ABSTRACT
The aim of the IBDU is to provide comprehensive care for patients with IBD (1,2). During the COVID-19 pandemic, telephone medical consultations and telemedicine training sessions were implemented to ensure patient safety (3). The aim of this study was to determine whether there was a difference in the degree of satisfaction between face-to-face and telephone care, as well as in the annual patient sessions.
Subject(s)
COVID-19 , Inflammatory Bowel Diseases , Hospitals , Humans , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/therapy , Pandemics , Patient Satisfaction , Personal Satisfaction , SARS-CoV-2 , TelephoneABSTRACT
La población de pacientes con enfermedad inflamatoria intestinal (EII) y trasplante de órgano sólido (TOS) va en aumento. Existen dos escenarios clínicos: la recurrencia de la EII preexistente al TOS, que es más frecuente, y la aparición de EII de novo, cuya incidencia es mucho más elevada que la de la población general. El curso clínico de ambas es diferente y puede tener impacto negativo en el injerto. Los mecanismos fisiopatológicos se desconocen. No existen recomendaciones específicas de tratamiento. La combinación entre la terapia biológica de la EII y el régimen inmunosupresor, para evitar el rechazo, obliga a una vigilancia estrecha para detectar infecciones, eventos autoinmunes y neoplasias. El cáncer colorrectal (CCR) está aumentando en esta población. El grupo de mayor riesgo es el de trasplante hepático (TH) por colangitis esclerosante (CEP) con EII
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Subject(s)
Humans , Inflammatory Bowel Diseases/etiology , Inflammatory Bowel Diseases/epidemiology , Organ Transplantation/adverse effects , Diarrhea/diagnosis , Postoperative Complications , Inflammatory Bowel Diseases/diagnosis , Immunosuppressive Agents/therapeutic use , Diagnosis, Differential , Diarrhea/therapy , Colectomy , Colitis, Ulcerative/complicationsABSTRACT
The population of patients with inflammatory bowel disease (IBD) and solid organ transplant (SOT) is increasing. Two clinical scenarios exist, recurrence of pre-existing IBD, which is more common, and de novo development of IBD, with a much higher incidence than in the general population. Their clinical course differs and may have a negative impact on the graft in both cases. The pathophysiological mechanisms remain unknown and no specific treatment recommendations are available. The combined effect of biologic therapy against IBD and immunosuppressive therapy against a potential rejection means that close monitoring is mandatory to identify infection, autoimmune events and malignancies. The colorectal cancer (CRC) rate is higher in this population. The group at greatest risk are patients with IBD undergoing liver transplantation (LT) for primary sclerosing cholangitis (PSC).
Subject(s)
Cholangitis, Sclerosing , Colitis , Inflammatory Bowel Diseases , Liver Transplantation , Cholangitis, Sclerosing/epidemiology , Cholangitis, Sclerosing/surgery , Humans , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/therapy , Risk FactorsABSTRACT
In recent years, the incidence of inflammatory bowel disease (IBD) has been on the rise, extending to countries where it was infrequent in the past. As a result, the gap between high and low incidence countries is decreasing. The disease, therefore, has an important economic impact on the healthcare system. Advances in recent years in pharmacogenetics and clinical pharmacology have allowed for the development of treatment strategies adjusted to the patient profile. Concurrently, new drugs aimed at inflammatory targets have been developed that may expand future treatment options. This review examines advances in the optimization of existing drug treatments and the development of novel treatment options for IBD.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Drug Discovery/trends , Gastrointestinal Agents/therapeutic use , Inflammatory Bowel Diseases/drug therapy , Molecular Targeted Therapy/trends , Animals , Anti-Inflammatory Agents/pharmacokinetics , Forecasting , Gastrointestinal Agents/pharmacokinetics , Humans , Incidence , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/epidemiology , Pharmacogenetics/trendsABSTRACT
Inflammatory bowel disease (IBD) affects a part of the young population and has a strong impact upon quality of life. The underlying etiology is not known, and the existing treatments are not curative. Furthermore, a significant percentage of patients are refractory to therapy. In recent years there have been great advances in our knowledge of stem cells and their therapeutic applications. In this context, autologous hematopoietic stem cell transplantation (HSCT) has been used in application to severe refractory Crohn's disease (CD), with encouraging results. Allogenic HSCT would correct the genetic defects of the immune system, but is currently not accepted for the treatment of IBD because of its considerable risks. Mesenchymal stem cells (MSCs) have immune regulatory and regenerative properties, and low immunogenicity (both autologous and allogenic MSCs). Based on these properties, MSCs have been used via the systemic route in IBD with promising results, though it is still too soon to draw firm conclusions. Their local administration in perianal CD is the field where most progress has been made in recent years, with encouraging results. The next few years will be decisive for defining the role of such therapy in the management of IBD.
