关键词： IPAA   Ileal pouch-anal anastomosis   TaTME   TaIPAA   Transanal  

摘要： PurposeInitial reports of transanal ileal pouch-anal anastomosis (taIPAA) suggest safety and feasibility compared with transabdominal IPAA. The purpose of this study was to evaluate differences in technique and results of taIPAA in three centers performing taIPAA across two *** IPAA registries from three institutions in the US and Europe were queried for patients undergoing taIPAA. Demographic, preoperative, intraoperative, and postoperative data were compiled into a single database and ***-two patients (median age 38years;range 16-68years, 43 (69%) male) underwent taIPAA in the three centers (USA 24, UK 23, Italy 15). Most patients had had a subtotal colectomy before taIPAA [n=55 (89%)]. Median surgical time was 266min (range 180-576min) and blood loss 100ml (range 10-500ml). Technical variations across the three institutions included proctectomy plane of dissection (intramesorectal or total mesorectal excision plane), specimen extraction site (future ileostomy site vs. anus), ileo-anal anastomosis technique (stapled vs. hand sewn) and use of fluorescence angiography. Despite technical differences, anastomotic leak rates (5/62;8%) and overall complications (18/62;29%) were acceptable across the three *** is the first collaborative report showing safety and feasibility of taIPAA. Despite technical variations, outcomes are similar across centers. A large multi-institutional, international IPAA collaborative is needed to compare technical factors and outcomes.

关键词： Paediatric   Ultrasound   Inflammatory bowel disease   Crohn's disease   Ulcerative colitis  

摘要： Ultrasound has long been favoured as first line when imaging children, primarily due to it being a non-invasive, relatively low cost, easily accessible modality. The many advantages of ultrasound evaluation in paediatric inflammatory bowel disease (IBD) vastly outweighs its limitations in both initial assessment and long term follow up. High frequency ultrasound provides excellent spatial resolution, and Doppler evaluation and compression sonography aids in providing real-time dynamic assessment in IBD where other modalities cannot. This paper outlines our ultrasound technique to maximise image quality and diagnostic accuracy, describes the imaging findings in paediatric IBD, and explores the advantages and limitations that ultrasound offers. We aim to illustrate to the reader that ultrasound is an invaluable imaging tool and should be the first line modality when imaging IBD in the paediatric patient.

关键词： Inflammatory bowel disease   ASCA   ANCA   Southern Israel   Arab Bedouin  

摘要： BackgroundSerological markers used for diagnostic purposes and disease stratification in inflammatory bowel *** aimed to investigate the frequency of ASCA and ANCA among Arab Bedouin IBD patients and its relationship to disease phenotype and *** cohort of 68, 25 Crohn's disease (CD) and 25 Ulcerative colitis (UC) patients were recruited (72%). ASCA IgG was determined by ELISA assay. Immunofluorescence analysis of ANCA was *** IgG ASCA was detected in 13 (52%) of the CD patients and in three (12%) UC patients. The prevalence of ANCA among UC patients was positive with 76%, sub-grouped, atypical ANCA in 9 patients (36%), pANCA in six patients (24%) and cANCA in 4 patients (16%).The detection of ASCA among CD patients was found not to be a reliable predictor of young age at diagnosis, gender, ileal involvement, anti-TNF treatment or *** patients with positive ANCA were younger, mean age 40.211.9 compared with 57.3 +/- 21.2 (p=0.03), and diagnosed at a younger age, 29.2 +/- 11.8 compared with 43.5 +/- 15.3 (p=0.05).Conclusion p id=Par7 The frequency of ASCA among Bedouin CD patients and ANCA among UC patients was high, however ASCA was not found to have a predictive value for disease phenotype or course. Positive ANCA in UC patients was predictive for younger age and age at diagnosis.

关键词： Dexamethasone   Microcrystals   Layer-by-layer coating   Colon-targeted drug delivery   Inflammatory bowel disease  

摘要： Oral colon-targeted drug delivery has gained popularity as an effective strategy for treatment of inflammatory bowel disease (IBD). In this study, we prepared colon-targeted dexamethasone microcrystals (DXMCs) coated with multilayers of chitosan oligosaccharide (CH), alginate (AG), and finally Eudragit S 100 (ES) (ES(1)AG(4)CH(5)DXMCs) using a layer-by-layer (LBL) coating technique. Particle size, surface charge, in vitro drug release, and in vivo anti-inflammatory activity of ES(1)AG(4)CH(5)-DXMCs were evaluated. ES(1)AG(4)CH(5)-DXMCs had an average particle size of 2.34 +/- 0.19 mu m and a negative surface charge of -48 +/- 9 mV. ES(1)AG(4)CH(5)-DXMCs demonstrated pH-dependent dexamethasone release, avoiding initial burst drug release in acidic pH conditions of the stomach and small intestine, and providing subsequent sustained drug release in the colonic pH. Importantly, ES(1)AG(4)CH(5)-DXMCs exhibited a significant therapeutic activity in a mouse model of colitis compared to other DXMCs. Overall, the LBL-coated DXMCs presented here could be a promising colon-targeted therapy for IBD.