Clin Med
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Infliximab is a biological agent that is licensed for the treatment of severe Crohn's disease. The annual cost of infliximab treatment is approximately pound 16,456 (excl VAT). In May 2010, the National Institute for Health and Clinical Excellence (NICE) recommended that patients should receive biological agents as a planned course of treatment only until treatment failure or until 12 months after the start of treatment, whichever is shorter. ⋯ Four patients were in deep clinical remission and discontinued infliximab. Implementation of the NICE recommendations on the use of infliximab in Crohn's disease is likely to be challenging in the face of significant resistance from patients who have an understandable fear of relapse. It might be more appropriate to discuss treatment withdrawal when high-quality evidence is available to support this management option.
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Sudden cardiac death in an athlete is a rare and heartrending event, often occurring in the absence of warning symptoms. The causes of sudden cardiac death in athletes are age dependent and demonstrate a degree of geographical variation. Pre-participation screening is recommended by both the European Society of Cardiology and the American Heart Association although there is no consensus regarding the utilisation of an electrocardiogram. This article will review the aetiology of sudden cardiac death and will present the evidence for pre-participation screening.