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Gastroenterology Clinics of North America

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https://www.readbyqxmd.com/read/30337045/pediatric-gastroenterology
#1
EDITORIAL
Robert J Shulman
No abstract text is available yet for this article.
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337044/pediatric-gastroenterology-not-just-dealing-with-little-adults
#2
EDITORIAL
Alan L Buchman
No abstract text is available yet for this article.
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337043/advances-in-pediatric-fatty-liver-disease-pathogenesis-diagnosis-and-treatment
#3
REVIEW
Hayley A Braun, Sarah A Faasse, Miriam B Vos
Pediatric nonalcoholic fatty liver disease is an increasingly prevalent disease, but its pathophysiology is not fully elucidated, diagnosis is difficult and invasive, and therapeutic options are limited. This article addresses the recent advancements made in understanding the pathophysiology of nonalcoholic fatty liver disease, the development of less invasive diagnostic modalities, and emerging therapeutic options, including ongoing clinical trials in children.
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337042/assessment-and-treatment-of-nonadherence-in-transplant-recipients
#4
REVIEW
Caitlin Shneider, Claire Dunphy, Eyal Shemesh, Rachel A Annunziato
Stable intake of an immunosuppressant medication regimen is essential for posttransplant survival in the vast majority of cases. And yet, many patients are nonadherent (do not take their medications as prescribed), and suffer consequences ranging from rejection to morbidity and mortality. We review the evidence related to monitoring of adherence to medications, and intervention strategies. Our aim is to provide a baseline from which readers may approach behavioral aspects of posttransplant care. This review may also help readers in designing clinical programs for routine monitoring of adherence, and inform the choice of intervention when adherence falls below a certain threshold...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337041/molecular-mechanisms-in-pediatric-cholestasis
#5
REVIEW
James E Squires, Patrick McKiernan
Pediatric cholestasis often results from mechanical obstruction of the biliary tract or dysfunction in the processes of forming and excreting bile. Various genetic defects with resulting molecular inaccuracies are increasingly being recognized, often with specific clinical characteristics. Identifying of the molecular abnormality can enable implementation of timely, appropriate treatment in some affected individuals and provide prognostic indicators for both families and care teams.
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337040/improving-care-in-pediatric-inflammatory-bowel-disease
#6
REVIEW
Matthew D Egberg, Michael D Kappelman, Ajay S Gulati
Pediatric patients with inflammatory bowel disease (IBD) stand to benefit from quality improvement (QI) due to the chronic nature of the disease, frequent interaction with the health care system, and exposure to high-risk treatments. The use of QI in health care has led to significant improvements in quality and reliability of care. Despite these advances, significant deficits in providing high-quality pediatric IBD care persist. This article describes a brief history of health care QI, identifies gaps and challenges in delivery of quality pediatric IBD care, highlights several IBD QI initiatives, and concludes with future directions for improving pediatric IBD outcomes...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337039/food-sensitivities-fact-versus-fiction
#7
REVIEW
Catherine DeGeeter, Stefano Guandalini
Food allergies are on the rise, for reasons that are not fully understood. However, there is a tendency to overestimate their frequency, mostly based on parents' reports or on the assumption that a positive skin or blood IgE test implies the existence of clinically relevant allergy. It is imperative to base food allergy diagnosis on well-defined criteria, avoiding "alternative" tests that are available to the general public. Non-celiac gluten sensitivity is a misnomer and should be abandoned in favor of non-celiac wheat intolerance, an entity suffering from lack of biomarkers and still not convincingly described in children...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337038/gastrointestinal-neuropathies-new-insights-and-emerging-therapies
#8
REVIEW
Marcella Pesce, Osvaldo Borrelli, Efstratios Saliakellis, Nikhil Thapar
The bewildering complexity of the enteric nervous system makes it susceptible to develop a wide array of motility disorders, collectively called enteric neuropathies. These gastrointestinal conditions are among the most challenging to manage, mainly given poor characterization of their etiopathophysiology and outcomes. Not surprisingly, therefore, targeted or curative therapies for enteric neuropathies are lacking and management is largely symptomatic. Nonetheless, recent advances in neurogastroenterology have witnessed improvements in established strategies, such as intestinal transplantation and the emergence of new treatments including novel drugs, electrical pacing, and manipulation of fecal microbiota, as well as stem cell and gene therapy...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337037/integration-of-biomedical-and-psychosocial-treatments-in-pediatrics-functional-gastrointestinal-disorders
#9
REVIEW
Miranda A L van Tilburg, Charles A Carter
Pediatric functional gastrointestinal disorders (FGIDs) are disorders of the brain-gut axis. Pathophysiological factors include alterations in gut motility, microbiota, immune system, central nervous system, and psychosocial factors. Given the complex pathophysiology of FGIDs, many patients are in need of integrative treatment approaches that may include a combination of biomedical, nutritional, and psychological approaches. In this article, we examine goals of treatment; give a brief overview of biomedical, nutritional, and psychological approaches; and finally discuss the integrative management of pediatric FGIDs...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337036/constipation-beyond-the-old-paradigms
#10
REVIEW
Peter L Lu, Hayat M Mousa
Constipation is a common problem in children. Although most children respond to conventional treatment, symptoms persist in a minority. For children with refractory constipation, anorectal and colonic manometry testing can identify a rectal evacuation disorder or colonic motility disorder and guide subsequent management. Novel medications used in adults with constipation are beginning to be used in children, with promising results. Biofeedback therapy and anal sphincter botulinum toxin injection can be considered for children with a rectal evacuation disorder...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337035/infantile-colic-new-insights-into-an-old-problem
#11
REVIEW
Tu Mai, Nicole Y Fatheree, Wallace Gleason, Yuying Liu, Jon Marc Rhoads
Infant colic is a characteristic group of behaviors seen in young infants. The most prominent feature is prolonged crying. Additional characteristics, including clenching of the fists and flexion of the hips, have led to the suggestion that these behaviors are related to abdominal discomfort. In this article, we show emerging evidence to support the concept that infant colic could represent gut inflammation and microbial dysbiosis that impacts brain function and even brain development.
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337034/new-insights-into-the-pathogenesis-and-treatment-of-malnutrition
#12
REVIEW
Grace E Thaxton, Peter C Melby, Mark J Manary, Geoffrey A Preidis
The volume of research into the pathogenesis and treatment of malnutrition has increased markedly over the past ten years, providing mechanistic insights that can be leveraged into more effective treatment options. These discoveries have been driven by several landmark studies employing metabolomics, metagenomics, and new preclinical models. This review highlights some of the most important recent findings, focusing in particular on the emerging roles of prenatal and perinatal factors, protein deficiency, impaired gut barrier function, immune deficiency, and the intestinal microbiome...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337033/multiplex-nucleic-acid-amplification-testing-to-diagnose-gut-infections-challenges-opportunities-and-result-interpretation
#13
REVIEW
Neil W Anderson, Phillip I Tarr
Multiplex nucleic acid testing is increasingly used to diagnose childhood gastroenteritis. The advantages of this disruptive technology include rapidity, sensitivity, and ability to detect pathogenic viruses, bacteria, and parasites simultaneously. The drawbacks are its capacity to identify organisms of uncertain clinical significance in North American children, cost, and inability to provide viable bacteria for strain typing by public health authorities. However, this technology will certainly improve our knowledge of the causes of human gut infections...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337032/gastrointestinal-development-implications-for-management-of-preterm-and-term-infants
#14
REVIEW
Mary W Lenfestey, Josef Neu
The gastrointestinal (GI) system provides digestive, absorptive, neuroendocrine, and immunologic functions to support overall health. If normal development is interrupted, a variety of complications and disease can arise. This article explores normal development of the GI tract and specific clinical challenges pertinent to preterm and term infants. Specific topics include abnormal motility, gastroesophageal reflux, current feeding recommendations for preterm infants, effects of parenteral nutrition, and the relationship between the GI tract and the immune system...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337031/inflammatory-bowel-disease-what-very-early-onset-disease-teaches-us
#15
REVIEW
Eileen Crowley, Aleixo Muise
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract, of which ulcerative colitis and Crohn's disease are the 2 most prevailing entities. Very early onset IBD (VEO-IBD) children diagnosed with IBD under age 6 years. Although the etiology of IBD is mostly unknown, it involves a complex interaction among host genetics, microbiota, environmental factors, and aberrant immune responses. Advances in the understanding of the genetic contribution, which appears to be much more significant in younger children, gives us a useful insight into the pathogenesis and potential future therapeutic targets in IBD...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337030/pediatric-pancreatitis-molecular-mechanisms-and-management
#16
REVIEW
Maisam Abu-El-Haija, Mark E Lowe
Pediatric pancreatitis is an emerging field with an increasing incidence of disease. Management of pediatric pancreatitis is understudied and, therefore, extrapolated from adult studies (although the etiologies are different). There is evidence that feeding is safe in mild acute pancreatitis in children without increased pain or length of stay. Studies are needed to predict course of the disease, disease severity, and risk of chronic pancreatitis in children.
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337029/brain-gut-axis-clinical-implications
#17
REVIEW
Julie Khlevner, Yeji Park, Kara Gross Margolis
This article provides an overarching view of what is currently known about the physiology of the brain-gut axis in both health and disease and how these concepts apply to irritable bowel syndrome, the most common functional gastrointestinal disorder in pediatrics.
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30337028/update-on-dietary-management-of-childhood-functional-abdominal-pain-disorders
#18
REVIEW
Bruno P Chumpitazi
Diet plays a significant role for children with functional abdominal pain disorders. A large majority of these children identify at least 1 food that exacerbates their symptoms. Malabsorbed carbohydrates may have both direct and microbiome-mediated physiologic effects. There are several factors associated with carbohydrate symptom generation, including (1) the amount ingested, (2) ingestion with a meal, (3) small intestinal enzymatic activity, (4) consuming the carbohydrate with microorganisms capable of breaking down the carbohydrate, (5) the gut microbiome, and (6) host factors...
December 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115446/gastrointestinal-imaging-rapid-advancements-leading-to-improved-patient-care
#19
EDITORIAL
Perry J Pickhardt
No abstract text is available yet for this article.
September 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/30115445/diagnostic-imaging-a-peephole-into-many-of-the-body-s-dressing-rooms
#20
EDITORIAL
Alan L Buchman
No abstract text is available yet for this article.
September 2018: Gastroenterology Clinics of North America
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