text:
Mohamed, Nadia A S
Ibrahim, Mohamed-Eltaher A R
Journal Article
England
Respir Med. 2007 May;101(5):977-82. Epub 2006 Oct 17.},
   abstract = {OBJECTIVES: Information on the occurrence and frequency of pulmonary involvement in patients with ulcerative colitis (UC) is inconsistent. Some authors reported pulmonary impairment with UC by standard pulmonary function tests (PFTs) and documented a reduced diffusing capacity for carbon monoxide (DLCO) especially in patients with active disease, whereas others could not detect differences in routine PFTs between UC patients and controls. AIM: The aim of this prospective study was to determine the frequency and type of pulmonary dysfunction in patients with UC with respect to disease activity. Furthermore, to evaluate the influence of smoking, nutritional status, sputum cytology and sulphasalazine therapy on PFT parameters. PATIENTS AND METHODS: Twenty-six patients with UC (20 with active disease, 6 inactive) and 16 age and sex matched healthy controls were investigated with respect to the following pulmonary function tests, forced vital capacity (FVC), forced expiratory volume in the 1s (FEV(1)%) and their ratio (FEV(1)/FVC) and forced expiratory flow 25-75% (FEF25-75%) as well as oxygen saturation. For UC patients, colonoscopy and biopsy were done. Disease activity was assessed by Truelove index for UC. Induced sputum was sampled for cytology. Smoking habit, body mass index (BMI) and medications were recorded. RESULTS: Fifteen out of 26 patients with UC (57.6%) exhibited at least one pathological pulmonary function test (<80% of predicted value). Small airway obstruction was reported in the 15 patients, restrictive dysfunction in 30.7% and obstructive dysfunction in 11.5%. The impairment of PFTs was significant and more pronounced in patients with active disease, FVC (-14% of predicted), FEV(1) (-9% of predicted) and FEF25-75% (-32% of predicted), P<0.01, 0.05 and 0.01, respectively. There was no significant influence of smoking and medications on PFTs. CONCLUSIONS: UC patients show significantly decreased lung function tests in comparison to healthy controls. The impairment in active disease exceeded that during the remission. Early recognition is important, as they can be strikingly steroid responsive.},
   keywords = {Adolescent
Adult
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Body Mass Index
Colitis, Ulcerative/*complications/drug therapy/physiopathology
Eosinophilia/etiology
Female
Forced Expiratory Volume
Humans
Lymphocytosis/etiology
Male
Middle Aged
Nutritional Status
Oxygen/blood
Prospective Studies
Respiration Disorders/*etiology/physiopathology
Respiratory Function Tests
Severity of Illness Index
Smoking/physiopathology
Sputum/cytology
Sulfasalazine/therapeutic use
Vital Capacity},
   ISSN = {0954-6111 (Print)
0954-6111},
   Accession Number = {17049827},
   DOI = {10.1016/j.rmed.2006.09.005},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Moughan, P. J. and Butts, C. A. and Rowan, A. M. and Deglaire, A.},
   title = {Dietary peptides increase endogenous amino acid losses from the gut in adults},
   journal = {Am J Clin Nutr},
   volume = {81},
   number = {6},
   pages = {1359-65},
   note = {Moughan, Paul J
Butts, Christine A
Rowan, Angela M
Deglaire, Amelie
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
United States
Am J Clin Nutr. 2005 Jun;81(6):1359-65.},
   abstract = {BACKGROUND: Accurate estimates of endogenous ileal total nitrogen and amino acid flows are necessary to ascertain true dietary amino acid digestibility coefficients and for the factorial estimation of dietary amino acid requirements. OBJECTIVE: The objective was to ascertain endogenous amino acid losses from the small bowel in human subjects consuming a protein-free diet or a diet with enzyme-hydrolyzed casein (EHC; MW <5000) as the sole source of nitrogen. DESIGN: The subjects were 8 men and women with terminal ileum ileostomies after ulcerative colitis who consumed the protein-free and EHC-based diets in a crossover design. Each subject received each test diet in single meals followed by 2 consecutive 9-h total collections of digesta. Digesta samples for the EHC treatment were centrifuged and ultrafiltered (10 000 MW cutoff), with the precipitate-plus-retentate fraction (>10 000 MW) providing a measurement of endogenous ileal amino acids. RESULTS: The mean endogenous flows for most of the amino acids and nitrogen were significantly (P < 0.05) higher when determined with the EHC-based diet than with the protein-free diet. Mean (n = 8) endogenous ileal nitrogen flows were 2061 and 4233 mug/g dry matter intake for the protein-free and EHC-based diets, respectively. CONCLUSION: The traditional protein-free method underestimates endogenous ileal amino acid loss in adults.},
   keywords = {Amino Acids/administration & dosage/*metabolism
Caseins/administration & dosage/*metabolism
Cross-Over Studies
*Diet, Protein-Restricted
Dietary Proteins/administration & dosage/*metabolism
Digestion
Female
Humans
Ileostomy
Ileum/*metabolism
Male
Middle Aged
Nitrogen/administration & dosage/metabolism
*Nutritional Requirements},
   ISSN = {0002-9165 (Print)
0002-9165},
   Accession Number = {15941887},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Moughan, P. J. and Butts, C. A. and van Wijk, H. and Rowan, A. M. and Reynolds, G. W.},
   title = {An acute ileal amino acid digestibility assay is a valid procedure for use in human ileostomates},
   journal = {J Nutr},
   volume = {135},
   number = {3},
   pages = {404-9},
   note = {Moughan, Paul J
Butts, Christine A
van Wijk, Henk
Rowan, Angela M
Reynolds, Gordon W
Journal Article
Research Support, Non-U.S. Gov't
United States
J Nutr. 2005 Mar;135(3):404-9.},
   abstract = {An acute (24-h) feeding/digesta sampling procedure was evaluated in a preliminary study using growing pigs. The validated acute procedure was then applied using human ileostomates to determine apparent and true ileal amino acid digestibilities of 4 dietary protein sources. The acute method involved feeding ileostomized pigs a single meal containing the test protein as part of a purified diet, with no previous dietary adaptation, followed by an 8-h collection of digesta. Apparent ileal N digestibility did not differ between the acute and conventional (14-d study) procedures. Eight adult human ileostomates each received a single meal of protein-free biscuits and a drink containing sodium caseinate, whey protein concentrate, soy protein isolate, or soy protein concentrate; this meal was followed by a 9-h total digesta collection period. Acid insoluble ash was used as an indigestible marker. True ileal amino acid digestibilities (means +/- SE) ranged from 90.5 +/- 2.74% for cysteine in soy protein concentrate to 105.3 +/- 5.66% for cysteine in sodium caseinate and were markedly higher than their apparent counterparts. True ileal digestibilities for total nitrogen were 101.9 +/- 0.70, 98.3 +/- 0.80, 99.5 +/- 0.80, and 98.5 +/- 1.20% for sodium caseinate, whey protein concentrate, soy protein isolate, and soy protein concentrate, respectively. The 4 protein sources were virtually completely digested in humans by the end of the small intestine.},
   keywords = {Amino Acids/*metabolism
Animals
Colectomy
Colitis, Ulcerative/surgery
Diet
Digestion/*physiology
Female
Humans
*Ileostomy
Ileum/*physiology
Intestinal Absorption/*physiology
Male
Models, Animal
Swine},
   ISSN = {0022-3166 (Print)
0022-3166},
   Accession Number = {15735070},
   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 = {Okada, H. and Takenaka, R. and Hiraoka, S. and Makidono, C. and Hori, S. and Kato, J. and Okazaki, H. and Kawamoto, H. and Mizuno, M. and Shiratori, Y.},
   title = {Centrifugal leukocytapheresis therapy for ulcerative colitis without concurrent corticosteroid administration},
   journal = {Ther Apher Dial},
   volume = {10},
   number = {3},
   pages = {242-6},
   note = {Okada, Hiroyuki
Takenaka, Ryuta
Hiraoka, Sakiko
Makidono, Chiho
Hori, Shin-Ichiro
Kato, Jun
Okazaki, Hiroaki
Kawamoto, Hirofumi
Mizuno, Motowo
Shiratori, Yasushi
Clinical Trial
Journal Article
Australia
Ther Apher Dial. 2006 Jun;10(3):242-6.},
   abstract = {Corticosteroid administration is an important therapy for active ulcerative colitis. However, long-term corticosteroid use is associated with serious complications such as osteoporosis, diabetes, and growth retardation. The effect of combination therapy corticosteroid plus leukocytapheresis has been previously reported, but that of leukocytapheresis with no corticosteroid is unknown. We carried out a preliminary study of six patients (two men and four women) with active ulcerative colitis (severe in two, moderately severe in four) who did not respond to 5-aminosalicylate derivatives, but refused corticosteroid use. Centrifugal leukocytapheresis was carried out once per week totaling four sessions per course. Treatment was considered effective when patients experienced clinical remission, which was defined as a frequency of diarrhea of four times or less and absence of visible blood in the stool, after one course. Leukocytapheresis was effective in five of six patients(83%). With cases stratified by severity, both severe cases and three of four moderately severe cases showed effectiveness. Clinical activity scores according to Lichtiger et al. in cases where leukocytapheresis was effective decreased from 9.8 to 6.6 at 1 week (P < 0.0001), declining further 2.4 at the end of the course. No obvious complications of leukocytapheresis were noted except for a decrease in hemoglobin by 1 g/dL. Centrifugal leukocytapheresis without corticosteroid treatment can induce remission in patients with active ulcerative colitis, and might be particularly beneficial for patients in whom adverse effects preclude the use of corticosteroids.},
   keywords = {Adolescent
Adrenal Cortex Hormones/contraindications
Adult
Aged
Colitis, Ulcerative/*therapy
Endoscopy, Digestive System
Female
Humans
Leukapheresis/*methods
Male
Mesalamine/pharmacology
Middle Aged
Parenteral Nutrition, Total/methods
Severity of Illness Index
Treatment Outcome},
   ISSN = {1744-9979 (Print)
1744-9979},
   Accession Number = {16817788},
   DOI = {10.1111/j.1744-9987.2006.00379.x},
   year = {2006},
   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 = {Pal, S. and Sahni, P. and Pande, G. K. and Acharya, S. K. and Chattopadhyay, T. K.},
   title = {Outcome following emergency surgery for refractory severe ulcerative colitis in a tertiary care centre in India},
   journal = {BMC Gastroenterol},
   volume = {5},
   pages = {39},
   note = {1471-230x
Pal, Sujoy
Sahni, Peush
Pande, Girish K
Acharya, Subrat K
Chattopadhyay, Tushar K
Journal Article
England
BMC Gastroenterol. 2005 Nov 30;5:39.},
   abstract = {BACKGROUND: Steroid-based intensive medical therapy for severe ulcerative colitis is successful in 60-70% of such patients. Patients with complications or those refractory to medical therapy require emergency colectomy for salvage. Little is known about the impact of timing of surgical intervention and surgical outcomes of such patients undergoing emergency surgery in India where the diagnosis is often delayed or missed in patients who are poor, malnourished and non-compliant to medical treatment. METHODS: The clinical records of all patients undergoing emergency surgery for severe ulcerative colitis or its complication in the Department of GI surgery AIIMS, New Delhi, India, between January 1985 and December 2003 were retrieved and data pertaining to demographic features, duration of intensive medical therapy, presence of complications, time from admission to emergency surgery, surgical procedure, in-hospital morbidity and mortality and follow up status extracted. RESULTS: A total of 72 patients underwent emergency surgery (Subtotal colectomy: 60; ileostomy alone under local anaesthesia: 12). Poor nutritional status was seen in 61% of the patients. Twenty-one patients (29%) underwent emergency surgery for complications of severe ulcerative colitis such as colonic perforation (spontaneous 6, iatrogenic 4), massive lower gastrointestinal haemorrhage (5), toxic megacolon (4) and large bowel obstruction (2). The remaining patients (n = 51) underwent emergency surgery following failed intensive therapy; 17 underwent surgery < or = 5 days (Group I) and 34 were operated > 5 days (Group II) after initiation of intensive therapy. In this group all the post-operative deaths (n = 8) occurred in those who were operated after 5 days. The difference in mortality in these two groups (i.e. surgical intervention < or = or > 5 days) was statistically significant {0/17 (Group I) vs 8/34 (Group II); p = 0.03}. Overall, 12 patients died (in-hospital mortality: 16.7%). The mortality was higher (10/43; 23.3%) in our early experience (i.e. 1985-1995) when compared to our subsequent experience (2/29; 6.9%) (1996-2003). A total of 48 patients (including 3 awaiting a restorative procedure) are alive on follow up (66.7%; 3 patients lost to follow up). A restorative procedure could be successfully completed in 81% of the survivors of the emergency procedure. CONCLUSION: To optimize the outcome, a combined team of physicians and surgeons should be involved in the management of patients with severe ulcerative colitis with focus on nutritional support, correction of metabolic derangements, close clinical monitoring and timely assessment for the need for emergency surgery. This retrospective analysis shows that improved results can be achieved with experience and by following a policy of early surgical intervention within 5 days, especially in patients who have failed intensive medical therapy.},
   keywords = {Adolescent
Adult
Aged
Colitis, Ulcerative/complications/*physiopathology/*surgery
Colon/surgery
*Developing Countries
*Digestive System Surgical Procedures/mortality
*Emergency Medical Services
Female
Gastrointestinal Hemorrhage/etiology/surgery
Hospital Mortality
Humans
India
Intestinal Obstruction/etiology/surgery
Intestinal Perforation/etiology/surgery
Intestine, Large
Male
Megacolon, Toxic/etiology/surgery
Middle Aged
Severity of Illness Index
Time Factors
Treatment Outcome},
   ISSN = {1471-230x},
   Accession Number = {16316474},
   DOI = {10.1186/1471-230x-5-39},
   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 = {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 = {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 = {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 = {Rahhal, R. M. and Pashankar, D. S. and Bishop, W. P.},
   title = {Ulcerative colitis complicated by ischemic colitis and Budd Chiari syndrome},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {40},
   number = {1},
   pages = {94-7},
   note = {Rahhal, Riad M
Pashankar, Dinesh S
Bishop, Warren P
Case Reports
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2005 Jan;40(1):94-7.},
   keywords = {Adolescent
Budd-Chiari Syndrome/*complications/pathology/surgery
Colitis, Ischemic/*complications/pathology/surgery
Colitis, Ulcerative/*complications/pathology/surgery
Female
Humans
Proctocolectomy, Restorative
Treatment Outcome},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {15625435},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Regueiro, M. and Curtis, J. and Plevy, S.},
   title = {Infliximab for hospitalized patients with severe ulcerative colitis},
   journal = {J Clin Gastroenterol},
   volume = {40},
   number = {6},
   pages = {476-81},
   note = {Regueiro, Miguel
Curtis, Jennifer
Plevy, Scott
Journal Article
United States
J Clin Gastroenterol. 2006 Jul;40(6):476-81.},
   abstract = {To evaluate the efficacy of infliximab in hospitalized ulcerative colitis (UC) patients refractory to intravenous corticosteroids. Treatment options for steroid-refractory UC patients are limited and include cyclosporine and colectomy. Although two recent studies (ACT I/II) demonstrate a benefit from infliximab in outpatients with moderate to severely active UC, the utility of infliximab in severe i.v. steroid-refractory UC is less clear. We report our open-label experience with infliximab in hospitalized UC patients at the University of Pittsburgh Medical Center. All hospitalized UC patients who had received infliximab were identified. Age, sex, extent of UC, duration of disease, concomitant medication, hospital course, and response to infliximab were recorded. Response to infliximab was defined as avoidance of colectomy and cessation of corticosteroids. There were 12 UC inpatients refractory to intravenous corticosteroids and subsequently treated with infliximab. Nine of the 12 patients (75%) failed to respond to infliximab and required a colectomy; median time to colectomy was 3 months. Three patients (25%) did respond to infliximab and were able to withdraw from corticosteroids. In this open-label analysis, infliximab was not effective for the majority of UC patients refractory to intravenous corticosteroids. Whether earlier use of infliximab would prevent the need for hospitalization and colectomy is uncertain.},
   keywords = {Adult
Aged
Antibodies, Monoclonal/*therapeutic use
Colectomy
Colitis, Ulcerative/*drug therapy/pathology/surgery
Drug Resistance/drug effects
Female
Gastrointestinal Agents/*therapeutic use
Glucocorticoids/administration & dosage/pharmacology
Hospitalization
Humans
Infliximab
Injections, Intravenous
Male
Middle Aged
Retrospective Studies
Treatment Outcome},
   ISSN = {0192-0790 (Print)
0192-0790},
   Accession Number = {16825928},
   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 = {Regueiro, M. and Loftus, E. V., Jr. and Steinhart, A. H. and Cohen, R. D.},
   title = {Clinical guidelines for the medical management of left-sided ulcerative colitis and ulcerative proctitis: summary statement},
   journal = {Inflamm Bowel Dis},
   volume = {12},
   number = {10},
   pages = {972-8},
   note = {Regueiro, Miguel
Loftus, Edward V Jr
Steinhart, A Hillary
Cohen, Russell D
Inflammatory Bowel Disease Center
Journal Article
United States
Inflamm Bowel Dis. 2006 Oct;12(10):972-8.},
   abstract = {There are few published guidelines for the treatment of inflammatory bowel disease. Physicians choose therapy based on evidence-based data, peer and expert opinion, and personal experience. This article provides treatment guidelines for the induction and maintenance of ulcerative proctitis and left-sided colitis and the management of disease refractory to 5-aminosalicylic acid (5-ASA) compounds and corticosteroids The guidelines are derived from evidence-based data and, when lacking, expert opinion or the authors' experience. The comprehensive review of the literature is presented in the accompanying article, "The Medical Management of Left-Sided Ulcerative Colitis and Ulcerative Proctitis: Critical Evaluation of Therapeutic Trials". Rectally administered 5-ASA and corticosteroid suppositories are effective treatment for most ulcerative proctitis patients. Corticosteroid and 5-ASA enemas, which reach the splenic flexure of the colon, are recommended for patients with left-sided ulcerative colitis. The combination of rectally administered 5-ASA enemas and oral 5-ASA agents may afford better treatment of left-sided colitis and possibly prevent proximal extension of disease. Patients refractory to 5-ASAs and corticosteroids may require an immunomodulator or biological response modifier therapy. Those who have ongoing signs and symptoms of ulcerative proctitis and left-sided ulcerative colitis despite maximal medical therapy require a proctocolectomy.},
   keywords = {Adrenal Cortex Hormones/therapeutic use
Algorithms
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Colitis, Ulcerative/drug therapy/*therapy
Drug Resistance/drug effects
Humans
Mesalamine/therapeutic use
Models, Biological
Proctitis/drug therapy/*therapy
Remission Induction/methods},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {17012968},
   DOI = {10.1097/01.mib.0000231496.92013.85},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Regueiro, M. and Loftus, E. V., Jr. and Steinhart, A. H. and Cohen, R. D.},
   title = {Medical management of left-sided ulcerative colitis and ulcerative proctitis: critical evaluation of therapeutic trials},
   journal = {Inflamm Bowel Dis},
   volume = {12},
   number = {10},
   pages = {979-94},
   note = {Regueiro, Miguel
Loftus, Edward V Jr
Steinhart, A Hillary
Cohen, Russell D
Journal Article
Meta-Analysis
United States
Inflamm Bowel Dis. 2006 Oct;12(10):979-94.},
   abstract = {BACKGROUND: The goal of this work was to critically evaluate the published studies on the treatment of ulcerative proctitis (UP) and left-sided ulcerative colitis (L-UC). The results of this review provided the content for the accompanying treatment guidelines, Clinical Guidelines for the Medical Management of Left-sided Ulcerative Colitis and Ulcerative Proctitis: Summary Statement. METHODS: All English language articles published between 1995 and September 2005 were identified through a comprehensive literature search using OVID and PubMed. The quality of the data supporting or rejecting the use of specific therapies was categorized by a data quality grading scale. An "A+" grade was assigned to treatment supported by multiple high-quality randomized controlled trials with consistent results, whereas a "D" grade was given to therapy supported only by expert opinion. The therapeutic efficacy of a treatment was defined by its success in treating UP and L-UC compared with placebo. A medication was ranked as "excellent" if it was specifically studied for UP and L-UC and had consistently positive results compared with placebo or another agent. Quality and efficacy scores were agreed on by author consensus. RESULTS: For the acute treatment of UP or L-UC, the rectally administered corticosteroids and mesalazine (5-ASA), either alone or in combination with oral 5-ASAs, are the most effective therapy: evidence quality, A+; efficacy, excellent. Only rectally administered 5-ASA received an A+/excellent rating for maintenance of remission. Infliximab received an A+ grade for induction and maintenance of remission but only a "good" rating because the studies were performed in all UC, not specifically UP or L-UC. CONCLUSIONS: This critical evaluation of treatment provides a "report card" on medications available for the management of patients with UP and L-UC. The guidelines should provide a useful reference and supplement for physicians treating UC patients.},
   keywords = {Adrenal Cortex Hormones/administration & dosage
Anti-Bacterial Agents/therapeutic use
Anti-Inflammatory Agents/administration & dosage
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
Antibodies/therapeutic use
*Clinical Trials as Topic/methods
Colitis, Ulcerative/diagnosis/drug therapy/*therapy
Drug Administration Routes
Drug Therapy, Combination
Escherichia coli
Fatty Acids, Volatile/therapeutic use
Heparin/therapeutic use
Humans
Immunologic Factors/therapeutic use
Mesalamine/administration & dosage
Nicotine/therapeutic use
Probiotics/therapeutic use
Proctitis/diagnosis/drug therapy/*therapy
Remission Induction/methods
Research Design
Treatment Outcome},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {17012969},
   DOI = {10.1097/01.mib.0000231495.92013.5e},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Rosman-Urbach, M. and Niv, Y. and Birk, Y. and Morgenstern, S. and Schwartz, B.},
   title = {Relationship between nutritional habits adopted by ulcerative colitis relevant to cancer development patients at clinical remission stages and molecular-genetic parameters},
   journal = {Br J Nutr},
   volume = {95},
   number = {1},
   pages = {188-95},
   note = {Rosman-Urbach, Maya
Niv, Yaron
Birk, Yehudith
Morgenstern, Sara
Schwartz, Betty
Journal Article
England
Br J Nutr. 2006 Jan;95(1):188-95.},
   abstract = {UC (ulcerative colitis) patients have an increased risk of developing colorectal cancer compared with the normal population. The cause underlying this higher risk is not fully defined but includes nutritional and environmental factors concomitant with genetic alterations. We aimed to evaluate genetic stability in the colonic tissue of UC patients in clinical remission compared with the healthy population, and to establish a possible correlation between nutritional habits and these molecular assessments. UC patients (n 42) and healthy controls (n 37) participated in the study. All participants were histopathologically and medically diagnosed. Participants completed five separate 7 d dietary records, food-frequency questionnaires and validated 24 h recalls for nutritional assessment. The extent of chromosome 17 loss and the calculated chromosome index was determined in colon tissue biopsies by fluorescence in situ hybridisation. Correlations between the molecular and nutritional assessments were performed using Pearson's correlation coefficients. Significant differences in the nutritional intake of total fat (65 (SD 15) v. 89 (SD 25) g), cholesterol (330 (SD 168) v. 464 (SD 177) mg), dietary fibre (32 (SD 4.7) v. 9 (SD 4) g), vitamin A (1009 (SD 209) v. 506 (SD 204) microg), vitamin C (308 (SD 108) v. 72 (SD 53) mg) and folic acid (412 (SD 89 microg) v. 187 (SD 107)) were recorded for UC patients compared with controls. Significant correlations were found for the consumption of different food groups and the chromosome index for chromosome 17. The results of our study suggest that the nutritional habits adopted by UC patients during clinical remission may affect key cellular components of the colonic tissue, inducing a high degree of aneuploidy and genetic instability, and probably affecting the development of colon cancer.},
   keywords = {Adult
Aged
Aneuploidy
Ascorbic Acid/administration & dosage
Calcium, Dietary/administration & dosage
Chromosomes, Human, Pair 17/genetics
Colitis, Ulcerative/genetics/*physiopathology
Colon/physiopathology
Colorectal Neoplasms/*genetics
Dietary Fats/administration & dosage
Dietary Fiber/administration & dosage
Energy Intake/physiology
Fabaceae
Feeding Behavior/*physiology
Female
Folic Acid/administration & dosage
Genetic Predisposition to Disease/genetics
Humans
In Situ Hybridization, Fluorescence/methods
Male
Middle Aged
Nutritional Status
Risk Factors
Vitamin A/administration & dosage},
   ISSN = {0007-1145 (Print)
0007-1145},
   Accession Number = {16441933},
   year = {2006},
   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
Nat Clin Pract Gastroenterol Hepatol. 2005 Jun;2(6):281-5; quiz 1 p following 285.},
   abstract = {BACKGROUND: An 18-year-old woman with a history of Crohn's disease presented in January 2004 with severe epigastric pain, nausea and vomiting of 4 hours' duration. The patient was diagnosed with inflammatory bowel disease, thought to be consistent with ulcerative colitis, in March 2003, but had no medical history up until this point. Initial treatment with mesalamine was unsuccessful and she subsequently presented with medically resistant fulminant colitis and required an urgent colectomy in June 2003. Her immediate postoperative course was uneventful and she was discharged on tapering doses of prednisone. In August 2003, an ileoscopy revealed inflamed, mildly ulcerated mucosa, and biopsies were consistent with Crohn's disease. Azathioprine was added to the treatment regimen and the patient tapered off prednisone. At this stage the patient continued to do well clinically up until presentation. INVESTIGATIONS: Small bowel series, abdominal CT scan, abdominal ultrasound, exploratory laparotomy. DIAGNOSIS: Acute mesenteric ischemia secondary to superior mesenteric vein thrombosis. MANAGEMENT: Resection of necrotic bowel, antibiotics and systemic anticoagulation.},
   keywords = {Adolescent
Anticoagulants/therapeutic use
Colectomy/*adverse effects
Colitis, Ulcerative/diagnosis/surgery
Crohn Disease/complications/*diagnosis/surgery/therapy
*Diagnostic Errors
Digestive System Surgical Procedures/adverse effects
Female
Humans
Intestine, Small/blood supply/surgery
*Mesenteric Veins
Parenteral Nutrition, Total
Short Bowel Syndrome/etiology/therapy
Venous Thrombosis/*etiology},
   ISSN = {1743-4378 (Print)
1743-4378},
   Accession Number = {16265232},
   DOI = {10.1038/ncpgasthep0195},
   year = {2005},
   type = {Ref–rence Type}
}

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

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

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

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

@article{
   author = {Sandor, Z. and Deng, X. M. and Khomenko, T. and Tarnawski, A. S. and Szabo, S.},
   title = {Altered angiogenic balance in ulcerative colitis: a key to impaired healing?},
   journal = {Biochem Biophys Res Commun},
   volume = {350},
   number = {1},
   pages = {147-50},
   note = {Sandor, Zs
Deng, X M
Khomenko, T
Tarnawski, A S
Szabo, S
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
United States
Biochem Biophys Res Commun. 2006 Nov 10;350(1):147-50. Epub 2006 Sep 15.},
   abstract = {Angiogenesis is an essential component of ulcer healing since it assures delivery of oxygen and nutrients to the healing site. Previous studies demonstrated increased serum and tissue levels of vascular endothelial growth factor (VEGF, the most potent angiogenic growth factor) in patients with active ulcerative colitis (UC) and animal models of UC. However, there is no explanation why the healing of UC-related mucosal injury is impaired despite increased expression of VEGF. Expression of angiogenesis inhibitors, angiostatin and/or endostatin, in UC has not been determined before. We examined expression of VEGF, angiostatin, and endostatin in two models of experimental UC. The results revealed that in addition to increased VEGF, both endostatin and angiostatin levels were markedly (2-3-folds) increased in colonic mucosa at early stage of experimental UC. This is the first demonstration that colitis triggers increase in angiostatin and endostatin levels. The results may explain why mucosal lesions heal slowly despite increased VEGF levels, and may provide a novel and mechanistic insight into UC.},
   keywords = {Angiostatins/metabolism
Animals
Colitis, Ulcerative/*metabolism/*pathology
Endostatins/metabolism
Enzyme-Linked Immunosorbent Assay
Female
*Neovascularization, Pathologic
Rats
Rats, Sprague-Dawley
Vascular Endothelial Growth Factor A/metabolism
*Wound Healing},
   ISSN = {0006-291X (Print)
0006-291x},
   Accession Number = {17011522},
   DOI = {10.1016/j.bbrc.2006.09.021},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Sathyanarayana, N. and Shenoy, K. R. and Alvares, J. F. and Pai, S. B.},
   title = {Enteral feeding by fistuloclysis in a midjejunal fistula},
   journal = {Indian J Gastroenterol},
   volume = {24},
   number = {3},
   pages = {124-5},
   note = {Sathyanarayana, N
Shenoy, K Rajgopal
Alvares, Jose Filipe
Pai, Srinivas B
Case Reports
Journal Article
India
Indian J Gastroenterol. 2005 May-Jun;24(3):124-5.},
   abstract = {Enterocutaneous fistulas are potentially life-threatening complications of gastrointestinal surgery. Nutritional support is the mainstay of management. We report a 32-year-old man who developed an enterocutaneous fistula following surgery for ulcerative colitis. Enteral feeding was attempted by introducing a Foley's catheter through the midjejunal fistula.},
   keywords = {Adult
Catheterization
Colitis, Ulcerative/surgery
*Cutaneous Fistula/etiology
Enteral Nutrition/*methods
Humans
*Intestinal Fistula/etiology
*Jejunal Diseases/etiology
Male
*Postoperative Complications/therapy},
   ISSN = {0254-8860 (Print)
0254-8860},
   Accession Number = {16041112},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Schwarzer, A. and Ricciardelli, I. and Kirkham, S. and Binnie, K. and Shah, N. and Elawad, M. A. and Hill, S. M. and Furman, M. and Smith, V. V. and Sebire, N. and Milla, P. J. and Londei, M. and Lindley, K. J.},
   title = {Management of fulminating ulcerative colitis in childhood with chimeric anti-CD25 antibody},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {42},
   number = {2},
   pages = {245-8},
   note = {Schwarzer, A
Ricciardelli, I
Kirkham, S
Binnie, K
Shah, N
Elawad, M A
Hill, S M
Furman, M
Smith, V V
Sebire, N
Milla, P J
Londei, M
Lindley, K J
Case Reports
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2006 Feb;42(2):245-8.},
   abstract = {Fulminating acute ulcerative colitis (UC) is a potentially life threatening medical emergency. Up to 30% of individuals respond poorly to corticosteroids alone and second line medical or surgical therapies are indicated. We describe the successful use of chimeric anti-CD25 therapy in 4 such children poorly responsive to combined therapy with intravenous steroids and calcineurin inhibitors with a pretreatment predictive risk of colectomy of 85-100%. Clinical disease activity scores normalized within 72 hours of anti-CD25 administration and colonic histology provided evidence of mucosal healing within 10-14 days. None required emergency colectomy. Anti-CD25 is efficacious in fulminating UC and randomized placebo controlled trials appear indicated.},
   keywords = {Acute Disease
Adolescent
Adrenal Cortex Hormones/therapeutic use
Antibodies, Anti-Idiotypic/*therapeutic use
Calcineurin Inhibitors
Child
Colectomy
Colitis, Ulcerative/*drug therapy
Humans
Receptors, Interleukin-2/*immunology
Risk Factors
Severity of Illness Index
Treatment Outcome},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {16456427},
   DOI = {10.1097/01.mpg.0000189347.32796.c5},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Seril, D. N. and Liao, J. and West, A. B. and Yang, G. Y.},
   title = {High-iron diet: foe or feat in ulcerative colitis and ulcerative colitis-associated carcinogenesis},
   journal = {J Clin Gastroenterol},
   volume = {40},
   number = {5},
   pages = {391-7},
   note = {Seril, Darren N
Liao, Jie
West, Alexander Brian
Yang, Guang-Yu
1R01CA104741-01A1/CA/NCI NIH HHS/United States
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
United States
J Clin Gastroenterol. 2006 May-Jun;40(5):391-7.},
   abstract = {Anemia associated with long-standing chronic inflammation and iron deficiency, and the increased risk for the development of dysplasia and carcinoma, are two of the most common complications in patients with ulcerative colitis (UC). Because of iron and nutrition deficiency, UC patients are encouraged to consume a high-protein and high-iron diet. The crucial clinical question is the effect of a high-iron diet on inflammation activity and inflammation-driven carcinogenesis. Is a high-iron diet a foe or a feat in UC and UC-associated carcinogenesis? This review updates the progress and information on (1) iron nutrition and iron-deficiency anemia in patients with UC, (2) experimental evidence of the exacerbating effect of a high-iron diet on UC and its associated carcinogenesis and the difference between a high-iron diet and parental iron supplementation, (3) the clinical efficacy of, and concerns about, oral and intravenous iron supplements in patients with inflammatory bowel disease and iron deficiency anemia, and (4) the clinical implications of long-term iron supplements and management of UC. These experimental findings from animal models provide evidence to warrant further consideration and clinical studies of iron nutrition, inflammation activity, and cancer development.},
   keywords = {Administration, Oral
Anemia, Iron-Deficiency/*drug therapy/*etiology
Animals
Biological Availability
Cell Transformation, Neoplastic
Colitis, Ulcerative/chemically induced/*complications/pathology
Colorectal Neoplasms/*complications/pathology
Dietary Supplements/adverse effects
Disease Models, Animal
Disease Progression
Dose-Response Relationship, Drug
Humans
Iron, Dietary/*adverse effects
Oxidative Stress},
   ISSN = {0192-0790 (Print)
0192-0790},
   Accession Number = {16721219},
   year = {2006},
   type = {Ref–rence Type}
}

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

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

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

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

@article{
   author = {Suzuki, A. and Mitsuyama, K. and Koga, H. and Tomiyasu, N. and Masuda, J. and Takaki, K. and Tsuruta, O. and Toyonaga, A. and Sata, M.},
   title = {Bifidogenic growth stimulator for the treatment of active ulcerative colitis: a pilot study},
   journal = {Nutrition},
   volume = {22},
   number = {1},
   pages = {76-81},
   note = {Suzuki, Asuka
Mitsuyama, Keiichi
Koga, Hironori
Tomiyasu, Nobuo
Masuda, Junya
Takaki, Kosuke
Tsuruta, Osamu
Toyonaga, Atsushi
Sata, Michio
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
United States
Nutrition. 2006 Jan;22(1):76-81. Epub 2005 Oct 12.},
   abstract = {OBJECTIVES: Experimental studies have shown that luminal antigens are involved in chronic intestinal inflammatory disorders. Bifidogenic growth stimulator (BGS) is a prebiotic preparation produced by Propionibacterium freudenreichii isolated from Swiss cheese. Previously BGS was shown to act in the colon as a growth stimulator of Bifidobacteria. This study investigated the efficacy and safety of BGS in the treatment of ulcerative colitis. METHODS: Twelve patients with mildly to moderately active ulcerative colitis received orally 4.5 g of BGS daily for 4 wk in an open-label treatment protocol while the baseline anti-inflammatory therapy was continued. The response to treatment was evaluated clinically and endoscopically. Concentrations of short-chain fatty acids and the composition of commensal bacteria, including Bifidobacteria, Enterobacteria and Bacteroides species, were studied in stool samples. RESULTS: Patients showed improvement in their clinical activity index scores, with a significant decrease in the score from 7.4 +/- 2.8 to 4.7 +/- 1.5 (mean +/- standard error of the mean, P < 0.01). The endoscopic index score decreased from 4.4 +/- 1.7 to 2.8 +/- 1.8 (P < 0.05) with treatment. Patients showed an increase in stool butyrate concentrations after BGS treatment (P < 0.05). There were no significant changes in stool levels of bacteria as a result of BGS treatment. No side effects related to BGS were observed. CONCLUSIONS: Oral BGS therapy may represent a non-toxic way to treat ulcerative colitis. However, controlled studies are needed to demonstrate its efficacy in the treatment of this disorder.},
   keywords = {Adolescent
Adult
Bifidobacterium/*growth & development
Chromatography, High Pressure Liquid
Colitis, Ulcerative/*therapy
Colony Count, Microbial
Fatty Acids, Volatile/*analysis/metabolism
Feces/chemistry/microbiology
Female
Humans
Male
Middle Aged
Pilot Projects
*Probiotics/administration & dosage/adverse effects
Propionibacterium/*physiology
Safety
Severity of Illness Index
Treatment Outcome},
   ISSN = {0899-9007 (Print)
0899-9007},
   Accession Number = {16226014},
   DOI = {10.1016/j.nut.2005.04.013},
   year = {2006},
   type = {Ref–rence Type}
}

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

@article{
   author = {Thapar, N. and Shah, N. and Ramsay, A. D. and Lindley, K. J. and Milla, P. J.},
   title = {Long-term outcome of intractable ulcerating enterocolitis of infancy},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {40},
   number = {5},
   pages = {582-8},
   note = {Thapar, Nikhil
Shah, Neil
Ramsay, Alan D
Lindley, Keith J
Milla, Peter J
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2005 May;40(5):582-8.},
   abstract = {BACKGROUND: Chronic enterocolitis is rare in infancy and accounts for less than 0.5% of all newly diagnosed inflammatory bowel disease (IBD) in the UK. Presentation at this young age is usually indicative of underlying immunodeficiency/immunodysregulation. A group of such infants suffer intractable ulcerating enterocolitis of infancy (IE) in which there is a pan-enteritis with marked oro-anal involvement and deep flask like mucosal ulcers throughout the colon. METHODS: Retrospective review of presenting features, treatment and long-term outcome in a series of 8 children with typical IE. RESULTS: The 8 children were aged between 1 and 4 weeks at onset (median 2 weeks, mean 2.3 weeks), of which 7 were followed up for 2-22 years (median 7.5 years, mean 11 years). All 8 children had an intractable disease course requiring a colectomy for control of symptoms. The median age at colectomy was 1.7 years (range 4 months-4 years). Three children developed a generalised lymphadenopathy due to uncontrolled EBV-related lymphoid proliferations (ages 4, 12, 18). These comprised a monomorphous B-lymphoycte lympho-proliferative disorder, a large pleomorphic follicular lymphoma, and a high grade pleomorphic B cell non-Hodgkin's lymphoma. CONCLUSIONS: Infants with IE have a high risk of developing lymphomatous proliferations that appears to be related to the underlying immunodysregulation. Use of aggressive immunosuppression and acquisition of EBV infection appears to accelerate this process; hence we advocate early colectomy in confirmed cases. In children with IE screening for EBV and vigilance for abnormal lymphoid proliferations is paramount.},
   keywords = {Adolescent
Adult
Azathioprine/therapeutic use
Child
Child, Preschool
Chronic Disease
*Colectomy
Colitis, Ulcerative/complications/*drug therapy/*surgery
Cyclosporine/therapeutic use
Enterocolitis/complications/*drug therapy/*surgery
Epstein-Barr Virus Infections/epidemiology
Female
Follow-Up Studies
Humans
Immunoglobulins/therapeutic use
Immunosuppressive Agents/*therapeutic use
Infant
Infant, Newborn
Lymphoma, Non-Hodgkin/epidemiology
Lymphoproliferative Disorders/epidemiology
Male
Steroids/therapeutic use
Thalidomide/therapeutic use
Time Factors
Treatment Outcome},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {15861020},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Tomomasa, T.},
   title = {[Guidelines for treatment of ulcerative colitis in children]},
   journal = {Nihon Rinsho},
   volume = {63},
   number = {5},
   pages = {891-6},
   note = {Tomomasa, Takeshi
Japanese Society for Pediatric Gastroenterology, Hepatology, and Nutrition
Japanese Society for Pediatric Inflammatory Bowel Disease
English Abstract
Journal Article
Review
Japan
Nihon Rinsho. 2005 May;63(5):891-6.},
   abstract = {Guidelines for treatment of ulcerative colitis in children have been created by the working group of the Japanese Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Japanese Society for Pediatric Inflammatory Bowel Disease. The ideas of these guidelines, with regard to the fundamental differences in medical treatment between children and adults, included (1) for children, intensive medical treatment including appropriate systemic management is important during the acute phase of illness. (2) Treatment with steroids, which can cause growth disturbances, should not be continued for long period of time. (3) Pulsed steroid therapy, selective removal of blood cells, and intravenous infusion of cyclosporin are included in the therapeutic option for severe and fluminant cases.},
   keywords = {6-Mercaptopurine/administration & dosage
Azathioprine/administration & dosage
Child
Colitis, Ulcerative/*therapy
Cyclosporins/administration & dosage
Growth Disorders/chemically induced/prevention & control
Humans
Immunosuppressive Agents/administration & dosage
Mesalamine/administration & dosage
*Practice Guidelines as Topic
Prednisolone/administration & dosage/adverse effects/contraindications
Pulse Therapy, Drug
Quality of Life},
   ISSN = {0047-1852 (Print)
0047-1852},
   Accession Number = {15881187},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Turner, D. and Walsh, C. M. and Steinhart, A. H. and Griffiths, A. M.},
   title = {Response to corticosteroids in severe ulcerative colitis: a systematic review of the literature and a meta-regression},
   journal = {Clin Gastroenterol Hepatol},
   volume = {5},
   number = {1},
   pages = {103-10},
   note = {1542-7714
Turner, Dan
Walsh, Catharine M
Steinhart, A Hillary
Griffiths, Anne M
Journal Article
Meta-Analysis
Review
United States
Clin Gastroenterol Hepatol. 2007 Jan;5(1):103-10. Epub 2006 Dec 4.},
   abstract = {BACKGROUND & AIMS: Colectomy is a potentially life-saving procedure for patients with severe attacks of UC who fail medical therapy. We aimed to systematically review studies that reported the short-term colectomy rate in severe UC or reported variables that could predict treatment failure. METHODS: We conducted a systematic literature search for cohort studies and controlled trials published between 1974-2006. RESULTS: Thirty-two studies met the inclusion criteria; 16 reported short-term outcome and predictors of therapy failure, 13 only outcome, and 3 only predictors. In the pooled analysis, 581 of 1991 patients required colectomy (weighted mean 27; 95% confidence interval [CI], 26%-28%), and 22 died (1%; 95% CI, 0.7%-1.5%). In a heterogeneity-controlled meta-regression, colectomy rate did not change during the last 30 years (R(2) = 0.07, P = .8). Cyclosporine was used in only 100 patients, with a 51% (95% CI, 41%-60%) short-term success rate. A second meta-regression failed to demonstrate a dose-colectomy response of methylprednisolone therapy beyond 60 mg daily (R(2) < 0.01, P = .98). More than 20 variables were identified in 19 studies to predict medical therapy failure, but only a few were consistently reproduced: disease extent, stool frequency, temperature, heart rate, C-reactive protein, albumin, and radiologic assessment. CONCLUSIONS: The short-term colectomy rate in severe UC has remained stable during the last 30 years, despite the introduction of cyclosporine, which was not used frequently. We could not find any support for administering methylprednisolone at a higher dose than 60 mg/day. Variables that predict outcome of corticosteroid therapy could aid in the development of guidelines for introduction of rescue therapies in severe UC.},
   keywords = {Adrenal Cortex Hormones/*therapeutic use
Colectomy/statistics & numerical data
Colitis, Ulcerative/*therapy
Cyclosporine/therapeutic use
Humans
Immunosuppressive Agents/therapeutic use
Methylprednisolone/therapeutic use
Severity of Illness Index},
   ISSN = {1542-3565},
   Accession Number = {17142106},
   DOI = {10.1016/j.cgh.2006.09.033},
   year = {2007},
   type = {Ref–rence Type}
}

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

@article{
   author = {Vidal Casariego, A. and de la Cuerda Compes, C. and Breton Lesmes, I. and Camblor Alvarez, M. and Velasco Gimeno, C. and Garcia Peris, P.},
   title = {[Avascular necrosis of both hips and knees in a patient with ulcerative colitis treated for a long term with high-dose corticosteroids]},
   journal = {Nutr Hosp},
   volume = {21},
   number = {1},
   pages = {109-12},
   note = {Vidal Casariego, A
de la Cuerda Compes, C
Breton Lesmes, I
Camblor Alvarez, M
Velasco Gimeno, C
Garcia Peris, P
Case Reports
English Abstract
Journal Article
Spain
Nutr Hosp. 2006 Jan-Feb;21(1):109-12.},
   abstract = {INTRODUCTION: Avascular necrosis represents the bone tissue death from vascularization failure, and it is mainly associated with the use of high-dose corticosteroids for a long time. CLINICAL CASE: A 25 years old female patient treated with high-dose corticosteroids for 7 months for ulcerative colitis presents with both knees pain and limited hip and knee motility. In a plain X-ray and in nuclear magnetic resonance imaging (MRI) avascular necrosis was observed at these joints. Bone densitometry showed osteopenia at the femoral head and lumbar osteoporosis. DISCUSSION: We present a striking case for its large involvement of the joints (both knees and hips) with simultaneous osteoporosis and osteopenia in a young patient treated with corticosteroids for ulcerative colitis. It is necessary to recommend the judicious use of glucocorticoids, prescribing the minimal necessary dose and for the least amount of time necessary to control the underlying disease.},
   keywords = {Adult
Colitis, Ulcerative/*drug therapy
Female
Femur Head Necrosis/chemically induced
Glucocorticoids/administration & dosage/*adverse effects
Humans
*Knee Joint
Methylprednisolone/administration & dosage/*adverse effects
Osteonecrosis/*chemically induced
Time Factors},
   ISSN = {0212-1611 (Print)
0212-1611},
   Accession Number = {16562821},
   year = {2006},
   type = {Ref–rence Type}
}

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

@article{
   author = {Weber, A. and Fein, F. and Koch, S. and Dupont-Gossart, A. C. and Mantion, G. and Heyd, B. and Carbonnel, F.},
   title = {Treatment of ulcerative colitis refractory to steroid therapy by oral microemulsion cyclosporine (Neoral)},
   journal = {Inflamm Bowel Dis},
   volume = {12},
   number = {12},
   pages = {1131-5},
   note = {Weber, Audrey
Fein, Francine
Koch, Stephane
Dupont-Gossart, Anne-Claire
Mantion, Georges
Heyd, Bruno
Carbonnel, Franck
Clinical Trial
Journal Article
United States
Inflamm Bowel Dis. 2006 Dec;12(12):1131-5.},
   abstract = {BACKGROUND: Intravenous cyclosporine is active in 60% to 80% of patients with ulcerative colitis (UC) who failed to respond to intravenous corticosteroids. Several studies have suggested that cyclosporine in microemulsion form (Neoral) has some efficacy in this setting, but the optimal dose, blood level, time to response, and remission need to be better defined. The aim of this study was to evaluate the response to Neoral and its toxicity in active corticosteroid-refractory UC. METHODS: Between March 2002 and August 2005, 20 courses of Neoral [initial dose, 2.3 mg/kg (range, 1.8 to 2.8 mg/kg) every 12 hours] were prescribed in 19 consecutive patients for a UC attack that did not respond to intravenous methylprednisolone. All patients received prophylaxis against Pneumocystis carinii. RESULTS: Response was obtained in 17 of 20 attacks (85%) after 3.5 days (range, 1 to 7). Remission was obtained in 15 of 20 attacks (75%) after 13 days (range, 2 to 30 days). Four responders relapsed and underwent colectomy 21 to 900 days after the start of Neoral. Overall, 14 of 19 patients (74%) were colectomy free after a median follow-up of 8 months (range, 1 to 41 months). Cyclosporine blood levels were measured at fasting (C0) and 2 hours after Neoral administration (C2) in a subgroup of 10 responders. The results were 103 ng/mL (range, 32 to 240 ng/mL) for C0 and 761 ng/mL (183 to 1390 ng/mL) for C2. One severe bedridden patient with neonatal encephalopathy died. Main side effects observed were mild transient renal impairment (n = 2), hypertension (n = 1), cytomegalovirus infection (n = 2), and esophageal candidiasis (n = 1). CONCLUSIONS: In active corticosteroid-refractory UC, Neoral seems to have the same efficacy and toxicity as the intravenous form. Trough target cyclosporine blood levels should not exceed 100 ng/mL for C0 and 700 ng/mL for C2.},
   keywords = {Administration, Oral
Adrenal Cortex Hormones/*therapeutic use
Adult
Aged
Colitis, Ulcerative/*drug therapy
Cyclosporine/*administration & dosage/adverse effects/blood/*therapeutic use
*Drug Resistance
Emulsions
Female
Humans
Immunosuppressive Agents/adverse effects/blood/*therapeutic use
Male
Middle Aged
Remission Induction
Treatment Outcome},
   ISSN = {1078-0998 (Print)
1078-0998},
   Accession Number = {17119387},
   DOI = {10.1097/01.mib.0000235096.78736.8e},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Wewer, V. and Hesselfeldt, P. and Qvist, N. and Husby, S. and Paerregaard, A.},
   title = {J-pouch ileoanal anastomosis in children and adolescents with ulcerative colitis: functional outcome, satisfaction and impact on social life},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {40},
   number = {2},
   pages = {189-93},
   note = {Wewer, Vibeke
Hesselfeldt, Peter
Qvist, Niels
Husby, Steffen
Paerregaard, Anders
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2005 Feb;40(2):189-93.},
   abstract = {OBJECTIVES: The aim of this study was to evaluate, over a 10-year period, severe surgical complications, functional outcome, patient satisfaction and impact on social life after colectomy and J-pouch ileoanal anastomosis for children and adolescents <18 years with ulcerative colitis. METHODS: Data were extracted retrospectively from medical records and obtained by mailed questionnaire. RESULTS: Thirty patients (18 girls) with a median age of 15 years (range, 7-17 years) were identified. Two patients (7%) had the J-pouch removed because of intractable diarrhea. Twenty-seven of 28 patients with preserved J-pouch answered the questionnaire. The median follow-up was 3.7 years (range, 0.3-9.2 years). Surgical complications included eight of 30 patients (27%) with small bowel obstruction, one of 30 (4%) with intra-abdominal abscess and two of 30 (7%) with perforation of the small intestine. The median number of daytime bowel movements was six (range, 3-10) and the median number of nighttime bowel movements was one (range, 0-2). Twelve patients (44%) were completely continent for stool and mucus, 12 patients (44%) leaked now and then and three (12%) leaked often or always. Antibiotic treatment for pouchitis was given in 13 patients (48%). Seventeen patients (63%) were completely satisfied with the operation, nine patients (33%) found the result fairly good and one patient (4%) was not satisfied. Twenty-six patients (96%) reported their health as completely or fairly good. CONCLUSIONS: The majority of patients with an intact J-pouch had an acceptable functional result with respect to defecation frequency, continence and number of pouchitis episodes. Most patients reported being satisfied with the procedure.},
   keywords = {Adolescent
*Anastomosis, Surgical
Anti-Bacterial Agents/therapeutic use
Child
Colitis, Ulcerative/complications/*surgery
Defecation/physiology
Female
Follow-Up Studies
Humans
Male
*Patient Satisfaction
Postoperative Complications/drug therapy/epidemiology
Pouchitis/drug therapy/epidemiology
Quality of Life
Retrospective Studies
Surveys and Questionnaires
Treatment Failure
Treatment Outcome},
   ISSN = {0277-2116 (Print)
0277-2116},
   Accession Number = {15699695},
   year = {2005},
   type = {Ref–rence Type}
}

@article{
   author = {Yamamoto-Furusho, J. K. and Takahashi-Monroy, T. and Vergara-Fernandez, O. and Reyes, E. and Uscanga, L.},
   title = {Perinuclear anti-neutrophil cytoplasmic antibodies (p-anca) in chronic ulcerative colitis: experience in a Mexican institution},
   journal = {World J Gastroenterol},
   volume = {12},
   number = {21},
   pages = {3406-9},
   note = {Yamamoto-Furusho, Jesus K
Takahashi-Monroy, Takeshi
Vergara-Fernandez, Omar
Reyes, Edgardo
Uscanga, Luis
Journal Article
Research Support, Non-U.S. Gov't
United States
World J Gastroenterol. 2006 Jun 7;12(21):3406-9.},
   abstract = {AIM: To assess the prevalence and clinical value of p-ANCA in a sample of Mexican ulcerative colitis (UC) patients. METHODS: In a prospective, IRB-approved protocol, p-ANCA was determined in 80 patients with UC (mean age, 32 +/- 12.9 years). The severity and extension of disease were determined by clinical methods, searching a statistical association with p-ANCA status. RESULTS: p-ANCA were detected in 41 (51%) patients. Severity of disease was the only clinical variable statistically associated with their presence (P < 0.0001; OR = 9; CI 95% = 3.2-24.7). CONCLUSION: The prevalence of p-ANCA was similar to that reported in other countries. Their presence was associated to UC severity, but offered no more information than the obtained by clinical methods.},
   keywords = {Adult
Antibodies, Antineutrophil Cytoplasmic/*blood/physiology
Chronic Disease
Colitis, Ulcerative/*blood/physiopathology
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Mexico
Prospective Studies
Severity of Illness Index},
   ISSN = {1007-9327 (Print)
1007-9327},
   Accession Number = {16733859},
   year = {2006},
   type = {Ref–rence Type}
}

@article{
   author = {Yamamoto-Furusho, J. K. and Uscanga-Dominguez, L. and Lopez-Martinez, A. and Granados, J.},
   title = {Association of the HLA-DRB1*0701 allele with perinuclear anti-neutrophil cytoplasmatic antibodies in Mexican patients with severe ulcerative colitis},
   journal = {World J Gastroenterol},
   volume = {12},
   number = {10},
   pages = {1617-20},
   note = {Yamamoto-Furusho, Jesus K
Uscanga-Dominguez, Luis
Lopez-Martinez, Alondra
Granados, Julio
Journal Article
Research

license: MIT

license_type: permissive

branch_name: refs/heads/master

extension: bib