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1.
Eur Rev Med Pharmacol Sci ; 26(19): 7277-7284, 2022 10.
Article in English | MEDLINE | ID: mdl-36263539

ABSTRACT

OBJECTIVE: Telemedicine (TM) has had a powerful impact in recent years, particularly on managing chronic diseases such as inflammatory bowel disease (IBD). Knowing patients' expectations and concerns is essential to increase their confidence in this mode of medical care. PATIENTS AND METHODS: We interviewed a large cohort of IBD patients enrolled at two Italian tertiary referral centers to investigate their trust in TM. RESULTS: A total of 376 patients completed the survey and were included in the study: 293 (77.9%) considered TM valuable for managing their disease, and 307 (85%) wanted to have TM service at their center. However, only 99 patients (26.3%) believed that TM guarantees the same level of care as the in-person visit. Among the socio-demographic variables, those independently associated with trust in TM were the higher education qualification (p=0.02) and the level of competence in information and communication technologies (ICT) (p=0.03). CONCLUSIONS: Our findings highlighted the importance of equipping IBD patients with basic ICT skills to utilize TM services and increase their confidence in ICT with the help of caregivers. Additionally, to improve the perceived value of TM, it will be helpful to use additional tools such as telemonitoring of disease activity using patients' reported outcomes or remote measurement of fecal calprotectin.


Subject(s)
COVID-19 , Inflammatory Bowel Diseases , Telemedicine , Humans , Pandemics , Cross-Sectional Studies , Trust , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/therapy , Inflammatory Bowel Diseases/epidemiology , Chronic Disease , Leukocyte L1 Antigen Complex
3.
Tech Coloproctol ; 25(1): 101-108, 2021 01.
Article in English | MEDLINE | ID: mdl-33025294

ABSTRACT

BACKGROUND: Crohn's disease (CD) and ulcerative colitis, two forms of inflammatory bowel disease (IBD), are chronic and relapsing conditions of the gastrointestinal tract both characterized by long lasting chronic inflammation and increased risk of dysplasia and colorectal cancer (CRC). The aim of our study was to evaluate the interobserver agreement about IBD-associated dysplasia among pathologists belonging to the Italian Group for Inflammatory Bowel Diseases (IG-IBD P). METHODS: The present multicenter survey was performed using telepathology, supported by an open source E-learning platform. Biopsy specimens from 30 colonoscopies and from 20 patients were included. The glass slides of any case, including clinical and endoscopic data, were digitalized and uploaded on the E-learning platform. All the digital slides were grouped in 54 diagnostic "blocks". Blinded histopathological evaluation on all the digital slides was performed by 20 gastrointestinal pathologists. Closed-ended questions about (1) the occurrence of IBD; (2) the classification of IBD (as UC or CD); (3) the presence of active versus quiescent disease; (4) the presence of dysplasia; (5) the possible association of dysplasia with the sites of disease (dysplasia-associated lesion or mass-DALM vs adenoma-like mass-ALM); (6) the grading of dysplasia according to the ECCO guidelines (negative, indefinite, low grade, high grade categories) and (7) the presence of associated serrated features, were proposed in each case. Inter-observer agreement was evaluated by mean agreement percentage and kappa statistic, when suitable. RESULTS: The diagnosis of IBD was confirmed in 19 of 20 patients, 17 of 19 being classified as UC, 2 as CD. The mean interobserver agreement percentages about (1) the evidence of IBD, (2) the presence of either UC or CD and (3) the activity grading resulted to be 80%, 69% and 86%, respectively. Dysplasia was detected in 8/20 patients, with moderate agreement between pathologists (mean 72%, k 0.48). Particularly, low grade dysplasia was found in 13 biopsies (combined k 0.38), whereas high grade dysplasia in 8 (combined k 0.47). When the endoscopic and histopathological data were combined, features consistent with DALM were found in 6 of 20 patients with low grade dysplasia and those consistent with ALM in 2 patients with low grade dysplasia in a single biopsy (mean agreement: 86%). An associated serrated pattern was discovered in 4 patients (7 biopsies). CONCLUSIONS: Our study showed moderate interobserver agreement about the histopathological detection and classification of IBD-associated dysplasia. Further efforts should be undertaken to integrate the histopathological data with both the ancillary tests and molecular investigations.


Subject(s)
Colitis, Ulcerative , Crohn Disease , Inflammatory Bowel Diseases , Colitis, Ulcerative/complications , Crohn Disease/complications , Humans , Italy/epidemiology , Neoplasm Recurrence, Local , Observer Variation , Pathologists
4.
Eur J Neurol ; 27(5): 887-893, 2020 05.
Article in English | MEDLINE | ID: mdl-32012408

ABSTRACT

BACKGROUND AND PURPOSE: Transient global amnesia (TGA) is characterized by a sudden onset of anterograde amnesia lasting up to 24 h. One major differential for TGA is transient epileptic amnesia, which typically lasts < 1 h. However, TGA can also be short in duration and little is known about the time trends, characteristics and prognosis of TGA cases lasting < 1 h. METHODS: We compared the clinical features of TGA ascertained in two independent cohort studies in Oxfordshire, UK [Oxford cohort 1977-1987 versus Oxford Vascular Study (OXVASC) 2002-2018] to determine the time trends of clinical features of TGA. Results were validated in another independent contemporary TGA cohort in Italy [Northern Umbria TGA registry (NU) 2002-2018]. We compared the risk factors, clinical features and long-term prognosis (major cardiovascular events, recurrent TGA and seizure/epilepsy) of patients presenting with episodes lasting < 1 h versus those lasting ≥ 1 h. RESULTS: Overall, 639 patients with TGA were included (114 Oxford cohort, 100 OXVASC, 425 NU). Compared with the original Oxford cohort, there were more cases with TGA lasting < 1 h in OXVASC [32 (32.0%) vs. 9 (8.8%)] and NU (11.8% vs. 8.8% in Oxford cohort). In both OXVASC and NU, patient age, vascular risk factors and clinical features were largely similar between those with TGA lasting < 1 h versus those lasting ≥ 1 h. Moreover, there was no difference in the long-term risk of seizure/epilepsy or major cardiovascular events between TGA lasting < 1 h versus TGA lasting ≥ 1 h. CONCLUSIONS: Short-duration TGA episodes (<1 h) were not uncommon and were more frequent than in earlier studies. The clinical features and long-term prognosis of short-duration TGA did not differ from more typical episodes lasting ≥ 1 h.


Subject(s)
Amnesia, Transient Global , Amnesia , Amnesia, Transient Global/diagnosis , Amnesia, Transient Global/epidemiology , Epilepsy/epidemiology , Humans , Italy/epidemiology , Prognosis
5.
Am J Gastroenterol ; 113(3): 396-403, 2018 03.
Article in English | MEDLINE | ID: mdl-29460920

ABSTRACT

OBJECTIVES: The long-term safety of exposure to anti-tumor necrosis factor (anti-TNFα) drugs during pregnancy has received little attention. We aimed to compare the relative risk of severe infections in children of mothers with inflammatory bowel disease (IBD) who were exposed to anti-TNFα drugs in utero with that of children who were not exposed to the drugs. METHODS: Retrospective multicenter cohort study. Exposed cohort: children from mothers with IBD receiving anti-TNFα medication (with or without thiopurines) at any time during pregnancy or during the 3 months before conception. Non-exposed cohort: children from mothers with IBD not treated with anti-TNFα agents or thiopurines at any time during pregnancy or the 3 months before conception. The cumulative incidence of severe infections after birth was estimated using Kaplan-Meier curves, which were compared using the log-rank test. Cox-regression analysis was performed to identify potential predictive factors for severe infections in the offspring. RESULTS: The study population comprised 841 children, of whom 388 (46%) had been exposed to anti-TNFα agents. Median follow-up after delivery was 47 months in the exposed group and 68 months in the non-exposed group. Both univariate and multivariate analysis showed the incidence rate of severe infections to be similar in non-exposed and exposed children (1.6% vs. 2.8% per person-year, hazard ratio 1.2 (95% confidence interval 0.8-1.8)). In the multivariate analysis, preterm delivery was the only variable associated with a higher risk of severe infection (2.5% (1.5-4.3)). CONCLUSIONS: In utero exposure to anti-TNFα drugs does not seem to be associated with increased short-term or long-term risk of severe infections in children.


Subject(s)
Antirheumatic Agents/therapeutic use , Infections/epidemiology , Inflammatory Bowel Diseases/drug therapy , Pregnancy Complications/drug therapy , Premature Birth/epidemiology , Prenatal Exposure Delayed Effects/epidemiology , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Adalimumab/therapeutic use , Adult , Case-Control Studies , Certolizumab Pegol/therapeutic use , Child, Preschool , Cohort Studies , Europe/epidemiology , Female , Humans , Incidence , Infant , Infant, Newborn , Infliximab/therapeutic use , Kaplan-Meier Estimate , Male , Multivariate Analysis , Pregnancy , Proportional Hazards Models , Retrospective Studies
7.
Mucosal Immunol ; 7(6): 1467-79, 2014 Nov.
Article in English | MEDLINE | ID: mdl-24850427

ABSTRACT

In inflammatory bowel disease (IBD), tissue damage is driven by an excessive immune response, poorly controlled by counter-regulatory mechanisms. SIRT1, a class III NAD+-dependent deacetylase, regulates negatively the expression of various proteins involved in the control of immune-inflammatory pathways, such as Stat3, Smad7, and NF-κB. Here we examined the expression, regulation, and function of SIRT1 in IBD. SIRT1 RNA and protein expression was less pronounced in whole biopsies and lamina propria mononuclear cells (LPMCs) of IBD patients in comparison with normal controls. SIRT1 expression was downregulated in control LPMC by tumor necrosis factor (TNF)-α and interleukin (IL)-21, and upregulated in IBD LPMC by neutralizing TNF-α and IL-21antibodies. Consistently, SIRT1 expression was increased in mucosal samples taken from IBD patients successfully treated with Infliximab. Treatment of IBD LPMC with Cay10591, a specific SIRT1 activator, reduced NF-κB activation and inhibited inflammatory cytokine synthesis, whereas Ex527, an inhibitor of SIRT1, increased interferon (IFN)-γ in control LPMC. SIRT1 was also reduced in mice with colitis induced by 2,4,6-trinitrobenzenesulphonic acid or oxazolone. Cay10591 prevented and cured experimental colitis whereas Ex527 exacerbated disease by modulating T cell-derived cytokine response. Data indicate that SIRT1 is downregulated in IBD patients and colitic mice and suggest that SIRT1 activation can help attenuate inflammatory signals in the gut.


Subject(s)
Gene Expression Regulation, Enzymologic/immunology , Inflammatory Bowel Diseases/immunology , Intestines/immunology , Sirtuin 1/immunology , Adjuvants, Immunologic/adverse effects , Adjuvants, Immunologic/pharmacology , Adult , Aged , Aged, 80 and over , Animals , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Antibodies, Monoclonal/administration & dosage , Female , Gene Expression Regulation, Enzymologic/genetics , Humans , Inflammatory Bowel Diseases/chemically induced , Inflammatory Bowel Diseases/drug therapy , Inflammatory Bowel Diseases/genetics , Inflammatory Bowel Diseases/pathology , Infliximab , Interferon-gamma/genetics , Interferon-gamma/immunology , Interleukins/genetics , Interleukins/immunology , Intestines/pathology , Male , Mice , Middle Aged , Oxazolone/adverse effects , Oxazolone/pharmacology , Sirtuin 1/genetics , Trinitrobenzenesulfonic Acid/toxicity , Tumor Necrosis Factor-alpha/genetics , Tumor Necrosis Factor-alpha/immunology
10.
Semin Immunol ; 25(4): 252-62, 2013 Nov 15.
Article in English | MEDLINE | ID: mdl-24183700

ABSTRACT

Humans are continuously exposed to a high number of diverse pathogens that induce different types of immune responses. Primary pathogen-specific immune responses generate multiple subsets of memory T cells, which provide protection against secondary infections. In recent years, several novel T cell subsets have been identified and have significantly broadened our knowledge about T cell differentiation and the regulation of immune responses. At the same time the rapidly growing number of incompletely characterized T cell subsets has also generated some controversies. We therefore review here the current knowledge on features and functions of human α/ß T cell subsets, focusing on CD4(+) T cells classified according to cytokine production and tissue localization. The principal helper and regulatory T cell subsets can be identified by a limited number of relevant surface markers, which are an integral part of the T cell differentiation programs because they are directly induced by the relevant lineage-defining transcription factors. In vivo occurring human T cell subsets can thus be purified directly ex vivo from relevant tissues for molecular and functional studies, and represent not only an ideal model to study T cell differentiation, but they also offer important clinical opportunities.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , T-Lymphocyte Subsets/immunology , Animals , Antigens, Surface/metabolism , CD4-Positive T-Lymphocytes/metabolism , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/metabolism , Cytokines/biosynthesis , Host-Pathogen Interactions/immunology , Humans , Immunophenotyping , T-Lymphocyte Subsets/metabolism , T-Lymphocytes, Helper-Inducer/immunology , T-Lymphocytes, Helper-Inducer/metabolism , T-Lymphocytes, Regulatory/immunology , T-Lymphocytes, Regulatory/metabolism
11.
Gut ; 58(11): 1481-9, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19570762

ABSTRACT

OBJECTIVE: In mice, a subpopulation of gut dendritic cells (DCs) expressing CD103 drives the development of regulatory T (T(reg)) cells. Further, it was recently described that the cross-talk between human intestinal epithelial cells (IECs) and DCs helps in maintaining gut immune homeostasis via the induction of non-inflammatory DCs. In this study, an analysis was carried out to determine whether IECs could promote the differentiation of CD103+ tolerogenic DCs, and the function of primary CD103+ DCs isolated from human mesenteric lymph nodes (MLNs) was evaluated. METHODS: Monocyte-derived DCs (MoDCs) and circulating CD1c+ DCs were conditioned or not with supernatants from Caco-2 cells or IECs isolated from healthy donors or donors with Crohn's disease and analysed for their ability to induce T(reg) cell differentiation. In some cases, transforming growth factor beta (TGFbeta), retinoic acid (RA) or thymic stromal lymphopoietin (TSLP) were neutralised before conditioning. CD103+ and CD103- DCs were sorted by fluorescence-activated cell sorting (FACS) from MLNs and used in T(reg) cell differentiation experiments. RESULTS: It was found that human IECs promoted the differentiation of tolerogenic DCs able to drive the development of adaptive Foxp3+ T(reg) cells. This control was lost in patients with Crohn's disease and paralleled a reduced expression of tolerogenic factors by primary IECs. MoDCs differentiated with RA or IEC supernatant upregulated the expression of CD103. Consistently, human primary CD103+ DCs isolated from MLNs were endowed with the ability to drive T(reg) cell differentiation. This subset of DCs expressed CCR7 and probably represents a lamina propria-derived migratory population. CONCLUSIONS: A population of tolerogenic CD103+ DCs was identified in the human gut that probably differentiate in response to IEC-derived factors and drive T(reg) cell development.


Subject(s)
Cell Differentiation , Dendritic Cells/cytology , Intestines/cytology , T-Lymphocytes, Regulatory/cytology , Antigens, CD/metabolism , Caco-2 Cells/cytology , Crohn Disease/immunology , Crohn Disease/pathology , Dendritic Cells/immunology , Epithelial Cells/cytology , Epithelial Cells/physiology , Humans , Immunity, Cellular , Integrin alpha Chains/metabolism , Lymph Nodes/cytology , Lymphocyte Activation/immunology
12.
Gut ; 57(12): 1674-80, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18625693

ABSTRACT

OBJECTIVE: Defects in Fas-mediated apoptosis are supposed to contribute to the accumulation of T lymphocytes in the gut of patients with Crohn's disease (CD). This phenomenon has been functionally linked with the elevated expression of Flip, an inhibitor of Fas-mediated apoptosis. In this study, the molecular mechanisms that control Flip in CD were examined. METHODS: Paired colonic biopsies of patients with CD, patients with ulcerative colitis (UC) and normal controls were analysed for Flip by real-time PCR and western blotting. Flip was also evaluated in CD3(+) lamina propria lymphocytes (T-LPLs) cultured with tosyl phenylalanyl chloromethyl ketone (TPCK; a nuclear factor-kappaB (NF-kappaB) inhibitor), AG490 (a Janus kinase 2 (Jak2)/signal transducer and activator of transcription (Stat) inhibitor) or 17-desmethoxy-17-N,N-dimethylamino-geldanamycin (DMAG; an inhibitor of heat shock protein 90). The rate of apoptosis was examined by flow cytometry. RESULTS: In CD, upregulation of Flip occurred at both the RNA and protein level. Treatment of CD CD3(+) T-LPLs with TPCK or AG490 markedly reduced Flip RNA, suggesting a role for NF-kappaB and Jak/Stat pathways in the transcriptional control of Flip in this condition. Consistently, both TPCK and AG490 sensitised CD T-LPLs to Fas-mediated apoptosis. Flip protein in cells from normal gut was rapidly degraded by the proteasome pathway. In contrast, in inflamed gut of both CD and UC patients, there was a reduced degradation of Flip via the ubiquitin-proteasome-dependent pathway, but Flip expression can be decreased by DMAG. CONCLUSIONS: The data demonstrate that Flip is regulated at both the transcriptional and post-translational level in CD, and indicate that in the normal but not inflamed gut Flip is degraded via the ubiquitin-proteasome-dependent pathway.


Subject(s)
Apoptosis , Caspases/metabolism , Colitis, Ulcerative/metabolism , Crohn Disease/metabolism , Fas Ligand Protein/metabolism , T-Lymphocytes/metabolism , Apoptosis/immunology , Blotting, Western , CD3 Complex/isolation & purification , Caspases/immunology , Colitis, Ulcerative/immunology , Colitis, Ulcerative/pathology , Crohn Disease/immunology , Crohn Disease/pathology , Female , Humans , Male , Reverse Transcriptase Polymerase Chain Reaction , Signal Transduction , Tosylphenylalanyl Chloromethyl Ketone/metabolism , Up-Regulation
13.
Gut ; 55(12): 1774-80, 2006 Dec.
Article in English | MEDLINE | ID: mdl-16682426

ABSTRACT

BACKGROUND: T cell-mediated immunity plays a central part in the pathogenesis of tissue damage in inflammatory bowel disease (IBD). The mechanism by which T cells mediate tissue damage during IBD remains unclear, but evidence indicates that T cell-derived cytokines stimulate fibroblasts to synthesise matrix metalloproteinases (MMPs), which then mediate mucosal degradation. We have previously shown that, in IBD, there is high production of interleukin (IL) 21, a T cell-derived cytokine, which enhances Th1 activity. AIM: To investigate whether IL21 controls MMP production by intestinal fibroblasts. METHODS: IL21 receptor (IL21R) was evaluated in intestinal fibroblasts by reverse transcriptase-polymerase chain reaction (RT-PCR) and western blotting. Fibroblasts were stimulated with IL21 and MMPs were evaluated by RT-PCR and western blotting. The effect of a neutralising IL21R fusion protein (IL21R/Fc) on the induction of MMPs in fibroblasts stimulated with IBD lamina propria mononuclear cell (LPMC) supernatants was also evaluated. RESULTS: Intestinal fibroblasts constitutively express both IL21R and the common gamma chain receptor, which are necessary for IL21-driven signalling. IL21 enhances fibroblast production of MMP-1, MMP-2, MMP-3 and MMP-9, but not tissue inhibitors of MMP-1 and MMP-2. Moreover, IL21 synergises with tumour necrosis factor alpha to increase synthesis of MMP synthesis. IL21 enhances MMP secretion without affecting gene transcription and protein synthesis. IBD LPMC supernatants stimulate MMP secretion by intestinal fibroblasts, and this effect is partly inhibited by IL21R/Fc. CONCLUSIONS: These results suggest that fibroblasts are a potential target of IL21 in the gut and that IL21 controls MMP secretion by fibroblasts.


Subject(s)
Fibroblasts/enzymology , Inflammatory Bowel Diseases/enzymology , Interleukins/immunology , Intestinal Mucosa/enzymology , Matrix Metalloproteinases/biosynthesis , Cells, Cultured , Colitis, Ulcerative/enzymology , Colitis, Ulcerative/immunology , Crohn Disease/enzymology , Crohn Disease/immunology , Fibroblasts/immunology , Humans , Inflammatory Bowel Diseases/immunology , Intestinal Mucosa/immunology , Matrix Metalloproteinases/immunology , RNA/analysis , Receptors, Interleukin-21/analysis , Reverse Transcriptase Polymerase Chain Reaction/methods , Signal Transduction/immunology , Tumor Necrosis Factor-alpha/immunology
15.
Rev Stomatol Chir Maxillofac ; 104(3): 133-8, 2003 Jun.
Article in French | MEDLINE | ID: mdl-12931063

ABSTRACT

BACKGROUND: The purpose of this study was to identify the particular cranio-facial pattern observed in patients with obstructive sleep apnea syndrome and to search for possible correlations between morphological anomalies and disease severity. MATERIAL AND METHODS: The study group included 49 dentate patients, mean age 47.7 years suffering from obstructive sleep apnea syndrome. Most of the patients were overweight. RESULTS: Typical features observed in these patients were a short craniospinal field, a retro-maxillary, a retro-mandibula, antero-inferior vertical excess of the face, and class II malocclusion. No correlation between severity of obstructive sleep apnea syndrome and craniofacial morphology could be identified. DISCUSSION: These results are in agreement with data in the literature. The absence of a morphological correlation appears to be related to the type of patients studied (overweight). Indeed, two categories of sleep apnea patients have been identified: obese patients who have few or no anomalies of the facial skeleton and thin patients with characteristic open bite class II malocclusion.


Subject(s)
Face/anatomy & histology , Sleep Apnea, Obstructive/diagnostic imaging , Adult , Aged , Cephalometry , Facial Bones/diagnostic imaging , Facies , Female , Humans , Male , Malocclusion, Angle Class II/complications , Malocclusion, Angle Class II/diagnostic imaging , Middle Aged , Obesity/complications , Open Bite/complications , Open Bite/diagnostic imaging , Radiography , Retrognathia/complications , Retrognathia/diagnostic imaging , Skull Base/diagnostic imaging , Sleep Apnea, Obstructive/complications
16.
Ann Chir Plast Esthet ; 46(4): 304-15, 2001 Aug.
Article in French | MEDLINE | ID: mdl-11534442

ABSTRACT

During the last ten years, osteodistraction genesis appeared as being a treatment of some maxillo-facial transversal deficiencies. A new technique have been develop in Lille Maxillo-Facial Department (Pr Ferri, France). This new technique is used in cases of mandibular hyposymphysis, which induce most of the time a mandibular incisor crowding. This distraction osteogenesis performed after sagittal osteotomy of the mandibular symphysis and associated with orthodontic treatment is a solution to avoid teeth extractions. Other treatments could be used to solve anterior mandibular teeth crowding but they have disadvantages: teeth slicing, teeth extraction or orthodontic teeth tilting. This new technique is performed with intra oral-device, small enough to be placed under mandibular periosteum. Three patients have been treated by this technique, they got a stable result. In these three cases, alveolar and basal bone is present. So for us, symphysis osteogenesis distraction appears to be an alternative treatments to mandibular incisor crowding.


Subject(s)
Mandible/abnormalities , Mandible/surgery , Osteogenesis, Distraction/methods , Plastic Surgery Procedures/methods , Adolescent , Humans , Male , Mandible/diagnostic imaging , Radiography
17.
Dig Liver Dis ; 33(4): 359-62, 2001 May.
Article in English | MEDLINE | ID: mdl-11432516

ABSTRACT

In July 2000, a 62-year-old female, with a ten-year history of chronic hepatitis C virus infection and persistently normal aspartate amino-transferase and alanine aminotransferase levels, presented with asthenia, weight loss, peripheral polyneuropathy and increased levels of aspartate aminotransferase (8 times upper normal limit), alanine aminotransferase (10 times upper normal limit) and gamma glutamyl-transferase (6 times upper normal limit). The ultrasound findings were consistent with massive liver steatosis. The patient had been previously diagnosed elsewhere as having hepatitis C virus-related "hepatitic flare" with neurological involvement related to concomitant mixed type-III cryoglobulinaemia. However intense exposure to trichloroethylene since April 2000 was revealed and liver histology was fully consistent with non-alcoholic steatohepatitis. The pathogenetic role of the solvent was definitely supported by the complete clinical and biochemical remission within six months of trichloroethylene withdrawal.


Subject(s)
Asthenia/chemically induced , Carrier State , Fatty Liver/chemically induced , Hepatitis C, Chronic/complications , Peripheral Nervous System Diseases/chemically induced , Female , Humans , Middle Aged , Solvents/adverse effects , Trichloroethylene/adverse effects
18.
Orthod Fr ; 71(3): 241-8, 2000 Sep.
Article in French | MEDLINE | ID: mdl-11039277

ABSTRACT

Many pathologies involve face. Among them, many have craniofacial growth consequences. The authors' aims are to analyze some of these pathologies, where clinical observations emphasize the role of the different craniofacial growth patterns. Despite a complex relation between the malformative part and the deformative one, untreated observations provide a better understanding of some craniofacial growth defects. Syndromes can be classified in 4 categories, involving the primitive causes of the clinical finding: 1. organic abnormalities of one or many functional matrix, 2. localized abnormalities of the anatomical structures, 3. general abnormalities of the conjunctive tissue, 4. mixed syndromes. Many observations will presented.


Subject(s)
Craniofacial Abnormalities/physiopathology , Maxillofacial Development , Cephalometry , Child , Child, Preschool , Humans , Infant
19.
Rev Stomatol Chir Maxillofac ; 101(6): 330-5, 2000 Dec.
Article in French | MEDLINE | ID: mdl-11242773

ABSTRACT

The incidence of osteomyelitis of the jaw has declined. Outcome is favorable with antibiotic therapy and surgery. We report a case in a women who experienced an unfavorable course with massive progressive diffusion, complicated by neoplastic conversion.


Subject(s)
Mandibular Diseases/complications , Osteomyelitis/complications , Carcinoma, Squamous Cell/etiology , Cell Transformation, Neoplastic , Chronic Disease , Female , Humans , Magnetic Resonance Imaging , Mandibular Diseases/diagnostic imaging , Mandibular Diseases/pathology , Mandibular Neoplasms/etiology , Middle Aged , Osteomyelitis/diagnostic imaging , Osteomyelitis/pathology , Radiography
20.
Rev Stomatol Chir Maxillofac ; 99(5-6): 250-7, 1998 Dec.
Article in French | MEDLINE | ID: mdl-10343997

ABSTRACT

We report the case of a 75-year-old woman who consulted for suppurative gingivitis and maxillary deformation with slow progression and associated severe joint disorder. The patient suffered both esthetic prejudice and functional impairment. Clinical signs and radiographic findings suggested the diagnosis of fibrous dysplasia, in its leontiasis ossea form, rarely reported in the literature. Primum non nocere guided our management. Abstention, a simple remodeling resection, or extensive resection and reconstruction would have been inappropriate in this elderly patient. We opted for an orthognatic attitude in spite of the vascular risk inherent in the orthodontic preparation and the osteotomy on an abnormal dystrophic bone. Outcome was satisfactory.


Subject(s)
Fibrous Dysplasia of Bone/surgery , Hyperostosis Frontalis Interna/surgery , Maxillary Diseases/surgery , Aged , Diagnosis, Differential , Disease Progression , Esthetics, Dental , Female , Fibrous Dysplasia of Bone/diagnosis , Gingivitis/surgery , Humans , Hyperostosis Frontalis Interna/diagnosis , Joint Diseases/diagnosis , Maxillary Diseases/diagnosis , Osteotomy, Le Fort , Treatment Outcome
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