The ethical questions suggested by the allocation of organs for transplantation can be assembled around the notion of justice. It is a domain of health care in which there is a chronic lack of resources, but for patients whose life is at stake, sometimes at short term. It has similarities with the triage, imposed in some conditions of emergency medicine, at war or during civil catastrophes. The question will be approached from the points of view of the main stakeholders.
{"title":"Ethical perspectives about organ allocation for transplantation.","authors":"D Houssin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The ethical questions suggested by the allocation of organs for transplantation can be assembled around the notion of justice. It is a domain of health care in which there is a chronic lack of resources, but for patients whose life is at stake, sometimes at short term. It has similarities with the triage, imposed in some conditions of emergency medicine, at war or during civil catastrophes. The question will be approached from the points of view of the main stakeholders.</p>","PeriodicalId":50942,"journal":{"name":"Acta Gastro-Enterologica Belgica","volume":"67 2","pages":"168-71"},"PeriodicalIF":1.5,"publicationDate":"2004-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Lerut, J Matthys, J Lemaire, V Van Thuyne, O Ciccarelli, P Goffette, A Peeters, S Aunac, M Boddeus, M A Carlier, E Danse, M De Kock, Ch De Reyck, M Donataccio, A Geubel, D Gonze, P Goubau, D Latinne, P F Laterre, A Luts, G Cool, J B Otte, Y Horsmans, J Martinez, G Orlando, J Rahier, R Reding, M Reynaert, P Starkel, Ch Sempoux, St Talpe, L Van Obbergh, F Veyckemans, P Wallemacq, X Wittebolle, F Roggen
The authors present the results of a single centre study of 587 liver transplants performed in 522 adults during the period 1984-2002. Results have improved significantly over time due to better pre-, peri- and post-transplant care. One, five, ten and fifteen year actuarial survivals for the whole patient group are 81.2; 69.8; 58.9 and 51.2%. The high incidence of de novo tumors (12.3%), of cardiovascular diseases (7.5%) and of end-stage renal function (3.6%) should be further incentives to tailor the immunosuppression to the individual patient and to direct the attention of the transplant physician to the long-term quality of life of the liver recipient.
{"title":"Adult liver transplantation at UCL: update 2002.","authors":"J Lerut, J Matthys, J Lemaire, V Van Thuyne, O Ciccarelli, P Goffette, A Peeters, S Aunac, M Boddeus, M A Carlier, E Danse, M De Kock, Ch De Reyck, M Donataccio, A Geubel, D Gonze, P Goubau, D Latinne, P F Laterre, A Luts, G Cool, J B Otte, Y Horsmans, J Martinez, G Orlando, J Rahier, R Reding, M Reynaert, P Starkel, Ch Sempoux, St Talpe, L Van Obbergh, F Veyckemans, P Wallemacq, X Wittebolle, F Roggen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The authors present the results of a single centre study of 587 liver transplants performed in 522 adults during the period 1984-2002. Results have improved significantly over time due to better pre-, peri- and post-transplant care. One, five, ten and fifteen year actuarial survivals for the whole patient group are 81.2; 69.8; 58.9 and 51.2%. The high incidence of de novo tumors (12.3%), of cardiovascular diseases (7.5%) and of end-stage renal function (3.6%) should be further incentives to tailor the immunosuppression to the individual patient and to direct the attention of the transplant physician to the long-term quality of life of the liver recipient.</p>","PeriodicalId":50942,"journal":{"name":"Acta Gastro-Enterologica Belgica","volume":"67 2","pages":"188-96"},"PeriodicalIF":1.5,"publicationDate":"2004-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40882004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Th Delaunoit, F Neczyporenko, R Duttmann, C Deprez, P Mendes da Costa, E de Koster
Cutaneous Paget's disease (PD) is a rare entity, predominantly involving the breasts. Anal involvement is rather exceptional, and can be associated with underlying malignancies, among which prostate and rectal adenocarcinoma. We report the case of a 71-year-old man suffering from a long history of anal itching, associated with an erythematosquamous lesion of the right buttock extending up to the anus. The diagnosis of perianal PD (PAPD) was confirmed by histopathological demonstration of Paget's cells from a biopsy performed after ineffective topical treatment. Radiological and further clinical inspections allowed us to exclude any synchronous malignancy. A first-step surgery consisted in coelioscopic diverting sigmoid colostomy, along with multiple perianal, anal and rectal biopsies revealing an anal canal involvement. Coelioscopic abdominoperineal surgery and a wide cutaneous excision were then performed. Histopathological analysis revealed positive posterior margin, requiring further excision. No adjuvant therapy was prescribed, and to this day, after a one-year and a half follow-up, the patient remains disease-free. Our case report and review of PAPD stress that appropriate management is required to improve the poor prognosis of this rare affection.
{"title":"Perianal Paget's disease: case report and review of the literature.","authors":"Th Delaunoit, F Neczyporenko, R Duttmann, C Deprez, P Mendes da Costa, E de Koster","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cutaneous Paget's disease (PD) is a rare entity, predominantly involving the breasts. Anal involvement is rather exceptional, and can be associated with underlying malignancies, among which prostate and rectal adenocarcinoma. We report the case of a 71-year-old man suffering from a long history of anal itching, associated with an erythematosquamous lesion of the right buttock extending up to the anus. The diagnosis of perianal PD (PAPD) was confirmed by histopathological demonstration of Paget's cells from a biopsy performed after ineffective topical treatment. Radiological and further clinical inspections allowed us to exclude any synchronous malignancy. A first-step surgery consisted in coelioscopic diverting sigmoid colostomy, along with multiple perianal, anal and rectal biopsies revealing an anal canal involvement. Coelioscopic abdominoperineal surgery and a wide cutaneous excision were then performed. Histopathological analysis revealed positive posterior margin, requiring further excision. No adjuvant therapy was prescribed, and to this day, after a one-year and a half follow-up, the patient remains disease-free. Our case report and review of PAPD stress that appropriate management is required to improve the poor prognosis of this rare affection.</p>","PeriodicalId":50942,"journal":{"name":"Acta Gastro-Enterologica Belgica","volume":"67 2","pages":"228-31"},"PeriodicalIF":1.5,"publicationDate":"2004-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report the MRI findings in a 31-year-old woman with veno-occlusive disease. MRI demonstrated patent hepatic veins and patchy signal enhancement of the liver after gadolinium chelate injection. This enhancement was compatible with sinusoidal congestion. The diagnosis of veno-occlusive disease was confirmed by histological examination of liver biopsy. The diagnosis of veno-occlusive disease should be evoked when patchy liver enhancement suggestive of sinusoidal congestion is observed in the absence of hepatic vein thrombosis and congestive heart failure.
{"title":"MR imaging findings in a patient with hepatic veno-occlusive disease.","authors":"Ch Dumont, M Lambert, B E Van Beers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report the MRI findings in a 31-year-old woman with veno-occlusive disease. MRI demonstrated patent hepatic veins and patchy signal enhancement of the liver after gadolinium chelate injection. This enhancement was compatible with sinusoidal congestion. The diagnosis of veno-occlusive disease was confirmed by histological examination of liver biopsy. The diagnosis of veno-occlusive disease should be evoked when patchy liver enhancement suggestive of sinusoidal congestion is observed in the absence of hepatic vein thrombosis and congestive heart failure.</p>","PeriodicalId":50942,"journal":{"name":"Acta Gastro-Enterologica Belgica","volume":"67 2","pages":"236-8"},"PeriodicalIF":1.5,"publicationDate":"2004-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment of chronic hepatitis C with interferon in combination with other compounds.","authors":"C Trepo, S N Ahmed, F Baily","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50942,"journal":{"name":"Acta Gastro-Enterologica Belgica","volume":"63 2","pages":"204-6"},"PeriodicalIF":1.5,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21764657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of novel anti-HCV therapies: HCV protease, helicase, and polymerase as therapeutic targets.","authors":"Z Hong, D N Standring, B Baroudy, J Y Lau","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50942,"journal":{"name":"Acta Gastro-Enterologica Belgica","volume":"63 2","pages":"210-2"},"PeriodicalIF":1.5,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21764664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report an 11-year-old boy with acute rheumatic fever who presented with gastric perforation while treated with corticosteroids (CS). He had been treated initially with acetylsalicylic acid for 11 days, CS replaced the treatment with acetylsalicylic acid due to deterioration of carditis. The possible pathogenesis is discussed.
{"title":"Perforated gastric ulcer complicating corticosteroid therapy in acute rheumatic fever.","authors":"A Klar, J Moise, A Brand, D Seror, H Hurvitz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report an 11-year-old boy with acute rheumatic fever who presented with gastric perforation while treated with corticosteroids (CS). He had been treated initially with acetylsalicylic acid for 11 days, CS replaced the treatment with acetylsalicylic acid due to deterioration of carditis. The possible pathogenesis is discussed.</p>","PeriodicalId":50942,"journal":{"name":"Acta Gastro-Enterologica Belgica","volume":"63 2","pages":"236-8"},"PeriodicalIF":1.5,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21765302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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