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Ulcerative colitis in smokers,non-smokers and ex-smokers

World Journal of Gastroenterology 2011年第22期17卷 2740-2747,2747页

作者： guillermo bastida Belén Beltrán Department of Gastroenterology Hospital Universitari i Politecnic Centro de Investigaciones Biomedicas en Red en Enfermedades Hepáticas y Digestivas 46009 Valencia Spain

Smoking is a major environmental factor that interferes in the establishment and clinical course of ulcerative colitis (UC). Firstly, the risk of smoking status impact in the development of UC is reviewed, showing that current smoking has a protective association with UC. Similarly, being a former smoker is associated with an increased risk of UC. The concept that smoking could have a role in determining the inflammatory bowel disease phenotype is also discussed. Gender may also be considered, as current smoking delays disease onset in men but not in women. No clear conclusions can be driven from the studies trying to clarify whether childhood passive smoking or prenatal smoke exposure have an influence on the development of UC, mainly due to methodology flaws. The influence of smoking on disease course is the second aspect analysed. Some studies show a disease course more benign in smokers that in non-smokers, with lower hospitalizations rates, less flare-ups, lower use of oral steroids and even less risk of proximal extension. This is not verified by some other studies. Similarly, the rate of colectomy does not seem to be determined by the smoking status of the patient. The third issue reviewed is the use of nicotine as a therapeutic agent. The place of nicotine in the treatment of UC is unclear, although it could be useful in selected cases, particularly in recent ex-smokers with moderate but refractory attacks of UC. Finally, the effect of smoking cessation in UC patients is summarised. Given that smoking represents a major worldwide cause of death, for inpatients with UC the risks of smoking far outweigh any possible benefit. Thus, physicians should advise, encourage and assist UC patients who smoke to quit.

关键词： Smoking Ulcerative colitis Nicotine Inflammatory bowel disease Colectomy Pouchitis

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Small intestinal bacterial overgrowth in inactive Crohn's disease:Influence of thiopurine and biological treatment

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World Journal of Gastroenterology 2014年第38期20卷 13999-14003页

作者： Cristina Sánchez-Montes Vicente Ortiz guillermo bastida Ester Rodríguez María Yago Belén Beltrán Mariam Aguas Marisa Iborra Vicente Garrigues Julio Ponce Pilar Nos Gastroenterology Unit Hospital Universitari i Politécnic La Fe

AIM: To investigate the influence of thiopurines and biological drugs on the presence of small intestinal bacterial overgrowth (SIBO) in patients with inactive Crohn’s disease (CD).

关键词： Crohn’ s disease Bacterial overgrowth Thiopurines Biologics Inflammatory bowel disease

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Adalimumab in prevention of postoperative recurrence of Crohn's disease in high-risk patients

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World Journal of Gastroenterology 2012年第32期18卷 4391-4398页

作者： Mariam Aguas guillermo bastida Elena Cerrillo Belén Beltrán Marisa Iborra Cristina Sánchez-Montes Fernando Muoz Jesús Barrio Sabino Riestra Pilar Nos Gastroenterology Unit Department of Digestive DiseaseNetworked Biomedical Research Center for Hepatic and Digestive DiseasesLa Fe University and Politechnic Hospital46026 ValenciaSpain Department of Gastroenterology La Fe University and Politechnic Hospital46026 ValenciaSpain Leon Hospital Complex 42132 LeónSpain Río Hortega University Hospital 47001 ValladolidSpain Central University Hospital of Asturias 33006 OviedoSpain

AIM:To evaluate the effectiveness of adalimumab in preventing recurrence after intestinal resection for Crohn's disease in high-risk ***:A multicenter,prospective,observational study was conducted from June 2009 until June *** consecutively included high-risk Crohn's disease patients who had undergone an ileal/ileocolonic ***-risk patients were defined as two or more criteria:smokers,penetrating pattern,one or more previous surgical resections or prior extensive *** adalimumab was administered 2 wk(± 5 d) after surgery at a dose of 40 mg eow,with an initial induction dose of 160/80 mg at weeks 0 and *** data,previous and concomitant treatments(antibiotics,5-aminosalicylates,corticosteroids,immunomodulators or biologic therapies),smoking status at the time of diagnosis and after the index operation and number of previous resections(type and reason for surgery) were all *** status was assessed with C-reactive protein,erythrocyte sedimentation rate and fecal *** year(± 3 mo) after surgery,an ileocolonoscopy and/or magnetic resonance enterography was *** recurrence was defined as Rutgeerts score ≥ *** recurrence was based on magnetic resonance(MR) score ≥ ***:Twenty-nine patients(55.2% males,48.3% smokers at diagnosis and 13.8% after the index operation),mean age 42.3 years and mean duration of the disease 13.8 years were included in the study.A mean of 1.76(range:1-4) resections previous to adalimumab administration and in 37.9% was considered extensive resection.51.7% had previously received *** were given concomitantly to 17.2% of *** of the 29(13.7%) developed clinical recurrence,6/29(20.7%) endoscopic recurrence and 7/19(36.8%) morphological recurrence after *** patients with clinical recurrence showed endoscopic and morphological recurrence.A high degree of concordance was found between clinical-endosc

关键词： Crohn's disease Postoperative recurrence Prevention Tumor necrosis factor alpha agents Adalimumab

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Inclusive Development in Latin America and Smallholders＇ Interactive Learning Spaces

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Sociology Study 2016年第5期6卷 293-311页

作者： Claudia bastida-Mercado Anastacio Garcia-Martinez guillermo Sanchez Instituto en Ciencias Agropecuarias y Rurales UniversidadAutonoma del Estado de Mexico Mexico Centro Universitario UAEM Temascaltepec Mexico National Institute of Agricultural Technology Argentina

Inclusive development appears as a challenge in Latin America countries after the rupture of the social inclusion as a trickle-down effect of the economic growth. Searching development with inclusion, several public policies were implemented in Latin American during the last 10 years focusing on the agri-food production. In order to assess the progress to reach such objectives, two cases are studied. Smallholder milk producers at the Loma Blanca community （Mexico） and smallholders olive producers at Aimogasta （Argentina） were considered. Interactive learning spaces were clearly identified as consequence of the linking among product, producers, and territory. The empirical evidence leaves to see a reflexive attachment between actor and activity in the both studied cases. Differences between dynamics in ILS （Interactive Learning Spaces） of each one of the studied cases were found. Nevertheless, opportunity windows are still opened in order to achieve successful interventions. Why does the small producer continue existing as such？ Why do the small producers remain in small scale rather than creating scale or exiting from the market？ These, and others, are trigger questions through which government and non-government organization can drive their action in the field.

关键词： Family farming social technology localized agri-food systems Mexico Argentina

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