23 results on '"Dewkoemar Ramsoekh"'
Search Results
2. Systematic review: non-endoscopic surveillance for colorectal neoplasia in individuals with Lynch syndrome
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Elsa L. S. A. van Liere, Nanne K. H. de Boer, Evelien Dekker, Monique E. van Leerdam, Tim G. J. de Meij, Dewkoemar Ramsoekh, Gastroenterology and hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Pediatrics, and Amsterdam Reproduction & Development (AR&D)
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Adenoma ,Hepatology ,Occult Blood ,Gastroenterology ,Biomarkers, Tumor ,Humans ,Pharmacology (medical) ,Colonoscopy ,Colorectal Neoplasms ,Colorectal Neoplasms, Hereditary Nonpolyposis ,neoplasms ,Early Detection of Cancer ,digestive system diseases - Abstract
BACKGROUND: Individuals with Lynch syndrome are at high risk for colorectal cancer (CRC). Regular colonoscopies have proven to decrease CRC incidence and mortality. However, colonoscopy is burdensome and interval CRCs still occur. Hence, an accurate, less-invasive screening method that guides the timing of colonoscopy would be of important value.AIM: To outline the performance of non-endoscopic screening modalities for Lynch-associated CRC and adenomas.METHODS: Systematic literature search in MEDLINE and EMBASE to identify studies investigating imaging techniques and biomarkers for detection of CRC and adenomas in Lynch syndrome. The QUADAS-2 tool was used for the quality assessment of included studies.RESULTS: Seven of 1332 screened articles fulfilled the inclusion criteria. Two studies evaluated either CT colonography or MR colonography; both techniques were unable to detect CRC and (advanced) adenomas CONCLUSIONS: Imaging techniques are unsuitable for colon surveillance in Lynch syndrome, whereas biomarkers are understudied. Having outlined biomarker research in Lynch-associated and sporadic CRC/adenomas, we believe that these non-invasive markers may hold potential (whether or not combined) for this population. As they could be of great value, (pre-)clinical studies in this field should be prioritised.
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- 2022
3. 8 weeks of sofosbuvir/ledipasvir is effective in DAA-naive non-cirrhotic HCV genotype 4 infected patients (HEPNED-001 study)
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Bart van Hoek, Bart J. A. Rijnders, Joop E. Arends, Anthonius S. M. Dofferhoff, Marjo E. E. van Kasteren, Guido E.L. van den Berk, Marc van der Valk, Dirk Posthouwer, Thomas Vanwolleghem, Dewkoemar Ramsoekh, Janke Schinkel, Anne Boerekamps, Jelle Koopsen, Eric Florence, Infectious diseases, AII - Infectious diseases, APH - Personalized Medicine, APH - Global Health, Graduate School, Medical Microbiology and Infection Prevention, Other Research, Gastroenterology and hepatology, AGEM - Digestive immunity, Medical Microbiology & Infectious Diseases, Gastroenterology & Hepatology, Internal Medicine, Med Microbiol, Infect Dis & Infect Prev, MUMC+: DA MMI Staf (9), and RS: FHML non-thematic output
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Male ,Ledipasvir ,medicine.medical_specialty ,Sustained Virologic Response ,Sofosbuvir ,Hepacivirus ,HEPATITIS-C ,Antiviral Agents ,Gastroenterology ,chemistry.chemical_compound ,Internal medicine ,Outcome Assessment, Health Care ,Genotype ,Humans ,Medicine ,Netherlands ,Fluorenes ,Duration of Therapy ,Hepatology ,business.industry ,Hepatitis C ,Hepatitis C, Chronic ,Middle Aged ,medicine.disease ,chemistry ,LEDIPASVIR ,RNA, Viral ,Benzimidazoles ,Female ,Human medicine ,Drug Monitoring ,Uridine Monophosphate ,business ,medicine.drug - Published
- 2019
4. 227: STOOL-BASED TESTING TO REDUCE THE NUMBER OF UNNECESSARY SURVEILLANCE COLONOSCOPIES: THE MOCCAS STUDY
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Beatriz Carvalho, Willemijn de Klaver, Francine van Wifferen, Meta van Lanschot, Wiesje van Wetering, Quirine E. van der Zander, Geertruida Maria Lemmens, Anne S. Bolijn, Marianne Tijssen, Pien Delis-van Diemen, Nikkie Buekers, Kathleen Daenen, Jaleesa van der Meer, Pauline van Mulligen, Brenda S. Hijmans, Sander de Ridder, René van der Hulst, Johan Kuijvenhoven, Anne-Marie Van Berkel, Annekatrien Depla, Monique Van Leerdam, Jeroen M. Jansen, Caroline Wientjes, Jan Willem Straathof, Eric Keulen, Dewkoemar Ramsoekh, L.M.G. Moons, Barry M. Berger, Graham P. Lidgard, Michael Zacherl, Ad Masclee, Marjolein J. Greuter, Veerle Coupe, Manon van Engeland, Evelien Dekker, and Gerrit Meijer
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Hepatology ,Gastroenterology - Published
- 2022
5. Outcomes of push and pull percutaneous endoscopic gastrostomy placements in 854 patients:A single-center study
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Hicham Bouchiba, Maarten A J M Jacobs, Gerd Bouma, Dewkoemar Ramsoekh, Gastroenterology and hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Neurosurgery, and ANS - Neurovascular Disorders
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Hepatology ,complications ,push ,gastrostomy ,Gastroenterology ,technology, industry, and agriculture ,pull ,Original Article ,Original Articles ,RC799-869 ,macromolecular substances ,Diseases of the digestive system. Gastroenterology ,percutaneous endoscopic gastrostomy - Abstract
Background and Aims Percutaneous endoscopic gastrostomy (PEG) is indicated for prolonged enteral nutrition. This study aimed to analyze the outcome and to identify potential risk factors for complications in PEG procedures. Methods A single‐center retrospective analysis of the performed PEG procedures during the period January 2010 till January 2020. Results A PEG placement procedure was performed in 854 patients (64.1% male) and was successful in 833 (97.5%). In total, 513 push (61.6%) and 320 pull (38.6%) PEGs were placed. The mean age was 60.7 years, and the median follow‐up was 267 days. The push PEG was associated with peri‐procedural bleeding (P = 0.002) and tube dislodgements (P, Our study shows that the push and pull PEG placements are both safe and feasible procedures, with a low PEG‐related mortality.
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- 2021
6. Clinical Course of Nodular Regenerative Hyperplasia in Thiopurine Treated Inflammatory Bowel Disease Patients
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Dewkoemar Ramsoekh, Melek Simsek, Sybrand Y. De Boer, Berrie Meijer, Jeroen M. Jansen, Marc A. M. T. Verhagen, Nanne K. H. de Boer, Toos Steinhauser, Dutch Initiative on Crohn, Frank Hoentjen, Bert den Hartog, Colitis (Icc), Gerard Dijkstra, Annemarie C. de Vries, Menno A. Brink, Egbert-Jan van der Wouden, Bas Oldenburg, Chris J. J. Mulder, Gerd Bouma, Ton H Naber, Ruud Beukers, Lennard P L Gilissen, Andrea Van Der Meulen, Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Translational Immunology Groningen (TRIGR), Groningen Institute for Organ Transplantation (GIOT), and Gastroenterology & Hepatology
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Adult ,Male ,medicine.medical_specialty ,LIVER ,Adolescent ,Azathioprine ,Asymptomatic ,Gastroenterology ,Inflammatory bowel disease ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Thioguanine ,Aged ,Hyperplasia ,Hepatology ,Thiopurine methyltransferase ,biology ,Mercaptopurine ,business.industry ,Liver Diseases ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,030220 oncology & carcinogenesis ,biology.protein ,Portal hypertension ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5] ,Nodular regenerative hyperplasia ,medicine.drug - Abstract
Item does not contain fulltext Nodular regenerative hyperplasia (NRH) is a poorly understood liver condition, which is increasingly recognized in thiopurine-treated patients with inflammatory bowel disease (IBD).(1) It is difficult to establish an optimal approach to NRH patients, because its manifestations are highly variable (from asymptomatic to symptoms of noncirrhotic portal hypertension [NCPH]) and the prognosis is unknown.(2) The aim of this study was to identify NRH cases in IBD patients treated with azathioprine, mercaptopurine, and/or thioguanine, and to describe its clinical course.
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- 2019
7. Transient elastography to assess liver stiffness in patients with inflammatory bowel disease
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Catherine A.M. Stedman, Chris Frampton, Chris J. J. Mulder, Gerd Bouma, Dewkoemar Ramsoekh, Berrie Meijer, Nanne K. H. de Boer, Richard B. Gearry, Charlotte K. van Everdingen, AGEM - Digestive immunity, Gastroenterology and hepatology, AII - Inflammatory diseases, AGEM - Re-generation and cancer of the digestive system, and AGEM - Endocrinology, metabolism and nutrition
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Adult ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,International Cooperation ,Azathioprine ,Gastroenterology ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Liver Function Tests ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Netherlands ,Liver injury ,Crohn's disease ,Hepatology ,medicine.diagnostic_test ,Thiopurine methyltransferase ,biology ,business.industry ,Middle Aged ,medicine.disease ,Inflammatory Bowel Diseases ,Liver ,030220 oncology & carcinogenesis ,Liver biopsy ,biology.protein ,Elasticity Imaging Techniques ,030211 gastroenterology & hepatology ,Female ,Waist Circumference ,Liver function tests ,Transient elastography ,business ,Immunosuppressive Agents ,medicine.drug ,New Zealand - Abstract
Background Liver injury during inflammatory bowel disease (IBD) is primarily diagnosed by liver biopsy, which has a small but serious risk of severe complications. The aim of this study was to assess liver stiffness, and subsequently the prevalence and associations of liver fibrosis in IBD patients with thiopurine therapy and other clinical factors, by using transient elastography (TE). Methods In this prospective, international two-center study, included IBD-patients underwent TE measurements. Laboratory results and medication reports, radiology results and historical liver biopsy results were extracted from the patient charts. Results Transient elastography results of 168 patients were presented. Moderate and severe fibrosis were detected in 4% (7/168) and 1% (1/168) of the cohort, respectively. Factors contributing to lower liver stiffness were female gender and (historical) exposure to azathioprine. Further, there was a statistical trend towards lower liver stiffness in patients using thiopurines overall (4.7 vs. 5.2 kPa, p = 0.07). Liver stiffness correlated positively with waist circumference, liver enzyme tests, hemoglobin and 6-methylmercaptopurine concentration and negatively with platelet count. Conclusion Exposure to thiopurine therapy was not associated with higher liver stiffness, although no clinical difference in severity of fibrosis was detected. Further research should robustly determine the accuracy of TE as an evaluation of liver fibrosis in IBD patients.
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- 2017
8. 89 – Multitarget Stool Dna Testing As Alternative for Colonoscopy-Based Surveillance: An Interim Analysis
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Joana Moreira, Meta C. J. van Lanschot, Jeroen M. Jansen, Barry M. Berger, Dewkoemar Ramsoekh, Veerle M.H. Coupé, Monique E. van Leerdam, Annekatrien C.T.M. Depla, Gerrit A. Meijer, Graham P. Lidgard, Ad A.M. Masclee, Anne-Marie van Berkel, René W M van der Hulst, Beatriz Carvalho, Geertruida Maria Lemmens, Silvia Sanduleanu-Dascalescu, J.W.A. Straathof, Eric T.P. Keulen, Manon van Engeland, C. A. Wientjes, Evelien Dekker, and Alouisa J. P. van de Wetering
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medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Colonoscopy ,Stool dna ,business ,Interim analysis - Published
- 2019
9. Yield of routine molecular analyses in colorectal cancer patients ≤70 years to detect underlying Lynch syndrome
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Eelco J. R. de Graaf, Celine H. Leenen, Anja Wagner, Monique E. van Leerdam, Pieter J. Westenend, Ernst J. Kuipers, Dewkoemar Ramsoekh, W. W. Vrijland, Hendrikus J. Dubbink, Ewout W. Steyerberg, L. M. M. Wolters, Winand N.M. Dinjens, Ans M.W. van den Ouweland, and Margot G. van Lier
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Colorectal cancer ,Microsatellite instability ,Odds ratio ,medicine.disease ,Logistic regression ,Gastroenterology ,digestive system diseases ,Lynch syndrome ,Pathology and Forensic Medicine ,Surgery ,Internal medicine ,Predictive value of tests ,medicine ,business ,Prospective cohort study ,Genetic testing - Abstract
Although early detection of Lynch syndrome (LS) is important, a considerable proportion of patients with LS remains unrecognized. We aimed to study the yield of LS detection by routine molecular analyses in colorectal cancer (CRC) patients until 70 years of age. We prospectively included consecutive CRC patients ≤70 years. Tumour specimens were analysed for microsatellite instability (MSI), immunohistochemical mismatch-repair protein expression and MLH1-promoter methylation. Tumours were classified as either: (a) likely caused by LS; (b) sporadic microsatellite-unstable (MSI-H); or (c) microsatellite-stable (MSS). Predictors of LS were determined by multivariable logistic regression. A total of 1117 CRC patients (57% males, median age 61 years) were included. Fifty patients (4.5%, 95% CI 3.4-5.9) were likely to have LS, and 71 had a sporadic MSI-H tumour (6.4%, 95% CI 5.1-8.0). Thirty-five patients likely to have LS (70%) were aged > 50 years. A molecular profile compatible with LS was detected in 10% (15/144) of patients aged ≤50, in 4% (15/377) of those aged 51-60 and in 3% (20/596) of patients > 61 years. Compared to MSS cases, patients likely to have LS were significantly younger (OR 3.9, 95% CI 1.7-8.7) and more often had right-sided CRCs (OR 14, 95% CI 6.0-34). In conclusion, molecular screening for LS in CRC patients ≤70 years leads to identification of a molecular profile compatible with LS in 4.5% of patients, with most of them not fulfilling the age criterion (≤50 years) routinely used for LS assessment. Routine use of MSI testing may be considered in CRC patients up to the age of 70 years, with a central role for the pathologist in the selection of patients.
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- 2012
10. A back-to-back comparison of white light video endoscopy with autofluorescence endoscopy for adenoma detection in high-risk subjects
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Jan Werner Poley, Monique E. van Leerdam, Paul G. van Putten, Jelle Haringsma, Ewout W. Steyerberg, Dewkoemar Ramsoekh, Herman van Dekken, Ernst J. Kuipers, Gastroenterology & Hepatology, Rheumatology, Pathology, and Public Health
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Adenoma ,Adult ,Male ,medicine.medical_specialty ,Colorectal cancer ,Colonoscopy ,Colorectal adenoma ,Sensitivity and Specificity ,Gastroenterology ,Asymptomatic ,Fluorescence ,Young Adult ,SDG 3 - Good Health and Well-being ,Internal medicine ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Colorectal Neoplasms, Hereditary Nonpolyposis ,digestive system diseases ,Lynch syndrome ,Endoscopy ,Female ,medicine.symptom ,business - Abstract
Objective To compare the sensitivity of autofluorescence endoscopy (AFE) and white light video endoscopy (WLE) for the detection of colorectal adenomas in high-risk patients belonging to Lynch syndrome (LS) or familial colorectal cancer (CRC) families. Methods This was a prospective single-centre study carried out in a tertiary referral centre. The subjects were 75 asymptomatic patients originating from LS or familial CRC families. Patients were examined with either WLE followed by AFE or AFE followed by WLE. Back-to-back colonoscopy was performed by two blinded endoscopists. All lesions were removed during the second endoscopic procedure. Lesions missed during the second procedure were identified and removed on third pass. The sensitivity calculations for colorectal adenomas were based on histology results. The main outcome measures were the difference in sensitivity between WLE and AFE for the detection of adenomas in patients with LS or familial CRC. Results At least one adenoma was detected in 41 (55%) patients. WLE identified adenomas in 28/41 patients and AFE in 37/41 patients, corresponding to a 32% increase. In total 95 adenomas were detected, 65 by WLE and 87 by AFE, resulting in a significantly higher sensitivity of AFE compared with WLE (92% vs 68%; p=0.001). The additionally detected adenomas with AFE were significantly smaller than the adenomas detected by WLE (mean 3.0 mm vs 4.9 mm, p
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- 2010
11. A high incidence of MSH6 mutations in Amsterdam criteria II-negative families tested in a diagnostic setting
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M E van Leerdam, Dennis Dooijes, W. Dinjens, Ewout W. Steyerberg, Anja Wagner, E. J. Kuipers, D J J Halley, Dewkoemar Ramsoekh, Internal Medicine, Clinical Genetics, Gastroenterology & Hepatology, Pathology, and Public Health
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Adult ,Male ,Oncology ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,DNA Mutational Analysis ,Guidelines as Topic ,Gene mutation ,Biology ,MLH1 ,Germline mutation ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Genetic Predisposition to Disease ,Genetic Testing ,neoplasms ,Germ-Line Mutation ,Adaptor Proteins, Signal Transducing ,Amsterdam Criteria II ,Genetics ,Gastroenterology ,Nuclear Proteins ,Microsatellite instability ,nutritional and metabolic diseases ,Middle Aged ,medicine.disease ,Colorectal Neoplasms, Hereditary Nonpolyposis ,Lynch syndrome ,digestive system diseases ,DNA-Binding Proteins ,MSH6 ,MutS Homolog 2 Protein ,Phenotype ,MSH2 ,Female ,Colorectal Neoplasms ,MutL Protein Homolog 1 ,Microsatellite Repeats - Abstract
Background and aims: In Lynch syndrome, the clinical phenotype in MSH6 mutation families differs from that in MLH1 and MSH2 families. Therefore, MSH6 mutation families are less likely to fulfil diagnostic criteria such as the Amsterdam II criteria (AC II) and the revised Bethesda guidelines (rBG), and will be underdiagnosed. The aim of the present study was to evaluate the contribution of MSH6 gene mutations in families that were analysed for Lynch syndrome in a diagnostic setting. Methods: Families that had molecular analysis for Lynch syndrome were included in this study. Complete molecular screening of the MLH1 , MSH2 and MSH6 genes was performed in all families. Microsatellite instability (MSI) and immunohistochemical (IHC) analysis was performed in almost all families. Clinical data were collected from medical records and family pedigrees. Results: A total of 108 families were included. MSI and IHC analysis was performed in 97 families, and in 40 an MSI-high phenotype with absent protein expression was found. Germline mutation analysis detected mutations in 23 families (7 MLH1 , 4 MSH2 and 12 MSH6 ). The majority of MSH6 families were AC II negative, but fulfilled the rBG. Conclusions: There is a high incidence of MSH6 mutations in families tested for Lynch syndrome in a diagnostic setting. Many of these families remain underdiagnosed using the AC II. The rBG are more useful to select these families for further analysis. However, to optimise the detection of MSH6 families, MSI and IHC analysis should also be performed in families with clustering of late-onset endometrial carcinoma.
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- 2008
12. Review article: detection and management of hereditary non-polyposis colorectal cancer (Lynch syndrome)
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Anja Wagner, Dewkoemar Ramsoekh, E. J. Kuipers, and M E van Leerdam
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Oncology ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Hepatology ,business.industry ,Colorectal cancer ,Genetic counseling ,Gastroenterology ,nutritional and metabolic diseases ,Cancer ,Microsatellite instability ,medicine.disease ,digestive system diseases ,Lynch syndrome ,Internal medicine ,Mutation (genetic algorithm) ,medicine ,Pharmacology (medical) ,Age of onset ,Family history ,business ,neoplasms - Abstract
Background The most common hereditary colorectal cancer syndrome is hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome. Diagnosis of this syndrome is difficult, because of lack of specific diagnostic fatures. Aim To discuss the diagnostic criteria and laboratory work up for HNPCC. Furthermore, survelillance programs for HNPCC and treatment of HNPCC associated colorectal cancer are discussed. Results Current diagnostic criteria, including the Amsterdam II and Bethesda criteria, are suboptimal for the detection of HNPCC. Molecular screening by microsatellite instability (MSI) and immunohistochemistry (IHC) is useful in the diagnosis of HNPCC. Both techniques have a higher sensitivity compared to the Amsterdam II and Bethesda criteria. A combination of both MSI and IHC provides the most optimal selection for mutation analysis. After identification of a mutation in an affected individual, genetic counselling and presymptomatic mutation analysis should be offered to relatives. Furthermore, colonoscopic surveillance should be performed in proven mutation carriers. Conclusions Identification of HNPCC is a clinical challenge involving many clinicians. Identification of persons at risk can be achieved by a combination of a detailed family history, testing with molecular and mutation analysis.
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- 2007
13. Population Screening for Colorectal Cancer: Faeces, Endoscopes or X-Rays?
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J. D. F. Habbema, M. van Ballegooijen, E. J. Kuipers, Dewkoemar Ramsoekh, M E van Leerdam, Gastroenterology & Hepatology, and Public Health
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Proteomics ,Cancer Research ,medicine.medical_specialty ,Colorectal cancer ,Colonoscopy ,Review ,Disease ,Gastroenterology ,lcsh:RC254-282 ,Colorectal cancer screening ,Pathology and Forensic Medicine ,Feces ,SDG 3 - Good Health and Well-being ,Internal medicine ,faecal DNA analysis ,medicine ,Humans ,Mass Screening ,participation ,lcsh:QH573-671 ,Mass screening ,medicine.diagnostic_test ,business.industry ,lcsh:Cytology ,Incidence (epidemiology) ,Cancer ,Sigmoidoscopy ,Cell Biology ,General Medicine ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Endoscopy ,Radiography ,Molecular Medicine ,Patient Participation ,Colorectal Neoplasms ,business ,screening methods - Abstract
Colorectal carcinoma (CRC) is a common cancer and the second most common cause of death. The therapeutic costs for this disease will continue to rise due to an increasing incidence and the introduction of new chemotherapeutic modalities. Colorectal carcinoma is preceded by precursor lesions, which can be used as a target for early detection and therapy. Biennial population screening with faecal occult blood tests (FOBT) lowers CRC mortality with 14–18%. Five year screening with flexible sigmoidoscopy is a cost-effective alternative, which yields a higher preventive effect when similar participation rates are achieved. Screening colonoscopy has the advantage of examination of the complete colon but disadvantages are the high participant burden and the higher demand for endoscopic personnel and endoscopy units. Future screening modalities like faecal DNA markers and CT colonography are promising but need further improvement. In Europe, faecal occult blood testing and flexible sigmoidoscopy are currently the most suitable screening modalities for colorectal cancer screening.
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- 2007
14. Reversible severe hepatitis in anorexia nervosa: a case report and overview
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Dewkoemar Ramsoekh, Pavel Taimr, Thomas Vanwolleghem, and Gastroenterology & Hepatology
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Adult ,medicine.medical_specialty ,Pediatrics ,Anorexia Nervosa ,Time Factors ,Nutritional Status ,Anorexia ,Enteral administration ,Severity of Illness Index ,Hepatitis ,Enteral Nutrition ,Liver Function Tests ,SDG 3 - Good Health and Well-being ,Internal medicine ,Severity of illness ,mental disorders ,medicine ,Humans ,Hepatology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Alanine Transaminase ,Clinical Enzyme Tests ,medicine.disease ,Hepatitis a virus ,Parenteral nutrition ,Endocrinology ,Treatment Outcome ,Anorexia nervosa (differential diagnoses) ,Fluid Therapy ,Female ,medicine.symptom ,business ,Liver function tests ,Biomarkers - Abstract
Mildly elevated transaminases are often observed in anorexia nervosa patients, but severe hepatitis is less common. We suggest that hypoperfusion is the pathogenetic factor that causes severe hepatitis in a patient with a very poor nutritional status and present an overview of previous case reports. In our patient, early initiation of intravenous fluids resulted in rapid recovery of the liver test abnormalities, despite minimal oral caloric intake, the refusal of enteral feeding and the development of a hypoglycemic coma. Two months after admission, transaminases had normalized. Reversible severe hepatitis has been described in most of the cases, with only one anorexia nervosa-related fatal hepatitis. In general, both adequate hydration and gradual enteral feeding with monitoring of electrolytes are essential in the management of anorexia patients with severe hepatitis.
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- 2014
15. Varicella zoster-associated gastric ulcers, hepatitis and pancreatitis in an immunocompromised patient
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A C de Vries, Dewkoemar Ramsoekh, R. G. Remmerswaal, H.R. van Buuren, and Gastroenterology & Hepatology
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Hepatitis ,medicine.medical_specialty ,SDG 3 - Good Health and Well-being ,business.industry ,Gastroenterology ,MEDLINE ,Medicine ,Pancreatitis ,Immunocompromised patient ,business ,medicine.disease ,Dermatology - Published
- 2012
16. Sporadic duodenal adenoma and the association with colorectal neoplasia: a case-control study
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Dewkoemar Ramsoekh, Herman van Dekken, Monique E. van Leerdam, Ernst J. Kuipers, R. Ouwendijk, Evelien Dekker, Internal Medicine, Gastroenterology & Hepatology, Molecular Genetics, Pathology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, and Gastroenterology and Hepatology
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Adenoma ,Adult ,Male ,medicine.medical_specialty ,endocrine system diseases ,Databases, Factual ,Colorectal cancer ,Gastroenterology ,Endoscopy, Gastrointestinal ,Duodenal Adenoma ,SDG 3 - Good Health and Well-being ,Duodenal Neoplasms ,Risk Factors ,Internal medicine ,medicine ,Prevalence ,Humans ,Colonic disease ,Aged ,Netherlands ,Aged, 80 and over ,Hepatology ,business.industry ,Incidence ,Case-control study ,Cancer ,Middle Aged ,medicine.disease ,digestive system diseases ,stomatognathic diseases ,medicine.anatomical_structure ,Case-Control Studies ,Duodenum ,Female ,business ,Colorectal Neoplasms ,Rectal disease - Abstract
OBJECTIVES: Sporadic duodenal adenomas are an uncommon finding. It is not clear whether patients with sporadic duodenal adenoma have a greater risk for colorectal neoplasia and should undergo colonoscopy. The aims of the present study were to estimate the prevalence of colorectal neoplasia in patients with sporadic duodenal adenoma, and to compare colorectal neoplasia rates in patients with sporadic duodenal adenomas versus those without them. METHODS: A retrospective case-control study was conducted to identify sporadic duodenal adenoma patients using the databases of two academic and one regional hospital in the Netherlands. Colonoscopic findings in the sporadic duodenal adenoma patients were compared with those of a control group of patients who underwent both gastroduodenoscopy and colonoscopy. Furthermore, the frequency of colorectal cancer in the sporadic duodenal adenoma patients was compared with the population incidence of colorectal cancer. RESULTS: During the period 1991-2006, 102 patients in total with sporadic duodenal adenomas were identified. Colonoscopy was performed in 49 patients (48%), and colorectal neoplasia was present in 21 of these patients (43%). There was a significantly higher rate of both colorectal neoplasia (43% vs 17%, odds ratio [OR] 3.6, 95% confidence interval [CI] 1.7-7.4) and advanced colorectal adenoma (18% vs 3%, OR 7.8, 95% CI 2.1-29.4) in the patients with sporadic duodenal adenoma compared to that in the control group. Also, the incidence of colorectal cancer was higher in sporadic duodenal adenoma patients compared to that in the population (P = 0.02). CONCLUSIONS: Individuals with sporadic duodenal adenomas appear to be at a significantly higher risk of colorectal neoplasia, and therefore should undergo colonoscopy.
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- 2008
17. Reply
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Dewkoemar Ramsoekh, G. N. J. Tytgat, E. A. J. Rauws, and M. E. van Leerdam
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medicine.medical_specialty ,Hepatology ,business.industry ,General surgery ,Gastroenterology ,medicine ,Peptic ulcer bleeding ,business ,Outcome (game theory) - Published
- 2006
18. S1081 Evaluation of Molecular Changes in Sporadic Duodenal Adenomas
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Monique E. van Leerdam, W. Dinjens, Ernst J. Kuipers, Karam S. Boparai, Ron Smits, Dewkoemar Ramsoekh, Wendy van Veelen, Evelien Dekker, and Myrthe Theeuwes
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endocrine system diseases ,Hepatology ,Adenoma ,business.industry ,Gastroenterology ,Microsatellite instability ,medicine.disease ,medicine.disease_cause ,digestive system diseases ,Lynch syndrome ,Familial adenomatous polyposis ,stomatognathic diseases ,medicine ,Cancer research ,Carcinoma ,Mutation testing ,Duodenal Carcinoma ,KRAS ,business - Abstract
Background: The duodenal adenomas as seen in familial adenomatous polyposis (FAP) are likely to develop through the classical adenoma-carcinoma pathway as they exhibit mutations in the APC gene, KRAS mutations, p53 dysfunction, and loss of E-cadherin expression. However, it is unknown whether sporadic duodenal adenomas also develop into duodenal carcinoma through the classical adenoma carcinoma sequence. Limited data suggest that sporadic adenomas show similar molecular features as colorectal adenomas, harboring APC and KRAS mutations. Therefore, the aim of the present study was to evaluate the molecular changes of sporadic duodenal adenomas. Methods: Tissue samples of 64 sporadic duodenal adenomas were available from the pathology archives of two academic hospitals. Tissue samples of patients with duodenal carcinoma or patients with FAP were excluded. None of the patients belonged to a known Lynch syndrome family. DNA was extracted from paraffin sections of the adenoma and analyzed for the presence of microsatellite instability. Also, mutation analysis using polymerase chain reaction followed by direct-sequencing was performed. The mutation analysis included mutational hotspots of the Wnt signaling pathway (APC, β-catenin), the MAP kinase pathway (KRAS and BRAF) and the del1100c mutation within the CHK2 gene. Results: Two (3%) of the 64 adenomas showed a high level of MSI (MSI-H). APC mutation analysis was possible in 52 adenomas and revealed a mutation in thirteen (24%), including seven duodenal adenomas with a recurrent 4684insA (K1555fsX1557)mutation. KRASmutation analysis was possible in 52 adenomas and revealed one (2%) mutation (34GGT>TGT (G12C)). β-catenin mutation analysis was possible in 48 adenomas and revealed one (2%) mutation (121ACC>GCC(T41A)). BRAF (58 adenomas) and CHK2 (53 adenomas) mutation analysis did not reveal any mutation. Conclusions: In our cohort of sporadic duodenal adenomas the frequency of Wnt signaling pathway abnormalities is low, most adenomas are microsatellite stable and the number of MAP kinase pathway abnormalities is negligible. In addition, CHK2 mutations seem not to be present in sporadic duodenal adenomas. These findings suggest that a proportion of sporadic duodenal adenomas develop via the same mechanisms (the adenoma-carcinoma sequence) as colorectal adenomas, but it is possible that other molecular changes may also underlie the development of sporadic duodenal adenomas.
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- 2009
19. T2034 A High Incidence of Msh6 Mutations in Amsterdam II Criteria Negative Families Tested in a Clinical Setting
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E. J. Kuipers, Dewkoemar Ramsoekh, Dennis Dooijes, Anja Wagner, W. Dinjens, Monique E. van Leerdam, and Ewout W. Steyerberg
- Subjects
MSH6 ,Pediatrics ,medicine.medical_specialty ,Hepatology ,business.industry ,Incidence (epidemiology) ,Gastroenterology ,Medicine ,business - Published
- 2008
20. T2036 Estimating Absolute Risk of Colorectal Cancer Based On Family History: An Epidemiological Approach
- Author
-
M.E. Leerdam van, Dewkoemar Ramsoekh, Anja Wagner, Clausa Liem, E. J. Kuipers, and Ewout W. Steyerberg
- Subjects
Oncology ,medicine.medical_specialty ,Hepatology ,Colorectal cancer ,business.industry ,Internal medicine ,Epidemiology ,Gastroenterology ,medicine ,Absolute risk reduction ,Family history ,medicine.disease ,business - Published
- 2008
21. T2041 Evaluation of Mutation Prediction Models in Lynch Syndrome
- Author
-
E. J. Kuipers, Anja Wagner, Monique E. van Leerdam, Dewkoemar Ramsoekh, and Ewout W. Steyerberg
- Subjects
Genetics ,Hepatology ,Mutation (genetic algorithm) ,Gastroenterology ,medicine ,Biology ,medicine.disease ,Lynch syndrome - Published
- 2008
22. T1083 Low Prevalence of Microsatellite Instability in Sporadic Duodenal Adenomas
- Author
-
M.E. Leerdam van, Dewkoemar Ramsoekh, E. J. Kuipers, and W. Dinjens
- Subjects
medicine.medical_specialty ,Hepatology ,Internal medicine ,Gastroenterology ,medicine ,Microsatellite instability ,Biology ,medicine.disease - Published
- 2008
23. Peptic Ulcer Bleeding, NSAID Use and Helicobacter Pylori Infection: A Prospective Study Evaluating Prevalence and Outcome
- Author
-
Monique E.Leerdam van, Guido N. J. Tytgat, Dewkoemar Ramsoekh, A. A.M. Geraedts, and Erik A.J. Rauws
- Subjects
medicine.medical_specialty ,Helicobacter pylori infection ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Radiology, Nuclear Medicine and imaging ,Peptic ulcer bleeding ,Prospective cohort study ,business - Published
- 2004
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