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Gastroenterology

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396 papers 500 to 1000 followers
By Jeff Bank Internal Medicine R2 at the University of Utah
https://www.readbyqxmd.com/read/27840364/25-years-of-proton-pump-inhibitors-a-comprehensive-review
#1
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...
November 14, 2016: Gut and Liver
https://www.readbyqxmd.com/read/27866880/efficacy-of-sterile-fecal-filtrate-transfer-for-treating-patients-with-clostridium-difficile-infection
#2
Stephan J Ott, Georg H Waetzig, Ateequr Rehman, Jacqueline Moltzau-Anderson, Richa Bharti, Juris A Grasis, Liam Cassidy, Andreas Tholey, Helmut Fickenscher, Dirk Seegert, Philip Rosenstiel, Stefan Schreiber
BACKGROUND & AIMS: Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridium difficile infection (CDI). However, transferring undefined living bacteria entails uncontrollable risks for infectious and metabolic or malignant diseases, particularly in immunocompromised patients. We investigated whether sterile fecal filtrates (containing bacterial debris, proteins, antimicrobial compounds, metabolic products and oligonucleotides/DNA), rather than intact microorganisms, are effective in patients with CDI...
November 17, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27845340/plastic-vs-self-expandable-metal-stents-for-palliation-in-malignant-biliary-obstruction-a-series-of-meta-analyses
#3
Majid A Almadi, Alan Barkun, Myriam Martel
OBJECTIVES: Self-expandable metal stents (SEMS) are thought to have an advantage over plastic stents in achieving biliary drainage. METHODS: We performed a systematic search of MEDLINE, EMBASE, Scopus, CENTRAL, and ISI Web of knowledge databases, from January 1980 to September 2015, for randomized-controlled trials (RCTs) comparing SEMS vs. plastic stents in the palliation of malignant biliary obstruction. Primary outcomes were durations of stent patency, patient survival, and 30-day mortality...
November 15, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27845341/long-term-proton-pump-inhibitor-use-is-not-associated-with-changes-in-bone-strength-and-structure
#4
Laura E Targownik, Andrew L Goertzen, Yunhua Luo, William D Leslie
OBJECTIVES: Multiple studies have reported an association between proton pump inhibitor (PPI) use and fracture. However, the causality of this association is questionable, as there is not a well defined mechanism of action, nor is there evidence of an effect on PPIs on areal bone mineral density (aBMD) using dual photon X-ray absorptiometry (DXA). It is possible that PPIs may induce changes in bone structure which would predispose to fracture in the absence of changes in aBMD. We used three-dimensional quantitative computed tomography (3D-QCT) imaging to determine if long-term PPI use was associated with structural changes in bone independent of aBMD...
November 15, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27765692/how-to-improve-your-adenoma-detection-rate-during%C3%A2-colonoscopy
#5
Neil Gupta
No abstract text is available yet for this article.
December 2016: Gastroenterology
https://www.readbyqxmd.com/read/27753435/recommendations-on-fecal-immunochemical-testing-to-screen-for-colorectal-neoplasia-a-consensus-statement-by-the-us-multi-society-task-force-on-colorectal-cancer
#6
Douglas J Robertson, Jeffrey K Lee, C Richard Boland, Jason A Dominitz, Francis M Giardiello, David A Johnson, Tonya Kaltenbach, David Lieberman, Theodore R Levin, Douglas K Rex
The use of the fecal occult blood test (FOBT) for colorectal cancer (CRC) screening is supported by randomized trials demonstrating effectiveness in cancer prevention and widely recommended by guidelines for this purpose. The fecal immunochemical test (FIT), as a direct measure of human hemoglobin in stool has a number of advantages relative to conventional FOBT and is increasingly used relative to that test. This review summarizes current evidence for FIT in colorectal neoplasia detection and the comparative effectiveness of FIT relative to other commonly used CRC screening modalities...
October 18, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27717864/extensive-testing-or-focused-testing-of-patients-with-elevated-liver-enzymes
#7
Elliot B Tapper, Sameer D Saini, Neil Sengupta
BACKGROUND: Many patients have elevated serum aminotransferases reflecting many underlying conditions, both common and rare. Clinicians generally apply one of two evaluative strategies: testing for all diseases at once (non-directed) or just common diseases first (directed). METHODS: We simulated the evaluation of 10,000 adult outpatients with elevated with alanine aminotransferase to compare both testing strategies. Model inputs employed population-based data from the US (National Health and Nutrition Examination Survey) and Britain (Birmingham and Lambeth Liver Evaluation Testing Strategies)...
October 4, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27712984/recent-discoveries-in-the-genetics-of-familial-colorectal-cancer%C3%A2-and-polyposis
#8
REVIEW
Laura Valle
The development of genome-wide massively parallel sequencing, ie, whole-genome and whole-exome sequencing, and copy number approaches has raised high expectations for the identification of novel hereditary colorectal cancer genes. Although relatively successful for genes causing adenomatous polyposis syndromes, both autosomal dominant and recessive, the identification of genes associated with hereditary non-polyposis colorectal cancer has proven extremely challenging, mainly because of the absence of major high-penetrance genes and the difficulty in demonstrating the functional impact of the identified variants and their causal association with tumor development...
October 3, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27725146/identification-of-an-intestinal-microbiota-signature-associated-with-severity-of-irritable-bowel-syndrome
#9
Julien Tap, Muriel Derrien, Hans Törnblom, Rémi Brazeilles, Stéphanie Cools-Portier, Joël Doré, Stine Störsrud, Boris Le Nevé, Lena Öhman, Magnus Simrén
BACKGROUND & AIMS: We have limited knowledge about the association between the composition of the intestinal microbiota and clinical features of irritable bowel syndrome (IBS). We collected information on the fecal and mucosa-associated microbiota of patients with IBS and evaluated whether these were associated with symptoms. METHODS: We collected fecal and mucosal samples from adult patients who met the Rome III criteria for IBS at secondary or tertiary care outpatient clinics in Sweden, as well as from healthy subjects...
October 7, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27725652/a-randomized-controlled-trial-comparing-the-low-fodmap-diet-vs-modified-nice-guidelines-in-us-adults-with-ibs-d
#10
Shanti L Eswaran, William D Chey, Theresa Han-Markey, Sarah Ball, Kenya Jackson
OBJECTIVES: There has been an increasing interest in the role of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) in irritable bowel syndrome (IBS). We report results from the first randomized controlled trial of the low FODMAP diet in US adults with IBS and diarrhea (IBS-D). The objectives were to compare the efficacy of the low FODMAP diet vs. a diet based upon modified National Institute for Health and Care Excellence guidelines (mNICE) on overall and individual symptoms in IBS-D patients...
October 11, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27670603/rescue-therapy-for-helicobacter-pylori-eradication-a-randomized-non-inferiority-trial-of-amoxicillin-or-tetracycline-in-bismuth-quadruple-therapy
#11
Qi Chen, Wei Zhang, Qingyan Fu, Xiao Liang, Wenzhong Liu, Shudong Xiao, Hong Lu
OBJECTIVES: To compare the efficacy and safety of bismuth-containing quadruple therapy with tetracycline or amoxicillin for rescue treatment of Helicobacter pylori. METHODS: The study was a non-inferiority trial of H. pylori eradication with at least two previous treatment failures. Subjects were randomized to receive 14-day therapy with b.i.d. lansoprazole 30 mg and bismuth 220 mg, plus metronidazole 400 mg q.i.d and amoxicillin 1 g t.i.d (amoxicillin group) or tetracycline 500 mg q...
September 27, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27663604/transjugular-intrahepatic-portosystemic-shunts-with-covered-stents-increase-transplant-free-survival-of-patients-with-cirrhosis-and-recurrent-ascites
#12
Christophe Bureau, Dominique Thabut, Frédéric Oberti, Sébastien Dharancy, Nicolas Carbonell, Antoine Bouvier, Philippe Mathurin, Philippe Otal, Pauline Cabarrou, Jean Marie Péron, Jean Pierre Vinel
BACKGROUND & AIMS: There is controversy over the ability of transjugular intrahepatic portosystemic shunts (TIPS) to increase survival times of patients with cirrhosis and refractory ascites. The high rate of shunt dysfunction with the use of uncovered stents counteracts the benefits of TIPS. We performed a randomized controlled trial to determine the effects of TIPS with stents covered with polytetrafluoroethylene in these patients. METHODS: We performed a prospective study of 62 patients with cirrhosis and at least 2 large-volume paracenteses within a period of at least 3 weeks; the study was performed at 4 tertiary care centers in France from August 2005 through December 2012...
September 20, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27612923/rectal-indomethacin-is-protective-against-post-ercp-pancreatitis-in-high-risk-patients-but-not-average-risk-patients-a-systematic-review-and-meta-analysis
#13
Sumant Inamdar, Dennis Han, Monica Passi, Divyesh V Sejpal, Arvind J Trindade
BACKGROUND AND AIMS: Rectal indomethacin is a popular chemopreventive agent to help prevent post-ERCP pancreatitis (PEP). Prior meta-analyses have shown an overall protective effect for PEP in average-risk and high-risk patients. However these meta-analyses are limited by a small number of studies. Recently, more trials have been published addressing this issue. The aim is to determine if rectal indomethacin prevents PEP in average-risk and high-risk groups, after incorporating this new data...
September 6, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27619833/the-periscreen-strip-is-highly-efficient-for-the-exclusion-of-spontaneous-bacterial-peritonitis-in-cirrhotic-outpatients
#14
Thierry Thévenot, Charline Briot, Vincent Macé, Hortensia Lison, Laure Elkrief, Alexandra Heurgué-Berlot, Christophe Bureau, Caroline Jézéquel, Ghassan Riachi, Alexandre Louvet, Arnaud Pauwels, Isabelle Ollivier-Hourmand, Rodolphe Anty, Nicolas Carbonell, Hélène Labadie, Karim Aziz, Denis Grasset, Eric Nguyen-Khac, Mehdi Kaassis, Sofia Hermann, Florence Tanné, Thomas Mouillot, Olivier Roux, Aurélie Le Thuaut, Jean-Paul Cervoni, Jean-François Cadranel, Matthieu Schnee
OBJECTIVES: We aimed to assess the performance of a new strip (Periscreen) for the rapid diagnosis of spontaneous bacterial peritonitis (SBP). METHODS: Ascitic fluid (AF) of cirrhotic patients hospitalized between March 2014 and August 2015 was independently tested by two readers using the new strip, which has four colorimetric graduations (negative, trace, small, and large). SBP was diagnosed on neutrophils in ascites>250/mm(3). Ascites not related to portal hypertension were excluded...
October 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27626318/esophageal-stenting-for-benign-and-malignant-disease-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline
#15
Manon C W Spaander, Todd H Baron, Peter D Siersema, Lorenzo Fuccio, Brigitte Schumacher, Àngels Escorsell, Juan-Carlos Garcia-Pagán, Jean-Marc Dumonceau, Massimo Conio, Antonella de Ceglie, Janusz Skowronek, Marianne Nordsmark, Thomas Seufferlein, André Van Gossum, Cesare Hassan, Alessandro Repici, Marco J Bruno
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations for malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliative treatment of malignant dysphagia over laser therapy, photodynamic therapy, and esophageal bypass (strong recommendation, high quality evidence)...
October 2016: Endoscopy
https://www.readbyqxmd.com/read/27623476/diverticulosis-and-diverticulitis
#16
Amy E Thompson
No abstract text is available yet for this article.
September 13, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27641510/similar-efficacy-of-proton-pump-inhibitors-vs-h2-receptor-antagonists-in-reducing-risk-of-upper-gastrointestinal-bleeding-or-ulcers-in-high-risk-users-of-low-dose-aspirin
#17
Francis K L Chan, Moe Kyaw, Tetsuya Tanigawa, Kazuhide Higuchi, Kazuma Fujimoto, Pui Kuan Cheong, Vivian Lee, Yoshikazu Kinoshita, Yuji Naito, Toshio Watanabe, Jessica Y L Ching, Kelvin Lam, Angeline Lo, Heyson Chan, Rashid Lui, Raymond S Y Tang, Yasuhisa Sakata, Yee Kit Tse, Toshihisa Takeuchi, Osamu Handa, Hiroko Nebiki, Justin C Y Wu, Takashi Abe, Tsuyoshi Mishiro, Siew C Ng, Tetsuo Arakawa
BACKGROUND & AIMS: It is not clear whether H2-receptor antagonists (H2RAs) reduce the risk of gastrointestinal (GI) bleeding in aspirin users at high risk. We performed a double-blind randomized trial to compare the effects of a proton pump inhibitor (PPI) vs a H2RA antagonist in preventing recurrent upper GI bleeding and ulcers in high-risk aspirin users. METHODS: We studied 270 users of low-dose aspirin (≤325 mg/day) with a history of endoscopically confirmed ulcer bleeding at 8 sites in Hong Kong and Japan...
September 15, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27580788/it-is-time-to-re-think-the-role-of-small-intestinal-bacterial-overgrowth-in-ibs-patients
#18
Edoardo Savarino, Manuele Furnari, Andrea Ottonello, Vincenzo Savarino
No abstract text is available yet for this article.
September 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27569859/clinical-outcomes-in-patients-with-bile-leaks-treated-via-ercp-with-regard-to-the-timing-of-ercp-a-large-multicenter-study
#19
Douglas G Adler, Linda Jo Taylor, Tyler McVay, Madeleine Birch, Gloria Francis, Andrew Zabolotsky, Sobia N Laique, Umar Hayat, Tingting Zhan, Ali A Siddiqui
INTRODUCTION: Postsurgical or traumatic bile duct leaks (BDLs) can be safely and effectively managed by endoscopic therapy via ERCP. The early diagnosis of BDL is important because unrecognized leaks can lead to serious adverse events. Our aim was to evaluate the relationship between timing of endotherapy after BDL and the clinical outcomes, adverse events, and long-term results of endoscopic therapy. METHODS: We conducted a multicenter, retrospective study on patients with BDLs who underwent ERCP between 2006 and 2014...
August 25, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27575713/a-randomized-multi-center-open-label-study-to-evaluate-the-efficacy-of-carvedilol-vs-propranolol-to-reduce-portal-pressure-in-patients-with-liver-cirrhosis
#20
Sang G Kim, Tae Y Kim, Joo H Sohn, Soon H Um, Yeon S Seo, Soon K Baik, Moon Y Kim, Jae Y Jang, Soung W Jeong, Bora Lee, Young S Kim, Ki T Suk, Dong J Kim
OBJECTIVES: Propranolol has been used as prophylaxis for variceal bleeding in patients with cirrhosis. More recent data suggest that carvedilol may be more effective for reducing the hepatic venous pressure gradient (HVPG) than propranolol. The primary aim of this study was to evaluate the hemodynamic response to carvedilol compared with propranolol. METHODS: A total of 110 patients with a baseline HVPG value >12 mm Hg were allocated randomly to receive either carvedilol or propranolol...
August 30, 2016: American Journal of Gastroenterology
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