text:
; budesonide must be preferred, as this steroid is better tolerated than prednisone. In patients refractory or intolerant to steroids, infliximab or artificial nutrition can be considered. Maintenance treatment is indicated in most of IBD patients. 5-ASA derivates are preferred in UC; in case of failure, azathioprine can be used. In Crohn's disease, azathioprine or methotrexate are more widely used; maintenance with infliximab is an option in case of failure. Surgery is mainly indicated for complications or in patients resistant to medical treatment.},
   keywords = {Adrenal Cortex Hormones/therapeutic use
Aminosalicylic Acids/therapeutic use
Humans
Immunosuppressive Agents/therapeutic use
Inflammatory Bowel Diseases/*therapy
Tumor Necrosis Factor-alpha/antagonists & inhibitors},
   ISSN = {0035-2640 (Print)
0035-2640},
   Accession Number = {16052969},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Levine, A. and Shamir, R. and Wine, E. and Weiss, B. and Karban, A. and Shaoul, R. R. and Reif, S. S. and Yakir, B. and Friedlander, M. and Kaniel, Y. and Leshinsky-Silver, E.},
   title = {TNF promoter polymorphisms and modulation of growth retardation and disease severity in pediatric Crohn's disease},
   journal = {Am J Gastroenterol},
   volume = {100},
   number = {7},
   pages = {1598-604},
   note = {Levine, Arie
Shamir, Raanan
Wine, Eytan
Weiss, Batya
Karban, Amir
Shaoul, Ron R
Reif, Shimon S
Yakir, Benjamin
Friedlander, Marcello
Kaniel, Yael
Leshinsky-Silver, Esther
Journal Article
United States
Am J Gastroenterol. 2005 Jul;100(7):1598-604.},
   abstract = {OBJECTIVES: Delayed growth is common in pediatric Crohn's disease (CD). Multiple factors have been shown to affect growth in this situation, the most prominent being the presence and severity of inflammation and inadequate nutritional intake. Inflammation, anorexia, and weight loss are all manifestations of circulating TNF-alpha, which is elevated in CD. The ability to secrete TNF-alpha may be affected by polymorphisms in the TNF-alpha promoter. The aim of our study was to determine whether growth retardation and disease severity in pediatric onset CD are affected by TNF promoter genotype. METHODS: Genotyping for TNF-alpha and NOD2/CARD15 single nucleotide polymorphisms was performed in 87 patients with detailed growth records. Parameters including disease location and disease severity were recorded, and the effect of these polymorphisms on Z-scores for height and weight at disease onset and during follow-up were analyzed. RESULTS: Lower age of onset was linked to more height retardation, while the presence of colonic disease and the absence of ileal disease were more likely to predict the absence of growth retardation. The presence of two polymorphisms thought to decrease circulating TNF-alpha was associated with higher mean Z-scores for height and a trend toward less growth retardation. Two other polymorphisms were modestly associated with disease severity. CONCLUSION: Polymorphisms in the TNF-alpha promoter may independently modulate growth and disease severity in pediatric onset CD. The effect of these polymorphisms does not appear to be mediated via weight loss, and is relatively modest.},
   keywords = {Adenine
Adolescent
Child
Cohort Studies
Crohn Disease/*complications/genetics/*physiopathology
Cytosine
Female
Genotype
Growth Disorders/*etiology/*physiopathology
Guanine
Humans
Male
*Polymorphism, Single Nucleotide
Promoter Regions, Genetic/*genetics
Severity of Illness Index
Thymine
Tumor Necrosis Factor-alpha/*genetics},
   ISSN = {0002-9270 (Print)
0002-9270},
   Accession Number = {15984988},
   DOI = {10.1111/j.1572-0241.2005.41737.x},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Lionetti, P. and Callegari, M. L. and Ferrari, S. and Cavicchi, M. C. and Pozzi, E. and de Martino, M. and Morelli, L.},
   title = {Enteral nutrition and microflora in pediatric Crohn's disease},
   journal = {JPEN J Parenter Enteral Nutr},
   volume = {29},
   number = {4 Suppl},
   pages = {S173-5; discussion S175-8, S184-8},
   note = {Lionetti, Paolo
Callegari, Maria Luisa
Ferrari, Susanna
Cavicchi, Maria Chiara
Pozzi, Elena
de Martino, Maurizio
Morelli, Lorenzo
Journal Article
United States
JPEN J Parenter Enteral Nutr. 2005 Jul-Aug;29(4 Suppl):S173-5; discussion S175-8, S184-8.},
   abstract = {BACKGROUND: Exclusive enteral nutrition (EN) is an established primary therapy for pediatric Crohn's disease (CD). The mechanism of action of such treatment is still conjectural. The aim of the present study was to investigate if EN-induced remission is associated with modification of the fecal microflora in CD. METHODS: Stool samples were collected from 5 healthy children and adolescents over a period of 3 months, and from 9 children and adolescents with active CD. To induce disease remission, children with CD received a course of exclusive EN for 8 weeks with a polymeric formula (Modulen IBD, Nestle). At the end of the course of exclusive EN, children returned to a free diet but continued to take 40% of the daily caloric intake as polymeric formula. Fecal microflora was analyzed by 16S ribosomal DNA polymerase chain reaction and temperature gradient gel electrophoresis (TGGE) with direct visual comparison of band profiles of PCR products. RESULTS: In 8 of 9 children, the exclusive EN alone induced disease remission. In 1 child, it was necessary to add steroids to the exclusive EN course to achieve remission. In all children with CD, analysis of gel band distribution revealed profound modification of the fecal microflora after exclusive EN. Variations of band distribution corresponding to different bacterial species were observed also in children on partial EN and required time to achieve stability of the band profile. In contrast, control healthy children showed a host-specific and stable TGGE profile over time. CONCLUSION: These data suggest that a possible mechanism of action of EN in inducing disease remission in CD is the capacity of modification of gut microflora. Possible explanations of such capacity are both low residue and prebiotic properties of the polymeric liquid formula.},
   keywords = {Adolescent
Child
Crohn Disease/*microbiology/*therapy
DNA, Bacterial/*analysis
Electrophoresis, Agar Gel
*Enteral Nutrition
Feces/*microbiology
Female
Humans
Male
Polymerase Chain Reaction
Probiotics/therapeutic use
RNA, Ribosomal, 16S/analysis
Remission Induction
Treatment Outcome},
   ISSN = {0148-6071 (Print)
0148-6071},
   Accession Number = {15980280},
   DOI = {10.1177/01486071050290s4s173},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Lloyd-Still, J.},
   title = {Re: Gastrointestinal outcomes and confounders in cystic fibrosis},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {42},
   number = {2},
   pages = {243-4; author reply 244},
   note = {Lloyd-Still, John
Comment
Letter
United States
J Pediatr Gastroenterol Nutr. 2006 Feb;42(2):243-4; author reply 244.},
   keywords = {Celiac Disease/complications/*epidemiology
Crohn Disease/complications/*epidemiology
Cystic Fibrosis/*complications
Humans
Prevalence},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16456424},
   DOI = {10.1097/01.mpg.0000189334.62397.86},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Lochs, H.},
   title = {To feed or not to feed? Are nutritional supplements worthwhile in active Crohn's disease?},
   journal = {Gut},
   volume = {55},
   number = {3},
   pages = {306-7},
   note = {Lochs, H
Comment
Journal Article
Review
England
Gut. 2006 Mar;55(3):306-7.},
   keywords = {Crohn Disease/*therapy
*Enteral Nutrition
Humans
Nutritional Status
Treatment Outcome},
   ISSN = {0017-5749 (Print)
0017-5749},
   Accession Number = {16474102},
   DOI = {10.1136/gut.2005.077602},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Lochs, H. and Dejong, C. and Hammarqvist, F. and Hebuterne, X. and Leon-Sanz, M. and Schutz, T. and van Gemert, W. and van Gossum, A. and Valentini, L. and Lubke, H. and Bischoff, S. and Engelmann, N. and Thul, P.},
   title = {ESPEN Guidelines on Enteral Nutrition: Gastroenterology},
   journal = {Clin Nutr},
   volume = {25},
   number = {2},
   pages = {260-74},
   note = {Lochs, H
Dejong, C
Hammarqvist, F
Hebuterne, X
Leon-Sanz, M
Schutz, T
van Gemert, W
van Gossum, A
Valentini, L
DGEM (German Society for Nutritional Medicine)
Lubke, H
Bischoff, S
Engelmann, N
Thul, P
ESPEN (European Society for Parenteral and Enteral Nutrition)
Consensus Development Conference
Journal Article
Practice Guideline
England
Clin Nutr. 2006 Apr;25(2):260-74. Epub 2006 May 15.},
   abstract = {Undernutrition as well as specific nutrient deficiencies have been described in patients with Crohn's disease (CD), ulcerative colitis (UC) and short bowel syndrome (SBS). The present guideline gives evidence-based recommendations for the indication, application and type of formula of enteral nutrition (EN) (oral nutritional supplements (ONS) or tube feeding (TF)) in these patients. It was developed in an interdisciplinary consensus-based process in accordance with officially accepted standards and is based on all relevant publications since 1985. ONS and/or TF in addition to normal food is indicated in undernourished patients with CD or CU to improve nutritional status. In active CD EN is the first line therapy in children and should be used as sole therapy in adults mainly when treatment with corticosteroids is not feasible. No significant differences have been shown in the effects of free amino acid, peptide-based and whole protein formulae for TF. In remission ONS is recommended only in steroid dependent patients in CD. In patients with SBS TF should be introduced in the adaptation phase and should be changed with progressing adaptation to ONS in addition to normal food.},
   keywords = {Colitis, Ulcerative/therapy
Crohn Disease/therapy
Enteral Nutrition/*standards
Europe
Gastroenterology/*standards
Humans
Practice Patterns, Physicians'
Short Bowel Syndrome/therapy},
   ISSN = {0261-5614 (Print)
0261-5614},
   Accession Number = {16698129},
   DOI = {10.1016/j.clnu.2006.01.007},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Macdonald, A.},
   title = {Omega-3 fatty acids as adjunctive therapy in Crohns disease},
   journal = {Gastroenterol Nurs},
   volume = {29},
   number = {4},
   pages = {295-301; quiz 302-3},
   note = {Macdonald, Angie
Journal Article
Review
United States
Gastroenterol Nurs. 2006 Jul-Aug;29(4):295-301; quiz 302-3.},
   abstract = {Crohns disease is an inflammatory bowel disease that can have a significant impact on the health of those afflicted. The etiology of the disease is unknown, but genetic, environmental, dietary, and immunological factors are thought to be involved. Multiple nutrients can become depleted during active disease due to inadequate intake or malabsorption. Preventing these deficiencies is paramount in the care of those suffering from Crohns disease. Often the traditional treatments (medications) have limited effectiveness and negative side effects that inhibit their use. Enteral nutrition has promising therapeutic benefits, but its use is often limited to the pediatric population due to poor patient acceptability. Omega-3 fatty acids have been investigated for their anti-inflammatory properties as an alternative to traditional care. This article reviews the etiology of Crohns disease, nutritional deficiencies, traditional treatments, and the use of omega-3 fatty acids in the prevention of Crohns recurrence. The results from clinical trials have been conflicting, but a new fish oil preparation that limits the side effects of traditional fish oil therapy shows promise as an adjunctive treatment for Crohns disease. Continued research is needed to validate these findings.},
   keywords = {Causality
Chemistry, Pharmaceutical
Clinical Trials as Topic/*standards
Crohn Disease/etiology/nursing/*prevention & control
Enteral Nutrition
Evidence-Based Medicine
Fatty Acids, Omega-3/chemistry/*therapeutic use
Forecasting
Genetic Predisposition to Disease/etiology
Health Services Needs and Demand
Humans
Nurse's Role
Nutrition Disorders/etiology/nursing/*prevention & control
Recurrence
Research Design/*standards
Treatment Outcome},
   ISSN = {1042-895X (Print)
1042-895x},
   Accession Number = {16974165},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {MacDonald, T. T. and Di Sabatino, A. and Gordon, J. N.},
   title = {Immunopathogenesis of Crohn's disease},
   journal = {JPEN J Parenter Enteral Nutr},
   volume = {29},
   number = {4 Suppl},
   pages = {S118-24; discussion S124-5, S184-8},
   note = {MacDonald, Thomas T
Di Sabatino, Antonio
Gordon, John N
Journal Article
Review
United States
JPEN J Parenter Enteral Nutr. 2005 Jul-Aug;29(4 Suppl):S118-24; discussion S124-5, S184-8.},
   abstract = {This review highlights the huge advances made in the understanding of Crohn's disease in the last 15 years. The pathogenic immune response in the gut wall is a highly polarised T helper cell type 1 response, probably directed against antigens of the commensal flora. There is marked over-expression of pro-inflammatory cytokines such as tumor necrosis factor (TNF)-alpha and increased production of matrix degrading enzymes by fibroblasts and macrophages, which are probably responsible for ulceration and fistula formation. Crohn's disease runs in families and the susceptibility genes identified so far are associated with innate recognition of microbial products (Nod2) or epithelial barrier function (OCTN cation transporter genes and DLG5). Endogenous healing pathways mediated by transforming growth factor (TGF)-beta1 are inhibited because mucosal inflammatory cells express Smad7, the endogenous intracellular inhibitor of TGF-beta signalling. This makes it unlikely that enteral feeds containing TFG-beta are therapeutic by means of direct anti-inflammatory effects, however TGF-beta may still be involved because it is a well known epithelial motogen and may promote mucosal healing, in synergy with changes in mucosal bacterial populations as a result of the change in the diet.},
   keywords = {*Crohn Disease/etiology/immunology/pathology/therapy
Cytokines/biosynthesis/immunology
*Enteral Nutrition
Genetic Predisposition to Disease
Granulocytes/immunology/metabolism
Humans
Intestinal Mucosa/*immunology/*microbiology/pathology
T-Lymphocytes/immunology/metabolism},
   ISSN = {0148-6071 (Print)
0148-6071},
   Accession Number = {15980273},
   DOI = {10.1177/01486071050290s4s118},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {MacLean, C. H. and Mojica, W. A. and Newberry, S. J. and Pencharz, J. and Garland, R. H. and Tu, W. and Hilton, L. G. and Gralnek, I. M. and Rhodes, S. and Khanna, P. and Morton, S. C.},
   title = {Systematic review of the effects of n-3 fatty acids in inflammatory bowel disease},
   journal = {Am J Clin Nutr},
   volume = {82},
   number = {3},
   pages = {611-9},
   note = {MacLean, Catherine H
Mojica, Walter A
Newberry, Sydne J
Pencharz, James
Garland, Rena Hasenfeld
Tu, Wenli
Hilton, Lara G
Gralnek, Ian M
Rhodes, Shannon
Khanna, Puja
Morton, Sally C
Journal Article
Meta-Analysis
Research Support, U.S. Gov't, Non-P.H.S.
Review
United States
Am J Clin Nutr. 2005 Sep;82(3):611-9.},
   abstract = {BACKGROUND: n-3 Fatty acids are purported to have health effects in patients with inflammatory bowel disease (IBD), but studies have reported mixed results. OBJECTIVE: We aimed to synthesize published and unpublished evidence to determine estimates of the effect of n-3 fatty acids on clinical outcomes in IBD and whether n-3 fatty acids modify the effects of or need for treatment with other agents. DESIGN: Computerized databases were searched for studies of n-3 fatty acids in immune-mediated diseases from 1966 to 2003. We also contacted experts in the nutraceutical industry to identify unpublished studies; however, none were identified. RESULTS: Reviewers identified 13 controlled trials that assessed the effects of n-3 fatty acids on clinical, sigmoidoscopic, or histologic scores; rates of induced remission or relapse; or requirements for steroids and other immunosuppressive agents in Crohn disease or ulcerative colitis. Most clinical trials were of good quality. Fewer than 6 were identified that assessed the effects of n-3 fatty acids on any single outcome of clinical, endoscopic, or histologic scores or remission or relapse rates. Consistent across 3 studies was the finding that n-3 fatty acids reduce corticosteroid requirements, although statistical significance was shown in only 1 of these studies. CONCLUSION: The available data are insufficient to draw conclusions about the effects of n-3 fatty acids on clinical, endoscopic, or histologic scores or remission or relapse rates.},
   keywords = {Controlled Clinical Trials as Topic
Fatty Acids, Omega-3/*therapeutic use
Humans
Immunosuppressive Agents/therapeutic use
Inflammatory Bowel Diseases/*drug therapy/pathology
Randomized Controlled Trials as Topic
Recurrence
Remission Induction
Severity of Illness Index
Treatment Outcome},
   ISSN = {0002-9165 (Print)
0002-9165},
   Accession Number = {16155275},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Makharia, G. K. and Sachdev, V. and Gupta, R. and Lal, S. and Pandey, R. M.},
   title = {Anti-Saccharomyces cerevisiae antibody does not differentiate between Crohn's disease and intestinal tuberculosis},
   journal = {Dig Dis Sci},
   volume = {52},
   number = {1},
   pages = {33-9},
   note = {Makharia, Govind K
Sachdev, Vikas
Gupta, Rajiva
Lal, Suman
Pandey, R M
Journal Article
Research Support, Non-U.S. Gov't
United States
Dig Dis Sci. 2007 Jan;52(1):33-9. Epub 2006 Dec 8.},
   abstract = {The clinical, morphological, and histological features of intestinal tuberculosis (IT) and Crohn's disease (CD) mimic so much, that it becomes difficult to differentiate between them. The sensitivity of anti-Saccharomyces cerevisiae antibody (ASCA) IgG and ASCA IgA in CD is 60%-80%, whereas the specificity is almost 90%. There are no reports of study of ASCA in patients with IT, nor has it ever been used to differentiate CD from IT. Patients with ulcerative colitis (UC; n=25), CD (n=59), and IT (n=30) and 21 healthy controls were included in this study. The location and behavior of CD were classified according to the Modified Montreal classification. Five milliliters of blood was taken from them and serum was stored at -70 degrees C. ASCA antibodies (both IgG and IgA) were estimated using commercially available ELISA kits (AESKU Diagnostics, Germany). Anti-neutrophilic cytoplasmic antibody was measured by indirect immunofluorescence test. ASCA IgA was positive in 4.7%, 28%, 33.9%, and 43.3% and ASCA IgG was positive in 4.7%, 24%, 50.8%, and 46.6% of healthy controls and patients with UC, CD, and IT, respectively. Either ASCA IgG or ASCA IgA was positive in 9.5%, 40%, 61% and 66.6% of healthy controls, UC, CD, and IT, respectively. ANCA was positive in 0%, 32%, 10.1%, and 6.6% of healthy controls, UC, CD, and IT, respectively. ASCA IgG was positive in a significantly higher number of patients with CD (P<0.0001) and IT (P<0.0001) in comparison to healthy controls. ASCA IgA was positive in a significantly higher number of patients with UC (P<0.04), CD (P<0.013), and IT (P<0.006) in comparison to healthy controls. In comparisons between diseases, ASCA IgG was positive in significantly more patients with CD (P<0.001) and IT (P<0.001) in comparison to UC. There was no significant difference in ASCA IgA (33.9% vs. 43.3%), ASCA IgG (50.86% vs. 46.6%), or ANCA (10.7%, 7.4%) in patients with CD and IT, respectively. There was no correlation between ASCA and duration, location and behavior of CD, and IT. We conclude that ASCA IgG and ASCA IgA do not help to differentiate between IT and CD.},
   keywords = {Adult
Antibodies, Antineutrophil Cytoplasmic/blood
Antibodies, Fungal/*blood
Biomarkers/blood
Crohn Disease/*diagnosis/immunology
Enzyme-Linked Immunosorbent Assay
Female
Fluorescent Antibody Technique, Indirect
Humans
Immunoglobulin A/blood
Immunoglobulin G/blood
Male
Middle Aged
Saccharomyces cerevisiae/*immunology
Sensitivity and Specificity
Tuberculosis, Gastrointestinal/*diagnosis/immunology},
   ISSN = {0163-2116 (Print)
0163-2116},
   Accession Number = {17160471},
   DOI = {10.1007/s10620-006-9527-0},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Mamula, P. and Markowitz, J. E. and Neiswender, K. and Baldassano, R. N. and Liacouras, C. A.},
   title = {Success rate and duration of paediatric outpatient colonoscopy},
   journal = {Dig Liver Dis},
   volume = {37},
   number = {11},
   pages = {877-81},
   note = {Mamula, P
Markowitz, J E
Neiswender, K
Baldassano, R N
Liacouras, C A
Journal Article
Netherlands
Dig Liver Dis. 2005 Nov;37(11):877-81. Epub 2005 Sep 15.},
   abstract = {BACKGROUND: The paediatric colonoscopy completion rates have rarely been reported. AIMS: We sought to evaluate colonoscopy completion rate and compare the rates using colonoscope versus enteroscope. METHODS: We prospectively investigated 60 patients who underwent colonoscopy between July 1999 and June 2001. The following data were collected: demographics, type of endoscope used, extent of colonoscopy, indication for procedure, histology, adverse events and time to reach the caecum and the terminal ileum. RESULTS: Sixty colonoscopies were performed during the study period, 30 with an enteroscope and 30 with a colonoscope. The caecum was reached in 56/60 (93%) and the terminal ileum in 50/60 (83%). An average time of 12.61 min (S.D. 7.3) was necessary to advance the instrument from the anus to the caecum, and additional 3.67 min (S.D. 3.62) to terminal ileum. There was no difference in the success rate between enteroscope and colonoscope. Six patients (10%) had definitive diagnosis established because a full colonoscopy was performed. No serious adverse events occurred. CONCLUSION: Paediatric colonoscopy to the caecum can be completed safely and expeditiously in more than 90% of procedures. Various types of instruments do not appear to influence completion rate. Full colonoscopy contributes to the establishment of a definitive diagnosis.},
   keywords = {Adolescent
Colonic Polyps/diagnosis
Colonoscopes
Colonoscopy/*utilization
Crohn Disease/diagnosis
Female
Humans
Male
Prospective Studies},
   ISSN = {1590-8658 (Print)
1590-8658},
   Accession Number = {16169306},
   DOI = {10.1016/j.dld.2005.07.012},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Mardini, H. E. and Gregory, K. J. and Nasser, M. and Selby, L. and Arsenescu, R. and Winter, T. A. and de Villiers, W. J.},
   title = {Gastroduodenal Crohn's disease is associated with NOD2/CARD15 gene polymorphisms, particularly L1007P homozygosity},
   journal = {Dig Dis Sci},
   volume = {50},
   number = {12},
   pages = {2316-22},
   note = {Mardini, Houssam E
Gregory, Kalvin J
Nasser, Munira
Selby, Lisbeth
Arsenescu, Razvan
Winter, Trevor A
de Villiers, Willem J S
Comparative Study
Journal Article
United States
Dig Dis Sci. 2005 Dec;50(12):2316-22.},
   abstract = {Limited data exist on the specific association between gastroduodenal Crohn's disease (GDCD) and NOD2/CARD15 gene polymorphisms. The aim of this study was to assess the association between NOD2 polymorphisms and GDCD, and to assess the specific association between each of the 3 major allelic variants G908R, L1007P, and R702W and the clinical features of Crohn's disease. We retrospectively reviewed the records of 202 patients with confirmed Crohn's disease and complete data was performed. Seventy-one patients (35%) had at least 1 allelic variant: 55 had 1 variant, 4 were homozygous for L1007fs, 2 homozygous for R702W, and 10 were compound heterozygous. Eighteen patients with confirmed GDCD were identified; 10 (56%) had wild type, 4 (22%) had 1 variant, and 4 (22%) had 2 allelic variants (2 were L1007P homozygous and 2 compound heterozygous). Compared to patients without gastroduodenal involvement, those with GDCD were more likely to have 2 allelic variants (22% vs. 6%; odds ratio [OR] 2.7; 95% confidence interval [CI] 1.6-7.3) and to be homozygous for L1007P (11% vs. 1%; OR 5.2; 95% CI 2.5-9.4). G908R heterozygosity was associated with ileal involvement (OR 1.4; 95% CI 1.1-2.9) and smoking habits (OR 2.4; 95% CI 1.2-3.8), whereas L1007P homozygosity was associated with GDCD (OR 5.8; 95% CI 2.6-10.8). L1007P variation was associated with younger age at diagnosis as well. There was no specific association between R702W homo- or heterozygosity and any of the characteristics examined. In conclusion, GDCD is associated with double dose of the NOD2/CARD15 gene variants, particularly L1007P homozygosity. There is evidence of specific variant-phenotype associations. G908R heterozygosity is associated with ileal involvement and smoking, whereas L1007P homozygosity is strongly associated with GDCD and younger age at diagnosis.},
   keywords = {Adolescent
Adult
Alleles
Base Sequence
Carrier Proteins/*genetics
Cohort Studies
Crohn Disease/diagnosis/epidemiology/*genetics
Duodenal Diseases/diagnosis/epidemiology/genetics
Female
*Genetic Predisposition to Disease
Homozygote
Humans
Incidence
Intracellular Signaling Peptides and Proteins/*genetics
Logistic Models
Male
Middle Aged
Molecular Sequence Data
Mutation, Missense
Nod2 Signaling Adaptor Protein
*Polymorphism, Genetic
Polymorphism, Restriction Fragment Length
Probability
Prognosis
Reverse Transcriptase Polymerase Chain Reaction
Risk Assessment
Statistics, Nonparametric
Stomach Diseases/diagnosis/epidemiology/genetics},
   ISSN = {0163-2116 (Print)
0163-2116},
   Accession Number = {16416181},
   DOI = {10.1007/s10620-005-3054-2},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Markowitz, J. and Markowitz, J. E. and Bousvaros, A. and Crandall, W. and Faubion, W. and Kirschner, B. S. and Perrault, J. and Rosh, J. and Winter, H.},
   title = {Workshop report: prevention of postoperative recurrence in Crohn's disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {41},
   number = {2},
   pages = {145-51},
   note = {Markowitz, James
Markowitz, Jonathan E
Bousvaros, Athos
Crandall, Wallace
Faubion, William
Kirschner, Barbara S
Perrault, Jean
Rosh, Joel
Winter, Harland
Journal Article
Research Support, Non-U.S. Gov't
Review
United States
J Pediatr Gastroenterol Nutr. 2005 Aug;41(2):145-51.},
   keywords = {Chemoprevention
Child
Crohn Disease/etiology/prevention & control/*surgery
Disease-Free Survival
Humans
Postoperative Period
Risk Factors
*Secondary Prevention
Time Factors},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16056092},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Martin, G. R. and Beck, P. L. and Sigalet, D. L.},
   title = {Gut hormones, and short bowel syndrome: the enigmatic role of glucagon-like peptide-2 in the regulation of intestinal adaptation},
   journal = {World J Gastroenterol},
   volume = {12},
   number = {26},
   pages = {4117-29},
   note = {Martin, G-R
Beck, P-L
Sigalet, D-L
Journal Article
Review
United States
World J Gastroenterol. 2006 Jul 14;12(26):4117-29.},
   abstract = {Short bowel syndrome (SBS) refers to the malabsorption of nutrients, water, and essential vitamins as a result of disease or surgical removal of parts of the small intestine. The most common reasons for removing part of the small intestine are due to surgical intervention for the treatment of either Crohn's disease or necrotizing enterocolitis. Intestinal adaptation following resection may take weeks to months to be achieved, thus nutritional support requires a variety of therapeutic measures, which include parenteral nutrition. Improper nutrition management can leave the SBS patient malnourished and/or dehydrated, which can be life threatening. The development of therapeutic strategies that reduce both the complications and medical costs associated with SBS/long-term parenteral nutrition while enhancing the intestinal adaptive response would be valuable. Currently, therapeutic options available for the treatment of SBS are limited. There are many potential stimulators of intestinal adaptation including peptide hormones, growth factors, and neuronally-derived components. Glucagon-like peptide-2 (GLP-2) is one potential treatment for gastrointestinal disorders associated with insufficient mucosal function. A significant body of evidence demonstrates that GLP-2 is a trophic hormone that plays an important role in controlling intestinal adaptation. Recent data from clinical trials demonstrate that GLP-2 is safe, well-tolerated, and promotes intestinal growth in SBS patients. However, the mechanism of action and the localization of the glucagon-like peptide-2 receptor (GLP-2R) remains an enigma. This review summarizes the role of a number of mucosal-derived factors that might be involved with intestinal adaptation processes; however, this discussion primarily examines the physiology, mechanism of action, and utility of GLP-2 in the regulation of intestinal mucosal growth.},
   keywords = {Animals
Central Nervous System/physiology
Enteric Nervous System/physiology
Gastrointestinal Hormones/*physiology
Glucagon-Like Peptide 2
Glucagon-Like Peptide-2 Receptor
Glucagon-Like Peptides/pharmacology/*physiology/therapeutic use
Humans
Intestinal Absorption/drug effects/physiology
Intestinal Mucosa/drug effects/growth & development/pathology
Intestine, Small/innervation/*physiopathology/surgery
Malabsorption Syndromes/complications
Postoperative Complications
Receptors, Glucagon/drug effects/physiology
Short Bowel Syndrome/drug therapy/etiology/*physiopathology},
   ISSN = {1007-9327 (Print)
1007-9327},
   Accession Number = {16830359},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Matarese, L. E. and Seidner, D. L. and Steiger, E. and Fazio, V.},
   title = {Practical guide to intestinal rehabilitation for postresection intestinal failure: a case study},
   journal = {Nutr Clin Pract},
   volume = {20},
   number = {5},
   pages = {551-8},
   note = {Matarese, Laura E
Seidner, Douglas L
Steiger, Ezra
Fazio, Victor
Case Reports
Journal Article
United States
Nutr Clin Pract. 2005 Oct;20(5):551-8.},
   abstract = {After massive small-intestinal resection or combined small-intestinal and colonic resection, diarrhea with resulting dehydration, electrolyte abnormalities, and malnutrition occur. Many patients become dependent on IV fluids and nutrition. An adaptation process manifested clinically by decreased diarrhea and improved nutrient absorption according to decreased parenteral nutrition and fluid requirements has been noted to occur over time. In some patients, adaptation is inadequate and may require special techniques to enhance and augment this process. This is a case of a 52-year-old woman who experienced increased stoma output 1 week after major intestinal resection, resulting in dehydration. She required IV fluids in order to maintain hydration. After the initiation of an intestinal rehabilitation program, which included modified diet, soluble fiber, oral rehydration solution (ORS), and medications, IV fluids were successfully weaned off in 3 months. She continues not to receive IV fluids and continues to follow the intestinal rehabilitation plan.},
   keywords = {Crohn Disease/complications/*surgery
Dehydration/etiology/therapy
*Diet
Female
Fluid Therapy
Humans
Middle Aged
Nutrition Therapy
Short Bowel Syndrome/*etiology/*therapy},
   ISSN = {0884-5336 (Print)
0884-5336},
   Accession Number = {16207697},
   DOI = {10.1177/0115426505020005551},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Matsui, T. and Sakurai, T. and Yao, T.},
   title = {Nutritional therapy for Crohn's disease in Japan},
   journal = {J Gastroenterol},
   volume = {40 Suppl 16},
   pages = {25-31},
   note = {Matsui, Toshiyuki
Sakurai, Toshihiro
Yao, Tsuneyoshi
Journal Article
Review
Japan
J Gastroenterol. 2005 Mar;40 Suppl 16:25-31.},
   abstract = {In Japan, nutritional therapy as both a primary and as a secondary treatment is widely used for Crohn's disease (CD). The rationale for its use is based on a variety of reasons. The first is its ability to induce remission and to ameliorate the activity of intestinal lesions in the short term by enteral (EN) or by parenteral nutritional therapy in which overexpressions of chemokine receptors in an active stage are decreased significantly in the remission stage. Second is its ability to maintain remission over the long term through home-based enteral nutrition in which tube feeding during the nighttime is encouraged. Third is its ability to reduce the steroid dosage over the period of a long-term treatment course. However, several disadvantages of this therapy such as unpalatability and sluggish effect have been pointed out. Several studies have attempted to resolve this issue and determine the best components of EN, especially in fat composition. Some data have been suggestive of too much long-chained fatty acid having a hazardous effect on EN's clinical efficacy because it works as a precursor of inflammatory prostaglandins. Our recent data show that medium-chained triglyceride did not have such a hazardous effect on clinical efficacy. Several studies suggested that the patient factors that were resistant to inducing remission in the short term were a long period of suffering CD, a high activity (on Crohn's Disease Activity Index, CDAI), hemorrhagic colitis, and colitis with marked cobblestoning. Japanese guidelines for the treatment of CD recommended nutritional therapy as a first-line therapy and as a maintenance therapy after inducing remission. This treatment policy has led to Japanese CD patients having lower mortality rates than that of patients who do not receive EN. If this therapy could be combined with other drug therapies, including strong immunosuppressants, treatment strategies would be improved over those we have at present.},
   keywords = {Adrenal Cortex Hormones/therapeutic use
Crohn Disease/*therapy
Dietary Fats/therapeutic use
*Enteral Nutrition
Humans
Japan
Practice Guidelines as Topic
Remission Induction
Time Factors},
   ISSN = {0944-1174 (Print)
0944-1174},
   Accession Number = {15902960},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Matsumoto, T. and Iida, M. and Kohgo, Y. and Imamura, A. and Kusugami, K. and Nakano, H. and Fujiyama, Y. and Matsu, T. and Hibi, T.},
   title = {Therapeutic efficacy of infliximab on active Crohn's disease under nutritional therapy},
   journal = {Scand J Gastroenterol},
   volume = {40},
   number = {12},
   pages = {1423-30},
   note = {Matsumoto, Takayuki
Iida, Mitsuo
Kohgo, Yutaka
Imamura, Akimichi
Kusugami, Kazuo
Nakano, Hiroshi
Fujiyama, Yoshihide
Matsu, Toshiyuki
Hibi, Toshifumi
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
England
Scand J Gastroenterol. 2005 Dec;40(12):1423-30.},
   abstract = {OBJECTIVE: The aim of this investigation was to elucidate retrospectively the therapeutic effect of infliximab in patients with active Crohn's disease (CD) under nutritional therapy. MATERIAL AND METHODS: Using a review of the clinical records in 24 nationwide institutions specializing in inflammatory bowel disease, the short-term effect of infliximab in 97 patients with active CD was retrospectively investigated. The Crohn's disease activity index (CDAI) at baseline and after 2 weeks of a single infliximab administration (5 mg/kg) was compared among patients under total parenteral nutrition (TPN group, n=36), those following an elemental or polymeric diet (EN group, n=49) and those without TPN and EN (NN group, n=12). A decrease in CDAI >or= 70 or a CDAI value <150 at 2 weeks was regarded as effective. RESULTS: There was no difference in CDAI at baseline among the three groups. In each group, CDAI decreased significantly (from 250 (195-290) [median (interquartiles)] to 152 (123-233) in the TPN group, p<0.0001; from 259 (200-325) to 180 (130-238) in the EN group, p<0.0001; from 278 (222-291) to 164 (132-196) in the NN group, p=0.003). Infliximab was effective in 63.9% of patients in the TPN group, in 55.1% of those in the EN group and in 75% of the NN group. There was no statistical difference in efficacy among the three groups (p=0.4). Multivariate logistic regression analysis revealed younger age to be a significant factor related to the efficacy of infliximab. CONCLUSIONS: Infliximab is effective in patients with CD under TPN or EN. Age at infliximab administration may be predictive of response to infliximab.},
   keywords = {Adolescent
Adult
Antibodies, Monoclonal/*administration & dosage
Combined Modality Therapy
Crohn Disease/*therapy
*Enteral Nutrition
Female
Gastrointestinal Agents/*administration & dosage
Humans
Infliximab
Japan
Male
Middle Aged
*Parenteral Nutrition, Total
Retrospective Studies
Time Factors
Treatment Outcome},
   ISSN = {0036-5521 (Print)
0036-5521},
   Accession Number = {16316890},
   DOI = {10.1080/00365520510023639},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {McCarthy, D. and Duggan, P. and O'Brien, M. and Kiely, M. and McCarthy, J. and Shanahan, F. and Cashman, K. D.},
   title = {Seasonality of vitamin D status and bone turnover in patients with Crohn's disease},
   journal = {Aliment Pharmacol Ther},
   volume = {21},
   number = {9},
   pages = {1073-83},
   note = {McCarthy, D
Duggan, P
O'Brien, M
Kiely, M
McCarthy, J
Shanahan, F
Cashman, K D
Journal Article
Research Support, Non-U.S. Gov't
England
Aliment Pharmacol Ther. 2005 May 1;21(9):1073-83.},
   abstract = {BACKGROUND: While winter-time vitamin D deficiency has been well-documented in Crohn's disease patients, less is known about vitamin D status during summertime and whether a seasonal variation exists in bone turnover. AIMS: To compare vitamin D status and bone turnover markers in Crohn's disease patients with age- and sex-matched controls during late-summer and late-winter. SUBJECTS: Crohn's disease patients (n = 44; mean age 36.9 years, currently in remission) and matched controls (n = 44) were recruited from Cork University Hospital and Cork City area, respectively. METHODS: Bloods were analysed for 25-hydroxyvitamin D, parathyroid hormone, bone-specific alkaline phosphatase, osteocalcin and urine analysed for N-telopeptides of type 1 collagen. RESULTS: Serum 25-hydroxyvitamin D concentrations were significantly (P < 0.003) lower in Crohn's disease patients than in control subjects during both seasons. In Crohn's disease patients, serum 25-hydroxyvitamin D concentrations were lower (P < 0.0001) whereas serum parathyroid hormone, osteocalcin and bone-specific alkaline phosphatase and urinary N-telopeptides of type 1 collagen levels were higher (P < 0.001) during late-winter than late-summer. CONCLUSION: There were notable seasonal variations in vitamin D status and bone turnover markers in Crohn's disease patients. The impact of winter decline in vitamin D status and increase in bone turnover on long-term risk of osteopenia/osteoporosis in Crohn's disease patients is unclear.},
   keywords = {Adult
Bone Remodeling/*physiology
Calcium/administration & dosage
Case-Control Studies
Crohn Disease/*blood/complications/physiopathology
Dietary Supplements
Female
Humans
Male
Parathyroid Hormone/blood
*Seasons
Vitamin D/administration & dosage/*analogs & derivatives/*blood
Vitamin D Deficiency/blood/*etiology/physiopathology},
   ISSN = {0269-2813 (Print)
0269-2813},
   Accession Number = {15854168},
   DOI = {10.1111/j.1365-2036.2005.02446.x},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Meier, R. and Steuerwald, M.},
   title = {Place of probiotics},
   journal = {Curr Opin Crit Care},
   volume = {11},
   number = {4},
   pages = {318-25},
   note = {Meier, Remy
Steuerwald, Michael
Journal Article
Review
United States
Curr Opin Crit Care. 2005 Aug;11(4):318-25.},
   abstract = {PURPOSE OF REVIEW: This review reports on the recent progress understanding mechanisms of action and clinical applications of probiotics. RECENT FINDINGS: New insights on regulating mechanisms of intestinal commensal bacteria to prevent and treat different gastrointestinal diseases have been reported. Some probiotics, though not all, exert beneficial effects by modulating the mucosal barrier function and immune activity. It seems that a combination of different probiotics is more effective than a single strain. It was demonstrated that not only viable bacteria administered to the intestinal tract but also isolated probiotic DNA is active, even if injected subcutaneously. There is reasonable evidence to recommend probiotics in infectious diarrhoea for prevention and treatment (mainly in children) and to prevent antibiotic-induced gastrointestinal side effects. Furthermore, probiotics are effective in maintaining remission in ulcerative colitis and preventing and treating pouchitis. Promising positive effects were published in major surgery patients (gastric resection, pancreatic resection, liver transplantation) and in severe necrotising acute pancreatitis. SUMMARY: Increasing knowledge on probiotics is exciting, but in the near future it must be defined which probiotics (single strains or a combination) are most effective in specific diseases. Well-designed, randomized clinical trials are still required to further define the role of probiotics as preventive and therapeutic agents.},
   keywords = {Colitis, Ulcerative/diet therapy
Critical Care/*methods
Crohn Disease/diet therapy
Dysentery/diet therapy
Gastrointestinal Diseases/*diet therapy
Humans
Inflammatory Bowel Diseases/diet therapy
Perioperative Care/methods
Pouchitis/diet therapy
Probiotics/*therapeutic use},
   ISSN = {1070-5295 (Print)
1070-5295},
   Accession Number = {16015109},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Mian, S. and Baron, H.},
   title = {Adalimumab, a novel anti-tumor necrosis factor-alpha antibody in a child with refractory Crohn's disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {41},
   number = {3},
   pages = {357-9},
   note = {Mian, Sameera
Baron, Howard
Case Reports
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2005 Sep;41(3):357-9.},
   keywords = {Adalimumab
Adolescent
Antibodies, Monoclonal/adverse effects/*therapeutic use
Antibodies, Monoclonal, Humanized
Crohn Disease/*drug therapy
Female
Humans
Intestinal Mucosa/drug effects/pathology
Safety
Treatment Outcome
Tumor Necrosis Factor-alpha/*immunology},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16131995},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Moreno, J. M. and Planas, M. and de Cos, A. I. and Virgili, N. and Gomez-Enterria, P. and Ordonez, J. and de la Cuerda, C. and Marti, E. and Apezetxea, A. and Forga, M. T. and Perez de la Cruz, A. and Munoz, A. and Rodriguez, A. and Cardona, D. and Pedron, C. and Luengo, L. M. and Garde, C. and Pares, R. M.},
   title = {[The year 2003 National Registry of Home-based Parenteral Nutrition]},
   journal = {Nutr Hosp},
   volume = {21},
   number = {2},
   pages = {127-31},
   note = {Moreno, J M
Planas, M
de Cos, A I
Virgili, N
Gomez-Enterria, P
Ordonez, J
de la Cuerda, C
Marti, E
Apezetxea, A
Forga, M T
Perez de la Cruz, A
Munoz, A
Rodriguez, A
Cardona, D
Pedron, C
Luengo, L M
Garde, C
Pares, R M
Grupo de Trabajo NADYA-SENPE
Comparative Study
English Abstract
Journal Article
Spain
Nutr Hosp. 2006 Mar-Apr;21(2):127-31.},
   abstract = {OBJECTIVE: To report the results of the Home-based Parenteral Nutrition (HBPN) registry of the NADYA-SENPE working group, for the year 2003. MATERIAL AND METHODS: Gathering of registry data introduced by all units responsible of HBPN patient care. This an on-line registry available for authorized users of the working group web page (www.nadya-senpe.com). Epidemiological data, diagnosis, access route, complications, hospital admissions, disability degree, and course at December 31st, 2003 RESULTS: Data from 86 patients (62% female and 38% male) from 17 hospitals were gathered. Mean age of adult patients was 50.7 +/- 15.0 years, whereas for patients younger than 14 years was 2.4 +/- 1.5 years (n = 5 patients). Diseases that prone HBPN were neoplasm (21%), followed by mesenteric ischemia (20%), radiation enteritis (16.3%), motility impairments (10.5%), and Crohn's disease (4.6%). Tunneled catheters were used in 66.3% of the cases versus 29.1% of subcutaneous reservoirs. Mean treatment duration has been 8.5 +/- 4.6 months; 67.4% of patients had been on HBPN for a period of time longer than 6 months. Patient follow-up was mostly done from the reference area hospital (88.4%). In no case patient follow-up was done by the primary care team or by specialists other than those prescribing nutritional support. Nutritional support-related complications were seen in 98 occasions. The most frequent complications were infectious ones. They represented 1.60 hospital admissions per patient. The mean number of visits was 7.9 per patient (6.4 for scheduled visits and 1.5 for emergency visits). By the end of the year, we observed that 73.3% of the patients were still on the program, whereas in 23.3% HBPN had been withdrawn. The main reasons for withdrawal were decease (11 patients), and advancing to oral diet (9 patients). As for the disability degree, 13% were confined to a wheelchair or bed, and only 28% had no disability degree or only mild social disability. CONCLUSIONS: We observed a mild increase in HBPN prevalence rate in Spain (2.15 patients pmp). The main indication was cancer followed by short-bowel syndrome secondary to vascular pathology. Nutritional support-related complications were common, especially those of an infectious origin.},
   keywords = {Adolescent
Adult
Age Distribution
Aged
Child
Female
Humans
Male
Middle Aged
Parenteral Nutrition, Home/adverse effects/*statistics & numerical data
Prevalence
Registries
Spain/epidemiology},
   ISSN = {0212-1611 (Print)
0212-1611},
   Accession Number = {16734063},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Moreno, J. M. and Planas, M. and Lecha, M. and Virgili, N. and Gomez-Enterria, P. and Ordonez, J. and de la Cuerda, C. and Apezetxea, A. and Marti, E. and Garcia Luna, P. P. and Forga, M. T. and Perez de la Cruz, A. and Munoz, A. and Bayo, P. and Rodriguez, A. and Chamorro, J. and Bonada, A. and Luengo, L. M. and Pedron, C. and Pares, R. M.},
   title = {[The year 2002 national register on home-based parenteral nutrition]},
   journal = {Nutr Hosp},
   volume = {20},
   number = {4},
   pages = {249-53},
   note = {Moreno, J M
Planas, M
Lecha, M
Virgili, N
Gomez-Enterria, P
Ordonez, J
de la Cuerda, C
Apezetxea, A
Marti, E
Garcia Luna, P P
Forga, M T
Perez de la Cruz, A
Munoz, A
Bayo, P
Rodriguez, A
Chamorro, J
Bonada, A
Luengo, L M
Pedron, C
Pares, R M
Grupo de Trabajo NADYA-SENPE
Comparative Study
English Abstract
Journal Article
Spain
Nutr Hosp. 2005 Jul-Aug;20(4):249-53.},
   abstract = {AIM: To report on the results of the Registry on Home-based Parenteral Nutrition (HPN) of the NADYA-SENPE working group, corresponding to the year 2002. MATERIALS AND METHOD: Compilation of the registry data loaded by the Units in charge of HPN patients care. It consists of an on-line registry available to the registered users of the group's web page (www.nadya-senpe.com). Epidemiological, diagnostic, access route, complications, hospital admissions, degree of disability, and course until December 31st of 2002. RESULTS: Data from 74 patients were gathered (56.8% women and 43.2% men), from 18 hospital centers. Mean age of adult patients was 49.4 +/- 15.5 years and 2.3-1.1 years for patients younger than 14 years (n=3 patients). Diseases that prompted the use of HPN were mesenteric ischemia (29.7%), followed by neoplasms (16.2%), radiation enteritis (12.2%), motility impairments (8.1%), and Crohn's disease (5.4%). Tunneled catheters were used in 52.7% of cases, as compared to 36.5% of subcutaneous reservoirs. Mean treatment duration was 8.7 +/- 4.4 months; 68.9% of patients remained on HPN for a duration longer than 6 months, and in 41.9% longer than one year. Patients' follow-up was mainly done from the reference hospital (87.8%), and the remaining patients (12.5%) by the home care team. In no case patients were followed by the primary care team or other specialists than the ones that prescribed nutritional support. In 94 cases there were complications related to nutritional therapy. The more frequent complications presented were infectious. These complications represented 1.84 admissions per patient. The mean number of visits was 12.9 per patient (10.2 routinary visits and 2.7 emergency visits). At the end of the year, we observed that 74.3% patients stayed in the program, whereas in the remaining 23.6% HPN had been discontinued. The main causes for discontinuation were death (52.9%), and switch to oral diet (23.5%) or enteral nutrition (11.8%). With regards to disability degree, 16.1% were confined to a wheelchair or bed, and 17.6% had no disability at all or only a mild social disability. CONCLUSIONS: We observed a sustained HPN prevalence rate in Spain (1.8 patient pmp). The main cause for its use was short bowel syndrome secondary to vascular disease, followed by cancer. Complications associated to nutritional therapy were common, especially of infectious origin.},
   keywords = {Adolescent
Adult
Aged
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Parenteral Nutrition, Home/adverse effects/*statistics & numerical data
*Registries
Spain},
   ISSN = {0212-1611 (Print)
0212-1611},
   Accession Number = {16045126},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Morinville, V. and McDonald, J.},
   title = {Clostridium difficile-associated diarrhea in 200 Canadian children},
   journal = {Can J Gastroenterol},
   volume = {19},
   number = {8},
   pages = {497-501},
   note = {Morinville, Veronique
McDonald, Jane
Comparative Study
Journal Article
Canada
Can J Gastroenterol. 2005 Aug;19(8):497-501.},
   abstract = {OBJECTIVE: Clostridium difficile-associated diarrhea is a major problem in adults. The present study was conducted to assess risk factors and outcomes in children with C difficile-associated diarrhea. METHODS: Laboratory records at a university-affiliated pediatric hospital were reviewed for all C difficile toxin-positive stools (cell culture cytotoxin assay) between 2000 and 2003. Charts on identified patients were reviewed. RESULTS: Two hundred patients with a diagnosis of C difficile-associated diarrhea were identified between February 2000 and November 2003. There were 107 males and 93 females (mean age 5.4 years; median age 2.6 years). Underlying factors were identified in 19% (12 patients underwent chemotherapy; seven patients had Crohn's disease; six were transplantation recipients; seven an immunodeficiency; four with Hirschsprung disease; two diagnoses of 'other'). Of the 200 identified patients, 149 (74.5%) had documentation of antibiotics in the previous two months (32 penicillins; 38 cephalosporins; three clindamycin, nine other single-agent, 59 multiple; eight not specified), and 111 (55.5%) had been hospitalized in the previous month. The symptoms of C difficile-associated diarrhea included bloody stools in 12.5% and frequent watery stools in 79%. Hospitalization was required in 27 of 116 outpatients; stay was prolonged in seven of the 84 patients already hospitalized. Fifty-five per cent received metronidazole, 34% were not treated, and treatment data were not available for the remainder. Recurrence occurred in 31% of those treated and retreatment consisted of vancomycin (15%), probiotics (15%) and cholestyramine (6%). No colectomies were required but two deaths occurred. CONCLUSIONS: The majority of pediatric patients developing symptomatic C difficile-associated diarrhea had antibiotic exposure or hospitalization within the previous one to two months. This is higher than previously reported. One-third had spontaneous symptom resolution. For those treated, recurrence rates were high. Mortality was significantly lower than described in adults, in agreement with prior literature.},
   keywords = {Child
Child, Preschool
Clostridium difficile/*isolation & purification
Diarrhea/*epidemiology/etiology
*Disease Outbreaks
Enterocolitis, Pseudomembranous/complications/epidemiology/*microbiology
Female
Humans
Male
Quebec/epidemiology
Retrospective Studies},
   ISSN = {0835-7900 (Print)
0835-7900},
   Accession Number = {16107901},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Mulder, S. J. and Mulder-Bos, G. C.},
   title = {Most probable origin of coeliac disease is low immune globulin A in the intestine caused by malfunction of Peyer's patches},
   journal = {Med Hypotheses},
   volume = {66},
   number = {4},
   pages = {757-62},
   note = {Mulder, S J
Mulder-Bos, G C
Journal Article
United States
Med Hypotheses. 2006;66(4):757-62. Epub 2006 Jan 5.},
   abstract = {Coeliac disease frequency increases by obscure reasons and affects in some Western countries as much as 1% of the populations. The second one of monozygotic twins does not develop the disease in 100% but only in 20-50%. To unravel these mysteries, literature was searched to determine the disease background and find suggestions for research and prevention. The causal antigen of coeliac disease is gluten of wheat that is neutralised in the intestine by secretory immune globulin A (sIgA). SIgA is secreted by the secondary (lymphoid) immune system that develops in a newborn infant after the primary (central) immune organs thymus and bone marrow have been primed with antigens of the intestine. Predisposed infants are sensitive for development of coeliac disease during the time without sIgA secretion into the intestine. The risk of the disease diminishes when sIgA cycles of gluten neutralisation develop. Peyer's patches (PP) of the secondary immune system play a central role in the cycles and possibly do not function well in the case of coeliac disease. Coeliac disease in predisposed infants may be prevented by delay of bread consumption till the time of normal sIgA secretion and by application of a challenge period with gluten (see Discussion). It is concluded that sIgA secretion into body cavities and malfunction of immune cells in PP should be included in the future research of coeliac disease as well as in more allergic diseases (type 1 diabetes, Crohn disease, asthma, hay fever).},
   keywords = {Celiac Disease/*immunology
Glutens/*immunology
Humans
IgA Deficiency/*immunology
Infant
Intestines/*immunology
Peyer's Patches/*physiopathology},
   ISSN = {0306-9877 (Print)
0306-9877},
   Accession Number = {16403601},
   DOI = {10.1016/j.mehy.2005.09.050},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Mullady, D. K. and O'Keefe, S. J.},
   title = {Treatment of intestinal failure: home parenteral nutrition},
   journal = {Nat Clin Pract Gastroenterol Hepatol},
   volume = {3},
   number = {9},
   pages = {492-504},
   note = {Mullady, Daniel K
O'Keefe, Stephen J D
Journal Article
Review
England
Nat Clin Pract Gastroenterol Hepatol. 2006 Sep;3(9):492-504.},
   abstract = {Intestinal failure can result from surgical resection, obstruction, dysmotility, congenital deficiencies or disease-associated loss of absorption. Before the development of intravenous feeding in the late 1960s, the condition was fatal, but by the 1990s approximately 40,000 patients were being successfully managed on long-term home parenteral nutrition (HPN) annually in the US. Survival on HPN depends on the nature of the underlying medical condition: over 80% of Crohn's disease patients survive for 5 years, but only 20% of cancer patients survive for 1 year. Although a patient's nutritional status is easy to maintain, there are serious long-term complications that arise from bypassing the gut and infusing nutrients directly into the systemic circulation. Catheter sepsis occurs about once per year (range 0-12 times). Abnormalities in liver function tests are common, but end-stage liver disease is rare. Central venous thrombosis develops in nearly all patients after 5 years. Although approximately 80% of patients on HPN are completely rehabilitated at home, their quality of life is impaired by the perpetual dependence on nocturnal intravenous infusions (every 8-12 h). In conclusion, HPN has allowed patients with previously fatal intestinal failure to survive and lead relatively normal lives at home, but their quality of life remains impaired by the dependence on intravenous infusions and complications that progress with time.},
   keywords = {Clinical Trials as Topic
Humans
Intestinal Diseases/etiology/*therapy
Parenteral Nutrition, Home/*adverse effects/methods
Quality of Life
Recovery of Function},
   ISSN = {1743-4378 (Print)
1743-4378},
   Accession Number = {16951666},
   DOI = {10.1038/ncpgasthep0580},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Newby, E. A. and Sawczenko, A. and Thomas, A. G. and Wilson, D.},
   title = {Interventions for growth failure in childhood Crohn's disease},
   journal = {Cochrane Database Syst Rev},
   number = {3},
   pages = {Cd003873},
   note = {1469-493x
Newby, E A
Sawczenko, A
Thomas, A G
Wilson, D
Journal Article
Review
England
Cochrane Database Syst Rev. 2005 Jul 20;(3):CD003873.},
   abstract = {BACKGROUND: Crohn's disease in childhood is a chronic relapsing condition. Fifteen to forty per cent of children with Crohn's disease have growth retardation (Griffiths 1993a). Some treatment modalities including corticosteroids have been implicated in growth failure but it is thought mainly to be secondary to uncontrolled disease activity (Motil 1993; Markowitz 1993). Growth is fundamental to the practice of pediatrics, so by taking growth as the primary outcome measure we address issues important to both patients, their families and pediatricians. OBJECTIVES: To evaluate the effectiveness of the different modalities available for the treatment of childhood Crohn's disease with regard to the reversal of growth failure and the promotion of normal growth. SEARCH STRATEGY: Searches were made of the following databases using the Collaborative Review Group Search Strategy: EMBASE (1984-2004), MEDLINE (1966-2004), The Cochrane Central Register of Controlled Trials, The Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register and the Science Citation Index. Abstracts from the major gastrointestinal research meetings and references from published articles were also reviewed. SELECTION CRITERIA: Randomized controlled trials pertaining to children less than 18 years of age with Crohn's disease were selected. Those with growth as an outcome measure were included in the review. DATA COLLECTION AND ANALYSIS: Data extraction and assessment of the methodological quality of each trial was independently reviewed by two reviewers. Only one good quality randomized controlled trial was included in the review and therefore no statistical analysis was possible. MAIN RESULTS: Three randomized controlled trials were identified. One was of good methodological quality (Markowitz 2000). This study looked at the use of 6-mercaptopurine (6-MP) as a steroid sparing agent. No difference in linear growth was observed between the intervention and placebo groups, although the total steroid dose received over the 18 month follow up period was reduced in the group receiving 6-MP. The two remaining randomized controlled trials (Sanderson 1987; Thomas 1993a) consider the use of enteral feeding versus corticosteroids for induction of remission, with height velocity standard deviation score at 6 months as an outcome measure. Although of less rigorous methodological quality, the results of these studies are discussed in detail in the review. In both studies height velocity standard deviation scores were significantly increased in the enteral feeding group compared with the corticosteroid group. AUTHORS' CONCLUSIONS: In addition to these randomized controlled trials, a body of lower quality evidence does exist relevant to two other important interventions; the use of supplemental enteral nutrition (Morin 1980; Belli 1988; Israel 1995) and the judicious use of surgical interventions in pre-pubertal children with refractory disease (Alperstein 1985; Lipson 1990; McLain 1990). Newer treatments, such as infliximab, are now becoming more widely used and may offer advantages in promoting growth. These effects are as yet unstudied. This review highlights the need for large, multi centre studies of the different treatment options in paediatric Crohn's disease and the importance of standardised measurements of growth, such as height velocity standard deviation scores and height standard deviation scores as outcome measures.},
   keywords = {6-Mercaptopurine/therapeutic use
Adrenal Cortex Hormones/therapeutic use
Antimetabolites/therapeutic use
Child
Crohn Disease/complications/*therapy
Enteral Nutrition
Growth Disorders/etiology/*therapy
Humans
Prednisolone/therapeutic use
Randomized Controlled Trials as Topic},
   ISSN = {1361-6137},
   Accession Number = {16034910},
   DOI = {10.1002/14651858.CD003873.pub2},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Ng, V. K. and Millard, W. M.},
   title = {Competing with Crohn's disease: management issues in active patients},
   journal = {Phys Sportsmed},
   volume = {33},
   number = {11},
   pages = {47-53},
   note = {Ng, Victor K
Millard, Wanda M
Journal Article
England
Phys Sportsmed. 2005 Nov;33(11):47-53. doi: 10.3810/psm.2005.11.257.},
   abstract = {Crohn's disease is a chronic inflammatory bowel disorder that has genetic and environmental risk factors. Although moderate physical activity seems to reduce the risk of developing Crohn's disease, some high-performance athletes live with the disease. Uncontrolled Crohn's disease predisposes patients to numerous nutrient deficiencies and associated health issues such as anemia and osteoporosis. Low-intensity exercise has been shown to decrease flare-ups in sedentary patients; however, high-intensity exercise may lead to increased symptoms. Physicians play a crucial role in coordinating a team approach among the athlete, parents, coach, and athletic trainers to provide the best possible management of diet, training schedule, and treatment.},
   ISSN = {0091-3847 (Print)
0091-3847},
   Accession Number = {20086340},
   DOI = {10.3810/psm.2005.11.257},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Norman, K. and Kirchner, H. and Lochs, H. and Pirlich, M.},
   title = {Malnutrition affects quality of life in gastroenterology patients},
   journal = {World J Gastroenterol},
   volume = {12},
   number = {21},
   pages = {3380-5},
   note = {Norman, Kristina
Kirchner, Henriette
Lochs, Herbert
Pirlich, Matthias
Journal Article
United States
World J Gastroenterol. 2006 Jun 7;12(21):3380-5.},
   abstract = {AIM: To investigate the association between malnutrition and quality of life in patients with benign gastrointestinal disease. METHODS: Two hundred patients (104 wellnourished and 96 malnourished) were assessed according to the Subjective Global Assessment, anthropometric measurements and bioelectrical impedance analysis. Quality of life was determined with the validated Medical Outcomes Study 36-item Short-Form General Health Survey (SF 36). Muscle function was assessed by hand grip strength and peak flow. RESULTS: Body mass index, body cell mass, arm muscle area and hand grip strength were significantly lower in the malnourished patients. Quality of life was generally lower when compared to norm values. Seven out of eight quality of life scales (excluding bodily pain) were significantly reduced in the malnourished patients. Comparing patients with liver cirrhosis and inflammatory bowel disease (IBD), patients with IBD experienced significantly lower values in the perception of bodily pain,social functioning and mental health. Malnourished liver cirrhotics suffered reductions in more scales (six out of eight) than malnourished IBD patients did (four out of eight). CONCLUSION: Quality of life is generally low in benign gastrointestinal disease and is further reduced in patients who are classified as malnourished. It appears that liver cirrhosis patients experience a higher quality of life than IBD patients do, but the impact of malnutrition seems to be greater in liver cirrhosis than in IBD.},
   keywords = {Adult
Aged
Anthropometry
Colitis, Ulcerative/complications
Crohn Disease/complications
Electric Impedance
Female
Gastrointestinal Diseases/*complications/*psychology
Humans
Interpersonal Relations
Liver Cirrhosis/physiopathology/psychology
Male
Malnutrition/*complications/etiology
Mental Health
Middle Aged
Nutritional Status
Pain/*pathology/psychology
*Quality of Life
Surveys and Questionnaires},
   ISSN = {1007-9327 (Print)
1007-9327},
   Accession Number = {16733855},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Ockenga, J. and Borchert, K. and Stuber, E. and Lochs, H. and Manns, M. P. and Bischoff, S. C.},
   title = {Glutamine-enriched total parenteral nutrition in patients with inflammatory bowel disease},
   journal = {Eur J Clin Nutr},
   volume = {59},
   number = {11},
   pages = {1302-9},
   note = {Ockenga, J
Borchert, K
Stuber, E
Lochs, H
Manns, M P
Bischoff, S C
Comparative Study
Journal Article
Randomized Controlled Trial
England
Eur J Clin Nutr. 2005 Nov;59(11):1302-9.},
   abstract = {BACKGROUND: Studies in animal models of inflammatory bowel disease (IBD) suggest that supplementation of total parenteral nutrition with glutamine (gln), a conditionally essential amino acid in catabolic conditions, increases gln plasma concentrations, reduces intestinal damage, improves nitrogen balance and may improve the course of the disease. However, human data supporting this assumption are missing. METHODS: A total of 24 consecutive patients with an acute exacerbation of IBD (19 Crohn's disease; five ulcerative colitis) and scheduled for total parenteral nutrition (TPN) (>7 days) were randomised. Parallel to a standardised anti-inflammatory therapy, the patients received either a TPN with 1.5 g/kg body weight of a standard amino acid or an isonitrogenic, isocaloric TPN with 1.2 g/kg body weight of a standard amino acid and 0.3 g/kg L-alanine-L-glutamine. Primary end points were gln plasma concentrations and intestinal permeability assessed by urinary lactulose and D-xylose ratio. RESULTS: Gln plasma levels did not differ significantly in either group throughout the study. Intestinal permeability did not change within 7 days either with or without gln supplementation (Delta-lactulose/xylose ratio: 0.01+/-0.05 (gln+) vs 0.02+/-0.1 (gln-)). The observed changes in inflammatory and nutritional parameters, and also disease activity, length of TPN and hospital stay, were independent of glutamine substitution. Five (41%) patients in the gln+ group and three (25%) patients in the gln- group needed surgical intervention. CONCLUSION: Although limited by the sample size, these results do not support the hypothesis that glutamine substitution has an obvious biochemical or clinical benefit in patients with active IBD scheduled for total parenteral nutrition.},
   keywords = {Acute Disease
Adult
*Dietary Supplements
Dipeptides/administration & dosage/therapeutic use
Disease Progression
Female
Glutamine/administration & dosage/blood/*therapeutic use
Humans
Inflammation/blood
Inflammatory Bowel Diseases/blood/*diet therapy
Intestines/metabolism
Lactulose/urine
Male
Middle Aged
Nitrogen/metabolism
Nutritional Status/drug effects
Parenteral Nutrition, Total/*methods
Permeability/drug effects
Sample Size
Time Factors
Xylose/urine},
   ISSN = {0954-3007 (Print)
0954-3007},
   Accession Number = {16077744},
   DOI = {10.1038/sj.ejcn.1602243},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {O'Sullivan, M. and O'Morain, C.},
   title = {Nutrition in inflammatory bowel disease},
   journal = {Best Pract Res Clin Gastroenterol},
   volume = {20},
   number = {3},
   pages = {561-73},
   note = {O'Sullivan, Maria
O'Morain, Colm
Journal Article
Review
Netherlands
Best Pract Res Clin Gastroenterol. 2006;20(3):561-73.},
   abstract = {Nutrition has an important role in the management of inflammatory bowel disease. This role includes the prevention and correction of malnutrition, the prevention of osteoporosis and in children the promotion of optimal growth and development. In active Crohn's disease nutritional therapy (in the form of enteral feeding) is an effective primary therapy for many patients. Corticosteroids, however, are more effective than enteral diet therapy in adults. Enteral diets should be considered as primary therapy in pediatric Crohn's disease, especially in children with poor nutritional status or growth impairment. Enteral nutrition does not have a proven primary therapeutic role in ulcerative colitis. There are many theories that suggest that diet may be implicated in the aetiology of inflammatory bowel disease, however, there are, as yet, no dietary approaches proven to reduce the risk of developing IBD.},
   keywords = {Adult
Body Composition
Child
Child Development
Child Nutritional Physiological Phenomena
Diet/adverse effects
Humans
Inflammatory Bowel Diseases/etiology/physiopathology/*therapy
Malnutrition/etiology/physiopathology/prevention & control
*Nutritional Support
Osteoporosis/etiology/prevention & control},
   ISSN = {1521-6918 (Print)
1521-6918},
   Accession Number = {16782529},
   DOI = {10.1016/j.bpg.2006.03.001},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Otley, A. R. and Griffiths, A. M. and Hale, S. and Kugathasan, S. and Pfefferkorn, M. and Mezoff, A. and Rosh, J. and Tolia, V. and Markowitz, J. and Mack, D. and Oliva-Hemker, M. and Wyllie, R. and Rothbaum, R. and Bousvaros, A. and Del Rosario, J. F. and Evans, J. and Blanchard, W. and Hyams, J.},
   title = {Health-related quality of life in the first year after a diagnosis of pediatric inflammatory bowel disease},
   journal = {Inflamm Bowel Dis},
   volume = {12},
   number = {8},
   pages = {684-91},
   note = {Otley, Anthony R
Griffiths, Anne M
Hale, Sandra
Kugathasan, Subra
Pfefferkorn, Marian
Mezoff, Adam
Rosh, Joel
Tolia, Vasundhara
Markowitz, James
Mack, David
Oliva-Hemker, Maria
Wyllie, Robert
Rothbaum, Robert
Bousvaros, Athos
Del Rosario, J Fernando
Evans, Jonathan
Blanchard, Wade
Hyams, Jeffrey
Pediatric IBD Collaborative Research Group
Journal Article
Research Support, Non-U.S. Gov't
United States
Inflamm Bowel Dis. 2006 Aug;12(8):684-91.},
   abstract = {BACKGROUND AND AIMS: Assessment of health-related quality of life (HRQOL) is of increasing importance in the evaluation of new therapies for inflammatory bowel disease (IBD). Available data concerning HRQOL in pediatric patients are sparse and uniformly cross-sectional. The aim of this study was to describe HRQOL and influential factors in newly diagnosed pediatric patients with Crohn's disease and ulcerative colitis during the first 12 months after diagnosis. MATERIALS AND METHODS: Participants were drawn from a large, prospectively derived observational IBD registry of pediatric patients studied through 18 U.S. and Canadian centers. Patients who had completed a baseline IMPACT questionnaire and for whom there were 12 months of follow-up data available were included. In addition to description of cohort, factors that were believed to influence HLQOL were assessed during the course of the year from diagnosis. RESULTS: Two hundred eighteen children met inclusion criteria (77% Crohn's disease, 23 % ulcerative colitis, mean age 12.7 +/- 1.9 years). Mean total IMPACT score at baseline was 154, 181 at 6 months, and 191 at 1 year (possible range 0-238, with increasing scores representing better quality of life). Repeated measures analysis showed that age and disease severity significantly negatively affected the IMPACT scores during the course of the year. CONCLUSIONS: In this large prospective pediatric IBD cohort, significant improvement in HRQOL is noted during the year from diagnosis. Mean IMPACT scores varied significantly depending on the disease severity and also decreased with increasing age.},
   keywords = {Adolescent
Child
Cohort Studies
*Colitis, Ulcerative/psychology
*Crohn Disease/psychology
Female
Follow-Up Studies
Humans
Male
*Quality of Life
Registries
Regression Analysis
Severity of Illness Index
Surveys and Questionnaires},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {16917222},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Paerregaard, A. and Uldall Urne, F.},
   title = {Anthropometry at the time of diagnosis in Danish children with inflammatory bowel disease},
   journal = {Acta Paediatr},
   volume = {94},
   number = {11},
   pages = {1682-3},
   note = {Paerregaard, Anders
Uldall Urne, Frederikke
Journal Article
Norway
Acta Paediatr. 2005 Nov;94(11):1682-3.},
   abstract = {UNLABELLED: All patients below 15 y of age living in the eastern part of Denmark with a diagnosis of inflammatory bowel disease (IBD) during the period 1998-2000 were identified (n=94) and anthropometrical data at the time of diagnosis were evaluated. CONCLUSION: The height-for-age and the BMI-for-age, as evaluated by z-scores, of children with ulcerative colitis (UC) did not differ from those of normal Danish children, but Crohn's disease (CD) children had significantly lower height and BMI values, both when compared to normal children and children with UC. In contrast to UC, CD is frequently complicated by malnutrition and growth retardation at the time of diagnosis.},
   keywords = {Adolescent
Body Height
Body Mass Index
Child
Child Nutrition Disorders/epidemiology
Child, Preschool
Colitis, Ulcerative/*epidemiology
Crohn Disease/*epidemiology
Denmark/epidemiology
*Growth
Humans
Infant},
   ISSN = {0803-5253 (Print)
0803-5253},
   Accession Number = {16303711},
   DOI = {10.1080/08035250500254068},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Pappa, H. M. and Gordon, C. M. and Saslowsky, T. M. and Zholudev, A. and Horr, B. and Shih, M. C. and Grand, R. J.},
   title = {Vitamin D status in children and young adults with inflammatory bowel disease},
   journal = {Pediatrics},
   volume = {118},
   number = {5},
   pages = {1950-61},
   note = {1098-4275
Pappa, Helen M
Gordon, Catherine M
Saslowsky, Tracee M
Zholudev, Anna
Horr, Brian
Shih, Mei-Chiung
Grand, Richard J
P30 DK040561/DK/NIDDK NIH HHS/United States
M01 RR002172/RR/NCRR NIH HHS/United States
P30 DK040561-11/DK/NIDDK NIH HHS/United States
DK 07477/DK/NIDDK NIH HHS/United States
T32 DK007471/DK/NIDDK NIH HHS/United States
T32 DK007477/DK/NIDDK NIH HHS/United States
M01 RR 02172/RR/NCRR NIH HHS/United States
T32 DK 07471/DK/NIDDK NIH HHS/United States
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
United States
Pediatrics. 2006 Nov;118(5):1950-61.},
   abstract = {OBJECTIVES: Previous studies of vitamin D status in pediatric patients with inflammatory bowel disease have revealed conflicting results. We sought to report (1) the prevalence of vitamin D deficiency (serum 25-hydroxy-vitamin D concentration < or = 15 ng/mL) in a large population with inflammatory bowel disease, (2) factors predisposing to this problem, and (3) its relationship to bone health and serum parathyroid hormone concentration. PATIENTS AND METHODS: A total of 130 patients (8-22 years of age) with inflammatory bowel disease, 94 with Crohn disease and 36 with ulcerative colitis, had serum 25-hydroxy-vitamin D, intact parathyroid hormone, and lumbar spine bone mineral density (using dual-energy x-ray absorptiometry) measured at Children's Hospital Boston. RESULTS: The prevalence of vitamin D deficiency was 34.6%. Mean serum 25-hydroxy-vitamin D concentration was similar in patients with Crohn disease and ulcerative colitis, 52.6% lower among patients with dark skin complexion, 33.4% lower during the winter months (December 22 to March 21), and 31.5% higher among patients who were taking vitamin D supplements. Serum 25-hydroxy-vitamin D concentration was positively correlated with weight and BMI z score, disease duration, and serum albumin concentration and negatively correlated with erythrocyte sedimentation rate. Patients with Crohn disease and upper gastrointestinal tract involvement were more likely to be vitamin D deficient than those without it. Serum 25-hydroxy-vitamin concentration was not associated with lumbar spine bone mineral density z score or serum parathyroid hormone concentration. CONCLUSIONS: Vitamin D deficiency is highly prevalent among pediatric patients with inflammatory bowel disease. Factors predisposing to the problem include having a dark-skin complexion, winter season, lack of vitamin D supplementation, early stage of disease, more severe disease, and upper gastrointestinal tract involvement in patients with Crohn disease. The long-term significance of hypovitaminosis D for this population is unknown at present and merits additional study.},
   keywords = {Adolescent
Adult
Bone Density
Child
Colitis, Ulcerative/blood/*complications/physiopathology
Crohn Disease/blood/*complications/physiopathology
Female
Humans
Male
Parathyroid Hormone/blood
Vitamin D Deficiency/*etiology},
   ISSN = {0031-4005},
   Accession Number = {17079566},
   DOI = {10.1542/peds.2006-0841},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Park, S. H. and Jeen, Y. T. and Chun, H. R. and Kim, D. I. and Baeck, C. W. and Kim, Y. S. and Chun, H. J. and Lee, H. S. and Um, S. H. and Choi, J. H. and Kim, C. D. and Ryu, H. S. and Hyun, J. H.},
   title = {[A case of refractory pediatric Crohn's disease with a successful treatment by infliximab therapy]},
   journal = {Korean J Gastroenterol},
   volume = {46},
   number = {4},
   pages = {297-301},
   note = {Park, Sang Hoon
Jeen, Yoon Tae
Chun, Hwang Rae
Kim, Dong Il
Baeck, Chang Won
Kim, Yong Sik
Chun, Hoon Jai
Lee, Hong Sik
Um, Soon Ho
Choi, Jai Hyun
Kim, Chang Duck
Ryu, Ho Sang
Hyun, Jin Hai
Case Reports
English Abstract
Journal Article
Korea (South)
Korean J Gastroenterol. 2005 Oct;46(4):297-301.},
   abstract = {Crohn's disease is a chronic inflammatory bowel disease which affects mainly children and young adults, and its cause remains unknown so far. Infliximab, a monoclonal antibody to the pivotal cytokine tumor necrosis factor-alpha, has been approved as a drug for both induction and maintenance therapy for moderately to severely active, or fistula-complicated Crohn's disease. The authors report a 12-year-old male patient diagnosed as Crohn's disease complicated with a perianal fistula, which was refractory to the conventional therapy. After the 0, 2, and 6 week scheduled intravenous infusion of infliximab, the patient reached to clinical remission in both subjective symptoms and objective manifestations. For children or young adults who develop Crohn's disease in a refractory course, infliximab may serve as a drug which leads to a clinical improvement or even to an extent of remission.},
   keywords = {Antibodies, Monoclonal/*administration & dosage
Child
Crohn Disease/*drug therapy
Drug Administration Schedule
Gastrointestinal Agents/*administration & dosage
Humans
Infliximab
Infusions, Intravenous
Male},
   ISSN = {1598-9992 (Print)
1598-9992},
   Accession Number = {16247274},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Pascher, A. and Klupp, J. and Kohler, S. and Langrehr, J. M. and Neuhaus, P.},
   title = {Transplantation of an eight-organ multivisceral graft in a patient with frozen abdomen after complicated Crohn's disease},
   journal = {World J Gastroenterol},
   volume = {12},
   number = {27},
   pages = {4431-4},
   note = {Pascher, Andreas
Klupp, Jochen
Kohler, Sven
Langrehr, Jan-M
Neuhaus, Peter
Case Reports
Journal Article
United States
World J Gastroenterol. 2006 Jul 21;12(27):4431-4.},
   abstract = {To report an extended multivisceral transplantation (MVTx) including right kidney and ascending colon in a patient with complicated Crohn's disease (CD). A 36-year old female suffering from short bowel syndrome and frozen abdomen due to fistulizing CD after multiple abdominal operations underwent MVTx of eight organs including stomach, pancreatoduodenal complex, liver, intestine, ascending colon, right kidney, right adrenal gland, and greater omentum in November 2003. Immunosuppression consisted of alemtuzumab, tacrolimus and steroids. The patient was off parenteral nutrition by postoperative wk 3. She experienced one episode of pneumonia. The patient recovered completely and discharged 2.5 mo and was doing well 30 mo after MVTx. This is one of the very rare cases in which a complete mulitivisceral graft of eight abdominal organs was transplanted orthotopically.},
   keywords = {Adrenal Glands/transplantation
Adult
Colon/transplantation
Crohn Disease/*complications
Duodenum/transplantation
Female
Humans
Kidney Transplantation
Liver Transplantation
Multiple Organ Failure/*etiology/*surgery
Omentum/transplantation
Organ Transplantation/*methods
Pancreas Transplantation
Stomach/transplantation
Treatment Outcome},
   ISSN = {1007-9327 (Print)
1007-9327},
   Accession Number = {16865793},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Paul, T. and Birnbaum, A. and Pal, D. K. and Pittman, N. and Ceballos, C. and LeLeiko, N. S. and Benkov, K.},
   title = {Distinct phenotype of early childhood inflammatory bowel disease},
   journal = {J Clin Gastroenterol},
   volume = {40},
   number = {7},
   pages = {583-6},
   note = {Paul, Thankam
Birnbaum, Audrey
Pal, Deb K
Pittman, Nanci
Ceballos, Clare
LeLeiko, Neal S
Benkov, Keith
Journal Article
United States
J Clin Gastroenterol. 2006 Aug;40(7):583-6.},
   abstract = {GOALS: Our goals were to answer 2 questions: (1) Is the presentation of early-onset inflammatory bowel disease (IBD) similar to typical adolescent-onset IBD? (2) Is there variability in familial aggregation in childhood IBD? BACKGROUND: The phenotype of IBD in children under 5 years of age (early-onset) is poorly defined. Clinical and genetic studies of IBD, however, generally assume the phenotype to be homogenous throughout childhood. STUDY: We analyzed data from 413 consecutive pediatric IBD outpatients attending our center between 1995 and 2000. Disease type, anatomic distribution, and family history were compared between children presenting before (early-onset) and after the age of five (5 to 15 y). RESULTS: Disease presentation was predominantly colonic in early-onset IBD, most patients presenting with ulcerative colitis (UC). Isolated colonic disease was most frequent in early-onset Crohn disease (colonic 76.5%, ileocolic 24%) compared with ileocolic disease (ileocolic 45.5%, colonic 26%, ileal 19.4%, proximal 6.3%) in the older age group. First-degree family history was highest in early-onset UC 26% versus 11% in the older UC group. CONCLUSIONS: We describe a distinct phenotype of early childhood onset IBD, with a strikingly high familial aggregation in UC and greater tendency to present with colonic disease. As more genetic heterogeneity is identified in IBD, careful definition of phenotype is required to identify further susceptibility genes. The early-onset form of UC presents an ideal group for further genetic analysis. These phenotype differences also suggest that treatment and outcome may vary in early-onset childhood IBD; prospective studies are required to confirm this.},
   keywords = {Adolescent
Age of Onset
Child
Child, Preschool
Colitis, Ulcerative/epidemiology/*genetics
Crohn Disease/epidemiology/*genetics
Female
Humans
Infant
Male
Phenotype
Retrospective Studies},
   ISSN = {0192-0790 (Print)
0192-0790},
   Accession Number = {16917397},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Pennazio, M.},
   title = {Small-intestinal pathology on capsule endoscopy: inflammatory lesions},
   journal = {Endoscopy},
   volume = {37},
   number = {8},
   pages = {769-75},
   note = {Pennazio, M
Journal Article
Germany
Endoscopy. 2005 Aug;37(8):769-75.},
   keywords = {Anti-Inflammatory Agents, Non-Steroidal/adverse effects
Constriction, Pathologic
Crohn Disease/pathology
Duodenal Ulcer/diagnosis
Endoscopy, Gastrointestinal/*methods
Enteritis/diagnosis
Humans
Ileal Diseases/pathology
Ileum/pathology
Inflammation/pathology
Intestinal Diseases/*diagnosis/pathology/surgery
Intestinal Mucosa/pathology
Jejunal Diseases/pathology},
   ISSN = {0013-726X (Print)
0013-726x},
   Accession Number = {16032499},
   DOI = {10.1055/s-2005-870178},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Pennazio, M.},
   title = {Capsule endoscopy: where are we after 6 years of clinical use?},
   journal = {Dig Liver Dis},
   volume = {38},
   number = {12},
   pages = {867-78},
   note = {Pennazio, M
Journal Article
Review
Netherlands
Dig Liver Dis. 2006 Dec;38(12):867-78. Epub 2006 Oct 11.},
   abstract = {Capsule endoscopy has revolutionised the management of digestive tract diseases by providing a new non-invasive way to view the entire small bowel mucosa directly. Obscure gastrointestinal bleeding is the primary and best validated indication to capsule endoscopy, which when used as first-line exploration is the most efficient strategy as regards diagnosis. In these patients, the technique is also helpful for effective decision-making concerning subsequent treatments. There is significant uncertainty regarding the role of capsule endoscopy in patients with Crohn's disease. Although it is clearly more sensitive than conventional imaging modalities, the implications of the lesions identified with this technique are not fully understood. Further prospective studies are required to identify the clinical settings where capsule endoscopy is most effective in these patients. Capsule endoscopy may potentially lead to diagnosis of small bowel tumours earlier in their course; it should be used as first-line surveillance procedure in patients with Peutz-Jeghers syndrome, and it may be of clinical value in selected patients with familial adenomatous polyposis. Although preliminary results are promising, additional research is necessary to determine its role in the diagnosis and management of coeliac disease, as well as for the diagnosis of oesophageal and large bowel disorders. Well-designed studies are also needed to better define the impact of capsule endoscopy on health care use and clinical outcome of patients with intestinal diseases.},
   keywords = {Adenomatous Polyposis Coli/diagnosis
Algorithms
*Capsule Endoscopy/adverse effects/contraindications
Celiac Disease/diagnosis
Gastrointestinal Diseases/diagnosis
Gastrointestinal Hemorrhage/diagnosis
Humans
Inflammatory Bowel Diseases/diagnosis},
   ISSN = {1590-8658 (Print)
1590-8658},
   Accession Number = {17045557},
   DOI = {10.1016/j.dld.2006.09.007},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Persad, R. and Jaffer, I. and Issenman, R. M.},
   title = {The prevalence of long bone fractures in pediatric inflammatory bowel disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {43},
   number = {5},
   pages = {597-602},
   note = {1536-4801
Persad, Rabindranath
Jaffer, Iqbal
Issenman, Robert M
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2006 Nov;43(5):597-602.},
   abstract = {INTRODUCTION: The association of inflammatory bowel disease (IBD) with decreased bone mineral density is well recognized. In the adult population, up to 50% of IBD patients are reported to have osteopenia, correlating with an increase in the incidence of fractures as compared with controls. The aim of this study was to determine the prevalence of fractures in a pediatric population with IBD as compared with healthy sibling controls (SC). PATIENTS AND METHODS: The families of 209 patients with IBD were sent a questionnaire asking them to compare their children with IBD to a healthy sibling (non-IBD). RESULTS: Surveys were returned by 132 of the 209 families (63%). The sample characteristics of this sample closely resembled the overall clinic population for age (mean 14.3 vs 14.7 years), gender (53% vs 59% male) and diagnosis (58.1 vs 57.8 Crohn disease). Completed surveys described 263 children. Of the 132 with IBD 73 (55%) had Crohn disease, 52 (39%) had ulcerative colitis and 7 (6%) had indeterminate colitis. There were 76/132 males (age range, 4-18 years) with IBD and 64/131 males (age range, 1-26 years) in the sibling controls. Mean ages of the IBD sample 14.3 +/-.3 was compared with 13.9 +/- in SC. Of the total group, 73/263 (28%) reported ever having a fracture, 44 (60%) were siblings (SC), and 29 (40%) had IBD. Of the 29 children with IBD, 17 (59%) reported having a fracture after diagnosis including 2 who had fractures both before and after diagnosis. The total number of fractures reported was 96 (55 SC:41 IBD). CONCLUSION: In this survey, we found no statistically significant difference in the prevalence of fracture in IBD patients compared with their normal siblings.},
   keywords = {Adolescent
Bone Density
Child
Child, Preschool
Female
Fractures, Bone/*epidemiology
Health Surveys
Humans
Infant
Inflammatory Bowel Diseases/*physiopathology
Male
Prevalence
Retrospective Studies
Risk Factors},
   ISSN = {0277-2116},
   Accession Number = {17130734},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Peyrin-Biroulet, L. and Vignal, C. and Dessein, R. and Simonet, M. and Desreumaux, P. and Chamaillard, M.},
   title = {NODs in defence: from vulnerable antimicrobial peptides to chronic inflammation},
   journal = {Trends Microbiol},
   volume = {14},
   number = {10},
   pages = {432-8},
   note = {Peyrin-Biroulet, Laurent
Vignal, Cecile
Dessein, Rodrigue
Simonet, Michel
Desreumaux, Pierre
Chamaillard, Mathias
Journal Article
Research Support, Non-U.S. Gov't
England
Trends Microbiol. 2006 Oct;14(10):432-8. Epub 2006 Aug 30.},
   abstract = {Defensins and cathelicidins are prevalent and essential gastrointestinal cationic antimicrobial peptides (CAPs). However, these defensive peptides are not infallible because certain enteropathogens can overcome their protective function. Furthermore, impaired defensin synthesis has been linked to the occurrence of Crohn's disease (CD), a chronic inflammatory bowel disease. Recently, defective bacterial sensing through NOD1 and NOD2 has been related to reduced defensin production, CD predisposition and susceptibility to enteric infection. Hence, we propose that microbial sensors at the gut interface monitor the levels of these effector peptides, which might function as "danger" signals to confer tolerance and alert immunocytes. Further work is required to clarify how gastrointestinal CAPs are regulated and to assess their role in maintaining epithelial homeostasis and triggering adaptive immunity.},
   keywords = {Amino Acid Sequence
Animals
Antimicrobial Cationic Peptides/chemistry/genetics/*physiology
Crohn Disease/immunology
Gastrointestinal Tract/chemistry/immunology
Humans
Inflammatory Bowel Diseases/immunology/*physiopathology
Molecular Sequence Data
Nod Signaling Adaptor Proteins/*physiology
Signal Transduction
Toll-Like Receptors/immunology},
   ISSN = {0966-842X (Print)
0966-842x},
   Accession Number = {16942880},
   DOI = {10.1016/j.tim.2006.08.008},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Pigott, A. and Casson, D.},
   title = {Thalidomide in Crohn disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {40},
   number = {2},
   pages = {236},
   note = {Pigott, A
Casson, D
Comment
Letter
United States
J Pediatr Gastroenterol Nutr. 2005 Feb;40(2):236.},
   keywords = {Clinical Trials as Topic
Crohn Disease/*drug therapy
Diagnosis, Differential
Dose-Response Relationship, Drug
Humans
Peripheral Nervous System Diseases/*chemically induced/diagnosis
Sensitivity and Specificity
Thalidomide/*adverse effects/*therapeutic use},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {15699709},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Piquet, M. A. and Gloro, R. and Justum, A. M. and Reimund, J. M.},
   title = {[Nutritional therapy in inflammatory bowel disease]},
   journal = {Gastroenterol Clin Biol},
   volume = {30},
   number = {2},
   pages = {262-71},
   note = {Piquet, Marie-Astrid
Gloro, Romain
Justum, Anne-Marie
Reimund, Jean-Marie
English Abstract
Journal Article
Review
France
Gastroenterol Clin Biol. 2006 Feb;30(2):262-71.},
   abstract = {Protein-energy malnutrition and specific nutrient deficiencies are common in inflammatory bowel diseases (IBD), more particularly in Crohn's disease. In adults, the use of artificial nutrition is indicated in the event of malnutrition, short bowel syndrome, or IBD refractory to all other treatments. In children, enteral nutrition has a place as first-line treatment to avoid side effects of corticosteroids on growth. The use, as a therapeutic tool, of specific nutrients (n-3 fatty acids, glutamine, antioxydant vitamins and minerals, TGF-beta, probiotics...) seems interesting at the pathophysiological level. Nevertheless, these nutrients are still under evaluation and there are not enough available studies to recommend them in clinical routine. A very promising solution is the use of probiotics for the treatment of refractory pouchitis.},
   keywords = {Antioxidants/therapeutic use
*Enteral Nutrition
Fatty Acids, Omega-3/therapeutic use
Glutamine/therapeutic use
Humans
Inflammatory Bowel Diseases/complications/*therapy
Malnutrition/etiology/therapy
Probiotics/therapeutic use
Secondary Prevention
Transforming Growth Factor beta/therapeutic use},
   ISSN = {0399-8320 (Print)
0399-8320},
   Accession Number = {16565660},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Porter, L. and Reynolds, N. and Ellis, J. D.},
   title = {Total parenteral nutrition, vitamin E, and reversible macular dysfunction morphologically mimicking age related macular degeneration},
   journal = {Br J Ophthalmol},
   volume = {89},
   number = {11},
   pages = {1531-2},
   note = {Porter, L
Reynolds, N
Ellis, J D
Case Reports
Letter
England
Br J Ophthalmol. 2005 Nov;89(11):1531-2.},
   keywords = {Crohn Disease/therapy
Diagnosis, Differential
Humans
Macular Degeneration/*etiology
Male
Middle Aged
Parenteral Nutrition, Total/*adverse effects
Vitamin E Deficiency/*complications},
   ISSN = {0007-1161 (Print)
0007-1161},
   Accession Number = {16234469},
   DOI = {10.1136/bjo.2005.074195},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Pozler, O. and Maly, J. and Bonova, O. and Dedek, P. and Fruhauf, P. and Havlickova, A. and Janatova, T. and Jimramovsky, F. and Klimova, L. and Klusacek, D. and Kocourkova, D. and Kolek, A. and Kotalova, R. and Marx, D. and Nevoral, J. and Petro, R. and Petru, O. and Plasilova, I. and Seidl, Z. and Sekyrova, I. and Semendak, N. and Schreierova, I. and Stanek, J. and Sykora, J. and Sulakova, A. and Toukalkova, L. and Travnickova, R. and Volf, V. and Zahradnicek, L. and Zeniskova, I.},
   title = {Incidence of Crohn disease in the Czech Republic in the years 1990 to 2001 and assessment of pediatric population with inflammatory bowel disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {42},
   number = {2},
   pages = {186-9},
   note = {Pozler, Oldrich
Maly, Jan
Bonova, Oldriska
Dedek, Petr
Fruhauf, Pavel
Havlickova, Alena
Janatova, Tatiana
Jimramovsky, Frantisek
Klimova, Lenka
Klusacek, Dalibor
Kocourkova, Dana
Kolek, Antonin
Kotalova, Radka
Marx, David
Nevoral, Jiri
Petro, Radim
Petru, Ondrej
Plasilova, Ivana
Seidl, Zbynek
Sekyrova, Ivana
Semendak, Norbert
Schreierova, Irena
Stanek, Jan
Sykora, Josef
Sulakova, Astrid
Toukalkova, Lenka
Travnickova, Radka
Volf, Vladimir
Zahradnicek, Lubomir
Zeniskova, Ivana
Journal Article
Research Support, Non-U.S. Gov't
United States
J Pediatr Gastroenterol Nutr. 2006 Feb;42(2):186-9.},
   abstract = {BACKGROUND: The aim of this study was to assess the pediatric population that suffered from inflammatory bowel disease (IBD) in the Czech Republic and to determine the incidence of Crohn disease (CD) in children up to 15 years age between 1990 and 2001. METHODS: Diagnostic criteria for CD, ulcerative colitis (UC), and indeterminate colitis (IC) were defined. Medical records provided a source of basic information about the children. A standardized protocol was filled out and sent to the coordinator of the study. All protocols were checked to see whether the data corresponded to the defined criteria and then were processed further. The study was retrospective in character for the years 1990 to 1999 and prospective for the years 2000 and 2001. RESULTS: Diagnostic criteria were met in 470 patients with IBD; 201 of them turned 18 years old during the study period. CD was diagnosed in 223 patients. The incidence of CD in children up to 15 years of age increased from 0.25/100,000 in 1990 to 1.25/100,000 in 2001. Eighty-two percent of children with CD were treated with aminosalicylates in combination with corticosteroids; 29% of patients received azathioprine. Severe growth retardation was recorded in 6.4% of adolescents with CD at the age of 18. UC was diagnosed in 202 patients. Therapy with aminosalicylates only was sufficient for control of the disease in 23% patients; 68% children were treated with corticosteroids, 15 of them (23% of the whole group) received additional azathioprine. Criteria for IC were met in 9.8% of all patients with IBD. CONCLUSION: This study confirmed an increase in incidence of CD in children younger than 15 years in the Czech Republic.},
   keywords = {Adolescent
Adrenal Cortex Hormones/*therapeutic use
Age Factors
Aminosalicylic Acids/*therapeutic use
Azathioprine/*therapeutic use
Child
Child, Preschool
Colitis/drug therapy/epidemiology
Colitis, Ulcerative/complications/drug therapy/epidemiology
Crohn Disease/complications/drug therapy/epidemiology
Czech Republic/epidemiology
Disease Progression
Drug Therapy, Combination
Female
Growth Disorders/etiology
Humans
Incidence
Infant
Inflammatory Bowel Diseases/complications/*drug therapy/*epidemiology
Male
Prospective Studies
Retrospective Studies},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16456413},
   DOI = {10.1097/01.mpg.0000189328.47150.bc},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Puder, J. J. and Endrass, J. and Moriconi, N. and Keller, U.},
   title = {How patients with insulin-treated type 1 and type 2 diabetes view their own and their physician's treatment goals},
   journal = {Swiss Med Wkly},
   volume = {136},
   number = {35-36},
   pages = {574-80},
   note = {Puder, Jardena J
Endrass, Jerome
Moriconi, Natascha
Keller, Ulrich
Journal Article
Research Support, Non-U.S. Gov't
Switzerland
Swiss Med Wkly. 2006 Sep 2;136(35-36):574-80.},
   abstract = {OBJECTIVES: To investigate the subjective treatment goals of insulin-treated diabetic patients. METHODS: 297 type 1 and 205 type 2 diabetic patients, representative of the North-western Swiss population, filled out a self report questionnaire focusing on their own treatment goals using standardized measures wherever available. Factor analysis of the 16 items reflecting their treatment goals revealed four subscales (Crohnbach's alpha): High actual quality of life (0.73), weight reduction/maintenance and daily hassles (0.68), good medical care and knowledge (0.64) and good long term glucose control (0.71). RESULTS: Good long term glucose control was the single most important main treatment goal for most patients (type 1: 60.2%, type 2: 49.7%, p = 0.025). However, both type 1 and type 2 diabetic patients believed that this goal - especially the value of HbA1c - was overestimated (both p <0.0001), while high actual quality of life was underestimated (p = 0.003 and p = 0.05, respectively) by their physicians compared to their own assessment. Good long term glucose control (OR 1.63, p = 0.003) and high actual quality of life (OR 2.17, p <0.0001) were more important and weight reduction/maintenance and coping with daily hassles (OR 0.75, p = 0.07) were slightly less important treatment goals for type 1 than for type 2 diabetic patients. These differences in goals were best associated with the mode of insulin therapy, self-monitoring, and with the extent of diabetes education. CONCLUSIONS: Patients believe that physicians overestimate the importance of long term glucose control and underestimate the importance of actual quality of life. Diabetes education and self management have the largest impact on patients' own treatment goals.},
   keywords = {Adult
Blood Glucose/analysis
Diabetes Mellitus, Type 1/psychology/*therapy
Diabetes Mellitus, Type 2/psychology/*therapy
Female
Goals
*Health Knowledge, Attitudes, Practice
Hemoglobin A, Glycosylated/analysis
Humans
Male
Middle Aged
Outpatient Clinics, Hospital
Outpatients/*psychology
*Patient Satisfaction
Quality of Life/psychology
Self Efficacy
Surveys and Questionnaires
Switzerland
*Treatment Outcome},
   ISSN = {1424-7860 (Print)
0036-7672},
   Accession Number = {17043950},
   DOI = {2006/35/smw-11502},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Ravikumara, M. and Sandhu, B. K.},
   title = {Epidemiology of inflammatory bowel diseases in childhood},
   journal = {Indian J Pediatr},
   volume = {73},
   number = {8},
   pages = {717-21},
   note = {0973-7693
Ravikumara, M
Sandhu, B K
Congresses
India
Indian J Pediatr. 2006 Aug;73(8):717-21.},
   abstract = {Inflammatory Bowel Disease (IBD) is common in most industrialised countries and childhood IBD accounts for nearly 30% of total cases. Various studies, mostly from Europe and USA have reported epidemiological characteristics of childhood IBD. The incidence figures vary greatly from region to region and within a region over time. Almost all reported studies have documented an increase in the incidence, mainly of Crohn's disease over the last few decades. The reasons for the increase are not clear but epidemiological observations have led to many postulates. Incidence in developing countries is perceived to be low, but limited data suggest that it may not be as uncommon as previously thought. IBD can occur at any age but is rare in infancy. Among childhood IBD, early onset IBD appears to be different epidemiologically and is characterised by predominance of colonic involvement and high positive family history. It has become apparent that only about 25% of childhood Crohn's disease presents with classical triad of abdominal pain, diarrhoea and weight loss. Pediatricians should be aware of atypical manifestations and should maintain high index of suspicion. Though epidemiological studies of childhood IBD done so far have contributed towards understanding of IBD, they have differed in study design, population, time period, age group and case definitions. Unfortunately there are no uniform, clear diagnostic criteria which are evidence based. To address this problem, recently the IBD working group of European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) has published "The Porto Criteria" which details a consensus based diagnostic criteria for the diagnosis of childhood IBD. This should bring uniformity in ascertainment of newly diagnosed IBD cases. An European multicentre prospective database has also been established to facilitate future epidemiological studies.},
   keywords = {Adolescent
Adult
Age Distribution
Asian Continental Ancestry Group
Child
Child, Preschool
Female
Geography
Humans
Incidence
Infant
Inflammatory Bowel Diseases/*epidemiology/ethnology/pathology
Male
Sex Distribution},
   ISSN = {0019-5456},
   Accession Number = {16936368},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Regueiro, M. and Kip, K. E. and Cheung, O. and Hegazi, R. A. and Plevy, S.},
   title = {Cigarette smoking and age at diagnosis of inflammatory bowel disease},
   journal = {Inflamm Bowel Dis},
   volume = {11},
   number = {1},
   pages = {42-7},
   note = {Regueiro, Miguel
Kip, Kevin E
Cheung, Onki
Hegazi, Refaat A
Plevy, Scott
Journal Article
United States
Inflamm Bowel Dis. 2005 Jan;11(1):42-7.},
   abstract = {OBJECTIVES: The incidence and age of onset of inflammatory bowel disease (IBD) appear to be changing. The aim of this study was to determine whether the prevalence of cigarette smoking differs among patients with Crohn's disease (CD) or ulcerative colitis (UC) at the time of diagnosis compared with the general population and whether smoking history is related to the type and age of IBD onset. METHODS: Prevalence rates of smoking at the time of IBD diagnosis were compared between patients with CD and UC from the IBD Center at the University of Pittsburgh Medical Center versus age-, gender-, and time period-adjusted rates in the Pennsylvania general population. Analyses also were stratified by gender and diagnoses before and after 40 years of age, i.e., early and late onset. RESULTS: There were 263 IBD patients (144 UC patients and 119 CD patients) seen in the IBD center between August 2000 and December 2002. The prevalence of active smoking was significantly higher at diagnosis in CD patients compared with the Pennsylvania general population (33% versus 24%, P = 0.04), particularly in those with CD onset at 40 years of age or later (47% versus 27%, P = 0.005). In contrast, smoking prevalence was significantly lower in UC patients than the general population (9% versus 28%, P < 0.0001), particularly among those with UC onset before the age of 40 years (6% versus 27%, P < 0.0001). Smoking cessation was associated with an approximate, but nonsignificant, 3-fold higher likelihood of late-onset UC compared with CD. CONCLUSIONS: Cigarette smoking is associated with the development of late-onset CD and is protective against developing UC at any age, particularly early onset. Former smoking is associated with a high likelihood of developing late-onset UC, but not CD.},
   keywords = {Adult
Age of Onset
Case-Control Studies
Colitis, Ulcerative/epidemiology/*etiology/prevention & control
Crohn Disease/epidemiology/*etiology/prevention & control
Female
Humans
Male
Prevalence
Retrospective Studies
Smoking/*adverse effects},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {15674112},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Reimund, J. M. and Arondel, Y. and Escalin, G. and Finck, G. and Baumann, R. and Duclos, B.},
   title = {Immune activation and nutritional status in adult Crohn's disease patients},
   journal = {Dig Liver Dis},
   volume = {37},
   number = {6},
   pages = {424-31},
   note = {Reimund, J-M
Arondel, Y
Escalin, G
Finck, G
Baumann, R
Duclos, B
Journal Article
Netherlands
Dig Liver Dis. 2005 Jun;37(6):424-31. Epub 2005 Mar 17.},
   abstract = {BACKGROUND: Recent attention focused on the effect of inflammatory cytokines on intermediary metabolism contributing to the nutritional disturbances observed in acute or chronic inflammatory diseases. AIMS: To examine the interactions between immune activation and nutritional parameters in adult Crohn's disease patients. PATIENTS AND METHODS: We analysed anthropometric and biochemical nutritional parameters in 40 Crohn's disease patients and 26 healthy controls, and related them to inflammatory and immune markers. RESULTS: Weight, body mass index, mid-arm circumference, triceps skinfold thickness, as well as albumin, transthyretin, retinol binding protein, insulin growth factor-I and Vitamin A were significantly decreased in Crohn's disease patients and negatively correlated to disease activity. By contrast, erythrocyte sedimentation rate, fibrinogen, C-reactive protein, alpha1-acylglycoprotein, soluble receptor of interleukin-2, blood neopterin, tumour necrosis factor-alpha and interleukin-1beta concentrations were significantly higher in patients and positively correlated to disease activity. Nutritional parameters and acute phase reactants were linked to tumour necrosis factor-alpha and interleukin-1beta concentrations, and markers of nutritional status were negatively correlated to positive acute phase reactants. CONCLUSIONS: In Crohn's disease, inflammatory cytokines appear partly responsible for decreased nutritional status. Thus, nutritional intervention to correct nutritional (in particular protein) depletion, and/or therapeutic intervention reducing inflammation and therefore restoring adequate nutritional proteins synthesis, appears a major therapeutic goal in active Crohn's disease.},
   keywords = {Adult
Biomarkers/blood
Blood Proteins/analysis
Blood Sedimentation
Body Mass Index
Body Weight/physiology
Case-Control Studies
Crohn Disease/*blood/*immunology
Female
Humans
Insulin-Like Growth Factor Binding Protein 1/blood
Interleukin-1/blood
Male
Multivariate Analysis
Neopterin/blood
*Nutritional Status
Receptors, Interleukin-2/blood
Solubility
Vitamin A/blood},
   ISSN = {1590-8658 (Print)
1590-8658},
   Accession Number = {15893281},
   DOI = {10.1016/j.dld.2005.01.010},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Remes-Troche, J. M. and Martinez-Benitez, B. and Valdovinos-Diaz, M. A.},
   title = {Crohn's disease of the esophagus},
   journal = {Gastroenterology},
   volume = {130},
   number = {4},
   pages = {1029, 1376},
   note = {Remes-Troche, Jose Maria
Martinez-Benitez, Braulio
Valdovinos-Diaz, Miguel A
Case Reports
Journal Article
United States
Gastroenterology. 2006 Apr;130(4):1029, 1376.},
   keywords = {Crohn Disease/*diagnosis/diagnostic imaging/pathology/surgery
Esophageal Diseases/*diagnosis/diagnostic imaging/pathology/surgery
Esophagectomy
Esophagoscopy
Esophagus/*diagnostic imaging/*pathology/surgery
Female
Humans
Middle Aged
Tomography, X-Ray Computed},
   ISSN = {0016-5085 (Print)
0016-5085},
   Accession Number = {16625740},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Roesler, J. and Thurigen, A. and Sun, L. and Koch, R. and Winkler, U. and Laass, M. W. and Gahr, M. and Rosen-Wolff, A. and Henker, J.},
   title = {Influence of CARD15 mutations on disease activity and response to therapy in 65 pediatric Crohn patients from Saxony, Germany},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {41},
   number = {1},
   pages = {27-32},
   note = {Roesler, Joachim
Thurigen, Anett
Sun, Liping
Koch, Rainer
Winkler, Ulf
Laass, Martin W
Gahr, Manfred
Rosen-Wolff, Angela
Henker, Jobst
Journal Article
Research Support, Non-U.S. Gov't
United States
J Pediatr Gastroenterol Nutr. 2005 Jul;41(1):27-32.},
   abstract = {OBJECTIVES: Certain genetic variants in the CARD15 gene are accompanied by an enhanced risk to develop Crohn disease with the main activity in the terminal ileum and ensuing stricturing early in life. The objective of this study was to evaluate the relation between CARD15 mutations and overall disease activity and response to therapy in pediatric patients. METHODS: 65 genomic DNA samples from such patients were tested for the presence of three main Crohn associated mutations in CARD15 by direct genomic sequencing. The number of mutations (none, one or two alleles affected) was correlated with body mass index and height, Pediatric Crohn Disease Activity Index, therapy and therapeutical success in terms of body mass index and Pediatric Crohn Disease Activity Index improvement. RESULTS: The authors found a nonsignificant trend of a lower body mass index and higher Pediatric Crohn Disease Activity Index in patients with CARD15 mutations. Physicians uninformed about their CARD15 status prescribed significantly more budesonide and prednisolone intermittently and more alimentary supplementation to these patients. The average improvement in terms of body mass index and Pediatric Crohn Disease Activity Index after 2 years of therapy was roughly similar in all patient groups. CONCLUSIONS: Pediatric Crohn patients with CARD15 mutations have a higher disease activity and need a more intensive therapy. With some exceptions, their medium-term response to therapy is nevertheless satisfying.},
   keywords = {Adolescent
Body Height
Body Mass Index
Child
Child, Preschool
Cohort Studies
Crohn Disease/*genetics/pathology/*therapy
Female
*Genotype
Germany
Humans
Intracellular Signaling Peptides and Proteins/*genetics
Male
Mutation
Nod2 Signaling Adaptor Protein
*Phenotype
Polymerase Chain Reaction
Sequence Analysis, DNA
Severity of Illness Index},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {15990626},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Ross, A. S. and Gasparaitis, A. and Hurst, R. and Hanauer, S. B. and Rubin, D. T.},
   title = {Superior mesenteric vein thrombosis after colectomy in a patient with Crohn's disease},
   journal = {Nat Clin Pract Gastroenterol Hepatol},
   volume = {2},
   number = {6},
   pages = {281-5; quiz 1 p following 285},
   note = {Ross, Andrew S
Gasparaitis, Arunas
Hurst, Roger
Hanauer, Stephen B
Rubin, David T
Case Reports
Journal Article
England

repository: KociOrges/pytag

repo_name: KociOrges/pytag