关键词： Clostridioides   Clostridium difficile   Resistotype   Ulcerative colitis   Reinfection   Vancomycin  

摘要： Two-year Clostridioides (Clostridium) difficile recurrences in a boy with ulcerative colitis are described. Isolates were toxin A/B positive and nonhypervirulent, and resistotypes of 2017 isolates differed from those in 2016, suggesting a reinfection, later confirmed by multilocus sequence typing (ST49 and ST92, respectively). Resistotypes may show the need of genotypic analysis. (C) 2019 Elsevier Inc. All rights reserved.

关键词： Crohn's disease   Ulcerative colitis   Malignancy   Carcinoma  

摘要： BackgroundCurrent guidelines recommend starting colorectal cancer (CRC) surveillance 8-10years after inflammatory bowel disease (IBD) onset. Recent studies report that the incidence of CRC within 8-10years of IBD onset (i.e., early CRC) ranges from 12 to 42%.AimsTo describe the current prevalence of early CRC in a tertiary care center IBD cohort with CRC and to identify associated risk *** performed a single-center observational study of IBD patients diagnosed with CRC from 2005 to 2015. We compared characteristics of patients with early CRC (diagnosis of CRC within 8years of initial IBD onset) to those with CRC diagnosed later in their IBD ***-three patients met inclusion criteria. Eleven (11.8%) patients developed CRC within 8years of initial IBD onset. On multivariable logistic regression, age greater than 28 at IBD onset (adjusted OR 12.0;95% CI 2.30, 62.75) and tobacco use (adjusted OR 8.52;95% CI 1.38, 52.82) were significant predictors of early CRC. A validation cohort confirmed calibration and discrimination of the *** out of every eight IBD patients with CRC developed their malignancy prior to the currently recommended timeframe for the initiation of surveillance colonoscopy. IBD onset at 28years or older and tobacco use were identified as predictors of early CRC. Early CRC should be considered in discussions of cancer surveillance in this population. Prospective cohort studies are necessary to further analyze the impact of early CRC in IBD.

关键词： Inflammatory bowel disease   Youth   Anxiety   Depression   Health-related quality of life  

摘要： Background In youth with inflammatory bowel disease (IBD), health-related quality of life (HRQOL) has been shown to be affected by individual disease factors and specific psychological factors. The innovative aim of this study is to examine the combined impact of psychological factors (illness perceptions, cognitive coping, anxiety, and depression) on HRQOL, over and above the associations of demographic and disease factors with HRQOL in youth with IBD. Method Data on clinical disease activity, illness perceptions, cognitive coping, anxiety, depression, and HRQOL were prospectively collected in 262 consecutive youth (age 10-20, 46.6% male) with confirmed IBD. Multiple linear regression analyses tested the associations of demographic, disease, and psychological variables with HRQOL in separate groups for Crohn's disease (CD;N = 147) and ulcerative colitis and IBD unclassified (UC/IBD-U;N = 115), using age-specific validated instruments. Results In both disease groups, more negative illness perceptions (beta = -.412;beta = -.438, p < .001) and more depression (beta = -.454;beta = -.279, p < .001) were related to lower HRQOL. In the UC/IBD-U group, more anxiety was related to lower HRQOL (beta = -.201, p = .001). The model with the psychological variables explained a large and significant amount of variance in both groups: 74% and 83%, respectively (p < .001). Conclusion In 10-20-year-old IBD patients, negative illness perceptions and depression were significantly and more strongly associated with lower HRQOL than demographic and disease factors. Thus, it is important to integrate psychological factors in the treatment for IBD patients. To improve HRQOL in young IBD patients, psychological interventions should be targeted at negative illness perceptions and depression.

关键词： cell-free nucleic acids   circulating nucleic acids   cell-free DNAs   cell-free RNAs   exosomes   inflammatory bowel disease   neutrophil extracellular traps   NETosis  

摘要： Cell-free nucleic acids (cfNAs) are defined as any nucleic acids that are present outside the cell. They represent valuable biomarkers in various diagnostic protocols such as prenatal diagnostics, the detection of cancer, and cardiovascular or autoimmune diseases. However, in the current literature, little is known about their implication in inflammatory bowel disease (IBD). IBD is a group of multifactorial, autoimmune, and debilitating diseases with increasing incidence worldwide. Despite extensive research, their etiology and exact pathogenesis is still unclear. Since cfNAs were observed in other autoimmune diseases and appear to be relevant in inflammatory processes, their role in the pathogenesis of IBD has also been suggested. This review provides a summary of knowledge from the available literature about cfDNA and cfRNA and the structures involving them such as exosomes and neutrophil extracellular traps and their association with IBD. Current studies showed the promise of cfNAs in the management of IBD not only as biomarkers distinguishing patients from healthy people and differentiating active from inactive disease state, but also as a potential therapeutic target. However, the detailed biological characteristics of cfNAs need to be fully elucidated in future experimental and clinical studies.

关键词： Diet   Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Relapse  

摘要： Background and aims: Individuals with inflammatory bowel disease (IBD) often hold strong beliefs on how diet impacts their disease. This study aimed to compare dietary intakes between IBD patients and individuals from the general population and to assess associations of dietary factors with relapse in patients with IBD. Methods: Patients with longstanding Crohn's disease and ulcerative colitis (n = 165) filled out food frequency questionnaires, as did individuals participating in a Dutch population-based study (controls) (n = 1469). Multivariable regression analyses were used to assess differences in habitual dietary intake between IBD patients and controls, and to estimate associations of dietary factors in patients in remission with the development of disease relapse at follow-up. Results: IBD patients had higher intakes of animal protein (3.50 g/d, 95% confidence interval (CI) 1.67 -5.34) and carbohydrate (10.1 g/d, 95% CI 5.23-14.9) than controls and lower intakes of (unsaturated) fat (-3.53 g/d, 95% CI -5.57- -1.50), dietary fiber (-2.19 g/d, 95% CI -3.05- -1.32) and alcohol (-0.84 g/d, 95% CI -1.46- -0.22). This was explained by a higher consumption of carbonated beverages, meat and poultry and lower consumption of fruit, vegetables and dairy products (except cheese) by IBD patients compared with controls. Several dietary factors, particularly (saturated) fat and fiber, appeared to be associated with risk of relapse. Conclusions: IBD patients had higher dietary intakes of (animal) protein and carbohydrate and lower intakes of (unsaturated) fat, dietary fiber and alcohol compared with a general Dutch population. The results further underscore that dietary factors may have a role in disease course. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

关键词： Administration   Costs and cost analysis   Denmark   Intravenous   Iron   Iron deficiency anemia  

关键词： Iron-Deficiency Anemia   letter   Inflammatory Bowel Diseases   Denmark   Intestinal Diseases   ferric carboxymaltose   Economic Evaluation   Patients  

摘要： Background Anti-TNF alpha agents have revolutionised management of chronic inflammatory diseases. Paradoxically, these agents might provoke development of de novo autoimmune diseases. Aim To examine whether there is an increased risk of developing Crohn's disease (CD) and ulcerative colitis (UC) while under treatment with anti-TNF alpha agents for diseases other than inflammatory bowel disease (IBD). Methods A nationwide cohort study, based on Danish health registries, of all patients who utilised anti-TNF alpha agents for non-IBD indications. Included were patients, who had diseases for which anti-TNF alpha agent is indicated (rheumatoid arthritis, psoriasis/psoriatic arthritis, ankylosing spondylitis, others). The observation period for development of de novo IBD started from 2004. Exposed patients had received at least one dose of anti-TNF alpha. Results In total 17 018 individuals with autoimmune diseases were exposed to anti-TNF alpha (the vast majority had infliximab, etanercept and adalimumab), and 63 308 individuals were not. Patients treated with etanercept had an increased risk of being diagnosed with CD and UC while under treatment, adjusted hazard ratio 2.0 [95% CI: 1.4-2.8] and 2.0 [95% CI: 1.5-2.8], respectively. The corresponding hazards ratios for infliximab were 1.3 [95% CI: 0.8-2.2] and 1.0 [95% CI:0.6-1.6], and for adalimumab 1.2 [95% CI: 0.8-1.8] and 0.6 [95% CI: 0.3-1.0]. Conclusions Patients treated for autoimmune diseases with anti-TNF alpha had an increased risk of being diagnosed with CD or UC while under treatment with etanercept. The nature of this association is uncertain. This finding has relevance to clinical care and insights into common mechanisms of the pathophysiology of these diseases.

关键词： inflammatory bowel disease   NLRP3 inflammasome   ulcerative colitis   Crohn's disease   inflammation   autophagy  

摘要： Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine, comprised of ulcerative colitis and Crohn's disease. Among the complicated pathogenic factors of IBD, the overaction of inflammatory and immune reaction serves as an important factor. Inflammasome is a form of innate immunity as well as inflammation. Among all kinds of inflammasomes, the NOD-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome is the most studied one, and has been revealed to be involved in the pathogenesis and progression of IBD. Here, in this review, the association between the NLRP3 inflammasome and IBD will be discussed. Furthermore, several NLRP3 inflammasome inhibitors which have been demonstrated to be effective in the alleviation of IBD will be described in this review.