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https://www.readbyqxmd.com/read/28874419/early-intervention-in-crohn-s-disease-towards-disease-modification-trials
#1
REVIEW
Silvio Danese, Gionata Fiorino, Laurent Peyrin-Biroulet
Crohn's disease (CD) is a chronic progressive destructive inflammatory bowel disease. As in rheumatoid arthritis, there is increasing evidence that early treatment initiation with disease-modifying agents, such as biological drugs, may lead to complete disease control, prevention of disease progression thus protecting against irreversible damage and restoration of normal quality of life. Data from randomised clinical trials with immunosuppressants and biologics suggest that treating patients with a disease duration of <2 years and an absence of complications may significantly reduce the risk for complications and increase time in remission in patients with CD...
September 5, 2017: Gut
https://www.readbyqxmd.com/read/28655976/iron-deficiency-anemia-in-chronic-liver-disease-etiopathogenesis-diagnosis-and-treatment
#2
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/28684104/acid-base-disorders-in-liver-disease
#3
REVIEW
Bernhard Scheiner, Gregor Lindner, Thomas Reiberger, Bruno Schneeweiss, Michael Trauner, Christian Zauner, Georg-Christian Funk
Alongside the kidneys and lungs, the liver has been recognised as an important regulator of acid-base homeostasis. While respiratory alkalosis is the most common acid-base disorder in chronic liver disease, various complex metabolic acid-base disorders may occur with liver dysfunction. While the standard variables of acid-base equilibrium, such as pH and overall base excess, often fail to unmask the underlying cause of acid-base disorders, the physical-chemical acid-base model provides a more in-depth pathophysiological assessment for clinical judgement of acid-base disorders, in patients with liver diseases...
July 3, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28600070/colorectal-cancer-screening-recommendations-for-physicians-and-patients-from-the-u-s-multi-society-task-force-on-colorectal-cancer
#4
Douglas K Rex, C Richard Boland, Jason A Dominitz, Francis M Giardiello, David A Johnson, Tonya Kaltenbach, Theodore R Levin, David Lieberman, Douglas J Robertson
No abstract text is available yet for this article.
July 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28274107/pathophysiology-and-management-of-alcoholic-liver-disease-update-2016
#5
REVIEW
Felix Stickel, Christian Datz, Jochen Hampe, Ramon Bataller
Alcoholic liver disease (ALD) is a leading cause of cirrhosis, liver cancer, and acute and chronic liver failure and as such causes significant morbidity and mortality. While alcohol consumption is slightly decreasing in several European countries, it is rising in others and remains high in many countries around the world. The pathophysiology of ALD is still incompletely understood but relates largely to the direct toxic effects of alcohol and its main intermediate, acetaldehyde. Recently, novel putative mechanisms have been identified in systematic scans covering the entire human genome and raise new hypotheses on previously unknown pathways...
March 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28053053/acute-on-chronic-liver-failure-an-update
#6
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
https://www.readbyqxmd.com/read/26309362/fluid-resuscitation-in-acute-pancreatitis-normal-saline-or-lactated-ringer-s-solution
#7
COMPARATIVE STUDY
Michal Lipinski, Alicja Rydzewska-Rosolowska, Andrzej Rydzewski, Grazyna Rydzewska
AIM: To investigate whether administration of Ringer's solution (RL) could have an impact on the outcome of acute pancreatitis (AP). METHODS: We conducted a retrospective study on 103 patients [68 men and 35 women, mean age 51.2 years (range, 19-92 years)] hospitalized between 2011 and 2012. All patients admitted to the Department of Gastroenterology of the Central Clinical Hospital of the Ministry of Interior (Poland) with a diagnosis of AP who had disease onset within 48 h of presentation were included in this study...
August 21, 2015: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/21645639/lactated-ringer-s-solution-reduces-systemic-inflammation-compared-with-saline-in-patients-with-acute-pancreatitis
#8
RANDOMIZED CONTROLLED TRIAL
Bechien U Wu, James Q Hwang, Timothy H Gardner, Kathryn Repas, Ryan Delee, Song Yu, Benjamin Smith, Peter A Banks, Darwin L Conwell
BACKGROUND & AIMS: Aggressive fluid resuscitation is recommended for initial management of acute pancreatitis. We performed a randomized controlled trial to evaluate the impact of a goal-directed fluid resuscitation protocol on systemic inflammation in patients with acute pancreatitis. We then determined the impact of resuscitation with lactated Ringer's solution, compared with normal saline. METHODS: We performed a randomized controlled trial of 40 patients with acute pancreatitis at 3 New England hospitals from May 2009-February 2010...
August 2011: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28119010/diagnosis-and-treatment-of-ascites
#9
Emmanuel A Tsochatzis, Alexander L Gerbes
No abstract text is available yet for this article.
January 22, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/24530646/bacterial-infections-in-cirrhosis-a-position-statement-based-on-the-easl-special-conference-2013
#10
Rajiv Jalan, Javier Fernandez, Reiner Wiest, Bernd Schnabl, Richard Moreau, Paolo Angeli, Vanessa Stadlbauer, Thierry Gustot, Mauro Bernardi, Rafael Canton, Agustin Albillos, Frank Lammert, Alexander Wilmer, Rajeshwar Mookerjee, Jordi Vila, Rita Garcia-Martinez, Julia Wendon, José Such, Juan Cordoba, Arun Sanyal, Guadalupe Garcia-Tsao, Vicente Arroyo, Andrew Burroughs, Pere Ginès
Bacterial infections are very common and represent one of the most important reasons of progression of liver failure, development of liver-related complications, and mortality in patients with cirrhosis. In fact, bacterial infections may be a triggering factor for the occurrence of gastrointestinal bleeding, hypervolemic hyponatremia, hepatic encephalopathy, kidney failure, and development of acute-on-chronic liver failure. Moreover, infections are a very common cause of repeated hospitalizations, impaired health-related quality of life, and increased healthcare costs in cirrhosis...
June 2014: Journal of Hepatology
https://www.readbyqxmd.com/read/27246107/evidence-based-clinical-practice-guidelines-for-liver-cirrhosis-2015
#11
REVIEW
Hiroshi Fukui, Hidetsugu Saito, Yoshiyuki Ueno, Hirofumi Uto, Katsutoshi Obara, Isao Sakaida, Akitaka Shibuya, Masataka Seike, Sumiko Nagoshi, Makoto Segawa, Hirohito Tsubouchi, Hisataka Moriwaki, Akinobu Kato, Etsuko Hashimoto, Kojiro Michitaka, Toshikazu Murawaki, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for liver cirrhosis in 2015. Eighty-three clinical questions were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. Manual searching of the latest important literature was added until August 2015. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
July 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27670600/risk-and-predictors-of-variceal-bleeding-in-cirrhosis-patients-receiving-primary-prophylaxis-with-non-selective-beta-blockers
#12
Richa Shukla, Jennifer Kramer, Yumei Cao, Jun Ying, Aylin Tansel, Annette Walder, Shailesh Advani, Hashem B El-Serag, Fasiha Kanwal
OBJECTIVES: Prior studies have demonstrated the efficacy of non-selective beta-blockers (NSBB) in preventing first variceal bleeding in patients with cirrhosis. However, little is known about the overall effectiveness of NSBB in routine clinical care. METHODS: We conducted a retrospective cohort study of cirrhotic patients without prior bleeding who initiated a NSBB (propranolol, nadolol) at any Veterans Administration facility between 2008 and 2013. The primary outcome was variceal bleeding within 12 months...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27801884/changing-concepts-of-cirrhotic-coagulopathy
#13
REVIEW
Armando Tripodi, Massimo Primignani, Pier M Mannucci, Stephen H Caldwell
The state of clinical art of the coagulopathy of cirrhosis changed considerably over the last decade. Until 2005, cirrhosis was considered as the epitome of the hemorrhagic coagulopathies and the abnormal hemostasis tests associated with the disease were corrected with infusion of fresh frozen plasma or platelets to minimize the risk of bleeding. Since that time, a great deal of work has been done and there is now a change of paradigm. The prothrombin time once considered as an isolated measure of bleeding risk was rejected, and cirrhosis shifted from a purely hemorrhagic construct to a mixed and thrombosis-prone paradigm...
February 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27840364/25-years-of-proton-pump-inhibitors-a-comprehensive-review
#14
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/27786365/portal-hypertensive-bleeding-in-cirrhosis-risk-stratification-diagnosis-and-management-2016-practice-guidance-by-the-american-association-for-the-study-of-liver-diseases
#15
Guadalupe Garcia-Tsao, Juan G Abraldes, Annalisa Berzigotti, Jaime Bosch
No abstract text is available yet for this article.
January 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27864004/beta-adrenergic-blockade-and-decompensated-cirrhosis
#16
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...
April 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/27783916/hepatic-encephalopathy
#17
REVIEW
Eelco F M Wijdicks
No abstract text is available yet for this article.
October 27, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27773805/pathophysiology-evaluation-and-management-of-chronic-watery-diarrhea
#18
REVIEW
Michael Camilleri, Joseph H Sellin, Kim E Barrett
Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (>4 weeks in duration) are more elusive. We review the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties...
February 2017: Gastroenterology
https://www.readbyqxmd.com/read/26845610/%C3%A2-report-of-the-baveno-vi-consensus-workshop
#19
EDITORIAL
Andres Cardenas, Angela Mendez-Bocanegra
No abstract text is available yet for this article.
March 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27236146/%C3%A2-hepatorenal-syndrome-current-concepts-related-to-diagnosis-and-management
#20
REVIEW
Ángelo Zambam de Mattos, Angelo Alves de Mattos, Nahum Méndez-Sánchez
 Renal failure in cirrhotic patients is a very severe condition. Hepatorenal syndrome has the worst prognosis among all causes of kidney failure in such patients. Hepatorenal syndrome is diagnosed especially in cirrhotic patients with ascites who develop loss renal function, despite diuretic suspension and volume expansion with albumin and for whom other causes of kidney injury have been excluded. Patients with hepatorenal syndrome should be treated with a vasoconstrictor in combination with albumin as a bridge to receiving a liver transplant...
July 2016: Annals of Hepatology
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