Publications by authors named "Laheij R"
Article Synopsis
- Gastrointestinal angiodysplasias are vascular abnormalities that can cause severe anemia requiring frequent blood transfusions, and octreotide has been suggested to help reduce rebleeding rates in patients.
- A multicenter, randomized controlled trial compared the effectiveness of octreotide (40 mg every 28 days) to standard care in reducing transfusion requirements over one year for patients with this condition.
- Results showed that patients treated with octreotide required significantly fewer transfusion units (11.0) compared to those receiving standard care (21.2), indicating that octreotide effectively reduces the need for transfusions in these patients.
Article Synopsis
- Patients with inflammatory bowel disease (IBD) treated with immunomodulators or biologics face a higher risk of infections and often experience malnutrition and vitamin deficiencies.* -
- A clinical trial was conducted with 320 IBD patients to assess if a daily multivitamin and mineral supplement could lower infection rates compared to a placebo over a 24-week period.* -
- The study's results showed no significant difference in infection rates between the two groups, indicating that the supplement did not reduce the risk of infections for patients in remission while on IBD treatments.*
Microbiota diversity and bacterial load after successful treatment of infection with honey lavage in 4 patients.
Biosci Microbiota Food Health
September 2021
Article Synopsis
- An experimental therapy using Manuka honey via colon lavage was conducted on four patients with therapy-resistant infections following a three-day fidaxomicin treatment.
- The procedure involved administering 300 mL of 15% Manuka honey via a spray catheter during an ileocolonoscopy, after which patients rested for two hours without defecating.
- Results showed a decrease in microbial load and restoration of microbiota diversity, leading to complete cessation of watery stools and no symptoms, suggesting the potential for further clinical research.
Article Synopsis
- * 232 patients were randomly assigned to either urgent ERCP with sphincterotomy or conservative treatment, with the main goal being to assess rates of mortality or major complications within 6 months.
- * Results showed no significant differences in the primary endpoint between the two groups, with 38% in the ERCP group and 44% in the conservative treatment group experiencing complications, suggesting that urgent ERCP may not confer a clear advantage.
Introduction: After standard diagnostic work-up, the aetiology of acute pancreatitis remains unknown in 16-27% of cases, a condition referred to as idiopathic acute pancreatitis (IAP). Determining the aetiology of pancreatitis is essential, as it may direct treatment in the acute phase and guides interventions to prevent recurrent pancreatitis.
Methods: Between 2008 and 2015, patients with acute pancreatitis were registered prospectively in 19 Dutch hospitals.
Article Synopsis
- Familial atypical multiple mole melanoma (FAMMM) syndrome is a genetic condition linked to multiple atypical moles and an increased likelihood of melanoma and pancreatic cancer due to mutations in the CDKN2A gene.
- The p16-Leiden variant of CDKN2A is particularly concerning as it significantly heightens cancer risks, including developing melanomas.
- A study of two patients with the p16-Leiden variant who also developed esophageal squamous cell cancer showed evidence of tumor cells losing the normal CDKN2A allele, indicating a link between FAMMM syndrome and this type of cancer.
Article Synopsis
- Disturbed circadian rhythms can lead to delirium in ICU patients, and bright-light therapy may help realign these rhythms to reduce delirium rates.
- A study was conducted in the Netherlands with 734 ICU patients, comparing high-intensity dynamic light application (DLA) against normal lighting to see if DLA could lower delirium incidence.
- Results showed no significant difference in delirium rates between the DLA group (38%) and the control group (33%), indicating that DLA alone is not effective and should be considered as part of a broader treatment strategy.
Article Synopsis
- The APEC trial studies how an early procedure called ERC with sphincterotomy can help people with biliary pancreatitis who are at high risk for serious problems.
- Doctors want to see if this procedure can prevent major complications or death compared to regular treatment.
- The trial will include 232 patients in 27 hospitals, and they'll be watched for 180 days to see how well they do after the treatment.
Background And Aims: Mucosal healing has become the treatment goal in patients with ulcerative colitis (UC) and Crohn's disease (CD). Whether low fecal calprotectin levels and histological healing combined with mucosal healing is associated with a further reduced risk of relapses is unknown.
Methods: Patients with CD, UC or inflammatory bowel disease-unclassified (IBD-U) scheduled for surveillance colonoscopy collected a stool sample prior to bowel cleansing.
Article Synopsis
- Active colitis can make it harder to detect tumors during colonoscopies in patients with inflammatory bowel disease, so the study aimed to see if testing for fecal calprotectin beforehand could help spot ineffective surveillance.
- In the study, 176 colonoscopies were conducted on patients with Crohn's disease or ulcerative colitis, and 14% showed moderate to severe inflammation, marking these as ineffective for cancer detection.
- Fecal calprotectin levels were notably higher in the ineffective surveillance group, and a cutoff of 539 mg/kg was effective in identifying patients at risk, demonstrating that low calprotectin levels can indicate when surveillance is likely to be successful.
Background: Aspirin is associated with gastrointestinal side effects such as gastric ulcers, gastric bleeding and dyspepsia. High-dose effervescent calcium carbasalate (ECC), a buffered formulation of aspirin, is associated with reduced gastric toxicity compared with plain aspirin in healthy volunteers, but at lower cardiovascular doses no beneficial effects were observed.
Aim: To compare the prevalence of self-reported gastrointestinal symptoms between low-dose plain aspirin and ECC.
Aim: Non-steroidal anti-inflammatory drug (NSAID) use is widespread and associated with gastrointestinal symptoms and complications. The aims of this study were to assess (i) gastrointestinal symptoms in users of prescribed and over-the-counter (OTC) NSAIDs and (ii) proton pump inhibitor (PPI) co-prescription rates in NSAID users at increased risk for gastrointestinal complications.
Methods: Surveys were sent to a randomly selected sample of the adult Dutch general population in December 2008.
Article Synopsis
- Fecal calprotectin is a noninvasive marker used to assess inflammation in inflammatory bowel disease (IBD), but its diagnostic accuracy is limited, prompting a comparison with fecal hemoglobin.* -
- In a study of 176 colonoscopies, fecal calprotectin showed 86% sensitivity and 72% specificity for predicting inflammation, while fecal hemoglobin had 74% sensitivity and 84% specificity at their respective cutoff values.* -
- Both markers can effectively identify active inflammation in IBD, but combining them does not significantly improve predictive accuracy compared to using calprotectin or hemoglobin alone.*
Background: Gastrointestinal symptoms are frequently reported adverse effects of antidepressants, but antidepressants are also a treatment modality in functional gastrointestinal disorders. We aimed to assess the association between antidepressant use and gastrointestinal symptoms in the general adult population.
Methods: We assessed gastrointestinal symptoms, medication use, and comorbidity through structured questionnaires in randomly selected individuals.
Symptoms associated with finding colorectal cancer during colonoscopy.
Eur J Gastroenterol Hepatol
November 2013
Article Synopsis
- Patients with certain symptoms, like rectal bleeding and changes in bowel habits, along with those over 50, are at higher risk for colorectal cancer (CRC) and should be prioritized for colonoscopy.
- A study involving 1,458 patients found that CRC was detected in 2.8% of them, and specific predictors like age and symptoms significantly increased the likelihood of CRC diagnosis.
- Conversely, having had prior endoscopy and reporting fatigue were linked to a decreased risk of CRC, suggesting that these patients might be lower priority for immediate testing.
Article Synopsis
- The study aimed to determine the current prevalence of gastrointestinal symptoms in the Dutch adult population and evaluate related factors and health-related quality of life.
- A total of 51,869 questionnaires were sent out, with 16,758 valid responses showing a prevalence rate of 26%, with bloating, borborygmi, and flatulence being the most common symptoms.
- Factors linked to higher prevalence included being female, having asthma/COPD, and using certain medications, while age over 65 and statin use were linked to lower prevalence; those with symptoms reported a significantly lower quality of life.
Context: Upper gastrointestinal cancer is associated with a poor prognosis. The multidimensional problems of incurable patients require close monitoring and frequent support, which cannot sufficiently be provided during conventional one to two month follow-up visits to the outpatient clinic.
Objectives: To compare nurse-led follow-up at home with conventional medical follow-up in the outpatient clinic for patients with incurable primary or recurrent esophageal, pancreatic, or hepatobiliary cancer.
Article Synopsis
- The study aimed to understand the immune response in patients with Legionnaires' disease by examining changes in lymphocyte subpopulations during the acute and subacute phases of the illness.
- Blood samples from patients showed a significant increase in overall lymphocyte counts from the acute phase to the subacute phase, particularly in T-cell counts, while B-cell counts remained unchanged.
- The findings indicate that while the acute phase is marked by low lymphocyte levels, there's a recovery and activation of T-cells in the subacute phase, supporting their critical role in the immune response.
Article Synopsis
- Computed tomography-colonography (CT-colonography) is a useful diagnostic tool that can provide information on both the colon and surrounding areas when a colonoscopy doesn't fully visualize the colon.
- This study analyzed 136 cases of patients who underwent CT-colonography following incomplete colonoscopies to assess intra- and extracolonic findings and their clinical significance.
- Results showed that CT-colonography identified additional polyps and cancers and revealed important extracolonic issues in some patients, highlighting its value in further diagnosis post-incomplete colonoscopy.
Aim: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts.
Methods: In this comparative observational study, two prospective cohorts of CRC cases were compared. The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT, of which, only subjects with a positive FIT were referred for colonoscopy.
Study Objective: The neutrophil-lymphocyte count ratio (NLCR) has been identified as a predictor of bacteremia in medical emergencies. The aim of this study was to investigate the value of the NLCR in patients with community-acquired pneumonia (CAP).
Methods And Results: Consecutive adult patients were prospectively studied.
Background: The pathophysiological mechanisms which contribute to an increased risk of community-acquired pneumonia (CAP) in patients using proton pump inhibitors are not well established.
Aim: To examine differences in microbial etiology in patients with CAP between patients with and without proton pump inhibitor (PPI) therapy and its possible impact on disease severity.
Methods: All individuals consulting the emergency care unit were prospectively registered and underwent chest radiography.
Background: Insight into patient adherence is needed to enable an effect evaluation of medication for dyspepsia.
Objectives: Adherence was explored by investigating two adherence outcome measures (completeness and intake fidelity) using data from the DIAMOND-study.
Methods: The DIAMOND-study is a pragmatic RCT comparing a 'step-up' with a 'step-down' treatment strategy.