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  1. Article ; Online: Pain in Patients with Crohn's and Colitis: Can We Solve the Puzzle?

    Drewes, Asbjørn Mohr

    Journal of Crohn's & colitis

    2022  Volume 16, Issue 9, Page(s) 1345–1346

    MeSH term(s) Colitis/complications ; Colitis, Ulcerative ; Crohn Disease/complications ; Humans ; Pain
    Language English
    Publishing date 2022-05-21
    Publishing country England
    Document type Editorial
    ZDB-ID 2390120-2
    ISSN 1876-4479 ; 1873-9946
    ISSN (online) 1876-4479
    ISSN 1873-9946
    DOI 10.1093/ecco-jcc/jjac060
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  2. Article ; Online: Metabolic Sequelae and All-Cause Mortality in Chronic Pancreatitis With and Without Prior Acute Pancreatitis: A Nationwide Population-Based Cohort Study.

    Cook, Mathias Ellgaard / Bruun, Niels Henrik / Davidsen, Line / Vestergaard, Peter / Drewes, Asbjørn Mohr / Olesen, Søren Schou

    The American journal of gastroenterology

    2024  

    Abstract: Objectives: To investigate the risk of metabolic sequelae and all-cause mortality in a population-based cohort of chronic pancreatitis (CP) patients with and without prior acute pancreatitis (AP).: Methods: We used nationwide health registries to ... ...

    Abstract Objectives: To investigate the risk of metabolic sequelae and all-cause mortality in a population-based cohort of chronic pancreatitis (CP) patients with and without prior acute pancreatitis (AP).
    Methods: We used nationwide health registries to identify all Danish residents (>18 years) with incident CP from 2000-2018. Information on AP/CP diagnoses, metabolic sequelae (post-pancreatitis diabetes mellitus (PPDM), exocrine pancreatic dysfunction (EPD), and osteoporosis), and all-cause mortality were obtained from Danish national health registries. CP cases were stratified based on the presence of AP prior to CP diagnosis. The risk of metabolic sequelae and all-cause mortality was expressed as hazard ratios (HRs) with 95% confidence intervals (CIs), calculated using multivariate Cox proportional hazards models.
    Results: A total of 9655 CP patients were included. Among CP patients, 3913 (40.5%) had a prior AP diagnosis. Compared to patients without a history of AP, patients with prior AP had a decreased risk of death (HR 0.79 (95% CI, 0.74-0.84)), which was largely confined to the initial period after CP diagnosis. Patients with prior AP had an increased risk of PPDM (HR 1.53 (95% CI, 1.38-1.69)), which persisted for up to a decade after CP diagnosis. No overall differences in risk were observed for EPD (HR 0.97 (95% CI, 0.87-1.07)) and osteoporosis (HR 0.87 (95% CI, 0.74-1.02)).
    Conclusions: This nationwide study revealed that the majority of CP patients have no prior episode(s) of AP, indicating that an attack of AP sensitizing the pancreas is not essential for CP development. CP patients with and without prior AP have different risk profiles of PPDM and all-cause mortality.
    Language English
    Publishing date 2024-04-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000002799
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  3. Article ; Online: Intra-pancreatic fat deposition and its relation to obesity: a magnetic resonance imaging study.

    Gjela, Mimoza / Askeland, Anders / Mellergaard, Maiken / Drewes, Asbjørn Mohr / Handberg, Aase / Frøkjær, Jens Brøndum

    Scandinavian journal of gastroenterology

    2024  , Page(s) 1–7

    Abstract: Objectives: Intra-pancreatic fat deposition (IPFD) is suspected to be associated with various medical conditions. This study aimed to assess pancreatic fat content in lean and obese individuals, characterize obese individuals with and without IPFD, and ... ...

    Abstract Objectives: Intra-pancreatic fat deposition (IPFD) is suspected to be associated with various medical conditions. This study aimed to assess pancreatic fat content in lean and obese individuals, characterize obese individuals with and without IPFD, and explore the underlying mechanisms.
    Materials and methods: Sixty-two obese individuals without diabetes and 35 lean controls underwent magnetic resonance imaging (MRI) using proton density fat fraction (PDFF) maps to evaluate pancreatic and hepatic fat content, and visceral adipose tissue (VAT) content. Pancreatic fibrosis was explored by T1 relaxation time and MR elastography (MRE) measurements. Associations between pancreatic fat, measures of obesity and metabolic syndrome were examined using uni- and multivariate regression analyses.
    Results: Pancreatic PDFF was higher in obese than in lean controls (median 8.0%, interquartile range (6.1;13.3) % vs 2.6(1.7;3.9)%,
    Conclusions: Pancreatic fat content was increased in obese individuals compared with lean controls and predominantly correlated with the amount of visceral adipose tissue. Pancreatic fat content was not clearly linked to measures of pancreatic fibrosis.
    Language English
    Publishing date 2024-04-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 82042-8
    ISSN 1502-7708 ; 0036-5521
    ISSN (online) 1502-7708
    ISSN 0036-5521
    DOI 10.1080/00365521.2024.2333365
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    Zs.A 567: Show issues Location:
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  4. Article ; Online: Opioids and the gut; not only constipation and laxatives.

    Drewes, Asbjørn Mohr

    Scandinavian journal of pain

    2017  Volume 15, Page(s) 81–82

    MeSH term(s) Analgesics, Opioid ; Cohort Studies ; Constipation ; Denmark ; Humans ; Laxatives
    Chemical Substances Analgesics, Opioid ; Laxatives
    Language English
    Publishing date 2017-02-20
    Publishing country Germany
    Document type Editorial ; Comment
    ZDB-ID 2515451-5
    ISSN 1877-8879 ; 1877-8860
    ISSN (online) 1877-8879
    ISSN 1877-8860
    DOI 10.1016/j.sjpain.2017.01.010
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  5. Article ; Online: Hvad er årsagerne til recidiverende abdominalsmerter?

    Drewes, Asbjørn Mohr

    Ugeskrift for laeger

    2015  Volume 177, Issue 2

    Title translation What are the causes of recurrent abdominal pain?.
    MeSH term(s) Abdominal Pain/etiology ; Humans ; Recurrence
    Language Danish
    Publishing date 2015-01-05
    Publishing country Denmark
    Document type Editorial
    ZDB-ID 124102-3
    ISSN 1603-6824 ; 0041-5782
    ISSN (online) 1603-6824
    ISSN 0041-5782
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  6. Article ; Online: Update on pain management in acute pancreatitis.

    Pandanaboyana, Sanjay / Huang, Wei / Windsor, John A / Drewes, Asbjørn Mohr

    Current opinion in gastroenterology

    2022  Volume 38, Issue 5, Page(s) 487–494

    MeSH term(s) Acute Disease ; Humans ; Pain Management ; Pancreatitis/complications ; Pancreatitis/diagnosis ; Pancreatitis/therapy
    Language English
    Publishing date 2022-07-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632571-3
    ISSN 1531-7056 ; 0267-1379
    ISSN (online) 1531-7056
    ISSN 0267-1379
    DOI 10.1097/MOG.0000000000000861
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    Zs.A 2072: Show issues Location:
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  7. Article: Spinal Excitability in Patients with Painful Chronic Pancreatitis.

    Knoph, Cecilie Siggaard / Nedergaard, Rasmus Bach / Olesen, Søren Schou / Kuhlmann, Louise / Drewes, Asbjørn Mohr

    Journal of pain research

    2023  Volume 16, Page(s) 2287–2298

    Abstract: Purpose: Abdominal pain is common in patients with chronic pancreatitis (CP), but management is challenging - possibly due to altered pain processing within the central nervous system rendering conventional treatments ineffective. We hypothesized that ... ...

    Abstract Purpose: Abdominal pain is common in patients with chronic pancreatitis (CP), but management is challenging - possibly due to altered pain processing within the central nervous system rendering conventional treatments ineffective. We hypothesized that many patients with painful CP have generalized hyperalgesia correlating with central neuronal hyperexcitability.
    Patients and methods: Seventeen CP patients with pain and 20 matched healthy controls underwent experimental pain testing, including repeated pain stimuli (temporal summation), pressure algometry performed in dermatomes with same spinal innervation as the pancreatic gland (pancreatic areas) and remote dermatomes (control areas), a cold pressor test and a conditioned pain modulation paradigm. To probe central neuronal excitability, the nociceptive withdrawal reflex was elicited by electrical stimulation of the plantar skin, and electromyography was obtained from the ipsilateral anterior tibial muscle together with somatosensory evoked brain potentials.
    Results: Compared to healthy controls, patients with painful CP had generalized hyperalgesia as evidenced by 45% lower pressure pain detection thresholds (P<0.05) and decreased cold pressor endurance time (120 vs 180 seconds, P<0.001). In patients, reflex thresholds were lower (14 vs 23 mA, P=0.02), and electromyographic responses were increased (16.4 vs 9.7, P=0.04) during the withdrawal reflex, reflecting predominantly spinal hyperexcitability. Evoked brain potentials did not differ between groups. A positive correlation was found between reflex thresholds and cold pressor endurance time (
    Conclusion: We demonstrated somatic hyperalgesia in patients with painful CP associated with spinal hyperexcitability. This highlights that management should be directed at central mechanisms using, eg, gabapentinoids or serotonin-noradrenaline reuptake inhibitors.
    Language English
    Publishing date 2023-07-05
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2495284-9
    ISSN 1178-7090
    ISSN 1178-7090
    DOI 10.2147/JPR.S408523
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  8. Article ; Online: A comparison of function lumen imaging probe measurements of anal sphincter function in fecal incontinence.

    O'Connor, Alexander / Liao, Donghua / Drewes, Asbjørn Mohr / Sharma, Abhiram / Vasant, Dipesh H / McLaughlin, John / Kiff, Edward / Telford, Karen

    Neurogastroenterology and motility

    2024  , Page(s) e14791

    Abstract: Background: The functional lumen imaging probe (FLIP) is a test of anal sphincter distensibility under evaluation by specialist centers. Two measurement protocols termed "stepwise" and "ramp" are used, risking a lack of standardization. This study aims ... ...

    Abstract Background: The functional lumen imaging probe (FLIP) is a test of anal sphincter distensibility under evaluation by specialist centers. Two measurement protocols termed "stepwise" and "ramp" are used, risking a lack of standardization. This study aims to compare the performance of these protocols to establish if there are differences between them.
    Methods: Patients with fecal incontinence were recruited and underwent measurement with both protocols at a tertiary pelvic floor referral unit. Differences in minimum diameter, FLIP bag pressure, and distensibility index (DI) at rest and during squeeze were calculated at various FLIP bag volumes.
    Key results: Twenty patients (19 female, mean age 61 [range: 38-78]) were included. The resting minimum diameter at 30 and 40 mL bag volumes were less in the stepwise protocol (mean bias: -0.55 mm and -1.18 mm, p < 0.05) along with the DI at the same bag volumes (mean bias: -0.37 mm
    Conclusion and inferences: There are differences between the two commonly described FLIP measurement protocols at rest, although there are no differences in the assessment of squeeze function. Consensus agreement is required to agree the most appropriate FLIP measurement protocol in assessing anal sphincter function.
    Language English
    Publishing date 2024-04-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 1186328-6
    ISSN 1365-2982 ; 1350-1925
    ISSN (online) 1365-2982
    ISSN 1350-1925
    DOI 10.1111/nmo.14791
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    Zs.A 2979: Show issues Location:
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  9. Article ; Online: Multistate Model of the Natural History of Inflammatory Pancreatic Diseases: A Nationwide Population-based Cohort Study.

    Cook, Mathias Ellgaard / Bruun, Niels Henrik / Davidsen, Line / Drewes, Asbjørn Mohr / Olesen, Søren Schou

    Gastroenterology

    2023  Volume 165, Issue 6, Page(s) 1547–1557.e4

    Abstract: Background & aims: Understanding the nature of inflammatory pancreatic diseases is essential for planning health care system requirements and interventions. The aim of this study was to quantify the trajectories of inflammatory pancreatic diseases and ... ...

    Abstract Background & aims: Understanding the nature of inflammatory pancreatic diseases is essential for planning health care system requirements and interventions. The aim of this study was to quantify the trajectories of inflammatory pancreatic diseases and their association with pancreatic cancer in a population-based setting.
    Methods: National health registries were used to identify all Danish residents (18 years or older) in the period from 2000 through 2018 with incident cases of acute pancreatitis (AP), recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), and pancreatic cancer. We used a multistate model to examine transitions from a healthy state to intermediate states of acute pancreatic inflammation (AP and RAP) to chronic states (CP and pancreatic cancer) and, ultimately, death. Results were reported as transition incidence rates per 1000 person-years with 95% CIs.
    Results: There were 4,663,864 individuals included (mean age, 46 years; 51% were women). During a mean follow-up of 16.8 years, 31,396 individuals were diagnosed with incident AP, 5546 with RAP, 8898 with CP, and 18,182 with pancreatic cancer. The cumulative incidence of pancreatitis (acute and chronic) during the study period was 0.80% (95% CI, 0.79%-0.80%). The transition incidence rates to CP were 12.1 (95% CI, 8.1-18.1) from AP, 46.8 (95% CI, 31.6-69.3) from RAP, and 0.07 (95% CI, 0.04-0.13) from a healthy state. Similar patterns were observed for transitions to pancreatic cancer. Most patients diagnosed with CP (64.2%) and pancreatic cancer (96.4%) transitioned directly from a healthy state. Among patients with pancreatitis, 41.0% (95% CI, 40.5%-41.5%) died during follow-up.
    Conclusions: The study findings revealed an increased risk of CP and pancreatic cancer in patients with a history of AP. However, most patients with CP and pancreatic cancer transitioned directly from a healthy state.
    MeSH term(s) Humans ; Female ; Middle Aged ; Male ; Acute Disease ; Cohort Studies ; Pancreatic Diseases ; Pancreatic Neoplasms/epidemiology ; Pancreatitis, Chronic/epidemiology ; Pancreatic Neoplasms
    Language English
    Publishing date 2023-09-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2023.08.042
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  10. Article ; Online: Varenicline for Smoking Cessation in Patients With Chronic Pancreatitis.

    Knoph, Cecilie Siggaard / Kamronn, Terese Matthesen / Drewes, Asbjørn Mohr / Nielsen, Lars Peter / Olesen, Søren Schou

    Pancreas

    2023  Volume 51, Issue 10, Page(s) e117–e118

    MeSH term(s) Humans ; Varenicline/therapeutic use ; Smoking Cessation ; Smoking ; Pancreatitis, Chronic/drug therapy
    Chemical Substances Varenicline (W6HS99O8ZO)
    Language English
    Publishing date 2023-04-20
    Publishing country United States
    Document type Letter
    ZDB-ID 632831-3
    ISSN 1536-4828 ; 0885-3177
    ISSN (online) 1536-4828
    ISSN 0885-3177
    DOI 10.1097/MPA.0000000000002201
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