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1.
Yonsei Med J ; 62(2): 99-108, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33527789

RESUMEN

Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic inflammatory disorders of the gastrointestinal tract caused by interactions between genetic, environmental, immunological, and microbial factors. While the incidence and prevalence of IBD in Asian populations were relatively lower than those in Western countries, they appear to be gradually increasing. A Westernized diet, high socioeconomic status, improvement of hygiene, and development of vaccination could affect the increases in IBD incidence and prevalence in Asian countries. This review describes the latest trends in the incidence and prevalence of IBD in Asia. Studying the epidemiology of IBD in Asia may unravel the etiopathogenesis of and risk factors for IBD.


Asunto(s)
Enfermedades Inflamatorias del Intestino/epidemiología , Asia/epidemiología , Grupo de Ascendencia Continental Asiática , Humanos , Incidencia , Prevalencia , Factores de Riesgo , Migrantes
2.
J Gastrointestin Liver Dis ; 29(4): 549-553, 2020 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-33331349

RESUMEN

BACKGROUND AND AIMS: Inflammatory bowel diseases (IBD) patients management has been challenging during the ongoing coronavirus disease 2019 (COVID-19) pandemic, due to lockdowns, limitation of access to medical facilities and new recommendations regarding patient management. The implications of the COVID-19 pandemic on IBD patients' management were assessed in our Tertiary Gastroenterology Center in Bucharest, Romania. METHODS: Medical records of IBD patients admitted between 15th of March and 15th of August 2020 were retrospectively reviewed and compared to a control cohort of consecutive IBD patients admitted to our unit during the corresponding period of 2019. RESULTS: There was a highly significant shift towards one-day hospitalization during the referral period in 2020 for IBD cases (91% in 2020 vs 82.2% in 2019, p=0.0001). There was no statistically significant difference between the distribution of patient's gender, IBD phenotype or newly diagnosed IBD cases. A significantly lower proportion of admitted patients received 5-aminosalicylic acid (29% vs 41.2%, p=0.0001), whereas a substantially higher number of patients were prescribed biological therapy in 2020 in comparison to the corresponding 2019-time frame (79.5% vs 57.9%, p<0.0001). The distribution of the biological agent used was significantly different in 2019 in comparison to the 2020 period mainly due to the increase in vedolizumab prescription in 2020 (p<0.0001). During the study period in 2020, seven IBD patients (1.7%) were diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) infection, all of them with mild symptoms without impact on the IBD course. CONCLUSIONS: The COVID-19 pandemic led to reorganizing medical care, limiting the hospital admissions in favor of severe IBD cases, favoring telemedicine for mild disease and optimization of treatment for moderate to severe IBD with an increased use of biologicals aimed to maximize the risk/benefit ratio. Incidence of SARS-Cov2 infection during the first wave of COVID-19 infection in our study group was 1.7% and did not adversely impact the IBD disease course.


Asunto(s)
Antiinflamatorios/uso terapéutico , Productos Biológicos/uso terapéutico , Prestación Integrada de Atención de Salud/tendencias , Hospitalización/tendencias , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Telemedicina/tendencias , Antiinflamatorios/efectos adversos , Productos Biológicos/efectos adversos , Humanos , Incidencia , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/epidemiología , Seguridad del Paciente , Estudios Retrospectivos , Rumanía/epidemiología , Centros de Atención Terciaria , Factores de Tiempo , Resultado del Tratamiento
3.
Harefuah ; 159(11): 815-819, 2020 Nov.
Artículo en Hebreo | MEDLINE | ID: mdl-33210852

RESUMEN

INTRODUCTION: nflammatory bowel diseases (IBD) which include Crohn's disease and ulcerative colitis cause chronic remitting inflammation of the gastrointestinal tract with the potential of bowel wall injury which can lead to disability. AIMS: This study aimed to evaluate the degree of disability among IBD patients in Israel using validated scales and to identify factors that are associated with disability. Furthermore, the study aimed to examine the association between disability and quality of life (QoL) among patients. METHODS: The study population included 96 patients who attended a dedicated IBD clinic, (71 patients (pts) with Crohn's disease (CD), 22 pts with ulcerative colitis (UC) and 3 pts with IBD-undefined (IBD-U)). The participants completed a 5-part questionnaire which included demographic parameters, a validated QoL measure (inflammatory bowel disease questionnaire (IBDQ), two validated disability scales (the work and social adjustment scale (WSAS) and the World Health Organization Disability Assessment Schedule V.2.0 (WHODAS2.0), employment status, and a disease activity measure (the Manitoba IBD index (MIBDI). RESULTS: Major disability was found among 20% of the participants (as defined by a WSAS score ≥17). Major disability was significantly associated with lower QoL (p<0.001) and with recognition of disability from the National Insurance Institute of Israel ("Hamosad Lebituach Leumi") (p=0.005). Significant association was found between WHODAS2.0 and low QoL (r=-0.763,p<0.001). There were no significant differences in rates of major disability among patients with CD vs. those with UC. CONCLUSIONS: Approximately one fifth of IBD patients in Israel have major disability, which in turn, is associated with a decreased quality of life and recognition of disability from the National Insurance Institute of Israel. There were no significant differences in rates of disability between patients with CD vs. those with UC.


Asunto(s)
Colitis Ulcerosa , Enfermedades Inflamatorias del Intestino , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/epidemiología , Estudios Transversales , Humanos , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/epidemiología , Israel/epidemiología , Calidad de Vida , Índice de Severidad de la Enfermedad
7.
Medicine (Baltimore) ; 99(44): e22897, 2020 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-33126343

RESUMEN

Inflammatory bowel disease (IBD) in Asia has become increasingly prevalent. As a treatment of IBD, many immunomodulators and biological agents were introduced and shown to be effective in inducing and maintaining remission. However, many cases with treatment failure were reported. To overcome the failure, combination therapy of immunomodulatory and biologics have emerged, showing better outcomes by optimizing biologic pharmacokinetics and minimizing immunogenicity. Adversely, rates of tuberculosis (TB) have been increased as a result. The aim of this study is to compare the risk of TB according to the therapy using large population data.We used data from the South Korean Health Insurance and Review Agency over the period 2008-2016 and calculated the hazard ratio (HR) for TB in IBD. We compared the risk of TB according to the medication: infliximab only, azathioprine only (AZA), combination of azathioprine and infliximab (CAI), azathioprine monotherapy and infliximab monotherapy (AIM), and azathioprine and infliximab whether simultaneously or separately (AISS).In IBD patients, a total of 249 patients were identified as active TB. After one-to-one matching with age, sex and disease duration, the risks of TB were significantly higher in AZA group (HR, 2.06; 95% CI, 1.35-3.12, P < .001), AIM group (HR, 3.26; 95% CI, 1.18-9.05, P = .02), AISS group (HR, 3.50; 95% CI, 1.92-6.37, P < .001), and CAI group (HR, 5.67; 95% CI, 2.42-10.21, P < .001), and the HR increased gradually in this order. In UC patients, the results were in similar pattern, but this pattern was not observed in CD patients in our study.Our study shows that Korean IBD patients are at risk of TB, and the risk increases with usage of IBD medication; moreover, the risk is the highest if combination therapy is used. These results highlight the importance of screening for TB in IBD patients, especially in combination therapy.


Asunto(s)
Azatioprina/uso terapéutico , Quimioterapia Combinada/métodos , Infliximab/uso terapéutico , Tuberculosis , Inmunidad Adaptativa/efectos de los fármacos , Productos Biológicos/uso terapéutico , Estudios de Cohortes , Femenino , Humanos , Factores Inmunológicos/uso terapéutico , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Inflamatorias del Intestino/epidemiología , Enfermedades Inflamatorias del Intestino/inmunología , Quimioterapia de Mantención/efectos adversos , Quimioterapia de Mantención/métodos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Medición de Riesgo , Factores de Riesgo , Tuberculosis/diagnóstico , Tuberculosis/epidemiología , Tuberculosis/prevención & control
8.
J Med Internet Res ; 22(11): e19574, 2020 11 02.
Artículo en Inglés | MEDLINE | ID: mdl-33006945

RESUMEN

BACKGROUND: After the COVID-19 outbreak, the Italian Government stopped most regular health care activity. As a result, patients with inflammatory bowel disease (IBD) had limited access to outpatient clinics and hospitals. OBJECTIVE: This study aimed to analyze the perception of the COVID-19 emergency among patients with IBD during the early weeks of the lockdown. METHODS: We invited adult patients with IBD from the University of Salerno (Campania, South Italy) and the University of Padua (Veneto, North Italy) by email to answer an ad hoc anonymous survey about COVID-19. We also collected data on demographic and disease characteristics. RESULTS: In total, 167 patients with IBD from Padua and 83 patients from Salerno answered the survey (age: mean 39.7 years, SD 13.9 years; female: n=116, 46.4%). We found that patients with IBD were particularly worried about the COVID-19 pandemic (enough: 77/250, 30.8%; much/very much: 140/250, 56.0%), as they felt more vulnerable to COVID-19 due to their condition (enough: 70/250, 28.0%; much/very much: 109/250, 43.6%). Patients with IBD from the red zone of Veneto were more worried than patients from Campania (P=.001), and men felt more susceptible to the virus than women (P=.05). Additionally, remote medicine was appreciated more by younger patients than older patients (P=.04). CONCLUSIONS: The results of our survey demonstrate that the lockdown had a significant impact on the psychological aspects of patients with IBD and suggest the need for increasing communication with patients with IBD (eg, through telemedicine) to ensure patients receive adequate health care, correct information, and proper psychological support.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Enfermedades Inflamatorias del Intestino/psicología , Pacientes Ambulatorios/psicología , Pandemias , Neumonía Viral/epidemiología , Encuestas y Cuestionarios , Telemedicina , Adulto , Ansiedad/epidemiología , Estudios Transversales , Prestación de Atención de Salud , Brotes de Enfermedades , Femenino , Humanos , Enfermedades Inflamatorias del Intestino/epidemiología , Italia/epidemiología , Masculino
10.
Inflamm Bowel Dis ; 26(11): e134-e136, 2020 10 23.
Artículo en Inglés | MEDLINE | ID: mdl-33029612
11.
J Immunol Res ; 2020: 2847316, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33062719

RESUMEN

Objectives: The COVID-19 epidemic triggered by coronavirus SARS-CoV-2 is rapidly spreading around the globe. This study is aimed at finding out the suspected or confirmed SARS-CoV-2 infection in patients with inflammatory bowel disease (IBD) in Hubei province, China. We also investigated symptoms, medications, life quality, and psychological issues of IBD patients under the ongoing pandemic. Methods: We conducted a self-reported questionnaire survey via an online survey platform. SARS-CoV-2 infection-related data was collected from IBD patients. The status quo of medications and symptoms of the subjects were investigated. Life quality, depression, and anxiety were measured by clinical questionnaires and rated on scoring systems. Results: A total of 204 IBD patients from Hubei province were included in this study. No suspected or confirmed SARS-CoV-2 infection case was found in this study. As a result of city shutdown, two-thirds of the patients (138/204) in our series reported difficulty in accessing medicines and nearly half of them (73/138) had to discontinue medications. Apart from gastrointestinal symptoms, systemic symptoms were common while respiratory symptoms were rare in the cohort. Though their quality of life was not significantly lowered, depression and anxiety were problems that seriously affected them during the COVID-19 epidemic. Conclusions: Inaccessibility to medications is a serious problem for IBD patients after city shutdown. Efforts have to be made to address the problems of drug withdrawal and psychological issues that IBD patients suffer from during the COVID-19 outbreak.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Accesibilidad a los Servicios de Salud , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Inflamatorias del Intestino/epidemiología , Neumonía Viral/epidemiología , Adulto , Ansiedad/psicología , Betacoronavirus/efectos de los fármacos , China/epidemiología , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Enfermedades Inflamatorias del Intestino/patología , Masculino , Pandemias , Calidad de Vida/psicología , Encuestas y Cuestionarios
14.
Inflamm Bowel Dis ; 26(11): 1779-1785, 2020 10 23.
Artículo en Inglés | MEDLINE | ID: mdl-32879978
16.
Dig Liver Dis ; 52(11): 1222-1227, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32928672

RESUMEN

BACKGROUND: Great efforts by the scientific community are rapidly expanding the evidence on the clinical interplay between Covid-19 and inflammatory bowel disease (IBD). AIMS: We performed a systematic review of the literature on published Covid-19 cases occurring in patients with IBD. METHODS: PubMed Central/Medline and Embase were systemically searched for records up to May 31, 2020. RESULTS: 13 cohort studies and 5 single case reports were included in the qualitative synthesis. A cumulative number of approximately 800 patients with IBD and Covid-19 were identified. The case fatality rate ranged from 0% to 20.0%. Overall, immunomodulators and biologics were not associated with higher risk of Covid-19 or with negative outcomes, while the use of systemic corticosteroids was related to worse prognosis in some studies. CONCLUSIONS: This systematic review highlighted two main points that may help clinicians dealing with IBD in reassuring their patients: (1) patients with IBD do not seem to be at higher risk of being infected by SARS-COV-2 than the general population; (2) in case of Covid-19, treatment with immunomodulators or biologics is not associated with worse prognosis, while systemic steroids are suspected to be potentially detrimental, even if more data are needed to confirm this point.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Enfermedades Inflamatorias del Intestino/epidemiología , Neumonía Viral/epidemiología , Corticoesteroides/administración & dosificación , Betacoronavirus , Comorbilidad , Humanos , Factores Inmunológicos/uso terapéutico , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Pandemias , Medición de Riesgo
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