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David L Suskind, Stanley A Cohen, Mitchell J Brittnacher, Ghassan Wahbeh, Dale Lee, Michele L Shaffer, Kimberly Braly, Hillary S Hayden, Jani Klein, Benjamin Gold, Matthew Giefer, Angela Stallworth, Samuel I Miller
GOAL: To determine the effect of the specific carbohydrate diet (SCD) on active inflammatory bowel disease (IBD). BACKGROUND: IBD is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Diet is a potential therapeutic option for IBD based on the hypothesis that changing the fecal dysbiosis could decrease intestinal inflammation. STUDY: Pediatric patients with mild to moderate IBD defined by pediatric Crohn's disease activity index (PCDAI 10-45) or pediatric ulcerative colitis activity index (PUCAI 10-65) were enrolled into a prospective study of the SCD...
December 27, 2016: Journal of Clinical Gastroenterology
Katarzyna Sznurkowska, Anton Żawrocki, Jacek Sznurkowski, Maciej Zieliński, Piotr Landowski, Katarzyna Plata-Nazar, Ewa Iżycka-Świeszewska, Piotr Trzonkowski, Agnieszka Szlagatys-Sidorkiewicz, Barbara Kamińska
BACKGROUND/AIMS: To determine the proportion of T-regulatory cells (CD4(+)CD25(high)FOXP3(+) cells) in peripheral blood and the number of FOXP3(+) cells in intestinal mucosa of children with inflammatory bowel disease (IBD), and to verify whether these parameters correlate with the activity of the disease. MATERIAL AND METHODS: 24 patients newly diagnosed for IBD were included in the study: ulcerative colitis (UC; n = 13) and Crohn's disease (CD; n = 11). Seventeen healthy controls (HC) and 16 patients with irritable bowel syndrome (IBS) served as a control group for peripheral and intestinal Tregs assessment, respectively...
October 19, 2016: Immunological Investigations
Edyta Szymanska, Maciej Dadalski, Sylwia Szymanska, Wieslawa Grajkowska, Maciej Pronicki, Jaroslaw Kierkus
INTRODUCTION: The clinical efficacy of infliximab (IFX) for induction of remission in both adults and children with active Crohn's disease (CD) has been well documented. Recently, so-called "deep remission" defined as mucosal healing has become the ultimate endpoint of the most recent therapeutic advances for CD. However, endoscopic evidence of mucosal healing is not necessarily associated with histological evidence of suppression of inflammation. AIM: Since data on that issue are limited, especially in the paediatric population, the aim of this study was to assess the impact of induction therapy with IFX on deep microscopic remission in paediatric patients with CD...
2016: Przegla̜d Gastroenterologiczny
Tamir Miloh, Mitchell Shub, Ramon Montes, Kristy Ingebo, Gary Silber, Brad Pasternak
: Successful treatment of patients with inflammatory bowel disease (IBD) requires regular intake of medication. Non- adherence to treatment is associated with increased frequency of relapses, morbidity and cost. METHODS: Pediatric IBD patients taking oral medication and with access to text message (TM) services were included. Children were randomized by age, gender, medication administration responsibility (self vs parent) and disease activity (Pediatric Crohn Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI)) into TM intervention and standard of care...
September 6, 2016: Journal of Pediatric Gastroenterology and Nutrition
Sara Valério de Azevedo, Catarina Maltez, Ana Isabel Lopes
BACKGROUND AND AIMS: Increasing evidence in adults demonstrates efficacy and safety of IV iron in inflammatory Bowel disease (IBD) associated iron deficiency anemia; however, evidence in pediatric patients is yet scarce and no previous study has included a long follow-up. This study aimed to evaluate safety and efficacy of IV iron (primary end point), and the need of re-treatment (secondary end point), in this setting. METHODS: Prospective recruitment (40 months); PCDAI determined before and after treatment; anemia defined according to WHO criteria; IV iron treatment included iron sucrose and ferric carboxymaltose...
January 2017: Scandinavian Journal of Gastroenterology
Oriane Truffinet, Christine Martinez-Vinson, Emilie Guerriero, Jean-Pierre Hugot, Jérôme Viala
OBJECTIVES: Tacrolimus is an immunosuppressive agent that has been proposed in the treatment of severe ulcerative colitis. This study examined the effectiveness and safety of tacrolimus in treating refractory Crohn Disease (CD) colitis in children. METHODS: All children treated by oral tacrolimus for CD colitis at a tertiary pediatric center were included in the study. All patients were refractory to steroids and infliximab. Clinical response (decreased PCDAI >15 and PCDAI < 30) and remission (PCDAI <10) were monitored at 2, 4, 6, 12 and 24 months after induction...
July 16, 2016: Journal of Pediatric Gastroenterology and Nutrition
Fabio Pomerri, Faise Al Bunni, Monica Zuliani, Graziella Guariso, Marco Gasparetto, Benedetta Giorgi, Mara Cananzi, Pier Carlo Muzzio
OBJECTIVES: This study was aimed at correlating a magnetic resonance index of activity (MaRIA) and a magnetic resonance enterography global score (MEGS) with activity indexes in a paediatric population with Crohn's disease (CD). METHODS: This retrospective study included 32 paediatric patients (median age 14.5 years, 18 male) with proven CD who underwent magnetic resonance enterography (MRE). A correlation analysis was performed on the MRE-based scores, the simplified endoscopic score for CD (SES-CD), the paediatric Crohn's disease activity index (PCDAI), and C-reactive protein (CRP) levels...
June 8, 2016: European Radiology
K Diederen, D R Hoekman, T Z Hummel, T G de Meij, B G P Koot, M M Tabbers, A M Vlieger, A Kindermann, M A Benninga
BACKGROUND: A large proportion (25-46%) of adults with inflammatory bowel disease in remission has symptoms of irritable bowel syndrome (IBS), which are thought to reflect ongoing inflammation. Data on paediatric inflammatory bowel disease patients are lacking. AIM: To investigate (i) the prevalence of IBS-type symptoms in paediatric inflammatory bowel disease patients in remission and (ii) the relationship of IBS-type symptoms with biochemical markers of disease activity...
July 2016: Alimentary Pharmacology & Therapeutics
Dan Turner, Arie Levine, Thomas D Walters, Gili Focht, Anthony Otley, Victor Navas López, Sibylle Koletzko, Robert Baldassano, David Mack, Jeffrey Hyams, Anne M Griffiths
INTRODUCTION: There is increasing interest in measuring mucosal inflammation in Crohn's disease (CD) but there are minimal data correlating the PCDAI versions (PCDAI, wPCDAI, abbrPCDAI and the shPCDAI) with mucosal inflammation. METHODS: We aimed to compare the four PCDAI versions head-to-head with endoscopic degree of inflammation as measured by the Simple Endoscopic Score in CD (SES-CD), fecal calprotectin, ESR and CRP and to explore cutoff values that are associated with mucosal healing...
April 4, 2016: Journal of Pediatric Gastroenterology and Nutrition
Z Grover, C Burgess, R Muir, C Reilly, P J Lewindon
BACKGROUND: Exclusive Enteral Nutrition (EEN) induction in children with luminal Crohn's disease (CD) gives early mucosal healing (MH), but the long-term benefits of EEN-induced MH are just emerging. AIMS & METHODS: We prospectively followed an Australian cohort of newly diagnosed children with predominantly luminal CD who completed at least six weeks EEN and with paired clinical Pediatric Crohn's Disease Activity Index (PCDAI), biochemical (C-reactive protein; CRP) and endoscopic assessment at diagnosis and post EEN...
October 2016: Journal of Crohn's & Colitis
Amy Grant, Michael Kappelman, Christopher Martin, Anthony Otley
BACKGROUND: The IMPACT-III is a validated, disease-specific HRQOL questionnaire for IBD patients ages 9 to 17. Items within IMPACT are grouped by domains, which cover different aspects of HRQOL. The domain structure has not been changed since validation, although 2 alternate domain structures have been proposed using different methodologies. Using a large, diverse cohort, the aim of this study was to develop the optimal domain structure for IMPACT. METHODS: Three prospectively collected datasets of adolescents with IBD were used: (1) an internet-based cohort of children with IBD from the Crohn's and Colitis Foundation of America (CCFA) Partners Kids & Teens study, (2) the REACH infliximab trial for pediatric Crohn's Disease (CD), and (3) the T72 infliximab trial in pediatric Ulcerative Colitis (UC)...
March 2016: Inflammatory Bowel Diseases
Anne Levine, David Keljo, David DeMaso, Athos Bousvaros, Eva Szigethy
BACKGROUND: Youth with inflammatory bowel disease (IBD) are at increased risk of developing depression. Clinical depression is a heterogeneous disorder comprising different symptom clusters, which may derive from different psychopathologic etiologies. Previous studies identified distinct depressive subtypes among youth with IBD, with nearly 20% experiencing somatic-symptom predominant depression. We aimed to identify depressive symptoms related to inflammatory disease activity in a large sample of youth with Crohn's disease (CD), the subtype of IBD associated with more systemic inflammation...
March 2016: Inflammatory Bowel Diseases
Massimo Martinelli, Caterina Strisciuglio, Annalisa Alessandrella, Francesca Rossi, Renata Auricchio, Natascia Campostrini, Domenico Girelli, Bruno Nobili, Annamaria Staiano, Silverio Perrotta, Erasmo Miele
BACKGROUND AND AIMS: We sought to correlate hepcidin levels in inflammatory bowel disease [IBD] children with disease activity, inflammatory markers, and iron load test [ILT] and to compare IBD patients with coeliac and healthy patients. METHODS: Between December 2012 and June 2013, 145 subjects [50 IBD patients, 45 coeliac patients and 50 healthy controls] were included in the study. All patients underwent the following examinations: blood count, iron status, erythropoiesis parameters, serum hepcidin, C-reactive protein [CRP], and erythrocyte sedimentation rate [ESR]...
May 2016: Journal of Crohn's & Colitis
Jernej Dolinšek, Petra Rižnik, Larisa Sabath, Dušanka Mičetić-Turk
OBJECTIVES: Inflammatory bowel disease (IBD) in children has a remitting and relapsing course. The aim of our study was to evaluate the value of fecal calprotectin (FC), C-reactive protein (CRP), and clinical scores in predicting endoscopic and histological lesions in children with IBD. METHODS: A total of 68 children with IBD (29 with ulcerative colitis (UC), 39 with Crohn's disease (CD), mean age 14.2 years) were included in the study. We retrospectively reviewed clinical scores (PUCAI, PCDAI), CRP values, endoscopic, and histological data as well as FC values in all included children...
April 2016: Wiener Klinische Wochenschrift
Chinonyelum Obih, Ghassan Wahbeh, Dale Lee, Kim Braly, Matthew Giefer, Michele L Shaffer, Heather Nielson, David L Suskind
OBJECTIVE: Despite dietary factors being implicated in the pathogenesis of inflammatory bowel disease (IBD), nutritional therapy, outside of exclusive enteral nutrition (EEN), has not had a defined role within the treatment paradigm of pediatric IBD within IBD centers. Based on emerging data, Seattle Children's Hospital IBD Center has developed an integrated dietary program incorporating the specific carbohydrate diet (SCD) into its treatment paradigm. This treatment paradigm uses the SCD as primary therapy as well as adjunctive therapy for the treatment of IBD...
April 2016: Nutrition
Rebekka Mueller, Farah Ziade, Valérie Pittet, Nicolas Fournier, Jessica Ezri, Alain Schoepfer, Susanne Schibli, Johannes Spalinger, Christian Braegger, Andreas Nydegger
BACKGROUND AND AIMS: Inflammatory bowel diseases (IBDs) may impair quality of life (QoL) in paediatric patients. We aimed to evaluate in a nationwide cohort whether patients experience QoL in a different way when compared with their parents. METHODS: Sociodemographic and psychosocial characteristics were prospectively acquired from paediatric patients and their parents included in the Swiss IBD Cohort Study. Disease activity was evaluated by the Paediatric Crohn's Disease Activity Index (PCDAI) and the Paediatric Ulcerative Colitis Activity Index (PUCAI)...
March 2016: Journal of Crohn's & Colitis
Xu Teng, Ling-Fen Xu, Mei Sun, Jing Guo
OBJECTIVE: To evaluate the efficacy and safety of infliximab in the treatment of Crohn's disease in children. METHODS: Thirteen children who were diagnosed with Crohn's disease and received routine comprehensive treatment and infliximab (5 mg/kg) between January 2011 and December 2014 were enrolled. The changes in their clinical manifestations, laboratory indices, and Pediatric Crohn's Disease Activity Index (PCDAI) after the 30-week treatment were analyzed retrospectively...
October 2015: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
B A Nanaeva, A V Vardanian, I L Khalif
AIM: To determine the efficacy of 0.1% tacrolimus ointment in patients with perianal Crohn's disease (CD). SUBJECTS AND METHODS: This prospective randomized trial enrolled 20 patients with perianal CD as anal fissures and rectal fistulas. The inclusion criteria were rectovaginal or extrasphincteric fistulas and purulent leakages. A study group comprised 11 patients, including 9 with anal fissures and 2 with fistulas. A control group included 9 patients, including 8 with fissures and 1 with fistulas...
2015: Terapevticheskiĭ Arkhiv
Katalin E Müller, Peter L Lakatos, Judit B Kovacs, Andras Arato, Agnes Varkonyi, Eva Nemes, Andras Tarnok, Gergely Toth, Maria Papp, Eniko Solyom, Agnes Horvath, Ildiko Guthy, Marta Kovacs, Gabor Veres
OBJECTIVES: Predicting short-term relapses and long-term prognosis is of utmost importance in paediatric inflammatory bowel disease (IBD). Our aim was to investigate the short-term disease outcome and medication during the first year in a paediatric incident cohort from Hungary. In addition, association laboratory markers and disease activity indices with short-term disease outcome and medication were analysed. METHODS: From January 1, 2008 to December 31, 2010, demographic data and clinical characteristics of newly diagnosed paediatric patients with IBD < 18 years of age were prospectively recorded...
January 2016: Journal of Pediatric Gastroenterology and Nutrition
Federica Nuti, Fortunata Civitelli, Silvia Bloise, Salvatore Oliva, Marina Aloi, Giuseppe Latorre, Franca Viola, Salvatore Cucchiara
BACKGROUND AND AIMS: There is growing evidence that in Crohn's disease the achievement and maintenance of mucosal healing (MH) through anti-TNFα antibodies may change the natural history of the disease. Few studies evaluating such outcome as a therapeutic goal are available in paediatrics. The primary aim of the study was to assess the efficacy of biologics in obtaining MH in a paediatric Crohn's disease cohort. The secondary aims were: (1) to assess response based on early or late treatment introduction and on combination therapy with immunomodulators versus biologics alone; and (2) to evaluate clinical outcome 2 years after the second endoscopy...
January 2016: Journal of Crohn's & Colitis
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