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Perianal disease

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https://www.readbyqxmd.com/read/29331943/modern-management-of-perianal-fistulas-in-crohn-s-disease-future-directions
#1
REVIEW
Paulo Gustavo Kotze, Bo Shen, Amy Lightner, Takayuki Yamamoto, Antonino Spinelli, Subrata Ghosh, Remo Panaccione
Perianal fistulae in patients with Crohn's disease (CD) can be associated with significant morbidity resulting in negative impact on quality of life. The last two decades have seen significant advancements in the management of perianal fistulas in CD, which has evolved into a multidisciplinary approach that includes gastroenterologists, colorectal surgeons, endoscopists and radiologists. Despite the introduction of new medical therapies such as antitumour necrosis factor and novel models of care delivery, the best fistula healing rates reported with combined medical and surgical approaches are approximately 50%...
January 13, 2018: Gut
https://www.readbyqxmd.com/read/29321063/first-clinical-case-report-of-local-microinjection-of-autologous-fat-and-adipose-derived-stromal-vascular-fraction-for-perianal-fistula-in-crohn-s-disease
#2
Cécile Philandrianos, Mélanie Serrero, Fanny Grimaud, Jérémy Magalon, Carine Visée, Mélanie Velier, Pauline Francois, Pierre Orsoni, Guy Magalon, Jean-Charles Grimaud, Ariadne Desjeux, Julie Véran, Florence Sabatier
Mesenchymal stem cell therapy is a promising treatment for perianal Crohn's fistulas refractory to conventional therapy, which are an extremely morbid complication and a true therapeutic challenge. Autologous adipose-derived stromal vascular fraction (ADSVF) is an easily accessible source of cells with angiogenic, anti-inflammatory, immunomodulatory, and regenerative properties. Here, we describe a case involving a patient with severe perianal Crohn's fistulas refractory to the best medical and surgical practices who received local treatment with ADSVF and microfat...
January 10, 2018: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29316139/stem-cell-therapy-in-refractory-perineal-crohn-s-disease-long-term-follow-up
#3
Claudio Wainstein, Rodrigo Quera, Daniela Fluxá, Udo Kronberg, Alejandro Conejero, Francisco López-Köstner, Claudio Jofre, Alejandro J Zarate
AIM: To describe the long-term outcomes of adipose-mesenchymal stem cells, platelet-rich plasma, and endorectal advancement flaps in patients with Perineal Crohn's Disease. METHOD: This was a single-center, prospective, observational pilot study performed between March 2013 and December 2016. The study included adult patients diagnosed with Perianal Crohn's Disease (with complex perianal fistulas) refractory to previous surgical and/or biological treatment. Patients underwent surgical treatment in two stages...
January 6, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29289343/rates-and-trends-for-inpatient-surgeries-in-pediatric-crohn-s-disease-in-the-united-states-from-2003-to-2012
#4
Audrey L Stokes, Afif N Kulaylat, Dorothy V Rocourt, Christopher S Hollenbeak, Walter Koltun, Tolulope Falaiye
BACKGROUND: Pediatric Crohn's disease (CD) is increasing in incidence globally. Trends in specific types of inpatient pediatric CD-related surgical procedures have not been widely reported. METHODS: Patients ≤20 years of age with CD were identified in the Kids' Inpatient Database for 2003, 2006, 2009, and 2012. Bowel resection, stoma creation, and perianal or percutaneous drainage procedures were identified using ICD-9 procedure codes, and trends were identified...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29284150/men-main-victims-of-hidradenitis-suppurativa-a-prospective-cohort-study
#5
Hemmat Maghsoudi, Hojjat Almasi, Mahmood Reza Miri Bonjar
BACKGROUND: hidradenitis suppurativa (HS) is a chronic inflammatory disease presenting as painful subcutaneous nodules, characterized by multiple abscess, inter-networking sinus tracts. We present the option of surgical treatment involving wide surgical excision and methods of reconstruction as well as the rate of recurrence. METHOD: This study reviewed 44 sites in 21 patients with moderate to extensive HS treated surgically in our hospital from 2000 to 2016, with a follow up of at least 24 months...
December 25, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29280702/effective-management-of-extensive-tissue-loss-after-abdominoperineal-resection-for-buschke-loewenstein-tumor
#6
G Balducci, G Carbotta, M G Sederino, A Delvecchio, R Laforgia, P Sallustio, P Lobascio, F Ferrarese, M Minafra, S Fedele, N Palasciano
The giant condyloma acuminatum or Buschke-Loewenstein tumor is a rare, sexually transmitted disease. It is an epithelial tumor characterized by its high potential of malignancy towards developing into a highly invasive squamous cell carcinoma. The present case concerns a drug addicted 40-year-old man who smuggled drugs using his rectum. He had a partially ulcerated mass in the perianal area of about 20 x 10 cm. He reported a progressive growth of this neoplasm during the last 3 years associated with perianal pain, obstructed defecation, bad sitting posture, no fever and weight loss...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29277560/long-term-efficacy-and-safety-of-stem-cell-therapy-cx601-for-complex-perianal-fistulas-in-patients-with-crohn-s-disease
#7
Julián Panés, Damián García-Olmo, Gert Van Assche, Jean Frederic Colombel, Walter Reinisch, Daniel C Baumgart, Axel Dignass, Maria Nachury, Marc Ferrante, Lili Kazemi-Shirazi, Jean C Grimaud, Fernando de la Portilla, Eran Goldin, Marie Paule Richard, Mary Carmen Diez, Ignacio Tagarro, Anne Leselbaum, Silvio Danese
BACKGROUND & AIMS: Therapies for perianal fistulas in patients with Crohn's disease (CD) are often ineffective in producing long-term healing. We performed a randomized placebo-controlled trial to determine the long-term efficacy and safety of a single local administration of allogeneic expanded adipose-derived stem cells (Cx601) in patients with CD and perianal fistulas. METHODS: We performed a double-blind study at 49 hospitals in Europe and Israel, comprising 212 patients with CD and treatment-refractory, draining, complex perianal fistulas...
December 22, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29250514/perianal-paget-disease-a-report-of-2-cases
#8
Youn Young Park, Moonsik Kim, Chinock Cheong, Sang Kyum Kim, Seung Yong Song, Kee-Yang Chung, Nam Kyu Kim
Extramammary Paget disease (EMPD) is a rare cutaneous neoplasm. Perianal Paget disease (PPD) is a subset of EMPD manifesting perianal lesions. Two cases of PPD in Severance Hospital are described in this article. A 65-year-old female and 78-year-old male patients visited our institution because of an unhealed perianal skin lesion despite treatment for a long period with topical agents. PPD was diagnosed by skin biopsies in both cases, and the patients underwent surgical treatment. Clinical manifestations, preoperative work-ups, and surgical treatments including different reconstruction methods are described in detail...
December 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29243105/comparative-effectiveness-of-infliximab-versus-adalimumab-in-patients-with-biologic-na%C3%A3-ve-crohn-s-disease
#9
Amine Benmassaoud, Talal Al-Taweel, Mark Solomon Sasson, Dasha Moza, Matthew Strohl, Uri Kopylov, Laurence Paradis-Surprenant, Mohanad Almaimani, Alain Bitton, Waqqas Afif, Peter L Lakatos, Talat Bessissow
BACKGROUND: Direct head-to-head studies comparing the long-term outcomes of infliximab (IFX) to adalimumab (ADA) in Crohn's disease (CD) are sparse. AIMS: We compared the short-term and long-term efficacy and safety of IFX and ADA in CD. METHODS: We performed a single-center retrospective study including biologic-naïve adult patients with CD who were started on IFX or ADA at the McGill University Health Center. The primary end points were clinical response and remission at 12 months...
December 14, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29237100/perianal-tuberculosis-in-an-immunocompetent-patient
#10
Gabriela Mosena, Andréia Della Giustina Pires, Jessica Matos D'Almeida Santos, Joel Schwartz, Josué Victorino
Tuberculosis (TB) is a major public health problem worldwide, considered to be the main cause of death from infectious diseases, ranking alongside HIV infection. Skin involvement occurs in 1.5% of the cases, and perianal involvement is extremely rare and tends to occur among immunocompromised patients. Due to its heterogeneous clinical presentation, the diagnosis of cutaneous TB is challenging, requiring a high level of suspicion. This article is protected by copyright. All rights reserved.
December 13, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29216685/patient-compliance-with-surveillance-colonoscopy-patient-factors-and-the-use-of-a-graded-recall-system
#11
Chahaya Gauci, Rebecca Lendzion, Kim-Chi Phan-Thien, Denis King, Dayashan S Perera
BACKGROUND: Surveillance colonoscopy allows for the early detection and improved treatment outcomes in colorectal neoplasms but compliance rates and factors require further investigation. METHODS: This is a retrospective cohort study examining 816 patients recalled for surveillance colonoscopy at an Australian colorectal practice over a 6-month period. Primary outcome was compliance with colonoscopy within 12 months of recall. The secondary outcome of this study was to identify factors affecting compliance including patient factors and the practices' graded recall system...
December 7, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29215479/major-abdominal-and-perianal-surgery-in-crohn-s-disease-long-term-follow-up-of-australian-patients-with-crohn-s-disease
#12
MULTICENTER STUDY
James W T Toh, Nelson Wang, Christopher J Young, Matthew J F X Rickard, Anil Keshava, Peter Stewart, Viraj Kariyawasam, Rupert Leong
BACKGROUND: Most patients with Crohn's disease still require surgery despite significant advances in medical therapy, surveillance, and management strategies. OBJECTIVE: The purpose of this study was to assess surgical strategies and outcomes in Crohn's disease, including surgical recurrence and emergency surgery. DESIGN: This was a multicenter, retrospective review of a prospectively collected database. SETTINGS: A specialist-referred cohort of patients with Crohn's disease between 1970 and 2009 was studied...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29211872/misplacement-of-stent-into-epidural-venous-plexus-with-resultant-cauda-equina-syndrome-and-open-surgical-treatment-a-case-report
#13
Benjamin B Whiting, Celene B Mulholland, Lorin Daniels, U Kumar Kakarla, Nicholas Theodore, Laura A Snyder
BACKGROUND AND IMPORTANCE: Endovascular therapy has proven to be a safe, minimally invasive treatment for multiple etiologies, but proper precautions must be taken to avoid complications. When complications occur, they should be promptly identified and corrected when possible. This case report describes endovascular stents misplaced into the epidural spinous venous plexus rather than the iliofemoral arteries, causing cauda equina syndrome, as well as the spinal procedure performed to treat the resulting spinal canal compression...
December 2, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29209921/fourteen-year-anti-tnf-therapy-in-crohn-s-disease-patients-clinical-characteristics-and-predictive-factors
#14
Aisaku Osamura, Yasuo Suzuki
BACKGROUND: Crohn's disease (CD) is an intractable disease that requires long-term treatment. Tumor necrosis factor (TNF) inhibitors have strong efficacy and are widely used for CD treatment. However, a loss of response is one of the issues in long-term TNF therapy. To identify the factors affecting the efficacy of long-term CD treatment with TNF inhibitors, we conducted a retrospective study of treatment outcomes and clinical factors using clinical data over a 14-year period. METHODS: Clinical characteristics and factors for surgery, hospitalization, and TNF inhibitor treatment discontinuation were examined in 219 biologic-naïve patients who were treated with TNF inhibitors at our hospital before October 2014...
December 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29203997/perianal-paget-s-disease-a-case-report-and-a-review-of-current-diagnosis-and-management
#15
Chintamani Godbole, Jyoti Mehta, Bijoy Methil, Reshma Palep, Prajesh Bhuta
Paget's disease is an intraepithelial adenocarcinoma arising from the apocrine gland component of the skin. Paget's disease is most common in the breast but extra mammary disease is also seen. Perianal Paget's disease is a rare form of extramammary disease with few cases reported in literature. It can be primary-arising from the skin or secondary-cutaneous metastases of anorectal or genitourinary malignancy. We hereby wish to report a case of perianal Paget's disease that presented as an eczematous lesion and was diagnosed incidentally on biopsy...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29202553/extramammary-paget-s-disease-associated-with-genital-wart-and-lichen-sclerosus
#16
Rana Rafiei, Hojat Eftekhari, Siamak Granmayeh, Nahid Nickhah, Behnam Rafiee
Extramammary Paget's disease is an uncommon intraepithelial adenocarcinoma in genital and perianal regions. Genital wart is the most common sexually transmitted disease caused by human papilloma viruses and vulval lichen sclerosus is chronic pruritic dermatitis in genital area which could be able to change to invasive squamous cell carcinoma. We report a patient who had simultaneous lichen sclerosus, genital wart and extramammary Paget's disease of the vulva. We could not find any significant association between them in literature...
September 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29199142/high-risk-of-anal-and-rectal-cancer-in-patients-with-anal-and-or-perianal-crohn-s-disease
#17
Laurent Beaugerie, Fabrice Carrat, Stéphane Nahon, Jean-David Zeitoun, Jean-Marc Sabate, Laurent Peyrin-Biroulet, Jean-Frédéric Colombel, Matthieu Allez, Jean-François Fléjou, Julien Kirchgesner, Magali Svrcek
BACKGROUND AND AIMS: Little is known about the magnitude of the risk of anal and rectal cancer in patients with anal and/or perineal Crohn's disease. We aimed to assess the risk of anal and rectal cancer in patients with Crohn's perianal disease followed in the Cancers Et Surrisque Associé aux Maladies inflammatoires intestinales En France (CESAME) cohort. METHODS: We collected data from 19,486 patients with Inflammatory Bowel Disease (IBD) enrolled in the observational CESAME study in France, from May 2004 through June 2005; 14...
November 30, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29191059/optimization-of-biologic-therapy-in-crohn-s-disease
#18
Mohammed Razvi, Mark Lazarev
Crohn's disease (CD) is a manifestation of inflammatory bowel disease (IBD), which can result in significant morbidity. Biologic therapy with anti-TNF medication has been effective in treating inflammation and reducing complications in CD. It is important for clinicians to have better knowledge of the various biologic therapies including mechanisms of action and optimization strategies. Areas covered: The review describes optimization of biologic therapy in CD including different mechanisms of loss of response, therapeutic drug monitoring in CD, clinical implications and management strategies which utilize drug monitoring, and areas of future development and research in optimization of biologic therapy...
November 30, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29177796/molecular-and-cellular-mechanisms-involved-in-mesenchymal-stem-cell-based-therapy-of-inflammatory-bowel-diseases
#19
REVIEW
Bojana Simovic Markovic, Tatjana Kanjevac, C Randall Harrell, Marina Gazdic, Crissy Fellabaum, Nebojsa Arsenijevic, Vladislav Volarevic
Mesenchymal stem cells (MSCs) are promising resource for the therapy of inflammatory bowel diseases (IBDs) on the grounds of their differentiation capabilities and immuno-modulatory characteristics. Results of clinical studies indicate that local application of MSCs is a secure and beneficial approach for the treatment of perianal fistulas while systemic application of MSCs leads to the attenuation or aggravation of IBDs. Herein, we emphasized molecular mechanisms and approaches that should improve efficacy of MSC-based therapy of IBDs...
November 25, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/29168104/safe-use-of-infliximab-for-the-treatment-of-severe-perianal-crohn-s-disease-after-diagnosis-and-treatment-of-lymphoma
#20
Carlos Bernardes, Pedro Russo, Diana Carvalho, Joana Saiote, Jaime Ramos
Inflammatory bowel disease is associated with an increased likelihood of developing lymphoma. However, it is still controversial if this risk may be attributed to the disease itself or rather represents an effect of immunosuppressive treatment. Although tumor necrosis factor alpha (TNFα) is a key cytokine for cancer immunosurveillance, the potential relationship between anti-TNFα agents and the pathogenesis of lymphoproliferative disorders remains unclear. Here, we describe the case of a patient with severe perianal Crohn's disease, treated with infliximab monotherapy, whose unusual presentation with acute groin pain required surgical intervention and led to the diagnosis of diffuse large B-cell lymphoma...
November 22, 2017: Clinical Journal of Gastroenterology
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