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https://www.readbyqxmd.com/read/28526076/rectal-sparing-type-of-ulcerative-colitis-predicts-lack-of-response-to-pharmacotherapies
#1
Yuki Horio, Motoi Uchino, Toshihiro Bando, Teruhiro Chohno, Hirofumi Sasaki, Akihiro Hirata, Yoshio Takesue, Hiroki Ikeuchi
BACKGROUND: Ulcerative colitis (UC) is known as an immune disorder of the colon that generally involves the rectum, but an atypical distribution of inflamed mucosa has previously been noted in certain subtypes of UC, such as the rectal-sparing type (RST). As noted in a previous report, patients with the RST may be at elevated risk for disease refractoriness, but the clinical significance of RST remains unknown. METHODS: UC patients who underwent surgery between January 2010 and April 2015 were included...
May 19, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28523327/complicated-diverticulitis-in-a-de-novo-kidney-transplanted-patient
#2
Liliana Ana TuŢă, Mădălina Boşoteanu, Eugen Dumitru, Mariana Deacu
Diverticular disease is frequent amongst the elderly and immunosuppressed patients. It mainly presents as sigmoid diverticulitis, but severe complications, like bleedings, infections and colon perforation may occur, frequently due to immunosuppressive therapy. Moreover, antibiotherapy and hemostatics may not efficiently control evolution in such cases. Early diagnose and adequate treatment of colonic diverticulosis complicated with lower gastrointestinal bleeding and diverticulitis in immunocompromised patients...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28511200/enteric-infection-in-relapse-of-inflammatory-bowel-disease-the-utility-of-stool-microbial-pcr-testing
#3
Jordan E Axelrad, Andrew Joelson, Yael R Nobel, Garrett Lawlor, Peter H R Green, Simon Lichtiger, Benjamin Lebwohl
BACKGROUND: The similar presentations in relapse of inflammatory bowel disease (IBD) and enteric infection pose substantial barriers to diagnosis and treatment. The objective of this study was to investigate the incidence, etiology, predictors, and treatment of enteric infection in patients with IBD. METHODS: We reviewed the records of 214 patients with IBD who underwent 295 gastrointestinal pathogen panel and Clostridium difficile infection (CDI) polymerase chain reaction (PCR) stool tests during an exacerbation of symptoms...
June 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28510798/total-laparoscopic-management-for-stage-iv-colorectal-cancer-requiring-multivisceral-resection
#4
Y Nancy You, Hironori Shiozaki, Jeffrey E Lee, Guillaume Passot, Claire Goumard, Masayuki Okuno, Thomas A Aloia, Cathy Eng, George Chang, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: Surgical resection of all sites of disease, in combination with effective systemic chemotherapy, offers the only potential chance for cure for patients with stage IV colorectal cancer (CRC). Coordinated multistage resection using a minimally invasive approach may provide optimal oncologic outcome while potentially offering the benefit of decreased morbidity. PATIENT: A 66-year-old women presented with transverse colon cancer and synchronous metastasis (CRLM) in segment IV involving the middle hepatic vein and main left portal pedicle, as well as the left adrenal gland...
May 16, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28504015/laparoscopic-surgery-in-patients-on-peritoneal-dialysis-a-review-of-the-literature
#5
Giulio Mari, Renzo Scanziani, Sara Auricchio, Jacopo Crippa, Dario Maggioni
Peritoneal dialysis (PD) is an effective renal replacement therapy for the treatment of end-stage renal disease. Patients on PD undergoing abdominal open surgery often fail to resume PD. Laparoscopic surgery has recently become a serious alternative to open surgery in patients on PD to treat different abdominal pathologies. However, only a few studies have reported successful procedures without Tenckhoff catheter removal. The aim of this review is to describe how a laparoscopic technique can allow PD patients to deal with abdominal surgery without shifting to hemodialysis...
May 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28502189/long-term-outcomes-of-infliximab-treatment-and-predictors-of-response-in-195-patients-with-ulcerative-colitis-a-hospital-based-cohort-study-from-korea
#6
Hyungil Seo, Kiju Chang, Sun-Ho Lee, Eun-Mi Song, Gwang-Un Kim, Myeongsook Seo, Ho-Su Lee, Sung-Wook Hwang, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
BACKGROUND: Large-scale studies regarding the long-term efficacy of infliximab (IFX) treatment in non-Caucasian patients with ulcerative colitis (UC) are lacking. STUDY: We analyzed the long-term outcomes of IFX in 195 Korean UC patients who received scheduled IFX treatments at Asan Medical Center. IFX failure was defined as IFX discontinuation due to colectomy or non-response to IFX, and additionally UC-related hospitalization or a need for rescue corticosteroids during the course of IFX...
May 14, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28501244/the-difficult-colorectal-polyp
#7
REVIEW
Mark J Pidala, Marianne V Cusick
Difficult colorectal polyps represent lesions that pose a challenge to traditional endoscopic snare polypectomy. These polyps have historically been managed by surgical resection. Currently, several less invasive options are available to avoid colectomy. Repeat colonoscopy and snare polypectomy by an expert endoscopist, endoscopic mucosal resection, endoscopic submucosal dissection, and combined endoscopic and laparoscopic surgery have been developed to remove difficult polyps without the need for formal surgical resection...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28500580/is-right-colectomy-a-complete-learning-procedure-for-a-robotic-surgical-program
#8
Paolo Raimondi, Francesco Marchegiani, Massimo Cieri, Annadomenica Cichella, Roberto Cotellese, Paolo Innocenti
This study analyses the utility of right colectomy as a learning procedure at the beginning of a robotic surgical program. The hypothesis is that right colectomy contains all the technical steps necessary to acquire basic abilities in robotics surgery. The first 23 consecutive robotic right colectomy performed at the beginning of a robotic program were analysed. All surgical times were recorded in the operating room and second checked on a dedicated video-database. Specific robotic times were analysed using CUSUM method to evaluate the learning curve...
May 12, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28500116/a-53-year-old-man-with-dyspnoea-respiratory-failure-consistent-with-infliximab-induced-acute-interstitial-pneumonitis-after-an-accelerated-induction-dosing-schedule
#9
Rymon Rofaiel, Sonny Kohli, Marco Mura, Seyed M Hosseini-Moghaddam
A 53-year-old man with ulcerative colitis (UC) suffered fatal acute interstitial pneumonitis (AIP) post completing an accelerated infliximab induction course. This is the first case reported in this setting. A literature review found four similar cases of infliximab-induced interstitial lung disease in the setting of treating patients with UC using standard infliximab regimens had successful treatment of the subjects post infliximab discontinuation. Unfortunately, the patient we are presenting, who had an accelerated infliximab induction course, did not survive...
May 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28498617/segmental-resection-is-a-safe-oncologic-alternative-to-total-proctocolectomy-in-elderly-patients-with-ulcerative-colitis-and-malignancy
#10
Nabeel Khan, Elisabeth Cole, Yash Shah, Emily Carter Paulson
AIM: The standard approach for the surgical management for colorectal cancer (CRC) in the setting of ulcerative colitis (UC) involves total proctocolectomy (TPC). However, some patients also undergo a partial resection (PR). This may be an attractive option in older patients with a high for surgery. The aim of this study is to compare the risk of metachronous cancer after PR or TPC for CRC in the setting of UC. METHOD: This was a retrospective cohort study conducted through the Nationwide Veterans Affairs Healthcare System (VA)...
May 12, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28490715/approach-to-cytomegalovirus-infections-in-patients-with-ulcerative-colitis
#11
REVIEW
Sung Chul Park, Yoon Mi Jeen, Yoon Tae Jeen
Cytomegalovirus (CMV) reactivation is common in patients with severe ulcerative colitis (UC), and may ref lect exacerbation of mucosal inf lammation and/or administration of immunosuppressants. The question of whether CMV is an active pathogen or 'an innocent bystander' in the exacerbation of UC remains controversial. Patients with UC exacerbated by reactivated CMV experience worse prognoses than those without CMV reactivation and antiviral therapy significantly reduces the need for colectomy in patients with severe UC and high-grade CMV infection, indicating that CMV plays a role in UC prognosis...
May 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28486626/proximal-disease-extension-in-patients-with-limited-ulcerative-colitis-a-danish-population-based-inception-cohort
#12
J Burisch, R Ungaro, I Vind, M V Prosberg, F Bendtsen, J-F Colombel, M K Vester-Andersen
Background and aims: Disease extent in ulcerative colitis (UC) is dynamic and can progress over time. Little is known about risk factors for UC extension in the era of biologics. We investigated the risk of UC extension and subsequent risk of surgery in a Danish population-based cohort. Methods: All incident UC cases in a strictly defined Copenhagen area between 2003 and 2004 were followed prospectively through 2011. Disease extension was defined as patients with limited UC (E1 or E2) at diagnosis having progressed from the initial extent by colonoscopy or surgery to E2 or extensive colitis (E3)...
May 9, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28486220/risk-factors-for-early-postoperative-small-bowel-obstruction-after-elective-colon-cancer-surgery-an-observational-study-of-1-244-consecutive-patients
#13
Xiao-Jie Wang, Pan Chi, Hui-Ming Lin, Xing-Rong Lu, Ying Huang, Zong-Bin Xu, Sheng-Hui Huang, Yan-Wu Sun, Dao-Xiong Ye
BACKGROUND: Early postoperative small bowel obstruction (EPSBO) is a common complication following colon cancer surgery. EPSBO is associated with increased hospital stays, mortality rates, and healthcare costs. The purpose of this study was to identify risk factors for EPSBO following elective colon cancer surgery. STUDY DESIGN: We retrospectively reviewed the clinicopathological variables of 1,244 patients with colon cancer who underwent partial colectomy from January 2000 to December 2014...
May 10, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28485025/adsorptive-granulocyte-monocyte-apheresis-use-in-severe-ulcerative-colitis-and-determination-of-changes-in-plasma-cytokines
#14
Belén Beltrán, Esteban Sáez-González, Inés Moret, Francia C Díaz-Jaime, Diego Alvarez-Sotomayor, Elena Cerrillo, Marisa Iborra, Guillermo Bastida, Mariam Aguas, Pilar Nos
Despite controversy regarding the use of granulocyte/monocyte adsorption (GMA) in inflammatory bowel disease, some studies have shown favorable outcomes when it is used in steroid-dependent patients with ulcerative colitis (UC). The mechanisms responsible for such outcomes are not well characterized, but changes in immune cell populations and cytokine levels have been suggested to play an important role. We report the cases of 3 patients with chronically active severe UC who underwent GMA due to an inadequate response to standard and rescue therapy, as well as changes to their plasma cytokine profile...
May 9, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28484890/as-infliximab-use-for-ulcerative-colitis-has-increased-so-has-the-rate-of-surgical-resection
#15
Cindy Kin, M Kate Bundorf
BACKGROUND: Infliximab was approved for ulcerative colitis in 2005 after randomized trials showed it reduced the risk of colectomy. Its effect on population-level surgery rates is unknown. Our aim is to assess the impact of infliximab approval for ulcerative colitis on surgical intervention. METHODS: Retrospective review of a private insurance claims database (2002 to 2013) was performed of patients aged 18-64 diagnosed with ulcerative colitis and with 2 years of follow-up...
May 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28484832/accuracy-of-routinely-collected-comorbidity-data-in-patients-undergoing-colectomy-a-retrospective-study
#16
Shahin Hajibandeh, Shahab Hajibandeh, Roger Deering, Dearbhla McEleney, John Guirguis, Sarah Dix, Abdelhakem Sreh, Afsana Kausar
OBJECTIVES: This paper aimed to determine the baseline accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of routinely collected comorbidity data in patients undergoing any types of colectomy. METHODS: All patients aged >18 who underwent right hemicolectomy, left hemicolectomy, sigmoid colectomy, subtotal colectomy, or total colectomy between 1 January 2015 and 1 November 2016 were identified. The following comorbidities were considered: hypertension, ischemic heart disease (IHD), diabetes, asthma, chronic obstructive pulmonary disease (COPD), cerebrovascular disease (CVD), chronic kidney disease (CKD), and hypercholesterolemia...
May 8, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28481976/electronically-available-comorbidities-should-be-used-in-surgical-site-infection-risk-adjustment
#17
Sarah S Jackson, Surbhi Leekha, Laurence S Magder, Lisa Pineles, Deverick J Anderson, William E Trick, Keith F Woeltje, Keith S Kaye, Timothy J Lowe, Anthony D Harris
Background: Healthcare-associated infections such as surgical site infections (SSI) are used by Centers for Medicare and Medicaid Services (CMS) as pay-for-performance metrics. Risk adjustment allows a fairer comparison of SSI rates across hospitals. Until 2016, Centers for Disease Control and Prevention (CDC) risk adjustment models for pay-for-performance SSI did not adjust for patient comorbidities. New 2016 CDC models only adjust for body mass index and diabetes. Methods: We performed a multicenter retrospective cohort study of patients undergoing surgical procedures at 28 US hospitals...
May 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28474219/impact-of-radiofrequency-energy-on-intraoperative-outcomes-of-laparoscopic-colectomy-for-cancer-in-obese-patients
#18
Diletta Cassini, Michelangelo Miccini, Matteo Gregori, Farshad Manoochehri, Gianandrea Baldazzi
Nowadays laparoscopic approach is accepted as a valid alternative to open surgery for the treatment of colorectal cancer. Several studies consider this approach to be safe and feasible also in obese patients, even if dissection in these patients may require a longer operative time and involve higher blood loss. To facilitate laparoscopic approach, more difficult in these patients, several energy sources for laparoscopic dissection and sealing, has been adopted recently. The aim of this study is to investigate the possible intraoperative advantages of radiofrequency energy in terms of blood loss and operative time in obese patients undergoing laparoscopic resection for cancer...
May 4, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28471820/prevalence-of-intestinal-complications-in-inflammatory-bowel-disease-a-comparison-between-paediatric-onset-and-adult-onset-patients
#19
Denise Herzog, Nicolas Fournier, Patrick Buehr, Vanessa Rueger, Rebekka Koller, Klaas Heyland, Andreas Nydegger, Christian P Braegger
INTRODUCTION: Intestinal complications in inflammatory bowel disease indicate active inflammation and typically result in the intensification of therapy. AIM: To analyse whether the rates of intestinal complications were associated with age at disease onset. PATIENTS AND METHODS: Data from 1506 individuals with Crohn's disease (CD) and 1201 individuals with ulcerative colitis (UC) were obtained from the Swiss inflammatory bowel disease cohort study database, classified into groups on the basis of age at diagnosis (<10, <17, <40 and >40 years of age), and retrospectively analysed...
May 3, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28471622/combination-of-corticosteroids-with-5-aminosalicylic-acids-compared-to-corticosteroids-alone-for-hospitalized-patients-with-active-ulcerative-colitis
#20
Ofir Har-Noy, Bun Kim, Rivi Haiat, Tal Engel, Bella Ungar, Rami Eliakim, Won Ho Kim, Jae Hee Cheon, Shomron Ben-Horin
BACKGROUND: Although 5-amino-salycilic acids (5-ASA) are often used with corticosteroid treatment in moderate-to-severe ulcerative colitis, the value of continuing/initiating 5-ASA in this clinical setting has not been explored. OBJECTIVES: To investigate the impact of a combination 5-ASA+corticosteroid therapy on the outcome of hospitalized patients with acute moderate-severe ulcerative colitis. METHODS: We conducted a retrospective study of patients hospitalized with moderate-severe ulcerative colitis in two centers, Israel and South Korea...
October 2016: Israel Medical Association Journal: IMAJ
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