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Klippenstein V, Ciesek S, Riemann JF. COVID-19 – eine Multiorganerkrankung stellt das Gesundheitssystem auf die Probe. Gastroenterologe 2020; 15:441-442. [PMID: 33250937 PMCID: PMC7686456 DOI: 10.1007/s11377-020-00487-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - S. Ciesek
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt, Paul-Ehrlich-Str. 40, 60590 Frankfurt, Deutschland
| | - J. F. Riemann
- Klinik für Gastroenterologie, Infektiologie, Diabetologie und Gastrointestinale Onkologie (Medizinische Klinik C), Klinikum Ludwigshafen, Ludwigshafen, Deutschland
- Stiftung LebensBlicke, Schuckertstr. 37, 67063 Ludwigshafen, Deutschland
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Riemann JF, Albert J, Altenhofen L, Aschenbeck J, Dahlhoff G, Dignaß A, Hohn H, Hüppe D, Jung M, Khoury M, Munte A, Neuhaus H, Philipper M, Rösch T, Zillinger C, Belle S. [Not Available]. Z Gastroenterol 2016; 54:259. [PMID: 27500297 DOI: 10.1055/s-0042-103070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Janisch HD, Koppold B, Deissler H, Riemann JF. Observational multicentric study to evaluate efficacy, adverse effects and acceptance of bowel cleansing prior to colonoscopy with sodium picosulfate / magnesium citrate formulation CitraFleet®. Z Gastroenterol 2016; 54:19-25. [PMID: 26751113 DOI: 10.1055/s-0041-104227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The various efficient methods available for bowel preparation prior to colonoscopy differ in patient acceptance. Combining the laxative sodium picosulfate with hyperosmotic magnesium citrate, used in this study in the formulation CitraFleet(®), allows the uptake of the purgative substances as a solution of low volume. This observational study with 737 patients evaluated efficacy of bowel preparation, potential side or adverse effects and patient acceptance of this medicinal product when used by resident physicians in Germany.Colon cleansing with CitraFleet(®) was considered very good to sufficient in 95.2 % of the patients and inadequate in only 4.8 %. In 75 % of the colonoscopies, bowel preparation was rated very good or good. Compared to the standard regimen of two portions taken the day before endoscopy, cleaning efficacy was better when patients received one of the doses on the morning of the day of colonoscopy. The quality of bowel preparation was rated lower by gastroenterologists without any prior experience with sodium picosulfate/magnesium citrate. The overall assessment of the colon cleansing procedure by the 76 participating physicians was very positive and patient acceptance was also very high which can be considered a clear advantage over alternative methods. Efficacy of colon cleansing with CitraFleet(®) was not substantially affected by typical deviations from the recommended standard procedure, emphasizing the robustness of the method. Only one of the patients reported a mild adverse effect potentially caused by the cleansing agents.
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Affiliation(s)
| | - B Koppold
- Medizinisches Informationsmanagement Gastroenterologie, Königsbrunn, Germany
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Hoffmeister A, Mayerle J, Beglinger C, Büchler MW, Bufler P, Dathe K, Fölsch UR, Friess H, Izbicki J, Kahl S, Klar E, Keller J, Knoefel WT, Layer P, Loehr M, Meier R, Riemann JF, Rünzi M, Schmid RM, Schreyer A, Tribl B, Werner J, Witt H, Mössner J, Lerch MM. English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis. Z Gastroenterol 2015; 53:1447-95. [PMID: 26666283 DOI: 10.1055/s-0041-107379] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Chronic pancreatitis is a disease of the pancreas in which recurrent inflammatory episodes result in replacement of pancreatic parenchyma by fibrous connective tissue. This fibrotic reorganization of the pancreas leads to a progressive exocrine and endocrine pancreatic insufficiency. In addition, characteristic complications arise, such as pseudocysts, pancreatic duct obstructions, duodenal obstruction, vascular complications, obstruction of the bile ducts, malnutrition and pain syndrome. Pain presents as the main symptom of patients with chronic pancreatitis. Chronic pancreatitis is a risk factor for pancreatic carcinoma. Chronic pancreatitis significantly reduces the quality of life and the life expectancy of affected patients. These guidelines were researched and compiled by 74 representatives from 11 learned societies and their intention is to serve evidence-based professional training as well as continuing education. On this basis they shall improve the medical care of affected patients in both the inpatient and outpatient sector. Chronic pancreatitis requires an adequate diagnostic workup and systematic management, given its severity, frequency, chronicity, and negative impact on the quality of life and life expectancy.
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Affiliation(s)
| | | | - C Beglinger
- Department of Gastroenterology and Hepatology, University Hospital Basel, Switzerland
| | - M W Büchler
- Department of General, Visceral and Transplantation Surgery, University Hospital, Heidelberg, Ruprecht Karls University, Heidelberg
| | - P Bufler
- Dr. von Haunersches Children's Hospital, Ludwig Maximilian University, Munich
| | - K Dathe
- German Society of Digestive and Metabolic Diseases (DGVS), Berlin
| | - U R Fölsch
- Department of General Internal Medicine, Christian Albrechts University, Kiel
| | - H Friess
- Surgical Clinic and Polyclinic at the Rechts der Isar Hospital, Technical University, Munich
| | - J Izbicki
- Department of General, Visceral and Thoracic Surgery at the University Medical Centre Hamburg-Eppendorf
| | - S Kahl
- Department of Internal Medicine, Specialisation Gastroenterology, Haematology and Oncology, Nephrology German Red Cross (DRK) Hospital Berlin-Köpenick
| | - E Klar
- General Surgery, Thoracic, Vascular and Transplantation Surgery, University of Rostock
| | - J Keller
- Department of Medicine, Israelitic Hospital Hamburg
| | - W T Knoefel
- Department of General, Visceral and Paediatric Surgery, University Hospital Dusseldorf of the Heinrich Heine University
| | - P Layer
- Department of Medicine, Israelitic Hospital Hamburg
| | - M Loehr
- Surgical Gastroenterology, Gastrocentrum, Karolinska University Hospital Huddinge
| | - R Meier
- Department for Gastroenterology, Kanton Hospital Liestal, Medical University Clinic
| | - J F Riemann
- Department of Medicine C at the Hospital of the City Ludwigshafen/Rhine gGmbH
| | - M Rünzi
- Division of Gastroenterology and Metabolic Disease, Clinics of South Essen
| | - R M Schmid
- Department of Medicine 2 at the Rechts der Isar Hospital, Technical University Munich
| | - A Schreyer
- Institute for Radiodiagnostics at the University Hospital of Regensburg
| | - B Tribl
- Internal Medicine IV, Dept. for Gastroenterology and Hepatology, University Hospital Vienna
| | - J Werner
- Department of General, Visceral and Transplantation Surgery, University Hospital, Heidelberg, Ruprecht Karls University, Heidelberg
| | - H Witt
- Department of Paediatric Medicine, Children's Hospital Munich Schwabing, Technical University of Munich
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Riemann JF. [Diverticular disease: an everyday problem in a new light]. Dtsch Med Wochenschr 2015; 140:1346. [PMID: 26360945 DOI: 10.1055/s-0041-105749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- J F Riemann
- Vorstandsvorsitzender der Stiftung Lebensblicke
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Frieling T, Bergdoldt G, Allescher HD, Riemann JF. [Chest pain - not always the heart! Clinical impact of gastrointestinal diseases in non-cardiac chest pain]. Z Gastroenterol 2015; 53:120-4. [PMID: 25668714 DOI: 10.1055/s-0034-1385770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Non cardiac chest pain (NCCP) are recurrent angina pectoris like pain without evidence of coronary heart disease in conventional diagnostic evaluation. The prevalence of NCCP is up to 70 % and may be detected in this order at all levels of the medical health care system (general practitioner, emergency department, chest pain unit, coronary care). Reduction of quality of life in NCCP is comparable, partially even higher compared to cardiac chest pain. Reasons for psychological strain are symptom recurrence in app. 50 %, nonspecific diagnosis with resulting uncertainty and insufficient integration of other medical disciplines in diagnostic work-up. Managing of patients with NCCP has to be interdisciplinary because non cardiac causes of chest pain may be found frequently. Especially gastroenterological expertise is required because in 50 - 60 % of cases gastroesophageal reflux disease (GERD), in 15 - 18 % hypercontractile esophageal motility disorders with nutcracker, jackhammer esophagus or distal esophageal spasmus or achalasia and in 32 - 35 % other esophageal alterations (e. g. infectious esophageal inflammation, drug-induced ulcer, rings, webs, eosinophilic esophagitis) as cause of chest pain may be detected. This implicates that regular interdisciplinary round wards and management of chest pain units are mandatory.
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Affiliation(s)
- T Frieling
- Medizinische Klinik II, HELIOS Klinikum Krefeld
| | - G Bergdoldt
- Medizinische Klinik I, HELIOS Klinikum Krefeld
| | - H D Allescher
- Klinik für Gastroenterologie, Hepatologie, Stoffwechsel & Nephrologie, Klinikum Garmisch-Partenkirchen GmbH, Garmisch-Partenkirchen
| | - J F Riemann
- Gastro-Liga e. V., Deutsche Gesellschaft zur Bekämpfung der Krankheiten von Magen, Darm und Leber sowie von Störungen des Stoffwechsels und der Ernährung (Gastro-Liga) e. V., Gießen
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Galle P, Riemann JF. [Visceral medicine: a partnership for the patient's benefit]. Dtsch Med Wochenschr 2014; 139:1757. [PMID: 25157861 DOI: 10.1055/s-0034-1387278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- P Galle
- I. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz
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Schreyer AG, Jung M, Riemann JF, Niessen C, Pregler B, Grenacher L, Hoffmeister A. S3 guideline for chronic pancreatitis - diagnosis, classification and therapy for the radiologist. ROFO-FORTSCHR RONTG 2014; 186:1002-8. [PMID: 25122174 DOI: 10.1055/s-0034-1385005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
UNLABELLED Chronic pancreatitis shows an increasing prevalence and incidence mainly in the Western Hemisphere. Early diagnosis and therapy are frequently delayed because of non-specific symptoms as well as non-specific blood values. The German Society of Digestive and Metabolic Diseases (DGVS) organized the preparation and publication of an interdisciplinary S3 level guideline with the support of the German Radiological Society (DRG) as 1 of 11 contributing societies. In this article we present and discuss the main topics of the guideline regarding the diagnosis, differential diagnosis and therapy of complications of this complex chronic disease with a focus on clinical and scientific radiologists. KEY POINTS • Ultarsound represents the perfect first line imaging modality • For further diagnostic werk up MRI with MRCP are recommended for the differential diagnosis of pancreatic cancer • For clinical studies the modified (CT, MRI) Cambridge classification is recommended.
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Affiliation(s)
- A G Schreyer
- Department of Radiology, University Hospital Regensburg
| | - M Jung
- Department of Interna! Medicine and Gastroenterology, Catholic Hospital Mainz
| | | | - C Niessen
- Department of Radiology, University Hospital Regensburg
| | - B Pregler
- Department of Radiology, University Hospital Regensburg
| | - L Grenacher
- Diagnostic and lnterventional Radiology, University Hospital Heidelberg
| | - A Hoffmeister
- Medical Clinic and Polyclinic II for Gastroenterology, University Hospital Leipzig
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Riemann JF. [Target audience-specific education of the general public - a must for bowel cancer screening]. Dtsch Med Wochenschr 2014; 139:1287. [PMID: 24833325 DOI: 10.1055/s-0034-1370091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Riemann JF. The right colon--a real challenge for the endoscopist. Digestion 2014; 87:139-40. [PMID: 23548625 DOI: 10.1159/000346848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Webendörfer S, Riemann JF. [Early detection of bowel cancer in occupational surveillance examinations: switching from a guaiak-based to an immunochemical fecal occult blood test]. Dtsch Med Wochenschr 2013; 139:79-83. [PMID: 24089288 DOI: 10.1055/s-0033-1349588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND If the diagnosis is made early the cure rate of bowel cancer is more than 90 %. Occupational preventative medical care required by law and carried out by company physicians can be supplemented by a medical consultation and by simple screenings to interest employees in cancer prevention and refer them to registered general practitioners and specialist doctors for further diagnosis and treatment. SUBJECTS AND METHODS Since 2001, BASF SE in Ludwigshafen, Germany offers its employees aged 45 and more a program to detect intestinal cancer early. The employees receive personal invitations for this program once a year. The participants answer a standard questionnaire about risk factors for bowel cancer and an endoscopic diagnosis, if this has already been carried out, and receive a FOBT. Since 2010 an immunological test system was used. We compare the results from two consecutive years with a Guajacum test system (g-FOBT) and an immunological test (i-FOBT). The German Association of Digestive and Metabolic Diseases, DGVS, recommends a colonoscopy if test results are positive or a family member has suffered from bowel cancer. RESULTS Between 2008 and 2011, a total of 52,797 invitations were sent to employees aged 45 and over. Overall, 16,730 men (37.7 % of 46,245) and 1,585 women (24.4 % of 6,552) took part (in some cases more than once). The return rate of the FOBT increased from 66.7 % in 2008 to 79.5 % in 2011. Due to positive results and/or suspicious information in the questionnaire, 2,441 colonoscopies were recommended, 849 of them because of a positive FOBT. The medical department was informed of 224 endoscopy diagnoses. In 8 cases, manifested cancer (6 × colon, 2 × rectum) and in 57 cases adenomatous polyps were diagnosed as preliminary stages of cancer. Most of these diagnoses were made using the i-FOBT, the simultaneous increase in positive test results and therefore more frequent recommendations for a colonoscopy. CONCLUSION The additional offer of a program for early detection of bowel cancer as part of an occupational surveillance examination helps detecting bowel cancer early in employees who show no symptoms. Since men on average fall ill earlier, it makes sense to offer these tests at the age of 45. Personal invitations lead to consistently high participant rates and the simplicity of the i-FOBT leads to high return rates of tests. The rate of positive test results is higher compared to g-FOBT. In our follow-up, significantly more intestinal cancer and possible preliminary stages were detected through screening with the immunological test.
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Affiliation(s)
- S Webendörfer
- Occupational Medicine & Health Protection, BASF SE, Ludwigshafen
| | - J F Riemann
- Stiftung LebensBlicke - Früherkennung Darmkrebs, Ludwigshafen
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Gerken G, Riemann JF. [Visceral medicine: co-operation instead of competition - unity is strength!]. Dtsch Med Wochenschr 2013; 138:1757-8. [PMID: 24002873 DOI: 10.1055/s-0033-1349482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- G Gerken
- Klinik für Gastroenterologie und Hepatologie, Medizinisches Zentrum, Universitätsklinikum Essen.
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Pox C, Aretz S, Bischoff SC, Graeven U, Hass M, Heußner P, Hohenberger W, Holstege A, Hübner J, Kolligs F, Kreis M, Lux P, Ockenga J, Porschen R, Post S, Rahner N, Reinacher-Schick A, Riemann JF, Sauer R, Sieg A, Scheppach W, Schmitt W, Schmoll HJ, Schulmann K, Tannapfel A, Schmiegel W. [S3-guideline colorectal cancer version 1.0]. Z Gastroenterol 2013; 51:753-854. [PMID: 23955142 DOI: 10.1055/s-0033-1350264] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- C Pox
- Medizinische Klinik, Knappschaftskrankenhaus GmbH Bochum, Ruhr-Universität Bochum, Bochum
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Riemann JF. [The Gastro-League congratulates the milestone birthday!]. Z Gastroenterol 2013; 51:347. [PMID: 23585262 DOI: 10.1055/s-0033-1335227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Rembacken B, Hassan C, Riemann JF, Chilton A, Rutter M, Dumonceau JM, Omar M, Ponchon T. Quality in screening colonoscopy: position statement of the European Society of Gastrointestinal Endoscopy (ESGE). Endoscopy 2012; 44:957-68. [PMID: 22987217 DOI: 10.1055/s-0032-1325686] [Citation(s) in RCA: 220] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- B Rembacken
- Centre for Digestive Diseases, Department of Gastroenterology, The General Infirmary at Leeds, Leeds, United Kingdom.
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Herzog J, Eickhoff A, Riemann JF. [New tests for the prevention of colorectal cancer]. Dtsch Med Wochenschr 2012; 137:1814-7. [PMID: 22956226 DOI: 10.1055/s-0032-1305240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J Herzog
- Medizinische Klinik II, Klinikum Hanau
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Hartmann D, Keuchel M, Philipper M, Gralnek IM, Jakobs R, Hagenmüller F, Neuhaus H, Riemann JF. A pilot study evaluating a new low-volume colon cleansing procedure for capsule colonoscopy. Endoscopy 2012; 44:482-6. [PMID: 22275051 DOI: 10.1055/s-0031-1291611] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS Colon capsule endoscopy (CCE) offers an alternative approach for endoscopic visualization of the colon. Some of the current CCE bowel cleansing regimens use sodium phosphate, which has raised safety concerns. Therefore, the aim of the current study was to test the feasibility and efficacy of a new low-volume, sodium phosphate-free polyethylene glycol (PEG) bowel preparation. METHODS The first 26 patients (original cleansing procedure) received a colon cleansing regimen of PEG plus ascorbic acid: patients drank 1 L in the evening and 0.75 L in the morning before capsule ingestion. Patients also drank an additional 0.5 L PEG boost and an optional 0.25 L PEG boost during the capsule procedure. Following an interim analysis, the cleansing procedure of the subsequent 24 patients was modified, with the morning intake before capsule ingestion being increased to 1 L, as well as the second boost (0.25 L) being administered 1 - 2 hours earlier (modified cleansing procedure). RESULTS The overall colon cleanliness was considered to be good or excellent in 83 % (original cleansing procedure) and 82 % (modified cleansing procedure) of patients, without any significant difference between regimens (P > 0.05). In 37 /49 (76 %) of the CCE procedures, the hemorrhoidal plexus was identified and thus the examination was considered complete, with no significant differences between the two CCE cleansing procedures. The capsule sensitivity and specificity for detecting colonic polyps ≥ 6 mm were 91 % (95 %CI 70 % - 98 %) and 94 % (95 %CI 87 % - 97 %), respectively, compared with standard optical colonoscopy. CONCLUSION A colon cleansing procedure using PEG + ascorbic acid for capsule colonoscopy yielded an adequate cleansing level in > 80 % of patients, a completion rate of 76 %, and good accuracy for detecting polyps. This procedure may be considered as an alternative, particularly for patients in whom sodium phosphate-based preparations are contraindicated.
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Affiliation(s)
- D Hartmann
- Department of Internal Medicine I, Sana Klinikum Lichtenberg, Berlin, Germany.
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Abstract
Europe has made significant progress in recent years by introducing population-based screening programs for colorectal cancer. Due to excellent evidence-based results on the basis of large prospective randomized trials, mass screening using the fecal occult blood test is currently the procedure of choice. Endoscopy-based programs do afford quality insurance programs which are outlined in the recommendations of the European Commission.
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Affiliation(s)
- J F Riemann
- LebensBlicke Foundation for Prevention of Colorectal Cancer, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany.
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Teichmann J, Riemann JF, Lange U. Prevalence of exocrine pancreatic insufficiency in women with obesity syndrome: assessment by pancreatic fecal elastase 1. ISRN Gastroenterol 2011; 2011:951686. [PMID: 22111014 PMCID: PMC3216381 DOI: 10.5402/2011/951686] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Accepted: 09/13/2011] [Indexed: 12/12/2022]
Abstract
Background. Previous research on the combined association of 25-hydroxyvitamin D [25(OH)D] and exocrine pancreas insufficiency may have been limited by restricted age variability and a lack of representation of both body weight and body mass index. There are still too few conclusive reports about conspicuous vitamin D metabolism according to pancreatic fecal elastase 1 (FE1) in obese patients. Methods. Between May 2004 and July 2008, we investigated in 125 female patients with obesity syndrome at an average age of approximately 52.9 years as well as in age-matched 80 healthy female controls the prevalence of pancreas insufficiency. Serum levels of PTH, total calcium, and D3 vitamins calcitriol and calcifediol, as well as the concentration of fecal elastase 1 (FE1) were determined in patients and controls. Results. In 75 female nondiabetic patients with obesity syndrome (BMI 35 ≤ 40 kg/m2), calcifediol was markedly decreased (25.0 ± 4.9 ng/mL) compared to controls (50.2 ± 14.7 nmol/L; P < 0.01). FE1 level was significantly decreased in obese subjects compared to controls ( P < 0.01). Calcifediol was significantly lower in patients with morbid obesity (for calcifediol, P < 0.05). Conclusion. In obese females, pancreatic FE1 in feces confirms the extent of vitamin D supply, and thus shows a vitamin D3 deficiency, depending on the loss of stool content. There seems to be a connection between the loss of exocrine function and the increasing body mass index. Pancreas insufficiency, as detected by low FE1 concentrations, is frequent in obese patients. However, the BMI is an additional factor for lowered fecal excretion of FE1.
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Affiliation(s)
- J Teichmann
- Department of Gastroenterology, Endocrinology, and Diabetology, Klinikum Lüdenscheid, 58515 Lüdenscheid, Germany
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Riemann JF, Maar C, Betzler M, Brenner H, Sauerbruch T. [Early detection of colonic cancer in the National Cancer Program--present status and recommendations]. Z Gastroenterol 2011; 49:1428-31. [PMID: 21964898 DOI: 10.1055/s-0031-1281757] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The National Cancer Programme of the German Federal Administration aims to assess the present status of the national fight against cancer in Germany. Experts in their field have analysed the present target-performance comparison in different working groups dealing with topics from cancer prevention to follow-up and have developed recommendations as to how improvements in the various fields of cancer care may be achieved and mainly how these imrpovements may be implemented in day-to-day cancer care. The working group "Advancement of Colon Cancer Screening, Early Detection and Prevention" proposes the establishment of regulatory proposals for a nationwide, population-based, postal invitational process and, according to Pilot-Projects in Bavaria and Baden-Wuerttemberg, to evaluate the essential recommendations in data protection, logistics, documentation and financing. There are already several programmes in preparation--for example, the Saarland Offensive, based on the results of the KolosSal-Study.
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Affiliation(s)
- J F Riemann
- Stiftung LebensBlicke, Klinikum Ludwigshafen.
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Eickhoff A, Herzog J, Riemann JF. [Colon cancer screening--adopt the chance of early detection!]. MMW Fortschr Med 2011; 153:80-84. [PMID: 21688501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Eickhoff A, Riemann JF. [Diverticulitis--conservative therapy]. Zentralbl Chir 2011; 138 Suppl 2:e63-9. [PMID: 21544755 DOI: 10.1055/s-0031-1271381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Diverticulitis due to diverticulosis of the colon is a common clinical problem with a high morbidity and socio-economic consequences. Frequent clinical signs are flatulence, abdominal pain, stool problems which may often be misinterpreted as the symptoms of an irritable bowel or a colitis. Accordingly, the diagnostic work-up must be adequate to allow for the stage-adapted planning and performance of the therapy. MATERIAL AND METHODS The following questions will be addressed in this review: What do we need to clarify diagnosis? Which antibiotics should be used? What is the best conservative approach for treatment? RESULTS AND CONCLUSIONS Basic conservative therapy consists of systemic antibiosis which can be extended by a topical antibiosis, and administration of aspirin as well as probiotics. The indications for a specific therapy is made on an individual basis according to stage (Hansen and Stock). Above all, a "team approach" and close communication between gastroenterologists and surgeons are mandatory for adequate treatment of these patients.
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Affiliation(s)
- A Eickhoff
- Klinikum Hanau, Medizinische Klinik II, Hanau, Deutschland
| | - J F Riemann
- Stiftung LebensBlicke, Früherkennung Darmkrebs, Ludwigshafen, Deutschland
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Schmidt-Tänzer W, Eickhoff A, Riemann JF. [Oesophago-gastro-duodenoscopy]. Dtsch Med Wochenschr 2011; 136:437-40. [PMID: 21344359 DOI: 10.1055/s-0031-1274526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- W Schmidt-Tänzer
- Medizinische Klinik II, Klinikum Hanau GmbH, Leimenstraße 20, 63450 Hanau.
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Eickhoff A, Vetter S, von Renteln D, Caca K, Kähler G, Eickhoff JC, Jakobs R, Riemann JF. Effectivity of current sterility methods for transgastric NOTES procedures: results of a randomized porcine study. Endoscopy 2010; 42:748-52. [PMID: 20669093 DOI: 10.1055/s-0030-1255597] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM Natural-orifice transluminal endoscopic surgery (NOTES) is an emerging transluminal technique in which interventions are carried out by entering the abdominal cavity via a natural orifice such as the stomach. Infection is a potential risk of the procedure, and the potential pathogens are different from those encountered with skin incisions. Currently, available data regarding prophylactic anti-infective treatment are limited. We compared the effectiveness of topical antimicrobial lavage of mouth and stomach and proton pump inhibitor therapy with gastric cleansing with sterile saline solution in preventing NOTES-related contamination and infection. METHODS A randomized survival swine study was performed. Eight pigs underwent preparation with intravenously administered proton pump inhibitors, mouth and gastric lavage (chlorhexidine), and gastric irrigation (diluted neomycin), plus single-shot intravenous antibiotics. Control group (n = 8) underwent gastric cleansing with sterile saline solution. Peritoneal biopsy, multiple smears, and dilutions for cultures were taken and incubated. The swine were sacrificed after 14 days. Bacterial load was expressed in colony-forming units (CFU). RESULTS One pig died due to gallbladder perforation after 3 days, 2/15 swine presented minor clinical signs of infection in the 14-day follow-up (all 3 pigs were in the control group). Mean C-reactive protein levels were 5.7 +/- 2.4 g/dL (therapy group) and 12.2 +/- 3.8 g/dL (control) ( P = 0.17). Bacterial growth was seen in 1/8 swine (therapy group) and 6/8 swine (control group) ( P = 0.002). Bacterial load was 282 CFU/mL (therapy) vs. 3.2 x 10 (5) CFU/mL (control) ( P = 0.023) in the follow-up. CONCLUSION The use of intravenous antibiotics in addition to topical antimicrobial lavage of mouth and stomach and treatment with proton pump inhibitors decreased the peritoneal bacterial load to almost zero and this was associated with a significantly lower peritoneal infection rate compared with saline-only lavage.
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Affiliation(s)
- A Eickhoff
- Medical Department C, Klinikum Ludwigshafen gGmbH, Ludwigshafen, Germany.
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25
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Hochdörffer R, Eickhoff A, Apel D, Eickhoff JC, Hartmann D, Jakobs R, Riemann JF. Endoscopic resection of "giant" colorectal lesions: long-term outcome and safety. Z Gastroenterol 2010; 48:741-7. [PMID: 20607630 DOI: 10.1055/s-0028-1109971] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Today, endoscopic resection is a standard procedure for the resection of colonic polyps. Before the establishment of endoscopic techniques, the surgical approach was a clearly preferred method for removal of polyps with a size larger than three centimeters. The safety and effectiveness concerning endoscopic resections of colorectal polyps also with a size of more than 3 cm have been demonstrated in numerous studies. PATIENTS AND METHODS Data from 165 patients (age: 68 +/- 10.4 years) harboring 167 polyps with a minimum diameter of 3 cm were retrospectively evaluated. Objects of interest were macroscopic morphology and histopathology of the polyps, their localization in the colon, the modality of endoscopic resection and follow-up. In those cases with macroscopic signs of malignancy the patients were excluded. RESULTS Successful endoscopic resections were obtained in 72.5 %. Therefrom, resection in the piecemeal-technique was necessary in 73.6 %. Recurrence polyps after endoscopic complete resections occurred in 26.3 % after a mean follow-up of 16 +/- 12.5 months. We registered a complication rate of 19.2 %. Relevant bleeding and perforation were registered as early complications in 18.6 %. We observed no intervention-related mortality. CONCLUSION Endoscopic mucosal resection is a safe and efficient method even for removing giant colorectal polyps. Controls are recommended at defined intervals for detecting polyp recurrence.
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Affiliation(s)
- R Hochdörffer
- Medical Department C, Klinikum Ludwigshafen Ludwigshafen, Germany.
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Mössner J, Riemann JF. [Small intestine--new approaches in diagnostics and therapy]. Internist (Berl) 2010; 51:693-4. [PMID: 20449559 DOI: 10.1007/s00108-010-2637-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rosenbaum A, Riemann JF, Schilling D. [Percutaneous endoscopic gastrostomy]. Dtsch Med Wochenschr 2010; 135:977-9. [PMID: 20446234 DOI: 10.1055/s-0030-1253687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Anika Rosenbaum
- Medizinische Klinik II, Diakoniekrankenhaus, Mannheim GmbH, Mannheim.
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Eickhoff A, Riemann JF. [Screening for colorectal malignancies]. MMW Fortschr Med 2010; 152:27-30. [PMID: 20201214 DOI: 10.1007/bf03365970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Wuppermann D, Wuppermann U, Riemann JF. [Actual state of knowledge of the german population about the early detection of colorectal cancer--a study by the "Stiftung LebensBlicke" in cooperation with the institute for demoscopy in Allensbach]. Z Gastroenterol 2009; 47:1132-6. [PMID: 19899020 DOI: 10.1055/s-0028-1109526] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Colorectal cancer is the most common cancer in Germany. The LebensBlicke foundation and it's supporting alliance have or many years, like others, been pushing information campaigns abour early detection measures and their chances for the general population. With the aid of the institute for public opinion research in Allensbach a representative cross-sectional investigation about the state of knowledge, opinions and attitudes concerning this topic was carried out. Surprisingly, it was demonstrated that an information deficit no longer exists and that especially people of older age are concerned about this topic. It is also remarkable that more than 40 % of the individuals over 50 years of age have had a colonoscopy at least once in their lifetime, that there is still a lack of knowledge in terms of familiy and genetic risk factors and that a doctor's recommendation is the most important driving factor to choose to undertake preventive measures. The data of this investigation will of course influence not only the work of the foundation in the next years, but should also be of major importance for medical societies and last not least for the politicians who control the health system.
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Affiliation(s)
- D Wuppermann
- Stiftung LebensBlicke, Früherkennung Darmkrebs und Förderverein, Klinikum Ludwigshafen.
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Eickhoff A, Koberstein S, Rothsching M, Gemmel C, Eickhoff JC, Riemann JF, Enderle MD. Fragmentation of bile duct stones: a prospective systematic in vitro evaluation of argon plasma coagulation, cryotechnology, and water-jet technology. Endoscopy 2009; 41:702-6. [PMID: 19670138 DOI: 10.1055/s-0029-1214990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIM Choledocholithiasis is a common disease in the West. Lithotripsy by mechanical methods using baskets and by laser or electrohydraulic methods varies in effectiveness. With argon plasma coagulation (APC), high temperatures are used for devitalization and fragmentation; cryogenic techniques use the selective controlled application of freeze-thaw cycles to devitalize pathological tissue; and the dissecting water jet exploits the high pressure action of a thin laminar jet. We aimed to assess the feasibility and effectiveness of APC, cryotechnology, and the dissecting water jet as options for the fragmentation of bile duct stones. METHODS In an in vitro feasibility study, we evaluated the fragmentation of 120 bile duct stones treated with the three methods. Primary measures were assessment of the fragmentation rate, fragmentation effect, and energy application for each technology. RESULTS Fragmentation was seen in only 10 % of stones treated cryogenically using liquid nitrogen. APC at a power setting of 30 - 50 W fragmented all the cholesterol stones, but results with hard pigment stones were unsatisfactory even at high energies of a 100 W setting and long application time. Using the water jet, all 40 stones (100 %) were cracked effectively and completely with a pressure of 10 - 50 bar. CONCLUSION In this feasibility study, the first of its kind, only the water-jet device demonstrated efficient fragmentation of large bile duct stones in vitro. APC and cryotechnology are not suitable for the treatment of bile duct stones; the fragmentation rate with these methods was inadequate.
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Affiliation(s)
- A Eickhoff
- Medical Department C, Klinikum Ludwigshafen, Academic Hospital of the University of Mainz, Germany.
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Arnold R, Dathe K, Kühne D, Birkner B, Gerken G, Hermans ML, Lerch MM, Riemann JF, Schepp W. [Gastroenterology in Germany: results of a survey in hospitals and practices]. Z Gastroenterol 2009; 47:563-74. [PMID: 19533546 DOI: 10.1055/s-0028-1109405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In future, the profile of gastroenterology in Germany - as in other countries - will change. New achievements such as capsule endoscopy, aero-scopes and advanced CT and MRI technology and others will become alternatives to conventional endoscopy. Additional emphasis in clinical and outpatient gastroenterology is shifted towards gastrointestinal oncology, dietetics, nutrition and metabolism and in the clinical setting onto infectious diseases, endocrinology/diabetology, intensive care medicine, emergency service and geriatric medicine. The German Confederation of Gastroenterology (BVGD) initiated two Germany-wide surveys on the current diagnostic and therapeutic spectrum in hospitals and out-patient facilities to achieve a base for future discussions regarding the development of gastroenterology. The number of gastroenterologists working in hospitals and in out-patient facilities has been analysed as well as the number of examinations passed successfully during the last few years in the speciality "gastroenterology". The results of this survey offer a valid basis for continuing discussions as to how gastroenterology should develop in Germany.
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Affiliation(s)
- R Arnold
- Die Institutsangaben sind am Ende des Beitrags gelistet.
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Abstract
In Germany approximately 29,000 people died of colorectal carcinoma (CRC) in 2002; the risk of getting CRC is 4-6% in Germany, rising with age from the 50th year of life. About one third of all people over 50 years of age have polyps with the potential for malignant transformation in the colorectum, which is a sufficiently high prevalence rate to justify screening. In contrast to most other cancer diseases, in the case of CRC it is possible to prevent the cancer and not only to detect it at an early stage. Application of the test for occult blood in persons between their 45th and 80th years can reduce the mortality of CRC by 14%. We can assume that already regular sigmoidoscopies with consistent performance of polypectomy when needed could reduce the incidence of CRC by 50-70%. There is no doubt that coloscopy is the technique of choice for secondary prevention, as it unites the possibility of complete diagnosis and treatment with a justifiably low level of risk. The economic advantages of an avoidance strategy compared with the treatment of CRC, which is certainly expensive, have been documented. On the basis of all the data reported, in the case of CRC preventive strategies can be emphatically recommended.
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Affiliation(s)
- G Layer
- Zentralinstitut für Diagnostische und Interventionelle Radiologie, Klinikum der Stadt Ludwigshafen gGmbH, Akademisches Lehrkrankenhaus der Johannes Gutenberg Universität Mainz, Ludwigshafen, Deutschland.
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Affiliation(s)
- M Bechtler
- Medizinische Klinik C, Klinikum Ludwigshafen, Ludwigshafen, Germany.
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Schorr F, Bechtler M, Riemann JF. [Gastroenterology 2009]. Dtsch Med Wochenschr 2009; 134:1329-32. [PMID: 19517325 DOI: 10.1055/s-0029-1225285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- F Schorr
- Medizinische Klinik C, Klinikum Ludwigshafen.
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Riemann JF. [Interventional endoscopy: curative and creative]. Dtsch Med Wochenschr 2009; 134:445. [PMID: 19242890 DOI: 10.1055/s-0029-1208067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Eickhoff A, Hahn A, Riemann JF. [Chronic pancreatitis: what can be treated endoscopically?]. Dtsch Med Wochenschr 2009; 134:461-6. [PMID: 19242893 DOI: 10.1055/s-0029-1208070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- A Eickhoff
- Medizinische Klinik C, Klinikum der Stadt Ludwigshafen, Germany
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Abstract
HISTORY A 38-year old man presented himself for further clarification of a previously discovered circumscribed stenosis of the pancreatic duct. He had experienced several episodes of pancreatitis characterized by abdominal pain and increased lipase values. INVESTIGATION The endoscopic retrograde cholangiopancreatography demonstrated a "double duct" sign with corresponding stenosis of the bile and pancreatic ducts. No space-occupying mass was identified. There was no evidence of chronic pancreatitis. DIAGNOSIS, TREATMENT AND COURSE Post-inflammatory stenosis of the pancreatic duct was suspected. As the patient requested definitive diagnosis Whipple's operation was performed. It confirmed that the changes were benign. Histologic examination revealed changes of an autoimmune pancreatitis. CONCLUSION Circumscribed changes in the pancreatic duct, especially in young patients, should be clarified with all modern invasive and noninvasive modes of investigation to exclude with certainty a malignancy and avoid unnecessary resection.
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Affiliation(s)
- F Schorr
- Medizinische Klinik C, Klinikum Ludwigshafen gGmbH, Germany.
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Bechtler M, Eickhoff A, Riemann JF. [Interval colon cancer and possible causes]. Dtsch Med Wochenschr 2008; 133:2458-62. [PMID: 19006045 DOI: 10.1055/s-0028-1100939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Colorectal cancer that occurs during an interval between screening colonoscopies is called "interval carcinoma". These cancers are more frequent than would be expected, diagnosed in about tow per thousand patient years. There are three main causes for interval carcinomas: 50 % result from failed detection of polyps during colonoscopy, 25 % are tumors that develop during the screening interval and 25 % result from incomplete polypectomy. Knowing these etiologies screening makes it possible to optimize treatment. Colonoscopy of the highest quality is essential for providing reliable screening. Risk stratification during the first colonoscopy allows for optimal timing of follow-up-examinations. Difficult polypectomies require frequent follow-ups. Serrated adenomas should be treated like adenomas. Interval carcinomas are often detected during screening at an early stage: colonoscopy screening can save life of these patients.
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Affiliation(s)
- M Bechtler
- Medizinische Klinik C, Klinikum Ludwigshafen, Bremserstrasse 79, 67063 Ludwigshafen.
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Schorr F, Riemann JF. [Glandular body cysts-polyposis in known Peutz-Jeghers syndrome]. Dtsch Med Wochenschr 2008; 133:1677-8. [PMID: 18686209 DOI: 10.1055/s-0028-1082784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- F Schorr
- Medizinische Klinik C, Klinikum Ludwigshafen, Bremserstrasse 79, 67063 Ludwigshafen am Rhein.
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Hoch J, Schorr F, Riemann JF. [Cap polyposis]. Dtsch Med Wochenschr 2008; 133:1433-4. [PMID: 18592452 DOI: 10.1055/s-2008-1081090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- J Hoch
- Klinikum Ludwigshafen, Medizinische Klinik C, Bremserstr. 79, 67063 Ludwigshafen am Rhein, Deutschland
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Schorr F, Riemann JF. [Gastroenterology 2008]. Dtsch Med Wochenschr 2008; 133:1362-5. [PMID: 18553263 DOI: 10.1055/s-2008-1081081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- F Schorr
- Medizinische Klinik C, Klinikum Ludwigshafen gGmbH, Bremserstr. 79, 67063 Ludwigshafen am Rhein.
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Teichmann J, Weickert U, Riemann JF. Gastric fundic gland polyps and colonic polyps - is there a link, really? Eur J Med Res 2008; 13:192-195. [PMID: 18559299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND AND AIM A retrospective analysis of endoscopic investigation was carried out. Gastric fundic gland polyps occur in patients with familial adenomatous polyposis. The aim of our study was to investigate if colonic polyps is present and related to gastric fundic gland polyps. PATIENTS AND METHODS A 6 years retrospective analysis was carried out. At baseline upper gastrointestinal endoscopy, gastric fundic gland polyps were diagnosed in patients suffered from intestinal bleeding. Subjects received a colonoscopy additionally. A total of 500 patients were enrolled into study: 250 fulfilled the diagnostic criteria for gastric fundic gland polyps and 250 age and sex matched served as controls. RESULTS Colonic cancer was more frequently observed in 39 (15.5%) patients who met the criteria of gastric fundic gland polyps as compared to 23 (9.2 %) patients of the controls (p <0.05). Patients with gastric fundic gland polyps tended to have more often colonic polyps 122 vs. 111, but these differences were not statistically significant. CONCLUSION The prevalence of colonic cancer was elevated in patients with gastric fundic gland polyp. Furthermore, this relationship did not differ significantly according to occurrence of colonic polyps. Even tough colonoscopy is prophylactic in preventing colonic cancer; the use of colonoscopy should be encouraged in patients with gastric fundic gland polyps.
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Affiliation(s)
- Joachim Teichmann
- Medizinische Klinik C, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Bremserstr. 79, 67063 Ludwigshafen, Germany.
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Bubnoff ACV, Martin WR, Adamek HE, Riemann JF. Karzinoide des Gastrointestinaltraktes. Dtsch Med Wochenschr 2008. [DOI: 10.1055/s-2008-1047708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lammert F, Neubrand MW, Bittner R, Feussner H, Greiner L, Hagenmüller F, Kiehne KH, Ludwig K, Neuhaus H, Paumgartner G, Riemann JF, Sauerbruch T. [Short version of the updated S3 (level 3) guidelines for diagnosis and treatment of gallstones of the German Society for Digestive and Metabolic Diseases and the German Society for the Surgery of the Alimentary Tract]. Dtsch Med Wochenschr 2008; 133:311-6. [PMID: 18253923 DOI: 10.1055/s-2008-1046712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This short version of the guidelines summarizes the evidence-based key recommendations for the diagnosis and treatment of gallstones. The guidelines were developed by an interdisciplinary team of gastroenterologists, surgeons, radiologists, geneticists, and patient support groups, under the auspice of the German Society for Gastroenterology and Metabolic Diseases and the German Society for General Surgery and Surgery of the Alimentary Tract. It used structural level 3 consensus-based methodology and includes statements on clinical practice, prevention, quality assurance, outcome analysis, and integration of outpatient and inpatient care for patients with gallstone disease.
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Affiliation(s)
- F Lammert
- Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Homburg/Saar.
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Rau S, Autschbach F, Riedel HD, Konig J, Kulaksiz H, Stiehl A, Riemann JF, Rost D. Expression of the multidrug resistance proteins MRP2 and MRP3 in human cholangiocellular carcinomas. Eur J Clin Invest 2008; 38:134-42. [PMID: 18226047 DOI: 10.1111/j.1365-2362.2007.01916.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cholangiocellular carcinomas and gallbladder carcinomas are highly aggressive tumours with a poor prognosis and are generally regarded as chemoresistant tumours. Overexpression of ATP-binding cassette transporters of the multidrug resistance protein (MDR) and multidrug resistance-related protein (MRP) family in cancer cells is a major cause for the multidrug resistance phenotype in vitro and in vivo. To further define the role of MRP family members in biliary tract cancer, we studied the expression and localization of MRP2 and MRP3 in cholangiocellular carcinomas and gallbladder carcinomas. MATERIALS AND METHODS The expression and cellular localization of the multidrug resistance proteins MRP2 and MRP3 in human cholangiocellular carcinomas and gallbladder carcinomas were analysed by immunohistochemistry using isoform-specific antibodies. Expression of MRP isoforms was studied in vitro in Mz-ChA-1 cells derived from gallbladder adenocarcinoma by reverse transcription-polymerase chain reaction (RT-PCR), immunoblotting and immunofluorescence microscopy. RESULTS Mz-ChA-1 cells constitutively expressed MDR P-glycoproteins, MRP1, MRP2 and MRP3 by RT-PCR, immunoblotting and immunofluorescence microscopy. MRP2 and MRP3 are expressed in the respective apical and basolateral membrane domains. MRP3 was the predominant MRP isoform in gallbladder carcinomas (93%) and cholangiocellular carcinomas (57%), whereas MRP2 expression was detected in only 29% of gallbladder carcinomas and was undetectable in cholangiocellular carcinomas. CONCLUSIONS Our findings suggest that the intrinsic multidrug resistance of cholangiocellular and gallbladder carcinomas seems to be independent of MRP2 expression while the expression of MRP3 may contribute to the MDR phenotype.
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Affiliation(s)
- S Rau
- University of Heidelberg, Heidelberg, Germany
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Lammert F, Neubrand MW, Bittner R, Feussner H, Greiner L, Hagenmüller F, Kiehne KH, Ludwig K, Neuhaus H, Paumgartner G, Riemann JF, Sauerbruch T. [S3-guidelines for diagnosis and treatment of gallstones. German Society for Digestive and Metabolic Diseases and German Society for Surgery of the Alimentary Tract]. Z Gastroenterol 2007; 45:971-1001. [PMID: 17874360 DOI: 10.1055/s-2007-963437] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This guideline provides evidence-based key recommendations for diagnosis and therapy of gallstones and upgrades version 2000. It was developed by an interdisciplinary team of gastroenterologists, surgeons, radiologists, geneticists, external comparative quality assurance and patient support groups under the auspices of the German Society for Digestive and Metabolic Diseases and the German Society for Surgery of the Alimentary Tract. The guideline used structural S3 consensus-based methodology and includes statements on clinical practice, prevention, outcome analysis, and integration of outpatient and inpatient care for patients with gallstone diseases.
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Affiliation(s)
- F Lammert
- Die Institutsangaben sind am Ende des Beitrags gelistet.
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Eickhoff A, Hartmann D, Eickhoff JC, Riemann JF, Enderle MD. Pain sensation and neuromuscular stimulation during argon plasma coagulation in gastrointestinal endoscopy. Surg Endosc 2007; 22:1701-7. [PMID: 18071803 DOI: 10.1007/s00464-007-9700-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 09/20/2007] [Accepted: 10/16/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND Argon plasma coagulation (APC) is a thermal coagulation technique that uses ionized argon for contact-free transmission of high-frequency electrical current to tissue. Prospective data on complications with the new APC-2 (VIO) system are lacking. METHODS A prospective trial was conducted with 152 patients treated for various gastrointestinal diseases using three modes of the APC-2. The study aimed to assess complications, focusing on the pain and neuromuscular stimulation (NMS) experienced during and after treatment. Patients reported pain and NMS using a scale ranging from 0 to 10 and were interviewed for symptoms such as tingling, paresthesia, muscle pain, and cramping or twitching. The endoscopists also graded NMS using a separate questionnaire. RESULTS A total of 85 males and 67 females (median age, 66 years) were enrolled in the study. All APC therapies were completed successfully. Two peri-interventional perforations were recorded. Of the 152 patients, 26 (17%) reported pain sensation during or after APC. The median pain sensation reported by the patients on the standardized scale was 3.7. The findings showed NMS in 14 (9.2%) of the 152 patients. Significantly more NMS events were seen with pulsed APC than with forced or precise APC. Additional risk factors for NMS were gender (female) and type of sedation (combination midazolam and pethidine). No complications were noted among patients with intracardiac defibrillators or cardiac pacemakers. CONCLUSIONS According to the findings, APC may be associated with minor complications such as pain sensation and NMS. These complications were rarely seen, but occurred more often with pulsed APC than with forced or precise APC. Physicians should be aware of these complications.
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Affiliation(s)
- A Eickhoff
- Medical Department C, Klinikum Ludwigshafen gGmbH, Bremserstrasse 79, D-67063, Ludwigshafen, Germany.
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Teichmann J, Riemann JF. [Peri-interventional antibiotic therapy for PEG-sites?]. Dtsch Med Wochenschr 2007; 132:2714. [PMID: 18058666 DOI: 10.1055/s-2007-993125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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