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https://www.readbyqxmd.com/read/28081040/azathioprine-therapy-in-a-pediatric-tpmt-deficient-patient-still-an-option
#1
S A W van Moorsel, N Bevers, M Meurs, L K van Rossum, P M Hooymans, D R Wong
We describe the case of a pediatric patient on azathioprine therapy with previously undiagnosed homozygote thiopurine S-methyltransferase (TPMT) deficiency, resulting in myelotoxic thiopurine metabolite levels. The patient was successfully treated with a very low azathioprine dose of 50 mg once a week (4% of standard dose), guided by frequent thiopurine metabolite measurement and a close clinical surveillance. We demonstrate that azathioprine therapy still might be an effective and safe therapeutic option in pediatric thiopurine S-methyltransferase-deficient IBD patients...
February 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28070659/diagnosis-treatment-and-consequences-of-anastomotic-leakage-in-colorectal-surgery
#2
Bodil Gessler, Olle Eriksson, Eva Angenete
PURPOSE: The aim of this study was to explore the choice of modality for diagnosis, treatments, and consequences of anastomotic leakage. METHODS: This is a retrospective study of consecutive patients who underwent surgery that included a colorectal anastomosis due to colorectal cancer, diverticulitis, inflammatory bowel disease (IBD), or benign polyps. RESULTS: A total of 600 patients were included during 2010-2012, and 60 (10%) had an anastomotic leakage...
January 9, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28042386/endoscopic-evaluation-in-diagnosis-and-management-of-inflammatory-bowel-disease
#3
REVIEW
Carthage P Moran, Barra Neary, Glen A Doherty
Endoscopy is a keystone in the management of patients with inflammatory bowel disease (IBD). It is the fundamental diagnostic tool for IBD, and can help discern between ulcerative colitis and Crohn's disease. Endoscopic assessment provides an objective end point in clinical trials, and identifies patients in clinical practice who may benefit from treatment escalation and may assist risk stratification in patients seeking to discontinue therapy. Recent advances in endoscopic assessment of patients with IBD include video capsule endoscopy, and chromoendoscopy...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28028930/an-update-on-cancer-risk-and-surveillance-in-primary-sclerosing-cholangitis
#4
Jennifer L Horsley-Silva, Eduardo A Rodriguez, Diana L Franco, Keith D Lindor
Malignancy represents substantial morbidity and mortality in patients with primary sclerosing cholangitis (PSC). This subset of patients has been proven to be at increased risk for developing cholangiocarcinoma, gallbladder carcinoma, and colorectal cancer in those with overlapping inflammatory bowel disease. Herein we review the prevalence of these malignancies and recommend screening tools and current knowledge to reduce the disease burden in this population. Cholangiocarcinoma is the most dominant malignancy affecting PSC patients, with a lifetime risk ranging from 5-20%...
December 27, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28000477/probiotic-effectiveness-nutrition-in-cancer-treatment-and-prevention
#5
Débora Mara Kich, Angélica Vincenzi, Fernanda Majolo, Claucia Fernanda Volken de Souza, Márcia Inês Goettert
Among the neoplasias, colorectal cancer is one of the leading causes of cancer death in men and women. The increasing incidence of this type of cancer is due to the increase in the population's life expectancy, by the increase in chronic inflammatory bowel diseases, primarily ulcerative colitis and Crohn's disease, and the change in eating habits. The American Cancer Society (2011) shows that diet might be responsible for approximately 30% of cancer cases in developed countries, moreover when considering only colorectal cancer, the number can reach 30% to 50%...
November 29, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/27951611/clinical-implications-of-low-grade-dysplasia-found-during-inflammatory-bowel-disease-surveillance-a-retrospective-study-comparing-chromoendoscopy-and-white-light-endoscopy
#6
Joren R Ten Hove, Erik Mooiweer, Andrea E van der Meulen de Jong, Evelien Dekker, Cyriel Y Ponsioen, Peter D Siersema, Bas Oldenburg
Background and study aims: Current guidelines recommend the use of pancolonic chromoendoscopy for surveillance of patients with inflammatory bowel disease (IBD). It is currently unknown whether low grade dysplasia (LGD) found using chromoendoscopy carries a similar risk of high grade dysplasia (HGD) or colorectal cancer (CRC) compared with LGD detected using white-light endoscopy (WLE). The aim of this study was to compare the risk of advanced neoplasia, a combined endpoint of HGD and CRC, during follow-up after detection of lesions containing LGD identified with either chromoendoscopy or WLE...
December 12, 2016: Endoscopy
https://www.readbyqxmd.com/read/27938789/surveillance-of-patients-with-inflammatory-bowel-disease
#7
REVIEW
Jessica X Yu, James E East, Tonya Kaltenbach
Patients with inflammatory bowel disease involving the colon are at increased risk for developing colorectal cancer. Colonoscopy surveillance is important to identify and treat IBD associated dysplasia. The SCENIC consensus provides evidence-based recommendations for optimal surveillance and management of dysplasia in IBD. Chromoendoscopy, with the surface application of dyes to enhance mucosal visualization, is the superior endoscopic surveillance strategy to detect dysplasia. Most dysplasia is visible, and can be endoscopically resected...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27938781/organization-of-surveillance-in-gi-practice
#8
REVIEW
Carlo Senore, Cristina Bellisario, Cesare Hassan
BACKGROUND: Several reports documented an inefficient utilisation of available resources, as well as a suboptimal compliance with surveillance recommendations. Although, evidence suggests that organisational issues can influence the quality of care delivered, surveillance protocols are usually based on non-organized approaches. METHODS: We conducted a literature search (publication date: 01/2000-06/2016) on PubMed and Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Cochrane Central Register of Controlled Trials for guidelines, or consensus statements, for surveys of practice, reporting information about patients, or providers attitudes and behaviours, for intervention studies to enhance compliance with guidelines...
December 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27933204/risk-factors-for-developing-colorectal-cancer-in-japanese-patients-with-ulcerative-colitis-a-retrospective-observational-study-capital-cohort-and-practice-for-ibd-total-management-in-kyoto-shiga-links-study-i
#9
Takuya Yoshino, Hiroshi Nakase, Tomohisa Takagi, Shigeki Bamba, Yusuke Okuyama, Takuji Kawamura, Teruki Oki, Hirozumi Obata, Chiharu Kawanami, Shinji Katsushima, Toshihiro Kusaka, Tomoyuki Tsujikawa, Yuji Naito, Akira Andoh, Takafumi Kogawa
BACKGROUND AND AIMS: Patients with ulcerative colitis (UC) are at risk for developing colorectal cancer (CRC), despite the development of new therapeutic agents. Stratification of the individual UC-patient's risk would be helpful to validate the risk factors for CRC. The aim of this study was to evaluate the risk factors for the development of CRC in a large cohort of patients with UC. METHODS: Data were obtained from 12 hospitals in the Kyoto-Shiga region during 2003-2013...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27723166/understanding-the-complications-of-anti-tnf-therapy-in-east-asian-patients-with-inflammatory-bowel-disease
#10
REVIEW
Jae Hee Cheon
Remarkable advances have been made in the treatment of inflammatory bowel disease (IBD) since the introduction of anti-tumor necrosis factor (TNF)-α agents, especially for patients who are refractory to or cannot tolerate conventional therapies. Currently, infliximab, adalimumab, and golimumab are available in the East Asian medical market, and these agents have been shown to be effective for inducing and maintaining long-term remission of IBD. Despite their clinical benefits, anti-TNF therapy can also lead to increased vulnerability to infections, development of autoimmune diseases and malignancy, and decreased immunogenicity of vaccinations...
October 10, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27663119/performance-of-administrative-case-definitions-for-depression-and-anxiety-in-inflammatory-bowel-disease
#11
Ruth Ann Marrie, John R Walker, Lesley A Graff, Lisa M Lix, James M Bolton, Zoann Nugent, Laura E Targownik, Charles N Bernstein
OBJECTIVES: Comorbid depression and anxiety are common in inflammatory bowel disease (IBD), but few population-based estimates of the burden of depression and anxiety exist. Methods to support population-based studies are needed. We aimed to test the performance of administrative case definitions for depression and anxiety in IBD and to understand what the prevalence estimated using such definitions reflects. METHODS: We linked administrative (health claims) data from the province of Manitoba, Canada with clinical data for 266 persons in the Manitoba IBD Cohort Study...
October 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27613257/low-rate-of-dysplasia-detection-in-mucosa-surrounding-dysplastic-lesions-in-patients-undergoing-surveillance-for-inflammatory-bowel-diseases
#12
Joren R Ten Hove, Erik Mooiweer, Evelien Dekker, Andrea E van der Meulen-de Jong, G Johan A Offerhaus, Cyriel Y Ponsioen, Peter D Siersema, Bas Oldenburg
BACKGROUND & AIMS: When dysplastic lesions are encountered during surveillance colonoscopy of patients with inflammatory bowel disease (IBD), guidelines recommend collection of additional biopsies from the surrounding mucosa to ensure the lesion has been adequately circumscribed. We aimed to determine the rate of dysplasia in mucosa biopsies collected from tissues surrounding dysplastic lesions during IBD surveillance. METHODS: In a retrospective study, we collected endoscopy and pathology reports from 1065 patients undergoing colonoscopic surveillance for IBD from 2000 through 2015 at 3 centers in the Netherlands...
September 6, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27612488/real-life-chromoendoscopy-for-neoplasia-detection-and-characterisation-in-long-standing-ibd
#13
Sabela Carballal, Sandra Maisterra, Antonio López-Serrano, Antonio Z Gimeno-García, María Isabel Vera, José Carlos Marín-Garbriel, José Díaz-Tasende, Lucía Márquez, Marco Antonio Álvarez, Luis Hernández, Luisa De Castro, Jordi Gordillo, Ignasi Puig, Pablo Vega, Marco Bustamante-Balén, Juan Acevedo, Beatriz Peñas, María López-Cerón, Elena Ricart, Miriam Cuatrecasas, Mireya Jimeno, María Pellisé
OBJECTIVE: Outside clinical trials, the effectiveness of chromoendoscopy (CE) for long-standing IBD surveillance is controversial. We aimed to assess the effectiveness of CE for neoplasia detection and characterisation, in real-life. DESIGN: From June 2012 to 2014, patients with IBD were prospectively included in a multicentre cohort study. Each colonic segment was evaluated with white light followed by 0.4% indigo carmine CE. Specific lesions' features were recorded...
September 9, 2016: Gut
https://www.readbyqxmd.com/read/27540581/diagnostic-yield-of-endomicroscopy-for-dysplasia-in-primary-sclerosing-cholangitis-associated-inflammatory-bowel-disease-a-feasibility-study
#14
Aldona Dlugosz, Ammar Mohkles Barakat, Niklas K Björkström, Åke Öst, Annika Bergquist
BACKGROUND AND STUDY AIMS: Primary sclerosing cholangitis associated inflammatory bowel disease (PSC-IBD) is characterized by a high risk of colorectal dysplasia. Surveillance colonoscopies with random biopsies have doubtful power for dysplasia detection. Our aim was to prospectively investigate the feasibility and efficacy of pCLE in surveillance colonoscopies in patients with PSC-IBD. PATIENTS AND METHODS: Sixty-nine patients with PSC-IBD underwent colonoscopy in 2 steps...
August 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27489295/health-care-maintenance-for-the-pediatric-patient-with-inflammatory-bowel-disease
#15
REVIEW
Ersilia M DeFilippis, Robbyn Sockolow, Elaine Barfield
Nearly one-quarter of patients with inflammatory bowel disease (IBD) are younger than 20 years of age at diagnosis. Furthermore, the incidence of IBD in children continues to increase. Nevertheless, variation in management exists within the care of patients with IBD with regards to disease screening and preventive care. A multidisciplinary approach that involves the general practitioner and pediatric gastroenterologist is needed to routinely monitor growth, bone health, vitamin and mineral deficiencies, vaccination status, and endoscopic surveillance...
September 2016: Pediatrics
https://www.readbyqxmd.com/read/27433142/the-role-of-small-bowel-endoscopy-in-small-bowel-crohn-s-disease-when-and-how
#16
REVIEW
Mikang Kim, Hyun Joo Jang
Endoscopy has a crucial role in the diagnosis, management, and surveillance of inflammatory bowel disease (IBD). It contributes in supporting the diagnosis of IBD with the clinical history, physical examination, laboratory findings, and targeted biopsies. Furthermore, endoscopy has a significant role in assessing disease activity and distribution in treatment efficacy evaluation, post-surgical recurrence risk, and cancer surveillance in patients with long-lasting illness. Endoscopy also provides therapeutic potential for the treatment of IBD, especially with stricture dilatation and treatment of bleeding...
July 2016: Intestinal Research
https://www.readbyqxmd.com/read/27413366/risk-and-surveillance-of-cancers-in-primary-biliary-tract-disease
#17
REVIEW
Valery Hrad, Yoftahe Abebe, Syed Haris Ali, Jared Velgersdyk, Mohammed Al Hallak, Mohamad Imam
Primary biliary diseases have been associated in several studies with various malignancies. Understanding the risk and optimizing surveillance strategy of these malignancies in this specific subset of patients are an important facet of clinical care. For instance, primary sclerosing cholangitis is associated with an increased risk for cholangiocarcinoma (which is very challenging to diagnose) and when IBD is present for colorectal cancer. On the other hand, primary biliary cirrhosis patients with cirrhosis or not responding to 12 months of ursodeoxycholic acid therapy are at increased risk of hepatocellular carcinoma...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27387455/management-of-inflammatory-bowel-disease-in-the-elderly
#18
REVIEW
Elizabeth S John, Kristina Katz, Mark Saxena, Sita Chokhavatia, Seymour Katz
A substantial and growing proportion of patients with inflammatory bowel disease (IBD) are elderly, and these patients require tailored treatment strategies. However, significant challenges exist in the management of this population due to the paucity of data. Establishing the initial diagnosis and assessing the etiology of future symptoms and flares can be challenging as several other prevalent diseases can masquerade as IBD, such as ischemic colitis, diverticular disease, and infectious colitis. Important pharmacologic considerations include reduced glomerular filtration rate and drug-drug interactions in the elderly...
September 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27358684/advanced-multimodality-imaging-of-inflammatory-bowel-disease-in-2015-an-update
#19
REVIEW
Emma Stanley, Heather K Moriarty, Carmel G Cronin
The diagnosis and effective management of inflammatory bowel disease (IBD) requires a combination clinical, endoscopic, histological, biological, and imaging data. While endoscopy and biopsy remains the gold standard for diagnosis of IBD, imaging plays a central role in the assessment of extra mural disease, in disease surveillance and in the assessment of response to medical treatments, which are often expensive. Imaging is also vital in the detection and diagnosis of disease related complications, both acute and chronic...
June 28, 2016: World Journal of Radiology
https://www.readbyqxmd.com/read/27354651/current-state-of-and-problems-related-to-cancer-of-the-intestinal-tract-associated-with-crohn-s-disease-in-japan
#20
Daijiro Higashi, Hidetoshi Katsuno, Hideaki Kimura, Kenichi Takahashi, Hiroki Ikeuchi, Toru Kono, Riichiro Nezu, Katsuyoshi Hatakeyama, Hitoshi Kameyama, Iwao Sasaki, Kouhei Fukushima, Kazuhiro Watanabe, Masato Kusunoki, Toshimitsu Araki, Kiyoshi Maeda, Shingo Kameoka, Michio Itabashi, Sayumi Nakao, Koutaro Maeda, Hiroki Ohge, Yusuke Watadani, Toshiaki Watanabe, Eiji Sunami, Masayuki Hotokezaka, Akira Sugita, Yuji Funayama, Kitaro Futami
BACKGROUND/AIM: Cancer of the intestinal tract (small and large intestine) associated with Crohn's disease has a low incidence but can be fatal if it develops. Thus, the key question is how to deal with this type of cancer. The current study surveyed major medical facilities that treat inflammatory bowel disease (IBD) surgically in Japan in order to examine the clinical features of cancer of the intestinal tract associated with Crohn's disease and explore ways to deal with this cancer in the future...
July 2016: Anticancer Research
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