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Clinical and Experimental Gastroenterology

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https://www.readbyqxmd.com/read/29983584/comparing-efficacy-of-lumen-apposing-stents-to-plastic-stents-in-the-endoscopic-management-of-mature-peripancreatic-fluid-collections-a-single-center-experience
#1
Matthew Fasullo, Yasir Al-Azzawi, Joan Kheder, Jeffrey Abergel, Wahid Wassef
Introduction: Mature peripancreatic fluid collection (MPFC) is a known and often challenging consequence of acute pancreatitis and often requires intervention. The most common method accepted is the "step-up approach," which consists of percutaneous drainage followed, if necessary, by minimally invasive retroperitoneal necrosectomy. Our paper aims to distinguish between plastic stents and lumen-apposing stents in the endoscopic management of MPFC in terms of morbidity, mortality, and haste of fluid collection resolution...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29950879/retrospective-analysis-of-a-lactose-breath-test-in-a-gastrointestinal-symptomatic-population-of-northeast-italy-use-of-h-2-2ch-4-versus-h-2-threshold
#2
Gregorio Peron, Stefano Dall'Acqua, Vincenzo Sorrenti, Maria Carrara, Stefano Fortinguerra, Giulia Zorzi, Alessandro Buriani
Background: Lactose malabsorption is normally evaluated by measuring exhaled H2 produced by intestinal flora, from unabsorbed lactose. However, differing microbiome composition can lead to the production of CH4 instead of H2 ; hence, some authors challenge the H2 method sensitivity and favor the evaluation of both intestinal gases. Aim: To compare different approaches to usage of a lactose breath test for lactose malabsorption diagnosis, after medical evaluation of gastrointestinal symptoms...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29928141/assessment-and-management-of-patients-with-intestinal-failure-a-multidisciplinary-approach
#3
REVIEW
Jennie T Grainger, Yasuko Maeda, Suzanne C Donnelly, Carolynne J Vaizey
Intestinal failure (IF) is a condition characterized by the inability to maintain a state of adequate nutrition, or fluid and electrolyte balance due to an anatomical or a physiological disorder of the gastrointestinal system. IF can be an extremely debilitating condition, significantly affecting the quality of life of those affected. The surgical management of patients with acute and chronic IF requires a specialist team who has the expertise in terms of technical challenges and decision-making. A dedicated IF unit will have the expertise in patient selection for surgery, investigative workup and planning, operative risk assessment with relevant anesthetic expertise, and a multidisciplinary team with support such as nutritional expertise and interventional radiology...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29881302/tumor-necrosis-factor-%C3%AE-induced-protein-3-a20-is-dysregulated-in-pediatric-crohn-disease
#4
Deenaz Zaidi, Hien Q Huynh, Matthew W Carroll, Shairaz Baksh, Eytan Wine
Purpose: A significant feature of pediatric inflammatory bowel diseases (IBD), which include Crohn disease (CD), and ulcerative colitis (UC), is failure to suppress inflammation. The inability to regulate inflammation renders a major challenge toward establishing effective treatments in IBD. Nuclear factor kappa-light-chain-enhancer of activated B-cells-induced inflammation is inhibited by A20 through interactions with TAX1BP1 (Tax1-binding protein 1) and A20-binding inhibitor of NF-κβ activation (ABIN)-1 (A20 binding and inhibitor of NF-κβ) and upon phosphorylation by inhibitor of nuclear factor kappa-β kinase subunit beta (IKKβ), which stabilizes it...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29872332/a-model-of-blood-ammonia-homeostasis-based-on-a-quantitative-analysis-of-nitrogen-metabolism-in-the-multiple-organs-involved-in-the-production-catabolism-and-excretion-of-ammonia-in-humans
#5
REVIEW
David G Levitt, Michael D Levitt
Increased blood ammonia (NH3 ) is an important causative factor in hepatic encephalopathy, and clinical treatment of hepatic encephalopathy is focused on lowering NH3 . Ammonia is a central element in intraorgan nitrogen (N) transport, and modeling the factors that determine blood-NH3 concentration is complicated by the need to account for a variety of reactions carried out in multiple organs. This review presents a detailed quantitative analysis of the major factors determining blood-NH3 homeostasis - the N metabolism of urea, NH3 , and amino acids by the liver, gastrointestinal system, muscle, kidney, and brain - with the ultimate goal of creating a model that allows for prediction of blood-NH3 concentration...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29872331/elevated-lactate-level-predicts-intensive-care-unit-admissions-endoscopies-and-transfusions-in-patients-with-acute-gastrointestinal-bleeding
#6
Manish P Shrestha, Mark Borgstrom, Eugene Abraham Trowers
Background and aims: Initial clinical management decision in patients with acute gastrointestinal bleeding (GIB) is often based on identifying high- and low-risk patients. Little is known about the role of lactate measurement in the triage of patients with acute GIB. We intended to assess if lactate on presentation is predictive of need for intervention in patients with acute GIB. Patients and methods: We performed a single-center, retrospective, cross-sectional study including patients ≥18 years old presenting to emergency with acute GIB between January 2014 and December 2014...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29750050/does-the-internet-promote-the-unregulated-use-of-fecal-microbiota-transplantation-a-potential-public-health-issue
#7
Jonathan Philip Segal, Faisal Abbasi, Cynthia Kanagasundaram, Ailsa Hart
Introduction: The Internet has become an increasingly popular resource for medical information. Fecal microbiota transplantation (FMT) has changed the treatment of Clostridium difficile with cure rates of 81% following one infusion of FMT, further studies have since validated these findings. The Medicines and Health care Products Regulatory Agency has classified FMT as a medicine and hence should be only utilized in strict clinical settings. Methods: We searched Facebook, Twitter, Google, and YouTube using the words "Faecal Microbiota Transplantation" and "FMT"...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29713191/endoscopic-comparison-of-gastroduodenal-injury-with-over-the-counter-doses-of-new-fast-dissolving-ibuprofen-and-paracetamol-formulations-a-randomized-placebo-controlled-4-way-crossover-clinical-trial
#8
Frank L Lanza, Agron Collaku, Dongzhou J Liu
Background: While gastrointestinal (GI) effects of standard ibuprofen and N-acetyl-p-aminophenol (APAP) have been reported, upper GI injury following treatment with fast-dissolving (FD) formulations of these analgesics has not been investigated. We evaluated upper GI effects of over-the-counter doses of 2 FD ibuprofen products and 1 FD-APAP product. Methods: In a randomized, placebo-controlled, endoscopist-blinded, 4-way crossover study, 28 healthy subjects received FD ibuprofen 2×200 mg liquid capsules 3 times daily (TID), ibuprofen 2×200 mg tablets TID, FD-APAP 2×500 mg tablets 4 times daily (QID), and placebo 2×500 mg tablets QID for 7 days...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29692620/complete-esophageal-obstruction-following-endoscopic-variceal-ligation-a-case-report-and-literature-review
#9
Jan Kubovy, Tom D Boswell, Guy Vautier, Malcolm M Arnold
Endoscopic variceal ligation (EVL) is an important treatment modality in managing complications of portal hypertension. Since its advent 30 years ago, the procedural complications have decreased significantly, especially when compared with variceal sclerotherapy. With the current widespread use of EVL, rare complications are now becoming increasingly recognized. We present a case of complete esophageal obstruction, its management, and clinical course. Our literature review identified only eight reported cases...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29670388/colonic-transit-time-and-pressure-based-on-bernoulli-s-principle
#10
Yoshiharu Uno
Purpose: Variations in the caliber of human large intestinal tract causes changes in pressure and the velocity of its contents, depending on flow volume, gravity, and density, which are all variables of Bernoulli's principle. Therefore, it was hypothesized that constipation and diarrhea can occur due to changes in the colonic transit time (CTT), according to Bernoulli's principle. In addition, it was hypothesized that high amplitude peristaltic contractions (HAPC), which are considered to be involved in defecation in healthy subjects, occur because of cecum pressure based on Bernoulli's principle...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29670387/systemic-inflammatory-response-syndrome-and-model-for-end-stage-liver-disease-score-accurately-predict-the-in-hospital-mortality-of-black-african-patients-with-decompensated-cirrhosis-at-initial-hospitalization-a-retrospective-cohort-study
#11
Alassan Kouamé Mahassadi, Justine Laure Konang Nguieguia, Henriette Ya Kissi, Anthony Afum-Adjei Awuah, Aboubacar Demba Bangoura, Stanislas Adjeka Doffou, Alain Koffi Attia
Background: Systemic inflammatory response syndrome (SIRS) and model for end-stage liver disease (MELD) predict short-term mortality in patients with cirrhosis. Prediction of mortality at initial hospitalization is unknown in black African patients with decompensated cirrhosis. Aim: This study aimed to look at the role of MELD score and SIRS as the predictors of morbidity and mortality at initial hospitalization. Patients and methods: In this retrospective cohort study, we enrolled 159 patients with cirrhosis (median age: 49 years, 70...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29628770/validation-of-a-risk-prediction-model-for-barrett-s-esophagus-in-an-australian-population
#12
Colin J Ireland, Andrea L Gordon, Sarah K Thompson, David I Watson, David C Whiteman, Richard L Reed, Adrian Esterman
Background: Esophageal adenocarcinoma is a disease that has a high mortality rate, the only known precursor being Barrett's esophagus (BE). While screening for BE is not cost-effective at the population level, targeted screening might be beneficial. We have developed a risk prediction model to identify people with BE, and here we present the external validation of this model. Materials and methods: A cohort study was undertaken to validate a risk prediction model for BE...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29606884/proton-pump-inhibitor-refractory-gastroesophageal-reflux-disease-challenges-and-solutions
#13
REVIEW
Joseph Mermelstein, Alanna Chait Mermelstein, Maxwell M Chait
A significant percentage of patients with gastroesophageal reflux disease (GERD) will not respond to proton pump inhibitor (PPI) therapy. The causes of PPI-refractory GERD are numerous and diverse, and include adherence, persistent acid, functional disorders, nonacid reflux, and PPI bioavailability. The evaluation should start with a symptom assessment and may progress to imaging, endoscopy, and monitoring of esophageal pH, impedance, and bilirubin. There are a variety of pharmacologic and procedural interventions that should be selected based on the underlying mechanism of PPI failure...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29588609/postoperative-pancreatic-fistula-a-review-of-traditional-and-emerging-concepts
#14
REVIEW
Christopher B Nahm, Saxon J Connor, Jaswinder S Samra, Anubhav Mittal
Postoperative pancreatic fistula (POPF) remains the major cause of morbidity after pancreatic resection, affecting up to 41% of cases. With the recent development of a consensus definition of POPF, there has been a large number of reports examining various risk factors, prediction models, and mitigation strategies for this costly complication. Despite these strategies, the rates of POPF have not significantly diminished. Here, we review the literature and evidence regarding both traditional and emerging concepts in POPF prediction, prevention, and management...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29559804/clinical-and-laboratory-features-of-intestinal-tuberculosis
#15
Bhumit Patel, Vipul D Yagnik
Background/aims: As increasing numbers of Crohn's disease (CD) cases are being recognized in India, so the differential diagnosis of CD and gastrointestinal tuberculosis (GITB) is becoming increasingly important. If patients are misdiagnosed with GITB, toxicity may result from unnecessary anti-TB therapy and treatment of the primary disease (ie, CD) gets delayed. We therefore aimed to assess the accuracy of various parameters that can be used to predict GITB diagnosis at index evaluation...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29535547/effects-of-resistant-maltodextrin-on-bowel-movements-a-systematic-review-and-meta-analysis
#16
REVIEW
Norikazu Watanabe, Masataka Suzuki, Yoshitake Yamaguchi, Yukari Egashira
It is well known that dietary fiber helps to relieve and prevent constipation, and there are a number of scientific papers, including systematic reviews and meta-analyses on the effects of naturally derived dietary fiber on bowel movements. In recent years, there has been an increase in the manufacture of dietary fiber ingredients obtained from food raw materials, and these are now commonly available in the market. Resistant maltodextrin (RMD), a soluble dietary fiber, is manufactured from starch, and industrially produced soluble dietary fiber is used worldwide...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29520160/cyclic-vomiting-syndrome-diagnostic-approach-and-current-management-strategies
#17
REVIEW
William J Hayes, Deidra VanGilder, Joseph Berendse, Michael D Lemon, John A Kappes
Cyclic vomiting syndrome (CVS) is a disorder characterized by episodes of nausea and vomiting lasting for 1-5 days followed by asymptomatic periods. The etiology of CVS is unknown, but it shares similar characteristics to migraine headaches. CVS is generally classified as having four phases: prodromal, acute/vomiting/hyperemesis, recovery, and remission/interepisodic. Current management strategies include trigger avoidance, abortive and prophylactic medication therapies, and supportive care. The goal of therapy for the remission phase is prophylaxis of further episodes...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29497323/bouveret-syndrome-current-management-strategies
#18
REVIEW
Kelly M Caldwell, Seeyuen J Lee, Phillip L Leggett, Kulvinder S Bajwa, Sheilendra S Mehta, Shinil K Shah
Bouveret syndrome is a rare complication of cholelithiasis that usually presents with signs and symptoms of gastric outlet obstruction. Given the relative rarity of this condition, there are no standardized guidelines for the management of this condition. In this paper, we review the diagnosis and management options (endoscopic, laparoscopic, and open approaches) of patients with Bouveret syndrome, including a report of one case to illustrate some of the endoscopic and surgical principles of management.
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29416370/prolonged-release-oxycodone-naloxone-reduces-opioid-induced-constipation-and-improves-quality-of-life-in-laxative-refractory-patients-results-of-an-observational-study
#19
Carsten Bantel, Shiva S Tripathi, David Molony, Tony Heffernan, Susmita Oomman, Vivek Mehta, Sara Dickerson
Background: Opioids are an effective treatment for moderate-to-severe pain. However, they are associated with a number of gastrointestinal side effects, most commonly constipation. Laxatives do not target the underlying mechanism of opioid-induced constipation (OIC), so many patients do not have their symptoms resolved. Fixed-dose prolonged-release (PR) oxycodone/naloxone (OXN) tablets contain the opioid agonist oxycodone and the opioid antagonist naloxone. Nal-oxone blocks the action of oxycodone in the gut without compromising its analgesic effects...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29416369/rationale-and-design-of-the-vision-study-a-randomized-open-label-study-to-evaluate-the-long-term-safety-of-vonoprazan-as-maintenance-treatment-in-patients-with-erosive-esophagitis
#20
Naomi Uemura, Yoshikazu Kinoshita, Ken Haruma, Takashi Yao, Ryoji Kushima, Tatsuhiro Kanoo
Erosive esophagitis (EE) occurs when the epithelial mucosa is damaged due to gastric acid reflux, and the incidence of this disease is increasing in Japan due to changes in diet and lifestyle. The condition can be treated using proton pump inhibitors (PPIs) that act by irreversibly blocking the H+ ,K+ -ATPase responsible for acid secretion. Vonoprazan is a K+ competitive channel inhibitor, which reversibly and potently inhibits gastric acid secretion. However, long-term data on vonoprazan use are limited. The aim of the VISION trial is to investigate the long-term efficacy and safety of vonoprazan in comparison with the PPI lansoprazole...
2018: Clinical and Experimental Gastroenterology
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