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Intestinal research (Intest Res) update

  • : 대한장연구학회
  • : 의약학분야  >  내과학
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  • : SCOPUS
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수록범위 : 1권1호(2003)~19권3호(2021) |수록논문 수 : 846
Intestinal research (Intest Res)
19권3호(2021년 07월) 수록논문
최근 권호 논문
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KCI등재 SCOPUS

1Correlation of serum levels of anti-tumor necrosis factor agents with perianal fistula healing in Crohn's disease: a narrative review

저자 : Eron Fabio Miranda , Rodrigo Bremer Nones , Paulo Gustavo Kotze

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 255-264 (10 pages)

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With the overspread use of measurement of serum levels of anti-tumor necrosis factor (TNF) agents (therapeutic drug monitoring, TDM), new therapeutic strategies have been used in the management of Crohn's disease (CD). Different targets are correlated with increased levels of circulating drugs. Recent evidence demonstrated that higher serum levels of anti-TNF agents may be associated to better outcomes in perianal fistulizing CD (PFCD). Overall, patients with healed fistulas had higher serum levels of infliximab and adalimumab as compared to those with active drainage. This was demonstrated in some cohort studies, in induction and maintenance, in adults and children with PFCD. In this narrative review, authors summarize current evidence on the use of serum level measurement of anti-TNF agents and its correlation with perianal fistula healing in CD patients. Data on the use of TDM in PFCD is discussed in detail. The retrospective design of the studies and the lack of objective parameters to measure fistula healing are the main limitations of published data. Prospective studies, with central reading of objective radiological parameters, such as pelvic magnetic resonance imaging scores, can improve the level of evidence on the possible advantages of TDM in perianal fistula in CD and are warranted. (Intest Res 2021;19:255-264)

KCI등재 SCOPUS

2Management of Clostridioides difficile infection in patients with inflammatory bowel disease

저자 : Sahil Khanna

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 265-274 (10 pages)

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Inflammatory bowel disease (IBD) is a common diarrheal illness with gastrointestinal and extraintestinal manifestations and complications. The most common infectious complication associated with IBD is Clostridioides difficile infection (CDI). Active IBD predisposes to CDI due to alterations in the gut microbiome. C. difficile is a toxin producing bacterium leading to worsening of underlying IBD, increasing the risk of IBD treatment failure and an increased risk of hospitalization and surgery. Since the symptoms of CDI overlap with those of an IBD flare; it is prudent to recognize that the diagnosis of CDI is challenging and diagnostic tests (nucleic-acid and toxin-based assays) should be interpreted in context of symptoms and test performance. First line treatments for management of CDI in IBD include vancomycin or fidaxomicin. Recurrence prevention strategies should be implemented to mitigate recurrent CDI risk. One needs to monitor IBD disease progression and manage immunosuppression. The risk of recurrent CDI after a primary infection is higher in IBD compared to non-IBD patients. Microbiota restoration therapies are effective to prevent recurrent CDI in IBD patients. This review summarizes the epidemiology, pathophysiology, diagnostic testing, outcomes and management of both CDI and IBD, in CDI complicating IBD. (Intest Res 2021;19:265-274)

KCI등재 SCOPUS

3Effect of resistance exercise training on Crohn's disease patients

저자 : Konstantinos Papadimitriou

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 275-281 (7 pages)

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Crohn's disease (CD) is observed with increased levels of cytokines which cause inflammation in many parts of the digestive tract. Aerobic exercise contributes to the reduction of the intestine's inflammation and increases the quality of life. Another type of exercise that shows research interest about its effects on CD symptoms is the resistance exercise (RE). The aim of the study was to review the influence of RE on CD patients. The study's literature was collected from PubMed and Scholar databases. According to the results, the main phase of a RE training program must have a gradual increase of intensity (60%-80%) and resting periods of 15-30 seconds after each exercise, and 2-3 minutes between exercises. Also, CD patients who were in remission improved the muscle strength and quality of life via their participation in RE training program. However, the secretion of interleukin-6 in both CD and RE contributes in various physiological mechanisms setting a contradictory role in the effectiveness of RE at the disease's inflammatory situation. So, the use of RE training in CD patients needs more research for safer participation. (Intest Res 2021;19:275-281)

KCI등재 SCOPUS

4Trends of inflammatory bowel disease at a tertiary care center in northern India

저자 : Ajit Sood , Kirandeep Kaur , Arshdeep Singh , Vandana Midha , Ramit Mahajan , Namita Bansal , Varun Mehta , Dharmatma Singh

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 282-292 (11 pages)

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Background/Aims: Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is increasingly being reported from India and other Asian countries. This study looks into the changing trends of IBD at a tertiary care center in north India over last two decades. Methods: Retrospective analysis of a prospectively maintained database of patients diagnosed with IBD between January 1991 and December 2015 was conducted. The study period was divided into five times cohorts (1991-1995, 1996-2000, 2001-2005, 2006-2010, 2011-2015). Results: During the study period, 2,467 patients (UC [n=2,137, 86.6%], CD [n=330, 13.3%], mean age 38.5±13.3 years; 55.9% males) were registered. The proportion of patients with CD increased (ratio of UC to CD declined from 15.7:1 to 4:1). The mean age at diagnosis decreased for UC (45.7±12.1 years in 1991-1995 vs. 37.6±13.0 years in 2011-2015; P=0.001) and remained consistent for CD (41.3±13.6 years in 1996-2000 vs. 41.3±16.9 years in 2011-2015, P=0.86). Patients with proctitis in UC and isolated ileal disease in CD increased over the study period (P=0.001 and P=0.007, respectively). Inflammatory CD increased (P=0.009) whereas stricturing CD decreased (P=0.01) across all cohorts. There was a trend towards less severe presentation of both UC and CD. The use of thiopurines (P=0.02) and biologics increased (P=0.001) with no significant change in trends for requirements of surgery (P=0.9). Conclusions: Increasing prevalence of CD, younger age at diagnosis, diagnosis at an earlier and milder stage, greater use of thiopurines and biologics were observed. (Intest Res 2021;19:282-290)

KCI등재 SCOPUS

5Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn's disease

저자 : Sanchit Sharma , Arti Gupta , Saurabh Kedia , Samagra Agarwal , Namrata Singh , Sandeep Goyal , Saransh Jain , Vipin Gupta , Pabitra Sahu , Sudheer Kumar Vuyyuru , Bhaskar Kante , Raju Sharma , Rajesh Panwa

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 291-301 (11 pages)

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Background/Aims: Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn's disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India. Methods: This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn's Disease Activity Index (CDAI), and clinical response (decline in CDAI >70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response. Results: Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2-6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260-320] vs. 240 [180-280], P=0.001) and 8 weeks (baseline 290 [260-320] vs. 186 [160-240], P=0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n=4), B2 (n=18), and B3 (n=9) phenotypes were 50%, 78.8%, and 100% respectively (log-rank test, P=0.093). The response rates at 8 weeks with polymeric (n=8) and semi-elemental diet (n=23) were 75% and 82.6% respectively (log-rank test, P=0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002-1.017; P=0.046) predicted response to EEN. Conclusions: EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN. (Intest Res 2021;19:291-300)

KCI등재 SCOPUS

6Long-term safety and effectiveness of adalimumab in 462 patients with intestinal Behçet's disease: results from a large real-world observational study

저자 : Yasuo Suzuki , Takashi Hagiwara , Mariko Kobayashi , Kazuo Morita , Tomoyo Shimamoto , Toshifumi Hibi

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 301-313 (13 pages)

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Background/Aims: The safety and effectiveness of adalimumab was demonstrated in a phase 3 trial in Japanese patients with intestinal Behçet's disease. The aim of this study was to evaluate the long-term safety and effectiveness of adalimumab in Japanese patients with intestinal Behçet's disease. Methods: This prospective, all-case, post-marketing study was conducted at 254 centers in Japanese patients with intestinal Behçet's disease receiving adalimumab. The primary endpoint was incidence of adverse drug reactions. Effectiveness endpoints included global improvement rating and change in C-reactive protein levels. Results: Of the 473 registered patients, 462 and 383 included in the safety and effectiveness populations were administered adalimumab for a mean of 515.3 and 579.5 days, respectively. Overall, 395 patients (85.5%) received adalimumab at the recommended dose. Adverse drug reactions and serious adverse drug reactions were reported in 120 (25.97%) and 51 (11.04%) patients, respectively. The incidence of adverse drug reactions was significantly higher in patients with comorbidities (P<0.0001), patients taking concomitant oral corticosteroids (P<0.0001), and those not self-administering adalimumab (P=0.0257). At study end, global improvement rating was “effective” (n=156, 40.7%) or “markedly effective” (n=168, 43.9%) in 324 patients (overall effective, 84.6%). Mean C-reactive protein levels (mg/dL) decreased from 1.96 at baseline (n=324) to 0.58 at week 24 (n=208) and 0.25 at week 156 (n=37). Conclusions: This large real-world study confirmed the long-term safety and effectiveness of adalimumab in patients with intestinal Behçet's disease. No new safety concerns were identified. (Clinical trial registration number: NCT01960790) (Intest Res 2021;19:301-312)

KCI등재 SCOPUS

7Incidence and risk factors for venous thrombosis among patients with inflammatory bowel disease in China: a multicenter retrospective study

저자 : Jing Liu , Xiang Gao , Ye Chen , Qiao Mei , Liangru Zhu , Jiaming Qian , Pinjin Hu , Qian Cao

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 313-322 (10 pages)

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Background/Aims: Risk of venous thrombosis is increased in patients with inflammatory bowel disease (IBD); data on Asian IBD patients is limited and status quo of thrombosis screening and prophylaxis are unknown. Therefore, we aimed to investigate the incidence, screening, prophylaxis, and risk factors for venous thrombosis among Asian IBD patients. Methods: Medical files of patients with Crohn's disease (CD) and ulcerative colitis (UC) from 17 hospitals across China between 2011 and 2016 were reviewed for venous thrombosis, use of screening and prophylaxis. A case-control study was performed among hospitalized patients with venous thrombosis and their age-, sex-matched IBD controls hospitalized around the same period; disease characteristics and known provoking factors of venous thrombosis were recorded. Risk factors were analyzed in both univariate and logistic regression analyses. Results: A total of 8,459 IBD patients were followed for 12,373 person-year. Forty-six patients (0.54%) had venous thrombosis, yielding an incidence of 37.18 per 10,000 person-year. Incidence increased with age, especially among CD. Less than 20% of patients received screening tests and 35 patients (0.41%) received prophylaxis. Severe disease flare was an independent risk factor for venous thrombosis (odds ratio [95% confidence interval]: CD, 9.342 [1.813-48.137]; UC, 5.198 [1.268-21.305]); past use of steroids and extensive involvement were 2 additional risk factors in CD and UC, respectively. Conclusions: Incidence of venous thrombosis in China was 37.18 per 10,000 person-year (0.54%). Use of screening and prophylaxis were rare. Severe disease flare was an independent risk factor for thrombosis among hospitalized patients. (Intest Res 2021;19:313-322)

KCI등재 SCOPUS

8Long-term outcomes of infliximab in a real-world multicenter cohort of patients with acute severe ulcerative colitis

저자 : Shin Ju Oh , Ga Young Shin , Hosim Soh , Jae Gon Lee , Jong Pil Im , Chang Soo Eun , Kang-moon Lee , Dong Il Park , Dong Soo Han , Hyo Jong Kim , Chang Kyun Lee

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 323-331 (9 pages)

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Background/Aims: Infliximab (IFX) has proven effective as rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC), however, the long-term real-world data are scarce. Our study aimed to assess the long-term treatment outcomes of IFX in a real-life cohort. Methods: We established a multicenter retrospective cohort of hospitalized patients with ASUC, who met Truelove and Witt's criteria and received intravenous corticosteroid (IVCS) or IFX during index hospitalization between 2006 and 2016 in 5 university hospitals in Korea. The cohort was systematically followed up until colectomy, death or last follow-up visit. Results: A total of 296 patients were followed up for a mean of 68.9±44.0 months. During index hospitalization, 49 patients were treated with IFX; as rescue therapy for IVCS failure in 37 and as first-line medical therapy for ASUC in 12. All patients treated with IFX avoided colectomy during index hospitalization. The cumulative rates of rehospitalization and colectomy were 20.4% and 6.1% at 3 months and 39.6% and 18.8% at the end of follow-up, respectively. Patients treated with IFX presented with significantly shorter colectomy-free survival than IVCS responders (P=0.04, log-rank test). Both cytomegalovirus colitis and Clostridioides difficile infection (CDI) were the significant predictors of colectomy in the overall study cohort (hazard ratios of 6.57 and 4.61, respectively). There were no fatalities. Conclusions: Our real-world cohort study demonstrated that IFX is an effective therapeutic option in Korean patients with ASUC, irrespective of IFX indication. Aggressive vigilance for cytomegalovirus colitis and CDI is warranted for hospitalized patients with ASUC. (Intest Res 2021;19:323-331)

KCI등재 SCOPUS

9Patterns of endoscopy during COVID-19 pandemic: a global survey of interventional inflammatory bowel disease practice

저자 : Yan Chen , Qiao Yu , Francis A. Farraye , Gursimran S. Kochhar , Charles N. Bernstein , Udayakumar Navaneethan , Kaicun Wu , Jie Zhong , David A. Schwartz , Hao Wu , Jing-jing Zheng , Marietta Iacucci , Rav

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 332-340 (9 pages)

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Background/Aims: Performance of diagnostic or therapeutic endoscopic procedures in inflammatory bowel disease (IBD) patients can be challenging during a viral pandemic; the main concerns being the safety and protection of patients and health care providers (HCP). The aim of this study is to identify endoscopic practice patterns and outcomes of IBD and coronavirus disease 19 (COVID-19) with a worldwide survey of HCP. Methods: The 20-item survey questionnaire was sent to physician members of the American Society for Gastrointestinal Endoscopy Special Interest Group in Interventional IBD, Chinese IBD Society Endoscopy Interest Group, and the China Crohn's and Colitis Foundation. Results: A total of 141 respondents submitted valid responses. Nighty-five respondents (67.9%) reported that at least 25% of their scheduled emergent endoscopic procedures were canceled or postponed during the pandemic. Fifty-six respondents (40.0%) have performed emergent endoscopy during the pandemic. A few respondents (9/140, 6.4%) estimated that more than 25% of their patients had worsened disease due to delayed or canceled emergent endoscopy procedures. More than 80% of respondents believed that personal protective equipment (PPE) for the endoscopy team, room sterilization, and pre-procedure screening of patients for COVID-19 were necessary. Out of 140 respondents, 16 (11.4%) reported that several of their patients had COVID-19. Eight clinicians (5.7%) reported that they or their endoscopy colleagues developed work-related COVID-19. Conclusions: Cancellation of elective and emergent endoscopy in IBD care during the pandemic was common. Few respondents reported that their patients' disease conditions worsened due to the cancellation of the endoscopy procedure. Most respondents voiced the need for proper PPE during the procedure regardless of patients' COVID-19 status and screening the patients for COVID-19. (Intest Res 2021;19:332-340)

KCI등재 SCOPUS

10Effect of gut microbiome on minor complications after a colonoscopy

저자 : Jae Hyun Kim , Youn Jung Choi , Hye Jung Kwon , Kyoungwon Jung , Sung Eun Kim , Won Moon , Moo In Park , Seun Ja Park

발행기관 : 대한장연구학회 간행물 : Intestinal research (Intest Res) 19권 3호 발행 연도 : 2021 페이지 : pp. 341-350 (10 pages)

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Background/Aims: Minor complications that might occur after colonoscopy, including abdominal discomfort, bloating, diarrhea, and constipation, could a barrier for patients to undergo a screening colonoscopy. In this study, we aimed to identify the effect of gut microbial diversity and composition on minor complications after colonoscopy. Methods: A total of 24 healthy subjects provided their stools before bowel preparation and on the 7th and 28th day after colonoscopy. On the 7th day after colonoscopy, the presence of minor complications was investigated using a questionnaire. We divided patients into 2 groups, the no complication group and complications group. The fecal microbial diversity, distribution, and composition were then compared between the groups. Results: Five of the 24 subjects reported that they had undergone minor complications after colonoscopy. Most of the symptoms were mild and self-limited, but 1 patient needed medication. Interestingly, the Firmicutes/Bacteroidetes ratio of the initial stool samples before bowel preparation in the complication group was significantly higher than that in no complication group. After bowel preparation, the Firmicutes/Bacteroidetes ratio of the complication group decreased, but not in the no complication group. The microbial diversity of the no complication group decreased after bowel preparation, but not in the complication group. Conclusions: The gut microbial composition and diversity before and after bowel preparation could be considered as one of the causes of minor complications after colonoscopy. Further studies are needed to delineate the role of gut microbiota in the occurrence of minor complications after colonoscopy. (Intest Res 2021;19:341-348)

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