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  • 1
    Online Resource
    Online Resource
    Romanian Guidelines for the Diagnosis and Treatment of GERD-induced Respiratory Manifestations
    Romanian Society of Gastroenterology and Hepatology ; 2022
    In:  Journal of Gastrointestinal and Liver Diseases Vol. 31, No. 1 ( 2022-03-19), p. 119-142
    Details
    In: Journal of Gastrointestinal and Liver Diseases, Romanian Society of Gastroenterology and Hepatology, Vol. 31, No. 1 ( 2022-03-19), p. 119-142
    Abstract: Background and Aims: Gastroesophageal reflux disease (GERD) is a common condition present in daily practice with a wide range of clinical phenotypes. In this line, respiratory conditions may be associated with GERD. The Romanian Societies of Gastroenterology and Neurogastroenterology, in association with the Romanian Society of Pneumology, aimed to create a guideline regarding the epidemiology, diagnosis and treatment of respiratory conditions associated with GERD.Methods: Delphi methodology was used and eleven common working groups of experts were created. The experts reviewed the literature according to GRADE criteria and formulated 34 statements and recommendations. Consensus ( 〉 80% agreement) was reached for some of the statements after all participants voted.Results: All the statements and the literature review are presented in the paper, together with their correspondent grade of evidence and the voting results. Based on 〉 80% voting agreement, a number of 22 recommendations were postulated regarding the diagnosis and treatment of GERD-induced respiratory symptoms. The experts considered that GERD may cause bronchial asthma and chronic cough in an important number of patients through micro-aspiration and vagal-mediated tracheobronchial reflex. GERD should be suspected in patients with asthma with suboptimal controlled or after exclusion of other causes, also in nocturnal refractory cough which needs gastroenterological investigations to confirm the diagnosis. Therapeutic test with double dose proton pump inhibitors (PPI) for 3 months is also useful. GERD induced respiratory conditions are difficult to treat; however,proton pump inhibitors and laparoscopic Nissen fundoplication are endorsed for therapy.Conclusions: This guideline could be useful for the multidisciplinary management of GERD with respiratory symptoms in current practice.
    Type of Medium: Online Resource
    ISSN: 1842-1121 , 1841-8724
    URL: Article
    DOI: 10.15403/jgld-4196
    Language: Unknown
    Publisher: Romanian Society of Gastroenterology and Hepatology
    Publication Date: 2022
    detail.hit.zdb_id: 2253255-9
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  • 2
    Online Resource
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    Hereditary Hemorrhagic Telangiectasia and Arterio-Venous Malformations—From Diagnosis to Therapeutic Challenges
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 9 ( 2022-05-07), p. 2634-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 9 ( 2022-05-07), p. 2634-
    Abstract: Hereditary hemorrhagic telangiectasia is a rare autosomal dominant vascular disease defined by the presence of mucosal and cutaneous telangiectasia and visceral arterio-venous malformations. The latter are abnormal capillary-free direct communications between the pulmonary and systemic circulations with the following consequences: arterial hypoxemia caused by right-to-left shunts; paradoxical embolism with transient ischemic attack or stroke and brain abscess caused by the absence of the normally filtering capillary bed; and hemoptysis or hemothorax due to the rupture of the thin-walled arterio-venous malformations (particularly during pregnancy). It is frequently underdiagnosed, commonly presenting as complications from shunting through arterio-venous malformations: dyspnea, chronic bleeding, or embolism. Arterio-venous malformations are present not only in the lungs, but can also be found in the liver, central nervous system (mainly in the brain), nasal mucosa, or the gastrointestinal tract. The first choice of therapy is embolization of the afferent arteries of the arterio-venous malformations, a minimally invasive procedure with a high efficacy, a low morbidity, and low mortality. Other therapeutic modalities are surgery (resection) or stereotactic radiosurgery (using radiation). Routine screening for arterio-venous malformations is indicated in patients diagnosed with this condition and can prevent severe complications such as acute hemorrhages, brain abscesses, or strokes. Clinicians should provide a long-term follow-up for patients with arterio-venous malformations, in an effort to detect their growth or reperfusion in case of previously treated malformations. In spite of two experts’ consensuses, it still possesses multiple therapeutic challenges for physicians, as several aspects regarding the screening and management of arterio-venous malformations still remain controversial. Multidisciplinary teams are especially useful in complex cases.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11092634
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 3
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    Online Resource
    Anemia in Crohn’s Disease—The Unseen Face of Inflammatory Bowel Disease
    MDPI AG ; 2021
    In:  Medicina Vol. 57, No. 10 ( 2021-09-30), p. 1046-
    Details
    In: Medicina, MDPI AG, Vol. 57, No. 10 ( 2021-09-30), p. 1046-
    Abstract: Background and Objectives: Anemia is the most frequent complication of inflammatory bowel diseases. Clinically, anemia can affect important quality-of-life (QoL) components, such as exercise capacity, cognitive function, and the ability to carry out social activities. The disease activity has a significant impact on QoL, mainly due to clinical manifestations, which are more severe during the periods of disease activity. Our aim was to estimate the impact of anemia on QoL in patients with Crohn’s disease. Material and Methods. We made a prospective study on 134 patients with Crohn’s disease (CD) in a Romanian tertiary center. The CD diagnosis was established by colonoscopy and histopathological examination. In particular cases, additional examinations were required (small bowel capsule endoscopy, computed tomography enterography, and magnetic resonance enterography). Anemia was defined according to the World Health Organization’s definition, the activity of the disease was assessed by Crohn’s disease activity index (CDAI) score, and the QoL was evaluated by Inflammatory Bowel Disease Questionnaire 32 (IBDQ 32). Results: 44.8% patient had anemia, statistically related to the activity of the disease and corticoids use. We found a strong association between QoL and disease activity on all four sub-scores: patients with more severe activity had a significantly lower IBDQ (260.38 ± 116.96 vs. 163.85 ± 87.20, p = 0.001) and the presence of anemia (127.03 vs. 148.38, p = 0.001). In multiple regression analyses, both disease activity and anemia had an impact on the QoL. Conclusions: Anemia has high prevalence in the CD in northeastern region of Romania. Anemia was more common in female patients, in patients undergoing corticosteroid treatment, and in those with active disease. Both anemia and disease activity had a strong negative and independent impact on QoL.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina57101046
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2088820-X
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  • 4
    Online Resource
    Online Resource
    Role of PNPLA3 in the Assessment and Monitoring of Hepatic Steatosis and Fibrosis in Patients with Chronic Hepatitis C Infection Who Achieved a Sustained Virologic Response
    MDPI AG ; 2021
    In:  Medicina Vol. 57, No. 11 ( 2021-10-24), p. 1153-
    Details
    In: Medicina, MDPI AG, Vol. 57, No. 11 ( 2021-10-24), p. 1153-
    Abstract: Background and Objectives: Hepatic diseases are an important public health problem. All patients with chronic hepatitis C virus (HCV) infection receive treatment, regardless of hepatic fibrosis severity. However, evaluation of hepatic fibrosis and steatosis is still useful in assessing evolution, prognosis and monitoring of hepatic disease, especially after treatment with direct-acting antivirals (DAAs). The aim of this study was to assess the link between patatin-like phospholipase domain-containing 3 (PNPLA3) polymorphism and the degree of hepatic steatosis and fibrosis in patients with chronic HCV infection, as well as changes in steatosis and fibrosis three monthsafter obtaining a sustained viral response (SVR). Materials and Methods:Ourstudy included 100 patients with chronic hepatitis C (CHC) infection and compensated cirrhosis who received DAA treatment and who were evaluated using Fibromax prior to and 3 months after SVR. The influence of PNPLA3 (CC, CG, GG) genotype among these patients on the degree of post-treatment regression of steatosis and fibrosis was assessed. Results: Regression was noticed in the degree of both hepatic steatosis and hepatic fibrosis post-DAA treatment (three months after SVR). Analysis of the correlation between PNPLA3 genotype and fibrosis indicated that the average level of fibrosis (F) before DAA treatment was higher in patients with the GG genotype than in patients with the CC or CG genotype. Three months after SVR, the average level of fibrosis decreased; however, it remained significantly increased in GG subjects compared to that in CC or CG patients. The degree of hepatic steatosis before treatment was not significantly different among patients with different PNPLA3 genotypes, and no significant correlations were observed three months after SVR. Conclusions: The genetic variants of PNPLA3 influence the evolution of hepatic fibrosis. The GG subtype plays an important role in the degree of hepatic fibrosis both before and after treatment (three months after SVR)and could be a prognostic marker for assessment of post-SVR evolution.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina57111153
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2088820-X
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  • 5
    Online Resource
    Online Resource
    Atrial fibrillation and sympathovagal balance in patients with gastroesophageal reflux disease
    AVES YAYINCILIK A.Ş. ; 2017
    In:  The Turkish Journal of Gastroenterology Vol. 28, No. 2 ( 2017-03-03), p. 88-93
    Details
    In: The Turkish Journal of Gastroenterology, AVES YAYINCILIK A.Ş., Vol. 28, No. 2 ( 2017-03-03), p. 88-93
    Type of Medium: Online Resource
    ISSN: 1300-4948 , 2148-5607
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.5152/tjg.2017
    DOI: 10.5152/tjg
    DOI: 10.5152/tjg.2017.16540
    Language: Unknown
    Publisher: AVES YAYINCILIK A.Ş.
    Publication Date: 2017
    detail.hit.zdb_id: 2060575-4
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  • 6
    Online Resource
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    Novel Mutation in APC Gene Associated with Multiple Osteomas in a Family and Review of Genotype-Phenotype Correlations of Extracolonic Manifestations in Gardner Syndrome
    MDPI AG ; 2021
    In:  Diagnostics Vol. 11, No. 9 ( 2021-08-28), p. 1560-
    Details
    In: Diagnostics, MDPI AG, Vol. 11, No. 9 ( 2021-08-28), p. 1560-
    Abstract: Gardner syndrome is a neoplasic disease that associates intestinal polyposis and colorectal adenocarcinoma with osteomas and soft tissue tumors determined by germline mutations in the APC gene. The early diagnosis and identification of high-risk individuals are important because patients have a 100% risk of colon cancer. We present the case of a family with Gardner syndrome. Cephalometric, panoramic X-rays and CBCT of the proband and her brother showed multiple osteomas affecting the skull bones, mandible and paranasal sinuses. The detailed family history showed an autosomal dominant transmission with the presence of the disease in the mother and maternal grandfather of the proband. Both had the typical signs of disease and died in the fourth decade of life. Based on these aspects the clinical diagnosis was Gardner syndrome. By gene sequencing, a novel pathogenic variant c.4609dup (p.Thr1537Asnfs*7) in heterozygous status was identified in the APC gene in both siblings. We reviewed literature data concerning the correlation between the localization of mutations in the APC gene and the extracolonic manifestations of familial adenomatous polyposis as well as their importance in early diagnosis and adequate oncological survey of patients and families based on abnormal genomic variants.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics11091560
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662336-5
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  • 7
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    Online Resource
    Uncommon Association of Mckittrick-Wheelock Syndrome and Clostridioides difficile Infection in Acute Renal Failure
    MDPI AG ; 2022
    In:  Diagnostics Vol. 12, No. 4 ( 2022-03-23), p. 784-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 4 ( 2022-03-23), p. 784-
    Abstract: We present the case of a 71-year-old male who suffered an episode of acute renal failure caused by the uncommon association of two different diseases (Clostridioides difficile infection and McKittrick-Wheelock syndrome). He presented with hypovolemic shock, severe hypokalemia, hyponatremia, metabolic acidosis and acute renal failure; consequences of secretory diarrhea caused by a giant rectal tumor revealed from colonoscopy. The biopsy results revealed tubulo-villous adenoma with low/high grade dysplasia. After correction of electrolyte imbalances and azotemia, the patient underwent surgical resection with full subsequent recovery. In the literature review, including papers published from which January 1945 to April 2021, we found only one case-report of acute renal failure associated with Clostridioides difficile infection and McKittrick-Wheelock syndrome.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12040784
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662336-5
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  • 8
    Online Resource
    Online Resource
    Gastro-Esophageal Reflux Disease and Paroxysmal Atrial Fibrillation Ablation
    MDPI AG ; 2023
    In:  Life Vol. 13, No. 5 ( 2023-04-28), p. 1107-
    Details
    In: Life, MDPI AG, Vol. 13, No. 5 ( 2023-04-28), p. 1107-
    Abstract: Patients undergoing ablation for atrial fibrillation may be at increased risk of developing gastroesophageal reflux disease. We prospectively studied the presence of symptomatic gastroesophageal reflux disease in naïve patients who underwent atrial fibrillation ablation. Methods: The presence of typical symptoms suggestive of gastroesophageal reflux disease was clinically assessed by the gastroenterologist at baseline and at 3 months after ablation. In addition to that, all patients underwent upper gastrointestinal endoscopy. Results: Seventy-five patients were included in two groups: 46 patients who underwent atrial fibrillation ablation (study group) and 29 patients without ablation (control group). Patients with atrial fibrillation ablation were younger (57.76 ± 7.66 years versus 67.81 ± 8.52 years; p = 0.001), predominantly male (62.2% versus 33.3%; p = 0.030) and with higher body mass index (28.96 ± 3.12 kg/m2 versus 26.81 ± 5.19 kg/m2; p = 0.046). At three months after the ablation, in the study and control groups, there were 88.9% and 57.1% patients in sinus rhythm, respectively, (p = 0.009). Symptomatic gastroesophageal reflux disease was not more frequent in the study group (42.2% versus 61.9%; p = 0.220). There was no difference in terms of sinus rhythm prevalence in patients with versus without symptomatic gastroesophageal reflux disease (89.5% versus 88.5%; p = 0.709). Conclusion: In this small prospective study, typical symptoms suggestive of gastroesophageal reflux disease were not more frequent three months following atrial fibrillation ablation.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    URL: Article
    DOI: 10.3390/life13051107
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662250-6
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  • 9
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    Online Resource
    Inulin, Choline and Silymarin in the Treatment of Irritable Bowel Syndrome with Constipation—Randomized Case-Control Study
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 8 ( 2022-04-17), p. 2248-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 8 ( 2022-04-17), p. 2248-
    Abstract: (1) Background: Irritable bowel syndrome (IBS) is a common disease, with multiple pathophysiological mechanisms involved. A single treatment for all the patients with IBS is not possible. Prebiotics may have a beneficial effect on IBS patients with constipation. (2) Methods: A randomized cross-over case-control study was conducted, including patients with IBS and constipation (IBS-C), who were randomized into two groups receiving a specific constipation diet with or without a food supplement containing inulin, choline and silymarin (Stoptoxin®, Fiterman Pharma, Iasi, Romania). Patients were evaluated at baseline, after four and eight weeks, using a questionnaire to assess IBS symptoms. (3) Results: 51 IBS-C patients were included, of which 47 patients finished the trial (33 women, mean age 52.82 years). Adding Stoptoxin® to a diet for constipation brought extra benefits. Abdominal pain severity improved by 68.3% after the diet and Stoptoxin® (p = 0.004) and abdominal bloating severity parameter improved by 34.8% (p = 0.040). The stool number per week and the stool consistency according to the Bristol scale were improved, but without statistical significance between groups (p 〉 0.05). (4) Conclusions: The combination of inulin, choline and silymarin associated with a specific-constipation diet had obvious clinical beneficial effects on IBS-C patients in terms of bowel movement, abdominal pain and bloating.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11082248
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 10
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    Online Resource
    A comparison using standardized measures for patients with irritable bowel syndrome: Trust in the gastroenterologist and reliance on the internet
    Wiley ; 2021
    In:  Neurogastroenterology & Motility Vol. 33, No. 5 ( 2021-05)
    Details
    In: Neurogastroenterology & Motility, Wiley, Vol. 33, No. 5 ( 2021-05)
    Abstract: Irritable bowel syndrome (IBS) patients’ use of the Internet for health information interacts with the way they trust their gastroenterologist. No standardized measure has targeted IBS patients and gastroenterologists specifically, nor their use of the Internet. The aims of this paper were as follows: the development of a scale that measures an IBS patient's trust in their gastroenterologist, the development of a scale measuring an IBS patient's reliance on Internet health information, and testing the hypothesis that IBS patients, who use the Internet for IBS‐related information, trust their gastroenterologist less than those who do not. Method A total of 82 patients (mean age 49, SD = 14.62) diagnosed with IBS completed two questionnaires: one about trust in their gastroenterologist and the other about the reliance on Internet health information regarding IBS. The two questionnaires were built using current literature as well as our previous qualitative research. The statistical computations were performed using the SPSS 20 program. Key Results Both questionnaires proved to be reliable in measuring gastroenterologist‐IBS patient trust (alpha = 0.87) and Internet information reliance (alpha = 0.88), respectively. The IBS patients who did not look for information about IBS over the Internet had significantly higher trust in their gastroenterologist compared with those who did (U = 535.5; z = −2.26; P   〈  0.05). Conclusions We developed two ready‐to‐use scales to measure both the gastroenterologist‐IBS patient's trust and the IBS patient's reliance on the Internet. Further studies will be able to explore the interaction among all variables in IBS patients’ trust.
    Type of Medium: Online Resource
    ISSN: 1350-1925 , 1365-2982
    URL: Issue
    URL: Article
    DOI: 10.1111/nmo.v33.5
    DOI: 10.1111/nmo.13977
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2008278-2
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