ABSTRACT
El cerebelo proviene del latín "pequeño cerebro", es aproximadamente una décima parte del cerebro en tamaño y peso, se encuentra en la fosa craneal posterior. está conectado directamente o indirectamente a una variedad de estructuras, incluyendo el tronco cerebral, la columna vertebral, las regiones corticales y subcorticales. El cerebelo contiene casi el 80 % del total de las neuronas del cerebro y se compone de formas diferenciadas de unidades neuronales, cada una compartiendo microcircuitos cerebelosos básicos. El cerebelo está formado por dos hemisferios laterales y una porción media o vermis . El cerebelo tiene varias funciones: coordinar los movimientos voluntarios especializados al influir en la actividad muscular y controlar el equilibrio, el tono muscular a través de conexiones con el sistema vestibular, la médula espinal y sus neuronas motoras alfa. Dentro de la corteza del cerebelo existe una organización somatotópica de las partes del cuerpo. El cerebelo es una pieza clave para el procesamiento de la información y participa en numerosas actividades motoras y no motoras, gracias a las características anatómicas de sus circuitos, las enormes capacidades de análisis y la alta conectividad con otras áreas del cerebro, puede verse afectado por diferentes factores como: anormalidades en el desarrollo embrionario, tóxicos, enfermedades autoinmunes, inflamatorias, vasculares y metabólicas, infecciones, tumores primarios y secundarios, traumas, iatrogénicos, enfermedades genéticas, esporádicas, dando origen a signos y síntomas que causan un síndrome cerebeloso de acuerdo al área anatómica comprometida. En la literatura científica no hay reportes de casos de síndrome cerebeloso por mesalamina (mesalazina). A continuación presentamos el primer caso.
Cerebellum is Latin for "little brain" is about a tenth of the brain in size and weight, is in the posterior cranial fossa. It connects directly or indirectly to a variety of structures, including brainstem, spinal cord, cortical and subcortical regions. The cerebellum contains almost 80% of all neurons in the brain and consists of different forms of neuronal units, each sharing basic cerebellar microcircuits. The cerebellum is formed by two lateral hemispheres and vermis or a middle portion . The cerebellum has several functions: coordinate movements specialized volunteers to influence muscle activity and control the balance, muscle tone through connections with the vestibular system, the spinal cord and alpha motor neurons. Within the cerebellar cortex somatotopic organization exists a body part. The cerebellum is a key to information processing and participates in numerous motor and non-motor activities, thanks to the anatomical characteristics of its routes, huge analysis capabilities and high connectivity with other brain areas, can be affected by different factors such as abnormalities in embryonic development, toxic, autoimmune, inflammatory, vascular and metabolic, infections, primary and secondary tumors, trauma, iatrogenic, genetic diseases, sporadic, giving rise to signs and symptoms that cause cerebellar syndrome according to compromised anatomical area. In the scientific literature no reported cases of cerebellar syndrome mesalamina (mesalazina), we report the first case.
ABSTRACT
5-aminosalicylic acid(5-ASA)is a first-line drug in the treatment of inflammatory bowel disease(IBD). It is a highly effective,safe,and well-tolerated drug for treatment of mild to moderate ulcerative colitis. As the emerging of new formulations of 5-ASA in recent years,the clinical indication has been extended. This article reviewed the characteristics of various formulations and clinical application of 5-ASA.
ABSTRACT
Background:It has been demonstrated that serum perinuclear antineutrophil cytoplasmic antibody( pANCA)occurred significantly more often in ulcerative colitis( UC ) than in Crohn ’s disease( CD ),so it is of great importance for differential diagnosis of UC and CD. Aims:To study the correlation of serum pANCA with efficacy of aminosalicylic acids ( ASA)on UC. Methods:A retrospective study was conducted in 70 mild to moderate active UC patients admitted between Jan. 2007 and Dec. 2013 at People’s Hospital of Xinjiang Uygur Autonomous Region,all of them received oral mesalazine therapy,35 were positive and 35 were negative for serum pANCA. The efficacy was compared between the two groups. Results:After a four-week oral mesalazine therapy,the remission rate and overall efficacy were significantly higher in pANCA-positive group than in pANCA-negative group( remission rate:80. 0% us. 54. 3%,P﹤0. 05;overall efficacy:94. 3% us. 77. 1%,P﹤0. 05). Conclusions:Mesalazine is more effective in serum pANCA-positive UC patients. Being a specific immunological biomarker of UC,pANCA might be an indicator for predicting the therapeutic efficacy of ASA in UC patients.
ABSTRACT
Objective To evaluate the effect and mechanism of 5-aminosalicylic acid (5-ASA) on bone marrow suppression caused by thiopurines, and to explore the proper dosage of thiopurines when combined with 5-ASA for inflammatory bowel diseases (IBD) patients.MethodsThe clinical data of IBD patients who took thiopurines were retrospectively analyzed. Thiopurine methyltransferase (TPMT) activity and 6-thioguanine nucleotide (6-TGN) concentration were tested.In prospective study, patients firstly treated with azathioprine (AZA) of 50 mg/d for 4 weeks, then combined with 5-ASA of 3 g/d for another 4 weeks.The concentration of 6-TGN in red blood cells (RBC) was analyzed at the end of 4th and 8th week.Results In retrospective study, there were 45 cases in AZA/6-mercaptopurine (MP) combined with 5-ASA group, 94 patients were in AZA/6-MP.alone group.The incidence of bone marrow suppression in these two groups were 46.7％ and 16.0％, respectively.Multivariates regression analysis indicated co-administration of 5-ASA was the only risk factor of increasing bone marrow suppression incidence (OR=3.45,95％ CI 1.31 ～ 9.04).There was no significant difference of TPMT activity between AZA/6-MP combined with 5-ASA group and AZA/6-MP alone group(t=-0.351 ,P=0.734).The 6-TGN concentration was significantly higher in AZA/6-MP combined with 5-ASA group than that of AZA/6-MP alone group (the median concentration was 384.9 pmol/8× 108 RBC and 286.4 pmol/8× 108 RBC,F=29.15,P=0.00).Prospective study was completed in 8 patients.After treated with AZA of 50 mg/d for 4 weeks, the 6-TGN concentration of 7 patients was lower than 230 pmol/8 × 108 RBC.After added with 5-ASA of 3 g/d for another 4weeks, the 6-TGN concentration of 7 patients was over 230 pmol/8 × 108 RBC, three patients of those was even higher than 420 pmol/8 × 108 RBC, and bone marrow suppression occurred in 2 patients.ConclusionsThe incidence of bone marrow suppression increased in Chinese IBD patients treated with recommended routine dossage of AZA/6-MP when conbined with 5-ASA.The mechanism may be related with the increased concentration of 6-TGN in RBC.To reduce the AZA dosage may possibly keep the efficacy while decrease the incidence of bone marrow suppression.
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BACKGROUND/AIMS: The aim of this study was to determine the actual practice patterns of clinicians caring for Korean patients with inflammatory bowel diseases (IBDs). METHODS: Questionnaires, including te indications and doses of 5-aminosalicylic acid (5-ASA), corticosteroids, or azathioprine/6-mercaptopurine (AZA/6-MP), assessment of response, the surveillance method, and the interval for adverse effects, were distributed during the 2008 KASID annual lecture. Thirty questionnaires were collected. RESULTS: Most of the responders (93.3%) were board-certified with sub-specialty training in gastroenterology. For active diseases, 43.3% of the responders escalated the dose of 5-ASA from conventional to maximal doses. Of the patients in disease remission, 36.7% were maintained on the conventional or a reduced dose for a fixed period of time. Corticosteroids were prescribed by dose-base (20/30 [66.7%]). In most cases, the starting dose was 40 mg/d (15/19 [78.9%]), and tapered within a 1 (43.3%) or 2 week interval (40.0%). There were various definitions of corticosteroid-refractoriness and -dependency among the responders. Most of the responders initiated AZA at 50 mg/d; 68.4% of the patients increased the dose by 25 mg and 55.6% of the patients increased the dose within a 4-week interval. For monitoring adverse events, such as leukopenia, 63.3% of the patients checked a complete blood count for 2 weeks in the 1st month of therapy. CONCLUSIONS: There were various patterns of practice in the treatment of Korean IBD patients, especially in terms of the prescribing patterns of drugs and assessment of response, which suggests that standard therapeutic guidelines of IBD should be established in Korea.
Subject(s)
Humans , Adrenal Cortex Hormones , Aminosalicylic Acids , Azathioprine , Blood Cell Count , Gastroenterology , Glucocorticoids , Inflammatory Bowel Diseases , Korea , Leukopenia , Mesalamine , Practice Patterns, Physicians' , Surveys and QuestionnairesABSTRACT
AIM: To examine the pharmacodynamics of a self-developed oral colon-specific delivery coated tablets of 4-aminosalicylic acid (4-ASA) on rats. METHODS: Ulcerative colitis rat model was developed by intrarectal administration of 2, 4, 6-trinitrobenzenesulfonic acid (TNBS) in alcohol. Rats were divided randomly into healthy control group, TNBS control group, TNBS + lower dose (coated tablets) group, TNBS +medium dose (coated tablets) group, TNBS + higher dose (coated tablets) group, TNBS + sulfasalazine (SASP) group, TNBS + medium dose non-coated tablet group. Several indices including macroscopic change,histological damage, and tissue myeloperoxidase (MPO) activity were examined after 5 consecutive oral drug administration to assess pharmacodynamics of the coated tablets. RESULTS: An experimental ulcerative colitis in rats was induced by TNBS. Compared with 4-ASA non-coated tablet group, decreased macroscopic and histological damage score and lower MPO activity were observed after the oral administration of 4-ASA coated tablets or SASP. There was no significant difference between the effects on the indices of higher dose of coated tablets and SASP (P ＞ 0.05) CONCLUSION: The self-made 4-ASA oral colon-specific delivery coated tablet showes higher effect than non-coated tablets to treat ulcerative colitis in rats.