bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0343 Gender Identity and Inflammatory Bowel Disease: The Patient Perspective
Authors: Colwill M , Jacob K , Pollok R , Poullis A 
Published: January 2025

Abstract

Background
The experience of transgender and gender non-conforming (TGNC) individuals in healthcare is under-researched particularly in relation to the impact of chronic diseases such as inflammatory bowel disease (IBD). IBD is believed to affect 1 in 123 individuals in the United Kingdom (UK)(1) and can have a profoundly negative impact upon both quality of life and mental health. However, the impact of the duality of suffering from IBD and identifying as TGNC is poorly understood and there is no data examining the experiences of these patient groups nor the specific challenges that they face when engaging with IBD healthcare services. We therefore aimed to explore the experiences of TGNC individuals with IBD (TGNC-IBD) in the UK healthcare system.

Methods
A literature review was performed to identify themes for discussion which were used to create an interview guide. Individuals who identified as TGNC and suffered from IBD were recruited through the charity Crohn’s and Colitis UK.(2) Participant information sheets were distributed to potential participants and once consented, an in-depth semi-structured focus group was performed with all participants. A second independent researcher reviewed the transcript and audio-visual recordings to ensure validity of the findings. Inductive thematic analysis was used to identify recurrent themes. Ethical approval was obtained from St. George’s University of London.

Results
Seventeen individuals contacted the team expressing interest in participating. Six respondents continued to engage and two pulled out on the preceding day. Four TGNC-IBD patients participated in the study with their demographics summarised in table 1. Six main themes emerged when discussing their experiences of healthcare encounters:
1. Healthcare professionals’ assumptions about gender identity
2. Inadequate mental health care provision
3. A lack of research and evidence-based practice specific to TGNC-IBD individuals
4. Distressing experiences due to gender-specific healthcare facilities
5. Transphobic comments from healthcare staff
6. The need for greater staff training.
Participants reported that these factors contributed to negative healthcare experiences and exacerbated both the physical and mental health challenges they faced.

Conclusion
TGNC-IBD individuals face unique challenges that negatively affect their healthcare experiences. Key areas for improvement include increased staff training, the creation of gender-neutral facilities and more research into the interplay between a TGNC identity and IBD. Addressing these concerns will enhance the quality of care and improve patient experiences for this underserved minority.

References
1.Crohn’s disease and ulcerative colitis in the UK. [Internet]. Available from: https://crohnsandcolitis.org.uk/news-stories/news-items/new-research-shows-over-1-in-123-people-in-uk-living-with-crohn-s-or-colitis
2.Crohn’s & Colitis UK [Internet]. [cited 2024 Oct 2]. Available from: https://crohnsandcolitis.org.uk
P0346 Pouch Fistulas: Experience From a Tertiary Center
Authors: Tubal Bronze S M , Wong S Y , Waite H , Plietz M , Hahn S , Greenstein A , Sylla P , Khaitov S , Colombel J F , Kayal M 
Published: January 2025

Abstract

Background
Ileoanal pouch-related fistulas (IAPRF) occur in up to 15% of patients with ulcerative colitis (UC) who undergo total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA). This study aimed to describe the frequency, risk factors, and outcomes of IAPRF in a large, single-center cohort of patients.

Methods
This is a retrospective study of patients who underwent TPC with IPAA at Mount Sinai Hospital between 2007 and 2022. The outcomes of interest were fistula development and remission defined as the resolution of both pain and drainage and closure of all external openings confirmed by imaging. Categorical data were presented as frequencies/percentages and quantitative data as mean ± SD. Associations were tested using chi-squared tests for categorical and Wilcoxon rank-sum for quantitative variables.

Results
Of the 772 patients who underwent IPAA at Mount Sinai Hospital, 98 (12.7%) developed pouch fistula. Among these, 34 had early-onset fistulas (within 12 months of the final surgical stage) and 64 had late-onset (beyond 12 months of the final surgical stage). The mean time to fistula occurrence was 3.8 months in the early-onset group and 5.1 years in the late-onset group. Of the 98 patients with IAPRF, 108 fistulas were identified, with the most common types being perianal (59.2%), pouch-vaginal (20.4%), enterocutaneous (11.1%), and enteroenteric (6.5%). Patients with early-onset IAPRF had higher rates of postoperative complications, including pelvic sepsis (5% vs. 2%, p=0.018), abscess formation (20% vs. 9%, p&lt;0.001), anastomotic leak (13% vs. 7%, p=0.017), abdominal pain (42% vs. 13%, p&lt;0.001), and fever (47% vs. 29%, p&lt;0.001) compared to those with late-onset IAPRF. In contrast, patients with late-onset IAPRF had higher rates of Crohn’s disease-like pouch inflammation (CDLPI) diagnosis (72% vs. 32%, p&lt;0.001) compared to those with early-onset IAPRF. Fistula remission occurred in 56% of early-onset and 38% of late-onset patients, and the incidence of pouch failure was similar (20.6% early-onset vs. 26.6% late-onset, p=0.53).

Conclusion
Early-onset fistulas were associated with post-operative complications, while late-onset were linked to CDLPI, highlighting the importance of understanding patient’s surgical history for accurate diagnosis and treatment.
P0347 Correlation between histologic disease activity in the distal and proximal colon in Ulcerative Colitis: A flexible sigmoidoscopy is insufficient to assess histology
Authors: De Marco D , Meadler Kron C , Marcus V , Bitton A , Lakatos P , Wild G , Afif W , Bessissow T 
Published: January 2025

Abstract

Background
Ulcerative Colitis (UC) is a chronic inflammatory bowel disease characterized by relapsing inflammation of the colon. Current therapeutic goals emphasize clinical and endoscopic remission; however, histological remission has emerged as an important target due to its association with reduced relapse rates and improved long-term outcomes. Despite this, limited data exist on the concordance of histological activity between colonic segments, especially in UC patients in clinical remission. This study investigates the correlation between histological disease activity in the rectosigmoid colon (RSC) and other colonic segments in patients with UC in clinical remission.

Methods
This prospective study analyzed data from 203 UC patients in clinical remission, defined as a partial Mayo score ≤2 and rectal bleeding score = 0 for at least three months. Colonoscopies with segmental biopsies were performed, and histological activity was assessed using the Geboes score. Histological remission was defined as a Geboes score &lt;2A.0, while active disease was classified as ≥3.1. Correlation between histological activity in the RSC and other colonic segments was evaluated using Spearman’s correlation coefficients and logistic regression. Statistical significance was defined as p &lt; 0.05.

Results
Among the 203 patients, the median age was 45 years, with 55.1% having pancolitis. Histological activity in the RSC showed poor correlation with other colonic segments. In patients with a RSC Geboes score of ≥3.1, the correlation coefficient between the RSC and descending colon was 0.05 (p = 0.62), between the RSC and transverse colon was -0.03 (p = 0.71), and between the RSC and right colon was 0.12 (p = 0.09). In patients with a RSC Geboes score of &lt;2A.0, the correlation coefficient between the RSC and descending colon was 0.12 (p = 0.22), between the RSC and transverse colon was 0.05 (p = 0.59), and between the RSC and right colon was 0.18 (p = 0.01). Even among patients with pancolitis, histological concordance between segments remained low. These findings underscore substantial segmental variability in histological activity.

Conclusion
Flexible sigmoidoscopy (FS) is commonly used to monitor UC due to its practicality; however, our findings suggest FS may not reliably reflect proximal histological disease. The lack of concordance highlights the limitations of FS in accurately assessing histological remission, including in patients with pancolitis or extensive colitis. Full colonoscopy with segmental biopsies remains the gold standard for comprehensive disease evaluation and management. Further research is warranted to refine histologic assessment strategies in UC.
P0354 Mild cognitive impairment occurs in patients with inflammatory bowel disease irrespective of disease activity
Authors: Compare D , Sgamato C , Minieri S , Marchitto S A , Cinque S , Ambrosio C , Zerella G , Nardone G 
Published: January 2025

Abstract

Background
Inflammatory bowel disease (IBD) has been linked to a heightened risk of mood, behavioral, and neurological disorders. Limited research has focused on cognitive function in these patients, with inconsistent findings. We aimed to assess mild cognitive impairment in IBD patients compared to healthy controls (HC) matched for age, sex, and education.

Methods
This single-center observational study included adult IBD patients. Demographic and clinical data were collected. Clinical remission was defined as a Harvey-Bradshaw Index &lt;5 for Crohn’s disease (CD) and a Partial Mayo Score &lt;2 for ulcerative colitis (UC). Healthy controls were recruited from friends and relatives of the physicians involved in the study. Exclusion criteria included psychiatric or neurological disorders, language barriers, sleep disturbances, previous surgery, significant comorbidities, alcohol abuse, and use of steroids or other neuropsychologically active medications within 3 months before enrollment. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCA), with a score &gt;26 considered normal. Anxiety and depression were screened using the Hospital Anxiety and Depression Scale (HADS). Statistical analyses included the Mann-Whitney rank-sum or t-test for continuous variables and the Chi-square or Fisher’s exact test for categorical variables. Multiple logistic regression was employed to identify baseline clinical-psychometric factors associated with abnormal MoCA scores.

Results
A total of 112 IBD patients (57 CD and 55 UC) and 68 HC were enrolled. No significant differences were observed between IBD patients and HC regarding sex (p=0.231), age (p=0.248), or education (p=0.267). A significantly higher proportion of IBD patients had a pathological MoCA compared to HC (58% vs. 41%, p=0.033), even after excluding individuals with probable anxiety or depression as identified by HADS (46% vs. 24%, p=0.021). UC patients scored lower in the memory domain than HC (mean score 2.4 vs. 3.2, p=0.041). Factors associated with a pathological MoCA included age (p=0.032), education (p=0.002), and UC (p=0.034). In multivariate analysis, age (OR 1.04, 95% CI 1-1.1, p=0.015) and UC (OR 2.2, 95% CI 1.4-5.3, p=0.039) emerged as independent predictors of a pathological MoCA.

Conclusion
IBD patients exhibited a significantly higher prevalence of mild cognitive impairment compared to controls, as measured by the MoCA. Specifically, UC patients demonstrated impairments in the memory domain. Our findings support the concept of a gut-brain axis and suggest that colonic, rather than small bowel inflammation may play a role in the development of cognitive impairment in IBD. A multidisciplinary approach to IBD management should incorporate cognitive function assessment.
P0356 A case of pulmonary nodules in Ulcerative Colitis and primary sclerosing cholangitis: is it drug or disease?
Authors: Badrulhisham F , Bhushan A , Djouider Y , Metwally A , Digby-Bell J 
Published: January 2025

Abstract

Background
Pulmonary manifestation of inflammatory bowel disease (IBD) is rare, with a broad range of lung diseases including airways, parenchymal, pleural, and pulmonary vascular disease. It is commonly associated with concurrent use of disease-modifying drugs. We present a case of a 26 year old man with ulcerative colitis and primary sclerosing cholangitis (PSC) who developed lung nodules.

Methods
Case summary:
He was diagnosed with PSC in 2017 and ulcerative colitis in 2018. He had active colitis while on an escalated dose of adalimumab, therefore he was switched to vedolizumab. His faecal calprotectin improved but due to ongoing rectal bleeding, the dose of vedolizumab was escalated from 8 to 4 weekly. 5 months after starting vedolizumab he developed night sweats, dry cough, and breathlessness. He has no history of foreign travel, exposure to tuberculosis, industrial exposure, or bird keeping.

Results
His initial investigations showed a raised CRP and bilirubin. His CT chest showed numerous lung nodules in both lower lobes. His sputum culture, AFB, and fungal blood markers were negative. Samples were also sent from a bronchoalveolar lavage fluid including for pneumocystis jirovecii, which were negative. He was treated with antimicrobials and antifungal, without improvement. He subsequently underwent a lung biopsy, which showed inflammatory changes in an interstitial pattern, which could be related to the biologic therapy, or underlying disease. Staining for fungus, EBV, CMV, HSV were negative.
He was treated as bronchiolitis obliterans organising pneumonitis induced by vedolizumab. Vedolizumab was stopped and prednisolone 40mg was started. His symptoms and inflammatory markers improved, and subsequent pulmonary imaging showed a reduction in the size of the lung nodules. Tapering the prednisolone dose to 10mg unfortunately caused a progression in the lung nodules, despite cessation of vedolizumab, which makes it less likely as the culprit drug. Prednisolone was then increased back up to 40mg, resulting in almost complete resolution of the lung nodules, with the plan for a much slower tapering. Despite the high doses of steroid his colitis is still moderately active on colonoscopy. However, further advanced therapy had to be put on hold while waiting for his lung nodules to resolve.

Conclusion
It remains difficult to determine whether his pulmonary disease is secondary to the biologic drugs, or the underlying disease process of ulcerative colitis. While pulmonary disease associated with IBD has been widely reported, there is currently unclear understanding of its pathophysiology and treatment. Clinicians need to be aware of this rare entity in IBD in order to improve patient outcomes.
P0358 The effects of reading experience on small intestine capsule endoscopy scoring of Crohn’s disease
Authors: Wada H , Omori T , Mitsui T , Hayashida M , Matsuura M , Hisamatsu T 
Published: January 2025

Abstract

Background
Small bowel capsule endoscopy (SBCE) is a less invasive modality for the evaluation of small bowel lesions in Crohn’s disease (CD). The CD small bowel lesions that are visualized include inflammation and stenosis, and standardized scores are used for objective assessment of activity. On the other hand, it is not clear whether experience or individual differences influence the scoring. We assessed the correlation of each investigator and interobserver agreement in the SBCE scores.

Methods
Retrospective study including 15 CD patients who underwent SBCE from 2015 to 2022 after confirming patency with a patency capsule. The patient information was blinded and assessed independently by three physicians, with no experience reading SBCE (Beginner A), less than 10 years of experience (Intermediate B), and more than 10 years of experience (Expert C). The activity of inflammation was calculated independently by individual physicians according to Lewis score (LS), capsule endoscopy Crohn’s disease activity index (CECDAI), and Crohn’s disease activity in capsule endoscopy (CDACE). The correlation was compared between the scores for each investigator individually. The interobserver agreement of scores between physicians (A to C) and those with at least 10 years of reading experience and at least 500 SBCE scoring experiences (Expert D as standard control) for LS &gt; 350 and CDACE &gt; 420 scores, which have been reported to predict relapse outcome, were compared using kappa coefficients for each. The correlation between LS, CECDAI, and CDACE scores and Harvey-Bradshaw index (HBI) and CRP was assessed by Expert D as the standard.

Results
Seven male patients, median age (min-max) 21 (14-72) years, disease duration 4 (2-38) months, HBI 3 (0-9), Montreal Classification B1: 14 (93.3%), B2: 1 (6.7%), L1: 4 (26.7%), L3: 11 (73.3%). Reading time differed significantly among readers, with the beginner taking the longest (median reading time of 60 minutes for the beginner, p&lt;0.0001). The correlation between each score per investigator regardless of experience was good, with the highest correlation between CECDAI and CDACE (Beginner A: ρ=0.87, Intermediate B: ρ=0.90, Expert C: ρ=0.93, Expert D: ρ=0.91, Spearman’s rank correlation coefficient). All physicians (A to C) showed moderate to high concordance (kappa coefficient 0.47 to 0.84) with Expert D for CDACE &gt; 420. However, all physicians (A to C) did not show agreement with Expert D (kappa coefficient -0.05 to 0.11) for LS&gt;350. There is no correlation was found between each score and HBI or CRP.

Conclusion
Reading time was affected by experience of SBCE, but the intraobserver correlation of each score was observed regardless of years of experience. Interobserver agreement was higher in CDACE compared to LS.
P0360 Bowel Ultrasonography and Computed Tomography tell the same story using different languages in analizing Crohn’s disease lesions
Authors: Les A , Sarbu A M , Dumitru R , Saizu R , Gheorghe L , Gheorghe C 
Published: January 2025

Abstract

Background
Inflammatory bowel diseases (IBD) are chronic diseases that require multiple endoscopic and imaging assessments, being diseases that not only involve a multitude of medical resources but patient compliance too. Bowel ultrasonography (BUS) and computed tomography (CT) have similar sensitivities (89.7% and 84.3%) and specificities (95.6% and 95.1%) in assessing IBD patients.Current guidelines recommend BUS altogether with other cross-sectional imaging methods to diagnose, monitor IBD patients and also for detecting complications and post-surgery recurrence

Methods
36 Crohn’s disease patients with established endoscopic and histologic diagnosis were included in the study. Patients with moderate and severe disease were prospectively evaluated using two cross-sectional imaging methods (CT and BUS) by two different examiners. Patients with superimposed infection or with surgical history were excluded. The BUS examination was performed using 5-12 MHz micro-convex transducer with no special preparation before, while CT examination was performed using both intra-venous and oral contrasts. Both examiners were blinded to each other’s data. Different bowel wall characteristics were noted using the two methods. A subjective overall assessment of the obtained images was noted according to each examiner.

Results
A moderate correlation was observed between the measurements of bowel wall thickness using BUS and CT (Spearman’s equation, r= 0.504, p&lt;0.01). Regarding bowel wall stratification, no corrrelation was observed using the two methods. Regarding the comb sign, there was no BUS surrogate for the CT observation. Doppler signal correlated well with the presence of bowel wall stratification observed using CT ( K= 0,36, p p&lt;0.006). A very good agreement was noticed regarding mesenteric fat densification using the two imaging techniques ( k=0,55, p p&lt;0.00006). A low but significantly statistic inter-observer agreement was obtained when lymph nodes were searched ( k=0.28, p p&lt;0.03). When comparing the overall assessment of the examinators, we obtained a good inter-rater agreement (k=0.58, p&lt;0.001) between the two cross-sectional techniques.

Conclusion
Several BUS and CT observations do not overlap even though the general aspect is similar. This happens when analizing bowel wall stratification that should be understood and applied in clinical pactice differently. The good inter-rater agreement between the two methods prooves that both investigations are useful and should be used according to availability.
P0363 Explore the application value of serum GOLM1 in the diagnosis of Inflammatory Bowel Disease
Authors: Zhao Y , Pan L , Pu T , Wen H 
Published: January 2025

Abstract

Background
Current biomarkers used to monitor the disease activity of inflammatory bowel disease (IBD) have several limitations in specificity and sensitivity, and there is an urgent need to identify novel biomarkers. Previously, Golgi membrane protein 1 (GOLM1) has been proven to protect against colitis by modulating the equilibrium of Notch signaling pathway. Therefore, we aimed to explore the possible value of serum GOLM1 in the clinical diagnosis and disease activity assessment of IBD.

Methods
Collected clinical data, including serum GOLM1 and inflammatory markers (ESR, CRP, and Interleukin-6 [IL-6]), from 60 IBD patients (30 UC and 30 CD) and 30 control subjects (patients with colon polyps) at the First Affiliated Hospital of Zhengzhou University between August 2023 and August 2024. Mayo score and Crohn’s Disease Activity Index (CDAI) were used to evaluate the clinical disease activity of UC and CD, respectively. In UC, endoscopic disease activity was determined by the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and in CD, it was measured by the Endoscopic Score for Crohn’s Disease (SES-CD). The level of serum GOLM1 was compared between IBD and the control subjects, as well as among different subgroups of IBD patients. Analysed the correlations between serum GOLM1 level and inflammatory markers, and between serum GOLM1 level and disease activity indices.

Results
1. Serum GOLM1 levels were all elevated in IBD patients (p &lt; 0.001), UC patients (p &lt; 0.001), and CD patients (p = 0.050) compared with the control patients, and this trend was more pronounced in UC (Figure 1). Serum GOLM1 levels did not differentiate between UC and CD. Also, there was no significant difference in serum GOLM1 levels between remissive and active IBD patients, whether assessed clinically or endoscopically.
2. The level of serum GOLM1 was positively correlated with ESR (r = 0.491, p &lt; 0.001), CRP (r = 0.397, p = 0.002) and IL-6 (r = 0.493, p &lt; 0.001) in IBD patients. The same trend was also observed in UC. Serum GOLM1 level was also positively correlated with UCEIS in endoscopically active UC patients (UCEIS ≥ 1) (r = 0.489, p = 0.048), but not with Mayo score in clinically active UC patients (Mayo ≥ 3) (Figure 2). In CD, serum GOLM1 level was only positively correlated with ESR (r = 0.437, p = 0.016) and IL-6 (r = 0.377, p = 0.040). In endoscopically active CD patients (SES-CD ≥ 3), serum GOLM1 level was not associated with SES-CD. Similarly, no association was found between serum GOLM1 level and CDAI in clinically active CD patients (CDAI ≥ 150).

Conclusion
This study revealed a significant increase in the serum GOLM1 level in IBD, especially in UC. GOLM1 may be involved in the inflammatory process of IBD and may serve as a potential biomarker of IBD.