Topical mesalazine as a cause of Stevens-Johnson syndrome.

Mesalazine is a drug routinely used in ulcerative colitis and usually has few side effects. There have been reports of uncommon cases of severe mucocutaneous damage, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), induced by salicylates. It is important to diagnose these promptly due to the high morbidity and mortality rates. We describe the case of a 46-year-old female with ulcerative proctitis, who developed SJS following topical mesalazine use. The lesions responded well to intravenous corticosteroids after discontinuation of the drug

Treatment with adalimumab in a patient with regenerative nodular hyperplasia secondary to azathioprine

Introduction: regenerative nodular hyperplasia (RNH) is a rare liver disease with an etiology that is not well understood. Among the etiological factors are purine-analogue drugs such as azathioprine. Case report: we present a case of a 47-year-old patient diagnosed with Crohn's disease in treatment with azathioprine due to corticosteroid dependency who developed RNH with clinical and laboratory signs of portal hypertension one year after starting treatment. After discontinuation of azathioprine, the patient started treatment and, given the poor disease progression, started treatment with adalimumab. This was continued with an excellent response and without deleterious effects on the liver. Discussion: the relevance of this case is twofold: First, this is a rare and early side effect of azathioprine treatment and this is an irreversible disease with potentially serious complications. Second, because treatment was carried out with biological drugs (adalimumab) despite the patient having advance liver disease with portal hypertension without any evidence of its worsening, nor signs of deleterious effects or complications, given that there is scarce or no experience with adalimumab treatment in this type of situation

Perianal Crohn's disease: clinical implications, prognosis and use of resources.

to investigate the prevalence of perianal disease, the associated phenotypical factors, its influence on prognosis and its impact on the use of health resources for patients with Crohn's disease. a unicentric retrospective observational study was performed with 430 patients with Crohn's disease tracked through a monographical consultation of intestinal inflammatory disease. Demographic and phenotypical data of Crohn's disease, pharmacological and surgical treatments, complementary tests carried out and hospital admissions were analyzed. A comparative study between those patients without perianal disease and those with perianal disease was performed, both in simple form and complex form. the prevalence of perianal disease was 40.2 %, and fistulas and abscesses were the most frequent manifestations. These appearances were associated with an affected rectum and the existence of extra-intestinal manifestations. The patients with perianal disease most frequently required immuno-suppressant and biological treatment, but no further abdominal surgery. Amongst the patients with perianal disease, the need for biologics was more frequent for luminal disease (42.8 % vs 30.7 %). Furthermore, more explorations were needed, aimed at the study of perianal disease and recto-colonoscopies, although more magnetic resonance (MR)/computed tomography (CT) enterographies were not required. perianal disease has a high prevalence among patients with Crohn's disease, especially when the rectum is affected. It is associated with a worse prognosis and more frequently requires biological treatments due to perianal and luminal evolution, especially in cases of complex perianal disease. This condition calls for more hospital admissions and complementary tests

Plan integral de atención a la accidentabilidad 2007-2012

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Igualdad, Salud y Políticas Sociales / Ciudadanía / Quiénes somos / Planes y Estrategias)YesEl Plan Integral de Atención a la Accidentabilidad se centra en tres líneas de trabajo simultáneas, que se corresponden con las distintas fases que rodean a un accidente, es decir antes, durante y después de que el mismo ocurra. Por ello, una de las líneas está precisamente dirigida, a través de acciones preventivas intersectoriales, a evitar que el accidente se produzca. Para cuando el accidente desafortunadamente no ha podido ser evitado, el Plan desarrolla una segunda línea destinada a la prestación de la mejor asistencia posible, potenciando la coordinación de los distintos servicios y dispositivos implicados. La tercera línea, por último, es la que plantea, tras el alta, las actuaciones necesarias que garanticen la continuidad asistencial en el domicilio en función de las secuelas

Cuadernos sobre salud y buen trato a la infancia y adolescencia en Andalucía

Publicado en la plataforma de la Red Sabia (Red de Salud y Buen Trato a la Infancia y la Adolescencia. http://www.redsabia.org/) de la Consejería de Igualdad, Salud y Políticas SocialesContiene: Cuaderno I: Intervención Integral desde salud ante el maltrato infantil. Enfoque de derechos de la Infancia; y, Cuaderno II: ¿Qué deben saber quienes trabajan en el sistema sanitario sobre el maltrato infantil?YesEstos cuadernos de trabajo sobre salud y buen arato a la infancia en Andalucía tienen por objetivo aportar un enfoque, un método de trabajo y unos instrumentos para mejorar y reforzar la reflexión y la práctica profesional relacionada con la prevención del maltrato infantil y la promoción del buen trato en la atención sanitaria a los niños, niñas y adolescentes, así como un tratamiento integral y de calidad a las víctimas infantiles de cualquier forma de violencia ejercida sobre ellos, siempre en colaboración con aquellas otras instituciones que configuran el sistema de atención a la infancia en Andalucía