Development of a core descriptor set for Crohn's anal fistula

AIM: Crohn's anal fistula (CAF) is a complex condition, with no agreement on which patient characteristics should be routinely reported in studies. The aim of this study was to develop a core descriptor set of key patient characteristics for reporting in all CAF research. METHOD: Candidate descriptors were generated from published literature and stakeholder suggestions. Colorectal surgeons, gastroenterologists and specialist nurses in inflammatory bowel disease took part in three rounds of an international modified Delphi process using nine-point Likert scales to rank the importance of descriptors. Feedback was provided between rounds to allow refinement of the next ratings. Patterns in descriptor voting were assessed using principal component analysis (PCA). Resulting PCA groups were used to organize items in rounds two and three. Consensus descriptors were submitted to a patient panel for feedback. Items meeting predetermined thresholds were included in the final set and ratified at the consensus meeting. RESULTS: One hundred and thirty three respondents from 22 countries completed round one, of whom 67.0% completed round three. Ninety seven descriptors were rated across three rounds in 11 PCA-based groups. Forty descriptors were shortlisted. The consensus meeting ratified a core descriptor set of 37 descriptors within six domains: fistula anatomy, current disease activity and phenotype, risk factors, medical interventions for CAF, surgical interventions for CAF, and patient symptoms and impact on quality of life. CONCLUSION: The core descriptor set proposed for all future CAF research reflects characteristics important to gastroenterologists and surgeons. This might aid transparent reporting in future studies

The Impact Of Preoperative Anti-tnf In Surgical And Infectious Complications Of Abdominal Procedures For Crohn's Disease: Controversy Still Persists.

[No abstract available]109113

Antecedents of retail employees’ service performance:a store-level exploration of a climate-centric versus an engagement-centric approach

This paper compares two store-level models of the antecedents of frontline employees’ in-role and extra-role service performance in a retail setting. In the climate-centric research model, service climate serves as a direct antecedent of in-role and extra-role service performance, while in the engagement-centric rival model, work engagement directly predicts in-role and extra-role service performance. The two competing models were assessed at the store-level of analysis on data collected from 781 frontline employees and 70 managers. Results indicate that service-oriented high-performance work systems and work engagement both predict service climate which, in turn, predicts employees’ in-role and extra-role service performance.https://www.tandfonline.com/loi/wsmq202024-10-27hj2023Marketing Managemen

Service-oriented high-performance work practices as predictors of retail employees’ work engagement and service climate perceptions

Using survey data collected from 781 frontline employees of a South African retailer, this study investigated the degree to which employees’ perceptions of six service-oriented high-performance work practices (HPWPs) – staffing, training, financial compensation, non-financial rewards, involvement, and empowerment – predict their work engagement and service climate perceptions. It was found that employees’ perceptions of involvement, training and staffing predicted their service climate perceptions, while only training was a statistically significant predictor of employees’ work engagement. The study contributes to the limited research on the relationship between individual service-oriented HPWPs and these two crucial employee outcomes.https://www.tandfonline.com/loi/wsmq202022-12-13hj2022Marketing Managemen

Comparative Analysis Of Adverse Events Between Infl Iximab And Adalimumab In Crohn's Disease Management: A Brazilian Single-centre Experience [análise Comparativa Dos Eventos Adversos Entre Infliximabe E Adalimumabe No Tratamento Da Doença De Crohn: Experiěncia Em Um Centro Brasileiro]

Introduction: Data is scarce regarding adverse events (AE) of biological therapy used in the management of Crohn's Disease (CD) among Brazilian patients. Objectives: To analyse AE prevalence and profile in patients with CD treated with Infliximab (IFX) or Adalimumab (ADA) and to verify whether there are differences between the two drugs. Method: Retrospective observational single-centre study of CD patients on biological therapy. Variables analysed: Demographic data, Montreal classifi cation, biological agent administered, treatment duration, presence and type of AE and the need for treatment interruption. Results: Forty-nine patients were analysed, 25 treated with ADA and 24 with IFX. The groups were homogeneous in relation to the variables studied. The average follow-up period for the group treated with ADA was 19.3 months and 21.8 months for the IFX group (p = 0.585). Overall, 40% (n = 10) of patients taking ADA had AE compared with 50% (n = 12) of IFX users (p = 0.571). There was a tendency towards higher incidence of cutaneous and infusion reactions in the IFX group and higher incidence of infections in the ADA treated group, although without significant difference. Conclusions: No difference was found in the AE prevalence and profile between ADA and IFX CD patients in the population studied. © 2013 Elsevier Editora Ltda. All rights reserved.3313338Rutgeerts, P., van Assche, G., Vermeire, S., Review article: Infliximab therapy for inflammatory bowel disease - seven years on (2006) Aliment Pharmacol Ther, 23, pp. 451-463Colombel, J.F., Sandborn, W.J., Panaccione, R., Robinson, A.M., Lau, W., Li, J., Adalimumab safety in global clinical trials of patients with Crohn's disease (2009) Infl Amm Bowel Dis, 15, pp. 1308-1319Colombel, J.F., Sandborn, W.J., Rutgeerts, P., Adalimumab for maintenance of clinical response and remission in patients with Crohn's disease: The CHARM trial (2007) Gastroenterology, 132, pp. 52-65Papadakis, K.A., Targan, S.R., Tumor necrosis factor: Biology and therapeutic inhibitors (2000) Gastroenterology, 119, pp. 1148-1157van Deventer, S.J., Tumour necrosis factor and Crohn's disease (1997) Gut, 40, pp. 443-448Hanauer, S.B., Feagan, B.G., Lichtenstein, G.R., Mayer, L.F., Schreiber, S., Colombel, J.F., Rachmilewitz, D., Rutgeerts, P., Maintenance infl iximab for Crohn's disease: The ACCENT I randomised trial (2002) Lancet, 359, pp. 1541-1549Targan, S.R., Hanauer, S.B., van Deventer, S.J., Mayer, L., Present, D.H., Braakman, T., Dewoody, K.L., Rutgeerts, P.J., A short term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease (1997) N Engl J Med, 337, pp. 1029-1035. , Crohn's Disease cA2 Study GroupSands, B.E., Anderson, F.H., Bernstein, C.N., Chey, W.Y., Feagan, B.G., Fedorak, R.N., Kamm, M.A., van Deventer, S.J., Infl iximab maintenance therapy for fi stulizing Crohn's disease (2004) N Engl J Med, 350, pp. 876-885Hyams, J., Crandall, W., Kugathasan, S., Induction and maintenance infl iximab therapy for the treatment of moderate-to-severe Crohńs disease in children (2007) Gastroenterology, 132 (3), pp. 863-873Sandborn, W.J., Rutgeerts, P., Enns, R., Hanauer, S.B., Colombel, J.F., Panaccione, R., Adalimumab induction therapy for Crohn's disease previously treated with infl iximab: A randomized trial (2007) Ann Intern Med, 146, pp. 829-838Zorzi, F., Zuzzi, S., Onali, S., Calabrese, E., Condino, G., Petruzziello, C., Effi cacy and safety of infl iximab and adalimumab in Crohn's disease: A single centre study (2012) Aliment Pharmacol Ther, 35 (12), pp. 1397-1407Burmester, G.R., Mease, P., Dijkmas, B.A.C., Gordon, K., Lovell, D., Panaccione, R., Adalimumab Safety and Mortality Rates from Global Clinical Trials of Six Immune-Mediated Infl ammatory Diseases (2009) Ann Rheum Dis. Ann Rheum Dis, 68, pp. 1863-1869Colombel, J.F., Rutgeerts, P., Reinisch, W., SONIC study group. Infl iximab, azathioprine, or combination therapy for Crohn's disease (2010) N Engl J Med, 362, pp. 1383-1395Present, D.H., Rutgeerts, P., Targan, S., Hanauer, S.B., Mayer, L., van Hogezand, R.A., Podolsky, D.K., van Deventer, S.J., Infl iximab for the treatment of fi stulas in patients with Crohn's disease (1999) N Engl J Med, 340, pp. 1398-140

Human Fibrinogen And Thrombin Patch For Extraluminal Protection Of Intestinal Anastomosis [membrana De Fibrinogênio E Trombina Humanos Para Proteção Extra-luminal De Anastomoses Intestinais]

In spite of recent advances regarding equipment and surgical techniques in colorectal surgery, rates of anastomotic dehiscence (AD) have remained stable throughout the years. The development of products to protect anastomosis aiming the reduction of AD rates has shown to be promising. Human fibrinogen and thrombin patch (HFTP - Tachosil®) have been used in experimental studies in animals and small case series in humans, with promising results. In this study, the authors describe the technique of HFTP use in details, aiming the protection of colorectal anastomosis, and retrospectively demonstrate the preliminary results in a pilot case series. HFTP was used in 4 patients submitted to conventional surgery. The procedures performed were: left colon resection, segmental colectomy (both for colorectal cancer), enteral anastomosis for fistula closure and right ileocolectomy. Anasto-motic healing and absence of complications were observed in 3 patients, and the patient submitted to right ileocolectomy developed AD and died after reoperation. The use of HFTP is safe and can be indicated in selected cases. However, AD can occur even after the use of this strategy. Randomized controlled trials with larger samples of patients are needed in order to properly define the real benef ts of this strategy in dehiscence prevention. © 2013 Elsevier Editora Ltda. All rights reserved.333174178Davis, B., Rivadeneira, D.E., Complications of Colorectal Anastomoses (2013) Surg Clin N Am, 93, pp. 61-87Shogan, B.D., Carlisle, E.M., Alverdy, J.C., Umanskiy, K., Do We Really Know Why Colorectal Anastomoses Leak? (2013) J Gastrointest Surg, , May 21 [Epub ahead of print]Caulfield, H., Hyman, N.H., Anastomotic Leak After Low Anterior Resection (2013) JAMA Surg, 148 (2), pp. 177-182Slieker, J.C., Daams, F., Mulder, I.M., Jeekel, J., Lange, J.F., Systematic review of the technique of colorectal anastomosis (2013) JAMA Surg, 148 (2), pp. 190-201. , FebDaams, F., Luyer, M., Lange, J.F., Colorectal anastomotic leakage: Aspects of prevention, detection and treatment World (2013) J Gastroenterol, 19 (15), pp. 2293-2297. , AprilNeutzling, C.B., Lustosa, S.A., Proenca, I.M., Stapled versus hand-sewn methods for colorectal anastomosis surgery (2012) Cochrane Database Syst Rev, 2, pp. CD003144Lustosa, S.A., Matos, D., Atallah, A.N., Castro, A.A., Stapled versus handsewn methods for colorectal anastomosis surgery (2001) Cochrane Database Syst Rev, 3, pp. CD003144Macrae, H.M., McLeod, R.S., Handsewn vs. stapled anastomoses in colon and rectal surgery: A meta-analysis (1998) Dis Colon Rectum, 41, pp. 180-189Ho, Y.H., Ashour, M.A.T., Techniques for colorectal anastomosis (2010) World J Gastroenterol, 16 (13), pp. 1610-1621. , April 7Parker, M.C., Pohlen, U., Borel Rinkes, I.H.M., Delvin, T., The application of TachoSil® for sealing colorectal anastomosis: A feasibility study (2013) Colorectal Disease, 15 (2), pp. 252-257Bakker, I.S., Morks, A.N., Hoedemaker, H.O.C., Burgerhof, J.G.M., Leuvenink, H.G., Ploeg, R.J., Havenga, K., The C-seal trial: Colorectal anastomosis protected by a biodegradable drain fixed to the anastomosis by a circular stapler, a multi-center randomized controlled trial (2012) BMC Surg, 12, p. 23Pommergaard, H.C., Achiam, M.P., Rosenberg, J., External coating of colonic anastomoses: A systematic review (2012) Int J Colorectal Dis, 27, pp. 1247-1258Vakalopoulos, K.A., Daams, F., Wu, Z., Timmermans, L., Jeekel, J.J., Kleinrensink, G.J., Ham, A.V.D., Lange, J.F., Tissue adhesives in gastrointestinal anastomosis: A systematic review (2013) Journal IF Surg Res, 180, pp. 290-300Huh, J.W., Kim, H.R., Kim, Y.J., Anastomotic leakage after laparoscopic resection of rectal cancer: The impact of fibrin glue (2010) Am J Surg, 199 (4), pp. 435-441Rickenbacher, A., Breitenstein, S., Lesurtel, M., Frilling, A., Efficacy of TachoSil a f brin-based haemostat in different f elds of surgery - a systematic review (2009) Expert Opin Biol Ther, 9, pp. 897-907Pantelis, D., Beissel, A., Kahl, P., Wehner, S., Vilz, T.O., Kalff, J.C., The effect of sealing with a f xed combination of collagen matrixbound coagulation factors on the healing of colonic anastomoses in experimental high-risk mice models (2010) Langenbecks Arch Surg, 395 (8), pp. 1039-1048Nordentoft, T., Rømer, J., Sørensen, M., Sealing of gastrointestinal anastomoses with a fibrin glue-coated collagen patch: A safety study (2007) J Invest Surg, 20, pp. 363-369de Stefano, A., Bettarini, F., Di Mare, G., Neri, A., Enteric anastomosis and Tachosil (2011) Minerva Chir, 66, pp. 183-18