Special Issue "Inflammatory Bowel Disease: Clinical Diagnosis and Treatment Guidelines"

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (1 February 2021) | Viewed by 2503

Special Issue Editor

Dr. Amosy E M'Koma
E-Mail Website
Guest Editor
Division of Biomedical Sciences, Meharry Medical College, Nashville, TN, USA
Interests: inflammatory bowel disease; ulcerative colitis (UC); Crohn’s diseases (CD); indeterminate colitis (IC); colorectal surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue of Medicina, “Clinical Diagnosis and Treatment Guidelines”, aims to present recent interesting advances and challenging aspects in research in inflammatory bowel disease (IBD). It is now clear that IDB is increasing worldwide and has become a global emergence. Inflammatory bowel disease, which includes Crohn’s disease (CD) and ulcerative colitis (UC), has been considered a problem in industrial–urbanized societies and attributed largely to Western culture habits, lifestyle, and other environmental factors. Its incidence and prevalence in developing countries is steadily rising, likely as a consequence of the rapid modernization and Westernization of the population. The two main medical sub-types of IBD are believed to have a multifactorial etiopathogenesis, and no drugs are available for their cure. Despite advances in diagnostics and therapeutics modalities, clinicians often painstakingly face the inconclusive diagnosis of “indeterminate colitis” when the diagnostic elements for the identification of the two diseases are insufficient, which hinders the planning of an appropriate treatment and the establishment of a prognosis. This often causes inappropriate surgery, poor treatment outcomes, and unnecessary costs. This Special Issue will present current advances to solve diagnostics challenges and determine correct treatment regimens for IBD and will highlight future research directions in this field.

Dr. Amosy E M'Koma
Guest Editor

Manuscript Submission Information

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Keywords

  • Inflammatory bowel disease
  • Crohn’s colitis
  • Ulcerative colitis
  • Indeterminate colitis
  • Molecular diagnostic (IBD)
  • Colitis-associated colorectal cancer
  • Treatment regimens (IBD)
  • Proctocolectomy
  • Restorative
  • Ileal pouch-anal anastomosis
  • Colonic ileal metaplasia (IBD)
  • Biomarkers (IBD)

Published Papers (2 papers)

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Research

Article
Correlation of Biomarkers with Endoscopic Score: Ulcerative Colitis Endoscopic Index of Severity (UCEIS) in Patients with Ulcerative Colitis in Remission
Medicina 2021, 57(1), 31; https://doi.org/10.3390/medicina57010031 - 31 Dec 2020
Cited by 1 | Viewed by 802
Abstract
Background and Objectives: Ulcerative colitis is a disease with an unpredictable evolution, often highlighted endoscopically, that is associated with persistent inflammation affecting the patient’s quality of life. An attempt was made to discover surrogate markers to evaluate the endoscopic remission of the disease [...] Read more.
Background and Objectives: Ulcerative colitis is a disease with an unpredictable evolution, often highlighted endoscopically, that is associated with persistent inflammation affecting the patient’s quality of life. An attempt was made to discover surrogate markers to evaluate the endoscopic remission of the disease in order to increase the patient’s quality of life and also their adherence to the treatment and monitoring plan. One such marker is fecal calprotectin (FC). To confirm the correlation between biomarkers and endoscopic disease activity and to define the optimal cut off value to detect clinical and endoscopic remission in a center of Romania. Materials and Methods: This was a prospective study that included 59 patients diagnosed with ulcerative colitis at the Department of Internal Medicine III, University Emergency Hospital of Bucharest. Patients had fecal calprotectin measurements and colonoscopy/rectosigmoidoscopy performed during baseline, 6 and 12 months. For endoscopic activity the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) was used. Results: During the study, relapses have occurred in 35.6% of patients, the median age was 47 years (21–77). During the study, the FC measurement was significantly increased at 3 months (median, range µg/g; 715, 14–4000) and at 6 months (median, range µg/g; 650, 4.5–3000) (p ≤ 0.05). Another inflammatory biomarker studied was CRP, which showed increased values at 3 months (median, range, mg/dL; 1.86, 0.14–58.9), at 6 months (median, range, mg/dL; 2.36, 0.12–45.8) and at 9 months (median, range, mg/dL; 2, 0.12–25.9) compared to the baseline (p = 0.01). Patients with recurrence of the disease also associated an increase in the values of clinical evaluation scores (SCCAI; p = 0.00001), but also endoscopic (UCEIS; p = 0.0006) Conclusion: A relapse is associated independently with younger age, the extension of the disease (E2-E3), increased FC level, C reactive protein, hemoglobin concentration, SCCAI index and UCEIS score. Full article
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Article
A Machine Learning Model Accurately Predicts Ulcerative Colitis Activity at One Year in Patients Treated with Anti-Tumour Necrosis Factor α Agents
Medicina 2020, 56(11), 628; https://doi.org/10.3390/medicina56110628 - 20 Nov 2020
Cited by 4 | Viewed by 983
Abstract
Background and objectives: The biological treatment is a promising therapeutic option for ulcerative colitis (UC) patients, being able to induce subclinical and long-term remission. However, the relatively high costs and the potential toxicity have led to intense debates over the most appropriate criteria [...] Read more.
Background and objectives: The biological treatment is a promising therapeutic option for ulcerative colitis (UC) patients, being able to induce subclinical and long-term remission. However, the relatively high costs and the potential toxicity have led to intense debates over the most appropriate criteria for starting, stopping, and managing biologics in UC. Our aim was to build a machine learning (ML) model for predicting disease activity at one year in UC patients treated with anti-Tumour necrosis factor α agents as a useful tool to assist the clinician in the therapeutic decisions. Materials and Methods: Clinical and biological parameters and the endoscopic Mayo score were collected from 55 UC patients at the baseline and one year follow-up. A neural network model was built using the baseline endoscopic activity and four selected variables as inputs to predict whether a UC patient will have an active or inactive endoscopic disease at one year, under the same therapeutic regimen. Results: The classifier achieved an excellent performance predicting the disease activity at one year with an accuracy of 90% and area under curve (AUC) of 0.92 on the test set and an accuracy of 100% and an AUC of 1 on the validation set. Conclusions: Our proposed ML solution may prove to be a useful tool in assisting the clinicians’ decisions to increase the dose or switch to other biologic agents after the model’s validation on independent, external cohorts of patients. Full article
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