Percorrer por autor "Arvanitakis, Marianna"
A mostrar 1 - 3 de 3
Resultados por página
Opções de ordenação
- Age-related differences in the presentation, management, and outcomes of lower gastrointestinal bleeding : a retrospective multinational cohort studyPublication . Vara-Luiz, Francisco; Palma, Carolina; Mascarenhas, Paulo; Tham, Tony C.; Arvanitakis, Marianna; Rodriguez-de-Santiago, Enrique; Pedroto, Isabel; Simas, Diogo; Radaelli, Franco; Camus, Marine; Gkolfakis, Paraskevas; Triantafyllou, Konstantinos; Fabbri, Carlo; Patita, Marta; Tan, Erica; Campbell, Ellen; Smyth, Michael; Beattie, Hannah; Seeruthun, Ravish; Hadefi, Alia; Rodríguez-Francisco, Gabriela; Paulo, João Pedro; Gonçalves, Luísa; Caetano, Isabel; Savino, Alberto; Goudot, Marie; Panagaki, Antonia; Koukoulioti, Eleni; Nikolaki, Maroulla; Gibiino, Giulia; Gattuso, Alberto; Mendes, Ivo; Piçarra, Francisco; Fonseca, JorgeBackground: Population ageing in Europe is reshaping the clinical profile and outcomes of lower gastrointestinal bleeding (LGIB), but age-related comparative data remain scarce. We aimed to compare clinical presentation, management and 30-day outcomes between older and younger adults with LGIB. Methods: This retrospective, multinational, cohort study included consecutive adults presenting to emergency departments with LGIB between January 1 and December 31 in 2024. European hospitals routinely managing LGIB were eligible to participate. Ethical approval was obtained at hospital level. Patients were categorised in two age groups (≥65 and <65 years). The primary outcome was 30-day mortality. Findings: Overall, 1058 patients from 11 centres in seven European countries were included. Of these, 77.3% (818/1058) were aged ≥65 years and demonstrated a higher Oakland (21.0 ± 7.15), ABC (4.0 ± 2.9), and ALIBI (8.94 ± 3.7) scores, and a higher transfusion rate (50.9%, 416/818). Aetiology differed by age, with anorectal and inflammatory bowel diseases more common in younger adults and diverticular bleeding predominating in older patients. Endoscopy was performed in most patients (84.9%, 899/1058) and the rates of endoscopic therapy, interventional radiology, and surgery were similar across groups. Overall, 30-day mortality was 11.7% (124/1058) and was higher in older adults (13.7%, 112/818 versus 5.0%, 12/240), mainly due to non-bleeding-related causes (89.3%, 100/112). In multivariable analyses, ALIBI score (OR = 1.26 per-point, 95% CI 1.14–1.39), ABC score (OR = 1.25 per-point, 95% CI 1.15–1.36), and Charlson Comorbidity Index (OR = 1.25 per-point, 95% CI 1.14–1.37) were independently associated with 30-day mortality (p < 0.001). Age was inversely associated with intensive care unit admission (OR = 0.95 per-year, 95% CI 0.92–0.98; p = 0.0028). Interpretation: LGIB in older adults presents distinct clinical features with more severe bleeding. Higher baseline vulnerability might explain the age-related differences in escalation of care and worse outcomes. This supports the need for better integrated pathways of care in ageing European populations.
- European consensus on malabsorption—UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 1 : definitions, clinical phenotypes, and diagnostic testing for malabsorptionPublication . Lenti, Marco Vincenzo; Hammer, Heinz Florian; Tacheci, Ilja; Burgos, Rosa; Schneider, Stephane; Foteini, Anastasiou; Derovs, Aleksejs; Keller, Jutta; Broekaert, Ilse; Arvanitakis, Marianna; Dumitrascu, Dan Lucian; Segarra-Cantón, Oscar; Krznarić, Željko; Pokrotnieks, Juris; Nunes, Gonçalo; Hammer, Johann; Pironi, Loris; Sonyi, Marc; Sabo, Cristina Maria; Mendive, Juan; Nicolau, Adrien; Dolinsek, Jernej; Kyselova, Denisa; Laterza, Lucrezia; Gasbarrini, Antonio; Surdea-Blaga, Teodora; Fonseca, Jorge; Lionis, Christos; Corazza, Gino Roberto; Sabatino, Antonio DiMalabsorption is a complex and multifaceted condition characterised by the defective passage of nutrients into the blood and lymphatic streams. Several congenital or acquired disorders may cause either selective or global malabsorption in both children and adults, such as cystic fibrosis, exocrine pancreatic insufficiency (EPI), coeliac disease (CD) and other enteropathies, lactase deficiency, small intestinal bacterial overgrowth (SIBO), autoimmune atrophic gastritis, Crohn's disease, and gastric or small bowel resections. Early recognition of malabsorption is key for tailoring a proper diagnostic work-up for identifying the cause of malabsorption. A patient's medical and pharmacological history is essential for identifying risk factors. Several examinations such as endoscopy with small intestinal biopsies, non-invasive functional tests and radiological imaging are useful in diagnosing malabsorption. Because of its high prevalence, CD should always be looked for in cases of malabsorption with no other obvious explanations and in high-risk individuals. Nutritional support is key in the management of patients with malabsorption; different options are available, including oral supplements, enteral or parenteral nutrition. In patients with short bowel syndrome, teduglutide proved effective in reducing the need for parenteral nutrition, thus improving the quality of life of these patients. Primary care physicians play a central role in the early detection of malabsorption and should be involved in multidisciplinary teams for improving the overall management of these patients. In this European consensus, involving ten scientific societies and several experts, we have dissected all the issues around malabsorption, including the definitions and diagnostic testing (Part 1), high-risk categories and special populations, nutritional assessment and management, and primary care perspective (Part 2).
- European consensus on malabsorption—UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 2: screening, special populations, nutritional goals, supportive care, primary care perspectivePublication . Lenti, Marco Vincenzo; Hammer, Heinz Florian; Tacheci, Ilja; Burgos, Rosa; Schneider, Stephane; Foteini, Anastasiou; Derovs, Aleksejs; Keller, Jutta; Broekaert, Ilse; Arvanitakis, Marianna; Dumitrascu, Dan Lucian; Segarra-Cantón, Oscar; Krznarić, Željko; Pokrotnieks, Juris; Nunes, Gonçalo; Hammer, Johann; Pironi, Loris; Sonyi, Marc; Sabo, Cristina Maria; Mendive, Juan; Nicolau, Adrien; Dolinsek, Jernej; Kyselova, Denisa; Laterza, Lucrezia; Gasbarrini, Antonio; Surdea-Blaga, Teodora; Fonseca, Jorge; Lionis, Christos; Corazza, Gino Roberto; Sabatino, Antonio DiMalabsorption is a complex and multifaceted condition characterised by the defective passage of nutrients into the blood and lymphatic streams. Several congenital or acquired disorders may cause either selective or global malabsorption in both children and adults, such as cystic fibrosis, exocrine pancreatic insufficiency (EPI), coeliac disease (CD) and other enteropathies, lactase deficiency, small intestinal bacterial overgrowth (SIBO), autoimmune atrophic gastritis, Crohn's disease, and gastric or small bowel resections. Early recognition of malabsorption is key for tailoring a proper diagnostic work-up for identifying the cause of malabsorption. Patient's medical and pharmacological history are essential for identifying risk factors. Several examinations like endoscopy with small intestinal biopsies, non-invasive functional tests, and radiologic imaging are useful in diagnosing malabsorption. Due to its high prevalence, CD should always be looked for in case of malabsorption with no other obvious explanations and in high-risk individuals. Nutritional support is key in management of patients with malabsorption; different options are available, including oral supplements, enteral or parenteral nutrition. In patients with short bowel syndrome, teduglutide proved effective in reducing the need for parenteral nutrition, thus improving the quality of life of these patients. Primary care physicians have a central role in early detection of malabsorption and should be involved into multidisciplinary teams for improving the overall management of these patients. In this European consensus, involving 10 scientific societies and several experts, we have dissected all the issues around malabsorption, including the definitions and diagnostic testing (Part 1), high-risk categories and special populations, nutritional assessment and management, and primary care perspective (Part 2).