Subject(s)
Antimetabolites, Antineoplastic/adverse effects , Fatty Liver/chemically induced , Liver Cirrhosis/chemically induced , Quinazolines/adverse effects , Thiophenes/adverse effects , Thymidylate Synthase/antagonists & inhibitors , Adenocarcinoma/drug therapy , Disease Progression , Drug Monitoring , Fat Necrosis , Fatty Liver/metabolism , Female , Humans , Liver Cirrhosis/metabolism , Liver Function Tests , Middle Aged , Rectal Neoplasms/drug therapySubject(s)
Acute Kidney Injury/chemically induced , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Hepatic Encephalopathy/chemically induced , Ketoprofen/adverse effects , Pancreatitis/chemically induced , Acute Disease , Acute Kidney Injury/diagnosis , Aged , Biopsy , Chemical and Drug Induced Liver Injury/diagnosis , Hepatic Encephalopathy/diagnosis , Humans , Liver Function Tests , Male , Pancreatitis/diagnosisABSTRACT
UNLABELLED: The aim of this prospective epidemiological study was to investigate the incidence of Inflammatory Bowel Disease in the Puy-de-Dôme county using the same methodology as EPIMAD's registry. METHODS: From 01/01/93 to 31/12/94, each gastroenterologist (n = 22) collected patients consulting for the first time with clinical symptoms compatible with inflammatory bowel disease. Data were reported on a questionnaire by an interviewer practitioner. The final diagnosis of Crohn's disease and ulcerative colitis was made in a blind manner by two expert gastroenterologists and recorded according to the Calkin's criteria as definite, probable, or possible diagnosis, or unclassifiable chronic colitis or acute colitis. RESULTS: 167 new cases were identified: 112 (67.1%) inflammatory bowel disease for the combined group of definite and probable cases with 79 Crohn's disease (70.5%), 29 ulcerative colitis (25.9%) of which 11 ulcerative proctitis (37.9%), 4 unclassifiable chronic colitis (3.6%) and 55 acute colitis (32.9%). The crude and age-adjusted incidence (per 10(5)/year) was respectively 6.6 and 5.7 for Crohn's disease and 2.4 and 1.9 for ulcerative colitis. The highest age-specific incidence rate for Crohn's disease was between 40-49 years (14.1) and for ulcerative colitis between 80-89 years (6.8). The female/male ratio was 0.8 for Crohn's disease and 1.1 for ulcerative colitis. The median age at the time of diagnosis was 42.6 years for Crohn's disease and 35.3 years for ulcerative colitis. CONCLUSIONS: These preliminary findings revealed a high incidence of Crohn's disease and low of ulcerative colitis in this county. However, these results must be managed carefully because these data were recorded only on two years and the inflammatory bowel disease classified possible and acute colitis require a follow-up.
Subject(s)
Inflammatory Bowel Diseases/epidemiology , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Chronic Disease , Colitis/epidemiology , Colitis, Ulcerative/epidemiology , Crohn Disease/epidemiology , Female , France/epidemiology , Humans , Incidence , Infant , Male , Middle Aged , Prospective Studies , RegistriesABSTRACT
OBJECTIVES: Various treatment regimens have been used for the management of Zenker's diverticulum. These include surgery (transcervical diverticulectomy, myotomy) and endoscopic treatment with rigid instruments or flexible endoscope. The aim of this study is to report the results of the treatment of Zenker's diverticulum with rigid endoscope applied CO2 laser and to compare them with other types of treatment. PATIENTS AND METHODS: Between May 1991 and November 1996, 17 patients (8 males, 9 females) with symptomatic Zenker's diverticulum underwent endoscopic treatment under short general anesthesia applied CO2 laser. The mean age of the patients was 73.2 years (range: 54 to 97 yrs). All patients had significant symptoms such as dysphagia (15 patients out of 17). All patients were clinically evaluated after the procedure. RESULTS: The endoscopic incision was performed in one session per patient. Symptoms and dysphagia disappeared in all patients except one (dysphagia). Two complications (one cervical emphysema, one fistula) were managed clinically. Mortality was 0%. Mean follow-up was 17 months. There was no recurrence of dysphagia, all patients remained asymptomatic. CONCLUSIONS: Rigid endoscopic treatment of symptomatic Zenker's diverticulum applied with laser CO2 is an efficient and safe method. It should be considered as an alternative therapy for Zenker's diverticulum, especially for patients at a high surgical risk.
