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Ulcerative colitis surgery

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https://www.readbyqxmd.com/read/28448381/higher-surgical-morbidity-for-ulcerative-colitis-patients-in-the-era-of-biologics
#1
Jonathan S Abelson, Fabrizio Michelassi, Jialin Mao, Art Sedrakyan, Heather Yeo
OBJECTIVE: To investigate differences in surgical approach and postoperative outcomes for patients with ulcerative colitis (UC) before and after the introduction of biologic therapy. BACKGROUND: Biologic use has dramatically increased since Food and Drug Administration approval of infliximab. Studies conflict as to the effect of these agents on surgical outcomes with some demonstrating worse surgical outcomes whereas others have found no difference. METHODS: We used an administrative, all-payer, all-age group database located in New York State...
April 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28445244/outcomes-after-primary-infliximab-treatment-failure-in-inflammatory-bowel-disease
#2
Sine Buhl, Casper Steenholdt, Maria Rasmussen, Märta K Borghede, Jørn Brynskov, Ole Ø Thomsen, Mark A Ainsworth
BACKGROUND: Primary infliximab treatment failure is common in patients with inflammatory bowel disease and represents a challenge to clinicians. Treatment options are limited. This study assessed the prognosis, defined as surgery-free survival, in patients with primary infliximab treatment failure as compared to patients without primary failure (initial responders). Furthermore, this study assessed the specter of medical therapies used after primary infliximab treatment failure along with treatment outcomes...
April 25, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28426675/indicators-of-suboptimal-biologic-therapy-over-time-in-patients-with-ulcerative-colitis-and-crohn-s-disease-in-the-united-states
#3
Haridarshan Patel, Trevor Lissoos, David T Rubin
This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn's disease (CD) patients over time in the United States (US). Data from a large US claims database (2005-2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only)...
2017: PloS One
https://www.readbyqxmd.com/read/28426451/quality-of-care-and-outcomes-among-hospitalized-inflammatory-bowel-disease-patients-a-multicenter-retrospective-study
#4
Geoffrey C Nguyen, Sanjay K Murthy, Brian Bressler, Mindy C W Lam, Ali Alali, Asmae Toumi, Jason Reinglas, Adam Rampersad, Adam V Weizman, Waqqas Afif
BACKGROUND: Half of patients with inflammatory bowel disease (IBD) require hospitalization. We sought to characterize inpatient quality indicators of care and outcomes during IBD-related hospitalizations at 4 major IBD referral centers in Canada. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD admitted from 2011 to 2013 to tertiary centers in Toronto, Montreal, Ottawa, and Vancouver. We assessed the following inpatient indicators of care: pharmacological venous thromboembolism (VTE) prophylaxis, Clostridium difficile testing, and medical rescue therapy for steroid-refractory ulcerative colitis (UC)...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28425825/reviewing-treatments-and-outcomes-in-the-evolving-landscape-of-ulcerative-colitis
#5
Marla C Dubinsky
Ulcerative colitis (UC) is a chronic inflammatory disease extending proximally from the rectum to varying lengths of the colon that is characterized by alternating cycles of relapse and remission. Therapeutic goals for patients with active UC include induction and maintenance of remission and improvement in quality of life, as well as mucosal healing, a clinical outcome recently recognized in treatment guidance as being equally important. Mucosal healing is associated with favorable long-term patient outcomes related to remission, surgery, hospitalization, and quality of life...
April 20, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28422836/fecal-microbiota-transplantation-is-a-rescue-treatment-modality-for-refractory-ulcerative-colitis
#6
Ahmet Uygun, Kadir Ozturk, Hakan Demirci, Cem Oger, Ismail Yasar Avci, Turker Turker, Mustafa Gulsen
BACKGROUND: Fecal microbial transplantation (FMT) provides to replace beneficial bacteria with more favorable microbiomes in recipient with dysbiosis. The aim of the present study was to prospectively investigate the efficacy of FMT by assessing the clinical and endoscopic response in patients with ulcerative colitis (UC) who had failed anti-inflammatory and immunosuppressive therapy. METHODS: In this prospective and uncontrolled study, 30 patients with UC were included...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28411286/rapid-induction-therapy-with-oral-tacrolimus-in-elderly-patients-with-refractory-ulcerative-colitis-can-easily-lead-to-elevated-tacrolimus-concentrations-in-blood-a-report-of-5-cases
#7
Haruna Kawamura, Satohiro Matsumoto, Noriyuki Nakamura, Hiroyuki Miyatani, Hirosato Mashima
BACKGROUND Tacrolimus is reportedly effective for the treatment of refractory ulcerative colitis (UC). At our hospital, there has been an increase in the number of patients, including elderly patients, with refractory UC treated with tacrolimus. Here, we review the data from 5 patients with elderly-onset UC treated with tacrolimus as remission induction therapy. CASE REPORT The subjects were 5 patients ≥65 years of age with refractory UC who had received oral tacrolimus as remission induction therapy between 2009 and 2014 (3 men and 2 women; median age at onset, 75 years)...
April 15, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28410340/inflammatory-bowel-disease-is-similar-in-patients-with-older-onset-and-younger-onset
#8
Bharati Kochar, Millie D Long, Joseph Galanko, Laura E Raffals, Ashwin Ananthakrishnan, Robert S Sandler
BACKGROUND: As the American population is aging, the number of older people with inflammatory bowel disease is increasing. We used clinical data from the Sinai-Helmsley Alliance for Research Excellence (SHARE), a prospective cohort, to examine disease and treatment differences in older adults. METHODS: We performed a cross-sectional study assessing demographics and disease behavior by age at diagnosis with univariate, bivariate, and multivariate analyses. "Older-onset" patients were diagnosed after age 60, "younger-onset" patients were diagnosed before age 60 but are older than 60 years, and the remainder were "young...
April 13, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28397433/induction-and-maintenance-infliximab-therapy-in-children-with-moderate-to-severe-ulcerative-colitis-retrospective-multicenter-study
#9
Barbara M Iwańczak, Jarosław Kierkuś, Józef Ryżko, Mariusz Szczepanik, Sabina Więcek, Grażyna Czaja-Bulsa, Magdalena Kacperska, Bartosz Korczowski, Jolanta Maślana, Franciszek Iwańczak
BACKGROUND: Pediatric ulcerative colitis (UC) is a severe disease characterised by the presence of extensive inflammatory lesions in the colon. The administration of intravenous corticosteroids is recommended in patients with acute relapse of the disease, whereas early treatment with cyclosporine, tacrolimus or infliximab is recommended if there is no improvement. OBJECTIVES: The aim of this study was to retrospectively evaluate the efficacy and safety of infliximab therapy in the treatment of moderate-to-severe and severe relapse of pediatric UC...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28391412/role-of-mirnas-in-inflammatory-bowel-disease
#10
REVIEW
Bo Cao, Xin Zhou, Jiaojiao Ma, Wei Zhou, Wanli Yang, Daiming Fan, Liu Hong
Inflammatory bowel diseases (IBD), mainly including Crohn's disease and ulcerative colitis, are characterized by chronic inflammation of the gastrointestinal tract. Despite improvements in detection, drug treatment and surgery, the pathogenesis of IBD has not been clarified. A number of miRNAs have been found to be involved in the initiation, development and progression of IBD, and they may have the potential to be used as biomarkers and therapeutic targets. Here, we have summarized the recent advances about the roles of miRNAs in IBD and analyzed the contribution of miRNAs to general diagnosis, differential diagnosis and activity judgment of IBD...
April 8, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28383450/long-term-outcomes-after-continent-ileostomy-creation-in-patients-with-crohn-s-disease
#11
Erman Aytac, David W Dietz, Jean Ashburn, Feza H Remzi
BACKGROUND: Patients with Crohn's disease have a higher failure rate after ileal pouch surgery compared with their counterparts with ulcerative colitis. OBJECTIVE: We hypothesized that risk of continent ileostomy failure can be stratified based on the timing of Crohn's disease diagnosis and aimed to assess long-term outcomes. DESIGN: This was a retrospective cohort study. SETTINGS: The investigation took place in a high-volume, specialized colorectal surgery department...
May 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28378692/can-we-predict-disease-course-with-clinical-factors
#12
Zsuzsanna Vegh, Zsuzsanna Kurti, Petra Anna Golovics, Laszlo Lakatos
The disease phenotype at diagnosis and the disease course of Crohn's disease (CD) and ulcerative colitis (UC) show remarkable heterogeneity across patients. In recent population-based epidemiological and referral cohort studies, the evolution of disease phenotype of CD and UC varied significantly. Most CD and severe UC patients still requires hospitalization or surgery/colectomy during follow-up. A change in the natural history of IBD with improved outcomes in parallel with tailored positioning of aggressive immunomodulator and biological therapy has been suspected according to the recently available literature...
March 28, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28361220/disease-severity-and-treatment-requirements-in-familial-inflammatory-bowel-disease
#13
María Pilar Ballester, David Martí, Joan Tosca, Marta Maia Bosca-Watts, Ana Sanahuja, Pablo Navarro, Isabel Pascual, Rosario Antón, Francisco Mora, Miguel Mínguez
PURPOSE: Several studies demonstrate an increased prevalence and concordance of inflammatory bowel disease among the relatives of patients. Other studies suggest that genetic influence is over-estimated. The aims of this study are to evaluate the phenotypic expression and the treatment requirements in familial inflammatory bowel disease, to study the relationship between number of relatives and degree of kinship with disease severity and to quantify the impact of family aggregation compared to other environmental factors...
March 31, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28350740/prevalence-of-hepatitis-b-and-c-and-factors-for-infection-and-nonimmune-in-inflammatory-bowel-disease-patients-in-china
#14
Dafan Chen, Shengzheng Luo, Qiwen Ben, Lungen Lu, Xinjian Wan, Jianjiong Wu
OBJECTIVE: The aims of this study were to investigate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in inflammatory bowel disease (IBD) patients and the risk factors related to the infection and nonimmune status. METHODS: A retrospective study was carried out at two clinical centers. The prevalence of viral markers and risk factors related to HBV and HCV infection and nonimmune status were analyzed in IBD patients. Age-matched and sex-matched healthy individuals were recruited as the controls...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28337230/health-related-quality-of-life-assessment-among-patients-with-inflammatory-bowel-diseases-after-surgery-review
#15
REVIEW
Grażyna Bączyk, Dorota Formanowicz, Łukasz Gmerek, Piotr Krokowicz
Aim of the work was to review systematically the published literature addressing whether quality of life (QoL) and health-related QoL (HRQoL) are influenced by surgery among patients with inflammatory bowel disease (IBD). Electronic databases and published articles were searched to identify relevant studies published in the years 1990-2015. Then, a multistep selection was undertaken to identify articles that met specific selection criteria, such us specific key-words (IBD, HRQoL, ulcerative colitis (UC), Crohn's disease (CD), and surgery), and the population was assessed (studies concerning patients < 18 years old were excluded)...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/28333769/the-incidence-of-low-seroimmunity-to-hepatitis-b-virus-in-children-with-inflammatory-bowel-disease
#16
Abhishek Watts, William E Bennett, Jean P Molleston, Sandeep K Gupta, Joseph M Croffie, Shamaila Waseem, Brian A McFerron, Steven J Steiner, Sanjay Kumar, Charles P Vanderpool, Emily C Hon, Molly A Bozic, Girish C Subbarao, Marian D Pfefferkorn
OBJECTIVES: Patients with inflammatory bowel disease (IBD) often receive immunosuppressive therapy which may make them vulnerable to infections such as hepatitis B. We hypothesized that hepatitis B virus (HBV) titers are low in the vaccinated pediatric IBD population. The aims of our study were to identify the incidence of lower titers of hepatitis B surface antibody (HBsAb) and determine which patient factors may be associated with lower HBsAb titers. METHODS: Patients with diagnosis of IBD, ages 5-18 years, were prospectively enrolled...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28328622/quality-of-care-and-outcomes-among-hospitalized-inflammatory-bowel-disease-patients-a-multicenter-retrospective-study
#17
Geoffrey C Nguyen, Sanjay K Murthy, Brian Bressler, Mindy C W Lam, Ali Alali, Asmae Toumi, Jason Reinglas, Adam Rampersad, Adam V Weizman, Waqqas Afif
BACKGROUND: Half of patients with inflammatory bowel disease (IBD) require hospitalization. We sought to characterize inpatient quality indicators of care and outcomes during IBD-related hospitalizations at 4 major IBD referral centers in Canada. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD admitted from 2011 to 2013 to tertiary centers in Toronto, Montreal, Ottawa, and Vancouver. We assessed the following inpatient indicators of care: pharmacological venous thromboembolism (VTE) prophylaxis, Clostridium difficile testing, and medical rescue therapy for steroid-refractory ulcerative colitis (UC)...
March 21, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28321155/pseudopolyps-in-inflammatory-bowel-diseases-have-we-learned-enough
#18
REVIEW
Dimitrios S Politis, Konstantinos H Katsanos, Epameinondas V Tsianos, Dimitrios K Christodoulou
Pseudopolyps are a well described entity in the literature and even though the exact pathogenesis of their formation is not completely understood, they are considered non-neoplastic lesions originating from the mucosa after repeated periods of inflammation and ulceration associated with excessive healing processes. Their occurrence is less common in Crohn's disease than in ulcerative colitis, and their overall prevalence ranges from 4% to 74%; moreover, they are found more often in colon but have been detected in other parts of the gastrointestinal tract as well...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28315811/variant-two-stage-ileal-pouch-anal-anastomosis-an-innovative-and-effective-alternative-to-standard-resection-in-ulcerative-colitis
#19
Jennifer Samples, Krista Evans, Nicole Chaumont, Paula Strassle, Timothy Sadiq, Mark Koruda
BACKGROUND: Ulcerative colitis patients have been historically treated with standard single, two and three stage operative approaches. We perform a variant two-stage procedure beginning with total abdominal colectomy and end ileostomy followed by completion proctectomy and ileal pouch-anal anastomosis without a diverting loop ileostomy. The present study evaluates the effectiveness of this innovative alternative. STUDY DESIGN: Patients with ulcerative colitis admitted to UNC Hospital between 2003 and 2010 for IPAA were eligible for inclusion...
January 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28301430/etiopathogenesis-of-nephrolithiasis-in-ulcerative-colitis-patients-with-the-ileal-pouch-anal-anastomosis
#20
Zubin Arora, Saurabh Mukewar, Rocio Lopez, Debra Camino, Bo Shen, Phillip Hall
BACKGROUND: Our previous study showed that nephrolithiasis is a common complication in ulcerative colitis patients after ileal pouch anal anastomosis (IPAA). However, the pathogenesis of nephrolithiasis in IPAA patients has not been studied. The aim of this study was to compare urine and serum metabolic compositions in IPAA patients with nephrolithiasis and controls with IPAA and no nephrolithiasis. METHODS: Using cross-sectional study design, serum and 24-hour urine metabolic compositions were compared between IPAA patients with nephrolithiasis (the study group) and those without (the control group)...
May 2017: Inflammatory Bowel Diseases
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