J Physician Assist Educ
October 2024
Introduction: Following ileocolic resection (ICR), the clinical importance and prognostic implications of histologic activity on biopsies in Crohn's disease (CD) patients with endoscopic remission are not well defined. The aim of this study was to determine if histologic activity in patients with endoscopic remission is associated with future risk of endoscopic and/or radiologic postoperative recurrence (POR).
Methods: In this multicenter retrospective cohort study, adult patients with CD who underwent ICR between 2009 and 2020 with endoscopic biopsies of ileal mucosa from Rutgeerts i0 on index colonoscopy were included.
Background: Fecal calprotectin (FC) is a reliable predictor of active bowel inflammation in postoperative Crohn's disease (CD), but cutoffs vary between studies. Recent guidelines recommend a cutoff of <50 ug/g to avoid routine endoscopy in patients at low pretest probability for CD recurrence. We evaluated the performance of this threshold in a real-world CD cohort after ileocolic resection (ICR).
View Article and Find Full Text PDFBackground & Aims: Preoperative risk stratification may help guide prophylactic biologic utilization for the prevention of postoperative Crohn's disease (CD) recurrence; however, there are limited data exploring and validating proposed clinical risk factors. We aimed to explore the preoperative clinical risk profiles, quantify individual risk factors, and assess the impact of biologic prophylaxis on postoperative recurrence risk in a real-world cohort.
Methods: In this multicenter retrospective analysis, patients with CD who underwent ileocolonic resection (ICR) from 2009 to 2020 were identified.
Background: Crohn's disease recurrence after ileocecal resection is common. Guidelines suggest colonoscopy within 6-12 months of surgery to assess for post-operative recurrence, but use of adjunctive monitoring is not protocolized. We aimed to describe the state of monitoring in post-operative Crohn's.
View Article and Find Full Text PDFBackground: Postoperative recurrence (POR) of Crohn's disease (CD) is common after surgical resection. We aimed to compare biologic type and timing for preventing POR in adult CD patients after ileocecal resection (ICR).
Methods: We performed a retrospective cohort study of CD patients who underwent an ICR at 2 medical centers.
Background & Aims: Postoperative Crohn's disease (CD) surveillance relies on endoscopic monitoring. The role of cross-sectional imaging is less clear. We evaluated the concordance of cross-sectional enterography with endoscopic recurrence and the predictive ability of radiography for future CD postoperative recurrence.
View Article and Find Full Text PDFIntroduction: Tuberous sclerosis complex (TSC) is a rare, multi-system, genetic disease. A significant cause of TSC-related morbidity is potential bleeding from renal angiomyolipoma (AML). To pre-emptively decrease AML bleeding, mTOR inhibitors can be used; however, thresholds for initiating and maintaining everolimus therapy remain uncertain.
View Article and Find Full Text PDFTakagi invaded Guam in 2003, and the influence on survival and demography of the host K.D. Hill population has been well-studied.
View Article and Find Full Text PDFCycad cone thermogenesis and its associated volatiles are intimately involved in mediating the behavior of their obligate specialist pollinators. In eastern Australia, thrips in the Cycadothrips chadwicki species complex are the sole pollinators of many Macrozamia cycads. Further, they feed and reproduce entirely in the pollen cones.
View Article and Find Full Text PDFThe presence of carotid arterial plaque by ultrasound enhances cardiovascular risk stratification beyond traditional risk factors. However, plaque quantification techniques require further outcomes-based investigation. The purpose of this study was to evaluate the utility of a focused carotid ultrasound protocol and novel plaque grading system developed by the American Society of Echocardiography (ASE).
View Article and Find Full Text PDFInvasions of non-native species can threaten native biodiversity, and island ecosystems are ideal for studying these phenomena. In this article, first, we report on the invasive species that combine to threaten the island cycad by reviewing the history of previously reported invasions and providing an update of recent invasions. Then, we prioritize the threat status of each herbivore and the interactions among them.
View Article and Find Full Text PDFGuam's established population of non-native coconut rhinoceros beetle (CRB, L.) began creating burrows in stem apices of several cycad species in a managed garden. We conducted an island-wide survey to determine the spatial patterns of CRB burrowing of stems of .
View Article and Find Full Text PDFMedEdPublish (2016)
April 2019
This article was migrated. The article was marked as recommended. Background An asynchronous curriculum is one in which residents complete structured learning assignments outside of the traditional Emergency Medicine conference day.
View Article and Find Full Text PDFBackground: Grayscale pixel ranges from ultrasound images, indicating differences in atherosclerotic plaque echogenicity, have been shown to represent different tissue types. Our objective was to determine whether carotid plaque composition was correlated with severity of coronary artery disease (CAD) and risk of cardiovascular (CV) events.
Methods: A focused carotid ultrasound was performed in 522 participants who had recently undergone coronary angiography.
Context: Phosphate has gained recognition as a risk factor for adverse cardiovascular outcomes, potentially due to accelerated vascular calcification. Fibroblast growth factor-23 (FGF-23) is a counter-regulatory hormone that increases renal phosphate excretion to maintain normal levels.
Objective: The purpose of the study was to determine the association of phosphate and FGF-23 to atherosclerosis.
Objective: Pre-clinical studies suggest that growth arrest-specific protein 6 (Gas6), a member of the vitamin K dependent family of proteins, is implicated in atherosclerosis. A role for Gas6 in stabilizing atherosclerotic plaque has been suggested. Our aim was to determine the association between Gas6 and measures of carotid artery atherosclerosis in humans undergoing elective coronary angiography.
View Article and Find Full Text PDFBackground: In countries with low calcium intake, the WHO recommends integrating calcium supplementation into antenatal care (ANC) to reduce the risk of preeclampsia, a leading cause of maternal mortality. Current WHO guidelines recommend women take 3-4 calcium supplements plus 1 iron-folic acid supplement at separate times daily. There is limited evidence about implementing these guidelines through routine ANC.
View Article and Find Full Text PDFBackground: Interatrial block (IAB) has been previously shown to predict atrial fibrillation (AF) in cardiac populations. This study sought to evaluate the relationship between IAB and new-onset AF in a population of patients undergoing clinically indicated coronary angiography who received carotid ultrasonography.
Methods: A population of 355 subjects undergoing coronary angiography and carotid ultrasound were retrospectively studied.
Purpose: Circumferential speckle tracking carotid artery strain is a novel method of quantifying vessel wall stiffness. We hypothesized that carotid wall stiffness would be associated with carotid intimal medial thickening (a medial process associated with risk factors), but not coronary artery disease (an intimal process).
Methods: Bilateral carotid artery ultrasound was conducted on outpatients who had previously undergone elective coronary angiography.
Pregnancy evokes many challenges on the maternal cardiovascular system that may unmask predispositions for future disease. This is particularly evident for women who develop pregnancy-related disorders, for example, pre-eclampsia and gestational diabetes or hypertension. Such pregnancy-related syndromes increase the risk for cardiovascular disease (CVD) postpartum.
View Article and Find Full Text PDFInt J Cardiovasc Imaging
July 2018
The carotid bifurcation is a common site of atherosclerotic plaque. Plaque development is thought to occur preferentially at geometrically predisposed areas such as arterial branch points. The aim of this study was to investigate the geometric and anatomical variables that contribute to the development of carotid plaque using three-dimensional (3D) ultrasound.
View Article and Find Full Text PDFBackground: Venous stents are commonly placed to ensure patency in patients with chronic peripheral venous insufficiency. Although serious complications are uncommon, peripheral venous stent placement can have some potentially life-threatening complications. One of the most feared, and certainly the most dramatic, complication is stent migration.
View Article and Find Full Text PDFBackground: Polymorphisms within natriuretic peptide (NP) genes have been associated with clinical outcomes for cardiovascular disease (CVD), but no previous study has compared the effect of these polymorphisms between men and women. This study aimed to investigate the association between single nucleotide polymorphisms (SNPs) in key genes of the NP system and coronary angiographic outcomes, with the focus on the sexual dimorphism in the effects of these SNPs.
Methods: Patients undergoing clinically indicated coronary angiography (n = 513, 328 men and 185 women) were consented and genotyped for rs5065, rs198389 and rs10758325.