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Papay P, Miehsler W, Tilg H, Petritsch W, Reinisch W, Mayer A, Haas T, Kaser A, Feichtenschlager T, Fuchssteiner H, Knoflach P, Vogelsang H, Platzer R, Tillinger W, Jaritz B, Schmid A, Blaha B, Dejaco C, Sobala A, Weltermann A, Eichinger S, Novacek G. Clinical presentation of venous thromboembolism in inflammatory bowel disease. J Crohns Colitis 2013; 7:723-9. [PMID: 23127785 DOI: 10.1016/j.crohns.2012.10.008] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 10/13/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Patients with inflammatory bowel disease (IBD) are at increased risk of venous thromboembolism (VTE), but data on frequency, site of thrombosis and risk factors are limited. We sought to determine prevalence, incidence as well as location and clinical features of first VTE among IBD patients. METHODS We evaluated a cohort of 2811 IBD patients for a history of symptomatic, objectively confirmed first VTE, recruited from 14 referral centers. Patients with VTE before IBD diagnosis or cancer were excluded. Incidence rates were calculated based on person-years from IBD diagnosis to first VTE or end of follow-up, respectively. RESULTS 2784 patients (total observation time 24,778 person-years) were analyzed. Overall, of 157 IBD patients with a history of VTE, 142 (90.4%) had deep vein thrombosis (DVT) and/or pulmonary embolism (PE), whereas 15 (9.6%) had cerebral, portal, mesenteric, splenic or internal jugular vein thrombosis. The prevalence and incidence rate of all VTE was 5.6% and 6.3 per 1000 person years, respectively. Patients with VTE were older at IBD diagnosis than those without VTE (34.4±14.8years vs 32.1±14.4years, p=0.045), but did not differ regarding sex, underlying IBD and disease duration. 121 (77.1%) VTE were unprovoked, 122 (77.7%) occurred in outpatients and 78 (60.9%) in patients with active disease. Medication at first VTE included corticosteroids (42.3%), thiopurines (21.2%), and infliximab (0.7%). CONCLUSION VTE is frequent in IBD patients. Most of them are unprovoked and occur in outpatients. DVT and PE are most common and unusual sites of thrombosis are rare.
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Affiliation(s)
- Pavol Papay
- Department of Internal Medicine III, Medical University Vienna, Austria
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Dulic M, Dulic-Lakovic E, Hellmich B, Blaha B, Gschwantler M. Successful treatment of a bleeding duodenal varix by endoscopic band ligation. J Gastrointestin Liver Dis 2011; 20:234. [PMID: 21961088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Melisa Dulic
- Wilhelminenspital, 4th Department of Internal Medicine, Vienna, Austria
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Rahier JF, Papay P, Salleron J, Sebastian S, Ellul P, Teich N, Fiorino G, Blaha B, Garcia-Sanchez V, Haas T, Van Gossum A, Abitbol V, Yazdanpanah Y, Chaparro MC. Influenza A (H1N1)v infection in patients with inflammatory bowel disease: a case series. Aliment Pharmacol Ther 2011; 33:499-500. [PMID: 21235603 DOI: 10.1111/j.1365-2036.2010.04558.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Novacek G, Weltermann A, Sobala A, Tilg H, Petritsch W, Reinisch W, Mayer A, Haas T, Kaser A, Feichtenschlager T, Fuchssteiner H, Knoflach P, Vogelsang H, Miehsler W, Platzer R, Tillinger W, Jaritz B, Schmid A, Blaha B, Dejaco C, Eichinger S. Inflammatory bowel disease is a risk factor for recurrent venous thromboembolism. Gastroenterology 2010; 139:779-87, 787.e1. [PMID: 20546736 DOI: 10.1053/j.gastro.2010.05.026] [Citation(s) in RCA: 170] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 04/11/2010] [Accepted: 05/13/2010] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Patients with inflammatory bowel disease (IBD) are at increased risk of a first venous thromboembolism (VTE), yet their risk of recurrent VTE is unknown. We performed a cohort study to determine the risk for recurrent VTE among patients with IBD compared with subjects without IBD. METHODS We assessed 2811 patients with IBD for a history of VTE, recruited from outpatient clinics at 14 referral centers (June 2006-December 2008). Patients with VTE before a diagnosis of IBD or those not confirmed to have VTE, cancer, or a VTE other than deep vein thrombosis or pulmonary embolism, were excluded. Recurrence rates were compared with 1255 prospectively followed patients without IBD that had a first unprovoked VTE (not triggered by trauma, surgery, or pregnancy). The primary end point was symptomatic, objectively confirmed, recurrent VTE after discontinuation of anticoagulation therapy after a first VTE. RESULTS Overall, of 116 IBD patients who had a history of first VTE, 86 were unprovoked. The probability of recurrence 5 years after discontinuation of anticoagulation therapy was higher among patients with IBD than patients without IBD (33.4%; 95% confidence interval [CI]: 21.8-45.0 vs 21.7%; 95% CI: 18.8-24.6; P = .01). After adjustment for potential confounders, IBD was an independent risk factor of recurrence (hazard ratio = 2.5; 95% CI: 1.4-4.2; P = .001). CONCLUSIONS Patients with IBD are at an increased risk of recurrent VTE compared to patients without IBD.
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Affiliation(s)
- Gottfried Novacek
- Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
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Ordubadi P, Blaha B, Schmid A, Krampla W, Hinterberger W, Gschwantler M. Capsule endoscopy with retention of the capsule in a duodenal diverticulum. Endoscopy 2008; 40 Suppl 2:E247-8. [PMID: 18991223 DOI: 10.1055/s-2008-1077563] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- P Ordubadi
- Fourth Department of Internal Medicine, Wilhelminenspital, Vienna, Austria
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Dzirlo L, Hubner M, Müller C, Blaha B, Formann E, Dellinger C, Petzelbauer P, Müllauer L, Huber K, Kneussl M, Gschwantler M. A mimic of sarcoidosis. Lancet 2007; 369:1832. [PMID: 17531892 DOI: 10.1016/s0140-6736(07)60822-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Larisa Dzirlo
- Fourth Department of Internal Medicine (Gastroenterology and Hepatology), Wilhelminenspital, Vienna, Austria.
| | - Marianne Hubner
- Second Department of Internal Medicine (Pulmonary Medicine), Wilhelminenspital, Vienna, Austria
| | - Christian Müller
- Department of Internal Medicine IV, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Benedikt Blaha
- Fourth Department of Internal Medicine (Gastroenterology and Hepatology), Wilhelminenspital, Vienna, Austria
| | - Elisabeth Formann
- Fourth Department of Internal Medicine (Gastroenterology and Hepatology), Wilhelminenspital, Vienna, Austria
| | | | - Peter Petzelbauer
- Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria
| | - Leonhard Müllauer
- Institute of Clinical Pathology, Medical University of Vienna, Vienna, Austria
| | - Kurt Huber
- Third Department of Internal Medicine (Cardiology), Wilhelminenspital, Vienna, Austria
| | - Meinhard Kneussl
- Second Department of Internal Medicine (Pulmonary Medicine), Wilhelminenspital, Vienna, Austria
| | - Michael Gschwantler
- Fourth Department of Internal Medicine (Gastroenterology and Hepatology), Wilhelminenspital, Vienna, Austria
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Dzirlo L, Blaha B, Müller C, Hubner M, Kneussl M, Huber K, Gschwantler M. Capsule endoscopic appearance of the small-intestinal mucosa in Whipple's disease and the changes that occur during antibiotic therapy. Endoscopy 2007; 39 Suppl 1:E207-8. [PMID: 17614081 DOI: 10.1055/s-2006-944990] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- L Dzirlo
- Fourth Department of Internal Medicine, Wilhelminenspital, Vienna, Austria.
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Maieron A, Hubner D, Blaha B, Deutsch C, Schickmair T, Ziachehabi A, Kerstan E, Knoflach P, Schoefl R. Multicenter retrospective evaluation of capsule endoscopy in clinical routine. Endoscopy 2004; 36:864-8. [PMID: 15452781 DOI: 10.1055/s-2004-825852] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND STUDY AIMS The small bowel is anatomically difficult to examine; disease conditions are rarely located in it, but can be serious. Neither conventional radiography nor push enteroscopy has sufficient sensitivity and specificity to detect distinct lesions. Wireless capsule endoscopy can theoretically allow imaging of the entire small bowel, with only minimal discomfort for the patient. PATIENTS AND METHODS Between November 2001 and May 2003, 191 patients received 195 capsules. Data were collected retrospectively from consecutive patients in three centers. The indications for capsule endoscopy were obscure or occult bleeding, suspected Crohn's disease, or other reasons in 151, 25, and 15 patients, respectively. The clinical outcome after 6 months was evaluated on the basis of interviews with patients or relatives. RESULTS Visualization of the entire small bowel was adequate in 78.4 % of the examinations. The colon was not reached in 16.9 % of cases, and there were minor technical problems in 4.6 %. Relevant pathological findings were identified in 56.2 % of 151 patients with obscure bleeding or iron-deficiency anemia (64 % of whom received blood transfusions). The most common findings were angiodysplasia in 39.7 % of cases and ulcers of the small bowel in 7.3 %. In addition, individual cases of tumors and parasitic worms were detected. Seven of the 25 patients with suspected Crohn's disease (28 %) had the disease confirmed. Three of five patients with polyposis syndrome of the colon were found to have polyps in the small bowel. CONCLUSIONS Wireless capsule endoscopy can be recommended as part of the routine work-up in patients with obscure bleeding or iron-deficiency anemia. In patients with Crohn's disease, the method may be helpful in establishing or ruling out the diagnosis.
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Affiliation(s)
- A Maieron
- Dept. of Internal Medicine 4, Krankenhaus der Elisabethinen, Fadingerstrasse 1, 4010 Linz, Austria.
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Ferenczi S, Ganyu A, Blaha B, Semsey S, Nagy T, Csiszovszki Z, Orosz L, Papp PP. Integrative plasmid vector for constructing single-copy reporter systems to study gene regulation in Rhizobium meliloti and related species. Plasmid 2004; 52:57-62. [PMID: 15212892 DOI: 10.1016/j.plasmid.2004.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2004] [Revised: 04/18/2004] [Indexed: 11/23/2022]
Abstract
The integrative system of phage 16-3 of Rhizobium meliloti 41 was shown to function in several bacterial species belonging to the Rhizobium, Bradyrhizobium, Azorhizobium, and Agrobacterium genera. It might also function in many other bacterial species provided that both the target site (attB) and the required host factor(s) are present. Here we report on the construction of a new integrative vector that can be utilized in gene regulation studies. It provides an opportunity to create a single-copy set-up for characterizing DNA-protein interactions in vivo, in a wide range of bacteria. To demonstrate the usefulness of the vector, transcription repression by binding of the C repressor protein of phage 16-3 to wild type operators was studied. The assay system provided highly reproducible quantitative data on repression.
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Affiliation(s)
- S Ferenczi
- Institute of Genetics, Agricultural Biotechnology Center, Gödöll, Szent-Györgyi A. 4. H-2100, Hungary
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Affiliation(s)
- F P Meyer
- Institut für Klinische Pharmakologie, Otto-von-Guericke Universität, Magdeburg, Germany
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McCay MH, Semak VV, Hopkins JA, Blaha B. Refractive index of NH(4)Cl-H2O as a function of wavelength: the effect of temperature and concentration. Appl Opt 1996; 35:3715-3718. [PMID: 21102768 DOI: 10.1364/ao.35.003715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The refractive index of NH(4)Cl-H(2)O solutions has been measured over a wavelength range from 496.5 to 690 nm. The NH(4)Cl concentration was varied from 15 to 30 wt. % over a temperature range from 10 to 35 °C. We obtained mathematical equations relating the refractive index to wavelength, temperature, and concentration using the least-squares method. A knowledge of these properties is important for analyzing and modeling the dendritic growth of this system.
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