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Update in medical therapy in inflammatory bowel disease: a clinician's view
Katz S
Recent advances in the therapy of inflammatory bowel disease specifically directed against the inflammatory and immune mechanisms include an impressive and often overwhelming cornucopia of anti-inflammatory agents, immunomodulators, antibiotics, biologicals, topical therapies, nicotine, heparin, and nutritional supplements. The interface of one drug regimen into another may lead to confounding and often confusing programs of treatment. This review will attempt to offer a perspective of care and an update of specific remedies, but the aim is practicality and usefulness, not encyclopedic detail
PMID: 10697665
ISSN: 0257-2753
CID: 11815
Anticipation in Crohn's disease may be influenced by gender and ethnicity of the transmitting parent [see comments] [Comment]
Heresbach D; Gulwani-Akolkar B; Lesser M; Akolkar PN; Lin XY; Heresbach-Le Berre N; Bretagne JF; Katz S; Silver J
OBJECTIVE: We sought to examine whether anticipation (an earlier age of onset in succeeding generations) is observed in Crohn's disease (CD) patients within the New York metropolitan area, and whether there are differences in the degree of anticipation with respect to gender and ethnicity of the affected parent. METHODS: Sixty-one parent-child pairs both affected by CD were identified; about half of the pairs were of Ashkenazi Jewish descent. An additional 17 pairs of second-degree relatives with CD were also identified. The intergenerational difference in age at diagnosis (AAD) was used to perform regression analysis and the degree of anticipation among subsets of patients separated on the basis of gender and ethnicity of the transmitting parent was determined. RESULTS: The AAD was consistently (90% of the time) lower in the younger member of the 61 parent-child pairs (35.3+/-1.6 yr vs 20.8+/-1.1 yr, p = 0.0001). Furthermore, the degree of anticipation was significantly greater for father-child pairs (20.6+/-3.2 yr) than for mother-child pairs (11.7+/-2.1 yr). However, when the patient population where the parent had an AAD of < 28 was analyzed separately, there was a lack of clear-cut evidence of anticipation in the population as a whole. Only when the population was subdivided by ethnicity was there convincing evidence of anticipation in the Jewish population. CONCLUSION: Ascertainment bias may be responsible for the apparent anticipation observed in the CD population as a whole or in the nonJewish CD subgroup. However, the Jewish CD population displays strong evidence of anticipation even after correction for ascertainment bias
PMID: 9860394
ISSN: 0002-9270
CID: 7344
Jejunal diverticulitis with localized perforation and intramesenteric abscess [Case Report]
Gotian A; Katz S
We report a rare case of a 69-yr-old white man with jejunal diverticulitis with localized perforation and intramesenteric abscess formation. This entity is often overlooked as a cause of acute abdominal pain in the elderly. Although the clinical diagnosis is difficult, a high index of suspicion should warrant a computed tomography scan or enteroclysis
PMID: 9672358
ISSN: 0002-9270
CID: 12091
Pseudogastroparesis as a presentation of adenocarcinoma of the proximal jejunum [Case Report]
Osias GL; Tepper RE; Zanzi I; Katz S
Establishing the presence of adenocarcinoma of the small bowel is exceedingly difficult. Survival is contingent on prompt diagnosis. We describe a patient with an atypical presentation of jejunal adenocarcinoma visualized via small bowel enteroclysis. She was referred with 'gastroparesis,' based on both a radionucleotide scan that revealed markedly delayed gastric emptying and a 'normal' small bowel series. A markedly abnormal scintigraphic study and a negative small bowel series does not exclude disease of the small intestine and should provide the impetus to further pursue the possibility of an obstructing lesion. The enteroclysis is a relatively safe and effective study in the preoperative diagnosis of small bowel tumors
PMID: 9647036
ISSN: 0002-9270
CID: 12102
Ulcerative colitis, hyperamylasemia, and asymptomatic pancreatic calcifications: making the case for pancreatitis as an extra luminal manifestation [Case Report]
Ahmad M; Bauer W; Katz S
PMID: 9399780
ISSN: 0002-9270
CID: 12206
Differences in risk of Crohn's disease in offspring of mothers and fathers with inflammatory bowel disease
Akolkar, P N; Gulwani-Akolkar, B; Heresbach, D; Lin, X Y; Fisher, S; Katz, S; Silver, J
OBJECTIVE: To determine whether there are any unusual patterns of transmission of susceptibility to inflammatory bowel disease (IBD) within multiplex families. METHODS: Individuals with IBD were recruited for genome-wide screening of susceptibility genes. The extent of familial aggregation and blood relationships in multiplex families were determined by questionnaires given to participants followed up by confirmation of disease diagnosis by participants' physicians. RESULTS: Of 135 families identified in which both a parent and a child had IBD, 93 involved transmission of susceptibility to disease from mother to child versus 42 examples of transmission from father to child (p = 0.00001, exact two-tailed binomial test). This distortion in transmission on the basis of the sex of the parent was observed only among non-Jewish pairs with Crohn's disease (CD), in which, of 33 parent-child pairs with CD, disease susceptibility was transmitted from the mother 28 times (p = 0.00007). CONCLUSION: Susceptibility to CD in a subset of patients may involve a gene that is imprinted
PMID: 9399762
ISSN: 0002-9270
CID: 140502
Inflammatory bowel disease: A managed care perspective [Meeting Abstract]
Katz, S; Miner, PB; Hanauer, SB; Singleton, JW; Sugerman, HJ; Jacobs, R; Platt; Moore; Edwards; Greenberg; Burns
ISI:000074774100001
ISSN: 1088-0224
CID: 53410
Preferential transmission of Crohn's disease from the mother to child. [Meeting Abstract]
Akolkar, P; GulwaniAkolkar, B; Lin, XY; Katz, S; Silver, J
ISI:A1997WV41903666
ISSN: 0016-5085
CID: 1446342
Inflammatory bowel disease : keys to diagnosis & treatment : a physician reference guide
Katz, Seymour; Sachar, David B; Achkar, Edgar; Kornbluth, Asher; Hanauer, Stephen B
Arlington, VA : American College of Gastroenterology, 1997
Extent: 1 volume (unpaged) ; 28 cm
ISBN: n/a
CID: 1446432
Increased oxidative stress and decreased antioxidant defenses in mucosa of inflammatory bowel disease
Lih-Brody L; Powell SR; Collier KP; Reddy GM; Cerchia R; Kahn E; Weissman GS; Katz S; Floyd RA; McKinley MJ; Fisher SE; Mullin GE
Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation whose cellular components are capable of oxidative respiratory bursts that may result in tissue injury. Mucosal biopsies were analyzed for protein carbonyl content (POPs), DNA oxidation products [8-hydroxy-2'-deoxyguanosine (8-OHdG)], reactive oxygen intermediates (ROIs), trace metals (copper, zinc, and iron) and superoxide dismutase (Cu-Zn SOD). In Crohn's disease biopsies, there was an increase in ROIs, POPs, 8-OHdG, and iron, while decreased copper and Cu-Zn SOD activity were found in inflamed tissues compared to controls. For ulcerative colitis, there was an increase in ROIs, POPs, and iron in inflamed tissue compared to controls, while decreased zinc and copper were observed. An imbalance in the formation of reactive oxygen species and antioxidant micronutrients may be important in the pathogenesis and/or perpetuation of the tissue injury in IBD and may provide a rationale for therapeutic modulation with antioxidants
PMID: 8888724
ISSN: 0163-2116
CID: 12530