bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0275 The Impact of Sarcopenia on Clinical Outcomes in Pediatric Crohn’s Disease
Authors: D’Arcangelo G , De Mitri D , Busato L , Verrino A , Bottino L , Maccioni F , Aloi M 
Published: January 2025

Abstract

Background
Sarcopenia, the age-related progressive loss of muscle mass and strength, affects up to 50% of adults with Crohn’s Disease (CD) and is related to major clinical outcomes. However, data on children is scarce. We investigated whether sarcopenia at the diagnosis impacts the outcomes of children with CD.

Methods
Retrospective, single-center, case-control study of newly diagnosed children with CD undergoing magnetic resonance (MR) within one month from the diagnosis, from 2011 to 2022. Sarcopenia was assessed by measuring total psoas muscle area (tPMA) at L3-L4 level on the MR and defined as z-score values ≤2 standard deviations. Sarcopenic and nonsarcopenic children were compared for the risk of disease flares, IBD-related hospitalization, complications, need for step-up treatment, and courses of steroids over a 2-year follow-up.

Results
Seventy-eight children were included (mean age 11.7 years, 41% females), 46 (59%) sarcopenic and 32 (41%) nonsarcopenic. Sarcopenic children presented at the diagnosis with higher serum levels of total cholesterol (140 ± 28 mg/dL vs. 105.6 ± 27 mg/dL, p=0.009) as well as LDL and HDL cholesterol (77 ± 26 vs. 57.7 ± 24. 4 mg/dL, p=0.03 and 42.8 ± 9.2 vs 36 ± 8 mg/dL, p=0.02, respectively). The risk of clinical relapse was higher in sarcopenic vs nonsarcopenic patients at 6 [21.7% vs. 0%, OR 8.6 (95% CI 1.2-96.2), p=0.004] and 12 months [34.7% vs. 6.6%, OR 7.4 (95% 1.6-34.4), p=0.005]. Additionally, the risk of steroid use was higher in sarcopenic vs. nonsarcopenic children at 12 months [34.7% vs. 13.3%, OR 3.4 (95% CI 1.1-10.3), p=0.06]. Kaplan Meier analysis showed lower survival free from relapses in sarcopenic vs nonsarcopenic patients [Log Rank p=0.004, HR 2.8 (95%CI 1.3-5.7)]. Multivariate logistic regression analysis identified sarcopenia as an independent predictor of relapse risk [OR (95%CI)142 (2.1-470), p=0.051].

Conclusion
The presence of sarcopenia at the diagnosis seems to increase the risk of unfavorable outcomes, specifically clinical relapses in the first year of diagnosis. An altered lipid profile may indicate an increased risk of reduced muscle mass children, highlighting the need for targeted nutritional and therapeutic interventions
P0284 A Comparison of the Milan Ultrasound Criteria with the Ulcerative Colitis Intestinal Ultrasound Index to Assess Disease Activity in Patients with Ulcerative Colitis
Authors: Yuksel I , Cagir Y , Durak M B , Atay A , Ozturk O , Ergul M , Oktay M E , Acun K , Kilic Z M Y 
Published: January 2025

Abstract

Background
Intestinal ultrasound (IUS) scoring systems have been developed to detect disease activity in patients with ulcerative colitis (UC). Nevertheless, further and comparing studies IUS scores to evaluate disease activity in UC patients are needed. We aimed to compare 2 existing validated scores, the Milan Ultrasound Criteria (MUC) and Ulcerative Colitis Intestinal Ultrasound (UC-IUS) index, for evaluating disease activity in patients with UC.

Methods
An observational cross-sectional study was performed in adult UC patients between November 2019 and June 2024. All UC patients underwent IUS before a day colonoscopy, and endoscopic Mayo score ≥2 was accepted as an active disease.

Results
Total 62 adult patients with UC (median age: 39 years) were included in the study, 39 (62.9%) patients were male, the median age was 39 years and the median duration of the disease was 6.32 (IQR, 2.63-12.32) years. Extensive location was the most prevalent extension 39 (62.9%) among all patients.
The median MUC was 8.42 (IQR, 6.34-10.96) and the median UC-IUS index was 5 (IQR, 4-6.25) for all UC patients. In patients with endoscopically remission group (endoscopic Mayo score &lt;2), which include 14 (22.6%) patients, the median MUC was 5.76 (IQR, 3.61-6.8) and the median UC-IUS index was 3 (IQR, 2-4). Nevertheless, in endoscopically active group, the median MUC was 9.14 (IQR, 7.6-11.63) and the median UC-IUS index was 6 (IQR, 4-7), MUC and UC-IUS index were higher in endoscopic active group than in remission group (p&lt; 0.001). Furthermore, the clinically active group (partial Mayo score ≥5) had greater MUC and UC-IUS index than the clinically remission group (p&lt; 0.005 and p&lt; 0.001, respectively).
The cut-off value for MUC to predict endoscopic activity (endoscopic Mayo score ≥2) was 7.46 (AUC: 0.906, 95% CI: 0.830-0.983, sensitivity: 81%, specificity: 86%, p &lt; 0.001), and the cut-off value for UC-IUS index to expect endoscopic activity was 4.5 (AUC: 0.846, 95% CI: 0.739-0.953, sensitivity: 71%, specificity: 86%, p &lt; 0.001).

Conclusion
In this study, we found that MUC and UC-IUS index demonstrates a strong correlation with the endoscopically active UC patients. The most accurate cut-off value for MUC was 7.6 and the most accurate cut-off value for UC-IUS index was 4.5 in UC patients with endoscopically active group.
P0289 Correlation between endoscopic scores and Nancy histological Index in ulcerative colitis: A real-world, single-center prospective study
Authors: Stratigakis L , Lakiotaki D , Lekakis V , Sakellariou S , Stofas A , Driva T , Karatzas P , Papatheodoridis G , Koutsoumpas A 
Published: January 2025

Abstract

Background
The Nancy Histological Index (NI) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) are established tools for evaluating disease activity in ulcerative colitis (UC). This study aims to evaluate the correlation between UCEIS and NI scores in various clinical scenarios, including endoscopies performed during clinical flares (Group A), to assess mucosal healing post-treatment (Group B), at initial disease diagnosis (Group C) and during surveillance (Group D).

Methods
This prospective single-center study was conducted between June 2022 and October 2024, involving 179 patients with confirmed UC, as part of a pilot phase of implementing NI in our Histology Lab. Patients underwent colonoscopy or flexible sigmoidoscopy during which UCEIS and Mayo Endoscopic Score (MES) were independently assessed by two experienced endoscopists in the most affected colon segment. Biopsies from the same segment were scored for histological activity using the NI by two blinded to the endoscopic score pathologists. Statistical analyses were performed with SPSS version 29.0.1.1. Correlations between UCEIS/MES and NI scores were analyzed using Spearman’s correlation coefficient. The correlation coefficients between UCEIS/NI and MES/NI for each group were compared using the Z-test. All test were two-tailed, with p-values less than 0.05 considered statistically significant.

Results
Data from 179 patients (median age:54 years) were collected. Flares accounted for 62% of endoscopy indications, followed by surveillance (26.3%), mucosal healing (8.9%) and diagnosis (2.8%). Correlation coefficient between UCEIS (0-8) and NI (0-4) for all UC patients was rs=0.77 (95%CI:0.70-0.82; p&lt;0.001), while correlation coefficient between MES (0-4) and NI was rs=0.71 (95%CI:0.63-0.78; p&lt;0.001). Across different clinical settings, the correlation coefficients between UCEIS and NI were as follows: Group A: rs=0.54 (95% CI:0.39-0.66; p&lt;0.001), group B: rs=0,84 (95%CI:0.58-0.94; p&lt;0.001), group C: rs=0.75 (95%CI:-0.42-0.98; p=0.14) and group D: rs=0.74 (95%CI:0.57-0.85; p&lt;0.001). The corresponding correlation coefficients between MES and NI were: Group A: rs=0.45 (95%CI:0.28-0.59; p&lt;0.001), Group B: rs=0,80 (95%CI:0,49-0.93; p&lt;0.001), Group C: rs=0.18 (95%CI:-0.84-0.98; p=0.76) and Group D: rs=0.72 (95%CI:0.54-0.84; p&lt;0.001). The correlation coefficients between UCEIS/NI and MES/NI showed no significant differences across any group.

Conclusion
This study highlights a strong correlation between UCEIS or MES and NI scores across various clinical settings, reinforcing their complementary role in evaluating UC severity. These findings support the integration of histological and endoscopic indices for more comprehensive disease activity assessment.
P0290 Predicting disease remission in Ulcerative Colitis patients - early results from the PRESAGER study
Authors: Nordestgaard R L M , Lo B , Bergstrøm R , Adzioski I , Nielsen H S , Hawwa I M , Holme S K , Tiftikci B , Majchrzak K , Vind I , Bendtsen F , Burisch J 
Published: January 2025

Abstract

Background
The disease course of Ulcerative Colitis (UC) remains unpredictable. While some patients experience years of remission, others experience frequent flares, hospitalization, and surgery. The PRESAGER study aims to develop decision models to predict UC disease activity. In this preliminary analysis, we created a logistic regression model to identify predictors of remission.

Methods
UC patients with disease activity (Mayo endoscopic score [MES] ≥ 1) were recruited into the study. Demographic data, disease history, IBD Disability Index (IBD-DI), biopsies, and blood samples were collected at inclusion. Eight weeks later, patients were followed up with IBD-DI, blood samples, and an optional sigmoidoscopy. Medications taken before inclusion and during the follow-up period were recorded. Symptomatic or endoscopic remission was noted depending on if patients opted for follow-up endoscopy.
Using multivariate logistic regression, we examined the association between inclusion data and disease remission. Stepwise model selection by Akiake information criterion (AIC) was used to create a logistic regression model with the most relevant predictors. Results were reported as odds ratios (ORs), 95% confidence intervals (CIs) and p-values. AI was used for writing inspiration and help with R coding, and no work was copied directly from an AI source.

Results
As of September 2024, 250 patients were included in the study. 182 (73%) patients had completed eight-week follow-up with IBD-DI and blood samples, and 72 (29%) patients had completed the eight-week follow-up sigmoidoscopy.
At inclusion, left-sided colitis and moderate disease activity were most common. When looking at medications taken within 14 days of inclusion, 66% of patients used mesalazine suppositories and 61% used oral mesalazine or sulfasalazine (Figure 1). Other treatments included mesalazine foam/enemas (30%), oral corticosteroids (26%), immunomodulators (18%), and biologics (14%).
A multivariate logistic regression model showed that older age and higher IBD-DI scores significantly reduced the likelihood of remission, whereas a longer disease duration was linked to a greater likelihood (Table 1). Surprisingly, calprotectin levels above 500 was associated with increased likelihood of remission compared to levels below 250. Additionally, patients with moderate disease activity had a greater likelihood of remission than those with mild activity, likely due to the increased use of corticosteroids and biologics in these cases.

Conclusion
Older age and higher disability scores significantly reduced the likelihood of remission for UC patients, while longer disease duration, moderate disease activity, and high calprotectin increased the likelihood.
P0295 Histological healing reduces the risk of relapse in ulcerative colitis: results of a prospective study
Authors: Yzet C , Robert C , Brazier F , Meudjo E , Moreau C , Chatelain D , Fumery M 
Published: January 2025

Abstract

Background
The STRIDE II guidelines recognize endoscopic mucosal healing (MH), defined by a UCEIS score ≤1 or a Mayo endoscopic subscore = 0 (MES), as one of the main therapeutic goals in ulcerative colitis (UC). Nevertheless, histological healing (HH) could reduce the risk of long-term complications in UC. The aim of this study was to assess the risk of relapse in UC depending on the degree of remission achieved.

Methods
We conducted a prospective study including all consecutive UC patients in clinical remission and endoscopic MH (MES 0 or 1) between January 2021 and January 2024. The primary endpoint was UC relapse, defined as the need for treatment intensification and/or corticosteroids initiation and/or UC-related hospitalization and/or colectomy. Patients were followed up every 6 months for two years. HH was defined as a Nancy index ≤ 1 (blinded double reading).

Results
A total of 75 patients were included. The median disease duration was 12 years (IQR [7.5-19.0]) and 66 (82%) patients had a left side colitis (E2) or pancolitis (E3). Patients were treated for a median of 3 years (IQR [1.2 - 6.9]) prior to colonoscopy. Mayo=0 and HH were observed in 49 (65%) and 55 (79%) patients, respectively. After a median follow-up of 21.0 months (IQR [12.0 - 26.5]), relapse was observed in 13 patients (17%) after a median delay of 11 months (IQR [6.0 - 18.0]). There was no significant difference in the risk of relapse between MES 1 and MES 0 patients (13.6% vs. 30.7% respectively p = 0.27). The risk of relapse in patient with MES 1 was significantly higher among patient with absence of HH (39.7% versus 20.1% respectively p = 0.04). Similarly, in patients with MES 0, the risk of relapse was significantly higher among patients without HH (70.0% versus 27.4% respectively, p = 0.023). No UC-related hospitalizations or colectomy were reported during follow-up. In multivariate analysis, only absence of HH was associated with disease relapse (HR = 6.1, 95% CI = [1.6 - 23.1], p = 0.01). The degree of correlation between rectal biopsies and whole-colon biopsies was almost perfect (к 0.84 (%-agree 93.1, p &lt; 0.001)) for HH assessment.

Conclusion
In this prospective study, histological healing was associated with improved long-term outcome in UC patients whatever the degree of endoscopic mucosal healing. Rectal biopsies were effective in identifying HH.
P0299 Luminal phenotype of Crohn’s disease: the effectiveness of ultrasound compression elastography in the early diagnosis of disease recurrence.
Authors: Iakovlev A A , Palenyi A , Nelasov N , Tarasova G , Volkov A 
Published: January 2025

Abstract

Background
In recent decades, the problem of early diagnosis of Crohn’s disease remains relevant. A traditional diagnostic method is ileocolonoscopy, which has a number of contraindications and complications due to its invasiveness. Ultrasound examination of the intestine is actively used for non-invasive diagnosis of tumor processes, as well as stenosis of the colon. Research data on the diagnostic value of various ultrasound signs of compression elastography in the luminal form of Crohn’s disease are contradictory. In this work, we assessed the parameters of compression elastography (CE) in patients with a luminal Crohn’s disease with endoscopic and clinical and laboratory markers of active of inflammation.

Methods
The study included 24 patients with endoscopically verified Crohn’s disease of the colon (mean age 38.7 years (95% CI 35.4–52.1)) - group 1 and 18 without endoscopic verification, but with clinical and laboratory markers of active inflammation (mean age 42.4 years (95% CI 38.7–55.4)) - group 2. All patients underwent ultrasound with CE (scanner Phillips IU 22 convex (9-4 MHz) and linear (5-12 MHz) sensors. Signs were examined: thickening of the colon wall (3 mm or more), color Doppler mapping indicators (type 0, type 1 and - 2), CE indicators (type 1B (green mapping - soft-elastic type), type 2BA (soft-elastic type with mosaic color pattern), type 1A (predominantly blue-hard type).

Results
When conducting ROC analysis, it was found that there was a significant increase in blood flow in the mesentery and intestinal wall, predominantly type 1A (predominantly blue-hard type) (color Doppler mapping), a sign of a “rigid wall” of the colon CE and its thickening of more than 3 mm (diagnostic efficiency 87.9%, 98.3%, 96.5%, P&lt;.0001) are reliable markers of the luminal form of Crohn’s disease (Fig. 1).

Conclusion
Luminal phenotype of Crohn’s disease: the effectiveness of ultrasound compression elastography in early diagnosis of relapse of the disease.
P0301 The Prevalence and Association Between Immune-Mediated Inflammatory Disorders and Inflammatory Bowel Disease
Authors: Mosli M , Osman B , Ruckn A , Alsharif A , Alghamdi J , Aldeen R , Rehal A , Alsiyoufi S , Saadah O , Alsahafi M 
Published: January 2025

Abstract

Background
Inflammatory bowel disease ([IBD]), comprising ulcerative colitis ([UC]) and Crohn’s disease ([CD]), represents chronic immune-mediated inflammatory disorders ([IMIDs])[1]. We aimed to ascertain the predictive factors and prevalence of IMIDs in patients with IBD.

Methods
The study was a single-center retrospective study conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia , included adult patients with confirmed inflammatory bowel disease (IBD), regardless of age, nationality, and sex, who followed up at the hospital between 2017 and 2022. The King Abdulaziz University (KAU) Inflammatory Bowel Disease Information System (IBDIS) registry was utilized to identify eligible patients.

Results
One hundred and seventy-two patients were randomly selected. This cohort had a mean age of 37.33 years; 55.8% were women, 87 (50.6%) had IMIDs other than IBD, 57% had CD, and 43% had UC. Patients with IMIDs showed shorter IBD duration [(10.06 (6.60) vs. 12.23 (5.23) years]) than those without IMIDs ([P &lt; .05]). IMID prevalence was lower among patients with CD exhibiting EIMs ([P &lt; .05]) than patients with UC with erythema nodosum [(EN]) or aphthous stomatitis ([P &lt; .05]). The male sex was a positive IMID predictor ([Odds Ratio [OR]: 2.57, 95% confidence interval (CI) = 1.08- 6.08, P = .031]), while EN ([OR: 4.75, 95% CI = 1.28 - 6.01, P = .001]) or pyoderma gangrenosum ([OR: 7.44, 95% CI = 1.46 - 17.95, P = .016]) were protective against IMID.

Conclusion
Our Retrospective study shows a substantial risk of patients with inflammatory bowel disease (IBD) developing associated immune-mediated inflammatory diseases (IMIDs).In the study cohort, 50% of individuals with IBD had comorbid IMIDs, with type1 diabetes mellitus (DM) and primary sclerosing cholangitis (PSC) being the most common.Several predictors were identified for the emergence of IMIDs, including male sex, shorter disease duration, specific laboratory findings, and the presence of complications.
Our findings emphasize the importance of recognizing multiple IMID predictors in the clinical management of IBD.

References
1.Centers for Disease Control and Prevention. Inflammatory bowel disease (IBD). 2023. Available from: https://www.cdc.gov/ibd/index.htm. Accessed November 20, 2023.
P0302 Outcomes of colectomy-IPAA for UC, is De Novo-CD on the rise?
Authors: Bakkaloglu O K , Tukek B , Atay K , Hatemi I , Celik A F , Erzin Y 
Published: January 2025

Abstract

Background
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the preferred surgical option for refractory ulcerative colitis (UC), dysplasia, or malignancy. De novo Crohn’s Disease (CD) is a recognized postoperative complication that can occur in UC patients after IPAA. Pouchitis, a common complication marked by nonspecific pouch inflammation, typically responds to antibiotics but can progress to proximal or penetrating transmural inflammation, later defined as de novo-CD.

Methods
This retrospective study analyzed UC patients who underwent proctocolectomy-IPAA between 2000 and 2022, focusing on the frequency of pouchitis and de novo-CD and associated risk factors.

Results
Among 1197 UC patients, 82 (6.8%) underwent proctocolectomy-IPAA. Of these, 65.9% (n=54) were male, with a mean UC diagnosis age of 35±12 years and a median disease duration of 49 (IQR: 112) months before surgery. Median follow-up was 83 (IQR: 86.5) months. Chronic inflammation was the primary indication for surgery, while malignancy accounted for 15.9%. Anti-TNF therapy was used in 37.8% of patients before colectomy, with a median duration of 9 (IQR: 9) months.
De novo-CD developed in 32.9% of patients, with 48% presenting with fistulizing disease. The median time to de novo-CD diagnosis was 35 (IQR: 63) months, with fistulizing disease diagnosed slightly earlier at 31 (IQR: 52) months. One-third of de novo-CD cases were initially misdiagnosed as pouchitis. Pouchitis occurred in 52% (n=43) of patients, with a median onset of 18 (IQR: 27) months. Overall, 62% of patients required treatment for pouchitis or de novo-CD, with antibiotics being the most common therapy (52%, median 2 courses). Biological therapies, primarily used in de novo-CD cases, were utilized in 24% of patients.
Patients with isolated pouchitis showed no significant differences in age at diagnosis, disease duration, gender, colectomy indication, or prior UC treatments compared to those without pouchitis. Pouchitis was more frequent in left-sided UC and less common in pancolitis. Emergency colectomy was associated with higher pouchitis rates. De novo-CD was more common in patients undergoing colectomy for malignancy and in surgeries performed in last decade.

Conclusion
De novo-CD develops in ~33% of UC patients after IPAA, typically within 2.5 years, with earlier onset in fistulizing disease. A third of cases initially mimic pouchitis. Pouchitis is more frequent in left-sided UC and less so in pancolitis. Shorter disease-free survival for de novo-CD in recent years may reflect evolving disease patterns.
P0303 Evaluation of the Terminal Ileum on Computed Tomography of Patients with Non-Traumatic Acute Abdominal Pain in the Emergency Department
Authors: Ergul M , Durak M B , Ozturk O , Cagir Y , Yuksel I 
Published: January 2025

Abstract

Background
Crohn’s Disease (CD) may be overlooked in patients presenting to the emergency department with acute abdominal pain. We aimed to determine the frequency of CD and increased terminal ileum wall thickness on abdominal computed tomography (CT) in patients presenting to the emergency department with non-traumatic acute abdominal pain.

Methods
A cross-sectional observational study was conducted among patients who had presented to the emergency department with non-traumatic acute abdominal pain and underwent CT between September 2023 and September 2024. Before CT, patients with known diseases such as CD, vasculitis, tuberculosis, and lymphoma were excluded from the study. A colonoscopy was performed on patients with terminal ileum wall thickness on CT examination.

Results
A total of 1014 patients were admitted to the emergency department with non-traumatic acute abdominal pain, 10 (1%) of whom were determined to increase terminal ileum wall thickness. The median age was 41.2, and 7 (70%) patients were female. Median terminal ileum wall thickness was measured as 6.04 mm. 9 (90%) had limited terminal ileum, 6 (60%) had a length of wall thickness more than &gt; 5cm, 7 (70%) had stenosis and 5 (50%) had pre-stenotic dilatation on CT. Colonoscopy revealed aphthous ulcers in the terminal ileum in 6 patients, longitudinal deep ulcers in 2 patients, and 2 patients with intact terminal ileum mucosa.
3 (0.3%) of the patients with terminal ileum wall thickness were diagnosed CD after colonoscopic examination. One patient had ileocolonic involvement with stricturing behavior, while the other two had isolated ileal involvement with inflammatory behavior. 2 patients were managed with medical treatment and the other patient with ileal resection. The remaining 5 patients with terminal ileal aphthous ulcers had a history of antibiotic, nonsteroidal anti-inflammatory drug use, or gastroenteritis within the last 3 months.

Conclusion
In this study, CD was detected in 3 (0.3%) patients who has previously undiagnosed, presented non-traumatic acute abdominal pain with terminal ileum wall thickness on CT. Terminal ileitis is a rare reason in patients presenting acute abdominal pain. However, CD should be kept in mind among differential diagnosis.