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Gastrointestinal diseases

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536 papers 100 to 500 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
https://www.readbyqxmd.com/read/26188762/perspectives-on-dual-hepatitis-b-and-c-infection-in-taiwan
#1
REVIEW
Chun-Jen Liu, Pei-Jer Chen, Ding-Shinn Chen, Tai-Chung Tseng, Jia-Horng Kao
Dual hepatitis C virus (HCV) and hepatitis B virus (HBV) infection is not rare in HBV or HCV endemic areas, and can be found in populations at risk of parenteral viral transmission. Clinical observatory studies suggest a higher risk of liver disease progression in patients with dual HCV/HBV infection than in HBV or HCV monoinfected patients. Recent trials confirmed that combination therapy of peginterferon alfa-2a or alfa-2b and ribavirin was effective and safe in dually infected patients with positive HCV RNA...
May 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/26894594/host-virus-interactions-in-hepatitis-b-and-hepatitis-c-infection
#2
REVIEW
Sachiyo Yoshio, Tatsuya Kanto
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are among the most endemic pathogens worldwide, with more than 500 million people globally currently infected with these viruses. These pathogens can cause acute and chronic hepatitis that progress to liver cirrhosis or hepatocellular carcinoma. Both viruses utilize multifaceted strategies to evade the host surveillance system and fall below the immunological radar. HBV has developed specific strategies to evade recognition by the innate immune system and is acknowledged to be a stealth virus...
May 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27374637/immune-responses-and-immunopathology-in-acute-and-chronic-viral-hepatitis
#3
REVIEW
Eui-Cheol Shin, Pil Soo Sung, Su-Hyung Park
Hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV) are responsible for most cases of viral hepatitis. Infection by each type of virus results in a different typical natural disease course and clinical outcome that are determined by virological and immunological factors. HCV tends to establish a chronic persistent infection, whereas HAV does not. HBV is effectively controlled in adults, although it persists for a lifetime after neonatal infection. In this Review, we discuss the similarities and differences in immune responses to and immunopathogenesis of HAV, HBV and HCV infections, which may explain the distinct courses and outcomes of each hepatitis virus infection...
2016: Nature Reviews. Immunology
https://www.readbyqxmd.com/read/28140702/antiviral-therapies-for-managing-viral-hepatitis-in-lymphoma-patients
#4
Michele Merli, Sara Rattotti, Manuel Gotti, Luca Arcaini
In patients with lymphoma the detection of positive hepatitis B or C viruses (HBV and HCV) serology involves crucial therapeutic consequences. In HBV-infected patients the serological profile of active (HBsAg-positive) or resolved (HBsAg-negative/anti-HBcAb-positive) infection is associated to differential risk of viral reactivation during rituximab-based therapy and require appropriate strategies of monitoring and of antiviral prophylaxis. In HCV-associated NHL patients consolidated data demonstrated that interferon (IFN)-based antiviral therapy (AT) is able to induce lymphoma regression strictly related to viral eradication, while preliminary data of the new direct-acting antivirals (DAAs) are very promising...
January 31, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28212588/colorectal-polypectomy-and-endoscopic-mucosal-resection-emr-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline
#5
Monika Ferlitsch, Alan Moss, Cesare Hassan, Pradeep Bhandari, Jean-Marc Dumonceau, Gregorios Paspatis, Rodrigo Jover, Cord Langner, Maxime Bronzwaer, Kumanan Nalankilli, Paul Fockens, Rawi Hazzan, Ian M Gralnek, Michael Gschwantler, Elisabeth Waldmann, Philip Jeschek, Daniela Penz, Denis Heresbach, Leon Moons, Arnaud Lemmers, Konstantina Paraskeva, Juergen Pohl, Thierry Ponchon, Jaroslaw Regula, Alessandro Repici, Matthew D Rutter, Nicholas G Burgess, Michael J Bourke
1 ESGE recommends cold snare polypectomy (CSP) as the preferred technique for removal of diminutive polyps (size ≤ 5 mm). This technique has high rates of complete resection, adequate tissue sampling for histology, and low complication rates. (High quality evidence, strong recommendation.) 2 ESGE suggests CSP for sessile polyps 6 - 9 mm in size because of its superior safety profile, although evidence comparing efficacy with hot snare polypectomy (HSP) is lacking. (Moderate quality evidence, weak recommendation...
February 17, 2017: Endoscopy
https://www.readbyqxmd.com/read/28185291/review-article-pathogenesis-and-clinical-manifestations-of-gastrointestinal-involvement-in-systemic-sclerosis
#6
REVIEW
S Kumar, J Singh, S Rattan, A J DiMarino, S Cohen, S A Jimenez
BACKGROUND: Gastrointestinal tract (GIT) involvement is a common cause of debilitating symptoms in patients with systemic sclerosis (SSc). There are no disease modifying therapies for this condition and the treatment remains symptomatic, largely owing to the lack of a clear understanding of its pathogenesis. AIMS: To investigate novel aspects of the pathogenesis of gastrointestinal involvement in SSc. To summarise existing knowledge regarding the cardinal clinical gastrointestinal manifestations of SSc and its pathogenesis, emphasising recent investigations that may be valuable in identifying potentially novel therapeutic targets...
February 9, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/25850008/dysphagia-current-reality-and-scope-of-the-problem
#7
REVIEW
Pere Clavé, Reza Shaker
Dysphagia is a symptom of swallowing dysfunction that occurs between the mouth and the stomach. Although oropharyngeal dysphagia is a highly prevalent condition (occurring in up to 50% of elderly people and 50% of patients with neurological conditions) and is associated with aspiration, severe nutritional and respiratory complications and even death, most patients are not diagnosed and do not receive any treatment. By contrast, oesophageal dysphagia is less prevalent and less severe, but with better recognized symptoms caused by diseases affecting the enteric nervous system and/or oesophageal muscular layers...
May 2015: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/25590391/dysphagia-revisited-common-and-unusual-causes
#8
REVIEW
Laura R Carucci, Mary Ann Turner
Dysphagia is a common clinical problem whose prevalence is increasing with the aging population in the United States. The term dysphagia is commonly used to describe subjective awareness of swallowing difficulty during the passage of a bolus from the mouth to the stomach or the perception of obstruction during swallowing. Dysphagia may be further classified as oropharyngeal or substernal, depending on the location of this sensation. It can be due to benign or malignant structural lesions, esophageal motility abnormalities, oropharyngeal dysfunction (including aspiration), neuromuscular disorders, or postsurgical changes and is also associated with gastroesophageal reflux disease...
January 2015: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/18940645/dysphagia-in-the-elderly
#9
REVIEW
Ianessa A Humbert, Joanne Robbins
The capacity to swallow or eat is a basic human need and can be a great pleasure. Older adults look forward to sharing mealtimes and participating in social interactions. The loss of capacity to swallow and dine can have far-reaching implications. With age, the ability to swallow undergoes changes that increase the risk for disordered swallowing, with devastating health implications for older adults. With the growth in the aging population, dysphagia is becoming a national health care burden and concern. Upward of 40% of people in institutionalized settings are dysphagic...
November 2008: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/20226990/porphyrias
#10
REVIEW
Hervé Puy, Laurent Gouya, Jean-Charles Deybach
Hereditary porphyrias are a group of eight metabolic disorders of the haem biosynthesis pathway that are characterised by acute neurovisceral symptoms, skin lesions, or both. Every porphyria is caused by abnormal function of a separate enzymatic step, resulting in a specific accumulation of haem precursors. Seven porphyrias are the result of a partial enzyme deficiency, and a gain of function mechanism has been characterised in a new porphyria. Acute porphyrias present with acute attacks, typically consisting of severe abdominal pain, nausea, constipation, confusion, and seizure, and can be life-threatening...
March 13, 2010: Lancet
https://www.readbyqxmd.com/read/26384356/how-i-treat-posttransplant-lymphoproliferative-disorders
#11
Daan Dierickx, Thomas Tousseyn, Olivier Gheysens
Posttransplant lymphoproliferative disorder (PTLD) is a potentially fatal disorder arising after solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT). Iatrogenically impaired immune surveillance and Epstein-Barr virus (EBV) primary infection/reactivation are key factors in the pathogenesis. However, current knowledge on all aspects of PTLD is limited due to its rarity, morphologic heterogeneity, and the lack of prospective trials. Furthermore, the broad spectrum of underlying immune disorders and the type of graft represent important confounding factors...
November 12, 2015: Blood
https://www.readbyqxmd.com/read/27707777/management-of-helicobacter-pylori-infection-the-maastricht-v-florence-consensus-report
#12
P Malfertheiner, F Megraud, C A O'Morain, J P Gisbert, E J Kuipers, A T Axon, F Bazzoli, A Gasbarrini, J Atherton, D Y Graham, R Hunt, P Moayyedi, T Rokkas, M Rugge, M Selgrad, S Suerbaum, K Sugano, E M El-Omar
Important progress has been made in the management of Helicobacter pylori infection and in this fifth edition of the Maastricht Consensus Report, key aspects related to the clinical role of H. pylori were re-evaluated in 2015. In the Maastricht V/Florence Consensus Conference, 43 experts from 24 countries examined new data related to H. pylori in five subdivided workshops: (1) Indications/Associations, (2) Diagnosis, (3) Treatment, (4) Prevention/Public Health, (5) H. pylori and the Gastric Microbiota. The results of the individual workshops were presented to a final consensus voting that included all participants...
January 2017: Gut
https://www.readbyqxmd.com/read/14971998/diagnostic-and-therapeutic-approach-to-cholestatic-liver-disease
#13
REVIEW
T Pérez Fernández, P López Serrano, E Tomás, Ma L Gutiérrez, J L Lledó, G Cacho, C Santander, C M Fernández Rodríguez
When cholestatic liver disease is present, liver ultrasound should be performed to ascertain if cholestasis is extrahepatic or intrahepatic. If bile ducts appear dilated and the probability of interventional treatment is high, endoscopic retrograde cholagio-pancreatography (ERCP) or trans-hepatic cholangiography (THC) should be the next step. If the probability of interventional therapeutics is low, cholangio-MRI should be performed. Once bile duct dilation and space occupying lesions are excluded, a work up for intrahepatic cholestasis should be started...
January 2004: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/18376240/update-on-progressive-familial-intrahepatic-cholestasis
#14
REVIEW
Feras T Alissa, Ronald Jaffe, Benjamin L Shneider
Three distinct forms of familial intrahepatic cholestasis are the result of mutations in the ATP8B1, ABCB11, and ABCB4 genes. The pathophysiologies of the latter 2 of these diseases are well characterized and are the result of abnormalities in canalicular excretion of bile acids and phospholipids, respectively. The molecular pathophysiology of the systemic disease associated with mutations in ATP8B1 remains unclear. In all of these diseases, wide variations in clinical phenotypes have been observed. The variability can be ascribed at least in part to predicted genotype:phenotype correlations...
March 2008: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/22541695/approach-to-a-patient-with-elevated-serum-alkaline-phosphatase
#15
REVIEW
Asma Siddique, Kris V Kowdley
Cholestasis develops either from a defect in bile synthesis, impairment in bile secretion, or obstruction to bile flow, and is characterized by an elevated serum alkaline phosphatase and gamma-glutamyltransferase disproportionate to elevation of aminotransferase enzymes. Key elements to the diagnostic workup include visualization of the biliary tree by cholangiography and evaluation of liver histology. The hope is that recent advances in understanding the genetic factors and immune mechanisms involved in the pathogenesis of cholestasis will lead to newer therapeutic interventions in the treatment of these diseases...
May 2012: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28088580/grand-round-anticoagulation-in-chronic-liver-disease
#16
REVIEW
Ameet Dhar, Benjamin H Mullish, Mark R Thursz
In this Grand Round, we first present a case of a man with decompensated liver disease who subsequently developed a fatal pulmonary embolism, having not been prescribed prophylactic anticoagulation to prevent venous thromboembolic disease. We go on to discuss the burden of thrombotic disease in those with chronic liver disease, before a more detailed discussion regarding the current evidence, safety data, and clinical dilemmas regarding the use of anticoagulation in patients with chronic liver disease, as well as discussing potential future directions within this field...
January 11, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28087657/european-consensus-conference-on-faecal-microbiota-transplantation-in-clinical-practice
#17
Giovanni Cammarota, Gianluca Ianiro, Herbert Tilg, Mirjana Rajilić-Stojanović, Patrizia Kump, Reetta Satokari, Harry Sokol, Perttu Arkkila, Cristina Pintus, Ailsa Hart, Jonathan Segal, Marina Aloi, Luca Masucci, Antonio Molinaro, Franco Scaldaferri, Giovanni Gasbarrini, Antonio Lopez-Sanroman, Alexander Link, Pieter de Groot, Willem M de Vos, Christoph Högenauer, Peter Malfertheiner, Eero Mattila, Tomica Milosavljević, Max Nieuwdorp, Maurizio Sanguinetti, Magnus Simren, Antonio Gasbarrini
Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance...
January 13, 2017: Gut
https://www.readbyqxmd.com/read/27995906/acg-clinical-guideline-evaluation-of-abnormal-liver-chemistries
#18
Paul Y Kwo, Stanley M Cohen, Joseph K Lim
Clinicians are required to assess abnormal liver chemistries on a daily basis. The most common liver chemistries ordered are serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase and bilirubin. These tests should be termed liver chemistries or liver tests. Hepatocellular injury is defined as disproportionate elevation of AST and ALT levels compared with alkaline phosphatase levels. Cholestatic injury is defined as disproportionate elevation of alkaline phosphatase level as compared with AST and ALT levels...
January 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28045663/caustic-ingestion
#19
REVIEW
Mircea Chirica, Luigi Bonavina, Michael D Kelly, Emile Sarfati, Pierre Cattan
Corrosive ingestion is a rare but potentially devastating event and, despite the availability of effective preventive public health strategies, injuries continue to occur. Most clinicians have limited personal experience and rely on guidelines; however, uncertainty persists about best clinical practice. Ingestions range from mild cases with no injury to severe cases with full thickness necrosis of the oesophagus and stomach. CT scan is superior to traditional endoscopy for stratification of patients to emergency resection or observation...
October 26, 2016: Lancet
https://www.readbyqxmd.com/read/28053053/acute-on-chronic-liver-failure-an-update
#20
REVIEW
Ruben Hernaez, Elsa Solà, Richard Moreau, Pere Ginès
Acute-on-chronic liver failure (ACLF) is a syndrome characterised by acute decompensation of chronic liver disease associated with organ failures and high short-term mortality. Alcohol and chronic viral hepatitis are the most common underlying liver diseases. Up to 40%-50% of the cases of ACLF have no identifiable trigger; in the remaining patients, sepsis, active alcoholism and relapse of chronic viral hepatitis are the most common reported precipitating factors. An excessive systemic inflammatory response seems to play a crucial role in the development of ACLF...
March 2017: Gut
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