8 research outputs found
Liberté / Libertés
« LibertĂ© » : concept exaltant et souvent exaltĂ© dont l'Ă©vidence semble absolue mais qui se dĂ©cline diffĂ©remment selon les cultures nationales ou selon que le locuteur est historien, juriste, philosophe ou homme de la rue. RevendiquĂ©e par toutes les civilisations occidentales, l'idĂ©e de libertĂ© se rĂ©vĂšle protĂ©iforme Ă l'infini mais contingente, modelĂ©e par l'Ă©poque et les circonstances, et souvent limitĂ©e par ses incertitudes. Si on peut vouloir mourir pour la libertĂ©, on sait rarement quel est son visage. 2Notre pratique d'anglicistes ou d'amĂ©ricanistes nous rend particuliĂšrement sensibles Ă ce hiatus qui s'Ă©tablit entre l'apparent consensus de nos civilisations sur la libertĂ© comme valeur suprĂȘme et les rĂ©alitĂ©s qu'elles ont placĂ©es derriĂšre ce terme. C'est la raison de ce colloque oĂč s'engage une rĂ©flexion qui permet de percevoir les bĂ©ances et les certitudes obsĂ©dantes de l'idĂ©e de libertĂ© dans nos cultures française, anglaise, amĂ©ricaine, de mĂȘme qu'elle nous en fait analyser les tĂątonnements et les bifurcations
Efficacy and tolerance of infliximab in children and adolescents with Crohn's disease.
Infliximab, a monoclonal antibody against tumor necrosis factor-alpha, has been shown to be effective for the treatment of refractory Crohn's disease in adult patients, but experience in pediatrics is limited. This retrospective study included 88 children and adolescents, 39 girls and 49 boys, with a median age of 14 years (range 3.3-17.9). Infliximab was indicated for active disease (66%) and/or fistulas (42%) that were refractory to corticosteroids (70%), and/or other immunosuppressive (82%) agents, and/or parenteral nutrition (20%). Patients received 1 to 17 infusions (median 4) of 5 mg/kg (range 3.8-7.3) of infliximab during a median time period of 4 months (1-17 months). Infusion reaction was noted in 13 patients (15%), with a total of 16 reactions in 450 infusions (4%). At Day 90 after the first infusion of infliximab, symptoms improved in 49% of patients, whereas 29% of patients were in remission and 13% of patients relapsed. From Day 0 to Day 90, Harvey-Bradshaw score decreased from 7.5 to 2.8 (P < 0.001), C-reactive protein from 36 to 16 mg/L (P < 0.01), and 1-hour erythrocyte sedimentation rate from 35 to 17 mm (P < 0.01). Dosage of corticosteroids decreased from to 0.59 to 0.17 mg/kg/d (P < 0.001); 53% of patients could be weaned of corticosteroids and 92% of parenteral nutrition. Treatment with infliximab is well tolerated and effective in most children and adolescents with Crohn's disease that is refractory to conventional immunosuppressive therapy. Nevertheless, long-term efficacy remains to be shown, and further studies are urgently needed to precisely determine the best modality of continuing treatment
Efficacy and tolerance of infliximab in children and adolescents with Crohn's disease
Infliximab, a monoclonal antibody against tumor necrosis factor-alpha, has been shown to be effective for the treatment of refractory Crohn's disease in adult patients, but experience in pediatrics is limited. This retrospective study included 88 children and adolescents, 39 girls and 49 boys, with a median age of 14 years (range 3.3-17.9). Infliximab was indicated for active disease (66%) and/or fistulas (42%) that were refractory to corticosteroids (70%), and/or other immunosuppressive (82%) agents, and/or parenteral nutrition (20%). Patients received 1 to 17 infusions (median 4) of 5 mg/kg (range 3.8-7.3) of infliximab during a median time period of 4 months (1-17 months). Infusion reaction was noted in 13 patients (15%), with a total of 16 reactions in 450 infusions (4%). At Day 90 after the first infusion of infliximab, symptoms improved in 49% of patients, whereas 29% of patients were in remission and 13% of patients relapsed. From Day 0 to Day 90, Harvey-Bradshaw score decreased from 7.5 to 2.8 (P < 0.001), C-reactive protein from 36 to 16 mg/L (P < 0.01), and 1-hour erythrocyte sedimentation rate from 35 to 17 mm (P < 0.01). Dosage of corticosteroids decreased from to 0.59 to 0.17 mg/kg/d (P < 0.001); 53% of patients could be weaned of corticosteroids and 92% of parenteral nutrition. Treatment with infliximab is well tolerated and effective in most children and adolescents with Crohn's disease that is refractory to conventional immunosuppressive therapy. Nevertheless, long-term efficacy remains to be shown, and further studies are urgently needed to precisely determine the best modality of continuing treatment