Publications by authors named "Raffals Laura"
Article Synopsis
- Spondyloarthritis (SpA) is a common condition among patients with inflammatory bowel disease (IBD), affecting up to 39% of individuals but lacks well-defined risk factors.
- The study involved assessing 588 IBD patients using two validated questionnaires to identify SpA symptoms, revealing significant positive screenings for SpA among these patients.
- Key risk factors for positive SpA screens included being female, older age, a history of smoking, bowel surgery, and exposure to biologic treatments, with a concerning number of undiagnosed cases identified.
Article Synopsis
- Spondyloarthritis (SpA) is a common issue for patients with inflammatory bowel disease (IBD), and using specific screening tools could help identify it earlier and improve treatment.
- A study analyzed 669 IBD patients using two questionnaires (DETAIL and IBIS-Q) to check for SpA symptoms; many patients screened positive, with more showing axial symptoms rather than peripheral issues.
- The results highlighted that a significant number of patients with IBD might have undiagnosed SpA, particularly with the IBIS-Q being more effective in identifying potential cases, indicating a need for better rheumatology referrals for these patients.
Introduction: Pouchitis and Crohn's-like disease of the pouch (CLDP) are common in patients who undergo ileal pouch anal anastomosis for ulcerative colitis. We conducted separate systematic reviews to evaluate the effectiveness of available interventions to prevent and treat pouchitis and CLDP.
Methods: Through systematic literature reviews, we identified studies that evaluated the effectiveness of probiotics, antibiotics, 5-aminosalicylates, nonsystemic oral corticosteroids, and advanced therapies for prevention and treatment of pouchitis and CLDP for meta-analysis.
Article Synopsis
- Patients with ulcerative colitis (UC) experiencing severe flares in the hospital are a unique and high-risk group requiring specialized clinical trial designs.
- A multi-centre consortium is developing a trial for hyperbaric oxygen therapy, addressing important factors like inclusion/exclusion criteria, disease activity measures, and tailored care pathways.
- The study highlights the need for comprehensive outcome measures and standardized care practices while emphasizing the significance of early intervention and statistical planning in these small clinical trials.
Article Synopsis
- The study focuses on differentiating perianal issues caused by hidradenitis suppurativa (HS) and perianal fistulizing inflammatory bowel disease (IBD), as they often present similar symptoms.
- A retrospective review of patient data at the Mayo Clinic identified 15 key clinical features using machine learning to help distinguish between HS and IBD cases.
- Findings revealed significant differences in symptoms, with HS patients showing more skin-related issues and IBD patients experiencing additional gastrointestinal symptoms, which may lead to better diagnosis and treatment strategies.
Writing Groups for Healthcare Professionals in Academic Medicine.
J Prim Care Community Health
July 2024
Within the Department of Medicine (DOM) in a large tertiary academic health care facility in midwestern United States, we have developed an educational offering that incorporates an academic writing program (AWP) blending the approaches of a writing accountability work group, a writing workshop, and didactic writing courses. The purpose of this AWP was to assist healthcare professionals (HCP) with their manuscript writing skills to enhance academic productivity. We report our evolving journey and experiences with this AWP.
View Article and Find Full Text PDFIntroduction: The aim of this case-control study was to determine if exposure to tumor necrosis factor alpha inhibitors (TNFIs) or immunomodulators (thiopurines or methotrexate) was associated with development of primary gastrointestinal lymphoma (PGIL) in patients with chronic inflammatory conditions.
Methods: Patients with PGIL and controls evaluated at a tertiary care center over 20 years were matched 1:3 using a medical record informatics search engine based on their chronic inflammatory condition (Crohn's disease [CD], ulcerative colitis [UC], rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis) and duration of follow-up. Patients who started on TNFI within 3 months of PGIL diagnosis were excluded.
Background: To study the effects of the Reflect, Inspire, Strengthen, and Empower (RISE) 2.0 Program designed for professional development of women staff. Topics included emotional intelligence, appreciative coaching, resilience, and strategic career development.
View Article and Find Full Text PDFChronically inflamed colonic mucosa is primed to develop dysplasia identified at surveillance colonoscopy by targeted or random biopsies. We aimed to explore the effect of mucosal inflammation on detection of visible and "invisible" dysplasia and the concordance between the degree of endoscopic and histologic inflammation. This was a 6-year cross-sectional analysis of endoscopic and histologic data from IBD.
View Article and Find Full Text PDFBackground: Patients with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC) frequently undergo restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for medically refractory disease or colonic dysplasia/neoplasia. Subtotal colectomy with ileosigmoid or ileorectal anastomosis may have improved outcomes but is not well studied. Due to increased risk for colorectal cancer in PSC-IBD, there is hesitancy to perform subtotal colectomy.
View Article and Find Full Text PDFArticle Synopsis
- Pouchitis is a common issue after surgery for ulcerative colitis, and the AGA has developed guidelines to help doctors manage this condition effectively.
- A panel assessed clinical questions and outcomes to create 9 recommendations for treating pouchitis, Crohn's-like disease, and cuffitis.
- Key recommendations include using antibiotics for intermittent pouchitis, considering probiotics for prevention, and exploring advanced immunosuppressive therapies for chronic cases or those resistant to antibiotics.
Background: Patients with ulcerative colitis and total abdominal proctocolectomy with ileal pouch-anal anastomosis have a 50% risk of pouchitis and a 5% to 10% risk of chronic pouchitis.
Aims: The goal of the study was to compare pouch microbiota and stool bile acid composition in patients with chronic pouchitis, chronic pouchitis and primary sclerosing cholangitis, and normal pouch.
Methods: Patients with ulcerative colitis and ileal pouch-anal anastomosis were recruited from March 20, 2014, to August 6, 2019, and categorized into normal pouch, chronic pouchitis, and chronic pouchitis/primary sclerosing cholangitis groups.
Introduction: There is a paucity of data on the real-world effectiveness of therapies in patients with Crohn's disease of the pouch.
Methods: This was a prospective multicenter study evaluating the primary outcome of remission at 12 months of therapy for Crohn's disease of the pouch.
Results: One hundred thirty-four patients were enrolled.
Background: Forty distinct primary sclerosing cholangitis (PSC) genomic loci have been identified through multiancestry meta-analyses. The polygenic risk score (PRS) could serve as a promising tool to discover unique disease behaviour, like PSC, underlying inflammatory bowel disease (IBD).
Aim: To test whether PRS indicates PSC risk in patients with IBD.
The intestinal barrier is composed of several essential elements including luminal enzymes, bile acids, water layer, epithelial layer, and enterocyte layer. It acts as a dynamic interface between the luminal contents of food, commensal and pathogenic bacteria, and the gastrointestinal tract. The role of barrier dysfunction is of significant research interest in the development and targeted treatment of chronic inflammatory gastrointestinal conditions, such as inflammatory bowel disease.
View Article and Find Full Text PDFIntroduction: The American Gastroenterological Association (AGA) has compiled risk factors that may be predictive of disease complications in Crohn's disease (CD) and ulcerative colitis (UC). The aim of this study was to evaluate the performance of the AGA risk factors for risk stratification in UC and CD.
Methods: We included participants of 2 cohorts: the Ocean State Crohn's and Colitis Area Registry cohort and the Mayo Clinic cohort.
Background: Evidence-based recommendations regarding the influence of diet on inflammatory conditions of the pouch after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) are limited.
Methods: We analyzed dietary patterns at enrollment in a prospective registry of patients with 1 of 4 inflammatory conditions of the pouch (acute pouchitis, chronic antibiotic-dependent pouchitis, chronic antibiotic refractory pouchitis, and Crohn's disease of the pouch). We analyzed dietary intake by disease activity at enrollment and then compared dietary patterns among patients who remained in remission throughout the 12-month follow-up to those patients who experienced a disease relapse.
Article Synopsis
- Researchers aimed to identify ulcerative colitis (UC) patients at risk for primary sclerosing cholangitis (PSC), as PSC impacts UC outcomes.
- A retrospective study analyzed data from multiple institutions, assessing various genetic and clinical predictors to evaluate the risk of developing PSC among UC patients.
- Results indicated that certain genetic markers significantly increased the risk of PSC and that the study's model showed strong accuracy, potentially aiding in early identification and management of at-risk patients.
Background: Hidradenitis suppurativa (HS) and inflammatory bowel disease (IBD) have been reported to have a wide variety of overlaps in their pathogenesis, laboratory findings, and histopathology. These two diseases can form draining tunnels and are difficult to differentiate, particularly from fistulizing lesions in the perianal area.
Objective: This retrospective study of HS and IBD patients with perianal lesions sought to analyze the anemia and systemic inflammation biomarkers in these disease groups.
Total abdominal proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) is associated with substantial complications despite the benefits of managing refractory and/or neoplasia-associated disease. For the purpose of this review, we focused on the diagnosis of some of the most common inflammatory and structural pouch disorders and their respective management. Pouchitis is the most common complication, and it is typically responsive to antibiotics.
View Article and Find Full Text PDFBackground: Optimizing therapy and monitoring response are integral aspects of inflammatory bowel disease treatment. We conducted a systematic review and meta-analysis to determine whether serum ustekinumab trough concentrations during maintenance therapy were associated with ustekinumab treatment response in patients with inflammatory bowel disease.
Methods: A systematic review was performed to March 21, 2022, to identify studies using MEDLINE, EMBASE, and the Cochrane library.
Background: Ileal pouch-anal anastomosis (IPAA) is the standard restorative procedure following proctocolectomy in patients with inflammatory bowel disease (IBD) who require colectomy. However, removal of the diseased colon does not eliminate the risk of pouch neoplasia. We aimed to assess the incidence of pouch neoplasia in IBD patients following IPAA.
View Article and Find Full Text PDFBackground: Microscopic colitis (MC) is suspected to result from increased immune activity in gut mucosa. Immune checkpoint inhibitors (ICIs) treat cancer by activating the immune system, and further investigation is needed regarding their role in the development of MC.
Methods: A retrospective case series investigated cases of endoscopically and histologically confirmed MC developing after administration of ICIs.