https://www.spg.pt/wp-content/uploads/2015/11/2012_UC_Consensus_1_Definitions_and_diagnosis.pdf

European evidence-based Consensus on the diagnosis and management of ulcerative colitis: Definitions and diagnosis

This third section of the European Crohn's and Colitis Organisation (ECCO) Consensus on the management of Crohn's disease concerns postoperative recurrence, fistulating disease, paediatrics, pregnancy, psychosomatics, extraintestinal manifestations, and alternative therapy. The first section on definitions and diagnosis reports on the aims and methods of the consensus, as well as sections on diagnosis, pathology, and classification of Crohn's disease. The second section on current management addresses treatment of active disease, maintenance of medically induced remission, and surgery of Crohn's disease.

https://gut.bmj.com/content/gutjnl/55/suppl_1/i36.full.pdf

European evidence based consensus on the diagnosis and management of Crohn's disease: special situations.

Botulinal neurotoxins: revival of an old killer.

The probiotic Escherichia coli strain Nissle 1917 is in addition to some Lactobacilli sp. one of the best-studied probiotic strains. This particular E. coli strain was isolated in 1917 based on its potential to protect from presumably infectious gastroenteritis. Initial therapeutic success was noted in the management of gastrointestinal infectious disorders and infections affecting the urinary tract; the focus shifted later to chronic inflammatory conditions. The unique combination of fitness and survival factors to support intestinal survival, the lack of virulence, and obvious probiotic properties make this microorganism a safe and effective candidate in the treatment of chronic inflammatory bowel diseases. Three large clinical trials have assessed the potential in the maintenance of remission of ulcerative colitis and equivalence to standard 5-ASA medication was documented. This review aims to discuss important mechanisms of E. coli Nissle 1917 and will review the available literature regarding treatment of inflammatory bowel diseases.

Clinical Use of E. coli Nissle 1917 in Inflammatory Bowel Disease

/pdf/european-evidence-based-consensus-on-the-management-of-1n9w067hjf.pdf

European evidence-based Consensus on the management of ulcerative colitis: Special situations

[Diagnosis and therapy of ulcerative colitis: results of an evidence based consensus conference by the German society of Digestive and Metabolic Diseases and the competence network on inflammatory bowel disease].

Surgery in ulcerative colitis

Introduction: Soft tissue sarcomas (STSs) are rare diseases. A high level of standardization and centralization was lacking in Germany until 2018. Methods: By developing an evidence-based guideline and a certification system for sarcoma centres, foundations for structured, guideline-based, and centralized sarcoma care were defined. First results of the certified sarcoma centres are presented. Results: The first 3 years of data collection show good results for case volume, presentation rates in pretherapeutic and postoperative tumour boards, psycho-oncological counselling, and study rates. However, other indicators (e.g., preoperative or postoperative radiotherapy for operated high-risk STS without GIST, counselling rates social services) still have potential for improvement. Based on these results, the set of indicators could be further improved. Conclusions: A sarcoma-specific quality assurance scheme that includes guideline-derived quality indicators was developed. In future, a broader database will allow further insights into sarcoma care in Germany.

Quality Measurement for Soft Tissue Sarcomas in Germany: First Results of the Certified Sarcoma Centres

Entitätsübergreifende Qualitätsindikatoren und Kennzahlen: Ergebnisse und Entwicklungen

Zielsetzung: Die Defakographie stellt bei Rektumentleerungsstorungen einen Grundpfeiler der Diagnostik dar. Die MR-Defakographie gibt uber die dynamische Darstellung der Rektumentleerung hinaus Informationen uber die Interaktion zwischen Rektum und den Organen des kleinen Beckens, ist aber bislang in der Routinediagnostik noch nicht voll etabliert. Anhand der postoperativen Kontrollen nach Resektionsrektopexie werden die Ergebnisse der MR-Defakographie denen der konventionellen Untersuchung gegenubergestellt. Material und Methoden: Im Zeitraum 01/95 bis 06/01 wurde wegen einer Rektumentleerungsstorung bei 35 Patienten eine Resektionsrektopexie durchgefuhrt. Im Rahmen des follow-up wurde neben einer detaillierten Inkontinenz-Anamnese eine morphologische Funktionsanalyse mittels konventioneller Defakographie erhoben. Bei 14 Patienten wurde zusatzlich eine MR-Defakographie (Magnetom Open; 0,23 Tesla) durchgefuhrt. Die im Cine-Mode gespeicherten Bilder dieser Patienten wurden hinsichtlich quantitativer (anorektaler Winkel, Beckenbodenlage) und qualitativer Merkmale (Deszensus und Kompression des Rektums) untersucht und mit den Ergebnissen der konventionellen Defakographie verglichen. Statistische Auswertung mittels Boxplot und Friedman-Test. Ergebnisse: Generell sind die quantitativen Ergebnisse der MR-Defakographie mit denen der konventionellen Untersuchung kongruent. Bei kleineren Absolutwerten unterscheiden sich die kernspintomographisch ermittelten anorektalen Winkel bei Anspannung und Entleerung des Rektums nicht von den konventionell bestimmten Befunden. Die Verteilung der Ruhedaten des anorektalen Winkels jedoch tendiert im MRT zu niedrigeren Werten. Die Lage des Beckenbodens ist in Ruhe und beim Heben des Beckenbodens in beiden Methoden vergleichbar, bei der Entleerung des Rektums ergibt die Strukturanalyse des Boxplots einen signifikanten Strukturunterschied. Bei 4/14 Patienten zeigte die MR-Defakographie zwar einen Descensus vesicae, ein Impression des Rektums von ausen war in keinem Patienten nachweisbare (Tabelle 1). Zusammenfassungg und Schlussfolgerung: (1) Die Ergebnisse der MR-Defakographie sind der konventionellen Defakographie hinsichtlich der Bestimmung des anorektalen Winkels bei Anspannung und Entleerung des Rektums vergleichbar. (2) Die Lage des Beckenbodens stimmt bei Ruhe und Anspannung in beiden Methoden uberein. (3) Aufgrund der Beurteilbarkeit der Nachbarorgane gibt die MR-Defakographie zusatzliche Informationen uber die Interaktion von Rektum und Organen des kleinen Beckens.

Postoperative Erfolgskontrolle nach Resektionsrektopexie: Vergleich von konventioneller vs. Magnet-Resonanz-Defäkographie

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