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Acta Gastro-Enterologica Belgica has become a fully open-access Journal! This was our wish, shared by the Associate Editors and founding societies, the Société Royale Belge de Gastro-Entérologie (SRBGE) and the Vlaamse Vereniging voor Gastro-Enterologie (VVGE). We announced this major improvement during our Acta Gastro-Enterologica Belgica board meeting in Antwerpen in March 2020 (Picture). It is indeed very important for the Belgian and international scientific community to get easy access to all the Acta Gastro-Enterologica Belgica manuscripts. [...]
The history of Acta Gastro-Enterologica Belgica is long, rich… and cloudy. There is no centralised archive available. However, all currently active gastroenterologists in Belgium have been trained with the journal, have published abstracts or manuscripts in it, or at least know of its existence. Whereas it started as a national society's journal in 1933, it has grown to a competitive international journal with Impact Factor. We felt the need to reconstruct the journal's long history, since this was never done before. This review tried to highlight some of the important milestones, without claiming to be complete. Looking back helps to better foresee and anticipate the future.
Recently, public availability of medical manuscripts free of charge was subject to a national discussion, pledging for obligatory open access journals (1). The idea is based upon the fact that many researches in medical sciences are (partially) funded by the government, and thus by tax payers. Therefore, all tax payers should have free access to the published results. However, the traditional publishing model is based on authors submitting their research results free of charge to a medical journal, and when accepted and published, only subscribers to the journal are allowed access to its content. Commercial publishers are thus financed by the subscribers (libraries and individuals) to their journals and by selling publicity of pharmaceutical companies. Because of the high subscription rates more and more publishers embarked on the open access model, also known as the author-pays model (2). The principle of open access journals requires authors to pay for the publication of their accepted manuscript, which then becomes freely available to the world. It is currently unclear which of the two financial models is more profitable for the publishers. However, the number of open access journals is steadily increasing with new releases on a weekly base. And all these journals need manuscripts (and publication fees) to financially survive. SO. the open access model has led to the danger of predatory publishing with questionable journal integrity and problematic peer review process. [...]
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UNLABELLED: Upper gastrointestinal bleeding (UGIB) remains a common disease affecting 100 to 170 per 100 000 adults per year and causing thereby a significant burden to healthcare resources. Despite the improvements in the management of this disorder, the associated mortality ranges from 5 to 14%. Since the general management of UGIB is not uniform, the main objective of this work is to provide guidelines for the care of adults and children presenting with bleeding caused by gastro-duodenal ulcer or variceal rupture. METHODS: In the absence of evidence-based recommendations, these guidelines were proposed after expert opinions reconciliation and graded accordingly. They are based on the published literature up to September 2010 and graded according to the class of evidence. RESULTS: The current guidelines for the management of UGIB include recommendations for the diagnostic process, general supportive care, pharmacological therapy aiming at bleeding control, specific and endoscopic treatment of acute bleeding and follow-up for both gastro-duodenal ulcers and portal hypertension-induced bleeding.
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We read with attention the letter of Xavier Verhelst in the last issue of Acta Gastro-Enterologica Belgica evaluating the results of a screening campaign in Lendelede (1). Patients undergoing blood examination were offered anti-HCV screening, further HCV RNA evaluation and hepatology consultation if indicated. During one year, 560 patients were screened in a single center. Of those, 5 patients (0.9%) had antibodies against HCV. Positive RNA was evidenced in 3 patients (0.5%) and two of them were referred for antiviral treatment. Thanks to those data, the authors highlight the need of screening campaigns for HCV infection in Belgium (1). We also performed a screening campaign for HCV infection in our hospital. We proposed an HCV screening through a simple finger-stick test without any questionnaire to people (patients, visitors or health care providers) who were present in the main hall of our academic hospital during one day (April 25, 2018). Of 200 volunteers who had been tested during one day, 3 were positive (1.5%). All three patients (one woman and two men) explained that they were already aware of their status (one patient with a previous failure of interferon therapy, one with a previous effective antiviral treatment and another who did not provide any further information). All were middle-age people (50-60 years). There were no newly diagnosed cases and no subsequent antiviral treatment. [...]
The world is changing... the landscape of gastro- enterology and hepatology too. First, scientific knowledge is evolving. The complex mechanisms that explain liver and digestive diseases are becoming better and better characterized. In the previous issue of Acta Gastro-Enterologica Belgica, for example, we discovered the role of angiogenesis in non- alcoholic steatohepatitis, one of the most common liver diseases without drug treatment available to date. [...]
Acta Gastro-Enterologica Belgica
Chronic pancreatitis (CP) is an inflammatory disorder characterized by inflammation and fibrosis, resulting in a progressive and irreversible destruction of exocrine and endocrine pancreatic tissue. Clinicians should attempt to classify patients into one of the six etiologic groups according to the TIGARO classification system. MRI/MRCP, if possible with secretin enhancement, is considered the imaging modality of choice for the diagnosis of early-stage disease.In CP, pain is the most disabling symptom, with a significant impact on quality of life. Pain should be assessed using the Izbicki score and preferably treated using the "pain ladder" approach. In painful CP, endoscopic therapy (ET) can be considered as early as possible. This procedure can be combined with extracorporeal shock-wave lithotripsy (ESWL) in the presence of large (> 4 mm), obstructive stone(s) in the pancreatic head, and with ductal stenting in the presence of a single main pancreatic duct (MPD) stricture in the pancreatic head with a markedly dilated MPD. Pancreatic stenting should be pursued for at least 12 months in patients with persistent pain relief. On-demand stent exchange should be the preferred strategy. The simultaneous placement of multiple, side-by-side, pancreatic stents can be recommended in patients with MPD strictures persisting after 12 months of single plastic stenting. We recommend surgery in the following cases: a) technical failure of ET ; b) early (6 to 8 weeks) clinical failure ; c) definitive biliary drainage at a later time point; d) pancreatic ductal drainage when repetitive ET is considered unsuitable for young patients; e) resection of an inflammatory pancreatic head when pancreatic cancer cannot be ruled out; f) duodenal obstruction. Duodenopancreatectomy or oncological distal pancreatectomy should be considered for patients with suspected malignancy. Pediatricians should be aware of and systematically search for CP in the differential diagnosis of chronic abdominal pain. As malnutrition is highly prevalent in CP patients, patients at nutritional risk should be identified in order to allow for dietary counseling and nutritional intervention using oral supplements. Patients should follow a healthy balanced diet taken in small meals and snacks, with normal fat content. Enzyme replacement therapy is beneficial to symptomatic patients, but also in cases of subclinical insufficiency. Regular follow-up should be considered in CP patients, primarily to detect subclinical maldigestion and the development of pancreatogenic diabetes. Screening for pancreatic cancer is not recommended in CP patients, except in those with the hereditary form.
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