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Prevalence and risk factors of gallstone disease in Korean patients with ulcerative colitis. 韩国溃疡性结肠炎患者胆石病患病率及危险因素分析
IF 3.4
Intestinal Research Pub Date : 2024-11-29 DOI: 10.5217/ir.2024.00070
Kwangwoo Nam, Jae Yong Lee, Sang Hyoung Park, Ha Won Hwang, Ho-Su Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Jin Hwa Park, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
{"title":"Prevalence and risk factors of gallstone disease in Korean patients with ulcerative colitis.","authors":"Kwangwoo Nam, Jae Yong Lee, Sang Hyoung Park, Ha Won Hwang, Ho-Su Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Jin Hwa Park, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang","doi":"10.5217/ir.2024.00070","DOIUrl":"https://doi.org/10.5217/ir.2024.00070","url":null,"abstract":"<p><strong>Background/aims: </strong>The prevalence of gallstone disease in patients with ulcerative colitis (UC) is higher than in the general population. However, risk factors of gallstone disease in these patients remain unclear. Thus, we investigated the prevalence and risk factors of gallstone disease in Korean patients with UC.</p><p><strong>Methods: </strong>Patients diagnosed with UC who underwent abdominal imaging studies between 1997 and 2020 were investigated using a well-established referral center-based large volume inflammatory bowel disease cohort. The prevalence and clinical characteristics of patients with gallstone disease were evaluated and compared with those without gallstone disease.</p><p><strong>Results: </strong>Overall, 2,811 patients with UC were enrolled. During the follow-up period (mean, 5.7 years), 198 patients (7.0%) were diagnosed with gallstone disease and compared with those without gallstone disease (n = 2,613). The proportion of extensive colitis at maximum extent, primary sclerosing cholangitis (PSC), history of cytomegalovirus, corticosteroid use, immunomodulatory use, colectomy, and appendectomy were significantly higher in the gallstone group (all P< 0.05). In multivariate analyses, age ≥ 60 years at gallstone evaluation (odds ratio [OR], 1.027; 95% confidence interval [CI], 1.002-1.052; P= 0.033), PSC (OR, 6.304; 95% CI, 3.162-12.565; P< 0.001), and history of colectomy (OR, 2.494; 95% CI, 1.222-5.087; P= 0.012) were significant risk factors for gallstone disease in patients with UC.</p><p><strong>Conclusions: </strong>The prevalence of gallstone disease in Korean patients with UC was 7.0%, and age ≥ 60 years at gallstone evaluation, PSC, and history of colectomy were significant risk factors for UC patients with gallstone disease.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis. 粪便钙蛋白对溃疡性结肠炎组织学缓解的预测准确性。
IF 3.4
Intestinal Research Pub Date : 2024-11-11 DOI: 10.5217/ir.2024.00068
Arshdeep Singh, Arshia Bhardwaj, Riya Sharma, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Dharmatma Singh, Simranjeet Kaur, Devanshi Jain, Namita Bansal, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Vandana Midha, Ajit Sood
{"title":"Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis.","authors":"Arshdeep Singh, Arshia Bhardwaj, Riya Sharma, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Dharmatma Singh, Simranjeet Kaur, Devanshi Jain, Namita Bansal, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Vandana Midha, Ajit Sood","doi":"10.5217/ir.2024.00068","DOIUrl":"https://doi.org/10.5217/ir.2024.00068","url":null,"abstract":"<p><strong>Background/aims: </strong>Accurate assessment of disease activity is crucial for effective management and treatment of ulcerative colitis (UC). This study evaluated the correlation between clinical, endoscopic, and histologic measures of disease activity in UC.</p><p><strong>Methods: </strong>Clinical, biochemical, endoscopic, and histologic disease activity was studied in 347 patients with UC. Agreements among various histologic classification systems, namely the Geboes Score (GS), Continuous GS, Nancy Index (NI), and Robarts Histopathology Index (RHI), were analyzed. The predictive accuracy of fecal calprotectin (FC) for endoscopic and histologic remission was assessed.</p><p><strong>Results: </strong>We demonstrate a fair to moderate correlation between clinical, endoscopic, and histologic measures of disease activity in UC. There was a robust concordance among GS, Continuous GS, NI, and RHI in distinguishing between patients in histologic remission or activity. The NI detected 75% of patients who met the remission criteria according to the RHI, whereas the RHI identified all patients in remission as defined by the NI. FC levels below 150 μg/g had >70% accuracy in predicting endoscopic remission. FC levels below 150 μg/g showed ≥80% accuracy, and FC levels below 100 μg/g demonstrated ≥ 85% accuracy in predicting histologic remission, regardless of the scoring index applied. Elevated FC levels were associated with both acute and chronic inflammatory infiltrates in biopsy samples.</p><p><strong>Conclusions: </strong>FC is a reliable predictor of histologic remission, with higher accuracy at lower thresholds. The GS, Continuous GS, NI, and RHI demonstrate comparable performance. FC could help stratify patients' need for colonoscopy for the assessment of endoscopic and histologic remission.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the link between celiac disease and obesity: a potential role of gut microbiome. 探索乳糜泻与肥胖之间的联系:肠道微生物组的潜在作用。
IF 3.4
Intestinal Research Pub Date : 2024-11-08 DOI: 10.5217/ir.2024.00049
Sunaina Addanki, Anastasia Mashukova, Arkene Levy
{"title":"Exploring the link between celiac disease and obesity: a potential role of gut microbiome.","authors":"Sunaina Addanki, Anastasia Mashukova, Arkene Levy","doi":"10.5217/ir.2024.00049","DOIUrl":"https://doi.org/10.5217/ir.2024.00049","url":null,"abstract":"<p><strong>Background/aims: </strong>In today's age, celiac disease (CD) is no longer solely characterized by chronic diarrhea in a malnourished child. Obesity is gradually being acknowledged as part of CD's clinical course. Both conditions have been linked to alterations of gut microbiome. Given the difficulty of strict gluten-free diet adherence, there is a need for less restrictive adjunctive therapies. We aimed to investigate the prevalence of obesity in patients diagnosed with CD with the goal of developing new therapeutic approaches.</p><p><strong>Methods: </strong>Baseline data from the National Institute of Health's All of Us Research Program, was used to evaluate the relationship between CD and obesity. A retrospective cohort study was conducted where groups of individuals with CD and without CD were matched by age range and health surveys. Statistical analysis with odds ratios (OR) with 95% confidence intervals (CI) were reported.</p><p><strong>Results: </strong>The prevalence of obesity was 32.6% in the CD group compared to 18.4% in the control group (OR, 2.111; 95% CI, 1.914-2.328; P< 0.0001). Women accounted for a greater population of patients with CD and obesity. The largest percentage of patients with CD and obesity were older than 65 years. The highest percentage of individuals in both the experimental and control groups were white, followed by African Americans.</p><p><strong>Conclusions: </strong>Our data shows a significant association between CD and increased prevalence of obesity. These results warrant further investigation into microbial changes and dietary exposures that affect the pathogenesis of both diseases.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient preferences for advanced therapies in ulcerative colitis using conjoint analysis. 利用联合分析法研究溃疡性结肠炎患者对先进疗法的偏好。
IF 3.4
Intestinal Research Pub Date : 2024-10-14 DOI: 10.5217/ir.2024.00101
Taku Kobayashi, Naomi Mizuno, Noriko Sato, Yutaka Kawaguchi, Yoshiko Ikawa, Naruyasu Komorita, Hirono Ishikawa
{"title":"Patient preferences for advanced therapies in ulcerative colitis using conjoint analysis.","authors":"Taku Kobayashi, Naomi Mizuno, Noriko Sato, Yutaka Kawaguchi, Yoshiko Ikawa, Naruyasu Komorita, Hirono Ishikawa","doi":"10.5217/ir.2024.00101","DOIUrl":"https://doi.org/10.5217/ir.2024.00101","url":null,"abstract":"<p><strong>Background/aims: </strong>Selecting an optimal advanced therapy for ulcerative colitis (UC) is difficult because of the increasing number of available therapies. This study assessed UC patients' preferences for drug profiles in decision-making regarding advanced therapies using conjoint analysis.</p><p><strong>Methods: </strong>A web-based survey was conducted from October to November 2023 in patients with UC aged ≥ 18 years with prior oral 5-aminosalicylic acid treatment (UMIN000052327). We quantified the importance of drug attributes (location of administration, route/frequency of administration, speed of onset-of-action, maintenancesustainability, risk of serious adverse events within 1 year, and novelty of the drug) and the part-worth utility of attribute levels in mild and severe symptom scenarios, including among employed versus unemployed patients.</p><p><strong>Results: </strong>Of 372 patients who completed the survey, 365 were evaluated. Patient preferences were generally highly individualized. The route/frequency of administration was the most important attribute in both the mild and severe symptom scenarios. Oral administration was preferred in the mild symptom scenario, whereas no specific preference was observed in the severe symptom scenario. The route/ frequency of administration was more valued in the mild symptom scenario than in the severe one, whereas speed of onset of action was more valued in the severe symptom scenario. No significant difference was found in the preference for drug profiles between employed and unemployed patients.</p><p><strong>Conclusions: </strong>Patient preferences for the route/frequency of administration, as well as other drug profiles, change with disease severity but demonstrate substantial interindividual variability. Therefore, shared decision-making is important to incorporate patients' perspectives into the selection of advanced therapies.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ulcerative colitis-associated neoplasms often harbor poor prognostic histologic components with low detection by biopsy. 溃疡性结肠炎相关肿瘤往往含有预后不良的组织学成分,而活检的检出率却很低。
IF 3.4
Intestinal Research Pub Date : 2024-10-01 Epub Date: 2024-05-07 DOI: 10.5217/ir.2024.00006
Ryoya Sakakibara, Shinya Sugimoto, Kaoru Takabayashi, Hiroki Kiyohara, Yusuke Wakisaka, Yuta Kaieda, Miho Kawaida, Yusuke Yoshimatsu, Tomohisa Sujino, Naoki Hosoe, Motohiko Kato, Masayuki Shimoda, Yohei Mikami, Yasushi Iwao, Takanori Kanai
{"title":"Ulcerative colitis-associated neoplasms often harbor poor prognostic histologic components with low detection by biopsy.","authors":"Ryoya Sakakibara, Shinya Sugimoto, Kaoru Takabayashi, Hiroki Kiyohara, Yusuke Wakisaka, Yuta Kaieda, Miho Kawaida, Yusuke Yoshimatsu, Tomohisa Sujino, Naoki Hosoe, Motohiko Kato, Masayuki Shimoda, Yohei Mikami, Yasushi Iwao, Takanori Kanai","doi":"10.5217/ir.2024.00006","DOIUrl":"10.5217/ir.2024.00006","url":null,"abstract":"<p><strong>Background/aims: </strong>Poorly differentiated adenocarcinoma, signet-ring cell carcinoma, and mucinous adenocarcinoma (por/sig/muc), which are considered to be histologic subtypes with a poor prognosis, occur more frequently with colitis-associated cancer than with sporadic tumors. However, their invasiveness and manifestations are unclear. This study aimed to determine the prevalence of the por/sig/muc component in ulcerative colitis-associated neoplasms (UCANs) and its association with invasiveness and to clarify its clinicohistologic and endoscopic features.</p><p><strong>Methods: </strong>This retrospective observational study included patients diagnosed with ulcerative colitis-associated high-grade dysplasia or adenocarcinoma from 1997 to 2022 who were divided according to the presence or absence of a por/sig/muc component.</p><p><strong>Results: </strong>Thirty-five patients had UCAN with a por/sig/muc component and 66 had UCAN without this component. The 5-year survival rate was significantly lower in the por/sig/muc group than in the tub group (67% vs. 96%, P= 0.001), which was attributed to disease above stage III and depth to below the subserosa. Biopsy-based diagnosis before resection detected a por/sig/muc component in only 40% of lesions (14/35). Lesions with a por/sig/muc component were prevalent even in the early stages: stage 0 (4/36, 11%), I (8/20, 40%), II (7/12, 58%), III (10/14, 71%), and IV (6/8, 75%).</p><p><strong>Conclusions: </strong>This is the first investigation that shows UCANs with a por/sig/muc component tended to be deeply invasive and were often not recognized preoperatively. Endoscopists should be aware that UCAN often has a por/sig/muc component that is not always recognized on biopsy, and the optimal treatment strategy needs to be carefully considered.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"428-438"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857048","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}
引用次数: 0
The evolving understanding of histology as an endpoint in ulcerative colitis. 对组织学作为溃疡性结肠炎终点的认识不断发展。
IF 3.4
Intestinal Research Pub Date : 2024-10-01 Epub Date: 2024-03-13 DOI: 10.5217/ir.2023.00120
Shintaro Akiyama, Yusuke Miyatani, David T Rubin
{"title":"The evolving understanding of histology as an endpoint in ulcerative colitis.","authors":"Shintaro Akiyama, Yusuke Miyatani, David T Rubin","doi":"10.5217/ir.2023.00120","DOIUrl":"10.5217/ir.2023.00120","url":null,"abstract":"<p><p>A therapeutic goal for patients with ulcerative colitis (UC) is deep remission including clinical remission and mucosal healing. Mucosal healing was previously defined by endoscopic appearance, but recent studies demonstrate that histological improvements can minimize the risks of experiencing clinical relapse after achieving endoscopic remission, and there is growing interest in the value and feasibility of histological targets of treatment in inflammatory bowel disease, and specifically UC. In this review article, we identify remaining challenges and discuss an evolving role of histology in the management of UC.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"389-396"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110272","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}
引用次数: 0
Efficacy of serum leucine-rich alpha-2 glycoprotein in predicting findings of Crohn's disease small bowel lesion in capsule endoscopy. 血清富亮氨酸α-2糖蛋白在胶囊内镜检查中预测克罗恩病小肠病变结果的有效性。
IF 3.4
Intestinal Research Pub Date : 2024-10-01 Epub Date: 2024-05-07 DOI: 10.5217/ir.2023.00139
Teppei Omori, Miki Koroku, Shun Murasugi, Ayumi Ito, Maria Yonezawa, Shinichi Nakamura, Katsutoshi Tokushige
{"title":"Efficacy of serum leucine-rich alpha-2 glycoprotein in predicting findings of Crohn's disease small bowel lesion in capsule endoscopy.","authors":"Teppei Omori, Miki Koroku, Shun Murasugi, Ayumi Ito, Maria Yonezawa, Shinichi Nakamura, Katsutoshi Tokushige","doi":"10.5217/ir.2023.00139","DOIUrl":"10.5217/ir.2023.00139","url":null,"abstract":"<p><strong>Background/aims: </strong>Small bowel capsule endoscopy (SBCE) is an evaluation method for small bowel (SB) lesions in Crohn's disease (CD). However, the relationship between SBCE findings and the serological biomarker leucine-rich alpha-2 glycoprotein (LRG) remains unclear. We aimed to establish appropriate cutoff values of LRG to predict the presence of SB lesions in CD through SBCE.</p><p><strong>Methods: </strong>Patients with CD with SB lesions who had undergone SBCE and LRG measurements 1 month before and after the SBCE were included. The LRG values for ulcers ≥0.5 cm and other inflammatory lesions noted in SBCE were determined using the Youden Index, and the sensitivity and specificity were calculated. Additionally, the correlation between the SBCE scores (CD Activity in Capsule Endoscopy) and LRG values was evaluated.</p><p><strong>Results: </strong>Forty patients without active colorectal lesions were included in the study. When the cutoff value of LRG for SB ulcers ≥ 0.5 cm was set at 14 μg/mL, the sensitivity was 92.3%, specificity was 81.5%, positive predictive value (PPV) was 70.6%, and negative predictive value (NPV) was 95.7%. In contrast, an LRG cutoff value of 12 μg/mL without inflammatory findings had a sensitivity of 91.7%, specificity of 82.1%, PPV of 68.8%, and NPV of 95.8%. CD Activity in Capsule Endoscopy correlated well with LRG values (Spearman's rank correlation coefficient ρ = 0.681, P< 0.001).</p><p><strong>Conclusions: </strong>An LRG cutoff value of 14 μg/mL may be useful in predicting the presence of SB ulcers ≥ 0.5 cm, and an LRG cutoff value of 12 μg/mL may be useful in predicting the absence of SB inflammatory findings.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"464-472"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857354","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}
引用次数: 0
What to do when traditional rescue therapies fail in acute severe ulcerative colitis. 当急性重度溃疡性结肠炎的传统抢救疗法失效时该怎么办?
IF 3.4
Intestinal Research Pub Date : 2024-10-01 Epub Date: 2024-05-16 DOI: 10.5217/ir.2024.00003
Christopher F D Li Wai Suen, Matthew C Choy, Peter De Cruz
{"title":"What to do when traditional rescue therapies fail in acute severe ulcerative colitis.","authors":"Christopher F D Li Wai Suen, Matthew C Choy, Peter De Cruz","doi":"10.5217/ir.2024.00003","DOIUrl":"10.5217/ir.2024.00003","url":null,"abstract":"<p><p>Acute severe ulcerative colitis (ASUC) is a medical emergency that affects approximately 25% of patients with ulcerative colitis at some point in time in their lives. Outcomes of ASUC are highly variable. Approximately 30% of patients do not respond to corticosteroids and up to 50% of patients do not respond to rescue therapy (infliximab or cyclosporin) and require emergency colectomy. Data are emerging on infliximab dosing strategies, use of cyclosporin as a bridge to slower acting biologic agents and Janus kinase inhibition as primary and sequential therapy. In this review, we outline contemporary approaches to clinical management of ASUC in the setting of failure to respond to traditional rescue therapies.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"397-413"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944613","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}
引用次数: 0
Perianal fistulizing lesions of Crohn's disease are associated with long-term behavior and its transition: a Chinese cohort study. 克罗恩病肛周瘘管病变与长期行为及其转变相关:一项中国队列研究。
IF 3.4
Intestinal Research Pub Date : 2024-10-01 Epub Date: 2024-07-15 DOI: 10.5217/ir.2024.00021
Wei Zhan, Xiaoyin Bai, Hong Yang, Jiaming Qian
{"title":"Perianal fistulizing lesions of Crohn's disease are associated with long-term behavior and its transition: a Chinese cohort study.","authors":"Wei Zhan, Xiaoyin Bai, Hong Yang, Jiaming Qian","doi":"10.5217/ir.2024.00021","DOIUrl":"10.5217/ir.2024.00021","url":null,"abstract":"<p><strong>Background/aims: </strong>Crohn's disease (CD) has a progressive nature and commonly perianal involvement. The aim of this study is to assess the prevalence, surgical treatment, and outcome of perianal fistulizing CD with associated risk factors in a large Chinese cohort.</p><p><strong>Methods: </strong>Hospitalized patients diagnosed with CD in our center were consecutively enrolled between January 2000 and December 2018. Transition of disease behavior was classified according to the presence or absence of penetrating behavior (B3 in the Montreal classification) at diagnosis and at a median follow-up of 102 months.</p><p><strong>Results: </strong>A total of 504 patients were included, of whom 207 (41.1%) were classified as B3 and 348 (69.0%) as L2/3 at follow-up. Transition of behavior to B3 was observed in 86 patients (17.1%). The incidence of perianal fistulizing lesions was 10.9% at 10 years with a final prevalence of 27.0% (n = 136) at the end of follow-up. Multivariate Cox regression identified independent risks of perianal fistulizing lesions for persistent B3 (hazard ratio, 4.72; 95% confidence interval, 1.91-11.66) and behavior transition of progressed to B3 (hazard ratio, 9.90; 95% confidence interval, 4.60-21.33). Perianal surgical treatments were performed in 104 patients (20.6%). Thirty-six cases (7.1%) were refractory, and it is independently associated with behavior of persistent B3 (P= 0.011).</p><p><strong>Conclusions: </strong>Perianal fistulizing lesions occurred frequently in Chinese CD patients. Its incidence and refractory outcome were closely associated with the penetrating CD behavior. An additional risk of perianal fistulizing lesions was indicated for CD patients with behavior of progressing to B3, suggesting further attention.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"484-495"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616394","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}
引用次数: 0
Defining management strategies for acute severe ulcerative colitis using predictive models: a simulation-modeling study. 利用预测模型确定急性重度溃疡性结肠炎的管理策略:一项模拟建模研究。
IF 3.4
Intestinal Research Pub Date : 2024-10-01 Epub Date: 2024-05-07 DOI: 10.5217/ir.2023.00175
Danny Con, Peter De Cruz
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