The risk of developing neoplasia leading to colorectal cancer is significantly increased in ulcerative colitis (UC) and most likely in Crohn's disease. Several endoscopic surveillance strategies have been implemen...The risk of developing neoplasia leading to colorectal cancer is significantly increased in ulcerative colitis (UC) and most likely in Crohn's disease. Several endoscopic surveillance strategies have been implemented to identify these lesions. The main issue is that colitisassociated neoplasms often occurs in flat mucosa, often being detected on taking random biopsies rather than by identification of these lesions via endoscopic imaging. The standard diagnostic procedure in long lasting UC is to take four biopsies every 10 cm. Image enhancement methods, such as chromoendoscopy and virtual histology using endomicroscopy, have greatly im- proved neoplasia detection rates and may contribute toreduced random biopsies by taking targeted "smart" biopsies. Chromoendoscopy may effectively be performed by experienced endoscopists for routine screening of UC patients. By contrast, endomicroscopy is often only available in selected specialized endoscopic centers. Importantly, advanced endoscopic imaging has the poten- tial to increase the detection rate of neoplasia whereas the interplay between endoscopic experience and interpretation of histological biopsy evaluation allows the physician to make a proper diagnosis and to find the appropriate therapeutic approach. Colitis-associated intraepithelial neoplasms may occur in flat mucosa of endoscopically normal appearance or may arise as dysplasia-associated lesion or mass (DALM), which may be indistinguishable from sporadic adenomas in healthy or non-colitis mucosa [adenoma-like mass (ALM)]. The aim of this review was to summarize endoscopic and histological characteristics of DALM and ALM in the context of therapeutic procedures.展开更多
Malaria is a major public health problem in the Cote d＇Ivoire where it is the leading cause of morbidity and mortality. The objective of this study was to assess the knowledge, attitudes and practices of health care ...Malaria is a major public health problem in the Cote d＇Ivoire where it is the leading cause of morbidity and mortality. The objective of this study was to assess the knowledge, attitudes and practices of health care providers on the diagnosis and therapeutic procedures used to ensure the management of uncomplicated malaria in the health district of Abidjan. A cross-sectional study was conducted from November 2008 to December 2008 among 169 caregivers who treated 1,691 cases of uncomplicated malaria. Results： The knowledge of the caregivers of the national guidelines regarding malaria was sufficient （89%）. A diagnosis of uncomplicated malaria was established only on clinical arguments （70%）. The percentage of patients who were prescribed artemisinin-based combination therapy （ACT） was 86%. However, 25% of the antimalarials drugs that were prescribed to patients （oral quinine, artemisinin derivatives monotherapy, and herbal medicine） did not meet the recommendations on first choice treatment as suggested by the national program against malaria. These results indicate sufficient knowledge of the national guidelines for the treatment of malaria by health care providers as evidenced by acceptable prescriptions for ACTs despite an incomplete knowledge of the guidelines.展开更多
文摘The risk of developing neoplasia leading to colorectal cancer is significantly increased in ulcerative colitis (UC) and most likely in Crohn's disease. Several endoscopic surveillance strategies have been implemented to identify these lesions. The main issue is that colitisassociated neoplasms often occurs in flat mucosa, often being detected on taking random biopsies rather than by identification of these lesions via endoscopic imaging. The standard diagnostic procedure in long lasting UC is to take four biopsies every 10 cm. Image enhancement methods, such as chromoendoscopy and virtual histology using endomicroscopy, have greatly im- proved neoplasia detection rates and may contribute toreduced random biopsies by taking targeted "smart" biopsies. Chromoendoscopy may effectively be performed by experienced endoscopists for routine screening of UC patients. By contrast, endomicroscopy is often only available in selected specialized endoscopic centers. Importantly, advanced endoscopic imaging has the poten- tial to increase the detection rate of neoplasia whereas the interplay between endoscopic experience and interpretation of histological biopsy evaluation allows the physician to make a proper diagnosis and to find the appropriate therapeutic approach. Colitis-associated intraepithelial neoplasms may occur in flat mucosa of endoscopically normal appearance or may arise as dysplasia-associated lesion or mass (DALM), which may be indistinguishable from sporadic adenomas in healthy or non-colitis mucosa [adenoma-like mass (ALM)]. The aim of this review was to summarize endoscopic and histological characteristics of DALM and ALM in the context of therapeutic procedures.
文摘Malaria is a major public health problem in the Cote d＇Ivoire where it is the leading cause of morbidity and mortality. The objective of this study was to assess the knowledge, attitudes and practices of health care providers on the diagnosis and therapeutic procedures used to ensure the management of uncomplicated malaria in the health district of Abidjan. A cross-sectional study was conducted from November 2008 to December 2008 among 169 caregivers who treated 1,691 cases of uncomplicated malaria. Results： The knowledge of the caregivers of the national guidelines regarding malaria was sufficient （89%）. A diagnosis of uncomplicated malaria was established only on clinical arguments （70%）. The percentage of patients who were prescribed artemisinin-based combination therapy （ACT） was 86%. However, 25% of the antimalarials drugs that were prescribed to patients （oral quinine, artemisinin derivatives monotherapy, and herbal medicine） did not meet the recommendations on first choice treatment as suggested by the national program against malaria. These results indicate sufficient knowledge of the national guidelines for the treatment of malaria by health care providers as evidenced by acceptable prescriptions for ACTs despite an incomplete knowledge of the guidelines.
