Publications by authors named "Kelly Gatt"

5 Publications

  • Page 1 of 1

The use of 5-aminosalicylate for patients with Crohn's disease in a prospective European inception cohort with 5 years follow-up - an Epi-IBD study.

United European Gastroenterol J 2020 10 26;8(8):949-960. Epub 2020 Jul 26.

Hull University Teaching Hospitals NHS Trust, Hull, UK.

Background: The lack of scientific evidence regarding the effectiveness of 5-aminosalicylate in patients with Crohn's disease is in sharp contrast to its widespread use in clinical practice.

Aims: The aim of the study was to investigate the use of 5-aminosalicylate in patients with Crohn's disease as well as the disease course of a subgroup of patients who were treated with 5-aminosalicylate as maintenance monotherapy during the first year of disease.

Methods: In a European community-based inception cohort, 488 patients with Crohn's disease were followed from the time of their diagnosis. Information on clinical data, demographics, disease activity, medical therapy and rates of surgery, cancers and deaths was collected prospectively. Patient management was left to the discretion of the treating gastroenterologists.

Results: Overall, 292 (60%) patients with Crohn's disease received 5-aminosalicylate period during follow-up for a median duration of 28 months (interquartile range 6-60). Of these, 78 (16%) patients received 5-aminosalicylate monotherapy during the first year following diagnosis. Patients who received monotherapy with 5-aminosalicylate experienced a mild disease course with only nine (12%) who required hospitalization, surgery, or developed stricturing or penetrating disease, and most never needed more intensive therapy. The remaining 214 patients were treated with 5-aminosalicylate as the first maintenance drug although most eventually needed to step up to other treatments including immunomodulators (75 (35%)), biological therapy (49 (23%)) or surgery (38 (18%)).

Conclusion: In this European community-based inception cohort of unselected Crohn's disease patients, 5-aminosalicylate was commonly used. A substantial group of these patients experienced a quiescent disease course without need of additional treatment during follow-up. Therefore, despite the controversy regarding the efficacy of 5-aminosalicylate in Crohn's disease, its use seems to result in a satisfying disease course for both patients and physicians.
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http://dx.doi.org/10.1177/2050640620945949DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707880PMC
October 2020

Multiorganism sepsis secondary to enteric aorto-iliac graft fistulation.

BMJ Case Rep 2020 May 27;13(5). Epub 2020 May 27.

Gastroenterology, Mater Dei Hospital, Msida, Malta.

A woman in her early 70s with a history of infrarenal aortic endarterectomy and aorto-bi-iliac Dacron grafting 4 years before presented with recurrent septicaemias, occasionally polymicrobial and caused by a wide variety of organisms. After treatment for her sixth bacteraemia, enteroscopy showed a small area of ulceration with synthetic graft material protruding into the distal duodenal lumen. This was followed by positron emission tomography/CT, which showed mild increase in tracer uptake in the same region localised by a previously placed haemoclip. Despite urgent vascular surgery to repair the duodenal fistulas and replace the grafts, the patient passed away. Our patient posed a diagnostic challenge due to repeated imaging studies of different modalities and routine endoscopy failing to show a source of sepsis. It is unique due to the variety of organisms cultured as a result of the enteric fistula.
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http://dx.doi.org/10.1136/bcr-2020-234936DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7259857PMC
May 2020

Kounis syndrome uncovers severe coronary disease: an unusual case of acute coronary syndrome secondary to allergic coronary vasospasm.

BMJ Case Rep 2019 Dec 23;12(12). Epub 2019 Dec 23.

Department of Medicine, Mater Dei Hospital, Msida, Malta.

Acute coronary syndrome occurring during the course of a type I hypersensitivity reaction constitutes Kounis syndrome. We report a case of a 64-year-old man who presented with a non-ST elevation myocardial infarction and peripheral blood eosinophilia. He had rhinitis and constitutional symptoms for several days prior to presentation. Blood investigations revealed moderate eosinophilia and elevated IgE levels. A cardiac MRI showed generalised oedema with a subtle wall motion abnormality in basal inferior/inferolateral wall, and subendocardial high signal on late gadolinium enhancement suggesting a localised myocardial infarction. A coronary angiogram then revealed triple vessel disease. A diagnosis of Kounis syndrome was made. Within days of starting appropriate treatment, the patient's eosinophil count returned to normal with improvement of clinical picture.
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http://dx.doi.org/10.1136/bcr-2019-232472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936473PMC
December 2019

Superimposed esophageal pemphigus vulgaris and herpes simplex infection.

Ann Gastroenterol 2019 Nov-Dec;32(6):654. Epub 2019 Jul 25.

Department of Gastroenterology (Kelly Gatt, Luca Conti, Pierre Ellul).

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http://dx.doi.org/10.20524/aog.2019.0408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826074PMC
July 2019

Infective complications of midline destruction in a cocaine user.

BMJ Case Rep 2019 Jul 26;12(7). Epub 2019 Jul 26.

Infectious Diseases, Mater Dei Hospital, Msida, Malta.

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http://dx.doi.org/10.1136/bcr-2019-231743DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6663203PMC
July 2019