Use of Advanced Modalities Does Not Guarantee Early Detection of Small-Bowel Crohn's Disease in the Absence of Complications.

CONCLUSIONS Early detection of SB CD without complications remains difficult even if advanced modalities are introduced. Our hypothesis is that the fecal occult blood test and routine blood test should be administered to patients with abdominal pain or gastrointestinal manifestations. Once the patients are found to have GI bleeding or anemia, they would be further examined according to the guideline and SBCE would be used in the early stage of SB CD. PMID: 31738744 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research

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Authors: Feres M, Retamal-Valdes B, Faveri M, Duarte P, Shibli J, Soares GMS, Miranda T, Teles F, Goodson M, Hasturk H, Van Dyke T, Ehmke B, Eickholz P, Schlagenhauf U, Meyle J, Koch R, Kocher T, Hoffmann T, Kim TS, Kaner D, Figueiredo LC, Doyle H Abstract OBJECTIVE: The selection of proper outcome measures is a critical step in clinical research. Most randomized clinical trials (RCTs) assessing the effects of initial anti-infective periodontal therapies use surrogate outcomes as primary outcome variables, such as mean changes in probing depth (PD) or in clinical attachment. However, these parameters do not reflect...
Source: Journal of the International Academy of Periodontology - Category: Dentistry Tags: J Int Acad Periodontol Source Type: research
CONCLUSIONS: Non-surgical periodontal therapy was effective during the first 18 months, but periodontal conditions were worse at 48 months after therapy. The distal sites of abutment teeth with direct retainers presented the worst periodontal conditions. PMID: 32224546 [PubMed - in process]
Source: Journal of the International Academy of Periodontology - Category: Dentistry Tags: J Int Acad Periodontol Source Type: research
Conclusions: Older adults who begin using cannabis are likely using for what they perceive to be medicinal purposes for a range of issues. However, they receive minimal guidance from their family physicians and instead obtain information from non-clinician sources.Clinical implications: Cannabis screening should be included in geriatric assessments and medicine reconciliation. Continuing education for clinicians needs to address knowledge gaps about cannabis use among older adults. PMID: 32223535 [PubMed - as supplied by publisher]
Source: Clinical Gerontologist - Category: Geriatrics Tags: Clin Gerontol Source Type: research
Conclusions: Continuing shifts in society's cultural landscape, ongoing emphasis on value versus volume, and other industry fiscal imperatives continue to evoke an evolution in end-of-life care. The attainment of successful outcomes by professional case managers with those populations will be dependent on awareness and comprehension of regulations, legislation, and reimbursement; the influences of ongoing industry trends; availability of emerging resources; and ongoing technological advances. Ethical excellence remains at the core of case management across the interprofessional workforce and the transitions of care. Imp...
Source: Professional Case Management - Category: Health Management Tags: Articles Source Type: research
This report provides an in-depth look at public drug program spending in Canada, using the Canadian Institute for Health Information's (CIHI) National Prescription Drug Utilization Information System. Public drug program spending does not include spending on drugs dispensed in hospitals or on those funded through cancer agencies and other special programs. Public drug program spending increased by 6.8% in 2018, compared to an increase of 5.3% in 2017. The growth in 2018 was largely because of the introduction of Ontario Health Insurance Plan+ (OHIP+), which extended drug coverage to all Ontario residents age 24 years or y...
Source: Healthcare Quarterly - Category: International Medicine & Public Health Source Type: research
In this study, we examined the effect of laparoscopic-guided transversus abdominis plane block (LG TAP) for further optimizing multimodal pain control.MethodsThis is a retrospective analysis of a prospectively collected database of 140 consecutive patients undergoing LSG without TAP block (pre-TAP group) compared to 131 patients undergoing LSG with LGTAP (TAP group). All operations were performed laparoscopically utilizing uniform clinical pathways. Baseline characteristics for both groups were comparable. Both groups received standardized anesthesia. Outcomes included time to postoperative ambulation, pain scores, PCA vol...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Abstract Crohn's disease is a chronic inflammatory condition that affects the gastrointestinal tract. It can cause lesions from mouth to anus and may result in extraintestinal complications. The prevalence of Crohn's disease is increasing in adults and children. Genetic predispositions to Crohn's disease have been identified, and specific environmental factors have been associated with its development. Common presenting symptoms include diarrhea, abdominal pain, rectal bleeding, fever, weight loss, and fatigue. Physical examination should identify unstable patients requiring immediate care, include an anorectal ex...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
Conclusions: VCE can be safely performed in the elderly. A proportion of cases may have unsuspected small-bowel CD despite negative endoscopies. FCP was the best screening test. Diagnosis frequently changed management. PMID: 29622900 [PubMed]
Source: Diagnostic and Therapeutic Endoscopy - Category: Surgery Tags: Diagn Ther Endosc Source Type: research
In conclusion, small intestinal CE is a secure method to clarify small intestinal diseases, especially obscure gastrointestinal bleeding, even in pre-operated patients without stenosis symptoms. Our study emphasizes in a collective of patients with extensive prior diagnostics that due to CE therapeutic measures resulted in 73%.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
A middle-aged female with inflammatory bowel disease (IBD) (with mixed features of ulcerative colitis and Crohn's disease), iron deficiency anaemia and recurrent Clostridium difficile colitis presented to the emergency department with complaints of abdominal pain, haematochezia and diarrhoea. An abdominal plain film obtained during her work-up demonstrated a portion of the distal transverse, descending and sigmoid colon lacking normal haustral patterns (lead pipe sign) (figure 1, arrows). Figure 1Lead pipe sign—abdominal X-ray showing a large burden of stool throughout the colon to the descending colon where the...
Source: Postgraduate Medical Journal - Category: General Medicine Authors: Tags: Drugs: gastrointestinal system, GI bleeding, Inflammatory bowel disease, Emergency medicine, Journalology, Immunology (including allergy), Pain (neurology), Malnutrition, Connective tissue disease, Dermatology, Ethics, Metabolic disorders Images in medi Source Type: research
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