Disease impact on the quality of life of children with inflammatory bowel disease

AIM To assess the impact of disease characteristics on the quality of life (QOL) in children with inflammatory bowel diseases(IBD).METHODS This was a cross-sectional study conducted at the First Department of Pediatrics of the University of Athens at the "Aghia Sophia" Children's Hospital. Children diagnosed with Crohn's disease (CD) or ulcerative colitis (UC), who were followed as outpatients or during a hospitalization, participated, after informed consent was obtained from their legal representative. QOL was assessed by the IMPACT-III questionnaire. Demographic data and disease characteristics were also collected. Statistical analyses included parametric(Student's t-test and Pearson's r) and non-parametric(Mann-Whitney test, Fisher's test and Spearman's rho) procedures.RESULTS Ninety-nine patients (UC: 37, 73.0% females, CD: 62, 51.6% females), aged 12.8±2.6 years were included.Overall, as well as, sub-domain scores did not differ between UC and CD(overall score: 73.9±13.3 vs 77.5±11.2, respectively, P=0.16). In the entire sample, total score was related to physician's global assessment(PGA, patients classified as "mild/moderate" active disease had, on average, 14.8±2.7 points lower total scores compared to those "in remission", P<0.001) and age at IMPACT completion (Pearson's r=0.29, P=0.05). Disease activity assessed by the indices Pediatric Ulcerative Colitis activity index, Pediatric Crohn's disease activity index or PGA was significantly associated with all subdomains scores. Presence of extraintestinal manifestations had a negative impact on emotional and social functioning domains.CONCLUSION Disease activity is the main correlate of QOL in children with IBD, underlining the importance of achieving and sustaining clinical

Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil

BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.

2023:A year of accomplishments for the 13 Science Citation Index Expanded-and Emerging Sources Citation Index-indexed Baishideng journals

In 2023,Baishideng Publishing Group(Baishideng)routinely published 47 openaccess journals,including 46 English-language journals and 1 Chinese-language journal.Our successes were accomplished through the collective dedicated efforts of Baishideng staffs,Editorial Board Members,and Peer Reviewers.Among these 47 Baishideng journals,7 are included in the Science Citation Index Expanded(SCIE)and 6 in the Emerging Sources Citation Index(ESCI).With the support of Baishideng authors,company staffs,Editorial Board Members,and Peer Reviewers,the publication work of 2023 is about to be successfully completed.This editorial summarizes the 2023 activities and accomplishments of the 13 SCIEand ESCI-indexed Baishideng journals,outlines the Baishideng publishing policy changes and additions made this year,and highlights the unique advantages of Baishideng journals.

Harnessing the potential of gene editing technology using CRISPR in inflammatory bowel disease

The molecular scalpel of clustered regularly interspersed short palindromic repeats/CRISPR associated protein 9(CRISPR/Cas9) technology may be sharp enough to begin cutting the genes implicated in inflammatory bowel disease(IBD) and consequently decrease the 6.3 billion dollar annual financial healthcare burden in the treatment of IBD. For the past few years CRISPR technology has drastically revolutionized DNA engineering and biomedical research field. We are beginning to see its application in gene manipulation of sickle cell disease,human immunodeficiency virus resistant embryologic twin gene modification and IBD genes such as Gatm(Glycine amidinotransferase, mitochondrial),nucleotide-binding oligomerization domain-containing protein 2, KRT12 and other genes implicated in adaptive immune convergence pathways have been subjected to gene editing, however there are very few publications. Furthermore,since Crohn's disease and ulcerative colitis have shared disease susceptibility and share genetic gene profile, it is paramount and is more advantageous to use CRISPR technology to maximize impact. Although, currently CRISPR does have its limitations due to limited number of specific Cas enzymes, off-target activity,protospacer adjacent motifs and crossfire between different target sites. However,these limitations have given researchers further insight on how to augment and manipulate enzymes to enable precise gene excision and limit crossfire between target sites.

Chronological age when health care transition skills are mastered in adolescents/young adults with inflammatory bowel disease

AIM To describe the longitudinal course of acquisition of healthcare transition skills among adolescents and young adults with inflammatory bowel diseases.METHODS We recruited adolescents and young adults(AYA) with inflammatory bowel diseases(IBD), from the pediatric IBD clinic at the University of North Carolina. Participants completed the TRx ANSITION Scale? at least once during the study period(2006-2015). We used the electronic medical record to extract participants' clinical and demographic data. We used ordinary least square regressions with robust standard error clustered at patient level to explore the variations in the levels and growths of healthcare transition readiness.RESULTS Our sample(n = 144) ranged in age from 14-22 years. Age was significantly and positively associated with both the level and growth of TRx ANSITION Scale? scores(P < 0.01). Many healthcare transition(HCT) skills were acquired between ages 12 and 14 years, but others were not mastered until after age 18, including self-management skills.CONCLUSION This is one of the first studies to describe the longitudinal course of HCT skill acquisition among AYA with IBD, providing benchmarks for evaluating transition interventions.

Disease trends after Helicobacter pylori eradication based on Japanese nationwide claims and the health check-up database

BACKGROUND Helicobacter pylori(H.pylori)infection is a risk factor for many diseases,including peptic ulcer disease and gastric cancer.While H.pylori eradication therapy can prevent these diseases,potentially unfavorable effects of eradication therapy have also been reported in some diseases,such as gastroesophageal reflux disease(GERD),Barrett’s esophagus(BE),inflammatory bowel disease(IBD),allergic diseases,and metabolic diseases.Consequently,both positive and negative impacts should be considered when assessing the effects of H.pylori eradication therapy.AIM To compare the incidence of these diseases before and after H.pylori eradication and to comprehensively assess its effects.METHODS This retrospective cohort study used a Japanese nationwide health claims database(April 2009-March 2020),developed by the Japanese Ministry of Health,Labour and Welfare.The database contained almost all health insurance claims data issued in Japan,and specific health check-up data for individuals who took the check-ups.Descriptive statistics were used for the analyses.Patients who received primary eradication therapy were defined as those prescribed medication for H.pylori eradication.New diagnoses,defined as incidence of upper gastrointestinal diseases and IBD,and prevalence of allergic diseases were compared before and after eradication.The incidence and prevalence of each disease were also compared between the 3-year period before eradication(from the 4th to the 2nd year prior to the year of eradication)and the 3-year period after eradication(from the 1st to the 3rd year after the year of eradication)based on the age category and calendar year and month.Changes in body mass index and proportion of patients with metabolic syndrome(MS)were examined before and after eradication.RESULTS We identified 5219731 patients who received primary eradication therapy.The 65-69 years age group had the greatest number of patients in both sexes.There was no significant increase in the incidence of GERD after eradication when considering the effects of aging and reporting period.However,the incidence of BE was higher in the 3-year period after eradication than in the 3-year period before eradication for all age categories(0.02%-0.10%vs<0.01%-0.05%).The incidence of IBD and prevalence of allergic disease were also higher after eradication.In contrast,the incidence of gastric and duodenal ulcers and gastritis was reduced after eradication.In patients with at least one entry of health check-up data(1701111 patients),the percentage of patients with MS showed a slight increase following eradication(11.0%in the year of eradication and 12.2%after 5 years).CONCLUSION The results suggest that H.pylori eradication therapy reduces peptic ulcers and gastritis;however,it is associated with increased incidence of several other chronic diseases.

Application of Big Data analysis in gastrointestinal research

Big Data,which are characterized by certain unique traits like volume,velocity and value,have revolutionized the research of multiple fields including medicine.Big Data in health care are defined as large datasets that are collected routinely or automatically,and stored electronically.With the rapidly expanding volume of health data collection,it is envisioned that the Big Data approach can improve not only individual health,but also the performance of health care systems.The application of Big Data analysis in the field of gastroenterology and hepatology research has also opened new research approaches.While it retains most of the advantages and avoids some of the disadvantages of traditional observational studies(case-control and prospective cohort studies),it allows for phenomapping of disease heterogeneity,enhancement of drug safety,as well as development of precision medicine,prediction models and personalized treatment.Unlike randomized controlled trials,it reflects the real-world situation and studies patients who are often under-represented in randomized controlled trials.However,residual and/or unmeasured confounding remains a major concern,which requires meticulous study design and various statistical adjustment methods.Other potential drawbacks include data validity,missing data,incomplete data capture due to the unavailability of diagnosis codes for certain clinical situations,and individual privacy.With continuous technological advances,some of the current limitations with Big Data may be further minimized.This review will illustrate the use of Big Data research on gastrointestinal and liver diseases using recently published examples.

改良营养不良通用筛查工具在炎症性肠病患者中的应用研究

目的探讨炎症性肠病(IBD)患者专用的改良营养不良通用筛查工具(mMUST)的应用效果。方法选取江阴市人民医院2023年2—4月收治的IBD非手术患者82例,分别使用mMUST和营养风险筛查2002(NRS 2002)对患者进行筛查。结果mMUST和NRS 2002筛查IBD患者营养风险一致性较好(Kappa=0.806,P<0.05),IBD患者使用mMUST筛查出低营养风险者34例(41.46%),中等风险12例(14.63%),高风险36例(43.90%);NRS 2002筛查无风险者57例(69.51%),高风险者25例(30.49%)。两种筛查高风险患者比例比较,差异无统计学意义(χ^(2)=3.058,P=0.076)。mMUST筛查出中高营养风险组体重指数(BMI)、握力、血红蛋白、总蛋白、血清白蛋白、前白蛋白值均低于低营养风险组;中高营养风险组C反应蛋白(CRP)>5 mg/L的比率和粪钙卫蛋白>50μg/g的比率均高于低营养风险组,差异有统计学意义(P<0.05);以营养风险等级作为因变量,采用二分类logistic回归分析探讨IBD患者营养风险的相关因素结果显示,BMI和前白蛋白是营养风险的影响因素。结论mMUST适用于IBD患者营养风险筛查,值得临床推广。

炎症性肠病病人饮食限制行为研究进展

为了减轻疾病症状和防止疾病复发,炎症性肠病病人存在普遍的自发的饮食限制现象,过度的饮食限制会对病人的疾病、营养状况、生活质量、心理状态产生不良后果。本研究主要对炎症性肠病病人的饮食限制现状和影响进行综述,以期引起临床医护人员的重视,为临床炎症性肠病病人的营养管理提供参考。

可穿戴设备在炎性肠病中的应用及研究进展

近年来,在医疗行业数字化、信息化、智能化背景下,可穿戴医疗设备不断快速发展。文章从可穿戴医疗设备的类型、作用方面概述其在炎性肠病(IBD)诊断、治疗、监测中的应用现状,并积极探索未来的发展方向,以期为IBD患者个性化诊疗和管理提供参考。

炎症性肠病患者经济毒性的研究进展

炎症性肠病(IBD)是一种病因未明的慢性非特异性肠道炎症性疾病,具有反复发作、迁延难愈的特点。经济毒性是指疾病所致的医疗费用给患者带来的客观经济负担和主观经济困扰,IBD患者因长期频繁就诊,表现出一定水平的经济毒性。本文对经济毒性概念、评价工具和IBD患者经济毒性现况进行综述,从一般人口学因素、疾病与治疗、心理社会方面分析IBD患者经济毒性的影响因素,总结并提出减轻IBD患者经济毒性的对策和未来研究的方向,以期为相关研究提供参考依据。

围生育期IBD患者药物治疗医药专家共识

(2022年5月25日发布,在线出版时间:2022-05-24)炎症性肠病(inflammatory bowel disease,IBD)是一组病因尚未完全明确的肠道慢性、复发性、非特异性炎症性疾病,包括克罗恩病(Crohn′s disease,CD)和溃疡性结肠炎(ulcerative colitis,UC)。IBD的发病高峰年龄在20~40岁,与人类生育年龄重叠。IBD患者需长期服药,因此从备孕期、妊娠期、分娩期再到哺乳期的围生育期用药安全是IBD患者非常关注的问题。