关键词： Pathophysiology   Intestinal Diseases   Health Care   Inflammatory Bowel Diseases   Western Europe  

摘要： Linked Content This article is linked to Shah et al paper. To view this article, visit https://***/10.1111/apt.15178. [ABSTRACT FROM AUTHOR]

关键词： Intestinal Diseases   Biosimilar Pharmaceuticals   Inflammatory Bowel Diseases   Biologic Products   switching  

关键词： Chromoendoscopy   Dysplasia   Endoscopic mucosal resection   Inflammatory bowel disease   Ulcerative colitis  

摘要： Background: Patients with ulcerative colitis and Crohn's colitis have an increased risk of developing dysplasia and colorectal cancer as compared to the general population;surveillance colonoscopy is recommended in this patient population. Methods: This review of the published literature aimed to assess the published evidence. Results: Detection of dysplasia requires examination of mucosa with targeted biopsies of the visible lesions as well as random biopsies to detect invisible lesions. Newer endoscopic techniques, in particular chromoendoscopy, increase the yield of identifying dysplastic lesions. The surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients International Consensus (SCENIC) guidelines recommends that colonoscopy using chromoendoscopy is the optimal endoscopic surveillance strategy to detect dysplasia. Once dysplastic lesions are discovered on surveillance endoscopic examination, careful and meticulous descriptions of lesions is mandatory to aid in further decision making. Management of dysplastic lesions in inflammatory bowel disease patients depends on endoscopic (morphological) and histologic findings and patient characteristics such as age, general condition of the patient, and patient preferences. Endoscopic mucosal resection, endoscopic submucosal dissection, and surgery are different therapeutic options for colonic dysplastic lesions detected in the setting of inflammatory bowel disease. Conclusions: In this review, we discuss the various techniques for endoscopic resection of dysplasia in patients with inflammatory bowel disease. Further research is required to determine the optimal approach to diagnosis and management of dysplasia in patients with inflammatory bowel disease.

关键词： azathioprine   inflammatory bowel disease   glutathione-S transferase   pharmacogenetics   pharmacokinetics  

摘要： The contribution of candidate genetic variants involved in azathioprine biotransformation on azathioprine efficacy and pharmacokinetics in 111 young patients with inflammatory bowel disease was evaluated. Azathioprine doses, metabolites thioguanine-nucleotides (TGN) and methylmercaptopurine-nucleotides (MMPN) and clinical effects were assessed after at least 3 months of therapy. Clinical efficacy was defined as disease activity score below 10. Candidate genetic variants (TPMT rs1142345, rs1800460, rs1800462, GSTA1 rs3957357, GSTM1, and GSTT1 deletion) were determined by polymerase chain reaction (PCR) assays and pyrosequencing. Statistical analysis was performed using linear mixed effects models for the association between the candidate variants and the pharmacological variables (azathioprine doses and metabolites). Azathioprine metabolites were measured in 257 samples (median 2 per patient, inter-quartile range IQR 1-3). Clinical efficacy at the first evaluation available resulted better in ulcerative colitis than in Crohn's disease patients (88.0% versus 52.5% responders, p = 0.0003, linear mixed effect model, LME). TGN concentration and the ratio TGN/dose at the first evaluation were significantly higher in responder. TPMT rs1142345 variant (4.8% of patients) was associated with increased TGN (LME p = 0.0042), TGN/dose ratio (LME p < 0.0001), decreased azathioprine dose (LME p = 0.0087), and MMPN (LME p = 0.0011). GSTM1 deletion (58.1% of patients) was associated with a 18.5% decrease in TGN/dose ratio (LME p = 0.041) and 30% decrease in clinical efficacy (LME p = 0.0031). GSTA1 variant (12.8% of patients) showed a trend (p = 0.046, LME) for an association with decreased clinical efficacy;however, no significant effect on azathioprine pharmacokinetics could be detected. In conclusion, GSTs variants are associated with azathioprine efficacy and pharmacokinetics.

关键词： anti-tumor necrosis factor-alpha   inflammatory bowel disease   paradoxical adverse effects   ulcerative colitis   ustekinumab  

摘要： Anti-tumor necrosis factor (TNF)-alpha agents may induce skin reactions, in particular in patients with inflammatory bowel diseases (IBD). The objective of this study was to determine the efficacy of ustekinumab in these patients. IBD patients facing therapeutic issues because of cutaneous reactions or tolerance issues, consequently treated with ustekinumab in our department, were included. Retrospective review of case records and clinical photographs was carried out. Twenty-six patients were included. Twenty-three patients were treated for Crohn's disease and three for ulcerative colitis. Fourteen patients presented psoriasiform lesions, nine eczematiform lesions, four anaphylactoid reactions, two alopecia areata-like lesions, one injection-site reaction, one cutaneous polyarteritis nodosa and five other skin reactions. Most of them resolved under ustekinumab. In detail, eczematiform lesions completely resolved in all cases, psoriasiform lesions completely resolved in 12 cases (85.7%) and had partial response in two cases (14.3%). Two cases of alopecia areata showed complete response (complete hair regrowth). Fourteen patients showed complete digestive response, 10 patients partial digestive response (seven of which needed IBD treatment optimization) and only two failure. In conclusion, ustekinumab is a drug of choice in patients with IBD who cannot tolerate TNF blockers.

关键词： 肛肠疾病   围术期   中医护理路径   应用效果  

摘要： 目的:探讨中医护理路径在112例肛肠疾病患者围术期的应用效果.方法:选取我院收治的肛肠疾病手术患者112例,将其随机分为2组,各56例.对照组围术期应用常规护理,基于此观察组应用中医护理路径.比较两组术后并发症、住院时间以及满意度.结果:在并发症上,观察组发生率3.57％较对照组17.86％明显较低,且P<0.05差异有统计学意义.在住院时间上,观察组较对照组明显较短,且P<0.05差异有统计学意义.在满意度上,观察组96.43％较对照组82.14％明显较高,且P<0.05差异有统计学意义.结论:中医护理路径在肛肠疾病患者围术期的应用效果显著,即可减少患者术后并发症,缩短其住院时间,且可提升其满意度,值得应用推广.

关键词： 中医综合疗法   肛肠疾病   心理压力   护理满意度  

摘要： 目的文章主要针对中医综合疗法对减少患者心理压力、降低疼痛评分、提高护理满意度的效果进行分析研究。方法选取我院收治的420例肛肠科患者作为研究对象,并随机分成两组,对其实施不同的护理方案。一组实施常规护理,另一组在此基础上实施中医综合疗法。结果研究发现,实施了中医综合疗法的干预组患者的护理满意度、心理状态和术后疼痛感明显优于仅进行常规护理的对照组(P<0.05),差异有统计学意义。结论对患者实施人性化护理管理,可以减少患者痛苦,提高患者的满意度,适合大力推广。

摘要： Following publication of the original article [1], the authors.

关键词： Eosinophils   CCR3   Colitis   Inflammatory bowel disease   Ulcerative colitis   IL-10 knockout mice  

摘要： Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD), which is triggered spontaneously by unknown mechanisms and manifests as chronic and relapsing inflammatory conditions in the colon. Eosinophil infiltration is often observed in the colonic tissue of ulcerative colitis patients. However, the role of eosinophils in the disease has not been well defined. The aim of this study is to investigate the role of eosinophils in colonic inflammation using the murine model of spontaneous colitis. C-C chemokine receptor type 3 (CCR3) and interleukin (IL)-10 double knockout mice (CCR3-/-;IL-10-/-) were utilized to evaluate the function of eosinophils in colitis. The levels of colitis were evaluated by colonoscopy, histology, and real-time PCR measurements to determine expression levels of inflammatory cytokines in the colonic tissue. The levels of cytokines produced by T cells in mesenteric lymph nodes were evaluated by ELISA. There was no significant difference in endoscopic and histological scores between the groups of CCR3-/-;IL-10-/- mice and control CCR3+/-;IL-10-/- mice. There was also no significant difference in the expression levels of pro-inflammatory cytokines in the intestinal tissue between the two groups. Similar results were found for IL-17A and interferon gamma (IFN-gamma) production from mesenteric lymph node-derived T cells. Our data indicate that eosinophils do not play a significant role in the immunopathology of colitis in IL-10-/- mice. (C) 2019 Elsevier Inc. All rights reserved.