关键词： Crohn's disease   inflammatory bowel disease   psychological symptoms   self-management   social support   ulcerative colitis  

摘要： Purpose The purpose was to determine the relationship between social support, psychological symptoms and self-management behaviors among adults with inflammatory bowel disease (IBD) and examine the influence of types of social support and patient age. Design This was a systematic review. PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Communication and Mass Media Complete, and Communication s were searched. Publication dates were limited to January 2000 to August 2018. Methods The systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement, and quality was appraised based on the Critical Appraisal Skills Programme for cohort studies tool. The data were synthesized using narrative synthesis techniques. Findings The literature review yielded 458 results. Eight articles met inclusion criteria. Articles utilized a variety of conceptualizations of both social support and self-management behaviors, making comparisons difficult. Findings demonstrated an inverse relationship between social support and psychological symptoms, and in one study only when social support buffered high stress. Studies with significant relationships between age and self-management behaviors indicated that a lower age was associated with decreased self-management behaviors. Conclusions Social support has the potential to influence psychological symptoms among patients with IBD. Future research should examine types of social support (i.e., emotional, informational, and tangible support) and measure levels of received social support. Clinical Relevance Social support may serve as a modifiable factor to improve psychological symptoms among adults with IBD. Younger adults (age <40 years) may benefit from specialized interventions to address self-management behaviors.

关键词： Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Hepatitis B virus immunity   Hepatitis B virus vaccination failure   Booster   Revaccination  

摘要： BackgroundStudies have shown the efficacy of hepatitis B (HBV) vaccination in patients with inflammatory bowel disease (IBD) is impaired, but few data exist regarding the effectiveness of revaccination strategies following primary vaccination failure. Our aim was to analyze the association between administration of additional vaccine doses and hepatitis B surface antibody (HBsAb) *** is a retrospective cohort study. Inclusion criteria are as follows: age 18, diagnosis of Crohn's disease (CD) or ulcerative colitis (UC), inadequate HBsAb <10IU/L following initial HBV vaccination series, subsequent administration of 1-3 additional doses of HBV vaccine with follow-up serum HBsAb measurements. Patients were stratified into groups of 2 or 3 doses received. Primary outcome was achieving HBsAb>10IU/L. Outcomes were stratified by age or <40years. We performed logistic and linear multivariable regression analyses for categorical and continuous *** study cohort consists of (n=149) 54.4% women;77.9% white;72.6% with CD, with mean age: 46.2. Patients of all ages and age 40years, who received 3 additional doses of vaccine, were more likely to achieve seroprotective HBsAb levels than patients who received 1 or 2 doses (OR 1.77, P=0.01;OR 1.9, P=0.03, respectively, after adjusting for age, sex, race, immunosuppressive medication exposure, time between vaccine/titer).ConclusionsFollowing initial HBV vaccination failure, patients with IBD of all ages are more likely to develop seroprotective levels of HBsAb following 3 additional vaccine doses, rather than 1 or 2 alone. In patients who fail primary HBV vaccination, providers should consider a more aggressive revaccination strategy with an additional 3-dose series.

摘要： The article analyses randomized control trials (RCT) of dipeptidyl peptidase 4 inhibitors (DPP4i) and risk of inflammatory bowel disease (IBD) in type 2 diabetes (T2D) patients as of 2019. Results show that there is similarity in IBD risk between DPP4i users and control subjects, and that there is no link between DPP4i use and IBD risk among T2D patients. Also noted however, are possibilities of a weak linkage and the need for further studies on the subject.

关键词： immunogenicity   inflammatory bowel disease   treatment discontinuation   vedolizumab  

摘要： Background and Aim The pivotal GEMINI trials reported low immunogenicity of vedolizumab. However, anti-vedolizumab antibodies (AVA) are frequently underestimated because most assays are not drug-tolerant and unable to detect antidrug antibodies while there is drug in the circulation. This study aimed to explore which antidrug antibody assay is best suited to detect AVA and investigated immunogenicity of vedolizumab in inflammatory bowel disease (IBD) patients discontinuing vedolizumab therapy. Methods A drug-tolerant affinity capture elution (ACE) assay was developed for the measurement of AVA in the presence of vedolizumab and compared with the previously established drug-resistant and drug-sensitive assays. Vedolizumab and AVA were measured at week 6, at the last infusion, and 12-20 weeks after treatment discontinuation in a cohort of 40 vedolizumab-treated IBD patients who stopped treatment due to primary non-response, loss of response, or adverse events. Results The drug-tolerant ACE assay could detect AVA in samples that the drug-resistant and drug-sensitive assays were unable to. Using the drug-tolerant ACE assay, 3 (8%) out of 40 vedolizumab-treated IBD patients who discontinued therapy were AVA positive at week 6, whereas no AVA were detected at the last infusion nor after treatment discontinuation. Primary non-responders had numerically lower median vedolizumab concentrations at week 6 compared with patients with loss of response (20.3 vs 30.7 mu g/mL, respectively, P = 0.0570). Conclusions Immunogenicity of vedolizumab is not the driving force of treatment failure, and AVA do not increase upon treatment discontinuation in vedolizumab-treated IBD patients. Underexposure during induction might partially be responsible for primary non-response.

关键词： IBD   Crohn's disease   Ulcerative colitis   GWAS   Network analytics   Systems bioinformatics  

摘要： BackgroundCrohn's disease (CD) and Ulcerative colitis (UC) are the two main entities of inflammatory bowel disease (IBD). Previous works have identified more than 200 risk factors (including loci and signaling pathways) in populations of predominantly European ancestry. Our study was conducted on an extended population-specific cohort of 573 Greek IBD patients (364 CD and 209 UC) and 445 *** highlight the different genetic and functional background of IBD and its phenotypes, utilizing contemporary systems bioinformatics ***-associated SNPs, obtained via our own 89 loci IBD risk GWAS panel, were detected with the whole genome association analysis toolset PLINK. These SNPs were used as input for 2 novel and different pathway analysis methods to detect functional interactions. Specifically, PathwayConnector was used to create complementary networks of interacting pathways whereas;the online database of protein interactions STRING provided protein-protein association networks and their derived pathways. Network analyses metrics were employed to identify proteins with high significance and subsequently to rank the signaling pathways those participate *** reported complementary pathway and enriched protein-protein association networks reveal several novel and well-known key players, in the functional background of IBD like Toll-like receptor, TNF, Jak-STAT, PI3K-Akt, T cell receptor, Apoptosis, MAPK and B cell receptor signaling pathways. IBD subphenotypes are found to have distinct genetic and functional profiles which can contribute to their accurate identification and classification. As a secondary result we identify an extended network of diseases with common molecular background to ***'s burden on the quality of life of patients and intricate functional background presents us constantly with new challenges. Our data and methodology provide researchers with new insights to a specific population, but also, t

关键词： Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Incidence   Prevalence  

摘要： BackgroundInflammatory bowel disease (IBD) was once considered as a Western disease. However, recent epidemiological data showed an emerging trend of IBD cases in the Eastern Asia countries. Clinico-epidemiological data of IBD in Malaysia is scarce. This study aimed to address this *** analysis of ulcerative colitis (UC) and Crohn's disease (CD), diagnosed from January 1980 till June 2018 was conducted at our *** total of 413 IBD patients (281 UC, 132 CD) were identified. Mean crude incidence of IBD has increased steadily over the first three decades: 0.36 (1980-1989), 0.48 (1990-1999) and 0.63 per 100,000 person-years (2000-2009). In the 2010 to 2018 period, the mean crude incidence has doubled to 1.46 per 100,000 person-years. There was a significant rise in the incidence of CD, as depicted by reducing UC:CD ratio: 5:1 (1980-1989), 5:1 (1990-1999), 1.9:1 (2000-2009) and 1.7:1 (2010-2018). The prevalence rate of IBD, UC and CD, respectively were 23.0, 15.67 and 7.36 per 100,000 persons. Of all IBD patients, 61.5% (n=254) were males. When stratified according to ethnic group, the highest prevalence of IBD was among the Indians: 73.4 per 100,000 persons, followed by Malays: 24.8 per 100,000 persons and Chinese: 14.6 per 100,000 persons. The mean age of diagnosis was 41.2years for UC and 27.4years for CD. Majority were non-smokers (UC: 76.9%, CD: 70.5%). The diseases were classified as follows: UC;proctitis (9.2%), left-sided colitis (50.2%) and extensive colitis (40.6%), CD;isolated ileal (22.7%), colonic (28.8%), ileocolonic (47.7%) and upper gastrointestinal (0.8%). 12.9% of CD patients had concurrent perianal disease. Extra intestinal manifestations were observed more in CD (53.8%) as compared to UC (12%). Dysplasia and malignancy, on the other hand, occurred more in UC (4.3%, n=12) than in CD (0.8%, n=1). Over one quarter (27.3%) of CD patients and 3.6% of UC patients received biologic *** incidence of IBD is r

关键词： 肛肠手术   疼痛   优质护理  

摘要： 探讨优质护理服务对肛肠手术患者疼痛的影响。方法:30例肛肠手术患者,随机分为对照组与观察组,每组15例。对照组采用常规肛肠手术护理,观察组给予优质护理服务。比较两组患者护理效果。结果:观察组患者术后当天、术后1d、术后2d尿潴留比例均显著低于对照组,差异有统计学意义(P<0.05)。两组患者术中视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);两组患者术后VAS评分低于术中,且观察组患者术后VAS评分(2.1±1.5)分明显低于对照组的(3.5±1.3)分,差异有统计学意义(P<0.05)。观察组患者非常满意9例,基本满意5例,不满意1例,护理满意度为93.3%;对照组患者非常满意4例,基本满意5例,不满意6例,护理满意度为60.0%;观察组患者护理满意度显著高于对照组,差异具有统计学意义(P<0.05)。结论:优质护理服务可大幅度减轻肛肠手术患者的疼痛,减少尿潴留发生情况,提高护理满意度,值得临床推广应用。

关键词： 心理护理   肛肠疾病手术   应用效果  

摘要： 探讨心理护理在肛肠疾病手术患者中的应用效果观察。方法:选取从2018年11月至2019年3月行肛肠疾病手术患者70例,随机分为常规组与观察组,35例/组。常规组予以基础护理干预,观察组患者则在此基础上介入心理护理模式,比较两组患者护理后SDS、SAS评分。结果:实施不同护理方案后,患者SAS、SDS指标评分均有明显变化,观察组患者明显优于对照组换作者,两组比较差异明显具有统计学意义(P<0.05)。结论:针对肛肠疾病手术患者介入心理护理干预,可以提升整体护理质量,稳定患者心理和情绪变化,提升了手术质量,有利于患者早日康复。