As doenças inflamatórias intestinais (DII) - doença de Crohn e retocolite ulcerativa, são condições crônicas que, na maioria dos casos, exigem controle com terapia medicamentosa. A atenção farmacêutica (AF), definida como a provisão responsável do tratamento farmacológico, com o propósito de alcançar resultados concretos que melhorem a qualidade de vida do paciente, constitui nova forma de cuidado ao paciente, que necessita ser mais extensivamente avaliada. Este estudo teve o objetivo de avaliar a contribuição da atenção farmacêutica ao tratamento clínico de pacientes com DII em acompanhamento ambulatorial em hospital terciário. Ao longo de um ano, foi avaliado um grupo que recebeu a atenção farmacêutica (GAF; N=18) e um grupo controle (GC; N=17) não submetido aos procedimentos da AF. Os resultados da contribuição da AF foram avaliados pela comparação de diferentes variáveis entre os grupos, que foram obtidas na primeira entrevista - T(0), aos seis - T(6) e 12 - T(12) meses do estudo. Quanto aos aspectos clínicos, houve redução significativa dos índices de atividade clínica de T(6) para T(12) no GAF (mediana; variação: 2,20; 0,99 3,77 versus 1,90; 0,99 3,77; p=0,02), o que não ocorreu no GC (1,69; 0,99 3,77 versus 1,69; 0,99 3,48). No GAF, houve aumento significativo do percentual de pacientes mais aderentes ao tratamento medicamentoso (27,8% versus 72,2%; p<0,05), quando da avaliação por meio do teste de Morisky, mas não foram observadas diferenças (72,2% versus 88,9%) na adesão avaliada pelo cotejo entre medicamentos utilizados e prescrições registradas. Em ambas as formas de avaliação da adesão, tanto pelo teste de Morisky (41,2% versus 41,2%), quanto pelo confronto das medicações utilizadas e prescrições registradas (88,2% versus 82,4%), não foram observadas alterações no GC. Houve aumento significativo dos índices de conhecimento do paciente sobre o tratamento no GAF entre T(0) e T(12) (mediana; variação: 80%; 40% 100% versus 100%; 100% 100%; p0,0001), o que não ocorreu no GC (80%; 0 100% versus 80%; 60% 100%). No que se refere à qualidade de vida, avaliada pelo instrumento SF36, houve diferenças estatisticamente significativas nos dois grupos apenas no domínio de saúde mental. No GAF, houve elevação dos escores deste domínio entre T(0) e T(12) (54,0 versus 66,0; p=0,04), o que, também ocorreu no GC (60,0 versus 68,0; p=0,01). Porém, no GAF, esta mudança ocorreu mais precocemente, de T(0) para T(6) (54,0 versus 66,0; p<0,01). A AF possibilitou a identificação, em média, de 3,8 problemas relacionados ao medicamento por paciente, que em sua maioria foram resolvidos, com intervenções predominantemente focadas em orientações aos pacientes. Os pacientes do GAF, ao término do estudo, apresentaram alto grau de satisfação com a AF. Os resultados obtidos permitem concluir que a introdução de um programa de atenção farmacêutica a pacientes ambulatoriais com DII seguidos em hospital terciário trouxe contribuição positiva, proporcionando benefícios mensuráveis aos pacientes. / Inflammatory bowel diseases (IBD) Crohns disease and ulcerative colitis are chronic conditions which are usually controlled with drug therapy. Pharmaceutical care (PC), defined as the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve patients quality of life, is a new patient care modality, which needs to be more extensively evaluated. This study aimed at assessing the contribution of pharmaceutical care to the clinical treatment of outpatients with IBD assisted at a reference hospital. During one year, a group receiving pharmaceutical care (PCG; N=18) and a control group (CG; N=17), which did not undergo PC procedures, were evaluated. Results of PC contribution were assessed by comparing the two groups regarding different variables obtained in the first interview at - T(0), at six - T(6) and 12 - T(12) months of study. Regarding the clinical aspects, there was a significant decrease of clinical activity indexes from T(6) to T(12) in the PCG (median; range: 2.20; 0.99 3.77 versus 1.90; 0.99 3.77; p=0.22), but not in the CG (1.69; 0.99 3.77 versus 1.69; 0.99 3.48). In the PCG, there was a significant increase in the percentage of patients who were more compliant to drug treatment (27.8 % versus 72.2 %; p<0.05) as assessed using the Morisky scale; however, no differences in compliance rates were observed (72.2 % versus 88.9 %) by comparing drugs taken with registered prescriptions. In the CG, no differences were observed in none of the compliance assessment methods, neither by the Morisky scale (41.2% versus 41.2%), nor by comparing drugs taken with registered prescriptions (88.2% versus 81.2%). There was a significant increase in the values of an index for patients knowledge about the treatment in the PCG between T(0) and T(12) (median; range: 80%; 40 100 versus 100%; 100 100; p0,0001), but not in the CG (80%; 0 100 versus 80%; 60 100). With respect to quality of life, assessed by the SF36 scale, there were statistically significant differences in both groups only in the mental health domain. There was an increase in scores for this domain between T(0) and T(12) in both PCG (54.0 versus 66.0; p=0,04), and CG (60.0 versus 68.0; p=0,01). However, PCG had this increasing scores earlier, between T(0) and T(12) (54.0 versus 74.0; p<0,01). PC enabled the identification of a number of drug-related problems per patient (mean = 3.8), which were mostly solved by interventions predominantly focused on patient orientation. At the end of the study, patients in the PC group showed a high degree of satisfaction with the intervention. The achieved results allow concluding that the implementation of a pharmaceutical care program to outpatients with IBD followed at a tertiary hospital gave a positive contribution, providing measurable benefits to patients.

A adesão ao tratamento medicamentoso é um importante fator determinante no sucesso terapêutico. A adesão do paciente pode ser influenciada por fatores diversos, ligados à doença, ao tratamento, ao paciente, às condições sociais e econômicas, como também, relacionada ao sistema de saúde que o atende. Ainda que existam inúmeros estudos sobre a adesão ao tratamento em portadores com doenças crônicas, são escassas as investigações sobre este tema nas doenças inflamatórias intestinais. O presente trabalho teve o objetivo de avaliar a adesão ao tratamento medicamentoso e os possíveis fatores que a influenciam, em pacientes portadores de doenças inflamatórias intestinais (DII): doença de Crohn (DC) e retocolite ulcerativa (RCU), do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP), da Universidade de São Paulo. Como controles, foram investigados pacientes portadores de pancreatite crônica e insuficiência pancreática (PC), com medicação fornecida pelo hospital, tal como os pacientes portadores de DII. Foram também investigados pacientes portadores de afecções digestivas variadas (ADV), grupo no qual a medicação prescrita não era fornecida pelo hospital. Por meio de estudo transversal e indireto, foi realizada entrevista estruturada para avaliar a adesão de 110 pacientes, que foram caracterizados como apresentando maior ou menor grau de adesão. Esta classificação foi baseada no cotejo entre os dados do prontuário e os informados pelo paciente em entrevista, considerando a afirmação do paciente que usava a medicação e que conhecia o nome da droga em uso. Utilizou-se, também, o teste de Morisky, que permite avaliar o padrão de comportamento do paciente em relação ao uso diário do medicamento. Este teste consiste de quatro perguntas padronizadas relacionadas ao esquecimento, descuido com o horário de tomada do medicamento, percepção de efeitos colaterais e ausência de sintomas. Na análise dos medicamentos utilizados pelo paciente, foram observadas as seguintes proporções de pacientes classificados como menos aderentes: 15,4% em pacientes portadores de DC, 13,3% na RCU, 8,4% na PC e 16,6% nos pacientes do grupo ADV. Porém, o teste de Morisky mostrou as seguintes proporções de menos aderentes: 50% de pacientes portadores de DC, 63,3% na RCU, 54,2% na PC e 63,4% na ADV. Não houve diferenças estatisticamente significativas, entre os grupos de pacientes, tanto na análise dos medicamentos utilizados pelo paciente como pelos resultados do teste de Morisky. Em análise univariada, nenhum dos fatores demográficos, sociais, clínicos ou referentes ao tratamento medicamentoso apresentou relação estatisticamente significativa, comum a todos os grupos, que indicasse influência sobre a adesão ao tratamento. Apesar do alto grau de adesão, de acordo com a análise dos medicamentos utilizados, detectou-se alto percentual de não-adesão ao tratamento medicamentoso ligado ao comportamento habitual e independente do diagnóstico, ou do acesso gratuito aos medicamentos. Isto pode indicar a existência de um padrão específico de comportamento dos usuários do serviço, o que sugere a necessidade de maior atenção dos profissionais de saúde para o problema, bem como medidas de educação do paciente quanto ao uso dos medicamentos. / Compliance to drug therapy is an important factor determining a successful treatment. Patient compliance may be influenced by various factors related to the disease, to treatment, to the patient himself, to his socioeconomic condition, as well as to the health system. Although many studies have assessed compliance to treatment in patients with chronic diseases, few investigations are available in inflammatory bowel diseases (IBD). The objective of the present study was to assess compliance to drug therapy in patients with IBD - Crohn’s disease (CD) and ulcerative colitis (UC), seen at the University Hospital, Faculty of Medicine of Ribeirão Preto (HCFMRP), University of São Paulo, Brazil. Patients with chronic pancreatitis (CP) and pancreatic insufficiency who received free medication supplied by the hospital, like the IBD patients, were used as controls. Patients with various digestive affections (VDA) whose prescribed medication was not supplied by the hospital were also investigated. In a transverse and indirect study, a structured interview was applied to assess the compliance of 110 patients, who were characterized as presenting a higher or lower degree of compliance. This classification was based on a comparison of data in the medical records to the information provided by the patient in the interview, considering the patient’s statements that he/she actually used the medication and was capable of produce correctly its name. The Morisky test was also used to assess the behavioral pattern of the patient regarding the daily use of the medication. This test consists of four standardized questions that evaluate forgetfulness, carelessness regarding the time when the medication should be taken, the perception of side effects, and the absence of symptoms. In the analysis of patient statements on medication in use, the proportions of patients regarded as less compliant were as follows: 15.4% of patients with CD, 13.3% of those with UC, 8.4% of those with CP, and 16.6% of those with VDA. However, the Morisky test revealed the following proportions of less compliant patients: 50% of patients with CD, 63.3% of those with UC, 54.2% of those with CP, and 63.4% of those with VDA. No statistically significant differences were observed between the four groups regarding evaluation according to either the analysis of patient statements or the results of the Morisky test. Univariate analysis revealed that none of the demographic, social, or clinical factors or the variables related to drug therapy showed statistically significant relationships, common to all groups, that would indicate their influence on compliance to treatment. Despite the high degree of compliance evaluated by patient statements on medication in use, a high degree of noncompliance to treatment linked to habitual behavior was detected. Those findings were independent on either disease type or free access to medication. This may indicate the existence of a specific behavioral pattern common to the local health system users, which suggests the need for better consideration of the problem on the part of the health professionals, as well as the need for measures of patient education regarding medication use.

This thesis describes studies in patients with inflammatory bowel disease (IBD) and collagenous colitis (CC). We investigated mucosal eosinophil and neutrophil granulocytes and T-cells involved in the inflammatory processes and aimed at determining whether these processes are reflected in the faecal (F) contents of specific proteins secreted by cells in the intestinal mucosa. Thus, we measured eosinophil cationic protein (ECP) and eosinophil protein X (EPX) and the neutrophil derived myeloperoxidase (MPO) and calprotectin (C); and in addition, chromogranin A (CgA), Chromogranin B (CgB) and secretoneurin (SN), derived from EEC cells and cells in the enteric nervous system. We found that a normalised FC level can serve as a surrogate marker for successful treatment in patients with IBD, but persistently high FC levels need further evaluation (study I). Furthermore, FC and F-MPO appear to relate better than F-EPX to treatment outcome in IBD. We evaluated F-ECP, F-EPX, F-MPO and FC as markers of disease activity and treatment outcome in patients with CC (study III) and concluded that F-ECP was the best discriminator of detecting active CC. Normalised F-ECP and F-EPX could serve as markers of successful treatment. We showed that the inflammation in CC is characterised by activated eosinophils, but that there is no neutrophil activity (study II). T-cells have a lower grade of activity in active CC than in control subjects. During budesonide treatment the normal activation of eosinophils and T-cells is restored, with concomitant clinical remission. The findings in studies II and III indicate that the eosinophils have an essential role in the pathophysiology of CC. Markedly higher values of F-CgA, F-CgB and F-SN were found in patients with CC than in those with IBD and controls (study IV) indicating a crucial role for the intestinal neuro-endocrine system in the pathogenesis of collagenous colitis.

Hintergrund: Angaben zu Inzidenz und Prävalenz von chronisch entzündlichen Darmerkrankungen (CED) bei Kindern und Jugendlichen in Deutschland fehlen bisher, die Daten des im Jahr 2000 gegründeten Sächsischen CED-Registers für Kinder und Jugendliche wurden bisher nicht veröffentlicht. Bei internen Diskussionen der Registerdaten zeigte sich stets eine nicht erklärbare abfallende altersspezifische Inzidenz der CED ab dem 15. Lebensjahr. Es wurde vermutet, dass einige ältere Jugendliche ausschließlich von Erwachsenengastroenterologen betreut wurden und bei einigen Adoleszenten eine längere diagnostische Latenz zur Diagnosestellung nach dem 18. Lebensjahr führte. Patienten und Methoden: Zur Prüfung der Thesen wurden alle gastroenterologisch tätigen Internisten in Leipzig aufgesucht und Patienten eingeschlossen, bei denen bis zum 26. Lebensjahr in den Jahren 2005-2009 eine CED endoskopisch neu diagnostiziert wurde. Die Auswertung des Sächsischen CED-Registers erfolgte hinsichtlich Inzidenz, Prävalenz, Geschlechterverteilung und diagnostischer Latenz im Zehnjahreszeitraum 2000-2009. Ergebnisse: Es wurden tatsächlich einige Jugendliche vor dem 18. Lebensjahr ausschließlich von Internisten betreut und nicht an das Register gemeldet. Die korrigierte Inzidenz von CED bei Patienten bis zum 18. Lebensjahr in Leipzig lag um 37 % höher als im Register angegeben. Nach dem 15. Lebensjahr wurde – ebenfalls in Abweichung zu den Registerdaten – ein kontinuierlicher Anstieg der altersspezifischen Inzidenz bis zum 18. Lebensjahr registriert. Es zeigte sich eine Tendenz zur längeren diagnostischen Latenz bei Adoleszenten, die sich jedoch nicht statistisch sichern ließ. Bis zum 15. Lebensjahr wurden nahezu alle Patienten im CED-Register erfasst.

Inflammatory bowel disease (IBD), comprises Crohn’s disease (CD) and ulcerative colitis (UC), and is a chronic relapsing inflammation of gastrointestinal tract without any known cause or cure. Currently, it is accepted that IBD is a result of a dysfunctional immune response to commensal bacteria in a genetically susceptible host, and that environmental factors can trigger the onset or reactivation of the disease. This thesis considers the possibility of a specific pathogenic agent as well as an imbalance in the composition of the normal microflora in the pathogenesis of IBD. Gut biopsy tissues were taken from a population-based case-control tissue bank held at the University of Manitoba. Automated ribosomal intergenic spacer analysis (ARISA) and terminal restriction fragment length polymorphisms (T-RFLP) were employed to assess the diversity of gut microbiota. The phylogenetic, virulence and biochemical characteristics of Escherichia coli isolated from IBD biopsies were examined using multi-locus sequence typing (MLST), DNA microarray technology and API 20E system. Utilizing ARISA and T-RFLP, a remarkable increase in the order of unclassified Clostridia was detected in inflamed tissues, particularly in CD patients (P < 0.05). Moreover, species richness and diversity were the highest in non-inflamed IBD biopsies. Culture-based quantification detected a significantly higher number of E. coli in IBD tissues (P < 0.05). Phylogenetic analysis revealed the tendency of E. coli isolated from IBD patients to be grouped into separate clonal clusters based on their allelic profiles (P = 0.02). A link was detected between uropathogenic E. coli (UPEC) CFT073 and strains isolated from IBD, with regards to gene distribution and virulence, using microarray technology. Amino acid substitutions N91S and S99N in FimH, the adhesive subunit of E. coli type I fimbria, were significantly associated to IBD (P < 0.05). This study demonstrated an increase in the microbial diversity of non-inflamed IBD tissues and suggested a recruitment phase of bacterial adherence and colonization, before the inflammation sets in. Furthermore, E. coli isolated from IBD tissues were distinct from commensal strains in both clonal and virulence characteristics and shared remarkable traits with extraintestinal pathogenic E. coli. Features involved in bacterial adhesion to epithelial cells may hold the key to E. coli pathogenesis in IBD.

Background: Inflammatory bowel disease (IBD) includes Crohn´s disease (CD) and ulcerative colitis (UK). The diseases are chronic and have a pattern of relapses interspersed with relatively symptom-free periods. Common symptoms during relapse are diarrhea, abdominal pain and weight loss. Since you have IBD for life it is important to find ways to relate to and cope with the disease. In that process a nurse can be of great help. Aim: The purpose of this literature review was to increase the understanding of how adult patients with inflammatory bowel disease experience their daily lives.   Method: The method used was a literature review. A literature search was performed in two separate databases which resulted in eleven examined and analyzed articles on the subject.  Results: After the analyze of the articles three different themes emerged: Limitations in daily life, Self-image and self-esteem and finally Self-care and strategies. Several individuals felt limited one way or the other in their daily life. They also described how their self-esteem was affected. Some positive changes due to the disease were also described. For example some changed their exercise and food habits for the better. Discussion: The results are discussed through the perspective of Antonovsky’s (1991/2005) salutogenic view and were connected to how the SOC (Sense of Coherence) was affected. The importance of relatives’ support and self-care was also discussed.

Inflammatory bowel disease (IBD), comprises Crohn’s disease (CD) and ulcerative colitis (UC), and is a chronic relapsing inflammation of gastrointestinal tract without any known cause or cure. Currently, it is accepted that IBD is a result of a dysfunctional immune response to commensal bacteria in a genetically susceptible host, and that environmental factors can trigger the onset or reactivation of the disease. This thesis considers the possibility of a specific pathogenic agent as well as an imbalance in the composition of the normal microflora in the pathogenesis of IBD. Gut biopsy tissues were taken from a population-based case-control tissue bank held at the University of Manitoba. Automated ribosomal intergenic spacer analysis (ARISA) and terminal restriction fragment length polymorphisms (T-RFLP) were employed to assess the diversity of gut microbiota. The phylogenetic, virulence and biochemical characteristics of Escherichia coli isolated from IBD biopsies were examined using multi-locus sequence typing (MLST), DNA microarray technology and API 20E system. Utilizing ARISA and T-RFLP, a remarkable increase in the order of unclassified Clostridia was detected in inflamed tissues, particularly in CD patients (P < 0.05). Moreover, species richness and diversity were the highest in non-inflamed IBD biopsies. Culture-based quantification detected a significantly higher number of E. coli in IBD tissues (P < 0.05). Phylogenetic analysis revealed the tendency of E. coli isolated from IBD patients to be grouped into separate clonal clusters based on their allelic profiles (P = 0.02). A link was detected between uropathogenic E. coli (UPEC) CFT073 and strains isolated from IBD, with regards to gene distribution and virulence, using microarray technology. Amino acid substitutions N91S and S99N in FimH, the adhesive subunit of E. coli type I fimbria, were significantly associated to IBD (P < 0.05). This study demonstrated an increase in the microbial diversity of non-inflamed IBD tissues and suggested a recruitment phase of bacterial adherence and colonization, before the inflammation sets in. Furthermore, E. coli isolated from IBD tissues were distinct from commensal strains in both clonal and virulence characteristics and shared remarkable traits with extraintestinal pathogenic E. coli. Features involved in bacterial adhesion to epithelial cells may hold the key to E. coli pathogenesis in IBD.

Bakgrund: Inflammatorisk tarmsjukdom (IBD) inkluderar ulcerös kolit och Crohns sjukdom. De är kroniska och uppkommer i skov då tarmslemhinnan blir inflammerad och sårig vilket ger en komplex symtombild med akuta diarréer, rektalblödning och buksmärtor. Behandlingen går ut på att minska symtom och förebygga uppkomst av skov. Då dessa sjukdomar påverkar det dagliga livet så påverkas också den individuella hälsorelaterade livskvaliteten, vilket mäter den fysiska, psykiska och sociala aspekten av ett hälsoproblem. Syfte: Syftet var att beskriva upplevelsen av hälsorelaterad livskvalitet hos personer med inflammatorisk tarmsjukdom. Metod: En litteraturöversikt har gjorts där tolv vetenskapliga artiklar har utgjort grunden till resultatet och skapat en översikt på befintlig forskning. De har lästs, sammanfattats och analyserats där likheter och skillnader har hittats och teman bildats. Resultat: Resultatets fyra huvudteman är Fysisk funktion, Psykisk funktion, Social funktion och Att återställa sin livskvalitet. Det framkom i resultatet att de fysiska symtomen och sjukdomsaktiviteten är det som i huvudsak styr såväl det psykiska välmåendet som de sociala restriktionerna. Detta visade sig även ha en negativ inverkan på den hälsorelaterade livskvaliteten. Men med tiden blev dock sjukdomen en normal del av livet och en bättre livskvalitet upplevdes. Diskussion: Metodens tillvägagångssätt samt fördelar och nackdelar diskuteras och analyseras. Vid diskussion av resultatet tas främst kunskap, utbildning och tidsperspektivet upp samt återkopplas till Orems egenvårdsteori. / Background: Inflammatory bowel disease (IBD) encompasses ulcerative colitis and Crohn's disease. They are chronic and occur in relapses when the mucosal becomes inflamed and ulcerated, causing complex symptoms such as acute diarrhoea, rectal bleeding and abdominal pain. The treatment aims to reduce symptoms and prevent the occurrence of relapses. As these diseases affect the daily life it also affects the individual health-related quality of life, which measures the physical, psychological and social aspects of a health problem. Aim: The purpose was to describe the experience of health-related quality of life in people with inflammatory bowel disease. Method: A literature review has been done where twelve original articles have formed the basis of the results, this creates an overview of existing research. They have been read, summarized and analysed where the similarities and differences were found and themes were formed. Results: The four main themes of the result is Physical function, Psychological function, Social function and Rebuilding their quality of life. It emerged in the results that physical symptoms and disease activity are those which essentially controls the psychological well-being as well as social constraints. This was shown in studies to have a negative impact on the health-related quality of life. But overtime the disease became a normal part of one's life and gave a better quality of life experience. Discussions: The method approach, benefits and weaknesses will be discussed and analysed. When discussing the results of the current study mainly knowledge, education, and time perspective will be addressed and analysed with Orem’s self-care theory.

The aim of the thesis – to investigate the role of the inflammatory bowel disease associated genetic variants in a subset of Crohn’s disease and ulcerative colitis patients from Lithuania and Latvia and to test the relation of genetic markers to disease phenotype. The following objectives were accomplished: the associations of the inflammatory bowel disease associated single nucleotide polymorphisms in the subset of Crohn’s disease and ulcerative colitis patients were determined; the associations of the single nucleotide polymorphisms with the phenotype of the inflammatory bowel disease were evaluated; the interactions of single nucleotide polymorphisms (SNP-SNP) and their association with inflammatory bowel disease were determined; the significance of the combinations of disease associated single nucleotide polymorphisms for diagnosis of inflammatory bowel disease was evaluated. TaqMan and SNPlex genotyping methods were used in this work. The statistical data analysis consisted of: statistical study power and data quality evaluations; single marker case-control association analysis using χ2 or Fisher's exact tests, Breslow-Day test, Cochran-Mantel-Haenzsel test and post-hoc Bonferroni correction; genotype–phenotype association analysis using χ2 test and post-hoc Bonferroni correction; SNP-SNP epistasis for case-control sample using logistic regression test and post-hoc Bonferroni correction; In sicilo prediction of gene interactive network; genetic risk profile construction... [to full text] / Disertacijos tikslas – ištirti su uždegiminėmis žarnyno ligomis siejamų ge¬netinių žymenų reikšmę Krono liga bei opiniu kolitu sergantiems Lietuvos ir Latvijos ligoniams bei nustatyti žymenų ryšį su ligos fenotipu. Tikslui pasiekti, įgyvendinti šie uždaviniai: ištirta su uždegiminėmis žarnyno ligomis siejamų vieno nukleotido polimorfizmų sąsaja su Krono liga bei opiniu kolitu; nustatyta vieno nukleotido polimorfizmų sąsaja su uždegiminių žarny¬no ligų fenotipu; ištirtos vieno nukleotido polimorfizmų tarpusavio epistazinės sąvei¬kos (VNP-VNP) bei jų ryšys su uždegiminėmis žarnyno ligomis; nustatytas su liga siejamų vieno nukleotido polimorfizmų derinių reikšmingumas uždegiminių žarnyno ligų diagnostikai. Darbe taikyti SNPlex ir TaqMan genotipavimo metodai. Statistinę duomenų analizę sudarė: studijos galios bei duomenų kokybės įvertinimas; atvejo-kontrolės genų sąsajos tyrimas, taikant χ2 arba Fišerio kriterijus, Breslow-Day testą, Cochran-Mantel-Haenzsel testą bei post-hoc Bonferroni kriterijų; genų sąsajų su Krono ligos ir opinio kolito fenotipu tyrimai, naudojant χ2 bei post-hoc Bonferroni kriterijų; VNP-VNP epistazinės sąveikos įvertinimas, taikant logistinės regresijos testą bei post-hoc Bonferroni kriterijų; genų tarpusavio sąveikos tinklo in silico tyrimas; genetinės rizikos profilio sudarymas, naudojant logistinę regresinę analizę.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.