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https://www.readbyqxmd.com/read/28453755/association-of-induction-infliximab-levels-with-clinical-response-in-perianal-crohn-s-disease
#1
Yana Davidov, Bella Ungar, Haggai Bar-Yoseph, Dan Carter, Ola Haj-Natour, Miri Yavzori, Yehuda Chowers, Rami Eliakim, Shomron Ben-Horin, Uri Kopylov
Background: The association of infliximab [IFX] trough levels with clinical and endoscopic outcomes in inflammatory bowel disease is well established. However, there is scarce data regarding the association of perianal fistula response with IFX. The aim of this study was to establish whether early induction infliximab levels and anti-infliximab antibodies [ATIs] are associated with perianal fistula response. Methods: Consecutive CD patients with perianal fistulae that were treated with IFX between 2008 and 2016 were included in the study...
May 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28427855/outcome-of-medical-management-of-intraabdominal-abscesses-in-children-with-crohn-s-disease
#2
Razan H Alkhouri, Gracielle Bahia, Ashley C Smith, Richard Thomas, Christine Finck, Wael Sayej
INTRODUCTION: Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that is complicated by fistulas, strictures, and intraabdominal abscesses (IAA) in 10%-30% of patients. To avoid surgical resection of the bowel, medical therapy with antibiotics (Ab) with or without percutaneous drainage (PD) is first undertaken. Our objectives are to examine the outcome of IAA in CD patients treated with antibiotics alone vs antibiotics and PD, and to identify risk factors for medical therapy failure...
March 30, 2017: Journal of Pediatric Surgery
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/28416240/efficacy-of-tumour-necrosis-factor-antagonists-in-stricturing-crohn-s-disease-a-tertiary-center-real-life-experience
#4
Mariangela Allocca, Cristiana Bonifacio, Gionata Fiorino, Antonino Spinelli, Federica Furfaro, Luca Balzarini, Stefanos Bonovas, Silvio Danese
BACKGROUND: Stenosis is the most common complication of Crohn's disease (CD). Long-term outcome of patients receiving tumour necrosis factor (TNF) antagonists for such disease complication is poorly understood. METHODS: 51 CD patients (from July 2006 to November 2015) who had a diagnosis of small bowel or colonic stenosis, diagnosed by colonoscopy and/or MRI enterography, and were treated with TNF antagonists (adalimumab or infliximab) were enrolled. The primary outcome was to assess the rate of success of TNF antagonists on avoiding abdominal surgery for stricturing CD patients...
March 30, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28406887/hospitalizations-for-crohn-s-disease-united-states-2003-2013
#5
Christopher A Malarcher, Anne G Wheaton, Yong Liu, Sujay F Greenlund, Suraj J Greenlund, Hua Lu, Janet B Croft
In 2009, an estimated 565,000 Americans had Crohn's disease (1), an inflammatory bowel disorder that can affect any part of the gastrointestinal tract. Symptoms include persistent diarrhea, abdominal cramps and pain, constipation leading to bowel obstruction, and rectal bleeding.* Symptoms sometimes intensify in severity and require hospitalization and surgeries of the small intestine, colon, or rectum (2). Hospital discharge data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) were used to estimate U...
April 14, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28401425/medical-therapies-for-stricturing-crohn-s-disease-efficacy-and-cross-sectional-imaging-predictors-of-therapeutic-failure
#6
Cécile Campos, Antoine Perrey, Céline Lambert, Bruno Pereira, Marion Goutte, Anne Dubois, Felix Goutorbe, Michel Dapoigny, Gilles Bommelaer, Constance Hordonneau, Anthony Buisson
BACKGROUND: Medical therapy efficacy remains controversial in stricturing Crohn's disease. Cross-sectional imaging, especially magnetic resonance imaging, has been suggested as very helpful to guide therapeutic decision making. AIM: To assess efficacy and predictors of therapeutic failure in patients receiving medical treatments for stricturing Crohn's disease. METHODS: In this retrospective study, therapeutic failure was defined as symptomatic stricture leading to surgical or endoscopic therapeutics, hospitalization, treatment discontinuation or additional therapy and short-term clinical response as clinical improvement assessed by two physicians...
April 11, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28401051/surgery-in-pediatric-crohn-s-disease-indications-timing-and-post-operative-management
#7
REVIEW
Seung Kim
Pediatric onset Crohn's disease (CD) tends to have complicated behavior (stricture or penetration) than elderly onset CD at diagnosis. Considering the longer duration of the disease in pediatric patients, the accumulative chance of surgical treatment is higher than in adult onset CD patients. Possible operative indications include perianal CD, intestinal stricture or obstruction, abdominal abscess or fistula, intestinal hemorrhage, neoplastic changes and medically untreatable inflammation. Growth retardation is an operative indication only for pediatric patients...
March 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28400193/autologous-mesenchymal-stem-cells-applied-in-a-bioabsorbable-matrix-for-treatment-of-perianal-fistulas-in-patients-with-crohn-s-disease
#8
Allan B Dietz, Eric J Dozois, Joel G Fletcher, Greg W Butler, Darcie Radel, Amy L Lightner, Maneesh Dave, Jessica Friton, Asha Nair, Emily T Camilleri, Amel Dudakovic, Andre J van Wijnen, William A Faubion
In patients with Crohn's disease (CD), perianal fistulas frequently recur, causing substantial morbidity. We performed a 12 patient, 6 month phase I trial to determine whether autologous mesenchymal stem cells (MSCs), applied in a bioabsorbable matrix, can heal the fistula. Fistula repair was not associated with any serious adverse events related to MSCs or plug placement. At 6 months, 10/12 patients (83%) had complete clinical healing and radiographic markers of response. We found placement of MSC-coated matrix fistula plugs in 12 patients with chronic perianal fistulas to be safe and lead to clinical healing and radiographic response in 10 patients...
April 8, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28399604/transperineal-ultrasound-for-perianal-fistulas-and-abscesses-a-systematic-review-and-meta-analysis
#9
Giovanni Maconi, Maria Teresa Greco, Anil Kumar Asthana
Purpose Transperineal ultrasound (TPUS) is a practical tool for assessing perianal inflammatory lesions. We systematically review its accuracy for detecting and classifying perianal fistulae and abscesses. Method The National Library of Medicine and Embase were searched for articles on TPUS for the assessment of idiopathic and Crohn's perianal fistulae and abscesses. Two reviewers independently reviewed eligible studies and rated them for quality using the QUADAS tool. The primary outcome measure was the accuracy of TPUS as measured by its sensitivity and positive predictive value (PPV) in detecting and classifying perianal fistulae, internal openings and perianal abscesses...
April 11, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28395390/surgical-treatment-of-rectovaginal-fistula-in-crohn-s-disease-a-tertiary-center-experience
#10
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Michele Grande
BACKGROUND: Rectovaginal fistula (RVF) is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a woman's quality of life. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics, and its published success rates vary with initial success being around 50% rising to 80% with repeated surgery...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28394805/factors-associated-with-fecal-incontinence-in-women-of-childbearing-age-with-crohn-s-disease
#11
Charlène Brochard, Laurent Siproudhis, Jean Levêque, Amélie Grouin, Anne-Laure Mallet, Jean-François Bretagne, Alain Ropert, Guillaume Bouguen
BACKGROUND: Fecal incontinence is common in women with Crohn's disease, but little is known about the impact of childbirth, perianal Crohn's disease, and past surgical history on fecal incontinence. METHODS: Self-administered questionnaires were mailed to consecutive women referred to a tertiary gastroenterology centre with a focus on fecal incontinence and childbirth. These data were cross-referenced with a prospective database of the same patients' own Crohn's disease histories...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28387062/association-of-coloproctology-of-great-britain-and-ireland-consensus-exercise-on-surgical-management-of-fistulating-perianal-crohn-s-disease
#12
M J Lee, N Heywood, P M Sagar, S R Brown, N S Fearnhead
BACKGROUND: Management of fistulating perianal Crohn's disease (fpCD) is a significant challenge for a colorectal surgeon. A recent survey of surgical practice in this condition showed variation in management approaches. As a result we set out to devise recommendations for practice for UK colorectal surgeons. METHODS: Results from a national survey were used to devise a set of potential consensus statements. Consultant colorectal surgeons were invited to participate in the exercise via the previous survey and the mailing list of the professional society...
April 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28383450/long-term-outcomes-after-continent-ileostomy-creation-in-patients-with-crohn-s-disease
#13
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/28379306/anal-neoplasia-in-inflammatory-bowel-disease-classification-proposal-epidemiology-carcinogenesis-and-risk-management-perspectives
#14
Andrew Wisniewski, Jean-Francois Fléjou, Laurent Siproudhis, Laurent Abramowitz, Magali Svrcek, Laurent Beaugerie
Patients with inflammatory bowel disease [IBD] may develop, similarly to individuals from general population, rare cases of human papilloma virus [HPV]-related anal canal squamous cell carcinoma [SCC] and intra-epithelial precursor lesions, as well as very rare cases of anal canal adenocarcinoma. Patients with chronic perianal Crohn's disease [CD] are at substantial risk of developing SCC or adenocarcinoma from the fistula-lining epithelium, as well as SCC or adenocarcinoma arising from chronic anorectal ulcerations or strictures...
March 30, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28372453/coloduodenal-and-enterocutaneous-fistula-in-twins-with-crohn%C3%A2-s-disease
#15
Maíia Pilar Ballester, David Martí, Marta Maia Boscá Watts, José Martín Arévalo, Miguel Mínguez
We present the case of a pair of 45-year-old monozygotic twins (A and B) diagnosed with Crohn's disease (CD) at age 20 (A) and 22 (B) with similar presenting symptoms: diarrhea, fever and weight loss. Both of them had duodenal and ileocolonic disease (A2, L3+L4 according to Montreal classification); twin B also presented jejunal involvement and perianal disease (B1p). They received treatment with antibiotics, corticosteroids, 5-ASA, azathioprine and anti-TNF with a poor control of activity. They both developed a coloduodenal fistula that required surgery...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28371062/increasing-experience-of-lift-procedure-for-patients-with-crohn-s-disease-what-have-we-learned
#16
Jan Pawel Kamiński, Karen Zaghiyan, Phillip Fleshner
BACKGROUND: Ligation of the inter-sphincteric fistula tract (LIFT) has been proposed as a treatment of trans-sphincteric fistula in perianal Crohn's disease (CD). STUDY DESIGN: Retrospective study of patients with trans-sphincteric Crohn's fistula tracts treated with the LIFT procedure between January 2011 and October 2015. Complete fistula healing as well as clinical outcomes were analyzed. RESULTS: Data was available for 23 patients After a median follow-up of 23 months, LIFT site healing was 48%...
March 29, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28359542/food-avoidance-in-patients-with-inflammatory-bowel-disease-what-when-and-who
#17
Fanny Bergeron, Mickael Bouin, Louise D'Aoust, Michel Lemoyne, Nancy Presse
BACKGROUND & AIMS: Patients with inflammatory bowel diseases avoid a variety of foods. However, it remains unclear how this behavior varies across patients. This cross-sectional study investigated how the food avoidance pattern in inflammatory bowel disease varies according to disease's activity, disease's subtype, Crohn's location, and prior history of bowel resection, strictures, and fistulae. METHODS: Outpatients with Crohn's disease (n = 173) and ulcerative colitis (n = 72) reported which food they avoid when they perceive they are in remission or in active disease using a list of 82 food items classified in 10 categories...
March 15, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28350751/time-trends-in-the-epidemiology-and-outcome-of-perianal-fistulizing-crohn-s-disease-in-a-population-based-cohort
#18
Kevin W A Göttgens, Steven F G Jeuring, Rosel Sturkenboom, Mariëlle J L Romberg-Camps, Liekele E Oostenbrug, Daisy M A E Jonkers, Laurents P S Stassen, Ad A M Masclee, Marieke J Pierik, Stéphanie O Breukink
OBJECTIVE: Perianal disease is a debilitating condition that frequently occurs in Crohn's disease (CD) patients. It is currently unknown whether its incidence has changed in the era of frequent immunomodulator use and biological availability. We studied the incidence and outcome of perianal and rectovaginal fistulas over the past two decades in our population-based Inflammatory Bowel Disease South-Limburg cohort. PATIENTS AND METHODS: All 1162 CD patients registered in the Inflammatory Bowel Disease South-Limburg registry were included...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28338158/-diagnosis-and-treatment-of-duodenal-injury-and-fistula
#19
Kunmei Gong, Shikui Guo, Kunhua Wang
Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28333258/anal-neoplasia-in-inflammatory-bowel-disease-classification-proposal-epidemiology-carcinogenesis-and-risk-management-perspectives
#20
Andrew Wisniewski, Jean-Francois Fléjou, Laurent Siproudhis, Laurent Abramowitz, Magali Svrcek, Laurent Beaugerie
Patients with inflammatory bowel disease (IBD) may develop, similarly to individuals from general population, rare cases of HPV-related anal canal squamous cell carcinoma (SCC) and their intra-epithelial precursor lesions, as well as very rare cases of anal canal adenocarcinoma. Patients with chronic perianal Crohn's disease (CD) are at substantial risk of developing SCC or adenocarcinoma from the fistula-lining epithelium, as well as SCC or adenocarcinoma arising from chronic anorectal ulcerations or strictures...
March 10, 2017: Journal of Crohn's & Colitis
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