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https://www.readbyqxmd.com/read/29464744/primary-perianal-adenocarcinoma-of-intestinal-type-a-new-proposed-entity
#1
Pelvender S Gill, Newton A C S Wong
AIMS: The currently recognised subtypes of anal canal/perianal adenocarcinoma are those arising from low rectal mucosa or columnar cuff, fistula-related tumours and anal gland carcinoma. This following report presents two examples of a hitherto undescribed subtype of perianal adenocarcinoma with an intestinal phenotype. METHODS AND RESULTS: A 74 year old man had a perianal tumour locally excised whereas a 73 year old female underwent an abdominoperineal resection for perianal Paget's disease with an underlying carcinoma...
February 21, 2018: Histopathology
https://www.readbyqxmd.com/read/29462397/duodenal-crohn-s-disease
#2
Amy L Lightner
Symptomatic duodenal Crohn's disease (CD) is an uncommon disease presentation, especially in isolation. The most common duodenal disease phenotype is stricturing disease rather than inflammatory or perforating. Most patients are asymptomatic and are therefore diagnosed incidentally by cross-sectional imaging or endoscopy. Medical management includes proton pump inhibitor therapy and immunosuppressive therapy including corticosteroids, immunomodulatory therapy, and biologic therapy. Symptomatic strictures can often be treated medically or endoscopically, and do not always require surgery...
February 15, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29462390/segmental-resection-versus-total-proctocolectomy-for-crohn-s-colitis-what-is-the-best-operation-in-the-setting-of-medically-refractory-disease-or-dysplasia
#3
Amy L Lightner
Crohn's disease (CD) may affect any part of the gastrointestinal tract. When isolated to the colon, and patients become medically refractory, there are several surgical options - segmental resection, subtotal colectomy with ileorectal anastomosis, or a total proctocolectomy and end ileostomy. Unfortunately, surgery does not cure CD, and, regardless of the extent of bowel removed, recurrence may be seen in the small bowel. This may lead to need for further immunosuppression or surgery. Therefore, when appropriate, a segmental colectomy or subtotal colectomy may prevent a permanent ostomy required with a total proctocolectomy...
February 15, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29462385/the-use-of-vedolizumab-in-preventing-postoperative-recurrence-of-crohn-s-disease
#4
Akihiro Yamada, Yuga Komaki, Nayan Patel, Fukiko Komaki, Joel Pekow, Sushila Dalal, Russell D Cohen, Lisa Cannon, Konstantin Umanskiy, Radhika Smith, Roger Hurst, Neil Hyman, David T Rubin, Atsushi Sakuraba
Background: Clinical and endoscopic recurrence are common after surgery in Crohn's disease (CD). Vedolizumab has been increasingly used to treat CD, however, its effectiveness in preventing postoperative recurrence remains unknown. We aimed to investigate the use of vedolizumab in the postoperative setting and compare the risk of recurrence between patients receiving vedolizumab and anti-tumor necrosis factor (TNF)-α agents. Methods: Medical records of CD patients who underwent surgery between April 2014 and June 2016 were reviewed...
February 15, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29462028/the-operative-risk-and-natural-history-after-the-diagnosis-of-ileal-penetrating-crohn-s-disease
#5
Peter Bossuyt, Celine Debeuckelaere, Marc Ferrante, Dirk Vanbeckevoort, Thomas Billiet, Albert Wolthuis, Gert van Assche, Andre D'Hoore, Séverine Vermeire
BACKGROUND AND PURPOSE: Crohn's disease (CD) is marked by transmural inflammation of the bowel wall leading to stricturing and/or penetrating complications in the majority of patients. The natural history and operative risk after the diagnosis of an ileal penetrating complication is understudied. The aim was to study the disease course and need for surgery in patients diagnosed with a penetrating ileal CD complication and to assess the risk factors associated with worse postoperative outcome...
February 16, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29457051/signet-ring-cell-carcinoma-ileal-crohn-disease-or-both-a-case-of-diagnostic-challenge
#6
Joana R Carvalho, Joana Tavares, Inês Goulart, Paula Moura Dos Santos, Emília Vitorino, Cristina Ferreira, Fátima Serejo, José Velosa
Signet ring cell carcinoma is a rare form of adenocarcinoma that predominantly affects the stomach. Signet ring cell carcinoma originated from the ileum is extremely rare and the prognosis is poor. We present a case of small bowel obstruction with features suggesting Crohn disease of the ileum. The symptoms were chronic diarrhea and abdominal pain with a family history of inflammatory bowel disease. The patient underwent surgery and histopathology revealed both aspects of signet ring cell carcinoma and Crohn disease of the ileum...
January 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29456097/the-timing-of-early-therapeutic-strategies-has-a-significant-impact-on-crohn-s-disease-prognosis
#7
Cláudia Camila Dias, Francisco Portela, Samuel Fernandes, Paula Ministro, Paula Lago, Isadora Rosa, Luis Correia, Fernando Magro
BACKGROUND: Abdominal surgery and immunosuppressive pharmacological treatments are two different therapeutic options used to manage Crohn disease. This study aimed to determine whether the timing of these interventions had an impact on patients' prognosis. METHOD: This manuscript entails a retrospective analysis of a multicentric cohort involving 498 CD patients that had bowel surgery after diagnosis and prior to immunosuppression treatments. Two endpoints were considered: the occurrence of disabling disease and the need to undergo further bowel surgeries...
February 1, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29454792/clinical-and-genomic-correlates-of-neutrophil-reactive-oxygen-species-production-in-pediatric-patients-with-crohn-s-disease
#8
Lee A Denson, Ingrid Jurickova, Rebekah Karns, Kelly A Shaw, David J Cutler, David Okou, Anne Dodd, Kathryn Quinn, Kajari Mondal, Bruce J Aronow, Yael Haberman, Aaron Linn, Adam Price, Ramona Bezold, Kathleen Lake, Kimberly Jackson, Thomas D Walters, Anne Griffiths, Robert N Baldassano, Joshua D Noe, Jeffrey S Hyams, Wallace V Crandall, Barbara S Kirschner, Melvin B Heyman, Scott Snapper, Stephen L Guthery, Marla C Dubinsky, Neal S Leleiko, Anthony R Otley, Ramnik J Xavier, Christine Stevens, Mark J Daly, Michael E Zwick, Subra Kugathasan
BACKGROUND & AIMS: Individuals with monogenic disorders of phagocyte function develop chronic colitis that resembles Crohn's Disease (CD). We tested for associations between mutations in genes encoding NADPH oxidases, neutrophil function, and phenotypes of CD in pediatric patients. METHODS: We performed whole-exome sequence analysis to identify mutations in genes encoding NADPH oxidases (such as CYBA, CYBB, NCF1, NCF2, NCF4, RAC1, and RAC2) using DNA from 543 pediatric patients with inflammatory bowel diseases...
February 15, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29453848/postoperative-recurrence-of-crohn-s-disease-pathophysiology-diagnosis-and-treatment
#9
Antonio Di Sario, Paola Sassaroli, Luigi Daretti, Giulia Annulli, Laura Schiada, Giorgia Falcioni, Emanuele Bendia, Simone Antuono, Antonio Benedetti
BACKGROUND: Up to 80% of Crohn`s disease (CD) patients require at least one surgical intervention in their lifetime and up to 70% of these patients develop postoperative endoscopic recurrence within 1 year. The most important predictors of early postoperative recurrence are represented by smoking, prior intestinal surgery, penetrating disease and perianal location. Genetic factors, gut microbiota structure and immunological alterations may be involved in the pathogenesis of postoperative recurrence of CD, although their specific roles have to be determined yet...
February 16, 2018: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/29452228/a-bach2-gene-variant-is-associated-with-postoperative-recurrence-of-crohn-s-disease
#10
Michael R Laffin, Richard N Fedorak, Eytan Wine, Bryan Dicken, Karen L Madsen
BACKGROUND: Crohn's disease often requires intestinal resection, which is not considered curative. Repeat surgical intervention is necessary in over half of the patients following their initial operation. Although many genetic loci are implicated in Crohn's disease, few have been associated with post-resection recurrence. STUDY DESIGN: A cohort of Crohn's disease subjects who underwent intestinal resection was analyzed to determine genetic and clinical factors associated with post-resection recurrence...
February 13, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29451523/-towards-new-therapeutic-paradigms-beyond-symptom-control-in-the-management-of-inflammatory-bowel-diseases
#11
Stefano Festa, Giulia Zerboni, Annalisa Aratari, Riccardo Ballanti, Claudio Papi
Inflammatory bowel diseases, Crohn's disease and ulcerative colitis are chronic relapsing conditions that may result in progressive bowel damage, high risk of complications, surgery and permanent disability. The conventional therapeutic approach for inflammatory bowel diseases is based mainly on symptom control. Unfortunately, a symptom-based therapeutic approach has little impact on major long-term disease outcomes. In other chronic disabling conditions such as diabetes, hypertension and rheumatoid arthritis, the development of new therapeutic approaches has led to better outcomes...
January 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29446812/surgical-management-of-primary-crohn-s-disease-descriptive-study-about-226-patients
#12
Amin Makni, Houcine Magherbi, Azza El Heni, Anis Haddad, Amin Daghfouss, Wael Rebai, Faouzi Chebbi, Rachid Ksantini, Fadhel Fterich, Mohamed Jouini, Montasser Kacem, Nabil Ben Mami, Azza Filali, Zoubeir Ben Safta
BACKGROUND: The surgery is required in more than 80% of patients with Crohn's disease (CD). Studies before confirm the specific genetic variation of CD in the Tunisian population compared with the others ethnic groups. AIM: This article aims to study the epidemiological, anatomical and therapeutic principles of surgical forms of CD in a cohort of Tunisian patients. METHODS: We report a retrospective study from January 1998 to September 2010 that studied 226 patients originated only from Tunisia (in North Africa), operated on for MC...
March 2017: La Tunisie Médicale
https://www.readbyqxmd.com/read/29440933/population-based-cohort-study-on-comparative-effectiveness-and-safety-of-biologics-in-inflammatory-bowel-disease
#13
Riccardo Di Domenicantonio, Francesco Trotta, Silvia Cascini, Nera Agabiti, Anna Kohn, Antonio Gasbarrini, Marina Davoli, Antonio Addis
Background: The comparison of effectiveness and safety of anti-tumor necrosis factor-alpha agents for the treatment of inflammatory bowel disease (IBD) is relevant for clinical practice and stakeholders. Objective: The objective of this study was to compare the risk of abdominal surgery, steroid utilization, and hospitalization for infection in Crohn's disease (CD) or ulcerative colitis (UC) patients newly treated with infliximab (IFX) or adalimumab (ADA). Methods: A retrospective population-based cohort study was performed using health information systems data from Lazio region, Italy...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29437911/developing-a-core-outcome-set-for-fistulising-perianal-crohn-s-disease
#14
Kapil Sahnan, Phil J Tozer, Samuel O Adegbola, Matthew J Lee, Nick Heywood, Angus G K McNair, Daniel Hind, Nuha Yassin, Alan J Lobo, Steven R Brown, Shaji Sebastian, Robin K S Phillips, Phillip F C Lung, Omar D Faiz, Kay Crook, Sue Blackwell, Azmina Verjee, Ailsa L Hart, Nicola S Fearnhead
OBJECTIVE: Lack of standardised outcomes hampers effective analysis and comparison of data when comparing treatments in fistulising perianal Crohn's disease (pCD). Development of a standardised set of outcomes would resolve these issues. This study provides the definitive core outcome set (COS) for fistulising pCD. DESIGN: Candidate outcomes were generated through a systematic review and patient interviews. Consensus was established via a three-round Delphi process using a 9-point Likert scale based on how important they felt it was in determining treatment success culminating in a final consensus meeting...
February 3, 2018: Gut
https://www.readbyqxmd.com/read/29435759/prognostic-value-of-preoperative-neutrophil-to-lymphocyte-ratio-in-crohn-s-disease
#15
Stanislaus Argeny, Anton Stift, Michael Bergmann, Martina Mittlböck, Svenja Maschke, Yushan Yang, Praminthra Chitsabesan, Stefan Riss
BACKGROUND: The Neutrophil-to-lymphocyte-ratio has recently gained increased attention as a prognostic marker for malignant disease and short term outcomes. There is little data available in patients with Crohn's disease, thus the present study was conducted to correlate preoperative Neutrophil-to-lymphocyte-ratio values with disease phenotype and postoperative course. METHODS: We comprised 373 patients, who underwent intestinal resection for symptomatic Crohn's disease at an academic tertiary referral centre between 2000 and 2014...
February 12, 2018: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29434453/faecal-calprotectin-and-magnetic-resonance-imaging-in-detecting-crohn-s-disease-endoscopic-postoperative-recurrence
#16
Pierre Baillet, Guillaume Cadiot, Marion Goutte, Felix Goutorbe, Hedia Brixi, Christine Hoeffel, Christophe Allimant, Maud Reymond, Hélène Obritin-Guilhen, Benoit Magnin, Gilles Bommelaer, Bruno Pereira, Constance Hordonneau, Anthony Buisson
AIM: To assess magnetic resonance imaging (MRI) and faecal calprotectin to detect endoscopic postoperative recurrence in patients with Crohn's disease (CD). METHODS: From two tertiary centers, all patients with CD who underwent ileocolonic resection were consecutively and prospectively included. All the patients underwent MRI and endoscopy within the first year after surgery or after the restoration of intestinal continuity [median = 6 mo (5.0-9.3)]. The stools were collected the day before the colonoscopy to evaluate faecal calprotectin level...
February 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29434451/impaired-granulocyte-macrophage-colony-stimulating-factor-bioactivity-accelerates-surgical-recurrence-in-ileal-crohn-s-disease
#17
Grace Gathungu, Yuanhao Zhang, Xinyu Tian, Erin Bonkowski, Leahana Rowehl, Julia Krumsiek, Billy Nix, Claudia Chalk, Bruce Trapnell, Wei Zhu, Rodney Newberry, Lee Denson, Ellen Li
AIM: To examine the relationship between elevated granulocyte-macrophage colony-stimulating factor (GM-CSF) auto-antibodies (Ab) level and time to surgical recurrence after initial surgery for Crohn's disease (CD). METHODS: We reviewed 412 charts from a clinical database at tertiary academic hospital. Patients included in the study had ileal or ileocolonic CD and surgical resection of small bowel or ileocecal region for management of disease. Serum samples were analyzed for serological assays including GM-CSF cytokine, GM-CSF Ab, ASCA IgG and IgA, and genetic markers including SNPs rs2066843, rs2066844, rs2066845, rs2076756 and rs2066847 in NOD2, rs2241880 in ATG16L1, and rs13361189 in IRGM...
February 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29431516/does-a-histologically-inflamed-resection-margin-increase-postoperative-complications-in-patients-with-crohn-s-disease
#18
Gisele Aaltonen, Ari Ristimäki, Ilona Keränen, Monika Carpelan-Holmström, Anna Lepistö
OBJECTIVES: Our study assessed whether the presence of histologically inflamed resection margins increased postoperative anastomotic complications in Crohn's disease (CD) patients. We also examined the influence of other risk factors for postoperative complications. MATERIALS AND METHODS: Presence of chronic inflammation and activity of inflammation was scored from the resection margin specimens of 70 patients undergoing surgery due to CD. Anastomotic complications were recorded with a one-month follow-up...
February 12, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29430672/review-article-predictors-of-response-to-vedolizumab-and-ustekinumab-in-inflammatory-bowel-disease
#19
REVIEW
A Barré, J-F Colombel, R Ungaro
BACKGROUND: Increased knowledge of pathways involved in the pathogenesis of IBD has led to the development of new treatment options for Crohn's disease (CD) and ulcerative colitis (UC). Two new biological agents have been recently approved for IBD: vedolizumab and ustekinumab. They have different therapeutic targets (α4 β7 integrin for vedolizumab and interleukin-12/23 pathways for ustekinumab) than the primary biological class, anti-tumour necrosis factor alpha (anti-TNF) agents. As the armamentarium for IBD increases in coming years, it will become important to understand factors associated with response in order to best position and personalise therapy...
February 12, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29427466/the-assessment-of-online-heath-videos-for-surgery-in-crohn-s-disease
#20
J H Marshall, D M Baker, M J Lee, G L Jones, A J Lobo, S R Brown
AIM: YouTube™ is an open-access, non-peer reviewed video-hosting site and is used as a source of publicly available healthcare information. This study aimed to assess the thematic content of the most viewed videos relating to surgery and Crohn's Disease and to explore the viewer interactions to these videos. METHOD: A search of YouTube™ was carried out using one search string. The 50 most viewed videos were identified and categorised by source, content themes and assessed for viewer interactions...
February 10, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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