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Gastroenterology

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By Jeff Bank Internal Medicine R2 at the University of Utah
https://www.readbyqxmd.com/read/28838972/acute-pancreatitis-recent-advances-through-randomised-trials
#1
REVIEW
Sven M van Dijk, Nora D L Hallensleben, Hjalmar C van Santvoort, Paul Fockens, Harry van Goor, Marco J Bruno, Marc G Besselink
Acute pancreatitis is one of the most common GI conditions requiring acute hospitalisation and has a rising incidence. In recent years, important insights on the management of acute pancreatitis have been obtained through numerous randomised controlled trials. Based on this evidence, the treatment of acute pancreatitis has gradually developed towards a tailored, multidisciplinary effort, with distinctive roles for gastroenterologists, radiologists and surgeons. This review summarises how to diagnose, classify and manage patients with acute pancreatitis, emphasising the evidence obtained through randomised controlled trials...
August 24, 2017: Gut
https://www.readbyqxmd.com/read/28847751/effects-of-mongersen-ged-0301-on-endoscopic-and-clinical-outcomes-in-patients-with-active-crohn-s-disease
#2
Brian G Feagan, Bruce E Sands, Guillermo Rossiter, Xiaobin Li, Keith Usiskin, Xiaojiang Zhan, Jean-Frédéric Colombel
GED-0301 is an antisense oligodeoxynucleotide with a sequence complementary to the Smad7 mRNA transcript. Smad7 is a negative regulator of transforming growth factor-β, which is increased in the intestinal mucosa of patients with active Crohn's disease (CD). We randomly assigned 63 CD patients to 4-, 8-, or 12-week treatment groups receiving oral GED-0301 (160 mg/day). The primary objective was to determine GED-0301's effect on endoscopic CD measures; secondary objectives included effects on clinical activity...
August 25, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28802875/primary-sclerosing-cholangitis-a-comprehensive-review
#3
REVIEW
Tom H Karlsen, Trine Folseraas, Douglas Thorburn, Mette Vesterhus
Primary sclerosing cholangitis (PSC) is a rare disorder characterized by multi-focal bile duct strictures and progressive liver disease. Inflammatory bowel disease (IBD) is usually present and there is a high risk of cholangiocarcinoma and colorectal cancer. With no effective medical therapy, most patients ultimately require liver transplantation, after which disease recurrence may occur. With limited therapeutic options and lack of proven surveillance strategies, patients experience significant unmet needs...
August 9, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28809386/complications-of-bariatric-surgery-what-you-can-expect-to-see-in-your-gi-practice
#4
REVIEW
Allison R Schulman, Christopher C Thompson
Obesity is one of the most significant health problems worldwide. Bariatric surgery has become one of the fastest growing operative procedures and has gained acceptance as the leading option for weight-loss. Despite improvement in the performance of bariatric surgical procedures, complications are not uncommon. There are a number of unique complications that arise in this patient population and require specific knowledge for proper management. Furthermore, conditions unrelated to the altered anatomy typically require a different management strategy...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28809388/dramatic-increase-in-incidence-of-ulcerative-colitis-and-crohn-s-disease-1988-2011-a-population-based-study-of-french-adolescents
#5
Silvia Ghione, Hélène Sarter, Mathurin Fumery, Laura Armengol-Debeir, Guillaume Savoye, Delphine Ley, Claire Spyckerelle, Benjamin Pariente, Laurent Peyrin-Biroulet, Dominique Turck, Corinne Gower-Rousseau
OBJECTIVES: Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period. METHODS: Pediatric-onset IBD (<17 years) was issued from a population-based IBD study in France between 1988 and 2011. Age groups and digestive location were defined according to the Paris classification...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28786407/strategies-to-combat-physician-burnout-in-gastroenterology
#6
Joseph C Anderson, Sheryl Pfeil, Christina Surawicz
No abstract text is available yet for this article.
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28785771/expansion-of-treatment-for-hepatitis-c-virus-infection-by-task-shifting-to-community-based-nonspecialist-providers-a-nonrandomized-clinical-trial
#7
MULTICENTER STUDY
Sarah Kattakuzhy, Chloe Gross, Benjamin Emmanuel, Gebeyehu Teferi, Veronica Jenkins, Rachel Silk, Elizabeth Akoth, Aurielle Thomas, Charisse Ahmed, Michelle Espinosa, Angie Price, Elana Rosenthal, Lydia Tang, Eleanor Wilson, Soren Bentzen, Henry Masur, Shyam Kottilil
Background: Direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection has resulted in high rates of disease cure; however, not enough specialists currently are available to provide care. Objective: To determine the efficacy of HCV treatment independently provided by nurse practitioners (NPs), primary care physicians (PCPs), or specialist physicians using DAA therapy. Design: Nonrandomized, open-label clinical trial initiated in 2015...
September 5, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28760445/coeliac-disease
#8
REVIEW
Benjamin Lebwohl, David S Sanders, Peter H R Green
Coeliac disease occurs in about 1% of people in most populations. Diagnosis rates are increasing, and this seems to be due to a true rise in incidence rather than increased awareness and detection. Coeliac disease develops in genetically susceptible individuals who, in response to unknown environmental factors, develop an immune response that is subsequently triggered by the ingestion of gluten. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentations...
July 28, 2017: Lancet
https://www.readbyqxmd.com/read/28762377/fecal-incontinence-is-associated-with-mortality-among-older-adults-with-complex-needs-an-observational-cohort-study
#9
Hamish A Jamieson, Philip J Schluter, Juno Pyun, Ted Arnold, Richard Scrase, Rebecca Nisbet-Abey, Vincent Mor, Joanne M Deely, Len Gray
OBJECTIVES: Fecal incontinence (FI) is a problem in growing older populations. Validating a suspected association between FI and mortality in community dwelling older adults could lead to improved planning for and management of the increasing complex older population. In a large cohort of New Zealand older adults, we assessed the prevalence of FI, urinary incontinence (UI), combined FI and UI, and their associations with mortality. METHODS: This study consisted of a retrospective analysis of international standardized geriatric assessment-home care (InterRAI-HC) data from community-dwelling adults aged 65 years or older, who met the criteria required for the InterRAI-HC, having complex needs and being under consideration for residential care...
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28762379/characterizing-normal-bowel-frequency-and-consistency-in-a-representative-sample-of-adults-in-the-united-states-nhanes
#10
Shuji Mitsuhashi, Sarah Ballou, Zhenghui G Jiang, William Hirsch, Judy Nee, Johanna Iturrino, Vivian Cheng, Anthony Lembo
OBJECTIVES: Our current understanding of normal bowel patterns in the United States (US) is limited. Available studies have included individuals with both normal and abnormal bowel patterns, making it difficult to characterize normal bowel patterns in the US. The current study aims to (1) examine frequency and consistency in individuals with self-reported normal bowel habits and (2) determine demographic factors associated with self-reported normalcy. METHODS: This study used data from adult participants who completed bowel health questions as part of the National Health and Nutrition Examination Survey (NHANES) in 2009-2010 and who reported normal bowel patterns (N=4,775)...
August 1, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28655976/iron-deficiency-anemia-in-chronic-liver-disease-etiopathogenesis-diagnosis-and-treatment
#11
REVIEW
Eleana Gkamprela, Melanie Deutsch, Dimitrios Pectasides
Chronic liver disease is accompanied by multiple hematological abnormalities. Iron deficiency anemia is a frequent complication of advanced liver disease. The etiology is multifactorial, mostly due to chronic hemorrhage into the gastrointestinal tract. The diagnosis of iron deficiency anemia is very challenging, as simple laboratory methods, including serum iron, ferritin, transferrin saturation (Tsat), and mean corpuscular volume are affected by the liver disease itself or the cause of the disease, resulting in difficulty in the interpretation of the results...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28741616/rural-and-urban-residence-during-early-life-is-associated-with-a-lower-risk-of-inflammatory-bowel-disease-a-population-based-inception-and-birth-cohort-study
#12
Eric I Benchimol, Gilaad G Kaplan, Anthony R Otley, Geoffrey C Nguyen, Fox E Underwood, Astrid Guttmann, Jennifer L Jones, Beth K Potter, Christina A Catley, Zoann J Nugent, Yunsong Cui, Divine Tanyingoh, Nassim Mojaverian, Alain Bitton, Matthew W Carroll, Jennifer deBruyn, Trevor J B Dummer, Wael El-Matary, Anne M Griffiths, Kevan Jacobson, M Ellen Kuenzig, Desmond Leddin, Lisa M Lix, David R Mack, Sanjay K Murthy, Juan Nicolás Peña Sánchez, Harminder Singh, Laura E Targownik, Maria Vutcovici, Charles N Bernstein
OBJECTIVES: To determine the association between inflammatory bowel disease (IBD) and rural/urban household at the time of diagnosis, or within the first 5 years (y) of life. METHODS: Population-based cohorts of residents of four Canadian provinces were created using health administrative data. Rural/urban status was derived from postal codes based on population density and distance to metropolitan areas. Validated algorithms identified all incident IBD cases from administrative data (Alberta: 1999-2008, Manitoba and Ontario: 1999-2010, and Nova Scotia: 2000-2008)...
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28719593/long-term-treatment-of-eosinophilic-esophagitis-with-swallowed-topical-corticosteroids-development-and-evaluation-of-a-therapeutic-concept
#13
Thomas Greuter, Christian Bussmann, Ekaterina Safroneeva, Alain M Schoepfer, Luc Biedermann, Stephan R Vavricka, Alex Straumann
OBJECTIVES: Swallowed topical corticosteroids (STCs) are efficacious in inducing and presumably maintaining remission in patients with active eosinophilic esophagitis (EoE). Hitherto, it has not been evaluated whether long-lasting remission can be achieved, and whether treatment can be stopped once patients have achieved this remission. METHODS: Since 2007, EoE patients included into a large database at the Swiss EoE Clinics were put on STCs as induction/maintenance therapy...
July 18, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28719595/risk-of-postoperative-complications-among-inflammatory-bowel-disease-patients-treated-preoperatively-with-vedolizumab
#14
Akihiro Yamada, Yuga Komaki, Nayan Patel, Fukiko Komaki, Arthur S Aelvoet, Anthony L Tran, Joel Pekow, Sushila Dalal, Russell D Cohen, Lisa Cannon, Konstantin Umanskiy, Radhika Smith, Roger Hurst, Neil Hyman, David T Rubin, Atsushi Sakuraba
OBJECTIVES: Vedolizumab is increasingly used to treat patients with ulcerative colitis (UC) and Crohn's disease (CD), however, its safety during the perioperative period remains unclear. We compared the 30-day postoperative complications among patients treated preoperatively with vedolizumab, anti-tumor necrosis factor (TNF)-α agents or non-biological therapy. METHODS: The retrospective study cohort was comprised of patients receiving vedolizumab, anti-TNF-α agents or non-biological therapy within 4 weeks of surgery...
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28695451/the-endoscopic-findings-of-the-upper-gastrointestinal-tract-in-patients-with-crohn-s-disease
#15
REVIEW
Yoshiki Nomura, Kentaro Moriichi, Mikihiro Fujiya, Toshikatsu Okumura
Crohn's disease (CD) is a type of chronic inflammatory bowel disease (IBD) associated with ulceration, and the main foci of the inflammation in CD patients are typically the terminal ileum and colon. However, in the upper gastrointestinal tract (GIT), including the esophagus, stomach and duodenum, inflammatory lesions are also detected as well, with a relatively high frequency (30-75%). Recent advances in imaging modalities, including endoscopy, have aided in the diagnosis of CD. Various lesions, including aphtha, erosion, ulcers, bamboo-joint-like appearance and notch-like appearance, are detected in the upper GI of CD patients...
August 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28716721/the-evolving-genomic-landscape-of-barrett-s-esophagus-and-esophageal-adenocarcinoma
#16
REVIEW
Gianmarco Contino, Thomas L Vaughan, David Whiteman, Rebecca C Fitzgerald
We have recently gained unprecedented insight into genetic factors that determine risk for Barrett's esophagus (BE) and progression to esophageal adenocarcinoma (EA). Next-generation sequencing technologies have allowed us to identify somatic mutations that initiate BE and track genetic changes during development of tumors and invasive cancer. These technologies led to identification of mechanisms of tumorigenesis that challenge the current multistep model of progression to EA. Newer, cost-effective technologies create opportunities to rapidly translate the analysis of DNA into tools that can identify patients with BE at high risk for cancer, detect dysplastic lesions more reliably, and uncover mechanisms of carcinogenesis...
September 2017: Gastroenterology
https://www.readbyqxmd.com/read/28677333/review-article-new-treatments-in-non-alcoholic-fatty-liver-disease
#17
REVIEW
S A Townsend, P N Newsome
BACKGROUND: Non-alcoholic fatty liver disease is the fastest growing cause of liver disease in the Western world, yet there is no approved pharmacotherapy. While lifestyle modifications remain the mainstay of treatment, only a proportion of individuals are able to make or sustain them, and so more treatment options are required. AIM: To review the potential benefit of drugs used in clinical practice, those entering phase II trials, and compounds being investigated in pre-clinical studies...
July 4, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#18
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis, leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain because of the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to estimate true GFR more accurately...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28695907/overuse-of-repeat-upper-endoscopy-in-the-veterans-health-administration-a-retrospective-analysis
#19
Joel H Rubenstein, Heiko Pohl, Megan A Adams, Eve Kerr, Robert Holleman, Sandeep Vijan, Jason A Dominitz, John M Inadomi, Dawn Provenzale, Joseph Francis, Sameer D Saini
OBJECTIVES: Americans undergo ∼7 million esophagogastroduodenoscopies (EGDs) annually, and one-third of Medicare beneficiaries undergo a repeat EGD within 3 years. As many as 43% of these repeat EGDs are inappropriate. We aimed to determine the rate of repeat inappropriate EGD within the Veterans Health Administration (VHA), and identify factors associated with repeat EGD. METHODS: We conducted retrospective analyses of Veterans undergoing an index EGD at 159 VHA facilities between 1 January 2003 and 30 June 2007...
July 11, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28695906/no-association-between-proton-pump-inhibitor-use-and-risk-of-alzheimer-s-disease
#20
Heidi Taipale, Anna-Maija Tolppanen, Miia Tiihonen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen
OBJECTIVES: The objective of the study was to investigate whether proton pump inhibitor (PPI) use is associated with an increased risk of clinically verified Alzheimer's disease (AD). METHODS: A Finnish nationwide nested case-control study MEDALZ includes all community-dwelling individuals with newly diagnosed AD during 2005-2011 (N=70,718), and up to four age-, sex-, and region of residence-matched comparison individuals for each case (N=282,858). Data were extracted from Finnish nationwide health-care registers...
July 11, 2017: American Journal of Gastroenterology
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