Inflammatory Intestinal Diseases最新文献

{"title":"Development and Examination of an Educational Program Combining E-Learning and Face-to-Face Training That Nurtures Inflammatory Bowel Disease Nurse Specialists.","authors":"Hikaru Mizuno, Yu Fujimoto, Yoshiko Furukawa, Mayu Katashima, Koji Yamamoto, Kayoko Sakagami, Maya Nunotani, Natsuko Seto","doi":"10.1159/000541485","DOIUrl":"10.1159/000541485","url":null,"abstract":"<p><strong>Introduction: </strong>The number of patients with inflammatory bowel disease (IBD) in Japan has continued to increase, leading to diverse and complex patient backgrounds. Despite these challenges, the education of IBD nurse specialists has not kept pace with the evolving circumstances. Therefore, our research aimed to develop and validate an educational program for the training of IBD nurse specialists.</p><p><strong>Methods: </strong>We designed an educational program targeting nurses involved with IBD care. The program included e-learning on the assessment of IBD activity and self-care support, as well as face-to-face group discussions. The understanding and practice of disease activity assessment and self-care support were evaluated before and after the e-learning sessions and face-to-face training. Face-to-face training satisfaction was assessed using the Course Interest Survey (CIS) scale and summarized through descriptive statistics.</p><p><strong>Results: </strong>Overall, data from 19 participants were analyzed. Scores for understanding and practice of disease activity assessment and self-care support increased across all training processes. Moreover, the items that significantly increased before and after e-learning were \"inflammation\" (<i>p</i> = 0.012), \"IBD recognition\" (<i>p</i> = 0.026), and \"treatment\" (<i>p</i> = 0.013) in terms of understanding and \"inflammation\" (<i>p</i> = 0.036) in terms of practice. The items that increased significantly from e-learning to face-to-face training were \"inflammation\" (<i>p</i> = 0.042), \"subject symptoms\" (<i>p</i> = 0.018), and \"treatment\" (<i>p</i> = 0.017) in terms of understanding. No significant differences in mean scores for understanding and practice were observed between the two groups. According to the CIS scale, the \"attention\" and \"relevance\" factors indicate that the training design was highly interesting and relevant. However, the \"confidence\" factor received a slightly lower average score than did the other factors.</p><p><strong>Conclusion: </strong>The educational program showed promising implications for the development of IBD nurse specialists. However, further consideration is needed to devise training content that fosters confidence in clinical practice.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11709696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Disease Activity in Eosinophilic Esophagitis: Is It Clinically Relevant or Simply an Amusement for Experts?","authors":"Ekaterina Safroneeva, Alain M Schoepfer","doi":"10.1159/000542470","DOIUrl":"10.1159/000542470","url":null,"abstract":"<p><strong>Background: </strong>Since the first description of eosinophilic esophagitis (EoE) as clinicopathologic syndrome three decades ago, considerable progress has been made to standardize and validate instruments to assess symptom severity, quality of life, endoscopic, and histologic activity for the purpose of randomized controlled trials (RCTs) and observational studies. Standardized assessment of EoE activity is crucial to be able to compare the results of therapeutic interventions and bring much needed therapies to patients. This review focuses on outcome assessment of disease activity in adults with EoE.</p><p><strong>Summary: </strong>The choice of endpoints/instruments to be used depends on the setting, which might be either an RCT, an observational study, or clinical practice. In RCTs, the choice of endpoints further depends on requirements from regional regulatory authorities. Primary endpoints chosen in RCTs typically focused on symptoms and esophageal peak eosinophil counts, although that likely will change, as therapies with new mechanism of action are explored. Validated symptom-based PRO instruments used in RCTs include the Daily Symptom Questionnaire (DSQ), the EoE activity index (EEsAI) PRO instrument, and numeric rating scales for dysphagia and pain. Histologic activity in RCT is assessed using the EoE histologic scoring system (EoEHSS) that takes into account the severity and extent of eight distinct histologic features. Endoscopic activity is assessed using the EREFS (Exudates, Rings, Edema, Furrows, Stricture) grading system. For observational studies, activity assessment is based on EEsAI PRO, epithelial peak eosinophil counts, and EREFS. In daily clinical practice, EoE activity is based on assessment of symptoms using a visual analog scale (VAS, from 0-10), peak eosinophil count, and EREFS. Several other instruments including the I-SEE, dysphagia-free days over a defined period, the dysphagia stress test, and impedance planimetry (EndoFLIP), to assess EoE severity in clinical practice are currently under evaluation.</p><p><strong>Key messages: </strong>EoE activity assessment based on symptom-based PRO, histology, and endoscopy has become increasingly complex and varies depending on the setting. While more stringent endpoints and daily recall PRO instruments are being used in RCTs, new instruments aimed at broader disease activity assessment and weekly recall PRO instruments are being used in observational studies and daily clinical practice.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"10-17"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Infusional Perioperative Tacrolimus Therapy in Crohn's Disease Patients Undergoing Intestinal Resection.","authors":"Maximilian Beck, Niklas Schomburg, Max Albers, Detlef Bartsch, Niklas Knapp, Jan Granseyer, Thomas Gress, Christian Bauer","doi":"10.1159/000542443","DOIUrl":"10.1159/000542443","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative optimization of Crohn's disease (CD) patients is mandatory in order to ensure favorable outcomes and limit perioperative morbidity such as anastomosis-related complications. The use of perioperative tacrolimus may offer beneficial inflammatory control and improve postoperative outcome. However, it also may exhibit unwanted effects of immunosuppression on infectious complications and wound healing.</p><p><strong>Methods: </strong>This is a single-center, retrospective study of CD patients undergoing intestinal resection between 2009 and 2018. Characteristics of CD patients receiving infusional perioperative tacrolimus or not were systematically evaluated and exploratively compared. To investigate the impact of tacrolimus and other predictors on postoperative infectious complications, simple regression with a threshold of <i>p</i> < 0.05 was used. Significant predictors of the simple regression analysis, as well as tacrolimus, were then included into multiple logistic regression.</p><p><strong>Results: </strong>This analysis included 30 patients (34.88%) having received tacrolimus perioperatively and 56 patients (65.12%) that were not treated with tacrolimus. In median, 1 mg/day of tacrolimus was given intravenously for 11 days. Adverse events occurred in 3 patients (10%). The most common adverse events were headache and paresthesia. Tacrolimus showed no significant correlation to postoperative infectious complications. Furthermore, multiple regression analysis found no significant effect of tacrolimus on postoperative infectious complications when controlling for previously identified confounders.</p><p><strong>Conclusion: </strong>Administration of tacrolimus showed no negative impact on postoperative infectious complications in the study cohort, indicating safety of perioperative tacrolimus therapy. By describing in detail our study population of patients receiving perioperative tacrolimus, we provide data guiding future prospective studies.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"10 1","pages":"18-33"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Esophageal Physiologic Tests in Eosinophilic Esophagitis.","authors":"Jeanine Wakim El-Khoury, Ekaterina Safroneeva, Alain M Schoepfer","doi":"10.1159/000542435","DOIUrl":"10.1159/000542435","url":null,"abstract":"<p><strong>Background: </strong>In patients with eosinophilic esophagitis (EoE), the correlation between symptoms of esophageal dysfunction and endoscopic and histologic disease activity is generally poor and probably related to multiple causes such as esophageal remodeling processes that might go undetected using endoscopy and histology as well as esophageal hypervigilance and symptom-specific anxiety. Hence, there is a need for a holistic management of patients that goes beyond the control of eosinophilia and symptoms.</p><p><strong>Summary and key messages: </strong>Physiological esophageal testing using high-resolution manometry, functional lumen imaging probe, pH-impedance, wireless pH monitoring, and mucosal impedance may unveil the effects of chronic transmural fibro-inflammatory changes of the esophageal wall as well as esophageal hypervigilance, thereby assisting to phenotype patients, predict therapeutic response to therapy, and identify motility disorders that may need a specific targeted therapy to ameliorate patients' outcomes. This article discusses the role of functional esophageal examinations in the diagnosis and management of EoE.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"9 1","pages":"296-303"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness and Safety of Carotegrast Methyl in Japanese Patients with Moderately Active Ulcerative Colitis.","authors":"Toshihide Ohmori","doi":"10.1159/000541663","DOIUrl":"10.1159/000541663","url":null,"abstract":"<p><strong>Introduction: </strong>Carotegrast methyl (CGM) is an oral, small-molecule α4-integrin antagonist, which became clinically available in Japan in May 2022. CGM is approved for remission induction treatment for moderately active ulcerative colitis (UC) with an inadequate response or intolerance to 5-aminosalicylates.</p><p><strong>Methods: </strong>We performed a single-center, retrospective, observational study of Japanese patients with moderately active UC to assess the real-world effectiveness and safety of CGM as remission induction treatment.</p><p><strong>Results: </strong>Of 14 patients, 71% (10/14) were women, and the median (range) age was 47 (20-68) years. Disease types were proctitis in 7% (1/14), left-sided colitis in 50% (7/14), and total colitis in 43% (6/14). With a median (range) treatment duration of 8 (2-26) weeks, the rate of endoscopic improvement (Mayo endoscopic subscore [MES] of 0 or 1) was 64% (9/14), and the rate of endoscopic remission (MES of 0) was 57% (8/14). After treatment with CGM, the median (range) MES decreased significantly from 3.0 (2-3) to 0.0 (0-3) (<i>p</i> = 0.008), the Mayo score decreased significantly from 7.0 (5-9) to 0.0 (0-9) (<i>p</i> = 0.006), and the clinical activity index decreased significantly from 6.0 (1-11) to 0.0 (0-9) (<i>p</i> = 0.015). Stool and diarrhea frequencies decreased significantly after initiating CGM, and the percentage of patients with bloody stool and abdominal pain tended to decrease. The cumulative relapse-free rate at week 26 among 9 patients who achieved endoscopic improvement with CGM was 77.8% (95% confidence interval, 36.5%-93.9%). No adverse drug reactions, including progressive multifocal leukoencephalopathy, were reported during the study period.</p><p><strong>Conclusion: </strong>This single-center, retrospective, observational study of 14 Japanese patients with UC showed that CGM was safe and effective as a remission induction treatment for moderately active UC with an inadequate response to 5-aminosalicylates in real-world settings.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"9 1","pages":"271-282"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and Responses to Diseases among Patients with Inflammatory Bowel Disease: Text Mining Analysis of Posts on a Japanese Patient Community Website.","authors":"Eujin Lee, Hiroaki Tsuchiya, Hajime Iida, Katsumasa Nagano, Yoko Murata, Atsuo Maemoto","doi":"10.1159/000541837","DOIUrl":"10.1159/000541837","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with inflammatory bowel disease (IBD) are increasingly using online platforms to communicate with other patients and healthcare professionals seeking disease-related information and support. Free-text posts on these platforms could provide insights into patients' everyday lives, which could help improve patient care. In this proof-of-concept (POC) study, we applied text mining to extract patient needs from free-text posts on a community forum in Japan, holistically visualized the patients' perceptions and their connections, and explored the patient characteristic-dependent trends in the use of words.</p><p><strong>Methods: </strong>Free-text posts written between May 11, 2020 and May 31, 2022 on the community forum were retrieved and subjected to text mining analysis. Trends in the use of words were extracted from the posts for correspondence and co-occurrence network analyses using KH Coder open-source text mining software.</p><p><strong>Results: </strong>Seventy-four posts were analyzed. Using text mining methods, we successfully extracted and visualized a variety of patient concerns and their connections. The correspondence and co-occurrence analyses revealed patient segment-dependent trends in the use of words. For example, patients with a disease duration of ≤5 years were more likely to use words related to emotions or their desire to change or quit their job, such as \"anxiety\" and \"resignation.\" Patients with a disease duration of >10 years were more likely to use words showing that they are finding ways to live with or accept their disease, and are getting used to the lifestyle, but some patients continued to experience worsening disease.</p><p><strong>Conclusions: </strong>We found that free-text posts on an IBD community forum can be a useful source of information to capture the wide variety of thoughts of patients. Text mining procedures can help visualize the relative importance of the topics identified from free-text posts. Our findings of this POC study will be useful for generating new hypotheses to better understand and address the needs of patients with IBD.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"9 1","pages":"283-295"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11620774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Concomitant Prescriptions and Lifestyle Factors on the Initial Course of Newly Diagnosed Inflammatory Bowel Disease.","authors":"Hiromu Morikubo, Takayoshi Nagahama, Katsuhiko Nagai, Hajime Yamazaki, Taku Kobayashi","doi":"10.1159/000541984","DOIUrl":"10.1159/000541984","url":null,"abstract":"<p><strong>Introduction: </strong>There is a close relationship between the relapse of inflammatory bowel disease (IBD) and lifestyle factors, including concomitant medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), antithrombotic drugs, smoking status, and alcohol consumption. However, solid evidence is limited regarding the risk factors at diagnosis and initial disease course. This study aimed to explore the impact of concomitant prescriptions and lifestyle factors in patients with newly diagnosed IBD using a large-scale real-world database.</p><p><strong>Methods: </strong>This is a retrospective inception cohort study using the insurance claims database. Newly diagnosed patients with UC and CD were enrolled between January 2005 and May 2020. Concomitant prescriptions and lifestyle factors were assessed for new biologics use, surgery, and hospitalization during the first year.</p><p><strong>Results: </strong>In total, 6,743 patients with UC and 1,000 patients with CD were enrolled. Proton pump inhibitors, antithrombotics, antibiotics, and NSAIDs were identified as associated factors for both biologics use and hospitalization in UC patients (all <i>p</i> < 0.01), and antithrombotics were identified as associated factors for both biologics use and hospitalization in CD patients (all <i>p</i> < 0.01) in multivariable analyses. Interestingly, smoking was protective against hospitalization in UC patients (<i>p</i> < 0.01) but not in CD patients (<i>p</i> = 0.997), analyzed by univariate analysis. Alcohol consumption was protective against hospitalization outcomes in UC patients (<i>p</i> = 0.02) but not in CD patients (<i>p</i> = 0.27), analyzed by univariate analysis.</p><p><strong>Conclusion: </strong>Immediate attention should be paid to concomitant medications at diagnosis because they may have impact on the initial course of IBD.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"9 1","pages":"260-270"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Real-World Comparison of Drug Trough Levels between Patients Experiencing a Secondary Nonimmune Loss of Response and Those Maintaining a Response to Infliximab on Long-Term Maintenance Therapy for Inflammatory Bowel Disease.","authors":"Michael Farber, Jeremy Polman, Nina Kohn, Vincent Chua, Arun Swaminath, Keith Sultan","doi":"10.1159/000541377","DOIUrl":"https://doi.org/10.1159/000541377","url":null,"abstract":"<p><strong>Introduction: </strong>A secondary loss of response (LOR) to infliximab (IFX) therapy for inflammatory bowel disease (IBD) is typically associated with low IFX trough levels, often with high levels of neutralizing antibodies to IFX (ATI). A small subset of patients on long-term therapy experience a \"nonimmune\" LOR, without ATI and with desired IFX trough levels ≥5 μg/mL, regarded as a LOR to the mechanism of action of IFX. However, this currently accepted IFX goal level is largely derived from observations of patients within the first year of therapy and may not apply to those on treatment beyond 1 year.</p><p><strong>Methods: </strong>Retrospective review of all IBD patients receiving IFX infusions for ≥12 months with at least 1 IFX trough and ATI measurement beyond 12 months was conducted. Chart review of all patients with absent ATI and an IFX trough ≥5 μg/mL classifies as LOR versus non-LOR based on physician assessment, with a comparison of IFX troughs between the two groups.</p><p><strong>Results: </strong>Of 167 patients using IFX ≥12 months, 13 (7.8%) experienced a nonimmune secondary LOR. The mean duration of IFX use was over 3 years for both LOR and non-LOR patients. The mean IFX trough for those with LOR was greater than for those without LOR, 18.5 μg/mL versus 13.1 μg/mL, <i>p</i> = 0.110.</p><p><strong>Conclusion: </strong>Our results did not demonstrate lower IFX levels among patients experiencing secondary nonimmune LOR on long-term therapy. Our results do not redefine the therapeutic IFX goal levels for those patients on long-term therapy and suggest that underdosing of IFX is not the cause of secondary LOR.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"9 1","pages":"252-259"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-Processed Foods Consumption Is Positively Associated with the Clinical Activity of Inflammatory Bowel Diseases: A Cross-Sectional Single-Center Study.","authors":"Chen Sarbagili-Shabat, Shira Zelber-Sagi, Naomi Fliss Isakov, Ayal Hirsch, Yulia Ron, Laura Sol Grinshpan, Ronit Anbar, Ahuva Bromberg, Tamar Thurm, Nitsan Maharshak","doi":"10.1159/000541196","DOIUrl":"https://doi.org/10.1159/000541196","url":null,"abstract":"<p><strong>Introduction: </strong>Western diet pattern and its food components have been suggested to impact inflammatory bowel diseases (IBDs) clinical course. However, the importance of food processing level is uncertain. We aimed to evaluate whether the intake of foods with varying processing levels is associated with disease activity in IBD patients.</p><p><strong>Methods: </strong>This cross-sectional study was performed at a tertiary center between August 2019 and June 2022. Consecutive adult IBD patients were recruited. Clinical disease activity was defined using HBI (Crohn's disease) and SCCAI (ulcerative colitis). Dietary intake was assessed using a food frequency questionnaire (FFQ) and a dedicated validated processed food questionnaire (PFQ) that categorizes dietary intake into three groups of processed food levels: unprocessed/minimally processed, processed, and ultra-processed. Adjusted odds ratios for active disease were determined using a multivariable logistic regression.</p><p><strong>Results: </strong>A total of 242 IBD patients (62.8% Crohn's disease patients) were enrolled, of whom 73.1% were in clinical remission. A higher (upper tertile vs. lowest tertile) unprocessed/minimally processed foods consumption was negatively associated with active disease (OR = 0.38, 95% CI: 0.14-0.99), while high consumption of ultra-processed foods (UPFs) was positively associated with clinically active disease (OR = 3.82, 95% CI: 1.49-9.8). Consumption of UPF groups, almost invariably, was positively associated with clinically active disease, while consumption of the ultra-processed meats group had the strongest association (OR = 4.45, 95% CI: 2.07-9.79).</p><p><strong>Conclusion: </strong>Higher consumption of UPFs is positively associated with clinically active IBD, while higher consumption of unprocessed/minimally processed foods may be protective. Prospective studies are needed to confirm these associations.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"9 1","pages":"241-251"},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal Ultrasonography Diagnostic Performance and Feasibility in IBD during Pregnancy: A Systematic Review and Narrative Synthesis.","authors":"Julie Pillet, Julia Voirol-Perrin, Myriam Martel, Omar Kherad, Sophie Restellini","doi":"10.1159/000541017","DOIUrl":"https://doi.org/10.1159/000541017","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are associated to poor maternal and foetal outcomes during pregnancy, requiring a strict monitoring of the disease activity, preferably with non-invasive modalities. There are numerous data confirming intestinal ultrasonography (IUS) accuracy and efficacy for the detection of IBD disease activity and complications, but data in pregnant IBD patients are scarce. We aimed to evaluate the diagnostic performance and feasibility of IUS to monitor IBD activity throughout pregnancy.</p><p><strong>Methods: </strong>A systematic literature review was performed to identify studies on the use of ultrasound modality in pregnant inflammatory bowel disease women from the date of inception until April 2024 using MEDLINE, Cochrane Library, EMBASE, and ISI Web of Science databases, with keywords including (1) ultrasound/ultrasonography, (2) pregnancy, and (3) IBD (CD and UC). Additional relevant studies were identified from cross-referencing and hand-searches of references of the retrieved articles. We included fully published observational studies and abstracts.</p><p><strong>Results: </strong>Overall, five studies have been selected from 264 citations. All studies were highly heterogeneous in the definition of disease activity as reference standard, IUS protocols, and outcomes. Two of them used a cut-off value of faecal calprotectin (FCP) >100 μg/g. In one of them, clinical scores were used when the FCP value was ≥100-249 μg/g and FCP ≥250 μg/g was considered as an active disease independently of clinical scores. Only one study used a single reference standard with a Harvey-Bradshaw Index (HBI) >4. Across these 3 studies, results suggest a relatively good specificity (range 83-98%) but low sensitivity (range 33-84%) to detect disease's activity. Only 1 study analysed IUS performance in detecting remission with a sensitivity of 80% and a specificity of 92% compared to the reference standard. The size of the uterus limits the visualization of the terminal ileum and the sigmoid from the second trimester and the third trimester, respectively. The evaluation of the rectum remains limited.</p><p><strong>Conclusion: </strong>IUS appears to offer a practical, readily available and non-invasive means of monitoring disease activity in IBD pregnant women. However, existing literature on IUS accuracy is limited and further studies with standardized reference comparator are needed.</p>","PeriodicalId":13605,"journal":{"name":"Inflammatory Intestinal Diseases","volume":"9 1","pages":"229-240"},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}