Impact of CONSORT extension for cluster randomised trials on quality of reporting and study methodology : review of random sample of 300 trials, 2000-8

Peer reviewedPublisher PD

Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes

Background Clinical activity and quality of life (QOL) indices assess disease activity in Crohn’s disease (CD) and ulcerative colitis (UC). However, a paucity of data exists on the validity of these indices according to disease characteristics. Aims To examine the correlation between QOL and clinical activity indices and endoscopic disease activity according to disease characteristics. Methods We used a prospective registry to identify CD and UC patients ≥18 years old with available information on Short Inflammatory Bowel Disease Questionnaire scores (SIBDQ), Harvey–Bradshaw Index (HBI) and simple endoscopic scores for CD (SES-CD), and Simple Clinical Colitis Activity Index (SCCAI) and Mayo endoscopic score for UC. We used Spearman rank correlations to calculate correlations between indices and Fisher transformation to compare correlations across disease characteristics. Results Among 282 CD patients, we observed poor correlation between clinical activity and QOL indices to SES-CD with no differences in correlation according to disease characteristics. Conversely, among 226 UC patients, clinical activity and QOL had good correlation to Mayo endoscopic score (r = 0.55 and −0.56, respectively) with better correlations observed with left-sided versus extensive colitis (r = 0.73 vs. 0.45, p = 0.005) and shorter duration of disease (r = 0.61 vs. 0.37, p = 0.04). Conclusions Our data suggest good correlation between SCCAI and endoscopic disease activity in UC, particularly in left-sided disease. Poor correlations between HBI or SIBDQ and SES-CD appear to be consistent across different disease phenotypes.American Gastroenterological Associatio

THE EFFECT OF SUPPLEMENTARY CALCIUM ON SERUM LIPIDS, LIPOPROTEINS AND APOLIPOPROTEINS IN HEALTHY ADULT WOMEN AGED 18-30 YEARS

Introduction: Several authors have noted that oral calcium treatment was associated with a change in serum Lipids and reduce the risk of cardiovascular disease. In present sutdy, we determined the effect of supplementary caicium on serum total cholesterol. TG, HOLe, LDLc, LDLcl HDLe, Apo AI, Apo B and Apo All Apo B profile in young healthy adult women.
 Methods: 53 volunteers were divided into two groups randomly, the treatment group received 1000 mg/day calcium (four doses of 625 mgs calcium carbonate) for one complete menstrual period and the control group received placebo (dextrose). Total cholesterol, TG and HDLc was determined enzymatically, Apo AI and Apo B was determined immunoturbidimetrically.
 Results: There were no correlation between any of the studied variables and calcium intake from food, calcium supplement did not change correlation coefficient of LDLc with HDLc and Apo AI with Apo B. Compared to placebo, calcium carbonate decreased serum Apo B concentration (13.7 mg/dl , p < 0.01) and incrdased Apo All Apo B (0.32 unit, P < 0.05) and TG (15.75 mg/dl, p <0.05) but the changes in other variables were not significant.
 Conclusion: These results suggest that calcium supplement increase serum TG and ApoAll Apo B but decrease Apo B. It seems that calcium supplementation may be useful for people who receive less calcium than recommended dietary allowance

Medication Utilization and the Impact of Continued Corticosteroid Use on Patient-reported Outcomes in Older Patients with Inflammatory Bowel Disease

BACKGROUND: Older individuals with inflammatory bowel disease (IBD) require ongoing medications. We aimed to describe 1) medication use in older and younger IBD patients and 2) medication associations with patient reported outcomes (PRO’s) in older patients. METHODS: We conducted cross-sectional and longitudinal analyses within CCFA Partners internet-based cohort of patients with self-reported IBD. We assessed medication use by disease sub-type and age. We used bivariate analyses to 1) compare medication use in older and younger patients and 2) determine associations between continued steroid use and PRO’s in older patients. RESULTS: We included 5382 participants with IBD; 1004 were older (≥ age 60). Older patients with Crohn’s disease (CD) had lower anti-tumor necrosis factor alpha (anti-TNF) use at baseline (29.1% vs 44.3%, p<0.001), comparable steroid use (16.0% vs. 16.5%, p=0.77), and higher aminosalicylate use (40.3% vs. 33.9%, p=0.003) versus younger patients. Older ulcerative colitis (UC) patients had similar anti-TNF use (16.0% vs. 19.2%, p=0.16), lower steroid use (9.6% vs. 15.4%, p=0.004) and higher aminosalicylate use (73.8% vs. 68.2%, p=0.04) at baseline. In longitudinal analyses, older CD patients had higher continued steroid use (11.6% vs. 7.8%, p=0.002); which was associated with worsened anxiety (p=0.02), sleep (p=0.01), and fatigue (p=0.001) versus non-use. Older CD patients on steroids, versus anti-TNF or immunomodulators, had increased depression (p=0.04) and anxiety (p=0.03). CONCLUSIONS: Medication utilization differs in older patients with IBD. Older CD patients have higher continued steroid use; associated with worsened PRO’s. As in younger IBD populations; continued steroid use should be limited in older patients