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Gastrointestinal diseases

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675 papers 500 to 1000 followers This is a recopilation of basic knowledge about GI diseases. I hope you enjoy it
By Andres Gomez Aldana Gastroenterology fellowship National University of Colombia
Pedro Pimentel-Nunes, Diogo Libânio, Mário Dinis-Ribeiro
Gastric cancer is one of the most common and lethal cancers in the world. In Portugal, it is a major health problem presenting one of the highest incidence rates among European countries. In most Western countries, gastric cancer is generally diagnosed in advanced stages. Nevertheless, with the widespread use of upper endoscopy, gastric superficial neoplastic lesions are being increasingly recognized and diagnosed. However, there are no clear recommendations regarding who should be screened for its presence and only recently guidelines concerning the evaluation and management of these lesions were published...
January 2017: GE Portuguese Journal of Gastroenterology
Scott C Howard, John McCormick, Ching-Hon Pui, Randall K Buddington, R Donald Harvey
: High-dose methotrexate (HDMTX), defined as a dose higher than 500 mg/m2, is used to treat a range of adult and childhood cancers. Although HDMTX is safely administered to most patients, it can cause significant toxicity, including acute kidney injury (AKI) in 2%-12% of patients. Nephrotoxicity results from crystallization of methotrexate in the renal tubular lumen, leading to tubular toxicity. AKI and other toxicities of high-dose methotrexate can lead to significant morbidity, treatment delays, and diminished renal function...
December 2016: Oncologist
Alejandro Forner, María Reig, Jordi Bruix
Hepatocellular carcinoma appears frequently in patients with cirrhosis. Surveillance by biannual ultrasound is recommended for such patients because it allows diagnosis at an early stage, when effective therapies are feasible. The best candidates for resection are patients with a solitary tumour and preserved liver function. Liver transplantation benefits patients who are not good candidates for surgical resection, and the best candidates are those within Milan criteria (solitary tumour ≤5 cm or up to three nodules ≤3 cm)...
January 4, 2018: Lancet
Stuart K Roberts, William Kemp
Several salvage therapies have been identified for autoimmune hepatitis refractory or recalcitrant to conventional therapy; however, the optimal salvage strategy remains unclear. High-dose prednisolone is currently recommended as the front-line salvage therapy, with alternative immunosuppressive therapies reserved for continuing treatment failure. Of the second-line therapies, the calcineurin inhibitors, cyclosporine and tacrolimus, and mycophenolate mofetil are preferred and have the most accrued clinical data...
November 2017: Seminars in Liver Disease
R Todd Stravitz, Caitlyn Ellerbe, Valerie Durkalski, Michael Schilsky, Robert J Fontana, Carolyn Peterseim, William M Lee
In patients with acute liver failure (ALF), elevatedprothrombin time and thrombocytopeniacan fuel a perception of a bleeding tendency. However, the incidence, site, risk factors, and clinical significance of bleeding complications have not been previously quantified in a large cohort of patients with ALF. We studied 1770adult patients enrolled in the ALF Study Group Registry between 1998 and 2016.Bleeding complications and blood component transfusions were collected for 7days after admission. The relationship of bleeding complications to 21-day mortality was assessed...
December 1, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Nikita Agrawal, David Ej Jones, Jessica K Dyson, Tim Hoare, Sharon A Melmore, Stephanie Needham, Nick P Thompson
We report a case of ileo-colonic Histoplasmosis without apparent respiratory involvement in a patient who had previously undergone an orthotopic liver transplant (OLT) for primary biliary cholangitis 15 years earlier. The recipient lived in the United Kingdom, a non-endemic region for Histoplasmosis. However, she had previously lived in rural southern Africa prior to her OLT. The patient presented with iron deficiency anaemia, diarrhoea, abdominal pain and progressive weight loss. She reported no previous foreign travel, however, it later became known that following her OLT she had been on holiday to rural southern Africa...
November 21, 2017: World Journal of Gastroenterology: WJG
George Cholankeril, Mairin Joseph-Talreja, Brandon J Perumpail, Andy Liu, Eric R Yoo, Aijaz Ahmed, Aparna Goel
Chronic hepatitis C virus (HCV) infection remains the leading indication for liver transplantation (LT) in the United States. While most patients with chronic HCV infection remain asymptomatic, up to one-third develop progressive liver disease resulting in cirrhosis. LT is often the only curative treatment once significant hepatic decompensation develops. However, antiviral therapy for HCV infection has advanced markedly in the past 5 years with the discovery and approval of direct-acting antiviral agents. These new regimens are well tolerated, of short duration and highly effective, unlike the traditional treatment with pegylated-interferon and ribavirin...
December 28, 2017: Journal of Clinical and Translational Hepatology
Andi L Shane, Rajal K Mody, John A Crump, Phillip I Tarr, Theodore S Steiner, Karen Kotloff, Joanne M Langley, Christine Wanke, Cirle Alcantara Warren, Allen C Cheng, Joseph Cantey, Larry K Pickering
These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.
November 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Yoshio Sumida, Masashi Yoneda
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease worldwide, and there is no approved pharmacotherapy. The efficacy of vitamin E and pioglitazone has been established in nonalcoholic steatohepatitis (NASH), a progressive form of NAFLD. GLP-1RA and SGLT2 inhibitors, which are currently approved for use in diabetes, have shown early efficacy in NASH, and also have beneficial cardiovascular or renal effects. Innovative NASH therapies include four main pathways. The first approach is targeting hepatic fat accumulation...
December 16, 2017: Journal of Gastroenterology
René M M van Aerts, Liyanne F M van de Laarschot, Jesus M Banales, Joost P H Drenth
In this Grand Round we present a typical case of a woman with polycystic liver disease (PLD). This case prompts questions which both patients and clinicians may face in clinical practice. This article aims to provide guidance to clinicians in the care of PLD patients in relation to recent key development in the field. We discuss the latest novelties in pathophysiology, natural course of disease, complications and treatment options. Finally, we discuss other potential new and effective therapies.
November 23, 2017: Journal of Hepatology
J B Dever, M Y Sheikh
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a severe and often fatal infection in patients with cirrhosis and ascites. AIM: To review the known and changing bacteriology, risk factors, ascitic fluid interpretation, steps in performing paracentesis, treatment, prophylaxis and evolving perspectives related to SBP. METHODS: Information was obtained from reviewing medical literature accessible on PubMed Central. The search term 'spontaneous bacterial peritonitis' was cross-referenced with 'bacteria', 'risk factors', 'ascites', 'paracentesis', 'ascitic fluid analysis', 'diagnosis', 'treatment', 'antibiotics', 'prophylaxis', 'liver transplantation' and 'nutrition'...
June 2015: Alimentary Pharmacology & Therapeutics
Agostino Di Ciaula, Gabriella Garruti, Raquel Lunardi Baccetto, Emilio Molina-Molina, Leonilde Bonfrate, David Q-H Wang, Piero Portincasa
The primary bile acids (BAs) are synthetized from colesterol in the liver, conjugated to glycine or taurine to increase their solubility, secreted into bile, concentrated in the gallbladder during fasting, and expelled in the intestine in response to dietary fat, as well as bio-transformed in the colon to the secondary BAs by the gut microbiota, reabsorbed in the ileum and colon back to the liver, and minimally lost in the feces. BAs in the intestine not only regulate the digestion and absorption of cholesterol, triglycerides, and fat-soluble vitamins, but also play a key role as signaling molecules in modulating epithelial cell proliferation, gene expression, and lipid and glucose metabolism by activating farnesoid X receptor (FXR) and G-protein-coupled bile acid receptor-1 (GPBAR-1, also known as TGR5) in the liver, intestine, muscle and brown adipose tissue...
October 28, 2017: Annals of Hepatology
Muhammed Sait Dağ, Zeynel Abidin Öztürk, Irem Akın, Ediz Tutar, Öztekin Çıkman, Murat Taner Gülşen
BACKGROUNDS/AIMS: Drugs can cause several complications in the esophagus and lead to pill esophagitis. In this paper, our purpose is to share our clinical experience in light of the literature and put forward the general characteristics of pill esophagitis. MATERIALS AND METHODS: In our clinic, between January 2008 and June 2012, by excluding other factors, 48 patients were included in the study, diagnosed as drug-induced esophagitis with their history, endoscopic view, and histopathologic evaluation...
April 2014: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Priscila Baptistella Yazbek, Ariane Biolcati Trindade, Chung Man Chin, Jean Leandro Dos Santos
Helicobacter pylori (H. pylori) is one of the leading causes of gastric diseases such as chronic gastritis, peptic ulcer, and gastric adenocarcinoma. The current treatment of H. pylori infection with antibiotics and proton pump inhibitors has several limitations, including poor adherence and intrinsic patient-related factors, drug resistance, and the absence of adequate treatments. This review summarizes the current therapeutic approaches to eradicating H. pylori, the difficulties associated with its treatment, and several new perspectives aimed at improving existing treatment strategies...
October 2015: Digestive Diseases and Sciences
Jennifer K Maratt, Audrey H Calderwood, Sameer D Saini
No abstract text is available yet for this article.
January 2018: American Journal of Gastroenterology
David H Woo, Jeanne M Laberge, Roy L Gordon, Mark W Wilson, Robert K Kerlan
The postoperative vascular complications following liver transplantation, specifically portal venous complications, have been well documented. These complications, which include portal venous stenosis and thrombosis, can be potentially devastating and lead to graft failure. The interventional techniques in managing these complications are relatively new and have been developed only in the past 15 to 20 years. Additionally with the increasing numbers of split liver and living related transplants that are being performed, so has the incidence of portal venous complications increased...
September 2007: Techniques in Vascular and Interventional Radiology
Vera C Mazurak, Puneeta Tandon, Aldo J Montano-Loza
Cirrhosis is the most common indication for liver transplantation (LT) worldwide. Malnutrition is present in at least two-thirds of patients with cirrhosis awaiting LT. It negatively impacts survival, quality of life, and the ability to respond to stressors, such as infection and surgery. Muscle wasting or sarcopenia is the most objective feature of chronic protein malnutrition in cirrhosis, and this condition is associated with increased morbidity and mortality before and after LT. In addition to its objectivity, muscularity assessment with cross-sectional imaging studies is a useful marker of nutritional status in LT candidates, as sarcopenia reflects a chronic decline in the general physical condition, rather than acute severity of the liver disease...
November 2017: Liver Transplantation
Philip N Newsome, Rob Cramb, Suzanne M Davison, John F Dillon, Mark Foulerton, Edmund M Godfrey, Richard Hall, Ulrike Harrower, Mark Hudson, Andrew Langford, Anne Mackie, Robert Mitchell-Thain, Karen Sennett, Nicholas C Sheron, Julia Verne, Martine Walmsley, Andrew Yeoman
These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine...
January 2018: Gut
Ingvar Bjarnason, Carmelo Scarpignato, Erik Holmgren, Michael Olszewski, Kim D Rainsford, Angel Lanas
Non-steroidal anti-inflammatory drugs (NSAIDs) can damage the gastrointestinal tract, causing widespread morbidity and mortality. Although mechanisms of damage involve the activities of prostaglandin-endoperoxide synthase 1 (PTGS1 or COX1) and PTGS1 (COX2), other factors are involved. We review mechanisms of gastrointestinal damage induction by NSAIDs, via COX-mediated and COX-independent processes. NSAIDs interact with phospholipids and uncouple mitochondrial oxidative phosphorylation, which initiates biochemical changes that impair function of the gastrointestinal barrier...
December 5, 2017: Gastroenterology
Tiffany Wu, Ryan M Kwok, Tram T Tran
Hepatitis B core antibody (anti-HBc) is considered the most sensitive serological marker for history of hepatitis B virus (HBV) infection. In a subset of anti-HBc carriers, anti-HBc is present in the absence of hepatitis B surface antigen and hepatitis B surface antibody-a serological pattern known as "isolated anti-HBc" (IAHBc). IAHBc has been of clinical interest over the past several years, with growing data to suggest its role as a serological marker for occult HBV infection (OBI). This article reviews the clinical significance and association of IAHBc with hepatitis C virus (HCV) co-infection, risk of HBV reactivation during direct-acting antiviral therapy for HCV as well as immune suppression, and development of hepatocellular carcinoma (HCC)...
October 31, 2017: American Journal of Gastroenterology
2017-12-03 21:28:59
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