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Presentation The Erasme-HUDERF Neuromuscular Reference Centre provides the services of an expert multidisciplinary team to offer integrated care to anyone with a neuromuscular disease. Neuromuscular diseases are conditions caused by dysfunction of the motor unit (consisting of the muscle, the neuromuscular junction and the nerve), which prevents the muscle from contracting normally. These diseases affect both children and adults. The age at which the disease appears, the initial symptoms and the severity of the condition vary depending on the disease. Motor, respiratory, cardiac and digestive functions may be affected to varying degrees and may require multidisciplinary care and follow-up.To request an appointment: %20Cons [dot] Neuromusculaire [dot] erasme [at] hubruxelles [dot] be (Cons[dot]Neuromusculaire[dot]erasme[at]hubruxelles[dot]be) or by telephone: +32 2 555 33 60. Image Image There are six groups of neuromuscular diseases:Myopathies (Steinert disease, dystrophies, myositis, myotonia, periodic paralysis, glycogen storage diseases, mitochondrial diseases, etc.).Diseases of the neuromuscular junction (myasthenia gravis and Lambert-Eaton syndrome).Motor neuron diseases (amyotrophic lateral sclerosis or “Charcot disease”, post-polio syndrome, spinal muscular atrophies, etc.).Neuropathies = polyneuritis = polyneuropathies (inflammatory, Guillain-Barré syndrome, CIDP/PIDC, Charcot-Marie-Tooth disease, diabetes-related, etc.).Degenerative syndromic conditions (often hereditary) (hereditary spastic paraplegias/Strümpell-Lorrain disease, Friedreich’s ataxia and spinocerebellar ataxias/SCA, etc.).Plexus disorders (cervicobrachial, lumbosacral).The care services cover all stages of the disease, from the most precise diagnosis through to treatment. The team’s work is primarily focused on optimising care, advising and guiding patients, their relatives and their care team, in close consultation and collaboration with local practitioners who are also involved in the patient’s care. The team’s main aim is to improve quality of life, slow disease progression, prevent and limit complications and, ultimately, improve the long-term prognosis. Structure and functioning The Erasme-HUDERF Neuromuscular Reference Centre (CRNM) brings together a multidisciplinary medical and paramedical team with expertise in neuromuscular diseases. Its activities are coordinated by the coordinating physicians, with the support of coordinating nurses and the secretariat. The core medical team, made up of specialists in neurology, paediatric neurology, physical medicine and genetics, works in conjunction with named referral physicians (for paediatric and adult patients) from various specialties (anaesthesiology, cardiology, dermatology, endocrinology, gastroenterology, gynaecology, internal medicine, emergency medicine, obstetrics, ophthalmology, orthopaedics, paediatrics, pneumology, psychiatry, stomatology and urology). This medical team’s expertise enables diagnosis and ensures medical follow-up and treatment during the multidisciplinary neuromuscular consultations held several times a month.All medical and technical examinations (for example, electromyography, neuromuscular biopsy, DNA analysis and cardiopulmonary assessment) are carried out within the Erasme-HUDERF Neuromuscular Reference Centre. Certain highly specialised laboratory analyses are performed in collaboration mainly with leading laboratories in Belgium and Europe. Neuromuscular biopsies are performed in close collaboration with the neuropathology laboratory of Brugmann University Hospital. The rehabilitation team (present at both the Erasme and HUDERF sites) consists of paramedical specialists representing the following professions: coordinating nurse, occupational therapist, physiotherapist, psychologist, social worker, speech therapist and dietitian.Patients’ files are systematically discussed during multidisciplinary team meetings, which makes it possible to shorten and refine the diagnostic process and accelerate care. A personalised and coordinated programme of medical and rehabilitation care is systematically proposed to the patient, their relatives and their home care team. There is close collaboration between the CRNM (Erasme site) and the rehabilitation centre located on the same site, which has both inpatient and outpatient facilities where neuromuscular patients are regularly treated during the acute phase and/or over the long term. Care management ExaminationsCardiac assessmentThe cardiac assessment as part of the Neuromuscular Reference Centre (CRNM) comprises five examinations: electrocardiogram, echocardiogram, Holter ECG, bone densitometry, and muscle and/or nerve biopsy.Electromyography (EMG)This examination involves inserting a fine needle into the muscle being studied in order to record the electrical activity produced by the muscle fibres when the muscles are activated or when they are at rest and fully relaxed.Cardiopulmonary exercise testingCardiopulmonary exercise testing is used to assess your exercise capacity (cycling). The examination is performed on a bicycle. Measurements are taken throughout the exercise to assess your respiratory system and your heart.Nerve conduction velocity testingNerve conduction velocity testing determines the speed at which electrical signals travel along a particular peripheral nerve. It is used to diagnose a nerve injury or dysfunction.Evoked potentialsThis technique involves stimulating the sensory organs to assess the function of specialised nerve structures involved in transmitting information related to touch, hearing and vision, using electrical stimuli, headphones and a screen, respectively.Repetitive stimulationRepetitive nerve stimulation (RNS) is a neurophysiological tool used to reveal certain neuromuscular transmission and muscle conduction deficits.Ischaemic forearm exercise testThe purpose of this test is to detect dysfunctions in muscle metabolism, particularly the muscle’s ability to use energy resources. After a cuff has been inflated around the upper arm and a catheter (a small plastic tube) has been placed in a vein in the forearm, the patient is asked to repeatedly clench their fist against resistance for several minutes.Treatments MedicationIn the context of neuromuscular diseases, drug treatments are numerous and vary considerably depending on the diagnosis made. It is therefore impossible to detail all the possible options here for the many diseases grouped under the term “neuromuscular diseases”. Each treatment will be adapted with your doctor to your condition and to your individual circumstances (medical history, age, etc.).Non-pharmacological treatmentsA significant proportion of patients with a neuromuscular disease experience limitations in their activities of daily living, and the disease often affects various areas of life: professional, family, social, psychological and economic consequences, etc. In this context, the centre’s team offers you integrated, continuous multidisciplinary follow-up over time, in order to identify the difficulties related to the disease as effectively as possible and to try to provide the most appropriate responses according to each patient’s specific needs. Regular physiotherapy is, in most situations, an essential treatment to recover and/or maintain the best possible motor function and functional independence in the medium and long term. A range of measures may be implemented to facilitate daily functioning when necessary: adaptations to the home, various forms of home assistance, different allowances, a reduced-mobility parking permit, etc.  Useful documents and brochures Brochure of the Neuromuscular Reference Centre External request – nerve biopsy External request – muscle biopsy Our specialists Our associated services In 2024, the H.U.B’s CRNM celebrates its 10th anniversary. On this occasion, the CRNM is organising a symposium on 23 November 2024 at the Museum of Medicine. Discover the programme

What is it about? An atrial septal defect is a “hole” in the interatrial septum, thereby creating a connection between the left atrium and the right atrium. It is a common congenital malformation (6–10% of congenital heart diseases; 1 in 1,500 births). As a result of this atrial septal defect, oxygenated blood mixes with “deoxygenated” blood. This leads to an increased workload for the right atrium, the right ventricle and the lungs. Symptoms Shortness of breath or fatigue during exertion, palpitations... People with an atrial septal defect are more prone to cerebrovascular accidents. Treatment It depends on their size, location, and effects on the heart and lungs. Very often, the atrial septal defect will be closed surgically. It is possible to close them percutaneously (that is, without surgically opening the chest, using cardiac catheterisation techniques).

What is it about? A ventricular septal defect is an opening between the left and right ventricles. It is a common malformation. This ventricular septal defect allows oxygenated blood to mix with “deoxygenated” blood. The result is an increased workload for the ventricles and therefore heart failure. Symptoms Shortness of breath or fatigue during exertion, palpitations... (symptoms of heart failure). Affected infants are more prone to respiratory infections. Treatments The ventricular septal defect will be closed surgically. Diuretics, digitalis, sodium restriction, and treatment of respiratory infections in the meantime if the situation is stable.

What is it about? Heart failure occurs when the heart’s pumping function is reduced below normal. This results in an insufficient blood supply to other organs, such as the liver and kidneys.The heart failure you are experiencing is sometimes of unknown origin. It is most often the consequence of coronary artery disease; your medical history then includes one or more myocardial infarctions, and possibly coronary artery bypass surgery.It may follow heart valve disease, in which case you have probably already undergone replacement of one or more valves. It may also be caused by a viral infection, drug toxicity (chemotherapy), dietary toxicity (alcoholism), or even pregnancy (very rare!).The course of your heart disease invariably and irreversibly leads to cardiac dilatation. Your heart is no longer able to ensure adequate perfusion of the organs, causing symptoms and dysfunction of other organs despite appropriate drug treatment. What are the causes? Coronary artery disease (= ischaemic cardiomyopathies, sequelae of myocardial infarction, etc.), diabetes, valvular heart disease, high blood pressure, pulmonary embolism, and myocarditis caused by a viral infection or toxins. Diagnosis A number of symptoms are associated with heart failure. Shortness of breath, which may occur at rest or during exertion, is undoubtedly one of the symptoms characteristic of heart failure. Other symptoms include rapid fatigue and fluid retention (oedema). Other symptoms, such as tachycardia, weight gain over a few days and reduced urine output, are observed in heart failure.The diagnosis is readily suspected based on the symptoms and confirmed by cardiac ultrasound. The cause of the decompensation must then be sought among the diseases mentioned above. Treatment Several types of medication are useful in the treatment of heart failure. These medications aim to improve the heart’s pumping function, reduce the signs and symptoms of heart failure, or reduce stress on the heart. Currently, medications known as “angiotensin-converting enzyme inhibitors” (e.g. Capoten, Zestril, Coversyl, Tritace, etc.) can be considered the cornerstone of treatment. In second place are beta-blockers (e.g. Kredex, Isoten, etc.), which, by reducing the heart’s energy requirements and oxygen consumption, are also a basic treatment for decompensated heart failure.It should not be forgotten that certain simple dietary measures (a salt-free diet and fluid restriction) are easy-to-implement treatments for reducing the signs of heart failure.

What is it about? The coronary arteries are the arteries that supply the heart and provide it with the oxygen it needs to function. They run along the surface of the heart. Two coronary arteries bring oxygen-rich blood to the heart: the left and right coronary arteries. These arteries divide into arterioles that end in capillaries within the heart muscle. Blood from the capillaries is collected in venules, which return the blood to the right side of the heart. Complete or partial blockage of a coronary artery deprives the heart of the oxygen it needs. This causes intense chest pain (a band-like pain) that radiates to the left arm or towards the jaw. Myocardial infarction refers to the sudden blockage of a coronary artery. The area of heart muscle that is no longer supplied with blood dies within a few hours. Angina pectoris is a painful episode resulting from an insufficient supply of oxygen to the heart muscle (myocardial ischaemia). This lack of oxygen is itself caused by narrowing of a coronary artery. An episode of angina pectoris occurs during exertion: this is when the heart no longer receives enough oxygen. It should be stressed that not all chest pain is due to angina pectoris. Angioplasty (dilation of the coronary arteries) or surgery may be necessary. How can a coronary artery become blocked? Through two different mechanisms: Atheromatosis, resulting from the formation of cholesterol plaques on the arterial walls. Spasm or contraction of the muscles in the coronary arteries. Atheromatosis results from several different causes: Excess cholesterol in the blood. High blood pressure. Smoking are the main risk factors. Other factors also play a role: Stress. Diabetes. Glucose intolerance. Obesity. A sedentary lifestyle. Factors beyond our control: age, sex and heredity. Treatment Addressing risk factors is essential. Medical treatment can slow down or reverse atherosclerotic lesions. In many cases, however, angioplasty (dilation of the coronary arteries) or surgery is necessary.

What is it about? Ascending aorta The first description was published in 1960 by Ellis et al., who associated disease of the aortic valve and ascending aorta (annuloaortic ectasia). The natural history of this disease usually leads to aortic regurgitation, but also to an aneurysm of the ascending thoracic aorta, the main complication of which is dissection. Marfan syndrome is one of the leading causes of annuloaortic ectasia. Surgery is indicated when aortic valve regurgitation is moderate to severe, with left ventricular involvement and/or dilatation of the ascending aorta to at least 45 mm in diameter. Surgical treatment is required because the natural course is rupture, with 100% mortality. Surgery is performed with cardiopulmonary bypass and consists of replacing the aortic valve and ascending aorta with a mechanical valve combined with a straight vascular graft, with reimplantation of the ostia of the left and right coronary arteries into the tubular prosthesis (the Bentall and Bono technique, described in 1968). There are other surgical techniques that are variants of the Bentall and Bono procedure, such as the Cabrol technique, which is now rarely used. There are also the David and Yacoub techniques, which have the advantage of preserving the native aortic valve if it is intact. The mortality associated with this surgery is close to that of aortic valve replacement surgery, i.e. less than 2%, except in an emergency situation without comorbidities, in which it is less than 10%. Descending Aneurysms Dissection

What is it about? Tricuspid regurgitation is characterised by regurgitation from the ventricle into the right atrium. It may lead to dilatation and subsequently failure of the right-sided chambers of the heart (the right atrium and ventricle). The causes may be functional (common) or organic (rare). In the former case, regurgitation is secondary to incomplete leaflet coaptation because the tricuspid annulus is dilated as a result of increased pressure caused by a downstream obstruction (in the pulmonary circulation, at the mitral valve, etc.). This may occur in the context of pulmonary hypertension, mitral-aortic valve disease, ischaemic heart disease, cor pulmonale (chronic respiratory conditions increasing resistance to right ventricular ejection into the pulmonary vessels), or acute or chronic pulmonary embolism. Organic causes of tricuspid valve damage are rarer; these include certain congenital malformations, bacterial endocarditis, acute rheumatic fever, chest trauma, right ventricular infarction and carcinoid syndrome. Symptoms The patient generally presents with signs of right-sided heart failure: oedema of the lower limbs, hepatomegaly, distended jugular veins or, in cases of global heart failure, dyspnoea or fatigue. Treatment Treatment is initially medical. Surgery is indicated in cases of functional tricuspid regurgitation associated with mitral valve disease, tricuspid valve infection that does not respond to antibiotics, or symptomatic severe tricuspid regurgitation. Usually, tricuspid valve repair by annuloplasty is performed; more rarely, the valve needs to be replaced.

What is it about? Aortic stenosis Aortic stenosis is a narrowing of the valve at the outlet of the left ventricle (the aortic valve). Narrowing of the outflow opening increases the workload of the heart, eventually leading to heart failure if left untreated. Causes of aortic stenosis There are three main causes of aortic stenosis: Degenerative disease, which is common in older patients. This degeneration is favoured by high blood pressure and possibly by atherosclerosis, but it can also appear at an early age in certain congenital abnormalities of the aortic valves. Bicuspid aortic valve, which is present in 1 to 2% of the general population. The structure of the aortic valve (2 cusps instead of 3) accelerates valve ageing; consequently, a bicuspid aortic valve is a more frequent cause of valvular disease in younger people. Acute rheumatic fever, which has become rare in Northern Europe thanks to the early administration of antibiotics in children with sore throats. Symptoms of aortic stenosis Angina pectoris: chest pain that generally occurs during exertion and may also occur in coronary artery disease. Exertional syncope. Dyspnoea (shortness of breath) occurs later in the course of the disease. Treatment of aortic stenosis This is the surgery used to remove the obstruction to left ventricular outflow. It generally involves replacing the aortic valve with either a biological or mechanical prosthesis. Less commonly, the valve is replaced with the patient’s pulmonary valve (Ross procedure). Surgery is indicated as soon as symptoms appear. Aortic regurgitation Valve insufficiency, particularly of the aortic valve in this case, is the inability of the valve to close completely. This results in retrograde leakage (regurgitation) of blood back into the heart chamber from which it originated. In this case, blood ejected from the aorta flows back into the left ventricle, causing it to become “overworked”. Causes of aortic regurgitation Acute rheumatic fever has become a rare cause in Europe. In this case, insufficiency is most often accompanied by stenosis (see above). This is then referred to as aortic valve disease. Bicuspid aortic valve (a congenital morphological abnormality). Infective endocarditis is the most common cause of acquired acute aortic insufficiency. Annulo-aortic ectasia: dilation of the aortic root, resulting in dilation of the valve annulus, whose leaflets no longer come into contact. Isolated valvular dysplasia, in which the valvular tissue degenerates. Dissection of the ascending aorta. Aortitis, such as syphilis, Takayasu disease, Kawasaki disease, ankylosing spondylitis, Horton’s disease, Behçet’s disease, etc. Connective tissue diseases such as systemic lupus erythematosus, antiphospholipid syndrome, etc. Chest trauma (extremely rare). Symptoms of aortic insufficiency Dyspnoea Presyncope; syncope is less common. Fatigue. Treatment of aortic regurgitation Initially, treatment is medical, with the aim of stabilising the patient and preventing deterioration of cardiac muscle function. If the patient develops symptoms or if the left ventricle deteriorates (on echocardiography), the valve should be replaced with a biological or mechanical prosthesis. In some cases, the valve can be repaired (for example, in annuloaortic ectasia). Acute aortic regurgitation (aortic dissection or endocarditis) most often constitutes a surgical emergency.

What is it about? Mitral stenosis The main cause of narrowing (less than 2 cm²) of the mitral valve is rheumatic heart disease, which occurs in patients who have had acute rheumatic fever. This disease has now become rare in Northern Europe. Other exceptional causes include lupus erythematosus, rheumatoid arthritis, radiotherapy, etc. Clinical manifestations Atrial fibrillation. Exertional or positional dyspnoea reflects an increase in left atrial pressure during exertion or when moving into a lying position. Pulmonary oedema. Cerebrovascular thromboembolic accident (CVA), resulting from the expulsion of a clot formed in the left atrium, most often associated with atrial fibrillation. Treatment If the patient initially needs to be treated with medication, valve repair (less frequently possible than in mitral regurgitation, see below) or valve replacement—either with a biological or a mechanical valve—is generally required as soon as symptoms occur.

What is it about? Patent ductus arteriosus is a congenital condition present at birth. It is characterised by the presence and persistence of a duct between the pulmonary artery and the aorta. It is very common in premature infants (80% of children born before the 28th week of gestation). Symptoms Primarily shortness of breath, breathing difficulties and possible episodes of apnea, as well as a decrease in heart rate. The diagnosis The electrocardiogram shows signs of left ventricular overload. The chest X-ray shows signs of left ventricular hypertrophy, which is the principal finding, and cardiomegaly. Echocardiography readily demonstrates the patent ductus arteriosus, measures pulmonary and aortic blood flow, and assesses the degree of arterial hypertension. Treatment Surgical intervention is mandatory because the risk of infective endocarditis and heart failure is significant. This duct must be closed.

What is this about? Fallot tetralogy is a complex heart defect characterised by cyanosis, meaning that patients have a bluish complexion due to inadequate oxygenation of the blood. In Fallot tetralogy, the heart is “not fully formed”. The pulmonary artery is underdeveloped and stenosed, and the ventricular septum is incomplete and absent beneath the roots of the aorta and pulmonary artery. In practice, blood enters the right ventricle. As it contracts, the right ventricle sends venous blood both into the pulmonary artery (but only in a small amount, given the resistance caused by the stenosis) and into the aorta. Arterial blood is therefore a mixture of non-oxygenated venous blood and red arterial blood, which accounts for the patient’s “bluish” appearance. Treatment It is surgical. Completely reparative surgery is performed as early as possible. This surgery consists of closing the ventricular septal defect and enlarging the pulmonary infundibulum and pulmonary arteries.

The Pancreatology and Nutritional Support Clinic is a specialised medical unit dedicated to the diagnosis, treatment and follow-up of pancreatic diseases, as well as to the nutritional management of patients suffering from undernutrition, digestive disorders or requiring artificial nutrition. Contact the Clinic Are you a doctor and would like to obtain your patients’ medical results?Are you looking for information or do you need to deal with an administrative matter?Contact our medical secretariat by email at SecMed [dot] GastroMed [dot] erasme [at] hubruxelles [dot] be (SecMed[dot]GastroMed[dot]erasme[at]hubruxelles[dot]be)  Provide each patient with specialised care The Pancreatology and Nutritional Support Clinic is dedicated to providing each patient with specialised, personalised and multidisciplinary care, incorporating the latest medical and scientific advances in the fields of pancreatology and clinical nutrition. Image Image Image We are committed to: Diagnose and treat all pancreatic diseases, whether inflammatory (acute and chronic pancreatitis), autoimmune, hereditary or tumour-related, using state-of-the-art technical facilities (interventional endoscopy, advanced imaging and specialised surgery). Provide nutritional support for patients suffering from malnutrition, malabsorption or dependence on artificial nutrition (enteral or parenteral nutrition), in close collaboration with dietitians, clinical nurses and specialised pharmacists. Coordinate a multidisciplinary approach to ensure a rigorous diagnostic assessment and individualized therapeutic management, in line with current scientific recommendations. Promote clinical and fundamental research in the fields of pancreatology and nutrition, in order to continuously improve practices and provide our patients with access to the most innovative treatments. Train tomorrow’s healthcare professionals as part of our university mission, by sharing our expertise with students and doctors in training or visiting doctors who join us. Our range of care services •    Acute pancreatitis•    Chronic pancreatitis, including idiopathic and genetic forms•    Pancreatic cysts•    Autoimmune pancreatitis•    Malnutrition requiring artificial nutritional support (enteral or parenteral nutrition)•    Placement and management of enteral feeding tubes (by the Digestive Endoscopy Clinic)•    Short bowel syndrome•    Obscure gastrointestinal bleeding originating from the small intestine Our team Our multidisciplinary team, comprising specialist physicians, nurses and paramedical professionals, provides comprehensive and coordinated care for pancreatic diseases and nutritional disorders, in close collaboration with the general practitioner to ensure continuity of care. Prof. Marianna Arvanitakis, Director of the Pancreatology and Nutritional Support Clinic Gastroenterologist specialising in pancreatic diseases, interventional endoscopy and clinical nutrition. Professor Marianna Arvanitakis specialised in pancreatology and interventional endoscopy as part of Professor Jacques Devière’s team at Erasme Hospital. After obtaining a university diploma in Clinical Nutrition in 2005, she took over the medical coordination of the nutritional support service in 2018. The research conducted within the clinic focuses in particular on optimising the management of patients with severe acute pancreatitis and chronic pancreatitis, as well as on the management of patients suffering from short bowel syndrome. A member of several scientific societies, she is Secretary General of the European Society of Gastrointestinal Endoscopy (ESGE) for the 2025–2027 term and a clinical supervisor in gastroenterology for the Université libre de Bruxelles (ULB). Prof. Alia Hadefi Professor Hadefi is a gastroenterologist with expertise in clinical nutrition and metabolic liver diseases. She completed her doctoral thesis in 2024 on the interaction between the intestine and liver diseases, and undertook additional training in 2025 within the Department of Gastroenterology, Chronic Inflammatory Bowel Diseases (IBD) and Nutritional Support at Beaujon Hospital (Paris).Languages spoken: French, English, Arabic. Dr Michael Fernandez Y Viesca Dr Fernandez is a gastroenterologist with expertise in pancreatology, acquired after obtaining a university diploma in pancreatology in 2017 (Sorbonne). He is the coordinating physician for benign pancreatic diseases within the multidisciplinary pancreatology consultation and is currently preparing a doctoral thesis on severe acute pancreatitis.Languages spoken: French, English, Spanish. Wound care, stomatherapy, clinical nutrition A nursing team by your side to treat wounds, support people with a digestive stoma bag, and ensure appropriate nutrition.Clinical nutrition nurseErasmus HospitalAsuncion Ballarin, Stomatherapy nurse, clinical nutritionValérie Burion Jules Bordet InstituteIngrid Amorison   Meet our nursing team The departments with which the clinic collaborates Digestive surgery Lien vers Digestive surgery Digestive Oncology Lien vers Digestive Oncology Medical Imaging Lien vers Medical Imaging Interventional Radiology Lien vers Interventional Radiology Anatomical Pathology Centre Dietetics Lien vers Dietetics Hospital Pharmacy Lien vers Hospital Pharmacy Image Research and Innovation The Pancreatology and Nutritional Support Clinic is involved in various research projectsOptimisation of the management of patients with severe acute pancreatitis (Dr Fernandez Y Viesca), in collaboration with the Medical Imaging DepartmentChronic pancreatitis: Quality of life and Patient-Reported Outcomes (PROMs) (Dr Fernandez)Prevention of refeeding syndrome (RFS) using an application (Prof. Hadefi)Impact of endoscopic suturing gastroplasty (ENDOMINA) on liver diseases (steatohepatitis associated with liver dysfunction), in collaboration with the Centre of Pathological Anatomy (Prof. Hadefi)Study of new medications for short bowel syndrome (GLP-2 analogues) (Prof. Hadefi)Relationship between short bowel syndrome and liver diseases (Intestinal Failure-Associated Liver Disease (IFALD) (Prof. Hadefi) Resources and useful links [SCIENTIFIC ARTICLE] Pancreatic cysts and the risk of malignant transformation [SCIENTIFIC ARTICLE] Infected pancreatic necrosis and multidrug-resistant bacte… [SCIENTIFIC ARTICLE] Nutrition and diabetes [SCIENTIFIC ARTICLE] Endoscopic and percutaneous drainage for acute pancreatitis [SCIENTIFIC ARTICLE] European recommendations for exocrine pancreatic insuffici… [SCIENTIFIC ARTICLE] ESPEN European recommendations on clinical nutrition in ac… [SCIENTIFIC ARTICLE] Nutritional strategies for non-alcoholic fatty liver disea… [SCIENTIFIC ARTICLE] ASGE-ESGE recommendations on bariatric and metabolic endos… [ARTICLE] Feeding tube: a tool to take care of yourself when your body needs it