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https://www.readbyqxmd.com/read/29665102/antibiotic-associated-disruption-of-microbiota-composition-and-function-in-cirrhosis-is-restored-by-fecal-transplant
#1
Jasmohan S Bajaj, Genta Kakiyama, Tor Savidge, Hajime Takei, Zain A Kassam, Andrew Fagan, Edith A Gavis, William M Pandak, Hiroshi Nittono, Phillip B Hylemon, Prapaporn Boonma, Anthony Haag, Douglas M Heuman, Michael Fuchs, Binu John, Masoumeh Sikaroodi, Patrick M Gillevet
Cirrhotic patients are often exposed to antibiotics that can lead to resistance and fungal overgrowth. The role of fecal microbial transplant (FMT) to restore gut microbial function is unclear in cirrhosis. In an FDA-monitored Phase 1 clinical safety trial, decompensated cirrhotic patients on standard therapies (lactulose and rifaximin) were randomized to standard-of-care (SOC, no antibiotics/FMT) or 5 days of broad-spectrum antibiotics followed by FMT from a donor enriched in Lachnospiraceae and Ruminococcaceae...
April 17, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29651649/systematic-review-of-the-economic-burden-of-overt-hepatic-encephalopathy-and-pharmacoeconomic-impact-of-rifaximin
#2
REVIEW
Guy Neff, Woodie Zachry Iii
BACKGROUND: Hepatic encephalopathy (HE), a common neurologic complication in cirrhosis, is associated with substantial disease and economic burden. Rifaximin is a non-systemic antibiotic that reduces the risk of overt HE recurrence and overt HE-related hospitalizations. OBJECTIVE: Our objective was to provide an overview of the direct HE-related costs and cost benefits of rifaximin, lactulose, and rifaximin plus lactulose. METHODS: A systematic review of PubMed and relevant meeting abstracts was conducted to identify publications since 1 January 2007 reporting economic data related to HE and rifaximin and/or lactulose...
April 12, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29644492/update-on-the-therapeutic-management-of-hepatic-encephalopathy
#3
REVIEW
Linda Skibsted Kornerup, Lise Lotte Gluud, Hendrik Vilstrup, Gitte Dam
PURPOSE OF REVIEW: Hepatic encephalopathy (HE) is a common and devastating complication to chronic liver disease. In this paper, we summarize the latest research and evidence of both conventional and up-coming treatments. RECENT FINDINGS: Meta-analyses report beneficial effects of lactulose, branched-chain amino acids, rifaximin, and to some degree L-ornithine L-aspartate on the manifestations of HE in patients with cirrhosis, and generally the numbers needed to treat are low...
April 11, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29643520/-comparison-of-gut-microbiotal-compositional-analysis-of-patients-with-irritable-bowel-syndrome-through-different-bioinformatics-pipelines
#4
S W Zhu, Z J Liu, M Li, H Q Zhu, L P Duan
OBJECTIVE: To assess whether the same biological conclusion, diagnostic or curative effects regarding microbial composition of irritable bowel syndrome (IBS) patients could be reached through different bioinformatics pipelines, we used two common bioinformatics pipelines (Uparse V2.0 and Mothur V1.39.5)to analyze the same fecal microbial 16S rRNA high-throughput sequencing data. METHODS: The two pipelines were used to analyze the diversity and richness of fecal microbial 16S rRNA high-throughput sequencing data of 27 samples, including 9 healthy controls (HC group), 9 diarrhea IBS patients before (IBS group) and after Rifaximin treatment (IBS-treatment, IBSt group)...
April 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29626003/probable-fidaxomicin-induced-pancytopenia
#5
Samantha Axtell, Aisha Shokoya, Christine Yocum
PURPOSE: A case of pancytopenia in a patient receiving treatment with fidaxomicin for Clostridium difficile infection (CDI) is described. SUMMARY: A 33-year-old Caucasian woman was admitted to the hospital with a chief complaint of loose stools occurring approximately 7 times a day; she also reported fever, nausea, diffuse abdominal pain, and fatigue. The patient had a history of recurrent CDI, recurrent urinary tract infections, nephrolithiasis, chronic hepatitis C, and endometriosis...
April 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29623099/treatment-of-diverticular-disease-an-update-on-latest-evidence-and-clinical-implications
#6
REVIEW
Marilia Carabotti, Bruno Annibale
Background: Diverticular disease (DD) is a common condition, especially in Western countries. In about 80% of patients, colonic diverticula remain asymptomatic (diverticulosis), while approximately 20% of patients may develop abdominal symptoms (symptomatic uncomplicated diverticular disease, SUDD) and, eventually complications as acute diverticulitis (AD). The management of this condition has been improved, and in the last five years European countries and the USA have published guidelines and recommendations...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29605976/clinical-practice-guidelines-for-irritable-bowel-syndrome-in-korea-2017-revised-edition
#7
REVIEW
Kyung Ho Song, Hye-Kyung Jung, Hyun Jin Kim, Hoon Sup Koo, Yong Hwan Kwon, Hyun Duk Shin, Hyun Chul Lim, Jeong Eun Shin, Sung Eun Kim, Dae Hyeon Cho, Jeong Hwan Kim, Hyun Jung Kim
In 2011, the Korean Society of Neurogastroenterology and Motility (KSNM) published clinical practice guidelines on the management of irritable bowel syndrome (IBS) based on a systematic review of the literature. The KSNM planned to update the clinical practice guidelines to support primary physicians, reduce the socioeconomic burden of IBS, and reflect advances in the pathophysiology and management of IBS. The present revised version of the guidelines is in continuity with the previous version and targets adults diagnosed with, or suspected to have, IBS...
April 30, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29580065/status-of-rifaximin-a-review-of-characteristics-uses-and-analytical-methods
#8
Ana Carolina Kogawa, Hérida Regina Nunes Salgado
Rifaximin, an oral antimicrobial, has many advantages because it is selective intestine, has minimal adverse effects and is used for the treatment of some diseases such as hepatic encephalopathy, irritable bowel syndrome, travelers' diarrhea, ulcerative colitis, Clostridium difficile and acute diarrhea. Rifaximin in the form of 200 mg tablets is commercially available. The crystalline α form is therapeutically safe and effective. In most of the official compendia, rifaximin has no monograph and in none of them is there a monograph for rifaximin tablets...
March 26, 2018: Critical Reviews in Analytical Chemistry
https://www.readbyqxmd.com/read/29515036/gut-microbial-rna-and-dna-analysis-predicts-hospitalizations-in-cirrhosis
#9
Jasmohan S Bajaj, Leroy R Thacker, Andrew Fagan, Melanie B White, Edith A Gavis, Phillip B Hylemon, Robert Brown, Chathur Acharya, Douglas M Heuman, Michael Fuchs, Swati Dalmet, Masoumeh Sikaroodi, Patrick M Gillevet
BACKGROUND: Cirrhosis is associated with gut microbial changes, but current 16S rDNA techniques sequence both dead and live bacteria. We aimed to determine the rRNA content compared with DNA from the same stool sample to evaluate cirrhosis progression and predict hospitalizations. METHODS: Cirrhotics and controls provided stool for RNA and DNA analysis. Comparisons were made between cirrhotics/controls and within cirrhosis (compensated/decompensated, infected/uninfected, renal dysfunction/not, rifaximin use/not) with respect to DNA and RNA bacterial content using linear discriminant analysis...
March 8, 2018: JCI Insight
https://www.readbyqxmd.com/read/29513251/the-use-of-rifaximin-in-pre-operative-period-of-patients-with-tumors-of-the-gastrointestinal-tract-a-retrospective-study-2013-2016
#10
Nina Moroz, Robert Sitarz, Andrzej Mruk, Robert Bakalarz, Ewa Maciąg, Jakub Litwiński, Ryszard Wierzbicki
ntroduction: One of the most important goals of preparing a patient for elective gastrointestinal cancer surgery is prevention of postoperative complications. The literature gives many ways to prepare for surgery, but only a few suggests that pre-operative use of rifaximin provides benefits in the form of fewer perioperative complications and reduces the severity of pain during this period. O bjective: The presented project is a retrospective analysis of the effectiveness of rifaximin in the prevention of perioperative complications in patients treated in the Unit of General Surgery with the Orthopedic and Urology in the Hospital of the Ministry of the Interior and Administration in Lublin, and a review of international literature in this subject...
February 28, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29507462/the-burden-of-minimal-hepatic-encephalopathy-from-diagnosis-to-therapeutic-strategies
#11
REVIEW
Lorenzo Ridola, Vincenzo Cardinale, Oliviero Riggio
Minimal hepatic encephalopathy (MHE) is the mildest form of hepatic encephalopathy (HE). It affects the performance of psychometric tests focused on attention, working memory, psychomotor speed, and visuospatial ability, as well as electrophysiological and other functional brain measures. MHE is a frequent complication of liver disease, affecting up to 80% of tested patients. By being related to falls, an impairment in fitness to drive and the development of overt HE, MHE severely affects the lives of patients and caregivers by altering their quality of life and their socioeconomic status...
March 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29485654/gut-liver-brain-axis-the-microbial-challenge-in-the-hepatic-encephalopathy
#12
Andrea Mancini, Francesca Campagna, Piero Amodio, Kieran M Tuohy
Hepatic encephalopathy (HE) is a debilitating neuropsychiatric condition often associated with acute liver failure or cirrhosis. Advanced liver diseases are characterized by a leaky gut and systemic inflammation. There is strong evidence that the pathogenesis of HE is linked to a dysbiotic gut microbiota and to harmful microbial by-products, such as ammonia, indoles, oxindoles and endotoxins. Increased concentrations of these toxic metabolites together with the inability of the diseased liver to clear such products is thought to play an important patho-ethiological role...
March 1, 2018: Food & Function
https://www.readbyqxmd.com/read/29482588/antifibrotic-and-molecular-aspects-of-rifaximin-in-alcoholic-liver-disease-study-protocol-for-a-randomized-controlled-trial
#13
Bjørn Stæhr Madsen, Jonel Trebicka, Maja Thiele, Mads Israelsen, Manimozhiyan Arumugan, Troels Havelund, Aleksander Krag
BACKGROUND: Alcoholic liver disease is the leading cause of cirrhosis worldwide. Due to an increase in alcohol overuse, alcoholic liver disease has become an increased burden on health care systems. Abstinence from alcohol remains the cornerstone of alcoholic liver disease treatment; however, this approach is hampered by frequent relapse and lack of specific therapy for treating advanced cases of liver disease. In the present study, we hypothesized that gut microbiota drive the development of liver fibrosis and that modulation of gut microbiota with the gut-selective, nonabsorbable antibiotic rifaximin attenuates alcoholic liver fibrosis...
February 26, 2018: Trials
https://www.readbyqxmd.com/read/29457869/assessment-of-the-spectrum-of-hepatic-encephalopathy-a-multi-center-study
#14
Bradley Reuter, Kara Walter, Julien Bissonnette, Michael D Leise, Jennifer Lai, Puneeta Tandon, Patrick S Kamath, Scott W Biggins, Christopher F Rose, James B Wade, Jasmohan S Bajaj
Hepatic encephalopathy (HE) is a major cause of morbidity in cirrhosis. However its severity assessment is often subjective, which needs to be studied systematically. AIM: To determine how accurately trainee and non-trainee practitioners grade and manage HE patients throughout its severity. METHODS: We performed a survey study using standardized simulated patient videos at 4 US and 3 Canadian centers. Participants were trainees (gastroenterology/hepatology fellows) and non-trainees (faculty, nurse practitioners, physician assistants)...
February 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29446765/gut-microbiota-based-therapies-for-irritable-bowel-syndrome
#15
Emily K Stern, Darren M Brenner
Irritable bowel syndrome (IBS) is a common, heterogeneous disorder characterized by abdominal pain associated with changes in bowel habits. The pathogenesis of IBS is multifactorial and may relate to alterations in the gut microbiota, changes in visceral sensation and motility, and genetic and environmental factors. Administration of systemic antibiotics may increase the risk of IBS by altering gastrointestinal homeostasis. Therapeutic interventions for IBS with diarrhea that are thought to target alterations in the gut microbiota include the nonsystemic antibiotic rifaximin, the medical food serum-derived bovine immunoglobulin, prebiotics, probiotics, and dietary modification...
February 15, 2018: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/29436337/rifaximin-reduces-markers-of-inflammation-and-bacterial-16s-rrna-in-zambian-adults-with-hepatosplenic-schistosomiasis-a-randomized-control-trial
#16
Edford Sinkala, Kanekwa Zyambo, Ellen Besa, Patrick Kaonga, Bright Nsokolo, Violet Kayamba, Michael Vinikoor, Rabison Zulu, Martin Bwalya, Graham R Foster, Paul Kelly
Cirrhosis is the dominant cause of portal hypertension globally but may be overshadowed by hepatosplenic schistosomiasis (HSS) in the tropics. In Zambia, schistosomiasis seroprevalence can reach 88% in endemic areas. Bacterial translocation (BT) drives portal hypertension in cirrhosis contributing to mortality but remains unexplored in HSS. Rifaximin, a non-absorbable antibiotic may reduce BT. We aimed to explore the influence of rifaximin on BT, inflammation, and fibrosis in HSS. In this phase II open-label trial (ISRCTN67590499), 186 patients with HSS in Zambia were evaluated and 85 were randomized to standard care with or without rifaximin for 42 days...
February 12, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29417604/effects-of-alcohol-on-the-brain-in-cirrhosis-beyond-hepatic-encephalopathy
#17
Brian C Davis, Jasmohan S Bajaj
Recent advances have led to a greater understanding of how alcohol alters the brain, both in acute stages (intoxication and alcohol withdrawal) and in chronic misuse. This review focuses on the current understanding of how alcohol affects the brain in cirrhosis patients with and without hepatic encephalopathy. Chronic alcohol use is associated with nutritional deficiencies, dementia, cirrhosis, and decompensating events such as hepatic encephalopathy. Direct toxicity on brain tissue, induction of neuro-inflammation, and alcohol's alterations of the gut microbiome are possible mechanisms for the clinical features of hepatic encephalopathy associated with alcohol use...
February 8, 2018: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/29411990/diagnosis-and-management-of-hepatic-encephalopathy
#18
Debbie L Shawcross
Overt and covert hepatic encephalopathy (HE) are debilitating complications of cirrhosis. HE results in a poor quality of life for patients and their caregivers and, unless there is access to liver transplantation, the prognosis is poor. The development of overt HE is often unpredictable, and its management, particularly in the ward, remains challenging. There is an urgent need for novel approaches to treat HE. Until recently, therapies for this complication were disappointing, with frequently intolerable side effects such as diarrhoea and faecal incontinence...
February 7, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29410518/rifaximin-decreases-virulence-of-crohn-s-disease-associated-escherichia-coli-and-epithelial-inflammatory-responses
#19
Belgin Dogan, Jing Fu, Shiying Zhang, Ellen J Scherl, Kenneth W Simpson
Escherichia coli with an adherent and invasive pathotype (AIEC) is implicated in the pathogenesis of Crohn's disease (CD). Rifaximin improves symptoms in mild-to-moderate CD. It is unclear if this outcome is due to its effects on bacteria or intestinal epithelial inflammatory responses. We examined the effects of rifaximin on the growth and virulence of CD-associated E. coli and intestinal epithelial inflammatory responses. Seven well-characterized CD-associated E. coli strains (six AIEC, one non-AIEC; four rifaximin-resistant, three sensitive) were evaluated...
February 6, 2018: Journal of Antibiotics
https://www.readbyqxmd.com/read/29408226/prevalence-genetic-relatedness-and-antibiotic-resistance-of-hospital-acquired-clostridium-difficile-pcr-ribotype-018-strains
#20
Mi-Ran Seo, Jieun Kim, Yangsoon Lee, Dong-Gyun Lim, Hyunjoo Pai
Clostridium difficile infection (CDI) is a major healthcare-associated infection. Aim of this study was to investigate the genetic relatedness of the endemic C. difficile PCR ribotype 018 strains in an institution and changes to their characteristics during five-year period. A total of 207 isolates obtained from inpatients at Hanyang University Hospital from 2009 to 2013 were analyzed using multilocus variable-number tandem-repeat analysis (MLVA). Minimum inhibitory concentrations (MICs) of several antibiotics were determined...
February 2, 2018: International Journal of Antimicrobial Agents
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