Publications by authors named "Uma Mahadevan"

Background & Aims: Pregnancy can be a complex and risk-filled event for women with inflammatory bowel disease (IBD). High-quality studies in this population are lacking, with limited data on medications approved to treat IBD during pregnancy. For patients, limited knowledge surrounding pregnancy impacts pregnancy rates, medication adherence, and outcomes.

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Background & Aims: Pregnancy can be a complex and risk filled event for women with inflammatory bowel disease (IBD). High-quality studies in this population are lacking, with limited data on medications approved to treat IBD during pregnancy. For patients, limited knowledge surrounding pregnancy impacts pregnancy rates, medication adherence, and outcomes.

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Background & Aims: Pregnancy can be a complex and risk-filled event for women with inflammatory bowel disease (IBD). High-quality studies in this population are lacking, with limited data on medications approved to treat IBD during pregnancy. For patients, limited knowledge surrounding pregnancy impacts pregnancy rates, medication adherence, and outcomes.

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Background & Aims: Pregnancy can be a complex and risk filled event for women with inflammatory bowel disease (IBD). High-quality studies in this population are lacking, with limited data on medications approved to treat IBD during pregnancy. For patients, limited knowledge surrounding pregnancy impacts pregnancy rates, medication adherence, and outcomes.

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Background & Aims: Pregnancy can be a complex and risk-filled event for women with inflammatory bowel disease (IBD). High-quality studies in this population are lacking, with limited data on medications approved to treat IBD during pregnancy. For patients, limited knowledge surrounding pregnancy impacts pregnancy rates, medication adherence, and outcomes.

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Introduction: Pregnancy can be a complex and risk filled event for women with inflammatory bowel disease (IBD). High-quality studies in this population are lacking, with limited data on medications approved to treat IBD during pregnancy. For patients, limited knowledge surrounding pregnancy impacts pregnancy rates, medication adherence, and outcomes.

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Pelvic surgery for inflammatory bowel disease (IBD) can reduce fertility. Pregnant women with IBD have higher rates of pregnancy loss and adverse outcomes. Awareness of these factors and adequate multidisciplinary monitoring throughout these high-risk pregnancies is important.

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Background: Women with inflammatory bowel disease (IBD) face complexities of disease management during pregnancy and childbirth. Apprehension regarding vaginal delivery in pregnant individuals with IBD persists due to concern for perianal disease and perineal trauma. The incidence of poor wound healing after obstetric anal sphincter injury is approximately 4% in the general population.

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Introduction: Low-dose aspirin (LDA) is recommended for pregnant individuals at elevated risk for hypertensive disorders of pregnancy (HDP). However, regular aspirin use may raise concerns of increased disease activity in patients with inflammatory bowel disease (IBD). We aimed to evaluate the prevalence of LDA use in pregnant IBD patients and the effect of LDA on IBD disease activity.

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Introduction: We aimed to compare pregnancy outcomes of women with inflammatory bowel disease using biosimilar vs originator infliximab (IFX).

Methods: In a prospective cohort of pregnant women with inflammatory bowel disease, we collected characteristics, medications, pregnancy outcomes, and developmental milestones. We compared outcomes by IFX biosimilar or originator use via bivariate statistics.

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Article Synopsis
  • - This study focused on developing a new imaging-based method called single-cell spatial transcriptomics (iSCST) to analyze archived, formalin-fixed, paraffin-embedded (FFPE) tissue samples from inflammatory bowel disease (IBD) patients, which helps to preserve the spatial context of various cell types within the tissue.
  • - Researchers benchmarked three iSCST platforms by analyzing 57 FFPE mucosal biopsies from IBD patients and healthy controls, allowing for detailed cell analysis and gene expression profiling through a consistent data processing pipeline.
  • - A custom gene panel showed the best performance for detecting and quantifying different cell subsets, revealing significant findings related to inflammation and treatment responses in ulcerative colitis, which could enhance
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Background: There is no guideline regarding whether patients treated with intravenous corticosteroids for acute severe ulcerative colitis (ASUC) should be monitored in the hospital after transitioning to oral steroids. Our study aimed to: (1) compare rates of oral steroid transition failure and 30-day readmission between ASUC hospitalizations with extended inpatient monitoring compared to accelerated inpatient monitoring, and (2) identify predictors of oral steroid transition failure.

Methods: A retrospective cohort study of ulcerative colitis (UC) related admissions at UCSF from 2014 to 2022 was conducted comparing rates of steroid transition failures in extended inpatient monitoring (≥ 24 h on oral steroids prior to discharge) to accelerated inpatient monitoring (< 24 h on oral steroids).

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Article Synopsis
  • Study Overview
  • : This research examined the nutritional status and malnutrition effects among older adults (65+) diagnosed with ulcerative colitis (UC), utilizing specific definitions and tools to assess malnutrition and risk factors.
  • Findings
  • : Among 290 patients studied, only 18% were malnourished, but a significant 76% had at least one micronutrient deficiency, with common deficiencies noted in vitamin D (38%), iron (43%), and B12 (11%).
  • Conclusions
  • : While malnutrition was less common, high rates of micronutrient deficiencies and bone health issues were identified, highlighting the necessity for routine evaluations regarding nutrition and bone density in older UC patients.
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Endoscopy plays a key role in diagnosis, monitoring of disease activity, assessment of treatment response, dysplasia surveillance, postoperative evaluation, and interventional therapy for patients with inflammatory bowel disease (IBD). Clinical practice patterns in the endoscopic management of IBD vary. A panel of experts consisting of IBD specialists, endoscopists, and GI pathologists participated in virtual conferences and developed this modified Delphi-based consensus document to address endoscopic aspects of IBD management.

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Article Synopsis
  • Opioid use in hospitalized patients with inflammatory bowel disease doesn't help with pain and might keep them in the hospital longer.
  • A study tracked patients with acute severe ulcerative colitis and found that those using a lot of opioids had delays in getting other important treatments.
  • Patients who used high amounts of opioids were more likely to leave the hospital with opioids, while overall, the use of opioids didn't change their hospital stay length or costs.
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Background And Objective: Upadacitinib is indicated for diseases affecting persons of childbearing potential including rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, atopic dermatitis, Crohn's disease, and ulcerative colitis; however, teratogenicity was observed in animal studies. Given the potential for human fetal risk, pregnancy avoidance measures were required during clinical trials. This analysis describes pregnancy outcomes in patients exposed to upadacitinib during pregnancy.

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Ulcerative colitis (UC) is driven by immune and stromal subsets, culminating in epithelial injury. Vedolizumab (VDZ) is an anti-integrin antibody that is effective for treating UC. VDZ is known to inhibit lymphocyte trafficking to the intestine, but its broader effects on other cell subsets are less defined.

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Janus kinase (JAK) inhibitors are effective anti-inflammatory agents for treatment of ulcerative colitis (UC). According to drug regulatory agencies and international guidelines, JAK inhibitors should be avoided during pregnancy and lactation. The existing evidence on safety of JAK inhibitors during pregnancy is scarce and almost exclusively limited to tofacitinib.

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