关键词： Inflammatory bowel disease   Crohn's disease   ulcerative colitis   population based   cohort   biobank   epidemiology   molecular epidemiology  

关键词： Bone fracture   Crohn's disease   ulcerative colitis   FRAX   inflammatory bowel disease   risk  

摘要： Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is associated with an increased prevalence of osteoporosis and osteopenia. We aim to evaluate the use of the World Health Organization Fracture Risk Assessment (FRAX (R)) tool in these patients to assess 10-yr risk of fracture. Electronic searches were performed with key words relating to IBD and FRAX in the MEDLINE, EMBASE, and SCOPUS databases. Summary estimates were calculated. A fixed or random-effects model was used depending on heterogeneity (I-2). The search yielded 146 references;7 that included research carried out in adult patients, were used in the systematic review and quantitative summary. No significant publication bias was noted according to the Harbord test. The 10-yr probability of hip and major osteoporotic fracture in adult IBD patients was 1.03% (95% confidence interval [CI]: 0.37%-2%;I-2 = 0%) and 4.05% (95% CI: 2.61%-5.79%;I-2 = 49%), respectively. In those patients with Crohn's disease, hip and major osteoporotic fractures calculated with FRAX increased to 1.74% (95% CI: 0.42%-3.93%;I-2 = 37.5%) and 6.65% (95% CI: 2.97%1-1.66%;I-2 = 8.7%), respectively. Risks of fracture in adults with ulcerative colitis were provided by a single study only. The FRAX tool has been limitedly used in patients with IBD;however, the evidence currently available only shows a modest increase in the 10-yr risks of bone fracture and does not support unequivocally the need for specific interventions. Further well-designed studies are needed to. confirm the results obtained from this systematic review.

关键词： inflammatory bowel disease   receptor modulators   small molecules   sphingosine-1-phosphate   therapy  

摘要： An unmet medical need exists for the development of targeted therapies for the treatment of inflammatory bowel disease (IBD) with easily administered and stable oral drugs, particularly as most patients on biologics [i.e., tumor necrosis factor (TNF) inhibitors and anti-integrins] are either primary non-responders or lose responsiveness during maintenance treatment. A new class of small molecules, sphingosine-1-phosphate (S1P) receptor modulators, has recently shown efficacy in IBD. Here we provide an overview of the mechanism of action of this novel treatment principle in the context of intestinal inflammation. The remarkable impact of therapeutic modulation of the S1P/S1P receptor axis reflects the complexity of the pathogenesis of IBD and the fact that S1P receptor modulation may be a logical therapeutic approach for the future management of IBD.

关键词： calprotectin   Crohn's disease   inflammatory bowel diseases   irritable bowel syndrome   stools  

摘要： Inflammatory bowel diseases (IBDs) are chronic diseases that result from the inflammation of the intestinal wall, suspected in any patient presenting with intestinal symptoms. Until recently, the diagnosis was mainly based on both clinical and endoscopic arguments. The use of an easy, fast, reliable, non-invasive, and inexpensive biological assay is mandatory not only in diagnosis but also in evolutionary and therapeutic monitoring. To date, the fecal calprotectin is the most documented in this perspective. This marker allows the discrimination between functional and organic bowel processes with good performance. The determination of the fecal calprotectin level contributes to the evaluation of the degree of disease activity and to monitoring of therapeutic response.

关键词： Hemoglobins   International Development Association   Intestinal Diseases   Pharmacokinetics   iron deficiency   Inflammatory Bowel Diseases   Iron-Deficiency Anemia  

摘要： Background Iron deficiency anemia (IDA) is a common complication of inflammatory bowel disease (IBD). Oral ferric maltol improves and normalizes hemoglobin (Hb) in patients with IBD. Aim This open-label, randomized Phase 1 study evaluated the pharmacokinetics of ferric maltol and its effect on iron indices in IBD patients with iron deficiency (with or without anemia). Methods Iron deficient adult IBD patients received ferric maltol 30, 60, or 90 mg twice daily during an 8-day period. Pharmacokinetics and iron uptake were assessed on days 1 and 8. Results Twenty-four patients were included: 13 with Crohn's disease and 11 with ulcerative colitis (mean age 39 years;67 % female, mean Hb 13.0 g/dL;mean reticu-locyte Hb content (CHr) 31.9 pg;mean ferritin 13.9 mu g/L). Plasma maltol and maltol glucuronide increased rapidly at all doses, reaching maximum plasma concentration (C-max) 1.0-1.5 h post-dose and declining to baseline after 3-6 h. Maltol and maltol glucuronide exposure (area under the concentration-time curve;AUC) appeared dose proportional with twice-daily dosing, with higher exposure to maltol glucuronide vs. maltol. Mean day 8/day 1 ratios for C-max and AUC(0-t) indicated no accumulation after 7 days of twice-daily dosing. Serum iron and transferrin saturation (TSAT) increased with all doses (maximum values at 1.5-3.0 h post-dose). Serum ferritin and CHr increased by day 8, with greater improvements with 60 and 90 mg twice-daily doses than with 30 mg twice-daily doses. Conclusions The key constituents of ferric maltol showed predictable pharmacokinetics, with no accumulation over 7 days and increased iron uptake and storage over time at 30-90 mg twice-daily doses.

摘要： Background Inflammatory bowel diseases (IBD) in adolescents are chronic medical conditions with a substantial influence on the well-being of the family members. Methods Total of 27 adolescents suffered from IBD, and 39 healthy adolescents completed questionnaires ADOR (parenting styles assessed by teenagers), KidScreen-10 (quality of life), SAD (Scale of Anxiety in Children), and CDI (Children's Depression Inventory). Their parents completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), and Pediatrics Quality of Life Family Impact Module (PedsQL). Results The parental styles of mothers and fathers of IBD adolescents and the parents of healthy controls were without statistically significant differences except for the fathers’ positive parental style, which was significantly higher in the fathers of controls. There were no statistically significant differences between IBD children and the healthy controls in the quality of life assessed. However, the parents’ quality of life of ill children was statistically significantly lower than of the parents of the controls. The mothers of IBD adolescents were significantly more anxious and the fathers more depressed than the parents of the healthy controls, but there was no difference in the levels of anxiety or depression between IBD adolescents and the controls. Positive parental style of parents of IBD children positively correlated with the quality of life of adolescents. Positive parental style of the fathers correlated negatively with the state and trait children's anxiety and negatively correlated with severity of childhood depression. Conclusions The parents of the adolescents with IBD represent important group for psychosocial support. Disclosure of interest The authors have not supplied their declaration of competing interest.

关键词： Necrosis   Meta-Analysis   Intestinal Diseases   Review, Systematic   Tumor Necrosis Factors   Infliximab   Inflammatory Bowel Diseases  

摘要： Background Biosimilars of anti-tumour necrosis factor (TNF)- agents have now become clinically available for the treatment of inflammatory bowel diseases (IBD). Aim To perform a systematic review and meta-analysis to evaluate the efficacy and safety of biosimilars of anti-TNF- agents in patients with IBD. Methods Electronic databases were searched. The outcomes were the pooled rates of clinical response or remission, sustained clinical response or remission, and adverse events in patients with IBD induced with or switched to biosimilars of anti-TNF- agents. Results Eleven observational studies reporting outcomes in 829 patients treated with biosimilar of infliximab (CT-P13) were identified. The pooled rates of clinical response among Crohn's disease (CD) and ulcerative colitis (UC) at 8-14 weeks were 0.79 (95% confidence interval (CI) = 0.65-0.88) and 0.74 (95% CI = 0.65-0.82), respectively, and at 24-30 weeks were 0.77 (95% CI = 0.63-0.86) and 0.77 (95% CI = 0.67-0.85) respectively. Adverse events were rare (CD, 0.08 (95% CI = 0.02-0.26);UC, 0.08 (95% CI = 0.03-0.17)). The pooled rates of sustained clinical response among CD and UC after switching from infliximab to CT-P13 at 30-32 weeks were 0.85 (95% CI = 0.71-0.93) and 0.96 (95% CI = 0.58-1.00), respectively, and at 48-63 weeks were 0.75 (95% CI = 0.44-0.92) and 0.83 (95% CI = 0.19-0.99) respectively. Adverse events were rare (CD, 0.10, 95% CI = 0.02-0.31;UC, 0.22, 95% CI = 0.04-0.63). Conclusions CT-P13 was associated with excellent clinical efficacy and safety profile, supporting its use in the treatment of IBD.

关键词： Medical matters   Primary dental care  

摘要： Inflammatory bowel disease (IBD) mainly comprises of two separate inflammatory conditions: Crohn's disease (CD) and ulcerative colitis (UC). The aetiology of these conditions is still being explored with current evidence pointing towards a combination of environmental and genetic components. However, the pathophysiology is understood as a cytokine driven inflammatory response. There is significant association between IBD and dental conditions such as dental caries, other infections and periodontitis. Anti-inflammatory medications such as 5 aminosalicylic acid (5ASA), steroids and biological therapies are the treatment of choice for these chronic conditions, dependent on aetiology. Therefore, this article aims to educate dentists regarding possible implications IBD and its treatment can have for clinical practice and future research.

关键词： Inflammatory bowel disease   Colorectal cancer   Survival outcomes   Clinicopathological characteristics  

摘要： Purpose The current study aims to use meta-analytical techniques to compare the clinicopathological characteristics and survival outcomes of inflammatory bowel disease (IBD) associated and sporadic colorectal carcinoma (CRC). Patients with IBD have an established increased risk of developing CRC. There is no consensus, however, on the clinicopathological characteristics and survival outcomes of IBD associated CRC when compared to sporadic CRC. Methods A comprehensive search for published studies comparing IBD associated and sporadic CRC was performed. Random effect methods were used to combine data. This study adhered to the recommendations of the MOOSE guidelines. Results Data were retrieved from 20 studies describing 571,278 patients. IBD associated CRC had an increased rate of synchronous tumors (OR 4.403, 95% CI 2.320-8.359;p < 0.001), poor differentiation (OR 1.875, 95% CI 1.425-2.466;p < 0.001), and a reduced rate of rectal cancer (OR 0.827, 95% CI 0.735-0.930;p = 0.002). IBD associated CRC however did not affect the frequency of T3/T4 tumors (OR 0.931, 95% CI 0.782-1.108;p = 0.421), lymph node positivity (OR 1.061, 95% CI 0.929-1.213;p = 0.381), metastasis at presentation (OR 0.970, 95% CI 0.776-1.211;p = 0.786), sex distribution (OR 0.978, 95% CI 0.890-1.074;p = 0.640), or 5-year overall survival (OR 1.105, 95% CI 0.414-2.949;p = 0.842). Conclusions In this large analysis of available data, IBD associated CRC was characterized by less rectal tumors and more synchronous and poorly differentiated tumors compared with sporadic cancers, but no discernable difference in sex distribution, stage at presentation, or survival could be identified.