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At least 847 records · Page 47Linked to original sources
PubMed2005

Accuracy of body composition measurements by dual energy x-ray absorptiometry in underweight patients with chronic intestinal disease and in lean subjects.

BACKGROUND: To assess the accuracy of Dual-energy X-ray absorptiometry (DXA) in underweight patients with chronic gastrointestinal disease, we investigated the ability of DXA to detect variations in body composition induced by infusion of parenteral nutrition (PN). Furthermore, the influence of a low body weight per se on the accuracy of DXA was studied by placing packets of lard on lean healthy subjects. METHODS: The hydration study included 11 patients with short bowel syndrome on long-term home parenteral nutrition (9 women and 2 men), and (mean +/- SD) 49.5 +/- 17.1 yr., 19.3 +/- 3.1 kg/m2. The lard study, where packets of lard were placed either over the thighs or the trunk region, was performed in 8 healthy lean male volunteers, 26.4 +/- 7.4 yr., and 21.0 + 0.9 kg/m2. Body composition, including measures of the total mass (TM), soft tissue mass (STM), lean tissue mass (LTM), fat mass (FM), and total body mineral content (TBBMC), was assessed by DXA. The fat fraction of the lard packets (3.49 kg), measured in triplicate by chemical fat extraction, was 52.2%. RESULTS: Hydration study; The increase in scale weight (BW) of approximately 0.90 kg due to infusion of PN correlated significantly to the increase in TM (R-square = 0.72, SEE 0.36 kg, p < 0.01), and the increase in STM (R-square = 0.69, SEE 0.38 kg, p < 0.01), however not with the increase LTM (R-square = 0.30, SEE 1.06 kg, p = 0.08). Mean changes in TM (0.88 kg), STM (0.88 kg), and LTM (0.81 kg) were not significantly different from changes in BW (p > 0.05). Lard study; Regardless of position, measurements of FM and LTM of the added lard were not significantly different from expected values. However, the composition of the lard packets into FM and LTM was more accurately detected when the packets were placed over the thighs than over the trunk region. The accuracy of DXA in individual subjects, expressed as the SD of the difference between expected and measured values, was 1.03 kg and 1.06 kg for the detection of changes in LTM and FM, respectively, and 0.18 kg for the detection of changes in STM and TM. CONCLUSIONS: On a group level, DXA provided sufficient accuracy to detect small changes in body composition in underweight patients with chronic gastrointestinal disease. However, the accuracy errors were higher than reported in normal weight subjects. The accuracy was not influenced by a low body weight per se.

Journal Article↗
PubMed1999

[The clinical and echographic assessment of thyroid function and structure in patients with a chronic inflammatory intestinal disease].

In Crohn's disease (CD) and in ulcerative colitis (UC) data about possible thyroid involvement are lacking. We studied thyroid morphology and function in 41 patients affected by active inflammatory bowel disease (IBD) (14 UC; 27 CD) before (all) and 45 and 90 days after onset of therapy (23/41), and in 60 normal control subjects. At each time, the following tests were performed: thyroid sonography, hormonal and immunological assays. A statistically significant increase of thyroid volume was found in IBD compared to control subjects, more frequently in CD (70.4%) than in UC (14.3%). Parenchymal structure was inhomogeneous (88.4% CD; 15.4% UC) with increased frequency compared to control subjects (12.7%). Hormone assays demonstrated increased FT4 values in UC (64.3%) and decreased T4 values in CD (51.8%). Patients affected with IBD showed an increased frequency of anti-thyroglobulin and anti-thyroid peroxidase antibodies. Such abnormalities subsided only partially after therapy. Our data suggest that in IBD there is a frequent thyroid involvement with morphological, hormonal, and immunological abnormalities.

Adult↗
PubMed1999

[Cost of early management of chronic inflammatory intestinal disease].

OBJECTIVES: The aim of this study was to assess the cost of the first management of inflammatory bowel disease (IBD) from the onset of first symptoms until 6 weeks after the diagnosis. This cost was calculated in French francs (FF) for all IBD and namely for Crohn's disease (CD), ulcerative colitis (UC), and ulcerative proctitis (UP). MATERIAL AND METHODS: Data concerning 258 patients were collected by the mean of a standardized questionnaire from 3 different sources: the patient, his general practitioner, and his gastroenterologist. RESULTS: Two hundred and fifty eight patients were included: 144 CD (55.8%), 76 UC (29.5%), 30 UP (11.6%), and 8 chronic unclassifiable colitis (CUC) (3.1%). The mean direct costs of the diagnosis (m +/- SD) were 23,116 +/- 40,820 FF for CD, 10,628 +/- 17,316 FF for UC and 3,451 +/- 2,743 FF for UP. Although unplanned hospitalizations occurred in only 38% of the patients (98/258), they represented the 3/4 of the mean costs: 78.2% for CD and 64% for UC. Indirect costs generated by days off work were 4,719 +/- 6,610 FF for CD, 2,996 +/- 6,897 FF for UC and 1,230 +/- 3,622 FF for UP. CONCLUSION: The first management of a patient with CD was twice more expensive than the one with UC and 6.5 times than the one with UP.

Adolescent↗
PubMed1999

[Revision and consensus in nutritional therapy: nutrition in inflammatory intestinal diseases].

Energy-protein malnutrition and the sub-clinical deficiencies of vitamins and trace elements, are frequent findings in ulcerative colitis and Crohn's disease, and these may negatively influence the clinical course of these diseases. In general, the majority of the patients with ulcerative colitis and uncomplicated Crohn's disease can ingest a normal diet that is well balanced and without any restrictions. The intolerance to specific foods is rare in Crohn's disease and the application of exclusion diets in a routine manner is not indicated. When the nutritional status cannot be adequately maintained with normal ingestion, the use of artificial nutrition is indicated. Enteral nutrition is the first choice nutritional support system if the gastrointestinal tract is accessible and at least partially functional. In Crohn's disease enteral nutrition could have a specific anti-inflammatory effect ("primary treatment"), and it has been suggested that this could be effective to induce the clinical remission of the activity bouts of the disease. Some types of dietary fiber could be effective in the treatment of ulcerative colitis. Initial studies suggest their usefulness in maintaining the remission of the disease.

Chronic Disease↗
PubMed1999

[Changes in the mouth mucosa in patients with chronic inflammatory intestinal diseases].

BACKGROUND: Oral mucosa and periodontal lesions occurrence in Inflammatory Bowel Disease (IBD), Ulcerative Colitis (UC) and Crohn Disease (CD). METHODS: This study involved 100 patients examined for 5 years (1990/1995), with a clinical and histopathological diagnosis of CD (21 patients) and UC (79 patients). RESULTS: The analysis of the data obtained, from our sample, showed that 5 patients out of 100 presented aphtha minor lesions; in 3 cases the diagnosis was, respectively, of two neoformations of the genian mucosa--which turned out to be a papilloma and a fibroma--and a retro-commissural leukoplakia, degree OIN I. The 50% of our patients presented parodontal lesions, oral candidosis in 15 out of 67 patients who presented a whitish coating on the back of the tongue. CONCLUSIONS: The results of this investigation, lessen the importance of an association between IBD and oral diseases.

Adolescent↗