52 results match your criteria: "Pediatric Gastroenterology Institute[Affiliation]"

Background And Aims: Patients with very early-onset inflammatory bowel disease (VEO-IBD), with an age of onset < 6 years, can present with severe manifestations and may require biologic therapy. Infliximab and adalimumab are approved for induction and maintenance in pediatric IBD patients but are licensed only above the age of 6 years. Effectiveness and safety data on adalimumab in this patient population are lacking.

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Background: The pharmacokinetics of biologic agents can differ between children and adults with inflammatory bowel disease (IBD), often necessitating modified paediatric dosing strategies.

Aims: To define the exposure-response relationship of vedolizumab in the paediatric IBD VedoKids cohort including the effect of baseline clearance on deep biochemical remission (normal C-reactive protein [CRP]/erythrocyte sedimentation rate [ESR] and steroid-free remission) at 30 weeks, and to use population pharmacokinetic models to find the best matches between adult and paediatric pharmacokinetic profiles.

Methods: We sought a pharmacokinetic model on 312 serum vedolizumab concentrations from 129 children, assisted by a published adult model as a Bayesian prior.

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Upadacitinib for Induction of Remission in Pediatric Ulcerative Colitis: An International Multi‑center Study.

J Crohns Colitis

November 2024

Pediatric Gastroenterology Institute, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

Background And Aims: Data on upadacitinib therapy in children with ulcerative colitis (UC) or unclassified inflammatory bowel disease (IBD-U) are scarce. We aimed to evaluate the effectiveness and safety of upadacitinib as an induction therapy in pediatric UC or IBD-U.

Methods: In this multicenter retrospective study, children treated with upadacitinib for induction of remission of active UC or IBD-U from 30 centers worldwide were enrolled.

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Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition of the gut affecting both adults and children. Neutrophil extracellular traps (NETs) are structures released by activated neutrophils, potentially contributing to tissue damage in various diseases. This study aimed to explore the presence and role of NETs in pediatric IBD.

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Article Synopsis
  • Curcumin and Qing Dai (QD) are herbal treatments found effective for ulcerative colitis (UC) in children, used since 2016 in a combination called CurQD.
  • A study involving 30 pediatric patients showed significant improvements, with over 50% experiencing a substantial reduction in disease activity and fecal calprotectin levels during treatment.
  • Follow-up results indicated that while 33% experienced a flare-up, many regained remission or responded well to adjustments in their treatment regimen, suggesting CurQD is both effective and safe for managing mild to moderate UC.
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The no-biopsy approach to diagnose celiac disease (CD), introduced in the 2012 European Society for Gastroenterology and Hepatology and Nutrition guidelines, requires an anti-endomysial antibody (EMA) confirmatory serology test following a high-positive immunoglobulin A anti-tissue transglutaminase-2 (anti-TG2) antibody ≥10 times the upper limit of normal (ULN). The aim of this retrospective study is to compare EMA positivity and high-positive anti-TG2 in patients who had their confirmatory test within 2 months of their first high-positive anti-TG2 test. Among 933 patients who had high-positive anti-TG2 serology more than 10 times the ULN in their first sample, all had both high-positive anti-TG2 and positive EMA, most of them with very high EMA titers (99.

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Peripheral Blood Eosinophilia at Diagnosis of Inflammatory Bowel Disease Is Associated with Severe Disease Course; A Nationwide Study From the epi-IIRN Cohort.

J Crohns Colitis

August 2024

Pediatric Gastroenterology Institute, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center and the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Article Synopsis
  • A nationwide study assessed the link between high eosinophil counts (PBE) and long-term outcomes in patients with inflammatory bowel diseases (IBD).
  • The analysis included over 28,000 patients, revealing that PBE occurred more frequently in individuals with ulcerative colitis and in pediatric patients compared to adults.
  • Results indicated that PBE is a significant predictor of severe disease progression, increased hospitalization, and higher medication needs in IBD patients, highlighting its potential as a marker for adverse outcomes and target for therapies.
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Article Synopsis
  • The study assessed how being overweight or obese affects treatment response and relapse rates in children with inflammatory bowel disease (IBD) undergoing anti-TNF therapy.
  • Conducted across 22 centers in 14 countries, it involved 637 children, with a comparison between those who were overweight/obese and those of normal weight.
  • Findings showed no difference in loss of response to treatment initially, but overweight/obese children had higher relapse rates by the end of follow-up, indicating a potential long-term risk associated with their weight status.
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The Prevalence and Characteristics of Inflammatory Bowel Disease-related Ocular Involvement in Children.

Inflamm Bowel Dis

July 2024

The Juliet Keidan IInstitute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University, Jerusalem, Israel.

Background: Ocular manifestations (OMs) in patients with inflammatory bowel disease (IBD) are uncommon, particularly in children. We aimed to explore the prevalence and characteristics of IBD-associated OM in a large cohort study.

Methods: A cross-sectional study was performed using the Maccabi Healthcare Services (MHS) database.

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Infantile and Very Early Onset Inflammatory Bowel Disease: A Multicenter Study.

Pediatrics

August 2024

Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel.

Objectives: This study described disease characteristics and long-term outcomes in patients diagnosed with very early onset inflammatory bowel disease (VEOIBD) (diagnosed before 6 years of age) and infantile-IBD (before 2 years).

Methods: Cases from 21 centers worldwide diagnosed with VEOIBD (2008-2018), with minimum 2 years of follow-up, were retrospectively reviewed.

Results: The cohort included 243 patients (52% males, median follow-up of 5.

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Article Synopsis
  • Autoimmune gastritis (AIG) is a rare and chronic inflammatory disorder in children, which can lead to long-term complications like gastric cancer, but little is known about its natural progression in pediatric cases.
  • A study tracked 33 children diagnosed with AIG over a period of more than two decades, finding that a significant number (66.7%) had specific antibodies and that iron deficiency anemia was the most common symptom (75%).
  • The study emphasizes the need for monitoring due to high rates of metaplasia (33% in follow-ups) and a reported case of a type 1 gastric neuroendocrine tumor, indicating that AIG needs careful surveillance even in the absence of H. pylori infection.
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Aim: Although sexual health (SH) impairment and sexually transmitted infections (STI) are occasionally encountered in patients with inflammatory bowel disease (IBD), paediatric gastroenterologists (PedGI) do not often discuss these issues. Literature about SH in the paediatric IBD population is limited. We aimed to assess PedGI knowledge and common practice related to sexual advice and STI workups in patients with IBD.

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Acute pancreatitis in children with inflammatory bowel disease: Risk factors, clinical course, and prognosis.

J Pediatr Gastroenterol Nutr

August 2024

The Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.

Article Synopsis
  • This study aimed to compare the clinical course of acute pancreatitis (AP) in children with inflammatory bowel disease (IBD) versus those without, while also identifying risk factors for AP among IBD patients.
  • The research analyzed data from 68 pediatric patients hospitalized for AP between 2005 and 2019, finding that 13 had a co-diagnosis of IBD, and they experienced milder pancreatitis with no need for invasive treatment.
  • The only significant risk factor for developing AP among IBD patients was the presence of IBD-associated arthritis, while other factors related to IBD and medication showed no significant links to AP development.
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Objective: A constitutional disease-causing variant (DCV) in the SMAD4 or BMPR1A genes is present in 40%-60% of patients with juvenile polyposis syndrome (JPS). The aim of this study was to characterize the clinical course and polyp burden in children with DCV-positive JPS compared to DCV-negative JPS.

Methods: Demographic, clinical, genetic, and endoscopic data of children with JPS were compiled from eight international centers in the ESPHGAN/NASPGHAN polyposis working group.

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Background And Aims: An increase in the number of cases of acute hepatitis of unknown origin (HUO) in children was observed in 2021. Adenovirus and adeno-associated virus 2 (AAV2) infections have been suggested as possible triggers. However, the potential etiology is still unclear.

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Effectiveness and Safety of Ustekinumab in Pediatric Ulcerative Colitis: A Multi-center Retrospective Study from the Pediatric IBD Porto Group of ESPGHAN.

Paediatr Drugs

September 2024

Pediatric Gastroenterology Institute, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center and the Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel.

Background And Objectives: Current data on ustekinumab therapy in children with ulcerative colitis (UC) or unclassified inflammatory bowel disease (IBDU) are limited. We aimed to evaluate the effectiveness and safety of ustekinumab in pediatric UC and IBDU.

Methods: This multicenter retrospective study included 16 centers affiliated with the IBD Interest and Porto groups of ESPGHAN.

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Endoscopy in pediatric polyposis syndromes: why, when and how.

Eur J Gastroenterol Hepatol

March 2024

Division of Gastroenterology, Hepatology and Nutrition, The University of Missouri in Kansas Division of Gastroenterology, Hepatology and Nutrition, City School of Medicine, Children's Mercy Hospital Kansas City, Missouri, USA.

Single or multiple polyps are frequently encountered during colonoscopy among children and adolescents and may be indicative of hereditary polyposis syndrome (HPS). The management of children with single or multiple polyps is guided by the number of polyps, their distribution and the histological findings. Children with HPS carry a high risk of complications, including intestinal and extra-intestinal malignancies.

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New-onset Blepharitis and Anti-TNF-Alpha Therapy in Patients with Crohn's Disease: A Case Series and Literature Review.

Isr Med Assoc J

December 2023

Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petah Tikva, Israel, School of Medicine, Tel Aviv University, Tel Aviv, Israel.

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Background And Aims: We sought to define the prevalence and to characterize possible predictive factors of Crohn's disease (CD) occurring in children with ulcerative colitis (UC) after ileal pouch-anal anastomosis (IPAA).

Methods: This was a multicenter, retrospective study including 15 centers of the Porto IBD group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Children with a confirmed diagnosis of UC undergoing colectomy with IPAA and a minimal follow up of 6 months were identified.

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Article Synopsis
  • The study investigates the characteristics and natural history of primary sclerosing cholangitis related to inflammatory bowel disease (PSC-IBD) diagnosed before age 6, referred to as very early onset IBD (VEO-IBD) compared to those diagnosed later.
  • A total of 69 children were analyzed, finding that while most had ulcerative colitis, the VEO-PSC-IBD group had a higher incidence of PSC/autoimmune hepatitis overlap syndrome.
  • Results suggest that VEO-PSC-IBD has similar initial characteristics to later-onset PSC-IBD but presents with a milder disease course, particularly regarding biliary complications.
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Background And Aims: Thiopurines are an established treatment for pediatric ulcerative colitis (UC). However, data regarding safety and efficacy are lacking. We aimed to determine short and long-term outcome following thiopurines use in children with UC.

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Article Synopsis
  • Ulcerative proctitis (UP) is a rare form of ulcerative colitis in children, with the study analyzing clinical features and outcomes of 196 diagnosed patients aged under 18 from 2016 to 2020.
  • Most patients presented with symptoms like bloody stools and abdominal pain, and the study found that higher initial disease activity scores (PUCAI) were linked to worse outcomes, including the need for more aggressive treatments.
  • By the end of the study, nearly half of the patients showed disease progression, and only a small percentage required colectomy, highlighting the challenges in managing UP in pediatric patients.
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Dual-Targeted Therapy in Pediatric Inflammatory Bowel Disease: A Comprehensive Review.

Paediatr Drugs

September 2023

Pediatric Gastroenterology Institute, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Inflammatory bowel disease (IBD) is a chronic systemic immune-mediated disorder. The disease is triggered and perpetuated by a complex interplay between genetic predisposition, dysregulated immune responses, and environmental factors. Pediatric IBD is considered to be more aggressive compared with adult-onset IBD, and commonly requires more intensive pharmacological and surgical treatments.

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Article Synopsis
  • The study explores the use of liraglutide, a GLP-1 analogue, as an off-label therapy for patients with rare genetic causes of early-onset obesity and related complications.
  • Three case studies demonstrated that liraglutide can significantly halt weight gain, improve metabolic parameters, and support overall health in affected individuals despite their complex genetic backgrounds.
  • The findings suggest that liraglutide may have broader benefits beyond weight loss, making it a potentially valuable treatment option for managing obesity-related conditions in genetically predisposed patients.
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Dual Biologic or Small Molecule Therapy in Refractory Pediatric Inflammatory Bowel Disease (DOUBLE-PIBD): A Multicenter Study from the Pediatric IBD Porto Group of ESPGHAN.

Inflamm Bowel Dis

February 2024

Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Current data on dual biologic therapy in children are limited. This multicenter study aimed to evaluate the effectiveness and safety of dual therapy in pediatric patients with inflammatory bowel disease (IBD).

Methods: A retrospective study from 14 centers affiliated with the Pediatric IBD Interest and Porto Groups of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition.

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