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Complications of Crohn's Disease

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https://www.readbyqxmd.com/read/29220430/postoperative-outcomes-in-ustekinumab-treated-patients-undergoing-abdominal-operations-for-crohn-s-disease
#1
Amy L Lightner, Nicholas P McKenna, Chung Sang Tse, Neil Hyman, Radhika Smith, Gayane Ovsepyan, Phillip Fleshner, Kristen Crowell, Walter Koltun, Marc Ferrante, Andre D'Hoore, Nathalie Lauwers, Bram Verstockt, Antonino Spinelli, Francesca DiCandido, Laura E Raffals, Kellie L Mathis, Edward V Loftus
Introduction: Ustekinumab, a monoclonal antibody targeting interleukins-12 and -23 is used to treat adults with Crohn's disease (CD). We determined the 30-day postoperative infectious complication rate among CD patients who received ustekinumab within 12 weeks prior to an abdominal operation as compared to patients who received anti-tumor necrosis factor (TNF) agents. Methods: A retrospective chart review of adults with CD who underwent an abdominal operation between 1/1/2015 and 5/1/2017 was performed across six sites...
December 6, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29215479/major-abdominal-and-perianal-surgery-in-crohn-s-disease-long-term-follow-up-of-australian-patients-with-crohn-s-disease
#2
James W T Toh, Nelson Wang, Christopher J Young, Matthew J F X Rickard, Anil Keshava, Peter Stewart, Viraj Kariyawasam, Rupert Leong
BACKGROUND: Most patients with Crohn's disease still require surgery despite significant advances in medical therapy, surveillance, and management strategies. OBJECTIVE: The purpose of this study was to assess surgical strategies and outcomes in Crohn's disease, including surgical recurrence and emergency surgery. DESIGN: This was a multicenter, retrospective review of a prospectively collected database. SETTINGS: A specialist-referred cohort of patients with Crohn's disease between 1970 and 2009 was studied...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29211912/intestinal-t-cell-profiling-in-inflammatory-bowel-disease-linking-t-cell-subsets-to-disease-activity-and-disease-course
#3
Carolijn Smids, Carmen S Horjus Talabur Horje, Julia Drylewicz, Britt Roosenboom, Marcel J M Groenen, Elly van Koolwijk, Ellen G van Lochem, Peter J Wahab
Introduction: A dysregulated intestinal T-cell response is presumed in patients with Inflammatory Bowel Disease (IBD). In this longitudinal study, we investigated the changes in intestinal T lymphocyte subsets in IBD at first presentation and over time during endoscopic active or inactive disease and relate them to disease activity and outcome. Material & method: We included 129 newly diagnosed patients (87 Crohn´s Disease (CD), 42 ulcerative colitis (UC)) and 19 healthy controls (HC)...
December 4, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29210919/the-role-of-combination-therapy-in-pediatric-inflammatory-bowel-disease-ibd-a-clinical-report-from-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition
#4
Andrew S Day, Ajay S Gulati, Nishaben Patel, Brendan Boyle, K T Park, Shehzad A Saeed
The treatment goal for children suffering from inflammatory bowel disease (IBD) has been evolving with biologic therapies like anti-TNF agents assuming a more central role in treatment of more aggressive and extensive phenotype. Earlier introduction of anti-TNF agents have shown to be more effective and may even alter the natural history of IBD. However, development of anti-drug antibodies (ADA) limits long term usage and leads to dose adjustment in almost half of patients treated with these medications. One of the strategies to minimize the development of ADA has been concomitant use of immunomodulator (IM) medications, resulting in fewer infusion reactions and sustained trough levels, potentially lowering the need for dose adjustments...
November 28, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29209693/health-self-perception-in-patient-with-crohn-s-disease-a-web-survey
#5
M Chiarini, E Di Simone, C Scafuro, F Auddino, M Fabbri, A Delli Poggi, S Catanzaro, N Giannetta, M Di Muzio
BACKGROUND: Crohn's Disease (CD) has an incidence on the physical and psychological autonomy of the patient, such as to alter their daily life. The impact of the disease on the daily life of the patients is related to the symptoms and complications of the disease. Patient autonomy and participation in social and work life are the goals that nurses must reach for patients with CD to improve their quality of life. AIM: To measure the perception of the health of people with a diagnosis of CD...
November 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/29206869/measurements-of-6-thioguanine-nucleotide-levels-with-tpmt-and-nudt15-genotyping-in-patients-with-crohn-s-disease
#6
Ji Hyeon Lee, Tae Jun Kim, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Li-Hwa Choi, Hye In Woo, Soo-Youn Lee, Young-Ho Kim
The association between the 6-thioguanine nucleotide (6-TGN) level and clinical remission in Crohn's disease (CD) remains controversial. Thiopurine-induced leukopenia is a life-threatening complication of CD in Asians that was recently shown to strongly correlate with NUDT15 genetic variants. This study aimed to determine the relationship between thiopurine metabolite levels and therapeutic response, and to investigate the association of NUDT15, TPMT, and thiopurine metabolites with leukopenia in patients with CD...
2017: PloS One
https://www.readbyqxmd.com/read/29204696/patients-perspective-on-bowel-resection-for-inflammatory-bowel-disease
#7
Milton Mui, Vinna An, Jane Lovell, Basil D'Souza, Rodney Woods
PURPOSE: The study aimed to determine whether patients are receiving adequate counselling about elective bowel resection and timely surgery for inflammatory bowel disease (IBD). METHODS: Patients with IBD who underwent an elective bowel resection in a tertiary referral centre between April 2012 and Dec 2014 were identified from a prospective database. Patients under the age of 16 years were excluded from the study. Patients were contacted over the phone to complete a questionnaire regarding their perspective on their surgery, including the consultations that took place, preparedness and timing of surgery, as well as patient attitude towards bowel resection and satisfaction with post-operative outcomes...
December 4, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29191059/optimization-of-biologic-therapy-in-crohn-s-disease
#8
Mohammed Razvi, Mark Lazarev
Crohn's disease (CD) is a manifestation of inflammatory bowel disease (IBD), which can result in significant morbidity. Biologic therapy with anti-TNF medication has been effective in treating inflammation and reducing complications in CD. It is important for clinicians to have better knowledge of the various biologic therapies including mechanisms of action and optimization strategies. Areas covered: The review describes optimization of biologic therapy in CD including different mechanisms of loss of response, therapeutic drug monitoring in CD, clinical implications and management strategies which utilize drug monitoring, and areas of future development and research in optimization of biologic therapy...
November 30, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29189768/inflammatory-bowel-disease-adversely-impacts-colorectal-cancer-surgery-short-term-outcomes-and-health-care-resource-utilization
#9
Mitchell Ramsey, Somashekar G Krishna, Peter P Stanich, Syed Husain, Edward J Levine, Darwin Conwell, Alice Hinton, Cheng Zhang
OBJECTIVES: Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC) compared to patients without IBD. There is a lack of population-based data evaluating the in-patient surgical outcomes of CRC in IBD patients. We sought to compare the hospital outcomes of CRC surgery between patients with and without IBD. METHODS: We used the National Inpatient Sample (2008-2012) and Nationwide Readmissions Database (NRD, 2013) and selected all adult patients (age ≥18 years) with ulcerative colitis (UC) or Crohn's disease (CD) who underwent CRC surgery...
November 30, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/29180886/next-generation-of-biologics-for-the-treatment-of-crohn-s-disease-an-evidence-based-review-on-ustekinumab
#10
REVIEW
Aranzazu Jauregui-Amezaga, Michael Somers, Heiko De Schepper, Elisabeth Macken
The limited efficacy of the currently available medical therapies in a proportion of patients with Crohn's disease has led to the research and development of molecules that can block new inflammatory pathways. Ustekinumab is a fully human IgG1 monoclonal antibody which targets the common p40 subunit of the cytokines interleukin-12 as well as interleukin-23. Consequently, the Th1 and Th17 inflammatory responses are inhibited. Ustekinumab has been recently approved for its use in patients with Crohn's disease...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29167943/penetrating-crohn-disease-does-it-occur-in-the-absence-of-stricturing-disease
#11
Emily S Orscheln, Jonathan R Dillman, Alexander J Towbin, Lee A Denson, Andrew T Trout
PURPOSE: To establish the relationship between penetrating complications and bowel luminal narrowing/stricturing disease in pediatric Crohn disease (CD). MATERIALS AND METHODS: This retrospective study was IRB-approved and HIPAA compliant with waiver of informed consent. CT and MRI examinations describing intra-abdominal penetrating complications in CD patients ≤ 18 years old between January 1, 2009 and March 31, 2016 were reviewed to document: type of complication, affected bowel segment, minimum bowel luminal diameter, maximum upstream diameter, location of penetrating complication relative to luminal narrowing, length of narrowed bowel segment, and the presence of active bowel wall inflammation...
November 22, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29165666/differences-in-outcomes-over-time-with-exclusive-enteral-nutrition-compared-to-steroids-in-children-with-mild-to-moderate-crohn-s-disease-results-from-the-growth-cd-study
#12
Noa Cohen-Dolev, Malgorata Sladek, Seamus Hussey, Dan Turner, Gabor Veres, Sibylle Koletzko, Javier Martin de Carpi, Annamaria Staiano, Ron Shaoul, Paolo Lionetti, Jorge Amil Dias, Anders Paerregaard, Federica Nuti, Tamar Pfeffer Gik, Tomer Ziv-Baran, Sivan Ben Avraham Shulman, Chen Sarbagili Shabat, Rotem Sigall Boneh, Richard K Russell, Arie Levine
Background: Exclusive enteral nutrition (EEN) and corticosteroids (CS) both induce similar rates of remission in mild to moderate pediatric Crohn's disease (CD), but differ with regard to mucosal healing. Our goal was to evaluate if EEN at diagnosis was superior to CS for improving long term outcomes. Methods: We prospectively followed newly diagnosed children <17 years with mild to moderate disease at baseline for two years in the GROWTH CD study. Patients were evaluated at baseline and at 8, 12, 78, and 104 weeks...
November 18, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29159164/does-anastomosis-configuration-influence-long-term-outcomes-in-patients-with-crohn-disease
#13
Parajuli Anuj, Yong Sik Yoon, Chang Sik Yu, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Jin Cheon Kim
Purpose: In this study, we evaluated the role of various anastomoses in surgical recurrence for patients with Crohn disease (CD). Methods: We analyzed data retrospectively from consecutive laparotomy cases involving complicated CD between 1991 and 2008. Clinical data were compared in terms of reoperation-free survival (RFS) according to the types of anastomoses, the materials used for the anastomoses, and the operating surgeon. Results: Of 233 patients with entero-enteric or entero-colic anastomoses, 199 (85%), 11 (5%), and 23 (10%) experienced side-to-side (SS), side-to-end (SE), and end-to-end (EE) anastomoses, respectively...
October 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/29155253/the-association-of-inflammatory-bowel-disease-and-immediate-postoperative-outcomes-following-lumbar-fusion
#14
Joseph E Tanenbaum, Stephanie T Kha, Edward C Benzel, Michael P Steinmetz, Thomas E Mroz
BACKGROUND CONTEXT: The United States Centers for Disease Control estimates the prevalence of inflammatory bowel disease (IBD) at over 3.1 million people. As diagnostic techniques and treatment options for IBD improve, the prevalence of IBD is expected to increase. For spine surgeons, patients with IBD have a unique complication profile because IBD patients may present with poor nutritional status and because the medications used to manage IBD have been associated with poor vertebral bone mineralization and immunosuppression...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29154237/results-of-home-parenteral-nutrition-in-patients-with-severe-inflammatory-bowel-disease-an-alternative-for-surgery-of-malnourished-patients
#15
Maryla Turkot, Jacek Sobocki
INTRODUCTION: In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition. AIM: The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications...
October 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29145572/difference-in-clinical-course-genetics-and-the-microbiome-between-familial-and-sporadic-inflammatory-bowel-diseases
#16
Nienke Z Borren, Grace Conway, John J Garber, Hamed Khalili, Shrish Budree, Himel Mallick, Vijay Yajnik, Ramnik J Xavier, Ashwin N Ananthakrishnan
Objective: Family history is the strongest risk factor for developing Crohn's disease (CD) or ulcerative colitis (UC). We investigated whether the proximity of relationship with the affected relative and concordance for type of IBD modifies the effect of family history on phenotype and disease severity. Design: This cross-sectional study included patients with a confirmed diagnosis of IBD in a clinical registry. Family history of IBD was assessed by a questionnaire ascertaining presence of disease in a 1 st degree, 2 nd degree or a distant relative...
November 14, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29142520/predictive-factors-for-malignancy-in-undiagnosed-isolated-small-bowel-strictures
#17
Ujjwal Sonika, Sujeet Saha, Saurabh Kedia, Nihar Ranjan Dash, Sujoy Pal, Prasenjit Das, Vineet Ahuja, Peush Sahni
Background/Aims: Patients with small bowel strictures have varied etiologies, including malignancy. Little data are available on the demographic profiles and etiologies of small bowel strictures in patients who undergo surgery because of intestinal obstruction but do not have a definitive pre-operative diagnosis. Methods: Retrospective data were analyzed for all patients operated between January 2000 and October 2014 for small bowel strictures without mass lesions and a definite diagnosis after imaging and endoscopic examinations...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29130989/preoperative-nutritional-optimization-for-crohn-s-disease-patients-can-improve-surgical-outcome
#18
Yael Dreznik, Nir Horesh, Mordechai Gutman, Aviad Gravetz, Imri Amiel, Harel Jacobi, Oded Zmora, Danny Rosin
BACKGROUND: Preoperative preparation of patients with Crohn's disease is challenging and there are no specific guidelines regarding nutritional support. The aim of this study was to assess whether preoperative nutritional support influenced the postoperative outcome. METHODS: A retrospective, cohort study including all Crohn's disease patients who underwent abdominal surgery between 2008 and 2014 was conducted. Patients' characteristics and clinical and surgical data were recorded and analyzed...
November 1, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29126510/long-term-outcomes-of-pediatric-inflammatory-bowel-disease
#19
Soheila Nasiri, Mary Ellen Kuenzig, Eric I Benchimol
The incidence and prevalence of childhood-onset inflammatory bowel diseases (IBD), including subtypes Crohn's disease and ulcerative colitis, have risen dramatically in recent years, and have emerged globally as important pediatric chronic diseases. Therefore, health care providers are more frequently encountering very young children with IBD, a chronic and incurable condition requiring life-long therapy. These children are living long lives with IBD and therefore knowledge of long-term outcomes is increasingly important to better counsel families and determine the best course of treatment...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29123578/the-role-of-adhesion-molecules-in-inflammatory-bowel-disease-in-children-assessment-of-the-possible-risk-of-cardiovascular-complications
#20
Aneta Trzeciak-Jędrzejczyk, Ryszard Makosiej, Michał Kolejwa, Ewa Głowacka, Elżbieta Czkwianianc
Introduction: Inflammatory bowel diseases (IBD) are chronic diseases that proceed with exacerbation and remission phases. Adhesion molecules play a significant role in inflammatory processes. The same adhesion molecules play an important role in atherogenesis. Aim: To assess the risk of atherosclerosis in IBD in children. Material and methods: The study included 40 patients with IBD (25 with Crohn's disease - CD and 15 with ulcerative colitis - UC) aged 4-17 years...
2017: Przegla̜d Gastroenterologiczny
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