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Perianal disease

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https://www.readbyqxmd.com/read/28790453/perianal-fistulizing-crohn-s-disease-pathogenesis-diagnosis-and-therapy
#1
REVIEW
Julián Panés, Jordi Rimola
Perianal fistulizing Crohn's disease has a major negative effect on patient quality of life and is a predictor of poor long-term outcomes. Factors involved in the pathogenesis of perianal fistulizing Crohn's disease include an increased production of transforming growth factor β, TNF and IL-13 in the inflammatory infiltrate that induce epithelial-to-mesenchymal transition and upregulation of matrix metalloproteinases, leading to tissue remodelling and fistula formation. Care of patients with perianal Crohn's disease requires a multidisciplinary approach...
August 9, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28782667/features-of-autoimmune-pancreatitis-associated-with-inflammatory-bowel-diseases
#2
Diane Lorenzo, Frédérique Maire, Carmen Stefanescu, Jean-Marc Gornet, Philippe Seksik, Mélanie Serrero, Barbara Bournet, Philippe Marteau, Aurelien Amiot, David Laharie, Caroline Trang, Benoit Coffin, Guy Bellaiche, Guillaume Cadiot, Catherine Reenaers, Antoine Racine, Stephanie Viennot, Arnaud Pauwels, Guillaume Bouguen, Guillaume Savoye, Anne-Laure Pelletier, Guillaume Pineton de Chambrun, Pierre Lahmek, Stéphane Nahon, Vered Abitbol
BACKGROUND & AIMS: Few people know of autoimmune pancreatitis (AIP), a rare disorder associated with inflammatory bowel diseases (IBD). We aimed to describe phenotype and outcomes of AIP in patients with AIP. METHODS: We performed a retrospective study of cases of AIP in IBD identified from the multi-center Groupe d'Etude Thérapeutique des Affections Inflammatoires du tube Digestif study, performed in Belgium and France from July 2012 through July 2015. Patients were diagnosed with AIP based on histological analysis of pancreatic resection specimens or samples collected by fine-need aspiration during endoscopic ultrasound...
August 3, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28757763/immune-reconstitution-inflammatory-syndrome-associated-disseminated-kaposi-s-sarcoma-in-a-patient-infected-with-human-immunodeficiency-virus-report-of-an-autopsy-case
#3
Chiu-Hsuan Cheng, Yung-Hsiang Hsu
Immune reconstitution inflammatory syndrome is a collection of inflammatory disorders associated with paradoxical worsening of preexisting infectious processes following the initiation of highly active antiretroviral therapy (HAART) in individuals infected with human immunodeficiency virus (HIV). It involves a wide range of pathogens, neoplasms such as Kaposi's sarcoma (KS) and some autoimmune diseases. We describe an autopsy report of a 40-year-old man infected with HIV. He experienced a rapid dissemination of KS resulting in death within 6 months after starting HAART...
January 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28753650/nf-kappa-b-activation-correlates-with-disease-phenotype-in-crohn-s-disease
#4
Yoo Min Han, Jaemoon Koh, Ji Won Kim, Changhyun Lee, Seong-Joon Koh, ByeongGwan Kim, Kook Lae Lee, Jong Pil Im, Joo Sung Kim
BACKGROUND/AIMS: Unregulated activation of nuclear factor-κB (NF-κB) plays a critical role in the pathogenesis of Crohn's disease. In this study, we investigated the clinical characteristics and disease outcome of Crohn's disease patients with varying levels of the NF-κB activation. METHODS: Crohn's disease patients who underwent surgical bowel resection were divided into two groups, based on the activation status of NF-κB. NF-κB activation was assessed by the immunoreactivity of nuclear NF-κB during immunohistochemical staining of bowel resection specimens...
2017: PloS One
https://www.readbyqxmd.com/read/28753181/real-life-anti-tumour-necrosis-factor-experience-in-500-paediatric-united-kingdom-inflammatory-bowel-disease-patients
#5
Victoria M Merrick, Kajal Mortier, Linda J Williams, Rafeeq Muhammed, Marcus Kh Auth, Mamoun Elawad, John Me Fell, R Mark Beattie, Sabarinathan Loganathan, Franco Torrente, Mary-Anne Morris, Charles Charlton, Nick M Croft, Astor Rodrigues, Mark Furman, Babu Vadamalayan, Huw Jenkins, Veena Zamvar, Sally G Mitton, Sonny Chong, Mike Cosgrove, Anthony Akobeng, David C Wilson, Richard K Russell
OBJECTIVES: To measure the effectiveness, safety and use of anti-Tumour necrosis Factor (TNF) therapy in paediatric inflammatory bowel disease (PIBD) in the United Kingdom (UK). METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment (PGA) +/or the Paediatric Crohn's Disease Activity Index (PCDAI). RESULTS: 37 centres participated (23 of 25 specialist PIBD sites)...
July 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28749789/surgical-approach-to-piles-at-risk-of-severe-postoperative-pain-tricks-and-tips
#6
Domenico Tuscano, Linda D'Amore, Fabio Gaj, Paolo Bruzzone, Elena Annesi, Daniele Ceccarelli, Paolox Paolo Negro, Maria Romana Grimaldi, Francesco Gossetti
AIM: Aim of the present study is to propose a clinic-therapeutic course for the treatment of hemorrhoidal disease able to combine radical anatomic surgery with a painless postoperative path. MATERIAL OF STUDY: The present study is based on the evaluation of 20 selected patients who underwent radical hemorrhoidectomy for very high grade hemorrhoidal disease. The clinical course was characterized by careful bowel cleansing, hemorrhoidectomy according to Milligan-Morgan using LigaSure, intraoperative perianal infiltration of Ropivacaine and postoperative use of analgesic drugs...
July 24, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28748454/recurrence-with-pagetoid-spread-arising-17%C3%A2-years-after-surgery-for-intramucosal-rectal-cancer-a-case-report
#7
Taichi Matsubara, Yuta Kasagi, Kippei Ogaki, Yu Nakaji, Ryota Nakanishi, Yuichiro Nakashima, Masahiko Sugiyama, Hideto Sonoda, Hiroshi Saeki, Eiji Oki, Yoshihiko Maehara
BACKGROUND: Perianal Paget's disease (pPD) is uncommon, with only about 180 cases documented in the literature. Anorectal carcinoma with pagetoid spread is even rarer. CASE PRESENTATION: An 81-year-old woman underwent rectal cancer extirpation with a transanal approach 17 years prior. She has since undergone two reoperations for local rectal cancer recurrence. Then, warts frequently appeared on the vulva on several occasions. Warts appeared on the vulva 1 year ago, which were diagnosed as pPD by biopsy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28748409/evolution-of-clinical-behavior-in-crohn-s-disease-factors-associated-with-complicated-disease-and-surgery
#8
Kátia Simone Cezário de Barros, Cristina Flores, Luciana Harlacher, Carlos Fernando Magalhães Francesconi
BACKGROUND: The phenotypic expression of Crohn's disease may vary over time. Establishment of Crohn's disease phenotypes is important for definition of patient care strategies. AIMS: The aim of the study was to evaluate the long-term evolution of patients based on disease phenotypes and the main factors associated with this evolution. METHODS: Data from 179 patients were collected from a unicentric prospective database. Montreal classification was employed...
July 26, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28738938/minimally-invasive-incision-and-drainage-technique-in-the-treatment-of-simple-subcutaneous-abscess-in-adults
#9
Hai V Salfity, Nakul Valsangkar, Melissa Schultz, Joseph Salfity, Katie Jo Stanton-Maxey, Ben Zarzaur, David V Feliciano, Michelle R Laughlin
A minimally invasive (MI) approach using small incisions and vessel loops for drainage of simple perianal abscesses has been described in the pediatric population with decreased postoperative pain and comparable results to the traditional incision and drainage (I&D). The hypothesis was MI I&D will yield similar outcomes in adults. Patients who underwent I&D of perianal abscesses at an urban hospital from January 2008 to December 2015 were identified by Current Procedural Terminology code. Patients below 18 years of age, with inflammatory bowel diseases, or fistulae were excluded...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28728256/-single-center-retrospective-study-of-184-children-with-inflammatory-bowel-disease-seen-from-2000-2014
#10
D X Guan, F H Yu, G L Wang, J Zhou, D Y Wang, X L Nie, X W Xu
Objective: To investigate the clinical data of children with inflammatory bowel disease (IBD) retrospectively, including Crohn's disease (CD) and ulcerative colitis (UC) and identify the clinical characteristics and trends of change. Method: Clinical data of hospitalized patients diagnosed as IBD in Beijing Children's Hospital from January 2000 to December 2014 were collected and retrospectively analyzed. Patients were divided into six groups based on type of disease and year of admission: Group A1(CD, 2000-2004) included 12 patients, Group B1(CD, 2005-2009) included 11, Group C1(CD, 2010-2014) included 51; Group A2(UC, 2000-2004) included 17, Group B2(UC, 2005-2009) included 25, Group C2(UC, 2010-2014) included 68...
July 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28722455/-hidradenitis-suppurativa-symptoms-diagnostics-and-therapy
#11
Monika Arenbergerová, Robert Artur Dahmen, Petr Arenberger
Hidradenitis suppurativa is a chronic skin disorder characterized by recurrent inflammatory nodules, fistulas, abscesses, and scarring mainly in the intertriginous areas with terminal hair and apocrine glands. Hidradenitis suppurativa manifests usually after puberty, in the third life decade and persists for many years. The prevalence of the disease is estimated to be 0,5 % in the Czech Republic. Women are most often affected in the axillary and inguinal parts, while men in the perianal and gluteal areas. The exact pathogenesis is still unknown...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28708274/utility-of-360%C3%A2-real-time-endoanal-sonography-for-evaluation-of-perianal-fistulas
#12
Yan Sun, Li-Gang Cui, Ji-Bin Liu, Jin-Rui Wang, He Ping, Zhao-Wen Chen
OBJECTIVES: To assess the diagnostic accuracy and performance of 360° endoanal sonography for preoperative evaluation of perianal fistulas using surgical results as a reference standard. METHODS: Between January 2012 and May 2016, 122 patients with suspicious anal fistulas and perianal abnormalities had real-time endoanal sonographic examinations using a 360° cross-sectional endoanal transducer (5-13 MHz) for preoperative evaluation of the disease. All patients underwent surgical interventions...
July 14, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28706405/vulvar-lichen-sclerosus-et-atrophicus
#13
REVIEW
Pragya Ashok Nair
Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis characterized by ivory-white plaques or patches with glistening surface commonly affecting the vulva and anus. Common symptoms are irritation, soreness, dyspareunia, dysuria, and urinary or fecal incontinence. Anogenital lichen sclerosus (LS) is characterized by porcelain-white atrophic plaques, which may become confluent extending around the vulval and perianal skin in a figure of eight configuration. Thinning and shrinkage of the genital area make coitus, urination, and defecation painful...
April 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28705292/a-case-of-ischemia-induced-perianal-ulceration-mimicking-pyoderma-gangrenosum
#14
Michael Joseph Lavery, Nicola Cooke
A 68-year-old woman, with a 75-pack-year smoking history and a history of chronic excess alcohol intake, presented with a 5-week history of worsening perianal pain and ulceration. She recently had an inpatient admission with back pain and urinary tract infection during which she developed diarrhea and fecal incontinence. Initially, the perianal ulceration was diagnosed as severe irritant contact dermatitis and treated with barrier creams and topical clobetasone 17-butyrate 0.05% weight for weight, oxytetracycline 3...
2017: Skinmed
https://www.readbyqxmd.com/read/28696956/long-term-outcomes-with-anti-tnf-therapy-and-accelerated-step-up-in-the-prospective-pediatric-belgian-crohn-s-disease-registry-belcro
#15
Lucas Wauters, Françoise Smets, Elisabeth De Greef, Patrick Bontems, Ilse Hoffman, Bruno Hauser, Philippe Alliet, Wim Arts, Harald Peeters, Stephanie Van Biervliet, Isabelle Paquot, Els Van de Vijver, Martine De Vos, Peter Bossuyt, Jean-François Rahier, Olivier Dewit, Tom Moreels, Denis Franchimont, Vincianne Muls, Fernand Fontaine, Edouard Louis, Jean-Charles Coche, Filip Baert, Jérôme Paul, Séverine Vermeire, Geneviève Veereman
BACKGROUND: Accelerated step-up or anti-tumor necrosis factor (TNF) before first remission is currently not recommended in pediatric Crohn's disease. METHODS: Five-year follow-up data from a prospective observational cohort of children diagnosed with Crohn's disease in Belgium were analyzed. Disease severity was scored as inactive, mild, or moderate to severe. Remission or inactive disease was defined as sustained if lasting ≥2 years. Univariate analyses were performed between anti-TNF-exposed versus naive patients and anti-TNF before versus after first remission and correlations assessed with primary outcomes average disease severity and sustained remission...
July 10, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28694669/magnetic-resonance-imaging-may-predict-deep-remission-in-patients-with-perianal-fistulizing-crohn-s-disease
#16
Lucie Thomassin, Laura Armengol-Debeir, Cloé Charpentier, Valerie Bridoux, Edith Koning, Guillaume Savoye, Céline Savoye-Collet
AIM: To evaluate the imaging course of Crohn's disease (CD) patients with perianal fistulas on long-term maintenance anti-tumor necrosis factor (TNF)-α therapy and identify predictors of deep remission. METHODS: All patients with perianal CD treated with anti-TNF-α therapy at our tertiary care center were evaluated by magnetic resonance imaging (MRI) and clinical assessment. Two MR examinations were performed: at initiation of anti-TNF-α treatment and then at least 2 years after...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28691941/extraintestinal-manifestations-are-common-in-obese-patients-with-crohn-s-disease
#17
Manish B Singla, Christa Eickhoff, John Betteridge
INTRODUCTION: Crohn's disease (CD) is a chronic condition associated with the risk of malabsorption. The incidence of obesity worldwide is increasing, and the effect of obesity on patients with CD is unknown. We aim to identify traits related to obesity in a cohort of patients with CD. METHODS: We conducted a retrospective study of 209 adult patients with CD. Age, Montreal disease classification, sex, race, duration of disease, erythrocyte sedimentation rate, C-reactive protein levels, physician global assessment, endoscopic appearance, histologic activity, medication use, and body mass index (BMI) were collected about each patient...
June 27, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28682970/validation-of-risk-factors-for-fecal-incontinence-in-patients-with-crohn-s-disease
#18
Paul F Vollebregt, Arjan P Visscher, Adriaan A van Bodegraven, Richelle J F Felt-Bersma
BACKGROUND: Fecal incontinence has a great impact on daily life, and many patients are reluctant to report it. OBJECTIVE: The purpose of this study was to estimate the prevalence of fecal incontinence in patients with Crohn's disease, validate risk factors, and relate outcome with quality of life. DESIGN: The design was cross-sectional. SETTINGS: The study was conducted at an academic tertiary center. PATIENTS: Consecutive patients with Crohn's disease treated between 2003 and 2013 were included in this study...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28670596/actinomycosis-causing-recurrent-perianal-fistulae
#19
Mariana Ferreira Cardoso, Carla Carneiro, Luís Carvalho Lourenço, Catarina Graça Rodrigues, Sara Folgado Alberto, Ana Alagoa João, Ricardo Rocha, Vasco Geraldes, Ana Costa, Jorge Reis, Vítor Nunes
Actinomycosis is a rare but easily curable infection that should be considered in the differential diagnosis of perianal fistulizing disease. We present the case of a 26-year-old woman with complex perianal fistulae, including trans-sphincteric and suprasphincteric fistulous tracts and a rectovaginal fistula, requiring multiple abscess drainages, seton placement, and antibiotic courses, with little improvement. After extensive investigation, Actinomyces spp. was identified in anal cytology. The patient underwent a 6-week course of intravenous penicillin followed by oral amoxicillin, with remarkable improvement...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28662984/mr-enterography-in-crohn-s-disease-complicated-with-enteroenteric-fistula
#20
Ayşe Erden, Sena Ünal, Habip Eser Akkaya, Mehmet Onay, Murat Törüner, Zeynep Bıyıklı Gençtürk, Aysun Çalışkan Kartal
OBJECTIVE: In this retrospective study, we aimed to evaluate MR enterography (MRE) findings, MR index of activity (MaRIA) and laboratory markers in Crohn patients with enteroenteric fistula. METHODS: Institution's electronic medical records (laboratory, pathology, ileocolonoscopy results and discharge summary) were reviewed and MR images retrieved from the PACS were reanalyzed in Crohn patients assessed at Gastroenterology Clinic of our university between July 2011 and July 2016...
June 20, 2017: European Journal of Radiology
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