Author(s): Campbell R.; Nelson E.; Hocking J.; Hickey T.; Hodgins J.; Geraghty V.
Source: Journal of Crohn's and Colitis; Feb 2018; vol. 12
Publication Date: Feb 2018
Publication Type(s): Conference Abstract
Abstract:Background: In the current financial climate the NHS is under pressure to change medications in order to improve the cost-effectiveness of prescribing. Despite this practice being widespread, there is a paucity of information on how patients feel about these changes. A key strategy for preventing relapses in patients with inflammatory bowel disease (IBD) is treatment with Mesalazine. Anecdotal reports have suggested that IBD patients find changes in their IBD medication worrying and that this may destabilise symptom control. 
Database: EMBASE

​Author(s): Abdulla, Omar; White, Emily
Source: British Journal of Hospital Medicine (17508460); Nov 2017; vol. 78 (no. 11); p. 654-654
Publication Date: Nov 2017
Publication Type(s): Academic Journal
Available  at British Journal of Hospital Medicine (17508460) -  from MAG Online Library
Abstract:The article describes the case of a 70-year-old woman who presented with severe abdominal pain and computed tomography of the abdomen and pelvis revealed a long, smooth distal sigmoid stricture with a proximal bowel dilatation and perforation probably caused by radiotherapy.
Database: CINAHL

Author(s): Hajibandeh S.; Deering R.; McEleney D.; Guirguis J.; Dix S.; Sreh A.; Kausar A.
Source: International Journal of Colorectal Disease; Sep 2017; vol. 32 (no. 9); p. 1341-1344

Publication Date: Sep 2017

Publication Type(s): Article

Abstract:Objectives: This paper aimed to determine the baseline accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of routinely collected comorbidity data in patients undergoing any types of colectomy. Methods: All patients aged >18 who underwent right hemicolectomy, left hemicolectomy, sigmoid colectomy, subtotal colectomy, or total colectomy between 1 January 2015 and 1 November 2016 were identified. The following comorbidities were considered: hypertension, ischemic heart disease (IHD), diabetes, asthma, chronic obstructive pulmonary disease (COPD), cerebrovascular disease (CVD), chronic kidney disease (CKD), and hypercholesterolemia. The comorbidity data from clinical notes were compared with corresponding data in hospital episode statistics (HES) database in order to calculate accuracy, sensitivity, specificity, PPV, and NPV of HES codes for comorbidities. In order to assess the agreement between clinical notes and HES data, we also calculated Cohen's kappa index value as a more robust measure of agreement. Results: Overall, 267 patients comprising 2136 comorbidity codes were included. Overall, HES codes for comorbidities in patients undergoing colectomy had substandard accuracy 94% (kappa 0.542), sensitivity (39%), and NPV (89%). The HES codes were 100% specific with PPV of 100%. The results were consistent when individual comorbidities were analyzed separately. Conclusions: Our results demonstrated that HES comorbidity codes in patients undergoing colectomy are specific with good positive predictive value; however, they have substandard accuracy, sensitivity, and negative predictive value. Better documentation of comorbidities in admission clerking proforma may help to improve the quality of source documents for coders, which in turn may improve the accuracy of coding.Copyright © 2017, Springer-Verlag Berlin Heidelberg.
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Database: EMBASE

Author(s): Campbell, R; Gaskell, S; Nelson, E; Bloor, R; Hocking, J; Hickey, T; Geraghty, V; Hodgins, J

Source: Journal of Crohn's & colitis; Feb 2017; vol. 11 ; p. S494

Publication Date: Feb 2017

Publication Type(s): Journal Article
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Database: Medline

Source: American Journal of Gastroenterology; Oct 2016; vol. 111

Publication Type(s): Journal: Conference Abstract

Author(s): Bhandare A.; Kadir S.

Abstract:Introduction: Spinchter of oddi dysfunction( SODD) is a syndrome of non calculous obstruction of the flow of bile and pancreatic juices causing pain, abnormal LFTs and pancreatitis.The cause of SOD dysfunction is not clearly understood.We looked at our data of patients who had biliary manometry from 2004-2012 in a tertiary Hepatobiliary centre to analyse if we could accurately predict the diagnosis of SOD dysfunction based on history and non invasive.

Methods: We did a Retrospective analysis of all the patients who had biliary manometry between 2004 to 2012 and were confirmed to have Spinchter of odds dysfunction on measurements of pressures . Data was identified by GI physiology department and a total of 37 patients were included. Results: Most of the patients in our data were of younger age with mean age of 46.As show in previous studies, majority (n=35/36) were female.The duration of the symptoms varied with most (n=16) having symptoms longer than 5 years.Almost all of them (n=28) had cholecystectomy in the past.

Twenty Five Patients were non smoker with all of them denying alcohol abuse of more 18 units per week.Only 8 patients had previous history of mental health disorders.Surprisingly almost all of them had previous episode of pancreatitis and were diabetic.Almost half were on chronic opiates even prior to the diagnosis of SOD dysfunction. With regards to the LFTs none of them had remarkably abnormal liver function test but all of them had gallstones.47% had confirmed biliary dilatation on imaging. Conclusion: In our cohort of patients most of the patients with confirmed SOD dysfunction on manometry had history of gallstone disease presumably causing pancreatitis and leading to cholecystectomy.

​We found a high prevalence of diabetes in these patients although we did not look into if they had developed chronic pancreatitis leading to diabetes.The prevalence of opiate use was also quite high which is a known cause of dilated CBD in itself. SOD dysfunction is not an uncommon condition in clinical practice and although its classified in the ROME III criteria of functional syndrome, it does lead to significant comorbidity and in some cases leads to unnecessary cholecystectomy. Furthermore biliary manometry and subsequently ERCP leads to a higher percentage of people developing pancreatitis.We were unable to identify a working equation to accurately predict the diagnosis of SOD dysfunction based on non invasive investigations.