-
Expert Opinion on Biological Therapy Jul 2018Crohn's disease (CD) is a chronic, recurring, idiopathic disease which is associated with imbalanced mucosal immune response, manifesting as a chronic inflammation of... (Review)
Review
INTRODUCTION
Crohn's disease (CD) is a chronic, recurring, idiopathic disease which is associated with imbalanced mucosal immune response, manifesting as a chronic inflammation of any location throughout the gastrointestinal tract. The purpose of currently available therapy is to suppress the heightened immune response. However, these treatments have no direct influence on the healing process of damaged tissues. The mesenchymal stem cell (MSC) therapy may represent a new alternative solution in both luminal and fistulizing CD, as it is able to inhibit the inflammation and promote the regeneration process at the same time.
AREAS COVERED
Aim of this review is to summarize the existing clinical data about the clinical impact of MSC therapy in luminal and perianal fistulizing CD.
EXPERT OPINION
Clinical trials demonstrated that MSC transplantation has an outstanding, durable efficacy with low fistula recurrence in biological therapy-refractory fistulizing CD; however, further clinical trials are required to confirm its effectiveness in luminal CD. Unlike to biological therapy, MSCs are able to promote the regeneration process of damaged tissues as well. This additional benefit besides their sustained immunosuppressive effect with no decrease of efficiency over time makes MSCs a new, highly potential therapeutic approach in the management of inflammatory bowel disease.
Topics: Animals; Crohn Disease; Humans; Inflammation; Inflammatory Bowel Diseases; Intestinal Fistula; Mesenchymal Stem Cell Transplantation; Mesenchymal Stem Cells; Perianal Glands; Rectal Fistula; Wound Healing
PubMed: 29939815
DOI: 10.1080/14712598.2018.1492543 -
Inflammatory Bowel Diseases Oct 2018The differentiation between intestinal tuberculosis (ITB) and Crohn's disease (CD) is a challenge. The aim of this study was to investigate a predictive model for...
BACKGROUND
The differentiation between intestinal tuberculosis (ITB) and Crohn's disease (CD) is a challenge. The aim of this study was to investigate a predictive model for differential diagnosis between ITB and CD.
METHODS
A total of 268 patients who were suspected of having ITB or CD were prospectively recruited between January 2013 and September 2016. The clinical, laboratory, radiological, endoscopic, and histological features were investigated and subjected to univariate and multivariate analyses. The final predictive model was developed based on the regression coefficients of multivariate logistic regression. To validate the model, the same regression equation was tested on the other group.
RESULTS
A total of 239 patients had a final diagnosis, including 86 ITB and 153 CD. Five variables (perianal disease, pulmonary involvement, longitudinal ulcer, left colon, and ratio of tuberculosis-specific antigen to phytohaemagglutinin) were selected for the predictive model to discriminate between ITB and CD. In the predictive model of the training data set, the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and accuracy, with a cutoff level of 0.29, were 0.975 (95% confidence interval [CI], 0.939-0.993), 96.7%, 90.7%, and 92.8%, respectively. Application of the predictive model to the validation data set showed similar performance in distinguishing ITB from CD. The area under the ROC curve, sensitivity, specificity, and accuracy were 0.950 (95% CI, 0.871-0.987), 88.5%, 93.5%, and 91.7%, respectively.
CONCLUSIONS
This 5-marker predictive model could be conveniently used by clinicians to draw a reliable differential diagnosis between ITB and CD in clinical practice. 10.1093/ibd/izy154_video1izy154.video15790725497001.
Topics: Adult; Animals; Antigens, Bacterial; Biomarkers; Colon; Crohn Disease; Female; Follow-Up Studies; Humans; Male; Perianal Glands; Phytohemagglutinins; Prognosis; Prospective Studies; Tuberculosis, Gastrointestinal; Ulcer
PubMed: 29860270
DOI: 10.1093/ibd/izy154 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2018The aim: The purpose of this study is to analyze the frequency and structure of parasitic lesion in women with reproductive health disorders.
OBJECTIVE
The aim: The purpose of this study is to analyze the frequency and structure of parasitic lesion in women with reproductive health disorders.
PATIENTS AND METHODS
Materials and methods: The immune-enzyme method tested immunoglobulins IgG to ascaris, lamblia, toxocara. Determination of the presence of pinworm eggs (sticky tape and perianal scrape method) and ascarid (methods of K.Cato, F.Fueleborna and E.S.Schulman).
RESULTS
Results: In women with complicated obstetric anamnesis, parasitic invasions occurred in (52.3 ± 5.0)% (Χ² = 34.9, p <0.01; 95% CI = 42.5-62.1). Enterobiasis was detected in (12,0 ± 3,3)% of patients, acarida eggs in (29,3 ± 4,6)%, positive titers of IgG to ascaris - in (11.5 ± 3.2)%, IgG to lamblia in - 7.5%, IgG to toxocara 3.5%, the combined detection - in (11.5 ± 3.2)% of the examined group. In patients of the control group, parasitic invasions were detected in (13.1 ± 3.4)%. The prevalence of parasitic lesion in women with primary infertility (58.0 ± 4.9)% (OR = 8.9; 95% CI = 5.2-15.3; p <0.01), in planning pregnancy (25, 7 ± 4.4)% (OR = 2.3, 95% CI = 1.3-4.0). The most significant aggressive parasite in women with complicated obstetric anamnesis, reproductive loss and infertility is ascariasis (95% CI 6.1-38; p <0.001). In women with parasitic lesion revealed the dominance of pathology of the mammary glands, gastrointestinal tract, acne, pathology of the urinary system, thyroid gland.
CONCLUSION
Conclusions: The obtained results make it possible to recommend parasite examination in women with infertility and complicated obstetric anamnesis.
Topics: Adult; Animals; Ascaris lumbricoides; Entamoeba histolytica; Enzyme-Linked Immunosorbent Assay; Female; Humans; Infertility, Female; Intestinal Diseases, Parasitic; Pregnancy; Pregnancy Complications, Infectious; Prenatal Care; Risk Factors; Schistosoma mansoni; Seroepidemiologic Studies; Young Adult
PubMed: 29783245
DOI: No ID Found -
Ultrasound Quarterly Mar 2020Extramammary Paget disease (EMPD) is a rare intraepithelial malignancy originating in areas rich in apocrine glands, such as the vulva, perineum, perianal area, scrotum,...
Extramammary Paget disease (EMPD) is a rare intraepithelial malignancy originating in areas rich in apocrine glands, such as the vulva, perineum, perianal area, scrotum, and penis. A few reports of EMPD involving the scrotum have been described in the literature. However, only few reports have described imaging features observed in patients presenting with EMPD. We report EMPD in a patient showing scrotal involvement, focusing on imaging features, particularly those determined ultrasonographically.
Topics: Aged; Biopsy; Genital Neoplasms, Male; Humans; Male; Neoplasm Staging; Paget Disease, Extramammary; Scrotum
PubMed: 29727346
DOI: 10.1097/RUQ.0000000000000362 -
American Journal of Physical... Aug 2018Sexual selection has seemingly influenced chemical communication in numerous non-human primates, although it is unclear whether it has influenced strictly pair-living...
OBJECTIVES
Sexual selection has seemingly influenced chemical communication in numerous non-human primates, although it is unclear whether it has influenced strictly pair-living and pair-bonded taxa. The physical similarities between male and female owl monkeys suggest that disruptive selection has not played a role in this taxon. However, given their nocturnality, olfactory traits may show differing patterns of sexual selection than visual traits. If sexual selection has influenced chemical communication in owl monkeys, we expect larger scent glands and greater scent-marking in females given the high degree of paternal care, as has been proposed for callitrichines.
MATERIALS AND METHODS
We evaluated sex differences in the qualitative and quantitative descriptions of the subcaudal and perianal glandular regions of captive male (n = 39) and female (n = 36) owl monkeys (A. nancymaae), and in the olfactory behaviors performed within breeding pairs (n = 16).
RESULTS
Males had larger areas of secretion retained in the hairs covering the subcaudal gland, and females had more and darker secretion than males covering the perianal region. Males inspected the genital region of their partners more frequently than females did, but the sexes did not differ much in other investigative and marking behaviors.
DISCUSSION
The observed sex differences and variation in olfactory traits are consistent with the hypothesis that sexual selection has influenced chemical communication in owl monkeys, with males having larger subcaudal glands and spending more time investigating odors. Still, sex differences in monogamous owl monkeys were less extreme than those in other, non-monogamous, taxa.
Topics: Animals; Anthropology, Physical; Aotidae; Behavior, Animal; Bodily Secretions; Female; Male; Pair Bond; Scent Glands; Sex Characteristics; Smell
PubMed: 29719049
DOI: 10.1002/ajpa.23487 -
Indian Journal of Pathology &... 2018Hidradenoma papilliferum is a rare cutaneous adnexal tumour of middle aged females arising mainly in the apocrine sweat glands of perianal and genital region. Ectopic...
Hidradenoma papilliferum is a rare cutaneous adnexal tumour of middle aged females arising mainly in the apocrine sweat glands of perianal and genital region. Ectopic forms of this entity have been described with majority of them occurring on the head and neck region. We report a case of 16 years young male who presented with two small, well circumscribed, greyish-brown, firm, nodules on his left upper and lower eyelid. A clinical impression of basal cell carcinoma was assumed but on histopathological examination it was diagnosed as hidradenoma papilliferum of eyelid. Immunohistochemistry was performed to support the diagnosis due to its unusual clinical presentation. To the best of our knowledge, only six cases in the upper eyelid and one case in the lower eyelid have been reported in the English literature. This is the first case report of hidradenoma papilliferum involving both upper and lower left eyelid in an adolescent boy.
Topics: Adolescent; Eyelid Neoplasms; Eyelids; Humans; Male; Sweat Gland Neoplasms; Tubular Sweat Gland Adenomas
PubMed: 29676381
DOI: 10.4103/IJPM.IJPM_686_16 -
Alimentary Pharmacology & Therapeutics May 2018Patient reported outcomes regarding perianal disease and faecal incontinence in the community-based inflammatory bowel disease population are poorly described.
BACKGROUND
Patient reported outcomes regarding perianal disease and faecal incontinence in the community-based inflammatory bowel disease population are poorly described.
AIMS
To determine the impacts of perianal disease and faecal incontinence on quality of life and employment in inflammatory bowel disease patients.
METHODS
For this cross-sectional study, a comprehensive survey was sent out to members of the Dutch National Crohn's and Colitis patient organisation. Validated questionnaires regarding faecal incontinence and active perianal disease were used to estimate its prevalence's. The effect on the quality of life (36-Item Short Form Survey) and on employment status (multivariate binary regression analysis) was assessed in this inflammatory bowel disease population.
RESULTS
A total number of 1092 returned questionnaires (58% responders) were used for analysis; 750 respondents (69%) were female; mean age was 47 years (IQR 35-59). In 621 patients (57%) Crohn's disease, in 422 (39%) ulcerative colitis and in 49 (4%) patients unclassifiable inflammatory bowel disease was self-reported. The 114 patients (10%) with a stoma were excluded for continence related analyses. Faecal incontinence was reported in 555 patients (57%), was comparable between the different inflammatory bowel disease diagnoses and affected all 36-Item Short Form Survey subscales adversely (incontinence vs continence: Physical functioning 75 vs 84, P < 0.0001; Limitations due to physical health 49 vs 63, P < 0.0001; Limitations due to emotional problems 49 vs 64, P < 0.0001; Energy/fatigue 47 vs 53, P < 0.0001; Emotional well-being 71 vs 74, P = 0.005; Social functioning 63 vs 73, P < 0.0001; Pain 66 vs 75, P < 0.0001; General health 41 vs 48, P < 0.0001). Active perianal disease was reported in 39% Crohn's disease, 16% ulcerative colitis (84% fissures) and 20% unclassifiable inflammatory bowel disease patients. Faecal incontinence was more common in patients with perianal disease (67% vs 53%, P = 0.003). When correcting for age, disease duration, inflammatory bowel disease-related surgery and faecal incontinence, active perianal disease was independently affecting employment (OR 0.67; 95% CI 0.50-0.91; P = 0.01).
CONCLUSIONS
Faecal incontinence and perianal disease are quality of life determining factors. Faecal incontinence needs more attention among clinicians, and development of new (drug) therapies needs to be focussed on perianal disease.
Topics: Adult; Animals; Anus Diseases; Cross-Sectional Studies; Employment; Fecal Incontinence; Female; Humans; Inflammatory Bowel Diseases; Male; Middle Aged; Netherlands; Perianal Glands; Prevalence; Quality of Life; Surveys and Questionnaires
PubMed: 29520808
DOI: 10.1111/apt.14599 -
Anatomical Record (Hoboken, N.J. : 2007) May 2018To better understand the cellular origins and differentiation of anal canal epithelial neoplasms, the immunohistochemical profiles of the anal canal epithelium in humans... (Comparative Study)
Comparative Study
To better understand the cellular origins and differentiation of anal canal epithelial neoplasms, the immunohistochemical profiles of the anal canal epithelium in humans and swine were evaluated. Formalin-fixed tissue sections were immunostained for mucin (MUC: MUC2, MUC5AC, MUC5B), desmoglein 3 (DGS3), p63, CDX2, SOX2, and α-smooth muscle actin (α-SMA). The anal transitional zone (ATZ) epithelium covered the anal sinus and consisted of a stratified epithelium with mucous cells interspersed within the surface lining. Anal glands opened into the anal sinus. Ducts and acini of intraepithelial or periepithelial mucous type were the main structures of human anal glands, whereas those of swine were compound tubuloacinar mixed glands. Distal to the ATZ epithelium, non-keratinized stratified squamous epithelium merged with the keratinized stratified squamous epithelium of the perianal skin. MUC5AC expression predominated over MUC5B expression in the ATZ epithelium, while MUC5B expression was higher in the anal glands. SOX2 was positive in the ATZ epithelium, anal glands, and squamous epithelium except in the perianal skin. In humans, DGS3 was expressed in the ATZ epithelium, anal gland ducts, and squamous epithelium. p63 was detected in the ATZ epithelium, anal glands, and squamous epithelium. Myoepithelial cells positive for α-SMA and p63 were present in the anal glands of swine. Colorectal columnar cells were MUC5B /MUC2 /CDX2 /MUC5AC /SOX2 . The ATZ epithelium seems to be a distinctive epithelium, with morphological and functional features allowing smooth defecation. The MUC5AC /SOX2 /MUC2 /CDX2 profile of the ATZ epithelium and anal glands is a useful feature for diagnosing adenocarcinoma arising from these regions. Anat Rec, 301:796-805, 2018. © 2017 Wiley Periodicals, Inc.
Topics: Actins; Anal Canal; Animals; CDX2 Transcription Factor; Desmoglein 3; Epithelial Cells; Humans; Immunohistochemistry; Intestinal Mucosa; Mucins; SOXB1 Transcription Factors; Swine
PubMed: 29232767
DOI: 10.1002/ar.23748 -
Journal of Clinical Neuroscience :... Nov 2017Extramammary Paget disease is an intraepithelial neoplasm affecting cells rich in apocrine glands-often located in the vulvar, scrotal, or perianal region. It typically...
Extramammary Paget disease is an intraepithelial neoplasm affecting cells rich in apocrine glands-often located in the vulvar, scrotal, or perianal region. It typically affects older patients, between the ages of 50 and 80years old, and is most often limited to the epidermis. A 47-year-old Asian male first presented with enlargement of the right inguinal lymph node. A subsequent biopsy revealed extrammamary Paget disease of the scrotum. The patient eventually developed significant worsening back pain with bilateral lower extremity numbness and weakness three months later. Imaging demonstrated a pathologic compression fracture of the L4 vertebral body with metastatic epidural spinal cord compression. The patient underwent surgical decompression of the spine with bilateral L4 laminectomy, resection of epidural tumor, and pedicle screw fixation from L2 to S1. Surgical pathology demonstrated metastatic adenocarcinoma consistent with extramammary Paget disease. Although two other case reports have described spinal metastases from extramammary Paget disease, to the author's knowledge, this represents the first report of surgical decompression and fusion for extramammary Paget disease of the spine.
Topics: Adenocarcinoma; Decompression, Surgical; Epidural Neoplasms; Epidural Space; Fractures, Compression; Humans; Laminectomy; Male; Middle Aged; Paget Disease, Extramammary; Scrotum; Spinal Fractures
PubMed: 28887080
DOI: 10.1016/j.jocn.2017.08.018 -
The Indian Journal of Surgery Aug 2017Extramammary Paget's disease (EMPD) is uncommon and only a few cases have been reported in the literature. They are identical to the Mammary Paget's disease. This can...
Extramammary Paget's disease (EMPD) is uncommon and only a few cases have been reported in the literature. They are identical to the Mammary Paget's disease. This can occur where the apocrine glands are in abundance, more commonly in the genitalia and perianal area. We report here a case of Extramammary Paget's disease in the perianal region. The colourful background of this ulcer is analysed and the literature reviewed.
PubMed: 28827914
DOI: 10.1007/s12262-017-1590-6