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https://www.readbyqxmd.com/read/28703786/fistulizing-crohn-s-disease
#1
Michael Scharl, Gerhard Rogler, Luc Biedermann
Fistulas still represent one of the most important complications in patients with Crohn's disease (CD). At least one third of CD patients suffer from fistulas during their disease course and amongst them longstanding remission of complex fistulas occurs only in about one third. So far, fistula pathogenesis is only partially understood. From a histopathological view, a fistula is a tube covered by flat epithelial cells. Current research suggests that the driving force for fistula development is epithelial-to-mesenchymal transition (EMT)...
July 13, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28686769/metastatic-crohn-disease-a-review-of-dermatologic-manifestations-and-treatment
#2
Adam Bender-Heine, John T Grantham, Stanley Zaslau, Robert Jansen
It is estimated that almost half of patients affected with Crohn disease (CD) experience a dermatologic manifestation of the condition. Metastatic CD (MCD) is a rare dermatologic entity, with as few as 100 cases reported in the literature. As such, MCD presents a clinical dilemma in diagnosis and management. The etiology of MCD is not well defined; however, prevailing theories agree that the underlying mechanism is an immunologic response to gut antigens. Diagnosis requires a high index of suspicion and usually is made by exclusion of other processes...
June 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28666580/current-trends-and-challenges-in-the-postoperative-medical-management-of-crohn-s-disease-a-systematic-review
#3
REVIEW
Andrew T Schlussel, Nicole B Cherng, Karim Alavi
BACKGROUND: Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the postoperative medical management of Crohn's disease. DATA SOURCES: A systematic literature review of medications administered following respective therapy for Crohn's disease was performed from 1979 through 2016...
June 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28639073/prognostic-factors-affecting-outcomes-in-fistulating-perianal-crohn-s-disease-a-systematic-review
#4
REVIEW
G C Braithwaite, M J Lee, D Hind, S R Brown
BACKGROUND: One in three patients with Crohn's disease will develop a perianal fistulae, and one third of these will achieve long-term healing or closure. A barrier to conducting well-designed clinical trials for these patients is a lack of understanding of prognostic factors. This systematic review sets out to identify factors associated with prognosis of perianal Crohn's fistulae. METHODS: This review was registered on the PROSPERO database (CRD42016050316) and conducted in line with PRISMA guidelines along a predefined protocol...
June 20, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#5
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28623282/a-nationwide-study-of-severe-and-protracted-diarrhoea-in-patients-with-primary-immunodeficiency-diseases
#6
Wen-I Lee, Chien-Chang Chen, Tang-Her Jaing, Liang-Shiou Ou, Chuen Hsueh, Jing-Long Huang
Diarrhoea lasting longer than 14 days and failing to respond to conventional management is defined as severe and protracted diarrhoea (SD). In this study, we investigated the prevalence, pathogens and prognosis of SD in primary immunodeficiency diseases (PIDs). Among 246 patients with predominantly paediatric-onset PIDs from 2003-2015, 21 [Btk (six), IL2RG (four), WASP, CD40L, gp91 (three each), gp47, RAG2 (one each)] and five [CVID (four), SCID (one)] without identified mutations had SD before prophylactic treatment...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28616081/anaerobic-adaptation-of-mycobacterium-avium-subspecies-paratuberculosis-in-vitro-similarities-to-m-tuberculosis-and-differential-susceptibility-to-antibiotics
#7
Nicole Parrish, Aravinda Vadlamudi, Neil Goldberg
BACKGROUND: Mycobacterium avium subspecies paratuberculosis (MAP) is the causative agent of Johne's disease in ruminants and is associated with Crohn's disease (CD) in humans, although the latter remains controversial. In this study, we investigated the ability of MAP to adapt to anaerobic growth using the "Wayne" model of non-replicating persistence (NRP) developed for M. tuberculosis. RESULTS: All strains adapted to anaerobiosis over time in a manner similar to that seen with MTB...
2017: Gut Pathogens
https://www.readbyqxmd.com/read/28598298/efficacy-of-exclusive-enteral-nutrition-in-complicated-crohn-s-disease
#8
Qingfan Yang, Xiang Gao, Huiping Chen, Miao Li, Xiaojian Wu, Min Zhi, Ping Lan, Pinjin Hu
AIM: To investigate the efficacy of exclusive enteral nutrition (EEN) in induction of remission in adult active Crohn's disease (CD) complicated with intestinal fistula/abdominal abscess or inflammatory intestinal stricture. METHOD: Patients diagnosed with active CD with complications were recruited between July 2013 and July 2015. Patients were offered EEN for 12 weeks. Patients with abscess received antibiotic treatment with or without percutaneous drainage. Clinical variables were recorded (ClinicalTrials...
September 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28548199/-acute-small-bowel-diverticulitis-in-a-patient-with-crohn%C3%A2-s-disease
#9
Macarena Hevia, Rodrigo Quera, Leonardo Soto, Tomás Regueira, Andrés O'Brien, Andrés Larach, Udo Kronberg
Diverticular disease of the small intestine is rare, especially when it is located in the jejunum. It is generally asymptomatic, but in some patients it may have complications such as acute diverticulitis with peritonitis, gastrointestinal bleeding or obstruction. In such cases, the recommended treatment is surgery. We report a 77-year-old patient with ileal Crohn’s disease with a long-standing inflammatory phenotype, who developed acute diverticulitis of the jejunum presenting a severe septic shock and secondary multiple-organ failure...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28481651/the-alternate-effects-of-anti-tnf%C3%AE-therapeutics-and-their-role-in-mycobacterial-granulomatous-infection-in-crohn-s-disease
#10
Ahmad Qasem, Abed Elrahman Naser, Saleh A Naser
Crohn's disease is an inflammatory bowel disease that has been debated to be associated with bacterial triggers such as Mycobacterium avium subspecies paratuberculosis (MAP). Standard treatment of Crohn's disease (CD) patients includes a family of immunomodulators and biologics such as Anti-Tumor Necrosis Factor alpha (Anti-TNFα). This cytokine in particular has been known to play vital roles in fighting microbial infections through formation and maintenance of granulomas. Areas covered: This perspective is focused on elucidating the negative effects of using Anti-TNFα therapeutic agents as a treatment option in CD patients who are more likely suspected to have MAP infection, and the role of other immunomodulators in MAP infection...
May 17, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28466260/autophagy-genes-of-host-responds-to-disruption-of-gut-microbial-community-by-antibiotics
#11
Sudha B Singh, Melissa Wilson, Nathaniel Ritz, Henry C Lin
BACKGROUND: Defective autophagic machinery, such as that in Crohn's disease patients homozygous for ATG16L1 risk allele, is associated with alteration of resident gut bacterial communities. However, whether or not host autophagy responds to changes in the resident gut microbial community is not known. Here, we investigated the effect of antibiotic-induced disruption of the gut microbiome (dysbiosis) on autophagy gene expression and the expression of antimicrobial peptides/protein (AMP) over time...
June 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28439845/a-systematic-review-of-the-clinical-presentation-diagnosis-and-treatment-of-small-bowel-obstruction
#12
REVIEW
Srinivas R Rami Reddy, Mitchell S Cappell
PURPOSE OF REVIEW: This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy. RECENT FINDINGS: SBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn's disease (5%), and other (15%). Bowel dilatation occurs proximal to obstruction primarily from swallowed air and secondarily from intraluminal fluid accumulation. Dilatation increases mural tension, decreases mucosal perfusion, causes bacterial proliferation, and decreases mural tensile strength that increases bowel perforation risks...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28427855/outcome-of-medical-management-of-intraabdominal-abscesses-in-children-with-crohn-s-disease
#13
Razan H Alkhouri, Gracielle Bahia, Ashley C Smith, Richard Thomas, Christine Finck, Wael Sayej
INTRODUCTION: Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that is complicated by fistulas, strictures, and intraabdominal abscesses (IAA) in 10%-30% of patients. To avoid surgical resection of the bowel, medical therapy with antibiotics (Ab) with or without percutaneous drainage (PD) is first undertaken. Our objectives are to examine the outcome of IAA in CD patients treated with antibiotics alone vs antibiotics and PD, and to identify risk factors for medical therapy failure...
March 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28372453/coloduodenal-and-enterocutaneous-fistula-in-twins-with-crohn%C3%A2-s-disease
#14
Maíia Pilar Ballester, David Martí, Marta Maia Boscá Watts, José Martín Arévalo, Miguel Mínguez
We present the case of a pair of 45-year-old monozygotic twins (A and B) diagnosed with Crohn's disease (CD) at age 20 (A) and 22 (B) with similar presenting symptoms: diarrhea, fever and weight loss. Both of them had duodenal and ileocolonic disease (A2, L3+L4 according to Montreal classification); twin B also presented jejunal involvement and perianal disease (B1p). They received treatment with antibiotics, corticosteroids, 5-ASA, azathioprine and anti-TNF with a poor control of activity. They both developed a coloduodenal fistula that required surgery...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28239323/metronidazole-induced-encephalopathy-in-a-patient-with-crohn-s-disease
#15
Jihye Kim, Jaeyoung Chun, Jae Yong Park, Seung Wook Hong, Joo Young Lee, Jin Woo Kang, Seongjun Hwang, Sang-Bae Ko, Jong Pil Im, Joo Sung Kim
Metronidazole is a widely used antibiotic for the treatment of anaerobic bacterial infections. Metronidazole-induced encephalopathy (MIEP) is a rare but potentially reversible disease. The mechanism of MIEP remains unclear, and differences in the neurotoxic effects of oral versus intravenous (IV) metronidazole administration have not yet been determined. We report the case of a Crohn's disease (CD) patient who experienced encephalopathy immediately after a single IV dose of metronidazole following long-term exposure to the oral form of the drug...
January 2017: Intestinal Research
https://www.readbyqxmd.com/read/28191024/recent-trends-in-pharmacological-activity-of-alkaloids-in-animal-colitis-potential-use-for-inflammatory-bowel-disease
#16
REVIEW
Ana Cristina Alves de Almeida, Felipe Meira de-Faria, Ricardo José Dunder, Luis Paulo Bognoni Manzo, Alba Regina Monteiro Souza-Brito, Anderson Luiz-Ferreira
Inflammatory bowel disease (IBD) is a chronic and disrupted inflammation of the gastrointestinal tract. IBD have two main conditions, Crohn's disease and ulcerative colitis, and have been extensively investigated in recent years. Antibiotics derived from salicylates, steroids, immunosuppressors, and anti-TNF therapy are part of the therapeutic arsenal for IBD. However, very often patients stop responding to treatments over the time. In this context, searching for alternative agents is crucial for IBD clinical management...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28161290/safety-of-treatments-for-inflammatory-bowel-disease-clinical-practice-guidelines-of-the-italian-group-for-the-study-of-inflammatory-bowel-disease-ig-ibd
#17
Livia Biancone, Vito Annese, Sandro Ardizzone, Alessandro Armuzzi, Emma Calabrese, Flavio Caprioli, Fabiana Castiglione, Michele Comberlato, Mario Cottone, Silvio Danese, Marco Daperno, Renata D'Incà, Giuseppe Frieri, Walter Fries, Paolo Gionchetti, Anna Kohn, Giovanni Latella, Monica Milla, Ambrogio Orlando, Claudio Papi, Carmelina Petruzziello, Gabriele Riegler, Fernando Rizzello, Simone Saibeni, Maria Lia Scribano, Maurizio Vecchi, Piero Vernia, Gianmichele Meucci, Massimo Rugge
Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn's disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs...
April 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28155620/nlrp3-inhibitors-as-potential-therapeutic-agents-for-treatment-of-inflammatory-bowel-disease
#18
Agampodi Promoda Perera, Dale Kunde, Rajaraman Eri
BACKGROUND: Inflammatory bowel disease (IBD) is a group of intestinal disorders characterised by chronic relapsing inflammation of the small intestine and colon. IBD manifests as either ulcerative colitis or Crohn's disease and increases the risk of developing colorectal cancer. METHODS: Here, we have reviewed current treatment regimen for IBD utilising anti-inflammatory drugs, immune system suppressors and antibiotics or a combination of these. However, these therapeutics lead to a number of adverse effects, remission or significant non-responsiveness creating an urgent need to develop potent drugs with novel mechanisms of action for IBD...
February 1, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28127561/metastatic-crohn-s-disease-an-approach-to-an-uncommon-but-important-cutaneous-disorder
#19
REVIEW
Babak Aberumand, Jessica Howard, John Howard
Objective. To provide physicians with a clinical approach to metastatic Crohn's disease (MCD). Main Message. Metastatic Crohn's disease, defined as skin lesions present in areas noncontiguous with the gastrointestinal tract, is the rarest cutaneous manifestation of Crohn's disease. MCD lesions vary in morphology and can arise anywhere on the skin. MCD presents equally in both sexes and across age groups. Cutaneous findings may precede, develop concurrently with, or follow gastrointestinal involvement. A detailed history and thorough physical examination including a full-skin exam may help to exclude other dermatoses, as MCD can mimic other common disorders...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28117024/natural-therapies-of-the-inflammatory-bowel-disease-the-case-of-rutin-and-its-aglycone-quercetin
#20
Solomon Habtemariam, Abebech Belai
Inflammatory bowel disease (IBD), commonly represented by ulcerative colitis and Crohn's disease, is a form of chronic inflammatory disorders of the gastrointestinal system. Its current drug treatment include the use of antibiotics, 5-aminosalicylates, corticosteroids, immune-modifying agents and biologics such as anti-TNF agents and adhesion molecules blockers. These drugs have inherent problems of efficacy as many IBD sufferers need surgical intervention at some stage, high cost especially for the protein-based drugs, loss of efficacy and unwanted side effects...
January 20, 2017: Mini Reviews in Medicinal Chemistry
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