Background
While there are multiple safe and effective agents for COVID-19 treatment, their impact in inflammatory bowel disease (IBD) remains uncertain.
Aims
Our objective was to assess the effects ...of these therapies on both IBD and COVID outcomes.
Methods
A single-center retrospective study of adult patients with IBD who contracted COVID-19 between 12/2020 and 11/2022 was performed. Patients were stratified by COVID-19 treatment (antivirals and/or intravenous antibodies) vs no therapy. The primary outcome was the development of severe COVID-19 infection, defined by need for supplemental oxygen, corticosteroids and/or antibiotics, or hospitalization. Secondary outcomes included rates of withholding advanced IBD therapy (defined as biologic agents or small molecules) and of post-COVID-19 IBD flare.
Results
Of 127 patients with COVID-19 infection, 70% were on advanced therapies, 35% received COVID-19 treatment, and 15% developed severe COVID-19. Those treated for COVID-19 were more likely to be on corticosteroids odds ratio (OR) 4.61, 95% confidence interval (CI) 1.72–12.39,
p
= 0.002 or advanced IBD therapies (OR 2.78, 95% CI 1.04–7.43,
p
= 0.041). After adjusting for age, race, sex, corticosteroid use, obesity, COVID-19 vaccination status, and severe COVID-19 infection, those treated for COVID-19 were more likely to have IBD therapy held (OR 6.95, 95% CI 1.72–28.15,
p
= 0.007). There was no significant difference in rates of post-COVID-19 IBD flares or severe COVID-19 infection. There were no COVID-related deaths.
Conclusions
Patients with IBD on advanced therapies were frequently treated for acute COVID-19. Although COVID-19 treatment was associated with temporary withholding of IBD therapy, it did not result in increased IBD flares.
Background
The association between preoperative use of infliximab and postoperative complications in patients with inflammatory bowel disease (IBD) is a subject of continued debate. Results from ...studies examining an association between the timing of last preoperative dose of infliximab and postoperative complications remain inconsistent.
Aims
To assess whether timing of last dose of infliximab prior to surgery affects the rate of postoperative complications in patients with Crohn’s disease or ulcerative colitis.
Methods
Retrospective chart review of IBD patients who have undergone surgery while receiving therapy with infliximab was conducted. Forty-seven patients were included in the analysis.
Results
No significant association was found between timing of infliximab and the rate of postoperative complications. Age, gender, disease type, steroid use, preoperative status, surgery type, or surgeon type was not associated with increased rate of postoperative complications.
Conclusion
Timing of last dose of infliximab does not affect the rate of postoperative complications in patients with Crohn’s disease or ulcerative colitis.
AU Mic b is a Neptune-sized planet on an 8.47-day orbit around the nearest pre-main sequence (~20 Myr) star to the Sun, the bright (
V
= 8.81) M dwarf AU Mic. The planet was preliminary detected in ...Doppler radial velocity time series and recently confirmed to be transiting with data from the TESS mission. AU Mic b is likely to be cooling and contracting and might be accompanied by a second, more massive planet, in an outer orbit. Here, we present the observations of the transit of AU Mic b using ESPRESSO on the Very Large Telescope. We obtained a high-resolution time series of spectra to measure the Rossiter-McLaughlin effect, to constrain the spin-orbit alignment of the star and planet, and to simultaneously attempt to retrieve the planet’s atmospheric transmission spectrum. These observations allowed us to study, for the first time, the early phases of the dynamical evolution of young systems. We applied different methodologies to derive the spin-orbit angle of AU Mic b, and all of them retrieve values consistent with the planet being aligned with the rotation plane of the star. We determined a conservative spin-orbit angle
λ
value of −2.96
−10.30
+10.44
degrees, indicative that the formation and migration of the planets of the AU Mic system occurred within the disc. Unfortunately, and despite the large signal-to-noise ratio of our measurements, the degree of stellar activity prevented us from detecting any features from the planetary atmosphere. In fact, our results suggest that transmission spectroscopy for recently formed planets around active young stars is going to remain very challenging, if at all possible, for the near future.
ABSTRACT We present ten young ( 10 Myr) late-K and M dwarf stars observed in K2 Campaign 2 that host protoplanetary disks and exhibit quasi-periodic or aperiodic dimming events. Their optical light ...curves show ∼10-20 dips in flux over the 80-day observing campaign with durations of ∼0.5-2 days and depths of up to ∼40%. These stars are all members of the Ophiuchus (∼1 Myr) or Upper Scorpius (∼10 Myr) star-forming regions. To investigate the nature of these "dippers" we obtained: optical and near-infrared spectra to determine stellar properties and identify accretion signatures; adaptive optics imaging to search for close companions that could cause optical variations and/or influence disk evolution; and millimeter-wavelength observations to constrain disk dust and gas masses. The spectra reveal Li i absorption and H emission consistent with stellar youth (<50 Myr), but also accretion rates spanning those of classical and weak-line T Tauri stars. Infrared excesses are consistent with protoplanetary disks extending to within ∼10 stellar radii in most cases; however, the sub-millimeter observations imply disk masses that are an order of magnitude below those of typical protoplanetary disks. We find a positive correlation between dip depth and WISE-2 (Wide-field Infrared Survey Explorer-2) excess, which we interpret as evidence that the dipper phenomenon is related to occulting structures in the inner disk, although this is difficult to reconcile with the weakly accreting aperiodic dippers. We consider three mechanisms to explain the dipper phenomenon: inner disk warps near the co-rotation radius related to accretion; vortices at the inner disk edge produced by the Rossby Wave Instability; and clumps of circumstellar material related to planetesimal formation.
Purpose of Review
As the incidence of inflammatory bowel disease (IBD) rises, gastroenterologists are more commonly facing management of the disease in women of childbearing age. This coincides with ...the development of new IBD therapies whose use in pregnancy must be considered.
Recent Findings
This review provides updated recommendations for newer biologic agents and small molecules that have been approved for IBD treatment since the previous guidelines were published. In addition, recent research has found that prior IBD-related surgeries, not just ileal pouch-anal anastomosis, can impact pregnancy outcomes. Reassuringly, assisted reproductive technology for IBD patients has been found to have similar success rates to the non-IBD population.
Summary
Ensuring disease remission prior to conception and throughout pregnancy is key for optimizing pregnancy and fetal outcomes. As gastroenterologists play an integral role in the management of IBD throughout the peripartum period, this review summarizes recent studies in combination with existing guidelines to address preconception counseling, medication safety, and management for quiescent and active disease throughout pregnancy.
The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to review the available evidence and provide expert advice regarding the management of ...patients with an enteral stoma.
This CPU was commissioned and approved by the AGA Institute Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPU Committee and external peer review through standard procedures of Clinical Gastroenterology and Hepatology. This expert commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of a multidisciplinary group of authors composed of gastroenterologists, a colorectal surgeon, a wound ostomy and continence nurse, and ostomate.
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