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Original articles
"Bifidobacterium lactis B94 plus inulin for Treatment of Helicobacter pylori infection in children : does it increase eradication rate and patient compliance ?"Price: €10,00 |
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| The aim of this study is to investigate the effects of Bifidobacterium
lactis B94 and inulin (synbiotic) treatment on eradication rate
and patient compliance in subjects treated for symptomatic H. pylori
infection. Patients with symptomatic H. pylori infection were
divided into two groups. One group was treated with standard triple
therapy (lansoprazole, amoxicillin, and clarithromycin) and
B. lactis B94 (5 × 109 CFU/dose) plus inulin (900 mg) twice daily for
seven days. The control group was treated with standard triple
therapy and placebo. The side effects and eradication rates were
evaluated at the end of the study. Ninety-three patients with H. pylori
infection were treated with either synbiotic plus triple therapy
(n = 47) or placebo plus triple therapy (n = 46). The infection eradication
rates were not significantly different between the synbiotic
and placebo groups [intent-to-treat (ITT), 80.8% and 67.3%,
p = 0.13, respectively ; per-protocol (PP), 86.3% and 81.5%,
p = 0.55, respectively]. The drug side effects were significantly
higher in the placebo group than in the synbiotic group (63% and
17%, respectively, p [Product Details...] |
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Budd-Chiari syndrome : reassessment of a step-wise treatment strategyPrice: €10,00 |
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| Background and study aims : The Budd-Chiari syndrome is a
rare disorder characterized by hepatic venous outflow obstruction.
A step-wise management was recently proposed. The aim of this
study is to reassess our treatment approach and long-term outcome.
Patients and methods : The data of 37 Budd-Chiari patients, seen
in our unit, were critically analyzed and compared with the ENVIE
(European Network For Vascular Disorders of the Liver) data.
Results : Most patients had multiple prothrombotic conditions
(41%), of which an underlying myeloproliferative neoplasm was
the most frequent (59%). The JAK2V617F mutation was associated
with more complete occlusion of all hepatic veins (JAK2 mutation
+ : 70% vs JAK2 mutation - : 23% and a higher severity score.
The step-wise treatment algorithm used in our unit, in function of
the severity of the liver impairment and the number and the extension
of hepatic veins occluded, resulted in the following treatments :
only anticoagulation (n = 7.21%), recanalization procedure (n =
4.21%), portosystemic shunts (n = 9.26%) and liver transplantation
(n = 14.44%). This resulted in a 10 year survival rate of 90%.
Treatment of the underlying hemostatic disorder offered a low recurrence
rate. None of the 21 patients with a myeloproliferative
neoplasm died in relation to the hematologic disorder.
Conclusion : An individualized treatment regimen consisting of
anticoagulation and interventional radiology and/or transplantation
when necessary and strict follow-up of the underlying hematologic
disorder, provided an excellent long-term survival, which
confirm the data of the ENVIE study. (Acta gastroenterol.
belg.,
2015, 78, 299-305). [Product Details...] |
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Comparison of the effects of bispectral index-controlled use of remifentanil on propofol consumption and patient comfort in patients undergoing colonoscopyPrice: €10,00 |
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| Background and study aims : In endoscopic procedures, propofol
can be safely administered either alone or in conjunction with
remifentanil. The aim of the study is to compare the effects of
the administration of propofol alone and the administration of
remifentanil
in addition to propofol on patient and endoscopist
satisfaction,
preoperative hemodynamic response, and propofol
consumption.
Materials and methods : A totally 60 patients were enrolled in the
study. Propofol group (Group 1) : A 0.4-mg/kg propofol bolus and
1 mg/kg/h maintenance infusion of propofol until a bispectral
Indexvalue
of 70-75 was achieved. Propofol + remifentanil group
(Group 2) received a 0.4 mg/kg propofol bolus dose and maintained
with a 0.5 mg/kg/h infusion of propofol + 0.2 mcg/kg/min infusion
of remifentanil. The infusion dose of remifentanil was maintained,
and the propofol infusion dose was titrated until a BIS value of 70-
75 was achieved.
Results : In Group 1 (colonoscopic intervention 1 and 5 min) and
Group 2 (colonoscopic intervention 10 min.), main blood pressure
(MBP) value has a significant decrease. Hypotension occurred
in 6
patients in group 1, while 12 patients in group 2. No significant difference
was found between the Patient’s endoscopist’ satisfaction,
MBP and heart rate. Propofol consumption was greater in group 1
than in group 2. When the Ramsay sedation levels of Group 1 and
Group 2 were compared, a statistically significant difference
was
observed.
Conclusion : The addition of remifentanil to propofol may be an
alternative to the use of alone propofol for sedation in colonoscopic
interventions. (Acta gastroenterol.
belg., 2015, 78, 314-318). [Product Details...] |
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Hepatic Sarcoidosis : Clinico-pathological characterization of symptomatic casesPrice: €10,00 |
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| Aim : The aim of this study was to investigate the clinical and
pathological features of hepatic sarcoidosis in symptomatic cases.
Methods : Twenty-two symptomatic hepatic sarcoidosis cases
were included in the study. Hepatic sarcoidosis was determined by
typical imaging, histopathology, and high angiotensin-converting
enzyme levels. Demographic data, laboratory data, imaging findings,
liver biopsies, and clinical findings were analyzed. Portal
hypertension
(PH) was defined by the presence of ascites and/or
varices ; imaging findings suggestive of PH-splenomegaly (> 12 cm
on longest axis) ; portal vein dilation (> 13 mm) ; collateral vessel
formation ; and hepatic venous pressure gradient ≥ 6 mmHg.
Results : Mean age was 49.63 ± 10.7 years. Liver tests showed
elevated
serum alkaline phosphatase and gamma-glutamyl transpeptidase
levels (95%). Serum albumin levels were low (is
mimics and overlaps with PBC and PSC. (Acta gastroenterol.
belg., 2015, 78, 306-313). [Product Details...] |
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Percutaneous radiofrequency ablation for hepatocellular carcinoma located in the caudate lobe of the liverPrice: €10,00 |
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| Aim : This study aimed to evaluate the effectiveness and safety of
radiofrequency ablation (RFA) for hepatocellular carcinoma
(HCC) located in the caudate lobe of the liver.
Patients and methods : Between 2012 April and 2014 February,
142 patients with HCC meeting the Milan criteria were enrolled in
this study. Of these patients, nine patients had HCC located in the
caudate lobe (caudate group). Six of the nine cases were located in
the Spiegel lobe, two cases were located in the paracaval portion
and one case was located in the caudate process. We evaluated the
local recurrence rate and RFA-related complications in the caudate
group and non-caudate group.
Results : The local recurrence rate in the caudate group was
12.5% at 1 year and 12.5% at 2 years, while the local recurrence
rate in the non-caudate group was 14.9% at 1 year and 29.0% at
2 years ; there were no significant differences between the groups.
No complications were observed in the caudate group, and minor
complications were observed in six patients (4.5%) in the non-caudate
group. No major complications or mortalities were
observed
in either group, and the complication rates were not
significantly
different between the groups (P = 1).
Conclusions : RFA for HCC in the caudate lobe and the noncaudate
lobe has equivalent effectiveness and safety. RFA is a
promising treatment option for HCC arising in the caudate lobe.
(Acta gastroenterol.
belg., 2015, 78, 267-273). [Product Details...] |
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Persisting signs of disease activity at Magnetic Resonance Enterocolonography predict clinical relapse and disease progression in quiescent Crohn’s diseasePrice: €10,00 |
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| Introduction : Deep remission including clinical remission and
tissue healing has been advocated as the therapeutic target in
Crohn’s disease. Yet, the definition of deep remission remains unclear.
The aim of this study was to assess the persisting lesions at magnetic
resonance enterocolonography (MREC) in clinically quiescent
Crohn’s disease as well as their relapse predictive value.
Methods : we performed a prospective monocentre cohort study.
We included patients with clinical remission. At baseline, these patients
had blood tests, the measurement of fecal calprotectin and
underwent a MREC. They were then followed up clinically for a
minimum of 1 year. A relapse was defined by a HBI > 4 with an
increase of at least 3 points. Correlations between clinical, demographic,
biological parameters and MREC signs were assessed as
well as the time-to-relapse predictive value of the studied variables.
Results : Twenty seven patients were recruited. Fourteen out of
27 had persisting disease activity at MREC. MREC signs only partly
correlated with biomarkers. Ten out of 27 patients relapsed over
a median follow up of 25 months. In univariate analysis, relative
contrast enhancement of the most affected segment (HR : 2.56 ;
P = 0.046), ulcers (HR : 12.5 ; P = 0.039), fistulas (HR : 14.1 ;
P = 0.009) and target sign (HR : 3.63 ; P = 0.049) were associated
with relapse. In multivariate analysis, fistula was the only one.
Conclusions : Half of the patients with clinically quiescent
Crohn’s disease had persisting signs of disease activity at MREC.
These signs predicted time-to-relapse. (Acta gastroenterol.
belg.,
2015, 78, 274-281). [Product Details...] |
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Prevalence of advanced histologic features in diminutive colon polypsPrice: €10,00 |
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| Background/Aims : Accurate in vivo differentiation of colon
polyp histology may serve to prevent the resection of diminutive
hyperplastic polyps in the distal colon or the need for histologic
assesment of diminutive polyps after resection. The clinical
implementation of these strategies depends on the prevalence of
advanced histologic findings among diminutive polyps. We aimed
to determine the prevalence of advanced histologic features (villous
features, high-grade dysplasia, and adenocarcinoma) in diminutive
colon polyps and compare it to small and larger polyps.
Patients/Methods : The data of patients who had undergone
elective
colonoscopy at a tertiary-care referral center were retrospectively
reviewed. The size, morphology, and location of all
polyps
were recorded. Polyps were divided into 3 groups according
to their size : diminutive (≤ 5 mm), small (6-9 mm), and large
(≥ 10 mm).
Results : A total of 7160 polyps in 3226 eligible patients were
evaluated. The mean diameter of the polyps were 6.7 ± 4.9 mm.
Histopathologic diagnosis were adenomatous in 4548 (63.5%) and
non-adenomatous in 2612 (36.5%). Out of 7160 polyps, 4902
(68.5%) were diminutive (1-5 mm), 1360 (19%) were small
(6-9 mm), and 898 (12.5%) large (≥ 10 mm) polyps. Among the diminutive
polyps 2739 (55.9%) had adenomatous histology. There
were 66 polyps (1.3%) with advanced histology in the diminutive
group, 72 (5.2%) in the small group, 263 (29.2%) in the large polyp
group. Diminutive polyps had a lower frequency of advanced histology
compared to small and large polyps (p = 0.001). When the
histology of the polyps were evaluated based on the size of the largest
polyp the patient has, 2202 patients had polyp(s) ≤ 5 mm. The
frequency of advanced histology was 2.2% in these patients.
Conclusions : The prevalence of advanced histology in diminutive
polyps is quite low (1.3%) which supports the clinical implementation
of discard, resect and discard strategies in diminutive
polyps. (Acta gastroenterol.
belg., 2015, 78, 287-291). [Product Details...] |
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Relationship of percutaneous endoscopic gastrostomy-related mortality and morbidity rates and effectiveness with advancing agePrice: €10,00 |
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| Background and aims : Percutaneous endoscopic gastrostomy
(PEG) is insertion of a tube to stomach through abdominal wall for
provision of nutrition in patients who couldn’t be fed by oral route.
In the present study, it was aimed to evaluate PEG procedures
performed
in our facility regarding indication, complication and
effectiveness and to determine whether these characteristics have a
relationship with advancing age.
Material and method : In this descriptive study, we reviewed
clinical and endoscopic records of 300 patients who underwent
PEG procedure between May 2009 and December 2011. The patients
were divided into 2 groups(group 1 > 75, group 2 ved in
total
protein values (p 0.05).
Conclusion : PEG should be preferred at early period in patients
who couldn’t be fed by oral route for prolonged time as it is a minimally
invasive, simple, inexpensive, highly effective, physiologic
and safe. PEG was found to have no relationship with advancing
age regarding indications, morbidity, mortality rate and effectiveness.
(Acta gastroenterol.
belg., 2015, 78, 292-298). [Product Details...] |
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Acta gastroenterologica is abstracted/indexed in Current Contents, Excerpta Medica, Index medicus, ISI.
Published by © Universa Press, Wetteren, Belgium. All rights reserved.
Published by © Universa Press, Wetteren, Belgium. All rights reserved.