A new protocolised treatment strategy optimising medical and surgical care leads to improved healing of Crohn's perianal fistulas.

Background & Aims: Crohn's perianal fistula healing rates remain low. We evaluated the efficacy of a protocolised multidisciplinary treatment strategy optimising care in adults with Crohn's perianal fistulas.

Methods: A new treatment strategy was established at a single tertiary centre.

- Experience of Trauma Awareness among Estonian Foster Parents and Residential Caregivers.

Trauma-informed care (TIC) is a relatively new topic in the Estonian child protection system, but it has become the particular focus of substitute care. The Estonian child protection system focuses on protecting children from maltreatment, and neglects the adult carers' right to adequate information about the child's trauma experience. This makes trauma-informed care vague.

Thiopurine Metabolite Shunting in Late Pregnancy Increases the Risk of Intrahepatic Cholestasis of Pregnancy in Women With Inflammatory Bowel Disease, and Can be Managed With Split Dosing.

Background And Aims: The risk of intrahepatic cholestasis of pregnancy [ICP] is increased in thiopurine-exposed pregnancies. Thiopurine 'shunting', with a 6-methylmercaptopurine [MMP] to 6-thioguanine [TGN] ratio of >11, progresses over pregnancy, and may promote ICP development. We aimed to explore the association between thiopurine exposure and ICP, including the hypothesised impact of thiopurine shunting, and identify risk minimisation strategies.

Thrombocytosis and Transaminitis in Infants Born to Women With Inflammatory Bowel Disease Is Associated With Exposure to Maternal Inflammation In Utero.

Background: Despite reassuring clinical safety data, thrombocytosis, anemia, lymphopenia, and liver function derangements have been observed in infants born to women with inflammatory bowel disease (IBD) treated with thiopurines and biologics. We aimed to define the prevalence, course, associations, and clinical impact of hematological and biochemical abnormalities in such infants.

Methods: This multicenter prospective cohort study assessed clinical, hematologic, and biochemical outcomes of infants exposed to thiopurines or biologics in utero for management of maternal IBD.

Thermo-optic VO-based silicon waveguide mid-infrared router with asymmetric activation thresholds and large bi-stability: errata.

The authors report an error in the phrasing and citation of the reference to simulation model input data in [Opt. Express31(14), 23260202310.1364/OE.

Outcomes of a Comprehensive Specialist Inflammatory Bowel Disease Nursing Service.

Background: Inflammatory bowel disease (IBD) is best managed by a multidisciplinary team within a dedicated IBD service. IBD nurses play an important role within this team. We aimed to evaluate the contribution of our comprehensive outpatient IBD nursing service on patient outcomes, quality of care, and healthcare costs.

Thermo-optic VO-based silicon waveguide mid-infrared router with asymmetric activation thresholds and large bi-stability.

We report a novel four-port optical router that exploits non-linear properties of vanadium dioxide (VO) phase-change material to achieve asymmetrical power threshold response with power limiting capability. The scope of this study lies within the concept, modeling, and simulation of the device, with practical considerations in mind for future experimental devices. The waveguide structure, designed to operate at the wavelength of 5.

Risk factors for malignancy and serious infection in patients with inflammatory bowel disease: a retrospective analysis.

Background: Patients with inflammatory bowel disease (IBD) are at increased risk of malignancy and infection compared to the general population.

Aims: We aim to identify risk factors for malignancy or serious infection in our IBD cohort.

Methods: Patients with IBD from a single tertiary referral centre were included.

Relationship Between Serum Ustekinumab Trough Concentration and Clinical and Biochemical Disease Activity: A Real-World Study in Adult Patients with Crohn's Disease.

Background And Objectives: The role of therapeutic drug monitoring for ustekinumab in the treatment of Crohn's disease has not been defined. This study aimed to explore the relationship of serum ustekinumab trough concentration (UTC) with clinical and biochemical disease outcomes in a real-world setting.

Methods: We performed a retrospective analysis of Crohn's disease patients treated at a single tertiary centre.

Isolated esophageal IgG4-related disease presenting with progressive dysphagia and weight loss in a middle-aged man.

Immunoglobulin G4-related disease (IgG4-RD) is an increasingly recognized immune-mediated condition that results in inflammation, stricturing and mass formation. It causes a wide spectrum of disease and clinical presentations depending on the organ system involved. Isolated esophageal IgG4-RD is rare and diagnosis can be difficult.

Interventions to Improve Adherence to Preventive Care in Inflammatory Bowel Disease: A Systematic Review.

Background: Preventive health measures reduce treatment and disease-related complications including infections, osteoporosis, and malignancies in patients with inflammatory bowel disease (IBD). Although guidelines and quality measures for IBD care highlight the importance of preventive care, their uptake remains variable. This systematic review evaluates interventions aimed at improving the rates of provision and uptake of preventive health measures, including vaccinations, bone density assessment, skin cancer screening, cervical cancer screening, and smoking cessation counseling.

Telehealth model of care for outpatient inflammatory bowel disease care in the setting of the COVID-19 pandemic.

Background: Advances in inflammatory bowel disease (IBD) monitoring, greater number of available treatments and a shift towards tight disease control, IBD care has become more dynamic with regular follow ups.

Aims: We assessed the impacts of the COVID-19 pandemic on outpatient IBD patient care at a tertiary centre in Melbourne. More specifically, we assessed patient satisfaction with a telehealth model of care, failure to attend rates at IBD clinics and work absenteeism prior to and during the pandemic.

Long-term outcomes of perianal fistulizing Crohn's disease in the biologic era.

Background And Aim: While the advent of biologic therapy has led to improved outcomes in perianal fistulizing Crohn's disease (pfCD), loss of response is common. Previous studies suggest that patients who achieve radiological healing (with healing of underlying tracts on magnetic resonance imaging [MRI]) have a longer duration of response. The aim of this study was to characterize MRI outcomes of pfCD at a specialist inflammatory bowel disease (IBD) unit and compare the long-term clinical outcomes between patients achieving MRI and clinical healing.

Thiopurine metabolite testing in inflammatory bowel disease.

Background: Thiopurine use in inflammatory bowel disease (IBD) is limited by drug toxicity and lack of therapeutic efficacy. We assessed the utility of thiopurine metabolite testing and the relationship between disease activity, dose, and metabolite levels in a real world setting.

Methods: Patients identified from pathology databases (2007-2012) at two tertiary IBD centers were included if they had thiopurines for at least four weeks.

Influence of bioselector processes on 17α-ethinylestradiol biodegradation in activated sludge wastewater treatment systems.

The removal of the potent endocrine-disrupting estrogen hormone, 17α-ethinylestradiol (EE2), in municipal wastewater treatment plant (WWTP) activated sludge (AS) processes can occur through biodegradation by heterotrophic bacteria growing on other organic wastewater substrates. Different kinetic and metabolic substrate utilization conditions created with AS bioselector processes can affect the heterotrophic population composition in AS. The primary goal of this research was to determine if these changes also affect specific EE2 biodegradation kinetics.

Inflammatory bowel disease cancer surveillance in a tertiary referral hospital: attitudes and practice.

Background: Physician adherence to guidelines for colorectal cancer (CRC) surveillance in inflammatory bowel disease (IBD) is often poor. This may lead to adverse patient outcomes and excess endoscopic workload.

Aims: To assess the attitudes and practice of IBD specialists in a tertiary centre towards colonoscopic surveillance.

Addition of thiopurines can recapture response in patients with Crohn's disease who have lost response to anti-tumor necrosis factor monotherapy.

Background And Aim: Anti-tumor necrosis factor (TNF) antibodies are effective in maintaining remission in Crohn's disease. However, a significant proportion of patients lose response to these agents with time. This study aimed to determine whether the introduction of a thiopurine in patients who have lost response to anti-TNF monotherapy results in regained response.

Determination of dose rate from Chernobyl-derived radiocaesium in Estonian soil.

The deposition and vertical depth distribution of 134Cs and 137Cs in the natural undisturbed soil profiles down to 20-25 cm were studied at locations in the North Eastern Estonia, which were most strongly affected by the Chernobyl fallout in 1986. The total depositions were estimated based on summing the sampled and measured activities of 134Cs and 137Cs in all sections of soil profiles. The Chernobyl 137Cs deposition values varied considerably from site to site and the range was from 3.