scholarly journals Preventing disability in inflammatory bowel disease

2017 ◽  
Vol 10 (11) ◽  
pp. 865-876 ◽  
Author(s):  
Patrick B. Allen ◽  
Corinne Gower-Rousseau ◽  
Silvio Danese ◽  
Laurent Peyrin-Biroulet

Disability is a common worldwide health challenge and it has been increasing over the past 3 decades. The treatment paradigm has changed dramatically in inflammatory bowel diseases (IBDs) from control of symptoms towards full control of disease (clinical and endoscopic remission) with the goal of preventing organ damage and disability. These aims are broadly similar to rheumatoid arthritis and multiple sclerosis. Since the 1990s, our attention has focused on quality of life in IBD, which is a subjective measure. However, as an objective end-point in clinical trials and population studies, measures of disability in IBD have been proposed. Disability is defined as ‘…any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.’ Recently, after 10 years of an international collaborative effort with the World Health Organization (WHO), a disability index was developed and validated. This index ideally would assist with the assessment of disease progression in IBD. In this review, we will provide the evidence to support the use of disability in IBD patients, including experience from rheumatoid arthritis and multiple sclerosis. New treatment strategies, and validation studies that have underpinned the interest and quantification of disability in IBD, will be discussed.

Author(s):  
Rabin Hamal ◽  
◽  
Rahul Pathak ◽  
Brindeswari Kafle Bhandari ◽  
Anurag Jha ◽  
...  

The World Health Organization officially declared infection with severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), leading to coronavirus disease 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and then as a pandemic on March 11, 2020 with reports of infection from most of the countries of the world [1]. COVID-19 has severely disrupted prevention and treatment for noncommunicable diseases. Severe illness can occur in otherwise healthy individuals of any age, but it predominantly occurs in adults with advanced age or certain underlying medical comorbidities [2]. Since the beginning of the health emergency, particular attention has been paid to the management of patients with chronic Inflammatory Bowel Diseases (IBDs) because they frequently are treated with immunosuppressive drugs and therefore potentially are exposed to a greater infectious risk than the general population [3].


Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1882
Author(s):  
Juliana Barreto de Albuquerque ◽  
Christoph Mueller ◽  
Bilgi Gungor

Tissue-resident memory T (TRM) cells critically contribute to the rapid immunoprotection and efficient immunosurveillance against pathogens, particularly in barrier tissues, but also during anti-tumor responses. However, the involvement of TRM cells also in the induction and exacerbation of immunopathologies, notably in chronically relapsing auto-inflammatory disorders, is becoming increasingly recognized as a critical factor. Thus, TRM cells may also represent an attractive target in the management of chronic (auto-) inflammatory disorders, including multiple sclerosis, rheumatoid arthritis, celiac disease and inflammatory bowel diseases. In this review, we focus on current concepts of TRM cell biology, particularly in the intestine, and discuss recent findings on their involvement in chronic relapsing–remitting inflammatory disorders. Potential therapeutic strategies to interfere with these TRM cell-mediated immunopathologies are discussed.


2021 ◽  
Vol 1 (6) ◽  
pp. 121-129
Author(s):  
G. R. Bikbavova ◽  
M. A. Livzan ◽  
D. G. Novikov ◽  
E. A. Bambulskaya

With the advent of modern cellular and genomic technologies, we have become participants in the integration of such areas as personalized, predictive, preventive, and precision medicine (referred to as 4P-medicine), into practical healthcare. In replace of the classic methods of diagnosis and treatment of diseases comes medicine, which makes it possible to predict (anticipate) the disease, and a personalized approach to each patient, taking into account their genetic, biochemical and physiological uniqueness. Precision medicine aims to improve the quality of medical care by opening up an individual approach to the patient and covers a wide range of areas, including drug therapy, genetics, and cause-and-effect relationships in order to make the right decisions based on evidence. 4P-medicine combines knowledge in the field of proteomics, metabolomics, genomics, bioinformatics with classical approaches of anatomy, therapy, laboratory and instrumental diagnostics as well as public health. The purpose of this review is to analyze and summarize the information available to date and to present examples of the application of modern approaches of medicine into clinical practice by diving into the example of inflammatory bowel diseases (IBD). The search for literature containing scientific information about relevant studies was conducted in the PubMed and Google Scholar systems with the use of the following keywords: precision medicine, 4P medicine, inflammatory bowel diseases. Despite significant progress in medicine in general, there is still a long way to go before implementing the principles of precision medicine in the field of IBD, since many clinicians continue to treat patients with IBD symptomatically. However, the use of specific biomarkers and new treatment strategies as described in the review, can significantly accelerate this path and contribute to the improvement of diagnostic and therapeutic approaches.


2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Rabin Hamal ◽  
◽  
Rahul Pathak ◽  
Brindeswari Kafle Bhandari ◽  
Anurag Jha; Arun Gnawali ◽  
...  

The World Health Organization officially declared infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to coronavirus disease 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and then as a pandemic on March 11, 2020 with reports of infection from most of the countries of the world [1]. COVID-19 has severely disrupted prevention and treatment for noncommunicable diseases. Severe illness can occur in otherwise healthy individuals of any age, but it predominantly occurs in adults with advanced age or certain underlying medical comorbidities [2]. Since the beginning of the health emergency, particular attention has been paid to the management of patients with chronic Inflammatory Bowel Diseases (IBDs) because they frequently are treated with immunosuppressive drugs and therefore potentially are exposed to a greater infectious risk than the general population [3].


Author(s):  
Igor G. Bakulin ◽  
Maria I. Skalinskaya ◽  
Ekaterina V. Skazyvaeva ◽  
Maria S. Zhuravleva

This review is devoted to the current issues on management of the patients with inflammatory bowel diseases during the new coronavirus SARS-CoV-2 pandemic. Since March 2020, the World Health Organization with the support of international gastroenterological associations has launched a project for monitoring and reporting outcomes of COVID-19 occurring in inflammatory bowel diseases patients SECURE-IBD aimed to define the impact of COVID-19 on patients with inflammatory bowel diseases and how factors such as age, comorbidities, and inflammatory bowel diseases treatments influence COVID outcomes (www.covidibd.org). According to the data of this Registry, no higher incidence of SARS-CoV-2 in patients with inflammatory bowel diseases compared to the general population has been reported. However, active inflammation, severe disease course, the induction period of immunosuppressive therapy and the use of systemic steroids are unfavorable predictors of severe COVID-19 infection course in case of inflammatory bowel diseases.


2020 ◽  
Author(s):  
Muhammet Fatih Aydin ◽  
Hamit Tasdemir

Abstract Background: COVID-19 pneumonia is a widespread viral disease, which affects all the world and has been accepted as pandemic by the World Health Organization (WHO). Coronavirus can remain in the stool for certain time even after recovery from COVID-19 pneumonia in some infected patients. Studies increasingly report involvement of other organs including gastrointestinal system in addition to respiratory symptoms in COVID-19. Ulcerative colitis is an inflammatory bowel disease with unknown cause. Emerging data suggest that gastrointestinal system may also be influenced by COVID-19 based via the expression of ACE-2. However, data abour the association of COVID-19 and inflammatory bowel diseases including ulcerative colitis are lacking. Case Presentation: In this report, we present a case of ulcerative colitis diagnosed in a 50-year-old male patient who presented with the complaints of bloody diarrhea and abdominal pain following the completion of the treatment of COVID-19 pneumonia. Conclusion: Patients presenting with gastrointestnal complaints should also be evaluated for COVID-19.


2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Gerry K. Schwalfenberg

This paper looks at the environmental role of vitamin D and solar radiation as risk reduction factors in autoimmune disease. Five diseases are considered: multiple sclerosis, type 1 diabetes, rheumatoid arthritis, autoimmune disease of the thyroid, and inflammatory bowel disease. Clinical relevant studies and factors that may indicate evidence that autoimmune disease is a vitamin D-sensitive disease are presented. Studies that have resulted in prevention or amelioration of some autoimmune disease are discussed. An example of the utility of supplementing vitamin D in an unusual autoimmune disease, idiopathic thrombocytic purpura, is presented.


2021 ◽  
pp. 135245852110302
Author(s):  
Joanna Laurson-Doube ◽  
Nick Rijke ◽  
Anne Helme ◽  
Peer Baneke ◽  
Brenda Banwell ◽  
...  

Background: Off-label disease-modifying therapies (DMTs) for multiple sclerosis (MS) are used in at least 89 countries. There is a need for structured and transparent evidence-based guidelines to support clinical decision-making, pharmaceutical policies and reimbursement decisions for off-label DMTs. Objectives/Results: The authors put forward general principles for the ethical use of off-label DMTs for treating MS and a process to assess existing evidence and develop recommendations for their use. Conclusion: The principles and process are endorsed by the World Federation of Neurology (WFN), American Academy of Neurology (AAN), European Academy of Neurology (EAN), Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Middle-East North Africa Committee for Treatment and Research in Multiple Sclerosis (MENACTRIMS) and Pan-Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS), and we have regularly consulted with the Brain Health Unit, Mental Health and Substance Use Department at the World Health Organization (WHO).


Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3178
Author(s):  
Ashutosh Tripathy ◽  
Jayalaxmi Dash ◽  
Sudhakar Kancharla ◽  
Prachetha Kolli ◽  
Deviyani Mahajan ◽  
...  

Colorectal cancer (CRC) is the World’s third most frequently diagnosed cancer type. It accounted for about 9.4% mortality out of the total incidences of cancer in the year 2020. According to estimated facts by World Health Organization (WHO), by 2030, 27 million new CRC cases, 17 million deaths, and around 75 million people living with the disease will appear. The facts and evidence that establish a link between the intestinal microflora and the occurrence of CRC are quite intuitive. Current shortcomings of chemo- and radiotherapies and the unavailability of appropriate treatment strategies for CRC are becoming the driving force to search for an alternative approach for the prevention, therapy, and management of CRC. Probiotics have been used for a long time due to their beneficial health effects, and now, it has become a popular candidate for the preventive and therapeutic treatment of CRC. The probiotics adopt different strategies such as the improvement of the intestinal barrier function, balancing of natural gut microflora, secretion of anticancer compounds, and degradation of carcinogenic compounds, which are useful in the prophylactic treatment of CRC. The pro-apoptotic ability of probiotics against cancerous cells makes them a potential therapeutic candidate against cancer diseases. Moreover, the immunomodulatory properties of probiotics have created interest among researchers to explore the therapeutic strategy by activating the immune system against cancerous cells. The present review discusses in detail different strategies and mechanisms of probiotics towards the prevention and treatment of CRC.


2008 ◽  
Vol 23 (8) ◽  
pp. 567-574 ◽  
Author(s):  
Daniela Z. Knijnik ◽  
Carlos Blanco ◽  
Giovanni Abrahão Salum ◽  
Carolina U. Moraes ◽  
Clarissa Mombach ◽  
...  

AbstractBackgroundBoth psychodynamic group therapy (PGT) and clonazepam are used as treatment strategies in reducing symptoms of generalized social anxiety disorder (GSAD). However, many individuals remain symptomatic after treatment with PGT or clonazepam.MethodFifty-eight adult outpatients with a diagnosis of GSAD according to DSM-IV were randomized to 12 weeks PGT plus clonazepam or clonazepam. The Clinical Global Impression-Improvement (CGI-I) Scale was the primary efficacy measure. Secondary efficacy measures included the Liebowitz Social Anxiety Scale (LSAS) total score, the World Health Organization Instrument to Assess Quality of Life—Brief (WHOQOL-Bref) Scale and the Beck Depression Inventory (BDI).ResultsCGI-I data from 57 patients (intent-to-treat population) showed that patients who received PGT plus clonazepam presented significantly greater improvement than those who received clonazepam (P = 0.033). There were no significant differences between the two groups in the secondary efficacy measures.ConclusionsOur study suggests that the combination of PGT with clonazepam may be a promising strategy for the treatment of GSAD, regarding gains in the global functioning. However the present study failed to detect more specific changes in social anxiety symptomatology between the two groups.


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