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Background:  The SARS-CoV-2 pandemic has majorly affected medical activity around the world. We sought to measure the impact of the COVID-19 pandemic on gastrointestinal (GI) endoscopy activity in France.Methods:  We performed a web-based survey, including 35 questions on the responders and their endoscopic practice, from 23 March to 27 March 2020, sent to the 3300 French gastroenterologists practicing endoscopy.Results:  694 GI endoscopists (21 %) provided analyzable data; of these, 29.4 % (204/694) were involved in the management of COVID-19 patients outside the endoscopy department. During the study period, 98.7 % (685/694) of endoscopists had had to cancel procedures. There were 89 gastroenterologists (12.8 %) who reported symptoms compatible with COVID-19 infection, and a positive PCR test was recorded in 12/197 (6.1 %) vs. 3/497 (0.6 %) endoscopists in the high vs. low prevalence areas, respectively (P < 0.001).Conclusions:  The COVID-19 pandemic led to a major reduction in the volume of GI endoscopies performed in France in March 2020. The prolonged limited access to GI endoscopy could lead to a delay in the management of patients with GI cancers. [ABSTRACT FROM AUTHOR]

Background: Recent evidence has indicated an increased risk of Barrett's esophagus (BE) in the long term after sleeve gastrectomy (SG). Aim: The aim of the study is to investigate the spectrum of gastroesophageal reflux disease (GERD) symptoms as well as the prevalence of BE, at minimum 5 years after SG in patients who underwent SG in different bariatric centers of two countries: France and Italy. Patients and Methods: Five high volume outpatient centers dedicated to bariatric surgery that routinely perform upper GI endoscopy before any bariatric procedures were invited to participate in the study. From January 2017 to June 2018, each center during scheduled postoperative evaluation after surgery asked a minimum 10 consecutive patients, which had performed SG at least 5 years before and with no evidence of BE preoperatively, to undergo another upper GI endoscopy. Results: Ninety (66 F) consecutive patients were enrolled. The mean follow-up was 78 ± 15 months, and the mean total body weight loss was 25 ± 12%. The prevalence of BE was 18.8% with no significant difference among centers. Weight loss failure was significantly associated with BE (p < 0.01). The prevalence of GERD symptoms, erosive esophagitis, and the usage of PPIs increased from 22%, 10%, and 22% before the SG to 76%, 41%, and 52% at the time of follow-up, respectively (p < 0.05). Conclusions: This multicenter study show a high rate of BE at least 5 years after SG. Weight loss failure was significantly associated with BE. We suggest to provide systematic endoscopy in these patients to rule out this condition. [ABSTRACT FROM AUTHOR]

Background: The prognosis for pancreatic cancer remains poor despite diagnostic advances and treatments with new chemotherapeutic regimens. The five year survival rate remains below 3%. Consequently, there is an urgent need for new treatments to significantly improve the prognosis. In addition, there is a big gap in terms of the screening, early diagnosis and prevention of pancreatic cancer the incidence of which is increasing dramatically.Methods: Design: the BACAP cohort is a prospective multicenter pancreatic cancer cohort (pancreatic ductal carcinoma) with clinical and multiple biological samples; Participating centers: 15 French academic and private hospitals; Study Population: any cytologically and/or histologically proven pancreatic carcinoma regardless of the stage (resectable, borderline, locally advanced or metastatic) or treatment (surgery, palliative chemotherapy, best supportive care). At least 1500 patients will be included. Clinical data collected include: disease presentation, epidemiological and social factors, baseline biology, radiology, endoscopic ultrasound, staging, pathology, treatments, follow-up (including biological and radiological), and survival. All these data are collected and stored through an e-observation system at a centralized data center. Biological samples and derived products (i.e. before any treatment): blood, saliva, endoscopic ultrasound-guided fine needle aspiration materials from the primary tumor, fine needle biopsy of metastases and surgically resected tissue. DNA and RNA are extracted from fine needle aspiration materials and are quantified and characterized for quality. Whole blood, plasma and serum are isolated from blood samples. Frozen tissues were specifically allocated to the cohort. All derived products and saliva are stored at - 80 °C. Main end-points: i) to centralize clinical data together with multiple biological samples that are harmonized in terms of sampling, the post sampling process and storage; ii) to identify new molecular markers for the diagnosis, prognosis and possibly the predictive response to pancreatic cancer surgery and or chemotherapy.Discussion: The BACAP cohort is a unique prospective biological clinical database that provides the opportunity to identify correlations between the presence/expression of a broad panel of biomarkers (DNA, RNA, miRNA, proteins, etc.), epidemiological and social data, various clinical situations, various stages and the differentiation of the tumor, treatments and survival.Trial Registration: ClinicalTrials.gov Identifier: NCT02818829 . Registration date: June 30, 2016. [ABSTRACT FROM AUTHOR]

The aims of this study were to determine whether alcohol consumption or cessation influences transient elastography (TE) measurements and whether TE is a useful tool to monitor alcoholic patients. Twenty-three consecutive heavy drinkers (20 men and 3 women; mean age 47.2 years) admitted for a 7-day hospitalization for alcohol detoxification were included. On admission (D0), a detailed medical history was taken and the following laboratory tests were performed [aspartate aminotransferase (ASAT), gamma glutamyltransferase (γGT), and carbohydrate-deficient transferrin (CDT) levels, and Fibroscan]. All examinations were repeated on D8, D30, and D60. Variation in the median Fibroscan value of >20% was considered significant. After 1 week of detoxification, the % variation in TE was −21.67 ± −27.6%. The median variation in TE between D8 and D60 was −20% in the abstinent group and 32% in the relapse group ( p = 0.007). An increase in proportion of patients with a significant decrease in TE was observed with an increased duration of abstinence: 41.7% at D8 and 66.7% at D60. TE values were significantly correlated with ASAT, γGT, and CDT at D0 and D8, and with ASAT and γGT at D60. TE in alcoholics is influenced by major variations in the biochemical activity of the disease. The kinetics of variation of TE suggest that this method may be useful to assess alcohol abuse and control. [ABSTRACT FROM AUTHOR]

L'obésité et le surpoids s'avèrent être des problèmes de santé publique de manière pandémique réduisant significativement l'espérance de vie des personnes touchées et présentant un impact médicoéconomique important, en lien avec les traitements qu'ils requièrent et leurs comorbidités. En France, la prise en charge thérapeutique de cette pathologie se résume à une modification du mode de vie ou à une approche chirurgicale. L'endoscopie a permis le développement d'alternatives thérapeutiques ces dernières années, bien que ces méthodes ne soient à l'heure actuelle pas toutes recommandées en France alors même que des résultats probants aient été démontrés. À l'heure de l'avènement de l'endoscopie interventionnelle préservant les organes, des procédures thérapeutiques novatrices mini-invasives ont vu le jour et vont tendre à se développer afin d'occuper une place à part entière dans le traitement de cette maladie chronique. Avec la mise à disposition de nouveaux traitements médicamenteux efficaces comme les agonistes du GLP-1, des approches combinées « endoscopie-médicament » pourraient être nouvellement définies permettant d'atteindre une efficacité clinique sans précédent. L'objectif de cette mise au point est de rappeler les techniques endoscopiques actuelles existantes dans la prise en charge de l'obésité, d'exposer les innovations dans le domaine en cours de développement et d'esquisser quel pourrait être l'avenir de l'endoscopie bariatrique. Obesity and overweight are proving to be pandemic public health problems that significantly reduce the life expectancy of those affected. Obesity has a significant medico-economic impact, in relation to the treatments it requires and its comorbidities. In France, the therapeutic management of this pathology is limited to a lifestyle modification or a surgical approach. Endoscopy has allowed the development of therapeutic alternatives in the management of obesity in recent years, although not all of these methods are currently recommended in France, even though convincing results have been shown. With the advent of organ-sparing interventional endoscopy, innovative minimally invasive therapeutic procedures have emerged and will tend to develop in order to take a full place in the treatment of this chronic disease. More ambitious endoscopic procedures could also be combined, thus combining the different modes of action of each of them. Finally, with the availability of new effective drug treatments, combined "endoscopy-drug" approaches could be newly defined to achieve unprecedented clinical effectiveness. The objective of this review will be to present the current endoscopic techniques available for the management of obesity, to discuss the innovative procedures under development and to outline the future of bariatric endoscopy, either by combining procedures or by combining them with medical therapies. [ABSTRACT FROM AUTHOR]

Unlabelled: Recent studies have shown that the diagnosis of spontaneous bacterial peritonitis (SBP) can be rapidly obtained using leukocyte esterase reagent strips. However, published studies were restricted to one or two centers, and the number of patients with SBP was thus limited. The aims of the current prospective multicenter study were: (1) to assess the diagnostic accuracy of the Multistix 8SG urine test for the diagnosis of SBP; and (2) to assess the prevalence of SBP. From January to May 2004, 2 reactive strips were tested independently in inpatients with cirrhosis and in outpatients undergoing paracentesis. Cultures of ascitic fluid were performed at the bedside using aerobic and anaerobic blood culture bottles. Two thousand one hundred twenty-three paracenteses were performed in 1,041 patients from 70 centers. One hundred seventeen samples, obtained from 91 patients, had ascites polymorphonuclear cell (PMN) counts>or=250/microl (range, 250-34,000), among which 56 were associated with positive ascitic fluid cultures. The prevalence of SBP was 5.5% in the whole population, 9% in inpatients, and 1.3% in outpatients (P<0.0001). The prevalence of SBP was 0.57% in asymptomatic outpatients versus 2.4% in symptomatic outpatients (P=0.04). Using a threshold of 2+ for positivity of the reagent strip, sensitivity was 45.3% for the diagnosis of SBP, specificity was 99.2%, positive predictive value was 77.9%, and negative predictive value was 96.9%., Conclusion: This study confirms the low prevalence of SBP in asymptomatic outpatients according to a priori defined criteria, and indicates an absence of diagnostic efficacy for this specific strip test.