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Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Psychosis: Goals of Pharmacotherapy01:26

Psychosis: Goals of Pharmacotherapy

Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...

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Related Experiment Videos

High-utilizing Crohn's disease patients under psychosomatic therapy.

Hans-Christian Deter1, Jörn von Wietersheim, Günther Jantschek

  • 1Department of Psychosomatics and Psychotherapy, Charité Campus Benjamin Franklin, Berlin, Germany. deter@charite.de

Biopsychosocial Medicine
|October 15, 2008
PubMed
Summary

Psychological treatment significantly reduced healthcare utilization in high-utilizing Crohn's disease (CD) patients. Depression and disease activity are key factors influencing CD outcomes and healthcare needs.

Related Experiment Videos

Area of Science:

  • Gastroenterology
  • Psychosomatic Medicine
  • Health Services Research

Background:

  • Limited research exists on healthcare utilization patterns in Crohn's disease (CD).
  • The impact of psychological interventions on high healthcare utilizers with CD remains underexplored.

Purpose of the Study:

  • To investigate the influence of Crohn's disease course on healthcare utilization (hospital days and sick leave days).
  • To examine the characteristics and outcomes of high-utilizing CD patients.
  • To evaluate the effect of psychological treatment on high utilizers compared to a control group.

Main Methods:

  • A sub-study of a prospective, multi-center investigation involving 87 Crohn's disease patients.
  • Collected data on hospital days (HD) and sick leave days (SLD) from German insurance companies.
  • Compared high healthcare utilizing patients receiving psychotherapy versus a control group over one year, alongside standardized somatic treatment.

Main Results:

  • Disease activity at randomization predicted the clinical course (r2 = 0.28).
  • Psychological factors (anxiety, depression, lack of control) predicted health-related quality of life (HRQL).
  • High utilizers receiving psychological treatment showed a significant reduction in HD and SLD compared to the control group.

Conclusions:

  • Both psychological and somatic factors influence the course of Crohn's disease, with depression being particularly significant.
  • Psychological treatment offers a significant benefit in reducing healthcare utilization for high-utilizing CD patients.
  • Further research is needed to confirm clinical outcomes in this specific CD subgroup.