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Expert Review of Gastroenterology & Hepatology

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https://www.readbyqxmd.com/read/28712339/the-role-of-bariatric-surgery-in-nonalcoholic-fatty-liver-disease-and-nonalcoholic-steatohepatitis
#1
Daniel Shouhed, Justin Steggerda, Miguel Burch, Mazen Noureddin
Nonalcoholic fatty liver disease (NAFLD) affects between 25% and 33% of the population, is more common in obese individuals, and is the most common cause of chronic liver disease in the United States. However, despite rising prevalence, effective treatments remain limited. Areas covered: We performed a literature search across multiple databases (Pubmed, Medline, etc.) to identify significant original research and review articles to provide an up-to-date and concise overview of disease pathogenesis and diagnostic evaluation and to expand on available treatment options with a specific focus on the potential role of bariatric surgery...
July 17, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28712319/primary-liver-cancer-genome-sequencing-translational-implications-and-challenges
#2
Demosthenes E Ziogas, Ioannis D Kyrochristos, Georgios K Glantzounis, Dimitrios Christodoulou, Evangelos Felekouras, Dimitrios H Roukos
The prognosis of primary liver cancer (PLC) remains poor and is explained by the slow progress in understanding the molecular pathways driving tumorigenesis, therapeutic resistance and relapse. For early PLCs, complete surgical resection is the only effective treatment, with sorafenib and, more recently, regorafenib prolonging overall survival by a few months. Areas covered: Application of next-generation sequencing (NGS), including targeted NGS (tNGS), whole-exome sequencing (WES), whole-genome sequencing (WGS) and RNA sequencing (RNAseq), on clinical samples from patients with hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) could aid in comprehending tumorigenesis, genetic and genomic heterogeneity, as well as developing molecular classifications for specialized targeted therapy...
July 17, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28708431/comparative-efficacy-of-vasoconstrictor-therapies-for-type-1-hepatorenal-syndrome-a-network-meta-analysis
#3
Ji-Na Zheng, Yi-Jing Han, Tian-Tian Zou, Yu-Jie Zhou, Dan-Qin Sun, Jian-Hong Zhong, Martin Braddock, Ming-Hua Zheng
The outcome of a comparative efficacy and safety of vasoconstrictor therapies for treatment of patients with type 1 hepatorenal syndrome (HRS-1) remain inconclusive. Areas covered: We searched literature databases for randomized controlled trials (RCTs) until 31 Jan 2016, and included ten eligible RCTs. In conclusion, terlipressin was the most efficacious vasoconstrictor drug for HRS-1, but had a higher probability of causing AEs. Norepinephrine was an attractive alternative to terlipressin and associated with less AEs...
July 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28708427/monitoring-and-detection-of-disease-recurrence-after-resection-for-crohn-s-disease-the-role-of-non-invasive-fecal-biomarkers
#4
Takayuki Yamamoto, Takahiro Shimoyama
Ileocolonoscopy is the gold standard for the diagnosis and assessment of postoperative recurrence in Crohn's disease (CD). Nevertheless, endoscopy is time-consuming and invasive. A minimally invasive and simple screening test would improve patient adherence to examination and provide greater clinical benefit. A number of fecal biomarkers have been evaluated for their utility for the diagnosis and monitoring of inflammatory bowel disease as alternative tests to endoscopy. Area covered: In this review, we focused on the utility of fecal biomarkers in the management of postoperative CD...
July 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28707966/targeted-molecular-ablation-of-cancer-stem-cells-for-curing-gastrointestinal-cancers
#5
Yong Seok Kim, Ho Jae Lee, Jong-Min Park, Young-Min Han, Napapan Kangwan, Ji Young Oh, Dong Yoon Lee, Ki Baik Hahm
Abundance of the ATPase-binding cassette (ABC) transporters and deranged self-renewal pathways characterize the presence of cancer stem cells (CSCs) in gastrointestinal cancers (GI cancers), which play crucial roles in tumorigenesis, chemotherapy resistance, tumor recurrence, and cancer metastasis. Therefore, in order to ensure high cure rates, chemoquiescence, CSCs should be ablated. Recent advances in either understanding CSCs or biomarker identification enable scientists to develop techniques for ablating CSCs and clinicians to provide cancer cure, especially in GI cancers characterized by inflammation-driven carcinogenesis...
July 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28705042/musculoskeletal-injuries-in-gastrointestinal-endoscopists-a-systematic-review
#6
Diana E Yung, Tommaso Banfi, Gastone Ciuti, Alberto Arezzo, Paolo Dario, Anastasios Koulaouzidis
INTRODUCTION: Gastrointestinal(GI) endoscopy forms a significant proportion of clinicians' workloads. However, little attention is given to the ergonomic aspects of endoscopy. This systematic review of musculoskeletal pain and/or injuries in GI endoscopists aims to better understand the types of occupational injuries resulting from endoscopic procedures and associated risk factors. Areas covered: Systematic literature search conducted for articles evaluating prevalence, risk factors and mechanism of musculoskeletal pain and/or injuries related to GI endoscopy...
July 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28697656/impact-of-liver-transplantation-on-the-risk-of-second-malignant-tumors-among-hepatocellular-carcinoma-patients
#7
Hani Oweira, Jan Schmidt, Daniel Helbling, Ulf Petrausch, Othmar Schöb, Arianeb Mehrabi, Anwar Giryes, Hazem Elhadedy, Omar Abdel-Rahman
BACKGROUND: Population-based data on the development of second malignant neoplasms (SMNs) following the diagnosis of hepatocellular carcinoma (HCC) are uncommon. We evaluated this clinical vignette in HCC patients within the Surveillance, Epidemiology and End Results (SEER) database. METHODS: The SEER database (1973-2012) was queried using the SEER*Stat program to determine the clinico-pathological features of HCC patients with more than one year survival who developed SMNs...
July 12, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28678570/head-and-neck-subcutaneous-emphysema-a-rare-complication-of-iatrogenic-perforation-during-colonoscopy-management-review-of-reported-cases-from-2000-2016
#8
Mathew John Lee, Tara M Connelly
INTRODUCTION: Subcutaneous face and neck emphysema secondary to colonic perforation is a rare complication of colonoscopy. Presentation may be complicated by pneumothorax and/or respiratory distress. Evidence limited to case studies. Therefore, no management consensus of these rarely reported cases exists. METHODS: All cases published on PubMed between January 1(st) 2000-November 1(st) 2016 reporting subcutaneous face and/or neck emphysema after colonoscopy are included...
July 5, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28673106/sofosbuvir-velpatasvir-and-voxilaprevir-combination-for-the-treatment-of-hepatitis-c
#9
Rebecca Voaklander, Ira M Jacobson
Introduction The advent of direct-acting antiviral (DAA) treatments for chronic hepatitis C virus (HCV) infection has dramatically increased rates of cure. However, there remain difficult-to-treat populations, including patients with genotype 3 infection and cirrhosis, and limited salvage treatment options for those that have failed first-line DAA therapy. Areas covered This is a review of the preclinical and clinical development of sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX), an interferon-free, oral, once daily, pangenotypic treatment for chronic HCV infection...
July 4, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28661190/current-clinical-evidence-for-nucleos-t-ide-analogues-in-patients-with-hbv-related-hepatocellular-carcinoma
#10
Yiqi Yu, Jingwen Ai, Wenhong Zhang
Hepatocellular carcinoma (HCC) is a leading cause of death globally and is frequently seen following Hepatitis B virus (HBV) or Hepatitis C virus infection. Areas with high HBV infection rates, such as Asia and sub-Saharan Africa, are therefore also high-risk areas for HCC. Areas covered: This review identifies and discusses the current evidence from robust clinical trials which have investigated the benefits of Nucleos(t)ide analogue (NA) antiviral therapy in HBV-related HCC patients, including HCC patients that underwent liver transplantation and HCC patients with or without curative treatment...
June 29, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28612637/treatment-options-for-children-and-adolescents-with-inflammatory-bowel-disease-is-granulomonocytapheresis-an-effective-alternative-to-drug-therapy
#11
Tomotaka Tanaka, Takayuki Yamamoto, Koji Sawada, Rodolfo Sacco
Patients with inflammatory bowel diseases (IBD) require life-long medications, which even if effective have the potential to cause adverse effects as additional morbidity factors. In pediatric patients, drug therapy has more serious limitations, including impaired physical and mental development. A non-drug therapeutic option is believed to be depletion of elevated and activated granulocytes and monocytes known to release inflammatory cytokines, like the CD14+CD16+ monocyte phenotype known to release tumor necrosis factor-α...
June 28, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28650209/the-intestinal-barrier-a-fundamental-role-in-health-and-disease
#12
Maaike Vancamelbeke, Séverine Vermeire
The gastrointestinal mucosa constitutes a critical barrier where millions of microbes and environmental antigens come in close contact with the host immune system. Intestinal barrier defects have been associated with a broad range of diseases and therefore denote a new therapeutic target. Areas covered: This review is based on an extensive literature search in PubMed of how the intestinal barrier contributes to health and as a trigger for disease. It discusses the anatomy of the intestinal barrier and explains the available methods to evaluate its function...
June 26, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28612634/lysosomal-acid-lipase-deficiency-a-form-of-non-obese-fatty-liver-disease-nofld
#13
Hassan H A-Kader
With the growing obesity epidemic, nonalcoholic fatty liver disease (NAFLD) is rapidly becoming one of the leading causes of liver disease worldwide. Although obesity is a main risk factor for the development of NAFLD, it can also develop in lean subjects and can be encountered in different clinical setting and in association with an array of genetic, metabolic, nutritional, infectious and drug-induced disorders. Areas covered: This article discusses causes of fatty liver in non-obese subjects focusing on Lysosomal acid lipase deficiency (LAL-D), a commonly overlooked disorder reviewing its prevalence, genetics, pathogenesis, clinical features, diagnosis and treatment...
June 26, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28633544/medical-versus-surgical-management-of-penetrating-crohn-s-disease-the-current-situation-and-future-perspectives
#14
Seema A Patil, Raymond K Cross
The development of penetrating Crohn's disease (CD) occurs in up to 50% of patients over the course of their lifetime. While the presentation of these complications, including free perforation, intra-abdominal abscess, and enteric fistula, are usually obvious, the management can require a nuanced approach, with distinct short and long-term approaches. Areas covered: This review discusses medical and surgical methods of treating these complications, including the role of percutaneous drainage of abscesses, the implications of a stricture associated with a fistula, and the efficacy of postoperative anti-TNF therapy in preventing recurrence after surgical treatment...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28627935/interactions-between-primary-sclerosing-cholangitis-and-inflammatory-bowel-disease-implications-in-the-adult-liver-transplant-setting
#15
Ken Liu, Simone I Strasser, David J Koorey, Rupert W Leong, Michael Solomon, Geoffrey W McCaughan
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease which is associated with inflammatory bowel disease (IBD) in most cases. As there is currently no medical therapy which alters the natural history of PSC, liver transplantation may be required. Areas covered: We searched for articles in PubMed and critically reviewed current literature on the interrelationship between PSC and IBD with a specific focus on considerations for patients in the liver transplant setting. Expert commentary: PSC is an uncommon disease which limits available studies to be either retrospective or contain relatively small numbers of patients...
June 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28613087/an-update-on-non-alcoholic-fatty-liver-disease-and-non-alcoholic-steatohepatitis-in-asia
#16
Ching-Sheng Hsu, Jia-Horng Kao
Non-alcoholic fatty liver disease (NAFLD) has become the most overwhelming liver disease in Asia. In consideration of its increasing medical and economic impact on Asian people, it is time for us to review the update data in Asian countries and formulate strategies to cope with this emerging health problem in Asia. Moreover, growing data indicates that NAFLD may be a systemic disease, not just confined to liver-specific morbidity and mortality, but also associated with several extra-hepatic manifestations, such as cardiovascular diseases, chronic renal diseases, and malignancy...
June 20, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28612636/phage-therapy-for-the-treatment-of-human-intestinal-bacterial-infections-soon-to-be-a-reality
#17
Harald Brüssow
No abstract text is available yet for this article.
June 19, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28621554/gut-microbiota-changes-and-chronic-hepatitis-c-virus-infection
#18
Tomislav Preveden, Emidio Scarpellini, Natasa Milić, Francesco Luzza, Ludovico Abenavoli
Hepatitis C virus (HCV) infection is a global health problem with 150 million infected people worldwide. Liver can be greatly affected by changes in gut microbiota due to increased intestinal permeability with passage of microbial antigens into the liver through the portal circulation. The concept of "gut-liver" axis is important to understand the pathophysiology of several liver diseases. Several recent studies also revealed that an altered gut microbiota can be implicated in the pathogenesis of HCV-induced chronic liver disease (CHC)...
June 16, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28618973/from-clinical-uncertainties-to-precision-medicine-the-emerging-role-of-the-gut-barrier-and-microbiome-in-small-bowel-functional-diseases
#19
Wojciech Marlicz, Diana Yung, Karolina Skonieczna-Żydecka, Igor Loniewski, Saskia van Hemert, Beata Loniewska, Anastasios Koulaouzidis
Over the last decade, remarkable progress has been made in the understanding of disease pathophysiology. Many new theories expound on the importance of emerging factors such as microbiome influences, genomics/omics, stem cells, innate intestinal immunity or mucosal barrier complexities. This has introduced a further dimension of uncertainty into clinical decision-making, but equally, may shed some light on less well-understood and difficult to manage conditions. Areas covered: Comprehensive review of the literature on gut barrier and microbiome relevant to small bowel pathology...
June 16, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28597703/scoring-model-to-predict-outcome-in-critically-ill-cirrhotic-patients-with-acute-respiratory-failure-comparison-with-meld-scoring-models-and-clif-sofa-score
#20
Xiao-Dong Zhou, Qin-Fen Chen, Ming-Chun Zhang, Sven Van Poucke, Wen-Yue Liu, Yao Lu, Ke-Qing Shi, Wei-Jian Huang, Ming-Hua Zheng
BACKGROUND: Critically ill cirrhotic patients have a high mortality, particularly with concomitant respiratory failure on admission. There are no specific models in use for mortality risk assessment in critically ill cirrhotic patients with acute respiratory failure (CICRF). The aim is to develop a risk prediction model specific to CICRF in order to quantify the severity of illness. METHODS: We analyzed 949 CICRF patients extracted from the MIMIC-III database. The novel model (ARF-CLIF-SOFA) was developed from the CLIF-SOFA score...
June 15, 2017: Expert Review of Gastroenterology & Hepatology
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