Background &Aims: Despite treatment with corticosteroids, severe to moderately severe attacks of ulcerative colitis have a high colectomy rate. We intended to find a rescue therapy other than cyclosporin A, which ...Background &Aims: Despite treatment with corticosteroids, severe to moderately severe attacks of ulcerative colitis have a high colectomy rate. We intended to find a rescue therapy other than cyclosporin A, which imposes a high risk of side effects and cyclosporine-related mortality. Methods: This was a randomized double-blind trial of infliximab or placebo in severe to moderately severe ulcerative colitis not responding to conventional treatment. Patients were randomized to infliximab/ placebo either on day 4 after the initiation of corticosteroid treatment if they fulfilled the index criteria for fulminant ulcerative colitis on day 3 or on day 6-8 if they fulfilled index criteria on day 5-7 for a severe or moderately severe acute attack of ulcerative colitis. Results were analyzed according to the intention-to-treat principle. The primary end point was colectomy or death 3 months after randomization. Secondary end points were clinical and endoscopic remission at that time in patients who did not undergo operation. Results: Forty-five patients were included (24 infliximab and 21 placebo). No patient died. Seven patients in the infliximab group and 14 in the placebo group had a colectomy (P =. 017; odds ratio, 4.9; 95%confidence interval, 1.4-17) within 3 months after randomization. No serious side effects occurred. Three patients in the placebo group required operation for septic complications. Conclusions: Infliximab 4-5 mg/kg is an effective and safe rescue therapy in patients experiencing an acute severe or moderately severe attack of ulcerative colitis not responding to conventional treatment.展开更多
Background: Non-alcoholic fatty liver disease (NAFLD) is considered to be the liver component of the metabolic syndrome and is frequently associated with obe sity, dyslipidemia and type II diabetes mellitus (NIDDM).We...Background: Non-alcoholic fatty liver disease (NAFLD) is considered to be the liver component of the metabolic syndrome and is frequently associated with obe sity, dyslipidemia and type II diabetes mellitus (NIDDM).We aimed to determine t he development of liver function tests (LFTs) and metabolic complications in pat ients previously diagnosed with NAFLD. Methods: One-hundred-and-two patients with NAFLD diagnosed in the period 1994-2001 were identified. Eighty were broug ht in for new investigations, including LFTs, blood pressure, BMI, lipid profile , blood glucose and insulin. Original liver biopsy was re-evaluated. Results: S ixty-two patients (77%) were males (median age 46 years; mean follow-up time 2.8 ±1.2 years). Fifty-four patients (68%) were light to moderately overweigh t with body mass index (BMI) 25-30 kg/m 2. Mean BMI (28.2) was the same at diag nosis and at follow-up (28.3). At the new examination, 18 patients (23%) had d eveloped diabetes mellitus type II (n = 6) or had impaired fasting glucose (IFG) (n = 12), compared to only 2 patients at diagnosis. Hyperinsulinemia was observ ed in 19 patients (24%). Dyslipidemia, with elevated triglycerides and/or hyper cholesterolemia, was now present in 65 patients (81%). Twenty-two patients (27 %) had hypertension compared to 9 (11%) at diagnosis. Liver biopsy was perform ed in 24%, and 89%of those fulfilled the criteria for NAFLD. However,mild infl ammation and fibrosis was observed, grade 1-2 (n = 17), stage I-II (n = 13) an d none had cirrhosis. Conclusion: A significant proportion of patients with both clinical and histological diagnosis of NAFLD develop metabolic problems soon af ter diagnosis. These patients should be screened regularly for metabolic disorde rs.展开更多
文摘Background &Aims: Despite treatment with corticosteroids, severe to moderately severe attacks of ulcerative colitis have a high colectomy rate. We intended to find a rescue therapy other than cyclosporin A, which imposes a high risk of side effects and cyclosporine-related mortality. Methods: This was a randomized double-blind trial of infliximab or placebo in severe to moderately severe ulcerative colitis not responding to conventional treatment. Patients were randomized to infliximab/ placebo either on day 4 after the initiation of corticosteroid treatment if they fulfilled the index criteria for fulminant ulcerative colitis on day 3 or on day 6-8 if they fulfilled index criteria on day 5-7 for a severe or moderately severe acute attack of ulcerative colitis. Results were analyzed according to the intention-to-treat principle. The primary end point was colectomy or death 3 months after randomization. Secondary end points were clinical and endoscopic remission at that time in patients who did not undergo operation. Results: Forty-five patients were included (24 infliximab and 21 placebo). No patient died. Seven patients in the infliximab group and 14 in the placebo group had a colectomy (P =. 017; odds ratio, 4.9; 95%confidence interval, 1.4-17) within 3 months after randomization. No serious side effects occurred. Three patients in the placebo group required operation for septic complications. Conclusions: Infliximab 4-5 mg/kg is an effective and safe rescue therapy in patients experiencing an acute severe or moderately severe attack of ulcerative colitis not responding to conventional treatment.
文摘Background: Non-alcoholic fatty liver disease (NAFLD) is considered to be the liver component of the metabolic syndrome and is frequently associated with obe sity, dyslipidemia and type II diabetes mellitus (NIDDM).We aimed to determine t he development of liver function tests (LFTs) and metabolic complications in pat ients previously diagnosed with NAFLD. Methods: One-hundred-and-two patients with NAFLD diagnosed in the period 1994-2001 were identified. Eighty were broug ht in for new investigations, including LFTs, blood pressure, BMI, lipid profile , blood glucose and insulin. Original liver biopsy was re-evaluated. Results: S ixty-two patients (77%) were males (median age 46 years; mean follow-up time 2.8 ±1.2 years). Fifty-four patients (68%) were light to moderately overweigh t with body mass index (BMI) 25-30 kg/m 2. Mean BMI (28.2) was the same at diag nosis and at follow-up (28.3). At the new examination, 18 patients (23%) had d eveloped diabetes mellitus type II (n = 6) or had impaired fasting glucose (IFG) (n = 12), compared to only 2 patients at diagnosis. Hyperinsulinemia was observ ed in 19 patients (24%). Dyslipidemia, with elevated triglycerides and/or hyper cholesterolemia, was now present in 65 patients (81%). Twenty-two patients (27 %) had hypertension compared to 9 (11%) at diagnosis. Liver biopsy was perform ed in 24%, and 89%of those fulfilled the criteria for NAFLD. However,mild infl ammation and fibrosis was observed, grade 1-2 (n = 17), stage I-II (n = 13) an d none had cirrhosis. Conclusion: A significant proportion of patients with both clinical and histological diagnosis of NAFLD develop metabolic problems soon af ter diagnosis. These patients should be screened regularly for metabolic disorde rs.
