Recurrent Acute Pancreatitis and Therapy for Ulcerative Colitis

Drugs are a rare cause of pancreatitis. Whereas some drugs are well known to induce an attack of pancreatitis, some people may be more prone to develop pancreatitis because of personal susceptibility. We describe a recurrent case of acute pancreatitis after administration of several drugs in a patient with intestinal inflammatory bowel disease that needed to be treated with subsequent antiinflammatory agents. Genetic mutation in the CFTR gene was found in the patient that led us to postulate that CFTR was a trigger for drug-induced acute pancreatitis. In conclusion, genetic analysis should be advised in case of recurrent pancreatitis in patient with intestinal inflammatory bowel disease

Positioning biologics in the treatment of IBD: A practical guide - Which mechanism of action for whom?

The number of available biological therapies have doubled over the last 10 years and the arrival of novel molecules (interleukin 23p19 inhibitors) is ongoing alongside the development of small molecules. As a result of this vast landscape of treatment, positioning advanced therapies (according to clinical situation, efficacy and safety) is of paramount importance to providing personalized, appropriate IBD treatment. In this publication the recent available literature is summarized for practical integration into clinical practice including comparative efficacy data, patient and disease demographics. We refer to recent publications and expert opinion in order to facilitate the decision making process of positioning biologicals IBD treatment

Patient self-reported concerns in inflammatory bowel diseases: A gender-specific subjective quality-of-life indicator.

Patient-reported disease perceptions are important components to be considered within a holistic model of quality of care. Gender may have an influence on these perceptions. We aimed to explore gender-specific concerns of patients included in a national bilingual inflammatory bowel disease cohort. Following a qualitative study, we built a questionnaire comprising 37 items of concern. Answers were collected on a visual analog scale ranging from 0 to 100. Principal axis factor analysis was used to explore concern domains. Linear multiple regressions were conducted to assess associations with patient characteristics. Of 1102 patients who replied to the survey, 54% were female and 54% had Crohn's disease. We identified six domains of concern: socialization and stigmatization, disease-related constraints and uncertainty, symptoms and their impact on body and mind, loss of body control (including sexuality), disease transmission, and long-term impact of the disease. Cancer concerns were among the highest scored by all patients (median 61.8). Severity of symptoms was the only factor associated with concerns, unrelated to dimension and gender (p<0.015). In women, being >40 years decreased disease-related constraints and uncertainty concerns, and being at home or unemployed increased them. Treatments were associated with increased socialization and stigmatization and with increased disease-related constraints and uncertainty concerns in men. Overall, psychosomatic characteristics were highly associated with concerns for both men and women. Depending on the concern dimensions, increased levels of concern were associated with the highest signs of anxiety in women or depression in men, as well as lower health-related quality of life in men. Patients have numerous concerns related to their illness that need to be reassessed regularly. Concerns differ between men and women, suggesting that information and communication about the disease should take gender differences and subjective perceptions of quality of life into consideration

Intensity Prediction Equations Based on the Environmental Seismic Intensity (ESI-07) Scale: Application to Normal Fault Earthquakes

Earthquake environmental effects may significantly contribute to the damage caused by seismic events; similar to ground motion, the environmental effects are globally stronger in the vicinity and decrease moving away from the epicenter or seismogenic source. To date, a single intensity prediction equation (IPE) has been proposed in the Italian Apennines for intensity scale dealings with environmental effects: the Environmental Seismic Intensity (ESI-07). Here, we evaluate the sensitivity of the IPE with respect to input data and methodological choices and we propose IPEs with global validity for crustal normal faults. We show the strong influence of input data on the obtained attenuation investigating the 1980 Irpinia-Basilicata (Southern Italy) earthquake. We exploit a dataset of 26 earthquakes to build an IPE considering the epicentral distance. We also propose an IPE considering the distance from the fault rupture, which is derived from a dataset of 10 earthquakes. The proposed equations are valid for normal faults up to 40 km from the epicenter/fault and may flank other models predicting ground motion or damage to the built environment. Our work thus contributes to the use of the ESI-07 scale for hazard purposes

Patient-reported healthcare expectations in inflammatory bowel diseases.

BACKGROUND: Patient-reported experience is an important component of a holistic approach to quality of care. Patients' expectations of treatments and global disease management may indicate their illness representations and their satisfaction and hopes regarding quality of care. OBJECTIVE: To study expectations of patients with inflammatory bowel disease. METHODS: Two focus groups were conducted with 14 patients to explore their expectations about treatments and disease management. From qualitative content analyses of focus group discussions, we built a 22-item expectations questionnaire that was sent to 1756 patients of the Swiss IBD cohort. Answers were collected on a visual analog scale from 0 to 100, and medians (interquartile range [IQR]) calculated. Factor analysis identified main expectation dimensions, and multivariate analyses were performed to describe associations with patient characteristics. RESULTS: Of 1094 patients (62%) included in the study, 54% were female, 54% had Crohn's disease, 35% had tertiary education, and 72% were employed. Expectation dimensions comprised realistic, predictive, and ideal expectations and were linked to information, communication, daily care, and disease recognition. Half (11 of 22) of the expectations were ranked as very high (median score > 70), the 2 most important being good coordination between general practitioners and specialists (median score: 89, IQR: 71-96) and information on treatment adverse events (89, IQR: 71-96). Women had overall higher levels of expectations than did men. Expectations were not associated with psychosocial measures, except those related to disease recognition, and most of them were highly associated with increased concerns on disease constraints and uncertainty. CONCLUSIONS: Patients have high expectations for information and communication among caregivers, the levels varying by gender and region. Patients also appear to request more active participation in their disease management

The Wiskott-Aldrich syndrome protein is required for the function of CD4+CD25+Foxp3+ regulatory T cells

The Wiskott-Aldrich syndrome, a primary human immunodeficiency, results from defective expression of the hematopoietic-specific cytoskeletal regulator Wiskott-Aldrich syndrome protein (WASP). Because CD4+CD25+Foxp3+ naturally occurring regulatory T (nTreg) cells control autoimmunity, we asked whether colitis in WASP knockout (WKO) mice is associated with aberrant development/function of nTreg cells. We show that WKO mice have decreased numbers of CD4+CD25+Foxp3+ nTreg cells in both the thymus and peripheral lymphoid organs. Moreover, we demonstrate that WKO nTreg cells are markedly defective in both their ability to ameliorate the colitis induced by the transfer of CD45RBhi T cells and in functional suppression assays in vitro. Compared with wild-type (WT) nTreg cells, WKO nTreg cells show significantly impaired homing to both mucosal (mesenteric) and peripheral sites upon adoptive transfer into WT recipient mice. Suppression defects may be independent of antigen receptor–mediated actin rearrangement because both WT and WKO nTreg cells remodeled their actin cytoskeleton inefficiently upon T cell receptor stimulation. Preincubation of WKO nTreg cells with exogenous interleukin (IL)-2, combined with antigen receptor–mediated activation, substantially rescues the suppression defects. WKO nTreg cells are also defective in the secretion of the immunomodulatory cytokine IL-10. Overall, our data reveal a critical role for WASP in nTreg cell function and implicate nTreg cell dysfunction in the autoimmunity associated with WASP deficiency

Environmental effects caused by the Mw 7.7, September 19, 2022, Michoacán (Mexico)

This document presents a collection of Earthquake Environmental Effects (EEEs) triggered by the Mw 7.7 Michoacan earthquake occurred on 19 September 2022. Data derive from original field surveys, published reports and papers, and from a search for EEEs posted online in social media and other websites. For each site where an EEE has been documented, the following information are provided: - Latitude and longitude; - Distance from epicenter (km); - Locality, i.e., geographic place where the EEE occurred; - EEE type; - Description of the observed effect; - Local intensity assessed using the ESI-07 (Environmental Seismic Intensity) scale; - Photographic documentation; - Referenc

Risk of Vaccine-Preventable Infections in Swiss Adults with Inflammatory Bowel Disease.

BACKGROUND Patients with inflammatory bowel disease (IBD) have a higher risk of infection and are frequently not up to date with their immunizations. OBJECTIVES This study aims to review vaccination status and evaluate whether age, disease type, or treatment regimen could predict the absence of seroprotection against selected vaccine-preventable infection in adults with IBD. METHODS Cross-sectional study using questionnaire, immunization records review, and assessment of tetanus-specific, varicella-specific, and measles-specific immunoglobulin G concentrations. ClinicalTrials.gov: NCT01908283. RESULTS Among the 306 adults assessed (median age 42.7 years old, 70% with Crohn's disease, 78% receiving immunosuppressive treatment), only 33% had an immunization record available. Absence of seroprotection against tetanus (6%) was associated with increasing age and absence of booster dose; absence of seroprotection against varicella (1%) or measles (3%) was exclusively observed in younger patients with Crohn's disease. There was no statistically significant difference in immunoglobulin concentrations among treatment groups. Although vaccinations are strongly recommended in IBD patients, the frequencies of participants with at least 1 dose of vaccine recorded were low for nearly all antigens: tetanus 94%, diphtheria 87%, pertussis 54%, poliovirus 22%, measles-mumps-rubella 47%, varicella-zoster 0%, Streptococcus pneumoniae 5%, Neisseria meningitidis 12%, hepatitis A 41%, hepatitis B 48%, human papillomavirus 5%, and tick-borne encephalitis 6%. CONCLUSIONS Although many guidelines recommend the vaccination of IBD patients, disease prevention through immunization is still often overlooked, including in Switzerland, increasing their risk of vaccine-preventable diseases. Serological testing should be standardized to monitor patients' protection during follow-up as immunity may wane faster in this population

Pregnancy and breastfeeding in patients with Crohn's disease

Crohn's disease commonly affects women of childbearing age. Available data on Crohn's disease and pregnancy show that women with Crohn's disease can expect to conceive successfully, carry to term and deliver a healthy baby. Control of disease activity before conception and during pregnancy is critical, to optimize both maternal and fetal health. Generally speaking, pharmacological therapy for Crohn's disease during pregnancy is similar to pharmacological therapy for nonpregnant patients. Patients maintained in remission by way of pharmacological therapy should continue it throughout their pregnancy. Sulfasalazine, mesalazine and corticosteroids are safe, azathioprine and 6-mercaptopurine are reasonably safe with few discordant data, infliximab seems safe as well, whereas methotrexate is contraindicated during pregnancy. During breastfeeding, mesalazine and prednisone are considered safe, azathioprine/6-mercaptopurine, budesonide and infliximab probably safe and methotrexate is contraindicated. [Ed.]]]> Anti-Infective Agents; Anti-Infective Agents/therapeutic use; Anti-Inflammatory Agents, Non-Steroidal; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use; Breast Feeding; Crohn Disease; Crohn Disease/drug therapy; Drug Therapy, Combination; Female; Glucocorticoids; Glucocorticoids/therapeutic use; Humans; Immunologic Factors/therapeutic use; Mesalamine; Pregnancy; Pregnancy Complications; Pregnancy Complications/drug therapy; Pregnancy Outcome; Safety eng oai:serval.unil.ch:BIB_3A1A65CACAE1 2022-05-07T01:15:44Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_3A1A65CACAE1 La construction de l'hypothèse de crise Despland, Jean-Nicolas Durigon, Daniel Valloton Zulauff, Sandrine info:eu-repo/semantics/bookPart incollection 2010 Intervention psychodynamique brève : un modèle de consultation thérapeutique chez l'adulte, pp. 59-75 Despland, Jean-Nicolas (ed.) Michel, Luc (ed.) De Roten, Yves (ed.) info:eu-repo/semantics/altIdentifier/isbn/9782294706882 fre oai:serval.unil.ch:BIB_3A1A6DE514EE 2022-05-07T01:15:44Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_3A1A6DE514EE Angio-scanner post-mortem : mise en place d'un protocole standard optimisé Grabherr, S. Doenz, F. Bruguier, C. Steger, B. Dominguez, A. Rizzo, E. Meuli, R. Mangin, P. info:eu-repo/semantics/conferenceObject inproceedings 2010 JFR 2010, 58e Journées Françaises de Radiologie, vol. 91, pp. 1418 info:eu-repo/semantics/altIdentifier/isbn/0221-0363 fre oai:serval.unil.ch:BIB_3A0D5A7ED75A 2022-05-07T01:15:44Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_3A0D5A7ED75A 1945 bis Gegenwart. Spanien, Portugal https://www.metzlerverlag.de/ Kunz, Marco info:eu-repo/semantics/bookPart incollection 2013 Phantastik. Ein interdisziplinäres Handbuch, pp. 181-183 Brittnacher, H.R. (ed.) May, M. (ed.) info:eu-repo/semantics/altIdentifier/isbn/9783476023414 ger oai:serval.unil.ch:BIB_3A0D7B66C923 2022-05-07T01:15:44Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_3A0D7B66C923 L'avènement de la didactique des langues étrangères: entre humanisme et néo-libéralisme info:doi:10.4000/edl info:eu-repo/semantics/altIdentifier/doi/10.4000/edl urn:isbn:978-2-940331-73-4 info:eu-repo/semantics/altIdentifier/isbn/978-2-940331-73-4 info:eu-repo/semantics/altIdentifier/pissn/0014-2026 info:eu-repo/semantics/altIdentifier/pissn/2296-5084 Zeiter, Anne-Christel Jeanneret, Thérèse info:eu-repo/semantics/other misc <![CDATA[Depuis les années 1950, l’enseignement des langues se construit en regard de l’idéal de la construction européenne de l’après-guerre, période où une Europe unie, pacifiée et surtout durablement en paix vient se poser en réaction aux atrocités de la Seconde Guerre mondiale. Cette idée évolue peu à peu jusqu’aux années 1970, où le Parlement européen se penche sur la faisabilité d’un système commun d’apprentissage des langues, en différentes étapes qui iront du Niveau-seuil (1976) à l’élaboration, dès 1991, du Cadre Européen Commun de Référence pour les Langues (CECR, 2001). Les années quatre-vingt marquent alors un changement important en ce qui concerne tant la manière que les raisons d’apprendre une nouvelle langue: l’enseignement doit permettre aux élèves de rencontrer non plus seulement des textes et œuvres, mais des personnes, avec qui il va être important d’échanger