关键词： Immunization   Measles   Mumps   Rubella   Inflammatory bowel disease   Immunity  

摘要： BackgroundThe Advisory Committee on Immunization Practices (ACIP) recommends using the immunization record and not serologic testing to determine immunity against measles and rubella in the general population, due to potential false negatives. However, it is unknown whether the immune response is less durable among patients who are *** primary aim of this study was to evaluate sustained vaccine-induced measles, mumps, and rubella (MMR) antibody concentrations in immunosuppressed patients with inflammatory bowel disease (IBD).MethodsWe performed a cross-sectional study to compare antibody concentrations following the two-dose (MMR) vaccine among 46 patients with IBD and 20 healthy controls (HC). Three IBD groups stratified by the immunosuppressive regimen that preceded study entry for at least 3 months: (1) thiopurine monotherapy, (2) anti-TNF monotherapy, or (3) combination therapy (anti-TNF agent combined with an immunomodulator) were *** subjects had measurable antibody concentrations to the three vaccine viruses. Age and time since receipt of MMR series were similar in both groups. There were no difference in the antibody concentration of measles (IBD 667mIU/ml vs HC 744mIU/ml;p=0.45), mumps (IBD 339EU/ml vs HC 402EU/ml;p=0.62), or rubella (IBD 25mIU/ml vs HC 62mIU/ml;p=0.11) among the groups. No differences in antibody concentrations were found among the IBD treatment *** patients with IBD have sustained antibody concentrations comparable to healthy controls. Thus, gastroenterologist should follow the ACIP recommendations and use the immunization record when available to determine immunity to measles and rubella in patients with *** Trials Registry # NCT02434133.

关键词： genetic susceptibility   Crohn Disease   microbiome   Intestinal Mucosa   Western Europe   Microbes   Medical Education   Inflammatory Disorder   Genome-Wide Association Study   Intestinal Diseases   innate immunity  

摘要： Inflammatory bowel diseases (IBDs), represented by Crohn disease and ulcerative colitis, are associated with major morbidity in Western countries and with increasing incidence in the developing world. Although analysis of the genome of patients with IBD, especially through genome-wide association studies, has unraveled multiple pathways involved in IBD pathogenesis, only part of IBD heritability has been explained by genetic studies. This finding has revealed that environmental factors also play a major role in promoting intestinal inflammation, mostly through their effects in the composition of the microbiome. However, in order for microbial dysbiosis to result in uncontrolled intestinal inflammation, the intestinal barrier formed by intestinal epithelial cells and the innate immune system should also be compromised. Finally, activation of the immune system depends on the working balance between effector and regulatory cells present in the intestinal mucosa, which have also been found to be dysregulated in this patient population. Therefore, IBD pathogenesis is a result of the interplay of genetic susceptibility and environmental impact on the microbiome that through a weakened intestinal barrier will lead to inappropriate intestinal immune activation. In this article, we will review the mechanisms proposed to cause IBD from the genetic, environmental, intestinal barrier, and immunologic perspectives. (C) 2018 Mayo Foundation for Medical Education and Research

摘要： The article "Fidaxomicin for the treatment of Clostridium difficile infection (CDI) in at-risk patients with inflammatory bowel disease, fulminant CDI, renal impairment or hepatic impairment: a retrospective study of routine clinical use (ANEMONE)", written by M.J.G.T. Vehreschild et al., was originally published at Springerlink on 11 August 2018 without open access.

关键词： IBD   Mindfulness   Systematic review  

摘要： Background: Mindfulness interventions are increasingly used as a part of integrated treatment in inflammatory bowel disease (IBD) but there are limited data and a lack of consensus regarding effectiveness. Objectives: We explored the efficacy of mindfulness interventions compared to treatment as usual (TAU), or other psychotherapeutic interventions, in treating physical and psychosocial symptoms associated with IBD. Methods: We conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs). We included a broad range of mindfulness interventions including mindfulness-based interventions and yoga, with no restrictions on date of publication, participants' age, language or publication type. We searched the following electronic databases: MEDLINE, EMBASE, PsycINFO, CINAHL and WHO ICTRP database. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines in conducting the review. Results: We included eight studies in the meta-analysis. Mindfulness interventions showed a statistically significant effect on stress in both the short(SMD = -0.48;95%CI:-0.97, 0.00;P =.05), and long term (SMD = -0.55;95%CI:-0.78,-0.32;P <.00001), significant long term effects on depression (SMD =-0.36;95%CI:-0.66, -0.07;P =.02) and quality of life (SMD = 0.38;95%CI:0.08, 0.68;P =.01),and small but not statistically significant improvements in anxiety (SMD = -0.27;95%CI:-0.65, 0.11;P =.16).Effects on physical outcomes were equivocal and not statistically significant. Conclusions: Mindfulness interventions are effective in reducing stress and depression and improving quality of life and anxiety, but do not lead to significant improvements in the physical symptoms of IBD. Further research involving IBD-tailored interventions and more rigorously designed trials is warranted.

关键词： Crohn disease   Patient-reported outcome   Quality of life   Ulcerative colitis  

摘要： Aim We evaluated how well medical staff or parents understood patients with inflammatory bowel disease (IBD) by comparing their evaluation of the patients' quality of life (QoL) with the patients' self-reported QoL. Methods This study was carried out at Severance Children's Hospital in Seoul, Korea, in 2017. The children with IBD were recruited from August 2017 to December 2017, and they had a mean age of 16.4 (range 9.3-18.9) years. We asked the 64 children (38 boys), 58 mothers, 16 fathers, three physicians and one IBD nurse to answer the IMPACT-III questionnaire, which measures QoL, and compared the scores. Results The intraclass correlation coefficient of the total IMPACT-III score was highest for the patient and their father (0.824) and then for the patient and their mother (0.689), physician (0.625) and IBD nurse (0.499). Parents and medical staff thought the patients' QoL was lower than the patients themselves. The differences in the IMPACT-III scores of the patients were -10.09 +/- 17.86 for physicians, -9.87 +/- 15.80 for mothers, -5.72 +/- 17.04 for nurses and -3.81 +/- 11.82 for fathers. Conclusion Parents and medical staff showed some correlation with the QoL documented by adolescent IBD patients, but tended to underestimate the levels.

关键词： IBD   inflammatory bowel disease  

关键词： Inflammatory bowel disease   Crohn disease   Colitis   ulcerative   Schools   nursing  

摘要： Background/Aims: School nurses' knowledge of inflammatory bowel disease (IBD) has not been evaluated. We aimed to investigate school nurses' knowledge of IBD and determine whether education could improve this knowledge. Methods: School nurses were invited to complete self-reported questionnaires on IBD. Then, IBD specialists from tertiary referral hospitals provided a 60-minute lecture with educational brochures on two occasions, with a 3-month interval. Within 6 months after the educational interventions, school nurses were asked to complete the same IBD questionnaire via e-mail. Results: Among 101 school nurses who were invited to participate, 54 nurses (53.5%) who completed two consecutive questionnaires were included in this study (median age, 45 years;range, 25 to 59 years;100% female);11.1% and 7.4% of the study participants had no knowledge regarding ulcerative colitis and Crohn's disease, respectively. They had heard of IBD most frequently from doctors (33.3%), followed by internet sources (25.9%). After 6 months, the number of nurses who could explain IBD to students with over 30% confidence increased from 24 (44.5%) to 42 (77.8%) (p<0.001). Most nurses (81.5%) reported that the educational intervention was helpful for managing students with abdominal pain or diarrhea. The number of students who received IBD-related welfare services from the Daegu Metropolitan Office of Education doubled when compared with the corresponding number during the prior educational year. Conclusions: There is room for improvement in school nurses' knowledge of IBD. A systematic educational program on IBD should be implemented for these nurses.

关键词： Inflammatory bowel disease   Trichinella spiralis cysteine protease inhibitors   Immunoregulation   TNBS-induced colitis  

摘要： Inflammatory bowel disease (IBD) is a chronic autoimmune disease with a high recurrence rate. Ulcerative colitis (UC) and Crohn's disease (CD) are two types of IBD. At present, parasite-derived cysteine protease inhibitors have received extensive attention from researchers, and experiments have confirmed that these protease have an effect on certain autoimmune diseases. So we conducted experiments to investigate the effect of Trichinella spiralis cysteine protease inhibitors on TNBS-induced mouse CD models. In this experiment, 72 male BALB/c mice aged 6-8 weeks were randomly divided into two groups: prevention group and therapy group. The mice were sacrificed and harvested on the 7th day after the model was established to measure the changes of various indicators of colitis. The comparison of the TsCystatin + TNBS group with the PBS + TNBS group showed that the DAI score, MPO activity, and colonic macroscopic and microscopic damage significantly reduced, IFN-gamma significantly decreased, IL-4 expression increased, and NF-kappa B expression decreased. The percentage of CD4 + CD25 + Foxp3 + Treg and CD8 + CD28 - Treg in spleen, and the proportion of CD4+ /CD8 + Treg cells decreased. In the therapy group, we found no significant difference between the TNBS + PBS group and TNBS + TsCystatin group. Treatment with TsCystatin exerted a good intervention effect on the TNBS-induced mouse CD model. TsCystatin possibly induced a Th2-type immune response in the body, which balanced the Th1-type immune response induced by TNBS administration, thereby relieving colitis.