Fecal calprotectin and lactoferrin determination may be useful in predicting impending clinical relapse-especially during the following 3 months-in both CD and UC patients.

SUMMARY BackgroundPancreatitis is a potentially severe condition. Patients with inflammatory bowel disease (IBD) seem to be at increased risk for acute pancreatitis.

Results of epidemiologic studies suggest an inverse association between breast cancer risk and physical activity; this is one of the few modifiable breast cancer risk factors identified to date. However, only 2 previous studies assessed the association between physical activity and the extent of mammographically-detected fibroglandular breast density, a marker of breast cancer risk. Moreover, there has been no study of physical inactivity and percent breast density, nor a study of this relationship in Hispanic women, who are less physically active than non-Hispanic whites. In the Chicago Breast Health Project, we collected information on sociodemographic, reproductive, medical and lifestyle factors and percent breast density, assessed quantitatively using full-field digital mammography, from 294 Hispanic women. In our study, we examined the independent associations of hours per day of physical inactivity with percent breast density using multivariate linear regression analysis adjusting for age, education, body mass index, parity, menopausal status, use of hormone replacement therapy and smoking status. Overall, the mean percent breast density was low (i.e., 17.7%) and ranged from 1.9% to 54.6%. There was no difference in percent breast density for women who reported 1.5-3.0 hr of physical inactivity per day compared to women who reported 0 -1 hr per day (␤ ‫؍‬ -0.08, p ‫؍‬ 0.95), but percent density was marginally significantly higher for women who were reported at least 3.5 hr per day of physical inactivity (␤ ‫؍‬ 3.18, p ‫؍‬ 0.056). Results were similar, albeit less statistically significant, in analyses of pre/perimenopausal and postmenopausal women separately. These results support the need for further research investigating the effect of physical activity on breast cancer risk. © 2003 Wiley-Liss, Inc. Key words: breast density; life style factors; physical inactivity; HispanicStudies of primarily non-Hispanic women have shown consistent associations of age, reproductive factors, body mass index (BMI) and use of postmenopausal hormone replacement therapy (HRT) with the extent of mammographically detected fibroglandular breast density, which is strongly related to breast cancer risk. 1 However, there are few data on the relationships of breast density with other, modifiable lifestyle factors linked to breast cancer. For example, although higher levels of physical activity has been associated with a modestly lower risk of breast cancer in most epidemiologic studies, 2 only 2 cross-sectional studies assessed the relationship between physical activity and percent breast density. 3,4 In general, these studies found only weak or no evidence of an inverse association.Hispanics are the fastest growing ethnic group in the United States. 5 Thus, there is growing recognition of the need to include Hispanics in cancer epidemiology and prevention research. 6 To date, however, there is a paucity of data on breast cancer risk in Hispanic women. This is particularly concerning because breast cancer is the most commonly occ...

Diverticulosis of the small bowel, complicated by enterolith formation with ensuing obturation obstruction, was recently documented in two patients. One patient had an enterolith formed within a Meckel's diverticulum; the other had an enterolith dislodged from an acquired diverticulum. Both patients presented with signs and symptoms of acute small bowel obstruction. Only 20 such cases of bowel obstruction secondary to jejunal enterolithiasis and five cases secondary to Meckel's enterolithiasis have been reported. The mechanism of obstruction may involve local encroachment or enterolith expulsion with distal bowel obstruction, although the latter is much more common. Optimally, enteroliths are broken up and milked into the proximal colon without incising the bowel. Alternatively, the enterolith may be milked proximally to a less edematous portion of bowel and an enterotomy may be performed. At times, the primary diverticulum is resected with the contained enterolith.

Pharmacological therapies, and in particular biological agents, are the main cost driver in complex perianal CD; costs due to surgery and hospitalizations are much lower.