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- Campieri, M, et al.
(författare)
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Oral budesonide is as effective as oral prednisolone in active Crohn's disease. The Global Budesonide Study Group
- 1997
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Ingår i: Gut. - : BMJ. - 0017-5749 .- 1468-3288. ; 41:2, s. 209-214
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Tidskriftsartikel (refereegranskat)abstract
- Background—The use of corticosteroids in active Crohn’s disease often becomes limited by side effects. Budesonide is a potent corticosteroid with low systemic bioavailability due to an extensive first pass liver metabolism.Aims—To compare the efficacy and safety of two dosage regimens of budesonide and prednisolone in patients with active Crohn’s disease affecting the ileum and/or the ascending colon.Patients and methods—One hundred and seventy eight patients were randomised to receive budesonide controlled ileal release (CIR) capsules 9 mg once daily or 4.5 mg twice daily, or prednisolone tablets 40 mg once daily. The treatment period was 12 weeks. The primary efficacy variable was clinical remission, defined as a Crohn’s Disease Activity Index (CDAI) of 150 or less.Results—After eight weeks of treatment, remission occurred in 60% of patients receiving budesonide once daily or prednisolone and in 42% of those receiving budesonide twice daily (p=0.062). The presence of glucocorticoid associated side effects was similar in all groups; however, moon face was more common in the prednisolone group (p=0.0005). The highest frequency of impaired adrenal function, as measured by a short ACTH test, was found in the prednisolone group (p=0.0023).Conclusions—Budesonide CIR, administered at 9 mg once daily or 4.5 mg twice daily, is comparable to prednisolone in inducing remission in active Crohn’s disease. The single dose administration is as promptly effective as prednisolone and represents a simpler and safer therapeutic approach, with a considerable reduction in side effects.
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- Hansson, L. A., et al.
(författare)
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Variation in physical, chemical and biological components in the subantarctic lakes of South Georgia
- 1996
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Ingår i: Ecography. - : Wiley. - 0906-7590. ; 19:4, s. 393-403
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Tidskriftsartikel (refereegranskat)abstract
- Physical, chemical and biological variables were quantified in 19 subantarctic lakes (South Georgia) as a prelude to comparing these pristine systems with temperate lakes and to improve the knowledge of spatial and temporal variation in water chemistry and abundances of organisms. Lakes close to the sea had higher phosphorus concentrations, contained higher abundances of most organisms, and had higher number of invertebrate species than lakes situated further from the sea. Differences were attributed to higher nutrient input from marine organisms, such as penguins, seals and petrels, and probably also to a somewhat longer ice-free period. Since the lakes of South Georgia lack fish, the pelagic invertebrate fauna is dominated by herbivorous macrozooplankton. Rotifers are rare in the open water and are restricted to the vegetation (mainly mosses) in shallow areas and to the sediment surface. Generally, the algal abundance at the sediment surface is high in subantarctic lakes, indicating that the main part of the primary production is provided by benthic algae, which is in contrast to what is normally the case in temperate waters.
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- Uddhammar, A, et al.
(författare)
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Cytokines and adhesion molecules in patients with polymyalgia rheumatica
- 1998
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Ingår i: British Journal of Rheumatology. - : Oxford University Press (OUP). - 0263-7103 .- 1460-2172. ; 37:7, s. 766-769
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Tidskriftsartikel (refereegranskat)abstract
- Serum levels of interleukin-1 beta (IL-1 beta), IL-1 receptor antagonist (IL-1ra), tumour necrosis factor alpha (TNF-alpha), IL-6, soluble IL-6 receptor (sIL-6R), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble E-selectin were measured in 15 patients with newly diagnosed polymyalgia rheumatica (PMR) before and after 3 months of corticosteroid therapy. Both IL-6 and IL-1ra were significantly increased in untreated PMR and remained elevated compared with controls during therapy, although significantly only for sIL-1ra. sICAM-1 was raised in 12/15 (87%) patients at diagnosis and remained high in 10/14 (71%) patients; soluble E-selectin levels were initially raised in 6/15 (40%) patients and decreased with therapy in those with the highest levels. IL-6, IL-1ra and sICAM-1 are sensitive indicators of continuing immunological activation in PMR; the advantages of these markers in assessing the response to therapy should be investigated in a longitudinal study.
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