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Background and objectives (Aim). To identify the features of the inflammatory status of the intestine in premature infants depending on gestational age. Materials and methods. The study included 36 premature babies. All children were divided into two groups, according to gestational age (GA): group 1-12 newborns with GA of 22 (0/7) 28 (6/7) weeks; and group 2-24 newborns with GA of 29(0/7) 32(6/7) weeks. The exclusion criteria were: the presence of congenital malformations, septic conditions, surgical pathologies. Results. The level of fecal calprotectin, as well as CRP in the 1st group of children was significantly higher than in the 2nd group, which demonstrates an inverse relationship between the severity of inflammation and the gestational age of premature newborns: the lower the gestational age, the higher the rates of inflammation in the intestines. The permeability of the intestinal barrier was high in both groups, which was reflected in increased values of fecal alpha-antitrypsin on the 3rd and 14th days of the examination, and did not have statistically significant differences between the groups. Children of group 1 required longer treatment than children of group 2, both in the ICU. Clinical manifestations of digestive disorders in premature infants were manifested by decreasing in body weight gain, the appearance of discharge from the tube with pathological impurities, while no significant difference was found between the groups. Conclusions. Premature neonates less than 28 weeks of age show greater signs of acute inflammation in the intestinal tract. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD), with its two main forms, Crohn’s disease, and ulcerative colitis, are characterized by chronic inflammation of the gastrointestinal tract. It is frequently diagnosed during childbearing years and its overlapping with pregnancy adds more complexity to the management of the disease. This review article aims to summarize what is acknowledged so far regarding IBD in pregnancy, providing up-to-date information. A systematic literature electronic search for journal articles and guidelines regarding IBD during pregnancy was undertaken. The most favorable pregnancy outcomes for pregnant women with IBD occur when the disease is in remission both at the time of conception and during the pregnancy. Most of IBD medication is considered safe during pregnancy and continuing therapy in pregnancy is fundamental for achieving optimal outcomes. Proper management of active IBD in pregnancy requires multidisciplinary care to lower adverse outcomes. There is insufficient knowledge among patients regarding how their pregnancy outcomes could be optimized. [ABSTRACT FROM AUTHOR]

Despite their known benefits, tumor necrosis factor alpha inhibitors (TNFi) may cause certain unexpected side effects, such as the aggravation of pre-existing autoimmune conditions or inducing the onset of new inflammatory conditions, these reactions being called “paradoxical adverse effects’’ (PAEs). The spectrum of TNFi-induced PAEs is vast and may include dermatological disease (frequently - psoriasiform skin reactions), gastroenterological disease (inflammatory bowel disease), ophthalmological disease (uveitis) and other autoimmune conditions (lupus-like reactions, vasculitis). PAEs are characterized by complex physiopathological mechanisms which remain a matter of further research and may significantly impact the patients’ evolution and quality of life. Importantly, a large number of patients require the cessation of TNFi treatment, as well as other types of therapeutic interventions. The present review aimed to analyze recent findings regarding certain paradoxical adverse effects (psoriasis, inflammatory bowel disease, and uveitis) in patients with RA, ankylosing spondylitis (AS), and PsA treated with TNFi. [ABSTRACT FROM AUTHOR]

Peripheral arthritis can be triggered by a variety of causes, two of them being calcium pyrophosphate (CPP) disease and peripheral spondyloarthritis (pSpA). After the identification of pSpA, further paraclinical investigations guided by the clinical context of the patient can help differentiate between different subsets of this pathology such as reactive arthritis (ReA), psoriatic arthritis and spondyloarthritis (SpA) related to inflammatory bowel disease. As in many other rheumatologic conditions, diagnostic criteria for pSpA are currently lacking. Classification criteria were implemented for research purpose and were not designed to be used in the case of an individual patient. Nevertheless, used with caution, classification criteria can serve as a valuable tool in guiding the diagnostic approach. We describe the case of a 52 year-old man for which the final diagnosis of ankylosing spondylitis (AS) with overlapped ReA and concurrent CPP disease was made based on a complex decision-making process, along with a comprehensive differential diagnosis. The association between SpA and crystal- induced arthritis is extremely rare, with only a few cases being reported until now. In this particular case, ASAS classification criteria for pSpA were able to strengthen the diagnosis. [ABSTRACT FROM AUTHOR]

The study of intestinal microbiota is an important and current subject. It is well known that the gut microbiota plays a decisive role in the development of intestinal function, contributes to the defense against different infections, gives tolerance to ingested foods, regulating and maintaining the function of the intestinal barrier. The gut microbiota is different from individual to individual, determining, through the molecular profile, an "individual profile". Intestinal dysbiosis is associated with multiple diseases such as IBD, irritable bowel syndrome, nosocomial infections or rheumatic inflammatory disorders. By characterizing intestinal dysbiosis in patients, a link could be made between these bacteria and the pathogenic mechanisms of the diseases, assigning these structures key roles in the onset of systemic disorders. This allows a better understanding of the pathophysiological mechanisms of the diseases and allow having a targeted treatment aimed at improving dysbiosis and restoring the normal microbial gut profile. [ABSTRACT FROM AUTHOR]

Objectives. Inflammatory bowel disease (IBD) are part of a pathology that has an ascending incidence both in Romania and around the world. It is well known that intestinal inflammation in IBD is not limited to the intestinal epithelium. Sometimes, extraintestinal manifestations (EIM) may have a more severe clinical expression than the intestinal disorder or may even encourage an increased morbidity. The research motivation focused on the development of specific clinical and epidemiological data for patients diagnosed with IBD who associate EIM. Material and methods. We performed a retrospective study including 517 patients with intestinal inflammation (Crohn disease - CD, ulcerative colitis - UC or undifferentiated colitis - NC) diagnosed during 1975-2016 in the N-E region of Romania. All the cases were extracted from the national database (IBD Prospect). Results. In our study the prevalence of UC versus CD cases prevailed. There were 368 cases (71.2%) of UC, 135 cases (26.1%) of CD and 10 cases of NC (1.9%). The prevalence of EIM in IBD patients in N-E Romania was 9,9% which was quite low. In the study group, EIMs occurred with a higher frequency in patients diagnosed with CD compared to UC. Thus, of the 51 cases of IBD and EIM, 27 (52.9%) belonged to the CD's phenotype and 24 cases (47.1%) of the UC's phenotype. Discussions. Both patients with CD and UC experienced a greater risk than the rest of patients for developing EIM. The most frequent EIMs were highlighted at the level of musculoskeletal system. Among EIM, there were 38 cases (74,5%) with articular manifestations (of which 26 had peripheral manifestations - arthritis, 12 cases developed axial manifestations - sacroiliitis/ankylosing spondylitis - SI/AS). Also, cases with multiple EIM had at least one articular manifestation. Conclusions. Our results sustain, once again, the fact that inflammation in IBD is not limited at the level of gastrointestinal tract. The presence of EIM, especially joint involvement, is a certainty validated by the results of many clinical trials. [ABSTRACT FROM AUTHOR]

Objectives. In the past few years we observed an increase in the number of patients with inflammatory bowel disease. We aimed to determine the epidemiology of this pathology among children in Romania over a 10 years period. Matherial and methods. The survey was conducted in Pediatric Gastroenterology Departments in Bucharest. We selected patients beeing carred for inflammatory bowel disease in 2011. A similar study, performed 10 years ago in 2001, reported the same epidemiologic characteristics and comparative data were available. Results. In 2001 we report 74 cases of inflammatory bowel disease, while there were 21 cases mentioned in 2001. We identified 35 cases of Crohn disease (47.29%) and 39 patients with ulcerative colitis (52.7%). The previous study reported 17 (81%) and 4 (19%), respectively. The mean age of onset of symptoms is 10.2 while in 2001 this was 13.2 years. Conclusions. Inflammatory bowel disease has tripled in the last 10 years. Ulcerative colitis is still the most frequent form but we report a growing number of cases with Crohn disease. [ABSTRACT FROM AUTHOR]

Objectives. Study the articular involvement present in inflammatory bowel disease, mainly in Crohn disease (CD) and ulcerohaemorrhagic rectocolitis (UHRC), the genetic and immune mechanism underlying the occurrence of these disorders and their complications, response to therapy, as well as the value of the immunoserology tests. Material and methods. The group of 204 patients that were monitored, consisted of two subgroups: 50 patients with CD, and 154 patients with UHRC and have been enrolled in a prospective longitudinal study. The patients were included in the study group according to strictly established criteria, taking into account the underlying inflammatory bowel disease that triggered the respective articular disorders, have been assessed according to a protocol including both individual parameters (clinical, biological), endoscopic, histopathologic, radiographs, RMN, CT evaluation. Results. 93 patients had joint manifestations. 65 of them had developed due articular lesions in ulcerative colitis and 28 Crohn's disease. In ulcerative colitis Joint damage occurred as follows: 58.5% sacroiliitis (38 cases), ankylosing spondylitis 7.7% (5) 10.7% acute arthritis (7). In Crohn's disease were detected: sacroiliac 35.8% (10 patients), 42.9% peripheral arthritis (12), acute arthritis 7.1% (2 cases), reactive arthritis 14.2% (4) with germs Salmonella (3) and Shigella (1). In 71 patients from those with articular manifestations of detecting the presence of HLAB27. Conclusions. Joint damage was correlated with the severity, type of inflammatory bowel disease (IBD) reflecting the state of activity. Joint manifestations were detected mainly in ulcerative colitis increased, unlike the literature. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (Crohn disease and ulcero-hemorrhagic rectocolitis) remains a chapter open to research due to its frequency (higher in the last decades), the clinical and evolutive particularities of digestive and extra digestive disorders, pathogenic enigma which represents a source of therapeutic difficulties. Specific genetic patterns and gene mutations favour the aberrant immune response to the antigens in the environment or the autoantigens causing bowel inflammations with high chronicization potential; the cytokines released and other still unknown mechanisms can be responsible for extra digestive disorders. The authors systematize recent data related to the pathogenesis of clinical evolutive types, modern diagnosis possibilities, the limits and the possibilities of modern therapeutic measures in arthropathies accompanying the inflammatory bowel disease. [ABSTRACT FROM AUTHOR]

Bolile inflamatorii intestinale (boala Crohn şi rectocolita ulcero-hemoragică) rămân un capitol deschis cercetării din cauza frecvenţei (în creştere în ultimele decade), particularităţilor clinico-evolutive a suferinţei digestive şi extradigestive, a enigmelor patogenetice, sursă a dificultăţilor terapeutice. Tipare genetice specifice, mutaţii genice favorizează răspuns imun aberant la antigeni din mediu sau la autoantigeni provocând o inflamaţie intestinală cu potenţial înalt de cronicizare; citokinele eliberate şi alte mecanisme încă necunoscute pot firesponsabile de manifestările extradigestive. Autorii sistematizează date recente privind patogeneza formelor clinico-evolutive, posibilităţi moderne de diagnostic, posibilităţile şi limitele măsurilor terapeutice moderne în artropatiile care însoţesc boala inflamatorie intestinală. [ABSTRACT FROM AUTHOR]

The inflammatory bowel diseases, consisting of Crohn's disease, ulcerative colitis and indeterminate colitis, are distinguished by idiopathic and chronic inflammation of the digestive tract. The distinction between inflammatory bowel diseases and functional bowel disorders, such as irritable bowel syndrome, can be complex because they often present with similar symptoms. Rapid and inexpensive noninvasive tests that are sensitive, specific and simple are needed to prevent patient discomfort, delay in diagnosis, and unnecessary costs. None of the current commercially available serological biomarker tests can be used as a stand-alone diagnostic in clinics. Instead, these are used as an adjunct to endoscopy in diagnosis and prognosis of the disease. Along these lines, fecal lactoferrin and calprotectin tests seem to be one step further from other tests with larger number of studies, higher sensitivity and specificity and wider availability. [ABSTRACT FROM AUTHOR]

Chronic nonspecific ulcerative colitis remaine a disease of unkown etiology, although much new information continues to be gleaned from basic research and clinical trials. In most instances, ulcerative colitis respond to medical therapy. Selecting appropriate drug therapy for a specific child dependends on the extent and severity of colitis. This article summarized the clinical information, diagnostic studies and approaches to management that should be considered when evaluating a child for ulcerative colitis. [ABSTRACT FROM AUTHOR]

The article presents abstracts on myasthenia gravis and muscular disorders including "Some clinico-immunological aspects in patients with ocular myasthenia gravis associated with inflammatory bowel disease," by I. M. Cojocaru, M. Cojocaru and R. Tanasescu, "Management of myasthenic crisis," by C. Vilciu, C. Banica and M. Marian, and "Mechanical ventilation for respiratory failure in myasthenia gravis," by D. Cernea, A. Vladoianu and M. Stoica.

Idiopathic inflammatory bowel disease is a significant cause of morbidity and mortality, affecting mostly young people. It comprises two entities: Crohn's disease and ulcerative colitis. The current study attempted to establish the endoscopic features of Crohn's disease and ulcerative colitis on 37 patients, aged between 0-18 years, hospitalized in Fundeni Hospital between 1995-2004. [ABSTRACT FROM AUTHOR]