John Deweyn idealismista

Vastine Sami Pihlströmin kirjoitukseen Tieteessä tapahtuu-lehden numerossa 4/2000

Appropriate maintenance treatment for Crohn's disease: results of a multidisciplinary international expert panel - EPACT II

Introduction: Biological. therapy has dramatically changed management of Crohn's disease (CD). New data have confirmed the benefit and relative long-term safety of anti-TNF alpha inhibition as part of a regular scheduled administration programme. The EPACT appropriateness criteria for maintenance treatment after medically-induced remission (MIR) or surgically-induced remission (SIR) of CD thus required updating. Methods: A multidisciplinary international expert panel (EPACT II, Geneva, Switzerland) discussed and anonymously rated detailed, explicit clinical indications based on evidence in the literature and personal expertise. Median ratings (on a 9-point scale) were stratified into three assessment categories: appropriate (7-9), uncertain (4-6 and/or disagreement) and inappropriate (1-3). Experts ranked appropriate medication according to their own clinical practice, without any consideration of cost. Results: Three hundred and ninety-two specific indications for maintenance treatment of CD were rated (200 for MIR and 192 for SIR). Azathioprine, methotrexate and/or anti-TNF alpha antibodies were considered appropriate in 42 indications, corresponding to 68% of all appropriate interventions (97% of MIR and 39% of SIR). The remaining appropriate interventions consisted of mesalazine and a "wait-and-see" strategy. Factors that influenced the panel's voting were patient characteristics and outcome of previous treatment. Results favour use of anti-TNF alpha agents after failure of any immunosuppressive therapy, while earlier primary use remains controversial. Conclusion: Detailed explicit appropriateness criteria (EPACT) have been updated for maintenance treatment of CD. New expert recommendations for use of the classic immunosuppressors as well as anti-TNF alpha agents are now freely available online (www.epact.ch). The validity of these criteria should now be tested by prospective evaluation. (C) 2009 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Public libraries: adapting to the digitised environment. An interview with John Lake

During John Lake's visit to Barcelona to take part in a seminar organized by the Facultat de Biblioteconomia i Documentació (Department of Library and Information Science) at the University of Barcelona (UB)1 EPI sought an interview to further explore some of the themes addressed in the seminar, drawing on his extensive experience in the world of public libraries.

Tuoreita metodisia näkökulmia suullisen runouden tutkimukseen : John Miles Foley Suomalaisen Kirjallisuuden Seuran vieraana 16.10.-24.11.2006

Ajankohtaista

Millepertuis, corticoïdes, cocaïne, alcool ... et un premier épisode maniaque. Femme, 36 ans, artiste [St. John's Wort, corticosteroids, cocaine, alcohol ... and a first manic episode].

We describe an alcohol and cocaine abusing female patient who developed a first manic episode in the context of a corticosteroid prescription. The differential diagnoses are discussed on the basis of the available literature on secondary manias.

Oeuvres de Locke et Leibnitz, contenant l'Essai sur l'entendement humain... accompagné de notes, par M. F. Thurot,... l'Éloge de Leibnitz par Fontenelle, le Discours sur la conformité de la foi et de la raison, l'Essai sur la bonté de Dieu, la liberté de l'homme et l'origine du mal, la Controverse réduite à des arguments de forme

Comprend : Éloge de M. Leibnitz