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Journal Cover United European Gastroenterology Journal
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   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 2050-6406 - ISSN (Online) 2050-6414
     Published by Sage Publications Homepage  [738 journals]
  • Giovanni Gasbarrini, winner of the UEG Lifetime Achievement Award 2013
    • Authors: Tack J.
      Pages: 253 - 253
      PubDate: 2014-07-28T09:01:50-07:00
      DOI: 10.1177/2050640614544249|hwp:resource-id:spueg;2/4/253
      Issue No: Vol. 2, No. 4 (2014)
       
  • Wheat-related disorders: A broad spectrum of 'evolving' diseases
    • Authors: Gasbarrini, G; Mangiola, F.
      Pages: 254 - 262
      Abstract: Throughout the world, cereals have always been recognized as a fundamental food. Human evolution, through the development of cooking, led to the production of food rich in gluten, in order to take full advantage of the nutritional properties of this food. The result has been that gluten intolerance has arisen only in those populations that developed the art of cooking wheat. It is also recognized that wheat, one of the central elements of the Mediterranean diet, cannot be tolerated in some individuals. Among the wheat-related pathologies, coeliac disease is the best known: it is a chronic inflammatory condition affecting the gastrointestinal tract, which develops in genetically predisposed individuals. The most common manifestation is the malabsorption of nutrients. Recently, another wheat-related disease has appeared: non-coeliac gluten sensitivity, defined as the onset of a variety of manifestations related to wheat, rye and barley ingestion, in patients in whom coeliac disease and wheat allergy have been excluded. In this paper we will explore the damaging power of wheat, analysing the harmful process by which it realizes the onset of clinical manifestations associated with wheat-related disorders.
      PubDate: 2014-07-28T09:01:50-07:00
      DOI: 10.1177/2050640614535929|hwp:resource-id:spueg;2/4/254
      Issue No: Vol. 2, No. 4 (2014)
       
  • Helicobacter pylori immunization and atopic dermatitis in South Italian
           children
    • Authors: Pedulla, M; Fierro, V, Del Tufo, E, Alfano, R, Triassi, M, Perrone, L.
      Pages: 263 - 267
      Abstract: Background The epidemiological decrease of Helicobacter pylori (Hp) infection has been recently associated to the increase of several extra-intestinal allergic disorders. Objective We investigated the role of specific Hp IgG production in the development of IgE or not IgE mediated food allergy (FA) in children affected by atopic dermatitis (AD). Methods From January 2010 to July 2013, 290 South Italian children, aged between 26 and 142 months, were consecutively referred to the Pediatric Clinic of the Pediatric Department at Second University of Naples and were diagnosed as affected by AD. The patients were classified in two groups on the basis of diagnosis of food allergy (88 FA affected and 202 not FA affected) and further divided on the basis of the diagnosis of atopy (63 IgE mediated and 23 not IgE mediated). Hp serum IgG was detected using an enzyme linked immunosorbent assay (ELISA) kit (Wampole® Helicobactor pylori IgG ELISA II, Wampole Laboratories, Cranbury, NJ) and Hp stool antigens using enzyme immunoassay (Premier Platinum HpSa plus, Cincinnati OH). Results We found a statistically significant higher prevalence of Hp serology positivity in not FA vs. FA AD-affected children (p = 0.032) and a significant inverse association between FA and Hp immunization (1/OR 0.32 95% CI 0.11–0.95). Further, we identified an absolute prevalence Hp serology positivity in not-IgE-mediated rather than in IgE-mediated FA AD-affected patients (p = 0.0006). Conclusion We hypothesize that specific Hp IgG production could protect against the development of both FA and atopy in AD-affected children.
      PubDate: 2014-07-28T09:01:50-07:00
      DOI: 10.1177/2050640614544314|hwp:resource-id:spueg;2/4/263
      Issue No: Vol. 2, No. 4 (2014)
       
  • Tetramer-visualized gluten-specific CD4+ T cells in blood as a potential
           diagnostic marker for coeliac disease without oral gluten challenge
    • Authors: Christophersen, A; Raki, M, Bergseng, E, Lundin, K. E, Jahnsen, J, Sollid, L. M, Qiao, S.-W.
      Pages: 268 - 278
      Abstract: Background Diagnosing coeliac disease (CD) can be challenging, despite highly specific autoantibodies and typical mucosal changes in the small intestine. The T-cell response to gluten is a hallmark of the disease that has been hitherto unexploited in clinical work-up. Objectives We aimed to develop a new method that directly visualizes and characterizes gluten-reactive CD4+ T cells in blood, independently of gluten challenge, and to explore its diagnostic potential. Methods We performed bead-enrichment of DQ2.5-glia-α1a and DQ2.5-glia-α2 tetramer+ cells in the blood of control individuals, treated (TCD) and untreated patients (UCD). We visualized these cells by flow cytometry, sorted them and cloned them. We assessed their specificity by antigen stimulation and re-staining with tetramers. Results We detected significantly more gliadin-tetramer+ CD4+ effector memory T cells (TEM) in UCD and TCD patients, compared to controls. Significantly more gliadin-tetramer+ TEM in the CD patients than in controls expressed the gut-homing marker integrin-β7. Conclusion Quantification of gut-homing, gluten-specific TEM in peripheral blood, visualized with human leukocyte antigen (HLA) -tetramers, may be used to distinguish CD patients from healthy individuals. Easy access to gluten-reactive blood T cells from diseased and healthy individuals may lead to new insights on the disease-driving CD4+ T cells in CD.
      PubDate: 2014-07-28T09:01:50-07:00
      DOI: 10.1177/2050640614540154|hwp:master-id:spueg;2050640614540154
      Issue No: Vol. 2, No. 4 (2014)
       
  • Optimized contrast-enhanced ultrasonography for characterization of focal
           liver lesions in cirrhosis: A single-center retrospective study
    • Authors: de Sio, I; Iadevaia, M. D, Vitale, L. M, Niosi, M, Del Prete, A, de Sio, C, Romano, L, Funaro, A, Meucci, R, Federico, A, Loguercio, C, Romano, M.
      Pages: 279 - 287
      Abstract: Background Hepatocellular carcinoma (HCC) is the leading cause of death amongst cirrhotic patients. Its diagnosis and discrimination from non-HCC malignant lesions in cirrhosis includes contrast enhanced computed tomography (CECT), contrast enhanced magnetic resonance imaging (CEMRI), or, in selected cases, liver biopsy. The role of contrast-enhanced ultrasonography (CEUS) is still controversial. Aims To evaluate whether, by selecting an appropriate ‘time to wash-out’ cut-off value, CEUS capability of discriminating between HCC and non-HCC malignancies in cirrhotic patients may be enhanced. Methods We enrolled 282 cirrhotic patients who underwent CEUS at our institute, from January 2008 to January 2012, for focal liver lesions (FLLs) detected at ultrasound (US). We used liver biopsy and subsequent histological evaluation as the gold standard for correct classification of FLLs. We calculated the area under receiver operator characteristic curves for CEUS to distinguish patients with HCC from those with non-HCC malignancies. The best ‘time to wash-out’ cut-off values were selected. Results Histological diagnosis of FLLs was as follows: 34 benign lesions (i.e. 25 regenerative nodules and 9 dysplastic nodules) and 248 malignant lesions (223 well-to-moderately differentiated HCCs; 7 poorly-differentiated HCCs; 5 intrahepatic colangiocellular carcinomas (ICCs); 5 primary non-Hodgkin B-cell lymphomas (NHBLs); and 8 metastatic liver tumors). A time to wash-out > 55 s identified patients with HCC with the highest level of accuracy (92.7%). Similarly, a time to wash-out ≤ 55 s correctly identified the vast majority of the non-HCC malignancies (100% sensitivity, 98.2% specificity and diagnostic accuracy of 98.3%). Conclusions CEUS is an accurate and safe procedure for discriminating FLLs in cirrhotic patients, especially when a cut-off time to wash-out of 55 s is chosen as a reference value.
      PubDate: 2014-07-28T09:01:51-07:00
      DOI: 10.1177/2050640614538964|hwp:master-id:spueg;2050640614538964
      Issue No: Vol. 2, No. 4 (2014)
       
  • Sensitivity and specificity of an abbreviated 13C-mixed triglyceride
           breath test for measurement of pancreatic exocrine function
    • Authors: Keller, J; Meier, V, Wolfram, K. U, Rosien, U, Layer, P.
      Pages: 288 - 294
      Abstract: Background A modified 13C-mixed triglyceride breath test (13C -MTGT) detects moderate pancreatic exocrine insufficiency noninvasively and reliably, but it requires prolonged breath sampling (6 hours (hr)). Objective We aimed to investigate whether 13C -MTGT can be abbreviated, to optimize clinical usability. Methods We analyzed the 13C-MTGT of 200 consecutive patients, retrospectively. Cumulative 1–5 hr 13C-exhalation values were compared with the standard parameter (6-hr cumulative 13C-exhalation). We determined the sensitivity and specificity of shortened breath sampling periods, by comparison with the normal values from 10 healthy volunteers, whom also underwent a secretin test to quantitate pancreatic secretion. Moreover, we evaluated the influence of gastric emptying (GE), using a 13C-octanoic acid breath test in a subset (N = 117). Results The 1–5 hr cumulative 13C-exhalation tests correlated highly and significantly with the standard parameter (p < 0.0001). Sensitivity for detection of impaired lipolysis was high (≥77%), but the specificity was low (≥38%) for the early measurements. Both parameters were high after 4 hrs (88% and 94%, respectively) and 5 hrs (98% and 91%, respectively). Multivariate linear correlation analysis confirmed that GE strongly influenced early postprandial 13C-exhalation during the 13C-MTGT. Conclusion Shortening of the 13C -MTGT from 6 to 4 hrs of duration was associated with similar diagnostic accuracy, yet increased clinical usability. The influence of GE on early postprandial results of the 13C-MTGT precluded further abbreviation of the test.
      PubDate: 2014-07-28T09:01:51-07:00
      DOI: 10.1177/2050640614542496|hwp:master-id:spueg;2050640614542496
      Issue No: Vol. 2, No. 4 (2014)
       
  • Variation in caecal intubation rates between screening and symptomatic
           patients
    • Authors: Nagrath, N; Phull, P. S.
      Pages: 295 - 300
      Abstract: Background The caecal intubation rate (CIR) is an important quality standard for endoscopists, as well as for national bowel cancer screening programmes; however, individuals undergoing colonoscopy for bowel screening and symptomatic patients represent different groups, and their characteristics may affect colonoscopy performance. Objective To compare colonoscopists’ performance, as assessed by the CIR, in symptomatic patients compared to individuals undergoing colonoscopy for bowel cancer screening. Methods Retrospective audit of CIRs for all patients undergoing colonoscopy at our institution during the year 2008. We retrieved the data from an endoscopy reporting software database and from the local bowel cancer screening programme database. Demographic data was extracted, as well as details of known factors that may affect completion of colonoscopy, such as poor bowel preparation, presence of diverticular disease, polyps, tumour and strictures. The unadjusted CIRs for colonoscopists participating in the screening programme were compared between the bowel screening and the symptomatic patient groups. Results Five screening colonoscopists performed 1056 colonoscopies, of which 488 were bowel screening procedures. The overall CIR was significantly lower in the symptomatic, compared to the screening, individuals (88.5% versus 93%, P < 0.02). No significant differences were observed between the two groups for risk factors that could impair the CIR. The CIR was
      PubDate: 2014-07-28T09:01:51-07:00
      DOI: 10.1177/2050640614536898|hwp:master-id:spueg;2050640614536898
      Issue No: Vol. 2, No. 4 (2014)
       
  • Diagnostic impact of routine colonoscopy following acute diverticulitis: A
           multicenter study in 808 patients and controls
    • Authors: Lecleire, S; Nahon, S, Alatawi, A, Antonietti, M, Chaput, U, Di-Fiore, A, Alhameedi, R, Marteau, P, Ducrotte, P, Dray, X.
      Pages: 301 - 306
      Abstract: Background The diagnosis of acute diverticulitis is mainly based on clinical, biological and computed tomography (CT)-scan findings. Elective colonoscopy is recommended after medical treatment, to rule out another diagnosis and to detect associated conditions; however, the relevance of this recommendation has been questioned. Patients and methods Between January 2005 and December 2011, we retrospectively identified in three referral centers the consecutive patients whom underwent a colonoscopy after the medical treatment of a CT scan-proven acute diverticulitis episode. We excluded from the analysis patients with haematochezia or recent change in bowel habits. Sex and age-matched asymptomatic patients undergoing a screening colonoscopy were chosen as a control group. We collected and compared the results of colonoscopy and histological findings in both groups. Results We matched 404 patients whom underwent a colonoscopy after an episode of acute diverticulitis with 404 control patients. Their mean age was 60.9 years, with 59% being women. Colorectal adenoma, advanced adenoma and cancer detection rates in acute diverticulitis patients were 12.1%, 2.7% and 0.25%, respectively; versus 14.6% (p = 0.35), 6.7% (p = 0.01) and 0.25% respectively, in control patients. Conclusions Diagnosis rates for adenomas and for colorectal cancer during a colonoscopy scheduled after acute diverticulitis were similar than those of control patients undergoing a screening colonoscopy, while the detection rate of advanced adenomas was lower. We suggest that colonoscopy should be indicated only in selected patients, i.e. those presenting with reasonable doubt on initial CT-scan, those with alarm symptoms, and those with identified risk factors for colorectal cancer.
      PubDate: 2014-07-28T09:01:51-07:00
      DOI: 10.1177/2050640614541765|hwp:master-id:spueg;2050640614541765
      Issue No: Vol. 2, No. 4 (2014)
       
  • Reappraisal of the so-called 'villous tumours' of the rectosigmoid, based
           on histological, immunohistochemical and genotypic features
    • Authors: Droy-Dupre, L; Kury, S, Coron, E, Bezieau, S, Laboisse, C. L, Mosnier, J.-F.
      Pages: 307 - 314
      Abstract: Background Villous tumours of the rectosigmoid are historically defined as broad-based lesions associated with secretory diarrhoea. Objective This study aimed to perform a reappraisal of these tumours, on the basis of newly introduced histological, immunohistochemical and molecular parameters. Methods For this study, 22 villous tumours, diagnosed by endoscopic criteria (19 Paris 0–IIa, three Paris 0–Is), were evaluated according to WHO classification. Microsatellite instability status, KRAS and BRAF mutations, MGMT status of villous tumours and associated invasive carcinoma were determined. Results The 22 villous tumours fell into four groups: 1) nine villous adenomas, 2) six tubulovillous adenomas, 3) three filiform traditional serrated adenomas, and 4) four traditional serrated adenomas with conventional dysplasia. Filiform serrated adenomas displayed a distinctive endoscopic protruding pattern (Paris 0-Is). Villous adenomas were strongly associated with secretory diarrhoea. All the villous tumours were microsatellite stable. Five tumours exhibited MGMT abnormalities. KRAS mutations were frequent in villous adenomas, whereas BRAF mutations were essentially detected in serrated lesions. Invasive carcinomas (n = 7) maintained the histopathological and molecular imprint of the prior villous tumour. Conclusion The rectosigmoid villous tumours are histologically and molecularly heterogeneous, including serrated neoplasias. Endoscopic and clinical findings are predictive of the histopathological diagnosis of some of these distinct entities.
      PubDate: 2014-07-28T09:01:51-07:00
      DOI: 10.1177/2050640614541258|hwp:master-id:spueg;2050640614541258
      Issue No: Vol. 2, No. 4 (2014)
       
  • Young Talent Group launches actions for young gastroenterologists by
           introducing the UEG Young GI Network
    • Pages: 316 - 316
      PubDate: 2014-07-28T09:01:51-07:00
      DOI: 10.1177/2050640614543876|hwp:resource-id:spueg;2/4/316
      Issue No: Vol. 2, No. 4 (2014)
       
  • UEG Public Affairs Activities: Successes and challenges ahead
    • Pages: 317 - 318
      PubDate: 2014-07-28T09:01:51-07:00
      DOI: 10.1177/2050640614543882|hwp:resource-id:spueg;2/4/317
      Issue No: Vol. 2, No. 4 (2014)
       
  • UEG Week Vienna 2014: Endoscopy - new features in a multi-disciplinary
           setting
    • Pages: 319 - 319
      PubDate: 2014-07-28T09:01:51-07:00
      DOI: 10.1177/2050640614543885|hwp:resource-id:spueg;2/4/319
      Issue No: Vol. 2, No. 4 (2014)
       
 
 
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