RESUMO
BACKGROUND/AIMS: Our aim was to assess the long-term data regarding efficacy and safety of infliximab (IFX) treatment for refractory Crohn's disease (CD) patients in our tertiary teaching hospital. METHODS: We have retrospectively analyzed the medical records of 89 CD patients who underwent IFX treatment between March 2003 and February 2011 at Kyung Hee University Hospital (Seoul, Korea). The primary outcome measurements were the rates of initial clinical response (CR) at 10 weeks after the 1st IFX infusion and sustained CR at the end of the follow-up. Overall adverse events related to IFX treatment were also evaluated. RESULTS: The mean (SD) follow-up period of eligible 80 patients was 33.7 (21.9) months. A total of 77 patients (96%) showed initial clinical response, but 8 patients showed loss of response to IFX during the follow-up. Finally, 59 patients (59/77, 76.6%) showed sustained CR at the end of the study. Logistic regression analyses showed that an initial CR at 10 weeks was the independent predictor associated with sustained CR (OR 22.286, 95% CI 2.742-132.717, p=0.001). Overall adverse events reported in 18 patients (18/80, 23.3%), including 3 serious infection (pulmonary tuberculosis and herpes zoster). CONCLUSIONS: Treatment with IFX was efficacious and relatively safe for refractory CD patients in Korea. An initial CR at 10 weeks was significantly associated with sustained CR.
Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Anticorpos Monoclonais/efeitos adversos , Doença de Crohn/tratamento farmacológico , Seguimentos , Fármacos Gastrointestinais/efeitos adversos , Herpes Zoster/etiologia , Modelos Logísticos , Razão de Chances , Estudos Retrospectivos , Resultado do Tratamento , Tuberculose Pulmonar/etiologiaRESUMO
Massive secretory diarrhea with pre-renal insufficiency, hyponatremia, hypokalemia and metabolic alkalosis or acidosis is associated with some large villous adenomas of the rectum and is called with depletion syndrome. This characteristic fluid and electrolyte depletion syndrome is caused by secretion of sodium, potassium, and fluid from the tumor. PGE2 formation in the villous adenoma appears to be the cause of fluid secretion by the abnormal tumor epithelium. Surgical removal of villous adenoma is the only promising therapy, In case of inoperability, denial of surgical intervention or just for palliative treatment prior to surgery, the use of PG synthetase inhibitors may facilitate the correction of severe fluid-electrolyte deficits. We reported a case of large villous adenoma of the rectum with depletion syndrome aceompanied by secretory diarrhea and fluid and electrolyte depletion with metabolic alkalosis due to severe vomiting.
Assuntos
Acidose , Adenoma Viloso , Alcalose , Negação em Psicologia , Diarreia , Dinoprostona , Epitélio , Hipopotassemia , Hiponatremia , Ligases , Cuidados Paliativos , Potássio , Reto , Sódio , VômitoRESUMO
Annular pancreas divisum is a very rare congenital anomaly involving the coexistence of an annular pancreas and pancreatic divisum in one pancreas, and showing characteristic radiologic findings of ring-like pancreatic tissue surrounding the second portion of the duodenum and no evidence of connection between ventral and dorsalductal systems. We described the radiologic findings of annular pancreas divisum, diagnosed by hypotonic duodenography, CT and ERCP.
Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Duodeno , PâncreasRESUMO
The ventricular power generated by ventricle during ejection is the product of intraventricular pressure and aortic flow. To investigate the usefuless of aortic flow velocity spectrum by Doppler echocardiography to assess left ventricular systolic performance, 16 normal subjects, 27 patients with left ventricular hypertrophy(LVH) with hypertension and 21 patients with dilated cardiomyopathy(DCM) were studied. Peak velocity(PV), peak acceleration(PA), systolic velocity intergral(SVI) and acceleration time/ejection time ratio(AT/ET) were measured form continuous-wave aortic Doppler spectrum. The results were as followed; 1) The peak velocities, peak accleration, systolic velocity intergrals and AT/ET rarios in ascending aortic blood flow Doppler spectrum were correlated with ejection fraction significantly(r=+0.387, +0.497, +0.609, -0.648, P<0.05). AT, ET, and SVI were higher than those of normal subjects(P<0.005 respectively). 2) In patients with LVH group, PV, PA, and SVI were higher than those of normal subjects(P<0.05). AT, ET, At/ET ratio and ejection fraction were not difference between two groups. 3) In patinets with DCM group, PV, PA SVI and EF were lower than those of normal subjects(all P<0.005). AT and At/ET ratio were significantly prolonged in patient with DCM, as compared with in normal and patients with LVH group(P<0.05). These results suggested that peak velocity, peak acceleration, systolic velocity integral, and AT/ET ratio on blood flow velocity Doppler spectrum from ascending aorta were useful indicator assessing left ventricular systolic performence.