Rheumatologic manifestations of gastrointestinal disorders.
Mody GM. Cassim B.
Department of Medicine, University of Natal, Durban, Kwa Zulu Natal, South Africa.
Rheumatologic features are among the most common extraintestinal manifestations of gastrointestinal disorders. They are an important cause of morbidity and continue to generate interest among researchers. Over the past year, reports have focused attention on inflammatory bowel disease and coeliac disease. Among the hepatic disorders, cryoglobulinemia, Sjogren's syndrome, and other immunological disorders have been reported in association with hepatitis C virus infections. Rheumatologic manifestations are well-documented in association with pancreatic disorders. There are also a number of interesting and unusual case reports that are reviewed.
Rheumatic manifestations of infectious diseases in children.
Barnsley District General Hospital, United Kingdom.
Infectious diseases continue to elicit worldwide attention. Many of these diseases have rheumatic manifestations as an incidental or principal feature. Because this is particularly true in children, rheumatic manifestations of infectious diseases in this population continue to be an area of great importance to rheumatologists. A variety of bacteria, viruses, fungi, and parasitic organisms can give rise to infectious diseases with rheumatic manifestations. A high index of clinical suspicion is frequently necessary for an accurate diagnosis. Prompt diagnosis and early and appropriate therapeutic intervention are usually required for a successful, and frequently curative, outcome. Over the past year, studies have addressed the pathogenetic mechanisms and clinical spectrum of the rheumatic manifestations of infectious diseases in children. There has been particular emphasis on septic arthritis, osteomyelitis, sickle-cell disease, and hepatitis C viral infection. There remains the daunting and unfortunate possibility of large numbers of children developing HIV-associated arthritis.
Biology and toxic effects of nonsteroidal anti-inflammatory drugs.
Beth Israel Deaconess Medical Center, Department of Medical Education, Boston, MA 02215, USA.
Nonsteroidal anti-inflammatory drugs (NSAIDs) continue to be important therapeutically. The development of drugs that are highly COX-2 selective has led to interesting new findings about their effects and potential toxic reactions. This year there were interesting observations about the effects of individual NSAIDs on the gastrointestinal mucosa, risk factors for sustaining an NSAID-induced gastric or duodenal ulcer, and there has been progress in further understanding what may or may not work to prevent a toxic reaction. Furthermore, information has been gathered about the effects of NSAIDs on colorectal polyps and the development of cancers.