Inflammatory bowel diseases
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Inflamm. Bowel Dis. · Oct 2014
Changing age demographics of inflammatory bowel disease in Ontario, Canada: a population-based cohort study of epidemiology trends.
International cohort studies have reported increased incidence of inflammatory bowel disease (IBD) in recent years, and Canada has among the highest rates of IBD in the world. This study assessed incidence and prevalence of IBD in Ontario, the most populous province of Canada, to determine changing trends in age of onset. ⋯ Ontario has among the highest prevalence of IBD in the world. Incidence of IBD increased between 1999 and 2008, owing to increased incidence in children and adults, with stable rates in elderly people. These findings demonstrate the changing age demographics and growing burden of IBD in Ontario, Canada.
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Inflamm. Bowel Dis. · Aug 2014
Postoperative complications and emergent readmission in children and adults with inflammatory bowel disease who undergo intestinal resection: a population-based study.
Although the nature and frequency of postoperative complications after intestinal resection in patients with inflammatory bowel disease have been previously described, short-term readmission has not been characterized in population-based studies. We therefore assessed the risk of postoperative complications and emergent readmissions after discharge from an intestinal resection. ⋯ Readmission and postoperative complications are common after intestinal resection in CD and UC. Clinicians should closely monitor surgical patients who required emergent admission, undergo surgery with stoma formation, or develop in-hospital postoperative complications to anticipate need for readmission or interventions to prevent readmission.
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Inflamm. Bowel Dis. · Jul 2014
ReviewMechanisms that mediate the development of fibrosis in patients with Crohn's disease.
Crohn's disease is complicated by the development of fibrosis and stricture in approximately 30% to 50% of patients over time. The pathogenesis of fibrostenotic disease is multifactorial involving the activation of mesenchymal cells by cytokines, growth factors, and other mediators released by immune cells, epithelial cells, and mesenchymal cells. Transforming growth factor β, a key activator of mesenchymal cells, is central to the process of fibrosis and regulates numerous genes involved in the disordered wound healing including collagens, and other extracellular matrix proteins, connective tissue growth factor, and insulin-like growth factors. ⋯ Among the 163 susceptibility genes identified that contribute to susceptibility in inflammatory bowel disease mutations in NOD2/CARD15, innate immune system components and autophagy jointly contribute to the activation of mesenchymal cells and pathogenesis of fibrosis in this polygenic disorder. Numerous growth factors cytokines and other mediators also contribute to development of fibrosis in the susceptible patient. This review focuses on the molecular mechanisms that regulate mesenchymal cell function, particularly smooth muscle cells, the largest compartment of mesenchyme in the intestine, that lead to fibrosis in Crohn's disease.
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Inflamm. Bowel Dis. · Jun 2014
ReviewSelenium and selenoproteins in inflammatory bowel diseases and experimental colitis.
Inadequate dietary intake of the essential trace element selenium (Se) is thought to be a risk factor for several chronic diseases associated with oxidative stress and inflammation. Biological actions of Se occur through low-molecular weight metabolites and through selenoproteins. Several key selenoproteins including glutathione peroxidases; selenoproteins M, P, and S; and selenium-binding protein 1 have been detected in the intestine. ⋯ While the cause-effect relationship of these observations remains to be clarified, the beneficial outcome of dietary Se supplementation and an optimization of selenoprotein biosynthesis in murine inflammatory bowel disease models have led to investigations of targets and actions of Se in the gastrointestinal tract. The Se status affects gene expression, signaling pathways, and cellular functions in the small and large intestine as well as the gut microbiome composition. This data, particularly from animal experiments, hold promise that adequate dietary Se supply may counteract chronic intestinal inflammation in humans.
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Inflamm. Bowel Dis. · Apr 2014
Effect of aging on healthcare costs of inflammatory bowel disease: a glimpse into the future.
Population aging is expected to result in a substantial additional burden on healthcare resources in the near future. We aimed to assess the current and future impact of aging on direct healthcare costs (DHC) attributed to inflammatory bowel disease (IBD). ⋯ Population aging has a negligible effect on IBD-attributable DHC of the IBD population in the near future, because the average costs incurred by elderly patients with IBD are considerably lower than those incurred by younger patients with IBD.