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| 1 | Hepatitis B virus prevalence and transmission risk factors in inflammatory bowel disease patients at Clementino Fraga Filho university hospital显示文摘AIM: To evaluate the prevalence of hepatitis B virus (HBV) infection in inflammatory bowel disease (IBD) patients that followed up in our hospital and try to identify the possible risk factors involved in this infection transmission. METHODS: This was a cross-sectional study for which 176 patients were selected according to their arrival for the medical interview. All these patients had already IBD diagnosis. The patient was interviewed and a questionnaire was filled out. RESULTS: In the group of 176 patients whom we examined, we found that 17% (30) were anti-HBc positive. Out of 30 patients with positive anti-HBc, 2.3% (4) had positive HBsAg and negative HBV-DNA. In an attempt to identify the possible HBV infection transmission risk factors in IBD patients, it was observed that 117 patients had been submitted to some kind of surgical procedure, but only 24 patients had positive anti-HBc (P = 0.085). It was also observed that surgery to treat IBD complications was not a risk factor for HBV infection transmission, since we did not get a statically significant P value. However, IBDpatients that have been submitted to surgery to treat IBD complications received more blood transfusions then patients submitted to other surgical interventions (P = 0.015). CONCLUSION: There was a high incidence of positive anti-HBc (17%) and positive HBsAg (2.3%) in IBD patient when compared with the overall population (7.9%). | Yolanda Faia Manhes Tolentino Homero Soares Fogaa Cyrla Zaltman Lia Laura Lewis Ximenes Henrique Sérgio Moraes Coelho | 2008 | World Journal of Gastroenterology2008，14，20： | 10 |
| 2 | Ophthalmic manifestations in patients with inflammatory bowel disease: a review显示文摘Clinical manifestations of inflammatory bowel disease(IBD) are not locally restricted to the gastrointestinal tract, and a significant portion of patients have involvement of other organs and systems. The visual system is one of the most frequently affected, mainly by inflammatory disorders such as episcleritis, uveitis and scleritis. A critical review of available literature concerning ocular involvement in IBD, as it appears in Pub Med, was performed. Episcleritis, the most common ocular extraintestinal manifestation(EIM), seems to be more associated with IBD activity when compared with other ocular EIMs. In IBD patients, anterior uveitis has an insidious onset, it is longstanding and bilateral, and not related to the intestinal disease activity. Systemic steroids or immunosuppressants may be necessary in severe ocular inflammation cases, and control of the underlying bowel disease is important to prevent recurrence. Our review revealed that ocular involvement is more prevalent in Crohn's disease than ulcerative colitis, in active IBD, mainly in the presence of other EIMs. The ophthalmic symptoms in IBD are mainly nonspecific and their relevance may not be recognized by the clinician; most ophthalmic manifestations are treatable, and resolve without sequel upon prompt treatment. A collaborative clinical care team for management of IBD that includes ophthalmologists is central for improvement of quality care for these patients, and it is also cost-effective. | Leandro Lopes Troncoso Ana Luiza Biancardi Haroldo Vieira de Moraes Jr Cyrla Zaltman | 2017 | World Journal of Gastroenterology2017，23，32： | 7 |
| 3 | High prevalence of vitamin A deficiency in Crohn's disease patients according to serum retinol levels and the relative dose-response test显示文摘AIM:To assess the vitamin A status of patients with Crohn's disease(CD) by evaluating serum retinol levels and the relative dose response(RDR) test(liver retinol stores).METHODS:Vitamin A nutritional status was measured by serum retinol obtained by high performance liquid chromatography and the RDR test for evaluation of the hepatic stores.Body composition was performed by densitometry by dual-energy X-ray absorptiometry.Vitamin A dietary intake was assessed from a semiquantitative food frequency questionnaire.RESULTS:This study included 38 CD patients and 33 controls.Low serum retinol concentrations were detected in 29% of CD patients vs 15% in controls(P < 0.005).The RDR test was positive in 37% of CD patients vs 12% in controls,which indicated inadequate hepatic vitamin A stores(P < 0.005).Individuals with hypovitaminosis A had lower BMI and body fat compared with those without this deficiency.There was no association between vitamin A deficiency and its dietary intake,ileal location,presence of disease activity and prior bowel resections.CONCLUSION:Patients with CD have higher prevalence of vitamin A deficiency,as assessed by two independent methods. | Márcia Soares-Mota Tianny A Silva Luanda M Gomes Marco AS Pinto Laura MC Mendon?a Maria Lúcia F Farias Tiago Nunes Andrea Ramalho Cyrla Zaltman | 2015 | World Journal of Gastroenterology2015，21，5： | 4 |
| 4 | Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil显示文摘BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil. | Rogerio Serafim Parra Julio MF Chebli Heda MBS Amarante Cristina Flores Jose ML Parente Odery Ramos Milene Fernandes Jose JR Rocha Marley R Feitosa Omar Feres Antonio S Scotton Rodrigo B Nones Murilo M Lima Cyrla Zaltman Carolina D Goncalves Isabella M Guimaraes Genoile O Santana Ligia Y Sassaki Rogerio S Hossne Mauro Bafutto Roberto LK Junior Mikaell AG Faria Sender J Miszputen Tarcia NF Gomes Wilson R Catapani Anderson A Faria Stella CS Souza Rosana F Caratin Juliana T Senra Maria LA Ferrari | 2019 | World Journal of Gastroenterology2019，25，38： | 2 |
| 5 | Crohn's disease environmental factors in the developing world: A case-control study in a statewide catchment area in Brazil显示文摘AIM To identify environmental risk factors associated with the development of Crohn's disease(CD) in order to reassess the hygiene hypothesis.METHODS A hospital-based, case-control study was carried out with CD patients(n = 145) and controls(n = 163)representing a socioeconomically diverse statewide catchment area in Brazil. Controls were recruited from caregivers of patients seen in different outpatient clinics at the same hospital. A multi-item survey with 94 questions regarding family history of CD, perinatal and childhood circumstances, living conditions, tobacco use and familial socioeconomic status was carried out by interviewers. RESULTS On the univariate analysis, predictive variables for CD included being male, under age of 40, a high education level, urban dweller, smaller family size, exposure to enteric pathogens and user of treated water(P < 0.005). On the multivariate analysis, variables significantly associated with CD were male gender(OR = 2.09), under age 40(OR = 3.10), white(OR = 2.32), from a small family in childhood(OR = 2.34) and adulthood(OR = 3.02), absence of viral infections in childhood(OR = 2.23), exposure to enteric pathogens(OR = 2.41), having had an appendectomy(OR = 2.47) and prior or current smoker(OR = 2.83/1.12). CONCLUSION Most variables supporting the 'hygiene hypothesis' are associated with the development of CD but are not independent predictors of the diagnosis. | Valéria Cristina Loureiro Salgado Ronir Raggio Luiz Neio Boechat Bianca C Schorr Isabella S Leao Tiago Nunes Cyrla Zaltman | 2017 | World Journal of Gastroenterology2017，23，30： | 2 |
| 6 | Pseudomelanosis duodeni associated with chronic renal failure显示文摘Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding,hypertension,chronic heart failure,chronic renal failure and consumption of different drugs.We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain,nausea,melena and progressive reduction of hemoglobin index.Gastroduodenal endoscopy revealed erosions in the esophagus and stomach,with no active bleeding at the moment.In addition,the duodenal mucosa presented marked signs of melanosis;later confirmed by histopathological study.Even though PD is usually regarded as a benign condition,its pathogenesis and clinical significance is yet to be defined. | Marcia Henriques de Magalhes Costa Maria da Gloria Fernandes Pegado Cleber Vargas Maria Elizabeth C Castro Kalil Madi Tiago Nunes Cyrla Zaltman | 2012 | World Journal of Gastroenterology2012，18，12： | 2 |
| 7 | Does active Crohn′s disease have decreased intestinal antioxidant capacity?显示文摘 | Marco Antonio S. Pinto Márcia Soares-Mota S. Lopes Sálua T.O. Bastos Carolina L.L. Reigada Rafael F. Dantas Jaime C.B. Neto Aderval S. Luna Kalil Madi Tiago Nunes Cyrla Zaltman | 2012 | Journal of Crohn’s and Colitis2012，，： | 1 |
| 8 | Risk factors associated with inflammatory bowel disease: A multicenter case-control study in Brazil显示文摘BACKGROUND The etiology of inflammatory bowel disease(IBD)is unknown,but it is believed to be multifactorial.The hygiene hypothesis proposes that better hygiene conditions would lead to less infectious disease during childhood and favor the development of immune-mediated diseases.AIM To test the hygiene hypothesis in IBD by assessing the environmental risk factors associated with IBD development in different regions of Brazil with diverse socioeconomic development indices.METHODS A multicenter case-control study was carried out with 548 Crohn’s disease(CD)and 492 ulcerative colitis(UC)outpatients and 416 healthy controls,from six IBD centers within different Brazilian states at diverse socioeconomic development stages.A semi-structured questionnaire with 87 socioeconomic and environmental questions was applied.Logistic regression model was created to assess the odds ratio(OR)with P value and 95%confidence intervals(CI).RESULTS Predictive variables for both diseases(CD and UC)were women[odd ratios(OR)=1.31;OR=1.69],low monthly family income(OR=1.78;OR=1.57),lower number of cohabitants(OR=1.70;OR=1.60),absence of vaccination(OR=3.11;OR=2.51),previous history of bowel infections(OR=1.78;OR=1.49),and family history of IBD(OR=5.26;OR=3.33).Associated risk factors for CD were age(18-39 years)(OR=1.73),higher educational level(OR=2.22),absence of infectious childhood diseases(OR=1.99).The UC predictive variables were living in an urban area(OR=1.62),inadequate living conditions(OR=1.48)and former smokers(OR=3.36).Appendectomy was a risk factor for CD(OR=1.58)with inverse association with UC(OR=4.79).Consumption of treated and untreated water was associated with risk of CD(OR=1.38)and UC(OR=1.53),respectively.CONCLUSION This is the first examining environmental exposures as risk factors for inflammatory bowel disease in Brazil.Most of the variables associated with disease risk support the role of the hygiene hypothesis in IBD development. | Valéria Cristina Loureiro Salgado Ronir Raggio Luiz Neio Lucio Fernandes Boéchat Isabella Sued Leao Bianca do Carmo Schorr JoséMiguel Luz Parente Daniela Calado Lima Eduardo Santos Silveira Júnior Genoile Oliveira Santana Silva Neogélia Pereira Almeida Andrea Vieira Maria Luiza Queiroz de Bueno Júlio Maria Chebli érika Ruback Bertges Luísa Martins da Costa Brugnara Columbano Junqueira Neto Stefania Burjack Gabriel Campbell Luana Letiza Discacciati Joao Paulo Silva Cézar Tiago Nunes Gilaad G Kaplan Cyrla Zaltman | 2020 | World Journal of Gastroenterology2020，26，25： | 1 |
| 9 | Real-world treatment patterns and disease control over one year in patients with inflammatory bowel disease in Brazil显示文摘BACKGROUND Crohn’s disease(CD)and ulcerative colitis(UC)are inflammatory bowel diseases(IBDs)with a remission-relapsing presentation and symptomatic exacerbations that have detrimental impacts on patient quality of life and are associated with a high cost burden,especially in patients with moderate-to-severe disease.The Real-world Data of Moderate-to-Severe Inflammatory Bowel Disease in Brazil(RISE BR)study was a noninterventional study designed to evaluate disease control,treatment patterns,disease burden and health-related quality of life in patients with moderate-to-severe active IBD.We report findings from the prospective follow-up phase of the RISE BR study in patients with active UC or CD.AIM To describe the 12-mo disease evolution and treatment patterns among patients with active moderate-to-severe IBD in Brazil.METHODS This was a prospective,noninterventional study of adult patients with active Crohn’s disease(CD:Harvey-Bradshaw Index≥8,CD Activity Index≥220),inadequate CD control(i.e.,calprotectin>200μg/g or colonoscopy previous results),or active ulcerative colitis(UC:Partial Mayo score≥5).Enrollment occurred in 14 centers from October 2016 to February 2017.The proportion of active IBD patients after 9-12 mo of follow-up,Kaplan-Meier estimates of the time to mild or no activity and a summary of treatment initiation,discontinuation and dose changes were examined.RESULTS The study included 118 CD and 36 UC patients,with mean±SD ages of 43.3±12.6 and 44.9±16.5 years,respectively.The most frequent drug classes at index were biologics for CD(62.7%)and 5-aminosalicylate derivates for UC patients(91.7%).During follow-up,65.3%of CD and 86.1%of UC patients initiated a new treatment at least once.Discontinuations/dose changes occurred in 68.1%of CD patients[median 2.0(IQR:2-5)]and 94.3%of UC patients[median 4.0(IQR:3-7)].On average,CD and UC patients had 4.4±2.6 and 5.0±3.3 outpatient visits,respectively.The median time to first mild or no activity was 319(IQR:239-358)d for CD and 320(IQR:288-358)d for UC patients.At 9-12 mo,22.0%of CD and 20.0%of UC patients had active disease.CONCLUSION Although a marked proportion of active IBD patients achieved disease control within one year,the considerable time to achieve this outcome represents an unmet medical need of the current standard of care in a Brazilian real-world setting. | Ligia Yukie Sassaki Sender J Miszputen Roberto Luiz Kaiser Junior Wilson R Catapani Mauro Bafutto António S Scotton Cyrla Zaltman Julio Pinheiro Baima Hagata S Ramos Mikaell Alexandre Gouvea Faria Carolina D Gonçalves Isabella Miranda Guimaraes Cristina Flores Heda M B S Amarante Rodrigo Bremer Nones JoséMiguel Luz Parente Murilo Moura Lima Júlio Maria Chebli Maria de Lourdes Abreu Ferrari Julia F Campos Maria G P Sanna Odery Ramos Rogério Serafim Parra Jose J R da Rocha Omar Feres Marley R Feitosa Rosana Fusaro Caratin Juliana Tosta Senra Genoile Oliveira Santana | 2021 | World Journal of Gastroenterology2021，27，23： | 0 |
| 10 | Real-world disease activity and sociodemographic,clinical and treatment characteristics of moderate-to-severe inflammatory bowel disease in Brazil显示文摘BACKGROUND Understanding the treatment landscape of inflammatory bowel diseases(IBD)is essential for improving disease management and patient outcomes.Brazil is the largest Latin American country,and it presents socioeconomic and health care differences across its geographical regions.This country has the highest increase in IBD incidence and prevalence in Latin America,but information about the clinical and treatment characteristics of IBD is scarce.AIM To describe the sociodemographic,clinical,and treatment characteristics of IBD outpatients in Brazil overall and in the Southeast,South and Northeast/Midwest regions.METHODS Multicenter,cross-sectional study with a 3-year retrospective chart review component.Patients with moderate-to-severe Crohn’s disease(CD)or ulcerative colitis(UC)were consecutively enrolled between October 2016 and February 2017.Active CD at enrollment was defined as a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or a calprotectin level>200μg/g or an active result based on colonoscopy suggestive of inadequate control during the previous year;active UC was defined as a partial Mayo score≥5.Descriptive statistics were used to analyze all variables.RESULTS In a total of 407 included patients,CD was more frequent than UC,both overall(264 CD/143 UC patients)and by region(CD:UC ratios of 2.1 in the Southeast,1.6 in the South and 1.2 in the Northeast/Midwest).The majority of patients were female(54.2%of CD;56.6%of UC),and the mean ages were 45.9±13.8 years(CD)and 42.9±13.0 years(UC).The median disease duration was 10.0(range:0.5-45)years for both IBD types.At enrollment,44.7%[95%confidence interval(CI):38.7-50.7]of CD patients and 25.2%(95%CI:18.1-32.3)of UC patients presented with active disease.More than 95%of IBD patients were receiving treatment at enrollment;CD patients were commonly treated with biologics(71.6%)and immunosuppressors(67.4%),and UC patients were commonly treated with mesalazine[5-Aminosalicylic acid(5-ASA)]derivates(69.9%)and immunosuppressors(44.1%).More than 50%of the CD patients had ileocolonic disease,and 41.7%presented with stricturing disease.One-quarter of CD patients had undergone CD-related surgery in the past 3 years,and this proportion was lower in the Northeast/Midwest region(2.9%).CONCLUSION In Brazil,there are regional variations in IBD management.CD outweighs UC in both frequency and disease activity.However,one-quarter of UC patients have active disease,and most are receiving 5-ASA treatment. | Cyrla Zaltman Rogério Serafim Parra Ligia Yukie Sassaki Genoile Oliveira Santana Maria de Lourdes Abreu Ferrari Sender J Miszputen Heda M B S Amarante Roberto Luiz Kaiser Junior Cristina Flores Wilson R Catapani JoséMiguel Luz Parente Mauro Bafutto Odery Ramos Carolina D Gonçalves Isabella Miranda Guimaraes Jose J R da Rocha Marley R Feitosa Omar Feres Rogerio Saad-Hossne Francisco Guilherme Cancela Penna Pedro Ferrari Sales Cunha Tarcia NF Gomes Rodrigo Bremer Nones Mikaell Alexandre Gouvea Faria Mírian Perpétua Palha Dias Parente António S Scotton Rosana Fusaro Caratin Juliana Senra Júlio Maria Chebli | 2021 | World Journal of Gastroenterology2021，27，2： | 0 |
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