M Rizzi — Page 7 | PubMed Health

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[Osteogenesis imperfecta and calcitonin. Considerations on 10 years of clinical experimentation].

Salmon and porcine calcitonin has been used in the drug treatment of Osteogenesis Imperfecta for ten years. The evaluation of its therapeutic efficacy is complex and inaccurate because of difficulty in clinical and pathogenetic classification of the disease and impossibility to standardize and evaluate the patients. Calcitonin therapy showed no capacity to modify the degree of osteoporosis and the incidence of pathological fracture and bone deformities, because it does not affect the underlying biochemical defect. Calcitonin may be useful only in selected patients and in addition to physiotherapeutic, orthopaedic and surgical measures.

Calcitonin↗

PubMedDate not supplied

[Emergency surgical treatment of ulcerative rectocolitis and Crohn's disease of the colon].

We examine the indications and the operative options for proceeding to emergency surgery in patients with inflammatory bowel disease. Emergency surgery is absolutely mandatory in case of generalized peritonitis due to bowel perforation. Other life-treating complications are acute disease not responding to medical treatment, toxic megacolon, bowel obstruction and massive hemorrhage. Early medical treatment of these conditions often prevents most severe clinical expressions and improves the prognosis. However surgery should be performed immediately if there is no improvement within 5 days of medical management in case of acute colitis, within 24-48 hours in case of toxic megacolon, within 48-72 hours in patients with intestinal obstruction or severe bleeding, or if the patient deteriorates during this period. In such circumstances, subtotal colectomy with ileostomy and mucous fistula of distal sigmoid colon is the best procedure. That is because it is relatively easy to perform and consents a simpler restorative operation than other procedures preserving the rectum. Moreover it leads to lower morbidity and mortality than the total proctocolectomy that should be reserved to patients with severe rectal disease or sphincter lesion. The most important factors influencing outcome of complicated or severe inflammatory bowel disease are the choice of the appropriate timing for surgery and the procedure performed.

Colectomy↗