Résumé
Background@#Crohn disease is a chronic bowel disease that causes serious complications. Prevalence of Crohn disease is increasing. Studies have shown that the behavior of the disease is not stable and severe complications secondary to behavior change over time have been shown. In this study, we aimed to evaluate the prognostic risk factors associated with phenotypic change in Crohn disease in a Turkish patient cohort.@*Methods@#Patients followed up from March 1986 to August 2011 were evaluated for demographic and clinical characteristics to determine possible risk factors and initial clinical phenotype of the disease based on the Montreal classification. The cumulative probabilities of developing stricturing or penetrating intestinal complications were estimated using the Kaplan-Meier analysis. Univariate and multivariate Cox-proportional hazard models were used to assess associations between baseline clinical characteristics and intestinal complications.@*Results@#Three hundred and thirty patients (mean age, 30.6 ± 11.1 years; 148 female) were included in the study. Mean follow-up duration was 7.4 ± 5.3 years (range: 1.0-25.0 years). At baseline 273 patients had inflammatory-type disease, 57 patients experienced stricturing/penetrating intestinal complications before or at the time of diagnosis. The cumulative probability of developing complicated disease was 37.4% at 5 years, 54.3% at 10 years, 78.8% at 25 years. Independent predictors associated with progression to intestinal complications were current smoking, perianal disease, extra-intestinal manifestations, and location of disease.@*Conclusions@#Location of disease is the most powerful indicator for the development of stenosis and penetrating complications in inflammatory-type disease. Patients with ileal involvement should be considered for more aggressive immunosuppressive therapy.
Résumé
Se propone analizar distintas cuestiones comportamentales que afectan la comunicación de las personas con Enfermedad de Parkinson (EP) en relación a su entorno, en función del desarrollo de una propuesta de comunicación basada en el marco de una antropología relacional. Se realizó una revisión bibliográfica con una propuesta teórica. El comportamiento es concebido como una relación co-constructiva entre individuo y entorno y la comunicación como condición de esta relación. Son revisados avances y opiniones acerca de la gestualidad y el comportamiento no verbal en personas con EP, tanto desde aquellos que ponen el acento en el déficit como un signo no motor del Parkinson como a partir de los estudios que indagan estos factores con la idea de estrategias compensatorias. Tomando como marco teórico la postura relacional del comportamiento humano, el artículo se propone una mirada co-constructiva del comportamiento no verbal en las personas con EP, propuesta que promueve la idea de salud en el contexto de la enfermedad crónica a través de las mismas posibilidades que las características del comportamiento ofrecen, fundamentalmente del fenómeno de la kinesia paradojal.
The analysis of some behavioral issues which affect communication in people with Parkinson's Disease (PD) relative to their environment is performed in order to develop a proposal of communication based on relational anthropology. A bibliographical review was developed, along with a theoretical proposal. Behavior is understood as a co-constructive relationship between individuals and their environment, while communication is seen as a condition of this relationship. Several advances and opinions about body language and non-verbal behavior in people with PD are reviewed from the perspective which emphasizes both the deficit as a non-motor sign of Parkinson and compensatory strategies. Taking as a theoretical framework the relational point of view of human behavior, this article puts forward a co-constructive approach of non-verbal behavior in people with PD, which promotes the idea of health in the context of a chronic illness through the same possibilities that the characteristics of behavior offer, primarily through the phenomenon of paradoxical kinesia.
Sujets)
Maladie de Parkinson , Communication , EnvironnementRésumé
@#ObjectiveTo observe the effects of neural stem cells transplantation on the behavioral deficits of Parkinson's disease mice.MethodsSpontaneous movement,Morris Water Maze and Rotarod were adopted to evaluate the behavioral changes.ResultsCompared with the control,the time of spontaneous movement was decreased,the latency of Water Maze was lengthened,and the time of Rotarod was shortened in the Parkinson's disease(PD) mice. These deficits were improved 2,4 and 8 weeks after unilateral and bilateral transplantation of neural stem cells.ConclusionsThe transplantation of neural stem cells can improve the behavioral deficits in the PD mice.