can also necessitate surgical intervention. Most patients benefit from resection or strictureplasty with an improved quality of life and remission of disease, but recurrence is common and 33% to 82% of patients will need a second operation, and 22% to 33% will require more than two resections. Short-bowel syndrome is unavoidable in a small percentage of Crohn's patients because of recurrent resection of affected small bowel and inflammatory destruction of the remaining mucosa. Although previously a lethal and unrelenting disease with death caused by malnutrition, patients with short-bowel syndrome today can lead productive lives with maintenance on total parenteral nutrition (TPN). This lifestyle, however, does not come without a price. Severe TPN-related complications, such as sepsis of indwelling central venous catheters and liver failure, do occur. Future developments will focus on more powerful and effective anti-inflammatory medication specifically targeting the immune mechanisms responsible for Crohn's disease. Successful medical management of the disease will alleviate the need for surgical resection and reduce the frequency of short-bowel syndrome. Improving the efficacy of immunosuppression and the understanding of tolerance induction should increase the safety and applicability of small-bowel transplant for those with short gut. Tissue engineering offers the potential to avoid immunosuppression altogether and supplement intestinal length using the patient's own tissues.

Estudio experimental de la adhesión interfacial del sistema Sn/Pb - Al2O3 asistido con láser

OpenAIRE

Guerrero, A; Puerta, J; Lira, J

2006-01-01

En el presente trabajo se propuso y construyó un diseño de cámara de experimentación que permitió realizar diferentes mediciones del ángulo de contacto. El substrato cerámico (Sn/Pb - Al2O3) fue previamente tratado con un láser de CO2 y sobre el mismo se depositó una aleación de Estaño-Plomo fundido empleando el método de la gota en reposo en alto vacío. Estas mediciones experimentales se realizaron con el fin de conocer el comportamiento físico-químico de la mojabilidad del sistema metal-cer...

Intestinal permeability of 51Cr-labelled ethylenediaminetetraacetic acid in patients with Crohn's disease and their healthy relatives

International Nuclear Information System (INIS)

Ainsworth, M.; Eriksen, J.; Rasmussen, J.W.; Muckadell, O.B.S. de

1989-01-01

An increased intestinal permeability has been proposed as an aetiologic factor in Crohn's disease. The 24-h urinary excretion of 100 μCi 51 Cr-labelled ethylenediaminetetraacetic acid (EDTA) was used to test the permeability in 15 patients with Crohn's disease and in 20 healthy first-degree relatives, who were known to have a genetic predisposition to inflammatory bowel disease. Twenty-eight healthy persons not related to patients with inflammatory bowel disease served as control material. The 51 Cr-EDTA excretion of the relatives was not significantly higher than that of the controls, whereas patients with Crohn's disease had a significantly higher excretion than both the relatives and the controls. Among patients the increased excretion was found only if the small intestine was involved. It is concluded that 1) as a group, patient with Crohn's disease in the small intestine have an increased intestinal permeability, in contrast to their healthy relatives, who have a normal permeability; 2) a considerable overlap of the results of the 51 Cr-EDTA test was found between the groups studied, and the test is not suitable for evaluating individual patients; 3) the results do not support the hypothesis of an increase in intestinal permeability as an aetiologic factor in Crohn's disease. 29 refs

Estudio Comparativo con prótesis total de rodilla de alta flexión. [Comparative ­study ­with ­high-flex ­total ­knee­ arthroplasty.

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Matías Costa Paz

2014-08-01

Full Text Available In­tro­duc­ción: El objetivo de este trabajo comparativo fue analizar los resultados funcionales y el rango de movimiento de rodilla entre dos grupos de pacientes con artroplastia total de rodilla: uno utilizando prótesis de alta flexión y el otro con un diseño convencional. Materiales­ y ­Métodos: Setenta y cuatro pacientes fueron operados con artroplastia total de rodilla con prótesis de Zimmer NexGen®, EE.UU. Veintidós (grupo A fueron tratados con diseño de alta flexión. Dos con artritis reumatoide fueron excluidos. Cuarenta y dos pacientes fueron tratados con una convencional, 21 de ellos fueron excluidos, por lo que el grupo B estaba conformado por 21 pacientes. La evaluación funcional se realizó con el Knee Society Score (KSS, el Western Ontario and McMaster Universities osteoathritis index y la escala analógica visual. Resultados: El promedio de flexión máxima preoperatoria fue de 99º en el grupo A y de 106º en el grupo B. En el posoperatorio, el promedio de flexión máxima del grupo A subió a 114º, con un aumento promedio de 15º y, en el grupo B, a 118º con una ganancia promedio de 12º. No hubo diferencias estadísticamente significativas (p <0,05. El puntaje KSS preoperatorio del grupo A fue de 36/48 y mejoró a 90/92. En el grupo B, fue de 46/49 y de 94/90 en el posoperatorio. Conclusión: Las evaluaciones clínicas funcionales y radiológicas son favorables en los dos diseños de prótesis evaluados. Este estudio muestra que no hay diferencias significativas entre el rango de movimiento de una prótesis de alta flexión y una prótesis convencional luego de un año de seguimiento.

Conn syndrome and Crohn disease in a pediatric case: an interesting parallel.

Science.gov (United States)

Rodriguez, Manuel A; Alkhoury, Fuad; Malvezzi, Leopoldo; Diaz, Alejandro

2013-01-01

Conn syndrome is characterized by surreptitious secretion of aldosterone in which patients are found to have hypertension, hypokalemia, and metabolic alkalosis. Although rare, the most common presentation in the pediatric population is bilateral hyperplasia of the adrenal glands as opposed to an adenoma. Crohn disease is part of the spectrum of inflammatory bowel disease, which manifests in children as flare-ups of bloody diarrhea and abdominal pain. The association of concurrent Conn syndrome and Crohn disease has been previously presented in two cases in adults. This is the first pediatric case to be reported in the literature.

Tubo gástrico con conservación anatómica y funcional del píloro Gastric tube with anatomical and functional conservation of the pylorus

OpenAIRE

Albio Ferrá Betancourt; Sixto Corona Mancebo

2008-01-01

INTRODUCCIÓN. No existe consenso en cuanto a la realización de un procedimiento de drenaje gástrico cuando se ha realizado una esofagectomía subtotal y se ha sustituido el esófago por el estómago tubulizado y desnervado. Es el objetivo de este estudio evaluar el resultado obtenido en pacientes a quienes se practicó esofagectomía subtotal y sustitución del órgano con estómago tubulizado sin aplicar drenaje gástrico (piloroplastia). MÉTODOS. Se analizaron 16 pacientes tratados con este procedim...

A Qualitative Exploration of the Lived Experiences of Patients Before and After Ileostomy Creation as a Result of Surgical Management for Crohn's Disease.

Science.gov (United States)

Morris, Andrew; Leach, Bethan

2017-01-01

Patient experiences pre- and post-ileostomy creation as a result of severe Crohn's Disease are underresearched. A qualitative phenomenological design involving a purposeful sampling approach was used to capture the lived physical and psychosocial transition of patients with Crohn's Disease before and after ileostomy formation. Patients were recruited from the membership of the United Kingdom Ileostomy Association; inclusion criteria stipulated participants must speak English and have a diagnosis of Crohn's Disease and subsequent stoma formation. Ten (10) patients (6 women, 4 men, ranging in age from 34 to 83 years with Crohn's Disease and an ileostomy [mean time with stoma 18.3 years, range 3-36 years]) participated in indepth, semistructured interviews with questions on sociodemographic characteristics along with questions informed by the relevant literature regarding life before and after the ileostomy. All interviews were audiorecorded and transcribed verbatim. Interpretative phenomenological analysis was used to examine the data and identify and interpret themes. Participants were asked to comment on these themes to ensure they were a realistic interpretation of their experiences. Two (2) major themes emerged that embodied ileostomy formation: being controlled by Crohn's and transition to a new life with an ileostomy. Crohn's symptoms controlled daily activities such as work and socializing due, in part, to the need to be in close proximity to toilet facilities. The ileostomy facilitated a transition to a new life that allowed patients to re-engage with work and social activities. One minor theme emerged: memories of Crohn's. Participants said their memories of Crohn's affected life with an ileostomy. Where Crohn's controlled every aspect of people's lives pre-ileostomy formation, the creation of the ileostomy was a positive experience because it helped manage Crohn's symptoms. Memories of life pre-ileostomy may affect individuals' behavior post

Relación del estado de salud bucal y condiciones socioeconómicas en el paciente con enfermedad renal crónica en tratamiento

OpenAIRE

Navia Jutchenko, María Fernanda; Muñoz López, Eliana Elisa; López Soto, Olga Patricia

2013-01-01

Objetivo Caracterizar la salud bucal en pacientes tratados con diferentes tipos de diálisis o con trasplante renal.Materiales y Método Este trabajo descriptivo consideró 336 pacientes, el 49 % recibía hemodiálisis, 34 % diálisis peritoneal, 7 % prediálisis y 10 % trasplante renal. La información fue tomada de una base de datos inicial que en este artículo aplicó un análisis multivariado. Las variables ilustrativas fueron edad, género, estado civil, ocupación, educación, índice de higiene oral...

NOD2/CARD15: geographic differences in the Spanish population and clinical applications in Crohn's disease NOD2/CARD15: diferencias geográficas en la población española y su aplicación clínica en la enfermedad de Crohn

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M. Barreiro-de-Acosta

2010-05-01

Full Text Available Crohn's disease (CD is a genetically complex disease in which both genetic susceptibility and environmental factors play key roles in the development of the disorder. NOD2/CARD15 mutations are associated with CD. NOD2 encodes for a protein that is an intracellular receptor for a bacterial product (muramyl dipeptide, though the exact functional consequences of these mutations remain the subject of debate. NOD2/CARD15 mutations are associated with ileal CD, with stricturing behavior, and possibly with a more complicated course of CD. NOD2/CARD15 mutations associated with CD have demonstrated heterogeneity across ethnicities and populations throughout the world, with regional variations across Europe and Spain. However, "NOD2/CARD15 testing" is not yet ready for use in the clinical setting. One of the reasons is that we know that these genetic variants increase the risk of disease only marginally, and many healthy individuals carry the risk alleles, At present it is not recommended to screen first-degree relatives, because we do not have the ability to prevent the disease at the present time.La enfermedad de Crohn (EC es una enfermedad compleja desde el punto de vista de la genética puesto que para el desarrollo de la enfermedad se tiene que producir una interacción entre factores genéticos y ambientales. Las mutaciones del gen NOD2/CARD15 se han asociado con la susceptibilidad a padecer la EC. El gen NOD2/CARD15 codifica una proteína que actúa como un receptor intracelular de la proteína dipeptidomuramil que se encuentran en la pared de cubierta de algunas bacterias. Actualmente se desconoce cuál es el papel exacto de estas mutaciones en el funcionamiento de la proteína NOD2/CARD15. Estas mutaciones se han asociado con la localización en intestino delgado de la enfermedad, el comportamiento fibroestenosante y con un curso más grave de la enfermedad. Las tres mutaciones asociadas con la EC presentan una distribución desigual entre las

Disminución de la necesidad de cobertura con injertos y baja tasa de cicatrización hipertrófica en quemaduras tras desbridamiento enzimático

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Carlos Corrales-Benítez

Full Text Available Introducción y Objetivo. El tratamiento clásico de las quemaduras se basa en la eliminación precoz de la escara; sin embargo, el desbridamiento tangencial de las quemaduras mixtas y profundas retira tejidos dérmicos viables, obligando a la cobertura con autoinjertos. El desbridamiento enzimático con enzimas proteolíticos enriquecidos con Bromelaína (Nexobrid® mantiene restos dérmicos que pueden permitir la reepitelización por sí misma de la quemadura. Evaluamos el uso en nuestra unidad de Nexobrid® (MediWound Ltd., Israel en quemaduras mixtas y dérmicas profundas, valorando la capacidad de reepitelización tras su uso, la tasa de injerto en los pacientes tratados, y la aparición de cicatrización hipertrófica. Pacientes y Método: Evaluamos retrospectivamente 36 pacientes tratados con Nexobrid® entre enero de 2015 y febrero de 2016, 11 mujeres y 25 varones con una media de edad de 42.89 años. La superficie corporal quemada media fue del 7.47% y la diagnosticada como profunda del 6.42%.Todos los pacientes presentaron quemaduras profundas con necesidad de cirugía para su desbridamiento y cobertura con injertos. Resultados: Tras el desbridamiento enzimático solo el 36.1% de los pacientes (13 de 36 requirió cobertura con injertos (p < 0.001.La superficie injertada fue tan solo del 2.67% frente al 4.98% que fue desbridada enzimáticamente (p < 0.001. A pesar de que el tiempo hasta la epitelización total de las quemaduras se alargó hasta los 25.69 días, tan solo un 11.1% de los pacientes desarrolló cicatriz hipertrófica. Conclusiones: Nexobrid® permite el desbridamiento completo de las quemaduras mixtas y dérmicas profundas disminuyendo el porcentaje de pacientes que requieren autoinjertos y la superficie injertada, con bajas tasas de cicatrización hipertrófica.

Endoscopic lesions in Crohn's disease early after ileocecal resection

NARCIS (Netherlands)

Tytgat, G. N.; Mulder, C. J.; Brummelkamp, W. H.

1988-01-01

Fifty patients with Crohn's disease were studied endoscopically 6 weeks to 6 months (median 9 weeks) after ileocecal or ileocolonic resection for evidence of non-resected abnormality. Only 8 of the 50 patients were endoscopically free of abnormalities. Microscopic examination of the surgical

El Tratado de Asunción y el Mercosur

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Miguel Berthet

2015-10-01

Full Text Available Texto de la conferencia pronunciada por el Embajador Dr. Miguel Berthet -Director de Relaciones Económicas Internacionales Y de Comercio Exterior de los Ministerios'de Relaciones Exteriores y de Economía y Finaszas- en nuestra Facultad. el 25 de abril de 1991, explicando el significado y alcance del Tratado de Asunción. ,suscrito pocos dias antes de esta exposición. La conferencia estuvo principalmente orientada a dar nociones básicas para los estudiantes

Evaluación clínico-citológica del herpes labial tratado con láser

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Teresa García Sánchez,

2001-08-01

Full Text Available Se realizó un estudio descriptivo, longitudinal y prospectivo consistente en la descripción citológica y clínica de las muestras obtenidas en 150 pacientes con herpes labial diagnosticadas y atendidas en las diferentes consultas, que reunieron criterios de inclusión objetivos y subjetivos. Las muestras obtenidas por raspado de la superficie afectada se fijaron con cytospray y se colorearon con el método de Papanicolau; fueron leídas al inicio y a las 48 horas para evaluar la recuperación de la mucosa bajo los efectos del láser infrarrojo de arsenurio de galio y aluminio en dosis de 0,6 J/cm2 durante 1 minuto, para un total de 2 a 3 sesiones. Las células intermedias de las mucosas mostraron el mayor nivel de multiplicación, la recuperación fue identificada a partir de las 48 horas de evaluación citológica, clínicamente al 4to. día. Se recomienda evaluar la eficiencia del nuevo esquema terapéutico con láser para esta afección, así como su costo y efectividad.A descriptive, longitudinal and prospective study consisting in the cytological and clinical description of the samples obtained in 150 patients with herpes labialis diagnosed and seen in different consultation rooms was conducted. Objective and subjective inclusion criteria were gathered. The samples of the affected surfaces obtained by curettage were fixed with cytospray and they were colored by using Papanicolau’s method. They were read at the beginning and 48 hours later to evaluate the recovery of the mucosa under the effects of the infrared laser of gallium and alluminum arsenide at doses of 0.6 J/cm3 during a minute for a total of 2 or 3 sessions. The intermediate cells of the mucosas showed the highest level of multiplication. The recovery was identified 48 hours after the cytologic evaluation and from the clinical point of view on the 4th day. It was recommended to evaluate the efficiency of the new therapeutic scheme with laser to treat this affection, as well

Biodegradación estimulada de los suelos contaminados con pesticidas organoclorados

Directory of Open Access Journals (Sweden)

María Kopytko

2017-06-01

Full Text Available DDT al igual que otros pesticidas organoclorados han sido utilizados extensivamente en Colombia entre los años 1970 y 1980 en cultivos de algodón. DDT es resistente a la degradación y fuertemente relacionado con numerosos problemas de salud y actualmente está  prohibido su uso. El propósito de esta investigación fue evaluar la biodegradación de DDT y de los productos DDD y DDE, presentes en el suelo contaminado durante 16 años en le municipio Agustín Codazzi, Cesar, Colombia. Se llevaron a cabo bioestimulación, bioaumentación y un tratamiento de control bajo condiciones anaerobias y aerobias secuenciales. El proceso de biodegradación anaerobia duró 8 semanas y consecutivamente se realizó el proceso aerobio por 20 semanas. En el proceso de bioestimulación se adicionó fósforo para optimizar la proporción C:N:P en el suelo tratado. De las bacterias nativas se aislaron las cepas bacterianas con la capacidad biodegradadora del DDT y fueron identificadas mediante las características morfológicas y ampliación por PCR de la región de 1465 pb del gen ribosomal 16S y secuenciación. De estas se seleccionaron cuatro cepas bacterianas para el proceso de bioaumentación: Burkholderia cepacia, Pseudomonas fluorescens, Aeromona caviae, y Bacillus sp,  las cuales fueron bioaumentadas en el laboratorio e inoculadas en el suelo tratado en concentración de 108 UFC/ml. La concentración de DDT, DDD y DDE se determinó por medio de cromatografía de gases. Los mejores resultados se obtuvieron durante la fase anaerobia logrando una remoción de DDT, DDD y DDE en un 56,2%, 17,1% y 44,5% respectivamente.

Enterovesical fistulas complicating Crohn's disease: clinicopathological features and management.

Science.gov (United States)

Yamamoto, T; Keighley, M R

2000-08-01

Enterovesical fistula is a relatively rare condition in Crohn's disease. This study was undertaken to examine clinicopathological features and management of enterovesical fistula complicating Crohn's disease. Thirty patients with enterovesical fistula complicating Crohn's disease, treated between 1970 and 1997, were reviewed. Urological symptoms were present in 22 patients; pneumaturia in 18, urinary tract infection in 7, and haematuria in 2. In 5 patients clinical symptoms were successfully managed by conservative treatment, and they required no surgical treatment for enterovesical fistula. Twenty-five patients required surgery. All the patients were treated by resection of diseased bowel and pinching off the dome of the bladder. No patients required resection of the bladder. The Foley catheter was left in situ for an average of 2 weeks after operation. Three patients developed early postoperative complications; two bowel anastomotic leaks, and one intra-abdominal abscess. All these complications were associated with sepsis and multiple fistulas at the time of laparotomy. After a median follow-up of 13 years, 3 patients having postoperative sepsis (anastomotic leak or abscess) developed a recurrent fistula from the ileocolonic anastomosis to the bladder, which required further surgery. In the other 22 patients without postoperative complications there has been no fistula recurrence. In conclusion, the majority of patients with enterovesical fistula required surgical treatment: resection of the diseased bowel and oversewing the defect in the bladder. The fistula recurrence was uncommon, but the presence of sepsis and multiple fistulas at the time of laparotomy increased the incidence of postoperative complications and fistula recurrence.

Intestinal lesions in pediatric Crohn disease: comparative detectability among pulse sequences at MR enterography

International Nuclear Information System (INIS)

Sohn, Beomseok; Kim, Myung-Joon; Lee, Mi-Jung; Koh, Hong; Han, Kyung Hwa

2014-01-01

Variable sequences can be used in MR enterography, and no consensus exists for the best protocol in children with Crohn disease. To compare the lesion detectability of various MR enterography sequences and to correlate the findings of these sequences with the Pediatric Crohn's Disease Activity Index (PCDAI) in children with Crohn disease. Children with clinically or pathologically confirmed Crohn disease underwent MR enterography, including a single-shot fast spin-echo (SSFSE) sequence, motility imaging (coronal 2-D balanced fast field echo), diffusion-weighted imaging (DWI), and dynamic contrast enhancement imaging (including arterial, portal and delayed phases). The lesion detectability of each sequence was graded 0-2 for each involved bowel segment. The lesion detectability and PCDAI result on different sequences were compared using the weighted least squares method and Student's t-test, respectively. Fifteen children (11 boys, 4 girls, mean age 13.7 ± 1.4 years) with a total of 41 lesions were included in this study. All lesions detected in more than two sequences were visible on the single-shot fast spin-echo (SSFSE) sequence. The relative lesion detection rate was 78.1% on motility imaging, 90.2% on DWI, and 92.7% on arterial, 95.1% on portal and 95.1% on delayed phase imaging. Compared to the SSFSE sequence, motility imaging (P < 0.001) and DWI (P = 0.039) demonstrated lower detectability. The mean PCDAI result in the detected lesions was statistically higher only on dynamic enhancement imaging (P < 0.001). All MR enterography sequences were found to have relatively high lesion detectability in children with Crohn disease, while motility imaging showed the lowest lesion detectability. Lesions detected on dynamic enhancement imaging showed a higher PCDAI result, which suggests that this sequence is specific for active inflammation. (orig.)

Altered Markers of Brain Development in Crohn's Disease with Extraintestinal Manifestations - A Pilot Study.

Directory of Open Access Journals (Sweden)

Anne K Thomann

Full Text Available Alterations of brain morphology in Crohn's disease have been reported, but data is scarce and heterogenous and the possible impact of disease predisposition on brain development is unknown. Assuming a systemic course of the disease, brain involvement seems more probable in presence of extraintestinal manifestations, but this question has not yet been addressed. The present study examined the relationship between Crohn's disease and brain structure and focused on the connection with extraintestinal manifestations and markers of brain development.In a pilot study, brains of 15 patients with Crohn's disease (of which 9 had a history of extraintestinal manifestations, i.e. arthritis, erythema nodosum and primary sclerosing cholangitis were compared to matched healthy controls using high resolution magnetic resonance imaging. Patients and controls were tested for depression, fatigue and global cognitive function. Cortical thickness, surface area and folding were determined via cortical surface modeling.The overall group comparison (i.e. all patients vs. controls yielded no significant results. In the patient subgroup with extraintestinal manifestations, changes in cortical area and folding, but not thickness, were identified: Patients showed elevated cortical surface area in the left middle frontal lobe (p<0.05 and hypergyrification in the left lingual gyrus (p<0.001 compared to healthy controls. Hypogyrification of the right insular cortex (p<0.05 and hypergyrification of the right anterior cingulate cortex (p<0.001 were detected in the subgroup comparison of patients with against without extraintestinal manifestations. P-values are corrected for multiple comparisons.Our findings lend further support to the hypothesis that Crohn's disease is associated with aberrant brain structure and preliminary support for the hypothesis that these changes are associated with a systemic course of the disease as indicated by extraintestinal manifestations. Changes

El régimen colombiano de la contratación estatal frente al TLC con Estados Unidos

OpenAIRE

López Silva, Jorge Alberto

2014-01-01

El presente escrito desarrolla un análisis comparado entre el sistema de compras públicas colombiano y el Tratado de Libre Comercio suscrito con los Estados Unidos en cuanto a compras públicas se refiere, poniendo en evidencia inconsistencias de tipo jurídico para efectos principalmente prácticos, acudiendo a temas de soporte para el desarrollo de las obligaciones contenidas en el acuerdo, como son las Normas de Origen de los Bienes y el régimen de responsabilidad del contratista estatal colo...

El impacto del TLC frente al derecho comunitario andino

Directory of Open Access Journals (Sweden)

Marcel Tangarife Torres

2006-01-01

Full Text Available En esta conferencia analiza el impacto del Tratado de Libre Comercio que se celebrará entre la República de Colombia y los Estados Unidos de Norteamérica frente al Derecho Comunitario Andino, con gran importancia en los temas relacionados con la propiedad intelectual. Adicional a lo anterior se suma un aspecto trascendental y es la supervivencia de la Comunidad Andina de Naciones y en este sentido se cuestiona la coexistencia de las normas comunitarias en relación con las previstas en el Tratado de Libre Comercio. De esta manera, se examina el marco constitucional del Tratado de Libre Comercio y del Acuerdo de Cartagena, para así determinar las características que tienen esta clase de tratados y con ello establecer el nivel jerárquico que le corresponden dentro del ordenamiento jurídico Colombiano. Finalmente se observa la prevalencía de las normas del Acuerdo de Cartagena y el Tratado de Libre Comercio o viceversa, para con ello encontrar soluciones frente a los posibles conflictos de normas que se pueden presentar por la coexistencia de dichas normatividades.

The Association between Hidradenitis Suppurativa and Crohn's Disease

DEFF Research Database (Denmark)

van der Zee, Hessel H; Horvath, Barbara; Jemec, Gregor B E

2016-01-01

Hidradenitis suppurativa is a chronic, autoinflammatory skin disease. Shalom et al. demonstrate in a large cross-sectional study an association between Crohn's disease and hidradenitis suppurativa, but not with ulcerative colitis. This association supports the hypothesis that a similar pathogenic...... mechanism contributes to both diseases, providing new possibilities for functional studies and therapy development....

EVALUACIÓN DE LAS TÉCNICAS DE CEPILLADO DE BASS Y VERTICAL EN UN GRUPO DE PACIENTES EN TRATAMIENTO DE ORTODONCIA CON TÉCNICA MBT

OpenAIRE

Yelitza Ivone Baracaldo Ortíz; Fredy Alexander Cabuya Cabuya; Rubén Darío Hurtado Rozo; Edwin Emil Ricaurte Vila; Diana Constanza Gamboa Martínez; Liliana Carolina Báez Quintero

2012-01-01

Objetivo: Evaluar la efectividad de las técnicas de Cepillado de Bass y Vertical en pacientes con aparatología ortodóntica fija tratados con la técnica MBT. Materiales y métodos: se realizó un estudio experimental “In vivo” aleatorizado doble ciego; la muestra fue de 100 personas distribuidas en dos grupos, a cada uno se le asignó una Técnica de Cepillado y se dieron instrucciones de higiene oral por medio de charlas personalizadas y por escrito. Se usó el índice de Sillnes y Löe para medir e...

Assessment of inflammatory activity in Crohn's disease by means of dynamic contrast-enhanced MRI.

Science.gov (United States)

Pupillo, V A; Di Cesare, E; Frieri, G; Limbucci, N; Tanga, M; Masciocchi, C

2007-09-01

Our aim was to perform a dynamic study of contrast enhancement of the intestinal wall in patients with Crohn's disease to quantitatively assess local inflammatory activity. We studied a population of 50 patients with histologically proven Crohn's disease. Magnetic resonance imaging (MRI) was performed using a 1.5-T magnet with a phased-array coil and acquisition of T2-weighted single-shot fast spin echo (SSFSE) half Fourier sequences before intravenous administration of gadolinium, and T1-weighted fast spoiled gradient (FSPGR) fat-saturated sequences before and after contrast administration. Before the examination, patents received oral polyethylene glycol (PEG) (1,000 ml for adults; 10 ml/Kg of body weight for children). Regions of interest (ROI) were placed on the normal and diseased intestinal wall to assess signal intensity and rate of increase in contrast enhancement over time. Data were compared with the Crohn's Disease Activity Index (CDAI). The diseased bowel wall showed early and intense uptake of contrast that increases over time until a plateau is reached. In patients in the remission phase after treatment, signal intensity was only slightly higher in diseased bowel loops than in healthy loops. There was a significant correlation between the peak of contrast uptake and CDAI. Dynamic MRI is a good technique for quantifying local inflammatory activity of bowel wall in patients with Crohn's disease.

Reconstrucción cervical tras resección de neurofibroma solitario gigante con colgajo anterolateral de muslo

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Mauricio Mendieta-Espinosa

Full Text Available Los tumores de cabeza y cuello son un grupo heterogéneo; los neurofibromas pueden originarse de cualquier nervio independientemente de su localización, incluyendo nervios periféricos o intracraneales y se dividen en 4 tipos. Los solitarios son tumores confinados, espontáneos y prácticamente sin ninguna manifestación. Anatómicamente, los neurofibromas del cuello son relativamente raros, con un crecimiento lento e indoloro. Presentamos el caso de un paciente varón de 41 años de edad, remitido a nuestra consulta por presentar neurofibroma solitario gigante en la base del lado izquierdo del cuello, de 10 cm de diámetro, con zona central ulcerada y sangrados intermitentes, adherido a planos profundos, de 30 años de evolución y que había sido tratado en 3 ocasiones con resecciones parciales y cubertura con colgajo acromial. Practicamos resección completa de la tumoración y reconstrucción inmediata con colgajo anterolateral de muslo, logrando la mejoría estético-funcional de la zona cervical y sin complicaciones.

Evaluation of therapeutic effect of low dose naltrexone in experimentally-induced Crohn's disease in rats.

Science.gov (United States)

Tawfik, Dina Ibrahim; Osman, Afaf Sayed; Tolba, Hedayat Mahmoud; Khattab, Aida; Abdel-Salam, Lubna O; Kamel, Mahmoud M

2016-10-01

Crohn's disease is a relapsing inflammatory condition afflicting the digestive tract. Drugs used for treatment of Crohn's disease may be associated with serious side effects. Endogenous opioid peptides modulate inflammatory cytokine production. Opioid antagonists have been shown to play a role in healing and repair of tissues. This work was designed to detect the possible beneficial effects of opioid antagonist naltrexone in indomethacin-induced Crohn's disease in rats. Enteritis was induced in male albino rats by two subcutaneous injection of indomethacin in a dose of 7.5mg/kg 24h apart started on day one. Salfasalazine, naltrexone and their combination were administered orally from day one of induction of enteritis to day 10. Disease activity index, serum levels of C-reactive protein and tumor necrosis factor-α, macroscopic and microscopic pathological scores and in vitro motility studies were evaluated. Induction of enteritis resulted in significant increase of disease activity index, significant elevation of serum levels of C-reactive protein and tumor necrosis factor-α, significant deterioration of pathological scores and significant increase in the mean contractility response of the isolated ileal segments compared with normal untreated rats. Treatment with sulfasalazine, low dose of natrexone or their combination resulted in significant improvement of all measured parameters compared with enteritis group. The current finding could provide new interesting opportunity for developing new therapeutic approaches for treatment of Crohn's disease. Use of naltrexone, especially in small dose, has little side effects making it of interest for treatment of Crohn's disease. Also, it provides the possibility of reduced doses of other drugs if it is used as combined therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Treatment of Crohn's disease with cannabis: an observational study.

Science.gov (United States)

Naftali, Timna; Lev, Lihi Bar; Yablecovitch, Doron; Yablekovitz, Doron; Half, Elisabeth; Konikoff, Fred M

2011-08-01

The marijuana plant cannabis is known to have therapeutic effects, including improvement of inflammatory processes. However, no report of patients using cannabis for Crohn's disease (CD) was ever published. To describe the effects of cannabis use in patients suffering from CD. In this retrospective observational study we examined disease activity, use of medication, need for surgery, and hospitalization before and after cannabis use in 30 patients (26 males) with CD. Disease activity was assessed by the Harvey Bradshaw index for Crohn's disease. Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 +/- 6.7 to 7 +/- 4.7 (P disease in humans. The results indicate that cannabis may have a positive effect on disease activity, as reflected by reduction in disease activity index and in the need for other drugs and surgery. Prospective placebo-controlled studies are warranted to fully evaluate the efficacy and side effects of cannabis in CD.

Direct bacterial killing in vitro by recombinant Nod2 is compromised by Crohn's disease-associated mutations.

Directory of Open Access Journals (Sweden)

Laurent-Herve Perez

2010-06-01

Full Text Available A homeostatic relationship with the intestinal microflora is increasingly appreciated as essential for human health and wellbeing. Mutations in the leucine-rich repeat (LRR domain of Nod2, a bacterial recognition protein, are associated with development of the inflammatory bowel disorder, Crohn's disease. We investigated the molecular mechanisms underlying disruption of intestinal symbiosis in patients carrying Nod2 mutations.In this study, using purified recombinant LRR domains, we demonstrate that Nod2 is a direct antimicrobial agent and this activity is generally deficient in proteins carrying Crohn's-associated mutations. Wild-type, but not Crohn's-associated, Nod2 LRR domains directly interacted with bacteria in vitro, altered their metabolism and disrupted the integrity of the plasma membrane. Antibiotic activity was also expressed by the LRR domains of Nod1 and other pattern recognition receptors suggesting that the LRR domain is a conserved anti-microbial motif supporting innate cellular immunity.The lack of anti-bacterial activity demonstrated with Crohn's-associated Nod2 mutations in vitro, supports the hypothesis that a deficiency in direct bacterial killing contributes to the association of Nod2 polymorphisms with the disease.

Intestinal microbiology in Crohn's disease: a study of Escherichia coli as a potential etiologic agent

OpenAIRE

Martínez Medina, Margarita

2009-01-01

Crohn's disease is a chronic inflammatory bowel disorder of unknown aetiology. Genetic and immunologic features that confer susceptibility on the host, together with external or environmental factors such as microorganisms and lifestyle, are thought to be involved. The main purpose of this work was to describe the bacterial populations particularly related with Crohn's disease patients in order to identify putative etiologic agents. The results are in agreement with previous research on the ...

Ramiprilate inhibits functional matrix metalloproteinase activity in Crohn's disease fistulas

DEFF Research Database (Denmark)

Efsen, Eva; Saermark, Torben; Hansen, Alastair

2011-01-01

Increased expression of matrix metalloproteinase (MMP)-2, -3 and -9 has been demonstrated in Crohn's disease fistulas, but it is unknown whether these enzymes are biologically active and represent a therapeutic target. Therefore, we investigated the proteolytic activity of MMPs in fistula tissue...... from six controls were also included. Total functional MMP activity was measured by a high-pressure liquid chromatography (HPLC)-based, fluorogenic MMP-substrate cleavage assay, and the specific activity of MMP-2, -3 and -9 by the MMP Biotrak Activity Assay. The MMP inhibitors comprised ethylene......-9.83) compared with non-Crohn's fistulas, [0.32 ng/ml, range 0-2.66, (p MMP-9 activity [0.64 ng/ml, range 0-5.66 and 0.17 ng/ml, range 0-1.1, respectively (p MMP activity level by 42% and suppressed the specific MMP-3...

Pediatric Crohn's disease: epidemiology and emerging treatment options

Directory of Open Access Journals (Sweden)

Kansal S

2014-07-01

Full Text Available Shivani Kansal,1–3 Anthony G Catto-Smith1,2 1Department of Paediatrics, University of Melbourne, 2Department of Gastroenterology, The Royal Children's Hospital Melbourne, 3Murdoch Children's Research Institute, Melbourne, VIC, Australia Abstract: There has been a dramatic increase in the incidence of Crohn's disease over the last two to three decades worldwide, which has affected both the developed world and increasingly also the developing world. Crohn's disease is a disease of youth and can have a profound effect on the growing child, both in terms of growth and skeletal health as well psychosocial maturation. Environmental risk factors appear to be crucially important, but it is not clear at present whether improved hygiene, especially in childhood, influences immunological conditioning, or whether there is a direct impact on the gut from a disturbed gut microbiota. Genetic variation appears to relate to how the host interacts with its microbiota, determining susceptibility rather than causation. The outcome is a sustained immune response, clinically presenting as a relapsing/remitting disease process. There is no current cure for Crohn's disease; treatments are designed to reduce symptoms and control inflammation, initially by inducing a remission, then trying to maintain it. Historical therapies have included 5-aminosalicylic acid-based drugs, corticosteroids, and immunomodulators. Two approaches which are gaining increasing interest are the use of exclusive enteral nutrition and biologicals. Enteral nutrition is a remarkably effective approach, though there is a limited understanding of its mechanism and difficulties in acceptance among the medical community. Biologicals are a class of drugs which specifically target molecules and pathways central to the inflammatory process; they are also very effective, but patients can develop a secondary loss of response as a result of antibodies to the biological agent. Infection and the development

Medium-term follow-up of Crohn's disease in Cape Town

African Journals Online (AJOL)

1989-08-09

Aug 9, 1989 ... Normally distributed data, such as age, were tested in the different groups by ... extent of disease at diagnosis had been determined by small ..... Brahme F, Lindstrom C, Wenckert A. Crohn's disease in a defined popula- tion.

Acute lower gastrointestinal bleeding in Crohn's disease: characteristics of a unique series of 34 patients. Belgian IBD Research Group

NARCIS (Netherlands)

Belaiche, J.; Louis, E.; D'Haens, G.; Cabooter, M.; Naegels, S.; de Vos, M.; Fontaine, F.; Schurmans, P.; Baert, F.; de Reuck, M.; Fiasse, R.; Holvoet, J.; Schmit, A.; van Outryve, M.

1999-01-01

Acute lower gastrointestinal bleeding is a rare complication of Crohn's disease, which represents a diagnostic and therapeutic challenge. The aim of this study was to define epidemiological characteristics and therapeutic options of hemorrhagic forms of Crohn's disease. Thirty-four cases of

Treatment of therapy-resistant perineal metastatic Crohn's disease after proctectomy using anti-tumor necrosis factor chimeric monoclonal antibody, cA2 - Report of two cases

NARCIS (Netherlands)

van Dullemen, HM; de Jong, E; Slors, F; Tytgat, GNJ; van Denventer, SJH

PURPOSE: Two young females with well-documented Crohn's disease and nonhealing perineal wounds following proctectomy compatible with "metastatic Crohn's disease" are described, We hypothesized that metastatic Crohn's disease would be a tumor necrosis factor-dependent inflammatory-reaction and have

Voz e qualidade de vida de pacientes tratados de câncer avançado de laringe

OpenAIRE

Vaneli de Cassia Colombo Rossi

2013-01-01

Resumo: OBJETIVO: Avaliar qualidade de vida e voz de pacientes tratados de câncer avançado de laringe por laringectomia total ou quimioradioterapia exclusiva com preservação de órgão. MATERIAL E MÉTODOS: 30 pacientes tratados de câncer avançado de laringe livres da doença há pelo menos quatro anos: dez laringectomizados totais sem produção de voz esofágica (SVE); dez laringectomizados totais com voz traqueoesofágica (VTE) e dez com voz laríngea. A qualidade de vida foi mensurada pelos protoco...

Inflammatory activity in Crohn disease: ultrasound findings.

Science.gov (United States)

Migaleddu, Vincenzo; Quaia, Emilio; Scano, Domenico; Virgilio, Giuseppe

2008-01-01

Improvements in the ultrasound examination of bowel disease have registered in the last years the introduction of new technologies regarding high frequency probes (US), highly sensitive color or power Doppler units (CD-US), and the development of new non-linear technologies that optimize detection of contrast agents. Contrast-enhanced ultrasound (CE-US) most importantly increases the results in sonographic evaluation of Crohn disease inflammatory activity. CE-US has become an imaging modality routinely employed in the clinical practice for the evaluation of parenchymal organs due to the introduction of new generation microbubble contrast agents which persist in the bloodstream for several minutes after intravenous injection. The availability of high frequency dedicated contrast-specific US techniques provide accurate depiction of small bowel wall perfusion due to the extremely high sensitivity of non-linear signals produced by microbubble insonation. In Crohn's disease, CE-US may characterize the bowel wall thickness by differentiating fibrosis from edema and may grade the inflammatory disease activity by assessing the presence and distribution of vascularity within the layers of the bowel wall (submucosa alone or the entire bowel wall). Peri-intestinal inflammatory involvement can be also characterized. CE-US can provide prognostic data concerning clinical recurrence of the inflammatory disease and evaluate the efficacy of drugs treatments.

Saccharomyces boulardii does not prevent relapse of Crohn's disease.

Science.gov (United States)

Bourreille, Arnaud; Cadiot, Guillaume; Le Dreau, Gérard; Laharie, David; Beaugerie, Laurent; Dupas, Jean-Louis; Marteau, Philippe; Rampal, Patrick; Moyse, Dominique; Saleh, Ashraf; Le Guern, Marie-Emmanuelle; Galmiche, Jean-Paul

2013-08-01

Saccharomyces boulardii is a probiotic yeast that has been shown to have beneficial effects on the intestinal epithelial barrier and digestive immune system. There is preliminary evidence that S boulardii could be used to treat patients with Crohn's disease (CD). We performed a randomized, placebo-controlled trial to evaluate the effects of S boulardii in patients with CD who underwent remission during therapy with steroids or aminosalicylates. We performed a prospective study of 165 patients who achieved remission after treatment with steroids or salicylates; they were randomly assigned to groups given S boulardii (1 g/day) or placebo for 52 weeks. The primary end point was the percentage of patients in remission at week 52. Time to relapse, Crohn's disease activity index scores, and changes in parameters of inflammation were secondary end points. CD relapsed in 80 patients, 38 in the S boulardii group (47.5%) and 42 in the placebo group (53.2%, a nonsignificant difference). The median time to relapse did not differ significantly between patients given S boulardii (40.7 weeks) vs placebo (39.0 weeks). There were no significant differences between groups in mean Crohn's disease activity index scores or erythrocyte sedimentation rates or in median levels of C-reactive protein. In a post hoc analysis, nonsmokers given S boulardii were less likely to experience a relapse of CD than nonsmokers given placebo, but this finding requires confirmation. Although the probiotic yeast S boulardii is safe and well tolerated, it does not appear to have any beneficial effects for patients with CD in remission after steroid or salicylate therapies. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

Biologic treatment or immunomodulation is not associated with postoperative anastomotic complications in abdominal surgery for Crohn's disease

DEFF Research Database (Denmark)

El-Hussuna, Alaa Abdul-Hussein H; Andersen, Jens; Bisgaard, Thue

2012-01-01

There are concerns that biologic treatments or immunomodulation may negatively influence anastomotic healing. This study investigates the relationship between these treatments and anastomotic complications after surgery for Crohn's disease.......There are concerns that biologic treatments or immunomodulation may negatively influence anastomotic healing. This study investigates the relationship between these treatments and anastomotic complications after surgery for Crohn's disease....

Endoscopic and histologic healing of Crohn's (ileo-) colitis with azathioprine

NARCIS (Netherlands)

D'Haens, G.; Geboes, K.; Rutgeerts, P.

1999-01-01

The correlation between disease activity and endoscopic findings in Crohn's disease is poor. Corticosteroids induce symptom relief without consistent improvement of endoscopic lesions. Our aim was to examine the effect of azathioprine therapy on healing of inflammatory lesions in patients with

Tratamiento con caspofungina de endocarditis por Candida tropicalis resistente a fluconazol Treatment with caspofungin of Candida tropicalis endocarditis resistant to fluconazol

Directory of Open Access Journals (Sweden)

Marcelo del Castillo

2004-04-01

Full Text Available Las endocarditis causadas por hongos, (Candida en particular, requieren tratamiento médico-quirúrgico, siendo la anfotericina B la droga de elección. Caspofungina es una equinocandina con gran actividad sobre Candida y Aspergillus. Se presenta un paciente con una endocarditis por Candida tropicalis resistente a fluconazol tratado con caspofungina bajo un esquema de salvataje, luego de haber presentado efectos adversos por anfotericina B. El paciente tuvo respuesta microbiológica.Fungal endocarditis, in particular due to Candida species, requires medical and surgical treatment and amphotericin B is the drug of choice. Caspofungin is an echinocandin very effective against Candida and Aspergillus. We present a patient with Candida tropicalis endocarditis, fluconazol resistant, treated with caspofungin, on a compassional basis as a result of adverse effects with amphotericin B. The patient had a microbiological response.

Recuperación del epitelio germinal masculino de ratones tratados con dosis única de Busulfán

Directory of Open Access Journals (Sweden)

Luis Guzmán

2013-05-01

Full Text Available Busulfán es un agente alquilante bifuncional tipo-éster, que interfiere con la replicación del ADN. Dosis elevadas de este compuesto son aplicadas antes de los transplantes de médula ósea y de células germinales, sin embargo no han sido cuantificados el daño ni la recuperación del sistema reproductor. Para cuantificar la recuperación del efecto en la espermatogénesis, se usaron ratones de la cepa Balb C, a los que se les inyectó Busulfán intraperitonealmente, 40 mg/kg de peso corporal, y se evaluó el peso testicular y la concentración espermática en cola de epidídimo, a los 30, 54 y 72 días y se realizaron cortes histológicos de testículo. Los resultados fueron analizados con la prueba U Mann-Whitney p>0.05. A los 30 días el peso testicular, la concentración espermática y el diámetro de los túbulos seminíferos presentaron una drástica reducción del 77,8%, 97,9% y 34,3% respectivamente, comparados con el grupo control. A los 54 días, el peso testicular y el diámetro testicular muestran una recuperación del 70%. A los 72 días, la recuperación es completa en los parámetros evaluados. Por lo tanto, Busulfán aplicado en una sola dosis afecta significativamente la espermatogénesis en el ratón y se logra la recuperación completa en dos ciclos espermáticos.

Velocidad de la onda de pulso y la excreción urinaria de albumina en pacientes hipertensos tratados con Perindopril

Directory of Open Access Journals (Sweden)

J. E. Tobilli

2002-12-01

Full Text Available La presión arterial sistólica, la presión arterial diastólica y la excreción urinaria de albúmina (EUA han sido reconocidas como predictores de riesgo cardiovascular. Además, los trastornos de la compliance arterial (CA evaluados mediante la velocidad de la onda de pulso elevada (VOP están estrechamente relacionados con los cambios de la presión arterial y correlacionados con la mortalidad cardiovascular y la presencia de ateroesclerosis. El objetivo primario de este estudio ha sido determinar la relación entre la VOP y la EUA en un grupo de pacientes no fumadores con hipertensión esencial y secundariamente evaluar los cambios producidos por un inhibidor de la enzima convertidora de angiotensina (perindopril sobre estas dos variables. En el estudio participaron setenta pacientes (33 hombres y 37 mujeres hipertensos no fumadores, sin tratamiento previo, de 50 ± 7 años (entre 35-69. La VOP de todos los pacientes fue estudiada por medio de un dispositivo computarizado (Complior en el período basal y a los seis meses de tratamiento con perindopril. También se determinó la EUA por el método de inmunodifusión radial al inicio del tratamiento y luego de seis meses de tratamiento con perindopril (4.6 ± 1.4 mg/día. Al finalizar el estudio se observó una reducción significativa de la presión arterial sistólica (PAS (160.2 ± 10.6 vs. 131.9 ± 7.1 mmHg, p<0.01, presión arterial diastólica (PAD (100.6 ± 5 vs. 81.6 ± 4.8 mmHg, p<0.01, VOP (13.4 ± 1 vs. 9.1 ± 0.9 m/seg, p<0.01 y EUA (42.2 ± 19.3 vs.11.1 ± 3.6 mg/día, p<0.01 al comparar estos valores con los del período basal. Por otra parte, la función renal evaluada por clearance de creatinina mostró una significativa mejoría en relación a los valores iniciales (87.5 ± 22.5 vs. 102.1 ± 23.5 ml/min, p<0.01. Asimismo, se apreció una significativa correlación positiva entre la EUA y la VOP al inicio del estudio (r = 0.81; p<0.01 y después de seis meses de tratamiento

Legitimidad y finalidad de los capítulos de propiedad intelectual en los tratados de libre comercio (TLC)

OpenAIRE

Frankel, Susy

2011-01-01

Una visión analítica de la realidad actual permite apreciar un auge de los Tratados de Libre Comercio, mientras se presenta un estancamiento en las negociaciones multilaterales de comercio. Si bien la negociación de los TLC no se limita a los países desarrollados, los negociados por los países en desarrollo no tienden a contemplar mejoras en los estándares de propiedad intelectual. Algunos de los capítulos relativos a la propiedad intelectual incluidos en los Tratados de Libre Comercio simple...

Nostalgia of the Encomienda. Rereading Juan Suárez de Peralta's Tratado del descubrimiento (1589

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Enrique González González

2009-10-01

Full Text Available The work Tratado del descubrimiento de las Yndias y su conquista, written  by the New Spain Creole Juan Suárez de Peralta around 1589, has traditionally been read as just another Conquest chronicle, scarcely interesting in its first chapters, but fully vivid in its “second” part, where the author  tells of the so-called conspiracy of Martín Cortés,  Second Marquis of the Valley of Oaxaca. This paper, however, suggests that the Tratado, in keeping with its title, must be read as a treatise in which Suárez de Peralta pleads for the legitimacy of the encomienda and offers an account of the fateful —as he sees them— consequences  brought about by the Crown's rulings to suppress it. Therefore, the Tratado must be considered within the great debates of the time on how conquered peoples, conquerors and their descendants  should be treated. Although not a professional lawyer, Suárez de Peralta turns out to be a resourceful and convincing writer. Far from offering a linear account  of a series of events, he takes advantage of ambiguity in order  to argue, from different  viewpoints,  on several issues. Sensing that he defends a lost cause, his allegation oozes irony, disillusion, and nostalgia.

A rare case of Crohn's ileitis in a patient with constitutional mismatch repair deficiency.

Science.gov (United States)

Kaimakliotis, Pavlos; Giardiello, Francis; Eze, Ogechukwu; Truta, Brindusa

2017-01-01

Constitutional mismatch repair deficiency (CMMRD), a variant of Lynch syndrome, is a rare disease characterized by café-au-lait spots, oligopolyposis, glioblastoma and lymphoma. A 24-year-old male, under surveillance for CMMRD, developed Crohn's ileitis after total colectomy with end ileostomy for colorectal cancer and failed to respond to oral corticosteroids. The patient underwent induction and maintenance of remission with vedolizumab infusions. We report the first patient with CMMRD developing Crohn's disease. The choice of immunosuppressive therapy in these patients is challenging and needs to be made according to their risk for malignancy.

Impacto del Tratamiento con Teriparatida en la Calidad de Vida de las Personas con Osteoporosis

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Marta Osca Guadalajara

2015-01-01

Full Text Available La pérdida ósea en pacientes osteoporóticos, conlleva riesgo de fracturas, dolor óseo vertebral y disminución de la calidad de vida. El objetivo de este trabajo fue analizar el efecto de la teriparatida (TPTD en pacientes osteoporóticos y con dolor vertebral. Métodos: Estudio observacional longitudinal prospectivo, entre abril de 2006 y febrero de 2014, en los 77 pacientes tratados con TPTD en la Unidad del Dolor del Hospital de Teruel. La duración del tratamiento fue de 18 o 24 meses. Se utilizó la Escala Visual Analógica (EVA para la medición del dolor y el cuestionario europeo de calidad de vida (EuroQol-5D para obtener la tarifa social (TS, antes y después el tratamiento. Se realizó un análisis descriptivo, de regresión lineal y logística. Resultados: Se observó una mejoría del dolor (80% y de la calidad de vida (65 %. Se mejoró la EVA media (5,42 a 3,47 puntos y el EuroQol-5D (0,36 a 0,58 puntos. La regresión indicó una mejora de la EVA en 0,441 puntos por cada punto de EVA inicial, y de la TS en 0,0528 puntos por cada 0,1 puntos de TS inicial. La probabilidad de mejorar la EVA en 3 puntos (OR=2,021, fue mayor que de mejorar 2 puntos (OR=1,695. Conclusiones: La TPTD en pacientes osteoporóticos reduce el dolor óseo y mejora la calidad de vida. Su efecto es mayor en pacientes con peor estado de salud inicial, pudiendo ser utilizado como criterio para las decisiones terapéuticas y de gestión clínica.

N-cadherin is overexpressed in Crohn's stricture fibroblasts and promotes intestinal fibroblast migration.

LENUS (Irish Health Repository)

Burke, John P

2012-02-01

BACKGROUND: Intestinal fibroblasts mediate stricture formation in Crohn\\'s disease (CD). Transforming growth factor-beta (TGF-beta) is important in fibroblast activation, while cell attachment and migration is regulated by the adhesion molecule N-cadherin. The aim of this study was to investigate the expression and function of N-cadherin in intestinal fibroblasts in patients with fibrostenosing CD. METHODS: Intestinal fibroblasts were cultured from seromuscular biopsies from patients undergoing resection for terminal ileal fibrostenosing CD (n = 14) or controls patients (n = 8). N-cadherin expression was assessed using Western blot and quantitative reverse-transcription polymerase chain reaction (qRT-PCR). Fibroblasts were stimulated with TGF-beta and selective pathway inhibitors Y27632, PD98050, and LY294002 were used to examine the Rho\\/ROCK, ERK-1\\/2, and Akt signaling pathways, respectively. Cell migration was assessed using a scratch wound assay. N-cadherin was selectively overexpressed using a plasmid. RESULTS: Fibroblasts from fibrostenosing CD express increased constitutive N-cadherin mRNA and protein and exhibit enhanced basal cell migration relative to those from directly adjacent normal bowel. Control fibroblasts treated with TGF-beta induced N-cadherin in a dose-dependent manner which was inhibited by Rho\\/ROCK and Akt pathway modulation. Control fibroblasts exhibited enhanced cell migration in response to treatment with TGF-beta or transfection with an N-cadherin plasmid. CONCLUSIONS: Fibroblasts from strictures in CD express increased constitutive N-cadherin and exhibit enhanced basal cell migration. TGF-beta is a potent inducer of N-cadherin in intestinal fibroblasts resulting in enhanced cell migration. The TGF-beta-mediated induction of N-cadherin may potentiate Crohn\\'s stricture formation.

¿Mejora la calidad de vida de pacientes con EPOC si son tratados por las enfermeras?

OpenAIRE

Vega Ramírez, Francisco Antonio; Quero Fuentes, María del Mar

2015-01-01

Cartel presentado en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de Madrid Introducción: la enfermedad pulmonar obstructiva crónica (EPOC), afecta a la calidad de vida (CV) de las personas y origina la necesidad de acciones adicionales de autocuidado. Objetivo: conocer si existe mejora en la calidad de vida en los pacientes con EPOC que son atendidos por enfermeras. Metodología: este estudio se basa en un di...

Biosíntesis de dextranos de alto peso molecular mediante la inoculación con Leuconostoc Mesenteroides, var. Mesenteroides (atcc 10830 de jugos residuales de la agroindustria de la piña: síntesis y caracterización de hierro-dextranos

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José Roberto Vega Baudrit

2013-01-01

Full Text Available En este trabajo se muestran los estudios realizados para obtener dextranos a partir de desechos de la agroindustria de piña. La fermentación se llevó a cabo en un biorreactor (10 L, se inoculó con un cultivo de Leuconostoc mesenteroides, var. mesenteroides (ATCC 10830. Se centrifugó y se precipitó y purificó con etanol. Fue caracterizado por medio de viscosidad, peso molecular y grupos funcionales por espectroscopía infrarroja. Este dextrano fue tratado con el fin de obtener hierro-dextranos.

Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn's disease assessment with histopathology of surgical specimens

NARCIS (Netherlands)

Tielbeek, Jeroen A. W.; Ziech, Manon L. W.; Li, Zhang; Lavini, Cristina; Bipat, Shandra; Bemelman, Willem A.; Roelofs, Joris J. T. H.; Ponsioen, Cyriel Y.; Vos, Frans M.; Stoker, Jaap

2014-01-01

To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn's disease. 3-T MR enterography was performed in consecutive Crohn's disease patients scheduled for surgery within 4 weeks.

Overexposure of radiation therapy patients in Panama: problem recognition and follow-up measures La sobreexposición de pacientes tratados con radioterapia en Panamá: reconocimiento del problema y medidas de seguimiento

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Cari Borrás

2006-09-01

se encontraban físicos médicos de la Organización Panamericana de la Salud (OPS, quienes comprobaron que 56 pacientes con cáncer cérvico-uterino, de endometrio, de próstata o de recto tratados mediante campos de teleterapia parcialmente bloqueados recibieron dosis calculadas mediante un sistema computarizado de planificación de tratamientos. Los físicos médicos de la OPS comprobaron que solo 11 de esos 56 pacientes recibieron una dosis absorbida dentro de los límites aceptables de ±5%. Veintiocho de los 56 pacientes recibieron dosis con errores entre +10 y +105%. De esos 28 pacientes que fueron sobreexpuestos, según los físicos del ION, 23 murieron antes de septiembre de 2005; de ellos, 18 murieron a causa de los efectos de las radiaciones, principalmente complicaciones rectales. Las consecuencias clínicas, psicológicas y jurídicas de esta sobreexposición menoscabaron gravemente los tratamientos contra el cáncer en Panamá y llevaron a la OPS a examinar de cerca las prácticas de radioterapia oncológica en América Latina y el Caribe. Los médicos del ION evaluaron los resultados del tratamiento de 125 pacientes atendidos en ese mismo intervalo de tiempo por los mismos tipos de cáncer sin haber sufrido sobreexposición y encontraron una tasa de recurrencia de cáncer cervicouterino mayor de la esperada. Esto llevó a la OPS a lanzar una iniciativa para la acreditación de los centros de radioterapia oncológica en América Latina y el Caribe, en colaboración con las sociedades profesionales de radioncólogos, físicos médicos y tecnólogos de radioterapia. La Asociación Latinoamericana de Terapia Radiante Oncológica estableció una comisión de acreditación que exigirá que los centros establezcan programas integrales de garantía de la calidad en radioterapia oncológica según los lineamientos internacionales. Asimismo, se recogerán datos estadísticos acerca de los resultados observados en los pacientes tratados para documentar las

Solución de controversias en los tratados bilaterales de inversión: mapa de situación en América del Sur

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Magdalena Bas Vilizzio

2015-03-01

Full Text Available Este trabajo analiza las características particulares del sistema legal internacional de solución de controversias inversor-Estado, con especial foco en los tratados bilaterales de inversión (TBI en vigor en América del Sur, salvo excepciones. En este marco, aplicando la teoría de los regímenes internacionales (Krasner, 1983, se examinan las tres posiciones de los Estados de la región en torno al tema: 1 no ratificar TBI ni ser miembro del Centro Internacional de Arreglo de Diferencias relativas a Inversiones (CIADI (Brasil; 2 denunciar los TBI en vigor y abandonar el CIADI (Bolivia, Ecuador y Venezuela; 3 mantener los TBI en vigor y permanecer en los foros de solución de controversias actuales (Argentina, Chile, Colombia, Guyana, Paraguay, Perú, Surinam y Uruguay.

Inflammation, Antibiotics, and Diet as Environmental Stressors of the Gut Microbiome in Pediatric Crohn's Disease.

Science.gov (United States)

Lewis, James D; Chen, Eric Z; Baldassano, Robert N; Otley, Anthony R; Griffiths, Anne M; Lee, Dale; Bittinger, Kyle; Bailey, Aubrey; Friedman, Elliot S; Hoffmann, Christian; Albenberg, Lindsey; Sinha, Rohini; Compher, Charlene; Gilroy, Erin; Nessel, Lisa; Grant, Amy; Chehoud, Christel; Li, Hongzhe; Wu, Gary D; Bushman, Frederic D

2015-10-14

Abnormal composition of intestinal bacteria--"dysbiosis"-is characteristic of Crohn's disease. Disease treatments include dietary changes and immunosuppressive anti-TNFα antibodies as well as ancillary antibiotic therapy, but their effects on microbiota composition are undetermined. Using shotgun metagenomic sequencing, we analyzed fecal samples from a prospective cohort of pediatric Crohn's disease patients starting therapy with enteral nutrition or anti-TNFα antibodies and reveal the full complement and dynamics of bacteria, fungi, archaea, and viruses during treatment. Bacterial community membership was associated independently with intestinal inflammation, antibiotic use, and therapy. Antibiotic exposure was associated with increased dysbiosis, whereas dysbiosis decreased with reduced intestinal inflammation. Fungal proportions increased with disease and antibiotic use. Dietary therapy had independent and rapid effects on microbiota composition distinct from other stressor-induced changes and effectively reduced inflammation. These findings reveal that dysbiosis results from independent effects of inflammation, diet, and antibiotics and shed light on Crohn disease treatments. Copyright © 2015 Elsevier Inc. All rights reserved.

Intestinal permeability to [51Cr]EDTA in children with Crohn's disease and celiac disease

International Nuclear Information System (INIS)

Turck, D.; Ythier, H.; Maquet, E.; Deveaux, M.; Marchandise, X.; Farriaux, J.P.; Fontaine, G.

1987-01-01

[ 51 Cr]EDTA was used as a probe molecule to assess intestinal permeability in 7 healthy control adults, 11 control children, 17 children with Crohn's disease, and 6 children with untreated celiac disease. After subjects fasted overnight, 75 kBq/kg (= 2 microCi/kg) 51 Cr-labeled EDTA was given by mouth; 24-h urinary excretion of [ 51 Cr]EDTA was measured and expressed as a percentage of the total oral dose. Mean and SD were as follows: control adults 1.47 +/- 0.62, control children 1.59 +/- 0.55, and patients with Crohn's disease or celiac disease 5.35 +/- 1.94. The difference between control children and patients was statistically significant (p less than 0.001). These results show that intestinal permeability to [ 51 Cr]EDTA is increased among children with active or inactive Crohn's disease affecting small bowel only or small bowel and colon, and with untreated celiac disease. The [ 51 Cr]EDTA permeability test could facilitate the decision to perform more extensive investigations in children suspected of small bowel disease who have atypical or poor clinical and biological symptomatology

LA AGROINDUSTRIA AZUCARERA DE ARGENTINA Y LOS DESAFÍOS FRENTE AL PROCESODE INTEGRACIÓN CON BRASIL

OpenAIRE

Verón, Alejandro; Calvo, Clara

2012-01-01

Desde la firma del Tratado de Asunción que dio origen a la conformación del Mercado Común el Sur (Mercosur), se facilitó el intercambio comercial entre los países miembros y con ello la apertura de los mercados, sin embargo en la actualidad aún existen productos que continúan sin entrar en competencia, tal el caso del azúcar. Al respecto y desde un lugar común, la mayoría de las opiniones concuerdan que la integración en materia azucarera es inviable: las barreras arancelarias de Argentina co...

Radiological sacroiliitis, a hallmark of spondylitis, is linked with CARD15 gene polymorphisms in patients with Crohn's disease

OpenAIRE

Peeters, Harald; Vander Cruyssen, Bert; Laukens, Debby; Coucke, Paul; MARICHAL, DENIS; VAN DEN BERGHE, MARTINA; Cuvelier, Claude; Remaut, Erik; Mielants, Herman; De Keyser, Filip; De Vos, Martine

2004-01-01

Background: Sacroiliitis is a common extraintestinal manifestation of Crohn's disease but its association with the HLA-B27 phenotype is less evident. Polymorphisms in the CARD15 gene have been linked to higher susceptibility for Crohn's disease. In particular, associations have been found with ileal and fibrostenosing disease, young age at onset of disease, and familial cases.

CUANTIFICACIÓN DE MERCURIO EN PASTO TRATADO CON BIOSÓLIDOS POR ESPECTROFOTOMETRÍA DE ABSORCIÓN ATÓMICA CON GENERADOR DE HIDRUROS

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Amilvia Yanett Ortiz Villa

Full Text Available Los subproductos sólidos de carácter orgánico generados por los procesos de tratamiento de aguas residuales municipales son utilizados comúnmente como fuente de nutrientes para tratamiento de suelos. Estos biosólidos contienen nutrientes contaminantes inorgánicos como el mercurio, el cual es empleado para el estudio, por el conocimiento ampliamente documentado de su toxicidad en sistemas vivos y sus efectos en seres humanos. En este mismo sentido, y puesto que las plantas constituyen la base de la cadena trófica, se centra la atención sobre el pasto, debido a su fácil crecimiento y uso como pastura de ganadería. El mercurio en pasto fue cuantificado mediante espectrofotometría de absorción atómica utilizando la técnica de generador de hidruros con vapor frío. Se verificaron algunos parámetros de validación con criterios de aceptación deseables tales como linealidad (r² = 0,999, exactitud (R = 93,14-96,12%, precisión (CV = 1,11-1,69%, límites de detección y cuantificación (0,001-0,003 ppb. Se evidenció que las concentraciones de mercurio se encuentran por debajo de los valores máximos permitidos por la normatividad Internacional, presentando el biosólido como fuente confiable de nutrientes para el agro. De esta forma se establece una metodología que puede ser una buena herramienta para la determinación analítica de mercurio en pastos.

Tratamiento de quistes óseos aneurismáticos con aloinjerto. [Treatment of aneurysmal bone cysts with allograft].

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Dany Olivera Nùñez

2016-05-01

Full Text Available Antecedentes Los pacientes con quiste óseo aneurismático (QOA plantean dificultades diagnósticas y terapéuticas. Han sido descritas múltiples opciones terapéuticas. Objetivos Nuestro objetivo fue evaluar los resultados obtenidos en pacientes tratados con curetaje y relleno con aloinjerto óseo. Material y métodos  Fue analizado un total de 16 quistes, correspondientes a 15 pacientes, con un seguimiento mínimo de 28 meses y una mediana de seguimiento de 83 meses. Resultados La edad media de los niños fue de 10 años (rango: 3-16 . La principal complicación fue la recidiva en el 37,5% de los pacientes, siendo más frecuente cuando existió compromiso fisario (62,5%  vs. 12,5% sin compromiso; p=0,05. La frecuencia de recidiva no varió para ambos sexos, para las distintas edades analizadas y respecto al uso o no de fresa de alta velocidad. Conclusión Pensamos que el tratamiento realizado es seguro, pero tiene una alta tasa de recidivas, similar a las publicadas en otras series.

Immunodeficiencies and autoimmune diseases: common variable immunodeficiency and Crohn-like

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Cristina Saldaña-Dueñas

Full Text Available Background: Common variable immunodeficiency (CVI gives a major risk of principally respiratory and digestive infections. It is associated with autoimmune diseases, granulomatous process and neoplasias. The digestive clinic is common, in 10% of patients it is the only symptom, and 60% present chronic diarrhea. Clinically it can be confused and related with other pathologies such as inflammatory bowel disease which is infrequent (2-13%. Case report: We present the case of a patient with CVI with digestive symptoms being diagnosed of Crohn-like disease with extent ileal affectation. The main treatment of these patients is the same as classical Crohn disease although in the most severe cases, as this one, the use of immunosupresors is necessary. At this time the patient remains on clinical remmision with infliximab. She presented a previous adverse reaction with adalimumab. Discussion: The few case series in this pathology makes the treatment with immunomodulators in this immunodeficiency a real diagnostic and therapeutic challenge.

Pachydermoperiostosis in a Patient with Crohn's Disease: Treatment and Literature Review.

Science.gov (United States)

Mobini, Maryam; Akha, Ozra; Fakheri, Hafez; Majidi, Hadi; Fattahi, Sanam

2018-01-01

Pachydermoperiostosis (PDP) is a rare disorder characterized by pachydermia, digital clubbing, periostitis, and an excess of affected males. It is the primary form of hypertrophic osteoarthropathy (HOA) and there are some rare associations of PDP with other disorders. Here we describe a patient with Crohn's disease associated with PDP. A 26-year-old man, who was a known case of Crohn's disease, referred with diffuse swelling in the upper and lower limbs and cutis verticis gyrata since 7 years ago. PDP was suspected and endocrinological and radiological studies were conducted for the evaluation of underlying disease. He was prescribed celecoxib, low-dose prednisolone, and pamidronate to control the swelling, periostitis, azathiopurine, and mesalazine according to gastrointestinal involvement. In conclusion, it is important to identify this condition since a misdiagnosis might subject the patient to unnecessary investigations.

Manifestaciones cardiovasculares en pacientes tratados con hemodiálisis periódica por fístula arteriovenosa funcional

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Ana S. Ayora Loaiza

2016-06-01

Conclusiones: No se encontró relación entre la localización de la fistula y los cambios en el sistema cardiovascular. El grupo de pacientes con fistula de más de cuatro años presentó mayores manifestaciones cardiovasculares y cambios significativos en el ecocardiograma.

La ciencia política en Colombia en el 2005-2006 : el análisis del conflicto armado y de las elecciones, dos temas tradicionales, pero con enfoques nuevos

OpenAIRE

Garibay , David

2007-01-01

Este reseña presenta un panorama de las trabajos académicos en ciencia politica publicados en Colombia en 2005 y 2006. Los temas del analisis del conflicto armado interno y del comportamiento electoral han dominado la produccion cientifica colombiana. Estos dos temas, sobre los cuales existe una tradicion establecida en Colombia, han sido tratados con enfoques nuevos, y de manera autonoma uno del otro

Radiological assessement of Crohn's disease

International Nuclear Information System (INIS)

Florio, F.; Palladino, M.; Stella, P.; Barbi, E.

1987-01-01

Fifty-eight consecutive cases of patients affected by Crohn's disease, with ileum (23/58), colon (10/58) and ileo-colic (25/58) involvement were studied. A good overall sensitivity was reached by the radiological procedures employed (barium meal, barium enema, enterclysis). Enterclysis is proposed as a second-step method for the study of ileum involvement, because it provides a quite precise assessement of disease stage and extent. Some criteria for a rational use of current radiological procedures in follow-up of both surgically and medically treated patients are proposed. Moreover it is suggested that better coordination of anatomo-radiological and clinical aspects could improve the therapeutic approach and prognostic judgement in such cases

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......, 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...

Birth outcome in women with ulcerative colitis and Crohn's disease, and pharmacoepidemiological aspects of anti-inflammatory drug therapy

DEFF Research Database (Denmark)

Nørgård, Bente Mertz

2011-01-01

, including patients with ulcerative colitis and Crohn's disease. The third part (and the latest publications) includes birth outcome in women with Crohn's disease; and the methods of cohort establishment in these studies are developed and improved due to the knowledge gathered from conducting the earlier...... prescription Database, the Danish National Hospital Discharge Registry, the Danish Medical Birth Registry, and review of selected medical records. After exposure to sulfasalazine during pregnancy our data suggest. No significantly increased overall relative risk of congenital abnormalities and no significantly...... National Hospital Discharge Registry, the nationwide Danish Prescription Database and the Danish Medical Birth Registry. Furthermore, birth outcomes are examined in Crohn's disease women with disease activity during pregnancy, based on data from review of hospital records, the Danish National Hospital...

Rotura del Bíceps Distal. Evaluación de resultados con técnica de doble fijación. [Distal biceps rupture: evaluation of results with double fixation technique

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Miguel Ángel Capomassi

2013-11-01

Full Text Available In­tro­duc­ción La rotura del bíceps distal es una lesión poco frecuente producida por la aplicación de una fuerza excéntrica sobre el codo flexionado. El objetivo de este trabajo es analizar los resultados obtenidos para la reinserción del bíceps distal mediante técnica de doble fijación con botón de anclaje cortical y tornillo interferencial de biotenodesis a través de una incisión anterior única. Materiales­ y­ Métodos Entre agosto de 2008 y febrero de 2013, registramos 19 casos de rotura del bíceps distal tratados quirúrgicamente por vía anterior limitada. Los 17 últimos casos consecutivos fueron tratados con doble fijación utilizando botón extracortical y tornillo de biotenodesis, y forman parte del estudio. Todos eran hombres, con una mediana de la edad de 41 años (rango 27-59. Los pacientes fueron evaluados con el Cuestionario DASH y el Puntaje Subjetivo/Objetivo de Andrews y Carson, y la fuerza de flexión y supinación se controló con la escala del British Medical Research Council modificada por Mackinnon y Dellon (M0-M5. Resultados El cuestionario DASH arrojó un valor mediano de 1,7 (0-5,83 y el de Andrews y Carson, de 195 (170-200 para el total; con 15 resultados excelentes y 2 buenos. Todos consiguieron una fuerza M5 para flexión y supinación de antebrazo. El seguimiento tuvo una mediana de 12 meses (4-32. En dos pacientes, se registraron complicaciones, ambas con recuperación ad íntegrum. Conclusión La técnica descrita ha demostrado ser confiable y eficaz, y permitió lograr resultados satisfactorios y una baja tasa de complicaciones.

Histologic scoring indices for evaluation of disease activity in Crohn's disease

NARCIS (Netherlands)

Novak, Gregor; Parker, Claire E.; Pai, Rish K.; Macdonald, John K.; Feagan, Brian G.; Sandborn, William J.; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

2017-01-01

Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and

Programa Uach Inclusiva: Fortaleciendo La Equidad Académica Y El Desarrollo Integral De Estudiantes Con Discapacidad

OpenAIRE

Fuentes, Paola; González Mimica, Mariela; Muñoz Jeréz, Zita; Perez, Diego

2016-01-01

La inclusión de personas con discapacidad, es un tema de preocupación mundial y nacional. En Chile existen más de 14 tratados internacionales, además de la ley 20.422. El primer estudio nacional de discapacidad (ENDISC) realizado el 2004, arrojó que en Chile un 12,9% de la población presenta alguna discapacidad. También, señala que de ellas, sólo el 1,32% completa la educación superior, mientras el 2,54%, comienza la universidad pero no la termina. En este contexto, la Universidad Austral de ...

Response and survival in acute myeloid leukemia patients not candidates to transplantation treated with azacitidine versus palliative treatment: a retrospective study

Directory of Open Access Journals (Sweden)

Mauricio Sarmiento Maldonado

2015-08-01

Full Text Available INTRODUCCIÓN La leucemia mieloide aguda tiene una alta mortalidad sin tratamiento. El trasplante hematopoyético es la única estrategia curativa hasta ahora. Los pacientes que tienen contraindicaciones para el trasplante, pueden ser tratados con fármacos hipometilantes que han mostrado mejorar la sobrevida libre de enfermedad y sobrevida global. OBJETIVOS Describir las características clínicas de los pacientes con síndrome mielodisplásico avanzado y leucemia mieloide aguda, las respuestas logradas y efectos adversos del tratamiento con el fármaco hipometilante. MÉTODOS Este reporte muestra nuestra experiencia en 38 pacientes con leucemia mieloide aguda tratados con azacitidina o con tratamiento paliativo. RESULTADOS La azacitidina permitió alargar la sobrevida en 80% de los pacientes con alta incidencia de efectos adversos y afectación de la calidad de vida. La mayoría de los pacientes tratados con intención paliativa, fallecieron en el primer mes post diagnóstico. CONCLUSIONES La azacitidina permite prolongar la sobrevida, pero con efectos adversos considerables.

Legitimidad y finalidad de los capítulos de propiedad intelectual en los tratados de libre comercio (TLC

Directory of Open Access Journals (Sweden)

Susy Frankel

2011-11-01

Full Text Available Una visión analítica de la realidad actual permite apreciar un auge de los Tratados de Libre Comercio, mientras se presenta un estancamiento en las negociaciones multilaterales de comercio. Si bien la negociación de los TLC no se limita a los países desarrollados, los negociados por los países en desarrollo no tienden a contemplar mejoras en los estándares de propiedad intelectual. Algunos de los capítulos relativos a la propiedad intelectual incluidos en los Tratados de Libre Comercio simplemente reafirman los estándares del acuerdo sobre los ADPIC, mientras que otros se orientan a ampliar el cubrimiento y alcance de los derechos internacionales de propiedad intelectual. El presente artículo se concentra en estudiar la legitimidad y la finalidad de los capítulos de propiedad intelectual en los Tratados de Libre Comercio, así como la relación entre los capítulos sobre propiedad intelectual y el sistema multilateral de la Organización Mundial del Comercio (OMC que facilita los TLC y los límites racionales de la propiedad intelectual en el contexto comercial.

Quality of life study in a regional group of patients with Crohn disease. A structured interview study

DEFF Research Database (Denmark)

Guassora, A D; Kruuse, C; Thomsen, O O

2000-01-01

of 100 consecutive out-patients with Crohn disease, 94 patients accepted to participate together with 94 age- and sex-matched healthy controls. A modified McMaster Inflammatory Bowel Disease Questionnaire (IBDQ23) was used, excluding bowel-related questions. Medical students conducted interviews without...... knowing who were Crohn disease patients and who were controls. The bowel-related questions and Crohn's Disease Activity Index (CDAI) were assessed by gastroenterologists at inclusion in the study. Responses were indicated on a seven-point scale (7 best/1 worst). Mean numeric score was calculated as well...... as a delta score, i.e. the difference in score between a patient and the matched control. RESULTS: In 21 of 23 questions the median delta score was zero, indicating no difference between patient and control. The median total delta score was 0.4 in favour of healthy controls (P

Quantifying the inflammatory activity in Crohn's disease using CE dynamic MRI

International Nuclear Information System (INIS)

Pauls, S.; Schmidt, S.A.; Brambs, H.J.; Gabelmann, A.; Kratzer, W.; Mittrach, C.; Adler, G.; Rieber, A.

2003-01-01

Purpose: Evaluation of dynamic contrast enhanced MRI in patients with Crohn's disease to assess local inflammatory activity. Material and Methods: Prospective study of 13 patients with histologically proven Crohn's disease. Axial and coronal slices were acquired by a 1.5 T MR (Magnetom Vision, Siemens, Germany): T1 flash 2 D (TR 72.5 ms, TE 4.1 ms), T2 (TR 2730 ms, TE 138 ms), turbo-flash sequences T1 (TR 94.2 ms, TE 4.1 ms) post contrast media fat saturated (Magnevist circledR , 0.2 ml/kg, flow 4 ml/s). In area of maximal thickening of terminal ileal wall, axial dynamic T1 sequences (TR 11 ms, TE 4.2 ms) were acquired every 1.5 s post contrast media application for a total duration of 1 min. Contrast uptake was subjectively measured by semiquantitative score and computed assisted ROI evaluation. MR parameters were correlated with CDAI (Crohn's disease activity index) and SAI (severe activity index). Results: Contrast uptake in the intestinal wall occurred after 18.5 s (range: 3.0-28.0), contrast upslope until plateau phase lasted for 16.1 s (range: 8.0-50.0). Maximum contrast enhancement into the bowel wall was 266% (105-450%) of baseline. After maximum contrast uptake, we observed a plateau phase in all cases for the total duration of measurement. A significant correlation existed for maximum contrast uptake to CDAI (r = 0.591; p = 0.033), for beginning of contrast upslope to the time until plateau phase (r = 0.822; p = 0.001), and for the time until plateau phase to CDAI (r = 0.562; p = 0.046). CDAI was on average 108, median 106; SAI was on average 114, median 115. SAI correlated significantly to CDAI (r = 0.874). Maximum contrast uptake, beginning of contrast upslope, and time until plateau phase were independent to creeping fat, local lymphadenitis, laboratory parameters, temperature, body mass index, heart frequency and systolic blood pressure. Conclusion: Dynamic MRI enables to quantify local inflammatory activity of bowel wall in patients with Crohn

La crisis de la integración andina durante los procesos de negociación de la biodiversidad en el TLC con los Estados Unidos

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Catalina Toro Pérez

2010-01-01

Full Text Available Los cambios recientes en la geopolítica andina, debido en gran parte a la emergencia de nuevos gobiernos progresistas de Ecuador, Bolivia y Venezuela como resultado de la resistencia social de los pueblos andinos frente al proyecto del ALCA (Acuerdo de Libre Comercio de las Américas y los tratados de Libre Comercio que Estados Unidos quiso imponer en la región, plantean la necesidad de pensar el desarrollo de una nueva agenda de integración. El proceso de negociación de libre comercio entre Colombia y Perú con los Estados Unidos y más recientemente con la Unión Europea, revela, sin embargo, no sólo la crisis de los procesos de integración entre los gobiernos pertenecientes a la Comunidad Andina de Naciones, sino también el creciente aislamiento de estos dos países, de las nuevas dinámicas regionales emergentes en América Latina. En este ensayo, planteamos como el proceso de negociación de los tratados de Libre Comercio con Estados Unidos y la Unión Europea en materia de biodiversidad, propiedad intelectual y conocimiento tradicional revelan, no sólo la crisis de los procesos de integración en lo que refiere a los desarrollos legislativos y normativos existentes en la Comunidad Andina de Naciones (CAN, sino también la situación de derechos colectivos de las comunidades indígenas y locales en la región.

Efectividad del tratamiento con neurofeedback en trastornos del estado del ánimo, ansiedad y fibromialgia: una revisión de literatura

OpenAIRE

Barrera Ferro, Laura; Gómez Olivella, Estefanía; Prieto Lizarazo, Luisa Fernanda

2013-01-01

El neurofeedback es una técnica no invasiva en la que se pretende corregir, mediante condicionamiento operante, ondas cerebrales que se encuentren alteradas en el electroencefalograma. Desde 1967, se han conducido numerosas investigaciones relacionadas con los efectos de la técnica en el tratamiento de alteraciones psicológicas. Sin embargo, a la fecha no existen revisiones sistemáticas que reúnan los temas que serán aquí tratados. El aporte de este trabajo es la revisión de 56...

Manejo exitoso de hernia diafragmática congénita con ECMO. Primer reporte de caso en México

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Ulises Garza-Serna

2017-11-01

Full Text Available INTRODUCCIÓN: la hernia diafragmática congénita es una enfermedad que afecta a 1 de 3000 recién nacidos, con un alto índice de morbilidad y mortalidad, especialmente si se presenta con otras malformaciones como las anomalías congénitas cardiacas. El manejo del paciente con este padecimiento debe ser tratado de forma multidisciplinaria e incluir su evaluación prenatal y atención posnatal. OBJETIVO: reportar el primer caso exitoso en México de un paciente con hernia diafragmática congénita manejado con membrana de oxigenación extracorpórea. CASO CLÍNICO: paciente masculino de 37.5 semanas de gestación con diagnóstico prenatal de hernia diafragmática congénita a las 24 semanas de gestación sin otras anomalías congénitas; índice pulmón/ cabeza de 1.7. A las seis horas de nacido presentó saturación de oxígeno preductal de 78% y posductal a 58% con índice de oxigenación de 41, a pesar del tratamiento agresivo médico y ventilatorio, por lo que se necesitó la intervención e implementación de la membrana de circulación extracorpórea.

Los tratados y el jardín renacentista en Italia. Principios, metodologías y técnicas

OpenAIRE

Taffuri, Tullio

2014-01-01

La tesis destaca la influencia que ejerció la teoría, las técnicas y la metodología de proyecto de los principales tratados de la época renacentista en la concepción, diseño y realización de algunos de los más importantes jardines de la época. Los tratados de Vitruvio, Alberti, Filarete, Di Giorgio, Serlio, Palladio, Colonna y Del Riccio establecen una nueva estética y una nueva visión del mundo, basadas en la geometría elemental y en los números simples. En la Grecia antigua, Platón y Pitágo...

Spontaneous remission of Crohn's disease following a febrile infection: case report and literature review

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van Netten Johannes P

2011-05-01

Full Text Available Abstract Crohn's disease is a chronic illness that may often follow a relapsing-remitting course. Many of the factors that may be associated with the spontaneous remission of this disease (i.e. not related to specific treatment remain to be determined. In the present report, we review the medical history of a patient with a long history of moderate to severe Crohn's whose complete remission immediately followed the development of a febrile infection. The patient first developed symptoms of Crohn's in her late adolescent years. At the time of diagnosis at age 23, she was placed on mesalamine - without effective control her disease symptoms. Due to progressive deterioration, the patient underwent a bowel resection at age 25. Soon afterwards symptoms recurred, gradually increasing in severity. In February 2005, at age 36, the patient developed a painful abscess associated with a rectal fistula. Other symptoms at the time included chronic bone and stomach pain, swollen joints, and debilitating fatigue. Surgical correction was scheduled in mid-March. In late February, the patient developed a respiratory infection associated with fevers of 103-104°F. After the onset of fever, the abscess pain disappeared and this was soon followed by a disappearance of all other disease symptoms. By the time the corrective surgery occurred, she had no Crohn's symptoms. Her remission lasted 10 weeks when the previous symptoms then reappeared. The patient has subsequently used a variety of conventional therapies, but still suffers from severe symptoms of her disease. In recent years, a growing body of literature has emphasized the important role that innate immunity plays in the etiology of Crohn's disease; however, a key component of innate immunity, the febrile response, has been overlooked. Other cases of spontaneous remission following febrile infection in inflammatory bowel disease have been reported. Moreover, induction of a febrile response was in the past used

Selection of symptomatic patients with Crohn's disease for abdominopelvic computed tomography: role of serum C-reactive protein.

LENUS (Irish Health Repository)

Desmond, Alan N

2012-11-01

Results of previous studies have shown that repeated abdominopelvic computed tomography (CT) examinations can lead to substantial cumulative diagnostic radiation exposure in patients with Crohn\\'s disease (CD). Improved selection of patients referred for CT will reduce unnecessary radiation exposure. This study examines if serum C-reactive protein (CRP) concentration predicts which symptomatic patients with CD are likely to have significant disease activity or disease complications (such as abscess) detected on abdominopelvic CT.

Analysis of factors affecting the quality of life of those suffering from Crohn's disease.

Science.gov (United States)

Chrobak-Bień, Joanna; Gawor, Anna; Paplaczyk, Małgorzata; Małecka-Panas, Ewa; Gąsiorowska, Anita

2017-08-31

Crohn's disease is an inflammatory bowel disease of unknown etiology. Its chronic nature, as well as symptoms of intestinal and overall significantly impedes the daily functioning of patients. Alternately occurring periods of exacerbation and remission are the cause of reduced quality of life of patients. Understanding the factors that caused the decrease in the quality of life, it allows us to understand the behavior and the situation of the patient and the ability to cope with stress caused by the disease. The aim of the study was to analyze the factors affecting the quality of life of people with Crohn's disease. The study group consisted of 50 people diagnosed with Crohn's disease. Respondents were treated at the Department of General Surgery and Colorectal Medical University of Lodz and Gastroenterological Clinic at the University Clinical Hospital No. 1 in Lodz. Quality of Life Survey was carried out by a diagnostic survey using a research tool SF-36v2 and surveys of its own design. Analysis of the results demonstrated that the quality of life of patients with Crohn's disease was reduced, especially during exacerbations. Evaluation of the quality of life of respondents in physical terms was slightly higher than in the mental aspect. Higher education subjects and the lack of need for surgical treatment significantly improves the quality of life. The occurrence of chronic disease reduces the quality of life of respondents. Elderly patients are better able to adapt to the difficult situation caused by the disease. The quality of life of women and men is at a similar level and patients in remission of the disease have a better quality of life of patients during exacerbations.

Integrated metagenomics/metaproteomics reveals human host-microbiota signatures of Crohn's disease.

Directory of Open Access Journals (Sweden)

Alison R Erickson

Full Text Available Crohn's disease (CD is an inflammatory bowel disease of complex etiology, although dysbiosis of the gut microbiota has been implicated in chronic immune-mediated inflammation associated with CD. Here we combined shotgun metagenomic and metaproteomic approaches to identify potential functional signatures of CD in stool samples from six twin pairs that were either healthy, or that had CD in the ileum (ICD or colon (CCD. Integration of these omics approaches revealed several genes, proteins, and pathways that primarily differentiated ICD from healthy subjects, including depletion of many proteins in ICD. In addition, the ICD phenotype was associated with alterations in bacterial carbohydrate metabolism, bacterial-host interactions, as well as human host-secreted enzymes. This eco-systems biology approach underscores the link between the gut microbiota and functional alterations in the pathophysiology of Crohn's disease and aids in identification of novel diagnostic targets and disease specific biomarkers.

Integrated Metagenomics/Metaproteomics Reveals Human Host-Microbiota Signatures of Crohn's Disease

Science.gov (United States)

Darzi, Youssef; Mongodin, Emmanuel F.; Pan, Chongle; Shah, Manesh; Halfvarson, Jonas; Tysk, Curt; Henrissat, Bernard; Raes, Jeroen; Verberkmoes, Nathan C.; Jansson, Janet K.

2012-01-01

Crohn's disease (CD) is an inflammatory bowel disease of complex etiology, although dysbiosis of the gut microbiota has been implicated in chronic immune-mediated inflammation associated with CD. Here we combined shotgun metagenomic and metaproteomic approaches to identify potential functional signatures of CD in stool samples from six twin pairs that were either healthy, or that had CD in the ileum (ICD) or colon (CCD). Integration of these omics approaches revealed several genes, proteins, and pathways that primarily differentiated ICD from healthy subjects, including depletion of many proteins in ICD. In addition, the ICD phenotype was associated with alterations in bacterial carbohydrate metabolism, bacterial-host interactions, as well as human host-secreted enzymes. This eco-systems biology approach underscores the link between the gut microbiota and functional alterations in the pathophysiology of Crohn's disease and aids in identification of novel diagnostic targets and disease specific biomarkers. PMID:23209564

Tratamiento de la compresión del tronco de la arteria coronaria izquierda en pacientes con hipertensión pulmonar

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María L. Talavera

2011-10-01

Full Text Available La angina de pecho es un síntoma frecuente en pacientes con hipertensión pulmonar (HP de cualquier etiología. Aunque su fisiopatología no está aclarada, las causas propuestas son: la isquemia subendocárdica por aumento del estrés parietal del ventrículo derecho, la dilatación de la arteria pulmonar por incrementos transitorios de la presión pulmonar y la compresión extrínseca del tronco de la arteria coronaria izquierda (TCI por la arteria pulmonar (AP dilatada. Se presentan tres casos que muestran la relación entre la angina de pecho y la compresión del TCI en pacientes con HP asociada a cardiopatías congénitas, tratados mediante implante de stent coronario.

Diagnostic performance of PET/MR in the evaluation of active inflammation in Crohn disease.

Science.gov (United States)

Catalano, Onofrio Antonio; Wu, Vincent; Mahmood, Umar; Signore, Alberto; Vangel, Mark; Soricelli, Andrea; Salvatore, Marco; Gervais, Debra; Rosen, Bruce R

2018-01-01

This study investigates the performance of PET/MR versus each sub-modality alone in the assessment of active inflammation in patients with Crohn disease, when compared to surgery as standard of reference. Sensitivity for detecting active inflammation was 91.5% for PET, 80% for MR, and 88% for PET/MR. Specificity for active inflammation was 74% for PET, 87% for MR, and 93% for PET/MR. Diagnostic accuracy was 84% for PET, 83% for MR, and 91% for PET/MR. In conclusion, PET/MR is significantly more accurate than either sub-modality alone and more specific than PET alone in the detection of active inflammation in patients with Crohn disease.

Contribution of rs11465788 in IL23R gene to Crohn's disease ...

Indian Academy of Sciences (India)

Multiple studies have shown that IL23 cytokine plays an essential role in the development of autoimmune diseases ... milial risk of IBD provide strong evidence, that the genetic ..... variant in German Crohn's disease patients: combined analysis.

A profile of patients treated at a national leprosy outpatient referral clinic in Rio de Janeiro, Brazil, 1986-2007 Perfil de los enfermos tratados en un servicio nacional de remisión de pacientes ambulatorios con lepra en Río de Janeiro, Brasil, 1986-2007

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Mariana A. Hacker

2012-06-01

Full Text Available OBJECTIVE: To analyze a profile of patients treated at a national leprosy outpatient referral clinic in metropolitan Rio de Janeiro, Brazil, over a period of more than two decades, and the subgroup of nationally registered leprosy cases from the same residential area, as well as all registered cases statewide. METHODS: An observational, descriptive analysis was carried out for patients treated from 1986 to 2007 at the Souza Araújo Outpatient Clinic (Ambulatório Souza Araújo, ASA, a national referral center for the diagnosis and treatment of leprosy at the Oswaldo Cruz Foundation (Fiocruz that serves clients from the city of Rio de Janeiro and other municipalities in the metropolitan area of Rio de Janeiro State. Demographic and clinical data for the subgroup of leprosy cases registered with Brazil's National Disease Notification System (Sistema Nacional de Informação de Agravos de Notificação, SINAN between 2001 and 2007 and residing in the same municipalities as the ASA patients, and for all registered cases statewide, were also analyzed. RESULTS: Among the ASA patients, there was a decrease in average family income (from 3.9 to 2.7 times the minimum salary between the periods 1998-2002 and 2003-2007; the proportion of multibacillary (MB patients (from 52.7% to 46.9%; and the proportion of patients younger than 15 years old (from 12.8% to 8.7%. Among the MB patients, the average initial and final bacilloscopic indices were significantly higher in 2003-2007. Compared with the SINAN cases, more ASA cases involved disability and were younger than 15 years old. CONCLUSIONS: Patients living with leprosy in the metropolitan area of the state of Rio de Janeiro belong to the most deprived social strata and have not benefited from the overall improvement in socioeconomic conditions in Brazil.OBJETIVO: Analizar el perfil de los enfermos tratados en un servicio nacional de remisión de pacientes ambulatorios con lepra ubicado en la zona

MRI predictors of treatment response for perianal fistulizing Crohn disease in children and young adults

Energy Technology Data Exchange (ETDEWEB)

Shenoy-Bhangle, Anuradha; Nimkin, Katherine; Gee, Michael S. [Massachusetts General Hospital for Children, Harvard Medical School, Department of Radiology, Boston, MA (United States); Goldner, Dana; Israel, Esther J. [Massachusetts General Hospital for Children, Harvard Medical School, Department of Pediatrics, Boston, MA (United States); Bradley, William F. [Analog Devices, Lyric Labs, Cambridge, MA (United States)

2014-01-15

Magnetic resonance imaging (MRI) is considered the imaging standard for diagnosis and characterization of perianal complications associated with Crohn disease in children and adults. To define MRI criteria that could act as potential predictors of treatment response in fistulizing Crohn disease in children, in order to guide more informed study interpretation. We performed a retrospective database query to identify all children and young adults with Crohn disease who underwent serial MRI studies for assessment of perianal symptoms between 2003 and 2010. We examined imaging features of perianal disease including fistula number, type and length, presence and size of associated abscess, and disease response/progression on follow-up MRI. We reviewed imaging studies and electronic medical records. Statistical analysis, including logistic regression, was performed to associate MR imaging features with treatment response and disease progression. We included 36 patients (22 male, 14 female; age range 8-21 years). Of these, 32 had a second MRI exam and 4 had clinical evidence of complete response, obviating the need for repeat imaging. Of the parameters analyzed, presence of abscess, type of fistula according to the Parks classification, and multiplicity were not predictors of treatment outcome. Maximum length of the dominant fistula and aggregate fistula length in the case of multiple fistulae were the best predictors of treatment outcome. Maximum fistula length <2.5 cm was a predictor of treatment response, while aggregate fistula length ≥2.5 cm was a predictor of disease progression. Perianal fistula length is an important imaging feature to assess on MRI of fistulizing Crohn disease. (orig.)

MRI predictors of treatment response for perianal fistulizing Crohn disease in children and young adults

International Nuclear Information System (INIS)

Shenoy-Bhangle, Anuradha; Nimkin, Katherine; Gee, Michael S.; Goldner, Dana; Israel, Esther J.; Bradley, William F.

2014-01-01

Magnetic resonance imaging (MRI) is considered the imaging standard for diagnosis and characterization of perianal complications associated with Crohn disease in children and adults. To define MRI criteria that could act as potential predictors of treatment response in fistulizing Crohn disease in children, in order to guide more informed study interpretation. We performed a retrospective database query to identify all children and young adults with Crohn disease who underwent serial MRI studies for assessment of perianal symptoms between 2003 and 2010. We examined imaging features of perianal disease including fistula number, type and length, presence and size of associated abscess, and disease response/progression on follow-up MRI. We reviewed imaging studies and electronic medical records. Statistical analysis, including logistic regression, was performed to associate MR imaging features with treatment response and disease progression. We included 36 patients (22 male, 14 female; age range 8-21 years). Of these, 32 had a second MRI exam and 4 had clinical evidence of complete response, obviating the need for repeat imaging. Of the parameters analyzed, presence of abscess, type of fistula according to the Parks classification, and multiplicity were not predictors of treatment outcome. Maximum length of the dominant fistula and aggregate fistula length in the case of multiple fistulae were the best predictors of treatment outcome. Maximum fistula length <2.5 cm was a predictor of treatment response, while aggregate fistula length ≥2.5 cm was a predictor of disease progression. Perianal fistula length is an important imaging feature to assess on MRI of fistulizing Crohn disease. (orig.)

Beneficios de la terapia con hidroxiúrea en niños con anemia de células falciformes = Benefits of hidroxyurea therapy in children with sickle cell disease

Directory of Open Access Journals (Sweden)

Donado Gómez, Jorge Hernando

2012-04-01

Full Text Available Objetivo: describir la toxicidad y los beneficios de la hidroxiúrea (HU en el tratamiento de niños con anemia de células falciformes (ACF.Materiales y métodos: estudio observacional descriptivo-retrospectivo de pacientes con ACF tratados con HU en el Hospital Pablo Tobón Uribe (HPTU de Medellín, Colombia, entre mayo de 2004 y septiembre de 2009. Se trató con este medicamento a 16 pacientes menores de 15 años, 11 de ellos (68,8% de sexo masculino. Todos los pacientes tenían anemia falciforme (Hb SS. Las variables se estudiaron antes y después del inicio de la HU. Resultados: se encontró una media de crisis dolorosas por ACF de 3,31 antes y 1,13 después de la HU (p = 0,006; la media de la necesidad de transfundir glóbulos rojos fue de 2,69 antes y 0,75 después (p = 0,112; los episodios de síndrome torácico agudo (STA tuvieron una media de 0,19 antes y 0,13 después (p = 0,705; la media de la necesidad de hospitalización por ACF fue de 1,94 antes y 1,06 después de la HU (p = 0,155. Un paciente (6,3% presentó toxicidad hematológica y dos (12,5% tuvieron toxicidad hepática, pero no hubo casos de toxicidad renal; tres pacientes (18,8% presentaron accidentes cerebrovasculares. No se encontraron neoplasias. Conclusión: la HU redujo significativamente la frecuencia de crisis dolorosas en los pacientes con ACF. La toxicidad fue en general aceptable. Se requieren estudios prospectivos, multicéntricos, doble ciego, controlados con placebo, para definir el papel de la HU en pacientes pediátricos.

Trombocitopenia de difícil manejo en niño preescolar con LES: Reporte de un caso

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Mario Nicolás Albani Pérez

2010-08-01

Full Text Available El lupus eritematoso sistémico (LES es una enfermedad autoinmune del tejido conectivo, infrecuente en el sexo masculino y durante la infancia. La trombocitopenia se presenta en 15% de los casos de LES, y como forma de inicio es poco común. Se reporta el caso de preescolar masculino de 3 años de edad con inicio de enfermedad a los 18 meses de edad que presentó diarrea, rash cutáneo, equimosis y trombocitopenia; ameritando transfusión de concentrado plaquetario obteniendo mejoría parcial y en control con hematólogo. A los  2 años de edad reaparece equimosis y se diagnostica Púrpura Trombocitopénica Idiopática, tratado con inmunoglobulinas y esteroides sin respuesta satisfactoria. Es referido a Inmunología donde solicitan estudios y los resultados son compatibles con LES, por lo cual recibió prednisona sin respuesta satisfactoria. En Febrero de 2009, presenta epistaxis requiriendo hospitalización y tratamiento con inmunoglobulinas. En Mayo de 2009, presenta otorragia derecha ameritando nuevamente hospitalización y tratamiento con inmunoglobulinas. Se emplea Danazol con buena respuesta. En caso que en el futuro no ofrezca mejoría, se plantea el uso alternativo de ciclosporinas o anticuerpos monoclonales Anti-CD20 (Rituximab dejando como último recurso la esplenectomía. Se presenta el caso clínico considerando la importancia con respecto a la edad de presentación y el manejo no convencional que se debió adoptar para tratar al paciente.

Trombocitopenia de difícil manejo en niño preescolar con LES: Reporte de un caso

Directory of Open Access Journals (Sweden)

Mario Nicolás Albani Pérez

2009-01-01

Full Text Available El lupus eritematoso sistémico (LES es una enfermedad autoinmune del tejido conectivo, infrecuente en el sexo masculino y durante la infancia. La trombocitopenia se presenta en 15% de los casos de LES, y como forma de inicio es poco común. Se reporta el caso de preescolar masculino de 3 años de edad con inicio de enfermedad a los 18 meses de edad que presentó diarrea, rash cutáneo, equimosis y trombocitopenia, ameritando transfusión de concentrado plaquetario obteniendo mejoría parcial y en control con hematólogo. A los 2 años de edad reaparece equimosis y se diagnostica Púrpura Trombocitopénica Idiopática, tratado con inmunoglobulinas y esteroides sin respuesta satisfactoria. Es referido a Inmunología donde solicitan estudios y los resultados son compatibles con LES, por lo cual recibió prednisona sin respuesta satisfactoria. En Febrero de 2009, presenta epistaxis requiriendo hospitalización y tratamiento con inmunoglobulinas. En Mayo de 2009, presenta otorragia derecha ameritando nuevamente hospitalización y tratamiento con inmunoglobulinas. Se emplea Danazol con buena respuesta. En caso que en el futuro no ofrezca mejoría, se plantea el uso alternativo de ciclosporinas o anticuerpos monoclonales Anti- CD20 (Rituximab dejando como último recurso la esplenectomía. Se presenta el caso clínico considerando la importancia con respecto a la edad de presentación y el manejo no convencional que se debió adoptar para tratar al paciente.

Energy expenditure and body composition in children with Crohn's disease: effect of enteral nutrition and treatment with prednisolone

OpenAIRE

Azcue, M; Rashid, M; Griffiths, A; Pencharz, P

1997-01-01

Background—Malnutrition and growth retardation are common complications of Crohn's disease in children. The contribution of resting energy expenditure (REE) to malnutrition is unclear. 
Aims—To characterise the REE and body composition in children with Crohn's disease and compare them with normal controls and patients with anorexia nervosa; to compare the effects of prednisolone and enteral nutrition on energy expenditure and body composition. 
Subjects—Twenty four children wit...

Evaluación económica de rituximab en combinación con fludarabina y ciclofosfamida en comparación con fludarabina y ciclofosfamida en el tratamiento de la leucemia linfática crónica Economic evaluation of rituximab added to fludarabine plus cyclophosphamide versus fludarabine plus cyclophosphamide for the treatment of chronic lymphocytic leukemia

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Luis Felipe Casado

2011-08-01

Full Text Available Objetivos: Evaluar el coste-efectividad del esquema de rituximab, fludarabina y ciclofosfamida (R-FC en comparación con el de fludarabina y ciclofosfamida (FC en dos tipos de pacientes con leucemia linfática crónica (LLC: no tratados previamente o bien en recidiva/resistentes al tratamiento previo. Métodos: Dos modelos de Markov, utilizando los resultados publicados de superviviencia libre de progresión (SLP de pacientes con LLC tratados con R-FC o FC en primera o segunda línea, las tasas de progresión de la enfermedad y las tasas de mortalidad en España. A los estados de SLP y progresión se les asignaron utilidades obtenidas en un estudio sobre LLC. Los costes de los medicamentos y de los tratamientos de soporte, así como los años de vida ajustados por calidad (AVAC, se estimaron para un periodo de 10 años. Se efectuaron análisis de sensibilidad univariados y probabilísticos (Monte Carlo. Resultados: La adición de rituximab a la quimioterapia con FC aumentó los años de vida ganados (AVG y los AVAC tanto en primera como en segunda línea de tratamiento. La razón de coste-eficacia incremental fue de 20.703 € por AVG y de 19.343 € por AVAC con la primera línea de tratamiento, y de 23.183 € por AVG y 24.781 € por AVAC con la segunda línea de tratamiento. Conclusiones: En los pacientes con LLC no tratados previamente y en aquellos en recaída o resistentes al tratamiento previo, la adición de rituximab al esquema FC aumentó la esperanza de vida y los AVAC, y en ambos casos resultó ser un tratamiento coste-efectivo.Objectives: We evaluated the cost-effectiveness of rituximab added to the chemotherapy regimen of fludarabine plus cyclophosphamide (R-FC versus fludarabine plus cyclophosphamide (FC for the treatment of patients with previously untreated or relapsed/refractory chronic lymphocytic leukemia (CLL. Methods: Two Markov models were built, using published results on progression-free survival (PFS in patients

Doctor Octavio Montoro y los primeros casos de diabetes tratados con insulina en Cuba Doctor Octavio Montoro and the first cases of diabetes treated with insulin in Cuba

Directory of Open Access Journals (Sweden)

Dagoberto Álvarez Aldana

2003-08-01

Full Text Available El uso clínico de la insulina por Banting y Best representa un hito en la historia de las ciencias médicas. Los avances en este campo han sido espectaculares y nuestro país no está ajeno a ellos. Sin embargo, poco se conoce sobre los primeros trabajos realizados por los médicos cubanos en relación con la insulinoterapia, hecho trascendental en la historia de la endocrinología cubana, pero desconocido principalmente para las nuevas generaciones de endocrinólogos. Esta revisión tiene como objetivos destacar la introducción en la clínica moderna de la insulina como un importante suceso en la historiografía médica cubana y divulgar la evolución clínica y el esquema terapéutico aplicado a los primeros casos de diabetes mellitus tratados con insulina en Cuba, así como resaltar el empeño y la capacidad de los profesionales de la salud pioneros en el uso clínico de la insulina en aquellos años, entre los que se destaca el Doctor Octavio Montoro. Para realizar este trabajo fue consultada la bibliografía médica de la época, archivos y otras fuentes. Como resultado se obtuvo que en Cuba se introdujo la insulina en el tratamiento de los pacientes diabéticos en febrero de 1923, por el Doctor Montoro, quien fue reconocido por sus conocimientos médicos y por su vasta cultura. Desempeñó múltiples cargos y recibió numerosas condecoraciones. Se concluyó que Cuba fue uno de los primeros países en el mundo que contó con la insulina como arma terapéutica contra la diabetes. El Doctor Octavio Montoro hizo importantes aportes en la investigación sobre la diabetes, por lo que merece ser considerado, a nuestro juicio, como el padre de la diabetología en nuestro país.The clinical use of insulin by Banting and Best represents a hallmark in the history of medical sciences. The advances in this field have been amazing and our country was also involved in this development. However, little is known about the first works carried out by Cuban

Caracterización de un suelo arcilloso tratado con hidróxido de calcio

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Carlos Hernando Higuera Sandoval

2013-02-01

Full Text Available Propone unametodología para el tratamiento de suelos susceptibles (arcillas mediante la incorporación del hidróxido de calcio como estabilizante, en busca del mejoramiento de sus características físicas, mecánicas y químicas. La caracterización del suelo consistió en la elaboración de una serie de ensayos de laboratorio que determinaran sus características físico-mecánicas y químicas. Además de esto, se diseñaron mezclas de suelo-hidróxido de calcio en las que se varió el porcentaje de aditivo entre el 2% y el 12%, con el fin de observar las tendencias de sus características y poder así seleccionar el porcentaje óptimo de hidróxido de calcio, que proporcionará mejores condicionesde trabajabilidad del suelo estudiado. Como resultado se obtuvo una mezcla que optimizó el comportamiento del suelo original en cuanto a sus propiedades de plasticidad, resistencia y estabilidad, transformando un suelo pobre en uno adecuado para estructuras de pavimentos.

Caracterización de un suelo arcilloso tratado con hidróxido de calcio

Directory of Open Access Journals (Sweden)

Óscar Eduardo Pardo Naranjo

2012-06-01

Full Text Available Propone una metodología para el tratamiento de suelos susceptibles (arcillas mediante la incorporación del hidróxido de calcio como estabilizante, en busca del mejoramiento de sus características físicas, mecánicas y químicas. La caracterización del suelo consistió en la elaboración de una serie de ensayos de laboratorio que determinaran sus características físico-mecánicas y químicas. Además de esto, se diseñaron mezclas de suelo-hidróxido de calcio en las que se varió el porcentaje de aditivo entre el 2% y el 12%, con el fin de observar las tendencias de sus características y poder así seleccionar el porcentaje óptimo de hidróxido de calcio, que proporcionará mejores condiciones de trabajabilidad del suelo estudiado. Como resultado se obtuvo una mezcla que optimizó el comportamiento del suelo original en cuanto a sus propiedades de plasticidad, resistencia y estabilidad, transformando un suelo pobre en uno adecuado para estructuras de pavimentos.

Bones and Crohn's: Estradiol deficiency in men with Crohn's disease is not associated with reduced bone mineral density

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Boehm BO

2008-10-01

Full Text Available Abstract Background Reduced bone mineral density (BMD and osteoporosis are frequent in Crohn's disease (CD, but the underlying mechanisms are still not fully understood. Deficiency of sex steroids, especially estradiol (E2, is an established risk factor in postmenopausal osteoporosis. Aim To assess if hormonal deficiencies in male CD patients are frequent we investigated both, sex steroids, bone density and bone metabolism markers. Methods 111 male CD patients underwent osteodensitometry (DXA of the spine (L1–L4. Disease related data were recorded. Disease activity was estimated using Crohn's disease activity index (CDAI. Testosterone (T, dihydrotestosterone (DHT, estradiol (E2, sex hormone binding globulin (SHBG, Osteocalcin and carboxyterminal cross-linked telopeptids (ICTP were measured in 111 patients and 99 age-matched controls. Results Patients had lower T, E2 and SHBG serum levels (p 10 g had lower BMD. 32 (28.8% patients showed osteoporosis, 55 (49.5% osteopenia and 24 (21.6% had normal BMD. Patients with normal or decreased BMD showed no significant difference in their hormonal status. No correlation between markers of bone turnover and sex steroids could be found. ICTP was increased in CD patients (p Conclusion We found an altered hormonal status – i.e. E2 and, to a lesser extent T deficiency – in male CD patients but failed to show an association to bone density or markers of bone turnover. The role of E2 in the negative skeletal balance in males with CD, analogous to E2 deficiency in postmenopausal females, deserves further attention.

The TB--Crohn's affair--a never ending dilemma.

Science.gov (United States)

Praveen, S; Razman, J

2008-08-01

An 80 year old lady presented with signs and symptoms of sub-acute intestinal obstruction which failed conservative management. CT scan abdomen revealed circumferential ileum thickening with proximal bowel dilatation. Laparotomy and segmental resection was done. Pathological findings were suggestive of chronic granulomatous ileits with differential of Crohn's disease and gastrointestinal tuberculosis. The patient was presumed to have gastrointestinal tuberculosis and commenced on anti tuberculosis treatment despite inconclusive evidence for confirmation and showed marked clinical improvement.

Limitations of fecal calprotectin at diagnosis in untreated pediatric Crohn's disease

DEFF Research Database (Denmark)

Shaoul, Ron; Sladek, Marlgozata; Turner, Dan

2012-01-01

Fecal Calprotectin (FC) is a validated screening test for intestinal inflammation in Crohn's disease (CD). The objective of the study was to prospectively evaluate the limitations of FC for identifying CD in newly diagnosed untreated pediatric patients and to assess the association of FC levels w...

Role of percutaneous abscess drainage in the management of young patients with Crohn disease

Energy Technology Data Exchange (ETDEWEB)

Pugmire, Brian S. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Gee, Michael S. [Massachusetts General Hospital for Children, Department of Radiology, Boston, MA (United States); Massachusetts General Hospital, Division of Abdominal Imaging, Boston, MA (United States); Kaplan, Jess L.; Winter, Harland S. [Massachusetts General Hospital for Children, Department of Pediatrics, Boston, MA (United States); Hahn, Peter F.; Gervais, Debra A. [Massachusetts General Hospital, Division of Abdominal Imaging, Boston, MA (United States); Doody, Daniel P. [Massachusetts General Hospital for Children, Department of Surgery, Boston, MA (United States)

2016-05-15

Intra-abdominal abscess is a common complication of Crohn disease in children. Prior studies, primarily in adults, have shown that percutaneous abscess drainage is a safe and effective treatment for this condition; however, the data regarding this procedure and indications in pediatric patients is limited. Our aim was to determine the success rate of percutaneous abscess drainage for abscesses related to Crohn disease in pediatric patients with a focus on treatment endpoints that are relevant in the era of biological medical therapy. We retrospectively reviewed 25 cases of patients ages ≤20 years with Crohn disease who underwent percutaneous abscess drainage. Technical success was defined as catheter placement within the abscess with reduction in abscess size on post-treatment imaging. Clinical success was defined as (1) no surgery within 1 year of drainage or (2) surgical resection following drainage with no residual abscess at surgery or on preoperative imaging. Multiple clinical parameters were analyzed for association with treatment success or failure. All cases were classified as technical successes. Nineteen cases were classified as clinical successes (76%), including 7 patients (28%) who required no surgery within 1 year of percutaneous drainage and 12 patients (48%) who had elective bowel resection within 1 year. There was a statistically significant association between resumption of immunosuppressive therapy within 8 weeks of drainage and both clinical success (P < 0.01) and avoidance of surgery after 1 year (P < 0.01). Percutaneous abscess drainage is an effective treatment for Crohn disease-related abscesses in pediatric patients. Early resumption of immunosuppressive therapy is statistically associated with both clinical success and avoidance of bowel resection, suggesting a role for percutaneous drainage in facilitating prompt initiation of medical therapy and preventing surgical bowel resection. (orig.)

La crítica de Hicks al Tratado del Dinero de Keynes

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Alexander Tobón

2004-12-01

Full Text Available El objetivo de este artículo es mostrar que la crítica que hace Hicks al Tratado del Dinero de Keynes es incorrecta. Para ello, presentamos el modelo de Keynes, mostrando que la igualdad entre la inversión y el ahorro es una condición de equilibrio monetario y no una identidad. Este resultado no puede ser obtenido en el análisis de Hicks.

Reduced fat oxidation rates during submaximal exercise in adolescents with Crohn's disease

NARCIS (Netherlands)

Nguyen, Thanh; Ploeger, Hilde E.; Obeid, Joyce; Issenman, Robert M.; Baker, Jeff M.; Takken, Tim; Parise, Gianni; Timmons, Brian W.

2013-01-01

Children with Crohn's disease (CD) suffer from malnutrition. Understanding substrate utilization during exercise may help patients with CD sustain a healthy active lifestyle without compromising nutrition. The aim of this study was to determine whether substrate utilization and bioavailability

Tratados y recetarios de técnica industrial en la España medieval. La Corona de Castilla, siglos XV - XVI

OpenAIRE

Criado Vega, Teresa

2013-01-01

El eje de esta tesis es analizar las técnicas industriales en la Corona de Castilla en la Baja Edad Media, a través de los recetarios y tratados técnicos localizados en distintas bibliotecas hispanas, como prueba evidente de que tales conocimientos no se transmitieron de forma oral únicamente, sino que fueron recogidos de forma escrita. Esta es una realidad constatada en el resto de Europa, donde han sido estudiados diversos recetarios y tratados, algunos de los cuales han sido utilizados par...

What Is the Risk of Anastomotic Leak After Repeat Intestinal Resection in Patients With Crohn's Disease?

Science.gov (United States)

Johnston, W Forrest; Stafford, Caitlin; Francone, Todd D; Read, Thomas E; Marcello, Peter W; Roberts, Patricia L; Ricciardi, Rocco

2017-12-01

Approximately half of Crohn's patients require intestinal resection, and many need repeat resections. The purpose of this study was to evaluate the increased risk of clinical anastomotic leak in patients with a history of previous intestinal resection undergoing repeat resection with anastomosis for Crohn's disease. This was a retrospective analysis of prospectively collected departmental data with 100% capture. The study was conducted at the department of colorectal surgery in a tertiary care teaching hospital between July 2007 and March 2016. A cohort of consecutive patients with Crohn's disease who were treated with intestinal resection and anastomosis, excluding patients with proximal fecal diversion, were included. The cohort was divided into 2 groups, those with no previous resection compared with those with previous resection. Clinical anastomotic leak within 30 days of surgery was measured. Of the 206 patients who met criteria, 83 patients had previous intestinal resection (40%). The 2 groups were similar in terms of patient factors, immune-suppressing medication use, and procedural factors. Overall, 20 clinical anastomotic leaks were identified (10% leak rate). There were 6 leaks (5%) detected in patients with no previous intestinal resection and 14 leaks (17%) detected in patients with a history of previous intestinal resection (p leak in patients with Crohn's disease with previous resection compared with no previous resection was 3.5 (95% CI, 1.3-9.4). Patients with 1 previous resection (n = 53) had a leak rate of 13%, whereas patients with ≥2 previous resections (n = 30) had a leak rate of 23%. The number of previous resections correlated with increasing risk for clinical anastomotic leak (correlation coefficient = 0.998). This was a retrospective study with limited data to perform a multivariate analysis. Repeat intestinal resection in patients with Crohn's disease is associated with an increased rate of anastomotic leakage when compared with initial

Arterite de Takayasu e doença de Crohn: uma associação incomum Takayasu's arteritis and Crohn's disease: an unusual association

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Clóvis Konopka

2009-12-01

Full Text Available A arterite de Takayasu e a doença de Crohn são doenças inflamatórias com etiologia desconhecida. Raramente ocorrem de modo concomitante em um mesmo indivíduo, havendo menos de 30 casos relatados na literatura. Este trabalho descreve essa associação em uma paciente de 36 anos de idade portadora de doença de Crohn, que apresentou redução dos pulsos no membro superior esquerdo e pressão arterial de 60/40 mmHg. A angiotomografia evidenciou estenose segmentar de artéria subclávia esquerda e espessamento parietal circunferencial da aorta na transição toracoabdominal entre T10 e L1, estabelecendo o diagnóstico de arterite de Takayasu. Ambas as patologias são mediadas imunologicamente e apresentam granulomas e vasculite granulomatosa, o que contribui para reforçar a hipótese de uma origem imunológica comum no seu desenvolvimento. Acreditamos que este seja o primeiro caso relatado na literatura brasileira da presença concomitante destas duas enfermidades.Takayasu's arteritis and Crohn's disease are chronic inflammatory diseases with unknown etiology. They rarely occur together in the same individual, with less than 30 cases reported in the literature. This case report describes this association in a 36-year-old woman with Crohn’s disease and weak pulses in her left arm with blood pressure of 60/40 mmHg. Angiotomography showed segmental stenosis in the left subclavian artery and circumferential thickening of the aortic wall between T10 and L1, establishing the diagnosis of Takayasu's arteritis. Both are organ-specific and immune-mediated diseases and exhibit granulomas and granulomatous vasculitis, which contribute to reinforce the hypothesis of a common immunologic origin. We believe that this is the first case of concomitant presence of these two diseases reported in the Brazilian literature.

High prevalence of overweight and obesity in adults with Crohn's disease: associations with disease and lifestyle factors.

LENUS (Irish Health Repository)

Nic Suibhne, Treasa

2013-08-01

Obesity and overweight are major public health issues. Although traditionally associated with weight loss, there is now evidence that increasing Body Mass Index (BMI) and overweight are emerging features of Crohn\\'s disease (CD) and may be associated with more severe disease course. The aim of the study was to determine the prevalence of overweight and obesity in patients with CD compared with matched healthy controls and to identify disease-specific and generic factors associated with current BMI in this group.

Less Anti-infliximab Antibody Formation in Paediatric Crohn Patients on Concomitant Immunomodulators

NARCIS (Netherlands)

Kansen, Hannah M.; van Rheenen, Patrick F.; Houwen, Roderick H. J.; Ten, Walther Tjon A.; Damen, Gerard M.; Kindermann, Angelika; Escher, Johanna C.; Wolters, Victorien M.

2017-01-01

Objectives: To evaluate the effect of immunomodulators on formation of antibodies to infliximab (ATI) in paediatric patients with Crohn disease (CD) and the association of ATI and loss of response. Methods: Retrospective multicentre observational study (January 2009-December 2014) among Dutch

Location and activity of ulcerative and Crohn's colitis by 111In leukocyte scan. A prospective comparison study

International Nuclear Information System (INIS)

Stein, D.T.; Gray, G.M.; Gregory, P.B.; Anderson, M.; Goodwin, D.A.; McDougall, I.R.

1983-01-01

A prospective blinded study comparing the 111 In leukocyte scan to barium enema, colonoscopy, or surgery or a combination of these, was carried out in 15 patients (10 with active ulcerative colitis and 5 with active Crohn's colitis). Correlation of disease location to colonic regions between indium scan and other diagnostic studies was excellent in 11 instances, good in 2, and poor in 3. In 2 of the 3 studies where major disagreement occurred, the comparative barium enema was performed greater than 2 mo after the indium scan. Disease activity, estimated by the intensity of radionuclide uptake, was compared to clinical disease activity assessed by the Crohn's Disease Activity Index for both forms of colitis. The relative degree of inflammation estimated by the indium scan correlated well with the independent clinical assessment (correlation coefficient . 0.81). The indium 111 leukocyte scan appears to be an accurate, noninvasive method for assessing the extent and the severity of the inflammation in patients with acute ulcerative or Crohn's colitis

Predicting and explaining inflammation in Crohn's disease patients using predictive analytics methods and electronic medical record data.

Science.gov (United States)

Reddy, Bhargava K; Delen, Dursun; Agrawal, Rupesh K

2018-01-01

Crohn's disease is among the chronic inflammatory bowel diseases that impact the gastrointestinal tract. Understanding and predicting the severity of inflammation in real-time settings is critical to disease management. Extant literature has primarily focused on studies that are conducted in clinical trial settings to investigate the impact of a drug treatment on the remission status of the disease. This research proposes an analytics methodology where three different types of prediction models are developed to predict and to explain the severity of inflammation in patients diagnosed with Crohn's disease. The results show that machine-learning-based analytic methods such as gradient boosting machines can predict the inflammation severity with a very high accuracy (area under the curve = 92.82%), followed by regularized regression and logistic regression. According to the findings, a combination of baseline laboratory parameters, patient demographic characteristics, and disease location are among the strongest predictors of inflammation severity in Crohn's disease patients.

Combinación de un inhibidor de la enzima convertidora de la angiotensina con un antagonista del calcio versus la monoterapia con el IECA: eficacia terapéutica en hipertensión arterial esencial y regresión de la hipertrofia cardíaca

Directory of Open Access Journals (Sweden)

Laura M. J. Brandani

2006-01-01

Full Text Available Objetivo Evaluar la eficacia y la tolerancia, así como su acción sobre la regresión de la hipertrofia ventricular izquierda, de la combinación de benazepril más amlodipina (B + A versus la monoterapia con benazepril (B. Material y métodos Se incluyeron 33 hipertensos esenciales. Durante 6 meses de tratamiento, 18 de ellos recibieron B + A (9 varones, 55 ± 2 años y los 15 restantes recibieron B (10 varones, 49 ± 2 años. Se realizó una presurometría (MAPA al comienzo y a los 3 y a los 6 meses de tratamiento. En un subgrupo de 23 pacientes se calculó la masa ventricular izquierda (MVI y el índice de MVI (IMVI al inicio y al final del tratamiento. Resultados A los 3 meses de tratamiento, los valores de la presión arterial (PA fueron significativamente menores (p < 0,05 en los pacientes tratados con B + A que con B (24 horas: 123 ± 1,7 / 77 ± 1,8 versus 132 ± 1,5 / 85 ± 1,6 mm Hg; día: 127 ± 1,9 / 81 ± 1,8 versus 137 ± 1,8 / 91 ± 1,9 mm Hg; noche: 115 ± 2,0 / 68 ± 2,1 versus 122 ± 2,0 / 76 ± 1,7 mm Hg. Esto se logró con una dosis menor y hubo mejor tolerancia. En el grupo B + A, la MVI y el IMVI disminuyeron de 225,3 ± 47,4 g y 125,5 ± 19,3 g/m2, a 187,2 ± 45,1 g y 104,7 ± 27,2 g/m2 (p < 0,05, mientras que en el grupo B la disminución no resultó estadísticamente significativa. Al finalizar el tratamiento, sólo en los pacientes tratados con B + A se observó una correlación positiva entre el descenso de la PAS y la MVI (r = 0,56, p < 0,025 y el IMVI (IMVI: r = 0,60; p < 0,01. Conclusión La combinación B + A mostró una reducción de la PA más precoz. Se requirió una dosis menor y se obtuvo mejor tolerancia clínica que con B solo. En relación con la MVI y el IMVI, estos parámetros disminuyeron en forma significativa sólo en B + A.

Ultrasound and MRI predictors of surgical bowel resection in pediatric Crohn disease

International Nuclear Information System (INIS)

Rosenbaum, Daniel G.; Conrad, Maire A.; Kelsen, Judith R.; Biko, David M.; Anupindi, Sudha A.; Ruchelli, Eduardo D.

2017-01-01

Imaging predictors for surgery in children with Crohn disease are lacking. To identify imaging features of the terminal ileum on short-interval bowel ultrasound (US) and MR enterography (MRE) in children with Crohn disease requiring surgical bowel resection and those managed by medical therapy alone. This retrospective study evaluated patients 18 years and younger with Crohn disease undergoing short-interval bowel US and MRE (within 2 months of one another), as well as subsequent ileocecectomy or endoscopy within 3 months of imaging. Appearance of the terminal ileum on both modalities was compared between surgical patients and those managed with medical therapy, with the following parameters assessed: bowel wall thickness, mural stratification, vascularity, fibrofatty proliferation, abscess, fistula and stricture on bowel US; bowel wall thickness, T2 ratio, enhancement pattern, mesenteric edema, fibrofatty proliferation, abscess, fistula and stricture on MRE. A two-sided t-test was used to compare means, a Mann-Whitney U analysis was used for non-parametric parameter scores, and a chi-square or two-sided Fisher exact test compared categorical variables. Imaging findings in surgical patients were correlated with location-matched histopathological scores of inflammation and fibrosis using a scoring system adapted from the Simple Endoscopic Score for Crohn Disease, and a Spearman rank correlation coefficient was used to compare inflammation and fibrosis on histopathology. Twenty-two surgical patients (mean age: 16.5 years; male/female: 13/9) and 20 nonsurgical patients (mean age: 14.8; M/F: 8/12) were included in the final analysis. On US, the surgical group demonstrated significantly increased mean bowel wall thickness (6.1 mm vs. 4.7 mm for the nonsurgical group; P = 0.01), loss of mural stratification (odds ratio [OR] = 6.3; 95% confidence interval [CI]: 1.4-28.4; P = 0.02) and increased fibrofatty proliferation (P = 0.04). On MRE, the surgical group showed

Ultrasound and MRI predictors of surgical bowel resection in pediatric Crohn disease

Energy Technology Data Exchange (ETDEWEB)

Rosenbaum, Daniel G. [NewYork-Presbyterian Hospital/Weill Cornell Medicine, Division of Pediatric Radiology, New York, NY (United States); Conrad, Maire A.; Kelsen, Judith R. [The Children' s Hospital of Philadelphia, Division of Gastroenterology, Hepatology and Nutrition, Philadelphia, PA (United States); Biko, David M.; Anupindi, Sudha A. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Ruchelli, Eduardo D. [The Children' s Hospital of Philadelphia, Division of Anatomic Pathology, Philadelphia, PA (United States)

2017-01-15

Imaging predictors for surgery in children with Crohn disease are lacking. To identify imaging features of the terminal ileum on short-interval bowel ultrasound (US) and MR enterography (MRE) in children with Crohn disease requiring surgical bowel resection and those managed by medical therapy alone. This retrospective study evaluated patients 18 years and younger with Crohn disease undergoing short-interval bowel US and MRE (within 2 months of one another), as well as subsequent ileocecectomy or endoscopy within 3 months of imaging. Appearance of the terminal ileum on both modalities was compared between surgical patients and those managed with medical therapy, with the following parameters assessed: bowel wall thickness, mural stratification, vascularity, fibrofatty proliferation, abscess, fistula and stricture on bowel US; bowel wall thickness, T2 ratio, enhancement pattern, mesenteric edema, fibrofatty proliferation, abscess, fistula and stricture on MRE. A two-sided t-test was used to compare means, a Mann-Whitney U analysis was used for non-parametric parameter scores, and a chi-square or two-sided Fisher exact test compared categorical variables. Imaging findings in surgical patients were correlated with location-matched histopathological scores of inflammation and fibrosis using a scoring system adapted from the Simple Endoscopic Score for Crohn Disease, and a Spearman rank correlation coefficient was used to compare inflammation and fibrosis on histopathology. Twenty-two surgical patients (mean age: 16.5 years; male/female: 13/9) and 20 nonsurgical patients (mean age: 14.8; M/F: 8/12) were included in the final analysis. On US, the surgical group demonstrated significantly increased mean bowel wall thickness (6.1 mm vs. 4.7 mm for the nonsurgical group; P = 0.01), loss of mural stratification (odds ratio [OR] = 6.3; 95% confidence interval [CI]: 1.4-28.4; P = 0.02) and increased fibrofatty proliferation (P = 0.04). On MRE, the surgical group showed

Os desafios do Brasil na implementação do Tratado sobre o Comércio de Armas (2013 - 2016)

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Frota, Luiz Phelipe Pimenta

2016-01-01

Trabalho de Conclusão de Curso apresentado ao Instituto Latino-Americano de Economia, Sociedade e Política da Universidade Federal da Integração Latino-Americana, como requisito parcial à obtenção do título de Bacharel em Relações Internacionais e Integração. Orientador: Prof. Dr. Gustavo Oliveira Vieira O presente trabalho tem por objetivo analisar a posição da política externa do Brasil em relação ao Tratado sobre Comércio de Armas - TCA. Este tratado, que foi propos...

Biological treatment of Crohn's disease

DEFF Research Database (Denmark)

Nielsen, Ole Haagen; Bjerrum, Jacob Tveiten; Seidelin, Jakob Benedict

2012-01-01

Introduction of biological agents for the treatment of Crohn's disease (CD) has led to a transformation of the treatment paradigm. Several biological compounds have been approved for patients with CD refractory to conventional treatment: infliximab, adalimumab and certolizumab pegol (and...... natalizumab in several countries outside the European Union). However, despite the use of biologics for more than a decade, questions still remain about the true efficacy and the best treatment regimens - especially about when to discontinue treatment. Furthermore, a need for optimizing treatment...... with biologics still exists, as 20-40% of patients with CD (depending on selection criteria) do not have any relevant response to the current biological agents (i.e. primary failures). A better patient selection might maximize the clinical outcome while minimizing the complications associated with this type...

Effect of childbirth on the course of Crohn's disease; results from a retrospective cohort study in the Netherlands

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Albers Lisette

2011-01-01

Full Text Available Abstract Background Pregnant women with Crohn's disease needs proper counselling about the effect of pregnancy and childbirth on their disease. However, Literature about the effect of childbirth on Crohn's disease is limited. This study examined the effect of childbirth on the course of Crohn's disease and especially perianal Crohn's disease. Methods This is a retrospective cohort study which was performed in a tertiary level referral hospital in the Netherlands. From the IBD database, female patients aged 18-80 years in 2004 were selected. Data analysis took place in the years 2005 and 2006. Eventually, 114 women with at least one pregnancy after the diagnosis of Crohn's disease were eligible for the study. Differences between groups were analyzed using Wilcoxon Mann Whitney tests and Chi-square analysis with 2 × 2 or 2 × 3 contingency tables. Two-tailed values were used and p values Results 21/114 women (18% had active luminal disease prior to pregnancy, with significantly more pregnancy related complications compared to women with inactive luminal disease (Odds ratio 2.8; 95% CI 1.0 - 7.4. Caesarean section rate was relatively high (37/114, 32%, especially in patients with perianal disease prior to pregnancy compared to women without perianal disease (Odds ratio 4.6; 95% CI 1.8 - 11.4. Disease progression after childbirth was more frequent in patients with active luminal disease prior to pregnancy compared to inactive luminal disease (Odds ratio 9.7; 95% CI 2.1 - 44.3. Progression of perianal disease seems less frequent after vaginal delivery compared with caesarean section, in both women with prior perianal disease (18% vs. 31%, NS and without prior perianal disease (5% vs 14%, NS. There were no more fistula-related complications after childbirth in women with an episiotomy or second degree tear. Conclusion A relatively high rate of caesarean sections was observed in women with Crohn's disease, especially in women with perianal disease

Artroplastía de superficie en cadera. Resultados iniciales favorables en pacientes selectos. [Hip resurfacing arthroplasty: favorable initial results in selected patients

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Fernando Martín Comba; Gerardo Zanotti; Martín Buttaro; Francisco Piccaluga

2013-01-01

In­tro­duc­ción El objetivo del presente trabajo es reportar los resultados clínicos y radiológicos iniciales de una serie consecutiva de pacientes selectos tratados en nuestra institución con un único diseño de artroplastia de superficie, comparando además la tasa de revisión temprana con un grupo control de pacientes tratados en el mismo lapso con una artroplastia total de cadera no cementada. Material y ­Métodos Cuarenta y siete pacientes de sexo masculino (49 caderas) con diag...

El reto de la contribución de la organización del Tratado de Cooperación Amazónica – OTCA– para el bienestar de las poblaciones locales y fronterizas

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Fernando Franco Hernández

2014-05-01

Full Text Available El documento aborda la descripción de las dinámicas sociales, económicas y políticas de las poblaciones fronterizas asentadas en la Amazonia, que discurren en medio de situaciones de conflicto y con formas diferenciadas de presencia de los Estados nacionales y sus instituciones. El escrito expone las políticas de organismos multilaterales como la OTCA (Organización del Tratado de Cooperación Amazónica, que tienen como objetivo formular planes y agendas estratégicas en torno al desarrollo sostenible y al uso y conservación de los sistemas naturales amazónicos y sus recursos. El argumento central es que tales políticas, planes y programas tienen un impacto mínimo en la resolución de los problemas y conflictos que enfrentan los pueblos amazónicos, dada la ausencia de instrumentos que articulen las formulaciones de carácter general con propuestas y proyectos que conduzcan al desarrollo sostenible y a un mejor vivir de las poblaciones amazónicas a escala regional.

Infección por Polyoma virus en un paciente con transplante renal: A propósito de un caso

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Reyner Loza Munarriz

2008-07-01

Full Text Available La nefropatia por polyoma virus (NVBK esta siendo reconocida como causa importante de falla del injerto, usualmente confundido con rechazo agudo. A la fecha, no se han reportado casos en el Perú. Se presenta el caso de un niño trasplantado, 17 años de edad, quien presentó elevación persistente de la creatinina sérica en el primer mes postrasplante. Fue tratado como rechazo agudo. Al no presentar mejoría se realizó biopsia renal que mostró marcado daño del epitelio tubular con necrosis parcial y desprendimiento hacia la luz tubular y la presencia de células atípicas con escaso citoplasma e inclusiones intranucleares basofilicas, hallazgos compatibles con infección por virus BK. No se evidenció signos de rechazo. Además, en el papanicolao de orina, se encontró Decoy cells. La carga viral de virus BK fue elevada en sangre y en orina. Se suspendió el tratamiento con mofetil micofenolato, se redujo la dosis de tacrolimus y se inició el tratamiento con leflunomide 40 mg/dia. Seis meses después la función renal del paciente se estabilizó, pero sin mejoría completa quedando con una depuración de creatinina de 30 ml/min/1,73 m² SC. (Rev Med Hered 2008;19:123-127

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn's disease with fecal calprotectin

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Juan María Vázquez-Morón

Full Text Available Background: Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn's disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing. Methods: The simple endoscopic score for Crohn's disease and the Crohn's disease activity index was calculated for 71 patients diagnosed with Crohn's. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test. Results: A fecal calprotectin cut-off concentration of ≥ 170 µg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06 predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 µg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08 predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170, mucosal healing (calprotectin ≤ 71 and uncertainty (71 > calprotectin < 170, with significant differences in endoscopic values (F = 26.407, p < 0.01. Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89% or mucosal healing (75% vs 87% in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores. Conclusions: The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context.

Role of magnetic resonance imaging in the management of perianal Crohn's disease.

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Gallego, Jose C; Echarri, Ana

2018-02-01

Perianal fistulas are a major problem in many patients with Crohn's disease. These are usually complex fistulas that adversely affect patients' quality of life, and their clinical management is difficult. Medical treatment sometimes achieves cessation of discharge and closure of the external opening; however, it is difficult to assess the status of the rest of the fistula tract. Magnetic resonance imaging is the method of choice with which to evaluate the condition of perianal fistulas and allows for assessment of the status of inaccessible areas. Magnetic resonance imaging also allows the clinician to evaluate other perianal manifestations of Crohn's disease that differ from the fistulas. This imaging technique is therefore a fundamental means of patient monitoring. When used in conjunction with assessment of the patient's morphological findings, it provides information that allows for both quantification of disease severity and evaluation of the response to treatment. New types of magnetic resonance sequences are emerging, such as diffusion, perfusion, and magnetisation transfer. These sequences may serve as biomarkers because they provide information reflecting the changes taking place at the molecular level. This will help to shape a new scenario in the early assessment of the response to treatments such as anti-tumour necrosis factor drugs. • MRI is the method of choice with which to evaluate perianal fistulas. • In perianal Crohn's disease, MRI is a fundamental means of patient monitoring. • The usefulness of the Van Assche score for patient monitoring remains unclear. • New MRI sequences' diffusion, perfusion, and magnetisation transfer may serve as biomarkers.

Herpes zoster oftálmico en pacientes con cáncer de pulmón Ophthalmic herpes zoster in patients with lung cancer

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Nancy Téllez Céspedes

2009-06-01

Full Text Available Se presentan 2 casos clínicos de ancianos con cáncer del pulmón, que acudieron al Servicio de Dermatología del Hospital General Docente “Dr. Juan Bruno Zayas Alfonso” por presentar dolor y lesiones maculares, eritematosas y vesiculosas en la región periorbitaria derecha, de modo que fueron ingresados en la institución con el diagnóstico de herpes zoster oftálmico y tratados con aciclovir, lo cual garantizó una evolución satisfactoria.Two clinical cases of elderly patients with lung cancer who went to the Dermatology Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital for presenting pain and macular, erithematous and vesiculous lesions in the right periorbital region, and so they were admitted in this institution with the diagnosis of ophthalmic herpes zoster and were treated with aciclovir, which guaranteed a satisfactory clinical course are presented.

Early combined immunosuppression for the management of Crohn's disease (REACT): a cluster randomised controlled trial.

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Khanna, Reena; Bressler, Brian; Levesque, Barrett G; Zou, Guangyong; Stitt, Larry W; Greenberg, Gordon R; Panaccione, Remo; Bitton, Alain; Paré, Pierre; Vermeire, Séverine; D'Haens, Geert; MacIntosh, Donald; Sandborn, William J; Donner, Allan; Vandervoort, Margaret K; Morris, Joan C; Feagan, Brian G

2015-11-07

Conventional management of Crohn's disease features incremental use of therapies. However, early combined immunosuppression (ECI), with a TNF antagonist and antimetabolite might be a more effective strategy. We compared the efficacy of ECI with that of conventional management for treatment of Crohn's disease. In this open-label cluster randomised controlled trial (Randomised Evaluation of an Algorithm for Crohn's Treatment, REACT), we included community gastroenterology practices from Belgium and Canada that were willing to be assigned to either of the study groups, participate in all aspects of the study, and provide data on up to 60 patients with Crohn's disease. These practices were randomly assigned (1:1) to either ECI or conventional management. The computer-generated randomisation was minimised by country and practice size. Up to 60 consecutive adult patients were assessed within practices. Patients who were aged 18 years or older; documented to have Crohn's disease; able to speak or understand English, French, or Dutch; able to access a telephone; and able to provide written informed consent were followed up for 2 years. The primary outcome was the proportion of patients in corticosteroid-free remission (Harvey-Bradshaw Index score ≤ 4) at 12 months at the practice level. This trial is registered with ClinicalTrials.gov, number NCT01030809. This study took place between March 15, 2010, and Oct 1, 2013. Of the 60 practices screened, 41 were randomly assigned to either ECI (n=22) or conventional management (n=19). Two practices (one in each group) discontinued because of insufficient resources. 921 (85%) of the 1084 patients at ECI practices and 806 (90%) of 898 patients at conventional management practices completed 12 months follow-up and were included in an intention-to-treat analysis. The 12 month practice-level remission rates were similar at ECI and conventional management practices (66·0% [SD 14·0] and 61·9% [16·9]; adjusted difference 2·5%, 95

Aspectos contábeis do Tratado de Itaipu : análise das práticas de avaliação dos ativos imobilizados da empresa Itaipu Binacional

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Nascimento, José Orcélio do

2010-01-01

Nos anos setenta do século vinte, houve uma expansão na produção de energia elétrica no Brasil. Em 26 de abril de 1973, foi celebrado o Tratado de Itaipu entre Brasil e Paraguai, o que possibilitou a construção de uma usina hidrelétrica na fronteira entre os dois países: a Itaipu Binacional, que é regida pelo Tratado de Itaipu e seus anexos. A contabilidade desta entidade apresenta singularidades como o Anexo C do Tratado de Itaipu que define as bases financeiras e de prestação dos serviços d...

Inherited determinants of Crohn's disease and ulcerative colitis phenotypes

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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 bet...... of a patient's disease, in part genetically determined, and the major driver to changes in disease behaviour over time. FUNDING: International Inflammatory Bowel Disease Genetics Consortium members funding sources (see Acknowledgments for full list)....

ASSESSMENT OF THE RESPONSE OF PATIENTS WITH CROHN'S DISEASE TO BIOLOGICAL THERAPY USING NEW NON-INVASIVE MARKERS: lactoferrin and calprotectin

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Islaine Martins NOGUEIRA

2013-04-01

Full Text Available Context The use of fecal markers to monitor Crohn's disease is crucial for assessing the response to treatment. Objective To assess the inflammatory activity of Crohn's disease by comparing fecal markers (calprotectin and lactoferrin, colonoscopy combined with biopsy, and the Crohn's disease activity index (CDAI, as well as serum markers, before treatment with infliximab, after the end of induction, and after the end of maintenance. Methods Seventeen patients were included who had been previously diagnosed with Crohn's disease and were using conventional treatment but required the introduction of biological therapy with infliximab. Each patient underwent a colonoscopy with biopsy, serum, and fecal (calprotectin and lactoferrin tests to assess inflammatory activity, and CDAI assessments before treatment with infliximab, after induction (week 8, and after maintenance (week 32. Results The calprotectin levels exhibited significant reductions (P = 0.04 between the assessment before treatment with infliximab and the end of induction, which did not occur after the end of the maintenance phase. Lactoferrin remained positive throughout the three phases of the study. Regarding the histological assessment, a significant difference was found only between the assessment before treatment and after the end of maintenance (P = 0.036, and 60% of the patients exhibited histological improvements after the completion of the follow-up period. The CDAI exhibited a significant difference between the assessment before treatment with infliximab and after induction, as well as before treatment and after maintenance (P<0.01. Conclusion Calprotectin and lactoferrin are not useful for monitoring inflammatory activity in Crohn's disease patients who are subjected to biological therapy.

Prediction of complicated disease course for children newly diagnosed with Crohn's disease: a multicentre inception cohort study.

Science.gov (United States)

Kugathasan, Subra; Denson, Lee A; Walters, Thomas D; Kim, Mi-Ok; Marigorta, Urko M; Schirmer, Melanie; Mondal, Kajari; Liu, Chunyan; Griffiths, Anne; Noe, Joshua D; Crandall, Wallace V; Snapper, Scott; Rabizadeh, Shervin; Rosh, Joel R; Shapiro, Jason M; Guthery, Stephen; Mack, David R; Kellermayer, Richard; Kappelman, Michael D; Steiner, Steven; Moulton, Dedrick E; Keljo, David; Cohen, Stanley; Oliva-Hemker, Maria; Heyman, Melvin B; Otley, Anthony R; Baker, Susan S; Evans, Jonathan S; Kirschner, Barbara S; Patel, Ashish S; Ziring, David; Trapnell, Bruce C; Sylvester, Francisco A; Stephens, Michael C; Baldassano, Robert N; Markowitz, James F; Cho, Judy; Xavier, Ramnik J; Huttenhower, Curtis; Aronow, Bruce J; Gibson, Greg; Hyams, Jeffrey S; Dubinsky, Marla C

2017-04-29

Stricturing and penetrating complications account for substantial morbidity and health-care costs in paediatric and adult onset Crohn's disease. Validated models to predict risk for complications are not available, and the effect of treatment on risk is unknown. We did a prospective inception cohort study of paediatric patients with newly diagnosed Crohn's disease at 28 sites in the USA and Canada. Genotypes, antimicrobial serologies, ileal gene expression, and ileal, rectal, and faecal microbiota were assessed. A competing-risk model for disease complications was derived and validated in independent groups. Propensity-score matching tested the effect of anti-tumour necrosis factor α (TNFα) therapy exposure within 90 days of diagnosis on complication risk. Between Nov 1, 2008, and June 30, 2012, we enrolled 913 patients, 78 (9%) of whom experienced Crohn's disease complications. The validated competing-risk model included age, race, disease location, and antimicrobial serologies and provided a sensitivity of 66% (95% CI 51-82) and specificity of 63% (55-71), with a negative predictive value of 95% (94-97). Patients who received early anti-TNFα therapy were less likely to have penetrating complications (hazard ratio [HR] 0·30, 95% CI 0·10-0·89; p=0·0296) but not stricturing complication (1·13, 0·51-2·51; 0·76) than were those who did not receive early anti-TNFα therapy. Ruminococcus was implicated in stricturing complications and Veillonella in penetrating complications. Ileal genes controlling extracellular matrix production were upregulated at diagnosis, and this gene signature was associated with stricturing in the risk model (HR 1·70, 95% CI 1·12-2·57; p=0·0120). When this gene signature was included, the model's specificity improved to 71%. Our findings support the usefulness of risk stratification of paediatric patients with Crohn's disease at diagnosis, and selection of anti-TNFα therapy. Crohn's and Colitis Foundation of America, Cincinnati

Gastroparesis in patients with inactive Crohn's disease: a case series

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Oyen Wim JG

2007-03-01

Full Text Available Abstract Background Few studies have described patients with foregut dysmotility in inflammatory bowel disease. The aim of this case series was to evaluate clinical characteristics of 5 patients with inflammatory bowel disease and symptoms and signs of upper gut dysmotility. Case presentations We describe a series of four patients with Crohn's disease and one with indeterminate colitis who presented with severe symptoms and signs of gastroparesis. We reviewed medical records of all cases. Gastric emptying of a solid meal was assessed by scintigraphy. Small bowel enteroclysis, gastroduodenoscopy and colonoscopy with biopsies were performed to estimate the activity of the disease and to exclude organic obstruction. None of the patients had any signs of active inflammation or stricture. All of the patients had markedly delayed gastric emptying with a mean t 1/2 of 234 minutes (range 110–380 minutes; normal values 54–94 minutes. Conclusion Clinicians should consider impaired gastric emptying when evaluating patients with Crohn's disease and severe symptoms of upper gut dysmotility, which cannot be attributed to active inflammation or organic obstruction of the digestive tract. Symptoms in these patients are refractory to various therapeutic interventions including tube feeding and gastric surgery.

Genotyping for NOD2 genetic variants and crohn disease: a metaanalysis

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Yazdanyar, Shiva; Weischer, Maren; Nordestgaard, Børge

2009-01-01

BACKGROUND: Arg702Trp, Gly908Arg, and Leu1007fsinsC variants of the NOD2 gene (nucleotide-binding oligomerization domain containing 2; alias, CARD15) influence the risk of Crohn disease. METHODS: We conducted a systematic review to examine whether Arg702Trp, Gly908Arg, and Leu1007fsinsC are equally...

Constitutive STAT3 activation in intestinal T cells from patients with Crohn's disease

DEFF Research Database (Denmark)

Lovato, Paola; Brender, Christine; Agnholt, Jørgen

2003-01-01

Via cytoplasmic signal transduction pathways, cytokines induce a variety of biological responses and modulate the outcome of inflammatory diseases and malignancies. Crohn's disease is a chronic inflammatory bowel disease of unknown etiology. Perturbation of the intestinal cytokine homeostasis is ...

A Recepção dos Tratados Internacionais em Matéria Tributária pelo Ordenamento Jurídico Brasileiro

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Bianca Castellar de Faria

2006-01-01

A presente dissertação objetiva analisar a forma de recepção dos tratados internacionais em matéria tributária pelo ordenamento jurídico brasileiro. Para isso, é fundamental verificar a relação entre o direito internacional e o direito interno, por meio da análise das teorias monista e dualista. Apresenta-se o Direito Tributário Internacional como uma das variações do Direito Internacional Público, com o objetivo de introduzir a matéria tributária. Estudam-se os tratados como uma das principa...

Evolución electrofisiológica en pacientes con síndrome del túnel del carpo tratados con cirugía

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Enrique Vergara Amador

2016-01-01

Conclusiones. La mejoría de los parámetros electrofisiológicos después de una liberación de síndrome de túnel del carpo es controversial: algunos reportes muestran mejoría desde el primer mes, especialmente en la velocidad de conducción sensitiva. Otros estudios muestran mejoría significativa entre las semanas 18 y 42 postoperatorias, siendo la recuperación motora más rápida que la sensitiva. En el presente estudio el 52% de los pacientes mejoraron en las escalas por disminución del grado de severidad. Las latencias distales motoras y sensitivas y el delta sensitivo del nervio mediano evidenciaron una mejoría. Estos resultados sugieren que los estudios electrodiagnóstico son efectivos en la evaluación objetiva de pacientes con síndrome de túnel del carpo y es el único examen que puede demostrar mejoría luego de una liberación del STC.

El soporte nutrimental y su relación con algunos indicadores pronósticos del niño quemado

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Alejandro Torres Amaro

2011-12-01

Full Text Available Introducción: las quemaduras constituyen una de las principales causas de accidentes en el niño. El tamaño de estas y el estado hipercatabólico son determinantes de la dinámica del tratamiento y la supervivencia del niño con grandes quemaduras. Objetivo: buscar la posible relación entre el soporte nutrimental establecido en las primeras horas después de la reanimación, y algunos indicadores pronósticos en niños quemados. Métodos: se realizó un estudio retrospectivo, de carácter analítico, que incluyó a 252 niños que tuvieron un ingreso en el servicio de quemados del Hospital Pediátrico Docente "Juan Manuel Márquez"de Marianao, en La Habana, con estadía superior a los 7 días, durante el decenio 2000-2009. A partir de la auditoría de las historias clínicas se obtuvieron los indicadores siguientes del pronóstico del niño quemado: superficie corporal quemada, tiempo de estadía, por ciento de pérdida de peso y mortalidad. De la misma forma se obtuvo la información acerca del tipo de soporte nutrimental metabólico empleado durante el tratamiento. Resultados: el tipo de soporte nutrimental metabólico más empleado fue el mixto, en el que se combinan las modalidades enteral y parenteral periférica, que abarcó al 52 % de los pacientes tratados. Los niños con menor por ciento de pérdida de peso (inferior al 10 % recibieron la forma enteral exclusiva (53,1 % de los casos tratados; en el 37,4 % el soporte fue mixto, pero usando la modalidad periférica de uso parenteral. Conclusiones: la estrategia nutrimental empleada en el niño quemado puede modificar algunos indicadores del pronóstico y debe ser una prioridad terapéutica para prevenir el deterioro clínico de estos pacientes.

Aprendiendo química con el tratamiento culinario de frutas, hortalizas y verduras

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Sánchez Guadix, Mª.A.

2007-09-01

Full Text Available La necesidad de acercar la ciencia a la realidad cotidiana del alumnado obliga a buscar nuevos recursos que tradicionalmente no eran tratados en la enseñanza formal: la química presente en la cocina y desarrollada a través de los trucos que han funcionadoen los tratamientos culinarios. En el presente artículo encontramos una reflexión acerca de la urgencia alfabetizar científicamente y de introducir saberes considerados femeninos en las aulas, una estrategia de búsqueda de recursos: la interpretacióncientífica y las aplicaciones didácticas de distintos trucos de cocina relacionados con frutas, hortalizas y verduras, y por último, algunas sugerencias para llevar a cabo distintas actividades en el aula de secundaria.

Neumostomía con sonda de balón en colecciones purulentas del pulmón

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Orestes Noel Mederos Curbelo

Full Text Available Introducción: el desarrollo de los antimicrobianos provocó que el drenaje externo dejara de realizarse en pacientes con absceso de pulmón, en quienes la resección pulmonar es la opción ante el fracaso médico. En los últimos años, la neumostomía ha resurgido por la necesidad de asistir a enfermos con un marcado deterioro físico que impide una intervención quirúrgica resectiva. Objetivo: caracterizar a los pacientes con supuración pulmonar tratados quirúrgicamente mediante drenaje percutáneo externo y neumostomía con sonda de balón (método de Monaldi practicados con anestesia local. Métodos: se realizó un estudio descriptivo longitudinal retrospectivo en el período de 1995 a 2012 en el Hospital Universitario "Comandante Manuel Fajardo". El universo estuvo conformado por 8 pacientes a los que se les practicó el método de Monaldi. En todos los casos se utilizaron sondas de goma de balón de 24 unidades F, de tres ramas. Resultados: cuatro pacientes padecían de absceso del pulmón y el resto de bullas enfisematosas voluminosas infectadas. Todos los casos tuvieron resolución de la colección infectada en un período inferior a las 2 semanas, y no hubo complicaciones ni mortalidad quirúrgica. Conclusiones: el drenaje percutáneo con anestesia local utilizando sondas de balón es un instrumento adecuado para el tratamiento de colecciones pulmonares en enfermos con deterioro físico por el cuadro infeccioso. Con él se logra la resolución de la lesión pulmonar, y es efectivo tanto en los abscesos pulmonares como en las bullas enfisematosas infectadas.

Ultrasound and MRI predictors of surgical bowel resection in pediatric Crohn disease.

Science.gov (United States)

Rosenbaum, Daniel G; Conrad, Maire A; Biko, David M; Ruchelli, Eduardo D; Kelsen, Judith R; Anupindi, Sudha A

2017-01-01

Imaging predictors for surgery in children with Crohn disease are lacking. To identify imaging features of the terminal ileum on short-interval bowel ultrasound (US) and MR enterography (MRE) in children with Crohn disease requiring surgical bowel resection and those managed by medical therapy alone. This retrospective study evaluated patients 18 years and younger with Crohn disease undergoing short-interval bowel US and MRE (within 2 months of one another), as well as subsequent ileocecectomy or endoscopy within 3 months of imaging. Appearance of the terminal ileum on both modalities was compared between surgical patients and those managed with medical therapy, with the following parameters assessed: bowel wall thickness, mural stratification, vascularity, fibrofatty proliferation, abscess, fistula and stricture on bowel US; bowel wall thickness, T2 ratio, enhancement pattern, mesenteric edema, fibrofatty proliferation, abscess, fistula and stricture on MRE. A two-sided t-test was used to compare means, a Mann-Whitney U analysis was used for non-parametric parameter scores, and a chi-square or two-sided Fisher exact test compared categorical variables. Imaging findings in surgical patients were correlated with location-matched histopathological scores of inflammation and fibrosis using a scoring system adapted from the Simple Endoscopic Score for Crohn Disease, and a Spearman rank correlation coefficient was used to compare inflammation and fibrosis on histopathology. Twenty-two surgical patients (mean age: 16.5 years; male/female: 13/9) and 20 nonsurgical patients (mean age: 14.8; M/F: 8/12) were included in the final analysis. On US, the surgical group demonstrated significantly increased mean bowel wall thickness (6.1 mm vs. 4.7 mm for the nonsurgical group; P = 0.01), loss of mural stratification (odds ratio [OR] = 6.3; 95% confidence interval [CI]: 1.4-28.4; P = 0.02) and increased fibrofatty proliferation (P = 0.04). On MRE, the

Nutrition interventions in patients with Crohn´s disease

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Eva Beňová

2016-10-01

Full Text Available Crohn's disease is a chronic non-specific inflammatory bowel disease of any part of the digestive tract. The seriousness of the disease requires a multi-disciplinary approach when providing patients with secondary and tertiary care. Patients also have specific problems from the nursing perspective that require intervention of nurses, e.g. in the area of nutrition. The role of a nurse in a specific community lies in supporting public health in the field of prevention, health education, group educational activities and care of the acutely or chronically ill. The regulation tool of nursing practice when providing community care is the documented form of nursing data expressed by means of expert terminology. The Omaha System is a standardised terminology for multi-disciplinary teams providing community care. The objective of the research is to draw attention to the possibility of using standardised terminology of the Omaha System when supporting public health in patients with Crohn's disease with nutrition problems. The research was divided into 3 stages: in the first stage we assessed the nutrition problem in 100 patients dispensarised in gastroenterology counselling centres using a form from the Omaha System. Out of these, identified 42 patients suffered from Crohn's disease and had problems with nutrition; in the second stage we chose interventions for nutrition from the Intervention Scheme of the Omaha System: their efficiency in patients was assessed by a nurse/nutritionist in the third stage of the research when the patients came to the gastroenterology counselling centre using Problem Rating Scale for Outcomes. When comparing the initial and final nutrition assessment with socio-demographic indicators we found a statistically significant difference (p = 0.000 between the status assessment where women scored a more remarkable advance than men when comparing the initial and the final assessment. With respect to age groups, education and jobs

1814 en Chile: de la desobediencia a Lima a la ruptura con España

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Ossa Santa Cruz, Juan Luis

2016-06-01

Full Text Available This article analyzes how the Chilean revolutionaries moved from the disobedience to Lima to the break with Spain in 1814. First, it studies the origins of the civil war that hit Chile since 1813. Then it studies the political factionalism within the revolutionary side and the importance of the Treaty of Lircay. Finally, it presents an account of the Americanist approach adopted by the Chilean rebels after signing a political and military alliance with José de San Martín.Este artículo interpreta el paso de la desobediencia a Lima a la ruptura definitiva con España durante el año 1814. Primero estudia los orígenes de la guerra civil en Chile comenzada en 1813. Luego presenta las causas del faccionalismo en el bando revolucionario y enfatiza la importancia del Tratado de Lircay. Finalmente, analiza la causa americanista seguida por los rebeldes chilenos después de firmar una alianza político-militar con José de San Martín.

High fat diet accelerates pathogenesis of murine Crohn's disease-like ileitis independently of obesity.

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Lisa Gruber

Full Text Available BACKGROUND: Obesity has been associated with a more severe disease course in inflammatory bowel disease (IBD and epidemiological data identified dietary fats but not obesity as risk factors for the development of IBD. Crohn's disease is one of the two major IBD phenotypes and mostly affects the terminal ileum. Despite recent observations that high fat diets (HFD impair intestinal barrier functions and drive pathobiont selection relevant for chronic inflammation in the colon, mechanisms of high fat diets in the pathogenesis of Crohn's disease are not known. The aim of this study was to characterize the effect of HFD on the development of chronic ileal inflammation in a murine model of Crohn's disease-like ileitis. METHODS: TNF(ΔARE/WT mice and wildtype C57BL/6 littermates were fed a HFD compared to control diet for different durations. Intestinal pathology and metabolic parameters (glucose tolerance, mesenteric tissue characteristics were assessed. Intestinal barrier integrity was characterized at different levels including polyethylene glycol (PEG translocation, endotoxin in portal vein plasma and cellular markers of barrier function. Inflammatory activation of epithelial cells as well as immune cell infiltration into ileal tissue were determined and related to luminal factors. RESULTS: HFD aggravated ileal inflammation but did not induce significant overweight or typical metabolic disorders in TNF(ΔARE/WT. Expression of the tight junction protein Occludin was markedly reduced in the ileal epithelium of HFD mice independently of inflammation, and translocation of endotoxin was increased. Epithelial cells showed enhanced expression of inflammation-related activation markers, along with enhanced luminal factors-driven recruitment of dendritic cells and Th17-biased lymphocyte infiltration into the lamina propria. CONCLUSIONS: HFD feeding, independently of obesity, accelerated disease onset of small intestinal inflammation in Crohn's disease

Problems in the Surgical Management of Crohn's Disease of the Colon

African Journals Online (AJOL)

classical ulcerative colitis and Crohn's disease when the latter affects the whole length of the colon and it is only during the last decade and in particular since the papers of. Lockhart-Mummery and Morson",l2 that the histological features of the two diseases have been described in detail. Since then many cases of primary ...

Talleres lúdico-pedagógicos con adolescentes: una herramienta para la promoción de la salud

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Dharah Puck Cordeiro Ferreira

2016-11-01

Full Text Available Relatar el intercambio de experiencias entre los adolescentes acerca de los temas tratados en los talleres. Se llevaron a cabo talleres lúdico-pedagógicos con adolescentes en una Unidad de Salud de la Familia en el periodo abril-junio de 2013, en el municipio de Garanhuns/PE, con la base conceptual de intervención psicosocial, ya que esto puede permitir la reflexión de los adolescentes sobre sus diversas experiencias. El sujeto expresa su subjetividad de manera diferente en cada etapa de su vida y contexto en que se insertan. Se producen, en la adolescencia, numerosos factores tales como la sexualidad, la entrada en la edad adulta, la violencia, el uso/abuso de alcohol y otras drogas, entre otros, que deben ser trabajados por los profesionales de la salud desde una perspectiva que tenga en cuenta la singularidad de cada sujeto, integralidad y articulaciones intersectoriales.

The development of a magnetic resonance imaging index for fistulising Crohn's disease

NARCIS (Netherlands)

Samaan, M. A.; Puylaert, C. A. J.; Levesque, B. G.; Zou, G. Y.; Stitt, L.; Taylor, S. A.; Shackelton, L. M.; Vandervoort, M. K.; Khanna, R.; Santillan, C.; Rimola, J.; Hindryckx, P.; Nio, C. Y.; Sandborn, W. J.; D'Haens, G.; Feagan, B. G.; Jairath, V.; Stoker, J.

2017-01-01

Magnetic resonance imaging (MRI) is the gold standard for assessment of perianal fistulising Crohn's disease (CD). The Van Assche index is the most commonly used MRI fistula index. To assess the reliability of the Van Assche index, and to modify the instrument to improve reliability and create a

Altered healing following mucogingival surgery in a patient with Crohn's disease: a literature review and case report.

Science.gov (United States)

Andersen, Kari M; Selvig, Knut A; Leknes, Knut N

2003-04-01

Crohn's disease is a chronic inflammatory bowel disease characterized by uncertainty in etiology and pathogenesis occasionally with manifestations in oral mucous membranes. This report reviews the literature on Crohn's disease and presents a patient with Crohn's disease on continuous anti-inflammatory and immunosuppressive medication who showed adverse healing response following surgical treatment of gingival recession type defects. A 28-year-old male in generally good health apart from his bowel disease requested treatment of multiple maxillary gingival recessions due to esthetic concerns and root sensitivity. Following oral hygiene instruction, 3 coronally advanced flap procedures were performed in the maxillary anterior region to cover the defects. In 2 of the surgical areas, the exposed root surfaces were treated by ethylenediaminetetraacetic acid (EDTA) in combination with enamel matrix derivative (EMD) before coronally positioning the buccal flap. Postoperatively, chlorhexidine gluconate was used for oral hygiene control. The first surgical procedure, performed as a coronally advanced flap, showed delayed and altered healing. Two weeks postoperatively, the flapped tissue remained intensely red and swollen. In the following 2 surgical sites where EDTA and EMD were applied the healing was uneventful. Differences in immediate tissue response, however, did not influence the 3-month treatment outcome with respect to root coverage. Patients with Crohn's disease on recommended systemic medications may show a delayed and altered wound healing indicating that periodontal surgery must be closely monitored. Treatment planning should take into account the potential wound healing promoting effects of enamel matrix derivative as well as adverse healing effects of chlorhexidine gluconate administration.

Resultados de un programa educativo con refuerzo audiovisual durante la sesión, en pacientes en hemodiálisis

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María Auxiliadora Santana Díez

Full Text Available Resumen Los medios audiovisuales son imprescindibles para reforzar la información del paciente. El objetivo del trabajo es describir la utilidad del uso de presentaciones educativas para los pacientes en hemodiálisis y los medios audiovisuales disponibles en la unidad. Se elaboraron tres presentaciones educativas en Microsoft Office Power Point y se pasaron una serie de cuestionarios con 13 preguntas que hacían referencia a aspectos fundamentales del cuidado tratados en las presentaciones, antes y después de éstas. Se realizó un análisis estadístico descriptivo con la distribución de frecuencias y porcentajes de las variables categóricas y con la media y la desviación típica de las variables cuantitativas. Para comprobar los resultados de las respuestas antes y después de las presentaciones/micropíldoras se ha utilizado la prueba de McNemar para dos muestras relacionadas con un nivel de significación estadística de p<0,05. El estudio consta de 45 pacientes, 73,3% varones con una edad media de 63,82 años. Se encontraron resultados estadísticamente significativos con p=0,031 y p=0,004, referentes a cuestiones sobre la desinfección de la fístula y el aporte proteico. El presente estudio ha servido para demostrar que la herramienta ha abierto nuevas posibilidades de formación a los pacientes.

Tratamiento quirúrgico con clavo intramedular elástico estable en fracturas diafisiarias del antebrazo en niños.

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Francisco Vera Rosas

2009-07-01

Full Text Available Objetivo: Evaluar los resultados del tratamiento quirúrgico de las fracturas diafisiarias del radio y/o cubito mediante la colocación intramedular de clavos Kirschner moldeados en pacientes pediátricos. Material y métodos: Estudio descriptivo observacional de pacientes tratados con clavo intramedular en fracturas diafisiarias de antebrazo en el Hospital Nacional Cayetano Heredia - Lima. Se usaron clavos Kirschner moldeado de acuerdo a especificaciones del clavo ESIN y se evaluaron la técnica operatoria, tiempo de consolidación, complicaciones y funcionalidad. Resultados: Se incluyeron 12 pacientes, 10 de sexo masculino, con edad promedio de 13.7 años (11 a 15 años, se encontró evidencia de consolidación a las seis semanas y el tiempo operatorio promedio fue de 75 minutos. Un paciente presentó parestesias del nervio cubital que remitió a los 4 meses, la perdida sanguínea fue mínima con un abordaje minimamente invasivo. Todas las fracturas consolidaron. Conclusión: El uso de clavo Kirschner moldeado es una alternativa de tratamiento en este tipo de fracturas debido a su bajo costo, y resultados comparables con el ESIN que es el tratamiento de elección. (Rev Med Hered 2009;20:151-155.

Postsurgical recurrence of ileal Crohn's disease: an update on risk factors and intervention points to a central role for impaired host-microflora homeostasis.

LENUS (Irish Health Repository)

Cunningham, Michael F

2010-07-01

A pressing need exists to identify factors that predispose to recurrence after terminal ileal resection for Crohn\\'s disease (CD) and to determine effective prophylactic strategies. This review presents an up-to-date summary of the literature in the field and points to a role for bacterial overproliferation in recurrence.

A single center experience of methotrexate in the treatment of Crohn's disease and ulcerative colitis: a case for subcutaneous administration.

Science.gov (United States)

Nathan, Debbie M; Iser, John H; Gibson, Peter R

2008-06-01

Methotrexate (MTX) is used as a second-line immuno-modulator in patients with inflammatory bowel disease when purine analogs are not tolerated or lack efficacy. High-level evidence indicates efficacy for intramuscular administration in Crohn's disease, but there are few reports of experience with subcutaneous delivery. This study aimed to evaluate the response to and tolerance of MTX where subcutaneous administration was the preferred option. The records of all patients treated with MTX were evaluated with regard to the dose, duration, response, and tolerance to MTX. Remission was defined as improvement in symptoms with no corticosteroid requirement for 3 months or ability to wean off steroids. MTX was initiated in 45 patients with Crohn's disease and 23 ulcerative colitis (median age, 46 years; range, 20-80 years; 54% men) because of intolerance (69%) or resistance (31%) to purine analogues. MTX was initiated in 74% of patients in doses of 25 mg (33) or 20 mg (17), administered by subcutaneous self-injection in 90% of subjects. Remission was achieved in 24 of 45 (53%) with Crohn's disease and 11 of 23 (48%) with ulcerative colitis. An additional four (9%) patients with Crohn's disease and three patients (13%) with ulcerative colitis demonstrated symptomatic improvement and/or ability to decrease corticosteroid dose. While nine patients ceased therapy and nine successfully reduced their doses due to intolerance, three of four patients had no adverse effects. Subcutaneous delivery was well accepted. Subcutaneously administered MTX exhibits apparent efficacy, acceptance, tolerance, and safety in patients with Crohn's disease or ulcerative colitis who are steroid-dependent and where purine analogs have been ineffective or intolerable.

Ideación suicida y respuesta a la terapia cognitiva conductual en adolescentes puertorriqueños/as con depresión mayor

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Jeannette Rosselló

2011-01-01

Full Text Available En Puerto Rico existe una alta prevalencia de depresión e ideación suicida (IS en adolescentes. Este estudio examinó la respuesta a una terapia cognitivo-conductual para la depresión con un protocolo para el manejo del riesgo suicida incorporado. Participaron 115 adolescentes con depresión mayor. Se realizaron análisis descriptivos, pruebas t de medidas repetidas, análisis de significancia clínica e índice de cambio confiable, correlaciones y de regresión múltiple. La IS al comienzo del tratamiento no tuvo un efecto sobre el tratamiento para la depresión. Un 34.8% de los/as participantes demostraron un índice de cambio confiable de las puntuaciones del pre al post tratamiento en IS y un 89.6% evidenciaron cambio clínico significativo en post-tratamiento. El nivel de desesperanza y la IS al comienzo del tratamiento mostraron un valor predictivo hacia el nivel de IS al finalizar el tratamiento. En conclusión, la mayoría de los/as adolescentes con depresión e IS tratados con la TCC redujeron significativamente sus pensamientos suicidas.

LA PRACTICA CLÍNICA DEL TRABAJO SOCIAL CON LAS PERSONAS MAYORES. BEAVER MARIÓN L MILLER DONJNTERVENCIÓN PRIMARIA, SECUNDARIA, TERCIARIA. PAIDÓS, SEGUNDA EDICIÓN, ESPAÑA 1988,457 PÁGINAS.

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Yesica Alexandra Rodríguez

2012-08-01

Full Text Available El texto brinda elementos clave para el desempeño del trabajo social con personas mayores. Los autores presentan una caracterización detallada de este tipo de población, dan a conocer formas practicas de intervención, tomando como referencia estudios de casos ya tratados y colocando al trabajador social en la posibilidad de observar aquellos papeles que pueda jugar en el momento de acceder esta población.

Fracturas perimplante de fémur tratadas con clavo retrógrado: reporte de un caso y descripción de la técnica quirúrgica.

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Pablo Ariel Slullitel

2016-02-01

Full Text Available Existe un riesgo tácito de fractura peri-implante de fémur en pacientes con antecedente de fractura pertrocantérica de fémur tratados con tornillos deslizantes de cadera (TDC debido al aumento de la expectativa de vida y a las múltiples comorbilidades. Diversas opciones terapéuticas son posibles dependiendo de si se mantiene la osteosíntesis previa o no. Dada la baja prevalencia de estas fracturas, no existe consenso en la bibliografía actual sobre el tratamiento ideal. El objetivo de este trabajo es reportar un caso y describir la técnica quirúrgica de enclavado endomedular retrógrado para el tratamiento de fracturas peri-implante debajo de un TDC.

Discontinuation of infliximab therapy in patients with Crohn's disease in sustained complete remission (the STOP IT study)

DEFF Research Database (Denmark)

Buhl, Sine Schnoor; Steenholdt, Casper; Brynskov, Jørn

2014-01-01

INTRODUCTION: Infliximab (IFX), a monoclonal chimeric antibody against tumour necrosis factor (TNF) α, is effective for induction and maintenance of remission in moderate to severe Crohn's disease. Discontinuation of IFX maintenance therapy in patients in remission should be considered in order......, biochemical and endoscopic remission (ie, Crohn's Disease Activity Index (CDAI) score therapy. The primary end point...... a patient exhibits sustained remission. Study results will be published in an English language scientific medical journal. The study is approved by the Danish Medicines Agency (EudraCT-number: 2012-002702-51) and the Regional Ethics Committee of Region Hovedstaden Denmark (Approval-number: H-4...

Infliximab Reduces Endoscopic, but Not Clinical, Recurrence of Crohn's Disease After Ileocolonic Resection

NARCIS (Netherlands)

Regueiro, Miguel; Feagan, Brian G.; Zou, Bin; Johanns, Jewel; Blank, Marion A.; Chevrier, Marc; Plevy, Scott; Popp, John; Cornillie, Freddy J.; Lukas, Milan; Danese, Silvio; Gionchetti, Paolo; Hanauer, Stephen B.; Reinisch, Walter; Sandborn, William J.; Sorrentino, Dario; Rutgeerts, Paul; Debinski, H.; Florin, T.; Hetzel, D.; Lawrance, I.; Radford-Smith, G.; Sloss, A.; Sorrentino, D.; Gassner, S.; Haas, T.; Reicht, G.; Reinisch, W.; Strasser, M.; Vogelsang, H.; Bossuyt, P.; Dewit, O.; D'Haens, G.; Franchimont, D.; Louis, E.; Vermeire, S.; Bernstein, C. N.; Bourdages, R.; Chiba, N.; Dhalla, S. S.; Feagan, B. G.; Fedorak, R. N.; Lachance, J. R.; Panaccione, R.; Ropeleski, M.; Singh Salh, B.; Lukas, M.; Colombel, J.-F.; Allez, M.; Desreumaux, P.; Dupas, J. L.; Grimaud, J.-C.; Hebuterne, X.; Laharie, D.; Lerebours, E.; Peyrin-Biroulet, L.; Reimund, J.-M.; Viennot, S.; Zerbib, F.; Antoni, C.; Atreya, R.; Baumgart, D. C.; Berg, C.; Boecker, U.; Bramkamp, G.; Bünning, C.; Ehehalt, R.; Howaldt, S.; Kucharzik, T.; Lamprecht, H. G.; Mudter, J.; Preiss, J. C.; Schreiber, S.; Seidler, U.; Altorjay, I.; Banai, J.; Lakatos, P. L.; Varga, M.; Vincze, A.; Avni-Biron, I.; Fishman, S.; Fraser, G. M.; Goldin, E.; Rachmilewitz, D.; Annese, V.; Ardizzone, S.; Biancone, L.; Bossa, F.; Danese, S.; Fries, W.; Gionchetti, P.; Maconi, G.; Terrosu, G.; Usai, P.; Gearry, R. B.; Hill, J.; Rowbotham, D. S.; Schultz, M.; Stubbs, R. S.; Wallace, D.; Walmsley, R. S.; Wyeth, J.; Malecka-Panas, E.; Paradowski, L.; Regula, J.; Beales, I. P.; Campbell, S.; Hawthorne, A. B.; Parkes, M.; Travis, S. P.; Achkar, J. P.; Behm, B. W.; Bickston, S. J.; Brown, K. J.; Chiorean, M. V.; DeVilliers, W. J. S.; Elliott, D. E.; Grunkmeier, D.; Hamilton, J. W.; Hanauer, S. B.; Hanson, J. S.; Hardi, R.; Helper, D. J.; Herfarth, H.; Higgins, P. D. R.; Holderman, W. H.; Kottoor, R.; Kreines, M. D.; Leman, B. I.; Li, X.; Loftus, E. V.; Noar, M.; Oikonomou, I.; Onken, J.; Peterson, K. A.; Phillips, R. P.; Randall, C. W.; Ricci, M.; Ritter, T.; Rubin, D. T.; Safdi, M.; Sandborn, W. J.; Sauberman, L.; Scherl, E.; Schwarz, R. P.; Sedghi, S.; Shafran, I.; Sninsky, C. A.; Stein, I.; Swoger, J.; Vecchio, J.; Weinberg, D. I.; Wruble, L. D.; Yajnik, V.; Younes, Z.

2016-01-01

BACKGROUND & AIMS: Most patients with Crohn's disease (CD) eventually require an intestinal resection. However, CD frequently recurs after resection. We performed a randomized trial to compare the ability of infliximab vs placebo to prevent CD recurrence. METHODS: We evaluated the efficacy of

Magnitude of Increased Infliximab Clearance Imposed by Anti-infliximab Antibodies in Crohn's Disease Is Determined by Their Concentration

DEFF Research Database (Denmark)

Edlund, Helena; Steenholdt, Casper; Ainsworth, Mark A

2017-01-01

in IFX clearance imposed by anti-IFX Abs has generally been evaluated using a binary classification, i.e., positive or negative. This analysis aimed to investigate if anti-IFX Ab concentrations provide a more adequate prediction of alterations in clearance. Data originated from a clinical trial on Crohn......'s disease patients with IFX treatment failure. The trial was not originally designed for pharmacokinetic analysis. Therefore, published pharmacokinetic models were utilized as priors to enable covariate investigation. The impact of anti-IFX Abs on clearance was assessed using different mathematical...

La igualdad de genero en el Tratado Constitucional de la Unión Europea

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Emanuela Lombardo

2012-02-01

Full Text Available El artículo analiza el tratamiento de la igualdad de género en el Tratado Constitucional Europeo de 2004, con especial referencia a la incorporación de una perspectiva de género en el proceso. Evalúa tanto los resultados positivos, relacionados con el mantenimiento del acervo comunitario en materia de igualdad, la inclusión de la Carta de los Derechos Fundamentales de la UE, y las movilizaciones a favor de la igualdad dentro y fuera de la Convención, como los resultados negativos, concernientes a la limitada capacidad de incorporar una perspectiva  de género en el proceso y en el texto constitucional. Ésta se atribuye al concepto estrecho de igualdad de género adoptado en el documento, a las resistencias en incorporar una perspectiva de género en todas las áreas políticas, a la baja representación de las mujeres en la Convención, y a la ausencia de una perspectiva de género en el proceso institucional y administrativo. En la conclusión se avanzan algunas hipótesis explicativas de dichas limitaciones. The article analyses the treatment of gender equality in the 2004 European Constitutional Treaty, with particular reference to the incorporation of a gender perspective in the process. The assessment includes positive results, that are related to the maintenance of the acquis cornrnmunautaire on equality, the inclusion of the Charter of Fundamental Rights, and the mobilisation in favour of equality within and outside the body of the Convention. It also considers the negative results that have to do with the limited capacity to incorporate a gender perspective into the process and the text of the Constitution. This limits are attributed to the narrow concept of gender equality adopted in the document, the resistance to incorporate a gender perspective into all policy areas, the low representation of women in the Convention, and the absence of a gender perspective in the institutional and administrative process. The

Diffusion-weighted MRI in Crohn's disease: Current status and recommendations

OpenAIRE

Dohan, A.; Taylor, S.; Hoeffel, C.; Barret, M.; Allez, M.; Dautry, R.; Zappa, M.; Savoye-Collet, C.; Dray, X.; Boudiaf, M.; Reinhold, C.; Soyer, P.

2016-01-01

Over the past years, technological improvements and refinements in magnetic resonance imaging (MRI) hardware have made high-quality diffusion-weighted imaging (DWI) routinely possible for the bowel. DWI is promising for the detection and characterization of lesions in Crohn's disease (CD) and has been advocated as an alternative to intravenous gadolinium-based contrast agents. Furthermore, quantification using the apparent diffusion coefficient may have value as a biomarker of CD activity and...

Endoscopic balloon dilatation of intestinal strictures in Crohn's disease: safe alternative to surgery.

Science.gov (United States)

Ajlouni, Yousef; Iser, John H; Gibson, Peter R

2007-04-01

Endoscopic balloon dilatation (EBD), a non-surgical treatment option for intestinal strictures in Crohn's disease, appears to be applied infrequently, possibly due to the perceived risk of perforation and early recurrence. This study aimed to determine the outcomes of EBD by a single endoscopist using a defined technique. The records of all patients with Crohn's disease in whom EBD was attempted over a 12-year period were examined to determine the rate of technical success, complications and outcome. A stricture was defined as that which prevented passage of the 14 mm diameter colonoscope. Technical success was defined as the ability to traverse the stricture postdilatation. Patients were selected on the colonoscopic appearance of the stricture and dilatation was performed using through-the-endoscope balloons. Antibiotics were given during and for 7 days postdilatation. EBD was attempted on 83 strictures (31 anastomotic and 52 primary) in 37 patients (15 males) and was successful in 75 (90%) of 31 patients. A single dilatation only was required in 21 patients who had a median follow-up of 20 months (range 6-122 months). Recurrent symptomatic stricture requiring dilatation (eight patients) or surgery (two patients) occurred 8 (1-112) months after the initial dilatation. The only complication occurred in one patient where an intra-abdominal fistula and abscess were probably related to the dilatation. EBD of intestinal strictures associated with Crohn's disease has a low complication rate and leads to prolonged clinical benefit. It should be considered as a real alternative to surgery.

Clinical status, quality of life, and work productivity in Crohn's disease patients after one year of treatment with adalimumab.

Science.gov (United States)

Saro, Cristina; Ceballos, Daniel; Muñoz, Fernando; de la Coba, Cristóbal; Aguilar, María Dolores; Lázaro, Pablo; García-Sánchez, Valle; Hernández, Mariola; Barrio, Jesús; de Francisco, Ruth; Fernández, Luis I; Barreiro-de Acosta, Manuel

2017-02-01

Clinical trials have shown the efficacy of adalimumab in Crohn's disease, but the outcome in regular practice remains unknown. The aim of the study was to examine clinical status, quality of life, and work productivity of Crohn's disease patients receiving adalimumab for one year in the context of usual clinical practice. This was a prospective, observational study with a one-year follow-up. After baseline, Crohn's disease patients were evaluated at 1, 3, 6, 9, and 12 months after starting treatment with adalimumab. Outcome variables included: clinical status (measured with CDAI), quality of life (measured with EuroQoL-5D and IBDQ), and work productivity (measured with WPAI questionnaire). These outcome variables were compared using the Student's t test or Wilcoxon test for paired comparison data according to the data distribution. Statistical significance was set at two-sided p work productivity impact decreased from 53% to 24% (p quality of life and work productivity.

Cyclophosphamide effect on paracoccidioidomycosis in the rat Efecto de la ciclofosfamida en ratas con paracoccidioidomicosis

Directory of Open Access Journals (Sweden)

J. L. Blejer

1995-06-01

Full Text Available Paracoccidioidomycosis is an endemic fungal disease widely distributed throughout Latin America. The potent immunosuppressor cyclophosphamide (CY has been used to modulate host immune response to Paracoccidioides brasiliensis in an experimental model. Inbred male Buffalo/Sim rats weighing 250-300 g were inoculated with 5 x 10(6 P. brasiliensis cells of the yeast phase form by intracardiac route. One group of animals was treated with 20 mg/kg body weight at days +4, +5, +6, +7, +11 and +12 post-infection (pi., while a control group was infected alone. No mortality was recorded in either group. Treated rats presented: a a decrease in granuloma size, which contained less fungal cells; b a lack of specific antibodies up to 35 days pi., and c a significant increase in the footpad swelling test (DTH against paracoccidioidin. Splenic cell transfer from CY-treated P. brasiliensis-infected donors to recipients infected alone led to a significant increase in DTH response in the latter versus untreated infected controls. Likewise, in treated infected recipients transferred with untreated infected donor spleen cells, footpad swelling proved greater than in controls. Thus, it would seem that each successive suppressor T lymphocyte subset belonging to the respective cascade may be sensitive to repeated CY doses administered up to 12 days pi.. Alternatively, such CY schedule may induce the appearance of a T cell population capable of amplifying DTH response.La paracoccidioidomicosis es una enfermedad endémica fúngica ampliamente distribuida en Latino-América. La ciclofosfamida ha sido usada como potente inmunosupresor para modular la respuesta inmune, en un modelo experimental infectado con Paracoccidioides brasiliensis. Ratas machos Buffalo/Sim endocriadas de 250-300 gr. de peso, fueron inoculadas por via intracardiaca con 5.10 6 células de P. brasiliensis en fase levaduriforme. Un grupo de animales fue tratado con 20 mg/kg de peso de ciclofosfamida en

Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial.

Science.gov (United States)

Colombel, Jean-Frederic; Panaccione, Remo; Bossuyt, Peter; Lukas, Milan; Baert, Filip; Vaňásek, Tomas; Danalioglu, Ahmet; Novacek, Gottfried; Armuzzi, Alessandro; Hébuterne, Xavier; Travis, Simon; Danese, Silvio; Reinisch, Walter; Sandborn, William J; Rutgeerts, Paul; Hommes, Daniel; Schreiber, Stefan; Neimark, Ezequiel; Huang, Bidan; Zhou, Qian; Mendez, Paloma; Petersson, Joel; Wallace, Kori; Robinson, Anne M; Thakkar, Roopal B; D'Haens, Geert

2018-12-23

Biomarkers of intestinal inflammation, such as faecal calprotectin and C-reactive protein, have been recommended for monitoring patients with Crohn's disease, but whether their use in treatment decisions improves outcomes is unknown. We aimed to compare endoscopic and clinical outcomes in patients with moderate to severe Crohn's disease who were managed with a tight control algorithm, using clinical symptoms and biomarkers, versus patients managed with a clinical management algorithm. CALM was an open-label, randomised, controlled phase 3 study, done in 22 countries at 74 hospitals and outpatient centres, which evaluated adult patients (aged 18-75 years) with active endoscopic Crohn's disease (Crohn's Disease Endoscopic Index of Severity [CDEIS] >6; sum of CDEIS subscores of >6 in one or more segments with ulcers), a Crohn's Disease Activity Index (CDAI) of 150-450 depending on dose of prednisone at baseline, and no previous use of immunomodulators or biologics. Patients were randomly assigned at a 1:1 ratio to tight control or clinical management groups, stratified by smoking status (yes or no), weight (2 years) after 8 weeks of prednisone induction therapy, or earlier if they had active disease. In both groups, treatment was escalated in a stepwise manner, from no treatment, to adalimumab induction followed by adalimumab every other week, adalimumab every week, and lastly to both weekly adalimumab and daily azathioprine. This escalation was based on meeting treatment failure criteria, which differed between groups (tight control group before and after random assignment: faecal calprotectin ≥250 μg/g, C-reactive protein ≥5mg/L, CDAI ≥150, or prednisone use in the previous week; clinical management group before random assignment: CDAI decrease of 200; clinical management group after random assignment: CDAI decrease of management group, 0·9 years [SD 1·7]; tight control group, 1·0 year [2·3]) were randomly assigned to monitoring groups (n=122 per group

CONTROL DE Anastrepha serpentina (Wiedemann Y CALIDAD DE LOS FRUTOS DE ZAPOTE MAMEY Pouteria sapota (Jacq Moore & Stearn TRATADOS CON AIRE CALIENTE FORZADO

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R. Ariza-Flores

2009-01-01

Full Text Available Los objetivos de este estudio fue evaluar la efectividad de tratamientos térmicos con aire caliente forzado húmedo en el combate de la mosca de los zapotes (Anastrepha serpentina Wiedemann "in vivo" y determinar la tolerancia a las condiciones aplicadas de frutos de zapote mamey. Los frutos no fueron dañados internamente por el tratamiento térmico cuando fueron expuestos a 43 °C·120 min-1. Los frutos alcanzaron su madurez de consumo a los ocho días a 25 °C, presentaron cambios rápidamente en color y perdieron más peso; mientras que, a 10 °C se mantuvieron con mayor firmeza, prolongaron su vida de anaquel y mostraron mayores daños en los haces vasculares. Con respecto a la mortandad de los huevos y larvas de mosca de la fruta A. serpentina, éstas fueron del 100 % con la atmósfera controlada (CA de aire caliente a 43 °C·120 min-1, igualmente los frutos no fueron dañados por la aplicación de la CA; las larvas murieron fácilmente por el calor a 40 °C·120 min-1, mientras que los huevos fueron más resistentes ya que ocurrieron larvas emergidas a 25 °C para los ocho días de almacenados.

Dynamic Contrast-Enhanced Magnetic Resonance Enterography and Dynamic Contrast-Enhanced Ultrasonography in Crohn's Disease

DEFF Research Database (Denmark)

Wilkens, Rune; Peters, David A; Nielsen, Agnete Hedemann

2017-01-01

Purpose e Cross-sectional imaging methods are important for objective evaluationof small intestinal inflammationinCrohn'sdisease(CD).The primary aim was to compare relative parameters of intestinal perfusion between contrast-enhanced ultrasonography (CEUS) and dynamic contrast-enhanced magnetic...

Evaluación del impacto de las técnicas de control del daño en el tratamiento de los pacientes con aneurisma roto de la aorta abdominal. Hospital Universitario San Vicente de Paúl, Medellín, Colombia, enero de 2000 a octubre de 2007

OpenAIRE

John Fernando García V.; Iván Ramiro Arismendi O.; René Fernando Timarán R.; Carolina Bravo C.; José Andrés Uribe M.; Giovanni García M.

2008-01-01

La mortalidad quirúrgica atribuible al aneurisma de la aorta abdominal (AAA) roto oscila entre 40 y 70% según los diversos informes de la literatura; la principal causa de ello es la falla orgánica múltiple (FOM), la que a su vez corresponde, en un porcentaje importante de casos, al complejo de hipertensión abdominal/síndrome del compartimento abdominal (HTA/SCA). A principios de la década de los años 90 aparecieron algunos artículos informando que los pacientes tratados con laparostomía, con...

The Reasons for Discontinuation of Infliximab Treatment in Patients with Crohn's Disease: A Review of Practice at NHS Teaching Hospital

OpenAIRE

Krupa, Lukasz Z.; Kennedy, Hugh J.; Jamieson, Crawford P.; Fisher, Nicola; Hart, Andrew R.

2011-01-01

Introduction. There is little information on the reasons for discontinuing infliximab treatment in patients with Crohn's disease. The aim of this study was to document these reasons to determine if any were preventable which would allow patients to continue the therapy. Aims & Methods. A review of the medical notes was conducted at the Norfolk and Norwich University Hospital on patients with Crohn's disease treated with infliximab between 2002–2008 to determine the reasons for stopping it. Re...

Difference in Recurrence Patterns Between Anastomosis and Strictureplasty After Surgical Treatment for Crohn Disease

Science.gov (United States)

Hayakawa, Shoichiro; Hotokezaka, Masayuki; Ikeda, Takuto; Uchiyama, Shuichiro; Chijiiwa, Kazuo

2012-01-01

This study aimed to investigate whether the initial indication for surgery or type of surgery (strictureplasty or resection) performed determines recurrence patterns in patients with Crohn disease. Recurrence patterns of 41 patients (31 patients: only resection and anastomosis of the intestine, and 10 patients: strictureplasty with/without resection and anastomosis) who underwent operation for recurrent Crohn disease (June 2002–December 2010) were evaluated. Strictureplasty for nonperforating disease was performed at 17 sites, and reoperation was required at 11 sites (10 sites for nonperforating disease and 1 site for perforating disease). There was a significant difference in the recurrence pattern in patients who underwent resection and anastomosis (P resection and anastomosis (P resection and anastomosis was performed for nonperforating and for perforating disease. Initial indication for surgery, but not the type of surgery, appeared to determine recurrence patterns. PMID:23102077

Intestinal permeability to (/sup 51/Cr)EDTA in children with Crohn's disease and celiac disease

Energy Technology Data Exchange (ETDEWEB)

Turck, D.; Ythier, H.; Maquet, E.; Deveaux, M.; Marchandise, X.; Farriaux, J.P.; Fontaine, G.

1987-07-01

(/sup 51/Cr)EDTA was used as a probe molecule to assess intestinal permeability in 7 healthy control adults, 11 control children, 17 children with Crohn's disease, and 6 children with untreated celiac disease. After subjects fasted overnight, 75 kBq/kg (= 2 microCi/kg) /sup 51/Cr-labeled EDTA was given by mouth; 24-h urinary excretion of (/sup 51/Cr)EDTA was measured and expressed as a percentage of the total oral dose. Mean and SD were as follows: control adults 1.47 +/- 0.62, control children 1.59 +/- 0.55, and patients with Crohn's disease or celiac disease 5.35 +/- 1.94. The difference between control children and patients was statistically significant (p less than 0.001). These results show that intestinal permeability to (/sup 51/Cr)EDTA is increased among children with active or inactive Crohn's disease affecting small bowel only or small bowel and colon, and with untreated celiac disease. The (/sup 51/Cr)EDTA permeability test could facilitate the decision to perform more extensive investigations in children suspected of small bowel disease who have atypical or poor clinical and biological symptomatology.

Comparison of outcomes parameters for induction of remission in new onset pediatric Crohn's disease

DEFF Research Database (Denmark)

Levine, Arie; Turner, Dan; Pfeffer Gik, Tamar

2014-01-01

BACKGROUND: Robust evaluation of induction therapies using both clinical and inflammatory outcomes in pediatric Crohn's disease (CD) are sparse. We attempted to evaluate clinical, inflammatory, and composite outcomes of induction of remission therapies (normal C reactive protein [CRP] remission) ...

Assessment of Crohn's disease activity in the small bowel with MR and conventional enteroclysis: preliminary results

International Nuclear Information System (INIS)

Gourtsoyiannis, Nicholas; Papanikolaou, Nickolas; Grammatikakis, John; Papamastorakis, George; Prassopoulos, Panos; Roussomoustakaki, Maria

2004-01-01

Every single imaging finding that can be disclosed on conventional and MR enteroclysis was correlated with the Crohn's disease activity index (CDAI). Nineteen consecutive patients with Crohn's disease underwent colon endoscopy and both conventional and MR enteroclysis examinations. Seventeen MR imaging findings and seven conventional enteroclysis findings were ranked on a four-point grading scale and correlated with CDAI, with a value of 150 considered as the threshold for disease activity. Six patients had active disease in the colon according to colon endoscopy. In the remaining 13 patients, the presence of deep ulcers (P=0.002), small bowel wall thickening (P=0.022) and gadolinium enhancement of mesenteric lymph nodes (P=0.014) identified on MR enteroclysis images were strongly correlated to disease activity. The product of deep ulcers and enhancement of lymph node ranks identified on MR enteroclysis were the optimum combination for discriminating active from non-active disease (F-test: 55.95, P<0.001). Additionally, the ranking of deep ulcers on conventional enteroclysis provided statistically significant differences between active and non-active patients (F-test: 14.12, P=0.004). Abnormalities strongly suggestive of active Crohn's disease can be disclosed on MR enteroclysis examinations and may provide pictorial information for local inflammatory activity. (orig.)

Pathogenic aspects and therapeutic avenues of intestinal fibrosis in Crohn's disease.

Science.gov (United States)

Zorzi, Francesca; Calabrese, Emma; Monteleone, Giovanni

2015-12-01

In Crohn's disease, one of the two major forms of inflammatory bowel diseases in human beings, persistent and chronic inflammation promotes fibrotic processes thereby facilitating formation of strictures, the most common indication for surgical intervention in this disorder. The pathogenesis of Crohn's disease-associated fibrosis is not fully understood, but variants of genes involved in the recognition of microbial components/products [e.g. CARD15 (caspase-activating recruitment domain 15) and ATG16L1 (autophagy-related 16-like 1)] are associated with this phenotype, and experimental evidence suggests that intestinal fibrosis results from an altered balance between deposition of ECM (extracellular matrix) and degradation of ECM by proteases. Studies have also contributed to identify the main phenotypic and functional alterations of cells involved in the fibrogenic process, as well as molecules that stimulate such cells to produce elevated amounts of collagen and other ECM-related proteins. In the present review, we assess the current knowledge about cellular and molecular mediators of intestinal fibrosis and describe results of recent studies aimed at testing the preventive/therapeutic effect of compounds in experimental models of intestinal fibrosis. © 2015 Authors; published by Portland Press Limited.

Preoperative Nutritional Optimization for Crohn's Disease Patients Can Improve Surgical Outcome.

Science.gov (United States)

Dreznik, Yael; Horesh, Nir; Gutman, Mordechai; Gravetz, Aviad; Amiel, Imri; Jacobi, Harel; Zmora, Oded; Rosin, Danny

2017-11-01

Preoperative preparation of patients with Crohn's disease is challenging and there are no specific guidelines regarding nutritional support. The aim of this study was to assess whether preoperative nutritional support influenced the postoperative outcome. A retrospective, cohort study including all Crohn's disease patients who underwent abdominal surgery between 2008 and 2014 was conducted. Patients' characteristics and clinical and surgical data were recorded and analyzed. Eighty-seven patients were included in the study. Thirty-seven patients (42.5%) received preoperative nutritional support (mean albumin level 3.14 vs. 3.5 mg/dL in the non-optimized group; p nutritional status prior to surgery. Preoperative albumin level, after adequate nutritional preparation, was similar between the 2 groups. The 2 groups differ neither in demographic and surgical data, overall post-op complication (p = 0.85), Clavien-Dindo score (p = 0.42), and length of stay (p = 0.1). Readmission rate was higher in the non-optimized group (p = 0.047). Nutritional support can minimize postoperative complications in patients with low albumin levels. Nutritional status should be optimized in order to avoid hazardous complications. © 2017 S. Karger AG, Basel.

Accounting for Pharmacokinetic Variability of Certolizumab Pegol in Patients with Crohn's Disease.

Science.gov (United States)

Vande Casteele, Niels; Mould, Diane R; Coarse, Jason; Hasan, Iram; Gils, Ann; Feagan, Brian; Sandborn, William J

2017-12-01

Certolizumab pegol is an effective biologic for patients with Crohn's disease (CD). Individual differences in certolizumab pegol apparent clearance (CL/F) affect exposure and possibly efficacy. A previously developed population pharmacokinetic (PK) model did not account for dynamic changes in clinical parameters during therapy. The aim of this study was to refine the existing PK model to capture the time-varying influence of covariates. Data collected from 2157 Crohn's disease patients in nine studies were analyzed using nonlinear mixed-effects modeling software (NONMEM). Certolizumab pegol concentration-time data were described by a one-compartment PK model with first-order absorption, and one-compartment disposition with linear, time-dependent elimination using antidrug antibody (ADAb) concentration as a continuous variable. The final dataset consisted of 12,926 analyzable records. Parameter estimates were absorption rate constant 1.83/day, CL/F 0.527 L/day, and apparent volume of distribution (V/F) 8.33 L. ADAb concentration (2.5-214 units/mL) increased the median CL/F by 142-174%. For a typical patient, body weight (46.8-100.5 kg) increased the median CL/F and V/F from 82 to 120%. Albumin (32-48 g/L) decreased and C-reactive protein (0.5-54.0 mg/L) increased the median CL/F from 123 to 85% and from 83 to 113%, respectively. Between-patient variability of CL/F was 19.6%. By incorporating time-varying covariates, this population PK model reduces between-patient variability on CL/F estimates, and the relative influence of ADAb can now be assessed. As Crohn's disease patient covariates are often time-dependent, this model is more reflective of patient drug exposure with sustained treatment.

Diagnostic and therapeutic impact of MR enterography in Crohn's disease

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Hafeez, R. [Department of Surgery, University College London Hospitals, NW1 2BU (United Kingdom); Punwani, S. [Centre for Medical Imaging, University College London (United Kingdom); Department of Specialist X-Ray, University College London Hospitals, NW1 2BU (United Kingdom); Boulos, P. [Department of Surgery, University College London Hospitals, NW1 2BU (United Kingdom); Bloom, S.; McCartney, S. [Department of Gastroenterology, University College London Hospitals, NW1 2BU (United Kingdom); Halligan, S. [Centre for Medical Imaging, University College London (United Kingdom); Department of Specialist X-Ray, University College London Hospitals, NW1 2BU (United Kingdom); Taylor, S.A., E-mail: csytaylor@yahoo.co.uk [Centre for Medical Imaging, University College London (United Kingdom); Department of Specialist X-Ray, University College London Hospitals, NW1 2BU (United Kingdom)

2011-12-15

Aim: To assess the impact of magnetic resonance enterography (MRE) on clinician diagnostic confidence and therapeutic strategy in patients under investigation for small bowel Crohn's disease. Material and methods: Gastroenterologists completed a proforma before and following MRE in 51 patients (mean age 35 years, 26 female) under investigation for small bowel Crohn's disease, indicating percentage confidence for presence/absence of small bowel involvement. In suspected disease, diagnostic confidence (using a scoring system from 1 = no to 6 = yes) was scored for subcategories: extent >30 cm (DE), terminal ileum (lTI), jejunal (JD), colonic disease (CoD), strictures (ST), activity (AD), extraluminal complications (EL), and surgical need (NS). Therapeutic strategy was recorded. Patients were divided into three groups: 1 = suspected disease, MRE normal (n = 15); 2 = suspected disease, MRE abnormal (n = 30); 3 = no suspected disease, MRE normal (n = 6). Binomial exact and paired t-tests were use to compare confidence pre and post-MRE. Results: Mean percentage confidence for the presence/absence of small bowel disease increased from 62 to 84% (p = 0.003), 87 to 98% (p = 0.0001), and 83 to 98% (p = 0.005) after MRE for groups 1, 2, and 3, respectively. In suspected disease, confidence changed significantly for all of the subcategories (p < 0.001) except EL in group 1. The percentage of patients with a confidence change ranged from 40% (CoD) to 87% (lTI; group 1) and from 7% (EL) to 93% (DE; group 2). Therapeutic strategy changed in 31/51 (61%, 95% CI 47-74%), 14 with a reduction in planned therapy and 17 with an increase. Conclusion: MRE had a positive diagnostic impact in patients under investigation for small bowel Crohn's disease and this influenced therapeutic strategy in 61% of the patients.

European Crohn's and Colitis Organisation Topical Review on Environmental Factors in IBD

DEFF Research Database (Denmark)

Maaser, Christian; Langholz, Ebbe; Gordon, Hannah

2017-01-01

This ECCO Topical Review of the European Crohn's and Colitis Organisation [ECCO] focuses on the role of environmental factors with respect to the development of inflammatory bowel disease [IBD] as well as their influence on the course of established IBD. The objective was to reach expert consensus...... to provide evidence-based guidance for clinical practice....

Características clínicas de pacientes tratados con terapia electroconvulsiva en un hospital público de Perú

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Carla Cortez-Vergara

2016-01-01

Full Text Available Con el objetivo de describir el perfil de uso de la terapia electroconvulsiva (TEC en pacientes hospitalizados en el Instituto Nacional de Salud Mental "Honorio Delgado - Hideyo Noguchi" de Lima, Perú, se revisaron las historias clínicas de pacientes que recibieron TEC entre los años 2001 y 2011. Se aplicaron 419 cursos de TEC a 372 pacientes, con un total de 5439 aplicaciones; la esquizofrenia paranoide fue el diagnóstico más frecuente (70,7%, y la indicación más usual fue la resistencia al tratamiento (80,7%; asimismo, la respuesta clínica a la TEC fue buena en 70,1% de casos, mientras que los efectos secundarios, en general, fueron pasajeros y leves. El uso de TEC disminuyó a lo largo del periodo estudiado, pero fue muy tolerable y segura, especialmente en su versión modificada, y mostró una alta respuesta que la mantiene como un tratamiento psiquiátrico de primera línea.

Medical Therapies for Stricturing Crohn's Disease: Efficacy and Cross-Sectional Imaging Predictors of Therapeutic Failure.

Science.gov (United States)

Campos, Cécile; Perrey, Antoine; Lambert, Céline; Pereira, Bruno; Goutte, Marion; Dubois, Anne; Goutorbe, Felix; Dapoigny, Michel; Bommelaer, Gilles; Hordonneau, Constance; Buisson, Anthony

2017-06-01

Medical therapy efficacy remains controversial in stricturing Crohn's disease. Cross-sectional imaging, especially magnetic resonance imaging, has been suggested as very helpful to guide therapeutic decision making. To assess efficacy and predictors of therapeutic failure in patients receiving medical treatments for stricturing Crohn's disease. In this retrospective study, therapeutic failure was defined as symptomatic stricture leading to surgical or endoscopic therapeutics, hospitalization, treatment discontinuation or additional therapy and short-term clinical response as clinical improvement assessed by two physicians. The 55 cross-sectional imaging examinations (33 magnetic resonance imaging and 22 CT scan) before starting medical therapy were analyzed independently by two radiologists. Results were expressed as hazard ratio (HR) or odds ratio (OR) with 95% confidence intervals (95% CI). Among 84 patients, therapeutic failure rate within 60 months was 66.6%. In multivariate analysis, Crohn's disease diagnosis after 40 years old (HR 3.9, 95% CI [1.37-11.2], p = 0.011), small stricture luminal diameter (HR 1.34, 95% CI [1.01-1.80], p = 0.046), increased stricture wall thickness (HR 1.23, 95% CI [1.04-1.46], p = 0.013) and fistula with abscess (HR 5.63, 95% CI [1.64-19.35], p = 0.006) were associated with therapeutic failure, while anti-TNF combotherapy (HR 0.17, 95% CI [0.40-0.71], p = 0.015) prevented it. Considering 108 therapeutic sequences, the short-term clinical response rate was 65.7%. In multivariate analysis, male gender (OR 0.15, 95% CI [0.03-0.64], p = 0.011), fistula with abscess (OR 0.09, 95% CI [0.01-0.77], p = 0.028) and comb sign (OR 0.23, 95% CI [0.005-0.97], p = 0.047) were associated with short-term clinical failure. Anti-TNF combotherapy seemed to prevent therapeutic failure, and cross-sectional imaging should be systematically performed to help medical management in stricturing Crohn's disease.

Evaluación clínica y funcional en niños asmáticos tratados con montelukast

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Concepción Sánchez Infante

2011-09-01

Full Text Available Introducción: el asma bronquial es una enfermedad que se considera puede ser controlable, aunque no puede curarse, pero sus manifestaciones clínicas, que son las que afectan al paciente, pueden desaparecer o disminuir hasta lograr una vida normal, o casi normal, para este y sus familiares, con una serie de medidas medicamentosas y no medicamentosas. Objetivo: evaluar la eficacia del montelukast en el tratamiento de niños asmáticos persistentes. Métodos: se realizó un estudio en 65 niños asmáticos persistentes en el Hospital Pediátrico Universitario "William Soler". Se evaluaron los síntomas, pruebas funcionales respiratorias, días perdidos en la escuela, y control de la enfermedad, inicialmente, y un año después de la introducción del montelukast. Se observó la posibilidad de efectos secundarios. Resultados: 55 pacientes (84,6 % tenían tos nocturna diaria antes del tratamiento. Al año, la tos nocturna diaria se observó solo en 9 (13,9 %; 43 (66,1 % presentaban sibilancias al reírse, mientras que al año 1 (1,6 % mantenía sibilancias diarias con la risa; 41 (63,0 % tenían, inicialmente, afectación de la actividad física, mientras que al año 51 (78,4 % no tenían limitaciones. El 100 % tenía ausencias escolares. Durante el año de tratamiento 34 (57,0 % no presentaron días perdidos; 42 (64,6 % tenían crisis diarias, sin embargo, al reevaluar, 38 (58,5 % no tuvieron crisis. Habían tenido ingresos hospitalarios 23 (35,4 %, pero posteriormente solo 5 necesitaron hospitalización. Antes del tratamiento, 49 (75,0 % necesitaron tratamiento de rescate, en cambio, durante el año disminuyó a 27 (41,0 %. 19 niños (38,0 % tenían inicialmente el volumen espiratorio forzado en 1 s menor del 80 %, y solamente 8 (16,0 % posteriormente. Antes del tratamiento el 100 % de los pacientes tenían asma no controlada o parcialmente controlada, mientras que al año el 57 % tenía el asma controlada. No se observaron reacciones adversas

ACERO GALVANIZADO PRE-TRATADO CON PELÍCULAS HÍBRIDAS OBTENIDO POR RECUBRIMIENTO POR INMERSIÓN: INFLUENCIA DE LA VELOCIDAD DE RETIRADA DEL SUBSTRATO DEL SOL

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Sandra Kunst

2013-01-01

Full Text Available En el presente trabajo, el acero galvanizado fue revestido con una película de silano obtenido a partir de un sol constituido por los precursores silano 3-(trimetoxisililpropil metacrilato (Tmspma y Tetraetoxisilano (Teos con adición de nitrato de cerio [0,01 M]. Se emplearon diferentes velocidades de retirada del sol (10, 20 y 30 cm.min-1, la caracterización de las películas fue realizada por Microscopía Electrónica de Barrido (MEB, perfilometría, ángulo de mojabilidad, potencial de circuito abierto, espectroscopia de impedancia electroquímica y polarización potenciodinámica. Los resultados muestran que la velocidad de retirada influye en el comportamiento electroquímico de las películas, las películas con mejor resistencia a la corrosión se obtiene con menores velocidades de retirada (10 y 20 cm.min-1.

Implantación de la moneda única europea en aplicación del Tratado de Maastricht y la crisis del sistema monetario europeo durante el periodo de convergencia económica : factores relevantes para la estabilidad cambiaria y análisis positivo del proceso de uni

OpenAIRE

Gomez Ortiz, Miguel Ángel

1993-01-01

Se analizan las variables relevantes del proceso de unión monetaria así como el funcionamiento del Sistema Monetario Europeo y el contenido del Tratado de Maastricht. Con esta base se plantea la preferencia de una moneda única como el mecanismo más idóneo para lograr optimizar el proceso de unión económica y monetaria de la Comunidad Europea, realizándose un análisis histórico e institucional tanto de la evolución monetario-financiera de la Comunidad como del mecanismo de cambios e intervenci...

Multimodal treatment of perianal fistulas in Crohn's disease: seton versus anti-TNF versus advancement plasty (PISA): study protocol for a randomized controlled trial.

LENUS (Irish Health Repository)

de Groof, E Joline

2015-08-20

Currently there is no guideline for the treatment of patients with Crohn\\'s disease and high perianal fistulas. Most patients receive anti-TNF medication, but no long-term results of this expensive medication have been described, nor has its efficiency been compared to surgical strategies. With this study, we hope to provide treatment consensus for daily clinical practice with reduction in costs.

La Auriculopuntura con semillas en el tratamiento del asma bronquial en edad pediátrica

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Tamara Hervis Lee

1999-01-01

Full Text Available Se realizó un estudio descriptivo investigativo en el Policlínico Docente "19 de Abril" durante el año 1996 en el que se incluyó a 97 niños portadores de asma bronquial, cuyas edades oscilaban entre 1 y 14 años. Fueron tratados con auriculopuntura usando el método de pega y presión, con semillas Wang Bu Liu Xin, desarrollado por la escuela de la profesora Huan Li Chung. Se obtuvo una disminución del uso de medicamentos durante la crisis y la intercrisis, así como del número de pacientes clasificados como asmáticos severos y moderados; incrementándose por ende el total de pacientes con asma ligera.A descriptive and investigative study was conducted at the "19 de Abril" Teaching Polyclinic during 1996. 97 children carriers of bronchial asthma, who were between 1 and 14 years old, were treated with auriculopuncture by the method of sticking and pressuring with Wang Bu Liu Xin seeds, a method that is developed by the school of professor Huan Li Chung. It was possible to reduce the use of drugs during the crises and intercrises, as well as the number of patients classified as severe and moderate asthmatic patients. As a result, there was an increase of patients with mild asthma.

Molecular prediction of disease risk and severity in a large Dutch Crohn's disease cohort

NARCIS (Netherlands)

Weersma, R.K.; Stokkers, P.C.F.; van Bodegraven, A.A.; van Hogezand, R.A.; Verspaget, H.W.; de Jong, D.J.; van der Woude, C.J.; Oldenburg, B.; Linskens, R.K.; Festen, E.A.M.; van der Steege, G.; Hommes, D.W.; Crusius, J.B.A.; Wijmenga, C.; Nolte, I.M.; Dijkstra, G.

2009-01-01

Background: Crohn's disease and ulcerative colitis have a complex genetic background. We assessed the risk for both the development and severity of the disease by combining information from genetic variants associated with inflammatory bowel disease (IBD). Methods: We studied 2804 patients (1684

Management of post-operative Crohn's disease in 2017: where do we go from here?

Science.gov (United States)

Nguyen, Vu; Kanth, Rajan; Gazo, Joshua; Sorrentino, Dario

2016-11-01

Postoperative recurrence (POR) of Crohn's disease is common after surgical resection. How to best manage POR remains uncertain. Areas covered: In this review, we will first describe the natural course and the best modalities to diagnose this surgical sequela. We will then focus on the potential risk factors for relapse and highlight the main shortcomings in the current study designs and endoscopic and clinical scoring systems, which may partly explain the unexpected outcomes of recent clinical trials. Finally, we will propose a strategy to address the management of POR. Expert commentary: Anti-tumor necrosis factor (Anti-TNF) agents are the most effective therapy to prevent POR in Crohn's disease. Patient risk stratification and active monitoring with scheduled ileocolonoscopy are cornerstones of optimal POR management. Further studies are needed to address areas of uncertainty including timing and duration of therapy and the role of therapeutic drug monitoring in this setting.

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Camino Willhuber, Gaston Oscar; Guzman Mentesana, Gustavo; Baez, Alejandra; Lo Presti, Silvina; Bazán, Carolina; Strauss, Mariana; Fretes, Ricardo; Paglini-Oliva, Patricia Adriana; Rivarola, Hector Walter

2017-09-08

 ResumenIntroducción: la actividad mitocondrial es esencial para el músculo cardíaco y esquelético. La relación entre la disfunción mitocondrial y diferentes condiciones cardiovasculares ha sido bien descrita. El tratamiento farmacológico de la insuficiencia cardíaca implica diferentes medicamentos como: inhibidores de la enzima convertidora de la angiotensina, bloqueadores B-adrenérgicos, glucósidos digitálicos y diuréticos. Los beneficios clínicos del tratamiento son claros, sin embargo, el papel de estos fármacos en el metabolismo mitocondrial no esta bien establecido.Objetivo del estudio: El objetivo de nuestro estudio fue analizar las características estructurales y funcionales de las mitocondrias del músculo cardíaco y esquelético en ratones tratados con fármacos habitualmente utilizados para la insuficiencia cardíaca y compararlo con un grupo control.Métodos: Veinticinco ratones albinos divididos en cinco grupos fueron tratados con la medicación para insuficiencia cardíaca durante 30 días (grupo I a IV). 30 días después del tratamiento se sacrificaron, el corazón y el músculo esquelético se analizaron y se compararon con un grupo control (V).Resultados: La actividad enzimática se incrementó ligeramente en los grupos tratados con medicamentos insuficiencia cardiaca en comparación con el grupo control (p> 0,05). morfología mitocondrial se modificó significativamente en los grupos tratados en comparación con el grupo control, además, el área mitocondrial fue significativamente mayor en los grupos tratados, tanto en el músculo cardíaco y estriado.Conclusiones: Concluimos que la medicación insuficiencia cardíaca podría producir modificaciones en la función mitocondrial; creemos que las mitocondrias pueden mantener la actividad enzimática mediante el aumento de tamaño y modificación de la morfología.

Experiencia en Cuba del tratamiento de la litiasis renoureteral con litotricia extracorpórea por ondas de choque en niños

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María Victoria Labrada Rodríguez

2012-06-01

Full Text Available Introducción: la litiasis urinaria en el niño resulta una enfermedad poco frecuente si se compara con su incidencia en el adulto. Objetivos: describir el resultado del tratamiento en Cuba de la litiasis del aparato urinario en niños, mediante la litotricia extracorpórea por ondas de choque, así como validar la eficacia del método. Métodos: la muestra corresponde a 227 niños, tratados en el Centro de Tratamiento de la Litiasis Urinaria del Hospital Clinicoquirúrgico "Hermanos Ameijeiras'' de La Habana, entre abril de 1986 y octubre de 2011, utilizando 3 tipos de litotritores: el HM3 (Dornier, Lithostar Plus (Siemens y Medical Modulith® SLX (Storz. Resultados: las edades límites fueron 2 y 18 años. De manera general resultó similar el total de pacientes tratados del sexo femenino que el masculino (51 %/49 %. El síntoma predominante fue el cólico nefrítico con cálculos renales (81,9 %, y en el uréter (18,1 %. La superficie media fue de 1,20 cm². Se utilizó anestesia general orotraqueal (34,4 % y general intravenosa (65,6 %. Los retratamientos fueron necesarios en 8 casos (3,52 %. Las complicaciones fueron la infección urinaria aguda (3,08 % y el hematoma subcapsular renal (0,88 %. Resultó libre de material litiásico el 96,04 %. Conclusiones: la terapéutica mediante la litotricia extracorpórea por ondas de choque resulta efectiva, con baja tasa de morbilidad y de complicaciones graves, por lo que creemos debe defenderse científicamente como la primera opción terapéutica en la resolución de la litiasis urinaria en estas edades. Debe recordarse que eliminar el cálculo no es suficiente, hay que identificar la enfermedad, su tratamiento de fondo, y evitar las recidivas.

Colostomía laparoscópica por puerto único con técnica de guante

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José L. Rodicio Miravalles

2014-06-01

Full Text Available La cirugía por puerto único con técnica de guante (glove port es un abordaje adecuado al momento económico y tecnológico que vivimos. Entre las intervenciones susceptibles de su aplicación está la realización de colostomías. Describimos la técnica quirúrgica y resultados de los pacientes a los que se realizó colostomía por puerto único con técnica de guante, a lo largo de los años 2011 y 2012, en dos hospitales de Asturias, España. Realizamos seis colostomías sigmoideas. Cuatro pacientes presentaban enfermedad tumoral, otro caso fue por una fascitis necrosante perineal, y el sexto un paciente con enfermedad de Crohn y fístulas perianales complejas. La edad media de los pacientes, cuatro hombres y dos mujeres, fue de 54 años (rango 42-67 años. El tiempo medio de intervención fue de 42 minutos (rango 30-65 minutos. No hubo complicaciones durante la cirugía ni en el postoperatorio. En nuestro medio, el gasto en material se redujo a la mitad con respecto a otros dispositivos convencionales de puerto único. La técnica de guante representa el abordaje por puerto único más económico y mínimamente invasivo para la realización de estomas, siendo en nuestra experiencia una técnica sencilla, segura y fácilmente reproducible.

Stress, coping and support needs of patients with ulcerative colitis or Crohn's disease: a qualitative descriptive study.

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Larsson, Kjerstin; Lööf, Lars; Nordin, Karin

2017-03-01

To examine disease-related stress, coping strategies and the need for information and support in patients with inflammatory bowel disease (ulcerative colitis or Crohn's disease). Psychological stress is an important factor in ulcerative colitis and Crohn's disease, and therefore, coping strategies and support needs should be considered in routine clinical practice. This is a qualitative study using a descriptive interview-based approach. Fifteen patients with ulcerative colitis (n = 7) or Crohn's disease (n = 8) were interviewed. The interviews were analysed with content analysis. The informants largely focused on disease-related stress (e.g. access to a toilet, symptoms and worries) and relations to other people (various reactions from others and social situations). Behavioural strategies (i.e. taking actions and the need for making plans, prepare and adapt), social strategies (seeking help and information and sharing feelings about the disease with others) and emotional strategies (distraction, positive attitude and acceptance) were adopted to cope with the stress associated with the disease. The need for information and support concerned instrumental support (disease-related information) and emotional support (to talk about disease management). Faecal urgency and the fear of losing bowel control are important stressors for patients with inflammatory bowel disease. The patients handle this problem using various coping strategies depending on the type of stressful events. Both instrumental and emotional support were requested which primarily occurred at the time of diagnosis and disease flare-ups. Patients with ulcerative colitis or Crohn's disease ask for information and psychosocial support that are tailored to their individual needs and at different stages in the disease trajectory to improve everyday life and strengthen self-management strategies. © 2016 John Wiley & Sons Ltd.

Tratamiento de la alveolitis dental con tintura de propóleos al 5 %

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Ada Vivian Bravo Venero

Full Text Available Objetivo: comparar la efectividad entre el tratamiento con tintura de propóleos al 5 % y el tratamiento farmacológico convencional en pacientes diagnosticados con alveolitis dental. Métodos: se realizó un estudio descriptivo, prospectivo, de corte longitudinal de casos y controles en la Clínica Estomatológica "José Martí" del municipio Consolación del Sur, durante el 2009. El universo estuvo constituido por 90 pacientes, los cuales se dividieron en dos grupos de tratamiento diferentes de manera aleatoria, teniendo en cuenta un grupo de casos (grupo I conformado por 30 pacientes a los que se les aplicó tratamiento con tintura de propóleos al 5 %, y otro grupo de controles (grupo II con 60 pacientes tratados con la terapéutica medicamentosa convencional. Para el procesamiento de los datos se utilizaron métodos de estadística descriptiva e inferencial. Resultados: en ambos grupos de tratamiento prevaleció el sexo femenino y hubo un predominio de la alveolitis en el grupo de edad entre los 46 y 60 años. El grupo I logró la remisión de los síntomas entre el segundo (36,6 % y el tercer días de tratamiento (60 % y solo un paciente requirió tratamiento por 5 días; mientras el grupo II requirió de un mayor período para la evolución del cuadro, entre 5 y 7 días de tratamiento para un 61,3 % (27 pacientes y 23,3 % (14 pacientes. Conclusiones: el tratamiento con tintura de propóleos al 5 % resultó altamente efectivo, pues aportó una remisión más notoria de los síntomas, ya que se observó una disminución de estos, así como la disminución del número de sesiones necesarias, lo que permite recomendarlo como una opción terapéutica adecuada.

Perspectives of IBD China: Is Crohn's and Colitis Foundation Model a Solution to Health Care Issues for the Country?

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Chen, Yan

2018-04-21

The success of the Crohn's and Colitis Foundation of America (CCFA), now Crohn's and Colitis Foundation (CCF) has established a role model for developing countries with an increasing incidence of inflammatory bowel disease (IBD), including China. While there are shared etiopathogenetic pathways and clinical features in IBD between Eastern and Western countries, patients with IBD as well as health care professionals in China are facing distinctive challenges, including the fragmented and inconsistent health insurance, social support system, and three-tiered health care service. Financial burden remains to be a tremendous obstacle to the management of IBD. In addition, poor rapport between patients and clinicians, and the lack of properly trained IBD specialists makes a noticeable gap in the management of IBD between China and Western countries. The China Crohn's &Colitis Foundation (CCCF), closely following the successful model of CCF, was established under the same doctrine, and served as a non-profit, volunteer-driven organization dedicated to improving quality of life of patients in by IBD through education and training.

Adalimumab for maintenance therapy for one year in Crohn's disease: results of a Latin American single-center observational study.

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Kotze, Paulo Gustavo; Abou-Rejaile, Vinícius Rezende; Uiema, Luciana Aparecida; Olandoski, Marcia; Sartor, Maria Cristina; Miranda, Eron Fábio; Kotze, Lorete Maria da Silva; Saad-Hossne, Rogério

2014-01-01

Adalimumab is a fully-human antibody that inhibits TNF alpha, with a significant efficacy for long-term maintenance of remission. Studies with this agent in Latin American Crohn's disease patients are scarce. The objective of this study was to outline clinical remission rates after 12 months of adalimumab therapy for Crohn's disease patients. Retrospective, single-center, observational study of a Brazilian case series of Crohn's disease patients under adalimumab therapy. Variables analyzed: demographic data, Montreal classification, concomitant medication, remission rates after 1, 4, 6 and 12 months. Remission was defined as Harvey-Bradshaw Index ≤ 4, and non-responder-imputation and last-observation-carried-forward analysis were used. The influence of infliximab on remission rates was analyzed by Fischer and Chi-square tests (Panalysis. After 12 months, remission on patients with previous infliximab occurred in 69.23% as compared to 94.59% in infliximab-naïve patients (P = 0.033). Adalimumab was effective in maintaining clinical remission after 12 months of therapy, with an adequate safety profile, and was also more effective in infliximab naïve patients.

Are gastroenterologists less tolerant of treatment risks than patients? Benefit-risk preferences in Crohn's disease management.

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Johnson, F Reed; Hauber, Brett; Özdemir, Semra; Siegel, Corey A; Hass, Steven; Sands, Bruce E

2010-10-01

Crohn's disease is a serious and debilitating gastrointestinal disorder with a high, unmet need for new treatments. Biologic agents have the potential to alter the natural course of Crohn's disease but present known risks of potential serious adverse events (SAEs). Previous studies have shown that patients are willing to accept elevated SAE risks in exchange for clinical efficacy. Gastroenterologists and patients may have similar goals of maximizing treatment benefit while minimizing risk; however, gastroenterologists may assess the relative importance of risk differently than patients. To (a) understand how gastroenterologists caring for patients with Crohn's disease balance benefits and risks in their treatment decisions and (b) compare their treatment preferences with those of adult patients with Crohn's disease. Both patient and gastroenterologist treatment preferences were elicited using a web-based, choice-format conjoint survey instrument. The conjoint questions required subjects to choose between 2 hypothetical treatment options with differing levels of treatment attributes. Patients evaluated the treatment options for themselves, and gastroenterologists evaluated the treatment options for each of 3 hypothetical patient types: (a) female aged 25 years with no history of Crohn's disease surgery (young), (b) male aged 45 years with 1 Crohn's disease surgery (middleaged), and (c) female older than 70 years with 4 Crohn's disease surgeries (older). Treatment attributes represented the expected outcomes of treatment: severity of daily symptoms, frequency of flare-ups, serious disease complications, oral steroid use, and the risks of 3 potentially fatal SAEs - lymphoma, serious or opportunistic infections, and progressive multifocal leukoencephalopathy (PML) - during 10 years of treatment. Maximum acceptable risk (MAR), defined as the highest level of SAE risk that subjects would accept in return for a given improvement in efficacy (i.e., the increase in

The effect of pre-operative optimization on post-operative outcome in Crohn's disease resections

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