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[PMID]: 29438165
[Au] Autor:Louie CY; Gomez AJ; Sibley RK; Bass D; Longacre TA
[Ad] Address:Department of Pathology, Veterans Affairs Palo Alto Health Care System, Palo Alto.
[Ti] Title:Histologic Features of Gastrointestinal Tract Biopsies in IgA Vasculitis (Henoch-Schönlein Purpura).
[So] Source:Am J Surg Pathol;42(4):529-533, 2018 Apr.
[Is] ISSN:1532-0979
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Immunoglobulin A (IgA) vasculitis or Henoch-Schönlein purpura (HSP) typically occurs in the pediatric population, although rare cases also occur in adults. Gastrointestinal (GI) involvement is common. The "classic" histologic finding in IgA vasculitis (HSP) is leukocytoclastic vasculitis (LCV); other histologic features in biopsies of IgA vasculitis (HSP) have only been rarely described. The pathology archival files at our institution were searched for GI biopsies from patients with IgA vasculitis (HSP). Slides were retrieved and histologic and clinical features were reviewed. We identified 16 patients with IgA vasculitis (HSP) with a GI biopsy series, including both adult and pediatric patients. The most common histologic abnormality was lamina propria hemorrhage (all cases) with many cases also showing lamina propria fibrin deposition with red cell sludging and nuclear debris (7 cases). Twelve of the 16 duodenal biopsies had acute duodenitis; 3 of which were severe and erosive. Several also had an eosinophilic infiltrate. Seven of the 9 jejunal and/or ileal biopsies had acute jejunitis or ileitis. An acute colitis or proctitis was observed in 9/12 colorectal biopsies. Four biopsies contained LCV; in each of these cases, the involved vessels were small capillaries within the lamina propria. Only 1 biopsy contained deeper submucosal vessels, but they were uninvolved. Sites involved by LCV included the colorectum (2 cases), colorectum and terminal ileum, terminal ileum only, duodenum, and jejunum (1 case each). All patients presented with abdominal pain; 13/16 developed a rash, 1 following the index biopsy. Other presenting symptoms included diarrhea and/or hematochezia (8 cases), nausea/vomiting (5 cases), and intussusception (1 case). Four patients had concurrent skin biopsies showing LCV; only 1 of these patients had LCV on GI biopsy. Indications for biopsy included nonspecific presenting symptoms, absence of rash at presentation, and/or failure to respond adequately to steroid therapy. Biopsies are commonly performed in patients with or without suspected IgA vasculitis (HSP) to rule out infection, inflammatory bowel disease, and less commonly, vasculitis. In general, vasculitis is not commonly observed in GI biopsies of patients with IgA vasculitis (HSP), and the spectrum of findings includes neutrophilic infiltrate within the small bowel and colon, with the duodenum most commonly affected. While the clinical and histologic findings may mimic early inflammatory bowel disease, the presence of predominant small bowel involvement, especially erosive duodenitis, should raise suspicion for IgA vasculitis (HSP). Biopsies should be obtained before steroid therapy is initiated, if possible.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1097/PAS.0000000000001036

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[PMID]: 29513173
[Au] Autor:Apers L; Florence E; Crucitti T; Anwar N
[Ti] Title:Lymphogranuloma venereum among patients presenting at the HIV/STI clinic in Antwerp, Belgium : a case series.
[So] Source:Acta Gastroenterol Belg;80(3):385-387, 2017 Jul-Sep.
[Is] ISSN:1784-3227
[Cp] Country of publication:Belgium
[La] Language:eng
[Ab] Abstract:Objective of this study was to describe the patient characteristics and clinical presentation of laboratory confirmed lymphogranuloma venereum (LGV) cases, diagnosed at the Institute of Tropical Medicine (ITM), Antwerp, Belgium. Demographic and biomedical characteristics of all patients with chlamydia-positive sample results were retrieved for the years 2013 and 2014. Samples were obtained from both symptomatic and asymptomatic patients who consulted at the HIV/STI clinic. Fifty four patients with laboratory confirmed LGV were detected among 3885 nucleic acid amplification tests (NAATs) performed for the detection of chlamydia during the two years under review. Fifty three were men and equally fifty three had sex with men only (MSM). HIV (87%) and HCV (31.5%) were common concomitant infections, whilst anal gonorrhoea and syphilis were detected at the moment of the LGV diagnosis among 19 (35.2%) and 6 (11.0%) cases respectively. All cases were symptomatic, except one. The most frequent symptoms that were recorded could be categorised as proctitis (in 40 patients (74%)). Lymphadenopathy, anal and genital ulcers were signs that were present in 7 (13.0%), 4 (7.4%) and 2 patients (3.7%) respectively. LGV remains an important sexually transmitted disease among MSM. In this retrospective study, the far majority of LGV was detected amongst symptomatic persons. HCV, HIV, anal gonorrhoea and syphilis were associated co-infections. Proctitis in a high risk patient should alert the clinician for the possibility of an STI.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review

  3 / 3238 MEDLINE  
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[PMID]: 28468648
[Au] Autor:Clark JL; Segura ER; Oldenburg CE; Rios J; Montano SM; Perez-Brumer A; Villaran M; Sanchez J; Coates TJ; Lama JR
[Ad] Address:David Geffen School of Medicine, University of California, Los Angeles, CA, USA. jlclark@mednet.ucla.edu.
[Ti] Title:Expedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial.
[So] Source:BMC Med;15(1):94, 2017 05 04.
[Is] ISSN:1741-7015
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Expedited Partner Therapy (EPT) has been shown to improve treatment outcomes among heterosexual partners of individuals with curable sexually transmitted infections (STIs). Although the use of EPT with men who have sex with men (MSM) has been debated, due to the potential for missed opportunities to diagnose unidentified cases of HIV and syphilis infection in symptomatic partners, increases in partner notification (PN) resulting from use of EPT may promote testing and treatment of otherwise unidentified partners. We assessed the impact of EPT on self-reported PN among MSM in Peru with gonorrheal (GC) and/or chlamydial (CT) infection. METHODS: We enrolled 173 MSM in Lima, Peru with symptomatic or asymptomatic GC and/or CT infection between 2012 and 2014. We enrolled 44 MSM with symptomatic urethritis/proctitis and 129 MSM with asymptomatic GC/CT infection, diagnosed based on nucleic acid testing (Aptima Combo 2 Transcription-Mediated Amplification [TMA]) from urethral, pharyngeal, and rectal sites. Eligible participants were randomly assigned to receive either standard PN counseling (n = 84) or counseling plus EPT (cefixime 400 mg/azithromycin 1 g) for up to five recent partners (n = 89). Self-reported notification was assessed by computer-assisted self-administered survey among 155 participants who returned for 14-day follow-up. RESULTS: The median age of participants was 26 (interquartile range [IQR]: 23-31) with a median of 3 sexual partners (IQR: 2-4) in the previous 30-day period. Among all participants, 111/155 (71.6%) notified at least one partner at 14-day follow-up with a median of 1 partner notified per participant (IQR: 0-2). For participants randomized to receive EPT, 69/83 (83.1%) reported notifying at least one partner, compared with 42/72 (58.3%) of participants in the control arm (odds ratio = 3.52; 95% confidence interval [CI]: 1.68-7.39). The proportion of all recent partners notified was significantly greater in the EPT than in the control arm (53.5%, 95% CI: 45.0-62.0% versus 36.4%, 95% CI: 27.0-47.4%). CONCLUSIONS: Provision of EPT led to significant increases in notification among Peruvian MSM diagnosed with GC/CT infection. Additional research is needed to assess the impact of EPT on biological outcomes, including persistent or recurrent infection, antimicrobial resistance, and HIV/STI transmission, in MSM sexual networks. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01720654 . Registered on 10/29/2012.
[Mh] MeSH terms primary: Chlamydia Infections/therapy
Contact Tracing
Gonorrhea/therapy
Sexual Partners
[Mh] MeSH terms secundary: Adult
Homosexuality, Male
Humans
Male
Peru
Pilot Projects
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1710
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[Js] Journal subset:IM
[Da] Date of entry for processing:170505
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12916-017-0858-9

  4 / 3238 MEDLINE  
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[PMID]: 29339645
[Au] Autor:Cuomo A; Sgambato D; D'Auria MV; Miranda A; Ferrante E; Romano M
[Ad] Address:Gastroenterology Unit "Umberto I" Hospital, Nocera Inferiore, Salerno, Italy.
[Ti] Title:Multi Matrix System Mesalazine Plus Rectal Mesalazine in the Treatment of Mild to Moderately Active Ulcerative Proctitis.
[So] Source:Dig Dis;36(2):130-135, 2018.
[Is] ISSN:1421-9875
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Mesalazine 1 g suppository/die is used for mild to moderately active ulcerative proctitis (UP). Whether addiction of Multi Matrix System (MMX) mesalazine increases the remission rate of UP and prevents proximal extension of disease is unknown. METHODS: This is a retrospective study on 116 outpatients with UP who had been treated with one of the following regimens: (1) MMX mesalazine 1.2 g/die plus mesalazine suppositories for 8 ± 2 weeks and, subsequently, MMX mesalazine 1.2 g/die plus rectal mesalazine 1 g every other day for at least 6 months; (2) mesalazine 1 g suppositories/die alone for 8 ± 2 weeks and, subsequently, rectal mesalazine 1 g every other day for 6 more months. Patients were evaluated clinically at 2 months (±2 weeks) and endoscopically at 6 months (±2 weeks). For categorical variables, Pearson chi-square test was used. RESULTS: A total of 46 of 55 patients (84%) on combined therapy and 49 of 61 patients (80%) on rectal mesalazine reached clinical remission (p > 0.05; OR 0.79, 95% CI 0.30-2.07). At 6 months follow-up, proximal extension of disease was observed in 7 of 55 (14%) patients on combined therapy and in 18 of 61 (29%) patients on rectal mesalazine alone (p < 0.05; OR 2.87, 95% CI 1.09-7.53). CONCLUSIONS: Oral MMX mesalazine plus rectal mesalazine combined treatment is associated with prevention of proximal extension of the disease compared with rectal mesalazine alone.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Process
[do] DOI:10.1159/000485614

  5 / 3238 MEDLINE  
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[PMID]: 29207381
[Au] Autor:Greuter T; Vavricka SR; Biedermann L; Pilz J; Borovicka J; Seibold F; Sauter B; Rogler G
[Ad] Address:Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
[Ti] Title:Alicaforsen, an Antisense Inhibitor of Intercellular Adhesion Molecule-1, in the Treatment for Left-Sided Ulcerative Colitis and Ulcerative Proctitis.
[So] Source:Dig Dis;36(2):123-129, 2018.
[Is] ISSN:1421-9875
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Data on the efficacy of intercellular adhesion molecule-1 antisense oligonucleotide alicaforsen in ulcerative colitis (UC) is inconsistent. METHODS: All patients, who had received at least one dose of alicaforsen, were analyzed retrospectively. Alicaforsen's efficacy was assessed in patients treated for left-sided UC and proctitis by comparing clinical and (if applicable) endoscopic disease activity before/after treatment. RESULTS: Twelve patients were treated for left-sided UC or proctitis. Eleven patients received a 6-week course of a once-daily 240 mg alicaforsen enema formulation. In 1 patient, treatment was discontinued, because it was found to be inefficient. Disease activity measured by the partial Mayo score and 6-point symptom score was significantly reduced after treatment (6.0 vs. 2.4, p = 0.011 and 3.7 vs. 1.4, p = 0.008). Faecal calprotectin showed a trend towards reduction (484.4 vs. 179.5 µg/g, p = 0.063). Clinical improvement was achieved in 10 patients (83.3%). In 7 patients, a relapse occurred (70%). Median duration of clinical improvement was 18.0 weeks (range 1-112). Three patients showed an ongoing improvement of >9 months. No adverse events were reported. CONCLUSIONS: A 6-week course of alicaforsen seemed to be safe and efficacious in inducing clinical improvement in patients with left-sided UC and proctitis. Prolonged clinical improvement was observed in many but not all patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Process
[do] DOI:10.1159/000484979

  6 / 3238 MEDLINE  
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[PMID]: 29182384
[Au] Autor:King RB; Osman SO; Fairmichael C; Irvine DM; Lyons CA; Ravi A; O'Sullivan JM; Hounsell AR; Mitchell DM; McGarry CK; Jain S
[Ad] Address:1 Centre for Cancer Research and Cell Biology, Queen's University Belfast , Belfast , Ireland.
[Ti] Title:Efficacy of a rectal spacer with prostate SABR-first UK experience.
[So] Source:Br J Radiol;91(1083):20170672, 2018 Feb.
[Is] ISSN:1748-880X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: This study assessed the use of implanted hydrogel rectal spacers for stereotactic ablative radiotherapy-volumetric modulated arc therapy (SABR-VMAT) patients, investigating practicality, dosimetric impact, normal tissue complication probability (NTCP) and early toxicity. METHODS: Data from the first 6 patients treated within a prostate SABR and rectal spacer trial were examined to determine spacer insertion tolerability, resultant changes in treatment planning and dosimetry and early toxicity effects. CT scans acquired prior to spacer insertion were used to generate SABR plans which were compared to post-insertion plans. Plans were evaluated for target coverage, conformity, and organs at risk doses with NTCPs also determined from resultant dose fluences. Early toxicity data were also collected. RESULTS: All patients had successful spacer insertion under local anaesthetic with maximal Grade 1 toxicity. All plans were highly conformal, with no significant differences in clinical target volume dose coverage between pre- and post-spacer plans. Substantial improvements in rectal dose metrics were observed in post-spacer plans, e.g. rectal volume receiving 36 Gy reduced by ≥42% for all patients. Median NTCP for Grade 2 + rectal bleeding significantly decreased from 4.9 to 0.8% with the use of a rectal spacer (p = 0.031). To date, two episodes of acute Grade 1 proctitis have been reported following treatment. CONCLUSION: The spacer resulted in clinically and statistically significant reduction in rectal doses for all patients. Advances in knowledge: This is one of the first studies to investigate the efficacy of a hydrogel spacer in prostate SABR treatments. Observed dose sparing of the rectum is predicted to result in meaningful clinical benefit.
[Mh] MeSH terms primary: Adenocarcinoma/radiotherapy
Prostatic Neoplasms/radiotherapy
Prostheses and Implants
Radiation Injuries/prevention & control
Radiosurgery/methods
Radiotherapy, Intensity-Modulated/methods
Rectum/radiation effects
[Mh] MeSH terms secundary: Adenocarcinoma/pathology
Adult
Aged
Biopsy
Fiducial Markers
Humans
Hydrogel, Polyethylene Glycol Dimethacrylate
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Organ Sparing Treatments
Organs at Risk
Prostatic Neoplasms/pathology
Radiometry
Radiotherapy Dosage
Rectum/diagnostic imaging
Tomography, X-Ray Computed
Treatment Outcome
United Kingdom
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:25852-47-5 (Hydrogel, Polyethylene Glycol Dimethacrylate)
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:171129
[St] Status:MEDLINE
[do] DOI:10.1259/bjr.20170672

  7 / 3238 MEDLINE  
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[PMID]: 29393142
[Au] Autor:Kato S; Ishibashi A; Kani K; Yakabi K
[Ti] Title:Optimized Management of Ulcerative Proctitis: When and How to Use Mesalazine Suppository.
[So] Source:Digestion;97(1):59-63, 2018.
[Is] ISSN:1421-9867
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Ulcerative proctitis, one of the disease types of ulcerative colitis, is considered one of the initial manifestations of ulcerative colitis. Prevention of aggravation of ulcerative proctitis is important for improving the prognosis of ulcerative colitis. Here we reviewed the epidemiology, diagnosis, and management of ulcerative proctitis. SUMMARY: The number of patients with ulcerative proctitis is increasing. Disease extension occurs in many patients with ulcerative proctitis. Differential diagnosis from other chronic proctitis is important and should be performed based on the clinical history and endoscopical and histological features. Mesalazine suppository has been the first-line therapy for patients with ulcerative proctitis because of its high effectiveness and safety. Topical treatment of ulcerative proctitis, particularly using mesalazine suppository has been underused in clinical practice. Key Messages: Mesalazine suppositories are more effective than dose intensification of oral mesalazine for relapsed patients with maintenance dose of oral mesalazine. However, low adherence to rectal mesalazine has hindered remission in patients with ulcerative proctitis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:In-Process
[do] DOI:10.1159/000484224

  8 / 3238 MEDLINE  
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[PMID]: 29465653
[Au] Autor:Ong JJ; Aung E; Read TRH; Fairley CK; Garland SM; Murray G; Chen MY; Chow EPF; Bradshaw CS
[Ad] Address:Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.
[Ti] Title:Clinical characteristics of anorectal Mycoplasma genitalium infection and microbial cure in men who have sex with men.
[So] Source:Sex Transm Dis;, 2018 Jan 18.
[Is] ISSN:1537-4521
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: We report clinical characteristics of proctitis caused solely by Mycoplasma genitalium(MG), compared with chlamydia and gonococcus. We determined the proportions cured with first-line (azithromycin) and second-line antimicrobials (moxifloxacin, pristinamycin). METHODS: 166 patients attending Melbourne Sexual Health Centre from 2012 to 2016 with symptoms of proctitis were tested for MG, Chlamydia trachomatis and Neisseria gonorrhoeae. Demographic characteristics, sexual behaviours, clinical symptoms and signs were recorded. Multinomial multivariable logistic regression was used to test for significant differences in symptoms and signs for the pathogens detected. RESULTS: Seventeen percent of men had MG (95% confidence interval [12-24]), 21% chlamydia [15-27], and 40% gonococcal monoinfection [32-48], whilst 22% had MG coinfection [16-29]. Relative to men with MG monoinfection, those with chlamydial monoinfection reported more anal pain (adjusted prevalence odds ratio(aPOR) 4.68, [1.41-14.19]), while men with gonococcal monoinfection reported more anal pain (aPOR 6.75, [2.21-20.55]) and tenesmus (aPOR 15.44, [1.62-146.90]), but less anal itch (aPOR 0.32, [0.11-0.93]). The microbiological cure for MG using azithromycin was low at 35% [22-50], while moxifloxacin subsequently cured 92% [64-100], and pristinamycin 79% [54-94] of infections. CONCLUSION: MG was almost as common as chlamydia in men presenting to a sexual health centre with symptoms of proctitis. Men with anorectal MG monoinfection were less likely to have symptoms and signs compared to those with chlamydia or gonococcus monoinfection. Cure for men with symptomatic anorectal MG by azithromycin was low. We suggest routine testing for MG in cases of proctitis, with test of cure following treatment being essential.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[St] Status:Publisher
[do] DOI:10.1097/OLQ.0000000000000793

  9 / 3238 MEDLINE  
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[PMID]: 29462845
[Au] Autor:Hirano A; Umeno J; Okamoto Y; Shibata H; Ogura Y; Moriyama T; Torisu T; Fujioka S; Fuyuno Y; Kawarabayasi Y; Matsumoto T; Kitazono T; Esaki M
[Ad] Address:Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
[Ti] Title:A comparison of the microbial community structure between inflamed and non-inflamed sites in patients with ulcerative colitis.
[So] Source:J Gastroenterol Hepatol;, 2018 Feb 20.
[Is] ISSN:1440-1746
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIM: The gut microbiota is suggested to play an important role in the pathogenesis of ulcerative colitis (UC). However, inter-individual and spatial variations hamper the identification of UC-related changes. We thus investigated paired mucosa-associated microbiota obtained from both inflamed and non-inflamed sites of UC patients and corresponding sites of non-IBD controls. METHODS: Mucosal biopsies of both inflamed and non-inflamed sites were obtained from 14 patients with active UC of the left-sided or proctitis type. Paired mucosal biopsies of the corresponding sites were obtained from 14 non-IBD controls. The microbial community structure was investigated using 16S rRNA gene sequences, followed by data analysis using Qiime and LEfSe software. RESULTS: Microbial alpha diversity in both inflamed and non-inflamed sites was significantly lower in UC patients compared with non-IBD controls. There were more microbes of the genus Cloacibacterium and the Tissierellaceae family, and there were less microbes of the genus Neisseria at the inflamed site when compared to the non-inflamed site in UC patients. Decreased abundance of the genera Prevotella, Eubacterium, Neisseria, Leptotrichia, Bilophila, Desulfovibrio, Butyricimonas was evident at the inflamed site of UC patients compared to the corresponding site of non-IBD controls. Among these taxa, the genera Prevotella and Butyricimonas were also less abundant at the non-inflamed site of UC patients compared to the corresponding site in non-IBD controls. CONCLUSIONS: Mucosal microbial dysbiosis occurs at both inflamed and non-inflamed sites in UC patients. The taxa showing altered abundance in UC patients might mediate colonic inflammation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:Publisher
[do] DOI:10.1111/jgh.14129

  10 / 3238 MEDLINE  
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[PMID]: 29205498
[Au] Autor:Choi YS; Kim WJ; Kim JK; Kim DS; Lee DH
[Ad] Address:Department of Gastroenterology, Daehang Hospital, Seoul, Korea.
[Ti] Title:Efficacy of topical 5-aminosalicylate monotherapy in patients with ulcerative proctitis with skip inflammation.
[So] Source:J Gastroenterol Hepatol;, 2017 Dec 04.
[Is] ISSN:1440-1746
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIM: In some patients with ulcerative proctitis (UP), skip inflammation is noted in the right side of the colon, but little is known about its clinical course. The aim of this study was to evaluate the clinical course of UP with skip inflammation and the efficacy of topical 5-aminosalicylate (5-ASA) monotherapy. METHODS: This study reviewed the data of 388 patients with an initial diagnosis of UP from January 2005 to October 2015. This study matched each UP patient with skip inflammation 1:2 with controls who had UP without skip inflammation; to reduce bias, this study matched the controls with the cases by age, gender, and initial disease activity. RESULTS: During the follow-up period (median: 69.5 months), the overall progression rates for the control group (n = 192) and the skip inflammation group (n = 96) were 24.0% and 32.9% at 10 years, respectively (log-rank P = 0.71). In the skip inflammation group, the progression rates were not significantly different between the 5-ASA combination group and the topical group, 33.4% and 26.6% at 10 years, respectively (log-rank P = 0.96). The overall acute exacerbation rates for the control and skip inflammation groups were 17.2% and 26.8% at 10 years, respectively (log-rank P = 0.68). In the skip inflammation group, the exacerbation rates were also not significantly different between the combination and topical treatment groups, 26.6% and 23.6% at 10 years, respectively (log-rank P = 0.88). CONCLUSION: The clinical course of UP with skip inflammation was not different from that of typical UP, and topical 5-ASA monotherapy for maintaining remission was as effective as 5-ASA combination therapy irrespective of the presence of skip lesions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[St] Status:Publisher
[do] DOI:10.1111/jgh.14052


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