References of "Acta Gastro-Enterologica Belgica"
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See detailMetabolomic, proteomic and preclinical imaging of patient-derived tumor xenografts for improving treatment of liver metastases patients
Perez Palacios, A; Blomme, A; Boutry, S et al

in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 134

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See detailTGF-B induced protein IG-H3 is essential for the growth of human liver metastases
Castronovo, Vincenzo ULg; Blomme, Arnaud; Delvenne, Philippe ULg et al

in Acta Gastro-Enterologica Belgica (2014, March), 77(1), 05

Introduction : Transforming growth factor-beta-induced protein ig-h3 (TGFBI) is extracellular matrix component known to be important for cell-collagen interaction. We and others have reported elevated ... [more ▼]

Introduction : Transforming growth factor-beta-induced protein ig-h3 (TGFBI) is extracellular matrix component known to be important for cell-collagen interaction. We and others have reported elevated expression of TGFBI in sev- eral human cancers, where its role remains controversial. Aim Current study aims at clarifying the function of TGFBI to date. Methods &Results : CRC-LM and in liver metastases originating from breast, lung and pancreatic tumors. We have next focused on func- tional aspects and have silenced TGFBI expression in SW1222 human colorectal carcinoma cells. The suppression of TGFBI protein led to a marked decrease in cell migration (-70%) and proliferation (-30%) in vitro. To study the effects in vivo we have developed a novel animal model of colorectal carcinoma based on chicken chorioallantoic membrane (CAM) that mimics human CRC-LM. TGFBI silencing resulted in 50% reduction of tumor volume in the CAM tumor model. Notably, the tumors displayed a marked inhibition of vascularization, suggesting an additional anti-angiogenic effect. Indeed, SW1222 cells silenced for TGFBI expression secreted lower levels of VEGFA in vitro. Finally, we have investigated if TGFBI can be used as systemically reachable target for antibody-drug delivery. For this purpose we have The in vivo data demonstrated that TGFBI is an accessible tumor target. Conclusions : Taken together, the present study shows that TGFBI is essential for promoting the development of CRC- LM and therefore represents a promising target for designing novel therapeutic approaches. [less ▲]

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See detailOrganized proteomic heterogeneity in colorectal liver metastases and implications for therapies
Turtoi, Andrei ULg; Blomme, Arnaud ULg; Debois, Delphine ULg et al

in Acta Gastro-Enterologica Belgica (2014, March), 77(1), 07

Introduction : Tumor heterogeneity is a major obstacle for developing effective anti-cancer treatments. Recent studies have pointed at large stochastic genetic heterogeneity within cancer lesions, where ... [more ▼]

Introduction : Tumor heterogeneity is a major obstacle for developing effective anti-cancer treatments. Recent studies have pointed at large stochastic genetic heterogeneity within cancer lesions, where no pattern seems to exist that would enable a more structured targeted therapy approach. Aim : Because to date no similar information is available at the protein (phenotype) level, we aimed at characterising the proteomic heterogeneity in human colorectal carcinoma (CRC) liver metastases. Methods & Results : We employed MALDI imaging-guided proteomics and explored the heterogeneity of extracellular distribution of over 1000 proteins we found unexpectedly that all liver metastasis lesions displayed a reproducible, zon- ally delineated, pattern of functional and therapeutic biomarker heterogeneity. Peritumoral region featured elevated lipid metabolism and protein synthesis, the rim of the metastasis displayed increased cellular growth, movement and drug metabolism whereas the center of the lesion was characterized by elevated carbohydrate metabolism and DNA- repair activity. From the aspect of therapeutic targeting zonal expression of known and novel biomarkers was evident, reinforcing the need to select several targets in order to achieve optimal coverage of the lesion. Finally we highlight two novel antigens, LTBP2 and TGFBI, whose expression is a consistent feature of CRC liver metastasis. Conclusions : proteome heterogeneity has a distinct, organized, pattern. This particular hallmark can now be used as a part of the strategy for developing rational therapies based on multiple sets of targetable antigens. [less ▲]

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See detailPrognostic value of FDG PET/CT in liver transplantation for hepatocarcinoma
DETRY, Olivier ULg; Govaerts, L; BLETARD, Noëlla ULg et al

in Acta Gastro-Enterologica Belgica (2014, March), 77(1), 08

AIM : FDG uptake has been shown to predict the outcome in large series of patients with hepatocarcinoma (HCC) in Asia, but few data are available regarding European populations. Our aim was to evaluate ... [more ▼]

AIM : FDG uptake has been shown to predict the outcome in large series of patients with hepatocarcinoma (HCC) in Asia, but few data are available regarding European populations. Our aim was to evaluate the prognostic value of pretreatment FDG PET-CT in patients treated by liver transplantation. Methods: We retrospectively analyzed the data of 27 patients (24 M and 3 W, mean age 58 ± 9 years). The mean follow-up was 26 ± 18 months (min 1 month, max 66 months). All patients had an FDG PET-CT before the transplantation. The FDG PET/CT was performed according to a standard clinical protocol: 4 MBqFDG/kg body weight, uptake 60 min., low-dose non-enhanced CT. We measured the SUVmax and SUVmean of the tumor and the normal liver. The tumor/liver activity ratios (RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors: MILAN, CLIP, OKUDA, TNM stage, alphafoetoprotein level, portal thrombosis, size of the largest nodule, tumor differentiation, microvascular invasion, underlying cirrhosis and liver function. Results : The DFS was 87.2% at 1y and 72.1% at 3y. The OS was 85.2% at 1y and 80.7% at 3y. According to an univariate Cox model, RSUVmax, RSUVmean and healthy liver were predictors of DFS and RSUVmax, RSUVmean, size of the largest nodule, CLIP, liver involvement>50%, and healthy liver predicted the OS. According to a multivariate Cox model, only RSUVmax predicted DFS and RSUVmax and liver involvement>50% predicted OS. An ROC analysis of the ratios showed that the 1.15 cut-off for RSUVmax was best for predicting both the DFS (Cox regression:HR 14.4, p=0.02) and OS (HR 5.6, p=0.049). The Kaplan-Meier curves and Logrank tests confirmed those results. Even though the MILAN criteria alone were not predictive, it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax<1.15 relapsed. Conclusions: The RSUVmax is a strong prognostic factor for recurrence and death in patients with HCC treated by liver transplantation with a cut-off value of 1,15. further prospective studies should test whether the metabolic index should be systematically included in the preoperative assessment. [less ▲]

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See detailControlled DCD donation is part of the solution to liver graft shortage, regardless of donor age
DETRY, Olivier ULg; MEURISSE, Nicolas ULg; DELWAIDE, Jean ULg et al

in Acta Gastro-Enterologica Belgica (2014, March), 77(1), 16

Aim: Results of donation after circulatory death (DCD) liver transplantation (LT) are impaired by ischemic bile duct lesions caused by procurement warm ischemia. Donor age is a risk factor in deceased ... [more ▼]

Aim: Results of donation after circulatory death (DCD) liver transplantation (LT) are impaired by ischemic bile duct lesions caused by procurement warm ischemia. Donor age is a risk factor in deceased donor LT, and particularly in DCD-LT. At the authors institute, age is not an absolute exclusion criterion to discard DCD liver grafts, controlled DCD donors receive comfort therapy before withdrawal, and cold ischemia is minimized. The aim of the present study was to report on the results of the first 10 years of this experience, and particularly on graft survival and the rate of post-transplant biliary complications, according to DCD donor age. 
 Methods: The authors retrospectively studied a consecutive series of 70 DCD-LT performed from 2003 to 2012, with at least one year of follow-up. This series was divided according to donor’s age, including 32 liver grafts from donors <55years, 20 between 56 and 69 years, and 18 from older donors >69 years. The three groups were compared in terms of donor and recipient demographics, procurement and transplantation conditions, peak laboratory values during the first post-transplant 72 hours, and results at one and four years. Median follow-up was 43 months. 
 Results: Overall graft survival was 98.5%, 91.4% and 69.5% at 1 month, 1 year and 4 years, respectively, without graft loss secondary to ischemic bile duct lesions. Cancer was the primary cause of graft loss and patient death. No difference other than age was noted between the three groups in donor and recipient characteristics, and in procurement conditions. There was no primary non-function but one patient needed re-transplantation for artery thrombosis. Biliary complications occurred similarly in the three groups. Graft and patient survival rates were not different at one and four years between the three groups. During the study period, there was an increasing liver procurement and transplantation activity, and in 2012, 30% of performed LT were DCD-LT, allowing a mean LT waiting time of 66 days. 
 Conclusions: This study shows comparable results between controlled DCD-LT from younger and older donors. Donor age >50 years should not be a contraindication to DCD-LT if other donor risk factors (such as warm and cold ischemia time) are minimized. DCD-LT with short cold ischemia may provide a significant source of liver grafts, decreasing waiting time. [less ▲]

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See detailBelgian consensus on chronic pancreatitis in adults and children: statements on diagnosis and nutritional, medical, and surgical treatment.
Delhaye, Myriam; Van Steenbergen, Werner; Cesmeli, Ercan et al

in Acta gastro-enterologica Belgica (2014), 77(1), 47-65

Chronic pancreatitis (CP) is an inflammatory disorder characterized by inflammation and fibrosis, resulting in a progressive and irreversible destruction of exocrine and endocrine pancreatic tissue ... [more ▼]

Chronic pancreatitis (CP) is an inflammatory disorder characterized by inflammation and fibrosis, resulting in a progressive and irreversible destruction of exocrine and endocrine pancreatic tissue. Clinicians should attempt to classify patients into one of the six etiologic groups according to the TIGARO classification system. MRI/MRCP, if possible with secretin enhancement, is considered the imaging modality of choice for the diagnosis of early-stage disease.In CP, pain is the most disabling symptom, with a significant impact on quality of life. Pain should be assessed using the Izbicki score and preferably treated using the "pain ladder" approach. In painful CP, endoscopic therapy (ET) can be considered as early as possible. This procedure can be combined with extracorporeal shock-wave lithotripsy (ESWL) in the presence of large (> 4 mm), obstructive stone(s) in the pancreatic head, and with ductal stenting in the presence of a single main pancreatic duct (MPD) stricture in the pancreatic head with a markedly dilated MPD. Pancreatic stenting should be pursued for at least 12 months in patients with persistent pain relief. On-demand stent exchange should be the preferred strategy. The simultaneous placement of multiple, side-by-side, pancreatic stents can be recommended in patients with MPD strictures persisting after 12 months of single plastic stenting. We recommend surgery in the following cases: a) technical failure of ET ; b) early (6 to 8 weeks) clinical failure ; c) definitive biliary drainage at a later time point; d) pancreatic ductal drainage when repetitive ET is considered unsuitable for young patients; e) resection of an inflammatory pancreatic head when pancreatic cancer cannot be ruled out; f) duodenal obstruction. Duodenopancreatectomy or oncological distal pancreatectomy should be considered for patients with suspected malignancy. Pediatricians should be aware of and systematically search for CP in the differential diagnosis of chronic abdominal pain. As malnutrition is highly prevalent in CP patients, patients at nutritional risk should be identified in order to allow for dietary counseling and nutritional intervention using oral supplements. Patients should follow a healthy balanced diet taken in small meals and snacks, with normal fat content. Enzyme replacement therapy is beneficial to symptomatic patients, but also in cases of subclinical insufficiency. Regular follow-up should be considered in CP patients, primarily to detect subclinical maldigestion and the development of pancreatogenic diabetes. Screening for pancreatic cancer is not recommended in CP patients, except in those with the hereditary form. [less ▲]

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See detailDepth of remission in Crohn's disease patients seen in a referral centre : associated factors and impact on disease outcome.
Poncin, M.; Reenaers, C.; Van Kemseke, C. et al

in Acta gastro-enterologica Belgica (2014), 77(1), 41-6

INTRODUCTION: Our goals were to assess the prevalence of biological and tissue remission in routine practice in Crohn's disease, and to evaluate the correlation between biological or tissue remission and ... [more ▼]

INTRODUCTION: Our goals were to assess the prevalence of biological and tissue remission in routine practice in Crohn's disease, and to evaluate the correlation between biological or tissue remission and clinical or demographic characteristics as well as their impact on disease outcome. METHODS: We performed a retrospective monocenter study. Biological remission was defined by a CRP < 5 mg/I. Tissue remission was defined by the absence of ulcer at endoscopy and/or absence of signs of acute inflammation at MRI. Association with demographic, clinical and laboratory markers was studied by logistic regression models and rates of relapses, hospitalizations and surgeries were compared using the logrank test. RESULTS: Among the 263 patients included, 147 were in clinical remission; 102/147 (69%) were in biological remission. Fifty-six patients also had morphological evaluation: 37 (66%) were in tissue remission. Biological remission was associated with older age, higher hemoglobin and lower BMI. Tissue remission was associated with older age, lower platelets count, absence of previous surgery, and the use of immunosuppressant. Time-to-relapse was significantly longer in patients with biological remission and in patients with tissue remission as compared to patients without biological or tissue remission. CONCLUSIONS: Among the patients in clinical remission seen as outpatients, two thirds were either in biological and/or tissue remission. Biological and/or tissue remission was associated with a better outcome than clinical remission alone. [less ▲]

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See detailResponse of Black African patients with hepatitis C virus genotype 4 to treatment with peg-interferon and ribavirin
Nkuize, M; Mulkay, JP; Adler, M et al

in Acta Gastro-Enterologica Belgica (2013), 76

Aim : To compare responses to therapy of Black African (BA) and non-Black African (non- BA) patients with hepatitis C virus genotype 4 (HCV-4) residing in Belgium. Methods : In this retrospective ... [more ▼]

Aim : To compare responses to therapy of Black African (BA) and non-Black African (non- BA) patients with hepatitis C virus genotype 4 (HCV-4) residing in Belgium. Methods : In this retrospective multicenter study, 473 patients with HCV-4 were selected from databases at 7 Belgian centers ; 209 treatment-naïve patients (154 BA) had received treatment with peg-interferon (peg-IFN) plus ribavirin (RBV) and were included in the study. Results : There was a greater percentage of female patients in the BA group than in the non- BA group ; BA patients were also older, had a greater body mass index, and more frequently had abnormal glucose metabolism. The route of contamination was more frequently unknown in BA than in non-BA patients and BA patients had more HCV-4 subtypes. There were no differences in other demographic factors between the groups. Sustained viral response (SVR) and complete early viral response rates were significantly lower and relapse rates significantly higher in BA than in non-BA patients. There were no differences between groups in rates of dose modification or in drug tolerance. Conclusion : In our cohort, treatment-naïve BA patients with HCV-4 who were treated with peg-IFN and ribavirin had a much lower SVR rate than treatment-naïve non-BA patients with HCV- 4 who were treated with peg-IFN and ribavirin, and a higher relapse rate, possibly related to a weaker response to interferonbased therapy. Treatment may need to be adapted in this population. [less ▲]

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See detailBelgian multicentre experience with intestinal transplantation
Ceulemans, L; DE ROOVER, Arnaud ULg; DETRY, Olivier ULg et al

in Acta Gastro-Enterologica Belgica (2013, March), 76(1), 07

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See detailTherapeutic Strategy and Patient Outcome during the First 2 Years of Pediatric Crohn’s Disease
Veereman, G; Mahachie John, Jestinah ULg; De Greef, E et al

in Acta Gastro-Enterologica Belgica (2013)

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See detailOptimal use of proton pump inhibitors for treating acid peptic diseases in primary care.
Tack, Jacques ULg; Louis, Edouard ULg; Persy, V. et al

in Acta gastro-enterologica Belgica (2013), 76(4), 393-402

Heartburn, reflux and epigastric pain are frequently encountered symptoms in primary care medicine. Acid peptic diseases such as peptic ulcer and gastrointestinal reflux disease have a high prevalence ... [more ▼]

Heartburn, reflux and epigastric pain are frequently encountered symptoms in primary care medicine. Acid peptic diseases such as peptic ulcer and gastrointestinal reflux disease have a high prevalence, can have important impact on patient quality of life and represent a considerable health care cost. Proton pump inhibitors (PPIs) are the most potent pharmacological inhibitors of gastric acid secretion currently available and are the mainstay medical therapy for acid peptic diseases. This review summarizes current evidence on treatment of acid-peptic diseases with proton pump inhibitors and provides primary care clinicians with best practice guidelines for optimal use of these drugs. [less ▲]

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See detailUpdate of the Belgian Association for the Study of the Liver Guidelines for the treatment of chronic hepatitis C genotype 1 with protease inhibitors.
Orlent, H; Deltenre, P; Francque, S et al

in Acta Gastro-Enterologica Belgica (2012), 75(2), 245-259

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See detailHBV infection in Belgium: results of the BASL observatory of 1456 HBsAg carriers.
Deltenre, P.; Laleman, W.; Van Gossum, M. et al

in Acta Gastro-Enterologica Belgica (2012), 75(1), 35-41

Introduction : Nationwide studies are mandatory to assess changes in the epidemiology of HBV infection in Europe. Aim : To describe epidemiological characteristics of HBsAgpositive patients, especially ... [more ▼]

Introduction : Nationwide studies are mandatory to assess changes in the epidemiology of HBV infection in Europe. Aim : To describe epidemiological characteristics of HBsAgpositive patients, especially inactive carriers, and to evaluate how practitioners manage HBV patients in real life. Methods : Belgian physicians were asked to report all chronically infected HBV patients during a one-year period. Results : Among 1,456 patients included, 1,035 (71%) were classified into one of four phases of chronic infection : immune tolerance (n = 10), HBeAg-positive hepatitis (n = 248), HBeAgnegative hepatitis (n = 420) and inactive carrier state (n = 357 HBeAg-negative patients with ALT < upper limit of normal (ULN) and HBV DNA < 2,000 IU/mL). Using less restrictive criteria for ALT (1-2 ULN) or HBV DNA (2,000-20,000 IU/mL), 93 unclassified patients were added to the group of inactive carriers. These 93 additional inactive carriers were younger, more frequently males, with similar risk factors for HBV infection and histological features compared to inactive carriers according to recent guidelines. Recent guidelines on management of HBV patients were generally followed, but systematic HBV DNA measurements and HDV coinfection screening should be reinforced. Conclusion : In Belgium, an inactive carrier state was a common form of chronic HBV infection. Using less restrictive criteria for classification of inactive carriers did not modify their main characteristics and seemed better adapted to clinical practice. Recent guidelines on management of HBV patients should be reinforced. [less ▲]

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See detailSafety and cost of infliximab for the treatment of Belgian pediatric patients with Crohn's disease.
De Greef, E.; Hoffman, I.; D'Haens, G. et al

in Acta Gastro-Enterologica Belgica (2012), 75(4), 425-31

Biologicals have become an important component in the treatment of Crohn's disease in children. Their increased and long term use raises safety concerns. We describe safety and cost of infliximab in ... [more ▼]

Biologicals have become an important component in the treatment of Crohn's disease in children. Their increased and long term use raises safety concerns. We describe safety and cost of infliximab in Belgian pediatric Crohn's disease patients. All patients on infliximab as part of the present or past treatment for Crohn's Disease until January 1st 2011 were selected from an existing database. Information on disease phenotype, medication and adverse events were extracted. Adverse events occurred in 25.9% of patients exposed to infliximab of which 29.6% were severe. In total 31.7% of patients stopped infliximab therapy. The main reasons for discontinuation were adverse events in 45.4% and loss of response in 30.3%. No malignancies or lethal complications occurred over this 241 patient year observation period. Immunomodulators were concomitant medication in 75% of patients and were discontinued subsequently in 38.4% of them. The cost of infliximab infusions per treated patient per year in the Belgian health care setting is approximately 9 474 euro, including only medication and hospital related costs. Even though infliximab is relatively safe in pediatric CD on the short term, close follow-up and an increased awareness of the possible adverse reactions is highly recommended. Adverse reactions appeared in 25.9% of all patients and were the main reason for discontinuation. Treatment cost has to be balanced against efficacy and modifications in disease course. In the Belgian health care system, the medication is available to all patients with moderate to severe CD. [less ▲]

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See detailFactors determining therapeutic strategy at diagnosis and evolution of disease severity in a cohort of Belgian pediatric Crohn’s disease patients (BELCRO)
De Greef, E; Mahachie John, Jestinah; Hoffman, I et al

in Acta Gastro-Enterologica Belgica (2012)

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See detailUpper gastrointestinal tract bleeding management: Belgian guidelines for adults and children.
Colle, I.; Wilmer, A.; Le Moine, O. et al

in Acta Gastro-Enterologica Belgica (2011), 74

Upper gastrointestinal bleeding (UGIB) remains a common disease affecting 100 to 170 per 100 000 adults per year and causing thereby a significant burden to healthcare resources. Despite the improvements ... [more ▼]

Upper gastrointestinal bleeding (UGIB) remains a common disease affecting 100 to 170 per 100 000 adults per year and causing thereby a significant burden to healthcare resources. Despite the improvements in the management of this disorder, the associated mortality ranges from 5 to 14 %. Since the general management of UGIB is not uniform, the main objective of this work is to provide guidelines for the care of adults and children presenting with bleeding caused by gastro-duodenal ulcer or variceal rupture. Methods: In the absence of evidence-based recommendations, these guidelines were proposed after expert opinions reconciliation and graded accordingly. They are based on the published literature up to September 2010 and graded according to the class of evidence. Results: The current guidelines for the management of UGIB include recommendations for the diagnostic process, general supportive care, pharmacological therapy aiming at bleeding control, specific and endoscopic treatment of acute bleeding and follow-up for both gastro-duodenal ulcers and portal hypertension induced bleeding. [less ▲]

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See detailAre patients with HBV and HCV infection different? Comparison between 2 cohorts of newly diagnosed cases included in prospective registries of the Belgian Association for the Study of the Liver
De Vroey, B.; Moreno, C.; Laleman, W. et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 21

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See detailOutcome of patients with hepatocellular carcinoma listed for liver transplantation before and after the MELD-based allocation system within Eurotransplant. A BElgian multicentre retrospective study.
Vos, B.; Rogge, S.; Nevens, F. et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 13

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