Effect of Inflammatory Bowel Disease-Related Characteristics and Treatment Interventions on Cardiovascular Disease Incidence

BACKGROUND: An association between inflammatory bowel disease (IBD) and cardiovascular diseases has been shown in multiple studies. However, little is known about the effect of IBD-related characteristics on cardiovascular events. METHODS: The authors conducted a retrospective, nested case-control study of IBD patients who presented to the institution from 2000 to 2004, allowing for a 10-year follow-up period. One hundred eleven patients who developed cardiovascular events (cases) and 222 patients who did not develop cardiovascular events (cases) were included in the study after matching for Framingham cardiovascular risk score (2008). Relationships between predictor variables and cardiovascular outcome were assessed by conditional logistic regression. RESULTS: The cases and controls were similar in age, gender, smoking and cholesterol level. There was no difference in disease subtype (ulcerative colitis or Crohn\u27s disease). On conditional logistic regression, thiopurine treatment (odds ratio [OR]: 0.42, 95% confidence interval [CI]: 0.19-0.87; P = 0.02) was associated with decreased cardiovascular events and tumor necrosis factor alpha antagonist use (OR: 2.63, 95% CI: 1.49-4.63; P = 0.001) was associated with increased cardiovascular events. Although not statistically significant, disease-related surgery (OR: 0.57, 95% CI: 0.32-1.02; P = 0.06) was associated with decreased cardiovascular events and disease-related hospitalization (OR: 1.58, 95% CI: 0.96-2.57; P = 0.07) was associated with increased incidence of cardiovascular disorders. CONCLUSIONS: The authors observed decreased incidence of cardiovascular diseases in patients with IBD who were treated with thiopurines and increased incidence of cardiovascular outcomes among patients treated with tumor necrosis factor alpha antagonist

Endoscopy in the Surgically Altered Bowel

Improved utilization of surgical interventions to improve patient outcomes has led to an increased need to endoscopically evaluate and treat the bowel after surgery. The best outcomes are attained when the endoscopist coordinates with the surgeon, and in some cases the pathologist or radiologist to plan the procedure. Understanding the anatomy and pathology anticipated can allow planning for sedation, bowel cleanse and equipment needed. Surgically altered anatomy can create challenges that with planning can be overcome. This article will review how to prepare and navigate several of the most commonly encountered surgical interventions

Successful Treatment of Hereditary Hemorrhagic Telangiectasia with Octreotide

Hereditary hemorrhagic telangiectasia (HHT) is a disorder characterized by telangiectasias and arteriovenous malformations. We present a case report of a 74-year-old man diagnosed with HHT having a favorable response to a somatostatin analogue for treatment. This patient had been suffering from chronic anemia from recurrent gastrointestinal bleeding, requiring oral/intravenous iron replacement, frequent endoscopic ablations, and blood transfusions. Due to insufficient treatment, he was started on subcutaneous octreotide, with significant improvement as evidenced by a steady increase in the hemoglobin level, decreased endoscopic interventions, and decreased blood transfusions, making this the first case of HHT successfully treated with octreotide

Successful Treatment of Hereditary Hemorrhagic Telangiectasia with Octreotide

Hereditary hemorrhagic telangiectasia (HHT) is a disorder characterized by telangiectasias and arteriovenous malformations. We present a case report of a 74-year-old man diagnosed with HHT having a favorable response to a somatostatin analogue for treatment. This patient had been suffering from chronic anemia from recurrent gastrointestinal bleeding, requiring oral/intravenous iron replacement, frequent endoscopic ablations, and blood transfusions. Due to insufficient treatment, he was started on subcutaneous octreotide, with significant improvement as evidenced by a steady increase in the hemoglobin level, decreased endoscopic interventions, and decreased blood transfusions, making this the first case of HHT successfully treated with octreotide

Authorship Trends in 30 Years of the Journal of Arthroplasty.

Background While various studies have investigated trends in characteristics of authors in other medical literature, no study has examined these characteristics in the field of arthroplasty. Methods A database was created of all articles published in The Journal of Arthroplasty in 1986, 1990, 1995, 2000, 2005, 2010, and 2015. Degree(s) of authors, number of authors, number of references, and region of institution were recorded. Results A total of 1343 original articles were assessed over the study period. There was a significant increase in the number of authors per publication from 3.45 in 1986 to 4.98 in 2015 (P \u3c .001) and number of references per article from 17.36 to 29.76 (P \u3c .001). There was a significant increase in proportion of first authors with a bachelor\u27s degree (P = .001), MD/PhD (P \u3c .001), and MD/MBA (P = .016), with a significant decrease in first authors with an MD degree only (P \u3c .001). There was a significant increase in number of last authors with an MD/PhD (P = .001) and MD/MBA (P = .003). There has been a significant growth in papers from outside North America (P = .007), with a decrease in articles from the UK/Ireland (P = .003) and an increase in contributions from the Far East (P \u3c .001). Conclusion Trends of authorship characteristics in the arthroplasty literature largely mirror those seen in other medical literature including increased number of authors per article over time, changes in author qualifications, and increased contributions from international author groups