AIM： Anti-Saccharomyces anti-nuclear associated cerevisiae antibodies （ASCA）, anti-neutrophil antibodies （NANA） and antibodies to exocrine pancreas （PAB）, are serological tools for discriminating Crohn＇s disea...AIM： Anti-Saccharomyces anti-nuclear associated cerevisiae antibodies （ASCA）, anti-neutrophil antibodies （NANA） and antibodies to exocrine pancreas （PAB）, are serological tools for discriminating Crohn＇s disease （CrD） and ulcerative colitis （UC）. Like CrD, coeliac disease （COD） is an inflammatory bowel disease （IBD） associated with （auto） antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS： Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence （IIF）. RESULTS： ASCA＋/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD.PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION： ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.展开更多
Inflammatory bowel diseases (IBD) are chronic disorders of the intestine with increasing incidence in Europe, Northern America and asiatic countries such as china. Thus, we have putted together these topic highlight a...Inflammatory bowel diseases (IBD) are chronic disorders of the intestine with increasing incidence in Europe, Northern America and asiatic countries such as china. Thus, we have putted together these topic highlight articles to give insights into the current understanding of IBD pathogenesis, diagnostics and treatment.展开更多
A 39-year-old male patient complaining of bilateral hand joint arthralgia was evaluated and found to have chronic hepatitis C and systemic sarcoidosis involving lung, skin, liver, and spleen. Hepatic and cutaneous sar...A 39-year-old male patient complaining of bilateral hand joint arthralgia was evaluated and found to have chronic hepatitis C and systemic sarcoidosis involving lung, skin, liver, and spleen. Hepatic and cutaneous sarcoidoses were confirmed by the presence of numerous noncaseating granulomas on histological examination. Pulmonary and splenic involvements were diagnosed by imaging studies. Fifteen months later, the sarcoidotic lesions in lung, liver, and spleen were resolved by radiological studies and a liver biopsy showed no granuloma but moderate to severe inflammatory activity, systemic sarcoidosis is a rare comorbidity of chronic hepatitis C which may spontaneously resolve.展开更多
Chronic inflammation is thought to be the leading cause of many human cancers including colorectal cancer(CRC).Accordingly,epidemiologic and clinical studies indicate that patients affected by ulcerative colitis and C...Chronic inflammation is thought to be the leading cause of many human cancers including colorectal cancer(CRC).Accordingly,epidemiologic and clinical studies indicate that patients affected by ulcerative colitis and Crohn's disease,the two major forms of inflammatory bowel disease,have an increased risk of developing CRC.In recent years,the role of immune cells and their products have been shown to be pivotal in initiation and progression of colitis-associated CRC.On the other hand,activation of the immune system has been shown to cause dysplastic cell elimination and cancer suppression in other settings.Clinical and experimental data herein reviewed,while confirming chronic inflammation as a risk factor for colon carcinogenesis,do not completely rule out the possibility that under certain conditions the chronic activation of the mucosal immune system might protect from colonic dysplasia.展开更多
AIM： To investigate the effect of a new oral preparation, highly concentrated in fish cartilage, in a group of inflammatory bowel diseases （IBD） patients with chronic iron deficient anemia. METHODS： In an open lab...AIM： To investigate the effect of a new oral preparation, highly concentrated in fish cartilage, in a group of inflammatory bowel diseases （IBD） patients with chronic iron deficient anemia. METHODS： In an open label pilot study, we supplemented a group of 25 patients （11 with Crohn＇s disease and 14 with ulcerative colitis） in stable clinical conditions and chronic anemia with a food supplement which does not contain iron but contains a standardized fraction of fish cartilage glycosaminoglycans and a mixture of antioxidants （Captafer Medestea, Turin, Italy）. Patients received 500 mg, twice a day during meals, for at least 4 mo. Patients were suggested to maintain their alimentary habit. At time 0 and after 2 and 4 too, emocrome, sideremia and ferritin were examined. Paired data were analyzed with Student＇s t test. RESULTS： Three patients relapsed during the study （2 in the 3^rd too, 1 in the 4^th too）, two patients were lost to follow up and two patients dropped out （1 for orticaria, 1 for gastric burning）. Of the remaining 18 patients, levels of serum iron started to rapidly increase within the 2^nd mo of treatment, P 〈 0.05）, whereas serum ferritin and hemoglobin needed a longer period to significantly improve their serum levels （too 4） P 〈 0.05. The product was safe, easy to administer and well tolerated by patients. CONCLUSION： These data suggest a potential new treatment for IBD patients with iron deficiency chronic anemia and warrant further larger controlled studies.展开更多
Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong treatment.However,non-adherence has been reported in over 40%of patients,especially those in remiss...Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong treatment.However,non-adherence has been reported in over 40%of patients,especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism,hospitalization risk, and the health care costs in chronic conditions,is enormous.The causes of medication non-adherence are complex,where the patient-doctor relationship, treatment regimen,and other disease-related factors play key roles.Moreover,subjective assessment might underestimate adherence.Poor adherence may result in more frequent relapses,a disabling disease course, in ulcerative colitis,and an increased risk for colorectal cancer.Improving medication adherence in patients is an important challenge for physicians.Understanding the different patient types,the reasons given by patients for non-adherence,simpler and more convenient dosage regimens,dynamic communication within the health care team,a self-management package incorporating enhanced patient education and physician-patient interaction,and identifying the predictors of nonadherence will help devise suitable plans to optimize patient adherence.This editorial summarizes the available literature on frequency,predictors,clinical consequences,and strategies for improving medical adherence in patients with IBD.展开更多
Ulcerative colitis (UC) is a chronic disease featuring re- current inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing comp...Ulcerative colitis (UC) is a chronic disease featuring re- current inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complica- tions of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice-orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.展开更多
In late November 2006, I was honored to participate in the Advanced Class on the Inheritance of Shanghai Senior TCM Doctors＇ Academic Experience, and studied under Professor CHEN Han-ping for 3 years. Now I introduce...In late November 2006, I was honored to participate in the Advanced Class on the Inheritance of Shanghai Senior TCM Doctors＇ Academic Experience, and studied under Professor CHEN Han-ping for 3 years. Now I introduced some of my clinical experience on acupuncture as follows.展开更多
文摘AIM： Anti-Saccharomyces anti-nuclear associated cerevisiae antibodies （ASCA）, anti-neutrophil antibodies （NANA） and antibodies to exocrine pancreas （PAB）, are serological tools for discriminating Crohn＇s disease （CrD） and ulcerative colitis （UC）. Like CrD, coeliac disease （COD） is an inflammatory bowel disease （IBD） associated with （auto） antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS： Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence （IIF）. RESULTS： ASCA＋/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD.PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION： ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.
文摘Inflammatory bowel diseases (IBD) are chronic disorders of the intestine with increasing incidence in Europe, Northern America and asiatic countries such as china. Thus, we have putted together these topic highlight articles to give insights into the current understanding of IBD pathogenesis, diagnostics and treatment.
文摘A 39-year-old male patient complaining of bilateral hand joint arthralgia was evaluated and found to have chronic hepatitis C and systemic sarcoidosis involving lung, skin, liver, and spleen. Hepatic and cutaneous sarcoidoses were confirmed by the presence of numerous noncaseating granulomas on histological examination. Pulmonary and splenic involvements were diagnosed by imaging studies. Fifteen months later, the sarcoidotic lesions in lung, liver, and spleen were resolved by radiological studies and a liver biopsy showed no granuloma but moderate to severe inflammatory activity, systemic sarcoidosis is a rare comorbidity of chronic hepatitis C which may spontaneously resolve.
基金Supported by"Associazione Italiana perla Ricerca sul Cancro",AIRC,MFAG-9353 and"Fondazione Umberto di Mario",Rome
文摘Chronic inflammation is thought to be the leading cause of many human cancers including colorectal cancer(CRC).Accordingly,epidemiologic and clinical studies indicate that patients affected by ulcerative colitis and Crohn's disease,the two major forms of inflammatory bowel disease,have an increased risk of developing CRC.In recent years,the role of immune cells and their products have been shown to be pivotal in initiation and progression of colitis-associated CRC.On the other hand,activation of the immune system has been shown to cause dysplastic cell elimination and cancer suppression in other settings.Clinical and experimental data herein reviewed,while confirming chronic inflammation as a risk factor for colon carcinogenesis,do not completely rule out the possibility that under certain conditions the chronic activation of the mucosal immune system might protect from colonic dysplasia.
文摘AIM： To investigate the effect of a new oral preparation, highly concentrated in fish cartilage, in a group of inflammatory bowel diseases （IBD） patients with chronic iron deficient anemia. METHODS： In an open label pilot study, we supplemented a group of 25 patients （11 with Crohn＇s disease and 14 with ulcerative colitis） in stable clinical conditions and chronic anemia with a food supplement which does not contain iron but contains a standardized fraction of fish cartilage glycosaminoglycans and a mixture of antioxidants （Captafer Medestea, Turin, Italy）. Patients received 500 mg, twice a day during meals, for at least 4 mo. Patients were suggested to maintain their alimentary habit. At time 0 and after 2 and 4 too, emocrome, sideremia and ferritin were examined. Paired data were analyzed with Student＇s t test. RESULTS： Three patients relapsed during the study （2 in the 3^rd too, 1 in the 4^th too）, two patients were lost to follow up and two patients dropped out （1 for orticaria, 1 for gastric burning）. Of the remaining 18 patients, levels of serum iron started to rapidly increase within the 2^nd mo of treatment, P 〈 0.05）, whereas serum ferritin and hemoglobin needed a longer period to significantly improve their serum levels （too 4） P 〈 0.05. The product was safe, easy to administer and well tolerated by patients. CONCLUSION： These data suggest a potential new treatment for IBD patients with iron deficiency chronic anemia and warrant further larger controlled studies.
文摘Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong treatment.However,non-adherence has been reported in over 40%of patients,especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism,hospitalization risk, and the health care costs in chronic conditions,is enormous.The causes of medication non-adherence are complex,where the patient-doctor relationship, treatment regimen,and other disease-related factors play key roles.Moreover,subjective assessment might underestimate adherence.Poor adherence may result in more frequent relapses,a disabling disease course, in ulcerative colitis,and an increased risk for colorectal cancer.Improving medication adherence in patients is an important challenge for physicians.Understanding the different patient types,the reasons given by patients for non-adherence,simpler and more convenient dosage regimens,dynamic communication within the health care team,a self-management package incorporating enhanced patient education and physician-patient interaction,and identifying the predictors of nonadherence will help devise suitable plans to optimize patient adherence.This editorial summarizes the available literature on frequency,predictors,clinical consequences,and strategies for improving medical adherence in patients with IBD.
文摘Ulcerative colitis (UC) is a chronic disease featuring re- current inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complica- tions of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice-orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.
文摘In late November 2006, I was honored to participate in the Advanced Class on the Inheritance of Shanghai Senior TCM Doctors＇ Academic Experience, and studied under Professor CHEN Han-ping for 3 years. Now I introduced some of my clinical experience on acupuncture as follows.
