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Crohn Disease: HELP
Articles by Sanja Kolaček
Based on 14 articles published since 2009
(Why 14 articles?)
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Between 2009 and 2019, S. Kolacek wrote the following 14 articles about Crohn Disease.
 
+ Citations + Abstracts
1 Guideline ECCO-ESCP Consensus on Surgery for Crohn's Disease. 2018

Bemelman, Willem A / Warusavitarne, Janindra / Sampietro, Gianluca M / Serclova, Zuzana / Zmora, Oded / Luglio, Gaetano / de Buck van Overstraeten, Anthony / Burke, John P / Buskens, Christianne J / Colombo, Francesco / Dias, Jorge Amil / Eliakim, Rami / Elosua, Tomás / Gecim, I Ethem / Kolacek, Sanja / Kierkus, Jaroslaw / Kolho, Kaija-Leena / Lefevre, Jérémie H / Millan, Monica / Panis, Yves / Pinkney, Thomas / Russell, Richard K / Shwaartz, Chaya / Vaizey, Carolynne / Yassin, Nuha / D'Hoore, André. ·Department of Surgery, Academic Medical Center [AMC], Amsterdam, The Netherlands. · Department of Surgery, St. Mark's Hospital, Harrow, UK. · Department of Surgery, ASST Fatebenefratelli Sacco - Ospedale "Luigi Sacco" Polo Universitario, Milan, Italy. · Department of Surgery, NH Hospital, a.s., Horovice, Czech Republic. · Department of Surgery, Sheba Medical Center, Tel Hashomer, Israel. · Surgical Coloproctology Unit, University of Naples Federico II, Naples, Italy. · Department of Abdominal Surgery, UZ Leuven, Campus Gasthuisberg, Leuven, Belgium. · Department of Colorectal Surgery, Beaumont Hospital, Dublin, Ireland. · Pediatric Gastroenterology Unit, Hospital S. João [University Hospital], Porto, Portugal. · Department of Gastroenterology and Hepatology, Sheba Medical Center, Tel Hashomer, Israel. · Servicio de Cirugía, Complejo Asistencial Universitario de León, León, Spain. · Colorectal Unit, Ankara University Medical School, Ankara, Turkey. · University Department of Paediatrics and Referral Center for Paediatric Gastroenterology & Nutrition, Children's Hospital Zagreb, Zagreb, Croatia. · Department of Gastroenterology, Hepatology, Feeding Disorders, and Pediatrics, Children's Memorial Health Institute, Warsaw, Poland. · Paediatric Gastroenterology of the Children's Hospital, University of Helsinki, Helsinki, Finland. · Department of General and Digestive Surgery, Hôpital Saint-Antoine and University Paris VI, Paris, France. · Department of Surgery, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain. · Department of Colorectal Surgery, Beaujon Hospital [APHP] and University Paris VII Denis-Diderot, Clichy, France. · Academic Department of Surgery, University of Birmingham, Birmingham, UK. · Department of Paediatric Gastroenterology, Royal Hospital for Children, Glasgow, UK. · Department of Surgery, Sheba Medical Center, Ramat Gan, Israel. · IBD Unit, University of Birmingham, Birmingham, St Mark's Hospital, London, UK. ·J Crohns Colitis · Pubmed #28498901.

ABSTRACT: -- No abstract --

2 Guideline Surgical Management of Crohn Disease in Children: Guidelines From the Paediatric IBD Porto Group of ESPGHAN. 2017

Amil-Dias, Jorge / Kolacek, Sanja / Turner, Dan / Pærregaard, Anders / Rintala, Risto / Afzal, Nadeem A / Karolewska-Bochenek, Katarzyna / Bronsky, Jiri / Chong, Sonny / Fell, John / Hojsak, Iva / Hugot, Jean-Pierre / Koletzko, Sibylle / Kumar, Devinder / Lazowska-Przeorek, Izabella / Lillehei, Craig / Lionetti, Paolo / Martin-de-Carpi, Javier / Pakarinen, Mikko / Ruemmele, Frank M / Shaoul, Ron / Spray, Christine / Staiano, Annamaria / Sugarman, Ian / Wilson, David C / Winter, Harland / Kolho, Kaija-Leena / Anonymous611001. ·*Department of Pediatrics, Centro Hospitalar, S. João, Porto, Portugal †Children's Hospital Zagreb, Faculty of Medicine, Zagreb, Croatia ‡The Juliet Keidan Institute of Pediatric Gastroenterology & Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel §Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Denmark ||Pediatric Surgery, Children's Hospital, University of Helsinki, Helsinki, Finland ¶Department of Pediatric Gastroenterology, University Hospital Southampton, Southampton, UK #Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland **Department of Pediatrics, University Hospital Motol, Prague, Czech Republic ††Queen Mary's Hospital for Children, Epsom and St Helier NHS Trust, Surrey ‡‡Chelsea and Westminster Hospital, London, UK §§Paris-Diderot Sorbonne-Paris-Cité University and Robert Debré Hospital, Paris, France ||||Pediatric Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital, Ludwig Maximilians-University, Munich, Germany ¶¶St George's, University of London, London, UK ##Boston Children's Hospital and Harvard Medical School, Boston, MA ***Department NEUROFARBA, University of Florence - Meyer Hospital, Florence, Italy †††Unit for the Comprehensive Care of Pediatric Inflammatory Bowel Disease, Hospital Sant Joan de Déu, Barcelona, Spain ‡‡‡Department of Pediatric Gastroenterology, Necker Enfants Malades University Hospital, Sorbonne Paris Cité University, Paris Descartes University, Institut IMAGINE - INSERM U1163, Paris, France §§§Pediatric Gastroenterology Institute, Ruth Children's Hospital, Rambam Medical Center, Haifa, Israel ||||||Department of Pediatric Gastroenterology, Bristol Royal Hospital for Children, Bristol, UK ¶¶¶Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II," Naples, Italy ###Department of Pediatric Surgery, Leeds Children's Hospital, Leeds General Infirmary, Leeds, UK ****Child Life and Health, University of Edinburgh, Scotland, UK ††††MassGeneral Hospital for Children, Harvard Medical School, Boston, MA ‡‡‡‡Children's Hospital, University of Helsinki, Helsinki, Finland. ·J Pediatr Gastroenterol Nutr · Pubmed #28267075.

ABSTRACT: The incidence of Crohn disease (CD) has been increasing and surgery needs to be contemplated in a substantial number of cases. The relevant advent of biological treatment has changed but not eliminated the need for surgery in many patients. Despite previous publications on the indications for surgery in CD, there was a need for a comprehensive review of existing evidence on the role of elective surgery and options in pediatric patients affected with CD. We present an expert opinion and critical review of the literature to provide evidence-based guidance to manage these patients. Indications, surgical options, risk factors, and medications in pre- and perioperative period are reviewed in the light of available evidence. Risks and benefits of surgical options are addressed. An algorithm is proposed for the management of postsurgery monitoring, timing for follow-up endoscopy, and treatment options.

3 Guideline Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease. 2014

Ruemmele, F M / Veres, G / Kolho, K L / Griffiths, A / Levine, A / Escher, J C / Amil Dias, J / Barabino, A / Braegger, C P / Bronsky, J / Buderus, S / Martín-de-Carpi, J / De Ridder, L / Fagerberg, U L / Hugot, J P / Kierkus, J / Kolacek, S / Koletzko, S / Lionetti, P / Miele, E / Navas López, V M / Paerregaard, A / Russell, R K / Serban, D E / Shaoul, R / Van Rheenen, P / Veereman, G / Weiss, B / Wilson, D / Dignass, A / Eliakim, A / Winter, H / Turner, D / Anonymous4720796 / Anonymous4730796. ·Department of Paediatric Gastroenterology, APHP Hôpital Necker Enfants Malades, 149 Rue de Sèvres 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 2 Rue de l'École de Médecine, 75006 Paris, France; INSERM U989, Institut IMAGINE, 24 Bd Montparnasse, 75015 Paris, France. Electronic address: frank.ruemmele@nck.aphp.fr. · Department of Paediatrics I, Semmelweis University, Bókay János str. 53, 1083 Budapest, Hungary. · Department of Gastroenterology, Helsinki University Hospital for Children and Adolescents, Stenbäckinkatu 11, P.O. Box 281, 00290 Helsinki, Finland. · Department of Paediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8 Toronto, ON, Canada. · Paediatric Gastroenterology and Nutrition Unit, Tel Aviv University, Edith Wolfson Medical Center, 62 HaLohamim Street, 58100 Holon, Israel. · Department of Paediatric Gastroenterology, Erasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, Netherlands. · Unit of Paediatric Gastroenterology, Hospital S. João, A Hernani Monteiro, 4202-451, Porto, Portugal. · Gastroenterology and Endoscopy Unit, Istituto G. Gaslini, Via G. Gaslini 5, 16148 Genoa, Italy. · Division of Gastroenterology and Nutrition, and Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland. · Department of Pediatrics, University Hospital Motol, Uvalu 84, 150 06 Prague, Czech Republic. · Department of Paediatrics, St. Marien Hospital, Robert-Koch-Str.1, 53115 Bonn, Germany. · Department of Paediatric Gastroenterolgoy, Hepatology and Nutrition, Hospital Sant Joan de Déu, Paseo Sant Joan de Déu 2, 08950 Barcelona, Spain. · Department of Pediatrics, Centre for Clinical Research, Entrance 29, Västmanland Hospital, 72189 Västerås/Karolinska Institutet, Stockholm, Sweden. · Department of Gastroenterology and Nutrition, Hopital Robert Debré, 48 Bd Sérurier, APHP, 75019 Paris, France; Université Paris-Diderot Sorbonne Paris-Cité, 75018 Paris France. · Department of Gastroenterology, Hepatology and Feeding Disorders, Instytut Pomnik Centrum Zdrowia Dziecka, Ul. Dzieci Polskich 20, 04-730 Warsaw, Poland. · Department of Paediatric Gastroenterology, Children's Hospital, University of Zagreb Medical School, Klaićeva 16, 10000 Zagreb, Croatia. · Department of Paediatric Gastroenterology, Dr. von Hauner Children's Hospital, Lindwurmstr. 4, 80337 Munich, Germany. · Department of Gastroenterology and Nutrition, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy. · Department of Translational Medical Science, Section of Paediatrics, University of Naples "Federico II", Via S. Pansini, 5, 80131 Naples, Italy. · Paediatric Gastroenterology and Nutrition Unit, Hospital Materno Infantil, Avda. Arroyo de los Ángeles s/n, 29009 Málaga, Spain. · Department of Paediatrics 460, Hvidovre University Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark. · Department of Paediatric Gastroenterology, Yorkhill Hospital, Dalnair Street, Glasgow G3 8SJ, United Kingdom. · 2nd Department of Paediatrics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Emergency Children's Hospital, Crisan nr. 5, 400177 Cluj-Napoca, Romania. · Department of Pediatric Gastroenterology and Nutrition, Rambam Health Care Campus Rappaport Faculty Of Medicine, 6 Ha'alya Street, P.O. Box 9602, 31096 Haifa, Israel. · Department of Paediatric Gastroenterology, Hepatology and Nutrition, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, Netherlands. · Department of Paediatric Gastroenterology and Nutrition, Children's University Hospital, Laarbeeklaan 101, 1090 Brussels, Belgium. · Paediatric Gastroenterology and Nutrition Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52625 Tel Hashomer, Israel. · Child Life and Health, Paediatric Gastroenterology, Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh EH9 1LF, United Kingdom. · Department of Medicine I, Agaplesion Markus Hospital, Wilhelm-Epstein-Str. 4, 60431 Frankfurt/Main, Gemany. · 33-Gastroenterology, Sheba Medical Center, 52621 Tel Hashomer, Israel. · Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Mass General Hospital for Children, 175 Cambridge Street, 02114 Boston, United States. · Pediatric Gastroenterology Unit, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel. ·J Crohns Colitis · Pubmed #24909831.

ABSTRACT: Children and adolescents with Crohn's disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric-onset CD. To develop the first evidenced based and consensus driven guidelines for pediatric-onset CD an expert panel of 33 IBD specialists was formed after an open call within the European Crohn's and Colitis Organisation and the European Society of Pediatric Gastroenterolog, Hepatology and Nutrition. The aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children and adolescents who did not have finished their growth, exclusive enteral nutrition (EEN) is the induction therapy of first choice due to its excellent safety profile, preferable over corticosteroids, which are equipotential to induce remission. The majority of patients with pediatric-onset CD require immunomodulator based maintenance therapy. The experts discuss several factors potentially predictive for poor disease outcome (such as severe perianal fistulizing disease, severe stricturing/penetrating disease, severe growth retardation, panenteric disease, persistent severe disease despite adequate induction therapy), which may incite to an anti-TNF-based top down approach. These guidelines are intended to give practical (whenever possible evidence-based) answers to (pediatric) gastroenterologists who take care of children and adolescents with CD; they are not meant to be a rule or legal standard, since many different clinical scenario exist requiring treatment strategies not covered by or different from these guidelines.

4 Clinical Trial The IMPACT-III (HR) questionnaire: a valid measure of health-related quality of life in Croatian children with inflammatory bowel disease. 2013

Abdovic, Slaven / Mocic Pavic, Ana / Milosevic, Milan / Persic, Mladen / Senecic-Cala, Irena / Kolacek, Sanja. ·Referral Center for Pediatric Gastroenterology and Nutrition, University Children's Hospital Zagreb, Zagreb Medical School, Croatia. Electronic address: sabdovic@mef.hr. ·J Crohns Colitis · Pubmed #23333037.

ABSTRACT: BACKGROUND AND AIMS: To assess the reliability and validity of IMPACT-III (HR), a disease-specific, health-related quality of life instrument in Croatian children with inflammatory bowel disease. METHODS: In a multicenter study, 104 children participated in a validation study of IMPACT-III (HR) cross-culturally adapted for Croatia. Factor analysis was used to determine optimal domain structure for this cohort, analysis of Cronbach's alpha coefficients to test internal reliability, ANOVA to assess discriminant validity, and correlation with Pediatric Quality of Life Inventory, Version 4.0 (PedsQL) using Pearson correlation coefficients to assess concurrent validity. RESULTS: Cronbach's alpha for the IMPACT-III (HR) total score was 0.92. The most robust factor solution was a 5-domain structure: Symptoms, Concerns, Socializing, Body Image, and Worry about Stool, all of which demonstrated good internal reliability (α=0.60-0.89), but two items were dropped to achieve this. Discriminant validity was demonstrated by significant differences (P<0.001) in mean IMPACT-III (HR) scores between quiescent and mild or moderate-severe disease activity groups for total (148 vs. 139 or 125) and following factor scores: Symptoms (84 vs. 71 or 61), Socializing (91 vs. 83 or 76), and Worry about Stool (significant only between quiescent and moderate-severe groups, 90 vs. 62, respectively). Concurrent validity of IMPACT-III (HR) with PedsQL showed significant correlation, which was strongest when similar domains were compared. CONCLUSION: IMPACT-III (HR) appears to be useful tool to measure health-related quality of life in Croatian children with Crohn's disease and ulcerative colitis.

5 Clinical Trial Disease phenotype at diagnosis in pediatric Crohn's disease: 5-year analyses of the EUROKIDS Registry. 2013

de Bie, Charlotte I / Paerregaard, Anders / Kolacek, Sanja / Ruemmele, Frank M / Koletzko, Sibylle / Fell, John M E / Escher, Johanna C / Anonymous4590725. ·Department of Pediatric Gastroenterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. ·Inflamm Bowel Dis · Pubmed #22573581.

ABSTRACT: BACKGROUND: It has been speculated that pediatric Crohn's disease (CD) is a distinct disease entity, with probably different disease subtypes. We therefore aimed to accurately phenotype newly diagnosed pediatric CD by using the pediatric modification of the Montreal classification, the Paris classification. METHODS: Information was collected from the EUROKIDS registry, a prospective, web-based registry of new-onset pediatric IBD patients in 17 European countries and Israel. When a complete diagnostic workup was performed (ileocolonoscopy, upper gastrointestinal [GI] endoscopy, small bowel imaging), CD patients were evaluated for ileocolonic disease extent, esophagogastroduodenal involvement, and jejunal/proximal ileal involvement. Disease behavior and the occurrence of granulomas were also analyzed. RESULTS: In all, 582 pediatric CD patients could be classified according to the Paris classification. Isolated terminal ileal disease (± limited cecal disease) was seen at presentation in 16%, isolated colonic disease in 27%, ileocolonic disease in 53%, and isolated upper GI disease in 4% of patients. In total, 30% had esophagogastroduodenal involvement and 24% jejunal/proximal ileal disease. Patients with L2 disease were less likely to have esophagogastroduodenal involvement or stricturing disease than patients with L1 or L3 disease. Terminal ileal disease and stricturing disease behavior were more common in children diagnosed after 10 years of age than in younger patients. Granulomas were identified in 43% of patients. CONCLUSIONS: Accurate phenotyping is essential in pediatric CD, as this affects the management of individual patients. Disease phenotypes differ according to age at disease onset. The Paris classification is a useful tool to capture the variety of phenotypic characteristics of pediatric CD.

6 Article Development and Validation of Diagnostic Criteria for IBD Subtypes Including IBD-unclassified in Children: a Multicentre Study From the Pediatric IBD Porto Group of ESPGHAN. 2017

Birimberg-Schwartz, Liron / Zucker, David M / Akriv, Amichay / Cucchiara, Salvatore / Cameron, Fiona L / Wilson, David C / Lazowska, Iza / Yianni, Lambri / Paul, Siba Prosad / Romano, Claudio / Kolacek, Sanja / Buderus, Stephan / Pærregaard, Anders / Russell, Richard K / Escher, Johanna C / Turner, Dan / Anonymous960904. ·Institute of Pediatric Gastroenterology, Shaare Zedek Medical Centre, Jerusalem, Israel. · Department of Statistics, Hebrew University of Jerusalem, Jerusalem, Israel. · Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy. · Child Life and Health, University of Edinburgh and Royal Hospital for Children, Edinburgh, UK. · Paediatric Gastroenterology Unit, Medical University of Warsaw, Warsaw, Poland. · University Hospital Southampton NHS Foundation Trust, Child Health, Southampton,UK. · Paediatric Gastroenterology, Bristol Royal Hospital for Children,Bristol, UK. · Pediatric Gastroenterology and Endoscopy, University of Messina, Messina, Italy. · Paediatric Gastroenterology Unit, Children's Hospital Zagreb, University Medical School, Zagreb, Croatia. · St.-Marien-Hospital, Department of Pediatrics, Bonn, Germany. · Department of Paediatrics, Hvidovre University Hospital, Copenhagen, Denmark. · Paediatric Gastroenterology Unit, Royal Hospital for Children, Glasgow, UK. · Pediatric Gastroenterology, Erasmus MC-Sophia, Rotterdam, The Netherlands. ·J Crohns Colitis · Pubmed #28430891.

ABSTRACT: Background: The revised Porto criteria identify subtypes of paediatric inflammatory bowel diseases: ulcerative colitis [UC], atypical UC, inflammatory bowel disease unclassified [IBDU], and Crohn's disease [CD]. Others have proposed another subclassifiction of Crohn's colitis. In continuation of the Porto criteria, we aimed to derive and validate criteria, termed "PIBD-classes," for standardising the classification of the different IBD subtypes. Methods: This was a multicentre retrospective longitudinal study from 23 centres affiliated with the Port -group of ESPGHAN. Both a hypothesis-driven judgmental approach and mathematical classification and regression tree [CART] modelling were used for creating a diagnostic algorithm. Since small bowel inflammation is easily recognised as CD, we focused here primarily on the phenotype of colitis. Results: In all, 749 IBD children were enrolled: 236 [32%] Crohn's colitis, 272 [36%] UC and 241 [32%] IBDU [age 10.9 ± 3.6 years] with a median follow-up of 2.8 years (interquartile range [IQR] 1.7-4.3). A total of 23 features were clustered in three classes according to their prevalence in UC: six class-1 features [0% prevalence in UC], 12 class-2 features [< 5% prevalence], and five class-3 features [5-10% prevalence]. According to the algorithm, the disease should be classified as UC if no features exist in any of the classes. When at least one feature exists, different combinations classify the disease into atypical UC, IBDU or CD. The algorithm differentiated UC from CD and IBDU with 80% sensitivity (95% confidence interval [CI] 71-88%) and 84% specificity [77-89%], and CD from IBDU and UC with 78% sensitivity [67-87%] and 94% specificity [89-97%]. Conclusions: The validated PIBD-classes algorithm can adequately classify children with IBD into small bowel CD, colonic CD, IBDU, atypical UC, and UC.

7 Article Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease--a multicenter European study. 2015

Hojsak, Iva / Kolacek, Sanja / Hansen, Lars Folmer / Bronsky, Jiri / Piekkala, Maija / Lionetti, Paolo / Skaba, Richard / Kolho, Kaija-Leena. ·Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia. Electronic address: ivahojsak@gmail.com. · Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia. · Hvidovre University Hospital, Copenhagen, Denmark. · Department of Paediatrics, University Hospital Motol, Prague, Czech Republic. · Children's Hospital, University of Helsinki, Helsinki, Finland. · Ospedale pediatrico Meyer, Florence, Italy. · Department of Paediatric Surgery, University Hospital Motol, Prague, Czech Republic. ·J Pediatr Surg · Pubmed #25913894.

ABSTRACT: PURPOSE: The aim of this study was to investigate the therapeutic role of an elective ileocecal resection in children with active localized Crohn's disease. METHODS: This was a retrospective multicenter study which included five European referral centers which included all children with Crohn's disease who underwent ileocecal surgery from 2000 to 2011 and had a minimum of 12 months follow-up. RESULTS: Altogether 68 patients fulfilled inclusion criteria. Median age at diagnosis was 13.7 years (6.6-17.9 years) and at surgery 15.2 years (8.6-18.5 years). Median duration of postoperative clinical remission was 20 months (3-95 months). Overall 54 patients (79.4%) were in remission one year after surgery and 38 (55.9%) during the total postsurgical follow up (median 30 months; range 12-95 months). Z score height for age significantly improved postoperatively in children who were at the time of surgery younger than 16 years of age (mean difference 0.232 SD; p=0.029). Cox proportional hazard regression model failed to indicate risk factors associated with postsurgical relapse. CONCLUSION: Elective ileocecal resection is a valid treatment option which should be considered in a subset of pediatric patients with localized Crohn's disease with the aim of achieving clinical remission and to improve growth.

8 Article Methotrexate is an efficient therapeutic alternative in children with thiopurine-resistant Crohn's disease. 2015

Hojsak, Iva / Mišak, Zrinjka / Jadrešin, Oleg / Močić Pavić, Ana / Kolaček, Sanja. ·Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, University of Zagreb Medical School , Zagreb , Croatia. ·Scand J Gastroenterol · Pubmed #25877164.

ABSTRACT: OBJECTIVE: This study aimed to investigate the role of methotrexate (MTX) in the maintenance of clinical remission and mucosal healing in children with Crohn's disease (CD), in whom azathioprine (AZA) treatment failed. MATERIALS AND METHODS: This was a retrospective, longitudinal cohort study which included all children who were diagnosed with CD during a period of 10 years and who received MTX for ≥12 months after failed AZA treatment. Remission was assessed clinically, defined by Pediatric Crohn's Disease Activity Index as a score of ≤10 and no need for the reintroduction of the remission induction therapy. In the subset of patients with sustained clinical remission, the rate of mucosal healing was endoscopically assessed. Endoscopic lesions were assessed by Simple Endoscopic Score for CD. Each patient served as his or her own historical control. RESULTS: Of the 32 included patients, 22 (68.7%) remained in the stable clinical remission after a period of 12 months and 14 (43.8%) did not experience relapse during the whole follow up (median duration 2.9 years; range 1-4.8 years). From all patients who were in clinical remission during the entire follow up (n = 14), endoscopy was performed in eight (57%) patients and showed complete mucosal healing macroscopically (Simple Endoscopic Score for CD score of 0) and microscopically in seven out of eight (87.5%) patients. CONCLUSION: MTX was found to be an efficient therapeutic alternative in the thiopurine-resistant patients, enabling the complete mucosal healing.

9 Article Risk factors for relapse and surgery rate in children with Crohn's disease. 2014

Hojsak, Iva / Pavić, Ana Močić / Mišak, Zrinjka / Kolaček, Sanja. ·Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, School of Medicine, University of Zagreb, Klaićeva 16, Zagreb, Croatia, ivahojsak@gmail.com. ·Eur J Pediatr · Pubmed #24310524.

ABSTRACT: CONCLUSION: This study underlines the importance of early EEN in the treatment of CD; it is not only efficacious in the remission induction but could also prevent relapse in the first year.

10 Article [Role of anti-TNF therapy (biologics) in the treatment of chronic inflammatory bowel disease in children]. 2013

Kolacek, Sanja. ·Referentni centar za djecju gastroenterologiju i poremećaje prehrane, Klinika za djedje bolesti Zagreb, Medicinskifakultet Sveucilista u Zagrebu, Zagreb, Hrvatska. sanja.kolacek@gmail.com ·Acta Med Croatica · Pubmed #24471292.

ABSTRACT: Inflammatory bowel disease (IBD) is diagnosed already during childhood or adolescence in every fourth patient. Compared to adult population, whereby recent studies show a tendency towards stabilization, incidence rates for children continue to rise. Though many features are shared with adult onset disease, paediatric ulcerative colitis and Crohn's Disease are, both, more aggressive and extensive already at diagnosis, with disease behaviour that changes with time. Therapeutic approaches, therefore, have to be adapted to specific needs of paediatric population. Aim of the article was to formulate guidelines on the role of biologic therapy in the treatment of paediatric onset inflammatory bowel disease, namely on the use of anti-TNF agent infliximab as it is the only biologic drug registrated for use in children with IBD. Recommendations are based on systematic review of the evidence in paediatric patients whenever it was available. However, due to lack of good randomised studies, adult practice was also taken into consideration. Finally, recommendations were dis-cussed on the consensus conference of all experts participating in the development of guidelines for adult and paediatric pa-tients.The recommendations are developed for Crohn's Disease and for Ulcerative Colitis, separately with respect to remission induction and for relapse prevention. Level of evidence is stated and following this procedure, recommendations are graded. Practice points are also provided with the aim to guide clinicians on the ward how to use biologics in the clinical practice. Com-plications of the treatment that are specific for children with inflammatory bowel disease are also addressed. These guidelines and practice points provide a structured guide for the use of anti-TNF therapy in the treatment of Crohn's Disease and Ulcerative Colitis in paediatric patients.

11 Article Chromosomal aberrations in peripheral blood lymphocytes in patients with newly diagnosed celiac and Crohn's disease. 2013

Hojsak, Iva / Gagro, Alenka / Petković, Iskra / Mišak, Zrinjka / Kolaček, Sanja. ·Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia. ivahojsak@gmail.com ·Eur J Gastroenterol Hepatol · Pubmed #23022983.

ABSTRACT: OBJECTIVES: The aims of this research were to determine the number of chromosomal aberrations in peripheral blood lymphocytes and to evaluate the number of circulating lymphocytes with CD103, integrin expressed on intraepithelial lymphocytes and preserved in enteropathy-associated T-cell lymphoma, in patients with newly diagnosed Crohn's disease, celiac disease, and healthy controls. METHODS: During the period of 30 months, we included 44 patients. Chromosome aberrations were analyzed in peripheral blood lymphocytes by a single cytogeneticist. Multicolor flow cytometric was used for immunophenotyping of peripheral blood lymphocytes. RESULTS: We found a significantly higher number of chromosomal aberrations/100 metaphases in the celiac and Crohn's disease group compared with the controls (P=0.01) and they also had a significantly higher number of aberrant cells compared with the controls (P<0.001). There was no statistically significant difference between the groups with respect to the percentage of CD103+ and CD8+CD103+ cells between groups (P=0.16 and 0.41, respectively) and no correlation between the total number of chromosomal aberrations and the percentage of CD103+ and CD8+CD103+ cells (P=0.06 and 0.06, respectively). CONCLUSION: Patients with active celiac and newly diagnosed Crohn's disease, before treatment initiation, have a significantly increased number of chromosomal aberrations in peripheral blood lymphocytes. No dissemination of intraepithelial cells in the blood and correlation to the chromosomal aberration was found.

12 Article Incidence of Clostridium difficile infection in children with inflammatory bowel disease compared to oncology and immunocompetent patients. 2012

Hojsak, Iva / Ferenc, Tea / Bojanić, Katarina / Mišak, Zrinjka / Močić Pavić, Ana / Lukić-Grlić, Amarela / Kolaček, Sanja. ·Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, University Hospital Center Sisters of Mercy, Zagreb, Croatia. ivahojsak@gmail.com ·Digestion · Pubmed #22688504.

ABSTRACT: AIMS: The aim of this study was to determine the incidence of Clostridium difficile infection in hospitalized children with inflammatory bowel disease (IBD) and to compare it to other immunosuppressed patients at risk (oncology patients) as well as to immunocompetent patients. METHODS: We analyzed data from all hospitalized children who underwent stool detection of C. difficile toxins A and B (n = 757) in a 5.5-year study period. RESULTS: The number of positive tests was significantly increased in the oncology group compared to the IBD group (12.45 vs. 6.02%, p = 0.03) and immunocompetent group (12.45 vs. 5.7%, p = 0.01). Patients who had C. difficile infection used antibiotics prior to the test more often than patients who did not (12.69 vs. 1.73%, p = 0.03). Pearson's correlation was positive for C. difficile infection and both antibiotics and immunosuppressants, while no correlation was found regarding age and gender. There were no significant differences regarding either IBD diagnosis (Crohn's disease vs. ulcerative colitis, p = 0.71) or treatment used for IBD (p = 0.53) and C. difficile infection. CONCLUSION: In our setting, the incidence of C. difficile infection among hospitalized children with active IBD was found to be low. Children at increased risk for C. difficile infection were oncology patients receiving immunosuppressants and antibiotics.

13 Article European evidenced-based consensus on reproduction in inflammatory bowel disease. 2010

van der Woude, C Janneke / Kolacek, Sanja / Dotan, Iris / Oresland, Tom / Vermeire, Séverine / Munkholm, Pia / Mahadevan, Uma / Mackillop, Lucy / Dignass, Axel / Anonymous3480680. ·Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands. c.vanderwoude@erasmusmc.nl ·J Crohns Colitis · Pubmed #21122553.

ABSTRACT: -- No abstract --

14 Article [Croatian guidelines for use of enteral nutrition in Crohn's disease]. 2010

Krznarić, Zeljko / Kolacek, Sanja / Bender, Darija Vranesić / Kelecić, Dina Ljubas / Cuković-Cavka, Silvija / Sincić, Brankica Mijandrusić / Banić, Marko / Borzan, Vladimir / Simunić, Miroslav / Persić, Mladen / Stimac, Davor / Vucelić, Boris. ·zeljko.krznaric1@zg.t-com.hr ·Lijec Vjesn · Pubmed #20359151.

ABSTRACT: Nutrition has an important role in the management of inflammatory bowel disease (IBD), especially in patients with Crohn's disease (CD). This role includes the prevention and correction of malnutrition, the prevention of osteoporosis and the promotion of optimal growth and development in children. In active Crohn's disease, nutritional therapy (in the form of enteral feeding) is an effective primary therapy for pediatric patients. Studies have shown that there is no difference in the efficacy of elemental, oligomeric and polymeric enteral formulas. Therefore, the use of polymeric formula is recommended because of higher palatability, better acceptance by patients, lower rate of complications and lower cost when compared with other enteral formulas. Today we have knowledge that some nutrients which are added to modified special enteral formulas have almost pharmacological terapeutic potential in the management of inflammatory bowel disease. Novel nutritional therapeutic strategies for inflammatory bowel disease, such as transforming growth factor-beta-enriched (TGF-beta2) enteral feeding, showed beneficial effects in several clinical studies. Croatian guidelines for enteral nutrition in Crohn's disease have been developed by interdisciplinary expert group of Croatian clinicians involved with inflammatory bowel disease. The guidelines are based on evidence from relevant medical literature and clinical experience of working group.