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Gastroenterology Guidelines

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https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#1
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28780013/therapeutic-drug-monitoring-in-inflammatory-bowel-disease
#2
Joseph D Feuerstein, Geoffrey C Nguyen, Sonia S Kupfer, Yngve Falck-Ytter, Siddharth Singh
No abstract text is available yet for this article.
August 2, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28774547/american-gastroenterological-association-technical-review-on-the-role-of-therapeutic-drug-monitoring-in-the-management-of-inflammatory-bowel-diseases
#3
Niels Vande Casteele, Hans Herfarth, Jeffry Katz, Yngve Falck-Ytter, Siddharth Singh
Therapeutic drug monitoring (TDM), which involves measurement of drug or active metabolite levels and anti-drug antibodies, is a promising strategy that can be used to optimize inflammatory bowel disease therapeutics. It is based on the premise that there is a relationship between drug exposure and outcomes, and that considerable inter-individual variability exists in how patients metabolize the drug (pharmacokinetics) and the magnitude and duration of response to therapy (pharmacodynamics). Therefore, the American Gastroenterological Association has prioritized clinical guidelines on the role of TDM in the management of inflammatory bowel disease...
July 31, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28770404/validation-of-the-american-gastroenterological-association-guidelines-on-management-of-intraductal-papillary-mucinous-neoplasms-more-than-5%C3%A2-years-of-follow-up
#4
Koh Imbe, Naoyoshi Nagata, Yuya Hisada, Yusuke Takasaki, Katsunori Sekine, Saori Mishima, Akihito Kawazoe, Tsuyoshi Tajima, Takuro Shimbo, Mikio Yanase, Junichi Akiyama, Kazuma Fujimoto, Naomi Uemura
OBJECTIVES: Recent guidelines suggest that imaging surveillance be conducted for 5 years for patients with at most one high-risk feature. If there were no significant changes, surveillance is stopped. We sought to validate this follow-up strategy. METHODS: In study 1, data were analysed for 392 patients with intraductal papillary mucinous neoplasms (IPMNs) and at most one high-risk feature who were periodically followed up for more than 1 year with imaging tests...
August 2, 2017: European Radiology
https://www.readbyqxmd.com/read/28761690/duodenal-biopsies-for-the-diagnosis-of-coeliac-disease-are-we-adhering-to-current-guidance
#5
Nilofer Husnoo, Wafaa Ahmed, Muhammad Hanif Shiwani
BACKGROUND: The British Society of Gastroenterology guidelines recommend taking at least four duodenal biopsy specimens at the time of upper gastrointestinal (UGI) endoscopy if coeliac disease (CD) is suspected and it has been shown to increase the diagnostic yield of CD. We assessed the compliance to these guidelines within our institution. We then applied measures to improve our compliance rate and assessed the resulting impact on our diagnostic rate of CD. METHODS: We performed a retrospective audit of electronic records for all patients, with no prior diagnosis of CD, who underwent UGI endoscopy with duodenal biopsies between August 2014 and May 2015...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28748314/the-present-status-of-fecal-microbiota-transplantation-and-its-value-in-the-elderly
#6
REVIEW
Yao-Wen Cheng, Monika Fischer
OPINION STATEMENT: PURPOSE OF REVIEW: This article will review current literature describing fecal microbiota transplantation (FMT) in the treatment of various diseases, and its potential role in elderly patients (age ≥ 65 years). RECENT FINDINGS: Research on FMT has blossomed in the last decade and its pivotal role in the treatment of recurrent Clostridium difficile infection (CDI) has been recognized by the American College of Gastroenterology in the latest guidelines...
July 26, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28737572/european-society-for-paediatric-gastroenterology-hepatology-and-nutrition-guidelines-for-the-evaluation-and-treatment-of-gastrointestinal-and-nutritional-complications-in-children-with-neurological-impairment
#7
Claudio Romano, Myriam van Wynckel, Jessie Hulst, Ilse Broekaert, Jiri Bronsky, Luigi Dall'Oglio, Nataša F Mis, Iva Hojsak, Rok Orel, Alexandra Papadopoulou, Michela Schaeppi, Nikhil Thapar, Michael Wilschanski, Peter Sullivan, Frédéric Gottrand
OBJECTIVES: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment...
August 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28735806/revisions-of-international-consensus-fukuoka-guidelines-for-the-management-of-ipmn-of-the-pancreas
#8
REVIEW
Masao Tanaka, Carlos Fernández-Del Castillo, Terumi Kamisawa, Jin Young Jang, Philippe Levy, Takao Ohtsuka, Roberto Salvia, Yasuhiro Shimizu, Minoru Tada, Christopher L Wolfgang
The management of intraductal papillary mucinous neoplasm (IPMN) continues to evolve. In particular, the indications for resection of branch duct IPMN have changed from early resection to more deliberate observation as proposed by the international consensus guidelines of 2006 and 2012. Another guideline proposed by the American Gastroenterological Association in 2015 restricted indications for surgery more stringently and recommended physicians to stop surveillance if no significant change had occurred in a pancreatic cyst after five years of surveillance, or if a patient underwent resection and a non-malignant IPMN was found...
July 13, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28728311/clinical-approach-to-incidental-pancreatic-cystic-neoplasm-in-outpatient-clinics
#9
REVIEW
Young Sik Woo, Kyu Taek Lee
Cystic lesions of the pancreas are increasingly observed due to increased use of abdominal images. The malignant rate of pancreas cystic lesion varies widely between various types. Identification of malignant or high-risk lesions is important when determining the appropriate course of management. Using these image findings, including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines provide a rationale in identifying higher risk patients requiring further workups using an endoscopic ultrasound (EUS)...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28709446/omitting-duodenal-biopsy-in-children-with-suspected-celiac-disease-and-extra-intestinal-symptoms
#10
Mauro Bozzola, Cristina Meazza, Chiara Gertosio, Sara Pagani, Daniela Larizza, Valeria Calcaterra, Ombretta Luinetti, Giovanni Farello, Carmine Tinelli, Lorenzo Iughetti
BACKGROUND: The aim of our study is to evaluate if in children with highly positive serology and HLA-DQ2/DQ8 (triple test, TT) and only extra-intestinal symptoms, it is possible to omit performing an intestinal biopsy for celiac disease (CD) diagnosis, as suggested by the new European Society for Pediatric Gastroenterology, Hepatology and Nutrition ESPGHAN guidelines. METHODS: In this retrospective study a total of 105 patients, suspected of having CD because of extra-intestinal symptoms and showing serum tissue transglutaminase antibody (anti-tTG) and anti-endomysial antibody (EMA) measurements and HLA genotyping, were considered for the final analysis (33 boys and 72 girls; age range 1...
July 15, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28708769/a-national-survey-on-peri-interventional-management-of-percutaneous-transhepatic-biliary-drainage
#11
Chulja J Pek, Monique van Dijk, Bas Groot Koerkamp, Adriaan Moelker, Casper H J van Eijck
PURPOSE: The purpose of this study is to evaluate knowledge about management of percutaneous transhepatic biliary drainage (PTBD) catheters among nurses taking care of hepato-pancreato-biliary (HPB) patients. METHODS: Six HPB nurses from the Dutch national HPB association created a questionnaire that was complemented by 2 HPB surgeons, 3 HPB interventional radiologists, and a methodologist. Registered nurses working at the department of gastroenterology or gastrointestinal surgery and familiar with the care for HPB patients were invited to complete the questionnaire...
August 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28701106/insights-into-the-diagnosis-and-management-of-iron-deficiency-in-inflammatory-bowel-disease
#12
Rayan Bou-Fakhredin, Racha Halawi, Joseph Roumi, Ali Taher
Iron deficiency is a frequent comorbidity of chronic diseases such as inflammatory bowel disease that can severely impact the health and quality of life of affected individuals. It can exist as a silent condition and manifest in non-specific symptoms even in the absence of anemia. Even though iron deficiency anemia is the most common complication and extra-intestinal manifestation of inflammatory bowel disease, the majority of inflammatory bowel disease patients who are diagnosed with iron deficiency anemia are not treated...
July 26, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28644351/adherence-to-celiac-disease-and-eosinophilic-esophagitis-biopsy-guidelines-is-poor-in-children
#13
Thomas Wallach, Robert M Genta, Benjamin Lebwohl, Peter H R Green, Norelle R Reilly
OBJECTIVES: Celiac disease (CD) and eosinophilic esophagitis (EoE) are underdiagnosed gastrointestinal conditions, which adversely affect children's health. Previous studies have shown that diagnostic guidelines for CD are not consistently followed in adults. The aims of the present study are to assess the frequency with which endoscopists comply with diagnostic guidelines for CD and EoE in children, and to determine whether an association exists between adherence to biopsy guidelines and disease detection in pediatric patients...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28643539/prevalence-of-iron-deficiency-anemia-and-iron-deficiency-in-a-pediatric-population-with-inflammatory-bowel-disease
#14
Fábia Susana Ginja de Carvalho, Inês Ambrósio de Medeiros, Henedina Antunes
OBJECTIVES: Iron deficiency is the most common cause of anemia in children with inflammatory bowel disease, although the real prevalence is unknown. Intravenous iron is suggested as the first line treatment. This study aims to determine the prevalence of iron deficiency anemia in children with inflammatory bowel disease followed in a Pediatric Gastroenterology Unit of a tertiary center and to evaluate this unit's experience with intravenous iron. MATERIALS AND METHODS: A retrospective cohort study was designed involving children with inflammatory bowel disease followed in that unit between January 2001 and April 2016...
June 23, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28643273/chronic-constipation-in-rome-iv-era-the-indian-perspective
#15
REVIEW
Uday C Ghoshal
Chronic constipation (CC) is a common problem in the community and in gastroenterology practice all over the world including India. After release of Rome IV guidelines in April 2016, there is increasing interest among gastroenterologists and physicians in India to look into special issues on CC in the Indian perspective. There are important differences in the bowel habit, definition, epidemiology, and pathophysiology including dietary factors and management of CC in India as compared to the West. As severity and frequency of abdominal pain, a symptom essential to diagnose constipation-predominant irritable bowel syndrome (IBS-C) rather than functional constipation (FC), is less common among Indian patients, FC is commoner than IBS-C in India...
May 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28631728/acg-and-cag-clinical-guideline-management-of-dyspepsia
#16
REVIEW
Paul M Moayyedi, Brian E Lacy, Christopher N Andrews, Robert A Enns, Colin W Howden, Nimish Vakil
We have updated both the American College of Gastroenterology (ACG) and the Canadian Association of Gastroenterology (CAG) guidelines on dyspepsia in a joint ACG/CAG dyspepsia guideline. We suggest that patients ≥60 years of age presenting with dyspepsia are investigated with upper gastrointestinal endoscopy to exclude organic pathology. This is a conditional recommendation and patients at higher risk of malignancy (such as spending their childhood in a high risk gastric cancer country or having a positive family history) could be offered an endoscopy at a younger age...
July 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28630808/management-of-acute-uncomplicated-diverticulitis-may-exclude-antibiotic-therapy
#17
REVIEW
Jonathan Mayl, Mikhail Marchenko, Emily Frierson
Diverticulitis is a common ailment that is prevalent in the developed world. As such, the management of diverticulitis places a substantial economic burden on healthcare. Research is ongoing to further elucidate both the pathogenesis of the disease, as well as ways to reduce associated expenditures. One of these emerging areas of research calls into question the use of antibiotics during treatment of acute uncomplicated diverticulitis. Current guidelines are largely based on expert opinion, with little evidence supporting the standard practice of antibiotic therapy...
May 15, 2017: Curēus
https://www.readbyqxmd.com/read/28630049/comparison-of-electroacupuncture-and-medical-treatment-for-functional-constipation-a-systematic-review-and-meta-analysis
#18
Sheng-Li Zhou, Xiu-Lai Zhang, Jing-Hua Wang
OBJECTIVES: To assess the effectiveness of electroacupuncture (EA) relative to conventional medication in functional constipation (FC). DESIGN: Systematic review and meta-analysis SETTING: To be included, studies needed to: (1) have been randomised controlled trials; (2) have recruited adult patients diagnosed with FC according to the Rome II/III criteria or the American Gastroenterological Association guideline for chronic FC; and (3) have randomised patients to be treated with EA or anti-constipation medication...
June 19, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/28626103/-study-on-lifestyle-in-patients-with-gastroesophageal-%C3%A2-reflux-disease
#19
Lingzhi Yuan, Dan Tang, Jin Peng, Nanfang Qu, Chun Yue, Fen Wang
To investigate the correlation between certain unhealthy lifestyles and the incidence of gastroesophageal reflux disease (GERD), thus to provide the lifestyle guidelines for GERD patients.
 Methods: Retrospective study were conducted for 402 GERD and 276 non-GERD out-patients in Department of Gastroenterology, Third Xiangya Hospital, Central South University from August, 2014 to August, 2015 based on questionnaire survey, then the correlation of unhealthy lifestyles with GERD were analyzed.
 Results: The top 10 common symptoms for GERD were as follows: reflux, acid regurgitation, postprandial fullness, heartburn, swallow obstruction or pain, epigastric burning sensation, paraesthesia pharynges, poststernal pain, chronic laryngopharyngitis, and chronic cough...
May 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28624578/accuracy-in-diagnosis-of-celiac-disease-without-biopsies-in-clinical-practice
#20
K J Werkstetter, I R Korponay-Szabó, A Popp, V Villanacci, M Salemme, G Heilig, S T Lillevang, M L Mearin, C Ribes-Koninckx, A Thomas, R Troncone, B Filipiak, M Mäki, J Gyimesi, M Najafi, J Dolinšek, S Dydensborg Sander, R Auricchio, A Papadopoulou, A Vécsei, P Szitanyi, E Donat, R Nenna, Ph Alliet, F Penagini, H Garnier-Lengliné, G Castillejo, K Kurppa, R Shamir, A C Hauer, F Smets, S Corujeira, M van Winckel, S Buderus, S Chong, S Husby, S Koletzko, Piotr Socha, Bozena Cukrowska, Hania Szajewska, Jan Wyhowski, Nailah Brown, Gauri Batra, Zrinjka Misak, Sven Seiwerth, Yulia Dmitrieva, Dmitry Abramov, Yvan Vandenplas, Annieta Goossens, Maaike W Schaart, V T H B M Smit, Nicolas Kalach, Pierre Gosset, Judit B Kovács, Anikó Nagy, Ilona Lellei, Rita Kőbányai, Katayoun Khatami, Maryam Monajemzadeh, Konstantina Dimakou, Amalia Patereli, Tine Plato Hansen, Rajko Kavalar, Miguel Bolonio, Hubert Kogler, Gabriele Amann, Roberta Kosova, Mariantonia Maglio, Elke Janssens, Ruth Achten, Pavel Frűhauf, Helena Skálová, Thomas Kirchner, Laura Petrarca, Fabio Massimo Magliocca, Francesc Martínez, Vanesa Morente, Sonja Thanner-Lechner, Manfred Ratschek, Marco Gasparetto, Liz Hook, Danielle Canioni, Catherine Wanty, Anne Mourin, Kaija Laurila, Martine Vornane, Vered Nachmias Friedler, Sara L Morgenstern, Jorge Amil Dias, Fátima Carneiro, Stephanie Van Biervliet, Saskia Vande Velde, Hany Banoub, Steve Sampson, Annette M Müller, Adina Ene, Mandana Rafeey, Iran Amir Taher Eftekhar Sadat
BACKGROUND & AIMS: The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition allow for diagnosis of celiac disease without biopsies in children with symptoms and levels of immunoglobulin A against tissue-transglutaminase (TGA-IgA) 10-fold or more the upper limit of normal (ULN), confirmed by detection of endomysium antibodies (EMA) and positivity for HLA-DQ2/DQ8. We performed a large, international prospective study to validate this approach. METHODS: We collected data from consecutive pediatric patients (18 years or younger) on a gluten-containing diet who tested positive for TGA-IgA from November 2011 through May 2014, seen at 33 pediatric gastroenterology units in 21 countries...
June 15, 2017: Gastroenterology
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