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Digestive Diseases

Claire Zar-Kessler, Braden Kuo, Elizabeth Cole, Anna Benedix, Jaime Belkind-Gerson
OBJECTIVES: Chronic constipation is a common childhood problem and often caused or worsened by abnormal dynamics of defecation. The aim of this study was to assess the benefit of pelvic floor physical therapy (PFPT), a novel treatment in pediatrics for the treatment of chronic constipation with dyssynergic defecation. METHODS: This was a retrospective study of 69 children seen at a pediatric neurogastroenterology program of a large tertiary referral center for chronic constipation and dyssynergic defecation, determined by anorectal manometry and balloon expulsion testing...
May 16, 2019: Digestive Diseases
Mitsuru Esaki, Waku Hatta, Tooru Shimosegawa, Tsuneo Oyama, Noboru Kawata, Akiko Takahashi, Shiro Oka, Shu Hoteya, Masahiro Nakagawa, Masaaki Hirano, Mitsuru Matsuda, Ken Ohnita, Ryo Shimoda, Motoyuki Yoshida, Osamu Dohi, Jun Takada, Keiko Tanaka, Shinya Yamada, Tsuyotoshi Tsuji, Hirotaka Ito, Hiroyuki Aoyagi, Takuji Gotoda
BACKGROUND: Additional surgery is recommended after noncurative endoscopic submucosal dissection (ESD) for early gastric cancer due to the risk of lymph node metastasis. However, age may affect the clinical management of these patients. OBJECTIVES: The aim of our retrospective multicenter study was to clarify whether age affects decision-making after noncurative ESD and if the decision affects long-term outcomes. METHODS: Age was classified as follows: non-elderly, <70 years (n = 811); elderly, 70-79 years (n= 760); and super-elderly, ≥80 years (n = 398)...
May 16, 2019: Digestive Diseases
Petr Dite, Ivo Novotny, Jana Dvorackova, Bohuslav Kianicka, Martin Blaho, Pavel Svoboda, Magdalena Uvirova, Tomas Rohan, Hana Maskova, Lumir Kunovsky
BACKGROUND: Diagnosis of pancreatic cancer (PC) in early stages is still challenging for gastroenterologists. The early detection of cancer is one of the utmost importance for the successful therapy of this malignancy. An accurate differential diagnosis of focal pancreatic lesions plays also an important role, whether it is differential diagnosis of chronic pancreatitis from PC or autoimmune pancreatitis (AIP) from PC. Raised serum immunoglobulin G4 (IgG4) levels to twice the normal value are considered one of significant diagnostic features of type 1 AIP...
May 10, 2019: Digestive Diseases
Mario Cottone, Chiara Sapienza, Fabio Salvatore Macaluso, Marco Cannizzaro
BACKGROUND: Inflammatory bowel disease (IBD) and psoriasis (PS) are associated conditions. The reason for this association lies in the sharing of predisposition genes and common immunological mechanisms. SUMMARY: This review will focus on the interplay between IBD and PS, with details on prevalence and phenotype of PS in IBD, genetics, pathogenetic pathways, and therapy. Key Messages: Microbiome seems relevant in both conditions: a reduction of beneficial bacteria has been observed...
May 10, 2019: Digestive Diseases
Carolina A Serrano, Simon C Ling, Sofia Verdaguer, Miguel León, Nicolás Jarufe, Juan Francisco Guerra, Juan Carlos Pattillo, Carlos Benítez, Andrea Villagrán, Javiera Torres, Mario Concha, Luis Villarroel, Paulina Dellepiane, Pilar Domínguez, Jorge Martínez, Juan Cristóbal Gana
BACKGROUND/AIMS: One hallmark of chronic liver disease in patients with portal hypertension is the formation of portal-systemic collaterals in which angiogenesis has a fundamental role. We studied patients with chronic liver disease undergoing liver transplantation to correlate levels of circulating angiogenic factors in portal and peripheral circulation with portal pressure and portal-systemic collaterals. METHODS: Sixteen patients who underwent liver transplantation were enrolled...
May 8, 2019: Digestive Diseases
Bernadett Márkus, László Herszényi, Melinda Matyasovszky, Krisztián Vörös, Péter Torzsa, Imre Rurik, Zsolt Tulassay, László Kalabay
BACKGROUND AIMS: Most patients with Helicobacter pylori infection are consulted for the first time by family physicians. We aimed to survey the adherence to the newest guidelines of the management of H. pylori infection in the primary and secondary care settings in Hungary. METHODS: From a total of 793 physicians, 94 trainees in family medicine, 334 family physicians without and 195 with board certification in internal medicine, 87 internists, 78 family paediatricians were invited to take part in the study...
May 8, 2019: Digestive Diseases
Shaina M Lynch, Jinjian Mu, James J Grady, Richard G Stevens, Thomas J Devers
BACKGROUND: Clostridium difficile is a gram-positive, anaerobic, and spore-forming bacillus, which is responsible for the majority of antibiotic-associated diarrhea and colitis. OBJECTIVE: Determine if fecal microbiota transplantation (FMT) is effective in a population sample from Connecticut. METHODS: We report the clinical experience of 92 consecutive patients from one gastroenterology practice in central Connecticut treated by colonoscopy with FMT for infection with Clostridium difficile from 2012 to 2017...
May 3, 2019: Digestive Diseases
Benjamin Crooks, John McLaughlin, Jimmy K Limdi
No abstract text is available yet for this article.
May 3, 2019: Digestive Diseases
Joaquín Hinojosa, Fernando Muñoz, Gregorio Juan Martínez-Romero
BACKGROUND: Adalimumab (ADA) is an anti-tumor necrosis factor agent that has been shown to be effective in inducing and maintaining remission in adult patients with inflammatory bowel disease. The relationship between the ADA trough levels and clinical efficacy has been demonstrated, but there is variability in the definition of the most suitable range for its clinical applicability. SUMMARY: A review of published studies during the last 5 years on ADA serum levels and its relationship with the clinical outcome was performed...
April 30, 2019: Digestive Diseases
Durga Prasad, Anshu Srivastava, Anil Tambe, Surender Kumar Yachha, Moinak Sen Sarma, Ujjal Poddar
OBJECTIVE: Intestinal lymphangiectasia (IL; primary or secondary) is an important cause of protein-losing enteropathy. We evaluated the clinicolaboratory profile, response to therapy, complications, and outcome of children with primary IL (PIL). METHODS: Consecutive children (≤18 years) diagnosed with PIL (clinical setting, typical small bowel histopathology, and exclusion of secondary causes) from 2007 to 2017 were evaluated. RESULTS: Twenty-eight children with PIL (16 boys, age at symptom onset-12 [1-192] months and at diagnosis 8 [1-18] years) were studied...
April 26, 2019: Digestive Diseases
Aleksandar P Simić, Ognjan M Skrobić, Predrag M Peško
BACKGROUND: Endoscopic mucosal resection and submucosal dissection (ESD) are indicated in a majority of mucosal esophageal, esophagogastric junction and gastric cancers (GC), and selected cases of submucosal cancers as well. SUMMARY: The presence of lymph node metastases in early esophageal cancer (EC) has been proven in up to 50% of -patients with sm3 cancers treated with surgical resection, and up to 18.5 and 30.5% in sm1 and sm2 cancer respectively. The presence of lymphovascular invasion (LVI), tumor depth >500 μm and poor tumor differentiation seem to be a common predictor of worse outcomes in literature reports...
April 26, 2019: Digestive Diseases
Jan Bornschein, Elizabeth L Bird-Lieberman, Peter Malfertheiner
While the primary risk factor for oesophageal adenocarcinoma (OAC) and its precursor lesion Barrett's oesophagus (BO) is gastro-oesophageal reflux, the infection with Helicobacter pylori (H. pylori) is the dominant risk factor for gastric cancer. Reduction of reflux by dietary measures and proton pump inhibitors has some merits in OAC prevention, and the chemopreventive effect of Aspirin and statins is being widely investigated; however, improved outcome in OAC occurs primarily as the result of secondary prevention...
April 10, 2019: Digestive Diseases
Jagpal Singh Klair, Rahman Nakshabendi, Maheen Rajput, Henning Gerke, Rami El-Abiad
A santorinicele is a rare anomaly defined as focal cystic dilation of the terminal portion of the dorsal pancreatic duct at the minor papilla. Importantly this anomaly has been suggested as a possible cause of relative stenosis of the minor papilla. This anomaly has been associated with pancreatic divisum and recurrent acute pancreatitis. Magnetic resonance imaging/magnetic resonance cholangiopancreatography and endoscopic ultrasound (EUS) are the main diagnostic modalities. Endoscopic minor papilla sphincterotomy has been shown to improve pain and quality of life in patients with this anomaly presenting with recurrent pancreatitis...
April 8, 2019: Digestive Diseases
Satoki Shichijo, Yoji Takeuchi, Kenshi Matsuno, Noriya Uedo, Mitsuhiro Kono, Hiromu Fukuda, Yusaku Shimamoto, Kentaro Nakagawa, Masayasu Ohmori, Taro Iwatsubo, Hiroyoshi Iwagami, Shuntaro Inoue, Noriko Matsuura, Hiroko Nakahira, Akira Maekawa, Takashi Kanesaka, Koji Higashino, Ryu Ishihara
BACKGROUND AND STUDY AIMS: We have reported the usefulness of traction-assisted colorectal endoscopic submucosal dissection (TAC-ESD) to overcome the technical difficulty of colorectal ESD. However, the direction of traction is toward the anal side only. We retrospectively evaluate the safety and efficacy of "pulley" TAC-ESD. PATIENTS AND METHODS: We retrospectively analyzed patients diagnosed with colorectal polyps and treated by "pulley" TAC-ESD at Osaka International Cancer Institute from December 2017 to June 2018...
April 3, 2019: Digestive Diseases
Aleksandra Pavlovic-Markovic, Sanja Dragasevic, Miodrag Krstic, Milica Stojkovic Lalosevic, Tomica Milosavljevic
BACKGROUND: The increasing incidence of duodenal neoplasm has underlined different methods of resection depending on the clinical presentation, endoscopic features and histopathology. In this comprehensive review, we systematically describe the current knowledge concerning the diagnosis and management of duodenal adenomas (DAs) and discuss data considering all possible therapeutic approaches. SUMMARY: Among a variety of duodenal lesions, including neuroendocrine tumors and gastrointestinal stromal tumors, DAs present precancerous lesions of the duodenal papilla or non-ampullary region necessitating removal...
March 28, 2019: Digestive Diseases
Milena Di Leo, Laura Poliani, Daoud Rahal, Francesco Auriemma, Andrea Anderloni, Cristina Ridolfi, Paola Spaggiari, Giovanni Capretti, Luca Di Tommaso, Paoletta Preatoni, Alessandro Zerbi, Carlo Carnaghi, Andrea Lania, Alberto Malesci, Alessandro Repici, Silvia Carrara
BACKGROUND: One of the controversial issues in the diagnosis of pancreatic neuroendocrine tumours (pNETs) is the accurate prediction of their clinical behaviour. OBJECTIVES: The aim of the study was to evaluate the role of endoscopic ultrasound (EUS) biopsy in the diagnosis and grading of pNETs in a certified ENETS Center. METHODS: A prospectively maintained database of EUS biopsy procedures was retrospectively reviewed to identify all consecutive patients referred to a certified ENETS Center with a suspicion of pNET between June 2014 and April 2017...
March 21, 2019: Digestive Diseases
Engin Tutar, Nevzat Aykut Bayrak, Burcu Volkan, Deniz Ertem
BACKGROUND AND OBJECTIVES: Bowel preparation (BP) for colonoscopy is a challenging procedure in children and different regimens have been used for this purpose. Polyethylene glycol (PEG) is the most preferred agent in recent years. The primary aim of this study was to evaluate the efficacy of 1-day PEG-3350 with bisacodyl (PEG-B) and comparing it with 3-day sennosides A+B. METHOD: In this prospective, randomized, and single-blinded study, children aged 2-18 years were included in the PEG-B group for 1 day or in Senna group for 3 days...
March 5, 2019: Digestive Diseases
Aleksandra Sokic-Milutinovic
Hereditary polyposis syndromes in which APC gene germline mutations can lead to colorectal carcinogenesis are familial adenomatous polyposis (FAP), attenuated FAP (AFAP) and MUTYH-associated polyposis. All 3 syndromes increase the potential for the development of colorectal cancer. AFAP is diagnosed if less than 100 adenomas are detected in the colon at presentation. AFAP is inherited in an autosomal dominant manner. We present a case of a 22-year-old female with AFAP who was treated with endoscopic polypectomy and surveilled by annual colonoscopy...
March 5, 2019: Digestive Diseases
Zsolt Tulassay
No abstract text is available yet for this article.
February 21, 2019: Digestive Diseases
Razi Even Dar, Yoav Mazor, Amir Karban, Sofia Ish-Shalom, Elena Segal
BACKGROUND: Inflammatory bowel disease (IBD) patients are reported to have lower bone density compared to healthy controls. There is limited consensus regarding factors affecting bone density among these patients. Our aim, therefore, was to determine clinical and genetic variables that contribute to lower bone mineral density (BMD) in IBD patients. METHODS: A cross-sectional study of IBD patients treated in a tertiary referral center was performed. Epidemiological and clinical data were collected, and genetic testing for the common mutations in Nucleotide-binding Oligomerization Domain-containing protein (NOD)2 was performed...
February 21, 2019: Digestive Diseases
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