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Miranda-Cordero RM, Bosques-Padilla FJ, Martínez-Vázquez MA, Barajas-Maldonado C, Rodriguez-Mendoza MM, Yamamoto-Furusho JK. Quality of life and burden of disease in a Mexican population with inflammatory bowel disease: an analysis of the RISE-MX trial. Therap Adv Gastroenterol 2025; 18:17562848251318032. [PMID: 40110343 PMCID: PMC11921005 DOI: 10.1177/17562848251318032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 01/17/2025] [Indexed: 03/22/2025] Open
Abstract
Background Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that have a negative impact on patient quality of life (QOL). Objective To evaluate QOL, work productivity, use of healthcare resources, and medical costs in patients with IBD from the RISE-MX trial. Design RISE-MX was a non-interventional, multicentric, cross-sectional, retrospective study conducted in a Mexican population with IBD. Methods The 36-item Short Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ) were used to assess QOL. The burden of disease was analyzed using the Work Productivity and Activity Impairment Questionnaire (WPAI), healthcare resources use, and medical costs. Results Of 326 subjects, 95 (29.1%) had CD, and 231 (70.8%) had UC. In patients with CD, 43 patients (45.3%) showed moderate-to-severe activity, and 42 (18.1%) had moderate-to-severe disease activity in patients with UC. In all SF-36 dimensions, a significant difference between moderate-to-severe and mild activity/in remission groups was observed in patients with UC, while in patients with CD, the difference between activity groups was significant only for physical functioning and social functioning dimensions. In patients with CD, a higher but non-significant IBDQ score difference between activity groups was observed while a statistical difference between activity groups was observed for all dimensions in UC patients. In WPAI, the total percentage for work impairment (absenteeism plus presenteeism) and the percentage of regular daily activity impairment were statistically significant between activity groups only for UC. The annual total costs (direct and indirect) per patient in CD were USD 19,757 (moderate-to-severe activity group) and USD 12,587 (mild activity/in remission group), while in patients with UC were USD 11,702 and USD 9144, respectively. Conclusion Moderate-to-severe activity of disease was associated with a substantial impact on QOL, work productivity, and medical costs in Mexican patients with IBD. Total costs were higher for patients with CD than for patients with UC.
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Affiliation(s)
- Rosa M Miranda-Cordero
- Clinica de Enfermedad Inflamatoria Intestinal, Centro Médico ISSEMyM, Estado de México, Mexico
| | - Francisco J Bosques-Padilla
- Departamento de Gastroenterología, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | | | | | | | - Jesús K Yamamoto-Furusho
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
- Clínica de Enfermedad Inflamatoria Intestinal, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
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Martínez-Vázquez MA, Bosques-Padilla FJ, Miranda-Cordero RM, Yamamoto-Furusho JK. RISE-MX, a real-world study of patients with moderate/severe inflammatory bowel disease returning for hospital follow-up in Mexico: baseline demographics and clinical characteristics, treatment and disease status. Therap Adv Gastroenterol 2025; 18:17562848251318857. [PMID: 39968532 PMCID: PMC11833814 DOI: 10.1177/17562848251318857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 01/21/2025] [Indexed: 02/20/2025] Open
Abstract
Background Inflammatory bowel disease (IBD) is characterized by periods of remission and relapses, and treatment is based on phenotype, risk factors, and disease severity. Treatments include 5-aminosalicylates (5-ASA), thiopurines, methotrexate, calcineurin inhibitors, corticosteroids (CS), biological therapy (BxT), and, more recently, small molecules. Objective To determine the baseline demographics and clinical characteristics, treatment patterns, and disease status of patients in Mexico with a history of moderate/severe IBD returning for hospital follow-up (Index Day). Design This was a non-interventional, cross-sectional study. Methods Socio-demographics, clinical characteristics, and prescribed treatments were collected from a retrospective review (3 years) of each patient's medical records. Results A total of 326 patients with a diagnosis of moderate/severe IBD at least 6 months before the Index Day were included in the analysis: 95 patients (29.2%) had Crohn's disease (CD) and 231 (70.9%) ulcerative colitis (UC). In the CD group, 45.3% (n = 43) had a Harvey Bradshaw Index score ⩾8 or Crohn's Disease Activity Index ⩾220; 10 patients had a B1-non-stenosing, non-penetrating phenotype and 17 had stenosis (B2). In the UC group, 18.2% (n = 42) had moderate/severe disease and the most frequent presentation was pancolitis (n = 56). Regarding treatment over the previous 3 years: for CD, 62 (65.3%) received CS and 20.0% (n = 19) were CS-dependent; 30.5% received 5-ASA + IMS; 27.4% BxT + IMS; and 38.9% 5-ASA + IMS + BxT. In the case of UC, 74.9% (n = 173) received CS and 32.9% (n = 76) were CS-dependent; 64.5% received 5-ASA + IMS; 2.2% BxT + IMS; and 31.6% 5-ASA + IMS + BxT. Conclusion In Mexico, 45.3% of CD patients and 18.1% with UC presented with moderate/severe disease activity. Conventional therapy was used to treat the majority of patients, and the availability of more advanced therapies and a personalized treatment approach is needed to improve clinical outcomes in the future.
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Affiliation(s)
| | - Francisco J. Bosques-Padilla
- Departamento de Gastroenterología, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
| | | | - Jesus K. Yamamoto-Furusho
- Clínica de Enfermedad Inflamatoria Intestinal, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
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García-Gamboa R, Díaz-Torres O, Gradilla-Hernández MS, Pérez-Brocal V, Moya A, González-Avila M. Gut Bacterial Composition and Nutritional Implications in Mexican and Spanish Individuals with Inflammatory Bowel Disease Compared to Healthy Controls. Int J Mol Sci 2024; 25:11887. [PMID: 39595956 PMCID: PMC11593679 DOI: 10.3390/ijms252211887] [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: 09/04/2024] [Revised: 10/19/2024] [Accepted: 10/31/2024] [Indexed: 11/28/2024] Open
Abstract
The intestinal microbiota plays a key role in the pathogenesis of inflammatory bowel disease (IBD), with its composition varying based on geographic location and dietary factors. This study was performed to examine and compare the bacterial composition of the gut microbiota in Mexican and Spanish individuals with IBD and healthy controls, while also considering the nutritional aspects. This study involved 79 individuals with IBD and healthy controls from Mexico and Spain. The fecal microbiota composition was analyzed using 16S rRNA gene sequencing, and the dietary intake and anthropometric measurements were collected. Alpha diversity analysis revealed a lower Chao1 index of the bacterial genera in the IBD groups. Beta diversity analysis showed significant differences in the bacterial composition, suggesting inter-individual variability within the healthy and IBD groups. Additionally, the relative abundance of the bacterial genera varied across the four groups. Faecalibacterium was more abundant in the IBD groups; Prevotella was found exclusively in the Mexican groups, and Akkermansia was found only in the Spanish groups. Akkermansia was positively correlated with meat and protein intake, Prevotella with lean mass, and Bacteroides with calorie intake. These findings highlight the importance of considering geographic and nutritional factors in future research on the gut microbiome's role in IBD pathogenesis.
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Affiliation(s)
- Ricardo García-Gamboa
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Av. General Ramon Corona 2514, Nuevo Mexico, Zapopan 45138, Jalisco, Mexico
| | - Osiris Díaz-Torres
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Laboratorio de Sostenibilidad y Cambio Climático, Av. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - Misael Sebastián Gradilla-Hernández
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Laboratorio de Sostenibilidad y Cambio Climático, Av. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - Vicente Pérez-Brocal
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Av. de Cataluña 21, 46020 València, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERSEP), c/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Andrés Moya
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Av. de Cataluña 21, 46020 València, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERSEP), c/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain
- Integrative Systems Biology Institute (I2SysBio), Universitat de València and Consejo Superior de Investigaciones Científicas (CSIC), c/Catedrático José Beltrán 2, 46980 Paterna, València, Spain
| | - Marisela González-Avila
- Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco A.C., Av. Normalistas No. 800, col Colinas de la Normal, Guadalajara 44270, Jalisco, Mexico
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Caron B, Honap S, Peyrin-Biroulet L. Epidemiology of Inflammatory Bowel Disease across the Ages in the Era of Advanced Therapies. J Crohns Colitis 2024; 18:ii3-ii15. [PMID: 39475082 PMCID: PMC11522978 DOI: 10.1093/ecco-jcc/jjae082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/12/2024] [Accepted: 05/31/2024] [Indexed: 11/02/2024]
Abstract
BACKGROUND AND AIMS The incidence of inflammatory bowel diseases [IBD] has risen over the past decade to become a global issue. The objectives of this review were to describe the incidence and/or prevalence of IBD in the era of advanced therapies, and to describe the association between environmental risk factors and both pathogenesis and disease course across the ages. METHODS We performed a search of English language publications listed in PubMed regarding the epidemiology of IBD and key environmental factors implicated in IBD from January 2000 to December 2023. RESULTS Annual incidence rates varied by geographical region with IBD estimates ranging from 10.5 to 46.14 per 100 000 in Europe, 1.37 to 1.5 per 100 000 in Asia and the Middle East, 23.67 to 39.8 per 100 000 in Oceania, 0.21 to 3.67 per 100 000 in South America, and 7.3 to 30.2 per 100 000 in North America. The burden of IBD among children and adolescents, and older people is rising globally. Key environmental factors implicated in IBD pathogenesis include exposure to tobacco smoking, antibiotics, non-steroidal anti-inflammatory drugs, oral contraceptives, infections, and ultra-high processed foods. Breastfeeding and a high-quality diet rich in fruit, vegetables, fish, and other fibre sources are important protective factors. Smoking has consistently been shown to negatively impact disease outcomes for Crohn's disease. CONCLUSION The epidemiology of IBD has undergone considerable change in recent decades, with an increase in the burden of disease worldwide. Optimally studying and targeting environmental triggers in IBD may offer future opportunities for disease modification.
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Affiliation(s)
- Bénédicte Caron
- Department of Gastroenterology, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
- INSERM, NGERE, University of Lorraine, F-54000 Nancy, France
- INFINY Institute, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
- FHU-CURE, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
| | - Sailish Honap
- INFINY Institute, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
- School of Immunology and Microbial Sciences, King’s College London, London, UK
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
- INSERM, NGERE, University of Lorraine, F-54000 Nancy, France
- INFINY Institute, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
- FHU-CURE, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
- Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada
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Olivera PA, Parks ML, Pellegrini D, Finn B, Gutierrez R, Zubiaurre I, Lasa J. Incidence and prevalence of inflammatory bowel diseases in a population from Buenos Aires, Argentina. GASTROENTEROLOGIA Y HEPATOLOGIA 2024; 47:804-812. [PMID: 37806345 DOI: 10.1016/j.gastrohep.2023.09.012] [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: 08/02/2023] [Revised: 09/07/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Inflammatory bowel diseases (IBD) incidence and prevalence in Latin America have experienced a significant shift in the last decades. There is paucity of IBD epidemiologic data in Argentina. AIM To determine the incidence and prevalence of IBD between 2018 and 2022 of a population from the city of Buenos Aires. MATERIALS AND METHODS From January 1st, 2018 to December 31st, 2022, the total population of two healthcare insurances were studied. 'Possible' IBD cases were identified using the following information sources: IBD-unit patient databases; electronic medical record; central laboratory electronic database; histopathology electronic database; pharmacy electronic database. Age-adjusted incidence and prevalence rates for Crohn's disease (CD), ulcerative colitis (UC) and IBD were estimated based on the number of patients compared with the at-risk population and expressed per 100,000 subjects. Trends in IBD incidence and prevalence were estimated as annual percentage changes; we used Poisson regression modeling to calculate significance in these trends over time. RESULTS Information source analysis rendered 172 possible cases, of which 82 cases of IBD were finally confirmed: 27.16% were CD and 72.84% were UC. Mean age-standardized incidence across the study period for IBD, CD and UC was 11.93 (11.28-12.55), 2.88 (2.65-3.07) and 9.05 (8.83-9.2) respectively. Point prevalence on December 31st, 2022 for IBD, UC and CD was 134 (95%CI 132.3-135.6), 98 (96.95-99.52) and 36 (35.69-36.4) respectively. CONCLUSIONS We found an incidence and prevalence of IBD in a population from Buenos Aires higher than those previously published in epidemiological studies in Argentina.
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Affiliation(s)
- Pablo Andrés Olivera
- Inflammatory Bowel Disease Unit, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina; Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - María Laura Parks
- Gastroenterology Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Deborah Pellegrini
- Health Informatics Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina; Internal Medicine Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Bárbara Finn
- Internal Medicine Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Ramiro Gutierrez
- Internal Medicine Department, Centro de Educación Médica en Investigación Clínica (CEMIC), Buenos Aires, Argentina
| | - Ignacio Zubiaurre
- Gastroenterology Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Juan Lasa
- Inflammatory Bowel Disease Unit, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina.
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Martínez-Vázquez SE, Corral-Ceballos JM, Yamamoto-Furusho JK. Correlation between the Quantity and Type of Dietary Fiber with the Activity in Mexican Patients with Ulcerative Colitis (UC). Nutrients 2024; 16:3198. [PMID: 39339798 PMCID: PMC11435422 DOI: 10.3390/nu16183198] [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: 08/30/2024] [Revised: 09/15/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024] Open
Abstract
Background/Objective: Ingestion of dietary fiber can influence in the remission of patients with ulcerative colitis (UC). There are no current recommendations for fiber intake in UC; therefore, we evaluate the association between dietary fiber and the activity of the disease. Methods: Ours is a cross-sectional study in patients with a confirmed diagnosis of UC to whom a 24 h recall was applied; this allowed for the estimation and classification of type of dietary fiber. The patients were divided into two groups: (1) remission and (2) active UC. We analyzed the quantity and type of fiber with the grades of disease activity through Spearman correlation and logistic regression. Results: A total of 152 patients were included; it was found that those with clinically active UC consumed less total fiber (p = 0.016) and insoluble fiber (p = 0.018). Meanwhile, in endoscopic grade, the difference was for insoluble fiber (p = 0.038). Insoluble fiber had an inversely significant correlation with fecal calprotectin levels (r = -0.204; p = 0.018). Logistic regression showed that less than 11 g of insoluble fiber was a risk factor for clinical activity (OR = 2.37; 95% CI 1.107-5.019; p = 0.026). Conclusions: Consumption below the current recommendation of total and insoluble dietary fiber is associated with clinical activity of UC.
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Affiliation(s)
- Sophia Eugenia Martínez-Vázquez
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México 14080, Mexico; (S.E.M.-V.); (J.M.C.-C.)
| | - José Miguel Corral-Ceballos
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México 14080, Mexico; (S.E.M.-V.); (J.M.C.-C.)
| | - Jesús K. Yamamoto-Furusho
- Inflammatory Bowel Disease Clinic, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Alcaldía Tlalpan, Ciudad de México 14080, Mexico
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Yamamoto-Furusho J, López-Gómez J, Bosques-Padilla F, Martínez-Vázquez M, De-León-Rendón J. Primer consenso mexicano de la enfermedad de Crohn. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2024; 89:280-311. [DOI: 10.1016/j.rgmx.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2024]
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Yamamoto-Furusho JK, López-Gómez JG, Bosques-Padilla FJ, Martínez-Vázquez MA, De-León-Rendón JL. First Mexican Consensus on Crohn's disease. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2024; 89:280-311. [PMID: 38762431 DOI: 10.1016/j.rgmxen.2024.03.001] [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: 12/11/2023] [Accepted: 03/19/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION Crohn's disease (CD) is a subtype of chronic and incurable inflammatory bowel disease. It can affect the entire gastrointestinal tract and its etiology is unknown. OBJECTIVE The aim of this consensus was to establish the most relevant aspects related to definitions, diagnosis, follow-up, medical treatment, and surgical treatment of Crohn's disease in Mexico. MATERIAL AND METHODS Mexican specialists in the areas of gastroenterology and inflammatory bowel disease were summoned. The consensus was divided into five modules, with 69 statements. Applying the Delphi panel method, the pre-meeting questions were sent to the participants, to be edited and weighted. At the face-to-face meeting, all the selected articles were shown, underlining their level of clinical evidence; all the statements were discussed, and a final vote was carried out, determining the percentage of agreement for each statement. RESULTS The first Mexican consensus on Crohn's disease was produced, in which recommendations for definitions, classifications, diagnostic aspects, follow-up, medical treatment, and surgical treatment were established. CONCLUSIONS Updated recommendations are provided that focus on definitions, classifications, diagnostic criteria, follow-up, and guidelines for conventional medical treatment, biologic therapy, and small molecule treatment, as well as surgical management.
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Affiliation(s)
- J K Yamamoto-Furusho
- Clínica de Enfermedad Inflamatoria Intestinal, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - J G López-Gómez
- Clínica de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - F J Bosques-Padilla
- Departamento de Gastroenterología, Hospital Universitario de la Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | | | - J L De-León-Rendón
- Clínica de Enfermedad Inflamatoria Intestinal, Servicio de Coloproctología, Hospital General de México, Mexico City, Mexico
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Weidner J, Glauche I, Manuwald U, Kern I, Reinecke I, Bathelt F, Amin M, Dong F, Rothe U, Kugler J. Correlation of Socioeconomic and Environmental Factors With Incidence of Crohn Disease in Children and Adolescents: Systematic Review and Meta-Regression. JMIR Public Health Surveill 2024; 10:e48682. [PMID: 38526534 PMCID: PMC11002755 DOI: 10.2196/48682] [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: 05/03/2023] [Revised: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND The worldwide incidence of Crohn disease (CD) in childhood and adolescence has an increasing trend, with significant differences between different geographic regions and individual countries. This includes an increase in the incidence of CD in countries and geographic regions where CD was not previously prevalent. In response to the increasing incidence, the pediatric care landscape is facing growing challenges. OBJECTIVE This systematic review and meta-analysis were undertaken to comprehensively delineate the incidence rates of CD in pediatric populations across different countries and to explore potential influencing factors. METHODS We performed a systematic review of PubMed and Embase (via Ovid) for studies from January 1, 1970, to December 31, 2019. In addition, a manual search was performed in relevant and previously published reviews. The results were evaluated quantitatively. For this purpose, random effects meta-analyses and meta-regressions were performed to investigate the overall incidence rate and possible factors influencing the incidence. RESULTS A qualitative synthesis of 74 studies was performed, with 72 studies included in the meta-analyses and 52 in the meta-regressions. The results of our meta-analysis showed significant heterogeneity between the individual studies, which cannot be explained by a sample effect alone. Our findings showed geographical differences in incidence rates, which increased with increasing distance from the equator, although no global temporal trend was apparent. The meta-regression analysis also identified geographic location, UV index, and Human Development Index as significant moderators associated with CD incidence. CONCLUSIONS Our results suggest that pediatric CD incidence has increased in many countries since 1970 but varies widely with geographic location, which may pose challenges to the respective health care systems. We identified geographic, environmental, and socioeconomic factors that contribute to the observed heterogeneity in incidence rates. These results can serve as a basis for future research. To this end, implementations of internationally standardized and interoperable registries combined with the dissemination of health data through federated networks based on a common data model, such as the Observational Medical Outcomes Partnership, would be beneficial. This would deepen the understanding of CD and promote evidence-based approaches to preventive and interventional strategies as well as inform public health policies aimed at addressing the increasing burden of CD in children and adolescents. TRIAL REGISTRATION PROSPERO International prospective register of systematic reviews CRD42020168644; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168644. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-037669.
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Affiliation(s)
- Jens Weidner
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ingmar Glauche
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ulf Manuwald
- Faculty of Applied Social Sciences, University of Applied Sciences (FHD), Dresden, Germany
| | - Ivana Kern
- Institute and Policlinic for Occupational and Social Medicine, Department of Health Sciences/Public Health, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ines Reinecke
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Franziska Bathelt
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
- Thiem-Research GmbH, Cottbus, Germany
| | - Makan Amin
- Institute and Policlinic for Occupational and Social Medicine, Department of Health Sciences/Public Health, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
- Department for Trauma Surgery and Orthopaedics, Park-Klinik Weissensee, Berlin, Germany
| | - Fan Dong
- Institute and Policlinic for Occupational and Social Medicine, Department of Health Sciences/Public Health, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Joachim Kugler
- Institute and Policlinic for Occupational and Social Medicine, Department of Health Sciences/Public Health, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Balderramo D, Quaresma AB, Olivera PA, Savio MC, Villamil MPG, Panaccione R, Ng SC, Kaplan GG, Kotze PG. Challenges in the diagnosis and treatment of inflammatory bowel disease in Latin America. Lancet Gastroenterol Hepatol 2024; 9:263-272. [PMID: 38340754 DOI: 10.1016/s2468-1253(23)00284-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 02/12/2024]
Abstract
The incidence and prevalence of inflammatory bowel disease (IBD), namely Crohn's disease and ulcerative colitis, have increased in Latin America over the past few decades. Although incidence is accelerating in some countries in the region, other areas in Latin America are already transitioning into the next epidemiological stage-ie, compounding prevalence-with a similar epidemiological profile to the western world. Consequently, more attention must be given to the diagnosis and management of IBD in Latin America. In this Review, we provide an overview of epidemiology, potential local environmental risk factors, challenges in the management of IBD, and limitations due to the heterogenity of health-care systems, both public and private, in Latin America. Unresolved issues in the region include inadequate access to diagnostic resources, biological therapies, tight disease monitoring (including treat to target therapy, surveillance and prevention of complications, drug monitoring), and specialised IBD surgery. Local guidelines are an important effort to overcome barriers in IBD management. Advancements in long-term health-care policies will be important to promote early diagnosis, access to new treatments, and improvements in research in Latin America. These improvements will not only affect overall health care but will also lead to optimal prioritisation of IBD-related costs and resources and enhance the quality of life of people with IBD in Latin America.
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Affiliation(s)
- Domingo Balderramo
- Gastroenterology Department, Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina
| | - Abel Botelho Quaresma
- Health Sciences Postgraduate Program, Pontificia Universidade Católica do Paraná, Curitiba, Brazil; IBD Outpatient Clinic, Universidade do Oeste de Santa Catarina, Joaçaba, Brazil.
| | - Pablo A Olivera
- Inflammatory Bowel Disease Unit, Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina; Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada; Division of Gastroenterology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - Mariane Christina Savio
- Health Sciences Postgraduate Program, Pontificia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Remo Panaccione
- Division of Gastroenterology and Hepatology, Inflammatory Bowel Disease Clinic, University of Calgary, Calgary, AB, Canada
| | - Siew C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS institute of Health Science, the Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Gilaad G Kaplan
- Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Paulo Gustavo Kotze
- Health Sciences Postgraduate Program, Pontificia Universidade Católica do Paraná, Curitiba, Brazil
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11
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Queiroz NSF, Martins CDA, Quaresma AB, Olivera Sendra PA, Ernest-Suarez K, Kotze PG. IBD barriers across the continents: a continent-specific analysis: Latin America. Therap Adv Gastroenterol 2023; 16:17562848231167953. [PMID: 37124371 PMCID: PMC10134129 DOI: 10.1177/17562848231167953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Latin America (LATAM) is a large region comprising 47 countries and territories. Each one carries a different cultural and historical background, diverse political systems, and a particular approach to healthcare management. There is a lack of high-quality data on the epidemiology of inflammatory bowel diseases (IBD) in this region, including broad and detailed information about the penetration of biological and advanced therapies as treatment strategies. From an IBD perspective, patients experience, in general, fragmentations and inequities in the healthcare systems, with different and usually delayed access to qualified health services. This review explores the barriers to accessing IBD care throughout LATAM. The authors compiled data from multiple sources, such as studies focusing on epidemiology, biological penetration, and surgical rates. In addition, overall access to IBD treatments was assessed through a questionnaire distributed to physicians in LATAM via email and direct messaging to capture local perspectives.
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Affiliation(s)
- Natália Sousa Freitas Queiroz
- Health Sciences Graduate Program, School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
| | | | - Abel Botelho Quaresma
- Health Sciences Graduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
- Universidade do Oeste de Santa Catarina (UNOESC), Joaçaba, Brazil
| | - Pablo A. Olivera Sendra
- IBD Unit, Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina
- Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Kenneth Ernest-Suarez
- Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hospital México, Caja Costarricense de Seguro Social, San José, Costa Rica
- Gastroenterology Postgraduate Program, School of Medicine, Universidad de Costa Rica, San José, Costa Rica
| | - Paulo Gustavo Kotze
- Health Sciences Graduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
- IBD Outpatient Clinics, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil
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12
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The Role of CD1 Gene Polymorphism in the Genetic Susceptibility to Spondyloarthropathies in the Moroccan Population and the Possible Cross-Link with Celiac Disease. Vaccines (Basel) 2023; 11:vaccines11020237. [PMID: 36851115 PMCID: PMC9963915 DOI: 10.3390/vaccines11020237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
Spondyloarthropathies (SpA) are a group of chronic inflammatory disorders usually affecting the axial spine and asymmetrical peripheral joints. Strong evidence links genetic and environmental factors to SpA pathogenesis. The HLA-B27 is the most important genetic factor associated with SpA. Nevertheless, the involvement of other HLA and non-HLA loci has been also reported. Some patients with SpA may also manifest features of celiac disease (CeD), thus suggesting a genetic overlap across these autoimmune diseases. Recently, CD1 glycoproteins, a class of molecules able to bind and present non peptidic antigens to T cells, aroused interest for their contribution to the pathogenesis of CeD. Therefore, to evaluate whether functional polymorphisms of CD1A and E genes also influence susceptibility to SpA, we analyzed 86 patients from Morocco affected by SpA and 51 healthy controls, using direct sequencing analysis. An increase of CD1E*01/01 homozygous genotype (p = 0.046) was found in SpA, compared with controls. CD1E*01/01 genotype was associated particularly to patients with sacroiliac joints/spine/peripheral joints pain (p = 0.0068), while a decrease of CD1E*01/02 genotype was evidenced compared to controls (p = 0.0065). Results from haplotypes analysis demonstrated that CD1A*02-E*02 decreased the risk of SpA, while CD1A*02-E*01 increased risk to develop disease. Our data indicate a relationship between CD1 genes and susceptibility to SpA in the Moroccan population and suggest the existence of shared genetic risk loci across SpA and CeD that might be useful to explain common pathogenetic features and define novel therapeutic strategies.
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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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14
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Martins AL, Fróes RDSB, Zago-Gomes MDP. Prevalence, phenotype and medication for the pediatric inflammatory bowel disease population of a state in Southeastern Brazil. World J Clin Pediatr 2022; 11:341-350. [PMID: 36052115 PMCID: PMC9331404 DOI: 10.5409/wjcp.v11.i4.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/23/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) can lead to social and economic impacts worldwide. In Brazil, where its adult prevalence is increasing, the epidemiology of the pediatric population is not well known, although there is a documented increase in pediatric IBD incidence worldwide. Brazil has continental dimensions, and Espírito Santo is a state of southeastern Brazil, the region with the highest demographic densities and is the economically most important in the country.
AIM To assess the prevalence, incidence, phenotype and medications in a Southeastern Brazilian pediatric population.
METHODS Data were retrieved from the Public Medication-Dispensing System of the Department of Health in Espírito Santo state from documentation required to have access to highly expensive medication from August 1, 2012 to July 31, 2014. There were 1048 registered patients with IBD of all ages, and of these patients, the cases ≤ 17 years were selected. The data were obtained through the analysis of administrative requests for these medications and included medical reports, endoscopy exams, histopathology and imaging tests, which followed the Clinical Protocols and Therapeutic Guidelines of the Brazilian Government. Only confirmed cases of IBD were included in the study.
RESULTS There were 55 pediatric patients/1048 registered patients (5.34%), with Crohn's disease (CD) representing 30/55 (55%), ulcerative colitis (UC) 24/55 (43.6%) and 1 unclassified IBD, a significant difference from adult patients (P = 0.004). The prevalence of IBD in pediatric patients was 5.02 cases/100.000 inhabitants; the incidence in 2014 was 1.36 cases/100.000 inhabitants. The mean age at diagnosis was 12.2 years (± 4.2). There were 7 children diagnosed up to 6 years old, 7 between 7 to 10 years old and 41 between 11 and ≤ 17 years old. There was no difference in the distribution of UC and CD between these age categories (P = 0.743). There was no difference in gender distribution in relation to adults. Children and adolescents with UC had a predominance of pancolitis, unlike adults (P = 0.001), and used aminosalicylates and immunomodulators for their treatment. Pediatric patients with CD did not present a difference in disease location but had a higher frequency of fistulizing behavior (P = 0.03) and perianal disease phenotype (P = 0.007) than adult patients. Patients with CD used more immunomodulators and biological therapy. Treatment with biological therapy was more frequently used in pediatric patients than in adults (P < 0.001).
CONCLUSION Although the data from this study demonstrate that incidence and prevalence rates are low in southeastern Brazil, these data demonstrate the severity of IBD in pediatric patients, with the need for early diagnosis and therapy, avoiding serious damage.
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Affiliation(s)
- Adalberta Lima Martins
- Pharmaceutical Assistance, Health Department of Espírito Santo, Vitoria 29052-210, Espírito Santo, Brazil
| | | | - Maria da Penha Zago-Gomes
- Departament of Medical Clinical, Hospital Universitário Cassiano Antonio Moraes, Vitoria 29042-755, Espírito Santo, Brazil
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15
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Juliao-Baños F, Grillo-Ardila CF, Alfaro I, Andara-Ramírez MT, Avelar-Escobar O, Barahona-Garrido J, Bautista-Martínez S, Bosques-Padilla FJ, De Paula JA, Ernest-Suárez K, Galiano MT, Iade-Vergara B, Patricio-Ibañez, Jara-Alba ML, Kotze PG, Miranda-Ojeda MC, Ortuño-Escalante R, Otoya-Moreno G, Piñol-Jiménez FN, Ramos-Polo IC, Sambuelli A, Toro M, Torres EA, Veitia-Velásquez GR, Yamamoto-Furusho JK, Zaltman C, Steinwurz F, Vallejo-Ortega M, Torres-Castillo JI, Hamon-Pinilla C, Calderon-Franco CH, Escobar-Villegas AM. Update of the PANCCO clinical practice guidelines for the treatment of ulcerative colitis in the adult population. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2022; 87:342-361. [PMID: 35879225 DOI: 10.1016/j.rgmx.2022.04.007] [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: 02/06/2022] [Accepted: 04/06/2022] [Indexed: 09/19/2023]
Abstract
Ulcerative colitis (US) is a chronic disease of unknown etiology. It is incurable and its clinical course is intermittent, characterized by periods of remission and relapse. The prevalence and incidence of the disease has been increasing worldwide. The update presented herein includes the participation of healthcare professionals, decision-makers, and a representative of the patients, all of whom declared their conflicts of interest. Answerable clinical questions were formulated, and the outcomes were graded. The information search was conducted on the Medline/PubMed, Embase, Epistemonikos, and LILACS databases, and covered grey literature sources, as well. The search was updated on November 30, 2020, with no restrictions regarding date or language. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system was implemented to establish the strength of the recommendation and quality of evidence. A formal consensus was developed, based on the RAND/UCLA methodology and the document was peer reviewed. The short version of the Clinical Practice Guidelines for the Treatment of Ulcerative Colitis in the Adult Population is presented herein, together with the supporting evidence and respective recommendations. In mild-to-moderate UC, budesonide MMX is an option when treatment with 5-ASA fails, and before using systemic steroids. In moderate-to-severe UC, infliximab, adalimumab, vedolizumab, ustekinumab, and tofacitinib can be used as first-line therapy. If there is anti-TNF therapy failure, ustekinumab and tofacitinib provide the best results. In patients with antibiotic-refractory pouchitis, anti-TNFs are the treatment of choice.
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Affiliation(s)
- F Juliao-Baños
- Clínica de Enfermedad Inflamatoria Intestinal, Unidad de Gastroenterología, Hospital Pablo Tobón Uribe, Medellín, Colombia.
| | - C F Grillo-Ardila
- Departamento de Ginecología y Obstetricia, Universidad Nacional de Colombia; Grupo de Investigación Clínica y Epidemiológica del Cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - I Alfaro
- Servicio Medicina Interna Hospital Regional de Concepción, Departamento de Medicina Interna, Universidad de Concepción, Concepción, Chile
| | - M T Andara-Ramírez
- Servicio de Gastroenterología, Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras
| | - O Avelar-Escobar
- Servicio de Gastroenterología, Instituto Salvadoreño del Seguro Social, San Salvador. El Salvador
| | - J Barahona-Garrido
- Servicio de Gastroenterología, Enfermedades Digestivas de Guatemala, Ciudad de Guatemala, Guatemala
| | - S Bautista-Martínez
- CEDIMAT Plaza de la salud, Departamento Gastroenterología, Clínica EII, Santo Domingo, Dominican Republic
| | - F J Bosques-Padilla
- Servicio de Gastroenterología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León (UANL), Monterrey, Nuevo León, Mexico
| | - J A De Paula
- Servicio de Gastroenterología del Hospital Italiano de Buenos Aires, Equipo de Enfermedades Inflamatorias del Intestinales del Servicio de Gastroenterología del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - K Ernest-Suárez
- Servicio de Gastroenterología y Endoscopía Digestiva, Hospital México, Caja Costarricense de Seguro Social, Escuela de Medicina de la Universidad de Costa Rica, San José, Costa Rica
| | - M T Galiano
- Gastroenteróloga y Endoscopista Gastrointestinal, Clínica de Marly, Bogotá, Colombia
| | - B Iade-Vergara
- Departamento de Gastroenterología de CASMU, Asociación de Crohn's y Colitis Uruguay (ACCU), ECCO y PANCCO, Montevideo, Uruguay
| | - Patricio-Ibañez
- Programa Enfermedad Inflamatoria Intestinal, Departamento de Gastroenterología, Clínica Las Condes, Facultad de Medicina Universidad de Chile, Campus CLC, Santiago de Chile, Chile
| | - M L Jara-Alba
- Grupo Ecuatoriano de Estudio de Enfermedad Inflamatoria Intestinal, Hospital Teodoro Maldonado Carbo, Clínica de Enfermedad Inflamatoria Intestinal, Hospital Teodoro Maldonado Carbo, Guayaquil, Ecuador
| | - P G Kotze
- Profesor Asistente de Cirugía, Clínica de Enfermedad Inflamatoria Intestinal, Universidad Católica de Paraná, Curitiba, Brazil
| | - M C Miranda-Ojeda
- Servicio de Gastroenterología, Hospital de Clínicas, San Lorenzo, Paraguay
| | - R Ortuño-Escalante
- Instituto de Gastroenterología Boliviano-Japonés, Ciudad de la Paz, Bolivia
| | - G Otoya-Moreno
- Servicio de Gastroenterología Hospital Nacional "Guillermo Almenara I", Lima, Peru
| | - F N Piñol-Jiménez
- Sociedad Cubana de Gastroenterología, Centro Nacional de Cirugía de Mínimo Acceso (CNCMA), La Habana, Cuba
| | - I C Ramos-Polo
- Servicio y de la Unidad de Endoscopia del Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Clínica Hospital San Fernando, Ciudad de Panamá, Panama
| | - A Sambuelli
- Sección de Enfermedades Inflamatorias Intestinales, Hospital Bonorino Udaondo, Buenos Aires, Argentina
| | - M Toro
- Gastroenterología y Endoscopía Digestiva, Grupo de Trabajo en Enfermedades Inflamatorias Intestinales de Clínica HIGEA, Mendoza, Argentina
| | - E A Torres
- Departamento de Medicina, Escuela de Medicina de la Universidad de Puerto Rico (UPR), Unidad de Investigación en Gastroenterología, Centro para Enfermedades Inflamatorias del Intestino, UPR, San Juan, Puerto Rico
| | | | - J K Yamamoto-Furusho
- Clínica de Enfermedad Inflamatoria Intestinal (EII), Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C Zaltman
- Departamento de Clínica Médica, Universidad de Federal do Rio de Janeiro, Ambulatorio de Doença Inflamatoria Intestinal, HUCFF-UFRJ, Río de Janeiro, Brazil
| | - F Steinwurz
- Gastroenterólogo del Hospital israelita Albert Einstein, São Paulo, Brazil
| | - M Vallejo-Ortega
- Instituto de Investigaciones, Universidad Nacional de Colombia, Grupo de Investigación Clínica y Epidemiológica del Cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - J I Torres-Castillo
- Servicio de Medicina de Emergencias, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - C Hamon-Pinilla
- Departamento de Ginecología y Obstetricia, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - C H Calderon-Franco
- Departamento de Medicina Interna, Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia
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Update of the PANCCO clinical practice guidelines for the treatment of ulcerative colitis in the adult population. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2022; 87:342-361. [DOI: 10.1016/j.rgmxen.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 04/06/2022] [Indexed: 11/20/2022] Open
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Quaresma AB, Damiao AO, Coy CS, Magro DO, Hino AA, Valverde DA, Panaccione R, Coward SB, Ng SC, Kaplan GG, Kotze PG. Temporal trends in the epidemiology of inflammatory bowel diseases in the public healthcare system in Brazil: A large population-based study. LANCET REGIONAL HEALTH. AMERICAS 2022; 13:100298. [PMID: 36777324 PMCID: PMC9903988 DOI: 10.1016/j.lana.2022.100298] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Population-based data on epidemiology of Inflammatory Bowel Diseases (IBD) in Brazil are scarce. This study aims to define temporal trends of incidence and prevalence rates of Crohn's disease (CD) and ulcerative colitis (UC) in Brazil. Methods All IBD patients from the public healthcare national system were included from January 2012 to December 2020. Average Annual Percent Change (AAPC) and 95% confidence intervals (CI) were calculated using log-linear regression for incidence and binomial regression for prevalence. Moran's I autocorrelation index was used to analyse clustering of cities by level of prevalence. Findings A total of 212,026 IBD patients were included. Incidence of IBD rose from 9.4 in 2012 to 9.6 per 100,000 in 2020 (AAPC=0.8%; 95% CI -0.37, 1.99); for UC, incidence increased from 5.7 to 6.9 per 100,000 (AAPC=3.0%; 95% CI 1.51, 4.58) and for CD incidence decreased from 3.7 to 2.7 per 100,000 (AAPC=-3.2%; 95% CI -4.45, -2.02). Prevalence of IBD increased from 30.0 in 2012 to 100.1 per 100,000 in 2020 (AAPC=14.8%; CI 14.78-14.95); for UC, from 15.7 to 56.5 per 100,000 (AAPC=16.0%; CI 15.94, 16.17); for CD from 12.6 to 33.7 per 100,000 (AAPC=12.1% CI 11.95, 12.02). A south-north gradient was observed in 2020 prevalence rates of IBD [I=0.40 (p<0.0001)], CD [I=0.22 (p<0.0001)] and UC [I=0.42 (p<0.0001)]. Interpretation Incidence of CD is decreasing whereas of UC is increasing, leading to stabilization in the incidence of IBD from 2012 to 2020 in Brazil. Prevalence of IBD has been climbing with 0.1% of Brazilians living with IBD in 2020. Funding None.
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Key Words
- AAPC, Average Annual Percent Change
- AC, Acre
- AL, Alagoas
- AM, Amazonas
- AP, Amapá
- BA, Bahia
- Brazil
- CAAE, Certificate of Presentation for Ethical Appreciation
- CD, Crohn's disease
- CE, Ceará
- CI, confidence intervals
- Crohn's disease
- DATASUS, Department of Health Informatics/Ministry of Health
- DF, Distrito federal
- ES, Espírito Santo
- Epidemiology
- GO, Goiás
- IBD, Inflammatory Bowel Diseases
- IBDU, Inflammatory Bowel Diseases undetermined
- IBGE, National Institute of Geographics and Statistics (Instituto Brasileiro de Geografia e Estatística)
- ICD-10, Classification of Diseases and Related Health Problems, Tenth Revision
- Incidence
- Inflammatory bowel disease
- MA, Maranhão
- MG, Minas Gerais
- MS, Mato Grosso do Sul
- MT, Mato Grosso
- PA, Pará
- PB, Paraíba
- PE, Pernambuco
- PI, Piauí
- PR, Paraná
- Prevalence
- RN, Rio Grande do Norte
- RO, Rondônia
- RR, Roraima
- RS, Rio Grande do Sul
- SC, Santa Catarina
- SE, Sergipe
- SP, São Paulo
- SUS, national public health system (Sistema Único de Saúde)
- TO, Tocantins
- UC, ulcerative colitis
- UNOESC, University of the West of Santa Catarina
- Ulcerative colitis
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Affiliation(s)
- Abel B. Quaresma
- Universidade do Oeste de Santa Catarina, UNOESC, Colorectal Surgery, Joaçaba, Brazil,Corresponding author.
| | | | - Claudio S.R. Coy
- University of Campinas UNICAMP, Colorectal Surgery Unit, Campinas, Brazil
| | - Daniela O. Magro
- University of Campinas UNICAMP, Colorectal Surgery Unit, Campinas, Brazil
| | - Adriano A.F. Hino
- Catholic University of Paraná, Health Sciences Postgraduate Program, Curitiba, Brazil
| | | | - Remo Panaccione
- University of Calgary, Department of Medicine, Division of Gastroenterology and Hepatology, Calgary, Canada
| | - Stephanie B. Coward
- University of Calgary, Department of Medicine, Division of Gastroenterology and Hepatology, Calgary, Canada
| | - Siew C. Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Gilaad G. Kaplan
- University of Calgary, Department of Medicine, Division of Gastroenterology and Hepatology, Calgary, Canada
| | - Paulo G. Kotze
- Catholic University of Paraná, Health Sciences Postgraduate Program, Curitiba, Brazil,Catholic University of Paraná, IBD outpatient Clinics, Colorectal Surgery Unit, Curitiba, Brazil
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Yamamoto-Furusho JK, Parra-Holguín NN, Juliao-Baños F, Puentes F, López R, Bosques-Padilla F, Torres EA, Nieves-Jimenéz H, Veitia-Velásquez GR, Jara-Alba ML, Bautista S, Piñol-Jimenez FN, Salgado-Rosado P, Villa-Ovalles KC, Abreu-Martinez YA, Borges Z, Davila-Bedoya S, Otoya-Moreno G, Iadé-Vergara B. Clinical differentiation of inflammatory bowel disease (IBD) in Latin America and the Caribbean. Medicine (Baltimore) 2022; 101:e28624. [PMID: 35060539 PMCID: PMC8772634 DOI: 10.1097/md.0000000000028624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/14/2021] [Accepted: 12/31/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT The aim of the present study was to describe the epidemiological and clinical characteristics of inflammatory bowel disease (IBD), including medical and surgical treatments, in several countries in Latin America and the Caribbean.IBD is recognized as a global health problem because its incidence and prevalence have increased significantly over the last few years.This multicenter retrospective cohort study included 4714 patients with IBD diagnosed from 9 countries in Latin America and the Caribbean: Colombia, Cuba, Dominican Republic, Ecuador, Mexico, Peru, Puerto Rico, Uruguay, and Venezuela.Crohn disease (CD) was more frequent in Puerto Rico (71.9%), the Dominican Republic (61.0%), and Peru (53.1%). Ulcerative colitis was more frequent in Colombia (78.6%), Venezuela (78.2%), Mexico (75.5%), Cuba (69.9%), Ecuador (64.1%), and Uruguay (60.9%). The following clinical characteristics were more frequent in the Caribbean: penetrating behavior in CD, steroid dependence, steroid resistance, intolerance to thiopurines, extraintestinal manifestations, surgeries, hospitalizations due to IBD, and family history of IBD. The factors associated with the use of biological therapy were pancolitis in ulcerative colitis, penetrating behavior in CD, steroid resistance and dependence, presence of extraintestinal manifestations, and the need for surgery.This study from Latin America and the Caribbean demonstrated the different epidemiological and clinical characteristics of IBD.
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Affiliation(s)
- Jesús K. Yamamoto-Furusho
- Inflammatory Bowel Disease Clinic, Gastroenterology Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Norma N. Parra-Holguín
- Inflammatory Bowel Disease Clinic, Gastroenterology Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico
| | | | | | | | - Francisco Bosques-Padilla
- Department of Gastroenterology, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | | | | | | | - Maria L. Jara-Alba
- Hospital Dr. Teodoro Maldonado Carbo - Instituto Ecuatoriano de Seguridad Social (IESS), Guayaquil, Ecuador
| | - Sócrates Bautista
- Centros de Diagnóstico y Medicina Avanzada y de Conferencias Médicas y Telemedicina (CEDIMAT) Gastroenterology Center, Santo Domingo, Dominican Republic
| | | | - Pablo Salgado-Rosado
- Hospital Dr. Teodoro Maldonado Carbo - Instituto Ecuatoriano de Seguridad Social (IESS), Guayaquil, Ecuador
| | - Keyla C. Villa-Ovalles
- Centros de Diagnóstico y Medicina Avanzada y de Conferencias Médicas y Telemedicina (CEDIMAT) Gastroenterology Center, Santo Domingo, Dominican Republic
| | - Yudelka A. Abreu-Martinez
- Regional University Hospital José María Cabral y Baez, Santiago de los Caballeros, Dominican Republic
| | - Zunilda Borges
- Regional University Hospital José María Cabral y Baez, Santiago de los Caballeros, Dominican Republic
| | | | | | - Beatriz Iadé-Vergara
- Centro de Asistencia del Sindicato Médico del Uruguay (CASMU) Cooperativa de Servicios Médicos (COSEM), Uruguay
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Yamamoto-Furusho JK, Parra-Holguín NN. Real-world experience with MMX mesalazine use in Mexican patients with ulcerative colitis at two tertiary care centers. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2021; 87:305-311. [PMID: 34794923 DOI: 10.1016/j.rgmxen.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS The 5-aminosalicylates, especially mesalazine, are the first option in the treatment of mild-to-moderate ulcerative colitis (UC). High rates of remission induction and maintenance have been observed with the new multimatrix (MMX) mesalazine formulation, mainly in patients with distal disease. Our aim was to describe the real-world experience with MMX mesalazine in patients with UC at two tertiary care centers. MATERIALS AND METHODS A retrospective cohort study was conducted that included 142 patients with confirmed UC diagnosis, analyzed in three study groups: 1) oral MMX mesalazine as monotherapy for remission induction, 2) oral MMX mesalazine as monotherapy for remission maintenance, and 3) oral MMX mesalazine plus topical therapy for remission induction. RESULTS The frequency of clinical remission induction in group 1 was 80.3%, with biochemical remission of 74.2%. Group 2 had 100% clinical and biochemical remission maintenance. The frequency of clinical remission induction in group 3 was 88.6%, biochemical remission was 85.7%, and topical therapy was suspended in 87.3% at the end of follow-up. No adverse events were documented. CONCLUSIONS There were high percentages of clinical and biochemical remission in the two corresponding study groups and topical therapy was suspended in the majority of patients in ashort follow-up period.
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Affiliation(s)
- J K Yamamoto-Furusho
- Clínica de Enfermedad Inflamatoria Intestinal, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Servicio de Gastroenterología y Obesidad, Hospital Médica Sur, Mexico City, Mexico.
| | - N N Parra-Holguín
- Clínica de Enfermedad Inflamatoria Intestinal, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Liang L, Lin R, Xie Y, Lin H, Shao F, Rui W, Chen H. The Role of Cyclophilins in Inflammatory Bowel Disease and Colorectal Cancer. Int J Biol Sci 2021; 17:2548-2560. [PMID: 34326693 PMCID: PMC8315013 DOI: 10.7150/ijbs.58671] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/04/2021] [Indexed: 12/12/2022] Open
Abstract
Cyclophilins (Cyps) is a kind of ubiquitous protein family in organisms, which has biological functions such as promoting intracellular protein folding and participating in the pathological processes of inflammation and tumor. Inflammatory bowel disease (IBD) and colorectal cancer (CRC) are two common intestinal diseases, but the etiology and pathogenesis of these two diseases are still unclear. IBD and CRC are closely associated, IBD has always been considered as one of the main risks of CRC. However, the role of Cyps in these two related intestinal diseases is rarely studied and reported. In this review, the expression of CypA, CypB and CypD in IBD, especially ulcerative colitis (UC), and CRC, their relationship with the development of these two intestinal diseases, as well as the possible pathogenesis, were briefly summarized, so as to provide modest reference for clinical researches and treatments in future.
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Affiliation(s)
- Lifang Liang
- Department of Pathogenic Biology and Immunology, School of Life Sciences and Biopharmaceuticals, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
| | - Rongxiao Lin
- Centrefor Novel Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
| | - Ying Xie
- Centrefor Novel Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
| | - Huaqing Lin
- Centrefor Novel Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
- GDPU-HKU Zhongshan Biomedical Innovation Plaform, Zhongshan 528437, Guangdong Province, PR China
- Guangdong Engineering & Technology Research Center of Topical Precise Drug Delivery System, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
| | - Fangyuan Shao
- Cancer Center, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Wen Rui
- Centrefor Novel Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
- Guangdong Engineering & Technology Research Center of Topical Precise Drug Delivery System, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
- Key Laboratory of Digital Quality Evaluation of Chinese Materia Medica of State Administration of TCM, Guangzhou 510006, Guangdong Province, PR China
- Guangdong Cosmetics Engineering & Technology Research Center,Guangzhou 510006, Guangdong Province, PR China
| | - Hongyuan Chen
- Department of Pathogenic Biology and Immunology, School of Life Sciences and Biopharmaceuticals, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
- GDPU-HKU Zhongshan Biomedical Innovation Plaform, Zhongshan 528437, Guangdong Province, PR China
- Guangdong Engineering & Technology Research Center of Topical Precise Drug Delivery System, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, PR China
- Key Laboratory of Digital Quality Evaluation of Chinese Materia Medica of State Administration of TCM, Guangzhou 510006, Guangdong Province, PR China
- Guangdong Cosmetics Engineering & Technology Research Center,Guangzhou 510006, Guangdong Province, PR China
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21
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Yamamoto-Furusho JK, Parra-Holguín NN. Real-world experience with MMX mesalazine use in Mexican patients with ulcerative colitis at two tertiary care centers. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2021; 87:S0375-0906(21)00058-6. [PMID: 34147309 DOI: 10.1016/j.rgmx.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/08/2020] [Accepted: 01/28/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION AND AIMS The 5-aminosalicylates, especially mesalazine, are the first option in the treatment of mild-to-moderate ulcerative colitis (UC). High rates of remission induction and maintenance have been observed with the new multimatrix (MMX) mesalazine formulation, mainly in patients with distal disease. Our aim was to describe the real-world experience with MMX mesalazine in patients with UC at two tertiary care centers. MATERIALS AND METHODS A retrospective cohort study was conducted that included 142 patients with confirmed UC diagnosis, analyzed in three study groups: 1) oral MMX mesalazine as monotherapy for remission induction, 2) oral MMX mesalazine as monotherapy for remission maintenance, and 3) oral MMX mesalazine plus topical therapy for remission induction. RESULTS The frequency of clinical remission induction in group 1 was 80.3%, with biochemical remission of 74.2%. Group 2 had 100% clinical and biochemical remission maintenance. The frequency of clinical remission induction in group 3 was 88.6%, biochemical remission was 85.7%, and topical therapy was suspended in 87.3% at the end of follow-up. No adverse events were documented. CONCLUSIONS There were high percentages of clinical and biochemical remission in the two corresponding study groups and topical therapy was suspended in the majority of patients in a short follow-up period.
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Affiliation(s)
- J K Yamamoto-Furusho
- Clínica de Enfermedad Inflamatoria Intestinal, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México; Servicio de Gastroenterología y Obesidad, Hospital Médica Sur, Ciudad de México, México.
| | - N N Parra-Holguín
- Clínica de Enfermedad Inflamatoria Intestinal, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
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22
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Reelin levels in inflammatory bowel disease: A case-control study. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.855197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Giang J, Lan X, Crichton M, Marx W, Marshall S. Efficacy and safety of biophenol-rich nutraceuticals in adults with inflammatory gastrointestinal diseases or irritable bowel syndrome: A systematic literature review and meta-analysis. Nutr Diet 2021; 79:76-93. [PMID: 33960587 PMCID: PMC9290971 DOI: 10.1111/1747-0080.12672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 12/19/2022]
Abstract
Aim Biophenol‐rich nutraceuticals may be an adjuvant treatment for Crohn's disease (CD), ulcerative colitis (UC), symptomatic uncomplicated diverticular disease (SUDD), and irritable bowel syndrome (IBS). This systematic review and meta‐analysis aimed to determine the efficacy and safety of biophenol‐rich nutraceutical supplementation on CD, UC, SUDD, and IBS on gastrointestinal symptoms (GIS), quality of life (QoL), inflammatory and oxidative stress biomarkers, and adverse events compared to usual care or placebo. Methods PubMed, Embase, CINAHL, and CENTRAL were searched for randomised controlled trials until 27 April 2020. Outcomes were GIS, inflammatory and oxidative stress markers, QoL, and adverse events. The Cochrane Risk of Bias tool and GRADE were used to appraise studies. Data were pooled using Revman. Results Twenty‐three trials in CD, UC, and IBS patients were included. Compared with placebo, biophenol‐rich nutraceuticals improved GIS (SMD: 0.43 [95%CI: 0.22, 0.63]; GRADE: very low) in UC, CD, and IBS participants. In UC and CD participants, biophenol‐rich nutraceuticals improved CRP by 1.6 mg/L [95%CI:0.08, 3.11; GRADE: low], malondialdehyde by 1 mmol/L [95%CI:0.55, 1.38; GRADE: low]; but only resveratrol improved QoL (SMD: −0.84 [95%CI: −1.24, −0.44; GRADE: high). Resveratrol (for UC and CD participants) and peppermint oil (for IBS participants) had greater certainty in the evidence for improving GIS and QoL (GRADE: moderate to high). There was no effect on adverse events (P > .05). Conclusions Biophenol‐rich nutraceuticals may be an effective and safe adjuvant treatment for the management of CD, UC, and IBS; with higher certainty of evidence for resveratrol for UC and CD and peppermint oil for IBS.
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Affiliation(s)
- Joanna Giang
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Xiao Lan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Megan Crichton
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Wolfgang Marx
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Skye Marshall
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
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Zavala-Solares MR, Salazar-Salas L, Yamamoto-Furusho JK. Validity and reliability of the health-related questionnaire IBDQ-32 in Mexican patients with inflammatory bowel disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2021; 44:711-718. [PMID: 33872624 DOI: 10.1016/j.gastrohep.2021.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/21/2021] [Accepted: 03/03/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Inflammatory bowel disease comprises two conditions: ulcerative colitis and Crohn's disease. Inflammatory Bowel Disease Questionnaire 32 (IBDQ-32) is a specific questionnaire which has been translated from English into Spanish and validated. In the Spanish-speaking countries of America it has not been validated. The aim was to determine the psychometric properties, validity and reliability of the Mexican version of the IBDQ-32 questionnaire. METHODS A total of 316 patients with inflammatory bowel disease and 100 healthy controls participated in the study. The questionnaires IBDQ-32 and SF-36 were issued on two occasions (separated by 15 days). The psychometric properties of the Mexican version of the IBDQ-32 questionnaire were determined. RESULTS Patients with inflammatory bowel disease had an impaired quality of life compared to healthy controls. There were no differences between ulcerative colitis and Crohn's disease in the total scores of IBDQ-32 and its domains. The internal consistency reliability was good. The intraclass coefficient showed good reliability (repeated measurement) for total scale and all four subscales. Factor analysis explained variance is higher than 50% therefore is considered adequate/acceptable. The correlation between IBDQ-32 and SF-36 showed a satisfactory association. The social domain is the only one that presented a ceiling effect. CONCLUSIONS The Mexican version of the IBDQ-32 quality of life questionnaire is valid and reliable. This sample included the entire spectrum of inflammatory disease (remission and activity) and was comparable when assessing quality of life with the SF-36 generic questionnaire.
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Affiliation(s)
- Mónica R Zavala-Solares
- Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
| | - Lucero Salazar-Salas
- Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
| | - Jesus K Yamamoto-Furusho
- Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico.
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25
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Juliao-Baños F, Puentes F, López R, Saffon M, Reyes G, Parra V, Galiano M, Barraza M, Molano J, Álvarez E, Corrales R, Vargas L, Gil F, Álvarez P, Limas L, Prieto R, Yance P, Díaz F, Bareño J, Juliao-Baños F, Arrubla M, Camargo J, Puentes F, Arango L, López R, García R, Mendoza B, Saffon MA, Roldan LF, Zuleta J, Reyes G, Parra V, Flórez C, Nuñez E, Galiano MT, Barraza M, Sanchez IC, Molano JL, Lizarazo JI, Cuellar I, Álvarez E, Corrales R, Gil F, Vargas LE, Álvarez P, Limas LM, Prieto R, Ballén H, Delgado L, Yance P, Díaz F. Characterization of inflammatory bowel disease in Colombia: Results of a national register. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2021. [DOI: 10.1016/j.rgmxen.2020.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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26
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de-León-Rendón JL, López-Pérez RY, Gracida-Mancilla NI, Jiménez-Bobadilla B, Alarcón-Bernés L, Mendoza-Ramírez S, Villanueva-Herrero JA. The controlling nutritional status score: A promising tool for nutritional screening and predicting severity in ulcerative colitis patients. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2021; 86:110-117. [PMID: 33261942 DOI: 10.1016/j.rgmx.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/28/2020] [Accepted: 05/14/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND AIMS The controlling nutritional status (CONUT) score has previously been shown to be useful for nutritional assessment and the prediction of several inflammatory and neoplastic diseases. The aim of the present study was to evaluate the potential use of the CONUT score as a method for nutritional screening and predicting severity in ulcerative colitis (UC). MATERIALS AND METHODS The study was conducted on 60 patients diagnosed with UC. Demographic, clinical, and biochemical patient characteristics were collected from their clinical records, and disease severity was assessed using the Truelove and Witts scale (TWS). The risks for malnutrition were evaluated through the nutritional risk index and the CONUT score. RESULTS More than 90% of the UC patients presented with malnutrition risk, according to the scores analyzed. Patients with a high (>6points) CONUT score presented with moderate-to-severe activity on the TWS. A higher CONUT score was also associated with an increase in C-reactive protein (CRP) (P=.002) and erythrocyte sedimentation rate (ESR) (P=.009). The data analysis was performed utilizing the SPSS version 19 program. CONCLUSIONS The CONUT score could be a promising tool for evaluating nutritional status in UC patients and predicting UC severity.
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Affiliation(s)
- J L de-León-Rendón
- Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México.
| | - R Y López-Pérez
- Servicio de Gastroenterología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - N I Gracida-Mancilla
- Servicio de Cirugía General, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - B Jiménez-Bobadilla
- Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - L Alarcón-Bernés
- Servicio de Cirugía General, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - S Mendoza-Ramírez
- Servicio de Patología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - J A Villanueva-Herrero
- Servicio de Coloproctología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
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27
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de-León-Rendón J, López-Pérez R, Gracida-Mancilla N, Jiménez-Bobadilla B, Alarcón-Bernés L, Mendoza-Ramírez S, Villanueva-Herrero J. The controlling nutritional status score: A promising tool for nutritional screening and predicting severity in ulcerative colitis patients. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2021. [DOI: 10.1016/j.rgmxen.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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28
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Teng S, Hao J, Bi H, Li C, Zhang Y, Zhang Y, Han W, Wang D. The Protection of Crocin Against Ulcerative Colitis and Colorectal Cancer via Suppression of NF-κB-Mediated Inflammation. Front Pharmacol 2021; 12:639458. [PMID: 33841156 PMCID: PMC8025585 DOI: 10.3389/fphar.2021.639458] [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: 12/09/2020] [Accepted: 02/11/2021] [Indexed: 12/12/2022] Open
Abstract
Background: In China, the incidence of ulcerative colitis (UC) is increasing every year, but the etiology of UC remains unclear. UC is known to increase the risk of colorectal cancer (CRC). The aim of this study was to investigate the protective effects of crocin against UC and CRC in mouse models. Methods: Crocin was used to treat the dextran sodium sulfate (DSS)-induced UC mice for 3 weeks, and ApcMinC/Gpt mice with colorectal cancer for 8 weeks. Proteomics screening was used to detect changes in the protein profiles of colon tissues of UC mice. Enzyme-linked immunosorbent assays and western blot were used to verify these changes. Results: Crocin strongly reduced the disease activity index scores of UC mice, and improved the pathological symptoms of the colonic epithelium. The anti-inflammatory effects of crocin were indicated by its regulation of the activity of various cytokines, such as interleukins, via the modulation of nuclear factor kappa-B (NF-κB) signaling. Crocin significantly suppressed tumor growth in ApcMinC/Gpt mice and ameliorated pathological alterations in the colon and liver, but had no effects on spleen and kidney. Additionally, crocin significantly decreased the concentrations of interleukins and tumor necrosis factor-α in the sera and colon tissues, suggesting its anti-inflammatory effects related to NF-κB signaling. Finally, 12-h incubation of SW480 cells with crocin caused cell cycle arrest, enhanced the apoptotic rate, promoted the dissipation of mitochondrial membrane potential, and the over-accumulation of reactive oxygen species. From the theoretical analyses, phosphorylated residues on S536 may enhance the protein-protein interactions which may influence the conformational changes in the secondary structure of NF-κB. Conclusion: The protective effects of crocin on UC and CRC were due to its suppression of NF-κB-mediated inflammation.
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Affiliation(s)
- Shanshan Teng
- School of Life Sciences, Jilin University, Changchun, China
| | - Jie Hao
- School of Life Sciences, Jilin University, Changchun, China
| | - Hui Bi
- Department of Anesthesiology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Congcong Li
- School of Life Sciences, Jilin University, Changchun, China
| | - Yongfeng Zhang
- School of Life Sciences, Jilin University, Changchun, China
| | - Yaqin Zhang
- School of Life Sciences, Jilin University, Changchun, China
| | - Weiwei Han
- School of Life Sciences, Jilin University, Changchun, China
| | - Di Wang
- School of Life Sciences, Jilin University, Changchun, China
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Polysaccharides-Based Complex Particles' Protective Role on the Stability and Bioactivity of Immobilized Curcumin. Int J Mol Sci 2021; 22:ijms22063075. [PMID: 33802882 PMCID: PMC8002829 DOI: 10.3390/ijms22063075] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 12/30/2022] Open
Abstract
The curcumin degradation represents a significant limitation for its applications. The stability of free curcumin (FC) and immobilized curcumin in complex particles (ComPs) based on different polysaccharides was studied under the action of several factors. Ultraviolet-visible (UV-VIS) and Fourier-transform infrared (FTIR) spectroscopy proved the FC photodegradation and its role as a metal chelator: 82% of FC and between 26% and 39.79% of curcumin within the ComPs degraded after exposure for 28 days to natural light. The degradation half-life (t1/2) decreases for FC when the pH increases, from 6.8 h at pH = 3 to 2.1 h at pH = 9. For curcumin extracted from ComPs, t1/2 was constant (between 10 and 13 h) and depended on the sample’s composition. The total phenol (TPC) and total flavonoids (TFC) content values increased by 16% and 13%, respectively, for FC exposed to ultraviolet light at λ = 365 nm (UVA), whereas no significant change was observed for immobilized curcumin. Antioxidant activity expressed by IC50 (µmoles/mL) for FC exposed to UVA decreased by 29%, but curcumin within ComPs was not affected by the UVA. The bovine serum albumin (BSA) adsorption efficiency on the ComPs surface depends on the pH value and the cross-linking degree. ComPs have a protective role for the immobilized curcumin.
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Osei JA, Peña-Sánchez JN, Fowler SA, Muhajarine N, Kaplan GG, Lix LM. Increasing Prevalence and Direct Health Care Cost of Inflammatory Bowel Disease Among Adults: A Population-Based Study From a Western Canadian Province. J Can Assoc Gastroenterol 2021; 4:296-305. [PMID: 34877469 PMCID: PMC8643630 DOI: 10.1093/jcag/gwab003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/03/2021] [Indexed: 12/14/2022] Open
Abstract
Objectives Our study aimed to calculate the prevalence and estimate the direct health care costs of inflammatory bowel disease (IBD), and test if trends in the prevalence and direct health care costs of IBD increased over two decades in the province of Saskatchewan, Canada. Methods We conducted a retrospective population-based cohort study using administrative health data of Saskatchewan between 1999/2000 and 2016/2017 fiscal years. A validated case definition was used to identify prevalent IBD cases. Direct health care costs were estimated in 2013/2014 Canadian dollars. Generalized linear models with generalized estimating equations tested the trend. Annual prevalence rates and direct health care costs were estimated along with their 95% confidence intervals (95%CI). Results In 2016/2017, 6468 IBD cases were observed in our cohort; Crohn’s disease: 3663 (56.6%), ulcerative colitis: 2805 (43.4%). The prevalence of IBD increased from 341/100,000 (95%CI 340 to 341) in 1999/2000 to 664/100,000 (95%CI 663 to 665) population in 2016/2017, resulting in a 3.3% (95%CI 2.4 to 4.3) average annual increase. The estimated average health care cost for each IBD patient increased from $1879 (95%CI 1686 to 2093) in 1999/2000 to $7185 (95%CI 6733 to 7668) in 2016/2017, corresponding to an average annual increase of 9.5% (95%CI 8.9 to 10.1). Conclusions Our results provide relevant information and analysis on the burden of IBD in Saskatchewan. The evidence of the constant increasing prevalence and health care cost trends of IBD needs to be recognized by health care decision-makers to promote cost-effective health care policies at provincial and national levels and respond to the needs of patients living with IBD.
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Affiliation(s)
- Jessica Amankwah Osei
- Department of Community Health and Epidemiology, College of Medicine, University Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Juan Nicolás Peña-Sánchez
- Department of Community Health and Epidemiology, College of Medicine, University Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sharyle A Fowler
- Department of Medicine, College of Medicine, University Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, College of Medicine, University Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Gilaad G Kaplan
- Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Juliao-Baños F, Kock J, Arrubla M, Calixto O, Camargo J, Cruz L, Hurtado J, Clavijo A, Donado J, Schwartz S, Abreu MT, Damas OM. Trends in the epidemiology of inflammatory bowel disease in Colombia by demographics and region using a nationally representative claims database and characterization of inflammatory bowel disease phenotype in a case series of Colombian patients. Medicine (Baltimore) 2021; 100:e24729. [PMID: 33607817 PMCID: PMC7899864 DOI: 10.1097/md.0000000000024729] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 01/18/2021] [Indexed: 01/05/2023] Open
Abstract
The incidence of inflammatory bowel disease (IBD) is on the rise in Latin America. The aims of this study were to examine epidemiologic trends of IBD in Colombia by demographics, region, urbanicity, and to describe the IBD phenotype in a large well-characterized Colombian cohort.We used a national database of 33 million adults encompassing 97.6% of the Colombian population in order to obtain epidemiologic trends of IBD using International Classification of Diseases 10codes for adults with ulcerative colitis (UC) and Crohn disease (CD). We calculated the incidence and prevalence of UC and CD from 2010-2017 and examined epidemiologic trends by urbanicity, demographics, and region. We then examined the IBD phenotype (using Montreal Classification), prevalence of IBD-related surgeries, and types of IBD-medications prescribed to adult patients attending a regional IBD clinic in Medellin, Colombia between 2001 and 2017.The incidence of UC increased from 5.59/100,000 in 2010 to 6.3/100,000 in 2017 (relative risk [RR] 1.12, confidence interval (CI) (1.09-1.18), P < .0001). While CD incidence did not increase, the prevalence increased within this period. The Andes region had the highest incidence of IBD (5.56/100,000 in 2017). IBD was seen less in rural regions in Colombia (RR=.95, CI (0.92-0.97), p < .01). An increased risk of IBD was present in women, even after adjusting for age and diagnosis year (RR 1.06 (1.02-1.08), P = .0003). The highest IBD risk occurred in patients 40 to 59 years of age. In the clinic cohort, there were 649 IBD patients: 73.7% UC and 24.5% CD. Mean age of diagnosis in CD was 41.0 years and 39.9 years in UC. UC patients developed mostly pancolitis (43%). CD patients developed mostly ileocolonic disease and greater than a third of patients had an inflammatory, non-fistulizing phenotype (37.7%). A total of 16.7% of CD patients had perianal disease. CD patients received more biologics than UC patients (odds ratio: 3.20, 95% CI 2.19-4.69 P < .001).Using both a national representative sample and a regional clinic cohort, we find that UC is more common in Colombia and is on the rise in urban regions; especially occurring in an older age cohort when compared to Western countries. Future studies are warranted to understand evolving environmental factors explaining this rise.
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Affiliation(s)
| | - Joshua Kock
- Takeda Pharmaceuticals, Medical Department, Bogotá
- Department of Medicine, Universidad de La Sabana, Chía
| | - Mateo Arrubla
- Department of Internal Medicine, Pontificia Bolivariana University, Medellin
| | - Omar Calixto
- Department of Internal Medicine. Nueva Granada Militar University. Bogotá
| | | | - Lina Cruz
- General Medicine. Medellin Clinic, Medellin Colombia
| | - Juan Hurtado
- Department of Internal Medicine. Universidad de Antioquia
| | - Absalon Clavijo
- Department of Internal Medicine, Pontificia Bolivariana University, Medellin
| | - Jorge Donado
- Department of Internal Medicine, Pontificia Bolivariana University, Medellin
- Department of Epidemiology. Pablo Tobón Uribe Hospital
| | - Seth Schwartz
- Division of Public Health Sciences, University of Miami Miller School of Medicine and Departments of Kinesiology, Health Education, and Educational Psychology, College of Education, University of Texas at Austin
| | - Maria T. Abreu
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami FL USA
| | - Oriana M. Damas
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami FL USA
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Scharrer-Cabello S, Baeza-Zapata A, Herrera-Quiñones G, Luna-Limón C, Benavides-Salgado D. Stricturing ulcerative colitis: a case of rapid disease progression. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2020. [DOI: 10.1016/j.rgmxen.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Scharrer-Cabello SI, Baeza-Zapata AA, Herrera-Quiñones G, Luna-Limón CG, Benavides-Salgado DE. Stricturing ulcerative colitis: a case of rapid disease progression. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2020; 85:491-493. [PMID: 33032840 DOI: 10.1016/j.rgmx.2019.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/05/2019] [Accepted: 11/28/2019] [Indexed: 06/11/2023]
Affiliation(s)
- S I Scharrer-Cabello
- Departamento de Gastroenterología y Endoscopía, Hospital Universitario «Dr. José E. González», Monterrey, México.
| | - A A Baeza-Zapata
- Departamento de Gastroenterología y Endoscopía, Hospital Universitario «Dr. José E. González», Monterrey, México
| | - G Herrera-Quiñones
- Departamento de Gastroenterología y Endoscopía, Hospital Universitario «Dr. José E. González», Monterrey, México
| | - C G Luna-Limón
- Departamento de Patología Clínica, Hospital Universitario «Dr. José E. González», Monterrey, México
| | - D E Benavides-Salgado
- Departamento de Gastroenterología y Endoscopía, Hospital Universitario «Dr. José E. González», Monterrey, México
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El-Shabrawi MHF, Tarek S, Abou-Zekri M, Meshaal S, Enayet A, Mogahed EA. Hepatobiliary manifestations in children with inflammatory bowel disease: A single-center experience in a low/middle income country. World J Gastrointest Pharmacol Ther 2020; 11:48-58. [PMID: 32844043 PMCID: PMC7416377 DOI: 10.4292/wjgpt.v11.i3.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/28/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There has been a worldwide increase in the reported incidence of inflammatory bowel disease (IBD) in children over the past 2-3 decades. The hepatobiliary (HB) manifestations of IBD have been well-studied in children in industrialized and developed countries but are infrequently reported in low- and middle-income countries (LMIC) such as Egypt. AIM To determine the prevalence of the HB manifestations in a cohort of Egyptian children with IBD. METHODS This cross-sectional observational study was carried out over a period of 6 mo (between June 2013 to December 2013) at the Paediatric Hepatology and Gastroenterology Units of Cairo University Children's Hospital, which is the largest paediatric tertiary care centre in the country. RESULTS The study included 48 patients with confirmed IBD based upon clinical, laboratory, endoscopic and histopathological features, 29 (60.4%) were male. Twenty-four patients (50%) had ulcerative colitis (UC), 11 (22.9%) had Crohn's disease (CD) and 13 (27.1%) had unclassified-IBD (IBD-U), which was formerly known as indeterminate colitis. The mean age of the patients at the time of presentation was 8.14 (± SD 4.02) years and the mean age at the time of study enrolment was 10.16 (± SD 4.19) years. All patients were screened for HB manifestations by physical examination, liver function tests, imaging and liver biopsy when indicated. HB disorders were confirmed in 13 patients (27.1%). Transaminases were elevated in 3 patients (6.3%). Two patients (4.2%) had elevated biliary enzymes (one was diagnosed as primary sclerosing cholangitis (PSC) and the other was diagnosed with PSC/autoimmune hepatitis overlap syndrome and the third patient had hepatitis C virus infection. Ten patients (20.8%) had bright echogenic liver on ultrasound suggesting fatty infiltration as a sequel of malnutrition or medication toxicity. CONCLUSION The commonest HB disorders in Egyptian children with IBD were abnormal liver function tests, fatty infiltration and PSC. These HB manifestations in paediatric patients in LMIC may be relatively more common than in industrialized countries. Therefore, IBD patients in LMIC should be meticulously screened for liver disease to allow prompt diagnosis and management.
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Affiliation(s)
- Mortada HF El-Shabrawi
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Sara Tarek
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Maha Abou-Zekri
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Safa Meshaal
- Department of Clinical Pathology, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Afaf Enayet
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Engy Adel Mogahed
- Department of Paediatrics, Kasr Alainy School of Medicine, Cairo University, Cairo 11562, Egypt
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Mortality and Hospitalizations in Mexican Patients with Inflammatory Bowel Disease: Results from a Nationwide Health Registry. Can J Gastroenterol Hepatol 2020; 2020:8825330. [PMID: 32832489 PMCID: PMC7422065 DOI: 10.1155/2020/8825330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/09/2020] [Accepted: 07/18/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Incidence of inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is increasing worldwide; nevertheless, it is still unknown if this is the case in Mexico. Thus, the aim of this study was to analyze the distribution and trends of hospital discharges (HD) (for the period between 2004 and 2015) and deaths (for the period between 2004 and 2013) reported for UC and CD in Mexico. METHODS Quantitative cross-sectional study was performed. Secondary data sources analysis was performed through Dynamic Cubes of the General Direction of Health Information; variables were categorized by diagnosis, age, sex, and state. The Mann-Whitney U test was used to analyze the differences between the first and last years that were studied. Statistical analysis was performed in SPSS v.24. RESULTS The number of HD increased by 98.9% between 2004 and 2015 (IBD: p=0.033, CD: p=0.009, UC: p=0.051); it was more frequent, for both sexes and diagnoses, between 15 and 44 years, with a second peak for men with UC (between 45 and 64 years). Deaths increased by 96.2% from 2004 to 2011 (IBD: p=0.056, CD: p=0.064, UC: p=0.04). UC is three times more frequent than CD. Mexico City has the highest number of HD (4,179; 22.7%) while the state of Veracruz has the highest number of deaths (273; 38.2%). CONCLUSIONS HD for IBD in Mexico is increasing significantly; the number of deaths increased until 2011, but from then on, they are apparently decreasing. IBD affects Mexican people without any gender predominance, often affecting patients between 15 and 44 years of age. UC is three times more frequent than CD.
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Juliao-Baños F, Puentes F, López R, Saffon MA, Reyes G, Parra V, Galiano MT, Barraza M, Molano J, Álvarez E, Corrales R, Vargas LE, Gil F, Álvarez P, Limas L, Prieto R, Yance P, Díaz F, Bareño J. Characterization of inflammatory bowel disease in Colombia: Results of a national register. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2020; 86:153-162. [PMID: 32723624 DOI: 10.1016/j.rgmx.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/29/2020] [Accepted: 05/14/2020] [Indexed: 02/07/2023]
Abstract
AIM To determine the clinical, sociodemographic, and treatment characteristics of inflammatory bowel disease (IBD) in a Colombian population register. METHODS A descriptive, analytic, observational, cross-sectional, multicenter study on patients with IBD from 17 hospital centers in 9 Colombian cities was conducted. RESULTS A total of 2,291 patients with IBD were documented, 1,813 (79.1%) of whom presented with ulcerative colitis (UC), 456 (19.9%) with Crohn's disease (CD), and 22 with IBD unclassified (0.9%). The UC/CD ratio was 3.9:1. A total of 18.5% of the patients with UC and 47.3% with CD received biologic therapy. Patients with extensive UC had greater biologic therapy use (OR = 2.78, 95% CI: 2.10-3.65, p = 0.000), a higher surgery rate (OR = 5.4, 95% CI: 3.5-8.3, p = 0.000), and greater frequency of hospitalization (OR = 4.34, 95% CI: 3.47-5.44, p = 0.000). Patients with severe UC had greater biologic therapy use (OR = 5.04, 95% CI: 3.75-6.78, p = 0.000), a higher surgery rate (OR = 8.64, 95% CI: 5.4-13.78, p = 0.000), and greater frequency of hospitalization (OR = 28.45, 95% CI: 19.9-40.7, p = 0.000). CD patients with inflammatory disease behavior (B1) presented with a lower frequency of hospitalization (OR = 0.12, 95% CI: 0.07-0.19, p = 0.000), a lower surgery rate (OR = 0.08, 95% CI: 0.043-0.15, p = 0.000), and less biologic therapy use (OR = 0.26, 95% CI: 0.17-0.41, p = 0.000). CONCLUSION In Colombia, there is a predominance of UC over CD (3.9:1), as occurs in other Latin American countries. Patients with extensive UC, severe UC, or CD with noninflammatory disease behavior (B2, B3) have a worse prognosis.
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Affiliation(s)
- F Juliao-Baños
- Clínica de Enfermedad Inflamatoria Intestinal, Hospital Pablo Tobón Uribe, Medellín, Colombia.
| | - F Puentes
- Unidad de Cirugía Gastrointestinal, Cirujanos Unidos, Manizales, Colombia
| | - R López
- Unidad de Gastroenterología y Patología, Fundación Santa Fe, Bogotá, Colombia
| | - M A Saffon
- Unidad de Gastroenterología, Instituto Gastroclínico, Medellín, Colombia
| | - G Reyes
- Unidad de Gastroenterología, Clínica Colombia, Bogotá, Colombia
| | - V Parra
- Unidad de Gastroenterología, Gastroadvanced, Bogotá-Medellín, Colombia
| | - M T Galiano
- Unidad de Gastroenterología, MTG Servimed SAS, Bogotá, Colombia
| | - M Barraza
- Unidad de Gastroenterología, Endodigestivos, Pereira, Colombia
| | - J Molano
- Unidad de Gastroenterología, Emdiagnóstica SAS, Bogotá, Colombia
| | - E Álvarez
- Unidad de Gastroenterología, IMAT, Montería, Colombia
| | - R Corrales
- Unidad de Gastroenterología, Clínica Intermedios, Montería, Colombia
| | - L E Vargas
- Unidad de Gastroenterología, Clínica La Misericordia, Barranquilla, Colombia
| | - F Gil
- Unidad de Gastroenterología, Clínica Colombia, Bogotá, Colombia
| | - P Álvarez
- Unidad de Gastroenterología, Clínica La Carolina, Bogotá, Colombia
| | - L Limas
- Unidad de Cirugía Gastrointestinal, LIMEQ, Tunja, Colombia
| | - R Prieto
- Unidad de Gastroenterología, Hospital Central de la Policía, Bogotá, Colombia
| | - P Yance
- Unidad de Gastroenterología, Gastrosalud, Santa Marta, Colombia
| | - F Díaz
- Unidad de Gastroenterología, Hospital Universitario del Caribe, Cartagena, Colombia
| | - J Bareño
- Centro de Epidemiología, Universidad CES, Medellín, Colombia
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Kotze PG, Steinwurz F, Francisconi C, Zaltman C, Pinheiro M, Salese L, Ponce de Leon D. Review of the epidemiology and burden of ulcerative colitis in Latin America. Therap Adv Gastroenterol 2020; 13:1756284820931739. [PMID: 32695230 PMCID: PMC7350039 DOI: 10.1177/1756284820931739] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/12/2020] [Indexed: 02/04/2023] Open
Abstract
The incidence and prevalence of ulcerative colitis (UC) has been reported to be rising in newly industrialised regions, such as Latin America. Here, we review data from published studies reporting demographics and clinical aspects of UC in Latin America to further understand epidemiology and disease burden. The incidence and prevalence of UC in Latin America varied between regions and studies, ranging between 0.04 to 8.00/100,000 and 0.23 to 76.1/100,000, respectively, and generally increased over the period from 1986 to 2015. The majority of patients with UC were female (53.6-72.6%) and urban residents (77.8-97.4%). Extraintestinal manifestations were reported in approximately 26-89.4% of patients. Use of biologic therapies was generally low (0.8-16.2%), with the exception of Mato Grosso do Sul, Brazil, with a greater proportion of patients tending to receive 5-aminosalicylates, immunosuppressants or corticosteroids; colectomy rates varied between studies (1.5-22%). A high proportion of patients had moderate to severe UC (45.9-73.0%) and, in 11 of 19 studies, the greatest proportion of patients had extensive disease (pancolitis). Colorectal cancer (0-1.7%) and mortality rates (0-7.6%) were low. This evaluation of published studies may influence therapeutic approaches and the development of strategies to improve healthcare access and patient outcomes, although further high-quality studies are required in patients with UC in Latin America.
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Affiliation(s)
- Paulo Gustavo Kotze
- Colorectal Surgery Unit, IBD Outpatient Clinics, Cajuru University Hospital, Catholic University of Paraná (PUCPR), Rua Bruno Filgueira, 369 cj.1205, Curitiba, PR, CEP 80440-220, Brazil
| | - Flavio Steinwurz
- Unit of Inflammatory Bowel Disease, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Cyrla Zaltman
- IBD Outpatient Clinic, Division of Gastroenterology, Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Yamamoto-Furusho JK, Fonseca-Camarillo G, Barrera-Ochoa CA, Furuzawa-Carballeda J. Synthesis of Interleukin-10 in Patients with Ulcerative Colitis and Helicobacter pylori Infection. Gastroenterol Res Pract 2020; 2020:4171083. [PMID: 32695157 PMCID: PMC7362266 DOI: 10.1155/2020/4171083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/25/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022] Open
Abstract
METHODS Detection of H. pylori infection was performed by a 13C-urea breath test in 31 patients with UC. In each patient, a serum sample was drawn to measure IL-10 by the ELISA technique. Based on the primary breath test result, two groups were formed and serum IL-10 was measured. RESULTS Serological IL-10 levels in patients with UC and negative 13C-urea breath test was 10.28 pg/ml whereas in patients with UC and positive 13C-urea breath test was 5.5 pg/ml (P = 0.035). IL-10 levels were higher in the inflammatory endoscopic and histological active groups which tested positive in the 13C-urea breath tests for H. pylori (P < 0.05). CONCLUSIONS The role of IL-10 secretion in patients with UC in determining the clinicopathological outcome of infection merits further study. This study suggests an association between serum IL-10 and disease severity in patients with UC and HP infection.
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Affiliation(s)
- Jesús K. Yamamoto-Furusho
- Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico
| | - Gabriela Fonseca-Camarillo
- Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico
| | - Carlos A. Barrera-Ochoa
- Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico
| | - Janette Furuzawa-Carballeda
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
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