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Gastrointestinal complication AND transplantation

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https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#1
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29092871/heart-transplant-outcomes-in-patients-with-pretransplant-diabetes-mellitus
#2
Anne Jalowiec, Kathleen L Grady, Connie White-Williams
BACKGROUND: Findings on outcomes of heart transplant patients who had diabetes mellitus before transplant are conflicting. OBJECTIVE: To compare survival, hospitalization, and complications in heart transplant recipients during the first 3 years after surgery in recipients with or without diabetes mellitus before transplant. METHODS: Of 347 recipients, 64 were diabetic (35.9% taking insulin; mean age 56 years; 17.2% females; 12.5% minorities) and 283 were not (mean age 51 years; 20...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29073801/management-of-gastrointestinal-complications-in-hereditary-transthyretin-amyloidosis-a-single-center-experience-over-40-years
#3
Jonas Wixner, Ole B Suhr, Intissar Anan
Hereditary transthyretin amyloidosis (ATTRm amyloidosis) is a rare disease caused by the deposition and accumulation of insoluble non-native transthyretin fibrils in the body. The disease inevitably results in widespread organ disruption, and poor life expectancy. The GI tract is one organ system vulnerable to disruption and, although the clinical presentation of the disease varies, GI involvement affects most patients with ATTRm amyloidosis. Areas covered: This article presents our experience with diagnosing and treating the GI symptoms of ATTRm amyloidosis patients at our center over the last 40 years, in the Swedish clustering area of the disease...
October 27, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29045348/choice-of-endoscopic-procedure-in-children-with-clinically-suspected-gastrointestinal-graft-versus-host-disease
#4
Thomas Mårtensson, Attila Szakos, Karin Mellgren, Jacek Toporski, Johan Arvidson, Thomas H Casswall, Britt Gustafsson
OBJECTIVES: Gastrointestinal graft-versus-host disease (GI-GVHD) is a potentially life-threatening complication after hematopoietic stem cell transplantation. Symptoms indicating GI-GVHD motivates endoscopy with biopsy sampling and histopathological confirmation. However, optimal extent of endoscopy in children is presently unknown. Therefore, we aimed to evaluate if biopsies from the rectosigmoid area versus the rest of the colon/ileocolon with or without biopsies from simultaneous upper endoscopy, were equally reliable for detection of GI-GVHD and relevant differential diagnoses...
October 17, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29018441/very-early-onset-inflammatory-manifestations-of-x-linked-chronic-granulomatous-disease
#5
Roxane Labrosse, Jane Abou-Diab, Annaliesse Blincoe, Guilhem Cros, Thuy Mai Luu, Colette Deslandres, Martha Dirks, Laura Fazilleau, Philippe Ovetchkine, Pierre Teira, Françoise LeDeist, Isabel Fernandez, Fabien Touzot, Helene Decaluwe, Ugur Halac, Elie Haddad
Chronic granulomatous disease (CGD) is a rare primary immune deficiency caused by mutations in genes coding for components of the nicotinamide adenine dinucleotide phosphate oxidase, characterized by severe and recurrent bacterial and fungal infections, together with inflammatory complications. Dysregulation of inflammatory responses are often present in this disease and may lead to granulomatous lesions, most often affecting the gastrointestinal (GI) and urinary tracts. Treatment of inflammatory complications usually includes corticosteroids, whereas antimicrobial prophylaxis is used for infection prevention...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28975509/short-term-follow-up-of-the-nutritional-status-of-children-with-fanconi-anemia-undergoing-hematopoietic-stem-cell-transplant
#6
Gisele Trennepohl da Costa Heinen, Daniella Schmit, Denise Johnsson Campos, Carmem Bonfim, Estela Iraci Rabito, Regina Maria Vilela
OBJECTIVE: The objective of this study was to evaluate the nutritional status of children diagnosed with Fanconi anemia (FA) during hematopoietic stem cell transplant (HSCT), comparing it with healthy children and children with other hematologic diseases. METHODS: Observational retrospective study was conducted with patients submitted to HSCT in a period of 5 years. We assessed anthropometric and biochemical data, food intake, and gastrointestinal complications in 49 FA patients...
October 3, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28951890/the-induction-of-oxalate-metabolism-in-vivo-is-more-effective-with-functional-microbial-communities-than-with-functional-microbial-species
#7
Aaron W Miller, Colin Dale, M Denise Dearing
For mammals, oxalate enters the body through the diet or is endogenously produced by the liver; it is removed by microbial oxalate metabolism in the gut and/or excretion in feces or urine. Deficiencies in any one of the these pathways can lead to complications, such as calcium oxalate urinary stones. While considerable research has been conducted on individual oxalate-degrading bacterial isolates, interactions between oxalate and the gut microbiota as a whole are unknown. We examined the reduction in oxalate excretion in a rat model following oral administration of fecal microbes from a mammalian herbivore adapted to a high oxalate diet or to fecal transplants consisting of two different formulations of mixed oxalate-degrading isolates...
September 2017: MSystems
https://www.readbyqxmd.com/read/28951581/acute-graft-versus-host-disease-of-the-gut-considerations-for-the-gastroenterologist
#8
REVIEW
Steven Naymagon, Leonard Naymagon, Serre-Yu Wong, Huaibin Mabel Ko, Anne Renteria, John Levine, Jean-Frederic Colombel, James Ferrara
Haematopoietic stem cell transplantation (HSCT) is central to the management of many haematological disorders. A frequent complication of HSCT is acute graft-versus-host disease (GVHD), a condition in which immune cells from the donor attack healthy recipient tissues. The gastrointestinal system is among the most common sites affected by acute GVHD, and severe manifestations of acute GVHD of the gut portends a poor prognosis in patients after HSCT. Acute GVHD of the gastrointestinal tract presents both diagnostic and therapeutic challenges...
September 27, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28914862/-liver-diseases-the-pathogenetic-role-of-the-gut-microbiome-and-the-potential-of-treatment-for-its-modulation
#9
K A Aitbaev, I T Murkamilov, V V Fomin
The paper gives an update on the role of the gut microbiome (GM) in the development of nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, alcoholic liver disease, liver cirrhosis (LC), and its complications, such as hepatic encephalopathy (HE) and hepatocellular carcinoma (HCC), and discusses the possibilities of its correction with prebiotics, probiotics, synbiotics, antibiotics, and fecal microbiota transplantation (FMT). The pathophysiology of the liver diseases in question demonstrates some common features that are characterized by pathogenic changes in the composition of the gastrointestinal tract microflora, by intestinal barrier impairments, by development of endotoxemia, by increased liver expression of proinflammatory factors, and by development of liver inflammation...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28838898/protocol-for-a-pilot-randomised-controlled-trial-of-metformin-in-pre-diabetes-after-kidney-transplantation-the-transplantation-and-diabetes-transdiab-study
#10
Basil Alnasrallah, Helen Pilmore, Paul Manley
INTRODUCTION: Post-transplant diabetes mellitus (PTDM) is a common complication of kidney transplantation and is associated with significant morbidity and mortality. In the general population, metformin has been used for diabetes prevention in high-risk individuals. Improving insulin sensitivity is one of many proven favourable effects of metformin. Despite the high incidence of PTDM in kidney transplant recipients, there is a lack of evidence for the role of metformin in the prevention of diabetes in this setting...
August 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28838432/autosomal-dominant-polycystic-kidney-disease-transplant-recipients-after-kidney-transplantation-a-single-center-experience
#11
L Illesy, D Á Kovács, R P Szabó, A B L Asztalos, B Nemes
Kidney transplantation is indicated for end-stage renal disease. Autosomal dominant polycystic kidney disease (ADPKD) causes structural degeneration of the kidney and eventually becomes end-stage renal disease. ADPKD patients usually have several renal and nonrenal complications. We analyzed our kidney transplantation activities between 1991 and 2010 regarding ADPKD. We followed up with patients to December 31, 2016. Data were collected as patient and graft survival rates, the prevalence of polycystic manifestation of the gastrointestinal tract and other organs, and the attendance of urinary tract infection...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28833332/pharmacotherapeutic-management-of-gastrointestinal-bleeding-in-patients-with-continuous-flow-left-ventricular-assist-devices
#12
REVIEW
Adam C Sieg, Jeremy D Moretz, Edward Horn, Douglas L Jennings
Continuous-flow left ventricular assist devices (CF-LVADs) have become an integral component of the management in patients with advanced heart failure, serving as destination therapy or as a bridge to heart transplantation. Despite significant advances in the design and longevity of the device, the ongoing risk for bleeding remains a significant concern. The genesis of gastrointestinal bleeding (GIB) in patients with CF-LVADs is likely multifactorial and may include components of acquired von Willebrand disease, angiodysplasia, and gastrointestinal arteriovenous malformations, as well as additional risk factors such as history of GIB and increased age...
August 22, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28804516/the-role-of-sebelipase-alfa-in-the-treatment-of-lysosomal-acid-lipase-deficiency
#13
REVIEW
Angelika L Erwin
Lysosomal acid lipase deficiency (LALD) is a lysosomal storage disorder (LSD) characterized either by infantile onset with fulminant clinical course and very poor prognosis or childhood/adult-onset disease with an attenuated phenotype. The disorder is often misdiagnosed or remains undiagnosed in children and adults due to a rather unspecific clinical presentation with dyslipidemia and steatohepatitis. Until recently, no good treatment options were available for LALD. Despite supportive and symptomatic therapies, death occurred before 1 year of age in patients with infantile-onset disease and patients with childhood/adult-onset LALD suffered from significant complications, such as liver cirrhosis, requiring liver transplantation and early-onset cardiovascular disease...
July 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28803487/a-mechanism-based-approach-to-management-of-children-with-end-stage-liver-disease
#14
Allah B Haafiz
Due to parallel advances in surgical and acute care disciplines, liver transplantation (LT) has revolutionized the outlook for children with end-stage liver disease (ESLD). Contrary to advances in technical aspects of LT and the peri-operative care, pre-transplant management of ESLD remains quite a formidable challenge. Areas covered: This review provides mechanisms based management strategies to address common complications of ESLD including malnutrition, amended metabolic pathways, gastrointestinal dysfunction, and development of ascites...
August 28, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28795840/a-complete-histologic-approach-to-gastrointestinal-biopsy-from-hematopoietic-stem-cell-transplant-patients-with-evidence-of-transplant-associated-gastrointestinal-thrombotic-microangiopathy
#15
REVIEW
Mikako Warren, Sonata Jodele, Christopher Dandoy, Kasiani C Myers, Gregory Wallace, Adam Nelson, Javier El-Bietar
CONTEXT: - Transplant-associated thrombotic microangiopathy is a serious complication of hematopoietic stem cell transplant that may progress to multi-organ dysfunction. Transplant-associated thrombotic microangiopathy may involve the intestinal vasculature (intestinal transplant-associated thrombotic microangiopathy [iTMA]), causing patients to experience debilitating symptoms of ischemic colitis, including disproportionately severe abdominal pain and gastrointestinal bleeding, requiring heavy narcotic use and frequent transfusion support...
November 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28753218/a-review-of-late-complications-of-allogeneic-hematopoietic-stem-cell-transplantations
#16
REVIEW
Erden Atilla, Pinar Ataca Atilla, Selami Kocak Toprak, Taner Demirer
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative treatment of different malignant and non-malignant diseases. Early transplant-related mortality after allo-HSCT has decreased with reduced-intensity conditioning regimens and effective anti-infectious treatments, but late transplant-related mortality is still a problem. Physicians are now paying more attention to late complications that may worsen the quality of life of many transplant recipients. Chronic graft versus host disease (cGVHD) is one of the major causes of late transplant-related mortality after allo-HSCT...
July 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28744150/radiofrequency-ablation-using-barrx-%C3%A2-for-the-endoscopic-treatment-of-gastric-antral-vascular-ectasia-a-series-of-three-cases-and-a-review-of-the-literature-on-treatment-options
#17
Anish Patel, Sunil Patel, Prasanna C Wickremesinghe, Deepak Vadada
Gastric antral vascular ectasia (GAVE), also known as "watermelon stomach", is an uncommon condition, which can cause gastrointestinal bleeding due to rupture of blood vessels that line the stomach. The pathogenesis of GAVE remains unclear; however it is thought that hemodynamic changes, mechanical stress, and autoimmune factors all have a part to play. A range of conditions are also commonly associated with the syndrome, such as portal hypertensive gastropathy, liver cirrhosis, and autoimmune disorders. Less commonly, chronic renal failure, cardiac diseases, and bone marrow transplantation have coexisted with GAVE...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28711168/surgical-treatment-of-intestinal-complications-of-graft-versus-host-disease-in-the-pediatric-population-case-series-and-review-of-literature
#18
REVIEW
Camille A Gutierrez, Mehul V Raval, Hannah R Vester, Sonali Chaudhury, Daniel von Allmen, David H Rothstein
BACKGROUND/PURPOSE: Intestinal complications of acute graft-versus-host disease (aGVHD) include hemorrhage and perforation in the short-term, and stricture with bowel obstruction in the long-term. As medical management of severe aGVHD has improved, more patients are surviving even advanced stages of intestinal aGVHD. This review summarizes the available pediatric literature on surgical treatment of complications of intestinal GVHD. METHODS: A systematic review was performed using PubMed, Cochrane, Embase, and Scopus databases...
November 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28688917/real-world-economic-burden-associated-with-transplantation-related-complications
#19
Miguel-Angel Perales, Machaon Bonafede, Qian Cai, Phillip M Garfin, Donna McMorrow, Neil C Josephson, Akshara Richhariya
Approximately 20,000 hematopoietic cell transplantation (HCT) procedures are performed annually in the United States. Real-world data on the costs associated with post-transplantation complications are limited. Patients with hematologic malignancies aged ≥18 years undergoing autologous HCT (auto-HCT) or allogeneic HCT (allo-HCT) between January 1, 2011, and June 30, 2014, were identified in the Truven Health MarketScan Research Databases. Patients were required to have 12 months of continuous medical and pharmacy enrollment before and after HCT; patients who experience inpatient death within 12 months post-HCT were also included...
October 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28688097/b-lymphocyte-chemoattractant-cxcl13-is-an-indicator-of-acute-gastrointestinal-gvhd-in-murine-model
#20
Yigeng Cao, Xiaoyi Qin, Na Wang, Erlie Jiang, Mingzhe Han, Yongyong Ma, Bin Liang, Kaiyan Yang, Kang Yu, Haige Ye
Gastrointestinal acute graft-vs.-host disease (GI aGVHD) remains a significant obstacle to the success of allogeneic hematopoietic cell transplantation and is a major cause of morbidity and mortality. In addition, GI aGVHD is often clinically indistinguishable from other causes of GI dysfunction such as conditioning regimen toxicity, infections, or medications, which complicates the diagnosis. Thus, specific biomarkers are needed to help improve diagnosis and obtain a deeper understanding of the cytokine changes in GI aGVHD...
July 7, 2017: Inflammation
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