Cerebral Arterial Thrombosis in Ulcerative Colitis

Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD). We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature

Patient and physician views on the quality of care for inflammatory bowel disease after one-year follow-up: Results from SOLUTION-2, a prospective IG-IBD study

Background and aims Perception of quality of care is important in the management of patients with chronic diseases, particularly inflammatory bowel disease. Aims and methods This longitudinal study aimed to investigate variations of the Quality of Care through the Patients\ue2\u80\u99 Eyes (QUOTE-IBD) questionnaire scores one year after the basal evaluation in the Studio Osservazionale quaLit\uc3  cUre malatTIe crOniche intestiNali (SOLUTION-1) study. Results Of the cohort of 992 patients, 936 were evaluable. The QUOTE-IBD score overcame satisfactory levels of more than the 80%, overall and in all subdomains except for the \ue2\u80\u9cContinuity of Care\ue2\u80\u9d sub-dimension (mean, 8.3; standard deviation, 1.49), scored satisfactory only by 34% of the patients. No significant changes in satisfaction were recorded overall, or considering patients subgroups. Significant differences were found at the end of the follow-up between physicians\ue2\u80\u99 and patients\ue2\u80\u99 perceptions of quality of care, with the former over-rating their performance in \ue2\u80\u9cContinuity of Cares\ue2\u80\u9d and under-rating \ue2\u80\u9cCosts\ue2\u80\u9d, \ue2\u80\u9cCompetence\ue2\u80\u9d, and \ue2\u80\u9cAccessibility\ue2\u80\u9d sub-domains of the score (p < 0.05 for all). Conclusion Perceived quality of care in a large cohort of Italian patients with inflammatory bowel disease remains unchanged after one-year follow-up and was not significantly affected by disease activity or therapeutic interventions. Differences between physicians\ue2\u80\u99 and patients\ue2\u80\u99 perceptions of quality of care should be taken into account

Continuous clinical remission with biologics in ulcerative colitis: the 'AURORA' comparison study

Comparative trials among biological drugs for the treatment of ulcerative colitis (UC) provided conflicting results. After patent expire of infliximab originator, adalimumab, infliximab biosimilar, golimumab and vedolizumab have been approved in Italy.We compared the efficacy of these four biologics in UC according to the concept of continuous clinical remission (CCR)

Influence of K-ras status and anti-tumour treatments on complications due to colorectal self-expandable metallic stents: A retrospective multicentre study

Background This study aimed to explore the relationship between K-ras status, anti-tumour treatments, and the complications of colorectal self-expandable metallic stenting in colorectal cancer. Methods This is a retrospective, multicentre study of 91 patients with obstructive advanced colorectal cancer palliated with enteral stents between 2007 and 2011. Results K-ras wild-type tumours were diagnosed in 44 patients (48.4%); 82 (90.1%) received chemotherapy and 45 (49.4%) had additional biological therapy (34 bevacizumab, 11 cetuximab). Twenty-one (23.1%) experienced stent-related complications: 11 (52.4%) occurred in the K-ras mutant group (P = 0.9). K-ras wild-type patients were not less likely to develop adverse events than K-ras mutant patients (OR, 0.99; 95% CI: 0.4\u20132.7). Overall mean time to complication was 167.6 days (range 4\u2013720 days), with no difference between the two groups (141 vs. 197 days; P = 0.5). Chemotherapy did not influence the risk of complications (OR, 0.56; 95% CI: 0.14\u20132.9), and there was no evidence that patients treated with chemotherapy and cetuximab were more likely to experience stent-related complications than patients treated with chemotherapy alone, or untreated (OR, 1.2; 95% CI: 0.2\u20135.9). Although perforation rates were higher with bevacizumab-based treatment (11.8% vs. 7%), this result was not statistically significant (P = 0.69). Conclusions K-ras mutation status, chemotherapy, and biological treatments should not influence colorectal stent-related complication rates