Crohn's disease (CD) is a chronic inflammatory disease of the digestive tract with systemic manifestations. Etiology is unknown, even if immunological, genetic and environmental factors are involved. The majority ...Crohn's disease (CD) is a chronic inflammatory disease of the digestive tract with systemic manifestations. Etiology is unknown, even if immunological, genetic and environmental factors are involved. The majority of CD patients require surgery during their lifetime due to progressive bowel damage, but, even when all macroscopic lesions have been removed by surgery, the disease recurs in most cases. Postoperative management represents therefore a crucial mean for preventing recurrence. Several drugs and approaches have been proposed to achieve this aim. Endoscopic inspection of the ileocolic anastomosis within 1 year from surgery is widely encouraged, given that endoscopic recurrence is one of the greatest predictors for clinical recurrence. A strategy should be planned only after stratifying patients according to their individual risk of recurrence, avoiding unnecessary therapies when possible benefits are reduced, and selecting high-risk patients for more aggressive intervention.展开更多
Pediatric glaucoma is a potentially sight-threatening disease and is considered the second leading cause of treatable childhood blindness.Pediatric glaucoma is a clinical entity including a wide range of conditions:pr...Pediatric glaucoma is a potentially sight-threatening disease and is considered the second leading cause of treatable childhood blindness.Pediatric glaucoma is a clinical entity including a wide range of conditions:primary congenital glaucoma,glaucoma secondary to ocular(e.g.,aniridia,Peter’s anomaly),or systemic disease(e.g.,Sturge Weber)and glaucoma secondary to acquired condition(pseudophakic,traumatic,uveitic glaucoma).The treatment algorithm of childhood glaucoma is a step-by-step approach,often starting with surgery,as in primary congenital glaucoma cases.Medical therapy is also crucial in the management of pediatric glaucoma.Here we reported the results of the randomized,controlled,clinical trials carried out in children treated with topical anti-glaucoma drugs.It is worth knowing that prostaglandin analogues showed an excellent systemic safety profile,while serious systemic events have been reported in children taking topical beta-blockers.Angle surgery is the first surgical option in patients diagnosed with primary congenital glaucoma,with ab interno and ab externo approaches showing similar outcomes.Trabeculectomy in children can be troublesome,as mitomycin C(MMC)can lead to bleb complications and a higher endophthalmitis rate than in adults.Glaucoma drainage devices(GDD)are no longer a last resort and can be considered a suitable option for the management of uncontrolled pediatric glaucoma after angle surgery failure.展开更多
文摘Crohn's disease (CD) is a chronic inflammatory disease of the digestive tract with systemic manifestations. Etiology is unknown, even if immunological, genetic and environmental factors are involved. The majority of CD patients require surgery during their lifetime due to progressive bowel damage, but, even when all macroscopic lesions have been removed by surgery, the disease recurs in most cases. Postoperative management represents therefore a crucial mean for preventing recurrence. Several drugs and approaches have been proposed to achieve this aim. Endoscopic inspection of the ileocolic anastomosis within 1 year from surgery is widely encouraged, given that endoscopic recurrence is one of the greatest predictors for clinical recurrence. A strategy should be planned only after stratifying patients according to their individual risk of recurrence, avoiding unnecessary therapies when possible benefits are reduced, and selecting high-risk patients for more aggressive intervention.
文摘Pediatric glaucoma is a potentially sight-threatening disease and is considered the second leading cause of treatable childhood blindness.Pediatric glaucoma is a clinical entity including a wide range of conditions:primary congenital glaucoma,glaucoma secondary to ocular(e.g.,aniridia,Peter’s anomaly),or systemic disease(e.g.,Sturge Weber)and glaucoma secondary to acquired condition(pseudophakic,traumatic,uveitic glaucoma).The treatment algorithm of childhood glaucoma is a step-by-step approach,often starting with surgery,as in primary congenital glaucoma cases.Medical therapy is also crucial in the management of pediatric glaucoma.Here we reported the results of the randomized,controlled,clinical trials carried out in children treated with topical anti-glaucoma drugs.It is worth knowing that prostaglandin analogues showed an excellent systemic safety profile,while serious systemic events have been reported in children taking topical beta-blockers.Angle surgery is the first surgical option in patients diagnosed with primary congenital glaucoma,with ab interno and ab externo approaches showing similar outcomes.Trabeculectomy in children can be troublesome,as mitomycin C(MMC)can lead to bleb complications and a higher endophthalmitis rate than in adults.Glaucoma drainage devices(GDD)are no longer a last resort and can be considered a suitable option for the management of uncontrolled pediatric glaucoma after angle surgery failure.
