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https://www.readbyqxmd.com/read/28821482/hypersegmented-neutrophils-and-oval-macrocytes-in-the-setting-of-b12-deficiency-and-pancytopaenia
#1
Sean James Farrelly, Kieran Anthony O'Connor
Vitamin B12 deficiency is a recognised pathology in several populations, with a particular prevalence in an older adult population. We present two cases whereby vitamin B12 deficiency is the causative factor in marked pancytopaenia. Oval macrocytosis and hypersegmented neutrophils were noted on both peripheral blood samples, which are a characteristic finding in macrocytic anaemia due to B12 deficiency. Distinct underlying pathologies were identified in both cases; food-cobalamin malabsorption and pernicious anaemia...
August 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28817113/clinical-and-histologic-mimickers-of-celiac-disease
#2
REVIEW
Amrit K Kamboj, Amy S Oxentenko
Celiac disease is an autoimmune disorder of the small bowel, classically associated with diarrhea, abdominal pain, and malabsorption. The diagnosis of celiac disease is made when there are compatible clinical features, supportive serologic markers, representative histology from the small bowel, and response to a gluten-free diet. Histologic findings associated with celiac disease include intraepithelial lymphocytosis, crypt hyperplasia, villous atrophy, and a chronic inflammatory cell infiltrate in the lamina propria...
August 17, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28814218/diagnosis-and-management-of-pancreatic-exocrine-insufficiency
#3
Mehrdad Nikfarjam, Jeremy S Wilson, Ross C Smith
In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food...
August 21, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28807538/lactose-malabsorption-and-taste-aversion-learning
#4
Joe Arthurs, Jian-You Lin, Roberto Ocampo, Steve Reilly
Consumption of foods can be suppressed by two feeding system defense mechanisms: conditioned taste aversion (CTA) or taste avoidance learning (TAL). There is a debate in the literature about which form of intake suppression is caused by various aversive stimuli. For instance, illness-inducing stimuli like lithium chloride are the gold standard for producing CTA and external (or peripheral) painful stimuli, such as footshock, are the traditional model of TAL. The distinction between CTA and TAL, which have identical effects on intake, is based on differential effects on palatability...
August 11, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28803707/patients-reasons-for-and-against-undergoing-roux-en-y-gastric-bypass-adjustable-gastric-banding-and-vertical-sleeve-gastrectomy
#5
Melissa Opozda, Gary Wittert, Anna Chur-Hansen
BACKGROUND: The most common bariatric procedures, Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (LAGB), and sleeve gastrectomy (SG), generally induce significant weight loss and health improvements. However, little is known about how patients decide which procedure to undergo. OBJECTIVE: Investigate patients' reasons for and against undergoing RYGB, LAGB, and SG. SETTING: Online questionnaire. METHODS: Data were analyzed from 236 Australian adults with current RYGB (15...
July 15, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28797308/coeliac-disease-in-infants-antibodies-to-deamidated-gliadin-peptide-come-first
#6
Michele Arigliani, Francesca Rech Morassutti, Martina Fabris, Paola Melli, Elio Tonutti, Paola Cogo
BACKGROUND: The onset of coeliac disease (CD) in the first year of life is uncommon and the diagnosis can be challenging due to the suboptimal sensitivity of tissue transglutaminase antibodies (tTG) at this age and the many other possible causes of malabsorption in infants. Antibodies to deamidated gliadin peptides (anti-DGPs), especially IgG, may appear earlier than IgA anti-tTG in very young children with CD. CASE PRESENTATION: We report here on an 8-month-old child who was evaluated for failure to thrive, constipation and developmental delay...
August 10, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28795875/animal-models-for-studying-epithelial-barriers-in-neonatal-necrotizing-enterocolitis-inflammatory-bowel-disease-and-colorectal-cancer
#7
Tiaosi Xing, Rolando Camacho Salazar, Yan-Hua Chen
The intestinal epithelial cells line the luminal surface of the entire gastrointestinal tract which is crucial for the absorption of nutrients and prevention of pathogens entering from the external environment. The epithelial barrier plays an important role in organ development, disease pathogenesis, and aging. The major component of an epithelial barrier is the single columnar epithelium and tight junctions. Tight junctions are located at the most apical region of the junctional complex and contain many integral membrane proteins, such as occludin, the claudin family, and junctional adhesion molecules (JAMs)...
July 20, 2017: Tissue Barriers
https://www.readbyqxmd.com/read/28780880/-vitamin-d-metabolism-and-osteoporosis-in-systemic-sclerosis
#8
Szilvia Szamosi, Ágnes Horváth, Zoltán Szekanecz, Gabriella Szűcs
In the past few years more and more data have become available on the important role of vitamin D in immunological processes and inflammation. The role of vitamin D deficiency in the pathogenesis as well as in disease progression of different autoimmune and inflammatory conditions is suspected. Vitamin D deficiency is prevalent in several autoimmune diseases, including systemic sclerosis. Hypovitaminosis has been found to be associated with low bone mineral density and higher prevalence of osteoporosis in this group of patients...
August 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28780310/outcome-of-neonates-with-gastroschisis-at-different-gestational-ages-using-a-national-database
#9
Ruby Gupta, Erwin T Cabacungan
BACKGROUND/PURPOSE: The optimal time for delivery of neonates with a prenatal diagnosis of gastroschisis (GS) is controversial. We compared the outcomes for GS at three different gestational ages (GAs), 33-34 weeks, 35-36 weeks, and ≥ 37 weeks. METHODS: We analyze hospital discharge data of neonates with GS using the 2006, 2009 and 2012 Healthcare Cost and Utilization Project Kids' Inpatient Database (HCUPKIDS). Multivariable analysis was used to compare the association between GS outcomes and the three GAs...
July 22, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28776152/glucose-metabolism-parameters-and-post-prandial-glp-1-and-glp-2-release-largely-vary-in-several-distinct-situations-a-controlled-comparison-among-individuals-with-crohn-s-disease-and-individuals-with-obesity-before-and-after-bariatric-surgery
#10
Daniéla Oliveira Magro, Everton Cazzo, Paulo Gustavo Kotze, Ana Carolina Junqueira Vasques, Carlos Augusto Real Martinez, Elinton Adami Chaim, Bruno Geloneze, José Carlos Pareja, Cláudio Saddy Rodrigues Coy
BACKGROUND: This study aims to compare the post-prandial curves of glucose, insulin, GLP-1, and GLP-2 among individuals with Crohn's disease (CD), obese individuals before and after bariatric surgery, and healthy controls. METHODS: This an exploratory cross-sectional study that involved five groups of patients (two groups of individuals with CD-active and inactive), bariatric patients (pre- and post-surgery, who were their own controls), and a distinct separated control group of healthy volunteers...
August 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28771242/pancreatic-and-intestinal-function-post-roux-en-y-gastric-bypass-surgery-for-obesity
#11
Stephen J D O'Keefe, Tina Rakitt, Junhai Ou, Ihab I El Hajj, Elizabeth Blaney, Kishore Vipperla, Jens-Jules Holst, Jens Rehlfeld
OBJECTIVES: Despite the fact that the most effective treatment for morbid obesity today is gastric bypass surgery, some patients develop life-threatening nutritional complications associated with their weight loss. METHODS: Here we examine the influence of the altered anatomy and digestive physiology on pancreatic secretion and fat absorption. Thirteen post Roux-en-Y gastric bypass (RYGB) patients who had lost >100 lbs in the first year following surgery and who gave variable histories of gastrointestinal (GI) dysfunction, were selected for study...
August 3, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28770185/intensive-nutrition-management-in-a-patient-with-short-bowel-syndrome-who-underwent-bariatric-surgery
#12
MeeRa Kweon, Dal Lae Ju, Misun Park, JiHyeong Choe, Yun-Suhk Suh, Eun-Mi Seol, Hyuk-Joon Lee
Many individuals with short bowel syndrome (SBS) require long-term parenteral nutrition (PN) to maintain adequate nutritional status. Herein, we report a successful intestinal adaptation of a patient with SBS through 13 times intensive nutritional support team (NST) managements. A thirty-five-year-old woman who could not eat due to intestinal discontinuity visited Seoul National University Hospital for reconstruction of the bowel. She received laparoscopic Roux-en-Y gastric bypass (RYGB) due to morbid obesity in Jan 2013 at a certain hospital and successfully reduced her weight from 110 kg to 68 kg...
July 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28768655/the-use-of-metabolic-balance-studies-in-the-objective-discrimination-between-intestinal-insufficiency-and-intestinal-failure
#13
August P Prahm, Christopher F Brandt, Carsten Askov-Hansen, Per B Mortensen, Palle B Jeppesen
Background: In research settings that use metabolic balance studies (MBSs) of stable adult patients with short bowel syndrome, intestinal failure (IF) and dependence on parenteral support (PS) have been defined objectively as energy absorption <84% of calculated basal metabolic rate (BMR), wet weight (WW) absorption <23 g · kg body weight(-1) · d(-1), or both. Objective: This study aimed to explore and validate these borderlines in the clinical setting.Design: Intestinal absorption was measured from April 2003 to March 2015 in 175 consecutive patients with intestinal insufficiency (INS) in 96-h MBSs...
August 2, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28767558/liver-function-in-patients-with-nonalcoholic-fatty-liver-disease-randomized-to-roux-en-y-gastric-bypass-versus-sleeve-gastrectomy-a-secondary-analysis-of-a-randomized-clinical-trial
#14
Piotr Kalinowski, Rafał Paluszkiewicz, Bogna Ziarkiewicz-Wróblewska, Tadeusz Wróblewski, Piotr Remiszewski, Mariusz Grodzicki, Marek Krawczyk
OBJECTIVES: The aim of the study was to compare the influence of sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB) on liver function in bariatric patients with non-alcoholic fatty liver disease (NAFLD) in a randomized clinical trial (NCT01806506). BACKGROUND: Rapid weight loss and malabsorption after bariatric surgery in patients with NAFLD or steatohepatitis (NASH) may impair liver function. METHODS: Sixty-six morbidly obese patients randomized to SG or RYGB were included in a secondary outcome analysis...
August 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28766554/campylobacter-jejuni-impairs-sodium-transport-and-epithelial-barrier-function-via-cytokine-release-in-human-colon
#15
R Bücker, S M Krug, V Moos, C Bojarski, M R Schweiger, M Kerick, A Fromm, S Janßen, M Fromm, N A Hering, B Siegmund, T Schneider, C Barmeyer, J D Schulzke
Campylobacter jejuni is the most prevalent cause of foodborne bacterial enteritis worldwide. Patients present with diarrhea and immune responses lead to complications like arthritis and irritable bowel syndrome. Although studies exist in animal and cell models, we aimed at a functional and structural characterization of intestinal dysfunction and the involved regulatory mechanisms in human colon. First, in patients' colonic biopsies, sodium malabsorption was identified as an important diarrheal mechanism resulting from hampered epithelial ion transport via impaired epithelial sodium channel (ENaC) β- and γ-subunit...
August 2, 2017: Mucosal Immunology
https://www.readbyqxmd.com/read/28766267/iodine-status-after-bariatric-surgery-a-prospective-10-year-report-from-the-swedish-obese-subjects-sos-study
#16
Sofia Manousou, Lena M S Carlsson, Robert Eggertsen, Lena Hulthén, Peter Jacobson, Kerstin Landin-Wilhelmsen, Penelope Trimpou, Per-Arne Svensson, Helena Filipsson Nyström
CONTEXT: Bariatric surgery can lead to nutrient deficiencies. Gastric by-pass (GBP) entails restriction and malabsorption, whereas, vertical banded gastroplasty (VBG) is only restrictive. OBJECTIVE: The objective of this study is to study whether GBP-patients develop iodine deficiency from malabsorption, and if GBP- and VBG-patients develop lower 24-h urinary iodine excretion (24-UIE) than obese non-operated controls (OB-controls) due to lower iodine intake. DESIGN: The Swedish Obese Subjects (SOS) study is a prospective, non-randomized study of 4047 obese patients included 1987-2001, who chose bariatric surgery or non-surgical treatment...
August 2, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28765690/diarrhea-after-bariatric-procedures-diagnosis-and-therapy
#17
REVIEW
Yves M Borbély, Alice Osterwalder, Dino Kröll, Philipp C Nett, Roman A Inglin
Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28761572/a-case-of-severe-iron-deficiency-anemia-associated-with-long-term-proton-pump-inhibitor-use
#18
REVIEW
David N Dado, Erin B Loesch, Sudha P Jaganathan
The use of proton pump inhibitors (PPIs) in the treatment of gastrointestinal diseases has evolved over recent years. Initially intended for short-term use, PPIs are increasingly being used, often inappropriately, as long-term maintenance medications. The mechanism of action of PPIs is suppression of gastric basal and stimulated acid secretion by inhibiting the parietal cell H(+)/K(+) ATP pump with a resultant increase in gastric pH and hypo- or achlorhydria. Although short-term use is related to few adverse effects, long-term use is associated with numerous complications...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/28760445/coeliac-disease
#19
REVIEW
Benjamin Lebwohl, David S Sanders, Peter H R Green
Coeliac disease occurs in about 1% of people in most populations. Diagnosis rates are increasing, and this seems to be due to a true rise in incidence rather than increased awareness and detection. Coeliac disease develops in genetically susceptible individuals who, in response to unknown environmental factors, develop an immune response that is subsequently triggered by the ingestion of gluten. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentations...
July 28, 2017: Lancet
https://www.readbyqxmd.com/read/28760109/bariatric-surgery-in-adolescents-is-routine-nutrient-supplementation-sufficient-to-avoid-anemia-following-bariatric-surgery
#20
Hanna R Goldberg, Vivian L Chin, Jeffrey L Zitsman, Chengchen Zhang, Kristen M Williams, Sharon Oberfield, Ilene Fennoy
BACKGROUND: Anemia following bariatric surgery is a known complication. To prevent nutrient deficiencies, adolescents require multivitamin/mineral supplementation following bariatric surgery. The purpose of this study was to investigate if routine multivitamin/mineral supplementation is sufficient to prevent anemia in adolescents undergoing bariatric surgery, particularly sleeve gastrectomy (SG), a procedure that may induce nutrient malabsorption. METHODS: We conducted a retrospective review of pediatric patients who underwent SG (34 patients) and laparoscopic adjustable gastric banding (LAGB) (141 patients) (January 2006 through December 2013)...
August 2017: Nutrition in Clinical Practice
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