Simplify to improve in capsule endoscopy - TOP 100 is a swift and reliable evaluation tool for the small bowel inflammatory activity in Crohn's disease.

Simplify to improve in capsule endoscopy - TOP 100 is a swift and reliable evaluation tool for the small bowel inflammatory activity in Crohn's disease. Scand J Gastroenterol. 2020 Mar 31;:1-6 Authors: Freitas M, Arieira C, Carvalho PB, Rosa B, Moreira MJ, Cotter J Abstract Background: Capsule endoscopy is a widely recognized method to study the small bowel, including in patients with Crohn's disease (CD). The Lewis score (LS) is a valuable tool in this setting, able to assess inflammatory activity. TOP100, a new software tool of the RAPID Reader®, emerged to assist in the time-consuming capsule reading process, by automatically selecting 100 images that will most likely contain abnormalities.Aim: Evaluate the agreement between TOP100 and classic reading (CR) in determining LS in the setting of CD.Methods: Retrospective study including consecutive patients undergoing small bowel capsule endoscopy (SBCE) for suspected or established CD. One experienced reader performed CR and calculated the LS. Another experienced reader, blinded to the CR results, reviewed all SBCE videos using TOP100 and calculated the LS.Results: One hundred and fifteen patients were included. SBCE detected significant inflammatory activity (LS ≥135) in 64 patients (55.7%). We verified a strong agreement between the two methods of capsule reading (Kappa = 0.83, p 
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research

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Conclusion: Patients undergoing emergency surgery for CD are at increased risk of exposure to ionizing radiations due to high perioperative use of CT scan.
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
Conclusions: We argue global FDG-PET/CT will be the gold standard moving forward for the diagnosis and clinical management of IBD. This molecular imaging technique has demonstrated superiority over purely structural imaging modalities. Therefore, future studies should further explore the role of FDG-PET/CT in IBD, as well as compare results to other imaging modalities.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibits Poster Session I Source Type: research
Authors: Arieira C, Magalhães R, Dias de Castro F, Boal Carvalho P, Rosa B, Moreira MJ, Cotter J Abstract Background: Pan-intestinal capsule endoscopy (Pan-CE) has been used to assess both the small and large bowel inflammation in Crohn's disease (CD) patients in a single examination. The capsule endoscopy Crohn's disease activity index (CECDAI) was initially developed to measure mucosal disease activity in the small bowel, although in 2018, it was extended to the colon for standardization of inflammatory activity (CECDAIic). The aim of this study was to apply the CECDAIic in a cohort of CD patients that und...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Authors: Dąbkowski K, Graca-Pakulska K, Zawada I, Ostrowski J, Starzyńska T Abstract Crohn's disease is an inflammatory disorder that can affect the entire gastrointestinal tract but typically involves the ileocecal region. Before endoscopy was widely used, involvement of the esophagus, stomach, and duodenum was thought to be rare. Recent publications demonstrated that not only are upper gastrointestinal lesions common in Crohn's disease (affecting up to 75% of the patients), but they also present characteristic endoscopic findings with potential clinical significance. It was suggested that lesions in the stomach...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Authors: de Sousa Magalhães R, Rosa B, Marques M, Boal Carvalho P, Cardoso H, Machado F, Macedo G, Cotter J Abstract Background: In suspected Crohn's disease (CD), non-diagnostic ileocolonoscopies are often followed by small bowel capsule endoscopy (SBCE). Adequate pre-selection of patients for SBCE is a key to optimize allocation of resources. We aimed to establish a rational approach for the CD diagnostic workflow, based on biochemical profile of patients with suspected CD, targeting an optimization of patients' selection for SBCE. Methods: Multicenter cohort study includes consecutive patients with suspec...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
A 63-year-old man presented with a history of abdominal pain, diarrhea, and weight loss. He had an abdominal computed tomography scan, which revealed duodenal, jejunal, and colonic thickening. This was followed by colonoscopy with biopsies, and the patient was diagnosed with inflammatory bowel disease, likely Crohn disease. However, upper endoscopy was performed, which revealed duodenal thickening, and biopsy revealed amyloid deposits by Congo red staining. Stool cultures were negative, and no source of infection was found.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Letter to the Editor Source Type: research
A 59-year-old woman presented with nonspecific abdominal pain. Gastroscopy and colonoscopy with intubation of the terminal ileum showed unremarkable results. A CT scan of the abdomen and pelvis revealed terminal ileitis with a mildly dilatated proximal ileum (A). The patient was scheduled for endoscopic small bowel evaluation, but she cancelled it. She was seen again 10 months later with an acute intestinal obstruction. Emergency laparotomy revealed multiple strictures in the terminal ileum about 1 foot proximal to the ileocecal junction and hard nodules on the mesentery (B).
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: At the focal point Source Type: research
This study showed a good safety and tolerability profile of the studied substance (Monteleone et al., 2012). Since TGFβ has been described to induce the profibrogenetic response of fibroblasts, patients were monitored for 6 months with intestinal ultrasonography, not showing signs of intestinal stenosis. Moreover, half of the patients maintained remission during the 6 months follow up period (Zorzi et al., 2012). Afterwards, a randomized, double-blind, phase 2 study was conducted in CD patients with inflammatory lesions in the terminal ileum and/or right colon, with steroid-dependence/resistance, randomized to three ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Crohn's disease and ulcerative colitis are chronic inflammatory diseases that lead to progressive bowel damage including the development of stricturing and penetrating complications. Increasingly, cross-sectional imaging with computed tomography or magnetic resonance scans have emerged as leading tools to: (1) assess disease activity; (2) monitor response to therapy or disease recurrence; and (3) identify disease-related complications. Several validated radiological scoring systems have been developed to quantify cross-sectional and longitudinal inflammatory burden in these diseases and to monitor response to treatment. Bo...
Source: Gastrointestinal Endoscopy Clinics of North America - Category: Gastroenterology Authors: Source Type: research
Abstract AIM: To determine whether cell division cycle (Cdc)42 is regulated by microRNA (miR)-15a in the development of pediatric inflammatory bowel disease (IBD). METHODS: We cultured 293T cells, used plasmids and performed dual-luciferase assay to determine whether Cdc42 is a miR-15a target gene. We cultured Caco-2 cells, and stimulated them with tumor necrosis factor (TNF)-α. We then employed lentiviruses to alter the expression of miR-15a and Cdc42. We performed quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunofluorescence to determine whether Cdc42 is regulated by mi...
Source: World Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
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