Efficacy and safety of colesevelam for the treatment of bile acid diarrhoea: a double-blind, randomised, placebo-controlled, phase 4 clinical trial.

Background: Bile acid diarrhoea is a common but overlooked cause of chronic watery diarrhoea. Plasma 7α-hydroxy-4-cholesten-3-one (C4) is an alternative to the gold standard tauroselcholic [Se] acid (SeHCAT) test. Low-certainty evidence supports sequestrant treatment, including colesevelam.

Biochemical Diagnosis of Bile Acid Diarrhea: Prospective Comparison With the 75Seleno-Taurohomocholic Acid Test.

Introduction: The diagnosis of bile acid diarrhea is often missed because the availability of the seleno-taurohomocholic acid (SeHCAT) test is limited. We aimed to compare the biomarkers 7α-hydroxy-4-cholesten-3-one (C4) and fibroblast growth factor 19 (FGF19) with the SeHCAT test.

Methods: Patients with chronic diarrhea without intestinal resection referred for SeHCAT were prospectively recruited for this diagnostic accuracy study.

F-FDG PET/CT Findings in Cytomegalovirus Colitis.

We present a case demonstrating the diagnostic work-up of a patient undergoing azathioprine treatment for inflammatory bowel disease (IBD), diagnosed with an acute cytomegalovirus (CMV) infection and CMV colitis. An F-FDG positron emission tomography/computed tomography (PET/CT) performed 2 weeks after debut of symptoms revealed pathological F-FDG uptake in the left side of the colon mucosa, mimicked activity of IBD. However, a diagnosis of CMV colitis was based on the presence of CMV IgM antibodies, a seroconversion of CMV IgG antibodies, presence of CMV DNA in plasma and the finding af CMV DNA in biopsies from the intestinal mucosa.

Energy intake, gastrointestinal transit, and gut hormone release in response to oral triglycerides and fatty acids in men with and without severe obesity.

Dietary fat, and particularly fatty acids (FAs) from hydrolyzed triglycerides (TGs), reduces appetite, whereas paradoxically, a high-fat diet leads to excess calorie intake. We therefore hypothesized that the appetite-regulating effects of FAs are perturbed in obesity. Ten men with severe obesity [median body mass index (BMI) of 51.

Gastrointestinal motility, gut hormone secretion, and energy intake after oral loads of free fatty acid or triglyceride in older and middle-aged men.

In young individuals, oral free fatty acid delays gastric emptying, promotes gut hormone release, and reduces energy intake more than an isocaloric load of triglyceride does. The objective of this study was to compare the effects of the free fatty acid oleic acid (OA) and the triglyceride olive oil (OO) on gastrointestinal motility, gut hormone secretion, and energy intake in older and middle-aged healthy volunteers. In a double-blind, randomized, cross-over, study 10 older (age 83.

F-FDG PET/CT Findings in a Patient with Chikungunya Virus Infection.

We present a case demonstrating the diagnostic work-up and follow-up of a patient with Chikungunya infection. An F-FDG PET/CT performed four weeks after debut of symptoms revealed pathological F-FDG uptake in enlarged lymph nodes on both side of the diaphragm, and inflammation of both shoulder and hip joints. Lymphoma and infection were the main differential diagnoses.

Comparison of analytical methods of brain [F]FDG-PET after severe traumatic brain injury.

Background: Loss of consciousness has been shown to reduce cerebral metabolic rates of glucose (CMRglc) measured by brain [F]FDG-PET. Measurements of regional metabolic patterns by normalization to global cerebral metabolism or cerebellum may underestimate widespread reductions.

New Method: The aim of this study was to compare quantification methods of whole brain glucose metabolism, including whole brain [18F]FDG uptake normalized to uptake in cerebellum, normalized to injected activity, normalized to plasma tracer concentration, and two methods for estimating CMRglc.

Whole-Body F-FDG PET/CT Is Superior to CT as First-Line Diagnostic Imaging in Patients Referred with Serious Nonspecific Symptoms or Signs of Cancer: A Randomized Prospective Study of 200 Patients.

A fast-track pathway has been established in Denmark to investigate patients with serious nonspecific symptoms and signs of cancer (NSSC), who are not eligible to enter an organ-specific cancer program. The prevalence of cancer in this cohort is approximately 20%. The optimal screening strategy in patients with NSSC remains unknown.

(18)F-FDG PET/CT Findings in Acute Epstein-Barr Virus Infection Mimicking Malignant Lymphoma.

We present a case demonstrating the diagnostic work-up and follow-up of a patient with acute Epstein-Barr virus (EBV) infection in which the clinical picture and imaging on (18)F-FDG PET/CT mimicked malignant lymphoma. Follow-up (18)F-FDG PET/CT scan in the patient performed 7 weeks after the abnormal scan revealed complete resolution of the metabolically active disease in the neck, axillas, lung hili, and spleen. This case highlights inflammation as one of the most well established false positives when interpreting (18)F-FDG PET/CT scans.

Diagnosis of bile acid diarrhoea by fasting and postprandial measurements of fibroblast growth factor 19.

Background: A deficiency in the ileal hormone fibroblast growth factor 19 (FGF19) has been described in patients with bile acid diarrhoea (BAD), but fasting FGF19 levels have insufficient diagnostic power. We assess whether single postprandial sampling of FGF19 has greater discriminative value than fasting FGF19 for detection of BAD and we evaluate the reproducibility of fasting FGF19.

Materials And Methods: Twenty-six patients consecutively referred to Se homocholic acid retention test (SeHCAT) were included.

A prospective comparison of 18F-FDG PET/CT and CT as diagnostic tools to identify the primary tumor site in patients with extracervical carcinoma of unknown primary site.

Background: The aim of the present study was to evaluate prospectively the diagnostic value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and conventional CT regarding the ability to detect the primary tumor site in patients with extracervical metastases from carcinoma of unknown primary (CUP) site.

Patients And Methods: From January 2006 to December 2010, 136 newly diagnosed CUP patients with extracervical metastases underwent (18)F-FDG PET/CT. A standard of reference (SR) was established by a multidisciplinary team to ensure that the same set of criteria were used for classification of patients, that is, either as CUP patients or patients with a suggested primary tumor site.

[Indications for the use of PET or PET/CT in patients with breast cancer].

PET and PET/CT, using 18F-fluoro-2-deoxy-D-glucose, are not suited for primary diagnostics of small tumours or lymph node metastases to the axilla. In return, the method has a high sensitivity and specificity regarding the detection of loco-regional recurrence and metastases to mediastinal lymph nodes, bones, liver and lungs. Whether the method can replace the conventional evaluation or be a supplement if conventional evaluation is non-conclusive, remains unresolved.

18F-FDG PET/CT as a diagnostic tool in patients with extracervical carcinoma of unknown primary site: a literature review.

Background: Carcinoma of unknown primary (CUP) represents a heterogeneous group of metastatic malignancies for which no primary tumor site can be identified after extensive diagnostic workup. Failure to identify the primary site may negatively influence patient management. The aim of this review was to evaluate (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) as a diagnostic tool in patients with extracervical CUP.

Effects of the H2-receptor antagonist ranitidine on gastric motor function after a liquid meal in healthy humans.

Objective: Studies on animals have shown that histamine may be involved in the regulation of gastrointestinal smooth muscle tone. However, the role of histamine in the regulation of human gastric motor function is not clear. This study examined the effect of ranitidine, an H(2)-receptor antagonist, on gastric volume and gastric emptying after a liquid meal in healthy humans.

PET/CT and histopathologic response to preoperative chemoradiation therapy in locally advanced rectal cancer.

Purpose: The objective of this study was to investigate the possibility of using positron emission tomography/computer tomography to predict the histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiation.

Methods: The study included 30 patients with locally advanced rectal adenocarcinoma treated with a combination of radiotherapy and concurrent Uftoral (uracil, tegafur) and leucovorine. All patients were evaluated by positron emission tomography/computer tomography scan seven weeks after end of chemoradiation, and the results were compared to histopathologic tumor regression as the "standard.

Single photon emission computed tomography for gastric volume assessment: a method with observer-defined regions of interest.

Aim: Single photon emission computed tomography (SPECT) imaging allows non-invasive measurement of gastric volume. In previous studies, the processing of the SPECT data involved global threshold algorithms that do not take into account the non-uniform distribution of radioactivity in the gastric wall. The aim of this study was to develop a simple alternative method based on observer-defined regions of interest.

[Myocardial scintigraphy. Clinical use and consequence in a non-invasive cardiological department].

Introduction: Myocardial perfusion imaging (MPI) is increasingly used for the diagnosis of ischaemic heart disease. The method is particularly applied as a gate keeper before coronary angiography (CAG) in patients with intermediate probability for ischaemic heart disease. This study aimed to analyse the clinical use of MPI in a university hospital without invasive cardiological laboratory.

Effects of ageing on gastrointestinal motor function.

Background: Existing data on the effect of ageing on gastrointestinal motility are few. In this study, we assessed the propulsive effect of all main segments of the gastrointestinal tract in a group of healthy older people.

Methods: 16 healthy volunteers (eight women, eight men) of mean age 81 years (range 74-85 years) participated in the study.

Reference values for the geometric centre analysis of colonic transit measurements with 111indium-labelled diethylenetriamine penta-acetic acid.

The geometric centre analysis is often used for evaluating colonic transit data obtained by scintigraphy after oral intake of 111indium-labelled diethylenetriamine penta-acetic acid (111In-DTPA). The purpose of this study was to establish reference values for the geometric centre analysis in adult humans. Forty-eight healthy volunteers (24 women, 24 men) who were equally distributed among three age groups (young, middle-aged, elderly) were studied.

Bile acid malabsorption or disturbed intestinal permeability in patients treated with enzyme substitution for exocrine pancreatic insufficiency is not caused by bacterial overgrowth.

Introduction: In some patients with severe exocrine pancreatic insufficiency, enzyme replacement therapy will not lead to clinical improvement or reduction of steatorrhea. Therefore, other mechanisms separately or in interplay with reduced enzyme secretion might be responsible for malabsorption in these patients.

Aims: To evaluate the prevalence of bacterial overgrowth, bile acid absorption capacity, and intestinal permeability in a group of patients with well-characterized exocrine pancreatic insufficiency.