text:
Nat Clin Pract Gastroenterol Hepatol. 2005 Jun;2(6):281-5; quiz 1 p following 285.},
   abstract = {BACKGROUND: An 18-year-old woman with a history of Crohn's disease presented in January 2004 with severe epigastric pain, nausea and vomiting of 4 hours' duration. The patient was diagnosed with inflammatory bowel disease, thought to be consistent with ulcerative colitis, in March 2003, but had no medical history up until this point. Initial treatment with mesalamine was unsuccessful and she subsequently presented with medically resistant fulminant colitis and required an urgent colectomy in June 2003. Her immediate postoperative course was uneventful and she was discharged on tapering doses of prednisone. In August 2003, an ileoscopy revealed inflamed, mildly ulcerated mucosa, and biopsies were consistent with Crohn's disease. Azathioprine was added to the treatment regimen and the patient tapered off prednisone. At this stage the patient continued to do well clinically up until presentation. INVESTIGATIONS: Small bowel series, abdominal CT scan, abdominal ultrasound, exploratory laparotomy. DIAGNOSIS: Acute mesenteric ischemia secondary to superior mesenteric vein thrombosis. MANAGEMENT: Resection of necrotic bowel, antibiotics and systemic anticoagulation.},
   keywords = {Adolescent
Anticoagulants/therapeutic use
Colectomy/*adverse effects
Colitis, Ulcerative/diagnosis/surgery
Crohn Disease/complications/*diagnosis/surgery/therapy
*Diagnostic Errors
Digestive System Surgical Procedures/adverse effects
Female
Humans
Intestine, Small/blood supply/surgery
*Mesenteric Veins
Parenteral Nutrition, Total
Short Bowel Syndrome/etiology/therapy
Venous Thrombosis/*etiology},
   ISSN = {1743-4378 (Print)
1743-4378},
   Accession Number = {16265232},
   DOI = {10.1038/ncpgasthep0195},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Ruemmele, F. M. and El Khoury, M. G. and Talbotec, C. and Maurage, C. and Mougenot, J. F. and Schmitz, J. and Goulet, O.},
   title = {Characteristics of inflammatory bowel disease with onset during the first year of life},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {43},
   number = {5},
   pages = {603-9},
   note = {1536-4801
Ruemmele, Frank M
El Khoury, Maurice G
Talbotec, Cecile
Maurage, Chantal
Mougenot, Jean-Francois
Schmitz, Jacques
Goulet, Olivier
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2006 Nov;43(5):603-9.},
   abstract = {BACKGROUND: Inflammatory bowel disease (IBD) is recognized in young children, however, only rare data on onset and evolution are available in children younger than 1 year. In the present clinical study, we aimed to analyze characteristics and clinical course of children with very early onset IBD. We were particularly interested in the relationship between bacterial infections and the use of antibiotics before the onset of IBD. PATIENTS AND METHODS: The IBD database of Necker-Enfants-Malades-Hospital was screened for patients with IBD with disease onset during the first year of life and a follow-up of at least 2.5 years. Ten patients were identified during the period 1996-2002. RESULTS: All patients presented with rectal bleeding and had colonic involvement. Four patients had definitive diagnosis of Crohn disease; ulcerative or indeterminate colitis was seen in 2 and 4 children, respectively. Five of the patients had a positive history of neonatal or early-onset bacterial infection with use of antibiotics before onset of IBD, 4 patients were still breastfed and 3 just weaned when GI symptoms started. Seven patients had a severe onset of disease requiring bowel rest, parenteral nutrition and steroid medication, followed by azathioprine or cyclosporine medication. Surgery was necessary in 3 of 10 patients. Disease relapses were frequent and observed in 8 of 10 children. DISCUSSION: Very early onset IBD may reflect a subgroup of patients characterized by a particular sensitivity to modifications of the intestinal flora. Neonatal IBD was most often severe in presentation and evolution.},
   keywords = {Age of Onset
Anti-Bacterial Agents/therapeutic use
Bacterial Infections
Female
Humans
Infant
Infant, Newborn
Inflammatory Bowel Diseases/diagnosis/*physiopathology/therapy
Male
Risk Factors
Severity of Illness Index},
   ISSN = {0277-2116},
   Accession Number = {17130735},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Rufo, P. A. and Bousvaros, A.},
   title = {Current therapy of inflammatory bowel disease in children},
   journal = {Paediatr Drugs},
   volume = {8},
   number = {5},
   pages = {279-302},
   note = {Rufo, Paul A
Bousvaros, Athos
Journal Article
Research Support, Non-U.S. Gov't
Review
Switzerland
Paediatr Drugs. 2006;8(5):279-302.},
   abstract = {Ulcerative colitis (UC) and Crohn disease (CD) are chronic intestinal inflammatory diseases that can present as bloody diarrhea, abdominal pain, and malnutrition. Collectively, these disorders are referred to as inflammatory bowel disease (IBD). All patients with IBD share a common pathophysiology. However, there are a number of developmental, psychosocial, and physiologic issues that are unique to the approximate, equals 20% of patients that present during childhood or adolescence. These include the possibility of disease-induced delays in linear growth or physical development, differences in drug dosing, and the changes in social and cognitive development that occur as children move from school-age years into adolescence and early adulthood. Gastroenterologists caring for these children must therefore develop an optimal regimen of pharmacologic therapies, nutritional management, psychologic support, and properly timed surgery (when necessary) that will maintain disease remission, minimize disease and drug-induced adverse effects, and optimize growth and development. This article reviews current approaches to the management of patients with UC and CD and highlights issues specific to the treatment of children with IBD. The principal medical therapies used to induce disease remission in patients with UC are aminosalicylates (for mild disease), corticosteroids (for moderate disease), and cyclosporine (ciclosporin) (for severe disease). If a patient responds to the induction regimen, maintenance therapies that are used to prevent disease relapse include aminosalicylates, mercaptopurine, and azathioprine. Colectomy with creation of an ileal pouch anal anastomosis (J pouch) has become the standard of care for patients with severe or refractory colitis and results in an improved quality of life in most patients. Therefore, the risks associated with using increasingly potent immunosuppressant agents must be balanced in each case against a patient's desire to retain their colon and avoid a temporary or potentially permanent ileostomy. Decisions about drug therapy in the management of patients with CD are more complex and depend on both the location (e.g. gastroduodenal vs small intestinal vs colonic), as well as the behavior of the disease (inflammatory/mucosal vs stricturing vs perforating) in a given patient. Induction therapies for CD typically include aminosalicylates and antibiotics (for mild mucosal disease), nutritional therapy (including elemental or polymeric formulas), corticosteroids (for moderate disease), and infliximab (for corticosteroid-resistant or fistulizing disease). Aminosalicylates, mercaptopurine, azathioprine, methotrexate, and infliximab can be used as maintenance therapies. Because surgical treatment of CD is not curative, it is typically reserved for those patients either with persistent symptoms and disease limited to a small section of the intestine (e.g. the terminal ileum and cecum) or for the management of complications of the disease including stricture or abdominal abscess. When surgery is necessary, maintenance medications administered postoperatively will postpone recurrence. Patients with UC and CD are at risk for the development of micronutrient deficiencies (including folate, iron, and vitamin D deficiencies) and require close nutritional monitoring. In addition, patients with UC and CD involving the colon are at increased risk of developing colon cancer, and should be enrolled into a colonoscopy surveillance program after 8-10 years of disease duration.},
   keywords = {Anti-Inflammatory Agents/therapeutic use
Child
Colitis, Ulcerative/diagnosis/epidemiology/physiopathology/therapy
Crohn Disease/diagnosis/epidemiology/physiopathology/therapy
Female
Gastrointestinal Agents/therapeutic use
Humans
Immunosuppressive Agents/therapeutic use
Inflammatory Bowel Diseases/diagnosis/epidemiology/*therapy
Nutrition Disorders/complications
Probiotics/therapeutic use},
   ISSN = {1174-5878 (Print)
1174-5878},
   Accession Number = {17037946},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Ruxton, C. H. and Calder, P. C. and Reed, S. C. and Simpson, M. J.},
   title = {The impact of long-chain n-3 polyunsaturated fatty acids on human health},
   journal = {Nutr Res Rev},
   volume = {18},
   number = {1},
   pages = {113-29},
   note = {1475-2700
Ruxton, C H S
Calder, P C
Reed, S C
Simpson, M J A
Journal Article
England
Nutr Res Rev. 2005 Jun;18(1):113-29. doi: 10.1079/NRR200497.},
   abstract = {A considerable literature has been published on the health benefits of fish, oil-rich fish and fish oils and their constituent long-chain (LC) n-3 PUFA. Evidence from epidemiological studies highlights the cardioprotective attributes of diets rich in fish, especially oil-rich fish. Data from intervention trials are consistent in suggesting that LC n-3 PUFA lower the risk of CVD, probably by the multiple mechanisms of lowering serum triacylglycerols, improving the LDL:HDL ratio, anti-arrhythmic effects on heart muscle, improved plaque stability, anti-thrombotic effects and reduced endothelial activation. Research indicates LC n-3 PUFA provision has an impact during development, and there is preliminary evidence that docosahexaenoic acid supplementation during pregnancy could optimise brain and retina development in the infant. LC n-3 PUFA are also postulated to ameliorate behavioural and mental health disturbances such as depression, schizophrenia, dementia and attention deficit hyperactivity disorder. However, despite some positive evidence in each of these areas, use of LC n-3 PUFA in these conditions remains at the experimental stage. In the case of immune function, there is little doubt that LC n-3 PUFA have a positive effect. Although intervention trials in rheumatoid arthritis show strong evidence of benefit, evidence for efficacy in other inflammatory conditions, including Crohn's disease, ulcerative colitis, psoriasis, lupus, multiple sclerosis, cystic fibrosis and asthma, is inconsistent or inadequate. More promising evidence in some conditions may come from studies which attempt to modify the fetal environment using LC n-3 PUFA supplementation during pregnancy.},
   ISSN = {0954-4224},
   Accession Number = {19079899},
   DOI = {10.1079/nrr200497},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Sakamoto, N. and Kono, S. and Wakai, K. and Fukuda, Y. and Satomi, M. and Shimoyama, T. and Inaba, Y. and Miyake, Y. and Sasaki, S. and Okamoto, K. and Kobashi, G. and Washio, M. and Yokoyama, T. and Date, C. and Tanaka, H.},
   title = {Dietary risk factors for inflammatory bowel disease: a multicenter case-control study in Japan},
   journal = {Inflamm Bowel Dis},
   volume = {11},
   number = {2},
   pages = {154-63},
   note = {Sakamoto, Naomasa
Kono, Suminori
Wakai, Kenji
Fukuda, Yoshihiro
Satomi, Masamichi
Shimoyama, Takashi
Inaba, Yutaka
Miyake, Yoshihiro
Sasaki, Satoshi
Okamoto, Kazushi
Kobashi, Gen
Washio, Masakazu
Yokoyama, Tetsuji
Date, Chigusa
Tanaka, Heizo
Epidemiology Group of the Research Committee on Inflammatory Bowel Disease in Japan
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
United States
Inflamm Bowel Dis. 2005 Feb;11(2):154-63.},
   abstract = {To evaluate the role of dietary factors in the etiology of inflammatory bowel disease (IBD), we conducted a multicenter hospital-based case-control study in a Japanese population. Cases were IBD patients aged 15 to 34 years [ulcerative colitis (UC) 111 patients; Crohn's disease (CD) 128 patients] within 3 years after diagnosis in 13 hospitals. One control subject was recruited for each case who was matched for sex, age, and hospital. A semiquantitative food frequency questionnaire was used to estimate preillness intakes of food groups and nutrients. All the available control subjects (n = 219) were pooled, and unconditional logistic models were applied to calculate odds ratios (ORs). In the food groups, a higher consumption of sweets was positively associated with UC risk [OR for the highest versus lowest quartile, 2.86; 95% confidence interval (CI), 1.24 to 6.57], whereas the consumption of sugars and sweeteners (OR, 2.12; 95% CI, 1.08 to 4.17), sweets (OR, 2.83; 95% CI, 1.38 to 5.83), fats and oils (OR, 2.64; 95% CI, 1.29 to 5.39), and fish and shellfish (OR, 2.41; 95% CI, 1.18-4.89) were positively associated with CD risk. In respect to nutrients, the intake of vitamin C (OR, 0.45; 95% CI, 0.21 to 0.99) was negatively related to UC risk, while the intake of total fat (OR, 2.86; 95% CI, 1.39 to 5.90), monounsaturated fatty acids (OR, 2.49; 95% CI, 1.23 to 5.03) and polyunsaturated fatty acids (OR, 2.31; 95% CI, 1.12 to 4.79), vitamin E (OR, 3.23; 95% CI, 1.45 to 7.17), and n-3 (OR, 3.24; 95% CI, 1.52 to 6.88) and n-6 fatty acids (OR, 2.57; 95% CI, 1.24 to 5.32) was positively associated with CD risk. Although this study suffers from the shortcoming of recall bias, which is inherent in most retrospective studies (prospective studies are warranted to confirm the associations between diet and IBD risk), the present findings suggest the importance of dietary factors for IBD prevention.},
   keywords = {Adolescent
Adult
Ascorbic Acid/pharmacology
Case-Control Studies
Colitis, Ulcerative/*etiology/prevention & control
Crohn Disease/*etiology/prevention & control
*Diet
Dietary Fats
Dietary Sucrose
Female
Humans
Japan
Male
Mental Recall
Odds Ratio
Reproducibility of Results
Risk Factors
Seafood},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {15677909},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Sanderson, I. R. and Croft, N. M.},
   title = {The anti-inflammatory effects of enteral nutrition},
   journal = {JPEN J Parenter Enteral Nutr},
   volume = {29},
   number = {4 Suppl},
   pages = {S134-8; discussion S138-40, S184-8},
   note = {Sanderson, Ian R
Croft, Nicholas M
Journal Article
Review
United States
JPEN J Parenter Enteral Nutr. 2005 Jul-Aug;29(4 Suppl):S134-8; discussion S138-40, S184-8.},
   abstract = {Enteral nutrition has a positive effect on growth in children with active Crohn's disease. The question arises: is this is due only to improved nutrition? Enteral formulas may also directly reduce inflammation, lowering the expression of cytokines like interleukin (IL)-6 that inhibit growth. Four lines of evidence support the hypothesis that enteral formulas directly lessen inflammation: enteral nutrition directly affects the inflamed intestine; changes in inflammatory markers precede repletion of nutrition status; molecular pathways exist linking changes in luminal contents to the expression of class II MHC genes in intestinal epithelium in animal studies; and enteral formulas have a direct effect on cytokine expression by intestinal epithelial cells.},
   keywords = {Child
Crohn Disease/immunology/*therapy
Cytokines/*biosynthesis
*Enteral Nutrition
Humans
Intestinal Mucosa/*drug effects/immunology/pathology
Nutritional Status},
   ISSN = {0148-6071 (Print)
0148-6071},
   Accession Number = {15980275},
   DOI = {10.1177/01486071050290s4s134},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Sawczenko, A. and Azooz, O. and Paraszczuk, J. and Idestrom, M. and Croft, N. M. and Savage, M. O. and Ballinger, A. B. and Sanderson, I. R.},
   title = {Intestinal inflammation-induced growth retardation acts through IL-6 in rats and depends on the -174 IL-6 G/C polymorphism in children},
   journal = {Proc Natl Acad Sci U S A},
   volume = {102},
   number = {37},
   pages = {13260-5},
   note = {Sawczenko, Andrew
Azooz, Omeia
Paraszczuk, Joanna
Idestrom, Maja
Croft, Nick M
Savage, Martin O
Ballinger, Anne B
Sanderson, Ian R
P30 DK040561/DK/NIDDK NIH HHS/United States
P30 DK040561-10/DK/NIDDK NIH HHS/United States
Journal Article
Research Support, Non-U.S. Gov't
United States
Proc Natl Acad Sci U S A. 2005 Sep 13;102(37):13260-5. Epub 2005 Sep 6.},
   abstract = {Inflammatory diseases frequently impair linear growth. Crohn's disease inhibits growth in up to one third of affected children. In rats with trinitrobenzenesulphonic acid-induced colitis, 40% of growth impairment is attributable to inflammation, with the rest being due to undernutrition. In transgenic mice without inflammation, raised IL-6 retards growth, suppressing insulin-like growth factor (IGF)-I. We hypothesized that IL-6, induced by intestinal inflammation, suppresses growth and inhibits IGF-I expression. Therefore, an anti-IL-6 Ab was given to rats with trinitrobenzene-sulphonic acid colitis. The Ab did not improve nutrient intake or decrease inflammation compared with untreated disease controls, but it significantly restored linear growth (P = 0.023) and increased IGF-I (P = 0.05). In humans, the IL-6 -174 G/C promoter polymorphism affects IL-6 transcription, with the GG genotype inducing the greatest IL-6 levels. Because IL-6 is increased in Crohn's disease, we further hypothesized that growth failure would vary with the IL-6 -174 genotype. At diagnosis, among 153 children with Crohn's disease, those with the IL-6 GG genotype were more growth-retarded than those with the GC or CC genotypes (height SD score, -0.51 vs. -0.10; P = 0.031). Also, the patients with the IL-6 GG genotype had higher circulating levels of C-reactive protein, an IL-6-induced product (36 vs. 18 mg/dl, P = 0.028). However, their risk of developing Crohn's disease was similar to other genotypes when compared with 351 healthy controls (P = 0.7). Thus, the IL-6 -174 genotype mediates growth failure in children with Crohn's disease.},
   keywords = {Animals
Antibodies/administration & dosage/pharmacology
Case-Control Studies
Child
Colitis/chemically induced/drug therapy
Crohn Disease/genetics
Disease Models, Animal
Genotype
Growth Disorders/*etiology
Humans
Inflammation/etiology/*physiopathology
Insulin-Like Growth Factor I/genetics
Interleukin-6/genetics/immunology/*physiology
Intestinal Diseases/drug therapy/*etiology/genetics
*Polymorphism, Single Nucleotide
Promoter Regions, Genetic
Rats
Rats, Wistar
Trinitrobenzenesulfonic Acid},
   ISSN = {0027-8424 (Print)
0027-8424},
   Accession Number = {16150725},
   DOI = {10.1073/pnas.0503589102},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Schiffrin, E. J. and El Yousfi, M. and Faure, M. and Combaret, L. and Donnet, A. and Blum, S. and Obled, C. and Breuille, D.},
   title = {Milk casein-based diet containing TGF-beta controls the inflammatory reaction in the HLA-B27 transgenic rat model},
   journal = {JPEN J Parenter Enteral Nutr},
   volume = {29},
   number = {4 Suppl},
   pages = {S141-8; discussion S149-50, S184-8},
   note = {Schiffrin, Eduardo J
El Yousfi, Mimoun
Faure, Magali
Combaret, Lydia
Donnet, Anne
Blum, Stephanie
Obled, Christiane
Breuille, Denis
Journal Article
United States
JPEN J Parenter Enteral Nutr. 2005 Jul-Aug;29(4 Suppl):S141-8; discussion S149-50, S184-8.},
   abstract = {BACKGROUND: A casein-based formula containing TGF-beta has been successfully used in adolescents during acute episodes of Crohn's disease. The role played by this molecule requires confirmation. We have examined the capacity of a TGF-beta containing diet to control the intestinal inflammation in HLA-B27 transgenic rats, and compared its effects with a similar diet devoid of TGF-beta. METHODS: Three groups of rats were studied. HLA-B27/hbeta2M transgenic rats were fed with a casein-based rat-adapted diet containing TGF-beta or a control casein-based diet without TGF-beta. Fischer control animals were fed the latter. Body weight, dietary intake, tissue weights, fecal samples, leukocyte counts, and acute phase response were analyzed. Intestinal inflammation was assessed by histology, myeloperoxidase, and mRNA expression of cytokines. MUC2 protein expression was assessed by immunohistochemistry. Breakdown of muscle protein was examined. RESULTS: The test diet improved diarrhea increasing the fecal dry matter and the colonic inflammation as shown by a lower inflammatory score (2.43 +/- 1.13 vs 4.42 +/- 0.53, p < .05), lower mucosal thickness (431.25 +/- 72.29 vs 508.57 +/- 81.32 microm, p = .08) and decreased IFNgamma mRNA expression. MUC2 protein expression was increased in HLA rats fed the TGF-beta diet compared with HLA rats fed the control diet, but restitution to normal pattern was not observed. The test diet also decreased leukocytosis and the acute phase response and improved the muscle catabolic response. CONCLUSION: The TGF-beta containing diet has a beneficial effect in an animal model of intestinal inflammation. Our observations support a potential role for dietary TGF-beta in the restoration of immune homeostasis.},
   keywords = {Acute-Phase Reaction
Animals
*Animals, Genetically Modified
Body Weight/drug effects
Caseins
Crohn Disease/*therapy
Disease Models, Animal
*Enteral Nutrition
HLA-B27 Antigen/*genetics
Immunohistochemistry
Mucin-2
Mucins/metabolism
Muscle, Skeletal/metabolism
RNA, Messenger/metabolism
Random Allocation
Rats
Rats, Inbred F344
Transforming Growth Factor beta/*therapeutic use
Treatment Outcome},
   ISSN = {0148-6071 (Print)
0148-6071},
   Accession Number = {15980276},
   DOI = {10.1177/01486071050290s4s141},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Schneider, S. M.},
   title = {[Enteral nutrition and its therapeutic role]},
   journal = {Gastroenterol Clin Biol},
   volume = {30},
   number = {8-9},
   pages = {988-98; quiz 987, 1007-8},
   note = {Schneider, Stephane M
Journal Article
Review
France
Gastroenterol Clin Biol. 2006 Aug-Sep;30(8-9):988-98; quiz 987, 1007-8.},
   keywords = {Crohn Disease/therapy
Enteral Nutrition/*methods
Food, Formulated
Home Care Services
Humans
Malabsorption Syndromes/therapy
Malnutrition/*prevention & control},
   ISSN = {0399-8320 (Print)
0399-8320},
   Accession Number = {17075446},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Semrin, G. and Fishman, D. S. and Bousvaros, A. and Zholudev, A. and Saunders, A. C. and Correia, C. E. and Nemeth, E. and Grand, R. J. and Weinstein, D. A.},
   title = {Impaired intestinal iron absorption in Crohn's disease correlates with disease activity and markers of inflammation},
   journal = {Inflamm Bowel Dis},
   volume = {12},
   number = {12},
   pages = {1101-6},
   note = {Semrin, Gaith
Fishman, Douglas S
Bousvaros, Athos
Zholudev, Anna
Saunders, Andrew C
Correia, Catherine E
Nemeth, Elizabeta
Grand, Richard J
Weinstein, David A
K23 RR 017560/RR/NCRR NIH HHS/United States
M01 RR002172-230441/RR/NCRR NIH HHS/United States
K23 RR017560-02/RR/NCRR NIH HHS/United States
M01 RR002172/RR/NCRR NIH HHS/United States
K23 RR017560-03/RR/NCRR NIH HHS/United States
T32 DK 07477/DK/NIDDK NIH HHS/United States
K23 RR017560-04/RR/NCRR NIH HHS/United States
T32 DK007477/DK/NIDDK NIH HHS/United States
M01 RR 02172/RR/NCRR NIH HHS/United States
K23 RR017560/RR/NCRR NIH HHS/United States
K23 RR017560-01A1/RR/NCRR NIH HHS/United States
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
United States
Inflamm Bowel Dis. 2006 Dec;12(12):1101-6.},
   abstract = {BACKGROUND: Anemia in patients with Crohn's disease (CD) is a common problem of multifactorial origin, including blood loss, malabsorption of iron, and anemia of inflammation. Anemia of inflammation is caused by the effects of inflammatory cytokines [predominantly interleukin-6 (IL-6)] on iron transport in enterocytes and macrophages. We sought to elucidate alterations in iron absorption in pediatric patients with active and inactive CD. METHODS: Nineteen subjects with CD (8 female, 11 male patients) were recruited between April 2003 and June 2004. After an overnight fast, serum iron and hemoglobin levels, serum markers of inflammation [IL-6, C-reactive protein (CRP), and erythrocyte sedimentation rate], and a urine sample for hepcidin assay were obtained at 8 am. Ferrous sulfate (1 mg/kg) was administered orally, followed by determination of serum iron concentrations hourly for 4 hours after the ingestion of iron. An area under the curve for iron absorption was calculated for each patient data set. RESULTS: There was a strong inverse correlation between the area under the curve and IL-6 (P = 0.002) and area under the curve and CRP levels (P = 0.04). Similarly, the difference between baseline and 2-hour serum iron level (Delta[Fe]2hr) correlated with IL-6 (P = 0.008) and CRP (P = 0.045). When cutoff values for IL-6 (>5 pg/mL) and CRP (>1.0 mg/dL) were used, urine hepcidin levels also positively correlated with IL-6 and CRP levels (P = 0.003 and 0.007, respectively). CONCLUSIONS: Subjects with active CD have impaired oral iron absorption and elevated IL-6 levels compared with subjects with inactive disease. These findings suggest that oral iron may be of limited benefit to these patients. Future study is needed to define the molecular basis for impaired iron absorption.},
   keywords = {Adolescent
Adult
Biomarkers/analysis
Child
Crohn Disease/*metabolism/*pathology
Cytokines/blood
Demography
Female
Humans
Inflammation/metabolism
Intestinal Absorption/*physiology
Iron/blood/*metabolism
Malabsorption Syndromes/*pathology
Male},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {17119383},
   DOI = {10.1097/01.mib.0000235097.86360.04},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Shaoul, R.},
   title = {[The importance of nutrition in inflammatory bowel disease in children]},
   journal = {Harefuah},
   volume = {144},
   number = {8},
   pages = {564-6, 598},
   note = {Shaoul, Ron
English Abstract
Journal Article
Review
Israel
Harefuah. 2005 Aug;144(8):564-6, 598.},
   abstract = {Many children with inflammatory bowel disease, mainly Crohn's disease, suffer from malnutrition and growth retardation. Maintenance of adequate nutrition is extremely important in the management of pediatric patients with Crohn's disease. This can usually be achieved by exclusive elemental formulae and polymeric formulae and rarely necessitates the use of parenteral nutrition. This review presents an update on the nutritional aspects of inflammatory bowel disease in children.},
   keywords = {Child
*Child Nutritional Physiological Phenomena
Crohn Disease/*physiopathology
Humans
Inflammatory Bowel Diseases/*physiopathology
Malnutrition/prevention & control},
   ISSN = {0017-7768 (Print)
0017-7768},
   Accession Number = {16146155},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Shaoul, R. and Eliakim, R. and Tamir, A. and Karban, A.},
   title = {Ileal lymphonodular hyperplasia is not associated with NOD2/CARD15 mutations},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {43},
   number = {1},
   pages = {30-4},
   note = {Shaoul, Ron
Eliakim, Rami
Tamir, Ada
Karban, Amir
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2006 Jul;43(1):30-4.},
   abstract = {INTRODUCTION: Lymphonodular hyperplasia (LNH) is a mass of lymphoid tissue that has been described in the terminal ileum, colon and duodenum mainly in children. Controversy exists regarding the benign nature of LNH. The combination of chronic abdominal pain and hematochezia leads many of these patients to undergo investigations for inflammatory bowel diseases. NOD2/CARD15 on chromosome 16 has been identified as a susceptibility gene for Crohn disease (CD). No study has yet examined the possible association of NOD2/CARD15 mutations with patients with LNH. The purpose of this study was to investigate the presence of NOD2/CARD15 mutations in patients with clinically proven LNH. METHODS: Children and young adults with gastrointestinal symptoms diagnosed as having terminal ileum LNH were eligible for the study. RESULTS: The study group consisted of 32 patients (15 males and 17 females), age range 3-23 years, mean 13.1 +/- 5 years. Twenty-seven (84%) had abdominal pain, 3 (9%) had rectal bleeding. The duration of symptoms ranged from 1-60 months (17.9 +/- 14.5). Only 2 patients (6.2%) were found to be heterozygote for the NOD2/CARD15 mutation (1007 fs), whereas all of the others did not carry any of the 3 common mutant alleles. This number is significantly lower (P < 0.001) than the mutation prevalence demonstrated in both pediatric and adult Israeli CD patients. CONCLUSIONS: NOD2/CARD15 mutations are not associated with LNH. This may strengthen the lack of association between CD and LNH that has been previously reported. We suggest that genotyping NOD2/CARD15 may help to distinguish LNH from inflammatory bowel diseases in selected patients.},
   keywords = {Adolescent
Adult
Alleles
Child
Child, Preschool
Crohn Disease/epidemiology/genetics/pathology
DNA Mutational Analysis
Endoscopy, Gastrointestinal
Female
Genetic Predisposition to Disease
Genotype
Humans
Hyperplasia/epidemiology/genetics
Ileum/*pathology
Israel/epidemiology
Lymph Nodes/pathology
Lymphoid Tissue/*pathology
Male
*Mutation
Nod2 Signaling Adaptor Protein/*genetics
Prevalence},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16819374},
   DOI = {10.1097/01.mpg.0000226381.48989.f8},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Shepanski, M. A. and Hurd, L. B. and Culton, K. and Markowitz, J. E. and Mamula, P. and Baldassano, R. N.},
   title = {Health-related quality of life improves in children and adolescents with inflammatory bowel disease after attending a camp sponsored by the Crohn's and Colitis Foundation of America},
   journal = {Inflamm Bowel Dis},
   volume = {11},
   number = {2},
   pages = {164-70},
   note = {Shepanski, Melissa A
Hurd, Linda B
Culton, Keri
Markowitz, Jonathan E
Mamula, Petar
Baldassano, Robert N
Evaluation Studies
Journal Article
United States
Inflamm Bowel Dis. 2005 Feb;11(2):164-70.},
   abstract = {PURPOSE: To describe the reported health-related quality of life (HRQOL) in children and adolescents with inflammatory bowel disease (IBD) after attending an IBD summer camp. METHODS: A prospective analysis of quality of life was completed at an overnight camp that was exclusively for patients with IBD, which was sponsored by the Crohn's and Colitis Foundation of America. The IMPACT-II questionnaire (Canada and United States) and the State-Trait Anxiety Inventory for Children were administered to the campers at the beginning and at the end of a 1-week camp to assess HRQOL and anxiety. The IMPACT-II questionnaire consists of 35 questions measuring 6 quality-of-life domains (i.e., bowel domain, systemic symptoms, emotional functioning, social functioning, body image, and treatment/interventions). The State-Trait Anxiety Inventory for Children consists of 2 different 20-item sets of questions. One set assesses state anxiety, and the other, trait anxiety. A repeated-measures multivariate analysis of variance was performed to determine the differences between scores attained before and after camp on the IMPACT-II questionnaire and in each of its domains. Paired sample t tests were performed on state and trait anxiety before and after camp. RESULTS: A total of 125 individuals consented to participate, but 61 patients (50 girls and 11 boys; age range, 9 to 16 y) completed the IMPACT-II questionnaire in full. Of those 61 patients, 47 had Crohn's disease and 14 had ulcerative colitis. There was statistically significant improvement between the mean (+/-SD) precamp total score (172.95 +/- 36.61) and the mean postcamp total score (178.71 +/- 40.97; P = 0.035), bowel symptoms scores (P = 0.036), social functioning scores (P = 0.022), and treatment interventions scores (P = 0.012). No difference was found between anxiety scores before and after camp on either the state or trait anxiety inventories (n = 55; P > 0.05). CONCLUSIONS: Overall, HRQOL improved in children after attending IBD summer camp. This exploratory study suggests that contributing factors for these improvements may be an increase in social functioning, a better acceptance of IBD symptoms, and less distress regarding treatment interventions, suggesting that a camp that is specifically designed for children with IBD may normalize the chronic illness experience. However, future research using a multimodal measurement approach is warranted to support these conclusions.},
   keywords = {Adolescent
*Anxiety
Camping
Child
Chronic Disease
Female
*Health Status
Humans
Inflammatory Bowel Diseases/*complications/*rehabilitation
Male
*Patient Education as Topic
Prospective Studies
Psychiatric Status Rating Scales
*Quality of Life
*Recreation
Severity of Illness Index
Social Behavior
Social Support
Stress, Psychological},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {15677910},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Sido, B. and Seel, C. and Hochlehnert, A. and Breitkreutz, R. and Droge, W.},
   title = {Low intestinal glutamine level and low glutaminase activity in Crohn's disease: a rational for glutamine supplementation?},
   journal = {Dig Dis Sci},
   volume = {51},
   number = {12},
   pages = {2170-9},
   note = {Sido, Bernd
Seel, Cornelia
Hochlehnert, Achim
Breitkreutz, Raoul
Droge, Wulf
Evaluation Studies
Journal Article
United States
Dig Dis Sci. 2006 Dec;51(12):2170-9. Epub 2006 Nov 1.},
   abstract = {Intestinal glutamine utilization is integral to mucosal regeneration. We analyzed the systemic and intestinal glutamine status in Crohn's disease (CD) and evaluated the therapeutic effect of glutamine supplementation in an animal model of ileitis. In CD, glutamine concentrations were decreased systemically and in noninflamed and inflamed ileal/colonic mucosa. Mucosal glutaminase activities were depressed in the ileum independent of inflammation but were not different from controls in the colon. In experimental ileitis, oral glutamine feeding prevented macroscopic inflammation, enhanced ileal and colonic glutaminase activities above controls, and normalized the intestinal glutathione redox status. However, glutamine supplementation enhanced myeloperoxidase activity along the gastrointestinal tract and potentiated lipid peroxidation in the colon. In conclusion, glutamine metabolism is impaired in CD. In experimental ileitis, glutamine supplementation prevents inflammatory tissue damage. In the colon, however, which does not use glutamine as its principal energy source, immune enhancement of inflammatory cells by glutamine increases oxidative tissue injury.},
   keywords = {Adult
Animals
Case-Control Studies
Colon/*metabolism/pathology
Crohn Disease/*diet therapy/*metabolism/pathology
Dietary Supplements
Disease Models, Animal
Enteral Nutrition
Female
Glutaminase/*metabolism
Glutamine/administration & dosage/*metabolism/*therapeutic use
Glutathione/metabolism
Humans
Ileitis/chemically induced/diet therapy
Ileum/*metabolism/pathology
Indomethacin
Intestinal Mucosa/metabolism/pathology
Lipid Peroxidation
Male
Middle Aged
Rats
Rats, Sprague-Dawley
Rectus Abdominis/metabolism/pathology},
   ISSN = {0163-2116 (Print)
0163-2116},
   Accession Number = {17078002},
   DOI = {10.1007/s10620-006-9473-x},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Siegmund, B. and Zeitz, M.},
   title = {Standards of medical treatment and nutrition in Crohn's disease},
   journal = {Langenbecks Arch Surg},
   volume = {390},
   number = {6},
   pages = {503-9},
   note = {Siegmund, Britta
Zeitz, Martin
Journal Article
Review
Germany
Langenbecks Arch Surg. 2005 Nov;390(6):503-9. Epub 2004 Sep 23.},
   abstract = {Crohn's disease is a condition of chronic inflammation potentially involving any location of the alimentary tract from mouth to anus but with a propensity for the distal small bowel and proximal large bowel. Frequent complications include stricture and fistula. Numerous extra-intestinal manifestations may also be present. The aetiology of Crohn's disease is incompletely understood, and therapy, although generally effective in alleviating the symptoms, is not curative. Due to the heterogeneity of the disease a major need for the therapeutic approach is the ability to define subgroups with distinct characteristics. However, with regard to the heterogeneity of demographic, anatomic and disease behaviour characteristics, distillation of the numerous possible phenotypes in simple categories is a formidable task. In the present review the focus will be on clinically relevant situations providing therapeutic algorithms according to international guidelines.},
   keywords = {Algorithms
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Antibodies, Monoclonal/therapeutic use
Crohn Disease/*therapy
Humans
Immunosuppressive Agents/therapeutic use
Nutritional Support/*standards
Quality of Life
Steroids/therapeutic use},
   ISSN = {1435-2443 (Print)
1435-2443},
   Accession Number = {15449064},
   DOI = {10.1007/s00423-004-0498-3},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Silbermintz, A. and Krishnan, S. and Banquet, A. and Markowitz, J.},
   title = {Granulomatous pneumonitis, sclerosing cholangitis, and pancreatitis in a child with Crohn disease: response to infliximab},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {42},
   number = {3},
   pages = {324-6},
   note = {Silbermintz, Ari
Krishnan, Sankaran
Banquet, Agnes
Markowitz, James
Case Reports
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2006 Mar;42(3):324-6.},
   keywords = {Adolescent
Antibodies, Monoclonal/adverse effects/*therapeutic use
Cholangitis, Sclerosing/*drug therapy/etiology
Crohn Disease/complications/*drug therapy
Female
Gastrointestinal Agents/adverse effects/*therapeutic use
Humans
Infliximab
Pancreatitis/*drug therapy/etiology
Pneumonia/*drug therapy/etiology
Treatment Outcome},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16540804},
   DOI = {10.1097/01.mpg.0000189347.32796.c5},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Silbermintz, A. and Markowitz, J.},
   title = {Inflammatory bowel diseases},
   journal = {Pediatr Ann},
   volume = {35},
   number = {4},
   pages = {268-74},
   note = {Silbermintz, Ari
Markowitz, James
Journal Article
Review
United States
Pediatr Ann. 2006 Apr;35(4):268-74.},
   abstract = {The inflammatory bowel diseases remain at the forefront of clinical investigation. Immunologic and genetic advances are fueling an explosion of novel diagnostic and therapeutic modalities. With further breakthroughs, there is hope that in the near future, these illnesses will no longer be considered either idiopathic or chronic.},
   keywords = {Adult
Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use
Child
*Colitis, Ulcerative/diagnosis/drug therapy/physiopathology
*Crohn Disease/diagnosis/drug therapy/physiopathology
Humans
Immunologic Factors/*therapeutic use},
   ISSN = {0090-4481 (Print)
0090-4481},
   Accession Number = {16637555},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Silva, M. A. and Menezes, J. and Deslandres, C. and Seidman, E. G.},
   title = {Anti-inflammatory role of interleukin-15 in Crohn's disease},
   journal = {Inflamm Bowel Dis},
   volume = {11},
   number = {3},
   pages = {219-30},
   note = {Silva, Manuel A
Menezes, Jose
Deslandres, Colette
Seidman, Ernest G
Journal Article
Research Support, Non-U.S. Gov't
United States
Inflamm Bowel Dis. 2005 Mar;11(3):219-30.},
   abstract = {BACKGROUND: Interleukin (IL)-15 is overexpressed in intestinal tissue with active Crohn's disease (CD). However, its role in the pathogenesis of the disease remains uncertain. We studied the effects of IL-15 on colonic mucosal proinflammatory cytokine response in vitro using organ culture of human colonic explants. METHODS: Colonic tissue was obtained from (1) resections in pediatric CD patients (inflamed and noninflamed) and (2) rectal biopsies in patients with CD undergoing colonoscopy (n = 31) and controls (n = 9). In preliminary experiments, explants from the resections were cultured in the presence or absence of a simulated T(H)1 stimulation using ionomycin (Io) and phorbol-myristate-acetate (PMA), with or without IL-15, or in medium alone. Rectal biopsies were cultured in the same conditions as above, with or without adding a monoclonal anti-IL-15 neutralizing antibody (mAb). Levels of interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, and IL-2R alpha were measured by enzyme-linked immunosorbent assay. RESULTS: IL-15, in the absence of Io + PMA, did not induce the expression of IFN-gamma, TNF-alpha, or IL-2R alpha. Only inflamed explants from resections stimulated with Io + PMA expressed IFN-gamma, TNF-alpha, and IL-2R alpha. This T(H)1 stimulatory effect was inhibited by IL-15 in a dose-dependent fashion. In rectal biopsy explants, inflamed, noninflamed CD, and control tissue responded to stimulation with Io + PMA (P < 0.05) with increased IFN-gamma and TNF-alpha (P < 0.05). This response was again inhibited by IL-15. The inhibitory effect of IL-15 was specifically reversed by anti-IL-15 mAb (P < 0.05). The data for the CD group were also analyzed according to the severity of colonic inflammation and medication use. CONCLUSIONS: Our results suggest a possible anti-inflammatory role for IL-15 in CD. We postulate that its overexpression in CD potentially represents a protective mechanism against the exaggerated T(H)1 immune response.},
   keywords = {Adolescent
Biopsy
Crohn Disease/*immunology
Cytokines/biosynthesis
Enzyme-Linked Immunosorbent Assay
Female
Gene Expression Regulation
Humans
Inflammation
Interleukin-15/biosynthesis/*immunology/*pharmacology
Male
Organ Culture Techniques},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {15735428},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Singh, V. V. and Draganov, P. and Valentine, J.},
   title = {Efficacy and safety of endoscopic balloon dilation of symptomatic upper and lower gastrointestinal Crohn's disease strictures},
   journal = {J Clin Gastroenterol},
   volume = {39},
   number = {4},
   pages = {284-90},
   note = {Singh, Virmeet V
Draganov, Peter
Valentine, John
Comparative Study
Journal Article
United States
J Clin Gastroenterol. 2005 Apr;39(4):284-90.},
   abstract = {GOALS: To evaluate efficacy and safety of endoscopic balloon dilation with or without intralesional steroid injection, of symptomatic upper gastrointestinal (UGI) and lower gastrointestinal (LGI) Crohn's disease (CD) strictures. BACKGROUND: Patients with CD commonly develop obstructive symptoms secondary to gastrointestinal strictures. When these do not resolve with medical management, surgery is usually the only alternative. Limited data are available on the safety and efficacy of endoscopic through-the-scope (TTS) balloon dilation of CD strictures. STUDY: We performed a retrospective review of TTS balloon dilations done on CD-related UGI and LGI strictures. Postdilation intralesional steroid injections were done at the discretion of the endoscopist. Stricture was defined as luminal stenosis <10 mm in diameter, through which a scope could not be passed. Technical success was defined as the ability of the scope to traverse the stricture postdilation. Long-term success rate was claimed if a patient remained asymptomatic and did not require surgery or further endoscopic dilation. RESULTS: Over 4 years, we performed 29 stricture dilations on 17 patients (10 female, 7 male) with 20 strictures. The mean follow-up period was 18.8 months (range, 5-50 months). Stricture locations were as follows: rectal, 5; sigmoid colon, 2; colo-colonic anastomosis, 3; ileocolonic anastomosis, 4; ileum, 1; descending colon, 1; cecum, 1; and distal duodenal bulb, 3 patients. Technical success was achieved in 28 of 29 stricture dilations (96.5%). Ten strictures (34.5%) were dilated to <15 mm and 19 (65.5%) to > or = 15 mm diameter. Long-term success rate in the <15 mm group was 70%, and in > or = 15 mm group was 68.4%. Four quadrant steroid injections were done on 11 strictures. The recurrence rate in this group was 10% and that in the nonsteroid group was 31.3%. The overall long-term success rate was 76.5% by intent-to-treat analysis. Three perforations occurred (all colonic) during 29 stricture dilations, a complication rate of 10% with no mortalities. CONCLUSION: We report the first series of TTS balloon dilations with or without intralesional steroid injection, of both primary and anastomotic UGI and LGI strictures in CD patients. Long-term success was achieved in 76.5% patients with a complication rate of 10%. This mode of therapy appears safe and effective and can be considered as an alternative to surgery in selected patients with medically refractory CD-associated GI strictures. Success rates were better in patients who received four quadrant steroid injections. No difference was seen in stricture recurrence rate or complications based on diameter of TTS balloon used.},
   keywords = {Adult
Aged
Aged, 80 and over
Catheterization/*methods/standards
Constriction, Pathologic/etiology/therapy
Crohn Disease/complications/*therapy
Endoscopy, Gastrointestinal/*standards
Female
Follow-Up Studies
Humans
Intestine, Large
Intestine, Small
Male
Middle Aged
Retrospective Studies
Safety
Treatment Outcome},
   ISSN = {0192-0790 (Print)
0192-0790},
   Accession Number = {15758621},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Socha, P. and Ryzko, J. and Koletzko, B. and Celinska-Cedro, D. and Woynarowski, M. and Czubkowski, P. and Socha, J.},
   title = {Essential fatty acid depletion in children with inflammatory bowel disease},
   journal = {Scand J Gastroenterol},
   volume = {40},
   number = {5},
   pages = {573-7},
   note = {Socha, Piotr
Ryzko, Jozef
Koletzko, Berthold
Celinska-Cedro, Danuta
Woynarowski, Marek
Czubkowski, Piotr
Socha, Jerzy
Journal Article
Research Support, Non-U.S. Gov't
England
Scand J Gastroenterol. 2005 May;40(5):573-7.},
   abstract = {OBJECTIVE: Children with inflammatory bowel disease (IBD) suffer from malabsorption and malnutrition and therefore may be at risk of developing polyunsaturated fatty acid (PUFA) deficiency. The aim of this study was to investigate PUFA status in children with IBD and the possible relationship to disease activity and nutritional status. MATERIAL AND METHODS: We assessed the fatty acid composition of plasma phospholipids (%wt/wt) of 21 children aged 5.5-18 years with IBD (ulcerative colitis, 15; Crohn's disease, 6) with mild or moderate disease activity. The clinical symptoms and biochemical indices of disease activity and nutritional status (lean and fat body mass, Hb, albumin serum conc.) were also determined. RESULTS: The patients had lower phospholipid PUFAs than 13 healthy, aged-matched controls (25.8+/-5.2 versus 34.2+/-5.7, M+/-SD, p<0.001), mainly due to lower values of linoleic acid (18:2n-6, 14.0+/-3.8 versus 18.3+/-4.3, p<0.01) and its major metabolite arachidonic acid (20:4n-6, 5.3+/-2.0 versus 9.3+/-1.9, p<0.0001). There were also higher values of a-linolenic acid (18:3n-3, 0.3+/-0.4 versus 0.2+/-0.1, p<0.01) while the long-chain n-3 PUFA-eicosapentaenoic and docosahexaenoic acids were normal. Total n-6 PUFA correlated inversely to erythrocyte sedimentation rate (p<0.01), seromucoid (p<0.05) and positively to Hb concentration (p<0.01). CONCLUSIONS: Children with inflammatory bowel disease have a high risk of n-6 PUFA depletion, which is related to disease activity.},
   keywords = {Adolescent
Body Mass Index
Case-Control Studies
Child
Colitis, Ulcerative/*metabolism
Crohn Disease/*metabolism
Fatty Acids, Unsaturated/blood/*deficiency
Fish Oils/administration & dosage
Humans
Malabsorption Syndromes/metabolism
Nutritional Status
Phospholipids/blood},
   ISSN = {0036-5521 (Print)
0036-5521},
   Accession Number = {16036510},
   DOI = {10.1080/00365520510012136},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Soler Palacin, P. and Garzon Lorenzo, P. and Castilla Fernandez, Y. and Arranz Amo, J. A. and Scheider, S. and Tormo Carnice, R. and del Toro Riera, M. and Figueras Nadal, C.},
   title = {[D-lactic acidosis in an 11-year-old patient with short bowel syndrome]},
   journal = {An Pediatr (Barc)},
   volume = {64},
   number = {4},
   pages = {385-7},
   note = {Soler Palacin, P
Garzon Lorenzo, P
Castilla Fernandez, Y
Arranz Amo, J A
Scheider, S
Tormo Carnice, R
del Toro Riera, M
Figueras Nadal, C
Case Reports
English Abstract
Journal Article
Spain
An Pediatr (Barc). 2006 Apr;64(4):385-7.},
   abstract = {The short bowel syndrome is the result of a congenital or acquired loss of a large part of the small intestine. The most frequent causes of surgical resection of the intestine in infants are arterial or venous thrombosis, intestinal volvulus, necrotizing enterocolitis, and Crohn's disease. Symptoms include nutrient and electrolyte malabsorption, steatorrhea and diarrhea, which can result in failure to thrive. The consequences of extensive small bowel resections consist of nutritional deficiencies, gastric acid hypersecretion, nephrolithiasis, cholelithiasis and lactic acidosis. Of these, D-lactic acidosis is an infrequent but important complication because of the symptoms that it can produce. D-lactic acid in the human organism is generated by intestinal bacteria, D-lactate ingestion, or endogenous production in the methyl glycoxylase pathway. Neurological symptoms such as somnolence, ataxia or altered behavior in a patient with short bowel syndrome should make us think of D-lactic acidosis caused by bacterial overgrowth. We present the case of an 11-year-old boy with short bowel syndrome secondary to multiple resections during the postnatal period who was admitted to hospital for episodes of confusion and altered behavior. The diagnosis was lactic acidosis. Outcome was favorable due to prompt instauration of treatment.},
   keywords = {Acidosis, Lactic/diagnosis/*etiology
Child
Humans
Male
Short Bowel Syndrome/*complications},
   ISSN = {1695-4033 (Print)
1695-4033},
   Accession Number = {16606577},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Sousa Guerreiro, C. and Cravo, M. and Costa, A. R. and Miranda, A. and Tavares, L. and Moura-Santos, P. and MarquesVidal, P. and Nobre Leitao, C.},
   title = {A comprehensive approach to evaluate nutritional status in Crohn's patients in the era of biologic therapy: a case-control study},
   journal = {Am J Gastroenterol},
   volume = {102},
   number = {11},
   pages = {2551-6},
   note = {Sousa Guerreiro, Catarina
Cravo, Marilia
Costa, Ana Raimundo
Miranda, Ana
Tavares, Lourdes
Moura-Santos, Paula
MarquesVidal, Pedro
Nobre Leitao, Carlos
Journal Article
United States
Am J Gastroenterol. 2007 Nov;102(11):2551-6. Epub 2006 Aug 4.},
   abstract = {OBJECTIVES: Evaluate the nutritional status of patients with inactive or mildly active Crohn's disease (CD), and identify possible causes for potential deficiencies. METHODS: A total of 78 CD patients and 80 healthy controls were evaluated in respect of nutritional status, dietary intake, and life styles factors. RESULTS: These 73/78 CD patients were on immunomodulating therapies. Mean body mass index (BMI) was lower in patients as compared to controls (P= 0.006) but 32% of CD patients and 33.8% of controls had a BMI > 25, whereas 8% and 23.8% in each group, respectively, were obese (BMI > 30Kg/m(2)). Fat free mass was significantly decreased in both genders (P < 0.05) whereas fat mass was decreased only in males (P= 0.01). Energy intake was significantly lower in CD patients (P < 0.0001) and we observed significantly lower adjusted mean daily intakes of carbohydrates, monounsaturated fat, fiber, calcium, and vitamins C, D, E, and K (P < 0.05). 29% of patients had excluded grains from their usual diet, 28% milk, 18% vegetables, and 11% fruits. Milk exclusion resulted in a significantly lower consumption of calcium and vitamin K (P < 0.001) and the exclusion of vegetables was associated to a lower consumption of vitamins C and E (P < 0.05). Physical activity was significantly lower in CD patients (P= 0.01) and this lack of physical activity was inversely correlated with increased fat mass percentage (r=-0.315, P= 0.001). CONCLUSIONS: Results showed that the most prevalent form of malnutrition in CD patients was an excess of body weight, which was concomitant with an inadequate dietary intake, namely micronutrients, clearly related to dietary exclusion of certain foods.},
   keywords = {Adult
Analysis of Variance
Body Mass Index
Case-Control Studies
Chi-Square Distribution
Crohn Disease/*complications/therapy
Energy Intake
Female
Humans
Life Style
Male
Nutrition Disorders/epidemiology/*etiology
*Nutritional Status
Portugal/epidemiology
Risk Factors},
   ISSN = {0002-9270 (Print)
0002-9270},
   Accession Number = {17680845},
   DOI = {10.1111/j.1572-0241.2007.01439.x},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Steenhagen, E. and de Roos, N. M. and Bouwman, C. A. and van Laarhoven, C. J. and van Staveren, W. A.},
   title = {Sources and severity of self-reported food intolerance after ileal pouch-anal anastomosis},
   journal = {J Am Diet Assoc},
   volume = {106},
   number = {9},
   pages = {1459-62},
   note = {Steenhagen, Elles
de Roos, Nicole M
Bouwman, Carolien A
van Laarhoven, Cees J H M
van Staveren, Wija A
Journal Article
United States
J Am Diet Assoc. 2006 Sep;106(9):1459-62.},
   abstract = {Data on food intolerance after ileal pouch-anal anastomosis are scarce. The aim of this study was to identify foods causing intolerance and to determine the nature and severity of reported symptoms. Patients from the Dutch Crohn's and Ulcerative Colitis Association were mailed a survey on food intolerance; 105 (31% men) of 137 patients took part. They all reported intolerance to one or more foods. Common symptoms (scored from 0=absent to 10=severe), included diarrhea (mean score=5.8), fatigue (mean score=5.5), and thirst (mean score=4.6). Spicy foods, cabbage, and citrus fruits (or juice) were most likely to decrease stool consistency, increase stool frequency, or cause perianal irritation. Onions, cabbage, or leeks were reported by 28% of the patients to cause flatulence. The urge to defecate was stronger after a cooked meal (45% within (1/2) hour) than after sandwiches (15% within (1/2) hour). Foods reported to increase stool consistency were potato products, bread, and bananas. This study demonstrates that food intolerance is a common, albeit mild, problem after ileal pouch-anal anastomosis. Food and nutrition professionals should encourage patients to base their food choices on individual tolerance as long as no (patho-) physiological-based evidence to the contrary is available.},
   keywords = {Adult
Anal Canal/*surgery
Anastomosis, Surgical/adverse effects
Colitis, Ulcerative/surgery
Colonic Pouches/*adverse effects
Crohn Disease/surgery
Defecation/physiology
Diarrhea/epidemiology/etiology
*Diet Surveys
Fatigue/epidemiology/etiology
Feeding Behavior
Female
Flatulence/epidemiology/etiology
Humans
Ileum/*surgery
Male
Postoperative Complications/*epidemiology
Self Disclosure
Severity of Illness Index
Surveys and Questionnaires
Thirst},
   ISSN = {0002-8223 (Print)
0002-8223},
   Accession Number = {16963353},
   DOI = {10.1016/j.jada.2006.06.013},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Sykora, J. and Subrt, I. and Didek, P. and Siala, K. and Schwarz, J. and Machalova, V. and Varvarovska, J. and Pazdiora, P. and Pozler, O. and Stozicky, F.},
   title = {Cytokine tumor necrosis factor-alpha A promoter gene polymorphism at position -308 G-->A and pediatric inflammatory bowel disease: implications in ulcerative colitis and Crohn's disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {42},
   number = {5},
   pages = {479-87},
   note = {1536-4801
Sykora, Josef
Subrt, Ivan
Didek, Petr
Siala, Konrad
Schwarz, Jan
Machalova, Veronika
Varvarovska, Jana
Pazdiora, Petr
Pozler, Oldrich
Stozicky, Frantisek
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2006 May;42(5):479-87.},
   abstract = {OBJECTIVES: Our pilot study aimed to determine the effect of tumor necrosis factor-alpha (TNF-alpha) 308 G-->A promoter single-nucleotide polymorphism in pediatric inflammatory bowel disease (IBD), its influence on inflammatory activity and the clinical manifestations. METHODS: We obtained genomic DNA from 164 subjects, 82 with long-standing IBD aged 8 to 18 years: 46 with Crohn disease (CD) and 36 with ulcerative colitis (UC). Eighty-two healthy children served as the control population. Genotyping was determined by using a restriction enzyme-based assay. TNF-alpha 308 G-->A polymorphism was assessed in terms of inflammatory (C-reactive protein [CRP]) and disease activity. The latter was assessed by the Pediatric Crohn's Disease Activity Index (PCDAI) and the Truelove index for CD and UC, respectively. RESULTS: Significant differences in TNF-alpha 308 A polymorphism were found between the IBD group and controls (P < 0.05) and the UC group and controls (P < 0.001). No differences were noted between TNF-alpha 308 A polymorphism and clinical characteristics in UC. The frequency of the -308 A allele of TNF was not different in CD compared with that in the control group. The frequency of TNF-alpha 308 A genotype was significantly higher in CD patients with predominantly stenosing/penetrating disease compared with patients without complications (P < 0.001) and healthy controls (P < 0.01). In CD patients, those carrying TNF -308 A had a significant increase in CRP (P < 0.05) and the PCDAI (P < 0.05). In CD, CRP levels strongly correlated with the PCDAI (r = 0.6150, P < 0.001). In UC, significant differences among the mean levels of CRP (P < 0.05) and disease activity (P < 0.001) related to TNF-alpha 308 A polymorphism were found. Allele distribution (odds ratio, 12.9; CI, 1.18-140.81, P < 0.001) and CRP serum levels (odds ratio, 1.020; CI, 1.00-1.04, P < 0.001) were independently associated with CD complications. CONCLUSIONS: Although not necessarily dictating IBD initiation, the TNF-alpha 308 A polymorphism may play a role in modifying the CD phenotype. The polymorphism may influence disease activity as well as more intense inflammatory activity in both forms of IBD and may modify the progression of chronic digestive tract inflammation.},
   keywords = {Adolescent
Child
Colitis, Ulcerative/genetics/immunology
Crohn Disease/genetics/immunology
Female
Humans
Inflammatory Bowel Diseases/*genetics/immunology
Male
Pilot Projects
Polymorphism, Genetic
Promoter Regions, Genetic
Tumor Necrosis Factor-alpha/*genetics/immunology},
   ISSN = {0277-2116},
   Accession Number = {16707968},
   DOI = {10.1097/01.mpg.0000221917.80887.9e},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Takagi, S. and Utsunomiya, K. and Kuriyama, S. and Yokoyama, H. and Takahashi, S. and Iwabuchi, M. and Takahashi, H. and Takahashi, S. and Kinouchi, Y. and Hiwatashi, N. and Funayama, Y. and Sasaki, I. and Tsuji, I. and Shimosegawa, T.},
   title = {Effectiveness of an 'half elemental diet' as maintenance therapy for Crohn's disease: A randomized-controlled trial},
   journal = {Aliment Pharmacol Ther},
   volume = {24},
   number = {9},
   pages = {1333-40},
   note = {Takagi, S
Utsunomiya, K
Kuriyama, S
Yokoyama, H
Takahashi, S
Iwabuchi, M
Takahashi, H
Kinouchi, Y
Hiwatashi, N
Funayama, Y
Sasaki, I
Tsuji, I
Shimosegawa, T
Journal Article
Randomized Controlled Trial
England
Aliment Pharmacol Ther. 2006 Nov 1;24(9):1333-40.},
   abstract = {BACKGROUND: Although thiopurines have a proven role in maintenance therapy for Crohn's disease, an alternative therapy is needed for patients intolerant or resistant to thiopurines. AIM: To evaluate the effectiveness of home enteral nutrition as a maintenance therapy regimen in which half of the daily calorie requirement is provided by an elemental diet and the remaining half by a free diet. We refer to this home enteral nutrition therapy as 'half elemental diet'. METHODS: Between 2002 and 2005, 51 patients in remission from two hospitals were randomly assigned to a half elemental diet group (n = 26) or a free diet group (n = 25). The primary outcome measure of this study was the occurrence of relapse over the 2-year period. RESULTS: The relapse rate in the half elemental diet group was significantly lower [34.6% vs. 64.0%; multivariate hazard ratio 0.40 (95% CI: 0.16-0.98)] than that in the free diet group after a mean follow-up of 11.9 months. Compliance was similar in the two groups. No adverse event occurred in any of the patients throughout the study. CONCLUSION: This randomized-controlled trial shows the effectiveness of an half elemental diet, which is a promising maintenance therapy for Crohn's disease patients.},
   keywords = {Adult
Crohn Disease/*diet therapy
Enteral Nutrition/methods
Female
Follow-Up Studies
*Food, Formulated
Humans
Male
Parenteral Nutrition/methods
Recurrence
Treatment Outcome},
   ISSN = {0269-2813 (Print)
0269-2813},
   Accession Number = {17059514},
   DOI = {10.1111/j.1365-2036.2006.03120.x},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Takahashi, K. and Funayama, Y. and Fukushima, K. and Shibata, C. and Ogawa, H. and Kumagai, E. and Sasaki, I.},
   title = {Pregnancy and delivery in patients with enterostomy due to anorectal complications from Crohn's disease},
   journal = {Int J Colorectal Dis},
   volume = {22},
   number = {3},
   pages = {313-8},
   note = {Takahashi, Ken-ichi
Funayama, Yuji
Fukushima, Kouhei
Shibata, Chikashi
Ogawa, Hitoshi
Kumagai, Eiko
Sasaki, Iwao
Journal Article
Germany
Int J Colorectal Dis. 2007 Mar;22(3):313-8. Epub 2006 May 20.},
   abstract = {BACKGROUND AND AIMS: Enterostomy is often undergone by patients with Crohn's disease (CD) due to severe anorectal lesions such as rectovaginal fistula (RVF). Reports of successful pregnancy and delivery, which are important determinants of quality of life for female CD patients with stoma, are limited. Thus, we investigated problems associated with pregnancy and delivery in female CD patients at our hospital. MATERIALS AND METHODS: Between 1985 and 2003, five female CD patients with enterostoma carried seven pregnancies and delivered eight babies in our hospital. For this study, we investigated CD activity, fetal growth, stoma complications, and the outcome of delivery in these seven pregnancies. RESULTS: Among the five patients, four underwent loop ileostomy and one loop sigmoidostomy for treatment of RVF or severe stricture of the rectum or sigmoid colon. Except for one case, no fertility treatment was done. During pregnancy, a flare-up was observed in one patient and was successfully treated with corticosteroids. Although home enteral or parenteral nutrition was required in two cases, fetal growth was within the normal range in all pregnancies. Preterm delivery occurred in one case with a twin pregnancy. The mean diameter of stoma increased during pregnancy (p<0.01), and a mucosal laceration of stoma by the edge of an ostomy appliance occurred in one case. All deliveries were safe, with six cesarean sections and one transvaginal delivery. After each delivery, the stoma returned to pre-pregnancy size. CONCLUSIONS: Pregnancy and delivery in CD patients with stoma is safe and should be encouraged. However, special attention to disease activity, nutritional support, and stoma-related complications is recommended.},
   keywords = {Adult
Crohn Disease/*complications/therapy
*Delivery, Obstetric
*Enterostomy
Female
Humans
Nutritional Support
Pregnancy
*Pregnancy Complications
Pregnancy Outcome
Rectal Diseases/etiology/*surgery},
   ISSN = {0179-1958 (Print)
0179-1958},
   Accession Number = {16715249},
   DOI = {10.1007/s00384-006-0148-z},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Takahashi-Monroy, T.},
   title = {[Surgical treatment of Crohn's disease]},
   journal = {Gac Med Mex},
   volume = {141},
   number = {5},
   pages = {351-5},
   note = {Takahashi-Monroy, Takeshi
English Abstract
Journal Article
Mexico
Gac Med Mex. 2005 Sep-Oct;141(5):351-5.},
   abstract = {OBJECTIVE: The experience with the surgical treatment of Crohn's Disease is analyzed in order to determine the indications for surgery, surgical procedures, postoperative complications and associated risk factors, and recurrence rates. MATERIAL AND METHODS: Retrospective analysis of patients operated upon for Crohn's Disease between 1979 and 1997. Risk factors for operative morbidity were searched, and actuarial curves for recurrence of disease were constructed. RESULTS: There were 34 patients with a mean age of 46 years. All patients were operated upon because of complications; the most frequent ones were stenosis and obstruction. The affected patterns were ileocecal in 53%, colitis in 35% and small bowel in 12%. Segmental resections were the most frequent ones, mainly ileo-cecal. Operative morbidity was 32% and mortality 6%. The presence of colonic affection and the necessity of its resection was a higher risk for complications (P< 0.05). Actuarial recurrence was 39% at 107 months. CONCLUSIONS: Surgery for Crohn's disease was mainly indicated in complications, presented high rates of morbidity associated with colonic involvement and resections, and there were high rates of recurrence at long-term.},
   keywords = {Adult
Aged
Crohn Disease/*surgery
Female
Humans
Male
Middle Aged
Postoperative Complications/epidemiology
Retrospective Studies},
   ISSN = {0016-3813 (Print)
0016-3813},
   Accession Number = {16353879},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Tapia, S. A. and Araya, M. M.},
   title = {[Oxidative stress, prooxidants and Crohn disease]},
   journal = {Rev Med Chil},
   volume = {134},
   number = {1},
   pages = {95-100},
   note = {Tapia S, Alexis
Araya M, Magdalena
English Abstract
Journal Article
Review
Chile
Rev Med Chil. 2006 Jan;134(1):95-100. Epub 2006 Mar 8.},
   abstract = {The frequency of Crohn disease shows a significant increase in the last century. Affected patients show a misbalance between production of free radicals and anti oxidant defenses. Thus, one of the increasingly accepted htypotheses to explain the origin of this disease, is the oxidative stress that occurs in the intestinal mucosa. Dietary factors including self administered vitamin and mineral supplements may play a role, especially when they contain excessive amounts of iron and copper, known for their prooxidant capacities. Unfortunately, little is known about how these metals may influence the antioxidant defenses in the intestinal mucosa. This article reviews the literature on the why and how these elements may act on individuals susceptible to develop Crohn disease, including the evidence supporting the hypothesis that oxidative stress in the intestinal mucosa is an important pathogenetic factor.},
   keywords = {Copper/toxicity
Crohn Disease/*etiology/metabolism
Dietary Supplements/toxicity
Humans
Intestinal Mucosa/*metabolism
Iron/toxicity
Oxidative Stress/*physiology
Reactive Oxygen Species/*metabolism},
   ISSN = {0034-9887 (Print)
0034-9887},
   Accession Number = {16532169},
   DOI = {/S0034-98872006000100014},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Thayu, M. and Markowitz, J. E. and Mamula, P. and Russo, P. A. and Muinos, W. I. and Baldassano, R. N.},
   title = {Hepatosplenic T-cell lymphoma in an adolescent patient after immunomodulator and biologic therapy for Crohn disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {40},
   number = {2},
   pages = {220-2},
   note = {Thayu, Meena
Markowitz, Jonathan E
Mamula, Petar
Russo, Pierre A
Muinos, William I
Baldassano, Robert N
Case Reports
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2005 Feb;40(2):220-2.},
   keywords = {6-Mercaptopurine/*adverse effects/therapeutic use
Adolescent
Antibodies, Monoclonal/*adverse effects/therapeutic use
Crohn Disease/*complications/drug therapy
Fatal Outcome
Female
Gastrointestinal Agents/adverse effects/therapeutic use
Humans
Immunosuppressive Agents/adverse effects/therapeutic use
Infliximab
Liver Neoplasms/diagnosis/*etiology
Lymphoma, T-Cell/diagnosis/*etiology
Splenic Neoplasms/diagnosis/*etiology
Tumor Necrosis Factor-alpha/antagonists & inhibitors},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {15699701},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Thompson, J. S. and Sudan, D. A. and Gilroy, R.},
   title = {Predicting outcome of procedures to slow intestinal transit},
   journal = {Transplant Proc},
   volume = {38},
   number = {6},
   pages = {1838-9},
   note = {Thompson, J S
Sudan, D A
Gilroy, R
Journal Article
United States
Transplant Proc. 2006 Jul-Aug;38(6):1838-9.},
   abstract = {Procedures designed to slow intestinal transit in patients with the short-bowel syndrome (SBS) have unpredictable outcomes. Our aim was to evaluate the outcome and predictive factors for this complication in SBS patients. Ten patients (37-61 years) underwent reversed segment (n = 9) or nipple valve creation (n = 1). All patients had remnant lengths over 90 cm and rapid intestinal transit times. All subjects had benign diseases, including Crohn's (n = 3). Six patients had a colon remnant. SBS had been present for 8 to 150 months. Nine (90%) required parental nutrition (PN) preoperatively. A procedure was performed either alone (n = 5) or concurrently with an ostomy closure (n = 3), an ostomy revision (n = 1), or a fundoplication (n = 1). There was one postoperative complication (urinary tract infection) and no deaths. Two patients developed bacterial overgrowth. One required repair of an ileocolonic stricture. One reversed segment was taken down 12 months later. Five (50%) patients improved (off PN), five remained on PN or had persistent diarrhea. Patients with a successful outcome were more likely to have had ostomy takedown (60% vs 0%). The duration of SBS; presence of Crohn's disease, a colon remnant, or type 1 anatomy; and the transit times were similar in both groups. Adjusted remnant length (small intestine +30 cm for type 2 anatomy and +60 cm for type 3) was similar (136 +/- 20 vs 154 +/- 25 cm). Procedures may benefit half of selected SBS patients with adequate remnant length and rapid transit. Successful patients are more likely to have an ostomy takedown, but the outcome is less determined by transit time or intestinal length if over 90 cm.},
   keywords = {Adult
Gastrointestinal Transit/*physiology
Humans
Intestines/*transplantation
Kinetics
Middle Aged
Parenteral Nutrition
Short Bowel Syndrome/physiopathology/*surgery
Transplantation, Homologous/methods
Treatment Outcome},
   ISSN = {0041-1345 (Print)
0041-1345},
   Accession Number = {16908298},
   DOI = {10.1016/j.transproceed.2006.05.007},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Trebble, T. M.},
   title = {Bone turnover and nutritional status in Crohn's disease: relationship to circulating mononuclear cell function and response to fish oil and antioxidants},
   journal = {Proc Nutr Soc},
   volume = {64},
   number = {2},
   pages = {183-91},
   note = {Trebble, T M
Journal Article
Review
England
Proc Nutr Soc. 2005 May;64(2):183-91.},
   abstract = {Crohn's disease is associated with osteoporosis, malnutrition and altered function of peripheral blood mononuclear cells (PBMC). The responses of circulating immune cells and extra-intestinal manifestations to increased inflammatory activity and to modulation by dietary supplementation are uncertain. The relationships between disease status, bone turnover and body mass and composition, PBMC function and fatty acid availability have been investigated in patients with Crohn's disease. The availability of n-3 and n-6 PUFA is altered in adult patients and interferon (IFN)-gamma production by PBMC is lower. Increased inflammatory activity is associated with increased bone resorption in adult patients and decreased body mass in paediatric patients. In healthy male subjects there is a proportionate relationship between supplementary intake of EPA and DHA (0.3-2.0 g as fish oil/d) in combination with antioxidants (vitamins A, C and E and Se) and incorporation into plasma phospholipids and PBMC, and a non-linear relationship with PBMC synthesis of TNF-alpha, IL-6 and prostaglandin E2 (decrease) and IFN-gamma (increase). In adults with Crohn's disease high-dose fish oil (2.7 g EPA+DHA/d) in combination with antioxidants (vitamins A, C and E and Se) increases the EPA and DHA content of PBMC and decreases the production of IFN-gamma by PBMC, but is not associated with effects on bone turnover or nutritional status.},
   keywords = {Antioxidants/*therapeutic use
Bone and Bones/*metabolism
Crohn Disease/*drug therapy/metabolism
Fish Oils/*administration & dosage
Humans
Leukocytes, Mononuclear/*physiology
Nutritional Status},
   ISSN = {0029-6651 (Print)
0029-6651},
   Accession Number = {15960863},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Trebble, T. M. and Stroud, M. A. and Wootton, S. A. and Calder, P. C. and Fine, D. R. and Mullee, M. A. and Moniz, C. and Arden, N. K.},
   title = {High-dose fish oil and antioxidants in Crohn's disease and the response of bone turnover: a randomised controlled trial},
   journal = {Br J Nutr},
   volume = {94},
   number = {2},
   pages = {253-61},
   note = {Trebble, Timothy M
Stroud, Mike A
Wootton, Stephen A
Calder, Philip C
Fine, David R
Mullee, Mark A
Moniz, Caje
Arden, Nigel K
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
England
Br J Nutr. 2005 Aug;94(2):253-61.},
   abstract = {Crohn's disease is associated with altered bone turnover that may be influenced by nutritional status, the systemic inflammatory response, cytokine production by circulating (peripheral blood) mononuclear cells (PBMC) and antioxidant micronutrient intake. High-dose fish oil is associated with reductions in disease relapse and inflammatory markers, and modulates PBMC function. The effect of fish oil plus antioxidants on bone turnover and PBMC function (the production of interferon-gamma and prostaglandin E2) in Crohn's disease was investigated in a randomised-controlled trial. Patients with currently or recently raised biochemical markers of inflammation (C-reactive protein > or = 6.9 mg/l or erythrocyte sedimentation rate > or =18 mm/h) received fish oil (providing 2.7 g/d EPA and DHA) and antioxidants (vitamins A, C and E, and Se) (n 31) or placebo (n 30) for 24 weeks. Bone turnover was assessed by measuring the concentrations of urinary deoxypyridinoline (bone resorption) and serum osteocalcin (bone formation). Fish oil plus antioxidants were associated with increases in EPA, DHA Se in plasma (all P < 0.01), and with a reduction in interferon-gamma production by mitogen-stimulated PBMC, which demonstrated a negative correlation with deoxypyridinoline/creatinine:osteocalcin ratio (r - 0.33, P = 0.009). There were no differences between the groups at 24 weeks in the response of deoxypyridinoline or osteocalcin or their ratio, or in nutritional status. Dietary supplementation in Crohn's disease with high intakes of EPA and DHA, as fish oil, plus antioxidants was associated with a modulated production of interferon-gamma by PBMC but not altered indices of bone turnover.},
   keywords = {Amino Acids/urine
Antioxidants/*administration & dosage/analysis
Biomarkers/metabolism
Blood Sedimentation
Bone Resorption/*diet therapy/etiology/metabolism
C-Reactive Protein/analysis
Crohn Disease/complications/*diet therapy/physiopathology
Double-Blind Method
Fatty Acids, Unsaturated/blood
Female
Fish Oils/*administration & dosage
Humans
Interferon-gamma/biosynthesis
Leukocytes, Mononuclear/*physiology
Male
Middle Aged
Osteocalcin/blood
*Osteogenesis/physiology
Vitamins/administration & dosage/analysis},
   ISSN = {0007-1145 (Print)
0007-1145},
   Accession Number = {16115360},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Uhlen, S. and Belbouab, R. and Narebski, K. and Goulet, O. and Schmitz, J. and Cezard, J. P. and Turck, D. and Ruemmele, F. M.},
   title = {Efficacy of methotrexate in pediatric Crohn's disease: a French multicenter study},
   journal = {Inflamm Bowel Dis},
   volume = {12},
   number = {11},
   pages = {1053-7},
   note = {Uhlen, S
Belbouab, R
Narebski, K
Goulet, O
Schmitz, J
Cezard, J P
Turck, D
Ruemmele, F M
Journal Article
Multicenter Study
United States
Inflamm Bowel Dis. 2006 Nov;12(11):1053-7.},
   abstract = {BACKGROUND: Immunosuppressors play a major role in maintaining remission in Crohn's disease (CD). In patients who do not tolerate or escape therapy with azathioprine (AZA)/6-mercaptopurine, there is a marked need for other immunosuppressive drugs. The aim of the present study was to evaluate the efficacy and safety of methotrexate (MTX) in children with active CD. METHODS: In a retrospective multicenter (n = 3) study, the efficacy of MTX to induce complete remission or a clinical improvement was analyzed in 61 children with active CD. RESULTS: CD was diagnosed at a mean age of 11.1 +/- 2.3 years, and MTX was introduced 3.1 +/- 2.2 years after diagnosis. Indications to use MTX were a nonresponse to or relapse under AZA (n = 42) or AZA intolerance/toxicity (n = 19). MTX improved or induced complete remission in 49 patients (80%), of whom 18 (29.5%) relapsed after 13 +/- 10 months of treatment. Under MTX medication, complete remission was observed in 39%, 49%, and 45% at 3, 6, and 12 months, respectively. Follow-up over at least 24 months in 11 children confirmed a sustained remission on MTX monotherapy up to 40 months. Adverse reactions were observed in 14 patients (24%), requiring discontinuation of MTX in 6 children (10%) (liver enzyme elevation, n = 2; varicella-zoster, n = 1; nausea, n = 3). MTX allowed corticosteroid discontinuation in 36 patients. CONCLUSIONS: MTX improved the clinical course in most pediatric CD patients who escaped or did not tolerate AZA. Short-time toxicity of MTX resulted in drug discontinuation in <10%. These data point to a beneficial and safe use of MTX in the treatment of pediatric CD.},
   keywords = {Azathioprine/adverse effects/therapeutic use
Child
Crohn Disease/*drug therapy
Female
Follow-Up Studies
Humans
Immunosuppressive Agents/adverse effects/*therapeutic use
Male
Methotrexate/adverse effects/*therapeutic use
Remission Induction
Retrospective Studies
Time Factors
Treatment Failure
Treatment Outcome},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {17075346},
   DOI = {10.1097/01.mib.0000235103.47280.bb},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Urlep, D. and Mamula, P. and Baldassano, R.},
   title = {Extraintestinal manifestations of inflammatory bowel disease},
   journal = {Minerva Gastroenterol Dietol},
   volume = {51},
   number = {2},
   pages = {147-63},
   note = {Urlep, D
Mamula, P
Baldassano, R
Journal Article
Review
Italy
Minerva Gastroenterol Dietol. 2005 Jun;51(2):147-63.},
   abstract = {Inflammatory bowel disease (IBD) predominantly affects the gastrointestinal system but it is associated with a large number of extraintestinal manifestations (EIM). These extraintestinal disorders can significantly contribute to morbidity and impair the overall life quality. EIM may be diagnosed before, concurrently with, or after the diagnosis of IBD is made. The precise etiology of EIM remains unknown. It currently is believed that mucosa from the underlying bowel disease may provide associated immune responses for the inflammatory process in the extraintestinal sites. The involvement of autoimmune mechanisms has been suggested when the shared and unique epitopes in the human colon, eye, joint and biliary epithelium were detected. Recently, the presence of long-lived populations of memory lymphocytes has been discovered which arise as a consequence of bowel inflammation and express homing receptors that direct their migration not only to the gut but also to the extraintestinal sites. The most common extraintestinal disorders associated with IBD include dermatologic, ophthalmologic, musculoskeletal and hepatobiliary diseases, although virtually every organ system may be involved. If these disorders can be considered as the real extraintestinal manifestations of IBD or represent just association between different syndromes of autoimmune etiology, is still not clear. It is important to acquire knowledge on these extraintestinal manifestations of Crohn's disease and ulcerative colitis to start the respective treatment early.},
   keywords = {Biliary Tract Diseases/etiology
Bone Diseases, Metabolic/etiology
Colitis, Ulcerative/complications
Crohn Disease/complications
Eye Diseases/etiology
Hematologic Diseases/etiology
Humans
Inflammatory Bowel Diseases/*complications
Musculoskeletal Diseases/etiology
Skin Diseases/etiology},
   ISSN = {1121-421X (Print)
1121-421x},
   Accession Number = {15990704},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Vaisman, N. and Dotan, I. and Halack, A. and Niv, E.},
   title = {Malabsorption is a major contributor to underweight in Crohn's disease patients in remission},
   journal = {Nutrition},
   volume = {22},
   number = {9},
   pages = {855-9},
   note = {Vaisman, Nachum
Dotan, Iris
Halack, Aharon
Niv, Eva
Journal Article
United States
Nutrition. 2006 Sep;22(9):855-9.},
   abstract = {OBJECTIVE: Undernutrition has been reported in 65-75% of patients with Crohn's disease. The present study aimed at identifying the relative contribution of malnutrition-causing factors in patients with Crohn's disease in remission. METHODS: Sixteen patients with Crohn's disease (age 19-57 y) in remission (Crohn's Activity Disease Index < 150) were included in the study. Their weight was stable for >3 mo and they were off steroids. They all completed 3-d food records and concomitantly collected stools. Self-reported food records were analyzed and energy content in stools was determined by a direct bomb calorimeter. Resting energy expenditure (REE) was studied by indirect calorimetry and body composition by dual-energy X-ray absorptiometry. The study cohort was divided into two groups, with a body mass index (BMI) equal to 18.5 kg/m(2) serving as a cutoff point. RESULTS: Subjects with lower BMIs tended to have less lean body mass (P = 0.006), less bone mineral density (P = 0.006), and lower REE (P = 0.003). No correlation was found between BMI and energy intake but the percentage of malabsorption was negatively correlated with BMI (P = 0.07). When dividing the study based on a BMI of 18.5 kg/m(2), no difference was found in caloric intake or REE between groups but subjects with lower BMIs had significant prominent malabsorption compared with the others (21.1 +/- 9.8% versus 11.7 +/- 3.5%, P = 0.015). CONCLUSION: In the presence of similar energy intake, REE does not seem to contribute to lower BMI, although nutrient malabsorption is higher in malnourished patients with Crohn's disease in remission. We suggest that malabsorption be evaluated in patients with Crohn's disease who fail to gain weight during disease remission to establish their extra caloric requirements.},
   keywords = {Absorptiometry, Photon
Adult
Basal Metabolism/*physiology
Body Composition/physiology
Body Mass Index
Body Weight/physiology
Bone Density/physiology
Calorimetry, Indirect
Cohort Studies
Crohn Disease/complications/*metabolism
Diet Records
Energy Intake/*physiology
Energy Metabolism/physiology
Female
Humans
Malabsorption Syndromes/*etiology/physiopathology
Male
Middle Aged
Nutritional Status
Thinness/*etiology/metabolism
Young Adult},
   ISSN = {0899-9007 (Print)
0899-9007},
   Accession Number = {16928471},
   DOI = {10.1016/j.nut.2006.05.013},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Valentine, J. F.},
   title = {Crohn's disease: the cost of comfortable inaction},
   journal = {Inflamm Bowel Dis},
   volume = {12},
   number = {12},
   pages = {1185-6},
   note = {Valentine, John F
Comment
Journal Article
United States
Inflamm Bowel Dis. 2006 Dec;12(12):1185-6.},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {17119393},
   DOI = {10.1097/01.mib.0000246781.68130.29},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {von Allmen, D.},
   title = {Surgical management of Crohn's disease in children},
   journal = {Curr Treat Options Gastroenterol},
   volume = {8},
   number = {5},
   pages = {405-10},
   note = {von Allmen, Daniel
Journal Article
United States
Curr Treat Options Gastroenterol. 2005 Oct;8(5):405-10.},
   abstract = {One of the most common beliefs in the management of Crohn's disease is that surgery should be considered only as a last resort. Surgery is often considered by patients and gastroenterologists to represent a "failure." However, the role of surgery in the care of patients with Crohn's disease has increasingly become a collaborative effort, with surgeons involved in many aspects of the management of these patients. This is particularly true in pediatric patients, as issues of growth and development may involve surgical intervention at earlier stages than might be required in older patients. In fact, surgical interventions may be indicated at any stage of the disease process. For example, early examination under anesthesia with abscess drainage and delineation of fistula tracts has proven very useful in patients with complex perineal disease. Surgery may contribute to the medical management of the disease by way of providing chronic enteral or parenteral access for nutritional interventions such as elemental feedings and total parenteral nutrition. Finally, surgical treatment of intra-abdominal complications including fistulas, phlegmon, and bowel strictures may have a dramatic impact on patient symptoms and side effects. Although bowel resection carries the long-term risk of short bowel syndrome should future resections be required, the improvements in medical therapy continue to reduce the risk of recurrent disease, making surgical resection more palatable. Surgical treatment of complicated disease offers significant potential to limit toxic medical therapy and improve quality of life. In addition, application of minimally invasive techniques can minimize the impact of insults to body image in this vulnerable patient population as well as speed recovery. Future interventions may be facilitated by reducing adhesion formation through the use of minimally invasive techniques. The dynamic nature of growth and development in the pediatric population presents unique complications from medical therapies that are different from those seen in adults. Criteria for surgical intervention must be interpreted in light of the specific challenges facing the pediatric population as frequently pointed out in the oft-quoted maxim, "children are not small adults!"},
   ISSN = {1092-8472 (Print)
1092-8472},
   Accession Number = {16162306},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Walther, F. and Fusch, C. and Radke, M. and Beckert, S. and Findeisen, A.},
   title = {Osteoporosis in pediatric patients suffering from chronic inflammatory bowel disease with and without steroid treatment},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {43},
   number = {1},
   pages = {42-51},
   note = {Walther, Frank
Fusch, Christoph
Radke, Michael
Beckert, Sybille
Findeisen, Annette
Journal Article
Research Support, Non-U.S. Gov't
United States
J Pediatr Gastroenterol Nutr. 2006 Jul;43(1):42-51.},
   abstract = {BACKGROUND: Children and adolescents suffering from inflammatory bowel disease (IBD) are at risk of developing osteoporosis as a result of treatment with corticosteroids as well as of nonsteroidal factors like inflammation and malnutrition. To study the impact of these factors on development of osteopathy, we compared the rate of osteoporosis in steroid-naive and steroid-treated pediatric IBD patients. METHODS: In 90 patients (50 girls) with IBD (34 steroid-naive, 53 steroid-treated, 3 not known) aged 8.8 to 19.2 (14.4 +/- 2.2) years and 52 controls (27 girls) aged 6.1 to 17.6 (12.9 +/- 3.0) years, bone mineral density (BMD) of the lumbar spine was assessed with dual energy x-ray absorptiometry. Areal BMD values were transformed into volumetric densities called bone mineral apparent density (BMAD) and expressed as standard deviation scores (SDS) on the basis of the BMAD values of the controls. RESULTS: The rate of osteoporotic patients (BMAD-SDS < -2) was 8% in girls and 20% in boys. There was a similar proportion of osteoporosis in steroid-naive (12%) and steroid-treated (11%) patients. SDS of body height showed a significant positive correlation with BMD-SDS but not with BMAD-SDS in almost all patient subgroups, indicating an interfering dependency of BMD from bone size. CONCLUSIONS: The prevalence of osteoporosis in pediatric patients with IBD is approximately the same as in adult patients. Osteoporosis is already present before steroid treatment. Data of dual energy x-ray absorptiometry measurements should be transformed into volumetric parameters to compensate for short stature. Otherwise, a lot of growth-stunted patients may be falsely diagnosed as osteopenic.},
   keywords = {Absorptiometry, Photon
Adolescent
Adrenal Cortex Hormones/administration & dosage/*adverse effects
Adult
Body Height/drug effects
Body Mass Index
Bone Density/drug effects
Bone Density Conservation Agents/therapeutic use
Case-Control Studies
Child
Colitis, Ulcerative/blood/*drug therapy/epidemiology/physiopathology
Crohn Disease/blood/*drug therapy/epidemiology/physiopathology
Cross-Sectional Studies
Dose-Response Relationship, Drug
Female
Germany/epidemiology
Humans
Lumbar Vertebrae/diagnostic imaging/metabolism/physiopathology
Male
Multivariate Analysis
Osteoporosis/blood/*chemically induced/epidemiology/physiopathology/prevention &
control
Sex Factors
Treatment Outcome
Vitamin D/blood},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16819376},
   DOI = {10.1097/01.mpg.0000228105.91240.80},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Wewer, V. and Riis, L. and Vind, I. and Husby, S. and Munkholm, P. and Paerregaard, A.},
   title = {Infliximab dependency in a national cohort of children with Crohn's disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {42},
   number = {1},
   pages = {40-5},
   note = {Wewer, Vibeke
Riis, Lene
Vind, Ida
Husby, Steffen
Munkholm, Pia
Paerregaard, Anders
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2006 Jan;42(1):40-5.},
   abstract = {AIM: The aim was to evaluate the pattern of responsiveness and to monitor side effects of episodic administration of infliximab in children with active Crohn's disease (CD) treated in Denmark from 1999 to 2003. MATERIAL AND METHODS: The National Danish Crohn Colitis Database of infliximab was used to identify all Danish CD patients treated at pediatric departments with infliximab. The clinical outcome was assessed by pattern recognition of the disease course 30 days after the first infliximab infusion and 90 days after intended end of treatment. RESULTS: During a 3 year period, infliximab was given to 24 CD patients (9 male/15 female) aged median 15.4 (range 9.8-18.6) years with a median disease duration of 26 (range 0.7-93) months and a median number of infusions of 6 (range 2-11). Five milligrams of infliximab per kilogram infusions were given intravenously. Immediate response was as follows: 8 (33%) patients achieved complete response (CR), 10 (42%) partial response (PR), and 6 (25%) no response (NR). Long-term response was as follows: 7 (29%) patients achieved prolonged response (PRO), defined as maintenance of CR or PR, 10 (42%) were infliximab dependent (ID), defined as relapse of symptoms requiring reinfusions of infliximab to regain CR or PR, and 6 (25%) had NR. Six (25%) patients needed surgery during or after treatment with infliximab. Side effects were seen in four (17%) patients. No serious events were noted. CONCLUSION: Seventy-one percent of the children appeared to benefit (PRO or ID) from infliximab treatment with minor side effects when given episodically. Among these patients, two response patterns were recognized: PRO after ending infliximab treatment (29%) or dependency on reinfusions of infliximab (42%).},
   keywords = {Adolescent
Antibodies, Monoclonal/*adverse effects/*therapeutic use
Child
Cohort Studies
Crohn Disease/*drug therapy
Female
Gastrointestinal Agents/*adverse effects/*therapeutic use
Humans
Infliximab
Infusions, Intravenous
Male
Recurrence
Remission Induction
Retrospective Studies
Time Factors
Treatment Outcome},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16385252},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Wierdsma, N. J. and van Bodegraven, A. A.},
   title = {[Energy losses from a short bowel: not only fat]},
   journal = {Ned Tijdschr Geneeskd},
   volume = {149},
   number = {8},
   pages = {381-4},
   note = {Wierdsma, N J
van Bodegraven, A A
Case Reports
English Abstract
Journal Article
Netherlands
Ned Tijdschr Geneeskd. 2005 Feb 19;149(8):381-4.},
   abstract = {Two adult patients, men aged 43 and 45 years, with Crohn's disease, complicated by high-output small-bowel-stomy and short-bowel syndrome due to several intestinal resections, presented with extreme weight loss. Although both patients followed a high-calorie diet combining solid foods and enteral nutrition by nasogastric tube, containing 16,000 kJ and 21,000 kJ, respectively, weight loss continued. Faecal fat excretion and basal metabolic rate were determined, but these could not explain the caloric deficit. Therefore, faecal bomb calorimetry, a measurement of total faecal energy content, was also performed, revealing a considerably higher faecal energy loss than had been calculated from faecal fat excretion; this indicates that faecal carbohydrate loss plays an important supplementary role. A stable weightwas achieved in both patients by prescribing extra food. Therefore, faecal fat excretion is an insufficient indicator of total faecal calorie loss in patients with high-output stomata and short-bowel syndrome. Bomb calorimetry may be considered as a tool to determine the remaining absorptive capacity in short-bowel patients.},
   keywords = {Adult
Calorimetry/methods
Carbohydrate Metabolism
Carbohydrates/*analysis
Crohn Disease/*complications/surgery
Energy Intake
Feces/*chemistry
Humans
Intestinal Absorption
Lipid Metabolism
Lipids/*analysis
Male
Middle Aged
Short Bowel Syndrome/*complications
*Weight Loss},
   ISSN = {0028-2162 (Print)
0028-2162},
   Accession Number = {15751315},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Wong, S. C. and Macrae, V. E. and McGrogan, P. and Ahmed, S. F.},
   title = {The role of pro-inflammatory cytokines in inflammatory bowel disease growth retardation},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {43},
   number = {2},
   pages = {144-55},
   note = {Wong, S C
Macrae, V E
McGrogan, P
Ahmed, S F
Journal Article
Research Support, Non-U.S. Gov't
Review
United States
J Pediatr Gastroenterol Nutr. 2006 Aug;43(2):144-55.},
   abstract = {Childhood inflammatory bowel disease (IBD) especially those with Crohn disease is commonly complicated by faltering growth and pubertal delay. Pro-inflammatory cytokines are often elevated in IBD and may affect linear growth and puberty either systemically or at the level of the growth plate. Further study of the underlying mechanisms of the deleterious effects of cytokines on the growth plate may improve management of faltering growth in childhood IBD. Well-controlled clinical studies of the respective effect of nutritional support, immunomodulatory therapy, biological agents and growth and puberty promoting agents on managing faltering growth also require further attention.},
   keywords = {Adolescent
Body Height/drug effects/physiology
Body Weight/drug effects/physiology
Child
Child, Preschool
Cytokines/adverse effects/*biosynthesis
Female
Growth/*drug effects/physiology
Growth Disorders/drug therapy/*etiology
Growth Hormone/therapeutic use
Humans
Inflammatory Bowel Diseases/metabolism/*physiopathology
Male
Puberty, Delayed/etiology
Steroids/therapeutic use},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16877976},
   DOI = {10.1097/01.mpg.0000226374.18494.14},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Yamamoto, T. and Nakahigashi, M. and Umegae, S. and Kitagawa, T. and Matsumoto, K.},
   title = {Impact of elemental diet on mucosal inflammation in patients with active Crohn's disease: cytokine production and endoscopic and histological findings},
   journal = {Inflamm Bowel Dis},
   volume = {11},
   number = {6},
   pages = {580-8},
   note = {Yamamoto, Takayuki
Nakahigashi, Maki
Umegae, Satoru
Kitagawa, Tatsushi
Matsumoto, Koichi
Journal Article
United States
Inflamm Bowel Dis. 2005 Jun;11(6):580-8.},
   abstract = {BACKGROUND: The aim of this study was to examine the impact of elemental diet on mucosal inflammation in Crohn's disease (CD), mainly by cytokine measurements. METHODS: Twenty-eight consecutive patients with active CD were treated with an elemental diet (Elental) for 4 weeks. The mucosal biopsies were obtained from the terminal ileum and large bowel before and after treatment. As a control group, mucosal biopsies were obtained from 20 patients without inflammation. Mucosal cytokine concentrations were measured by enzyme-linked immunosorbent assay. RESULTS: After treatment, clinical remission was achieved in 20 patients (71%). Endoscopic healing and improvement rates were 44% and 76% in the terminal ileum and 39% and 78% in the large bowel, respectively. Histologic healing and improvement rates were 19% and 54% in the terminal ileum and 20% and 55% in the large bowel, respectively. Before treatment, the mucosal concentrations of interleukin (IL)-1beta, IL-1 receptor antagonist (IL-1ra), IL-6, IL-8, and tumor necrosis factor-alpha in the ileum and large bowel were significantly higher than in controls. These cytokine concentrations decreased to the levels of control after treatment. IL-1ra/IL-1beta ratio in the ileum and large bowel was significantly lower than in controls before treatment. The ratio increased to the level of controls after treatment. The endoscopic and histologic healing of the mucosal inflammation was associated with a decline of the mucosal cytokines and an increase of the IL-1ra/IL-1beta ratio. CONCLUSIONS: The elemental diet (Elental) reduced mucosal cytokine production and corrected an imbalance between proinflammatory and anti-inflammatory cytokines in CD.},
   keywords = {Adult
Biopsy
Crohn Disease/*diet therapy/*immunology
Cytokines/*biosynthesis
Enzyme-Linked Immunosorbent Assay
Female
*Food, Formulated
Humans
*Inflammation
Intestinal Mucosa/*immunology/pathology
Male
Parenteral Nutrition
Prospective Studies
Treatment Outcome},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {15905706},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Yao, G. X. and Wang, X. R. and Jiang, Z. M. and Zhang, S. Y. and Ni, A. P.},
   title = {Role of perioperative parenteral nutrition in severely malnourished patients with Crohn's disease},
   journal = {World J Gastroenterol},
   volume = {11},
   number = {36},
   pages = {5732-4},
   note = {Yao, Guo-Xiang
Wang, Xiu-Rong
Jiang, Zhu-Ming
Zhang, Si-Yuang
Ni, An-Ping
Controlled Clinical Trial
Journal Article
United States
World J Gastroenterol. 2005 Sep 28;11(36):5732-4.},
   abstract = {AIM: To evaluate the effect of perioperative parenteral nutrition on serum immunoglobulin, weight change, and post-operative outcome in severely malnourished patients with Crohn's disease. METHODS: Thirty-two severely malnourished patients with Crohn's disease who had undergone surgery in our hospital were reviewed. Sixteen patients who received perioperative parenteral nutrition were enrolled in the study group, and the other 16 patients who did not receive parenteral nutrition were enrolled in the control group. Serum immunoglobulin, body mass index (BMI), liver function, weight change, and postoperative complications were evaluated. RESULTS: Serum IgM levels elevated 1 wk before surgery in both groups, and decreased to normal value (from 139+/-41 to 105+/-29 mg/dL, P = 0.04) 4 wk after operation in the study group, while no significant changes was noted in the control group (from 133+/-16 to 129+/-13 mg/dL, P = 0.34). There were no significant changes in concentrations of IgG and IgA. The BMI of the study group increased from 13.9+/-0.6 to 15.3+/-0.7 kg/m(2) (P = 0.02) with no significant change in the control group (14.1+/-0.7 and 14.5+/-0.5, respectively, P = 0.81). The percentage of resuming work was higher in the study group than in the control group. CONCLUSION: Perioperative parenteral nutrition possibly ameliorates the humoral immunity, reverses malnutrition, and facilitates rehabilitation.},
   keywords = {Crohn Disease/*complications
Humans
Immunoglobulin A/blood
Immunoglobulin G/blood
Immunoglobulin M/blood
Malnutrition/*complications/*diet therapy
*Parenteral Nutrition
*Perioperative Care
Weight Gain},
   ISSN = {1007-9327 (Print)
1007-9327},
   Accession Number = {16237776},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Zheng, J. J.},
   title = {Clinical aspects of ulcerative colitis in mainland China},
   journal = {Chin J Dig Dis},
   volume = {7},
   number = {2},
   pages = {71-5},
   note = {Zheng, Jia Ju
Journal Article
Review
Australia
Chin J Dig Dis. 2006;7(2):71-5.},
   abstract = {Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is reported to be increasing in incidence and prevalence in provinces and cities in mainland China. This article specifically reviews clinical features, extra-intestinal manifestations, complications, diagnosis and differential diagnosis, and medical treatment of UC. Compared to patients in Western countries, more mild to moderate and left-sided colitis cases were observed in a nation-wide study in China. Complications included anal fistula, anal abscess, anal fissure, severe bleeding, intestinal perforation, intestinal obstruction and colonic carcinoma. The extra-intestinal manifestations were arthritis/arthralgia, eye and skin disorders and oral ulcers. The high specificity of antineutrophil cytoplasmic antibody may useful for distinguishing UC from infectious colitis; in addition, serum levels of anti-saccharomyces cerevisiae antibody may be helpful for distinguishing between UC and CD. Oral sulfasalazine and 5-aminosalicylic acid (ASA) remain the mainstays for the management of mild to moderate UC in China. Corticosteroids and immunosuppressive agents are also widely used in severe or refractory UC.},
   keywords = {Aminosalicylic Acids/therapeutic use
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
China/epidemiology
Colitis, Ulcerative/diagnosis/drug therapy/epidemiology/etiology/*pathology
Crohn Disease/diagnosis
Diagnosis, Differential
Diagnostic Errors
Humans
Sulfasalazine/therapeutic use},
   ISSN = {1443-9611 (Print)
1443-9573},
   Accession Number = {16643333},
   DOI = {10.1111/j.1443-9573.2006.00251.x},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Zheng, J. J. and Zhu, X. S. and Huangfu, Z. and Gao, Z. X. and Guo, Z. R. and Wang, Z.},
   title = {Crohn's disease in mainland China: a systematic analysis of 50 years of research},
   journal = {Chin J Dig Dis},
   volume = {6},
   number = {4},
   pages = {175-81},
   note = {Zheng, Jia Ju
Zhu, Xia Shuang
Huangfu, Zhao
Gao, Zhi Xin
Guo, Zhi Rong
Wang, Zhen
Journal Article
Review
Australia
Chin J Dig Dis. 2005;6(4):175-81.},
   abstract = {BACKGROUND: Crohn's disease appears to be increasing in frequency in many areas of the world. However, little information with regard to disease incidence, prevalence and temporal trends has been published in China. OBJECTIVE: The aim of this review is to better understand the occurrence of Crohn's disease in mainland China, and to give an overview of the current status of the disease. METHODS: We used a computer-based literature search using 50-years of records from the Chinese Database of Biology and Medicine (CBM, 1979-2002), combined with a manual year-by-year search of the literature from 1950 to 1979. Each article was double-reviewed, and all descriptive epidemiological data were recorded, pooled and statistically analyzed. RESULTS: In total, 1526 cases of Crohn's disease since 1950 have been reported by more than 50 hospitals from 22 provinces and cities in mainland China, comprising 884 male and 642 female patients, with a 1.38:1 male predominance. More than 70% of patients were aged 20 to 50 years old, with a mean age of 37.2 +/- 2.68 (ranging from 1 to 83) years. The extrapolated disease incidence and prevalence rates are 0.28/100,000 person years and 1.38/100,000 persons, respectively. CONCLUSIONS: The incidence and prevalence rates of Crohn's disease are still lower than those in Western and other Asian countries, but these rates have been increasing rapidly, and the disease is no longer uncommon. An underestimation may occur because the patients who were misdiagnosed or did not seek medical advice could not be included in the study. A future population-based survey is warranted.},
   keywords = {Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Child
Child, Preschool
China/epidemiology
Crohn Disease/*epidemiology
Female
Humans
Incidence
Infant
Male
Middle Aged
Prevalence},
   ISSN = {1443-9611 (Print)
1443-9573},
   Accession Number = {16246226},
   DOI = {10.1111/j.1443-9573.2005.00227.x},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Zhong, J. and Eckhardt, E. R. and Oz, H. S. and Bruemmer, D. and de Villiers, W. J.},
   title = {Osteopontin deficiency protects mice from Dextran sodium sulfate-induced colitis},
   journal = {Inflamm Bowel Dis},
   volume = {12},
   number = {8},
   pages = {790-6},
   note = {Zhong, Jian
Eckhardt, Erik R M
Oz, Helieh S
Bruemmer, Dennis
de Villiers, Willem J S
Journal Article
United States
Inflamm Bowel Dis. 2006 Aug;12(8):790-6.},
   abstract = {BACKGROUND: Osteopontin (OPN), a secreted glycoprotein that promotes TH1 immune responses, is involved in several inflammatory conditions. Recently, OPN plasma levels have been demonstrated to be elevated in patients with Crohn's disease. From this evidence, we investigated in the present study whether OPN deficiency protects mice against dextran sodium sulfate (DSS)-induced colitis. MATERIALS AND METHODS: Colitis was induced in OPN -/- mice and matched wild-type Black Swiss control mice by adding 3.5% DSS to their drinking water. Disease progression was evaluated for 10 days by measuring body weight, stool consistency, rectal bleeding, colon lengths, histology, and immunohistochemistry. Levels of the acute-phase protein serum amyloid A, O PN, the proinflammatory cytokines interleukin (IL)-6 and IL-12, and the anti-inflammatory cytokine IL-10 were measured in the serum and, in the case of IL-10 and IL-12, in supernatants from colonic explants at the end of treatment. RESULTS: After DSS treatment, OPN -/- mice exhibited significantly decreased disease activity compared with wild-type mice, as evidenced by reduced rectal bleeding, weight loss, and histological intestinal injury (P < 0.002). Furthermore, serum levels of serum amyloid A and IL-6 increased to a lesser extent (P < 0.001), which also was the case for the release of IL-12 by colonic explants (P < 0.01). The release of IL-10 by colonic explants, however, was increased (P < 0.01). Serum levels of IL-10 and IL-12 were not affected by DSS treatment in both wild-type and OPN-/- mice. Macrophage infiltration into inflamed colonic tissue also was markedly attenuated in DSS-treated OPN -/- mice compared with wild-type mice. CONCLUSIONS: This study shows that OPN deficiency significantly protected mice from colitis by attenuating the TH1 response and macrophage chemotaxis. OPN may represent a novel attractive target for pharmacological treatment of inflammatory bowel disease.},
   keywords = {Administration, Oral
Animals
Colitis/chemically induced/metabolism/*prevention & control
Colon/pathology
Cytokines/blood/*metabolism
Dextran Sulfate
Mice
Mice, Transgenic
Osteopontin
Serum Amyloid A Protein/*metabolism
Sialoglycoproteins/*deficiency},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {16917234},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Zvirbliene, A. and Kiudelis, G. and Zalinkevicius, R. and Kupcinskas, L.},
   title = {[Dietary characteristics of patients with inflammatory bowel diseases]},
   journal = {Medicina (Kaunas)},
   volume = {42},
   number = {11},
   pages = {895-9},
   note = {1648-9144
Zvirbliene, Aida
Kiudelis, Gediminas
Zalinkevicius, Rimantas
Kupcinskas, Limas
Comparative Study
Evaluation Studies
Journal Article
Netherlands
Medicina (Kaunas). 2006;42(11):895-9.},
   abstract = {OBJECTIVE: To evaluate nutritional status and dietary habits of Lithuanian patients with ulcerative colitis and Crohn's disease and to compare with those of healthy controls. MATERIALS AND METHODS: A case-control study was conducted in the Department of Gastroenterology, Kaunas University of Medicine Hospital. A total of 101 patients with ulcerative colitis, 44 with Crohn's disease, and 178 healthy controls were examined with the help of standard self-report questionnaire about daily dietary habits. Healthy controls were evaluated in primary care centers during preventive examinations. Body mass index was calculated for all patients in a standard way. RESULTS: There was no statistically significant difference between patients and controls concerning consumption of coffee, tea, chewing gum, type of fat for meal preparation, white bread, cooked potatoes and sausages, non-carbonated water. Patients with inflammatory bowel diseases statistically significantly less frequently consumed fresh milk, cheese, fish, fried potatoes, and soda drinks. Patients with Crohn's disease statistically significantly less frequently consumed fresh fruits and patients with ulcerative colitis--fresh vegetables as compared to controls. Body mass index of patients with inflammatory bowel diseases was significantly lower compared to controls, and patients with Crohn's disease had significantly lower body mass index than ulcerative colitis patients. CONCLUSIONS: Patients with inflammatory bowel diseases have lower body mass index than healthy controls. Patients consume fresh milk, cheese, canned and fresh vegetables and fruits less frequently; therefore, primary care physicians and patients should be provided with teaching and more information about nutrition issues.},
   keywords = {Adult
Body Mass Index
Case-Control Studies
*Colitis, Ulcerative/epidemiology
*Crohn Disease/epidemiology
Diet Surveys
*Feeding Behavior
Female
Humans
Male
Middle Aged
*Nutritional Status
Patient Education as Topic
Primary Health Care
Rural Population
Surveys and Questionnaires
Urban Population},
   ISSN = {1010-660x},
   Accession Number = {17172790},
   year = {2006},
   type = {Ref–rence Type}
}

license: MIT

license_type: permissive

branch_name: refs/heads/master

extension: bib