Real-world experience with glucagon-like peptide 2 analogues in patients with short bowel syndrome and chronic intestinal failure: Results from an international survey in expert intestinal failure centers.

Background And Aims: Glucagon-like peptide 2 (GLP-2) analogues are the first available disease-modifying treatments for patients with intestinal failure (IF) due to short bowel syndrome (SBS). Efficacy in terms of reduction of parenteral support (PS) has been demonstrated in multiple studies and real-world reports. However, it remains unclear how many patients are eligible to receive the treatment, when treatment is started after intestinal resection, how treatment efficacy is assessed outside of clinical trials, and how the treatment is modified in case of non-response or adverse events.

Real-World Management of High Stool Output in Patients with Short Bowel Syndrome: An International Multicenter Survey.

Background: International practice guidelines for high-stool-output (HSO) management in short bowel syndrome (SBS) are available, but data on implementation are lacking. This study describes the approach used to manage HSO in SBS patients across different global regions.

Methods: This is an international multicenter study evaluating medical management of HSO in SBS patients using a questionnaire survey.

A multidisciplinary team evaluation of management guidelines for adult short bowel syndrome.

Background & Aims: An international, multidisciplinary management working group (MWG) convened to review clinically useful short bowel syndrome (SBS) literature and identify gaps and inconsistencies in the management of adults with SBS.

Methods: Using nominal group technique for literature review, key publications were identified, discussed, and ranked by importance related to management of SBS. Gaps in management recommendations for SBS were identified upon critical review of the selected publications.

Characteristics of adult intestinal failure centers: An international multicenter survey.

Background: Current guidelines recommend that patients with chronic intestinal failure (CIF) should be managed by a multidisciplinary team (MDT). However, the characteristics of real-world IF centers and the patients they care for are lacking. The study aims to describe IF center characteristics as well as characteristics of patients with CIF across different global regions.

Standardisation of diet and exercise in clinical trials of NAFLD-NASH: Recommendations from the Liver Forum.

Lifestyle modification is the foundation of treatment recommendations for non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). The design of clinical trials in NASH may be impeded by the lack of a systematic approach to identify and evaluate how lifestyle changes and/or modifications influence clinical trial outcomes and associated endpoints. Furthermore, there are additional uncertainties regarding the methods that can be utilised to better characterise and quantify lifestyle variables - which can influence disease activity and alter trial endpoints - to allow for comparisons of trial outcomes across different phases of research and/or within drug-classes.

Exposure to persistent organic pollutants and sperm DNA methylation changes in Arctic and European populations.

Persistent organic pollutants (POPs), such as PCBs (polychlorinated biphenyls) and DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane], are environmental contaminants with potential endocrine disrupting activity. DNA methylation levels in peripheral blood lymphocytes have been associated with serum concentrations of POPs in Greenland Inuit and Korean populations. Greenland Inuits are characterized by the highest worldwide POP levels.

Current and future use of the mannitol bronchial challenge in everyday clinical practice.

Objectives: Asthma is a disease associated with inflammation, airway hyperresponsiveness (AHR) and airflow limitation. Clinical diagnosis and management of asthma often relies on assessment of lung function and symptom control, but these factors do not always correlate well with underlying inflammation. Bronchial challenge tests (BCTs) assess AHR, and can be used to assist in the diagnosis and management of asthma.

Colonic epithelial ion transport is not affected in patients with diverticulosis.

Background: Colonic diverticular disease is a bothersome condition with an unresolved pathogenesis. It is unknown whether a neuroepithelial dysfunction is present. The aim of the study was two-fold; (1) to investigate colonic epithelial ion transport in patients with diverticulosis and (2) to adapt a miniaturized Modified Ussing Air-Suction (MUAS) chamber for colonic endoscopic biopsies.

Therapeutic procedures for submucosal tumors in the gastrointestinal tract.

This review is part three of three and will present an update on the therapeutic options and procedures concerning gastrointestinal (GI) submucosal tumors (SMTs). The aim of this paper is to investigate the treatments of GI SMTs and to present a case of a gastrointestinal stromal tumor (GIST). Literature searches were performed to find information on therapy for GI SMTs.

Classification of submucosal tumors in the gastrointestinal tract.

This review is part two of three, which will present an update on the classification of gastrointestinal submucosal tumors. Part one treats of the diagnosis and part three of the therapeutic methods regarding gastrointestinal submucosal tumors. In the past there has been some confusion as to the classification of gastrointestinal submucosal tumors.

Diagnostic procedures for submucosal tumors in the gastrointestinal tract.

This review is part one of three, which will present an update on diagnostic procedures for gastrointestinal (GI) submucosal tumors (SMTs). Part two identifies the classification and part three the therapeutic methods regarding GI SMTs. Submucosal tumors are typically asymptomatic and therefore encountered incidentally.

The reliability of the ICD-10 and the DC 0-3 in an epidemiological sample of children 1½ years of age.

The aims of this study were to investigate the reliability of ICD-10 and DC 0-3 in the diagnostic classification of mental health problems in 1½ -year-old children from the general population. The reliability study was conducted as a part of an epidemiological survey of psychopathology in 1½ -year-old children from the general population. In this survey, the children were assessed and diagnosed according to the ICD-10 and the DC 0-3 after a 2-hr session including standardized and clinical methods and videorecordings.

Splenic cysts.

The treatment of splenic cysts is a difficult challenge to surgeons and physicians. This paper reviews the literature on splenic cysts, with special attention to the pathogenesis, diagnosis, and various options of surgical treatment. Splenic cysts are classified as primary or secondary cysts, according to the presence of an epithelial lining.

The enteric nervous system I: organisation and classification.

Major advances have been made in our understanding of the nervous system in the gastrointestinal tract, the enteric nervous system. Because of its importance, neurogastroenterology is being increasingly recognised in clinical pharmacology. The enteric nervous system is a collection of neurones that can function more or less independently of the central nervous system and controls or modulates motility, exocrine and endocrine secretions, microcirculation and immune and inflammatory processes.

Neurohumoral control of gastrointestinal motility.

Neurohumoral substances and their receptors play a major part in the complex regulation of gastrointestinal motility and have therefore been the predominant targets for drug development. The numerous receptors involved in motility are located mainly on smooth muscle cells and neuronal structures in the extrinsic and intrinsic parts of the enteric nervous system. Within this system, receptor agonists and antagonists interacts directly to modify excitatory or inhibitory signals.

Environmental factors as a cause for the increase in allergic disease.

Learning Objectives: To be able to understand the interaction among genetic factors, environmental exposure to allergens, and nonspecific adjuvant factors contributing to the increase in atopic diseases in developed countries.

Data Sources: Peer-reviewed literature identified by searching medical databases.

Study Selection: Careful review of epidemiologic cross-sectional, sequential, and longitudinal population studies and, when appropriate, intervention studies.

Comparison of dermatoscopic ABCD rule and risk stratification in the diagnosis of malignant melanoma.

For didactic and documentation purposes the dermatoscopic ABCD rule and the dermatoscopic risk stratification have been proposed. The aim of this investigation was to compare the ability of the 2 methods to separate patients with cutaneous malignant melanoma from individuals with other pigmented skin lesions. Three dermatologists, experienced users of dermatoscopy, assessed macroscopic clinical and dermatoscopic slides from 258 patients referred to the skin cancer outpatient clinic by the ABCD rule and risk stratification methods.

Resistance to activated protein C: a common anticoagulant deficiency in patients with venous leg ulceration.

Patients with leg ulcers caused by venous insufficiency often show evidence of previous deep venous thrombosis. Resistance to activated protein C (APC resistance) is a newly identified, autosomal dominant inherited defect in the anticoagulant system which significantly predisposes affected individuals to develop venous thrombosis. To elucidate the significance of APC resistance in venous leg ulcer patients, APC resistance was determined in plasma samples obtained from 46 unselected, consecutive patients with venous leg ulcers, admitted to hospital during a 6-month period.

Low anti-streptokinase IgG concentrations following streptokinase-streptodornase treatment of leg ulcer patients.

We have evaluated whether neutralising anti-streptokinase IgG antibodies are produced following streptokinase-streptodornase therapy of leg ulcer patients. Serum anti-streptokinase IgG concentrations in 10 leg ulcer patients were determined before, and 1 week, 2 weeks, and 3 weeks following the treatment. We observed only a negligible increase in neutralizing anti-streptokinase IgG concentrations during the observation period, which was probably of no therapeutical significance.