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https://www.readbyqxmd.com/read/29920654/immunotherapy-with-oral-administration-of-humanized-anti-cd3-monoclonal-antibody-a-novel-gut-immune-system-based-therapy-for-metaflammation-and-nash
#1
REVIEW
Yaron Ilan, Kunwar Shailubhai, Arun Sanyal
BACKGROUND: The immune system plays a role in the pathogenesis of NASH underlying hepatocyte injury and fibrosis progression at all disease stages. Oral administration of anti-CD3 monoclonal antibody (mAb) has been shown in pre-clinical studies to be an effective method for systemic immune modulation and alleviates immune-mediated disorders without T-cell depletion. AIM: In the present review, we summarize the concept of the oral administration of humanized anti-CD3 mAb in patients with NASH and discuss the potential of this treatment to address the current requirements of treatments for NASH...
June 19, 2018: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/29915665/peribiliary-cysts-a-systematic-review-and-proposal-of-a-classification-framework
#2
Fateh Bazerbachi, Samir Haffar, Takaaki Sugihara, Taofic M Mounajjed, Naoki Takahashi, Mohammad Hassan Murad, Barham K Abu Dayyeh
Objective: Peribiliary cysts are usually benign, although severe complications and mortality may occur, and they may be confounded with other diseases. No classification delineating their different characteristics exists. Design: We performed a systematic review of the frequency and clinical manifestations of peribiliary cysts. Two reviewers identified studies after searching multiple databases on 2 August 2017. Results: These cysts were prevalent in cirrhosis (9%)...
2018: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29912758/role-of-cholecystectomy-after-endoscopic-sphincterotomy-in-the-management-of-choledocholithiasis-in-high-risk-patients-a-systematic-review-and-meta-analysis
#3
Muhammad Ali Khan, Zubair Khan, Claudio R Tombazzi, Chiranjeevi Gadiparthi, Wade Lee, C Mel Wilcox
BACKGROUND: Endoscopic retrograde cholangiography and endoscopic sphincterotomy (ES) with subsequent cholecystectomy is the standard of care for the management of patients with choledocholithiasis. There is conflicting evidence in terms of mortality reduction, prevention of complications specifically biliary pancreatitis and cholangitis with the use of early cholecystectomy particularly in high-risk surgical and elderly patients. AIMS: We conducted this systematic review and meta-analysis of randomized controlled trials to compare the early cholecystectomy versus wait and watch strategy after ES...
June 16, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29901555/spectrum-of-pediatric-autoimmune-liver-disease-and-validation-of-its-diagnostic-scores-in-indian-children
#4
Vikrant Sood, Bikrant Bihari Lal, Dinesh Rawat, Rajeev Khanna, Archana Rastogi, Chhagan Bihari, Guresh Kumar, Seema Alam
OBJECTIVES: There is limitedliterature on the spectrum of pediatric autoimmune liver disease (AILD, encompassing both autoimmune hepatitis/AIH and autoimmune sclerosing cholangitis/ASC) in Asian populations and its diagnostic scores similarly require further validation. This work thus aimed to study the clinical characteristics, and to validate available diagnostic criteria in the local pediatric AILD cohort. METHODS: A review of all pediatric AILD cases, presenting over a 6 year (2011-2017) period was done, along with comparison of the available diagnostic scores: original (1999), simplified (2008) score and new proposed (2017) score...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29901259/the-role-of-mri-and-ercp-in-the-evaluation-of-disease-activity-and-severity-in-primary-sclerosing-cholangitis
#5
Andrea Tenca, Harri Mustonen, Kati Lind, Eila Lantto, Kaija-Leena Kolho, Sonja Boyd, Johanna Arola, Kalle Jokelainen, Martti Färkkilä
BACKGROUND AND AIMS: Endoscopic retrograde cholangiography (ERCP) has been considered the gold standard for the diagnosis and follow-up of primary sclerosing cholangitis, but it has been replaced by less invasive magnetic resonance imaging and cholangio-pancreatography (MRI-MRCP). However, the role of these two techniques in the evaluation of disease activity and severity needs to be elucidated. METHODS: Patients with primary sclerosing cholangitis (n: 48, male 31, median age: 35...
June 14, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29896036/the-international-liver-congress-2018
#6
Walter Alexander
Our coverage of this year's International Liver Congress reviews sessions on hepatitis C, primary biliary cholangitis, nonalcoholic steatohepatitis, homozygous familial hypercholesterolemia, and advanced hepatocellular carcinoma.
June 2018: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29895203/pregnancy-after-whipple-procedure-a-new-case-and-review-of-the-literature
#7
Giulia Magoga, Laura Felder, Francesco Palazzo, Vincenzo Berghella
BACKGROUND: Whipple procedure is a complex operation usually performed to treat periampullary neoplasms. There are only four case reports of five pregnancies after Whipple procedure, with limited evidence about how to manage pregnancy after this surgery. CASE: A 28-year-old gravida 5 Para 2022 presented to our hospital at 20 weeks with worsening depression. She had a history of Whipple for a solid pseudopapillary neoplasm of the pancreas followed by two pregnancies...
June 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29891522/clinical-impact-of-local-progression-in-pancreatic-cancer
#8
Nicholas Cardillo, Daniel M Seible, Katherine E Fero, Andrew R Bruggeman, Reith R Sarkar, Alexa Azuara, Daniel R Simpson, James D Murphy
Background: The high prevalence of distant metastatic disease among patients with pancreatic cancer often draws attention away from the local pancreatic tumor. This study aimed to define the complications and hospitalizations from local versus distant disease progression among a retrospective cohort of patients with pancreatic cancer. Methods: Records of 298 cases of pancreatic cancer treated at a single institution from 2004 through 2015 were retrospectively reviewed, and cancer-related symptoms and complications requiring hospitalization were recorded...
June 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29886518/update-in-the-care-and-management-of-patients-with-primary-sclerosing-cholangitis
#9
REVIEW
Mai Sedki, Cynthia Levy
PURPOSE OF REVIEW: Primary sclerosing cholangitis (PSC) is a progressive cholestatic liver disease for which specific medical therapy is not available. The goals of treatment are primarily early detection and management of complications. In this review, we discuss novel therapies under evaluation and provide the foundation for surveillance strategies. RECENT FINDINGS: Drugs under investigation include norursodeoxycholic acid, nuclear receptor agonists, anti-fibrotics, antibiotics, and anti-inflammatory drugs...
June 9, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29883229/endoscopic-management-of-primary-sclerosing-cholangitis
#10
James H Tabibian, Todd H Baron
Primary sclerosing cholangitis (PSC) is a rare but clinically important cholestatic liver disease. Histopathologically and cholangiographically, PSC is characterized by intra- and/or extra-hepatic bile duct inflammation and fibro-obliteration, which ultimately leads to biliary cirrhosis and related sequelae, including development of hepatobiliary and colorectal carcinomata. PSC can be diagnosed at essentially any age and carries a median survival of 15-20 years, regardless of age at diagnosis, and is a foremost risk factor for cholangiocarcinoma...
June 18, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29881604/association-between-smoking-and-risk-of-primary-sclerosing-cholangitis-a-systematic-review-and-meta-analysis
#11
Karn Wijarnpreecha, Panadeekarn Panjawatanan, Omar Y Mousa, Wisit Cheungpasitporn, Surakit Pungpapong, Patompong Ungprasert
Background/Objectives: Studies have suggested that smokers may have a lower risk of primary sclerosing cholangitis (PSC) although the results have been inconsistent. This systematic review and meta-analysis was conducted to summarize all available data to better characterize this association. Methods: A comprehensive literature review was conducted using Medline and Embase databases through January 2018 to identify all studies that compared the risk of PSC among current/former smokers versus nonsmokers...
May 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29871021/emerging-technologies-for-the-diagnosis-of-perihilar-cholangiocarcinoma
#12
Sumera Rizvi, John Eaton, Ju Dong Yang, Vinay Chandrasekhara, Gregory J Gores
The diagnosis of malignant biliary strictures remains problematic, especially in the perihilar region and in primary sclerosing cholangitis (PSC). Conventional cytology obtained during endoscopic retrograde cholangiography (ERC)-guided brushings of biliary strictures is suboptimal due to limited sensitivity, albeit it remains the gold standard with a high specificity. Emerging technologies are being developed and validated to address this pressing unmet patient need. Such technologies include enhanced visualization of the biliary tree by cholangioscopy, intraductal ultrasound, and confocal laser endomicroscopy...
May 2018: Seminars in Liver Disease
https://www.readbyqxmd.com/read/29862092/tumor-necrosis-factor-alpha-inhibition-for-inflammatory-bowel-disease-after-liver-transplant-for-primary-sclerosing-cholangitis
#13
Ravish Parekh, Ahmed Abdulhamid, Sheri Trudeau, Nirmal Kaur
Background: Outcome data regarding the use of tumor necrosis factor alpha inhibitors (anti-TNF α ) in patients with inflammatory bowel disease (IBD) after liver transplant (LT) for primary sclerosing cholangitis (PSC) are scant. Methods: We performed a retrospective chart review to investigate outcomes among a series of post-liver-transplant PSC/IBD patients receiving anti-TNF α therapy at Henry Ford Health System ((HFHS), Detroit, MI). Results: A total of five patients were treated with anti-TNF α agents for IBD after LT for PSC from 1993 through 2015...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29850458/efficacy-and-safety-of-lumen-apposing-self-expandable-metal-stents-for-eus-guided-cholecystostomy-a-meta-analysis-and-systematic-review
#14
REVIEW
Nikhil R Kalva, Vishwas Vanar, David Forcione, Matthew L Bechtold, Srinivas Reddy Puli
Background: Patients with acute cholecystitis are treated with early cholecystectomy. A subset of patients are unfit for surgery due to comorbidities and late presentation. Prompt gall bladder drainage (GBD) with percutaneous or endoscopic approach remains a viable therapeutic option for nonoperative candidates. Endoscopic ultrasound (EUS) guided transluminal gall bladder drainage (EUS-GBD) continues to evolve as an alternative approach to percutaneous drainage. With continued refinement in stent technology, lumen apposing self-expandable metal stent (LAMS) offers several advantages...
2018: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29804066/factors-affecting-the-operating-time-for-complete-cyst-excision-and-roux-en-y-hepaticojejunostomy-in-paediatric-cases-of-congenital-choledochal-malformation-a-retrospective-case-study-in-southeast-china
#15
Wan-Liang Guo, Yang Zhan, Fang Fang, Shun-Gen Huang, Yan-Bing Deng, Jun-Gang Zhao, Jian Wang
OBJECTIVE: The aim of this study was to evaluate factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation (CCM). DESIGN: A 3-year retrospective study was undertaken between January 2013 and December 2015 in four centres in China. SETTING: This involved a retrospective chart review of paediatric patients with CCM in four large hospitals in Southeast China...
May 26, 2018: BMJ Open
https://www.readbyqxmd.com/read/29794362/clip-stone-and-t-clip-sinus-a-clinical-analysis-of-six-cases-on-migration-of-clips-and-literature-review-from-1997-to-2017
#16
Liwei Pang, Jindong Yuan, Yan Zhang, Yuwen Wang, Jing Kong
Introduction: With the development of laparoscopic skills, the laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) has become the standard surgical procedure for choledocholithiasis. We usually use Hem-o-lok clips to control cystic duct and vessels, which is safe on most occasions and has few perioperative complications such as major bleeding, wound infection, bile leakage, and biliary and bowel injury. However, a rare complication of post-cholecystectomy clip migration (PCCM) increases year by year due to the advancement and development of LC, CBD exploration as well as the wide use of surgical ligation clips...
May 24, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29791424/-primary-biliary-cholangitis-part-2-state-of-the-art-diagnosis-associated-diseases-treatment-and-prognosis
#17
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...
January 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29761165/a-real-world-observational-cohort-of-patients-with-primary-biliary-cholangitis-target-primary-biliary-cholangitis-study-design-and-rationale
#18
Cynthia Levy, Christopher L Bowlus, Elizabeth Carey, Julie M Crawford, Karen Deane, Marlyn J Mayo, W Ray Kim, Michael W Fried
Primary biliary cholangitis (PBC) is a rare chronic cholestatic liver disease that may progress to biliary cirrhosis if left untreated. The first-line therapy for PBC is ursodeoxycholic acid (UDCA). Unfortunately, 1 of 3 patients does not respond to UDCA. These patients are at risk for developing clinical events, including cirrhosis, complications of portal hypertension, hepatocellular carcinoma, liver transplant, or death. Recently, the U.S. Food and Drug Administration approved obeticholic acid to be used in certain patients with PBC...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29758112/novel-and-emerging-therapies-for-cholestatic-liver-diseases
#19
Jordan Goldstein, Cynthia Levy
While bile acids are important for both digestion and signaling, hydrophobic bile acids can be harmful especially when in high concentrations. Mechanisms for protection of cholangiocytes against bile acid cytotoxicity include negative feedback loops via farnesoid X nuclear receptor (FXR) activation, the bicarbonate umbrella, cholehepatic shunting and anti-inflammatory signaling, among others. By altering or overwhelming these defense mechanisms, cholestatic diseases such as primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) can further progress to biliary cirrhosis, end-stage liver disease and death or liver transplantation...
May 14, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29742738/percutaneous-cholecystostomy-for-high-risk-patients-with-acute-cholangitis
#20
Yan-Lin Li, Kin-Hoi Wong, Keith Wan-Hang Chiu, Andrew Kai-Chun Cheng, Ronald Kin-On Cheung, Max Kai-Ho Yam, Angie Lok-Chi Chan, Victor Siang-Hua Chan, Martin Wai-Ming Law, Paul Sing-Fun Lee
Percutaneous cholecystostomy (PC) is a well-established treatment for acute cholecystitis. We investigate the performance and role of PC in managing acute cholangitis.Retrospective review on all patients who underwent PC for acute cholangitis between January 2012 and June 2017 at a major regional hospital in Hong Kong.Thirty-two patients were included. The median age was 84 years and median American Society of Anaesthesiologists (ASA) physical status was Class III (severe systemic disease). All fulfilled Tokyo Guidelines 2013 (TG13) diagnostic criteria for moderate or severe cholangitis...
May 2018: Medicine (Baltimore)
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