关键词： Bowel ultrasound   Small intestine   Imaging   Gastrointestinal disease   Celiac disease   Appendicitis   Diverticular disease   Intestinal neoplasm   Intestinal ischemia  

摘要： The use of bowel ultrasonography (US) for the evaluation of gut diseases has increased in recent years and has been proven to provide a widely available, non-invasive and inexpensive method for the initial work-up and follow-up of different intestinal diseases, limited mostly by technical challenges posed by the patient's anatomy. The present review aims to provide an extensive overview of the main pathologic features at US examination of intestinal diseases other than inflammatory bowel disease, both acute (e.g., acute appendicitis, colonic diverticulitis, infectious diseases and ischemic conditions) and chronic (e.g., celiac disease, cystic fibrosis and other enterocolites). The identification of typical US features may help in the diagnostic process and guide the treatment approach. Therefore, the application of knowledge of the US appearance of gastrointestinal diseases is of relevance in enabling greater diagnostic performance and better patient management. (E-mail: ***@***) (C) 2017 World Federation for Ultrasound in Medicine & Biology.

关键词： Adherence   adolescent   IBD   medication   pediatric  

摘要： Low adherence is a pervasive issue among youth with inflammatory bowel diseases (IBD), yet our understanding of perceived adherence barriers is hampered by a lack of validated instruments. This study sought to address this by evaluating the reliability and predictive validity of the Beliefs About Medication Scale (BAMS) among youth with IBD. Seventy-six youth (ages 11-18) with IBD who were prescribed a daily oral IBD medication completed baseline ratings of perceived adherence barriers via the BAMS. Parents provided information about patient demographic and disease factors. Subjective medication adherence was assessed via the medication adherence measure. Objective medication adherence was assessed via Medication Event Monitoring System (MEMS) Track Caps. BAMS subscales demonstrated adequate internal consistency (s = .78-.90) and test-retest reliability (rs = .64-.79). BAMS subscales reliably distinguished between adherent and low adherent groups, though intent to adhere (IA) was the only independent predictor of adherence status. The BAMS holds promise as a tool for assessing adherence barriers among adolescents with IBD. IA may be of particular value in identifying adolescents at risk for low adherence.

关键词： inflammatory bowel disease   Crohn’s disease   ulcerative colitis   next-generation sequencing   exome sequencing  

摘要： Genomic technologies inform the complex genetic basis of polygenic inflammatory bowel disease (IBD) as well as Mendelian disease-associated IBD. Aiming to diagnose patients that present with extreme phenotypes due to monogenic forms of IBD, genomics has progressed from 'orphan disease' research towards an integrated standard of clinical care. Advances in diagnostic clinical genomics are increasingly complemented by pathway-specific therapies that aim to correct the consequences of genetic defects. This highlights the exceptional potential for personalized precision medicine. IBD is nevertheless a challenging example for genomic medicine because the overall fraction of patients with Mendelian defects is low, the number of potential candidate genes is high, and interventional evidence is still emerging. We discuss requirements and prospects of explanatory and predictive clinical genomics in IBD.

关键词： camp   Crohn disease   inflammatory bowel disease   ulcerative colitis  

摘要： Inflammatory bowel disease (IBD) affects many children and adolescents in terms of their confidence, acceptance, and ability to build friendships. New Zealand held its first summer camp for children with IBD in January 2015. We obtained feedback from the campers (ages 10-18 years) in terms of their confidence, acceptance, and quality of life. We also asked what experience was most beneficial to them, whether they made new friends with IBD, and if they would attend the camp again. Thirty-six campers responded (81.8% response rate;median age 14 years [range 10-18];83.3% Crohn disease;41.7% girls). Most reported that the camp improved their confidence (86.1%), acceptance (83.3%), and overall quality of life (75.0%) relating to IBD. Moreover, most reported that meeting their fellow campers was the most beneficial experience to come from the camp (72.2%). Overall, these results emphasize the importance and relevance of such an undertaking.

关键词： INFLAMMATORY bowel disease treatment   INFLAMMATORY bowel diseases   BEHAVIOR therapy   MENTAL illness   PSYCHOLOGICAL aspects   PHYSIOLOGICAL aspects  

摘要： The author discusses findings of a study on treatment of inflammatory bowel disease. The author states impact of depression on the course of inflammatory bowel disease (IBD), and mentions treatment of depression through psychotropic medication or behavioral therapy. The author notes that low resilience increases an individual's vulnerability during periods of adversity.

关键词： ADAb   anti-drug antibody   AGA   American Gastroenterological Association   AZA   azathioprine   CBC   complete blood count   CD   Crohn’s disease   CI   confidence interval   CRP   C-reactive protein   ECLIA   electrochemiluminescence immunoassay   ELISA   enzyme-linked immunosorbent assay   GRADE   Grading of Recommendations Assessment, Development, and Evaluation   HMSA   homogenous mobility shift assay   IBD   inflammatory bowel disease   6-MMP   6-methylmercaptopurine   6-MP   6-mercaptopurine   RCT   randomized controlled trial   RIA   radioimmunoassay   RR   relative risk   TDM   therapeutic drug monitoring   6-TGN   6-thioguanine   TNF   tumor necrosis factor   TPMT   thiopurine methyltransferase   UC   ulcerative colitis  

摘要： Therapeutic drug monitoring (TDM), which involves measurement of drug or active metabolite levels and anti-drug antibodies, is a promising strategy that can be used to optimize inflammatory bowel disease therapeutics. It is based on the premise that there is a relationship between drug exposure and outcomes, and that considerable inter-individual variability exists in how patients metabolize the drug (pharmacokinetics) and the magnitude and duration of response to therapy (pharmacodynamics). Therefore, the American Gastroenterological Association has prioritized clinical guidelines on the role of TDM in the management of inflammatory bowel disease. To inform these clinical guidelines, this technical review was developed in accordance with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework for interventional and prognostic studies, and focused on the application of TDM for biologic therapy, specifically antitumor necrosis factor-alpha agents, and for thiopurines. Focused questions address the benefits and risks of a strategy of reactive TDM (in patients with active inflammatory bowel disease) to guide treatment changes compared with empiric treatment changes, and the benefits and risks of a strategy of routine proactive TDM (during routine clinical care in patients with quiescent disease) compared with no routine TDM. Additionally, the review addresses the benefits and risks of routine measurement of thiopurine methyltransferase enzyme activity or genotype before starting thiopurine therapy compared with empiric weight-based dosing and explores the performance of different trough drug concentrations for anti-tumor necrosis factor agents and thiopurines to inform clinical decision making when applying TDM in a reactive setting. Due to a paucity of data, this review does not address the role of TDM for more recently approved biologic agents, such as vedolizumab or ustekinumab.

关键词： INFLAMMATORY bowel diseases   BOWEL obstructions  

摘要： Inflammatory bowel disease (IBD) remains a topic of ongoing research given its prevalence, yet the pathogenesis and all clinical manifestations of the disease remain poorly understood. Giant inflammatory polyposis is one of the clinical manifestations of IBD that has rarely been described to the best of our knowledge. This is a recognized clinical entity, however, only a limited number of IBD associated cases have been described in literature to date. This phenomenon consists of numerous benign, inflammatory polyps that clump together giving the appearance of a larger mass, which may cause clinical colonic obstruction and radiographic findings mimicking colonic neoplasm. This clinical entity may present in 10-20% of patients with IBD.

关键词： INFLAMMATORY bowel diseases   HEMOPHILIA   BLOOD coagulation disorders   CROHN'S disease   CLINICAL trials  

摘要： A study which investigated the coincidence of inflammatory bowel disease (IBD) and haemophilia in Poland is presented. Topics covered include a case of an 11-year-old boy with severe haemophilia A and was diagnosed of Crohn's disease, prevalence of IBD in Poland, and the need for a multi-centre prospective trials that could explain the real impact of an anticoagulative state on protection of IBD.