SUMMARY BackgroundInflammatory bowel diseases (IBD) commonly affect young patients in the reproductive phase of their lives. The chronic and relapsing nature of IBD and the potential need for medical or surgical interventions raise concerns about family planning issues.
Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages. Systematic review of randomized trials Randomized trial Non-randomized controlled cohort/ follow-up study** Case-series, casecontrol, or historically controlled studies** Mechanism-based reasoning Kucharzik T et al. Aktualisierte S3-Leitlinie Colitis… Z Gastroenterol | © 2020. Thieme. All rights reserved. Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages. ▶ Tab. 6 Ausdehnung der Colitis ulcerosa (nach Silverberg et al. [3]) Einteilung Ausdehnung Beschreibung E1 Proktitis Limitiert auf das Rektum (distal des rektosigmoidalen Übergangs) E2 Linksseitencolitis Befall bis zur linken Flexur E3 Ausgedehnte Colitis Ausdehnung über die linke Flexur hinaus bis zur Pancolitis Kucharzik T et al. Aktualisierte S3-Leitlinie Colitis… Z Gastroenterol | © 2020. Thieme. All rights reserved. Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.
Background and aims Physical activity is beneficial in several chronic disorders including Crohn′s disease, but the preferred type of exercise is unknown. Our study aimed to examine and compare the safety, feasibility and potential beneficial effects of individual moderate endurance and moderate muscle training in patients with Crohn’s disease. Methods Quiescent or mildly active (Crohn’s disease activity index <220) patients with Crohn’s disease were randomly allocated to either a control, endurance, or muscle training group. Participants exercised individually for 3 months three times per week. Endpoints included dropout rate, disease activity, inflammatory parameters including faecal calprotectin, anthropometric data, quality of life, physical activity and strength. Results A total of 45 patients with Crohn’s disease were randomly allocated. In the endurance group ( n = 17), the dropout rate was significantly higher (47% vs. 13%) compared with the muscle group ( n = 15). In both groups the maximal and average strength in the upper and lower extremities increased significantly (all P < 0.04). In the endurance group emotional function was significantly improved ( P = 0.03). Statistically significant changes of disease activity and other outcome parameters were not observed in this pilot cohort. Conclusion Both individual moderate endurance and muscle training can be safely performed in patients with mild or quiescent Crohn’s disease. Muscle training appears more feasible and may be favoured. Both forms of exercise have beneficial effects on strength. Quality of life increased in both intervention groups, although statistical significance was only reached in one subgroup.
BackgroundBecause Endomyocardial Biopsy has low sensitivity of about 20%, it can be performed near to myocardium that presented as Late Gadolinium Enhancement (LGE) in cardiovascular magnetic resonance (CMR). However the important issue of comparing topography of CMR and histological findings has not yet been investigated. Thus the current study was performed using an animal model of myocarditis.ResultsIn 10 male Lewis rats Experimental Autoimmune myocarditis was induced, 10 rats served as control. On day 21 animals were examined by CMR to compare topographic distribution of LGE to histological inflammation. Sensitivity, specificity, positive and negative predictive values for LGE in diagnosing myocarditis were determined for each segment of myocardium. Latter diagnostic values varied widely depending on topographic distribution of LGE and inflammation as well as on the used CMR sequence. Sensitivity of LGE was up to 76% (left lateral myocardium) and positive predictive values were up to 85% (left lateral myocardium), whereas sensitivity and positive predictive value dropped to 0-33% (left inferior myocardium).ConclusionsTopographic distribution of LGE and histological inflammation seem to influence sensitivity, specifity, positive and negative predictive values. Nevertheless, positive predictive value for LGE of up to 85% indicates that Endomyocardial Biopsy should be performed "MR-guided". LGE seems to have greater sensitivity than Endomyocardial Biopsy for the diagnosis of myocarditis.
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