bluuebunny/crossref_metadata_2025_split huggingface dataset:
P135 Usefulness of clinical and ultrasound indices to assess enthesis lesions in patients with inflammatory bowel diseases
Authors: Gainullina G , Abdulganieva D , Kirillova E , Odintsova A 
Published: January 2022

Abstract

Background
The aim of the study was to assess existing clinical and ultrasound indices for the evaluation of enthesopathies in patients with inflammatory bowel diseases (IBD).

Methods
95 pts with IBD were prospectively enrolled into the study: 55 of them with ulcerative colitis (UC) and 40 with Crohn’s disease (CD). Clinically we counted tender entheses in 46 points of the upper and lower extremities. LEI (Leeds Enthestis Index) (0–6 points), MASES (Maastricht Ankylosing Spondylitis Enthesitis Score) (0–13 points) and the SPARCC index (Spondylarthritis Research Consortium of Canada) (0–16 points) were calculated. Ultrasound examination was performed in B-mode and PD-mode. Entheseal hypoechogenicity, entheseal thickening, presence of vascularization were considered as acute lesions. Bone erosions and enthesophytes were considered as chronic lesions. GUESS (Glasgow Ultrasound Enthesitis Scoring System) (0–36 points), MASEI (Madrid Sonography Enthesitis Index) (0–136 points) and BUSES (Belgrade Ultrasound Enthesitis Score) (0–132 points) were calculated. Spearman coefficient used to calculate correlations.

Results
In pts with tender ≥ 1 enthesis, the LEI was positive in 26% of patients, the MASES index - in 7%, the SPARCC index - in 18%, the US indices were positive in a larger number of patients: GUESS - in 47%, MASEI - in 40% and BUSES - 54%.A total of 6460 entheses were examined using Doppler ultrasound. The number of enthesites was 293/6460 (4.5%), the number of enthesites with vascularization was 62/6460 (1.0%), the number of erosions was 313/6460 (4.8%), the number of enthesophytes was 91/6460 (1, 4%).A direct correlation is observed between the number of enthesites and LEI indices (SR = 0.54; p = 0.00), MASES (SR = 0.42; p = 0.00), SPARCC (SR = 0.54; p = 0, 00), GUESS (SR = 0.22; p = 0.02), BUSES (SR = 0.32; p = 0.001), as well as between the number of enthesitis with vascularization and LEI indices (SR = 0.24; p = 0.017), MASES (SR = 0.34; p = 0.00), GUESS (SR = 0.23; p = 0.022), MASEI (SR = 0.32; p = 0.001), BUSES (SR = 0, 29; p = 0.003). A statistically significant relationship was found between the number of erosion and the GUESS indices (SR = 0.48; p = 0.00), MASEI (SR = 0.49; p = 0.00), BUSES (SR = 0.5; p = 0, 00), as well as between the number of enthesophytes and the GUESS indices (SR = 0.75; p = 0.00), MASEI (SR = 0.28; p = 0.00), BUSES (SR = 0.57; p = 0.00).

Conclusion
Acute lesion of enthesis in patients with IBD can be assessed using both clinical (LEI, MASES, SPARCC) and ultrasound indices (GUESS, MASEI, BUSES). To assess chronic lesions (erosion, enthesophyte) changes in enthesis in patients with IBD, it is preferable to use ultrasound indices.
P159 Faecal S100A12 as a non-invasive marker of inflammatory activity in Inflammatory Bowel Disease
Authors: Cenni S , Casertano M , Caprio A M , Pacella D , Miele E , Martinelli M , Staiano A , Strisciuglio C 
Published: January 2022

Abstract

Background
Calgranulin-C (f-S100A12) and zonulin are considered faecal marker of intestinal inflammation. The aim of our study was to evaluate f-S100A12 and fecal zonulin as alternative markers in the follow-up of IBD children to monitore the disease activity and to predict the clinical and endoscopic relapse, compared with FC and serum inflammatory markers.

Methods
Between September 2019 and March 2020, we prospectively enrolled all IBD pediatric patients, both Crohn’s Disease (CD) and Ulcerative Colitis (UC). S100A12, zonulin and faecal calprotectin (FC) were determined by enzyme-linked immunosorbent assay (ELISA).

Results
One hundred seventeen consecutive children, 39.3% with CD and 71 60.7% with UC were enrolled. No differences were found for FC, f-S100A12 and zonulin values in UC and CD. In both CD and UC there was a direct correlation between FC and f- S100A12 levels (r=0.54; p&lt;0.001 and r = 0.63; p&lt;0.001, respectively). F-S100 correlated directly with fibrinogen (r=0.32; p=0.038), platelets count (r=0.35; p=0.021), WBC (r=0.39; p=0.009) and SES CD (r=0.459, p=0.004) and inversely with hemoglobin (r= -0.40; p=0.0077), hematocrit (r=-0.43; p=0.015). In patient with UC we found a direct correlation between f-S100 and CRP (r=0.252; p=0.040) and platelet count (r=0.254; p=0.038). There was no correlation between f-S100A12 and PUCAI or PCDAI score. No association was found between Paris and fecal biomarkers evaluated both in CD and UC. No significant correlation were found between zonulin and the different parameters studied.

Conclusion
Our data suggest that f-S100A12 and FC but not F-zonulin are useful non-invasive biomarkers in the management of pediatric IBD in follow up and to monitor endoscopic relapse in CD patients.
P180 The prevalence and clinical course of atypical distribution of inflammation in newly diagnosed ulcerative colitis
Authors: Kim N Y , Lee Y J , Kim K O , Kim E S , Lee H S , Kim S K , Jang B I , Kim E Y , Cho K B , Kim J 
Published: January 2022

Abstract

Background
Ulcerative colitis (UC) is characterized by continuous mucosal inflammation extending from rectum to the proximal lesion. However, there are cases of atypical distribution of inflammation, such as appendiceal orifice inflammation (AOI), skipped lesion, and rectal sparing. This study aimed to evaluate the prevalence and clinical course of atypical distribution of inflammation in newly diagnosed UC.

Methods
Between 2013 and 2021, 374 patients who underwent a colonoscopy at the time of diagnosis of UC were retrospectively reviewed. Clinical courses including relapse rate within 1-year, 2-year of diagnosis and exposure to immunomodulator or biologics during follow-up were retracted from the prospective IBD registry (ClinicalTrial.gov, NCT02193464). Atypical UC was defined as patients with AOI, skipped lesion or rectal sparing at initial colonoscopy. The clinical courses and changes of endoscopic findings were compared between typical UC group and atypical UC group.

Results
Of 374 patients, 116 (31.0%) categorized as atypical UC; specifically, 90 (24.1%) showed AOI, 17 (4.5%) showed rectal sparing and 49 (13.1%) showed skipped lesion. When 90 patients with AOI were reclassified according to the extent of inflammation, 62(16.6%) had a localized inflammation at peri-appendiceal area, 13(3.5%) had an inflammation of the entire cecum, 15(4.0%) had an inflammation extends to the proximal A-colon. The clinical courses of atypical UC were not different from typical UC group, however, patients with skipped lesion showed a lower 1-year relapse rate compared to those without skipped lesion (P=0.042). Of 96 patients with atypical UC who underwent follow-up endoscopy, 73 (75.8%) demonstrated a typical distribution of UC at their follow-up colonoscopy.

Conclusion
Atypical distribution of UC including AOI, skipped lesion, and rectal sparing are not uncommon in patient with newly diagnosed UC. However, most of these features do not appear to correlate significantly with prognosis in the clinical course of UC. In majority of patients with atypical UC, the lesion turned into typical UC on follow-up colonoscopy.
P183 A systematic review on outcome measures of long-term efficacy in clinical trials concerning Crohn’s disease patients
Authors: Janssen L , Creemers R , van Bodegraven A , Pierik M 
Published: January 2022

Abstract

Background
Treatment goals for Crohn’s disease (CD) tend to shift from clinical towards endoscopic remission as a potential means to reduce intestinal damage. Additionally, sustained corticosteroid (CS) free remission is warranted to prevent drug related side effects.
In clinical trials, long-term efficacy of treatment is assessed by a range of outcome measures at variable time points. Besides clinical activity, it is recommended by the EMA to measure biochemical and endoscopic activity, given the poor correlation between commonly applied clinical activity indices and mucosal inflammation. Finally, STRIDE advices to add a PROM given the frequent perception gap in disease control between patient and health care professionals.
Moreover, the relapsing-remitting nature of CD challenges timing of efficacy evaluations. Use of cross-sectional outcomes only on predetermined moments disregards the health status in between these measurements.
In this systematic review, we provide an overview of the outcomes employed to assess long-term efficacy of maintenance (drug) therapy or treatment strategies in randomized controlled trials and their open label extensions in CD patients.

Methods
A systematic search of Pubmed and Embase databases was performed. Giving the emerging treatment goals, the search was restricted to trials published since 2007.
Two independent reviewers screened titles and abstracts and selected eligible trials. We assessed whether and when long-term (i.e. &gt;48 weeks) clinical, biochemical and/or endoscopic efficacy outcomes were used. In addition, data on patient perspective and CS use were collected.

Results
Sixty-seven out of 1947 articles were included (figure 1).

Clinical activity indices were used in 66 studies (99%) as long-term efficacy outcome, with 20 studies (30%) taking into account concomitant CS use. C-reactive protein concentration was (part of) an outcome in 29 studies (43%), and faecal calprotectin in 15 studies (22%). Endoscopic activity was evaluated in 30 studies (45%). PROMs were used in 29 studies (43%), with IBDQ being the most frequently used. Seven studies measure long-term clinical, biochemical, endoscopic activity and patient perspective, in three studies a sustained CS free status as part of the outcome was required (table 1). In most studies cross-sectional measures or multiple measurements over time, so-called panel data, were used.

Conclusion

We established a lack of objective outcome measures of inflammation and patient perspective in clinical trials in CD, consequently missing pivotal data to evaluate current treatment goals. Additionally, cross-sectional outcomes on fixed time points were mostly applied, resulting in loss of efficacy information in chronic relapsing-remitting diseases.
P186 Can transabdominal bowel ultrasound accurately detect both small and large bowel Crohn Disease in pediatric patients when compared to MRE?
Authors: Hudson A , Huynh H Q , Ma H , Kuc A , Kim J , Almeida P , Carroll M W , Wine E , Thompson A , Isaac D M 
Published: January 2022

Abstract

Background
Magnetic resonance enterography (MRE) has been the modality of choice to assess small bowel inflammation in patients with Crohn disease (CD). It can also assess large bowel when not feasible to assess endoscopically. Transabdominal bowel ultrasound (TABUS) is an attractive non-invasive tool to assess CD activity. Studies to date have focused on its correlation to large bowel endoscopic findings in adult CD. This study aimed to compare TABUS and MRE in identifying small and large bowel CD in pediatric patients.

Methods
Pediatric patients (≤18 years old) seen for suspected CD were prospectively enrolled and underwent baseline TABUS, endoscopy, MRE, blood work and stool studies. The Pediatric Crohn’s Disease Activity Index (PCDAI) and Simple Endoscopic Score for Crohn’s Disease (SES-CD) were used to assess disease activity. Bowel wall thickness (BWT) was assessed by TABUS and MRE. TABUS measurements were scored with the Simple Ultrasound Activity Score for Crohn Disease (SUS-CD) (0=≤3mm, 1=3–4.9mm, 2=5–7.9mm, 3=≥8mm). Pearson Chi-square was used to compare BWT between TABUS and MRE.

Results
21 patients (71% male) were included, with a median age of 13 years (range 6–16). Median PCDAI was 40 (25–49) and SES-CD 15 (6.5–22). There was a high level of agreement between MRE and TABUS (Figure 1) with some disagreement in the jejunum (n=9/21, 43%). For terminal ileal (TI) disease where there was disagreement, endoscopy of TI was in agreement with TABUS in two patients and MRE in five patients. Endoscopic TI disease that was documented as normal on TABUS was mild (SES-CD 3). In patients with abnormal MRE, BWT was not significantly different between the two modalities (Table 1). In patients with normal MRE, TABUS SUS-CD scores were accurately 0 in almost all segments (score 1 in TI) (Table 2). TABUS correctly identified no fistulae and 2 small bowel strictures (identified at endoscopy), but did not detect 1 intra-abdominal abscess and 4 large bowel strictures (only 1 stricture seen on endoscopy). Excessive lymph nodes (&gt;4) were successfully seen on TABUS in 10/16 patients. TABUS correctly identified 75% of patients with significant mesenteric fibrofatty proliferation. Hyperemia on TABUS corresponded to an abnormal MRE for that segment in 92–100% of small bowel and 50–86% of large bowel.

Conclusion
TABUS and MRE are comparable modalities in the assessment of small and large bowel disease in newly diagnosed pediatric CD patients. Assessment of proximal small bowel is complex, and MRE may over-call disease. MRE still plays an important role in assessing abscesses and mild large bowel narrowing. Hyperemia on TABUS is an important indicator of active bowel inflammation, and is particularly useful for endoscopically inaccessible small bowel.
P193 Correlation of the IBD Disk scores with diagnosis of IBD, Faecal calprotectin and Endoscopic scores in patients presenting to a rapid access IBD inception clinic
Authors: Shariff S , Sharma N , Quraishi M N , Cooney R , Iqbal T , Rimmer P 
Published: January 2022

Abstract

Background
The IBD-Disk was adapted from the Inflammatory Bowel Disease –Disability Index as a tool to capture a patient’s functional status for Health Care Professionals to review. Patients complete this disk for ten symptoms with scores ranging from 0 to 10. Patients with higher scores have a significant burden of disease. We explore correlation of IBD disk score with faecal calprotectin, endoscopic scores, and a diagnosis of IBD in patients referred to our inception clinic service.

Methods
Patients with symptoms compatible with Inflammatory Bowel Disease (IBD) and a raised faecal calprotectin are fast tracked to our rapid access inception clinic service for further assessment. We prospectively collected data on demographics, faecal calprotectin levels and IBD disk scores. We assessed correlation between the total score and individual components of the IBD disk score with demographics, faecal calprotectin (F.Cal) at presentation and subsequent diagnosis of IBD and endoscopic scores. Descriptive and multivariate regression analysis was performed.

Results
68 patients (47% female; median age 35.5 years [IQR 16.8]) attending the inception clinic were included in this analysis. Of these patients 17/68 (25%) were diagnosed with Crohn’s disease (CD), 18/68 (26%) with ulcerative colitis (UC) and 5/68 (7%) with indeterminate colitis. 33 (33.8%) had unclear diagnoses and are currently undergoing further investigation. IBD was excluded in 5/68 (7%) patients. Younger patients (age 15 – 30 years) and patients above 60 years of age had a relatively higher F.Cal at presentation (Figure 1).
The total IBD disk score was significantly higher in younger patients (p=0.03). No correlation was seen between the eventual diagnosis of IBD and total score at presentation or individual components of the IBD disk score. Multivariate regression analysis, however, demonstrated significant correlation between regulated defecation and interpersonal interactions with F.Cal at baseline in patients with IBD (p&lt;0.05). No correlation was seen with other variables of the IBD disk and faecal calprotectin levels.
IBD Disk score as well as Harvey Bradshaw index correlated well with Simple Endoscopic Score in Crohn’s disease (SES-CD) (Figure 2). No significant correlation was seen between IBD Disk score and baseline F.Cal or Endoscopic Mayo Score. The simple Mayo score showed a better correlation between F.Cal and Endoscopic Mayo score than IBD Disk.

Conclusion
Correlation of F.Cal with certain elements of the IBD Disk tool highlights its utility in capturing both inflammatory and non-inflammatory related disability in patients with IBD. IBD Disk Scores correlate with CD endoscopic severity scores (ie SES-CD) but not UC scores (ie Endoscopic Mayo Score).
P194 A modified Rutgeerts score of i2a after ileocolic resection for Crohn’s Disease: endoscopic recurrence or anastomotic healing?
Authors: Van Der Does De Willebois E , Duijvestein M , Wasmann K , D’Haens G , Buskens C , Bemelman W 
Published: January 2022

Abstract

Background
The reliability and reproducibility of scoring endoscopic recurrence is of utmost importance because it generally determines initiating postoperative medical therapy and it is used as outcome parameter in clinical trials. Variability in endoscopic scoring may result in inappropriate therapeutic decisions and study conclusions. It is hypothesised that different types of anastomoses have an influence on scoring endoscopic recurrence using the Rutgeerts’ score. The aim of this study is to analyse to what extent the ulcerations are determined by the type of anastomosis and how it interferes with the scoring of Crohn’s recurrence.

Methods
This is a retrospective review of endoscopy videos to re-assess endoscopic recurrence. All videotapes of the ileocolonoscopy were blinded and scored by a trained gastroenterologist (MD) and a surgeon (WB). Videos were excluded if the quality of the video was low or if the anastomosis was not visualised properly. The primary outcome is the presence of ulcerations six months after surgery, on individual parts of the anastomosis: inverting stapled anastomosis (side to side conjunction) and everting type of junction (transection ends). In the latter group, at least one site – colon, ileum or both – was scored.

Results
Of 99 available endoscopy videos, eighty-nine eligible patients were included in this retrospective study for analysis. The inverting and everting stapled anastomosis were scored individually using the SES-CD. A SES-CD of zero was found in 21/89 (23.6%) of the inverting anastomoses versus 74/75 (98.67%) in the everting anastomoses.

Conclusion
This study demonstrated a significant difference in wound healing of the inverting anastomosis versus the everting anastomosis. Inverting anastomoses show ulcerations and a circular scar long after surgery irrespective of the presence of ulcerations of terminal ileum. A normal wound healing phenomena might mistakenly be seen for recurrent Crohns’ disease. Everting anastomosis, on the contrary, heal without residue.
P209 Disproportionate low albumin and high neutrophil-to-lymphocyte ratio in small bowel adenocarcinoma in long-term Crohn’s disease patients
Authors: Veisman I , Oppenheim A , Sub laban Z , Kenig A , Ukashi O , Shacham-Shmueli E , Engel T , Kopylov U , Ben-Horin S , Lang A 
Published: January 2022

Abstract

Background
Although Crohn’s disease (CD) is a known risk factor for small bowel adenocarcinoma (SBA), early diagnosis remains a significant clinical challenge with many cases diagnosed inadvertently during small bowel resection or biopsies performed for presumed active or structuring CD. Identification of biomarkers for SBA may lead to early detection and improved prognosis in CD patients. The aim of the study was to explore a possible association between two simple laboratory values – serum albumin levels and neutrophil-to-lymphocyte ratio (NLR) and SBA in CD patients.

Methods
A retrospective case-control study comparing long-standing (&gt;10 years) CD patients who have undergone small bowel (SB) resection with carcinoma detection by histopathology examination, compared with long-standing CD patients who underwent SB resection without malignancy detection at a ratio of 1:3 of cases to controls. Demographics, disease behavior, NLR, albumin levels and total parenteral nutrition (TPN) status during the three months period prior to surgery were retrieved and compared between groups.

Results
Forty-two patients with long-standing CD were included (11 with SBA and 31 patients without SBA). Median age was 55 [Interquartile range (IQR) 44–65] in the malignancy group and 37 (IQR 31–47) in the no-malignancy group (p-value &lt; 0.05). Median NLR in the three months prior to surgery was 8.5 (IQR 6.2–31.3) in SBA patients and 3.8 (IQR 2.8–5.3) for patients without SBA (p &lt; 0.05). Mean albumin levels during the three months period prior to surgery were significantly lower among patients with SBA compared with patients without SBA (2.6 ± 0.6 g/dL versus 3.5 ± 0.6 g/dL, respectively, p &lt; 0.05), despite SBA patients being treated with TPN for significantly longer duration.

Conclusion
CD patients with SBA have statistically significant increased NLR and lower albumin compared with surgically treated CD patients without SBA. If corroborated by further studies, high NLR and disproportionate low albumin levels in long-duration CD patients may be useful biomarkers of SBA.
P211 Vaccination against Sars-Cov-2 in IBD patients: experience from a single tertiary referral centre
Authors: Bezzio C , Guarino A D , Arena I , Della Corte C , Devani M , Manes G , Schettino M , Sablich E , Vernero M , Saibeni S 
Published: January 2022

Abstract

Background
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 have afflicted millions of people in a global pandemic. Recently developed vaccines against SARS-CoV-2 represent one of the most important tool in limiting widespread of infection. However, it is known that vaccination rates in IBD patients are suboptimal. The aim of this study was to compare clinical and socio-demographic features of IBD patients undergoing or not vaccination against SARS-CoV-2, and assess the reasons of who expressed their consent.

Methods
A questionnaire was administered to all consecutive IBD contacted by a tertiary referral center for vaccine against SARS-CoV-2 from April 10th 2021 to May 16th 2021. Comparisons of prevalence were assessed by Fisher’s exact test (significance level p&lt;0.05)

Results
475 IBD patients were contacted by phone call: 28 of them were not reachable, 98 were already vaccinated. Of the remaining 349 IBD patients, 324 (92.8%) accepted to be vaccinated while 25 (7.2%) refused. The questionnaire was compiled by 248/324 (76.5) of accepting and by 19/25 (76.0%) of refusing patients. Their demographic, social and clinical features are shown in Table 1. Among the different variables, only a previous unwillingness to be vaccinated against influenza was associated with the refuse of vaccine anti-SARS-CoV-2. Age, sex, diagnosis, marital status, educational level, employment, previous COVID-19 and biologics and/or immunosuppressants were not associated with the decision to be vaccinated or not.
171 (68.9%) IBD patients have been always pro-vaccine, while the others 77 decided after discussion with their own gastroenterologist (41, 53.2%), relatives (16, 20.8%), general practitioner (9, 11.7%) or according to mass-media (9, 11.7%). The reasons leading to be vaccinated were: duty of collective (190, 76.6%), back to the normality (91, 36.7%) and fear to get sick (71, 28.6%). The possibility to be vaccinated in their own IBD Centre was considered relevant by 141 (56.8%) IBD patients. After vaccine, 67 (27.0%) reported no concerns; the others reported the following: side effects in the short- and long-term (60, 24.2% and 62, 25.0%, respectively), IBD flare (22 (8.9%), interference with IBD medications (19, 7.7%) and inefficacy (18, 7.3%).

Conclusion
The majority of IBD patients accepted to be vaccinated against SARS-CoV-2. IBD patients who previously refused vaccine against influenza also refused vaccine against SARS-CoV-2. The possibility to be vaccinated in their own IBD Centre and, among undecided patients, the gastroenterologist recommendations played a relevant role towards the decision to be vaccinated.