Epidemiology and clinical course of drug-induced liver injury

Effectiveness of adalimumab for ulcerative colitis: A multicentre, retrospective study of clinical practice in Italy.

Abstract Background Adalimumab is used to treat ulcerative colitis, but additional effectiveness and safety data are needed. Patients and methods This retrospective study considered adults with ulcerative colitis treated with adalimumab at 19 hospitals. Clinical data were collected from the start of treatment, after 2, 6 and 12 months, and at the last visit. Outcome measures of effectiveness were treatment duration, reasons for discontinuation and colectomy. Results We studied 381 patients treated with adalimumab for a median of 12.1 months. Disease activity at the start of treatment was moderate to severe in 262 cases (68.8%) and endoscopic activity was moderate to severe in 339 cases (89.…

Adalimumab in active ulcerative colitis: A “real-life” observational study

Abstract Background and aims The effectiveness of adalimumab in the treatment of ulcerative colitis is under debate. Although controlled trials have shown that adalimumab is significantly better than placebo, the absolute clinical benefit is modest. We report data on the effectiveness of adalimumab in a cohort of ulcerative colitis patients treated in 22 Italian centres. Methods All patients with active disease treated with adalimumab were retrospectively reviewed. Co-primary endpoints were clinical remission at weeks 4, 12, 24 and 54. Secondary endpoints were sustained clinical remission, steroid discontinuation, endoscopic remission and need for colectomy. Results Eighty-eight patients we…

MR enteroclysis versus conventional enteroclysis in Crohn’s disease patients

Learning objectives: To provide a detailed step-by-step description of the technique of MR enteroclysis (MRE). To illustrate the spectrum of MRE findings in patients with Crohn’s disease (CD) and their correlation with findings at conventional enteroclysis (CE). To discuss the advantages and limitations of MRE in patients with CD. Background: CE is the gold standard for small bowel pathologies. However, submucosal and mesenteric involvements, which are common in CD, cannot be assessed by CE. Therefore, the evaluation of the mucosa alone by CE may under-represent the extent and activity of the disease. Also, CE is associated with the risk of several complications, mainly exacerbation in seve…

Personality Traits, Defense Mechanisms and Perception of Quality of Life (QOL) in Patients With Inflammatory Bowel Disease (IBD) and Matched Controls

Dizziness and vertigo in a department of emergency medicine.

Dizziness is a common and vexing diagnostic problem in emergency departments. The term is rather undefinite and often misused, but can in practice be classified into four categories: fainting, disequilibrium, vertigo and miscellaneous syndromes. Vertigo is the most common category of dizziness. Classification of vertigo can be based either on chronological criteria (acute, recurrent or chronic vertigo) or on topographical criteria (peripheral or central vertigo). Physicians working in emergency departments must be able to rapidly identify patients with potentially serious forms of vertigo, which could cause death or disability, and patients with mild conditions, that can be effectively trea…

Tumor Necrosis Factor Alpha Antagonists and Occurrence of Autoantibodies in Inflammatory Bowel Disease Patients: A Single Center Experience

Background & Aims: Appearance of auto antibodies have been described during anti-tumor necrosis factor (TNF) alpha therapy; however, their prevalence and clinical relevance are still unclear. We investigated prevalence of autoantibodies in inflammatory bowel diseases (IBD) patients on anti-TNFα treatment and occurrence of clinical symptoms. Methods: Titers of ANA, anti-dsDNA, SMA, AMA, LKM were evaluated from blood samples in patients receiving anti-TNFα inhibitor (adalimumab, infliximab). Results: Among 39 patients treated with anti-TNFα therapy, twenty of them developed ANA, mostly induced by infliximab. 55% ANA positive patients developed peripheral polyarthralgias with no need for inter…