Predictive factors for an uncomplicated long-term course of Crohn's disease: a retrospective analysis.

BACKGROUND: Predictive factors for a mild course of Crohn's disease (CD) may have therapeutic consequences, but as yet have not been identified. AIMS: To identify baseline factors that predict mild CD and design a predictive scoring system. METHODS: A retrospective, multicenter study of newly diagnosed CD patients allocated to mild CD (no therapy, mesalazine only, or mesalazine with a single initial short course of low-dose prednisone) or moderate CD (all other patients including resected patients). RESULTS: 162 patients (median follow-up 43 months) were analyzed: 47 mild CD and 115 moderate CD. For mild CD versus moderate CD, mean age at first diagnosis was higher (41.1 versus 33.9 years, p=0.02), mean C-reactive protein (CRP) concentration was lower (1.6 versus 3.6 mg/L, p<0.01), and perianal lesions were less frequent (0% versus 10.4%, p=0.02). The combined incidence of complications (stenosis, any type of fistula, extraintestinal complications or fever) was 21.3% in mild CD versus 35.7% in moderate CD (p=0.07). A scoring system based on age, CRP, endoscopic severity (adapted Rutgeert's score), perianal lesions and combined incidence of complications was developed which can predict a mild prognosis at the initial diagnosis, giving patients the chance of simplified therapy and accelerated step-up in the event of treatment failure. CONCLUSIONS: Approximately a third of CD patients experience a mild disease course and require only basic therapy. A possible scoring system to predict mild CD which may avoid overtreatment and unnecessary risks for the patient and costs is suggested.

Gender differences in ethical perceptions of business practices: a social role theory perspective.

This study presents a meta-analysis of research on gender differences in perceptions of ethical decision making. Data from more than 20,000 respondents in 66 samples show that women are more likely than men to perceive specific hypothetical business practices as unethical. As suggested by social role theory (A. H. Eagly, 1987), the gender difference observed in precareer (student) samples declines as the work experience of samples increases. Social role theory also accounts for greater gender differences in nonmonetary issues than in monetary issues. T. M. Jones's (1991) issue-contingent model of moral intensity helps explain why gender differences vary across types of behavior. Contrary to expectations, differences are not influenced by the sex of the actor or the target of the behavior and do not depend on whether the behavior involves personal relationships or action vs. inaction.

[Clinical and functional studies of diabetic cardiopathy]. / Klinische und funktionsanalytische Untersuchungen zur diabetischen Kardiopathie.

In 30 diabetics and 30 patients with healthy metabolism who anamnestically, clinically and electrocardiographically did not show any references to a coronary heart disease the systolic time intervals and contractility indices of the carotid pulse curve were determined in lying position as well as under passive and active orthostasis load. Diabetics with a microangiopathy already under conditions of rest showed a tendency to pathological values. Unequivocal deviations were to be registered under conditions of the tilting table, particularly when the values obtained under orthostasis are related to the measuring data in rest. The restricted cardiac regulation breadth of diabetics with microangiopathy is particularly expressed in a compared with the control groups clearly reduced reaction of the presphygmic phase, the time of pressure increase as well as the quotients PEP/LVET, LVET/ICT and PEPstanding/PEPlying.