Low Surgery Rates in Early Crohn's Disease: Results from a Prospective Population-Based Inception Cohort-The Inflammatory Bowel Disease in South-Eastern Norway III Study.

Background And Aims: The emergence of biologic therapy has coincided with a decline in surgery rates for Crohn's disease (CD). This study aims to describe the disease course, including intra-abdominal surgery rates, biologic therapy use, and variables associated with biologic therapy initiation in a cohort of newly diagnosed CD patients.

Methods: The Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III study is a population-based inception cohort study.

Fatigue in patients with inflammatory bowel disease in remission one year after diagnosis (the IBSEN III study).

Background And Aims: Fatigue is commonly observed in Crohn's disease (CD) and ulcerative colitis (UC), but its association to achieving remission is not clearly established. In this study we describe the odds for fatigue in patients with CD/UC one year after diagnosis based on different definitions of remission and identified factors associated with chronic fatigue (CF) among patients in endoscopic/radiological remission.

Methods: Patients ≥18 years with CD/UC were recruited from the IBSEN III cohort.

Bleeding disorders: characterization, dental considerations and management.

Hemostasis is a finely balanced process in which an insult to a blood vessel wall, either by injury or surgical intervention, stimulates a pair of parallel, yet associated, pathways that lead to the termination of blood loss. The coagulation cascade is initiated by the interaction between exposed subendothelial tissue factor and circulating blood and includes a series of amplification steps that result in thrombin generation. Concurrently, exposed subendothelial collagen stimulates platelets, which, in the presence of thrombin, are consolidated by fibrin to form a blood clot, thus terminating blood loss.

Temperament and trait anxiety as predictors of child behavior prior to general anesthesia for dental surgery.

Children's individual styles of interaction with the environment (temperament) influence stable tendencies towards distress (trait anxiety) and context-specific manifestations of distress (state anxiety). Measures of temperament and trait anxiety were examined as predictors of state anxiety (i.e.

A light and scanning electron microscopic study of enamel decalcification in children living in a water-fluoridated area.

Eleven children, each having one or two pairs of premolars to be extracted for orthodontic purposes, participated in the study. The model involved placement of a special orthodontic band that allowed the accumulation of plaque in a defined area between the band and the buccal enamel. Examination of enamel changes was carried out in experimental teeth that had been exposed to local plaque accumulation for one, two, four, eight or 14 days.

The microflora associated with the development of initial enamel decalcification below orthodontic bands in vivo in children living in a fluoridated-water area.

Thirty-four caries-free teeth destined for orthodontic extraction were banded to provide a protected area for the accumulation of plaque. The teeth were extracted at one, two, four, eight, and 14 days after being banded, and samples of the flora below the band were analyzed for the presence of Streptococcus sanguis, Streptococcus 'mitior', 'mutans streptococci', Actinomyces viscosus, Actinomyces naeslundii, Actinomyces odontolyticus, Lactobacillus species, and Veillonella. After plaque sampling, the teeth were sent to the Royal Dental College (Copenhagen) for histological analysis.

Designing a modern hospital pharmacy.

Cooperation between the pharmacy director and the hospital's architects in planning a modern hospital pharmacy is described. The pharmacy director at an 870-bed voluntary nonprofit institution and the hospital's architects planned the design for a new 3250-square foot pharmacy department. They developed a preliminary floor plan based on the following functions that the pharmacy would perform: centralized unit dose drug distribution; compounding; bulk and unit dose prepackaging; preparation of sterile products; controlled substance storage; outpatient and employee prescription dispensing; reserve stock storage; purchasing, receiving, and inventory control; drug information services; and administrative services.

Influence of pH and fluoride on properties of an oral strain of Lactobacillus casei grown in continuous culture.

A freshly isolated oral strain, Lactobacillus casei RB1014, was grown in continuous culture to compare the effects of pH and fluoride on growth and metabolism. The cells were grown at pH 7.0 to 3.

The 24-hour secretory pattern of LH and the response to LHRH in transsexual men.

Ten separate aspects of hypothalamic and pituitary function were studied in 13 male-to-female transsexuals and compared to the results of 7 heterosexual adult men. In 4 of 5 transsexuals, the 24-hour mean serum concentration of LH, the LH pulse frequency or amplitude, or the apparent half-life of disappearance of serum LH were greater than the 95% confidence limit of normal men. The maximum concentration of LH or FSH following the administration of 100 micrograms LHRH, the area under the response curve of LH or FSH following LHRH, or both were significantly greater than normal in 5 of 13 male-to-female transsexuals.

Anterior-pituitary adrenal function of gold-treated patients with juvenile rheumatoid arthritis.

The hypothesis that gold therapy enhances endogenous cortisol secretion was tested in juvenile rheumatoid arthritis patients. The secretion of cortisol, dehydroepiandrosterone-sulfate (DHEA-S) and several peptide hormones was determined from plasma samples collected every 20 min for 24 hours. In random patients cortisol secretion was significantly greater in gold treated patients than in similar patients not receiving gold.

Daily rhythms in cortisol and melatonin in primate cerebrospinal fluid. Effects of constant light and dark.

Cerebrospinal fluid was continuously collected from the cisternal-cervical subarachnoid space of chair-restrained rhesus monkeys. The concentrations of melatonin and cortisol were measured in the cerebrospinal fluid. Under diurnal lighting (light:dark, 12:12 h) melatonin concentrations were elevated during darkness and low during illumination.

Effects of clonidine on 24-hour hormonal secretory patterns, cardiovascular hemodynamics, and central nervous function in hypertensive adolescents.

To assess the potential of antihypertensive drugs for interference with somatic growth and sexual development in hypertensive children, the effect of clonidine therapy on various endocrine, cardiovascular, and neuromuscular functions has been examined in five male adolescents with idiopathic hypertension. In studies done before and at the end of 4 weeks of twice-daily clonidine therapy, in an average daily dose of 0.31 mg, no significant effects were noted in the secretory patterns of growth hormone, luteinizing hormone, follicle-stimulating hormone, prolactin, cortisol, aldosterone, or testosterone, measured in blood obtained every 20 minutes for 24 hours.

Gonadal function in trisomy 21.

Endocrinologic evaluation of 39 patients with trisomy 2 and associated hypogonadism demonstrated elevations of follicle-stimulating hormone and luteinizing hormone; consequently, it can be concluded that both germinal and Leydig cell function are affected. A negative correlation between testicular size and plasma follicle-stimulating hormone was documented. Plasma testosterone levels were found to be normal in male patients as were estradiol levels in female patients with trisomy 21.

Accumulation of hormones in breast cyst fluid.

The concentration of some immunoreactive peptide hormones in breast cyst fluid and serum from a series of patients with cystic breast disease were compared. The concentrations of the two pituitary gonadotropins, LH and FSH, were consistently higher in serum than in cyst fluid, confirming earlier more limited observations. The mean PRL concentration, on the other hand, was elevated in cyst fluid though the variability was great.

Circadian cortisol secretory rhythms in Cushing's disease.

Plasma cortisol was measured at 20-min intervals for 24 h in eight patients with Cushing's disease and ACTH-secreting pituitary tumors. The 24-h mean (+/- SD) cortisol level was 25.6 +/- 11.

[Melatonin and LH secretion patterns in pubertal boys (author's transl)].

Plasma melatonin and LH were measured at 20 minute intervals for 24 hours in four normal pubertal boys. All four subjects showed a significant augmentation of LH and melatonin during noctural sleep. There was also a significant correlation between the LH and melatonin levels (p less than 0.

LH and melatonin secretion patterns in pubertal boys.

Four normal pubertal boys had plasma LH and melatonin measured at 20-minute intervals for 24-hours. All four subjects showed a significant augmentation of LH and melatonin during nocturnal sleep. There was also a significant correlation between the LH and melatonin levels (P less than 0.

Weight and circadian luteinizing hormone secretory pattern in anorexia nervosa.

In previous studies we had established that emaciated women with active primary anorexia nervosa (AN) had immature 24-hr luteinizing hormone (LH) secretory patterns. In this study, we have examined the circadian LH patterns of eight women with AN who had partially or fully recovered their ideal weights. Three of the women were studied before and after weight gain and five women were studied only after the appearance of binge-eating and consequent weight gain (by history).

Twenty-four-hour plasma prolactin patterns in prepubertal and adolescent boys.

The concentration of PRL was measured every 20 min for 24 h in six prepubertal and three adolescent boys. In both groups, PRL secretory episodes occurred throughout the 24-h period. In all subjects, the mean concentration of PRL was significantly higher during sleep than during wakefulness; the mean concentration during the entire 24-h period, during sleep or during wakefulness, was not different between the prepubertal subjects and the adolescents.

Studies of gonadotropin-gonadal dynamics in patients with androgen insensitivity.

Four patients with androgen insensitivity had plasma LH and FSH measured at 20-min intervals for 24 h and at 15- to 30-min intervals for 3 h after the injection of LRH. Twenty-four-hour mean testosterone (T), estradiol, and androstenedione (delta 4) levels were also measured. Patients with androgen insensitivity had significantly elevated LH levels (P less than 0.

Luteinizing hormone and follicle-stimulating hormone secretory dynamics in Turner's syndrome.

In eight teenage patients with Turner's syndrome, LH and FSH were measured at 20-min intervals for 24 h. The 24-h mean LH and FSH levels ranged from 20.2-70.