Publications by authors named "C Delaney"

777 Publications

Colonic Disease Recurrence following Proctectomy with End Colostomy for Anorectal Crohn's Disease.

Colorectal Dis 2021 Jun 22. Epub 2021 Jun 22.

Department of Surgery, Mount Sinai Hospital, University of Toronto, Canada.

Aim: In patients with anorectal Crohn's disease, it remains uncertain whether a total proctocolectomy with end ileostomy or proctectomy with end colostomy should be recommended due to the unknown rate of disease recurrence in the remaining colon.

Methods: A retrospective review of all patients with a known diagnosis of Crohn's disease who underwent a proctectomy with end colostomy for distal Crohn's disease between January 1, 2010 and January 1, 2019 at two IBD referral centers was conducted. Data collected included patient demographics, surgical variables at the time of proctectomy, and postoperative clinical, endoscopic and surgical recurrence rates.

Results: A total of 63 patients were included; the mean age was 47 years (SD 15 years) and 32 (50.8%) were female. The majority of patients underwent a proctectomy with end colostomy (n=56; 88.9%) while the remaining 7 patients (11.1%) underwent a proctectomy with end colostomy and concurrent ileocectomy. A total of 55 patients (87.3%) had proctitis, 51 (81%) had perianal fistulating disease, 34 (54%) had anal canal stenosis or ulceration. Most patients had medically refractory disease (n=54; 85.7%) versus neoplasia (n=9; 14.3%). The median length of long-term follow-up was 17.7 months (IQR: 4.72, 38.7 months). During that time, 14 (22.2%) experienced clinical recurrence, 10 of 34 evaluated (29.4%) had endoscopic recurrence, and 3 (4.76%) required a completion total abdominal colectomy for recurrent medically refractory disease in the colon.

Conclusion: Colonic recurrence remains low following proctectomy and descending colostomy suggesting this operative management strategy is reasonable in Crohn's patients with distal disease.
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http://dx.doi.org/10.1111/codi.15777DOI Listing
June 2021

Upgrading Your Surgical Skills Through Preceptorship.

J Am Coll Surg 2021 Jun 11. Epub 2021 Jun 11.

Division of Education, American College of Surgeons, Chicago, IL.

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http://dx.doi.org/10.1016/j.jamcollsurg.2021.04.034DOI Listing
June 2021

Evaluating Systemized Nomenclature of Medicine Clinical Terms Coverage of Complementary and Integrative Health Therapy Approaches Used Within Integrative Nursing, Health, and Medicine.

Comput Inform Nurs 2021 Jun 1. Epub 2021 Jun 1.

Author Affiliations: School of Nursing (Dr Austin, Mr Lu, and Drs Geiger-Simpson, Ringdahl, Pruinelli, Lindquist, Monsen, and Delaney) and Earl E. Bakken Center for Spiritualty and Healing (Drs Austin, Ringdahl, Lindquist, and Monsen), University of Minnesota, Minneapolis; and College of Nursing, University of Arizona, Tucson (Dr Koithan).

The use of complementary and integrative health therapy strategies for a wide variety of health conditions is increasing and is rapidly becoming mainstream. However, little is known about how or if complementary and integrative health therapies are represented in the EHR. Standardized terminologies provide an organizing structure for health information that enable EHR representation and support shareable and comparable data; which may contribute to increased understanding of which therapies are being used for whom and for what purposes. Use of standardized terminologies is recommended for interoperable clinical data to support sharable, comparable data to enable the use of complementary and integrative health therapies and to enable research on outcomes. In this study, complementary and integrative health therapy terms were extracted from multiple sources and organized using the National Center for Complementary and Integrative Health and former National Center for Complementary and Alternative Medicine classification structures. A total of 1209 complementary and integrative health therapy terms were extracted. After removing duplicates, the final term list was generated via expert consensus. The final list included 578 terms, and these terms were mapped to Systemized Nomenclature of Medicine Clinical Terms. Of the 578, approximately half (48.1%) were found within Systemized Nomenclature of Medicine Clinical Terms. Levels of specificity of terms differed between National Center for Complementary and Integrative Health and National Center for Complementary and Alternative Medicine classification structures and Systemized Nomenclature of Medicine Clinical Terms. Future studies should focus on the terms not mapped to Systemized Nomenclature of Medicine Clinical Terms (51.9%), to formally submit terms for inclusion in Systemized Nomenclature of Medicine Clinical Terms, toward leveraging the data generated by use of these terms to determine associations among treatments and outcomes.
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http://dx.doi.org/10.1097/CIN.0000000000000764DOI Listing
June 2021

Mechanical biofilm disruption causes microbial and immunological shifts in periodontitis patients.

Sci Rep 2021 May 7;11(1):9796. Epub 2021 May 7.

Oral Sciences, Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK.

Periodontitis is characterized by subgingival biofilm dysbiosis, inflammation and tissue destruction. Current treatment involves mechanical biofilm disruption known as non-surgical periodontal therapy (NSPT). This study sought to characterise the impact of treatment on microbial diversity and overall community, and the parallel impact on host inflammation in the oral cavity. Fourty-two periodontitis patients were included in this study, with periodontal clinical parameters, subgingival plaque and saliva samples collected at baseline and 90 days after treatment. Salivary cytokines were quantified, and subgingival plaque was analysed using 16S rRNA sequencing. After treatment, there were marked health-associated alterations in microbial composition and diversity, including differential abundance of 42 genera and 61 species. These changes were accompanied by substantial clinical improvement (pockets ≥ 5 mm, 27.50% to 9.00%, p < 0.001) and a decrease in salivary IL-1β (p < 0.001)-a putative marker of periodontal inflammation. Despite significant reductions in disease associated anaerobes, several genera (Fusobacterium, Prevotella, Tanenerella, Treponema) remained present and formed a distinct subnetwork associated with residual disease. Collectively, this study shows that current periodontal treatment results in partial restoration of a healthy microbial ecosystem, but features of biofilm dysbiosis and host inflammation remain in some patients, which were surprisingly independent of clinical response.
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http://dx.doi.org/10.1038/s41598-021-89002-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105330PMC
May 2021

Nursing Big Data Science.

J Nurs Scholarsh 2021 05 5;53(3):259-261. Epub 2021 May 5.

University of Minnesota School of Nursing, Minneapolis, MN.

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http://dx.doi.org/10.1111/jnu.12664DOI Listing
May 2021