Studies on the regulation of gastric function

The stomach is one of the most extensively studied organs in gastrointestinal physiology. Gastric motility and the secretion of gastric acid have been studied for many years and have been the source of many scientific controversies. Due to modern investigational methods our understanding of gastric physiology and pathophysiology has greatly increased during the past few decades. ... Zie: Summary

Are pancreatic autoantibodies associated with azathioprine-induced pancreatitis in Crohn's disease?

CONTEXT: Azathioprine is frequently used in the treatment of Crohn's disease. A severe side effect is acute pancreatitis, which is specific for Crohn's disease. Autoantibodies against exocrine pancreas occur in about 30% of Crohn's disease cases but not in other inflammatory diseases. Pancreatic autoantibody positive Crohn's disease patients might have a low grade inflammation of the pancreas which may be aggravated by the introduction of azathioprine, resulting in clinically overt acute pancreatitis. OBJECTIVE: We hypothesized that the presence of pancreatic autoantibodies in Crohn's disease patients is associated with the development of azathioprine-induced pancreatitis. PARTICIPANTS: Eight patients with Crohn's disease and azathioprine-induced pancreatitis and 26 patients with Crohn's disease not using azathioprine. MAIN OUTCOME MEASURE: Pancreatic autoantibodies were determined by a standardized immunofluorescence method. RESULTS: Two out of 8 patients with azathioprine-induced pancreatitis were positive for pancreatic autoantibodies (25.0%), detectable in serum dilutions of 1:40 and 1:160, respectively. In the control group of Crohn's disease patients, two (7.7%) were positive in serum dilutions of 1:2. All positive samples had an extracellular fluorescence pattern. The difference in the prevalence of pancreatic autoantibodies was not statistically significant (P=0.229). CONCLUSIONS: We could not confirm our hypothesis that most or all patients with azathioprine-induced pancreatitis were pancreatic autoantibody positive. The prevalence of pancreatic autoantibodies in the Crohn's disease patients in our group was lower than in previous reports.This study does not support an association between pancreatic autoantibodies and azathioprine-induced pancreatitis in Crohn's disease. However, this association should not be definitively excluded and larger, preferably prospective, studies are needed

Are pancreatic autoantibodies associated with azathioprine-induced pancreatitis in Crohn's disease?

CONTEXT: Azathioprine is frequently used in the treatment of Crohn's disease. A severe side effect is acute pancreatitis, which is specific for Crohn's disease. Autoantibodies against exocrine pancreas occur in about 30% of Crohn's disease cases but not in other inflammatory diseases. Pancreatic autoantibody positive Crohn's disease patients might have a low grade inflammation of the pancreas which may be aggravated by the introduction of azathioprine, resulting in clinically overt acute pancreatitis. OBJECTIVE: We hypothesized that the presence of pancreatic autoantibodies in Crohn's disease patients is associated with the development of azathioprine-induced pancreatitis. PARTICIPANTS: Eight patients with Crohn's disease and azathioprine-induced pancreatitis and 26 patients with Crohn's disease not using azathioprine. MAIN OUTCOME MEASURE: Pancreatic autoantibodies were determined by a standardized immunofluorescence method. RESULTS: Two out of 8 patients with azathioprine-induced pancreatitis were positive for pancreatic autoantibodies (25.0%), detectable in serum dilutions of 1:40 and 1:160, respectively. In the control group of Crohn's disease patients, two (7.7%) were positive in serum dilutions of 1:2. All positive samples had an extracellular fluorescence pattern. The difference in the prevalence of pancreatic autoantibodies was not statistically significant (P=0.229). CONCLUSIONS: We could not confirm our hypothesis that most or all patients with azathioprine-induced pancreatitis were pancreatic autoantibody positive. The prevalence of pancreatic autoantibodies in the Crohn's disease patients in our group was lower than in previous reports.This study does not support an association between pancreatic autoantibodies and azathioprine-induced pancreatitis in Crohn's disease. However, this association should not be definitively excluded and larger, preferably prospective, studies are needed

Clinical outcome of Crohn's disease according to the Vienna classification:disease location is a useful predictor of disease course

Objectives Crohn's disease (CD) is a complex genetic disease with multiple clinical patterns. Clinical classifications may help to identify subgroups of patients that have a distinct pattern of disease, and they are also a prerequisite for the conduction of genetic and therapeutic studies. The aim of this study was to determine the usefulness of the Vienna classification in patient care and clinical studies. Methods The clinical data of patients were carefully reviewed retrospectively. The behaviour and location of the disease were determined according to the Vienna classification and additional clinical characteristics including surgical data, vitamin 1312 status and medication were also assessed. Results Data according to the Vienna classification of 292 CD cases were available. The mean age at diagnosis was 31.4 years. The operation rate was higher in patients with ileocolonic localization (P <0.05) and stricturing and penetrating disease behaviour (P <0.001). The incidence of vitamin B12 deficiency was 41.9% in cases with ileal involvement and 20.7% in cases with disease confined to the colon. In 187 cases (64.0%) an operation was performed because of CD-related complications, in a majority (126, 674%) this took place within 5 years after diagnosis. Intolerance of azathioprine occurred in 36 cases (22.0%). Conclusions IIeocolonic disease localization is associated with a complicated course of disease. Vitamin B12 deficiency occurs frequently, also in patients with disease apparently confined to the colon. We propose that location parameters can be used for the prediction of disease course in clinical settings and in interventional studies. Eur J Gastroenterol Hepatol 18:255-261 (c) 2006 Lippincott Williams & Wilkins