1.The Duodenal Microenvironment in Functional Dyspepsia
Pauline HUYGHE ; Matthias CEULEMANS ; Åsa V KEITA ; Johan SÖDERHOLM ; Inge DEPOORTERE ; Jan TACK ; Lucas WAUTERS ; Tim VANUYTSEL
Journal of Neurogastroenterology and Motility 2025;31(2):186-198
Functional dyspepsia (FD) is a chronic gastrointestinal disorder without a readily identifiable organic cause, resulting in bothersome upper abdominal symptoms. It is a highly prevalent disorder of which the pathophysiology remains mostly elusive, despite intensive research efforts. However, recent studies have found alterations in the microenvironment of the duodenum in patients with FD. In this review we summarize the duodenal microenvironment in homeostatic conditions and the alterations found in patients with FD, highlighting the similarities and discrepancies between different studies. The most consistent findings, being an impaired duodenal barrier and duodenal immune activation, are reviewed. We discuss the potential triggers for these observed alterations, including psychological comorbidities, luminal alterations and food related triggers. In summary, this review presents the evidence of molecular and cellular changes in patients with FD, with an impaired duodenal barrier and activated mucosal eosinophils and mast cells, challenging the notion that FD is purely functional, and offering different targets for potential future treatments.
2.The Duodenal Microenvironment in Functional Dyspepsia
Pauline HUYGHE ; Matthias CEULEMANS ; Åsa V KEITA ; Johan SÖDERHOLM ; Inge DEPOORTERE ; Jan TACK ; Lucas WAUTERS ; Tim VANUYTSEL
Journal of Neurogastroenterology and Motility 2025;31(2):186-198
Functional dyspepsia (FD) is a chronic gastrointestinal disorder without a readily identifiable organic cause, resulting in bothersome upper abdominal symptoms. It is a highly prevalent disorder of which the pathophysiology remains mostly elusive, despite intensive research efforts. However, recent studies have found alterations in the microenvironment of the duodenum in patients with FD. In this review we summarize the duodenal microenvironment in homeostatic conditions and the alterations found in patients with FD, highlighting the similarities and discrepancies between different studies. The most consistent findings, being an impaired duodenal barrier and duodenal immune activation, are reviewed. We discuss the potential triggers for these observed alterations, including psychological comorbidities, luminal alterations and food related triggers. In summary, this review presents the evidence of molecular and cellular changes in patients with FD, with an impaired duodenal barrier and activated mucosal eosinophils and mast cells, challenging the notion that FD is purely functional, and offering different targets for potential future treatments.
3.The Duodenal Microenvironment in Functional Dyspepsia
Pauline HUYGHE ; Matthias CEULEMANS ; Åsa V KEITA ; Johan SÖDERHOLM ; Inge DEPOORTERE ; Jan TACK ; Lucas WAUTERS ; Tim VANUYTSEL
Journal of Neurogastroenterology and Motility 2025;31(2):186-198
Functional dyspepsia (FD) is a chronic gastrointestinal disorder without a readily identifiable organic cause, resulting in bothersome upper abdominal symptoms. It is a highly prevalent disorder of which the pathophysiology remains mostly elusive, despite intensive research efforts. However, recent studies have found alterations in the microenvironment of the duodenum in patients with FD. In this review we summarize the duodenal microenvironment in homeostatic conditions and the alterations found in patients with FD, highlighting the similarities and discrepancies between different studies. The most consistent findings, being an impaired duodenal barrier and duodenal immune activation, are reviewed. We discuss the potential triggers for these observed alterations, including psychological comorbidities, luminal alterations and food related triggers. In summary, this review presents the evidence of molecular and cellular changes in patients with FD, with an impaired duodenal barrier and activated mucosal eosinophils and mast cells, challenging the notion that FD is purely functional, and offering different targets for potential future treatments.
4.Professional quality of life and workplace psychosocial support interventions among nurses in the Philippines during the COVID-19 pandemic
Johan Y. Castillejos ; Danica May O. Cañ ; on ; Rupert I. Estor ; Marian Danille C. Santillan ; John Vian C. Villaluz ; Vivien Fe F. Fadrilan-camacho ; Paul Michael R. Hernandez
Acta Medica Philippina 2025;59(4):42-55
BACKGROUND AND OBJECTIVE
Nurses comprise the majority of the health workforce in the Philippines. Previous studies revealed that nurses manifest negative mental health outcomes exacerbated by COVID-19 pandemic. This study aims to determine the Professional Quality of Life (ProQOL) of nurses in the Philippines and their workplace psychosocial support interventions during the pandemic. The ProQOL measures compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS).
METHODSA self-administered online questionnaire was disseminated by the Philippine Nurses Association, Inc. to affiliated nurses via email and Facebook posts. Out of 713 responses, 239 were eligible with their data analyzed using t-test, one-way ANOVA, and post hoc pairwise multiple comparisons.
RESULTSRespondents were found to have high CS (41.95 [SD 5.97]), moderate BO (23.56 [SD 6.07]), and moderate STS (26.62 [SD 8.18]). The most reported intervention was policies on confidentiality of workers’ mental health (84.94%) while the least reported was community engagements under the hospital’s mental health program (61.51%). ProQOL scores significantly differed in CS by age (p=0.011), position (p=0.044) and monthly income (p=0.016), BO by age (p=0.001) and years with current employer (p=0.009), and STS by region (p=0.017) and area of assignment (p=0.015). The existence of interventions yielded significant increase in CS and decrease in BO scores.
CONCLUSIONNurses in the Philippines exhibit high and favorable ProQOL during the pandemic. The majority of respondents reported the presence of workplace interventions which yield significant differences in CS and BO. The findings highlight the importance of workplace psychosocial support interventions and the need to strengthen implementation.
Human ; Nurses ; Quality Of Life ; Psychosocial Intervention ; Occupational Health ; Covid-19 Pandemic ; Covid-19
5.Decoding the influence of external beam radiotherapy to brachytherapy duration and overall treatment on response and early recurrences in cervical cancer patients treated with chemoradiation
Abhishek KRISHNA ; Bharat Sai MAKKAPATTI ; M. S. ATHIYAMAAN ; Dilson LOBO ; Challapalli SRINIVAS ; Johan SUNNY ; Vaishak JAWAHAR ; Harleen KAUR ; Sourjya BANERJEE
Radiation Oncology Journal 2024;42(4):257-262
Purpose:
Cervical cancer is a significant global health issue affecting approximately 600,000 women each year. This study aimed to address the knowledge gaps surrounding the influence of treatment time parameters, including the duration of external beam radiotherapy (EBRT) to brachytherapy and overall treatment duration, on early recurrences.
Materials and Methods:
Details on demographics, tumor characteristics, treatment details, and outcomes in patients undergoing chemoradiation and brachytherapy for cervical cancer were collected from the medical records. Early recurrence was defined as tumor reappearance within 6 months after treatment in patients with an initial complete response. Statistical analyses included descriptive statistics chi-square tests, independent t-tests, and logistic regression.
Results:
A total of 288 cervical cancer patients were included. Stage IIB was the most common stage and 93% of patients had a complete response, 4.5% partial response, and 3.1% had progressive disease at 3rd month. At 6 months, 8% experienced early. The average interval between EBRT and brachytherapy was 10.4 ± 4.2 days among the no recurrence group and 12.3 ± 4.5 days among early recurrence group. A total of 203 patients had a gap of 10 or fewer days and 123 patients had a gap of more than 10 days between EBRT and brachytherapy. Difference was observed in the overall treatment time between the two groups had significant differences (no recurrence group, 61.6 ± 11.5 days; early recurrence group, 73.8 ± 8.8 days; p < 0.001).
Conclusion
The study revealed that longer overall treatment durations were associated with a higher risk of early recurrences, highlighting the need for further investigation and optimized treatment strategies.
6.Decoding the influence of external beam radiotherapy to brachytherapy duration and overall treatment on response and early recurrences in cervical cancer patients treated with chemoradiation
Abhishek KRISHNA ; Bharat Sai MAKKAPATTI ; M. S. ATHIYAMAAN ; Dilson LOBO ; Challapalli SRINIVAS ; Johan SUNNY ; Vaishak JAWAHAR ; Harleen KAUR ; Sourjya BANERJEE
Radiation Oncology Journal 2024;42(4):257-262
Purpose:
Cervical cancer is a significant global health issue affecting approximately 600,000 women each year. This study aimed to address the knowledge gaps surrounding the influence of treatment time parameters, including the duration of external beam radiotherapy (EBRT) to brachytherapy and overall treatment duration, on early recurrences.
Materials and Methods:
Details on demographics, tumor characteristics, treatment details, and outcomes in patients undergoing chemoradiation and brachytherapy for cervical cancer were collected from the medical records. Early recurrence was defined as tumor reappearance within 6 months after treatment in patients with an initial complete response. Statistical analyses included descriptive statistics chi-square tests, independent t-tests, and logistic regression.
Results:
A total of 288 cervical cancer patients were included. Stage IIB was the most common stage and 93% of patients had a complete response, 4.5% partial response, and 3.1% had progressive disease at 3rd month. At 6 months, 8% experienced early. The average interval between EBRT and brachytherapy was 10.4 ± 4.2 days among the no recurrence group and 12.3 ± 4.5 days among early recurrence group. A total of 203 patients had a gap of 10 or fewer days and 123 patients had a gap of more than 10 days between EBRT and brachytherapy. Difference was observed in the overall treatment time between the two groups had significant differences (no recurrence group, 61.6 ± 11.5 days; early recurrence group, 73.8 ± 8.8 days; p < 0.001).
Conclusion
The study revealed that longer overall treatment durations were associated with a higher risk of early recurrences, highlighting the need for further investigation and optimized treatment strategies.
7.Tuberculosis Death and Associated Risk Factors in Hulu Langat District
Hemanath Sinnathamby ; Fredie Robinson ; Zailiza Suli ; Vanushya Alagasan ; Muhammad Hafiq Syazwan Abu Johan
Malaysian Journal of Medicine and Health Sciences 2024;20(No.2):91-98
Introduction: Addressing the challenge of mortality among tuberculosis (TB) patients undergoing treatment is a
significant concern in Malaysia. It is essential to identify the factors linked to TB mortality to evaluate national TB
control programs and identify high-risk individuals. The objective of this study was to assess the percentage of TB
mortality among patients receiving treatment over a three-year duration and identify the associated factors in Hulu
Langat District. Method: The study used secondary data collected from the national TB registry from 2019 to 2021,
and all registered TB cases that met the inclusion and exclusion criteria were included. The data in the study were
tested using regressions. Results: The results showed that 11.5% of total registered TB patients had died during their
course of treatment, and multiple logistic regression identified several significant factors associated with TB mortality, including gender (aOR= 0.75, 95%CI: 0.58, 0.97; p=0.026), age (aOR= 16.94, 95%CI: 5.14, 55.81; p<0.001),
household income level (aOR= 1.56, (95%CI: 1.22, 1.99; p<0.001), living area (aOR= 1.53, 95%CI: 1.00, 2.32;
p=0.048) education level (aOR= 1.89, 95%CI: 1.06, 3.35; p=0.030), the severity of chest x-ray (aOR= 5.03, 95%CI:
2.95, 8.58; p<0.001), and HIV status (aOR= 3.72, 95%CI: 2.71, 5.19; p<0.001). Conclusion: TB mortality in the
Hulu Langat district is a significant public health concern and interventions such as intensified case finding, home
visits for elderly patients, and health promotion are needed to reduce TB mortality and achieve the WHO End TB
strategy milestone.
8.Digital tomography in the diagnosis of a posterior pneumothorax in the intensive care unit
Shauni WELLEKENS ; Nico BULS ; Johan DE MEY ; Vincent VAN NIEUWENHOVE ; Jeroen CANT ; Joop JONCKHEER
Acute and Critical Care 2024;39(2):323-326
Portable chest radiography is a valuable tool in the intensive care unit. However, the supine position causes superposition of anatomical structures resulting in less reliable detection of certain abnormalities. Recently, a portable digital tomosynthesis (pDTS) prototype with a modified motorized x-ray device was developed. We aimed to compare the diagnostic value of pDTS to standard bedside chest radiography in the diagnosis of a posterior pneumothorax. A modified motorized x-ray device was developed to perform 15 radiographic projections while translating the x-ray tube 25 cm (10 cm ramp up and 15 cm during x-ray exposure) with a total radiation dose of 0.54 mSv. This new technique of pDTS was performed in addition to standard bedside chest x-ray in a patient with a confirmed posterior hydropneumothorax. The images were compared with the standard bedside chest x-ray and computed tomography (CT) images by two experienced radiologists. The posterior hydropneumothorax previously identified with CT was visible on tomosynthesis images but not with standard bedside imaging. Combining the digital tomosynthesis technique with the portable x-ray machine could increase the diagnostic value of bedside chest radiography for the diagnosis of posterior pneumothoraces while avoiding intrahospital transport and limiting radiation exposure compared to CT.
9.Digital tomography in the diagnosis of a posterior pneumothorax in the intensive care unit
Shauni WELLEKENS ; Nico BULS ; Johan DE MEY ; Vincent VAN NIEUWENHOVE ; Jeroen CANT ; Joop JONCKHEER
Acute and Critical Care 2024;39(2):323-326
Portable chest radiography is a valuable tool in the intensive care unit. However, the supine position causes superposition of anatomical structures resulting in less reliable detection of certain abnormalities. Recently, a portable digital tomosynthesis (pDTS) prototype with a modified motorized x-ray device was developed. We aimed to compare the diagnostic value of pDTS to standard bedside chest radiography in the diagnosis of a posterior pneumothorax. A modified motorized x-ray device was developed to perform 15 radiographic projections while translating the x-ray tube 25 cm (10 cm ramp up and 15 cm during x-ray exposure) with a total radiation dose of 0.54 mSv. This new technique of pDTS was performed in addition to standard bedside chest x-ray in a patient with a confirmed posterior hydropneumothorax. The images were compared with the standard bedside chest x-ray and computed tomography (CT) images by two experienced radiologists. The posterior hydropneumothorax previously identified with CT was visible on tomosynthesis images but not with standard bedside imaging. Combining the digital tomosynthesis technique with the portable x-ray machine could increase the diagnostic value of bedside chest radiography for the diagnosis of posterior pneumothoraces while avoiding intrahospital transport and limiting radiation exposure compared to CT.
10.Digital tomography in the diagnosis of a posterior pneumothorax in the intensive care unit
Shauni WELLEKENS ; Nico BULS ; Johan DE MEY ; Vincent VAN NIEUWENHOVE ; Jeroen CANT ; Joop JONCKHEER
Acute and Critical Care 2024;39(2):323-326
Portable chest radiography is a valuable tool in the intensive care unit. However, the supine position causes superposition of anatomical structures resulting in less reliable detection of certain abnormalities. Recently, a portable digital tomosynthesis (pDTS) prototype with a modified motorized x-ray device was developed. We aimed to compare the diagnostic value of pDTS to standard bedside chest radiography in the diagnosis of a posterior pneumothorax. A modified motorized x-ray device was developed to perform 15 radiographic projections while translating the x-ray tube 25 cm (10 cm ramp up and 15 cm during x-ray exposure) with a total radiation dose of 0.54 mSv. This new technique of pDTS was performed in addition to standard bedside chest x-ray in a patient with a confirmed posterior hydropneumothorax. The images were compared with the standard bedside chest x-ray and computed tomography (CT) images by two experienced radiologists. The posterior hydropneumothorax previously identified with CT was visible on tomosynthesis images but not with standard bedside imaging. Combining the digital tomosynthesis technique with the portable x-ray machine could increase the diagnostic value of bedside chest radiography for the diagnosis of posterior pneumothoraces while avoiding intrahospital transport and limiting radiation exposure compared to CT.


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