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PubMed2004

A comparison of observational studies and controlled trials of heparin in ulcerative colitis.

OBJECTIVES: To compare the efficacy of heparin in ulcerative colitis (UC) as demonstrated in observational studies and controlled clinical trials. INTRODUCTION: Ulcerative colitis (UC) is a chronic condition with a relapsing and remitting course. Several studies have been conducted (observational and controlled clinical trials) to test the usefulness of heparin in this condition but the results of these studies are variable. Some studies demonstrate efficacy while others do not. METHODS: We pooled the results of observational studies and clinical trials separately in order to compare the results of observational studies and clinical trials using meta-analysis. With the aid of Medline and a manual search in Index Medicus and cross-references of articles published up to July 2003, we identified studies designed to evaluate the effects of heparin on UC. The pooled cure rate in observational studies was calculated. RESULTS: The results of controlled clinical trials evaluated using meta-analysis showed that the pooled cure rate for observational studies was 87.7% (range 80 - 100). The odds ratio for the controlled trial was 0.34 (95% CI 0.08 - 1.49) using a random effects model and 0.21 (95% CI 0.06 - 1.38) using a fixed effects model. The results of meta-analysis demonstrate a non-significant effect of heparin in controlled clinical trials. CONCLUSION: The findings of the clinical trials differ markedly from observational studies and indicate a lack of efficacy of heparin in patients with ulcerative colitis.

Colitis, Ulcerative↗
PubMed1980

Pyoderma gangrenosum and ulcerative colitis.

The relationship of pyoderma gangrenosum and ulcerative colitis remains uncertain. We investigating 14 patients with pyoderma gangrenosum by colonoscopy with multiple biopsies. Six patients had ulcerative colitis and all of these had disease affecting the whole colon. There were no correlations between exacerbations of the colitis and the onset or course of pyoderma gangrenosum. The remaining eight patients with pyoderma gangrenosum had no other disease and they were found to be significantly older than those patients with coexisting colitis (P less than 0.002).

Adult↗
PubMed1986

The incidence of colon carcinoma complicating ulcerative colitis.

The tendency for development of cancer in patients with ulcerative colitis is well documented. Each physician must take into account the clinical presentation of the patient and the known risk factors and must adapt follow-up and consultation to the patient and family accordingly. Presently, after a 5- to 7-year history of ulcerative colitis, it is reasonable to document mucosal changes with air-contrast barium enema examination and laboratory assessment with carcinoembryonic antigen levels being obtained. If the extent of disease is more limited to the distal colon, then the surveillance should be modified accordingly because the relative risk is reduced. In the future, the addition of histochemical and immunohistologic analysis of mucosal biopsies will result in better criteria for patient selection for surgical intervention. Because of the delay in recognition of a cancerous lesion in patients with ulcerative colitis, a total proctocolectomy is recommended by some after the first decade of disease. Most prefer, however, to continue surveillance of some type. During surveillance, if moderate or severe dysplasia is found, a proctocolectomy should be performed. This mode of surveillance and treatment of patients at risk for developing colonic carcinoma subsequent to ulcerative colitis remains an evolving process. There will be further changes in management following better classification of the neoplastic changes and the discovery of the etiology of the disease process itself.

Colitis, Ulcerative↗
PubMed2006

[Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) in children with ulcerative colitis].

UNLABELLED: The analysis of bibliography referring to the role of haemostasis disturbances in pathogenesis of ulcerative colitis in children revealed considerable discrepancies in the obtained findings of the study and some controversies in their interpretation. The aim of the study was the assessment of tissue plasminogen activator (t-PA) and its inhibitor (PAI-1) in children with ulcerative colitis. MATERIAL AND METHODS: The 22 children with ulcerative colitis were included in our investigation, there were 7 girls and 15 boys whose mean age was 15, 55 (+/- 3.0) years. The reference group was made up of 22 children suffering from celiac disease covering the period of full compensation in the range of similar age and sex. Blood was drawn from the cubital vein in the morning with minimal stasis into a tube containing 3.2% sodium citrate at the ratio of 1:10. The levels of t-PA and PAI-1 were measured with ELISA. RESULTS: In children with ulcerative colitis and in the control group we found out similar concentration of antigen tissue plasminogen activator (t-PA:Ag). In the group of children with ulcerative colitis under investigation a mean concentration of antigen inhibitor plasminogen activator (PAI-1:Ag) was statistically higher. CONCLUSIONS: Elevation of PAI-1:Ag concentration in plasma of the children suffering from ulcerative colitis may confirm the participation of PAI-1 in inflammatory reaction of disease- induced changes in colon mucosa.

Adolescent↗