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gastroenterologist and hematology

Cláudio Martins, Cristina Teixeira, Suzane Ribeiro, Daniel Trabulo, Cláudia Cardoso, João Mangualde, Ricardo Freire, Élia Gamito, Ana Luísa Alves, Isabelle Cremers, Cecília Alves, Anabela Neves, Ana Paula Oliveira
Mastocytosis is a clonal neoplastic disorder of the mast cells (MC) that can be limited to the skin (cutaneous mastocytosis) or involve one or more extracutaneous organs (systemic mastocytosis). The clinical manifestations of mastocytosis are heterogeneous ranging from indolent disease with a long-term survival to a highly aggressive neoplasm with survival of about 6 mo. Although liver involvement in aggressive systemic mastocytosis (ASM) is relatively common, the development of portal hypertension with or without cirrhosis is rare...
July 28, 2016: World Journal of Gastroenterology: WJG
Archie Ramaswami, Danya J Rosen, Jaime Chu, Birte Wistinghausen, Ronen Arnon
Deferesirox (DFX), an oral chelating agent, is used to treat chronic iron overload in several hematological diseases such as β-thalassemia, sickle cell disease, and myelodysplastic anemia. DFX is generally well tolerated with the exception of gastrointestinal disturbances and rash, although cases of renal toxicity, as well as acute and chronic liver failure, have been reported in adults and children. Here we describe a 3-year-old girl with β-thalassemia undergoing treatment with DFX who presented with acute liver failure and Fanconi's syndrome...
July 29, 2016: Journal of Pediatric Hematology/oncology
Livia Biancone, Sara Onali, Carmelina Petruzziello, Emma Calabrese, Francesco Pallone
The widespread use of thiopurines and anti-tumor necrosis factors (TNFs) in inflammatory bowel disease (IBD) is a rising concern regarding their potential cancer risk. MEDLINE, EMBASE, and the Cochrane Library database were searched for articles regarding immunomodulators anti-TNF agents in IBD, hematologic malignancies, and solid tumors. Current evidences support that thiopurines and anti-TNFs used alone or in combination do not increase the overall cancer risk in IBD. Thiopurines use, with or without anti-TNFs, is associated with an increased risk of lymphoma, particularly non-Hodgkin lymphoma, in Crohn's disease...
March 2015: Inflammatory Bowel Diseases
Markus Franz, Matthias Scholz, Ilka Henze, Stefan Röckl, Luis I Gomez
Numerous studies have shown that early screening for the presence of pre-cancerous colon polyps and their subsequent removal decreases the risk of developing colon cancer. Colonoscopy is currently the most effective screening method, but due to the invasive nature of the procedure many patients avoid forgo testing. Futhermore, the procedure itself requires perfect execution by the gastroenterologist. Against this backdrop, a non-invasive blood screening method for the detection of colon polyps that has higher sensitivity than current screening techniques would be beneficial in the early identification of patients at risk for colon cancer...
2013: Journal of Translational Medicine
Steven G Schauer, Andrew J Thompson, Vikhyat S Bebarta
We report the case of a 19-year-old military trainee that presented to the emergency department with a 3-week history of diffuse abdominal pain, 1 to 2 hours postprandially. The timing, onset, quality, and location of her pain was concerning for intestinal angina. Her serum chemistry, hematology, and liver function tests were normal. The radiologist's interpretation of the computed tomography angiogram of the abdomen was an abnormally narrow takeoff angle of the superior mesenteric artery (SMA) from the aorta near the third portion of the duodenum...
March 2013: Military Medicine
Amitesh Agarwal, Oliveira Eduardo
SESSION TYPE: Cancer Student/Resident Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Antibodies against tumor necrosis factor alpha (TNF-α) are approved for treatment of luminal and fistulizing Crohn's disease. Anti -TNFα are shown to have increase hematologic malignancy and a few trials shows increase solid organ malignancies. There is no published data for increase risk of pulmonary carcinoid in crohn's disease. Here we are reporting a case of pulmonary carcinoid tumor developing in a Crohn's disease patient on adalimumab therapy...
October 1, 2012: Chest
Panagiotis Papagiannakis, Christos Michalopoulos, Fani Papalexi, Despoina Dalampoura, Michael D Diamantidis
Helicobacter pylori (H. pylori) is a Gram-negative spiral bacterium, classified as a carcinogen of class I, according to the World Health Organization (WHO). The infection is a major cause of gastritis, gastric and duodenal ulcer disease and increases the risk of gastric cancer. It has been implicated in the pathogenesis of several gastrointestinal, systemic or hematological diseases. The present review aims in deciphering the role of the bacterium in hematological disorders, increasing the awareness of gastroenterologists, hematologists and internal medicine practitioners, regarding the bacterium-associated hematological diseases...
December 2013: European Journal of Internal Medicine
Ipek Yonal, Asli Ciftcibasi, Suut Gokturk, Mustafa Nuri Yenerel, Filiz Akyuz, Cetin Karaca, Kadir Demir, Fatih Besisik, Sevgi Kalayoglu-Besisik
Involvement of the serosa may be the presenting feature in a wide and complex variety of lymphoproliferative diseases, with differing clinical outcomes covering a spectrum of benign and malignant conditions. Effusions involving peritoneal and pericardial cavities are uncommon during the course of hematological malignancies. Obstructive and/or infiltrative tumor mass or vascular leakage due to stimulation by vascular endothelial growth factor contribute to the pathogenesis. In addition to clinical findings, cytomorphology and flow cytometric immunophenotyping of the serosal fluid yield valuable information in the differential diagnosis of lymphocytic infiltrates...
September 2012: Case Reports in Gastroenterology
Marianne Sinn, Sven Bischoff, Oliver Nehls, Uwe Pelzer, Fritz von Weizsäcker, Stefan Kubicka, Jens M Stieler, Karel Caca, Hanno Riess
BACKGROUND: The low incidence and the variable presentation complicate clinical investigations on biliary tract cancer. The results of Valle et al. in 2009 provided, for the first time, an evidence-based palliative treatment for this rare tumor type. So far no data are available in Germany regarding the current daily care practice. METHODS: We started this national survey in May 2011, including about 3,400 members of the AIO (Working Group Medical Oncology), DGHO (German Society of Hematology and Oncology) and GGHBB (Society of Gastroenterology and Hepatology in Berlin and Brandenburg)...
2012: Onkologie
Gary L Freed, Kelly M Dunham, Carol Loveland-Cherry, Kristy K Martyn, Marc J Moote
OBJECTIVE: Historically, most pediatric subspecialists have conducted their clinical work in academic health centers. However, increases in the absolute numbers of pediatric subspecialists in past decades, combined with greater concentrations of children in urban and suburban settings, might result in more opportunities for pediatric subspecialists to enter private practice. Our goal was to assess the proportions of subspecialists in private practice. METHODS: We surveyed a stratified, random, national sample of 1696 subspecialists from 5 subspecialties and assessed the ownership of their current clinical practice settings...
October 2011: Pediatrics
Jae Hee Cheon, Sung Jae Shin, Sang Woo Kim, Kang Moon Lee, Joo Sung Kim, Won Ho Kim et al.
Due to similar manifestations of intestinal Behçet's disease (BD) to those of other colitis such as Crohn's disease or intestinal tuberculosis, it is still challenging for gastroenterologist to accurately diagnose intestinal BD in patients with ileo-colonic ulcers. Moreover, no reliable diagnostic criteria for intestinal BD have been developed yet. Therefore, IBD Study Group of KASID was formulated to establish the guideline for the diagnosis of intestinal BD using a modified Delphi process. The novel diagnostic criteria for intestinal BD were developed based on two aspects; colonoscopic findings and extra-intestinal systemic manifestations, in which patients were categorized into 4 groups including definite, probable, suspected, and non-diagnostic for intestinal BD...
March 2009: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Jose Antonio Moreno Chulilla, Maria Soledad Romero Colás, Martín Gutiérrez Martín
Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classification (microcytic, macrocytic and normocytic) and pathogenic classification (regenerative and hypo regenerative), and integration of these classifications. Interpretation of laboratory tests is included, from the simplest (blood count, routine biochemistry) to the more specific (iron metabolism, vitamin B12, folic acid, reticulocytes, erythropoietin, bone marrow examination and Schilling test)...
October 7, 2009: World Journal of Gastroenterology: WJG
Parijat Gupte, Aabha Nagral
There has been significant progress in the understanding of the pathophysiologic basis of common haematological problems like cytopenias, coagulopathies and thrombophilic disorders in the background of liver disease. Diagnosis has improved with newer tests like detection of JAK2 mutation and better radiological imaging. Additionally, therapeutic options have expanded with availability of drugs like activated factor VII and eltrombopeg and improved expertise in procedures like TIPSS for treatment of the Budd-Chiari syndrome...
April 2009: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Somchai Amornyotin, Prapun Aanpreung, Ungkab Prakarnrattana, Wiyada Chalayonnavin, Sukanda Chatchawankitkul, Wichit Srikureja
BACKGROUND: The aim of this study was to evaluate the clinical efficacy of intravenous sedation for pediatric gastrointestinal endoscopy (GIE) at a tertiary care teaching hospital in a developing country. METHODS: We undertook a retrospective review of the sedation service records of pediatric patients who underwent GIE. All endoscopies were performed by a pediatric gastroenterologist. All of the sedation was administered by staff anesthesiologist or anesthetic personnel in the gastroenterology procedure room...
August 2009: Paediatric Anaesthesia
R Peshin, M Phelan
We assessed investigations and management protocols for patients starting long-term steroid therapy. Rheumatology, respiratory, hematology, oncology, and gastroenterology consultants were asked five questions designed to assess investigation and management protocols followed in dealing with 50-year-old male, 25- and 75-year-old female patients. The response rates were as follows: rheumatologists 11/14 (78.6%), gastroenterologists 19/31 (61.3%), respiratory physicians 13/26 (50%), hematologists 10/25 (40%), oncologists 6/21 (28...
September 2007: Clinical Rheumatology
B D Cash, W D Chey
Irritable bowel syndrome (IBS) represents one of the most common reasons for primary care visits and consultation with a gastroenterologist. It is characterized by abdominal discomfort, bloating and disturbed defecation in the absence of any identifiable physical, radiologic or laboratory abnormalities indicative of organic gastrointestinal disease. IBS is a costly disorder, responsible for significant direct and indirect costs to patients and society. Much of the cost attributed to IBS arises from the time and resources used to establish the diagnosis...
June 15, 2004: Alimentary Pharmacology & Therapeutics
Robert P. McCabe
Most primary immunodeficiencies are diagnosed in children and, therefore, are managed by pediatricians and pediatric specialists. Generally, internists and adult gastroenterologists only rarely encounter patients with primary immunodeficiency, and have little or no involvement in actual treatment. However, gastroenterologists should be familiar with primary immunodeficiency because 1) current and future therapy for immunodeficiency will allow more patients to survive into adulthood, 2) some primary immunodeficiencies, particularly common variable immunodeficiency, may have their first clinical manifestation in adolescence or early adulthood, and 3) recently it has been hypothesized that Crohn's disease may be an immunodeficiency...
February 2002: Current Treatment Options in Gastroenterology
R J Farrell, C P Kelly
Celiac sprue is a common lifelong disorder affecting 0.3-1% of the Western world and causing considerable ill health and increased mortality, particularly from lymphoma and other malignancies. Although high prevalence rates have been reported in Western Europe, celiac sprue remains a rare diagnosis in North America. Whether celiac sprue is truly rare among North Americans or is simply underdiagnosed is unclear, although serological screening of healthy American blood donors suggests that a large number of American celiacs go undiagnosed...
December 2001: American Journal of Gastroenterology
I Rasul, G P Kandel
Iron-deficiency anemia is a common reason for referral to a gastroenterologist. In adult men and postmenopausal women, gastrointestinal tract pathology is often the cause of iron-deficiency anemia, so patients are frequently referred for endoscopic evaluation. Endoscopy may be costly and at times difficult for the patient. Therefore, physicians need to know what lesions can be identified reliably and, more importantly, the importance of ruling out life-threatening conditions such as occult malignancy. Over the past decade, a number of prospective studies have been completed that examined the yield of endoscopy in the investigation of iron-deficiency anemia...
November 2001: Canadian Journal of Gastroenterology, Journal Canadien de Gastroenterologie
M M Schuster
Approximately 20% of the general population has irritable bowel syndrome (IBS). Although the majority of these individuals do not consult a physician, IBS accounts for 25% of visits to a gastroenterologist and up to 12% of visits to a primary care physician. Consequently, the direct and indirect costs associated with IBS are estimated at $8 billion annually. IBS symptoms, with no apparent structural pathology, include altered bowel habits, abdominal pain/discomfort, and bloating. The Rome II criteria, a standardized guideline for the diagnosis of IBS, contains in its definition abdominal pain or discomfort associated with altered bowel habits...
July 2001: American Journal of Managed Care
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