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Clinical and Experimental Gastroenterology

Ghada M El Sagheer, Asmaa K Ahmad, Aliaa S Abd-ElFattah, Zienab M Saad, Lamia Hamdi
Background: Fibroblast growth factor (FGF) 21 was reported to be induced by different injurious agents, including chronic hepatitis C (CHC) virus, affecting the liver. The aims of this study were to evaluate the FGF21 levels in CHC patients before and after the treatment with direct-acting antiviral agents (DAAs) in comparison to that in control subjects and to correlate these levels with insulin resistance (IR), lipid profile, and fibrosis stages. Patients and methods: We studied 75 naive CHC patients and 40 age- and gender-matched healthy control subjects...
2018: Clinical and Experimental Gastroenterology
Jihan Harki, Mustafa Suker, M Sherezade Tovar-Doncel, Louisa Jd van Dijk, Désirée van Noord, Casper Hj van Eijck, Marco J Bruno, Ernst J Kuipers, Can Ince
Background: Little is known about the microcirculatory alterations in patients with chronic mesenteric ischemia (CMI). We hypothesized that patients with CMI have an impaired microcirculatory function and show an oral microcirculatory response after caloric challenge compared to healthy controls. Methods: All patients and controls received the standard workup for CMI. Sublingual micro-circulation was evaluated before (T0) and 20 minutes after (T1) feeding. The total vessel density (TVD; mm/mm2 ), perfused vessel density (PVD; mm/mm2 ), proportion of perfused vessels (PPV; %) and microvascular flow index (MFI; AU) were assessed...
2018: Clinical and Experimental Gastroenterology
Stephen Inns, Jeffrey Wong, Dena McPhedran, Gladys De Guzman, Katherine Broome, Dalice Sim, Rosemarie Sandford
Introduction: Efficient and accurate triage of endoscopy referrals is essential. Many of the decisions made are based on national and local triage criteria. Standardizing this approach for nurse use could maintain quality, address clinical risk and significantly improve resource utilization. Aims: This study aimed to compare gastroenterologist and nurse triage of unselected gastroenterology referrals in order to evaluate the proportion of referrals felt able to be triaged to endoscopy and the inter-rater agreement between a triage gastroenterologist and endoscopy nurses for clinical triage decisions regarding the urgency of gastroscopy and colonoscopy...
2018: Clinical and Experimental Gastroenterology
Spencer D Dorn, Holly O Cirri, Audrey O Chang, Seth D Crockett, Joseph A Galanko, John A Baron
Purpose: Managing and communicating colonoscopy-generated pathology results and appropriate follow-up recommendations can be challenging. To improve this process, we developed and implemented a standardized electronic health record-based intervention with built-in decision support. Methods: Fourteen attending endoscopists performed enough colonoscopies to qualify for the study. For each, we randomly sampled and abstracted data from 35 colonoscopies that met prespecified inclusion criteria during both the pre-intervention and also post-intervention periods...
2018: Clinical and Experimental Gastroenterology
Michael Kukulka, Sai Nudurupati, Maria Claudia Perez
Objective: To assess the effect of route of administration on the bioavailability of dexlansoprazole 60 mg delayed-release capsule granules. Methods: One open-label, Phase I, single-dose, 3-period crossover study was conducted in healthy adults. The bioavailability of Dexilant® (dexlansoprazole) after dexlansoprazole capsule granules were mixed with water and administered via 16 French nasogastric tube or orally via syringe was compared to administration of the intact capsule in the fasted state, swallowed with water...
2018: Clinical and Experimental Gastroenterology
Michele Malaguarnera, Saverio Latteri, Gaetano Bertino, Roberto Madeddu, Vito Emanuele Catania, Giuseppe Currò, Antonio Maria Borzì, Filippo Drago, Giulia Malaguarnera
Purpose: Portal vein thrombosis (PVT) is one of the severe complications of hepatocellular carcinoma (HCC). PVT deteriorates the liver, and its dysfunction increases the risk of bleeding, influencing the prognosis of patients with liver cirrhosis and HCC. The aim of our study was to investigate whether D-dimer testing could be a sensitive marker for the diagnosis and prognosis of HCC patients with PVT. Patients and methods: Between June 2010 and December 2015, 118 HCC patients were admitted to Cannizzaro Hospital, Catania, and 50 controls were recruited from their relatives for health examinations...
2018: Clinical and Experimental Gastroenterology
Silvana Bonilla, Samuel Nurko
Chronic abdominal pain is frequently encountered in pediatric practice. A large proportion of cases meet Rome criteria for abdominal pain-functional gastrointestinal disorders (AP-FGIDs). These disorders are costly and, in some cases, lead to impairment of daily functioning and overall quality of life. Pathophysiologic mechanisms include early stressful events, visceral hypersensitivity, dysmotility, changes in intestinal microbiota, and altered central nervous system processing. They are considered disorders of the brain-gut interaction...
2018: Clinical and Experimental Gastroenterology
Danny J Avalos, Irene Sarosiek, Priyadarshini Loganathan, Richard W McCallum
Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain are associated with DMGP. Uncontrolled symptoms can lead to overall poor quality of life and financial burdens on the healthcare system. A combination of antiemetics and prokinetics is used in symptom control; metoclopramide is the main prokinetic available for clinical use and is the only U.S. Food and Drug Administration-approved agent in the United States...
2018: Clinical and Experimental Gastroenterology
Christopher Chang
Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder characterized by abdominal pain that occurs with defecation or alterations in bowel habits. Further classification is based on the predominant bowel habit: constipation-predominant IBS, diarrhea-predominant IBS (IBS-D), or mixed IBS. The pathogenesis of IBS is unclear and is considered multifactorial in nature. GI dysbiosis, thought to play a role in IBS pathophysiology, has been observed in patients with IBS. Alterations in the gut microbiota are observed in patients with small intestinal bacterial overgrowth, and overgrowth may occur in a subset of patients with IBS...
2018: Clinical and Experimental Gastroenterology
Vanessa Mateus, João Rocha, Hélder Mota-Filipe, Bruno Sepodes, Rui Pinto
Purpose: Hemin is a heme-oxygenase inducer, which can confer anti-inflammatory, cytoprotective, and antiapoptotic effects. These properties are beneficial therapeutical effects to inflammatory bowel disease (IBD). IBD is a worldwide health problem characterized by chronic inflammation of intestinal epithelium, which promotes intestinal and extraintestinal symptomatology. Current treatment only induces and maintains the patient in remission and results in many side effects. The research of other pharmacologic approaches is crucial to the treatment of IBD...
2018: Clinical and Experimental Gastroenterology
Kamesh Gupta, Pooja Rani, Anurag Rohatgi, Mukesh Verma, Shivani Handa, Keemi Dalal, Anand Jain
Objective: To evaluate the effectiveness of noradrenaline for the treatment of hepatorenal syndrome (HRS). Background: HRS represents the development of renal failure in cirrhotic patients. The standard treatment for HRS is terlipressin, which, as opposed to noradrenaline, is more expensive and less accessible in most tertiary care centers. Patients and methods: Thirty consecutive patients with HRS type 1 received noradrenaline (1-4.0 mg/hour) and albumin for 14 days...
2018: Clinical and Experimental Gastroenterology
Maura Torres-Aguilera, José María Remes Troche
Esophageal cancer affects more than 4,50,000 persons worldwide, and its incidence has increased in recent years. It is the eighth most common cancer across the globe. The main histologic types are esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EA), and their associated risk factors are well known. Achalasia, an idiopathic esophageal disorder that conditions aperistalsis and the absence of lower esophageal sphincter relaxation, stands out among them. The prevalence of ESCC in subjects with esophageal achalasia is 26 in every 1,000 cases, whereas the prevalence of EA is 4 in every 1,000...
2018: Clinical and Experimental Gastroenterology
Zohair Ahmed, Umair Ahmed, Saqib Walayat, Jinma Ren, Daniel K Martin, Harsha Moole, Sean Koppe, Sherri Yong, Sonu Dhillon
Background and aims: Many patients with liver disease come to medical attention once they have advanced cirrhosis or acute decompensation. Most often, patients are screened for liver disease via liver function tests (LFTs). There is very limited published data evaluating laboratory values with biopsy-proven stages of hepatic fibrosis. We set out to evaluate whether any correlation exists between routine LFTs and stages of hepatic fibrosis. Methods: A large retrospective observational study on 771 liver biopsies was conducted for evaluating the stage of fibrosis with AST, ALT, INR, BUN, creatinine, platelets, alkaline phosphatase, bilirubin, and albumin...
2018: Clinical and Experimental Gastroenterology
Aliya Ishaq, Muhammad Jamshaid Husain Khan, Turab Pishori, Rufina Soomro, Shadab Khan
Objectives: This study aimed to determine the change in anatomical location of appendix in full-term pregnancy. Study design: This was a descriptive cross-sectional study. Place and duration of study: Liaquat National University Hospital, Karachi, Pakistan, Department of General Surgery, January 01 to July 31, 2010. Patients and methods: Full-term pregnant women undergoing caesarean section were enrolled. The anatomical position of the appendix was noted by visual inspection with reference to the transtubercular plane (TTP)...
2018: Clinical and Experimental Gastroenterology
Kevin M Izquierdo, Ece Unal, John H Marks
Over the past 30 years, colorectal surgery has evolved to include minimally invasive surgical techniques. Minimally invasive surgery is associated with reduced postoperative pain, reduced wound complications, earlier return of bowel function, and possibly shorter length of hospital stay. These benefits have been attributed to a reduction in operative trauma compared to open surgery. The need to extract the specimen in colorectal operations through a "mini-laparotomy" can negate many of the advantages of minimally invasive surgery...
2018: Clinical and Experimental Gastroenterology
Emilie Aubry, Natalie Friedli, Philipp Schuetz, Zeno Stanga
Aging is linked to physiological and pathophysiological changes. In this context, elderly patients often are frail, which strongly correlates with negative health outcomes and disability. Elderly patients are often malnourished, which again is an independent risk factor for both frailty and adverse clinical outcomes. Malnutrition and resulting frailty can be prevented by adequate nutritional interventions. Yet, use of nutritional therapy can also have negative consequences, including a potentially life-threatening metabolic alteration called refeeding syndrome (RFS) in high-risk patients...
2018: Clinical and Experimental Gastroenterology
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
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
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
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
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