共查询到20条相似文献,搜索用时 15 毫秒
1.
Neera Gupta Robert H. Lustig Michael A. Kohn Eric Vittinghoff 《Digestive diseases and sciences》2012,57(11):2975-2981
Background and Aims
The timing of menarche in Crohn’s disease (CD) is poorly described. Our objectives were to study age at menarche onset in CD, and factors associated with this.Methods
We compared the age at menarche of 34 CD patients with that for 545 controls, using data in the National Health and Nutrition Examination Survey (NHANES).Results
Mean chronological age (CA) of CD patients (15.6 years) did not differ from that of the NHANES cohort (15.7 years; P = 0.91). The median CA at menarche (13.9 years) in CD was older than in the NHANES sample (12.0 years) (P < 0.00005). In CD patients, the cumulative incidence of menarche was 10 % at CA 12 years, 51 % at CA 14 years, and 100 % at CA 16 years. Sixty-eight percent reached menarche by bone age (BA) 13.5 years and 100 % by BA greater than 14.0 years. Menarche occurred earliest in South Asians, followed by East Asians, and then Caucasians (P = 0.02).Conclusions
CA at menarche is delayed in CD compared with the NHANES cohort. BA at menarche in CD is similar to BA at menarche reported for healthy children. CA at menarche in CD differs by race. If menarche has not occurred by BA greater than 14.0 years, endocrinology referral should be considered. 相似文献2.
Il Woong Sohn Sung Tae Kim Bun Kim Hyun Jung Lee Soo Jung Park Sung Pil Hong Tae Il Kim Won Ho Kim Jae Hee Cheon 《Gut and liver》2016,10(2):255-261
Background/Aims
Adalimumab is effective for both remission induction and the maintenance of Crohn’s disease (CD) in Western countries. We evaluated the efficacy of adalim-umab in the conventional step-up treatment approach for CD in Korea.Methods
We retrospectively reviewed 62 patients with CD who were treated with adalimumab. Their Crohn’s disease activity index (CDAI) was measured at weeks 4, 8, and 52. Clinical remission was defined as a CDAI score <150. Induction and maintenance outcomes were analyzed.Results
Forty-one patients (66.1%) achieved a reduction of 70 CDAI points at week 8. Among them, 28 (45.2%) achieved clinical remission at week 8, 20 (32.3%) maintained remission at week 52. The absence of prior anti-tumor necrosis factor (TNF) therapy and Montreal classification L1 at baseline predicted clinical remission at week 8 in the multivariate logistic regression analysis. In the Cox proportional hazards model, the hazard ratio for the secondary loss of response during maintenance therapy after clinical remission induction was significantly higher in patients who showed initial mild CDAI severity or Montreal classification A3.Conclusions
In our study, anti-TNF therapy-naive and Montreal classification L1 were associated with adalimumab efficacy as induction therapy in CD. Further studies are warranted to determine the prognostic factors for the long-term response after adalimumab therapy. 相似文献3.
von Roon AC Reese G Teare J Constantinides V Darzi AW Tekkis PP 《Diseases of the colon and rectum》2007,50(6):839-855
Purpose The risk of cancer in patients with Crohn’s disease is not well defined. Using meta-analytical techniques, the present study
was designed to quantify the risk of intestinal, extraintestinal, and hemopoietic malignancies in such patients.
Methods A literature search identified 34 studies of 60,122 patients with Crohn’s disease. The incidence and relative risk of cancer
were calculated for patients with Crohn’s disease and compared with the baseline population of patients without Crohn’s disease.
Overall pooled estimates, with 95 percent confidence intervals, were obtained, using a random-effects model.
Results The relative risk of small bowel, colorectal, extraintestinal cancer, and lymphoma compared with the baseline population was
28.4 (95 percent confidence interval, 14.46–55.66), 2.4 (95 percent confidence interval, 1.56–4.36), 1.27 (95 percent confidence
interval, 1.1–1.47), and 1.42 (95 percent confidence interval, 1.16–1.73), respectively. On subgroup analysis, patients with
Crohn’s disease had an increased risk of colon cancer (relative risk, 2.59; 95 percent confidence interval, 1.54–4.36) but
not of rectal cancer (relative risk, 1.46; 95 percent confidence interval, 0.8–2.55). There was significant association between
the anatomic location of the diseased bowel and the risk of cancer in that segment. The risk of small bowel cancer and colorectal
cancer was found to be higher in North America and the United Kingdom than in Scandinavian countries with no evidence of temporal
changes in the cancer incidence.
Conclusions The present meta-analysis demonstrated an increased risk of small bowel, colon, extraintestinal cancers, and lymphoma in patients
with Crohn’s disease. Patients with extensive colonic disease that has been present from a young age should be candidates
for endoscopic surveillance; however, further data are required to evaluate the risk of neoplasia over time.
Presented at the meeting of the European Society of Coloproctology, Lisbon, Portugal, September 13 to 16, 2006. 相似文献
4.
Zouiten-Mekki L Zaouali H Boubaker J Karoui S Fekih M Matri S Hamzaoui S Filali A Chaabouni H Hugot JP 《Digestive diseases and sciences》2005,50(1):130-135
Crohns disease (CD) is a heterogeneous disorder. A genetic linkage to chromosome 16 (IBD1) has been previously observed and replicated in unrelated populations. Recently, in this region, NOD2/CARD15 has been identified as a susceptibility gene. The aim of this report is to determine whether this gene is implicated in CD in a Tunisian population. One hundred thirty patients with CD and 90 healthy individuals were genotyped for the three common NOD2 variants (C2104T in exon 4, G2722C in exon 8, and 3020insC in exon 11). Furthermore, the 11 exons of the NOD2 gene were sequenced in 20 patients with CD. Results showed that the frequency of the CARD15 variants in the Tunisian population is significantly lower than that observed in the European and American population. Direct sequencing of CARD15 did not permit us to identify a characteristic mutation in our population. No association was confirmed between CD and the NOD2 gene in our Tunisian population. Furthermore, the NOD2/CARD15 gene has a variable association with CD in different populations. These results indicate the genetic variation of CD in different ethnic groups. 相似文献
5.
Leyla J. Ghazi Alison D. Lydecker Seema A. Patil Ankur Rustgi Raymond K. Cross Mark H. Flasar 《Digestive diseases and sciences》2014,59(10):2508-2513
Background
The existing literature on racial differences in Crohn’s disease (CD) activity and quality of life (QOL) is limited and extrapolated from surrogate measures.Aim
The aim of our study was to compare objective markers of disease activity and QOL over time by race.Study
A clinical data repository of inflammatory bowel disease (IBD) patients at University of Maryland, Baltimore IBD Program, was used. CD patients from 2004 to 2009 were included if they had greater than or equal to two clinic visits with disease activity and QOL scores during the study period. Differences in disease activity and QOL were compared by race over time.Results
A total of 296 patients with CD met inclusion criteria; of these, 19 % (56/296) were African Americans (AA) and 81 % (240/296) were Caucasian. Baseline disease activity and QOL scores did not differ by race (p > 0.05). Caucasians had a steady decline in disease activity and increase in QOL. AA experienced a similar pattern of change in disease activity and QOL scores over time; however, the declines were not statistically significant between groups. At each time point post-baseline, disease activity and QOL scores were similar between races.Conclusion
We found that Caucasian and AA patients with CD had similar disease activity and QOL scores at initial presentation and over time. Thus, AA do not represent a more severe subgroup of CD patients to treat. These findings have important implications for clinicians that care for patients with CD. 相似文献6.
Nos P Garrigues V Bastida G Maroto N Ponce M Ponce J 《Digestive diseases and sciences》2004,49(11-12):1771-1776
The nonstenotic, nonfistulizing (or inflammatory) pattern of Crohn's disease appears to be unstable in time and may evolve toward either the stenotic or the fistulizing pattern. We aimed to assess the course of the inflammatory disease and its relation to certain clinical characteristics. After a mean follow-up of 93 months, we evaluated 73 patients with an inflammatory pattern. The behavior trend and its relation to disease location, initial treatment, and need for corticosteroids, immunosuppressors, and surgical resection were analyzed. In 64% of the patients the inflammatory pattern did not change, while in 14 and 22% it evolved toward a stenotic and a fistulizing pattern, respectively. This change was mainly determined by the appearance of perianal disease (75%). The mean time to behavior evolution was 67 months. Most patients required corticosteroids (92%). Need for immunosuppressors (48%) and surgical resection (30%) was significantly greater (P < 0.05) among patients with a change in pattern than in those with persistent inflammatory disease. The inflammatory pattern of CD remains stable in about half of patients. The course of this pattern is not indolent, however, since the needs for immunosuppression and surgical resection during follow-up are considerable. 相似文献
7.
Andreu-Ballester JC Amigó-García V Catalán-Serra I Gil-Borrás R Ballester F Almela-Quilis A Millan-Scheiding M Peñarroja-Otero C 《Digestive diseases and sciences》2011,56(9):2613-2622
Background
Gammadelta T lymphocytes are an important component of innate immunity. Previous studies have shown their role in the development of Crohn’s-like colitis in mice. 相似文献8.
Seo Hyungil Ye Byong Duk Song Eun Mi Lee Sun-Ho Chang Kiju Lee Ho-Su Hwang Sung Wook Park Sang Hyoung Yang Dong-Hoon Kim Kyung-Jo Byeon Jeong-Sik Myung Seung-Jae Yang Suk-Kyun 《Digestive diseases and sciences》2017,62(10):2882-2893
Digestive Diseases and Sciences - Large-scale studies regarding the long-term outcomes of adalimumab (ADA) treatment in Asian patients with Crohn’s disease (CD) are still scarce. We... 相似文献
9.
Background
Little is known about the factors that predict clinical relapse in Crohn’s disease patients receiving thiopurine therapy to maintain remission. The objective of this study was, therefore, to investigate these factors. 相似文献10.
Kasparek MS Glatzle J Temeltcheva T Mueller MH Koenigsrainer A Kreis ME 《Diseases of the colon and rectum》2007,50(12):2067-2074
Purpose Symptomatic perianal fistulas impair quality of life in patients with Crohn’s disease. Fecal diversion improves symptoms but
may impair quality of life. This study was designed to compare long-term quality of life in patients with Crohn’s disease
with symptomatic perianal fistulas who were treated with or without fecal diversion.
Methods From 1996 to 2002, perianal fistulas were treated in 116 patients with Crohn’s disease. A questionnaire, including four quality
of life instruments, was mailed to each patient (Short-Form General Health Survey, Gastrointestinal Quality of Life Index,
Cleveland Global Quality of Life Score, Short Inflammatory Bowel Disease Questionnaire).
Results Questionnaires were returned by 77 of 116 patients (66 percent). Thirty-four of these patients had undergone fecal diversion,
whereas 43 had not. Median follow-up was 49 (range, 18–97) months in diverted and 44 (range, 14–98) months in undiverted patients
(not significant). In the diverted group, 44 percent complained of Crohn’s disease-related symptoms, which was less compared
with 79 percent in undiverted patients (P < 0.05). Diverted patients achieved 68 ± 1 percent of the maximum possible score on the Gastrointestinal Quality of Life
Index compared with 60 ± 2 percent in undiverted patients (mean ± standard error of the mean; P < 0.001); diverted patients scored better on the subscale “gastrointestinal symptoms” of the Gastrointestinal Quality of
Life Index (81 ± 1 percent vs. 67 ± 2 percent; P < 0.001). There was no difference in the Short Inflammatory Bowel Disease Questionnaire between diverted and undiverted patients
except for the subscale “bowel function” (91 ± 2 percent vs. 76 ± 2 percent; P < 0.0001). No difference in quality of life was detected by the Short-Form General Health Survey and Cleveland Global Quality
of Life Score.
Conclusions In the investigated population of patients with Crohn’s disease, quality of life seems to be similar or potentially superior
in diverted patients suffering from perianal fistulas compared with undiverted patients. A diverting stoma, therefore, may
improve quality of life in patients with severe perianal Crohn’s disease.
Presented at the meeting of the American Gastroenterological Association, Digestive Diseases Week, Los Angeles, California,
May 20 to 25, 2006, and published in abstract form Gastroenterology 2006;130(Suppl 2):A620. 相似文献
11.
Picetti Dominic Kim Jihoon Zhu Wenhong Sandborn William J. Jairath Vipul Singh Siddharth 《Digestive diseases and sciences》2022,67(7):3115-3123
Digestive Diseases and Sciences - 5-aminosalicylates (5-ASA) are frequently used in the management of Crohn’s disease (CD). We used a de-identified administrative claims database to compare... 相似文献
12.
Karban A Atia O Leitersdorf E Shahbari A Sbeit W Ackerman Z Mualem R Levine A Nesher S Safadi R Eliakim R 《Digestive diseases and sciences》2005,50(9):1692-1697
The prevalence of Crohn’s disease depends on geographic location and racial background. Arg702Trp, Gly908Arg, and Leu1007fsinsC
mutations in the NOD2/CARD15 gene are associated with Crohn’s disease in Caucasians. The mutation rate among Israeli Jewish
patients is 27%–41%. The prevalence of Crohn’s disease is much lower in the Israeli Arab compared to the Israeli Jewish population.
We studied the NOD2/CARD15 mutation rate and disease phenotype (according to the Vienna classification) among the Israeli
Arabs and compared them with those in an Israeli Jewish cohort. We recruited 66 Israeli Arab patients and 122 ethnically matched
controls. Five patients (8.2%) and three controls (2.3%) carried one NOD2/CARD15 mutation. The phenotypic characteristics
of the Arab and Jewish patients were very similar. We conclude that NOD2/CARD15 mutations do not contribute to Crohn’s susceptibility
in the Israeli Arab population and suggest that NOD2/CARD15 mutations have an important effect on Crohn’s prevalence within
a specific population but not on the phenotype.
R. Safadi, MD, and R. Eliakim, MD, share senior authorship 相似文献
13.
Braveman JM Schoetz DJ Marcello PW Roberts PL Coller JA Murray JJ Rusin LC 《Diseases of the colon and rectum》2004,47(10):1613-1619
PURPOSE Recent studies have suggested that a subset of patients with Crohns colitis may have a favorable outcome after ileal pouch-anal anastomosis and have advocated elective ileal pouch-anal anastomosis in selected patients with Crohns disease. We have not offered ileal pouch-anal anastomosis to patients with known Crohns disease, but because of the overlap in clinical presentation of ulcerative colitis and indeterminate colitis, some patients receiving an ileal pouch-anal anastomosis are subsequently found to have Crohns disease. We review our experience with these patients to identify potential preoperative predictors of ultimate pouch failure.METHODS Patients with a final diagnosis of Crohns disease were identified from an ileal pouch-anal anastomosis registry. These patients are followed prospectively. Preoperative and postoperative clinical and pathologic characteristics were evaluated as predictors of outcome. Median (range) values are listed.RESULTS Thirty-two (18 females) patients (4.1 percent) with a final diagnosis of Crohns disease were identified from a registry of 790 ileal pouch-anal anastomosis patients (1980–2002). Patients underwent ileal pouch-anal anastomosis in two stages (11 patients) or three stages (21 patients). The preoperative diagnosis was ulcerative colitis in 24 patients and indeterminate colitis in 8 patients. Median follow-up was 153 (range, 13–231) months. The median time from ileal pouch-anal anastomosis to diagnosis of Crohns disease was 19 (range, 0–188) months. Complications occurred in 93 percent, including perineal abscess/fistula (63 percent), pouchitis (50 percent), and anal stricture (38 percent). Pouch failure (excision or current diversion) occurred in nine patients (29 percent) at a median of 66 (range, 6–187) months. Two of these 9 patients had preoperative anal disease (not significant). Comparing patients with failed pouches (n = 9) to patients with functioning pouches (n = 23), post-ileal pouch-anal anastomosis perineal abscess (67 vs. 26 percent, P = 0.05) and pouch fistula (89 vs. 30 percent, P = 0.01) were more commonly associated with pouch failure. Preoperative clinical, endoscopic, and pathologic features were not predictive of pouch failure or patient outcome. For those with a functional pouch, 50 percent have been or are currently on medication to treat active Crohns disease. This group had six bowel movements in 24 (range, 3–10) hours, with leakage in 60 percent and pad usage in 45 percent.CONCLUSIONS Patients who undergo ileal pouch-anal anastomosis and are subsequently found to have Crohns disease experience significant morbidity. Preoperative characteristics, including the presence of anal disease, were not predictive of subsequent pouch failure. We choose not to recommend the routine application of ileal pouch-anal anastomosis in any subset of patients with known Crohns disease.Reprints are not available. 相似文献
14.
Nathanson JW Yadron NE Farnan J Kinnear S Hart J Rubin DT 《Digestive diseases and sciences》2008,53(2):474-480
Background: Mutations in the tumor suppressor gene p53 are associated with neoplasia in ulcerative colitis, but little is understood
of their significance in Crohn’s disease (CD). Purpose: To explore p53 expression as a marker of neoplasia in CD patients. Methods: This is a retrospective review of CD patients who underwent p53 IHC staining in our center between 1995 and 2003. The p53
status was correlated to the presence and grade of neoplasia at the time of staining and in subsequent follow-up. Results: Fourteen CD patients had p53 assessment: eight were p53 positive and six were p53 negative. Seven of eight p53+ had dysplasia
(six LGD, one HGD); one of six p53−had dysplasia (LGD) (P = 0.03). Four p53+ patients with follow-up had persistent dysplasia and two had progression to a higher grade. Three p53−
patients with follow-up remained free of dysplasia. Conclusions: This limited study shows that p53 over expression in CD patients is associated with dysplasia that may progress to a higher
grade of neoplasia over time. 相似文献
15.
Leung Y Kaplan GG Rioux KP Hubbard J Kamhawi S Stasiak L Cohen RD Devlin SM Panaccione R Hanauer SB Rubin DT 《Digestive diseases and sciences》2012,57(4):1026-1032
Background
Patients with Crohn’s disease (CD) who smoke have a more complicated disease course.Aims
Our primary objective was to assess smoking related variables that were associated with smoking cessation versus continued smoking in patients with CD.Methods
A multi-center study identified CD patients who were seen at the University of Chicago and University of Calgary IBD clinics. Patients were categorized into three subgroups: lifetime non-smokers, current smokers, or ex-smokers. Participants completed questionnaires assessing their cigarette smoking behavior. Current smokers were prospectively followed for 6?months to assess smoking status and attempts to quit. Logistic regression analysis was performed to identify factors associated with smoking cessation.Results
Three hundred patients were enrolled with 148 identifying themselves as lifetime non-smokers, 70 as current smokers, and 82 as ex-smokers. Patients who reported their first cigarette within 5?min of waking were more likely to be current smokers (OR?=?21; 95% CI 3.94–107.3) as compared to patients who waited greater than 60?min. Current smokers were more likely to have one or more household members who smoked compared to ex-smokers (P?0.05). Nearly half (49%) of the current smokers were in the precontemplation stage of change (i.e. no intention to quit smoking). At the 6-month follow-up, only 11% reported they quit smoking.Conclusions
Patients who report a short time to first cigarette in the morning may have more difficulty in smoking cessation. Current smokers were more likely to have another smoker in the household compared to ex-smokers. Current smokers had low levels of motivation to quit smoking and consequently with no intervention, very few quit 6?months after the baseline assessment. 相似文献16.
There are limited data available that address the prevalence of vaginal complaints in women with Crohn’s disease. This study
assessed the frequency of vaginal involvement and types of vaginal symptoms in women with Crohn’s disease managed at a university
inflammatory bowel disease program. The charts of 50 women with Crohn’s disease seen consecutively during a three-month period
were reviewed for the presence of vaginal involvement. The intestinal distribution of Crohn’s disease [colonic, small bowel
(SB), colonic/SB] was determined, and the presence of vaginal symptoms and types of complaints were assessed. Eleven of the
50 women (22%) described vaginal symptoms. Vaginal complaints included ten patients with labial swelling and one patient with
passage of stool through the vagina. Nine of the 11 women with vaginal complaints also had concurrent intestinal symptoms
and perineal manifestations (P < 0.001). This study suggests that vaginal involvement in Crohn’s disease may be a more frequent phenomenon than previously
reported. 相似文献
17.
Background
Intestinal permeability and altered inflammatory responses, along with genetic and environmental factors, likely contribute to the pathogenesis of Crohn’s disease. 相似文献18.
Purpose Alimentary factors, especially those modifying the intestinal flora, may influence the course of inflammatory bowel disease.
It is known that T and B cells of patients with Crohn’s disease can be stimulated with the yeast antigen, mannan. We evaluated
the impact of eating habits with special respect to food containing yeast on the course of inflammatory bowel disease.
Methods Questionnaires were sent to 180 German-speaking patients of the Inflammatory Bowel Disease Outpatient Clinic at the University
Hospital Bern, Switzerland. The following information was obtained by the questionnaires: (1) course of disease, (2) eating
habits, (3) environmental data, and (4) inflammatory bowel disease questionnaire. The survey was anonymous.
Results A total of 145 patients (80.5 percent 95 with Crohn’s disease, and 50 with ulcerative colitis) responded. Food items containing
yeast were better tolerated by patients with ulcerative colitis than by patients with Crohn’s disease. A significant difference
between the two groups was observed concerning food containing raw yeast (dough, P = 0.04; and pastry, P = 0.001).
Conclusions Food items containing raw yeast led to more frequent problems for patients with Crohn’s disease than for patients with ulcerative
colitis. This observation supports our previous data, which showed the stimulatory effect of the yeast antigen, mannan, on
B and T cells of patients with Crohn’s disease but not of controls.
Poster presentation at Digestive Disease Week (DDW), organized by the American Gastrointestinal Association, Chicago, Illinois,
May 14 to 19, 2005. 相似文献
19.
Zamani F Shahram F Shakeri R Zayyeni H Davatchi F Amiri A Malekzadeh R 《Digestive diseases and sciences》2009,54(8):1736-1739
Background Behcet's disease and Celiac disease, both common in Iran, share many immunopathogenic and clinical features. Based on the
possible association between these two diseases, this study is designed to determine the frequency of non-diagnosed celiac
disease in patients with Behcet’s disease. Methods The sera of 288 consecutive patients with Behcet’s disease were screened with anti-endomysial antibody and anti-tissue transglutaminase
antibody for celiac disease. Those with a positive test underwent upper gastrointestinal endoscopy and duodenal biopsies to
confirm the diagnosis of celiac disease. The patients with celiac disease were put on a gluten free diet to evaluate its efficacy
on the improvement of their lesions. Results Fourteen patients had positive anti-tissue transglutaminase antibody test (two with positive anti-endomysial antibody as
well). Duodenal biopsies showed findings compatible with Marsh 3 in one and Marsh 1 in three other patients. All the diagnosed
patients with celiac disease responded to the gluten free diet. Conclusion Our findings didn’t support any association between celiac disease and Behcet’s disease in Iranian patients compared to the
general population of Iran. 相似文献
20.
Zhenwu Lin John P. Hegarty Wei Yu Jon A. Cappel Xi Chen Pieter W. Faber Yunhua Wang Lisa S. Poritz Jian-Bing Fan Walter A. Koltun 《Digestive diseases and sciences》2012,57(12):3145-3153