Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study

Euers, Lindsay; Abughazaleh, Shaadi; Glassner, Kerri; Gajula, Prianka; Jones-Pauley, Michelle; Ezeana, Chika F.; Puppala, Mamta; Wang, Lin; Wong, Stephen T.C.; Oglat, Ayah; Nickerson, Stephanie; Abraham, Bincy

doi:10.3390/jcm10122679

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…Steroids, which are either derived from dietary sources or synthesized within the body, are defined by their distinctive four-ring carbon structure and play vital roles as hormones in various physiological functions. These compounds have been employed in numerous therapeutic applications for a broad array of human disorders [ 38 , 39 , 40 ], such as vascular conditions, although their use continues to be a subject of debate [ 41 ]. Specifically, the importance of progesterone (PRG), a key female sex steroid, in preserving the integrity of the blood–brain barrier has been the focus of extensive research.…”

Section: Introductionmentioning

confidence: 99%

CmPn/CmP Signaling Networks in the Maintenance of the Blood Vessel Barrier

Gnanasekaran

Aickareth

Hawwar

et al. 2023

JPM

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Cerebral cavernous malformations (CCMs) arise when capillaries within the brain enlarge abnormally, causing the blood–brain barrier (BBB) to break down. The BBB serves as a sophisticated interface that controls molecular interactions between the bloodstream and the central nervous system. The neurovascular unit (NVU) is a complex structure made up of neurons, astrocytes, endothelial cells (ECs), pericytes, microglia, and basement membranes, which work together to maintain blood–brain barrier (BBB) permeability. Within the NVU, tight junctions (TJs) and adherens junctions (AJs) between endothelial cells play a critical role in regulating the permeability of the BBB. Disruptions to these junctions can compromise the BBB, potentially leading to a hemorrhagic stroke. Understanding the molecular signaling cascades that regulate BBB permeability through EC junctions is, therefore, essential. New research has demonstrated that steroids, including estrogens (ESTs), glucocorticoids (GCs), and metabolites/derivatives of progesterone (PRGs), have multifaceted effects on blood–brain barrier (BBB) permeability by regulating the expression of tight junctions (TJs) and adherens junctions (AJs). They also have anti-inflammatory effects on blood vessels. PRGs, in particular, have been found to play a significant role in maintaining BBB integrity. PRGs act through a combination of its classic and non-classic PRG receptors (nPR/mPR), which are part of a signaling network known as the CCM signaling complex (CSC). This network couples both nPR and mPR in the CmPn/CmP pathway in endothelial cells (ECs).

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Section: Introductionmentioning

confidence: 99%

CmPn/CmP Signaling Networks in the Maintenance of the Blood Vessel Barrier

Gnanasekaran

Aickareth

Hawwar

et al. 2023

JPM

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“…The prevalence of IBD is increasing worldwide, including Europe, North America, and some developing countries [ 9 , 10 ]. The prevalence of IBD is equal between men and women [ 11 ]. Several studies have reported that patients with IBD have an increased risk of colorectal cancer [ 12 , 13 ] and extraintestinal malignancies (including cholangiocarcinoma, skin cancer, and hematologic malignancies) [ 14 ], which is believed to be a consequence of immunosuppressive therapies and an underlying inflammatory state [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Intestinal Immune Imbalance is an Alarm in the Development of IBD

Hu,

Liao,

et al. 2023

Mediators of Inflammation

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Immune regulation plays a crucial role in human health and disease. Inflammatory bowel disease (IBD) is a chronic relapse bowel disease with an increasing incidence worldwide. Clinical treatments for IBD are limited and inefficient. However, the pathogenesis of immune-mediated IBD remains unclear. This review describes the activation of innate and adaptive immune functions by intestinal immune cells to regulate intestinal immune balance and maintain intestinal mucosal integrity. Changes in susceptible genes, autophagy, energy metabolism, and other factors interact in a complex manner with the immune system, eventually leading to intestinal immune imbalance and the onset of IBD. These events indicate that intestinal immune imbalance is an alarm for IBD development, further opening new possibilities for the unprecedented development of immunotherapy for IBD.

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“…Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is chronic, fluctuating, and relapsing. Due to the complexity of the disease and complications such as strictures, fistulas, or perforations, medical image studies such as computed tomography are usually required to diagnose the disease and manage the complications [ 1 , 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Radiation Exposure among Patients with Inflammatory Bowel Disease: A Single-Medical-Center Retrospective Analysis in Taiwan

Yang

Yen

Chen

et al. 2022

JCM

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Inflammatory bowel disease (IBD) is a chronic and relapsing disease that can be complicated by abscesses, fistulas, or strictures of the damaged bowel. Endoscopy or imaging studies are required to diagnose and monitor the treatment response or complications of the disease. Due to the low incidence of the disease in Taiwan, the pattern of radiation exposure from medical imaging has not been well studied previously. This retrospective study aimed to evaluate the pattern of radiation exposure in 134 Taiwanese IBD patients (45 CD and 89 UC) diagnosed and followed at Changhua Christian Hospital from January 2010 to December 2020. We reviewed the patient demographic data and radiation-containing image studies performed during the follow-up. The cumulative effective dose (CED) was calculated for each patient. During a median follow-up of 4 years, the median CED was higher for patients with CD (median CED 21.2, IQR 12.1–32.8) compared to patients with UC (median CED 2.1, IQR 0–5.6) (p < 0.001). In addition, the CD patients had a trend of a higher rate of cumulative ≥50 mSv compared with the UC patients (6.7% vs. 1.1%, p = 0.110). In conclusion, our study found a higher radiation exposure among CD patients compared to patients with UC, representing the complicated nature of the disease. Therefore, increasing the use of radiation-free medical imaging such as intestinal ultrasound or magnetic resonance imaging should be advocated in daily practice to decrease the risk of excessive radiation exposure in these patients.

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Risk Factors for and Frequency of CT Scans, Steroid Use, and Repeat Visits in Inflammatory Bowel Disease Patients Seen at a Single-Center Emergency Department: A Retrospective Cohort Study

Cited by 4 publications

References 36 publications

CmPn/CmP Signaling Networks in the Maintenance of the Blood Vessel Barrier

CmPn/CmP Signaling Networks in the Maintenance of the Blood Vessel Barrier

Intestinal Immune Imbalance is an Alarm in the Development of IBD

Radiation Exposure among Patients with Inflammatory Bowel Disease: A Single-Medical-Center Retrospective Analysis in Taiwan

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