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Journal Cover United European Gastroenterology Journal
  [2 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2050-6406 - ISSN (Online) 2050-6414
   Published by Sage Publications Homepage  [852 journals]
  • Performance measures for upper gastrointestinal endoscopy: A European
           Society of Gastrointestinal Endoscopy quality improvement initiative
    • Authors: Bisschops, R; Areia, M, Coron, E, Dobru, D, Kaskas, B, Kuvaev, R, Pech, O, Ragunath, K, Weusten, B, Familiari, P, Domagk, D, Valori, R, Kaminski, M. F, Spada, C, Bretthauer, M, Bennett, C, Senore, C, Dinis-Ribeiro, M, Rutter, M. D.
      Pages: 629 - 656
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640616664843
      Issue No: Vol. 4, No. 5 (2016)
  • Endoscopic risk factors for neoplastic progression in patients with
           Barretts oesophagus
    • Authors: Bureo Gonzalez, A; Bergman, J. J, Pouw, R. E.
      Pages: 657 - 662
      Abstract: Barrett’s oesophagus is a precursor lesion for oesophageal adenocarcinoma, which generally has a poor prognosis. Patients diagnosed with Barrett’s oesophagus therefore undergo regular endoscopic surveillance to detect neoplastic lesions at a curable stage. The efficacy of endoscopic surveillance of Barrett’s oesophagus patients is, however, hampered by difficulties to detect early neoplasia endoscopically, biopsy sampling error, inter-observer variability in histological assessment and the relatively low overall progression rate. Efficacy and cost-effectiveness of Barrett’s surveillance may be improved by using endoscopic and clinical characteristics to risk-stratify Barrett’s patients to high- and low-risk categories. Recent national and international surveillance guidelines have incorporated Barrett’s length and presence of low-grade dysplasia in the advised surveillance intervals. In this review we will discuss endoscopic characteristics that may be associated with neoplastic progression in Barrett’s oesophagus and that may be used to tailor surveillance in Barrett’s patients.
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640616635509
      Issue No: Vol. 4, No. 5 (2016)
  • Oesophageal biopsies are insufficient to predict final histology after
           endoscopic resection in early Barretts neoplasia
    • Authors: Werbrouck, E; De Hertogh, G, Sagaert, X, Coremans, G, Willekens, H, Demedts, I, Bisschops, R.
      Pages: 663 - 668
      Abstract: BackgroundEndoscopic resection (ER) with or without ablation is the first choice treatment for early Barrett’s neoplasia. Adequate staging is important to assure a good oncological outcome.ObjectiveThe purpose of this study was to investigate the diagnostic accuracy of pre-operative biopsies in patients who undergo ER for high-grade dysplasia (HGD) or early adenocarcinoma (EAC) in Barrett’s oesophagus (BE) and the cardia.MethodsBetween November 2005–May 2012, 142 ERs performed in 137 patients were obtained. Worst pre-ER and ER histology were compared. Upgrading/downgrading was defined as any more/less severe histological grading on the ER specimen.ResultsThe accuracy of pre-ER biopsies in predicting final histology was 61%. ER changed the pre-treatment diagnosis in 55 of the 142 procedures (39%) with downgrading in 23 cases (16%) and upgrading from HGD to T1a or T1b in 32 cases (23%). In the majority of upgraded cases, a visible lesion according to the Paris classification could be detected (26/32, 81%).ConclusionThe diagnostic accuracy of oesophageal biopsies alone in predicting final pathology in Barrett’s dysplasia is only 61%. The majority of upgraded lesions are detectable. When ablative therapy is considered in HGD Barrett's dysplasia a meticulous inspection for and removal of all small visible lesions is mandatory.
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640615626320
      Issue No: Vol. 4, No. 5 (2016)
  • Prediction of low bone mineral density in patients with inflammatory bowel
    • Authors: Schüle, S; Rossel, J.-B, Frey, D, Biedermann, L, Scharl, M, Zeitz, J, Freitas-Queiroz, N, Pittet, V, Vavricka, S. R, Rogler, G, Misselwitz, B, for the Swiss IBD cohort study
      Pages: 669 - 676
      Abstract: BackgroundLow bone mineral density (BMD) remains a frequent problem in patients with inflammatory bowel diseases (IBD). There is no general agreement regarding osteoporosis screening in IBD patients.MethodsCases of low BMD and disease characteristics were retrieved from 3172 patients of the Swiss IBD cohort study. Multivariate logistic regression analysis was conducted for predictive modeling. In a subgroup of 877 patients, 253 dual-energy X-ray absorptiometry (DXA) scans were available for validation.ResultsLow BMD was prevalent in 19% of patients. We identified seven predictive factors: type of IBD, age, recent steroid usage, low body mass index, perianal disease, recent high disease activity and malabsorption syndrome. Low BMD could be predicted with a sensitivity of 79% and a specificity of 64%, a positive predictive value (PPV) of 35% and a negative predictive value (NPV) of 93%. The area under the curve of the receiver operating characteristics was 0.78. In the validation cohort we calculated a PPV of 26% and an NPV of 88%.ConclusionWe provide a comprehensive analysis of risk factors for low BMD and propose a predictive model with seven clinical variables. The high NPV of models such as ours might help in excluding low BMD to prevent futile investigations.
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640616658224
      Issue No: Vol. 4, No. 5 (2016)
  • Sphingosine kinase 1 inhibition improves
           lipopolysaccharide/D-galactosamine-induced acute liver failure by
           inhibiting mitogen-activated protein kinases pathway
    • Authors: Tian, T; Tian, W, Yang, F, Zhao, R, Huang, Q, Zhao, Y.
      Pages: 677 - 685
      Abstract: BackgroundSphingosine kinase 1 (SphK1)/sphingosine-1-phosphate (S1P)/sphingosine-1-phosphate receptors (S1PRs) signaling plays a key role in inflammatory responses. Lei et al. showed that SphK1 inhibition presented a hepatoprotective effect on acute liver damage via decreasing hepatic high-mobility group box 1 (HMGB1) cytoplasmic translocation.ObjectiveWe aim to determine whether SphK1 or S1PRs inhibition improves lipopolysaccharide (LPS)/D-galactosamine (GalN)-induced acute liver failure by inhibiting the mitogen-activated protein kinases (MAPKs) pathway.MethodsA mouse model of acute liver failure was induced by LPS/GalN. Male C57BL/6J mice (6–8 weeks) were randomly distributed into five groups: control group, LPS/GalN group, SphK1 inhibition group (LPS/GalN+SKI-5c), S1PR1 inhibition group (LPS/GalN+W146), and S1PR3 inhibition group (LPS/GalN+CAY10444).ResultsWe confirmed the findings of Lei et al. that hepatic SphK1 expression was upregulated; serum transaminase activity (AST, ALT), as well as serum TNF-α and IL-6, were decreased by SphK1 inhibition. We further showed that the expression of S1PR1 and S1PR3 was augmented in response to LPS/GalN. SphK1 inhibition improves hepatic hemorrhage, and the activities of hepatic caspase-3 and myeloperoxidase (MPO). Furthermore, the activation of the MAPKs family (JNK, ERK and p38) was suppressed by SphK1 inhibition. However, S1PR1 or S1PR3 inhibition did not protect the mouse against liver damage, though S1PR1 or S1PR3 inhibition reduced serum TNF-α and IL-6, and partially attenuated the phosphorylation of the MAPKs signaling.ConclusionsSphK1 inhibition improves LPS/GalN-induced liver injury by inhibiting activation of MAPKs signaling.
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640616637968
      Issue No: Vol. 4, No. 5 (2016)
  • Towards a healthy stomach' Helicobacter pylori prevalence has
           dramatically decreased over 23 years in adults in a Swedish community
    • Authors: Agreus, L; Hellström, P. M, Talley, N. J, Wallner, B, Forsberg, A, Vieth, M, Veits, L, Björkegren, K, Engstrand, L, Andreasson, A.
      Pages: 686 - 696
      Abstract: BackgroundIn Western countries the prevalence of Helicobacter pylori (H. pylori) infection may be declining but there is a lack of recent longitudinal population studies. We evaluated the changing epidemiology over a 23-year period in Sweden.Materials and methodsIn 1989, the validated Abdominal Symptom Questionnaire (ASQ) was mailed to a random sample of inhabitants (ages 22–80 years) in a Swedish community, and 1097 (87%) responded. H. pylori serology was analysed in a representative subsample (n = 145). Twenty-three years later, the ASQ was mailed again using similar selection criteria, and 388 out of 1036 responders had an upper endoscopy with assessment of H. pylori and corpus atrophy status.ResultsThe prevalence of positive H. pylori serology decreased from 37.9% (1989) to 15.8% (2012), corresponding to a decrease in odds of 75% per decade (odds ratio (OR): 0.25; 95% confidence interval (CI): 0.11–0.59, p = 0.001) independent of age, gender, body mass index (BMI) and level of education, with a pattern consistent with a birth cohort effect. The prevalence increased with increasing age (p = 0.001). The prevalence of H. pylori on histology in 2012 was 11.4% (95% CI 8.6–15.0). The prevalence of corpus atrophy on serology and/or histology in 2012 was 3.2% (95% CI 1.8–5.5); all cases were ≥57 years old.ConclusionThe stomach is healthier in 2012 compared with 1989. H. pylori prevalence in adults has decreased over the last two decades to a level where clinical management might be affected.
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640615623369
      Issue No: Vol. 4, No. 5 (2016)
  • Systematic review and meta-analysis: Small intestinal bacterial overgrowth
           in chronic pancreatitis
    • Authors: Capurso, G; Signoretti, M, Archibugi, L, Stigliano, S, Delle Fave, G.
      Pages: 697 - 705
      Abstract: BackgroundEvidence on small intestinal bacterial overgrowth (SIBO) in patients with chronic pancreatitis (CP) is conflicting.AimThe purpose of this study was to perform a systematic review and meta-analysis on the prevalence of SIBO in CP and to examine the relationship of SIBO with symptoms and nutritional status.MethodsCase-control and cross-sectional studies investigating SIBO in CP patients were analysed. The prevalence of positive tests was pooled across studies, and the rate of positivity between CP cases and controls was calculated.ResultsIn nine studies containing 336 CP patients, the pooled prevalence of SIBO was 36% (95% confidence interval (CI) 17–60%) with considerable heterogeneity (I2 = 91%). A sensitivity analysis excluding studies employing lactulose breath test gave a pooled prevalence of 21.7% (95% CI 12.7–34.5%) with lower heterogeneity (I2 = 56%). The odds ratio for a positive test in CP vs controls was 4.1 (95% CI 1.6–10.4) (I2 = 59.7%). The relationship between symptoms and SIBO in CP patients varied across studies, and the treatment of SIBO was associated with clinical improvement.ConclusionsOne-third of CP patients have SIBO, with a significantly increased risk over controls, although results are heterogeneous, and studies carry several limitations. The impact of SIBO and its treatment in CP patients deserve further investigation.
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640616630117
      Issue No: Vol. 4, No. 5 (2016)
  • Mortality and complications following surgery for diverticulitis:
           Systematic review and meta-analysis
    • Authors: Haas, J. M; Singh, M, Vakil, N.
      Pages: 706 - 713
      Abstract: BackgroundThe surgical treatment of diverticulitis is in a state of evolution. Clinicians across many disciplines need to counsel patients regarding surgical choices.ObjectivesA systematic review and meta-analysis was conducted to determine the mortality and complication rates following surgery for diverticulitis in both the emergent and elective setting.MethodsWe searched PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant articles published from 1980 to 2012. The primary outcome of interest was the point estimate of mortality, following surgery for diverticulitis.ResultsOf the 289 citations reviewed, we included 59 studies. Overall, the point estimate for mortality was 3.05%, with a 95% confidence intereval (CI) of 1.73–5.32 and p < 0.001. Mortality following emergent surgery was 10.64% (95% CI 7.95–14.11; p < 0.001), versus 0.50% (95% CI 0.46–0.54; p < 0.001) following elective operations. A laparoscopic approach had an estimated mortality of 0.75% (95% CI 0.35–1.58; p < 0.001), compared to an open surgical approach, which had a mortality of 4.69% (95% CI 2.29–9.36, p < 0.001). The mortality following a resection with primary anastomosis was 1.96% (95% CI 1.22–3.13; p < 0.001) and for the Hartmann’s procedure was 14.18% (95% CI 9.83–20.03; p < 0.001). A comparative analysis found that the risk of post-operative mortality was significantly higher following emergent surgery, compared to elective surgery (odds ratio (OR): 6.12 with 95% CI 1.62–23.10; p = 0.008; Q = 2.56, p = 0.46 and I2 = 0); the open approach, compared to a laparoscopic approach (OR: 36.43 with 95% CI 9.94–133.6; p = 0.13; and Q = 2.79, p = 0.25 and I2 = 28.26); and for Hartmann’s procedure, compared to primary anastomosis without diversion (OR: 25.45 with 95% CI 15.13–42.81, p < 0.001; and Q = 23.34, p = 0.14 and I2 = 27.16). The overall reported post-operative complication rate was 32.64% (95% CI 27.43–38.32; p < 0.00). The overall surgical and medical complication rates were 18.96% and 13.93%, respectively.ConclusionsUrgent surgical treatment of diverticulitis has a significant complication rate. Even elective surgery has a significant complication rate that needs to be considered when doing the clinical decision-making for recurrent diverticulitis.
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640615617357
      Issue No: Vol. 4, No. 5 (2016)
  • Basophil activation test in oral desensitization to cows milk allergy
    • Authors: Chirumbolo; S.
      Pages: 714 - 715
      Abstract: The recent paper by Nucera et al., showed that the basophil activation test (BAT) in flow cytometry is able to monitor an acquired tolerance induced by a desensitization treatment in food allergy. The paper by Nucera et al. reported two standpoints in the CD63 response to food allergy and OAT and their large difference in CD63 response before and after suggests for the optimal performance of a CD123/HLADR/CD63 BAT in oral food allergy immunotherapy.
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640615614793
      Issue No: Vol. 4, No. 5 (2016)
  • Highlights of UEG Week 2017, Barcelona
    • Authors: Tilg; H.
      Pages: 716 - 716
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640616669649
      Issue No: Vol. 4, No. 5 (2016)
  • How to achieve a smooth transition from fellowship to faculty
    • Authors: Krag, A; Thiele, M.
      Pages: 717 - 718
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640616669651
      Issue No: Vol. 4, No. 5 (2016)
  • UEG Visiting Fellowship Programme - my experience with the Visiting
           Fellowship for Clinicians Award
    • Pages: 719 - 719
      PubDate: 2016-09-27T08:04:12-07:00
      DOI: 10.1177/2050640616669650
      Issue No: Vol. 4, No. 5 (2016)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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Fax: +00 44 (0)131 4513327
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