Zeitschrift fur Gastroenterologie最新文献

{"title":"Sub-optimal therapy of patients with primary biliary cholangitis (PBC) in the real-life stetting of the German PBC cohort.","authors":"Johannes Wiegand, Annegret Franke, Tobias Müller, Kerstin Stein, Heike Bantel, Rainer Günther, Gerald Denk, Philipp A Reuken, Jörn M Schattenberg, Uwe Naumann, Tobias Böttler, Andreas Weber, Stefan Zeuzem, Matthias Hinz, Robin Greinert, Christoph Berg, Thaddäus Till Wissniowski, Karl-Georg Simon, Jonel Trebicka, Rüdiger Behrens, Harald Grümmer, Wolf Peter Hofmann, Nektarios Dikopoulos, Christoph Sarrazin, Elke Roeb, Andreas E Kremer, Marion Muche, Marc Ringelhan, Andreas Teufel, Patrick Michl, Verena Keitel, Jens U Marquardt, Achim Kautz, Frank Tacke, Katja Piotrowski, Nicole Köppe-Bauernfeind, Christian Trautwein, Thomas Berg","doi":"10.1055/a-2382-7720","DOIUrl":"10.1055/a-2382-7720","url":null,"abstract":"<p><p>Real-world data on the management of patients with primary biliary cholangitis (PBC) are so far scarce in Germany. Therefore, we aimed to establish a nationwide registry and describe the clinical characteristics and therapy of PBC patients.Three different cohorts defined as ursodeoxycholic acid (UDCA) responders, as inadequate responders according to Paris II criteria, and as newly diagnosed patients were prospectively recruited.This manuscript includes the baseline data of the project.In total, 33/77 (43%) contacted centres (58% of university hospitals, 38% of non-university hospitals, and 24% of private practices) recruited 515 patients including 204 UDCA responders, 221 inadequate responders to UDCA, and 90 newly diagnosed patients.All patients were treated with UDCA; however, a UDCA dosage below the recommended dosage of 13 mg/kg/d was observed in 38.5% of individuals after 12 months of treatment. UDCA dosages were lower in nonacademic compared to academic centres.Only 75/219 (38.5%) of inadequate responders to UDCA received a second-line therapy with obeticholic acid (OCA) and/or bezafibrate (BZF). OCA (13% vs. 4.5%) and BZF (14% vs. 6.5%) were significantly more often prescribed by academic vs. nonacademic centres.Pruritus (27% vs. 15.5%), fatigue (23% vs. 4.5%), and sicca syndrome (14% vs. 1%) were significantly more often reported by academic centres.The German PBC registry could be established, which indicates suboptimal therapy in a relevant proportion of patients and shows significant differences between academic and nonacademic centres. Results are fundamental to improving clinical management at different levels of care.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of gastric granulosa cell tumor resected by endoscopic submucosal dissection.","authors":"Shijie Lu, Chengyi Xu, Lian Zhang, Junan Li","doi":"10.1055/a-2321-1446","DOIUrl":"10.1055/a-2321-1446","url":null,"abstract":"<p><p>Granular cell tumors, uncommon soft tissue growths, predominantly manifest in the subcutaneous and tongue areas, while those in the gastrointestinal tract are scarce and develop slowly. Patients typically show no distinct clinical symptoms and are hard to differentiate from gastrointestinal mesenchymal tumors, smooth muscle tumors, neural sheath tumors, and rhabdomyosarcomas using endoscopy. This paper details a case of a granular cell tumor in the stomach addressed through endoscopic submucosal dissection, focusing on its endoscopic attributes and clinicopathological traits.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From modern pathogenetic insights and molecular understanding to new deescalating therapeutic strategies in gastric MALT-lymphoma.","authors":"Wolfgang Fischbach, Matthias Eck, Andreas Rosenwald","doi":"10.1055/a-2382-7820","DOIUrl":"10.1055/a-2382-7820","url":null,"abstract":"<p><p>Based on new insights into the aetiology and pathogenesis of gastric marginal-zone B-cell lymphoma of MALT (MALT-lymphoma) and its histomorphological and molecular characteristics, important progress in our understanding of the disease and its clinical management has been made during the last decades. A landmark in this development was the identification of <i>Helicobacter pylori</i> as the decisive pathogenetic factor for gastric MALT lymphoma. We, here, give an overview about the history and the current knowledge of the histology, genetics, and molecular characteristics and pathogenesis of gastric MALT lymphoma. We then focus on how these findings have fundamentally changed its clinical management over the last three decades with consequent deescalating therapeutic strategies.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: From modern pathogenetic insights and molecular understanding to new deescalating therapeutic strategies in gastric MALT-lymphoma.","authors":"Wolfgang Fischbach, Matthias Eck, Andreas Rosenwald","doi":"10.1055/a-2427-5237","DOIUrl":"10.1055/a-2427-5237","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peristomal skin lesions - identifying patients at risk.","authors":"Louisa Dietmaier, Scarlett Summa, Moritz Ronicke, Cornelia Erfurt-Berge","doi":"10.1055/a-2360-5099","DOIUrl":"10.1055/a-2360-5099","url":null,"abstract":"<p><strong>Background and objectives: </strong>Diagnosis and therapy of peristomal skin lesions are challenging for the majority of therapists. Established diagnostic tools have not yet been validated. Our objective was to outline the spectrum of and to identify risk factors for skin lesions in ostomy patients. A focus was set on peristomal ulcerations and their differentiation as peristomal pyoderma gangrenosum.</p><p><strong>Methods: </strong>In a retrospective analysis, frequency and character of peristomal skin lesions in patients presenting at two departments were analysed. Patients suffering from peristomal ulcerations were subjected to a more detailed analysis including application of the PARACELSUS score.</p><p><strong>Results: </strong>A total of 565 patients with ostomy were analysed; 40.2% (n = 227) presented with peristomal skin lesions. Moisture-associated skin damage (27.9%) was the most common, while ulcerations (21.9%) and eczematous skin alterations (19.1%) were seen with comparable frequency. Peristomal pyoderma gangrenosum was diagnosed in 7.9% of all observed peristomal lesions. Among patients with inflammatory bowel disease (n = 98), peristomal ulcerations were the leading finding (35.7%), and pyoderma gangrenosum was more frequent in these patients (16.3%).</p><p><strong>Conclusions: </strong>It is necessary to assess and classify peristomal skin lesions. Further studies for the validation of different scores or the development of diagnostic tools are needed.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative versus surgical therapy for idiopathic and secondary megacolon or megarectum in adults - a retrospective multicentre controlled study.","authors":"Daniel Schmitz, Emilia Meier, Steffen Axt, Gerrit Arlt, Peter Kienle, Jonas Johannink, Alfred Königsrainer, Owais Mohammad, Ralf Jakobs, Stefan Willis, Ihsan Ekin Demir, Helmut Friess, Svetlana Hetjens, Matthias Philip Ebert, Christoph Reissfelder, Georgi Vassilev","doi":"10.1055/a-2360-5008","DOIUrl":"10.1055/a-2360-5008","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic and secondary megacolon (MC) and megarectum (MR) in adults is associated with persistent bowel dilatation and reduced intestinal motility. Little is known about the optimal treatment of this rare disease. Therefore, we retrospectively analysed long-term data from these patients in 5 community and university hospitals, focusing on conservative versus surgical treatment.</p><p><strong>Methods: </strong>Patient records from 7/2004 to 9/2021 were screened for colorectal diseases with severe constipation and persistent megacolon ≥ 9.0 cm and/or megarectum ≥ 6.5 cm. Follow up-data was collected through telephone interviews and written surveys. ClinicalTrialsgov NCT04340856.</p><p><strong>Results: </strong>Sixty-seven patients with idiopathic (n=10) and secondary (n=57) MC or MR were identified with only 20 of 67 patients (29.9%) correctly diagnosed. Mean/median age was 64/69 (range 18-93) years. Thirty-two patients were treated with laxative regimens, and 35 underwent surgery (colostomy: n=12, segmental resection, or hemicolectomy: n=10, (sub)total colectomy: n= 13) after conservative treatment attempts in 32/35 (91.4%). The mean/median follow-up was 4.2/2.7 (range 0.1-17.0) years. The readmission rate for MC-associated symptoms was significantly higher after conservative treatment than after surgical therapy at 12 (0.84 vs. 0.36 per patient, p=0.036), 24 (1.00 vs. 0.52, p=0.048) and 36 (1.13 vs. 0.58, p=0.047) months, as was the number of patients with persistent laxative dependence (28/32 (87.5%) vs. 19/33 (57.6%); p = 0.007). Therapy-associated adverse events (Clavien-Dindo classification) were documented more often in surgically treated patients (11/35, 31.4%) (p=0.025).</p><p><strong>Conclusion: </strong>Surgical treatment may be considered earlier if idiopathic or secondary MC or MR is correctly diagnosed, and conservative treatment has been attempted.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leitlinienreport der S3-Leitlinie zum exokrinen Pankreaskarzinom.","authors":"Thomas Seufferlein, Julia Mayerle, Steffi Derenz, Markus Follmann, Angelika Kestler, Marie-Jolin Köster, Thomas Langer, Dana Rütters, Nadine Fischer","doi":"10.1055/a-2338-3660","DOIUrl":"https://doi.org/10.1055/a-2338-3660","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should we perform regular surveillance capsule endoscopies in patients following small-bowel adenocarcinoma resection? A case report and discussion.","authors":"Damian Wiedbrauck, Stephan Hollerbach, Felix Wiedbrauck","doi":"10.1055/a-2360-8586","DOIUrl":"10.1055/a-2360-8586","url":null,"abstract":"<p><p>Because small-bowel tumors are rare, prospective data on the utility of video capsule endoscopy (VCE) for their detection are limited. Current guidelines do not advocate for surveillance VCEs in patients following small-bowel tumor resection, which is mostly due to a lack of data. Here, we report an 81-year-old male patient who had undergone curative segmental ileal adenocarcinoma resection 15 years ago and another segmental jejunal adenocarcinoma resection (TNM-Classification: pT2 pN0 (0/2) G2M0) 7 years ago. He now presents with melena, progressive dyspnea, and decreased hemoglobin levels. VCE revealed local intestinal recurrence of the previously resected jejunal adenocarcinoma, leading to a second segmental jejunal resection (TNM-Classification: pT3 L1 pN0 (0/5) G2 M0). We believe that regular surveillance VCEs after the first jejunal adenocarcinoma resection might have facilitated earlier detection of tumor recurrence in this patient's case. Therefore, we suggest considering regular surveillance VCEs, at least in patients with recurrent small-bowel malignancies. However, future prospective studies are warranted to validate our findings.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student Ultrasound Education, Current Views and Controversies; Who Should be Teaching?","authors":"Gregor Barth, Helmut Prosch, Michael Blaivas, Anna Maria Gschmack, Roman Hari, Beatrice Hoffmann, Christian Jenssen, Kathleen Möller, Ricarda Neubauer, Nasenien Nourkami-Tutdibi, Florian Recker, Johannes Peter Ruppert, Friederike Von Wangenheim, Johannes Weimer, Susan Campbell Westerway, Constantinos Zervides, Christoph F Dietrich","doi":"10.1055/a-2356-7906","DOIUrl":"10.1055/a-2356-7906","url":null,"abstract":"<p><p>Acquiring diagnostic ultrasound competencies and skills is crucial in modern health care, and achieving the practical experience is vital in developing the necessary anatomy interpretation and scan acquisition skills. However, traditional teaching methods may not be sufficient to provide hands-on practice, which is essential for this skill acquisition. This paper explores various modalities and instructors involved in ultrasound education to identify the most effective approaches. The field of ultrasound instruction is enriched by the diverse roles of physicians, anatomists, peer tutors, and sonographers. All these healthcare professionals can inspire and empower the next generation of ultrasound practitioners with continuous training and support. Physicians bring their clinical expertise to the table, while anatomists enhance the understanding of anatomical knowledge through ultrasound integration. Peer tutors, often medical students, provide a layer of social congruence and motivation to the learning process. Sonographers provide intensive practical experience and structured learning plans to students. By combining different instructors and teaching methods, success can be achieved in ultrasound education. An ultrasound curriculum organized by experts in the field can lead to more efficient use of resources and better learning outcomes. Empowering students through peer-assisted learning can also ease the burden on faculty. Every instructor must receive comprehensive didactic training to ensure high-quality education in diagnostic ultrasound.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S3-Leitlinie Exokrines Pankreaskarzinom – Version 3.1.","authors":"Thomas Seufferlein, Julia Mayerle, Stefan Boeck, Thomas Brunner, Thomas J Ettrich, Lars Grenacher, Thomas Mathias Gress, Thilo Hackert, Volker Heinemann, Angelika Kestler, Marianne Sinn, Andrea Tannapfel, Ulrich Wedding, Waldemar Uhl","doi":"10.1055/a-2338-3716","DOIUrl":"https://doi.org/10.1055/a-2338-3716","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}