Biomedical subjects

M G Russel

Publications and source records attributed to M G Russel.

23 records · Page 2Linked to original sources

PubMed1996

Cigarette smoking and quality of life in patients with inflammatory bowel disease. South Limburg IBD Study Group.

OBJECTIVE: Smoking has been reported as influencing disease activity in inflammatory bowel disease. The aim of our study was to elucidate the relationship between smoking and aspects of disease-specific quality of life in inflammatory bowel disease. DESIGN: Cross-sectional study. METHODS: In 1105 prevalent patients with inflammatory bowel disease, diagnosed according to the criteria of Lennard-Jones and Truelove and Witts, disease-specific quality of life was investigated using the Inflammatory Bowel Disease Questionnaire (IBDQ). RESULTS: In Crohn's disease, smoking females reported a lower quality of life than non-smoking females (all four dimensions of the IBDQ). Using an explanatory model of relationships between the four dimensions for the analysis, it became evident that smoking is associated with more bowel symptoms in young Crohn's disease females, with more emotional dysfunction in all Crohn's disease females, and with more systemic symptoms in all three diagnostic groups with marked bowel symptoms. Moderately smoking male ulcerative colitis patients reported fewer bowel complaints compared with non-smoking male ulcerative colitis patients. CONCLUSION: There is a relationship between smoking and disease-specific quality of life in both ulcerative colitis and Crohn's disease. The hypothesis is presented that a part of the observed differences in the studied quality of life dimensions with respect to age, sex and disease group are related to concomitant oral contraceptive use.

Adolescent↗

PubMed1996

Epidemiology of inflammatory bowel disease: an update.

What have epidemiologic studies on IBD taught so far? Consistent findings are as follows: A high incidence of both CD and UC in industrialized countries and an increase in these areas of the incidence of CD during the years 1960-80 followed by a plateau phase, and a more stable pattern in UC during the same period have been found. A greater number of mild cases have probably been diagnosed recently. This also helps to explain the differences in severity and survival between community and referral centre groups. The male to female ratio is greater than 1 in UC, and this is the opposite in CD. Mortality of IBD has decreased during the past decades. As young people are especially prone to develop IBD, most of those affected will have their disease for many years. In developing IBD, genetic influences are of importance. However, epidemiologic studies strongly point to possible interactions between genetically determined features and environmental or other factors. Of these exogenic factors smoking is the most consistent, being of negative influence in CD and protective in UC. Diet and oral contraceptives may influence disease expression, and perinatal events such as viral infections may alter adult susceptibility. The question remains open whether UC and CD are one diseases entity. Similarities in the epidemiologic features of UC and CD support the idea of IBD being one disease. Other findings suggest dividing UC and CD into further subgroups: in CD it has been suggested that fibrostenotic, penetrating, and inflammatory behaviour should be considered different disease entities; in UC some groups consider ulcerative proctitis a disease entity on its own, separating it from the proximally extending colitis. In therapeutic trials this approach has proved to be of importance, and it is not inconceivable that in subgroups, with regard to aetiopathogenetic mechanisms, different factors have to be looked for.

Adolescent↗

PubMed1994

Eosinophilic enterocolitis diagnosed by means of technetium-99m albumin scintigraphy and treated with budesonide (CIR).

A patient with a 15 year history of diarrhoea of unknown origin is described. Scintigraphy with technetium-99m labelled albumin suggested albumin loss at the terminal ileum and caecum; subsequent colonoscopic biopsies of these macroscopically normal looking areas showed abundant infiltration with eosinophils. A diagnosis of eosinophilic enterocolitis was made. Treatment with prednisolone had good results, but had to be stopped because of severe side effects. Oral cromoglycate and mesalazine were not effective. Budesonide (CIR), a new topically active corticosteroid with very little systemic effects, was at least as effective as prednisolone without producing side effects.

Adult↗

PubMed1992

The extent of diffuse intravascular coagulation and fibrinolysis in patients with liver cirrhosis.

Twenty-five patients with different stages of liver cirrhosis were evaluated with regard to the degree of liver synthesis reduction, the extent of the decrease of blood coagulation factors and/or alterations of the fibrinolytic system. For the assessment of the residual level of liver synthesis we used pseudo-cholinesterase and serum albumin as references. We did not find a correlation between these quantities and antithrombin III or fibrinogen, but highly significant inverse correlations with tissue plasminogen activator activity and D-dimer concentration. We found considerable alterations in the concentrations of the coagulation and fibrinolysis factors, with the exception of fibrinogen and plasminogen activator inhibitor. Significant increases were seen for thrombin-antithrombin III complex, tissue plasminogen activator activity and D-dimer, while significant decreases were seen for antithrombin III and alpha 2-antiplasmin, compared with a group of healthy volunteers. In the group of patients with liver cirrhosis and reduced liver synthesis, as documented by lowered pseudo-cholinesterase and serum albumin, the reduction of both antithrombin III and alpha 2-antiplasmin was most prominent. Intravascular coagulation was negligibly small. For the fibrinolytic system, the increase of tissue plasminogen activator, the decrease of the fibrinolysis inhibitor (alpha 2-antiplasmin) and the elevated D-dimer concentration seem to be important. These results suggest an acceleration of fibrinolysis and the prolonged presence of cross-linked fibrin degradation products.

Adult↗

PubMed1992

Porphyria cutanea tarda in a patient with AIDS.

A 53-yr-old man, known to have had AIDS for 6 months, developed the clinical signs and symptoms of porphyria cutanea tarda (PCT) preceding deterioration of his illness. Urinary porphyrin analysis confirmed the diagnosis of PCT. At the time the cutaneous blistering and scars developed, he was taking zidovudine and fluconazole. Reviewing the literature suggested that association of the two disorders is not purely coincidental. Anaemia, due to chronic immune activation and therapeutic options in the light of AIDS, could play an important role in the development of PCT. We recommend analysing the urine for porphyrins in HIV-positive patients who have chronic photosensitivity of the skin.

Acquired Immunodeficiency Syndrome↗