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Crohns disease surgery

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https://www.readbyqxmd.com/read/29142520/predictive-factors-for-malignancy-in-undiagnosed-isolated-small-bowel-strictures
#1
Ujjwal Sonika, Sujeet Saha, Saurabh Kedia, Nihar Ranjan Dash, Sujoy Pal, Prasenjit Das, Vineet Ahuja, Peush Sahni
Background/Aims: Patients with small bowel strictures have varied etiologies, including malignancy. Little data are available on the demographic profiles and etiologies of small bowel strictures in patients who undergo surgery because of intestinal obstruction but do not have a definitive pre-operative diagnosis. Methods: Retrospective data were analyzed for all patients operated between January 2000 and October 2014 for small bowel strictures without mass lesions and a definite diagnosis after imaging and endoscopic examinations...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29140942/minority-pediatric-patients-with-inflammatory-bowel-disease-demonstrate-an-increased-length-of-stay
#2
Edward L Barnes, Bharati Kochar, Millie D Long, Christopher F Martin, Michael D Kappelman
BACKGROUND: Genetic and other biological factors may lead to differences in disease behavior among children with inflammatory bowel disease of different races, which may be further modified by disparities in care delivery. Using the Kids' Inpatient Database, we aimed to evaluate differences in the management of pediatric patients with inflammatory bowel disease by race, focusing on length of stay (LOS). METHODS: We performed a cross-sectional analysis using 2000 to 2012 data from the Kids' Inpatient Database, a nationally representative database...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29140453/faecal-transplantation-for-ibd-management-pitfalls-and-promises
#3
M N Quraishi, T Critchlow, N Bhala, N Sharma, T Iqbal
Background: Faecal microbiota transplantation (FMT) as a potential treatment for inflammatory bowel disease (IBD) is an area of active current research, having been stimulated by the remarkable efficacy of FMT in treatment of Clostridium difficile-associated colitis. Sources of data: This review is based on data from numerous case series on FMT in IBD since 1989 and results of four RCTs in ulcerative colitis (UC); three fully published. Areas of agreement: Early signals of short to medium-term efficacy of FMT for UC are promising...
November 13, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/29139091/pharmacological-approach-to-the-management-of-crohn-s-disease-patients-with-perianal-disease
#4
REVIEW
Fernando Bermejo, Iván Guerra, Alicia Algaba, Antonio López-Sanromán
Perianal localization of Crohn's disease involves significant morbidity, affects quality of life and results in an increased use of healthcare resources. Medical and surgical therapies contribute to its management. The objective of this review is to address the current understanding in the management of perianal Crohn's disease, with the main focus in reviewing pharmacological therapies, including stem cells. In complex fistulas, once local sepsis has been controlled by surgical drainage and/or antibiotics, anti-TNF drugs (infliximab, adalimumab) are the first-line therapy, with or without associated immunomodulators...
November 14, 2017: Drugs
https://www.readbyqxmd.com/read/29134965/depression-is-associated-with-more-aggressive-inflammatory-bowel-disease
#5
Bharati Kochar, Edward L Barnes, Millie D Long, Kelly C Cushing, Joseph Galanko, Christopher F Martin, Laura E Raffals, Robert S Sandler
OBJECTIVES: Depression is prevalent in inflammatory bowel disease (IBD) patients. The impact of depression on IBD is not well-studied. It is unknown how providers should assess depression. METHODS: We used data from the Sinai-Helmsley Alliance for Research Excellence cohort, to assess methods of diagnosing depression and effects of baseline depression on disease activity at follow-up. A patient health questionnaire (PHQ-8) score ≥5 was consistent with mild depression...
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29133254/characteristics-and-progression-of-preclinical-inflammatory-bowel-disease
#6
Iago Rodríguez-Lago, Olga Merino, Irene Azagra, Ainara Maiz, Eva Zapata, Rebeca Higuera, Isabel Montalvo, María Fernández-Calderón, Paz Arreba, Juan Carrascosa, Ainara Iriarte, Isabel Portillo, Urko Aguirre, Manuel Barreiro-de Acosta, Miguel Muñoz-Navas, José Luis Cabriada
BACKGROUND & AIMS: Inflammatory bowel disease (IBD) is a chronic disease usually diagnosed after the appearance of gastrointestinal symptoms. Little is known about IBD progression during its early and even preclinical phases. We aimed to determine the number of new incidental diagnoses of IBD in an older population, and evaluate disease progression from its early stages. METHODS: We performed a retrospective analysis of 31,005 colonoscopies performed during colorectal cancer screening of patients with positive results from fecal immunochemical tests, at 11 centers in the Basque Country (Spain) from 2009 through 2014...
November 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29130989/preoperative-nutritional-optimization-for-crohn-s-disease-patients-can-improve-surgical-outcome
#7
Yael Dreznik, Nir Horesh, Mordechai Gutman, Aviad Gravetz, Imri Amiel, Harel Jacobi, Oded Zmora, Danny Rosin
BACKGROUND: Preoperative preparation of patients with Crohn's disease is challenging and there are no specific guidelines regarding nutritional support. The aim of this study was to assess whether preoperative nutritional support influenced the postoperative outcome. METHODS: A retrospective, cohort study including all Crohn's disease patients who underwent abdominal surgery between 2008 and 2014 was conducted. Patients' characteristics and clinical and surgical data were recorded and analyzed...
November 1, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29130230/-protective-measures-in-laparoscopic-resection-for-upper-or-mid-rectal-cancer-and-sigmoid-colon-cancer-with-transrectal-specimen-extraction-surgery
#8
Chuangang Fu, Zhuqing Zhou, Junyi Han, Bin Lu, Wei Gao, Zhe Zhu, Qixin Jiang, Fang Ji, Tao Du
OBJECTIVE: To introduce the use of a self-made specimen protective sleeve in laparoscopic resection for upper or mid rectal cancer and sigmoid colon cancer with transrectal specimen extraction surgery and the improvement of implantation method, so as to avoid and reduce bacterial contamination and tumor cell dissemination in abdominal cavity. METHODS: During June 2015 and May 2017, 48 cases of high located rectal or sigmoid colon cancer were operated laparoscopically with natural orifices specimen extraction surgery (NOSES) using a self-made specimen protecting sleeve...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29129185/combined-use-of-high-doses-of-vasopressin-and-corticosteroids-in-a-patient-with-crohn-s-disease-with-refractory-septic-shock-after-intestinal-perforation-a-case-report
#9
Salvatore Notaro, Marcello Sorrentino, Aniello Ruocco, Annalisa Notaro, Antonio Corcione, Patrizia Murino, Eugenio Piscitelli, Marianna Tamborino
BACKGROUND: In this article, we present a clinical case of refractory septic shock resulting from intestinal perforation treated with high doses of vasopressin and hydrocortisone during emergency surgery. The use of such high doses of vasopressin for this type of shock is not described in the literature. CASE PRESENTATION: A 49-year-old white woman with grade III obesity, Crohn's disease, and an intestinal perforation presented with refractory septic shock. Initially, a low dose of vasopressin was used...
November 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29126510/long-term-outcomes-of-pediatric-inflammatory-bowel-disease
#10
Soheila Nasiri, Mary Ellen Kuenzig, Eric I Benchimol
The incidence and prevalence of childhood-onset inflammatory bowel diseases (IBD), including subtypes Crohn's disease and ulcerative colitis, have risen dramatically in recent years, and have emerged globally as important pediatric chronic diseases. Therefore, health care providers are more frequently encountering very young children with IBD, a chronic and incurable condition requiring life-long therapy. These children are living long lives with IBD and therefore knowledge of long-term outcomes is increasingly important to better counsel families and determine the best course of treatment...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29126506/surgical-care-of-the-pediatric-crohn-s-disease-patient
#11
Dylan Stewart
Despite the significant advances in the medical management of inflammatory bowel disease over the last decade, surgery continues to play a major role in the management of pediatric Crohn's disease (CD). While adult and pediatric Crohn's disease may share many clinical characteristics, pediatric Crohn's patients often have a more aggressive phenotype, and the operative care given by the pediatric surgeon to the newly diagnosed Crohn's patient is very different in nature to the surgical needs of adult patients after decades of disease progression...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29124774/early-drug-and-anti-infliximab-antibody-levels-for-prediction-of-primary-nonresponse-to-infliximab-therapy
#12
H Bar-Yoseph, N Levhar, L Selinger, U Manor, M Yavzori, O Picard, E Fudim, U Kopylov, R Eliakim, S Ben-Horin, Y Chowers, B Ungar
BACKGROUND: Primary nonresponse, defined as lack of clinical benefit during the induction phase, occurs in up to 30% of IBD patients treated with infliximab. The mechanisms underlying primary nonresponse have not yet been clearly defined. AIM: To evaluate the association of early (week 2 and week 6) induction infliximab and anti-infliximab antibody levels with primary nonresponse. METHODS: A retrospective observational case-control study of inflammatory bowel disease patients treated with infliximab and followed at Sheba Medical Center between 2009 and 2016 was performed...
November 9, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29121041/the-incidence-rate-of-surgical-interventions-in-patients-with-crohn-s-disease-treated-with-anti-tumour-necrosis-factor-biologics
#13
Aleksandra Sobolewska-Włodarczyk, Anna Zielińska, Paweł Siwiński, Ewa Jędraszczyk, Krystyna Stec-Michalska, Marcin Włodarczyk, Maria Wiśniewska-Jarosińska
BACKGROUND: Anti-tumour necrosis factor alpha drugs (anti-TNF-α) effectively reduce the risk of surgery in Crohn's disease (CD). Unsatisfactory response to anti-TNF-α agents leads to the development of disease complications in a great percentage of patients. Simultaneously, possible predictive factors for ares during biological treatment remain uncertain. AIMS: To investigate the incidence rate of intestinal resection during biological treatment and search for predicting factors for ares demanding a surgical intervention...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/29118554/risk-factors-for-postoperative-recurrence-of-crohn-s-disease-with-emphasis-on-surgical-predictors
#14
REVIEW
Antonios Gklavas, Dionysios Dellaportas, Ioannis Papaconstantinou
Intestinal resection for Crohn's disease is not curative and postoperative recurrence rates remain high. Early detection of indices associated with recurrence and risk stratification are fundamental for the postoperative management of patients. Early endoscopy at 6-12 months is the "gold standard" procedure, whereas other modalities such as fecal calprotectin and imaging techniques can contribute to the diagnosis of recurrence. The purpose of this review is to summarize current data regarding risk factors correlated with postoperative relapse...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29112566/what-is-the-risk-of-anastomotic-leak-after-repeat-intestinal-resection-in-patients-with-crohn-s-disease
#15
W Forrest Johnston, Caitlin Stafford, Todd D Francone, Thomas E Read, Peter W Marcello, Patricia L Roberts, Rocco Ricciardi
BACKGROUND: Approximately half of Crohn's patients require intestinal resection, and many need repeat resections. OBJECTIVE: The purpose of this study was to evaluate the increased risk of clinical anastomotic leak in patients with a history of previous intestinal resection undergoing repeat resection with anastomosis for Crohn's disease. DESIGN: This was a retrospective analysis of prospectively collected departmental data with 100% capture...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29112200/peripheral-eosinophilia-in-patients-with-inflammatory-bowel-disease-defines-an-aggressive-disease-phenotype
#16
Benjamin Click, Alyce M Anderson, Ioannis E Koutroubakis, Claudia Ramos Rivers, Dmitriy Babichenko, Jorge D Machicado, Douglas J Hartman, Jana G Hashash, Michael A Dunn, Marc Schwartz, Jason Swoger, Arthur Barrie Iii, Sally E Wenzel, Miguel Regueiro, David G Binion
OBJECTIVES: Peripheral blood eosinophilia (PBE) in inflammatory bowel disease (IBD) is associated with ulcerative colitis (UC) and active disease. Little data exist on the long-term impact of PBE on disease course. We aimed to investigate the multi-year patterns of PBE and its impact on disease severity in a large IBD cohort. METHODS: We performed a registry analysis of a consented, prospective, natural history IBD cohort at a tertiary center from 2009 to 2014. Demographics, comorbidities, disease activity, healthcare utilization, and time to hospitalization or surgical resection of patients who displayed PBE were compared to patients without PBE...
November 7, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29108979/prediction-of-clinical-outcomes-in-crohn-s-disease-by-using-confocal-laser-endomicroscopy-results-from-a-prospective-multicenter-study
#17
Gian Eugenio Tontini, Jonas Mudter, Michael Vieth, Claudia Günther, Valentina Milani, Raja Atreya, Timo Rath, Andreas Nägel, Giorgia Hatem, Giacomo Carlo Sturniolo, Maurizio Vecchi, Markus F Neurath, Peter R Galle, Andrea Buda, Helmut Neumann
BACKGROUND & AIMS: Assessment of prognostic factors in Crohn's disease (CD) patients is of pivotal importance for early intervention and "treat-to-target" strategies. Confocal Laser Endomicroscopy (CLE) enables on demand in vivo characterization of mucosal inflammatory and architectural changes during endoscopy. We prospectively assessed the value of CLE for prediction of clinical outcome parameters in CD. METHODS: Consecutive patients with CD undergoing colonoscopy were included in a multicentre study...
November 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29102619/incidence-and-treatment-of-patients-diagnosed-with-inflammatory-bowel-diseases-at-60-years-or-older-in-sweden
#18
Åsa H Everhov, Jonas Halfvarson, Pär Myrelid, Michael C Sachs, Caroline Nordenvall, Jonas Söderling, Anders Ekbom, Martin Neovius, Jonas F Ludvigsson, Johan Askling, Ola Olén
BACKGROUND & AIMS: Diagnosis of inflammatory bowel diseases (IBD) is increasing among elderly persons (60 years or older). We performed a nationwide population-based study to estimate incidence and treatment. METHODS: We identified all incident IBD cases in Sweden, from 2006 through 2013, using national registers, and up to 10 matched population comparator subjects. We collected data on the patients' health care contacts and estimated incidence rates, health service burden, pharmacologic treatments, extra-intestinal manifestations, and surgeries in relation to age of IBD onset (pediatric, less than 18 years; adults, 18-59 years; elderly, 60 years or older)...
November 1, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29100078/colonic-strictures-in-children-and-young-adults-with-crohn-s-disease-recognition-on-mr-enterography
#19
David M Biko, Petar Mamula, Nancy A Chauvin, Sudha A Anupindi
OBJECTIVES: Identify MRE features of colonic strictures in children/young adults with Crohn's disease. METHODS: Included are patients with colonic strictures on colonoscopy imaged with MRE. Bowel wall thickening (BWT) with luminal narrowing, pre-stenotic dilatation (PSD), bowel wall enhancement, and diffusion restriction were evaluated. RESULTS: All potential strictures (n=12) had BWT with luminal narrowing on MRE. 8/12 had PSD, meeting our MRE stricture criteria...
October 20, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/29097874/risk-factors-for-postoperative-recurrence-after-primary-bowel-resection-in-patients-with-crohn-s-disease
#20
Kwan Mo Yang, Chang Sik Yu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Sang Hyoung Park, Byong Duk Ye, Suk-Kyun Yang, Jin Cheon Kim
AIM: To evaluate the risk factors for postoperative recurrence after primary bowel resection in a cohort of Korean Crohn's disease (CD) patients. METHODS: This study included 260 patients with no history of previous bowel surgery who underwent primary surgery for CD between January 2000 and December 2010 at Asan Medical Center (Seoul, South Korea). The median follow-up period was 101 mo. RESULTS: During the follow-up period, 66 patients (25...
October 14, 2017: World Journal of Gastroenterology: WJG
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