Inflammatory bowel disease is associated with an increased risk of colorectal cancer. The study aims to identify the risk factors for ulcerative colitis-colorectal cancer and to perform a survival curve analysis of the outcome. This retrospective cohort study included 254 patients from March 2016 to October 2017. Age, age at diagnosis, follow-up time, smoking status, and family history of colorectal cancer were analyzed as risk factors for colorectal cancer. The mean patient age was 46.6 ± 16.9 years; 5.5% of the patients were smokers and 49.6% had pancolitis. Six patients (2.36%) had colorectal cancer, which was associated with age at diagnosis (odds/hazard ratio 1.059 [95% confidence interval: 1.001–1.121]; P = .04), family history of colorectal cancer (12.992 [1.611–104.7]; P = .02), and follow-up time (0.665 [0.513–0.864]; P = .002). Active smoking was the main identified risk factor, after both logistic (8.477 [1.350–53.232]; P = .02) and Cox proportional-hazards (32.484 [2.465–428.1]; P = .008) regression analysis. The risk of colorectal cancer was 3.17% at 10 years and 4.26% at 20 years of follow-up. Active smoking and family history were identified as risk factors for colorectal cancer. These findings should aid the early identification of patients who require vigorous surveillance, and prevent exposure to risk factors.

Inflammatory bowel disease (IBD) is a chronic condition that globally affects the health of people who suffer from it, deteriorating their quality of life (QoL). An aspect rarely explored by healthcare providers is the influence of the disease on the sexual functioning of individuals. This discretion is mainly due to an unconscious resistance when asking our patients about their sexual functioning because of a lack of knowledge and skills to tackle this topic or disinterest on the part of professionals, and fear or shame on the part of patients. Sexual function is a constant concern in IBD patients that has been reflected in several studies, especially if we consider that the prevalence of sexual dysfunction (SD) in IBD is higher than that reported in the general population. The etiology of SD in patients with IBD remains unclear but is likely to be multifactorial, where biological, psychosocial, and disease-specific factors are involved. Currently, there are no formal recommendations in the IBD clinical guidelines on how to manage SD in these patients. The use of validated clinical scales could improve the detection of SD and allow the treatment of the underlying causes in order to improve the QoL of patients with IBD. This review aims to illustrate the different aspects involved in SD in IBD patients and the importance of the participation of a multidisciplinary team in the early detection and treatment of SD at different stages of the disease.

O judô, assim como outros esportes que envolvem categorias de pesos, é uma modalidade em que os atletas apresentam grande risco de hipo-hidratação devido aos processos de desidratação involuntária e/ou voluntária. Sendo assim, o objetivo deste estudo foi avaliar a taxa de sudorese (ml/min) de judocas em um dia de treino e associar o grau de desidratação com alterações subjetivas de fome e apetite. A amostra foi composta por 14 atletas (nove homens e cinco mulheres), com idade média de 19,6 ± 5,9 anos. Para a realização do estudo, foram mensuradas a massa corporal e as taxas subjetivas de fome, apetite e esforço, expressas em uma escala de zero a 10, antes e logo após o treino. A massa corporal foi significantemente menor após o treino (68,8 ± 18,1kg versus 66,9 ± 17,3kg; p < 0,01), com redução de 2,6 ± 1,1%. As taxas de fome e esforço foram significantemente maiores após o exercício (2,1 ± 2,2 versus 4,8 ± 3,6, p = 0,02 e 0 versus 7,2 ± 1,3, p < 0,01), assim como a taxa de apetite por frutas (4,3 ± 3,8 versus 8,0 ± 2,8, p = 0,01). Correlações positivas foram obtidas entre: 1) escala de esforço e apetite por laticínios pós-treino (r = 0,63, p < 0,05); 2) percentual de redução de massa corporal e fome pós-treino (r = 0,55, p < 0,05) e, 3) percentual de redução de massa corporal e apetite por salgados pós-treino (r = 0,59, p < 0,05). Foi possível concluir que a taxa de sudorese média representou um quadro de desidratação moderado ao longo de uma sessão de treino de judô e que alterações no estado de hidratação podem estar associadas com modificações da percepção subjetiva de fome e apetite por determinados alimentos.

BACKGROUND: Biological therapy and new drugs have revolutionized the treatment of inflammatory bowel disease. Ideally, the choice of medication should be a shared decision with the patient, aiming at greater satisfaction, compliance, and consequently, favorable clinical outcome. OBJECTIVE: This study aims to evaluate patient’s preferences in the choice of their therapy and the factors that influence this choice. METHODS: This cross-sectional study enrolled 101 outpatients with Crohn’s disease or ulcerative colitis. The inclusion criteria were age ≥18 years and no previous exposure to biological therapy. Patients’ preferences were assessed through questions that addressed the preferred mode of administration (oral, subcutaneous, or intravenous) and the factors that determined the choice of medication (efficacy, medical indication, fear of medication, convenience, mode of application, and personal doctors’ indication). RESULTS: The mean age was 43.6±13.5 years, 75.3% were female, and 81.2% were cases of ulcerative colitis. Regarding the mode of administration, the majority of patients preferred oral (87.1%), followed by intravenous (6.93%) and subcutaneous (5.94%) medications. The reasons were “I prefer to take it at home” (42.57%), “I have more freedom” (36.63%), “I don’t like self-application” (29.70%), and “I believe it works better” (19.80%). Younger patients and patients in clinical disease activity preferred intravenous mode compared to the oral route (P<0.05). Doctor’s opinion (98%) was an important factor associated with the medication choice. CONCLUSION: Oral route was the preferred mode of administration and most patients took their physician’s opinion into account in their choice of medication.

Background: Hidradenitis suppurativa is a chronic inflammatory skin disorder associated with inflammatory bowel disease. However, it can arise as a paradoxical side effect of anti-TNF treatment. Methods: The article reports on three patients with Crohn's disease who developed hidradenitis suppurativa during the treatment with adalimumab. Results: Case 1: A 38-year-old female exhibited an infiltrative lesion in the inguinal region and vulva, consistent with hidradenitis suppurativa, after three months of adalimumab. These lesions were treated with partial vulvectomy. Case 2: After adalimumab treatment, a 27-year-old female, originally diagnosed with ileocolonic Crohn's disease, went into clinical and endoscopic remission. The patient eventually presented two hyperchromic nodules in the inguinal region, which were diagnosed as hidradenitis suppurativa. The patient showed improvement after treatment with oral doxycycline and local therapy. Case 3: A 34-year-old female with fistulizing and stenosing ileocolonic Crohn's disease, started adalimumab in 2010, with optimization in 2015. One year after, the patient developed bilateral, erythematous, hardened, inguinal nodulations with purulent drainage, consistent with hidradenitis suppurativa. Treatment with oral doxycycline, fusidic acid, and infiltration with triamcinolone resulted in partial improvement of the lesions. In 2018, the lesions deteriorate. The patient underwent surgical treatment. Conclusion: Patients with inflammatory bowel disease are more likely to the development of other mediated inflammatory diseases, such as hidradenitis suppurativa. Hidradenitis suppurativa may appear as a paradoxical reaction to anti-TNF therapy. Clinical teams must be aware of this type of complication. Early diagnosis and treatment are essential for controlling the disease and preventing the onset of complications.