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51. Als coeliakie niet beter wordt

Author

van Wanrooij, R.L.J., Neefjes-Borst, E.A., von Blomberg, B.M.E., Mulder, C.J.J., Bouma, G., Gastroenterology and hepatology, Pathology, and CCA - Immuno-pathogenesis

Published
2012

56. Inflammatory bowel disease: a systematic review on the value of diagnostic testing in primary care

Author

Jellema, A.P., van Tulder, M.W., van der Horst, H.E., Florie, J., Mulder, C.J.J., van der Windt, D.A.W.M., General practice, Epidemiology and Data Science, Gastroenterology and hepatology, EMGO - Musculoskeletal health, CCA - Innovative therapy, Health Economics and Health Technology Assessment, and EMGO+ - Musculoskeletal Health

Subjects
SDG 16 - Peace, Justice and Strong Institutions
Abstract

Aim: The clinical presentation of inflammatory bowel disease in primary care represents a diagnostic challenge as its symptoms are heterogeneous and common. To assist the primary care physician, we have summarized the available evidence on diagnostic tests in patients with abdominal symptoms. Method: We searched PubMed and Embase and screened references. Studies were selected if the design was a primary diagnostic study. Patients were adults attending with nonacute abdominal symptoms. Tests included clinical assessment, blood or faecal tests or abdominal ultrasonography. Quality assessment using a modified version of the QUADAS tool and data extraction was performed by two reviewers independently. Diagnostic two-by-two tables and pooled estimates of sensitivity and specificity are given. We refrained from pooling when there was considerable clinical or statistical heterogeneity. Results: A total of 24 studies were included. While the diagnostic performance of the individual symptoms was highly variable (range sensitivity 0.0-0.96, specificity 0.09-1.0), the performance of symptom-based classification systems was both more consistent and better (sensitivity 0.65-1.0, specificity 0.17-0.82). Among faecal and blood tests, calprotectin was studied most frequently and showed the best results (sensitivity 0.61-1.0, specificity 0.71-1.0). Statistical pooling for ultrasonography resulted in a sensitivity of 0.73 (0.65-0.80) and a specificity of 0.95 (0.91-0.97). Conclusion: Although calprotectin and ultrasonography showed consistent and promising findings, none of the studies was performed in primary care. To assist primary care physicians in diagnostic decision making, we urgently need high quality studies performed in primary care. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Published
2011
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57. Azathioprine or mercaptopurine-induced acute pancreatitis is not a disease-specific phenomenon

Author

van Geenen, E.M., de Boer, N.K., Stassen, P., Linskens, R.K., Bruno, M.J., Mulder, C.J.J., Stegeman, C.A., van Bodegraven, A.A., Groningen Kidney Center (GKC), Translational Immunology Groningen (TRIGR), Gastroenterology and hepatology, and CCA - Innovative therapy

Subjects
6-MERCAPTOPURINE, ULCERATIVE-COLITIS, 6-THIOGUANINE, SYSTEMIC VASCULITIDES, ASSOCIATION, THIOPURINE, IBD PATIENTS, SCLEROSING CHOLANGITIS, digestive system diseases, CROHNS-DISEASE, INFLAMMATORY-BOWEL-DISEASE
Abstract

P>Background Several reports suggest an increased rate of adverse reactions to azathioprine in patients with Crohn's disease. Aim To compare the incidence of thiopurine-induced acute pancreatitis in patients with inflammatory bowel disease (IBD) with that in patients with vasculitis. Methods This retrospective analysis was performed using data collected in three databases by two university hospitals (241 patients with IBD and 108 patients with vasculitis) and one general district hospital (72 patients with IBD). Results The cumulative incidence of thiopurine-induced acute pancreatitis in Crohn's disease equalled that of ulcerative colitis (UC) (2.6% vs. 3.7%) and this did not differ from vasculitis patients (2.6% vs.1.9%). In addition, the cumulative incidence of thiopurine-induced acute pancreatitis in UC patients was not different from that in vasculitis patients. In the IBD group, 100% of thiopurine-induced acute pancreatitis patients were women, whereas in the vasculitis group the two observed thiopurine-induced acute pancreatitis cases (n = 2 of 2) concerned were men (P = 0.012). Conclusions In this study, the alleged higher cumulative incidence of thiopurine-induced acute pancreatitis in Crohn's disease compared with vasculitis or UC patients was not confirmed. Female gender appears to be a risk factor for developing thiopurine-induced acute pancreatitis in IBD patients.

Published
2010
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60. Colorectal cancer Authors' reply

Author

de Vet, H.C.W., Jellema, P., van der Windt, D.A.W.M., Bruinvels, D.J., Mallen, C.D., van Weyenberg, S.J.B., Mulder, C.J.J., Epidemiology and Data Science, General practice, Public and occupational health, Gastroenterology and hepatology, EMGO - Musculoskeletal health, CCA - Innovative therapy, and EMGO+ - Musculoskeletal Health

Published
2010
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61. Dna Copy Number Alterations in Flat Colorectal Adenomas

Author

Voorham, Q.J.M., Carvalho, B., Spiertz, A., van Grieken, N.C.T., Grabsch, H., Rembacken, B., Kliment, M., van de Wiel, M., Bruine, A., Mulder, C.J.J., van Engeland, M., Meijer, G.A., Pathology, Epidemiology and Data Science, Gastroenterology and hepatology, and CCA - Oncogenesis

Published
2010

63. Richtlijn 'Coeliakie en dermatitis herpetiformis'

Author

Nieuwenhuis, W.P., Kneepkens, C.M.F., Houwen, RH, de Beer, H.J., Mulder, C.J.J., Mearin, M.L., Pediatric surgery, Gastroenterology and hepatology, and CCA - Innovative therapy

Published
2010

66. Liver Histology of Ibd Patients Who Are Treated with 6-Thioguanine Due to Failure of Conventional Thiopurines Reveals Very Few Cases of Nodular Regenerative Hyperplasia

Author

van Asseldonk, D.P., Bloemena, E., de Boer, K.H.N., den Hartog, G., Engels, L.G.J.B., Jharap, B., Kolkman, J.J., Mulder, C.J.J., van Bodegraven, A.A., Westerveld, B.D., Zondervan, P.E., Gastroenterology and hepatology, Pathology, Oral and Maxillofacial Surgery / Oral Pathology, and CCA - Innovative therapy

Published
2010

74. Timing and impact of infections in acute pancreatitis

Author

Besselink, M.G., van Santvoort, H.C., Boermeester, M.A., Nieuwenhuijs, V.B., van Goor, H., Dejong, C.H., Cuesta valentin, M.A., Mulder, C.J.J., Schaapherder, A.F., Gooszen, H.G., Surgery, Gastroenterology and hepatology, Other Research, Other departments, AII - Amsterdam institute for Infection and Immunity, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Algemene Heelkunde, RS: NUTRIM - R2 - Gut-liver homeostasis, and Faculteit Medische Wetenschappen/UMCG

Subjects
Adult, Male, medicine.medical_specialty, Pancreatic disease, Age-related aspects of cancer [ONCOL 2], Time Factors, Bacteremia, NEEDLE-ASPIRATION HELPFUL, CONTROLLED-TRIAL, Gastroenterology, DOUBLE-BLIND, ACUTE NECROTIZING PANCREATITIS, Enteral Nutrition, Interquartile range, Internal medicine, medicine, Pneumonia, Bacterial, Humans, Molecular gastro-enterology and hepatology [IGMD 2], Gram-Positive Bacterial Infections, Cause of death, Aged, COMPLICATIONS, business.industry, Pancreatitis, Acute Necrotizing, MORTALITY, NECROSIS, Odds ratio, Middle Aged, medicine.disease, bacterial infections and mycoses, Prognosis, Surgery, Anti-Bacterial Agents, Pneumonia, Mycoses, Pancreatitis, Evaluation of complex medical interventions [NCEBP 2], Acute Disease, Acute pancreatitis, ANTIBIOTIC-TREATMENT, Female, business, ORGAN FAILURE, Gram-Negative Bacterial Infections
Abstract

Background Although infected necrosis is an established cause of death in acute pancreatitis, the impact of bacteraemia and pneumonia is less certain. Methods This was a cohort study of 731 patients with a primary episode of acute pancreatitis in 2004–2007, including 296 patients involved in a randomized controlled trial to investigate the value of probiotic treatment in severe pancreatitis. Time of onset of bacteraemia, pneumonia, infected pancreatic necrosis, persistent organ failure and death were recorded. Results The initial infection in 173 patients was diagnosed a median of 8 (interquartile range 3–20) days after admission (infected necrosis, median day 26; bacteraemia/pneumonia, median day 7). Eighty per cent of 61 patients who died had an infection. In 154 patients with pancreatic parenchymal necrosis, bacteraemia was associated with increased risk of infected necrosis (65 versus 37·9 per cent; P = 0·002). In 98 patients with infected necrosis, bacteraemia was associated with higher mortality (40 versus 16 per cent; P = 0·014). In multivariable analysis, persistent organ failure (odds ratio (OR) 18·0), bacteraemia (OR 3·4) and age (OR 1·1) were associated with death. Conclusion Infections occur early in acute pancreatitis, and have a significant impact on mortality, especially bacteraemia. Prophylactic strategies should focus on early intervention.

Published
2009
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77. Diagnose en behandeling van auto-immune hepatitis

Author

Verwer, B.J., Bouma, G., Bloemena, E., Schreuder, T.C.M.A., Mulder, C.J.J., van Nieuwkerk, C.M.J., Gastroenterology and hepatology, Pathology, Oral and Maxillofacial Surgery / Oral Pathology, and CCA - Innovative therapy

Published
2009

80. Diagnostic yield of colorectal neoplasia in daily clinical practice: consequences for future colorectal cancer screening?

Author

Terhaar sive Droste, J.S., Craanen, M.E., van der Hulst, R.W.M., Bartelsman, J.F., Bezemer, P.D., Cappendijk, K.R., Meijer, G.A., Morsink, L.M., Snel, P., Tuynman, H.A., van Wanrooy, R.L.J., Wesdorp, I.C.E., Mulder, C.J.J., Gastroenterology and hepatology, Epidemiology and Data Science, Pathology, EMGO - Quality of care, and CCA - Innovative therapy

Published
2009

85. Associations with tight junction genes PARD3 and MAGI2 in Dutch patients point to a common barrier defect for coeliac disease and ulcerative colitis

Author

Wapenaar, MC, Monsuur, A.J., van Bodegraven, A.A., Weersma, R.K., Bevova, M.R., Linskens, R.K., Howdle, P., Holmes, G., Mulder, C.J.J., Dijkstra, G., van Heel, D.A., Wijmenga, C., University of Groningen, Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Translational Immunology Groningen (TRIGR), Groningen Institute for Organ Transplantation (GIOT), Gastroenterology and hepatology, Human genetics, and CCA - Disease profiling

Subjects
EPITHELIAL BARRIER, GENETICS, ION-TRANSPORT, ALTERED EXPRESSION, MYOSIN IXB, PERMEABILITY, VARIANTS, DLG5, CROHNS-DISEASE, INFLAMMATORY-BOWEL-DISEASE
Abstract

Background: Coeliac disease (gluten-sensitive enteropathy; GSE) and inflammatory bowel disease (IBD) are common gastrointestinal disorders. Both display enhanced intestinal permeability, initiated by gluten exposure (GSE) or bacterial interactions (IBD). Previous studies showed the association of both diseases with variants in MYO9B, presumably involved in epithelial permeability. Aim: It was hypothesised that genetic variants in tight junction genes might affect epithelial barrier function, thus contributing to a shared pathogenesis of GSE and IBD. Methods: This hypothesis was tested with a comprehensive genetic association analysis of 41 genes from the tight junction pathway, represented by 197 tag single nucleotide polymorphism (SNP) markers. Results: Two genes, PARD3 (two SNPs) and MAGI2 (two SNPs), showed weak association with GSE in a Dutch cohort. Replication in a British GSE cohort yielded significance for one SNP in PARD3 and suggestive associations for two additional SNPs, one each in PARD3 and MAGI2. Joint analysis of the British and Dutch data further substantiated the association for both PARD3 (rs10763976, p= 6.4x10(-5); OR 1.23, 95% CI 1.11 to 1.37) and MAGI2 (rs6962966, p= 7.6x10(-4); OR 1.19, 95% CI 1.08 to 1.32). Association was also observed in Dutch ulcerative colitis patients with MAGI2 ( rs6962966, p= 0.0036; OR 1.26, 95% CI 1.08 to 1.47), and suggestive association with PARD3 (rs4379776, p= 0.068). Conclusions: These results suggest that coeliac disease and ulcerative colitis may share a common aetiology through tight junction-mediated barrier defects, although the observations need further replication.

Published
2008
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88. The toll-like receptor 4 (TLR4) Asp299Gly polymorphism is associated with colonic localisation of Crohn's disease without a major role for the Saccharomyces cerevisiae mannan-LBP-CD14-TLR4 pathway

Author

Ouburg, S., Mallant-Hent, R., Crusius, J.B.A., van Bodegraven, A.A., Mulder, C.J.J., Linskens, R., Pena, A.S., Morre, S.A., Medical Microbiology and Infection Prevention, AII - Infectious diseases, Gastroenterology and hepatology, Laboratory Medicine, CCA - Cancer biology and immunology, and VU University medical center

Published
2005

90. O131 GENOME-WIDE ASSOCIATION STUDY IN AUTOIMMUNE HEPATITIS IDENTIFIES RISK VARIANT IN THE SH2B3 REGION

Author

de Boer, Y.S., primary, van Gerven, N.M., additional, Verwer, B., additional, Zwiers, A., additional, van Hoek, B., additional, van Erpecum, K.J., additional, Beuers, U., additional, van Buuren, H.R., additional, Drenth, J.P.H., additional, den Ouden, J.W., additional, Verdonk, R.C., additional, Koek, G.H., additional, Brouwer, J.T., additional, Guichelaar, M.M.J., additional, Vrolijk, J.M., additional, Kraal, G., additional, Mulder, C.J.J., additional, van Nieuwkerk, C.M.J., additional, Fischer, J., additional, Berg, T., additional, Stickel, F., additional, Sarrazin, C., additional, Schramm, C., additional, Lohse, A.W., additional, Weiler-Normann, C., additional, Lerch, M.M., additional, Nauck, M., additional, Völzke, H., additional, Homuth, G., additional, Bloemena, E., additional, Kumar, V., additional, Zhernakova, A., additional, Wijmenga, C., additional, Franke, L., additional, and Bouma, G., additional

Published
2014
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91. Azathioprine and prednisone combination therapy in refractory coeliac disease

Author

Goerres, M.S., Meijer, J.W., Wahab, P.J., Kerckhaert, J.A., Groenen, P.J.T.A., Krieken, J.H.J.M. van, Mulder, C.J.J., and VU University medical center

Subjects
Tumor microenvironment [UMCN 1.3]
Abstract

Contains fulltext : 142751.pdf (Publisher’s version ) (Closed access) INTRODUCTION: Refractory coeliac disease (RCD) is a rare syndrome with a poor prognosis, defined by malabsorption due to gluten-related enteropathy after initial or subsequent failure of a strict gluten-free diet and after exclusion of any disorder mimicking coeliac disease. PATIENTS AND METHODS: Nineteen patients were included and treated. Based on intraepithelial T-lymphocyte(IEL) phenotyping, patients were recorded as having RCD type I with normal IELs, or RCD type II with phenotypically immature IELs defined by a lack of characteristic T-cell markers. Treatment consisted of azathioprine combined with prednisone for 1 year, which was tapered and, if possible, stopped. RESULTS: Clinical improvement was seen in nearly all patients in both groups. Eight of 10 RCD type I patients responded histologically, and complete normalization of villi was seen in four patients. In RCD type II, 6/8 patients developed enteropathy-associated T-cell lymphoma (EATL) and 7/8 patients died. CONCLUSIONS: For the first time we report a promising therapeutic treatment option for RCD type I. In RCD type II, azathioprine and prednisone therapy (APT) is not effective, therefore we suggest that other (chemo)therapeutic agents are considered. Not all RCD type II patients presented with a monoclonal TCRgamma-gene rearrangement and immunohistological changes as is currently reported in the literature. Therefore, immunophenotyping seems mandatory in the work-up of RCD.

Published
2003
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93. Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial)

Author

Brunschot, S. (Sandra) van, Grinsven, J. (Janneke) van, Voermans, R.P. (Rogier), Bakker, O.J. (Olaf ), Besselink, M.G. (Marc), Boermeester, M.A. (Marja), Bollen, T.L. (Thomas), Bosscha, K. (Koop), Bouwense, S.A.W. (Stefan), Bruno, M.J. (Marco), Cappendijk, V.C., Consten, E.C. (Esther), Dejong, C.H. (Cees), Dijkgraaf, M.G.W. (Marcel), Eijck, C.H.J. (Casper) van, Erkelens, D.W. (Dirk Willem), Goor, H. (Harry) van, Hadithi, M. (Muhammed), Haveman, J.-W. (Jan-Willem), Hofker, S.H. (Sijbrand), Jansen, J.J.M. (Jeroen), Laméris, J.S. (Johan ), Lienden, K.P. (Krijn) van, Manusama, E.R. (Eric), Meijssen, M.A.C. (Maarten), Mulder, C.J.J. (Chris), Nieuwenhuis, V.B. (Vincent), Poley, J.-W. (Jan-Werner), Ridder, R. (Rogier) de, Rosman, C. (Camiel), Schaapherder, A.F.M. (Alexander), Scheepers, J.J. (Joris), Schoon, E.J. (Erik), Seerden, T.C.J. (Tom), Spanier, B.W.M. (Marcel), Straathof, J.W.A., Timmer, R. (Robin), Venneman, N.G. (Niels), Vleggaar, F.P. (Frank), Witteman, B.J.M. (Ben), Gooszen, H.G. (Hein), Santvoort, H.C. (Hjalmar) van, Fockens, P. (Paul), Brunschot, S. (Sandra) van, Grinsven, J. (Janneke) van, Voermans, R.P. (Rogier), Bakker, O.J. (Olaf ), Besselink, M.G. (Marc), Boermeester, M.A. (Marja), Bollen, T.L. (Thomas), Bosscha, K. (Koop), Bouwense, S.A.W. (Stefan), Bruno, M.J. (Marco), Cappendijk, V.C., Consten, E.C. (Esther), Dejong, C.H. (Cees), Dijkgraaf, M.G.W. (Marcel), Eijck, C.H.J. (Casper) van, Erkelens, D.W. (Dirk Willem), Goor, H. (Harry) van, Hadithi, M. (Muhammed), Haveman, J.-W. (Jan-Willem), Hofker, S.H. (Sijbrand), Jansen, J.J.M. (Jeroen), Laméris, J.S. (Johan ), Lienden, K.P. (Krijn) van, Manusama, E.R. (Eric), Meijssen, M.A.C. (Maarten), Mulder, C.J.J. (Chris), Nieuwenhuis, V.B. (Vincent), Poley, J.-W. (Jan-Werner), Ridder, R. (Rogier) de, Rosman, C. (Camiel), Schaapherder, A.F.M. (Alexander), Scheepers, J.J. (Joris), Schoon, E.J. (Erik), Seerden, T.C.J. (Tom), Spanier, B.W.M. (Marcel), Straathof, J.W.A., Timmer, R. (Robin), Venneman, N.G. (Niels), Vleggaar, F.P. (Frank), Witteman, B.J.M. (Ben), Gooszen, H.G. (Hein), Santvoort, H.C. (Hjalmar) van, and Fockens, P. (Paul)

Abstract

_Background:_ Infected necrotising pancreatitis is a potentially lethal disease that nearly always requires intervention. Traditionally, primary open necrosectomy has been the treatment of choice. In recent years, the surgical step-up approach, consisting of percutaneous catheter drainage followed, if necessary, by (minimally invasive) surgical necrosectomy has become the standard of care. A promising minimally invasive alternative is the endoscopic transluminal step-up approach. This approach consists of endoscopic transluminal drainage followed, if necessary, by endoscopic transluminal necrosectomy. We hypothesise that the less invasive endoscopic step-up approach is superior to the surgical step-up approach in terms of clinical and economic outcomes. _Methods/Design:_ The TENSION trial is a randomised controlled, parallel-group superiority multicenter trial. Patients with (suspected) infected necrotising pancreatitis with an indication for intervention and in whom both treatment modalities are deemed possible, will be randomised to either an endoscopic transluminal or a surgical step-up approach. During a 4 year study period, 98 patients will be enrolled from 24 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite of death and major complications within 6 months following randomisation. Secondary endpoints include complications such as pancreaticocutaneous fistula, exocrine or endocrine pancreatic insufficiency, need for additional radiological, endoscopic or surgical intervention, the need for necrosectomy after drainage, the number of (re-)interventions, quality of life, and total direct and indirect costs. _Discussion:_ The TENSION trial will answer the question whether an endoscopic step-up approach reduces the combined primary endpoint of death and major complications, as well as hospital stay and related costs compared with a surgical step-up approach in patients with infected necrotising pancreatitis.

Published
2013
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94. Changes in Natural Foxp3+Treg but Not Mucosally-Imprinted CD62LnegCD38+Foxp3+Treg in the Circulation of Celiac Disease Patients

Author

Van Leeuwen, M.A. (Marieke), Pré, M.F. (Fleur) du, Wanrooij, R.L.J. (Roy) van, Ruiter, L.F. (Lilian) de, Raatgeep, R.H. (Rolien), Lindenbergh-Kortleve, D.J. (Dicky), Mulder, C.J.J. (Chris), Ridder, L. (Lissy) de, Escher, J.C. (Johanna), Samsom, J.N. (Janneke), Van Leeuwen, M.A. (Marieke), Pré, M.F. (Fleur) du, Wanrooij, R.L.J. (Roy) van, Ruiter, L.F. (Lilian) de, Raatgeep, R.H. (Rolien), Lindenbergh-Kortleve, D.J. (Dicky), Mulder, C.J.J. (Chris), Ridder, L. (Lissy) de, Escher, J.C. (Johanna), and Samsom, J.N. (Janneke)

Abstract

Background:Celiac disease (CD) is an intestinal inflammation driven by gluten-reactive CD4+ T cells. Due to lack of selective markers it has not been determined whether defects in inducible regulatory T cell (Treg) differentiation are associated with CD. This is of importance as changes in numbers of induced Treg could be indicative of defects in mucosal tolerance development in CD. Recently, we have shown that, after encounter of retinoic acid during differentiation, circulating gut-imprinted T cells express CD62LnegCD38+. Using this new phenotype, we now determined whether alterations occur in the frequency of natural CD62L+Foxp3+ Treg or mucosally-imprinted CD62LnegCD38+Foxp3+ Treg in peripheral blood of CD patients. In particular, we compared pediatric CD, aiming to select for disease at onset, with adult CD.Methods:Cell surface markers, intracellular Foxp3 and Helios were determined by flow cytometry. Foxp3 expression was also detected by immunohistochemistry in duodenal tissue of CD patients.Results:In children, the percentages of peripheral blood CD4+Foxp3+ Treg were comparable between CD patients and healthy age-matched controls. Differentiation between natural and mucosally-imprinted Treg on the basis of CD62L and CD38 did not uncover differences in Foxp3. In adult patients on gluten-free diet and in refractory CD increased percentages of circulating natural CD62L+Foxp3+ Treg, but normal mucosally-imprinted CD62LnegCD38+Foxp3+ Treg frequencies were observed.Conclusions:Our data exclude that significant numeric deficiency of mucosally-imprinted or natural Foxp3+ Treg explains exuberant effector responses in CD. Changes in natural Foxp3+ Treg occur in a subset of adult patients on a gluten-free diet and in refractory CD patients.

Published
2013
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96. Recurrent acute biliary pancreatitis: The protective role of cholecystectomy and endoscopic sphincterotomy

Author

Geenen, E-J.M. (Erwin-Jan), Peet, D.L. (Donald) van der, Mulder, C.J.J. (Chris), Cuesta, M.A. (Miguel), Bruno, M.J. (Marco), Geenen, E-J.M. (Erwin-Jan), Peet, D.L. (Donald) van der, Mulder, C.J.J. (Chris), Cuesta, M.A. (Miguel), and Bruno, M.J. (Marco)

Abstract

Background: Recurrent attacks of acute biliary pancreatitis (RABP) are prevented by (laparoscopic) cholecystectomy. Since the introduction of endoscopic retrograde cholangiopancreaticography (ERCP), several series have described a similar reduction of RABP after endoscopic sphincterotomy (ES). This report discusses the different treatment options for preventing RABP including conservative treatment, cholecystectomy, ES, and combinations of these options as well as their respective timing. Methods: A search in PubMed for observational studies and clinical (comparative) trials published in the English language was performed on the subject of recurrent acute biliary pancreatitis and other gallst

Published
2009
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97. Polymorphic expression of biotransformation enzymes in patients with Barrett's esophagus and esophageal cancer

Author

Lieshout, E.M.M. van, Roelofs, H.M.J., Dekker, S.K., Mulder, C.J.J., Wobbes, T., Jansen, J.B.M.J., and Peters, W.H.M.

Subjects
Surgical Oncology, mogelijke oorzaken en gevolgen (sepsis en ontsteking) [Sepsis en niet-bacteriële gegeneraliseerde ontsteking], Chirurgische Oncologie, causes and effects (sepsis and inflammation) [Sepsis and non-bacterial generalized inflammation]
Abstract

Item does not contain fulltext

Published
1999

100. Diet, lifestyle and risk of K-ras mutation-positive and -negative colorectal adenomas.

Author

Wark, P.A., Kuil, W. van der, Ploemacher, J., Muijen, G.N.P. van, Mulder, C.J.J., Weijenberg, M.P., Kok, F.J., Kampman, E., Wark, P.A., Kuil, W. van der, Ploemacher, J., Muijen, G.N.P. van, Mulder, C.J.J., Weijenberg, M.P., Kok, F.J., and Kampman, E.

Abstract

Contains fulltext : 50657.pdf (publisher's version ) (Closed access), K-ras mutation-positive (K-ras+) and -negative (K-ras-) colorectal adenomas may differ clinically and pathologically. As environmental compounds may cause mutations in the growth-related K-ras oncogene or affect clonal selection depending on mutational status, we evaluated whether the aetiology of K-ras+ and K-ras- adenomas differs. K-ras mutations in codons 12 and 13 were assessed in colorectal adenoma tissue (K-ras+: n = 81, K-ras-: n = 453). Dietary and lifestyle data were collected through questionnaires that were also administered to 709 polyp-free controls. Multiple logistic regression analyses showed that intake of vitamin B2 and monounsaturated fat were differently associated with risk of K-ras+ and K-ras- adenomas; vitamin B2 was inversely associated with K-ras- (highest vs. lowest tertile: odds ratio (OR) = 0.70, 95% confidence interval (CI) = 0.50-0.97, p trend = 0.020), but not with K-ras+ adenomas, and a positive association with monounsaturated fat was confined to K-ras- adenomas (OR = 1.57, 95% CI = 1.06-2.34, p trend = 0.029). Besides, potential, not statistically significant, differences in risk arose because red meat was distinctly positively associated with K-ras+ adenomas (OR = 1.70, 95% CI = 0.94-3.09, p trend = 0.061); total dietary and polyunsaturated fat tended to be inversely associated with risk of K-ras+ but not of K-ras- adenomas; inverse associations with dairy products, calcium, protein and tea were confined to K-ras- adenomas, and smoking was more markedly positively associated with K-ras- adenomas. No differences in risk of K-ras+ and K-ras- adenomas could be detected for other factors. In conclusion, dietary and lifestyle factors may influence risk of K-ras+ and K-ras- adenomas differently. However, epidemiological literature on diet, lifestyle and colorectal K-ras mutations is inconsistent.

Published
2006

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