Fatigue is a prevalent and often debilitating symptom in individuals with inflammatory bowel disease(IBD),affecting a substantial proportion of patients,even during periods of disease remission.The prevalence of fatig...Fatigue is a prevalent and often debilitating symptom in individuals with inflammatory bowel disease(IBD),affecting a substantial proportion of patients,even during periods of disease remission.The prevalence of fatigue in IBD remains high,affecting around half of the IBD patients and being more common in patients with active disease than those in remission.Several risk factors contribute to fatigue in IBD,including active disease and pro-inflammatory state,nutritional deficiencies and anemia,sleep disturbances,psychological comorbidities,microbiota changes and the gut-brain axis,muscle dysfunction,sarcopenia,and physical inactivity.Assessing fatigue in IBD is challenging due to its subjective nature and the lack of a uniformly quantifiable method.Fatigue significantly impacts the quality of life,affecting physical functioning,psychological and emotional wellbeing,and social and relational consequences.The management of fatigue in IBD requires a comprehensive,multidisciplinary approach.This includes addressing disease activity through conventional drug treatment,biologicals and small molecules,and surgical treatment.Psychological interventions such as cognitive behavioral therapy,problem-solving therapy,solution-focused therapy,mindfulness-based cognitive therapy,and brief behavioral therapy have shown promise in improving fatigue.Nutritional interventions,including treating deficiencies and supplementation,and lifestyle interventions,such as physical exercise,aromatherapy,and sleep interventions,are also important components of fatigue management.Pharmacological interventions like modafinil and bupropion may be considered in refractory cases.This review aims to summarize the current evidence on fatigue in IBD,including its prevalence,risk factors,assessment methods,outcomes,and management strategies.展开更多
Background and Aims:The impact of coronavirus disease-2019(COVID-19)on liver function remains to be fully elucidated.This study was designed to investigate such and determine the clinical significance in determining m...Background and Aims:The impact of coronavirus disease-2019(COVID-19)on liver function remains to be fully elucidated.This study was designed to investigate such and determine the clinical significance in determining mortality risk.Methods:A retrospective study was conducted in patients with COVID-19 from March 2020 to July 2020.Clinical details were retrieved from electronic medical records to obtain clinical characteristics,medical history,laboratory tests,therapeutic intervention,and outcome data.Results:A total of 184 patients with COVID-19 were included(median age:45.5 years),comprised of 62.5%men.In total,22(12.0%)patients had severe infection and 162(88.0%)had mild to moderate infection.Overall,95(51.6%)showed abnormal liver function test(LFT)and 17(9.2%)showed normal LFT at admission.The median age,hospital stay,and LFT were significantly higher in severe vs.non-severe infection(p<0.001).Out of 12 deaths,the majority were due to severe infection(n=11).Deaths were also due to acute respiratory distress syndrome(n=5),cardiac reasons(n=3),and sepsis with multiorgan failure(n=3).The median age,hospital stay and number of intensive care unit admissions were higher in patients having abnormal LFT compared to normal LFT.Incidence of elevated aspartate aminotransferase(42.8%and 40.4%),alanine transaminase(43.7%and 41.6%),and hypoalbuminemia(71.4%and72.7%)at admission and discharge were more common in severe infection.The mean survival was significantly lower in severe infection compared to those with non-severe disease(17.2 vs.52.3 days;p<0.001).Conclusions:Incidence of abnormal liver function was higher in patients with severe COVID-19 and was associated with prolonged hospital stay;mortality was associated with severity of COVID-19.For ruling out the risk of liver injury,it is crucial to vigilantly monitor the liver function parameters in patients with COVID-19 admitted to hospital.展开更多
文摘Fatigue is a prevalent and often debilitating symptom in individuals with inflammatory bowel disease(IBD),affecting a substantial proportion of patients,even during periods of disease remission.The prevalence of fatigue in IBD remains high,affecting around half of the IBD patients and being more common in patients with active disease than those in remission.Several risk factors contribute to fatigue in IBD,including active disease and pro-inflammatory state,nutritional deficiencies and anemia,sleep disturbances,psychological comorbidities,microbiota changes and the gut-brain axis,muscle dysfunction,sarcopenia,and physical inactivity.Assessing fatigue in IBD is challenging due to its subjective nature and the lack of a uniformly quantifiable method.Fatigue significantly impacts the quality of life,affecting physical functioning,psychological and emotional wellbeing,and social and relational consequences.The management of fatigue in IBD requires a comprehensive,multidisciplinary approach.This includes addressing disease activity through conventional drug treatment,biologicals and small molecules,and surgical treatment.Psychological interventions such as cognitive behavioral therapy,problem-solving therapy,solution-focused therapy,mindfulness-based cognitive therapy,and brief behavioral therapy have shown promise in improving fatigue.Nutritional interventions,including treating deficiencies and supplementation,and lifestyle interventions,such as physical exercise,aromatherapy,and sleep interventions,are also important components of fatigue management.Pharmacological interventions like modafinil and bupropion may be considered in refractory cases.This review aims to summarize the current evidence on fatigue in IBD,including its prevalence,risk factors,assessment methods,outcomes,and management strategies.
文摘Background and Aims:The impact of coronavirus disease-2019(COVID-19)on liver function remains to be fully elucidated.This study was designed to investigate such and determine the clinical significance in determining mortality risk.Methods:A retrospective study was conducted in patients with COVID-19 from March 2020 to July 2020.Clinical details were retrieved from electronic medical records to obtain clinical characteristics,medical history,laboratory tests,therapeutic intervention,and outcome data.Results:A total of 184 patients with COVID-19 were included(median age:45.5 years),comprised of 62.5%men.In total,22(12.0%)patients had severe infection and 162(88.0%)had mild to moderate infection.Overall,95(51.6%)showed abnormal liver function test(LFT)and 17(9.2%)showed normal LFT at admission.The median age,hospital stay,and LFT were significantly higher in severe vs.non-severe infection(p<0.001).Out of 12 deaths,the majority were due to severe infection(n=11).Deaths were also due to acute respiratory distress syndrome(n=5),cardiac reasons(n=3),and sepsis with multiorgan failure(n=3).The median age,hospital stay and number of intensive care unit admissions were higher in patients having abnormal LFT compared to normal LFT.Incidence of elevated aspartate aminotransferase(42.8%and 40.4%),alanine transaminase(43.7%and 41.6%),and hypoalbuminemia(71.4%and72.7%)at admission and discharge were more common in severe infection.The mean survival was significantly lower in severe infection compared to those with non-severe disease(17.2 vs.52.3 days;p<0.001).Conclusions:Incidence of abnormal liver function was higher in patients with severe COVID-19 and was associated with prolonged hospital stay;mortality was associated with severity of COVID-19.For ruling out the risk of liver injury,it is crucial to vigilantly monitor the liver function parameters in patients with COVID-19 admitted to hospital.
