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Gastroenterology Report

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https://www.readbyqxmd.com/read/29230300/preoperative-hypoalbuminemia-is-associated-with-an-increased-risk-for-intra-abdominal-septic-complications-after-primary-anastomosis-for-crohn-s-disease
#1
Xuanhui Liu, Xianrui Wu, Chi Zhou, Tuo Hu, Jia Ke, Yufeng Chen, Xiaosheng He, Xiaobin Zheng, Xiaowen He, Jiancong Hu, Min Zhi, Xiang Gao, Pinjin Hu, Xiaojian Wu, Ping Lan
Objective: The aim of this study was to evaluate the impact of preoperative hypoalbuminemia on the development of intra-abdominal septic complications (IASCs) after primary anastomosis for patients with Crohn's disease (CD). Methods: All CD patients undergoing bowel resection with a primary anastomosis during the study period from 2007 to 2015 were enrolled. The association of preoperative hypoalbuminemia (<30 g/L) with the risk for IASCs were assessed using both univariate and multivariate analyses...
November 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/29230299/predictors-of-acute-gastrointestinal-bleeding-in-diabetic-ketoacidosis-a-retrospective-observational-study-in-minority-population
#2
Kanthi Rekha Badipatla, Preeti Jadhav, Sushma Vaddigiri, Bharat Bajantri, Amandeep Singh, Chaitanya Chandrala, Vijay S Are, Suresh Kumar Nayudu
Background: Diabetic ketoacidosis (DKA) is a common acute complication of diabetes mellitus requiring aggressive medical management. We attempted to study the incidence and various clinical and laboratory variables associated with acute gastrointestinal bleeding (AGIB) and acute upper AGIB (AUGIB) in patients with DKA. Methods: We conducted a retrospective chart review of all the patients admitted to our hospital with DKA between January 2010 and December 2015. We collected demographic, clinical, laboratory, endoscopy and hospitalization details using an electronic medical-record database...
November 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/29230298/hepatic-paragonimiasis-a-single-center-retrospective-analysis-of-32-cases-in-mainland-china
#3
Xiwen Ye, Xianze Xiong, Nansheng Cheng, Jiong Lu, Yixin Lin
Background: In paragonimiasis, the lungs and pleural cavity are the major target organs, and the central nervous system can also be affected. The liver is an organ in which ectopic paragonimiasis rarely occurs. Because the symptoms and examinations in hepatic paragonimiasis (HP) are not typical, the disease is often misdiagnosed in the clinic. Methods: From February 2008 to March 2015, our department accepted 32 patients who presented with a liver mass upon ultrasound and computed tomography imaging and in whom the source of the mass could not be identified upon numerous further diagnostic tests...
November 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/29230297/from-genetics-and-epigenetics-to-the-future-of-precision-treatment-for-obesity
#4
REVIEW
Xulong Sun, Pengzhou Li, Xiangwu Yang, Weizheng Li, Xianjie Qiu, Shaihong Zhu
Obesity has become a major global health problem, epitomized by excess accumulation of body fat resulting from an imbalance between energy intake and expenditure. The treatments for obesity range from modified nutrition and additional physical activity, to drugs or surgery. But the curative effect of each method seems to vary between individuals. With progress in the genetics and epigenetics of obesity, personalization of the clinical management of obesity may be at our doorstep. This review presents an overview of our current understanding of the genetics and epigenetics of obesity and how these findings influence responses to treatments...
November 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/29230296/intestinal-autotransplantation
#5
REVIEW
Guosheng Wu
Most abdominal neoplasms involving the root of the superior mesenteric artery and/or celiac artery are difficult to manage with conventional operative techniques because of limited intestinal ischemia times and poor accessibility to the tumor region. Ex vivo surgery followed by intestinal autotransplantation (IATx) is a relatively novel surgical strategy to offer chances for complete resection in such hopeless circumstances. This review aims to assess potential surgical indications, operative techniques and clinical outcomes after IATx...
November 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28852526/identification-of-the-distinguishing-features-of-crohn-s-disease-and-ischemic-colitis-using-computed-tomographic-enterography
#6
Min Chen, Erick M Remer, Xiuli Liu, Rocio Lopez, Bo Shen
Background and aims: The differential diagnosis between Crohn's disease (CD) and ischemic colitis (ISC) is important as their clinical management is different. ISC can easily be misdiagnosed as CD, especially in elderly populations. The distinctive radiographic features of the two disease entities have not been investigated. The aim of this study is to assess the utility of computed tomographic enterography (CTE) in the differential diagnosis between CD and ISC. Methods: Patients with confirmed CD and ISC were identified through an electronic medical record search of the Cleveland Clinic Foundation...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28852525/real-world-experience-with-pegylated-interferon-and-ribavirin-in-hepatitis-c-genotype-1-population-with-favourable-il28b-polymorphism
#7
Victoria Ekstrom, Rajneesh Kumar, Yi Zhao, Mei Ling Yee, Cynthia Sung, Dorothy Toh, Poh Yen Loh, Jessica Tan, Eng Kiong Teo, Wan Cheng Chow
Background and aim: Conventional hepatitis C treatment using pegylated interferon (PEG-IFN) and ribavirin is associated with significant side effects. IL28B polymorphism can predict response to treatment, with CC genotype having a better response. ITPA gene deficiency protects against clinically significant anaemia induced by treatment. The purpose of this study was to determine IL28B polymorphism and ITPA variation among hepatitis C genotype 1 patients who have undergone therapy with PEG-IFN and ribavirin and their association with sustained viral response (SVR)...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28852524/fecal-microbiota-transplantation-for-clostridium-difficile-infection-in-patients-with-ileal-pouches
#8
Nan Lan, Jean Ashburn, Bo Shen
Background:Clostridium difficile infection (CDI) in patients with ileal pouch-anal anastomosis (IPAA) has been increasingly recognized. The aim of this study was to evaluate the outcome of fecal microbiota transplantation (FMT) in patients with pouch and CDI. Methods: All consecutive patients that underwent FMT for CDI from 2012 to 2016 were extracted from our IRB-approved, prospectively maintained Registry of Pouch Disorders. The primary outcome was negative stool tests for Clostridium difficile after FMT and the secondary outcomes were symptomatic and endoscopic responses...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28852523/variceal-bleeding-in-cirrhotic-patients
#9
REVIEW
Maxime Mallet, Marika Rudler, Dominique Thabut
Variceal bleeding is one of the major causes of death in cirrhotic patients. The management during the acute phase and the secondary prophylaxis is well defined. Recent recommendations (2015 Baveno VI expert consensus) are available and should be followed for an optimal management, which must be performed as an emergency in a liver or general intensive-care unit. It is based on the early administration of a vasoactive drug (before endoscopy), an antibiotic prophylaxis and a restrictive transfusion strategy (hemoglobin target of 7 g/dL)...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28852522/systematic-review-of-mixed-cryoglobulinemia-associated-with-hepatitis-e-virus-infection-association-or-causation
#10
REVIEW
Fateh Bazerbachi, Michael D Leise, Kymberly D Watt, M Hassan Murad, Larry J Prokop, Samir Haffar
Background and aim: Mixed cryoglobulinemia (MC) has been associated with several viral infections, and chronic hepatitis C is recognized as a major cause. MC associated with hepatitis E virus (HEV) has been described and little is known about this rare association. The aim of this study is to perform a systematic review of MC associated with HEV, and examine the presence of a causal relationship. Methods: An experienced librarian conducted a search of databases from each database's inception to 12 December 2016 based on a priori criteria...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28852521/perioperative-use-of-immunosuppressive-medications-in-patients-with-crohn-s-disease-in-the-new-biological-era
#11
Amy L Lightner, Bo Shen
Crohn's disease (CD) is characterized by transmural inflammation of the gastrointestinal tract leading to inflammatory, stricturing and/or and fistulizing disease. Once a patient develops medically refractory disease, mechanical obstruction, fistulizing disease or perforation, surgery is indicated. Unfortunately, surgery is not curative in most cases, underscoring the importance of bowel preservation and adequate perioperative medical management. As many of the medications used to treat CD are immunosuppressive, the concern for postoperative infectious complications and anastomotic healing are particularly concerning; these concerns have to be balanced with preventing and treating residual or recurrent disease...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533912/portal-vein-thrombosis-in-patients-with-cirrhosis
#12
Leona von Köckritz, Andrea De Gottardi, Jonel Trebicka, Michael Praktiknjo
Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty and investigation in international guidelines. In this article, we elaborate on PVT classification, geographical differences in clinical presentation and standards of diagnosis, and briefly on the current pathophysiological understanding and risk factors...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533911/hepatic-encephalopathy
#13
Peter Ferenci
Hepatic encephalopathy (HE) is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases. The precise pathophysiology of HE is still under discussion; the leading hypothesis focus on the role of neurotoxins, impaired neurotransmission due to metabolic changes in liver failure, changes in brain energy metabolism, systemic inflammatory response and alterations of the blood brain barrier. HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533910/renal-dysfunction-in-cirrhosis-acute-kidney-injury-and-the-hepatorenal-syndrome
#14
Theresa Bucsics, Elisabeth Krones
Renal dysfunction is a common complication of liver cirrhosis and of utmost clinical and prognostic relevance. Patients with cirrhosis are more prone to developing acute kidney injury (AKI) than the non-cirrhotic population. Pre-renal AKI, the hepatorenal syndrome type of AKI (HRS-AKI, formerly known as 'type 1') and acute tubular necrosis represent the most common causes of AKI in cirrhosis. Correct differentiation is imperative, as treatment differs substantially. While pre-renal AKI usually responds well to plasma volume expansion, HRS-AKI and ATN require different specific approaches and are associated with substantial mortality...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533909/recent-advances-in-the-management-of-variceal-bleeding
#15
Ihteshamul Haq, Dhiraj Tripathi
Acute haemorrhage from ruptured gastroesophageal varices is perhaps the most serious consequence of uncontrolled portal hypertension in cirrhotic patients. It represents a medical emergency and is associated with a high morbidity and mortality. In those who survive the initial bleeding event, the risks of further bleeding and other decompensated events remain high. The past 30 years have seen a slow evolution of management strategies that have greatly improved the chances of surviving a variceal haemorrhage...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533908/ascites-refractory-ascites-and-hyponatremia-in-cirrhosis
#16
Brett Fortune, Andres Cardenas
Ascites is the most common complication related to cirrhosis and is associated with increased morbidity and mortality. Ascites is a consequence of the loss of compensatory mechanisms to maintain the overall effective arterial blood volume due to worsening splanchnic arterial vasodilation as a result of clinically significant portal hypertension. In order to maintain effective arterial blood volume, vasoconstrictor and antinatriuretic pathways are activated, which increase overall sodium and fluid retention...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533907/novel-treatment-options-for-portal-hypertension
#17
Philipp Schwabl, Wim Laleman
Portal hypertension is most frequently associated with cirrhosis and is a major driver for associated complications, such as variceal bleeding, ascites or hepatic encephalopathy. As such, clinically significant portal hypertension forms the prelude to decompensation and impacts significantly on the prognosis of patients with liver cirrhosis. At present, non-selective β-blockers, vasopressin analogues and somatostatin analogues are the mainstay of treatment but these strategies are far from satisfactory and only target splanchnic hyperemia...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533906/diagnosis-of-cirrhosis-and-portal-hypertension-imaging-non-invasive-markers-of-fibrosis-and-liver-biopsy
#18
REVIEW
Bogdan Procopet, Annalisa Berzigotti
The concept of 'cirrhosis' is evolving and it is now clear that compensated and decompensated cirrhosis are completely different in terms of prognosis. Furthermore, the term 'advanced chronic liver disease (ACLD)' better reflects the continuum of histological changes occurring in the liver, which continue to progress even after cirrhosis has developed, and might regress after removing the etiological factor causing the liver disease. In compensated ACLD, portal hypertension marks the progression to a stage with higher risk of clinical complication and requires an appropriate evaluation and treatment...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28567286/re-appraisal-and-consideration-of-minimally-invasive-surgery-in-colorectal-cancer
#19
REVIEW
Mahmoud Abu Gazala, Steven D Wexner
Throughout history, surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative trauma. During the last three decades, there have been tremendous advances in the field of minimally invasive colorectal surgery, with an explosion of different technologies and approaches offered to treat well-known diseases. Laparoscopic surgery has been shown to be equal or superior to open surgery. The boundaries of laparoscopy have been pushed further, in the form of single-incision laparoscopy, natural-orifice transluminal endoscopic surgery and robotics...
February 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28110300/irritable-bowel-syndrome-and-diet
#20
REVIEW
Piero Portincasa, Leonilde Bonfrate, Ornella de Bari, Anthony Lembo, Sarah Ballou
Irritable bowel syndrome (IBS) is a chronic functional disorder of the gastrointestinal tract and is one of the most commonly diagnosed gastrointestinal diseases. The impact of IBS on the general population is large due to its high prevalence, suboptimal medical treatments and significant economic burden. The pathophysiology of IBS is complex and treatments are often symptom-specific. The most common therapeutic approaches for IBS include education and reassurance, lifestyles (especially nutrition-based interventions), peripherally acting medications (which typically target motility), centrally acting medications (which target visceral hypersensitivity and pain) and psychological interventions (which aim to reduce the effects of stress or symptom-specific anxiety)...
February 2017: Gastroenterology Report
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