BackgroundAlthough the cost of Crohn’s disease (CD) treatment differs considerably, hospitalization and surgery costs account for most of the total treatment cost. Decreasing hospitalization and surgery rates are pivotal issues in reducing health-care costs.Material/MethodsWe evaluated the effect of azathioprine (AZA) compared with mesalazine on incidence of re-hospitalizations due to all causes and for CD-related surgeries. In this controlled, randomized study, 72 subjects with sub-occlusive ileocecal CD were randomized for AZA (2–3 mg/kg per day) or mesalazine (3.2 g per day) therapy during a 3-year period. The primary end point was the re-hospitalization proportion due to all causes, as well as for surgical procedures during this period evaluated between the groups.ResultsOn an intention-to-treat basis, the proportion of patients re-hospitalized within 36 months due to all causes was lower in patients treated with AZA compared to those on mesalazine (0.39 vs. 0.83, respectively; p=0.035). The AZA group had also significantly lower proportions of re-hospitalization for surgical intervention (0.25 vs. 0.56, respectively; p=0.011). The number of admissions (0.70 vs. 1.41, p=0.001) and the length of re-hospitalization (3.8 vs. 7.7 days; p=0.002) were both lower in AZA patients.ConclusionsPatients with sub-occlusive ileocecal CD treated with AZA had lower re-hospitalization rates due to all causes and for surgical management of CD compared to those treated with mesalazine during a 3-year period. The long-term use of AZA in ileocecal CD patients recovering from a sub-occlusion episode can save healthcare costs.
OBJETIVO: Realizar um estudo morfométrico comparativo da musculatura longitudinal e circular do intestino delgado de ratos submetidos à construção cirúrgica de um e de dois piloros no intestino delgado utilizando-se da técnica de criação de piloros proposta por Rena et al. MÉTODO: Foram utilizados 52 ratos Wistar machos divididos em três grupos. O Grupo A, destacado como controle, composto de 10 animas, cada um forneceu 20mm de segmento de intestino para o estudo. Os animais do Grupo B, composto de 32 animais, foram submetidos à construção de dois piloros, um a 100mm e outro a 150mm da válvula ileocecal e os animais do grupo C, composto de 10 animais, foram submetidos à construção de um piloro a 100mm da mesma. A eutanásia ocorreu no décimo dia. A morfometria das camadas musculares longitudinal e circular acima e abaixo dos piloros foi estudada com utilização do microscópico modelo "Axiostar plus" conectado à câmera "Axioncam Version 5.05.10" com objetiva X5 / 0,12 no o programa "AxioVision 3.1.2.1". RESULTADOS: As alças apresentaram aumento da espessura da camada muscular acima e abaixo do ponto da operação. O estudo morfométrico comparativo das camadas musculares longitudinal e circular mostrou aumento significativo em comparação ao controle, não demonstrando significância entre os grupos B e C. CONCLUSÃO: Os resultados deste estudo revelaram importante aumento de espessura das camadas musculares, porém, menos acentuados que aqueles descritos na literatura quando foram realizados em animais submetidos à estenose fixa. Esses dados indicam que a construção operatória de piloros pela técnica utilizada promove alterações musculares de menor monta, possivelmente, pela função valvular do piloro.
BackgroundPatients with subocclusive Crohn’s disease (CD) who received azathioprine (AZA) therapy had lower re-hospitalization rates due to all causes and for surgical management of CD compared to those treated with mesalazine during a 3-year period. We investigated whether AZA also was effective for prevention of recurrent bowel obstruction.Material/MethodsRates of recurrent bowel occlusion were compared between patients treated with AZA and those treated with mesalazine. We assessed the time interval-off intestinal obstruction as well as the occlusion-free survival for both groups.ResultsThere was a significantly lower cumulative rate of patients with recurrent subocclusion in the AZA group (56%) compared with the mesalazine group (79%; OR 3.34, 95% CI 1.67–8.6; P=0.003), with the number needed to treat in order to prevent 1 subocclusion episode of 3.7 favoring AZA. The occlusion-free time interval was longer in the AZA group compared with the mesalazine group (28.8 vs. 18.3 months; P=0.000). The occlusion-free survival at 12, 24, and 36 months was significantly higher in the AZA group (91%, 81%, and 72%, respectively) than in the mesalazine group (64.7%, 35.3%, and 23.5%, respectively; P<0.05 for all comparisons).ConclusionsIn an exploratory analysis of patients with subocclusive ileocecal CD, maintenance therapy with AZA is more effective than mesalazine for eliminating or postponing recurrent intestinal obstruction during 3 years of therapy.
BACKGROUND: Iron deficiency anemia (IDA) is one of the most common inflammatory bowel disease (IBD) complications. Importantly, anemia can contribute to patients’ poor quality of life, mainly because of its negative impact on the patients’ wellbeing, physical performance, mood, and cognitive function. In addition, anemia is a significant predictor of increased hospitalization risk, as well as of increased mortality in IBD patients. To the best of our knowledge, there are no published data concerning the use of oral liposomal iron to treat IDA in IBD patients. Therefore, the current study was a pilot study to assess the efficacy and safety of the oral liposomal iron in to treat mild IDA in patients with IBD, as well as to assess the impact of this treatment on psychometric scores. METHODS: Patients with inactive or mildly active IBD were screened for anemia in this interventional study conducted from November 2016 to March 2018. Patients with mild anemia were treated with oral liposomal iron for 8 weeks. The oral iron replenishment was provided to the patients on a compassionate use basis at the dose of two liposomal iron tablets per day (equivalent to 28 mg of liposomal iron). The primary endpoint of the study was the response rate to liposomal oral iron therapy. Treatment responders were defined as patients who achieved hemoglobin (Hb) increase of at least; 1 g/dL and/or Hb normalization by the 8th treatment week. The secondary endpoints included changes in ferritin concentration and transferrin saturation index (TSI) percentage from the baseline to the 8th week; impacts of the oral iron treatment on quality of life, and fatigue; changes in disease activity (assessed by HBI, Truelove and Witt’s criteria, and C-reactive protein - CRP); and treatment safety and tolerability. RESULTS: Of the 200 patients screened, 33 (16.5%) patients had anemia. Of the 21 patients who completed treatment, 13 (62%) responded to oral liposomal iron replacement therapy (mean increases of Hb 11.4 to 12.6 g/dL). The transferrin saturation index (TSI) increased by an average of 10.2 (P = 0.006) and the quality of life 26.3 (P 0.0001), despite no significant difference in baseline ferritin values. There was also a mean reduction of 9.2 in the perception of fatigue (P 0.0001). There was a linear correlation between the increase in Hb levels and the improvement of quality of life as evaluated by IBDQ (r = 0.54; P = 0.01). Following oral liposomal iron therapy, no change was seen in clinical disease activity (P = 0.10). In addition, CRP remains unchanged after treatment (P = 0.98). CONCLUSION(S): Treatment of IBD patients with oral liposomal iron was effective in improving anemia and quality of life, as well as in decreasing fatigue. This pilot study provides actual data supporting the therapeutic use of liposomal iron for treating mild IDA in IBD and paves the way for future studies evolving larger IBD populations utilizing higher doses of this drug and longer follow-up, to confirm the role of oral liposomal iron in treating quiescent or mildly active IBD patients presenting mild IDA.*This study is partially supported by the FAPEMIG-Brazil.
O Brasil, atualmente, é um dos principais países produtores e exportadores de carne suína do mundo. Para que continue nesta colocação é preciso investir em tecnologia que busca o bem-estar do animal através da bioclimatologia e ambiência. O maior desafio enfrentado na produção de suínos é o conforto térmico, pois estes animais são altamente afetados pelas altas e baixas temperaturas. Sendo assim, o objetivo deste trabalho foi avaliar se o setor suinocultura de uma instituição de ensino federal atende aos requisitos básicos de bioclimatologia e ambiência. Para isso, foram coletados dados de temperatura, umidade, precipitação e velocidade do vento entre os meses de janeiro e setembro, coletados dados in loco, medidas dos galpões, dimensionamento das baias, tipo de piso usado, tipo de telhado, presença de lanternim, forro e cortina e quantidade dos animais, comparando-se com a literatura e verificando se os requisitos foram atendidos. Alguns requisitos foram atingidos, como quantidade de animais por galpão e uso de cortinas no setor de maternidade e creche. Algumas modificações poderiam ser efetuadas no local, como a aplicação de forro conjugado com ventilador e uso de ventilação artificial associada a nebulização. Estas adaptações seriam importantes para se atender melhor à necessidade de conforto térmico, o que impactaria positivamente no bem-estar dos animais alojados. Destaca-se que o setor deverá se adequar também à nova normativa de bem-estar publicada em 2020.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.