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Ledermann JA, Matias-Guiu X, Amant F, Concin N, Davidson B, Fotopoulou C, González-Martin A, Gourley C, Leary A, Lorusso D, Banerjee S, Chiva L, Cibula D, Colombo N, Croce S, Eriksson AG, Falandry C, Fischerova D, Harter P, Joly F, Lazaro C, Lok C, Mahner S, Marmé F, Marth C, McCluggage WG, McNeish IA, Morice P, Nicum S, Oaknin A, Pérez-Fidalgo JA, Pignata S, Ramirez PT, Ray-Coquard I, Romero I, Scambia G, Sehouli J, Shapira-Frommer R, Sundar S, Tan DSP, Taskiran C, van Driel WJ, Vergote I, Planchamp F, Sessa C, Fagotti A. ESGO-ESMO-ESP consensus conference recommendations on ovarian cancer: pathology and molecular biology and early, advanced and recurrent disease. Ann Oncol 2024; 35:248-266. [PMID: 38307807 DOI: 10.1016/j.annonc.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/17/2023] [Accepted: 11/28/2023] [Indexed: 02/04/2024] Open
Abstract
The European Society of Gynaecological Oncology, the European Society for Medical Oncology (ESMO) and the European Society of Pathology held a consensus conference (CC) on ovarian cancer on 15-16 June 2022 in Valencia, Spain. The CC panel included 44 experts in the management of ovarian cancer and pathology, an ESMO scientific advisor and a methodologist. The aim was to discuss new or contentious topics and develop recommendations to improve and harmonise the management of patients with ovarian cancer. Eighteen questions were identified for discussion under four main topics: (i) pathology and molecular biology, (ii) early-stage disease and pelvic mass in pregnancy, (iii) advanced stage (including older/frail patients) and (iv) recurrent disease. The panel was divided into four working groups (WGs) to each address questions relating to one of the four topics outlined above, based on their expertise. Relevant scientific literature was reviewed in advance. Recommendations were developed by the WGs and then presented to the entire panel for further discussion and amendment before voting. This manuscript focuses on the recommendation statements that reached a consensus, their voting results and a summary of evidence supporting each recommendation.
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Affiliation(s)
- J A Ledermann
- Department of Oncology, UCL Cancer Institute, University College London, London, UK.
| | - X Matias-Guiu
- CIBERONC, Madrid; Department of Pathology, Hospital Universitari Arnau de Vilanova, IRBLLEIDA, University of Lleida, Lleida; Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain.
| | - F Amant
- Department of Gynaecologic Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium; Department of Gynecology, Center for Gynecological Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N Concin
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria; Department of Gynaecology and Gynaecologic Oncology, Evang. Kliniken Essen-Mitte, Essen, Germany
| | - B Davidson
- Department of Pathology, Norwegian Radium Hospital, Oslo University Hospital, Oslo; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - C Fotopoulou
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - A González-Martin
- Department of Medical Oncology and Program in Solid Tumours-Cima, Cancer Center Clínica Universidad de Navarra, Madrid, Spain
| | - C Gourley
- Cancer Research UK Scotland Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - A Leary
- Department of Medicine, Institut Gustave Roussy, Villejuif, France
| | - D Lorusso
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Department of Woman, Child and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - S Banerjee
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK
| | - L Chiva
- Department of Gynaecology and Obstetrics, Cancer Center Clínica Universidad de Navarra, Navarra, Spain
| | - D Cibula
- Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - N Colombo
- Department of Gynecologic Oncology, Istituto Europeo di Oncologia IRCCS, Milan; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - S Croce
- Department of Biopathology, Bergonié Institut, Bordeaux, France
| | - A G Eriksson
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gynecologic Oncology, Division of Cancer Medicine, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - C Falandry
- Institute of Aging, Hospices Civils de Lyon, Lyon; CarMeN Laboratory, INSERM U1060/Université Lyon 1/INRAE U1397/Hospices Civils Lyon, Pierre-Bénite, France
| | - D Fischerova
- Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - P Harter
- Department of Gynaecology and Gynaecologic Oncology, Evang. Kliniken Essen-Mitte, Essen, Germany; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Study Group, Germany
| | - F Joly
- GINECO Group, Department of Medical Oncology, Centre François-Baclesse, University of Caen Normandy, Caen, France
| | - C Lazaro
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL-CIBERONC), L'Hospitalet de Llobregat, Barcelona, Spain
| | - C Lok
- Department of Gynecology, Center for Gynecological Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S Mahner
- Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Study Group, Germany; Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich
| | - F Marmé
- Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Study Group, Germany; Department of Obstetrics and Gynecology, University Hospital Mannheim, Mannheim; Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - C Marth
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| | - W G McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK
| | - I A McNeish
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - P Morice
- Department of Gynecologic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - S Nicum
- Department of Oncology, UCL Cancer Institute, University College London, London, UK
| | - A Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona
| | - J A Pérez-Fidalgo
- Department of Medical Oncology, Hospital Clínico Universitario - INCLIVA, CIBERONC, Valencia, Spain
| | - S Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori di Napoli, IRCCS Fondazione Pascale, Napoli, Italy
| | - P T Ramirez
- Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, USA
| | - I Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard, University Claude Bernard, Lyon, France
| | - I Romero
- Department of Medical Oncology, Instituto Valenciano Oncologia, Valencia, Spain
| | - G Scambia
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Department of Woman, Child and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - J Sehouli
- North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin; Department of Gynecology with Center for Oncological Surgery, Charité Berlin University of Medicine, Berlin, Germany
| | | | - S Sundar
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham; Pan Birmingham Gynaecological Cancer Centre, City Hospital, Birmingham, UK
| | - D S P Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; National University of Singapore (NUS) Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Cancer Science Institute, National University of Singapore, Singapore; Department of Haematology-Oncology, National University Cancer Institute Singapore, National University Hospital, Singapore, Singapore
| | - C Taskiran
- Department of Gynecologic Oncology, School of Medicine, Koç University, Istanbul, Turkey
| | - W J van Driel
- Department of Gynecology, Center for Gynecological Oncology Amsterdam, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - I Vergote
- Department of Gynaecologic Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | | | - C Sessa
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - A Fagotti
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Department of Woman, Child and Public Health, Catholic University of Sacred Heart, Rome, Italy.
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Ricci L, Joly F, Coly A, Guillemin F, Quilliot D. Important issues in proposing autonomy training in home parenteral nutrition for short bowel syndrome patients: a qualitative insight from the patients' perspectives. Eur J Clin Nutr 2024:10.1038/s41430-024-01415-x. [PMID: 38424159 DOI: 10.1038/s41430-024-01415-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES The standard treatment for short bowel syndrome is home parenteral nutrition. Patients' strict adherence to protocols is essential to decrease the risk of complications such as infection or catheter thrombosis. Patient training can even result in complete autonomy in daily care. However, some patients cannot or do not want too much responsibility. However, doctors often encourage them to acquire these skills. Based on qualitative investigations with patients, we wanted to document issues of importance concerning perceptions of autonomy in daily care. METHODS Semistructured interviews were conducted with 13 adult patients treated by home parenteral nutrition using a maximum variation sampling strategy. We proceeded to a thematic analysis following an inductive approach. RESULTS After achieving clinical management of symptoms, a good quality of life is within the realm of possibility for short bowel syndrome patients with home parenteral nutrition. In this context, achieving autonomy in home parenteral nutrition could be a lever to sustain patients' quality of life by providing better life control. However, counterintuitively, not all patients aim at reducing constraints by reaching autonomy in home parenteral nutrition. First, they appreciate the social contact with the nurses, which is particularly true among patients who live alone. Second, they can feel safer with the nurse's visits. Regaining freedom was the main motivation for patients in the training program and the main benefit for those who were already autonomous. CONCLUSIONS Medical teams should consider patients' health locus of control (internal or external) for disease management to support them concerning the choice of autonomy in daily care for parenteral nutrition.
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Affiliation(s)
- Laetitia Ricci
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000, Nancy, France.
- Université de Lorraine, Inserm, INSPIIRE, F-54000, Nancy, France.
| | - Francisca Joly
- Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University of Paris Inserm UMR, 1149, Paris, France
| | - Alfa Coly
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000, Nancy, France
| | - Francis Guillemin
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000, Nancy, France
- Université de Lorraine, Inserm, INSPIIRE, F-54000, Nancy, France
| | - Didier Quilliot
- Department of Diabetology-Endocrinology-Nutrition, Brabois Hospital, Nancy University Hospital, 54511, Vandoeuvre-lès-Nancy, France
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Pironi L, Allard JP, Joly F, Geransar P, Genestin E, Pape UF. Use of teduglutide in adults with short bowel syndrome-associated intestinal failure. Nutr Clin Pract 2024; 39:141-153. [PMID: 37294295 DOI: 10.1002/ncp.11015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 03/24/2023] [Accepted: 04/24/2023] [Indexed: 06/10/2023] Open
Abstract
Short bowel syndrome (SBS) is a rare gastrointestinal disorder associated with intestinal failure (SBS-IF) and poor health-related outcomes. Patients with SBS-IF are unable to absorb sufficient nutrients or fluids to maintain significantly metabolic homeostasis via oral or enteral intake alone and require long-term intravenous supplementation (IVS), consisting of partial or total parenteral nutrition, fluids, electrolytes, or a combination of these. The goal of medical and surgical treatment for patients with SBS-IF is to maximize intestinal remnant absorptive capacity so that the need for IVS support may eventually be reduced or eliminated. Daily subcutaneous administration of the glucagon-like peptide 2 analog, teduglutide, has been shown to be clinically effective in reducing IVS dependence and potentially improving the health-related quality of life of patients with SBS-IF. The management of patients with SBS-IF is complex and requires close monitoring. This narrative review discusses the use of teduglutide for patients with SBS-IF in clinical practice. The screening of patient eligibility for teduglutide treatment, initiation, monitoring of efficacy and safety of treatment, adapting or weaning off IVS, and the healthcare setting needed for SBS-IF management are described, taking into consideration data from clinical trials, observational studies, and clinical experience.
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Affiliation(s)
- Loris Pironi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Centre for Chronic Intestinal Failure-Clinical Nutrition and Metabolism Unit, IRCCS AOUBO, Bologna, Italy
| | - Johane P Allard
- Division of Gastroenterology, Department of Medicine, Toronto General Hospital, Toronto, ON, Canada
| | - Francisca Joly
- Service de Gastro-entérologie, MICI et Assistance Nutritive, Université de Paris, Hôpital Beaujon, Centre de Référence des Maladies Digestives Rares, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Parnia Geransar
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | | | - Ulrich-Frank Pape
- Department of Internal Medicine and Gastroenterology, Asklepios Klinik St. Georg, Hamburg, Germany
- Department of Hepatology and Gastroenterology, Campus Virchow Klinikum and Charité Mitte, Berlin, Germany
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Franzoi MA, Aupomerol M, Havas J, Soldato D, Lambertini M, Massarotti C, Hang H, Pistilli B, Fasse L, Tredan O, Gillanders E, Joly F, Cottu P, Mouret-Reynier MA, Tarpin C, Arnaud A, Everhard S, Martin AL, Di Meglio A, Vaz-Luis I. Investigating sexual health after breast cancer by longitudinal assessment of patient-reported outcomes. ESMO Open 2024; 9:102236. [PMID: 38350335 PMCID: PMC10937197 DOI: 10.1016/j.esmoop.2024.102236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/28/2023] [Accepted: 01/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Sexual concerns are a major unaddressed need among survivors of breast cancer (BC) with significant negative effects on quality of life. We longitudinally analyzed sexual health over time, using patient-reported outcomes. METHODS Patients with stage I-III BC prospectively included from the CANcer TOxicity cohort (CANTO) provided data at diagnosis, then 1, 2, and 4 years afterward. Sexual concerns outcomes included poor body image (score ≤91/100), poor sexual functioning (≤16/100), poor sexual enjoyment (≤66/100), and sexual inactivity (EORTC QLQ-B23). Multivariate generalized estimating equation models assessed associations with sexual concerns after diagnosis, adjusting for age, sociodemographic, tumor, treatment, and clinical characteristics. RESULTS Nearly 78.1% among 7895 patients reported at least one sexual concern between diagnosis and 4 years' follow-up. Over time, the proportion of patients reporting sexual concerns either increased or remained constant with diagnosis. Less than half (46%, range 11.4-57) of the patients with sexual concerns reported the use of supportive care strategies, including gynecological or psychological consultations (range 11.4-57.4). Factors consistently associated with sexual concerns up to 4 years after diagnosis included already reporting the same concern at diagnosis [odds ratio (OR)poor body image 3.48 [95% confidence interval (CI) 3.11-3.89]; ORsexual inactivity 9.94 (95% CI 8.84-11.18), ORpoor sexual function 9.75 (95% CI 8.67-10.95), ORpoorsexual enjoyment 3.96 (95% CI 3.34-4.69)], endocrine therapy use [ORpoor body image 1.15 (95% CI 1.01-1.31); ORsexual inactivity 1.19 (95% CI 1.02-1.39), ORpoor sexual function 1.17 (95% CI 1.01-1.37), ORpoor sexual enjoyment 1.23 (95% CI 1.00-1.53)], and depression [ORpoor body image 2.00 (95% CI 1.72-2.34); ORsexual inactivity 1.66 (95% CI 1.40-1.97), ORpoor sexual function 1.69 (95% CI 1.43-2.00), ORpoor sexual enjoyment 1.94 (95% CI 1.50-2.51)]. Outcome-specific associations were also identified. CONCLUSIONS Sexual concerns seem frequent, persistent, and insufficiently addressed. Pretreatment concerns, endocrine therapy, and emotional distress are commonly associated factors. A proactive evaluation of sexual health across the care continuum is needed, to promptly identify patients suitable for multidisciplinary counseling, referral, and supportive interventions.
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Affiliation(s)
- M A Franzoi
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif.
| | - M Aupomerol
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - J Havas
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - D Soldato
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova; Gynecology Department, Policlinico San Martino, University of Genova, Genova; Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova
| | - C Massarotti
- Physiopatology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Health (DiNOGMI department), School of Medicine, University of Genova, Genova, Italy
| | - H Hang
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - B Pistilli
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - L Fasse
- Interdisciplinary and Patient Pathway Department, Institut Gustave Roussy, Villejuif
| | | | - E Gillanders
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - F Joly
- Centre François Baclesse, Caen
| | | | | | - C Tarpin
- Institut Paoli Calmettes, Marseille
| | | | | | | | - A Di Meglio
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
| | - I Vaz-Luis
- Breast Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy Institute, Villejuif
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Berger MM, Amrein K, Barazzoni R, Bindels L, Bretón I, Calder PC, Cappa S, Cuerda C, D'Amelio P, de Man A, Delzenne NM, Forbes A, Genton L, Gombart AF, Joly F, Laviano A, Matthys C, Phyo PP, Ravasco P, Serlie MJ, Shenkin A, Stoffel NU, Talwar D, van Zanten ARH. The science of micronutrients in clinical practice - Report on the ESPEN symposium. Clin Nutr 2024; 43:268-283. [PMID: 38104489 DOI: 10.1016/j.clnu.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 11/27/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND & AIMS The European Society for Clinical Nutrition and Metabolism published its first clinical guidelines for use of micronutrients (MNs) in 2022. A two-day web symposium was organized in November 2022 discussing how to apply the guidelines in clinical practice. The present paper reports the main findings of this symposium. METHODS Current evidence was discussed, the first day being devoted to clarifying the biology underlying the guidelines, especially regarding the definition of deficiency, the impact of inflammation, and the roles in antioxidant defences and immunity. The second day focused on clinical situations with high prevalence of MN depletion and deficiency. RESULTS The importance of the determination of MN status in patients at risk and diagnosis of deficiencies is still insufficiently perceived, considering the essential role of MNs in immune and antioxidant defences. Epidemiological data show that deficiencies of several MNs (iron, iodine, vitamin D) are a global problem that affects human health and well-being including immune responses such as to vaccination. Clinical conditions frequently associated with MN deficiencies were discussed including cancer, obesity with impact of bariatric surgery, diseases of the gastrointestinal tract, critical illness, and aging. In all these conditions, MN deficiency is associated with worsening of outcomes. The recurrent problem of shortage of MN products, but also lack of individual MN-products is a worldwide problem. CONCLUSION Despite important progress in epidemiology and clinical nutrition, numerous gaps in practice persist. MN depletion and deficiency are frequently insufficiently searched for in clinical conditions, leading to inadequate treatment. The symposium concluded that more research and continued education are required to improve patient outcome.
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Affiliation(s)
- Mette M Berger
- Lausanne University, Faculty of Biology & Medicine, 1005 Lausanne, Switzerland.
| | - Karin Amrein
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Laure Bindels
- Faculty of Pharmacy and Biomedical Sciences, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.
| | - Irene Bretón
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Stefano Cappa
- IUSS Cognitive Neuroscience (ICoN) Center, University School for Advanced Studies (IUSS-Pavia), 27100 Pavia, Italy.
| | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Patrizia D'Amelio
- Service de gériatrie et réadaptation gériatrique, Département de Médecine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Angélique de Man
- Department of Intensive Care Medicine, Research VUMC Intensive Care, Amsterdam Cardiovascular Science, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands.
| | - Nathalie M Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.
| | - Alastair Forbes
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
| | - Laurence Genton
- Clinical Nutrition Unit, Department of Endocrinology, Geneva University Hospitals, Geneva, Switzerland.
| | - Adrian F Gombart
- Linus Pauling Institute, Department of Biochemistry and Biophysics, Oregon State University, Corvallis, OR 97331, USA.
| | - Francisca Joly
- Beaujon Hospital, APHP, Clichy, University of Paris VII, France.
| | - Alessandro Laviano
- Department of Translational and Precision Medicine, University La Sapienza, Rome, Italy.
| | | | - Pyi Pyi Phyo
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, WHO Regional Office for Europe, Copenhagen, Denmark.
| | - Paula Ravasco
- Coordinator of the Curricular Units Diabetes, Obesity and Lifestyle, Digestion and Defence, University of Lisbon - Católica Medical School, Lisbon, Portugal.
| | - Mireille J Serlie
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Nicole U Stoffel
- Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, Switzerland; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.
| | - Dinesh Talwar
- Department of Biochemistry, Glasgow Royal Infirmary, Glasgow, UK.
| | - Arthur R H van Zanten
- Gelderse Vallei Hospital, Ede and Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
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Leroy G, Boettcher P, Joly F, Looft C, Baumung R. Multifunctionality and provision of ecosystem services by livestock species and breeds at global level. Animal 2024; 18:101048. [PMID: 38160592 DOI: 10.1016/j.animal.2023.101048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Beyond providing food, livestock species are linked to a wide range of uses and ecosystem services (ESs). Based on information reported by 41 countries on 3 361 national breed populations to the Domestic Animal Diversity Information System of the Food and Agriculture Organization of the United Nations, we investigated how factors such as species, region, breed adaptedness, or management system associate with the recognition of provision of a set of 52 ESs. Among species, a greater number of cultural ESs were reported for horses (2.47 for horses vs 0.75 on average across all species), while the major ruminant species (cattle, goats and sheep) were on average associated with more provisioning ESs (2.99 vs 2.39), and more regulating and maintenance ESs (1.86 vs 1.32). Compared to European breeds, African livestock contribute more provisioning ES (3.95 vs 1.88). Native breeds and, to a lesser extent, locally adapted breeds, were linked to more ESs than were exotic breeds (5.97 and 4.10 vs 2.90, respectively), regardless of the ES category considered. The total number of ES reported was greater for breeds primarily kept under Back Yard/Farm Yard and extensive management systems than in other production environments. Different "bundles" of ES were identified in relation to the interdependence among themselves, or according to species or regional specificities. Overall, our results highlight that native and locally adapted breeds, which tend to be raised in less specialized production systems than exotic breeds, are reported to play multiple roles contributing to rural community livelihoods and environmental sustainability of food systems.
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Affiliation(s)
- G Leroy
- Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153 Roma, Italy.
| | - P Boettcher
- Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153 Roma, Italy
| | - F Joly
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR Herbivores, 63122 Saint-Genès-Champanelle, France
| | - C Looft
- Neubrandenburg University of Applied Sciences, Brodaer Str. 2, Neubrandenburg, Germany
| | - R Baumung
- Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153 Roma, Italy
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Bourrienne MC, Ben Salah I, de Raucourt E, Debus J, Billiauws L, Cazals-Hatem D, Joly F, Trichet C. Pancytopenia related to acquired sea-blue histiocytosis during chronic parenteral nutrition. Am J Hematol 2023. [PMID: 38115676 DOI: 10.1002/ajh.27185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
Bone marrow smear showing histiocytes (black arrow) containing sea blue granules stained with May-Grünwald Giemsa.
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Affiliation(s)
- Marie-Charlotte Bourrienne
- Laboratoire d'Hématologie, Hôpital Bichat-Claude Bernard, AP-HP Nord Université de Paris, Paris, France
- INSERM, UMRS-1148, LVTS, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
| | - Imen Ben Salah
- Service d'Hématologie Biologique, Hôpital Beaujon, AP-HP Nord Université de Paris, Clichy, France
| | - Emmanuelle de Raucourt
- INSERM, UMRS-1148, LVTS, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
- Service d'Hématologie Biologique, Hôpital Beaujon, AP-HP Nord Université de Paris, Clichy, France
| | - Jérôme Debus
- Service d'Hématologie Biologique et Transfusion, Hôpital Louis-Mourier, AP-HP Nord Université de Paris, Colombes, France
| | - Lore Billiauws
- Department of Gastroenterology, IBD and Intestinal Failure, Hôpital Beaujon, F-92110 Clichy & Université Paris Cité, INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France
| | - Dominique Cazals-Hatem
- Département de Pathologie, Hôpital Beaujon, AP-HP Nord Université de Paris, Clichy, France
| | - Francisca Joly
- Department of Gastroenterology, IBD and Intestinal Failure, Hôpital Beaujon, F-92110 Clichy & Université Paris Cité, INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France
| | - Catherine Trichet
- Service d'Hématologie Biologique, Hôpital Beaujon, AP-HP Nord Université de Paris, Clichy, France
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Cohen M, Hounkonnou C, Billiauws L, Lecoq E, Villain C, Alvarado C, Joly F. Central venous catheter (CVC) salvage in case of central line-associated bloodstream infection (CLABSI): A monocentric prospective study in patients on long-term home parenteral nutrition (HPN). Clin Nutr ESPEN 2023; 58:89-96. [PMID: 38057041 DOI: 10.1016/j.clnesp.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/07/2023] [Accepted: 09/07/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIMS CLABSI is a major complication in HPN and frequently leads to central venous catheter (CVC) removal. We developed a salvaging attitude in long term HPN patients due to the necessity of venous preservation. The main objective of this study is to determine the prognosis of CLABSI. METHODS We followed-up for three months, in an approved HPN centre, a cohort of 250 adult patients receiving HPN with CLABSI from 2018 to 2020. CLABSI was defined by a blood culture growth differential [peripheral blood] - [CVC blood] ≥ 2h. A therapeutic approach to conserve CVC was established according to the department's protocol. The primary endpoint was conservation of CVC with negative CVC and peripheral blood cultures at 3 months without complications. RESULTS Data from 30 CLABSIs were collected for 22 HPN patients. The incidence rate of CLABSIs was 0.28 infections/1000 catheter days. Sixteen CVCs were removed immediately, with causes due to the type of germ (staphylococcus aureus: n = 6, candida parapsilosis: n = 4, klebsiella: n = 2), chronic colonization (n = 4) or initial complications (n = 4). Among the 14 non-removed CVC, 11 were maintained at 3 months with blood cultures on CVC and peripheral negative for 9 (80%) of them. 3 CVC were removed during the 3 months follow-up (non-CVC-related sepsis n = 2, and resistant pseudomonas aeruginosa n = 1). CONCLUSION The incidence rate of CLABSIs in an expert HPN centre remains low. In case of CLABSIs, according to specific protocol, approximately 50% of CVC were removed immediately (essentially due to bacteriological characteristics). In case of CLABSIs and without initial complication, 80% of CVCs can be maintained at 3 months. These results justify a conservative attitude according to standardized protocol.
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Affiliation(s)
- Mathilde Cohen
- Gastroenterology, MICI and Nutrition, MarDi Constitutive Centre, Beaujon Hospital, Clichy, France
| | - Cornelia Hounkonnou
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, CIC-EC 1425, F-75018 Paris, France; Department of Epidemiology Biostatistics and Clinical Research, APHP, Bichat Hospital, Paris, France
| | - Lore Billiauws
- Gastroenterology, MICI and Nutrition, MarDi Constitutive Centre, Beaujon Hospital, University of Paris, INSERM UMR1149, France
| | - Emilie Lecoq
- Gastroenterology, MICI and Nutrition, MarDi Constitutive Centre, APHP, Beaujon Hospital, Clichy, France
| | - Claude Villain
- Gastroenterology, MICI and Nutrition, MarDi Constitutive Centre, APHP, Beaujon Hospital, Clichy, France
| | - Cathy Alvarado
- Gastroenterology, MICI and Nutrition, MarDi Constitutive Centre, APHP, Beaujon Hospital, Clichy, France
| | - Francisca Joly
- Gastroenterology, MICI and Nutrition, MarDi Constitutive Centre, Beaujon Hospital, University of Paris, INSERM UMR1149, France.
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Fourati S, de Dreuille B, Bettolo J, Hutinet C, Le Gall M, Bado A, Joly F, Le Beyec J. Hyperphagia is prominent in adult patients with short bowel syndrome: A role for the colon? Clin Nutr 2023; 42:2109-2115. [PMID: 37751660 DOI: 10.1016/j.clnu.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/24/2023] [Accepted: 09/03/2023] [Indexed: 09/28/2023]
Abstract
RATIONALE Short Bowel Syndrome (SBS) is the major cause of chronic intestinal failure (IF) and requires parenteral nutrition (PN). After bowel resection, some patients develop spontaneous intestinal adaptations and hyperphagia. Since promoting oral energy intake contributes to PN weaning, this study aims to characterize hyperphagia in patients with SBS and identify its determinants. METHODS This observational retrospective study included adult patients with SBS who were followed at an expert PN center between 2006 and 2019, with at least 2 separate nutritional assessments. Exclusion criteria were: active neoplasia, alternative treatment for IF or appetite-affecting medication. Resting energy expenditure (REE) was calculated for each patient using the Harris-Benedict equation. Food Intake Ratio (FIR) was calculated by dividing the highest caloric oral intake by REE and hyperphagia was defined as FIR >1.5. RESULTS Among the 59 patients with SBS included in this study, 82.6% had a FIR >1.5, including 15.5% with a FIR >3. Protein supplied approximately 16% of total energy intake while fat and carbohydrates provided 36% and 48%, respectively. The FIR was independent of gender and whether patients received oral nutrition alone (n = 28) or combined with PN (n = 31). The FIR was also not associated with residual small bowel length, nor the proportion of preserved colon. However, it was negatively correlated with the body mass index (BMI) of these patients (r = -0.533, p < 0.001), whether they had PN support or not. Patients with either a jejuno-colonic (n = 31) or a jejuno-ileal anastomosis (n = 9), had a significantly higher FIR compared to those with an end-jejunostomy (n = 18) (p < 0.05). However, no difference was found in the proportion of calories provided by protein, fat and carbohydrate between the 3 patients groups divided according to the SBS anatomical type. CONCLUSION A large majority of patients with SBS exhibited a hyperphagia regardless of PN dependence or bowel length, which was inversely correlated with BMI. The presence of the colon in continuity, thus in contact with the nutritional flow, seems to favor a higher oral intake which is beneficial for the nutritional autonomy of patients. This raises the question of a role of colonic microbiota and hormones in this behavior. Finally, this study also revealed an unexpected discrepancy between recommended energy intakes from protein, fat and carbohydrate and the actual intake of patients with SBS.
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Affiliation(s)
- Salma Fourati
- UMR-S 1149 Centre de Recherche sur l'Inflammation Inserm, Université Paris Cité, 75018 Paris, France; Service de Biochimie Endocrinienne et Oncologique, Hôpital de la Pitié-Salpêtrière-Charles Foix, Sorbonne Université, 75013 Paris, France.
| | - Brune de Dreuille
- UMR-S 1149 Centre de Recherche sur l'Inflammation Inserm, Université Paris Cité, 75018 Paris, France
| | - Joanna Bettolo
- Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University of Paris Inserm UMR 1149, Paris, France
| | - Coralie Hutinet
- Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University of Paris Inserm UMR 1149, Paris, France
| | - Maude Le Gall
- UMR-S 1149 Centre de Recherche sur l'Inflammation Inserm, Université Paris Cité, 75018 Paris, France
| | - André Bado
- UMR-S 1149 Centre de Recherche sur l'Inflammation Inserm, Université Paris Cité, 75018 Paris, France
| | - Francisca Joly
- UMR-S 1149 Centre de Recherche sur l'Inflammation Inserm, Université Paris Cité, 75018 Paris, France; Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University of Paris Inserm UMR 1149, Paris, France
| | - Johanne Le Beyec
- UMR-S 1149 Centre de Recherche sur l'Inflammation Inserm, Université Paris Cité, 75018 Paris, France; Service de Biochimie Endocrinienne et Oncologique, Hôpital de la Pitié-Salpêtrière-Charles Foix, Sorbonne Université, 75013 Paris, France
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10
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Joly F, Nuzzo A, Bozzetti F, Cuerda C, Jeppesen PB, Lal S, Lamprecht G, Mundi M, Szczepanek K, Van Gossum A, Wanten G, Pironi L. A multi-national survey of experience and attitudes towards managing catheter related blood stream infections for home parenteral nutrition. Clin Nutr ESPEN 2023; 57:126-130. [PMID: 37739646 DOI: 10.1016/j.clnesp.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/08/2023] [Accepted: 06/23/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND AND AIMS Catheter-related bloodstream infection (CRBSI) is the most common complication of home parenteral nutrition (HPN) in patients with chronic intestinal failure (CIF). The aim of this study was to assess the broad range of practices of international multi-disciplinary teams involved in the care of this complication occurring in CIF patients. DESIGN An online questionnaire was designed and distributed to members of the European Society for Clinical Nutrition and Metabolism (ESPEN) and distributed to colleagues involved in managing patients with CIF. RESULTS A total of 47 responses were included from centers across 21 countries. The centers had been delivering HPN for a median 21 years (IQR 11-35) and were actively following a median 58 patients (27-120) per center for benign CIF in 80% of cases (67-95). Tunneled catheters were the most common type of central venous catheters (CVC), representing 70% (47-86) of all CVC in use. For the management of CRBSI, written procedures were provided in 87% of centers. First measures included simultaneous central and peripheral blood cultures (90%), stopping HPN infusion (74%), and administrating an antibiotic lock and systemic antibiotics (44%). Immediate removal of the CVC was more likely in case of fungal infection (78%), Staphylococcus aureus (53%), or in case of PICC catheter (52%) (all p < 0.01). After the first CRBSI, 80% of centers used preventive CVC locks (taurolidine in 84% of cases, p < 0.001). We observed a large heterogeneity in practices regarding preparation, duration, reaspiration, and volume of CVC locks, and monitoring of CRBSI (timing of blood cultures, radiological work-up). CONCLUSION In this international survey of HPN expert centers, we observed a significant consensus regarding the initial management of CRBSI and the use of secondary preventive CVC locks, while areas of variation exist. Management of CRBSI may be improved with clearer recommendations based on the micro-organism and the type of CVC, including PICC lines which are increasingly used yet insufficiently studied in HPN patients.
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Affiliation(s)
- Francisca Joly
- Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University Paris Cité, Inserm UMR, Paris 1149, France.
| | - Alexandre Nuzzo
- Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University Paris Cité, Inserm UMR, Paris 1149, France
| | | | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Palle B Jeppesen
- Department of Intestinal Failure and Liver Diseases, Rigshospitalet, Inge Lehmanns Vej 5 Opgang 3, 12. Og 16, Sal 2100, København Ø, Denmark
| | - Simon Lal
- Gastroenterology, Salford Royal & University of Manchester, UK
| | - Georg Lamprecht
- Department of Medicine II, Division of Gastroenterology and Endocrinology, Rostock University, Medical Center, Rostock, Germany
| | - Manpreet Mundi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Kinga Szczepanek
- General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
| | - André Van Gossum
- Department of Gastroenterology and Clinical Nutrition, Hopital Erasme/Institut Bordet Brussels, Belgium
| | - Geert Wanten
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Loris Pironi
- Alma Mater Studiorum -University of Bologna, Department of Medical and Surgical Sciences, Italy IRCCS Azienda Ospedaliero-Universitaria di Bologna, Centre for Chronic Intestinal Failure - Clinical Nutrition and Metabolism Unit, Italy
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11
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Pironi L, Cuerda C, Jeppesen PB, Joly F, Jonkers C, Krznarić Ž, Lal S, Lamprecht G, Lichota M, Mundi MS, Schneider SM, Szczepanek K, Van Gossum A, Wanten G, Wheatley C, Weimann A. ESPEN guideline on chronic intestinal failure in adults - Update 2023. Clin Nutr 2023; 42:1940-2021. [PMID: 37639741 DOI: 10.1016/j.clnu.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 07/21/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND & AIMS In 2016, ESPEN published the guideline for Chronic Intestinal Failure (CIF) in adults. An updated version of ESPEN guidelines on CIF due to benign disease in adults was devised in order to incorporate new evidence since the publication of the previous ESPEN guidelines. METHODS The grading system of the Scottish Intercollegiate Guidelines Network (SIGN) was used to grade the literature. Recommendations were graded according to the levels of evidence available as A (strong), B (conditional), 0 (weak) and Good practice points (GPP). The recommendations of the 2016 guideline (graded using the GRADE system) which were still valid, because no studies supporting an update were retrieved, were reworded and re-graded accordingly. RESULTS The recommendations of the 2016 guideline were reviewed, particularly focusing on definitions, and new chapters were included to devise recommendations on IF centers, chronic enterocutaneous fistulas, costs of IF, caring for CIF patients during pregnancy, transition of patients from pediatric to adult centers. The new guideline consist of 149 recommendations and 16 statements which were voted for consensus by ESPEN members, online in July 2022 and at conference during the annual Congress in September 2022. The Grade of recommendation is GPP for 96 (64.4%) of the recommendations, 0 for 29 (19.5%), B for 19 (12.7%), and A for only five (3.4%). The grade of consensus is "strong consensus" for 148 (99.3%) and "consensus" for one (0.7%) recommendation. The grade of consensus for the statements is "strong consensus" for 14 (87.5%) and "consensus" for two (12.5%). CONCLUSIONS It is confirmed that CIF management requires complex technologies, multidisciplinary and multiprofessional activity, and expertise to care for the underlying gastrointestinal disease and to provide HPN support. Most of the recommendations were graded as GPP, but almost all received a strong consensus.
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Affiliation(s)
- Loris Pironi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Center for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy.
| | - Cristina Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Francisca Joly
- Center for Intestinal Failure, Department of Gastroenterology and Nutritional Support, Hôpital Beaujon, Clichy, France
| | - Cora Jonkers
- Nutrition Support Team, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Željko Krznarić
- Center of Clinical Nutrition, Department of Medicine, University Hospital Center, Zagreb, Croatia
| | - Simon Lal
- Intestinal Failure Unit, Salford Royal Foundation Trust, Salford, United Kingdom
| | | | - Marek Lichota
- Intestinal Failure Patients Association "Appetite for Life", Cracow, Poland
| | - Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Kinga Szczepanek
- General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
| | | | - Geert Wanten
- Intestinal Failure Unit, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Carolyn Wheatley
- Support and Advocacy Group for People on Home Artificial Nutrition (PINNT), United Kingdom
| | - Arved Weimann
- Department of General, Visceral and Oncological Surgery, St. George Hospital, Leipzig, Germany
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Fourati S, Hamon A, Daclat R, Salem JE, Peoc’h K, Le Beyec J, Joly F, Lacorte JM. Circulating Apolipoprotein B-48 as a Biomarker of Parenteral Nutrition Dependence in Adult Patients with Short Bowel Syndrome. Nutrients 2023; 15:3982. [PMID: 37764766 PMCID: PMC10536633 DOI: 10.3390/nu15183982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Short bowel syndrome (SBS) is a rare but serious condition that may lead to chronic intestinal failure. Citrulline concentrations are currently used to reflect the residual intestinal mass in patients with SBS, although this method has several limitations. In a cohort of patients with SBS, we quantified apolipoprotein B-48 (ApoB-48), which is exclusively synthesized by enterocytes and secreted associated with dietary lipids and investigated the relationship between ApoB-48 and clinical and biological data as well as PN dependence. A total of 51 adult patients were included, 36 of whom were PN-dependent. We found a robust positive correlation between circulating ApoB-48 and residual small bowel length, which was also found in the subgroup of patients with jejunocolic anastomosis. Fasting ApoB-48 levels were significantly lower in PN-dependent patients than in PN-weaned patients and negatively correlated with parenteral nutrition dependence. Our results suggest that ApoB-48 could be proposed as a marker of intestinal absorptive function and could be an interesting follow-up marker in patients with SBS.
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Affiliation(s)
- Salma Fourati
- Service de Biochimie Endocrinienne et Oncologique, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, UMR-S 1149 Centre de Recherche sur l’Inflammation Inserm, Paris Cité University, 75013 Paris, France
| | - Annick Hamon
- Department of Gastroenterology, IBD and Nutrition Support, CRMR MarDi, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, 92110 Clichy, France
| | - Rita Daclat
- UMR_S1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition Inserm, Pitié-Salpêtrière Hospital, Sorbonne University, 75013 Paris, France
| | - Joe-Elie Salem
- Department of Pharmacology and Clinical Investigation Centre (CIC-1901), Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, INSERM, 75013 Paris, France
| | - Katell Peoc’h
- Department of Biochemistry, CRI INSERM UMR1149, HUPNVS, Assistance Publique-Hôpitaux de Paris, Paris Cité University, 75018 Paris, France
| | - Johanne Le Beyec
- Service de Biochimie Endocrinienne et Oncologique, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, UMR-S 1149 Centre de Recherche sur l’Inflammation Inserm, Sorbonne University, 75013 Paris, France;
| | - Francisca Joly
- Department of Gastroenterology, IBD and Nutrition Support, CRMR MarDi, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, 92110 Clichy, UMR-S 1149 Centre de Recherche sur l’Inflammation Inserm, Université Paris Cité, 75018 Paris, France;
| | - Jean-Marc Lacorte
- Service de Biochimie Endocrinienne et Oncologique, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Research Unit on Cardiovascular and Metabolic Disease, UMR ICAN, Sorbonne University, Inserm, 75013 Paris, France;
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El Khatib M, Billiauws L, Joly F. The indications and results of the use of teduglutide in patients with short bowel. Curr Opin Clin Nutr Metab Care 2023:00075197-990000000-00096. [PMID: 37421385 DOI: 10.1097/mco.0000000000000964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
Short bowel syndrome (SBS) is a rare condition defined as a reduced residual functional small intestinal length to less than 200 cm often resulting from extensive intestinal resection, and can lead to chronic intestinal failure (CIF). Patients with SBS-CIF are unable to absorb sufficient nutrients or fluids to maintain metabolic homeostasis through oral or enteral intake and require long-term parenteral nutrition and/or fluids and electrolytes. However, complications may arise from both SBS-IF and life-sustaining intravenous support, such as intestinal failure-associated liver disease (IFALD), chronic renal failure, metabolic bone disease and catheter-related complications. An interdisciplinary approach is required to optimize intestinal adaptation and decrease complications. In the last two decades, glucagon-like peptide 2 (GLP-2) analogs have sparked pharmacological interest as a potential disease-modifying therapy for SBS-IF. Teduglutide (TED) is the first developed and marketed GLP-2 analog for SBS-IF. It is approved in the United States, Europe, and Japan for use in adults and children with SBS-IF who are intravenous supplementation dependent. This article discusses the indications, candidacy criteria and results of the use of TED in patients with SBS.
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Affiliation(s)
- Myriam El Khatib
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, Clichy
| | - Lore Billiauws
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, Clichy
- Laboratory of Plasticity of Gastrointestinal Mucosa in Nutritional Pathologies and After Surgery, University of Paris, Paris
| | - Francisca Joly
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, Clichy
- Laboratory of Plasticity of Gastrointestinal Mucosa in Nutritional Pathologies and After Surgery, University of Paris, Paris
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de Dreuille B, Cazals-Hatem D, Ronot M, Theou-Anton N, Dermine S, Le Beyec-Le Bihan J, Billiauws L, Le Gall M, Bado A, Joly F. Unexpected upper gastrointestinal polyps in patients with short bowel syndrome treated with teduglutide: need for close monitoring. Am J Clin Nutr 2023; 117:1143-1151. [PMID: 37270288 DOI: 10.1016/j.ajcnut.2023.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Teduglutide is a GLP-2 analog indicated for the treatment of short bowel syndrome (SBS) since 2015. Its efficacy in reducing parenteral nutrition (PN) has been shown in patients with SBS. OBJECTIVES Because teduglutide is a trophic factor, the aim of this study was to assess risk of developing polypoid intestinal lesions during treatment. METHODS A retrospective study was conducted in 35 patients with SBS treated with teduglutide for ≥1 y in a home PN expert center. All patients underwent ≥1 follow-up intestinal endoscopy during treatment. RESULTS In the 35 patients, the small bowel length was 74 cm (IQR: 25-100), and 23 patients (66%) had a colon in continuity. Upper and lower gastrointestinal endoscopy was performed after a mean treatment duration of 23 mo (IQR: 13-27), and polypoid lesions were found in 10 patients (6 with a colon in continuity, 4 with an end jejunostomy) and no lesion in 25 patients. In 8 out of the 10 patients, the lesion was found in the small bowel. Five of these lesions presented an aspect of hyperplastic polyp without dysplasia, and 3 of a traditional adenoma with low-grade dysplasia. CONCLUSIONS Our study highlights the importance of performing follow-up upper and lower gastrointestinal endoscopy in SBS patients treated with teduglutide and the potential need to make changes to the recommendations with respect to treatment initiation and follow-up.
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Affiliation(s)
- Brune de Dreuille
- Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France
| | | | - Maxime Ronot
- Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France; Radiology Department, Hôpital Beaujon, Clichy, France
| | | | - Solène Dermine
- Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France
| | - Johanne Le Beyec-Le Bihan
- Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France; Endocrine and Oncological Biochemistry Department, Hôpital Pitié-Salpêtrière, Paris, France
| | - Lore Billiauws
- Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France
| | - Maude Le Gall
- Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France
| | - André Bado
- Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France
| | - Francisca Joly
- Gastroenterology and Nutritional Support Department, Hôpital Beaujon, Clichy, France; Université Paris Cité, Inserm UMR, Centre de Recherche sur l'Inflammation, Paris, France.
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de Dreuille B, Nuzzo A, Bataille J, Mailhat C, Billiauws L, Le Gall M, Joly F. Post-Marketing Use of Teduglutide in a Large Cohort of Adults with Short Bowel Syndrome-Associated Chronic Intestinal Failure: Evolution and Outcomes. Nutrients 2023; 15:nu15112448. [PMID: 37299413 DOI: 10.3390/nu15112448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Teduglutide, a GLP-2 analogue, has been available in France since 2015 to treat short-bowel-syndrome (SBS)-associated chronic intestinal failure (CIF) but it remains very expensive. No real-life data on the number of potential candidates are available. The aim of this real-life study was to assess teduglutide initiation and outcomes in SBS-CIF patients. All SBS-CIF patients cared for in an expert home parenteral support (PS) center between 2015 and 2020 were retrospectively included. Patients were divided into two subpopulations: prevalent patients, already cared for in the center before 2015, and incident patients, whose follow-up started between 2015 and 2020. A total of 331 SBS-CIF patients were included in the study (156 prevalent and 175 incident patients). Teduglutide was initiated in 56 patients (16.9% of the cohort); in 27.9% of prevalent patients and in 8.0% of incident patients, with a mean annual rate of 4.3% and 2.5%, respectively. Teduglutide allowed a reduction in the PS volume by 60% (IQR: 40-100), with a significantly higher reduction in incident versus prevalent patients (p = 0.02). The two- and five-year treatment retention rates were 82% and 64%. Among untreated patients, 50 (18.2%) were considered ineligible for teduglutide for non-medical reasons. More than 25% of prevalent SBS patients were treated with teduglutide compared to 8% of incident patients. The treatment retention rate was >80% at 2 years, which could be explained by a careful selection of patients. Furthermore, this real-life study confirmed the long-term efficacy of teduglutide and showed a better response to teduglutide in incident patients, suggesting a benefit in early treatment.
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Affiliation(s)
- Brune de Dreuille
- Department of Gastroenterology and Nutrition Support, Hôpital Beaujon (AP-HP), 92110 Clichy, France
- Inserm UMR 1149, Centre de Recherche sur l'Inflammation, Université Paris Cité, 75018 Paris, France
| | - Alexandre Nuzzo
- Department of Gastroenterology and Nutrition Support, Hôpital Beaujon (AP-HP), 92110 Clichy, France
- Inserm UMR 1148, Laboratoire de Recherche Vasculaire Translationnelle, Université Paris Cité, 75018 Paris, France
| | - Julie Bataille
- Pharmacy Department, Hôpital Beaujon (AP-HP), 92110 Clichy, France
| | - Charlotte Mailhat
- GETAID (Groupe d'Étude Thérapeutique des Affections Inflammatoires du Tube Digestif), 75009 Paris, France
| | - Lore Billiauws
- Department of Gastroenterology and Nutrition Support, Hôpital Beaujon (AP-HP), 92110 Clichy, France
- Inserm UMR 1149, Centre de Recherche sur l'Inflammation, Université Paris Cité, 75018 Paris, France
| | - Maude Le Gall
- Inserm UMR 1149, Centre de Recherche sur l'Inflammation, Université Paris Cité, 75018 Paris, France
| | - Francisca Joly
- Department of Gastroenterology and Nutrition Support, Hôpital Beaujon (AP-HP), 92110 Clichy, France
- Inserm UMR 1149, Centre de Recherche sur l'Inflammation, Université Paris Cité, 75018 Paris, France
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Rodari MM, Cazals-Hatem D, Uzzan M, Martin Silva N, Khiat A, Ta MC, Lhermitte L, Touzart A, Hanein S, Rouillon C, Joly F, Elmorjani A, Steffann J, Cerf-Bensussan N, Parlato M, Charbit-Henrion F. Insights into the expanding intestinal phenotypic spectrum of SOCS1 haploinsufficiency and therapeutic options. J Clin Immunol 2023:10.1007/s10875-023-01495-7. [PMID: 37156989 DOI: 10.1007/s10875-023-01495-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE Hyper activation of the JAK-STAT signaling underlies the pathophysiology of many human immune-mediated diseases. Herein, the study of 2 adult patients with SOCS1 haploinsufficiency illustrates the severe and pleomorphic consequences of its impaired regulation in the intestinal tract. METHODS Two unrelated adult patients presented with gastrointestinal manifestations, one with Crohn's disease-like ileo-colic inflammation refractory to anti-TNF and the other with lymphocytic leiomyositis causing severe chronic intestinal pseudo-occlusion. Next-generation sequencing was used to identify the underlying monogenic defect. One patient received anti-IL-12/IL-23 treatment while the other received the JAK1 inhibitor, ruxolitinib. Peripheral blood, intestinal tissues, and serum samples were analyzed before-and-after JAK1 inhibitor therapy using mass cytometry, histology, transcriptomic, and Olink assay. RESULTS Novel germline loss-of-function variants in SOCS1 were identified in both patients. The patient with Crohn-like disease achieved clinical remission with anti-IL-12/IL-23 treatment. In the second patient with lymphocytic leiomyositis, ruxolitinib induced rapid resolution of the obstructive symptoms, significant decrease of the CD8+ T lymphocyte muscular infiltrate, and normalization of serum and intestinal cytokines. Decreased frequencies of circulating Treg cells, MAIT cells, and NK cells, with altered CD56bright:CD16lo:CD16hi NK subtype ratios were not modified by ruxolitinib. CONCLUSION SOCS1 haploinsufficiency can result in a broad spectrum of intestinal manifestations and need to be considered as differential diagnosis in cases of severe treatment-refractory enteropathies, including the rare condition of lymphocytic leiomyositis. This provides the rationale for genetic screening and considering JAK inhibitors in such cases.
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Affiliation(s)
- Marco M Rodari
- Université Paris-Cité, Institut Imagine, Laboratory of Intestinal Immunity, INSERM U1163, Paris, France
| | - Dominique Cazals-Hatem
- Department of Pathology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Mathieu Uzzan
- Department of Gastroenterology, IBD unit, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
- Paris Est Créteil University UPEC, Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Hospital, Gastroenterology department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, F-94010, Créteil, France
| | | | - Anis Khiat
- Université Paris-Cité, Institut Imagine, Laboratory of Intestinal Immunity, INSERM U1163, Paris, France
| | - Minh Chau Ta
- Department of Pathology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Ludovic Lhermitte
- Université Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151, Paris, France
| | - Aurore Touzart
- Université Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151, Paris, France
- Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Sylvain Hanein
- Bioinformatic Platform, Institute of Genetic Diseases, INSERM UMR1163, Imagine, Université Paris-Cité and Structure Fédérative de Recherche Necker, 75015, Paris, France
| | - Cléa Rouillon
- Department of Gastroenterology, Caen University Hospital, Caen, France
| | - Francisca Joly
- Department of Gastroenterology, IBD unit, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Adrienne Elmorjani
- Genomic Medecine of Rare Diseases, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Julie Steffann
- Genomic Medecine of Rare Diseases, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nadine Cerf-Bensussan
- Université Paris-Cité, Institut Imagine, Laboratory of Intestinal Immunity, INSERM U1163, Paris, France
| | - Marianna Parlato
- Université Paris-Cité, Institut Imagine, Laboratory of Intestinal Immunity, INSERM U1163, Paris, France.
| | - Fabienne Charbit-Henrion
- Université Paris-Cité, Institut Imagine, Laboratory of Intestinal Immunity, INSERM U1163, Paris, France.
- Genomic Medecine of Rare Diseases, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.
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17
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Wauters L, Joly F. Treatment of short bowel syndrome: Breaking the therapeutic ceiling? Nutr Clin Pract 2023; 38 Suppl 1:S76-S87. [PMID: 37115030 DOI: 10.1002/ncp.10974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/26/2023] [Accepted: 02/04/2023] [Indexed: 04/29/2023] Open
Abstract
Short bowel syndrome (SBS) is the most common cause of chronic intestinal failure, requiring home parenteral support (intravenous fluid, parenteral nutrition, or parenteral nutrition with intravenous fluid) to compensate for severe malabsorption. The loss of mucosal absorptive area after extensive intestinal resection is accompanied by an accelerated transit and hypersecretion. Changes in physiology and clinical outcomes differ between patients with SBS with or without the distal ileum and/or colon-in-continuity. This narrative review summarizes the treatments used in SBS, with a focus on novel approaches with intestinotrophic agents. During the early postoperative years, spontaneous adaptation occurs and can be induced or accelerated with conventional therapies, which include dietary and fluid modifications and antidiarrheal and antisecretory drugs. Based on the proadaptive role of enterohormones (eg, glucagon-like peptide [GLP]-2), analogues have been developed to allow enhanced or hyperadaptation after a period of stabilization. Teduglutide is the first GLP-2 analogue developed and commercialized with proadaptive effects resulting in reduced parenteral support needs; however, the potential for weaning of parenteral support is variable. Whether early treatment with enterohormones or accelerated hyperadaptation would further improve absorption and outcomes remains to be shown. Longer-acting GLP-2 analogues are currently being investigated. Encouraging reports with GLP-1 agonists require confirmation in randomized trials, and dual GLP-1 and GLP-2 analogues have yet to be clinically investigated. Future studies will prove whether the timing and/or combinations of different enterohormones will be able to break the ceiling of intestinal rehabilitation in SBS.
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Affiliation(s)
- Lucas Wauters
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- Department of Gastroenterology and Nutrition Support, Assistance Publique des Hopitaux de Paris, University of Paris, Clichy, France
| | - Francisca Joly
- Department of Gastroenterology and Nutrition Support, Assistance Publique des Hopitaux de Paris, University of Paris, Clichy, France
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18
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De Dreuille B, Hutinet C, Bettolo J, Mailhat C, Bouhnik Y, Le Gall M, Bado A, Joly F. Impact Of Food Intake On The Efficacy Of Teduglutide Treatment In Adult Patients With Short Bowel Syndrome. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Fourati S, De Dreuille B, Hutinet C, Bettolo J, Bado A, Le Gall M, Joly F, Le-Beyec J. Determinants Of Hyperphagia In Patients With Short Bowel Syndrome. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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20
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De Dreuille B, Nicolle R, Cazals-Hatem D, Cros J, Bado A, Le Beyec-Le Bihan J, Le Gall M, Joly F. Glp-2 Modulated Genes In Adult Patients With Short Bowel Syndrome Treated With Teduglutide. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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21
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Pape UF, Zhang P, Allard J, Genestin E, Gondolesi G, Jeppesen P, Joly F, Mason J, Pironi L, Schwartz L, Virgili Casas M. Long-Term Effectiveness Of Teduglutide Treatment In Adult Patients With Short Bowel Syndrome And Intestinal Failure. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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22
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Wauters L, Dermine S, de Dreuille B, Bettolo J, Hutinet C, Lecoq E, Billiauws L, Nuzzo A, Stefanescu C, Treton X, Corcos O, Bouhnik Y, Joly F. Malnutrition Is Common After Weaning Off Parenteral Nutrition In Patients With Short Bowel Syndrome. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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23
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Joly F, Nuzzo A, Cuerda C, Jeppesen P, Lal S, Lamprecht G, Manpreet M, Szczepanek K, Van Gossum A, Wanten G, Pironi L. A Multi-National Survey Of Experience And Attitudes Towards Managing Catheter Related Blood Stream Infection During Hpn. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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24
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Bond A, Allan P, Conley TE, Farrer K, Mackillop L, Bozzetti F, Cuerda C, Jeppesen P, Joly F, Lamprecht G, Mundi M, Szczepanek K, Van Gossum A, Wanten G, Pironi L, Lal S. Experience and opinions relating to pregnancy in patients with chronic intestinal failure: an international survey. Frontline Gastroenterol 2023; 14:377-383. [PMID: 37581192 PMCID: PMC10423604 DOI: 10.1136/flgastro-2023-102384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/09/2023] [Indexed: 08/16/2023] Open
Abstract
Introduction Pregnancy in patients with chronic intestinal failure (CIF) is a relatively rare occurrence but is an important contemporary topic given both the increasing use of home parenteral nutrition (HPN) and the demographics of patients with CIF. Method An opinion-based survey was produced in a multidisciplinary manner, which was then distributed internationally, via the European Society for Clinical Nutrition and Metabolism network, using a web-based survey tool for healthcare professionals with a specialist interest in the management of CIF. Results Seventy specialists from 11 countries completed the survey. Fifty-four per cent of the respondents reported some experience of managing pregnancy in patients with CIF. However, 60% stated that they did not feel that it was their role to discuss the topic of pregnancy with their patients, with fewer than 10% stating that they routinely did so. Respondents felt that an individualised approach was required when considering alterations to parenteral support prior to conception, during pregnancy and in the postnatal period. Most respondents also felt there was no increased risk of catheter-related blood stream infections, while catheter-related thrombosis was deemed to be the most significant HPN-related complication for pregnant women. Conclusion This study reports a variable experience, knowledge and confidence of healthcare professionals when considering pregnancy in patients with CIF. The risk of HPN-related complication was felt to be greater during pregnancy, with an individualised approach being the preferred route for most aspects of care. The findings support the need for an international registry and subsequent consensus guidelines for the management of pregnancy in CIF.
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Affiliation(s)
- Ashley Bond
- Intestinal Failure, Salford Royal NHS Foundation Trust, Salford, UK
- School of Medical Sciences, University of Manchester, Manchester, UK
| | - Philip Allan
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK
| | | | - Kirstine Farrer
- Intestinal Failure, Salford Royal NHS Foundation Trust, Salford, UK
| | - Lucy Mackillop
- Obstetrics and Gynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | - Palle Jeppesen
- Department of Intestinal Failure and Liver Diseases, Rigshospitalet, Kobenhavn, Denmark
| | | | - Georg Lamprecht
- Gastroenterology and Endocrinology, Rostock University Medical Center, Rostock, Mecklenburg-Vorpommern, Germany
| | - Manpreet Mundi
- Division of Endocrinology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kinga Szczepanek
- Multi-Disciplinary Hospital named after Stanley Dudrick in Skawina, Skawina, Poland
| | | | - Geert Wanten
- Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Loris Pironi
- Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy
| | - Simon Lal
- Intestinal Failure, Salford Royal NHS Foundation Trust, Salford, UK
- School of Medical Sciences, University of Manchester, Manchester, UK
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25
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Bischoff SC, Bager P, Escher J, Forbes A, Hébuterne X, Hvas CL, Joly F, Klek S, Krznaric Z, Ockenga J, Schneider S, Shamir R, Stardelova K, Bender DV, Wierdsma N, Weimann A. ESPEN guideline on Clinical Nutrition in inflammatory bowel disease. Clin Nutr 2023; 42:352-379. [PMID: 36739756 DOI: 10.1016/j.clnu.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 01/15/2023]
Abstract
The present guideline is an update and extension of the ESPEN scientific guideline on Clinical Nutrition in Inflammatory Bowel Disease published first in 2017. The guideline has been rearranged according to the ESPEN practical guideline on Clinical Nutrition in Inflammatory Bowel Disease published in 2020. All recommendations have been checked and, if needed, revised based on new literature, before they underwent the ESPEN consensus procedure. Moreover, a new chapter on microbiota modulation as a new option in IBD treatment has been added. The number of recommendations has been increased to 71 recommendations in the guideline update. The guideline is aimed at professionals working in clinical practice, either in hospitals or in outpatient medicine, and treating patients with IBD. General aspects of care in patients with IBD, and specific aspects during active disease and in remission are addressed. All recommendations are equipped with evidence grades, consensus rates, short commentaries and links to cited literature.
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Affiliation(s)
- Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Palle Bager
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
| | - Johanna Escher
- Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.
| | - Alastair Forbes
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
| | - Xavier Hébuterne
- Department of Gastroenterology and Clinical Nutrition, CHU of Nice, University Côte d'Azur, Nice, France.
| | - Christian Lodberg Hvas
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
| | - Francisca Joly
- Department of Gastroenterology and Nutrition Support, CHU de Beaujon, APHP, University of Paris, Paris, France.
| | - Stansilaw Klek
- Surgical Oncology Clinic, Maria Sklodowska-Curie National Cancer Institute, Krakow, Poland.
| | - Zeljko Krznaric
- Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre Zagreb, University of Zagreb, Croatia.
| | - Johann Ockenga
- Medizinische Klinik II, Klinikum Bremen-Mitte, Bremen FRG, Bremen, Germany.
| | - Stéphane Schneider
- Department of Gastroenterology and Clinical Nutrition, CHU de Nice, University Côte d'Azur, Nice, France.
| | - Raanan Shamir
- Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Kalina Stardelova
- University Clinic for Gastroenterohepatology, Clinical Campus "Mother Theresa", University St Cyrul and Methodius, Skopje, North Macedonia.
| | - Darija Vranesic Bender
- Unit of Clinical Nutrition, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Nicolette Wierdsma
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
| | - Arved Weimann
- Department of General, Visceral and Oncological Surgery, St. George Hospital, Leipzig, Germany.
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26
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Pironi L, Boeykens K, Bozzetti F, Joly F, Klek S, Lal S, Lichota M, Mühlebach S, Van Gossum A, Wanten G, Wheatley C, Bischoff SC. ESPEN practical guideline: Home parenteral nutrition. Clin Nutr 2023; 42:411-430. [PMID: 36796121 DOI: 10.1016/j.clnu.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 01/11/2023]
Abstract
This guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home parenteral nutrition (HPN) providers, as well as healthcare administrators and policy makers, about appropriate and safe HPN provision. This guideline will also inform patients requiring HPN. The guideline is based on previous published guidelines and provides an update of current evidence and expert opinion; it consists of 71 recommendations that address the indications for HPN, central venous access device (CVAD) and infusion pump, infusion catheter and CVAD site care, nutritional admixtures, program monitoring and management. Meta-analyses, systematic reviews and single clinical trials based on clinical questions were searched according to the PICO format. The evidence was evaluated and used to develop clinical recommendations implementing Scottish Intercollegiate Guidelines Network methodology. The guideline was commissioned and financially supported by ESPEN and members of the guideline group were selected by ESPEN.
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Affiliation(s)
- Loris Pironi
- University of Bologna, Department of Medical and Surgical Sciences, Italy; IRCCS AOUBO, Centre for Chronic Intestinal Failure - Clinical Nutrition and Metabolism Unit, Italy.
| | - Kurt Boeykens
- Vitaz Hospital, Nutrition Support Team, Sint-Niklaas, Belgium
| | | | - Francisca Joly
- Beaujon Hospital, APHP, University of Paris VII, Clichy, France
| | - Stanislaw Klek
- Surgical Oncology Clinic, The Maria Sklodowska-Curie National Cancer Institute, Krakow, Poland
| | - Simon Lal
- Salford Royal NHS Foundation Trust, Salford, UK
| | - Marek Lichota
- Intestinal Failure Patients Association "Appetite for Life", Cracow, Poland
| | - Stefan Mühlebach
- Division of Clinical Pharmacy and Epidemiology and Hospital Pharmacy, University of Basel, Basel, Switzerland
| | | | - Geert Wanten
- Intestinal Failure Unit, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Carolyn Wheatley
- Support and Advocacy Group for People on Home Artificial Nutrition (PINNT), UK
| | - Stephan C Bischoff
- University of Hohenheim, Institute of Nutritional Medicine, Stuttgart, Germany
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27
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Joly F, Mundi M, Barazzoni R, Berger MM, Bozzetti F, Cuerda C, Jeppesen PB, Lal S, Lamprecht G, Szczepanek K, Van Gossum A, Schneider S, Shenkin A, Wanten G, Pironi L. How to deal with micronutrient product shortage - Editorial. Clin Nutr 2023; 42:143-147. [PMID: 36565561 DOI: 10.1016/j.clnu.2022.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Francisca Joly
- Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University of Paris Inserm UMR 1149, Paris, France.
| | - Manpreet Mundi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
| | - Rocco Barazzoni
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Trieste, Italy.
| | - Mette M Berger
- Dpt of Adult Intensive Care, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
| | | | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Palle B Jeppesen
- Department of Intestinal Failure and Liver Diseases, Rigshospitalet, Inge Lehmanns Vej 5 Opgang 3, 12. Og 16. Sal 2100 København Ø, Denmark.
| | - Simon Lal
- Gastroenterology, Salford Royal & University of Manchester, UK.
| | - Georg Lamprecht
- Department of Medicine II, Division of Gastroenterology and Endocrinology, Rostock University, Medical Center, Rostock, Germany.
| | - Kinga Szczepanek
- General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland.
| | - André Van Gossum
- Department of Gastroenterology and Clinical Nutrition, Hopital Erasme/Institut Bordet Brussels, Belgium.
| | - Stéphane Schneider
- Gastroentérologie et Nutrition Clinique, CHU de Nice, Université Côte D'Azur, Nice, France.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Geert Wanten
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, 6500 HB Nijmegen, the Netherlands.
| | - Loris Pironi
- Alma Mater Studiorum -University of Bologna, Department of Medical and Surgical Sciences, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Centre for Chronic Intestinal Failure - Clinical Nutrition and Metabolism Unit, Italy.
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28
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Wauters L, Dermine S, de Dreuille B, Bettolo J, Hutinet C, Mohamed A, Lecoq E, Billiauws L, Nuzzo A, Corcos O, Joly F. Malnutrition with Low Muscle Mass Is Common after Weaning off Home Parenteral Nutrition for Chronic Intestinal Failure. Nutrients 2023; 15:nu15020338. [PMID: 36678209 PMCID: PMC9860702 DOI: 10.3390/nu15020338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
The differences in outcomes after weaning off intravenous support (IVS) for chronic intestinal failure (IF) are unclear. Adult IF patients who are weaned off IVS at a tertiary care center (June 2019−2022) were included in this study, and nutritional and functional markers were assessed before, during, and after weaning. Short bowel syndrome (SBS) was present in 77/98 of the IF patients, with different outcomes according to the final anatomy. The body weight and the BMI increased during IVS in those with a jejunocolonic (JC) anastomosis (p < 0.001), but weight loss was significant during follow-up (p < 0.001). Malnutrition was present in >60%, with a reduced muscle mass, which was found using bioelectrical impedance analysis (BIA), in >50% of SBS-JC patients. Although reduced hand-grip strength and sarcopenia were less common, the muscle quality, or phase angle (BIA), decreased during follow-up, also correlating with serum albumin and muscle mass (p ≤ 0.01). The muscle quality and albumin were low in the patients restarting IVS, which was only the case with ≤60 cm of small bowel. Closer follow-up and earlier treatment with teduglutide (TED) should be considered in these patients, as none of the TED-treated patients were malnourished or sarcopenic. Studies on the potential benefits of nutritional and physical interventions for low muscle mass and associations with outcomes are needed in chronic IF patients.
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Affiliation(s)
- Lucas Wauters
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
- Institut National de la Santé et de la Recherche Médicale (INSERM), University of Paris, UMR 1149, 75890 Paris, France
- Correspondence:
| | - Solène Dermine
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Brune de Dreuille
- Institut National de la Santé et de la Recherche Médicale (INSERM), University of Paris, UMR 1149, 75890 Paris, France
| | - Joanna Bettolo
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Coralie Hutinet
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Ashiq Mohamed
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Emilie Lecoq
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Lore Billiauws
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Alexandre Nuzzo
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
- Laboratoire de Recherche Vasculaire Translationnelle (LVTS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Cité, Bichat Hospital, U1148, 75018 Paris, France
| | - Olivier Corcos
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
- Laboratoire de Recherche Vasculaire Translationnelle (LVTS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Cité, Bichat Hospital, U1148, 75018 Paris, France
| | - Francisca Joly
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
- Institut National de la Santé et de la Recherche Médicale (INSERM), University of Paris, UMR 1149, 75890 Paris, France
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Fourati S, Dumay A, Roy M, Willemetz A, Ribeiro-Parenti L, Mauras A, Mayeur C, Thomas M, Kapel N, Joly F, Le Gall M, Bado A, Le Beyec J. Fecal microbiota transplantation in a rodent model of short bowel syndrome: A therapeutic approach? Front Cell Infect Microbiol 2023; 13:1023441. [PMID: 36936775 PMCID: PMC10020656 DOI: 10.3389/fcimb.2023.1023441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/03/2023] [Indexed: 03/06/2023] Open
Abstract
Extensive intestinal resection leads to Short Bowel Syndrome (SBS), the main cause of chronic intestinal failure. Colon preservation is crucial for spontaneous adaptation, to improve absorption and reduce parenteral nutrition dependence. Fecal microbiota transplantation (FMT), a promising approach in pathologies with dysbiosis as the one observed in SBS patients, was assessed in SBS rats with jejuno-colonic anastomosis. The evolution of weight and food intake, the lenght of intestinal villi and crypts and the composition of fecal microbiota of Sham and SBS rats, transplanted or not with high fat diet rat microbiota, were analyzed. All SBS rats lost weight, increased their food intake and exhibited jejunal and colonic hyperplasia. Microbiota composition of SBS rats, transplanted or not, was largely enriched with Lactobacillaceae, and α- and β-diversity were significantly different from Sham. The FMT altered microbiota composition and α- and β-diversity in Sham but not SBS rats. FMT from high fat diet rats was successfully engrafted in Sham, but failed to take hold in SBS rats, probably because of the specific luminal environment in colon of SBS subjects favoring aero-tolerant over anaerobic bacteria. Finally, the level of food intake in SBS rats was positively correlated with their Lactobacillaceae abundance. Microbiota transfer must be optimized and adapted to this specific SBS environment.
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Affiliation(s)
- Salma Fourati
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
- Sorbonne Université, AP-HP, Hôpital de la Pitié‐Salpêtrière‐Charles Foix, Service de Biochimie Endocrinienne et Oncologique, Paris, France
- Paris Center for Microbiome Medicine, Federation Hospitalo-Universitaire, Paris, France
| | - Anne Dumay
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
| | - Maryline Roy
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
| | - Alexandra Willemetz
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
| | - Lara Ribeiro-Parenti
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
- AP-HP, Hôpital Bichat -Claude Bernard, Service de chirurgie Générale OEsogastrique et Bariatrique, Paris, France
| | - Aurélie Mauras
- Paris Center for Microbiome Medicine, Federation Hospitalo-Universitaire, Paris, France
- UMR1319 - Micalis Institute, Institut National de Recherche pour l’Agriculture, l’alimentation et l’environnement (INRAE), AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Camille Mayeur
- Paris Center for Microbiome Medicine, Federation Hospitalo-Universitaire, Paris, France
- UMR1319 - Micalis Institute, Institut National de Recherche pour l’Agriculture, l’alimentation et l’environnement (INRAE), AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Muriel Thomas
- Paris Center for Microbiome Medicine, Federation Hospitalo-Universitaire, Paris, France
- UMR1319 - Micalis Institute, Institut National de Recherche pour l’Agriculture, l’alimentation et l’environnement (INRAE), AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Nathalie Kapel
- Paris Center for Microbiome Medicine, Federation Hospitalo-Universitaire, Paris, France
- UMR-S 1139, INSERM, Universite Paris Cite, Paris, France
- AP-HP, Hôpital de la Pitié‐Salpêtrière‐Charles Foix, Service de Coprologie fonctionnelle, Paris, France
| | - Francisca Joly
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
- Department of gastroenterology, IBD and nutrition Support, AP‐HP, CRMR MarDi, Hôpital Beaujon, Clichy, France
| | - Maude Le Gall
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
| | - André Bado
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
| | - Johanne Le Beyec
- UMR-S1149, Centre de recherche sur l’inflammation, INSERM, Universite Paris Cite, Paris, France
- Sorbonne Université, AP-HP, Hôpital de la Pitié‐Salpêtrière‐Charles Foix, Service de Biochimie Endocrinienne et Oncologique, Paris, France
- Paris Center for Microbiome Medicine, Federation Hospitalo-Universitaire, Paris, France
- *Correspondence: Johanne Le Beyec, ;;
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Vaz-Luis I, Masiero M, Cavaletti G, Cervantes A, Chlebowski RT, Curigliano G, Felip E, Ferreira AR, Ganz PA, Hegarty J, Jeon J, Johansen C, Joly F, Jordan K, Koczwara B, Lagergren P, Lambertini M, Lenihan D, Linardou H, Loprinzi C, Partridge AH, Rauh S, Steindorf K, van der Graaf W, van de Poll-Franse L, Pentheroudakis G, Peters S, Pravettoni G. ESMO Expert Consensus Statements on Cancer Survivorship: promoting high-quality survivorship care and research in Europe. Ann Oncol 2022; 33:1119-1133. [PMID: 35963481 DOI: 10.1016/j.annonc.2022.07.1941] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The increased number of cancer survivors and the recognition of physical and psychosocial challenges, present from cancer diagnosis through active treatment and beyond, led to the discipline of cancer survivorship. DESIGN AND METHODS Herein, we reflected on the different components of survivorship care, existing models and priorities, in order to facilitate the promotion of high-quality European survivorship care and research. RESULTS We identified five main components of survivorship care: (i) physical effects of cancer and chronic medical conditions; (ii) psychological effects of cancer; (iii) social, work and financial effects of cancer; (iv) surveillance for recurrences and second cancers; and (v) cancer prevention and overall health and well-being promotion. Survivorship care can be delivered by structured care models including but not limited to shared models integrating primary care and oncology services. The choice of the care model to be implemented has to be adapted to local realities. High-quality care should be expedited by the generation of: (i) focused and shared European recommendations, (ii) creation of tools to facilitate implementation of coordinated care and (iii) survivorship educational programs for health care teams and patients. The research agenda should be defined with the participation of health care providers, researchers, policy makers, patients and caregivers. The following patient-centered survivorship research areas were highlighted: (i) generation of a big data platform to collect long-term real-world data in survivors and healthy controls to (a) understand the resources, needs and preferences of patients with cancer, and (b) understand biological determinants of survivorship issues, and (ii) develop innovative effective interventions focused on the main components of survivorship care. CONCLUSIONS The European Society for Medical Oncology (ESMO) can actively contribute in the efforts of the oncology community toward (a) promoting the development of high-quality survivorship care programs, (b) providing educational material and (c) aiding groundbreaking research by reflecting on priorities and by supporting research networking.
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Affiliation(s)
- I Vaz-Luis
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy-Cancer Campus, Villejuif; UMR 981, Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy-Cancer Campus, Villejuif, France.
| | - M Masiero
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
| | - G Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - A Cervantes
- Department of Medical Oncology, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - E Felip
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - A R Ferreira
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon; Catolica Medical School, Universidade Católica Portuguesa, Lisbon, Portugal
| | - P A Ganz
- UCLA Jonsson Comprehensive Cancer Center and UCLA Fielding School of Public Health, Los Angeles, USA
| | - J Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - J Jeon
- Exercise Medicine Center for Cancer and Diabetes Patients (ICONS), Department of Sport Industry, Cancer Prevention Center, Yonsei Cancer Center, Shinchon Severance Hospital, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - C Johansen
- Centre for Cancer Late Effect Research (CASTLE), Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - F Joly
- Department of Medical Oncology, Centre François Baclesse, U1086 Anticipe, Unicaen Normandy Universtity, Caen, France
| | - K Jordan
- Department for Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam; Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - B Koczwara
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - P Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Surgery and Cancer, Imperial College London, London, UK
| | - M Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - D Lenihan
- International Cardio-Oncology Society, Tampa, USA
| | - H Linardou
- Fourth Oncology Department & Comprehensive Clinical Trials Center, Metropolitan Hospital, Athens, Greece
| | | | - A H Partridge
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Rauh
- Department of Medical Oncology, Centre Hospitalier Emile Mayrisch, Esch, Luxembourg
| | - K Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - W van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer institute, Erasmus University Medical Center, Rotterdam
| | - L van de Poll-Franse
- Division of Psychosocial Research & Epidemiology, Department of Psycological Research, The Netherlands Cancer Institute, Amsterdam; Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht; CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - S Peters
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
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Aupetit A, Dermine S, Joly F. Complications hépatiques de la nutrition artificielle parentérale chez l’adulte en 2022 : de la surveillance au traitement. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Woopen H, Sehouli J, Davis A, Lee Y, Cohen P, Ferrero A, Gleeson N, Jhingran A, Kajimoto Y, Mayadev J, Barretina-Ginesta M, Sundar S, Suzuki N, van Dorst E, Joly F. Erratum to “GCIG-Consensus guideline for long-term survivorship in gynecologic cancer: A position paper from the Gynecologic Cancer InterGroup (GCIG) symptom benefit committee” [Cancer Treatm. Rev. 107 (2022) 102396]. Cancer Treat Rev 2022; 109:102431. [DOI: 10.1016/j.ctrv.2022.102431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Oaknin A, Bosse TJ, Creutzberg CL, Giornelli G, Harter P, Joly F, Lorusso D, Marth C, Makker V, Mirza MR, Ledermann JA, Colombo N. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2022; 33:860-877. [PMID: 35690222 DOI: 10.1016/j.annonc.2022.05.009] [Citation(s) in RCA: 111] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/27/2022] [Accepted: 05/19/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- A Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - T J Bosse
- Departments of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - C L Creutzberg
- Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - G Giornelli
- Department of Oncology, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - P Harter
- Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
| | - F Joly
- ANTICIPE, Cancer and Cognition Platform, Normandie University, Caen, France; Medical Oncology Department, Centre François Baclesse, Caen, France
| | - D Lorusso
- Department of Life Science and Public Health, Catholic University of Sacred Heart, Largo Agostino Gemelli, Rome, Italy; Department of Women and Child Health, Division of Gynaecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - C Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - V Makker
- Gynecologic Medical Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA; Department of Medicine, Weill Cornell Medical College, New York, USA
| | - M R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J A Ledermann
- Cancer Institute, University College London (UCL), London, UK; Department of Oncology, UCL Hospitals, London, UK
| | - N Colombo
- Department of Gynecologic Oncology, Istituto Europeo di Oncologia IRCCS, Milan, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Röth A, Broome CM, Barcellini W, Henrik Anderson Tvedt T, Miyakawa Y, D’Sa S, Cella D, Joly F, Wang J, Sourdille T, Shafer F, Wardęcki M, Weitz IC. S304: SUTIMLIMAB, A COMPLEMENT C1S INHIBITOR, PROVIDES SUSTAINED IMPROVEMENTS IN PATIENT-REPORTED OUTCOMES IN PATIENTS WITH COLD AGGLUTININ DISEASE (CAD): 2 YEAR FOLLOW-UP FROM THE CARDINAL STUDY. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000844108.70297.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Iwanoff A, Bataille J, Joly F, Billiauws L, Pons Kerjean N, Stocco J. La prise en charge d’un patient en nutrition parentérale au long cours est-elle économiquement standardisable ? NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cohen M, Hounkonnou C, Billiauws L, Lecoq E, Villain C, Alvarado C, Gault N, Joly F. Pronostic des infections liées à une voie veineuse centrale (VVC) dans une population de patient en nutrition parentérale à domicile (NPAD). NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Naghibi M, Skinner C, Burden S, Bozzetti F, Cuerda C, Joly F, Jeppesen P, Lamprecht G, Mundi M, Szczepanek K, Van Gossum A, Wanten G, Pironi L, Lal S. A multi-national survey of experience and attitudes towards commencing home parenteral nutrition for patients with advanced cancer. Clin Nutr ESPEN 2022; 47:246-251. [DOI: 10.1016/j.clnesp.2021.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 01/16/2023]
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Billiauws L, Cohen M, Cazals-Hatem D, Joly F. Small intestine motility disorders: Chronic intestinal pseudo-obstruction. J Visc Surg 2022; 159:S22-S27. [DOI: 10.1016/j.jviscsurg.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Joly F, Quilliot D, Chambrier C, Schneider S, Fotsing G, Poullenot F, Layec S, Flori N, Thibault R, Fontaine E, Ressiot E, Campana V, Schmidely N, Seguy D. EQUATIVE : étude française de la qualité de vie des adultes atteints d’un syndrome de grêle court sous Teduglutide. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Déchelotte P, Joly F. Nutrition clinique et métabolisme : une revue en progression pour un champ d’intérêt plus large, une SFNCM toujours plus ouverte … et une nouvelle présidente ! NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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De Dreuille B, Cazals-Hatem D, Billiauws L, Le Gall M, Joly F. Développement précoce de polypes intestinaux chez des patients atteints du syndrome de grêle court traités par Teduglutide. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nuzzo A, Czernichow S, Hertig A, Ledoux S, Poghosyan T, Quilliot D, Le Gall M, Bado A, Joly F. [Nutritionnal complications and patients follow-up after bariatric surgery]. Rev Prat 2022; 72:168-175. [PMID: 35289526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
NUTRITIONNAL COMPLICATIONS AND PATIENTS FOLLOW-UP AFTER BARIATRIC SURGERYBariatric surgery is the most consistently effective method for sustained weight reduction and can result in a substantial improvement in overall survival in patients with severe obesity. Complex mechanisms underlying metabolic benefits could also drive preventable, but potentially life-threatening, long-term nutritional complications. Consequently, physicians should be familiar with the lifelong monitoring of patients after bariatric surgery and the potential long-term complications in this paradoxical situation where the long-awaited weight loss can lead to severe nutritional complications.
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Affiliation(s)
- Alexandre Nuzzo
- AP-HP, département de gastroentérologie, IBD and Intestinal Failure, hôpital Beaujon, Clichy, France. Université de Paris, Paris, France
| | - Sébastien Czernichow
- Université de Paris, Paris, France. AP-HP, service de nutrition, centre spécialisé obésité, Hôpital européen Georges-Pompidou, Paris, France . Inserm, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, France
| | - Alexandre Hertig
- Sorbonne Université, département de néphrologie, hôpital La Pitié-Salpêtrière, AP-HP, Paris, France
| | - Séverine Ledoux
- Université de Paris, Paris, France AP-HP, service des explorations fonctionnelles, centre spécialisé obésité, hôpital Louis-Mourier, Colombes, France. Inserm, UMRS 1149, centre de recherche sur l'inflammation Paris Montmartre, Paris, France
| | - Tigran Poghosyan
- Université de Paris, Paris, France Inserm, UMRS 1149, centre de recherche sur l'inflammation Paris Montmartre, Paris, France. AP-HP, service de chirurgie digestive, oncologique et bariatrique, centre spécialisé obésité, Hôpital européen Georges-Pompidou, Paris, France 9. Unité multidisciplinaire de chirurgie de l'obésité, CHRU de Nancy, France
| | - Didier Quilliot
- Unité multidisciplinaire de chirurgie de l'obésité, CHRU de Nancy, France
| | - Maude Le Gall
- Université de Paris, Paris, France AP-HP, service des explorations fonctionnelles, centre spécialisé obésité, hôpital Louis-Mourier, Colombes, France. Inserm, UMRS 1149, centre de recherche sur l'inflammation Paris Montmartre, Paris, France
| | - André Bado
- Université de Paris, Paris, France AP-HP, service des explorations fonctionnelles, centre spécialisé obésité, hôpital Louis-Mourier, Colombes, France. Inserm, UMRS 1149, centre de recherche sur l'inflammation Paris Montmartre, Paris, France
| | - Francisca Joly
- AP-HP, département de gastroentérologie, IBD and Intestinal Failure, hôpital Beaujon, Clichy, France.Université de Paris, Paris, France AP-HP, service des explorations fonctionnelles, centre spécialisé obésité, hôpital Louis-Mourier, Colombes, France. Inserm, UMRS 1149, centre de recherche sur l'inflammation Paris Montmartre, Paris, France
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45
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Juhász MF, Vereczkei Z, Ocskay K, Szakó L, Farkas N, Szakács Z, Zádori N, Wilschanski M, Pandol SJ, Joly F, Capurso G, Arcidiacono PG, Izbéki F, Czakó L, Papp M, Czopf L, Hegyi P, Párniczky A. The EFFect of dietary fat content on the recurrence of pancreaTitis (EFFORT): Protocol of a multicenter randomized controlled trial. Pancreatology 2022; 22:51-57. [PMID: 34750077 DOI: 10.1016/j.pan.2021.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/10/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Around 20% of patients with acute pancreatitis (AP) will develop acute recurrent pancreatitis (ARP) and 10% will progress to chronic pancreatitis. While interventions to avoid recurrences exist for the two most common causes - abstinence for alcoholic and cholecystectomy for biliary pancreatitis - the are no known preventive measures in idiopathic ARP. Though it is not included in any of the guidelines, a low-fat diet is often recommended. Our aim is to test dietary fat reduction's effect on AP recurrence in a randomized controlled setting, in order to provide high-quality evidence for the validity of such an intervention. METHODS, DESIGN Participants with at least 2 episodes of AP in the preceding 2 years of which the last episode was idiopathic will be randomized to one of two diets with different fat contents: a 'reduced fat diet' (15% fat, 65% carbohydrate, 20% protein) and a 'standard healthy diet' (30% fat, 50% carbohydrate, 20% protein; based on WHO recommendations). Participants will be followed-up for 2 years (visits will be scheduled for months 3, 6, 12, 18 and 24) during which they will receive a repeated session of nutritional guidance, complete food frequency questionnaires and data on relapse, mortality, BMI, cardiovascular parameters and serum lipid values will be collected. DISCUSSION This study will determine the effect of modifying the dietary fat content on AP recurrence, mortality, serum lipids and weight loss in idiopathic cases.
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Affiliation(s)
- Márk Félix Juhász
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Zsófia Vereczkei
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
| | - Klementina Ocskay
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
| | - Lajos Szakó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
| | - Nelli Farkas
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
| | - Zsolt Szakács
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
| | - Noémi Zádori
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
| | | | - Stephen J Pandol
- Cedars-Sinai Medical Center and University of California, Los Angeles, USA.
| | - Francisca Joly
- Centre for Intestinal Failure, Department of Gastroenterology and Nutritional Support, Hôpital Beaujon, Clichy, France.
| | - Gabriele Capurso
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Paolo Giorgio Arcidiacono
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ferenc Izbéki
- Szent György Teaching Hospital of County Fejér, Székesfehérvár, Hungary.
| | - László Czakó
- First Department of Medicine, University of Szeged, Szeged, Hungary.
| | - Mária Papp
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Hungary.
| | - László Czopf
- First Department of Internal Medicine, Medical School, University of Pécs, Pécs, Hungary.
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
| | - Andrea Párniczky
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Heim Pál National Pediatric Institute, Budapest, Hungary.
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De Dreuille B, Cazals-Hatem D, Billiauws L, Joly F. Early development of small-intestinal polyps in patients with short bowel syndrome treated with teduglutide. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cohen M, Hounkonnou C, Billiauws L, Lecoq E, Villain C, Alvarado C, Gault N, Joly F. Salvage of central line in case of catheter - associated blood stream infections (clabsis) a prospective observational study in adult patients on long-term home parenteral nutrition (HPN). Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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48
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de Seze M, de Dreuille B, Billiauws L, Bettolo J, Hutinet C, Damas V, Bonvalet F, Cazals-Hatem D, Villain C, Bouhnik Y, Joly F, Uzzan M. Impact of teduglutide, a GLP-2 agonist, on inflammatory bowel disease-associated short bowel syndrome: a tertiary single-center study. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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49
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Joly F, Quilliot D, Chambrier C, Schneider S, Fotsing G, Poullenot F, Layec S, Flori N, Thibault R, Fontaine E, Ressiot E, Campana V, Schmidely N, Seguy D. Equative: quality of life in adult patients with short bowel syndrome treated by teduglutide, a french real-world study. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Pfister C, Gravis G, Flechon A, Chevreau C, Mahammedi H, Laguerre B, Guillot A, Joly F, Soulié M, Allory Y, Harter V, Culine S. Dose dense methotrexate, vinblastine, doxorubicin et cisplatin (DD-MVAC) versus gemcitabine et cisplatin (GC) comme chimiothérapie péri-opératoire dans le cancer de vessie localisé infiltrant le muscle. résultats de la phase III GETUG/AFU vesper V05. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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