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  • 2000-2004  (5)
  • 1
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Extracorporeal photochemotherapy has been proven effective in selected T-cell mediated diseases.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To evaluate the safety and efficacy of extracorporeal photochemotherapy in patients with steroid-dependent Crohn’s disease by an open, monocentric trial in three phases of 24 weeks each.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:In phase 1 standardized steroid tapering was initiated in patients with a history of steroid-dependent Crohn’s disease. Those with a prospectively evaluated maintenance dose of at least 10 mg/day prednisolone continued steroid-withdrawal under the application of extracorporeal photochemotherapy in phase 2. The duration of remission or response was followed during phase 3. Colonic tissue bioptically obtained before and after extracorporeal photochemotherapy was studied by immunofluorescence microscopy for the presence of photoadduct positive cells.〈section xml:id="abs1-4"〉〈title type="main"〉Results:Out of 24 patients included in phase 1, 10 entered phase 2 for extracorporeal photochemotherapy. Four subjects achieved remission and four others response. Significant reductions in serum C-reactive protein levels and intestinal permeability were measured, as well as increases in quality of life and plasma adrenocorticotropic hormone levels. No major side-effects were observed. Remission remained stable in three out of four patients during phase 3. In three patients, positive nuclear stainings of photoadducts were detected in colonic mononuclear cells after extracorporeal photochemotherapy.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:Extracorporeal photochemotherapy represents a safe steroid-sparing approach in patients with Crohn’s disease and is associated with intestinal homing of photopheresed cells.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 18 (2003), S. 0 
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : 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.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Conventional non-steroidal anti-inflammatory drugs have been associated with an increased risk of exacerbation of inflammatory bowel disease.Aim: To evaluate, in a prospective, open-label study, the safety and efficacy of a 20-day regimen of the selective cyclo-oxygenase-2 inhibitor, rofecoxib, 12.5–25 mg/day, in inflammatory bowel disease patients with associated peripheral arthropathy and/or arthritis.Methods: Patients with clinically inactive to mild inflammatory bowel disease and a joint pain score of at least two points on a scale ranging from zero (none) to four (very poor) were eligible. Response was defined by a decrease of at least two points in the arthralgia score.Results: Of the 32 patients included, 26 (81%) were treated with rofecoxib, 25 mg/day, and six (19%) with rofecoxib, 12.5 mg/day. In three patients (9%), rofecoxib had to be withdrawn after a few days due to gastrointestinal complaints which ceased immediately after drug discontinuation. No flare of inflammatory bowel disease occurred. Thirteen of the 32 patients (41%) were responders and, overall, the arthralgia score decreased from two to one (P = 0.0001).Conclusions: This is the first prospective study on the use of a selective cyclo-oxygenase-2 inhibitor in inflammatory bowel disease patients with peripheral arthropathy and/or arthralgia. The promising safety and efficacy profile warrants further evaluation in controlled trials.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: We aimed to investigate the influence of indoor factors on the prevalence of symptoms suggestive of atopic rhinitis in children aged 6–9 years in Upper Austria. Methods: We analyzed the results from an extended ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, answered by the parents, about indoor environment and symptoms strongly suggesting atopic rhinitis. This was defined as having reported a running, obstructed, or itchy nose apart from having a cold in the last year. The overall response rate was 93.4%. After excluding 6016 children (17.1%) with changed indoor environment (due to allergies in the family), we analyzed the remaining subsample of 18606 questionnaires. Results: The following factors were associated with an increased risk: mother's smoking during pregnancy and/or during time of breast-feeding (OR 1.28; CI 1.07–1.52), synthetic bedding (OR 1.21; CI 1.09–1.36), dampness/mold at home (OR 1.51; CI 1.31–1.74), central heating with gas (OR 1.75; CI 1.06–2.87), and space heating (OR 1.66; CI 1.01–2.98). Cooking with wood (OR 0.62; CI 0.46–0.84) was negatively associated with symptoms. Conclusions: The indoor environment plays a role in the symptoms of atopic rhinitis in children. However, the population-attributable risks were not particularly high; they were between −2.7% and 9% for the various exposures considered in this study.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 343-347 
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Stillen ; ISAAC ; Atopie ; Prädisposition ; Key words Breastfeeding ; ISAAC ; Atopy ; Predisposition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Background and methods: As part of the population – based ISAAC (International Study of Asthma and Allergy in Childhood) study conducted in Upper Austria we analyed breastfeeding and its effects on the development of atopic diseases in children up to the age of 6–9 years. Results: 74.6% of the parents reported breastfeeding their children; 25.9% of the children were breastfed for less than 2 months, 25.9% for 2 to 4 months, the recommended duration of exclusive breastfeeding for 5–6 months was followed by 13.2% of the mothers, and 10.4% of the children were exclusively breastfed for more than 6 months. Smoking during pregnancy and low educational level were inversly related to breastfeeding and the duration of exclusive breastfeeding. 23.8% of children were classified risk-children (one first grade relative with at least one atopic disease), 7.2% of children were classified high-risk children ( more than one first grade relative with an atopic disease). Discussion: In comparison to children without family predisposition, risk and high risk-children were breastfed both more often and also for a longer period of time. A protective effect of breastfeeding was only found for the prevalence of allergic rhinitis. We found no significant relation between asthma or atopic eczema and breastfeeding and dura-tion of exclusive breastfeeding respectively.
    Notes: Zusammenfassung Hintergrund und Methode: Im Rahmen einer ISAAC(International Study of Asthma and Allergy in Childhood)-Vollerhebung in Oberösterreich wurden die Stillgewohnheiten von Müttern und die Auswirkung des Stillverhaltens auf das Auftreten atopischer Erkrankungen der Kinder bis zum Alter von 6–9 Jahren analysiert. Ergebnisse: Insgesamt gaben 74,6% der Eltern (retrospektiv mittels Fragebogen) Stillen als Ernährungsform ihrer Kinder an; jeweils 25,9% der Kinder wurden weniger als 2 Monate bzw. 2–4 Monate ausschließlich mit Muttermilch ernährt, an die empfohlene Stilldauer von 5–6 Monaten hielten sich 13,2% der Mütter und 10,4% der Kinder wurden mehr als 6 Monate gestillt. Rauchen der Mutter und niedrige Bildung der Eltern zeigten eine signifikant inverse Beziehung zu Stillprävalenz und Stilldauer. 23,8% der Kinder wurden als Risikokinder (1 Verwandter 1. Grads mit zumindest einer atopischen Erkrankung) eingestuft, 7,2% der Kinder wurden als Hochrisikokinder (mehr als 1 Verwandter 1. Grads mit atopischer Erkrankung) bezeichnet. Diskussion: Im Vergleich zu Kindern ohne familiäre Belastung wurden Risikokinder und Hochrisikokinder signifikant häufiger und länger gestillt. Eine protektive Wirkung des Stillens konnte allerdings nur für das Auftreten einer allergischen Rhinitis festgestellt werden. Zwischen Stillverhalten bzw. Stilldauer und dem Auftreten von Asthma bronchiale und atopischem Ekzem bis zum Alter von 6–9 Jahren konnte kein signifikanter Zusammenhang gefunden werden.
    Type of Medium: Electronic Resource
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