Does Disease Activity After Induction Treatment With Biologics Predict Short-Term Outcome in Crohn’s Disease and Ulcerative Colitis?

Background Secondary loss of response to biological therapy is a challenge when treating Crohn’s disease (CD) and ulcerative colitis (UC). Currently, no single marker has been found to be valid as a prognostic indicator of response to biologic therapy in patients with CD and UC. In this study, we aimed to assess whether disease activity after 14 weeks of biologic therapy has a prognostic impact on surgery and steroid-free remission during 6 months following completion of induction therapy. Methods In an unselected cohort study based on data from 4 national Danish health registries, we identified 493 patients with UC and 620 patients with CD who completed induction therapy with biologics from 2016 to 2019. Following induction therapy with biologics, we defined disease activity based on C-reactive protein and clinical scores of disease activity. The composite endpoint, “not being well treated,” included surgery or use of corticosteroid within 6 months following induction therapy. Results In patients with UC with disease activity following induction therapy, the adjusted odds ratio for surgery or steroid treatment during 6 months of follow-up was 3.9 (95% CI, 1.6-9.3) compared with patients without disease activity, and in patients with CD, the adjusted odds ratio was 3.6 (95% CI, 1.7-7.6). Conclusions A positive treatment response to biologic treatment after induction therapy (measured by C-reactive protein and clinical scores) predicts a better short-term outcome in patients with CD and UC.

Short term outcome of midline laparotomies in view abdominalfascia closer

Background: This is a prospective non randomized observational comparative study for surgical site infections and surgical site occurrences after laparotomy fascia closer with two different techniques. Regular bite remains the standard of care in most hospitals. Laparotomies were done for elective and emergency cases.Methods: There were two techniques used to close abdominal wall fascia. The present study has evaluated small bite abdominal closer verses regular bite closer. Author and his team had used small bite fascia closer technique for all laparotomies, while other group of surgeons utilized regular bite fascia closer.Results: Out of 26 laparotomies in short bite closer, 8 had surgical site infections and surgical site occurrences, while 26 laparotomies in regular bite closer group had 15 patients with surgical site infections and surgical site occurrences. There is significant reduction in surgical site infection and surgical site occurrences observed in small bite abdominal closer group.Conclusions: It is recommended all laparotomies elective or emergent should be closed with small bite technique as it reduces surgical site infections and surgical site occurrences.

Role of neuron-specific enolase, glial fibrillar acidic protein and NR2-antibodies in early diagnostic of ischemic stroke

Background. Application of a biomarker panel during the acute period of the ischemic stroke (IS) can contribute to a more accurate and prompter diagnostics and verification of the optimal approach to a patients’ management.Objective. We aimed to clarify values of neuron-specific enolase (NSE), glial fibrillar acidic protein (GFAP) and antibodies for NMDA receptor’s NR2-subunit (NR2-antibodies) in the acute period of IS, to compare with such values in patients without IS, to assess their relationship with severity of neurological deficit and short-term outcome and also to establish sensitivity and specificity of the biomarker panel.Design and methods. 63 patients with IS and 31 people (11 with chronic brain ischemia and 20 healthy individuals) as controls were included. Results. NSE and GFAP values in IS group exceeded reference values at the onset of disease, lowering significally by 10-14 day, while NR2-antibodies’ values were lower at the onset of the disease compared with controls, rising by 10-14 day. In patients with unfavourable short-term outcome higher levels of NSE, GFAP and NR2-antibodies were found. A panel of such biomarkers has higher sensitivity and specificity than each of them individually.Conclusion. Researched substances can be used in a biomarker panel for IS diagnostics, brain damage monitoring, patient’s condition evaluation and short outcome prognosing.

O-B02 Robotic versus Laparoscopic Roux-en-Y Gastric Bypass: A comparison of short-term outcomes and weight loss

Background The benefits of robotic over laparoscopic surgery for Roux-en-Y gastric bypass (RYGB) are debatable, with current evidence suggesting no significant differences in short-term outcomes. This study compares short-term outcomes and excess weight loss (EWL) % difference between these two techniques. Methods A retrospective study of patients undergoing RYGB between January 2016 and November 2020 at a single centre. Demographic, peri-operative and EWL% data were analysed. Results 424 RYGB procedures were performed by three surgeons including 77 robotic (RRYGB) and 347 laparoscopic (LRYGB) operations. The first 8 RRYGB were excluded being early in the learning curve and the operative technique was modified afterwards. There were no statistically significant demographic differences. The median operative time was 179 (151 – 195) and 149 (123 -171) minutes in the RRYGB and LRYGB groups respectively (P < 0.001). There were no statistically significant differences between both groups in complications, length of stay, 30-day readmission and EWL% at 6 and 12 months. The EWL% at 2 years was 88.5 (+/-19.1) and 66.6 (+/-29.8) in the RRYGB and LRYGB groups respectively (P = 0.003). Conclusions RRYGB increases the operative time with no significant short-term outcome differences. The EWL% was higher at 2 years, probably due to a narrower hand-sewn gastro-jejunal anastomosis.