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Perianal disease

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https://www.readbyqxmd.com/read/29165666/differences-in-outcomes-over-time-with-exclusive-enteral-nutrition-compared-to-steroids-in-children-with-mild-to-moderate-crohn-s-disease-results-from-the-growth-cd-study
#1
Noa Cohen-Dolev, Malgorata Sladek, Seamus Hussey, Dan Turner, Gabor Veres, Sibylle Koletzko, Javier Martin de Carpi, Annamaria Staiano, Ron Shaoul, Paolo Lionetti, Jorge Amil Dias, Anders Paerregaard, Federica Nuti, Tamar Pfeffer Gik, Tomer Ziv-Baran, Sivan Ben Avraham Shulman, Chen Sarbagili Shabat, Rotem Sigall Boneh, Richard K Russell, Arie Levine
Background: Exclusive enteral nutrition (EEN) and corticosteroids (CS) both induce similar rates of remission in mild to moderate pediatric Crohn's disease (CD), but differ with regard to mucosal healing. Our goal was to evaluate if EEN at diagnosis was superior to CS for improving long term outcomes. Methods: We prospectively followed newly diagnosed children <17 years with mild to moderate disease at baseline for two years in the GROWTH CD study. Patients were evaluated at baseline and at 8, 12, 78, and 104 weeks...
November 18, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29147878/knowledge-gaps-in-the-management-of-postoperative-crohn-s-disease-a-us-national-survey
#2
Vu Q Nguyen, Jessica L Mays, Marissa Lang, Yingxing Wu, Themistocles Dassopoulos, Miguel Regueiro, Alan Moss, Deborah D Proctor, Dario Sorrentino
BACKGROUND: Postoperative recurrence (POR) of Crohn's disease (CD) is common. Guidelines on POR management have recently been issued, but clinical practice may vary. AIMS: To examine the current clinical practice of POR management in the USA METHODS: A web-based survey was sent to all members of the American Gastroenterological Association and the American College of Gastroenterology. The survey consisted of multiple-choice questions with clinical scenarios to assess how participants manage POR...
November 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29145312/bilateral-femoral-posterior-neurocutaneous-perforater-flap-successfully-treating-fournier-gangrene-a-case-report
#3
Tao Wang, Gang Zhao, Yong-Jun Rui, Jing-Yi Mi
RATIONALE: Necrotizing fasciitis (NF), characterized by widespread fascial necrosis, is a rare disease in clinic. Fournier gangrene (FG) is a special type of NF involved of perineum and scrotum. To our knowledge, no article has reported on bilateral femoral posterior neurocutaneous perforater flap treating for FG. PATIENT CONCERNS: A 61-year-old Chinese male complained of perineal skin necrosis for 19 days. The patient received treatment in other hospital due to chronic bronchitis on April 15th and body temperature ranged from 38 to 39 °C...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143190/role-of-magnetic-resonance-imaging-in-the-management-of-perianal-crohn-s-disease
#4
REVIEW
Jose C Gallego, Ana Echarri
Perianal fistulas are a major problem in many patients with Crohn's disease. These are usually complex fistulas that adversely affect patients' quality of life, and their clinical management is difficult. Medical treatment sometimes achieves cessation of discharge and closure of the external opening; however, it is difficult to assess the status of the rest of the fistula tract. Magnetic resonance imaging is the method of choice with which to evaluate the condition of perianal fistulas and allows for assessment of the status of inaccessible areas...
November 15, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/29140941/phenotype-and-management-of-infantile-onset-inflammatory-bowel-disease-experience-from-a-tertiary-care-center-in-china
#5
Ziqing Ye, Ying Zhou, Ying Huang, Yuhuan Wang, Junping Lu, Zifei Tang, Shijian Miao, Kuiran Dong, Zhinong Jiang
BACKGROUND: Infantile-onset inflammatory bowel disease (IBD) comprises rare and clinically severe disorders. We examined the phenotypes and genetic causes of patients with infantile-onset IBD from a tertiary medical center. METHODS: We enrolled 38 patients with infantile-onset IBD and applied standardized treatment with medical, surgical, and supportive care. Targeted sequencing and whole-exome sequencing were performed. Clinical data were retrieved from medical records...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29139091/pharmacological-approach-to-the-management-of-crohn-s-disease-patients-with-perianal-disease
#6
REVIEW
Fernando Bermejo, Iván Guerra, Alicia Algaba, Antonio López-Sanromán
Perianal localization of Crohn's disease involves significant morbidity, affects quality of life and results in an increased use of healthcare resources. Medical and surgical therapies contribute to its management. The objective of this review is to address the current understanding in the management of perianal Crohn's disease, with the main focus in reviewing pharmacological therapies, including stem cells. In complex fistulas, once local sepsis has been controlled by surgical drainage and/or antibiotics, anti-TNF drugs (infliximab, adalimumab) are the first-line therapy, with or without associated immunomodulators...
November 14, 2017: Drugs
https://www.readbyqxmd.com/read/29135086/can-mr-enterography-screen-for-perianal-disease-in-pediatric-inflammatory-bowel-disease
#7
Zehour AlSabban, Nicholas Carman, Rahim Moineddin, Ryan T Lo, Sebastian K King, Jacob C Langer, Thomas D Walters, Anne M Griffiths, Peter C Church, Mary-Louise C Greer
BACKGROUND: Pediatric Crohn's disease is associated with perianal disease (PAD). Magnetic resonance enterography (MRE) assesses small bowel involvement in pediatric inflammatory bowel disease (PIBD). Pelvic MRI (P-MRI) is the gold standard for assessing PAD. PURPOSE: To determine if MRE can accurately detect PAD in PIBD, distinguishing perianal fistulae (PAF) from perianal abscesses (PAA), referenced against P-MRI. STUDY TYPE: Retrospective...
November 14, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29126509/treatment-of-perianal-crohn-s-disease
#8
Jill M Zalieckas
Perianal Crohn's is a common manifestation of Crohn's disease. Primary manifestations of perianal disease mirror common anorectal conditions, however treatment is less successful than in those patients without Crohn's related perianal disease. A multimodal approach to therapy including medical and surgical modalities is often necessary. The goal of treatment is to manage symptoms while maintaining continence.
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29118554/risk-factors-for-postoperative-recurrence-of-crohn-s-disease-with-emphasis-on-surgical-predictors
#9
REVIEW
Antonios Gklavas, Dionysios Dellaportas, Ioannis Papaconstantinou
Intestinal resection for Crohn's disease is not curative and postoperative recurrence rates remain high. Early detection of indices associated with recurrence and risk stratification are fundamental for the postoperative management of patients. Early endoscopy at 6-12 months is the "gold standard" procedure, whereas other modalities such as fecal calprotectin and imaging techniques can contribute to the diagnosis of recurrence. The purpose of this review is to summarize current data regarding risk factors correlated with postoperative relapse...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29112567/a-pilot-study-of-the-prevalence-of-anal-human-papillomavirus-and-dysplasia-in-a-cohort-of-patients-with-ibd
#10
Ross D Cranston, Miguel Regueiro, Jana Hashash, Jonathan R Baker, Nicola Richardson-Harman, Laura Janocko, Ian McGowan
BACKGROUND: Defective cell-mediated immunity increases the risk of human papillomavirus-associated anal dysplasia and cancer. There is limited information on anal canal disease in patients with IBD. OBJECTIVE: The purpose of this study was to assess anal/vaginal human papillomavirus and anal dysplasia prevalence in patients with IBD. DESIGN: Patients had an anal examination before routine colonoscopy. SETTINGS: The study was conducted at a tertiary IBD referral center...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29108399/effects-of-perianal-involvement-on-clinical-outcomes-in-crohn-s-disease-over-10-years
#11
Jin Young Yoon, Jae Hee Cheon, Soo Jung Park, Tae Il Kim, Won Ho Kim
Background/Aims: There was the assumption that CD patients with perianal lesions might have different clinical courses compared to those without. However, quantifiable data comparing the long-term outcomes between the two groups are scarce. Methods: We retrospectively reviewed 221 consecutive patients newly diagnosed with CD and registered at the IBD clinic of Severance Hospital, in Seoul, Korea, between January 1990 and October 2005. We compared patients with perianal CD (PCD) and non-perianal CD (NPCD) in terms of clinical outcomes over 10 years...
November 8, 2017: Gut and Liver
https://www.readbyqxmd.com/read/29097874/risk-factors-for-postoperative-recurrence-after-primary-bowel-resection-in-patients-with-crohn-s-disease
#12
Kwan Mo Yang, Chang Sik Yu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Sang Hyoung Park, Byong Duk Ye, Suk-Kyun Yang, Jin Cheon Kim
AIM: To evaluate the risk factors for postoperative recurrence after primary bowel resection in a cohort of Korean Crohn's disease (CD) patients. METHODS: This study included 260 patients with no history of previous bowel surgery who underwent primary surgery for CD between January 2000 and December 2010 at Asan Medical Center (Seoul, South Korea). The median follow-up period was 101 mo. RESULTS: During the follow-up period, 66 patients (25...
October 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29096549/advances-in-mesenchymal-stromal-cell-therapy-in-the-management-of-crohn-s-disease
#13
Hajir Ibraheim, Chiara Giacomini, Zain Kassam, Francesco Dazzi, Nick Powell
The aim of therapy in Crohn's disease (CD) is induction and maintenance of remission, promotion of mucosal healing and restoration of quality of life. Even the best treatment regimes, including combinations of biologics and immunomodulators lack durable efficacy and have well documented side effects. Accordingly, there is an unmet need for novel therapies. Mesenchymal stromal cells (MSCs) are a subset of non-hematopoietic stem cells that home to sites of inflammation where they exert potent immunomodulatory effects and contribute to tissue repair...
November 2, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29069227/bone-mineral-density-and-inflammatory-bowel-disease-severity
#14
C A Lima, A C Lyra, C M C Mendes, M B Lopes, F G Coqueiro, R Rocha, G O Santana
Inflammatory bowel disease (IBD) is associated with low bone mineral density (BMD). In this study, the association between disease severity and BMD in patients with IBD was evaluated. Associations between BMD and the Montreal classification, disease activity and drug therapy were also tested. A cross-sectional prevalence study with a comparison group was conducted. One hundred and twenty-eight patients were evaluated: 68 patients with ulcerative colitis (UC), and 60 with Crohn's disease (CD). The control group consisted of 67 healthy subjects...
October 19, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29046093/video-assisted-anal-fistula-treatment-a-high-volume-unit-initial-experience
#15
F Y Cheung, N D Appleton, S Rout, R Kalaiselvan, J A Nicholson, A Samad, M Chadwick, R Rajaganeshan
Introduction Perianal fistulas are a common problem. Video-assisted anal fistula treatment is a new technique for the management of this difficult condition. We describe our initial experience with the technique to facilitate the treatment of established perianal fistulas. Methods We reviewed a prospectively maintained database relating to consecutive patients undergoing video-assisted anal fistula treatment in a single unit. Results Seventy-eight consecutive patients had their perianal fistulas treated with video-assistance from November 2014 to June 2016...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29045603/ustekinumab-drug-levels-in-maternal-and-cord-blood-in-a-woman-with-crohn-s-disease-treated-until-33-weeks-gestation
#16
Catherine R Rowan, Garret Cullen, Hugh E Mulcahy, Denise Keegan, Kathryn Byrne, Deirdre J Murphy, Juliette Sheridan, Glen A Doherty
A 35-year old woman with ileocolonic, perianal and vulval Crohn's disease was treated with subcutaneous ustekinuamb (USK) throughout pregnancy. Dose intervals were shortened from 6-weekly to 4-weekly to maintain clinical remission. The last dose of USK was administered at 33 weeks gestation and a healthy baby boy was delivered by caesarean section at 37 weeks. Maternal trough USK levels remained stable during pregnancy. Cord blood USK levels were nearly two-fold higher than contemporaneous maternal serum levels...
October 16, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29045353/impaired-il-10-receptor-mediated-suppression-in-monocyte-from-patients-with-crohn-s-disease
#17
Moran Y Nunberg, Lael Werner, Uri Kopylov, Yael Haberman, Avishay Lahad, Batia Weiss, Dror S Shouval
OBJECTIVES: Interleukin-10 (IL-10) is an immunoregulatory cytokine that has a central role in suppressing pro-inflammatory responses. Patients with deleterious mutations in IL-10 or IL-10 receptor (IL-10R) genes develop severe colitis and perianal disease in the first months of life. Whether IL-10R expression and signaling in pediatric- or adult-onset Crohn's disease (CD) are altered is unknown. The objective of this study was to characterize IL-10R expression and IL-10R-mediated suppression in patients with CD...
October 17, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29043209/perianal-langerhans-cell-histiocytosis-a-rare-presentation-in-an-adult-male
#18
Asmaa Gaber Abdou, Doha MaherTaie
Langerhans cell histiocytosis (LCH) is a rare disease characterized by a proliferation of cells that show immunophenotypic and ultrastructural similarities with antigen-presenting Langerhans cells of mucosal sites and skin. LCH in adults is rare, and there are still many undiagnosed/misdiagnosed patients. We describe LCH involvement of the perianal region of a 33-year-old male with a previous history of diabetes insipidus. The differential diagnosis and all the reported cases of LCH of the perianal skin involvement since its description in 1984 till 2016 are discussed...
July 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/29030149/clinical-management-of-women-presenting-with-field-effect-of-hpv-and-intraepithelial-disease
#19
REVIEW
T S Adams, N H Mbatani
Anogenital human papillomavirus is the most common sexually transmitted infection acquired through skin-to-skin contact. Most infections are cleared by an intact immune system. Persistence of these infections results in precancerous lesions and, eventually, to cancers of the cervix, vagina, vulva, and perianal area. The introduction of the prophylactic human papilloma virus (HPV) vaccinations may reduce the incidence of these infections, but the effect of these vaccinations will be seen only in the decades that follow...
September 6, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29029635/individual-signatures-and-environmental-factors-shape-skin-microbiota-in-healthy-dogs
#20
Anna Cuscó, Janelle M Belanger, Liza Gershony, Alma Islas-Trejo, Kerinne Levy, Juan F Medrano, Armand Sánchez, Anita M Oberbauer, Olga Francino
BACKGROUND: The individual, together with its environment, has been reported as the main force driving composition and structure of skin microbiota in healthy dogs. Therefore, one of the major concerns when analyzing canine skin microbiota is the likely influence of the environment. Despite the dense fur covering, certain skin diseases exhibit differential prevalence among skin sites, dog breeds, and individuals. RESULTS: We have characterized the normal variability of dog skin microbiota in a well-controlled cohort of a large number of Golden-Labrador Retriever crossed dogs (N = 35) with similar ages, related genetic background, and a shared environment...
October 13, 2017: Microbiome
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