首页 > 最新文献

Acta gastro-enterologica Belgica最新文献

英文 中文
Tofacitinib, celiac disease and the elderly: mind the gut! 托法替尼、乳糜泻和老年人:注意肠道!
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.51821/86.3.12207
N Boutrid, H Rahmoune
To the Editor, We read with great attention the interesting case report by Lenfant et al. narrating the successful use of tofacitinib in a patient with microscopic colitis and celiac disease (1), and we would point some insights about this peculiar situation. In fact, tofacitinib depicts potential side effects, including a higher risk of malignancies, and the FDA has even issued a warning about this drug’s hazard (2). Actually, a randomized open-label trial published in the New England Journal of Medicine in 2021 found that patients with rheumatoid arthritis who took tofacitinib had a higher risk of developing cancer than those who took a tumor necrosis factor (TNF) inhibitor (3). Recently, two recent randmoized controlled trials from the ORAL Surveillance Trial and published in the Annals of the Rheumatic Diseases in 2023 also contributed to shed the light on this potential risk : that patients with rheumatoid arthritis aged > 50 with cardiovascular risk who took tofacitinib had a higher risk of developing any type of cancer than those who took a TNF inhibitor (4), and secondary stratification found that they were more likely to develop cancer if they were over the age of 65 years (5). Adding insult to injury, the maligancies are also driven by the two peculiar forms of celiac disease : seronegative and refractory celiac disease (RCD), and this risk is also increased in CD diagnosed at adulthood : particularly, elder patients are prone to present a RCD, and giving immune checkpoint therapy might increase this risk (6). In conclusion, RCD ought to be definetly ruled out before starting JAK inhibitor therapy, especially in aged population with seronegative celiac disease and microscopic colitis, two well-known conditions associated with RCD.
{"title":"Tofacitinib, celiac disease and the elderly: mind the gut!","authors":"N Boutrid, H Rahmoune","doi":"10.51821/86.3.12207","DOIUrl":"10.51821/86.3.12207","url":null,"abstract":"To the Editor, We read with great attention the interesting case report by Lenfant et al. narrating the successful use of tofacitinib in a patient with microscopic colitis and celiac disease (1), and we would point some insights about this peculiar situation. In fact, tofacitinib depicts potential side effects, including a higher risk of malignancies, and the FDA has even issued a warning about this drug’s hazard (2). Actually, a randomized open-label trial published in the New England Journal of Medicine in 2021 found that patients with rheumatoid arthritis who took tofacitinib had a higher risk of developing cancer than those who took a tumor necrosis factor (TNF) inhibitor (3). Recently, two recent randmoized controlled trials from the ORAL Surveillance Trial and published in the Annals of the Rheumatic Diseases in 2023 also contributed to shed the light on this potential risk : that patients with rheumatoid arthritis aged > 50 with cardiovascular risk who took tofacitinib had a higher risk of developing any type of cancer than those who took a TNF inhibitor (4), and secondary stratification found that they were more likely to develop cancer if they were over the age of 65 years (5). Adding insult to injury, the maligancies are also driven by the two peculiar forms of celiac disease : seronegative and refractory celiac disease (RCD), and this risk is also increased in CD diagnosed at adulthood : particularly, elder patients are prone to present a RCD, and giving immune checkpoint therapy might increase this risk (6). In conclusion, RCD ought to be definetly ruled out before starting JAK inhibitor therapy, especially in aged population with seronegative celiac disease and microscopic colitis, two well-known conditions associated with RCD.","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dumping syndrome after bariatric surgery: prevalence, pathophysiology and role in weight reduction - a systematic review. 减肥手术后的倾倒综合征:患病率、病理生理学和在减肥中的作用——一项系统综述。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.51821/86.3.11476
A D'hoedt, T Vanuytsel

Background: Dumping syndrome is a frequent and wellknown adverse event after bariatric surgery and covers a dynamic spectrum of early and late dumping. Accelerated gastric emptying is generally considered to be the cause of gastrointestinal and vasomotor complaints. However, there is much uncertainty regarding the exact pathophysiology of dumping. It has been speculated that the syndrome is a desired consequence of bariatric surgery and contributes to more efficient weight loss, but supporting data are scarce.

Methods: A systematic search was conducted in PubMed in July-August 2021. The prevalence of dumping after the most frequently performed bariatric procedures was analyzed, as well as underlying pathophysiology and its role in weight reduction.

Results: Roux-en-Y gastric bypass (RYGB) is associated with the highest postoperative prevalence of dumping. The fast transit induces neurohumoral changes which contribute to an imbalance between postprandial glucose and insulin levels, resulting in hypoglycemia which is the hallmark of late dumping. Early dumping can, when received in a positive way, become a tool to maintain a strict dietary pattern, but no significant relationship to the degree of weight loss has been shown. However, late dumping is detrimental and promotes overall higher caloric intake.

Conclusion: Dumping syndrome is common after bariatric surgery, especially after RYGB. The pathophysiology is complex and ambiguous. Currently available data do not support dumping as a necessary condition to induce weight loss after bariatric surgery.

背景:倾倒综合征是减肥手术后常见且众所周知的不良事件,涵盖了早期和晚期倾倒的动态范围。胃排空加速通常被认为是胃肠道和血管舒缩性疾病的原因。然而,倾倒的确切病理生理学还有很多不确定性。据推测,该综合征是减肥手术的理想结果,有助于更有效地减肥,但支持数据很少。方法:于2021年7-8月在PubMed进行系统检索。分析了最常见的减肥手术后倾倒的发生率,以及潜在的病理生理学及其在减肥中的作用。结果:Roux-en-Y胃分流术(RYGB)与术后倾倒发生率最高有关。快速转运诱导神经体液变化,导致餐后血糖和胰岛素水平失衡,导致低血糖,这是晚倾倒的标志。如果以积极的方式接受,早期倾倒可以成为保持严格饮食模式的工具,但与减肥程度没有显著关系。然而,延迟倾倒是有害的,并促进整体更高的热量摄入。结论:Dumping综合征常见于减肥手术后,尤其是RYGB手术后。病理生理学是复杂和模糊的。目前可用的数据不支持倾倒作为减肥手术后诱导体重减轻的必要条件。
{"title":"Dumping syndrome after bariatric surgery: prevalence, pathophysiology and role in weight reduction - a systematic review.","authors":"A D'hoedt,&nbsp;T Vanuytsel","doi":"10.51821/86.3.11476","DOIUrl":"10.51821/86.3.11476","url":null,"abstract":"<p><strong>Background: </strong>Dumping syndrome is a frequent and wellknown adverse event after bariatric surgery and covers a dynamic spectrum of early and late dumping. Accelerated gastric emptying is generally considered to be the cause of gastrointestinal and vasomotor complaints. However, there is much uncertainty regarding the exact pathophysiology of dumping. It has been speculated that the syndrome is a desired consequence of bariatric surgery and contributes to more efficient weight loss, but supporting data are scarce.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed in July-August 2021. The prevalence of dumping after the most frequently performed bariatric procedures was analyzed, as well as underlying pathophysiology and its role in weight reduction.</p><p><strong>Results: </strong>Roux-en-Y gastric bypass (RYGB) is associated with the highest postoperative prevalence of dumping. The fast transit induces neurohumoral changes which contribute to an imbalance between postprandial glucose and insulin levels, resulting in hypoglycemia which is the hallmark of late dumping. Early dumping can, when received in a positive way, become a tool to maintain a strict dietary pattern, but no significant relationship to the degree of weight loss has been shown. However, late dumping is detrimental and promotes overall higher caloric intake.</p><p><strong>Conclusion: </strong>Dumping syndrome is common after bariatric surgery, especially after RYGB. The pathophysiology is complex and ambiguous. Currently available data do not support dumping as a necessary condition to induce weight loss after bariatric surgery.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A remarkable presentation of a massive Budd-Chiari syndrome. 一个巨大的布-加综合征的显著表现。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.51821/86.3.11994
K Ferdinande, H Degroote, A Geerts, H Van Vlierberghe, X Verhelst, S Raevens
A 59-year-old female presented to the emergency department with malaise, significant weight loss, abdominal discomfort, dyspnoea and severely swollen peripheral extremities. She had a past medical history of sickle cell anaemia, a latent tuberculosis infection and a chronic hepatitis B that was treated with PEG-interferon alpha-2 in 2008. Since 2018, she was lost to follow-up. The patient was critically ill, sarcopenic and lethargic. Clinical examination revealed icteric sclerae and a markedly distended and diffusely tender abdomen and peripheral oedemas. Her vital signs included a blood pressure of 105/64 mmHg, tachycardia of 130 bpm, hypothermia of 35.6°C and a SpO2 of 100% in ambient air. Laboratory workup demonstrated a total bilirubin of 12.9 mg/dL, AST 500 U/L, ALT 218 U/L, ALP 178 U/L and GGT 126 U/L, a thrombocytopenia of 34 x10E3/ μL, 16,01 x10E3/μL leukocytes, a CRP of 94.8 mg/L and a lactate of 10,12 mmol/L. The serum creatinine was 1.04 mg/dL, eGFR 54.1 ml/min. The INR was 2.77 and there was a severe hypoalbuminemia (22 g/L). D-dimers were >20 000 ng/ml. The patient presented also with spontaneous hypoglycaemia. A multiphasic contrast-enhanced thoracic and abdominal computed tomography (CT) was performed (figure 1). Given the results of the CT, a 2D echocardiogram was urgently requested (figure 2).
{"title":"A remarkable presentation of a massive Budd-Chiari syndrome.","authors":"K Ferdinande, H Degroote, A Geerts, H Van Vlierberghe, X Verhelst, S Raevens","doi":"10.51821/86.3.11994","DOIUrl":"10.51821/86.3.11994","url":null,"abstract":"A 59-year-old female presented to the emergency department with malaise, significant weight loss, abdominal discomfort, dyspnoea and severely swollen peripheral extremities. She had a past medical history of sickle cell anaemia, a latent tuberculosis infection and a chronic hepatitis B that was treated with PEG-interferon alpha-2 in 2008. Since 2018, she was lost to follow-up. The patient was critically ill, sarcopenic and lethargic. Clinical examination revealed icteric sclerae and a markedly distended and diffusely tender abdomen and peripheral oedemas. Her vital signs included a blood pressure of 105/64 mmHg, tachycardia of 130 bpm, hypothermia of 35.6°C and a SpO2 of 100% in ambient air. Laboratory workup demonstrated a total bilirubin of 12.9 mg/dL, AST 500 U/L, ALT 218 U/L, ALP 178 U/L and GGT 126 U/L, a thrombocytopenia of 34 x10E3/ μL, 16,01 x10E3/μL leukocytes, a CRP of 94.8 mg/L and a lactate of 10,12 mmol/L. The serum creatinine was 1.04 mg/dL, eGFR 54.1 ml/min. The INR was 2.77 and there was a severe hypoalbuminemia (22 g/L). D-dimers were >20 000 ng/ml. The patient presented also with spontaneous hypoglycaemia. A multiphasic contrast-enhanced thoracic and abdominal computed tomography (CT) was performed (figure 1). Given the results of the CT, a 2D echocardiogram was urgently requested (figure 2).","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A retrospective analysis of the histology of resected polyps and colonoscopy quality parameters in Belgium. 回顾性分析比利时切除息肉的组织学和结肠镜检查质量参数。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.51821/86.2.10880
E Macken, S Van Dongen, G Van Hal

Background and aims: adenoma detection rate is a well known quality parameter for colonoscopy. However recently other quality parameters have emerged. We wanted to evaluate the histology of the resected polyps, different quality indicators of colonoscopy and post colonoscopy colorectal cancer (PCCRC) in Belgium and analyzed data about colonoscopies performed between 2008-2015.

Methods: Reimbursement data on colorectal related medical procedures from the Intermutualistic Agency were linked with data on clinical and pathological staging of colorectal cancer and with histologic data of resected polyps available at the Belgian Cancer Registry over a period covering 8 years (2008-2015).

Results: 298,246 polyps were resected in 294,923 colonoscopies, of which 275,182 were adenomas (92 %) and 13,616 were SSLs (4%). There was a significant but small correlation between the different quality parameters and PCCRC. Post colonoscopy colorectal cancer rate after 3 years was 7.29 %. There were marked geographic differences in Belgium concerning adenoma detection rate, sessile adenoma detection rate and post colonoscopy colorectal cancer.

Conclusion: Most resected polyps were adenomas, only a small percentage involved sessile serrated lesions. There was a significant correlation between adenoma detection rate and other quality parameters, and a small but significant correlation between PCCRC and the different quality parameters. The lowest post colonoscopy colorectal cancer rate was reached with an ADR of 31.4 % and a SSL-DR of 1.2 %.

背景与目的:腺瘤检出率是结肠镜检查的一个重要质量指标。然而,最近出现了其他质量参数。我们想要评估比利时切除息肉的组织学,结肠镜检查和结肠镜检查后结直肠癌(PCCRC)的不同质量指标,并分析2008-2015年结肠镜检查的数据。方法:将Intermutualistic Agency提供的结直肠癌相关医疗程序的报销数据与比利时癌症登记处提供的结直肠癌临床和病理分期数据以及切除息肉的组织学数据相关联,时间跨度为8年(2008-2015年)。结果:294,923例结肠镜检查共切除息肉298,246例,其中腺瘤275,182例(92%),ssl16例(4%)。不同质量参数与PCCRC之间存在显著但较小的相关性。结肠镜检查后3年结直肠癌发生率为7.29%。比利时在腺瘤检出率、无底腺瘤检出率和结肠镜后结直肠癌方面存在显著的地理差异。结论:大部分切除的息肉为腺瘤,只有一小部分为无根的锯齿状病变。腺瘤检出率与其他质量参数相关性显著,PCCRC与不同质量参数相关性虽小但显著。结肠镜检查后结直肠癌发生率最低,ADR为31.4%,SSL-DR为1.2%。
{"title":"A retrospective analysis of the histology of resected polyps and colonoscopy quality parameters in Belgium.","authors":"E Macken,&nbsp;S Van Dongen,&nbsp;G Van Hal","doi":"10.51821/86.2.10880","DOIUrl":"https://doi.org/10.51821/86.2.10880","url":null,"abstract":"<p><strong>Background and aims: </strong>adenoma detection rate is a well known quality parameter for colonoscopy. However recently other quality parameters have emerged. We wanted to evaluate the histology of the resected polyps, different quality indicators of colonoscopy and post colonoscopy colorectal cancer (PCCRC) in Belgium and analyzed data about colonoscopies performed between 2008-2015.</p><p><strong>Methods: </strong>Reimbursement data on colorectal related medical procedures from the Intermutualistic Agency were linked with data on clinical and pathological staging of colorectal cancer and with histologic data of resected polyps available at the Belgian Cancer Registry over a period covering 8 years (2008-2015).</p><p><strong>Results: </strong>298,246 polyps were resected in 294,923 colonoscopies, of which 275,182 were adenomas (92 %) and 13,616 were SSLs (4%). There was a significant but small correlation between the different quality parameters and PCCRC. Post colonoscopy colorectal cancer rate after 3 years was 7.29 %. There were marked geographic differences in Belgium concerning adenoma detection rate, sessile adenoma detection rate and post colonoscopy colorectal cancer.</p><p><strong>Conclusion: </strong>Most resected polyps were adenomas, only a small percentage involved sessile serrated lesions. There was a significant correlation between adenoma detection rate and other quality parameters, and a small but significant correlation between PCCRC and the different quality parameters. The lowest post colonoscopy colorectal cancer rate was reached with an ADR of 31.4 % and a SSL-DR of 1.2 %.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10188528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Irritable bowel syndrome-like symptoms before and after bariatric surgery and association with short-chain fermentable carbohydrates consumption: an observational prospective study. 减肥手术前后肠易激综合征样症状与短链可发酵碳水化合物消耗的关系:一项观察性前瞻性研究
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.51821/86.2.11530
P Van Ouytsel, H Piessevaux, A Szalai, P Loi, H Louis
Background and aims Irritable Bowel Syndrome (IBS)-like symptoms are frequent following bariatric surgery. This study aims to evaluate the frequency of IBS symptoms severity before and after bariatric surgery and their association with short-chain fermentable carbohydrates (FODMAPs) consumption. Patients and methods IBS symptoms severity in a cohort of obese patients was evaluated prospectively before, 6 and 12 months after bariatric surgery by validated questionnaires and tools (Irritable Bowel Syndrome Severity Scoring System (IBS SSS), Bristol Stool Scale (BSS), Quality of Life Short- Form-12 (SF-12), Hospital Anxiety and Depression scale (HAD)). FODMAPs consumption and its association with IBS symptom severity was evaluated by using a food frequency questionnaire focused on high-FODMAPs food consumption. Results Fifty-one patients were included (41 female; mean age 41 years (SD: 12)), 84% received a sleeve gastrectomy, and 16% a Roux-en-Y gastric bypass. Symptoms compatible with IBS were observed in 43% of patients before surgery, in 58% of patients at 6 months and 33% at 12 months (NS, p-value=0,197 and 0,414). In a multivariate model, a significant association was found between the IBS SSS score and lactose consumption at 6 months (β = + 58, 1; p = 0.03), and with polyols consumption at 12 months (β = + 112,6; p = 0.01). Conclusions Mild to moderate IBS symptoms are frequent in obese patients before bariatric surgery. A significant association between lactose and polyols consumption and IBS SSS score was observed after bariatric surgery, suggesting a potential link between the severity of IBS symptoms and some specific FODMAPs consumption.
背景和目的:肠易激综合征(IBS)样症状在减肥手术后很常见。本研究旨在评估减肥手术前后IBS症状严重程度的频率及其与短链可发酵碳水化合物(FODMAPs)摄入的关系。患者和方法:通过经验证的问卷和工具(肠易激综合征严重程度评分系统(IBS SSS)、布里斯托尔大便量表(BSS)、短期生活质量12(SF-12)、医院焦虑和抑郁量表(HAD)),在减肥手术前、手术后6个月和12个月前瞻性评估肥胖患者队列中的IBS症状严重程度。FODMAPs的摄入及其与IBS症状严重程度的关系通过使用关注高FODMAPs食物摄入的食物频率问卷进行评估。结果:51名患者(41名女性;平均年龄41岁(SD:12)),84%接受袖状胃切除术,16%接受Roux-en-Y胃旁路术。43%的患者在手术前、58%的患者在6个月时和33%的患者在12个月时观察到与IBS兼容的症状(NS,p值分别为0197和0414)。在一个多变量模型中,发现IBS SSS评分与6个月时的乳糖消耗量(β=+58,1;p=0.03)和12个月时多元醇消耗量(α=+112,6;p=0.01)之间存在显著相关性。结论:肥胖患者在减肥手术前经常出现轻度至中度IBS症状。减肥手术后观察到乳糖和多元醇的摄入与IBS SSS评分之间存在显著关联,这表明IBS症状的严重程度与某些特定FODMAP的摄入之间存在潜在联系。
{"title":"Irritable bowel syndrome-like symptoms before and after bariatric surgery and association with short-chain fermentable carbohydrates consumption: an observational prospective study.","authors":"P Van Ouytsel,&nbsp;H Piessevaux,&nbsp;A Szalai,&nbsp;P Loi,&nbsp;H Louis","doi":"10.51821/86.2.11530","DOIUrl":"10.51821/86.2.11530","url":null,"abstract":"Background and aims Irritable Bowel Syndrome (IBS)-like symptoms are frequent following bariatric surgery. This study aims to evaluate the frequency of IBS symptoms severity before and after bariatric surgery and their association with short-chain fermentable carbohydrates (FODMAPs) consumption. Patients and methods IBS symptoms severity in a cohort of obese patients was evaluated prospectively before, 6 and 12 months after bariatric surgery by validated questionnaires and tools (Irritable Bowel Syndrome Severity Scoring System (IBS SSS), Bristol Stool Scale (BSS), Quality of Life Short- Form-12 (SF-12), Hospital Anxiety and Depression scale (HAD)). FODMAPs consumption and its association with IBS symptom severity was evaluated by using a food frequency questionnaire focused on high-FODMAPs food consumption. Results Fifty-one patients were included (41 female; mean age 41 years (SD: 12)), 84% received a sleeve gastrectomy, and 16% a Roux-en-Y gastric bypass. Symptoms compatible with IBS were observed in 43% of patients before surgery, in 58% of patients at 6 months and 33% at 12 months (NS, p-value=0,197 and 0,414). In a multivariate model, a significant association was found between the IBS SSS score and lactose consumption at 6 months (β = + 58, 1; p = 0.03), and with polyols consumption at 12 months (β = + 112,6; p = 0.01). Conclusions Mild to moderate IBS symptoms are frequent in obese patients before bariatric surgery. A significant association between lactose and polyols consumption and IBS SSS score was observed after bariatric surgery, suggesting a potential link between the severity of IBS symptoms and some specific FODMAPs consumption.","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9867290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Diverticulitis associated pancreatitis: a report of 2 cases and review of the literature. 憩室炎相关性胰腺炎:附2例报告并文献复习。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.51821/86.2.11616
H Colin, D Ndjekembo Shango, B Pilet, F Waignein, P Yengue

Duodenal diverticula are the second most common type of digestive diverticula after those in the colon. They are present in approximately 27% of patients who undergo upper digestive endoscopy. Most of these diverticula, especially those located near the papilla, are asymptomatic. However, in rare cases, they can be associated with obstructive jaundice (Lemmel Syndrome), bacterial infection, pancreatitis, or bleeding. In this report, we present two cases of acute obstructive pancreatitis caused by duodenal diverticulitis. Both patients were managed conservatively, resulting in a positive outcome.

十二指肠憩室是仅次于结肠的第二种最常见的消化憩室。在接受上消化道内窥镜检查的患者中,大约有27%的患者存在这种情况。大多数憩室,尤其是那些位于乳头附近的憩室,是无症状的。然而,在极少数情况下,它们可能与梗阻性黄疸(Lemmel综合征)、细菌感染、胰腺炎或出血有关。本文报告两例由十二指肠憩室炎引起的急性梗阻性胰腺炎。两例患者均采用保守治疗,结果均为阳性。
{"title":"Diverticulitis associated pancreatitis: a report of 2 cases and review of the literature.","authors":"H Colin,&nbsp;D Ndjekembo Shango,&nbsp;B Pilet,&nbsp;F Waignein,&nbsp;P Yengue","doi":"10.51821/86.2.11616","DOIUrl":"https://doi.org/10.51821/86.2.11616","url":null,"abstract":"<p><p>Duodenal diverticula are the second most common type of digestive diverticula after those in the colon. They are present in approximately 27% of patients who undergo upper digestive endoscopy. Most of these diverticula, especially those located near the papilla, are asymptomatic. However, in rare cases, they can be associated with obstructive jaundice (Lemmel Syndrome), bacterial infection, pancreatitis, or bleeding. In this report, we present two cases of acute obstructive pancreatitis caused by duodenal diverticulitis. Both patients were managed conservatively, resulting in a positive outcome.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9813076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tofacitinib for celiac disease and microscopic colitis: killing two birds with one stone. 托法替尼治疗乳糜泻和显微镜下结肠炎:一举两得。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.51821/86.2.11639
M Lenfant, G De Hertogh, B Verstockt

Microscopic colitis is a chronic inflammatory condition of the colon. Firstline treatment consists of budesonide, with the consideration of biological agents in refractory cases. Celiac disease is a chronic immune mediated and gluten-induced enteropathy, with treatment consisting of a gluten-free diet. There is an association between microscopic colitis and instead of xand celiac disease, especially in refractory cases they can coincide. In this manuscript, we report for the first time the efficacy of tofacitinib, a pan Janus kinase inhibitor, in the treatment of concomitant microscopic colitis and celiac disease, resulting in persistent clinical and histological remission.

显微镜下结肠炎是结肠的一种慢性炎症性疾病。一线治疗包括布地奈德,在难治性病例中考虑使用生物制剂。乳糜泻是一种慢性免疫介导和麸质诱导的肠病,其治疗方法包括无麸质饮食。显微镜下结肠炎和乳糜泻之间存在关联,尤其是在难治性病例中,它们可以同时发生。在这篇手稿中,我们首次报道了泛Janus激酶抑制剂托法替尼治疗并发显微镜下结肠炎和乳糜泻的疗效,从而导致持续的临床和组织学缓解。
{"title":"Tofacitinib for celiac disease and microscopic colitis: killing two birds with one stone.","authors":"M Lenfant,&nbsp;G De Hertogh,&nbsp;B Verstockt","doi":"10.51821/86.2.11639","DOIUrl":"10.51821/86.2.11639","url":null,"abstract":"<p><p>Microscopic colitis is a chronic inflammatory condition of the colon. Firstline treatment consists of budesonide, with the consideration of biological agents in refractory cases. Celiac disease is a chronic immune mediated and gluten-induced enteropathy, with treatment consisting of a gluten-free diet. There is an association between microscopic colitis and instead of xand celiac disease, especially in refractory cases they can coincide. In this manuscript, we report for the first time the efficacy of tofacitinib, a pan Janus kinase inhibitor, in the treatment of concomitant microscopic colitis and celiac disease, resulting in persistent clinical and histological remission.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Motorized spiral enteroscopy: effectiveness when used for new indications. 电动螺旋肠镜检查:用于新适应症的有效性。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.51821/86.2.11779
H Colin, A Donati, L Monino, T G Moreels

Background and study aims: Motorized spiral enteroscopy is proven to be effective in antegrade and retrograde enteroscopy. Nevertheless, little is known about its use in less common indications. The aim of this study was to identify new indications for the motorized spiral enteroscope.

Methods: Monocentric retrospective analysis of 115 patients who underwent enteroscopy using PSF-1 motorized spiral enteroscope between January 2020 and December 2022.

Results: A total of 115 patients underwent PSF-1 enteroscopy. 44 (38%) were antegrade procedures and 24 (21%) were retrograde procedures in patients with normal gastrointestinal anatomy with conventional enteroscopy indications. The remaining 47 (41%) patients underwent PSF-1 procedures for secondary less conventional indications: n=25 (22%) enteroscopy-assisted ERCP, n=8 (7%) endoscopy of the excluded stomach after Roux-en-Y gastric bypass, n=7 (6%) retrograde enteroscopy after previous incomplete conventional colonoscopy and n=7 (6%) antegrade panenteroscopy of the entire small bowel. In this group of secondary indications, technical success rate was significantly lower (72.5%) as compared to technical success rates in the conventional groups (98-100%, p<0.001 Chi-square). Minor adverse events occurred in 17/115 patients (15%), all treated conservatively (AGREE I and II).

Conclusion: This study demonstrates the capabilities of PSF-1 motorized spiral enteroscope for secondary indications. PSF-1 is useful to complete colonoscopy in case of long redundant colon, to reach the excluded stomach after Roux-en-Y gastric bypass, to perform unidirectional pan-enteroscopy and to perform ERCP in patients with surgically altered anatomy. However, technical success rates are lower as compared to conventional antegrade and retrograde enteroscopy procedures, with only minor adverse events.

背景与研究目的:电动螺旋肠镜在顺行和逆行肠镜检查中是有效的。然而,人们对其在不常见适应症中的应用知之甚少。本研究的目的是确定电动螺旋肠镜的新适应症。方法:对2020年1月至2022年12月期间使用PSF-1电动螺旋肠镜进行肠镜检查的115例患者进行单中心回顾性分析。结果:115例患者行PSF-1肠镜检查。44例(38%)为顺行手术,24例(21%)为逆行手术,患者胃肠道解剖正常,常规肠镜检查指征。其余47例(41%)患者接受PSF-1手术治疗继发的非常规适应症:25例(22%)采用肠镜辅助ERCP, 8例(7%)采用Roux-en-Y胃旁路术后排除胃内窥镜检查,7例(6%)采用不完全常规结肠镜检查后逆行肠镜检查,7例(6%)采用整个小肠顺行全肠镜检查。在这组次要适应症中,技术成功率(72.5%)明显低于常规组的技术成功率(98-100%)。结论:本研究证明了PSF-1电动螺旋肠镜在次要适应症中的能力。PSF-1在长结肠冗余情况下完成结肠镜检查,Roux-en-Y胃旁路手术后到达被排除的胃,单向泛肠镜检查和手术改变解剖结构的患者进行ERCP时都是有用的。然而,与传统的顺行和逆行肠镜检查相比,技术成功率较低,只有轻微的不良事件。
{"title":"Motorized spiral enteroscopy: effectiveness when used for new indications.","authors":"H Colin,&nbsp;A Donati,&nbsp;L Monino,&nbsp;T G Moreels","doi":"10.51821/86.2.11779","DOIUrl":"https://doi.org/10.51821/86.2.11779","url":null,"abstract":"<p><strong>Background and study aims: </strong>Motorized spiral enteroscopy is proven to be effective in antegrade and retrograde enteroscopy. Nevertheless, little is known about its use in less common indications. The aim of this study was to identify new indications for the motorized spiral enteroscope.</p><p><strong>Methods: </strong>Monocentric retrospective analysis of 115 patients who underwent enteroscopy using PSF-1 motorized spiral enteroscope between January 2020 and December 2022.</p><p><strong>Results: </strong>A total of 115 patients underwent PSF-1 enteroscopy. 44 (38%) were antegrade procedures and 24 (21%) were retrograde procedures in patients with normal gastrointestinal anatomy with conventional enteroscopy indications. The remaining 47 (41%) patients underwent PSF-1 procedures for secondary less conventional indications: n=25 (22%) enteroscopy-assisted ERCP, n=8 (7%) endoscopy of the excluded stomach after Roux-en-Y gastric bypass, n=7 (6%) retrograde enteroscopy after previous incomplete conventional colonoscopy and n=7 (6%) antegrade panenteroscopy of the entire small bowel. In this group of secondary indications, technical success rate was significantly lower (72.5%) as compared to technical success rates in the conventional groups (98-100%, p<0.001 Chi-square). Minor adverse events occurred in 17/115 patients (15%), all treated conservatively (AGREE I and II).</p><p><strong>Conclusion: </strong>This study demonstrates the capabilities of PSF-1 motorized spiral enteroscope for secondary indications. PSF-1 is useful to complete colonoscopy in case of long redundant colon, to reach the excluded stomach after Roux-en-Y gastric bypass, to perform unidirectional pan-enteroscopy and to perform ERCP in patients with surgically altered anatomy. However, technical success rates are lower as compared to conventional antegrade and retrograde enteroscopy procedures, with only minor adverse events.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sarcopenia in end-stage liver disease and after liver transplantation. 终末期肝病和肝移植后的肌肉减少症。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.51821/86.2.11412
S Leunis, M Vandecruys, A H Van Craenenbroeck, V Cornelissen, S Bogaerts, S De Smet, D Monbaliu

Sarcopenia occurs in 30-70% of patients with end-stage liver disease and is associated with inferior pre- and post-liver transplant outcomes such as prolonged intubation times, long intensive care and hospitalization times, heightened risk of post-transplant infection, reduced health-related quality of life, and increased rates of mortality. The pathogenesis of sarcopenia is multifactorial and involves biochemical disturbances such as hyperammonemia, low serum concentrations of branched-chain amino acids (BCAAs) and low serum levels of testosterone, as well as chronic inflammation, inadequate nutritional status, and physical inactivity. Prompt recognition and accurate assessment of sarcopenia are critical and require imaging, dynamometry, and physical performance testing for the assessment of its subcomponents: muscle mass, muscle strength, and muscle function, respectively. Liver transplantation mostly fails to reverse sarcopenia in sarcopenic patients. In fact, some patients develop de novo sarcopenia after undergoing liver transplantation. The recommended treatment of sarcopenia is multimodal and includes a combination of exercise therapy and complementary nutritional interventions. Additionally, new pharmacological agents (e.g. myostatin inhibitors, testosterone supplements, and ammonia-lowering therapy) are under investigation in preclinical studies. Here, we present a narrative review of the definition, assessment, and management of sarcopenia in patients with end-stage liver disease prior to and after liver transplantation.

骨骼肌减少症发生在30-70%的终末期肝病患者中,并与肝移植前和移植后较差的预后相关,如插管时间延长、重症监护和住院时间延长、移植后感染风险增加、健康相关生活质量降低和死亡率增加。肌少症的发病机制是多因素的,涉及生化紊乱,如高氨血症、低血清支链氨基酸(BCAAs)浓度和低血清睾酮水平,以及慢性炎症、营养状况不足和缺乏运动。及时识别和准确评估肌肉减少症是至关重要的,需要影像学、动力测量和物理性能测试来评估其子成分:肌肉质量、肌肉力量和肌肉功能。肝移植大多不能逆转肌肉减少症患者的肌肉减少症。事实上,一些患者在接受肝移植后会出现肌肉减少症。肌少症的推荐治疗是多模式的,包括运动治疗和补充营养干预的结合。此外,新的药理学药物(如肌生长抑制素抑制剂、睾酮补充剂和降氨疗法)正在临床前研究中进行调查。在此,我们对肝移植前后终末期肝病患者肌肉减少症的定义、评估和处理进行了综述。
{"title":"Sarcopenia in end-stage liver disease and after liver transplantation.","authors":"S Leunis,&nbsp;M Vandecruys,&nbsp;A H Van Craenenbroeck,&nbsp;V Cornelissen,&nbsp;S Bogaerts,&nbsp;S De Smet,&nbsp;D Monbaliu","doi":"10.51821/86.2.11412","DOIUrl":"https://doi.org/10.51821/86.2.11412","url":null,"abstract":"<p><p>Sarcopenia occurs in 30-70% of patients with end-stage liver disease and is associated with inferior pre- and post-liver transplant outcomes such as prolonged intubation times, long intensive care and hospitalization times, heightened risk of post-transplant infection, reduced health-related quality of life, and increased rates of mortality. The pathogenesis of sarcopenia is multifactorial and involves biochemical disturbances such as hyperammonemia, low serum concentrations of branched-chain amino acids (BCAAs) and low serum levels of testosterone, as well as chronic inflammation, inadequate nutritional status, and physical inactivity. Prompt recognition and accurate assessment of sarcopenia are critical and require imaging, dynamometry, and physical performance testing for the assessment of its subcomponents: muscle mass, muscle strength, and muscle function, respectively. Liver transplantation mostly fails to reverse sarcopenia in sarcopenic patients. In fact, some patients develop de novo sarcopenia after undergoing liver transplantation. The recommended treatment of sarcopenia is multimodal and includes a combination of exercise therapy and complementary nutritional interventions. Additionally, new pharmacological agents (e.g. myostatin inhibitors, testosterone supplements, and ammonia-lowering therapy) are under investigation in preclinical studies. Here, we present a narrative review of the definition, assessment, and management of sarcopenia in patients with end-stage liver disease prior to and after liver transplantation.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hyperferritinemia and non-HFE hemochromatosis: differential diagnosis and workup. 高铁素血症和非hfe血色素沉着症:鉴别诊断和检查。
IF 1.5 4区 医学 Q2 Medicine Pub Date : 2023-04-01 DOI: 10.51821/86.2.11249
E Lommaert, W Verlinden, I Duysburgh, T Holvoet, J Schouten

Hyperferritinemia is a common reason for referral to a hepatogastroenterologist. The most frequent causes are not associated with iron overload (e.g. inflammatory diseases, alcohol abuse, metabolic syndrome, etc.). However, hyperferritinemia can also be caused by a genetic variant in one of the iron regulatory genes, called hereditary hemochromatosis, often but not always associated with iron overload. A variation in the human Hemostatic Iron Regulator protein (HFE) gene is the most common genotype, but many other variants have been described. In this paper we discuss two cases of rare hyperferritinemia associated disorders, ferroportin disease and hyperferritinemia-cataract syndrome. We also propose an algorithm for evaluating hyperferritinemia, facilitating a correct diagnosis and preventing potentially unnecessary examinations and therapeutic actions.

高铁素血症是一个常见的原因转介到肝胃肠病学家。最常见的原因与铁超载无关(如炎症性疾病、酗酒、代谢综合征等)。然而,高铁素血症也可能是由一种铁调节基因的遗传变异引起的,称为遗传性血色素沉着症,通常但并不总是与铁超载有关。人类止血铁调节蛋白(HFE)基因的变异是最常见的基因型,但已经描述了许多其他变异。本文讨论了两例罕见的高铁蛋白血症相关疾病,铁转运蛋白病和高铁蛋白血症-白内障综合征。我们还提出了一种评估高铁蛋白血症的算法,促进正确诊断,防止可能不必要的检查和治疗行动。
{"title":"Hyperferritinemia and non-HFE hemochromatosis: differential diagnosis and workup.","authors":"E Lommaert,&nbsp;W Verlinden,&nbsp;I Duysburgh,&nbsp;T Holvoet,&nbsp;J Schouten","doi":"10.51821/86.2.11249","DOIUrl":"https://doi.org/10.51821/86.2.11249","url":null,"abstract":"<p><p>Hyperferritinemia is a common reason for referral to a hepatogastroenterologist. The most frequent causes are not associated with iron overload (e.g. inflammatory diseases, alcohol abuse, metabolic syndrome, etc.). However, hyperferritinemia can also be caused by a genetic variant in one of the iron regulatory genes, called hereditary hemochromatosis, often but not always associated with iron overload. A variation in the human Hemostatic Iron Regulator protein (HFE) gene is the most common genotype, but many other variants have been described. In this paper we discuss two cases of rare hyperferritinemia associated disorders, ferroportin disease and hyperferritinemia-cataract syndrome. We also propose an algorithm for evaluating hyperferritinemia, facilitating a correct diagnosis and preventing potentially unnecessary examinations and therapeutic actions.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Acta gastro-enterologica Belgica
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1