Biologics and immunomodulators for treating Crohn’s disease developing after surgery for an initial diagnosis of ulcerative colitis: a review of current literature

Crohn’s Disease (CD) or CD-like (CDL) conditions of the pouch are rare long-term inflammatory complications of patients who were initially diagnosed with ulcerative colitis (UC) who undergo total proctocolectomy with ileo-anal anastomosis (IPAA). There are no societal guidelines nor a consensus on their treatment, resulting in significant challenges for clinicians for their diagnosis and management. It is important to differentiate them from other more common pouch-related complications like pouchitis, cuffitis, irritable pouch syndrome, surgery associated stricture, and fistula. In this review, we focus on the less common presentation of CD and CDL conditions of the pouch and their treatment with the use of anti-TNF therapy with or without immunomodulator.     

Analyzing psychological conditions of field-workers in the construction industry

The Korean construction industry has experienced poor labor productivity and high accident rates. Previous studies have reported that workers’ mental health can cause negative impacts on work performance; thus, enhancing workers’ psychological conditions would help achieve more productive and safer workplaces. This research aimed to understand the level of psychological conditions of construction field-workers using four categories: (1) stress (occupational stress and stress-coping style), (2) personal temperament, (3) emotional disturbance (depression and trait anxiety), and (4) drinking habits. This research used validated questionnaires commonly used in the field of clinical psychology, surveyed 430 respondents from road, bridge, tunnel, subway, and apartment construction sites in Korea, and analyzed the overall psychological tendency of construction workers with the collaboration of professional clinical psychologists using the Z-test, analysis of variance (ANOVA), and cross-tabulation. The research also investigated how the mental conditions differed according to different working conditions, such as demographic information, employment status, work types, work experience, and wage conditions. The results indicated that construction workers suffer from a high level of stress and showed high inclination for problem-focused coping: impulsive, cautious, and dependent on other people. Two out of five construction workers suffer from depression and experience trait anxiety. More seriously, three out of five workers show alcohol-use problems that require clinical attention. This study also revealed the particular psychological problems that occur under different working conditions. The findings can be used to promote the awareness of the importance of construction workers’ mental well-being and to help in setting targets for improvement.     

Effectiveness of ‘in-cast’ pneumatic intermittent pedal compression for the pre-operative management of closed ankle fractures: A clinical audit

BackgroundTiming of surgery for ankle fractures is largely dependent on the condition of the surrounding soft-tissues. This study aimed to determine the clinical effectiveness of a pre-operative in-cast artero-venous (AV) impulse device in the management of closed ankle fractures requiring surgery.MethodsA consecutive series of 64 closed ankle fractures were managed using the AV impulse system prior to surgery. Patients were compared to 73 consecutive closed ankle fractures managed surgically in the same unit immediately prior to the implementation of the AV impulse device study. Outcomes measured were time to surgery, length of hospital stay and surgical site infections.ResultsMedian length of time to surgery, hospital stay duration and surgical site infections were all significantly reduced in the study group as compared to the control group.ConclusionsIn-cast intermittent AV compression foot pumps in the pre-operative management of closed ankle fractures were associated with earlier surgery, earlier discharge and reduced complications.     

恶性肿瘤治疗中维和策略的实施与思考

健康是一种和谐的状态,是一些成对的相反因素之间的平衡,中医学谓之"阴平阳秘,精神乃治"。人体内外环境失和,脏腑阴阳气血失调,正气亏虚,加之外邪、情志、饮食等多种因素作用于人体,就会出现虚、痰、瘀、毒等病理改变,导致肿瘤的发生发展。晚期肿瘤不能手术,不能耐受放化疗,但并非意味着"不治",可通过一定的方法和手段,维持人体内环境的相对和谐稳定,使肿瘤失去生长的环境,调动人体自身的抗病能力达到抑制肿瘤生长的目的,使患者长期带瘤生存。常用的治法有补法、消法、和法等,一般而言,发病早中期正盛邪实,正气尚盛,消法为主以祛邪;中后期正虚邪稽,正气衰败,注重补法以扶正;放化疗期则以和法为主。临床表现复杂多样,具体治法运用必须知常达变,消中有补,补中有消,和中有消,消中有和,从而获得预期效果。     

Effect of litter quality on foot pad dermatitis,hock burns and breast blisters in broiler breeders during the production period

Foot pad dermatitis and hock burn lesions are a form of contact dermatitis, a condition affecting skin areas in contact with unsuitable or irritating material. Contact dermatitis is a common problem, reducing the welfare of broilers, and is believed to also affect broiler breeders. However, there is very little research on contact dermatitis in breeders. This study followed the severity of foot pad lesions in broiler breeders throughout the production period. At slaughter the presence of hock burns and breast blisters was also determined. In addition, changes in litter condition over time and the impact of litter quality on foot pads were evaluated. The study was performed on 10 broiler breeder farms, including altogether 18 flocks. Foot pads of 100 hens per flock were assessed at the end of rearing period, three times during the production period, and at slaughter. Foot pad and hock lesions, as well as litter condition were scored on a 5-point scale. Litter quality was evaluated as pH, moisture and ammonia content. The condition of foot pads deteriorated towards slaughter age, with the occurrence of severe lesions reaching a maximum of 64% on average at slaughter. Hock lesions and breast blisters were rare. The litter layer became drier over time. Although poorer litter condition and wetness influenced foot pad health negatively, the effect on severe lesions was not significant. We also observed a negative effect on foot pad condition of larger slat areas. In conclusion, maintaining good litter quality alone is not enough to ensure healthy foot pads in broiler breeders.     

Factors associated to repeated influenza vaccination in the Portuguese adults with chronic conditions

Annual influenza vaccination is recommended to people with chronic conditions. This study aimed to estimate the proportion of chronically ill adults vaccinated against influenza in consecutive seasons and to identify associated factors.We used data from the first National Health Examination Survey (INSEF), a cross-sectional study conducted in 2015 on a probabilistic sample of individuals aged 25–74 years. The population was restricted to individuals who self-reported diabetes, a respiratory, cardiovascular, liver or kidney disease. Self-reported vaccination in 4 consecutive seasons was categorized in 3 levels: unvaccinated, occasionally (vaccinated 1–3 seasons) and repeatedly vaccinated (in all 4 seasons). A multinomial logistic regression was applied to estimate odds-ratio (OR) of influenza vaccination according to sociodemographic factors, chronic condition, health care use and status.In the target population, the 2014/15 influenza vaccine coverage was 33.8% (95% CI: 29.8–38.1). The higher coverage was found in individuals reporting renal disease (66.7%) and diabetes (43.8%). The coverage decreased to 32.6%, 26.0% and 20.8% for individuals with respiratory, cardiovascular and liver diseases, respectively. The probability of being repeatedly vaccinated, compared to unvaccinated, was higher in males (OR = 2.14: 95% CI: 1.31–3.52); aged 65 and 74 (OR = 4.39; 95% CI: 1.99–9.69); whom had an appointment with a general practitioner (OR = 2.77; 95% CI: 1.00–7.66) or other physician (OR = 3.95: 95% CI: 2.53–6.16); with no smoking habits (OR = 1.58; 95% I: 1.02–2.46) and reporting diabetes (OR = 2.13; 95% CI: 1.02–4.45). Finally, having a self-reported cardiovascular condition decreased the likelihood of being occasionally (OR = 0.38; 95% CI = 0.22–0.65) vaccinated against influenza.Younger individuals, females and the ones with a self-reported cardiovascular condition were identified as more likely of non-compliance to the vaccine uptake recommendation. Future vaccination strategies should focus on the previous identified population subgroups. Also, the medical recommendation of the influenza vaccine uptake should continue and be reinforced particularly in individuals with a cardiovascular condition.     

Quantitative Analysis of the Growth of the hip jo Int: A Radiological Study

Growth of the hip joint is described on the basis of annual radiographs taken of the intact hip joints of 50 boys aged between 5–15 years. the ossification centre of the femoral head grows at a faster rate in breadth than in height. the growth rate in breadth of the bony centrum exceeds also that of the proximal metaphysis and, accordingly, in the case of normal ossification, the radio-anatomical condition of these two parts is characteristic of the age of the individual. the osseous acetabulum also grows at a faster rate in breadth than in depth. in the period studied up until the 15th year the width of the “articular space” gradually decreases. the ossification rate in the age group examined manifests—with slower and faster periods—a gradually declining tendency. the changes revealed by the radiographs have been interpreted from the viewpoint of bone development and an analysis is also given of the spatial conditions of ossification.     

人芽囊原虫在不同培养基中生长状况的观察

目的筛选培养人芽囊原虫的最适培养基。方法将同一株人芽囊原虫阳性粪便标本以2×105细胞/管接种至RPMI1640、199和LES培养基中,加入20%小牛血清及青、链霉素,pH值为7.5,放置厌氧罐中于37℃恒温培养,每24h计数,每6d转种1次。观察人芽囊原虫在3种培养基中的存活时间、虫体密度和虫体形态。结果人芽囊原虫在RPMI1640培养基中存活时间最长、虫体密度最高,虫体以空泡型多见;在LES培养基中存活时间最短、虫体密度最低,但虫体形态清晰、规则;在199培养基中存活时间和虫体密度均介于前两者之间。结论RPMI1640培养基适宜人芽囊原虫的生长繁殖,为人芽囊原虫体外培养的首选培养基;LES培养基中虫体形态清晰、规则,可用于人芽囊原虫的形态学研究;199培养基也可用于人芽囊原虫的体外培养,但不作为首选。