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Clinical and Experimental Gastroenterology

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https://www.readbyqxmd.com/read/28424557/vedolizumab-toward-a-personalized-therapy-paradigm-for-people-with-ulcerative-colitis
#1
REVIEW
Robin J Dart, Mark A Samaan, Nick Powell, Peter M Irving
Ulcerative colitis (UC) is a chronic relapsing and remitting inflammatory bowel disease, with a characteristic leukocytic infiltration of the mucosa. Immunosuppression including anti-TNF-α therapy is a mainstay of treatment for many; however, systemic immunosuppression is not universally effective and is associated with potential side effects. The gut-tropic integrin α4β7, which is expressed on leukocytes, mediates migration from the circulation to the intestinal mucosa. Vedolizumab is a monoclonal antibody which blocks the egress of leukocytes via α4β7, preventing accumulation in the mucosa, and attenuating inflammation without systemic immunosuppression...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28408850/endoscopic-ultrasound-guided-biliary-drainage-versus-percutaneous-transhepatic-biliary-drainage-after-failed-endoscopic-retrograde-cholangiopancreatography-a-meta-analysis
#2
Ramkaji Baniya, Sunil Upadhaya, Seetharamprasad Madala, Subash Chandra Subedi, Tabrez Shaik Mohammed, Ghassan Bachuwa
The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%-7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28255251/bioavailability-of-a-dexlansoprazole-delayed-release-orally-disintegrating-tablet-effects-of-food-and-mode-of-administration
#3
Michael Kukulka, Sai Nudurupati, Maria Claudia Perez
BACKGROUND: Dexlansoprazole is a proton pump inhibitor (PPI) approved for use in dual delayed-release capsule and orally disintegrating tablet (ODT) formulations. AIM: To assess effects of food, water, and route of administration on the bioavailability of dexlansoprazole 30-mg ODT. METHODS: Two separate open-label, phase 1, single-dose crossover studies were conducted in healthy adults. In study 1, pharmacokinetic parameters were analyzed in participants receiving dexlansoprazole ODT in a fed or fasted state with and without water...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28223835/perianal-crohn-s-disease-challenges-and-solutions
#4
REVIEW
Katherine A Kelley, Taranjeet Kaur, Vassiliki L Tsikitis
Perianal Crohn's disease affects a significant number of patients with Crohn's disease and is associated with poor quality of life. The nature of the disease, compounded by presentation of various disease severities, has made the treatment of perianal Crohn's disease difficult. The field continues to evolve with the use of both historical and contemporary solutions to address the challenges associated with it. The goal of this article is to review current literature regarding medical and surgical treatment, as well as the future directions of therapy...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28223834/bile-salt-receptor-tgr5-is-highly-expressed-in-esophageal-adenocarcinoma-and-precancerous-lesions-with-significantly-worse-overall-survival-and-gender-differences
#5
Chunhong Pang, Amy LaLonde, Tony E Godfrey, Jianwen Que, Jun Sun, Tong Tong Wu, Zhongren Zhou
Bile acid reflux in the esophagus plays an important role in the carcinogenesis of esophageal adenocarcinoma (EAC). The G-protein coupled bile acid receptor (TGR5) has been associated with the development of gastrointestinal cancer. However, little is known regarding the role of TGR5 in esophageal carcinoma and precancerous lesions. We analyzed genomic DNA from 116 EACs for copy number aberrations via Affymetrix SNP6.0 microarrays. The TGR5 gene locus was amplified in 12.7% (14/116) of the EACs. The TGR5 protein expression was also assessed using immunohistochemistry from tissue microarrays, including Barrett's esophagus (BE), low-(LGD) and high-grade dysplasia (HGD), columnar cell metaplasia (CM), squamous epithelium (SE), EAC and squamous cell carcinoma...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28223833/autoimmune-atrophic-gastritis-current-perspectives
#6
REVIEW
Artem Minalyan, Jihane N Benhammou, Aida Artashesyan, Michael S Lewis, Joseph R Pisegna
At present there is no universally accepted classification for gastritis. The first successful classification (The Sydney System) that is still commonly used by medical professionals was first introduced by Misiewicz et al in Sydney in 1990. In fact, it was the first detailed classification after the discovery of Helicobacter pylori by Warren and Marshall in 1982. In 1994, the Updated Sydney System was proposed during the International Workshop on the Histopathology of Gastritis followed by the publication in The American Journal of Surgical Pathology by Dixon et al...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28176894/autoimmune-hepatitis-current-challenges-and-future-prospects
#7
REVIEW
Yoshio Aizawa, Atsushi Hokari
Autoimmune hepatitis (AIH) is a chronic progressive liver disease characterized by high levels of aminotransferases and autoantibodies, hypergammaglobulinemia, and interface hepatitis. AIH affects all races and all ages worldwide, regardless of sex, although a preponderance of females is a constant finding. The etiology of AIH has not been completely elucidated, but immunogenetic background and environmental parameters may contribute to its development. The most important genetic factor is human leukocyte antigens (HLAs), especially HLA-DR, whereas the role of environmental factors is not completely understood...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28115863/correlation-between-obesity-and-metabolic-syndrome-related-factors-and-cecal-intubation-time-during-colonoscopy
#8
Ryo Kawasato, Shinichi Hashimoto, Tomohiro Shirasawa, Atsushi Goto, Takeshi Okamoto, Jun Nishikawa, Isao Sakaida
PURPOSE: To investigate which colonoscopy (CS) cases should be presided over by endoscopists in training, using factors including obesity and metabolic syndrome. PATIENTS AND METHODS: Items investigated were sex, age, body mass index (BMI), waist circumference, hypertension, diabetes, hyperlipidemia, history of abdominal surgery (excluding colectomy), colon diverticulosis, prescription of antithrombotic agents, and quality of bowel preparation. Expert physicians were defined as those with at least 9 years of endoscopy experience; all other physicians were defined as being in training...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27980432/absorption-and-safety-of-serum-derived-bovine-immunoglobulin-protein-isolate-in-healthy-adults
#9
Audrey L Shaw, David W Mathews, John E Hinkle, Bryon W Petschow, Eric M Weaver, Christopher J Detzel, Gerald L Klein, Timothy P Bradshaw
PURPOSE: Previous studies have shown that oral administration of bovine immunoglobulin protein preparations is safe and provides nutritional and intestinal health benefits. The purpose of this study was to evaluate the plasma amino acid response following a single dose of serum-derived bovine immunoglobulin/protein isolate (SBI) and whether bovine immunoglobulin G (IgG) is present in stool or in blood following multiple doses of SBI in healthy volunteers. METHODS: A total of 42 healthy adults were administered a single dose of placebo or SBI at one of three doses (5 g, 10 g, or 20 g) in blinded fashion and then continued on SBI (2...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27920566/hcverso1-and-2-faldaprevir-with-deleobuvir-bi-207127-and-ribavirin-for-treatment-na%C3%A3-ve-patients-with-chronic-hepatitis-c-virus-genotype-1b-infection
#10
Christoph Sarrazin, Francesco Castelli, Pietro Andreone, Maria Buti, Massimo Colombo, Stanislas Pol, Filipe Calinas, Massimo Puoti, Antonio Olveira, Mitchell Shiffman, Jerry O Stern, George Kukolj, Michael Roehrle, Stella Aslanyan, Qiqi Deng, Richard Vinisko, Federico J Mensa, David R Nelson
The interferon-free combination of once-daily faldaprevir 120 mg, twice-daily deleobuvir 600 mg, and weight-based ribavirin was evaluated in two Phase III studies (HCVerso1, HCVerso2) in hepatitis C virus genotype-1b-infected, treatment-naïve patients, including those ineligible for peginterferon (HCVerso2). Patients without cirrhosis were randomized to 16 weeks (Arm 1; n=208 HCVerso1, n=213 HCVerso2) or 24 weeks (Arm 2; n=211 in both studies) of faldaprevir + deleobuvir + ribavirin. Patients with compensated cirrhosis received open-label faldaprevir + deleobuvir + ribavirin for 24 weeks (Arm 3; n=51, n=72)...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27826206/necrotizing-pancreatitis-challenges-and-solutions
#11
REVIEW
Victoria A Bendersky, Mohan K Mallipeddi, Alexander Perez, Theodore N Pappas
Acute pancreatitis is a common disease that can progress to gland necrosis, which imposes significant risk of morbidity and mortality. In general, the treatment for pancreatitis is a supportive therapy. However, there are several reasons to escalate to surgery or another intervention. This review discusses the pathophysiology as well as medical and interventional management of necrotizing pancreatitis. Current evidence suggests that patients are best served by delaying interventions for at least 4 weeks, draining as a first resort, and debriding recalcitrant tissue using minimally invasive techniques to promote or enhance postoperative recovery while reducing wound-related complications...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27826205/comparison-of-glasgow-blatchford-score-and-full-rockall-score-systems-to-predict-clinical-outcomes-in-patients-with-upper-gastrointestinal-bleeding
#12
Marjan Mokhtare, Vida Bozorgi, Shahram Agah, Mehdi Nikkhah, Amirhossein Faghihi, Amirhossein Boghratian, Neda Shalbaf, Abbas Khanlari, Hamidreza Seifmanesh
BACKGROUND: Various risk scoring systems have been recently developed to predict clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). The two commonly used scoring systems include full Rockall score (RS) and the Glasgow-Blatchford score (GBS). Bleeding scores were assessed in terms of prediction of clinical outcomes in patients with UGIB. PATIENTS AND METHODS: Two hundred patients (age >18 years) with obvious symptoms of UGIB in the emergency department of Rasoul Akram Hospital were enrolled...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27789969/managing-inflammatory-bowel-disease-in-pregnancy-current-perspectives
#13
REVIEW
Matthew Pinder, Katie Lummis, Christian P Selinger
Inflammatory bowel disease (IBD) affects many women of childbearing age. The course of IBD is closely related to pregnancy outcomes with poorly controlled IBD increasing the risk of prematurity, low weight for gestation, and fetal loss. As such, women with IBD face complex decision making weighing the risks of active disease versus those of medical treatments. This review summarizes the current evidence regarding the safety and efficacy of IBD treatments during pregnancy and lactation aiming to provide up-to-date guidance for clinicians...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27785086/systematic-review-treatment-pattern-and-clinical-effectiveness-and-safety-of-pharmaceutical-therapies-for-crohn-s-disease-in-europe
#14
REVIEW
Filippo Lelli, Solomon Nuhoho, Xin Ying Lee, Weiwei Xu
BACKGROUND: Although many clinical trials have been conducted in treatments of Crohn's disease (CD), whether the trial results were representative of daily practice needs to be supported by studies conducted in real-world settings. AIM: This study aims to identify how CD is treated and what are the clinical effectiveness and safety of the pharmaceutical therapies of CD in real-world settings. METHODS: A systematic literature review was conducted based on Medline(®), Embase(®), and Cochrane...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27703391/cigarette-smoking-adversely-affects-disease-activity-and-disease-specific-quality-of-life-in-patients-with-crohn-s-disease-at-a-tertiary-referral-center
#15
Sandra M Quezada, Patricia Langenberg, Raymond K Cross
PURPOSE: Smoking has a negative impact on disease activity in Crohn's disease (CD). Smoking may also affect the quality of life, but this has not been evaluated using validated measures over time. We assessed the relationship between smoking and disease-specific quality of life over time in a tertiary referral inflammatory bowel disease cohort. PATIENTS AND METHODS: Retrospective cohort study from July 2004 to July 2009 in patients with CD identified from the University of Maryland, Baltimore, Institutional Review Board-approved University of Maryland School of Medicine Inflammatory Bowel Disease Program database...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27703390/splenosis-involving-the-gastric-fundus-a-rare-cause-of-massive-upper-gastrointestinal-bleeding-a-case-report-and-review-of-the-literature
#16
Jason Reinglas, Kirstin Perdrizet, Stephen E Ryan, Rakesh V Patel
Splenosis, the autotransplantation of splenic tissue following splenic trauma, is uncommonly clinically significant. Splenosis is typically diagnosed incidentally on imaging or at laparotomy and has been mistakenly attributed to various malignancies and pathological conditions. On the rare occasion when splenosis plays a causative role in a pathological condition, a diagnostic challenge may ensue that can lead to a delay in both diagnosis and treatment. The following case report describes a patient presenting with a massive upper gastrointestinal bleed resulting from arterial enlargement within the gastric fundus secondary to perigastric splenosis...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27703389/ineffective-esophageal-motility-and-the-vagus-current-challenges-and-future-prospects
#17
REVIEW
Ji-Hong Chen
Ineffective esophageal motility (IEM) is characterized by low to very low amplitude propulsive contractions in the distal esophagus, hence primarily affecting the smooth muscle part of the esophagus. IEM is often found in patients with dysphagia or heartburn and is commonly associated with gastroesophageal reflux disease. IEM is assumed to be associated with ineffective bolus transport; however, this can be verified using impedance measurements or evaluation of a barium coated marshmallow swallow. Furthermore, water swallows may not assess accurately the motor capabilities of the esophagus, since contraction amplitude is strongly determined by the size and consistency of the bolus...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27695356/managing-eosinophilic-esophagitis-challenges-and-solutions
#18
REVIEW
Nisha A Shah, Dustin M Albert, Noah M Hall, Fouad J Moawad
Eosinophilic esophagitis (EoE) is a chronic and progressive immune-mediated condition defined by symptoms of esophageal dysfunction and dense eosinophilic infiltration of the esophageal mucosa. Therapies consist of anti-eosinophilic medications and specialized diets aimed to decrease the progression of EoE and alleviate its symptoms, namely, dysphagia and food impaction. Assessing response to therapy remains challenging, as treatment end points are not well defined and currently consist of clinical, histologic, and endoscopic features...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27695355/influence-of-saccharomyces-boulardii-cncm-i-745on-the-gut-associated-immune-system
#19
Heike Stier, Stephan C Bischoff
BACKGROUND: The probiotic Saccharomyces boulardii CNCM I-745 (also known as Saccharomyces cerevisiae HANSEN CBS 5926; in the following S. boulardii) has proven its effectiveness in preventive and therapeutic treatment of many gastrointestinal diseases, especially diseases associated with acute diarrhea. In particular, antibiotic-associated diarrhea, Clostridium difficile-associated diarrhea, traveller's diarrhea, as well as acute diarrhea due to common viral and bacterial infections in children and adults...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27601930/self-management-in-patients-with-inflammatory-bowel-disease-strategies-outcomes-and-integration-into-clinical-care
#20
REVIEW
Jill M Plevinsky, Rachel N Greenley, Laurie N Fishman
Self-management, including medication adherence, is associated with improved health and outcomes for patients with inflammatory bowel disease. The concept of self-management is complex, but can be divided into those aspects that involve the individual patient, those that involve the provider-patient relationship, and those that encompass the social environment. At the individual level, enhancing problem-solving skills and self-efficacy have both been shown to improve self-management tasks, particularly adherence to treatment...
2016: Clinical and Experimental Gastroenterology
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