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Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease

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World Journal of Gastroenterology 2015年第12期21卷 3663-3670页

作者： Réme Mountifield Jane M Andrews Antonina Mikocka-Walus Peter Bampton Department of Gastro-enterology and Hepatology Flinders Medical Centre Flinders University of South Australia ibd service Department of Gastroenterology and Hepatology and School of Medicine University of Adelaide at Royal Adelaide Hospital School of Nursing and Midwifery University of South Australia

AIM: To examine the frequency of regular complementary and alternative therapy(CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts. METHODS: A cross sectional questionnaire was administered to inflammatory bowel disease(ibd) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards ibd medication and psychological parameters such as anxiety, depression, personality traits and quality of life(QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis. RESULTS: In 473 respondents(mean age 50.3 years, 60.2% female) regular CAM use was reported by45.4%, and did not vary between cohorts. Only 54.1%of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction(P < 0.001), seeking psychological treatment(P < 0.001), adverse effects of conventional medication(P = 0.043), and higher QOL(P < 0.001).Newly identified predictors were CAM use by family or friends(P < 0.001), dissatisfaction with patient-doctor communication(P < 0.001), and lower depression scores(P < 0.001). CONCLUSION: In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions.

关键词： Complementary medicine Alternative therapy Therapy

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Sexual health and fertility for individuals with inflammatory bowel disease

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World Journal of Gastroenterology 2019年第36期25卷 5423-5433页

作者： Romain Leenhardt Pauline Riviere Patrick Papazian Isabelle Nion-Larmurier Guillaume Girard David Laharie Philippe Marteau Sorbonne Universite Hepatologie Gastroenterologie et Saint Antoine IBD NeTwork APHP Hopital St Antoine Paris 75012 Ile-de-France France CHU de Bordeaux Hopital Haut-Leveque Service d'Hepatogastroenterologie CMC Magellan Bordeaux 33604 Pessac France Hopital Bichat Service des maladies infectieuses et tropicales APHP Paris 75018 France service de gynecologie obstetrique Hopital Armand Trousseau Paris 75012 Ile-de-France France

The impact of a chronic disease such as inflammatory bowel disease (ibd) on sexual functioning and body image can significantly impair the quality of life of patients. This review considers the sexual and fertility aspects of ibd patients and their daily management. Modern ibd healthcare management should include appropriate communication on sexuality and consider psychological, physiological, and biological issues. Patients with ibd have less children than the general population, and voluntary childlessness is frequent. The most influential factors reported by ibd patients who experience fertility alteration are psychological and surgery-related problems. Pregnancy is a major concern for patients, and any pregnancy for ibd patients should be closely followed-up to keep the chronic disease in a quiescent state. Preconceptional consultation is of great help.

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Fertility Pregnancy Sexuality

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Early surgery in Crohn's disease a benefit in selected cases

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World Journal of Gastrointestinal Surgery 2016年第7期8卷 492-500页

作者： Vinna An Lauren Cohen Matthew Lawrence Michelle Thomas Jane Andrews James Moore Department of Colorectal Surgery Royal Adelaide Hospital ibd service Department of Gastroenterology and School of Medicine Royal Adelaide Hospital

AIM: To compare the outcomes of a cohort of Crohn's disease(CD) patients undergoing early surgery(ES) to those undergoing initial medical therapy(IMT).METHODS: We performed a review of a prospective database CD patients managed at a single tertiary institution. Inclusion criteria were all patients with ileal or ileocolonic CD between 1995-2014. Patients with incomplete data, isolated colonic or perianal CD were excluded. Primary endpoints included the need for, and time to subsequent surgery. Secondary endpoints included the number and duration of hospital admissions, and medical therapy. RESULTS: Forty-two patients underwent ES and 115 underwent IMT. The operative intervention rate at 5 years in the ES group was 14.2% vs IMT 31.3%(HR = 0.41, 95%CI: 0.23-0.72, P = 0.041). The ES group had fewer hospital admissions per patient [median 1 vs 3(P = 0.012)] and fewer patients required anti-TNF therapy than IMT(33.3% vs 57%, P = 0.003). A subgroup analysis of 62 IMT patients who had undergone surgery were compared to ES patients, and showed similar 5 year(from index surgery) re-operation rates 16.1% vs 14.3%. In this subset, a significant difference was still found in median number of hospital admissions favouring ES, 1 vs 2(P = 0.002).CONCLUSION: Our data supports other recent studies suggesting that patients with ileocolonic CD may have a more benign disease course if undergoing early surgical intervention, with fewer admissions to hospital and atrend to reduced overall operation rates.

关键词： Crohn’s disease Surgery Inflammatory bowel disease Terminal ileitis Operation

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Inflammatory bowel diseases: A disease (s) of modern times? Is incidence still increasing?

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World Journal of Gastroenterology 2008年第36期14卷 5491-5498页

作者： Cristina Saro Gismera Beatriz Sicilia Aladrén service of Digestive Diseases Hospital de Cabuees Gijón Spain service of Digestive Diseases Alcaiz Hospital Spain

Inflammatory bowel diseases (ibd) are a heterogeneous group of diseases, not always easy to diagnose, even more difficult to classify, and diagnostic criteria are not always uniform. Well done population-based studies are not abundant, and so comparisons among different geographical areas or populations are not always very reliable. In this article, we have reviewed epidemiological studies available on the world’s population while making a critical review of published data.

关键词： Inflammatory bowel diseases Epidemiological Incidence Diagnostic criteria

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Old-age inflammatory bowel disease onset:A different problem?

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World Journal of Gastroenterology 2011年第22期17卷 2734-2739页

作者： Joaquin Hinojosa del Val Gastroeneterology service Hospital de Manises Valencia 46940 Spain

Inflammatory bowel disease （ibd） in patients aged 60 accounts for 10%-15% of cases of the disease. Diganostic methods are the same as for other age groups. Care has to be taken to distinguish an ibd colitis from other forms of colitis that can mimick clinically, endoscopically and even histologically the ibd entity. The clinical pattern in ulcerative colitis （UC） is proctitis and left-sided UC, while granulomatous colitis with an inflammatory pattern is more common in Crohn’s disease （CD）. The treatment options are those used in younger patients, but a series of considerations related to potential pharmacological interactions and side effects of the drugs must be taken into account. The safety profile of conventional immunomodulators and biological therapy is acceptable but more data are required on the safety of use of these drugs in the elderly population. Biological therapy has risen question on the possibility of increased side effects, however this needs to be confirmed. Adherence to performing all the test prior to biologic treatment administration is very important. The overall response to treatment is similar in the different patient age groups but elderly patients have fewer recurrences. The number of hospitalizations in patients 65 years is greater than in younger group, accounting for 25% of all admissions for ibd. Mortality is similar in UC and slightly higher in CD, but significantly increased in hospitalized patients. Failure of medicaltreatment continues to be the most common indication for surgery in patients aged 60 years. Age is not considered a contraindication for performing restorative proctocolectomy with an ileal pouch-anal anastomosis. However, incontinence evaluation should be taken into account an individualized options should be considered

关键词： Inflammatory bowel diseases Ulcerative colitis Crohn’s disease Eldery population

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Utility of faecal calprotectin analysis in adult inflammatory bowel disease

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World Journal of Gastroenterology 2012年第46期18卷 6782-6789页

作者： Lyn A Smith Daniel R Gaya Inflammatory Bowel Diseases service Gastroenterology Unit Glasgow Royal Infirmary

The inflammatory bowel diseases (ibd), Crohn's disease and ulcerative colitis, are chronic relapsing, remitting disorders. Diagnosis, along with assessment of disease activity and prognosis present challenges to managing clinicians. Faecal biomarkers, such as faecal calprotectin, are a non-invasive method which can be used to aid these decisions. Calprotectin is a calcium and zinc binding protein found in the cytosol of human neutrophils and macrophages. It is released extracellularly in times of cell stress or damage and can be detected within faeces and thus can be used as a sensitive marker of intestinal inflammation. Faecal calprotectin has been shown to be useful in the diagnosis of ibd, correlates with mucosal disease activity and can help to predict response to treatment or relapse. With growing evidence supporting its use, over the last decade this faecal biomarker has significantly changed the way ibd is managed.

关键词： Faecal calprotectin Inflammatory bowel disease Crohn's disease Ulcerative colitis Faecal biomarker

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Historical origins of current ibd concepts

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World Journal of Gastroenterology 2001年第2期7卷 175-184页

作者： Joseph B.Kirsner The Louis Block Distinguished service Professor of Medicine Department of MedicineUniversity of Chicago

INTRODUCTIONThe“nonspecific” inflammatory bowel diseases ,ulcerative colitis and Crohn,s represent a group of heterogeneous inflammatory and ulcerative disases of the small and large intestines of unknown etiology ,associated with many gastrointestinal and systemic complications .Appearing initially as isolated cases in Great Britain and northern Europe during the 19th and early 20th centuries ,they have steadily increased numerically and geographically and today are recognized worldwide.

关键词： Colitis, Ulcerative Crohn Disease History, 16th Century History, 17th Century History, 18th Century History, 19th Century History, 20th Century Humans

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Dextran sodium sulfate colitis murine model: An indispensable tool for advancing our understanding of inflammatory bowel diseases pathogenesis

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World Journal of Gastroenterology 2017年第33期23卷 6016-6029页

作者： Derrick D Eichele Kusum K Kharbanda Department of Internal Medicine Nebraska Medical Center Research service Veterans Affairs Nebraska-Western Iowa Health Care System Department of Biochemistry and Molecular Biology Nebraska Medical Center

Inflammatory bowel diseases(ibd),including Crohn's disease and ulcerative colitis,are complex diseases that result from the chronic dysregulated immune response in the gastrointestinal tract. The exact etiology is not fully understood,but it is accepted that it occurs when an inappropriate aggressive inflammatory respon-se in a genetically susceptible host due to inciting environmental factors occurs. To investigate the path-ogenesis and etiology of human ibd,various animal models of ibd have been developed that provided indispensable insights into the histopathological and morphological changes as well as factors associated with the pathogenesis of ibd and evaluation of therapeutic options in the last few decades. The most widely used experimental model employs dextran sodium sulfate(DSS) to induce epithelial damage. The DSS colitis model in ibd research has advantages over other various chemically induced experimental models due to its rapidity,simplicity,reproducibility and controllability. In this manuscript,we review the newer publicized advances of research in murine colitis models that focus upon the disruption of the barrier function of the intestine,effects of mucin on the development of colitis,alterations found in microbial balance and resultant changes in the metabolome specifically in the DSS colitis murine model and its relation to the pathogenesis of ibd.

关键词： Dextran sodium sulfate Experimental colitis Inflammatory bowel disease Pathogenesis Intestinal barrier

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Immunogenetic biomarkers in inflammatory bowel diseases:Role of the ibd3 region

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World Journal of Gastroenterology 2014年第41期20卷 15037-15048页

作者： Manuel Muro Ruth López-Hernández Anna Mrowiec Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd) Immunology ServiceUniversity Hospital Virgen de la Arrixaca

Many studies have demonstrated the linkage between the ibd3 region (6p21.1-23), an area which encompasses the famous human leukocyte antigen (HLA) complex, and Crohn’s disease (CD) or ulcerative colitis (UC). ibd3 is the only region that meets genome-wide significance, and provides stronger evidence of the linkage than 16p13.1-16q12.2 (ibd1), the locus that contains the susceptibility gene CARD15. However, despite these findings, ibd3 susceptibility genes remain elusive and unclear due to the strong linkage disequilibrium, extensive polymorphism, and high gene density that characterize this area and also due to varying allele frequencies in populations around the world. This area presents an extremely high abundance of genes, including the classical and non-classical major histocompatibility complex (MHC) class I and II genes, and other genes, namely MHC class III genes tumor necrosis factor (TNF)-α and -β, and Hsp, whose proteins play key functions in immunological processes. To date, it is not clear which genes within the MHC family contribute to the ibd pathogenesis, although certain HLA alleles have been associated with ibd. Recent insights into the biological function of other genes encoded within the ibd3 region, such as the MHC class I chain-related (MIC) genes, have led investigators to a more comprehensive exploration of this region. MHC class I chain-related molecule A (MICA) is highly polymorphic and interacts with NKG2D, its receptor on the surface of NK, Tγδ and T CD8+ cells. Increased expression of MICA in intestinal epithelial cells and increased expression of NKG2D in CD4+ T cells (lamina propria) in patients with CD have also been reported. MICA alleles have also been associated with ibd, and a variation at amino acid position 129 of the α2-heavy chain domain seems to categorize MICA alleles into strong and weak binders of NKG2D rece

关键词： ibd3 Tumor necrosis factor MICA HLA Inflammatory bowel disease

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Familial Forms of Spondyloarthritis Study of 100 Senegalese Multiplex Families

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第3期14卷 132-143页

作者： Adama Bah Chiekh Ahamadou Bamba Diaw Dieynaba Sala Tamara Kane Adama Doucouré Siddiki Charifah Ramadhane Bouchrane Harine Abdel Aziz Garba Aissatou N’diaye Mondukpe Joane Immanuelle Houansou Laurine Marlyse Adogle Yaye Aminata Gueye Moustapha Niasse Saidou Diallo service de Rhumatologie CHU Aristide Le Dantec Dakar Sngal service de Rhumatologie Hpital National Ignace Deen Conakry Conakry Guine service de Mdecine Interne Hpital Dalal Jamm de Dakar Dakar Sngal

Introduction: Spondyloarthritis (SpA) comprises a group of chronic inflammatory rheumatic diseases characterized by predominant axial involvement. These include ankylosing spondylitis (AS), reactive arthritis (ReA), psoriatic arthritis (PsA), arthritis associated with inflammatory bowel diseases (ibd), SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis), juvenile spondyloarthritis (JSPA), and undifferentiated SpA. Their exact cause is unknown but is believed to stem from a combination of factors. The first familial forms were described by de Blécourt et al. in 1961. The objective was to evaluate the epidemiological, clinical, therapeutic and evolutionary aspects of familial forms of SpA and in particular, to prove the severity of the disease in family members compared to index cases in the rheumatology department of the Aristide Le Dantec University Hospital in Dakar. Methodology: This was a prospective, cross-sectional and descriptive study with an analytical aim on patients with the familial form of spondyloarthritis defined by the existence of at least one other family member with SpA outside the propositus, collected within the Aristide Le Dantec rheumatology department in Dakar over a period of 10 years between January 2012 and December 2021. There were two phases of study, the first of which consisted of collecting index cases with miserly SpA and the second of which consisted of family screening after consent. The data analysed were epidemiological, clinical, paraclinical, therapeutic and evolving. Results: Out of 100 families of 1905 members, 667 SpA patients included, i.e. a prevalence of 35%, including 225 (33.73%) men and 412 women (61.17%), i.e. a ratio of 1.8. The mean age at diagnosis among relatives was 26.3 years (range 13 and 80 years), 47.14 years among the propositus, in whom the mean age at onset was 36.26 years and that of relatives 49.9 years in the first degree, 15 years in the second degree and 1 year in the third degree.

关键词： Familial Forms of Spondyloarthritis Propositus Senegal

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