Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis: A global survey of physicians' practice.

Aim: To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC).

Methods: A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents.

Clostridium difficile infection in inflammatory bowel disease: challenges in diagnosis and treatment.

The problem of Clostridium difficile infection (CDI) has reached epidemic proportions, particularly in industrialized nations. The pathophysiology, disease course and the potential complications are well appreciated in the general hospitalized patient. However, when CDI occurs in the setting of inflammatory bowel disease (IBD), a number of distinct differences in the diagnosis and clinical management of the infection in this population should be appreciated by gastroenterologists, hospitalists and other care providers.

Hospitalized burden and outcomes of coccidioidomycosis: A nationwide analysis, 2005-2012.

The incidence of coccidioidomycosis (CM) infection has increased over the last 20 years. We investigated recent trends of CM-associated hospitalization in the United States. patients with CM-associated hospitalization were identified from the Nationwide Inpatient Sample, 2005-2012.

Outcomes of Clostridium difficile infection in hospitalized leukemia patients: a nationwide analysis.

BACKGROUND The incidence of Clostridium difficile infection (CDI) has increased among hospitalized patients and is a common complication of leukemia. We investigated the risks for and outcomes of CDI in hospitalized leukemia patients. METHODS Adults with a primary diagnosis of leukemia were extracted from the United States Nationwide Inpatient Sample database, 2005-2011.

Portal vein thrombosis.

Portal vein thrombosis (PVT) is a rare event in the general medical setting that commonly complicates cirrhosis with portal hypertension, and can also occur with liver tumors. The diagnosis is often incidental when a thrombus is found in the portal vein on imaging tests. However, PVT may also present with clinical symptoms and can progress to life-threatening complications of ischemic hepatitis, liver failure, and/or small intestinal infarction.

Increasing Volume but Decreasing Mortality of Hospitalized Hepatitis C Patients in the United States, 2005 to 2011.

Background: Patients with hepatitis C virus infection often require hospitalization for progressive liver disease and complications, incurring high cost and risk of death.

Goals: The aim of our study was to investigate recent trends in the economic burden and outcomes of patients hospitalized for hepatitis C in the United States.

Study: Patients with hepatitis C-associated hospitalization were identified from the Nationwide Inpatient Sample 2005 to 2011.

Clinical experience of natalizumab in Crohn's disease patients in a restricted distribution program.

Background: Natalizumab (NAT) is a humanized monoclonal antibody against a4-integrin initially approved for the treatment of multiple sclerosis, and then withdrawn from the market in 2005 due to the risk of progressive multifocal leukoencephalopathy. NAT was approved for the treatment of Crohn's disease in the United States in 2008 under a restricted distribution program. There has been limited data on NAT since then.

Practice of gastroenterologists in treating flaring inflammatory bowel disease patients with clostridium difficile: antibiotics alone or combined antibiotics/immunomodulators?

Background: The optimal management of Clostridium difficile infection (CDI) in flaring inflammatory bowel disease (IBD) patients has not been defined. Limited data suggest that coadministration of immunomodulators (IM) with antibiotics (AB) results in a worse outcome. We investigated the prevalent practice among North American gastroenterologists in this scenario.

Efalizumab, a human monoclonal anti-CD11a antibody, in the treatment of moderate to severe Crohn's Disease: an open-label pilot study.

Background And Aims: Efalizumab is a monoclonal antibody targeting CD11a, an adhesion molecule involved in the activation and trafficking of T-lymphocytes. This agent has proven efficacy in the treatment of psoriasis. We performed an open-label study to evaluate the efficacy and safety of efalizumab in Crohn's disease (CD).

Patients with late-adult-onset ulcerative colitis have better outcomes than those with early onset disease.

Background & Aims: The influence of age on the presentation, clinical course, and therapeutic response of patients with adult-onset ulcerative colitis (UC) is understudied. Given potential age-related differences in risk factors and immune function, we sought to determine if disease behavior or clinical outcomes differed between patients diagnosed with UC in later versus earlier stages of adulthood.

Methods: We performed a retrospective cohort study of 295 patients with UC seen at a tertiary care center from 2001 to 2008.

NOD2 status and human ileal gene expression.

Background: NOD2 single nucleotide polymorphisms have been associated with increased risk of ileal Crohn's disease (CD). This exploratory study was conducted to compare ileal mucosal gene expression in CD patients with and without NOD2 risk alleles.

Methods: Ileal samples were prospectively collected from 18 nonsmoking CD patients not treated with anti-TNF-α biologics and 9 nonsmoking control patients without inflammatory bowel disease undergoing initial resection and genotyped for the 3 major NOD2 risk alleles (Arg702Trp, Gly908Arg, Leu1007fs).

Risk of arterial thrombotic events in inflammatory bowel disease.

Objectives: Patients with inflammatory bowel disease (IBD) have an increased risk of venous thrombotic events. The risk of arterial thrombotic events in IBD, however, has been less well characterized. We explored whether Crohn's disease (CD) and ulcerative colitis (UC) are associated with a higher risk for thrombotic events involving the mesenteric, cardiac, or cerebral arteries.

A key role for autophagy and the autophagy gene Atg16l1 in mouse and human intestinal Paneth cells.

Susceptibility to Crohn's disease, a complex inflammatory disease involving the small intestine, is controlled by over 30 loci. One Crohn's disease risk allele is in ATG16L1, a gene homologous to the essential yeast autophagy gene ATG16 (ref. 2).

Risk factors for surgical recurrence after ileocolic resection of Crohn's disease.

Purpose: We evaluated the effect of potential clinical factors on surgical recurrence of ileal Crohn's disease after initial ileocolic resection.

Methods: One hundred seventy-six patients with ileal Crohn's disease who underwent an ileocolic resection with anastomosis were identified from our database. The outcome of interest was time from first to second ileocolic resection.

Incidence of Clostridium difficile infection in inflammatory bowel disease.

Background & Aims: Clostridium difficile-associated disease (CDAD) rates have been increasing. We sought to determine whether CDAD incidence has increased specifically in hospitalized patients with IBD. We also explored possible differences in the risk for and time to presentation of CDAD between IBD and non-IBD patients.

The combined effect of maternal smoking and obesity on the risk of preeclampsia.

Aims: Cigarette smoking during pregnancy is associated with a lower risk of preeclampsia, whereas obesity increases the risk of preeclampsia. We sought to assess the combined effect of smoking and obesity on the risk of preeclampsia.

Methods: We conducted a population-based cohort study of 129,674 women who delivered singleton infants during 2000-2001.

Reactive hemophagocytic syndrome complicating the treatment of inflammatory bowel disease.

Background And Aims: Reactive hemophagocytic syndrome (RHS) is a rare disease in which inappropriately activated macrophages consume bone marrow-derived cells. Most cases are associated with infection in the setting of immunodeficiency. The widespread use of immunosuppressive therapy in the treatment of inflammatory bowel disease (IBD) places patients with Crohn's disease and ulcerative colitis at risk of this complication.

Gut-enriched Krüppel-like factor regulates colonic cell growth through APC/beta-catenin pathway.

Studies on colorectal carcinogenesis have suggested a critical role of the adenomatous polyposis coli (APC) gene in the development of colorectal cancer. Gut-enriched Krüppel-like factor (GKLF) is a zinc-finger transcription protein with high expression in the colonic epithelium. Our previous studies have shown that GKLF transcript was significantly decreased in colon cancer tissue and suggested that it might play a role in the tumorigenesis of the colon.