RESUMEN
BACKGROUND: Exclusive enteral nutrition (EEN) is the recommended induction treatment of mild to moderate active pediatric Crohn's disease (CD). This study compared outcomes of 2 proprietary polymeric formulas. Treatment effectiveness was examined along with practical aspects of formula delivery and differences in estimated treatment costs. METHODS: Data were retrospectively collected from patients with CD who received a generic oral nutritional supplement (Fortisip) across 2 centers (RCH, Melbourne and RHSC, Edinburgh). This was compared with a prospective cohort (RHC, Glasgow) that used a specialized formula (Modulen IBD). The data collected included patient demographics, remission rates, biochemical markers, administration method, and anthropometrics. The estimated treatment cost was performed by comparing price per kcal between each formula. RESULTS: One hundred seventy-one patients were included (106 Fortisip, 65 Modulen IBD, 70 female; median age 13.3 yrs). No difference was demonstrated in remission rate (Fortisip nâ =â 67 of 106 [63%] vs Modulen IBD nâ =â 41 of 64 [64%], P = .89), nonadherence rate (Fortisip nâ =â 7 of 106 [7%] vs Modulen IBD 3 of 64 [5%], P = .57) or method of administration (NGT Fortisip use nâ =â 16 of 106 [12%] vs Modulen IBD 14 of 65 [22%]; P = .31). There was no difference in reduction of biochemical disease markers between the groups (C-reactive protein , P = .13; erythrocyte sedimentation rate, P = .49; fecal calprotectin, P = .94). However, there was a cost-saving of around £500/patient/course if the generic oral nutritional supplement was used. CONCLUSIONS: The generic oral nutritional supplement and specialized formulas both had similar clinical effectiveness in induction of remission in pediatric CD. However, there is considerable cost-saving when using a generic oral nutritional supplement.
Asunto(s)
Enfermedad de Crohn , Niño , Humanos , Femenino , Adolescente , Inducción de Remisión , Estudios Retrospectivos , Estudios Prospectivos , Enfermedad de Crohn/tratamiento farmacológico , Resultado del Tratamiento , BiomarcadoresRESUMEN
Electrical burns of the mouth are the most common electrical injury in children and can have serious, long-term functional and aesthetic consequences. Presented is a review of the pathogenesis of the associated injury and sequelae, as well as a case report. In the presented case, a multidisciplinary approach was used with input from pediatric dentistry, plastic/burn surgery, and oral and maxillofacial surgery. This collaborative effort and a novel microstomia prevention device produced a superior functional and aesthetic result. Without the aid of a microstomia device, the resultant contracture and associated functional deficits are difficult to release and reconstruct. Thus, proper timing and sequencing of treatment is critical.
Asunto(s)
Quemaduras por Electricidad/cirugía , Mucosa Bucal/lesiones , Grupo de Atención al Paciente , Quemaduras por Electricidad/complicaciones , Preescolar , Cicatriz/etiología , Cicatriz/cirugía , Conducta Cooperativa , Instrumentos Dentales , Odontología , Humanos , Masculino , Microstomía/prevención & control , Boca/lesiones , Boca/cirugía , Mucosa Bucal/cirugía , Aparatos OrtodóncicosAsunto(s)
Consejo , Neoplasias , Voluntarios , Humanos , Reino Unido , Agencias Voluntarias de SaludRESUMEN
The clinical history, light microscopic, electron microscopic, and immunopathologic findings of an ovarian myxoma in a 32-year-old woman are described. We believe this to be only the fourth such case reported.