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https://www.readbyqxmd.com/read/28426675/indicators-of-suboptimal-biologic-therapy-over-time-in-patients-with-ulcerative-colitis-and-crohn-s-disease-in-the-united-states
#1
Haridarshan Patel, Trevor Lissoos, David T Rubin
This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn's disease (CD) patients over time in the United States (US). Data from a large US claims database (2005-2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only)...
2017: PloS One
https://www.readbyqxmd.com/read/28426451/quality-of-care-and-outcomes-among-hospitalized-inflammatory-bowel-disease-patients-a-multicenter-retrospective-study
#2
Geoffrey C Nguyen, Sanjay K Murthy, Brian Bressler, Mindy C W Lam, Ali Alali, Asmae Toumi, Jason Reinglas, Adam Rampersad, Adam V Weizman, Waqqas Afif
BACKGROUND: Half of patients with inflammatory bowel disease (IBD) require hospitalization. We sought to characterize inpatient quality indicators of care and outcomes during IBD-related hospitalizations at 4 major IBD referral centers in Canada. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD admitted from 2011 to 2013 to tertiary centers in Toronto, Montreal, Ottawa, and Vancouver. We assessed the following inpatient indicators of care: pharmacological venous thromboembolism (VTE) prophylaxis, Clostridium difficile testing, and medical rescue therapy for steroid-refractory ulcerative colitis (UC)...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28421339/small-bowel-adenocarcinoma-complicating-crohn-s-disease-a-single-centre-experience-emphasizing-the-importance-of-screening-for-dysplasia
#3
Chloé Grolleau, Nicolas M Pote, Nathalie S Guedj, Magaly Zappa, Nathalie Theou-Anton, Yoram Bouhnik, Yves Panis, Dominique L Cazals-Hatem
Small bowel adenocarcinoma (SBA) complicating Crohn's disease (CD) is rare and generally found incidentally on surgical specimens. We report our experience in CD-associated SBA observed this last decade in a tertiary referral centre in order to update its incidence, clinical presentation and pathological features. All SBAs diagnosed in patients who underwent surgery for CD between 2006 and 2016 were retrospectively included. Clinico-pathological characteristics were reviewed, and follow-up was updated. SBA was diagnosed in 9 (1...
April 18, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28419282/autologous-hematopoietic-stem-cell-transplantation-for-refractory-crohn-s-disease-efficacy-in-a-single-centre-cohort
#4
Alicia López-García, Montserrat Rovira, Aranzazu Jauregui-Amezaga, Pedro Marín, Rebeca Barastegui, Azucena Salas, Vicent Ribas, Faust Feu, J Ignasi Elizalde, Francesc Fernández-Avilés, Carmen Martínez, Gonzalo Gutiérrez, Laura Rosiñol, Enric Carreras, Alvaro Urbano, Miguel Lozano, Joan Cid, Maria Suárez-Lledó, Maria Carme Masamunt, Dolors Comas, Angel Giner, Marta Gallego, Ignacio Alfaro, Ingrid Ordás, Julian Panés, Elena Ricart
Background: Hematopoietic stem cell transplantation (HSCT) is considered a therapeutic option for patients with severe Crohn's disease (CD) unresponsive to currently available therapies. Methods: Autologous HSCT was considered for CD patients with active disease, unresponsive or intolerant to approved medications and unsuitable for surgery. After HSCT, patients were closely followed-up every 6 weeks during the first 2 years and every 6 months thereafter up to 5 years...
April 13, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28416240/efficacy-of-tumour-necrosis-factor-antagonists-in-stricturing-crohn-s-disease-a-tertiary-center-real-life-experience
#5
Mariangela Allocca, Cristiana Bonifacio, Gionata Fiorino, Antonino Spinelli, Federica Furfaro, Luca Balzarini, Stefanos Bonovas, Silvio Danese
BACKGROUND: Stenosis is the most common complication of Crohn's disease (CD). Long-term outcome of patients receiving tumour necrosis factor (TNF) antagonists for such disease complication is poorly understood. METHODS: 51 CD patients (from July 2006 to November 2015) who had a diagnosis of small bowel or colonic stenosis, diagnosed by colonoscopy and/or MRI enterography, and were treated with TNF antagonists (adalimumab or infliximab) were enrolled. The primary outcome was to assess the rate of success of TNF antagonists on avoiding abdominal surgery for stricturing CD patients...
March 30, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28414674/a-clot-possibly-due-to-loss-of-tnf-%C3%AE-supression
#6
J Broussard, M Berlinger, D Lauret
INTRODUCTION: Inflammation and venous thrombosis enjoy a close Relationship. We present a patient who had multiple DVTs following the discontinuation of anti- TNF-α therapy. CASE: A 34 year old African American female with a history of multiple DVT's, miscarriages, and reported Crohn's disease presented with shortness of breath. In the Emergency Department, CTA showed bilateral pulmonary emboli. The patient had been off adalimumab for one year and reported abdominal pain with 6-7 non-bloody bowel movements daily...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28410345/development-of-a-novel-predictive-model-for-the-clinical-course-of-crohn-s-disease-results-from-the-connect-study
#7
Yehyun Park, Jae Hee Cheon, Yi Lang Park, Byong Duk Ye, You Sun Kim, Dong Soo Han, Joo Sung Kim, Sung Noh Hong, Young Ho Kim, Seong Ran Jeon, Won Ho Kim
BACKGROUND: A considerable number of patients with Crohn's disease (CD) develop irreversible intestinal damage, although the early administration of immunomodulatory or biological therapies might prevent this. The aims of our study were to develop and validate a novel predictive model that can be used to predict the risk of surgical intervention in Korean patients with CD. METHODS: The prognostic model was derived from the multicenter longitudinal CONNECT (CrOhn's disease cliNical NEtwork and CohorT) study cohort consisting of 1338 patients with CD, who were split into training and validation sets...
April 13, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28410340/inflammatory-bowel-disease-is-similar-in-patients-with-older-onset-and-younger-onset
#8
Bharati Kochar, Millie D Long, Joseph Galanko, Laura E Raffals, Ashwin Ananthakrishnan, Robert S Sandler
BACKGROUND: As the American population is aging, the number of older people with inflammatory bowel disease is increasing. We used clinical data from the Sinai-Helmsley Alliance for Research Excellence (SHARE), a prospective cohort, to examine disease and treatment differences in older adults. METHODS: We performed a cross-sectional study assessing demographics and disease behavior by age at diagnosis with univariate, bivariate, and multivariate analyses. "Older-onset" patients were diagnosed after age 60, "younger-onset" patients were diagnosed before age 60 but are older than 60 years, and the remainder were "young...
April 13, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28408997/endoscopic-balloon-dilatation-of-crohn-s-associated-intestinal-strictures-high-patient-satisfaction-and-long-term-efficacy
#9
Anna Rueda Guzmán, Jan Wehkamp, Andreas Kirschniak, Aline Naumann, Nisar P Malek, Martin Goetz
INTRODUCTION: Stricture formation is a common long-term complication of Crohn's disease. Endoscopic balloon dilatation offers a bowel-sparing treatment option, but long-term outcome and its association with patient-, stricture-, and procedure-related factors is only poorly understood. Patient satisfaction with endoscopic balloon dilatation is largely unknown. METHODS: We performed a retrospective review of all endoscopic balloon dilatation for Crohn's disease-related strictures between January 2005 and January 2013...
December 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28408996/risk-factors-for-complications-after-ileocolonic-resection-for-crohn-s-disease-with-a-major-focus-on-the-impact-of-preoperative-immunosuppressive-and-biologic-therapy-a-retrospective-international-multicentre-study
#10
Takayuki Yamamoto, Antonino Spinelli, Yasuo Suzuki, Rogerio Saad-Hossne, Fabio Vieira Teixeira, Idblan Carvalho de Albuquerque, Rodolff Nunes da Silva, Ivan Folchini de Barcelos, Ken Takeuchi, Akihiro Yamada, Takahiro Shimoyama, Lorete Maria da Silva Kotze, Matteo Sacchi, Silvio Danese, Paulo Gustavo Kotze
BACKGROUND: Author note: TY, AS, YS, FVT and PGK designed the study. All authors did data collection and gave scientific contribution to the study design and discussion. TY, AS and PGK drafted the article. All authors read and approved the final version of the manuscript.In the era of biologic agents, risk factors for complications following resection for Crohn's disease have not been fully identified. In particular, the association of preoperative use of immunosuppressive and biologic agents with the incidence of complications after resection remains to be elucidated...
December 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28406887/hospitalizations-for-crohn-s-disease-united-states-2003-2013
#11
Christopher A Malarcher, Anne G Wheaton, Yong Liu, Sujay F Greenlund, Suraj J Greenlund, Hua Lu, Janet B Croft
In 2009, an estimated 565,000 Americans had Crohn's disease (1), an inflammatory bowel disorder that can affect any part of the gastrointestinal tract. Symptoms include persistent diarrhea, abdominal cramps and pain, constipation leading to bowel obstruction, and rectal bleeding.* Symptoms sometimes intensify in severity and require hospitalization and surgeries of the small intestine, colon, or rectum (2). Hospital discharge data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) were used to estimate U...
April 14, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28404197/mercaptopurine-versus-placebo-to-prevent-recurrence-of-crohn-s-disease-after-surgical-resection-toppic-a-multicentre-double-blind-randomised-controlled-trial
#12
Craig Mowat, Ian Arnott, Aiden Cahill, Malcolm Smith, Tariq Ahmad, Sreedhar Subramanian, Simon Travis, John Morris, John Hamlin, Anjan Dhar, Chuka Nwokolo, Cathryn Edwards, Tom Creed, Stuart Bloom, Mohamed Yousif, Linzi Thomas, Simon Campbell, Stephen J Lewis, Shaji Sebastian, Sandip Sen, Simon Lal, Chris Hawkey, Charles Murray, Fraser Cummings, Jason Goh, James O Lindsay, Naila Arebi, Lindsay Potts, Aileen J McKinley, John M Thomson, John A Todd, Mhairi Collie, Malcolm G Dunlop, Ashley Mowat, Daniel R Gaya, Jack Winter, Graham D Naismith, Holly Ennis, Catriona Keerie, Steff Lewis, Robin J Prescott, Nicholas A Kennedy, Jack Satsangi
BACKGROUND: Up to 60% of patients with Crohn's disease need intestinal resection within the first 10 years of diagnosis, and postoperative recurrence is common. We investigated whether mercaptopurine can prevent or delay postoperative clinical recurrence of Crohn's disease. METHODS: We did a randomised, placebo-controlled, double-blind trial at 29 UK secondary and tertiary hospitals of patients (aged >16 years in Scotland or >18 years in England and Wales) who had a confirmed diagnosis of Crohn's disease and had undergone intestinal resection...
December 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28401051/surgery-in-pediatric-crohn-s-disease-indications-timing-and-post-operative-management
#13
REVIEW
Seung Kim
Pediatric onset Crohn's disease (CD) tends to have complicated behavior (stricture or penetration) than elderly onset CD at diagnosis. Considering the longer duration of the disease in pediatric patients, the accumulative chance of surgical treatment is higher than in adult onset CD patients. Possible operative indications include perianal CD, intestinal stricture or obstruction, abdominal abscess or fistula, intestinal hemorrhage, neoplastic changes and medically untreatable inflammation. Growth retardation is an operative indication only for pediatric patients...
March 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28400196/association-of-rnaset2-gene-polymorphisms-with-decreased-expression-and-clinical-characteristics-of-severity-in-crohn-s-disease
#14
Rivkah Gonsky, Phillip Fleshner, Richard L Deem, Eva Biener-Ramanujan, Dalin Li, Alka A Potdar, Janine Bilsborough, Shaohong Yang, Dermot P B McGovern, Stephan R Targan
BACKGROUND & AIMS: Variants in the tumor necrosis factor superfamily member 15 gene (TNFSF15, also called TL1A) have been associated with risk for inflammatory bowel diseases (IBD). TL1A affects expression of multiple cytokines to promote mucosal inflammation. Little is known about the TL1A-response pathways that regulate cytokine expression. We investigated T-cell gene expression patterns to determine the mechanisms by which TL1A regulates cytokine production, and whether these associate with outcomes of patients with Crohn's disease (CD)...
April 8, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28395390/surgical-treatment-of-rectovaginal-fistula-in-crohn-s-disease-a-tertiary-center-experience
#15
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Michele Grande
BACKGROUND: Rectovaginal fistula (RVF) is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a woman's quality of life. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics, and its published success rates vary with initial success being around 50% rising to 80% with repeated surgery...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28394805/factors-associated-with-fecal-incontinence-in-women-of-childbearing-age-with-crohn-s-disease
#16
Charlène Brochard, Laurent Siproudhis, Jean Levêque, Amélie Grouin, Anne-Laure Mallet, Jean-François Bretagne, Alain Ropert, Guillaume Bouguen
BACKGROUND: Fecal incontinence is common in women with Crohn's disease, but little is known about the impact of childbirth, perianal Crohn's disease, and past surgical history on fecal incontinence. METHODS: Self-administered questionnaires were mailed to consecutive women referred to a tertiary gastroenterology centre with a focus on fecal incontinence and childbirth. These data were cross-referenced with a prospective database of the same patients' own Crohn's disease histories...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28393997/-benign-multicystic-peritoneal-mesothelioma-in-a-patient-with-crohn-disease
#17
Daniela Fluxá, Udo Kronberg, Jaime Lubascher, Andrés O'Brien, Facundo Las Heras, Patricio Ibáñez, Rodrigo Quera
Benign multicystic peritoneal mesothelioma is an uncommon lesion arising from the peritoneal mesothelium. It is asymptomatic or presents with unspecific symptoms. Imaging techniques may reveal it, however the final diagnosis can only be made by histopathology. Surgery is the only effective treatment considering its high recurrence rate. We report a 19 years old male with Crohn’s disease. Due to persistent abdominal pain, an abdominal magnetic resonance imaging was performed, showing a complex cystic mass in the lower abdomen...
December 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28391412/role-of-mirnas-in-inflammatory-bowel-disease
#18
REVIEW
Bo Cao, Xin Zhou, Jiaojiao Ma, Wei Zhou, Wanli Yang, Daiming Fan, Liu Hong
Inflammatory bowel diseases (IBD), mainly including Crohn's disease and ulcerative colitis, are characterized by chronic inflammation of the gastrointestinal tract. Despite improvements in detection, drug treatment and surgery, the pathogenesis of IBD has not been clarified. A number of miRNAs have been found to be involved in the initiation, development and progression of IBD, and they may have the potential to be used as biomarkers and therapeutic targets. Here, we have summarized the recent advances about the roles of miRNAs in IBD and analyzed the contribution of miRNAs to general diagnosis, differential diagnosis and activity judgment of IBD...
April 8, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28383450/long-term-outcomes-after-continent-ileostomy-creation-in-patients-with-crohn-s-disease
#19
Erman Aytac, David W Dietz, Jean Ashburn, Feza H Remzi
BACKGROUND: Patients with Crohn's disease have a higher failure rate after ileal pouch surgery compared with their counterparts with ulcerative colitis. OBJECTIVE: We hypothesized that risk of continent ileostomy failure can be stratified based on the timing of Crohn's disease diagnosis and aimed to assess long-term outcomes. DESIGN: This was a retrospective cohort study. SETTINGS: The investigation took place in a high-volume, specialized colorectal surgery department...
May 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28378692/can-we-predict-disease-course-with-clinical-factors
#20
Zsuzsanna Vegh, Zsuzsanna Kurti, Petra Anna Golovics, Laszlo Lakatos
The disease phenotype at diagnosis and the disease course of Crohn's disease (CD) and ulcerative colitis (UC) show remarkable heterogeneity across patients. In recent population-based epidemiological and referral cohort studies, the evolution of disease phenotype of CD and UC varied significantly. Most CD and severe UC patients still requires hospitalization or surgery/colectomy during follow-up. A change in the natural history of IBD with improved outcomes in parallel with tailored positioning of aggressive immunomodulator and biological therapy has been suspected according to the recently available literature...
March 28, 2017: Current Drug Targets
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