13 research outputs found

    Long-term efficacy and safety of otilonium bromide in the management of irritable bowel syndrome: a literature review

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    John K Triantafillidis, George Malgarinos Inflammatory Bowel Disease Unit, IASO General Hospital, Athens, Greece Abstract: Irritable bowel syndrome (IBS) is a very common functional gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits. The disease affects a large part of the world population. The clinical course is mostly characterized by a cyclic recurrence of symptoms. Therefore, IBS patients should receive, as an initial therapeutic approach, a short course of treatment, and long-term treatment should be reserved for those patients with recurrent symptoms. The available clinical trials show that significant improvement of the symptoms over placebo could be achieved with various drugs, although this improvement is frequently time dependent and with high relapse rates after the cessation of the treatment. In a proportion of patients, clinically obvious relapse could appear long after stopping the treatment. Some of the available pharmacologic agents, including otilonium bromide (OB), are able to significantly prolong the time to the appearance of relapse, compared with placebo. As a consequence, some authors suggest that a cyclic treatment could be of benefit. Antispasmodic drugs have been used for many years in an effort to control the symptoms of IBS. OB is a poorly absorbed spasmolytic drug, exerting significantly greater control of the symptoms of IBS compared with placebo. Recent data suggest that the drug could effectively be used for the long-term management of patients with IBS. The aim of this review is to provide the reader with an evidence-based overview of the efficacy and tolerability of OB in the long-term management of IBS patients, based on the results of the clinical trials published so far. Keywords: irritable bowel syndrome, IBS, treatment, otilonium bromid

    Entero-vesical fistulas in CROHN'S disease: A case series report and review of the literature

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    Background Entero-vesical fistula (EVF) is an abnormal link between the enteric lumen and the urinary bladder. Crohn's disease (CD) represents, nowadays, the most common cause in the formation of this fistula. Materials and methods The aim of this study was to describe the diagnostic and treating modalities applied in nine patients with CD and EVFs, the clinical/epidemiological features of this clinical entity and to perform a systemic review of the literature, concerning the diagnosis and treatment of this complication. Results The medical records of eight men and one woman (mean age 42 ± 12 years) with EVFs were analyzed. The terminal ileum and the ileocecal region were affected in three and six cases, respectively. The most common symptoms were pneumaturia, fecaluria, fever, urinary urgency and abdominal pain. The diagnosis was suspected by abdominal CT scan and by indirect findings of bladder infection in cystoscopy. MRI with concurrent cystography set the diagnosis in three patients. Colonoscopy was not helpful. Conservative treatment, including administration of antibiotics and immunosuppressive agents in all patients and anti-TNF-a agent (infliximab) in six patients, was ineffective. Surgical treatment was applied in seven cases (77.8%), including fistula repair in all patients, drainage of coexistent intraabdominal abscess in two, small bowel resection in four and ileocecectomy in two cases. Conclusion EFVs are uncommon but potentially dangerous complications of CD. Abdominal CT scan and cystoscopy are the most commonly used diagnostic modalities. Surgical treatment seems to be unavoidable in most cases, although medical treatment could also benefit a small cohort of patients. © 2017 The Author(s

    Droplet impingement and evaporation on a solid surface

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    An efficient spray injection leads to better vaporization and better air–fuel mixing, resulting in the stable combustion and reduced emissions in the internal combustion (IC) engines. The impingement of liquid fuels on chamber wall or piston surface in IC engines is a common phenomenon, and fuel film formed during the impingement plays a critical role in engine performance and emissions, particularly under cold start conditions. Therefore, the study on the characteristics of spray impingement on the chamber wall or piston surface is necessary. However, first, due to the complexity of the practical fuel injection systems, it is difficult to attain the detailed specific information of the spray impingement from the experiments such as droplet size, mass, number, and velocity distributions in the vicinity of wall region. Second, because of the Lagrangian particle/parcel concept (a particle representing a number of droplets in simulations), the spray–wall interaction model under Eulerian–Lagrangian approach is often developed based on the individual droplet. Therefore, the individual droplet’s impingement on wall and the droplet-to-droplet collision have been extensively studied to assist in a profound perception on the spray–wall impingement. In this chapter, the encouraging experimental observations of applying optical diagnostics technology to study droplet–wall impingement are extensively discussed. Single droplet impingement on a solid surface with various conditions was examined to understand the detailed impinging dynamic process. The droplet–wall interaction outcomes, in particular focusing on the splashing criteria, were inspected, and a new correlation of deposition–splashing is developed. Post-impingement characterizations including spreading factor, height ratio, contact line velocity, and dynamic contact angle were then analyzed based on the experimental data at various test conditions. Further, the non-evaporation volume of fluid (VOF) method based on Eulerian approach was used to characterize single droplet impinging on the wall and provide a better understanding of the dynamic impact process. The simulation results of the spreading factor and height ratio matched well with the experimental results during the droplet impingement process. In addition, due to the evaporation drawing more attention during the engine combustion process, an evaporation VOF (e-VOF) sub-model was developed and applied to multi-droplet impingement on a heated surface to qualitatively and quantitatively analyze the vaporizing process as droplets impacting onto the hot surface. The information obtained from VOF simulations can be applied to improve the spray–wall interaction models in the liquid spray Eulerian–Lagrangian method
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