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https://www.readbyqxmd.com/read/28937552/naspghan-clinical-report-on-postoperative-recurrence-in-pediatric-crohn-disease
#1
Judy B Splawski, Marian D Pffefferkorn, Marc E Schaefer, Andrew S Day, Oliver S Soldes, Todd A Ponsky, Philip Stein, Jess L Kaplan, Shehzad A Saeed
Pediatric Crohn disease is characterized by clinical and endoscopic relapses. The inflammatory process is considered to be progressive and may lead to strictures, fistulas, and penetrating disease that may require surgery. In addition, medically refractory disease may be treated by surgical resection of inflamed bowel in an effort to reverse growth failure. The need for surgery in childhood suggests severe disease and these patients have an increased risk for recurrent disease and potentially more surgery. Data show that up to 55% of patients had clinical recurrence in the first 2 years after initial surgery...
October 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28922370/ileocolic-resection-is-associated-with-increased-susceptibility-to-injury-in-a-murine-model-of-colitis
#2
Troy Perry, Michael Laffin, Richard N Fedorak, Aducio Thiesen, Bryan Dicken, Karen L Madsen
Ileocolic resection (ICR) is the most common intestinal resection performed for Crohn's disease, with recurrences commonly occurring at the site of the anastomosis. This study used an animal model of ICR in wild-type mice to examine immunologic changes that developed around the surgical anastomosis and how these changes impacted gut responses to minor acute injury. ICR was performed in adult 129S1/SvlmJ mice and results compared with mice receiving sham or no surgery. Dextran sodium sulfate was given either on post-operative day 9 or day 24 to evaluate immune responses in the intestine both immediately following surgery and after a period of healing...
2017: PloS One
https://www.readbyqxmd.com/read/28922207/sweet-sixteen-the-prospective-clinical-trials-of-john-l-cameron-md-the-clinician-scientist-from-alternate-allocation-to-randomized-controlled-trials
#3
Charles J Yeo
: The era of randomized controlled trials was ushered in by the British epidemiologist-statistician Austin Bradford Hill, with his work on the use of streptomycin in patients with tuberculosis. John L. Cameron, can be linked to 16 prospective clinical trials over his career thus far, starting with alternate-allocation trials and transitioning to prospective, randomized, placebo-controlled trials. These trials studied various topics in surgery-from pancreatitis to surgical site infections, to drain trials, a trial in Crohn disease and multiple trials in pancreatic surgery and cancer...
September 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28913968/risk-factors-for-unfavourable-postoperative-outcome-in-patients-with-crohn-s-disease-undergoing-right-hemicolectomy-or-ileocaecal-resection-an-international-audit-by-escp-and-s-ecco
#4
(no author information available yet)
BACKGROUND: Patient and disease-related factors, as well as operation technique all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. AIM: To investigate the effect of pre- and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. METHOD: International prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection...
September 15, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28905800/analysis-of-factors-affecting-the-quality-of-life-of-those-suffering-from-crohn-s-disease
#5
Joanna Chrobak-Bień, Anna Gawor, Małgorzata Paplaczyk, Ewa Małecka-Panas, Anita Gąsiorowska
INTRODUCTION: Crohn's disease is an inflammatory bowel disease of unknown etiology. Its chronic nature, as well as symptoms of intestinal and overall significantly impedes the daily functioning of patients. Alternately occurring periods of exacerbation and remission are the cause of reduced quality of life of patients. Understanding the factors that caused the decrease in the quality of life, it allows us to understand the behavior and the situation of the patient and the ability to cope with stress caused by the disease...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28905225/the-feasibility-and-short-term-clinical-outcomes-of-single-incision-laparoscopic-surgery-for-patients-with-complex-crohn-s-disease
#6
Kiyoshi Maeda, Hisashi Nagahara, Masatsune Shibutani, Tatsunari Fukuoka, Shigetomi Nakao, Hirokazu Yamagami, Noriko Kamata, Kazuya Muguruma, Hiroaki Tanaka, Takahiro Toyokawa, Kosei Hirakawa, Masaichi Ohira
PURPOSE: Single-incision laparoscopic surgery (SILS) offers excellent cosmetic results compared with conventional multi-port laparoscopic surgery. Recently, this technique has been applied to Crohn's disease (CD) with primary ileocolic strictures; however, the application of a laparoscopic approach for complex CD, which involves abscess formation, fistula formation, and recurrent CD, is controversial. The aim of this study was to investigate the safety and feasibility of SILS for patients with complex disease and to compare its clinical results in patients with complex disease vs...
September 13, 2017: Surgery Today
https://www.readbyqxmd.com/read/28888700/surgical-repair-of-rectovaginal-fistula-using-the-modified-martius-procedure-a-step-by-step-guide
#7
Dan Wang, Juan Chen, Lan Zhu, Mingchen Sang, Fan Yu, Qing Zhou
STUDY OBJECTIVE: to demonstrate the surgical repair of rectovaginal fistula by the modified Martius procedure. DESIGN: step by step presentation of the procedure using video. SETTING: Rectovaginal fistula (RVF) is abnormal epithelialized connections between the vagina and rectum. Causes of rectovaginal fistula include obstetrical trauma, Crohn disease, pelvic irradiation and postsurgical complications. Many surgical interventions have been developed, from laparoscopic technique to muscle transposition and even rectal resection...
September 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28885229/impact-of-diagnostic-delay-and-associated-factors-on-clinical-outcomes-in-a-u-s-inflammatory-bowel-disease-cohort
#8
Vu Q Nguyen, Dingfeng Jiang, Sharon N Hoffman, Srikar Guntaka, Jessica L Mays, Anthony Wang, Joseph Gomes, Dario Sorrentino
BACKGROUND: The impact of diagnostic delay in inflammatory bowel disease, including Crohn's disease (CD) and ulcerative colitis (UC), on disease course remains uncertain. This study examines factors that may influence time to diagnosis and disease outcomes in a U.S. patient cohort. METHODS: We retrospectively collected data on patient characteristics, time to diagnosis, disease phenotype, and complications in 177 patients with inflammatory bowel disease (110 CD and 67 UC) diagnosed at our institution from 2008 to 2015...
September 6, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28884201/pouch-functional-outcomes-after-restorative-proctocolectomy-with-ileal-pouch-reconstruction-in-patients-with-ulcerative-colitis-japanese-multi-center-nationwide-cohort-study
#9
Motoi Uchino, Hiroki Ikeuchi, Akira Sugita, Kitaro Futami, Toshiaki Watanabe, Kouhei Fukushima, Kenji Tatsumi, Kazutaka Koganei, Hideaki Kimura, Keisuke Hata, Kenichi Takahashi, Kazuhiro Watanabe, Tsunekazu Mizushima, Yuji Funayama, Daijiro Higashi, Toshimitsu Araki, Masato Kusunoki, Takeshi Ueda, Fumikazu Koyama, Michio Itabashi, Riichiro Nezu, Yasuo Suzuki
BACKGROUND: Although several complications capable of causing pouch failure may develop after restorative proctocolectomy (RPC) for ulcerative colitis (UC), the incidences and causes are conflicting and vary according to country, race and institution. To avoid pouch failure, this study aimed to evaluate the rate of pouch failure and its risk factors in UC patients over the past decade via a nationwide cohort study. METHODS: We conducted a retrospective, observational, multicenter study that included 13 institutions in Japan...
September 7, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28881875/efficacy-safety-and-long-term-outcome-of-serial-endoscopic-balloon-dilation-for-upper-gastrointestinal-crohn-s-disease-associated-strictures-a-cohort-study
#10
Amandeep Singh, Neha Agrawal, Satya Kurada, Rocio Lopez, Hermann Kessler, Jessica Philpott, Bo Shen, Bret Lashner, Florian Rieder
Background: Gastric and duodenal Crohn's disease [CD]-associated strictures are rare. Evidence on endoscopic balloon dilation [EBD] of upper gastrointestinal [GI] CD strictures is limited, in particular in respect to serial dilations. Methods: Prospective short- and long-term outcome data as well as complication rates on a cohort of upper GI CD-associated stricture dilations [stomach and duodenum] were collected from 1999 to 2015. Factors linked with clinical and technical success, long-term efficacy and complication rates were investigated...
September 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28877085/current-health-status-and-medical-therapy-of-patients-with-pediatric-onset-inflammatory-bowel-disease-a-survey-based-analysis-on-1280-patients-aged-10-25-years-focusing-on-differences-by-age-of-onset
#11
Antje Timmer, Renee Stark, Jenny Peplies, Martin Classen, Martin W Laass, Sibylle Koletzko
OBJECTIVE: There are inconsistent reports on age-related differences in inflammatory bowel disease (IBD). On the basis of patient information, we describe the clinical presentation and therapy in relation to age at diagnosis in longstanding pediatric IBD. PATIENTS AND METHODS: Two surveys were conducted in children and young adults (age: 10-25 years) by pretested postal questionnaires. The main analyses are descriptive, showing proportions and distributions per grouped age of diagnosis...
September 4, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28875688/clinical-utility-of-the-patency-capsule-a-large-volume-center-experience
#12
Armando Peixoto, Marco Silva, Rosa Coelho, Rui Gaspar, Rodrigo Liberal, Rui Castro, Andreia Albuquerque, Margarida Marques, Hélder Cardoso, Guilherme Macedo
BACKGROUND: In patients with suspected or known obstructive gastrointestinal pathology, the use of patency capsule (PC) aims to minimize the risk of subsequent retention of the endoscopic capsule. However, its clinical utility is not consensual. The aim was to evaluate the indications, results and safety profile of the PC. METHODS: Retrospective analysis of PCs (Agile patency Capsule) conducted between 2011 and 2015. Patency evaluation was performed after 30 hours, with radiological confirmation if PC was detected...
September 5, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28873259/increased-enteric-glial-cells-in-proximal-margin-of-resection-is-associated-with-postoperative-recurrence-of-crohn-s-disease
#13
Yi Li, Yuanyuan Ge, Weiming Zhu, Jianfeng Gong, Lei Cao, Zhen Guo, Lili Gu, Jieshou Li
BACKGROUND AND AIM: The enteric nervous system can amplify or modulate intestinal inflammation through secretion of neuropeptides, and enteric glial cells has been implicated in the pathophysiology of Crohn's disease. The goal of the study was to search for an association between the density of neurons, neuropeptides, as well as enteric glial cells and postoperative recurrence. METHODS: The ileal proximal uninflamed section from ileocolonic sample was studied using immunohistochemistry with antibodies directed against vasoactive intestinal polypeptide (VIP), substance P (SP), neuron-specific enolase (NES), and the glial marker protein S100...
September 5, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28872123/ileectomy-induced-bile-overaccumulation-in-mouse-intestine
#14
Rongli Zhang, Jonathan W Ray, Mukesh K Jain, Shuxin Han
Intestinal resection is a common therapeutic approach for human diseases such as obesity, inflammatory bowel disease, Crohn's disease, and colon cancer that often results in severe short bowel syndrome-like adverse effects including bile acid diarrhea, dehydration, electrolyte disturbances, and nutrient malabsorption. Here we introduce a murine ileal resection model, termed ileectomy, to evaluate tissue communication and the maintenance of systemic homeostasis. After ileal resection, circulating blood is permanently devoid of the ileum-specific endocrine hormone fibroblast growth factor 15 (FGF15), which releases its endocrinal inhibition of bile acid synthesis in the liver...
August 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28869010/-simultaneous-intestinal-tuberculosis-and-adenocarcinoma
#15
Kristian Buch, Erica Gould Christiansen, Anne-Marie Skau
Intestinal tuberculosis is a rare diagnosis, which may often be mistaken for mb. Crohn or cancer. We present a case of a 57-year-old man, who was diagnosed with intestinal tuberculosis. Due to increased abdominal pain, a computed tomography was performed, revealing a growing sigmoidal tumour, and the biopsies taken showed an adenocarcinoma. Further histological tests revealed no spread of cancer, and the patient could receive curative surgery. While intestinal tuberculosis can appear similar to colon cancer, it may also as in this case be an intercurrent disease...
July 31, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28867978/when-not-to-pouch-important-considerations-for-patient-selection-for-ileal-pouch-anal-anastomosis
#16
Shannon Chang, Bo Shen, Feza Remzi
Ileal pouch-anal anastomosis (IPAA) is the preferred surgical treatment for patients who undergo colectomy and wish to avoid a permanent ileostomy. The overall outcomes are positive, with an improved quality of life and stable long-term pouch retention. However, certain conditions or disease states may be at a higher risk of pouch dysfunction or failure. For example, obese patients have an increased risk for postoperative complications. In addition, women with a history of obstetric complications and elderly patients with a history of sphincter damage or dysfunction may be at an increased risk for postoperative incontinence, although quality-of-life indices do not necessarily correlate with incontinence scores...
August 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28864649/phenotypic-features-and-longterm-outcomes-of-pediatric-inflammatory-bowel-disease-patients-with-arthritis-and-arthralgia
#17
Osnat Nir, Firas Rinawi, Gil Amarilyo, Liora Harel, Raanan Shamir, Amit Assa
OBJECTIVE: The natural history of pediatric inflammatory bowel disease (IBD) patients with joint involvement has not been clearly described. Thus, we aimed to investigate phenotypic features and clinical outcomes of this distinct association. METHODS: The medical records of patients with pediatric IBD diagnosed from 2000 to 2016 were reviewed retrospectively. Main outcome measures included time to first flare, hospitalization, surgery, and biologic therapy. RESULTS: Of 301 patients with Crohn disease (median age 14...
September 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28858864/early-intervention-with-infliximab-prevents-reoperation-in-crohn-s-disease-a-single-center-retrospective-analysis
#18
Manabu Ishii, Ken-Ichi Tarumi, Akiko Shiotani, Tomoari Kamada, Minoru Fujita, Hiroshi Matsumoto, Takahisa Murao, Noriaki Manabe, Hiroaki Kusunoki, Jiro Hata, Ken Haruma
BACKGROUND/AIMS: We aimed to evaluate the prognostic factors that can aid in the prevention of first and second surgeries in patients with Crohn's disease (CD). METHODS: The clinical records of 115 patients with CD whose disease onset was between January 1987 and July 2012 were retrospectively investigated. The cumulative rate of bowel resection for CD-related intestinal manifestations following onset until the first surgery and the cumulative rate of reoperation following the first to second surgeries were estimated using the Kaplan-Meier method, and the relationship to each factor was statistically analyzed using the log-rank test...
September 1, 2017: Digestion
https://www.readbyqxmd.com/read/28854988/-changes-in-the-treatment-of-crohn-s-disease-fewer-hospitalizations-less-surgery-and-reduced-glucocorticoid-use
#19
S F G Jeuring, T R A van den Heuvel, M P Zeegers, J J Haans, M J L Romberg-Camps, L E Oostenbrug, L P S Stassen, A A M Masclee, D M A E Jonkers, M J Pierik
OBJECTIVE: To study changes in treatment and disease course in patients with Crohn's disease (CD) in the South Limburg region of the Netherlands between 1991 and 2014. DESIGN: Population-based cohort study. METHODS: All 1162 CD patients in the 'IBD South Limburg cohort' were divided across three subcohorts on the basis of year of diagnosis: 1991-1998 (N = 316), 1999-2005 (N = 387) and 2006-2011 (N = 459). We compared the risk of hospitalization, bowel resection and the development of strictures and/or fistulas across the subcohorts...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28852521/perioperative-use-of-immunosuppressive-medications-in-patients-with-crohn-s-disease-in-the-new-biological-era
#20
Amy L Lightner, Bo Shen
Crohn's disease (CD) is characterized by transmural inflammation of the gastrointestinal tract leading to inflammatory, stricturing and/or and fistulizing disease. Once a patient develops medically refractory disease, mechanical obstruction, fistulizing disease or perforation, surgery is indicated. Unfortunately, surgery is not curative in most cases, underscoring the importance of bowel preservation and adequate perioperative medical management. As many of the medications used to treat CD are immunosuppressive, the concern for postoperative infectious complications and anastomotic healing are particularly concerning; these concerns have to be balanced with preventing and treating residual or recurrent disease...
August 2017: Gastroenterology Report
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