scholarly journals Progression of CIN1/LSIL HPV Persistent of the Cervix: Actual Progression or CIN3 Coexistence

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Maria Teresa Bruno ◽  
Nazario Cassaro ◽  
Francesca Bica ◽  
Sara Boemi
Keyword(s):  
Spontaneous Regression ◽  
De Novo ◽  
High Grade ◽  
Viral Genotype ◽  
Hpv Test ◽  
History Of ◽  
Initial Biopsy ◽  
Elevated Rate ◽  
Histological Confirmation

Objective. The natural history of the CIN1 lesions is characterized by an elevated rate of spontaneous regression (80%), some authors recognize a capacity to progress to HSIL in 10% of cases, and other authors do not recognize the capacity of progression of LSIL (CIN1). This study was aimed to evaluate the incidence of progression to HSIL (CIN3) in women with a histological diagnosis of LSIL (CIN1). Furthermore, to this end, we studied the histological outcomes of cone specimens collected by the LEEP. Methods. All the data were retrospectively analyzed. All participants underwent a follow-up of 4 years, during which each woman underwent an HPV test and genotyping, cervical cytological sampling, or biopsy every six months. The endpoint was the histological confirmation of CIN3 lesions in any moment during follow-up. Results. Progression to CIN3 occurred in 7 cases (1,5%). Analyzing the histological exams of the cones of the 7 cases that progressed to CIN3, we found the coexistence of CIN1 and CIN3 lesions in all cases. Conclusion. After 4 years of follow-up, only 1.5% (7/475) of the women with LSIL developed CIN3, all within the first two years of follow-up, and were immediately treated. The most likely explanations for “progression” from LSIL to HSIL are (1) actual progression, (2) underdiagnosis of HSIL on initial biopsy, (3) overdiagnosis of HSIL on follow-up biopsy/cone, and (4) CIN3 arose de novo. Analyzing the histological exams of the cones of the 7 cases that progressed to high-grade, we found the coexistence of CIN1 and CIN3 lesions in all cases. Some recent studies have shown that a viral genotype corresponds to different lesions in the same cervix; therefore, CIN1 coexisting with CIN3 does not always indicate progression of CIN1. Other authors have doubted the capacity of LSIL to progress.

Long-Term Follow-Up of Reduced Intensity Transplantation with an Alemtuzumab-Containing Regimen for Aggressive Non-Hodgkins Lymphoma.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1661-1661
Author(s):  
Kirsty Thomson ◽  
Emma Morris ◽  
Adrian Bloor ◽  
Gordon Cook ◽  
Donald Milligan ◽  
...  
Keyword(s):  
De Novo ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Grade ◽  
Autologous Transplant ◽  
Donor Type ◽  
Unrelated Donors ◽  
Reduced Intensity

Abstract The outlook for patients with relapsed or refractory high-grade NHL failing autologous transplant is poor. Allogeneic transplant with myeloablative conditioning carries a high non-relapse mortality (NRM) in this setting, and reduced intensity conditioning is being investigated. We report 54 consecutive patients with a diagnosis of diffuse large B cell lymphoma (n=48;89%: presenting de novo [n=31] or following transformation from follicular lymphoma [FL, n=17]) or anaplastic large cell lymphoma (n=6;11%) who underwent reduced intensity allogeneic transplantation (RIC) at 8 centres. Conditioning was with fludarabine 150mg/m2, melphalan 140mg/m2 and alemtuzumab (20–100mg), and cyclosporin A was given at 3mg/kg. Donors were HLA-matched siblings in 34 (63%), and unrelated in 20 (37%), of whom 11 were HLA-mismatched at up to 3/10 loci. Median age was 44 yrs (18–64), median lines of prior therapy was 4 (1–7), 37 (69%) patients had previously undergone autologous transplantation, and 11 (20%) had chemorefractory disease at the time of RIC. Median follow-up from RIC was 49 months (8–87). NRM was 30% at 1 yr and 34% at 5 yrs, with 18/19 events occurring within the 1st 16 months. There was no significant association between NRM and donor type or prior autograft. Estimated relapse rate was 32% at 5 years for all patients: 25% in de novo high-grade NHL and 46% in those with transformed FL. Fifteen of the 16 relapses occurred within the 1st yr post-transplant, at a median of 3 months (1–42). Twelve patients received donor lymphocyte infusions (DLI) at a starting dose of 1–10 × 106 CD3+ cells/kg. Of the 12, 5 had primary DLBCL- 4 died within 5 months of DLI having had no response, and 1 had additional anti-tumor therapy pre-DLI and remitted. Of the 7 with transformed FL, 4 remitted, 2 with therapy prior to DLI and 1 with GVHD. Overall survival (OS) for the whole cohort was 45% at 5 yrs, with current progression-free survival (cPFS) of 46% at 5 yrs. There was no significant difference in OS or cPFS when analysed by donor type (5 yr OS 46% for sibling donors, 44% for unrelated donors;p=0.612), presence of prior autologous transplant (5 yr OS 43% for those having failed autograft, 51% for those who had not undergone autograft;p=0.614), or presence of de novo high-grade NHL (OS 39% at 5 yrs for those with de novo high-grade NHL, 58% for those with transformed FL;p=0.208). Both OS (p=0.003) and cPFS (p=0.002) were significantly impacted by the presence of chemorefractory disease pre-RIC, with both OS and cPFS 55% at 5 yrs for chemosensitive disease, and 9% at 5 yrs for chemorefractory. In conclusion, given the median follow-up of over 4 yrs and the aggressive nature of the disease in these patients, with extensive pre-treatment including a failed autologous transplant in the majority, these are encouraging results raising the prospect of long-term survival in a significant cohort. We propose that all patients with DLBCL relapsing following an autograft whose disease is sensitive to salvage chemotherapy should be strongly considered for RIT, using related or unrelated donors.

scholarly journals Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil

2018 ◽  
Vol 40 (03) ◽  
pp. 121-126 ◽  
Author(s):  
Geilson Oliveira ◽  
Judite Oliveira ◽  
Renata Eleutério ◽  
José Eleutério Júnior
Keyword(s):  
Northeastern Brazil ◽  
National Guideline ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
National Guidelines ◽  
Squamous Cells ◽  
Negative Results ◽  
Hpv Test ◽  
Intraepithelial Lesion

Objective To assess the management chosen by gynecologists after atypical squamous cells (ASCs) cytology results, and to evaluate the outcomes of these cases in Brazilian women. Methods A prospective observational study evaluated the initial management offered by the gynecologist in the case of 2,458 ASCs cytology results collected between January of 2010 and July of 2016. The outcomes of the cytology, high-risk human papilloma virus (HR-HPV) test and histology were compared in two subgroups: atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H). Results In many cases of ASC-US (36.97%) and ASC-H (40.50%), no clinical actions were taken. Cytology was the most frequent follow-up chosen, including for cases of ASC-H, which goes against the conduct recommended in the national guideline. In women over 30 years of age, the period of time elapsed between an ASC-US result and a new cytology was in 13.03 months, in disagreement with the national guideline recommendations (p < 0.0001). Negative for intraepithelial lesions or malignancy (NILM) cytologic (p = 0.0026) and histologic (p = 0.0017) results in the follow-up were associated with prior ASC-US, while negative results for ASC-H were cytologically (p < 0.0001) and histologically associated with high-grade squamous intraepithelial lesion (HSIL) (p < 0.0001). Two invasive cervical carcinomas (ICCs) were found in the follow-up for ASC-H, and there was a statistically significant association (p = 0.0341). A positive HR-HPV test was associated with ASC-H (p = 0.0075). Conclusion The data suggest that even for a population of Brazilian women assisted at private clinics, the national guidelines recommendations for ASCs results are not followed.

scholarly journals 772 Incidence of stroke in patients with hypertrophic cardiomyopathy implanted with a cardiac implantable electronic device

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Carlo Fumagalli ◽  
Chiara Zocchi ◽  
Francesca Bonanni ◽  
Luigi Tassetti ◽  
Matteo Beltrami ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Sinus Rhythm ◽  
Left Atrial ◽  
De Novo ◽  
Multivariable Analysis ◽  
Unmet Need ◽  
Prior History ◽  
Advanced Stage ◽  
History Of

Abstract Aims Incidence of stroke in patients with an advanced stage hypertrophic cardiomyopathy (HCM) is associated with adverse outcome, impaired quality of life and loss of productivity. Still today, however, the real burden of stroke in both patients with and without atrial fibrillation (AF) is unresolved. To assess the prevalence and incidence of AF and stroke in patients with an advanced stage HCM implanted with cardiac implantable electronic devices (CIEDs) at our institution, a long-standing high flow referral centre for cardiomyopathies. Methods and results Clinical and instrumental data of HCM patients implanted with CIEDs [either pacemakers (PM) or implantable cardioverter defibrillator (ICD)] from 1998 to 2019 were retrospectively reviewed. Inclusion criteria were site-designated diagnosis of HCM, age at diagnosis &gt;18 years, Follow-up &gt;1 year. HCM phenocopies (e.g. Fabry disease) were carefully excluded. Patients were divided into three categories according to presence of AF (‘AF prior to CIED implantation’ vs. ‘AF after CIED implantation’ vs. ‘sinus rhythm’). Outcome was measured against incidence of thromboembolic events [stroke or transient ischaemic attack (TIA)] at Follow-up. Patients were also stratified by left atrial diameter (LAD) in two groups (&lt;47 vs.  &gt; 48mm). Of 1861 patients followed at our Unit, a total of 185 (9.9%) patients implanted with a CIED were included (57% men, mean age at implantation 54 ± 17 years). At baseline, AF was present in 72 (36%) patients. Mean CHA2DS2VASc was 1.7 + 1.3 with no differences among patients with or without AF. Patients with AF at baseline had a more pronounced LAD dilation (51 ± 7 vs. 44 ± 8, P &lt; 0.001) and a lower ejection fraction (55 ± 11 vs. 64 ± 12, P &lt; 0.001). After 5.0 ± 3.8 years from CIED implantation, de novo AF was detected in 24 (21%) individuals, resulting in an annual incidence rate of 4.1%/year. Overall, 89 (48%) of patients remained is sinus rhythm. Stroke/TIAs were reported in 19 (10.3%) patients: seven (37%, 1.1%/year) occurred in patients with prior history of AF, three (16%, 2.2%/year) in patients with de novo AF, and nine (63%, 2.3%/year) in patients with no history of arrhythmias documented at CIED interrogation. Among patients in sinus rhythm, those with a LAD &gt; 48 mm had the greatest risk of stroke (4.8%/year vs. 0.5%/year, P &lt; 0.01, for LAD &gt; 48 vs. LAD &lt; 47, respectively). At multivariable analysis, after adjustment for CHA2DS2VASc, AF, and obstructive physiology, only LAD was associated with a higher risk for stroke (HR: 1.09, 95% CI: 1.03–1.11, P &lt; 0.001). Conclusions In a large cohort of consecutive high risk HCM patients referred to CIED implantation, the incidence of stroke was high, with 1-in-10 patients experiencing at least one event. Among patients in sinus rhythm, those with a marked left atrial dilatation were at highest risk of ischaemic stroke, suggesting the existence of an unmet need to stratify risk of stroke even in patients with no detected arrhythmias.

scholarly journals Spontaneous regression of extradural intraspinal cysts in a dog: a case report

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Marília de Albuquerque Bonelli ◽  
Ronaldo Casimiro da Costa
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Spontaneous Regression ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Lumbosacral Region ◽  
History Of ◽  
The One ◽  
Intraspinal Cyst

Abstract Background Extradural intraspinal cysts are fluid accumulations that appear to be associated with increased motion at vertebral joints. Case presentation We report the spontaneous regression of lumbar and lumbosacral cysts (presumably synovial cysts) and the unusual occurrence of an S1–2 extradural intraspinal cyst in a dog. The dog presented with lumbosacral pain. Six extradural intraspinal cysts were observed on high-field magnetic resonance imaging from L5–6 to S1-S2. The cysts between L5–6 and L7-S1 ranged from 0.12 to 0.44cm2 at their largest area. The largest cyst was located at S1–2 (left), measuring 0.84 cm2 at its largest view. The dog was medically managed. A follow-up magnetic resonance imaging scan was obtained 3.5 years after the first imaging. All cysts except the one at S1–2 had reduced in size. Mean reduction in size was 59.6% (35–81%). Conclusions In summary, we report a case with multiple extradural intraspinal cysts that underwent spontaneous regression of all but one cyst during a 3.5-year follow-up period. Whether this is a single occurrence, or is part of the natural history of these cysts in the lumbosacral region of dogs, remains to be established. Spontaneous regression of intraspinal cysts had not been described in dogs.

Utility of quantitative fluorescent in situ hybridization (FISH) to predict non-muscle-invasive bladder cancer (NMIBC) recurrence.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 286-286
Author(s):  
H. M. Rosevear ◽  
A. J. Lightfoot ◽  
M. A. O'Donnell
Keyword(s):  
High Risk ◽  
First Year ◽  
Fish Analysis ◽  
High Grade ◽  
Intermediate Risk ◽  
Binary Variable ◽  
Risk Patients ◽  
History Of ◽  
Abnormal Cells

286 Background: Urovysion's (Abbot Laboratories, Downers Grove, IL) FISH analysis is used to monitor bladder cancer recurrence in patients with a history of NMIBC and is often reported as a binary variable (normal/abnormal). We investigated whether the percentage of abnormal cells as determined by FISH analysis in patients with a history of NMIBC correlated with risk of recurrence. Methods: At our institution, barbotage FISH analysis is routinely done along with cystoscopy and cytology on both high risk (Ta/T1 high grade or CIS) and low or intermediate risk patients (all others) at every 3-month follow-up for the first year post-resection. We retrospectively reviewed 241 consecutive NMIBC patients and identified 399 FISH analyses for which we had one year follow-up. Normal FISH analyses were defined as 2 or fewer abnormal cells per sample. We calculated the percentage of abnormal cells and correlated that to the number of patients who had a recurrence of NMIBC as defined by positive high grade cytology or tumor on cystoscopy during the first year of follow-up. Results: The sensitivity, specificity, and positive and negative predictive values of FISH analysis if reported as a binary variable was 55, 43, 16 and 89%, respectively. Considering only those patients with abnormal FISH, the average percentage of abnormal cells for patients who were found to have NMIBC recurrence at 1 year was 38% (range 6–100) compared to 21% (range 6–100) for patients who were recurrence-free at 1 year (p<0.0001). High risk patients who recurred within 1 year had a statistically higher percentage of abnormal cells as compared to those who did not recur within 1 year (50% [range 6–100] vs. 25% [range 6– 100], respectively p=0.001). There was no difference in the percentage of abnormal cells for those patients with low or intermediate risk disease based on recurrence within 1 year (22% [range 6–100] vs. 20% [range 6–100], respectively p=0.25). Conclusions: The percentage of abnormal cells in FISH analysis correlates with risk of recurrence for patients with high risk disease and can be used to guide surveillance interval decisions in patients with no other evidence of recurrence. [Table: see text]

Safety and Efficacy of High-Dose Cyclophosphamide, Etoposide, and Ranimustine (CEM) Regimen Followed by Autologous Peripheral Blood Stem Cell Transplantation for Patients with High Risk De Novo Diffuse Large B-Cell Lymphoma or Diffuse Large B-Cell Lymphoma Associated with Follicular Lymphoma.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3121-3121
Author(s):  
Yujin Kobayashi ◽  
Yoshihiro Hatta ◽  
Atsuko Hojo ◽  
Masaru Nakagawa ◽  
Machiko Kusuda ◽  
...  
Keyword(s):  
High Risk ◽  
De Novo ◽  
Late Onset ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
History Of ◽  
Autologous Pbsct

Abstract Abstract 3121 Background We evaluated the safety and efficacy of the CEM regimen containing ranimustine (MCNU) with autologous peripheral blood stem cell transplantation (PBSCT) in adult patients with relapsed or high-risk de novo DLBCL or DLBCL associated with follicular lymphoma (FL/DLBCL) in our institution. Patients and methods We retrospectively analyzed 55 consecutive patients who underwent autologous PBSCT following the CEM regimen between March 1999 and June 2011 for the treatment of relapsed or high-risk DLBCL and FL/DLBCL. High-risk DLBCL was defined as partial or no response to initial treatment or high-intermediate/high risk disease according to international prognostic index (IPI) at initial diagnosis. Age-adjusted IPI was used for patients under 60. The CEM regimen consisted of CY (60 mg/kg on days -7 and -6), etoposide (500 mg/m2 on days -6 to -4) and MCNU (250 mg/m2on day -3 and -2), followed by PBSCT. Results Median age at transplant was 51 years (range, 23–66), and median time from diagnosis to transplant was 5 months (range, 3–241). Of them, 7 patients received radiation therapy before transplant, and 11 had no history of rituximab use before transplant. The 36 patients in CR1 at transplant were with high or high-intermediate risk according to international prognostic index at diagnosis. Other 15 patients in CR2, and 4 patients who were not in CR1/2 at transplant were included. CY dose was reduced in five patients by physicians choice. The median number of infused CD34-positive cells was 3.98 × 106/kg (range, 1.36–26.87). The median post-transplant days of neutrophil recovery and platelet were 11 days (range, 9–20) and 12 days (range, 7–53), respectively. Common grade 3/4 non-hematological treatment-related toxicities within the first 100 days after transplant were nausea (24%), vomit (4%), stomatitis (15%), and diarrhea (9%). Infections included febrile neutropenia (85%), sepsis (15%) which contained catheter-related bacteremia (n=4) and pneumonia (n=2). Other less common severe toxicities were acute renal impairment (n=3), and pleural effusion (n=1). No sever cardiac, neurologic toxicity, or veno-occlusive disease of the liver was observed in any of the patients. Late-onset adverse effects during follow-up period includes chronic renal impairment (n= 5), therapy-related myelodysplastic syndrome (refractory anemia) (n=1, 120 months), and prostate cancer (n=1, 83 months). Serious late cardiac or pulmonary impairment was not diagnosed in this cohort. Median follow-up duration of 42 patients surviving at the time of the analysis was 52 months (range, 1–159). Relapse or disease progression after PBSCT was documented in 21 cases (range, 0–81 months after PBSCT). No therapy related mortality (TRM) associated with PBSCT was observed, and all the 13 deaths were due to disease relapse/progression. The 5-year estimated overall survival (OS) and progression-free survival (PFS) were 70.6% (95% CI, 54.0–82.1)% and 57.0% (95% CI, 39.5–71.2)% for all patients, respectively. In a univariate analysis for factors affecting OS and PFS, no significant factors associated with unfavorable OS and PFS was found including age at transplant, gender, history of rituximab use, histology, disease status at transplant, and previous BM involvement. Conclusion We conclude that the CEM regimen using MCNU would be a tolerable, effective conditioning regimen of autologous PBSCT for high-risk or relapsed de novo DLBCL or FL/DLBCL. Although no TRM was observed, relapse was the major cause of treatment failure. Late-onset complications in long-term survivors can occur, and should be carefully monitored. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Free Floating Thrombus in Carotid Artery in a Patient with Recurrent Strokes

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Moni Roy ◽  
Ashish Kumar Roy ◽  
Jeffrey R. DeSanto ◽  
Murad Abdelsalam
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
High Grade ◽  
Past Medical History ◽  
Floating Thrombus ◽  
History Of ◽  
Recurrent Strokes ◽  
Ica Stenosis

We present a case of 72-year-old male with reported past medical history of recurrent transient ischemic attacks (TIAs) presenting with myriad of neurological symptoms. Patient was transferred from outlying hospital with complaints of right sided facial droop and dysarthria. Computed tomography angiography (CTA) showed high grade proximal left internal carotid artery (ICA) stenosis along with interesting finding of a free floating thrombus (FFT) in the left ICA. After discussion with the neurosurgical team, our case was treated conservatively with combination of antiplatelet therapy with Aspirin and anticoagulation with Warfarin without recurrence of TIAs or strokes on six-month follow-up.

Increased mortality among smokers with myelodysplastic syndrome (MDS).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19036-e19036
Author(s):  
Phaedon D. Zavras ◽  
Prateek Pophali ◽  
Aditi Shastri ◽  
Lizamarie Bachier-Rodriguez ◽  
Alejandro R. Sica ◽  
...  
Keyword(s):  
De Novo ◽  
Medical Center ◽  
Multivariable Analysis ◽  
Smoking History ◽  
Tp53 Mutations ◽  
Increased Risk ◽  
History Of ◽  
The Difference ◽  
Myelomonocytic Leukemia

e19036 Background: Recent studies have shown smoking to be an independent risk factor for MDS. We aimed to assess whether smoking is associated with worse outcomes among patients (pts) with MDS at Montefiore Medical Center, Bronx, NY. Methods: Pts with MDS and chronic myelomonocytic leukemia (CMML) diagnosed between June 16, 2000 and November 13, 2020 were analyzed. Those without available tissue diagnosis or smoking history data were excluded. Descriptive statistics compared ever-smokers to non-smokers. Cox PH regression was used to analyze the risk of transformation to acute myeloid leukemia (AML) and mortality in the 2 groups and multivariable analysis (MVA) adjusted for age, sex, de novo disease and R-IPSS. Results: A total of 147 pts were identified, 109 (74.1%) had a diagnosis of de novo MDS, 89 (60.5%) had history of active or former smoking and 58 (39.5%) were non-smokers. Smokers were predominantly males (66.3%) in contrast to non-smokers (37.9%) (p=0.001). Smokers were diagnosed more frequently with high or very high risk MDS, although the difference was not statistically significant (38.1% vs 28.6%, respectively; p=0.28). TP53 mutations were numerically more frequent among smokers (24.4%), compared to non-smokers (12.8%) (p=0.16). Median follow-up time for smokers and non-smokers was 19.4 and 31.4 months, respectively. In MVA, there was a trend for increased risk of AML transformation in smokers vs non-smokers (HR 2.03, 95% CI 0.99 – 4.15; p=0.052). Smokers with MDS were found to have significantly greater mortality compared to non-smokers (HR 2.08, 95% CI, 1.22 – 3.54; p=0.007). Conclusions: Smoking was associated with worse survival among MDS pts in our cohort. Although not significantly different, the prevalence of TP53 mutations was higher among smokers. Larger studies are warranted to confirm our findings.[Table: see text]

Family History of Crohn’s Disease (CD) May Be a Risk Factor for Developing de novo CD following Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative Colitis (UC)

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
H Li ◽  
M Arslan ◽  
Z Fu ◽  
H Lee ◽  
M Mikula
Keyword(s):  
Family History ◽  
De Novo ◽  
Smoking Status ◽  
Smoking History ◽  
Current Smoking Status ◽  
Current Smoking ◽  
History Of ◽  
Former Smokers ◽  
Never Smokers

Abstract Introduction/Objective A subset of patients with an established diagnosis of UC develops signs of CD (de novo CD) following IPAA. While the etiology and risk factors of de novo CD remain largely unknown, preliminary studies have shown controversial results regarding family history of inflammatory bowel disease (IBD) and smoking history. Methods Patients that underwent IPAA for UC, with at least 1 year of follow-up, were identified (n=161; 1996 to 2018). We retrospectively reviewed the electronic medical records. Patients that were diagnosed with de novo CD during the follow-up period were further identified. Smoking history and family history of IBD were evaluated. Chi square test was performed to compare the frequencies. Odds ratio (OR) and 95% confidence intervals (CIs) were estimated by logistic regression model. P&lt;0.05 was considered statistically significant. Results 29 de novo CD were identified. At the time of proctocolectomy, the family history of IBD and smoking history was documented in 152 UC patients including 27 that subsequently developed de novo CD. 23 of 152 had a family history of IBD (12 UC, 9 CD and 2 IBD, NOS). 19/129 (14.7%) UC patients without a family history of any type of IBD, 4/9 (44.4%) with a family history of CD, and 4/12 (33.3%) with a family history of UC developed de novo CD. Patients with a family history of CD were more likely to develop de novo CD post IPAA than those without a family history of any type of IBD (OR 4.63, 95% CI 1.14-18.82, p=0.03). Family history of UC did not correlate with development of de novo CD (OR 2.90; 95% CI 0.79-10.57, p=0.108). At the time of proctocoletomy, 11 were current smokers, 25 were former smokers, and 116 never smoked. In de novo CD group, there were 4/27 (14.8 %) former smokers and 23/27 (85.2 %) never smokers. No de novo CD patient was current smoker. In the UC group that remained as UC following IPAA, 11/125 (8.8%) were current smokers, 21/125 (16.8 %) former smokers, and 93/125 (74.4 %) were never smokers. Current smoking status was not associated with development of de novo CD (p = 0.214). Conclusion Family history of CD may be a risk factor for developing de novo CD following IPAA for UC. Current smoking status was not associated with development of de novo CD following IPAA for UC.

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