关键词： INFLAMMATORY bowel disease treatment   NECROSIS   INFLIXIMAB   TREATMENT   THERAPEUTIC use  

摘要： See "Clinical Use of Measuring Trough Levels and Antibodies against Infliximab in Patients with Pediatric Inflammatory Bowel Disease" by So Yoon Choi, et al. on page 55, Vol. 11. No. 1, 2017

关键词： MRE   Diffusion-weighted imaging   Inflammatory bowel disease   Children  

摘要： Purpose: To determine interobserver agreement (IOA) and accuracy of conventional MR enterography (MRE), qualitative diffusion, and apparent diffusion coefficient (ADC) values for detecting clinically active inflammation. Methods: MREs in 57 consecutive children with suspected inflammatory bowel disease were retrospectively reviewed. Results: Substantial IOA for conventional MRE (kappa=0.65) and qualitative diffusion (kappa=0.64), but fair to good IOA for ADC (intra-class coefficient=0.63) were seen. Conventional MRE detected active clinical inflammation well (area under curve [AUC] 0.725), while qualitative diffusion and ADC did not perform well (AUC=0.572 and 0.461, respectively). Conclusion: DWI can be helpful in diagnosing inflammatory bowel disease but does not perform well in identifying those with active inflammation. (C) 2016 Elsevier Inc. All rights reserved.

关键词： Inflammatory bowel   diseases   Quality of life   Predictors   Saudi Arabia  

摘要： Inflammatory bowel disease patients have impaired quality of life with physical, social and emotional dysfunction. This project aimed to assess effects of socio-demographic and clinical variables on quality of life and to identify its predictors. In a cross-sectional paper-based study, 50 consecutive non-selected patients attending the teaching hospital completed a disease-specific McMaster quality of life tool. Socio-demographic and clinical data were collected from patients' records. The t-test and Mann Whitney test were used to determine the probability of significant differences between quality of life domains and independent variables. Multiple linear regression was used to determine quality of life predictors. Younger and highly educated patients had higher social scores. Those with shorter disease durations had higher systemic scores. Patients in remission had higher systemic, social, bowel and overall scores. Relapse was a significant predictor of decreased systemic, social, bowel and overall scores. Long disease duration was a significant predictor of decreased systemic and overall scores. Younger age at disease onset was a significant predictor of decreased emotional score. However, high education was a significant predictor of improved social score. Relapse, long disease duration, low education and young age at disease onset were associated with low quality of life. Prospective studies should investigate how interventions addressing these predictors may lead to improved quality of life. (C) 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Limited. All rights reserved.

关键词： INFLAMMATORY bowel disease treatment   MEDICATION safety   SYSTEMATIC reviews (Medical research)   MEDICAL innovations   MEDICAL databases   FOLLOW-up studies (Medicine)  

摘要： Background and Objectives Biologic drugs are used in innovative therapies for the management of inflammatory bowel diseases (IBDs). The aim of this study was to compare the safety profile of biologic drugs in patients with IBD. Methods A systematic literature search was performed using PubMed, Embase, and CENTRAL databases, up to 22 August 2016. We included randomized, placebo-controlled, or head-to-head clinical trials that compared the safety of different biologics in patients with IBDs. Two reviewers independently conducted the search and selection of studies and rated each trial's risk of bias. The network meta-analysis (NMA) was conducted for a mid-term (20-30 weeks) and long-term (>= 52 weeks) follow-up with a Bayesian hierarchical random effects model using the ADDIS (R) software. The PROSPERO registration number was CRD42015029884. Results Sixteen randomized controlled trials were included in the systematic review with NMA. In the case of the mid-term follow-up, it was possible to conduct the NMA for assessing the relative safety profile of certolizumab pegol and infliximab, and in the case of the long-term follow-up, of infliximab, adalimumab, golimumab, and vedolizumab. There were no significant differences in the rate of adverse events in patients treated with all analyzed biologic drugs for IBD. The analysis of probability for being the safest treatment showed that infliximab was the best option in most analyzed endpoints both in mid-term and in long-term follow-ups. Conclusions We showed no significant differences in the relative safety profile of the analyzed biologic drugs. Further studies are needed to confirm our findings, including head-to-head comparisons between these drugs.

关键词： Infliximab   rapids   Inflammatory Bowel Diseases   Intestinal Diseases   Child  

摘要： The article presents the result of a retrospective case-notes review on all patients receiving infliximab (IFX) based on a rapid infusion protocol (RP) at Monash Children's Hospital between 2011 and 2013. The variables considered including children who had given IFX, median age at diagnosis and a comparison of the IFX infusion based on historical protocol and RP. The use of IFX in children with inflammatory bowel disease (IBD) is discussed.

关键词： Diverticular disease   inflammatory bowel disease   segmental colitis associated with diverticulosis  

摘要： Segmental colitis associated with diverticulosis (SCAD) is an inflammatory process that affects colonic luminal mucosa in segments that are also affected by diverticulosis. Its prevalence varies between 1.15% and 11.4% amongst those suffering from diverticular disease (DD). Being closely associated with DD, it is slightly commoner in males and usually presents in the sixth decade of life. Although the exact pathogenesis of SCAD is unknown, it is probably heterogeneous and includes mechanisms that also play a part in inflammatory bowel disease (IBD). The clinical presentation is non-specific and similar to that of other pathologies involving the sigmoid colon, and its diagnosis is based on endoscopic findings in correlation with histology. Currently, there are no guidelines for its management, which is usually based on the administration of salicylates and antibiotics, with surgery being reserved for refractory cases. The rarity of SCAD may be multifactorial: whereas milder forms go undiagnosed or are attributed to DD, more severe forms can be misdiagnosed as IBD. This latter distinction is an important one to make, since SCAD and IBD differ as regards their natural history and prognosis, while very often no long-term medications are required in SCAD.

关键词： 舒适护理干预   肛肠疾病手术   效果   观察  

摘要： 目的:分析在肛肠疾病手术时使用舒适护理干预的效果.方法:收集我院肛肠疾病手术患者80例,将其按照护理方法的不同分为对照组和观察组,均为40例.对照组实施常规方法护理,观察组在此基础上实施舒适护理.结果:观察组住院时间、术后VAS疼痛评分均明显低于对照组,同时观察组的满意程度评分明显高于对照组,差异均显著(P<0.05).结论:在对肛肠疾病手术患者实施舒适护理干预,可明显提升治疗时的舒适性,改善治疗效果,提升安全性.

摘要： 目的:探讨胃肠超声造影对胃十二指肠疾病的诊断价值.方法:选取2014年9月至2017年6月220例临床疑似胃十二指肠疾病的受检者为研究对象,对所有病例进行口服胃肠超声造影检查及胃镜检查,并要时进行胃镜下病理活检,以最终临床诊断及病理检查结果为金标准.分析胃肠超声造影对胃十二指肠疾病诊断的特异度、敏感度.结果:胃肠超声造影的诊断率为:胃炎98.52%,胃溃疡81.25%,复合性溃疡87.50%,十二指肠球炎88.88%,十二指肠球部溃疡86.67%,胃癌75.00%,胃息肉80.95%,胃良性肿瘤86.95%.胃肠超声造影在胃十二指肠疾病诊断的敏感度、特异度为98.63%、96.30%.结论:胃肠超声造影具有胃镜所欠缺的一些特性,胃肠超声造影能够作为胃镜检查的互补项目,对胃十二指肠疾病具有诊断价值.

关键词： Inflammatory bowel disease   Ulcerative colitis   Crohn's disease   Diagnosis   Management   Bayesian network  

摘要： Background: Diagnostic and therapeutic strategies in inflammatory bowel disease (IBD) vary among countries in terms of availability of modalities, affordability of health care resource, health care policy and cultural background. This may be the case in different countries in Eastern Asia. The aim of this study was to determine and understand the differences in diagnostic and therapeutic strategies of IBD between Japan and the rest of Asian countries (ROA). Methods: Questionnaires with regard to clinical practice in IBD were distributed to members of the International Gastroenterology Consensus Symposium Study Group. The responders were allowed to select multiple items for each question, as multiple modalities are frequently utilized in the diagnosis and the management of IBD. Dependency and independency of selected items for each question were evaluated by the Bayesian network analysis. Results: The selected diagnostic modalities were not very different between Japan and ROA, except for those related to small bowel investigations. Balloon-assisted enteroscopy and small bowel follow through are frequently used in Japan, while CT/MR enterography is popular in ROA. Therapeutic modalities for IBD depend on availability of such modalities in clinical practice. As far as modalities commonly available in both regions are concerned, there seemed to be similarity in the selection of each therapeutic modality. However, evaluation of dependency of separate therapeutic modalities by Bayesian network analysis disclosed some difference in therapeutic strategies between Japan and ROA. Conclusion: Although selected modalities showed some similarity, Bayesian network analysis elicited certain differences in the clinical approaches combining multiple modalities in various aspects of IBD between Japan and ROA. (C) 2016 S. Karger AG, Basel.