ABSTRACT
To determine the frequency and the predictive factors of colectomy and coloproctectomy in patients with ulcerative colitis. We conducted an 11-year retrospective study based on hospitalized ulcerative colitis patients followed up for more than 6 months. From 1995 to 2005, 115 patients were included [50 men, 65 women, mean age: 38.4 years]. Mean duration of follow-up was 39.2 months [6 - 145]. Colectomy was performed in 20 patients [17%], with an actuarial risk of 16% at 5 years and 35% at 10 years. Proctocolectomy with ileoanal anastomosis was performed in 16 cases and total colectomy with ileorectal anastomosis in 4 cases. In univariate analysis, factors associated with an increased risk of colectomy were pancolitic location [p=0.02], acute severe colitis [p < 0.0001], treatment by intravenous corticosteroids [p < 0.0001] and intravenous cyclosporine [p=0.001]. In multivariate analysis, acute severe colitis was the only independent factor associated with colectomy [p = 0.04 OR[CI95%] :6.66[1.04 - 50]]. In patients with distal location, the independent factor associated with colectomy was colonic extension during follow up [p = 0.04 OR[CI95%] :7.69[1.07 - 50]]. In patients with pancolitic location, risk of colectomy was associated with acute severe colitis [p = 0.01 OR[CI95%] :9.09[1.58 - 50]] and years of hospitalization from 1995 to 1999 [p = 0.02 OR[CI95%] :7.14[1.35 - 44]]. Although the diffusion of treatment by intravenous cyclosporin, surgery is frequently performed in our ulcerative colitis patients, specially in case of acute severe colitis. Evaluation of colonic extension during the follow-up is associated with an important prognostic impact
Subject(s)
Humans , Male , Female , Colectomy , Proctocolectomy, Restorative , Retrospective Studies , Follow-Up Studies , Cyclosporine , Adrenal Cortex HormonesABSTRACT
To determine the histological aspects and associated factors to significant or severe fibrosis in patients with chronic viral hepatitis C. Consecutive patients recruited between 1999 and 2005 were studied. Lecture of hepatic biopsies was performed by the same histopathologist, using the METAVIR grading. We investigated 109 patients [36 men and 73 women, mean age:49.3 years [19 - 65 years]. Activity was graded AO, Al, A2 and A3 in respectively 2,49,51 and 7 cases. Fibrosis was graded FO, Fl, F2, F3 and F4 in 3, 34, 35, 16 and 21 cases. In univariate analysis, associated factors to fibrosis more than F2 were age, diabetes, levels of AS AT, gamma glutamyl transpeptidase, alkaline phosphatase, prothrombin index and APRI score. In multivariate analysis, only age more than 50 years was associated with fibrosis more than F2 [p=0,006 adjusted OR [CI95%] :5,57[1,63 - 18,9]]. Associated factors to fibrosis graded F4 were age, levels of AS AT, ALAT, gamma glutamyl transpeptidase, alkaline phosphatase, leucocytes, platelets, prothrombin index, APRI score and hepatic dysmorphy on ultrasound examination. In multivariate analysis, only APRI score more than 1,5 was associated with fibrosis graded F4 [p=0,04 adjusted OR[CI95%] :4,35[2,25-6,76]]. Age and APRI score are important prognosis factors in chronic viral hepatitis C
ABSTRACT
Aim: To determine the frequency of gastroesophageal reflux disease on 24-hour esophageal pH monitoring in asthmatics patients and to evaluate the clinical and pHmetric characteristics of nocturnal reflux in these patients
Methods: We conducted a retrospective study based on results of 24-hour esophageal pH monitoring during a 10-year period in asthmatics patients with or without digestive symptoms of gastroesophageal reflux disease
Results: We studied 81 patients [37 men, 44 women; mean age: 32 years]. Gastroesophageal reflux was found in 42 patients [52%]. Nocturnal reflux was observed in 35 patients [43%], mostly in association with pathological reflux in the total period [32 cases]. Presence of digestive symptoms was the only associated factor to gastroesophageal reflux during 24-hour, in nocturnal or in diurnal period. Compared to the diurnal period, the nocturnal period was characterized by fewer number of reflux episodes [22.69 + 23 vs 70.16 + 56.15; p<0.001], more longer duration of reflux episodes [25.92 + 23.34 minutes vs 15.52 + 16.27 minutes; p=0.02], fewer respiratory symptoms [2.24 + 1.89 vs 6.18 + 4.12; p=0.01] and better symptomatic correlation [13/17: 76% vs 9/24:37%; p=0.02]
Conclusion: Gastroesophageal reflux disease is frequent in asthma. Nocturnal reflux is associated with overall reflux on the 24 hour examination. Nocturnal period is characterized by more longer reflux episodes and better symptomatic correlation