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Gastrointestinal diseases

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521 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/28088580/grand-round-anticoagulation-in-chronic-liver-disease
#1
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
#2
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
#3
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
#4
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
#5
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...
January 4, 2017: Gut
https://www.readbyqxmd.com/read/28024986/the-natural-history-of-diminutive-and-small-colorectal-polyps-a-systematic-literature-review
#6
REVIEW
Jasper L A Vleugels, Yark Hazewinkel, Paul Fockens, Evelien Dekker
BACKGROUND: Diminutive (1-5 mm) and small (6-9 mm) polyps comprise 90% of detected lesions during colonoscopy and rarely contain advanced histology or colorectal cancer (CRC). Routine removal of these lesions results in a significant burden to colonoscopy programs. At the same time, the risk for progression of these polyps to CRC is unclear. We performed a systematic review to explore the natural history of diminutive and small colorectal polyps. METHODS: We searched MEDLINE and EMBASE for studies investigating the natural history of colorectal polyps...
December 23, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/24531850/hepatocellular-carcinoma-clinical-frontiers-and-perspectives
#7
REVIEW
Jordi Bruix, Gregory J Gores, Vincenzo Mazzaferro
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death and is currently the main event leading to death in patients with cirrhosis. Evolving information suggests that the metabolic syndrome with non-alcoholic liver disease may be an important cause of HCC in addition to viral hepatitis and alcohol-induced liver disease. The molecular pathogenesis is extremely complex and heterogeneous. To date the molecular information has not impacted on treatment decisions. Periodic surveillance imaging of patients with cirrhosis is widely practiced, especially because diagnostic, radiographic criteria for early-stage HCC have been defined (including nodules between 1 and 2 cm) and effective treatment is available for tumours detected at an early stage...
May 2014: Gut
https://www.readbyqxmd.com/read/26614611/the-clinical-phenotypes-of-autoimmune-hepatitis-a-comprehensive-review
#8
REVIEW
Qixia Wang, Fan Yang, Qi Miao, Edward L Krawitt, M Eric Gershwin, Xiong Ma
Autoimmune hepatitis (AIH) fulfills the generally accepted contemporary criteria of an autoimmune liver disease: the presence of autoantibodies and autoreactive T cells, a female gender bias, association with other autoimmune diseases, response to immunosuppressive therapy and strong associations with the major histocompatibility complex HLA loci. It occurs worldwide in both children and adults and is marked by both etiopathogenic and clinical heterogeneity, differing from the other putative autoimmune liver diseases, primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), albeit occasionally presenting with overlapping features of PBC or PSC...
January 2016: Journal of Autoimmunity
https://www.readbyqxmd.com/read/24261965/systematic-review-with-meta-analysis-clinical-manifestations-and-management-of-autoimmune-hepatitis-in-the-elderly
#9
REVIEW
J Chen, G D Eslick, M Weltman
BACKGROUND: Autoimmune hepatitis is an uncommon chronic progressive inflammatory disease of the liver, characterised by hypergammaglobulianemia, circulating autoantibodies, and interface hepatitis histologically. It is traditionally thought to be a disease of young women. However, recent epidemiological and retrospective studies suggest that it might be a disease predominantly of older women. Studies of AIH in elderly patients have been fairly limited. AIM: To investigate the differences in the clinical presentations and the management of AIH in the elderly and the younger patients...
January 2014: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27785449/hepatocellular-carcinoma-a-review
#10
REVIEW
Julius Balogh, David Victor, Emad H Asham, Sherilyn Gordon Burroughs, Maha Boktour, Ashish Saharia, Xian Li, R Mark Ghobrial, Howard P Monsour
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is a leading cause of cancer-related death worldwide. In the United States, HCC is the ninth leading cause of cancer deaths. Despite advances in prevention techniques, screening, and new technologies in both diagnosis and treatment, incidence and mortality continue to rise. Cirrhosis remains the most important risk factor for the development of HCC regardless of etiology. Hepatitis B and C are independent risk factors for the development of cirrhosis...
2016: Journal of Hepatocellular Carcinoma
https://www.readbyqxmd.com/read/27825384/inhibiting-the-proton-pump-mechanisms-benefits-harms-and-questions
#11
Jeffrey K Aronson
Inhibition of the H(+)/K(+)-adenosine triphosphatase (the proton pump) is the final common mechanistic pathway in reducing gastric acid secretion pharmacologically. Proton pump inhibitors are widely used in upper gastrointestinal diseases, including gastric and duodenal ulcers, eradication of Helicobacter pylori in combination with antibiotics, gastroesophageal reflux disease, Zollinger-Ellison syndrome, eosinophilic esophagitis, and prevention of non-steroidal anti-inflammatory drug-induced peptic ulceration...
November 9, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27864004/beta-adrenergic-blockade-and-decompensated-cirrhosis
#12
REVIEW
Thomas Reiberger, Mattias Mandorfer
Non-selective betablockers (NSBBs) remain the cornerstone of medical treatment of portal hypertension. The evidence for their efficacy to prevent variceal bleeding is derived from prospective trials, which largely excluded patients with refractory ascites and renal failure. In parallel to the increasing knowledge on portal hypertension-induced changes in systemic hemodynamics, cardiac function, and renal perfusion, emerging studies have raised concerns about harmful effects of NSBBs. Clinicians are facing an ongoing controversy on the use of NSBBs in patients with advanced cirrhosis...
November 15, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/19280533/appropriateness-of-colonoscopy-in-europe-epage-ii-chronic-diarrhea-and-known-inflammatory-bowel-disease
#13
REVIEW
S Schusselé Filliettaz, P Juillerat, B Burnand, C Arditi, A Windsor, C Beglinger, R W Dubois, I Peytremann-Bridevaux, V Pittet, J-J Gonvers, F Froehlich, J-P Vader
BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for investigation of chronic diarrhea, management of patients with known inflammatory bowel disease (IBD), and for colorectal cancer (CRC) surveillance in such patients, and to report report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews, and primary studies regarding the evaluation of chronic diarrhea, the management of IBD, and colorectal cancer surveillance in IBD was performed...
March 2009: Endoscopy
https://www.readbyqxmd.com/read/27660341/3rd-european-evidence-based-consensus-on-the-diagnosis-and-management-of-crohn-s-disease-2016-part-1-diagnosis-and-medical-management
#14
Fernando Gomollón, Axel Dignass, Vito Annese, Herbert Tilg, Gert Van Assche, James O Lindsay, Laurent Peyrin-Biroulet, Garret J Cullen, Marco Daperno, Torsten Kucharzik, Florian Rieder, Sven Almer, Alessandro Armuzzi, Marcus Harbord, Jost Langhorst, Miquel Sans, Yehuda Chowers, Gionata Fiorino, Pascal Juillerat, Gerassimos J Mantzaris, Fernando Rizzello, Stephan Vavricka, Paolo Gionchetti
This paper is the first in a series of two publications relating to the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the diagnosis and management of Crohn's disease and concerns the methodology of the consensus process, and the classification, diagnosis and medical management of active and quiescent Crohn's disease. Surgical management as well as special situations including management of perianal Crohn's disease of this ECCO Consensus are covered in a subsequent second paper [Gionchetti et al JCC 2016]...
January 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/27840364/25-years-of-proton-pump-inhibitors-a-comprehensive-review
#15
REVIEW
Daniel S Strand, Daejin Kim, David A Peura
Proton pump inhibitors (PPIs) were clinically introduced more than 25 years ago and have since proven to be invaluable, safe, and effective agents for the management of a variety of acid-related disorders. Although all members in this class act in a similar fashion, inhibiting active parietal cell acid secretion, there are slight differences among PPIs relating to their pharmacokinetic properties, metabolism, and Food and Drug Administration (FDA)-approved clinical indications. Nevertheless, each is effective in managing gastroesophageal reflux disease and uncomplicated or complicated peptic ulcer disease...
January 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/27512925/gamma-glutamyltransferase-friend-or-foe-within
#16
Setor K Kunutsor
Gamma-glutamyltransferase (GGT) is a liver enzyme, which is located on the plasma membranes of most cells and organ tissues, but more commonly in hepatocytes, and is routinely used in clinical practice to help indicate liver injury and as a marker of excessive alcohol consumption. Among the liver enzymes, important advances have especially been made in understanding the physiological functions of GGT. The primary role of GGT is the extracellular catabolism of glutathione, the major thiol antioxidant in mammalian cells, which plays a relevant role in protecting cells against oxidants produced during normal metabolism; GGT, therefore, plays an important role in cellular defence...
August 11, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27818588/update-on-occult-hepatitis-b-virus-infection
#17
REVIEW
Manoochehr Makvandi
The event of mutations in the surface antigen gene of hepatitis B virus (HBV) results in undetectable hepatitis B surface antigen with positive/negative anti-hepatitis B core (anti-HBc) antibody status in serum and this phenomenon is named occult hepatitis B infection (OBI). The presence of anti-HBc antibody in serum is an important key for OBI tracking, although about 20% of OBI cases are negative for anti-HBc antibody. The diagnosis of OBI is mainly based on polymerase chain reaction (PCR) and real-time PCR assays...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/25819140/asia-pacific-consensus-statements-on-crohn-s-disease-part-1-definition-diagnosis-and-epidemiology-asia-pacific-crohn-s-disease-consensus-part-1
#18
REVIEW
Choon Jin Ooi, Govind K Makharia, Ida Hilmi, Peter R Gibson, Kwong Ming Fock, Vineet Ahuja, Khoon Lin Ling, Wee Chian Lim, Kelvin T Thia, Shu-chen Wei, Wai Keung Leung, Poh Koon Koh, Richard B Gearry, Khean Lee Goh, Qin Ouyang, Jose Sollano, Sathaporn Manatsathit, H Janaka de Silva, Rungsun Rerknimitr, Pises Pisespongsa, Muhamad Radzi Abu Hassan, Joseph Sung, Toshifumi Hibi, Christopher C M Boey, Neil Moran, Rupert W L Leong
Inflammatory bowel disease (IBD) was previously thought to be rare in Asia, but emerging data indicate rising incidence and prevalence of IBD in the region. The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology with the goal of developing best management practices, coordinating research, and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis with specific relevance to the Asia-Pacific region...
January 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/25819311/asia-pacific-consensus-statements-on-crohn-s-disease-part-2-management
#19
REVIEW
Choon Jin Ooi, Govind K Makharia, Ida Hilmi, Peter R Gibson, Kwong Ming Fock, Vineet Ahuja, Khoon Lin Ling, Wee Chian Lim, Kelvin T Thia, Shu-chen Wei, Wai Keung Leung, Poh Koon Koh, Richard B Gearry, Khean Lee Goh, Qin Ouyang, Jose Sollano, Sathaporn Manatsathit, H Janaka de Silva, Rungsun Rerknimitr, Pises Pisespongsa, Muhamad Radzi Abu Hassan, Joseph Sung, Toshifumi Hibi, Christopher C M Boey, Neil Moran, Rupert W L Leong
The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology (APAGE) with the goal of developing best management practices, coordinating research and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis (UC) with specific relevance to the Asia-Pacific region...
January 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/23090001/evidence-based-clinical-practice-guidelines-for-crohn-s-disease-integrated-with-formal-consensus-of-experts-in-japan
#20
Fumiaki Ueno, Toshiyuki Matsui, Takayuki Matsumoto, Katsuyoshi Matsuoka, Mamoru Watanabe, Toshifumi Hibi
Crohn's disease is a disorder of unknown etiology and complicated pathogenesis. A substantial amount of evidence has accumulated recently and has been applied to clinical practice. The present guidelines were developed based on recent evidence and the formal consensus of experts relevant to this disease. Here we provide an overview of these guidelines, as follows. Target disease: Crohn's disease Users: Clinical practitioners in internal medicine, surgery, gastroenterology, and general practice Purpose: To provide appropriate clinical indicators to practitioners Scope of clinical indicators: Concept of Crohn's disease, epidemiology, classifications, diagnosis, treatment, follow up, and special situations Intervention: Diagnosis (interview, physical examination, clinical laboratory tests, imaging, and pathology) and treatment (lifestyle guidance, drug therapy, nutritional therapy, surgery, etc...
January 2013: Journal of Gastroenterology
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