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Perianal disease

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https://www.readbyqxmd.com/read/28914206/mesenchymal-stem-cell-as-a-potential-therapeutic-for-inflammatory-bowel-disease-myth-or-reality
#1
Sanjucta Adak, Sayani Mukherjee, Dwaipayan Sen
BACKGROUND: Inflammatory bowel diseases (IBD), which include Crohn's disease and Ulcerative Colitis, are inflammatory autoimmune diseases which severely affect the quality of life. Till date, no long-lasting cure has been found for the disease and all the current treatment strategies are mainly focused on dampening the symptomatic inflammatory process that has certain side effects. In addition, a large number of patients remain refractory to conventional therapies. Mesenchymal stem cells (MSCs) can be looked upon as a biodrug to treat IBD owing to their immune-suppressive and regenerative capabilities...
September 13, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28900730/review-of-local-injection-of-anti-tnf-for-perianal-fistulising-crohn-s-disease
#2
REVIEW
Samuel O Adegbola, Kapil Sahnan, Philip J Tozer, Robin Ks Phillips, Omar D Faiz, Janindra Warusavitarne, Ailsa Hart
BACKGROUND: Perianal fistulising Crohn's disease (PFCD) affects a third of Crohn's disease patients and represents a disabling phenotype with poor outcome. The anti-tumour necrosis factor alpha (TNF) therapies have been shown to maintain clinical remission in a third of patients after 1 year of treatment. Maintenance therapy with systematic administration schedules confers greatest benefit, but exposes patients to risks/side effects of continued systemic use and led to consideration of local drug delivery (first described in 2000)...
September 12, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28893632/patients-experiences-with-extramammary-paget-s-disease-an-online-pilot-study-querying-a-patient-support-group
#3
Paul H Chung, Jeremy T Kampp, Bryan B Voelzke
OBJECTIVE: To illustrate the heterogeneous care delivered to patients with Extramammary Paget's Disease (EMPD), a rare and lethal malignancy with poorly described treatment methodologies, by characterizing the clinical and pathological characteristics of an international patient support group. METHODS: Institutional review board approval was obtained to develop and distribute a non-validated survey to patients from an international, online EMPD support group. The survey was developed to capture patient clinical and pathological details and was distributed between January 2017 and February 2017...
September 8, 2017: Urology
https://www.readbyqxmd.com/read/28889960/outcomes-after-fecal-diversion-for-colonic-and-perianal-crohn-disease-in-children
#4
Rajmohan Dharmaraj, Melodee Nugent, Pippa Simpson, Marjorie Arca, Bhaskar Gurram, Steven Werlin
BACKGROUND: Temporary fecal diversion by means of an ileostomy or colostomy has been used in the surgical management of refractory colonic and perianal Crohn disease (CD). The aims of our study were to evaluate the outcomes after fecal diversion in pediatric patients with colonic and perianal CD. METHODS: The records of patients who underwent fecal diversion for colonic and perianal CD at Children's Hospital of Wisconsin between July 2000 and June 2014 were reviewed retrospectively...
August 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28887080/a-rare-case-of-metastatic-extramammary-paget-disease-of-the-spine-and-review-of-the-literature
#5
A Karim Ahmed, C Rory Goodwin, Nancy Abu-Bonsrah, Doreen Nguyen, Daniel M Sciubba
Extramammary Paget disease is an intraepithelial neoplasm affecting cells rich in apocrine glands-often located in the vulvar, scrotal, or perianal region. It typically affects older patients, between the ages of 50 and 80years old, and is most often limited to the epidermis. A 47-year-old Asian male first presented with enlargement of the right inguinal lymph node. A subsequent biopsy revealed extrammamary Paget disease of the scrotum. The patient eventually developed significant worsening back pain with bilateral lower extremity numbness and weakness three months later...
September 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28885229/impact-of-diagnostic-delay-and-associated-factors-on-clinical-outcomes-in-a-u-s-inflammatory-bowel-disease-cohort
#6
Vu Q Nguyen, Dingfeng Jiang, Sharon N Hoffman, Srikar Guntaka, Jessica L Mays, Anthony Wang, Joseph Gomes, Dario Sorrentino
BACKGROUND: The impact of diagnostic delay in inflammatory bowel disease, including Crohn's disease (CD) and ulcerative colitis (UC), on disease course remains uncertain. This study examines factors that may influence time to diagnosis and disease outcomes in a U.S. patient cohort. METHODS: We retrospectively collected data on patient characteristics, time to diagnosis, disease phenotype, and complications in 177 patients with inflammatory bowel disease (110 CD and 67 UC) diagnosed at our institution from 2008 to 2015...
September 6, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28884323/-proctology-for-internists
#7
J Feisthammel, J Mössner
In proctology patients can often be helped with very little effort. With knowledge of the most common disease symptoms the treating physician can in many cases correctly recognize the cause of the complaints and initiate the appropriate therapy or arrange referral to a proctological institution. This article aims to briefly and succinctly present the most common diseases in proctology (e.g. mariscae, hemorrhoids, anal fissures, perianal venous thrombosis, abscesses and fistulas, condyloma acuminatum and anal carcinoma) and to provide the treating internist, even outside of gastroenterology, assistance with the management of proctological symptoms...
September 7, 2017: Der Internist
https://www.readbyqxmd.com/read/28882616/screening-of-inflammatory-bowel-disease-and-spondyloarthritis-for-referring-patients-between-rheumatology-and-gastroenterology
#8
Jesús Sanz Sanz, Xavier Juanola Roura, Daniel Seoane-Mato, Miguel Montoro, Fernando Gomollón
OBJECTIVE: To define clinical screening criteria for spondyloarthritis (SpA) in patients with inflammatory bowel disease (IBD) and vice versa, which can be used as a reference for referring them to the rheumatology or gastroenterology service. METHOD: Systematic literature review and a two-round Delphi method. The scientific committee and the expert panel were comprised of 2 rheumatologists and 2 gastroenterologists, and 7 rheumatologists and 7 gastroenterologists, respectively...
September 4, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28881579/methylation-of-hpv-and-a-tumor-suppressor-gene-reveals-anal-cancer-and-precursor-lesions
#9
Attila T Lorincz, Mayura Nathan, Caroline Reuter, Rhian Warman, Mohamed A Thaha, Michael Sheaff, Natasa Vasiljevic, Amar Ahmad, Jack Cuzick, Peter Sasieni
We studied DNA methylation patterns of human papillomavirus (HPV) and tumor suppressor gene EPB41L3 in 148 anal and perianal biopsies to determine whether high levels of methylation would be associated with anal intraepithelial neoplasia (AIN). The most prevalent HPV type was HPV16, detected in 54% of the 30 benign biopsies, 33% of the 43 low-grade AIN (lgAIN), 82% of the 59 high grade AIN (hgAIN) and 4 of the 5 anal cancers. A methylation score was developed (0.561*HPV16me+0.439*EPB41L3) which had increasing values with severity of disease: the mean was 8...
August 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/28881336/perianal-pseudolymphoma-a-case-report-and-review-of-the-literature
#10
Tahleesa Cuda, Pieter Prinsloo
INTRODUCTION: Perianal pseudolymphoma is a rare lymphoproliferative disorder that can mimic cutaneous lymphoma. The condition can present acutely with concerns of perianal sepsis. The purpose of this case review is to review the current literature on perianal pseudolymphoma and emphasise to the surgical community its presentation, suggested aetiology and management. CASE PRESENTATION: In this case report, we detail the case of a 28-year-old female who presented with perianal pseudolymphoma...
August 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28871935/topical-imiquimod-is-an-effective-and-safe-drug-for-molluscum-contagiosum-in-children
#11
George Badavanis, Efstathia Pasmatzi, Alexandra Monastirli, Sophia Georgiou, Dionysios Tsambaos
Dear Editor, Molluscum contagiosum (MC) is a very common skin infection caused by a molluscipox virus gene of the poxvirus family. It usually occurs in young children, sexually active adults, and immunocompromised individuals. The typical clinical picture of this infection is characterized by asymptomatic flesh-colored, single or multiple papules, measuring 2-6 mm in diameter with a central umbilication that occur on the skin and the mucous membranes. In adults, the skin lesions are predominantly located in the genital region, whereas in children they are found on the trunk, the extremities, and the face...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28871380/mri-of-anal-canal-common-anal-and-perianal-disorders-beyond-fistulas-part-2
#12
REVIEW
Ayşe Erden
A broad spectrum of disease, from benign processes to life-threatening pathologies, can cause anal pain. MR imaging (MRI) has become increasingly widely used method over the past two decades for the evaluation of individuals with anorectal symptoms. Although imaging is rarely necessary to determine the etiology of the majority of cases, MRI is particularly useful as a noninvasive method of excluding severe neoplastic conditions. In this article, MRI findings of a number of pathologies such as anal and perianal neoplasms, hemorrhoidal disease, arteriovenous malformation of the perianal region, and anal sphincter lesions (defects, scarring, atrophy) which may lead to fecal incontinence are presented...
September 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28868004/a-disease-modifying-approach-for-advanced-hidradenitis-suppurativa-regimen-with-metformin-liraglutide-dapsone-and-finasteride-a-case-report
#13
Birgit N Khandalavala
Hidradenitis suppurativa (HS) is a challenging skin disease with limited therapeutic options. Obesity and metabolic syndrome are being increasingly implicated and associated with younger ages and greater metabolic severity. A 19-year-old female with an 8-year history of progressively debilitating cicatricial HS disease presented with obesity, profound anemia, leukocytosis, increased platelet count, hypoalbuminemia, and elevated liver enzymes. A combination of metformin, liraglutide, levonorgestrel-ethinyl estradiol, dapsone, and finasteride was initiated...
May 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28864649/phenotypic-features-and-longterm-outcomes-of-pediatric-inflammatory-bowel-disease-patients-with-arthritis-and-arthralgia
#14
Osnat Nir, Firas Rinawi, Gil Amarilyo, Liora Harel, Raanan Shamir, Amit Assa
OBJECTIVE: The natural history of pediatric inflammatory bowel disease (IBD) patients with joint involvement has not been clearly described. Thus, we aimed to investigate phenotypic features and clinical outcomes of this distinct association. METHODS: The medical records of patients with pediatric IBD diagnosed from 2000 to 2016 were reviewed retrospectively. Main outcome measures included time to first flare, hospitalization, surgery, and biologic therapy. RESULTS: Of 301 patients with Crohn disease (median age 14...
September 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28858069/comparison-of-health-care-utilization-and-costs-between-patients-with-perianal-fistulizing-crohn-s-disease-treated-with-biologics-with-or-without-previous-seton-placement
#15
David A Schwartz, Anthony Wang, Burak Ozbay, Martha Skup, Samantha F Eichner, Jay Lin, Jingdong Chao
BACKGROUND: Fistulas are a common and often debilitating complication of Crohn's disease (CD). Tumor necrosis factor inhibitors and/or seton drainage are effective treatment options. We compared health care utilization and costs for patients with perianal CD who had setons placed before treatment with biologics versus those who did not. METHODS: Patients with CD (≥18 yr) were identified from the Truven Health MarketScan Database by ICD-9 code 555.x (January 1, 2006-March 31, 2015); those with external fistulas were identified by ICD-9 codes 565...
August 29, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28857130/natural-history-of-anorectal-sepsis
#16
K Sahnan, A Askari, S O Adegbola, P J Tozer, R K S Phillips, A Hart, O D Faiz
BACKGROUND: Progression from anorectal abscess to fistula is poorly described and it remains unclear which patients develop a fistula following an abscess. The aim was to assess the burden of anorectal abscess and to identify risk factors for subsequent fistula formation. METHODS: The Hospital Episode Statistics database was used to identify all patients presenting with new anorectal abscesses. Cox regression analysis was undertaken to identify factors predictive of fistula formation...
August 31, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28851611/the-efficacy-of-infliximab-combined-with-surgical-treatment-of-fistulizing-perianal-crohn-s-disease-comparative-analysis-according-to-fistula-subtypes
#17
Eun Jung Park, Ki-Hwan Song, Seung Hyuk Baik, Jae Jun Park, Jeonghyun Kang, Kang Young Lee, Ja Il Goo, Nam Kyu Kim
BACKGROUND/OBJECTIVE: Infliximab is regarded as an effective therapeutic to treat Crohn's disease. This study aimed to assess the efficacy of infliximab combined with surgery and to analyze clinical manifestations according to fistula subtypes in patients with fistulizing perianal Crohn's disease. METHODS: From April 2013 to December 2015, 47 patients with perianal Crohn's disease in two hospitals of South Korea (Goo Hospital, Gangnam Severance Hospital) were evaluated retrospectively...
August 26, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28840368/mri-of-anal-canal-normal-anatomy-imaging-protocol-and-perianal-fistulas-part-1
#18
REVIEW
Ayşe Erden
Anal complaints are very common in the general population and are caused by a variety of disorders mostly benign in nature. The aim of this article is to provide the radiologist with a detailed description of the MRI anatomy and technique, and an overview of the various diseases most commonly presenting with anal pain, by descriptions and illustrative examples of MRI features of each entity.
August 24, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28839437/elaboration-and-validation-of-crohn-s-disease-anoperineal-lesions-consensual-definitions
#19
Clémence Horaist, Vincent de Parades, Laurent Abramowitz, Paul Benfredj, Guillaume Bonnaud, Dominique Bouchard, Nadia Fathallah, Agnès Sénéjoux, Laurent Siproudhis, Ghislain Staumont, Manuelle Viguier, Philippe Marteau
AIM: To establish consensual definitions of anoperineal lesions of Crohn's (APLOC) disease and assess interobserver agreement on their diagnosis between experts. METHODS: A database of digitally recorded pictures of APLOC was examined by a coordinating group who selected two series of 20 pictures illustrating the various aspects of APLOC. A reading group comprised: eight experts from the Société Nationale Française de Colo Proctologie group of study and research in proctology and one academic dermatologist...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28838644/laparoscopic-ileocaecal-resection-versus-infliximab-for-terminal-ileitis-in-crohn-s-disease-a-randomised-controlled-open-label-multicentre-trial
#20
Cyriel Y Ponsioen, E Joline de Groof, Emma J Eshuis, Tjibbe J Gardenbroek, Patrick M M Bossuyt, Ailsa Hart, Janindra Warusavitarne, Christianne J Buskens, Ad A van Bodegraven, Menno A Brink, Esther C J Consten, Bart A van Wagensveld, Marno C M Rijk, Rogier M P H Crolla, Casper G Noomen, Alexander P J Houdijk, Rosalie C Mallant, Maarten Boom, Willem A Marsman, Hein B Stockmann, Bregje Mol, A Jeroen de Groof, Pieter C Stokkers, Geert R D'Haens, Willem A Bemelman
BACKGROUND: Treatment of patients with ileocaecal Crohn's disease who have not responded to conventional therapy is commonly scaled up to biological agents, but surgery can also offer excellent short-term and long-term results. We compared laparoscopic ileocaecal resection with infliximab to assess how they affect health-related quality of life. METHODS: In this randomised controlled, open-label trial, in 29 teaching hospitals and tertiary care centres in the Netherlands and the UK, adults with non-stricturing, ileocaecal Crohn's disease, in whom conventional therapy has failed were randomly allocated (1:1) by an internet randomisation module with biased-coin minimisation for participating centres and perianal fistula to receive laparoscopic ileocaecal resection or infliximab...
August 21, 2017: Lancet. Gastroenterology & Hepatology
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