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First Physician (first + physician)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Early clinical experience with adalimumab in treatment of inflammatory bowel disease with infliximab-treated and naïve patients

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2009
A. SWAMINATH
Summary Background, Adalimumab, at an induction dose of 160/80 mg followed by 40 mg every other week is approved for treatment of refractory Crohn's disease (CD) and for patients with loss of response to infliximab. Aim, To evaluate the indications for adalimumab, the proportion of inflammatory bowel disease patients who require dose escalation and to identify whether this strategy is effective in inducing or maintaining remission. Methods, Patients prescribed adalimumab for CD were identified and included for analysis, if they had follow-up of at least 6 weeks. Adalimumab dose was escalated if patients had return of symptoms prior to next dose. Clinical judgment was used to determine severity of disease. A second GI physician confirmed disease severity as determined by the first physician. Results, A total of 48 out of 60 patients met inclusion criteria. Adalimumab was used to treat CD in 47/48 (98%) and ulcerative colitis in one (2%). Most patients had moderate 30/48 (63%) or severe 17/48 (35%) disease. Prior infliximab exposure was present in 42/48 (88%). Adalimumab dose escalation occurred in 14/48 (29%) within an average time of 2.2 months (s.d. 1.5 months). A majority of patients who required dose escalation, nine of 14 (64%) did not improve clinically. Steroids could be discontinued in three of 16 (18.8%). Clinical improvement was noted in 21/48 (43.8%) and one of 48 (2%) patients achieved clinical remission. Adverse drug reactions necessitated drug discontinuation in four of 48 (8%) of patients. Conclusions, This retrospective review from a single academic medical centre suggests that a minority of patients, who cannot be maintained on 40 mg every other week, of adalimumab benefit from an increased dose. This suggests the need for a treatment with an alternative mode of action in anti-TNF failures. [source]

Scopoli's work in the field of mercurialism in light of today's knowledge: Past and present perspectives

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2010
Alfred Bogomir Kobal MD
Abstract The Idrija Mercury Mine (1490,1994) appointed its first physician, Joannes Antonius Scopoli, in 1754. Most of his descriptions of mercurialism are still relevant today. This study highlights Scopoli's observations on the interaction between elemental mercury (Hg°) and alcohol, on the appearance of lung impairment, insomnia, and depressive mood in mercurialism. This presentation is based on Scopoli's experiences presented in his book, De Hydrargyro Idriensi Tentamina (1761), current knowledge, and our own experience acquired through health monitoring of occupational Hg° exposure. Some studies have confirmed Scopoli's observation that alcohol enhances mercurialism and his hypothesis that exposure to high Hg° concentrations causes serious lung impairment. Neurobiological studies have highlighted the influence of Hg° on sleep disorder and depressive mood observed by Scopoli. Although today's knowledge provides new perspectives of Scopoli's work on mercurialism, his work is still very important and can be considered a part of occupational medicine heritage. Am. J. Ind. Med. 53:535-547, 2010. © 2010 Wiley-Liss, Inc. [source]

Diffuse hypertrichosis and faun-tail naevus as cutaneous markers of spinal dysraphism

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 8 2002
F. C. Antony
Summary We describe two cases of spinal dysraphism where detection of the cutaneous signs , namely a faun-tail naevus and diffuse hypertrichosis , led to early recognition of the occult neurological abnormalities and institution of corrective surgery. The dermatologist may be the first physician to observe these skin changes and an early neurosurgical referral can prevent subsequent neurological complications. [source]

Giovanni Filippo Ingrassia: A five-hundred year-long lesson

CLINICAL ANATOMY, Issue 7 2010
Francesco Cappello
Abstract Giovanni Filippo Ingrassia was born five centuries ago in Regalbuto, a small town in the center of Sicily. After his medical course in Padua, under the guidance of Vesalius and Fallopius, he gained international fame as a physician and was recruited as a Professor of human anatomy in Naples and later in Palermo. He is remembered as "the new Galen" or "the Sicilian Hippocrates." He contributed to the knowledge of human anatomy through the description of single bones rather than the whole skeleton. In particular, he was the first to describe the "stapes," the "lesser wings of the sphenoid" and various other structures in the head (probably the pharyngotympanic tube) as well as in the reproductive system (corpora cavernosa and seminal vesicles). He was also a pioneer in the study of forensic medicine, hygiene, surgical pathology, and teratology. As Protomedicus of Sicily, he developed the scientific culture in this country. During those years, he faced the spread of malaria and plague with competence and authoritativeness. Indeed, he was one of the first physicians to suppose that certain diseases could be transmitted between individuals, therefore, introducing revolutionary measures of prevention. He is remembered for his intellectual authority and honesty. Five-hundred years after his birth, his teaching is still alive. In this article, we survey the life and contribution of this pioneer of early anatomical study. Clin. Anat. 23:743,749, 2010. © 2010 Wiley-Liss, Inc. [source]