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| 1 | Comorbidity in inflammatory bowel disease显示文摘Patients with inflammatory bowel disease (IBD) can be affected by other unrelated diseases. These are called comorbid conditions, and can include any secondary health problem that affects a person suffering from a primary or main disease, and which is neither linked physiopathologically to the primary condition, nor is it due to the treatments used for the primary condition or to its long-term anatomical or physiological consequences. Different comorbid conditions, as well as their influence on IBD, are discussed. | Antonio López San Román Fernando Muoz | 2011 | World Journal of Gastroenterology2011，17，22： | 3 |
| 2 | Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases显示文摘Allogeneic blood transfusion (ABT) is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD), especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient), febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury, transfusion associated circulatory overload, transfusion-related immuno-modulation, and transmission of almost all infectious diseases (bacteria, virus, protozoa and prion), which might result in increased risk of morbidity and mortality. Unfortunately, the main physiological goal of ABT, i.e. to increase oxygen consumption by the hypoxic tissues, has not been well documented. In contrast, the ABT is usually misused only to increase the haemoglobin level within a f ixed protocol [mostly two by two packed red blood cell (PRC) units] independently of the patient' s tolerance to normovolemic anaemia or his clinical response to the transfusion of PRC units according to a 'one-by-one' administration schedule. Evidencebased clinical guidelines may promote best transfusion practices by implementing restrictive transfusion protocols, thus reducing variability and minimizing the avoidable risks of transfusion, and the use of autologous blood and pharmacologic alternatives. In this regard, preoperative autologous blood donation (PABD) consistently diminished the frequency of ABT, although its contribution to ABT avoidance is reduced when performed under a transfusion protocol. In addition, interpretation of utility of PABD in surgical IBD patients is hampered by scarcity of published data. However, the role of autologous red blood cells as drug carriers is promising. Finally, it must be stressed that a combination of methods used within wellconstructed protocols will offer better prospects for blood conservation in selected IBD patients undergoing elective surgery. | José Antonio García-Erce Fernando Gomollón Manuel Muoz | 2009 | World Journal of Gastroenterology2009，15，37： | 3 |
| 3 | Participatory Early Warning Systems: Youth, Citizen Science,and Intergenerational Dialogues on Disaster Risk Reduction in Brazil显示文摘Building national people-centered early warning systems(EWS) is strongly recommended by the United Nations International Strategy for Disaster Reduction(UNISDR). Most of the scientific literature is critical of the conventional view of EWS as a linear model with a topdown approach, in which technological features are given more attention than human factors. It is argued that EWS should be people-centered, and used for risk prevention,with an emphasis on resilience, rather than only being triggered when a hazard occurs. However, both the UNISDR and the literature fail to say how a people-centered EWS should be built, and what steps are needed to put EWS into effect. This article examines the obstacles and measures required to promote people-centered EWS,with a focus on the situation in Brazil. After assessing the institutional vulnerability of EWS, we analyze some measures that can be taken to reduce institutional vulnerability,based on experiences with a participatory citizen science educational project that involved high school students.Some guidelines are developed for adopting a bottom-up approach towards achieving the four elements of EWS—risk knowledge, monitoring, communication of warnings,and response capability—with the help of school curricula. | Victor Marchezini Rachel Trajber Dbora Olivato Viviana Aguilar Muoz Fernando de Oliveira Pereira Andra Eliza Oliveira Luz | 2017 | International Journal of Disaster Risk Science2017，8，4： | 1 |
| 4 | Adalimumab in prevention of postoperative recurrence of Crohn's disease in high-risk patients显示文摘AIM:To evaluate the effectiveness of adalimumab in preventing recurrence after intestinal resection for Crohn's disease in high-risk patients.METHODS:A multicenter,prospective,observational study was conducted from June 2009 until June 2010.We consecutively included high-risk Crohn's disease patients who had undergone an ileal/ileocolonic resection.High-risk patients were defined as two or more criteria:smokers,penetrating pattern,one or more previous surgical resections or prior extensive resection.Subcutaneous adalimumab was administered 2 wk(± 5 d) after surgery at a dose of 40 mg eow,with an initial induction dose of 160/80 mg at weeks 0 and 2.Demographic data,previous and concomitant treatments(antibiotics,5-aminosalicylates,corticosteroids,immunomodulators or biologic therapies),smoking status at the time of diagnosis and after the index operation and number of previous resections(type and reason for surgery) were all recorded.Biological status was assessed with C-reactive protein,erythrocyte sedimentation rate and fecal calprotectin.One year(± 3 mo) after surgery,an ileocolonoscopy and/or magnetic resonance enterography was performed.Endoscopic recurrence was defined as Rutgeerts score ≥ i2.Morphological recurrence was based on magnetic resonance(MR) score ≥ MR1.RESULTS:Twenty-nine patients(55.2% males,48.3% smokers at diagnosis and 13.8% after the index operation),mean age 42.3 years and mean duration of the disease 13.8 years were included in the study.A mean of 1.76(range:1-4) resections previous to adalimumab administration and in 37.9% was considered extensive resection.51.7% had previously received infliximab.Immunomodulators were given concomitantly to 17.2% of patients.Four of the 29(13.7%) developed clinical recurrence,6/29(20.7%) endoscopic recurrence and 7/19(36.8%) morphological recurrence after 1-year.All patients with clinical recurrence showed endoscopic and morphological recurrence.A high degree of concordance was found between clinical-endoscopic recurrence(k = 0.76,P < 0.001) and clinical-morphological recurrence(k = 0.63,P = 0.003).Correlation between endoscopic and radiological findings was good(comparing the 5-point Rutgeerts score with the 4-point MR score,a score of i4 was classified as MR3,i3 as MR2,and i2-i1 as MR1)(P < 0.001,r s = 0.825).During follow-up,five(17.2%) patients needed adalimumab dose intensification(40 mg/wk);Mean time to intensification after the introduction of adalimumab treatment was 8 mo(range:5 to 11 mo).In three cases(10.3%),a biological change was needed due to a worsening of the disease after the dose intensification to 40 mg/wk.One patient suffered an adverse event.CONCLUSION:Adalimumab seems to be effective and safe in preventing postoperative recurrence in a selected group of patients who had undergone an intestinal resection for their CD. | Mariam Aguas Guillermo Bastida Elena Cerrillo Belén Beltrán Marisa Iborra Cristina Sánchez-Montes Fernando Muoz Jesús Barrio Sabino Riestra Pilar Nos | 2012 | World Journal of Gastroenterology2012，18，32： | 3 |
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