Development, Validation, and Evaluation of a Pediatric Ulcerative Colitis Activity Index: A Prospective Multicenter Study

Turner, Dan; Otley, Anthony; Mack, David R.; Hyams, Jeffrey S.; Bruijne, Joep de; Uusoue, Krista; Walters, Thomas D.; Zachos, Mary; Mamula, Petar; Beaton, Dorcas; Steinhart, A. Hillary; Griffiths, Anne M.

doi:10.1053/j.gastro.2007.05.029

Cited by 902 publications

(675 citation statements)

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“…22 The diagnosis of IBD was made with established clinical, radiologic, and histologic criteria. 23 The Pediatric Crohn's Disease Activity Index and Pediatric Ulcerative Colitis Clinical Activity Index were used as measures of clinical severity of IBD. 22,24 We observed a significant increase in the transcript levels of iNOS in CD-and UC-affected biopsies compared with normal tissue (Figure 1).…”

Section: Results Inos Expression Is Up-regulated In Uc Patientsmentioning

confidence: 99%

Altered cGMP Dynamics at the Plasma Membrane Contribute to Diarrhea in Ulcerative Colitis

Arora

Sinha

Zhang

et al. 2015

The American Journal of Pathology

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Ulcerative colitis (UC) belongs to inflammatory bowel disorders, a group of gastrointestinal disorders that can produce serious recurring diarrhea in affected patients. The mechanism for UC-and inflammatory bowel disorder-associated diarrhea is not well understood. The cystic fibrosis transmembraneconductance regulator (CFTR) chloride channel plays an important role in fluid and water transport across the intestinal mucosa. CFTR channel function is regulated in a compartmentalized manner through the formation of CFTR-containing macromolecular complexes at the plasma membrane. In this study, we demonstrate the involvement of a novel macromolecular signaling pathway that causes diarrhea in UC. We found that a nitric oxide-producing enzyme, inducible nitric oxide synthase (iNOS), is overexpressed under the plasma membrane and generates compartmentalized cGMP in gut epithelia in UC. The scaffolding protein Na þ /H þ exchanger regulatory factor 2 (NHERF2) bridges iNOS with CFTR, forming CFTR-NHERF2-iNOS macromolecular complexes that potentiate CFTR channel function via the nitric oxide-cGMP pathway under inflammatory conditions both in vitro and in vivo. Potential disruption of these complexes in Nherf2 À/À mice may render them more resistant to CFTR-mediated secretory diarrhea than Nherf2 þ/þ mice in murine colitis models. Our study provides insight into the mechanism of pathophysiologic occurrence of diarrhea in UC and suggests that targeting CFTR and CFTR-containing macromolecular complexes will ameliorate diarrheal symptoms and improve conditions associated with inflammatory bowel disorders. (Am J Pathol 2015 http://dx

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Section: Results Inos Expression Is Up-regulated In Uc Patientsmentioning

confidence: 99%

Altered cGMP Dynamics at the Plasma Membrane Contribute to Diarrhea in Ulcerative Colitis

Arora

Sinha

Zhang

et al. 2015

The American Journal of Pathology

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“…The clinical activity of the disease was assessed according to PUCAI scale developed by Turner et al with the following symptoms: abdominal pain, rectal bleeding, stool consistency, the number of stools, nocturnal stools, activity level. 10 The PUCAI score ranging from 65 to 85 points indicated the severe relapse of the disease, 35-64 points moderate relapse, 10-34 points mild relapse. Scores of < 10 points indicated inactive disease, in clinical remission.…”

Section: Methodsmentioning

confidence: 99%

“…Scores of < 10 points indicated inactive disease, in clinical remission. 10 The location and the extent of large bowel lesions in children during endoscopic examination were assessed based on Paris classification, developed by Levinea et al in 2011. 14 According to this classification, ulcerative proctitis (proctitis), left-sided inflammation (distal to splenic flexure), extensive (distal to hepatic flexure), and pancolitis have been distinguished.…”

Section: Methodsmentioning

confidence: 99%

“…Turner et alin 2007 proposed to assess the severity of relapses in children on the basis of the non-invasive point scale based on the disease symptoms (Pediatric Ulcerative Colitis Activity Index -PUCAI). 10 The treatment includes glucocorticoids, 5-ASA preparations, immunomodulators, antibiotics, and surgical treatment. The administration of biological drugs was introduced in patients who had not responded to conventional therapies.…”

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confidence: 99%

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Evaluation of the infliximab therapy of severe form of pediatric Crohn’s disease in Poland: Retrospective, multicenter studies

Iwańczak¹,

Kierkuś²,

Ryżko³

et al. 2017

Adv Clin Exp Med

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“…We used the Pediatric Ulcerative Colitis Activity Index (range: 0-85, with 0 indicating no disease and higher scores indicating worse disease) 7 for patients with ulcerative/ indeterminate colitis and the abbreviated Pediatric Crohn's Disease Activity Index (range: 0-70, with 0 indicating no disease) 8 for patients with Crohn disease. For CF, we used the Cystic Fibrosis Clinical Score (range: 10-50, with 10 indicating no disease) 9 .…”

Section: Disease Statusmentioning

confidence: 99%

Preparing Adolescents With Chronic Disease for Transition to Adult Care: A Technology Program

2014

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Adolescents with chronic disease are a diverse population with common needs for transition. Disease-specific interventions have shown promise at improving patient outcomes but with substantial personnel and resource costs. Whether a generic approach across diseases may be useful is unknown. WHAT THIS STUDY ADDS:This study is among the first to evaluate a generic (across disease) approach to transition of adolescents to adult care. The approach demonstrated promise and cost savings due to reduced personnel requirement and use of lowcost technology dissemination methods.abstract BACKGROUND: Adolescents with chronic disease (ACD) must develop independent disease self-management and learn to communicate effectively with their health care team to transition from pediatric to adult-oriented health care systems. Disease-specific interventions have been implemented to aid specific ACD groups through transition. A generic approach might be effective and cost-saving.METHODS: Eighty-one ACD, aged 12 to 20 years, were recruited for a randomized clinical trial evaluating an 8-month transition intervention (MD2Me). MD2Me recipients received a 2-month intensive Web-based and text-delivered disease management and skill-based intervention followed by a 6-month review period. MD2Me recipients also had access to a texting algorithm for disease assessment and health care team contact. The intervention was applicable to adolescents with diverse chronic illnesses. Controls received mailed materials on general health topics. Disease management, health-related self-efficacy, and health assessments were performed at baseline and at 2 and 8 months. Frequency of patient-initiated communications was recorded over the study period. Outcomes were analyzed according to assigned treatment group over time. RESULTS:MD2Me recipients demonstrated significant improvements in performance of disease management tasks, health-related selfefficacy, and patient-initiated communications compared with controls.CONCLUSIONS: Outcomes in ACD improved significantly among recipients of a generic, technology-based intervention. Technology can deliver transition interventions to adolescents with diverse chronic illnesses, and a generic approach offers a cost-effective means of positively influencing transition outcomes. Further research is needed to determine whether improved short-term outcomes translate into an improved transition for ACD.

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Development, Validation, and Evaluation of a Pediatric Ulcerative Colitis Activity Index: A Prospective Multicenter Study

Cited by 902 publications

References 48 publications

Altered cGMP Dynamics at the Plasma Membrane Contribute to Diarrhea in Ulcerative Colitis

Altered cGMP Dynamics at the Plasma Membrane Contribute to Diarrhea in Ulcerative Colitis

Evaluation of the infliximab therapy of severe form of pediatric Crohn’s disease in Poland: Retrospective, multicenter studies

Preparing Adolescents With Chronic Disease for Transition to Adult Care: A Technology Program

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