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您的检索式：作者名="Annabel Clancy"
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| 1 | Crohn’s strictures open with anti-mycobacterial antibiotic therapy:A retrospective review显示文摘BACKGROUND Medical therapy for strictures is limited and first-line treatment consists of endoscopic balloon dilatation,strictureplasty or surgical resection.Mycobacterium tuberculosis,Helicobacter pylori and Streptococcus can all cause stenosis,for which antibiotic treatment achieves stricture resolution.Mycobacterium avium ssp.paratuberculosis is a suspected causative agent in Crohn’s disease(CD).Thus,specialized antimicrobial treatment,in particular,anti-mycobacterial antibiotic therapy(AMAT)has been proposed as a potential treatment option.To our knowledge,the opening of CD strictures has not been recorded using any form of antibiotic therapy.We hypothesized that AMAT would resolve strictures in patients with CD.AIM To investigate the effect and outcomes of AMAT in a cohort of CD patients with an ileal stricture.METHODS A single center,retrospective,medical record case review was conducted on an observational cohort of patients with CD who had an ileal stricture on colonoscopy and were treated with AMAT.Forty patients meeting the inclusion criteria were identified from the internal medical database.Thirty(75%)patients had follow-up colonoscopy and clinical data available.The AMAT regimen was prescribed after the initial colonoscopy for a duration of at least six months until follow-up colonoscopy with the attending gastroenterologist.Patient demographics,symptoms,colonoscopy reports,inflammatory serum markers and concurrent medications were recorded at pre-treatment and follow-up between January 1995 and June 2018.RESULTS Of the patients that returned for follow-up after>24 mo of AMAT,twenty(67%)had complete resolution(CR)of their ileal strictures,three(10%)had partial resolution and seven(23%)had no resolution.Irrespective of stricture outcome,21 patients(70%)demonstrated clinical response to AMAT and there was a statistically significant reduction in inflammatory serum markers C-reactive protein(P<0.0001)and erythrocyte sedimentation rate(P=0.04)from pretreatment to follow-up.It was observed that 11(37%)patients experienced side effects,but no serious adverse effects were attributable to AMAT.At follow-up there were 26(87%)patients on concomitant medication for CD and a statistically significant association between CR and AMAT with a concomitant immunomodulator(P=0.02).CONCLUSION This study demonstrated a high rate of stricture resolution(67%)similar to that seen in tuberculosis strictures(70%),suggesting a shared mycobacterial origin of strictures,and perhaps disease. | Rhys Collyer Annabel Clancy Gaurav Agrawal Thomas J Borody | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，12： | 0 |
| 2 | Two-day enema antibiotic therapy for parasite eradication and resolution of symptoms显示文摘BACKGROUND Blastocystis hominis(B.hominis)and Dientamoeba fragilis(D.fragilis)are two protozoan parasites of human bowel that are found throughout the world.There is still debate about the pathogenicity of these protozoans,despite them being commonly associated with gastrointestinal symptoms and can cause health issue in both children and adults.These parasites are usually transmitted through faecal-oral contact particularly under poor hygiene conditions or food/water contamination.Once a person is infected,the parasites live in the large intestine and are passed in the faeces.AIM To investigate the effect of triple antibiotic therapy using enema infusion in the treatment of B.hominis and D.fragilis infections.METHODS This retrospective longitudinal study was conducted in a single medical centre,which included fifty-four patients(≥18 years)who were positive for D.fragilis,B.hominis or both between 2017 and 2018.The treatment consisted of triple antibiotics that were infused over two consecutive days through rectal enema.Faecal samples were collected from participants pre-and post-treatment and were tested for parasites using microscopy and polymerase chain reaction.Patients’symptoms were recorded prior and after the treatment as well as patient demographic data.RESULTS Patients(n=54),were either positive for B.hominis(37%),D.fragilis(35%)or both(28%).All patients completed the two-day treatment and no serious adverse effect was reported.The most common side effect experienced by the patients during the treatment was urine discolouration which was cleared by six weeks of followup.Common symptoms reported prior to treatment were diarrhoea,abdominal pain,constipation and fatigue.Other symptoms included abdominal discomfort,dizziness and blood in the stool.Eighty-nine percent of patients completed a final stool test post-treatment.At six weeks post-treatment,79%of patients cleared the parasites from their faeces.Symptoms such as abdominal discomfort,dizziness and blood in the stool decreased significantly at both seven days and six weeks post-treatment(P<0.040).The enema retention time,bowel preparation,previous antibiotic treatment or previous gastrointestinal problems had no significant effect on parasite eradication.CONCLUSION Overall,eradication of parasites and improvement of clinical outcomes were observed in treated patients,showing the efficacy of this combination to eradicate the parasites and provide positive clinical outcome. | Niloufar Roshan Annabel Clancy Anoja W Gunaratne Antoinette LeBusque Denise Pilarinos Thomas J Borody | 2020 | World Journal of Gastroenterology2020，26，26： | 0 |
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