bluuebunny/crossref_metadata_2025_split huggingface dataset:
P075 Multidimensional assessment of interoceptive abilities, emotion processing and the role of early life stress in Inflammatory Bowel Disease
Authors: Atanasova K , Lotter T , Reindl W , Lis S 
Published: May 2021

Abstract

Background
Perception of internal bodily sensations includes three dissociable processes: interoceptive accuracy, interoceptive sensibility, and interoceptive awareness. Interoception plays a crucial role in emotional processing and alterations of these processes have been already observed in gastrointestinal disorders. Although impairments in interoception may contribute to the burden of disease in IBD, no study has investigated interoceptive processing in IBD as a multidimensional concept. The aim of the current study was to investigate the associations between the different dimensions of interoception and emotional processing in IBD, while taking childhood traumatization into account.

Methods
We recruited 35 remitted IBD patients and 35 healthy control participants (HC) matched for age, sex and education. Interoception was assessed as a multidimensional construct using the Heartbeat tracking task and the Multidimensional Assessment of Interoceptive Awareness questionnaire. Emotional processing was measured using an experimental task, where participants were asked to rate the valence and arousal when presented with affective visual stimuli. Childhood traumatization was assessed using the Childhood Trauma Questionnaire.

Results
IBD patients reported greater awareness of the connection between bodily sensations and emotional states and showed a stronger tendency to use distraction from unpleasant sensations compared with HC. Our findings suggest that emotional processing in IBD is related to interoceptive sensibility and not to the objective interoceptive accuracy. The association between interoception and emotional processing was modulated by the severity of childhood traumatization in both groups.

Conclusion
This is the first study showing that IBD patients did not differ in their ability to detect visceral signals but in their subjective perception of these. Psychotherapeutic interventions in IBD might profit from taking the interplay between emotion processing, interoception and childhood trauma into account.
P110 Symptomology and most bothersome symptoms among pediatric Crohn’s disease and ulcerative colitis patients: Results from a physician and patient survey
Authors: Dotson J , Hunter T , Lukanova R , Crandall W , Komocsar W , Larkin A , Meakin S , Otley A 
Published: May 2021

Abstract

Background
Crohn’s disease (CD) and ulcerative colitis (UC) are chronic gastrointestinal diseases, which often present during one’s most productive years. The objective of this study was to assess the symptomology and most bothersome symptoms of pediatric CD and UC patients.

Methods
Data from a cross-sectional survey of physicians and their pediatric CD and UC patients (age 2–17 years) conducted in France, Germany, Italy, Spain, United Kingdom, Japan, and United States were analyzed. Data were collected in 2019–2020 via physician-completed patient record forms and patient-self completed forms. Patients age 12–17 years completed their own questionnaires, while caregivers of younger children completed their respective questionnaires. Patient demographics and current symptoms were reported by physicians, while the most bothersome symptoms were reported by the patient/caregiver. All descriptive analyses were conducted for CD and UC patients separately.

Results
Data from 1,213 CD patients and 1,162 UC patients were included in this analysis. CD patients had a mean age of 12.8 years, 59.5% were male, 75.5% were Caucasian and had a mean sPCDAI score of 10.7. Similarly, UC patients had a mean age of 12.9 years, 54.0% were male, 71.0% were Caucasian, and had a mean PUCAI score of 23.7. The majority of CD (94.9%) and UC patients (94.6%) were currently enrolled in school/education; however, 68.3% of CD and 61.1% of UC patients indicated that they have missed school/education because of their IBD symptoms. Abdominal pain was the most frequently reported symptoms among CD (41.9%) and UC (38.6%) patients. CD and UC patients reported abdominal pain, diarrhea, abdominal cramps, and bowel urgency as their most bothersome symptoms.

Conclusion
Pediatric CD and UC patients experience multiple symptoms with the most bothersome symptoms being related to abdominal pain and bowel movements. These symptoms may impact pediatric CD and UC patients’ daily lives and cause them to miss school.
P127 Assessing the vaccination and immunization status in a Paediatric Inflammatory Bowel Disease diagnosis
Authors: Palomino Pérez L M , Velasco Rodríguez-Belvis M , León Falconi J L , Sánchez Fernández-Bravo C , Vazquez Gómez J A , Muñoz Codoceo R A 
Published: May 2021

Abstract

Background
Paediatric inflammatory bowel disease (PIBD) patients are especially prone to vaccine-preventable diseases and opportunistic infections. The aim was to evaluate the immunization and vaccination status in PIBD.

Methods
Descriptive and retrospective study that analyzes the immunization and/or vaccination for measles, mumps and rubella (MMR), hepatitis B virus (HBV), chickenpox, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) of PIBD patients in a tertiary paediatric hospital (Jan 2015- Oct 2019) in the first 6 months after diagnosis.

Results
Amongst 57 patients, 17 (30%) had ulcerative colitis (UC), 35 (61%) Crohn ́s disease (CD) and 5 (9%) unclassified IBD (uIBD). Up to 35 (61%) were male and the mean age at diagnosis was 10.2±4.1 years. A total of 18 (32%) were currently on biological treatment and 45 (79%) on immunosuppressants. The disease location in CD patients was L3 (Paris classification) in 22 (63%) and L4a in 13 (37%). Only 2 (6%) showed perianal involvement. From the UC patients, 11 (65%) were E4. A delayed growth was observed in 6 (10%), all CD patients. At diagnosis, 37 (65%) were HBV-vaccinated, 13 of them (35%) had a serological response and 22 (59%) had no response. 18 were re-vaccinated and 9 (50%) had a documented serological response. Up to 34 patients (60%) were MMR-vaccinated and 13 (38%) showed a complete response. Only 6 patients could be re-vaccinated. Up to 30 (52%) showed chickenpox immunization. Only 4 of the non-immunized patients could be vaccinated and all of them responded to a single dose. Regarding CMV and EBV, 17 and 16 patients (46 and 43%) were IgG positive respectively, all of them IgM negative. Patients with CD were more likely to need HBV re-vaccination than other IBDs (p&lt; 0.05). Regarding chickenpox, CD patients without growth delay (G0) needed less re-vaccination than those whose growth was affected (G1) (p&lt; 0.05). However, UC patients with extensive disease (E4) needed less re-vaccination than those with limited disease (p&lt; 0.05). Male patients seemed to be less likely to need re-vaccination, with no significant differences.

Conclusion
The serological assessment of vaccine-preventable diseases immunization yielded poor results. A high percentage of HBV and MMR vaccinated patients showed no response. CD patients tended to more likely need revaccination, especially in the most severe cases (G1). Surprisingly, severity was not related with vaccination response in UC. Our results suggest that less than half of the patients had been previously infected by CMV or EBV. It seems reasonable to serologically check the immunization status in PIBD patients in order to, when appropriate, re-vaccinate before starting immunosuppressive therapies.
P147 Progression to biologic treatment in very early onset inflammatory bowel disease patients- a long term follow up retrospective study
Authors: Eindor A , Meleady L , Jacobson K 
Published: May 2021

Abstract

Background
Very early onset inflammatory bowel disease (VEOIBD) prevalence has been increasing over the last decades. These young patients have been known to have special disease characteristics and disease location. Although it is known that only a low percentage of these patients require biologic treatment after diagnosis, there is only scarce evidence about their long- term outcome and biologic requirements. We aimed to assess the long term outcome of VEOIBD patients and the time of progression to biologic treatment.

Methods
We retrospectively reviewed IBD patients diagnosed under 6 years of age, between January 2005 and December 2019, from the British Columbia (BC) Pediatric IBD database. Demographic data, disease characteristics and symptoms at diagnosis were documented. The disease location and severity were documented according to the Paris classification. Data collected retrospectively until the last appointment recorded in the electronic medical records included whether the patient received biologic treatment at the time of follow up, the time to intiation of the treatment, the type of biologic treatment and response. Kaplan meier curves were used to asses the number of years to progression to biologic treatment and the parameters influencing it.

Results
89 patients under the age of 6 were diagnosed with IBD during the study period. 3 patients failed to meet inclusion criteria and were excluded. Median age at diagnosis was 3.8 (IQR 2.6–5.1). 45.3% of patients had Crohn’s disease (CD) and 62.8% were males. Median time of follow up was 6.39 (IQR 3.71–10.55). 68.1% of the ulcerative colitis (UC) patients had pancolitis and 48.7% of CD patients had ileocolonic disease. 39.5% of patients were started on biologic treatment and 7.1% underwent surgery. Kaplan Meier curves demonstrated that patients diagnosed in the years 2012 -2019 had shorter duration of progression to biologics than those diagnosed 2005–2011 (p=0.0047). In patients with CD those with perianal or stricturing disease progressed faster to biologic treatment (p=0.024,p=0.038, respectively) and in UC patients those with high severity of disease (p=0.017). 63.6% of patients were reported to be on clinical remission on the biologic treatment.

Conclusion
Although VEOIBD patients have more extensive diseas, they require less biologic treatment than previously reported in older patients. Factors influencing shorter duration of progression to biologics were the severity of disease and behaviour and not disease location. Patients diagnosed more recently had shorter duration to biologic treatment which might reflect physicians perception on using biologic treatment in these young patients rather than disease severity.
P169 Vitamin D levels are inversely associated with inflammation in pediatric InflammatoryBowel Disease patients
Authors: Cenni S , Russo G , De Nigiris A , Casertano M , Pacella D , Miele E , Martinelli M , Staiano A , Strisciuglio C 
Published: May 2021

Abstract

Background
Multiple pathways link Vitamin D status with the risk of development and the clinical course of Inflammatory Bowel Disease (IBD). However, limited studies have been conducted on the relationship between vitamin D and disease activity in IBD, especially in pediatric population and the results have been inconsistent. Moreover Vitamin D metabolites may provide a more precise assessment of sufficiency and mineral metabolism than total 25-hydroxyvitamin-D (25(OH)D). The aim of our study was to evaluate the concentrations of total25(OH)D, 24,25-dihydroxyvitamin D (24,25(OH)2D) and calcitriol (1,25-(OH)2D) to correlate these values with the disease activity markers.

Methods
We prospectively enrolled all IBD pediatric patients. Total 25(OH)D, 24,25(OH)2D and1,25-(OH)2D levels were measured by enzyme-linked immunosorbent assay (ELISA). In each patient with IBD, the activity scores of disease and the main inflammation markers were correlated to Vitamin D metabolites. We prospectively enrolled all IBD pediatric patients. Total 25(OH)D, 24,25(OH)2D and1,25-(OH)2D levels were measured by enzyme-linked immunosorbent assay (ELISA). In each patient with IBD, the activity scores of disease and the main inflammation markers were correlated to Vitamin D metabolites.

Results
One hundred twenty three consecutive IBD children were enrolled, 43% with Crohn Disease (CD),55% Ulcerative colitis (UC), 2% indeterminate colitis. No difference in 25(OH)D,24,25(OH)2D and 1,25-(OH)2D levels were found between CD and UC patients. A significant indirect correlation was found between C reactive protein and 1,25-(OH)2D levels in patients with IBD (r=-0.275, p=0.046) and in CD group (r=-0.477, p=0.039). Moreover, in patients with IBD and CD we found a significant indirect correlation between erythrocyte sedimentation rate(ESR) and 25(OH)D (r=-0.212, p=0.024 and and r=-0.282, p=0.047 respectively). Instead, in the UC group we found only a direct correlation for both fibrinogen and ESR with 1,25-(OH)2Dlevels (r=0.407, p 0.028 and r=0.446, p=0.013).

Conclusion
Our results suggest that both the active form and the total Vitamin D levels are inversely associated with disease activity especially in CD children. Further studies are needed to clarify the role of Vitamin D deficiency as a consequence or a cause of inflammation.
P175 Complete endoscopic healing is associated with lower disability than partial mucosal healing in Crohn’s disease: a prospective multicentric study
Authors: Yzet C , Brazier F , Sebbagh V , Vanelslander P , Dejour V , David B , Nguyen-Khac E , Diouf M , Fumery M 
Published: May 2021

Abstract

Background
Crohn’s disease (CD) has a significant impact on health status and quality of life, by affecting physical and emotional well-being and by impairment of social and functional abilities. In the era of treat to target concept, endoscopic healing has emerged to be the goal to achieve to prevent intestinal damage and disability. It is not clear what level of endoscopic healing is associated with CD disability. We, therefore, aimed to compare disability associated to complete endoscopic healing or partial endoscopic healing in patients with CD.

Methods
We conducted a multicentric prospective study, between September 2019 and November 2020, in one University Hospital, one general hospital and one private practice center including consecutive patients with CD in clinical remission and either complete mucosal healing (CDEIS =0) or partial mucosal healing (CDEIS &gt; 0 and ≤ 4). The 10-item self-questionnaire IBD-disk was used to assess disability. Moderate-to-severe disability was defined as an overall IBD-disk score ≥ 40.

Results
A total of 82 patients were included. Forty-four (53%) were women, the median age and disease duration were respectively 35.3 years (Interquartile range (IQR 28.6–45.2) and 8.0 years (IQR, 3.0–17.0). The median overall IBD-disk score was 26.5 (IQR, 9 -45.0) and 30 (36.6%) had moderate-to-severe disability. Complete endoscopic healing was observed in 48 patients (57.3%). Median IBD-Disk score was respectively 24 (IQR, 9.0–40.5) and 34 (IQR, 9.5–51.5) for patients with complete and partial endoscopic healing (p=0.068). Respectively, 13/48 (27%) and 17/34 (50%) of patients with complete and partial endoscopic healing had moderate-to-severe disability (p=0.039). In multivariate analysis, partial mucosal healing (OR=3.04, CI95% [1.11, 8.94], p=0.03), female gender (OR=3.93, CI95% [1.43, 11.94], p=0.008) and smoking (OR= CI95% 5.88 [1.72, 25.0] p=0.039) were significantly associated with moderate-to-severe disability. Among the IBD-disk subscores, defecation score (median, IQR) (0.0 [0.0–3.0] vs 4.0 [0.0–7.5], p=0.028) and energy score (4.0 [0.0–6.0] vs 6.0 [2.5–8.0], p=0.023) were significantly lower in complete endoscopic healing.

Conclusion
One-third of patient with endoscopic healing reported moderate-to-severe disability. Complete endoscopic healing (CDEIS = 0) was associated with lower disability than partial endoscopic healing (CDEIS &gt; 0 and ≤ 4) in CD. Deeper endoscopic healing may be needed to reduce the risk of disability in CD.
P177 Adherence to a bowel cleansing regimen for pan-enteric capsule endoscopy in patients with suspected Crohn’s disease and factors affecting the image quality
Authors: Jacob Broder B , Karina Winther A , Jensen M D 
Published: May 2021

Abstract

Background
Pan-enteric capsule endoscopy (CE) is an attractive diagnostic approach in patients examined for Crohn’s disease (CD). The current bowel cleansing regimen was developed for patients with suspected gastrointestinal neoplasia (polyps). Since the majority of patients with CD have diarrhoea, a reduced volume of bowel preparation may be sufficient for cleansing the colon. The aim of this study was to examine the adherence to the recommended bowel cleansing regimen in patients with suspected CD examined with pan-enteric CE and determine clinical factors affecting the image quality.

Methods
Patients with clinically suspected CD were prospectively enrolled in a trial examining non-invasive modalities for diagnosing CD (http://ClinicalTrials.gov Identifier NCT03134586). All patients had a standardized work-up including medical history, physical examination, blood and stool samples and pan-enteric CE. CE was performed with the PillCam™ Crohn’s capsule (Medtronic, Dublin, Ireland) after overnight fasting and bowel preparation with 2 + 2 litres of Polyethylene glycol (Moviprep®, PEG + ascorbic acid) and Sodium Phosphate booster as previously described by ESGE. Readers were blinded to the results of other examinations. The image quality was graded on a 4-point scale (poor, fair, good, excellent). A good or excellent image quality defined a diagnostic procedure.

Results
The volume of ingested PEG was recorded in 59 patients (Table 1). The mean volume was 2.5 L (CI 2.3–2.8). 10 patients (17%) were able to drink all 4 L of PEG, and 44 patients (75%) ingested &gt; 2 L. The image quality was poor, fair, good or excellent in 0%, 29.3%, 29.3% and 41.4%, respectively. The mean volume of PEG was 1.9 L (CI 1.4–2.4), 2.2 L (CI 1.8–2.7) and 3.2 L (CI 2.8–3.5) in patients with a fair, good or excellent image quality (P &lt; 0,001, Figure 1). In a regression analysis including multiple clinical variables, only the volume of ingested PEG was associated with the obtained image quality (Spearman’s rho = 0.52; P &lt; 0.001). Stool consistency, number of bowel movements, diagnosis of inflammatory bowel disease (IBD) or the degree of inflammation did not affect the image quality. The diagnostic yield was equal in patients with a diagnostic or non-diagnostic image quality (44% and 44%, respectively). The capsule was excreted in 53 patients (90%), and the analysis was not able to determine factors affecting the completion rate.

Conclusion
In patients examined with pan-enteric CE for suspected CD, the ingested volume of PEG is the major factor affecting the image quality. However, only few patients are able to ingest the recommended volume. Future research should determine the optimal bowel cleansing regimen for patients examined for IBD.
P209 Prevalence and risk factors for fatigue in chronic inflammatory bowel disease
Authors: Hassine A , Hammami A , Braham A , Jaziri H , Jmaa A 
Published: May 2021

Abstract

Background
Fatigue is one of the most common symptoms reported by patients with chronic inflammatory bowel disease (IBD), being in flare or in remission. Thus, several fatigue measurement tools have been developed. The objective of our work was to assess the prevalence of fatigue in patients with IBD and its impact on daily life, and to determine its risk factors.

Methods
This is a cross-sectional study of patients followed for IBD who presented to our consultation during the three months preceding the study. Fatigue assessment was performed by IBD-F score (The Inflammatory Bowel Disease Fatigue Self-assessment Scale). The higher the score, the more disabling the fatigue. The activity of Crohn’s disease (CD) was assessed by the Harvey-Bradshaw index (HBI), that of ulcerative colitis (UC) by the clinical Mayo score.

Results
One hundred patients were included. Thirty-two patients (32%) had UC and 68 patients (68%) had CD. The mean age was 42.18 years [16–81 years], with a predominance of men (sex ratio = 1.5). Severe disease activity was noted in 14 patients (20.6%) with CD and 10 patients (31.3%) with UC. Extra-intestinal manifestations, particularly articular, were noted in 20% of cases. 36% of patients were in clinical remission. The prevalence of fatigue was 94.11% in MC and 93.75% in RCH. Fatigue was noted in 83.3% of patients in remission.Fatigue was severe (section I score between 11 and 20) in 40% of patients. We found a significant association and a linear correlation between the presence and severity of fatigue and CD activity (p &lt;0.001, r = 0.84), as well as UC activity (p &lt;0.001, r = 0.74). A significant association was found with extra-intestinal manifestations (p = 0.028), as well as with the presence of other chronic diseases (p = 0.014). In 30% of cases, fatigue was responsible for a functional handicap (section II score between 61 and 120). This effect was also strongly correlated with disease activity: MC (p &lt;0.001, r = 0.74) and RCH (p &lt;0.001, r = 0.73).

Conclusion
Assessing the severity of fatigue and its impact on the daily activities of patients is a crucial pillar in the management of patients with IBD. In our series, the prevalence of fatigue was 94%. It was associated and correlated with the degree of disease activity.
P211 Pseudopolyps are associated with increased fecal calprotectin levels in patients with Inflammatory Bowel Disease in clinical and endoscopic remission
Authors: Spigarelli De Rábago I , Suárez Ferrer C , Poza Cordón J , Martín Arranz E , Sánchez Azofra M , Rueda García J L , Suarez Cabredo C G , Hernández Pérez M , Martín Arranz M D 
Published: May 2021

Abstract

Background
Fecal calprotectin (FC) has become a fundamental tool in the non-invasive monitorization of activity in patients with inflammatory bowel diseases (IBD). However, there is still debate over the choice of the optimal cut-off point for the different clinical settings. The aim of this study is to analyze whether the presence of pseudopolyps and their characteristics have an impact on the value of FC and should therefore be taken into account when deciding the optimal cutoff values.

Methods
A single-centered, retrospective analysis including data from patients with colonic Crohn′s disease or Ulcerative colitis who underwent colonoscopy for dysplasia screening at our center between 2018 and 2019. Patients that did not have a FC registered within 8 months from to the colonoscopy, or that did not maintain clinical remission between the colonoscopy and the measurement of the FC, were excluded. Patients that had activity in the colonoscopy (Mayo endoscopic score &gt;0, SESCD &gt;0) were also excluded.

Results
73 patients were included. 26 (35.6%) of them had pseudopolyps in the colonoscopy. The median value of the FC was significantly different in patients with pseudopolyps (110.1 µg/g, CI 95% [48.6–171.5]) compared to those without them (52.5 µg/g, CI 95% [29.9–75.1]). In 11 (42.3%) of the patients with pseudopolyps, biopsies were taken, observing histological activity in 3 of them (27.3%) and no inflammatory activity in the other 8 (72.7%). We found that FC was higher in patients with inflammatory polyps (119.0 µg/g) in comparison to those without histological activity in their pseudopolyps (96.9 µg/g); however, these results were not statistically significant. The location of the pseudopolyps had no influence over the FC in our study. In addition, no correlation was found between the presence of polyps or diverticula and FC.

Conclusion
In our study, the presence of pseudopolyps is associated with significantly higher levels of FC. Moreover, our results suggest a tendency towards higher FC in patients who had active colitis in the histological samples of their pseudopolyps.