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Vienna Classification (vienna + classification)

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Medical Sciences	100%

Selected Abstracts

How useful is the Vienna Classification in clinical practice?

INFLAMMATORY BOWEL DISEASES, Issue S2 2008
Fernando Tavarela Veloso MD
No abstract is available for this article. [source]

Crohn's Disease runs a more aggressive course in young asian patients

INFLAMMATORY BOWEL DISEASES, Issue 1 2006
Kelvin Teck Joo Thia MRCP
Abstract Background: Crohn's disease is a heterogeneous inflammatory bowel disease. The impact of age at diagnosis on the clinical course of patients varies widely as reported in the Western literature. Using the Vienna Classification, we seek to determine whether young Crohn's disease patients in an Asian population followed a different clinical course than old patients. Methods: The case records of 100 Crohn's disease patients who were treated at the Inflammatory Bowel Disease Center, Singapore General Hospital, were studied retrospectively. The age group and location of disease and behavior according to the Vienna classification were determined at diagnosis. Results: A1 group (age <40 years) defined as "young" and A2 group (age ,40) defined as "old" contained 65 and 35 patients, respectively. Median age for the young group was 27.4 years and that for the old group was 52.6 years. Of the young patients, 66.7% flared at least once compared with 28.6% of the old patients, odds ratio of 5.0 (P < 0.001). Young patients were more likely to be steroid dependent (20.0% of A1 versus 8.6% of A2, P = 0.14), received azathioprine (38.5% of A1 versus 5.7% of A2, P < 0.001) and experienced complications (31% of A1 versus 20% of A2, P = 0.25)-numerically higher rates that did not reach statistical significance. There was no significant difference between the age groups for the location and behavior of disease as well as requirement for surgery. Conclusion: In this first Asian study looking specifically at the impact of age at diagnosis of Crohn's disease, we found that young patients underwent a more aggressive clinical course. [source]

Indications for laparoscopic surgery for Crohn's disease using the Vienna Classification

COLORECTAL DISEASE, Issue 9 2007
K. Okabayashi
Abstract Objective, The aim of this study was to investigate the clinical outcome of laparoscopic surgery for Crohn's disease and clarify the indications using the Vienna Classification. Method, Between September 1994 and July 2004, 107 patients with Crohn's disease underwent 124 procedures. Of these, 91 laparoscopic procedures formed the basis of this study. The Vienna Classification, which consists of three subgroups , age at diagnosis (A1-2), location (L1-4) and behaviour (B1-3) , was applied to compare the conversion to open surgery and incidence of postoperative complications. Results, Conversion to open surgery was necessary in 12 (13.2%) patients. Major and minor postoperative complications occurred in five (5.5%) and 13 (19.8%) patients respectively. The conversion rate, major and total complications in the B3L3/4 subgroup were significantly greater than in the other subgroups. Multivariate analysis showed that B3L3/4 was the only predictive factor for all complications. However, the incidence of major and all complications in the B3L3/4 subgroup did not differ between the open and laparoscopic surgery groups. Conclusion, Laparoscopic surgery for Crohn's disease is the procedure of choice for all uncomplicated cases (B2L1-4, B3L1/2). For patients in the complicated group (B3L3/4), laparoscopy is also feasible and justified; however, the surgeon must be aware of the propensity for higher rate of conversion. [source]

Crohn's Disease runs a more aggressive course in young asian patients

The interleukin-25 gene located in the inflammatory bowel disease (IBD) 4 region: no association with inflammatory bowel disease

INTERNATIONAL JOURNAL OF IMMUNOGENETICS, Issue 5 2003
C. Büning
Summary Genetic predisposition has been suggested to play an important role in the pathogenesis of inflammatory bowel diseases (IBDs). Linkage studies have identified a Crohn's disease susceptibility locus on chromosome 14 (14q11,12; IBD4). Interleukin-25 (IL-25) is a newly identified proinflammatory cytokine that has been shown to promote Th2 responses by inducing cytokines such as IL-4, IL-5 and IL-13. The IL-25 gene is located within this susceptibility region at 14q11.2. As IBDs are characterized by an imbalance of the Th1/Th2 cytokine response, we hypothesized that genetic alterations within the IL-25 gene might contribute to IBD. First, direct sequencing of the coding regions of the IL-25 gene in 40 patients with Crohn's disease or ulcerative colitis revealed only a newly reported polymorphism (c424C/A) in exon 2. Next, the frequency of this polymorphism was further investigated in 151 patients with Crohn's disease, 111 patients with ulcerative colitis, and 119 healthy controls to determine its clinical relevance. The genotypes of the c424C/A polymorphism did not reveal any significant differences between patients with Crohn's disease or ulcerative colitis and controls. Genoytype,phenotype relations in patients with Crohn's disease showed a comparable distribution of the c424C/A polymorphism in all subgroups of the Vienna classification. In summary, our data indicate that genetic alterations in the coding regions of the IL-25 gene are unlikely to play a role in IBDs, but the c424C/A polymorphism in the IL-25 gene should be investigated for a potential association with other chronic inflammatory and inherited disorders such as autoimmune diseases. [source]

Combined type-1 plasminogen activator inhibitor and NOD2/CARD15 genotyping predicts complicated Crohn's disease behaviour

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2007
M. ALVAREZ-LOBOS
Summary Background NOD2/CARD15 gene variants have not been universally associated with stricturing behaviour in Crohn's disease. Other behaviour modifying genes could explain these results. Aim To study the combined influence of NOD2/CARD15 variants and 4G/4G genotype of type-1 plasminogen activator inhibitor (PAI-1) gene on Crohn's disease behaviour. Methods One hundred and seventy Crohn's disease patients were studied prospectively, with a mean follow-up of 7± 6 years. Disease behaviour was registered by using two criteria: the Vienna classification and a non-hierarchical classification based on the behavioural Vienna categories. Results In the multivariate analysis for stricturing behaviour according to the Vienna categories, only absence of colonic disease (OR, 4.0; 95% CI: 1.49,11.1; P = 0.006) was an independent predictive factor. However, in the multivariate analysis for stricturing disease applying a non-hierarchical criteria, ileal disease (OR, 4.19; 95% CI: 1.30,13.5; P = 0.01), and carrying both NOD2/CARD15 variants and the 4G/4G PAI-1 genotype (OR, 5.02; 95% CI: 1.44,17.48; P = 0.01) were independent predictive factors. In the multivariate analysis for penetrating behaviour, the 4G/4G PAI-1 (OR, 3.10; 95% CI: 1.54,6.23; P = 0.001) and male sex (OR, 2.44; 95% CI: 1.30,4.60; P = 0.005) were independent predictive factors irrespective of criteria applied. Conclusions Combined PAI-1 and NOD2/CARD15 genotyping predict complicated Crohn's disease. Patients with these variants could benefit from early interventions. [source]