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Biomedical subjects

J B Kirsner

Publications and source records attributed to J B Kirsner.

At least 37 records · Page 2Linked to original sources
PubMed1989

Cigarette smoking in Crohn's disease.

Crohn's disease is a chronic disease of unknown etiology. Previous reports have suggested that cigarette smoking may be associated with the development of Crohn's disease. To examine this association, we conducted a case-control study of patients referred to a single practice over a 7-month period. The cigarette-smoking habits of 115 patients with Crohn's disease were compared with the cigarette-smoking exposure of 109 patients with the irritable bowel syndrome. Patients with Crohn's disease were more likely to smoke at the time of symptom onset than were irritable bowel syndrome controls (age and sex adjusted odds ratio 3.71, 95% confidence interval 1.93-7.13). After the diagnosis of Crohn's disease, patients were less likely to quit smoking (odds ratio 0.35, 95% confidence interval 0.18-0.69) than controls. This study demonstrates an association and a temporal relationship between cigarette smoking and Crohn's disease. For the exposure to be considered an etiologic factor for disease, biologic plausibility and pathophysiologic mechanisms require elucidation.

Adult↗
PubMed1988

Historical aspects of inflammatory bowel disease.

Ulcerative colitis and regional enteritis (Crohn's disease), probably first appeared as isolated cases, several centuries ago; but not until the latter half of the 19th century did their clinical presentation attract medical interest as definable entities. This review of the early medical literature reveals a surprising number of reports of inflammatory bowel disease consistent with present descriptions of these conditions. As with other diseases, the steadily increasing numbers of patients with ulcerative colitis during the first third of the 20th century and of patients with regional enteritis during the latter two thirds of the century follows a familiar pattern encountered with diseases wherein environmental factors play a pathogenetic role. The early history of ulcerative colitis is lost in the complex mixture of infectious colitides, only partially unraveled in the past 100 years. The early history of regional enteritis probably is linked with the numerous European and American reports of tumor-like granulomas of the small intestine, initially regarded as neoplastic lesions requiring surgical removal. It now seems possible that physicians over a period of several centuries may have encountered these conditions but were not in a position to appreciate their uniqueness. The careful accounts of many authors, especially Morgagni (1761), Wilks (1859), Fenwick (1889), Dalziel (1913) and of Crohn, Ginzburg, and Oppenheimer (1932) of then obscure intestinal inflammatory processes thus re-emphasizes the importance of meticulous clinical and pathological descriptions in the subsequent elucidation of obscure disorders. If the course of ulcerative colitis and of Crohn's disease follow the historical pattern of other once important and later disappearing human illnesses, we may have reason to anticipate clarification of their etiology and possible relationship in the not too distant future.

Colitis, Ulcerative↗
PubMed1986

Prevalence and incidence of inflammatory bowel disease in family members.

To determine the risk of having or developing inflammatory bowel disease (IBD) in a family member of an IBD patient, a population of 245 IBD probands was randomly selected from the University of Chicago IBD Registry and their family history was elucidated by questionnaire and follow-up telephone call. One hundred seventy-nine (73%) probands responded to the questionnaire. There were no demographic distinctions between those eligible for the study, those who were complete responders, those who were nonresponders, and those with a positive family history of IBD. Fifty-four family members from 40 proband families (22%) had confirmed IBD. Prevalence of IBD in family members at the time of diagnosis of the proband was highest for parents (4.6%), siblings (2.6%), and children (1.9%). Grandparents, aunts and uncles, and first cousins had prevalence of IBD of less than 1%. Incident case frequency was determined by dividing the number of cases incident after the diagnosis of the proband by all those ever at risk. The incident case frequency was highest for siblings (1.9%), parents (1.0%), and children (1.0%). There was concordance noted for type of disease in the proband and the relative. No association could be discerned between the familial risk of IBD and gender, race, or religion of the proband. Despite a high occurrence rate of proband families with IBD, the specific risk to first, second, or third degree family members is low.

Adolescent↗
PubMed1986

Acute pancreatitis associated with high-concentration lipid emulsion during total parenteral nutrition therapy for Crohn's disease.

A 17-yr-old boy with Crohn's disease and growth retardation developed an acute abdominal crisis while receiving total parenteral nutritional support. Acute pancreatitis was confirmed surgically. After recovery, in an attempt to provide adequate calories and to elucidate the inciting agent, he was rechallenged with his original total parenteral nutritional solution which contained 500 ml/day of a 20% fat emulsion. Symptoms and signs of acute pancreatitis quickly returned. Total parenteral nutrition was continued without the fat emulsion and symptoms and signs disappeared. This case suggests that acute pancreatitis was due to intolerance of high-concentration lipid emulsion.

Acute Disease↗
PubMed1985

Inflammatory bowel disease in the pregnant woman.

This article discusses fertility and inflammatory bowel disease, the influence of inflammatory bowel disease on pregnancy, the influence of pregnancy on inflammatory bowel disease, the safety of breast-feeding while taking medication for active disease, and abdominal pain in the pregnant woman with inflammatory bowel disease.

Abdomen↗
PubMed1983

The prognosis of inflammatory bowel disease.

The complications of ulcerative colitis generally develop during the first two years of disease. The mortality is higher than expected and the highest likelihood of colectomy also occurs early in the disease. Mortality in Crohn's disease is greater than expected, especially in males. For both conditions, the overall mortality has decreased steadily, and currently is less than 5%. Ulcerative colitis is curable with proctocolectomy and ileostomy. In Crohn's disease, intestinal resection and reanastomosis is followed by recurrence in the majority of patients. The recurrence rate after proctocolectomy and ileostomy for Crohn's disease of the colon also is considerable, ranging from 20% to 35%. In ulcerative colitis, the more colon involved, the more frequent and more serious are the complications. In Crohn's disease, the anatomic pattern of disease tends to predict the type and extent of complications. Both ulcerative colitis and Crohn's disease appear to follow a more severe course in children and adolescents with "inflammatory bowel disease." Patients with either ulcerative colitis or Crohn's disease are at increased risk for the later development of cancer. In ulcerative colitis, the excess risk is limited to colorectal cancer. Patients with Crohn's disease have increased cancer rates for both the small and large bowel. Finally, most patients with these diseases are able to maintain normal occupations and enjoy reasonably stable social and economic situations. The successful adaptation of patients with inflammatory bowel disease is influenced by a hopeful, optimistic personality and by an encouraging, supportive physician.

Colectomy↗