Anti-tumour necrosis factor-α(TNF) therapy has revolutionised the management of chronic inflammatory conditions.With ever increasing numbers of patients being treated with these agents,uncommon adverse reactions will...Anti-tumour necrosis factor-α(TNF) therapy has revolutionised the management of chronic inflammatory conditions.With ever increasing numbers of patients being treated with these agents,uncommon adverse reactions will inevitably occur more frequently.Cutaneous manifestations are associated with many of these chronic conditions and can complicate anti-TNF therapy in about 20% of cases.Vasculitic complications are rarely associated with anti-TNF therapy.Henoch-Schnlein purpura(HSP),a small vessel vasculitis,has been described following infliximab and etanercept therapy but never with adalimumab,a fully humanized TNF antibody.The risk of such immune-mediated reactions is theoretically less with adalimumab compared to infliximab but can still occur.Here we report the f irst case in the literature of HSP that can be attributed to the use of adalimumab in a 19-year-old male with recalcitrant Crohn's disease.展开更多
AIM： To compare high resolution colonoscopy （Olympus Lucera） with a megapixel high resolution system （Pentax HiLine） as an in-service evaluation. METHODS： Polyp detection rates and measures of performance were c...AIM： To compare high resolution colonoscopy （Olympus Lucera） with a megapixel high resolution system （Pentax HiLine） as an in-service evaluation. METHODS： Polyp detection rates and measures of performance were collected for 269 colonoscopy procedures. Five colonoscopists conducted the study over a three month period, as part of the United Kingdom bowel cancer screening program. RESULTS：There were no differences in procedure duration （x^2 p = 0.98）, caecal intubation rates （x^2 P = 0.67）, or depth of sedation （x^2 P = 0.64）. Mild discomfort was more common in the Pentax group （x^2 p = 0.036）. Adenoma detection rate was significantly higher in the Pentax group （x^2 test for trend P = 0.01）. Most of the extra polyps detected were flat or sessile adenomas. CONCLUSION： Megapixel definition colonoscopes improve adenoma detection without compromising other measures of endoscope performance. Increased polyp detection rates may improve future outcomes in bowel cancer screening programs.展开更多
文摘Anti-tumour necrosis factor-α(TNF) therapy has revolutionised the management of chronic inflammatory conditions.With ever increasing numbers of patients being treated with these agents,uncommon adverse reactions will inevitably occur more frequently.Cutaneous manifestations are associated with many of these chronic conditions and can complicate anti-TNF therapy in about 20% of cases.Vasculitic complications are rarely associated with anti-TNF therapy.Henoch-Schnlein purpura(HSP),a small vessel vasculitis,has been described following infliximab and etanercept therapy but never with adalimumab,a fully humanized TNF antibody.The risk of such immune-mediated reactions is theoretically less with adalimumab compared to infliximab but can still occur.Here we report the f irst case in the literature of HSP that can be attributed to the use of adalimumab in a 19-year-old male with recalcitrant Crohn's disease.
基金Supported by Proportion of UCLH/UCL funding from the Department of Health’s NIHR Biomedical Research Centres funding schemeA grant from the UCL experimental cancer medicine centreUnrestricted educational grant support from Pentax United Kingdom (Lovat LB)
文摘AIM： To compare high resolution colonoscopy （Olympus Lucera） with a megapixel high resolution system （Pentax HiLine） as an in-service evaluation. METHODS： Polyp detection rates and measures of performance were collected for 269 colonoscopy procedures. Five colonoscopists conducted the study over a three month period, as part of the United Kingdom bowel cancer screening program. RESULTS：There were no differences in procedure duration （x^2 p = 0.98）, caecal intubation rates （x^2 P = 0.67）, or depth of sedation （x^2 P = 0.64）. Mild discomfort was more common in the Pentax group （x^2 p = 0.036）. Adenoma detection rate was significantly higher in the Pentax group （x^2 test for trend P = 0.01）. Most of the extra polyps detected were flat or sessile adenomas. CONCLUSION： Megapixel definition colonoscopes improve adenoma detection without compromising other measures of endoscope performance. Increased polyp detection rates may improve future outcomes in bowel cancer screening programs.
