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Article ; Online: Progress report: Peutz-Jeghers syndrome.

Jelsig, Anne Marie / Karstensen, John Gásdal / Overeem Hansen, Thomas V

2024

Abstract: Peutz-Jeghers syndrome is a rare, autosomal dominant polyposis syndrome. Presenting with a remarkable phenotype including development of characteristic gastrointestinal polyps, mucocutaneous pigmentations, and an increased risk of cancer, the syndrome ... ...

Abstract	Peutz-Jeghers syndrome is a rare, autosomal dominant polyposis syndrome. Presenting with a remarkable phenotype including development of characteristic gastrointestinal polyps, mucocutaneous pigmentations, and an increased risk of cancer, the syndrome has been subject to many studies concerning the natural course of disease. In most patients, pathogenic germline variants are detected in the STK11 gene including cases of mosaicism and structural variants. Yet, studies assessing the effect of surveillance, understanding of cancer development, as well as clinical studies evaluating chemoprevention are lacking. In addition, the impact of Peutz-Jeghers syndrome on mental health, education, and family planning are insufficiently addressed. In this progress report, we describe current knowledge, clinical phenotype, surveillance strategies, and future areas of research.
Language	English
Publishing date	2024-03-16
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1502496-9
ISSN	1573-7292 ; 1389-9600
ISSN (online)	1573-7292
ISSN	1389-9600
DOI	10.1007/s10689-024-00362-7
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Zs.A 6099: Show issues

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Article ; Online: Tailoring treatment to the circumstance: reasoning behind metal versus plastic drainage of pancreatic collections - authors' reply.

Karstensen, John Gásdal / Novovic, Srdan / Schmidt, Palle Nordblad

Gut

2023

Language	English
Publishing date	2023-09-12
Publishing country	England
Document type	Letter
ZDB-ID	80128-8
ISSN	1468-3288 ; 0017-5749
ISSN (online)	1468-3288
ISSN	0017-5749
DOI	10.1136/gutjnl-2023-330948
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Zs.A 160: Show issues

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Article ; Online: Circulating Biomarkers Involved in the Development of and Progression to Chronic Pancreatitis-A Literature Review.

Poulsen, Valborg Vang / Hadi, Amer / Werge, Mikkel Parsberg / Karstensen, John Gásdal / Novovic, Srdan

Biomolecules

2024 Volume 14, Issue 2

Abstract: Chronic pancreatitis (CP) is the end-stage of continuous inflammation and fibrosis in the pancreas evolving from acute- to recurrent acute-, early, and, finally, end-stage CP. Currently, prevention is the only way to reduce disease burden. In this ... ...

Abstract	Chronic pancreatitis (CP) is the end-stage of continuous inflammation and fibrosis in the pancreas evolving from acute- to recurrent acute-, early, and, finally, end-stage CP. Currently, prevention is the only way to reduce disease burden. In this setting, early detection is of great importance. Due to the anatomy and risks associated with direct sampling from pancreatic tissue, most of our information on the human pancreas arises from circulating biomarkers thought to be involved in pancreatic pathophysiology or injury. The present review provides the status of circulating biomarkers involved in the development of and progression to CP.
MeSH term(s)	Humans ; Pancreatitis, Chronic/diagnosis ; Pancreatitis, Chronic/complications ; Pancreatitis, Chronic/pathology ; Pancreas ; Inflammation/pathology ; Fibrosis ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2024-02-18
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2701262-1
ISSN	2218-273X ; 2218-273X
ISSN (online)	2218-273X
ISSN	2218-273X
DOI	10.3390/biom14020239
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Article ; Online: Pancreatic-portal vein fistula in acute pancreatitis successfully treated with endoscopic approach.

Poulsen, Valborg Vang / Jensen, Annette Bøjer / Hadi, Amer / Ærenlund, Mia Prindahl / Karstensen, John Gásdal / Novovic, Srdan

Endoscopy

2024 Volume 56, Issue S 01, Page(s) E354–E355

MeSH term(s)	Humans ; Portal Vein/diagnostic imaging ; Pancreatic Fistula/etiology ; Pancreatic Fistula/surgery ; Pancreatic Fistula/diagnostic imaging ; Pancreatic Fistula/therapy ; Pancreatitis/etiology ; Pancreatitis/complications ; Pancreatitis/surgery ; Male ; Acute Disease ; Arteriovenous Fistula/surgery ; Arteriovenous Fistula/complications ; Arteriovenous Fistula/diagnostic imaging ; Arteriovenous Fistula/etiology ; Middle Aged
Language	English
Publishing date	2024-04-25
Publishing country	Germany
Document type	Journal Article ; Case Reports ; Video-Audio Media
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/a-2299-2052
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Zs.A 669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 162: Show issues

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Article ; Online: Endoscopic ultrasound-guided biopsies vs surgical specimens for establishing patient-derived pancreatic cancer organoids: A systematic review and meta-analysis.

Grützmeier, Simon Ezban / Sodal, Hafsa Mahad Mahamud / Kovacevic, Bojan / Vilmann, Peter / Karstensen, John Gásdal / Klausen, Pia

Gastrointestinal endoscopy

2024

Abstract: Background and aims: Patient-Derived Tumor Organoids (PDTOs) is a promising new disease model in pancreatic cancer for use in personalized medicine, but overall success rate (SR) of establishing these cultures from endoscopic ultrasound-guided biopsies ... ...

Abstract	Background and aims: Patient-Derived Tumor Organoids (PDTOs) is a promising new disease model in pancreatic cancer for use in personalized medicine, but overall success rate (SR) of establishing these cultures from endoscopic ultrasound-guided biopsies is unknown. Methods: We searched relevant databases publications reporting SR of PDTO establishment from pancreatic cancer. The primary outcome was SR stratified on tissue acquisition method (EUS-guided biopsies, percutaneous biopsies, and surgical specimens). Results: We identified 24 studies including 1,053 attempts at establishing PDTOs. Overall SR was 63% (95% CI: 54%-72%). Pooled SR of PDTO establishment from EUS-guided biopsies, percutaneous biopsies, and surgical specimens were 60% (95% CI: 43-76%), 36% (95% CI: 14-61%) and 62% (95% CI: 48-75%), respectively and did not differ significantly (p = 0.1975). Conclusion: The SR of PDTO establishment from EUS-guided biopsies is comparable to surgical specimens. Both techniques are suitable for tissue acquisition for PDTOs in clinical and research settings.
Language	English
Publishing date	2024-04-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2024.04.012
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Zs.B 283: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 519: Show issues

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Article: Hereditary polyposis syndromes remain a challenging disease entity: Old dilemmas and new insights.

Pachler, Frederik Rønne / Byrjalsen, Anna / Karstensen, John Gásdal / Jelsig, Anne Marie

World journal of gastrointestinal surgery

2023 Volume 15, Issue 1, Page(s) 1–8

Abstract: In this editorial we present an overview and insights of the management of hereditary polyposis syndromes. The primary focus was on familial adenomatous polyposis, juvenile polyposis syndrome and Peutz-Jegher syndrome. Genetic testing has become ... ...

Abstract	In this editorial we present an overview and insights of the management of hereditary polyposis syndromes. The primary focus was on familial adenomatous polyposis, juvenile polyposis syndrome and Peutz-Jegher syndrome. Genetic testing has become increasingly available and is easier than ever to integrate into clinical practice. Furthermore, several genes have been added to the expanding list of genes associated with hereditary polyposis syndromes, allowing for precise diagnostics and tailored follow-up. Endoscopic evaluation of patients with hereditary polyposis syndromes is paramount in the surveillance strategies. Current endoscopic procedures include both diagnostic procedures and surveillance as well as therapeutic interventions. Recommendations for endoscopic procedures in the upper and lower gastrointestinal canal were described. Surgery is still a key component in the management of patients with hereditary polyposis syndromes. The increased cancer risk in these patients often render prophylactic procedures or intended curative procedures in the case of cancer development. Surgical interventions in the upper and lower gastrointestinal canal were described with relevant considerations. Development of chemopreventive medications is ongoing. Few drugs have been investigated, including nonsteroidal anti-inflammatory drugs. It has been demonstrated that cyclooxygenase-2 inhibitors may lower the number of polyps. Other medications are currently under investigation, but none have, to date, consistently been able to prevent development of disease.
Language	English
Publishing date	2023-01-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2573700-4
ISSN	1948-9366
ISSN	1948-9366
DOI	10.4240/wjgs.v15.i1.1
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Article ; Online: Endoscopic small bowel balloon dilations in patients with Crohn's disease: a Danish nationwide cohort study, 1997-2015.

Wewer, Mads Damsgaard / Karstensen, John Gásdal / Burisch, Johan

European journal of gastroenterology & hepatology

2022 Volume 34, Issue 8, Page(s) 831–837

Abstract: Objective: Small bowel strictures are a common complication in Crohn's disease. Endoscopic balloon dilation (EBD) is an emerging therapeutic approach that is minimally invasive and helps to preserve the bowel. The aim of this study was to describe the ... ...

Abstract	Objective: Small bowel strictures are a common complication in Crohn's disease. Endoscopic balloon dilation (EBD) is an emerging therapeutic approach that is minimally invasive and helps to preserve the bowel. The aim of this study was to describe the use of EBD in adult Crohn's disease patients with small bowel strictures. Methods: This nationwide cohort comprised individuals ≥18 years old, diagnosed with Crohn's disease in Denmark between 1 January 1997 and 31 December 2015, according to the National Patient Registry (NPR). Results: The cohort consisted of 9737 incident Crohn's disease patients that were followed for a median of 8.2 years [interquartile range (IQR) = 4.1-13.3]. During the observation period, a total of 90 (1%) patients underwent a small bowel-related EBD. After a follow-up period of a median of 3.4 (IQR = 1.8-5.0) years, primary small bowel strictures treated only with one dilation and no subsequent small bowel surgery accounted for 29 (59%) of 49 cases. A median of 7.2 (IQR = 2.4-13.2) months after their first dilation, 13 (27%) of those 49 patients underwent small bowel surgery. Forty-one patients with postsurgical strictures were dilated after a median of 6.5 (IQR = 2.5-10.2) years following small bowel surgery. Postsurgical strictures treated with only one dilation and no further small bowel surgery accounted for 20 (49%) of the 41 cases. Conclusion: The frequency of EBD in this Danish nationwide cohort was low. During a median follow-up of 5 years after EBD, most patients did not require further surgery. This suggests that EBD is an effective treatment and could be offered to more patients with Crohn's disease.
MeSH term(s)	Adolescent ; Adult ; Cohort Studies ; Constriction, Pathologic ; Crohn Disease/complications ; Crohn Disease/epidemiology ; Crohn Disease/therapy ; Denmark/epidemiology ; Dilatation/adverse effects ; Endoscopy, Gastrointestinal/adverse effects ; Humans ; Intestinal Obstruction/epidemiology ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2022-06-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1034239-4
ISSN	1473-5687 ; 0954-691X
ISSN (online)	1473-5687
ISSN	0954-691X
DOI	10.1097/MEG.0000000000002390
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Zs.A 2932: Show issues

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Article ; Online: Evaluation of confocal laser endomicroscopy for assessment and monitoring of therapeutic response in patients with inflammatory bowel disease.

Karstensen, John Gásdal

Danish medical journal

2016 Volume 63, Issue 11

Abstract: Background: Crohn's disease (CD) and ulcerative colitis (UC) have been associated with altered intestinal barrier function. Moreover, it has been proposed that a defective barrier function is related to risk of relapse in patients with quiescent CD. ... ...

Abstract	Background: Crohn's disease (CD) and ulcerative colitis (UC) have been associated with altered intestinal barrier function. Moreover, it has been proposed that a defective barrier function is related to risk of relapse in patients with quiescent CD. Fluorescein-aided confocal laser endomicroscopy (CLE) is a novel endoscopic method, which enables real-time in vivo microscopy. Hence, the intestinal barrier function can be assessed as part of endoscopic evaluation of patients with inflammatory bowel disease (IBD) by measuring microerosions and fluorescein leakage into the intestinal lumen. Furthermore, barrier dysfunction can be correlated with biomarkers associated with intestinal barrier impairments. E-cadherin is a key factor for the adherence of epithelial cells and Smad4 is a cofactor in TGF-β signalling, which is compromised in IBD. Aim: To correlate ileal and colonic CLE parameters with endoscopy and histopathology in IBD. Further, we wanted to correlate these features with risk of relapse and evaluate whether they were reproducible and reversible after intensified medical treatment. We also wanted to analyse, whether Smad4 and E-cadherin mucosal protein expression levels were associated with impairments of intestinal barrier function. Methods: CLE was performed and correlated to histopathology and endoscopic appearance in two prospective studies in CD (n = 39, controls = 11) and UC patients (n = 22, controls = 7), respectively. In the first study, results were correlated to risk of relapse, whereas the latter assessed the reversibility of CLE features in a longitudinal setting. κ-statistics were used in both studies to assess reproducibility of the CLE findings. Furthermore, ileal biopsy specimens from CD patients and controls were stained by immunohistochemistry for Smad4 and E-cadherin and subsequently correlated to the severity of CD and intestinal barrier impairments. Results: We found that fluorescein leakage and microerosions in the terminal ileum were significantly associated with CD com-pared to controls (p = 0.005 and p = 0.006, respectively) and that ileal fluorescein leakage and microerosions could predict relapse (log-rank p = 0.003 and p = 0.017, respectively). In UC patients with clinical relapse, an augmented crypt architecture and colonic fluorescein leakage were significantly correlated to the severity of the disease (p = 0.001 and p < 0.001, respectively). After intensified medical treatment, a correlation was found between histopathological progress and improvement of abnormal colonic crypt architecture (rs = 0.35, p = 0.016), but we did not observe a resolution of the intestinal barrier dysfunction (rs = 0.09, p = 0.56). The inter-observer variability of CLE parameters ranged from fair to substantial, while the intra-observer variability was somewhat higher. Smad4 expression (rs = 0.56, p = 0.002), but not E-cadherin (rs = 0.01, p = 0.95), was correlated with the severity of the disease; however, Smad4 expression did not correlate with a defect barrier function. Conclusions: CLE can visualise crypt alteration and barrier impairments in both CD and UC, which are otherwise undetectable. Further studies are warranted to incorporate CLE in the endoscopic and therapeutic management algorithm for CD and UC possibly refining the definition of mucosal healing. Smad4 expression was correlated with CD as well as disease severity and may serve as a novel treatment target.
MeSH term(s)	Colitis, Ulcerative/diagnostic imaging ; Colitis, Ulcerative/drug therapy ; Colitis, Ulcerative/pathology ; Crohn Disease/diagnostic imaging ; Crohn Disease/drug therapy ; Crohn Disease/pathology ; Endoscopy, Gastrointestinal ; Humans ; Microscopy, Confocal ; Severity of Illness Index
Language	English
Publishing date	2016-11
Publishing country	Denmark
Document type	Journal Article ; Review
ZDB-ID	2648771-8
ISSN	2245-1919 ; 2245-1919
ISSN (online)	2245-1919
ISSN	2245-1919
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Article: A core curriculum for basic EUS skills: An international consensus using the Delphi methodology.

Karstensen, John Gásdal / Nayahangan, Leizl Joy / Konge, Lars / Vilmann, Peter

Endoscopic ultrasound

2022 Volume 11, Issue 2, Page(s) 122–132

Abstract: Background and objectives: During recent years, the demand for EUS has increased. However, standardized training programs and assessments of clinical quality measures are lacking. We therefore aimed to establish a basic curriculum for EUS fellows that ... ...

Abstract	Background and objectives: During recent years, the demand for EUS has increased. However, standardized training programs and assessments of clinical quality measures are lacking. We therefore aimed to establish a basic curriculum for EUS fellows that includes a prioritized list of interpretational capabilities and technical skills. Materials and methods: International key-opinion leaders were invited to participate in a Delphi process. An electronic three-round iterative survey was performed to attain consensus on skills that 70% of the participants found either very important or essential for a newly graduated endosonographer. Results: Of 125 invited experts, 77 participated in the survey. Initially, 1,088 skills were suggested, resulting in a core curriculum containing 29 interpretational skills and 12 technical skills. The top-five interpretation skills included abilities to discern between normal anatomy and pathology, to identify the entire pancreas and ampullary region, to identify solid versus fluid-filled structures, to detect bile duct and gallstones, and to identify a pancreatic mass of 5 mm or larger. For technical skills, ability to insert the endoscope from the mouth to the second part of duodenum, to obtain FNA adequately and safely, to navigate the scope tip to follow anatomical landmark structures, to achieve endoscopic position of each of the four stations, and to perform passage of the scope past a hiatal hernia were given the highest ranking. Conclusions: After a structured Delphi process involving 77 international experts, a consensus was reached for a basic curriculum for EUS fellows to be included during training.
Language	English
Publishing date	2022-04-30
Publishing country	China
Document type	Journal Article
ZDB-ID	2998317-4
ISSN	2226-7190 ; 2303-9027
ISSN (online)	2226-7190
ISSN	2303-9027
DOI	10.4103/EUS-D-21-00125
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Article: EUS-guided transcolonic drainage and necrosectomy in walled-off necrosis: a retrospective, single-center case series.

Ebrahim, Mohamed / Novovic, Srdan / Schmidt, Palle Nordblad / Feldager Hansen, Erik / Karstensen, John Gásdal

Endoscopy international open

2023 Volume 11, Issue 6, Page(s) E618–E622

Abstract: Background and study ... ...

Abstract	Background and study aims
Language	English
Publishing date	2023-06-29
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722
ISSN (online)	2196-9736
ISSN	2364-3722
DOI	10.1055/a-2095-0272
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