Michael A. Kamm

University of Melbourne

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Myopathy of internal anal sphincter with polyglucosan inclusions

The Journal of Pathology (1990)

Joanne E. Martin Michael Swash Michael A. Kamm K. Mather E. L. Cox

Abstract In two members of an affected family with a hereditary syndrome of proctalgia fugax and constipation, a hypertro‐phied internal anal sphincter was found with histological features suggesting a myopathy of this muscle. In these two patients, and in an unrelated patient with a similar clinical syndrome, smooth muscle fibres of the internal anal sphincter showed numerous vacuoles, many of which contained ovoid inclusion bodies. The structural features and histochemical reactions of the inclusion bodies were consistent with a polyglucosan composition. Histological examination of the internal anal sphincter may reveal smooth muscle abnormalities in functional bowel disorders.

Internal anal sphincter

Anal sphincter

Urethral sphincter

External anal sphincter

10.1002/path.1711610308

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Citations (32)

Disability in inflammatory bowel diseases: Developing ICF core sets for patients with inflammatory bowel diseases based on the international classification of functioning, disability, and health

Inflammatory Bowel Diseases (2009)

Laurent Peyrin‐Biroulet Alarcos Cieza William J. Sandborn Nenad Kostanjsek Michael A. Kamm

The inflammatory bowel diseases (IBDs) are associated with a reduced quality of life. The impact of IBD on disability remains largely unknown. With the International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization (WHO), we can now rely on a globally agreed-upon framework and system for classifying the typical spectrum of problems in the functioning of persons with a specific disease given the environmental context in which they live. The aim of this article is to outline the methods to be utilized to develop ICF Core Sets for IBD. The project is a cooperation between the ICF Research Branch of the WHO, the IPNIC group, the International Society of Physical Rehabilitation Medicine (ISPRM), and the International Organization on Inflammatory Bowel Disease (IOIBD). Four worldwide studies will be conducted from 2009 to 2010. ICF categories relevant for IBD will be identified by systematic literature review of outcomes and measures used in IBD research, semistructured patient interviews, Internet-based expert survey, and cross-sectional study for clinical applicability. The final definition of ICF Core Sets for IBD will be determined at a Consensus Conference. Field testing will then be used to validate the ICF Core Sets. ICF Core Sets are being designed to provide useful standards for research and clinical practice. This tool will enable research that improves understanding of functioning, disability, and health in IBD, and may lead to interventions to improve and maintain functioning and minimize disability among IBD patients throughout the world.

Inflammatory Bowel Diseases

10.1002/ibd.21010

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Citations (92)

Corrigendum: The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD With the European Crohn's and Colitis Organization: When to Start, When to Stop, Which Drug to Choose, and How to Predict Response?

The American Journal of Gastroenterology (2011)

Geert R. D’Haens Remo Panaccione Peter Higgins Séverine Vermeire Miquel A. Gassull

D'Haens, Geert R; Panaccione, Remo; Higgins, Peter D R; Vermeire, Severine; Gassull, Miquel; Chowers, Yehuda; Hanauer, Stephen B; Herfarth, Hans; Hommes, Daan W; Kamm, Michael; Löfberg, Robert; Quary, A; Sands, Bruce; Sood, A; Watermayer, G; Lashner, Bret; Lémann, Marc; Plevy, Scott; Reinisch, Walter; Schreiber, Stefan; Siegel, Corey; Targan, Stephen; Watanabe, M; Feagan, Brian; Sandborn, William J; Colombel, Jean Frédéric; Travis, Simon

Statement (logic)

Position statement

10.1038/ajg.2010.484

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Citations (12)

Das Konzept der Bioraffinerie – Produktion von Plattformchemikalien und Finalprodukten

Chemie Ingenieur Technik (2007)

Birgit Kamm Michael A. Kamm

Abstract Die Nutzung von nachwachsenden Rohstoffen wird in den nächsten Jahren und Jahrzehnten aus vielen Gründen an Bedeutung gewinnen und die nationalen Volkswirtschaften und globale Weltwirtschaft gravierend verändern. Die partielle oder gar vollständige Umstellung ganzer Volkswirtschaften auf erneuerbare Rohstoffe erfordert völlig neue Ansätze in Forschung, Entwicklung und Produktion. Die Entwicklung von Bioraffinerien stellt dabei den Schlüssel für eine integrierte Produktion von Nahrungsmitteln, Futtermitteln, Chemikalien, Materialien, Gebrauchsgütern und Kraftstoffen der Zukunft dar. Bioraffinerien kombinieren die notwendigen Technologien von biogenen Rohstoffen mit denen der Plattformchemikalien und Finalprodukte. Das Hauptaugenmerk ist auf die Verknüpfung von biotechnologischer und chemischer Stoffwandlung und die Entwicklung der Bioraffineriesysteme: die Lignocellulose‐Feedstock‐Bioraffinerie, die Getreide‐Ganzpflanzen‐Bioraffinerie, die Grüne Bioraffinerie, das Zwei‐Plattform‐Konzept sowie die Plattformchemikalien gerichtet.

10.1002/cite.200700005

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Citations (35)

Development of the Lémann Index to Assess Digestive Tract Damage in Patients With Crohn's Disease

Gastroenterology (2014)

Benjamin Pariente Jean-Yves Mary Silvio Danese Yehuda Chowers Peter De Cruz

Anus

10.1053/j.gastro.2014.09.015

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Citations (288)

Population Density and Risk of Inflammatory Bowel Disease: A Prospective Population-Based Study in 13 Countries or Regions in Asia-Pacific

The American Journal of Gastroenterology (2018)

Siew C. Ng Gilaad G. Kaplan Whitney Tang Rupa Banerjee Bhargavi Adigopula

Living in an urban environment may increase the risk of developing inflammatory bowel disease (IBD). It is unclear if this observation is seen globally. We conducted a population-based study to assess the relationship between urbanization and incidence of IBD in the Asia-Pacific region.Newly diagnosed IBD cases between 2011 and 2013 from 13 countries or regions in Asia-Pacific were included. Incidence was calculated with 95% confidence interval (CI) and pooled using random-effects model. Meta-regression analysis was used to assess incidence rates and their association with population density, latitude, and longitude.We identified 1175 ulcerative colitis (UC), 656 Crohn's disease (CD), and 37 IBD undetermined (IBD-U). Mean annual IBD incidence per 100 000 was 1.50 (95% CI: 1.43-1.57). India (9.31; 95% CI: 8.38-10.31) and China (3.64; 95% CI, 2.97-4.42) had the highest IBD incidence in Asia. Incidence of overall IBD (incidence rate ratio [IRR]: 2.19; 95% CI: 1.01-4.76]) and CD (IRR: 3.28; 95% CI: 1.83-9.12) was higher across 19 areas of Asia with a higher population density. In China, incidence of IBD (IRR: 2.37; 95% CI: 1.10-5.16) and UC (IRR: 2.63; 95% CI: 1.2-5.8) was positively associated with gross domestic product. A south-to-north disease gradient (IRR: 0.94; 95% CI: 0.91-0.98) was observed for IBD incidence and a west-to-east gradient (IRR: 1.14; 95% CI: 1.05-1.24) was observed for CD incidence in China. This study received IRB approval.Regions in Asia with a high population density had a higher CD and UC incidence. Coastal areas within China had higher IBD incidence. With increasing urbanization and a shift from rural areas to cities, disease incidence may continue to climb in Asia.

Rate ratio

10.1038/s41395-018-0233-2

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Citations (206)

OC-069 Efficacy of 12-week treatment with prucalopride (resolor) in patients with chronic constipation: combined results of three randomised, double-blind, placebo-controlled phase 3 trials

Gut (2010)

Michael A. Kamm Michael Camilleri René Kerstens Renate Specht Gryp Lieve Vandeplassche

Introduction

Treatment of severe chronic constipation (CC) is suboptimal. This study evaluates the combined efficacy results of prucalopride (PRU) in three identical pivotal, randomised, placebo (PLA)-controlled trials. The objective of each trial was to compare the efficacy and safety of a 12 week once daily treatment of 2 mg or 4 mg PRU with PLA in CC.

Methods

All three trials were of identical design with three parallel treatment groups: PLA, PRU 2 mg and PRU 4 mg. Treatment phase followed a 2-week run-in. Two trials were executed in the US and one in Europe, Canada, Australia and South Africa. The main inclusion criterion was ≤2 spontaneous complete bowel movements (SCBM) per week in combination with straining, sensation of incomplete evacuation or hard stools, at least 25% of the time. The primary efficacy parameter was the percentage of patients with an average of ≥3 SCBM/week over the 12-week treatment period. The two main secondary endpoints were the percentage of patients with an average increase of ≥1 SCBM/week and the percentage of patients with an improvement ≥1 on the satisfaction subscale of the validated quality of life instrument, PAC-QOL. Other endpoints were based on number of (S) BM, time to first BM, stool consistency, straining and patient-reported global evaluation of severity of constipation. Data analysis followed intent-to-treat (ITT) principles.

Results

Total 1924 ITT patients, 89% female, average age 47 years, average duration of constipation ∼20 years, prior treatments rated inadequate for 83%. Main Complaints: Infrequent defecation (30%), abdominal bloating (24%), abdominal pain (14%), during 2-week run-in ∼57% of the patients had no SCBM, and average weekly number of SCBM was 0.47. In each individual trial the results for the primary endpoint and secondary endpoints were significantly better for both PRU groups compared to PLA. For the three trials combined, the percentage of patients with an average of ≥3 SCBM per week over the 12 week treatment period (primary endpoint) were 11.3%, 23.6% end 24.7% for PLA, PRU 2 mg and PRU 4 mg, respectively (both p<0.001 PRU vs PLA); similar for subjects who rated their previous therapy as inadequate. Response was highest in week 1 of treatment and stable over the remaining 11 weeks. PRU 2 mg and 4 mg consistently showed significant differences with PLA on all other secondary endpoints. Except for higher incidences of diarrhoea, nausea and headache on first day of treatment, PRU was well tolerated.

Conclusion

Both 2 and 4 mg PRU significantly improve bowel function and associated symptoms in CC compared to PLA. Results are reflected consistently in all observed efficacy parameters, including QOL.

Clinical endpoint

10.1136/gut.2009.208975q

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Citations (0)

Treatment of impaired defecation associated with rectocele by behavioral retraining (biofeedback)

Diseases of the Colon & Rectum (2000)

Toshiki Mimura Amanda Roy Julie B. Storrie Michael A. Kamm

Large rectoceles have been associated with symptoms of impaired rectal evacuation, often leading to rectocele repair. However, these symptoms, or the anatomic abnormality, may be caused, at least in part, by a primary disturbance of rectoanal coordination. This study aimed to determine the efficacy of biofeedback therapy in such patients.Thirty-two female patients (median age, 52 years) complaining of impaired rectal evacuation and with a rectocele greater than 2 cm at proctography were evaluated by structured questionnaire before, immediately after treatment, and at follow-up. Physiologic and proctographic findings were related to outcome.Immediate results were available in 32 patients and medium-term follow-up (median, 10; range, 2-30 months) in 25 patients. At follow-up 14 (56 percent) patients felt a little and 4 (16 percent) patients felt major improvement in symptoms, including 3 (12 percent) with complete symptom relief. Immediately after biofeedback there was a modest reduction in need to strain (from 72 to 50 percent), feeling of incomplete evacuation (from 78 to 59 percent), need to assist defecation digitally (from 84 to 63 percent), and need to use an evacuant (from 47 to 28 percent), and this was maintained at follow-up. Bowel frequency was significantly normalized at follow-up (P = 0.02). Pretreatment presence of symptoms of digitally assisting defecation, pelvic floor incoordination, and proctographic rectocele size and contrast trapping, did not predict outcome.Behavioral therapy, including biofeedback, leads to major symptom relief in a minority, and partial symptom relief in a majority, of patients with a feeling of impaired defecation and the presence of a large rectocele. Residual symptoms are common. Biofeedback may be a reasonable first-line treatment for such patients.

Biofeedback

Defecography

Obstructed defecation

Colorectal Surgery

Abnormality

Anorectal manometry

Symptom relief

10.1007/bf02237434

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Citations (70)

Review article: 5‐aminosalicylate formulations for the treatment of ulcerative colitis – methods of comparing release rates and delivery of 5‐aminosalicylate to the colonic mucosa

Alimentary Pharmacology & Therapeutics (2008)

Gary R. Lichtenstein Michael A. Kamm

Summary Background Many oral 5‐aminosalicylic acid (5‐ASA) formulations are designed to maximize 5‐ASA release in the colon where it acts topically on the colonic mucosa. Delayed‐release formulations and azo‐prodrugs minimize 5‐ASA absorption in the upper gastrointestinal (GI) tract. Aims To review methods for assessing 5‐ASA release and colonic distribution from oral formulations, and the potential use of this information for guiding clinical decisions. Methods PubMed and recent conference abstracts were searched for articles describing techniques used to assess 5‐ASA release from ulcerative colitis (UC) therapies. Results In‐vitro GI models, although unable to simulate more complex aspects of GI physiology, can provide useful data on 5‐ASA release kinetics and bioaccessibility. Gamma‐scintigraphy is useful for investigating GI disintegration of different formulations, but may not accurately reflect 5‐ASA distribution. Plasma pharmacokinetic studies provide data on systemic exposure, but not on colonic distribution or mucosal uptake. Mucosal biopsies provide direct evidence of colonic distribution and may predict clinical efficacy, but must be interpreted cautiously because of considerable inter‐subject variability and other confounding factors. Conclusion While assessment of 5‐ASA release is important, limitations of individual measurement techniques mean that randomized clinical studies in UC patients remain the best guide for dosing and treatment regimen decisions.

Mesalazine

Regimen

10.1111/j.1365-2036.2008.03751.x

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Citations (71)

A winking anus may signify spinal injury

Gut (2001)

A. J. Malouf Michael A. Kamm

Case report— A 41 year old woman was referred for assessment of worsening bladder and bowel dysfunction. At the age of 17 years she had suffered a traumatic fracture-subluxation of T12–L1 following a trampoline accident in which she fell heavily on to her back. She immediately lost sensation below the waist but this returned over several days. Following eight weeks of bed rest she gradually regained the ability to walk. She subsequently had no neurological deficit in her legs. Since the accident she had experienced bladder and bowel dysfunction. She experienced urinary frequency, urgency, urge incontinence, and episodes of spontaneous bladder emptying without warning. There had been no stress incontinence. Urodynamic studies showed a small capacity bladder of 257 ml but good voiding and minimal residual volume (30 ml). She did however have marked urgency at 150 ml. From a gastrointestinal point of view, she developed constipation …

Anus

Spinal injury

10.1136/gut.48.5.728

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Citations (0)