bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0450 World-wide Development and Validation of the IBD LIFE Questionnaire and Country-specific Patterns of Normal Life Impairment
Authors: Van Oostrom J , Anjie S , Lasa J , Karimi N , Horrigan J , Sareen H , Adi B , Ganesh G , Parks M L , Broër C , de Kruif A , Peyrin-Biroulet L , Ye B D , Banerjee R , Olivera P , Siegel C , Connor S , Gecse K , D’Haens G ,   IBD LIFE consortium
Published: January 2025

Abstract

Background
For patients with inflammatory bowel diseases (IBD), the ultimate goal is to live a ‘normal life’, yet no validated patient-reported outcome measure (PROM) exists to assess this. We aimed to develop and validate a globally relevant PROM to assess the impact of IBD on normal life through a world-wide, patient-centred approach, the ‘IBD LIFE’.

Methods
Patients with Crohn’s disease (CD) or ulcerative colitis (UC) from Argentina, Australia, India, the Netherlands, South Korea, and the USA without ostomies, pouches, or significant comorbidities were eligible. The development phase involved (A) patient interviews, (B) a Delphi consensus, (C) patient focus groups, (D) pilot-testing, and (E) cross-cultural translation, resulting in a 23-item PROM with five domains: physical, activities, social, psychological, and circumstances.
For the validation phase, CD and UC patients speaking Dutch, English, and Spanish were recruited (n=100 per disease, per language). IBD LIFE and generic and IBD-specific quality of life (QoL) PROMs ((Short-From-36 (SF-36) and IBD Questionnaire (IBDQ)) were administered at baseline, 2 weeks (n=30 per language) and ≥8 weeks. Clinical disease activity was measured at baseline and ≥8 weeks using Harvey Bradshaw Index (HBI) for CD and Simple Clinical Colitis Activity Index (SCCAI) for UC. Construct validity was tested through correlations between baseline indices, repeatability using intraclass correlation coefficient (ICC) in patients with stable QoL at 2 weeks, and responsiveness through a Receiver Operating Characteristic curve analysis for detection of a clinically meaningful change in IBDQ at ≥8 weeks. Country-specific normal life impairment patterns were assessed using total IBD LIFE scores and domain weights.

Results
Among 605 patients (300 CD/305 UC, table 1), IBD LIFE’s construct validity was supported by strong correlations with QoL indices (IBDQ r=-0.90; SF-36 r=-0.83), and moderate correlations with clinical disease indices (HBI r=0.52; SCCAI r=0.51). IBD LIFE showed strong repeatability (ICC=0.91) and responsiveness (AUC=0.873).
IBD LIFE scores ranged from 0-90 (mean 18.51 ± 18.73), with higher scores being associated with more impairment on normal life. Physical and psychological domains had most impact on patients’ lives (indicated by highest domain weights, figure 1). USA patients had the lowest IBD LIFE score compared to other countries (mean 12.27 ± 14.20; P&lt;0.001), yet showed disproportionately higher impact in the physical domain and lower impact in activities (Figure 1).

Conclusion
IBD LIFE, developed with extensive patient involvement, is a valid PROM of IBD’s impact on normal life. It allows tailored patient support to achieve normal life across all life domains affected by IBD.
P0456 Peripheral blood eosinophilia: A novel predictor of disease severity in Inflammatory Bowel Disease - A single-center retrospective study
Authors: Saidani R , Cherif D , Hassine H , Yacoub H , Debbabi H , Kchir H , Maamouri N 
Published: January 2025

Abstract

Background
Identifying early predictors of disease severity in inflammatory bowel diseases (IBD) remains crucial for optimizing therapeutic strategies. We investigated whether peripheral blood eosinophilia (PBE) at diagnosis could predict long-term outcomes in adult IBD patients.

Methods
We conducted a retrospective analysis of 128 IBD patients (78 Crohn’s disease [CD], 50 ulcerative colitis [UC]) diagnosed between 2003 and 2021, comparing them with 49 non-IBD controls. PBE was defined as an eosinophil count exceeding 0.5 × 109/L. We defined severe disease course as meeting any of these criteria: corticosteroid dependency, requirement for multiple biologic therapies (≥2 different classes), or surgical intervention. Disease location, behavior, and severity were classified according to Montreal classification. Outcomes were analyzed using Cox proportional hazard models.

Results
PBE was detected in 17 IBD patients (13.3%) compared to 2 controls (4.1%, p&lt;0.001). UC patients showed higher PBE prevalence with 8 cases (16%) versus 9 CD patients (11.5%). Regarding disease location in CD patients with PBE, 5 patients (55.5%) had ileocolonic involvement, 3 (33.3%) had isolated ileal disease, and 1 (11.1%) had isolated colonic disease. In UC patients with PBE, 6 (75%) had extensive colitis. During the follow-up period (median 5.2 years), PBE-positive patients demonstrated significantly worse outcomes: 14 out of 17 (82.3%) developed severe disease course compared to 45 out of 111 (40.5%) PBE-negative patients. PBE-positive patients required more frequent hospitalizations (71% vs 35%), had higher rates of corticosteroid use (88% vs 45%), and increased need for biological therapy (76% vs 38%). Notably, 65% of PBE-positive patients developed corticosteroid dependency compared to 30% in the PBE-negative group. Multivariate analysis confirmed PBE as an independent predictor of severe disease course (HR = 1.49, 95% CI: 1.38-1.62, p&lt;0.001).

Conclusion
This study establishes PBE as a valuable prognostic marker for IBD severity. The presence of eosinophilia at diagnosis strongly correlates with a more aggressive disease course, suggesting the need for early therapeutic optimization in these patients. These findings not only provide a simple and accessible prognostic tool but also highlight eosinophils as a potential therapeutic target in IBD management. Further prospective studies are warranted to validate these findings and explore eosinophil-targeted therapies.
P0460 Intestinal ultrasound in inflammatory bowel disease: Do we really need experts to monitor our patients?
Authors: Achemlal A , Taibi O , Ouahid S , Salaheddine T , Saouab R , Tamzaourte M 
Published: January 2025

Abstract

Background
Intestinal ultrasound (IUS) has emerged as an important tool in monitoring inflammatory bowel disease (IBD) due to its accessibility, cost-effectiveness, and non-invasive nature, making it an attractive option for gastroenterologists. Our study aimed to assess the agreement between young sonographers and experts in the interpretation of IUS examinations in patients with IBD

Methods
We video-recorded the IUS of a patient with ulcerative colitis in severe acute relapse. A cine-loop of the sigmoid colon was made from the video including a longitudinal and transverse B-mode and CDS-mode. The cine-loop and an electronic form, were sent to 30 radiology residents (Ten in their 2nd year, ten 3rd year and ten 4th year, chosen randomly), along with an IUS expert with 10 years’ experience. Participants were asked to complete the electronic form including key parameters in IUS, such as bowel wall thickness [BWT], color Doppler signal [CDS] (using the modified Limberg score), inflammatory fat [i-fat], bowel wall stratification loss [BWS], haustration loss and presence of lymph nodes. Two scores covering these parameters were also used: Milan ultrasound criteria (MUC) and the International Bowel Ultrasound Segmental Activity Score [IBUS-SAS]. Inter-observer reliability was analyzed using Cohen’s Kappa coefficient (Jamovi version 2.3)

Results
The expert’s findings compared to the average values reported by all residents were as follows: BWT (6.04mm vs 6.3mm ± 3.63), MUC (10.46 vs 10.7 ± 4.81), IBUS (87.17 vs 65.6 ± 21.7). A strong positive association was found between the 3rd and 4th years for BWT (r= 0.562), although not statistically significant (p= 0.091). Fair agreement was found for BWS [κ = 0.329, p= 0.003]. No significant differences in BWT, MUC, IBUS, and modified Limberg score values were found between the three groups of residents (p= 0.762, p= 0.759, p= 0.922, and p= 0.781 respectively). When compared with the expert’s values, there were no significant differences between the BWT and MUC values (2nd year p= 0.625, 3rd year p = 0.492, 4th year p= 0.375). In contrast, the residents’ IBUS and modified Limberg score values were significantly different from the expert’s values (IBUS: 2nd year p= 0.002, 3rd year p= 0.05, 4th year p= 0.01, Limberg: 2nd year p= 0.01, 3rd year: p= 0.017, 4th year p= 0.025)

Conclusion
This study has shown us that our young sonographers are providing encouraging results in the monitoring of IBD. However, the presence of an expert in intestinal ultrasound remains essential in the evaluation of the various ultrasound parameters. Current recommendations in gastroenterology place IUS for IBD in the spotlight, and it is essential that our collaborators can easily help us in the monitoring of these patients
P0464 exploring the Relationship Between Gender, Age at Onset, and the Presence and Severity of Ano-Perineal Lesions in Inflammatory Bowel Disease
Authors: Elommal H , Koulali H , Elmqaddem O , Zazour A , ismaili Z , Kharrasse G 
Published: January 2025

Abstract

Background
Ano-perineal lesions (APLs), including fissures, abscesses, fistulae, and thrombosed hemorrhoids, are common complications in inflammatory bowel disease (IBD). While several factors have been linked to the development of APLs, the impact of gender and age at disease onset on the prevalence and severity of these lesions remains underexplored. This study investigates the relationship between gender, age at IBD onset, and the presence and severity of APLs.

Methods
A retrospective cohort study was conducted on IBD patients to assess the relationship between gender, age at disease onset, and the presence and severity of ano-perineal lesions. The severity of APLs was categorized as mild (isolated lesions) or severe (complex fistulae, extensive abscesses). Age at onset was classified as early (&lt;30 years) or late (&gt;30 years). Statistical analysis, including chi-squared tests and multivariate logistic regression, was used to determine the correlation between these variables.

Results
• Gender differences: Male patients were more likely to present with fistulae (45%) and abscesses (34%) compared to females (fistulae: 32%, abscesses: 22%). Women, however, were more likely to have thrombosed hemorrhoids (25% vs. 15% in males).
• Age at onset: Patients with early onset of IBD (&lt;30 years) had a significantly higher likelihood of developing severe APLs (OR: 2.8, p &lt; 0.01). Early onset was also associated with a higher prevalence of fistulae and abscesses (40% and 35%, respectively) compared to those with late-onset disease (30% and 20%).
• Severity correlation: Early-onset IBD patients had more complex ano-perineal lesions, with severe fistulae and abscesses noted in 55% of cases. In contrast, late-onset patients had a significantly lower severity (25% of cases were severe). Gender further influenced severity, with males more likely to develop severe APLs (fistulae and abscesses) than females, particularly among early-onset cases.
• Multivariate analysis: Gender (p = 0.02) and early age at onset (p = 0.01) were independently associated with a higher likelihood of severe APLs, with males showing a higher risk of complex lesions.

Conclusion
Both gender and age at onset are significant predictors of the presence and severity of ano-perineal lesions in IBD patients. Early-onset disease and male gender are associated with more severe and complex APLs, especially fistulae and abscesses. These findings emphasize the importance of early diagnosis and gender-specific management strategies for patients at higher risk of developing severe ano-perineal complications in IBD.
P0467 Increased risk for depression and low quality of life in patients with active inflammatory bowel disease
Authors: Topala M.D.- PhD student M , Ionescu V , Iacob R , Gheorghe C 
Published: January 2025

Abstract

Background
Patients diagnosed with inflammatory bowel disease (IBD) are at increased risk of developing mental health issues, such as depression, especially when experiencing disability and poor quality of life (QoL). Recent studies showed that the relationship between depression and IBD appears to be bidirectional, through the brain-gut axis.

Methods
We aimed to evaluate the risk for depression and the QoL in patients with active IBD hospitalized between January 2021-April 2024 in our clinic, at the moment of biologic initiation and at 6 months follow-up, for those achieving clinical remission. We screened for symptoms of depression using the self-administered Center for Epidemiologic Studies Depression Scale (CES-D) – ranging score 0-60 (0-15 no to mild; 16-23 moderate; 24-60 severe symptomatology). The self-administered Short Inflammatory Bowel Disease Questionnaire (SIBDQ) was used to evaluate the health-related QoL through social, bowel, emotional and systemic dimension, with a score ranging from 10 (poor) to 70 (optimal).

Results
We included 47 patients (53.19% ulcerative colitis, 57.44% males, age 38.51±12.26 years old), with a disease duration of 6.43±6.28 years. 21 patients were reevaluated at 6 months. In patients with active IBD, the CES-D score was 14.15±13.04 and the SIBDQ score was 42.2±15.8 (42.6±19.2 social; 44.3±16 bowel; 43.6±16.9 emotional; 36.5±18 systemic). 18 patients (38.29%) were at risk for clinical depression, of whom 11 patients (23.40%) had severe depressive symptomatology. Patients being at risk for depression had lower SIBDQ scores (p&lt;0.001), lower levels of serum albumin (p=0.007) and lower body mass index (p=0.004). In the subgroup analysis, both CES-D (17.23±15.63 vs. 8.09±7.19, p=0.005) and SIBDQ (40.81±16.45 vs. 56.09±10.68, p=0.002) were significantly improved after achieving clinical remission.

Conclusion
Considering the high rate of patients prone for depressive symptomatology, screening tools for depression and assessing QoL should be routinely used, and specialized psychiatric treatment should be integrated in the comprehensive care for IBD patients.
P0468 Prevalence of traditional cardiovascular risk factors in Crohn’s disease
Authors: Fissah M , Rechach A , Charifi M , Menzou F , Djouhri M , Touati N , Talbi L , Chibane A 
Published: January 2025

Abstract

Background
Cardiovascular risk in inflammatory bowl disease (IBD) has only recently been described, whereas the increased risk of venous thromboembolic events in IBD was identified long before. An excess risk of ischaemic heart disease and stroke of around 20% has already been demonstrated. Are traditional cardiovascular risk factors the best way of assessing this excess risk? Our aim is to determine the frequency of traditional risk factors in Crohn’s disease

Methods
This was a prospective observational study involving 118 patients with CD. All patients were thoroughly interviewed, and screened for arterial hypertension by self-measurement validated by the European Society of Cardiology (ESC), fasting blood glucose, glycated haemoglobin and lipid profiles, the rest of the factors were gathered through questioning. The data collected was entered and analysed using EPIINFOV and SPSS statistical software.

Results
There were 70 men (59.3%) and 48 women (40.7%) with a sex ratio of 1.46. The mean age was 36. 49 +/- 11.62 with a median of 34 years and extremes of 19 and 67 years, There were only five subjects whose age represented a risk factor - two men and three women In our population, the family history of cardiovascular disease was 10.2%, smoking as a cardiovascular risk factor was present in 28% of patients, arterial hypertension was present in only 10.2% of patients, with a non-significant female predominance with a p = 0.06, In our series there were only two type 2 diabetic patients on metformin, Only 11.9% of our subjects were sedentary. In our female population, 16.7% were postmenopausal for more than ten years, 57.6% of our patients had dyslipidaemia (according to ESC 2017), the cardiovascular risk was low in the majority of our patients at 88.1% according to the Framingham score.
The prevalence of traditional risk factors in our population is low. This result is consistent with those in the literature, which may be due to the specific features of Crohn’s disease, such as weight loss or hypovolaemia during flare-ups, but also to the fact that our population is young?

Conclusion
The low frequency of traditional cardiovascular risk factors does not explain the increased risk of developing cardiovascular disease found in Crohn’s disease. The study of non-traditional risk factors is imperative and could explain this paradox.
P0469 Impact of gynecologic malignancy on ileal pouch-anal anastomosis survival: a matched case-control study
Authors: Unal E , Lavryk O , Kanters A , Spivak A , Falloon K , Naseer M , Qazi T , Lipman J , Michener C , Hull T , Debernardo R , Holubar S 
Published: January 2025

Abstract

Background
Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard operative treatment for patients with medically refractory inflammatory bowel disease or familial adenomatous polyposis requiring colectomy. In patients who develop malignancy after IPAA, chemoradiation has been shown to increase the risk of pouch failure in small studies. We aimed to describe pouch survival in patients who underwent surgery for gynecologic malignancy (GYN-Ca).

Methods
We retrospectively reviewed adults who underwent IPAA and developed gynecologic cancer afterwards between 2000 and 2023. Patients with IPAA and GYN-Ca were matched using 1:5 nearest neighbor propensity score matching to control patients with history of IPAA only, on age, year of IPAA, colorectal diagnosis, and procedure. Demographics, operative data, complications, and pouch survival were collected.

Results
We identified 15 patients diagnosed with GYN-Ca after IPAA who underwent surgery (Table 1). The most common GYN-Ca was endometrial cancer (53%); overall, 14 (93.3%) underwent hysterectomy, while 1 (6.7%) underwent salpingo-oophorectomy; 80% had no short-term postoperative complications. After GYN-Ca in IPAA patients, median overall survival was 51 (21-106) months; median disease-free survival was 41.3 (8-106) months. Pouch failure was seen in 5 (33%) patients, of these, 2 patients (40%) had pouch revision, 2 patients (40%) had pouch excision with permanent end ileostomy and 1 patient (20%) had only permanent end ileostomy. Etiology of pouch failure included radiation enteritis of the pouch (n=2, 40%), afferent limb syndrome from IPAA stenosis (n=1, 20%), inlet obstruction due to Crohn’s stricture (n=1, 20%), and recurrent anastomotic leak secondary to invasive ovarian cancer recurrence (n=1, 20%). After matching, 75 control patients were included for a total of 90 unique patients. The pouch failure rate in the Gyn-Ca and matched control groups were 33% vs. 5.3%, p=0.002, respectively. Kaplan-Meier survival analysis (Figure 1) showed a hazard ratio for pouch failure in GYN-Ca patients of 2.34 (p=0.18, robust SE 0.63) compared to matched control patients, a clinically but not statistically significant result likely due to lack of power.

Conclusion
In experienced hands, surgery for gynecologic malignancy in pouch patients was safe with an accepted rate of post-operative complications. However, the patients who suffered recurrence or underwent chemoradiation were at increased risk of pouch failure compared to healthy control pouch patients. Patients who develop gynecologic malignancy after IPAA should be monitored closely for pouch dysfunction using a multidisciplinary approach to optimize pouch survival after pelvic surgery.
P0476 Long-term outcomes of patients with negative small bowel video capsule endoscopy performed for suspected Crohn’s disease: A cohort study
Authors: Edelman-Klapper H , Avni-Biron I , Ollech J E , Hegger S , Levi Z , Dotan I , Yanai H 
Published: January 2025

Abstract

Background
Crohn’s disease (CD) is a heterogeneous condition that can affect the entire gastrointestinal tract, with isolated small bowel (SB) involvement occurring in 20–30% of patients. According to ECCO and other international guidelines, the standard diagnostic approach for CD includes ileocolonoscopy and cross-sectional SB imaging. When these modalities yield inconclusive results, video capsule endoscopy (VCE) is recommended for evaluating SB mucosa. Despite negative findings on comprehensive evaluations, a significant proportion of patients continue to experience symptoms suggestive of CD.
This study aimed to assess the long-term outcomes of patients with a negative comprehensive assessment for CD and a negative VCE study.

Methods
This retrospective cohort study was conducted at a large tertiary inflammatory bowel disease (IBD) center in Israel, serving a broad catchment area and providing VCE services for the entire national population insured by the largest Israeli health maintenance organization. Patients referred for VCE due to suspected CD and inconclusive endoscopy and cross-sectional imaging findings between 2008 and 2017 were included. Two individual capsule endoscopy readers revised all VCE studies. Longitudinal electronic medical records were analyzed to identify subsequent CD or alternative diagnoses. Clinical and laboratory data at the time of the index VCE were also evaluated.

Results
A total of 615 patients were included, of whom 354 (57.5%) were female, with a median age of 36 years (IQR: 27–55). CD was diagnosed in 192 patients (31.2%) based on the index VCE, with a median Lewis score (LS) of 900 (IQR: 450–1350). The remaining 423 patients (68.8%) had normal or minimal findings (LS &lt;135) on VCE. This sub-cohort with negative VCE findings was further followed for a median duration of 8 years (IQR: 5–10; range: 3–12), corresponding to 3,042 patient years of observation. Notably, during follow-up, only 19 patients (4.5%) were diagnosed with CD; the majority based on clinical judgement alone (with no other objective findings), while one patient was diagnosed after a third VCE study. The median time to CD diagnosis was 1.5 years (IQR: 1–3) post-index VCE. Neither clinical symptoms nor basic laboratory results at the time of index VCE predicted CD diagnosis following the negative index VCE.

Conclusion
The incidence of CD diagnosis following a negative VCE study is exceptionally low, with most diagnoses occurring early after the index study. Patients with negative VCE findings may benefit from further diagnostic evaluation to investigate non-CD etiologies for their symptoms.