Management of the Elderly Inflammatory Bowel Disease Patient

Hrúz, Petr; Juillerat, Pascal; Kullak-Ublick, Gerd-Achim; Schoepfer, Alain; Mantzaris, Gerassimos J.; Rogler, Gerhard

doi:10.1159/000503099

Cited by 29 publications

(27 citation statements)

References 127 publications

(144 reference statements)

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“…CD and UC reportedly have a bimodal age distribution, with a first peak at approximately 25 years of age and a second peak after 60 years of age, according to population-based studies and hospitalization statistics. ( 11 – 15 ) Our findings were similar. The Cox proportional hazard regression indicated that patients aged ≥65 years had a higher HR for IBD (aHR: 3.14, 95% CI: 1.04–9.44, p < 0.05; Table 2 ).…”

Section: Discussionsupporting

confidence: 84%

Increased Risk of Inflammatory Bowel Disease Among Patients With Ankylosing Spondylitis: A 13-Year Population-Based Cohort Study

et al. 2020

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Aim Ankylosing spondylitis (AS) primarily affects the axial skeleton and extraarticular structures. Small-scaled studies have reported that the incidence and prevalence of inﬂammatory bowel disease (IBD) are higher in patients with AS than in the general population. This study determined the incidence of IBD in patients with AS using a large scale population-based cohort dataset. Methods This was a retrospective cohort study. Patient data were collected from the Taiwan National Health Insurance Research Database from 2000 to 2012. We enrolled 3,804 patients with AS and 7,608 non-AS patients. The endpoint was IBD diagnosis by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding 555 and 556 after at least three outpatient visits or one hospital admission, until the end of 2012. The Kaplan–Meier analysis was performed to discriminate the cumulative incidence of IBD and the log-rank test was used to test the significance. A Cox proportional hazard model was used to estimate the hazard ratio (HR) for IBD between the AS and non-AS groups. Results Among the population as a whole the Cox proportional hazard regression indicated that patients aged ≥65 years [adjusted HR (aHR): 2.48, 95% confidence interval (CI): 1.38–4.47] or with comorbidity of cancer (aHR: 3.51, 95% CI: 1.40–8.80) had a higher HR for IBD. Kaplan–Meier curves of cumulative incidence proportion of IBD indicated that patients with AS had a higher risk of IBD than the non-AS group in the subgroup aged <40 years (HR: 2.85, 95% CI: 1.51–5.40, p = 0.001). Conclusions Patients with AS aged <40 years had a higher IBD risk than did those without AS in Taiwan. Clinicians and patients should be aware of this association.

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Section: Discussionsupporting

confidence: 84%

Increased Risk of Inflammatory Bowel Disease Among Patients With Ankylosing Spondylitis: A 13-Year Population-Based Cohort Study

et al. 2020

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“…Inflammatory bowel diseases (IBDs) are chronic inflammatory and relapsing conditions of the gastrointestinal tract [ 111 ]. IBDs, whose incidence and prevalence are increasing since the second half of the 20th century, occur in both males and females and are increasingly diagnosed among older people [ 111 , 112 , 113 ].…”

Section: Inflammatory Bowel Diseases (Ibds) and Colorectal Cancer mentioning

confidence: 99%

Lactoferrin in the Prevention and Treatment of Intestinal Inflammatory Pathologies Associated with Colorectal Cancer Development

Cutone

Ianiro

Lepanto

et al. 2020

Cancers

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The connection between inflammation and cancer is well-established and supported by genetic, pharmacological and epidemiological data. The inflammatory bowel diseases (IBDs), including Crohn’s disease and ulcerative colitis, have been described as important promoters for colorectal cancer development. Risk factors include environmental and food-borne mutagens, dysbalance of intestinal microbiome composition and chronic intestinal inflammation, with loss of intestinal epithelial barrier and enhanced cell proliferation rate. Therapies aimed at shutting down mucosal inflammatory response represent the foundation for IBDs treatment. However, when applied for long periods, they can alter the immune system and promote microbiome dysbiosis and carcinogenesis. Therefore, it is imperative to find new safe substances acting as both potent anti-inflammatory and anti-pathogen agents. Lactoferrin (Lf), an iron-binding glycoprotein essential in innate immunity, is generally recognized as safe and used as food supplement due to its multifunctionality. Lf possesses a wide range of immunomodulatory and anti-inflammatory properties against different aseptic and septic inflammatory pathologies, including IBDs. Moreover, Lf exerts anti-adhesive, anti-invasive and anti-survival activities against several microbial pathogens that colonize intestinal mucosa of IBDs patients. This review focuses on those activities of Lf potentially useful for the prevention/treatment of intestinal inflammatory pathologies associated with colorectal cancer development.

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“…However, as our study was hospital based it was impossible to construct a control group with enough young patients without inflammatory disease, as such patients are usually diagnosed in an ambulatory way. Moreover, the age profile of IBD patients is changing due to growing incidence of early- and late-onset IBD cases [ 35 ]. Another limitation of the present study is the fact that most of the samples in all groups were not complete.…”

Section: Discussionmentioning

confidence: 99%

Machine Learning Prediction Model for Inflammatory Bowel Disease Based on Laboratory Markers. Working Model in a Discovery Cohort Study

Kraszewski

Szczurek

Szymczak

et al. 2021

JCM

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Inflammatory bowel disease (IBD) is a chronic, incurable disease involving the gastrointestinal tract. It is characterized by complex, unclear pathogenesis, increased prevalence worldwide, and a wide spectrum of extraintestinal manifestations and comorbidities. Recognition of IBD remains challenging and delays in disease diagnosis still poses a significant clinical problem as it negatively impacts disease outcome. The main diagnostic tool in IBD continues to be invasive endoscopy. We aimed to create an IBD machine learning prediction model based on routinely performed blood, urine, and fecal tests. Based on historical patients’ data (702 medical records: 319 records from 180 patients with ulcerative colitis (UC) and 383 records from 192 patients with Crohn’s disease (CD)), and using a few simple machine learning classificators, we optimized necessary hyperparameters in order to get reliable few-features prediction models separately for CD and UC. Most robust classificators belonging to the random forest family obtained 97% and 91% mean average precision for CD and UC, respectively. For comparison, the commonly used one-parameter approach based on the C-reactive protein (CRP) level demonstrated only 81% and 61% average precision for CD and UC, respectively. Results of our study suggest that machine learning prediction models based on basic blood, urine, and fecal markers may with high accuracy support the diagnosis of IBD. However, the test requires validation in a prospective cohort.

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Management of the Elderly Inflammatory Bowel Disease Patient

Abstract: f on behalf of the Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology

Cited by 29 publications

References 127 publications

Increased Risk of Inflammatory Bowel Disease Among Patients With Ankylosing Spondylitis: A 13-Year Population-Based Cohort Study

Increased Risk of Inflammatory Bowel Disease Among Patients With Ankylosing Spondylitis: A 13-Year Population-Based Cohort Study

Lactoferrin in the Prevention and Treatment of Intestinal Inflammatory Pathologies Associated with Colorectal Cancer Development

Machine Learning Prediction Model for Inflammatory Bowel Disease Based on Laboratory Markers. Working Model in a Discovery Cohort Study

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