目的:分析影响克罗恩病患者在手术后30天内出现并发症的相关影响因素。方法:对88例接受手术治疗的克罗恩病患者进行回顾性资料分析,运用Logistic回归法探讨该患者群体在术后30天内发生并发症的相关因素。结果:共有15例患者出现术后并发...目的:分析影响克罗恩病患者在手术后30天内出现并发症的相关影响因素。方法:对88例接受手术治疗的克罗恩病患者进行回顾性资料分析,运用Logistic回归法探讨该患者群体在术后30天内发生并发症的相关因素。结果:共有15例患者出现术后并发症,其中3例肠梗阻,4例吻合口瘘,1例切口感染,5例腹腔感染,1例腹腔脓肿,1例泌尿系感染。根据Logistic多因素回归分析得出术前营养状态(P = 0.012, OR = 1.89, 95%CI: 1.682~2.190)、C-反应蛋白指数(P = 0.004, OR = 2.15, 95%CI: 1.301~2.652)以及术前CDAI评分的高低(P = 0.042, OR = 1.1051, 95%CI: 1.686~13.628)是影响克罗恩病患者术后发生并发症的危险因素,术前肠内营养可显著减少术后并发症的发生。结论:术前营养不良、CRP指标高、术前CDAI评分偏高是CD患者术后并发症发生的重要影响因素,因此这些因素可作为克罗恩病术后并发症发生风险的预测指标,而术前进行肠内营养支持有助于降低术后并发症的发生几率。Objective: Analyze the relevant influencing factors that affect the occurrence of complications in Crohn’s disease patients within 30 days after surgery. Methods: A retrospective data analysis was conducted on 88 patients with Crohn’s disease who underwent surgical treatment, and Logistic regression was used to explore the related factors of complications in this patient population within 30 days after surgery. Results: A total of 15 patients experienced postoperative complications, including 3 cases of intestinal obstruction, 4 cases of anastomotic leakage, 1 case of incision infection, 5 cases of abdominal infection, 1 case of abdominal abscess, and 1 case of urinary tract infection. According to Logistic multiple regression score, the preoperative nutritional status (P = 0.012, OR = 1.89, 95%CI: 1.682~2.190), C-reactive protein index (P = 0.004, OR = 2.15, 95%CI: 1.301~2.652), and preoperative CDAI score (P = 0.042, OR = 1.1051, 95%CI: 1.686~13.628) were identified as factors affecting postoperative complications in patients with Crohn’s disease. Preoperative enteral nutrition can significantly reduce the incidence of postoperative complications. Conclusion: Preoperative malnutrition, high CRP levels, and high preoperative CDAI scores are important influencing factors for the occurrence of postoperative complications in CD patients. Therefore, these factors can serve as predictive indicators for the risk of postoperative complications in Crohn’s disease. Preoperative enteral nutrition support can help reduce the incidence of postoperative complications.展开更多
Curcumin,a natural product,has exhibited promising effects in both animal models and clinical trials,interacting with a multitude of factors linked to Inflammatory Bowel Disease(IBD).These factors encompass cytokines,...Curcumin,a natural product,has exhibited promising effects in both animal models and clinical trials,interacting with a multitude of factors linked to Inflammatory Bowel Disease(IBD).These factors encompass cytokines,oxidative stress-associated enzymes,and modulation of the intestinal microbiota.Notably,curcumin has demonstrated therapeutic potential in animal models of colitis,wherein it exerts a negative regulatory influence on pivotal signaling pathways such as PI3/Akt,JAK/STAT,andβ-catenin.Moreover,it inhibits the expression of proinflammatory enzymes and co-stimulatory molecules(including RANKL,ICAM-1,CD205,CD256,TLR4,among others),while curbing immune cell chemotaxis,thereby attenuating the characteristic neutrophil infiltration observed in IBD.Another facet of curcumin’s action involves its modulation of the intestinal microbiota.Notably,the microbiota itself contributes to beneficial biotrans formations of curcumin,thereby enhancing its effectiveness in IBD treatment.On a clinical front,curcumin has demonstrated the ability to induce clinical and/or endoscopic remission without any reported toxic effects.Hence,curcumin warrants consideration as an adjunctive therapy in IBD management.Subsequent clinical investigations should concentrate on meticulously evaluating curcumin’s impact on these precise therapeutic targets.展开更多
Crohn’s disease (CD) is a chronic inflammatory disease whose pathogenesis involves disturbances of the gastrointestinal microbiota. As the prevalence of CD increases, the need for a more effective and safe treatment ...Crohn’s disease (CD) is a chronic inflammatory disease whose pathogenesis involves disturbances of the gastrointestinal microbiota. As the prevalence of CD increases, the need for a more effective and safe treatment is integral. Probiotics have been reported to be beneficial for numerous gastrointestinal diseases, providing health benefits and considering the microbial characteristics of CD’s pathogenesis. However, our knowledge of the efficacy of probiotic therapy in preventing relapse in CD is limited. How gastroenterologists have incorporated probiotics into their practice or probiotics observed implications for patients with CD has not been assessed. A quantitative survey was distributed to determine how gastroenterologists perceive and use probiotic-based therapies in CD practice. The second objective was to conduct a meta-analysis of the efficacy of probiotics for maintaining remission and preventing clinical and endoscopic relapse in CD. Performing a meta-analysis and survey will examine the role of probiotics in CD treatment. Surveyed gastroenterologists cited that probiotics have an adjunctive role and have been observed to alleviate common CD symptoms. Probiotics seem effective in reducing the relapse rate, specifically those of the multi-strain variety are more likely to be effective in maintaining CD remission. Further research with larger trials is required to replicate and solidify this efficacy. The meta-analysis only assessed the efficacy of probiotics as a maintenance treatment as measured by the risk of relapse;thus, no evidence supports probiotics’ ability to induce remission. The results of the meta-analysis and survey indicate that probiotics cannot treat CD without accompanying conventional drug therapies;nevertheless, independent of treatment capacities, probiotics still yield health benefits for CD patients.展开更多
Rheumatoid Arthritis is characterized by increased cardiovascular morbidity and mortality that cannot be fully explained by the presence of classical cardiovascular disease (CVD) risk factors suggesting that novel ris...Rheumatoid Arthritis is characterized by increased cardiovascular morbidity and mortality that cannot be fully explained by the presence of classical cardiovascular disease (CVD) risk factors suggesting that novel risk factors may play a role. Evidence accumulated over the past decade points that uric acid (UA) may be one such novel CVD risk factor in rheumatoid arthritis, and therefore one may hypothesize that UA may contribute to the increased CVD burden in RA. The current study attempted to correlate the levels of clinical disease activity index (CDAI), high sensitivity C reactive protein (hs-CRP) and uric acid in DMARD naive non-diabetic, non-hypertensive, euthyroid patients with normal lipid profile suffering from early and established Rheumatoid Arthritis before and after 3 months of DMARD therapy. It showed a positive and significant correlation among uric acid levels and CDAI and hs-CRP levels at diagnosis. There was significant reduction in the levels of CDAI, hs-CRP and UA after 3 months of DMARD therapy with significant correlation among the changes in the 3 parameters and the change in Uric Acid also correlated with the levels of CDAI and hs-CRP at diagnosis. We propose to measure uric acid both as acute phase reactant and marker for cardiovascular morbidity in patients suffering from Rheumatoid Arthritis.展开更多
文摘目的:分析影响克罗恩病患者在手术后30天内出现并发症的相关影响因素。方法:对88例接受手术治疗的克罗恩病患者进行回顾性资料分析,运用Logistic回归法探讨该患者群体在术后30天内发生并发症的相关因素。结果:共有15例患者出现术后并发症,其中3例肠梗阻,4例吻合口瘘,1例切口感染,5例腹腔感染,1例腹腔脓肿,1例泌尿系感染。根据Logistic多因素回归分析得出术前营养状态(P = 0.012, OR = 1.89, 95%CI: 1.682~2.190)、C-反应蛋白指数(P = 0.004, OR = 2.15, 95%CI: 1.301~2.652)以及术前CDAI评分的高低(P = 0.042, OR = 1.1051, 95%CI: 1.686~13.628)是影响克罗恩病患者术后发生并发症的危险因素,术前肠内营养可显著减少术后并发症的发生。结论:术前营养不良、CRP指标高、术前CDAI评分偏高是CD患者术后并发症发生的重要影响因素,因此这些因素可作为克罗恩病术后并发症发生风险的预测指标,而术前进行肠内营养支持有助于降低术后并发症的发生几率。Objective: Analyze the relevant influencing factors that affect the occurrence of complications in Crohn’s disease patients within 30 days after surgery. Methods: A retrospective data analysis was conducted on 88 patients with Crohn’s disease who underwent surgical treatment, and Logistic regression was used to explore the related factors of complications in this patient population within 30 days after surgery. Results: A total of 15 patients experienced postoperative complications, including 3 cases of intestinal obstruction, 4 cases of anastomotic leakage, 1 case of incision infection, 5 cases of abdominal infection, 1 case of abdominal abscess, and 1 case of urinary tract infection. According to Logistic multiple regression score, the preoperative nutritional status (P = 0.012, OR = 1.89, 95%CI: 1.682~2.190), C-reactive protein index (P = 0.004, OR = 2.15, 95%CI: 1.301~2.652), and preoperative CDAI score (P = 0.042, OR = 1.1051, 95%CI: 1.686~13.628) were identified as factors affecting postoperative complications in patients with Crohn’s disease. Preoperative enteral nutrition can significantly reduce the incidence of postoperative complications. Conclusion: Preoperative malnutrition, high CRP levels, and high preoperative CDAI scores are important influencing factors for the occurrence of postoperative complications in CD patients. Therefore, these factors can serve as predictive indicators for the risk of postoperative complications in Crohn’s disease. Preoperative enteral nutrition support can help reduce the incidence of postoperative complications.
基金support of the CNPq(Conselho Nacional de Desenvolvimento Científico e Tecnológico)(435704/2018-4)INCT-Bioanalítica(Instituto Nacional de Ciências e Tecnologia em Bioanalítica)(465389/2014-7)+1 种基金CAPES/RENORBIO/PROAP(Coorde-nação de Aperfeiçoamento de Pessoal de Nível Superior)FAPEAL/PPSUS(Fundação de AmparoàPesquisa do Estado de Alagoas/Programa Pesquisa para o SUS)(60030-00879).
文摘Curcumin,a natural product,has exhibited promising effects in both animal models and clinical trials,interacting with a multitude of factors linked to Inflammatory Bowel Disease(IBD).These factors encompass cytokines,oxidative stress-associated enzymes,and modulation of the intestinal microbiota.Notably,curcumin has demonstrated therapeutic potential in animal models of colitis,wherein it exerts a negative regulatory influence on pivotal signaling pathways such as PI3/Akt,JAK/STAT,andβ-catenin.Moreover,it inhibits the expression of proinflammatory enzymes and co-stimulatory molecules(including RANKL,ICAM-1,CD205,CD256,TLR4,among others),while curbing immune cell chemotaxis,thereby attenuating the characteristic neutrophil infiltration observed in IBD.Another facet of curcumin’s action involves its modulation of the intestinal microbiota.Notably,the microbiota itself contributes to beneficial biotrans formations of curcumin,thereby enhancing its effectiveness in IBD treatment.On a clinical front,curcumin has demonstrated the ability to induce clinical and/or endoscopic remission without any reported toxic effects.Hence,curcumin warrants consideration as an adjunctive therapy in IBD management.Subsequent clinical investigations should concentrate on meticulously evaluating curcumin’s impact on these precise therapeutic targets.
文摘Crohn’s disease (CD) is a chronic inflammatory disease whose pathogenesis involves disturbances of the gastrointestinal microbiota. As the prevalence of CD increases, the need for a more effective and safe treatment is integral. Probiotics have been reported to be beneficial for numerous gastrointestinal diseases, providing health benefits and considering the microbial characteristics of CD’s pathogenesis. However, our knowledge of the efficacy of probiotic therapy in preventing relapse in CD is limited. How gastroenterologists have incorporated probiotics into their practice or probiotics observed implications for patients with CD has not been assessed. A quantitative survey was distributed to determine how gastroenterologists perceive and use probiotic-based therapies in CD practice. The second objective was to conduct a meta-analysis of the efficacy of probiotics for maintaining remission and preventing clinical and endoscopic relapse in CD. Performing a meta-analysis and survey will examine the role of probiotics in CD treatment. Surveyed gastroenterologists cited that probiotics have an adjunctive role and have been observed to alleviate common CD symptoms. Probiotics seem effective in reducing the relapse rate, specifically those of the multi-strain variety are more likely to be effective in maintaining CD remission. Further research with larger trials is required to replicate and solidify this efficacy. The meta-analysis only assessed the efficacy of probiotics as a maintenance treatment as measured by the risk of relapse;thus, no evidence supports probiotics’ ability to induce remission. The results of the meta-analysis and survey indicate that probiotics cannot treat CD without accompanying conventional drug therapies;nevertheless, independent of treatment capacities, probiotics still yield health benefits for CD patients.
文摘Rheumatoid Arthritis is characterized by increased cardiovascular morbidity and mortality that cannot be fully explained by the presence of classical cardiovascular disease (CVD) risk factors suggesting that novel risk factors may play a role. Evidence accumulated over the past decade points that uric acid (UA) may be one such novel CVD risk factor in rheumatoid arthritis, and therefore one may hypothesize that UA may contribute to the increased CVD burden in RA. The current study attempted to correlate the levels of clinical disease activity index (CDAI), high sensitivity C reactive protein (hs-CRP) and uric acid in DMARD naive non-diabetic, non-hypertensive, euthyroid patients with normal lipid profile suffering from early and established Rheumatoid Arthritis before and after 3 months of DMARD therapy. It showed a positive and significant correlation among uric acid levels and CDAI and hs-CRP levels at diagnosis. There was significant reduction in the levels of CDAI, hs-CRP and UA after 3 months of DMARD therapy with significant correlation among the changes in the 3 parameters and the change in Uric Acid also correlated with the levels of CDAI and hs-CRP at diagnosis. We propose to measure uric acid both as acute phase reactant and marker for cardiovascular morbidity in patients suffering from Rheumatoid Arthritis.
