bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0253 Identification of baseline Pediatric Crohn’s disease location and complications: How do intestinal ultrasound and magnetic resonance enterography compare?
Authors: Morrissey M , Hudson A , Huynh H Q , Carroll M W , Wine E , Thompson A , Isaac D 
Published: January 2025

Abstract

Background
Pediatric patients with newly diagnosed Crohn’s disease (CD) often undergo magnetic resonance enterography (MRE) to assess bowel not accessible by endoscopy and to evaluate for CD complications. In contrast to intestinal ultrasound (IUS), MRE access is quite limited, expensive, and not feasible for young patients. Little is known about how MRE and IUS compare, with a recent systematic review reporting inconclusive results when comparing diagnostic accuracy in pediatric CD. This study therefore aimed to compare MRE and IUS at diagnosis of pediatric CD.

Methods
Pediatric patients (≤18 years old) seen for suspected CD were prospectively consecutively enrolled (2019-2022) and underwent endoscopy (Simple Endoscopic Score for Crohn Disease (SES-CD)), MRE, IUS (performed by IUS trained pediatric gastroenterologists), calprotectin, blood work and assessment (weighted Pediatric Crohn Disease Activity Index (wPCDAI)). A blinded pediatric radiologist read all MREs. An interim analysis was done after 21 patients before the final analysis. Statistical analyses included descriptive statistics and Pearson chi-square.

Results
58 patients (n=38, 66% male) were included; median age 13 years (IQR 10-15, range 6-17). Disease activity at diagnosis was moderate: median SES-CD 14 (IQR 10-21), wPCDAI 48 (IQR 34-59), calprotectin 1455ug/g (IQR 840-2454), C-reactive protein 47mg/L (IQR 27-72), and erythrocyte sedimentation rate 33mm/hr (IQR 18-46). Jejunum and proximal ileum involvement had high levels of agreement between MRE and IUS for non-inflamed bowel, but less agreement for inflammation (Figure 1). There was higher agreement for inflamed distal ileum compared to proximal ileum or jejunum (Figure 1). MRE and IUS performed similarly in identifying endoscopically inflamed bowel, with the highest accuracy for the terminal ileum (TI) (Figure 2). Both were more accurate for moderate/severe (segment SES-CD≥7) vs. mild/moderate/severe disease (segment SES-CD≥3) (Figure 2). For patients with endoscopic TI strictures (n=8/58, 14%), this was seen on MRE (n=8/8, 100%) more often than IUS (n=5/8, 63%). Those without endoscopic TI strictures were still reported on MRE (n=15/50, 30%), more than IUS (n=2/50, 4%). There were no significant differences in MRE vs. IUS bowel wall thickness measurements in all segments of the small and large bowel (p&gt;0.05).

Conclusion
IUS and MRE performed similarly in distal small bowel and colonic CD assessment in both the identification and measurement of inflamed bowel. More proximal small bowel disease may be over reported by MRE or under reported by IUS. MRE also over reported TI stricturing disease. Both may miss mild CD. For initial and longitudinal pediatric CD assessment, repeating IUS rather than MRE is a viable option.
P0262 Analysis of remission maintenance rate according to the extent of MES 1 inflammation in ulcerative colitis
Authors: Kanazawa M , Tominaga K , Tanaka T , Kojimahara S , Masuyama S , Watanabe S , Sugaya T , Haruyama Y , Irisawa A 
Published: January 2025

Abstract

Background
Endoscopic evaluation of inflammation in ulcerative colitis (UC) is important as a predict marker for relapse and maintenance of remission. Mayo endoscopic subscore (MES) is frequently used for endoscopic evaluation in UC, and MES 0 and MES 1 are often considered endoscopic healing. Although MES is evaluated based on findings in the most intense areas, a partial decrease in vascular pattern is rated as MES 1, even if MES 0 is seen in most areas. There are no reports detailing the long-term prognosis of patients with extensive or partial MES 1. In this study, we investigated the remission maintenance rate according to the extent of inflammation in UC patients and analyzed the usefulness of this method.

Methods
This retrospective study was conducted at a single institution in accordance with the ethical principles associated with the Declaration of Helsinki. It was approved by the Dokkyo Medical University Hospital Ethics Committee (approval no. 29002). This study included 285 of 549 UC patients treated at Dokkyo Medical University Hospital. They were diagnosed as MES 0 or MES 1 at the first colonoscopy after remission induction, and their clinical course was followed for 2 years after the colonoscopy. The colon was divided into six segments: cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. Based on ROC analysis and Youden index results, patients with MES 1 were divided into the 1-3 segment inflammation group and the 4-6 segment inflammation group, and the remission maintenance rate was examined according to the extent of inflammation. In addition, the remission maintenance rates of the MES 0 vs. the MES 1 1-3 segment inflammation group were analyzed (Figure 1).

Results
The remission maintenance rate during the 2-year follow-up period was significantly higher in the 1-3 segment inflammation group than the 4-6 segment inflammation group (P &lt; 0.001). Comparing the MES 0 vs. MES 1 1-3 segment inflammation group, the 2-year remission maintenance rate was significantly higher in the MES 0 group (P &lt; 0.001).

Conclusion
The result of this study suggests that the additional evaluation of MES 1 inflammation range may be a more accurate predictor of remission maintenance.
P0266 Ultrasound Spectroscopy for the detection of inflammation in inflammatory bowel disease
Authors: Petzsche J , Chaghaneh O , Kegel J , Koop P H , Gabriel T , Pfeifer J , Kampfrath N , Queck A , Arsova M , Büttner M , Nauber R , Fettweis G , Siegmund B , Hampe J , Lehmann M , Herzog M ,   HybridEcho
Published: January 2025

Abstract

Background
Accurate assessment of inflammation within the intestinal wall is crucial in managing patients with Inflammatory Bowel Disease (IBD), a condition with rising incidence and prevalence worldwide. Ultrasound offers an effective, non-invasive diagnostic option to diagnose and monitor the disease. However, traditional ultrasound is highly user-dependent and requires considerable experience to accurately determine the degree of inflammation. As an extension, Quantitative Ultrasound (QUS), the analysis of raw ultrasound data consisting of unprocessed acoustic signals, contains both frequency and phase information, enabling spectroscopy. We hypothesize that these signals allow a precise estimation of inflammation within the intestinal wall.

Methods
The study was conducted at the Sonography Departments of University Clinic Dresden and Charité- Universitätsmedizin Berlin, where patients attended bowel examinations. In addition to the Limberg-Score acquired with a Highend-Ultrasound-Systems, raw data were obtained using a handheld ultrasound device (Clarius L15). For spectroscopy analysis, time-gain compensation was first reversed from the radio frequency data, followed by frequency analysis using short-time fast Fourier transformation.

Results
We included 35 patients (22 male, 13 female) aged 19 to 85 years. They were either diagnosed with Crohn’s disease (24) or ulcerative colitis (11). Our results indicate a positive correlation between the Limberg score (0–4) and peak frequency in MHz, as determined through the raw ultrasound data spectroscopy. Pairwise comparisons applying analysis of variance (ANOVA) testing, followed by a t-test with Benjamini-Hochberg correction as post hoc, revealed statistically significant differences between Limberg scores 0 and 2 (p ≤ 0.05), 0 and 3 (p ≤ 0.01) and scores 0 and 4 (p ≤ 0.05). The comparison between groups 0 and 1 demonstrated a trend but did not reach statistical significance (p=0.058).

Conclusion
Our findings indicate that higher Limberg scores are associated with increased center frequency, with statistically significant differences evident at advanced inflammation levels. This exploratory study demonstrates, for the first time, the capability of QUS to detect changes in intestinal tissues, offering an innovative approach for objectively monitoring inflammatory bowel disease. However, potential confounders such as attenuation in varying imaging depths and mixed causality of the inflammation need to be considered. A reevaluation after including larger sample sizes is required to reinforce the study’s findings and further explore the potential of QUS in the context of IBD.
P0267 Proactive Remote Monitoring of Inflammatory Bowel Disease for Improved Outcomes and Flare Prediction
Authors: Goren M , Talan Asher A , Haj O , Godis T , Briskman Shakhnovsky N , Levi T , Fizdel B , Shtein I , Galper A , Albshesh A , Barda L , Ben Shalom Y , Laks D , Tzur M , Ungar B , Sagi M , Sina S , Goshen G , Ben-Horin S , Zimlichman E , Kopylov U 
Published: January 2025

Abstract

Background
This study evaluated a remote monitoring program for IBD patients, using a mobile app to track disease activity and improve patient-provider communication. The app included disease activity questionnaires, quality of life assessments, and home-based calprotectin tests. we aimed to develop a data-driven, patient-reported care management system for early detection of clinical flares in IBD patients, enabling timely treatment adjustments.

Methods
A 12-month prospective cohort study included 100 adult IBD patients. Participants completed monthly online questionnaires via the “DATOS” platform, assessing disease activity (PRO2/SCCAI), quality of life (PROMIS-10, SIBDQ), emotional state (DASS-21), and perceived disease control (IBD CONTROL). Home calprotectin tests were performed at baseline, 6 months, and 12 months. Data from 533 monthly observations were used to develop a machine learning model to predict flares.

Results
Among 100 patients (74% Crohn’s, 26% ulcerative colitis; median age 31 years), 94% were on biological therapy. Adherence to the remote platform declined over time (86% at 0 months, 53% at 6 months, 30% at 12 months). Over the study period, 40 flares, 14 hospitalizations, 6 surgeries, and 31 changes in biological therapy occurred. Patients experiencing a flare had significantly higher fecal calprotectin levels (mean: 901.8 vs. 330.6 mg/kg, p=0.044), as well as increased anxiety, depression, and stress (DASS-21, p&lt;0.05), poorer quality of life (PROMIS-10, p=0.005; SIBDQ, p&lt;0.001), and reduced perceived disease control (IBD-Control, p&lt;0.001). A machine learning model incorporating calprotectin and patient-reported outcomes demonstrated a 0.85 accuracy in predicting flares.

Conclusion
This study demonstrates the feasibility of a remote monitoring program for IBD patients. Although the program facilitated streamlined patient follow-up, long-term adherence was challenging, highlighting the need for improvements in system usability and patient engagement. The machine-learning model, which combined fecal calprotectin and patient-reported outcomes, showed good accuracy in identifying patients at risk of flares. These findings suggest that remote monitoring, supported by machine learning, could enhance IBD management.
P0268 Patient-reported outcomes in a Greek cross-sectional survey of inflammatory bowel disease patients treated with biologic therapy
Authors: Tzanetakos C , Vakouftsi V , Mavridoglou G , Gourzoulidis G 
Published: January 2025

Abstract

Background
Patient reported-outcomes [PROs] are a major therapeutic goal in inflammatory bowel disease [IBD]. The study objective was to investigate the burden of IBD and unmet medical need in patients who receive biologic therapy in Greece.

Methods
Between October 2023 and January 2024, adult patients who were members of Hellenic Society of Crohn’s disease’s (CD) and Ulcerative Colitis’ (UC) patients (HELLESCC) filled out a structured self-questionnaire. The survey questionnaire included sociodemographic characteristics, smoking habits, history of comorbidities, disease activity, disease characteristics, IBD medications, and PROs (Short Inflammatory Bowel Disease Questionnaire [SIBDQ], Work Productivity and Activity Impairment-Specific Health Problem [WPAI-SHP], Patient Health Questionnaire-9 [PHQ-9], treatment satisfaction and treatment adherence).

Results
Datasets were obtained from 287 IBD patients (median age 42 years, proportion of females 57.8%, median BMI 26, proportion of current smokers 35.2%, median age at diagnosis and disease duration 30 and 10 years, respectively). According to disease activity scores, 42.9% were in remission, 26.8% had mild disease, and 30.3% had moderate/severe disease. Around 76% of patients reported moderately [SIBDQ 45–59: 31.8%] to severely [SIBDQ &lt;45: 44.5%] impaired quality of life (QoL) (30% of them were in remission). One-fifth reported work productivity loss and 30% reported activity impairment (severe work and activity impairment [&gt;50%] in 30.2% and 42.9% of patients respectively). Around half of patients reported moderate to severe depressive symptoms [PHQ-9≥10: 48.1%]. The 39.1% of patients were “not at all”, “little” or “quite” satisfied by their biologic treatment, with the main reason of dissatisfaction being the “fatigue is increasing”. Nine out of ten patients (89.1%) reported that they follow their biologic treatment regularly. Statistically significant relationships were found between PROs but not between disease types [CD or UC] or therapeutic classes (tumor necrosis factor-α antagonists, anti-integrin agents, and interleukin-12/23 antagonists).

Conclusion
Despite the use of biologic therapies, the disease burden is very high in IBD, with poor QoL as well as increased work impairment, depression, and disease activity in Greek patients. Marked treatment dissatisfaction was reported by four out of ten patients.
P0271 Overweight is associated with low mediterranean diet adherence and increased disability in patients with Inflammatory Bowel Disease
Authors: Nardone O M , Leo C , Calabrese G , Guarino A D , Ciotola N , Caldiero A , Bonacci L , Petolicchio M , Testa A , Rispo A , Castiglione F 
Published: January 2025

Abstract

Background
The prevalence of obesity in inflammatory bowel disease (IBD) has risen, with 15–40% of adults classified as obese and an additional 20–40% as overweight1. Poor dietary habits and sedentary lifestyles contribute to overweight and sarcopenia, potentially worsening IBD-related disability. This study aimed to evaluate the relationships between nutritional status, adherence to the Mediterranean diet, sarcopenia and disability in IBD patients.

Methods
This cross-sectional study included consecutive IBD patients attending an outpatient clinic or infusion unit between 2023-2024. Bioelectrical impedance analysis (BIA) was used to estimate the fat-free mass index (FFMI), a recognized measure of skeletal muscle mass. Physical function was assessed via gait speed (time to walk 6 meters), and handgrip strength (HGS) measured using a Jamar dynamometer. Sarcopenia was diagnosed based on FFMI, HGS, and walking speed. Disability was evaluated using the IBD-Disk questionnaire, with scores ≥40 indicating moderate-to-severe disability. Adherence to the Mediterranean diet was assessed using the Medi-Lite score, with scores &lt;9 reflecting low adherence. Demographic, clinical, and disease-related data were collected

Results
A total of 95 IBD patients (58% with Crohn’s disease, CD), 57.8% female, with a median age of 42 years (IQR 26-58) were included. Clinical activity ,measured with the Harvey-Bradshaw index (HBI) had a median score of 6 (IQR 4–7) for CD, while the median pMayo score for ulcerative colitis (UC) was 4 (IQR 2–6).
The median BMI was 23.60 (IQR 21-27). Overweight prevalence was 43.2% (41/95). Low adherence to the Mediterranean diet was significantly more frequent in overweight patients compared to non-overweight patients (p&lt;0.001). Overweight was also associated with increased age (p &lt; 0.001). Sarcopenia prevalence was 7% (7/95) and was more common in non-overweight patients than in overweight patients (p = 0.002). The median BMI among sarcopenic patients was 20.6 (18.5–25.3). The mean IBD-Disk score was 41 ± 23.2, with 46.3% of patients reporting moderate-to-severe disability. Overweight patients were more likely to experience moderate-to-severe disability compared to non-overweight patients [27 (65.9%) vs. 23 (42.6%), p = 0.02]. No significant association was found between sarcopenia and moderate-to-severe disability (p = 0.44).

Conclusion
Overweight is associated with low adherence to the Mediterranean diet and increased disability in IBD patients. Targeted interventions to improve adherence to the Mediterranean diet and manage overweight could potentially reduce disability in IBD patients.

References
1.Singh S et al, Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes, Nat Rev Gastroenterol Hepatol. 2017 February ; 14(2): 110–121
P0273 Advances in understanding and managing perianal Crohn’s disease: Insights from the new classification system and results from a single-center series.
Authors: Mesonero Gismero F , García de la Filia I , López Cardona J , Fernández C , Abadía P , Ocaña J , Ballestero A , Tobaruela E , García-Pérez J C , Die Trill J , López-Sanroman A 
Published: January 2025

Abstract

Background
A new classification for perianal disease has been published to assist clinicians in identifying and treating this phenotype (1). However, no studies have evaluated its use in real-world settings. We analyzed the distribution and appropriateness of perianal fistula management in a single center.

Methods
This was a retrospective and unicentric study. Crohn´s disease patients with perianal fistulizing phenotype were included. Non fistulizing perianal disease, recto-vaginal fistulae, ileoanal pouch-related fistula or patients without follow-up were excluded. Fistulas were identified according to the new classification system. Baseline characteristics, the applied treatment, and the probability of progression were analyzed. Therapeutic success and management errors were based on consensus recommendations. Descriptive statistics were applied.

Results
Over 1068 patients diagnosed with Crohn´s disease a total of 267 patients presented perianal disease (25%). Finally, 184 patients were included (the majority of excluded patients were due to non fistulating perianal disease or rectovaginal fistulae). Basal characteristics are shown in Table 1. Perianal fistulae distribution according to new classification is presented in Figure 1. Thirty six patients (20%) changed fistulae class after a median time of 44 months (range 20-265): class 2b (11 patients, 31%), class 2c (16 patients, 44%), class 3 (7 patients, 20%). No patients presented class 4 fistulae during period evaluation.
The treatment employed was: seton plus biological therapy (41%), biological therapy plus reparative surgery (22%), seton replacement alone (10%), biological therapy alone (4%), proctectomy (3%) and defunctioning ostomy (3%). No treatment was administered to 17% of cases. In 44% of cases, there were management errors according to established recommendations. These were: no reparative surgery (40%), no biological therapy use (35%), no defunctioning ostomy (15%). It was significantly higher in the case of type 2a class (37 vs 7%, p 0.001). Despite this findings, 78% of cases achieved the therapeutic goal according to new recommendations.

Conclusion
Class 2 perianal fistulae are the most common and where management errors may occur. However, the majority of patients achieve the therapeutic goal.

References
1.Geldof J, Iqbal N, LeBlanc JF, Anandabaskaran S, Sawyer R, Buskens C, Bemelman W, Gecse K, Lundby L, Lightner AL, Danese S, Spinelli A, Carvello M, Faiz O, Warusavitarne J, Lung P, De Looze D, D’Hoore A, Vermeire S, Hart A, Tozer P. Classifying perianal fistulising Crohn’s disease: an expert consensus to guide decision-making in daily practice and clinical trials. Lancet Gastroenterol Hepatol. 2022 Jun;7(6):576-584.
P0274 Progression from Segmental Colitis Associated with Diverticulosis to Ulcerative Colitis
Authors: Asumu L M , Mayorga Ayala L F , Herrera De Guise C M , Serra-Ruiz X , Céspedes Martínez E , Robles Alonso V , Lastiri Gonzalez E , Borruel Sainz N 
Published: January 2025

Abstract

Background
Despite the high prevalence of diverticulosis in the population, segmental colitis associated with diverticulosis (SCAD) is uncommon. Due to its overlap with characteristics typical of inflammatory bowel diseases, especially Ulcerative Colitis (UC), a possible link in its pathogenesis has been postulated, with some cases of disease progression from one to the other described. We present a series of SCAD cases that progressed to UC

Methods
We describe SCAD cases followed at our IBD Unit at Hospital Universitari Vall d’Hebron that were subsequently diagnosed with UC between 2016 and 2024. Demographic and clinical data from all patients were collected and analyzed.

Results
We identified 5 cases, 3 female and 2 male, with a median age of 73±3 years, initially diagnosed with SCAD. All patients had significant inflammatory involvement in the peridiverticular mucosa at the sigmoid and descending colon. Four patients presented with luminal substenosis and inflammatory pseudopolyps. Histopathology revealed chronic active nonspecific cryptodestructive colitis with a marked mixed lymphoplasmacytic infiltrate. The remaining colon and rectum were preserved in all cases. Treatments for SCAD included mesalamine and antibiotics for 3 patients, oral corticosteroids for 1, and sigmoidectomy for 1 due to refractory disease. Progression to UC occurred in a median of 63 weeks after SCAD diagnosis, with all colonoscopies showing distal progression of inflammation with rectal involvement, and biopsies compatible with UC. Four patients required therapy escalation to biological agents, and only one remained on oral mesalamine with adequate control. One patient underwent a left hemicolectomy due to refractoriness.

Conclusion
Our study showed that progression from SCAD to UC can be aggressive, with most patients in our series requiring biological therapy. It is important to recognize the potential evolution of SCAD into UC for an effective diagnosis and management of these patients.