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1.
J Clin Gastroenterol ; 55(10): 823-829, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34617932

RESUMO

Climate change has been described as the greatest public health threat of the 21st century. It has significant implications for digestive health. A multinational team with representation from all continents, excluding Antarctica and covering 18 countries, has formulated a commentary which outlines both the implications for digestive health and ways in which this challenge can be faced.


Assuntos
Mudança Climática , Gastroenterologia , Humanos
2.
J Pediatr Gastroenterol Nutr ; 65(2): 200-206, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27801751

RESUMO

BACKGROUND: There is a paucity of data on extraintestinal manifestations (EIM) and their treatment in pediatric patients with inflammatory bowel disease (IBD). METHODS: Since 2008, the Pediatric Swiss IBD Cohort Study has collected data on the pediatric IBD population in Switzerland. Data on 329 patients were analyzed retrospectively. RESULTS: A total of 55 patients (16.7%) experienced 1-4 EIM (39 Crohn disease, 12 ulcerative colitis, and 4 IBD-unclassified patients). At IBD onset, presence of EIM was more frequent than in the adult population (8.5% vs 5.0%, P = 0.014). EIM were more frequent in Crohn disease when compared to ulcerative colitis/IBD-unclassified (22.5% vs 10.3%, P = 0.003). The most prevalent EIM were peripheral arthritis (26/329, 7.9%) and aphthous stomatitis (24/329, 7.3%). Approximately 27.6% of all EIM appeared before IBD diagnosis. Median time between IBD diagnosis and occurrence of first EIM was 1 month (-37.5-149.0). Thirty-one of the 55 patients (56.4%) were treated with 1 or more anti-tumor necrosis factor (TNF) agents. IBD patients with EIM were more likely to be treated with anti-TNF compared to those without (56.4% vs 35.0%, P = 0.003). Response rates to anti-TNF depended on underlying EIM and were best for peripheral arthritis (61.5%) and uveitis (66.7%). CONCLUSIONS: In a cohort of pediatric patients with IBD, EIM were frequently encountered. In up to 30%, EIM appeared before IBD diagnosis. Knowledge of these findings may translate into an increased awareness of underlying IBD, thereby decreasing diagnostic delay. Anti-TNF for the treatment of certain EIM is effective, although a substantial proportion of new EIM may present despite ongoing anti-TNF therapy.


Assuntos
Colangite Esclerosante/etiologia , Colite Ulcerativa/complicações , Doença de Crohn/complicações , Artropatias/etiologia , Dermatopatias/etiologia , Uveíte/etiologia , Adolescente , Anti-Inflamatórios/uso terapêutico , Criança , Pré-Escolar , Colangite Esclerosante/diagnóstico , Colangite Esclerosante/tratamento farmacológico , Colangite Esclerosante/epidemiologia , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/tratamento farmacológico , Doença de Crohn/diagnóstico , Doença de Crohn/tratamento farmacológico , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Artropatias/diagnóstico , Artropatias/tratamento farmacológico , Artropatias/epidemiologia , Modelos Logísticos , Masculino , Prevalência , Estudos Retrospectivos , Dermatopatias/diagnóstico , Dermatopatias/tratamento farmacológico , Dermatopatias/epidemiologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/epidemiologia
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