Military Aviators with Inflammatory Bowel Diseases Continued Flying

2021 ◽  
Vol 92 (10) ◽  
pp. 831-834
Author(s):  
Omer Tehori ◽  
Benjamin Koslowsky ◽  
Daniel Gabbai ◽  
Shachar Shapira ◽  
Oded Ben-Ari
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Military Service ◽  
High Performance ◽  
Final Diagnosis ◽  
Long Term Results ◽  
Current Recommendation ◽  
Biologic Treatment ◽  
Crohns Disease ◽  
Bowel Diseases ◽  
Inflammatory Bowel

INTRODUCTION: Military aviators are likely to be first diagnosed with inflammatory bowel diseases (IBD) during military service. Current recommendations support continuing flying with restrictions, but risks may be significant. The aim of the study was to document the long-term results of aviators newly diagnosed with IBD. METHODS: A prospective observational study over a 23-yr period included all Israeli Air Force (IAF) aviators with IBD. Primary end point was the qualification and safety to continue operational flying following IBD diagnosis. RESULTS: Subjects were 16 male aviators with an average follow-up of 130 mo. Average age was 27 (2045) and average time from symptoms onset to final diagnosis was 7.3 mo. Eight (50%) patients had Crohns disease (CD), and the other eight had ulcerative colitis (UC). Eight (50%) were high performance platform aviators. Two patients received biologic treatment, two were treated with repeated corticosteroid courses, and four with immunosuppressive therapy. Two patients underwent surgery and four needed different lengths of hospitalizations. Eight (50%) aviators (3 CD, 5 UC) were grounded for a mean of 177 d (5590). Altogether grounding for IBD aviators was 46/2087 mo (2.2%). Most grounding periods were short term and reversible. All aviators continued flying under annual monitoring or as needed and no compromise of their abilities was documented. CONCLUSIONS: All aviators were able to continue flying and no events of sudden incapacitation or severe disabling flares have been seen among patients. Our study findings support the current recommendation to continue flying when IBD is in stable remission. Tehori O, Koslowsky B, Gabbai D, Shapira S, Ben-Ari O. Military aviators with inflammatory bowel diseases continued flying. Aerosp Med Hum Perform. 2021; 92(10):831834.

Epidemiological features and clinical variants of inflammatory bowel diseases in St. Petersburg in the setting of outpatient practice

2020 ◽  
Vol 22 (4) ◽  
pp. 148-155
Author(s):  
D. S. Purgina ◽  
M. V. Solovyev ◽  
L. V. Lyalina ◽  
V. V. Rassokhin
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Diseases ◽  
Developed Countries ◽  
Leningrad Region ◽  
Crohns Disease ◽  
Epidemiological Features ◽  
Bowel Diseases ◽  
Clinical Variants ◽  
Inflammatory Bowel ◽  
Outpatient Practice

Epidemiological features and clinical variants of inflammatory bowel diseases in St. Petersburg in conditions of outpatient practice are considered. It was established that among patients suffering from ulcerative colitis in the Vyborg and Frunze regions, women predominate in a ratio of 1:2. At the same time, more than 50% of cases of ulcerative colitis and Crohns disease come from the age of 2049 years. The vast majority of patients examined with ulcerative colitis experienced a moderate attack. In more than half of cases, left-sided localization was noted with endoscopic activity of 23 points on the Schroeder scale, rectal lesion was observed in 22% of cases, total colitis was detected in only 14%. In general, the incidence and prevalence of ulcerative colitis in the Vyborg and Frunze regions is higher than Crohns disease. However, more extensive and lengthy studies of the problem are needed, but there are some difficulties associated with the lack of a unified registration base for patients suffering from inflammatory bowel diseases. Given that the incidence of ulcerative colitis and Crohns disease is higher among women and more than 50% of patients are of the most able-bodied age (2049 years), inflammatory bowel disease is a group of highly relevant and socially significant diseases. Lower figures for the incidence and prevalence of inflammatory bowel diseases compared with those of developed countries indicate insufficient detection, diagnostic and clinical features of these diseases, as well as the need to optimize specialized medical care in places of residence of patients suffering from inflammatory bowel diseases. Nevertheless, currently in St. Petersburg and the Leningrad Region a fairly effective system of early detection and dynamic observation of patients suffering from ulcerative colitis has been created, which includes the activities of therapists and gastroenterologists of polyclinics, endoscopists and specialists of centers for the treatment of inflammatory bowel diseases of academic and university clinics.

scholarly journals On-Treatment Decrease of Serum Interleukin-6 as a Predictor of Clinical Response to Biologic Therapy in Patients with Inflammatory Bowel Diseases

2020 ◽  
Vol 9 (3) ◽  
pp. 800 ◽  
Author(s):  
Gian Caviglia ◽  
Chiara Rosso ◽  
Francesco Stalla ◽  
Martina Rizzo ◽  
Alessandro Massano ◽  
...  
Keyword(s):  
Clinical Response ◽  
Inflammatory Bowel Diseases ◽  
Biologic Therapy ◽  
Multivariate Logistic Regression Analysis ◽  
Response To Treatment ◽  
Control Group ◽  
Biologic Treatment ◽  
Necrosis Factor Alpha ◽  
Bowel Diseases ◽  
Inflammatory Bowel

In patients with inflammatory bowel diseases (IBD) undergoing biologic therapy, biomarkers of treatment response are still scarce. This study aimed to evaluate whether serum zonulin, a biomarker of intestinal permeability; soluble CD163 (sCD163), a macrophage activation marker; and a panel of serum cytokines could predict the response to biologic treatment in patients with IBD. For this purpose, we prospectively enrolled 101 patients with IBD and 19 patients with irritable bowel syndrome (IBS) as a control group; 60 out of 101 patients underwent treatment with biologics. Zonulin, sCD163, and cytokines were measured at the baseline in all patients and after 10 weeks of treatment in the 60 patients who underwent biologic therapy. We observed that zonulin levels were higher in IBD patients with active disease compared to those in remission (p = 0.035), and that sCD163 values were higher in patients with IBD compared to those with IBS (p = 0.042), but no association with therapy response was observed for either biomarker. Conversely, interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-alpha showed a significant reduction from baseline to week 10 of treatment, particularly in responder patients. By multivariate logistic regression analysis corrected for disease (Crohn’s disease or ulcerative colitis), type of biologic drug (Infliximab, Adalimumab, Vedolizumab, or Ustekinumab) and disease activity, the reduction in IL-6 values was associated with a clinical response at 12 months of biological therapy (odds ratio (OR) = 4.75, 95% confidence interval (CI) 1.25–18.02, p = 0.022). In conclusion, the measurement of serum IL-6 in biologics-treated IBD patients may allow for the prediction of response to treatment at 12 months of therapy and thus may help with tailoring personalized treatment strategies.

scholarly journals Pharmacotherapy of inflammatory bowel diseases: efficacy performance and safety management

2021 ◽  
Vol 93 (8) ◽  
pp. 841-852
Author(s):  
Igor G. Bakulin ◽  
Maria I. Skalinskaya ◽  
Igor V. Maev ◽  
Ekaterina V. Skazyvaeva ◽  
Mariia S. Zhuravleva ◽  
...  
Keyword(s):  
Side Effects ◽  
Inflammatory Bowel Diseases ◽  
Safety Management ◽  
Skin Lesions ◽  
Infectious Complications ◽  
Malignant Neoplasms ◽  
Duration Of Treatment ◽  
Crohns Disease ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Treatment of inflammatory bowel diseases IBD (Crohns disease, ulcerative colitis) is aimed at achieving clinical, endoscopic and histological remission, minimizing surgical complications, and ensuring a normal quality of life. However, the use of medical treatment is potentially associated with various adverse events, among which infectious complications, malignant neoplasms, as well as myelotoxicity, hepatotoxicity, skin lesions and others. The risk of side effects depends on the type of drug therapy (5-aminosalicylates, thiopurines, biologicals, etc.), the duration of treatment, the presence of extra-intestinal manifestations, etc. The article provides an overview of data on both the effectiveness and frequency of various side effects of the main classes of drugs in IBD, presents methods of investigation which can predict the effectiveness and development of side effects, the implementation of which can be considered as a variant of personalized therapy in IBD.

scholarly journals Cytokines and Biologic Therapy in Patients with Inflammatory Bowel Diseases

2021 ◽  
Vol 12 (4) ◽  
pp. 443-445
Author(s):  
Gian Paolo Caviglia ◽  
Davide Giuseppe Ribaldone ◽  
Aurora Nicolosi ◽  
Rinaldo Pellicano
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Diseases ◽  
Biologic Therapy ◽  
Crohns Disease ◽  
Inflammatory Disorders ◽  
Immune Mediated ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory bowel diseases (IBD) are chronic inflammatory disorders, including Crohns’ disease (CD) and ulcerative colitis (UC), both characterized by a clinical relapsing course and an immune-mediated pathogenesis [...]

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