Zobrazení zdroje stránky Sutherlandpiper5318

7% (44/66) and 42.9% (15/35) were in remission. At M6 remission rates was significantly higher while response rates tended to be higher among biologic-naïve versus biologic-failure CD patients. Conclusions VDZ offers an effective treatment option in real-life settings and treatment effectiveness appears higher in biologic-naïve versus biologic-failure CD patients. (Acta gastroenterol. belg., 2020, 83, 15-23). © Acta Gastro-Enterologica Belgica.Background To assess mortality rate of oesophageal perforation cases and study their etiology, diagnosis and management in a single specialized UK centre. Patients and methods A prospective observational study was performed between January 2012 and January 2015. All consecutive patients admitted with acute iatrogenic or spontaneous esophageal perforation were included. Anastomotic leak patients were excluded. Patients were managed conservatively, endoscopically, surgically or with a combination of the above. Primary outcome was mortality rate and its association with time to hospital admission. Secondary outcomes were nature of perforation, anatomic location, type of management as well as length of hospital stay and surgical complication rate. Results There were 13 cases included. Mean patients' age was 58.3 years. Overall 90-day mortality rate was 38.4% (n=5), while 30-day mortality rate 30.8% (n=4). Admission within 24 hours of perforation was recorded in 69.2% of patients (n=9). The main anatomic location of perforation was the lower third of the esophagus in 53.8% (n=7). Operative management was adopted in 53.8% of cases (n=7). Mean hospital stay was 58.3 days. Mean follow-up was 3.1 years, while no patient developed any complication from the perforation or surgery. Conclusions Mortality following esophageal perforation is at approximately 40%, while there is a significant impact of time of presentation on prognosis. © Acta Gastro-Enterologica Belgica.Background and study aims Bleeding esophageal varices is a common life-threatening emergency that carries a significant morbidity and mortality. Acute variceal bleeding is considered active when spurting and/or oozing varix is seen at the time of endoscopy, or inactive in the presence of large esophageal varices with blood in the stomach with no other bleeding source at the time of endoscopy. Aim comparing endoscopic variceal ligation (EVL) versus cyanoacrylate injection (CI) in active esophageal variceal bleeding control. Patients and methods a retrospective single tertiary center study from April 2014 to February 2018, including 401 patients with active esophageal variceal bleeding. Results Endoscopic hemostasis was achieved by both endoscopic variceal ligation in 182 patients (91.9%) and cyanoacrylate injection in 197 patients (97.05%) without significant difference (P value 0. 15). Re-bleeding occurred more frequently in EVL group 20 patients (10.1%) compared to 14 patients (6.9%) in CI (P value 0.01). Early six-week Mortality was higher among EVL group (20.7%) compared to CI (17.2%) without statistical significance (P value 0.3). Conclusion Both EVL and CI are almost as effective in achieving endoscopic hemostasis. CI is more effective, feasible, and could be used as a salvage therapy and/or spared for risky active bleeding esophageal varices. © Acta Gastro-Enterologica Belgica.Bone transportation technology (Ilizarov technique) effectively solves the clinical problem of chronic osteomyelitis with structural bone defect. The paper combined with own clinical experience and a large number of literatures, the results showed that this method had some complications related to severe bone healing, such as non union of the joint ends and poor mineralization of the extended gap. Maintenance of force line during operation, protection of osteotomy end tissues, appropriate transporting velocity and stress stimulation after operation, and application of "accordion technology" are the keys to reduce such complications. At present, there is still much controversy about the timing of removal of external fixator. Once the re fracture is caused by early removal, it must be treated actively as soon as possible. In addition, it is necessary to reduce the local thermal injury of nail canal during operation and strengthen the nursing of nail canal after operation in order to prevent nail canal infection. Reasonable analgesic regimen combined with active functional exercise is an important method to avoid the occurrence of adjacent joint dysfunction.Heterotopic ossification is the formation of pathological bone in non-skeletal tissues (including muscles, tendons or other soft tissues), and the pathogenesis is not completely clear. It is often caused by musculoskeletal trauma, postoperative bone and joint surgery, or damage of the nervous system, the clinical manifestations are joint swelling, pain, and movement disorders, which often occur around the hips, knees, and elbows. At present, the prevention of heterotopic ossification mainly includes drugs, radiotherapy, molecular biological mechanism intervention, and Chinese medicine-related measures. Among them, drugs and radiotherapy are more effective methods to prevent heterotopic ossification. The intervention of molecular biology mechanism to prevent heterotopic ossification has become a new research direction and focus of attention inrecent years, and is basically at the experimental research stage. The treatment of heterotopic ossification includes various methods such as drugs, physical therapy, and surgery. Among them, surgery is recognized as the most effective treatment, however there are still some controversies and disagreements about the choice of operation time and surgical methods.OBJECTIVE To explore short-term curative effect of staging operation for large gouty stone on the first metatarsophalangeal joint. METHODS From January 2015 to December 2016, 12 patients with giant gout stone on the first metatarsophalangeal joint were treated with staging operation, including 12 males, aged from 45 to 73 years old, 6 cases on the right side and 6 cases on the left side. After conservative treatment for more than 2 years, the size and location of ventilator stone were detected by dual energy CT. The bone destruction of the first metatarsophalangeal joint was observed on X-ray examination. [https://www.selleckchem.com/ selleck inhibitor] All patients underwent stageⅠgout radical removal and temporary fixation with Kirschner wire, and metatarsophalangeal joint fusion and internal fixation were performed after local soft tissue conditions were stabilized. The level of blood uric acid before and after hand were compared, and correction and complications of limb deformity were observed, VAS score was applied to evaluate pain relieved degree. RESULTS All patients were successfully completed two stages ' operation.