Description
Respiratory diseases in children, such as asthma, pneumonia, and bronchiolitis, are significant causes of morbidity and mortality worldwide. These conditions often present with symptoms like wheezing, coughing, and difficulty breathing, requiring prompt diagnosis and management. Advances in medical care have improved the treatment outcomes, but disparities in healthcare access still pose challenges. Preventative measures, including vaccination and reducing exposure to environmental pollutants, play a crucial role in mitigating the impact of these diseases. Early intervention and comprehensive care are essential to enhance the quality of life for affected children.
Résumé
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by continuous mucosal inflammation in the colon, starting in the rectum. Unlike Crohn's disease, UC only affects the large intestine. The goal of UC treatment is to control symptoms, induce remission, and improve quality of life, with a focus on healing inflammation and preventing complications like cancer and surgery.
- The main treatments for UC are pharmacological and non-pharmacological. Salicylate derivatives, like mesalazine and sulfasalazine, are first-line treatments for mild to moderate UC. Steroids and biologicals are used in more severe cases. Emerging experimental treatments include probiotics, dietary changes (gluten-free, lactose-free, FODMAP), and fecal microbiota transplantation, though their benefits are not yet fully proven.
- UC is classified based on the extent of colon involvement: proctitis (rectum only), left-sided, and extensive. The Mayo score is used clinically to assess disease activity based on stool frequency, rectal bleeding, mucosal appearance, and physician's global assessment. Treatment choices depend on the severity of the disease, with mild to moderate cases initially treated with mesalazine and more severe cases requiring anti-TNF or other biologicals.
- Mesalazine is a topical anti-inflammatory agent with various mechanisms of action, including inhibiting prostaglandin and leukotriene synthesis, and reducing macrophage and neutrophil activity. It is available in oral and topical (enemas, foam, suppositories) formulations. Oral mesalazine comes in different delivery systems (time-dependent, pH-dependent) designed to increase its concentration in the colon.
- Different mesalazine formulations like Pentasa, Asacol, and Salofalk vary in their delivery systems and release mechanisms. pH-dependent formulations, like Salofalk/Crohn deliver a higher concentration of mesalazine to the colon mucosa with less systemic absorption compared to time-dependent formulations. Combining oral and topical mesalazine is more effective than either alone. While mesalazine is generally safe, side effects are minimal. It is also proactive for coloral cancer.
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