text:
and its activity, age, Body body mass index (BMI), weight loss history, the hospitalization period; the dependent variables were SGA, bowel movements, change in nutritional status, disease severity, clinical findings, and also consumption of macronutrients. RESULTS: Prevalance of malnutrition (SGA-B or SGA-C) for all the patients was 92.1% at the beginning and 71.1% at the end of study. Improvements in disease activity score for the patients with UC were statistically significant in both the Study Group and the Controls (p=0.006 for the Study Group and p=0.001 for the Controls, respectively). Macronutrients, total and water soluble fiber consumption levels improved, with statistically significant differences for all the groups. CONCLUSION: The prevalence of malnutrition is a major problem in patients with IBD. Not only the regulation of hospital food, but also enteral nutritional support, improved their levels of malnutrition, as well as their energy, macronutrients, and fiber consumption, and SGA is an easy method for nutritional monitoring.},
   keywords = {Adolescent
Adult
Aged
Body Mass Index
Colitis, Ulcerative/*complications
Crohn Disease/*complications
Dietary Carbohydrates
Dietary Fats
Dietary Fiber
Dietary Proteins
Energy Intake
Energy Metabolism
*Enteral Nutrition
Female
Humans
Length of Stay
Male
Malnutrition/complications/*therapy
Middle Aged
*Nutritional Status
Severity of Illness Index
Weight Gain
Young Adult},
   ISSN = {1300-4948},
   Accession Number = {25417609},
   DOI = {10.5152/tjg.2014.4955},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Soldavini, J. and Kaunitz, J. D.},
   title = {Pathobiology and potential therapeutic value of intestinal short-chain fatty acids in gut inflammation and obesity},
   journal = {Dig Dis Sci},
   volume = {58},
   number = {10},
   pages = {2756-66},
   note = {1573-2568
Soldavini, Jessica
Kaunitz, Jonathan D
I01 BX001245/BX/BLRD VA/United States
R01 DK054221/DK/NIDDK NIH HHS/United States
Journal Article
Review
United States
Dig Dis Sci. 2013 Oct;58(10):2756-66. doi: 10.1007/s10620-013-2744-4. Epub 2013 Jul 10.},
   abstract = {BACKGROUND: The lumen of the gastrointestinal tract contains many substances produced from the breakdown of foodstuffs, from salivary, esophageal, intestinal, hepatic, and pancreatic secretions, and from sloughed cells present in the gastrointestinal lumen. Although these substances were traditionally regarded as waste products, there is increasing realization that many can be biologically active, either as signalling compounds or as nutrients. For example, proteins are broken down into amino acids, which are then sensed by nutrient receptors. The gut microbiome, which is at highest abundance in the ileocecum, has powerful metabolic activity, digesting and breaking down unabsorbed carbohydrates, proteins, and other ingested nutrients into phenols, amines, volatile organic compounds, methane, carbon dioxide, hydrogen, and hydrogen sulfide into volatile fatty acids, also called short-chain fatty acids (SCFAs). CONCLUSION: These latter substances are the topic of this review. In this review, we will briefly discuss recent advances in the understanding SCFA production, signalling, and absorption, followed by a detailed description and discussion of trials of SCFAs, probiotics, and prebiotics in the treatment of gastrointestinal disease, in particular ulcerative colitis (UC), pouchitis, short bowel syndrome, and obesity.},
   keywords = {Colitis, Ulcerative/drug therapy/physiopathology
Fatty Acids, Volatile/*metabolism/*therapeutic use
Gastrointestinal Diseases/*drug therapy/physiopathology
Humans
Inflammation/*drug therapy/physiopathology
Intestinal Absorption/physiology
Intestines/*metabolism
Obesity/*drug therapy/physiopathology
Pouchitis/drug therapy/physiopathology
Short Bowel Syndrome/drug therapy/physiopathology
Signal Transduction/physiology},
   ISSN = {0163-2116},
   Accession Number = {23839339},
   DOI = {10.1007/s10620-013-2744-4},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Soliman, A. M. and Carlson, A. M.},
   title = {Analysis of health care cost data: a cautionary tale},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {56},
   number = {2},
   pages = {e12},
   note = {1536-4801
Soliman, Ahmed M
Carlson, Angeline M
Comment
Letter
United States
J Pediatr Gastroenterol Nutr. 2013 Feb;56(2):e12. doi: 10.1097/MPG.0b013e31827e20b3.},
   keywords = {Colitis, Ulcerative/*economics
Crohn Disease/*economics
Female
*Health Care Costs
Hospitalization/*economics
Humans
*Inpatients
Male},
   ISSN = {0277-2116},
   Accession Number = {23201708},
   DOI = {10.1097/MPG.0b013e31827e20b3},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Song, J. L. and Choi, J. H. and Seo, J. H. and Lim, Y. I. and Park, K. Y.},
   title = {Anti-colitic effects of kanjangs (fermented soy sauce and sesame sauce) in dextran sulfate sodium-induced colitis in mice},
   journal = {J Med Food},
   volume = {17},
   number = {9},
   pages = {1027-35},
   note = {1557-7600
Song, Jia-Le
Choi, Jung-Ho
Seo, Jae-Hoon
Lim, Yaung-Iee
Park, Kun-Young
Journal Article
Research Support, Non-U.S. Gov't
United States
J Med Food. 2014 Sep;17(9):1027-35. doi: 10.1089/jmf.2013.3119.},
   abstract = {This study was conducted to investigate the preventive effects of different kanjangs (Korean soy sauces), including acid-hydrolyzed soy sauce (AHSS), fermented soy sauce (FSS), and fermented sesame sauce (FSeS), on 2% dextran sulfate sodium (DSS)-induced ulcerative colitis in C57BL/6J mice. The fermented sauces, particularly FSeS, significantly suppressed DSS-induced body weight loss, increased colon length, and decreased colon weight/length ratios. Histological observations suggested that the fermented sauces prevented edema, mucosal damage, and the loss of crypts induced by DSS compared to the control mice and animals fed AHSS. FSeS and FSS decreased the serum levels of tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), interleukin (IL)-6, and IL-17alpha. mRNA expression of these cytokines as well as that of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in colon mucosa was also inhibited by the two sauces. Our results suggest that fermented sauces, especially FSeS, exert an anticolitic effect partially by reducing the serum levels of proinflammatory cytokines and inhibiting the mRNA expression of these factors in the colon tissue of mice treated with DSS. However, AHSS did not protect against DSS-induced colitis. In addition, low-dose treatment (4 mL/kg) with the fermented sauces resulted in greater anticolitic effects than consumption of a high quantity (8 mL/kg) of the sauces.},
   keywords = {Animals
Anti-Inflammatory Agents/pharmacology/therapeutic use
Colitis, Ulcerative/blood/chemically induced/*diet therapy/pathology
Colon/*drug effects/metabolism/pathology
Cyclooxygenase 2/blood/genetics/metabolism
Cytokines/blood/genetics/*metabolism
Dextran Sulfate
Edema/prevention & control
Female
Fermentation
Intestinal Mucosa/*drug effects/metabolism/pathology
Mice, Inbred C57BL
Nitric Oxide Synthase Type II/blood/genetics/metabolism
Phytotherapy
Plant Preparations/pharmacology/*therapeutic use
*Sesamum
*Soy Foods
Weight Loss/drug effects
colitis
dextran sulfate sodium
fermented sesame sauce
fermented soy sauce
kanjang
pro-inflammatory cytokines},
   ISSN = {1096-620x},
   Accession Number = {25188463},
   DOI = {10.1089/jmf.2013.3119},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Song, J. L. and Qian, Y. and Li, G. J. and Zhao, X.},
   title = {Anti-inflammatory effects of kudingcha methanol extract (Ilex kudingcha C.J. Tseng) in dextran sulfate sodium-induced ulcerative colitis},
   journal = {Mol Med Rep},
   volume = {8},
   number = {4},
   pages = {1256-62},
   note = {1791-3004
Song, Jia-Le
Qian, Yu
Li, Gui-Jie
Zhao, Xin
Journal Article
Greece
Mol Med Rep. 2013 Oct;8(4):1256-62. doi: 10.3892/mmr.2013.1635. Epub 2013 Aug 14.},
   abstract = {The present study aimed to investigate the antiinflammatory effects of Ilex kudingcha C.J. Tseng methanol extracts (KME) on 3% dextran sulfate sodium (DSS)induced ulcerative colitis (UC) in mice (C57BL/6J strain). Body weight, disease activity index (DAI), colon length, colon weight to length ratio, colonic myeloperoxidase (MPO), glutathione (GSH) and malondialdehyde (MDA) levels were measured. Histological changes were observed by hematoxylin and eosin staining. Colonic levels of tumor necrosis factoralpha (TNFalpha), interleukin(IL)1beta and IL6 were measured with an enzymelinked immunosorbent assay. The mRNA expression of TNFalpha, IL1beta, 6, inducible nitric oxide synthase (iNOS) and cyclooxygenase2 (COX-2) in the colon tissue, was quantified by RTPCR. KME significantly suppressed DSSinduced body weight loss, colon length shortening and decreased the colon weight to length ratio. It also resulted in increased GSH and reduced MPO and MDA levels in the colon tissue. Histological observation suggested that KME prevented edema, mucosal damage and loss of crypts, which are induced by DSS. In addition, KME decreased the levels of TNFalpha, IL1beta and 6 in the colon tissues, while inhibiting the mRNA expression of these cytokines, as well as iNOS and COX2. The results of this study suggested that KME has antiinflammatory effects on DSSinduced UC in mice (C57BL/6J strain) by reducing the colonic levels and inhibiting the mRNA expression of proinflammatory cytokines.},
   keywords = {Animals
Anti-Inflammatory Agents/*pharmacology/therapeutic use
Colitis, Ulcerative/chemically induced/*drug therapy/immunology
Colon/drug effects/pathology
Cyclooxygenase 2/genetics/metabolism
Cytokines/genetics/metabolism
Dextran Sulfate
Drug Evaluation, Preclinical
Drugs, Chinese Herbal/*pharmacology/therapeutic use
Gene Expression
Glutathione/metabolism
Ilex/*chemistry
Male
Malondialdehyde/metabolism
Methanol/chemistry
Mice
Mice, Inbred C57BL
Nitric Oxide Synthase Type II/genetics/metabolism
Solvents/chemistry},
   ISSN = {1791-2997},
   Accession Number = {23969782},
   DOI = {10.3892/mmr.2013.1635},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Speca, S. and Dubuquoy, L. and Desreumaux, P.},
   title = {Peroxisome proliferator-activated receptor gamma in the colon: inflammation and innate antimicrobial immunity},
   journal = {J Clin Gastroenterol},
   volume = {48 Suppl 1},
   pages = {S23-7},
   note = {1539-2031
Speca, Silvia
Dubuquoy, Laurent
Desreumaux, Pierre
Journal Article
Research Support, Non-U.S. Gov't
Review
United States
J Clin Gastroenterol. 2014 Nov-Dec;48 Suppl 1:S23-7. doi: 10.1097/MCG.0000000000000253.},
   abstract = {Peroxisome proliferator-activated receptor gamma (PPARgamma) is a nuclear receptor, originally described in adipose tissue, which controls the expression of a large number of regulatory genes in lipid metabolism and insulin sensitization. Well known by endocrinologists, thiazolidinedionesare classical PPARgamma synthetic agonists, which were currently used as insulin-sensitizing agents in the treatment of type 2 diabetes. Although the clinical benefits of thiazolidinediones in treating metabolic disorders have been clearly demonstrated, studies performed in animal models of colitis and in patients with ulcerative colitis have also revealed the key roles of PPARgamma activation in the regulation of inflammation and immune response, notably in the colon through epithelial cells.},
   keywords = {Animals
Anti-Inflammatory Agents/therapeutic use
Bacteria/immunology/*metabolism
Colon/drug effects/immunology/*metabolism/microbiology
Gastrointestinal Agents/therapeutic use
Host-Pathogen Interactions
Humans
*Immunity, Innate/drug effects
Inflammatory Bowel Diseases/drug therapy/immunology/*metabolism/microbiology
Intestinal Mucosa/drug effects/immunology/*metabolism/microbiology
PPAR gamma/agonists/immunology/*metabolism
Signal Transduction
Thiazolidinediones/therapeutic use},
   ISSN = {0192-0790},
   Accession Number = {25291120},
   DOI = {10.1097/mcg.0000000000000253},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Spooren, C. E. and Pierik, M. J. and Zeegers, M. P. and Feskens, E. J. and Masclee, A. A. and Jonkers, D. M.},
   title = {Review article: the association of diet with onset and relapse in patients with inflammatory bowel disease},
   journal = {Aliment Pharmacol Ther},
   volume = {38},
   number = {10},
   pages = {1172-87},
   note = {1365-2036
Spooren, C E G M
Pierik, M J
Zeegers, M P
Feskens, E J M
Masclee, A A M
Jonkers, D M A E
Journal Article
Research Support, Non-U.S. Gov't
Review
England
Aliment Pharmacol Ther. 2013 Nov;38(10):1172-87. doi: 10.1111/apt.12501. Epub 2013 Oct 3.},
   abstract = {BACKGROUND: The role of diet in inflammatory bowel disease (IBD) is supported by migration studies and increasing incidences in line with Westernisation. AIM: To give a complete overview of studies associating habitual diet with the onset or relapses in ulcerative colitis (UC) or Crohn's disease (CD). METHODS: A structured search in Pubmed, the Cochrane Library and EMBASE was performed using defined key words, including only full text papers in English language. RESULTS: Forty-one studies were identified, investigating onset (n = 35), relapses (n = 5) or both (n = 1). Several studies reported high intake of sugar or sugar-containing foods (n = 7 UC, n = 12 CD), and low intake of fruits and/or vegetables (n = 5 UC, n = 10 CD) to be associated with an increased onset risk. However, these findings could not be confirmed by similar or higher numbers of other studies. A possible protective role was found for grain-derived products in CD onset, but results were inconsistent for dietary fibre in UC and CD and grain-derived products in UC. No definite conclusions could be drawn for unsaturated fatty acids (UFA), protein and energy intake due to limited and/or inconsistent results. Six studies reported on diet and relapse risk, of which only two (n = 1 UC, n = 1 CD) had a prospective follow-up. CONCLUSIONS: The current evidence is not sufficient to draw firm conclusions on the role of specific food components or nutrients in the aetiology of IBD. Furthermore, large prospective studies into the role of habitual diet as a trigger of relapses are needed, to identify new therapeutic or preventive targets.},
   keywords = {Colitis, Ulcerative/epidemiology/*etiology
Crohn Disease/epidemiology/*etiology
Diet/*adverse effects
Energy Intake
Feeding Behavior
Humans
Recurrence
Research Design
Risk},
   ISSN = {0269-2813},
   Accession Number = {24118051},
   DOI = {10.1111/apt.12501},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Spooren, C. E. and Pierik, M. J. and Zeegers, M. P. and Feskens, E. J. and Masclee, A. A. and Jonkers, D. M.},
   title = {Letter: role of diet in the onset and relapse of inflammatory bowel disease from the patients' perspective--authors' reply},
   journal = {Aliment Pharmacol Ther},
   volume = {39},
   number = {3},
   pages = {340-1},
   note = {1365-2036
Spooren, C E G M
Pierik, M J
Zeegers, M P
Feskens, E J M
Masclee, A A M
Jonkers, D M A E
Comment
Letter
England
Aliment Pharmacol Ther. 2014 Feb;39(3):340-1. doi: 10.1111/apt.12586.},
   keywords = {Colitis, Ulcerative/*etiology
Crohn Disease/*etiology
Diet/*adverse effects
Humans},
   ISSN = {0269-2813},
   Accession Number = {24397322},
   DOI = {10.1111/apt.12586},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Stadnicki, A.},
   title = {Thrombin generation and microparticles in inflammatory bowel diseases},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {56},
   number = {4},
   pages = {343},
   note = {1536-4801
Stadnicki, Antoni
Comment
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2013 Apr;56(4):343. doi: 10.1097/MPG.0b013e31827daf94.},
   keywords = {*Blood Coagulation
Cell-Derived Microparticles/*metabolism
Colitis, Ulcerative/*physiopathology
Crohn Disease/*physiopathology
Female
Humans
Male
Thrombin/*metabolism
Thromboplastin/*metabolism
Venous Thromboembolism/*etiology},
   ISSN = {0277-2116},
   Accession Number = {23531480},
   DOI = {10.1097/MPG.0b013e31827daf94},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Stein, A. C. and Cohen, R. D.},
   title = {Dietary fiber intake and Crohn's disease},
   journal = {Gastroenterology},
   volume = {146},
   number = {4},
   pages = {1133},
   note = {1528-0012
Stein, Adam C
Cohen, Russell D
Comment
Letter
United States
Gastroenterology. 2014 Apr;146(4):1133. doi: 10.1053/j.gastro.2013.12.044. Epub 2014 Feb 24.},
   keywords = {Colitis, Ulcerative/*epidemiology
Crohn Disease/*epidemiology
Dietary Fiber/*administration & dosage/*therapeutic use
Female
Humans},
   ISSN = {0016-5085},
   Accession Number = {24576734},
   DOI = {10.1053/j.gastro.2013.12.044},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Strid, H. and Simren, M. and Lasson, A. and Isaksson, S. and Stridsberg, M. and Ohman, L.},
   title = {Fecal chromogranins and secretogranins are increased in patients with ulcerative colitis but are not associated with disease activity},
   journal = {J Crohns Colitis},
   volume = {7},
   number = {12},
   pages = {e615-22},
   note = {1876-4479
Strid, Hans
Simren, Magnus
Lasson, Anders
Isaksson, Stefan
Stridsberg, Mats
Ohman, Lena
Journal Article
Research Support, Non-U.S. Gov't
England
J Crohns Colitis. 2013 Dec;7(12):e615-22. doi: 10.1016/j.crohns.2013.04.019. Epub 2013 May 18.},
   abstract = {BACKGROUND: Little is known of the importance of chromogranins (Cg) and secretogranins (Sg) in ulcerative colitis (UC). We therefore investigated fecal levels of CgA, CgB, SgII and SgIII, and their association with inflammatory activity, disease duration and medical therapy in UC. METHODS: Analyses of CgA, CgB, SgII, SgIII and calprotectin in stool samples from 41 UC patients and 29 healthy controls were performed. Two stool samples, during relapse and remission, respectively, were obtained from each UC patient. RESULTS: The levels of fecal CgA and SgII were higher in UC patients with active disease as compared to healthy controls. CgB and SgII were positively correlated with disease duration, but none of the granins were positively correlated with calprotectin, Mayo score, CRP or serum concentrations of TNF in UC patients with active disease. Also UC patients in remission had higher levels of CgA, CgB, SgII, and SgIII as compared to healthy controls. However, levels of fecal CgA, CgB, SgII and SgIII were lower during active disease relative to remission. Moreover, fecal levels of CgA and SgII were higher in UC patients in remission treated with thiopurines than in thiopurine-naive patients in remission. CONCLUSION: Fecal chromogranins and secretogranins are increased in UC but are not associated with disease activity, but seem to increase with duration of the disease. Thus, fecal granins might reflect structural changes associated with chronicity of disease, or medical therapy.},
   keywords = {Adult
C-Reactive Protein/metabolism
Chromogranin A/*analysis
Chromogranin B/*analysis
Chromogranins/*analysis
Colitis, Ulcerative/blood/drug therapy/*metabolism
Feces/*chemistry
Female
Humans
Leukocyte L1 Antigen Complex/analysis
Male
Middle Aged
Purines/therapeutic use
Recurrence
Remission Induction
Secretogranin II/*analysis
Severity of Illness Index
Time Factors
Tumor Necrosis Factor-alpha/blood
Young Adult
Chromogranin
Ibd
Secretogranin
Ulcerative colitis},
   ISSN = {1873-9946},
   Accession Number = {23694857},
   DOI = {10.1016/j.crohns.2013.04.019},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Sukumaran, A. and James, J. and Janardhan, H. P. and Amaladas, A. and Suresh, L. M. and Danda, D. and Jeyeseelan, V. and Ramakrishna, B. S. and Jacob, M.},
   title = {Expression of iron-related proteins in the duodenum is up-regulated in patients with chronic inflammatory disorders},
   journal = {Br J Nutr},
   volume = {111},
   number = {6},
   pages = {1059-68},
   note = {1475-2662
Sukumaran, Abitha
James, Jithu
Janardhan, Harish Palleti
Amaladas, Anita
Suresh, Lekshmy Madathilazhikathu
Danda, Debashish
Jeyeseelan, Visalakshi
Ramakrishna, Balakrishnan Siddharth
Jacob, Molly
Journal Article
Research Support, Non-U.S. Gov't
England
Br J Nutr. 2014 Mar 28;111(6):1059-68. doi: 10.1017/S0007114513003334. Epub 2013 Oct 25.},
   abstract = {Mechanisms responsible for derangements in Fe homeostasis in chronic inflammatory conditions are not entirely clear. The aim of the present study was to test the hypothesis that inflammation affects the expression of Fe-related proteins in the duodenum and monocytes of patients with chronic inflammatory disorders, thus contributing to dysregulated Fe homeostasis. Duodenal mucosal samples and peripheral blood monocytes obtained from patients with chronic inflammatory disorders, namely ulcerative colitis (UC), Crohn's disease (CD) and rheumatoid arthritis, were used for gene and protein expression studies. Hb levels were significantly lower and serum C-reactive protein levels were significantly higher in patients in the disease groups. The gene expression of several Fe-related proteins in the duodenum was significantly up-regulated in patients with UC and CD. In patients with UC, the protein expression of divalent metal transporter 1 and ferroportin, which are involved in the absorption of dietary non-haem Fe, was also found to be significantly higher in the duodenal mucosa. The gene expression of the duodenal proteins of interest correlated positively with one another and negatively with Hb. In patients with UC, the gene expression of Fe-related proteins in monocytes was found to be unaffected. In a separate group of patients with UC, serum hepcidin levels were found to be significantly lower than those in the control group. In conclusion, the expression of Fe-related proteins was up-regulated in the duodenum of patients with chronic inflammatory conditions in the present study. The effects appeared to be secondary to anaemia and the consequent erythropoietic drive.},
   keywords = {Adult
Aged
Arthritis, Rheumatoid/*metabolism
C-Reactive Protein/analysis
Colitis, Ulcerative/metabolism
Crohn Disease/metabolism
Duodenum/*metabolism
Female
Ferritins/blood/genetics
*Gene Expression
Hemoglobins/analysis
Hepcidins/blood
Humans
Inflammatory Bowel Diseases/*metabolism
Iron/blood/*metabolism
Iron-Binding Proteins/genetics
Male
Middle Aged
Monocytes/metabolism
*Up-Regulation},
   ISSN = {0007-1145},
   Accession Number = {24160450},
   DOI = {10.1017/s0007114513003334},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Sun, H. and Lee, J. J. and Papadopoulos, E. J. and Lee, C. S. and Nelson, R. M. and Sachs, H. C. and Rodriguez, W. J. and Mulberg, A. E.},
   title = {Alternate endpoints and clinical outcome assessments in pediatric ulcerative colitis registration trials},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {58},
   number = {1},
   pages = {12-7},
   note = {1536-4801
Sun, Haihao
Lee, Jessica J
Papadopoulos, Elektra J
Lee, Catherine S
Nelson, Robert M
Sachs, Hari C
Rodriguez, William J
Mulberg, Andrew E
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2014 Jan;58(1):12-7. doi: 10.1097/MPG.0000000000000186.},
   abstract = {OBJECTIVES: Presently, there is no consensus on endpoint measures to assess clinical outcomes for pediatric ulcerative colitis (UC). This study reviewed the endpoints used in the registration trials of approved drugs for pediatric UC. METHODS: The primary efficacy endpoints of all registration trials completed from 1950 to 2008 that led to Food and Drug Administration approval for indications in pediatric and adult UC were reviewed. RESULTS: Colazal and Remicade have been approved for pediatric UC indication, and clinical response was used as a primary endpoint in these registration trials. The clinical response in the adult Colazal trials was defined as a reduction of rectal bleeding and improvement in at least one of the other assessed symptoms (stool frequency, patient functional assessment, abdominal pain, sigmoidoscopic grade, and physician's global assessment) assessed by the Sutherland UC Activity Index. The pediatric Colazal trial defined clinical response using the Modified Sutherland UC Activity Index, which excluded abdominal pain and functional assessment. Both adult and pediatric Remicade trials used clinical response defined by the Mayo score as the primary endpoint. The Pediatric Ulcerative Colitis Activity Index was used to measure various secondary endpoints in the pediatric Remicade trial. CONCLUSIONS: Pediatric-specific endpoints were used, but outcome measures and definition of clinical response were not consistent in pediatric UC trials. Consensus on the definition of successful treatment outcome (clinical response and/or remission) and collaboration in the development of well-defined and reliable measures of signs and symptoms for use in conjunction with endoscopic parameters of mucosal healing will facilitate pediatric drug development.},
   keywords = {Antibodies, Monoclonal/*therapeutic use
Colitis, Ulcerative/complications/*drug therapy
Humans
Infliximab
Mesalamine/*therapeutic use
*Outcome Assessment (Health Care)
Phenylhydrazines/*therapeutic use},
   ISSN = {0277-2116},
   Accession Number = {24121142},
   DOI = {10.1097/mpg.0000000000000186},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Sun, H. and Vesely, R. and Nelson, R. M. and Taminiau, J. and Szitanyi, P. and Isaac, M. and Klein, A. and Uzu, S. and Griebel, D. and Mulberg, A. E.},
   title = {Steps toward harmonization for clinical development of medicines in pediatric ulcerative colitis-a global scientific discussion, part 2: data extrapolation, trial design, and pharmacokinetics},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {58},
   number = {6},
   pages = {684-8},
   note = {1536-4801
Sun, Haihao
Vesely, Richard
Nelson, Robert M
Taminiau, Jan
Szitanyi, Peter
Isaac, Maria
Klein, Agnes
Uzu, Shinobu
Griebel, Donna
Mulberg, Andrew E
International Inflammatory Bowel Disease Working Group
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2014 Jun;58(6):684-8. doi: 10.1097/MPG.0000000000000322.},
   abstract = {OBJECTIVES: To facilitate global drug development, the International Pediatric Inflammatory Bowel Disease Working Group (i-IBD Working Group) discussed data extrapolation, trial design, and pharmacokinetic (PK) considerations for drugs intended to treat pediatric ulcerative colitis (UC), and considered possible approaches toward harmonized drug development. METHODS: Representatives from the US Food and Drug Administration, European Medicines Agency, Health Canada, and the Pharmaceuticals and Medical Devices Agency of Japan convened monthly to explore existing regulatory approaches, reviewed the results of a literature search, and provided perspectives on pediatric UC drug development based on the available medical literature. RESULTS: Although pediatric UC, when compared with UC in adults, has a similar disease progression and response to intervention, the similarity of the exposure-response relation has not been adequately established. Consequently, clinical endpoints should be selected to optimally assess efficacy in children. The inclusion of a placebo control in pediatric trials to assure assay sensitivity may be appropriate under limited circumstances. In clinical studies, although the drug under investigation could provide possible direct benefit, placebo treatment should present no more than a minor increase over minimal risk to children with UC. CONCLUSIONS: Partial extrapolation of efficacy from informative adult studies may be appropriate. Placebo-controlled efficacy trials are scientifically and ethically appropriate for pediatric UC given appropriate patient selection and the use of early escape. Clinical studies in pediatric UC may include initial dose-finding studies and exposure-response modeling followed by an efficacy and safety study to further explore the exposure-response relation.},
   keywords = {Canada
Child
*Clinical Trials as Topic
Colitis, Ulcerative/*drug therapy
Cooperative Behavior
Dose-Response Relationship, Drug
Europe
Humans
Japan
*Outcome Assessment (Health Care)
Pharmacokinetics
Placebo Effect
*Research Design
United States},
   ISSN = {0277-2116},
   Accession Number = {24866782},
   DOI = {10.1097/mpg.0000000000000322},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Sun, H. and Vesely, R. and Taminiau, J. and Szitanyi, P. and Papadopoulos, E. J. and Isaac, M. and Klein, A. and Uzu, S. and Griebel, D. and Mulberg, A. E.},
   title = {Steps toward harmonization for clinical development of medicines in pediatric ulcerative colitis-a global scientific discussion, part 1: efficacy endpoints and disease outcome assessments},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {58},
   number = {6},
   pages = {679-83},
   note = {1536-4801
Sun, Haihao
Vesely, Richard
Taminiau, Jan
Szitanyi, Peter
Papadopoulos, Elektra J
Isaac, Maria
Klein, Agnes
Uzu, Shinobu
Griebel, Donna
Mulberg, Andrew E
International Inflammatory Bowel Disease Working Group
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2014 Jun;58(6):679-83. doi: 10.1097/MPG.0000000000000306.},
   abstract = {OBJECTIVES: There is a pressing need for drug development in pediatric ulcerative colitis (UC). Lack of scientific consensus on efficacy endpoints and disease outcome assessments presents a hurdle for global drug development in pediatric UC. Scientists from 4 regulatory agencies convened an International Inflammatory Bowel Disease Working Group (i-IBD Working Group) to harmonize present thinking about various aspects of drug development in pediatric UC globally. METHODS: The i-IBD Working Group was convened in 2012 by scientists from the US Food and Drug Administration, European Medicines Agency, Health Canada, and the Pharmaceuticals and Medical Devices Agency of Japan. The members of this group considered reasons for differences in their acceptance of efficacy endpoints and disease activity indices used in pediatric UC, reviewed the available literature, and developed consensus opinions regarding approaches for evaluating outcomes in pediatric UC trials. RESULTS: There is lack of harmonization in using efficacy endpoint and outcome assessments including disease activity indices to assess clinical benefit in pediatric UC trials. Many disease activity indices have been developed, but their biometric properties, such as responsiveness, reliability, and validity, have not been properly validated. Biomarkers, such as fecal calprotectin and lactoferrin, are being investigated for their potential as noninvasive surrogate endpoints in UC. CONCLUSIONS: Consensus on the efficacy endpoints, disease activity indices, and outcome assessments is needed for globalization of pediatric UC trials. The i-IBD Working Group offers several perspectives to facilitate harmonization across regions. The development of noninvasive biomarkers as reliable surrogate endpoints needs to be explored further.},
   keywords = {Canada
Child
*Clinical Trials as Topic
Colitis, Ulcerative/*drug therapy
Cooperative Behavior
Europe
Humans
Japan
*Outcome Assessment (Health Care)
*Research Design
United States},
   ISSN = {0277-2116},
   Accession Number = {24866781},
   DOI = {10.1097/mpg.0000000000000306},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Sung, M. K. and Park, M. Y.},
   title = {Nutritional modulators of ulcerative colitis: clinical efficacies and mechanistic view},
   journal = {World J Gastroenterol},
   volume = {19},
   number = {7},
   pages = {994-1004},
   note = {2219-2840
Sung, Mi-Kyung
Park, Mi-Young
Journal Article
Research Support, Non-U.S. Gov't
Review
United States
World J Gastroenterol. 2013 Feb 21;19(7):994-1004. doi: 10.3748/wjg.v19.i7.994.},
   abstract = {Ulcerative colitis (UC) is an inflammation-associated disease of the colon and rectum. The onset and progress of the disease are directly influenced by the nature of the intestinal microflora, the intestinal barrier function, and the immunological responses of the host. The epithelial invasion of pathogenic bacteria due to excess contact and/or barrier dysfunction is related to inflammation mediated by intestinal immune responses. Although the etiology of UC is not clearly understood, recent studies have shown a rising incidence of UC worldwide, and this phenomenon is more prominent in Asian countries and in Asian immigrants in Western countries. The increased prevalence of UC also contributes to an increased risk of developing colorectal cancer. Environmental factors, including changes in dietary habits, have been suggested as major risk factors of UC. A systematic review showed a negative association between UC risk and vegetable intake, whereas total fat, omega-6 fatty acids and meat intake were positively associated with an increased risk of UC. Individual dietary factors and energy balance have been suggested as having important roles in inducing changes in the microbial population and intestinal barrier integrity and in regulating inflammatory immune responses, directly or indirectly. Excess energy intake is now known to increase pathogenic microbial populations. Likewise, the application of appropriate probiotics may reverse the pathogenic progression of the disease. In the meantime, dietary anti-inflammatory compounds, including omega-3 fatty acids and other phytochemicals, may directly suppress inflammatory responses in the course of UC development. In this review, the increased prevalence of UC and its management are interpreted from the standpoint of nutritional modulation to regulate the intestinal microflora population, intestinal epithelium permeability, and inflammatory responses.},
   keywords = {Animals
Anti-Inflammatory Agents/therapeutic use
Antioxidants/therapeutic use
Colitis, Ulcerative/epidemiology/immunology/microbiology/*physiopathology/therapy
Diet/*adverse effects
Energy Intake
Feeding Behavior
Humans
Intestines/immunology/microbiology/*physiopathology
Nutrition Assessment
*Nutritional Status
Permeability
Prevalence
Probiotics
Prognosis
Risk Factors
Risk Reduction Behavior
Antioxidants
Clinical
Immunity
Inflammation
Intestinal microflora
Obesity
Omega-3 fatty acids
Ulcerative colitis},
   ISSN = {1007-9327},
   Accession Number = {23467687},
   DOI = {10.3748/wjg.v19.i7.994},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Suskind, D. L. and Wahbeh, G. and Burpee, T. and Cohen, M. and Christie, D. and Weber, W.},
   title = {Tolerability of curcumin in pediatric inflammatory bowel disease: a forced-dose titration study},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {56},
   number = {3},
   pages = {277-9},
   note = {1536-4801
Suskind, David L
Wahbeh, Ghassan
Burpee, Tyler
Cohen, Morty
Christie, Dennis
Weber, Wendy
KL2 RR025015/RR/NCRR NIH HHS/United States
TL1 RR025016/RR/NCRR NIH HHS/United States
UL1 RR025014/RR/NCRR NIH HHS/United States
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
United States
J Pediatr Gastroenterol Nutr. 2013 Mar;56(3):277-9. doi: 10.1097/MPG.0b013e318276977d.},
   abstract = {BACKGROUND: Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation in the absence of a recognized etiology. The primary therapies are medications that possess anti-inflammatory or immunosuppressive effects. Given the high use of complementary alternative medicines in pediatric IBD, a prospective tolerability study of curcumin, an herbal therapy with known anti-inflammatory effects, was conducted to assess possible dosage in children with IBD. METHODS: Prospectively, patients with Crohn disease or ulcerative colitis in remission or with mild disease (Pediatric Crohn's Disease Activity Index [PCDAI] <30 or Pediatric Ulcerative Colitis Activity Index [PUCAI] score <34) were enrolled in a tolerability study. All patients received curcumin in addition to their standard therapy. Patients initially received 500 mg twice per day for 3 weeks. Using the forced-dose titration design, doses were increased up to 1 g twice per day at week 3 for a total of 3 weeks and then titrated again to 2 g twice per day at week 6 for 3 weeks. Validated measures of disease activity, using the PUCAI and PCDAI, and the Monitoring of Side Effect System score were obtained at weeks 3, 6, and 9. RESULTS: All patients tolerated curcumin well, with the only symptom that was consistently reported during all 3 visits being an increase in gassiness, which occurred in only 2 patients. Three patients saw improvement in PUCAI/PCDAI score. CONCLUSIONS: This pilot study suggests that curcumin may be used as an adjunctive therapy for individuals seeking a combination of conventional medicine and alternative medicine.},
   keywords = {Adolescent
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage/*adverse
effects/therapeutic use
Child
Colitis, Ulcerative/*diet therapy/drug therapy/immunology/physiopathology
Combined Modality Therapy/adverse effects
Crohn Disease/*diet therapy/drug therapy/immunology/physiopathology
Curcumin/administration & dosage/*adverse effects/therapeutic use
Dietary Supplements/*adverse effects/analysis
Female
Flatulence/etiology
Humans
Inflammatory Bowel Diseases/diet therapy/drug therapy/immunology/physiopathology
Male
Medicine, Ayurvedic
Mesalamine/therapeutic use
Pilot Projects
Remission Induction
Severity of Illness Index
Tumor Necrosis Factor-alpha/antagonists & inhibitors},
   ISSN = {0277-2116},
   Accession Number = {23059643},
   DOI = {10.1097/MPG.0b013e318276977d},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Swoger, J. M. and Regueiro, M.},
   title = {Stopping, continuing, or restarting immunomodulators and biologics when an infection or malignancy develops},
   journal = {Inflamm Bowel Dis},
   volume = {20},
   number = {5},
   pages = {926-35},
   note = {1536-4844
Swoger, Jason M
Regueiro, Miguel
Journal Article
Review
United States
Inflamm Bowel Dis. 2014 May;20(5):926-35. doi: 10.1097/MIB.0000000000000002.},
   abstract = {Thiopurines and biologics are being used earlier and more frequently for the treatment of Crohn's disease and ulcerative colitis. These medications are generally well tolerated and usually do not require cessation due to a side effect. Rare but serious infections and cancers may develop in patients on these immunosuppressants. Evidence-based data are lacking to guide physicians on whether continuing or stopping thiopurines and biologics is necessary and, when a side effect does occur, if and when restarting these medications is feasible. The aim of this review was to outline the infectious and malignant complications that may develop on these treatments and to provide recommendations for continuing, stopping, and restarting thiopurines and biologics once a patient develops a treatment-related complication. These are not formal guidelines and should not replace individualized care by the treating physician.},
   keywords = {Colitis, Ulcerative/*drug therapy
Crohn Disease/*drug therapy
Humans
Immunologic Factors/*therapeutic use
Infection/chemically induced/*drug therapy/epidemiology
Neoplasms/chemically induced/*drug therapy/epidemiology
Prognosis
Risk Factors},
   ISSN = {1078-0998},
   Accession Number = {24651584},
   DOI = {10.1097/mib.0000000000000002},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Takashima, T. and Sakata, Y. and Iwakiri, R. and Shiraishi, R. and Oda, Y. and Inoue, N. and Nakayama, A. and Toda, S. and Fujimoto, K.},
   title = {Feeding with olive oil attenuates inflammation in dextran sulfate sodium-induced colitis in rat},
   journal = {J Nutr Biochem},
   volume = {25},
   number = {2},
   pages = {186-92},
   note = {1873-4847
Takashima, Toru
Sakata, Yasuhisa
Iwakiri, Ryuichi
Shiraishi, Ryosuke
Oda, Yasutomo
Inoue, Norie
Nakayama, Atsushi
Toda, Shuji
Fujimoto, Kazuma
Journal Article
Research Support, Non-U.S. Gov't
United States
J Nutr Biochem. 2014 Feb;25(2):186-92. doi: 10.1016/j.jnutbio.2013.10.005. Epub 2013 Nov 8.},
   abstract = {Chronic inflammation of long-term ulcerative colitis contributes to an increased risk of colon cancer. Few studies address whether extra-virgin olive oil (EVOO) intake suppresses inflammation, cell proliferation and signal transducers and activators of transcription (STAT) in the experimental colitis model. The aim of this study was to assess whether a 5% EVOO suppressed inflammation, increased cell proliferation and the expressions of STAT3 and STAT3 phosphorylation (pSTAT3) in dextran sulfate sodium (DSS)-induced colitis. Rats were administered DSS via drinking water (weight percentage: 4%) for 1 week with a 1-week recovery period for three cycles. Rats were divided into three groups: control group, standard diet without DSS; DSS group, standard diet+DSS; and DSS+EVOO group, EVOO diet (weight percentage: 5%)+DSS. Rats were sacrificed 5 weeks after DSS was first administered, and colonic damage was histologically and biochemically evaluated. As a result, chronic feeding of 5% EVOO attenuated inflammation. This was evaluated using a disease activity index, body weight loss and a histological score. Enhanced expressions of STAT3, pSTAT3, COX-2 and iNOS by DSS was attenuated by EVOO. In addition, EVOO attenuated increases in cell proliferation (PCNA) caused by DSS and recovered decreases in apoptosis (cleaved caspase-3). In conclusion, the study indicated that chronic feeding of 5% EVOO inhibited chronic inflammation in DSS-induced colitis in rats and also attenuated cell proliferation and recovered apoptosis in DSS colitis.},
   keywords = {Animals
Colitis/*chemically induced/metabolism/prevention & control
Cyclooxygenase 2/metabolism
Cytokines/metabolism
Dextran Sulfate/*adverse effects
Male
Nitric Oxide Synthase Type II/metabolism
Olive Oil
Plant Oils/*administration & dosage
Rats
Rats, Sprague-Dawley
Apoptosis
Colon cancer
Inflammatory bowel disease
Stat3
Ulcerative colitis
pSTAT3},
   ISSN = {0955-2863},
   Accession Number = {24445043},
   DOI = {10.1016/j.jnutbio.2013.10.005},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Targownik, L. E. and Bernstein, C. N. and Leslie, W. D.},
   title = {Inflammatory bowel disease and the risk of osteoporosis and fracture},
   journal = {Maturitas},
   volume = {76},
   number = {4},
   pages = {315-9},
   note = {1873-4111
Targownik, Laura E
Bernstein, Charles N
Leslie, William D
Journal Article
Review
Ireland
Maturitas. 2013 Dec;76(4):315-9. doi: 10.1016/j.maturitas.2013.09.009. Epub 2013 Sep 27.},
   abstract = {Inflammatory bowel disease (IBD) is commonly believed to increase the risk of bone mineral loss, leading to osteoporosis and an increased risk of disabling fractures. In this narrative review, we will presenting a summary of the published medical literature in regards to the relationship between IBD and the development of osteoporosis, bone mineral loss, and fractures. We will explore the epidemiology of metabolic bone disease in IBD, focusing on the prevalence and both the general and IBD-specific risk factors for the development of osteoporosis and of fracture in persons with IBD. We will also examine the role of the inflammatory process in IBD promoting excessive bone mineral loss, as well as the role that low body mass, corticosteroid use, diet, and nutrient malabsorption play in contributing to bone disease. Last, we will discuss our recommendation for: screening for osteoporosis in IBD patients, the use of preventative strategies, and therapeutic interventions for treating osteoporosis in persons with IBD.},
   keywords = {Adrenal Cortex Hormones/adverse effects
*Bone Density
Diet/adverse effects
Fractures, Bone/*etiology/metabolism
Humans
Inflammatory Bowel Diseases/*complications
Malabsorption Syndromes/complications
Osteoporosis/diagnosis/epidemiology/*etiology/therapy
Thinness/complications
Bone mineral density
Crohn's disease
Fracture
Inflammatory bowel disease
Osteoporosis
Ulcerative colitis},
   ISSN = {0378-5122},
   Accession Number = {24139749},
   DOI = {10.1016/j.maturitas.2013.09.009},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Targownik, L. E. and Bernstein, C. N. and Leslie, W. D.},
   title = {Risk factors and management of osteoporosis in inflammatory bowel disease},
   journal = {Curr Opin Gastroenterol},
   volume = {30},
   number = {2},
   pages = {168-74},
   note = {1531-7056
Targownik, Laura E
Bernstein, Charles N
Leslie, William D
Journal Article
Review
United States
Curr Opin Gastroenterol. 2014 Mar;30(2):168-74. doi: 10.1097/MOG.0000000000000037.},
   abstract = {PURPOSE OF REVIEW: To provide a synopsis on established and new research evaluating bone disease in patients with inflammatory bowel disease (IBD). RECENT FINDINGS: Persons with IBD, including Crohn's disease and ulcerative colitis are believed to be at high risk for osteoporosis and fracture. As osteoporosis is clinically silent and persons with IBD are not universally screened, the burden of bone disease in IBD has been difficult to accurately assess. It is also unclear whether bone disease is due to inflammatory activity, medication use, poor nutrient intake/absorption, or body habitus characteristics. Recent studies using population-wide databases of bone mineral density (BMD) analyses suggest that Crohn's disease is responsible for a small effect on BMD after adjusting for other risk factors for low BMD, whereas ulcerative colitis does not appear to confer an independent risk. Furthermore, IBD does not appear to be a risk for overall fracture once controlling for factors which are associated with both IBD and fracture risk. The ability to assess BMD on incidentally performed computed tomography scans may allow detection of low BMD in IBD patients. SUMMARY: Although reduced BMD and fracture are more common in persons with IBD, the precise burden is not well characterized. Also, the relative impact of IBD-associated factors and IBD-specific inflammation on bone health is still uncertain.},
   keywords = {Bone Density/physiology
Humans
Inflammatory Bowel Diseases/*complications/physiopathology
Mass Screening/methods
Osteoporosis/*etiology/physiopathology/prevention & control
Osteoporotic Fractures/etiology/prevention & control
Risk Factors},
   ISSN = {0267-1379},
   Accession Number = {24419292},
   DOI = {10.1097/mog.0000000000000037},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Teitelbaum, J. E. and Rajaraman, R. R. and Jaeger, J. and Para, S. and Rakitt, T.},
   title = {Correlation of health-related quality of life in children with inflammatory bowel disease, their parents, and physician as measured by a visual analog scale},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {57},
   number = {5},
   pages = {594-7},
   note = {1536-4801
Teitelbaum, Jonathan E
Rajaraman, Rajsekar R
Jaeger, Joseph
Para, Sindhu
Rakitt, Tina
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2013 Nov;57(5):594-7. doi: 10.1097/MPG.0b013e31829cf923.},
   abstract = {BACKGROUND AND AIMS: Inflammatory bowel disease has been shown to affect children's health-related quality of life (HRQOL) through the use of lengthy questionnaires. We examined whether a pediatric patient's HRQOL, measured by a rapid visual analog scale ("feeling thermometer"), correlates with the perceptions of the HRQOL as determined by the patient's pediatric gastroenterologist and parent(s). Additionally, we attempted to determine whether the HRQOL correlates with the patient's disease activity as determined by validated activity indices. METHODS: A cross-sectional study of pediatric patients (ages 7-21 years) who were diagnosed as having Crohn disease, ulcerative colitis, or indeterminate colitis was conducted from January 2011 to May 2011. Each participant (patient, parent(s), and treating pediatric gastroenterologist) completed feeling thermometers to determine the symptom burden as well as therapeutic burden of the patient. The parent(s) and doctor were blinded to the patient's results. Pediatric Ulcerative Colitis Activity Index or a Short Pediatric Crohn Disease Activity Index (S-PCDAI) was calculated. Correlations between the participant's perceived burdens as well as their calculated disease activity were determined. RESULTS: Sixty-seven children and their families participated, resulting in 101 visits. Patients had a mean age of 15.0 years, and there were 38 boys. There was a strong significant correlation between the patient's perceived symptom burden and that of the parent's (rho 0.59, P < 0.001) and physician (rho 0.48, P < 0.001). Similarly, there was a strong significant correlation between patient's perceived treatment burden and that of the parent treatment burden (rho 0.49, P < 0.001) and, to a lesser degree, the physician (rho 0.29, P < 0.003). The correlation coefficient was strongest between the physician's perception of the patient's symptom burden against the standard disease activity indices Pediatric Ulcerative Colitis Activity Index (rho 0.69, P < 0.001) and Short Pediatric Crohn Disease Activity Index (rho 0.65, P < 0.001). CONCLUSIONS: The patient's HRQOL was highly correlated to both the physician's and parent's perceptions as well as their disease activity. The feeling thermometer is a quick, easy-to-use, visual analog scale that can be implemented in everyday practice to measure a pediatric patient's HRQOL.},
   keywords = {Academic Medical Centers
Adolescent
Adult
Attitude of Health Personnel
Attitude to Health
Child
Colitis, Ulcerative/physiopathology/therapy
Crohn Disease/physiopathology/therapy
Cross-Sectional Studies
Female
Gastroenterology/manpower
Hospitals, Pediatric
Humans
Inflammatory Bowel Diseases/*physiopathology/therapy
Male
New Jersey
Parents
Pediatrics/manpower
Physicians
*Quality of Life
Severity of Illness Index
Young Adult},
   ISSN = {0277-2116},
   Accession Number = {23752079},
   DOI = {10.1097/MPG.0b013e31829cf923},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Tenorio Jimenez, C. and Manzano Garcia, G. and Prior Sanchez, I. and Corpas Jimenez, M. S. and Molina Puerta, M. J. and Benito Lopez, P.},
   title = {[Bariatric surgery in inflammatory bowel disease; case report and review of the literature]},
   journal = {Nutr Hosp},
   volume = {28},
   number = {3},
   pages = {958-60},
   note = {1699-5198
Tenorio Jimenez, Carmen
Manzano Garcia, Gregorio
Prior Sanchez, Inmaculada
Corpas Jimenez, Maria Sierra
Molina Puerta, Maria Jose
Benito Lopez, Pedro
Case Reports
English Abstract
Journal Article
Review
Spain
Nutr Hosp. 2013 May-Jun;28(3):958-60. doi: 10.3305/nh.2013.28.3.6408.},
   abstract = {Inflammatory bowel disease (IBD) is rarely associated with obesity, as malabsorption is a common feature of these diseases (1). However, some patients may experience morbid obesity and associated complications refractory to dietary treatment and benefit from bariatric surgery. It has even been postulated that surgery may result in improvement of IBD by reducing inflammatory markers (2). However, patients may experience a higher incidence of complications following surgery in the context of immunosuppressive therapy and prior malabsorption. Therefore, if surgery is performed, careful patient selection and individualization of technique are essential. We present a patient diagnosed with ulcerative colitis who presented severe protein malnutrition after bariatric surgery type bilio-pancreatic diversion and review the available literature.},
   keywords = {Adult
Bariatric Surgery/*adverse effects
Colitis, Ulcerative/*complications
Female
Humans
Obesity, Morbid/*complications/*surgery
Protein-Energy Malnutrition/*etiology},
   ISSN = {0212-1611},
   Accession Number = {23848125},
   DOI = {10.3305/nh.2013.28.3.6408},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Thies, F. and Masson, L. F. and Boffetta, P. and Kris-Etherton, P.},
   title = {Oats and bowel disease: a systematic literature review},
   journal = {Br J Nutr},
   volume = {112 Suppl 2},
   pages = {S31-43},
   note = {1475-2662
Thies, Frank
Masson, Lindsey F
Boffetta, Paolo
Kris-Etherton, Penny
Journal Article
Research Support, Non-U.S. Gov't
Review
England
Br J Nutr. 2014 Oct;112 Suppl 2:S31-43. doi: 10.1017/S0007114514002293.},
   abstract = {Whole-grain foods such as oats may protect against colorectal cancer and have benefits on inflammatory bowel disease and coeliac disease. The present study aimed to systematically review the literature describing intervention studies that investigated the effects of oats or oat bran on risk factors for bowel disease. A literature search was conducted using Embase, Medline and the Cochrane library, which identified 654 potential articles. Thirty-eight articles describing twenty-nine studies met the inclusion criteria. Two studies carried out in participants with a history of colorectal adenomas found no effects of increased oat-bran intake on indirect risk makers for colorectal cancer. One of two interventions with oat bran in patients with ulcerative colitis showed small improvements in the patients' conditions. Most of the eleven studies carried out in adults with coeliac disease showed no negative effects of uncontaminated oat consumption. The fourteen studies carried out in volunteers with no history of bowel disease suggest that oats or oat bran can significantly increase stool weight and decrease constipation, but there is a lack of evidence to support a specific effect of oats on bowel function compared with other cereals. A long-term dietary intake of oats or oat bran could benefit inflammatory bowel disorders, but this remains to be proven. A protective effect on colorectal adenoma and cancer incidence has not yet been convincingly shown. The majority of patients with coeliac disease could consume up to 100 g/d of uncontaminated oats, which would increase the acceptability of, and adherence to, a gluten-free diet.},
   keywords = {*Avena
Celiac Disease/*diet therapy
Colitis, Ulcerative/diet therapy
Colonic Diseases/*diet therapy/prevention & control
Colorectal Neoplasms/prevention & control
Constipation/*prevention & control
*Diet
Diet, Gluten-Free
Dietary Fiber/*therapeutic use
Edible Grain
Glutens
Humans},
   ISSN = {0007-1145},
   Accession Number = {25267242},
   DOI = {10.1017/s0007114514002293},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Tolkien, Z. and Pereira, D. I. and Prassmayer, L. and Fitt, E. and Pot, G. and Greenfield, S. M. and Powell, J. J.},
   title = {Dietary iron does not impact the quality of life of patients with quiescent ulcerative colitis: an observational study},
   journal = {Nutr J},
   volume = {12},
   pages = {152},
   note = {1475-2891
Tolkien, Zoe
Pereira, Dora I A
Prassmayer, Laura
Fitt, Emily
Pot, Gerda
Greenfield, Simon M
Powell, Jonathan J
MC_U105960384/Medical Research Council/United Kingdom
MC_U105960399/Medical Research Council/United Kingdom
U105960399/Medical Research Council/United Kingdom
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
England
Nutr J. 2013 Nov 23;12:152. doi: 10.1186/1475-2891-12-152.},
   abstract = {BACKGROUND: In animal models, excess luminal iron exacerbates colonic inflammation and cancer development. Moreover, in inflammatory bowel disease (IBD) patients with mild to moderate disease activity dietary fortificant iron intake is inversely related to quality of life. Here we sought to determine whether dietary iron intakes were also related to quality of life in IBD patients in remission. METHODS: Forty eight patients with ulcerative colitis (UC), 42 of which had quiescent disease during this observational study, and 53 healthy control subjects completed quality of life questionnaires and 7-day food diaries. For comparative analysis, 34/group were matched and the linear relationship between dietary iron intakes (total, haem, non-haem or fortificant) and EuroQol quality of life measures was investigated. For UC patients the linear relationship between dietary iron intakes and the scores from the disease specific inflammatory bowel disease questionnaire (IBDQ) was also considered. RESULTS: The intake of dietary iron, and its various sub-fractions, were not associated with quality of life (EuroQol) in patients with quiescent disease or in healthy control subjects. The picture was similar for the 42 quiescent UC patients when disease-specific IBDQ was used. However, the 6 patients who relapsed during the study again showed an inverse association between IBDQ and dietary iron intake (p = 0.03). CONCLUSIONS: Our data suggest that dietary iron does not impact on quality of life in quiescent UC patients but support that, once the disease is triggered, luminal iron may be a permissive factor for exacerbation of disease activity resulting in lower quality of life.},
   keywords = {Adolescent
Adult
Aged
Aged, 80 and over
Colitis, Ulcerative/immunology/*physiopathology
Colon/immunology/*physiopathology
England
Food, Fortified/adverse effects
Gastrointestinal Agents/administration & dosage/*adverse effects
Humans
Intestinal Mucosa/immunology/*physiopathology
Iron, Dietary/administration & dosage/*adverse effects
Irritants/administration & dosage/*adverse effects
Matched-Pair Analysis
Middle Aged
Outpatient Clinics, Hospital
*Quality of Life
Recurrence
Severity of Illness Index
Young Adult},
   ISSN = {1475-2891},
   Accession Number = {24267915},
   DOI = {10.1186/1475-2891-12-152},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Torrente, F. and Barabino, A. and Bellini, T. and Murch, S. H.},
   title = {Intraepithelial lymphocyte eotaxin-2 expression and perineural mast cell degranulation differentiate allergic/eosinophilic colitis from classic IBD},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {59},
   number = {3},
   pages = {300-7},
   note = {1536-4801
Torrente, Franco
Barabino, Arrigo
Bellini, Tommaso
Murch, Simon H
Journal Article
Research Support, Non-U.S. Gov't
United States
J Pediatr Gastroenterol Nutr. 2014 Sep;59(3):300-7. doi: 10.1097/MPG.0000000000000432.},
   abstract = {OBJECTIVES: Allergic colitis shows overlap with classic inflammatory bowel disease (IBD). Clinically, allergic colitis is associated with dysmotility and abdominal pain, and mucosal eosinophilia is characteristic. We thus aimed to characterise mucosal changes in children with allergic colitis compared with normal tissue and classic IBD, focusing on potential interaction between eosinophils and mast cells with enteric neurones. METHODS: A total of 15 children with allergic colitis, 10 with Crohn disease (CD), 10 with ulcerative colitis (UC), and 10 histologically normal controls were studied. Mucosal biopsies were stained for CD3 T cells, Ki-67, eotaxin-1, and eotaxin-2. Eotaxin-2, IgE, and tryptase were localised compared with mucosal nerves, using neuronal markers neurofilament protein, neuron-specific enolase, and nerve growth factor receptor. RESULTS: Overall inflammation was greater in patients with CD and UC than in patients with allergic colitis. CD3 T-cell density was increased in patients with allergic colitis, similar to that in patients with CD but lower than in patients with UC, whereas eosinophil density was higher than in all other groups. Eotaxin-1 and -2 were localised to basolateral crypt epithelium in all specimens, with eotaxin-1+ lamina propria cells found in all of the colitis groups. Eotaxin-2+ intraepithelial lymphocyte (IEL) density was significantly higher in allergic colitis specimens than in all other groups. Mast cell degranulation was strikingly increased in patients with allergic colitis (12/15) compared with that in patients with UC (1/10) and CD (0/1). Tryptase and IgE colocalised on enteric neurons in patients with allergic colitis but rarely in patients with IBD. CONCLUSIONS: Eotaxin-2+ IELs may contribute to the periepithelial eosinophil accumulation characteristic of allergic colitis. The colocalisation of IgE and tryptase with mucosal enteric nerves is likely to promote the dysmotility and visceral hyperalgesia classically seen in allergic gastrointestinal inflammation.},
   keywords = {Adolescent
Antigens, CD3/analysis
*Cell Degranulation
Chemokine CCL11/analysis
Chemokine CCL24/*analysis
Child
Child, Preschool
Colitis/immunology/*pathology
Colitis, Ulcerative/pathology
Crohn Disease/pathology
Enteric Nervous System/chemistry
Eosinophilia/immunology/*pathology
Epithelium/chemistry
Female
Food Hypersensitivity/*pathology
Humans
Immunoglobulin E/analysis
Infant
Intestinal Mucosa/chemistry/pathology
Ki-67 Antigen/analysis
Lymphocyte Count
Male
Mast Cells/*physiology
Neurons/chemistry
T-Lymphocytes/*chemistry
Tryptases/analysis},
   ISSN = {0277-2116},
   Accession Number = {24813533},
   DOI = {10.1097/mpg.0000000000000432},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Triantafillidis, J. K. and Papalois, A. E.},
   title = {The role of total parenteral nutrition in inflammatory bowel disease: current aspects},
   journal = {Scand J Gastroenterol},
   volume = {49},
   number = {1},
   pages = {3-14},
   note = {1502-7708
Triantafillidis, John K
Papalois, Apostolos E
Journal Article
Review
England
Scand J Gastroenterol. 2014 Jan;49(1):3-14. doi: 10.3109/00365521.2013.860557.},
   abstract = {Total parenteral nutrition (TPN) represents a therapeutic modality that could save the life of a patient with inflammatory bowel disease (IBD) facing severe nutritional problems, by restoring the patient's impaired nutritional status. TPN does not compete with enteral nutrition (EN), the latter being the first choice for all patients having anatomically intact and functionally normal digestive tract. TPN allows bowel rest while supplying adequate calorific intake and essential nutrients, and removes antigenic mucosal stimuli. The value of TPN in malnourished patients with intestinal failure due to CD is beyond doubt. However, it is difficult to suggest TPN as a sole treatment for active CD. An increased rate of remission could not be expected by applying TPN. The utility of TPN is restricted to certain cases involving efforts to close enterocutaneous or other complicated fistulas in patients with fistulizing CD, the treatment of short bowel syndrome following extensive resections for CD, or when EN is impractical for other reasons. There are no advantages of TPN therapy over EN therapy regarding fistula healing. TPN has no influence on the surgical intervention rate and little benefit by bypassing the intestinal passage could be expected. Also TPN shows no advantage if the disease is chronically active. However, an optimal supply of nutrients improves bowel motility, intestinal permeability and nutritional status, and reduces inflammatory reactions. TPN might be associated with an increased risk of adverse events, although TPN undertaken by experienced teams does not cause more complications than does EN.},
   keywords = {Carbohydrates/administration & dosage
Catheterization, Central Venous
Catheterization, Peripheral
Colitis, Ulcerative/*therapy
Crohn Disease/*therapy
Fats/administration & dosage
Glutamine/administration & dosage
Humans
*Parenteral Nutrition, Total/adverse effects/methods
Proteins/administration & dosage
Trace Elements/administration & dosage
Vitamins/administration & dosage},
   ISSN = {0036-5521},
   Accession Number = {24354966},
   DOI = {10.3109/00365521.2013.860557},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Trivedi, P. P. and Jena, G. B.},
   title = {Mechanistic insight into beta-carotene-mediated protection against ulcerative colitis-associated local and systemic damage in mice},
   journal = {Eur J Nutr},
   volume = {54},
   number = {4},
   pages = {639-52},
   note = {1436-6215
Trivedi, P P
Jena, G B
Journal Article
Research Support, Non-U.S. Gov't
Germany
Eur J Nutr. 2015 Jun;54(4):639-52. doi: 10.1007/s00394-014-0745-5. Epub 2014 Jul 30.},
   abstract = {PURPOSE: Ulcerative colitis (UC), a chronic gastrointestinal disorder, is a debilitating disease affecting many people across the globe. Research suggests that the levels of several antioxidants, including beta-carotene (beta-CAR), decrease in the serum of patients with UC. The present study was aimed at elucidating the molecular mechanisms involved in beta-CAR-mediated protection against UC in mice. METHODS: UC was induced in mice using 3%w/v dextran sulfate sodium in drinking water for two cycles; one cycle comprised of 7 days of dextran sulfate sodium-treated water followed by 14 days of normal drinking water. beta-CAR was administered at the doses of 5, 10 and 20 mg/kg bw/day, po throughout the experiment. The effect of beta-CAR in mice with UC was evaluated using biochemical parameters, histological evaluation, comet and micronucleus assays, immunohistochemistry and Western blot analysis. RESULTS: The results indicated that beta-CAR treatment ameliorated the severity of UC by modulating various molecular targets such as nuclear factor-kappa B, cyclooxygenase-2, interleukin 17, signal transducer and activator of transcription 3, nuclear erythroid 2-related factor 2, matrix metalloproteinase-9 and connective tissue growth factor. Further, beta-CAR treatment maintained the gut integrity by increasing the expression of a tight junction protein, occludin, which was decreased in the colon of mice with UC. Also beta-CAR treatment significantly reduced UC-associated elevated plasma lipopolysaccharide level, systemic inflammation and genotoxicity. CONCLUSION: beta-CAR ameliorated UC-associated local and systemic damage in mice by acting on multiple targets.},
   keywords = {Animals
Antioxidants/pharmacology
Colitis, Ulcerative/chemically induced/*drug therapy
Comet Assay
Connective Tissue Growth Factor/genetics/metabolism
Cyclooxygenase 2/genetics/metabolism
DNA Damage/drug effects
Dextran Sulfate/adverse effects
Disease Models, Animal
Dose-Response Relationship, Drug
Glutathione/metabolism
Inflammation/chemically induced/drug therapy
Interleukin-17/metabolism
Interleukin-6/blood
Lipid Peroxidation/drug effects
Lipopolysaccharides/blood
Male
Matrix Metalloproteinase 9/genetics/metabolism
Mice
NF-E2-Related Factor 2/genetics/metabolism
NF-kappa B/metabolism
Occludin/genetics/metabolism
Oxidative Stress/drug effects
STAT3 Transcription Factor/genetics/metabolism
Tight Junction Proteins/genetics/metabolism
Tumor Necrosis Factor-alpha/blood
beta Carotene/blood/*pharmacology},
   ISSN = {1436-6207},
   Accession Number = {25074825},
   DOI = {10.1007/s00394-014-0745-5},
   year = {2015},
   type = {Ref–rence Type}
}

@article{
   author = {Tsiountsioura, M. and Wong, J. E. and Upton, J. and McIntyre, K. and Dimakou, D. and Buchanan, E. and Cardigan, T. and Flynn, D. and Bishop, J. and Russell, R. K. and Barclay, A. and McGrogan, P. and Edwards, C. and Gerasimidis, K.},
   title = {Detailed assessment of nutritional status and eating patterns in children with gastrointestinal diseases attending an outpatients clinic and contemporary healthy controls},
   journal = {Eur J Clin Nutr},
   volume = {68},
   number = {6},
   pages = {700-6},
   note = {1476-5640
Tsiountsioura, M
Wong, J E
Upton, J
McIntyre, K
Dimakou, D
Buchanan, E
Cardigan, T
Flynn, D
Bishop, J
Russell, R K
Barclay, A
McGrogan, P
Edwards, C
Gerasimidis, K
Journal Article
Research Support, Non-U.S. Gov't
England
Eur J Clin Nutr. 2014 Jun;68(6):700-6. doi: 10.1038/ejcn.2013.286. Epub 2014 Jan 15.},
   abstract = {BACKGROUND/OBJECTIVES: In the era of modern multidisciplinary clinical management, very little is known about the prevalence and presentation of malnutrition in children with gastrointestinal disorders (GastroD) particularly employing composite, global measures of nutritional status. SUBJECTS/METHODS: Anthropometry, body composition, dietary intake, eating habits and grip strength were assessed with bedside methods in 168 patients from outpatient gastroenterology clinics (n, median (IQR) years; Crohn's disease (CD): n=53, 14.2 (11.6:15.4); ulcerative colitis (UC): n=27, 12.2 (10.7:14.2); coeliac disease: n=31, 9.3 (7.5:13.6); other GastroD: n=57, 9.8 (7.2:13.8)) and compared with 62 contemporary healthy controls (n, median (IQR): 9.8 (6.9:13.8)) and the results of the recent UK, National Diet and Nutritional Survey (NDNS). RESULTS: Children with CD had lower BMI z-scores than controls (median (IQR): -0.3 (-0.9:0.4) vs 0.3 (-0.6:1.4); P=0.02) but only 2% were classified as thin (BMI z-score <-2 s.d.). The prevalence of obesity in children with UC was 19%, 6% in CD, 11% in children with other GastroD and 15% in controls. No difference was found in grip strength measurement between groups. Except for CD children, the proportion of patients with suboptimal micronutrient intake was similar to that of controls and the cohort of children from the latest NDNS. A higher proportion of children with CD had suboptimal intake for riboflavin, vitamin B6 and calcium and consumed significantly more meat products, juices (including carbonated drinks), spreads/jams and crisps and savoury snacks and significantly fewer portions of dairy, fish, fruits and vegetables compared with healthy controls. CONCLUSIONS: GastroD affect children's body composition, growth, strength, dietary intake and eating habits, particularly CD, but to a lesser extent than expected.},
   keywords = {Adolescent
Body Composition
*Body Mass Index
*Body Weight
Case-Control Studies
Celiac Disease/complications
Child
Colitis, Ulcerative/complications
Crohn Disease/complications
*Diet
*Feeding Behavior
Female
Gastrointestinal Diseases/*complications
Hand Strength
Hospitalization
Humans
Male
Micronutrients/administration & dosage
*Nutrition Assessment
*Nutritional Status
Obesity/complications/epidemiology
Prevalence
Thinness/complications/epidemiology},
   ISSN = {0954-3007},
   Accession Number = {24424079},
   DOI = {10.1038/ejcn.2013.286},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Turner, D.},
   title = {Relapsing and refractory ulcerative colitis in children},
   journal = {Dig Dis},
   volume = {32},
   number = {4},
   pages = {419-26},
   note = {1421-9875
Turner, Dan
Journal Article
Review
Switzerland
Dig Dis. 2014;32(4):419-26. doi: 10.1159/000358148. Epub 2014 Jun 23.},
   abstract = {Approximately half of the children with ulcerative colitis (UC) have refractory, relapsing or steroid-dependent disease. UC in children is more extensive than in adults, presents more often with severe attacks and carries a more aggressive disease course. Therefore, although a step-up approach is usually recommended in UC, aggressive therapy will often be indicated in children since steroid dependency should never be tolerated. It is vital to ensure that in every resistant case, the symptoms are truly related to the inflammatory disease activity and not to other conditions such as poor adherence to treatment, infections, adverse reactions to drugs, irritable bowel syndrome, lactose intolerance, celiac disease and bacterial overgrowth. The clinician should be ready to escalate therapy in a timely manner but only after ensuring optimization of current treatments. Optimization may include, among others, appropriate dosage, utilization of assays that determine thiopurine, calcineurin inhibitors and anti-tumor necrosis factor levels, introduction of combination therapy when indicated (enemas and immunomodulators) and a long enough time for treatment to become effective. Colectomy is always a valid option and should be discussed before major treatment escalations. Experimental therapies can be considered when all else fails and the family prefers to avoid colectomy. The management of refractory and relapsing disease is particularly challenging in children, and this review summarizes the available evidence to guide treatment decisions in this setup.},
   keywords = {Child
Colectomy
Colitis, Ulcerative/drug therapy/*pathology/surgery
Humans
Recurrence
Treatment Outcome},
   ISSN = {0257-2753},
   Accession Number = {24969290},
   DOI = {10.1159/000358148},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Turner, D. and Levine, A. and Kolho, K. L. and Shaoul, R. and Ledder, O.},
   title = {Combination of oral antibiotics may be effective in severe pediatric ulcerative colitis: a preliminary report},
   journal = {J Crohns Colitis},
   volume = {8},
   number = {11},
   pages = {1464-70},
   note = {1876-4479
Turner, Dan
Levine, Arie
Kolho, Kaija-Leena
Shaoul, Ron
Ledder, Oren
Journal Article
Multicenter Study
England
J Crohns Colitis. 2014 Nov;8(11):1464-70. doi: 10.1016/j.crohns.2014.05.010. Epub 2014 Jun 20.},
   abstract = {BACKGROUND: The results of previous studies on the effectiveness of antibiotics in ulcerative colitis (UC) seem more effective when used orally. In this retrospective, multicenter study, we aimed to report our experience of using a combination of 3-4 antibiotics in children with moderate-severe refractory UC and IBD-unclassified including metronidazole, amoxicillin, doxycycline, and if during hospital admission, also vancomycin (MADoV). METHODS: All children treated during 2013 with the antibiotic cocktail for 2-3weeks in an attempt to alleviate inflammation in refractory colitis were included. Doxycycline was substituted with oral gentamycin or ciprofloxacin in children younger than 8years or when an allergy was known to one of the drugs. Children were assessed using the PUCAI and CRP weekly for 3weeks. RESULTS: All 15 included children had moderate to severe disease with refractory disease course to multiple immunosuppressants (mean age 13.6+/-5.1years, median disease duration 2 (IQR 0.8-3.2) years, 11 females (73%), and 13 (87%) extensive disease; 14 (93%) were corticosteroid-dependent or resistant, and 12 (80%) refractory to anti-TNF therapy). The cocktail was definitely effective in 7 of the 15 included children (47%) who entered complete clinical remission (PUCAI<10) without additional interventions. Questionable or partial short-term response was noted in another 3 (20%), totaling 67% of patients. CONCLUSION: The use of oral wide-spectrum antibiotic cocktail in pediatric UC seems promising in half of patients, refractory to other salvage therapy. A pediatric randomized controlled trial to assess this intervention is underway.},
   keywords = {Adolescent
Amoxicillin/*therapeutic use
Anti-Bacterial Agents/*therapeutic use
C-Reactive Protein/metabolism
Child
Colitis, Ulcerative/blood/*drug therapy
Doxycycline/*therapeutic use
Drug Resistance
Drug Therapy, Combination
Female
Humans
Immunosuppressive Agents
Male
Metronidazole/*therapeutic use
Remission Induction
Retreatment
Retrospective Studies
Severity of Illness Index
Tumor Necrosis Factor-alpha/antagonists & inhibitors
Vancomycin/*therapeutic use
Antibiotics
Children
Doxycyline
Severe UC
Ulcerative colitis
Vancomycin},
   ISSN = {1873-9946},
   Accession Number = {24958064},
   DOI = {10.1016/j.crohns.2014.05.010},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Turner, D. and Wolters, V. M. and Russell, R. K. and Shakhnovich, V. and Muise, A. M. and Ledder, O. and Ngan, B. and Friesen, C.},
   title = {Anti-TNF, infliximab, and adalimumab can be effective in eosinophilic bowel disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {56},
   number = {5},
   pages = {492-7},
   note = {1536-4801
Turner, Dan
Wolters, Victorien M
Russell, Richard K
Shakhnovich, Valentina
Muise, Aleixo M
Ledder, Oren
Ngan, Bo
Friesen, Craig
MOP119457/Canadian Institutes of Health Research/Canada
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
United States
J Pediatr Gastroenterol Nutr. 2013 May;56(5):492-7. doi: 10.1097/MPG.0b013e3182801e60.},
   abstract = {BACKGROUND: Eosinophilic enterocolitis (EEC) is an emerging distinct inflammatory bowel disease of unknown etiology. There are no published data on the effect of infliximab (IFX) or adalimumab (ADA) for the treatment of refractory cases. METHODS: A report of all pediatric cases with EEC treated with anti-tumor necrosis factor, identified after an open international call. RESULTS: We describe here the first 8 children with refractory EEC who were treated with IFX (75% boys; mean age at diagnosis 8.6 +/- 4.03 [range 1.6-14 years]; mean age at IFX treatment 11.7 +/- 4.4 [range 4.2-16 years]). Allergic and infectious causes of EEC were excluded in all cases. Rapid and complete clinical remission was documented in 6 (75%) children following the induction infusions: 3 (38%) with endoscopic remission, 2 (25%) with endoscopic improvement, and 1 unknown. Four of the 6 responders had secondary loss of response and were switched to ADA, 3 of whom with sustained remission using high doses. Overall, the 6 responders were followed for a median of 7 years (range 4-12; interquartile range 6.4-8.8 years) without evidence of developing Crohn disease or ulcerative colitis. The only case with macroscopic findings on endoscopy was a primary nonresponder. CONCLUSIONS: IFX and ADA may be effective in cases of refractory idiopathic EEC; however, because this is an uncontrolled report, further prospective studies are warranted.},
   keywords = {Adalimumab
Adolescent
Anti-Inflammatory Agents/therapeutic use
Antibodies, Monoclonal/*therapeutic use
Antibodies, Monoclonal, Humanized/*therapeutic use
Child
Child, Preschool
Endoscopy
Enterocolitis/*drug therapy/metabolism
Eosinophilia/*drug therapy/metabolism
Eosinophils/metabolism
Female
Follow-Up Studies
Humans
Infant
Inflammatory Bowel Diseases/*drug therapy/metabolism
Infliximab
Male
Remission Induction
Treatment Outcome
Tumor Necrosis Factor-alpha/*antagonists & inhibitors},
   ISSN = {0277-2116},
   Accession Number = {23221994},
   DOI = {10.1097/MPG.0b013e3182801e60},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Tursi, A. and Elisei, W. and Picchio, M. and Penna, A. and Forti, G. and Giorgetti, G. M. and Faggiani, R. and Zampaletta, C. and Pelecca, G. and Brandimarte, G.},
   title = {Effectiveness of adalimumab for ambulatory ulcerative colitis patients after failure of infliximab treatment: a first "real-life" experience in primary gastroenterology centers in Italy},
   journal = {Ann Gastroenterol},
   volume = {27},
   number = {4},
   pages = {369-373},
   note = {Tursi, Antonio
Elisei, Walter
Picchio, Marcello
Penna, Antonio
Forti, Giacomo
Giorgetti, Gian Marco
Faggiani, Roberto
Zampaletta, Costantino
Pelecca, Giorgio
Brandimarte, Giovanni
Journal Article
Greece
Ann Gastroenterol. 2014;27(4):369-373.},
   abstract = {BACKGROUND: Adalimumab (ADA) is the key treatment for ulcerative colitis (UC) unresponsive or intolerant to standard treatments. Our aim was to assess the efficacy and safety of ADA in treating ambulatory UC patients in primary gastroenterology centers. METHODS: Fifteen patients (6 male, median age 29.9 years, range 22.8-39.9 years) were enrolled. All were previously treated with infliximab (IFX). Clinical activity and endoscopic severity were scored according to the Crohn's disease activity index (CDAI) score and Mayo subscore for endoscopy, respectively. Patients were clinically assessed at weeks 4, 8, and thereafter at weeks 16, 24, 32, 40, 48, and 54. Colonoscopy was performed before starting treatment, at weeks 24 and 54. The co-primary endpoints were clinical remission at 24 and 54 weeks. The secondary endpoints included: 1) sustained clinical remission; 2) steroid-sparing effect; 3) mucosal healing; 4) need for colectomy. Induction dose of ADA was 160 mg at week 0, and then 80 mg at week 2, while ADA maintenance treatment was 40 mg every two weeks. RESULTS: Clinical remission was obtained in 11 (73.3%) and 15 (100%) patients at weeks 24 and 54 respectively. Ten patients (66.7%) were able to discontinue steroids and were under corticosteroid-free remission at week 54. No patients underwent to colectomy. Eight patients (53.33%) at week 24 and 9 patients (60%) at week 54 achieved complete mucosal healing (Mayo endoscopic score 0). Side effects were reported in 2 of 15 patients (13.3%); none of those patients stopped treatment. CONCLUSION: ADA seems to be effective and safe in UC outpatients affected by UC, and previously treated with IFX.},
   keywords = {Adalimumab
clinical practice
clinical remission
mucosal healing
ulcerative colitis},
   ISSN = {1108-7471 (Print)
1108-7471},
   Accession Number = {25331091},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Tursi, A. and Elisei, W. and Picchio, M. and Penna, A. and Lecca, P. G. and Forti, G. and Giorgetti, G. and Faggiani, R. and Zampaletta, C. and Pelecca, G. and Brandimarte, G.},
   title = {Managing ambulatory ulcerative colitis patients with infliximab: a long term follow-up study in primary gastroenterology centers},
   journal = {Eur J Intern Med},
   volume = {25},
   number = {8},
   pages = {757-61},
   note = {1879-0828
Tursi, Antonio
Elisei, Walter
Picchio, Marcello
Penna, Antonio
Lecca, Piera Giuseppina
Forti, Giacomo
Giorgetti, GianMarco
Faggiani, Roberto
Zampaletta, Costantino
Pelecca, Giorgio
Brandimarte, Giovanni
Journal Article
Multicenter Study
Netherlands
Eur J Intern Med. 2014 Oct;25(8):757-61. doi: 10.1016/j.ejim.2014.07.007. Epub 2014 Jul 30.},
   abstract = {BACKGROUND: Infliximab (IFX) is the key treatment for ulcerative colitis (UC) unresponsive to standard treatments. The aim of the present study was to assess the efficacy and safety of IFX in treating ambulatory UC patients in primary gastroenterology centers. METHODS: One hundred and eighteen patients (65 M, 63 F, median age 34 years, range 19-71 years), affected by UC, were treated with IFX. Clinical efficacy, safety, mucosal healing (MH), and histological healing (HH) were assessed at a scheduled follow-up of 42 months. RESULTS: Percentage of patients with clinical remission persistence at 42-month follow-up was 70.4%. Colectomy occurred in only 3 patients (2.7%). At 42-month follow-up percentage of patients with MH was 44.6%, and percentage of patients with HH was 24.3%. HH at 6-month follow-up occurred in 13 out of 34 patients (38.2%) with C-reactive protein (CRP) <3 and in 8 out of 76 patients (10.5%) with CRP >/= 3 (p=0.002). Side effects were reported in 16 patients (13.6%): infusion reactions occurred in 7 patients, other severe side-effects occurred in 3 patients, and opportunistic infections occurred in 3 patients (2.5%). Finally, 3 cancers (2.5%) occurred during the follow-up period (1 breast, 1 kidney and 1 rectal cancer). Both univariate and multivariate analyses showed Hb <11.5 g/dL and HH at 6-month follow-up to be significantly associated with treatment failure during follow-up. CONCLUSIONS: IFX seems to be effective and safe in long-term treatment of outpatients affected by UC.},
   keywords = {Adult
Aged
Antibodies, Monoclonal/*therapeutic use
Colitis, Ulcerative/*drug therapy/pathology
Disease Progression
Female
Follow-Up Studies
Gastric Mucosa/pathology
Gastrointestinal Agents/*therapeutic use
Humans
Infliximab
Male
Middle Aged
Multivariate Analysis
Remission Induction
Young Adult
Clinical practice
Clinical remission
Histological healing
Mucosal healing
Ulcerative colitis},
   ISSN = {0953-6205},
   Accession Number = {25086677},
   DOI = {10.1016/j.ejim.2014.07.007},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Tyagi, A. and Kumar, U. and Santosh, V. S. and Reddy, S. and Mohammed, S. B. and Ibrahim, A.},
   title = {Partial replacement of dietary linoleic acid with long chain n-3 polyunsaturated fatty acids protects against dextran sulfate sodium-induced colitis in rats},
   journal = {Prostaglandins Leukot Essent Fatty Acids},
   volume = {91},
   number = {6},
   pages = {289-97},
   note = {1532-2823
Tyagi, Anupama
Kumar, Uday
Santosh, Vadakattu Sai
Reddy, Suryam
Mohammed, Saazida Bhanu
Ibrahim, Ahamed
Journal Article
Research Support, Non-U.S. Gov't
Scotland
Prostaglandins Leukot Essent Fatty Acids. 2014 Dec;91(6):289-97. doi: 10.1016/j.plefa.2014.09.003. Epub 2014 Sep 28.},
   abstract = {Imbalances in the dietary n-6 and n-3 polyunsaturated fatty acids have been implicated in the increased prevalence of inflammatory bowel disease. This study investigated the effects of substitution of linoleic acid with long chain n-3 polyunsaturated fatty acids and hence decreasing n-6:n-3 fatty acid ratio on inflammatory response in dextran sulfate sodium induced colitis. Male weanling Sprague Dawley rats were fed diets with n-6:n-3 fatty acid in the ratios of 215,50,10 or 5 for 3 months and colitis was induced by administration of dextran sulfate sodium in drinking water during last 11 days. Decreasing the dietary n-6:n-3 fatty acid ratio to 10 and 5 significantly attenuated the severity of colitis as evidenced by improvements in clinical symptoms, reversal of shortening of colon length, reduced severity of anemia, preservation of colonic architecture as well as reduced colonic mucosal myeloperoxidase activity. This protection was associated with suppression of colonic mucosal proinflammatory mediators such as TNFalpha, IL-1beta and nitric oxide. These findings suggest that long chain n-3 polyunsaturated fatty acids at a level of 3.0 g/kg diet (n-6:n-3 ratio of 10) prevents dextran sulfate sodium induced colitis by suppressing the proinflammatory mediators.},
   keywords = {Animals
Colitis/*chemically induced/pathology/*prevention & control
Colon/chemistry/pathology
*Dextran Sulfate
Dietary Fats/*administration & dosage
Disease Models, Animal
Fatty Acids, Omega-3/*administration & dosage
Interleukin-1beta/analysis
Intestinal Mucosa/chemistry/enzymology
Linoleic Acid/*administration & dosage
Male
Nitric Oxide/analysis
Peroxidase/metabolism
Rats
Rats, Sprague-Dawley
Tumor Necrosis Factor-alpha/analysis
Dextran sulfate sodium
Inflammatory bowel disease
Long chain n-3 polyunsaturated fatty acids
Proinflammatory cytokines
Ulcerative colitis},
   ISSN = {0952-3278},
   Accession Number = {25451558},
   DOI = {10.1016/j.plefa.2014.09.003},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Uhlig, H. H. and Schwerd, T. and Koletzko, S. and Shah, N. and Kammermeier, J. and Elkadri, A. and Ouahed, J. and Wilson, D. C. and Travis, S. P. and Turner, D. and Klein, C. and Snapper, S. B. and Muise, A. M.},
   title = {The diagnostic approach to monogenic very early onset inflammatory bowel disease},
   journal = {Gastroenterology},
   volume = {147},
   number = {5},
   pages = {990-1007.e3},
   note = {1528-0012
Uhlig, Holm H
Schwerd, Tobias
Koletzko, Sibylle
Shah, Neil
Kammermeier, Jochen
Elkadri, Abdul
Ouahed, Jodie
Wilson, David C
Travis, Simon P
Turner, Dan
Klein, Christoph
Snapper, Scott B
Muise, Aleixo M
COLORS in IBD Study Group and NEOPICS
R56 AI050950/AI/NIAID NIH HHS/United States
R01 AI050950/AI/NIAID NIH HHS/United States
P30 DK034854/DK/NIDDK NIH HHS/United States
P01 HL059561/HL/NHLBI NIH HHS/United States
G0800675/Medical Research Council/United Kingdom
Journal Article
Review
United States
Gastroenterology. 2014 Nov;147(5):990-1007.e3. doi: 10.1053/j.gastro.2014.07.023. Epub 2014 Jul 21.},
   abstract = {Patients with a diverse spectrum of rare genetic disorders can present with inflammatory bowel disease (monogenic IBD). Patients with these disorders often develop symptoms during infancy or early childhood, along with endoscopic or histological features of Crohn's disease, ulcerative colitis, or IBD unclassified. Defects in interleukin-10 signaling have a Mendelian inheritance pattern with complete penetrance of intestinal inflammation. Several genetic defects that disturb intestinal epithelial barrier function or affect innate and adaptive immune function have incomplete penetrance of the IBD-like phenotype. Several of these monogenic conditions do not respond to conventional therapy and are associated with high morbidity and mortality. Due to the broad spectrum of these extremely rare diseases, a correct diagnosis is frequently a challenge and often delayed. In many cases, these diseases cannot be categorized based on standard histological and immunologic features of IBD. Genetic analysis is required to identify the cause of the disorder and offer the patient appropriate treatment options, which include medical therapy, surgery, or allogeneic hematopoietic stem cell transplantation. In addition, diagnosis based on genetic analysis can lead to genetic counseling for family members of patients. We describe key intestinal, extraintestinal, and laboratory features of 50 genetic variants associated with IBD-like intestinal inflammation. In addition, we provide approaches for identifying patients likely to have these disorders. We also discuss classic approaches to identify these variants in patients, starting with phenotypic and functional assessments that lead to analysis of candidate genes. As a complementary approach, we discuss parallel genetic screening using next-generation sequencing followed by functional confirmation of genetic defects.},
   keywords = {Age of Onset
Colitis, Ulcerative/*diagnosis/epidemiology/*genetics/therapy
Crohn Disease/*diagnosis/epidemiology/*genetics/therapy
Genetic Predisposition to Disease
*Genetic Testing/methods
Humans
Phenotype
Predictive Value of Tests
Prognosis
Risk Factors
Crohn's Disease
Genetics
IBD Unclassified
Immunodeficiency
Indeterminate Colitis
Inflammatory Bowel Disease
Next-Generation Sequencing
Pediatrics
Ulcerative Colitis
Unclassified Colitis
Whole Exome Sequencing},
   ISSN = {0016-5085},
   Accession Number = {25058236},
   DOI = {10.1053/j.gastro.2014.07.023},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Um, M. Y. and Park, J. H. and Gwon, S. Y. and Ahn, J. and Jung, C. H. and Ha, T. Y.},
   title = {Agaricus bisporus attenuates dextran sulfate sodium-induced colitis},
   journal = {J Med Food},
   volume = {17},
   number = {12},
   pages = {1383-5},
   note = {1557-7600
Um, Min Young
Park, Jae Ho
Gwon, So Young
Ahn, Jiyun
Jung, Chang Hwa
Ha, Tae Youl
Journal Article
Research Support, Non-U.S. Gov't
United States
J Med Food. 2014 Dec;17(12):1383-5. doi: 10.1089/jmf.2014.3191.},
   abstract = {Agaricus bisporus (white button mushroom, WBM) is widely consumed in most countries and is reported to have anti-inflammatory and antioxidant activities. However, little is known regarding its effects in dextran sulfate sodium (DSS)-induced colitis, which are related to dysfunction of intestinal immunity. The aim of the present study was to investigate the effects of WBMs in an animal model of DSS-induced colitis. Male, 4-week-old ICR mice (n=10 per group) were fed a normal diet with or without 10% WBM for 4 weeks, and colitis was induced by 3% DSS in drinking water for 7 days. WBMs prevented DSS-induced shortening of colon length (P=.033) and diminished diarrhea (P=.049) and gross bleeding (P=.001), resulting in a decreased disease activity index. Results of histological analysis showed that WBMs suppressed mucosal damage. In addition, WBMs attenuated the DSS-induced increase in myeloperoxidase activity (P=.012) and upregulation of proinflammatory cytokine tumor necrosis factor-alpha (P=.020) in the colon segment. Taken together, these findings suggest a possible role for the WBM as an immunomodulator that can prevent and/or treat ulcerative colitis.},
   keywords = {*Agaricus
Animals
Colitis/chemically induced/*drug therapy
Cytokines/metabolism
Dextran Sulfate
Disease Models, Animal
Male
Mice
Mice, Inbred ICR
*Phytotherapy
Tumor Necrosis Factor-alpha/metabolism
Agaricus bisporus
colitis
dextran sulfate sodium
inflammation},
   ISSN = {1096-620x},
   Accession Number = {25357009},
   DOI = {10.1089/jmf.2014.3191},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Urbano, A. P. and Sassaki, L. Y. and Dorna, M. S. and Carvalhaes, M. A. and Martini, L. A. and Ferreira, A. L.},
   title = {Nutritional intake according to injury extent in ulcerative colitis patients},
   journal = {J Hum Nutr Diet},
   volume = {26},
   number = {5},
   pages = {445-51},
   note = {1365-277x
Urbano, A P S
Sassaki, L Y
Dorna, M S
Carvalhaes, M A de Barros Leite
Martini, L A
Ferreira, A L A
Journal Article
Research Support, Non-U.S. Gov't
England
J Hum Nutr Diet. 2013 Oct;26(5):445-51. doi: 10.1111/jhn.12064. Epub 2013 Apr 8.},
   abstract = {BACKGROUND: Ulcerative colitis (UC) is often associated with nutritional deficiency, which appears to contribute to the progression of UC severity. The present study aimed to evaluate nutritional status and dietary intake in UC remission patients. METHODS: The present study comprised a cross-sectional study in which variables such as extent of disease (distal colitis, left-sided colitis, pancolitis), remission period, sex and age were recorded. Extent of disease was assessed by the results of a colonoscopy and dietary intake was evaluated by using 3-day, 24-h recalls. A Kruskall-Wallis test was used to compare the intake of macro- and micronutrients among the three study groups. The analysis was complemented by the Mann-Whitney test. A logistic regression analysis was performed to identify predictive factors of extent of disease (pancolitis versus left-sided colitis versus distal colitis). RESULTS: The median (range) age of the 59 patients was 49.0 (37.0-63.0) years and 53.3% were female. Twenty-six (44.1%) patients had distal colitis, 11 (18.6%) patients had left-sided colitis and 22 (37.3%) patients had pancolitis. A high probability of an inadequate intake of fibre (100%), fat soluble vitamins (>40% for vitamin A and >95% for vitamin E), vitamin C (>34%), calcium (>90%) and magnesium (>50%) was identified in the study group. Vitamin D intake (odds ratio = 0.60; 95% confidence interval = 0.39-0.94; P < 0.05) was significantly associated with increased intestinal damage. CONCLUSIONS: A large number of individuals showed an inadequate intake of nutrients. In addition, the consumption of vitamin D was significantly associated with extent of disease.},
   keywords = {Adult
Ascorbic Acid/administration & dosage
Body Mass Index
Calcium, Dietary/administration & dosage
Colitis, Ulcerative/complications/*pathology
Colonoscopy
Cross-Sectional Studies
Dietary Carbohydrates/administration & dosage
Dietary Fats/administration & dosage
Dietary Fiber/administration & dosage
Dietary Proteins/administration & dosage
*Energy Intake
Female
Humans
Male
Malnutrition/complications/*pathology
Micronutrients/administration & dosage
Middle Aged
*Nutritional Status
Vitamin A/administration & dosage
Vitamin D/administration & dosage
Vitamin K/administration & dosage
inadequate intake
nutrient intake
nutritional assessment
overweight
ulcerative colitis
vitamin D},
   ISSN = {0952-3871},
   Accession Number = {23560822},
   DOI = {10.1111/jhn.12064},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Urganci, N. and Kalyoncu, D.},
   title = {Immunogenecity of hepatitis A and B vaccination in pediatric patients with inflammatory bowel disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {56},
   number = {4},
   pages = {412-15},
   note = {1536-4801
Urganci, Nafiye
Kalyoncu, Derya
Comparative Study
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2013 Apr;56(4):412-15. doi: 10.1097/MPG.0b013e31827dd87d.},
   abstract = {OBJECTIVES: Aim of the study was to evaluate the response to hepatitis A and B vaccination in pediatric patients with inflammatory bowel disease (IBD). METHODS: A total of 47 patients with IBD (25 ulcerative colitis, 14 Crohn's disease, and 8 indeterminate colitis) ages 3 to 17 years were compared with 50 healthy age- and sex-matched controls. Screening for hepatitis A and B serology was carried out before vaccination. Susceptible cases received 20 mg of recombinant DNA vaccine for hepatitis B (0, 1, and 6 months)and 720 milliELISA units of inactivated hepatitis A virus vaccine (HAV) (0 and 6 months). Postvaccination serologic evaluation was performed 1 month after the last dose of primary vaccination, 1 month after the booster dose, and once every year during follow-up. RESULTS: A total of 23 patients and 35 controls received HAV and protective anti-HAV antibodies were developed in all of the patients and controls (P =1.00). Forty-seven patients and 50 controls received hepatitis B vaccine and 70.2% of the patients versus 90% of the controls achieved seroprotection(anti-HBs titers 10 mIU/mL) 1 month after primary vaccination (95% confidence interval 0.71-0.87, P = 0.02). The overall seroprotection rates were 96% in controls and 85.1% in patients after the whole hepatitis B vaccination series (95% confidence interval 0.83-0.95, P = 0.08). No significant reduction was observed in antibody response among patients and controls during the follow-up period. CONCLUSIONS: The rate of seroconversion to the hepatitis B vaccine was lower in pediatric patients with IBD than in healthy controls and hepatitis A vaccine was highly immunogenic among patients with IBD.},
   keywords = {Adolescent
Child
Child, Preschool
Colitis, Ulcerative/blood/immunology
Crohn Disease/blood/immunology
Female
Follow-Up Studies
Hepatitis A Antibodies/analysis
Hepatitis A Vaccines/*immunology
Hepatitis A Virus, Human/immunology
Hepatitis B Antibodies/analysis
Hepatitis B Vaccines/*immunology
Hepatitis B virus/immunology
Humans
*Immunity, Humoral
Inflammatory Bowel Diseases/blood/*immunology
Male
Prospective Studies
Vaccines, DNA/immunology
Vaccines, Inactivated/immunology
childhood, Crohn's Disease, hepatitis A vaccine, hepatitis B vaccine,
inflammatory bowel disease, ulcerative colitis},
   ISSN = {0277-2116},
   Accession Number = {23841120},
   DOI = {10.1097/MPG.0b013e31827dd87d},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Urlep, D. and Trop, T. K. and Blagus, R. and Orel, R.},
   title = {Incidence and phenotypic characteristics of pediatric IBD in northeastern Slovenia, 2002-2010},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {58},
   number = {3},
   pages = {325-32},
   note = {1536-4801
Urlep, Darja
Trop, Tina K
Blagus, Rok
Orel, Rok
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2014 Mar;58(3):325-32. doi: 10.1097/MPG.0000000000000207.},
   abstract = {OBJECTIVES: The purpose of the present study was to determine the incidence of inflammatory bowel disease (IBD) and its subgroups in children in northeastern Slovenia (NE Slovenia) during the period 2002-2010, and to assess the phenotypic characteristics at the diagnosis and during the follow-up. METHODS: A retrospective investigation was conducted on a cohort of newly diagnosed children and adolescents with IBD ages 0 to 18 years between 2002 and 2010 and residing in NE Slovenia. The phenotypic characteristics were determined at presentation and during follow-up. The location of Crohn disease (CD) and ulcerative colitis (UC) was assessed according to the Paris classification at diagnosis, and later in patients who had a follow-up period >2 years. The type of therapy at diagnosis and during follow-up, and the need for surgery were determined. The study covered approximately one-third of the total pediatric population (0-18 years). RESULTS: In total, 107 cases of IBD were diagnosed during the study period. The mean annual incidence (per 100,000) was 7.6 (95% confidence interval [CI] 6.3-9.2) for all IBD, 4.6 (95% CI 3.6-5.9) for CD, and 2.8 (95% CI 1.9-3.8) for UC. The incidences of total IBD, CD, and UC increased from 5.7 (3.8-8.2), 3.9 (2.3-6.1), and 1.8 (0.8-3.5) in the period 2002-2004, respectively, to 8.9 (6.3-12.2), 5.0 (3.1-7.6), and 3.4 (1.9-5.6) in the period 2008-2010, respectively. During the follow-up, the proportion of complicated CD disease behavior (stricturing/penetrating) had doubled. A total of 18.5% of patients with CD underwent bowel surgery. CONCLUSIONS: The incidence of childhood IBD in the northeastern part of the country is high and comparable with that reported from the developed western countries of Europe, and is probably still increasing. This increase may be the result of changes in the lifestyle, especially in dietary habits during the last 20 years.},
   keywords = {Adolescent
Child
Child, Preschool
Colitis, Ulcerative/*epidemiology
Crohn Disease/*epidemiology/pathology/surgery
Female
Humans
Incidence
Infant
Intestines/surgery
Male
Retrospective Studies
Slovenia/epidemiology},
   ISSN = {0277-2116},
   Accession Number = {24135984},
   DOI = {10.1097/mpg.0000000000000207},
   year = {2014},
   type = {Ref–rence Type}
}

@article{
   author = {Ushiku, T. and Moran, C. J. and Lauwers, G. Y.},
   title = {Focally enhanced gastritis in newly diagnosed pediatric inflammatory bowel disease},
   journal = {Am J Surg Pathol},
   volume = {37},
   number = {12},
   pages = {1882-8},
   note = {1532-0979
Ushiku, Tetsuo
Moran, Christopher J
Lauwers, Gregory Y
P30 DK043351/DK/NIDDK NIH HHS/United States
DK043351/DK/NIDDK NIH HHS/United States
Journal Article
Research Support, N.I.H., Extramural
United States
Am J Surg Pathol. 2013 Dec;37(12):1882-8. doi: 10.1097/PAS.0b013e31829f03ee.},
   abstract = {Although the significance of focally enhanced gastritis (FEG) as a marker of Crohn disease (CD) in adults has been contested, several studies suggest that it may be more specific of CD in pediatric patients. This study describes the detailed histologic features of FEG in pediatric inflammatory bowel disease (IBD) and clarifies its association with CD. A series of 119 consecutive newly diagnosed IBD patients (62 CD cases, 57 ulcerative colitis [UC] cases) with upper and lower gastrointestinal biopsies were evaluated. The histology of the gastric biopsies was reviewed blinded to final diagnoses and compared with age-matched healthy controls (n=66). FEG was present in 43% of IBD patients (CD 55% vs. UC 30%, P=0.0092) and in 5% of controls. Among CD patients, FEG was more common in younger patients (73% in children aged 10 y and below, 43% in children above 10 y of age, P=0.0358), with the peak in the 5- to 10-year age group (80%). The total number of glands involved in each FEG focus was higher in UC (6.4+/-5.1 glands) than in CD (4.0+/-3.0 glands, P=0.0409). Amongst the CD cohort, patients with FEG were more likely than those without FEG to have active ileitis (79% vs. 40%, P=0.0128) and granulomas elsewhere in the gastrointestinal tract (82% vs. 43%, P=0.0016). There was no correlation between FEG and other gastrointestinal findings of UC. We demonstrate that differences in FEG seen in pediatric CD and UC relate to not only their frequencies but also the morphology and relationship with other gastrointestinal lesions. Further, FEG is associated with disease activity and the presence of granulomas in pediatric CD.},
   keywords = {Adolescent
Child
Child, Preschool
Female
Gastritis/*complications/*pathology
Humans
Inflammatory Bowel Diseases/*complications/*pathology
Male
Retrospective Studies
Young Adult},
   ISSN = {0147-5185},
   Accession Number = {24121177},
   DOI = {10.1097/PAS.0b013e31829f03ee},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Vadlamudi, N. and Maclin, J. and Dimmitt, R. A. and Thame, K. A.},
   title = {Cryptosporidial infection in children with inflammatory bowel disease},
   journal = {J Crohns Colitis},
   volume = {7},
   number = {9},
   pages = {e337-43},
   note = {1876-4479
Vadlamudi, Narendra
Maclin, Jeanine
Dimmitt, Reed A
Thame, Kirk A
Journal Article
Observational Study
England
J Crohns Colitis. 2013 Oct;7(9):e337-43. doi: 10.1016/j.crohns.2013.01.015. Epub 2013 Feb 15.},
   abstract = {BACKGROUND AND AIMS: Cryptosporidiosis is usually a self-limiting illness in healthy patients. However, it can cause severe life threatening complications in immunocompromised patients. The effect of cryptosporidial infection on inflammatory bowel disease (IBD) has not been well studied and available literature is largely restricted to adult case reports. The purpose of this study is to describe the clinical characteristics of cryptosporidial infection in children with IBD. METHODS: Stool studies from children with IBD presenting with presumed relapse during the period 2005-2011 were reviewed retrospectively. Cryptosporidial infection was diagnosed by stool enzyme immunoassay. An age matched control group of IBD patients without cryptosporidial infection was used for comparison. RESULTS: Medical records of 170 IBD patients were reviewed and a total of 149 presumed relapses were identified. Cryptosporidial infection was found in seven of the 39 patients with positive stool studies (four ulcerative colitis/three Crohn's disease) presenting with relapse. The median age was 13 years (range: 3-17) and five patients were female. The median duration of the IBD was 18 months (range 2-48 months). All but one patient had stable disease prior to acquiring infection. Five patients required hospitalization due to significant dehydration. Three of the five patients treated with nitazoxanide had significant clinical improvement in 3 days. All patients had complete resolution of symptoms by three weeks and no infection related complications were noted. In comparison to patients with cryptosporidial infection, the control group required an increased need for escalation of therapy (71% vs. 0.0%, p=001) and higher re-hospitalization rates (24% Vs.0.0%, p=0.54) within 6 months following indexed relapse. CONCLUSION: In IBD patients, cryptosporidiosis can cause significant illness leading to increased need for hospitalization. In the absence of appropriate stool studies, cryptosporidiosis can be misdiagnosed as disease relapse and lead to inappropriate therapy. Nitazoxanide appears to be effective along with supportive therapy.},
   keywords = {Adolescent
Adrenal Cortex Hormones/administration & dosage
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
Antiparasitic Agents/therapeutic use
Case-Control Studies
Child
Child, Preschool
Colitis, Ulcerative/*complications/drug therapy
Crohn Disease/*complications/drug therapy
Cryptosporidiosis/*complications/diagnosis/drug therapy
Cryptosporidium/isolation & purification
Diarrhea/*etiology/parasitology
Feces/parasitology
Female
Humans
Immunosuppressive Agents/administration & dosage
Male
Patient Readmission
Recurrence
Retrospective Studies
Severity of Illness Index
Thiazoles/therapeutic use
5-asa
5-Amino-salicylic acid
Anti-tumor necrosis factor alpha
Cd
Crohn's disease
Cryptosporidium
Gastroenteritis
Ibd
Inflammatory bowel disease
Nitazoxanide
Uc
Ulcerative colitis
aTNFalpha},
   ISSN = {1873-9946},
   Accession Number = {23415795},
   DOI = {10.1016/j.crohns.2013.01.015},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {van Schaik, F. D. and Oldenburg, B. and Hart, A. R. and Siersema, P. D. and Lindgren, S. and Grip, O. and Teucher, B. and Kaaks, R. and Bergmann, M. M. and Boeing, H. and Carbonnel, F. and Jantchou, P. and Boutron-Ruault, M. C. and Tjonneland, A. and Olsen, A. and Crowe, F. L. and Peeters, P. H. and van Oijen, M. G. and Bueno-de-Mesquita, H. B.},
   title = {Serological markers predict inflammatory bowel disease years before the diagnosis},
   journal = {Gut},
   volume = {62},
   number = {5},
   pages = {683-8},
   note = {1468-3288
van Schaik, Fiona D M
Oldenburg, Bas
Hart, Andrew R
Siersema, Peter D
Lindgren, Stefan
Grip, Olof
Teucher, Birgit
Kaaks, Rudolf
Bergmann, Manuela M
Boeing, Heiner
Carbonnel, Franck
Jantchou, Prevost
Boutron-Ruault, Marie-Christine
Tjonneland, Anne
Olsen, Anja
Crowe, Francesca L
Peeters, Petra H M
van Oijen, Martijn G H
Bueno-de-Mesquita, H Bas
Department of Health/United Kingdom
Medical Research Council/United Kingdom
Cancer Research UK/United Kingdom
British Heart Foundation/United Kingdom
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
England
Gut. 2013 May;62(5):683-8. doi: 10.1136/gutjnl-2012-302717. Epub 2012 Jul 26.},
   abstract = {OBJECTIVE: Anti-neutrophil cytoplasmic antibodies and anti-Saccharomyces cerevisiae mannan antibodies (ASCAs) have been detected in the serum of patients with ulcerative colitis (UC) and Crohn's disease (CD) and their unaffected family members. The aim of this study was to establish the value of serological markers as predictors of UC and CD. DESIGN: Individuals who developed CD or UC were identified from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. At recruitment, none of the participants had a diagnosis of CD or UC. For each incident case, two controls were randomly selected matched for centre, date of birth, sex, date of recruitment and time of follow-up. Serum of cases and controls obtained at recruitment were analysed for ASCA IgG, ASCA IgA, perinuclear anti-neutrophil cytoplasmic antibody (pANCA), antibodies against Escherichia coli outer membrane porin C (OmpC) and flagellin CBir1. Conditional logistic regression was used to determine risk of CD and UC. Receiver operating characteristic curves were constructed to test accuracy. RESULTS: A total of 77 individuals were diagnosed with CD and 167 with UC after a mean follow-up of 4.5 (SD 3.2) and 4.4 (SD 3.1) years following blood collection, respectively. Combinations of pANCA, ASCA, anti-CBir1 and anti-OmpC were most accurate in predicting incident CD and UC (area under curve 0.679 and 0.657, respectively). The predictive value of the combination of markers increased when time to diagnosis of CD or UC decreased. CONCLUSION: A panel of serological markers is able to predict development of CD and UC in individuals from a low-risk population.},
   keywords = {Adult
Antibodies, Antineutrophil Cytoplasmic/*blood
Biomarkers/blood
Case-Control Studies
Cohort Studies
Colitis, Ulcerative/diagnosis/immunology
Crohn Disease/diagnosis/immunology
Europe
Female
Flagellin/blood
Follow-Up Studies
Humans
Immunoglobulin A/*blood
Immunoglobulin G/*blood
Immunologic Factors/*blood
Inflammatory Bowel Diseases/*diagnosis/*immunology
Logistic Models
Male
Middle Aged
Porins/blood
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity},
   ISSN = {0017-5749},
   Accession Number = {22842615},
   DOI = {10.1136/gutjnl-2012-302717},
   year = {2013},
   type = {Ref–rence Type}
}

@article{
   author = {Varni, J. W. and Bendo, C. B. and Denham, J. and Shulman, R. J. and Self, M. M. and Neigut, D. A. and Nurko, S. and Patel, A. S. and Franciosi, J. P. and Saps, M. and Verga, B. and Smith, A. and Yeckes, A. and Heinz, N. and Langseder, A. and Saeed, S. and Zacur, G. M. and Pohl, J. F.},
   title = {PedsQL gastrointestinal symptoms module: feasibility, reliability, and validity},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {59},
   number = {3},
   pages = {347-55},
   note = {1536-4801
Varni, James W
Bendo, Cristiane B
Denham, Jolanda
Shulman, Robert J
Self, Mariella M
Neigut, Deborah A
Nurko, Samuel
Patel, Ashish S
Franciosi, James P
Saps, Miguel
Verga, Barbara
Smith, Alicia
Yeckes, Alyson
Heinz, Nicole
Langseder, Annette
Saeed, Shehzad
Zacur,

repository: KociOrges/pytag

repo_name: KociOrges/pytag