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The Role of Noninvasive Surrogates of Inflammation in Monitoring Pediatric Inflammatory Bowel Diseases
Effectiveness of limited available therapies for pediatric inflammatory bowel disease has reached stagnation. Previous non-invasive monitoring strategies have relied upon cumbersome tools to evaluate clinical symptoms and biochemical markers that do not reflect endoscopic activity or respond quickly to treatments. Novel, patient-centric, and highly accurate, monitoring strategies with a focus on intestinal ultrasound for a direct, precise monitoring of activity to achieve disease modification are now possible. Ultimately, research on the optimal tight control monitoring strategies, individualized to each pediatric inflamma...
Source: Gastroenterology Clinics of North America - June 26, 2023 Category: Gastroenterology Authors: Michael Todd Dolinger Source Type: research

Building a Self-Management Toolkit for Patients with Pediatric Inflammatory Bowel Disease: Introducing the resilience 5
Transition from pediatric to adult health care is a complex process that calls for complex interventions and collaboration between health care teams and families. However, many inflammatory bowel disease (IBD) clinical care teams do not have the resources to implement rigorous transition programs for youth. This review provides a description of the Resilience5: self-efficacy, disease acceptance, self-regulation, optimism, and social support. The Resilience5 represents teachable skills to support IBD self-management, offset disease interfering behaviors, and build resilience in adolescents and young adults transitioning to ...
Source: Gastroenterology Clinics of North America - June 20, 2023 Category: Gastroenterology Authors: Sara Ahola Kohut, Laurie Keefer Source Type: research

Optimizing the Transition and Transfer of Care in Pediatric Inflammatory Bowel Disease
Health care transition from pediatric to adult care has been identified as a priority in the field of medicine, especially for those with chronic illnesses such as inflammatory bowel disease (IBD). Although there is no universally accepted model of preparing the pediatric patient for transfer to adult care, transition care is best accomplished in a structured and consistent manner. The authors highlight concepts for optimizing the transition of care for patients with IBD, which include setting expectations throughout adolescence with the gradual nurturing of self-management skills, preparing and assessing of readiness for ...
Source: Gastroenterology Clinics of North America - June 20, 2023 Category: Gastroenterology Authors: Laurie N. Fishman, Julia Ding Source Type: research

Building a Self-Management Toolkit for Patients with Pediatric Inflammatory Bowel Disease
Transition from pediatric to adult health care is a complex process that calls for complex interventions and collaboration between health care teams and families. However, many inflammatory bowel disease (IBD) clinical care teams do not have the resources to implement rigorous transition programs for youth. This review provides a description of the Resilience5: self-efficacy, disease acceptance, self-regulation, optimism, and social support. The Resilience5 represents teachable skills to support IBD self-management, offset disease interfering behaviors, and build resilience in adolescents and young adults transitioning to ...
Source: Gastroenterology Clinics of North America - June 20, 2023 Category: Gastroenterology Authors: Sara Ahola Kohut, Laurie Keefer Source Type: research

The State of Clinical Trials in Pediatric Inflammatory Bowel Disease
The gap between available biologic and small molecule therapy for inflammatory bowel disease for children and adults remains large. At present only 2 anti-TNF agents are licensed for pediatric use compared with multiple other agents with different mechanisms of action being used in adults. The reasons are many but largely revolve around the inadequate acceptance of adult efficacy data to children, and the reluctance of industry to commit to early pediatric drug development for fear of inadequate return on investment. We suggest common sense steps that need to be taken to improve this situation. (Source: Gastroenterology Cl...
Source: Gastroenterology Clinics of North America - June 20, 2023 Category: Gastroenterology Authors: Jeffrey S. Hyams, Richard K. Russell Source Type: research

Health Care Maintenance in Pediatric Inflammatory Bowel Disease
Patients with pediatric inflammatory bowel disease (pIBD) are at an increased risk for complications and comorbidities including infection, nutritional deficiencies, growth delay, bone disease, eye disease, malignancy, and psychologic disorders. Preventative health maintenance and monitoring is an important part to caring for patients with pIBD. Although practice is variable and published study within pIBD is limited, this article summarizes the important field of health-care maintenance in pIBD. A multidisciplinary approach, including the gastroenterologist provider, primary care provider, social worker, psychologist, as ...
Source: Gastroenterology Clinics of North America - June 20, 2023 Category: Gastroenterology Authors: Elana B. Mitchel, Andrew Grossman Source Type: research

The Past, Present, and Future of Pediatric Inflammatory Bowel Disease
Pediatric Inflammatory Bowel Disease (IBD) cases continue to rise globally, as does the demand for accurate and up-to-date information and education that pay special attention to the unique features and considerations for managing these patients. The state-of-the-art content in this special issue has been curated by leaders in the field in their respective areas of interest and expertise. This review highlights where we are in the field of IBD with a special emphasis on how the advances in the field apply to IBD diagnosed in childhood. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 20, 2023 Category: Gastroenterology Authors: Marla C. Dubinsky Tags: Preface Source Type: research

The Role of Therapeutic Drug Monitoring in Children
The use of biologic therapies has changed the treatment landscape for children with inflammatory bowel disease. While the novel biologics have improved clinical outcomes, there remains a significant gap in achieving endoscopic remission, prolonged steroid-free remission, and drug durability. Contributing to this gap is the paucity of real-world pharmacokinetic studies in children and a failure to dose optimize therapy during induction. Emerging data from a pediatric clinical trial and several observational studies have shown that the combination of proactive therapeutic drug monitoring and achievement of early therapeutic ...
Source: Gastroenterology Clinics of North America - June 9, 2023 Category: Gastroenterology Authors: Alexander Nasr, Phillip Minar Source Type: research

Safety Summary of Pediatric Inflammatory Bowel Disease Therapies
Therapeutic options for the treatment of pediatric inflammatory bowel disease include aminosalicylates, enteral nutrition, corticosteroids, immunomodulators, biologics, and emerging small molecule agents. Infectious risk due to systemic immunosuppression should be mitigated by appropriate screening before therapy initiation. Rare but serious malignancies have been associated with thiopurine use alone and in combination with anti-tumor necrosis factor agents, often in the setting of a primary Epstein –Barr virus infection. Potential agent-specific adverse events such as cytopenias, hepatotoxicity, and nephrotoxicity warra...
Source: Gastroenterology Clinics of North America - June 7, 2023 Category: Gastroenterology Authors: Xiaoyi Zhang, Joel R. Rosh Source Type: research

Appetite, Energy Expenditure, and the Regulation of Energy Balance
At usual weight, energy intake and expenditure are coupled and covary to maintain body weight (energy stores). A change in energy balance, especially weight loss, invokes discoordinated effects on energy intake and output that favor return to previous weight. These regulatory systems reflect physiological changes in systems regulating energy intake and expenditure rather than a lack of resolve. The biological and behavioral physiology of dynamic weight change are distinct from those of attempts at static weight maintenance of an altered body weight. This suggests that optimal therapeutic approaches to losing or gaining vs....
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Authors: Michael Rosenbaum Source Type: research

Health Complications of Obesity
Obesity is associated with a wide range of comorbidities that transverse multiple specialties in clinical medicine. The development of these comorbidities is driven by various mechanistic changes including chronic inflammation and oxidative stress, increased growth-promoting adipokines, insulin resistance, endothelial dysfunction, direct loading and infiltrative effect of adiposity, heightened activities of the renin-angiotensin-aldosterone system and sympathetic nervous system, impaired immunity, altered sex hormones, altered brain structure, elevated cortisol levels, and increased uric acid production, among others. Some...
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Authors: Michele M.A. Yuen Source Type: research

The Effects of Obesity on Health Care Delivery
This article reviews a broad range of topics, from the effects of increased adiposity on drug pharmacokinetics and pharmacodynamics to the changes health care environments are making to accommodate patients with obesity. The significant social impacts of weight bias are reviewed, as are the economic consequences of the obesity epidemic. Finally, a patient case that demonstrates the effects of obesity on health care delivery is examined. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Authors: Amanda Velazquez, Caroline M. Apovian Source Type: research

Obesity and Viral Infections
The 2019 novel coronavirus disease (COVID-19) triggered a rapidly expanding global pandemic. The presence of obesity in patients with COVID-19 has been established as a risk factor for disease severity, hospital admission, and mortality. Thus, it is imperative those living with obesity be vaccinated against COVID-19. Although there is a timeframe COVID-19 vaccines are efficacious in those living with obesity, more studies need to be conducted to ensure that those long-lasting protection is maintained, as obesity has implications on the immune system. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Authors: Priya Jaisinghani, Rekha Kumar Source Type: research

Management of Obesity, Part I: Overview and Basic Mechanisms
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Authors: Lee M. Kaplan Source Type: research

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Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 16, 2023 Category: Gastroenterology Source Type: research