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Budesonide for ulcerative colitis
Marín-Jiménez,I.; Pe?a,A. S.;
Revista Espa?ola de Enfermedades Digestivas , 2006, DOI: 10.4321/S1130-01082006000500007
Abstract: in this review, we examined studies published on oral and topical formulations of budesonide (entocort? and budenofalk?, in spain: entocord? and intestifalk?) for the treatment of ulcerative colitis. this glycocorticosteroid has a potent local action and an important first-pass liver metabolism. it has proven successful over the last years as a controlled-release formulation. it obtained results similar to prednisolone, without the latter's significant suppression of plasma cortisol. many publications exist on the effects of oral budesonide for the treatment of crohn's disease (cd). these have led to the registration of this drug for the treatment of cd. studies on oral formulations of budesonide for the treatment of ulcerative colitis (uc) are scarce. after reviewing published evidence, we suggest the conduction of controlled trials for the treatment of uc to obtain evidence-based efficacy and safety results in order to benefit patients with this form of inflammatory bowel disease (ibd).
Swallowed foreign body: Is interventional management always required?  [cached]
Al Shehri Gharamah,Al Malki Talal,Al Shehri Mohammed,Ajao Oluwole
Saudi Journal of Gastroenterology , 2000,
Abstract: A retrospective study of 20 cases diagnosed as "swallowed foreign body" seen over a five-year period (July 1993-June 1998) at Asir Central Hospital was performed. Six (30%) were children and 14 (70%) adults. In the children, five were boys and one was a girl. Objects swallowed included metal nails. coins, hair pins and a chain pendant. In the adult group, eight (57%) were males and six (43%) females. Objects swallowed included sewing needles, sharp blades, pieces of glass, paper clips and gravel. The swallowed foreign body in all the patients passed innocuously through the gastrointestinal tract in two to ten (average 4.7) days. Our method of treatment consisted of giving high fiber diet, Metamucil or lactulose and liquid paraffin. There was no mortality.
Use of budesonide in the treatment of microscopic colitis  [cached]
Tangri Vikram,Chande Nilesh
Saudi Journal of Gastroenterology , 2010,
Abstract: Collagenous colitis and lymphocytic colitis, the two types of microscopic colitis, cause watery diarrhea. Budesonide, a glucocorticoid medication with limited systemic availability, is commonly used to treat these illnesses. Budesonide has proven efficacy in the induction of clinical remission in both collagenous colitis and lymphocytic colitis. Budesonide is effective as a maintenance drug for patients with collagenous colitis, but has not been studied for this indication in patients with lymphocytic colitis. This drug improves quality of life in patients while causing few mild adverse events. Budesonide is an effective treatment of microscopic colitis that is safe and well tolerated.
Endoscopic Removal of an Inadvertently Swallowed Toothbrush in the Emergency Department
Martyn Harvey,Grant Cave,Gaynor Prince
Case Reports in Emergency Medicine , 2012, DOI: 10.1155/2012/568163
Abstract: A 16-year-old girl inadvertently swallowed a toothbrush during attempted manual induction of emesis. The 20 cm toothbrush was successfully removed via overtube facilitated endoscopy using a retractable snare while the patient was sedated in the emergency department.
Pharmacokinetics of topically applied sparfloxacin in rabbits  [cached]
Satia Milan,Mody Vandana,Modi Rajiv,Kabra P
Indian Journal of Ophthalmology , 2005,
Abstract: PURPOSE: Fluoroquinolones are antimicrobial agents that have a broad spectrum of activity and are widely used against many of the ocular pathogens, responsible for conjunctivitis, blepharitis, corneal ulcers etc. The aim of our study was to evaluate the ocular pharmacokinetics of sparfloxacin (0.3% w/v) in the aqueous humour of rabbits. MATERIALS AND METHODS: Pharmacokinetics of topically administered sparfloxacin were determined after a single application of 50 μl topically. The aqueous humour samples were collected at 0, 0.25, 0.5, 1, 2, 3, 4, 5 or 6 hours after instillation. High Performance Thin Layer Chromatographic method was used to analyse the drug concentration in the aqueous humour samples. RESULTS: Fifteen minutes after the instillation of 50 μl of sparfloxacin 0.3% solution, the mean concentration in aqueous humour was found to be 1.4 μg/ml, which reaches the peak level of 3.7 μg/ml after 1.3 hours. At 6 hours, the sparfloxacin aqueous levels were 0.562 μg/ml. The clinical efficacy was predicted based on the Maximum Concentration (Cmax): Minimum Inhibitory Concentration (MIC) and Area Under the Concentration-time curve (AUC):MIC ratios. CONCLUSION: The sparfloxacin levels in aqueous humour of rabbits are sufficiently high up to the 6 hours after instillation in the conjunctival sac to provide bactericidal effect against most of the ocular pathogens. Both Cmax:MIC and AUC:MIC ratios are high enough to provide bactericidal effect against most of the ocular pathogens. Sparfloxacin (0.3%) ophthalmic preparation has excellent penetration through cornea.
A swallowed sewing needle migrating to the liver
Serhat Avcu,?zkan ünal,?zkan ?zen,Ayd?n Bora
North American Journal of Medical Sciences , 2009,
Abstract: Context: Swallowing foreign bodies is a common problem in children. Although most objects pass through the gastrointestinal tract with no untoward effect; long, sharppointed, or slender objects can perforate the gut. Migration of a swallowed object to the liver is extremely rare and very few cases have been reported in the literature up to now. The aim of this study is to draw attention to this subject once again by contributing a case report of a child with hepatic migration of a swallowed sewing needle. Case Report: A 16-year-old girl presented to the emergency room of pediatrics department in our hospital with complaints of abdominal pain, nausea and vomiting. Physical examination revealed tenderness on the right upper quadrant of the abdomen. Laboratory examination revealed increased hepatic enzymes as well as increased white blood cell count. Abdominal ultrasonography and computed tomography examinations revealed foreign body in the liver accompanied by surrounding abscess formation. The foreign body (sewing needle) was removed surgically after two operations. Conclusion: The children may not be able to remember the swallowing of the foreign body or they may try to hide such a condition. The radiological diagnosis in such cases which can be achieved by X-rays, ultrasonography or computed tomography is of critical importance, as well as getting detailed patient history for foreign body swallowing.
Swallowed Words: bringing up an Aboriginal past in the city  [PDF]
Kristina Everret
Coolabah , 2011,
Abstract: Many Aboriginal stories have not been allowed to be told historically due to theover-whelming dominance of non-Aboriginal stories. Many Aboriginal stories were onceoutlawed and so were forgotten, some only partially remembered, many now only told in thelanguage of the invaders. There are other Aboriginal stories, however, especially those ofparticular urban Aboriginal peoples, which have lain ‘dormant’, protected by subversive familyhistories and embedded in objects claimed as the possessions of the Aboriginal peopleconcerned. Some of these once ‘swallowed’ stories are now being regurgitated, re-emerging intoa world that does not always recognise them as true. I am a non-Indigenous womananthropologist and in this paper I recount some different versions of a story ‘told’ in differentways; through the signs and symbols of the Australian nation state, the movements of myAboriginal research collaborators through what is claimed as their Country, through verbalstorytelling, and through artefacts and paintings.
Double balloon enteroscopy to retrieve an accidentally swallowed dental reamer deep in the jejunum  [cached]
Shingo Kato,Kazuhito Kani,Hidehiko Takabayashi,Ryuichi Yamamoto
World Journal of Gastrointestinal Endoscopy , 2011, DOI: 10.4253/wjge.v3.i4.78
Abstract: Accidentally swallowed foreign objects are not uncommon but difficult to manage without complications. We describe the case of a 68 year old man who accidentally a swallowed sharp-pointed dental reamer that had reached deep in his jejunum. Double balloon enteroscopic retrieval was performed with polypectomy snare but the reamer was entangled in the wire loop of the snare and penetrated the jejunal wall. After releasing the reamer by pushing and pulling the snare for approximately 30 min, the reamer was retrieved with biopsy forceps. This is the first report of double balloon enteroscopic removal of a dental reamer. Furthermore, this is a novel case with regard to decision making in situations when sharp objects are swallowed.
The significance of different formulations of aerosolized colistin
Argyris Michalopoulos, Sofia K Kasiakou, Matthew E Falagas
Critical Care , 2005, DOI: 10.1186/cc3506
Abstract: There are two different forms of colistin available for clinical use. Colistin sulfate is administered orally for bowel decontamination and is administered topically as a powder for the treatment of bacterial skin infections; and colistimethate sodium (also called colistin methanesulfate, pentasodium colistimethanesulfate, colistin sulfamethate, and colistin sulfonyl methate) is administered intravenously and intramuscularly [3]. It is obvious that the terminology regarding the different formulations of colistin may be confusing. Colistimethate sodium is produced by a sulfomethylation reaction of colistin in which the primary amine groups of L-α-γ-diaminobutyric acid are reacted with formaldehyde followed by sodium bisulfite [4].Both formulations of colistin (colistin sulfate and colistimethate sodium) have been used for aerosol treatment. However, colistimethate sodium is associated with fewer adverse effects such as chest tightness, throat irritation, and cough compared with colistin sulfate [5]. The formulation of colistin that was administered to our patients was therefore colistimethate sodium (i.e. the less toxic form of the drug), not colistin sulfate. In fact, the exact trade names of colistin that were administered to our patients are stated in our paper [2].S Mubareka and E RubinsteinWe would like to thank the authors for their response to our editorial [1]. We acknowledge that colistimethate may be better tolerated from a respiratory point of view. What remains unknown, however, is the systemic absorption of inhaled colistin in critically ill patients, particularly in those with pneumonia in whom the barrier between the alveolar cell layer and the vascular system may be damaged. It is appreciated that this parameter may not be determined in a retrospective study, and these preliminary results suggest that further research is called for.High-pressure liquid chromatography has been used to measure serum levels of colistin in humans [6]. Appreciable limitati
Endoscopic Removal of an Inadvertently Swallowed Toothbrush in the Emergency Department  [PDF]
Martyn Harvey,Grant Cave,Gaynor Prince
Case Reports in Emergency Medicine , 2012, DOI: 10.1155/2012/568163
Abstract: A 16-year-old girl inadvertently swallowed a toothbrush during attempted manual induction of emesis. The 20?cm toothbrush was successfully removed via overtube facilitated endoscopy using a retractable snare while the patient was sedated in the emergency department. 1. Introduction Foreign body ingestion represents a common emergency department presentation. While the vast majority of ingested foreign bodies traverse the gastrointestinal tract with nil adverse sequelae [1, 2], few require early endoscopic removal due to their corrosive nature [3], potential for alimentary tract perforation [4], or physical size [4]. We report a 16-year-old girl who accidentally swallowed a toothbrush which was extracted via endoscopy without complication. 2. Case A 16-year-old female presented to our tertiary care facility two hours following ingestion of a household toothbrush. She admitted to excess alcohol intake the evening prior and have woken feeling “hung-over.” Due to ongoing nausea, she had attempted to induce emesis via manual pharyngeal stimulation with a toothbrush. However, during this process, she claimed to have “choked,” lost control of the toothbrush handle, and ingested the “white-and-orange” toothbrush whole. Clinical examination revealed a well-appearing 16-year-old female in no distress. Mild pharyngeal abrasions were apparent on examination of the oral cavity. Cardiovascular, respiratory, and abdominal examination proved unremarkable; in particular no abdominal tenderness was reported on manual palpation. Soft tissue lateral X-ray of the neck and chest X-ray revealed no evidence of ingested foreign body. Endoscopic retrieval of the toothbrush was undertaken in the emergency department. Given the dimension of the ingested foreign body and anticipated requirement for overtube utilization, airway protection was afforded with endotracheal intubation following standard rapid sequence intubation (RSI). Sedation was maintained with propofol/ketamine combination. Gastroscopy was performed with visualization of the distal (brush) end of toothbrush protruding from the gastric outlet, the proximal (handle) having already traversed the pylorus (Figure 1). The brush was snared (Figure 2), and withdrawn en masse with the pictured overtube (Figure 3) to the level of cricopharyngeus. Removal was then completed under direct laryngoscopy with Magills forceps. Relook endoscopy was undertaken with confirmation of nil-induced trauma. Figure 1: Endoscopic view of toothbrush in gastric antrum, handle having disappeared into the pylorus. Figure 2: Attempted snare of
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