Opportunistic infections in patients with inflammatory bowel disease: prevention and diagnosis

Viget, N.; Vernier‐Massouille, Gwénola; Salmon‐Céron, Dominique; Yazdanpanah, Yazdan; Colombel, Jean–Frédéric

doi:10.1136/gut.2006.114660

Cited by 166 publications

(135 citation statements)

References 97 publications

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“…1,78 Therefore, given the recommendation to vaccinate before starting treatment with immunosuppressive agents, the best time for immunisation is at diagnosis of IBD. 1,[12][13][14][15] …”

Section: Who Should Be Vaccinated Against Hbv Infection and When?mentioning

confidence: 99%

“…In spite of the aforementioned recommendations and the presence of significant risk factors in IBD patients, 12 vaccines are under-prescribed, indicating that immunisation against selected vaccine-preventable illnesses -including viral hepatitis -is uncommon. Melmed et al 13 assessed risk of exposure and immunisation status among patients receiving care in an IBD specialty clinic.…”

Section: Are Ibd Patients Correctly Vaccinated Against Hbv Infection mentioning

confidence: 99%

“…Thus, alternative anti-viral medications for HBV, such as tenofovir or entecavir, are preferred in these cases, as they have the lowest rates of resistance with long-term use. 1,12,69 In this setting, entecavir is preferred to adefovir because of its rapid action and lack of nephrotoxicity. Nevertheless, there has recently been a report of an HBV flare with entecavir in patients with concurrent CD.…”

Section: How Frequent Is Progression To Liver Cirrhosis In Ibd Patienmentioning

confidence: 99%

“…77 In patients diagnosed with IBD, the present method for prevention of opportunistic infections rests on vaccinations and on a thorough clinical and laboratory work-up before administration of immunosuppressors and ⁄ or biologics. 12 Patients with IBD are very likely to need immunosuppressive therapy in the course of their disease. Furthermore, response rates to some vaccines, for example HBV vaccine, are considerably lower in patients receiving immunosuppressive agents or anti-TNF therapy (see below).…”

Section: Who Should Be Vaccinated Against Hbv Infection and When?mentioning

confidence: 99%

“…12 Today, it is generally accepted that all IBD patients should be screened for exposure to HBV. In fact, screening for HBV should be performed at diagnosis of IBD, rather than waiting until initiation of therapy with immunomodulators or tumour necrosis factor-a (TNF) antagonists.…”

Section: Which Ibd Patients Should Be Screened For Prior Hbv ⁄ Hcv Exmentioning

confidence: 99%

See 4 more Smart Citations

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Gisbert

Chaparro

Esteve

2011

Alimentary Pharmacology &Amp; Therapeutics

105

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“…1,78 Therefore, given the recommendation to vaccinate before starting treatment with immunosuppressive agents, the best time for immunisation is at diagnosis of IBD. 1,[12][13][14][15] …”

Section: Who Should Be Vaccinated Against Hbv Infection and When?mentioning

confidence: 99%

Section: Are Ibd Patients Correctly Vaccinated Against Hbv Infection mentioning

confidence: 99%

Section: How Frequent Is Progression To Liver Cirrhosis In Ibd Patienmentioning

confidence: 99%

Section: Who Should Be Vaccinated Against Hbv Infection and When?mentioning

confidence: 99%

Section: Which Ibd Patients Should Be Screened For Prior Hbv ⁄ Hcv Exmentioning

confidence: 99%

See 3 more Smart Citations

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Gisbert

Chaparro

Esteve

2011

Alimentary Pharmacology &Amp; Therapeutics

105

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Risk of Infection Associated With Administration of Intravenous Iron

et al. 2021

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IMPORTANCEIntravenous iron is recommended by many clinical guidelines based largely on its effectiveness in reducing anemia. However, the association with important safety outcomes, such as infection, remains uncertain. OBJECTIVE To examine the risk of infection associated with intravenous iron compared with oral iron or no iron. DATA SOURCES Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for randomized clinical trials (RCTs) from 1966 to January 31, 2021. Ongoing trials were sought from ClinicalTrials.gov, CENTRAL, and the World Health Organization International Clinical Trials Search Registry Platform. STUDY SELECTION Pairs of reviewers identified RCTs that compared intravenous iron with oral iron or no iron across all patient populations, excluding healthy volunteers. Nonrandomized studies published since January 1, 2007, were also included. A total of 312 full-text articles were assessed for eligibility. DATA EXTRACTION AND SYNTHESIS Data extraction and risk of bias assessments were performed according to the Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) and Cochrane recommendations, and the quality of evidence was assessed using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach. Two reviewers extracted data independently. A random-effects model was used to synthesize data from RCTs. A narrative synthesis was performed to characterize the reporting of infection. MAIN OUTCOMES AND MEASURESThe primary outcome was risk of infection. Secondary outcomes included mortality, hospital length of stay, and changes in hemoglobin and red blood cell transfusion requirements. Measures of association were reported as risk ratios (RRs) or mean differences.RESULTS A total of 154 RCTs (32 920 participants) were included in the main analysis. Intravenous iron was associated with an increased risk of infection when compared with oral iron or no iron (RR, 1.17; 95% CI, 1.04-1.31; I 2 = 37%; moderate certainty of evidence). Intravenous iron also was associated with an increase in hemoglobin (mean difference, 0.57 g/dL; 95% CI, 0.50-0.64 g/dL; I 2 = 94%) and a reduction in the risk of requiring a red blood cell transfusion (RR, 0.93; 95% CI, 0.76-0.89; I 2 = 15%) when compared with oral iron or no iron. There was no evidence of an effect on mortality or hospital length of stay. (continued) Key Points Question In patients who require treatment with intravenous iron, what is the evidence that this intervention increases the risk of developing a new infection? Findings In this systematic review and meta-analysis of 154 randomized clinical trials that included 32 920 participants, intravenous iron was associated with an increased risk of infection. Meaning The results of this study suggest that, despite broad advocacy in clinical guidelines, intravenous iron may increase the risk of infection, which must be balanced with the potential benefits of treating anemia and reducing blood transfusion requirements.

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Visuospatial information in the retinotectal system of xenopus before correct image formation by the developing eye

Richards

Rheede

Akerman

2012

Developmental Neurobiology

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The retinotectal pathway of Xenopus laevis is a well-established experimental model for studying activity-dependent processes during visual system development. Such processes can be guided by stimulus-evoked activity patterns, which depend on the refractive characteristics of the eye. Previous work has shown that many animals are hyperopic at early developmental stages due to immature refractive properties. Whether this is also the case for Xenopus laevis is unknown. Here, we measure the focal length of the lens and the size of the eye of embryos at different stages and find that Xenopus laevis exhibits a similar shift from hyperopia to emmetropia. At early stages, immediately after innervation of the tectum by the optic nerve, Xenopus embryos are hyperopic. Soon afterwards the focal length of the lens decreases and the eye converges to a state of emmetropia. Despite being hyperopic we find that some visuospatial information is available to the young circuit. Calculations based on the optical properties of the eye show that even when the animals are hyperopic the blurred retinal image provides a crude spatial resolution. Furthermore, using whole-cell recordings in the optic tectum combined with visual stimulation through the intact eye, we show that tectal neurons in hyperopic embryos have spatially restricted glutamatergic receptive fields. Our data demonstrate that Xenopus laevis eyes undergo a process of developmental emmetropization, and suggest that despite an initial stage of suboptimal image formation there is potentially enough information to guide activity-dependent refinements of the retinotectal pathway from the onset of vision.

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Opportunistic infections in patients with inflammatory bowel disease: prevention and diagnosis

Cited by 166 publications

References 97 publications

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Risk of Infection Associated With Administration of Intravenous Iron

Visuospatial information in the retinotectal system of xenopus before correct image formation by the developing eye

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