scholarly journals Features of inflammatory bowel diseases in St. Petersburg and peculiarities of basic therapy in the regional healthcare system: cross-sectional study results

2021 ◽  
Vol 1 (6) ◽  
pp. 29-39
Author(s):  
Yu. P. Uspenskiy ◽  
S. V. Ivanov ◽  
Yu. A. Fominikh ◽  
M. M. Galagudza

Background. Inflammatory bowel diseases (ulcerative colitis and Crohn’s disease) are serious problem in modern gastroenterology, as these diseases affect the working population, have a progressive chronic course, a high risk of disabling complications and require significant costs for the drug management.Aim. We wanted to assess the inflammatory bowel diseases structure and features of the use of basic drugs in outpatient and inpatient treatment in St. Petersburg, Russia.Materials and methods. A cross-sectional study was performed. Data about drug therapy, disease features and demographic from 42 outpatient institutions and from 6 city hospitals for the period 2018–2020 in St. Petersburg was collected. The analysis included data from 617 patients with ulcerative colitis and 455 patients with Crohn’s disease.Results. The median age of patients with ulcerative colitis was 44 years, which was statistically significant more than with Crohn’s disease (39 years). In ulcerative colitis, the left-sided localization of colon lesions (56%) prevailed over total colitis (23%) and proctitis (21%) In Crohn’s disease, the prevalence of ilecocolitis (36%) was approximately equal to the prevalence of colitis (35%), the frequency of terminal ileitis was significantly less (26%), other variants of gastrointestinal lesions were found in 3% cases. In Crohn’s disease compared to ulcerative colitis, the proportion of patients with mild disease was similar (36.6% and 38.2% respectively), but in in Crohn’s disease the frequency of severe disease there was more than three times compared to ulcerative colitis. There has been a significantly higher incidence of surgery in the past for Crohn’s disease compared to ulcerative colitis (14.8% and 2.6%, respectively). The vast majority of patients (more than 80%) received therapy with oral 5-aminosalycilic acid drugs. Topical formulas of 5-aminosalycilic acid drugs in ulcerative colitis were prescribed in about 50% of cases (it was significantly less than commonly used in Crohn’s disease). Corticosteroids were used in the treatment of 16.6% of ulcerative colitis patients and in 24.4% Crohn’s disease patients. In both diseases in the conditions of inpatient treatment, this group of drugs was used several times more often than in outpatient observation. Immunosuppressants (tyopurines, methotrexate) were administered in 6.9% ulcerative colitis patients with and in 17.0% Crohn’s disease patients.Conclusion. Clinical features of inflammatory bowel diseases in St. Petersburg and the features of basic therapy in comparison with the nationwide indicators in Russia demonstrate similar trends. The key problem points of therapy of inflammatory bowel diseases remains the widespread use of drugs of the group of 5-aminosalycilic acid in Crohn’s disease, insufficient use of rectal forms of 5-aminosalycilic acid in ulcerative colitis, a relatively small frequency of use of immunosupressors to maintain remission in Crohn’s disease. The solution to the problem of optimizing the therapy of patients with inflammatory bowel diseases within the framework of routine practice includes educational activities, as well as the creation of a regional register of patients with inflammatory bowel diseases in St. Petersburg.

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252458
Author(s):  
Doreen Busingye ◽  
Allan Pollack ◽  
Kendal Chidwick

The burden of inflammatory bowel disease (IBD) in Australia is increasing but national data about the current prevalence are limited. We aimed to estimate the prevalence of IBD (including Crohn’s disease, ulcerative colitis and unspecified IBD) as well as Crohn’s disease and ulcerative colitis separately in a general practice population in Australia. We also assessed risk factors associated with Crohn’s disease and ulcerative colitis. We conducted a cross-sectional study using data from MedicineInsight, a national database of general practice electronic health records, from 1 July 2017 to 30 June 2019. The prevalence of IBD was calculated and stratified by sociodemographic characteristics. Logistic regression analysis was conducted to assess risk factors associated with Crohn’s disease and ulcerative colitis. The study comprised 2,428,461 regular patients from 481 practices. The estimated crude prevalence of IBD was 653 per 100,000 patients; Crohn’s disease was 306 per 100,000 and ulcerative colitis was 334 per 100,000. Males were independently associated with a lower risk of Crohn’s disease (OR: 0.86; 95% CI: 0.81, 0.90) but a greater risk of ulcerative colitis (OR: 1.12; 95% CI: 1.06, 1.17) than females. Compared to non-smokers, patients who were current smokers were associated with a greater risk of Crohn’s disease (OR: 1.13; 95% CI: 1.04, 1.23) but a lower risk of ulcerative colitis (OR: 0.52; 95% CI: 0.47, 0.57). Other factors positively associated with both Crohn’s disease and ulcerative colitis were age (≥ 25 years), non-Indigenous status and socioeconomic advantage. Our findings provide a current estimate of the prevalence of IBD, Crohn’s disease and ulcerative colitis in a large national general practice population in Australia and an assessment of the factors associated with Crohn’s disease and ulcerative colitis. These data can assist in estimating the health burden and costs, and planning for health services.


2014 ◽  
Vol 86 (9) ◽  
Author(s):  
Aneta Raczkowska ◽  
Michał Ławiński ◽  
Aleksandra Gradowska ◽  
Urszula Zielińska-Borkowska

AbstractOne of the elements of treatment considering inflammatory bowel diseases is nutritional therapy. The duration of the above-mentioned depends on the prevalence of such symptoms as fever, bowel move-ments, length of the functioning gastrointestinal tract, stoma and intestinal fistula presence. Nutritional therapy is an essential element of successful treatment alongside pharmacological, surgical, and biological therapy, as well as other methods. Crohn's disease and ulcerative colitis considered as chronic diseases, lead towards physical and biopsychosocial disability, being responsible for the reduction in the quality of life.was to determine the quality of life after surgical procedures in case of patients diagnosed with Crohn's disease and ulcerative colitis, subjected to natural and parenteral nutrition.The study group comprised 52 patients from the Department of Gastroen-terology, Military Medical Institute, and Department of Surgery and Clinical Nutrition, Clinical Hospital in Warsaw. The study was performed between October, 2011 and April, 2012. The World Health Organization Quality of Life Instrument - Bref (WHOQOL-BREF) questionnaire was used to deter-mine the patients’ quality of life.A lower quality of life was observed in case of patients subjected to parenteral nutrition, poor education, disease symptoms exacerbation, in the majority-rural inhabitants. The quality of life does not depend on gender, type of disease, family status, and additional medical care.


2015 ◽  
Vol 52 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Lorete Maria da Silva KOTZE ◽  
Renato Mitsunori NISIHARA ◽  
Sandra Beatriz MARION ◽  
Murilo Franco CAVASSANI ◽  
Paulo Gustavo KOTZE

Background Determination of fecal calprotectin can provide an important guidance for the physician, also in primary care, in the differential diagnosis of gastrointestinal disorders, meanly between inflammatory bowel diseases and irritable bowel syndrome. Objectives The aims of the present study were to prospectively investigate, in Brazilian adults with gastrointestinal complaints, the value of fecal calprotectin as a biomarker for the differential diagnosis between functional and organic disorders and to correlate the concentrations with the activity of inflammatory bowel diseases. Methods The study included consecutive patients who had gastrointestinal complaints in which the measurement levels of fecal calprotectin were recommended. Fecal calprotectin was measured using a Bühlmann (Basel, Switzerland) ELISA kit Results A total of 279 patients were included in the study, with median age of 39 years (range, 18 to 78 years). After clinical and laboratorial evaluation and considering the final diagnosis, patients were allocated into the following groups: a) Irritable Bowel Syndrome: 154 patients (102 female and 52 male subjects). b) Inflammatory Bowel Diseases group: 112 patients; 73 with Crohn’s disease; 38 female and 35 male patients; 52.1% (38/73) presented active disease, and 47.9% (35/73) had disease in remission and 39 patients with ulcerative colitis;19 female and 20 male patients; 48.7% (19/39) classified with active disease and 49.3% (20/39) with disease in remission. A significant difference (P<0.001) was observed between the median value of fecal calprotectin in Irritable Bowel Syndrome group that was 50.5 µg/g (IQR=16 - 294 µg/g); 405 µg/g (IQR=29 - 1980 µg/g) in Crohn’s disease patients and 457 µg/g (IQR=25 - 1430 µg/g) in ulcerative colitis patients. No difference was observed between the values found in the patients with Crohn’s disease and ulcerative colitis. Levels of fecal calprotectin were significantly lower in patients with inflammatory bowel diseases in remission when compared with active disease (P<0.001). Conclusions The present study showed that the determination of fecal calprotectin assists to differentiate between active and inactive inflammatory bowel diseases and between inflammatory bowel diseases and irritable bowel syndrome.


1997 ◽  
Vol 75 (6) ◽  
pp. 789-794 ◽  
Author(s):  
Guylaine Roy ◽  
Stéphane Mercure ◽  
Frédéric Beuvon ◽  
Jean-Pierre Perreault

Circular RNAs reminiscent of viroids and the human hepatitis delta virus have been proposed as possible nonconventional pathogens responsible for Crohn's disease and ulcerative colitis, two inflammatory bowel diseases. Consequently, RNA was extracted from various areas of intestinal tissues from individuals with either Crohn's disease or ulcerative colitis as well as several appropriate control diseases, and analyzed by two-dimensional gel electrophoresis. No circular viroid-like RNAs (<1500 nucleotides) were detected, confirming a previous report that was limited to the investigation of small RNAs (<300 nucleotides). However, three small, unusually stable, linear RNAs were shown to be associated to both Crohn's disease and ulcerative colitis tissues: a specific 28S ribosomal RNA cleavage product characterized previously; a 5.8S ribosomal RNA conformer; and a fragment homologous to transcripts from DNA CpG islands. The two last RNAs were detected prior to visible morphological tissue alterations, suggesting that they are produced early during the inflammation and that they have value as molecular diagnostic tools for the inflammatory bowel diseases. The potential cellular mechanisms producing these RNAs and their involvement in inflammatory bowel disease are discussed. Key words: ribosomal RNA, inflammatory bowel diseases, human intestine, inflammation, viroids.


2007 ◽  
Vol 27 (4) ◽  
pp. 503-509 ◽  
Author(s):  
Cristina Costa Duarte Lanna ◽  
Maria de Lourdes Abreu Ferrari ◽  
Sidney Lemos Rocha ◽  
Evaldo Nascimento ◽  
Marco Antônio Parreiras de Carvalho ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Katarzyna Jakubowska ◽  
Anna Pryczynicz ◽  
Piotr Iwanowicz ◽  
Andrzej Niewiński ◽  
Elżbieta Maciorkowska ◽  
...  

Crohn’s disease (CD) and ulcerative colitis (UC) belong to a group of inflammatory bowel diseases (IBD). The aim of our study was to evaluate the expression of MMP-2, MMP-7, MMP-9, TIMP-1, and TIMP-2 in ulcerative colitis and Crohn’s disease. The study group comprised 34 patients with UC and 10 patients with CD. Evaluation of MMP-2, MMP-7, MMP-9, TIMP-1, and TIMP-2 expression in tissue samples was performed using immunohistochemistry. The overexpression of MMP-9 and TIMP-1 was dominant in both the glandular epithelium and inflammatory infiltration in UC patients. In contrast, in CD subjects the positive expression of MMP-2 and TIMP-1 was in glandular tubes while mainly MMP-7 and TIMP-2 expression was in inflammatory infiltration. Metalloproteinases’ expression was associated with the presence of erosions, architectural tissue changes, and inflammatory infiltration in the lamina propria of UC patients. The expression of metalloproteinase inhibitors correlated with the presence of eosinophils and neutrophils in UC and granulomas in CD patients. Our studies indicate that the overexpression of metalloproteinases and weaker expression of their inhibitors may determine the development of IBD. It appears that MMP-2, MMP-7, and MMP-9 may be a potential therapeutic target and the use of their inhibitors may significantly reduce UC progression.


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