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Crohn Disease: HELP
Articles by Mitchell Bernstein
Based on 2 articles published since 2010
(Why 2 articles?)
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Between 2010 and 2020, Mitchell Bernstein wrote the following 2 articles about Crohn Disease.
 
+ Citations + Abstracts
1 Article Alvimopan for the Prevention of Postoperative Ileus in Inflammatory Bowel Disease Patients. 2020

Jang, Janice / Kwok, Benjamin / Zhong, Hua / Xia, Yuhe / Grucela, Alexis / Bernstein, Mitchell / Remzi, Feza / Hudesman, David / Chen, Jingjing / Axelrad, Jordan / Chang, Shannon. ·Division of Gastroenterology and Hepatology, New York University Langone Health, 240 East 38th Street, 23rd Floor, New York, NY, 10016, USA. · Department of Internal Medicine, New York University Langone Health, New York, NY, USA. · Department of Population Health, New York University Langone Health, New York, NY, USA. · Department of Surgery, New York University Langone Health, New York, NY, USA. · Department of Internal Medicine, Stanford University Medical Center, Stanford, CA, USA. · Division of Gastroenterology and Hepatology, New York University Langone Health, 240 East 38th Street, 23rd Floor, New York, NY, 10016, USA. Shannon.Chang@nyulangone.org. ·Dig Dis Sci · Pubmed #31522323.

ABSTRACT: BACKGROUND: Postoperative ileus (POI) is a temporary delay of coordinated intestinal peristalsis. Alvimopan, an oral peripherally acting mu-opioid receptor antagonist approved for accelerating gastrointestinal recovery, has never been studied specifically in patients with inflammatory bowel disease (IBD). AIM: To investigate the efficacy of alvimopan in preventing POI among IBD patients. METHODS: A retrospective chart review was conducted on 246 IBD patients undergoing bowel surgery between 2012 and 2017. Data collected included demographics, IBD subtype, length of stay (LOS), postoperative gastrointestinal symptoms, and administration of alvimopan. The primary outcome was POI; secondary gastrointestinal recovery outcomes were: time to first flatus, time to first bowel movement, time to tolerating a liquid diet, time to tolerating solid food, and LOS. RESULTS: When compared with the control group, patients in the alvimopan group had shorter times to tolerating liquids and solids, first flatus, and first bowel movements (p < 0.01). LOS was shorter in the alvimopan group when compared with controls (p < 0.01). The overall incidence of POI was higher in controls than in the alvimopan group (p = 0.07). For laparoscopic surgeries, the incidence of POI was also higher in controls than in the alvimopan group (p < 0.01). On multivariable analysis, alvimopan significantly decreased time to all gastrointestinal recovery endpoints when compared to controls (p < 0.01). CONCLUSIONS: Alvimopan is effective in accelerating time to gastrointestinal recovery and reducing POI in IBD patients. While the benefits of alvimopan have been demonstrated previously, this is the first study of the efficacy of alvimopan in IBD patients.

2 Article Factors Associated with Short-Term Morbidity in Patients Undergoing Colon Resection for Crohn's Disease. 2018

Aydinli, H Hande / Aytac, Erman / Remzi, Feza H / Bernstein, Mitchell / Grucela, Alexis L. ·Department of Surgery, Division of Colon and Rectal Surgery, Department of Colorectal Surgery, New York University Langone Medical Center, 530 First Ave Suite 7V, New York, NY, 10016, USA. · Department of Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey. · Department of Surgery, Division of Colon and Rectal Surgery, Department of Colorectal Surgery, New York University Langone Medical Center, 530 First Ave Suite 7V, New York, NY, 10016, USA. Alexis.Grucela@nyumc.org. ·J Gastrointest Surg · Pubmed #29663305.

ABSTRACT: BACKGROUND: Patients undergoing colon resection for Crohn's disease are at risk of developing postoperative complications. The aim of this study is to identify factors associated with short-term (30-day) morbidity in patients undergoing colon resection for Crohn's disease from a national database. METHODS: Patients who underwent colon resection for Crohn's disease in 2015 were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. The groups were classified based on presence of postoperative 30-day complications. The overall morbidity was calculated by including patients who had at least one postoperative complication. Demographics, preoperative, and operative factors were assessed and compared between the two groups. Further multivariate logistic regression analysis was conducted. RESULTS: A total of 1643 patients met the inclusion criteria [mean age of 41.2 (± 15.5) years, 871 (53%) female]. Sixty percent (n = 993) of the procedures were performed laparoscopically and 128 (12.8%) cases were converted to open. Ninety-five patients (5%) underwent emergent resections. Thirty percent (n = 507) of patients had at least one postoperative complication within 30 days of surgery. Ileus (16%), transfusion (7%), and organ-space surgical site infection (6%) were the most common morbidities. Independent risk factors for postoperative morbidity were male gender (p = 0.01), open surgery (p = 0.002), preoperative severe anemia (p = 0.001), and preoperative weight loss (p = 0.04). CONCLUSION: Approximately one third of the patients who undergo colon resection for Crohn's disease experience postoperative complications. Preoperative optimization of nutrition and anemia may improve outcomes. Laparoscopic technique appears to be the preferred surgical treatment option for resection when feasible.