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https://www.readbyqxmd.com/read/29411404/review-article-the-evidence-that-vancomycin-is-a-therapeutic-option-for-primary-sclerosing-cholangitis
#1
REVIEW
J L Damman, E A Rodriguez, A H Ali, C W Buness, K L Cox, E J Carey, K D Lindor
BACKGROUND AND AIMS: PSC is an autoimmune biliary inflammatory disorder that is often associated with inflammatory bowel disease (IBD), with 50%-75% of patients with PSC having coexisting IBD, most commonly ulcerative colitis. Currently, no medical therapies have been shown to improve the disease course or slow its progression. However, ongoing research has resulted in a growing interest in the use of antibiotics for treatment of PSC, of which vancomycin is the most studied. In this review, we summarise the current evidence on the use of vancomycin in PSC and comment on future research areas of interest...
February 7, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29404489/drug-induced-cholestasis
#2
REVIEW
Vinay Sundaram, Einar S Björnsson
Cholestatic drug-induced liver injury (DILI) can be a diagnostic challenge due to a large differential diagnosis, variability in clinical presentation, and lack of serologic biomarkers associated with this condition. The clinical presentation of drug-induced cholestasis includes bland cholestasis, cholestatic hepatitis, secondary sclerosing cholangitis, and vanishing bile duct syndrome. The associate mortality of cholestatic DILI can be as high as 10%, and thus prompt recognition and removal of the offending agent is of critical importance...
October 2017: Hepatology Communications
https://www.readbyqxmd.com/read/29400703/comprehensive-review-of-autoantibodies-in-patients-with-hyper-igm-syndrome
#3
Mohamed-Ridha Barbouche, Qubo Chen, Marco Carbone, Imen Ben-Mustapha, Zakera Shums, Mehdi Trifa, Federica Malinverno, Francesca Bernuzzi, Haiyan Zhang, Nourhen Agrebi, Gary L Norman, Christopher Chang, M Eric Gershwin, Pietro Invernizzi
Hyper-immunoglobulin M syndrome is an X-linked primary immunodeficiency disease caused by mutations in the CD40 ligand gene. The CD40 ligand has been recently highlighted as playing a key role in the pathogenesis of primary biliary cholangitis. In the present study, we assessed an extensive set of serum autoantibodies in a series of well-defined patients with hyper-immunoglobulin M syndrome. Serum, liver-related and liver-not-related autoantibodies IgG, IgM and IgA were tested by ELISA and standard indirect immunofluorescence in HEp-2 cells in 13 Tunisian patients (8 males and 5 females, aged 1-12 years) with hyper-immunoglobulin M syndrome during 1995-2012 and, as controls, 21 age- and gender-matched blood donors...
February 5, 2018: Cellular & Molecular Immunology
https://www.readbyqxmd.com/read/29399608/endoscopic-ultrasound-guided-hepaticogastrostomy-and-antegrade-clearance-of-biliary-lithiasis-in-patients-with-surgically-altered-anatomy
#4
Amy Hosmer, Mohamed M Abdelfatah, Ryan Law, Todd H Baron
Background and study aims:  Endoscopic retrograde cholangiography (ERC) in patients with complex surgically-altered anatomy (SAA) is technically demanding and has limitations. Developments in EUS-guided procedures allow alternative approaches for patients with altered gastrointestinal anatomy and biliary lithiasis. Patients and methods:  Single-center, retrospective review of prospectively entered patients with SAA who underwent EUS-guided hepaticogastrostomy (HGS) followed by an interval antegrade endoscopic clearance of biliary lithiasis...
February 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29380173/surgery-reduces-risk-of-complications-even-in-high-risk-veterans-after-endoscopic-therapy-for-biliary-stone-disease
#5
Samarth S Patel, Divyanshoo R Kohli, Jeannie Savas, Pritesh R Mutha, Alvin Zfass, Tilak U Shah
BACKGROUND: In otherwise healthy patients, randomized trials have shown reduced mortality with cholecystectomy (CCY) when compared to non-operative management after endoscopic retrograde cholangiopancreatography (ERCP) for biliary stone disease. These findings may not apply to veterans with multiple comorbidities, who have an increased risk of postoperative complications. AIMS: Our study assessed the benefit of CCY among veterans with multiple comorbidities. METHODS: Medical records of patients undergoing ERCP for biliary stone-related diseases from July 2008 to December 2016 were reviewed...
January 29, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29380060/serum-levels-of-a-cell-death-biomarker-predict-the-development-of-cirrhosis-related-conditions-in-primary-biliary-cholangitis
#6
Manabu Hayashi, Kazumichi Abe, Masashi Fujita, Ken Okai, Atsushi Takahashi, Yoshihiro Nozawa, Hiromasa Ohira
Non-invasive predictors for the development of cirrhosis-related conditions are needed for patients with primary biliary cholangitis (PBC). We investigated the association between cytokeratin-18 fragments (M30 and M65) and liver histology, treatment response and the development of cirrhosis-related conditions in patients with PBC. We retrospectively reviewed the clinical data of 111 individuals with biopsy-proven PBC. Serum M30 and M65 levels were measured using stored sera. M30 were significantly decreased after treatment, but there was no significant change in the M65 levels...
January 29, 2018: Medical Molecular Morphology
https://www.readbyqxmd.com/read/29372374/cysto-cholecystostomy-a-more-physiological-procedure-for-hepatic-cysts-with-biliary-communications-and-cystic-dilatations-of-main-intrahepatic-ducts
#7
Mei Diao, Long Li, Wei Cheng
OBJECTIVE: Hepatic cysts with biliary communications (HC) and cystic dilatations of main intrahepatic ducts (CIHD) can cause biliary obstruction, cholestasis, stone formation, cholangitis, liver damage and carcinoma. Conventionally, Roux-Y cysto-jejunostomy is employed to manage these conditions. However, it is technically demanding and may be complicated with major biliary disruption and bacteria migration from intestine to intrahepatic duct. We have carried out laparoscopic cysto-cholecystostomies for HC with biliary communication and CIHD and evaluated outcomes...
January 25, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29370346/reduced-risk-of-inflammatory-bowel-disease-associated-colorectal-neoplasia-with-use-of-thiopurines-a-systematic-review-and-meta-analysis
#8
Zhehui Zhu, Zubing Mei, Yuegui Guo, Guanghui Wang, Tingyu Wu, Ximao Cui, Zhenyu Huang, Yilian Zhu, Dongpeng Wen, Jinlve Song, Hailan He, Weimin Xu, Long Cui, Chenying Liu
Background & Aims: The association between thiopurines and colorectal neoplasia risk remains controversial in inflammatory bowel disease (IBD) patients. We performed a systematic review and meta-analysis examining this association. Methods: A comprehensive search of the PubMed, EMBASE and Cochrane Library databases was performed to identify relevant literature. Random-effects models were applied to calculate the pooled odds ratio (OR) and relative risk (RR) with corresponding 95% confidence intervals (CIs) among case-control and cohort studies, respectively...
January 23, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29361103/reviewing-the-risk-of-colorectal-cancer-in-inflammatory-bowel-disease-after-liver-trasnplantation-for-primary-sclerosing-cholangitis
#9
Bhavana Bhagya Rao, Bret Lashner, Kris V Kowdley
The presence of concomitant primary sclerosing cholangitis (PSC) with inflammatory bowel disease (IBD) represents a distinct disease phenotype that carries a higher risk of colorectal cancer (CRC) than the average IBD patient. Given that liver transplantation (LT) is the only treatment that offers a survival benefit in PSC patients with hepatic dysfunction, management decisions in IBD patients' post-LT for PSC are frequently encountered. One such consideration is the risk of CRC in this immunosuppressed cohort...
January 18, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29360613/minimally-invasive-surgery-versus-open-hepatectomy-for-hepatolithiasis-a-systematic-review-and-meta-analysis
#10
REVIEW
Jiao Lei, Junmin Huang, Xiaobo Yang, Yuan Zhang
OBJECTIVE: Hepatectomy for hepatolithiasis can be performed by following an open approach or a minimally invasive surgery (MIS) approach. MIS is associated with theoretical advantages, but there is no consensus regarding to the best treatment method for hepatolithiasis. The objective of this study was to evaluate the clinical outcomes of MIS hepatectomy compared with those of open hepatectomy in hepatolithiasis patients. METHODS: A systematic literature search was performed using PubMed, Embase and Cochrane Library databases...
January 19, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29356767/lack-of-correlation-of-liver-tests-with-fibrosis-stage-at-diagnosis-in-pediatric-primary-sclerosing-cholangitis
#11
Jillian M Cotter, Lorna P Browne, Kelley E Capocelli, Annette McCoy, Cara L Mack
OBJECTIVES: The aims of this study were to characterize pediatric primary sclerosing cholangitis (PSC) at a regional referral-based institution, including scoring of biliary stricturing and liver fibrosis and correlation analyses of scores with serum liver tests, to identify biomarkers of disease severity. METHODS: A retrospective review of 39 PSC subjects was performed, with collection of demographic and outcomes data. Magnetic resonance cholangiopancreaticogram (MRCP) and liver biopsies were re-reviewed and scores of stricturing and fibrosis were correlated with serum liver tests...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29350267/modern-work-up-and-extended-resection-in-perihilar-cholangiocarcinoma-the-amc-experience
#12
REVIEW
F Rassam, E Roos, K P van Lienden, J E van Hooft, H J Klümpen, G van Tienhoven, R J Bennink, M R Engelbrecht, A Schoorlemmer, U H W Beuers, J Verheij, M G Besselink, O R Busch, T M van Gulik
AIM: Perihilar cholangiocarcinoma (PHC) is a challenging disease and requires aggressive surgical treatment in order to achieve curation. The assessment and work-up of patients with presumed PHC is multidisciplinary, complex and requires extensive experience. The aim of this paper is to review current aspects of diagnosis, preoperative work-up and extended resection in patients with PHC from the perspective of our own institutional experience with this complex tumor. METHODS: We provided a review of applied modalities in the diagnosis and work-up of PHC according to current literature...
January 19, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29348111/leveraging-social-networking-sites-for-an-autoimmune-hepatitis-genetic-repository-pilot-study-to-evaluate-feasibility
#13
Megan Comerford, Rachel Fogel, James Robert Bailey, Prianka Chilukuri, Naga Chalasani, Craig Steven Lammert
BACKGROUND: Conventional approaches to participant recruitment are often inadequate in rare disease investigation. Social networking sites such as Facebook may provide a vehicle to circumvent common research limitations and pitfalls. We report our preliminary experience with Facebook-based methodology for participant recruitment and participation into an ongoing study of autoimmune hepatitis (AIH). OBJECTIVE: The goal of our research was to conduct a pilot study to assess whether a Facebook-based methodology is capable of recruiting geographically widespread participants into AIH patient-oriented research and obtaining quality phenotypic data...
January 18, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29340827/single-incision-laparoscopic-hepaticojejunostomy-for-children-with-perforated-choledochal-cysts
#14
Mei Diao, Long Li, Wei Cheng
BACKGROUND: Conventionally, perforated choledochal cyst (CDC) is a contraindication of laparoscopic treatment. The current study is to evaluate efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) in children with perforated CDCs. METHODS: One hundred and thirty-three children with perforated CDCs who underwent SILHs in our hospital between August 2011 and August 2017 were reviewed. RESULTS: Fifteen (11.3%) patients were converted to open procedures due to severe adhesions and oozing...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29325285/-primary-biliary-cholangitis-and-bile-acid-metabolism
#15
L Wang, Y C Han, Y Han
Primary biliary cholangitis (PBC) is an immune-mediated cholestatic liver disease of unknown pathogenesis. The research on immunologic injury in the past helps us to understand more about this disease, but there are still many problems and challenges in the research on PBC. With a focus on the cholestatic features of PBC, this article reviews the research advances in bile acid metabolism in the field of PBC, in order to provide new thoughts for future research.
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29325284/-risk-factors-and-therapeutic-strategies-for-primary-biliary-cholangitis-patients-with-poor-prognosis
#16
Y W Shi, H Ma
With the progress in detection methods and the update of diagnostic and therapeutic concepts, more and more patients with primary biliary cholangitis (PBC) have been diagnosed and treated. A high proportion of PBC patients, however, progress to liver decompensation, with an increased risk of liver transplantation and death and a significant reduction in long-term survival. These patients need early diagnosis and urgent treatment. This article discusses how to identify the PBC patients with poor prognosis early from the aspects of biochemical response, disease features, and biomarkers, and reviews the progress in related complementary therapies and new drugs including Ocaliva, Fibrates, UDCA-derived drugs, and molecular targeted drugs...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29325273/-how-to-understand-the-clinical-significance-of-autoantibodies-in-primary-biliary-cholangitis
#17
H P Yan, H P Zhang, X X Chen
Autoantibodies are important indicators for the diagnosis of primary biliary cholangitis (PBC). The autoantibodies in PBC patients are mainly antimitochondrial antibodies (AMAs) and antinuclear antibodies (ANAs). AMAs are one of the diagnostic indices of PBC. PBC-specific ANAs (nuclear dots or nuclear envelope, anti-sp100, and anti-gp210) have a high specificity in the diagnosis of AMA-negative PBC. This article reviews the clinical significance of these autoantibodies and analyzes some misconceptions about the clinical diagnosis of AMA-negative PBC and PBC-AIH overlap syndrome...
November 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29316057/-a-promising-medium-term-follow-up-of-pediatric-sclerosing-cholangitis-mild-phenotype-or-early-diagnosis
#18
F Ferrari, G Ranucci, M Aloi, L Della Volpe, F Viola, E Miele, S Cucchiara, R Iorio
BACKGROUND AND AIMS: Sclerosing cholangitis (SC) is a chronic cholestatic liver disease whose diagnosis is being increasingly recognized in childhood. Long-term course and prognosis of pediatric SC is poorly described. METHODS: We reviewed data of pediatric SC patients, followed in two referral centers during a period of up to 20 years. We aimed to evaluate long-term outcomes according to SC phenotype. RESULTS: Among 45 patients (median age: 10...
January 9, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29310470/new-therapies-target-the-toxic-consequences-of-cholestatic-liver-disease
#19
Peter L M Jansen
In most cholestatic liver diseases the primary cholestasis-causing lesions are located in the biliary tree and may be of (auto)immune origin. Bile salts are responsible for the secondary toxic consequences. Bile salt and nuclear hormone directed therapies primarily aim at improving this secondary toxic injury. In primary biliary cholangitis, trials show statistically significant responses on biochemical endpoints. Preclinical studies suggest that FXR- and PPAR-agonists, inhibitors of the apical sodium-dependent bile salt transporter (ASBT-inhibitors) and the C23 UDCA derivative nor-UDCA are promising agents for the treatment of primary sclerosing cholangitis (PSC)...
January 10, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29301479/risk-factors-and-prognosis-for-recurrent-primary-sclerosing-cholangitis-after-liver-transplantation-a-nordic-multicentre-study
#20
Lina Lindström, Kristin K Jørgensen, Kirsten M Boberg, Maria Castedal, Allan Rasmussen, Andreas Arendtsen Rostved, Helena Isoniemi, Matteo Bottai, Annika Bergquist
OBJECTIVES: The risk for recurrent primary sclerosing cholangitis (rPSC) after liver transplantation is associated with inflammatory bowel disease (IBD). We assessed the frequency of rPSC and studied risk factors for recurrent disease with special focus on IBD. We also evaluated the importance of rPSC for prognosis. MATERIALS AND METHODS: All liver transplanted PSC patients in the Nordic countries between 1984 and 2007 (n = 440), identified by the Nordic Liver Transplant Registry, were studied...
January 4, 2018: Scandinavian Journal of Gastroenterology
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