bluuebunny/crossref_metadata_2025 huggingface dataset:
P027 Could Fecal Calprotectin Guide the Therapeutic Regimen of Infliximab in Inflammatory Bowel Disease?
Authors: Freitas Marta , Magalhaes Rui , Dias de Castro Francisca , Moreira Maria João , Cotter José
Published: December 2019

BACKGROUND:

Infliximab is a monoclonal antibody against tumor necrosis factor α approved for induction and maintenance of remission in inflammatory bowel disease (IBD). Therapeutic monitoring, with determination of infliximab levels, allows to guide therapeutic decisions and helps to prevent loss of response.

AIM:

To identify predictive factors of non-therapeutic infliximab levels (<0.50 µg/mL) in IBD patients.

METHODS:

Retrospective single-center study including patients treated with infliximab with at least one determination of infliximab levels and with a minimum follow-up of six months. Clinical and demographic data obtained included disease phenotype, surgical background, duration of infliximab therapy, presence of anti-infliximab antibodies at the time of analysis, concomitant immunomodulator therapy, compliance, occurrence of an infusion reaction and biochemical assessment at the time of first induction infusion.

RESULTS:

104 patients were included, 56 females (53.8%) with a mean age of 38.2 ± 13.1 years. The overall prevalence of non-therapeutic infliximab levels was 29.8%. In the majority (90.4%) of the patients, the first determination was performed during maintenance therapy. 29.0% of the patients with non-therapeutic levels had simultaneously positive antibodies, and of the remainder, 27.3% acquired antibodies in a subsequent analysis. It was found that patients with non-therapeutic levels had significantly higher fecal calprotectin values at the initiation of treatment with infliximab (1184 ± 679 vs 708 ± 621, P = 0.02). No statistically significant association was found with other analytical parameters, like haemoglobin (12.7 ± 1.7 vs 12.9 ± 1.6, P = 0.55), C-reactive protein (11.2 ± 12.2 vs 15.9 ± 20.0, P = 0.22), sedimentation rate (22.4 ± 20.7 vs 23.7 ± 19.3, P = 0.76), ferritin (138.3 ± 128.2 vs 165.5 ± 166.6, P = 0.42) or albumin (3.50 ± 0.45 vs 3.56 ± 0.47, P = 0.54).

CONCLUSION(S):

Patients with non-therapeutic levels of infliximab have higher values of calprotectin prior to treatment, which may be related to increased inflammatory activity. In these cases infliximab regimens with higher and/or more frequent doses may be considered.
P028 The Use of Combination Biologic or Small Molecule Therapy in Inflammatory Bowel Disease: A Retrospective Cohort Study
Authors: Glassner Kerri , Oglat Ayah , Duran Antonio , Koduru Pramoda , Perry Caroline , Wilhite Amanda , Abraham Bincy
Published: December 2019

BACKGROUND:

There is limited data on the use of more than one biologic or small molecule in the treatment of patients with inflammatory bowel disease (IBD). The aim of our study was to determine the effectiveness and safety of combining two or more biologics or a biologic and small molecule in patients with IBD.

METHODS:

We collected data on 50 patients with Crohn’s disease (CD) or ulcerative colitis (UC) who received treatment with a combination of two biologics or a biologic and small molecule from 2015 to 2019 for persistent disease activity or concomitant rheumatologic or dermatologic disease. Combinations included vedolizumab (VDZ) with either ustekinumab (UST) (n = 25), adalimumab (ADA) (n = 3), certolizumab (CZP) (n = 2), golimumab (GOL) (n = 2), or tofacitinib (TOF) (n = 8); or TOF with either infliximab (IFX) (n = 4), GOL (n = 4), CZP (n = 1), or UST (n = 3); or ADA and apremilast (n = 1). There were 3 patients who received more than one combination during follow up for a total of 53 combinations in 50 patients. Clinical scoring and inflammatory markers (ESR, CRP, hemoglobin, and albumin) were collected within one month prior to starting combination therapy (baseline) and at follow up (after at least two months on combination therapy). Endoscopic data was collected within 6 months prior to initiation of combination therapy and at follow up (after at least two months on combination therapy). Adverse events were documented.

RESULTS:

The mean age was 36.7 years, 68% were female, 76% Caucasian, with a disease duration of 14.8 years (2–48). Patients had failed therapy with an average of 2 previous biologic medications. There were significantly more patients in clinical and endoscopic remission at follow up, 50% vs 14%, P = 0.002, delta 33%; 95% CI 0.13–0.53, and 34% vs 6%, P = 0.004, delta 28%; 95% CI 0.09–0.47 respectively. The median ESR and CRP decreased, 17 vs 13, P = 0.002, and 5 vs 2.35, P = 0.002, respectively. The mean hemoglobin and albumin improved, 12.12 vs 12.6, P = 0.022, and 3.58 vs 3.79, P = 0.017. There were 8 serious adverse events (SAE), and no deaths. Of those with a SAE, 57% were on an immunomodulator compared to 17.4% of those without a SAE, P = 0.019.

CONCLUSION(S):

Combination biologic therapy is an effective option for IBD patients with refractory disease or concomitant autoimmune disease inadequately controlled by biologic monotherapy. There appears to be an increased risk of serious infection compared to biologic monotherapy, however this risk may be minimized by discontinuing immunomodulators prior to initiation of combination therapy. Larger prospective studies are needed to confirm these findings.
P044 Comparative Frequency of Adverse Events in Patients With Ulcerative Colitis, Receiving the Original Infliximab and Its Biosimilar
Authors: Knyazev Oleg , Shkurko Tatyana , Kagramanova Anna , Lishchinskaya Albina , Korneeva Irina , Zvyaglova Mariya , Kulakov Dmitriy , Parfenov Asfold
Published: December 2019

BACKGROUND:

Biosimilars are analogues of biopharmaceutical drugs, with a close but not identical original molecule. They are modern drugs based on proteins obtained by biological synthesis in yeast and bacteria cells. Biosimilars offer greater access to affordable treatment for inflammatory bowel diseases, and they are comparable in efficacy and safety to the original drugs.

OBJECTIVE:

To identify the frequency of adverse events during the year of observation in patients with ulcerative colitis, receiving the original drug infliximab and its biosimilar.

METHODS:

In the Department of inflammatory bowel diseases from December 2017 to December 2018, 56 patients with UC were observed who received the original infliximab (IFX) for a long time (more than 5 years); 16 (26.6%) patients switched to the introduction of biosimilar; 13 bionic patients with UC were prescribed the original drug IFX, 29 patients biosimilar IFX. In 14 cases there was an alternation of the introduction of the original IFX and its biosimilar. Thus, the analytical group included 98 patients with UC receiving the original infliximab and its biosimilar. The comparative analysis was carried out by the method of four-field tables using nonparametric statistical criteria.

RESULTS:

During the year, adverse events (AE) of different clinical significance (urticaria, bronchospasm, nausea, headaches, anaphylactic shock) developed in 12 patients with UC. Among patients with UC, receiving the original IFX for a long time, AE for a year of observation was not observed. Of the 16 patients who switched to biosimilar administration, AE developed in 2/16 (12.5%) (OR-1.62; 95% CI 0.65–15.98; x2 -0.18, P = 0.673). Bioneurix among patients with UC who received the original IFX, AE occurred in 1/13 (7.7 %). Among bionaive patients with UC treated with biosimilar, AE also developed in 1/29 (3.5%) patient (OR-2.2; 95% CI 0.151–32.98; x2 -0.36, P = 0.852). Most AE (8 (66.7%)) developed in the case of alternating administration of the original IFX and its biosimilar (OR-7.4; 95% CI 1.1–51.5; x2 -9.9, P = 0.007).

CONCLUSION(S):

The frequency of adverse events in patients with UC regularly receiving the original IFX and its biosimilar does not differ. The frequency of adverse events in patients with UC when translated from the original IFX to its biosimilar IFX is not higher than in patients with UC, regularly receiving the original IFX. The frequency of adverse events is much higher in patients with UC, alternating the introduction of the original IFX and its biosimilar.
P049 Correlation of Surgical Pathology With Preoperative Colonoscopy in Patients With IBD
Authors: Seok Lee Hyun , Kim Kyeong Ok , Chiorean Michael , Boden Elisa , James Lord , Simianu Val
Published: December 2019

BACKGROUND:

Previous studies have shown a very high rate of advanced neoplasia including cancer among patients referred for colectomy for dysplasia detected during surveillance colonoscopy. Our goal was to re-evaluate this correlation using a more recent cohort of patients from a single IBD center.

METHODS:

This is a single center, retrospective study of IBD patients who underwent colectomy for any indication from 1998 to 2017. Patients who underwent colonoscopy before colectomy were included. Demographic and clinical variables as well as the colonoscopy to surgery interval were collected from medical records. Pathological findings including location, lesion type and grade were compared between surgery and colonoscopy using the Spearman correlation index. Variables associated with discordant findings were also determined using regression analysis.

RESULTS:

A total of 192 patients with IBD (31.8% CD, 68.2% UC) underwent colectomy and all but 2 preceding colonoscopies were performed with white light (median interval t months, range s-z). All but 2 colonoscopies were performed with white light only. 52 patients had neoplasia in the resected specimen: 10 adenocarcinoma (Ca), 7 HGD, 30 LGD, 3 indefinite and 2 were sessile serrated lesion (SSL). Colonoscopy identified 4 patients with Ca, 4 with HGD, 1 LGD, and 1 SSL. The correlation between surgical and endoscopic pathological findings was modest (r = X, P = z). The following variables were associated with a missed diagnosis of advanced neoplasia during colonoscopy in univariate and multivariate analysis (a, b, c, d, e.g. male sex, moderate-severely active disease, standard vs. HD imaging and length of time between colonoscopy and surgery).

CONCLUSION(S):

These findings confirm a poor correlation between pre- and postoperative findings when using white light colonoscopy in patients with IBD. Image enhanced colonoscopy may reduce the rate of discordant results but this needs to be addressed in a prospective fashion.
P050 Endoscopic Balloon Dilation of Crohn's Disease Strictures With or Without Fluoroscopic Guidance
Authors: Hyun Seok Lee , Chiorean Michael
Published: December 2019

BACKGROUND:

Strictures are common complications in Crohn’s disease (CD). CD-associated strictures are usually managed with medical, endoscopic, and surgical approaches, or combinations. Endoscopic therapy is easier to perform in experienced hand and helpful to avoid the need for surgery. In clinical practice, endoscopic balloon dilatation (EBD) under a fluoroscopic guidance is preferred. The use of fluoroscopy allows for the delineation of the stricture and the orientation of the entire balloon catheter. The use of fluoroscopy exposes the patient, the endoscopist, and the endoscopy nurses to excessive radiation. EBD is performed without fluoroscopic guidance in some cases. However, the benefit of fluoroscopic guidance for dilating CD strictures has not been readily demonstrated. The hypothesis of the study is that there are no significant differences in efficacy and safety between EBD with and without fluoroscopic guidance for CD strictures. The aim of this study is to compare efficacy and safety between EBD with and without fluoroscopic guidance for CD strictures.

METHODS:

We performed a retrospective review of EBD for CD strictures between 2016 and 2017. We investigated the technical success and clinical success as the efficacy in EBD with and without fluoroscopic guidance for CD strictures. Technical success was defined as the ability to pass the scope through the stricture after balloon dilation. Clinical success was defined as improved obstructive symptoms.

RESULTS:

A total of 43 patients with CD strictures were identified (11 at EBD with fluoroscopic guidance group and 32 at EBD without fluoroscopic guidance group). Technical success was achieved in 10 patients (90.9%) at EBD with fluoroscopic guidance and 32 patients (100%) at EBD without fluoroscopic guidance (P = 0.084). Clinical success was achieved in 4 patients (36.4%) at EBD with fluoroscopic guidance and 18 patients (56.2%) at EBD without fluoroscopic guidance (P = 0.255). Additional surgery was performed in 4 patients (36.4%) at EBD with fluoroscopic guidance and 8 patients (25.0%) at EBD without fluoroscopic guidance (P = 0.469). Secondary EBD was performed in 2 patients (18.2%) at EBD with fluoroscopic guidance and 6 patients (18.8%) at EBD without fluoroscopic guidance (P = 0.967).There were no serious complications in both groups.

CONCLUSION(S):

There were no significant differences in efficacy and safety between EBD with and without fluoroscopic guidance for CD strictures. EBD guidance for CD strictures could be safe and effective in the setting without fluoroscopic guidance.
P087 Prevalence and Risk Factors for Developing Anastomotic Ring Inflammation After Ileal Resection and Ileo-Colonic Anastomosis in Patients With Crohn’s Disease
Authors: Schwartz Michael , Stein Daniel , Beniwal-Patel Poonam , Patel Amir , Otterson Mary , Yarur Andres
Published: December 2019

BACKGROUND:

The development of early inflammation proximal to the anastomosis in patients with Crohn’s disease that undergo ileal resection has a significant prognostic significance. However, many patients also develop inflammatory changes at the level of the anastomotic ring. The prevalence and significance of this findings is unknown. The aim of this study is to assess the prevalence and risk factors for developing anastomotic ring inflammation (ARI) in patients with Crohn’s disease after an ileal resection and ileo-colonic anastomosis.

METHODS:

In this retrospective cohort study we analyzed 91 patients with Crohn’s disease (CD) who underwent ileal resection and ileocolonic anastomosis and surveillance colonoscopy within 24 months. The patients were followed from time of surgery through up to four subsequent colonoscopes if applicable. A board certified gastroenterologist reviewed all the endoscopic images for the procedures done. The primary outcome was ARI (partial or full).

RESULTS:

The cohort population of 91 patients was 51.6% female. Twenty patients had ARI on the first surveillance colonoscopy (4 of the complete anastomotic ring and 16 partial), with an additional 13 developing inflammation at subsequent colonoscopies. The type of surgical anastomosis performed (end to end, end to side or side to side) was not associated with the development of ARI (P > 0.05 for all). There was no difference in time between bowel resection and endoscopic assessment between those patients with and without ARI (12 [IQR: 7-26] and 11 [IQR: 8-18] months respectively [P = 0.62]). There were no differences in median Rutgeerts score or simple endoscopic score (SES-CD) in patients that did present with ARI versus those who did not (median Rutgeerts score of 1 [IQR: 0-2] and 0 [IQR: 0-2] [P = 0.37], and median SES-CD of 2 (IQR: 0-3] and 0 [IQR: 0-4] respectively [P = 0.52]). There was also no association between the presence of ARI and active histologic inflammation in the ileum proximal to the anastomosis (P = 0.23). There was also no statistically significant difference in age at the time of surgery between those patients with and without ARI (median of 35 [IQR:28-42] and 36 [IQR: 27-52] years respectively [P = 0.7]). Starting post-operative prophylaxis for CD recurrence was not associated with a lower prevalence of ARI (OR: 0.26 [95% CI: 0.03-2.1]. P = 0.18).

CONCLUSION(S):

No demographic or phenotypic variables were associated with development of inflammatory changes at the level of the anastomotic ring. Furthermore, the presence of inflammation did not correlate with endoscopic CD disease activity. Studies looking into the long term clinical significance of ARI are warranted.
P088 Ulcerative Colitis Related Colorectal Cancer Admissions—Insights From National Cancer Database
Authors: Seril Darren , Senatore Frank , Bhurwal Abhishek
Published: December 2019

BACKGROUND:

Ulcerative colitis is associated with higher risk of colorectal cancer. Crude annual incidence of colorectal is estimated around 0.06-0.16%. However, there is relative paucity of colorectal cancer related admissions in Ulcerative colitis on a national level. As such, we set out to determine the proportion of CRC-related hospital admissions in Ulcerative colitis along with outcomes over the last five years.

METHODS:

This was a retrospective study utilizing the 2008-2014 National Inpatient Database Cohort for all principal discharges of Colorectal cancer in patients utilizing ICD 9 CM codes. Primary outcomes were the trends of colorectal cancer related admissions and trends in surgery related to colorectal cancer in patients with Ulcerative Colitis. Secondary outcomes were mortality, impact on healthcare utilization in terms of length of stay. These were then adjusted for confounders utilizing multivariate and Poisson regression analysis. All statistics were performed utilizing STATA software.

RESULTS:

A total of 564,372 patients were admitted to a hospital with a principal diagnosis of CRC and captured by the NIS database. Out of these, 0.25% (1,459) of these admissions were related to UC. Although the number of hospitalized CRC patients decreased from 2010 to 2014 (114,038 to 110,475; P value = 0.002), the proportion of discharges with Ulcerative colitis related CRC have not changed significantly (0.25% in 2010 to 0.29% in 2014; P > 0.05). There was a similar trend for colorectal surgeries performed during the time period (overall 0.32%). There was significant difference in CRC related admissions with UC as compared to general population. UC related CRC was noticed in younger patients (61.31 years vs 67.17 years; P < 0.001). UC related CRC admissions were more likely males (60% vs 52%; P = 0.002). There has been no significant difference in ethnicity or regional admissions. UC related CRC was less likely to be associated with liver metastasis (4.65% vs 12.6%, P < 0.001) and lung metastasis (3.4% vs 3.8%; P = 0.001). CRC related admissions with UC were more likely to undergo colorectal surgery during the admission (75% vs 60%, P < 0.001). Similarly, the mortality in UC related CRC is significantly lower as compared to general population (0.65% vs 2.34%; P < 0.001). The healthcare utilization in terms of length of stay has been similar in both the cohorts.

CONCLUSION(S):

There was a steady decrease in the number of hospitalized patients with colorectal cancer during the last several years, primarily attributable to a decrease in the older than 50 years age patients with colorectal cancer patients. This indirectly relates to the impact of colon cancer screening in the population above 50 years of age. However, UC related with CRC admissions have not witnessed the same decline over the last five years. Low frequency of liver and lung metastases indirectly indicate impact of surveillance in identifying cancer in early stage.
P089 Secukinumab Induced Ulcerative Colitis in a Patient With Psoriatic Arthritis: A Novel Approach to Refractory Cases
Authors: Sethi Vikas , Jacobs Adam , Sethi Ashwani
Published: December 2019

INTRODUCTION:

Secukinumab is an anti-IL 17A monoclonal antibody currently used to treat psoriasis, ankylosing spondylitis, and psoriatic arthritis. It may induce inflammation in the GI tract causing exacerbation of IBD and rarely causing IBD de novo. This phenomenon itself is seldom documented with only a handful of case reports in the US and overseas. The few cases of psoriatic arthritis and Secukinumab- induced UC were managed successfully with infliximab. However, there have been no case reports managing patients refractory to TNF-alpha inhibitors. This case illustrates an alternative therapy for management of Secukinumab- induced UC who have previously failed anti-TNF treatment for psoriatic arthritis.

CASE DESCRIPTION:

A 52-year-old female with a past history of psoriatic arthritis on Secukinumab presented with one-month history of bloody diarrhea. Colonoscopy showed diffuse ulcerative colitis (UC) from hepatic flexure to rectum. Biopsies showed crypt abscesses consistent with inflammatory bowel disease (IBD) along with a positive serum p-ANCA. The patient had no prior history of ulcerative colitis with a negative screening colonoscopy 2 years ago. Stool studies were negative for infection and biopsies were negative for CMV colitis. CT Scan of Abdomen and Pelvis showed no small intestinal disease. This patient had failed prior treatment for her psoriatic arthritis with Etanercept, Leflunomide, Adalimumab and Methotrexate. Secukinumab was discontinued and the patient was started on prednisone 40 mg po daily along with mesalamine 4.8 gm po daily. She improved and was discharged home. Later, she was started on Tofacitinib 10mg po bid to treat both psoriatic arthritis and ulcerative colitis to allow prednisone taper. The patient continued to improve with resolution of the bloody diarrhea along with symptomatic and objective improvement of her psoriatic arthritis.

DISCUSSION:

There have been case reports of Ulcerative Colitis developing in patients being treated with Secukinumab for psoriatic arthritis and Ankylosing Spondylitis. During phase three clinical trials of Secukinumab, only two patients, 0.058% of the subject population, on Secukinumab developed new onset IBD. In case reports of Secukinumab induced- UC, patients were successfully treated with the monoclonal TNF-alpha antibody, infliximab. However, in this case, the patient had already failed prior therapy with a monoclonal TNF-alpha antibody, Adalimumab, and a soluble TNF decoy receptor, Etanercept. Given her resistance to multiple forms of TNF-alpha inhibition, she was started on Tofacitinib, an inhibitor of JAK1 and JAK2 kinase, approved for both psoriatic arthritis and ulcerative colitis. There are no documented case reports treating both these conditions that are refractory to other biologics. In this subset of rare patients, this case illustrates a novel approach of using Tofacitinib in achieving therapeutic response for both psoriatic arthritis and ulcerative colitis.
P106 Description of Outcomes of Inflammatory Bowel Disease Patients With Granuloma on Histology: A Single-Center Experience
Authors: Wehbe Hisham , Hosni Mohamad , Tamim Hani , Hashash Jana , Binion David
Published: December 2019

BACKGROUND:

It has been suggested that the presence of granulomas on histologic tissue of patients with Crohn’s disease (CD) is associated with a more aggressive disease phenotype. We sought to investigate the outcomes of patients who had granulomas identified on their tissue histology.

METHODS:

This was a retrospective chart review for all inflammatory bowel disease patients who had the word ‘granuloma’ listed on their pathology report, whether from an endoscopic procedure (EGD or colonoscopy) or surgical intestinal resection specimen. We searched reports between 1997 and 2018. All patients who had a gastrointestinal granuloma were identified. Demographic, clinical, and histologic information were obtained from the medical records of these patients.

RESULTS:

A total of 41 CD patients were found to have a granuloma identified on their pathology specimen; 8 were found on a surgical resection specimen while 33 were found on endoscopic biopsies. Of the 41 patients, 53.7% were males, 41.7% were smokers, and the average age at CD diagnosis of these patients was 32 ± 15 years. The most common site for granuloma detection was the ileum accounting for 23 cases (56%). A total of 13 patients had granulomas present in more than one site/location (31.7%). The median C-reactive protein within 2 weeks of colonoscopy was 16.5 mg/L; IQR 2.9-58 (normal <2.5 mg/L), median erythrocyte sedimentation rate was 25 mm/hr; IQR 15-45 (normal 17.5 mm/hr), and median hemoglobin was 12g/dL; IQR 10.3-13.6 (normal 12.5g/dL). Of the 41 CD patients with granulomas, 42.5% were on a biologic agent, 41% on an immunomodulatory drug, and 20% had received a steroid at any time for their disease. Moreover, 24.3% had stricturing disease, 15.2% had a history of an intra-abdominal abscess, and 13.9% had a history of peri-anal disease. A total of 32.5% of granuloma CD patients had an intestinal resection and 34% had a CD related hospitalization.

CONCLUSION(S):

We suspect that granuloma patients have a more aggressive disease course. The results demonstrate that CD patients with granulomas have higher levels of inflammatory markers and lower hemoglobin. The rates of hospitalizations and need for intestinal resection approached a third of patients with granulomas.
P107 Evolution of Imaging in the Preoperative Assessment of Patients Undergoing Ileal Pouch Surgery
Authors: Wood Trevor , Zaghiyan Karen , Lightner Amy , Fleshner Phillip
Published: December 2019

BACKGROUND:

Ileal pouch-anal anastomosis (IPAA) is the standard operative approach for ulcerative colitis (UC) or inflammatory bowel disease unclassified (IBDu) patients with medical refractory disease or dysplasia. Pouchitis or denovo Crohn’s disease are frequent adverse outcomes. The presence of small bowel (SB) mucosal inflammation before surgery might be an important predictor of these outcomes after surgery. Although small bowel follow through (SBFT) with barium has been the traditional imaging modality, cross sectional imaging using CT enterography (CTE) or MR enterography (MRE) have become increasingly utilized for preoperative SB assessment. The aim of this study was to assess changes in the utilization of SBFT versus CTE/MRE in UC and IBDu patients undergoing IPAA.

METHODS:

Prospectively generated clinical profiles on consecutive UC and IBDu patients undergoing IPAA between November 2006 and August 2019 were reviewed. Patients were classified into 2 groups: Group A (2006-2012) and Group B (2013-2019). Each patient was evaluated for preoperative SB imaging within their respective group. Baseline demographics were compared between groups. Imaging modalities included SBFT, CTE, MRE or ‘no imaging’.

RESULTS:

The study cohort of 354 patients had a mean age of 37.3 years (SD 17.1) years and included 50% males. Group A included 196 (55%) patients and Group B included 158 (45%) patients. Groups were comparable in terms of age, gender, and indication for surgery. Patients in Group A had a significantly longer disease duration (115 vs 85 months, P = 0.01) and greater number of IBDU patients (37% vs 22%, P < 0.01) versus UC patients (64% vs 77%, P < 0.01). When comparing imaging modalities, there was a significantly higher use of SBFT in Group A (44% vs 4%, P < 0.01), significantly higher use of CTE and MRE in Group B (11% vs 27%, P < 0.01 and 7% vs 40%, P < 0.01, respectively), and no difference in ‘no imaging’ between the two groups (32% vs 29%, P = 0.56).

CONCLUSION(S):

Cross sectional imaging using CTE or MRE has become the preferred modality of preoperative SB imaging in UC and IBDu patients undergoing IPAA.
P110 Using Wearable Devices to Predict Length of Stay For IBD Patients After Bowel Surgery
Authors: Yi Yangtian , Sossenheimer Philip , Rai Victoria , El Jurdi Katia , Rubin David
Published: December 2019

BACKGROUND:

Understanding the factors that contribute to a prolonged length of stay (LOS) for IBD patients after bowel surgery is essential to improving the quality of care provided to these patients. Early ambulation and sleep are important for post-operative recovery (1,2). We used activity and sleep data collected from a wearable biosensor to predict LOS for IBD patients undergoing bowel surgery.

METHODS:

We conducted a prospective study of IBD patients undergoing bowel surgery. Patients were provided a Fitbit (Charge or Alta HR, San Francisco, CA) and asked to download and install a proprietary smart phone application (Litmus Health, Austin, TX) for collection of step and sleep data. We also collected sociodemographic and clinical data via review of all patients’ medical records. Associations were assessed using Pearson’s correlation coefficient (r).

RESULTS:

Our final sample included 22 patients (17 CD, 5 UC), 4 of whom were excluded from analysis of sleep data only. At time of surgery, mean age was 40.6 years, and the mean BMI was 27.33 kg/m2. The median LOS was 5 days (IQR, 4-6.75 days). Compliance wearing Fitbit was 81.5% for step data collection and 64.1% for sleep data collection. There was a significant increase in step count from post-operative day 1 (POD1) to POD5 (r = 0.33, P = 0.015). Between POD1 and POD5, an additional POD was associated with a 421-step increase in step count. However, Pearson’s correlation analysis failed to reveal significant associations of sleep duration and sleep efficiency with post-operative days (P > 0.05). Furthermore, mean daily steps, mean sleep duration, or mean sleep efficiency was not significantly associated with post-operative LOS (r = -0.14, P = 0.52; r = 0.22, P = 0.37; r = -0.12, P = 0.64 respectively). However, a longer sleep duration on POD5 was associated with a longer LOS (r = 0.87, P = 0.026), while a higher sleep efficiency on POD5 was associated with a shorter LOS (r = -0.88, P = 0.019). Moreover, a more positive change in sleep duration from POD4-5 was associated with a longer LOS (r = 0.95, P = 0.003), whereas a more positive change in sleep efficiency from POD4-5 was associated with a shorter LOS (r = -0.92, P = 0.011).

CONCLUSION(S):

This is the first study to characterize associations of physical activity and sleep quality with LOS for IBD patients after bowel surgery. We found a significant increase in step count from POD1 to POD5. We also demonstrated that longer sleep duration or lower sleep efficiency on POD5 was associated with a longer LOS. More positive change in sleep duration or more negative change in sleep efficiency from POD4-5 was associated with a longer LOS. We plan to conduct an interventional study to assess the effect of physical activity and sleep quality on LOS for IBD patients after bowel surgery.
Content and chemical composition of the essential oil of Lippia gracilis Schauer accessions in different drying times
Authors: Melo Juliana Oliveira de , Blank Arie Fitzgerald , Souza de Oliveira Alisson Marcel , Andrade Thiago Matos , Arrigoni-Blank Maria de Fátima , Alves Péricles Barreto
Published: December 2019

Lippia gracilis, popularly known in Brazil as ‘alecrim-de-tabuleiro’, is used for many purposes, especially as antimicrobial and antiseptic. The drying process of aromatic and medicinal plants aims to minimize the loss of active principles and slow their deterioration, which may greatly influence the yield and chemical composition of some species. The objective of this study was to evaluate the effect of drying times (0, 2, 4, and 8 days) on the content and chemical composition of the essential oil of L. gracilis accessions LGRA-106, LGRA-109, and LGRA-201. The leaves were dried at 40 oC, and essential oil was extracted by hydrodistillation. Chemical analysis was performed by GC/MS. The experiment was carried out in a completely randomized design with three replications. The accessions of L. gracilis LGRA-106, LGRA-109, and LGRA-201 presented higher essential oil at four days of drying time. The accession LGRA-201 showed the highest essential oil yields at four and eight days of drying, with mean values of 0.038 and 0.029 mL g-1, respectively. The drying time did not influence the contents of thymol, methyl-thymol, γ-terpinene, and carvacrol in the essential oils of L. gracilis, but affected the contents of β-caryophyllene, p-cymene, and carvacrol acetate. The essential oils of the three accessions analyzed in this study revealed different chemical profiles.
Estimation of leaf area of Erythroxylum citrifolium from linear leaf dimensions
Authors: Ribeiro João Everthon da Silva , Coêlho Ester dos Santos , Figueiredo Francisco Romário Andrade , Lopes Sérgio de Faria , Albuquerque Manoel Bandeira de
Published: December 2019

Erythroxylum citrifolium is a neotropical plant species recorded in all regions of Brazil. Determining leaf area is of fundamental importance to studies related to plant propagation and growth. The objective was to obtain an equation to estimate the leaf area of E. citrifolium from linear dimensions of the leaf blade (length and width). A total of 200 leaf blades were collected in Parque Estadual Mata do Pau-Ferro in the municipality of Areia, state of Paraíba, Northeast Brazil. The models evaluated were: linear, linear without intercept, quadratic, cubic, power and exponential. The best model was determined by the criteria of: high coefficient of determination (R²), low root mean square error (RMSE), low Akaike information criterion (AIC), high Willmott concordance index (d) and a BIAS index close to zero. All of the models constructed satisfactorily estimated the leaf area of E. citrifolium, with coefficients of determination above 0.9050, but the power model using the product between length and width (L*W) ŷ = 0.5966 * LW1.0181 was the best, with the highest values of R² and d, low values of RMSE and AIC, and a BIAS index closest to zero.
Irrigation with saline water on pineapple grown in the semi-arid of bahia state
Authors: Brito Cleiton Fernando Barbosa , Fonseca Varley Andrade , Santos Marcelo Rocha dos , Arantes Alessandro de Magalhães , Donato Sergio Luiz Rodriguez
Published: December 2019

We aimed to evaluate the effects of different irrigation depths with saline water on growth, yield, water-use efficiency, and fruit quality of ‘Pérola’ pineapple plant grown in the semi-arid of Bahia state. The experiment was carried out in a randomized block design with five treatments which represented the irrigation depths: 100% of crop evapotranspiration (ETc) with irrigation water of 0.75 dS m-1 in electrical conductivity (ECiw); and 50, 75,100, and 125% of ETc with water of 3.6 dS m-1 in ECiw. Pineapples were grown under field conditions watered by drip irrigation in which pressure compensating emitters had 8 L h-1 flow rate. We observed that the irrigation depth 100% of ETc with water of 0.75 and 3.6 dS m-1 in ECiw provides higher pineapple yields under the semi-arid conditions of this study, and the chemical quality of the fruits are up to commercial standards, except when applying 125% of ETc with water of 3.6 dS m-1 in ECiw.
Effects of pneumoperitoneum and trendelenburg position on intraocular pressure (IOP) in isofluorane anesthetised cats
Authors: De Souza Arilton Teodoro , De Oliveira Garcia Débora , Nishimura Lilian Toshiko , Magalhães Marcos Lúcio , De Mattos-junior Ewaldo , Paulino-Junior Daniel , Torrecilhas Jorge Adriana , Dos Santos Honsho Cristiane
Published: December 2019

The aim of this study was to determine whether a pneumoperitoneum of 10 mmHg combined or not with the Trendelenburg position could lead to significant changes in intraocular pressure (IOP), ocular pressure perfusion (OPP), and cardiorespiratory variables; as well as determine whether a correlation exists between IOP and mean arterial blood pressure (MAP), and/or partial pressure of carbon dioxide in arterial blood (PaCO2) in cats. Animals were allocated in two groups (n=7/group): GC (without inclination) and GTREN (Trendelenburg position). The variables were recorded before (baseline) and during 30 minutes (T5-T30) after insufflation. In GTREN, a reduction in heart rate was observed at T5 and in respiratory rate at T5 and T15. There was an increase in IOP at T5-T30 in comparison to baseline. There was a reduction in potential of hydrogen in arterial blood in both groups at all times in comparison to baseline. Partial pressure of carbon dioxide in arterial blood was increased at T15-T30 in GC and at T5-T30 in GTREN. In conclusion, the pneumoperitoneum of 10mmHg CO2 did not significantly affect IOP or OPP in cats anaesthetised with isofluorane and kept under spontaneous ventilation. However, induced pneumoperitoneum combined with Trendelenburg position resulted in an increase in IOP in cats subjected to the same anaesthetic conditions, but did not affect OPP.
Role of growth regulators and plant water extracts on the productivity and water use efficiency of wheat genotypes under limited water supply
Authors: Hussain Safdar , Rehman Abdul , Akram Muhammad , Iqbal Javaid , Batool Qaisrani Tahira , Wasaya Allah , Nafees M.
Published: December 2019

Empowerment of wheat genotypes by application of growth regulators, compatible solutes and plant extracts under water restriction is an important strategy for getting sustainable yield. Field trail was performed at the research area of the Faculty of Agricultural Sciences, Ghazi University, Dera Ghazi Khan, Pakistan. Three wheat cultivars Aas-2011, Faisalabad- 2008 and Triple dwarf-1 were subjected to drought stress (skipping the irrigation at grain filling stage). The wheat genotypes were subjected to treatments viz., T1 i.e. All normal irrigation without application of abscisic acid (ABA), salicylic acid (SA), moringa (MLE) and mulberry leaf water extract (MBLE), T2­ i.e. skipping the irrigation at grain filling stage and application of 2µM ABA, T3 i.e. skipping the irrigation at grain filling stage and application of 10 m mol SA, T4 i.e. skipping the irrigation at grain filling stage and application of 15% MLE and T5 i.e. skipping the irrigation at grain filling stage and application of 10% MBLE. The experiment was laid out in Randomized Complete Block Design with factorial arrangement and repeated three times. From this study it is concluded that Aas-2011 shown best result under drought condition by applying growth regulators and plant water extracts.
rs and plant water extracts.
Yield and soil insect resistance in sweet potato clones
Authors: Nóbrega Daiane da Silva , Peixoto José Ricardo , Vilela Michelle Souza , Nóbrega Anne Kelly da Silva , Santos Elaine Caetano , Costa Anne Pinheiro , Carmona Ricardo
Published: December 2019

Sweet potato (Ipomoea batatas) is a rustic horticultural crop with high production potential. However, the crop is susceptible to many pests and diseases. The objective of this study was to evaluate 10 genotypes of sweet potato regarding their yield and resistance to soil insects, under Brazilian cerrado soil conditions. Genotypes were selected from the Sweet Potato Germplasm Bank of Embrapa Hortaliças. The experiment was conducted at Água Limpa Farm, belonging to University of Brasilia (UnB), and consisted of a randomized block design, with 10 treatments (genotypes), 10 plants per plot, and four replications. The following traits were analyzed: number of perforations per root, incidence of roots injured by insects, plant resistance degree, root shape, total and marketable root yields, root peel color, root pulp color, pulp total soluble solids, pulp titratable acidity, pulp TSS/TA ratio, pulp moisture, and pulp starch yield. Genotype CNPH 53 (26.78 t ha-1) presented total root yield greater than the commercial variety Brazlândia Rosada (17.54 t ha-1). Genotype Santa Sofia (11.77 t ha-1) and Brazlândia (13.5 t ha-1) had similar marketable root yields. CNPH 53 showed the best agronomic performance, exhibiting moderate susceptibility to soil insects and root shape meeting the market standards. It also had low pulp TA (2.53%); high pulp TSS (12.25 °Brix) and pulp TSS/AT ratio (4.24); pulp moisture content close to 70%; and the highest pulp starch content (11.98%). The traits number of perforations per root, root shape, and pulp TA presented heritability values close to 70%. Marketable root yield, pulp moisture, and pulp starch content demonstrated heritability values greater than 90% and CVG/CVE greater than 1.
Agronomic traits of dual-purpose wheat with different plant architectures under defoliation strategies
Authors: Rodolfo Giselle Regina , Souza Clovis Arruda , Stefen Deivid Luiz Vieira , Sbrissia André Fischer
Published: December 2019

Crop-livestock system implies in the balance of appropriate animal foraging, minimizing effects on grain production on the same crop season. This study aims to assess canopy heights (20 and 30 cm) and cuts number (no cut, 1, 2 and 3 cuts) effects on wheat productivity and bromatological composition of forage, and grain yield of BRS Umbu and BRS Tarumã cultivars. Regardless cuts number and cultivars, 30 cm provided higher forage productivity (1032 and 1348 kg DM ha-1) than 20 cm (554 and 909 kg DM ha-1), for BRS Umbu and Tarumã, respectively, in average crop seasons. For both cultivars and crop seasons, mean values of 26% crude protein, 55% neutral detergent fiber and 26% acid detergent fiber were obtained. At 20 cm no difference in grain yield was observed as a function of cuts number with 3780 kg ha-1 for BRS Umbu, in average crop seasons and 4306 kg ha-1 in 2014, for BRS Tarumã. However, at 30 cm, the grain yield was penalized at least in 30% as a result only third cut. These results indicate that wheat as dual-purpose can be employed in southern Brazil in grazing systems in forage shortage times and then produce grains without yield penalties as a function to the management used.
Compatibility of Heterorhabditis amazonensis MC01 (Nematoda: rhabditida) with fertilizers and soil conditioners
Authors: Andaló Vanessa , Rocha Fernando da Silva , Faria Lucas Silva de
Published: December 2019

Entomopathogenic nematodes are natural enemies of insect pests present in the soil; however, the intensive use of agricultural inputs can affect the action of these organisms. The objective of this study was to evaluate the effects of exposure of the nematode Heterorhabditis amazonensis MC01 to soil fertilizers containing different active ingredient, verifying their influence in the viability, infectivity and nematode production in Tenebrio molitor L. larvae. Nine products were tested, including fertilizers and soil conditioners, using the adapted IOBC/WPRS protocol. The infective juveniles were exposed to the highest concentration recommended by the manufacturer of each product for a period of 48 h. After this period, the viability, infectivity and production were evaluated and the values of mortality, infectivity reduction, production reduction and insecticide effect were obtained in order to classify the products according to IOBC criteria. In this way, the nematode H. amazonensis MC01 was compatible with most of the products under the tested conditions, so could be present in the soil at the same time. However, the product Nutriterge® Formula 3 was considered slightly harmful and Nem out® considered harmful. However, further field tests should be performed with these products to prove the deleterious effect on the nematode tested.
O silêncio dos colaboradores de Van Dyne, Ang e Botero (2003): Estudo da validade fatorial e da invariância da medida para Portugal
Authors: Sabino Ana , Cesário Francisco
Published: December 2019

O silêncio dos colaboradores tem sido entendido como a decisão deliberada do indivíduo em reter informação, opiniões e sugestões acerca da organização. Nos últimos anos tem-se verificado um acréscimo de estudos sobre este constructo verificando-se, no entanto, falta de consistência teórica e empírica. O presente estudo tem como objetivo estudar a validade fatorial e a invariância da medida proposta por van Dyne, Ang e Botero (2003) para Portugal. Partindo de uma estrutura teórica tridimensional, os resultados sugerem que, para a população portuguesa, a medida é invariante e composta por duas dimensões que se correlacionam, negativamente. Uma primeira denominada de silêncio de adesão que corresponde ao silêncio prosocial de van Dyne et al. (2003) e uma dimensão de rejeição composta pela junção das dimensões defensiva e submissa de van Dyne et al. (2003). As implicações teóricas e práticas são discutidas
Work orientation: Dimensionality and internal model
Authors: Pitacho Liliana Alexandra , Palma Patrícia , Correia Pedro
Published: December 2019

Esta investigação tem como principal objetivo estudar a dimensionalidade da orientação para o trabalho e propor um modelo interno. O presente estudo teve em consideração o modelo de orientação para o trabalho proposto por Bellah et al. (1985). Este modelo assume que existem três tipos de orientação para o trabalho: chamamento, carreira e emprego. Tratou-se de um estudo transversal com 959 adultos portugueses entre os 18 e os 71 anos. Recorreu-se à análise fatorial confirmatória para estudar a dimensionalidade da orientação para o trabalho e, para o estudo do modelo interno da orientação para o trabalho recorreu-se à modelagem de equações estruturais. Complementarmente, os resultados destas análises sugerem que a orientação para o trabalho é realmente tridimensional e, adicionalmente, sugerem que as dimensões da orientação para o trabalho têm um impacto direto umas nas outras. Este estudo fornece contribuições importantes para a teoria da orientação para o trabalho e introduz para discussão e pesquisa um conjunto ainda maior de questões.
Subjetividades infantiles femeninas y pedagogías de la cotidianidad
Authors: Delgadillo Ingrid Sissy
Published: December 2019

Este trabajo pretende contribuir a identificar las subjetividades femeninas infantiles que se han construido mediante la producción y circulación de textos como la Revista Tú —dirigida a un público entre los 9 y los 18 años—. Se busca así evidenciar cómo este tipo de productos culturales están anclados en una pedagogía que rebasa los límites de la escuela y se instala en la vida cotidiana, en la familiaridad de la vida de las niñas y adolescentes, aportando referentes para “ser” y actuar en un mundo en el que el consumo y la apariencia se han perfilado como principios casi éticos. Se aclara, no obstante, que dichas subjetividades mediáticas no corresponden linealmente a las particularidades de los sujetos, pero sí marcan tendencias y orientaciones culturales bastante permeadas por las lógicas del mercado.
Habilidades pragmáticas, imaginación y comprensión de los estados mentales en los niños
Authors: Benavides Delgado Jacqueline
Published: December 2019

El objetivo de este artículo es analizar la influencia del lenguaje y la imaginación en el desarrollo de la teoría de la mente (Theory of Mind o ToM) en los niños. Inicia con la definición del concepto de ToM y la exposición de las diferentes teorías que han intentado explicar dicho desarrollo en los niños. De igual forma, el artículo aborda estudios que relacionan la ToM con la imaginación y con el lenguaje pragmático. Con respecto a la imaginación, se hace un recorrido especial por los estudios que involucran a los niños con amigos imaginarios y su relación con el mundo social. En relación con el lenguaje pragmático se destaca la influencia de las conversaciones familiares con contenido mental para el desarrollo de la ToM. Por último, el artículo muestra la importancia de los procesos simbólicos en el desarrollo de la ToM en los niños y aporta desde su conclusión elementos para fomentar su desarrollo.
Sobre la palabra y su uso: reflexiones para la enseñanza de matemáticas
Authors: Fonseca Rojas Angie , Ramírez Herrera Leonardo , Albadán Vargas Juan Pablo
Published: December 2019

Este artículo enuncia reflexiones emergentes de la práctica docente —intensiva—, de la Licenciatura en Educación Básica con Énfasis en Matemáticas de la Universidad Distrital Francisco José de Caldas, a propósito del papel del lenguaje en la enseñanza de las matemáticas. Se abordan cuestionamientos de contraste entre creencias individuales de los profesores en formación y creencias colectivas que rodean este fenómeno. Para ello, se establecen paralelos entre los discursos construidos bajo la perspectiva de la importancia del lenguaje para la enseñanza de las matemáticas y el papel de la palabra, además, se hacen reflexiones sobre su uso para aprender, evaluar, motivar e incluir. Se concluye que sin un discurso configurador de significantes y significados que discierna su dimensión de uso e intención, no se logra dar paso al desarrollo de constructos matemáticos (conceptualizar) pretendidos en la educación inicial.