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Original articles
"Percutaneous endoscopic gastrostomy for critically ill patients in a general intensive care unit"Price: €10,00 |
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Background and Aim : percutaneous endoscopic gastrostomy
(PEG) is an effective way of providing enteral feeding to patients
with functionally normal gastrointestinal tract who cannot meet
their nutritional needs because of inadequate oral intake. This retrospective
study evaluated the clinical outcome of critically ill patients
with high assistance level undergoing PEG in a general ICU
over a 12 year period.
Patients and Methods : we studied a cohort of 82 patients who
underwent PEG over a 12-year period between 1 January 1999 and
31 December 2010. Patients were followed-up for 1 year after PEG
placement.
Results : There were no complications related either to the procedure
or to the management of PEG, even in house nursing. In one
patient, PEG with a collapsible bumper was successfully removed
because the patient fully recovered from his neurological problem.
Catheter substitution was necessary in three patients during the
first year, because of stoma inflammation due to enteric reflux between
the stoma and the catheter. One year after PEG, 66 patients
were still alive while 16 patients died from the underlying disease
during hospitalization. None of the patients with PEG had aspiration
pneumonia.
Conclusions : PEG, in expert hands, is a safe and effective procedure
for enteral nutrition. Moreover, catheters should be chosen in
relation to the duration of enteral feeding and as to whether the
patient is likely to recover from his underlying disease. (Acta gastroenterol.
belg., 2013, 76, 306-310). [Product Details...] |
Diagnosing oesophagitis in children : how discriminative is histology ?Price: €10,00 |
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Background and study aims : We set out to evaluate the discriminatory
value of currently available histologic criteria in the differential
diagnosis of reflux oesophagitis and eosinophilic oesophagitis
in children.
Patients and Methods : We evaluated the oesophageal biopsies of
145 children and selected 28 demonstrative cases of clinically confirmed
eosinophilic oesophagitis (n = 7), and reflux oesophagitis
(n = 11) with a control group with normal histology (n = 10). Histological
assessment was performed for the presence of papillary
elongation, dilatation of intercellular spaces, basal cell hyperplasia
and the number of intraepithelial eosinophils, lymphocytes and
neutrophils.
Results : Among 28 children, there were 3 boys and 4 girls in
eosinophilic oesophagitis group, 8 boys and 3 girls in reflux group,
and 5 boys and 5 girls in normal group. The mean age was
10,4 years. Basal cell hyperplasia was observed in 12 cases while
papillary elongation was found in 25, and dilated intercellular
spaces were present in 20 cases. Lymphocyte and neutrophil counts
were significantly higher in reflux group when compared to eosinophilic
oesophagitis and normal group. Eosinophil counts were
significantly
higher in eosinophilic group.
Conclusions : Results of the present study suggest that, basal cell
hyperplasia, papillary elongation, and dilated intercellular spaces
all seem to be markers of oesophagitis regardless of the underlying
pathology and etiology, thereby, highlighting their rather nonspecific
nature in the differential diagnosis of various types of
oesophagitis.
The additional information on inflammatory cell
counts may help to distinguish reflux oesophagitis from other
causes of oesophagitis including EoO. (Acta gastroenterol.
belg.,
2013, 76, 300-305). [Product Details...] |
Liver transplantation for alcoholic liver disease : a retrospective analysis of recidivism, survival and risk factors predisposing to alcohol relapsePrice: €10,00 |
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Abstract
Background and study aims : Alcoholic liver disease (ALD) is the
second most common indication for liver transplantation. The aim
of this study was to evaluate the alcohol relapse rate and long-term
survival after liver transplantation for ALD and to identify risk
factors predisposing to alcohol relapse.
Patients and methods : Between 2000 and 2007, 108 patients
transplanted for ALD in the Ghent University Hospital were included
in this retrospective analysis. Relapse was defined as any
drinking after transplantation, problem drinking as more than
2 units/day for women and 3 units/day for men. A wide range of
variables was obtained from a questionnaire and medical records.
Results : The mean follow-up was 55 months. Relapse was observed
in 29%, 16% in problem drinking. The one- and five-year
survival was 87% and 74% respectively. No significant difference
in survival was found between non-relapsers, occasional drinkers
and problem drinkers. The following risk factors were found to be
significantly associated with relapse into problem drinking in an
univariate analysis : a shorter pre-transplant abstinence period,
the presence of a first degree relative with alcohol abuse and a higher
number of prior attempts to quit. In multivariable analysis, the
presence of a first degree relative with alcohol abuse was found associated
with relapse into problem drinking.
Conclusions : The presence of a first degree relative with alcohol
abuse is a valuable pre-transplant variable evaluating an ALD patient’s
eligibility for liver transplantation. Other variables are also
helpful to outline the broader context of the drinking behavior of
the patient. (Acta gastroenterol.
belg., 2013, 76, 282-290). [Product Details...] |
Longitudinal observation of viral load changes in untreated HBeAg negative chronic hepatitis BPrice: €10,00 |
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Abstract
Introduction : An HBV DNA level of 2000 IU/ml has been used to
differentiate HBeAg negative chronic hepatitis B from the inactive
carrier state. We sought to examine the nature and frequency of
fluctuations in viral load and ALT around this threshold.
Methods : A retrospective review of St Vincent’s Hospital database
was performed to identify patients who had been observed,
untreated, with HBV DNA and ALT levels over a period of at least
18 months.
Results : 27 HBeAg negative patients with HBV DNA had a drop of HBV DNA to 2000 IU/ml.
Conclusions : Minor fluctuations in HBV DNA up to 20,000 IU/
ml, accompanied by persistently normal ALT occur frequently in
HBeAg negative chronic hepatitis B. (Acta gastroenterol.
belg., 2013,
76, 275-281). [Product Details...] |
Response of Black African patients with hepatitis C virus genotype 4 to treatment with peg-interferon and ribavirinPrice: €10,00 |
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Abstract
Aim : To compare responses to therapy of Black African (BA)
and non-Black African (non- BA) patients with hepatitis C virus
genotype 4 (HCV-4) residing in Belgium.
Methods : In this retrospective multicenter study, 473 patients
with HCV-4 were selected from databases at 7 Belgian centers ;
209 treatment-naïve patients (154 BA) had received treatment with
peg-interferon (peg-IFN) plus ribavirin (RBV) and were included
in the study.
Results : There was a greater percentage of female patients in the
BA group than in the non- BA group ; BA patients were also older,
had a greater body mass index, and more frequently had abnormal
glucose metabolism. The route of contamination was more frequently
unknown in BA than in non-BA patients and BA patients
had more HCV-4 subtypes. There were no differences in other demographic
factors between the groups. Sustained viral response
(SVR) and complete early viral response rates were significantly
lower and relapse rates significantly higher in BA than in non-BA
patients. There were no differences between groups in rates of dose
modification or in drug tolerance.
Conclusion : In our cohort, treatment-naïve BA patients with
HCV-4 who were treated with peg-IFN and ribavirin had a much
lower SVR rate than treatment-naïve non-BA patients with HCV-
4 who were treated with peg-IFN and ribavirin, and a higher
relapse
rate, possibly related to a weaker response to interferonbased
therapy. Treatment may need to be adapted in this population.
(Acta gastroenterol.
belg., 2013, 76, 291-299). [Product Details...] |
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Acta Gastro-Enterologica Belgica is indexed in NCBI/PubMed.
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica