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Therapeutic colonoscopy

Shelley A Deeke, Amanda E Starr, Zhibin Ning, Sara Ahmadi, Xu Zhang, Janice Mayne, Cheng-Kang Chiang, Ruth Singleton, Eric I Benchimol, David R Mack, Alain Stintzi, Daniel Figeys
OBJECTIVE: Improved biomarkers are an unmet clinical need for suspected inflammatory bowel disease (IBD). Need is greatest for children, since current biomarkers suffers from low specificity, particularly in this population; thus, invasive testing methods, with the accompanying risk of complications, are necessary. Additionally, current biomarkers do not delineate disease extent assessment for ulcerative colitis (UC), a factor involved in therapeutic decisions. METHODS: Intestinal mucosal-luminal interface (MLI) aspirates from the ascending colon (AC) and descending colon (DC) were collected during diagnostic colonoscopy from treatment-naïve children...
March 12, 2018: American Journal of Gastroenterology
Lucrezia Laterza, Anna Chiara Piscaglia, Laura Maria Minordi, Iolanda Scoleri, Luigi Larosa, Andrea Poscia, Fabio Ingravalle, Arianna Amato, Sergio Alfieri, Alessandro Armuzzi, Giovanni Cammarota, Antonio Gasbarrini, Franco Scaldaferri
AIM: To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn's disease (CD). METHODS: We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively...
March 7, 2018: Digestive Diseases
Zou Yang, Wang Lei, Li Xiao-Li, Tian Xiao-Jun, Li Wei, An Yi-Jun, Qi Zhi-Qun, Li Jing-Jing, Wang Fei, Huang Min-Jun
OBJECTIVE: To analyze the clinical features of 6 patients with imported schistosomiasis mansoni, including the epidemic history, clinical manifestations, laboratory tests and therapeutic effect, so as to provide references for improving the levels of diagnosis and treatment of physicians. METHODS: The clinical data of 6 patients with imported schistosomiasis mansoni from January 2009 to July 2016 were collected and analyzed. RESULTS: All the 6 imported patients with schistosomiasis mansoni had a clear history of cercarial infested water exposure...
March 10, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
Haijun Liu, Hong Zhang, Xiao Wang, Xuemei Yu, Cheng Hu, Xueli Zhang
BACKGROUND: Changes in gut microbiota induced by bariatric surgery have been associated with metabolic benefits. OBJECTIVES: Our aim was to identify specific gut microbiota that may contribute to the improvement of type 2 diabetes (T2D) after Roux-en-Y gastric bypass (RYGB). SETTING: Laboratories of Shanghai Diabetes Institute and Shanghai Sixth People's Hospital. METHODS: Diabetic rats induced via a high-fat diet and low-dose streptozotocin administration were randomized to RYGB or sham surgery, and stool samples were collected at baseline and at postoperative week 8...
January 17, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Ryoichi Miyanaga, Naoki Hosoe, Makoto Naganuma, Kenro Hirata, Seiichiro Fukuhara, Yoshihiro Nakazato, Keisuke Ojiro, Eisuke Iwasaki, Naohisa Yahagi, Haruhiko Ogata, Takanori Kanai
Background and study aims:  In Japan, the elderly population has been increasing annually. The number of elderly patients for whom esophagogastroduodenoscopy (EGD) and colonoscopy (CS) is indicated also has been rising. The aim of this study was to evaluate the safety and efficacy of routine endoscopy in a cohort of octogenarians aged 85 years and older - defined by the World Health Organization as the very elderly. Patients and methods:  A total of 5,586 patients underwent EGDs, and 2,484 patients underwent CSs performed at the Keio University Hospital from January to September 2014...
February 2018: Endoscopy International Open
Nicola de'Angelis, Salomone Di Saverio, Osvaldo Chiara, Massimo Sartelli, Aleix Martínez-Pérez, Franca Patrizi, Dieter G Weber, Luca Ansaloni, Walter Biffl, Offir Ben-Ishay, Miklosh Bala, Francesco Brunetti, Federica Gaiani, Solafah Abdalla, Aurelien Amiot, Hany Bahouth, Giorgio Bianchi, Daniel Casanova, Federico Coccolini, Raul Coimbra, Gian Luigi de'Angelis, Belinda De Simone, Gustavo P Fraga, Pietro Genova, Rao Ivatury, Jeffry L Kashuk, Andrew W Kirkpatrick, Yann Le Baleur, Fernando Machado, Gustavo M Machain, Ronald V Maier, Alain Chichom-Mefire, Riccardo Memeo, Carlos Mesquita, Juan Carlos Salamea Molina, Massimiliano Mutignani, Ramiro Manzano-Núñez, Carlos Ordoñez, Andrew B Peitzman, Bruno M Pereira, Edoardo Picetti, Michele Pisano, Juan Carlos Puyana, Sandro Rizoli, Mohammed Siddiqui, Iradj Sobhani, Richard P Ten Broek, Luigi Zorcolo, Maria Clotilde Carra, Yoram Kluger, Fausto Catena
Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45-60% of ICPs are diagnosed by the endoscopist while performing the colonoscopy, many ICPs are not immediately recognized but are instead suspected on the basis of clinical signs and symptoms that occur after the endoscopic procedure. There are three main therapeutic options for ICPs: endoscopic repair, conservative therapy, and surgery. The therapeutic approach must vary based on the setting of the diagnosis (intra- or post-colonoscopy), the type of ICP, the characteristics and general status of the patient, the operator's level of experience, and surgical device availability...
2018: World Journal of Emergency Surgery: WJES
Hiroki Imamura, Kohei Murata, Yoshinori Kagawa, Rieko Okubo, Takuya Sakamoto, Atsushi Naito, Kohei Murakami, Yoshiteru Katsura, Yoshiaki Ohmura, Atsushi Takeno, Shinichi Nakatsuka, Kimihiko Ito, Yutaka Takeda, Takeshi Kato, Shigeyuki Tamura
We report a case of a woman who was suffering from post-radiochemotherapy perineum abscess concurrent with the recurrence of vaginal cancer for which total pelvic exenteration was performed. A 66-year-oldwoman presentedat our hospital with irregular genital bleeding in November 2014. A series of examinations showedthat she was suffering from vaginal cancer(cT2N0M0, cStage II ). A radiochemotherapy regimen(external irradiation 45 Gy/25 Fr, CDDP 40mg/m2, 5 course)was commencedin January 2015. In the meantime, MRI revealedsome therapeutic effect, but in October 2015, MRI indicated the enlargement of the primary tumor(PD)...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Dirk Van de Putte, Christelle Demarquay, Elke Van Daele, Lara Moussa, Christian Vanhove, Marc Benderitter, Wim Ceelen, Piet Pattyn, Noëlle Mathieu
Cancer patients treated with radiotherapy (RT) could develop severe late side effects that affect their quality of life. Long-term bowel complications after RT are mainly characterized by a transmural fibrosis that could lead to intestinal obstruction. Today, surgical resection is the only effective treatment. However, preoperative RT increases the risk of anastomotic leakage. In this study, we attempted to use mesenchymal stromal cells from adipose tissue (Ad-MSCs) to improve colonic anastomosis after high-dose irradiation...
December 2017: Cell Transplantation
Emily K Wright, Michael A Kamm, Peter De Cruz, Amy L Hamilton, Fabiyola Selvaraj, Fred Princen, Alexandra Gorelik, Danny Liew, Lani Prideaux, Ian C Lawrance, Jane M Andrews, Peter A Bampton, Simon L Jakobovits, Timothy H Florin, Peter R Gibson, Henry Debinski, Finlay A Macrae, Douglas Samuel, Ian Kronborg, Graham Radford-Smith, Richard B Gearry, Warwick Selby, Sally J Bell, Steven J Brown, William R Connell
Background: Anti-TNF prevents post-operative Crohn's disease recurrence in most patients but not all. This study aimed to define the relationship between adalimumab pharmacokinetics, maintenance of remission and recurrence. Methods: As part of a study of post-operative Crohn's disease management, some patients undergoing resection received prophylactic post-operative adalimumab. In these patients, serum and faecal adalimumab concentration and serum anti-adalimumab antibodies (AAA) were measured at 6, 12 and 18 months post-operatively...
January 27, 2018: Journal of Crohn's & Colitis
B P Chumpitazi, G L Kearns, R J Shulman
BACKGROUND: Peppermint oil has been used for centuries as a treatment for gastrointestinal ailments. It has been shown to have several effects on gastrointestinal physiology relevant to clinical care and management. AIM: To review the literature on peppermint oil regarding its metabolism, effects on gastrointestinal physiology, clinical use and efficacy, and safety. METHODS: We performed a PubMed literature search using the following terms individually or in combination: peppermint, peppermint oil, pharmacokinetics, menthol, oesophagus, stomach, small intestine, gallbladder, colon, transit, dyspepsia, nausea, abdominal pain, and irritable bowel syndrome...
January 26, 2018: Alimentary Pharmacology & Therapeutics
Adi Lahat, Daniela Necula, Miri Yavzori, Orit Picard, Sharon Halperin, Rami Eliakim, Shomron Ben-Horin
BACKGROUND: Recent data suggest continuous chronic inflammation in patients after an acute diverticulitis (AD) episode. GOALS: The aim of this article was to compare clinical parameters, inflammatory cytokine expression, and immune-cell infiltrates between patients after severe versus nonsevere AD, as defined by radiology examination during the acute episode. STUDY: Sixteen patients, after suffering an episode of AD, were included, and, of them, 8 had severe disease...
January 19, 2018: Journal of Clinical Gastroenterology
L J Xu, Y Y Luo, J D Yu, J G Lou, Y H Fang, J Chen
Objective: To analyze the clinical characteristics of X-linked inhibitor of apoptosis (XIAP) deficient patients with clinical manifestation of Crohn's disease. Methods: Clinical manifestations, laboratory investigations, genetic testing and therapeutic interventions of one case of XIAP deficiency who was admitted to Department of Gastroenterology in Children's Hospital, Zhejiang University School of Medicine in May 2016 were summarized. PubMed and Chinese database for articles published from January 2016 to June 2017 were searched using the key words of'Crohn's disease'and'XIAP', and the relevant literature was reviewed...
January 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Henar Núñez-Rodríguez, Pilar Diez-Redondo, Manuel Pérez-Miranda, Manuel Gonzalez Sagrado, Rosa Conde, Carlos De la Serna
GOALS: The aim of this study was to compare a new, full-spectrum endoscope (Fuse; EndoChoice, Alpharetta, GA) to standard forward-viewing colonoscopy in the detection of colorectal neoplasms. BACKGROUND: Colonoscopy, the gold standard for the detection of colorectal cancer, fails to detect 22% to 28% of polyps, increasing the risk of interval cancer. Endoscopic improvement of the adenoma detection rate decrease interval carcinomas. Full-spectrum endoscopy (FUSE) (330-degree field of view), in a tandem study, has been shown to reduce the adenoma miss rate...
December 27, 2017: Journal of Clinical Gastroenterology
Ebubekir Gündeş, Hüseyin Çiyiltepe, Ulaş Aday, Durmuş Ali Çetin, Aziz Serkan Senger, Orhan Uzun, Kamuran Cumhur Değer, Mustafa Duman, Erdal Polat
Objective: Our aim in this study was to present the cases of our patients who contracted colonic perforation during elective colonoscopy and became emergency cases; we also discuss treatment modalities along with literature reports on the subject. Material and Methods: Cases of patients who contracted iatrogenic colonic perforation following endoscopy of the colorectal system between January 2009 and December 2015 at Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital's Endoscopy Unit were reviewed retrospectively...
2017: Turkish Journal of Surgery
Lauren C Chartier, Gordon S Howarth, Ian C Lawrance, Debbie Trinder, Scott J Barker, Suzanne Mashtoub
BACKGROUND/AIMS: Ulcerative colitis is a remitting and relapsing inflammatory bowel disorder. Current treatments are limited, and if poorly controlled, colitis may progress to colorectal cancer. Previously, Emu Oil protected the intestine in experimental models of gut damage. We aimed to determine whether Emu Oil could reduce the severity of chronic colitis and prevent the onset of neoplasia in a mouse model of colitis-associated colorectal cancer. METHODS: Female C57BL/6 mice were injected (day 0) with azoxymethane, followed by ad libitum access to three dextran sulfate sodium/water cycles (7 days of dextran sulfate sodium and 14 days of water)...
January 2018: Digestive Diseases and Sciences
K Papamichael, S Rakowsky, C Rivera, A S Cheifetz, M T Osterman
BACKGROUND: Endoscopic and histologic healing are emerging as new therapeutic goals in ulcerative colitis (UC), as these endpoints are associated with less relapse, hospitalization and colectomy. AIM: To investigate the association of serum infliximab trough concentrations during maintenance therapy with endoscopic or histologic healing in UC. METHODS: In this multi-center retrospective cohort study, we included consecutive patients with moderate-to-severe UC on infliximab maintenance therapy who had an endoscopic evaluation and underwent therapeutic drug monitoring within three months of the colonoscopy, between February 2008 and March 2016...
February 2018: Alimentary Pharmacology & Therapeutics
Sveva Auletta, Rita Bonfiglio, Andreas Wunder, Michela Varani, Filippo Galli, Filippo Borri, Manuel Scimeca, Heiko G Niessen, Tanja Schönberger, Elena Bonanno
Inflammatory bowel diseases are lifelong disorders affecting the gastrointestinal tract characterized by intermittent disease flares and periods of remission with a progressive and destructive nature. Unfortunately, the exact etiology is still not completely known, therefore a causal therapy to cure the disease is not yet available. Current treatment options mainly encompass the use of non-specific anti-inflammatory agents and immunosuppressive drugs that cause significant side effects that often have a negative impact on patients' quality of life...
March 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
Nicola Tartaglia, Alessandra Di Lascia, Pasquale Cianci, Alberto Fersini, Francesca Sanguedolce, Roberta Iadarola, Sabino Capuzzolo, Vincenzo Neri, Antonio Ambrosi
INTRODUCTION: Neuroendocrine tumors (NETs) are a heterogeneous group of tumors. NET of colon represent less than 1% of colonic tumors. Synchronous liver metastases, present in 75-80%, are considered significant adverse prognostic indicators. Liver is the second commonest site for metastasis in patients with colorectal neuroendocrine tumors. Available treatment options include surgical resection, chemotherapy, biotherapy. Surgery is the gold standard for curative therapy and it is strictly related to the localization, the grade of tumor, and the stage of disease...
November 20, 2017: Annali Italiani di Chirurgia
Brigitte Moreau, Pierre Clement, Yves Theoret, Ernest G Seidman
Background: Thiopurines, azathioprine (AZA) and 6-mercaptopurine (6-MP) are common maintenance medications for inflammatory bowel disease (IBD). Excessive methylation via thiopurine methyltransferase (TPMT) frequently causes therapeutic failure. Allopurinol reduces excessive 6-methyl-mercaptopurine (6-MMP) while enhancing 6-thioguanine (6-TGN) levels. The aim of this study was to evaluate clinical, metabolic and endoscopic impact of allopurinol in combination with low-dose thiopurine in IBD...
November 2017: Therapeutic Advances in Gastroenterology
Yu Wang, Cheryl de Vallière, Pedro H Imenez Silva, Irina Leonardi, Sven Gruber, Alexandra Gerstgrasser, Hassan Melham, Achim Weber, Katharina Leucht, Lutz Wolfram, Martin Hausmann, Carsten Krieg, Koray Thomasson, Onur Boyman, Isabelle Frey-Wagner, Gerhard Rogler, Carsten A Wagner
BACKGROUND AND AIMS: During active inflammation tissue intraluminal intestinal pH is decreased in patients with inflammatory bowel disease (IBD). Acidic pH may play a role in IBD pathophysiology. Recently, proton sensing G-protein coupled receptors were identified, including GPR4, OGR1 (GPR68), and TDAG8 (GPR65). We investigated whether GPR4 is involved in intestinal inflammation. METHODS: The role of GPR4 was assessed in murine colitis models: chronic dextran sulphate sodium (DSS) administration and by crossbreeding into an IL-10 deficient background for development of spontaneous colitis...
November 9, 2017: Journal of Crohn's & Colitis
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