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Díaz Molina RJ, Comesaña Castellar C, Crespí Rigo J, Radu Tomsa C, Quesada Bauzá P, Porcel Corra I, Sendra Rumbeu P, Royo Escosa V, Herrera González MD, Puchol Segarra E, Ginard Vicens D. Descriptive observational study on the use of virtual reality in patients with inflammatory bowel disease undergoing biological treatment. GASTROENTEROLOGIA Y HEPATOLOGIA 2024:502236. [PMID: 39173828 DOI: 10.1016/j.gastrohep.2024.502236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 08/11/2024] [Accepted: 08/15/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Virtual reality (VR) is a neurosensory experience in which simulated spaces a person has the sensation of being able to function within them. Some patients with inflammatory bowel disease (IBD) receive intravenous biological treatments in an Adult Day Hospital (ADH) regime. VR has been used in some fields of medicine, demonstrating its usefulness in reducing negative symptoms. However, we do not have any literature showing the applicability in real clinical practice of VR in IBD. METHODS Descriptive observational pilot study based on an initial cohort of 87 patients that were obtained from the ADH of the IBD Unit. Satisfaction and acceptance of VR through the use of 3D glasses and the reduction of negative symptoms during intravenous biological treatment in patients with IBD in ADH have been assessed. RESULTS 43 patients (52.4%) used VR and completed the study. In the comparative analysis of the results of the questionnaires before and after the use of VR, a statistically significant improvement was observed in the patients' view on the ability of VR to achieve a reduction in stress (65% patients improve; p: 0.0021) and pain (VAS, 54% p. improve; p<0.05) during treatment. Likewise, with the applicability of VR in other areas of medicine (53%; p: 0.05) and with the possibility of improving well-being during the stay in the ADH (56%; p: 0.0014). No side effects were reported with the use of the 3D glasses. CONCLUSIONS VR is a useful complementary tool to improve the stay of patients with IBD on ADH during intravenous treatment.
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Affiliation(s)
- Raúl José Díaz Molina
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain.
| | - Carlos Comesaña Castellar
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain
| | | | | | | | | | - Pau Sendra Rumbeu
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain
| | - Vanesa Royo Escosa
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain
| | | | - Eva Puchol Segarra
- Infirmary Adult Day Hospital for Inflammatory Bowel Disease of the Son Espases University Hospital, Spain
| | - Daniel Ginard Vicens
- Gastroenterology Department, Son Espases University Hospital, Carretera Valldemossa, 79, 07010 Palma de Mallorca, Spain; Lipids in Human Pathology Group, Institut Universitari d'Investigació en Ciències de la Salut, Universitat de les Illes Balears, 07122 Palma, Spain; Instituto de Investigación Sanitaria Illes Balears (IdISBa), 07010 Palma, Spain
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Barnes A, Bryant RV, Mukherjee S, Spizzo P, Mountifield R. Sleep quality is associated with reduced quality of life in inflammatory bowel disease through its interaction with pain. JGH Open 2024; 8:e70021. [PMID: 39185482 PMCID: PMC11344164 DOI: 10.1002/jgh3.70021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 07/07/2024] [Accepted: 08/07/2024] [Indexed: 08/27/2024]
Abstract
Background and Aim Quality of life is reduced in people with inflammatory bowel disease (IBD) and poor sleep is prevalent in people with IBD. This study aimed to investigate the influence of sleep on quality of life (QoL) in people with inflammatory bowel disease. Methods An online questionnaire was administered through three tertiary IBD centers, social media, and through Crohn's Colitis Australia. The questionnaire included the EQ-5D-5L measures of health-related QoL, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index (PSQI), and validated IBD activity and mental health scores. Results There were 553 responses included with a diagnosis of Crohn's disease (62.2%), with over half on biologic therapy (53.1%). Poor sleep and clinically significant insomnia were associated with lower QoL (EQ-5D-5L scores: EQVAS, utility score, P < 0.001 for all). Sleep quality scores correlated with the EQ-5D-5L domains of "pain" (ρ 0.35, P < 0.001), "usual activities" (ρ 0.32, P < 0.001), and "depression-anxiety" (ρ 0.37, P < 0.001). After adjusting for demographic variables, IBD activity, and depression and anxiety via multivariate regression, the "pain" domain continued to be associated with PSQI components "sleep quality" (P < 0.001), "sleep disturbance" (P < 0.001), and "sleep duration" (P < 0.001). Clinically significant insomnia was associated with a reduction in QoL (EQVAS, utility score) independent of IBD activity (P < 0.001) and of a similar magnitude to that seen with IBD activity. Conclusion Health-related QoL in IBD is influenced by aspects of sleep quality irrespective of IBD activity and mental health conditions. The presence of insomnia is associated with a reduction in health-related QoL. Consideration should be given to sleep targeting interventional studies in an IBD population.
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Affiliation(s)
- Alex Barnes
- Department of GastroenterologySouthern Adelaide Local Health Network (SALHN) Flinders Medical CentreBedford ParkSouth AustraliaAustralia
- College of Medicine and Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Robert V Bryant
- School of Medicine, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
- Department of GastroenterologyQueen Elizabeth HospitalWoodvilleSouth AustraliaAustralia
| | - Sutapa Mukherjee
- Adelaide Institute for Sleep Health, Flinders Health and Medical Research InstituteCollege of Medicine and Public Health, Flinders UniversityBedford ParkSouth AustraliaAustralia
- Department of Respiratory and Sleep MedicineSouthern Adelaide Local Health Network (SALHN) Flinders Medical CentreBedford ParkSouth AustraliaAustralia
| | - Paul Spizzo
- Department of GastroenterologySouthern Adelaide Local Health Network (SALHN) Flinders Medical CentreBedford ParkSouth AustraliaAustralia
| | - Réme Mountifield
- Department of GastroenterologySouthern Adelaide Local Health Network (SALHN) Flinders Medical CentreBedford ParkSouth AustraliaAustralia
- College of Medicine and Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
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Serrano-Fernandez V, Laredo-Aguilera JA, Navarrete-Tejero C, Molina-Gallego B, Lopez-Fernandez-Roldan A, Carmona-Torres JM. The Role of Environmental and Nutritional Factors in the Development of Inflammatory Bowel Diseases: A Case-Control Study. Nutrients 2024; 16:2463. [PMID: 39125343 PMCID: PMC11313778 DOI: 10.3390/nu16152463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 07/20/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND The incidence and prevalence of inflammatory bowel diseases (IBD) are increasing around the world, especially in Western countries. The objective of this study was to evaluate the health habits of healthy controls and individuals with IBDs to identify possible risk factors for IBD development. METHODS A case-control study was conducted among Spanish participants over 18 years of age. A self-administered questionnaire was completed by subjects to collect information on several sociodemographic variables and habits, such as the consumption of tobacco, alcohol, antibiotics, nonsteroidal anti-inflammatory agents and macronutrients; anxiety and depression; and quality of life. RESULTS The main risk factors identified were age; living in an urban environment; anxiety; and excessive consumption of proteins, carbohydrates and fats. In addition, the consumption of fibre had a preventive effect against IBD development. CONCLUSIONS Age, anxiety and living in urban areas pose a risk of suffering from IBD, as does the excessive consumption of certain macronutrients. However, the consumption of fibre has a protective effect on the development of some IBD types.
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Affiliation(s)
- Victor Serrano-Fernandez
- Facultad de Fisioterapia y Enfermeria, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain; (V.S.-F.); (C.N.-T.); (B.M.-G.); (A.L.-F.-R.); (J.M.C.-T.)
- Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
| | - Jose Alberto Laredo-Aguilera
- Facultad de Fisioterapia y Enfermeria, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain; (V.S.-F.); (C.N.-T.); (B.M.-G.); (A.L.-F.-R.); (J.M.C.-T.)
- Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
| | - Carlos Navarrete-Tejero
- Facultad de Fisioterapia y Enfermeria, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain; (V.S.-F.); (C.N.-T.); (B.M.-G.); (A.L.-F.-R.); (J.M.C.-T.)
| | - Brigida Molina-Gallego
- Facultad de Fisioterapia y Enfermeria, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain; (V.S.-F.); (C.N.-T.); (B.M.-G.); (A.L.-F.-R.); (J.M.C.-T.)
| | - Angel Lopez-Fernandez-Roldan
- Facultad de Fisioterapia y Enfermeria, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain; (V.S.-F.); (C.N.-T.); (B.M.-G.); (A.L.-F.-R.); (J.M.C.-T.)
| | - Juan Manuel Carmona-Torres
- Facultad de Fisioterapia y Enfermeria, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain; (V.S.-F.); (C.N.-T.); (B.M.-G.); (A.L.-F.-R.); (J.M.C.-T.)
- Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071 Toledo, Spain
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Sun C, Zhang L, Zhang M, Wang J, Rong S, Lu W, Dong H. Zinc pyrithione induces endothelium-dependent hyperpolarization-mediated mesenteric vasorelaxation in healthy and colitic mice. Biochem Pharmacol 2023; 217:115828. [PMID: 37774954 DOI: 10.1016/j.bcp.2023.115828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Although Zinc pyrithione (ZPT) could lower blood pressure by inducing vasorelaxation, it is unclear if it is able to induce vasorelaxation of mesenteric arterioles in health and ulcerative colitis (UC) to exert anti-colitic action. METHODS The vasorelaxation of the second-order branch of the mesenteric artery from wide type (WT) mice, TRPV1-/-(KO) mice, and TRPV4-/-(KO) mice was determined using a Mulvany-style wire myograph. Calcium imaging and patch clamp were applied to analyze the actions of ZPT in human vascular endothelial cells. Mouse model of UC was used to evaluate the anti-colitic action of ZPT. RESULTS ZPT dose-dependently induced mesenteric vasorelaxation predominately through endothelium-dependent hyperpolarization (EDH), which could be attenuated by intracellular Zn2+ and Ca2+ chelators TPEN and BAPTA-AM. The ZPT/EDH-mediated vasorelaxation via TRPV1, TRPV4 and TRPA1 channels was verified by a combination of selective pharmacological inhibitors and TRPV1-KO and TRPV4-KO mice. Moreover. ZPT induced Ca2+ entry via vascular endothelial TRPV1/4 and TRPA1 channels and enhanced membrane non-selective currents through these channels. Notably, ZPT exerted anti-colitic effects by rescuing the impaired acetylcholine (ACh)-induced mesenteric vasorelaxation in colitic mice. CONCLUSIONS ZPT/Zn2+ induces EDH-mediated mesenteric vasorelaxation through activating endothelial multiple TRPV1/4 and TPPA1 channels in health, and rescues the impaired ACh-induced vasorelaxation to exert anti-colitic action. Our study may open a new avenue of potential vessel-specific targeted therapy for UC.
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Affiliation(s)
- Chensijin Sun
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, #1 Ningde Road, Qingdao 266073, China
| | - Luyun Zhang
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, #1 Ningde Road, Qingdao 266073, China; Department of Pediatric Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Mengting Zhang
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, #1 Ningde Road, Qingdao 266073, China
| | - Jianxin Wang
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, #1 Ningde Road, Qingdao 266073, China
| | - Shaoya Rong
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, #1 Ningde Road, Qingdao 266073, China
| | - Wei Lu
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, #1 Ningde Road, Qingdao 266073, China.
| | - Hui Dong
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College, #1 Ningde Road, Qingdao 266073, China.
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Horvát B, Dávid A, Sallay V, Rafael B, Njers S, Orbán K, Molnár T, Csabai M, Martos T. Improving disease management of patients with inflammatory bowel disease: the potential role of self-concordant health goals. Front Psychol 2023; 14:1115160. [PMID: 37484082 PMCID: PMC10359902 DOI: 10.3389/fpsyg.2023.1115160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Inflammatory bowel diseases (IBD) are chronic gastrointestinal conditions that significantly impact patients' quality of life. Previous research indicates that patients with IBD have a higher prevalence of anxiety compared to the general population and other chronic diseases. This pilot study aimed to investigate the relationships between goal integration, positive and negative emotions, goal self-efficacy, and trait anxiety as the outcome variable, focusing on patients' self-management strategies. Drawing from the Self-Concordance Model (SCM) of Self-Determination Theory (SDT), the study explored how goal integration is associated with more fulfilling and enjoyable experiences and fewer negative emotions, ultimately improving psychological well-being. Health-related goals were evaluated using the Personal Project Analysis technique, while the State-Trait Anxiety Inventory was utilized to measure general anxiety levels. Among the 141 participants with inflammatory bowel disease, 96 reported having health-related goals. Of these, 66 were female (68.75%), and 30 were male participants (31.25%). Path analysis revealed a moderate negative association between self-concordance (SC) and negative emotions, which, in turn, predicted higher levels of trait anxiety. Furthermore, the alternative model tested indicated that trait anxiety predicted a lower level of self-concordance. Setting well-integrated health goals involves an internal capacity, enabling patients to experience less negative emotions during self-management activities. Anxiety can hinder individuals from accessing their inner needs, resulting in less self-concordant aspirations and more negative emotions. These findings may contribute to developing prevention and intervention programs to enhance IBD patients' adherence to lifestyle changes, ultimately improving their overall well-being.
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Affiliation(s)
- Barbara Horvát
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Anett Dávid
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Viola Sallay
- Institute of Psychology, University of Szeged, Szeged, Hungary
| | - Beatrix Rafael
- Department of Preventive Medicine, University of Szeged, Szeged, Hungary
| | - Sanela Njers
- Department of Cognitive and Neuropsychology, University of Szeged, Szeged, Hungary
| | - Kata Orbán
- Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary
| | - Tamás Molnár
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Márta Csabai
- Department of Clinical Psychology, Károli Gáspár University of the Reformed Church, Budapest, Hungary
| | - Tamás Martos
- Institute of Psychology, University of Szeged, Szeged, Hungary
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Aslam T, Mehmood A. Prevalence and Risk Factors of Anemia in Inflammatory Bowel Diseases: A Case-Control Study. Cureus 2023; 15:e41990. [PMID: 37593267 PMCID: PMC10427948 DOI: 10.7759/cureus.41990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/19/2023] Open
Abstract
Introduction Inflammatory bowel diseases (IBDs) including Crohn's disease and ulcerative colitis may induce anemia, ranging from 25% to 75% depending on the study population and diagnostic criteria. It might negatively impact their health and quality of life. Objectives The aim of this work is to study the effectiveness and safety of treatments for anemia in patients with IBD. Methodology This case-control study compared patients with IBD who have anemia (cases; n=60) with patients who have IBD but do not have anemia (controls; n=60) from June 2019 to August 2021 in Hayatabad Medical Complex, Peshawar, Pakistan. Data were collected through interviews, from patients` medical records, and from lab test reports. Statistical analysis was performed using SPSS, Version 23.0 (IBM Corp., Armonk, NY). Results Cases had a greater mean age (45.2 years) than controls (42.8 years). Cases included 60% females and controls 45%. Also, cases earned less (p = 0.019). Anemic patients (group 1) had lower mean hemoglobin (10.2 g/dL) and iron than non-anemic controls (group 2) (p = 0.042 and 0.009, respectively). Anemia increased Crohn's Disease Activity Index and Mayo Score. Group 1 has iron deficiency anemia, whereas group 2 has chronic disease. Group 1 reacts rapidly, but gastrointestinal side effects, allergies, and iron overload are more prevalent. Conclusion IBD patients exhibited low hemoglobin and iron, suggesting anemia. Anemia increased disease activity, but not statistically. IBD patients need iron and anemia treatment. Comparing groups demonstrates differences in anemia types, iron replacement history, treatment response, and bad effects, proposing targeted iron supplementation for deficiency anemia and managing chronic illness factors for chronic disease anemia. IBD anemia treatment involves individualization.
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Affiliation(s)
- Tahir Aslam
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Asim Mehmood
- Respiratory Medicine, Derriford Hospital, Plymouth, GBR
- Respiratory Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
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Fiorino G, Colombel JF, Katsanos K, Mearin F, Stein J, Andretta M, Antonacci S, Arenare L, Citraro R, Dell’Orco S, Degli Esposti L, Ramirez de Arellano Serna A, Morin N, Koutroubakis IE. Iron deficiency anemia impacts disease progression and healthcare resource consumption in patients with inflammatory bowel disease: a real-world evidence study. Therap Adv Gastroenterol 2023; 16:17562848231177153. [PMID: 37274300 PMCID: PMC10236249 DOI: 10.1177/17562848231177153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/04/2023] [Indexed: 06/06/2023] Open
Abstract
Background Iron deficiency anemia (IDA) is a common extraintestinal manifestation of inflammatory bowel disease (IBD), affecting around one-third of patients. Objective To compare IBD progression and healthcare resource utilization in patients with and without a co-diagnosis of IDA in a real-world setting. Design A retrospective comparative study was conducted using Italian entities' administrative databases, covering 9.3 million health-assisted individuals. Methods Adult IBD patients diagnosed with ulcerative colitis and/or Crohn's disease were enrolled between January 2010 and September 2017. Within 12 months from IBD diagnosis, IDA was identified by at least one prescription for iron and/or IDA hospitalization and/or blood transfusion (proxy of diagnosis). IBD population was divided according to the presence/absence of IDA. Given the nonrandom patients' allocation, propensity score matching (PSM) was applied to abate potential unbalances between the groups. Before and after PSM, IBD progression (in terms of IBD-related hospitalizations and surgeries), and healthcare resource costs were assessed. Results Overall, 13,475 IBD patients were included, with an average age at diagnosis of 49.9 years, and a 53.9% percentage of male gender. Before PSM, 1753 (13%) patients were IBD-IDA, and 11,722 (87%) were IBD-non-IDA. Post-PSM, 1753 IBD-IDA patients were matched with 3506 IBD-non-IDA. Before PSM, IBD progression was significantly higher in IBD-IDA (12.8%) than in IBD-non-IDA (6.5%) (p < 0.001). After PSM, IBD progression and IBD-related hospitalizations were significantly (p < 0.001) more frequent in IBD-IDA patients (12.8% and 12.0%, respectively) compared to IBD-non-IDA (8.7% and 7.7%). Consistently, healthcare expenditures resulted significantly higher among IDA patients (p < 0.001), with an overall mean annual cost of €5317 compared to €2798 for patients without IDA. These results were confirmed after PSM matching, as the mean annual total cost/patient in IBD-IDA versus IBD-non-IDA were €3693 and €3046, respectively (p < 0.001). Conclusion In a real-life setting, IDA co-diagnosis in IBD patients was associated with disease progression and higher related economic burden.
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Affiliation(s)
- Gionata Fiorino
- Gastroenterology and Digestive Endoscopy,
Vita-Salute San Raffaele University, Milan, Italy
- Gastroenterology and Digestive Endoscopy, San
Camillo-Forlanini Hospital, Rome, Italy
| | | | | | | | - Jürgen Stein
- DGD Kliniken Frankfurt Sachsenhausen,
Frankfurt/Main, Germany
| | | | | | | | - Rita Citraro
- Azienda Ospedaliero-Universitaria Mater
Domini, Catanzaro, Italy
| | | | - Luca Degli Esposti
- CliCon S.r.l. Società Benefit Health,
Economics & Outcomes Research, Bologna, Italy
| | | | | | - Ioannis E. Koutroubakis
- Department of Gastroenterology, University
Hospital Heraklion, P.O. BOX 1352, Heraklion, Crete 71110, Greece
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Laakso EL, Ewais T. A Holistic Perspective on How Photobiomodulation May Influence Fatigue, Pain, and Depression in Inflammatory Bowel Disease: Beyond Molecular Mechanisms. Biomedicines 2023; 11:biomedicines11051497. [PMID: 37239169 DOI: 10.3390/biomedicines11051497] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Numerous mechanisms, mostly molecular, have been tested and proposed for photobiomodulation. Photobiomodulation is finding a niche in the treatment of conditions that have no gold-standard treatment or only partially effective pharmacological treatment. Many chronic conditions are characterised by symptoms for which there is no cure or control and for which pharmaceuticals may add to the disease burden through side effects. To add quality to life, alternate methods of symptom management need to be identified. OBJECTIVE To demonstrate how photobiomodulation, through its numerous mechanisms, may offer an adjunctive therapy in inflammatory bowel disease. Rather than considering only molecular mechanisms, we take an overarching biopsychosocial approach to propose how existing evidence gleaned from other studies may underpin a treatment strategy of potential benefit to people with Crohn's disease and ulcerative colitis. MAIN FINDINGS In this paper, the authors have proposed the perspective that photobiomodulation, through an integrated effect on the neuroimmune and microbiome-gut-brain axis, has the potential to be effective in managing the fatigue, pain, and depressive symptoms of people with inflammatory bowel disease.
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Affiliation(s)
- E-Liisa Laakso
- Mater Research Institute-University of Queensland, South Brisbane, QLD 4101, Australia
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD 4215, Australia
| | - Tatjana Ewais
- Mater Adolescent and Young Adult Health Clinic, South Brisbane, QLD 4101, Australia
- School of Medicine, The University of Queensland, St Lucia, QLD 4068, Australia
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Southport, QLD 4215, Australia
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Marsilio S, Freiche V, Johnson E, Leo C, Langerak AW, Peters I, Ackermann MR. ACVIM consensus statement guidelines on diagnosing and distinguishing low-grade neoplastic from inflammatory lymphocytic chronic enteropathies in cats. J Vet Intern Med 2023; 37:794-816. [PMID: 37130034 PMCID: PMC10229359 DOI: 10.1111/jvim.16690] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/10/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Lymphoplasmacytic enteritis (LPE) and low-grade intestinal T cell lymphoma (LGITL) are common diseases in older cats, but their diagnosis and differentiation remain challenging. OBJECTIVES To summarize the current literature on etiopathogenesis and diagnosis of LPE and LGITL in cats and provide guidance on the differentiation between LPE and LGITL in cats. To provide statements established using evidence-based approaches or where such evidence is lacking, statements based on consensus of experts in the field. ANIMALS None. METHODS A panel of 6 experts in the field (2 internists, 1 radiologist, 1 anatomic pathologist, 1 clonality expert, 1 oncologist) with the support of a human medical immunologist, was formed to assess and summarize evidence in the peer-reviewed literature and complement it with consensus recommendations. RESULTS Despite increasing interest on the topic for clinicians and pathologists, few prospective studies were available, and interpretation of the pertinent literature often was challenging because of the heterogeneity of the cases. Most recommendations by the panel were supported by a moderate or low level of evidence. Several understudied areas were identified, including cellular markers using immunohistochemistry, genomics, and transcriptomic studies. CONCLUSIONS AND CLINICAL IMPORTANCE To date, no single diagnostic criterion or known biomarker reliably differentiates inflammatory lesions from neoplastic lymphoproliferations in the intestinal tract of cats and a diagnosis currently is established by integrating all available clinical and diagnostic data. Histopathology remains the mainstay to better differentiate LPE from LGITL in cats with chronic enteropathy.
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Affiliation(s)
- Sina Marsilio
- Department of Veterinary Medicine and EpidemiologyUC Davis School of Veterinary MedicineDavisCaliforniaUSA
| | - Valerie Freiche
- Ecole Nationale Vétérinaire d'AlfortCHUVA, Unité de Médecine InterneMaisons‐AlfortFrance
| | - Eric Johnson
- Department of Surgical & Radiological SciencesUC Davis School of Veterinary MedicineDavisCaliforniaUSA
| | - Chiara Leo
- Anicura Istituto Veterinario NovaraNovaraItaly
| | | | | | - Mark R. Ackermann
- Oregon Veterinary Diagnostic Laboratory, Oregon State UniversityCorvallisOregonUSA
- Present address:
US Department of AgricultureNational Animal Disease CenterAmesIowaUSA
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Li M, Tao Y, Sun Y, Wu J, Zhang F, Wen Y, Gong M, Yan J, Liang H, Bai X, Niu J, Miao Y. Constructing a prediction model of inflammatory bowel disease recurrence based on factors affecting the quality of life. Front Med (Lausanne) 2023; 10:1041505. [PMID: 36968835 PMCID: PMC10034041 DOI: 10.3389/fmed.2023.1041505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
AimThis study aimed to determine the factors affecting the quality of life of patients with inflammatory bowel disease (IBD) and to construct a disease recurrence prediction model based on these influencing factors.MethodsA prospective, single-center study in China was conducted between October 2020 and March 2021. The quality of life of patients was assessed using the Inflammatory Bowel Disease Questionnaire (IBDQ). Multiple stepwise regression analysis was used to analyze the factors influencing the quality of life of patients with IBD. The chi-square test and the point-biserial correlation analysis were performed to identify factors associated with clinical recurrence. A binary logistic regression model was constructed to predict the recurrence. The receiver operating characteristic curve was used to evaluate the prediction model. Patients with IBD from April 2021 to June 2021 were randomly included for model verification to evaluate the disease recurrence prediction model.ResultsThe average IBDQ score of patients with IBD was 172.2 ± 35.0 (decreased by 23.2%). The scores of all dimensions of the IBDQ were decreased, especially emotional function and systemic symptoms. Disease activity, age, extraintestinal manifestations (EIMs), and annual household income were important factors influencing the IBDQ scores of patients with ulcerative colitis, and these accounted for ~57.0% of the factors affecting the quality of life. Disease activity, EIMs, and occupational stress were important factors influencing the IBDQ scores of patients with Crohn's disease, and they accounted for approximately 75.1% of the factors affecting the quality of life. Annual household income, occupational stress, and IBDQ scores were independent risk factors for recurrence. The area under the curve of the recurrence prediction model was 81.1%. The sensitivity and specificity were 81.7 and 71.7%, respectively. The Youden index of the model was 0.534. The established recurrence prediction model has good discriminant validity in the validation cohort.ConclusionThe quality of life of patients with IBD was generally poor. The use of factors affecting the quality of life to predict disease recurrence has high predictive value and can support the management of IBD by selecting patients at a higher risk for relapse.
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Affiliation(s)
- Maojuan Li
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Yan Tao
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Yang Sun
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Jing Wu
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Fengrui Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Yunling Wen
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Min Gong
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Jingxian Yan
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Hao Liang
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Xinyu Bai
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
| | - Junkun Niu
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
- Junkun Niu
| | - Yinglei Miao
- Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
- *Correspondence: Yinglei Miao
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Zhou J, Yan X, Bi X, Lu S, Liu X, Yang C, Shi Y, Luo L, Yin Z. γ-Glutamylcysteine rescues mice from TNBS-driven inflammatory bowel disease through regulating macrophages polarization. Inflamm Res 2023; 72:603-621. [PMID: 36690783 DOI: 10.1007/s00011-023-01691-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/30/2022] [Accepted: 01/08/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To explore the molecular mechanism of γ-glutamylcysteine (γ-GC) in response to inflammation in vivo and in vitro on regulating the polarization of macrophages. METHODS The expressions of gene or protein were assessed by qPCR and Western blot assays, respectively. Cell viability was investigated by CCK-8 assay. Eight-week-old male BALB/c mice were established to examine the therapeutic effects of γ-GC in vivo. The release of TNF-α and IL-4 was determined by ELISA assay. Macrophages polarization was identified by flow cytometry assay. RESULTS Our data showed that γ-GC treatment significantly improved the survival, weight loss, and colon tissue damage of IBD mice. Furthermore, we established M1- and M2-polarized macrophages, respectively, and our findings provided evidence that γ-GC switched M1/M2-polarized macrophages through activating AMPK/SIRT1 axis and inhibiting inflammation-related signaling pathway. CONCLUSION Collectively, both in vivo and in vitro experiments suggested that γ-GC has the potential to become a promising novel therapeutic dipeptide for the treatment of IBD, which provide new ideas for the treatment of inflammatory diseases in the future.
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Affiliation(s)
- Jinyi Zhou
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, No. 1 Wenyuan Road, Nanjing, 210046, People's Republic of China
| | - Xintong Yan
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, No. 1 Wenyuan Road, Nanjing, 210046, People's Republic of China
| | - Xiaowen Bi
- Department of Medical Genetics and Cell Biology, School of Basic Medical Sciences, Nanchang University, Nanchang, People's Republic of China
| | - Shuai Lu
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, No. 1 Wenyuan Road, Nanjing, 210046, People's Republic of China
| | - Xianli Liu
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, No. 1 Wenyuan Road, Nanjing, 210046, People's Republic of China
| | - Chen Yang
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, No. 1 Wenyuan Road, Nanjing, 210046, People's Republic of China
| | - Yingying Shi
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, No. 1 Wenyuan Road, Nanjing, 210046, People's Republic of China
| | - Lan Luo
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Science, Nanjing University, Nanjing, 210023, People's Republic of China.
| | - Zhimin Yin
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, No. 1 Wenyuan Road, Nanjing, 210046, People's Republic of China.
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Vezza T, Molina-Tijeras JA, González-Cano R, Rodríguez-Nogales A, García F, Gálvez J, Cobos EJ. Minocycline Prevents the Development of Key Features of Inflammation and Pain in DSS-induced Colitis in Mice. THE JOURNAL OF PAIN 2023; 24:304-319. [PMID: 36183969 DOI: 10.1016/j.jpain.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/30/2022] [Accepted: 09/23/2022] [Indexed: 02/07/2023]
Abstract
Abdominal pain is a common feature in inflammatory bowel disease (IBD) patients, and greatly compromises their quality of life. Therefore, the identification of new therapeutic tools to reduce visceral pain is one of the main goals for IBD therapy. Minocycline, a broad-spectrum tetracycline antibiotic, has gained attention in the scientific community because of its immunomodulatory and anti-inflammatory properties. The aim of this study was to evaluate the potential of this antibiotic as a therapy for the management of visceral pain in dextran sodium sulfate (DSS)-induced colitis in mice. Preemptive treatment with minocycline markedly reduced histological features of intestinal inflammation and the expression of inflammatory markers (Tlr4, Tnfα, Il1ß, Ptgs2, Inos, Cxcl2, and Icam1), and attenuated the decrease of markers of epithelial integrity (Tjp1, Ocln, Muc2, and Muc3). In fact, minocycline restored normal epithelial permeability in colitic mice. Treatment with the antibiotic also reversed the changes in the gut microbiota profile induced by colitis. All these ameliorative effects of minocycline on both inflammation and dysbiosis correlated with a decrease in ongoing pain and referred hyperalgesia, and with the improvement of physical activity induced by the antibiotic in colitic mice. Minocycline might constitute a new therapeutic approach for the treatment of IBD-induced pain. PERSPECTIVE: This study found that the intestinal anti-inflammatory effects of minocycline ameliorate DSS-associated pain in mice. Therefore, minocycline might constitute a novel therapeutic strategy for the treatment of IBD-induced pain.
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Affiliation(s)
- Teresa Vezza
- Department of Pharmacology, University of Granada, Granada, Spain
| | - Jose Alberto Molina-Tijeras
- Department of Pharmacology, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Rafael González-Cano
- Department of Pharmacology, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Biomedical Research Center, Institute of Neuroscience, University of Granada, Granada, Spain.
| | - Alba Rodríguez-Nogales
- Department of Pharmacology, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.
| | - Federico García
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Clinical Microbiology Service, Hospital Universitario San Cecilio, Red de Investigación en SIDA, Granada, Spain
| | - Julio Gálvez
- Department of Pharmacology, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Centro de Investigación Biomédica en Red - Enfermedades Hepáticas y Digestivas (CIBER-EHD)
| | - Enrique J Cobos
- Department of Pharmacology, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Biomedical Research Center, Institute of Neuroscience, University of Granada, Granada, Spain
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Karami H, Shirvani Shiri M, Ebadi Fard Azar F, Bagheri Lankarani K, Ghahramani S, Rezapour A, Tatari M, Heidari Javargi Z. Factors associated with health-related quality of life in patients with Crohn's disease in Iran: A prospective observational study. Front Med (Lausanne) 2023; 9:1091330. [PMID: 36760884 PMCID: PMC9907090 DOI: 10.3389/fmed.2022.1091330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
This was a 1-year prospective observational study of the health-related quality of life (HRQoL) of moderate to severe crohn's disease (CD) patients in Iran. Patients' HRQoL were measured using the EQ-5D 3L, EQ-VAS, and IBDQ-9 tools. HRQoL among CD patients were compared using the T-test, Mann-Whitney, Chi-square, and Fisher's exact tests. To discover factors influencing patients' HRQoL, multivariate linear regression and multivariate logistic regression tests were utilized. The study included 222 CD patients, with a mean age of 34.67 and mean disease duration of 7.32 years. The dimensions with the worst reported "relatively or extreme problems" were P/D: 77.5% and A/D: 63.1%. Employment, having "other chronic diseases," and ADA consumption were the most important independent predictors of HRQoL in CD patients, [β = 0.21 (EQ-5D index), β = 19.61 (EQ-VAS), β = 12.26 (IBDQ-9), OR: 0.09 (MO), OR: 0.12 (UA), OR: 0.21 (P/D), OR: 0.22 (A/D)], [β = -0.15 (EQ-5D index), β = -5.84 (IBDQ-9), β = -11.06 (EQ-VAS), OR: 4.20 (MO), OR: 6.50 (UA)], and [OR: 2.29 (A/D)], respectively. Unemployment, presence of "other chronic conditions" had the greatest negative impact on HRQoL of CD patients. There were significant differences in the probability of reporting "relatively or extreme problems" in the SC and A/D dimensions between patients using adalimumab (ADA) and infliximab (IFX).
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Affiliation(s)
- Hassan Karami
- Department of Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Shirvani Shiri
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farbod Ebadi Fard Azar
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran,*Correspondence: Farbod Ebadi Fard Azar ✉
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Sulmaz Ghahramani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Tatari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Vice Chancellery of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Zahra Heidari Javargi
- Department of Clinical Medicine, School of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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14
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Rahmati L, Mooghali A, Kamani SMH, Zare F, Askari H, Safarpour AR. Economic Burden of Inflammatory Bowel Disease in Shiraz, Iran. ARCHIVES OF IRANIAN MEDICINE 2023; 26:23-28. [PMID: 37543918 PMCID: PMC10685812 DOI: 10.34172/aim.2023.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/27/2021] [Indexed: 08/08/2023]
Abstract
BACKGROUND The epidemiological burden of chronic diseases and their risk factors is increasing all over the world, especially in developing and low-income countries. Inflammatory bowel disease (IBD) is one of the chronic diseases which has imposed a great financial burden on individuals and the society. OBJECTIVES The current study aimed at estimating the economic burden of IBD among 90 patients with IBD who referred to Namazi hospital and Motahari clinic of Shiraz in 2019. The costs to patients were monitored for a year to detect their expenses. METHODS This study is descriptive cross-sectional and from a social perspective. The cost-of-illness method, based on the human capital theory, has been used. Both direct and indirect costs have been estimated using a prevalence approach and bottom-up method. Hospital costs were extracted from patients' records and the accounting system of Namazi Hospital. Outpatient expenses were obtained according to the number of outpatient visits and the average cost of visit were obtained by interviewing patients. Socio-economic status, medical expenses and number of days absent from work were determined using a valid and reliable questionnaire. Assessment of the cost of hospital care was made on the basis of the average daily. Non-medical direct costs such as transportation and residence, etc. were also calculated. RESULTS The total annual economic costs of IBD per patient were estimated at 1229.74 USD. Finally, increased use of health care as well as lost productivity leads to increased disease costs. CONCLUSION IBD imposes a substantial economic burden on patients, families and the society. Establishing a correct diagnosis early, management of IBD worsening, and appropriate treatment can reduce the costs of treatment and lost production to some extent. Therefore, policymakers should take this into consideration and according to available health resources, provide services and facilities for the prevention and treatment of the disease.
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Affiliation(s)
- Leila Rahmati
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Department of Management, Payame Noor University, Tehran, Iran
| | | | | | - Fatemeh Zare
- Department of Research Deputy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Askari
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Department of Management, Payame Noor University, Tehran, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Department of Management, Payame Noor University, Tehran, Iran
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Radford SJ. The impact of Inflammatory Bowel Disease related fatigue on Health-Related Quality of Life: a qualitative semi-structured interview study. J Res Nurs 2022; 27:685-702. [PMID: 36530749 PMCID: PMC9755563 DOI: 10.1177/17449871211061048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
Background Fatigue is a frequently reported symptom of Inflammatory Bowel Disease (IBD), having a negative impact on Health-Related Quality of Life (HRQoL). Patients' experiences of this have not been researched in IBD. Methods Semi-structured interviews were conducted with adults with Crohn's Disease from out-patient clinics in the United Kingdom. Interviews were audio-recorded and transcribed verbatim, then analysed using thematic analysis. Results Fourteen participant interviews were conducted. Three key themes were identified: 1) 'The new normal' established through adaptation and acceptance; 2) 'Energy as a resource' describing attempts to better manage fatigue through planning and prioritising tasks; 3) 'Keeping healthy' encompasses participants' beliefs that 'good health' allows better management of fatigue. Conclusion Participants establish a 'new' normality, through maintaining the same or similar level of employment/education activities. However, this is often at the expense of social activities. Further research is required to explore patient led self-management interventions in IBD fatigue.
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Affiliation(s)
- Shellie J Radford
- Senior Research Nurse, Nottingham Digestive Diseases Centre, School of Medicine, The University of Nottingham, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, GI and Liver Theme, University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
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Elamir A, Shaker O, Kamal M, Khalefa A, Abdelwahed M, Abd El Reheem F, Ahmed T, Hassan E, Ayoub S. Expression profile of serum LncRNA THRIL and MiR-125b in inflammatory bowel disease. PLoS One 2022; 17:e0275267. [PMID: 36206229 PMCID: PMC9543963 DOI: 10.1371/journal.pone.0275267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022] Open
Abstract
Background Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract. We aimed to investigate, for the first time, the expression profile of serum level of LncRNA THRIL and MiR-125b in IBD patients and their relations with patient’s clinical and biochemical investigations. Methods Our study included 210 subjects divided into 70 healthy subjects considered as control group (male and female), 70 patients with ulcerative colitis (UC), and 70 patients with Crohn’s disease (CD). Blood samples were obtained from all subjects. Expression of LncRNA THRIL and MiR-125b in serum was detected by Quantitative real time PCR (qRT-PCR). Results Our results showed a significant increase in the fold change of LncRNA THRIL in UC patients (Median = 11.11, IQR; 10.21–12.45, P<0.001) and CD patients (Median = 5.87, IQR; 4.57–7.88, P<0.001) compared to controls. Meanwhile there was a significant decrease in the fold change of MiR-125b in UC patients (Median = 0.36, IQR; 0.19–0.61, P<0.001) and CD patients (Median = 0.69, IQR; 0.3–0.83, P<0.001) compared to controls. Furthermore, there was a negative significant correlation between LncRNA THRIL and MiR-125b in UC patients (r = -0.28, P = 0.016) and in CD patients (r = -0.772, P<0.001). ROC curve analysis was done showing the diagnostic value of these markers as predictors in differentiating between cases of UC, CD, and control. Conclusion Serum LncRNA THRIL and MiR-125b could be used as potential biomarkers for diagnosis and prognosis of ulcerative colitis and Crohn’s disease.
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Affiliation(s)
- Azza Elamir
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Olfat Shaker
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa Kamal
- Department of Clinical Pharmacy, Faculty of Pharmacy, Fayoum University, Fayoum, Egypt
| | - Abeer Khalefa
- Department of Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mostafa Abdelwahed
- Department of Physiology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Fadwa Abd El Reheem
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Tarek Ahmed
- Department of Internal Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Essam Hassan
- Department of Tropical Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Shymaa Ayoub
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
- * E-mail: ,
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Morus macroura Miq. Fruit extract protects against acetic acid-induced ulcerative colitis in rats: Novel mechanistic insights on its impact on miRNA-223 and on the TNFα/NFκB/NLRP3 inflammatory axis. Food Chem Toxicol 2022; 165:113146. [PMID: 35595039 DOI: 10.1016/j.fct.2022.113146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 11/23/2022]
Abstract
Nod-like receptor pyrin domain-1 containing 3 (NLRP3) inflammasome/tumor necrosis factor alpha (TNFα)/nuclear factor kappa B (NFκB) inflammatory pathway is known to be involved in the pathogenesis of ulcerative colitis (UC). Inversely, miRNA-223 can exert counter-regulatory effect on NLRP3 expression. The mulberry tree (Morus macroura) fruit is attaining increased importance for its antioxidant and anti-inflammatory activity in addition to its high safety profile. Accordingly, we attempted to explore the possible protective effect of mulberry fruit extract (MFE) in acetic acid (AA)-induced UC rat model. Phytochemical constituents of MFE were characterized using high performance liquid chromatography coupled to mass spectrometry (HPLC-MS). In the in vivo study, three doses of MFE were orally given for seven days before intra-rectal induction of UC by AA on day eight. Screening study revealed that MFE (300 mg/kg) significantly reduced macroscopic and microscopic UC scores. Biochemically, MFE ameliorated oxidative stress, levels of TNFR1, NLRP3, p-NFκB p65, TNFα, IL-1β, and IL-18, caspase-1 activity, but enhanced miRNA-223 expression. In conclusion, our study provided a novel protective impact for MFE against UC, in which miRNA-223 and TNFα/NFκB/NLRP3 pathway are involved. These results provide a promising step that might encourage further investigations of MFE as a protective agent in UC patients.
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Kaur S, D’Silva A, Shaheen AA, Raman M. Yoga in Patients With Inflammatory Bowel Disease: A Narrative Review. CROHN'S & COLITIS 360 2022; 4:otac014. [PMID: 36777040 PMCID: PMC9802393 DOI: 10.1093/crocol/otac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Despite advancements in the treatment of inflammatory bowel disease (IBD), the global prevalence of IBD is increasing. Patients with IBD often experience a high psychosocial burden, worsening their IBD symptoms and increasing relapse, hospitalization rates, and healthcare costs, which impairs their quality of life (QoL). Evidence suggests that mind-body intervention in many chronic illnesses is effective in improving symptoms and QoL. Yoga is the most frequently used mind-body practice globally. Meta-analyses of randomized clinical trials and prospective studies have highlighted that yoga improves symptoms and QoL of patients with IBD; however, recommendations about indications for yoga as well as dose and frequency of yoga are lacking. The present narrative review aims to describe the available evidence regarding the effects of yoga on common patient-reported outcome measures in IBD, including depression, anxiety, stress, and QoL. Physicians can hence promote yoga interventions in their discussions with patients to help control these IBD-related outcome measures.
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Affiliation(s)
| | | | - Abdel-Aziz Shaheen
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Maitreyi Raman
- Address correspondence to: Maitreyi Raman, 6D33 TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4N1, Canada ()
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Naegeli AN, Balkaran BL, Shan M, Hunter TM, Lee LK, Jairath V. The impact of symptom severity on the humanistic and economic burden of inflammatory bowel disease: a real-world data linkage study. Curr Med Res Opin 2022; 38:541-551. [PMID: 35175166 DOI: 10.1080/03007995.2022.2043655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Few studies have examined the association between inflammatory bowel disease (IBD) severity, and humanistic, and economic burden. We addressed this gap using a unique real-world data source that links self-reported patient data from the US National Health and Wellness Survey (NHWS) to claims data. METHODS This cross-sectional study linked the 2015-2018 US NHWS data with medical, and pharmacy claims. Patients (≥18 years) who self-reported a physician diagnosis of IBD (ulcerative colitis [UC], or Crohn's disease [CD]) in the NHWS, and had a medical or pharmacy claim indicating a possible diagnosis of IBD were included. Disease symptom severity was defined by a weighted symptom score and main outcomes include health-related quality of life (HRQoL), work productivity (WPAI), healthcare resource use (HRU), and associated costs. RESULTS Overall, 687 patients with IBD were included, of which 347 were identified with UC and 340 with CD. Validation analysis showed that 94.7% of UC and 88.7% of patients with CD who self-reported diagnosis of CD or UC in NHWS had evidence of diagnosis and/or treatment patterns in claims. Patients with both UC and CD with moderate or severe symptoms had significantly lower HRQoL, increased work productivity loss, greater HRU, and associated costs compared with patients with mild symptoms. CONCLUSIONS Patients with moderate/severe UC or CD experience substantial humanistic, and economic burden compared with patients with mild UC or CD. These factors should be considered within treatment goals for patients in order to provide holistic care beyond the treatment of objective markers or disease severity and symptoms alone.
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Affiliation(s)
- April N Naegeli
- Global Patient Outcomes and Real-World Evidence, Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Mingyang Shan
- Global Patient Outcomes and Real-World Evidence, Eli Lilly and Company, Indianapolis, IN, USA
| | - Theresa Marie Hunter
- Global Patient Outcomes and Real-World Evidence, Eli Lilly and Company, Indianapolis, IN, USA
| | - Lulu K Lee
- Real-World Evidence, Cerner Enviza, Malvern, PA, USA
| | - Vipul Jairath
- Department of Gastroenterology, Western University & London Health Sciences Centre, London, Ontario, Canada
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20
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Dhillon I, Ham J, Maul X, Rosenfeld G, Thamboo A. A pilot prospective prevalence study of chronic rhinosinusitis associated with inflammatory bowel disease. World J Otorhinolaryngol Head Neck Surg 2022; 8:339-344. [DOI: 10.1002/wjo2.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 11/05/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- India Dhillon
- Division of Otolaryngology, St. Paul's Sinus Centre University of British Columbia Vancouver British Columbia Canada
| | - Jennifer Ham
- Division of Otolaryngology, St. Paul's Sinus Centre University of British Columbia Vancouver British Columbia Canada
| | - Ximena Maul
- Division of Otolaryngology, St. Paul's Sinus Centre University of British Columbia Vancouver British Columbia Canada
| | - Gregory Rosenfeld
- Division of Gastroenterology University of British Columbia Vancouver British Columbia Canada
| | - Andrew Thamboo
- Division of Otolaryngology, St. Paul's Sinus Centre University of British Columbia Vancouver British Columbia Canada
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21
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Prasad SS, Walker MM, Talley NJ, Keely S, Kairuz T, Jones MP, Duncanson K. Healthcare Needs and Perceptions of People Living With Inflammatory Bowel Disease in Australia: A Mixed-Methods Study. CROHN'S & COLITIS 360 2022; 4:otab084. [PMID: 36777548 PMCID: PMC9802190 DOI: 10.1093/crocol/otab084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Indexed: 11/14/2022] Open
Abstract
Background Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis are inflammatory bowel diseases (IBDs) that adversely affect the healthcare needs and quality of life (QoL) of people with IBD. The aim of this study was to explore the needs and perceptions of people with IBD in a primary care setting. Methods This sequential explanatory mixed-methods study consisted of a cross-sectional survey (included validated tools), followed by semistructured interviews on participants' perceptions: IBD management, healthcare professionals, IBD care, flare management, and pharmacist's IBD roles. Results Sixty-seven participants completed the survey, and 8 completed interviews. Quantitative findings: Age at diagnosis had significant association with medication nonadherence (P = .04), QoL (P = .04), and disease control (P = .01) among the respondents. The odds of medication nonadherence were 8 times (adjusted odds ratio [AOR] = 8.04, 95% confidence interval [CI] = 1.08, 60.10) higher among younger participants aged <30 years. Those diagnosed with CD (P = .02) reported more likely to have unfavorable perceptions of pharmacists' role in managing their IBD (AOR = 9.45, 95% CI = 1.57, 56.62) than those with UC and indeterminate colitis. Qualitative findings: General practitioners were considered the most important care provider and the first point of contact for patients in managing all aspects of IBD. Participants identified their key need to be timely access to specialized IBD care and found that other primary healthcare professionals lacked disease-specific knowledge for managing IBD. Conclusions Primary healthcare professionals are well positioned but need targeted training to influence the needs of IBD patients. The specialty role of an IBD educator could complement existing services to deliver and address patient-specific care.
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Affiliation(s)
- Sharmila S Prasad
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia,NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, New Lambton Heights, New South Wales, Australia,Address correspondence to: Sharmila S. Prasad, MPharm, Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, University of Newcastle, University Dr, Callaghan, NSW 2308, Australia ()
| | - Marjorie M Walker
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, New Lambton Heights, New South Wales, Australia,School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, New Lambton Heights, New South Wales, Australia
| | - Nicholas J Talley
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, New Lambton Heights, New South Wales, Australia,School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, New Lambton Heights, New South Wales, Australia
| | - Simon Keely
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia,NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, New Lambton Heights, New South Wales, Australia
| | - Therése Kairuz
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Michael P Jones
- School of Psychological Sciences, Macquarie University, Macquarie Park, Sydney, New South Wales, Australia
| | - Kerith Duncanson
- NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, New Lambton Heights, New South Wales, Australia,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, New Lambton Heights, New South Wales, Australia
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22
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Kim JY, Choi MJ, Ha S, Hwang J, Koyanagi A, Dragioti E, Radua J, Smith L, Jacob L, de Pablo GS, Lee SW, Yon DK, Thompson T, Cortese S, Lollo G, Liang CS, Chu CS, Fusar-Poli P, Cheon KA, Shin JI, Solmi M. Association between autism spectrum disorder and inflammatory bowel disease: A systematic review and meta-analysis. Autism Res 2021; 15:340-352. [PMID: 34939353 DOI: 10.1002/aur.2656] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/02/2021] [Accepted: 12/01/2021] [Indexed: 12/17/2022]
Abstract
Children with autism spectrum disorder (ASD) are frequently diagnosed with co-occurring medical conditions including inflammatory bowel disease (IBD). To investigate the association, we conducted a systematic review registered in PROSPERO (ID:CRD42021236263) with a random-effects meta-analysis. We searched PubMed, Embase, and PsycInfo (last search on January 25, 2021), and manually searched relevant publications. We included observational studies measuring the association between ASD and IBD. The primary outcome was the association (odds ratio, OR) between ASD and later development of IBD. Sensitivity analyses were conducted by quality, confounding adjustment, and study design. We performed meta-regression analyses and assessed heterogeneity, publication bias, and quality of studies with the Newcastle-Ottawa Scale. Overall, we included six studies consisting of eight datasets, including over 11 million participants. We found that ASD was significantly associated with subsequent incident IBD (any IBD, OR = 1.66, 95% confidence interval[CI] = 1.25-2.21, p < 0.001; ulcerative colitis, OR = 1.91, 95%CI = 1.41-2.6, p < 0.001; Crohn's disease, OR = 1.47, 95%CI = 1.15-1.88, p = 0.002). ASD and IBD were also associated regardless of temporal sequence of diagnosis (any IBD, OR = 1.57, 95%CI = 1.28-1.93, p < 0.001; ulcerative colitis, OR = 1.7, 95%CI = 1.36-2.12, p < 0.001; Crohn's disease, OR = 1.37, 95%CI = 1.12-1.69, p = 0.003). Sensitivity analyses confirmed the findings of the main analysis. Meta-regression did not identify any significant moderators. Publication bias was not detected. Quality was high in four datasets and medium in four. In conclusion, our findings highlight the need to screen for IBD in individuals with ASD, and future research should identify who, among those with ASD, has the highest risk of IBD, and elucidate the shared biological mechanisms between ASD and IBD.
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Affiliation(s)
- Jong Yeob Kim
- Yonsei University College of Medicine, Seoul, South Korea
| | - Min Je Choi
- Yonsei University College of Medicine, Seoul, South Korea
| | - Sungji Ha
- Department of Child and Adolescent Psychiatry, Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jimin Hwang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,ICREA, Barcelona, Spain
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Joaquim Radua
- Mental Health Research Networking Center (CIBERSAM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Child and Adolescent Mental Health Services, South London & Maudsley NHS Trust, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
| | - Dong Keon Yon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Trevor Thompson
- Centre for Chronic Illness and Ageing, University of Greenwich, London, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life sciences & Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK.,Solent NHS Trust, Southampton, UK.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, New York, USA
| | - Gianluca Lollo
- Department of Gastroenterology, Ospedale Regionale di Bellinzona e Valli (Ente Ospedaliero Cantonale: EOC), Bellinzona, Switzerland
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Society of Psychophysiology, Non-invasive Neuromodulation Consortium for Mental Disorders, Taipei, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Keun-Ah Cheon
- Department of Child and Adolescent Psychiatry, Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life sciences & Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.,Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Ontario, Canada
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23
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Glynn H, Möller SP, Wilding H, Apputhurai P, Moore G, Knowles SR. Prevalence and Impact of Post-traumatic Stress Disorder in Gastrointestinal Conditions: A Systematic Review. Dig Dis Sci 2021; 66:4109-4119. [PMID: 33433790 DOI: 10.1007/s10620-020-06798-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/16/2020] [Indexed: 02/06/2023]
Abstract
Psychological distress is often observed in patients with gastrointestinal illness. To date, there has been limited research conducted to assess the prevalence and impact of post-traumatic stress disorder (PTSD) in gastrointestinal cohorts. The aim of this systematic review is to review the evidence for the prevalence of PTSD in gastrointestinal cohorts versus comparator groups (healthy controls and chronic illness groups), predictive factors associated with the development and management of PTSD and the impact on patient outcomes. Adult studies were identified through systematic searches of eight databases (MEDLINE, Embase, Emcare, PsycINFO, Ovid Nursing, CINAHL, Informit Health Collection, and Cochrane Library) in February 2020. The overall pooled prevalence rate of PTSD in GI cohorts was 36%; however, the prevalence rate in non-veteran-specific gastrointestinal cohorts of 18% across all GI classification groups is likely to be the more representative rate. The non-gastrointestinal chronic illness cohort PTSD prevalence rate was 11%. Predictors identified in the development of post-traumatic stress in gastrointestinal cohorts include: female gender, poor social support, life adversity, subjective pain, and dietary choices. Post-traumatic stress was found to exacerbate gastrointestinal symptoms in a Crohn's Disease sample, whereby disease exacerbation was four times in those who met the criteria for probable PTSD. Post-traumatic stress symptoms affect around one in five individuals (non-veteran status) with a gastrointestinal condition. Further research is needed to understand the psychological and biological mechanisms by which PTSD increases the risk of developing and exacerbating gastrointestinal symptoms.
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Affiliation(s)
- Heidi Glynn
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, John Street, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Stephan P Möller
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, John Street, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Helen Wilding
- St Vincent's Hospital Library Service, St Vincent's Hospital, Melbourne, Australia
| | - Pragalathan Apputhurai
- Department of Health Sciences and Biostatistics, Swinburne University of Technology, Melbourne, Australia
| | - Gregory Moore
- Monash Medical Centre, Melbourne, Australia
- School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Simon R Knowles
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, John Street, Hawthorn, Melbourne, VIC, 3122, Australia.
- Department of Mental Health, St Vincent's Hospital, Melbourne, Australia.
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24
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Dranga M, Boiculese LV, Popa IV, Floria M, Gavril OI, Bărboi OB, Trifan A, Cijevschi Prelipcean C, Mihai C, Gavrilescu O. Anemia in Crohn's Disease-The Unseen Face of Inflammatory Bowel Disease. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57101046. [PMID: 34684083 PMCID: PMC8539193 DOI: 10.3390/medicina57101046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/19/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023]
Abstract
Background and Objectives: Anemia is the most frequent complication of inflammatory bowel diseases. Clinically, anemia can affect important quality-of-life (QoL) components, such as exercise capacity, cognitive function, and the ability to carry out social activities. The disease activity has a significant impact on QoL, mainly due to clinical manifestations, which are more severe during the periods of disease activity. Our aim was to estimate the impact of anemia on QoL in patients with Crohn's disease. Material and Methods. We made a prospective study on 134 patients with Crohn's disease (CD) in a Romanian tertiary center. The CD diagnosis was established by colonoscopy and histopathological examination. In particular cases, additional examinations were required (small bowel capsule endoscopy, computed tomography enterography, and magnetic resonance enterography). Anemia was defined according to the World Health Organization's definition, the activity of the disease was assessed by Crohn's disease activity index (CDAI) score, and the QoL was evaluated by Inflammatory Bowel Disease Questionnaire 32 (IBDQ 32). Results: 44.8% patient had anemia, statistically related to the activity of the disease and corticoids use. We found a strong association between QoL and disease activity on all four sub-scores: patients with more severe activity had a significantly lower IBDQ (260.38 ± 116.96 vs. 163.85 ± 87.20, p = 0.001) and the presence of anemia (127.03 vs. 148.38, p = 0.001). In multiple regression analyses, both disease activity and anemia had an impact on the QoL. Conclusions: Anemia has high prevalence in the CD in northeastern region of Romania. Anemia was more common in female patients, in patients undergoing corticosteroid treatment, and in those with active disease. Both anemia and disease activity had a strong negative and independent impact on QoL.
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Affiliation(s)
- Mihaela Dranga
- Medicale I Department “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania; (M.D.); (M.F.); (O.I.G.); (O.-B.B.); (A.T.); (O.G.)
- Institute of Gastroenterology and Hepatology, St. Spiridon Emergency Hospital, 700111 Iasi, Romania;
| | - Lucian Vasile Boiculese
- Department of Medical Informatics, Biostatistics, Computer Science, Mathematics and Modelling Simulation “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania;
| | - Iolanda Valentina Popa
- Medicale II Department “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania;
| | - Mariana Floria
- Medicale I Department “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania; (M.D.); (M.F.); (O.I.G.); (O.-B.B.); (A.T.); (O.G.)
- Department of Internal Medicine, Dr. Iacob Czihac Emergency Military Hospital, 700483 Iasi, Romania
| | - Oana Irina Gavril
- Medicale I Department “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania; (M.D.); (M.F.); (O.I.G.); (O.-B.B.); (A.T.); (O.G.)
- Department of Internal Medicine, CF Hospital, 700506 Iasi, Romania
| | - Oana-Bogdana Bărboi
- Medicale I Department “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania; (M.D.); (M.F.); (O.I.G.); (O.-B.B.); (A.T.); (O.G.)
- Institute of Gastroenterology and Hepatology, St. Spiridon Emergency Hospital, 700111 Iasi, Romania;
| | - Anca Trifan
- Medicale I Department “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania; (M.D.); (M.F.); (O.I.G.); (O.-B.B.); (A.T.); (O.G.)
- Institute of Gastroenterology and Hepatology, St. Spiridon Emergency Hospital, 700111 Iasi, Romania;
| | | | - Cătălina Mihai
- Medicale I Department “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania; (M.D.); (M.F.); (O.I.G.); (O.-B.B.); (A.T.); (O.G.)
- Institute of Gastroenterology and Hepatology, St. Spiridon Emergency Hospital, 700111 Iasi, Romania;
- Correspondence:
| | - Otilia Gavrilescu
- Medicale I Department “Grigore T. Popa”, University of Medicine and Pharmacy, 700111 Iasi, Romania; (M.D.); (M.F.); (O.I.G.); (O.-B.B.); (A.T.); (O.G.)
- Institute of Gastroenterology and Hepatology, St. Spiridon Emergency Hospital, 700111 Iasi, Romania;
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25
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Dembiński Ł, Stelmaszczyk-Emmel A, Sznurkowska K, Szlagatys-Sidorkiewicz A, Radzikowski A, Banaszkiewicz A. Immunogenicity of cholera vaccination in children with inflammatory bowel disease. Hum Vaccin Immunother 2021; 17:2586-2592. [PMID: 33794737 PMCID: PMC8475559 DOI: 10.1080/21645515.2021.1884475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The cholera vaccine can protect patients with inflammatory bowel disease (IBD) against both cholera and travelers' diarrhea. However, both immunosuppressive treatment and IBD can affect its vaccine immunogenicity. The aim of this study was to assess the immunogenicity and safety of the cholera vaccine in children with IBD. Children older than 6 years with diagnosed IBD were enrolled in this multicenter study. All patients were administered two doses of the oral cholera vaccine (Dukoral®). Anti-cholera toxin B subunit IgA and IgG seroconversion rates were evaluated in a group with immunosuppressive (IS) treatment and a group without IS treatment (NIS). Immunogenicity was assessed in 70 children, 79% of whom received IS treatment. Post-vaccination seroconversion was displayed by 33% of children, for IgA, and 70% of children, for IgG. No statistically significant differences were found in the immune responses between the IS and NIS groups: 35% vs. 27% (p = .90), for IgA, and 68% vs. 80.0% (p = .16), for IgG, respectively. One case of IBD exacerbation after vaccination was reported. The oral cholera vaccine is safe. The immunogenicity of the oral cholera vaccine in children with IBD was lower than previously observed in healthy ones. The treatment type does not seem to affect the vaccine immunogenicity.
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Affiliation(s)
- Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
- CONTACT Łukasz Dembiński ; Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Zwirki I Wigury 63A, Warsaw02-091, Poland
| | - Anna Stelmaszczyk-Emmel
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Sznurkowska
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Agnieszka Szlagatys-Sidorkiewicz
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Andrzej Radzikowski
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
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26
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de Bock E, Filipe MD, Meij V, Oldenburg B, van Schaik FDM, Bastian OW, Fidder HF, Vriens MR, Richir MC. Quality of life in patients with IBD during the COVID-19 pandemic in the Netherlands. BMJ Open Gastroenterol 2021; 8:e000670. [PMID: 34215570 PMCID: PMC8257293 DOI: 10.1136/bmjgast-2021-000670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/07/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE COVID-19 has put a strain on regular healthcare worldwide. For inflammatory bowel disease (IBD), gastrointestinal surgeries were postponed and changes in treatment and diagnostic procedures were made. As abrupt changes in treatment regimens may result in an increased morbidity and consequent well-being of patients with IBD, the aim of this study was to determine the effect of the COVID-19 pandemic on health-related quality of life (HRQoL) in patients with IBD. DESIGN All patients with IBD who completed both Inflammatory Bowel Disease Questionnaire (IBDQ) and 36-Item Short Form Health Survey (SF-36) questionnaire between 31 August and 13 September 2020 were included in our cohort study. The primary end point was to determine the HRQoL in patients with IBD, measured by the IBDQ and SF-36 questionnaire. The secondary end point was determining which factors influence the HRQoL in patients with IBD. RESULTS 582 patients with IBD filled in the IBDQ and SF-36 questionnaire. The HRQoL in our study population was low according to the questionnaires on both physical and mental subscales. In addition, multivariate analysis showed that increased age, female sex and patients who underwent surgery had a significantly lower HRQoL, most frequently on the physical domains in both questionnaires. CONCLUSION Patients with IBD had an overall low HRQoL during the COVID-19 pandemic. Furthermore, older patients, women and patients who underwent surgical procedures had the lowest physical HRQoL.
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Affiliation(s)
| | | | | | - Bas Oldenburg
- Gastroenterology and Hepatology, UMC Utrecht, Utrecht, The Netherlands
| | | | | | - Herma F Fidder
- Gastroenterology and Hepatology, UMC Utrecht, Utrecht, The Netherlands
| | | | - Milan C Richir
- Surgery, UMC Utrecht, Utrecht, The Netherlands
- Internal Medicine, Section Pharmacotherapy, Amsterdam UMC, Locatie VUmc, Amsterdam, The Netherlands
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27
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Abstract
PURPOSE OF REVIEW In the rapidly progressing world of inflammatory bowel disease, this review discusses and summarizes new drug targets and results from major clinical trials in order to provide an update to physicians treating patients with inflammatory bowel diseases (IBD). RECENT FINDINGS Multiple new mechanisms in the treatment of IBD are being developed and many are showing promising results in both ulcerative colitis and Crohn's disease patients. In addition to efficacy, some of these treatments may provide safety benefits over existing therapies. SUMMARY The IBD physicians' therapeutic armamentarium is rapidly expanding and keeping abreast of these developments is required in order to provide patients with optimized individualized care.
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Affiliation(s)
- Nathaniel A Cohen
- The University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, Illinois, USA
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28
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Translation and validation of the inflammatory bowel disease fatigue (IBD-F) patient self-assessment questionnaire. GASTROENTEROLOGY REVIEW 2021; 16:136-143. [PMID: 34276841 PMCID: PMC8275968 DOI: 10.5114/pg.2021.106665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 08/10/2020] [Indexed: 11/21/2022]
Abstract
Introduction Inflammatory bowel disease (IBD) is a group of chronic gastrointestinal diseases with frequent systemic complications that are incurable according to current knowledge. These diseases adversely affect various areas of life, lowering patients’ quality of life. One of the most frequently reported symptoms is fatigue. Aim Translation and validation of the IBD-F patient self-assessment scale with a Polish IBD population. Material and methods After consent from the author of the questionnaire had been obtained, the questionnaire was translated using the forward- and back-translation method. After arriving at the final Polish version of the questionnaire and ensuring that the questions and statements were comprehensible, the questionnaire was validated with a group of 129 IBD patients. Results High values of intraclass correlation coefficient (ICC) were achieved for overall results in both parts of the IBD-F questionnaire between test and retest (values exceeding 0.75). A high Cronbach’s α consistency coefficient was achieved for the entire IBD-F questionnaire, both in the test and in the retest (0.968 and 0.975, respectively). Broken down into parts, Cronbach’s α coefficient for Section I (presence and severity of fatigue) of the IBD-F questionnaire was 0.883, and for Section II (impact of fatigue on the person’s life) it was 0.966. All patients evaluating the Polish version of the IBD-F questionnaire deemed the content of the questions comprehensible. Conclusions The analysis of the results obtained, the Polish version of the IBD-F questionnaire was considered valid, reliable, and clinically useful.
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29
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Marsilio S. Feline chronic enteropathy. J Small Anim Pract 2021; 62:409-419. [PMID: 33821508 DOI: 10.1111/jsap.13332] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 01/22/2023]
Abstract
Feline chronic enteropathy is a common disorder, especially in the senior cat population, with rising incidence over the past decade. Feline chronic enteropathy is considered an umbrella term comprising different diseases including food-responsive enteropathy, idiopathic inflammatory bowel disease and alimentary small cell lymphoma. However, differentiation between those diseases is often difficult in practice. This review will discuss the clinical approach to cats with chronic enteropathy, state-of-the-art diagnostic tests and pitfalls thereof as well as current therapeutic approaches. Although, much of the etiopathogenesis is still unknown, increased research efforts in this field have brought new insights into diagnostic and therapeutic options for these cats.
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Affiliation(s)
- S Marsilio
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, One Shields Avenue, Davis, CA, 95616, USA
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Barello S, Guida E, Leone S, Previtali E, Graffigna G. Does patient engagement affect IBD patients' health-related quality of life? Findings from a cross-sectional study among people with inflammatory bowel diseases. Health Qual Life Outcomes 2021; 19:77. [PMID: 33678181 PMCID: PMC7938585 DOI: 10.1186/s12955-021-01724-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 03/01/2021] [Indexed: 01/19/2023] Open
Abstract
Background Patients diagnosed with inflammatory bowel disease (IBD) are required to deal with the unpredictability of this clinical condition, which is associated with poorer health-related quality of life (HRQoL) compared to other clinical conditions. Patient engagement is currently demonstrated to relate with chronic patients’ HRQoL, but few studies have been conducted among this population. Methods A cross-sectional study was conducted among 1176 IBD patients. Data were collected on participants’ HRQoL (SIBD-Q) and patient engagement (PHE-s®). Regression analysis was used to examine the effects of patient engagement on HRQoL. Results About the half of the sample (47%) reported a low patient engagement level. 30% of the sample reported a low level of HRQoL. Psycho-emotional functioning resulted to be the aspect of HRQoL most impacted in the 37% of the sample. The regression model showed that PHE-s® is significantly related to the SIBD-Q total score (B = .585; p < .001; R squared = .343) and to the subscales’ scores—systemic symptoms (B = .572; p < .001; R squared = .327), bowel symptoms (B = .482; p < .001; R squared = .232), social (B = .485; p < .001; R squared = .234) and psycho-emotional (B = .607; p < .001; R squared = .369) functioning. Conclusions Patients who are engaged in their IBD care pathway are more likely to report higher level of HRQoL, thus offering clues to potential therapeutic approaches to ameliorating IBD patients’ wellbeing. As this is a modifiable factor, screening for patient health engagement levels, coupled with appropriate interventions, could improve care, and ultimately improve HRQoL outcomes among IBD patients.
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Affiliation(s)
- Serena Barello
- EngageMinds Hub, Consumer, Food and Health Engagement Research Center, Faculty of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - Elena Guida
- EngageMinds Hub, Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Guendalina Graffigna
- EngageMinds Hub, Consumer, Food & Health Engagement Research Center, Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Piacenza, Italy
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The Antioxidant and Anti-Inflammatory Effects of Quercus brantii Extract on TNBS-Induced Ulcerative Colitis in Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3075973. [PMID: 33505492 PMCID: PMC7808820 DOI: 10.1155/2021/3075973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/15/2020] [Accepted: 12/19/2020] [Indexed: 12/16/2022]
Abstract
Objectives Ulcerative colitis is a common subtype of persistent inflammatory bowel disease with high morbidity consequences. Despite unknown definite pathogenesis, multiple anti-inflammatory medications are used for its treatment. Traditionally, Quercus brantii (QB), mostly available in the Middle East, has been used for gastrointestinal disorders. Other beneficial effects associated with QB include reduction of oxidative stress, inflammations, homeostatic instability, and improvement in clinical conditions. Materials and Methods This experimental study was designed to assess the possible therapeutic effects of QB on UC and compare its effects with those of sulfasalazine. Of the 70 Wistar rats clustered in seven groups, ten received only alcohols and sixty were confirmed to be suffering from trinitrobenzene sulfonic acid- (TNBS-) induced colitis. Four groups received different dosages of QB extract via oral and rectal routes, one received sulfasalazine, and the other remaining two groups received nothing. The effects of QB were evaluated by assessing macroscopic and histologic scoring, measuring inflammatory mediators, and determining oxidative stress markers. Results Comparing to the untreated TNBS-induced control groups, QB-treated groups showed a dose- and route-dependent improvement comparable with sulfasalazine. Treating rats with QB reduced the microscopic and macroscopic damage, decreased TNF-α, IL-6, NO, MPO activity, and MDA content, increased superoxide dismutase (SOD) activity, and reduced body weight loss. Conclusions Our data recommended the anti-inflammatory and antioxidant effects of QB extract in a dose-dependent manner.
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Gavrilescu O, Prelipcean CC, Dranga M, Soponaru C, Mihai C. The specialized educational and psychological counseling in inflammatory bowel disease patients - a target or a challenge? TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 31:760-766. [PMID: 33361038 DOI: 10.5152/tjg.2020.19669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND/AIMS Stress, in its various forms, plays an important role in the development and evolution of inflammatory bowel disease (IBD). For patients with IBD, the evidence related to the effects of various types of psychological therapies remains inconclusive. This study aimed to evaluate whether cognitive behavioral therapy, in combination with educational counseling, influenced disease activity and quality of life (QoL) among patients with IBD. MATERIALS AND METHODS We conducted a randomized controlled trial with 60 patients diagnosed with IBD. All patients completed the IBD questionnaire-32 (IBDQ-32) and the Big Five Inventory. Group A (experimental group) received specialized educational and psychological counseling (SEPC), and group B (control group) was treated according to the current medical practice. All patients were reassessed after 12 months. RESULTS After the SEPC, there was no improvement in disease activity as estimated by fecal calprotectin levels. However, the QoL of patients in group A was significantly improved. The highest mean difference between the initial and final IBDQ scores was found among patients whose main personality trait was openness to experience (48.58±28.80), and the lowest mean difference between these 2 scores was found among patients whose main personality trait was closedness to experience (3.33±2.97, p=0.009). CONCLUSION Although there was no improvement in disease activity after the SEPC, this therapy improved patients' QoL in terms of both emotional and social functions, especially among patients whose dominant personality trait was openness to experience or neuroticism.
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Affiliation(s)
- Otilia Gavrilescu
- Department of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, "Sf. Spiridon" Emergency University Hospital Iasi, Iasi, Romania
| | - Cristina Cijevschi Prelipcean
- Department of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, "Sf. Spiridon" Emergency University Hospital Iasi, Iasi, Romania
| | - Mihaela Dranga
- Department of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, "Sf. Spiridon" Emergency University Hospital Iasi, Iasi, Romania
| | - Camelia Soponaru
- Alexandru Ioan Cuza University, School of Psychology and Education Sciences, Iasi, Romania
| | - Catalina Mihai
- Department of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, "Sf. Spiridon" Emergency University Hospital Iasi, Iasi, Romania
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Affiliation(s)
- Eleonora Allocati
- Istituto di Ricerche Farmacologiche 'Mario Negri' IRCCS, Milan, Italy
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- School of Pharmacy, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Pharmaceutical Sciences Department, Universiti Sains Malaysia, Penang, Malaysia
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Chimenti MS, Conigliaro P, Polistena B, Triggianese P, D'Antonio A, Neri B, Sena G, Spandonaro F, Biancone L, Perricone R. Observational study on the evaluation of quality of life in patients affected by enteropathic spondyloarthritis. Musculoskeletal Care 2020; 18:527-534. [PMID: 32815627 DOI: 10.1002/msc.1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/03/2020] [Accepted: 08/08/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Enteropathic spondyloarthritis (ESpA) and inflammatory bowel diseases (IBD) have high impact on physical and psychological health but health-related quality of life (HRQoL) has never been evaluated in ESpA patients. PURPOSE Cross-sectional multidisciplinary study was performed to evaluate HRQoL, state of health, and well-being in IBD and ESpA patients. METHODS Consecutive IBD and ESpA outpatients were enrolled. Disease activity, inflammatory parameters, function, and quality of life (EuroQol questionnaire) were assessed at visit time and compared with 12 months ago. RESULTS Two hundred fifty-three IBD patients were evaluated. Ninety-five patients met inclusion criteria. ESpA was established in 65.3% IBD patients. Most ESpA patients had discreet or good health perception (65.3% and 22.5%, respectively), similar to IBD group (64.6% and 20.7%, respectively). In both groups, no patients had exceptional state of general well-being. Compared with previous 12 months, ESpA group showed improved state of health in 12% of patients, worsening in 28% and stable state of health in 60%. Similar results were obtained in IBD group. Emotional and psychological problems (anxiety, depression, and feeling of loneliness and isolation) were reported: In ESpA patients, these feelings were observed in 58.1%, 40.57%, and 29% of cases, respectively; IBD patients showed slightly lower percentage. More than half of ESpA and IBD patients reported an embarrassment about their condition and worry about disease's future progression and physical pain. CONCLUSIONS Well-being, quality of life, and psychological problems were described in ESpA and IBD patients. Disease management should include also social, mental, and psychological impacts, in terms of QoL.
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Affiliation(s)
- Maria Sole Chimenti
- Rheumatology Unit, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Paola Conigliaro
- Rheumatology Unit, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Polistena
- Department of Economic and Finance, University of Rome Tor Vergata, C.R.E.A. Sanità (Consortium for Applied Economic Research in Healthcare), Rome, Italy
| | - Paola Triggianese
- Rheumatology Unit, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Arianna D'Antonio
- Rheumatology Unit, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Benedetto Neri
- GI Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giorgia Sena
- GI Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Federico Spandonaro
- Department of Economic and Finance, University of Rome Tor Vergata, C.R.E.A. Sanità (Consortium for Applied Economic Research in Healthcare), Rome, Italy
| | - Livia Biancone
- GI Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Perricone
- Rheumatology Unit, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Larussa T, Flauti D, Abenavoli L, Boccuto L, Suraci E, Marasco R, Imeneo M, Luzza F. The Reality of Patient-Reported Outcomes of Health-Related Quality of Life in an Italian Cohort of Patients with Inflammatory Bowel Disease: Results from a Cross-Sectional Study. J Clin Med 2020; 9:jcm9082416. [PMID: 32731482 PMCID: PMC7464775 DOI: 10.3390/jcm9082416] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
Inflammatory bowel disease (IBD) has a negative impact on patients’ physical and psychological well-being, social performance, and working capacity, thereby worsening their health-related quality of life (HRQoL). Clinicians should take care of the patients’ global health, including the psychological, social, and emotional spheres. We aimed to investigate the reality of patient-reported outcomes of HRQoL in a series of IBD patients. Consecutive Crohn´s disease (CD) and ulcerative colitis (UC) patients in clinical remission were recruited. The survey consisted of the Short Inflammatory Bowel Disease Questionnaire (S-IBDQ), the Hospital Anxiety and Depression Scale (HADS), the Brief Illness Perception Questionnaire (B-IPQ), and a questionnaire dealing with impact of IBD on patients’ lives. Demographic and clinical characteristics were recorded. Of 202 participants (29% CD and 71% UC; 54% male; median age 48 years; mean disease duration 14 ± 11 years), 52% had poor HRQoL, 45% anxiety/depression, and 35% sleep disturbance and a high perception of disease (mean score 42.8 ± 14.3). In the multivariate analysis, a low HRQoL was rather associated with UC than CD (p = 0.037), IBD surgery (p = 0.010), disease duration (p = 0.01), sleep disturbance (p = 0.014), anxiety/depression (p = 0.042), and high illness perception (p = 0.006). IBD affected working performance and social activities in 62% and 74% of patients, respectively. Satisfaction regarding quality of care, biologics, and surgery approach were claimed in 73%, 69%, and 76% of patients, respectively. Although 84% of patients trusted their gastroenterologist, only 66% of them discussed IBD impact on HRQoL during visit. In a series of IBD patients in remission, the low HRQoL was significantly associated with surgery, disease duration, sleep disturbance, anxiety/depression, and high illness perception. Even though patients were satisfied with the quality of their care, it appears that clinicians should pay more attention to patients’ emotional status.
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Affiliation(s)
- Tiziana Larussa
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (T.L.); (D.F.); (L.A.); (E.S.); (R.M.); (M.I.)
| | - Danilo Flauti
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (T.L.); (D.F.); (L.A.); (E.S.); (R.M.); (M.I.)
| | - Ludovico Abenavoli
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (T.L.); (D.F.); (L.A.); (E.S.); (R.M.); (M.I.)
| | - Luigi Boccuto
- Greenwood Genetic Center, Greenwood, Clemson University, Clemson, SC 29631, USA;
| | - Evelina Suraci
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (T.L.); (D.F.); (L.A.); (E.S.); (R.M.); (M.I.)
| | - Raffaella Marasco
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (T.L.); (D.F.); (L.A.); (E.S.); (R.M.); (M.I.)
| | - Maria Imeneo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (T.L.); (D.F.); (L.A.); (E.S.); (R.M.); (M.I.)
| | - Francesco Luzza
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (T.L.); (D.F.); (L.A.); (E.S.); (R.M.); (M.I.)
- Correspondence: ; Tel.: +39-0961-3647-113
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Ilias T, Bungau S, Tit DM, Maghiar D, Hocopan C, Brata R, Bratu OG, Negrut N, Diaconu C, Fratila O. Psychosocial profile of the patients with inflammatory bowel disease. Exp Ther Med 2020; 20:2493-2500. [PMID: 32765741 DOI: 10.3892/etm.2020.8816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 02/28/2020] [Indexed: 12/12/2022] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic, disabling entity of unknown aetiology, with negative impact on the patient's life, including psychological patterns. This study assessed multiple psychosocial factors (satisfaction with life, coping mechanisms, emotional profile, mental recognition of the disease and cognition schemes related to patients' demographic characteristics, clinical picture, form and duration of the disease, therapeutic plans) in IBD patients vs. a healthy group. This non-interventional study comprised 60 participants who attended for medical advice/check-up as an ambulatory visit or during hospitalization. The patients completed questionnaires after receiving explanations from the psychologist. Statistical analyses (Kolmogorov-Smirnov test, Independent-Samples t-test, One-Way ANOVA and Post Hoc Multiple Comparisons) were conducted using IMB for the Social Sciences (SPSS), version 20 (P≤0.05). IBD patients (G1) are more hostile when compared to the healthy group (G2). Those who experience abdominal pain are more likely to use active coping mechanisms and those who experience fatigue are more likely to use acceptance, emotional venting, behavioural disengagement and mental disengagement. G1 have higher levels of others-downing vs. G2. Regarding negative emotions, IBD patients generally experience more negative emotions compared to healthy participants (who have higher levels of life satisfaction). Regarding the perception of illness, there are no differences between patients in terms of illness coherence, personal or treatment control, consequences, timeline, or emotional representations. Results indicate that psychological factors and different characteristics of IBD patients play a relevant role in the way these patients deal with their disease.
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Affiliation(s)
- Tiberia Ilias
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | | | - Cristian Hocopan
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Roxana Brata
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Ovidiu Gabriel Bratu
- Clinical Department 3, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Nicoleta Negrut
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Camelia Diaconu
- Department 5, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Internal Medicine Clinic, Clinical Emergency Hospital of Bucharest, 041914 Bucharest, Romania
| | - Ovidiu Fratila
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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Radford SJ, McGing J, Czuber-Dochan W, Moran G. Systematic review: the impact of inflammatory bowel disease-related fatigue on health-related quality of life. Frontline Gastroenterol 2020; 12:11-21. [PMID: 33489066 PMCID: PMC7802486 DOI: 10.1136/flgastro-2019-101355] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Fatigue is frequently reported in inflammatory bowel disease (IBD) and impacts on health-related quality of life (HRQoL). HRQoL has not been systematically reviewed in IBD fatigue. AIM To investigate what impact IBD fatigue has on HRQoL in adults with IBD. METHODS Systematic searches (CINAHL, EMBASE, PsychINFO, Medline) were conducted on 25 September 2018, restricted to 'human', 'adult', 'primary research' and 'English language'. Search terms encompassed concepts of 'fatigue', 'IBD' and 'HRQoL'. A 5-year time limit (2013-2018) was set to include the most relevant publications. Publications were screened, data extracted and quality appraised by two authors. A narrative synthesis was conducted. RESULTS Eleven studies were included, presenting data from 2823 participants. Fatigue experiences were significantly related to three HRQoL areas: symptom acceptance, psychosocial well-being and physical activity. Patients reporting high fatigue levels had low symptom acceptance. Psychosocial factors were strongly associated with both fatigue and HRQoL. Higher social support levels were associated with higher HRQoL. Physical activity was impaired by higher fatigue levels, lowering HRQoL, but it was also used as a means of reducing fatigue and improving HRQoL. Quality appraisal revealed methodological shortcomings in a number of studies. Notably, use of multiple measures, comparison without statistical adjustment and fatigue and HRQoL assessment using the same tool were some of the methodological shortcomings. CONCLUSION Psychosocial factors, symptom management and acceptance and physical activity levels have significant impact on HRQoL. Results support application of psychosocial or exercise interventions for fatigue management. Further exploration of HRQoL factors in IBD fatigue is required, using validated fatigue and HRQoL measures. PROSPERO REGISTRATION NUMBER CRD42018110005.
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Affiliation(s)
- Shellie Jean Radford
- Nottingham Digestive Diseases Centre, University of Nottingham, University Park Campus, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jordan McGing
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Wladyslawa Czuber-Dochan
- Florence Nightingale school of Nursing, Midwifery and Pallative care, King's College London, London, UK
| | - Gordon Moran
- Nottingham Digestive Diseases Centre, University of Nottingham, University Park Campus, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Fu H, Kaminga AC, Peng Y, Feng T, Wang T, Wu X, Yang T. Associations between disease activity, social support and health-related quality of life in patients with inflammatory bowel diseases: the mediating role of psychological symptoms. BMC Gastroenterol 2020; 20:11. [PMID: 31937264 PMCID: PMC6961247 DOI: 10.1186/s12876-020-1166-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 01/07/2020] [Indexed: 02/06/2023] Open
Abstract
Background Previous studies have indicated that disease activity, psychological symptoms and social support were associated with health-related quality of life (HRQoL) in patients with inflammatory bowel diseases(IBD). However, it is unclear how disease activity, psychological symptoms and social support interact to affect HRQoL. The main purpose of this study was to examine the mediation effect of psychological symptoms in the relationship between disease activity, social support and HRQoL. Methods This was a cross-sectional study, which collected data using convenience sampling, between December 2016 and March 2018, from the Third XiangyaHospital of Central South University in Changsha, China. An online self-administered questionnaire (including demographic and clinical information), Inflammatory Bowel Disease Questionnaire, Disease Activity Indices scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale, were administered to each participant. Descriptive statistics and Pearson’s correlations were used to summarize data, whereas PROCESS analysis was performed to examine the pre-specified mediation effect. Results A total of 199 patients with IBD were included. Disease activity indices (DAI) and hospital anxiety and depression (HAD) were negatively correlated with HRQoL (β = − 3.37, − 2.54 respectively, P < 0.001), while social support was positively correlated with HRQoL (β = 1.38, P < 0.01). HAD partially mediated the negative relationship between DAI and HRQoL (β = − 0.83, P < 0.001) with the mediation effect ratio of 24.6%, and completely mediated the positive relationship between social support and HRQoL (β = 1.20, P < 0.001). Conclusions Psychological symptoms acted as a mediator in the relationship between disease activity, social support and HRQoL. Interventions to improve HRQoL in patients with IBD should take into account the mediation effect of psychological symptoms.
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Affiliation(s)
- Hanlin Fu
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, NO. 238 Shangmayuanling Road, Kaifu District, Changsha, 410078, Hunan Province, China.,Department of Dermatology and Venereal Disease, Shenzhen Center for Chronic Disease Control, Province518020, Shenzhen, Guangdong, China
| | - Atipatsa Chiwanda Kaminga
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, NO. 238 Shangmayuanling Road, Kaifu District, Changsha, 410078, Hunan Province, China.,Department of Mathematics and Statistics, Mzuzu University, Private Bag 201, Luwinga, Mzuzu 2, Malawi
| | - Yan Peng
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan Province, China
| | - Tiejian Feng
- Department of Dermatology and Venereal Disease, Shenzhen Center for Chronic Disease Control, Province518020, Shenzhen, Guangdong, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, NO. 238 Shangmayuanling Road, Kaifu District, Changsha, 410078, Hunan Province, China
| | - Xiaobing Wu
- Department of Dermatology and Venereal Disease, Shenzhen Center for Chronic Disease Control, Province518020, Shenzhen, Guangdong, China
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, NO. 238 Shangmayuanling Road, Kaifu District, Changsha, 410078, Hunan Province, China.
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Skolmowska D, Głąbska D, Guzek D, Lech G. Association between Dietary Isoflavone Intake and Ulcerative Colitis Symptoms in Polish Caucasian Individuals. Nutrients 2019; 11:E1936. [PMID: 31426486 PMCID: PMC6722525 DOI: 10.3390/nu11081936] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/08/2019] [Accepted: 08/14/2019] [Indexed: 02/08/2023] Open
Abstract
Currently there are contradictory observations regarding the associations between the isoflavone intake and inflammatory bowel disease in terms of its prevention and treatment, and this may be attributed to the diversity of applied doses and influence of various isoflavones. The aim of the presented cross-sectional study is to analyze the association between intake of various isoflavones (daidzein, genistein, glicytein and total isoflavones) and ulcerative colitis symptoms (fecal blood, mucus and pus) in Polish Caucasian individuals in confirmed remission. Assessment of diet was based on self-reported data obtained from patients' three-day dietary records and their individual assessments of symptoms. A total of 56 Caucasian patients with ulcerative colitis in confirmed remission were recruited for the study (37 females and 19 males, aged 18-80). For individuals with no fecal mucus observed, higher daidzein (p = 0.035, 122 vs. 19 µg) and total isoflavone intakes (p = 0.034, 302.2 vs. 123.7 µg) were observed in comparison with individuals not declaring this symptom, while for daidzein it was confirmed for the component density of their diets. The opposite association was stated for fecal pus, as for individuals with a lack of this symptom, lower daidzein intake was stated in comparison with individuals declaring this symptom (p = 0.049, 103.3 vs. 206.7 µg), but it was not confirmed for the component density of the diets. It was stated that the high intake of isoflavones by Caucasian individuals, as in a western diet, may influence the symptoms of ulcerative colitis, with the strongest influence by daidzein. Taking this into account, isoflavones may be included into the diets of ulcerative colitis patients in remission if well-tolerated, but there is a need for further study.
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Affiliation(s)
- Dominika Skolmowska
- Chair of Dietetics, Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159c Nowoursynowska Str., 02-776 Warsaw, Poland
| | - Dominika Głąbska
- Chair of Dietetics, Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159c Nowoursynowska Str., 02-776 Warsaw, Poland.
| | - Dominika Guzek
- Chair of Consumption Research, Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159c Nowoursynowska Str., 02-776 Warsaw, Poland
| | - Gustaw Lech
- Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland
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40
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Habibi F, Mahdavi SB, Khaniabadi BM, Habibi ME, Gharavinia A, Baghaei A, Emami MH. Sleep quality and associated factors in Iranian inflammatory bowel disease patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:59. [PMID: 31523245 PMCID: PMC6670003 DOI: 10.4103/jrms.jrms_14_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 01/09/2019] [Accepted: 04/23/2019] [Indexed: 01/24/2023]
Abstract
Background: Sleep is essential in maintaining health and quality of life. Inflammatory bowel disease (IBD) patients suffer from poor sleep quality. This study aimed to investigate the prevalence of sleep disturbances in Iranian IBD patients as well as the variables which can be attributed to the quality of sleep in IBD patients. Materials and Methods: Seventy-one patients filled in Pittsburg Sleep Quality Index (PSQI) questionnaire and a sociodemographic questionnaire. Disease activity was assessed by Crohn's Disease (CD) Activity Index and Ulcerative Colitis (UC) Activity Index. Regression analysis was used to identify the association between sociodemographic and disease characteristics with sleep quality. Results: We found that 32.4% of all patients, 23.1% of patients with “in remission to mild” disease, and 66.7% of patients with “moderate” disease, had poor sleep quality. CD patients were more likely to have poor sleep quality comparing UC ones in crude (odds ratio [OR] =2.14; 95% confidence interval [CI] 1.14–4.04) and adjusted (OR = 6.19; 95% CI 1.13, 34.07) models. Patients with good quality of sleep had lower systolic blood pressure and diastolic blood pressure (P = 0.09 and 0.035 respectively). Conclusion: Notable percentage of IBD patients suffer from poor sleep quality even in the remission phase. Treatment of sleep disturbances, especially in CD patients, is recommended in the IBD patient-care program.
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Affiliation(s)
- Farzaneh Habibi
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sadegh Baradaran Mahdavi
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Child Growth and Development Research Center, Research Institute for Primordial Prevention and Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bita Moradi Khaniabadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention and Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Emadoddin Habibi
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Gharavinia
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolmehdi Baghaei
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Emami
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Internal Medicine, Division of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran
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41
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An Exploratory Study of Inflammatory Bowel Disease and the Psychosocial Factors Affecting Health-Related Quality of Life. Med Sci (Basel) 2019; 7:medsci7020018. [PMID: 30691020 PMCID: PMC6409541 DOI: 10.3390/medsci7020018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 12/15/2022] Open
Abstract
Health-related quality of life (HRQoL) is a multidimensional concept that assesses an individual’s personal satisfaction with his/her daily life while coping with a medical condition and/or its consequent therapy. This study aims to determine the psychosocial needs most commonly affected among inflammatory bowel disease (IBD) patients. Psychosocial needs which were pertinent to the IBD community were assessed using a questionnaire designed by the gastrointestinal team at the Port of Spain General Hospital, Trinidad after getting ethical approval. The chi-squared test was used to assess for statistically significant associations. Of the total 115 participants who completed the survey, a majority of 73 (63%) were females and 70 (61%) were in the 18 to 40-year age group. A majority of 66 (57%) were diagnosed with ulcerative colitis and 66 (57%) were on non-biologic drug therapy. Diet was the need most prevailingly affected, with 87% of participants indicating such. Ability to maintain good hygiene was the need least affected, with 32% of participants identifying concern. We found a significant association between participant’s illness perception (IP) and each of the ten psychosocial variables. The participants’ IP was in turn strongly associated with the ability to cope with the illness while not being associated with the demographic or clinical details of the participants. The results can be used to improve the quality of care delivered to patients living with IBD.
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Jones JL, Nguyen GC, Benchimol EI, Bernstein CN, Bitton A, Kaplan GG, Murthy SK, Lee K, Cooke-Lauder J, Otley AR. The Impact of Inflammatory Bowel Disease in Canada 2018: Quality of Life. J Can Assoc Gastroenterol 2018; 2:S42-S48. [PMID: 31294384 PMCID: PMC6512247 DOI: 10.1093/jcag/gwy048] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023] Open
Abstract
Inflammatory bowel disease (IBD) has a substantial impact on quality of life. It causes considerable personal, emotional and social burdens. The impact of IBD on quality of life cannot readily be quantified as a cost; however, the impact places a significant burden on the patient and caregivers. Numerous studies have shown that health-related quality of life is impaired in patients living with IBD as compared with the general population. While disease activity and severity is an important driver of physical and mental health–related quality of life, patients may experience psychological distress even during clinical remission. Reduced quality of life can impact persons living with IBD as they pursue employment, family planning and personal milestones. Further, the impact of IBD extends to the patient influencing the quality of lives of those around them, including their caregivers. Improving quality of life requires a multidisciplinary approach that includes screening for and managing psychological distress. Adaptive coping mechanisms help manage illness perceptions and reduce psychosocial distress. Highlights Key Summary Points Gaps in Knowledge and Future Directions
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Affiliation(s)
- Jennifer L Jones
- Canadian Gastro-Intestinal Epidemiology Consortium, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Geoffrey C Nguyen
- Canadian Gastro-Intestinal Epidemiology Consortium, Canada.,Mount Sinai Hospital Centre for IBD, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Eric I Benchimol
- Canadian Gastro-Intestinal Epidemiology Consortium, Canada.,Children's Hospital of Eastern Ontario IBD Centre, Department of Pediatrics and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Charles N Bernstein
- Canadian Gastro-Intestinal Epidemiology Consortium, Canada.,University of Manitoba IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alain Bitton
- Canadian Gastro-Intestinal Epidemiology Consortium, Canada.,McGill IBD Centre of Excellence, McGill University Health Centre, Montreal, Quebec, Canada
| | - Gilaad G Kaplan
- Canadian Gastro-Intestinal Epidemiology Consortium, Canada.,Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Sanjay K Murthy
- Canadian Gastro-Intestinal Epidemiology Consortium, Canada.,Ottawa Hospital Research Institute, Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Kate Lee
- Crohn's and Colitis Canada, Toronto, Ontario, Canada
| | | | - Anthony R Otley
- Canadian Gastro-Intestinal Epidemiology Consortium, Canada.,Division of Gastroenterology and Nutrition, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
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