检索结果-南通市图书馆

Medical consultation in ulcerative colitis:Key elements for improvement

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2023年第6期29卷 917-925页

作者： Yago González-Lama elena ricart Ana Cábez Pilar Fortes Susana Gómez Francesc Casellas Inflammatory Bowel Disease Unit Department of Gastroenterology and HepatologyHospital Universitario Puerta de Hierro-MajadahondaMadrid 28222Spain Inflammatory Bowel Disease Unit Department of GastroenterologyHospital ClínicBarcelona 08036Spain Biomedical Research Networking Center in Hepatic and Digestive Diseases(CIBERehd) Barcelona 08036Spain Department of Medical Pfizer SpainMadrid 28108Spain Servicio de Reumatología Hospital Universitario de SalamancaSalamanca 37007Spain Department of Gastroenterology Vall d'Hebron Research InstituteBarcelona 08035Spain

Ulcerative colitis(UC)is a chronic inflammatory disease with a high *** order to improve patient outcomes,the clinician-patient relationship in daily practice is *** guidelines provide a framework for UC diagnosis and ***,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been ***,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the *** this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging *** key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational *** key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational *** role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.

关键词： Ulcerative colitis Patient experience Shared decision making Medical consultation Motivational interviewing Patient education

Evaluation of 5 versus 10 granulocyteaphaeresis sessions in steroid-dependent ulcerative colitis: A pilot, prospective, multicenter, randomized study

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第15期13卷 2193-2197页

作者： elena ricart Maria Esteve Montserrat Andreu Francesc Casellas David Monfort Miquel Sans Natalia Oudovenko Raúl Lafuente Julián Panés Hospital de Sant Pau Barcelona Spain Hospital Mútua de Terrassa Terrassa Spain Hospital del Mar Barcelona Spain Hospital de la Vall d'Hebró Barcelona Spain Hospital Clínic CIBER-EHD BarcelonaSpain Otsuka Pharmaceutical Spain

AIM： To evaluate the efficacy of 5 compared to ：tO granulocyteaphaeresis sessions in patients with active steroid-dependent ulcerative colitis. METHODS： In this pilot, prospective, multicenter randomized trial, 20 patients with moderately active steroid-dependent ulcerative colitis were randomized to 5 or 10 granulocyteaphaeresis sessions. The primary objective was clinical remission at wk 17. Secondary measures included endoscopic remission and steroid consumption.RESULTS： Nine patients were randomized to 5 granulocyteaphaeresis sessions （group 1） and 11 patients to 10 granulocyteaphaeresis sessions （group 2）. At wk 17, 37.5% of patients in group 1 and 45.45% of patients in group 2 were in clinical remission. Clinical remission was accompanied by endoscopic remission in all cases. Eighty-six percent of patients achieving remission were steroid-free at wk 17. Daily steroid requirements were significantly lower in group 2. Eighty-nine per cent of patients remained in remission during a one year follow-up. One serious adverse event, not related to the study therapy, was reported. CONCLUSION： Granulocyteaphaeresis is safe and effective for the treatment of steroid-dependent ulcerative colitis. In this population, increasing the number of aphaeresis sessions is not associated with higher remission rates, but affords a significant steroid-sparing effect.

关键词： Ulcerative colitis Granulocyteaphaeresis Steroid-dependence Inflammatory bowel diease treatment

Influence of a nucleotide oligomerization domain 1 (NOD1) polymorphism and NOD2 mutant alleles on Crohn's disease phenotype

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第41期13卷 5446-5453页

作者： Elisabet Cantó elena ricart David Busquets David Monfort Esther García-Planella Dolors González Joaquim Balanzó José L Rodríguez-Sánchez Sílvia Vidal Department of Immunology Sant Pau Hospital & Research Inst.Sant Pau HospitalBarcelona 08025Spain Department of Gastroenterology CIBER-EHD.Clinic HospitalBarcelona-08025Spain Department of Digestive Pathology Sant Pau HospitalBarcelona 08025Spain

AIM： To examine genetic variation of nucleotide oligomerization domain 1 （NOD/） and NOD2, their respective influences on Crohn＇s disease phenotype and gene-gene interactions. METHODS：（ND1＋32656＊1） NOD1 polymorphism and SNPS, SNP12 and SNP13 of NOD2 were analyzed in 97 patients and 50 controls. NOD2 variants were determined by reaction restriction fragment length polymorphism analysis. NOD1 genotyping and NOD2 variant confirmation were performed by specific amplification and sequencing. RESULTS： The distribution of NOD1 polymorphism in patients was different from controls （P = 0.045） and not altered by existence of NOD2 mutations. In this cohort, 30.92% patients and 6% controls carried at least one NOD2 variant （P 〈 0.001） with R702W being the most frequent variant. Presence of at least one NOD2 mutation was inversely associated with colon involvement （9.09% with colon vs 36.4% with ileal or ileocolonic involvement, P = 0.04） and indicative of risk of penetrating disease （52.63% with penetrating vs 25.64% with non-penetrating or stricturing behavior, P = 0.02）. L1007finsC and double NOD2 mutation conferred the highest risk for severity of disease （26.3% with penetrating disease vs 3.8% with non-penetrating or stricturing behavior presented L1007finsC, P = 0.01 and 21.0% with penetrating disease vs 2.5% with non-penentrating or stricturing behavior carried double NOD2 mutation, P = 0.007）. Exclusion of patients with NOD2 mutations from phenotype/NODl-genotype analysis revealed higher prevalence of ＊1＊1 genotype in groups of younger age at onset and colonic location.CONCLUSION： This study suggests population differences in the inheritance of risk NOD1 polymorphism and NOD2 mutations. Although no interaction between NOD1-NOD2 was noticed, a relationship between disease location and Nod-like receptor molecules was established.

关键词： Crohn's disease Nucleotide oligomerization domain 1 Nucleotide oligomerization domain 2

Predictors of bowel damage in the long-term progression of Crohn’s disease

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2022年第33期10卷 12208-12220页

作者： Agnes Fernández-Clotet Julian Panés elena ricart Jesús Castro-Poceiro Maria Carme Masamunt Sonia Rodríguez Berta Caballol Ingrid Ordás Jordi Rimola Department of Gastroenterology Hospital ClinicBarcelona 08036Spain Universitat de Barcelona Institut d'Investigacions Biomèdiques August Pi i Sunyer(IDIBAPS)Barcelona 08036Spain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas CIBEREHDMadrid 28029Spain Department of Radiology Hospital ClinicBarcelona 08036Spain

BACKGROUND Crohn’s disease(CD)is a chronic inflammatory bowel disorder that progresses to bowel damage(BD)over *** image-based index,the Lémann index(LI),has been developed to measure cumulative *** To characterize the long-term progression of BD in CD based on changes in the LI and to determine risk factors for long-term *** This was a single-center longitudinal cohort *** who had participated in prospective studies on the accuracy of magnetic resonance imaging using endoscopy as a gold standard and who had a follow-up of at least 5 years were reevaluated after 5-12 *** Seventy-two patients were *** increased in 38 patients(52.8%),remained unchanged in 9 patients(12.5%),and decreased in 25 patients(34.7%).The small bowel score and surgery subscale significantly increased(P=0.002 and P=0.001,respectively),whereas the fistulizing subscale significantly decreased(P=0.001).Baseline parameters associated with BD progression were ileal location(P=0.026),CD phenotype[stricturing,fistulizing,or both(P=0.007,P=0.006,and P=0.035,respectively)],disease duration>10 years(P=0.019),and baseline LI stricturing score(P=0.049).No correlation was observed between BD progression and baseline clinical activity,biological markers,or severity of endoscopic *** BD,as assessed by the LI,progressed in half of the patients with CD over a period of 5-12 *** main determinants of BD progression were ileal location,stricturing/fistulizing phenotype,and disease duration.

关键词： Crohn’s disease Lémann index Bowel damage Inflammatory bowel disease Magnetic resonance imaging

Effectiveness of infliximab after adalimumab failure in Crohn's disease

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2012年第37期18卷 5219-5224页

作者： María Chaparro Montserrat Andreu Manuel Barreiro-de Acosta Esther García-Planella elena ricart Eugeni Domènech María Esteve Olga Merino Pilar Nos Mireia Pealva Javier P Gisbert Department of Gastroenterology Hospital Universitario de La PrincesaInstituto de Investigación Princesa(IP)and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas(CIBEREHD)28006 MadridSpain Americio 17 portal E 2℃28021 Madrid Department of Gastroenterology Hospital del Mar Department of Gastroenterology Hospital Clínico Universitario de Santiago Department of Gastroenterology Hospital Santa Creui Sant Pau Department of Gastroenterology Hospital ClínicBarcelonaand Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas Department of Gastroenterology Hospital Germans Triasi Pujol and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas(CIBEREHD) Department of Gastroenterology Hospital Mutua de Terrassa Department of Gastroenterology Hospital de Cruces Department of Gastroenterology Hospital Universitario La Fe and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas(CIBEREHD) Department of Gastroenterology Hospital de Bellvitge Department of Gastroenterology Hospital Universitario de La PrincesaInstituto de Investigación Princesa(IP)and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas(CIBEREHD)

AIM:To evaluate the effectiveness of infliximab as a second-line therapy in Crohn's disease patients after adalimumab failure. METHODS:A historical cohort study in a community-based gastroenterology practice evaluated Crohn's disease patients treated with infliximab (induction plus maintenance) after adalimumab failure. Patients were identified using a large Spanish database (ENEIDA). RESULTS:We included 15 Crohn's disease patients who received infliximab after adalimumab failure. Five patients discontinued adalimumab due to loss of response, 3 due to adverse events and 7 due to partial response. After infliximab therapy was started, all patients who had interrupted adalimumab due to loss of efficacy regained response. All patients who discontinued adalimumab due to adverse events responded to infliximab and maintained this response; one of these patients had an uneventful course on infliximab, but 2 developed adverse events. None of the 7 patients who interrupted adalimumab due to partial response reached remission with infliximab. CONCLUSION:Switching from adalimumab to infliximab may be useful in patients who develop adverse effects or loss of response, however, the benefit of infliximab in primary nonresponders was not established.

关键词： Adalimumab Biologics Crohn's disease In-fliximab Switch

Endoscopic response to tumor necrosis factor inhibitors predicts long term benefits in Crohn's disease

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2019年第14期25卷 1764-1774页

作者： Ignacio Alfaro Maria Carme Masamunt Nuria Planell Alicia López-García Jesús Castro Marta Gallego Rebeca Barastegui Angel Giner Alejandro Vara Azucena Salas elena ricart Julián Panés Ingrid Ordás Gastroenterology Department Hospital Clínic de Barcelona Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) University of Barcelona

BACKGROUND Identifying predictors of therapeutic response is the cornerstone of personalized *** To identify predictors of long-term mucosal healing(MH) in patients with Crohn's disease(CD) treated with tumor necrosis factor α(TNF-α) *** Prospective single center study. Consecutive patients with clinically active CD requiring treatment with a TNF-α inhibitor were included. A baseline segmental CD Endoscopic Index of Severity(CDEIS) ≥ 10 in at least one segment or the presence of ulcerations were required for inclusion. Clinical, biological and endoscopic data were obtained at baseline, weeks 14 and 46. Endoscopic response(ER) was defined as a decrease ≥ 50% from baseline CDEIS and MH as partial CDEIS ≤ 5 in all *** Of 62 patients were included. At baseline, median CD Activity Index and CDEIS were 201 and 6.7, respectively with a significant reduction after one year of treatment(53 and 3.0 respectively, P < 0.001). At week 14, 56% of patients achieved ER and 34% MH. At week 46, the corresponding percentages were 52%and 44%. Baseline disease characteristics or biomarkers did not predict MH. A decrease from baseline CDEIS at week 14 of at least 80% was the best predictor of MH at week 46(59% sensitivity and 91% specificity; area under the curve =0.778).CONCLUSION Clinical and biomarker data are not useful predictors of response to TNF-αinhibitors in CD, whereas ER to induction therapy, defined as 80% reduction in global CDEIS, is a robust predictor of long-term MH. Achievement of this endoscopic endpoint may be considered as a therapeutic target for anti-TNF-αtherapy.

关键词： Crohn’s disease Endoscopy Mucosal healing Crohn’s Disease Endoscopic Index of Severity Tumor necrosis factor