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‣ Manifestações orais da doença inflamatória intestinal: estudo clínico-patológico retrospectivo; Oral manifestations of inflammatory bowel disease: retrospective clinical-pathologic study

Pincelli, Thaís Prota Hussein
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 12/05/2010 Português
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O termo doença inflamatória intestinal engloba duas doenças inflamatórias crônicas, imunologicamente mediadas, envolvendo o trato gastrointestinal: a doença de Crohn e a retocolite ulcerativa. Os sintomas intestinais são predominantes, porém, durante o curso da doença, podem ocorrer manifestações extraintestinais, incluindo o envolvimento da cavidade oral. O envolvimento oral na doença inflamatória intestinal pode se dar por diferentes tipos de lesões, sendo o tipo mais comum a afta. Lesões menos frequentes incluem, entre outras, a pioestomatite vegetante e as lesões granulomatosas da doença de Crohn. Apresentamos dez casos de doentes com manifestações orais de doença inflamatória intestinal, sendo que, em alguns desses casos, essas foram essenciais para o diagnóstico definitivo da doença, além de revisão detalhada da literatura. O envolvimento da cavidade oral pode ser prévio ou simultâneo aos sintomas gastrointestinais. Porém, na maior parte dos casos, a doença inflamatória intestinal precede o início das lesões orais em meses ou anos. Em muitos doentes, a sintomatologia intestinal pode ser mínima ou mesmo ausente, o que justifica exame minucioso do trato gastrointestinal em todos os doentes com lesões orais suspeitas...

‣ Treatment of inflammatory bowel disease and pregnancy: a review of the literature

Correia,Lucianna Motta; Bonilha,Danielle Queiroz; Ramos,Juliana Dantas; Ambrogini,Orlando; Miszputen,Sender Jankiel
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2010 Português
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CONTEXT: The inflammatory bowel disease is diagnosed frequently among woman of childbearing capacity. The management must be carefully because there are potential risks for the mother and fetus. RESULTS AND CONCLUSIONS: We review literature about the management of inflammatory bowel disease in pregnancy. Some studies are needed to ensure the best approach to inflammatory bowel disease in pregnant women.

‣ Small Bowel Endoscopy in Inflammatory Bowel Disease

Yamagami, Hirokazu; Watanabe, Kenji; Kamata, Noriko; Sogawa, Mitsue; Arakawa, Tetsuo
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Artigo de Revista Científica
Português
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Crohn disease (CD) is a chronic inflammatory bowel disease that affects the entire gastrointestinal tract but is most frequently localized to the large and small bowel. Small bowel endoscopy helps with the differential diagnosis of CD in suspected CD patients. Early diagnosis of CD is preferable for suspected CD conditions to improve chronic inflammatory infiltrates, fibrosis. Small bowel endoscopy can help with the early detection of active disease, thus leading to early therapy before the onset of clinical symptoms of established CD. Some patients with CD have mucosal inflammatory changes not in the terminal ileum but in the proximal small bowel. Conventional ileocolonoscopy cannot detect ileal involvement proximal to the terminal ileum. Small bowel endoscopy, however, can be useful for evaluating these small bowel involvements in patients with CD. Small bowel endoscopy by endoscopic balloon dilation (EBD) enables the treatment of small bowel strictures in patients with CD. However, many practical issues still need to be addressed, such as endoscopic findings for early detection of CD, application compared with other imaging modalities, determination of the appropriate interval for endoscopic surveillance of small bowel lesions in patients with CD...

‣ Computed Tomography Enterography for Evaluation of Inflammatory Bowel Disease

Park, Min Jung; Lim, Joon Seok
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Artigo de Revista Científica
Português
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Computed tomography enterography (CTE) has become a main modality for the evaluation of inflammatory bowel disease (IBD). It simultaneously offers visualization of the small bowel and extraintestinal status, which is helpful for diagnosing IBD. Crohn disease has long segmental enhancing wall thickening related with the eccentric longitudinal distribution. In addition, mural stratification, fibrofatty proliferation, positive comb sign by increased mesenteric vascularity and internal/perianal fistula are characteristics of Crohn disease and can be identified on CTE. Short segmental inflammatory wall thickening and the central low attenuated lymph nodes are favorable CT finding of intestinal tuberculosis. A geographic, relatively large, and deep penetrating ulcer with bowel wall thickening and mural hyperenhancement in ileocecal area are characteristics of intestinal Behcet disease. Each of CTE findings for the IBDs is helpful for differential diagnosis. The main disadvantage of this technique is the requisite radiation exposure of patients, particularly in young patients. However, recent development of advanced CT techniques is promising for radiation dose reduction without compromising diagnostic image quality.

‣ Site-specific changes in transforming growth factor-α and -β1 expression in colonic mucosa of adolescents with inflammatory bowel disease; Site-specific changes in transforming growth factor-alpha and -beta1 expression in colonic mucosa of adolescents with inflammatory bowel disease

Xian, C.; Xu, X.; Mardell, C.; Howarth, G.; Byard, R.; Moore, D.; Miettinen, P.; Read, L.
Fonte: Informa Publicador: Informa
Tipo: Artigo de Revista Científica
Publicado em //1999 Português
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BACKGROUND: Transforming growth factors (TGF-alpha and -beta1) play important roles in intestinal growth and repair. To further understand their roles in the pathophysiology of inflammatory bowel disease (IBD), this study examined changes in their expression in colonic mucosa of adolescents with IBD. METHODS: TGF-alpha and -beta1 expression was examined by immunohistochemistry and in situ hybridization. RESULTS: TGF-gamma immunostaining and mRNA labelling appeared unchanged in the epithelium of specimens with active IBD. Similarly, expression of epithelial TGF-beta1 remained unaltered in IBD. However, the numbers of TGF-beta1-positive cells, including T cells, neutrophils, and monocytes/macrophages, in the lamina propria increased during disease activity. CONCLUSIONS: Adolescent IBD is characterized by a normal expression of TGF-alpha and -beta1 peptide and mRNA in the colonic epithelium but by an increased density of TGF-beta1-positive immune cells in the lamina propria during disease activity, suggesting a role in inflammatory modulation in IBD.; C. J. Xian, X. Xu, C. E. Mardell, G. S. Howarth, R. W. Byard, D. J. Moore, P. Miettinen & L. C. Read

‣ Quality of life in adolescents with inflammatory bowel disease: a systematic review of the literature

Lopes, Rosa Cristina Correia; Fernandes, Adriana Mendes; Oliveira, Ivan Garcias de
Fonte: Escola Superior de Enfermagem de Coimbra Publicador: Escola Superior de Enfermagem de Coimbra
Tipo: Outros
Publicado em 14/09/2014 Português
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Inflammatory bowel disease is a chronic disease that occurs frequently in adolescence and its incidence is increasing. Adolescence is a transition period marked by change course and physical, psychological and social adjustment. The adolescent not only has to adapt to a new physical condition, often seen as limiting, but also manage the disease and its symptoms with your family, social and school environment. This study aims to analyse the impact of inflammatory bowel disease in adolescents in all its dimensions. Was used as the research methodology Systematic Review of the Literature and the research was conducted in the search engine b-on. The research question was prepared by the method of PI[C]OD - What is the impact of inflammatory bowel disease on quality of life of adolescents?. A literature search was performed the b-on electronic platform, we used the following keywords adolescen*, inflammatory bowel disease*, impact and quality of life, the timeframe between two thousand and eight (2008) and two thousand and thirteen (2013), not setting any language. To intersetar research articles the Boolean operator "AND" was used. This research was returned six hundred sixty-seven (667) results. The search was refined by descriptor (MeSH) inflammatory bowel diseases...

‣ Quality of life in adolescents with inflammatory bowel disease: a systematic review of the literature

Lopes, Rosa Cristina Correia; Fernandes, Adriana Mendes; Oliveira, Ivan Garcias de
Fonte: Escola Superior de Enfermagem de Coimbra Publicador: Escola Superior de Enfermagem de Coimbra
Tipo: Conferência ou Objeto de Conferência
Publicado em 17/09/2014 Português
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Inflammatory bowel disease is a chronic disease that occurs frequently in adolescence and its incidence is increasing. Adolescence is a transition period marked by change course and physical, psychological and social adjustment. The adolescent not only has to adapt to a new physical condition, often seen as limiting, but also manage the disease and its symptoms with your family, social and school environment. This study aims to analyse the impact of inflammatory bowel disease in adolescents in all its dimensions. Was used as the research methodology Systematic Review of the Literature and the research was conducted in the search engine b-on. The research question was prepared by the method of PI[C]OD - What is the impact of inflammatory bowel disease on quality of life of adolescents?. A literature search was performed the b-on electronic platform, we used the following keywords adolescen*, inflammatory bowel disease*, impact and quality of life, the timeframe between two thousand and eight (2008) and two thousand and thirteen (2013), not setting any language. To intersetar research articles the Boolean operator "AND" was used. This research was returned six hundred sixty-seven (667) results. The search was refined by descriptor (MeSH) inflammatory bowel diseases...

‣ The epidemiology, phenotype and disease course of Australian children with inflammatory bowel disease.

Abu-Assi, Rammy
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2014 Português
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Inflammatory bowel disease (IBD) is the term for a group of disorders of the gastrointestinal tract, encompassing Crohn’s disease (CD), ulcerative colitis (UC) and inflammatory bowel disease unclassified (IBDU). The aims of this study were to review the disease phenotype at diagnosis in children with IBD, investigate any significant associations, determine the incidence in South Australia and to assess the disease course. Methodology: Phenotypic features at diagnosis of children collected into the Australian Paediatric and Adolescent IBD database (APAIBD) and follow-up details of South Australian children were analysed. Incidence of IBD in South Australia was calculated. Statistical testing included the independent t-tests/ANOVA (parametric), Mann-Whitney/Kruskal-Wallis testing (non-parametric), chi-square analysis, linear and logistic regression, Kaplan-Meier survival, Cox Proportional Hazards, negative binomial regression and linear mixed effects model. P<0.05 was considered to be statistically significant. Results: There were 2101 children diagnosed with IBD during the period 1996-June, 2010. The majority had CD (1247; 59.4%), followed by UC (631; 30%) and IBDU (223; 10.6%). Overall, there was a male predominance (56.4%), which was significantly greater in CD compared to the background Australian paediatric population (58.6% vs 51.3%; p<0.05). The majority of children with CD presented with ileocolonic disease (57%; 662)...

‣ Avaliação da infecção pelo citomegalovírus em pacientes com doença inflamatória intestinal; Cytomegalovirus infection evaluation in inflammatory bowel disease patients

Carmo, Alexandre Medeiros do
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 12/02/2014 Português
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Introdução: Citomegalovírus (CMV) é um DNA vírus de alta prevalência, e tem uma capacidade peculiar de infectar e permanecer integrado ao DNA das células do hospedeiro, mantendo-se na forma de infecção latente. O vírus também pode ocasionar doença, o que normalmente ocorre em pacientes imunocomprometidos, promovendo o aumento da morbidade e mortalidade nestes pacientes. As doenças inflamatórias intestinais (DII), doença de Crohn (DC) e retocolite ulcerativa (RCU), são enfermidades crônicas que afetam o trato gastrointestinal. A fisiopatologia e o tratamento destas doenças, muitas vezes, pode induzir um estado de imunossupressão. Isso incitou a ideia de que os pacientes com DII são mais susceptíveis à infecção e doença por CMV. Ainda há dúvidas e controvérsias sobre a relação entre a doença inflamatória intestinal e o CMV. Objetivos: Avaliar a frequência de infecção por CMV em pacientes com doença inflamatória intestinal, e se existe associação entre replicação viral do CMV com a atividade da DII, mediante índices clínicos e laboratoriais. Metodologia: Pacientes com DII previamente diagnosticada foram submetidos à entrevista, revisão de registros e coleta de amostras de sangue e fezes. Foram realizados os seguintes exames: pesquisa de citomegalovírus por IgG e IgM no sangue...

‣ EXCESSIVE WEIGHT – MUSCLE DEPLETION PARADOX AND CARDIOVASCULAR RISK FACTORS IN OUTPATIENTS WITH INFLAMMATORY BOWEL DISEASE

ANDRADE,Maria Izabel Siqueira de; MAIO,Regiane; DOURADO,Keila Fernandes; MACÊDO,Patrícia Fortes Cavalcanti de; BARRETO NETO,Augusto César
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2015 Português
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Background Evidence suggests a nutritional transition process in patients with inflammatory bowel disease. Obesity, which was once an uncommon occurrence in such patients, has grown in this population at the same prevalence rate as that found in the general population, bringing with it an increased risk of cardiovascular disease. Objective The aim of the present study was to determine the nutritional status and occurrence of cardiovascular risk factors in patients with inflammatory bowel disease. Methods A case-series cross-sectional study was conducted involving male and female adult outpatients with inflammatory bowel disease. Data were collected on demographic, socioeconomic, clinical and anthropometric variables as well as the following cardiovascular risk factors: sedentary lifestyle, excess weight, abdominal obesity, medications in use, comorbidities, alcohol intake and smoking habits. The significance level for all statistical tests was set to 5% (P< 0.05). Results The sample comprised 80 patients with inflammatory bowel disease, 56 of whom (70.0%) had ulcerative colitis and 24 of whom (30.0%) had Crohn's disease. Mean age was 40.3±11 years and the female genre accounted for 66.2% of the sample. High frequencies of excess weight (48.8%) and abdominal obesity (52.5%) were identified based on the body mass index and waist circumference...

‣ Inflammatory Bowel Disease Cause-specific Mortality: A Primer for Clinicians

Kassam, Zain; Belga, Sara; Roifman, Idan; Hirota, Simon; Jijon, Humberto; Kaplan, Gilaad G.; Ghosh, Subrata; Beck, Paul L.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Português
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Background: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC) is perceived to harbor significant morbidity but limited excess mortality, thought to be driven by colon cancer, compared with the general population. Recent studies suggest mortality rates seem higher than previously understood, and there are emerging threats to mortality. Clinicians must be up to date and able to clearly convey the causes of mortality to arm individual patients with information to meaningfully participate in decisions regarding IBD treatment and maintenance of health. Methods: A MEDLINE search was conducted to capture all relevant articles. Keyword search included: “inflammatory bowel disease,” “Crohn's disease,” “ulcerative colitis,” and “mortality.” Results: CD and UC have slightly different causes of mortality; however, malignancy and colorectal cancer–associated mortality remains controversial in IBD. CD mortality seems to be driven by gastrointestinal disease, infection, and respiratory diseases. UC mortality was primarily attributable to gastrointestinal disease and infection. Clostridium difficile infection is an emerging cause of mortality in IBD. UC and CD patients have a marked increase in risk of thromboembolic disease. With advances in medical and surgical interventions...

‣ Bone mineral density and nutritional status in children with chronic inflammatory bowel disease

Boot, A; Bouquet, J; Krenning, E; de Muinck, Keizer-... S M P F
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/1998 Português
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Background—Osteoporosis has been reported in adult patients with inflammatory bowel disease. 
Aims—To evaluate bone mineral density (BMD), nutritional status, and determinants of BMD in children with inflammatory bowel disease. 
Patients—Fifty five patients (34 boys and 21 girls, age range 4-18) were studied; 22 had Crohn's disease and 33 ulcerative colitis. 
Methods—Lumbar spine and total body BMD, and body composition were assessed by dual energy x ray absorptiometry (DXA). Results were expressed as standard deviation scores (SDS). Lean body mass was also assessed by bioelectrical impedance analysis (BIA). Yearly measurements during two years were performed in 21patients. 
Results—The mean SDS of lumbar spine BMD and total body BMD were significantly lower than normal (−0.75 and −0.95, both p<0.001). Height SDS and body mass index SDS were also decreased. The decrease in BMD SDS could not be explained by delay in bone maturation. The cumulative dose of prednisolone correlated negatively with lumbar spine BMD SDS (r=−0.32, p<0.02). Body mass index SDS correlated positively with total body BMD SDS (r=0.36, p<0.02). Patients with Crohn's disease had significantly lower lumbar spine and total body BMD SDS than patients with ulcerative colitis...

‣ Anti-Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease: prevalence and diagnostic role

Quinton, J; Sendid, B; Reumaux, D; Duthilleul, P; Cortot, A; Grandbastien, B; Charrier, G; Targan, S; Colombel, J; Poulain, D
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1998 Português
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Background—Perinuclear antineutrophil cytoplasmic autoantibodies (pANCA) are a well recognised marker for ulcerative colitis. Antibodies to oligomannosidic epitopes of the yeast Saccharomyces cerevisiae (ASCA) are a new marker associated with Crohn's disease. 
Aims—To assess the value of detecting pANCA and/or ASCA for the diagnosis of ulcerative colitis and Crohn's disease. 
Methods—Serum samples were obtained from 100 patients with Crohn's disease, 101 patients with ulcerative colitis, 27 patients with other miscellaneous diarrhoeal illnesses, and 163 healthy controls. Determination of pANCA and ASCA was performed using the standardised indirect immunofluorescence technique and an ELISA, respectively. 
Results—The combination of a positive pANCA test and a negative ASCA test yielded a sensitivity, specificity, and positive predictive value of 57%, 97%, and 92.5% respectively for ulcerative colitis. The combination of a positive ASCA test and a negative pANCA test yielded a sensitivity, specificity, and positive predictive value of 49%, 97%, and 96% respectively for Crohn's disease. Among patients with miscellaneous non-inflammatory bowel disorders, three were ASCA positive and two were pANCA positive. One control was ASCA positive. The presence of ASCA in patients with Crohn's disease was associated with small bowel involvement. 
Conclusion—ASCA and pANCA are strongly associated with Crohn's disease and ulcerative colitis...

‣ Cell therapy in experimental model of inflammatory bowel disease

Marcelino,Mônica Yonashiro; Fuoco,Natália Langenfeld; Quaglio,Ana Elise Valencise; Bittencourt,Renata Aparecida de Camargo; Garms,Bruna Cambraia; Conceição,Thaís Helena da Motta; Stasi,Luiz Claudio Di; Ribeiro-Paes,João Tadeu
Fonte: Sociedade Brasileira de Coloproctologia Publicador: Sociedade Brasileira de Coloproctologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2015 Português
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Inflammatory bowel disease, which mainly involves Crohn's disease and ulcerative rectocolitis, is an inflammatory condition of the mucosa that can afflict any segment of the gastrointestinal tract. Despite the fact that the existing therapies result in improvement in patient's symptomatology and quality of life, there is no curative treatment. Surgical treatment involves complex procedures associated with high morbidity and mortality rates. In this context, cell therapy with stem cells has emerged as a treatment with broad potential applicability. In this study, we intended to verify the efficacy of transplantation of adipose tissue-derived stem cells in rats with intestinal inflammation induced by trinitrobenzenesulfonic acid. The cell population was isolated from the adipose tissue of inguinal region of rats and processed for culture by mechanical dissociation. The animals were evaluated with respect to clinical and biochemical aspects, as well as by macroscopic, microscopic and histological analyses. In the experimental model of bowel inflammation by 2,4,6-trinitrobenzenesulfonic acid, the infusion of adipose tissue significantly reduced the presence of adhesions in the colon and adjacent organs and decreased the activity of myeloperoxidase...

‣ Probiotics in arthralgia and spondyloarthropathies in patients with inflammatory bowel disease: Prospective randomized trials are necessary

Karimi,O.; Peña,A. S.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/08/2005 Português
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Arthralgias and spondyloarthropathies of the peripheral and axial joints are common in inflammatory bowel disease. Evidence for a strong association between these clinical manifestations and diseases of the joints has been provided by several clinical and epidemiological studies. Immunological studies have shown the presence of shared inflammatory cells both in the gut and the synovium in spondyloarthropathies. Genetic factors play a crucial role in the pathogenesis of spondyloarthropathies and inflammatory bowel disease. The role of the ubiquitous bacterial flora and pathogenic microorganisms present in the intestinal lumen may induce these joint diseases in patients with inflammatory bowel disease. In this review we will focus on the pathogenesis of spondyloarthropathies and arthralgia in patients suffering from inflammatory bowel disease. Based on preliminary clinical observations in patients with arthralgia and IBD, we put forward the hypothesis that probiotics may be helpful in the management of common extraintestinal manifestations such as arthralgia in patients with ulcerative colitis and Crohn's disease.

‣ Relationship between socio-demographic and clinical variables, and health-related quality of life in patients with inflammatory bowel disease

López Blanco,B.; Moreno-Jiménez,B.; Devesa Múgica,J. M.; Rodríguez Muñoz,A.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/12/2005 Português
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Objective: the principal aim of the present study is to evaluate the influence of socio-demographic and clinical variables on health-related quality of life (HRQL) in patients with inflammatory bowel disease. Patients and method: this was a cross-sectional study. health-related quality of life was measured with the Inflammatory Bowel Disease Questionnaire (IBDQ). A total of 120 patients, 60 with ulcerative colitis and 60 with Crohn's disease, participated in the study. Results: no significant differences were observed between ulcerative colitis and Crohn's disease patients in IBDQ dimensions. However, a multivariate analysis revealed that sex, type of treatment, extraintestinal symptoms, number of relapses in previous year, satisfaction with surgery, and need for psychological support were related to HRQL. Conclusions: the identification of these variables associated with HRQL in patients with inflammatory bowel disease shows them to be basically non-disease factors. Knowledge of such elements can turn out to be very useful in order to guide future research and modify specific factors in further interventions.

‣ A population-based study on the incidence of inflammatory bowel disease in Oviedo (Northern Spain)

Rodrigo,L.; Riestra,S.; Niño,P.; Cadahía,V.; Tojo,R.; Fuentes,D.; Moreno,M.; González-Ballina,E.; Fernández,E.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/05/2004 Português
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Objective: to assess the incidence of inflammatory bowel disease in Oviedo (Northern Spain), and to describe the clinical features of new patients. Patients and methods: a prospective population-based study was made at the Health Area IV, Principality of Asturias (Oviedo, 312,324 inhabitants). All new diagnosed patients with inflammatory bowel disease were registered over a 2-year period. Results: a total of 85 patients were included, 47 of these with ulcerative colitis (UC), 37 with Crohn's disease (CD), and 1 with undetermined colitis. The overall adjusted incidence rate of UC and CD per 10(5) inhabitants between 15-64 years was 9.1 (95% CI: 5-13.1) and 7.5 (95% CI: 3.8-11.2), respectively. The global male/female ratio was 0.9, without significant differences between both diseases. CD patients were younger than those with UC (33 ± 15 years vs 45 ± 20 years; p < 0.05). Mostly, CD patients were diagnosed at an age younger than 35 years (65%), while UC patients were diagnosed at an age between 25 and 64 years (81%). Disease extension in UC was proctitis in 11%, left-side colitis in 53% and extensive colitis in 36%. With respect to CD, the ileo-colonic form predominated (49%), followed by the ileal (40%) and colonic (11%) forms; an inflammatory...

‣ Adherence to treatment in inflammatory bowel disease

López San Román,A.; Bermejo,F.; Carrera,E.; Pérez-Abad,M.; Boixeda,D.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/04/2005 Português
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Aim: adherence to therapy is important to ensure success. We wanted to explore this feature in patients with inflammatory bowel disease. Patients and methods: we explored adherence to treatment and its modifiers in 40 patients with inflammatory bowel disease using a battery of tests. Results: a 67% of patients (95% CI: 51-81%) acknowledged a certain degree of involuntary nonadherence, and 35% (95% CI: 20-51%) of voluntary nonadherence. Overall, 72% (95% CI: 56-85%) of patients had some form of nonadherence. An objective correlation of these self-reported data was assessed by the determination of urine salicylate levels in the subset of patients treated with mesalazine or its derivatives (15 cases). Two of them (13%) had no detectable urinary drug levels, indicating complete nonadherence. Voluntary nonadherence was higher in patients with lower scores in the intestinal (p = 0.02) and social areas (p = 0.015) of IBDQ-32, as well as in those with less active Crohn's disease (p < 0.005), patients with high depression scores and high patient-physician discordance (p = 0.01), patients with long-standing disease (p = 0.057), patients who considered themselves not to be well informed about the treatment they were getting (p = 0.04) or who trusted their attending physicians less (p = 0.03). Conclusions: intentional nonadherence to therapy is prevalent among patients with inflammatory bowel disease. A correction of factors associated to poor adherence could lead to higher therapeutic success.

‣ Th17 response and autophagy - main pathways implicated in the development of inflammatory bowel disease by genome-wide association studies: new factors involved in inflammatory bowel disease susceptibility

Díaz-Peña,Roberto; Valdés,Eliana; Cofré,Cecilia; Castro-Santos,Patricia
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/09/2015 Português
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Inflammatory bowel disease (IBD) is an entity that mainly includes ulcerative colitis (UC) and Crohn's disease (CD). Improved health care, diet changes, and higher industrialization are associated with an increase in IBD prevalence. This supports the central role of environmental factors in the pathology of this disease. However, IBD also shows a relevant genetic component as shown by high heritability. Classic genetic studies showed relevant associations between IBD susceptibility and genes involved in the immune response. This is consistent with prior theories about IBD development. According to these, contact of the immune system with a high number of harmless antigens from the diet and the bacterial flora should originate tolerance while preserving response against pathogens. Failure to achieve this balance may originate the typical inflammatory response associated with IBD. Recently, genome-wide association studies (GWASs) have confirmed the implication of the immune system, particularly the Th17 immune response, previously associated to other autoimmune diseases, and of autophagy. In this paper, the mechanisms involved in these two relevant pathways and their potential role in the pathogenesis of IBD are reviewed.

‣ Questionnaires for measuring fatigue and its impact on health perception in inflammatory bowel disease

Castillo-Cejas,María Dolores; Robles,Virginia; Borruel,Natalia; Torrejón,Antonio; Navarro,Ester; Peláez,Andrés; Casellas,Francesc
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/03/2013 Português
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Introduction: fatigue impacts perceived health, but its importance in inflammatory bowel disease is not known. Objectives: to define the applicability of the fatigue measurement questionnaires and analyze it in patients with Crohn's disease and ulcerative colitis. Material and methods: in a first phase, the psychometric properties of 3 fatigue measurement questionnaires were determined in 99 patients: Daily Fatigue Impact Scale, Fatigue Severity Scale, and Modified Fatigue Impact Scale. In a second phase, fatigue status and its relationship to disease and quality of life was determined in 127 patients and 69 healthy controls. Results: the first part of the study showed the applicability of the questionnaires listed in inflammatory bowel disease, the Daily Fatigue Impact Scale (DFIS) having the best correlation with the quality of life and clinical activity. In the second phase, significantly higher levels of fatigue were observed in active disease than in disease in remission and healthy controls (p < 0,05). The severity of fatigue was significantly correlated with quality of life (r = -0.66 and -0.72 between IBDQ-9 and DFIS and in Crohn's disease and ulcerative colitis, respectively) and with disease activity (r = 0.25 and Crohn's disease and ulcerative colitis...