Eosinophile Ösophagitis: Die Sicht des Gastroenterologen

Zusammenfassung: Die eosinophile Ösophagitis ist charakterisiert durch Symptome ösophagealer Dysfunktion (meist Dysphagie) und eosinophile Entzündungsinfiltrate im Ösophagus. Diese kommen in anderen Abschnitten des Gastrointestinaltrakts nicht vor. Differenzialdiagnosen, die mit ösophagealer Eosinophilie einhergehen, müssen vor der Diagnose einer eosinophilen Ösophagitis ausgeschlossen werden. Der typische Patient mit eosinophiler Ösophagitis ist männlich und hat atopische Begleiterkrankungen. Zu den Behandlungsoptionen gehören medikamentöse Therapie, Eliminationsdiät sowie ösophageale Dilatatio

Eosinophile Ösophagitis : Die Sicht des Gastroenterologen [Eosinophilic esophagitis : The gastroenterologist's perspective].

Eosinophilic esophagitis is characterized by symptoms of esophageal dysfunction and eosinophil-predominant esophageal inflammation. Eosinophilic inflammation in other parts of the gastrointestinal tract is absent and several differential diagnoses for esophageal eosinophilia have to be excluded before diagnosing eosinophilic esophagitis. Most patients are male and have concomitant atopic disorders. Therapeutic options are based on drugs, diet and dilation

Prevalence and risk factors for thromboembolic complications in IBD patients

Background: Inflammatory bowel disease (IBD) patients have an increased risk of venous thromboembolic complications (VTEC) such as deep vein thrombosis (DVT) and pulmonary embolism when compared to the non-IBD population. However, studies assessing VTEC prevalence in IBD as well as analyses of VTEC associated risk factors are scarce. We aimed to assess VTEC prevalence in IBD patients and to identify associated risk factors. Methods: Data from patients enrolled in the Swiss IBD Cohort Study (SIBDCS) were analyzed. Since 2006 the SIBDCS collects data on a large sample of IBD patients from hospitals and private practices across Switzerland. Results: A  total of 90/2284 (3.94%) IBD patients suffered from VTEC. Of these, 45/1324 (3.4% overall; 2.42% with DVT, 1.51% with PE) had CD, and 45/960 (4.7% overall; 3.23% with DVT, 2.40% with PE) presented with UC

Iron clad wetlands: Soil iron-sulfur buffering determines coastal wetland response to salt water incursion

Coastal freshwater wetland chemistry is rapidly changing due to increased frequency of salt water incursion, a consequence of global change. Seasonal salt water incursion introduces sulfate, which microbially reduces to sulfide. Sulfide binds with reduced iron, producing iron sulfide (FeS), recognizable in wetland soils by its characteristic black color. The objective of this study is to document iron and sulfate reduction rates, as well as product formation (acid volatile sulfide (AVS) and chromium reducible sulfide (CRS)) in a coastal freshwater wetland undergoing seasonal salt water incursion. Understanding iron and sulfur cycling, as well as their reduction products, allows us to calculate the degree of sulfidization (DOS), from which we can estimate how long soil iron will buffer against chemical effects of sea level rise. We show that soil chloride, a direct indicator of the degree of incursion, best predicted iron and sulfate reduction rates. Correlations between soil chloride and iron or sulfur reduction rates were strongest in the surface layer (0–3 cm), indicative of surface water incursion, rather than groundwater intrusion at our site. The interaction between soil moisture and extractable chloride was significantly related to increased AVS, whereas increased soil chloride was a stronger predictor of CRS. The current DOS in this coastal plains wetland is very low, resulting from high soil iron content and relatively small degree of salt water incursion. However, with time and continuous salt water exposure, iron will bind with incoming sulfur, creating FeS complexes, and DOS will increase

Seasonal Salinization Decreases Spatial Heterogeneity of Sulfate Reducing Activity

Evidence of sulfate input and reduction in coastal freshwater wetlands is often visible in the black iron monosulfide (FeS) complexes that form in iron rich reducing sediments. Using a modified Indicator of Reduction in Soils (IRIS) method, digital imaging, and geostatistics, we examine controls on the spatial properties of FeS in a coastal wetland fresh-to-brackish transition zone over a multi-month, drought-induced saltwater incursion event. PVC sheets (10 - 15 cm) were painted with an iron oxide paint and incubated vertically belowground and flush with the surface for 24 h along a salt-influenced to freshwater wetland transect in coastal North Carolina, USA. Along with collection of complementary water and soil chemistry data, the size and location of the FeS compounds on the plate were photographed and geostatistical techniques were employed to characterize FeS formation on the square cm scale. Herein, we describe how the saltwater incursion front is associated with increased sulfate loading and decreased aqueous Fe(II) content. This accompanies an increased number of individual FeS complexes that were more uniformly distributed as reflected in a lower Magnitude of Spatial Heterogeneity at all sites except furthest downstream. Future work should focus on streamlining the plate analysis procedure as well as developing a more robust statistical based approach to determine sulfide concentration

Seasonal Salinization Decreases Spatial Heterogeneity of Sulfate Reducing Activity

This work is licensed under a Creative Commons Attribution 4.0 International License.Evidence of sulfate input and reduction in coastal freshwater wetlands is often visible in the black iron monosulfide (FeS) complexes that form in iron rich reducing sediments. Using a modified Indicator of Reduction in Soils (IRIS) method, digital imaging, and geostatistics, we examine controls on the spatial properties of FeS in a coastal wetland fresh-to-brackish transition zone over a multi-month, drought-induced saltwater incursion event. PVC sheets (10 × 15 cm) were painted with an iron oxide paint and incubated vertically belowground and flush with the surface for 24 h along a salt-influenced to freshwater wetland transect in coastal North Carolina, USA. Along with collection of complementary water and soil chemistry data, the size and location of the FeS compounds on the plate were photographed and geostatistical techniques were employed to characterize FeS formation on the square cm scale. Herein, we describe how the saltwater incursion front is associated with increased sulfate loading and decreased aqueous Fe(II) content. This accompanies an increased number of individual FeS complexes that were more uniformly distributed as reflected in a lower Magnitude of Spatial Heterogeneity at all sites except furthest downstream. Future work should focus on streamlining the plate analysis procedure as well as developing a more robust statistical based approach to determine sulfide concentration

Genetic Algorithms for the Discovery of Homogeneous Catalysts

In this account, we discuss the use of genetic algorithms in the inverse design process of homogeneous catalysts for chemical transformations. We describe the main components of evolutionary experiments, specifically the nature of the fitness function to optimize, the library of molecular fragments from which potential catalysts are assembled, and the settings of the genetic algorithm itself. While not exhaustive, this review summarizes the key challenges and characteristics of our own (i.e., NaviCatGA) and other GAs for the discovery of new catalysts

Eosinophilic Esophagitis beyond Eosinophils - an Emerging Phenomenon Overlapping with Eosinophilic Esophagitis: Collegium Internationale Allergologicum (CIA) Update 2023.

Having long been considered the mainstay in eosinophilic esophagitis (EoE) diagnosis and pathogenesis, the role of eosinophils has been questioned and might be less important than previously thought. It is well known now that EoE is a Th2-mediated disease with many more disease features than eosinophilic infiltration. With more knowledge on EoE, less pronounced phenotypes or nuances of the disease have become apparent. In fact, EoE might be only the tip of the iceberg (and the most extreme phenotype) with several variant forms, at least three, lying on a disease spectrum. Although a common (food induced) pathogenesis has yet to be confirmed, gastroenterologists and allergologists should be aware of these new phenomena in order to further characterize these patients. In the following review, we discuss the pathogenesis of EoE, particularly those mechanisms beyond eosinophilic infiltration of the esophageal mucosa, non-eosinophilic inflammatory cell populations, the new disease entity EoE-like disease, variant forms of EoE, and the recently coined term mast cell esophagitis

Crohn's versus Cancer: Comparison of Functional and Surgical Outcomes after Right-Sided Resections.

The objective of this study was to compare functional and surgical outcomes of patients undergoing ileocecal resection for Crohn's disease (CD) to patients undergoing oncological right colectomy. Retrospective single-center cohort study including consecutive patients undergoing right colectomy for adenocarcinoma (oncological resection) or CD (mesentery-sparing resection) between July 2011 and November 2017. Outcome measures were pathological details (lymph node yield), postoperative recovery (pain levels, return to flatus and stool, intake of fluids, weight change, and mobilization), and early (30-day) outcomes (surgical/medical complications, hospital stay, readmissions). A total of 195 patients (153 [78%] with cancer and 42 [22%] with CD) were included. Overall compliance with the institutional enhanced recovery protocol was comparable between the 2 groups (compliance ≥70%: 60% in CD patients vs. 62% in cancer, p = 0.458). The adenocarcinoma group had a larger lymph node yield than the CD group (26 ± 13 vs. 2.4 ± 5, respectively, p < 0.001). While the CD group experienced significantly more pain (3.7 ± 1.9/10 vs. 2.8 ± 2.5/10, p = 0.007, patients requiring opioids: 65 vs. 28%, p = 0.001), return of flatus (2.3 ± 1.2 days vs. 2.4 ± 2.8 days, p = 0.642) and stool (4.1 ± 6.0 vs. 3.0 ± 1.8 days, p = 0.292) was no different in both groups. No difference was observed regarding postoperative complications, length of stay, and readmission rate. This study revealed no differences in both functional and surgical outcomes in CD and cancer patients undergoing mesentery-sparing or formal oncological right colectomy, respectively