Home » AGEB Journal » Issues » Volume 87 » Fasc.3 - Original articles

Volume 87 - 2024 - Fasc.3 - Original articles

Investigation of the prevalence of functional constipation and its related factors for in older outpatients

Background: Functional constipation (FC) is a geriatric syndrome that is common in the older adult’s population and can seriously affect the quality of life and may be a frequent cause of hospital visits. In this study, we planned to investigate the relationship between FC and its related factors for in older outpatients. Patients and Methods: Participants aged 65 and over who applied to the geriatrics outpatient were included in the study. The diagnosis of FC was made according to the presence of the Rome IV criteria. Frailty was screened by the using FRAIL scale, ≥ 3 a score of were evaluated as frail. Participants quality of life was evaluated by Euro-Quality of Life Visual Analog Scale (EQ-VAS). Results: The study included 602 participants. FC prevalence was found 28.7%. In univariate analyses, FC was found related to age, having a diagnosis of depression or Parkinson diseases, frailty, urinary incontinence, sleep disorders, number of chronic diseases, and EQ-VAS. In multivariate analyses, FC was not found to be associated by the frailty while the number of chronic diseases [OR=1.212, 95%CI (1.084-1.355), p=0.001] and EQ-VAS were found to be related [OR=0.988, 95%CI (0.978-0.997), p=0.012]. Conclusion: In the results of this study, FC was not found to be associated by frailty in older outpatients but it emerged as a syndrome that should be screened frequently in patients with a high number of chronic diseases and a low general quality of life. (Acta gastroenterol. belg., 2024, 87, 361-365.

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Are nucleot(s)ide analogues a negative factor for HBsAg seroconversion in acute hepatitis B?

Background and study aim: There are several studies comparing patients treated with lamivudine and those not given antiviral therapy in acute hepatitis B. Some of these studies showed that antiviral treatment significantly contributed to survival, whereas one other study suggested that antiviral treatment had no effect. The aim of this study was to investigate the efficacy of tenofovir disoproxil fumarate (TDF) therapy and its effect on HBsAg seroconversion in patients with acute viral hepatitis B. Patients and methods: The files of 126 patients who were under follow-up for acute HBV infection in the Department of Gastroenterology were analyzed retrospectively. Demographic data, molecular, ELISA, and biochemistry tests at the time of diagnosis and in the follow-up, period were evaluated using the hospital automation system. Results: The rate of chronicity of HBV was found to be higher in the TDF group than in the group without antiviral treatment. The rate of protective anti-HBs acquisition was found to be lower in the TDF group (p<0.05). Conclusion: Antiviral treatment with TDF in acute HBV infection may increase the rate of chronicity. It may reduce the development of natural immunity. Further studies are warranted.

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Prevalence of metabolic dysfunction-associated fatty liver disease after pancreatic surgery in a historical Belgian cohort and review of the literature

Background and objectives: Metabolic dysfunction-associated fatty liver disease (MAFLD) has been reported as a complication after pancreatic surgery. The aim of this study is to assess this phenomenon in a Belgian population, specifically in a period in time when less perioperative chemotherapy was given. Methods: We performed a retrospective monocentric cohort study with 124 selected patients who underwent pancreatic surgery – pancreaticoduodenectomy (PD), distal pancreatectomy (DP) or total pancreatectomy – between 2005 and 2014. Steatosis was assessed radiologically, using Hounsfield units on liver and spleen. Data on imaging, liver function, weight and other relevant parameters were gathered preoperatively as well as 2 and 6 months, 1 and 2 years after surgery. Results: Thirty-eight (31%) out of 124 patients developed liver steatosis at least at one point in time in the two years following surgery, with a prevalence of 21.0% at 2 months, 28.6% at 6 months, 16.4% at 1 year and 20.8 % at 2 years. A statistically significant association with preoperative AST and ALT values, administration of pancreatic enzyme supplementation as a surrogate for pancreatic exocrine insufficiency (PEI) and weight loss at 2 years was detected. Conclusion: MAFLD is seen in 31% of patients with PD or DP pancreatic resection in this retrospective analysis of a monocentric Belgian cohort. Both early and late onset of MAFLD was observed, implying that long-term follow-up is necessary. Clinical impact as well as a direct correlation with patients’ weight and oral enzyme supplements needs to be further investigated.

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Bile acid malabsorption investigated by selenium-75-homocholic acid taurine (75SeHCAT) scans, a retrospective single-centre experience

Background: Bile acid malabsorption (BAM) is a common entity in patients experiencing chronic watery diarrhea. However, literature suggests that BAM is underdiagnosed and undertreated. In many countries 75SeHCAT is the gold standard for diagnosing BAM (1-5). The aim of this retrospective study was to investigate the frequency of BAM using 75SeHCAT scintigraphy and the response to treatment with bile acid sequestrants. Methods: We retrospectively evaluated the clinical data of 420 patients who had a 75SeHCAT scan from January 2016 to January 2023. Electronic medical records were investigated for risk factors of BAM. BAM was defined as a 75SeHCAT retention of less than 15%. Response to bile acid sequestrants was evaluated based on outpatient clinical reports. Results: Median age at the time of 75SeHCAT test was 47 years (range 14-87). Out of 420 patients, 192 (46%) had a positive result for BAM. Cholecystectomy and ileal resection were significant predictors for BAM (p<0.001). BAM type 1 is statistically more likely to be more severe compared to type 2 (p<0.0001) and compared to type 3 (p=0.0021). In patients who fulfilled Rome IV criteria for IBS-D or functional diarrhea, 75 out of 121 (38%) tested positive for BAM. Overall, treatment with bile acid binders was effective in 76%. Conclusions: This retrospective study of patients who underwent SeHCAT scanning confirms that about 1/3 patients presenting with therapy-resistant chronic diarrhea in secondary care suffer from BAM. Including the test in clinical management protocols of chronic diarrhea allows early and quantitative diagnosis and treatment of BAM.

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Noninvasive evaluation of significant liver fibrosis in chronic hepatitis B patients

Background & Aims: Chronic hepatitis B is still a major cause of morbidity and mortality worldwide. In recent years, there has been increasing research on inexpensive, noninvasive, reproducible methods for detecting fibrosis in the liver. In this study, we examined the efficacy of 15 different noninvasive fibrosis markers for predicting significant liver fibrosis in chronic hepatitis B patients. Methods: Patients who underwent liver biopsy for chronic hepatitis B between 01.01.2010 and 01.01.2022 were retrospectively analysed. The study population was divided into two groups according to significant fibrosis (F≥3). Receiver operating characteristic analysis was performed to examine the diagnostic performance of these noninvasive fibrosis markers for the prediction of significant fibrosis. Multiple logistic regression analysis was used create a model which predicts significant fibrosis better than the individual markers. Results: In total, 234 chronic hepatitis B patients were enrolled in this study. Among the 15 noninvasive fibrosis markers, King’s score was found to have the biggest AUC in predicting significant fibrosis (F≥3). Furthermore, a model containing King’s score, GUCI and GPR has the ability of prediction of significant fibrosis better than every individual marker (cut-off of the model >0,3356, p<0.0001). Conclusion: According to our study results, the model containing King’s score, GUCI and GPR can be used to predict significant liver fibrosis in chronic hepatitis B patients followed-up in countries with limited sources.

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