Septic thrombophlebitis of the superior mesenteric vein and multiple liver abscesses in a patient with Crohn's disease at onset

Aguas, Mariam; Bastida, Guillermo; Nos, Pilar; Beltrán, Belén; Grueso, Jose Luis; Grueso, Julio

doi:10.1186/1471-230x-7-22

Cited by 36 publications

(28 citation statements)

References 10 publications

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“…Rarely, mesenteric septic thrombophlebitis may be observed in the setting of small bowel Crohn disease. When mesenteric venous thrombosis is noted, the liver should be carefully evaluated for abscesses (24). Spectral Doppler US has also been used to assess the mesenteric vasculature in patients with Crohn disease, although some researchers have concluded that spectral Doppler US findings do not reliably correlate with disease activity (11,25).…”

Section: Mesenteric Findings Inflammationmentioning

confidence: 99%

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Dillman¹,

Smith

Sanchez³

et al. 2015

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Small bowel Crohn disease is commonly diagnosed during the pediatric period, and recent investigations show that its incidence is increasing in this age group. Diagnosis and follow-up of this condition are commonly based on a combination of patient history and physical examination, disease activity surveys, laboratory assessment, and endoscopy with biopsy, but imaging also plays a central role. Ultrasonography (US) is an underutilized well-tolerated imaging modality for screening and follow-up of small bowel Crohn disease in children and adolescents. US has numerous advantages over computed tomographic (CT) enterography and magnetic resonance (MR) enterography, including low cost and no required use of oral or intravenous contrast material. US also has the potential to provide images with higher spatial resolution than those obtained at CT enterography and MR enterography, allows faster examination than does MR enterography, does not involve ionizing radiation, and does not require sedation or general anesthesia. US accurately depicts small bowel and mesenteric changes related to pediatric Crohn disease, and US findings show a high correlation with MR imaging findings in this patient population.

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Section: Mesenteric Findings Inflammationmentioning

confidence: 99%

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Dillman¹,

Smith

Sanchez³

et al. 2015

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“…In the shift analysis (analysis of change in the distribution of outcomes across an ordinal scale), a statistical test searches for evidence of a favorable shift toward wellness, e.g. in the distribution of the mRS scores across the range of disabilities in the treated group versus the placebo control group [4]. It has been argued that a shift analysis takes into account the full range of treatment effects across the range of disabilities on an outcome scale while a dichotomized approach privileges a single health transition state as a clinically meaningful treatment effect and discards other potentially salient outcomes [5].…”

Section: Introductionmentioning

confidence: 99%

Outcome Analysis in Clinical Trial Design for Acute Stroke: Physicians’ Attitudes and Choices

Savitz¹,

Benatar

Saver

et al. 2008

Cerebrovasc Dis

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Background: Thrombolysis remains the only proven therapy to benefit acute ischemic stroke (AIS) patients. Recent studies have introduced more sensitive outcome measures such as the shift analysis to detect a treatment effect in AIS trials and are also including imaging as a surrogate of injury. Methods: We conducted a cross-sectional, internet-based survey of academic neurologists regarding their attitudes, choices and understanding of various outcome measures in clinical trial design for AIS. The survey population consisted of neurologists who specialize in the care of stroke patients and are on faculty at university-affiliated hospitals in the USA. Results: 152 of 300 neurologists completed the survey. There were 79% men and 21% women. Among commonly used outcome scales in acute stroke, the most frequent ones selected for use as trial primary endpoints were the global statistic (59%), modified Rankin scale (mRS) (52%), and NIHSS (30%). When given choices about which outcome on the mRS would justify a therapeutic intervention, 54% chose a shift analysis of change in the distribution of outcomes and 39% chose a dichotomized outcome (mRS ≤2). A majority of respondents favored health transition states of 4–3, 3–2 and 2–1 on the mRS as clinically worthwhile. Only 2% of the respondents thought that a single transition point on the mRS was clinically meaningful. However, 20% of the respondents did not understand the shift analysis. In addition, nearly two thirds of the respondents believed that the presence of a mismatch on brain imaging is relevant to the success of neuroprotective agents. Conclusion: The majority of respondents accepted an analysis of the entire distribution of the mRS scores as an appropriate endpoint analytic technique in AIS trials and did not require the traditional dichotomized outcome to demonstrate a treatment effect; however, a better understanding of the shift strategy is needed. Our data also support the importance of incorporating mismatch imaging into future neuroprotection trials.

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“…[62] While these microbiota frequently do not cause sepsis, sepsis is significantly commoner in IBD, both in immunosuppressed patients and in patients who are newly diagnosed and not on immunosuppressive therapy. [63][64] An increased incidence of bacterial endocarditis in both UC and CD has also been reported. [65] Rifaximin appears to be a promising antibiotic in inducing remission of CD (69% in open studies and significantly better than placebo in double blind trials) and UC (76% in open studies and significantly better than placebo in controlled studies).…”

Section: Inflammatory Bowel Disease and Sepsismentioning

confidence: 99%