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Complications of Crohn's Disease

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https://www.readbyqxmd.com/read/28815354/nf-e2-related-factor-2-suppresses-intestinal-fibrosis-by-inhibiting-reactive-oxygen-species-dependent-tgf-%C3%AE-1-smads-pathway
#1
Yadi Guan, Yue Tan, Weiyu Liu, Jun Yang, Dongxu Wang, Di Pan, Yan Sun, Changqing Zheng
BACKGROUND AND AIMS: This study aimed to evaluate the antifibrotic effects of NF-E2-Related Factor 2 (Nrf2) on intestinal fibrosis. Intestinal fibrosis is a common complication of Crohn's disease; however, its mechanism of intestinal fibrosis is largely unclear. METHODS: BALB/c mice received 2,4,6-trinitrobenzene sulfonic acid weekly via intrarectal injections to induce chronic fibrotic colitis. They also diet containing received 1% (w/w) tert-butylhydroquinone (tBHQ), which is an agonist of Nrf2...
August 16, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28815031/capsule-retention-related-to-small-bowel-capsule-endoscopy-a-large-european-single-center-10-year-clinical-experience
#2
Artur Nemeth, Gabriele Wurm Johansson, Jörgen Nielsen, Henrik Thorlacius, Ervin Toth
BACKGROUND: The most concerning complication of video capsule endoscopy (VCE) is capsule retention (CR) in the gastrointestinal (GI) tract although clinical outcome and management of patients with CR are still uncertain in a large single center material. OBJECTIVES: The aim of this retrospective study was to investigate incidence, causes, risk factors, management and clinical outcomes of CR in a large single center between 2001 and 2011. RESULTS: 2401 consecutive small-bowel (SB) VCEs were performed...
August 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28814767/application-of-the-onodera-prognostic-nutrition-index-and-neutrophil-to-lymphocyte-ratio-in-risk-evaluation-of-postoperative-complications-in-crohn-s-disease
#3
Wei-Ming Kang, Chang-Zhen Zhu, Xiao-Xu Yang, Jian-Chun Yu, Zhi-Qiang Ma, Xin Ye, Kang Li, Dong Liu
This study aimed to investigate application of Onodera prognostic nutrition index (OPNI) and neutrophil-to-lymphocyte ratio (NLR) in evaluating risk of postoperative complications in Crohn's disease (CD). Clinical data of 108 postoperative CD patients in 9 years were respectively reviewed. OPNI and NLR were within 1 week preoperatively. Average OPNI was 38.8 ± 8.2 and significantly lower in patients with: CD type B3; lymphopenia; decreased haemoglobin, prealbumin, and albumin; and daily enteral nutrition <500 kcal/d...
August 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28808566/laparoscopic-double-tract-reconstruction-after-total-gastrectomy-for-postoperative-duodenal-surveillance-case-series
#4
Ryota Otsuka, Hideki Hayashi, Naoyuki Hanari, Hisashi Gunji, Koichi Hayano, Masayuki Kano, Hisahiro Matsubara
INTRODUCTION: When gastric cancer or carcinoid patients have coexisting diseases such as duodenal adenoma, FAP, or Crohn's disease, periodic observation of the duodenum is necessary. METHODS: Between August 2013 and April 2015, we performed four consecutive laparoscopic total gastrectomies with double tract reconstruction for duodenal surveillance. Three of the patients were diagnosed with gastric cancer, while the remaining patient was diagnosed with gastric carcinoid...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28805827/transcriptional-risk-scores-link-gwas-to-eqtls-and-predict-complications-in-crohn-s-disease
#5
Urko M Marigorta, Lee A Denson, Jeffrey S Hyams, Kajari Mondal, Jarod Prince, Thomas D Walters, Anne Griffiths, Joshua D Noe, Wallace V Crandall, Joel R Rosh, David R Mack, Richard Kellermayer, Melvin B Heyman, Susan S Baker, Michael C Stephens, Robert N Baldassano, James F Markowitz, Mi-Ok Kim, Marla C Dubinsky, Judy Cho, Bruce J Aronow, Subra Kugathasan, Greg Gibson
Gene expression profiling can be used to uncover the mechanisms by which loci identified through genome-wide association studies (GWAS) contribute to pathology. Given that most GWAS hits are in putative regulatory regions and transcript abundance is physiologically closer to the phenotype of interest, we hypothesized that summation of risk-allele-associated gene expression, namely a transcriptional risk score (TRS), should provide accurate estimates of disease risk. We integrate summary-level GWAS and expression quantitative trait locus (eQTL) data with RNA-seq data from the RISK study, an inception cohort of pediatric Crohn's disease...
August 14, 2017: Nature Genetics
https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#6
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28796371/inflammatory-bowel-disease-with-primary-sclerosing-cholangitis-a-danish-population-based-cohort-study-1977-2011
#7
Jakob Ørskov Sørensen, Ole Haagen Nielsen, Mikael Andersson, Mark Andrew Ainsworth, Henriette Ytting, Erika Bélard, Tine Jess
BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) may be complicated by primary sclerosing cholangitis (PSC). We aimed to assess the characteristics of Danish PSC-IBD patients and to compare their prognosis with IBD patients without PSC. METHODS: A retrospective nationwide population-based cohort of 257 PSC-IBD patients was assessed through Danish national registries and manual scrutiny of patient files. RESULTS: For all PSC-IBD patients diagnosed after 1976 (n=222) and 8,231 IBD controls (i...
August 10, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28783205/successful-treatment-of-chronic-hepatitis-c-with-ground-ledipasvir-sofosbuvir-in-a-patient-with-crohn-s-disease-and-short-bowel-syndrome
#8
Johann von Felden, Christoph Scheurich, Jin Yamamura, Diana M Brainard, Erik Mogalian, Ansgar W Lohse, Julian Schulze-Zur-Wiesch
We read the comprehensive review by Gitto et al. entitled 'NS5A inhibitors for the treatment of hepatitis C infection' (CHC) with great interest (1). Indeed, the development of direct acting antivirals (DAAs) now enables successful treatment of formerly difficult-to-treat patient populations (e.g. cirrhosis or chronic kidney disease). However, little is known about the use of DAAs in patients with short bowel syndrome, e.g. following inflammatory bowel disease (IBD), because these patients are yet excluded from clinical trials (2)...
August 7, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28765713/inflammatory-bowel-disease-in-bahrain-single-center-experience
#9
Maheeba Abdulla, Mahmood Al Saeed, Rawdha Hameed Fardan, Hawra Faisal Alalwan, Zahra S Ali Almosawi, Amal Fuad Almahroos, Jehad Al Qamish
PURPOSE: The number of newly diagnosed inflammatory bowel disease (IBD) cases such as ulcerative colitis (UC), Crohn's disease (CD), and indeterminate colitis (IC) is rapidly increasing in Gulf countries and Saudi Arabia. The aim of this study was to investigate the incidence and prevalence of IBD in patients who have attended the Salmaniya Medical Complex, Bahrain, between the years 1984 and 2014. PATIENTS AND METHODS: All patients who had attended the Salmaniya Medical Complex, Bahrain, and had been diagnosed with UC, CD, or IC, between the years 1984 and 2014, were included in the analysis...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28749002/-natalizumab-for-the-treatment-of-crohn%C3%A2-s-disease-report-of-three-cases
#10
Daniela Fluxá, Patricio Ibáñez, Lilian Flores, Carolina Figueroa, Jaime Lubascher, Udo Kronberg, Daniela Simian, Gonzalo Pizarro, Paola Toche, Rodrigo Quera
Anti-tumor necrosis factor-α (TNF) agents have dramatically changed the management of Crohn’s Disease (CD). However, a significant number of these patients do not respond at all or cease to respond to antibodies against TNF. In this clinical situation, the options include intensification of anti-TNF therapy by either increasing the dose or by shortening the administration interval, the use of a second anti-TNF or medications with a different mechanism of action. Among the later, Natalizumab, a humanized IgG4 monoclonal antibody against α4β1 and α4β7 integrins, is safe and effective in inducing and maintaining remission in active CD patient’s refractory to anti-TNF...
April 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28748409/evolution-of-clinical-behavior-in-crohn-s-disease-factors-associated-with-complicated-disease-and-surgery
#11
Kátia Simone Cezário de Barros, Cristina Flores, Luciana Harlacher, Carlos Fernando Magalhães Francesconi
BACKGROUND: The phenotypic expression of Crohn's disease may vary over time. Establishment of Crohn's disease phenotypes is important for definition of patient care strategies. AIMS: The aim of the study was to evaluate the long-term evolution of patients based on disease phenotypes and the main factors associated with this evolution. METHODS: Data from 179 patients were collected from a unicentric prospective database. Montreal classification was employed...
July 26, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28738237/a-case-report-of-unexpected-pathology-within-an-incarcerated-ventral-hernia
#12
Erica D Kane, Katharine R Bittner, Michelle Bennett, John R Romanelli, Neal E Seymour, Jacqueline J Wu
INTRODUCTION: Incidence of hernial appendicitis is 0.008%, most frequently within inguinal and femoral hernias. Up to 2.5% of appendectomy patients are found to have Crohn's disease. Elucidating the etiology of inflammation is essential for directing management. PRESENTATION OF CASE: A 51-year-old female with achondroplastic dwarfism, multiple cesarean sections, and subsequent massive incisional hernia, presented with ruptured appendicitis within her incarcerated hernia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28737951/monitoring-of-small-bowel-crohn-s-disease
#13
Uri Kopylov, Anastasios Koulaouzidis, Eyal Klang, Dan Carter, Shomron Ben-Horin, Rami Eliakim
In recent years, the therapeutic paradigm in Crohn's disease has shifted from a mere symptom-oriented approach, to aiming to healing of the underlying inflammation and prevention of long-term structural complications. Such "treat-to-target" approach may allow for a more stable disease course with less hospitalizations, lower requirement for surgery and improved quality of life. In Crohn's disease, the small bowel is affected in the majority of patients; frequently, Crohn's involves only the small bowel, which remains inaccessible to conventional ileocolonoscopic techniques...
July 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28732299/enterovesical-fistula-a-rare-complication-of-meckel-s-diverticulum-a-case-report
#14
Bourguiba M A, Gharbi M, Ghalleb M, Ben Taher A, Souai F, Bensafta Y, Sayari S, Ben Moussa M
INTRODUCTION: Enterovesical fistulas usually result from diverticulitis, Crohn's disease, or colorectal cancer. A perforated Meckel's diverticulum can exceptionally result in an vesico-diverticulum fistula, as noted in only seven previously reported cases. CASE REPORT: A 35-year old Arabic male, quadriplegic,who presented epigastralgia evolving for a week, associated with abdominal distension and cloudy urine. On examination he was feverish (38.5°C), dehydrated with tenderness in the entire distended abdomen; rectal examination revealed a hypotonic sphincter with no other abnormality...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28728316/use-of-novel-oral-anticoagulant-to-treat-pulmonary-thromboembolism-in-patient-with-ulcerative-colitis-superinfected-cytomegalovirus-colitis
#15
Seok Hwan Kim, Sunhee Jang, Yegyu Sung, Jun Kyu Park, Yunjung Park, Jintak Yun, Sang Bum Kang
Crohn's disease and ulcerative colitis are the two major types of inflammatory bowel disease, and affect mainly the gastrointestinal tract but also have extraintestinal sequelae, such as arterial and venous thromboembolism. Thromboembolic complications, particularly pulmonary thromboembolism, can be life threatening and require prompt management with anticoagulants. Conventional vitamin K antagonists have been used for the treatment of thromboembolic complications, but the development of novel oral anticoagulants has shifted the paradigm...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28719595/risk-of-postoperative-complications-among-inflammatory-bowel-disease-patients-treated-preoperatively-with-vedolizumab
#16
Akihiro Yamada, Yuga Komaki, Nayan Patel, Fukiko Komaki, Arthur S Aelvoet, Anthony L Tran, Joel Pekow, Sushila Dalal, Russell D Cohen, Lisa Cannon, Konstantin Umanskiy, Radhika Smith, Roger Hurst, Neil Hyman, David T Rubin, Atsushi Sakuraba
OBJECTIVES: Vedolizumab is increasingly used to treat patients with ulcerative colitis (UC) and Crohn's disease (CD), however, its safety during the perioperative period remains unclear. We compared the 30-day postoperative complications among patients treated preoperatively with vedolizumab, anti-tumor necrosis factor (TNF)-α agents or non-biological therapy. METHODS: The retrospective study cohort was comprised of patients receiving vedolizumab, anti-TNF-α agents or non-biological therapy within 4 weeks of surgery...
July 18, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28718336/coexistence-of-takayasu-s-arteritis-and-ankylosing-spondylitis-may-not-be-accidental-is-there-a-need-for-a-new-subgroup-in-the-spondyloarthritis-family
#17
Pawel Mielnik, Anja Myhre Hjelle, Jan Leidulv Nordeide
Aortitis of ascending aorta is a recognized complication of ankylosing spondylitis (AS). There are a few published cases of diffuse aortitis and aorta collaterals inflammation that fulfill Takayasu's arteritis (TA) criteria coexisting with AS. We have reviewed published cases from literature and present three new cases of such coexistence. We identified three patients who fulfilled definite AS New York criteria in our Takayasu's vasculitis cohort of eight patients. One of this patients had been diagnosed with Crohn's disease before AS and TA diagnosis...
July 18, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28711286/novel-therapeutic-targets-for-inflammatory-bowel-disease
#18
REVIEW
Marjorie Argollo, Gionata Fiorino, Pieter Hindryck, Laurent Peyrin-Biroulet, Silvio Danese
Inflammatory bowel disease (IBD), including Crohn's disease (CD) and Ulcerative Colitis (UC), are immune mediated conditions associated with progressive damage of the inflamed gut tissue, and have a considerable impact on the patient's quality of life. The pathogenesis remains uncertain, but it is clear that complex mechanisms associated with host and luminal factors are involved, generating an unbalance between pro- and anti-inflammatory signaling. It is well established that the purpose of an adequate and complete control of the intestinal inflammation measured not only by clinical symptoms, but also with more objective data such as fecal biomarkers (calprotectin) and endoscopy...
July 12, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28708806/understanding-the-cautions-and-contraindications-of-immunomodulator-and-biologic-therapies-for-use-in-inflammatory-bowel-disease
#19
H Matthew Cohn, Maneesh Dave, Edward V Loftus
Ulcerative colitis and Crohn's disease are chronic inflammatory bowel diseases for which there are no cures. These diseases are immunopathogenic, and medical treatment is centered on the temperance of a dysregulated immune response to allow mucosal healing and prevent the sequelae of fistulation and stenosis. Accordingly, the armamentarium of medications, which has expanded immensely in recent history, is not without significant infectious and neoplastic risks. Many of these untoward effects can be mitigated by screening and avoidance of contraindicated medications...
August 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28708248/oral-and-upper-gastrointestinal-crohn-s-disease
#20
REVIEW
Robyn Laube, Ken Liu, Mark Schifter, Jessica L Yang, Michael K Suen, Rupert W Leong
Crohn's disease is a heterogeneous, inflammatory condition that can affect any location of the gastrointestinal tract. Proximal gastrointestinal involvement occurs in 0.5-16% of patients, and it is usually diagnosed after recognition of intestinal disease. Symptoms are often mild and non-specific, however upper gastrointestinal disease predicts a more severe Crohn's phenotype with a greater frequency of complications such as obstruction and perforation. Gastroscopy and biopsy is the most sensitive diagnostic investigation...
July 14, 2017: Journal of Gastroenterology and Hepatology
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