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Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis

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World Journal of Gastroenterology 2014年第28期20卷 9458-9467页

作者： Bruno César da silva Andre Castro Lyra Raquel Rocha genoile oliveira s.ntana Post-graduate Program in Medicine and Health Federal University of Bahia Gastroenterology Department of the University Hospital Professor Edgard santos Federal University of Bahia Gastro-Hepatology service of Hospital s?o Rafael Department of sciences of Nutrition School of NutritionFederal University of Bahia

Ulcerative colitis(UC)is a chronic disease characterized by diffuse inflammation of the mucosa of the colon and *** hallmark clinical symptom of UC is bloody *** clinical course is marked by exacerbations and remissions,which may occur spontaneously or in response to treatment changes or intercurrent *** is most commonly diagnosed in late adolescence or early adulthood,but it can occur at any *** incidence of UC has increased worldwide over recent decades,especially in developing *** contrast,during this period,therapeutic advances have improved the life expectancy of patients,and there has been a decrease in the mortality rate over *** is important to emphasize that there is considerable variability in the phenotypic presentation of *** this context,certain clinical and demographic characteristics are useful in identifying patients who tend to have more severe evolution of the disease and a poor *** this group of patients,better clinical surveillance and more intensive therapy may change the natural course of the *** aim of this article was to review the epidemiology and demographic characteristics of UC and the factors that may be associated with its clinical prognosis.

关键词： Ulcerative colitis Incidence Prevalence Risk factors Predictive factors

Thalidomide induces mucosal healing in Crohn's disease: Case report

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World Journal of Gastroenterology 2011年第45期17卷 5028-5031页

作者： Márcio Rios Leite sandra sousa santos André Castro Lyra Jaciane Mota genoile oliveira s.ntana Department of Gastroenterology Prof. Edgard Santos University Hospital Federal University of Bahia Salvador Department of Gastrohepatology So Rafael Hospital Monte Tabor Foundation So Marcos Avenue

Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract that is defi ned by relapsing and remitting episodes. Tumor necrosis factor alpha (TNF-α) appears to play a central role in the pathophysiology of the disease. standard therapies for inflammatory bowel disease fail to induce remission in about 30% of patients. Biological therapies have been associated with an increased incidence of infections, especially infection by Mycobacterium tuberculosis (Mtb). Thalidomide is an oral immunomodulatory agent with anti-TNF-α properties. Recent studies have suggested that thalidomide is effective in refractory luminal and fistulizing Crohn's disease. Thalidomide costimulates T lymphocytes, with greater effect on CD8+ than on CD4+ T cells, which contributes to the protective immune response to Mtb infection. We present a case of Crohn's disease with gastric, ileal, colon and rectum involvement as well as steroid dependency, which progressed with loss of response to infliximabafter three years of therapy. The thorax computed tomography scan demonstrated a pulmonary nodule suspected to be Mtb infection. The patient was started on thalidomide therapy and exhibited an excellent response.

关键词： Anti-tumor necrosis factor alpha Crohn’s disease Mucosal healing Mycobacterium tuberculosis Thalidomide

Crohn's disease in one mixed-race population in Brazil

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World Journal of Gastroenterology 2007年第33期13卷 4489-4492页

作者： genoile oliveira s.ntana Luiz Guilherme Costa Lyra Tamara Celi Almeida s.ntana Lidiane Bianca dos Reis Jorge Carvalho Guedes Maria Betania Toralles André Castro Lyra Gastrohepatology Unit Federal University of Bahia Brazil Gastrohepatology Unit Hospital San Rafael BahiaBrazil Gastrohepatology Unit Federal University of Bahia Brazil Department of Medicine Federal University of Bahia Brazil Gastrohepatology Unit Hospital San Rafael BahiaBrazil Department of Medicine Federal University of Bahia Brazil Gastrohepatology Unit Federal University of Bahia Brazil Department of Medicine Federal University of Bahia Brazil Genetic Unit Federal University of Bahia Brazil

AIM： To evaluate the classification and severity of Crohn＇s disease in different racial groups. METHODs： Patients with Crohn＇s disease from the outpatient clinic of the University Hospital Prof. Edgard santos were enrolled in the study. This hospital is a reference centre for inflammatory bowel disease. Race was determined using self-identification. The Vienna＇s classification was applied for all subjects. The severity of Crohn＇s disease was determined according to the number of surgical procedures, hospital admissions in the last year and treatment with steroids and immunosuppressors. statistical analysis was calculated using t test for means,χ^2 or F for proportions. A P value 〈 0.05 was considered to be significant. REsULTs： sixty-five patients were enrolled. Non-white patients were more frequently diagnosed with Crohn＇s disease in the age less than 40 years than white patients. The behaviour of disease was similar in both groups with a high frequency of the penetrating form. There was a tendency for non-white patients to have a greater frequency of hospital admissions in the last year compared to white subjects. Non-whites also had a higher rate of colonic and upper gastrointestinal involvement, and were also more frequently on treatment with immunossupressors than white patients although this difference was not statistically significant. CONCLUsION： Non-white patients with Crohn＇s disease had an earlier diagnosis and appeared to have had a more severe disease Dresentation than white patients.

关键词： Racial group Brazil Race Inflammatory bowel disease Crohn's disease

Crohn's disease of esophagus,stomach and duodenum

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2019年第2期10卷 35-49页

作者： Andréa Maia Pimentel Raquel Rocha genoile oliveira s.ntana Programa de Pós gradua??o em Medicina e saúde Universidade Federal da Bahia Departamento de Ciências da Nutri??o Universidade Federal da Bahia

Crohn's disease with involvement of the esophagus, stomach and duodenum has a prevalence of 0.5% to 4% in symptomatic adult patients, but some studies have shown that these results may be underestimated, since upper gastrointestinal endoscopy is not performed routinely in the initial evaluation of the disease in adult patients, as it is in the pediatric population. In general, involvement of the upper gastrointestinal tract in Crohn's disease occurs concomitantly with involvement of the lower gastrointestinal tract. The diagnosis depends on clinical,endoscopic, histological and radiological evaluation. The presence of aphthoid ulcers, longitudinal ulcers, bamboo-joint-like appearance, stenoses and fistulas are endoscopic findings suggestive of the disease, and it is important to exclude the presence of Helicobacter pylori infection. The primary histological findings,which facilitate the diagnosis, are the presence of a chronic inflammatory process with a predominance of lymphoplasmacytic cells and active focal gastritis. The presence of epithelioid granuloma, although less frequent, is highly suggestive of the disease in the absence of chronic granulomatous disease. Treatment should include the use of proton pump inhibitors associated with corticosteroids,immunomodulators and biological therapy according to the severity of the disease.

关键词： Crohn’s disease Upper gastrointestinal tract Upper digestive endoscopy Esophagus stomach Duodenum Chronic gastritis Focal gastritis Epithelioid granuloma

Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America

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World Journal of Gastroenterology 2020年第44期26卷 6993-7004页

作者： Flora Maria Lorenzo Fortes Ney Boa sorte Victor D Mariano Laila D Andrade Fernanda A oliveira Monique CA santos Claudia Ivanilda N dos santos Catharina A Passos Mila P Pacheco Valdiana C surlo Neogelia P de Almeida Jaciane AM Fontes Andrea M Pimentel Raquel Rocha genoile oliveira s.ntana Pharmaceutical sciences Pos-graduation Program State University of BahiaSalvadorBA 40460-120Brazil Outpatient Gastroenterology Unit General Hospital Roberto SantosSalvadorBA 40286-901Brazil Life sciences Department State University of BahiaSalvadorBA 41150-000Brazil Department of Medicine FTC UniversitySalvadorBA 41741-590Brazil Department of sciences of Nutrition School of NutritionFederal University of BahiaSalvadorBA 41701-035Brazil

BACKGROUND There has been an increase in cases of inflammatory bowel disease(IBD)in recent *** is also greater access and availability of immunosuppressive and biological agents,which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal ***(TB)remains a public health problem,and it has a high incidence in several ***,knowledge of the risk of developing TB in patients with IBD is *** To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin *** A standard questionnaire included demographic variables,clinical aspects of IBD disease,history of active TB during treatment,active TB characteristics and evolution,initial screening and results and time from the start of anti-tumor necrosis factor alpha(TNFα)to TB *** Azathioprine,anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB *** TNFα blockers increased the relative risk of developing active TB compared to other *** four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active *** adjustment for sex,age,type of IBD and latent TB,anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional *** TB,which was diagnosed 3 mo after the start of anti-TNFα,was the most *** Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin *** risk was increased when anti-TNFα was combined with *** time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.

关键词： Inflammatory bowel disease Therapy Tumor necrosis factor alpha Relative risk Tuberculosis Latent tuberculosis

Factors Associated with Low Intake of Dietary Fiber in Inflammatory Bowel Disease Patients

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Health 2014年第11期6卷 1300-1309页

作者： Vanessa Rosa Brito oliveira Raquel Rocha Mirella Brasil Lopes Fernanda Gomes Coqueiro Naiade silveira Almeida sandra santos Valois genoile oliveira s.ntana Department of sciences of Nutrition School of Nutrition Federal University of Bahia Salvador Brazil Gastroenterology Unit University Hospital Professor Edgard Santos Federal University of Bahia Salvador Brazil

Inflammatory bowel disease patients reduce their intake of foods rich in dietary fibers in an attempt to prevent recurrence of the disease, predisposing these patients to nutritional losses. The aim of this study was to evaluate the intake of dietary fiber and associated factors in a group of patients with inflammatory bowel disease. This was a cross-sectional study with 61 inflammatory bowel disease patients, and all participants were outpatients in salvador, Bahia. Patients completed a semi-structured questionnaire that included questions about demographics, socioeconomic status and anthropometric and clinical information and a food frequency questionnaire to assess the intake of dietary fiber. The mean intake of dietary fiber was 28.2 ± 14.8 g/day for inflammatory bowel disease patients, 27.9 ± 10.1 g/day for ulcerative colitis (UC) patients and 28.9 ± 21.1 g/days for those with Crohn’s disease (CD) (p > 0.05). Most inflammatory bowel disease patients (52.5%) had intake below that recommended for dietary fiber. Inadequate consumption was present in 56.3% of CD patients and 43.8% of those with UC (p = 0.28). Men had lower fiber intake than women (p = 0.04). No significant associations between fiber intake and disease activity, location, presence of complications, gastrointestinal complaints, and nutrition counseling were found (p > 0.05). The low intake of dietary fiber was present in most patients, and the greatest inadequacy was found in males. Insufficient intake of dietary fiber appears to be linked to demographic features and not necessarily clinical characteristics relevant to inflammatory bowel disease.

关键词： Inflammatory Bowel Disease Dietary Fiber Eating

Overweight and abdominal fat are associated with normal bone mineral density in patients with ulcerative colitis

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2022年第4期13卷 57-66页

作者： Mirella Brasil Lopes Andre Castro Lyra Raquel Rocha Fernanda Gomes Coqueiro Carla Andrade Lima Carolina Cunha de oliveira genoile oliveira s.ntana Programa de Pós-graduação em Medicina e saúde Universidade Federal da BahiaSalvador 40110-060Brazil Departamento Ciências da Nutrição Universidade Federal da BahiaSalvador 40110-060Brazil Departamento de Nutrição Universidade Federal de SergipeLagarto 49060-110Brazil Departamento Ciências da Vida Universidade do Estado da BahiaSalvador 41.150-000Brazil

BACKGROUND Low bone mineral density(BMD)is common in patients with inflammatory bowel ***,nutritional risk factors for low BMD in the ulcerative colitis(UC)population are still poorly *** To investigate the association of anthropometric indicators and body composition with BMD in patients with *** This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis.A control group consisting of healthy volunteers,family members,and close people was also *** nutritional indicators evaluated were body mass index(BMI),total body mass(TBM),waist circumference(WC),body fat in kg(BFkg),body fat in percentage(BF%),trunk BF(TBF),and also lean *** composition and BMD assessments were performed by dual-energy X-ray *** The sociodemographic characteristics of patients with UC(n=68)were similar to those of healthy volunteers(n=66)(P>0.05).Most patients(97.0%)were in remission of the disease,58.8%were eutrophic,33.8%were overweight,39.0%had high WC,and 67.6%had excess BF%.However,mean BMI,WC,BFkg,and TBF of UC patients were lower when compared to those of the control group(Ps present in 41.2%of patients with UC(38.2%with osteopenia and 2.9%with osteoporosis)and 3.0%in the control group(Ps with low BMD had lower BMI,TBM,and BFkg values than those with normal BMD(Ps were more likely to have low BMD(prevalence ratio[PR]=1.86;95%confidence interval[CI]:1.07-3.26).Those with excess weight(PR=0.43;95%CI:0.19-0.97)and high WC(PR=0.44;95%CI:0.21-0.94)were less likely to have low *** Patients with UC in remission have a high prevalence of metabolic bone *** fat appears to protect against the development of low BMD in these patients.

关键词： Ulcerative colitis Bone mineral density Body composition Fat body Abdominal fat

Influence of nutritional status in the postoperative period of patients with inflammatory bowel disease

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2021年第5期12卷 90-99页

作者： Raquel Rocha Geisa de J santos genoile s.ntana Department of sciences of Nutrition School of NutritionFederal University of BahiaSalvador 40110-150BahiaBrazil Department of Life sciences State University of BahiaSalvador 40110060BahiaBrazil

Inflammatory bowel diseases(IBDs)are a group of chronic inflammatory diseases that affect the gastrointestinal tract,including Crohn's disease(CD)and ulcerative *** is a treatment option,and more than half of the patients with CD will undergo surgical interventions over the course of the *** complications are common in IBD patients,the most frequent being intraabdominal sepsis,infection of the surgical site,and adynamic ileum,and nutritional status is a factor that can influence postoperative *** studies have shown that malnutrition,obesity,sarcopenia,and myosteatosis are predictors of surgical ***,most were retrospective studies with small patient samples and heterogeneity of clinical and nutritional assessment methods,which limit the extrapolation of ***,knowing the pathophysiological mechanisms of IBD and identifying the best parameters for assessing nutritional status are essential for prompt implementation of adequate nutritional interventions.

关键词： Inflammatory bowel diseases Crohn disease Ulcerative colitis Nutritional status Postoperative complications surgery

Nutritional status as a predictor of hospitalization in inflammatory bowel disease:A review

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2019年第2期10卷 50-56页

作者： Raquel Rocha Uli H sousa Thamiris L M Reis genoile O s.ntana Escola de Nutri??o Universidade Federal da Bahia Pós gradua??o em Medicina e saúde Universidade Federal da Bahia Department of Life sciences Universidade do Estado da Bahia

BACKGROUND Inflammatory bowel disease(IBD) presents an inflammatory picture that in the long run can lead to complications and consequently more hospitalizations compared to other *** To evaluate the influence of nutritional status on the occurrence of IBD-related *** This integrative review was conducted in the online databases PubMed and MEDLINE, using the terms "obesity" and "malnutrition" accompanied by"hospitalization", each combined with "Crohn's disease" or "ulcerative colitis".Only studies conducted with humans, adults, and published in English or spanish were selected, and those that were not directly associated with nutritional status and hospitalization were excluded from this review. The Preferred Reporting Items for systematic Reviews and Meta-Analyzes guide was used as the basis for selection of *** Of the 80 studies identified, only five met the proposal of this review. None evaluated the association of good nutritional status with the risk of hospitalization. Malnutrition had a strong correlation with the risk of hospitalization related to IBD, and there was disagreement among three studies regarding the association of obesity and hospitalization *** Few studies have evaluated nutritional status as a predictor of IBD-related hospitalization. The presence of malnutrition appears to be associated with hospitalization in these patients, but further studies are needed to elucidate the issue.

关键词： Nutritional status Inflammatory bowel disease Hospitalization Obesity Malnutrition