Összefoglaló közlemények / Reviews

Local endoscopic haemostatis modality in gastrointestinal bleedings

Varga Márta dr.

Békés Megyei Központi Kórház, Dr. Réthy Pál Tagkórház, Gasztroenterológia, Békéscsaba

Treating gastrointestinal tract bleeding is of high importance in gastroenterologic emergency care. The life endangering state is a serious task both for the oxiology specialists and for the endoscopy experts. For the treatment of a bleeding patient every endoscopy premises must have the recommended equipment, accessories and further items that are required for the moderation of the bleeding. Naturally it is also necessary to have a skilled staff. Until there is no Hungarian guideline, international (ESGE, ASGE) guidelines must be followed to have evidences that facilitate the safe and successful treatment. This publication provides information on the applied and recommended possibilities of the local moderation of the gastrointestinal tract bleeding. This includes the applicable, recommended injections, glues and topical haemostatasis treatments.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 1

PhD fórum / PhD forum

Changing epidemiological trends of Crohn’s – disease, result from Veszprem province, population – based IBD database

Lovász Barbara Dorottya dr.1,7, Végh Zsuzsanna dr.1, Golovics Petra Anna dr.1, Kiss Lajos Sándor dr.1, Horváth Ágnes dr.2, Szita István dr.3, Pandúr Tünde dr.3, Molnár Csaba dr.4, Komáromi Erzsébet dr.5, Mester Gábor dr.6, Balogh Mihály dr.6, Lakatos László dr.3, Lakatos Péter László dr.1

1Semmelweis Egyetem, I. sz. Belgyógyászati Klinika, Budapest;
2Csolnoky Ferenc Megyei Kórház, Gyermekgyógyászati Osztály, Veszprém;
3Csolnoky Ferenc Megyei Kórház, Gasztroenterológiai – Belgyógyászati Osztály, Veszprém;
4Magyar Imre Kórház, Infektológiai Osztály, Ajka;
5Városi Kórház, Gasztroenterológiai Osztály, Várpalota;
6Gróf Eszterházy Kórház, Pápa;
7Semmelweis Egyetem, Egészségtudományi Kar, Egészségtudományi Klinikai Tanszék, Budapest (a szerzők munkahelyei a PhD-tézis alapjául szolgáló publikációk közlésekor)

The multifactorial lifelong standing relapsing Crohn’s disease develops in genetically predisposed individual’s trigerred by environmental factors. Significant increase of incidence was observed in previously lower incidence areas in the last few decades. Background of this is only partly understand, lifestyle changes, westernized diet, developed hygiene conditions and higher diagnostic awareness are also possible etiology. Other important factor is the true change in epidemiology trends, also reported from our results from Veszprem province inflammatory bowel diseases database. Crohn's disease is a progressive disease, usually inflammatory disease behavior at diagnosis, becoming more severe, complicated phenotype during follow up. Pediatric or early age onset inflammatory bowel diseases often leads to more severe disease phenotype and disease course. In our study based almost three decade long patient follow up data from Veszprem province population based database we found no differences in behavior of adult and pediatric onset Crohn’s disease. The conclusions showed pediatric onset Crohns’s disease did not have more severe disease course with frequent complications compared to adult onset Crohn’s disease, but ileal involvement in addition need for immunosuppressant azathioprine treatment was higher. In ulcerative colitis extensive disease localization was more frequent. Effect of chronic inflammation of the intestinal can lead to carcinogenesis by enhanced cell proliferation, thereby increased occurrence of malignant hematologic and malignant diseases can be associated to inflammatory bowel diseases. Controversial results were available in the literature previously, on different disease phenotype and malignant transformation, it was questionable, which patient groups should be checked more frequently. Based on our results, only patients with stenosing disease and colonic involvement in Crohn’s disease was associated with higher risk of colorectal cancer. Beyond chronic inflammation, the effect of immunosuppressive medication can be linked to increased risk of lymphoma. However, population-based studies have not reported significant difference to the normal population. In line with these previous results, in our study, the incidence of lymphoma was very low in patients with inflammatory bowel diseases and any relation to drug therapy could not be detected.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 1

Összefoglaló közlemények / Reviews

Recent advances in the application of liquid biopsy in gastrointestinal malignancies

János Karczub MD, András Budai MD, Endre Konstek, András Kiss MD PhD DSc

2nd Department of Pathology, Semmelweis University, Budapest, Hungary

Liquid biopsy is an emerging diagnostic tool in medicine. That means non-invasive sampling and analysis of whole blood, serum, saliva and urine samples for cancer-associated particles (e.g. circulating tumor cells, circulating cell-free nucleotides, exosomes, cancer associated proteins, etc.). Liquid biopsy could develop to be a crucial step in the diagnosis and management of gastrointestinal tumors. Compared to currently used tissue based (core biopsy, fine-needle aspiration biopsy, surgical resection) diagnostic methods it might deliver comparable information regarding molecular and genetic profiling of tumors. Further, it might provide earlier diagnosis and better reflect tumor heterogeneity. Used together with other diagnostic modalities (e.g. imaging studies, currently used tumor markers) liquid biopsy could provide useful information for precision medicine and personalized therapy.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 1

Szerkesztőségi közlemény / Editorial

A protonpumpa-gátló készítmények korszerű használata

Altorjay István dr.

Debreceni Egyetem Klinikai Központ, ÁOK, Gasztroenterológiai Tanszék, Debrecen

The most widely used pharmaceutical agent for the inhibition of gastric acid secretion is the group of proton pump inhibitors. They belong to the drugs sold in the highest quantity all-over-the-world. In the 3rd issue of CEU-JGH vol. 4. a publication by Gelley A et al. pages 144–149 was published, that provoked some questions to the editors, therefore it was decided to give a short summary of practical principles regarding the use of PPIs. Since in the recent years the possible undesirable side effects of continuously administered PPIs became an inportant theme of several publications, it is important to make decisions about indications more rationalistic and consize.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 1