The aim of the present study was to find out whether the incorporation of organic dairy and meat products in the maternal diet affects the contents of the conjugated linoleic acid isomers (CLA) and trans-vaccenic acid (TVA) in human breast milk. To this purpose, milk samples from 312 breastfeeding mothers participating in the KOALA Birth Cohort Study have been analysed. The participants had documented varying lifestyles in relation to the use of conventional or organic products. Breast milk samples were collected 1 month postpartum and analysed for fatty acid composition. The content of rumenic acid (the main CLA) increased in a statistically significant way while going from a conventional diet (no organic dairy/meat products, 0·25 weight % (wt%), n 186) to a moderately organic diet (50-90 % organic dairy/meat, 0·29 wt%, n 33, P¼ 0·02) and to a strict organic diet (. 90 % organic dairy/meat, 0·34 wt%, n 37, P# 0·001). The levels of TVA were augmented among the participants with a moderately organic diet (0·54 wt%) and those with a strict organic diet (0·59 wt%, P#0·001), in comparison with the conventional group (0·48 wt%). After adjusting for covariables (recruitment group, maternal age, maternal education, use of supplements and season), statistical significance was retained in the group of the strict organic dairy users (P, 0·001 for rumenic acid). Hence, the levels of CLA and TVA in human milk can be modulated if breastfeeding mothers replace conventional dairy and/or meat products by organic ones. A potential contribution of CLA and TVA to health improvement is briefly discussed.

BACKGROUND: Malignancy may occur as long-term complication of inflammatory bowel disease (IBD) due to different risk factors. We assessed prevalence and incidence of malignancy, and predictive factors in the Swiss IBD Cohort Study (SIBDCS). METHODS: All IBD patients in the SIBDCS were analyzed from a cross-sectional and longitudinal perspective. Patients with malignancies were compared to controls. Standardized incidence ratios (SIR) were calculated based on age-specific and sex-specific background rates. RESULTS: Malignancies were identified in 122 of 3119 patients (3.9%). In a logistic regression model, age (OR 1.04 per year), intestinal surgery (OR 3.34), and treatment with steroids (OR 2.10) were the main predictors for the presence of malignancy, while treatment with 5-ASA (OR 0.57) and biologics (OR 0.38) were protective. From a longitudinal perspective, 67 out of 2580 patients (2.6%) were newly diagnosed with malignancy during a follow-up of 12,420.8 years (median 4.9 years). While there was no increased risk for malignancy overall (SIR 0.93, 95% CI 0.72–1.18) and colorectal cancer (SIR 1.55, 95% CI 0.71–2.95), IBD patients had an increased risk for lymphoma (SIR 2.98, 95% CI 1.36–5.66) and biliary cancer (SIR 6.3, 95% CI 1.27–18.41). In a Cox regression model, age and recent use of immunomodulators were the main predictors for development of malignancies, while 5-ASA, biologics were protective. CONCLUSIONS: IBD patients showed increased risk for lymphoma and biliary cancer, but not colorectal cancer and cancer overall. Age and recent use of immunomodulators were the main risk factors for malignancy, while aminosalicylates and biologics appear to be protective.

Background and Aims: Paradoxically, psoriasis or psoriasiform skin lesions induced or exacerbated by anti-TNF antibodies have been described. Here, we report a series of 13 novel cases featuring exacerbation or occurrence of psoriatic skin lesions induced by anti-TNF antibodies in patients with Crohn's disease (CD). Methods: We performed a systematic analysis of exacerbation or occurrence of psoriasis or psoriasiform skin lesions induced by anti-TNF antibodies in an inflammatory bowel disease patient cohort at the University Hospital Zurich. Results: We identified 13 CD patients who developed psoriasis or psoriasiform lesions while receiving anti-TNF therapy. 10 of the 13 patients were female with an average age of 26.9 years at diagnosis. 11 of the 13 patients had a complicated disease. The mean time of clinical latency between diagnosis and onset of psoriasis was about 9.4 years, and the time between the beginning of all biological infusions and the onset of psoriasis was about 7 months. 7 of the 13 patients received infliximab, 3 adalimumab, and 3 certolizumab pegol at onset of psoriasis. In most of the cases, anti-TNF therapy was changed or discontinued and skin lesions improved. Conclusion: Most of our described patients featured a complicated disease course of CD and had an improvement of the rash after changing the anti-TNF therapy.

Background: Gastrointestinal and extraintestinal malignancies are long-term complications in patients with inflammatory bowel disease (IBD), likely as a result of chronic inflammation and the use of immunosuppressive medications used to control inflammation. Here, we assessed the frequency of malignancies in a large tertiary IBD centre at the University Hospital Zurich. Methods: We performed a retrospective analysis of data from 1,026 patients from our IBD clinic treated between 2007 and 2014. Results: Twenty two of the 1,026 patients developed 28 cases of malignancies, 14 patients were male and 8 patients female. The median latency between IBD diagnosis and first malignancy was 13 years (range 2-27 years). Most common malignancies were non-Hodgkin lymphoma, colorectal cancer (CRC), urothelial carcinoma, cholangiocellular carcinoma (CCC) and prostate cancer. The most common tumour type in Crohn's disease patients (13/22) was lymphoma (5 cases), in ulcerative colitis patients (9/22) CCC (2 cases) and CRC (2 cases). The observed incidence of lymphoma (32.5/100,000), bladder carcinoma (21.7/100,000) and CCC (10.8/100,000) was higher than expected and known from general population. All of the patients that developed a malignancy had received immunosuppressive therapy. Compared to a cohort of 927 IBD patients without malignancies there were no statistical differences regarding gender, antibodies targeting tumour necrosis factor and thiopurine use. Conclusion: Our data support the assumption that a long-standing disease course and immunosuppressive therapy increase the risk for developing malignancies in IBD patients.

FMT represents a therapeutic procedure that is of interest for IBD patients. As FMT has been receiving increasing interest as an alternative treatment in IBD and more studies on FMT in IBD are being carried out, it is important to learn about the knowledge, attitude, and preferences of patients to provide better education to patients on this topic. However, there are reservations because of the fact that data on the benefits of FMT in IBD are controversial and several limitations exist on the use of FMT in IBD.