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  • 1
    Online Resource
    Online Resource
    Impact of a Gluten-Free Diet on Quality of Life and Health Perception in Patients With Type 1 Diabetes and Asymptomatic Celiac Disease
    The Endocrine Society ; 2021
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 106, No. 5 ( 2021-04-23), p. e1984-e1992
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 106, No. 5 ( 2021-04-23), p. e1984-e1992
    Abstract: Celiac disease (CD) is a common comorbidity seen in patients with type 1 diabetes (T1D) and is frequently asymptomatic. As chronic conditions requiring significant lifestyle changes, there are limited reports assessing changes in health-related quality of life (HRQoL) during transition to a gluten-free diet (GFD) in patients with T1D who are asymptomatic for CD. Objective This work aims to prospectively assess HRQoL and health perception in children and adults with T1D and asymptomatic CD after random assignment to GFD vs usual diet. Methods Patients with T1D aged 8 to 45 years without CD symptoms were serologically screened for CD, with positive results confirmed with intestinal biopsy. Participants were randomly assigned in an open-label fashion to a GFD or gluten-containing diet (GCD) for 12 months. Generic and diabetes-specific HRQoL and self-perceived wellness (SPW) were assessed longitudinally. Results A total of 2387 T1D patients were serologically screened. CD was biopsy-confirmed in 82 patients and 51 participants were randomly assigned to a GFD (N = 27) or GCD (N = 24). Excellent adherence to the assigned diets was observed. Overall, no changes in generic (P = .73) or diabetes-specific HRQoL (P = .30), or SPW (P = .41) were observed between groups over 12 months. Hemoglobin A1c (HbA1c) and gastrointestinal symptoms were consistent predictors of HRQoL and SPW. Conclusion HRQoL and SPW were not significantly affected by the adoption of a GFD over 12 months, but worsened with symptom onset and increased HbA1c. Our findings indicate that transition to a GFD can be made successfully in this population without adversely affecting quality of life.
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/clinem/dgaa977
    RVK:
    XA 10000
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    Non-operative Management of Necrotic Pancreatic Collection and Bleeding Pseudoaneurysm Communicating with Bowel Lumen at Multiple Sites: a Case Report and Review of the Literature
    Romanian Society of Gastroenterology and Hepatology ; 2016
    In:  Journal of Gastrointestinal and Liver Diseases Vol. 25, No. 1 ( 2016-03-01), p. 109-114
    Details
    In: Journal of Gastrointestinal and Liver Diseases, Romanian Society of Gastroenterology and Hepatology, Vol. 25, No. 1 ( 2016-03-01), p. 109-114
    Abstract: Pancreatic pseudocysts and foci of walled-off necrosis (WON) are well-known complications of acute pancreatitis. We present a case of severe gallstone pancreatitis complicated by WON, fistulization to the bowel and gastrointestinal bleeding. Bleeding was localized to a pseudoaneurysm of the gastroduodenal artery within the WON using imaging and endoscopy. Angiography and image-guided therapy were then used to control bleeding with coil-embolization. To our knowledge, this is the first report of non-operative management of a patient with severe pancreatitis complicated by WON and a bleeding pseudoaneurysm with multiple communications to the hollow viscera. Therapeutic options are discussed and a thorough literature review is included. Abbreviations: EGD: esophagogastroduodenoscopy; ERCP: endoscopic retrograde cholangiopancreatography; GDA: gastroduodenal artery; GI: gastrointestinal; IEP: interstitial edematous pancreatitis; IPDA: inferior pancreaticoduodenal artery; WON: walled-off necrosis.
    Type of Medium: Online Resource
    ISSN: 1842-1121 , 1841-8724
    URL: Article
    DOI: 10.15403/jgld.2014.1121.251.cll
    Language: Unknown
    Publisher: Romanian Society of Gastroenterology and Hepatology
    Publication Date: 2016
    detail.hit.zdb_id: 2253255-9
    detail.hit.zdb_id: 2427021-0
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  • 3
    Online Resource
    Online Resource
    Gastrointestinal Symptoms in Type 1 Diabetes: Relationship With Autoimmune and Microvascular Complications
    The Endocrine Society ; 2022
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 107, No. 6 ( 2022-05-17), p. e2431-e2437
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 107, No. 6 ( 2022-05-17), p. e2431-e2437
    Abstract: To assess reported rates of gastrointestinal (GI) symptoms and their association with autoimmune diseases and microvascular complications in adults and children with type 1 diabetes. Methods The Gastrointestinal Symptom Scale was used to assess GI symptom type and severity in 2370 patients with type 1 diabetes aged 8 to 45 years evaluated as part of a clinical trial screening for celiac disease (CD). The presence and severity of GI symptoms and relationships with demographic, clinical, and other diabetes-related factors were evaluated. Results Overall, 1368 adults (57.7%) aged 19 to 45 years and 1002 (42.3%) pediatric patients aged 8 to 18 years were studied. At least 1 GI symptom was reported in 34.1% of adults as compared with 21.7% of children (P  & lt; 0.0001). Common symptoms in children included upper and lower abdominal pain while adults more frequently reported lower GI symptoms. Participants with GI symptoms had higher hemoglobin A1c (HbA1c) levels (68 ± 14mmol/mol; 8.35 ± 1.37%) than those without symptoms (66 ± 15mmol/mol; 8.22 ± 1.40%; P = 0.041). Patients with microvascular complications (nephropathy, retinopathy, and/or neuropathy) were 1.8 times more likely to report GI symptoms (95% CI: 1.26-2.60; P  & lt; 0.01) after adjusting for age and sex. No association was observed between GI symptoms and the presence of autoimmune conditions, including thyroid and biopsy-confirmed CD (odds ratio = 1.1; 95% CI: 0.86-1.42; P = 0.45). Main Conclusions These results highlight that GI symptoms are an important clinical morbidity and are associated with increasing age, duration of type 1 diabetes, HbA1c, and microvascular complications but not with autoimmune comorbidities including CD.
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/clinem/dgac093
    RVK:
    XA 10000
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2022
    detail.hit.zdb_id: 2026217-6
    detail.hit.zdb_id: 3029-6
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  • 4
    Online Resource
    Online Resource
    Diagnostic Accuracy of Serologic Screening Tests for Celiac Disease in Asymptomatic Adults and Children with Type 1 Diabetes
    American Diabetes Association ; 2018
    In:  Diabetes Vol. 67, No. Supplement_1 ( 2018-07-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 67, No. Supplement_1 ( 2018-07-01)
    Abstract: Background: As related autoimmune conditions, celiac disease (CD) is more common in individuals with type 1 diabetes (T1D) and is frequently asymptomatic. Despite this association, evidence as to the diagnostic accuracy of screening as well as the potential benefits or harms of screening for CD is limited in asymptomatic patients with T1D. Methods: T1D patients, aged 8-45 years, were serologically screened for CD at multiple centers across Ontario, Canada as part of the Celiac Disease and Diabetes Dietary Intervention and Evaluation Trial (CD-DIET). Patients were deemed asymptomatic on the basis of the absence of GI symptoms, weight changes, anemia and other CD-related clinical features. Screening was conducted in 2,386 patients using chemiluminescent (CL, BioFlash™) and/or ELISA (Celikey™) tissue transglutaminase (TTG) IgA assays, yielding 140 positives. Of these, 104 patients had a duodenal biopsy with CD confirmation (Marsh ≥2). Receiver operating characteristic (ROC) curve analysis was conducted and positive predictive values (PPV) of available screening tests for CD were evaluated. Results: CL and ELISA data were available for 100/104 and 36/104 patients, respectively. The area under the curve of the ROC for CL TTG was 0.918, while the PPV using the manufacturer referenced upper limit (RUL) of 30 CU was 85.9% (95% CI: 82.3-90.8%). According to our data, an optimal cut-off of 156.5 CU, or 5.2 times the RUL, showed an improved PPV of 95.8% (95% CI: 92.4-100.0%). With respect to ELISA TTG, the PPV was 94.4% at the RUL of 8 U/ml and reached to 100% at the optimal cut-off determined by our analysis of 58.7 U/ml, which translates to 7.3 times the RUL. Conclusion: Results from serologic CL and ELISA TTG assays that were greater than 5 times the reported upper limit showed a high PPV for biopsy-confirmed CD in asymptomatic adult and pediatric T1D patients, which may help guide diagnostic evaluation in this population. Disclosure M. Gould: None. F.H. Mahmud: None. A.B. Clarke: None. E. Assor: None. A. Parikh: None. A. Advani: Research Support; Self; AstraZeneca, Boehringer Ingelheim GmbH. Other Relationship; Self; Boehringer Ingelheim GmbH. B.A. Perkins: Advisory Panel; Self; Boehringer Ingelheim GmbH. Research Support; Self; Boehringer Ingelheim GmbH, Novo Nordisk Inc.. Advisory Panel; Self; Novo Nordisk Inc., Abbott. Speaker's Bureau; Self; Abbott, Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Insulet Corporation. Speaker's Bureau; Self; Insulet Corporation, Dexcom, Inc.. B.R. Shah: None. C.S. Zuijdwijk: None. C. McDonald: None. D. Mack: None. D. Koltin: None. E. Hsieh: None. E.M. Szentgyorgyi: None. F. Saibil: None. G. Mukerji: None. H.A. Lochnan: Research Support; Self; Amylin Pharmaceuticals, Boston Therapeutics, Inc., Sanofi. J. Gilbert: Other Relationship; Self; AstraZeneca, Boehringer Ingelheim GmbH, Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Janssen Pharmaceuticals, Inc., Sanofi. K. Bax: None. M.L. Lawson: None. M.D. Beaton: Advisory Panel; Self; Takeda Canada Inc., Janssen Pharmaceuticals, Inc., AbbVie Inc.. N.A. Saloojee: None. O. Lou: None. P.H. Gallego: None. R.L. Houlden: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., AstraZeneca, Eli Lilly and Company. R. Aronson: Other Relationship; Self; Novo Nordisk Inc., Janssen Pharmaceuticals, Inc., Sanofi, AstraZeneca. Research Support; Self; Eli Lilly and Company, Becton, Dickinson and Company, Merck & Co., Inc., Senseonics, Boehringer Ingelheim Pharmaceuticals, Inc.. S.E. Kirsch: None. W.G. Paterson: None. Z. Punthakee: Research Support; Self; Amgen, Astra Zeneca/Bristol Myers Squibb, Lexicon, Merck, NovoNordisk, Sanofi. Speaker's Bureau; Self; Abbott, Astra Zeneca/Bristol Myers Squibb, Boehringer Ingelheim/Eli Lilly, Janssen, Merck, NovoNordisk, Pfizer, Sanofi. Advisory Panel; Self; Astra Zeneca/Bristol Myers Squibb, Boehringer Ingelheim/Eli Lilly, Dexcom, Janssen, Medtronic, NovoNordisk, Pfizer, Sanofi. M.A. Marcon: None.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db18-1579-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2018
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    detail.hit.zdb_id: 1501252-9
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  • 5
    Online Resource
    Online Resource
    Frequency, Severity, and Associations of Gastrointestinal Symptoms in Adults and Children with Type 1 Diabetes
    American Diabetes Association ; 2018
    In:  Diabetes Vol. 67, No. Supplement_1 ( 2018-07-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 67, No. Supplement_1 ( 2018-07-01)
    Abstract: Background: Significant variability is reported as to the presence and quality of gastrointestinal (GI) symptoms in patients with type 1 diabetes (T1D). Objective: To assess reported GI symptoms and associated comorbidities in adults and children with T1D. Methods: The Gastrointestinal Symptom Scale (GISS) and a Visual Analog Scale (VAS) were used to assess GI symptom type and severity in 2,370 patients with T1D aged 8-45 years as part the screening phase of the Celiac Disease and Diabetes Dietary Intervention and Evaluation Trial (CD-DIET). Co-morbidities, including diabetes-related complications, were extracted from clinical records. The presence and severity of GI symptoms and relationships with demographic, clinical and other diabetes-related factors were evaluated. Results: Overall, 1368 adults (57.7%) aged 19-45 years and 1002 (42.3%) pediatric patients aged 8-18 years were studied. At least one GI symptom was reported in 34.1% of adults as compared with 21.7% of children (p & lt;0.0001). Common symptoms in children included upper abdominal pain, lower abdominal pain and nausea while adults more frequently reported lower GI symptoms with females describing more severe symptoms. Overall, patients with ≥1 GI symptom were more likely to have diabetes complications when adjusted for age and sex (OR=1.41; 95% CI=1.1-1.7; p=0.002). Conversely, patients who reported diabetes complications such as nephropathy, retinopathy and/or cardiovascular disease were 1.94 (95% CI=1.49-2.52) times more likely to report GI symptoms. No association was observed between autoimmune conditions (including screen-detected celiac disease and reported thyroid disease) and GI symptoms. Conclusions: In this large screening study in a contemporary T1D cohort, significant differences were found between age groups with more frequent GI symptoms in adults. Significant associations were observed between GI symptoms and diabetes complications along with diabetes duration. Disclosure F.H. Mahmud: None. E. Nunes de Melo: None. A.B. Clarke: None. E. Assor: None. A. Parikh: None. A. Advani: Research Support; Self; AstraZeneca, Boehringer Ingelheim GmbH. Other Relationship; Self; Boehringer Ingelheim GmbH. B.A. Perkins: Advisory Panel; Self; Boehringer Ingelheim GmbH. Research Support; Self; Boehringer Ingelheim GmbH, Novo Nordisk Inc.. Advisory Panel; Self; Novo Nordisk Inc., Abbott. Speaker's Bureau; Self; Abbott, Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Insulet Corporation. Speaker's Bureau; Self; Insulet Corporation, Dexcom, Inc.. B.R. Shah: None. C.S. Zuijdwijk: None. C. McDonald: None. D. Mack: None. D. Koltin: None. E. Hsieh: None. E.M. Szentgyorgyi: None. F. Saibil: None. G. Mukerji: None. H.A. Lochnan: Research Support; Self; Amylin Pharmaceuticals, Boston Therapeutics, Inc., Sanofi. J. Gilbert: Other Relationship; Self; AstraZeneca, Boehringer Ingelheim GmbH, Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Janssen Pharmaceuticals, Inc., Sanofi. K. Bax: None. M.L. Lawson: None. M.D. Beaton: Advisory Panel; Self; Takeda Canada Inc., Janssen Pharmaceuticals, Inc., AbbVie Inc.. N.A. Saloojee: None. O. Lou: None. P.H. Gallego: None. R.L. Houlden: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., AstraZeneca, Eli Lilly and Company. R. Aronson: Other Relationship; Self; Novo Nordisk Inc., Janssen Pharmaceuticals, Inc., Sanofi, AstraZeneca. Research Support; Self; Eli Lilly and Company, Becton, Dickinson and Company, Merck & Co., Inc., Senseonics, Boehringer Ingelheim Pharmaceuticals, Inc.. S.E. Kirsch: None. W.G. Paterson: None. Z. Punthakee: Research Support; Self; Amgen, Astra Zeneca/Bristol Myers Squibb, Lexicon, Merck, NovoNordisk, Sanofi. Speaker's Bureau; Self; Abbott, Astra Zeneca/Bristol Myers Squibb, Boehringer Ingelheim/Eli Lilly, Janssen, Merck, NovoNordisk, Pfizer, Sanofi. Advisory Panel; Self; Astra Zeneca/Bristol Myers Squibb, Boehringer Ingelheim/Eli Lilly, Dexcom, Janssen, Medtronic, NovoNordisk, Pfizer, Sanofi. M.A. Marcon: None.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db18-1578-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2018
    detail.hit.zdb_id: 80085-5
    detail.hit.zdb_id: 1501252-9
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  • 6
    Online Resource
    Online Resource
    The association between Crohn's disease and desmoid tumors: A novel case and review of the literature
    Oxford University Press (OUP) ; 2010
    In:  Journal of Crohn's and Colitis Vol. 4, No. 2 ( 2010-6), p. 207-210
    Details
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 4, No. 2 ( 2010-6), p. 207-210
    Type of Medium: Online Resource
    ISSN: 1873-9946
    URL: Article
    DOI: 10.1016/j.crohns.2009.11.008
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2010
    detail.hit.zdb_id: 2390120-2
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  • 7
    Online Resource
    Online Resource
    Ultra-high dose of mesalamine to treat steroid-dependent ulcerative colitis
    Oxford University Press (OUP) ; 2014
    In:  Journal of Crohn's and Colitis Vol. 8, No. 12 ( 2014-12), p. 1745-1746
    Details
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 8, No. 12 ( 2014-12), p. 1745-1746
    Type of Medium: Online Resource
    ISSN: 1873-9946
    URL: Article
    DOI: 10.1016/j.crohns.2014.08.007
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2014
    detail.hit.zdb_id: 2390120-2
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  • 8
    Online Resource
    Online Resource
    Treatment of Severe Odynophagia with Long-Acting Topical Nitroglycerin Ointment in a Patient with Acquired Immune Deficiency Syndrome
    Wiley ; 1993
    In:  Canadian Journal of Gastroenterology Vol. 7, No. 4 ( 1993), p. 349-352
    Details
    In: Canadian Journal of Gastroenterology, Wiley, Vol. 7, No. 4 ( 1993), p. 349-352
    Type of Medium: Online Resource
    ISSN: 0835-7900
    URL: Article
    DOI: 10.1155/1993/528013
    Language: English
    Publisher: Wiley
    Publication Date: 1993
    detail.hit.zdb_id: 639439-5
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  • 9
    Online Resource
    Online Resource
    Efficiency of an endoscopy suite in a teaching hospital: delays, prolonged procedures, and hospital waiting times
    Elsevier BV ; 2006
    In:  Gastrointestinal Endoscopy Vol. 64, No. 5 ( 2006-11), p. 760-764
    Details
    In: Gastrointestinal Endoscopy, Elsevier BV, Vol. 64, No. 5 ( 2006-11), p. 760-764
    Type of Medium: Online Resource
    ISSN: 0016-5107
    URL: Article
    DOI: 10.1016/j.gie.2006.02.047
    RVK:
    XA 44545
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2006
    detail.hit.zdb_id: 391583-9
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  • 10
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    Online Resource
    Perspectives on colorectal cancer screening: a focus group study
    Wiley ; 2004
    In:  Health Expectations Vol. 7, No. 1 ( 2004-03), p. 51-60
    Details
    In: Health Expectations, Wiley, Vol. 7, No. 1 ( 2004-03), p. 51-60
    Abstract: Objective  To assess attitudes and acceptability of Ontario consumers and doctors towards colorectal screening with faecal occult blood testing (FOBT) and colonoscopy. Design, setting and participants  Focus groups with gender‐specific samples of the population, high‐risk gastroenterology patients and family doctors. Method  Semi‐structured interview guides used by facilitator to lead groups through knowledge of risk factors and prevention of colorectal cancer, the screening modalities, requirements for implementing screening programmes, barriers to screening and preferences towards screening. Main findings  There were low levels of knowledge about colorectal cancer and its prevention in the general population. FOBT was an acceptable screening modality, but considerable education about its use and benefits would be necessary to implement a screening programme. Colonoscopy was not perceived to be a good choice for a primary screen in the general population. The high‐risk group supported use of FOBT in the general population and emphasized the need for education. The doctors were more reluctant about screening, requesting clear guidelines. They also identified the time and resources that would be required if a screening programme were initiated. Conclusion  While colorectal screening is acceptable in this sample, information and decision aids are required to enable consumers and providers to make effective decisions. Implementation of colorectal screening programmes requires substantial educational efforts for both consumers and doctors.
    Type of Medium: Online Resource
    ISSN: 1369-6513 , 1369-7625
    URL: Article
    DOI: 10.1046/j.1369-6513.2003.00252.x
    Language: English
    Publisher: Wiley
    Publication Date: 2004
    detail.hit.zdb_id: 2006357-X
    detail.hit.zdb_id: 2119434-8
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