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Surgery and ibd

Eva Carlsson, Jeanette Fingren, Anne-Marie Hallén, Charlotta Petersén, Elisabet Lindholm
Despite advancements in the creation and care of stomas, ostomy and peristomal skin complications are common immediately following surgery as well as in the months and years thereafter. A prospective study to determine the prevalence of ostomy and peristomal skin complications and the influence of ostomy configuration on such complications was conducted 1 year after ostomy surgery among all patients at a university hospital in Sweden. All participants received regular (10 to 14 days post discharge, 6 weeks, 3 months, 6 months, and 1 year post surgery) ostomy follow-up care by a wound ostomy continence (WOC) nurse...
October 2016: Ostomy/wound Management
Fernando Velayos, Priya Kathpalia, Emily Finlayson
This review chronicles the evolution of dysplasia detection and management in IBD since 1925, the year the first case report of colitis-related colorectal cancer was published. We have grouped advances in colorectal cancer research, endoscopic techniques, surgery, and technology into 4 unequally timed eras, before colonoscopy, early era of colonoscopy, new century, and 2017 and beyond. We conclude that colorectal cancer prevention and dysplasia management for patients with IBD has changed over these periods, from somewhat hopeless to hopeful...
October 17, 2016: Gastroenterology
Kimberly N Weaver, Michael D Kappelman, Robert S Sandler, Christopher F Martin, Wenli Chen, Kristen Anton, Millie D Long
BACKGROUND: As variation in care has previously been linked to quality, we aimed to describe variations in inflammatory bowel diseases care by gastroenterology (GI) practice setting. METHODS: We performed a cross-sectional study within the Crohn's and Colitis Foundation of America Partners and used bivariate analyses to compare patient characteristics by GI practice setting (GI-academic [GIA], GI-private, or GI-other). Regression models were used to describe the effects of provider type on steroid use, disease activity, and the quality of life...
November 2016: Inflammatory Bowel Diseases
Firas Rinawi, Amit Assa, Corina Hartman, Yael Mozer Glassberg, Vered Nachmias Friedler, Yoram Rosenbach, Ari Silbermintz, Noam Zevit, Raanan Shamir
BACKGROUND: Data describing the incidence and the risk factors for surgical interventions in pediatric Crohn's disease (CD) is inconsistent. Our aim was to describe the rates of intestinal surgery and to identify associated risk factors in a large cohort of children with CD. METHODS: Medical charts of 482 children with CD from the Schneider Pediatric Inflammatory Bowel Disease cohort who were diagnosed between 1981 and 2013 were carefully reviewed retrospectively...
October 13, 2016: Inflammatory Bowel Diseases
Deepanshu Jain, Ejaz Mahmood, Shashideep Singhal
Benign intestine strictures secondary to postoperative narrowing or inflammatory bowel disease can be managed surgically or conservatively. Some patients may not be suitable surgical candidates and some patients may choose not to have repeat surgery. Biodegradable (BD) stents offer a prolonged dilatory effect before gradual degradation and obviates the need of a second procedure for stent removal. BD stents have high technical success rates (mean, 94.4%; median, 100%; range, 86% to 100%) but widely variable clinical success rates (range, 45% to 100%)...
October 4, 2016: Journal of Clinical Gastroenterology
Rachelle N Damle, Julie M Flahive, Jennifer S Davids, Justin A Maykel, Paul R Sturrock, Karim Alavi
BACKGROUND: Racial disparities in outcomes are well described among surgical patients. OBJECTIVE: The purpose of this work was to identify any racial disparities in the receipt of a minimally invasive approach for colorectal surgery. DESIGN: Adults undergoing colorectal surgery were studied using the University HealthSystem Consortium. Univariate and multivariable analyses were used to identify predictors for the receipt of a minimally invasive approach...
November 2016: Diseases of the Colon and Rectum
Jordan Axelrad, Anuja Kriplani, Umut Ozbek, Noam Harpaz, Jean-Frederic Colombel, Steven Itzkowitz, Randall F Holcombe, Celina Ang
BACKGROUND: Inflammatory bowel disease (IBD), comprising Crohn disease and ulcerative colitis, is a risk factor for colorectal cancer (CRC). Chemotherapy toxicity may exacerbate IBD symptoms and vice versa, but data are limited. We evaluated chemotherapy tolerance and oncologic outcomes in patients with CRC with and without IBD. PATIENTS AND METHODS: Medical records of patients with CRC with and without IBD treated between 2008 and 2013 were reviewed. Where possible, patients were matched by age, sex, stage, and diagnosis year...
September 20, 2016: Clinical Colorectal Cancer
A Schnabel, U Range, G Hahn, T Siepmann, R Berner, C M Hedrich
Historically, osteomyelitis was considered an infectious disorder. More recently, inflammatory mechanisms were recognized causing a significant proportion of pediatric osteomyelitis. This study was to compare characteristics of children with chronic non-bacterial (CNO) and bacterial osteomyelitis (BOM). A chart review of osteomyelitis patients from the departments of pediatrics, pediatric surgery, orthopedic surgery, and oral and maxillofacial surgery was conducted in a tertiary referral center, covering the years 2004-2014...
October 11, 2016: Rheumatology International
Hamed Khalili, Martin Neovius, Anders Ekbom, Jonas F Ludvigsson, Johan Askling, Andrew T Chan, Ola Olen
OBJECTIVES: Oral contraceptive (OC) use has been consistently linked to increased risk of inflammatory bowel disease. Nonetheless, a specific role of OC in the natural history of ulcerative colitis (UC) is unknown. METHODS: We identified 6,104 incident female UC cases aged 16-51 years at diagnosis from the Swedish National Patient Register starting in January of 2003. Information on current OC use was obtained from the Prescribed Drug Register starting in July of 2005...
October 11, 2016: American Journal of Gastroenterology
Walter Fries, Anna Viola, Natalia Manetti, Iris Frankovic, Daniela Pugliese, Rita Monterubbianesi, Giuseppe Scalisi, Annalisa Aratari, Laura Cantoro, Maria Cappello, Leonardo Samperi, Simone Saibeni, Giovanni Casella, Giammarco Mocci, Matilde Rea, Federica Furfaro, Antonella Contaldo, Andrea Magarotto, Francesca Calella, Francesco Manguso, Gaetano Inserra, Antonino C Privitera, Mariabeatrice Principi, Fabiana Castiglione, Flavio Caprioli, Sandro Ardizzone, Silvio Danese, Claudio Papi, Fabrizio Bossa, Anna Kohn, Alessandro Armuzzi, Renata D'Incà, Vito Annese, Angela Alibrandi, Stefanos Bonovas, Gionata Fiorino
BACKGROUND: Late-onset UC represents an important issue for the near future, but its outcomes and relative therapeutic strategies are yet poorly studied. AIM: To better define the natural history of late-onset ulcerative colitis. METHODS: In a multicenter retrospective study, we investigated the disease presentation and course in the first 3 years in 1091 UC patients divided into 3 age-groups: diagnosis ≥65years, 40-64 years, and <40years...
September 21, 2016: Digestive and Liver Disease
Juan Paredes Méndez, Guillermo Otoya Moreno, Ana Lucía Mestanza Rivas Plata, Luis Lazo Molina, Katia Acuña Ordoñez, José Luis Arenas Gamio, Eduardo Huamán Egoavil, Fabián Juliao Baños
OBJECTIVE: To identify sociodemographic, clinical, and endoscopic characteristics in patients with inflammatory bowel disease (IBD). MATERIALS AND METHODS: The study period was from January 2004 to December 2014. The final diagnosis was determined by clinical gastroenterologists experienced in the diagnosis and management of IBD, based on internationally accepted diagnostic criteria. RESULTS: 105 patients with IBD were studied, 77% with ulcerative colitis (UC) and 23% with Crohn's disease (CD)...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Dr Dharmendra Kanoriya, Dr A R Pradeep, Dr Vibhuti Garg, Dr Sandeep Singhal
BACKGROUND: Different materials have been instigated for renewal of lost supporting periodontal structures and tested for furcation defects treatment. Platelet-rich fibrin (PRF) is a pool of growth promoting factors and cytokines which promotes bone regeneration and maturation of soft tissue. Alendronate (ALN), an influential member of bisphosphonate group is known to enhance osteoblastogenesis and inhibits osteoclastic bone resorption, thus promoting tissue regeneration. This randomized trial was done to assess the effectiveness of PRF and 1% ALN gel combination in mandibular degree II furcation defects treatment in comparison to PRF and access therapy alone...
October 7, 2016: Journal of Periodontology
E Zittan, Grace W Ma, N Wong-Chong, R Milgrom, R S McLeod, M Silverberg, Z Cohen
BACKGROUND: We aimed to summarize the outcomes of ulcerative colitis (UC) patients receiving an ileal pouch-anal anastamosis (IPAA) over an 11-year period at a high-volume Canadian inflammatory bowel disease (IBD) center. METHODS: A retrospective chart review was performed for subjects with UC who underwent IPAA between 2002 and 2013. Patient charts were reviewed for demographic data, clinical characteristics, preoperative medical treatment, and surgical outcomes...
October 4, 2016: International Journal of Colorectal Disease
Peter A Najjar, Arin L Madenci, Cheryl K Zogg, Eric B Schneider, Christian A Dankers, Marc T Pimentel, Amrita S Chabria, Joel E Goldberg, Gaurav Sharma, Gregory Piazza, Ronald Bleday, Dennis P Orgill, Allen Kachalia
BACKGROUND: Prophylactic anticoagulation is routinely used in the inpatient setting; however, the risk of VTE remains elevated after discharge. Extensive evidence and clinical guidelines suggest post-discharge VTE prophylaxis is critical in at-risk populations but it remains severely underutilized in practice. STUDY DESIGN: We performed a single institution retrospective, non-randomized, pre- and post-intervention analysis of a systematic post-discharge pharmacological prophylaxis program against the primary outcome, post-discharge symptomatic VTE...
September 27, 2016: Journal of the American College of Surgeons
Malgorzata Krzystek-Korpacka, Sabina Gorska, Dorota Diakowska, Bartosz Kapturkiewicz, Magdalena Podkowik, Andrzej Gamian, Iwona Bednarz-Misa
Midkine is a multifunctional cytokine and growth factor displaying proinflammatory and pro-tumorigenic activity. Its association with bowel diseases has not been fully elucidated. Our purpose was to delineate midkine expression pattern by RT-qPCR in inflamed/cancerous bowel (n=208) and whole blood (n=150) in colorectal cancer (CRC), Crohn's disease (CD), and ulcerative colitis (UC) and to evaluate midkine dynamics in early postoperative period following colorectal surgery. The expression of midkine was significantly up-regulated in stage III CRC and independently associated with lymph node metastasis...
September 28, 2016: Cytokine
Gautam Ray
There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India. IBD in second generation Indian migrants to the West takes the early onset and more severe form of the West whereas it retains the nature of its country of origin in migrants to SEA countries...
September 28, 2016: World Journal of Gastroenterology: WJG
Erika Lehtola, Johanna Haapamäki, Martti A Färkkilä
BACKGROUND: Biological medications, particularly TNF-α inhibitors, are used increasingly for active inflammatory bowel disease (IBD). Even though they are superior to many older medications in achieving remission and mucosal healing, primary nonresponse and loss of response remain significant problems, and a remarkable proportion of patients still need surgery at some point. OBJECTIVE: To study the outcome of IBD patients treated with TNF-α inhibitors, either infliximab or adalimumab, with a two-year follow-up...
December 2016: Scandinavian Journal of Gastroenterology
J Greene, G M O'Kane, D N Carney, E Aherne, G C O'Toole
Patients with inflammatory bowel disease (IBD) have an increased risk of developing malignancy. The use of immunosuppressive therapies and tumour necrosis factor (TNF) inhibitors in these patients may provide a further risk for the development of malignancy. We report the clinical and pathological findings of a high grade osteosarcoma in a patient with Crohns disease receiving TNF inhibitor therapy. In this case, a 32-year old female presented with a painful right knee after receiving maintenance adalimumab for Crohns disease for a period of six years...
2016: Irish Medical Journal
R L Prosst, A K Joos
BACKGROUND: One hundred consecutive applications of a new clipping device, the OTSC(®) Proctology (Ovesco Endoscopy AG), were analyzed to assess its efficacy for the treatment of complex anorectal fistulas. METHODS: In patients with anorectal fistulas, minimally invasive surgery with the OTSC(®) Proctology system was performed according to a standardized technique: the fistula tract was debrided using a special fistula brush, and the clip was applied on the internal fistula opening...
September 26, 2016: Techniques in Coloproctology
Ganglei Liu, Xianrui Wu, Yi Li, Yuanyi Rui, Luca Stocchi, Feza H Remzi, Bo Shen
BACKGROUND: There are no published studies on the impact of visceral adipose tissue (VAT) change on outcomes of restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA). The aim of this historic cohort study was to evaluate the impact of excessive VAT gain on the outcomes of inflammatory bowel disease (IBD) patients with IPAA. METHODS: We evaluated all eligible patients with at least two sequential CT scans after pouch construction from our prospectively maintained Pouchitis Registry between 2002 and 2014...
September 25, 2016: Gastroenterology Report
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