[Inflammatory bowel disease: new comments in diagnosis and treatment]

Ulcerative colitis [UC] and Crohn's disease [CD] are chronic inflammatory bowel diseases with uncertain etiology thought to be triggered by interactions between various environmental, genetic and immunologic factors. Incidence rate of CD and UC is different in various geographic areas around the world, between 0.1-11 and 0.5-24.5 per 100, 000 people for CD and UC, respectively. Recent studies indicate a gradual increase in both CD and UC all over the world. Given the fact that the prevalence of IBD in high rate incidence areas duplicates every 10 years, it is predicted that these diseases are going to be among the most important health issues even in developing countries. Since patients are mostly young adults and because of 50% recurrence rate in IBD, quality of life will be affected greatly. Having more information about these diseases will improve health status in our country. In this study, we decided to discuss the main topics on IBD by reviewing the literature and recent papers

Platelet GP IIb/IIIa receptor inhibition by eptifibatide in non ST-elevation MI-acute coronary syndrome

Recent trials of platelet glycoprotein IIb/IIIa receptor inhibitors have improved our understanding to best use these powerful antiplatelet drugs in acute coronary syndrome. We tested the hypothesis that inhibition of GPIIb/IIIa platelet receptor with Eptifibatide is effective as an empiric therapy in patients with acute coronary syndrome who do not necessarily undergo immediate revascularization. Since Feb 2006 one hundred and ninety-six patients who had presented with non ST-elevation acute coronary syndrome [NSTE-ACS] were randomly assigned to receive Eptifibatide in addition to standard therapy, for up to 72 hours or routine standard therapy. The primary end point was composite of death and non-fatal myocardial infarction [MI] or urgent target vessel revascularization [TVR] in 30 days. The incidence of composite end point of death, non fatal MI and urgent TVR was significantly lower in Eptifibatide group than standard group [16% vs. 0% - P value <0.01],particularly in troponin positive subgroup of patients [27.8% vs. 0% - P value <0.01]. Any major adverse reaction such as major bleeding, stroke, or thrombocytopenia was not seen. Early administration of GP IIb/IIIa receptor inhibitor is recommended in patients with high-risk acute coronary syndrome