Inflammatory Articular Disease in Patients with Inflammatory Bowel Disease: Result of the Swiss IBD Cohort Study

BACKGROUND Inflammatory bowel diseases (IBD) are systemic conditions that commonly display extraintestinal manifestations. Inflammatory articular disease (IAD: axial or peripheral) is the most common extraintestinal manifestation. The aim of this study was to evaluate the prevalence and the clinical characteristics associated with IAD in patients with IBD. METHODS We analyzed patients enrolled in the Swiss IBD cohort study. IAD was defined as persistent or recurrent joint pain with an inflammatory pattern (night pain, progressive relief during the day, morning stiffness lasting at least 30 minutes) or the presence of arthritis as diagnosed by the physicians. A multivariate logistic regression was performed to analyze which disease characteristics were independently associated with the presence of IAD. RESULTS A total of 2353 patients with IBD, 1359 with Crohn's disease, and 994 with ulcerative colitis (UC) were included. Forty-four percent of patients fulfilled the criteria for IAD, whereas 14.5% presented with other extraintestinal manifestations. IAD was associated with Crohn's disease, with female sex, with older age, and generally in patients with more active intestinal disease. Only in UC, IAD was further associated with tobacco smoking and with increasing body mass index. CONCLUSIONS This population of patients with IBD displays a high prevalence of IAD. IAD was more strongly associated with Crohn's disease than UC. Other risk factors for IAD were female sex, advanced age, active digestive disease, and tobacco consumption in patients with UC, which is interesting given the established association between smoking and other inflammatory arthritides.

[Smoking and digestive tract: a complex relationship. Part 1: Inflammatory bowel disease and cigarette smoking]

Little is known about the effects of smoking on inflammatory bowel diseases (IBD). However the co-occurrence of smoking and IBD often happens in ambulatory care. Smokers have a doubled risk of developing a Crohn's disease with a more active disease course. After quitting, a decrease in risk can be observed after only one year. An inverse relationship is found between smoking and ulcerative colitis. Smoking seems protective for the development of the disease and its course is less active among smokers. Smoking cessation transitorily increases the risk of developing ulcerative colitis. Nevertheless, continuing smoking cannot be justified among those patients given the risks of long-term extra-digestive effects. It is thus important to counsel all smokers with an IBD to quit smoking.

The second European evidenced-based consensus on reproduction and pregnancy in inflammatory bowel disease

Trying to conceive and being pregnant is an emotional period for those involved. In the majority of patients suffering from inflammatory bowel disease, maintenance therapy is required during pregnancy to control the disease, and disease control might necessitate introduction of new drugs during a vulnerable period. In this updated consensus on the reproduction and pregnancy in inflammatory bowel disease reproductive issues including fertility, the safety of drugs during pregnancy and lactation are discussed.

Quality of Life in Swiss Paediatric Inflammatory Bowel Disease Patients: Do Patients and Their Parents Experience Disease in the Same Way?

BACKGROUND AND AIMS Inflammatory bowel diseases (IBDs) may impair quality of life (QoL) in paediatric patients. We aimed to evaluate in a nationwide cohort whether patients experience QoL in a different way when compared with their parents. METHODS Sociodemographic and psychosocial characteristics were prospectively acquired from paediatric patients and their parents included in the Swiss IBD Cohort Study. Disease activity was evaluated by the Paediatric Crohn's Disease Activity Index (PCDAI) and the Paediatric Ulcerative Colitis Activity Index (PUCAI). We assessed QoL using the KIDSCREEN questionnaire. The QoL domains were analysed and compared between children and parents according to type of disease, parents' age, origin, education and marital status. RESULTS We included 110 children and parents (59 Crohn's disease [CD], 45 ulcerative colitis [UC], 6 IBD unclassified [IBDU]). There was no significant difference in QoL between CD and UC/IBDU, whether the disease was active or in remission. Parents perceived overall QoL, as well as 'mood', 'family' and 'friends' domains, lower than the children themselves, independently of their place of birth and education. However, better concordance was found on 'school performance' and 'physical activity' domains. Marital status and age of parents significantly influenced the evaluation of QoL. Mothers and fathers being married or cohabiting perceived significantly lower mood, family and friends domains than their children, whereas mothers living alone had a lower perception of the friends domain; fathers living alone had a lower perception of family and mood subscores. CONCLUSION Parents of Swiss paediatric IBD patients significantly underestimate overall QoL and domains of QoL of their children independently of origin and education.

Pregnancy Outcomes in Subjects Exposed to Certolizumab Pegol.

OBJECTIVE To provide information on pregnancy outcomes in women receiving certolizumab pegol (CZP). METHODS The UCB Pharma safety database was searched for pregnancies through to September 1, 2014. Reports for maternal and paternal CZP exposure were included and outcomes examined, and data on CZP exposure, pregnancy, comorbidities, and infant events were extracted by 2 independent reviewers. Concomitant medications and disease activity were reviewed for clinical trial patients. RESULTS Of 625 reported pregnancies, 372 (59.5%) had known outcomes. Paternal exposure pregnancies (n = 33) reported 27 live births, 4 miscarriages, 1 induced abortion, and 1 stillbirth. Maternal exposure pregnancies (n = 339) reported 254 live births, 52 miscarriages, 32 induced abortions, and 1 stillbirth. Almost all reported pregnancies had exposure to CZP in the first trimester, when organogenesis takes place, and a third of them continued the drug into the second and/or third trimesters. The most frequent indications for maternal CZP use were Crohn disease (192/339) and rheumatic diseases (118/339). Twelve cases of congenital malformation and a single neonatal death were reported. CONCLUSION Analysis of pregnancy outcomes after exposure to CZP supports previous reports, suggesting a lack of harmful effect of maternal CZP exposure on pregnancy outcomes. However, additional data from a larger number of outcomes after exposure and studies including an unexposed comparison group are required to fully evaluate CZP safety and tolerability in pregnancy.

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 696 - Dankesschreiben wegen der Einlenkung in den familiären Vermögensangelegenheiten

u.a.: Schlaganfall 1823; Krankheit und Todesgedanken von Arthur Schopenhauer;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 698 - Zwischenzeitliche Klärung in der Angelegenheit der Zahlungsaufforderung an die Familie Schopenhauer

u.a.: Ratschläge an den Sohn; Krankheit;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 699 - Klarstellung anlässlich vorhandener Zweifel an der Seriosität des eingesetzten Verwalters

u.a.: Angst vor Selbstmordabsichten des Sohnes;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 874 - Erklärung der Umstände der verspäteten Briefzusendung und Vertragsangelegenheiten zur Erbpacht in Danzig

Abschrift vorhanden; veröffentlicht in: Schopenhauer, Arthur : Arthur Schopenhauers sämtliche Werke - München : Piper - Bd. 15 : Der Briefwechsel Arthur Schopenhauers ; 2 (1849 - 1860), Nr. 439

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 613 - Mitteilung über den Tod der Schwester Adele

u.a.: Krankheit; Anerkennung des Testaments von Adele;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 870 - Mitteilung über die Gründe der verspäteten Briefversendung

u.a. Krankheit Adele Schopenhauer;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 871 - Krankheitsverlauf von Adele Schopenhauer

u.a. Erbschaftsangelegenheiten; Testament;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 182 - Mitteilung von Alexandre Minut über die Ereignisse nach seinem Aufenthalt in Frankfurt am Main

u.a.: Universität Halle; Hotel Englischer Hof; unglückliche Liebschaft, Krankheit; Gubnemaux; Brunner; Martin Emden;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 568 - Mitteilung über die Überweisung von 800 Gulden

u.a.: Krankheit Schopenhauer; A.E. Eichthal;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 936 - Erfahrungsaustausch über Arthur Schopenhauer

u.a. Telegraph; Krankheit; Erholung in Partenkirchen; Zusendung eines Fotos von Wilhelm Gwinner; Rezeption; Adolf Friedrich Trendelenburg; Julius Frauenstädt und Otto Lindner; Foucher de Careil; Aposteln und Evangelisten; Biographie; Charakter; Ralph Waldo Emerson; Pessimismus; Religion; Buddhismus; Wille; Ding an Sich; Veröffentlichung der Korrespondenzen; Augsburger Allgemeine Zeitung; Aufsatz Gwinners im Westminster Review; Karl Georg Bähr;