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Crohns antibiotic treatment

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https://www.readbyqxmd.com/read/29471381/efficacy-of-vedolizumab-in-fistulising-crohn-s-disease-exploratory-analyses-of-data-from-gemini-2
#1
Brian G Feagan, David Schwartz, Silvio Danese, David T Rubin, Trevor W Lissoos, Jing Xu, Karen Lasch
Background and Aims: Medical management of fistulising Crohn's disease (CD) is constrained by the limited number of available therapies. We evaluated the efficacy of vedolizumab, a gut-selective α4β7 integrin antagonist approved for treating moderately to severely active CD, in a subpopulation of patients with fistulising CD who participated in the GEMINI 2 trial (NCT00783692). Methods: Exploratory analyses of data from the GEMINI 2 trial were conducted in 461 responders to 6-week vedolizumab induction therapy who received maintenance placebo (VDZ/PBO, N=153) or vedolizumab (VDZ/VDZ, N=308)...
February 17, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29453848/postoperative-recurrence-of-crohn-s-disease-pathophysiology-diagnosis-and-treatment
#2
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/29446723/immunomodulatory-effects-of-flavonoids-in-the-prophylaxis-and-treatment-of-inflammatory-bowel-diseases-a-comprehensive-review
#3
Daniela Ribeiro, Carina Proenca, Silvia Rocha, Jose L F C Lima, Felix Carvalho, Eduarda Fernandes, Marisa Freitas
Inflammatory bowel diseases (IBD) comprise two disorders of idiopathic chronic intestinal inflammation that affect about three million people worldwide: Crohn's disease and ulcerative colitis. Nowadays, the first-line of treatment for patients with mild to moderate symptoms of IBD comprises corticosteroids, immunosuppressants, antibiotics, and biological agents. Unfortunately, none of these drugs are curative, and their long-term use may cause severe side effects and complications. Almost 40% of IBD patients use alternative therapies to complement the conventional one, and flavonoids are gaining attention for this purpose...
February 14, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29417077/ciprofloxacin-use-in-hospitalized-children-approved-or-off-label
#4
Toktam Faghihi, Leila Yavari Tekmehdash, Mania Radfar, Kheirollah Gholami
Objective: Fluoroquinolones are not routinely used as the first-line antimicrobial therapy in pediatrics. The American Academy of Pediatrics (AAP) and the United States Food and Drug Administration (FDA) approved fluoroquinolones on certain indications in children. The aim of this study was to evaluate to what extent and how ciprofloxacin is used on approved indication or as off-label. Besides, dose adequacy and treatment duration were assessed. Methods: In a 10-month observational study, all children receiving systemic ciprofloxacin were assessed...
October 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29415186/microbial-spectrum-of-intra-abdominal-abscesses-in-perforating-crohn-s-disease-results-from-a-prospective-german-registry
#5
P A Reuken, W Kruis, C Maaser, N Teich, J Büning, J C Preiß, R Schmelz, T Bruns, S Fichtner-Feigl, A Stallmach
Background: Intra-abdominal abscesses (IAA) are common life threatening complications in patients with Crohn's disease (CD). In addition to interventional drainage and surgical therapy, empirical antibiotic therapy represents a corner stone of treatment but contemporary data on microbial spectra and antimicrobial resistance are scarce. Methods: We recruited 105 patients with CD and IAA from 9 German centers for a prospective registry in order to characterize the microbiological spectrum, resistance profiles, antibiotic therapy and outcome...
February 5, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29374617/efficacy-of-medical-therapies-for-fistulizing-crohn-s-disease-systematic-review-and-meta-analysis
#6
REVIEW
Matthew J Lee, Claire E Parker, Sarah R Taylor, Leonardo Guizzetti, Brian G Feagan, Alan J Lobo, Vipul Jairath
BACKGROUND & AIMS: Fistulas are debilitating complications of Crohn's disease (CD) that affect up to 50% of patients. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of treatments for fistulizing CD. METHODS: We searched publication databases from inception through December 13, 2016 for trials comparing the efficacy of a therapeutic agent (single or combination) with placebo or another active therapy in adult patients with any form of fistulizing CD...
January 25, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29361089/differential-susceptibility-to-t-cell-induced-colitis-in-mice-role-of-the-intestinal-microbiota
#7
Cynthia Reinoso Webb, Hendrik den Bakker, Iurii Koboziev, Yava Jones-Hall, Kameswara Rao Kottapalli, Dmitry Ostanin, Kathryn L Furr, Qinghui Mu, Xin M Luo, Matthew B Grisham
One of the best characterized mouse models of the inflammatory bowel diseases (IBD; Crohn's disease, ulcerative colitis) is the CD4+CD45RBhigh T cell transfer model of chronic colitis. Following our relocation to Texas Tech University Health Sciences Center (TTUHSC), we observed a dramatic reduction in the incidence of moderate-to-severe colitis from a 16-year historical average of 90% at Louisiana State University Health Sciences Center (LSUHSC) to <30% at TTUHSC. We hypothesized that differences in the commensal microbiota at the 2 institutions may account for the differences in susceptibility to T cell-induced colitis...
January 18, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29282051/microbiota-dysbiosis-in-inflammatory-bowel-diseases-in-silico-investigation-of-the-oxygen-hypothesis
#8
Michael A Henson, Poonam Phalak
BACKGROUND: Inflammatory bowel diseases (IBD), which include ulcerative colitis and Crohn's disease, cause chronic inflammation of the digestive tract in approximately 1.6 million Americans. A signature of IBD is dysbiosis of the gut microbiota marked by a significant reduction of obligate anaerobes and a sharp increase in facultative anaerobes. Numerous experimental studies have shown that IBD is strongly correlated with a decrease of Faecalibacterium prausnitzii and an increase of Escherichia coli...
December 28, 2017: BMC Systems Biology
https://www.readbyqxmd.com/read/29127201/loss-of-the-mucosal-barrier-alters-the-progenitor-cell-niche-via-jak-stat-signaling
#9
Liping Zhang, Katharina Ribbeck, Bradley Turner, Kelly G Ten Hagen
The mucous barrier of our digestive tract is the first line of defense against pathogens and damage. Disruptions in this barrier are associated with diseases such as Crohn's disease, colitis and colon cancer, but mechanistic insights into these processes and diseases are limited. We have previously shown that loss of a conserved O-glycosyltransferase (PGANT4) in Drosophila results in aberrant secretion of components of the peritrophic/mucous membrane in the larval digestive tract. Here, we show that loss of pgant4 disrupts the mucosal barrier, resulting in epithelial expression of the IL-6-like cytokine Upd3, leading to activation of JAK/STAT signaling, differentiation of cells that form the progenitor cell niche and abnormal proliferation of progenitor cells...
November 10, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29038892/-pityriasis-amiantacea-and-folliculitis-decalvans-an-unusual-manifestation-associated-with-antitumor-necrosis-factor-%C3%AE-therapy
#10
M Zamperetti, B Zelger, R Höpfl
We report on a 21-year-old woman with a 3-year history of crusts and erosions on her scalp that had appeared after starting treatment with adalimumab due to Crohn's disease. By clinicopathological correlation pityriasis amiantacea with underlying folliculitis decalvans was diagnosed. Topical and systemic antibiotic treatment showed rapid response. The occurrence of pityriasis amiantacea in folliculitis decalvans associated with tumor necrosis factor (TNF)-α inhibitor therapy is remarkable and highlights the ambivalent role of TNF-α in diseases with immunological dysfunctions in combination with infections...
October 16, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28980821/enteral-nutrition-is-associated-with-a-decreased-risk-of-surgical-intervention-in-crohn-s-disease-patients-with-spontaneous-intra-abdominal-abscess
#11
Xiao-Bin Zheng, Xiang Peng, Xiao-Yu Xie, Lei Lian, Xian-Rui Wu, Jian-Cong Hu, Xiao-Wen He, Jia Ke, Yu-Feng Chen, Min Zhi, Xiao-Jian Wu, Xiao-Sheng He, Ping Lan
BACKGROUND: The impact of enteral nutrition (EN) on surgical risk in Crohn's disease (CD) patients suffering from spontaneous intra-abdominal abscess (IAA) was evaluated. METHODS: CD patients diagnosed with spontaneous IAA from 2008 to 2015 were included in the study. The impact of EN on surgical risk was evaluated using both univariate and multivariate analyses. RESULTS: A total of 87 patients were enrolled, 66 (75.9%) were male. The mean age at the development of an abscess was 30...
October 5, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28945635/comparison-of-stromal-vascular-fraction-with-or-without-a-novel-bioscaffold-to-fibrin-glue-in-a-porcine-model-of-mechanically-induced-anorectal-fistula
#12
Gerald W Dryden, Eugene Boland, Vijay Yajnik, Stuart Williams
BACKGROUND: Anorectal fistulas (ARFs) are a common, devastating, event in the life of a patient with Crohn's disease. ARFs occur in up to 50% of patients with Crohn's disease. Treatment begins with surgical drainage of the initial abscess, followed by antibiotic therapy, then anti-inflammatory medications. If medical therapy fails to close the fistula tract, surgical intervention is often pursued. Surgery incurs risk of incontinence because of sphincter injury. Increasingly, the role of cell-based therapy is being investigated in ARFs...
November 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28858069/comparison-of-health-care-utilization-and-costs-between-patients-with-perianal-fistulizing-crohn-s-disease-treated-with-biologics-with-or-without-previous-seton-placement
#13
David A Schwartz, Anthony Wang, Burak Ozbay, Martha Skup, Samantha F Eichner, Jay Lin, Jingdong Chao
BACKGROUND: Fistulas are a common and often debilitating complication of Crohn's disease (CD). Tumor necrosis factor inhibitors and/or seton drainage are effective treatment options. We compared health care utilization and costs for patients with perianal CD who had setons placed before treatment with biologics versus those who did not. METHODS: Patients with CD (≥18 yr) were identified from the Truven Health MarketScan Database by ICD-9 code 555.x (January 1, 2006-March 31, 2015); those with external fistulas were identified by ICD-9 codes 565...
October 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28838414/interdisciplinary-management-of-perianal-crohn-s-disease
#14
REVIEW
Amy L Lightner, William A Faubion, Joel G Fletcher
Perianal disease is a common manifestation of Crohn disease (CD) that results in significant morbidity and decreased quality of life. Despite several medical and surgical options, complex perianal CD remains difficult to treat. Before the advent of biologic therapy, antibiotics were the mainstay of medical treatment. Infliximab remains the most well-studied medical therapy for perianal disease. Surgical interventions are limited by the risk of nonhealing wounds and potential incontinence. When treatment options fail, fecal diversion or proctectomy may be necessary...
September 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28703786/fistulizing-crohn-s-disease
#15
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
#16
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
#17
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...
November 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28639073/prognostic-factors-affecting-outcomes-in-fistulating-perianal-crohn-s-disease-a-systematic-review
#18
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
#19
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...
September 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
#20
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
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