The effect of a multispecies probiotic on the composition of the faecal microbiota and bowel habits in chronic obstructive pulmonary disease patients treated with antibiotics

Short-term antibiotic treatment profoundly affects the intestinal microbiota, which may lead to sustained changes in microbiota composition. Probiotics may restore such a disturbance. The objective of the present study was to investigate the effect of a multispecies probiotic on the faecal microbiota during and after antibiotic intake in patients with a history of frequent antibiotic use. In this randomised, placebo-controlled, double-blind study, thirty chronic obstructive pulmonary disease (COPD) patients treated with antibiotics for a respiratory tract infection received 5 g of a multispecies probiotic or placebo twice daily for 2 weeks. Faecal samples were collected at 0, 7, 14 and 63 d. Changes in the composition of the dominant faecal microbiota were determined by PCR-denaturing gradient gel electrophoresis (DGGE). Changes in bacterial subgroups were determined by quantitative PCR and culture. Bowel movements were scored daily according to the Bristol stool form scale. During and after antibiotic treatment, DGGE-based similarity indices (SI) were high ( >/= 84 %) and band richness was relatively low, both remaining stable over time. No difference in SI was observed between patients with and without diarrhoea-like bowel movements. The multispecies probiotic had a modest effect on the bacterial subgroups. Nevertheless, it affected neither the composition of the dominant faecal microbiota nor the occurrence of diarrhoea-like bowel movements. The dominant faecal microbiota was not affected by antibiotics in this COPD population, suggesting an existing imbalance of the microbiota, which may also have contributed to the lack of effect by probiotic intak

Chromosome aberrations in adenomas of the colon. Proof of trisomy 7 in tumor cells by combined interphase cytogenetics and immunocytochemistry

Chromosome aberrations in adenomas of the colon. Proof of trisomy 7 in tumor cells by combined interphase cytogenetics and immunocytochemistry. Herbergs J, de Bruine AP, Marx PT, Vallinga MI, Stockbrugger RW, Ramaekers FC, Arends JW, Hopman AH. Department of Pathology, University Hospital, Maastricht, The Netherlands. Thirty-five colon adenomas from 26 patients were analyzed with centromeric probes for chromosomes 1, 7, 17, X and Y in order to study numerical aberrations, chromosome imbalances, aneuploidy and tetraploidization. The fluorescent in situ hybridization (FISH) technique was applied to single-cell suspensions and a combination of FISH and immunocytochemistry (ICC) was employed to identify the cell type under study. Trisomy of chromosome 7 was detected in 37% of the cases. In 7 out of 13 cases this aberration was combined with abnormalities of one or 2 of the other investigated chromosomes. No correlation could be demonstrated between any of the detected chromosomal aberrations and size, localization or degree of epithelial dysplasia. With the combined FISH/ICC procedure, the abnormal cells were shown to be of epithelial rather than of stromal origin. Our data indicate that trisomy 7 is a common chromosome aberration in the epithelial component of colon adenoma

The future European gastroenterologist: circumstances, training and task.

Dept. of Gastroenterology and Hepatology, University Hospital Maastricht, The Netherlands. The Section and Board of Gastroenterology within the EUMS/UEMS, representing the professional organisations of non-academic and academic gastroenterologists in the 15 EC member countries, have tried to create a uniform concept of the future European gastroenterologist, who should be able to pursue his profession within the EC in a reliable and controlled way after well programmed training in recognized centres. The training programme, to be agreed upon by the members, should aim at a high quality and not at a minimum common denominator. The programme should include a core of obligatory knowledge and skills, and should allow a variation of options which would enable the gastroenterologist to perform in varying professional and administrative environments, in cooperation with either internists, or surgeons, or working on his own

Nonsteroidal anti-inflammatory drugs (NSAIDs) in the prevention of colorectal cancer.

Department of Gastroenterology, Akademisch Ziekenhuis, Maastricht, The Netherlands. [email protected] Shortly after the discovery of prostaglandins being involved in vertebrate carcinogenesis (during the 1970s), trials in patients with familial adenomatous polyposis (FAP) had shown that nonsteroidal anti-inflammatory drugs (NSAIDs) could reduce the number and size of these precancerous lesions. In the late 1980s epidemiological evidence was provided that long term use of aminosalicylic acid (ASA) for various indications seemed to be protective against colonic cancer and malignancies of other sites. Controlled intervention studies with nonselective cyclo-oxygenase (COX) inhibitors (i.e. traditional NSAIDs) were hampered by the risks of gastrointestinal and renal side effects. Recently, selective COX-2 receptor antagonists have been developed, improving pain and inflammation without the above mentioned adverse effects. In animal models it has been shown that COX-2 inhibitors are able to reduce colonic neoplasia and/or its proxy markers. This is the rationale for the presently ongoing testing of those drugs in hereditary and sporadic colonic adenomas. Publication Types: Review Review, Tutoria

Screening for colorectal cancer: medical and economic aspects

Screening for colorectal cancer: medical and economic aspects. Sanduleanu S, Stockbrugger RW. Dept. of Gastroenterology and Hepatology, University Hospital Maastricht, The Netherlands. [email protected] BACKGROUND: Colorectal cancer (CRC) is the second commonest cause of cancer death in the Western world. In The Netherlands, CRC causes about 4400 deaths per year, and its diagnosis and treatment make up for a large share of health-care costs. METHODS: Review and discussioN. RESULTS: Experts in the field presently assume that screening for CRC and its precursor lesions, colorectal adenomas (CRAs), could prevent death from colorectal neoplasia by more than 80%. Additionally, there is increasing acknowledgement that CRC screening programmes can save lives at a cost similar to, or even less than, the generally accepted breast cancer or cervical cancer screening programmes. Nonetheless, while neighbouring countries have taken vigorous measures to fight CRC, the Dutch are still hesitating in this matter. This is partly due to some yet unanswered questions concerning the acceptability of screening for CRC in the general population, the starting age and the frequency of screening, the type of screening tests to be used, and the programme organization. In this commentary, general epidemiological and pathogenetic aspects of CRC are addressed. In addition, some frequently asked questions (FAQ) and (very subjective) answers about screening for CRC are offered, as potential substrate for further in-depth discussions. CONCLUSION: The emerging message for the community is that an effective national screening programme is urgently required to reduce the substantial morbidity and mortality from this disease