bluuebunny/crossref_metadata_2025_split huggingface dataset:
P808 Prevalence and factors associated with sleep disturbances in inflammatory bowel disease patients compared with normal controls
Authors: Caloz E , Vullièmoz M , Haba Rubio J , Pittet V , Mamadou Barry P , Michetti P , Heinzer R , Maillard M H 
Published: January 2020

Abstract

Background
Environmental factors, including sleep disturbances, have been associated with the risk of flare in inflammatory bowel disease (IBD). Symptoms, treatment side effects and pro-inflammatory status have been shown to have an effect on sleep quality and duration. Previous studies showed that around 44% of IBD patients suffer from sleep disorders. We aimed at determining the prevalence of sleep disturbances in IBD patients, as compared with normal controls, and factors associated with disturbances.

Methods
We conducted a cross-sectional study on adult patients included in the Swiss IBD cohort study. We excluded pregnant women and night workers. We used the HypnoLaus cohort as a control population. Demographics, clinical, treatments, SF-36 and IBDQ (bowel, emotional, social and systemic sub-scores) quality of life data were extracted from the SIBDCS. We sent patients a questionnaire comprising the Pittsburgh Sleep Quality Index (PSQI), Epworth score (ESS), and Restless Leg Syndrome (RLS) Score. We assessed differences regarding those scores between IBD and controls. We performed logistic regression analyses to evaluate factors associated with sleep disturbances in the IBD population.

Results
A total of 1139 patients answered to the questionnaire: 613 CD, 526 UC, 47% males, mean (SD) age: 50(15) years, median (IQR) disease duration: 15 (15) years. One out of five patients had extraintestinal manifestations (EIM). Forty-one percent were receiving biologic treatment (UC: 27.6%, CD: 53.0%). We found 906 age-sex-BMI matched controls who answered the PSQI, ESS and RLS. A significantly higher proportion of IBD patients had impaired sleep quality (PSQI) as compared with the control population (61.3% vs. 33.9%; p &lt; .001). The proportion of IBD patients with ESS sleep deficiency (incl. daytime sleepness) was significantly higher as compared with controls (32.5% vs. 23.4%; p &lt; .001). We also found a higher prevalence of RLS in IBD than in controls (27.8% vs. 13.0%; p &lt; .001). Factors associated with impaired sleep quality were female gender (OR=1.37; p = .048), IBDQ bowel (OR=1.03; p = .033) and IBDQ systemic (OR=0.83; p &lt; .001). ESS sleep deficiency was associated with IBDQ emotional (OR=1.02, p = .050) and social (OR=0.95; p = .046). RLS was associated with increased age (OR=1.02, p &lt; .001), being a smoker (OR=1.54; p = 0.035), prior steroid use (OR=2.17, p = .001) and IBDQ emotional (OR=0.95, p = .005).

Conclusion
Sleep disturbances are highly prevalent in IBD patients compared with the control population. In IBD, sleep disturbances were associated with IBD-specific quality of life, but not with disease activity and EIM. Future studies should address whether early detection and active management of sleep disorders might influence disease control and long-term outcomes.
P817 Influence of inflammatory bowel diseases on depression and suicidal risk: a questionnaire-based survey
Authors: Molnár T , Miheller P , Sarlós P , Sánta A , Juhász A , Hamvas E , Nyári T , Szántó K J , Bor R , Fábián A , Bálint A , Milassin Á , Rutka M , Szepes Z , Farkas K 
Published: January 2020

Abstract

Background
Inflammatory bowel diseases (IBD) patients are at increased risk for mental health problems. Managing IBD patients requires cooperation between gastroenterologists and psychologists and psychiatrists. We would like to assess the frequency of depression and suicidal thoughts among Hungarian IBD patients.

Methods
Multicentre, questionnaire-based survey among inflammatory bowel diseases patients. Demographic data and patient’s medical history was obtained with self-filling questionnaires. Patients’ psychic status was measured with Patient’s Health Questionnaire (PHQ-9), Beck Hopelessness Scale (short version). The survey was conducted in 3 IBD centres in Hungary, First Department of Medicine, University of Szeged, First Department of Surgery, University of Semmelweis and First Department of Medicine, University of Pécs.

Results
Three hundred IBD patients filled the questionnaires from the 3 IBD centres. Female-male ratio was 57% - 47%. Mean age at the time of the study was 38.8 years (SD 12.5) and mean disease duration was 11.5 years (SD 8.2). Sixty-two point three% was diagnosed with Crohn’s disease, 37.7% with ulcerative colitis, one patients reported IBD unclassified and three patients did not know the type of IBD. Sixty-nine point three% of the patients self-reported the remission state of IBD, while 30.7% self-reported to have active IBD. Proportion of patients on each category of PHQ-9 scale were the followings: severe 2%, moderate to severe 5.3%, moderate 21.3%, mild 33.6% and 37.6% had normal score. Nine point three% of the patients had elevated suicidal risk. More severe PHQ-9 category was associated with elevated risk for suicide. Significant difference was shown in the Hopelessness Scale’s results among the two genders, female patients had higher risks for suicidal thoughts. Those IBD patients in remission have lower probability for moderate or severe depression.

Conclusion
We have to be aware of that every IBD patient has increased risk for depression and suicide. Among our patients the rate of moderate to severe and severe depression was relatively low. Every tenth of our patients had elevated risk of suicide.
P842 Analysis of fungal microbiota dysbiosis in inflammatory bowel disease
Authors: Zeng L , Wang Y , Zhuo M 
Published: January 2020

Abstract

Background
Inflammatory bowel disease（IBD）is chronic relapsing and remitting disease of the gastrointestinal tract. Although the precise aetiology and pathogenesis of IBD remains elusive, epidemiological data conclusively point to be attributed to an aberrant immune response against environmental factors such as the gut microbiota in a genetically susceptible host. The bacterial microbiota plays a major role in human physiology and pathogenesis of IBD. The Fungi are often ignored in studies. Although the role of fungi has been suggested in pathogenesis of IBD, the available data are scarce. The aim of our study was to analyse and compare the faecal fungal microbiota in patients with IBD and healthy subjects (HS).

Methods
Our study evaluated fungal composition of the faecal microbiota of 66 patients with CD and 38 patients with UC diagnosed in West China Hospital and 39 HS by ITS2 sequencing. The Qiime pipeline was used to assess composition and diversity. Using LEfSe observed differential fungal composition between subjects.

Results
The faecal fungal microbiota was dominated by two phyla, basidiomycetes and ascomycetes in both IBD and HS. We observed that fungal microbiota was skewed in IBD, with an decreased basidiomycota/ascomycota ratio, a decreased proportion of Aspergillus and Saccharomyces and an increased proportion of Exophiala. Polythrincium, clonostachys, Candida compared with HS. Using LEfSe, we observed several differential fungal composition in different subject. Exophial a (p = 0.02), Agaricales (p = 0.02)species were overrepresented in UC, whereas Bulleribasidiaceae (p = 0.01), Ustilaginaceae (p = 0.007), Ustilaginales (p = 0. 007),Ustilaginomycetes (p = 0.007)species were overrepresented in HS. We then directly compared the fungal composition between subgroup of CD and UC, we observed Eurotiales（p = 0.007）, Aspergillus（p = 0.025), Thermoascus（p = 0.04）species were overrepresented in UC-remission. Ascomycota (p = 0.008) and Didymellaceae (p = 0.02)species were associated with CD-remission, whereas Saccharomyces (p = 0.03) and Xylariaceae (p = 0.006) species were associated with CD-flare. There was no significant difference in fungal Alpha diversity between IBD and HS. Beta diversity analysis showed that one subgroup of IBD samples segregated from HS whereas another subgroup overlapped with HS.

Conclusion
There was no significant change in fungal diversity in IBD. However, we observed fungal composition was skewed with decreased basidiomycota/ascomycota ratio on phyla level, particularly in IBD-flare group. The fungal composition was dominated by Aspergillus and Saccharomyces in HS, while the proportion of Exophiala, Polythrincium, Clonostachys, Candida was increased in IBD on genus level.
P849 Analysis of rectal swabs for microbiome sampling in a cohort of IBD patients during disease exacerbation. POLIBD survey results
Authors: Filip R , Gruszecka J 
Published: January 2020

Abstract

Background
There are only a few studies that have investigated the role of intestinal infections other than Clostridium difficile in Inflammatory Bowel Disease (IBD). Objectives: Our goal was to investigate the frequency of intestinal infections detected by rectal swabs in IBD patients during admission due to exacerbation of the disease.

Methods
We conducted a cross-sectional analysis of 299 patients who underwent microbiome sampling with the use of rectal swabs from January 1, 2017 to June 30, 2019, treated at a tertiary IBD centre in Poland. Our main goal was to assess the presence of any infection that could mimic or coexist with IBD exacerbation.

Results
A total of 299 patients were subjected to microbiological examination, including 61 patients with Crohn’s Disease (CD), 143 patients with Ulcerative Colitis (UC) and 95 patients with diarrhoea not related to IBD. Positive results of rectal swab culture were found in a total of 22 samples - in 17 patients with IBD and 5 patients without IBD. Among the IBD patients, positive rectal swab cultures were obtained in cases of UC - 13 samples, 76.5%, p &lt;0.001, CD - 4 samples, 23.5% positive results, p = 0.001. In patients with IBD compared with patients without IBD, a higher incidence of intestinal infections was found (in patients with IBD 8.3%, p &lt;0.001, in patients without IBD 5.2%, p &lt; 0.001). Analysis of the results obtained showed seasonal variability in the number of positive microbiological tests found for cultures of rectal swabs in IBD patients. Positive results of rectal swabs from patients with IBD were significantly more frequent in the summer months - 12, 70.6%, p &lt; 0.001 than in the winter months, when 5 positive test results were found (29.4%, p &lt;0.001).

Conclusion
A retrospective analysis of rectal swabs for microbiome sampling collected from IBD patients during disease exacerbation treated in a tertiary IBD centre in Poland was performed. Intestinal infections, other than Clostridium difficile, were found in 17 patients with IBD symptoms. Positive results from rectal swabs of patients without symptoms of IBD were found in 5 cases. The evaluation of the obtained results shows that positive results of rectal swabs were found more often in samples taken from women (12 samples - 68.7%) than from men (5 samples - 29.3%).
N04 Knowledge, attitude and perception of inflammatory bowel disease patients towards colorectal cancer risk, its management and the role of healthcare providers: a cross-sectional study in the UK
Authors: Khan F , Czuber-Dochan W , Norton C 
Published: January 2020

Abstract

Background
Inflammatory bowel disease (IBD) increases the risk of colorectal cancer (CRC) and requires specialised cancer risk management. Although literature exists on general disease-related knowledge in IBD patients, limited studies have assessed IBD patients’ knowledge of CRC risk and its management. Consequently, patient perception of the role of a healthcare provider (HCP) in patient education of CRC risk and their attitude towards recommended risk management has not been assessed in UK IBD patients.

Methods
We conducted a cross-sectional online survey with IBD patients recruited via charity sources from April-July 2019. Adult patients (&gt;18 years) with a confirmed diagnosis of IBD for 2 years and adequate command of English language were included. A self-designed and piloted questionnaire with open and closed-ended questions was used. Closed-ended data were analysed using descriptive statistics and open-ended responses were analysed using content analysis. Fischer’s exact test and bivariate logistic regression were used to test for association between knowledge and patient demographics.

Results
92 participants, including 52.5% CD and 67.5% females, responded. 88% knew that IBD increases CRC risk. The mean fear of CRC risk (0–10 visual analogue scale) was 6.37 (SD ± 2.8). One-fifth were aware of colonoscopy as the best screening tool; 88% were unaware of screening initiation time. 90% would agree to their doctor’s recommendation of colonoscopy to ensure early cancer diagnosis and treatment. For dysplasia with 10% risk of CRC, 46.7% would not agree to colectomy mainly due to 10% risk of CRC not being high enough to undergo surgery. Forty-eight per cent of participants said that they never had a discussion about increased CRC risk in IBD with their doctor. Almost two-thirds were not informed about the role of screening/surveillance in cancer. Two-thirds were satisfied with the information provided by their HCP. Overall, patients desired more information about their individualised cancer risk and services available for managing the increased risk.

Conclusion
IBD patients are well informed about IBD-associated CRC risk, feared this risk greatly but were poorly aware of screening initiation time. HCP’s role in cancer knowledge dissemination was sub-optimal and patients desired more knowledge. We need deeper understanding of patients’ educational needs related to CRC.
N10 Effectiveness of self-management workshop in inflammatory bowel diseases according to psychosocial profiles. Clinical trial
Authors: Rivera Sequeiros A , Torres Dominguez Y , Á M , Macías Izquierdo , Ruiz Romero M V 
Published: January 2020

Abstract

Background
The main objective in the management of chronic diseases is to maintain and improve the quality of life. In this sense, the involvement of the patient in their self-care should be a priority for nursing, but we know that the results are not always the desired ones. Self-care education and training should focus on social and emotional aspects, identified as predictors of the deterioration of the quality of life. Studies have identified psychosocial profiles (Controlled, Reinforced, Weak, Fragile) of patients with inflammatory bowel diseases (IBD) based on their level of social support and emotional coping. These profiles could predict the effectiveness of these educational workshops. This study aims to compare the effectiveness of a self-management workshop in different patient profiles to identify what type of patient might benefit and which don’t.

Methods
Non-randomised clinical trial. 61 outpatients were included. Inclusion criteria: Have IBD, be over 18 years old and sign the informed consent. They were included in a self-management training programme to learn about the disease and coping. There were 4 sessions in a month. They completed a questionnaire before the workshop, at the end of the workshop, at 3 months and at 6 months. The variables were sociodemographic, clinical, quality of life, coping, perceived stress, social support and anxiety-depression.

Results
The characteristics of the sample are shown in Table 1. The four psychosocial profiles described in the literature were identified and the effectiveness of the workshop in each one was analysed. The intrasubject linear analysis showed a linear type increase in the quality of life of patients with Reinforced and Weakening profile, between baseline and third month (−3.81, p = 0.036, CI: (− 7.45; −0.17) and − 6.21, p = 0.004, CI: (− 11.08; −1.35) respectively). The observed power was 91.5% and 93.8% for each case. However, no significant differences were found in patients with Controlled profile and Fragiles. The results found were not associated with other variables of the study.

Conclusion
Identifying psychosocial profiles allows us to succeed with the type of education we offer to patients. We must customise the information and resources. In the case of patients with a great lack of family support, one would first have to intervene with the family and then offer emotional education and not vice versa.
113 Echocardiographic assessment of right ventricular outflow tract obstruction in hypertrophic cardiomyopathy - efficacy of dual chamber pacing in reducing of gradient
Authors: Wojtkowska A , Zarczuk R , Brzozowski W , Lukasik S , Tomaszewski M , Czekajska-Chehab E , Wysokinski A , Tomaszewski A 
Published: January 2020

Abstract
Hypertrophy of the right ventricle (RV) in the course of hypertrophic cardiomyopathy (HCM) is found in 30-60% of cases, with the possibility of a right ventricular outflow tract obstruction (RVOTO), obstruction in the apex or the middle part of the right ventricle.
A patient, aged 41, admitted due to limitation of exercise tolerance, effort dyspnea, presyncope. In an echocardiogram, interventricular septum (IVS) hypertrophy was observed up to 2.0 cm; normal size of the heart cavities; normal left ventricular systolic function (EF-70%). A color doppler mapping detected the zone of flow acceleraction and turbulent flow in right ventricular outflow tract (RVOT), next a spectral doppler examination showed the RVOT obstruction with a maximal gradient of 64 mmHg. Because of the suboptimal echocardiographic imaging, a heart CT scan was performed, revealing the features of left ventricular hypertrophy, most severe at the base and the medium part of IVS (up to 25 mm). Asymmetric hypertrophy of the middle portion of the right ventricle and right ventricular outflow tract obstruction was also observed. A hemodynamic study confirmed the presence of gradient in RVOT, up to 40 mmHg. Holter electrocardiogram recorded an episode of non-sustained ventricular tachycardia. Taking into account the clinical picture, the family history of the disease, and calculated HCM Risk SCD (7.55%), the decision was made to implant a dual chamber cardioverter defibrillator. The defibrillator electrode was fixed at the apex of the right ventricle. A short AV delay was programmed for prevalent right ventricular stimulation (AV delay 100 ms), resulting in 99.6% ventricular stimulation. The control echocardiogram showed a reduction in the maximum gradient in RVOT to 24 mmHg. In addition, the patient was treated with a beta-blocker.
To sum up, in the case of HCM we should always examine the RV with color and spectral doppler to exclude potential narrowing in RV.
Constant AV sequential stimulation with a short AV delay is a recognized method that can be considered in symptomatic adult HCM patients with a left ventricular outflow tract obstruction. In the case described here, the above mentioned method proved effective in the significant reduction of the gradient in the right ventricular outflow tract.
Abstract 113 Figure. gradient in RVOT
157 Reduced non-invasive myocardial work predicts significant coronary artery disease
Authors: Sabatino J , Leo I , De Rosa D , Polimeni A , Sorrentino S , Spaccarotella C , Mongiardo A , Aquila I , Di Salvo G , Indolfi C 
Published: January 2020

Abstract

Funding Acknowledgements
ESC Training Grant 2019

Background
Non-invasive prediction of critical coronary artery stenosis (CCS) is challenging. CCS may cause persistent impaired longitudinal function at rest, which could be detected by two-dimensional speckle tracking echocardiography (2D-STE). However, strain parameters are load dependent, hence they might not reflect systolic function accurately. A novel non-invasive method to calculate MW recently showed a strong correlation with invasive work measurements.

Objectives
To investigate the ability of non-invasive Myocardial Work (MW) indices: 1) to identify the ischaemic risk area during acute coronary occlusion (ACO); 2) to predict the ischaemic risk area underlying a CCS before coronary angiography.

Methods
The study population comprises 80 individuals: fifty consecutive patients (pts) referred for coronary angiography in a single tertiary coronary care centre and thirty controls (CTRL). Echocardiography recordings (GE-Healthcare) with systolic and diastolic non-invasive pressures, were obtained immediately before coronary angiography, during ACO, and immediately after revascularization to measure longitudinal strain along with myocardial work indices: Myocardial Work Index (MWI), Myocardial Constructive Work (MCW), Myocardial Wasted work (MWW), Myocardial work efficiency (MWE).

Results
Compared to baseline, we found a significant reduction of global longitudinal strain (GLS) (p = 0.005), MWI, MCW and MWE (p &lt; 0.001) during ACO. After the procedure, we observed a significant improvement in GLS, MWI, MCW and MWE (p &lt; 0.001) compared to the findings obtained during CO.
Interestingly, baseline global MWI, MCW and MWE were significantly reduced in pts with CCS at angiography compared to controls (p &lt; 0.05). Moreover, regional MWE, but not longitudinal strain, measured within the myocardial segments underlying the CCS, was significantly reduced compared to non-target segments (p &lt; 0.001).

Conclusions
Our results demonstrate that non-invasive estimation of regional and global MW parameters are able to identify myocardial ischemia upon ACO. Moreover, myocardial work indices measured at rest were able to predict the presence of CCS before invasive angiography, whereas MWE was more sensitive than myocardial strain to document regional impairment of myocardial function.
Abstract 157 Figure.