Evaluation of the Danish Colorectal Cancer Screening Program Among People With Cystic Fibrosis.

Goals: We aimed to evaluate the Danish CRC screening program, estimate colonic neoplasia's prevalence, and assess the utilized BP regimens.

Background: People with cystic fibrosis (pwCF) have an increased risk of precancerous polyps and colorectal cancer (CRC), with occurrence at an earlier age compared with the general population. Consequently, colonoscopy screening is recommended.

Motorized spiral enteroscopy: results of an international multicenter prospective observational clinical study in patients with normal and altered gastrointestinal anatomy.

BACKGROUND : Motorized spiral enteroscopy (MSE) has been shown to be safe and effective for deep enteroscopy in studies performed at expert centers with limited numbers of patients without previous abdominal surgery. This study aimed to investigate the safety, efficacy, and learning curve associated with MSE in a real-life scenario, with the inclusion of patients after abdominal surgery and with altered anatomy. METHODS : Patients with indications for deep enteroscopy were enrolled in a prospective observational multicenter study.

Gene Expression in the Liver Remnant Is Significantly Affected by the Size of Partial Hepatectomy: An Experimental Rat Study.

Extended hepatectomies may result in posthepatectomy liver failure, a condition with a high mortality. The main purpose of the present study was to investigate and compare the gene expression profiles in rats subjected to increasing size of partial hepatectomy (PH). Thirty Wistar rats were subjected to 30%, 70%, or 90% PH, sham operation, or no operation.

Gastroesophageal reflux after peroral endoscopic myotomy: a multicenter case-control study.

 The variables associated with gastroesophageal reflux (GER) after peroral endoscopic myotomy (POEM) are largely unknown. This study aimed to: 1) identify the prevalence of reflux esophagitis and asymptomatic GER in patients who underwent POEM, and 2) evaluate patient and intraprocedural variables associated with post-POEM GER.  All patients who underwent POEM and subsequent objective testing for GER (pH study with or without upper gastrointestinal [GI] endoscopy) at seven tertiary academic centers (one Asian, two US, four European) were included.

Long-term outcome of peroral endoscopic myotomy for esophageal achalasia in patients with previous Heller myotomy.

Background: Peroral endoscopic myotomy (POEM) is an emerging procedure in the treatment of esophageal achalasia, a primary motility disorder. However, the long-term outcome of POEM in patients, who have previously undergone a Heller myotomy, is unknown.

Methods: Using a local database, we identified patients with esophageal achalasia, who underwent POEM.

[Concurrent achalasia and severe obesity].

Achalasia is a rare oesophageal motility disorder which classically is not associated with obesity. We present the case of a 50-year-old woman who underwent gastric bypass and afterwards was diagnosed with achalasia. Following, she was treated successfully with peroral endoscopic myotomy (POEM).

Peroral endoscopic myotomy (POEM) for nutcracker esophagus. Three cases with 12 months follow-up.

Introduction: Peroral endoscopic myotomy (POEM) has been introduced as a new treatment of achalasia, and studies are emerging on POEM treatment of other esophageal motility disorders. The effects of medical treatment, botox injections and dilatations are often limited in patients with severe nutcracker esophagus (NE). We therefore decided to perform POEM in three patients with severe NE.

[Presentation, diagnosis and management of swallowed foreign bodies].

Foreign body ingestion occurs commonly. In 80-90% of cases, the ingested foreign body passes uneventfully through the gastrointestinal tract; endoscopy is performed in 20% of cases, and surgery in less than 1%. Complications usually occur when the ingested foreign body is sharp, large, a button battery or multiple magnets.

Next-generation stool DNA test accurately detects colorectal cancer and large adenomas.

Background & Aims: Technical advances have led to stool DNA (sDNA) tests that might accurately detect neoplasms on both sides of the colorectum. We assessed colorectal neoplasm detection by a next-generation sDNA test and effects of covariates on test performance.

Methods: We performed a blinded, multicenter, case-control study using archived stool samples collected in preservative buffer from 252 patients with colorectal cancer (CRC), 133 with adenomas ≥ 1 cm, and 293 individuals with normal colonoscopy results (controls); two-thirds were randomly assigned to a training set and one-third to a test set.

Sensitive digital quantification of DNA methylation in clinical samples.

Analysis of abnormally methylated genes is increasingly important in basic research and in the development of cancer biomarkers. We have developed methyl-BEAMing technology to enable absolute quantification of the number of methylated molecules in a sample. Individual DNA fragments are amplified and analyzed either by flow cytometry or next-generation sequencing.

Detection of colorectal cancer in symptomatic outpatients without visible rectal bleeding: Validity of the fecal occult blood test.

Background: In 2002, a new diagnostic strategy in symptomatic outpatients without known established colorectal cancer risk factors aged 40 years or older was implemented in Denmark. Fecal occult blood test (Hemoccult Sensa®) was a part of that strategy in patients without visible rectal bleeding.

Aims: The aim was to assess the validity of the Hemoccult Sensa® test in detecting colorectal cancer in the above-mentioned outpatients.

[Danish National Guidelines for diagnostic strategy of patients with colorectal cancer symptoms].

Danish National Guidelines (DNG) for diagnostic strategy of patients with colorectal cancer (CRC) symptoms are structured to ensure prompt and specific diagnostic testing, thus minimizing treatment delay. DNG state that the function of the general practitioner is to refer patients to a specialist as soon as the patient presents with CRC symptoms. Unfortunately, 60% of CRC patients experience a delay in referrals due to the fact that the guidelines are not followed as exemplified in our two cases.

Evaluation of the Danish national strategy for selective use of colonoscopy in symptomatic outpatients without known risk factors for colorectal cancer.

Objective: A diagnostic strategy implemented in Denmark in 2002 recommends selective use of colonoscopy in outpatients without known colorectal cancer (CRC) risk factors who are referred with symptoms consistent with possible CRC. Selection of patients for colonoscopy was based on the presenting symptom(s) and findings at the initial examination (flexible sigmoidoscopy/faecal occult blood test). The aim of this study was to evaluate the strategy by assessing the prevalence of patients with diagnosed CRC, the frequency of patients with missed CRC, the adherence to the strategy and the number of examinations performed.

[Diagnostic strategy with respect to symptoms of colorectal cancer].

In relation to the risk of colorectal cancer, the population is divided into high-risk and average-risk groups. Patients at high risk are followed according to the national recommendations. Patients at average risk are examined according to their primary symptom(s).