Inflammatory bowel diseases
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Inflamm. Bowel Dis. · Aug 2013
High rates of metachronous colon cancer or dysplasia after segmental resection or subtotal colectomy in Crohn's colitis.
In ulcerative colitis, total proctocolectomy is the treatment of choice for patients with colonic dysplasia or cancer because of the high risk for metachronous neoplasia. It is unknown whether patients with Crohn's disease and colon cancer or dysplasia have a similar risk. ⋯ The high rate of metachronous colon cancer after surgical resection suggests that total proctocolectomy should be considered. Larger studies are required to determine if the same is true for dysplasia.
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Inflamm. Bowel Dis. · Jul 2013
Randomized Controlled Trial Multicenter Study Comparative Study52-week efficacy of adalimumab in patients with moderately to severely active ulcerative colitis who failed corticosteroids and/or immunosuppressants.
The results of an open-label follow-up until week 52 of patients with moderately to severely active ulcerative colitis who participated in a double-blind placebo-controlled adalimumab induction trial (ULTRA 1, NCT00385736) are reported. ⋯ In this open-label study, adalimumab was effective for maintaining clinical remission in anti-tumor necrosis factor-naive patients with moderately to severely active ulcerative colitis who did not adequately respond to conventional therapy.
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Inflamm. Bowel Dis. · Jul 2013
Randomized Controlled Trial Multicenter StudyIron deficiency generates secondary thrombocytosis and platelet activation in IBD: the randomized, controlled thromboVIT trial.
Secondary thrombocytosis is a common clinical feature. In patients with cancer, it is a risk factor for venous thromboembolic events. In inflammatory bowel disease (IBD), thrombocytosis is so far considered a marker of active disease and may contribute to the increased thromboembolic risk in this population. Observed effects of iron therapy on normalization of platelet counts led us to hypothesize that iron itself may regulate megakaryopoiesis. Here, we want to test the effect of iron replacement on platelet count and activity in IBD-associated thrombocytosis. ⋯ FCM lowers platelet counts and platelet activation in patients with IBD-associated secondary thrombocytosis.
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Inflamm. Bowel Dis. · Jun 2013
Comparative StudyDysmenorrhea in women with Crohn's disease: a case-control study.
Dysmenorrhea and Crohn's disease (CD) have overlapping symptoms; however, their relationship is poorly understood. The aims of this study were to examine (1) the impact of dysmenorrhea on pain severity and pain medication use in CD and (2) the relationships between dysmenorrhea, CD activity, and health-related quality of life (HRQOL). ⋯ Dysmenorrhea is common in women with CD and has an additive effect on overall pain severity. It is not, however, associated with greater nonsteroidal anti-inflammatory drug use. Menstrual distress is positively correlated with CD activity scores and associated with lower HRQOL by some measures. Treatment of dysmenorrhea may improve the pain experienced by women with CD, the perception of CD activity, and the quality of life in women with CD.
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Inflamm. Bowel Dis. · May 2013
Chronic pain in inflammatory bowel disease: characteristics and associations of a hospital-based cohort.
Chronic pain (CP) is a common symptom in patients with inflammatory bowel disease. This study aimed to examine its prevalence, severity, clinical associations, and impact on psychological well-being and to identify patient factors that independently predict the presence of severe/disabling pain. ⋯ CP has major effects on quality of life and functional and social outcomes. Active disease and maladaptive coping strategies and negative attitudes and beliefs toward symptoms are independently associated with more severe pain. Management strategies should move the focus away from analgesic dependence toward psychosocial intervention and nonpharmacologic therapy.