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Crohn Disease HELP
Based on 13,580 articles published since 2009
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These are the 13580 published articles about Crohn Disease that originated from Worldwide during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
451 Review The importance of the polymorphisms of the ABCB1 gene in disease susceptibility, behavior and response to treatment in inflammatory bowel disease: A literature review. 2018

Petryszyn, Paweł W / Wiela-Hojeńska, Anna. ·Department of Clinical Pharmacology, Wroclaw Medical University, Poland. ·Adv Clin Exp Med · Pubmed #30412370.

ABSTRACT: Crohn's disease (CD) and ulcerative colitis (UD) are the 2 common clinical subtypes of idiopathic inflammatory bowel disease (IBD) characterized by chronic inflammation of the gastrointestinal tract. The multifactorial etiology and pathogenesis of IBD is still unknown; however, the interaction between genetic, environmental and immunological factors seems to be crucial. A member of the adenosine triphosphate (ATP)-binding cassette family, P-glycoprotein, encoded by the human ABCB1 gene, is among the most extensively studied transporters involved in drug disposition and effects. Single nucleotide polymorphisms (SNPs) located in exons 21, 26 and 12, i.e., G2677T/A, C3435T and C1236T, are of the greatest clinical importance. Functional defects of the intestinal epithelial barrier due to the lack of P-glycoprotein expression may constitute possible reasons for the development of colitis. Given that several drugs central to the therapy of IBD are also P-glycoprotein substrates, it has been hypothesized that its altered expression in IBD patients could modify the response to medical treatment. Nevertheless, there are conflicting reports of an association between these 3 SNPs and IBD. This article aims to review all relevant studies investigating the role of the polymorphisms of the ABCB1 gene in disease susceptibility, behavior and response to treatment in IBD.

452 Review Lipid and Bile Acid Dysmetabolism in Crohn's Disease. 2018

Uchiyama, Koji / Kishi, Hisashi / Komatsu, Wataru / Nagao, Masanori / Ohhira, Shuji / Kobashi, Gen. ·Laboratory of International Environmental Health, Center for International Cooperation, Dokkyo Medical University, Tochigi 321-0293, Japan. · Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan. ·J Immunol Res · Pubmed #30402511.

ABSTRACT: Crohn's disease is one of the systemic autoimmune diseases. It commonly affects the small intestine and colon but may involve any portion of the gastrointestinal tract from the mouth to the anus. The most affected area by Crohn's disease is the distal part of the small intestine, in which the bile acid molecules are most efficiently reabsorbed. Bile acids form mixed micelles together with fatty acids, which function as a transport vehicle to deliver fatty acids to the apical membrane of enterocytes for absorption. Therefore, if the terminal ileum is impaired, bile acid malabsorption may occur, which may cause congenital diarrhoea in Crohn's disease. Similarly, the impairment of the terminal ileum also induces fatty acid malabsorption, which may influence the role of fatty acids in Crohn's disease. In contrast, a recent study reported that multidrug resistance protein 1 (MDR1) regulated effector T-cell function in the ileum from bile acid-driven oxidative stress and MDR1 loss of function in a subset of patients with Crohn's disease. However, the role of consumption of fatty acids in Crohn's disease remains to be fully elucidated. This review is aimed at providing an overview of some recent developments in research of Crohn's disease from comprehensive perspective with a focus on the connection between disease location and behaviour, lipid diets, and bile acid malabsorption.

453 Review [ESTABLISHING A REGISTRY FOR INFLAMMATORY BOWEL DISEASE PATIENTS IN MACCABI HEALTHCARE SERVICES - JOINT PROJECT BETWEEN HOSPITALS, EPI-IIRN GROUP AND COMMUNITY MEDICINE]. 2018

Kariv, Revital / Turner, Dan / Rosenblum, Joseph / Morad, Vered / Zigman, Nir / Friedman, Mira / Focht, Gili / Leder, Oren / Avitzour, Malka / Goren, Iris. ·Health Division, Maccabi Healthcare Services. · Department of Gastroenterology, Tel Aviv Sourasky Medical Center. · Faculty of Medicine, Tel Aviv University. · The Juliet Keiden Institute of Pediatric Gastroenterology and Nutrition Shaare Zedek Medical Center, the Hebrew University of Jerusalem. · Medical Informatics, Maccabi Healthcare Services. ·Harefuah · Pubmed #30343545.

ABSTRACT: INTRODUCTION: Inflammatory bowel diseases (IBD) are becoming a significant cause for chronic long term complex morbidity, particularly among adolescents and young adults. IBD patients require multidisciplinary management and considerable health resources. Recent advances and developments in the diagnostics and therapeutic options require identification and tight monitoring of these patients at both hospital and community level for better management and care. AIMS: To establish at Maccabi Healthcare Services (MHS) a dedicated registry for inflammatory bowel disease patients for long term monitoring in order to optimize care, better use of health resources and to promote high quality research. METHODS: A national project, initiated and headed by a team from Shaare Zedek Medical Center aimed to resolve the complexity in identifying IBD patients at the community setting. The project included data from all Israeli HMOs and major hospitals, that was incorporated into various algorithms to determine prevalence and incidence and to distinguish between Crohn's disease and ulcerative colitis diagnoses. Eventually, an algorithm that includes the number of diagnoses, number of purchases and duration of IBD-related medications showed the best results for separating those that suffer from IBD and those that do not. This algorithm was further validated by chart review. RESULTS: According to the established registry criteria there were 14488 IBD patients in MHS, 13000 active. Additionally we have established an ongoing platform for ongoing monitoring of clinical, therapeutic, laboratory and imaging information. DISCUSSION: Establishing an IBD registry in MHS was enabled by a national project that combined deep professional knowledge of the disease by leading academic centers together with advanced informatics and community large data. We now move on to operate the registry in real life, together with live monitoring of various parameters in order to promote excellent care, communication with patients, management and control and to enable prospective high quality research.

454 Review Fecal Calprotectin. 2018

Ayling, Ruth M / Kok, Klaartje. ·FRCPath Consultant Chemical Pathologist, Clinical Biochemistry, Pathology and Pharmacy Building, Royal London Hospital, London, United Kingdom. · MRCP Consultant Gastroenterologist, Barts Health NHS Trust, London, United Kingdom. ·Adv Clin Chem · Pubmed #30342711.

ABSTRACT: Calprotectin is a 36kDa member of the S100 family of proteins. It is derived predominantly from neutrophils and has direct antimicrobial effects and a role within the innate immune response. Calprotectin is found in various body fluids in proportion to the degree of any existing inflammation and its concentration in feces is about six times that of plasma. Measurement of fecal calprotectin is a useful surrogate marker of gastrointestinal inflammation. It has a high negative predictive value in ruling out inflammatory bowel disease (IBD) in undiagnosed, symptomatic patients and a high sensitivity for diagnosing the disease making it useful as a tool for prioritising endoscopy. In patients with known IBD, fecal calprotectin can be a useful tool to assist management, providing evidence of relapse or mucosal healing to enable therapy to be intensified or reduced. There are a number of commercial calprotectin assays with marked difference in performance as judged by external quality assessment and at present no standardised reference material exists. Various factors may affect results including age, medication and day to day variation. Laboratories should therefore be mindful of the characteristics of their own assay and factors that may affect results.

455 Review Ram's Horn Sign: Gastric antrum in Crohn's disease. 2018

Xiang, Hao / Han, Jason / Ridley, William E / Ridley, Lloyd J. ·Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia. · University of New England, Armidale, New South Wales, Australia. · Medical Imaging, University of Sydney, Sydney, New South Wales, Australia. ·J Med Imaging Radiat Oncol · Pubmed #30309108.

ABSTRACT: -- No abstract --

456 Review Darvadstrocel: A Review in Treatment-Refractory Complex Perianal Fistulas in Crohn's Disease. 2018

Scott, Lesley J. ·Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand. demail@springer.com. ·BioDrugs · Pubmed #30298387.

ABSTRACT: Darvadstrocel (Alofisel

457 Review Mesenchymal stromal cells in the treatment of perianal fistulas in Crohn's disease. 2018

Castro-Poceiro, Jesús / Fernández-Clotet, Agnès / Panés, Julián. ·Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain. ·Immunotherapy · Pubmed #30296868.

ABSTRACT: Significant unmet needs remain in patients with Crohn's disease and perianal fistulas. Mesenchymal stromal cells have potent immunomodulatory actions. The Phase II studies reported efficacy of local injection of mesenchymal stromal cells to achieve closure of fistulas. A Phase III trial demonstrated that in patients with Crohn's disease and refractory complex perianal fistulas, a single injection of 120 × 10

458 Review The risk for opportunistic infections in inflammatory bowel disease with biologics: an update. 2018

Borman, Zachary A / Côté-Daigneault, Justin / Colombel, Jean-Frédéric. ·a The Henry D. Janowitz Division of Gastroenterology , One Gustave L. Levy Place , New York , NY , USA. · b Gastroenterology Service , Centre Hospitalier de l'Université de Montréal (CHUM) , Montreal , Quebec , Canada. ·Expert Rev Gastroenterol Hepatol · Pubmed #30277409.

ABSTRACT: INTRODUCTION: Crohn's disease and Ulcerative Colitis are forms of inflammatory bowel disease (IBD), chronic diseases treated with medical and surgical therapy. Patients with IBD are treated with potent immunomodulatory agents, leading to immunosuppression, and the potential for opportunistic infections. In 2014, the ECCO guidelines were released to guide the prevention, diagnosis and treatment of a variety of these opportunistic infections. Since 2014, there have been a number of new agents released as well as a significant expansion in our knowledge of the safety profile of IBD medications. In this article, we review the literature after 2014 regarding opportunistic infections and updates on safety data. Areas covered: We review updates in immunomodulatory therapies for IBD and opportunistic infections since the 2014 ECCO guidelines were published. Expert commentary: The prevention, diagnosis, and treatment of opportunistic infections continue to evolve, as new drugs are approved, and the use of a combination of biologic agents are considered for therapy in clinical trials. What causes some patients to fail to respond to vaccination, or for others to develop severe infections, remains unclear. Improved risk stratification for opportunistic infections in IBD patients and updated ECCO 2014 guidelines would be of significant benefit.

459 Review Biosimilars in paediatric inflammatory bowel disease. 2018

Sieczkowska-Golub, Joanna / Jarzebicka, Dorota / Oracz, Grzegorz / Kierkus, Jaroslaw. ·The Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children's Memorial Health Institute, Warsaw 04-730, Poland. · The Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children's Memorial Health Institute, Warsaw 04-730, Poland. j.kierkus@med-net.pl. ·World J Gastroenterol · Pubmed #30254406.

ABSTRACT: The introduction of biological treatments has changed disease outcomes for patients with inflammatory bowel disease. Biologicals have high efficacy, and can induce and maintain remission after failed responses to conventional immunosuppressive and/or steroid therapy. The increasing occurrence of severe disease at diagnosis has resulted in infliximab being more often introduced as the first-line treatment in a "top-down" approach. Besides their favourable efficacy and safety profile, biologicals have one significant disadvantage, which is their high cost. This results in many patients stopping therapy prematurely, with the maintenance phase being too short. This often leads to disease exacerbation shortly after treatment cessation. Every newly started course of biological therapy can induce production of anti-drug antibodies, which can result in treatment failure and possible allergic/anaphylactic reactions. The introduction of biological biosimilars was intended to greatly reduce therapy costs thus increasing the availability of these agents to more patients. It was also anticipated that biosimilars would prevent premature termination of therapy. Analyses of paediatric data suggest that biosimilar infliximabs are equally effective as the reference infliximab. Safety patterns also seem to be similar. Paediatric experience places cost-therapy reductions at around 10%-30%.

460 Review Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment. 2018

Spiceland, Clayton M / Lodhia, Nilesh. ·Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC 29425, United States. · Division of Gastroenterology and Hepatology, University of North Carolina, Charlotte, NC 28204, United States. Nilesh.lodhia@atriumhealth.org. ·World J Gastroenterol · Pubmed #30254405.

ABSTRACT: Endoscopy plays a fundamental role in the diagnosis, management, and treatment of inflammatory bowel disease (IBD). Colonoscopy, flexible sigmoidoscopy, and esophagogastroduodenoscopy have long been used in the care of patients with IBD. As endoscopic technologies have progressed, tools such as endoscopic ultrasound, capsule endoscopy, and balloon-assisted enteroscopy have expanded the role of endoscopy in IBD. Furthermore, chromoendoscopy has enhanced our ability to detect dysplasia in IBD. In this review article, we will focus on the roles, indications, and limitations of these tools in IBD. We will also discuss the most commonly used endoscopic scoring systems, as well as special considerations in post-surgical patients. Lastly, we will discuss the role of endoscopy in the diagnosis and management of fistulae and strictures.

461 Review SB5: An Adalimumab Biosimilar. 2018

Frampton, James E. ·Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand. demail@springer.com. ·BioDrugs · Pubmed #30251234.

ABSTRACT: SB5 (Imraldi

462 Review Acute febrile neutrophilic dermatosis in a patient with Crohn's disease: case report and review of the literature. 2018

Skok, Pavel / Skok, Kristjan. ·Department of Gastroenterology, University Medical Centre Maribor, Maribor, Slovenia. · Faculty of Medicine, University of Maribor, Maribor, Slovenia. ·Acta Dermatovenerol Alp Pannonica Adriat · Pubmed #30244270.

ABSTRACT: Crohn's disease is a chronic inflammatory bowel disease. The disease is characterized by acute exacerbations with diarrhea, abdominal pain, fever, anorexia, intestinal bleeding, and weight loss. Immune-mediated diseases that are frequently associated with Crohn's disease include arthritis, ankylosing spondylitis, sacroiliitis, episcleritis, uveitis, and skin lesions, such as erythema nodosum and pyoderma gangrenosum. The authors present the case of a 22-year-old female patient that was admitted to their hospital due to diarrhea, fever, arthralgias, and diffuse erythematous papules and plaques with vesicles and pustules affecting the patient's face, lips, arms, trunk, and legs. Six months prior to onset, the patient was diagnosed with terminal ileitis and Crohn's disease of the sigmoid colon. Treatment with mesalazine and budesonide had been introduced. In the diagnostic procedure, a skin biopsy was taken from the patient. Histology confirmed dense infiltration of neutrophilic polymorphonuclear leukocytes, or Sweet's syndrome. This condition is a rare manifestation of chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. This syndrome is thought to be a hypersensitivity reaction and may be associated with various inflammatory, infectious, or neoplastic diseases. The patient was treated with high doses of methylprednisolone (60 mg IV), which resulted in rapid improvement of Crohn's disease and skin lesions.

463 Review [Crohn's disease-associated colorectal carcinogenesis : TP53 mutations and copy number gains of chromosome arm 5p as (early) markers of tumor progression]. 2018

Hirsch, D / Gaiser, T. ·Institut für Pathologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland. daniela.hirsch@umm.de. · Institut für Pathologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland. timo.gaiser@umm.de. ·Pathologe · Pubmed #30229283.

ABSTRACT: BACKGROUND: Patients with inflammatory bowel diseases, i. e., ulcerative colitis and Crohn's disease (CD), face an increased risk of developing colorectal cancer (CRC). Evidence, mainly from ulcerative colitis, suggests that TP53 mutations represent an initial step in the progression from inflamed colonic epithelium to CRC. OBJECTIVES: In this study, we aimed to analyze the genetic events that define CD-CRCs, in particular the dynamics of their development from histologically undetectable precursor lesions to invasive disease. MATERIALS AND METHODS: We analyzed 73 tissue samples from 28 patients with CD-CRC, including precursor lesions by next generation sequencing (563 gene panel) and array-based comparative genomic hybridization. The results were compared with our own data and the Cancer Genome Atlas data on sporadic CRC. RESULTS: The gain of 5p was significantly more prevalent in CD-CRCs than in sporadic CRCs, despite an overall similar chromosomal aberration pattern. CD-CRCs had a distinct mutation signature with TP53 being the most frequently mutated gene in CD-CRCs. TP53 mutations and copy number alterations were early events in CD progression and could sometimes already be detected in non-dysplastic colonic mucosa, indicating occult tumor evolution. CONCLUSIONS: Molecular profiling of CD-CRCs and precursor lesions revealed an inflammation-associated landscape of genome alterations: gains of 5p and TP53 mutations occurred early in tumor development. Detection of these aberrations in precursor lesions may help predict disease progression and distinguishes CD-associated from sporadic colorectal neoplasia.

464 Review Targeting IL-23 in Crohn's disease. 2018

Sedda, Silvia / Bevivino, Gerolamo / Monteleone, Giovanni. ·a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy. ·Expert Rev Clin Immunol · Pubmed #30223688.

ABSTRACT: INTRODUCTION: Interleukin (IL)-23, a cytokine produced by antigen presenting cells, targets both T cells and non-T cell types with the downstream effect of enhancing inflammatory pathways. Genome-wide association studies and data from human and mouse models of intestinal inflammation support the pathogenic role of IL-23 in Crohn's disease (CD), an immune-mediated disorder that can involve any part of the gastrointestinal tract. Areas covered: This review summarizes the available data on the role of IL-23 in CD and discusses the therapeutic relevance of blocking the function of IL-23 in this disorder. Expert commentary: The use of biologic drugs, such as anti-TNF and anti-integrins, has largely improved the management of CD patients. However, a significant proportion of CD patients taking these drugs continue to experience symptoms and have inflammation in the gut, thus suggesting a need for new agents, which block other inflammatory signals. Data emerging from trials with IL-23p40 and p19 blockers indicate that IL-23 is a valid therapeutic target. More studies are needed to optimize the therapeutic regimens, ascertain whether selective inhibition of IL-23p19 is more advantageous than blockade of p40, a subunit shared by IL-12 and IL-23, and evaluate the long-term risk of these approaches.

465 Review Assessment of thyroid cancer risk in more than 334,000 patients with inflammatory bowel disease: a case-control study and a meta-analysis. 2018

Cao, Lihong. ·Department of Ear-nose-throat, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China. caolihong2012@yeah.net. ·World J Surg Oncol · Pubmed #30200972.

ABSTRACT: BACKGROUND: Potential risk of thyroid cancer in patients with inflammatory bowel disease has not been well investigated. The aim of the study was to reveal the relationship between history of inflammatory bowel disease and risk of thyroid cancer. METHODS: First, 1392 patients with inflammatory bowel disease and 1392 controls were included in a case-control study. All patients did not receive immunosuppressive therapy. A multivariate logistic regression analysis was adopted to determine the relationship between history of inflammatory bowel disease and risk of thyroid cancer. Second, a literature search was performed and eight articles were collected. Pooled odds ratios with 95% confidence intervals were reported for relevant risk estimates in fixed or random effect model. RESULTS: In the case-control study, thyroid cancer was more common in patients with inflammatory bowel disease than in controls (P = 0.032). After Bonferroni correction, association of thyroid cancer risk with history of total inflammatory bowel disease or its two subtypes was not found. In the meta-analysis, patients with total inflammatory bowel disease or ulcerative colitis showed an increased risk of thyroid cancer, but patients with Crohn's disease did not. Furthermore, inflammatory bowel disease patients with immunosuppressive therapy showed an increased risk of the cancer, but patients without immunosuppressive therapy did not have this finding. CONCLUSIONS: Risk of thyroid cancer probably elevates in patients with inflammatory bowel disease. Inflammatory bowel disease (particularly ulcerative colitis) itself and use of immunosuppressant might contribute to the development of the cancer.

466 Review From bench to bedside: Fecal calprotectin in inflammatory bowel diseases clinical setting. 2018

Mumolo, Maria Gloria / Bertani, Lorenzo / Ceccarelli, Linda / Laino, Gabriella / Di Fluri, Giorgia / Albano, Eleonora / Tapete, Gherardo / Costa, Francesco. ·Department of General Surgery and Gastroenterology, Gastroenterology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa 56124, Italy. · Department of New Technologies and Translational Research in Medicine and Surgery, University of Pisa, Pisa 56122, Italy. · Department of General Surgery and Gastroenterology, Gastroenterology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa 56124, Italy. fcosta@med.unipi.it. ·World J Gastroenterol · Pubmed #30197475.

ABSTRACT: Fecal calprotectin (FC) has emerged as one of the most useful tools for clinical management of inflammatory bowel diseases (IBD). Many different methods of assessment have been developed and different cut-offs have been suggested for different clinical settings. We carried out a comprehensive literature review of the most relevant FC-related topics: the role of FC in discriminating between IBD and irritable bowel syndrome (IBS) and its use in managing IBD patients In patients with intestinal symptoms, due to the high negative predictive value a normal FC level reliably rules out active IBD. In IBD patients a correlation with both mucosal healing and histology was found, and there is increasing evidence that FC assessment can be helpful in monitoring disease activity and response to therapy as well as in predicting relapse, post-operative recurrence or pouchitis. Recently, its use in the context of a treat-to-target approach led to a better outcome than clinically-based therapy adjustment in patients with early Crohn's disease. In conclusion, FC measurement represents a cheap, safe and reliable test, easy to perform and with a good reproducibility. The main concerns are still related to the choice of the optimal cut-off, both for differentiating IBD from IBS, and for the management of IBD patients.

467 Review Caught in the Crossfire of the Syndemic. 2018

Dobbs, Gina / Fogger, Susanne A. ·Gina Dobbs, DNP, MSN, FNP-BC, CRNP, University of Alabama at Birmingham. Susanne A. Fogger, DNP, CRNP, PMHNP-BC, CARN-AP, FAANP, School of Nursing, University of Alabama at Birmingham. ·J Addict Nurs · Pubmed #30180008.

ABSTRACT: The worsening opioid epidemic ignites infectious disease development and transmission as opioids abused by insufflation and/or injection establish a pathway for infection to the user and propagate vulnerability to diseases. The phenomenon of the synergistic collision of epidemics intensifying the load of disease constitutes a syndemic. Merrill Signer (1994) voiced the term "syndemic" to characterize the complex nexus of politics, economics, psychosocial/environmental factors, and health disparities resulting in the inner-city AIDS crisis of the 1990s. Today, the surge of opioid use puts individuals at risk for disease transmission and living the catastrophic clash wrought by the epidemics. By following a case study caught in the crossfire of epidemics, this article prompts to underscore recognition of the at-risk patient for HIV infection and to embolden care integration of prevention and treatment strategies nurses are qualified to execute.

468 Review Positioning of old and new biologicals and small molecules in the treatment of inflammatory bowel diseases. 2018

Reinglas, Jason / Gonczi, Lorant / Kurt, Zsuzsanna / Bessissow, Talat / Lakatos, Peter L. ·Department of Gastroenterology, McGill University Health Center, Montreal, Québec H4A 3J1, Canada. · First Department of Medicine, Semmelweis University, H-1083, Budapest, Koranyi S. 2A, Hungary. ·World J Gastroenterol · Pubmed #30166855.

ABSTRACT: The past decade has brought substantial advances in the management of inflammatory bowel diseases (IBD). The introduction of tumor necrosis factor (TNF) antagonists, evidence for the value of combination therapy, the recognition of targeting lymphocyte trafficking and activation as a viable treatment, and the need for early treatment of high-risk patients are all fundamental concepts for current modern IBD treatment algorithms. In this article, authors review the existing data on approved biologicals and small molecules as well as provide insight on the current positioning of approved therapies. Patient stratification for the selection of specific therapies, therapeutic targets and patient monitoring will be discussed as well. The therapeutic armamentarium for IBD is expanding as novel and more targeted therapies become available. In the absence of comparative trials, positioning these agents is becoming difficult. Emerging concepts for the future will include an emphasis on the development of algorithms which will facilitate a greater understanding of the positioning of novel biological drugs and small molecules in order to best tailor therapy to the patient. In the interim, anti-TNF therapy remains an important component of IBD therapy with the most real-life evidence and should be considered as first-line therapy in patients with complicated Crohn's disease and in acute-severe ulcerative colitis. The safety and efficacy of these 'older' anti-TNF therapies can be optimized by adhering to therapeutic algorithms which combine clinical and objective markers of disease severity and response to therapy.

469 Review Trichuris suis ova therapy in inflammatory bowel disease: A meta-analysis. 2018

Huang, Xing / Zeng, Li-Rong / Chen, Feng-Song / Zhu, Jing-Ping / Zhu, Meng-Hua. ·Digestive Endoscopy Center. · Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan. · Department of Gastroenterology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei. · Department of Gastroenterology. · Department of Intensive Care Unit, Haimen People's Hospital, Haimen, Nantong, Jiangsu, P.R. China. ·Medicine (Baltimore) · Pubmed #30142867.

ABSTRACT: BACKGROUND: In recent years, Trichuris suis ova (TSO) therapy in inflammatory bowel disease (IBD) has attracted much attention. However, efficacy and safety of TSO therapy are still not well described. The aim of the study was to perform a meta-analysis to assess the effectiveness of TSO therapy in IBD. METHODS: PubMed, Embase, Web of Science, ClinicalTrials.gov, and Cochrane Library were searched from inception to August 2017. Only randomized, double-blind, placebo-controlled trials (RCTs) were included. The pooled estimate rates were performed by meta-analysis and reported according to the standard Cochrane guidelines and the PRISMA statement. RESULTS: In ulcerative colitis study (3 RCTs, n = 74), the induced rates of clinical remission and clinical response were 10.8% (4/37) and 53.8% (21/39) in TSO group, while 6.7% (2/30) and 29.0% (9/31) in placebo group (all P > .26). Twenty-two (9/41) percent of patients in TSO group experienced at least 1 adverse event compared with 27.3% (9/33) of placebo [relative ratio (RR) 0.75, 95% confidence interval (95% CI) 0.17-3.27]. In Crohn disease study (3 RCTs, n = 538), 40.7% (74/182) of patients in TSO group achieved clinical remission compared with 42.9% (90/210) of placebo (RR 0.95, 95% CI 0.75-1.20); 45.9% (141/307) of patients in TSO group entered clinical response compared with 45.1% (151/335) of placebo (RR 1.02, 95% CI 0.86-1.21). There were sparse data of adverse events reporting both TSO and placebo group (RR 1.00, 95% CI 0.88-1.13). CONCLUSION: TSO therapy showed no statistical benefit for IBD patients, so it suggested clinicians consider its value carefully before putting into clinical practice. Perhaps continued investigations of larger sample size are necessary due to the previous results with lack of power.

470 Review Interdisciplinary Updates in Crohn's Disease Reporting Nomenclature, and Cross-Sectional Disease Monitoring. 2018

Baker, Mark E / Fletcher, Joel G / Al-Hawary, Mahmoud / Bruining, David. ·Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue - L10, Cleveland, OH 44195, USA. Electronic address: bakerm@ccf.org. · Department of Radiology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. · Department of Radiology, Michigan Medicine, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 489109, USA. · Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. ·Radiol Clin North Am · Pubmed #30119768.

ABSTRACT: Computed tomography enterography and magnetic resonance enterography are essential in the evaluation and treatment of patients with Crohn's disease. As such, examination reporting must use standardized nomenclature for effective communication. This report documents an interdisciplinary consensus of the Society of Abdominal Radiology, the Society of Pediatric Radiology, and the American Gastroenterology Association on the computed tomography enterography/magnetic resonance enterography imaging findings and imaging-based morphologic phenotypes.

471 Review Magnetic Resonance Enterography for Inflammatory and Noninflammatory Conditions of the Small Bowel. 2018

Khatri, Gaurav / Coleman, Jay / Leyendecker, John R. ·Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA. · Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA. Electronic address: John.Leyendecker@utsouthwestern.edu. ·Radiol Clin North Am · Pubmed #30119767.

ABSTRACT: Magnetic resonance enterography (MRE) is an effective noninvasive tool for evaluation of inflammatory and noninflammatory conditions of the small bowel. MRE allows for repeated evaluation of patients with Crohn disease without exposure to ionizing radiation, and can be used to assess disease status and direct management. MRE also allows evaluation of neoplastic and other nonneoplastic conditions of the small bowel. Adequate patient preparation and acquisition techniques are required for optimal image quality.

472 Review Computed Tomography and Magnetic Resonance Small Bowel Enterography: Current Status and Future Trends Focusing on Crohn's Disease. 2018

Park, Seong Ho / Ye, Byong Duk / Lee, Tae Young / Fletcher, Joel G. ·Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. Electronic address: parksh.radiology@gmail.com. · Department of Gastroenterology, Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. · Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. · Department of Radiology, Mayo Clinic, 200 First Street, Southwest, Rochester, MN 55905, USA. ·Gastroenterol Clin North Am · Pubmed #30115433.

ABSTRACT: Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are presently state-of-the-art radiologic tests used to examine the small bowel for various indications. This article focuses on CTE and MRE for the evaluation of Crohn disease. The article describes recent efforts to achieve more standardized interpretation of CTE and MRE, summarizes recent research studies investigating the role and impact of CTE and MRE more directly for several different clinical and research issues beyond general diagnostic accuracy, and provides an update on progress in imaging techniques. Also addressed are areas that need further exploration in the future.

473 Review Resolution of chronic inflammatory disease: universal and tissue-specific concepts. 2018

Schett, Georg / Neurath, Markus F. ·Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nürnberg and Universitatsklinikum Erlangen, 91054, Erlangen, Germany. georg.schett@uk-erlangen.de. · Department of Internal Medicine 1, Friedrich-Alexander University Erlangen-Nürnberg and Universitatsklinikum Erlangen, 91054, Erlangen, Germany. ·Nat Commun · Pubmed #30111884.

ABSTRACT: Inflammation and its resolution is under-studied in medicine despite being essential for understanding the development of chronic inflammatory disease. In this review article, we discuss the resolution of inflammation in both a biological and translational context. We introduce the concept of impaired resolution leading to diseases like rheumatoid arthritis, Crohn's disease, and asthma, as well as the cellular and molecular components that contribute to resolution of joint, gut, and lung inflammation, respectively. Finally, we discuss potential intervention strategies for fostering the resolution process, and their implications for the therapy of inflammatory diseases.

474 Review [Ustekinumab - Current position]. 2018

Siegmund, Britta / Högenauer, Christoph / Novacek, Gottfried / Petritsch, Wolfgang / Reinisch, Walter / Schoepfer, Alain / Schreiber, Stefan / Vavricka, Stephan / Bokemeyer, Bernd / Anonymous1501386. ·Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin, Germany. · Klinische Abteilung für Gastroenterologie und Hepatologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Österreich. · Medizinische Universität Wien, Universitätsklinik für Innere Medizin III, Klinische Abteilung für Gastroenterologie und Hepatologie, Wien, Österreich/Austria. · Centre hospitalier universitaire vaudois, Service de gastro-énterologie et d'hépatologie, Lausanne, Schweiz. · Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel. · Zentrum für Gastroenterologie und Hepatologie, Zürich, Schweiz. · Gastroenterologische Gemeinschaftspraxis Minden. ·Z Gastroenterol · Pubmed #30103222.

ABSTRACT: The present review by the IBD-Dach group provides a comprehensive summary of the mode of action, clinical development, approval, efficacy and safety aspects of the novel anti-p40 antibody Ustekinumab. The review provides current data, including the large clinical trials as well as smaller case series and work outside the field of inflammatory bowel diseases for shedding more light into special situations. Together, the data indicate that Ustekinumab shows clinical efficacy as well as a good safety profile for the treatment of Crohn's disease.

475 Review Differential diagnosis of inflammatory bowel disease: imitations and complications. 2018

Gecse, Krisztina B / Vermeire, Severine. ·Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands. · Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium. Electronic address: severine.vermeire@uzleuven.be. ·Lancet Gastroenterol Hepatol · Pubmed #30102183.

ABSTRACT: Inflammatory bowel disease (IBD) is characterised by episodes of relapse and periods of remission. However, the clinical features, such as abdominal pain, diarrhoea, and rectal bleeding, are not specific. Therefore, the differential diagnosis can include a broad spectrum of inflammatory or infectious diseases that mimic IBD, as well as others that might complicate existing IBD. In this Review, we provide an overview of ileocolitis of diverse causes that are relevant in the differential diagnosis of IBD. We highlight the importance of accurate patient profiling and give a practical approach to identifying factors that should trigger the search for a specific cause of intestinal inflammation. Mimics of IBD include not only infectious causes of colitis-and particular attention is required for patients from endemic areas of tuberculosis-but also vascular diseases, diversion colitis, diverticula or radiation-related injuries, drug-induced inflammation, and monogenic diseases in very-early-onset refractory disease. A superinfection with cytomegalovirus or Clostridium difficile can aggravate intestinal inflammation in IBD, especially in patients who are immunocompromised. Special consideration should be made to the differential diagnosis of perianal disease.

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