يعرض 1 - 10 نتائج من 12 نتيجة بحث عن '"Spicakova, K."', وقت الاستعلام: 1.52s تنقيح النتائج
  1. 1
    دورية أكاديمية

    المصدر: Journal of Crohn's and Colitis ; volume 18, issue Supplement_1, page i2085-i2088 ; ISSN 1873-9946 1876-4479

    مصطلحات موضوعية: Gastroenterology, General Medicine

    الوصف: Background Aims: 1) To describe the main epidemiological and clinical characteristics of patients at IBD diagnosis and the long-term outcomes; 2) to analyse the use of drugs for IBD, and the need of hospitalisations and surgeries; 3) to compare IBD management based on the type of disease and the resources of the hospitals. Methods Prospective, population-based nationwide registry. Adult patients diagnosed with IBD, Crohn’s Disease (CD), Ulcerative Colitis (UC) or IBD unclassified, during 2017 in the 17 Spanish regions were included. Patients who consented were followed-up for 5 years (yr) after diagnosis. Treatment was grouped into 5 categories: mesalamine (oral or topical), steroids (intravenous, oral, or topical), immunomodulators (thiopurines, methotrexate or cyclosporine), biologics (anti-TNF, vedolizumab, ustekinumab) or JAK inhibitors (JAKi), and surgery. Hospitals were classified into high resources and low resources ones. Cumulative incidence of exposure to each of the studied treatments was estimated by Kaplan-Meier curves; curves were compared with log-rank test. Results 3,301 incident cases of IBD diagnosed during 2017 in 108 hospitals, covering over 22 million inhabitants in Spain (about 50% of the population), were enrolled into the follow-up study. Main characteristics of the cohort are summarised in table 1. Median diagnosis delayed was 3.5 months (5.6 in CD and 2.7 in UC, p<0.001). During the 5-yr follow-up, 25% of UC patients progressed to more extensive involvement, while 8% of CD patients with inflammatory behaviour progressed to either stricturing or fistulising behaviour. Most of the patients who received mesalamine, corticosteroids, or immunomodulators initiated treatment within the first 2 years after diagnosis (figure 1). However, the cumulative incidence of biologics/JAKi usage steadily increased over time, reaching 49% by the 5-yr timepoint in CD. In terms of surgeries, a progressive increase in cumulative incidence was observed in CD; the incidence of colectomy remained ...

  2. 2
    دورية أكاديمية

    المصدر: Journal of Crohn's and Colitis ; volume 16, issue Supplement_1, page i449-i450 ; ISSN 1873-9946 1876-4479

    مصطلحات موضوعية: Gastroenterology, General Medicine

    الوصف: Background The use of biological drugs for the treatment of IBD in elderly patients is becoming more frequent in our environment. However, given the greater risk of these patients to develop related adverse effects, the profile of the patients in whom it is applied and the type of drug to choose, has not been established. Methods Patients have been retrospectively included with established diagnosis of IBD UC, CD or indeterminate colitis (IC) by usual criteria (clinical, laboratory, endoscopic, radiological and / or histological) 65 years at the time of initiating biological treatment (Infliximab, Adalimumab, Golimumab, Ustekinumab or Vedolizumab) and that they have received at least the induction doses. Variables corresponding to the baseline characteristics of the patients have been collected, as well as data referring to the characteristics of IBD that have been considered relevant for the study. We calculated the comorbidity of the patients using the Charlston index The statistical analysis was completed using Stata 15.0. For continuous variables, after checking the normality of the distribution, were compared using t Student and categorical variables chi2 test for proportions Results 1090 biological treatments started in patients aged 65 years or older have been retrospectively included. The baseline characteristics are summarized in TABLE 1 and those related to his IBD in TABLE 2.most used treatments in order of frequency were: Infliximab (377, 34.8%), Adalimumab(311, 28.7%),Golimumab (28, 2.6%), Ustekinumab (157, 14.5%) and Vedolizumab (209, 19.3%). It should be noted that most of the patients had monotherapy treatment, finding only 27.7% (299 patients) combined with immunosuppressants (IMS) (thiopurines in 72.9% of cases). Identify 705 patients (64.8%) had a Charlston score = <1 (absence of comorbidity), 219 patients (20.13%) 2 points (low comorbidity) and 164 (15.07%) score => 3 points (high comorbidity). It was objective that the choice of the type of biological could be ...

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    دورية أكاديمية

    المصدر: Journal of Crohn's and Colitis ; volume 16, issue Supplement_1, page i400-i401 ; ISSN 1873-9946 1876-4479

    مصطلحات موضوعية: Gastroenterology, General Medicine

    الوصف: Background The most feared adverse events related to biological treatment in patients with inflammatory bowel disease (IBD) are the development of tumors and / or serious infections. These events are generally more frequent in elderly patients, so the increased use of biological drugs in these patients today makes it necessary to assess the safety of these drugs in this population. Methods Patients have been retrospectively included with established diagnosis of IBD at age, 65 at the time of initiating biological treatment(Infliximab, Adalimumab, Golimumab, Ustekinumab or Vedolizumab).Data regarding the development of oncological events during treatment have been collected. Variables related to infectious processes during biological treatment have also been included, documented by microbiological analysis and requiring systemic treatment and / or hospitalization(excluding bowel infection by CMV). Statistical analysis was performed with Stata, 15.0,categorical variables were compared with the chi2 test for proportions Results 1090 patients have been retrospectively included. Regarding the development of tumors, we observed an oncological event in, 74 (6.9%). They developed in, 30 patients (8%) with infliximab, 23 patients (7.1%) with adalimumab, 3 patients(11.1%) with golimumab, 10 patients (6.4%) with ustekinumab, and, 8 (3, 8%) vedolizumab. It was significantly lower(p = 0.04) for the vedolizumab group compared to other treatments, however, statistical significance was not reached for the ustekinumab group (p = 0.5)., 31% (23 patients) had an oncological history prior to the start of the biological treatment under study. The most frequently developed tumors were cutaneous, not melanocytic in, 10 patients, lung in, 10 patients and hematological tumors (7 non-Hodgkin lymphoma, 3 acute leukemias and, 2 intestinal lymphomas), 7 bladder tumors, 5 prostate and, 4 colorectal carcinoma.Regarding the development of infections, these occurred in, 160 patients during biological treatment(14.9%), without ...

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    دورية أكاديمية

    المؤلفون: Chaparro, M., Garre, A., Núñez Ortiz, A., Diz-Lois Palomares, M. T., Rodríguez, C., Riestra, S., Vela, M., Benítez, J. M., Fernández Salgado, E., Sánchez Rodríguez, E., Hernández, V., Ferreiro-Iglesias, R., Ponferrada Díaz, Á., Barrio. J., Huguet, J. M., Sicilia, B., Martín-Arranz, M. D., Calvet, X., Ginard, D., Alonso-Abreu, I., Fernández-Salazar, L., Varela Trastoy, P., Rivero, M., Vera-Mendoza, I., Vega, P., Navarro, P., Sierra, M., Cabriada, J. L., Aguas, M., Vicente, R., Navarro-Llavat, M., Echarri, A., Gomollón, F., Guerra del Río, E., Piñero, C., Casanova, M. J., Spicakova, K., Ortiz de Zarate, J., Torrella Cortés, E., Gutiérrez, A., Alonso-Galán, H., Hernández-Martínez, Á., Marrero, J. M., Lorente Poyatos, R., Calafat, M., Martí Romero, L., Robledo, P., Bosch, O., Jiménez, N., Esteve Comas, M., Duque, J. M., Fuentes Coronel, A. M., Sampedro, M. J., Sesé Abizanda, E., Herreros Martínez, B., Pozzati, L., Fernández Rosáenz, H., Crespo Suarez, B., López Serrano, P., Lucendo, A. J., Muñoz Vicente, M., Bermejo, F., Ramírez Palanca, J. J., Menacho, M., Carmona, A., Camargo, R., Torra Alsina, S., Maroto, N., Nerín de la Puerta, J., Castro, E., Marín-Jiménez, I., Botella, B., Sapiña, A., Cruz, N., Forcelledo, J. L. F., Bouhmidi, A., Castaño-Milla, C., Opio, V., Nicolás, I., Kutz, M., Abraldes Bechiarelli, A., Gordillo, J., Ber, Y., Torres Domínguez, Y., Novella Durán, M. T., Rodríguez Mondéjar, S., Martínez-Cerezo, F. J., Kolle, L., Sabat, M., Ledezma, C., Iyo E., Roncero, Ó., Irisarri, R., Lluis, L., Blázquez Gómez, I., Zapata, E. M., Alcalá, M. J., Martínez Pascual, C., Montealegre, M., Mata, L., Monrobel, A., Hernández Camba, A., Hernández, L., Tejada, M., Mir, A., Galve, M. L., Soler, M., Hervías, D., Gómez-Valero, J. A., Barreiro de Acosta, M., Rodríguez-Artalejo, F., García-Esquinas, E., Gisbert, J. P.

    الوصف: (1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD—Crohn’s disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)—during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100, 000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31–56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

    وصف الملف: application/pdf

    العلاقة: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI16-01296; info:eu-repo/grantAgreement/ES/ISCIII/FI17-00143; http://zaguan.unizar.es/record/111680Test

  5. 5
    دورية أكاديمية

    المصدر: Journal of Crohn's and Colitis ; volume 15, issue Supplement_1, page S018-S020 ; ISSN 1873-9946 1876-4479

    مصطلحات موضوعية: Gastroenterology, General Medicine

    الوصف: Background The management of inflammatory bowel disease (IBD) has substantially changed in the last decades, both in relation to medical and surgical treatments. Aims Principal: To know the rate of surgery in a newly diagnosed IBD cohort within the first year after diagnosis. Secondary: To describe the type of surgeries and indications in this cohort, and to identify predictive factors for surgery (focused on intestinal resection) in these patients. Methods Prospective, population-based nationwide registry. Adult patients diagnosed with IBD -Crohn’s disease (CD) and ulcerative colitis (UC)- during 2017 in Spain were included and were followed-up for 1 year. Kaplan-Meier curves were used to calculate the rate of surgery. In patients with intestinal resections, only medical treatments before surgery were considered. Predictive factors for surgery were identified by Cox-regression analysis. Results 3,454 patients (1,647 CD and 1,807 UC) were included (table 1). The incidence rate for surgery was significantly higher among CD patients (figure 1). A total of 197 patients (6%) underwent surgery within the first 12 months: 126 (64%) intestinal resections, and 71 (36%) perianal surgeries. Fifty-seven percent of intestinal resections were urgent, and 43% elective. The main indications for intestinal resections were: intestinal obstruction in 37%, abscess/fistula in 27%, perforation/acute abdomen in 25%, and refractoriness to medical treatment in 18% of cases. A total of 174 CD patients (10.6%) underwent surgery ¾61% intestinal resections and 39% perianal. Twenty-three UC patients (1.3%) were operated on; the number of surgeries in UC was too low to identify predictive factors. In CD patients, to have been treated with thiopurines [Hazard ratio (HR)=0.2, 95% confidence interval (CI)=0.1–0.3) was associated with lower likelihood of intestinal resection. Disease behaviour at diagnosis [stricturing vs. inflammatory (HR=6.5, 95%CI=4–10) and fistulising vs. inflammatory (HR=13, 95%CI=9–21)] was associated with the ...

  6. 6
    دورية أكاديمية

    المؤلفون: Chaparro, M., Donday, M. G., Barreiro de Acosta, Manuel, Domènech, E., Esteve, M., García-Sánchez, V., Nos, P., Panés, J., Martínez, C., Gisbert, J. P., Abad, F., Aguas Peris, M., Agüero Tejado, E., Alba, C., Albert, M., Alemán, H., Algaba, A., Alonso Abreu, I., Amador, M. P., Amat, M., Angueira, T., Arajol, C., Arias-González, L., Arrondo Velasco, A., Baldán, M., Bardán García, B., Bargalló García, A., Barreiro de Acosta, M., Barrio Andrés, J., Bastida Paz, G., Bastón Rey, Iria, Batista, L., Bellver Martínez, M., Beltrán Niclós, B., Benítez, J. M., Ber Nieto, Y., Bermejo, F., Bernardo, D., Blázquez Gómez, I., Bouhmidi Assakali, A., Busquets Casals, D., Cabriada Nuño, J. L., Calvet Calvo, X., Calvo Hernández, M. V., Calvo, M., Camps, B., Carbajo, A. Y., Cardona Peitx, G., Caro-Patón, T., Carrillo Palau, M., Carrión Bolorino, S., Casanova, M. J., Casellas Valdé, J. A., Castaño García, A., Castro Senosiain, B., Ceballos, D., Cerrillo, E., Chacón Martínez, S., Consuelo Cañete Pizarro, F., de Castro Parga, M. L., de Miguel, M., de Francisco García, R., de la Cruz Ramírez, M. D., del Hoyo Francisco, J., Delgado Guillena, P., Desongles Corrales, T., Echarri Piudo, A., Espino Paisan, E., Espona Quer, M., Fernández Pordomingo, A., Fernández Forcelledo, J. L., Fernández-Tomé, S., Ferreiro Iglesias, R., Ferrer Bradley, I., Ferrer, A., Figueroa, A., Gallach Montero, M., García Iglesias, P., García García-Lezcún, C., García Ramírez, L., García García, M. J., García-Bosh, O., Garre, A., Giménez Poderós, T., Gómez Irwin, L., Gómez Pastrana, B., Gómez Delgado, E., González Lama, Y., Gracia García, Á, Gracia García, B., Guardiola, J., Guerra, I., Guerra, E., Guillot, V., Gustmancher Saiz, S., Gutiérrez Casbas, A., Hernández Ramírez, V., Hernando Verdugo, M. M., Hernández Muniesa, B., Hernanz Chaves, R., Herrera Justiniano, J. M., Hinojosa del Val, J., Ibáñez Feijoo, S., Iborra Colomino, M., Iglesias Flores, E., Izquierdo García, E., Sampedro González, M. J., Lucendo, A. J., Jiménez García, N., Leo Carnerero, E., Loizaga Díaz, I., López de Torre Querejazu, A., López Sánchez, P., Luis Parras, J., Maia Boscá, M., Mañosa, M., Marín Pedrosa, S., Marín, A., Marinero, Á, Marín-Jiménez, I., Márquez Mosquera, L., Márquez Galán, J. L., Martín Arranz, E., Martín Arranz, M. D., Martínez Cadilla, J., Martínez Sesmero, J. M., Martínez Sánchez, B., Matallana, V., Mateos Hernández, M. I., McNicholl, A. G., Mejuto Fernández, R., Melcarne, L., Menchén, L., Méndez-Castrillón Rodríguez, J., Merino Ochoa, O., Mínguez, M., Molas Ferrer, G., Montoro Huguet, M., Montserrat Torres, A., Mora, F., Moraleja Yudego, I., Morales Alvarado, V. J., Morales Martínez, L., Morell, A., Motos García, C., Muñoz Alonso, F., Muñoz Villafranca, M. C., Muñoz, J. E., Mur, A., Nantes, Ó, Navarro, P., Navarro- Llavat, M., Nos Mateu, P., Núñez Alonso, A., Núñez Ortiz, A., Olivares, D., Ollero Pena, V., Orobitg, J., Ortega, L., Ortiz de Zárate, J., Pallarés Manrique, H., Paradela Carreiro, A., Peral Ballester, L., Pereira Bueno, S., Pérez Martínez, I., Pineda Mariño, J. R., Piñero Pérez, C., Planas Giner, A., Plaza Santos, M. R., Ponferrada Díaz, Á, Poza Cardón, J., Prieto Vicente, V., Puchades, L., Ramos López, L., Redondo, S., Riestra Menéndez, S., Rivero Tirado, M., Rodríguez Lago, I., Rodríguez Gutiérrez, C., Rodríguez, E., Romero Izquierdo, S., Rubio Iturria, S., Ruiz Antorán, M. B., Ruiz, A., Salazar, L. F., Sánchez Ulayar, A., Sánchez Gómez, E., Sánchez, C., Sangrador, C., Serra, K., Spicakova, K., Suárez Ferrer, C., Talavera Fabuel, A., Taxonera, C., Tordera, M., Torrella Cortés, E., Tosca, J., Trigo Salado, C., Uriarte Estefanía, F., Van Domselaar, M., Vázquez Morón, J. M., Ventura López, P., Vera, M., Vicuña Arregui, M., Villoria Ferrer, A., Virgós Aller, T., Yáñez Feria, D., on behalf of the, Exit study group of Geteccu

    المساهمون: PREDICROHN Study Group from GETECCU

    مصطلحات موضوعية: CHUS

    الوصف: Background: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1 year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn’s disease or ulcerative colitis who have achieved clinical remission for ⩾6 months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1 year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-10

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    دورية أكاديمية
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    دورية أكاديمية
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    دورية أكاديمية
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