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Expert Review of Gastroenterology & Hepatology

Chelsie K Sievers, William M Grady, Richard B Halberg, Perry J Pickhardt
Tumors in the large intestine have been postulated to arise via a stepwise accumulation of mutations, a process that takes up to 20 years. Recent advances in lineage tracing and DNA sequencing, however, are revealing new evolutionary models that better explain the vast amount of heterogeneity observed within and across colorectal tumors. Areas Covered: A review of the literature supporting a novel model of colorectal tumor evolution was conducted. The following commentary examines the basic science and clinical evidence supporting a modified view of tumor initiation and progression in the colon...
May 15, 2017: Expert Review of Gastroenterology & Hepatology
Whitney E Jackson, Gregory T Everson
Direct acting antivirals are revolutionizing the treatment of chronic hepatitis C. Specifically, the combination therapy sofosbuvir and velpatasvir offers a pangenotypic regimen with high sustained viral response (SVR). Areas covered: Reviewed here are the clinical trials that led to the FDA approval of sofosbuvir and velpatasvir combination therapy, the adverse events during registration trials, and drug-drug interactions. Sofosbuvir and velpatasvir is a fixed dose regimen that is both interferon- and ribavirin-free...
May 11, 2017: Expert Review of Gastroenterology & Hepatology
J Calvin Coffey, D Peter O'Leary
No abstract text is available yet for this article.
May 9, 2017: Expert Review of Gastroenterology & Hepatology
Aisha Elsharkawy, Rasha Eletreby, Rabab Fouad, Zeinab Soliman, Mohamed Abdallah, Mohamed Negm, Mohamed Mohy, Gamal Esmat
BACKGROUND: Huge efforts have been made to control chronic HCV in Egypt with introduction of Direct-Acting Antivirals (DAAs) with their anticipated excellent efficacy and tolerability. AIM: To evaluate the effect of various DAA regimens on liver biochemical profile and hematological indices during treatment. METHODS: 272 patients chronically infected with HCV genotype 4 were treated by different DAA regimens (SOF/RBV, SOF/DAC ± RBV, SOF/SIM) for a duration of 12 or 24 weeks in Kasr Alainy Viral Hepatitis Center, Cairo University...
May 8, 2017: Expert Review of Gastroenterology & Hepatology
Samba Siva Reddy Pulusu, Ian C Lawrance
Inflammatory bowel disease (IBD) patients are at an increased risk of developing colorectal cancer (CRC), a devastating complication of which intestinal dysplasia is the precursor. Considerable progress has been made to determine CRC risk in IBD, identification & management of dysplasia and preventative methods. Traditionally, surveillance colonoscopies with random colonic biopsies was used. However recent data suggests that chromoendoscopy is a better method of surveillance. Using 5-aminosalicylic acid agents primarily for chemoprevention is an ongoing debate however, when prescribed along with other strategies to control inflammation, their use is considered of benefit...
May 5, 2017: Expert Review of Gastroenterology & Hepatology
Arash Nickkholgh, Daniel Maluf
There have been remarkable efforts to characterize the key responsible pathophysiologic mechanisms, as well as to ameliorate the organ preservation and ischemia reperfusion injury with the ultimate goal of expanding the donor pool and further improvement of the outcomes of liver transplantation. Attempts to translate the experimental results from bench to bedside have yielded no valid protective concepts in the field of clinical liver transplantation yet. Nonetheless, there has been a considerable amount of ongoing clinical research to develop clinically relevant graft protective strategies...
May 5, 2017: Expert Review of Gastroenterology & Hepatology
Salvatore Oliva, Salvatore Cucchiara, Stanley Allen Cohen
Pediatric gastrointestinal endoscopy has become a fundamental component of health care for infants and children. New imaging technologies and creative extraluminal applications have brought exciting and clinically important benefits to pediatric gastrointestinal endoscopy. Areas covered: The impact of different new technologies in pediatric endoscopy and focused on improvements in mucosa visualization and the application of new noninvasive tools and procedures to avoid biopsies or surgery are reviewed. Expert commentary: Enhancement in mucosal visualization and reduction of anesthesia and biopsies are the main goals that guide the endoscopy development in pediatrics...
May 5, 2017: Expert Review of Gastroenterology & Hepatology
Ashton A Connor, Steven Gallinger
Pancreatic ductal adenocarcinoma (PDAC) has the highest mortality rate of all epithelial malignancies and a paradoxically rising incidence rate. Clinical translation of next generation sequencing (NGS) of tumour and germline samples may ameliorate outcomes by identifying prognostic and predictive genomic and transcriptomic features in appreciable fractions of patients, facilitating enrolment in biomarker-matched trials. Areas covered: The literature on precision oncology is reviewed. It is found that outcomes may be improved across various malignancies, and it is suggested that current issues of adequate tissue acquisition, turnaround times, analytic expertise and clinical trial accessibility may lessen as experience accrues...
May 2, 2017: Expert Review of Gastroenterology & Hepatology
Elles Steenhagen, Jonna K van Vulpen, Richard van Hillegersberg, Anne M May, Peter D Siersema
Nutritional status and dietary intake are increasingly recognized as essential areas in esophageal cancer management. Nutritional management of esophageal cancer is a continuously evolving field and comprises an interesting area for scientific research. Areas covered: This review encompasses the current literature on nutrition in the pre-operative, peri-operative, and post-operative phases of esophageal cancer. Both established interventions and potential novel targets for nutritional management are discussed...
April 28, 2017: Expert Review of Gastroenterology & Hepatology
Lutz Schomburg, David J Hughes
No abstract text is available yet for this article.
April 18, 2017: Expert Review of Gastroenterology & Hepatology
Eva Juárez-Hernández, Daniel Motola-Kuba, Norberto Carlos Chávez-Tapia, Misael Uribe, Varenka Barbero Becerra
Current methods for HCC diagnosis have not an optimal diagnostic accuracy. The detection of more than one biomarker seems to improve their individual performance and provide an accurate HCC diagnosis approach. Individual gene expression seems to influence whether or not the treatment is successful, since several molecules have interfere with cancer associated pathways and have been related to poor prognosis which condition the lack of effective treatment options. Areas covered: Novel biomarkers have been proposed as a useful tool in each patient prognosis...
April 11, 2017: Expert Review of Gastroenterology & Hepatology
Yongzhan Nie, Kaichun Wu, Jun Yu, Qiaoyi Liang, Xiqiang Cai, Yulong Shang, Jinfeng Zhou, Kaifeng Pan, Liping Sun, Jingyuan Fang, Yuan Yuan, Weicheng You, Daiming Fan
Gastric cancer (GC) is a highly aggressive cancer and a major cause of cancer-related deaths worldwide. Approximately half of the world's GC cases and deaths occur in china. GC presents challenges in early diagnosis and effective therapy due to a lack of understanding of the underlying molecular biology. The primary goals of this review are to outline current GC research in china and describe future trends in this field. Areas covered: This review mainly focuses on a series of GC-related advances China has achieved...
April 10, 2017: Expert Review of Gastroenterology & Hepatology
Amit Kumar Dutta, Umesh Basavaraju, Laura Sales, John Samuel Leeds
BACKGROUND: Radiofrequency ablation (RFA) causes coagulative necrosis of tissue and may be beneficial prior to biliary stenting. We report our experience using RFA for malignant biliary obstruction and review the literature. METHODS: Retrospective analysis of all patients undergoing RFA for malignant biliary obstruction over the last two years. Success, complications and re-intervention following RFA were assessed. Controls were age, sex and disease matched who had stenting alone...
April 7, 2017: Expert Review of Gastroenterology & Hepatology
Lynne V McFarland
C. difficile infections (CDI) have been a challenging disease to treat, much less to prevent, for decades. Efforts for primary prevention have mainly focused on improving infection control practices, but CDI outbreaks continue to plague healthcare facilities. Areas covered: A literature search from 1970-December 2016 found 13 facility-level and 2 patient-level strategies that were evidence-based. The aim of this manuscript is to assess the current state of the literature on primary prevention of CDI and offer insights into which strategies may be more effective...
April 5, 2017: Expert Review of Gastroenterology & Hepatology
Pilvi Laurikka, Katri Kaukinen, Kalle Kurppa
No abstract text is available yet for this article.
April 3, 2017: Expert Review of Gastroenterology & Hepatology
Joel V Chua, Shyam Kottilil
No abstract text is available yet for this article.
March 28, 2017: Expert Review of Gastroenterology & Hepatology
Cristina Bezzio, Robert V Bryant, Gianpiero Manes, Giovanni Maconi, Simone Saibeni
perianal disease, most commonly manifest as fistula or abscess formation, affects up to 40% of patients with crohn's disease. perianal crohn's disease is disabling, associated with poor outcomes, and represents a therapeutic challenge for physicians. correct diagnosis and classification of perianal disease is the first crucial step for appropriate multidisciplinary management. Areas covered: A literature search was performed of the PubMed database using the terms 'transperineal ultrasonography', 'transperineal ultrasound', 'perianal disease', 'perianal fistula', 'perianal abscess', 'magnetic resonance', 'endoanal ultrasonography', 'endoscopic ultrasound' in combination with 'Crohn's disease'...
March 28, 2017: Expert Review of Gastroenterology & Hepatology
Walter A Koltun
No abstract text is available yet for this article.
March 28, 2017: Expert Review of Gastroenterology & Hepatology
Grace J Lee, John Y Kao
The incidence of celiac disease (CD) has increased over the last half-century, resulting in rising interest in identifying risk factors for CD. The necessity of duodenal biopsies in the diagnosis of CD has recently been challenged. Areas covered: This review covers the recent literature regarding the role of infant feeding practices, including breastfeeding and timing of gluten introduction, and the microbiota in the development of CD. Additionally, the application of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for a non-biopsy approach to the diagnosis of CD is reviewed...
March 28, 2017: Expert Review of Gastroenterology & Hepatology
May Yw Wong, Geoffrey W McCaughan, Simone I Strasser
Polycystic liver disease (PLD) is characterized by the presence of multiple cholangiocyte-derived hepatic cysts that progressively replace liver tissue. They are classified as an inherited ciliopathy /cholangiopathy as pathology exists at the level of the primary cilia of cholangiocytes. Aberrant expression of the proteins in primary cilia can impair their structures and functions, thereby promoting cystogenesis. Areas covered: This review begins by looking at the epidemiology of PLD and its natural history...
March 28, 2017: Expert Review of Gastroenterology & Hepatology
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