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Baltes P, Dray X, Riccioni M, Pérez-Cuadrado-Robles E, Fedorov E, Wiedbrauck F, Chetcuti Zammit S, Cadoni S, Bruno M, Rondonotti E, Wurm Johansson G, Mussetto A, Beaumont H, Perrod G, McNamara D, Plevris J, Spada C, Pinho R, Rosa B, Hervás N, Carretero C, Tontini G, Keuchel M. CAPSULE ENDOSCOPY IN PATIENTS WITH MECKEL`S DIVERTICULUM- CLINICAL FEATURES AND DIAGNOSTIC FINDINGS – A EUROPEAN MULTICENTRE STUDY. ESGE Days 2022 2022. [DOI: 10.1055/s-0042-1744627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- P. Baltes
- Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
| | - X. Dray
- Hospital Saint Antoine, Sorbonne University, Paris, France
| | - M.E. Riccioni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - E. Fedorov
- Moscow University Hospital N31, Pirogov Russia National Research Medical University, Moscow, Russian Federation
| | | | | | | | - M. Bruno
- University Hospital City of Science and Health Turin, Turin, Italy
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- Santa Maria delle Croci Hospital, Ravenna, Italy
| | - H. Beaumont
- Amsterdam University Medical Center, location VU, Amsterdam, Netherlands
| | - G. Perrod
- Georges Pompidou European Hospital, Paris, France
| | - D. McNamara
- Tallaght University Hospital, Dublin, Ireland
| | - J. Plevris
- The Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - C. Spada
- Fondazione Poliambulanza, Brescia, Italy
| | - R. Pinho
- Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | - B. Rosa
- Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - N. Hervás
- Complejo Hospitalario Navarra, Pamplona, Spain
| | | | - G.E. Tontini
- Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M. Keuchel
- Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
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Chetcuti Zammit S, Ching HL, McAlindon ME, Sanders DS, Healy A, Thurston V, Sidhu R. The Changing Platform of Small Bowel Endoscopy: a 15-Year Experience of Demand and Outcomes. J Gastrointest Surg 2018; 22:1305-1306. [PMID: 29679344 DOI: 10.1007/s11605-018-3772-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/02/2018] [Indexed: 01/31/2023]
Affiliation(s)
- S Chetcuti Zammit
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK.
| | - H-L Ching
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - M E McAlindon
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - D S Sanders
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - A Healy
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - V Thurston
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - R Sidhu
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
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Abstract
BACKGROUND AND AIMS Haemorrhage from small bowel angioectasias (SBAs) can be debilitating to patients who are very often elderly and have multiple comorbidities. Our aim was to assess the use of lanreotide in addition to endotherapy in patients with SBAs. METHOD Patients with SBAs on capsule endoscopy (CE) who received lanreotide injections from January 2010 to till the present day at the Royal Hallamshire Hospital in Sheffield were included. Baseline demographics were recorded. Efficacy was evaluated in terms of improvement in mean haemoglobin, transfusion requirements and bleeding episodes. RESULTS Twelve patients (67% males, mean age 74 SD ± 15.5 years) were included. All patients had multiple comorbidities. Lanreotide was given at a dosage of 60 mg (42%), 90 mg (33%) or 120 mg (25%). It was given at a four-week interval in 75% of patients and at a six-week interval in 17% of patients. One patient (8%) received a single dose. The mean duration of treatment was 19 months SD ± 14.5. Only 17% of patients had their lanreotide stopped due to cholelithiasis. There was a significant improvement in mean haemoglobin: 86.8 versus 98.0 (131-166 g/L, p = .012). The mean number of bleeding episodes (4.18 versus 1.09, p = .010) and packed red cells (323 versus 152, p = .006) received improved. Patients required less DBEs ± APCs after starting lanreotide (19 versus 11 p = .048). CONCLUSION Lanreotide is a useful adjuvant treatment to therapeutic enteroscopy in patients with refractory obscure gastrointestinal bleeding due to SBAs. It improves haemoglobin levels, reduces transfusion requirements, bleeding episodes and number of DBEs. Overall, it has a good safety profile.
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Affiliation(s)
- S Chetcuti Zammit
- a Department of Gastroenterology , Royal Hallamshire Hospital , Sheffield, UK
| | - D S Sanders
- a Department of Gastroenterology , Royal Hallamshire Hospital , Sheffield, UK
| | - R Sidhu
- a Department of Gastroenterology , Royal Hallamshire Hospital , Sheffield, UK
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Chetcuti Zammit S, Chircop A, Cortis K, Pullicino E, Gerada J. Hepatobiliary and Pancreatic: Congenital intrahepatic portosystemic venous shunting: A great mimicker of liver cirrhosis. J Gastroenterol Hepatol 2016; 31:1917. [PMID: 27898994 DOI: 10.1111/jgh.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2016] [Indexed: 12/09/2022]
Affiliation(s)
| | - A Chircop
- Department of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - K Cortis
- Department of Radiology, Mater Dei Hospital, Msida, Malta
| | - E Pullicino
- Department of Gastroenterology, Mater Dei Hospital, Msida, Malta
| | - J Gerada
- Department of Gastroenterology, Mater Dei Hospital, Msida, Malta
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Fenech M, Abela R, Chetcuti Zammit S, Mercieca L, Gauci J, Edwards N, Carachi E, Mifsud M, Piscopo T. Wound swab use and misuse at a regional general hospital. J Wound Care 2014; 23:634-42. [DOI: 10.12968/jowc.2014.23.12.634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
BACKGROUND Klebsiella pneumoniae bacteraemia (KPB) has been associated with multiple risk factors. However association of these risk factors with mortality secondary to KPB has been poorly documented. OBJECTIVES To assess underlying co-morbidities in patients with KPB and any associated presentations. These findings were then used to devise a score to estimate the risk of in-hospital mortality in patients with underlying KPB. METHODS A retrospective analysis of all patients diagnosed with KPB between November 2007 and March 2012 at Mater Dei hospital in Malta was carried out. Using the odds ratios of risk factors for mortality associated with KPB, a mortality risk score was then prepared. RESULTS 186 patients (mean age 62 years; mean hospital stay 22.6 days) were included. 51 patients died as inpatients. Being admitted to intensive care (Overall risk (OR): 9, p<0.0001), having a solid organ tumour (OR 3, p<0.005), and having an underlying pneumonia (OR 3, p<0.021) were statistically significant risk factors associated with mortality. There were 0% mortality in patients with a score of 0, and progressively increasing mortalities with increasing scores up to a 100% mortality in patients with scores of >15. This translated into a validated risk score where an increasing score reflected an increasing mortality. CONCLUSIONS Klebsiella pneumoniae bacteraemia is associated with high in-patient mortality. ICU admission, underlying solid tumours, and co-existent pneumonias are among the factors used in our mortality risk score. This needs to be further validated in larger populations.
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Affiliation(s)
| | - N Azzopardi
- Department of Medicine, Mater Dei Hospital, Msida MSD 2090, Malta
| | - J Sant
- Department of Medicine, Mater Dei Hospital, Msida MSD 2090, Malta
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Abstract
BACKGROUND Streptococcus gallolyticus bacteraemia has been associated with several pathologies, including bacterial endocarditis and colorectal cancer. AIMS In this study, we have analysed whether Streptococcus gallolyticus bacteraemia is associated with an increased risk of hepatobiliary and colonic pathology. The association with other pathologies and the antibiotic sensitivities of Streptococcus gallolyticus were also analysed. DESIGN Observational retrospective study. METHODS The case notes of patients with documented Streptococcus gallolyticus bacteraemia between 2007 and 2012 at Mater Dei hospital (Malta) were reviewed. Demographic and clinical data, including co-morbidities, clinical investigations, antibiotic sensitivities and mortality were analysed. RESULTS A total of 42 patients (33 males, 9 females) were recruited. Two patients were pre-term infants and were therefore excluded from the study. Mean age of the cohort population studied was 72 years (SD ± 14). One-year survival rate was 62%. Gastrointestinal (colonic and hepatobiliary-pancreatic) pathologies were present in 59.5% of patients with 16% of this group having more than one gastrointestinal pathology. High incidence rates of underlying diabetes mellitus (28.6%), valvular heart disease (21.4%) and malignancies (21.4%) were noted in this study. Furthermore, we observed that 14.3% of patients had an underlying respiratory pathology. Streptococcus gallolyticus was 100% sensitive to cefotaxime and vancomycin but was highly resistant to clindamycin, erythromycin and tetracycline. CONCLUSION Streptococcus gallolyticus bacteraemia is commoner in the elderly and in those with multiple underlying co-morbidities. The high incidence of gastrointestinal pathologies among patients with Streptococcus gallolyticus bacteraemia (59.5%) suggests that a thorough work-up for colonic and hepatobiliary/pancreatic pathology should be carried out in these patients.
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Mo N, Oakley J, O'Sullivan M, Shaikh MF, Soory D, Parker RA, Shenker NG, Farrugia C, Chetcuti Zammit S, Lauri J, Borg AA. Psychology, Measurement and Management of Pain [319-321]: 319. Hospital Anxiety and Depression (Had) Scores in Rheumatoid Arthritis: Associations with Function, Disease Duration and Employment Status. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cuzzupe AN, Hutton CA, Lilly MJ, Mann RK, McRae KJ, Zammit SC, Rizzacasa MA. Total synthesis of the epidermal growth factor inhibitor (-)-reveromycin B. J Org Chem 2001; 66:2382-93. [PMID: 11281779 DOI: 10.1021/jo001646c] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The total synthesis of the epidermal growth factor inhibitor reveromycin B (2) in 25 linear steps from chiral methylene pyran 13 is described. The key steps involved an inverse electron demand hetero-Diels-Alder reaction between dienophile 13 and diene 12 to construct the 6,6-spiroketal 11 which upon oxidation with dimethyldioxirane and acid catalyzed rearrangement gave the 5,6-spiroketal aldehyde 9. Lithium acetylide addition followed by oxidation/reduction and protective group manipulation provided the reveromycin B spiroketal core 8 which was converted into the reveromycin A (1) derivative 6 in order to confirm the stereochemistry of the spiroketal segment. Introduction of the C1-C10 side chain began with sequential Wittig reactions to form the C8-C9 and C7-C6 bonds, and a tin mediated asymmetric aldol reaction installed the C4 and C5 stereocenters. The final key steps to the target molecule 2 involved a Stille coupling to introduce the C21-C22 bond, succinoylation, selective deprotection, oxidation, and Wittig condensation to form the final C2-C3 bond. Deprotection was effected by TBAF in DMF to afford reveromycin B (2) in 72% yield.
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Affiliation(s)
- A N Cuzzupe
- School of Chemistry, The University of Melbourne, Victoria 3010, Australia
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Abstract
[structure: see text] The total synthesis of the epidermal growth factor inhibitor reveromycin B (2) is described. A novel, convergent, and stereoselective reaction sequence was utilized to construct the 5,6-spiroketal system 10 which was converted into the natural product 2 by a 16-step sequence.
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Affiliation(s)
- A N Cuzzupe
- School of Chemistry, The University of Melbourne, Parkville, Victoria, Australia
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