The management of iron deficiency in inflammatory bowel disease

__Background__ Iron deficiency is a common and undertreated problem in inflammatory bowel disease (IBD). __Aim__ To develop an online tool to support treatment choice at the patient-specific level. __Methods__ Using the RAND/UCLA Appropriateness Method (RUAM), a European expert panel assessed the appropriateness of treatment regimens for a variety of clinical scenarios in patients with non-anaemic iron deficiency (NAID) and iron deficiency anaemia (IDA). Treatment options included adjustment of IBD medication only, oral iron supplementation, high-/low-dose intravenous (IV) regimens, IV iron plus erythropoietin-stimulating agent (ESA), and blood transfusion. The panel process consisted of two individual rating rounds and three plenary discussion meetings. __Results__ The panel reached agreement on 71% of treatment indications. 'No treatment' was never considered appropriate, and repeat treatment after previous failure was generally discouraged. For 98% of scenarios, at least one treatment was appropriate. Adjustment of IBD medication was deemed appropriate in all patients with active disease. Use of oral iron was mainly considered an option in NAID and mildly anaemic patients without disease activity. IV regimens were often judged appropriate, with high-dose IV iron being the preferred option in 77% of IDA scenarios. Blood transfusion and IV+ESA were indicated in exceptional cases only. __Conclusions__ The RUAM revealed high agreement amongst experts on the management of iron deficiency in patients with IBD. High-dose IV iron was more often considered appropriate than other options. To facilitate dissemination of the recommendations, panel outcomes were embedded in an online tool, accessible via http://ferroscope.com/

The Caravan Rolls On

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68409/2/10.1177_107554707900100103.pd

IMG 305 - PEMBUNGKUSAN MAKANAN NOV.05.

We discuss the use of Agent-based Modelling for the development and testing of theories about emergent social phenomena in marketing and the social sciences in general. We address both theoretical aspects about the types of phenomena that are suitably addressed with this approach and practical guidelines to help plan and structure the development of a theory about the causes of such a phenomenon in conjunction with a matching ABM. We argue that research about complex social phenomena is still largely fundamental research and therefore an iterative and cyclical development process of both theory and model is to be expected. To better anticipate and manage this process, we provide theoretical and practical guidelines. These may help to identify and structure the domain of candidate explanations for a social phenomenon, and furthermore assist the process of model implementation and subsequent development. The main goal of this paper was to make research on complex social systems more accessible and help anticipate and structure the research process

Management of Patients With Crohn's Disease and Ulcerative Colitis During the Coronavirus Disease-2019 Pandemic: Results of an International Meeting

The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) is the only global organization devoted to the study of and management of the inflammatory bowel diseases (IBDs), namely, Crohn?s disease and ulcerative colitis. Membership is composed of physician-scientists who have established expertise in these diseases. The organization hosts an annual meeting and a number of working groups addressing issues of the epidemiology of IBD, diet and nutrition, and the development and use of treatments for IBD. There are currently 89 members of IOIBD representing 26 different countries. The organization has taken particular interest in the coronavirus disease-2019 (COVID-19) pandemic and how it may affect the IBD patient population. This document summarizes the results of 2 recent virtual meetings of the group and subsequent expert guidance for patients and providers

High serum osteoprotegerin and low RANKL in primary biliary cirrhosis

újratöltve - bibEBI0001859

ATG16L1 and IL23 receptor (IL23R) genes are associated with disease susceptibility in Hungarian CD patients

Background. North American and European genome-wide association scans have identified ATG16L1 and IL23R as novel inflammatory bowel disease (11313) susceptibility genes and Subsequent reports continued these findings in large independent populations. The aims of this study were to investigate the association and examine genotype-phenotype relationships in a Hungarian 1131) cohort. Methods. 415 unrelated IBD patients (CD: 266, age: 35.2 +/- 12.1 years, duration: 8.7 +/- 7.5 years and UC: 149, age: 44.4 +/- 15.4 years, duration: 10.7 +/- 8.9 years) and 149 healthy subjects were investigated. IL23R Arg381GIn (R381Q, rs 11209026) and ATG16L1 Thr300Ala (T300A, rs2241880) polymorphisms were tested using LightCycler allele discrimination method. Detailed clinical phenotypes were determined by reviewing the medical charts. Results. The association between IL23R rs 11209026, ATG16L1 rs2241880 and CD was confirmed (ORIL23R381Q: 0.38, 95% CI: 0.16-0.87; ORATG161-1300AA: 1.86, 95% CI: 1.04-3.40). No difference was found between patients with UC and either controls or CD. In CID, IL23R 381Gln heterozygosity was associated with inflammatory disease (70% vs. 34%, p = 0.037), while disease restricted to the colon was more prevalent in patients with the ATG16L1 300Ala/Ala homozygosity (33.3% vs. 21.1%, p = 0.036). In addition, carriage of the variant alleles did not predict response to steroids, infliximab or need for surgery. Conclusions. We confirmed that ATG16L1 and IL23R are susceptibility loci for CD in Hungarian CID patients. Further studies are needed to confirm the reported phenotype-genotype associations found in this Study