bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION OF HIDRADENITIS SUPPURATIVA AND INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Polpichai Natchaya , Trongtorsak Angkawipa , Sereeaphinan Chudapa , Danpanichkul Pojsakorn , Wattanachayakul Phuuwadith , Wetwittayakhlang Panu 
Published: January 2024

Abstract

INTRODUCTION
Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic inflammatory skin condition that affects apocrine gland-bearing areas. Previous studies have demonstrated that HS is potentially associated with various autoimmune diseases. However, the relationship between HS and inflammatory bowel disease (IBD) has been unclear.

METHODS
A comprehensive literature search was conducted in electronic databases, PubMed and Embase, from inception to October 2023. We included published studies that provided estimated effects with a 95% confidence interval (CI) or raw data. The quality of the selected studies was evaluated using the Newcastle-Ottawa Scale. Crohn's disease and ulcerative colitis were analyzed separately. Data from each study were combined using the random-effects model and the generic inverse variance method to calculate the pooled odds ratio (OR) with a 95% confidence interval (CI) and I2 statistics.

RESULTS
Ten case-control studies involving 26,496,569 individuals (110,648 with HS and 26,385,921 without HS) were included in this meta-analysis. HS was associated with significantly higher risk in the IBD group (Pooled OR 2.18; 95% CI 1.42-3.32; P = 0.0003; I2 = 97%). Additionally, our analysis demonstrated a significant association between HS and ulcerative colitis (Pooled OR 1.49; 95% CI 1.26-1.78; P &lt; 0.00001, I2 = 63%) and between HS and Crohn's disease (Pooled OR 1.79; 95% CI 1.33-2.40; P = 0.0001; I2 = 88%).

CONCLUSION
Our meta-analysis demonstrated that HS is significantly associated with IBD and IBD subtypes (Crohn's disease and ulcerative colitis). This finding emphasizes the need for awareness when patients with HS present with symptoms associated with IBD. Further studies should be conducted to understand the mechanism of the gut-skin axis in shared immune and inflammatory processes.
HERMANSKY-PUDLAK SYNDROME-ASSOCIATED INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW ON CLINICAL MANIFESTATIONS AND INVESTIGATIONS INTO OPTIMAL MANAGEMENT
Authors: Miranda Clive , Javaheri Nariman , Carlson Alexander , Aijaz Ali , Nallapeta Naren 
Published: January 2024

Abstract
Hermansky-Pudlak Syndrome (HPS) is a rare autosomal condition resulting from a mutation in 1 of at least 7 different genes leading to the triad of tyrosine-positive oculocutaneous albinism, platelet dysfunction leading to prolonged bleeding time, and ceroid lipofuscin within the reticuloendothelial system. The latter of these can result in systemic derangements including renal failure, pulmonary fibrosis, cardiomyopathy, and a disabling granulomatous colitis. This colitis is a unique type of inflammatory bowel disease (IBD) with complications such as intestinal fistulization, ileitis, enterocolitis and perianal disease. There is data to suggest that HPS colitis is due to the development of classical IBD. However, optimal management remains undetermined. Our systematic review aims to analyze the clinical presentation behind HPS colitis, endoscopic versus histopathological findings, and ultimate treatment plans required for optimal management of this disease among HPS genotypes.
A comprehensive literature review was conducted on patients with HPS and its associated colitis manifestations from inception to August 2023. Analyses on patient demographics, clinical presentation, HPS genotype, endoscopic versus histopathological findings, medical versus surgical interventions were thoroughly performed.
Six cohort studies on HPS patients with coexisting colitis were identified. A total of 84 patients comprised these studies with mean age 32 +/- 9.65. Racial breakdowns were 68% Puerto Rican, 23% white, 4% Indian, 2% Mexican, 1% Honduran, and 1% African American. 59 patients had the HPS-1 genotype, 8 with HPS-3, 3 with HPS-4, and 1 with HPS-6. The most common presenting symptoms were hematochezia (37%), diarrhea (23%), abdominal pain (16%), and constipation (10%). Endoscopic evaluation showed normal gross findings in 65% of cases and abnormalities in only 35%. However, IBD-associated histopathological positivity was more prevalent with the most common findings being granulomas (33%), macrophages without colitis (19%), macrophages with colitis (15%), and lymphoid aggregates (10%). Medical therapy was initiated in 48 cases with the most common medications being steroids (46%), followed by anti-TNFa agents (40%), and immunomodulators (35%). 28 cases required surgical intervention with the most common operation performed being a (subtotal) colectomy and ileostomy. There were scattered cases of laparoscopic loop ileostomies, total colectomies, and proctocolectomies too. Interestingly, 10 patients received no intervention whatsoever.
HPS-associated colitis is a debilitating condition that remarkably resembles IBD. There is no consensus on optimal therapy and many patients ultimately require operative intervention. The HPS-1 gene appears to be highly prevalent in this condition and younger patients are more affected, however more research is needed.
INFLAMMATORY BOWEL DISEASE AND RHEUMATOID ARTHRITIS
Authors: Martinez Evelyn Calderon , Vilchez Esmeralda , Ng Wern Lynn , Gautam Seema Sharma , Gavilanes Diana , Joseph Maria , Zevallos-Delgado Christian 
Published: January 2024

Abstract
Inflammatory bowel disease has been associated with arthritis since the late 20th century, but it was not until a few decades ago that IBD-associated arthritis was recognized as a distinct pathology independent from rheumatoid arthritis (RA). There is evidence that RA and other autoimmune conditions exist in higher rates in patients with IBD compared to the general population. This is an important distinction because of the different pathophysiology, clinical manifestations, management, complications, and prognosis of both diseases.
METHODS: This study was reviewed and approved by the University of Pittsburgh Medical Center of Central Pennsylvania Review Board. Using Epic’s SlicerDicer function, patients with Inflammatory Bowel disease were identified using ICD-10 codes (K50 and K51). Those with incomplete information or duplicated were excluded obtaining a total of 3613 patients. Data collected included basic demographic information, surgical history, and the presence of Rheumatoid arthritis. We reported continuous variables as mean (range) and categorical variables as number (percent). We used Student’s t-test to analyze between group differences for the continuous variables. When it was determined that variances for the comparisons of continuous data were unequal, Welch-Satterthwaite t test statistics were used. We used chi-square test to analyze between group differences for the categorical variables. The Fisher exact test was employed when any of the expected frequencies was five or less. All tests were 2-sided with criterion for statistical significance at a p-value less than 0.05. All the analyses were done by SAS 9.4 (SAS Institute, Cary NC).

RESULTS: Of the approximately 2.7 million adults in SlicerDicer, there were 3613 patients (0.13%) identified with Inflammatory Bowel disease. Patients with Ulcerative Colitis accounted for 37% of the total group (n= 1343) and 2270 patients (62.8%) had Crohn’s Disease. From the total, 2084 were women (57.68%) and 1529 (42.32%) were men. The mean age was 53.3 +- 18.5. 848 (23.47%) had documented Rheumatoid arthritis. Mortality was higher in patients with IBD and RA than those with IBD alone (7.31% vs 3.98%, p value= &lt;0.0001). More than 90% of the patients were white (n=3321).
CONCLUSION: IBD patients with RA have higher mortality than patients with IBD alone.
THE ROLE OF ALCOHOL USE IN THE DEVELOPMENT OF CROHN’S DISEASE COMPLICATIONS: A RETROSPECTIVE ANALYSIS
Authors: Iqbal Humzah , Haddadin Rakahn , Haidary Hasib , Zhang Patrick , Prajapati Devang 
Published: January 2024

Abstract

BACKGROUND
Crohn’s disease (CD) is a type of inflammatory bowel disease (IBD) characterized by transmural inflammation that can occur anywhere along the gastrointestinal (GI) tract. Complications of CD include fistulization, abscess formation, and GI bleed. Many social and environmental factors have been associated with CD. The role of alcohol use remains unclear, with some studies suggesting that it may increase the risk of CD and worsen symptoms, and others showing no relationship between alcohol and CD. We aimed to assess the association between alcohol use and the development of CD complications using a large nationwide database.

METHODS
Patients with a diagnosis of CD were identified using the 2020 Nationwide Inpatient Sample (NIS). Patients were stratified based on whether they had a history of alcohol use. Outcomes included development of fistula, abscess, or bleed. Data were also collected regarding age, gender, race, primary insurance, median income, hospital region, hospital bed size, and comorbidities. The relationship between alcohol use and the development of fistula, abscess, or bleed among patients hospitalized with CD was analyzed using multivariate regression analysis.

RESULTS
A total of 178,279 patients with a diagnosis of CD were included in the study. Of these, 7,131 (4.0%) had a history of alcohol use. Patients in the alcohol group had lower odds of developing fistula (aOR 0.51, P &lt; 0.001) and abscess (aOR 0.42, P &lt; 0.001). There was no difference in the development of bleed in CD patients with alcohol use compared to without. Patients in the alcohol group had overall lower odds of developing any complication of CD (aOR 0.60, P &lt; 0.001).

CONCLUSION
CD is a chronic and complex inflammatory disease that can lead to a variety of GI complications including fistula formation, abscess, and bleeding. Many genetic, environmental, social, and immune factors play a role in the disease course. Our study found that alcohol use is associated with a decreased risk of developing CD-related fistula or abscess. Patients with a history of alcohol use have been shown to exhibit earlier and more severe GI symptoms in CD, possibly leading to earlier presentation. Additionally, alcohol use has been found to suppress the immune response, potentially explaining our findings. Further studies are needed to assess the role of alcohol in the pathogenesis and disease course of CD.

Inclusion process for the study.
DECIPHERING THE BURDEN OF INFLAMMATORY BOWEL DISEASE LANDSCAPE (1990-2019) IN HIGH INCOME NORTH AMERICA: PROJECTIONS, TEMPORAL SHIFTS, AND A GLIMPSE BEYOND TO 2040
Authors: Patel Rahul , Roy Vivek , Bollu Sashank Sai , Anne Sai Nitya Tejaswi , Naradasu Pranathi Royal , Patel Sneh , Desai Hardik Dineshbhai 
Published: January 2024

Abstract

BACKGROUND
In High-Income North America, IBD ranks as the 6th leading cause of disability and the 9th primary cause of mortality among all digestive diseases. The increasing prevalence in this region underscores the urgent need to address both the clinical and socio-economic challenges of managing this chronic condition in a developed setting.

METHOD
Utilizing Global Burden of DIsease tool, we estimated IBD prevalence, incidence, mortality, and Disability Adjusted Life Years (DALYs) of IBD in High-Income North America. Standardized statistical techniques facilitated comparisons by age, sex, year within this specific region. The DisMod-MR 2.1 tool was employed to estimate incidence and prevalence, while mortality rates were discerned using the Cause of Death Ensemble Model (CODEm). Additionally, we projected the deaths and Years of Life Lost (YLLs) up to 2040 using regression analysis.

RESULTS
From 1990 to 2019, the overall IBD prevalence in High-Income North America showed a decline from 1,100,006 (95%UI: 961,427-1,248,969) to 920,749 (859,032-982,587). However, deaths rose sharply from 2,442 (2,189-2,963) in 1990 to 6,313 (5,075-6,885) in 2019, marking an Annual Percentage Change (APC) surge of 159% (84-182). Meanwhile, DALYs grew by 17% (2-33). Age-Standardized Rates (ASR) indicate a reduction in incidence and DALYs rates by 30% and 22%, respectively, while mortality rates climbed by 42% (1-54). Country-specific trends show Canada and Greenland with incidence APC increases of 28% and 37%, respectively, while the U.S. saw a 12% decline. For mortality, the U.S. led with a 172% APC rise, followed by Greenland at 1,485% and Canada at 49%. In age-specific trends, children under five witnessed a 20% APC surge in incidence per 100,000 population, whereas the under-20 age bracket saw a 13% rise. Notably, those aged under 70 experienced an 89% jump in deaths from 1990-2019.

CONCLUSION
The marked shift in IBD prevalence and mortality in High-Income North America over three decades underscores the escalating challenge this disease presents to the healthcare landscape. The substantial increase in deaths, especially in countries like the U.S. and Greenland, combined with the age-specific trends, emphasizes the pressing need for targeted interventions and robust healthcare policies. Notably, in 2019, IBD was responsible for 4.43% of all deaths linked to digestive diseases and contributed to 6.13% of the total disabilities arising from digestive conditions. This data accentuates the profound and growing impact of IBD in the region and demands immediate, evidence-based action.
EVOLVING LANDSCAPE OF INFLAMMATORY BOWEL DISEASE IN G20 NATIONS (1990-2019): A COMPREHENSIVE GLOBAL ASSESSMENT
Authors: Patel Rahul , Sajeev Krishna , Sojitra Vani , Patel Krina Manojbhai , Naradasu Pranathi Royal , Patel Sneh , Desai Hardik Dineshbhai 
Published: January 2024

Abstract

BACKGROUND
As pivotal players in the global economy, the G20 countries not only lead in economic dynamics but also in health challenges. Recent data reveals an escalating burden of Inflammatory Bowel Disease (IBD) in these nations. Understanding this trend is crucial to frame healthcare strategies and ensure the well-being of a significant portion of the global population.

METHOD
We employed data on IBD prevalence, incidence, mortality, and DALYs for G20 countries from the Global Burden of Disease (GBD) 2019 study. Using standardized statistical techniques, we analyzed by age, sex, year and location across G20 countries, estimating incidence and prevalence with the DisMod-MR 2.1 tool and mortality through the Cause of Death Ensemble Model (CODEm).

RESULTS
From 1990 to 2019, IBD prevalence figures in the G20 nations escalated from 2,999,730 (95%UI: 2,625,581-3,416,963) to 4,254,467 (3,809,445-4,751,041), marking a 42% (38-46) surge in the Annual Percentage Change (APC). Meanwhile, the incidence rose by 30% (26-35), mortality by 72% (49-97), and DALYs by 27% (15-43). Among these nations, China witnessed a striking 314% increase in incidence, closely followed by South Korea at 288%. Death rates were most pronounced in European Union members, with Portugal at the helm (441%), trailed by Italy (433%) and Germany (418%). Germany also led in DALYs growth with a 289% APC. Examining Age-standardized mortality rates, Germany again topped the list with a 244% increase, shadowed by Italy (186%) and the United States (147%). Over the past three decades, older populations demonstrated a rising IBD burden. In gender comparisons, males experienced a more significant incidence increase (32% vs. females at 28%) and DALYs (30% vs. females at 24%). Conversely, females had a steeper death rate growth, 77% as opposed to males at 67%.

CONCLUSION
In 2019, IBD was responsible for 2.02% of digestive disease-related deaths and 2.30% of associated disabilities in the G20 nations. The stark rise in IBD prevalence, especially in countries like China, South Korea, and European Union members, emphasizes a pressing need for targeted clinical approaches and proactive health policies to mitigate this escalating burden.

Age-standardized rate (per 100,000 person years) of Inflammatory Bowel Disease in G20 Countries, 2019. A: ASIR, B: ASMR, C:ASDALR.
PATIENTS WITH ULCERATIVE COLITIS AFFECTED BY NON-ALCOHOLIC FATTY LIVER DISEASE HAVE A GREATER RISK OF MORTALITY AND WORSE CLINICAL OUTCOMES
Authors: Rahima Kenan , Khokhlov Leonid , Albuni Mhd Kutaiba , Hijazi Mohamad , Ikpeze Tochukwu , Muddana Venkata 
Published: January 2024

Abstract
Ulcerative colitis (UC) affects millions of patients worldwide and keeps trending upward. Non-Alcoholic Fatty Liver Disease (NAFLD) is an emerging disease predisposing to adverse outcomes. There is limited evidence of clinical outcomes of NAFLD in patients with UC. We sought to investigate this population.
METHODS: We queried NIS 2017-2020 for adults hospitalized with UC & NAFLD. The primary outcome was inpatient mortality. Secondary outcomes were cardiogenic shock, cardiac arrest, GIB, intubation, LOS & total hospital charge. Multivariable logistic regression analysis was used to estimate clinical outcomes.
RESULTS: There were 489870 hospitalizations with UC and 21695 (4.4%) had NAFLD. NAFLD & non-NAFLD cohorts had a mean age of 57 vs. 57.2 yrs; males 55.1% vs 46%; Caucasians 73% vs 75.8%; Heart failure 15% vs 12%; Pulmonary Hypertension (PH) 3.9% vs 2.5%; Acute Kidney Injury (AKI) 35% vs 17%; obesity 13% vs 13.4%; Dyslipidemia 24 % vs 30.6%; anemia 26.8% vs 22.6%; Acute Coronary Syndrome (ACS) 5.3% vs 3.6%; stroke 1% vs 1.4%, respectively.
CONCLUSION: The UC with NAFLD cohort showed significantly higher mortality, worse clinical outcomes & resource utilization (Table 1). They were older and had more of PH, AKI, anemia, and ACS. NAFLD is associated with greater risk for MACE, GIB, & ICU care. NALFD is an important risk factor among patients with UC that predicts adverse outcomes.
PROTEIN ARGININE METHYLTRANSFERASE 1 REGULATES ADULT INTESTINAL CELL PROLIFERATION AND ENTEROENDOCRINE CELLS DIFFERENTIATION
Authors: Peng Zhaoyi , Bao Lingyu , Shi Yun-Bo 
Published: January 2024

Abstract
The adult intestinal epithelium is a complex, self-renewing tissue composed of specialized cell types with diverse functions. Intestinal stem cells (ISCs) at the base of crypts divide and differentiate into absorptive and secretory cells. Enteroendocrine cells (EEC), one type of secretory cells, are the most abundant hormone-producing cells in mammals and involved in the control of energy homeostasis. Many studies investigated the mechanisms that control cell fate determination; however, regulation of EEC development and function are still unclear or controversial. Here, we found that Protein arginine methyltransferase 1(PRMT1), a major arginine methyltransferase, is highly expressed in the proliferating transit-amplifying (TA) cells and ISCs of adult mouse intestinal crypts. By using tamoxifen-induced intestinal epithelial cell-specific deletion of PRMT1 in adult mice, we observed the number of EEC dramatically increased. Transcription analyses showed the expression levels of Enteroendocrine-specific hormone and transcription factors are upregulated in PRMT1-deficient small intestine. In addition, the top enriched upregulated pathways were all associated with EEC functions. Concomitantly, Neurogenin 3-expressing progenitor cells accumulate in the mutant small intestine, and its target genes such as Neuod1, pax4, insm1 are upregulated of mutant crypts by RT-PCR. Furthermore, intestinal epithelium of the mutant mice showed elongated crypts in the small intestine, while increased cell proliferation in TA cells. Additionally, inducible PRMT1 deletion led to increased cell death, which compensated for increased cell proliferation in the crypts to maintain overall intestinal morphology and intestinal homeostasis. Together, our results revealed that the loss of PRMT1 in the adult intestinal epithelium altered TA cell proliferation and EEC differentiation, which was probably via Neurogenin 3-mediated pathway. Thus, our results may provide potential roles of PRMT1 as an essential transcriptional regulator of EECs specification and strategy for metabolic disorder.
COST-DRIVERS OF HEALTHCARE EXPENDITURES IN INFLAMMATORY BOWEL DISEASE
Authors: Berinstein Jeffrey , Melmed Gil , Allen John , Berry Sameer 
Published: January 2024

Abstract

INTRODUCTION
Inflammatory bowel diseases (IBD) are gastrointestinal (GI) conditions associated with significant costs. Effective management of IBD should focus on improving patient symptoms and outcomes while containing healthcare costs. To develop high-value treatment strategies and influence policy on high-value care, we must first have a better understanding of the primary drivers of cost in this population.

METHODS
We conducted a real-world descriptive cohort study using data from IBM Watson, which is a nationwide insurance claims database covering millions of commercially insured individuals across the US. We identified adult patients aged 18 to 65 years with encounters associated with a diagnosis of IBD in the primary or secondary position from January 2019 to January 2020 based on ICD-10-CM codes for Crohn's disease (555.x) and ulcerative colitis (556.x). Analysis of IBD prevalence, costs, and service utilization was based on ICD, CPT, and NDC codes related to IBD conditions and services. All other codes without an associated GI diagnosis in the primary or secondary position were attributed to all-cause costs. Measures of cost and utilization were calculated as a per member per year (PMPY).

RESULTS
105,496 patients with IBD were identified (Table 1). The mean PMPY total costs were $40,842 of which $31,051 (76%) were directly related to GI-related costs. Mean PMPY total costs in this population ranged from $1,178 to $144,945, with 15% of members experiencing costs &gt; $76,346 PMPY. The main drives of GI-related costs can be divided into the following three categories: Inpatient costs ($8,206 [26%]), outpatient medical service costs ($11,306 [36%]), and drug costs ($11,539 [37%]) (Table 2). Per member utilization includes: 0.22 inpatient admissions, 0.10 surgeries, 1.02 GI visits, 2.87 non-gastroenterologist GI visit (which could include a visit to a primary medical doctor, rheumatologist, dietician, etc), 4.57 GI-testing, 0.48 GI imaging, 0.61 GI endoscopy, and 1.07 biologic medication prescriptions.

CONCLUSIONS
IBD care carries a significant financial burden on the US healthcare system. Unplanned emergency service and medication utilization continue to make up the majority of costs of IBD care and need to be the focus of value-based interventions. While appropriate high-cost pharmaceutical utilization should not be reduced, innovative strategies leveraging more cost-effective medication delivery may provide an important opportunity to curb costs. Furthermore, the high rate of non-gastroenterologist GI visits suggests that there is a potential for optimizing care pathways, by incorporating multidisciplinary care including, PCPs, mid-level providers, and other ancillary services into the IBD care model.