OP pH metry detected less reflux episodes than MII/pH; 35% of the OP events were swallows according to impedance. Time correlation between cough and reflux could not be demonstrated with OP pH metry.

Background: Fluorescein-enhanced autofluorescence thoracoscopy (FEAT) reveals regions of abnormal fluorescence in patients with primary spontaneous pneumothorax and in normal subjects. Some of these lesions are undetectable by white light thoracoscopy and it has been hypothesized that they represent underlying pleural and/or parenchymal abnormalities. Objectives: In order to standardize and evaluate this novel technique, we developed an animal model. Methods: Six pigs underwent thoracoscopy after the inhalation of nebulized sodium fluorescein by either volume-controlled mechanical ventilation or spontaneous ventilation. Pleural cavity and lung surface were inspected by white light thoracoscopy and FEAT during a period of 90 min. Fluorescence intensities were quantified in pleura and in blood. Regions of interest were examined postmortem for a histological assessment of the lesions. Results:FEAT lesions were observed in all animals, with a maximum intensity of the lesions 20–30 min after the onset of fluorescein administration. The plasma concentrations of sodium fluorescein reached a maximum after approximately 20 min. The microscopic findings suggest that fluorescein accumulates in the subpleural space of better ventilated lung areas. Conclusions:This is the first animal model using FEAT. Valuable information has been gathered but further investigations are required to explain the phenomena observed in humans and pigs.

Background and aims Extra-intestinal manifestations are frequently reported in inflammatory bowel diseases. However, data comparing the effect of vedolizumab and ustekinumab on articular extra-intestinal manifestations are limited. The aim was to evaluate differences in new onset and evolution of pre-existing joint extra-intestinal manifestations during both treatments. Methods An international multicentric retrospective study was performed on inflammatory bowel disease patients who started vedolizumab or ustekinumab between May 2010 and December 2020. Extra-intestinal manifestations were assessed at baseline and joint extraintestinal manifestations were evaluated throughout the 2-year follow-up. Arthropathy was defined by joint inflammation (arthritis/sacroiliitis), diagnosed by a rheumatologist, and arthralgia as articular pain without confirmed inflammation. Additionally, skin, ocular and hepatic extra-intestinal manifestations were assessed at baseline. Uni- and multivariate analyses were performed. Results In total 911 patients (vedolizumab:584; ustekinumab:327) were included. Deterioration of pre-existing arthropathy and rate of new onset arthropathy were not significantly associated with vedolizumab over ustekinumab. Arthropathy was reason to stop treatment in 6 vedolizumab and 2 ustekinumab patients. The odds of developing new arthralgia within 6 months was higher in patients who took vedolizumab compared to ustekinumab (aOR: 2.28 [1.01-5.15], p=0.047). However, this effect was not sustained during the 2-year follow-up (aOR: 1.35 [0.80-2.29], p=0.259). Deterioration of pre-existing arthralgia was comparable between ustekinumab and vedolizumab treated patients. In 2 vedolizumab-treated patients arthralgia was reason to stop treatment. Conclusions Vedolizumab and ustekinumab can be used safely in patients with articular extra-intestinal manifestations. Only a temporary increased risk for developing arthralgia has been observed under vedolizumab.

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