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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]
  • Genetic susceptibility to Barretts oesophagus: Lessons from early studies
    • Authors: Findlay, J. M; Middleton, M. R, Tomlinson, I.
      Pages: 485 - 492
      Abstract: Barrett’s oesophagus (BO) is a common condition, predisposing strongly to the development of oesophageal adenocarcinoma (OAC). Consequently, there has been considerable effort to determine the processes involved in the development of BO metaplasia, and ultimately develop markers of patients at risk. Whilst a number of robust acquired risk factors have been identified, a genetic component to these and the apparent increased susceptibility of certain individuals has long been suspected. This has been evidenced in part by linkage studies, but subsequently two recent genome-wide association studies (GWAS) have suggested mechanisms underlying the heritability of BO, as well as providing the first direct evidence at modern levels of statistical significance. This review discusses BO heritability, in addition to that of individual variants and genes reported to be associated with BO to date. Through this, we identify a number of plausible associations, although often tempered by issues of methodology, and discuss the priorities and need for future research.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615611018
      Issue No: Vol. 4, No. 4 (2016)
  • Toward an antifibrotic therapy for inflammatory bowel disease
    • Authors: Rieder; F.
      Pages: 493 - 495
      Abstract: Fibrosis in inflammatory bowel disease (IBD) is a largely unresolved clinical problem. Despite recent advances in anti-inflammatory therapies over the last few decades, the occurrence of intestinal strictures in Crohn’s disease patients has not significantly changed. No antifibrotic therapies are available. This journal supplement will address novel mechanisms of intestinal fibrosis, biomarker and imaging techniques and is intended to provide a roadmap toward antifibrotic therapies in IBD.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640616660000
      Issue No: Vol. 4, No. 4 (2016)
  • Genetic and epigenetic regulation of intestinal fibrosis
    • Authors: Li, C; Kuemmerle, J. F.
      Pages: 496 - 505
      Abstract: Crohn’s disease affects those individuals with polygenic risk factors. The identified risk loci indicate that the genetic architecture of Crohn’s disease involves both innate and adaptive immunity and the response to the intestinal environment including the microbiome. Genetic risk alone, however, predicts only 25% of disease, indicating that other factors, including the intestinal environment, can shape the epigenome and also confer heritable risk to patients. Patients with Crohn’s disease can have purely inflammatory disease, penetrating disease or fibrostenosis. Analysis of the genetic risk combined with epigenetic marks of Crohn’s disease and other disease associated with organ fibrosis reveals common events are affecting the genes and pathways key to development of fibrosis. This review will focus on what is known about the mechanisms by which genetic and epigenetic risk factors determine development of fibrosis in Crohn’s disease and contrast that with other fibrotic conditions.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640616659023
      Issue No: Vol. 4, No. 4 (2016)
  • The two sides of the coin: Similarities and differences in the
           pathomechanisms of fistulas and stricture formations in irritable bowel
    • Authors: Scharl, M; Bruckner, R. S, Rogler, G.
      Pages: 506 - 514
      Abstract: Fistulas and fibrosis or strictures represent frequent complications in irritable bowel disease (IBD) patients. To date, treatment options for fistulas are limited and surgery is often required. Similarly, no preventive treatment for fibrosis and stricture formation has been established. Frequently, stricture formation and fibrosis precede fistula formation, indicating that both processes may be connected or interrelated. Knowledge about the pathology of both processes is limited. A crucial role for the epithelial-to-mesenchymal transition (EMT) in fistula development has been demonstrated. Of note, EMT also plays a major role in the pathogenesis of fibrosis in many organs, and most likely also plays that role in the intestine. In addition, aberrant matrix remodeling, as well as soluble factors such as tumor necrosis factor (TNF), interleukin 13 (IL-13) and tumor growth factor beta (TGFβ) were involved, both in the onset of the fistula and fibrosis formation. Both fistulas and fibrosis may occur due to deregulated wound healing mechanisms from chronic and severe intestinal inflammation; however, further research is required to obtain a better understanding of the complex pathophysiology of fistula and intestinal fibrosis formation, to allow the development of new and more effective preventive treatment options for those important disease complications.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640616635957
      Issue No: Vol. 4, No. 4 (2016)
  • Imaging of intestinal fibrosis: current challenges and future methods
    • Authors: Stidham, R. W; Higgins, P. D.
      Pages: 515 - 522
      Abstract: Crohn’s disease (CD) activity assessments are dominated by inflammatory changes without discrete measurement of the coexisting fibrotic contribution to total bowel damage. Intestinal fibrosis impacts the development of severe structural complications and the overall natural history of CD. Measuring intestinal fibrosis is challenging and existing methods of disease assessment are unable to reliably distinguish fibrosis from inflammation. Both the immediate clinical need to measure fibrosis for therapeutic decision-making and the near-future need for tools to assess pipeline anti-fibrotic medications highlight the demand for biomarkers of fibrosis in CD. Developing non-invasive technologies exploit changes in intestinal perfusion, mechanical properties, and macromolecular content to provide quantitative markers of fibrosis. In this review of existing and experimental technologies for imaging intestinal fibrosis, we discuss the expanding capabilities of quantitative MR and ultrasound imaging, encouraging developments in non-invasive elastography, and emerging novel methods including photoacoustic imaging.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640616636620
      Issue No: Vol. 4, No. 4 (2016)
  • Biomarkers of intestinal fibrosis - one step towards clinical trials for
           stricturing inflammatory bowel disease
    • Authors: Giuffrida, P; Pinzani, M, Corazza, G. R, Di Sabatino, A.
      Pages: 523 - 530
      Abstract: Intestinal fibrosis, caused by an excessive deposition of extracellular matrix components, and subsequent stricture development are a common complication of inflammatory bowel disease. However, currently there are no biomarkers which reliably predict the risk of developing intestinal strictures or identify early stages of fibrosis prior to clinical symptoms. Candidate biomarkers of intestinal fibrosis, including gene variants (i.e. nucleotide-binding oligomerization domain-2 gene), serum microRNAs (miR-19, miR-29), serum extracellular matrix proteins (i.e. collagen, fibronectin) or enzymes (i.e. tissue inhibitor of matrix metalloproteinase-1), serum growth factors (i.e. basic fibroblast growth factor, YKL-40), serum anti-microbial antibodies (i.e. anti-Saccharomyces cerevisiae) and circulating cells (i.e. fibrocytes) have shown conflicting results on relatively heterogeneous patients’ cohorts, and none of them was proven to be strictly specific for fibrostenosis, but rather predictive of a disease disabling course. In this review we critically reassess the diagnostic and prognostic value of serum biomarkers of intestinal fibrosis in inflammatory bowel disease.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640616640160
      Issue No: Vol. 4, No. 4 (2016)
  • Cytokine and anti-cytokine therapies in prevention or treatment of
           fibrosis in IBD
    • Authors: Jacob, N; Targan, S. R, Shih, D. Q.
      Pages: 531 - 540
      Abstract: The frequency of fibrosing Crohn’s disease (CD) is significant, with approximately 40% of CD patients with ileal disease developing clinically apparent strictures throughout their lifetime. Although strictures may be subdivided into fibrotic, inflammatory, or mixed forms, despite immunosuppressive therapy in CD patients in the form of steroids or immunomodulators, the frequency of fibrostenosing complications has still remained significant. A vast number of genetic and epigenetic variables are thought to contribute to fibrostenosing disease, including those that affect cytokine biology, and therefore highlight the complexity of disease, but also shed light on targetable pathways. Exclusively targeting fibrosis may be difficult, however, because of the relatively slow evolution of fibrosis in CD, and the potential adverse effects of inhibiting pathways involved in tissue repair and mucosal healing. Acknowledging these caveats, cytokine-targeted therapy has become the mainstay of treatment for many inflammatory conditions and is being evaluated for fibrotic disorders. The question of whether anti-cytokine therapy will prove useful for intestinal fibrosis is, therefore, acutely relevant. This review will highlight some of the current therapeutics targeting cytokines involved in fibrosis.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640616649356
      Issue No: Vol. 4, No. 4 (2016)
  • Pharyngeal pH monitoring in gastrectomy patients - what do we really
    • Authors: Wilhelm, D; Jell, A, Feussner, H, Schmid, R. M, Bajbouj, M, Becker, V.
      Pages: 541 - 545
      Abstract: Aim Diagnosis of laryngopharyngeal reflux (LPR) has dramatically increased over the last years. For diagnosis of gastroesophageal reflux, a newly designed pharyngeal probe (Dx-pH) was recently introduced. It is also recommended to guide therapy decision in antireflux surgery. However, diagnostic results are questionable. Therefore, we establish a reliable reference group with asymptomatic patients after total gastrectomy and, thus, complete extinction of gastric acid production. Methods Pharyngeal pH monitoring was performed in 10 consecutive patients with history of total gastrectomy. All patients were off proton pump inhibitor (PPI) therapy and followed a non-acid diet during the complete measurement period. Results All procedures were performed without any complication. Six of the 10 asymptomatic gastrectomy patients (60%) had pathological results derived from the validated reference values (Ryan score) in pharyngeal pH monitoring. Conclusion Pathological pH values assessed by the Dx-pH device, usually interpreted as pathological aerosolized acidic gastroesophageal and/or laryngopharyngeal reflux, are obviously dissociated from gastric acid production. Further studies are required to determine diagnostic value of the new system. Therefore, the pharyngeal pH monitoring system seems currently not to be useful to guide any diagnostic or therapeutic decisions, in particular if surgical therapy is considered.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615617637
      Issue No: Vol. 4, No. 4 (2016)
  • Systematic review and meta-analysis: Multi-strain probiotics as adjunct
           therapy for Helicobacter pylori eradication and prevention of adverse
    • Authors: McFarland, L. V; Huang, Y, Wang, L, Malfertheiner, P.
      Pages: 546 - 561
      Abstract: Background Eradication rates with triple therapy for Helicobacter pylori infections have currently declined to unacceptable levels worldwide. Newer quadruple therapies are burdened with a high rate of adverse events. Whether multi-strain probiotics can improve eradication rates or diminish adverse events remains uncertain. Methods Relevant publications in which patients with H. pylori infections were randomized to a multi-strain probiotic or control were identified in PubMed, Cochrane Databases, and other sources from 1 January 1960–3 June 2015. Primary outcomes included eradication rates, incidence of any adverse event and the incidence of antibiotic-associated diarrhea. As probiotic efficacy is strain-specific, pooled relative risks and 95% confidence intervals were calculated using meta-analysis stratified by similar multi-strain probiotic mixtures. Results A total of 19 randomized controlled trials (20 treatment arms, n = 2730) assessing one of six mixtures of strains of probiotics were included. Four multi-strain probiotics significantly improved H. pylori eradication rates, five significantly prevented any adverse reactions and three significantly reduced antibiotic-associated diarrhea. Only two probiotic mixtures (Lactobacillus acidophilus/Bifidobacterium animalis and an eight-strain mixture) had significant efficacy for all three outcomes. Conclusions Our meta-analysis found adjunctive use of some multi-strain probiotics may improve H. pylori eradication rates and prevent the development of adverse events and antibiotic-associated diarrhea, but not all mixtures were effective.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615617358
      Issue No: Vol. 4, No. 4 (2016)
  • Clinical course and prognosis of pediatric-onset primary sclerosing
    • Pages: 562 - 569
      Abstract: Background The natural history of pediatric-onset primary sclerosing cholangitis (PSC) and overlap with autoimmune hepatitis (PSC/AIH) is poorly known. Objective The aim of this study was to evaluate the clinical outcome of patients with pediatric-onset disease in a tertiary referral center. Methods We traced 33 patients (median age at diagnosis 16 years), with PSC or PSC/AIH in cholangiography and liver histology diagnosed between December 1993 and 2011, at Helsinki University Hospital. Diagnostic procedures and long-term follow-up were reassessed until the end of December 2013. Results PSC was confirmed in all 33 patients; 19 of them had an overlap with AIH. At diagnosis, three of 33 had cirrhosis. Inflammatory bowel disease (IBD) was associated in 76% of the patients, mostly ulcerative colitis (70%); treatment of IBD being a minor determinant of the clinical outcome of liver disease. In the last follow-up (median nine years), all patients were alive, and no malignancy occurred. Most patients (91%) were on ursodeoxycholic acid and 12 PSC/AIH patients on immunosuppression. Endoscopic retrograde cholangiography during follow-up showed a progression of intra-hepatic disease in 12 patients (36%). Four patients (12%) had undergone liver transplantation, and one was listed; no recurrence of the disease in the graft was seen. Conclusion The clinical course and outcome of pediatric-onset PSC and PSC/AIH seem to be favourable in the majority of patients until early adulthood. In about one-third of patients, however, PSC is progressive, challenging the current treatment guidelines and warranting further studies on disease pathogenesis.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615616012
      Issue No: Vol. 4, No. 4 (2016)
  • Short-term effects and adverse events of endoscopically applied
           radiofrequency ablation appear to be comparable with photodynamic therapy
           in hilar cholangiocarcinoma
    • Authors: Schmidt, A; Bloechinger, M, Weber, A, Siveke, J, von Delius, S, Prinz, C, Schmitt, W, Schmid, R, Neu, B.
      Pages: 570 - 579
      Abstract: Background and study aims Radiofrequency ablation (RFA) is a new endoscopic palliation therapy for malignant biliary obstruction. The aim of this study was to compare the short-term effects of biliary drainage and adverse events of this technique with the standard of endoscopical treatment of hilar cholangiocarcinoma, photodynamic therapy (PDT). Patients and methods We retrospectively and since December 2012 prospectively investigated the efficacy and adverse events of RFA in patients with hilar cholangiocarcinoma in two tertiary referral centers between November 2011 and January 2013. The approach of the study was prospective, but because of the large amount of retrospectively included patients, the design of the study is overall retrospective. A group of 20 patients treated with PDT between April 2005 and May 2011 served as a historical control. Results Fourteen patients received 31 biliary RFAs and 20 patients received 36 PDTs. Within the RFA group, a significant decrease (p = 0.046) of the bilirubin level was seen 14 days after the first RFA (3.3 ± 3.9 (mg/dl) versus 2.3 ± 2.6 (mg/dl)). In the PDT group no significant decrease (p = 0.67) of the bilirubin level was obtained (4.1 ± 6.9 (mg/dl) versus 3.5 ± 5.3 (mg/dl)). In the PDT group (13/20, 65%) a significantly higher number of premature stent replacements (
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615621235
      Issue No: Vol. 4, No. 4 (2016)
  • Accuracy of 2012 International Consensus Guidelines for the prediction of
           malignancy of branch-duct intraductal papillary mucinous neoplasms of the
    • Authors: Robles, E. P.-C; Maire, F, Cros, J, Vullierme, M.-P, Rebours, V, Sauvanet, A, Aubert, A, Dokmak, S, Levy, P, Ruszniewski, P.
      Pages: 580 - 586
      Abstract: Objective To determine accuracy of 2012 International Consensus Guidelines (ICG) predicting malignancy in a surgical cohort of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN). Methods This study included all consecutive patients with final pathological diagnosis of pure BD-IPMN resected between 2006 and 2014 at Beaujon Hospital. Neoplasms were classified as malignant in presence of high-grade dysplasia (HGD) or invasive carcinoma. Medical, pathological, and radiological data were retrospectively recorded. Results One hundred and twenty patients (65 males, mean age: 57.9 ± 10.8 years) were included. Malignant BD-IPMN accounted for 30% (HGD: 18%, invasive: 12%). Thickened cyst walls (odds ratio (OR): 3.058, 95% confidence interval (CI 95%): 1.102–8.484, p = 0.032), main duct diameter 5–9 mm (OR: 3.395, CI 95%: 1.349–8.543, p = 0.007), and mural nodule (OR: 3.802, CI 95%: 1.156–12.511, p = 0.028) were independently associated with malignancy in multivariate analysis. Among the 89 patients (74%) who underwent surgical resection with ICG criteria, the malignancy rate was 38%, compared with 6% in the 31 ICG-negative group. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for malignancy of having at least one ICG criteria were 94%, 34%, 38%, 94%, and 53%, respectively. Patients with malignant tumors had more ICG criteria than those with benign lesions (2.06 ± 0.98 vs. 0.99 ± 0.95, p < 0.001). Conclusions 2012 ICG criteria are useful to manage BD-IPMN permitting not to miss a malignant form (NPV of 94%), but frequently point out unnecessary surgery (PPV of 38%). Malignancy rate increases with the number of ICG criteria. In patients with only one criterion, additional criteria would be necessary.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615623370
      Issue No: Vol. 4, No. 4 (2016)
  • Interval cancers in a national colorectal cancer screening programme
    • Authors: Steele, R. J; Stanners, G, Lang, J, Brewster, D. H, Carey, F. A, Fraser, C. G.
      Pages: 587 - 594
      Abstract: Background Little is known about interval cancers (ICs) in colorectal cancer (CRC) screening. Objective The purpose of this study was to identify IC characteristics and compare these with screen-detected cancers (SCs) and cancers in non-participants (NPCs) over the same time period. Design This was an observational study done in the first round of the Scottish Bowel Screening Programme. All individuals (772,790), aged 50–74 years, invited to participate between 1 January 2007 and 31 May 2009 were studied by linking their screening records with confirmed CRC records in the Scottish Cancer Registry (SCR). Characteristics of SC, IC and NPC were determined. Results There were 555 SCs, 502 ICs and 922 NPCs. SCs were at an earlier stage than ICs and NPCs (33.9% Dukes’ A as against 18.7% in IC and 11.3% in NPC), screening preferentially detected cancers in males (64.7% as against 52.8% in IC and 59.7% in NPC): this was independent of a different cancer site distribution in males and females. SC in the colon were less advanced than IC, but not in the rectum. Conclusion ICs account for 47.5% of the CRCs in the screened population, indicating approximately 50% screening test sensitivity: guaiac faecal occult blood testing (gFOBT) sensitivity is less for women than for men and gFOBT screening may not be effective for rectal cancer.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615624294
      Issue No: Vol. 4, No. 4 (2016)
  • Underwater endoscopic mucosal resection: The third way for en bloc
           resection of colonic lesions'
    • Authors: Amato, A; Radaelli, F, Spinzi, G.
      Pages: 595 - 598
      Abstract: Background Underwater endoscopic mucosal resection without submucosal injection has been described for removing large flat colorectal lesions. Objective We aim to evaluate the reproducibility of this technique in terms of ease of implementation, safety and efficacy. Methods A prospective observational study of consecutive underwater endoscopic mucosal resection in a community hospital was performed. Results From September 2014 to April 2015, 25 flat or sessile colorectal lesions (median size 22.8 mm, range 10–50 mm; 18 placed in the right colon) were removed in 25 patients. Two of the lesions were adenomatous recurrences on scar of prior resection and one was a recurrence on a surgical anastomosis. The resection was performed en bloc in 76% of the cases. At the pathological examination, 14 lesions (56%) had advanced histology and seven (28%) were sessile serrated adenomas (two with high-grade dysplasia). Complete resection was observed in all the lesions removed en bloc. Intra-procedural bleeding was observed in two cases; both were managed endoscopically and were uneventful. No major adverse events occurred. Conclusion Underwater endoscopic mucosal resection appears to be an easy, safe and effective technique in a community setting. Further studies evaluating the efficacy of the technique (early and late recurrence), as well as comparing it with traditional mucosal resection, are warranted.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615617635
      Issue No: Vol. 4, No. 4 (2016)
  • Confocal laser endomicroscopy features of sessile serrated adenomas/polyps
    • Authors: Parikh, N. D; Gibson, J, Nagar, A, Ahmed, A. A, Aslanian, H. R.
      Pages: 599 - 603
      Abstract: Background and aims Sessile serrated adenomas/polyps (SSA/Ps) are difficult to differentiate from non-neoplastic tissue on white-light endoscopy. Confocal laser endomicroscopy (CLE) provides subcellular imaging and real-time "optical biopsy". The aim of this study was to prospectively describe CLE features of SSA/Ps. Patients and methods Consecutive patients with SSA/Ps were prospectively evaluated with probe-based CLE imaging. CLE images and polyp histology were independently reviewed by three endoscopists and an expert gastrointestinal (GI) pathologist. Distinguishing CLE features of SSA/Ps were identified in conjunction with pathologic correlation. Results In total, 260 CLE images were generated from nine SSA/Ps evaluated in seven patients. Four consensus CLE features of SSA/P were identified: (1) a mucus cap with a bright, cloud-like appearance; (2) thin, branching crypts; (3) increased number of goblet cells and microvesicular mucin-containing cells; and (4) architectural disarray, with dystrophic goblet cells and lack of regular circular crypts Conclusion This is a novel description of characteristic CLE features of SSA/Ps. The four features we identified are easy to detect and may allow for CLE to serve as a diagnostic modality.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615621819
      Issue No: Vol. 4, No. 4 (2016)
  • Predictive value of the Diverticular Inflammation and Complication
           Assessment (DICA) endoscopic classification on the outcome of diverticular
           disease of the colon: An international study
    • Authors: Tursi, A; Brandimarte, G, Di Mario, F, Annunziata, M. L, Bafutto, M, Bianco, M. A, Colucci, R, Conigliaro, R, Danese, S, De Bastiani, R, Elisei, W, Escalante, R, Faggiani, R, Ferrini, L, Forti, G, Latella, G, Graziani, M. G, Oliveira, E. C, Papa, A, Penna, A, Portincasa, P, Soreide, K, Spadaccini, A, Usai, P, Bonovas, S, Scarpignato, C, Picchio, M, DICA Collaborative Group: Luigi Di Cesare, Lecca, P. G, Zampaletta, C, Cassieri, C, Damiani, A, Desserud, K. F, Fiorella, S, Landi, R, Goni, E, Lai, M. A, Pigo, F, Rotondano, G, Schiaccianoce, G.
      Pages: 604 - 613
      Abstract: Background Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification has been recently developed for patients suffering from diverticulosis and diverticular disease. Aims We assessed retrospectively the predictive value of DICA in patients for whom endoscopic data and clinical follow-up were available. Methods For each patient, we recorded: age, severity of DICA, presence of abdominal pain, C-reactive protein and faecal calprotectin test (if available) at the time of diagnosis; months of follow-up; therapy taken during the follow-up to maintain remission (if any); occurrence/recurrence of diverticulitis; need of surgery. Results We enrolled 1651 patients (793 M, 858 F, mean age 66.6 ± 11.1 years): 939 (56.9%) patients were classified as DICA 1, 501 (30.3%) patients as DICA 2 and 211 (12.8%) patients as DICA 3. The median follow-up was 24 (9–38) months. Acute diverticulitis (AD) occurred/recurred in 263 (15.9%) patients; surgery was necessary in 57 (21.7%) cases. DICA was the only factor significantly associated to the occurrence/recurrence of diverticulitis and surgery either at univariate (2 = 405.029; p < 0.0001) or multivariate analysis (hazard ratio = 4.319, 95% confidence interval (CI) 3.639–5.126; p < 0.0001). Only in DICA 2 patients was therapy effective for prevention of AD occurrence/recurrence with a hazard ratio (95% CI) of 0.598 (0.391–0.914) (p = 0.006, log rank test). Mesalazine-based therapies reduced the risk of AD occurrence/recurrence and needs of surgery with a hazard ratio (95% CI) of 0.2103 (0.122–0.364) and 0.459 (0.258–0.818), respectively. Conclusions DICA classification is a valid parameter to predict the risk of diverticulitis occurrence/recurrence in patients suffering from diverticular disease of the colon.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640615617636
      Issue No: Vol. 4, No. 4 (2016)
  • Oesophageal motility disorders in infected immigrants with Chagas disease
           in a non-endemic European area
    • Authors: Roure, S; Valerio, L, Valles, X, Morales, B, Garcia-Diaz, M. I, Pedro-Botet, M. L, Serra, J.
      Pages: 614 - 620
      Abstract: Background Immigration-related new diseases pose a growing challenge for healthcare services in receptor countries. Following Latin American migration, Chagas disease has inevitably appeared in Europe. Aim To determine the prevalence and characteristics of oesophageal motility disorders in immigrants infected with Trypanosoma cruzi, using high resolution oesophageal manometry (HREM). Methods In all newly-diagnosed cases with chronic Chagas infection referring upper digestive symptoms, a protocolized clinical evaluation and complementary tests including barium oesophagogram and HREM were carried out. As control group, 14 healthy subjects from the same endemic areas were studied with HREM. Results We included 61 patients (46 female, 15 male; age range 26–63 years). Only seven patients (11%) had a minor alteration on barium oesophagogram. By contrast, 23 (37%) patients showed an alteration in oesophageal manometry, mainly minor motility disorders (34%). Only one healthy control (7%) had a minor motility disorder at HREM (p = 0.029 vs. patients). Conclusions Oesophageal motor disorders in infected immigrants with Chagas disease are common, and mainly characterized by a minor motility disorder that is not detected by barium oesophagogram. Hence, as well as barium oesophagogram examination, HREM should be considered, to assess oesophageal damage in this specific group of patients.
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640616630856
      Issue No: Vol. 4, No. 4 (2016)
  • UEG Standards and Guidelines: A UEG initiative to reduce health
           inequalities across Europe
    • Authors: Dignass; A.
      Pages: 621 - 622
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/1363461516660042
      Issue No: Vol. 4, No. 4 (2016)
  • The ABC of E-learning: Utilizing E-learning resources for training and
           research in gastroenterology
    • Authors: Adar, T; Murray, C.
      Pages: 623 - 624
      PubDate: 2016-07-14T01:19:48-07:00
      DOI: 10.1177/2050640616660043
      Issue No: Vol. 4, No. 4 (2016)
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