137 results on '"Kruis W"'
Search Results
2. Synchronous pathologic findings in patients with colorectal cancer and preoperative incomplete colonoscopy
- Author
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Krause, Carolin and Kruis, W.
- Published
- 2019
- Full Text
- View/download PDF
3. Moderne Therapie der Divertikelkrankheit
- Author
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Leifeld, L. and Kruis, W.
- Abstract
Zusammenfassung: Neue Konzepte finden Einzug in die Therapie der Divertikelkrankheit. Die leichte unkomplizierte Divertikulitis kann ambulant mit einem Aminosalizylat als Monotherapeutikum therapiert werden. Bei moderater Divertikulitis werden additiv oder alternativ Antibiotika verabreicht. Die schwere Divertikulitis wird stationär mittels Nulldiät, parenteraler Ernährung und i.v.-Breitbandantibiotika behandelt. Die komplizierte Divertikulitis wird interdisziplinär behandelt, größere Abszesse sollten zunächst perkutan drainiert werden, um anschließend einzeitig operiert werden zu können. Freie Perforationen bleiben eine Indikation zur Notfalloperation. Bei der rekurrierenden Divertikulitis wird die Operationsindikation nicht mehr von der Häufigkeit der Schübe, sondern vom Ausmaß der vorangegangenen Divertikulitis abhängig gemacht.
- Published
- 2024
- Full Text
- View/download PDF
4. Divertikulitis: Domäne der konservativen bzw. medikamentösen Therapie?
- Author
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Böhm, S. and Kruis, W.
- Published
- 2017
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- View/download PDF
5. Lifestyle, behaviour, and environmental modification for the management of patients with inflammatory bowel diseases: an International Organization for Study of Inflammatory Bowel Diseases consensus
- Author
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Ananthakrishnan, Ashwin N, primary, Kaplan, Gilaad G, additional, Bernstein, Charles N, additional, Burke, Kristin E, additional, Lochhead, Paul J, additional, Sasson, Alexa N, additional, Agrawal, Manasi, additional, Tiong, Jimmy Ho Tuan, additional, Steinberg, Joshua, additional, Kruis, Wolfgang, additional, Steinwurz, Flavio, additional, Ahuja, Vineet, additional, Ng, Siew C, additional, Rubin, David T, additional, Colombel, Jean-Frederic, additional, Gearry, Richard, additional, Abreu, M, additional, Ahuja, V, additional, Allez, M, additional, Ananthakrishnan, A, additional, Bemelman, W, additional, Bernstein, C, additional, Braun, J, additional, Chowers, Y, additional, Colombel, J-F, additional, Danese, S, additional, D'Haens, G, additional, D'Hoore, A, additional, Dignass, A, additional, Dotan, I, additional, Dubinsky, M, additional, Ekbom, A, additional, Fleshner, P, additional, Gasche, C, additional, Gassull, MA, additional, Gearry, R, additional, Ghosh, S, additional, Gibson, P, additional, Griffiths, A, additional, Halfvarson, J, additional, Hanauer, S, additional, Harpaz, N, additional, Hart, A, additional, Hibi, T, additional, Kamm, M, additional, Kaplan, G, additional, Kaser, A, additional, Korelitz, B, additional, Kotze, P, additional, Koutroubakis, I, additional, Kruis, W, additional, Lakatos, P, additional, Lewis, J, additional, Lindsay, J, additional, Loftus, E, additional, Louis, E, additional, Lukas, M, additional, Magro, F, additional, Mahadevan, U, additional, Mantzaris, G, additional, Mary, J-Y, additional, McGovern, D, additional, Moum, B, additional, Munkholm, P, additional, Neurath, M, additional, Ng, S, additional, O'Morain, C, additional, Oresland, T, additional, Panaccione, R, additional, Panes, J, additional, Panis, Y, additional, Pemberton, J, additional, Peyrin-Biroulet, L, additional, Prantera, C, additional, Rachmilewitz, D, additional, Ran, Z, additional, Reinisch, W, additional, Remzi, F, additional, Rhodes, J, additional, Riddell, R, additional, Rogler, G, additional, Rubin, D, additional, Sachar, D, additional, Sandborn, W, additional, Sands, B, additional, Sartor, B, additional, Schoelmerich, J, additional, Schreiber, S, additional, Siegel, C, additional, Siegmund, B, additional, Silverberg, M, additional, Söderholm, J, additional, Sood, A, additional, Spinelli, A, additional, Stange, E, additional, Steinwurz, F, additional, Targan, S, additional, Travis, S, additional, Turner, D, additional, Tysk, C, additional, Vatn, M, additional, Vermeire, S, additional, Watanabe, M, additional, Yamamoto, T, additional, and Yamamoto-Furusho, J, additional
- Published
- 2022
- Full Text
- View/download PDF
6. Lifestyle, behaviour, and environmental modification for the management of patients with inflammatory bowel diseases:an International Organization for Study of Inflammatory Bowel Diseases consensus
- Author
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Ananthakrishnan, A., Kaplan, G., Bernstein, C., Burke, Kristin E., Lochhead, Paul J., Sasson, Alexa N., Agrawal, Manasi, Tiong, Jimmy Ho Tuan, Steinberg, Joshua, Kruis, W., Steinwurz, Flavio, Ahuja, V., Ng, Siew C., Rubin, David T., Colombel, Jean Frederic, Gearry, Richard, Abreu, M., Allez, M., Bemelman, W., Braun, J., Chowers, Y., Colombel, J. F., Danese, S., D'Haens, G., D'Hoore, A., Dignass, A., Dotan, I., Dubinsky, M., Ekbom, A., Fleshner, P., Gasche, C., Gassull, M. A., Ghosh, S., Gibson, P., Griffiths, A., Halfvarson, J., Hanauer, S., Harpaz, N., Hart, A., Hibi, T., Kamm, M., Kaser, A., Korelitz, B., Kotze, P., Koutroubakis, I., Munkholm, P., Ananthakrishnan, A., Kaplan, G., Bernstein, C., Burke, Kristin E., Lochhead, Paul J., Sasson, Alexa N., Agrawal, Manasi, Tiong, Jimmy Ho Tuan, Steinberg, Joshua, Kruis, W., Steinwurz, Flavio, Ahuja, V., Ng, Siew C., Rubin, David T., Colombel, Jean Frederic, Gearry, Richard, Abreu, M., Allez, M., Bemelman, W., Braun, J., Chowers, Y., Colombel, J. F., Danese, S., D'Haens, G., D'Hoore, A., Dignass, A., Dotan, I., Dubinsky, M., Ekbom, A., Fleshner, P., Gasche, C., Gassull, M. A., Ghosh, S., Gibson, P., Griffiths, A., Halfvarson, J., Hanauer, S., Harpaz, N., Hart, A., Hibi, T., Kamm, M., Kaser, A., Korelitz, B., Kotze, P., Koutroubakis, I., and Munkholm, P.
- Abstract
Environmental and lifestyle factors play an important role in the natural history of Crohn's disease and ulcerative colitis. A group of international experts from the International Organization for the Study of Inflammatory Bowel Diseases voted on a series of consensus statements to inform the management of inflammatory bowel disease (IBD). The recommendations include avoiding traditional cigarette smoking in patients with Crohn's disease or ulcerative colitis, screening for symptoms of depression, anxiety, and psychosocial stressors at diagnosis and during flares (with referral to mental health professionals when appropriate), and encouraging regular physical activity as tolerated. Patients using dietary approaches for treatment of their IBD should be encouraged to adopt diets that are best supported by evidence and involve monitoring for the objective resolution of inflammation. We recommend formal assessment for obesity and nutritional deficiencies, and patients should be encouraged to maintain a normal body-mass index. A shared decision-making approach to contraception should include the consideration of IBD-related factors, and risk factors for venous thromboembolism. Long-term or frequent use of high-dose non-steroidal anti-inflammatory drugs should be avoided. For primary prevention of disease in the offspring of patients with IBD, we recommend avoiding passive exposure to tobacco, using antibiotics judiciously, and considering breastfeeding when able.
- Published
- 2022
7. Patient Education in a 14-month Randomised Trial Fails to Improve Adherence in Ulcerative Colitis: Influence of Demographic and Clinical Parameters on Non-adherence
- Author
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Nikolaus, S, Schreiber, S, Siegmund, B, Bokemeyer, B, Bästlein, E, Bachmann, O, Görlich, D, Hofmann, U, Schwab, M, and Kruis, W
- Published
- 2017
- Full Text
- View/download PDF
8. The DICA Endoscopic Classification for Diverticular Disease of the Colon Shows a Significant Interobserver Agreement among Community Endoscopists: an International Study
- Author
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Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G. A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D. L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P. G., Maconi G., Malfertheiner P., Mazzarri A., Mearin F., Milosavljevic T., Nardone G., de Oliveira E. C., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L. L., Walker M. M. D., Allegretta L., Altavilla N., Amaro P., Annunziata M. L., Barberio F., Basile G., Bedogni G., Belfiori V., Benvenuti S., Bertolami C., Bisello M., El Dammak M. B., Bozzi R., Buono M., Cambie G., Capezzuto E., Casamassima C., Chavoushian A., Ciofani R., Citarella C., Compare D., Cotruta B., D'amico F., Dulk M. D., Dyrda B. E., Festa V., Gallina S., Grasso R., Hanzel J., Taieb J. M., Lai M. A., Latella G., Lisi D., Lodi L., Marangi S., Mardegan A., Marlicz W., Maurano A., Milazzo G., Militaru V., Miraglia S., Monica F., Moskalev A., Natale A., Nicolas C., Pancetti A., Penna A., Pepe A. S., Pisano M., Pontone S., Prati M., Prisco A., Rando L., Hernandez E. R., Rosati O., Rossi G., Passoni G. R., Papa V., Nesme N. S., Schiffino L., Schillaci D., Selvaggi G., Taborchi F., Tornar A., Trebuna F., Triggiani C., Testai F. V., Vassallo R., Violi A., Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, A., Biondo, S., Cassieri, C., Crucitti, A., Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzarri, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, A., Papagrigoriadis, S., Pera, M., Persiani, R., Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Walker, M. M. D., Allegretta, L., Altavilla, N., Amaro, P., Annunziata, M. L., Barberio, F., Basile, G., Bedogni, G., Belfiori, V., Benvenuti, S., Bertolami, C., Bisello, M., El Dammak, M. B., Bozzi, R., Buono, M., Cambie, G., Capezzuto, E., Casamassima, C., Chavoushian, A., Ciofani, R., Citarella, C., Compare, D., Cotruta, B., D'Amico, F., Dulk, M. D., Dyrda, B. E., Festa, V., Gallina, S., Grasso, R., Hanzel, J., Taieb, J. M., Lai, M. A., Latella, G., Lisi, D., Lodi, L., Marangi, S., Mardegan, A., Marlicz, W., Maurano, A., Milazzo, G., Militaru, V., Miraglia, S., Monica, F., Moskalev, A., Natale, A., Nicolas, C., Pancetti, A., Penna, A., Pepe, A. S., Pisano, M., Pontone, S., Prati, M., Prisco, A., Rando, L., Hernandez, E. R., Rosati, O., Rossi, G., Passoni, G. R., Papa, V., Nesme, N. S., Schiffino, L., Schillaci, D., Selvaggi, G., Taborchi, F., Tornar, A., Trebuna, F., Triggiani, C., Testai, F. V., Vassallo, R., Violi, A., Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G.A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D.L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P.G., Maconi G., Malfertheiner P., Mazzari A., Mearin F., Milosavljevic T., Nardone G., Chavez De Oliveira E., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L.L., and Walker M.M.
- Subjects
BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences ,Diverticular Disease ,Endoscopic classification ,Video Recording ,Colonoscopy ,Gastroenterology ,Severity of Illness Index ,endoscopic classification ,Diverticulum ,classification ,complications ,Diverticular diseases ,Endoscopy ,methods ,Colonic Diseases ,0302 clinical medicine ,Community Health Services ,Community Health Service ,Observer Variation ,0303 health sciences ,medicine.diagnostic_test ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti ,agreement − colonoscopy − community setting − diverticular disease of the colon− endoscopic classification ,3. Good health ,Diverticulosis ,Malalties del còlon ,Diverticular disease of the colon ,Diverticular disease ,616.344-007.64 [udc] ,Community setting ,030211 gastroenterology & hepatology ,Human ,medicine.medical_specialty ,Scoring system ,Colonic Disease ,Settore MED/12 - GASTROENTEROLOGIA ,Reproducibility of Result ,agreement ,colonoscopy ,community setting ,diverticular disease of the colon ,Agreement ,03 medical and health sciences ,Internal medicine ,Severity of illness ,medicine ,Diverticulosis, Colonic ,Humans ,Colonic diseases ,030304 developmental biology ,Diverticular Diseases ,business.industry ,Colonoscòpia ,Reproducibility of Results ,medicine.disease ,Inter-rater reliability ,business ,Kappa - Abstract
Background and Aims: The Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification of diverticulosis and diverticular disease (DD) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement on this classification in an international endoscopists community setting. Methods: A total of 96 doctors (82.9% endoscopists) independently scored a set of DD endoscopic videos. The percentages of overall agreement on DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of interrater agreement. Results: Overall agreement in using DICA was 91.8% with a free-marginal kappa of 88% (95% CI 80-95). The overall agreement levels were: DICA 1, 85.2%; DICA 2, 96.5%; DICA 3, 99.5%. The free marginal κ was: DICA 1 = 0.753, DICA 2 = 0.958, DICA 3 = 0.919. The agreement about the main endoscopic items was 83.4% (k 67%) for diverticular extension, 62.6% (k 65%) for number of diverticula for each district, 86.8% (k 82%) for presence of inflammation, and 98.5 (k 98%) for presence of complications. Conclusions: The overall interrater agreement in this study ranges from good to very good. DICA score is a simple and reproducible endoscopic scoring system for diverticulosis and DD.
- Published
- 2019
9. Erkrankungsschwere bei CED: Einschätzung standardisierter Fallvignetten durch Betroffene im Vergleich zum arztbasierten Disease Severity Index (DSI)
- Author
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Timmer, A, additional, de Sordi, D, additional, Kappen, S, additional, Hensel, A, additional, Azimi, LS, additional, Helwig, U, additional, Böcker, U, additional, Morgenstern, J, additional, Schmidt-Lauber, M, additional, Koletzko, L, additional, Meinhardt, C, additional, Arlt, A, additional, Kaltz, B, additional, Sander, C, additional, Preiß, J, additional, and Kruis, W, additional
- Published
- 2021
- Full Text
- View/download PDF
10. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon
- Author
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Schultz, J.K. (J. K.), Azhar, N. (N.), Binda, G.A. (G. A.), Barbara, G. (G.), Biondo, S. (S.), Boermester, M.A. (M. A.), Chabok, A. (A.), Consten, E.C. (Esther), Dijk, S.M. (Sven) van, Johanssen, A. (A.), Kruis, W. (W.), Lambrichts, D.P.V. (Daniël), Post, S. (S.), Ris, F. (F.), Rockall, T.A. (T. A.), Samuelsson, A. (A.), Di Saverio, S. (Salomone), Tartaglia, D. (D.), Thorisson, A. (A.), Winter, D.C. (D. C.), Bemelman, W.A., Angenete, E. (E.), Schultz, J.K. (J. K.), Azhar, N. (N.), Binda, G.A. (G. A.), Barbara, G. (G.), Biondo, S. (S.), Boermester, M.A. (M. A.), Chabok, A. (A.), Consten, E.C. (Esther), Dijk, S.M. (Sven) van, Johanssen, A. (A.), Kruis, W. (W.), Lambrichts, D.P.V. (Daniël), Post, S. (S.), Ris, F. (F.), Rockall, T.A. (T. A.), Samuelsson, A. (A.), Di Saverio, S. (Salomone), Tartaglia, D. (D.), Thorisson, A. (A.), Winter, D.C. (D. C.), Bemelman, W.A., and Angenete, E. (E.)
- Abstract
Aim: The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods: The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results: This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion: This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.
- Published
- 2020
- Full Text
- View/download PDF
11. Cough meets Colic - a rare Cause of a progressive Cough - a Case Report
- Author
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Engelmann, E., Scheel, A., Buhr, M., Kruis, W., Schlesinger, A., Engelmann, E., Scheel, A., Buhr, M., Kruis, W., and Schlesinger, A.
- Published
- 2020
12. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon
- Author
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Schultz, J. K., Azhar, N., Binda, G. A., Barbara, G., Biondo, S., Boermester, M. A., Chabok, A., Consten, E. C. J., van Dijk, S. T., Johanssen, A., Kruis, W., Lambrichts, D., Post, S., Ris, F., Rockall, T. A., Samuelsson, A., Di Saverio, S., Tartaglia, D., Thorisson, A., Winter, D. C., Bemelman, W., Angenete, E., Schultz, J. K., Azhar, N., Binda, G. A., Barbara, G., Biondo, S., Boermester, M. A., Chabok, A., Consten, E. C. J., van Dijk, S. T., Johanssen, A., Kruis, W., Lambrichts, D., Post, S., Ris, F., Rockall, T. A., Samuelsson, A., Di Saverio, S., Tartaglia, D., Thorisson, A., Winter, D. C., Bemelman, W., and Angenete, E.
- Abstract
Aim The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.
- Published
- 2020
13. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon
- Author
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Schultz, JK, Azhar, N, Binda, GA, Barbara, G, Biondo, S, Boermeester, MA, Chabok, A, Consten, ECJ, van Dijk, ST, Johanssen, A, Kruis, W, Lambrichts, Daniël, Post, S, Ris, F, Rockall, TA, Samuelsson, A, Di Saverio, S, Tartaglia, D, Thorisson, A, Winter, DC, Bemelman, W, Angenete, E, Schultz, JK, Azhar, N, Binda, GA, Barbara, G, Biondo, S, Boermeester, MA, Chabok, A, Consten, ECJ, van Dijk, ST, Johanssen, A, Kruis, W, Lambrichts, Daniël, Post, S, Ris, F, Rockall, TA, Samuelsson, A, Di Saverio, S, Tartaglia, D, Thorisson, A, Winter, DC, Bemelman, W, and Angenete, E
- Published
- 2020
14. Updated S3-Guideline Colitis ulcerosa. German Society for Digestive and Metabolic Diseases (DGVS) : AWMF Registry 021/009
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Kucharzik, Torsten, Dignass, Axel U., Atreya, Raja, Bokemeyer, Bernd, Esters, Philip, Herrlinger, Klaus, Kannengießer, Klaus, Kienle, Peter, Langhorst, Jost, Lügering, Andreas, Schreiber, Stefan, Stallmach, Andreas, Stein, Jürgen, Sturm, Andreas, Teich, Niels, Siegmund, Britta, Andus, T., Autschbach, F., Bachmann, O., Baretton, G., Baumgart, D.C., Bettenworth, D., Bläker, M., Buderus, S., Büning, J., Ehehalt, R., Fellermann, K., Fichtner-Feigl, S., Götz, M., Gross, C., Hartmann, F., Hartmann, P., In Der Smitten, S., Häuser, W., Helwig, U., Kaltz, B., Kanbach, I., Keller, K.M., Klaus, J., Koletzko, S., Kroesen, A., Kruis, W., Kühbacher, T., Leifeld, L., Maaser, C., Matthes, H., Moog, G., Ockenga, J., Pace, A., Reinshagen, M., Rijcken, E., Rogler, G., Stange, E., Veltkamp, C., and Zemke, J.
- Subjects
Medizin ,Gastroenterology - Abstract
ZusammenfassungDie neue S3-Leitlinie Colitis stellt aktuelle und evidenzbasierte Empfehlungen zur Behandlung der Colitis ulcerosa zur Verfügung. Sie ersetzt damit die Vorläuferversion von 2011. Neben den neuesten Erkenntnissen zu Diagnostik und Therapie werden insbesondere infektiologische Probleme, chirurgische und Ernährungsmaßnahmen aufgegriffen. Unter der Federführung der DGVS wurde die Leitlinie gemeinsam mit 10 weiteren Fachgesellschaften und Patientenvertretern erarbeitet mit dem Ziel, eine optimale interdisziplinäre Versorgung der Patienten zu gewährleisten.
- Published
- 2018
15. OC.08.3 THE “DICA” ENDOSCOPIC CLASSIFICATION FOR DIVERTICULAR DISEASE OF THE COLON SHOWS A SIGNIFICANT INTEROBSERVER AGREEMENT AMONG COMMUNITY ENDOSCOPISTS: AN INTERNATIONAL STUDY
- Author
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Tursi, A., primary, Brandimarte, G., additional, Di Mario, F., additional, Lanas, A., additional, Scarpignato, C., additional, Bafutto, M., additional, Barbara, G., additional, Bassotti, G., additional, Binda, G.A., additional, Biondi, A., additional, Biondo, S., additional, Cambiè, G., additional, Cassieri, C., additional, Crucitti, A., additional, Dumitrascu, D., additional, Elisei, W., additional, Escalante, R., additional, Herszènyi, L., additional, Kruis, W., additional, Kupcinskas, J., additional, Lahat, A., additional, Lecca, P.G., additional, Maconi, G., additional, Malfertheiner, P., additional, Mazzari, A., additional, Mearìn, F., additional, Milosavljevic, T., additional, Nardone, G., additional, Chavez De Oliveira, E., additional, Papa, A., additional, Papagrigoriadis, S., additional, Pera, M., additional, Persiani, R., additional, Picchio, M., additional, Regula, J., additional, Štimac, D., additional, Stollman, N., additional, Strate, L., additional, Violi, A., additional, and Walker, M., additional
- Published
- 2020
- Full Text
- View/download PDF
16. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon
- Author
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Schultz, J. K., primary, Azhar, N., additional, Binda, G. A., additional, Barbara, G., additional, Biondo, S., additional, Boermeester, M. A., additional, Chabok, A., additional, Consten, E. C. J., additional, van Dijk, S. T., additional, Johanssen, A., additional, Kruis, W., additional, Lambrichts, D., additional, Post, S., additional, Ris, F., additional, Rockall, T. A., additional, Samuelsson, A., additional, Di Saverio, S., additional, Tartaglia, D., additional, Thorisson, A., additional, Winter, D. C., additional, Bemelman, W., additional, and Angenete, E., additional
- Published
- 2020
- Full Text
- View/download PDF
17. Cough meets Colic – eine seltene Ursache eines progredienten Hustens – eine Falldarstellung
- Author
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Engelmann, E, additional, Scheel, A, additional, Buhr, M, additional, Kruis, W, additional, and Schlesinger, A, additional
- Published
- 2020
- Full Text
- View/download PDF
18. International consensus on diverticulosis and diverticular disease. Statements from the 3rd international symposium on diverticular disease
- Author
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Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, Alberto, Biondo, S., Cambie, G., Cassieri, C., Crucitti, Antonio, Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzari, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, Alfredo, Papagrigoriadis, S., Pera, M., Persiani, Roberto, Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Violi, A., Walker, M. M. D., Biondi A. (ORCID:0000-0002-2470-7858), Crucitti A. (ORCID:0000-0003-3496-4185), Persiani R. (ORCID:0000-0002-1537-5097), Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, Alberto, Biondo, S., Cambie, G., Cassieri, C., Crucitti, Antonio, Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzari, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, Alfredo, Papagrigoriadis, S., Pera, M., Persiani, Roberto, Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Violi, A., Walker, M. M. D., Biondi A. (ORCID:0000-0002-2470-7858), Crucitti A. (ORCID:0000-0003-3496-4185), and Persiani R. (ORCID:0000-0002-1537-5097)
- Abstract
The statements produced by the Chairmen and Speakers of the 3rd International Symposium on Diverticular Disease, held in Madrid on April 11th-13th 2019, are reported. Topics such as current and evolving concepts on the pathogenesis, the course of the disease, the news in diagnosing, hot topics in medical and surgical treatments, and finally, critical issues on the disease were reviewed by the Chairmen who proposed 39 statements graded according to level of evidence and strength of recommendation. Each topic was explored focusing on the more relevant clinical questions. The vote was conducted on a 6-point scale and consensus was defined a priori as 67% agreement of the participants. The voting group consisted of 124 physicians from 18 countries, and agreement with all statements was provided. Comments were added explaining some controversial areas.
- Published
- 2019
19. Microbial Spectrum of Intra-Abdominal Abscesses in Perforating Crohn's Disease: Results from a Prospective German Registry
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Reuken, P. A., Kruis, W., Maaser, C., Teich, N., Buening, J., Preiss, J. C., Schmelz, R., Bruns, T., Fichtner-Feigl, S., Stallmach, A., Reuken, P. A., Kruis, W., Maaser, C., Teich, N., Buening, J., Preiss, J. C., Schmelz, R., Bruns, T., Fichtner-Feigl, S., and Stallmach, A.
- Abstract
Background: Intra-abdominal abscesses [IAAs] are common life-threatening complications in patients with Crohn's disease [CD]. In addition to interventional drainage and surgical therapy, empirical antibiotic therapy represents a cornerstone of treatment, but contemporary data on microbial spectra and antimicrobial resistance are scarce. Methods: We recruited 105 patients with CD and IAAs from nine German centres for a prospective registry in order to characterize the microbiological spectrum, resistance profiles, antibiotic therapy and outcome. Results: In 92 of 105 patients, microbial investigations of abscess material revealed pathogenic microorganisms. A total of 174 pathogens were isolated, with a median of 2 pathogens per culture [range: 1-6]. Most frequently isolated pathogens were E. coli [45 patients], Streptococcus spp. [28 patients], Enterococci [27 patients], Candida [13 patients] and anaerobes [12 patients]. Resistance to third-generation cephalosporins, penicillins with beta-lactamase inhibitors and quinolones were observed in 51, 36 and 35 patients, respectively. Seven patients had multiple-drug-resistant bacteria. Thirty patients received inadequate empirical treatment, and this was more frequent in patients receiving steroids or immunosuppression [37%] than in patients without immunosuppression [10%: p = 0.001] and was associated with a longer hospital stay [21 days vs 13 days, p = 0.003]. Conclusion: Based on antimicrobial resistance profiles, we herein report a high rate of inadequate empirical first-line therapy for IAAs in CD, especially in patients receiving immunosuppression, and this is associated with prolonged hospitalization.
- Published
- 2018
20. Randomised clinical trial:mesalazine versus placebo in the prevention of diverticulitis recurrence
- Author
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Kruis, W. (W.), Kardalinos, V. (V.), Eisenbach, T. (T.), Lukas, M. (M.), Vich, T. (T.), Bunganic, I. (I.), Pokrotnieks, J. (J.), Derova, J. (J.), Kondrackiene, J. (J.), Safadi, R. (R.), Tuculanu, D. (D.), Tulassay, Z. (Z.), Banai, J. (J.), Curtin, A. (A.), Dorofeyev, A. E. (A. E.), Zakko, S. F. (S. F.), Ferreira, N. (N.), Björck, S. (S.), Diez Alonso, M. M. (M. M.), Mäkelä, J. (J.), Talley, N. J. (N. J.), Dilger, K. (K.), Greinwald, R. (R.), Mohrbacher, R. (R.), and Spiller, R. (R.)
- Abstract
Background: Previous studies have reached conflicting conclusions regarding the efficacy of mesalazine in the prevention of recurrent diverticulitis. Aim: To investigate the efficacy and safety of mesalazine granules in the prevention of recurrence of diverticulitis after acute uncomplicated diverticulitis. Methods: Two phase 3, randomised, placebo‐controlled, double‐blind multicentre trials (SAG‐37 and SAG‐51) investigated mesalazine granules in patients with prior episodes (1 episode. Safety data revealed no new adverse events. Conclusion: Mesalazine was not superior to placebo in preventing recurrence of diverticulitis.
- Published
- 2017
21. Karzinome des Anorektums bei fistulierendem M. Crohn: Besonderheiten der operativen Therapie?
- Author
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Müller, G, additional, Kruis, W, additional, Stöckmann, H, additional, and Marek, P, additional
- Published
- 2018
- Full Text
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22. Randomised clinical trial: mesalazine versus placebo in the prevention of diverticulitis recurrence
- Author
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Kruis, W., Kardalinos, V., Eisenbach, T., Lukas, M., Vich, T., Bunganic, I., Pokrotnieks, J., Derova, J., Kondrackiene, J., Safadi, R., Tuculanu, D., Tulassay, Z., Banai, J., Curtin, A., Dorofeyev, A. E., Zakko, S. F., Ferreira, N., Bjorck, S., Alonso, M. M. Diez, Makela, J., Talley, N. J., Dilger, K., Greinwald, R., Mohrbacher, R., Spiller, R., Kruis, W., Kardalinos, V., Eisenbach, T., Lukas, M., Vich, T., Bunganic, I., Pokrotnieks, J., Derova, J., Kondrackiene, J., Safadi, R., Tuculanu, D., Tulassay, Z., Banai, J., Curtin, A., Dorofeyev, A. E., Zakko, S. F., Ferreira, N., Bjorck, S., Alonso, M. M. Diez, Makela, J., Talley, N. J., Dilger, K., Greinwald, R., Mohrbacher, R., and Spiller, R.
- Abstract
Background: Previous studies have reached conflicting conclusions regarding the efficacy of mesalazine in the prevention of recurrent diverticulitis. Aim: To investigate the efficacy and safety of mesalazine granules in the prevention of recurrence of diverticulitis after acute uncomplicated diverticulitis. Methods: Two phase 3, randomised, placebo-controlled, double-blind multicentre trials (SAG-37 and SAG-51) investigated mesalazine granules in patients with prior episodes (<6 months) of uncomplicated left-sided diverticulitis. Patients were randomised to receive either 3 g mesalazine once daily or placebo (SAG-37, n=345) or to receive either 1.5 g mesalazine once daily, 3 g once daily or placebo for 96 weeks (SAG-51, n=330). The primary endpoint was the proportion of recurrence-free patients during 48 weeks (SAG-37 and SAG-51) or 96 weeks (SAG-51) of treatment. Results: Mesalazine did not increase the proportion of recurrence-free patients over 48 or 96 weeks compared to placebo. In SAG-37, the proportion of recurrence-free patients during 48 weeks was 67.9% with mesalazine and 74.4% with placebo (P=.226). In SAG-51, the proportion of recurrence-free patients over 48 weeks was 46.0% with 1.5 g mesalazine, 52.0% with 3 g mesalazine and 58.0% with placebo (P=.860 for 3 g mesalazine vs placebo) and over 96 weeks 6.9%, 9.8% and 23.1% respectively (P=.980 for 3 g mesalazine vs placebo). Patients with only one diverticulitis episode in the year prior to study entry had a lower recurrence risk compared to >1 episode. Safety data revealed no new adverse events. Conclusion: Mesalazine was not superior to placebo in preventing recurrence of diverticulitis.
- Published
- 2017
23. Editorial: mesalazine to prevent recurrent acute diverticulitis-the final nail in the coffin. Authors' reply
- Author
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Kruis, W., Greinwald, R., Kruis, W., and Greinwald, R.
- Published
- 2017
24. Editorial: mesalazine to prevent recurrent acute diverticulitis-the final nail in the coffin. Authors’ reply
- Author
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Kruis, W., primary and Greinwald, R., additional
- Published
- 2017
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25. Divertikulitis
- Author
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Böhm, S., primary and Kruis, W., additional
- Published
- 2017
- Full Text
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26. Randomised clinical trial: mesalazine versus placebo in the prevention of diverticulitis recurrence
- Author
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Kruis, W., primary, Kardalinos, V., additional, Eisenbach, T., additional, Lukas, M., additional, Vich, T., additional, Bunganic, I., additional, Pokrotnieks, J., additional, Derova, J., additional, Kondrackiene, J., additional, Safadi, R., additional, Tuculanu, D., additional, Tulassay, Z., additional, Banai, J., additional, Curtin, A., additional, Dorofeyev, A. E., additional, Zakko, S. F., additional, Ferreira, N., additional, Björck, S., additional, Diez Alonso, M. M., additional, Mäkelä, J., additional, Talley, N. J., additional, Dilger, K., additional, Greinwald, R., additional, Mohrbacher, R., additional, and Spiller, R., additional
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- 2017
- Full Text
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27. Karzinome bei M. Crohn des Anorektums: Diagnostische Fallstricke – Therapeutische Möglichkeiten
- Author
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Müller, G, Stöckmann, H, and Kruis, W
- Subjects
ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Einleitung: Das Risiko colorektaler Karzinome ist bei Crohnpatienten allgemein erhöht, bei Crohnbefall des Anorektums steigt es auf das 4-fache (Canavan 2006). Malignität scheint insbesondere mit dem Vorhandensein von Fisteln und Strikturen oder Stenosen assoziiert zu sein. Das Risiko maligner[for full text, please go to the a.m. URL], 132. Kongress der Deutschen Gesellschaft für Chirurgie
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- 2015
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28. Looking beyond symptoms and disease activity to define disease severity in inflammatory bowel disease: results of an IOIBD specialist panel
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Siegel, C., Whitman, C., Spiegel, B., Feagan, B., Sands, B., Loftus, E., Panaccione, R., D'Haens, G., Bernstein, C., Gearry, R., Ng, S., Mantzaris, G., Sartor, B., Silverberg, M., Riddell, R., Koutroubakis, I., O'Morain, C., Lakatos, P., McGovern, D., Halfvarson, J., Reinisch, W., Rogler, G., Kruis, W., Tysk, C., Schreiber, S., Danese, S., Sandborn, W., Griffiths, A., Moum, B., Gasche, C., Pallone, F., Travis, S., Panes, J., Colombel, J. -F., Hanauer, S., Peyrin-Biroulet, L., Siegel, C., Whitman, C., Spiegel, B., Feagan, B., Sands, B., Loftus, E., Panaccione, R., D'Haens, G., Bernstein, C., Gearry, R., Ng, S., Mantzaris, G., Sartor, B., Silverberg, M., Riddell, R., Koutroubakis, I., O'Morain, C., Lakatos, P., McGovern, D., Halfvarson, J., Reinisch, W., Rogler, G., Kruis, W., Tysk, C., Schreiber, S., Danese, S., Sandborn, W., Griffiths, A., Moum, B., Gasche, C., Pallone, F., Travis, S., Panes, J., Colombel, J. -F., Hanauer, S., and Peyrin-Biroulet, L.
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- 2016
29. Adenokarzinom des Dünndarms bei M. Crohn: die verkannte Komplikation
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Müller, G, Stöckmann, H, Kruis, W, Müller, G, Stöckmann, H, and Kruis, W
- Published
- 2016
30. Biosimilars in der Behandlung chronisch entzündlicher Darmerkrankungen
- Author
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Siegmund, B., additional, Atreya, R., additional, Bokemeyer, B., additional, Kruis, W., additional, Mudter, J., additional, Sander, C., additional, Schreiber, S., additional, Reindl, W., additional, Zeissig, S., additional, and Kucharzik, T., additional
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- 2016
- Full Text
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31. A single factor of compliance may not be sufficient to improve outcomes in Ulcerative Colitis
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Kruis, W. and Kruis, W.
- Published
- 2015
32. Vedolizumab bei Colitis ulcerosa und Morbus Crohn: eine Standortbestimmung
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Schreiber, S, Dignass, A U, Hartmann, H, Kruis, W, Rogler, G, Siegmund, B, Stallmach, A, Witte, C, Bokemeyer, B, Schreiber, S, Dignass, A U, Hartmann, H, Kruis, W, Rogler, G, Siegmund, B, Stallmach, A, Witte, C, and Bokemeyer, B
- Abstract
Vedolizumab, the first drug in the class of anti-integrin molecules, is newly approved for ulcerative colitis and Crohn's disease and can be prescribed in Germany since mid-2014. By a specific receptor binding a relatively gut-selective mode of action was achieved without the known side effects of the systemic immunosuppression of the anti-TNF-alpha antibodies. According to the present data the safety profile of Vedolizumab appears to be more favorable than that of the anti-TNF- alpha therapy. Vedolizumab is suitable for induction therapy in patients with ulcerative colitis and Crohn's disease, however the kinetic of response compared with the anti-TNF-alpha antibodies seems to be slower. For maintenance therapy the Vedolizumab data show a deep and sustained remission in patients initially responding to induction therapy with a lower loss of efficacy in the long-term treatment known from the anti-TNF-alpha therapy. On the basis of currently available data the efficacy of Vedolizumab in ulcerative colitis appears to be slightly better than in Crohn's disease.
- Published
- 2015
33. Inzidenz und Schweregrad einer Azathioprin-induzierten akuten Pankreatitis bei Patienten mit chronisch entzündlichen Darmerkrankungen
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Teich, N, primary, Mohl, W, additional, Siegmund, B, additional, Helwig, U, additional, Weismüller, J, additional, Bokemeyer, B, additional, Bündgens, B, additional, Büning, J, additional, Miehlke, S, additional, Hüppe, D, additional, Maaser, C, additional, Klugmann, T, additional, Kruis, W, additional, Drabik, A, additional, and Stallmach, A, additional
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- 2015
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34. Sicherheit und Wirksamkeit einer sechsmonatigen 6-Thioguanin Nukleotid-adaptierten Therapie mit Azathioprin im Vergleich zu einer Standardtherapie mit 2,5mg/kg Azathioprin bei Patienten mit chronisch aktivem Morbus Crohn – Eine randomisierte, kontrollierte, offene Phase IV Studie
- Author
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Reinshagen, M, primary, Kruis, W, additional, Malchow, H, additional, Stallmach, A, additional, Herfarth, H, additional, Stein, J, additional, Behrens, C, additional, Bias, P, additional, Adler, G, additional, and Tirpitz, C von, additional
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- 2015
- Full Text
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35. Vedolizumab bei Colitis ulcerosa und Morbus Crohn: eine Standortbestimmung
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Schreiber, S., additional, Dignass, A., additional, Hartmann, H., additional, Kruis, W., additional, Rogler, G., additional, Siegmund, B., additional, Stallmach, A., additional, Witte, C., additional, and Bokemeyer, B., additional
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- 2015
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36. Aktualisierte S3-Leitlinie – „Diagnostik und Therapie des Morbus Crohn“ 2014
- Author
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Preiß, J., additional, Bokemeyer, B., additional, Buhr, H., additional, Dignaß, A., additional, Häuser, W., additional, Hartmann, F., additional, Herrlinger, K., additional, Kaltz, B., additional, Kienle, P., additional, Kruis, W., additional, Kucharzik, T., additional, Langhorst, J., additional, Schreiber, S., additional, Siegmund, B., additional, Stallmach, A., additional, Stange, E., additional, Stein, J., additional, and Hoffmann, J., additional
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- 2014
- Full Text
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37. Divertikelkrankheit: frühe Klassifikation ermöglicht beste Behandlung
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Kruis, W., additional
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- 2014
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38. International consensus on diverticulosis and diverticular disease. Statements from the 3rd international symposium on diverticular disease
- Author
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Marjorie M. Walker, László Herszényi, Giovanni Barbara, Gabrio Bassotti, Wolfgang Kruis, Angel Lanas, G. Cambiè, Enio Chavez De Oliveira, Andrea Mazzari, A. Violi, Jaroslaw Regula, Giovanni Brandimarte, Roberto Persiani, Walter Elisei, Miguel Pera, Marcello Picchio, Sebastiano Biondo, Fermín Mearin, Claudio Cassieri, Juozas Kupcinskas, Savvas Papagrigoriadis, Antonio Tursi, Giovanni Maconi, Davor Štimac, Antonio Crucitti, Ricardo Escalante, Neil Stollman, Lisa L. Strate, P.G. Lecca, M. Bafutto, Gerardo Nardone, Tomica Milosavljeviċ, Carmelo Scarpignato, Alfredo Papa, Francesco Di Mario, Alberto Biondi, Gian Andrea Binda, Dan L. Dumitrascu, Adi Lahat, Peter Malfertheiner, Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G.A., Biondi A., Biondo S., Cambie G., Cassieri C., Crucitti A., Dumitrascu D.L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P.G., Maconi G., Malfertheiner P., Mazzari A., Mearin F., Milosavljevic T., Nardone G., de Oliveira E.C., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L.L., Violi A., Walker M.M.D., Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, A., Biondo, S., Cambie, G., Cassieri, C., Crucitti, A., Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzari, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, A., Papagrigoriadis, S., Pera, M., Persiani, R., Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Violi, A., and Walker, M. M. D.
- Subjects
BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences ,Medical therapy ,Etiology ,Disease ,0302 clinical medicine ,Voting ,Diagnosis ,Medicine ,Disease management (health) ,Diverticuliti ,health care economics and organizations ,media_common ,Diverticulosis ,Evidence-Based Medicine ,Diverticulosi ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti ,Gastroenterology ,Consensus ,Diverticular disease ,Diverticulitis ,Surgical therapy ,3. Good health ,Malalties inflamatòries intestinals ,Hot topics ,030220 oncology & carcinogenesis ,Etiologia ,030211 gastroenterology & hepatology ,Diagnosi ,medicine.medical_specialty ,Settore MED/12 - GASTROENTEROLOGIA ,media_common.quotation_subject ,education ,MEDLINE ,Consensu ,Therapeutics ,Inflammatory bowel diseases ,diverticulosis – diverticular disease – diverticulitis – consensus – diagnosis – medical therapy – surgical therapy ,03 medical and health sciences ,Humans ,Diverticular Diseases ,business.industry ,Evidence-based medicine ,Congresses as Topic ,medicine.disease ,Terapèutica ,Diverticulum ,Family medicine ,business - Abstract
The statements produced by the Chairmen and Speakers of the 3rd International Symposium on Diverticular Disease, held in Madrid on April 11th-13th 2019, are reported. Topics such as current and evolving concepts on the pathogenesis, the course of the disease, the news in diagnosing, hot topics in medical and surgical treatments, and finally, critical issues on the disease were reviewed by the Chairmen who proposed 39 statements graded according to level of evidence and strength of recommendation. Each topic was explored focusing on the more relevant clinical questions. The vote was conducted on a 6-point scale and consensus was defined a priori as 67% agreement of the participants. The voting group consisted of 124 physicians from 18 countries, and agreement with all statements was provided. Comments were added explaining some controversial areas.
- Published
- 2019
39. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon
- Author
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Najia Azhar, Timothy Rockall, S. T. van Dijk, M A Boermester, Giovanni Barbara, J K Schultz, Sebastiano Biondo, Stefan Post, A Samuelsson, A Johanssen, Wolfgang Kruis, Eva Angenete, Gian Andrea Binda, Abbas Chabok, A Thorisson, Esther C. J. Consten, Dario Tartaglia, Des C. Winter, Daniël P. V. Lambrichts, Frédéric Ris, S. Di Saverio, W. A. Bemelman, Schultz J.K., Azhar N., Binda G.A., Barbara G., Biondo S., Boermeester M.A., Chabok A., Consten E.C.J., van Dijk S.T., Johanssen A., Kruis W., Lambrichts D., Post S., Ris F., Rockall T.A., Samuelsson A., Di Saverio S., Tartaglia D., Thorisson A., Winter D.C., Bemelman W., Angenete E., Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and Robotics and image-guided minimally-invasive surgery (ROBOTICS)
- Subjects
INFERIOR MESENTERIC-ARTERY ,Evidence-based practice ,Consensus ,ACUTE PERFORATED DIVERTICULITIS ,Colon ,media_common.quotation_subject ,diverticular disease ,MEDLINE ,COLORECTAL ANASTOMOTIC LEAKAGE ,Online voting ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,COLOVESICAL FISTULA ,Voting ,Medicine ,RANDOMIZED-CLINICAL-TRIAL ,Humans ,COMPUTED-TOMOGRAPHY ,Colonic diseases ,Research question ,media_common ,Diverticular Diseases ,Medical education ,ddc:617 ,business.industry ,UNCOMPLICATED DIVERTICULITIS ,Gastroenterology ,Guideline ,LAPAROSCOPIC SIGMOID RESECTION ,Malalties del còlon ,Diverticular disease ,030211 gastroenterology & hepatology ,SUPERIOR RECTAL ARTERY ,MODIFIED NEFF CLASSIFICATION ,business ,Working group - Abstract
Aim: The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods: The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than90% agreement was considered a consensus. The final phrasing of the statements with
- Published
- 2020
40. Hot Topics in Medical Treatment of Diverticular Disease: Evidence Pro and Cons
- Author
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Claudio Cassieri, Davor Štimac, M. Bafutto, Giovanni Brandimarte, Alessandro D'Avino, Wolfgang Kruis, P.G. Lecca, Luka Vranić, Peter Malfertheiner, Giovanni Barbara, Carmelo Scarpignato, Fermín Mearin, Brandimarte G., Bafutto M., Kruis W., Scarpignato C., Mearin F., Barbara G., Stimac D., Vranic L., Cassieri C., Lecca P.G., D'Avino A., and Malfertheiner P.
- Subjects
Antibiotics ,diverticular disease ,Disease ,Gut flora ,Probiotic ,01 natural sciences ,Gastroenterology ,chemistry.chemical_compound ,0302 clinical medicine ,Diverticuliti ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina ,Evidence-Based Medicine ,biology ,Medical treatment ,Diverticulosi ,Anti-Inflammatory Agents, Non-Steroidal ,Diverticulitis ,Anti-Bacterial Agents ,rifaximin ,030220 oncology & carcinogenesis ,mesalazine ,Diverticular disease ,diverticulosis – diverticular disease – diverticulitis – rifaximin – mesalazine – probiotics ,Mesalazine ,010407 polymers ,medicine.medical_specialty ,medicine.drug_class ,diverticulosis ,Rifaximin ,03 medical and health sciences ,Gastrointestinal Agents ,Internal medicine ,medicine ,Humans ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine ,Diverticular Diseases ,business.industry ,Probiotics ,biology.organism_classification ,medicine.disease ,0104 chemical sciences ,Gastrointestinal Microbiome ,diverticulitis ,chemistry ,probiotics ,business - Abstract
Symptomatic Uncomplicated Diverticular Disease (SUDD) is the most common clinical form of Diverticular Disease (DD). The therapy should be aimed at reducing both the intensity and frequency of symptoms as well as preventing complications. The pharmacological treatments include fibers, not absorbable antibiotics (for example rifaximin), anti-inflammatory drugs (for example 5-amino-salycilic acid) and probiotics, alone or in combination with other drugs. Although some of these treatments seem to be effective in treating SUDD, but their efficacy in preventing complications of the disease is still uncertain. It has been hypothesized that microbial imbalance associated with bacterial overgrowth of the colon, may be the key to the development of diverticular disease (DD). Therefore, drugs that can manipulate gut microbiota such as probiotics or rifaximine are considered as a potential key therapy. Rifaximine is able to modulate the intestinal ecosystem, restoring eubiosis. Traditionally, DD of the colon is thought to be related to low grade of inflammation. By analogy with other inflammatory bowel diseases mesalazine has been studied also in DD. There are several evidences that may support the use of mesalazine in the SUDD. Unfortunately, mesalazine cannot be used to prevent diverticulitis because of the paucity of high-quality studies. Currently, mesalazine has a limited place for the management of SUDD. In SUDD probiotics have been proven as an effective therapy in reducing abdominal symptoms, but unfortunately there has been limited number of relevant studies regarding efficacy of this therapy.
- Published
- 2019
41. Development of an index to define overall disease severity in IBD
- Author
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Richard B. Gearry, Julián Panés, Remo Panaccione, Gerassimos J. Mantzaris, Curt Tysk, Charles N. Bernstein, Stefan Schreiber, Anne M. Griffiths, Edward V. Loftus, Siew C. Ng, Ioannis E. Koutroubakis, Cynthia B. Whitman, Simon Travis, Mark S. Silverberg, Laurent Peyrin-Biroulet, Brian G. Feagan, William J. Sandborn, Gerhard Rogler, Bruce E. Sands, Silvio Danese, Geert R. D'Haens, Balfour R. Sartor, Jean-Frederic Colombel, Stephen B. Hanauer, Corey A. Siegel, Francesco Pallone, Walter Reinisch, Jonas Halfvarson, Dermot P.B. McGovern, Bjørn Moum, Peter L. Lakatos, Colm O'Morain, Brennan Spiegel, Robert H. Riddell, Christoph Gasche, Wolfgang Kruis, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Siegel, Ca, Whitman, Cb, Spiegel, Bmr, Feagan, B, Sands, B, Loftus, Ev, Panaccione, R, D'Haens, G, Bernstein, Cn, Gearry, R, Ng, Sc, Mantzaris, Gj, Sartor, B, Silverberg, M, Riddell, R, Koutroubakis, Ie, O'Morain, C, Lakatos, Pl, Mcgovern, Dpb, Halfvarson, J, Reinisch, W, Rogler, G, Kruis, W, Tysk, C, Schreiber, S, Danese, S, Sandborn, W, Griffiths, A, Moum, B, Gasche, C, Pallone, F, Travis, S, Panes, J, Colombel, Jf, Hanauer, S, and Peyrin-Biroulet, L
- Subjects
Adult ,Male ,medicine.medical_specialty ,Abdominal Abscess ,Activities of daily living ,Delphi Technique ,Disease ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Crohn Disease ,Disease severity ,Internal medicine ,Activities of Daily Living ,Intestinal Fistula ,Humans ,Medicine ,In patient ,Intestinal Mucosa ,Abscess ,Aged ,Biological Products ,Crohn's disease ,biology ,business.industry ,C-reactive protein ,Gastroenterology ,Middle Aged ,medicine.disease ,Ulcerative colitis ,Surgery ,C-Reactive Protein ,030220 oncology & carcinogenesis ,biology.protein ,Colitis, Ulcerative ,Female ,030211 gastroenterology & hepatology ,Symptom Assessment ,business - Abstract
Background and aimDisease activity for Crohn's disease (CD) and UC is typically defined based on symptoms at a moment in time, and ignores the long-term burden of disease. The aims of this study were to select the attributes determining overall disease severity, to rank the importance of and to score these individual attributes for both CD and UC.MethodsUsing a modified Delphi panel, 14 members of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) selected the most important attributes related to IBD. Eighteen IOIBD members then completed a statistical exercise (conjoint analysis) to create a relative ranking of these attributes. Adjusted utilities were developed by creating proportions for each level within an attribute.ResultsFor CD, 15.8% of overall disease severity was attributed to the presence of mucosal lesions, 10.9% to history of a fistula, 9.7% to history of abscess and 7.4% to history of intestinal resection. For UC, 18.1% of overall disease severity was attributed to mucosal lesions, followed by 14.0% for impact on daily activities, 11.2% C reactive protein and 10.1% for prior experience with biologics. Overall disease severity indices were created on a 100-point scale by applying each attribute's average importance to the adjusted utilities.ConclusionsBased on specialist opinion, overall CD severity was associated more with intestinal damage, in contrast to overall UC disease severity, which was more dependent on symptoms and impact on daily life. Once validated, disease severity indices may provide a useful tool for consistent assessment of overall disease severity in patients with IBD.
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- 2016
42. Long-term Efficacy and Safety of Stem Cell Therapy (Cx601) for Complex Perianal Fistulas in Patients With Crohn's Disease
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Julián Panés, Damián García-Olmo, Gert Van Assche, Jean Frederic Colombel, Walter Reinisch, Daniel C. Baumgart, Axel Dignass, Maria Nachury, Marc Ferrante, Lili Kazemi-Shirazi, Jean C. Grimaud, Fernando de la Portilla, Eran Goldin, Marie Paule Richard, Mary Carmen Diez, Ignacio Tagarro, Anne Leselbaum, Silvio Danese, Jean F. Colombel, Anton Stift, Jörg Tschmelitsch, Karl Mrak, Herbert Tilg, Irmgard Kroberger, André D’Hoore, Danny De Looze, Filip Baert, Paul Pattyn, Philippe Zerbib, Frank Zerbib, Stéphanie Viennot, Jean-Louis Dupas, Pierre-Charles Orsoni, Xavier Hebuterne, Amine Rahili, Matthieu Allez, Yves Panis, Max Reinshagen, Roland Scherer, Andreas Sturm, Wolfgang Kruis, Daniel-Simon Duek, Matti Waterman, Adi Lahat-Zok, Oded Zmora, Hagit Tulchinsky, Yair Edden, Antonino Spinelli, Vito Annese, Imerio Angriman, Gabriele Riegler, Francesco Selvaggi, Bas Oldenburg, Lennard Gilissen, Gust Van Montfort, Mark Lowenberg, Adrianus Willem Bemelman, Raúl Almenara, María Dolores Martín Arranz, Mariano García-Arranz, Javier Pérez Gisbert, Rosana Palasí, Carlos Taxonera Samsó, Jose Manuel Herrera Justiniano, Ricardo Rada, Mª Teresa Butrón, Daniel Carpio López, Antonio López-Sanromán, Joaquín Hinojosa de Val, Amparo Solana, F. Xavier González Argenté, Carlos Pastor, Hector Guadalajara, Panes, J, Garcia-Olmo, D, Van Assche, G, Colombel, Jf, Reinisch, W, Baumgart, Dc, Dignass, A, Nachury, M, Ferrante, M, Kazemi-Shirazi, L, Grimaud, Jc, de la Portilla, F, Goldin, E, Richard, Mp, Diez, Mc, Tagarro, I, Leselbaum, A, Danese, S, Panes, J., Garcia-Olmo, D., Van Assche, G., Colombel, J. F., Reinisch, W., Baumgart, D. C., Dignass, A., Nachury, M., Ferrante, M., Kazemi-Shirazi, L., Grimaud, J. C., de la Portilla, F., Goldin, E., Richard, M. P., Diez, M. C., Tagarro, I., Leselbaum, A., Danese, S., Stift, A., Tschmelitsch, J., Mrak, K., Tilg, H., Kroberger, I., D'Hoore, A., De Looze, D., Baert, F., Pattyn, P., Zerbib, P., Zerbib, F., Viennot, S., Dupas, J. -L., Orsoni, P. -C., Hebuterne, X., Rahili, A., Allez, M., Panis, Y., Reinshagen, M., Scherer, R., Sturm, A., Kruis, W., Duek, D. -S., Waterman, M., Lahat-Zok, A., Zmora, O., Tulchinsky, H., Edden, Y., Spinelli, A., Annese, V., Angriman, I., Riegler, G., Selvaggi, F., Oldenburg, B., Gilissen, L., Van Montfort, G., Lowenberg, M., Bemelman, A. W., Almenara, R., Martin Arranz, M. D., Garcia-Arranz, M., Perez Gisbert, J., Palasi, R., Samso, C. T., Herrera Justiniano, J. M., Rada, R., Butron, M. T., Lopez, D. C., Lopez-Sanroman, A., Hinojosa de Val, J., Solana, A., Gonzalez Argente, F. X., Pastore, Concetta, Guadalajara, H., Gastroenterology and Hepatology, and AGEM - Digestive immunity
- Subjects
Male ,Time Factors ,Intention to Treat Analysi ,medicine.medical_treatment ,Gastroenterology ,0302 clinical medicine ,Crohn Disease ,Risk Factors ,Clinical endpoint ,Israel ,Transplantation, Homologou ,Crohn's disease ,education.field_of_study ,medicine.diagnostic_test ,Remission Induction ,Stem-cell therapy ,Magnetic Resonance Imaging ,Intention to Treat Analysis ,Europe ,Treatment Outcome ,Adipose Tissue ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Clinical Remission ,Human ,Adult ,Homologous ,medicine.medical_specialty ,Time Factor ,Population ,Placebo ,03 medical and health sciences ,Double-Blind Method ,Internal medicine ,medicine ,Transplantation, Homologous ,Humans ,Rectal Fistula ,education ,Adverse effect ,Transplantation ,Intention-to-treat analysis ,Hepatology ,business.industry ,Risk Factor ,Cell Therapy ,Magnetic resonance imaging ,Anal Fistula ,Combined Remission ,Stem Cell Transplantation ,medicine.disease ,business - Abstract
Background & Aims: Therapies for perianal fistulas in patients with Crohn's disease are often ineffective in producing long-term healing. We performed a randomized placebo-controlled trial to determine the long-term efficacy and safety of a single local administration of allogeneic expanded adipose-derived stem cells (Cx601) in patients with Crohn's disease and perianal fistulas. Methods: We performed a double-blind study at 49 hospitals in Europe and Israel, comprising 212 patients with Crohn's disease and treatment-refractory, draining, complex perianal fistulas. Patients were randomly assigned (1:1) to groups given a single local injection of 120 million Cx601 cells or placebo (control), in addition to the standard of care. Efficacy endpoints evaluated in the modified intention-to-treat population (randomly assigned, treated, and with 1 or more post-baseline efficacy assessment) at week 52 included combined remission (closure of all treated external openings draining at baseline with absence of collections >2 cm, confirmed by magnetic resonance imaging) and clinical remission (absence of draining fistulas). Results: The study's primary endpoint, at week 24, was previously reported (combined remission in 51.5% of patients given Cx601 vs 35.6% of controls, for a difference of 15.8 percentage points; 97.5% confidence interval [CI] 0.5–31.2; P =.021). At week 52, a significantly greater proportion of patients given Cx601 achieved combined remission (56.3%) vs controls (38.6%) (a difference of 17.7 percentage points; 95% CI 4.2–31.2; P =.010), and clinical remission (59.2% vs 41.6% of controls, for a difference of 17.6 percentage points; 95% CI 4.1–31.1; P =.013). Safety was maintained throughout week 52; adverse events occurred in 76.7% of patients in the Cx601 group and 72.5% of patients in the control group. Conclusion: In a phase 3 trial of patients with Crohn's disease and treatment-refractory complex perianal fistulas, we found Cx601 to be safe and effective in closing external openings, compared with placebo, after 1 year. ClinicalTrials.gov no: NCT01541579.
- Published
- 2018
43. Integrating the Patient Perspective to Validate a Measure of Disease Severity in Inflammatory Bowel Disease: Online Survey of Patients and Their Physicians.
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Timmer A, Neuser J, de Sordi D, Schmidt-Lauber M, Allgayer H, Reichel C, Klebl F, Obermeier F, Schnoy E, Jessen P, Morgenstern J, Helwig U, Maaser C, Leifeld L, Schmidt S, Meinhardt C, Böcker U, Arlt A, Bästlein E, Bokemeyer A, Preiß JC, Otto-Sobotka F, Kaltz B, Sander C, and Kruis W
- Abstract
Background: The patient perspective is essential for assessing disease severity, but it is not always adequately considered. We describe how a comprehensive clinical disease severity index (DSI) for inflammatory bowel disease (IBD) correlates with patient global self-assessment (PGSA)., Methods: In an individually linked parallel online survey, physicians provided the DSI, and patients provided self-assessed severity using a global question and visual analog scale (0-100) (PGSA). Mean DSI values by PGSA were calculated with 95% confidence intervals. Pearson correlation (r) and the intraclass correlation coefficient were calculated for PGSA vs DSI. Positive predictive values for identifying severe disease with PGSA categories as a reference were based on a threshold >22 points., Results: The primary analysis included 89 pairs (46 Crohn's disease [CD], 43 ulcerative colitis [UC]) with strict criteria and 147 pairs when less stringent. Common reasons for exclusion were missing values for albumin or colonoscopy. Mean DSI values showed no clear trend with increasing PGSA in CD but good discrimination between moderate, severe, and very severe PGSA in UC. For PGSA on the visual analog scale, r was 0.54 for CD and 0.59 for UC (difference in means: CD 27.7, UC 13.8; intraclass correlation coefficient: CD 0.48, UC 0.58). A high DSI predicted severe disease in 76.2% of CD and 65.2% of UC., Conclusions: The DSI showed good discrimination for patient-reported disease severity in UC but performed unsatisfactorily in CD. Correlations were moderate. Further refinement of the DSI is suggested to better reflect the patient perspective., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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44. Prospective Evaluation of the Prediction Score for a Mild Course of Crohn's Disease (PreMiCC) in Newly Diagnosed Patients With Crohn's Disease: The PROGNOS Study.
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Kruis W, Bokemeyer B, Jessen P, Hoesl M, Mroß M, Morgenstern J, Reimers B, Müller-Grage N, and Leifeld L
- Abstract
Background and Aims: The course of Crohn's disease (CD) is highly variable. The Prospektive Evaluation eines Score zur Vorhersage eines milden Verlaufsbei neu diagnostizierten Morbus Crohn-Patienten in gastroenterologischen Fachpraxen (PROGNOS) study aimed to determine the frequency of a mild disease course and validate a proposed prediction score., Methods: The PROGNOS study is a prospective study of CD patients who were newly diagnosed and, except for 1 course of 5-aminosalicylic acid or steroids for ≤10 days, therapy-naïve. Among other predefined inclusion criteria, the initial diagnosis had to be made ≤6 weeks before enrollment. All inception cohort patients were diagnosed and screened consecutively in participating gastroenterology practices in Germany specialized in inflammatory bowel disease. All screened CD patients were scored and, if possible, included in the study for up to 5 years (NCT02193048)., Results: A total of 201 CD patients were included in the study (43.3% male; mean age 33 years, mean follow-up 38 months). Altogether, 29.5% of the patients had a mild course at 36 months. Among those with a score ≤2, therapy escalation at 36 months was necessary for only 24.2%, whereas in the group with a score >2, therapy escalation was necessary for 70.2% of patients. In the Kaplan-Meier curve showing time to therapy escalation in the 2 groups, there was a pronounced and statistically significant divergence of the curves starting at 3 months and extending to 48 months (P < .001)., Conclusions: In this prospective study, about 30% of incident CD patients had a mild disease course. Our suggested PreMiCC (prediction score for a mild course of Crohn's disease) successfully predicted this., (© 2024 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation.)
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- 2024
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45. Mesalazine granules promote disease clearance in patients with mild-to-moderate ulcerative colitis.
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Kruis W, Meszaros S, Wehrum S, Mueller R, Greinwald R, and Nacak T
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- Humans, Anti-Inflammatory Agents, Non-Steroidal, Endoscopy, Remission Induction, Mesalamine, Colitis, Ulcerative diagnosis, Colitis, Ulcerative drug therapy
- Abstract
Background: Over the past decade, treatment targets for ulcerative colitis (UC) have become more stringent, incorporating multiple parameters. Recently, the concept of 'disease clearance'-defined as combined clinical, endoscopic, and histological remission-has been proposed as an ultimate endpoint in treating UC., Objective: To determine the rates of disease clearance in patients with mild-to-moderate UC treated with different doses of mesalazine granules as induction therapy., Methods: In a post hoc analysis, data were pooled from four randomised, active-controlled, phase 3 clinical trials in patients with mild-to-moderate UC receiving 8-week induction therapy with mesalazine granules at daily doses of 1.5, 3.0 or 4.5 g. Rates of clinical, endoscopic, and histological remission were determined using stringent criteria and used to calculate rates of the composite endpoints of clinical plus endoscopic remission, endoscopic plus histological remission, and disease clearance (clinical plus endoscopic plus histological remission)., Results: A total of 860 patients were included in the analysis. Among the total population, 20.0% achieved disease clearance with mesalazine granules: 13.1% in patients receiving 1.5 g mesalazine granules/day, 21.8% in those receiving 3.0 g/day and 18.9% in those receiving 4.5 g/day. Among patients with moderate UC, 16.8% achieved disease clearance: 7.1% with 1.5 g/day, 18.8% with 3.0 g/day and 16.2% with 4.5 g/day., Conclusion: Disease clearance, proposed to be predictive of improved long-term outcomes, can be achieved in a clinically meaningful proportion of mild-to-moderate UC patients treated with mesalazine granules. A daily dose of 3.0 g appears optimal to reach this target., (© 2023 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
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- 2023
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46. Low Dietary Flavonoid Consumption Is Associated to Severe Inflammatory Bowel Disease.
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Kölbel B, Hamacher S, Hellmich M, and Kruis W
- Abstract
Background and Aims: Associations between diet habits and inflammatory bowel disease (IBD) have been widely described. Flavonoids are taken with vegetables, fruits, and green tea. Because of barrier-protective and anti-inflammatory effects, flavonoid consumption (FC) may influence the severity of IBD. The aim of this study was to reveal the role of FC in the course and severity of IBD., Methods: A prospective cohort study including 204 IBD patients (Crohn's disease n = 126, ulcerative colitis n = 78) was conducted between 2016 and 2021. FC was calculated using questionnaires. In addition to standard activity scores and different treatments, a "severity index" was related to individual FC. Differences between groups and odds ratios were analyzed., Results: Inverse correlation (r = -0.0549; P = .01) between FC and severity of IBD was found. Patients were assigned to 3 different severity index ranges: mild, moderate, and severe disease. FC of patients with severe disease (331 ± 330 mg/week) was less than FC of patients with mild (1404 ± 1086 mg/ week) disease ( P < .001). The risk of IBD patients with low FC (1000 mg/week) experiencing overall severe disease was 17 times increased ( P < .001) compared to patients with high FC (>1000 mg/week). Patients with UC and low FC had a 9.6-times higher risk for disease progression ( P < .001)., Conclusion: Consumption of dietary flavonoids and the overall severity of IBD are inversely correlated. Patients with mild diseases consume higher amounts of flavonoids than patients with severe diseases. Low dietary flavonoids were related to a considerable risk of severe IBD., (© 2024 Published by Elsevier Inc. on behalf of the AGA Institute.)
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- 2023
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47. Novel Budesonide Suppository and Standard Budesonide Rectal Foam Induce High Rates of Clinical Remission and Mucosal Healing in Active Ulcerative Proctitis: a Randomised, Controlled, Non-inferiority Trial.
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Kruis W, Siegmund B, Lesniakowski K, Simanenkov V, Khimion L, Sobon M, Delmans G, Maksyashina SV, Sablin OA, Pokrotnieks J, Mostovoy Y, Datsenko O, Abdulkhakov S, Dorofeyev A, Levchenko O, Alexeeva O, Andreev P, Kolesnik IP, Mihaly E, Abrahamovych O, Baluta M, Kharchenko N, Viacheslav N, Uspenskiy Y, Vieth M, Mohrbacher R, Mueller R, and Greinwald R
- Subjects
- Humans, Budesonide, Quality of Life, Treatment Outcome, Mesalamine therapeutic use, Double-Blind Method, Remission Induction, Colitis, Ulcerative drug therapy, Colitis, Ulcerative chemically induced, Proctitis drug therapy, Proctitis etiology
- Abstract
Background and Aims: Proctitis is the least extensive type of ulcerative colitis, for which rectal therapy is rarely studied and is underused. This study evaluated the efficacy, safety, and patient's preference of a novel formulation of budesonide suppository 4 mg, compared with a commercially available budesonide rectal foam 2 mg, for the treatment of mild to moderate ulcerative proctitis., Methods: This was a randomised, double-blind, double-dummy, active-controlled trial. Patients were randomly assigned in a 1:1 ratio to receive either budesonide 4 mg suppository or budesonide 2 mg foam once daily for 8 weeks. The co-primary endpoints were changes from baseline to Week 8 in clinical symptoms, for which clinical remission was defined as having a modified Ulcerative Colitis-Disease Activity Index [UC-DAI] subscore for stool frequency of 0 or 1 and a subscore for rectal bleeding of 0, and mucosal healing, defined as having a modified UC-DAI subscore for mucosal appearance of 0 or 1. Using a more stringent criterion, we additionally analysed deepened mucosal healing, which was defined as a mucosal appearance subscore of 0. Patient's preference, physician's global assessment, and quality of life were also assessed and analysed., Results: Overall, 286 and 291 patients were included in the 4 mg suppository and 2 mg foam groups, respectively. Budesonide 4 mg suppository met the prespecified criterion for non-inferiority to the 2 mg foam in both co-primary endpoints of clinical remission and mucosal healing. Secondary endpoints consistently supported the non-inferiority of the suppository. Trends in favour of the suppository were observed in the subgroup of mesalazine non-responders. More patients reported a preference for the suppository over rectal foam., Conclusions: In patients with ulcerative proctitis, budesonide 4 mg suppository was non-inferior to budesonide 2 mg foam in efficacy, and both were safe and well tolerated., (© The Author(s) 2022. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.)
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- 2022
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48. Prevalence of abnormal Pap smear results in inflammatory bowel disease: a prospective study.
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Brunner A, Kruis W, Schömig-Markiefka B, Morgenstern J, Engels M, Büttner R, and Forner DM
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- Cohort Studies, Female, Humans, Immunosuppressive Agents adverse effects, Papanicolaou Test, Papillomaviridae, Prevalence, Prospective Studies, Vaginal Smears, Alphapapillomavirus, Inflammatory Bowel Diseases complications, Inflammatory Bowel Diseases epidemiology, Papillomavirus Infections complications, Papillomavirus Infections diagnosis, Papillomavirus Infections epidemiology, Uterine Cervical Neoplasms diagnosis, Uterine Cervical Neoplasms epidemiology, Uterine Cervical Neoplasms pathology
- Abstract
Purpose: Development of malignancy is a pending threat for patients with inflammatory bowel disease (IBD). Aim of this study was to analyze cervical dysplasia and infection with human papilloma virus (HPV) in patients with IBD., Methods: This was a prospective, single center cohort study in Germany. Consecutive IBD patients admitted to the Department of Gastroenterology were sent to Gynecology, where a questionnaire was answered and gynecological examinations including a smear for cytology and HPV were taken. Participants of a general screening program constituted controls. Descriptive statistics, 95% confidence intervals and odds ratios were calculated., Results: A total of 101 patients were recruited of which 99 patients participated. Analysis showed a significant (p = 0.05) difference between the prevalence of abnormal smears in patients with (22%) and without (6%) immunosuppressive therapy, while the latter had cervical abnormalities comparable with healthy controls (5%). All immunosuppressants showed similarly high risks for abnormal smear results. Only 11/99 (11%) patients had positive high-risk HPV tests, which is comparable with general population., Conclusion: The prevalence of abnormal cervical smears is higher in IBD patients compared to healthy individuals, but the difference is confined to patients with IBD and immunosuppressive therapy. Annual screening is advisable., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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49. German guideline diverticular disease/diverticulitis: Part I: Methods, pathogenesis, epidemiology, clinical characteristics (definitions), natural course, diagnosis and classification.
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Kruis W, Germer CT, Böhm S, Dumoulin FL, Frieling T, Hampe J, Keller J, Kreis ME, Meining A, Labenz J, Lock JF, Ritz JP, Schreyer A, and Leifeld L
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- Humans, Aged, Diverticular Diseases diagnosis, Diverticular Diseases epidemiology, Diverticular Diseases therapy
- Abstract
Diverticulosis and diverticular disease are ranked among the most common gastroenterological diseases and conditions. While for many years diverticulitis was found to be mainly an event occurring in the elder population, more recent work in epidemiology demonstrates increasing frequency in younger subjects. In addition, there is a noticeable trend towards more complicated disease. This may explain the significant increase in hospitalisations observed in recent years. It is not a surprise that the number of scientific studies addressing the clinical and socioeconomic consequences in the field is increasing. As a result, diagnosis and conservative as well as surgical management have changed in recent years. Diverticulosis, diverticular disease and diverticulitis are a complex entity and apparently an interdisciplinary challenge. To meet theses considerations the German Societies for Gastroenterology and Visceral Surgery decided to create joint guidelines addressing all aspects in a truely interdisciplinary fashion. The aim of the guideline is to summarise and to evaluate the current state of knowledge on diverticulosis and diverticular disease and to develop statements as well as recommendations to all physicians involved in the management of patients with diverticular disease., (© 2022 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
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- 2022
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50. German guideline diverticular disease/diverticulitis: Part II: Conservative, interventional and surgical management.
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Kruis W, Germer CT, Böhm S, Dumoulin FL, Frieling T, Hampe J, Keller J, Kreis ME, Meining A, Labenz J, Lock JF, Ritz JP, Schreyer AG, and Leifeld L
- Subjects
- Humans, Aged, Diverticular Diseases diagnosis, Diverticular Diseases surgery
- Abstract
Diverticulosis and diverticular disease are ranked among the most common gastroenterological diseases and conditions. While for many years diverticulitis was found to be mainly an event occurring in the elder population, more recent work in epidemiology demonstrates increasing frequency in younger subjects. In addition, there is a noticeable trend towards more complicated disease. This may explain the significant increase in hospitalisations observed in recent years. It is not a surprise that the number of scientific studies addressing the clinical and socioeconomic consequences in the field is increasing. As a result, diagnosis and conservative as well as surgical management have changed in recent years. Diverticulosis, diverticular disease and diverticulitis are a complex entity and apparently an interdisciplinary challenge. To meet theses considerations the German Societies for Gastroenterology and Visceral Surgery decided to create joint guidelines addressing all aspects in a truely interdisciplinary fashion. The aim of the guideline is to summarise and to evaluate the current state of knowledge on diverticulosis and diverticular disease and to develop statements as well as recommendations to all physicians involved in the management of patients with diverticular disease., (© 2022 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
- Published
- 2022
- Full Text
- View/download PDF
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