bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0463 Co-infection of Clostridium innocuum Worsens Outcomes in Inflammatory Bowel Disease Patients with Clostridioides difficile Infection
Authors: Ching Reigh H , Le P H , Chiu C H , Chiu C T , Su M Y , Kuo C J , Chang M L 
Published: January 2025

Abstract

Background
Clostridioides difficile infection (CDI) is known to trigger acute flare-ups and worsen clinical outcomes in patients with inflammatory bowel disease (IBD). Increasing evidence suggests that co-infection with Clostridium innocuum (CI), which is resistant to vancomycin, also contributes to negative outcomes. However, CI is often overlooked or misdiagnosed. No previous study has specifically examined the impact of CI co-infection in IBD patients with CDI. This study aims to address this gap.

Methods
This retrospective cohort study included 142 IBD inpatients at Linkou Chang Gung Memorial Hospital, Linkou, between January 2000 and May 2021, of whom 79 were diagnosed with CDI based on stool toxin A/B tests. Patients were classified into two groups: 50 with CDI alone and 29 with co-infection of CDI and CI, based on stool culture results. Clinical manifestations, outcomes, and between-group differences were analyzed using the Mann-Whitney U test, while independent risk factors were evaluated through multivariable analysis.

Results
Among the 79 IBD patients included, 50 had CDI and 29 had CDI with CI co-infection. In the co-infection group, the most common symptoms were bloody stool (69%) and diarrhea (65.5%) (Table 1). Clinically, the co-infection group experienced a higher rate of biological therapy failure (1 vs. 0, p = 0.050) and took longer to achieve clinical remission (6.5 vs. 2 months, p = 0.002) and steroid-free remission (11 vs. 6 months, p = 0.016). Multivariable analysis identified biologic use as the only independent predictor of CDI/CI co-infection (OR 5.375, 95% CI 1.822–15.857, p = 0.002).

Conclusion
Co-infection with Clostridioides difficile and Clostridium innocuum is associated with poorer outcomes in IBD patients, including prolonged time to remission and increased risk of biological therapy failure. Early recognition of CI, even in IBD patients with CDI, is crucial for improving clinical management and outcomes.

References
1.Yu S, Ge X, Xu H, Tan B, Tian B, Shi Y, Dai Y, Li Y, Hu S, Qian J. Gut microbiome and mycobiome in inflammatory bowel disease patients with Clostridioides difficile infection. Front Cell Infect Microbiol. 2023;13:1129043. doi:10.3389/fcimb.2023.1129043.
2.Wu HY, Kuo CJ, Chou CH, Ho MW, Chen CL, Hsu TS, Chen YC, Chiang-Ni C, Chen YM, Chiu CH, Lai CH. Clostridium innocuum, an emerging pathogen that induces lipid raft-mediated cytotoxicity. Virulence. 2023;14(1):2265048. doi: 10.1080/21505594.2023.2265048.
3.Bai M, Guo H, Zheng XY. Inflammatory bowel disease and Clostridium difficile infection: clinical presentation, diagnosis, and management. Therap Adv Gastroenterol. 2023;16:17562848231207280. doi:10.1177/17562848231207280.
4.Le PH, Chiu CT, Yeh PJ, Pan YB, Chiu CH. Clostridium innocuum infection in hospitalised patients with inflammatory bowel disease. J Infect. 2022;84(3):337-342. doi: 10.1016/j.jinf.2021.12.031.
P0465 Chromoendoscopy for Dysplasia Detection in High-Risk IBD Patients: A Decade of Experience at a Tertiary Care Centre
Authors: Weisshof R , Postnikov M , Gorelik Y , Ben-Hur D , Waterman M , Koifman E 
Published: January 2025

Abstract

Background
Ulcerative colitis (UC) and colonic Crohn’s disease (CD), carries an increased risk of colorectal cancer, necessitating effective surveillance strategies. Dye spraying and electronic virtual chromoendoscopy techniques enhance mucosal visualisation and aid in dysplasia detection. We aim to presents the effectiveness and characteristics of chromoendoscopy (CE) in a tertiary care center.

Methods
We conducted a retrospective cohort study of inflammatory bowel disease (IBD) patients who underwent CE at our center between 2014 and 2024, following recommended guidelines. Dysplasia detection rates were documented, and associated risk factors were analysed. Advanced dysplasia was defined as villous pathology features, lesion ≥ 10mm, high-grade dysplasia, or malignancy.

Results
A total of 139 patients (50% female; median age at procedure: 51.6 years [IQR 40.6–62.8]; median duration from diagnosis: 17.5 years [IQR 12.2–25.5]) underwent a median of 2 endoscopies (IQR 1–4) with a median Boston bowel preparation score of 8 (IQR 7–9). Among these patients, 75% had UC and 70.8% were non-smokers. Dysplasia was detected in 13 patients (9.4%) at the first surveillance. Overall, the dysplasia detection rate was 17.4% per procedure (64/367) and 14.4% per patient (20/139). Advanced dysplasia was identified in 13 procedures (3.5%). Univariate analysis revealed significant associations between dysplasia detection and male sex (67.4% vs. 44.2%; p = 0.03), age at diagnosis (35 years [IQR 28.5–41.3] vs. 29.2 years [IQR 19.6–37.6]; p = 0.03), age at procedure (62.7 years [IQR 53.2–67.1] vs. 50.4 years [IQR 43.2–62.3]; p = 0.025), and prior dysplasia at first surveillance (25.7% vs. 2.9%; p &lt; 0.001). No correlations were identified with family history of colorectal cancer, treatment history, primary sclerosing cholangitis, or smoking status. Multivariate analysis identified age at procedure as the only significant risk factor (OR: 1.07, 95% CI: 1.02–1.12). Over the past decade, a notable shift was observed from dye chromoendoscopy (usage declined from 74% to 36%) to electronic chromoendoscopy (usage increased from 8.3% to 67.6%). Dysplasia detection rates remained steady over time (figure 1).

Conclusion
Routine chromoendoscopy surveillance in high-risk colitis patients yields high dysplasia detection rates. Our findings reaffirm the association of some of the known risk factors with increased dysplasia detection and highlight the growing preference for electronic CE in endoscopic surveillance. These results further reinforce the value of chromoendoscopy in targeted and effective surveillance strategies.
P0466 Impact of the COVID-19 Pandemic on Clinical Presentation and Management of Inflammatory Bowel Disease: A Multicentre Study in the West Midlands, UK
Authors: Rafique H , Ismail A , Umar N , Hasaan S , Rahania K , Saeed M H , Harvey P , De Silva S 
Published: January 2025

Abstract

Background
The COVID-19 pandemic disrupted healthcare systems globally, exacerbating disease severity and delaying management of chronic conditions like inflammatory bowel disease (IBD). This multicentre study investigates the pandemic’s impact on clinical presentation, treatment patterns, and outcomes of ulcerative colitis (UC) and Crohn’s disease (CD) patients at two UK district hospitals.

Methods
A retrospective study was conducted between July 2017–June 2022 at two district hospitals, comparing pre- and post-COVID outcomes in UC and CD patients. Factors analyzed included disease extent, inflammatory markers, treatment patterns, diagnostic investigations, and patient outcomes, such as emergency surgery.

Results
Among 602 IBD patients (52.2% UC, 47.8% CD), the median age was 41 years (IQR 29), and 51.3% were male. Post-COVID, UC patients presented with more severe disease: UC E3 (Extensive Colitis) increased from 24.0% to 32.8% (p=0.01), while UC E1 (Proctitis) decreased from 18.4% to 7.4% (p=0.004). Median hospital stays rose from 4 to 6 days (p=0.03), with inflammatory markers showing significant increases—median CRP levels rose from 25 to 35 mg/L (p=0.016), and faecal calprotectin levels increased from 600 to 1800 µg/g (p&lt;0.0001). Treatment patterns shifted, with reduced 5-ASA (77.6% to 59.3%, p=0.001) and immunosuppressant use (19.2% to 9.0%, p=0.004) but increased biologic therapy (27.2% to 31.7%, p=0.001).
In CD, disease localization shifted significantly: terminal ileum involvement (CD L1) rose from 30.6% to 46.8% (p=0.001), while ileocolonic disease (CD L3) decreased from 45.9% to 31.1% (p=0.01). Imaging utilization nearly doubled, with CT/MRI use increasing from 36.7% to 71.6% (p&lt;0.001). Post-COVID CD patients were younger, with median age decreasing from 42 to 39 years (p=0.05). Untreated cases in the younger cohort of age &lt;43 years rose from 64% to 84% (p=0.004). Emergency surgery rates in both UC and CD and ITU admission rates remained unchanged pre- and post-COVID.

Conclusion
Post-COVID, UC patients presented with more extensive colitis, higher inflammatory markers, and longer hospital stays. CD patients showed shifts in disease localization, increased imaging use, and a younger, less-treated demographic. Delayed access to care likely fostered disease progression, compounded by pandemic-related psychological stress and immune dysregulation. Strengthening healthcare systems with robust referral pathways and timely IBD treatment is essential to mitigate impacts of any future systemic disruptions.
P0470 Albumin as a prognostic marker in IBD : Insights from a Tertiary Care Hepato-Gastroenterology Center Experience
Authors: Adamou Mainassra F , Koulali H , Hassini A , Essadi B , Douhri I , Elmqddem O , Zazour A , Zahi I , Kharrasse G 
Published: January 2025

Abstract

Background
Chronic inflammatory bowel diseases (IBD) are persistent conditions characterized by alternating phases of flare-ups and remissions, ranging from mild exacerbations to severe cases, such as those in ulcerative colitis (UC), which may require colectomy and significantly affect patients’ functional and vital outcomes. Over time, several predictive markers, particularly in Crohn’s disease (CD), have been identified at diagnosis. This raises an essential question: could hypoalbuminemia be considered a prognostic factor in the clinical course of IBD?

Methods
This retrospective descriptive and analytical study spanned 5 years and 2 months (January 2018 to March 2023) and included all IBD patients monitored in our department. Data analysis was conducted using SPSS, with chi-square tests and multivariate logistic regression employed to evaluate relationships

Results
302 IBD patients were analyzed, with a mean age of 40.7 years and a female predominance ( sex ratio = 0.7).165 had Crohn’s disease (CD), and 143 had ulcerative colitis (UC), categorized as pancolitis (61 cases), UC E2 (46 cases), and UC E1 (30 cases). In the CD cohort, 30% (50 patients) underwent ileocecal resection. Smoking and alcoholism were reported in 14.9% and 6.6% of cases, respectively, while NSAID and PPI use were noted in 11.5% and 3.3%. Additionally, 8.6% reported phytotherapy use. Hypoalbuminemia was defined as serum albumin ≤35 mg/L, with 32% (97 patients) meeting this criterion. Patients with hypoalbuminemia were treatment-naïve and had serum albumin levels assessed at diagnosis, with follow-up for at least one year.

Key findings included
• Steroid Use: 78.35% of hypoalbuminemic patients required at least two courses of corticosteroids, compared to 12.68% with normal albumin levels (P=0.003).
• Thiopurines and Anti-TNF: Thiopurines were used in 81% of hypoalbuminemic patients vs. 45.8% (P=0.001), and anti-TNF therapy in 42.2% vs. 16.58% (P=0.006).
• Colectomy: Rates were higher in hypoalbuminemic patients (17.52%) compared to those with normal albumin (0.4%, P=0.009).
• Anemia: Observed in 92.78% of hypoalbuminemic cases vs. 18.53% with normal albumin levels (P=0.001).
Notably, only 7.2% of hypoalbuminemic patients were treated with combined oral and rectal 5-ASA, achieving sustained clinical and endoscopic remission over three years.

Conclusion
In conclusion, our study highlights hypoalbuminemia as a critical prognostic marker in the progression of IBD. Assessing albumin levels at diagnosis, particularly in UC, provides valuable insight for identifying patients at higher risk of severe disease, guiding the need for intensified treatment and closer follow-up. This reinforces the importance of early, comprehensive evaluation in optimizing IBD management strategies
P0471 Prevalence and risk factors for gallstone and renal stone formation in patients with intestinal Behçet’s disease
Authors: Park J , Jae Hee C 
Published: January 2025

Abstract

Background
The association between inflammatory bowel disease (IBD) and gallstone and renal stone formation has been established. However, few studies have investigated this association in patients with intestinal Behçet’s disease (BD).We aimed to examine the prevalence of gallstones and renal stones in patients with intestinal BD and identify potential risk factors.

Methods
We analyzed gallstone and renal stone occurrences in 553 patients diagnosed with intestinal BD who had undergonecross-sectional imaging examinations between March 2005 and April 2021 at the IBD Center, Severance Hospital,Seoul, South Korea. Logistic regression models were used to identify risk factors for gallstone and renal stone formation.

Results
Of 553 patients over a mean 12.1-year duration, 141 (25.4%) patients had gallstones and 35 (6.3%) had renal stones. In multivariate logistic regression analysis, disease duration &gt; 19 years (OR 2.91, 95% CI 1.56–5.44, p &lt; 0.001), prior intestinal BD-related surgery (OR 2.29, 95% CI 1.42–3.68, p &lt; 0.001), and disease activity index for intestinal BD scores ≥ 75(OR 2.23, 95% CI 1.12–4.45, p = 0.022) were associated with increased gallstone occurrence. A positive correlation was observed between renal stones, disease duration &gt; 19 years (OR 5.61, 95% CI 1.98–15.90, p = 0.001) and frequent hospitalization(&gt; 3 times) (OR 3.29, 95% CI 1.52–7.13, p = 0.002). No significant correlation was observed between gallstone and renal stone occurrence.

Conclusion
These findings contribute to greater understanding concerning gallstone and renal stone prevalence and associated risk factors in patients with intestinal BD.

References
1.Sakane T, Takeno M, Suzuki N, Inaba G. Behçet’s disease. NEngl J Med 1999;341:1284-1291.
2.Kaklamani VG, Kaklamanis PG. Treatment of Behçet’s disease--an update. Semin Arthritis Rheum 2001;30:299-312.
3.Kim DH, Cheon JH. Intestinal Behçet’s disease: a true inflammatorybowel disease or merely an intestinal complication ofsystemic vasculitis? Yonsei Med J 2016;57:22-32.
4.Suzuki Y, Hagiwara T, Kobayashi M, Morita K, Shimamoto T,Hibi T. Long-term safety and effectiveness of adalimumab in462 patients with intestinal Behçet’s disease: results from alarge real-world observational study. Intest Res 2021;19:301-312.
5.Song EM, Yang SK. Natural history of inflammatory boweldisease: a comparison between the East and the West. IntestRes 2022;20:418-430.
P0473 Establishment of a prediction model for endoscopic activity of Ulcerative Colitis based on Intestinal ultrasound combined with biochemical indicators
Authors: Zhao Y , Pei J , Li Y , Pu T , Wen H 
Published: January 2025

Abstract

Background
Intestinal ultrasound (IUS) is becoming a standard evaluation tool for ulcerative colitis (UC). Since the limited diagnostic efficacy of individual ultrasound parameters, we aimed to develop and validate a predictive model for endoscopic disease activity in ulcerative colitis based on transabdominal intestinal ultrasound in combination with biochemical indices, to improve the non-invasive standard of UC synthetically

Methods
This study enrolled 101 consecutive adult UC patients in the First Affiliated Hospital of Zhengzhou University from June 2022 to August 2024. Classified by Mayo endoscopic score (MES) as remission (MES = 0), mild (MES = 1), moderate (MES = 2), and severe (MES = 3). The 101 patients were split into a training set (n = 81) and a test set (n = 20), with 10% of the training set as the validation set. The neural network model was built using an MLP multi-layer perceptron (Fig. 1), and the prediction performance of the model was evaluated using accuracy, precision, recall, and AUC.

Results
1. The ultrasound indicators selected for correlation analysis with MES score including bowel wall thickness (BWT), Limberg blood flow signal, blood flow velocity, resistance index, and mesenteric hypertrophy were statistically significant (p&lt;0.05).
2. The laboratory indicators selected for correlation analysis with the MES score including WBC, PLT count, hemoglobin, CRP, PCT, ESR, and ALB were statistically significant (p&lt;0.05).
3. Seven biochemical indices and five IUS indices that had strong correlations were selected as inputs to construct an MLP network. In the test set, the combined US-bio model was used to predict the states of remission (MES = 1), mild (MES = 2), moderate (MES = 3), and severe (MES = 4), and the AUC values were 94.7%, 93.3%, 73.3%, and 94.9% respectively. When predicting the overall disease activity, the combined model predicted the disease activity of UC patients, with an AUC of 89.1%, an accuracy of 53.2%, and a recall of 52.2% (Table 1).

Conclusion
The indicators of IUS and laboratory biochemical are significantly related to the disease activity of UC patients. The neural network prediction model established based on IUS indicators combined with biochemical indicators can effectively predict the disease activity of UC patients.
P0475 Differential characteristics and predictors of time to colectomy in ulcerative colitis: stratified by medical refractory disease vs. colitis-associated neoplasia
Authors: Kim J , Hebert-milette I , Conner J , Borowski K , Stempak J , Lee S H , Silverberg M S 
Published: January 2025

Abstract

Background
Colectomy rates for ulcerative colitis (UC) have likely decreased in recent decades due to advancements in therapy, but surgery remains crucial for managing medically refractory disease or UC-associated neoplasia. This study aimed to evaluate the differential characteristics and predictors of early colectomy in UC patients undergoing colectomy for medical refractoriness versus UC-associated neoplasia.

Methods
We retrospectively reviewed the medical records of 569 UC patients who underwent colectomy at Mount Sinai Hospital, Toronto, between January 2010 to June 2023. Patients with pathologically confirmed UC and surgery due to medical refractoriness (MR) or UC-associated neoplasia were included. We analyzed the clinical characteristics and their impact on time to colectomy from diagnosis using Kaplan-Meier survival analysis and multivariate Cox proportional hazards regression models.

Results
Among the 394 patients who met the criteria, 57.1% were male, 94.7% had extensive colitis. The median ages at UC diagnosis and colectomy were 25 years (IQR 19–36) and 36 years (IQR 26-49), respectively. Of these, 288 patients (73.1%) underwent colectomy for MR, and 106 patients (26.9%) for UC-associated neoplasia. The median age at colectomy differed between the MR and neoplasia groups (33 years [IQR 24-44] vs 47 years [IQR 35-55], P &lt; 0.001), as did the median UC duration (4 year [IQR 2-8] vs 16 years [IQR 9-21], P &lt; 0.001). The proportion of patients with primary sclerosing cholangitis was higher in the neoplasia group (2.4% vs 20.5%, P &lt; 0.001). The use of systemic steroids (67.7% vs 15.1%, P &lt; 0.001) and biologics or small molecules (68.8% vs 43.4%, P &lt; 0.001) prior to surgery was higher in the MR group. In the MR group, male sex (HR 1.30, 95% CI 1.02-1.66, P = 0.036), never smoking (HR 1.42, 95% CI 1.02-1.98, P = 0.039), and diagnosis age &gt; 40 year (HR 1.58, 95% CI, 1.15-2.16, P = 0.005) were associated with a shorter time to colectomy. In contrast, in the neoplasia group, age at diagnosis &gt; 40 years (HR 0.39, 95% CI 0.25–0.63, P &lt; 0.001) was linked to a longer time to colectomy.

Conclusion
Significant differences in clinical characteristics were identified between UC patients undergoing colectomy for MR compared with UC-associated neoplasia. Late-onset UC, diagnosed after the age of 40, may be linked to a shorter time to colectomy for medically refractory disease while it seems to have a lower likelihood of early colectomy for neoplasia.
P0478 Peripheral blood cytokines in patients with paediatric-onset Inflammatory Bowel Disease – a systematic review and meta-analysis
Authors: Jansson S , Ehrström A , Rask C U , Burisch J , Benros M E , Seidelin J , Malham M , Wewer V 
Published: January 2025

Abstract

Background
Cytokines play a central role in the aetiology, disease severity and treatment of adult-onset inflammatory bowel disease (IBD)1. However, despite the aggressive phenotype reported in paediatric-onset IBD, little is known about the cytokine levels in paediatric-onset IBD. This systematic review and meta-analysis aimed to summarize findings of cytokine levels in peripheral blood in patients with paediatric-onset IBD compared to healthy controls.

Methods
This systematic review followed the PRISMA guidelines2 and was registered at Prospero [CRD42024579684]. A literature search was performed on the 1st of August 2024 in PubMed, EMBASE, Web of Science and Scopus. We included studies that reported levels of cytokines in plasma or serum, in patients with paediatric-onset IBD and healthy controls. To ensure a complete overview, we did not exclude studies based on patients’ treatment status. Pooled effect sizes of mean values were calculated using Hedges’ g for any cytokine reported by two or more studies. The Newcastle-Ottawa scale was used for quality assessment.

Results
The literature search revealed 10,110 papers (4,582 duplicates), and 5,528 articles were independently screened by two authors. Twenty-one articles met the inclusion criteria including a total of 950 patients with paediatric-onset IBD, and 481 healthy controls. Studies reported on 57 different cytokines. Meta-analysis was performed for interleukin-6 (IL-6) (12 studies, of which 7 provided mean values) and tumour necrosis factor-α (TNF-α) (7 studies, of which 2 provided mean values). Mean values of other cytokines were not provided by two or more studies, and meta-analysis could therefore not be performed. Pooled effect sizes showed increased levels of IL-6 (standardized mean difference: 1.99, 95% confidence interval: 1.15-3.26). However, the heterogeneity between studies was high (Figure 1). Levels of TNF-α did not differ between patients and controls (standardized mean difference: 0.36 95% confidence interval: -0.08-0.79). Overall, the included studies had moderate-good quality.

Conclusion
IL-6 was increased in the peripheral blood of patients with paediatric-onset IBD. Data on other cytokines were scarce.

References
1)Neurath MF. Cytokines in inflammatory bowel disease. Nat Rev Immunol. 2014;14(5):329-342. doi:10.1038/nri3661
2)Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. Published 2021 Mar 29. doi:10.1136/bmj.n71