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Letter: Enhancing the Rigor of Research on Herpes Zoster Risk in IBD Patients Post-SARS-CoV2: Recommendations for Global and Detailed Analyses-Authors' Reply. 信提高 SARS-CoV2 后 IBD 患者带状疱疹风险研究的严谨性:关于全面和详细分析的建议--作者的回复。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izae223
Aakash Desai, Francis A Farraye, Freddy Caldera
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引用次数: 0
Response to the Letter to the Editor, "Refining the Understanding of Cannabis Impact on Inflammatory Bowel Disease Outcomes: Recommendations for Enhanced Research and Healthcare Practices". 回应致编辑的信,"进一步了解大麻对炎症性肠病结果的影响:加强研究和医疗实践的建议"。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izae228
Danny Glickman, Shannon Dalessio, Wesley M Raup-Konsavage, Kent E Vrana, Matthew D Coates
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引用次数: 0
Correction to: Challenges in IBD Research 2024: Novel Technologies. 更正为:2024 年肠道疾病研究的挑战:新技术。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izae149
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引用次数: 0
KONO-S Anastomosis Is Not Superior to Conventional Anastomosis for the Reduction of Postoperative Endoscopic Recurrence in Crohn's Disease. KONO-S吻合在减少克罗恩病术后内镜复发方面并不优于传统吻合。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izad214
Gaëlle Tyrode, Zaher Lakkis, Dewi Vernerey, Antoine Falcoz, Valentine Clairet, Line Alibert, Stéphane Koch, Lucine Vuitton

Background: Surgical resection rates remain high in Crohn's disease (CD). Reducing postoperative recurrence (POR) is challenging. Besides drug therapy, the surgical anastomosis technique may reduce POR. We aimed to compare the endoscopic POR rate after Kono-S vs standard ileocolic anastomosis.

Methods: The study included all consecutive CD patients operated on for ileocolic resection with a Kono-S anastomosis between February 2020 and March 2022. These patients were prospectively followed, and colonoscopy was performed 6 to 12 months after surgery. Patients were compared with a historical cohort of patients operated on with a conventional anastomosis in the same center. The primary end point was endoscopic POR (Rutgeerts score ≥i2). Factors associated with POR were assessed by univariate and multivariable analyses.

Results: A total of 85 patients were included, 30 in the Kono-S group and 55 in the control group. At baseline, there was no significant difference between the 2 groups regarding CD characteristics or known POR risk factors, including previous exposure to biologics. At 6 to 12 months, endoscopic POR rate did not differ significantly between groups (56.7% in the Kono-S group vs 49.1% in the control group; P = .50), nor did endoscopic POR according to the modified Rutgeerts score ≥i2b (46.7% in the Kono-S group vs 40% in the control group; P = .55). Severe endoscopic POR rates were 23.3% and 18.2% in each group, respectively. Clinical recurrence rate was similar in both groups, and no recurrent surgery occurred. By multivariable analysis, the type of anastomosis was not associated with endoscopic POR (OR, 1.229; 95% CI, 0.461-3.274, P = .68); however, postoperative treatment with anti-TNF was (OR, 0.337; 95% CI, 0.131-0.865 P = .02).

Conclusions: Kono-S anastomosis was not associated with a reduced rate of endoscopic POR. These results warrant confirmation in prospective, randomized, multicenter studies.

背景:克罗恩病(CD)的手术切除率仍然很高。减少术后复发(POR)具有挑战性。除了药物治疗外,手术吻合技术还可以降低POR。我们的目的是比较Kono-S与标准回结肠吻合后的内镜POR率。方法:该研究包括2020年2月至2022年3月期间接受回结肠切除术并进行Kono-S吻合的所有连续CD患者。对这些患者进行前瞻性随访,并在手术后6至12个月进行结肠镜检查。将患者与在同一中心进行传统吻合手术的历史患者队列进行比较。主要终点是内镜下POR(Rutgeerts评分≥i2)。通过单变量和多变量分析评估与POR相关的因素。结果:共纳入85例患者,其中Kono-S组30例,对照组55例。在基线时,两组在CD特征或已知POR风险因素(包括之前接触过生物制品)方面没有显著差异。在6-12个月时,各组的内镜POR发生率没有显著差异(Kono-S组为56.7%,对照组为49.1%;P = .50),根据改良Rutgeerts评分≥i2b的内镜POR也没有(Kono-S组为46.7%,对照组为40%;P = .55)。各组的严重内镜POR发生率分别为23.3%和18.2%。两组患者的临床复发率相似,均未发生复发性手术。通过多变量分析,吻合类型与内镜POR无关(OR,1.229;95%CI,0.461-3.274,P = .68);然而,抗TNF的术后治疗是(OR,0.337;95%CI,0.131-0.865 P = .结论:Kono-S吻合与内镜下POR发生率的降低无关。这些结果值得在前瞻性、随机、多中心研究中得到证实。
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引用次数: 0
Rates of Endoscopic Recurrence In Postoperative Crohn's Disease Based on Anastomotic Techniques: A Systematic Review And Meta-Analysis. 基于吻合技术的克罗恩病术后内镜复发率:系统综述和荟萃分析。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izad252
Olga Maria Nardone, Giulio Calabrese, Brigida Barberio, Mariano Cesare Giglio, Fabiana Castiglione, Gaetano Luglio, Edoardo Savarino, Subrata Ghosh, Marietta Iacucci

Background: Patients with Crohn's disease (CD) after ileocolic resection may develop an endoscopic postoperative recurrence (ePOR) that reaches 40% to 70% of incidence within 6 months. Recently, there has been growing interest in the potential effect of anastomotic configurations on ePOR. Kono-S anastomosis has been proposed for reducing the risk of clinical and ePOR. Most studies have assessed the association of ileocolonic anastomosis and ePOR individually, while there is currently limited data simultaneously comparing several types of anastomosis. Therefore, we performed a systematic review and meta-analysis to assess the impact of different ileocolonic anastomosis on ePOR in CD.

Methods: We searched PubMed and Embase from inception to January 2023 for eligible studies reporting the types of anastomoses and, based on these, the rate of endoscopic recurrence at ≥6 months. Studies were grouped by conventional anastomosis, including side-to-side, end-to-end, and end-to-side vs Kono-S, and comparisons were made between these groups. Pooled incidence rates of ePOR were computed using random-effect modelling.

Results: Seventeen studies, with 2087 patients who underwent ileocolic resection for CD were included. Among these patients, 369 (17,7%) Kono-S anastomoses were performed, while 1690 (81,0%) were conventional ileocolic anastomosis. Endoscopic postoperative recurrence at ≥6 months showed a pooled incidence of 37.2% (95% CI, 27.7-47.2) with significant heterogeneity among the studies (P < .0001). In detail, patients receiving a Kono-S anastomosis had a pooled incidence of ePOR of 24.7% (95% CI, 6.8%-49.4%), while patients receiving a conventional anastomosis had an ePOR of 42.6% (95% CI, 32.2%-53.4%).

Conclusions: Kono-S ileocolic anastomosis was more likely to decrease the risk of ePOR at ≥6 months compared with conventional anastomosis. Our findings highlight the need to implement the use of Kono-S anastomosis, particularly for difficult to treat patients. However, results from larger randomized controlled trials are needed to confirm these data.

背景:回结肠切除术后克罗恩病(CD)患者可能在6个月内发生内镜下术后复发(ePOR),其发病率达到40%至70%。最近,人们对吻合口构型对ePOR的潜在影响越来越感兴趣。Kono-S吻合已被提出用于降低临床和ePOR的风险。大多数研究都单独评估了回肠结肠吻合和ePOR的关系,而目前同时比较几种类型吻合的数据有限。因此,我们进行了一项系统综述和荟萃分析,以评估不同回肠结肠吻合对CD ePOR的影响。研究按常规吻合分组,包括侧对侧、端对端和端对侧与Kono-S,并在这些组之间进行比较。使用随机效应模型计算ePOR的合并发病率。结果:纳入了17项研究,其中2087名患者接受了CD回结肠切除术。在这些患者中,进行了369次(17,7%)Kono-S吻合,而进行了1690次(81,0%)常规回结肠吻合。内镜下术后复发≥6个月时,合并发生率为37.2%(95%CI,27.7-47.2),研究之间具有显著的异质性(P<.0001)。详细而言,接受Kono-S吻合的患者的ePOR合并发病率为24.7%(95%CI,6.8%-49.4%),而接受常规吻合的患者ePOR为42.6%(95%CI,32.2%-53.4%)。结论:与常规吻合相比,Kono-S回结肠吻合更有可能降低≥6个月时发生ePOR的风险。我们的研究结果强调了实施Kono-S吻合的必要性,特别是对于难以治疗的患者。然而,需要更大规模的随机对照试验的结果来证实这些数据。
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引用次数: 0
Patient Perspectives of Bowel Urgency and Bowel Urgency-Related Accidents in Ulcerative Colitis and Crohn's Disease. 溃疡性结肠炎和克罗恩病患者对肠急症和肠急症相关事故的看法。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izae044
Vipul Jairath, Theresa Hunter Gibble, Alison Potts Bleakman, Kaitlin Chatterton, Paolo Medrano, Megan McLafferty, Brittany Klooster, Sonal Saxena, Richard Moses

Background: Bowel urgency is bothersome in patients with ulcerative colitis (UC) or Crohn's disease (CD) and impacts their well-being but remains underappreciated in clinical trials and during patient-healthcare provider interactions. This study explored the experiences of bowel urgency and bowel urgency-related accidents to identify the concepts most relevant and important to patients.

Methods: Adults with a diagnosis of moderate-to-severe UC or CD for ≥6 months and experience of bowel urgency in the past 6 months were included. Qualitative, semi-structured interviews were conducted via telephonic/Web-enabled teleconference. Interview transcripts were coded and analyzed in ATLAS.ti 9 using a systematic thematic analysis.

Results: In total, 30 participants with UC or CD (n = 15 each) (mean age 52 and 50 years, respectively) participated in the interviews. The majority of participants were receiving biologic and/or conventional therapy (80% and 87%, respectively). Most participants with UC (87%) and all with CD experienced bowel urgency-related accidents. The most frequently reported symptoms co-occurring with bowel urgency were abdominal pain, fatigue, and abdominal cramping. Abdominal pain and abdominal cramping were the most bothersome co-occurring symptoms of bowel urgency and bowel urgency-related accidents. In both groups, participants reported decreased frequency of bowel urgency and not wanting to experience bowel urgency-related accidents at all as a meaningful improvement.

Conclusions: Participants with UC or CD expressed bowel urgency and bowel urgency-related accidents to be bothersome and impactful on their daily lives despite use of biologic and/or conventional therapy. These findings underscore the need for development of patient-reported outcome measures to assess bowel urgency in clinical settings.

背景:排便急迫是溃疡性结肠炎(UC)或克罗恩病(CD)患者的困扰,影响着他们的健康,但在临床试验以及患者与医疗服务提供者的互动过程中,排便急迫仍未得到充分重视。本研究探讨了肠紧迫感和肠紧迫感相关事故的经历,以确定与患者最相关和最重要的概念:研究对象包括确诊中重度 UC 或 CD ≥6 个月且在过去 6 个月中有过肠紧迫感的成年人。通过电话/网络远程会议进行半结构化定性访谈。访谈记录在 ATLAS.ti 9 中使用系统主题分析法进行编码和分析:共有 30 名 UC 或 CD 患者(各 15 人)(平均年龄分别为 52 岁和 50 岁)参加了访谈。大多数参与者正在接受生物和/或常规治疗(分别为 80% 和 87%)。大多数 UC 患者(87%)和所有 CD 患者都曾发生过肠道急迫相关事故。最常报告的肠紧迫症状是腹痛、疲劳和腹部绞痛。腹痛和腹部绞痛是排便急迫和排便急迫相关事故中最令人烦恼的并发症状。在这两组患者中,参与者都认为肠紧迫感频率降低和完全不想经历肠紧迫感相关事故是有意义的改善:结论:尽管使用了生物疗法和/或传统疗法,UC 或 CD 参与者仍表示肠紧迫感和肠紧迫感相关事故令人烦恼并影响其日常生活。这些发现强调了在临床环境中开发患者报告的结果测量方法来评估肠紧迫性的必要性。
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引用次数: 0
An Insight into Patients' Perspectives of Ulcerative Colitis Flares via Analysis of Online Public Forum Posts. 通过分析在线公共论坛帖子,了解患者对溃疡性结肠炎的看法。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izad247
David T Rubin, Joana Torres, Iris Dotan, Lan Terry Xu, Irene Modesto, John C Woolcott, Sean Gardiner, Bruce E Sands

Background: The knowledge of patients' perceptions of factors contributing to ulcerative colitis (UC) flares is limited; however, online patient communications could offer insight. This analysis aimed to identify the most frequent patient-reported triggers and symptoms of UC flares, which could highlight potential interventions for outcome improvement.

Methods: Online posts written pre- and postflare by patients with UC on 8 public forums in 6 countries between January 1, 2019, and February 14, 2021, were identified using flare-related keywords. Flare-related posts were captured and Netbase Quid™ artificial intelligence text analytics and natural language processing software were used to semantically map and identify commonly discussed themes and topics (subsets of themes).

Results: Of >27 000 patient posts, 12 900 were identified as flare related. The most frequent themes were treatment experiences and side effects (28.5% of posts), followed by flare symptoms (22.9% of posts). The most frequent topic was emotional/peer support (9.4% of posts), followed by experiences with mesalamine (and other oral/rectal formulations; 8.0% of posts), and dietary recommendations (6.0% of posts). Stress and anxiety were the most frequently reported flare triggers (37.9% of posts), followed by diet (28.4% of posts). Stress and anxiety were frequently identified as both triggers for, and general symptoms of, flare. Blood in the stool was the most discussed flare indicator (57.8% of posts).

Conclusions: Frequently discussed patient-perceived triggers of UC flares included diet, stress, and anxiety. These results suggest that physicians could incorporate a broader and more holistic approach to UC monitoring and management than is currently practiced.

背景:患者对溃疡性结肠炎(UC)发作因素的认知是有限的;然而,在线患者交流可以提供洞察力。该分析旨在确定UC发作最常见的患者报告触发因素和症状,这可能会突出改善结果的潜在干预措施。方法:2019年1月1日至2021年2月14日期间,UC患者在6个国家的8个公共论坛上发布的突发事件前后的在线帖子,使用突发事件相关关键词进行识别。捕捉到了与Flare相关的帖子,并进行了Netbase测验™ 使用人工智能文本分析和自然语言处理软件对常见讨论的主题和主题(主题子集)进行语义映射和识别。最常见的主题是治疗经历和副作用(28.5%的帖子),其次是突发症状(22.9%的帖子)。最常见的话题是情感/同伴支持(9.4%的帖子),其次是美沙拉秦(和其他口服/直肠制剂;8.0%的帖子;)和饮食建议(6.0%的帖子。压力和焦虑是最常见的突发事件触发因素(37.9%的帖子),其次是饮食(28.4%的帖子)。压力和焦虑经常被认为是突发事件的诱因和一般症状。粪便中的血液是最常讨论的发作指标(57.8%的帖子)。结论:经常讨论的UC发作的患者感知触发因素包括饮食、压力和焦虑。这些结果表明,医生可以采用比目前更广泛、更全面的方法来监测和管理UC。
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引用次数: 0
Crohn's Disease Mortality and Ambient Air Pollution in New York City. 克罗恩病死亡率与纽约市环境空气污染。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izad243
Alexandra Feathers, Gina S Lovasi, Zoya Grigoryan, Kade Beem, Samit K Datta, David M Faleck, Thomas Socci, Rachel Maggi, Arun Swaminath

Background: The worldwide increase in Crohn's disease (CD) has accelerated alongside rising urbanization and accompanying decline in air quality. Air pollution affects epithelial cell function, modulates immune responses, and changes the gut microbiome composition. In epidemiologic studies, ambient air pollution has a demonstrated relationship with incident CD and hospitalizations. However, no data exist on the association of CD-related death and air pollution.

Methods: We conducted an ecologic study comparing the number of CD-related deaths of individuals residing in given zip codes, with the level of air pollution from nitric oxide, nitrogen dioxide, sulfur dioxide (SO2), and fine particulate matter. Air pollution was measured by the New York Community Air Survey. We conducted Pearson correlations and a Poisson regression with robust standard errors. Each pollution component was modeled separately.

Results: There was a higher risk of CD-related death in zip codes with higher levels of SO2 (incidence rate ratio [IRR], 1.16; 95% confidence interval [CI], 1.06-1.27). Zip codes with higher percentage of Black or Latinx residents were associated with lower CD-related death rates in the SO2 model (IRR, 0.58; 95% CI, 0.35-0.98; and IRR, 0.13; 95% CI, 0.05-0.30, respectively). There was no significant association of either population density or area-based income with the CD-related death rate.

Conclusions: In New York City from 1993 to 2010, CD-related death rates were higher among individuals from neighborhoods with higher levels of SO2 but were not associated with levels of nitric oxide, nitrogen dioxide, and fine particulate matter. These findings raise an important and timely public health issue regarding exposure of CD patients to environmental SO2, warranting further exploration.

背景:随着城市化进程的加快和空气质量的下降,克罗恩病(CD)在全球范围内的增加速度加快。空气污染影响上皮细胞功能,调节免疫反应,并改变肠道微生物组的组成。在流行病学研究中,环境空气污染与CD事件和住院有着明显的关系。然而,没有关于CD相关死亡与空气污染之间关系的数据。方法:我们进行了一项生态研究,将居住在特定邮政编码内的个人CD相关死亡人数与一氧化氮、二氧化氮、二氧化硫(SO2)和细颗粒物的空气污染水平进行了比较。空气污染是由纽约社区空气调查测量的。我们进行了具有稳健标准误差的皮尔逊相关和泊松回归。每个污染成分都是单独建模的。结果:在SO2水平较高的邮政编码地区,CD相关死亡的风险较高(发病率比[IRR],1.16;95%置信区间[CI],1.06-1.27)。在SO2模型中,黑人或拉丁裔居民比例较高的邮政代码与CD相关死亡率较低相关(IRR,分别为0.58;95%CI,0.35-0.98;以及IRR,0.13;95%CI,0.05-0.30)。人口密度或地区收入与CD相关死亡率没有显著关联。结论:从1993年到2010年,在纽约市,来自SO2水平较高的社区的个体与CD相关的死亡率较高,但与一氧化氮、二氧化氮和细颗粒物水平无关。这些发现提出了一个关于CD患者暴露于环境SO2的重要而及时的公共卫生问题,值得进一步探索。
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引用次数: 0
Correction to: Implication of Inflammatory Bowel Disease Diagnosed Before the Age of 18 for Achieving an Upper Secondary Education: A Nationwide Population-Based Cohort Study. 更正:18岁前确诊的炎症性肠病对完成高中教育的影响:基于全国人口的队列研究》。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izae134
{"title":"Correction to: Implication of Inflammatory Bowel Disease Diagnosed Before the Age of 18 for Achieving an Upper Secondary Education: A Nationwide Population-Based Cohort Study.","authors":"","doi":"10.1093/ibd/izae134","DOIUrl":"10.1093/ibd/izae134","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1926-1927"},"PeriodicalIF":4.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In Acute Severe Ulcerative Colitis Patients Who Receive Rescue Therapy, Prior Maintenance Therapy and Day 3 C-Reactive Protein After Rescue Therapy Are Associated With 12-Month Colectomy Risk. 在接受抢救性治疗的急性严重溃疡性结肠炎患者中,先前的维持治疗和抢救性治疗后的第3天C反应蛋白与12个月的结肠切除风险相关。
IF 4.5 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-03 DOI: 10.1093/ibd/izad215
Jared A Sninsky, Ana-Maria Staicu, Edward L Barnes
{"title":"In Acute Severe Ulcerative Colitis Patients Who Receive Rescue Therapy, Prior Maintenance Therapy and Day 3 C-Reactive Protein After Rescue Therapy Are Associated With 12-Month Colectomy Risk.","authors":"Jared A Sninsky, Ana-Maria Staicu, Edward L Barnes","doi":"10.1093/ibd/izad215","DOIUrl":"10.1093/ibd/izad215","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1911-1913"},"PeriodicalIF":4.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Inflammatory Bowel Diseases
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