Factors influencing postoperative recurrence of Crohn's disease in childhood
Article Abstract:
Crohn's disease is an inflammatory condition affecting the ileum and colon. Surgical resection of the affected intestinal segment is one of the most effective treatments, virtually assuring an asymptomatic period following surgery. Although there is a high probability of disease recurrence, success rates are often higher than with other treatment strategies such as steroid administration and dietary therapy, which are fraught with undesirable side effects and problems maintaining patient compliance. This is particularly so with younger (under 21 years of age) patients. To determine which factors influence the likelihood of recurrence of Crohn's disease following surgery in children, the records of 82 patients (average age 14.8 years) undergoing their first intestinal resection between 1970 and 1987 were reviewed. Anatomical location of the disease was a strong predictor of recurrence; patients with extensive involvement of the ileum and colon were much more likely to suffer relapse in the first year than patients with more restricted localization. Patients who underwent surgery because of failure of other forms of medical therapy were also much more likely to have recurrence of inflammation than were patients who underwent surgery for a specific intestinal complication (such as an abscess or obstruction). Finally, preoperative duration of disease was a strong predictor of rate of relapse; patients undergoing surgery within one year of symptom onset were much less likely to have recurrent inflammation than patients with longer symptom onset-surgery intervals. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1991
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Fifth disease and other parvovirus B19 infections
Article Abstract:
There are five commonly occurring childhood exanthematous diseases. These illnesses involve rash accompanied by inflammation and include measles (rubeola), chickenpox (varicella), german measles (rubella), scarlet fever and fifth disease. Fifth disease, caused by parvovirus B19, is also known as erythema infectiosum (EI) and the slap-in-the-face disease because of the red appearance of the patient's face. Parvovirus 19 is also responsible for two other distinct clinical entities: aplastic crisis (AC; deficient red blood cell production) and intrauterine infections causing fetal loss. The greatest risk of this virus is a nosocomially- or hospital-acquired infection in pregnant women. AC is a major concern for patients with pre-existing conditions, such as sickle cell anemia and other chronic hemolytic diseases (which involve the destruction of red blood cells). The virus is usually shed in respiratory secretions. Transmission can occur via the respiratory route, through blood and blood products, and transplacentally (across the placenta from mother to fetus). There is no effective treatment or vaccine to prevent the infections caused by parvovirus B19. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Heart and Lung
Subject: Health
ISSN: 0147-9563
Year: 1991
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