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Biomedical subjects

J J Thornton

Publications and source records attributed to J J Thornton.

7 recordsLinked to original sources
PubMed1991

Alternate-day prednisone treatment and treatment maintenance in Crohn's disease.

We have reviewed our data from 55 patients with Crohn's disease (CD) treated with alternate-day prednisone (average dose: 25 mg every other morning) between 1966 and 1989 for a mean duration of 6.6 yr. Daily divided corticosteroid doses were given to all patients with active disease that had not been responsive to supportive measures and, in almost all cases, not responsive to sulfasalazine alone. After initial remission was achieved, patients were switched to alternate-day doses. Treatment evaluations utilized global assessment and the CD activity index of Harvey and Bradshaw (CDAI-HB) shown to correlate closely with the National Cooperative Crohn's Disease Study (NCCDS) activity index (CDAI). CDAI-HB scores of 0-1 indicated no or minimal activity, whereas scores of 2-15 indicated progressive activity. With the CDAI-HB and global assessments, in agreement in all cases, 33 patients (60%) showed favorable responses with 95% confidence intervals (CI) of 46.8 to 73.2. Comparing the results with a literature-based 20% spontaneous long-term remission rate, the data are significant at p less than 0.01. Serious complications were gratifyingly low, with no observed instances of osteonecrosis. It is concluded that alternate-day prednisone treatment and treatment maintenance, with or without concomitant sulfasalazine, after conventional induction of remission with daily steroid doses, is a reasonable treatment option for patients with CD not responsive to sulfasalazine alone.

Adolescent↗
PubMed1987

Favorable effects of sulfasalazine on small bowel Crohn's disease: a long-term study.

Due to conflicting reports in the literature regarding the efficacy of sulfasalazine for Crohn's disease (CD) involving small bowel alone, we reviewed the treatment results of our systematic sulfasalazine treatment in CD over a 23-yr period. We identified 28 patients with CD of small bowel alone treated between 1 and 23 yr by means of sulfasalazine alone and who went into complete clinical remission. Of these, 12 also showed total regression of radiographic abnormalities, 12 showed partial regression, while four patients still await radiographic reexamination. While our data do not permit a precise estimate, it seems that about 25% of patients with small bowel CD respond to sulfasalazine alone. Reasons are discussed why our data are at variance with some and in accord with other reports. While our study of necessity could not be carried out in double-blind fashion, patients served as their own controls, having previously failed to respond to other treatment modalities or no treatment. We conclude that sulfasalazine should be tried in the treatment of CD of small bowel because of its relatively low toxicity and reasonably high efficacy.

Adolescent↗
PubMed1977

Diagnosis and treatment of diffuse ileojejunitis.

Thirteen patients with diffuse ileojejunitis have been diagnosed and treated by us over the past ten years. The disease bears close resemblance to Crohn's disease and may represent a variant of it. No clearcut relationship to celiac sprue was observed in this group of patients. Therapeutic success was obtained in the majority of patients treated with the anti-inflammatory drugs, sulfasalazine and steroids, with four patients requiring resectional surgery, all others manageable by nonsurgical means. There was no mortality in this series of patients.

Adolescent↗
PubMed1976

Anti-inflammatory drug treatment in Crohn's disease.

In a prospective evaluation of all patients with Crohn's disease treated by us since 1970, 62 have completed at least one year, or required bowel resection after at least three months, of anti-inflammatory drug treatment. Sulfasalazine alone was used in 24 patients, steroids alone were used in four patients, both drugs were used together in 29 patients and azathioprine was added to the drug regimen of five patients. The initial choice of drug followed a set design but the regimens ultimately arrived at depended upon patient responses. Favorable complete or partial clinical responses were obtained in 54 patients, while 37 patients showed objective radiographic improvement or regression. No radiographic improvement was found in the eight patients with clinical treatment failure as well as in 11 patients with clinical improvement. Six clinically improved patients had not yet been re-examined radiographically. The study provides objective evidence that the majority of patients with Crohn's disease can be successfully treated by means of anti-inflammatory drugs.

Anti-Inflammatory Agents↗
PubMed1976

Treatment of chronic radiation enteritis and colitis with salicylazosulfapyridine and systemic corticosteroids. A pilot study.

Four patients with severe chronic radiation enteritis and/or colitis were treated with anti-inflammatory drugs that are used conventionally in the treatment of idiopathic inflammatory bowel disease. Salicylazosulfapyridine (SASP) was used in the treatment of all four patients, while one patient received oral prednisone together with SASP. All four patients were treated and observed for over one year, with follow-up observations now extending to over three years. The four patients showed striking clinical improvement, accompanied by improvement in the radiographic appearance of affected bowel, complete or almost complete in three and incomplete in the fourth patient. The results of this pilot investigation are encouraging and call for wider clinical trials of the same and related drugs in larger groups of patients with chronic radiation enterocolitis, a serious condition that has until now not been successfully treated with drugs.

Aged↗
PubMed1976

Ileojejunitis in a pair of identical twins.

A pair of identical twin brothers with identical white and red blood cell antigens and diffuse ileojejunitis is reported. One brother initially presented with granulomatous gastritis, presumably Crohn's disease of the stomach. The relationship of diffuse ileojejunitis to Crohn's disease and the suspected genetic predisposition to develop Crohn's disease are briefly discussed.

Adolescent↗