ABSTRACT
OBJECTIVE: The role of capsule endoscopy (CE) in Crohn's disease (CD) has expanded with greater understanding of the technology. The ability of CE to differentiate CD from other causes of inflammation has been questioned. Longitudinal studies are required to assess the long-term impact and significance of CE findings in suspected CD. The aim of this work is to verify in how many misunderstood cases of suspected Crohn's Disease CE was able to identify precociously and "by chance" when it is performed for recurrent obscure GI bleeding (OGIB), to evaluate how many of them were later confirmed during a median 24 months follow-up. Moreover, we observed the role of the early diagnosis in changing the clinical management of these patients. PATIENTS AND METHODS: A retrospective review was carried out on CE procedures performed for suspected OGIB. 1008 consecutive patients was enrolled and 492 included in the study. Previous investigations such as ileo-colonoscopy and/or previous small bowel imaging were documented. Only patients with at least 6 months of documented follow-up were included. A chart review was undertaken to record CE findings/correlate with subsequent diagnosis and outcome. RESULTS: 94/492 (19.1%) patients positive for suspected CD were identified. Follow-up data were available 64/94 (68%). The mean follow-up was 24 months. There was a strong positive correlation between results of CE and subsequent clinical diagnosis. The suspected CD was confirmed in 100% (94/94) of follow-up patients. CONCLUSIONS: CE appears able to identify lesions compatible with suspected Crohn's disease otherwise unacknowledged with consequently change in treatment options for the patients.
Subject(s)
Capsule Endoscopy , Crohn Disease/diagnosis , Crohn Disease/epidemiology , Gastrointestinal Hemorrhage/diagnosis , Incidental Findings , Capsule Endoscopy/methods , Capsule Endoscopy/statistics & numerical data , Chronic Disease , Colonoscopy/statistics & numerical data , Crohn Disease/complications , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/etiology , Humans , Intestine, Small/pathology , Male , Middle Aged , Recurrence , Retrospective StudiesABSTRACT
This work follows up the previous edited in the year 2004, and deals with the still serious and discussed problem of work risks even though the use of asbestos has been forbidden since 10 years, and the tobacco's smoke since one year. The Authors discuss the question related to the genetic point of view as a first and multiplying action caused at the some time by the tobacco's smoke and asbestos dust in the working places. This work report an up-to-date list of law about environmental prevention.
Subject(s)
Asbestos/adverse effects , Lung Neoplasms/etiology , Smoking/adverse effects , Dust , Humans , Lung Neoplasms/genetics , Occupational Exposure/adverse effectsABSTRACT
The authors report the importance of hip dislocation and pelvic imbalance in patients with cerebral palsy, as the cause of pain, decubitus, and severe secondary deformities of the vertebral column. They report their experience in the surgical treatment of spastic hip, based on 231 cases with a mean follow-up of 5.4 years. The authors emphasize the importance of obtaining a balanced pelvis to allow for walking and sitting in the severest patients, and in order to avoid severe deformity of the vertebral column. The surgical methods used, with particular interest in the importance of stabilizing reduction by intertrochanteric osteotomies of the femur and/or acetabular roof osteotomies, are described. Results obtained, positive in 88% of cases, are also reported.
Subject(s)
Cerebral Palsy/complications , Hip Dislocation/prevention & control , Hip Joint/surgery , Osteotomy , Acetabulum/pathology , Acetabulum/surgery , Bone Diseases, Metabolic/prevention & control , Child, Preschool , Ethanol/administration & dosage , Ethanol/therapeutic use , Femur/surgery , Gait Disorders, Neurologic/physiopathology , Gait Disorders, Neurologic/prevention & control , Hip Dislocation/etiology , Hip Dislocation/surgery , Humans , Infant , Injections, Intramuscular , Muscle Spasticity/complications , Muscle Spasticity/therapy , Muscle, Skeletal/surgery , Posture , Sclerotherapy , Tendons/surgery , Treatment OutcomeABSTRACT
The surface of soft contact lenses made of crosslinked poly(2-hydroxyethyl methacrylate). pHEMA, has been investigated with atomic force microscopy in contact mode. The friction force and adhesive force measurements were able to differentiate the non-crosslinked pHEMA chains from the surface of the crosslinked pHEMA networks. These non-crosslinked pHEMA chains at the surface were anchored to the crosslinked pHEMA network, most likely by entanglement and their surfaces were about 2-4nm higher than the surrounding surface in a dehydrated state. In saline solution, the surface friction and adhesive force of the contact lens were significantly reduced compared to those measured for the surface-dehydrated contact lens.
Subject(s)
Biocompatible Materials/chemistry , Contact Lenses, Hydrophilic , Hydrogels/chemistry , Adhesiveness , Desiccation , Friction , Materials Testing , Methanol , Microscopy, Atomic Force , Polyhydroxyethyl Methacrylate/chemistry , Polymers/chemistry , Sodium Chloride , Surface Properties , WaterSubject(s)
Humans , Male , Female , Child, Preschool , Brain Injuries/classification , Brain Injuries/diagnosis , Brain Injuries/therapyABSTRACT
A new case of congenital, hypotonic-sclerotic muscular dystrophy is presented. The patient showed congenital hyperlaxity and looseness of distal joints, muscle weakness, and spur-like protrusion of the calcaneus. Afterwards rapid progressive contractures of both knees and hip joints developed. Muscle biopsies revealed unequivocal dystrophic abnormalities and small atrophic fibers with numerous foldings of basal lamina suggestive of a neurogenic lesion. The disease presents clinical variability but the diagnosis is possible when a newborn shows: no dominant family history, slender body, marked distal joint laxity and hyperflexibility, proximal joint contractures and normal or slightly increased serum enzymes.
Subject(s)
Kyphosis/congenital , Muscular Dystrophies/congenital , Scoliosis/congenital , Child, Preschool , Hip Contracture/complications , Hip Contracture/physiopathology , Humans , Joint Instability/complications , Joint Instability/physiopathology , Knee Joint/physiopathology , Kyphosis/diagnostic imaging , Male , Microscopy, Electron , Muscles/pathology , Muscles/ultrastructure , Radiography , Scoliosis/diagnostic imagingABSTRACT
From a retrospective study of 10 cases of osteogenesis imperfecta the authors have verified the usefulness of the classification proposed by Sillence. This has particular advantages in relation to correct prenatal diagnosis and genetic counselling.
