Navegando por Palavras-chave "Crohn's disease"
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- ItemSomente MetadadadosAnti-neutrophil cytoplasmic antibodies in Brazilian patients with inflammatory bowel disease(H G E Update Medical Publishing S A, 2003-03-01) Cabral, Virginia Lucia Ribeiro [UNIFESP]; Miszputen, Sender Jankiel [UNIFESP]; Catapani, Wilson Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background/Aims: Anti-neutrophil cytoplasmic antibody has been observed in the sera of patients with inflammatory bowel disease, but its prevalence depends on the population being studied and the method employed for its detection.Methodology: We evaluated the prevalence of anti-neutrophil cytoplasmic antibody by immunofluorescence assay in a series of Brazilian patients with inflammatory bowel disease: 40 patients with ulcerative colitis and 36 with Crohn's disease. We also correlated the presence of this antibody with duration of symptoms, site of the disease and inflammatory activity. Thirty healthy individuals comprised the control group.Results: Anti-neutrophil cytoplasmic antibody was detected in 27.5% of the patients with ulcerative colitis, and in 14.3% of those with Crohn's colitis. Perinuclear staining pattern was the most common, but atypical and nuclear patterns were also observed. There was no correlation between the presence of this antibody and any of the studied clinical variables No patient of the control group presented positive test.Conclusions: A positive anti-neutrophil cytoplasmic antibody test would not be helpful in the differential diagnosis between ulcerative colitis and Crohn's Colitis, since it has a moderate specificity of 86% for ulcerative colitis patients.
- ItemAcesso aberto (Open Access)Anti-tissue transglutaminase antibodies (IgA and IgG) in both Crohn's disease and autoimmune diabetes(Aran Ediciones, S A, 2011-09-01) Cabral, Virginia Lucia Ribeiro [UNIFESP]; Patricio, Francy Reis da Silva [UNIFESP]; Ambrogini-Junior, Orlando [UNIFESP]; Miszputen, Sender Jankiel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: a strong association has been observed between celiac disease, generally its silent clinical form, and autoimmune disorders. A potential correlation with inflammatory bowel disease has also been suggested. Anti-tissue transglutaminase antibodies have been detected in Crohn's disease. We investigated the prevalence of celiac disease in patients with autoimmune diabetes and in Crohn's disease patients and also evaluated the correlation between anti-transglutaminase antibody positivity and the clinical status of these diseases.Methods: anti-tissue transglutaminase and anti-endomysium antibodies were assessed by enzyme-linked immunosorbent assay and indirect immunofluorescence, respectively. Upper digestive endoscopy and duodenal biopsy were indicated for cases with positive serology.Results: anti-transglutaminase antibodies were detected in five diabetic patients (prevalence of 11.1%). only one serum sample was positive for IgG isotypes. Nine of thirty-three patients with Crohn's disease had low positive levels for IgA anti-transglutaminase. Anti-endomysium antibodies were detected only in celiac patients. Celiac disease was confirmed in all diabetic patients submitted to duodenal biopsies who presented both anti-transglutaminase and anti-endomisyum antibodies positivity. In Crohn's disease, its clinical status and the diagnosis of celiac disease were not associated with positive anti-transglutaminase result.Conclusions: the prevalence of celiac disease was high in diabetic patients. Anti-tissue transglutaminase antibodies were sensitive and specific markers of celiac disease in this diabetic group, while these antibodies were of limited value for celiac disease screening in patients with Crohn's disease.
- ItemSomente MetadadadosAssociation of ankylosing spondylitis, Crohn's disease and Takayasu's arteritis in a child(Clinical & Exper Rheumatology, 1998-01-01) Hilário, Maria Odete Esteves [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Prismich, Glaucia [UNIFESP]; Len, Claudio Arnaldo [UNIFESP]; Kihara, E. N.; Goldenberg, José [UNIFESP]; Solé, Dirceu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hosp Israelita Albert EinsteinThe authors report the case of a 15-year-old, HLA-B27-positive male patient who presented a rare association of ankylosing spondylitis, Crohn's disease and Takayasu's arteritis, which resulted in death. A brief review of the literature is provided.
- ItemAcesso aberto (Open Access)Do standardization and quantification of histopathological criteria improve the diagnosis of inflammatory bowel disease?(Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2014-06-01) Baldin, Rosimeri Kuhl Svoboda; Telles, José Ederaldo Queiroz; Bonardi, Renato Araújo; Amarante, Heda Maria Barska Dos Santos; Baldin Júnior, Antônio; Universidade Federal do Paraná Hospital de Clínicas Medical Pathology Department; Universidade Federal de São Paulo (UNIFESP); UFPR Hospital de Clínicas Medical Pathology Department; UFPR Department of Surgery; UFPR Internal Medicine Department; UFPR Hospital de ClínicasIntroduction:Inflammatory bowel disease comprises two major categories: Crohn's disease and ulcerative rectocolitis, both with different clinical and histological aspects, causing sometimes significant morbidity.Objectives:Choose and apply standardized and quantified histopathological diagnosis method, and compare the results and quality index with the original diagnosis.Materials and methods:43 histological colonoscopic biopsies of 37 patients were re-evaluated by standardized system.Results and discussion:The original diagnoses were more inconclusive (23.3%) than those standardized (2.3%). The agreement with gold standard (clinical, colonoscopical, and radiological diagnosis) was higher on standardized diagnoses (95.3%) than in original (74.4%), especially in relation to Crohn's disease, which percentages were 92.3% and 46.1%, respectively. The quality index was calculated in conclusive diagnosis of each method. For ulcerative rectocolitis, both methods showed sensitivity and negative predictive value of 100%; otherwise the original diagnosis demonstrated specificity of 85.7%, positive predictive value of 96.3% and accuracy of 97.0%, and the standardized diagnosis 92.3%, 96.7% and 97.6%, respectively. For Crohn's disease, there is specificity and positive predictive value of 100% in both methods; the original diagnosis showed sensitivity of 85.7%, negative predictive value of 96.3% and accuracy of 97%, while for the standardized diagnoses 92.3%, 96.7%, and 97.6%, respectively.Conclusion:The standardized diagnosis presented a higher percentage of correct and conclusive diagnoses than those presented in the original diagnosis, especially for Crohn's disease, as well as equal or slightly higher values in some quality index.
- ItemAcesso aberto (Open Access)Ferro intravenoso em crianças e adolescentes com doença inflamatória intestinal(Universidade Federal de São Paulo (UNIFESP), 2018-08-20) Venturieri, Maissara Obara [UNIFESP]; Sdepanian, Vera Lucia [UNIFESP]; http://lattes.cnpq.br/8273324982105660; http://lattes.cnpq.br/8349024217236009; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the therapeutic response and the adverses effects of Noripurum EV® in children and adolescents with inflammatory bowel disease and iron deficiency anemia. Methods: A cohort study was conducted at the Pediatric Gastroenterology Clinic of the Federal University of São Paulo (UNIFESP) from January 2013 to May 2018, on patients with Crohn's disease (CD) and ulcerative colitis (UC) who received treatment for iron deficiency anemia with Noripurum EV®. The research was approved by institutional review board nº: 0951/2016. Data were analyzed by SigmaPlot 14.0 and Bioestat 5.3 (α5%). Results: Noripurum EV® was applied in 13 patients and 3 required reinfusion after 12 years; summing up to 16 cases. Of the 16 subjects, 10 (62.5%) were male. The mean (SD) age was 11.3 (4.6) years, 75% (12/16) with CD and 25% (4/16) with UC. Iron deficiency anemia was found in 93.7% patients and iron deficiency anemia associated with anemia of chronic disease in 6.3%. All patients presented a hemoglobin increase (p <0.001), whose mean (SD) was 2.8 (1.3) g / dl, after median (2575 percentiles) of 4.5 (3.06.0) weeks at the end of intravenous iron infusion. No adverse events have been reported, even in patients receiving IV iron after application of adalimumab. Conclusions: Noripurum EV® in pediatric patients with inflammatory bowel disease and iron deficiency anemia was effective and safe. Therefore, Noripurum EV® can be considered as an adequate option for clinical management of in these individuals.
- ItemSomente MetadadadosFurther analysis of VNTR and MIRU in the genome of Mycobacterium avium complex, and application to molecular epidemiology of isolates from South America(Elsevier B.V., 2005-10-31) Romano, M. I.; Amadio, A.; Bigi, F.; Klepp, L.; Etchechoury, I; Llana, M. N.; Morsella, C.; Paolicchi, F.; Pavlik, I; Bartos, M.; Leao, S. C.; Cataldi, A.; INTA; Universidade Federal de São Paulo (UNIFESP); Vet Res InstAll members of Mycobacterium avium complex are serious pathogens for humans and animals. the aim of this study was to look for and analyze VNTR-MIRU loci in the genome of M. avium complex and their preliminary application to test these isolates. in the present study, we identified 22 novel VNTR-MIRU by using Tandem Repeat software: five with a structure similar to MIRU and 17 without MIRU structure; these latter were designated as VNTR. Most VNTR were located within predicted coding regions. Most MIRU were intercistronic with their extremities overlapping the termination and initiation codons of their flanking genes. Some of these VNTR-MIRU exhibited polymorphism among M. avium complex isolates due to insertion or deletion of whole repeats and/or of nucleotide sequence degeneration. We determined the variability of six VNTR-MIRU loci in 21 M. avium subsp. hominissuis and 26 M. avium subsp. paratuberculosis. the analysis identified 15 different alleles with the combination of six VNTR-MIRU in the 21 M. avium subsp. hominissuis with 16 different IS1245 RFLP and four different profiles with PCR-restriction analysis of hsp65 (PRA). However, neither the six VNTR-MIRU loci nor the PRA were able to distinguish M. avium subsp. paratuberculosis isolates with five different IS900 RFLP profiles. in conclusion, some of the VNTR-MIRU loci identified were useful to differentiate M. avium subsp. hominissuis but not M. avium subsp. paratuberculosis isolates here included. However, we observed polymorphism in VNTR-MIRU loci between M. avium subsp. hominissuis and M. avium subsp. paratuberculosis genomes, which could be important in the understanding of the obvious differences in the pathogenic effects of these mycobacteria. (c) 2005 Elsevier B.V. All rights reserved.
- ItemAcesso aberto (Open Access)Qualidade de vida de pacientes portadores de doença inflamatória intestinal(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2011-01-01) Souza, Mardem Machado De; Barbosa, Dulce Aparecida [UNIFESP]; Espinosa, Mariano Martinez; Belasco, Angélica Gonçalves Silva [UNIFESP]; UNIC Faculdade de Medicina Departamento de Cirurgia; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Mato Grosso Departamento de EstatísticaOBJECTIVES: To assess the quality of life (QV) in patients with inflammatory bowel disease (DII), and relate it to demographic data and morbidity. METHODS: Cross-sectional study with 103 patients with DII, registered in the high cost pharmacy of Cuiabá - Mato Grosso, who responded to the Standard Medical Record, the general QV questionnaire SF-36 and the specific IBDQ. RESULTS: Among 103 patients with DII, 62 had ulcerative colitis and 41 had Crohn's disease; 62% were women; 69.9% were married; 48.5% were of mixed race; 49.5% were smokers; 37.9% required surgery; and, 40.8% had active disease. We observed significant changes in QV in men, smokers and those with active disease. CONCLUSION: DII affect QV in several respects. Measures for maintenance of QV, psychological, social and education support should be considered for patients with DII.
- ItemSomente MetadadadosRisk factors for low bone mineral density in children and adolescents with inflammatory bowel disease(Springer, 2008-10-01) Caldas Lopes, Leticia Helena [UNIFESP]; Sdepanian, Vera Lucia [UNIFESP]; Szejnfeld, Vera Lucia [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Fagundes-Neto, Ulysses [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective To evaluate bone mineral density of the lumbar spine in children and adolescents with inflammatory bowel disease, and to identify the clinical risk factors associated with low bone mineral density. Methods Bone mineral density of the lumbar spine was evaluated using dual-energy X-ray absorptiometry (DXA) in 40 patients with inflammatory bowel disease. Patients were 11.8 (SD = 4.1) years old and most of them were male (52.5%). Multiple linear regression analysis was performed to identify potential associations between bone mineral density Z-score and age, height-for-age Z-score, BMI Z-score, cumulative corticosteroid dose in milligrams and in milligrams per kilogram, disease duration, number of relapses, and calcium intake according to the dietary reference intake. Results Low bone mineral density (Z-score bellow -2) was observed in 25% of patients. Patients with Crohn's disease and ulcerative colitis had equivalent prevalence of low bone mineral density. Multiple linear regression models demonstrated that height-for-age Z-score, BMI Z-score, and cumulative corticosteroid dose in mg had independent effects on BMD, respectively, beta = 0.492 (P = 0.000), beta = 0.460 (P = 0.001), beta = -0.014 (P = 0.000), and these effects remained significant after adjustments for disease duration, respectively, beta = 0.489 (P = 0.013), beta = 0.467 (P = 0.001), and beta = -0.005 (P = 0.015). the model accounted for 54.6% of the variability of the BMD Z-score (adjusted R(2) = 0.546). Conclusions the prevalence of low bone mineral density in children and adolescents with inflammatory bowel disease is considerably high and independent risk factors associated with bone mineral density are corticosteroid cumulative dose in milligrams, height-for-age Z-score, and BMI Z-score.
- ItemSomente MetadadadosTreatment of Crohn's disease in pregnant women: Drug and multidisciplinary approaches(Baishideng Publishing Group Inc, 2014-07-21) Cury, Didia Bismara [UNIFESP]; Moss, Alan C.; Universidade Federal de São Paulo (UNIFESP); Ctr Inflammatory Bowel Dis; Harvard Med Sch; Beth Israel Deaconess Med CtrInflammatory bowel disease affects a substantial number of women in their reproductive years. Pregnancy presents a number of challenges for clinicians and patients; the health of the baby needs to be balanced with the need to maintain remission in the mother. Historically, treatments for Crohn's disease (CD) were often discontinued during the pregnancy, or nursing period, due to concerns about teratogenicity. Fortunately, observational data has reported the relative safety of many agents used to treat CD, including 5-aminosalicylic acid, thiopurines, and tumor necrosis factor. Data on the long-term development outcomes of children exposed to these therapies in utero are still limited. It is most important that physicians educate the patient regarding the optimal time to conceive, discuss the possible risks, and together decide on the best management strategy. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
- ItemSomente MetadadadosVedolizumab for the treatment of Crohn's disease(Taylor & Francis Ltd, 2018) Argollo, Marjorie [UNIFESP]; Fiorino, Gionata; Peyrin-Biroulet, Laurent; Danese, SilvioIntroduction: Crohn's disease (CD) is an immune-mediated condition characterized by inflammation of the gut tissue, associated with progressive damage of the affected intestinal tract and possible complications. A treat-to-target approach is strongly advocated, consisting of early and aggressive inflammatory control. However, a great proportion of affected subjects lack response or are intolerant to conventional therapy. Even though the first-line biologic therapy targeting tumor necrosis factor-alfa (TNF-) is associated with improvement of inflammation in some patients, others do not respond at first or lose response over time. These findings brought about the possibility of different mechanisms being involved in perpetuating the chronic inflammatory state. Novel drugs targeting different inflammatory pathways have been studied in CD, specifically addressed to leucocyte trafficking.Areas covered: We aim to review the relevant data available in the literature and briefly summarize the efficacy and safety profile of vedolizumab in the treatment of CD.Expert commentary: Vedolizumab has shown, from pivotal and real-life data, significant clinical benefit among CD patients, in addition to a singular safety profile. Future studies will provide helpful data concerning its use in special situations.