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Therapeutic Advances in Gastroenterology

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https://www.readbyqxmd.com/read/28203285/automated-low-flow-ascites-pump-for-the-treatment-of-cirrhotic-patients-with-refractory-ascites
#1
REVIEW
Guido Stirnimann, Vanessa Banz, Federico Storni, Andrea De Gottardi
Cirrhotic patients with refractory ascites (RA) can be treated with repeated large volume paracentesis (LVP), with the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) or with liver transplantation. However, side effects and complications of these therapeutic options, as well as organ shortage, warrant the development of novel treatments. The automated low-flow ascites pump (alfapump(®)) is a subcutaneously-implanted novel battery-driven device that pumps ascitic fluid from the peritoneal cavity into the urinary bladder...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28203284/novel-emerging-treatments-for-hepatitis-c-infection-a-fast-moving-pipeline
#2
REVIEW
Ara A Kardashian, Paul J Pockros
Advances in the treatment of chronic hepatitis C has been one of the pinnacles of medical science in the last 25 years. The age of direct-acting antivirals (DAAs) has led to cure rates >95% with shorter duration and low toxicity regimens, thus changing the landscape of the era of pegylated interferon and ribavirin (RBV). However, there remain some challenges with these therapies as there are multiple regimens available with a fair amount of sophistication required to administer them. Treatment continues to require knowledge of prior treatment status, viral genotype and fibrosis assessment, thus affording an opportunity for improvement in future regimens...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28203283/current-and-emergent-pharmacologic-treatments-for-irritable-bowel-syndrome-with-diarrhea-evidence-based-treatment-in-practice
#3
REVIEW
Susan Lucak, Lin Chang, Albena Halpert, Lucinda A Harris
Irritable bowel syndrome with diarrhea (IBS-D) is a common, chronic functional gastrointestinal disorder with symptoms that can be distressing for patients and often result in substantially impaired quality of life. This review focuses on providing clinicians with information on practical, evidence-based treatment for IBS-D. Current therapies commonly used for the treatment of IBS-D, including pharmacologic and nonpharmacologic interventions, are briefly reviewed, followed by discussion of the emergent pharmacologic treatments (rifaximin and eluxadoline) and medical foods (IBgard(®) and EnteraGam(®))...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28203282/the-role-of-dexlansoprazole-modified-release-in-the-management-of-gastroesophageal-reflux-disease
#4
REVIEW
Ronnie Fass, Rosita Frazier
Dexlansoprazole modified-release (MR) is the R-enantiomer of lansoprazole and is currently the only proton-pump inhibitor (PPI) with a novel dual delayed release (DDR) formulation. Overall, dexlansoprazole MR demonstrates a similar safety and side-effect profile as lansoprazole. Dexlansoprazole MR has been shown to be highly efficacious in healing erosive esophagitis, maintaining healed esophageal mucosa in patients with erosive esophagitis and controlling symptoms of patients with nonerosive reflux disease (NERD)...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28203281/minimum-absolute-lymphocyte-counts-during-radiation-are-associated-with-a-worse-prognosis-in-patients-with-unresectable-hepatocellular-carcinoma
#5
Qianqian Zhao, Xiaoqing Xu, Jinbo Yue, Kunli Zhu, Rui Feng, Shumei Jiang, Zhonghua Qi, Renben Wang
BACKGROUND: Peripheral blood lymphocytes play an important role in antitumour immunity. We examined the relationship between the minimum absolute lymphocyte counts (Min ALCs) during radiotherapy (RT) and clinical outcomes in patients with hepatocellular carcinoma (HCC). METHODS: Data from a total of 69 HCC patients who had received RT were retrospectively analysed. Peripheral blood lymphocytes were measured before RT, weekly during RT and after RT. Regression and mixed-effect models were used to assess the relationships with and potential predictors of overall survival (OS)...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28203280/differences-in-the-prognosis-of-early-gastric-cancer-according-to-sex-and-age
#6
Do Dam Suh, Seong Tae Oh, Jeong Hwan Yook, Byung-Sik Kim, Beom Su Kim
BACKGROUND: Few studies have compared early gastric cancer (EGC) outcomes according to sex and age. METHODS: We retrospectively reviewed 2085 patients who underwent curative gastrectomy for EGC between 1989 and 2000. Prognosis and risk factors for nodal involvement were evaluated according to sex and age. RESULTS: Male sex and age were independent prognostic factors for overall survival (OS) but not relapse-free survival (RFS). In young (⩽55 years) patients, there were no significant differences in RFS and OS between men and women...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28203279/a-noninvasive-diagnostic-model-to-assess-nonalcoholic-hepatic-steatosis-in-patients-with-chronic-hepatitis-b
#7
Hongjie Ou, Shaohang Cai, Ying Liu, Muye Xia, Jie Peng
OBJECTIVE: The objective of this study was to develop a noninvasive diagnostic test for nonalcoholic hepatic steatosis in patients with chronic hepatitis B (CHB) by using routinely available clinical markers. METHODS: A retrospective study of patients with CHB, with or without hepatic steatosis (fatty change) who were diagnosed with controlled attenuation parameter (CAP) measured by transient elastography were included. Patient information was analyzed on lifestyle; laboratory tests, including serum lipid levels; blood pressure; blood uric acid; and medical history of type 2 diabetes mellitus (T2DM)...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28203278/efficacy-of-granulocyte-and-monocyte-apheresis-for-antibiotic-refractory-pouchitis-after-proctocolectomy-for-ulcerative-colitis-an-open-label-prospective-multicentre-study
#8
Takayuki Yamamoto, Toshiaki Tanaka, Tadashi Yokoyama, Takahiro Shimoyama, Hiroki Ikeuchi, Motoi Uchino, Toshiaki Watanabe
BACKGROUND: Granulocyte and monocyte apheresis (GMA) has shown therapeutic efficacy in active ulcerative colitis (UC). We thought that in patients with pouchitis after proctocolectomy for UC, GMA might produce immunological effects in the intestinal mucosa, and improve clinical symptoms. This prospective study was to evaluate the efficacy of GMA for antibiotic-refractory pouchitis after proctocolectomy for UC. METHODS: A total of 13 patients with pouchitis disease activity index (PDAI) > 7 unresponsive to 2 weeks of antibiotic therapy were included...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803744/endoscopic-characteristics-and-usefulness-of-endoscopic-dilatation-of-anastomotic-stricture-following-pancreaticojejunostomy-case-series-and-a-review-of-the-literature
#9
REVIEW
Akihiko Kida, Yukihiro Shirota, Yuji Houdo, Tokio Wakabayashi
The incidence of pancreatitis induced by anastomotic stricture following pancreaticodigestive tract anastomosis as a late-onset adverse event has been reported to be 3% or lower, but some cases repeatedly relapse and are difficult to treat. Endoscopic identification and treatment of the anastomotic site are considered to be difficult, and only a small number of cases have been reported. We present three cases with recurrent pancreatitis induced by anastomotic stricture following pancreaticojejunostomy applied after pancreaticoduodenectomy...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803743/hepatocellular-adenoma-when-and-how-to-treat-update-of-current-evidence
#10
REVIEW
Maarten G Thomeer, Mirelle Broker, Joanne Verheij, Michael Doukas, Turkan Terkivatan, Diederick Bijdevaate, Robert A De Man, Adriaan Moelker, Jan N IJzermans
Hepatocellular adenoma (HCA) is a rare, benign liver tumor. Discovery of this tumor is usually as an incidental finding, correlated with the use of oral contraceptives, or pregnancy. Treatment options have focused on conservative management for the straightforward, smaller lesions (<5 cm), with resection preferred for larger lesions (>5 cm) that pose a greater risk of hemorrhage or malignant progression. In recent years, a new molecular subclassification of HCA has been proposed, associated with characteristic morphological features and loss or increased expression of immunohistochemical markers...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803742/direct-acting-antivirals-for-the-treatment-of-chronic-hepatitis-c-in-patients-with-chronic-kidney-disease
#11
REVIEW
Anita Kohli, Ali Alshati, Fawaz Georgie, Richard Manch, Robert G Gish
All-oral, direct-acting antivirals (DAAs) have significantly improved the efficacy and safety of chronic hepatitis C (CHC) treatment but their effectiveness and safety among patients with chronic kidney disease (CKD) remains poorly understood. Our aim was to assess the efficacy and safety of DAAs for treatment of CKD patients. The National Library of Medicine through PubMed was searched for studies evaluating the efficacy of DAAs for the treatment of patients with CKD stages 4 or 5, as defined by the Kidney Disease Outcomes Quality Initiative guidelines [i...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803741/the-biological-complexity-of-colorectal-cancer-insights-into-biomarkers-for-early-detection-and-personalized-care
#12
REVIEW
Marina De Rosa, Daniela Rega, Valeria Costabile, Francesca Duraturo, Antonello Niglio, Paola Izzo, Ugo Pace, Paolo Delrio
Colorectal cancer has been ranked the third and second most prevalent of all cancers in men and women, respectively, and it represents the fourth most common cause of cancer deaths. In 2012, there were 1.4 million estimated cases of colorectal cancer worldwide, and 700,000 estimated deaths, which implies significant impact on public health, especially in economically-developed countries. In recent years, there has been an increase in the number of tumors, although this has been accompanied by decreased mortality, due to more appropriate and available information, earlier diagnosis, and improvements in treatment...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803740/antagonizing-programmed-death-1-and-programmed-death-ligand-1-as-a-therapeutic-approach-for-gastric-cancer
#13
REVIEW
Xiaojun Liu, Zhongxia Yang, Olivier Latchoumanin, Liang Qiao
Malignant tumor cells are equipped with mechanisms that can help them escape the surveillance by host immune system. Immune checkpoint molecules can transduce coinhibitory signals to immunocompetent cells and exert immunosuppressive roles in antitumor immunity. Programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) are the two important checkpoint molecules with great potential in targeted cancer therapy. Several antibodies targeting PD-1 and PD-L1 have been approved for clinical use. In this review, we focus on the recent development of targeting PD-1 and PD-L1 in gastric cancer (GC) therapy...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803739/vonoprazan-based-therapy-for-helicobacter-pylori-eradication-experience-and-clinical-evidence
#14
REVIEW
Yuko Akazawa, Daisuke Fukuda, Yutaka Fukuda
Stable suppression of gastric acid secretion is a crucial factor in Helicobacter pylori eradication. Vonoprazan is a potassium-competitive acid blocker recently approved for use in Japan. As vonoprazan has a long duration of action and causes rapid and strong inhibition of gastric acid secretion, it has gained clinical attention for treating erosive oesophagitis, peptic ulcers, and H. pylori infection. In this review, we discuss the recent knowledge regarding the safety and efficacy of vonoprazan, focusing on its use in H...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803738/helicobacter-pylori-and-gastric-acid-an-intimate-and-reciprocal-relationship
#15
REVIEW
Helge L Waldum, Per M Kleveland, Øystein F Sørdal
Helicobacter pylori (Hp) is the main cause of gastritis, peptic ulcer disease and gastric cancer. There are still unanswered questions related to the interaction between Hp and man, like what determines the susceptibility for the initial infection and the mechanisms for the carcinogenic effect. The initial infection seems to require a temporal gastric hypoacidity. For Hp to survive in the gastric mucous layer, some acidity is necessary. Hp itself is probably not directly carcinogenic. Only when inducing oxyntic mucosal inflammation and atrophy with hypoacidity, Hp predisposes for gastric cancer...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803737/impact-of-ornithine-phenylacetate-ocr-002-in-lowering-plasma-ammonia-after-upper-gastrointestinal-bleeding-in-cirrhotic-patients
#16
Meritxell Ventura-Cots, Mar Concepción, José Antonio Arranz, Macarena Simón-Talero, Maria Torrens, Albert Blanco-Grau, Inma Fuentes, Pilar Suñé, Edilmar Alvarado-Tapias, Cristina Gely, Eva Roman, Beatriz Mínguez, German Soriano, Joan Genescà, Juan Córdoba
BACKGROUND: Ornithine phenylacetate (OP) has been proven effective in lowering ammonia plasma levels in animals, and to be well tolerated in cirrhotic patients. A trial to assess OP efficacy in lowering plasma ammonia levels versus placebo in cirrhotic patients after an upper gastrointestinal bleeding was performed. The primary outcome was a decrease in venous plasma ammonia at 24 hours. METHODS: A total of 38 consecutive cirrhotic patients were enrolled within 24 hours of an upper gastrointestinal bleed...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803736/the-location-of-obstruction-predicts-stent-occlusion-in-malignant-gastric-outlet-obstruction
#17
Douglas Grunwald, Jonah Cohen, Anthony Bartley, Jennifer Sheridan, Ram Chuttani, Mandeep S Sawhney, Douglas K Pleskow, Tyler M Berzin, Meir Mizrahi
BACKGROUND: Gastric outlet obstruction (GOO) can occur with locally invasive or metastatic cancer involving the upper gastrointestinal tract at the pylorus or the duodenum. Endoscopic management with self-expanding metal stents (SEMSs) is often the preferred palliative approach. Stent occlusion is a common reason for failure and reintervention. We set out to determine whether the location of the malignant obstruction is associated with the angulation of the stent and can predict stent occlusion...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803735/prediagnosis-aspirin-use-and-outcomes-in-a-prospective-cohort-of-esophageal-cancer-patients
#18
James L Araujo, Nasser K Altorki, Joshua R Sonett, Adriana Rodriguez, Kivilcim Sungur-Stasik, Cathy F Spinelli, Alfred I Neugut, Julian A Abrams
BACKGROUND: Esophageal cancer remains associated with poor outcomes, yet little is known regarding factors that influence survival. Aspirin use prior to cancer diagnosis may influence outcomes. We aimed to assess the effects of prediagnosis aspirin use in patients with esophageal cancer. METHODS: We conducted a prospective cohort study of newly-diagnosed esophageal cancer patients at two tertiary care centers. We assessed history of prediagnosis aspirin use, and prospectively followed patients and assessed mortality, cause of death, and development of metastases...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803734/usefulness-of-spectral-computed-tomography-for-evaluation-of-intestinal-activity-and-severity-in-ileocolonic-crohn-s-disease
#19
Jiang Chen Peng, Qi Feng, Jiong Zhu, Jun Shen, Yu Qi Qiao, Jian Rong Xu, Zhi Hua Ran
BACKGROUND: Assessment of intestinal activity and severity of Crohn's disease (CD) is crucial to guide treatment. In this study, we aimed to investigate the accuracy of spectral computed tomography (CT) in this assessment and make a comparison with conventional CT. METHODS: A total of 50 patients with ileocolonic CD underwent spectral CT scanning. Conventional CT and spectral CT images were reconstructed. Endoscopic lesions were classified as absent, mild lesions and severe lesions...
November 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27803733/detection-of-anti-infliximab-antibodies-is-impacted-by-antibody-titer-infliximab-level-and-igg4-antibodies-a-systematic-comparison-of-three-different-assays
#20
Joana Afonso, Susana Lopes, Raquel Gonçalves, Paulo Caldeira, Paula Lago, Helena Tavares de Sousa, Jaime Ramos, Ana Rita Gonçalves, Paula Ministro, Isadora Rosa, Ana Isabel Vieira, Rosa Coelho, Patrícia Tavares, João Soares, Ana Lúcia Sousa, Diana Carvalho, Paula Sousa, João Pereira da Silva, Tânia Meira, Filipa Silva Ferreira, Cláudia Camila Dias, Yehuda Chowers, Shomron Ben-Horin, Fernando Magro
BACKGROUND: There is scant information on the accuracy of different assays used to measure anti-infliximab antibodies (ADAs), especially in the presence of detectable infliximab (IFX). We thus aimed to evaluate and compare three different assays for the detection of IFX and ADAs and to clarify the impact of the presence of circulating IFX on the accuracy of the ADA assays. METHODS: Blood samples from 79 ulcerative colitis (UC) patients treated with infliximab were assessed for IFX levels and ADAs using three different assays: an in-house assay and two commercial kits, Immundiagnostik and Theradiag...
November 2016: Therapeutic Advances in Gastroenterology
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