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Frontline Gastroenterology

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https://www.readbyqxmd.com/read/29082939/rifaximin-treatment-for-encephalopathy-reduces-hospital-resource-use-real-world-data-don-t-fail-to-impress
#1
COMMENT
John D Ryan, Emmanuel A Tsochatzis
No abstract text is available yet for this article.
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067158/proof-of-concept-short-term-non-invasive-cervical-vagus-nerve-stimulation-in-patients-with-drug-refractory-gastroparesis
#2
Emma Paulon, Despoina Nastou, Francesca Jaboli, Juana Marin, Eric Liebler, Owen Epstein
BACKGROUND: Gastric electric stimulation (GES) is a treatment approach to refractory gastroparesis, possibly acting centrally via afferent vagus nerve stimulation (VNS). Non-invasive VNS (nVNS) is a potential alternative to GES that could eliminate the safety risks of or identify likely responders to implantable neurostimulators. OBJECTIVE: This open-label proof-of-concept study assessed the effects of nVNS in patients with severe drug-refractory gastroparesis. METHODS: Patients used the Gastroparesis Cardinal Symptom Index (GCSI) to grade symptoms in diaries daily for 2 weeks before treatment (baseline) and during ≥3 weeks of nVNS therapy...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067157/guide-to-managing-persistent-upper-gastrointestinal-symptoms-during-and-after-treatment-for-cancer
#3
H Jervoise N Andreyev, Ann C Muls, Clare Shaw, Richard R Jackson, Caroline Gee, Susan Vyoral, Andrew R Davies
BACKGROUND: Guidance: the practical management of the gastrointestinal symptoms of pelvic radiation disease was published in 2014 for a multidisciplinary audience. Following this, a companion guide to managing upper gastrointestinal (GI) consequences was developed. AIMS: The development and peer review of an algorithm which could be accessible to all types of clinicians working with patients experiencing upper GI symptoms following cancer treatment. METHODS: Experts who manage patients with upper GI symptoms were asked to review the guide, rating each section for agreement with the recommended measures and suggesting amendments if necessary...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067156/the-national-oesophagogastric-cancer-awareness-campaign-a-locality-outcome-analysis-from-county-durham
#4
Sara Koo, Bidour Awadelkarim, Anjan Dhar
INTRODUCTION: Oesophageal and gastric cancer is common. Despite advances in investigation and treatment, the outcomes from these cancers remain poor. As part of the Be Clear On Cancer Campaign, the Department of Health runs the National Oesophagogastric Cancer Campaign each year, with key messages of (1) 'Having heartburn most days, for 3 weeks or more could be a sign of cancer' and (2) 'if food is sticking when you swallow, tell your doctor'. METHODS: We evaluated the effect of the National Oesophagogastric Cancer Campaign in our locality...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067155/the-2015-upper-gastrointestinal-be-clear-on-cancer-campaign-its-impact-on-gastroenterology-services-and-malignant-and-premalignant-diagnoses
#5
Keith Siau, Andrew Chong Yew, Samantha Hingley, James Rees, Nigel John Trudgill, Andrew M Veitch, Neil C Fisher
OBJECTIVE: To assess the impact of the upper gastrointestinal 'Be Clear on Cancer' campaign launched by Public Health England between January and February 2015 on open-access gastroscopy referrals, incidence of target diagnoses (oesophagogastric cancer and Barrett's oesophagus), cancer staging at presentation, 1-year survival and cost per additional diagnosis. DESIGN: We performed a retrospective study of patients referred for 2-week-wait (2WW), open-access endoscopy 3 months following the campaign with diagnoses, endoscopic findings, staging and 12-month survival compared with data from corresponding months in 2014...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067154/a-positive-sehcat-test-results-in-fewer-subsequent-investigations-in-patients-with-chronic-diarrhoea
#6
James M Turner, Sanjeev S Pattni, Richard N Appleby, Julian Rf Walters
Chronic diarrhoea is a common condition, resulting from a number of different disorders. Bile acid diarrhoea, occurring in about a third of these patients, is often undiagnosed. We hypothesised that a positive diagnosis of bile acid diarrhoea would reduce the need for subsequent investigations for alternative diagnoses. METHODS: Patients previously recruited to a study of chronic diarrhoea who had selenium homocholic acid taurine (SeHCAT) testing and subsequent follow-up at our institution were identified...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067153/implementing-a-self-management-strategy-in-inflammatory-bowel-disease-ibd-patient-perceptions-clinical-outcomes-and-the-impact-on-service
#7
Seth Ian Squires, Allan John Boal, Selina Lamont, Graham D Naismith
INTRODUCTION: Patient self-management and its service integration is not a new concept but it may be a key component in the long-term sustainability of inflammatory bowel disease (IBD) service provision, when considering growing disease prevalence and limited resources. METHODS: The IBD team at the Royal Alexandra and Vale of Leven Hospitals in the Clyde Valley region developed a self-management tool, called the 'flare card'. Patients were asked to complete a questionnaire which reflected their opinion on its viability as a self-management intervention...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067152/are-patients-in-the-ibd-clinic-at-risk-of-proctitis-secondary-to-sexually-transmitted-infections
#8
Maximillian Groome, Emma M Robinson, Craig Mowat, Alix M L Morieux, Sarah Allstaff
OBJECTIVE: To gauge the potential risk of sexually transmitted infection (STI) as a cause of proctitis in a cohort of patients with inflammatory bowel disease (IBD) and to gauge whether this cohort could benefit from STI testing in the future. DESIGN: Patients attending the IBD clinic were given an anonymous questionnaire recording demographics, sexual behaviour, rectal symptoms, history of receptive anal intercourse (RAI), STIs and attitudes towards sexual health screening...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067151/primary-sclerosing-cholangitis-and-the-management-of-uncertainty-and-complexity
#9
REVIEW
Katherine Arndtz, Gideon M Hirschfield
Primary sclerosing cholangitis (PSC) is a rare chronic autoimmune disease with no effective therapy and a large unmet need for new treatments. Patients require significant healthcare resources over their lifetime with high rates of hospital admission, malignancy, liver transplantation and death. As a rare disease, expertise in management can be limited to large referral liver transplant programmes, and even then there is frequently variation in practice. In this case-based review, we aim to discuss common clinical dilemmas encountered by clinicians managing patients with PSC and address related competencies in the 2010 Gastroenterology Curriculum...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067150/care-standards-for-non-alcoholic-fatty-liver-disease-in-the-united-kingdom-2016-a-cross-sectional-survey
#10
David A Sheridan, Guru Aithal, William Alazawi, Michael Allison, Quentin Anstee, Jeremy Cobbold, Shahid Khan, Andrew Fowell, Stuart McPherson, Philip N Newsome, Jude Oben, Jeremy Tomlinson, Emmanouil Tsochatzis
OBJECTIVE: Guidelines for the assessment of non-alcoholic fatty liver disease (NAFLD) have been published in 2016 by National Institute for Health and Care Excellence and European Associations for the study of the Liver-European Association for the study of Diabetes-European Association for the study of Obesity. Prior to publication of these guidelines, we performed a cross-sectional survey of gastroenterologists and hepatologists regarding NAFLD diagnosis and management. DESIGN: An online survey was circulated to members of British Association for the Study of the Liver and British Society of Gastroenterology between February 2016 and May 2016...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067149/the-impact-of-rifaximin-%C3%AE-on-the-hospital-resource-use-associated-with-the-management-of-patients-with-hepatic-encephalopathy-a-retrospective-observational-study-impress
#11
Mark Hudson, Amr Radwan, Paola Di Maggio, Riccardo Cipelli, Stephen D Ryder, John F Dillon, William Jonathan Cash, Robert T Przemioslo, Mark Wright, Debbie L Shawcross, Rajiv Jalan, Sushma Saksena, Michael Allison, Paul Richardson, Elizabeth Farrington, Richard J Aspinall
OBJECTIVE: To compare all-cause and liver-related hospital resource use in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation in UK patients with hepatic encephalopathy (HE). DESIGN: A UK multicentre, retrospective, observational study. Patients' medical records were reviewed for demographics, clinical outcomes and adverse events (AEs) to rifaximin-α. Details of hospital admissions/attendances in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation were extracted from hospital electronic databases...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067148/assays-for-measurement-of-tnf-antagonists-in-practice
#12
Niels Vande Casteele
Tumour necrosis factor (TNF) antagonist drug exposure is correlated with clinical, endoscopic and pathophysiological outcomes during induction and maintenance therapy. Measuring drug concentrations is therefore a useful tool when treating to target and optimising therapy. One of the main factors leading to suboptimal drug exposure is the formation of antidrug antibodies (ADAs), due to an immunogenic reaction of the immune system towards the non-self protein. The development of ADA does pose important concerns for drug efficacy and for safety as ADAs have been associated with acute infusion reactions, hypersensitivity reactions and serum sickness...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29067147/collagenous-panenteritis-a-rare-cause-of-chronic-diarrhoea
#13
Sandev Singh, Larry Ee Juan Loo, Christopher Watters, Suhail Ahmed
Collagenous panenteritis is a rare inflammatory condition that causes profound diarrhoea and weight loss. There has only been a handful of cases reported in the literature. We report this rare case and the diagnostic difficulties encountered in securing the diagnosis. A 59-year-old woman presented with an 8-month history of diarrhoea and weight loss on a background of a family history of coeliac disease. Her presentation was complicated with acute kidney injury secondary to prerenal losses. Repeated gastroscopies and colonoscopies along with biopsies were inconclusive...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28840917/combined-ph-impedance-testing-for-reflux-current-state-of-play-and-future-challenges
#14
Santosh Sanagapalli, Rami Sweis
No abstract text is available yet for this article.
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28839912/a-quasi-experimental-evaluation-of-dried-blood-spot-testing-through-community-pharmacies-in-the-tayside-region-of-scotland
#15
Andrew Radley, Karen Melville, Jan Tait, Brian Stephens, Josie M M Evans, John F Dillon
OBJECTIVE: Comparison of uptake of dried blood spot testing (DBST) for hepatitis C virus (HCV) infection between community pharmacies and established services. DESIGN: Quantitative evaluation of a service development with qualitative process evaluation undertaken in parallel. SETTING: Six pharmacies from 36 community pharmacies within Dundee City, a large urban settlement with high levels of socioeconomic deprivation. PARTICIPANTS: Patients in receipt of opioid substitution therapy (OST) not tested for HCV within 12 months...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28839911/the-role-of-multidisciplinary-meetings-for-benign-pancreatobiliary-diseases-a-tertiary-centre-experience
#16
Noor L H Bekkali, Sam Murray, Lesley Winter, Vinay Sehgal, George J M Webster, Michael H Chapman, Steven Bandula, Zahir Amin, Samantha Read, Stephen P Pereira, Gavin J Johnson
Multidisciplinary meetings are central to the management of chronic and complex diseases and they have become widely established across the modern healthcare. Patients with pancreatobiliary diseases can often present with complex clinical dilemmas, which fall out with the scope of current guidelines. Therefore, these patients require a personalised management approach discussed in a multidisciplinary meeting.
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28839910/postoperative-prophylaxis-in-crohn-s-disease-after-intestinal-resection-a-retrospective-analysis
#17
Anthony O'Connor, Peter J Hamlin, Jennifer Taylor, Christian Selinger, Nigel Scott, Alexander C Ford
INTRODUCTION: Up to 80% of patients with Crohn's disease (CD) may require surgery at some point in their lives, and it is estimated that as many as 40% may require several surgeries. It has been suggested that prophylactic medication decreases the rate of clinical and endoscopic recurrence following intestinal resection. This study aims to describe real-world clinical outcomes observed from a pragmatic, individualised strategy in postoperative CD. METHODS: All patients undergoing intestinal resection for CD between 2009 and 2013 were identified...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28839909/vedolizumab-early-experience-and-medium-term-outcomes-from-two-uk-tertiary-ibd-centres
#18
Mark A Samaan, Polychronis Pavlidis, Emma Johnston, Ben Warner, Jonathan Digby-Bell, Ioannis Koumoutsos, Steven Fong, Rimma Goldberg, Kamal Patel, Shraddha Gulati, Lucy Medcalf, Marlene Sastrillo, Cordella Brown-Clarke, Johanna Bidewell-Sullivan, Katrina Forsyth, Emma Lee, Anna Stanton, Julie Duncan, Guy Chung-Faye, Patrick Dubois, Nick Powell, Simon Anderson, Jeremy Sanderson, Bu'Hussain Hayee, Peter M Irving
OBJECTIVE: To gain an understanding of the efficacy of vedolizumab in a 'real-world' setting. DESIGN: Retrospective cohort study using prospectively maintained clinical records. SETTING: Two UK tertiary inflammatory bowel disease (IBD) centres. PATIENTS: Patients with IBD commenced on vedolizumab at Guy's & St Thomas' and King's College Hospitals during November 2014-November 2015. INTERVENTION: Vedolizumab, a monoclonal antibody to α-4 β-7 integrins that selectively inhibit leucocyte migration into the gut...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28839908/utilisation-of-anti-tnf-levels-in-a-uk-tertiary-ibd-centre
#19
E L Johnston, B D Warner, J L Digby-Bell, N Unsworth, S Anderson, J D Sanderson, Z Arkir, P M Irving
OBJECTIVE: To ascertain how anti-tumour necrosis factor (TNF) drug and anti-drug antibody levels testing is used in a 'real-world' setting to optimise inflammatory bowel disease (IBD) treatment. DESIGN: Retrospective cohort study of prospectively collected patient data. SETTING: Tertiary IBD centre in London, UK. PATIENTS: All patients at Guy's and St Thomas' Hospitals on anti-TNF who had levels measured between the start of testing in 2012 and October 2014...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28839907/validation-of-a-care-pathway-for-the-use-of-faecal-calprotectin-in-monitoring-patients-with-crohn-s-disease
#20
James Turvill, Lisa Rook, Maxine Rawle, Gerry Robins, Simon Smale, Prashant Kant, Anne Phillips
INTRODUCTION: We have previously published an evidence-based care pathway for the use of faecal calprotectin (FC) to monitor patients with Crohn's disease established on therapy. Patients are treated as low, intermediate or high risk of continuing Crohn's disease activity based on their FC, whatever their phenotype and surgical status are. Low-risk patients (FC <100 µg/g) are offered 12 monthly follow-ups or step down of therapy if asymptomatic or initial expectant symptomatic treatment...
July 2017: Frontline Gastroenterology
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