Editor-in-Chief, Deputy Editor 2017-2019





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Original articles

A Facebook survey to obtain alcohol-related information by young people and adolescents. An Italian Study.

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Background : Alcohol consumption by adolescents and young adults is an issue of significant public concern. Internet-based Social Networking sites, such as Facebook™, are potential avenues to reach young people easily. Objective : to underline the innovation in proposing surveys to collect health-related information regarding young people alcohol consumption and other substances abuse by using Social Networking Websites, particularly Facebook™. Methods : A questionnaire investigating modalities of alcohol consumption, drinking patterns’ risk behaviors and other substances abuse was proposed through a “Facebook event” to young Italian Facebook users aged between 16 and 32. Each Facebook user invited to the event was free to participate, to answer to the questionnaire and to invite his “Facebook friends”. Results : During the 89 days of permanence on the Social Network, 1846 Facebook users participated the event and 732 of them decided spontaneously to answer the questionnaire. The frequency of answering was 8,2 people per day. About 200 users wrote a positive comment to the initiative on the wall of the event. Sixty% of subjects participating the survey were females. Ninety-one% of people answering the questionnaire were alcohol consumers. More than 50% of alcohol consumers were also smokers. Approximately 50% of subjects were binge drinkers. Illegal drugs were used by the 22.2% of the interviewed people. Conclusions : Facebook™ resulted an efficient and rapid tool to reach young people from all over Italy and to propose surveys in order to investigate alcohol consumption and alcohol-related health problems in the youth. (Acta gastroenterol. belg., 2014, 77, 18-24). [Product Details...]

Characteristics, treatment, and virologic responses of chronic hepatitis C patients treated with peginterferon alfa-2a and ribavirin in Belgium : a sub-analysis of the PROPHESYS study

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Background and study aims : PROPHESYS was a prospective, international cohort study of monoinfected, treatment-naive chronic hepatitis C patients treated with a combination of peginterferon alfa-2a or alfa-2b and ribavirin. It included worldwide 7,163 patients from 19 countries (including 384 patients from Belgium alone) and demonstrated that sustained virologic response rates in the real world were similar to those achieved in well-controlled clinical trials. The objective of this sub-analysis was to present an overview of the baseline characteristics, anti-hepatitis C drug treatment, and virologic responses of the patients treated in Belgium, infected with HCV genotype 1, 2, 3, or 4, and administered peginterferon alfa-2a. Moreover, the impact of ribavirin dosage on the response to treatment was studied. Patients and methods : 356 patients were included in this subanalysis. All variables were summarized using descriptive statistics. Results : Compared to the published data of the whole study population (1), the Belgian data presented some significant differences in terms of genotype distribution and response to treatment (e.g. lower prevalence of HCV genotype 1 infection, lower virologic response rates in HCV genotype 2 patients). Deviations from existing recommendations were identified (e.g. higher dose of ribavirin in HCV genotype 2 or 3 patients). Patients who received less than 80% of the target dose of ribavirin experienced a significantly weaker response to treatment. Conclusion : This sub-analysis provided an interesting profile of the Belgian experience in the treatment of chronic hepatitis C. (Acta gastroenterol. belg., 2014, 77, 30-40). [Product Details...]

Clinical significance of bowel wall thickening on computed tomography in HIV-infected patients : association of anemia and hypoalbuminemia.

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Computed tomography scanning of the abdomen and pelvis is a frequently used procedure. Advanced technology and the availability of superior scanning instruments [such as helical or multidetector scanners (MDCT)] have made detection of subtle gastrointestinal tract disorders facile. Thickening of the gastrointestinal or bowel wall is an increasingly recognized abnormality seen on computed tomography (CT) scanning of the abdomen and pelvis. Normally, on CT scanning of the abdomen, esophageal wall thickness is not greater than 5 millimeters (mm) in thickness (1), the stomach wall is usually less than 3 mm (2) or 5 mm (1) in thickness, the duodenal wall is less than 3 mm (2), the small bowel wall is less than 4 mm, and the colonic wall is less than 3 mm (1,2). [Product Details...]

Depth of remission in Crohn’s disease patients seen in a referral centre : associated factors and impact on disease outcome

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Introduction : Our goals were to assess the prevalence of biological and tissue remission in routine practice in Crohn’s disease, and to evaluate the correlation between biological or tissue remission and clinical or demographic characteristics as well as their impact on disease outcome. Methods : We performed a retrospective monocenter study. Biological remission was defined by a CRP remission ; 102/147 (69%) were in biological remission. Fifty-six patients also had morphological evaluation : 37 (66%) were in tissue remission. Biological remission was associated with older age, higher hemoglobin and lower BMI. Tissue remission was associated with older age, lower platelets count, absence of previous surgery, and the use of immunosuppressant. Time-to-relapse was significantly longer in patients with biological remission and in patients with tissue remission as compared to patients without biological or tissue remission. Conclusions : Among the patients in clinical remission seen as outpatients, two thirds were either in biological and/or tissue remission. Biological and/or tissue remission was associated with a better outcome than clinical remission alone. (Acta gastroenterol. belg., 2014, 77, 41-46). [Product Details...]

Diagnosing and treating pediatric Crohn’s disease patients : is there a difference between adult and pediatric gastroenterologist’s practices ? Results of the BELCRO cohort.

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In many countries the cut off age for pediatric care lies between 15-18 y of age (1). Above that age, patients are transferred to gastroenterologists for adult patients. Adequate transition for these patients has been the subject of many publications (1-3). Even though pediatric Crohn’s disease (CD) patients differ from adults (4), there is often a grey zone for teenagers, whom gastroenterologists accept under their care. Pediatric CD patients present more often with severe and extensive disease, growth retardation and pubertal delay (4,5). Growth is specific to childhood and adolescence and it is a crucial factor at diagnosis. Disease management needs to incorporate the achievement of full growth potential (6). Even though general treatment practices for pediatric care are derived from adult practice, specific approaches such as nutritional therapy, have proven to be particularly efficient in the pediatric age group (7). Specific criteria for the diagnosis of pediatric inflammatory bowel disease (IBD), the Porto Criteria, have been published evoking the importance of clinical, biochemical and endoscopic evaluation of upper and lower gastrointestinal (GI) tract as well as small bowel imaging (8). The diagnostic yield of an upper endoscopy in pediatric CD is around 10% in recent studies (9,10), while upper endoscopy in adult care is not considered mandatory. In this article we review the difference in presentation, diagnostic procedures and initial treatment between pediatric CD patients registered in the Belgium registry for pediatric Crohn’s disease (BELCRO) by pediatric gastroenterologists and gastroenterologists for adult patients. The BELCRO database was initiated in May 2008 through a collaboration of the IBD working group of the Belgian Society for Pediatric Gastroenterology, Hepatology and Nutrition (BESPGHAN) and the Belgian IBD Research and Development Group (BIRD). The registry recruited previously and newly diagnosed pediatric CD patients over a 2 y period and is following them prospectively for 5 years. All Belgian pediatric and adult gastroenterology centers were invited to participate in the registry. [Product Details...]

Gastrostomy use in children : a 3-year single centre experience.

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Aim : Monocentric retrospective paediatric study describing indications for gastrostomy and major complications, compared to literature data as part of a quality check. Methods : Records of all gastrostomy patients consulting at the UZ Ghent paediatric gastro-enterology department between January 2007-December 2009 were reviewed in December 2010 regarding indication, age and weight at tube insertion, insertion method, major complications and current gastrostomy tube type. Results : 178 patients were included of which 165 (93%) were placed using the endoscopic pull technique, the others were placed surgically (n = 13). Neurodevelopmental disability with oral motor dysfunction was the major indication (113, 63%). Other indications were failure to thrive due to concomitant disease (65, 37%). Median age at tube insertion was 3yr (interquartile range (IQR) 0.6-9) with median tube time of 3.9 yr (IQR 1.9-7.2). Immediate complications were 1 peritonitis and 1 post-insertion fever episode. Late complications (10, 5.6%) were 1 gastrocolic fistula, 1 dislocation and 8 buried bumpers after 4 yr (range 3.5- 10.4) of tube insertion. The incidence of buried bumper increased significantly with increasing PEG tube time (P [Product Details...]

Modified sequential Helicobacter Pylori eradication therapy using high dose omeprazole and amoxicillin in the initial phase in the extensive metaboliser turkish for CYP2C19 polymorphism is ineffective

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Aim : To investigate whether the sequential therapy composed of high dose omeprazole and high dose amoxicillin in the first step was effective in eradication of H. pylori and whether there was a relation between effectiveness of the therapy and CYP2C19 gene polymorphism. Method : 134 dyspeptic patients with H. pylori were administered a modified sequential therapy composed of omeprazole 40 mg t.i.d. and amoxicillin 1000 mg t.i.d. for the first five days followed by omeprazole 20 mg b.d., metronidazole 500 mg t.i.d. and tetracycline 500 mg t.i.d. for the next five days. CYP2C19 genotype status was determined in patients. Hp eradication status was investigated by C14 UNT four weeks after treatment. Results : The eradication rates were 64,9% in ITT and 74,3% in PP analysis. In subgroup analyses, eradication rates were 73,8% and 60,8% (p : 0,145) in ITT for peptic ulcer and non-ulcer dyspepsia patients respectively and 86,1% and 69,1% (p : 0,052) in PP analysis for peptic ulcer and non-ulcer dyspepsia patients respectively. The difference was not significant. As for the CYP2C19 gene status, 81,5% of the patients had HoEM and 17,3% of the patients had HeEM, and eradication rates were 72% and 75% in ITT analysis for HoEM and HeEM respectively (p : 0.803) and 73.9% and 85.7% in PP analysis for HoEM and HeEM respectively (p : 0.347). There was not a significant difference in H. pylori eradication rates between the two groups. Conclusion : This modified high-dose sequential therapy was ineffective in a Turkish sample, nearly all of whom had EM in terms of CYP2C19 gene status. (Acta gastroenterol. belg., 2014, 77, 3-7). [Product Details...]

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