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Psychological factors such as a depressive mood associated with anxiety and impaired HRQOL may exert a negative influence on the course of IBD. Therefore, assessment and management of psychological distress should be included in clinical treatment of patients with IBD.

Our telemedical support program, VIE-DIAB, proved to be feasible in adolescents and helped to improve glycemic control.

Most patients who have anemia associated with Crohn disease respond to intravenous iron alone. Erythropoietin has additional effects on hemoglobin concentrations.

SummaryBackground : Antibiotics and thiopurines have been employed in the management of fistulizing Crohn's disease, although evidence of their efficacy is rare.Aim : To evaluate, in a prospective, open‐label study, the influence of antibiotics and azathioprine on the clinical outcome of perianal fistulas in patients with Crohn's disease.Methods : Fifty‐two patients entered the study, starting with an 8‐week regimen of ciprofloxacin (500–1000 mg/day) and/or metronidazole (1000–1500 mg/day). Seventeen patients had already received daily azathioprine (2–2.5 mg/kg) at enrolment, whereas in 14 patients azathioprine was initiated after 8 weeks of antibiotic treatment. Outcome was evaluated by Fistula Drainage Assessment and the Perianal Disease Activity Index at weeks 8 and 20.Results : Overall, 26 patients (50%) responded to antibiotic treatment, with complete healing in 25% of patients at week 8. The Perianal Disease Activity Index decreased significantly from 8.4 ± 2.9 to 6.0 ± 4.0 (P < 0.0001). At week 20, the outcome was assessed in 49 patients (94%), 29 of whom (59%) had received azathioprine. Response was noted in 17 of the 49 patients (35%), with complete healing in nine patients (18%). Patients who received azathioprine were more likely to achieve a response (48%) than those without immunosuppression (15%) (P = 0.03). The Perianal Disease Activity Index was closely associated with treatment response and perianal disease activity.Conclusion : Antibiotics are useful to induce a short‐term response in perianal Crohn's disease, and may provide a bridging strategy to azathioprine, which seems to be essential for the maintenance of fistula improvement.

The increased likelihood of homicide in subjects with MMDs cannot be fully explained by comorbid alcoholism. The results point to the special importance of sufficient treatment for a subgroup of mentally ill individuals being at higher risk of violence.

No abstract

Changes in EEG background activity are powerful but nonspecific markers of brain dysfunction. Early EEG and amplitudeintegrated EEG (aEEG) pattern predict further neurodevelopmental outcome in term infants; however, sufficient data for prognostic value of aEEG in preterm infants are not available so far. The aim of the study was to evaluate whether aEEG predicts further outcome and to compare it to cerebral ultrasound assessment. In 143 preterm infants, aEEG within the first 2 wk of life and outcome data at 3 y of age (Bayley Scales) could be obtained .aEEG was classified into a graded score according to background activity, appearance of sleep-wake cycling, and occurrence of seizure activity. In preterm infants, aEEG was significantly associated with further outcome. Specificity was 73% for assessment within the first and increased to 95% in the second week of life, whereas sensitivity stayed nearly the same 87% (first week) to 83% (second week). Cerebral ultrasound showed a specificity of 86% within the first and second week, sensitivity also stayed nearly the same (74 and 75%). aEEG has a predictive value for later outcome in preterm infants and can be used as an early prognostic tool. D espite recent advances in perinatal care, the incidence of impaired outcome in preterm infants has not decreased. Rates of CP and overt cerebral lesions [e.g. cystic leukomalacia and intraventricular hemorrhage (IVH)] are decreasing, but the incidence of neurodevelopmental impairment stays high in preterm infants. This is due to different mechanisms in brain injury (e.g. inflammation, oxidative stress, impaired connectivity) and result in mainly cognitive impairment (1-3). Extensive studies have demonstrated the usefulness of cerebral ultrasound (CUS) in detecting cerebral lesions and predicting neurological outcome (4 -7). Also conventional EEG is proven to be useful in evaluating brain function and in predicting further development (8). On the background of an acute brain insult, EEG activity shows various degrees of depression and its severity parallels the magnitude of the brain lesion. These "acute-stage" abnormalities gradually improve with time and are replaced by "chronic-stage" abnormalities such as dysmaturity and disorganization. Several studies suggest that acute changes in the EEG background are powerful but nonspecific markers of brain dysfunction (8,9). In addition, a correlation between chronic-stage abnormalities and cognitive impairment is suggested (10 -13). Although early postnatal EEG has been used increasingly in preterm infants during the last years, there is no clear evidence to confirm its prognostic value in preterm infants of Ͻ30 wk GA (9).The most dominant feature of the extremely preterm infants' EEG is discontinuity, making a "grading" and "severityscoring" in terms of depression in these infants difficult. Furthermore validated reference criteria with regard to maturation and appearance of sleep-wake cycling (SWC) to score "disorganization" and/or "dysmaturity" are still scarce.Recordi...