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current gastroenterology

Wolfgang Miehsler, Clemens Dejaco, Hans-Peter Gröchenig, Harry Fuchssteiner, Christoph Högenauer, Lili Kazemi-Shirazi, Harald Maier, Andreas Mayer, Alexander Moschen, Walter Reinisch, Wolfgang Petritsch, Reingard Platzer, Pius Steiner, Herbert Tilg, Harald Vogelsang, Heimo Wenzl, Gottfried Novacek
Anti-TNFα-antibodies have revolutionized the therapy of inflammatory bowel diseases and other immune-mediated inflammatory diseases. Due to the increasing application of these substances, the Working Group of Inflammatory Bowel Diseases of the Austrian Association of Gastroenterology and Hepatology intended to update their consensus report on the safe use of Infliximab (published in 2010) and to enlarge its scope to cover all anti-TNFα-antibodies. The present consensus report summarizes the current evidence on the safe use of anti-TNFα-antibodies and covers the following topics: general risk of infection, bacterial infections (i...
March 2018: Zeitschrift Für Gastroenterologie
Ziad Bakouny, Fares Yared, Elie El Rassy, Rita Jabbour, Rachel Hallit, Nathalie Khoury, Khalil Honein, Joseph Bou Jaoude
INTRODUCTION: There is a lack of studies on the optimal anti-tumor necrosis factor (anti-TNF) agent for postoperative prophylaxis of Crohn's disease (CD) recurrence. Therefore, we conducted a network meta-analysis (NMA) of prospective trials to compare the efficacy of anti-TNF agents in the prevention of postoperative endoscopic and clinical recurrence of CD following ileocolonic resection. METHODS: We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and recent American gastroenterology association (AGA) meeting abstracts through August 2017...
March 6, 2018: Journal of Clinical Gastroenterology
Roberta Barachetti, Elisabetta Villa, Mario Barbarini
The introduction of solid food is necessary for any infant in order to provide adequate nutrition because when they grow up milk is insufficient for their nutritional needs. Infants born preterm have increased nutritional requirements. The high nutrient demands as well as the organ immaturity of preterm infants combine to render it difficult to achieve dietary intakes that will allow preterm infants to match their in utero growth rates. Current guidelines for the introduction of solid food to term infants cannot be directly translated to preterm infants...
December 22, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
Andrea Brusaferro, Edoardo Farinelli, Letizia Zenzeri, Rita Cozzali, Susanna Esposito
Recurrent abdominal pain (RAP) is one of the most common health complaints in both children and adults. Although RAP is considered a functional disorder rather than an organic disease, affected children and their families can still experience anxiety and concerns that can interfere with school, sports, and regular daily activities and lead to frequent attendances at pediatric emergency departments or pediatric gastroenterology clinics. Our review shows experts do not agree on a universally proven management that will work on every child presenting with functional abdominal pain (FAP)...
March 2, 2018: Paediatric Drugs
Heather A Long, Lauren Solski, Jill A Rebuck, Colin Bridgeman
OBJECTIVES: Recent guidelines defined and differentiated the management of gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD). The guidelines recommend against using empiric acid suppression therapy for infantile GER. The primary objective of this study was to assess inpatient guideline adherence regarding management of infantile GER through the perspective of pharmacists. Secondary objectives included assessing pharmacist comfort level with differentiation between GER and GERD, observing current trends in practice relating to the primary objective, and determining the availability of institution-specific guidelines that address the management of infantile GER...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Aodhnait S Fahy, Christopher R Moir
Colorectal adenomatous polyposis syndromes encompass a diverse group of disorders with varying modes of inheritance and penetrance. Children may present with overt disease or within screening programs for families at high risk. We provide an overview of the array of pediatric polyposis syndromes, current screening recommendations, and surgical indications and technical considerations. Optimal disease management for these pediatric patients is still evolving and has implications for screening, surveillance, pediatric surgical management, and transition of care gastroenterologic neoplasia physicians and surgeons...
March 2018: Clinics in Colon and Rectal Surgery
Eric H Rosenfeld, Richard Sola, Yangyang Yu, Shawn D St Peter, Sohail R Shah
PURPOSE: To review current management and outcomes of ingested batteries and develop a clinical management algorithm. METHODS: Children <18years old who ingested a battery between 1/2011 and 9/2016 at two tertiary care children's hospitals were reviewed. Demographics, imaging, management and outcomes were analyzed using descriptive statistics, Chi-square and Wilcoxon Rank-sum tests. RESULTS: There were 180 battery ingestions. The median age was 3...
February 2, 2018: Journal of Pediatric Surgery
Anton R Lord, Lisa A Simms, Allison Brown, Katherine Hanigan, Krupa Krishnaprasad, Belinda Schouten, Anthony R Croft, Mark N Appleyard, Graham L Radford-Smith
BACKGROUND: Gastroenterology Departments at hospitals within Australia receive thousands of General Practitioner (GP)-referral letters for gastrointestinal investigations every month. Many of these requests are for colonoscopy. This study aims to evaluate the performance of the current symptoms-based triage system compared to a novel risk score using objective markers. METHODS: Patients with lower abdominal symptoms referred by their GPs and triaged by a Gastroenterology consultant to a colonoscopy consent clinic were recruited into the study...
February 27, 2018: BMC Cancer
V Kalliakmanis, I Perysinakis, K Koutsouvas, P Karras, E Margaris, C Angelakis
Intussusception is a rare cause of intestinal obstruction in adults and represents a diagnostic challenge for the surgeon. In the majority of cases, presenting symptoms are not specific, making preoperative diagnosis difficult. Several medical conditions may cause intestinal intussusception. We present the case of a 16-year-old female patient with intussusception due to a hamartomatous Peutz-Jeghers type polyp. This is an extremely rare case in which the first manifestation of the intestinal polyp was jejunojejunal intussusception very close to the duodenojejunal junction, with a necrotic intussusceptum about 50 cm long...
February 27, 2018: Annals of the Royal College of Surgeons of England
Matthew James Lee, Steven R Brown, Nicola S Fearnhead, Ailsa Hart, Alan J Lobo
Objective: Fistulating perianal Crohn's disease represents a significant challenge to both clinicians and patients. This survey set out to describe current practice and variation in the medical management of this condition. Design: A survey was designed by an expert group of gastroenterologists and surgeons with an inflammatory bowel disease (IBD) interest. The questionnaire aimed to capture opinions from consultant gastroenterologists with a UK practice on the management of acutely symptomatic fistula, assessment of a new fistula presentation, medical management strategies and surgical intervention...
January 2018: Frontline Gastroenterology
Diego Andrés Rodríguez Lugo, Jorge Julián Coronado Tovar, Giovana Alejandra Solano Villamarin, Wiliam Otero Regino
Primary biliary cholangitis (PBC) is a chronic autoimmune cholangiopathy characterized by a selective destruction of biliary epithelial cells of small and medium caliber hepatic ducts, which mainly affects women. The main symptoms are fatigue and pruritus, however, a large proportion of patients may be asymptomatic. The diagnosis is based on AMA titers >1:40, alkaline phosphatase >1.5 times the upper limit for more than 24 weeks and compatible liver histology. It is associated with multiple autoimmune diseases mainly extrahepatic, thyroid diseases, bone diseases, among others...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Agata Skórka, Małgorzata Pieścik-Lech, Maciej Kołodziej, Hania Szajewska
In 2011, the Committee on Nutrition of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition systematically reviewed published evidence related to the safety and health effects of the administration of formulae supplemented with pro- and/or prebiotics compared with unsupplemented formulae. We updated evidence on the effects of the administration of prebiotic-supplemented infant formulae (IF) compared with unsupplemented IF. Five databases were searched up to March 2017 for randomised controlled trials...
February 19, 2018: British Journal of Nutrition
John W Wiley, Lin Chang
Articles appearing in Gastroenterology have played an integral role in the evolution of our understanding of Functional Bowel Disorders (FBD), including Irritable Bowel Syndrome (IBS), beginning with the prescient contributions of Almy and Tulin in 1947 and 1949 that highlighted the role of stress to enhance perception of abdominal pain and promote colon contractions. Subsequent publications have codified diagnostic criteria and stratified subpopulations of FBD (Manning and ROME I-IV), which resulted in improved symptom-based therapeutic interventions...
February 15, 2018: Gastroenterology
Stefan Fritz, Regina Küper-Steffen, Katharina Feilhauer, Christoph M Sommer, Götz M Richter, René Hennig, Jörg Köninger
RATIONALE: Intraductal papillary mucinous neoplasms of the pancreas (IPMNs) are benign cystic tumors with a relevant risk of malignant transformation over time. Currently, follow-up after surgical resection of benign IPMNs remains controversial. PATIENT CONCERNS: This is a case report of a 68-year-old male who underwent pancreatic head resection for a multicystic side-branch IPMN with low-grade epithelial dysplasia in March 2009 at the Katharinenhospital Stuttgart, Germany...
February 2018: Medicine (Baltimore)
Alexander Niecke, Hanna Lemke, Tobias Goeser, Martin Hellmich, Frank Vitinius, Christian Albus
BACKGROUND: In the field of gastroenterology and hepatology, associations and interactions with comorbid mental disorders are often described, but there is currently a lack of methodologically high-quality studies on prevalence and the need for care. The aim of the study was to take account of this shortcoming. METHODS: Prospective, monocentric, cross-sectional study of a representative sample of inpatients at a university hospital. A total of 308 participants were examined for the presence of 8 frequent psychological syndromes with a validated questionnaire (PHQ-D)...
February 13, 2018: Psychotherapie, Psychosomatik, Medizinische Psychologie
Jose Manuel Mella, Estanislao Jesús Gómez, Mariana Omodeo, Matias Manzotti, Mariela Roel, Lisandro Pereyra, Carolina Fischer, Nicolás Panigadi, Raquel González, Pablo Luna, Silvia Cecilia Pedreira, Daniel Gustavo Cimmino, Luis Alberto Boerr
BACKGROUND: Most pancreatic cysts (PCs) found incidentally by CT and MRI scans might not be clinically important according to the Fukuoka guidelines, the American Gastroenterological Association (AGA) guidelines and European guidelines. AIMS: To determine and compare the prevalence of incidental clinically important PCs (CIPCs). METHODS: Abdominal contrast-enhanced CT or MRI scans performed during a one-year period were retrospectively reviewed to identify incidental PCs...
February 8, 2018: Gastroenterología y Hepatología
Seri Hong, Mina Suh, Kui Son Choi, Boyoung Park, Jae Myung Cha, Hyun-Soo Kim, Jae Kwan Jun, Dong Soo Han
Background/Aims: People around the world are increasingly choosing to undergo colorectal cancer screening via colonoscopy. As a result, guideline adherence to postpolypectomy colonoscopy surveillance has drawn increasing attention. The present study was performed to assess recognition and adherence to guidelines among primary care physicians and gastroenterologists and to identify characteristics associated with compliance. Methods: A nationwide sample of primary care physicians employed at cancer screening facilities and registered members of the Korean Society of Gastrointestinal Endoscopy were recruited...
February 13, 2018: Gut and Liver
Fahrettin Haczeyni, Matthew M Yeh, George N Ioannou, Isabelle A Leclercq, Robert Goldin, Yock Young Dan, Jun Yu, Narcissus C Teoh, Geoffrey C Farrell
Nonalcoholic steatohepatitis (NASH) is strongly associated with overnutrition, insulin resistance, and predisposition to type 2 diabetes. To critically analyze the translational significance of currently-used animal models of NASH, we reviewed articles published during the last three years that studied NASH pathogenesis using mouse models. Among 146 articles, 34 (23%) used models in which overnutrition was reported, and 36 (25%) demonstrated insulin resistance, with or without glucose intolerance. Half the articles contained no information on whether mice exhibited overnutrition or insulin resistance...
February 9, 2018: Journal of Gastroenterology and Hepatology
Sarah M Ordway, Manish B Singla, Patrick E Young, Rohit Satoskar, Ryan M Kwok
Despite an unmet need for hepatologists in the United States, every year transplant hepatology (TH) fellowship positions remain unfilled. To address this, we investigated factors that influence trainee decisions about pursuing a career in hepatology. We invited current gastroenterology (GI) and TH fellows from all Accreditation Council for Graduate Medical Education-accredited programs for the academic year 2014-2015 to participate in an online survey about factors influencing decisions to train in hepatology...
June 2017: Hepatology Communications
Austin Jorski, Jared Scott, Trace Heavener, Matt Vassar
AIM: The objective of this study was to evaluate the current recommendations and requirements of gastroenterology and hepatology journals concerning reporting guidelines and clinical trial registration. Current research on the topic is sparse and in need of further research in both clinical trial registration and guideline adherence. METHODS: The authors performed a review of journal protocols and 'Instructions for Authors' regarding guideline adherence and trial registration requirements within 30 gastroenterology and hepatology journals...
January 22, 2018: International Journal of Evidence-based Healthcare
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