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nature reviews gastroenterology

Andrea Z Ali-Panzarella, Tamika J Bryant, Hannah Marcovitch, Jeffery D Lewis
PURPOSE OF REVIEW: We highlight the need for a multidisciplinary approach to the diagnosis of medical child abuse, also known as factitious disorder imposed on another (FDIA) or Munchausen syndrome by proxy (MSP), and review our experience focusing on the variety of symptoms that often present to the pediatric gastroenterologist many months before the diagnosis is made. RECENT FINDINGS: Recent literature on medical child abuse, mostly case reports, is markedly limited, highlighting a need for increased research on this topic...
April 2017: Current Gastroenterology Reports
J Matthias Löhr, Enrique Dominguez-Munoz, Jonas Rosendahl, Marc Besselink, Julia Mayerle, Markus M Lerch, Stephan Haas, Fatih Akisik, Nikolaos Kartalis, Julio Iglesias-Garcia, Jutta Keller, Marja Boermeester, Jens Werner, Jean-Marc Dumonceau, Paul Fockens, Asbjorn Drewes, Gürlap Ceyhan, Björn Lindkvist, Joost Drenth, Nils Ewald, Philip Hardt, Enrique de Madaria, Heiko Witt, Alexander Schneider, Riccardo Manfredi, Frøkjer J Brøndum, Sasa Rudolf, Thomas Bollen, Marco Bruno
BACKGROUND: There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. METHODS: Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions...
March 2017: United European Gastroenterology Journal
Linda N Nilsson, Margaret G Keane, Awad Shamali, Judith Millastre Bocos, Monica Marijinissen van Zanten, Anne Antila, Cristina Verdejo Gil, Marco Del Chiaro, Johanna Laukkarinen
BACKGROUND: The current management of pancreatic mucinous cystic neoplasms (MCN) is defined by the consensus European, International Association of Pancreatology and American College of Gastroenterology guidelines. However, the criterion for surgical resection remains uncertain and differs between these guidelines. Therefore through this systematic review of the existing literature we aimed to better define the natural history and prognosis of these lesions, in order to clarify recommendations for future management...
November 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Catherine A O'Neill, Giovanni Monteleone, John T McLaughlin, Ralf Paus
As crucial interface organs gut and skin have much in common. Therefore it is unsurprising that several gut pathologies have skin co-morbidities. Nevertheless, the reason for this remains ill explored, and neither mainstream gastroenterology nor dermatology research have systematically investigated the 'gut-skin axis'. Here, in reviewing the field, we propose several mechanistic levels on which gut and skin may interact under physiological and pathological circumstances. We focus on the gut microbiota, with its huge metabolic capacity, and the role of dietary components as potential principle actors along the gut-skin axis...
August 24, 2016: BioEssays: News and Reviews in Molecular, Cellular and Developmental Biology
Shahida A Khan, Aziz M Khan, Sajjad Karim, Mohammad Amjad Kamal, Ghazi A Damanhouri, Zeenat Mirza
Nigella sativa (NS) or black cumin is a dark, thin, and crescent-shaped, seeded shrub belonging to the Ranunculaceae family commonly growing on Mediterranean coasts in Saudi Arabia, northern Africa and Asia. They have amazing curative and therapeutic features that make them one of the most popular, safe, non-detrimental, and cytoprotective medicinal plant that can be used for prevention and treatment of many complicated diseases. Originally, N. sativa was used to treat migraines and allergy, and researches have shown its effectiveness in destroying cancer cells as well...
July 2016: Saudi Journal of Biological Sciences
Maddalena Napolitano, Matteo Megna, Anna Balato, Fabio Ayala, Serena Lembo, Alessia Villani, Nicola Balato
Psoriasis is a chronic, immune-mediated, inflammatory skin disease, affecting 1-3% of the white population. Although the existence of two psoriasis incidence peaks has been suggested (one in adolescence before 20 years of age and another in adulthood), its onset may occur at any age, including childhood and adolescence, in which the incidence is now estimated at 40.8 per 100,000. As for adult psoriasis, pediatric psoriasis has recently been associated with obesity, metabolic syndrome, increased waist circumference percentiles and metabolic laboratory abnormalities, warranting early monitoring and lifestyle modifications...
June 2016: Dermatology and Therapy
Eugene P DiMagno, Matthew J DiMagno
On May 16, 2015 at the invitation of the American Gastroenterological Association Institute Council E.P.D. presented a state-of-the-art lecture at Digestive Disease Week 2015. The aims were to discuss a selection of landmark papers in chronic pancreatitis (CP) that influence modern management and to conclude by suggesting some future directions. This is based on that presentation. We will specifically review the following: duct anatomy and pancreas divisum, description of chronic relapsing pancreatitis and its differentiation from recurrent acute pancreatitis and established CP (ECP), natural histories and gene discoveries of alcoholic, idiopathic and hereditary pancreatitis, development of pancreatic cancer in CP, exocrine pancreatic insufficiency and calculation of dose and delivery of enzymes, endoscopic ultrasonography, and autoimmune pancreatitis...
May 2016: Pancreas
Zhi Ven Fong, Cristina R Ferrone, Keith D Lillemoe, Carlos Fernández-Del Castillo
With the widespread use and advances in radiographic imaging, Intraductal Papillary Mucinous Neoplasms (IPMNs) of the pancreas are identified with increasing frequency. Although many studies have addressed its biology and treatment, true understanding of its natural history continues to elude us. Its malignant potential places careproviders in a clinical dilemma of balancing the morbidity of pancreatectomy against the risk of malignant transformation while under continuous surveillance. Recently, there have been conflicting data published in the literature, generating more uncertainty in the field...
May 2016: Annals of Surgery
Shafqat Mehmood, Muhammad Qayyum Khan
BACKGROUND: Ovarian carcinoma is the fourth most common malignant disease of women. Types of ovarian carcinoma, including serous, mucinous, endometrioid, and transitional carcinoma, differ from each other with respect to morphology, genetic alterations and in their clinical course. Ovary is a common site for tumour metastases with 5-30% of ovarian cancers metastatic in nature. Differentiating primary from metastatic mucinous ovarian adenocarcinoma is often challenging. We assessed the usefulness of colonoscopy...
April 2015: Journal of Ayub Medical College, Abbottabad: JAMC
Hirohito Mori, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tsutomu Masaki
Natural-orifice transluminal endoscopic surgery (NOTES) using flexible endoscopy has attracted attention as a minimally invasive surgical method that does not cause an operative wound on the body surface. However, minimizing the number of devices involved in endoscopic, compared to laparoscopic, surgeries has remained a challenge, causing endoscopic surgeries to gradually be phased out of use. If a flexible endoscopic full-thickness suturing device and a counter-traction device were developed to expand the surgical field for gastrointestinal-tract collapse, then endoscopic full-thickness resection using NOTES, which is seen as an extension of endoscopic submucosal dissection for full-thickness excision of tumors involving the gastrointestinal-tract wall, might become an extremely minimally invasive surgical method that could be used to resect only full-thickness lesions approached by the shortest distance via the mouth...
September 23, 2015: Gut and Liver
Ankur Arora, S Rajesh, Amar Mukund, Yashwant Patidar, Shalini Thapar, Asit Arora, Vikram Bhatia
PURPOSE: Paraduodenal pancreatitis (PP) is a unique form of focal chronic pancreatitis that selectively involves the duodenum and aberrant pancreatic tissue located near the minor papilla (beyond the pancreas proper). The pseudotumoral nature of the disease often generates considerable clinical quandary and patient apprehension, and therefore merits a better understanding. The present study appraises the clinicoradiological manifestations of PP in 33 patients. MATERIALS AND METHODS: Clinical, laboratory, and radiological manifestations of 33 patients of PP treated in gastroenterology/hepatology and hepato-pancreatico-biliary surgery units during June 2010-August 2014 were retrospectively reviewed...
July 2015: Indian Journal of Radiology & Imaging
Yongjun Wang, John K MacDonald, Ben Vandermeer, Anne Marie Griffiths, Wael El-Matary
BACKGROUND: Methotrexate, a folate antagonist, is an immunosuppressant drug that is effective for treating several inflammatory disorders including Crohn's disease. Ulcerative colitis, a related chronic inflammatory bowel disease, can be challenging to treat. T his updated systematic review summarizes the current evidence on the use of methotrexate for induction maintenance of remission in ulcerative colitis. OBJECTIVES: The objectives of this review were to assess the efficacy and safety of methotrexate for maintenance of remission in patients with ulcerative colitis...
2015: Cochrane Database of Systematic Reviews
Andrew S Brock, Don C Rockey
One of the most important advances in gastroenterology has been the use of endoscopic hemostasis techniques to control nonvariceal upper gastrointestinal bleeding, particularly when high-risk stigmata are present. Several options are available, including injection therapy, sprays/topical agents, electrocautery, and mechanical methods. The method chosen depends on the nature of the lesion and experience of the endoscopist. This article reviews the available mechanical hemostatic modalities.
July 2015: Gastrointestinal Endoscopy Clinics of North America
Javier Ramos-Torrecillas, Elvira De Luna-Bertos, Olga García-Martínez, Concepción Ruiz
INTRODUCTION: Many elements are involved in the regenerative processof injured tissues, such as cytokines and growth factors. Growth factors contained in platelets represent an important physiological mixture of factors that may be involved in the healing process. METHOD: A literature review on the role played by certain biomolecules, such as growth factors and platelet-rich plasma (PRP), in the healing of different tissues and on their therapeutic use to promote this process was undertaken...
July 2014: Wounds: a Compendium of Clinical Research and Practice
Joseph Romagnuolo, Andrew S Brock, Nathaniel Ranney
GOAL: We aimed to summarize pooled rebleeding rates of angioectasia after therapeutic endoscopy, and compare these to historical control (no intervention) rates. BACKGROUND: Obscure gastrointestinal bleeding continues to be challenging to diagnose and treat; in America, small bowel angioectasias are the most common cause. Technology advances led to higher diagnostic yield for these lesions; however, therapeutic impact of endoscopy remains unclear. STUDY: A PubMed search (June 1, 2006 to September 19, 2013) with 2 independent reviews sought articles reporting rebleeding rates of symptomatic angioectasia without therapy (natural history) and after endoscopic treatment...
November 2015: Journal of Clinical Gastroenterology
Mark Tighe, Nadeem A Afzal, Amanda Bevan, Andrew Hayen, Alasdair Munro, R Mark Beattie
BACKGROUND: Gastro-oesophageal reflux (GOR) is a common disorder, characterised by regurgitation of gastric contents into the oesophagus. GOR is a very common presentation in infancy in both primary and secondary care settings. GOR can affect approximately 50% of infants younger than three months old (Nelson 1997). The natural history of GOR in infancy is generally that of a functional, self-limiting condition that improves with age; < 5% of children with vomiting or regurgitation continue to have symptoms after infancy (Martin 2002)...
November 24, 2014: Cochrane Database of Systematic Reviews
Caitlyn Braschi, Debra J Pelto, Marie O Hennelly, Kristen K Lee, Brijen Shah, Guy H Montgomery, Steven H Itzkowitz, Lina Jandorf
PURPOSE: Patients with a history of advanced adenomas are at increased risk of developing colorectal cancer (CRC), yet rates of adherence to current surveillance colonoscopy guidelines are poor. We determined rates of referral and adherence to 3-year interval surveillance colonoscopy in patients with advanced adenomas and identified modifiable factors as possible intervention targets to improve surveillance referral and adherence in these at-risk patients. METHODS: We reviewed electronic medical records (EMR) of patients (N = 103) who had pathology findings on screening colonoscopy that warranted a 3-year surveillance colonoscopy...
December 2014: Journal of Gastrointestinal Cancer
Sergey Karamnov, Natalia Sarkisian, Rebecca Grammer, Wendy L Gross, Richard D Urman
INTRODUCTION: Moderate sedation outside the operating room is performed for a variety of medical and surgical procedures. It involves the administration of different drug combinations by nonanesthesia professionals. Few data exist on risk stratification and patient outcomes in the adult population. Current literature suggests that sedation can be associated with significant adverse outcomes. OBJECTIVES: The aims of this study were to evaluate the nature of adverse events associated with moderate sedation and to examine their relation to patient characteristics and outcomes...
September 8, 2014: Journal of Patient Safety
A Diamanti, A G Fiocchi, T Capriati, F Panetta, N Pucci, F Bellucci, G Torre
BACKGROUND/OBJECTIVES: Neonatal short bowel syndrome (SBS) follows early intestinal resections that may expose the children to increased intestinal contact with undigested food proteins and to the risk of food allergy. We report three consecutive cases of cow's milk allergy (CMA) in SBS infants. SUBJECTS/METHODS: We reviewed three cases of CMA developed in 37 children with neonatal SBS followed up in the last 10 years. The setting of the survey was the Gastroenterology-Hepatology and Nutrition Unit of the Pediatric Hospital 'Bambino Gesù' in Rome...
January 2015: European Journal of Clinical Nutrition
Ashish Aggarwal, Kanika Puri, Suraj Thangada, Nizar Zein, Naim Alkhouri
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children and adolescents in the United States. It is strongly associated with childhood obesity, insulin resistance and metabolic syndrome. Although some children with NAFLD may remain asymptomatic, progression to nonalcoholic steatohepatitis (NASH), and to advanced stages of fibrosis and cirrhosis is well recognized. Unfortunately, despite the increase in awareness of this disease, there are still no reliable non-invasive diagnostic tests and liver biopsy remains the gold standard for the diagnosis of NASH and staging of fibrosis...
2014: Current Pediatric Reviews
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