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https://www.readbyqxmd.com/read/28542298/early-anti-tnf-immunomodulator-therapy-is-associated-with-better-long-term-clinical-outcomes-in-asian-patients-with-crohn-s-disease-with-poor-prognostic-factors
#1
Eun Hye Oh, Kyunghwan Oh, Minkyu Han, Hyungil Seo, Kiju Chang, Sun-Ho Lee, Gwang-Un Kim, Eun Mi Song, Myeongsook Seo, Ho-Su Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Byong Duk Ye
Although early treatment of Crohn's disease (CD) patients with anti-tumor necrosis factor (TNF) agents or immunomodulators (IMs) may improve long-term outcomes, especially those with poor prognostic factors, their effectiveness in Asians remains unclear. In this study, Korean patients with CD naïve to both intestinal surgery and intestinal complications, and with at least two risk factors for progression (diagnosis at age <40 years, systemic corticosteroid treatment <3 months after diagnosis, and perianal fistula at diagnosis) were retrospectively analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28537654/effect-of-ecological-immune-enhanced-enteral-nutrition-on-patients-with-gastrointestinal-fistulas
#2
Q-H Wang
OBJECTIVE: The aim of this study was to determine the effects of early ecological immune-enhanced enteral nutrition on the nutritional status, immune function and intestinal mucosal barrier in patients with gastrointestinal fistulas. PATIENTS AND METHODS: 54 patients with gastrointestinal fistulas were randomized to either the ecological immune-enhanced enteral nutrition group (EIEN group, 28) or the parenteral nutrition group (PN group, 26). The changes in the immunity, nutrition index and intestinal mucosal barrier indexes before the ecological immune-enhanced enteral nutrition support and at 7 days and 14 days after the ecological immune-enhanced enteral nutrition support were determined...
May 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28536687/abdominal-and-pelvic-actinomycosis-due-to-longstanding-intrauterine-device-a-slow-and-devastating-infection
#3
Evelyn Sue Nakahira, Linda Ferreira Maximiano, Fabiana Roberto Lima, Edson Yassushi Ussami
Actinomycosis is a chronic or subacute bacterial infection characterized by large abscess formation, caused mainly by the gram-positive non-acid-fast, anaerobic, or microaerophilic/capnophilic, obligate parasites bacteria from the Actinomyces genus. Although pelvic inflammatory disease is an entity associated with the longstanding use of intrauterine devices (IUDs), actinomycosis is not one of the most frequent infections associated with IUDs. We present the case of a 43-year-old female patient who was referred to the emergency facility because of a 20-day history of abdominal pain with signs of peritoneal irritation...
January 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28534335/-consistency-analysis-between-preoperative-ct-enterography-and-intraoperative-findings-in-patients-undergoing-surgery-for-crohn-s-disease
#4
Jianbo Yang, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the diagnostic value of preoperative CT enterography (CTE) on obstruction, fistula and abscess formation compared to intraoperative findings in patients undergoing surgery for Crohn's disease(CD), aiming to provide reference to clinical practice. METHODS: Preoperative CTE data of 176 CD patients confirmed by clinic, endoscopy, imaging, operation and pathology at the Department of General Surgery in Nanjing Jinling Hospital from January 2013 to December 2015 were enrolled in retrospective cohort study...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534332/-efficacy-comparison-of-robotic-and-laparoscopic-radical-surgery-in-the-treatment-of-middle-low-rectal-cancer
#5
Hairong Zhang, Weitang Yuan, Quanbo Zhou, Xiaoming Gu, Fuqi Wang
OBJECTIVE: To compare the clinical efficacy of robotic and laparoscopic radical surgery in the treatment of middle-low rectal cancers. METHODS: From January 2015 to March 2016, intra-operative and postoperative follow-up data of 30 patients with middle-low rectal cancers who underwent robotic radical resection(robot group) and 32 patients with middle-low rectal cancers who underwent laparoscopic radical resection (laparoscopy group)n in our department were retrospectively collected...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534329/-predictive-value-of-procalcitonin-in-postoperative-intra-abdominal-infections-after-definitive-operation-of-intestinal-fistulae
#6
Huajian Ren, Gefei Wang, Guosheng Gu, Qiongyuan Hu, Guanwei Li, Zhiwu Hong, Xiuwen Wu, Jianan Ren
OBJECTIVE: To investigate the predictive value of procalcitonin(PCT) in postoperative intra-abdominal infections (IAI) after definitive operation of intestinal fistulae(IF). METHODS: With the exclusion of emergence operation, preoperative clinical infection, preoperative renal or hepatic dysfunction, and age less than 18 years, a total of 356 consecutive patients who underwent elective digestive tract reconstruction of intestinal fistulae from February 2012 to December 2015 at Intestinal Fistula Center of Jinling Hospital were prospectively enrolled in the study...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28532242/antioxidant-supplementation-a-linchpin-in-radiation-induced-enteritis
#7
Mumtaz Anwar, Shabeer Ahmad, Reyhan Akhtar, Akhtar Mahmood, Safrun Mahmood
Radiation enteritis is one of the most feared complications of abdominal and pelvic regions. Thus, radiation to abdominal or pelvic malignancies unavoidably injures the intestine. Because of rapid cell turnover, the intestine is highly sensitive to radiation injury, which is the limiting factor in the permissible dosage of irradiation. Bowel injuries such as fistulas, strictures, and chronic malabsorption are potentially life-threatening complications and have an impact on patient quality of life. The incidence of radiation enteritis is increasing because of the current trend of combined chemotherapy and radiation...
January 1, 2017: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/28522947/clinical-efficacy-of-adalimumab-versus-infliximab-and-the-factors-associated-with-recurrence-or-aggravation-during-treatment-of-anal-fistulas-in-crohn-s-disease
#8
Cheng-Chun Ji, Shota Takano
BACKGROUND/AIMS: Infliximab has proven to be effective in the treatment of perianal fistulas in Crohn's disease (CD) but the efficacy of adalimumab is still unclear. The aim of this study is to assess the clinical efficacy of adalimumab and compare the results with those for infliximab. METHODS: Forty-seven CD patients treated for perianal fistulas with infliximab from September 2005 to December 2010 (n=31), or with adalimumab from November 2010 to May 2012 (n=16), were enrolled in this retrospective study...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28501133/intraintestinal-administration-of-ulinastatin-protects-against-sepsis-by-relieving-intestinal-damage
#9
Bingchang Yang, Min Gao, Kangkai Wang, Yu Jiang, Yue Peng, Huali Zhang, Mingshi Yang, Xianzhong Xiao
BACKGROUND: Intravenous administration of ulinastatin (UTI), a broad spectral protease inhibitor, has been used on an experimental basis with severe sepsis patients in Asia. However, the effects of intraintestinal administration of UTI on intestinal and multiple organ damage in sepsis have not been reported. MATERIALS AND METHODS: In this study, we established a sepsis model in rats using cecal ligation and puncture and compared the effects of intraintestinal administration of UTI through an artificial fistula of duodenum and intraperitoneal administration of UTI on the pathophysiological changes of sepsis...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28487805/squamous-cell-carcinoma-originating-from-a-crohn-s-enterocutaneous-fistula
#10
Bogdan Protyniak, Travis Shutt, Russell Farmer
Purpose. Squamous cell carcinoma (SCC) developing within fistulae and chronic wounds in patients with Crohn's disease is a rare phenomenon with few reported studies in the literature. Clinical suspicion for SCC in Crohn's disease patients with chronic painful fistulae is low, leading to delayed diagnosis and treatment. We present a patient with long-standing Crohn's disease complicated by malignant degeneration of an enterocutaneous fistula tract. Methods. Workup with MRI, CT, and fistulogram revealed a 7 × 3 cm fistulous connection between a loop of small intestine and the patient's perineum...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28481070/-negative-pressure-system-in-the-treatment-of-enterocutaneous-fistulas-in-the-pediatric-population
#11
V Núñez Cerezo, M I Romo Muñoz, M V Amesty Morello, A Vilanova Sánchez, M Dore Reyes, M Gómez Cervantes, A M Andrés Moreno, E Martínez-Ojinaga Nodal, L Martínez Martínez, M López Santamaría
AIM OF THE STUDY: The management of children with enterocutaneous fistulas (EF) along with large abdominal wall defects secondary to multiple surgical interventions can be difficult and sometimes lead to intestinal failure (IF). The aim of this study is to present the results of negative pressure systems and their properties (edema reduction angiogenesis promotion and granulation tissue formation) in children with enterocutaneous fistulas (EF) and their prognosis. MATERIALS AND METHODS: A retrospective analysis of children with refractory, high output EF treated with NPS between 2008-2014...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28480091/duodenal-graft-perforation-after-simultaneous-pancreas-kidney-transplantation
#12
Akihito Sannomiya, Ichiro Nakajima, Yuichi Ogawa, Kotaro Kai, Ichiro Koyama, Shohei Fuchinoue
A 45-year-old woman with type 1 diabetes and chronic renal failure on dialysis underwent simultaneous pancreas-kidney transplantation from a brain dead donor. On postoperative day 15, acute generalized peritonitis was diagnosed and emergency laparotomy was performed. Perforation of the donor duodenum was found, which had apparently resulted from duodenal compression by the tip of the intestinal fistula tube placed for decompression. The perforation was sutured and the intestinal fistula tube was exchanged. Following this, perforation repeatedly recurred at the same site and open repair at laparotomy was required a total of four times...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28463948/emergency-management-of-the-ingested-magnet-an-algorithmic-approach
#13
Brent Bauman, Kendall McEachron, Deborah Goldman, Amanda Louiselle, Eugene Zheng, David Mills, Jeffrey Louie, Bradley Segura
INTRODUCTION: Accidental ingestion of foreign bodies is an increasing problem in the pediatric population. Symptoms are often nonspecific and may lead to a missed diagnosis because the ingestion event often goes unwitnessed. CASE: We present a case of a missed diagnosis of a multiple magnet ingestion event in a pediatric patient leading to operative management. A 2-year-old boy with a 4-week history of nonspecific abdominal pain presented to the emergency department (ED) with vomiting and worsening abdominal pain...
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28460202/neoplastic-sigmoid-uterine-fistula-an-exceptional-complication-of-large-intestine-cancer
#14
G Zanghì, V Leanza, R Vecchio, A D'Agati, S Cordova, N M Rinzivillo, M Lodato, G Leanza
Neoplastic sigmoid-uterine fistula is an extremely rare condition because the uterus is a thick and muscular organ. A 74-year-old woman was admitted to the First Aid Station suffering from abdominal pain and foul smelling vaginal discharge. Gynaecological examination showed fecal drainage from the cervical orifice, while the uterus was regular in size but very firm and painful. Ovaries and fallopian tubes were not palpable owing to abdominal tenderness. Ultrasounds reveled inhomogeneous thickening of uterine cavity, without detecting fistula...
January 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28458507/endoscopy-and-cross-sectional-imaging-for-assessing-crohn-s-disease-activity
#15
Ryan W Stidham, Raymond K Cross
Crohn's disease (CD) is principally characterized by chronic and recurrent inflammation of the gastrointestinal tract, most commonly found in the ileo-colonic region. The chronicity and severity of intestinal inflammation together contribute to progressive, cumulative, deep, transmural intestinal damage, including stricturing, obstruction, abscesses, and fistulae. Both intestinal inflammation and its chronic complications result in a range of symptoms subsequently leading to patient presentations with diarrhea, abdominal pain, and anemia related to intestinal blood loss...
July 2016: Techniques in Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28442849/operative-management-of-enteroatmospheric-fistula-in-bj%C3%A3-rck-4-open-abdomen-patients-by-the-help-of-laparoscopic-lateral-approach
#16
Fahri Yetişir, A Ebru Sarer
As the open abdomen (OA) management increases, the number of fistula formation has also been increasing during the last two decades. These fistulas in OA have been defined as enteroatmospheric fistula (EAF). EAF occurring in a frozen OA is classified as Björck 4 OA. Management of Björck 4 OA patient is not easy and mortality of these patients is very high in spite of the presence of modern treatment modalities. There are a few surgical approaches for treatment of Björck 4 OA patients. One of them is excising the hostile segment by lateral abdominal approach from the healthy side or entering from lateral border of OA wound after enough time intervals for subsiding of the edematous intestine in acute inflammatory reaction in the hostile environment...
April 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#17
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28435855/first-clinical-experiences-with-a-novel-endoscopic-over-the-scope-clip-system
#18
Marco Dinelli, Barbara Omazzi, Paolo Andreozzi, Nicola Zucchini, Alessandro Redaelli, Gianpiero Manes
We describe our experience with a new over-the-scope clip (OTSC) system (Padlock Clip?) in the treatment of 14 patients. Eight of the 14 patients were treated for closure of gastrointestinal fistulas (n?=?4), iatrogenic gastrointestinal perforations (n?=?2), or hemostasis of post-polypectomy bleeding (n?=?2). The site of clipping was the lower gastrointestinal tract in five patients and the upper gastrointestinal tract in three patients. The clip was successfully delivered in seven out of the eight patients and clinical success was achieved in all patients...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28433486/gallstone-ileus-an-overview-of-the-literature
#19
C F Ploneda-Valencia, M Gallo-Morales, C Rinchon, E Navarro-Muñiz, C A Bautista-López, L F de la Cerda-Trujillo, L A Rea-Azpeitia, C R López-Lizarraga
INTRODUCTION: Gallstone ileus represents 4% of the causes of bowel obstruction in the general population, but increases to 25% in patients above the age of 65 years. Gallstone ileus does not present with unique symptoms, making diagnosis difficult. Its management is surgical, but there is no consensus as to which of the different surgical techniques is the procedure of choice. At present, there is no recent review of this pathology. AIM: To conduct an up-to-date review of this disease...
April 19, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28424736/a-case-of-xanthogranulomatous-pyelonephritis-associated-with-renoduodenal-fistula
#20
R Conor Holton-Burke, Mini Varughese
Xanthogranulomatous pyelonephritis (XGP) is a rare form of pyelonephritis associated with repeated infection, chronic inflammation, and obstruction. Various fistulas, including those to the intestine, are a known association with XGP. Here, a 55-year-old woman with a history of multiple previous renal calculi presented with dysuria and back pain. Contrast-enhanced computed tomography (CT) revealed a soft tissue density in her renal pelvis and perirenal space consistent with XGP along with a tract connecting the upper pole of her right kidney to the second portion of the duodenum...
2017: Case Reports in Medicine
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