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145 results on '"Faiz, Omar D."'

2. Cancer Biology or Ineffective Surveillance? A Multicentre Retrospective Analysis of Colitis-Associated Post-Colonoscopy Colorectal Cancers.

Author

Kabir, Misha, Thomas-Gibson, Siwan, Ahmad, Ahmir, Kader, Rawen, Al-Hillawi, Lulia, Mcguire, Joshua, David, Lewis, Shah, Krishna, Rao, Rohit, Vega, Roser, East, James E, Faiz, Omar D, Hart, Ailsa L, and Wilson, Ana

Abstract

Background and Aims Inflammatory bowel disease [IBD] is associated with high rates of post-colonoscopy colorectal cancer [PCCRC], but further in-depth qualitative analyses are required to determine whether they result from inadequate surveillance or aggressive IBD cancer evolution. Methods All IBD patients who had a colorectal cancer [CRC] diagnosed between January 2015 and July 2019 and a recent [<4 years] surveillance colonoscopy at one of four English hospital trusts underwent root cause analyses as recommended by the World Endoscopy Organisation to identify plausible PCCRC causative factors. Results In total, 61% [ n  = 22/36] of the included IBD CRCs were PCCRCs. They developed in patients with high cancer risk factors [77.8%; n  = 28/36] requiring annual surveillance, yet 57.1% [ n  = 20/35] had inappropriately delayed surveillance. Most PCCRCs developed in situations where [i] an endoscopically unresectable lesion was detected [40.9%; n  = 9/22], [ii] there was a deviation from the planned management pathway [40.9%; n  = 9/22], such as service-, clinician- or patient-related delays in acting on a detected lesion, or [iii] lesions were potentially missed as they were typically located within areas of active inflammation or post-inflammatory change [36.4%; n  = 8/22]. Conclusions IBD PCCRC prevention will require more proactive strategies to reduce endoscopic inflammatory burden, and to improve lesion optical characterization, adherence to recommended surveillance intervals, and patient acceptance of prophylactic colectomy. However, the significant proportion appearing to originate from non-adenomatous-looking mucosa which fail to yield neoplasia on biopsy yet display aggressive cancer evolution highlights the limitations of current surveillance. Emerging molecular biomarkers may play a role in enhancing cancer risk stratification in future clinical practice. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Attenuated Familial Adenomatous Polyposis

Author

Anele, Chukwuemeka C., primary, Martin, Isabel, additional, McGinty, Patricia, additional, Chauhanx, Jeshu, additional, Clark, Susan K., additional, Faiz, Omar D., additional, and Latchford, Andrew R., additional

Published
2021
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18. Differences in amino acid and lipid metabolism distinguish Crohn’s from idiopathic/cryptoglandular perianal fistulas by tissue metabonomic profiling and may offer clues to underlying pathogenesis

Author

Adegbola, Samuel O., primary, Sarafian, Magali, additional, Sahnan, Kapil, additional, Ding, Nik S., additional, Faiz, Omar D., additional, Warusavitarne, Janindra, additional, Phillips, Robin K.S., additional, Tozer, Phil J., additional, Holmes, Elaine, additional, and Hart, Ailsa L., additional

Published
2020
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21. Regular endoscopic surveillance and polypectomy is effective in managing rectal adenoma progression following colectomy and ileorectal anastomosis in patients with familial adenomatous polyposis.

Author

Anele, Chukwuemeka C., Xiang, Jinpo, Martin, Isabel, Hawkins, Menna, Man, Ripple, Clark, Susan K., Faiz, Omar D., and Latchford, Andrew

Subjects
POLYPECTOMY, ADENOMATOUS polyposis coli, RESTORATIVE proctocolectomy, COLECTOMY, SURGICAL anastomosis, ADENOMA, RECTAL cancer
Abstract

Aim: Total colectomy with ileorectal anastomosis (TC‐IRA) is a surgical option for patients with familial adenomatous polyposis (FAP). Regular endoscopic surveillance of the rectum is recommended to prevent rectal cancer. We aimed to document polyp progression in the rectum following TC‐IRA and evaluate the role of polypectomy during surveillance. Method: Patients with FAP who underwent TC‐IRA between 1990 and 2017 were identified. Demographic, endoscopic and genetic data were retrieved. Cumulative rectal adenoma (polyp) counts were obtained, whilst accounting for any polypectomies during the study period. The rate of polyp progression and factors influencing secondary proctectomy were evaluated. Results: One hundred and ninety‐nine patients fulfilled our inclusion criteria, of which 44% were male. The median age at colectomy was 19 (range 11–70) years and median preoperative rectal polyp count was 7 (range 0–50). All patients had an APC pathogenic variant, of which 151 (79%) were 5' of the mutation cluster region (MCR), 19 (10%) in the MCR, six (3%) were 3' of the MCR and 15 (8%) had a gross deletion. After a median follow‐up of 8.6 (range1–27) years and a median of 11 (range 2–37) flexible sigmoidoscopies per patient, the median rate of polyp progression was 5.5 polyps/year (range 0–70.2). There was no evidence of polyp regression. Eight (4%) patients underwent secondary proctectomy for neoplasia, of which one (0.5%) had rectal adenocarcinoma. A total of 13,527 polyps were removed, a median of 35 polyps/patient (range 0–829). The rate of polyp progression was not significantly associated with genotypic or phenotypic factors. Conclusion: Progression of rectal adenoma burden following TC‐IRA appears to be slow and dependent on the length of follow‐up. In the modern era of stringent endoscopic surveillance and therapeutic procedures such as cold snare polypectomy, the rate of secondary proctectomy and the risk of rectal cancer after TC‐IRA are very low. These findings are important when counselling patients with regard to the choice of surgery for FAP and implementing endoscopic surveillance. [ABSTRACT FROM AUTHOR]

Published
2022
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25. Long term outcomes of initial infliximab therapy for inflammatory pouch pathology: a multi-Centre retrospective study

Author

Segal, Jonathan P., primary, Penez, Lawrence, additional, Mohsen Elkady, Soad, additional, Worley, Guy H. T., additional, McLaughlin, Simon D., additional, Mullish, Benjamin H., additional, Quraishi, Mohammed N., additional, Ding, Nik S., additional, Glyn, Tamara, additional, Kandiah, Kesavan, additional, Samaan, Mark A., additional, Irving, Peter M., additional, Faiz, Omar D., additional, Clark, Susan K., additional, and Hart, Ailsa L., additional

Published
2018
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26. Improving the Understanding of Perianal Crohn Fistula Through 3D Modeling

Author

Sahnan, Kapil, primary, Adegbola, Samuel O., additional, Tozer, Phillip J., additional, Gupta, Arun, additional, Baldwin-Cleland, Rachel, additional, Yassin, Nuha, additional, Warusavitarne, Janindra, additional, Faiz, Omar D., additional, Hart, Ailsa L., additional, Phillips, Robin K. S., additional, and Lung, Phillip F. C., additional

Published
2018
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30. Developing a core outcome set for fistulising perianal Crohn’s disease

Author

Sahnan, Kapil, primary, Tozer, Phil J, additional, Adegbola, Samuel O, additional, Lee, Matthew J, additional, Heywood, Nick, additional, McNair, Angus G K, additional, Hind, Daniel, additional, Yassin, Nuha, additional, Lobo, Alan J, additional, Brown, Steven R, additional, Sebastian, Shaji, additional, Phillips, Robin K S, additional, Lung, Phillip F C, additional, Faiz, Omar D, additional, Crook, Kay, additional, Blackwell, Sue, additional, Verjee, Azmina, additional, Hart, Ailsa L, additional, and Fearnhead, Nicola S, additional

Published
2018
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31. Biological therapy for the treatment of prepouch ileitis: a retrospective observational study from three centers

Author

Segal,Jonathan P, Rottoli,Matteo, Felwick,Richard K, Worley,Guy HT, McLaughlin,Simon D, Vallicelli,Carlo, Bassett,Paul, Faiz,Omar D, Hart,Ailsa L, Clark,Susan K, Segal,Jonathan P, Rottoli,Matteo, Felwick,Richard K, Worley,Guy HT, McLaughlin,Simon D, Vallicelli,Carlo, Bassett,Paul, Faiz,Omar D, Hart,Ailsa L, and Clark,Susan K

Abstract

Jonathan P Segal,1,2 Matteo Rottoli,3 Richard K Felwick,4 Guy HT Worley,1,2 Simon D McLaughlin,4 Carlo Vallicelli,3 Paul Bassett,5 Omar D Faiz,1,2 Ailsa L Hart,1,2 Susan K Clark1,2 1Inflammatory Bowel Disease Department, St Mark’s Hospital, Harrow, UK; 2Department of Surgery and Cancer, Imperial College, London, UK; 3Surgery of the Alimentary Tract, Sant’Orsola – Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy; 4Department of Gastroenterology, The Royal Bournemouth and Christchurch Hospitals, Bournemouth, UK; 5Statsconsultancy Ltd, Amersham, UK Aim: Prepouch ileitis (PPI) is inflammation of the ileum proximal to an ileoanal pouch, usually associated with pouchitis. The treatment of PPI as a specific entity has been poorly studied, but it is generally treated concurrently with pouchitis. This to our knowledge is the largest study to explore the efficacy of biologics for the specific treatment of PPI.Methods: This was a retrospective observational study reporting outcomes following biological treatment in patients with PPI across three centers. Data were collected between January 2004 and February 2018 from two centers in the UK and one center in Italy. Outcomes included the continued presence of PPI following biologic therapy, pouch failure defined by the need for an ileostomy, and remission of PPI defined by the absence of any prepouch inflammation on endoscopic assessment within a year of biologic therapy.Results: There were 29 patients in our cohort. On last endoscopic follow-up, 20/29 still had endoscopic evidence of PPI, seven had achieved endoscopic remission and avoided an ileostomy, and two had no endoscopic follow-up. In our cohort 11 patients had an ileostomy after a median time from starting a biologic of 25 months (range 14–91).Conclusion: Biologics fail to induce endoscopic remission of PPI in the majority of patients. Just under one-third patients with PPI coexistent with pouchitis ca

Published
2018

32. Acute Renal Failure in Association with Community-Acquired Clostridium difficile Infection and McKittrick-Wheelock Syndrome

Author

Learney, Robert M., Ziprin, Paul, Swift, Pauline A., and Faiz, Omar D.

Subjects
Published: August 2011, Haemofiltration, McKittrick-Wheelock syndrome, lcsh:Diseases of the digestive system. Gastroenterology, Clostridium difficile, lcsh:RC799-869, Acute kidney failure, Villous adenoma
Abstract

We report the case of a 65-year-old Caucasian woman who experienced two separate episodes of acute renal failure within an 18-month period, both requiring emergency admission and complicated treatment. Each episode was precipitated by hypovolaemia from intestinal fluid losses, but from two rare and independent pathologies. Her first admission was attributed to community-acquired Clostridium difficile-associated diarrhoea (CDAD) and was treated in the intensive therapy unit. She returned 18 months later with volume depletion and electrolyte disturbances, but on this occasion a giant hypersecretory villous adenoma of the rectum (McKittrick-Wheelock syndrome) was diagnosed following initial abnormal findings on digital rectal examination by a junior physician. Unlike hospital-acquired C. difficile, community-acquired infection is not common, although increasing numbers are being reported. Whilst community-acquired CDAD can be severe, it rarely causes acute renal failure. This case report highlights the pathological mechanisms whereby C. difficile toxin and hypersecretory villous adenoma of the rectum can predispose to acute renal failure, as well as the values of thorough clinical examination in the emergency room, and early communication with intensivist colleagues in dire situations.

Published
2011

37. Developing a core outcome set for fistulising perianal Crohn's disease.

Author

Sahnan, Kapil, Tozer, Phil J., Adegbola, Samuel O., Lee, Matthew J., Heywood, Nick, McNair, Angus G. K., Hind, Daniel, Yassin, Nuha, Lobo, Alan J., Brown, Steven R., Sebastian, Shaji, Phillips, Robin K. S., Lung, Phillip F. C., Faiz, Omar D., Crook, Kay, Blackwell, Sue, Verjee, Azmina, Hart, Ailsa L., and Fearnhead, Nicola S.

Subjects
CROHN'S disease, ANAL fistula, OTITIS media with effusion
Published
2019
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38. A Systematic Review: The Management and Outcomes of Ileal Pouch Strictures.

Author

Segal, Jonathan P., Adegbola, Samuel O., Worley, Guy H. T., Sahnan, Kapil, Tozer, Philip, Lung, Phillip F. C., Faiz, Omar D., Clark, Susan K., and Hart, Ailsa L.

Abstract

Background: Restorative proctocolectomy with ileal pouch-anal anastomosis removes the diseased tissue in ulcerative colitis but also allows gastrointestinal continuity and stoma-free living. Pouch strictures are a complication with a reported incidence of 5-38%. The three areas where pouch strictures occur are in the pouch inlet, mid-pouch and pouch-anal anastomosis. Aim: To undertake a systematic review of the literature and to identify management strategies available for pouch-anal, mid-pouch and pre-pouch ileal strictures and their outcomes. Methods: A computer-assisted search of the online bibliographic databases MEDLINE and EMBASE limited to 1966 to February 2016 was performed. Randomized controlled trials, cohort studies, observational studies and case reports were considered. Those where data could not be extracted were excluded. Results: Twenty-two articles were considered eligible. Pouch-anal strictures have been initially managed using predominately dilators which include bougie and Hegar dilators with various surgical procedures advocated when initial dilatation fails. Mid-pouch strictures are relatively unstudied with both medical, endoscopic and surgical management reported as successful. Pouch inlet strictures can be safely managed using a combined medical and endoscopic approach. Conclusion: The limited evidence available suggests that pouch-anal strictures are best treated in a stepwise fashion with initial treatment to include digital or instrumental dilatation followed by surgical revision or resection. Management of mid-pouch strictures requires a combination of medical, endoscopic and surgical management. Pouch inlet strictures are best managed using a combined medical and endoscopic approach. Future studies should compare different treatment modalities on separate stricture locations to enable an evidenced-based treatment algorithm. [ABSTRACT FROM AUTHOR]

Published
2018
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