# Inflammatory Bowel Disease — GCMD Library living collection

Everything in the library about inflammatory bowel disease — built automatically from dossiers that name it.

Updated: n/a · 5 episodes · 72 cited statements

## Episodes
### Evidence & Research
- [Best of the Best Gen Surg - Therapeutic Effect of Oridonin against Inflammatory Bowel Disease Involves Inhibition of Intestinal Fibrosis via NF-kB and p38STAT1 Pathways - Dr. Mao](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857) — video · 11:56 · [machine version](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857.md)
- [Best of the Best Gen Surg - Limited Health Literacy is Associated with Reduced Adherence to ERP Components. - Dr. Shao](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860) — video · 9:23 · [machine version](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860.md)
- [Journal of Pediatric Surgery Article Review:  May 2023, CAPS Issue](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077) — podcast · 11:17 · [machine version](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077.md)
- [Quick Literature Updates Episode 15](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927) — video · 4:12 · [machine version](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927.md)

### Case-Based Learning
- [Colorectal Quiz Episode 26: Perianal Crohn's Disease](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890) — podcast · 23:58 · [machine version](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890.md)

## Chapters
- [0:05](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=5) Introduction and case presentation setup (Ep 1)
- [1:49](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=109) Case presentation and diagnostic workup discussion (Ep 1)
- [5:12](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=312) Imaging workup and biologic risks (Ep 1)
- [7:51](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=471) Surgical planning and timing (Ep 1)
- [11:21](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=681) Operative findings and surgical technique (Ep 1)
- [15:22](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=922) Postoperative course and endoscopic findings (Ep 1)
- [16:46](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1006) Biologic therapy timing and seton management (Ep 1)
- [21:52](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1312) Summary and closing (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=0) Introduction and Paper Title (Ep 2)
- [0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26) Background on IBD, Fibrosis, and EMT (Ep 2)
- [4:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=240) Oridonin Compound and Study Hypotheses (Ep 2)
- [5:30](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=330) Methods and First Results: Fibrosis Marker Inhibition (Ep 2)
- [7:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=420) NF-κB Pathway Inhibition Results (Ep 2)
- [8:10](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=490) P38/STAT1 Pathway Results and Conclusions (Ep 2)
- [9:03](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=543) Discussion and Commentary (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=0) Introduction to health literacy and ERP adherence study (Ep 3)
- [0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24) Study presentation: health literacy, ERP adherence, and outcomes (Ep 3)
- [5:12](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=312) Discussion of practical implementation challenges and solutions (Ep 3)
- [9:14](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=554) Closing remarks (Ep 3)
- [0:06](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=6) Introduction and Episode Overview (Ep 4)
- [1:33](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=93) Hirschsprung-Associated Inflammatory Bowel Disease (Ep 4)
- [3:51](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=231) COVID-19 Pandemic Policies and Appendicitis Outcomes (Ep 4)
- [7:31](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=451) Critical Airway Response Team for Button Battery Removal (Ep 4)
- [10:01](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=601) Summary and Closing (Ep 4)
- [0:00](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=0) Introduction and Hirschsprung-Associated IBD Study (Ep 5)
- [1:43](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=103) Choledochal Cyst Resection Outcomes (Ep 5)
- [2:48](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=168) Solid Organ Injury Management and Closing (Ep 5)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- In pediatric patients, unlike adult patients, the first presenting factor for Crohn's disease can often be perianal disease. — Jason Frischer (clinical) [Ep 1 · 9:29](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=569)
- Male gender over the age of 10, and presence of a fistula are risk factors with much higher incidence of Crohn's disease being diagnosed in patients presenting with perianal lesions to the emergency room. — Jason Frischer (epidemiological) [Ep 1 · 9:00](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=540)
- The mucosa heals first compared to skin in perianal disease, so leaving a mucosal opening without a seton risks recurrent abscess when biologics heal the mucosa. — Jason Frischer (clinical) [Ep 1 · 12:31](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=751)
- Making a large cruciate incision and packing a perianal abscess in a child with undiagnosed Crohn's disease may result in non-healing and potentially require colostomy or ileostomy. — Jason Frischer (clinical) [Ep 1 · 13:12](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=792)
- The highest risk factors for lymphoma with biologic therapy are male gender, teenage age, and combination therapy with methotrexate. — Jason Frischer (clinical) [Ep 1 · 6:52](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=412)
- Real risks of biologic agents include infectious complications such as tuberculosis and risk of lymphoma. — Cristine Velazco (clinical) [Ep 1 · 6:29](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=389)
- When the colonoscope cannot intubate the terminal ileum, capsule endoscopy or fecal calprotectin can be used to aid diagnosis. — Cristine Velazco (clinical) [Ep 1 · 3:47](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=227)
- If terminal ileum cannot be intubated, gastroenterologists may treat presumptively and re-scope after a few months of treatment when inflammation has decreased. — Jason Frischer (clinical) [Ep 1 · 4:36](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=276)
- Setons should remain in place for at least 6 months to allow the inflammatory tract to become non-inflammatory. — Lisa McMahon (clinical) [Ep 1 · 17:54](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1074)
- Before removing a seton, the bottom must look better, drainage must be better, the patient must be symptom-free, and they must have reached steady state of biologic (loading dose plus at least 3 more doses, typically 2-3 months from start). — Jason Frischer (clinical) [Ep 1 · 19:23](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1163)
- Inflammatory markers including fecal calprotectin, ESR, and CRP should be checked before removing a seton to ensure systemic disease is under control. — Jason Frischer (clinical) [Ep 1 · 19:55](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1195)
- The initial Remicade paper from 1998 or 1999 in the New England Journal of Medicine was on perianal disease and demonstrated improved healing time and improved length of time between recurrence when combination of seton and infliximab is used versus either separately. — Jason Frischer (clinical) [Ep 1 · 20:49](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1249)
- Remicade (infliximab) has the most literature on healing perianal disease; Humira also has good evidence but less literature; Stelara and vedolizumab are sometimes used with less information available. — Lisa McMahon (clinical) [Ep 1 · 20:27](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1227)
- Literature shows about a 10% response rate for perianal fistulas even without biologics if a seton is placed and removed, with much better outcomes with biologics. — Lisa McMahon (epidemiological) [Ep 1 · 19:12](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1152)
- Source control of infection must be achieved before starting immunosuppressive therapy including steroids and biologics. — Jason Frischer (clinical) [Ep 1 · 17:17](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1037)
- If an abscess is not adequately drained, reimaging should be performed before giving biologics or steroids. — Jason Frischer (clinical) [Ep 1 · 17:17](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1037)
- Hydrogen peroxide is preferred over methylene blue for identifying fistula tracts because it is neater; 3% hydrogen peroxide in a syringe with 16-20 gauge angiocath is used with a speculum in the anus. — Jason Frischer (clinical) [Ep 1 · 14:15](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=855)
- When a fistula opening cannot be found despite hydrogen peroxide testing, a seton should not be placed at that time to avoid creating a hole where there isn't one. — Jason Frischer (clinical) [Ep 1 · 14:54](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=894)
- For recurrent patients requiring repeat seton placement, repeat imaging should be obtained before seton removal. — Lisa McMahon (clinical) [Ep 1 · 18:45](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=1125)
- It is common to have perianal disease in Crohn's; this patient had a delay in diagnosis and had perianal disease for quite some time with multiple skin tags and fissures. — Lisa McMahon (clinical) [Ep 1 · 7:24](https://origin-library.globalcastmd.com/watch/colorectal-quiz-episode-26-perianal-crohn-s-disease-4890?t=444)
- Three risk factors for Hirschsprung-associated IBD are trisomy 21, a history of enterocolitis following pull-through surgery, and long segment disease. — Jacob Langer (clinical) [Ep 4 · 2:24](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=144)
- Biologic therapy is most likely to be effective for treating Hirschsprung-associated IBD. — Sonia Butterworth (clinical) [Ep 4 · 2:33](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=153)
- Hirschsprung's associated IBD is very poorly defined, presents in a number of different ways, and the reason why it happens is unknown. — Jacob Langer (clinical) [Ep 4 · 3:05](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=185)
- Hirschsprung's enterocolitis that persists past age 5, or that is unresponsive to typical treatment under age 5, should prompt consideration of Hirschsprung-associated IBD diagnosis. — Sonia Butterworth (clinical) [Ep 4 · 3:18](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=198)
- Complicated appendicitis was defined as: all perforated appendicitis, clear purulent peritonitis, or small bowel obstruction from appendicitis. — Greta Bercher (clinical) [Ep 4 · 5:18](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=318)
- Median symptom duration between onset and emergency presentation was 1 day pre-COVID and 2 days during pandemic, representing a clinically significant difference despite lack of statistical significance. — Sonia Butterworth (epidemiological) [Ep 4 · 5:55](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=355)
- During COVID-19, the government of Ontario made it mandatory that all patients below 18 years of age had to be treated at a pediatric hospital. — Greta Bercher (guideline) [Ep 4 · 7:08](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=428)
- Patients during COVID-19 had an increased rate of perforation compared to pre-pandemic, stayed in hospital longer, and had increased risks of complications. — Sonia Butterworth (epidemiological) [Ep 4 · 6:56](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=416)
- The institution already had a CART (critical airway response team) that activated all stakeholders except gastroenterology, which was added for the button battery protocol. — Katerina Dukleska (clinical) [Ep 4 · 8:20](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=500)
- Even the pre-protocol time of 73 minutes for button battery removal was a very impressive target. — Sonia Butterworth (opinion) [Ep 4 · 9:10](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=550)
- Button battery ingestions are not common events. — Katerina Dukleska (epidemiological) [Ep 4 · 9:45](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=585)
- With the reduced time to removal, a decrease in at least major complications for button battery patients is anticipated over time. — Katerina Dukleska (opinion) [Ep 4 · 9:45](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=585)
- Health literacy is defined as the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Health literacy is modifiable and health literacy-based interventions have been shown to improve outcomes and patient experience. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Patients with lower health literacy are more likely to have higher health care costs, higher rates of hospital and emergency room visits, and higher mortality rates. — Connie Chow (epidemiological) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Patients with lower health literacy are less likely to follow treatment plans. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- The presenter's group previously showed that limited health literacy is associated with increased complications compared to patients with higher health literacy. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Many studies have shown that increased adherence to components of enhanced recovery is associated with improved postoperative outcomes. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- The study was a retrospective cohort study from December 2018 to November 2021 of elective inpatient colorectal surgeries tracked by the institutional ACS NSQIP database. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Seven ERP adherence variables were extracted from the NSQIP database and cross-referenced with a health literacy database that tracked patients' brief health literacy scores measured in clinic. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- In the study cohort, patients on average were about 56 years old, about 70% white, a quarter black, majority female, with mean BMI of about 30. — Connie Chow (epidemiological) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- In the study cohort, 12% had a surgical site infection within 30 days of surgery, average length of stay was about 5.5 days, and about 10% of patients were readmitted within 30 days. — Connie Chow (epidemiological) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Only two factors were associated with increased ERP adherence: increased health literacy and a diagnosis of cancer. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- There is a direct linear correlation between increased health literacy score and increased percent adherence to the seven components of ERP that were tracked. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Black race, case duration, ostomy placement, and the diagnosis of IBD are associated with increased length of stay. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- The only protective factor for decreased length of stay was adherence to the different components of enhanced recovery. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Higher health literacy is independently associated with greater ERP adherence. — Connie Chow (clinical) [Ep 3 · 0:24](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=24)
- Enhanced recovery at UAB has been a big deal for the last decade, with initial great uptake in teaching among nurses and successful closing of the gap in disparities in care between black and white patients. — Connie Chow (clinical) [Ep 3 · 6:43](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=403)
- Travel nurses are not as well trained in enhanced recovery because they are not from the institution and travel to many different institutions. — Connie Chow (opinion) [Ep 3 · 6:43](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-limited-health-literacy-is-associated-with-reduced-adh-5860?t=403)
- Inflammatory bowel disease affects approximately 3 million adults in the United States. — Diana Mao (epidemiological) [Ep 2 · 0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26)
- Annual medical expenses for a patient with IBD is estimated to be $15,000. — Diana Mao (epidemiological) [Ep 2 · 0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26)
- The value of work-related opportunity lost due to IBD has been reported to be up to $5.5 billion. — Diana Mao (epidemiological) [Ep 2 · 0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26)
- Intestinal fibrosis affects 30-50% of Crohn's disease patients. — Diana Mao (epidemiological) [Ep 2 · 0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26)
- Intestinal fibrosis is seen with ulcerative colitis at a rate of 5%. — Diana Mao (epidemiological) [Ep 2 · 0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26)
- The fibrosis process can lead to complications that present clinically in the form of strictures, obstruction, and fistulas. — Diana Mao (clinical) [Ep 2 · 0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26)
- Epithelial mesenchymal transition (EMT) is defined by the loss of adherences, tight junctions, and cytoskeleton proteins that are normally found in epithelial cells, with loss of epithelial markers such as E-cadherin and ZO-1. — Diana Mao (clinical) [Ep 2 · 0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26)
- During EMT, cells gain extracellular matrix and fibroblast morphology as well as migratory capacity, with increased expression of fibroblast markers such as α-SMA and fibronectin. — Diana Mao (clinical) [Ep 2 · 0:26](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=26)
- Oridonin is a diterpenoid derived from the plant species Rhabdosa rubiscens. — Diana Mao (clinical) [Ep 2 · 4:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=240)
- Rhabdosa rubiscens has been used for hundreds of years in eastern medicine to treat common ailments such as cough, abdominal pain, and muscle aches. — Diana Mao (clinical) [Ep 2 · 4:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=240)
- Research has demonstrated that oridonin has antioxidant, anti-tumor, and anti-inflammatory effects on various tissues, thought to be due to inhibition of multiple signaling pathways including NF-κB and P38. — Diana Mao (clinical) [Ep 2 · 4:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=240)
- In studies with in vitro experiments and animal models, oridonin has resulted in slower IBD disease progression and decreased levels of inflammatory cytokines and cells. — Diana Mao (clinical) [Ep 2 · 4:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=240)
- Oridonin inhibited LPS-induced increases in α-SMA, a marker of EMT and fibrosis. — Diana Mao (clinical) [Ep 2 · 5:30](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=330)
- Oridonin inhibited LPS-induced increases in fibronectin, another marker of EMT and fibrosis. — Diana Mao (clinical) [Ep 2 · 5:30](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=330)
- Pre-treatment with oridonin attenuated LPS-induced decreases in ZO-1 levels and restored ZO-1 expression. — Diana Mao (clinical) [Ep 2 · 5:30](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=330)
- NF-κB is a key pro-inflammatory pathway that regulates α-SMA. — Diana Mao (clinical) [Ep 2 · 7:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=420)
- Oridonin inhibited the activation of NF-κB by preventing the nuclear translocation of NF-κB p65. — Diana Mao (clinical) [Ep 2 · 7:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=420)
- Oridonin inhibited the phosphorylation of IKK-α/β and I-κB-α, and prevented total I-κB-α degradation. — Diana Mao (clinical) [Ep 2 · 7:00](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=420)
- The P38 inhibitor SB 203580 dose-dependently attenuated LPS-induced α-SMA expression. — Diana Mao (clinical) [Ep 2 · 8:10](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=490)
- Oridonin inhibits LPS-induced STAT1 activity, which is a downstream factor of P38. — Diana Mao (clinical) [Ep 2 · 8:10](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=490)
- Oridonin inhibits EMT-related fibrosis via inhibition of the NF-κB and P38/STAT1 pathways. — Diana Mao (clinical) [Ep 2 · 8:10](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=490)
- Oridonin is derived from China and used in eastern medicine, having been utilized for hundreds of years for common ailments. — Diana Mao (clinical) [Ep 2 · 9:08](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=548)
- After breaking down the Rhabdosa rubiscens plant, researchers found that the most active compound was oridonin. — Diana Mao (clinical) [Ep 2 · 9:08](https://origin-library.globalcastmd.com/watch/best-of-the-best-gen-surg-therapeutic-effect-of-oridonin-against-inflammatory-bo-5857?t=548)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- The Hirschsprung-associated IBD study was a retrospective study from 2000 to 2021 at 17 institutions with 55 patients. — Cecilia Gigena summarizing the discussion [Ep 4 · 1:33](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=93)
- 50% of Hirschsprung-associated IBD patients had long segment disease. — Cecilia Gigena summarizing the discussion [Ep 4 · 2:05](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=125)
- Enterocolitis was reported in 68% of Hirschsprung patients after pull-through. — Cecilia Gigena summarizing the discussion [Ep 4 · 2:05](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=125)
- The most common presentation for Hirschsprung-associated IBD was colonic or small bowel inflammation resembling IBD. — Cecilia Gigena summarizing the discussion [Ep 4 · 2:17](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=137)
- The COVID-19 appendicitis study assessed patients from February 2018 to June 2019 (pre-pandemic control) and mid-February 2020 to June 2021 (COVID period). — Em Tombash summarizing the discussion [Ep 4 · 4:32](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=272)
- The study included 1100 patients total: 44% in pre-pandemic control group and 56% in COVID-19 group. — Em Tombash summarizing the discussion [Ep 4 · 4:55](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=295)
- A larger proportion of complicated appendicitis occurred during COVID-19 compared to pre-pandemic period. — Em Tombash summarizing the discussion [Ep 4 · 4:55](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=295)
- Symptom duration at presentation and length of stay were not significantly different between pre-pandemic and COVID-19 groups. — Em Tombash summarizing the discussion [Ep 4 · 5:28](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=328)
- The button battery study evaluated whether implementation of a clinical algorithm shortened time from diagnosis to removal of esophageal button battery. — Cecilia Gigena summarizing the discussion [Ep 4 · 7:54](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=474)
- The algorithm was based on the national database algorithm and implemented in October 2019. — Cecilia Gigena summarizing the discussion [Ep 4 · 8:09](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=489)
- After implementing the critical airway response team algorithm, time from chest X-ray to button battery removal was reduced from 73 minutes to 35 minutes. — Cecilia Gigena summarizing the discussion [Ep 4 · 8:45](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-may-2023-caps-issue-7077?t=525)
- The Hirschsprung-associated IBD study was a retrospective study gathering patients from 2000 to 2021 at 17 institutions. — Cecilia Gigena summarizing a resource [Ep 5 · 0:59](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=59)
- The study gathered 55 Hirschsprung patients, and 50% had long segment disease. — Cecilia Gigena summarizing a resource [Ep 5 · 1:14](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=74)
- 68% of the Hirschsprung patients had Hirschsprung-associated enterocolitis. — Cecilia Gigena summarizing a resource [Ep 5 · 1:19](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=79)
- 10% of the Hirschsprung patients had trisomy 21. — Cecilia Gigena summarizing a resource [Ep 5 · 1:19](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=79)
- Long segment disease, Hirschsprung-associated enterocolitis, and trisomy 21 can be potential risk factors for IBD-like symptoms in Hirschsprung patients after pull through. — Cecilia Gigena summarizing a resource [Ep 5 · 1:19](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=79)
- The choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018. — Ellen Encisco summarizing a resource [Ep 5 · 2:11](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=131)
- The majority of pediatric choledochal cyst patients underwent open resection. — Ellen Encisco summarizing a resource [Ep 5 · 2:21](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=141)
- Patients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy. — Ellen Encisco summarizing a resource [Ep 5 · 2:21](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=141)
- Patients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy. — Ellen Encisco summarizing a resource [Ep 5 · 2:21](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=141)
- Patients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay. — Ellen Encisco summarizing a resource [Ep 5 · 2:36](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=156)
- Patients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection. — Ellen Encisco summarizing a resource [Ep 5 · 2:36](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=156)
- Patients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection. — Ellen Encisco summarizing a resource [Ep 5 · 2:36](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=156)
- The solid organ injury study was a retrospective study done in South Carolina examining if isolated solid organ injuries after blunt abdominal trauma can be discharged from the ED. — Cecilia Gigena summarizing a resource [Ep 5 · 3:09](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=189)
- The study gathered 262 patients with isolated solid organ injuries, grades 1 to 3. — Cecilia Gigena summarizing a resource [Ep 5 · 3:19](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=199)
- 148 patients had solid organ injuries grades 1 or 2, and none of them required an acute intervention. — Cecilia Gigena summarizing a resource [Ep 5 · 3:26](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=206)
- Of 114 patients with grade 3 solid organ injuries, only 3 patients required an acute intervention. — Cecilia Gigena summarizing a resource [Ep 5 · 3:34](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=214)
- Isolated solid organ injuries after blunt abdominal trauma, grades 1 or 2, can be discharged from the ED. — Cecilia Gigena summarizing a resource [Ep 5 · 3:44](https://origin-library.globalcastmd.com/watch/quick-literature-updates-episode-15-7927?t=224)

## Changelog
- Sep 17: 2 items added automatically
- Sep 7: 3 items added automatically

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