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Clinical Medicine Insights. Gastroenterology

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https://read.qxmd.com/read/30627002/biodegradable-stents-in-resistant-peptic-oesophageal-stricture-is-it-the-right-way-to-go
#1
REVIEW
Tom Richardson, Gerlin Naidoo, Namal Rupasinghe, Howard Smart, Sayantan Bhattacharya
Peptic oesophageal stricture can be considered as the end result of prolonged gastro-oesophageal reflux. The 'gold standard' treatment for peptic stricture is endoscopic dilatation with balloon or bougie. It is predicted that up to 40% of patients remain symptomatic with dysphagia due to refractory (resistant to treatment) or recurrent strictures, needing frequent interventions at short intervals. Such patients have poor nutritional status due to the primary disease and are susceptible to complications related to repeated endoscopic dilatation such as bleeding and perforation...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30574001/melanosis-coli-a-helpful-contrast-effect-or-a-harmful-pigmentation
#2
Fadi Abu Baker, Amir Mari, Dan Feldman, Muhammad Suki, Oren Gal, Yael Kopelman
Background: Melanosis coli, a brown discoloration of colonic mucosa, is considered as a benign condition mainly observed in patients under chronic anthranoid laxatives. Recent data link this condition with an increased adenoma detection rate. Moreover, its tumorigenic potential and possible association with the development of colorectal cancer remains uncertain. We conducted this study to compare the polyp detection rate and colorectal cancer diagnosis in patients with melanosis against matched control group without melanosis...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30546265/understanding-therapeutic-concepts-in-crohn-s-disease
#3
Gilles Rg Monif
For more than a decade, the therapeutic focus for Crohn's disease has remained fixed at temporary arrestment of symptomology. The Centers for Disease Control and Prevention (CDC) lists Crohn's disease as a disease entity without current cure. Biologics in combination with antibiotics can frequently achieve remissions. Without ongoing drug administration, these remissions tend to be of limited duration. Conceptual advancements in understanding the pathogenesis of Crohn's disease have identified treatment approaches, the focus of which goes beyond temporary remission...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30505152/the-benefits-of-neuromuscular-electrical-stimulation-in-the-muscular-and-functional-capacity-of-patients-with-liver-cirrhosis-protocol-for-a-randomized-clinical-trial
#4
Carolina Luana de Mello, Thaís Martins Albanaz da Conceição, Tarcila Dal Pont, Catherine Corrêa Peruzzolo, Mariana Nunes Lúcio, Elaine Paulin
Cirrhosis causes systemic and metabolic changes that culminate in various complications, such as compromised pulmonary function, ascites, hepatic encephalopathy, weight loss, and muscle weakness with significant physical function limitations. Our aim is to evaluate the effects of training with neuromuscular electrical stimulation (NMES) on the muscular and functional capacity of patients with cirrhosis classified as Child-Pugh B and C. A total of 72 patients diagnosed with cirrhosis will be recruited and randomized to perform an NMES protocol for 50 minutes, 3 times a week, for 4 weeks...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30305797/impact-of-video-aid-on-quality-of-bowel-preparation-among-patients-undergoing-outpatient-screening-colonoscopy
#5
Sanna Fatima, Deepanshu Jain, Christopher Hibbard
Aim: To investigate the effect of video aid on quality of bowel preparation. Study: A retrospective study was done on patients undergoing outpatient screening colonoscopy. All subjects received educational video prior to colonoscopy in addition to the standard counseling. Patient charts were reviewed to collect data regarding quality of bowel preparation (adequate or inadequate). The study population was stratified into four groups according to viewing status: Group I 0% (control group), Group II <50%, Group III >50% to <75%, and Group IV watched ⩾75% of the video...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30262989/pancreatic-extramedullary-plasmacytoma-presenting-as-a-pancreatic-mass
#6
Michelle Le, Balarama Krishna Surapaneni, Vardhmaan Jain, Rakesh Vinayek, Sudhir K Dutta
Extramedullary plasmacytomas (EMP) are a subcategory of plasma cell neoplasm that involves organs outside the bone marrow. Involvement of the pancreas is relatively rare, reported in only 2.3% of autopsies. Radiologic findings in plasmacytoma are nonspecific, but endoscopic ultrasound fine-needle aspiration is a fast and reliable technique to acquire a histologic sample for initial diagnosis. Recently, the use of fluorine-18 fluorodeoxyglucose PET/CT has been recommended in patients with active multiple myeloma and solitary plasmacytoma...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30083065/plasma-free-amino-acid-profiles-in-crohn-s-disease-relationship-with-the-crohn-disease-activity-index
#7
Toshimi Chiba, Kazuyuki Suzuki, Takayuki Matsumoto
We aimed to clarify the relationship between plasma-free amino acid (PFAA) profiles and the Crohn's disease (CD) activity index (CDAI) in patients with CD. Methods: We measured fasting PFAA concentrations in 29 patients with CD and their correlation with disease activity. Results: In all patients, significant correlations were noted between CDAI and concentrations of valine, methionine, leucine, histidine, tryptophan, alanine, tyrosine, total amino acids (TAAs), nonessential amino acids (NEAAs), essential amino acids (EAAs), and branched-chain amino acids (BCAAs)...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30083064/esophageal-adenocarcinoma-opportunities-for-targeted-prevention-in-ohio
#8
Julie A Stephens, James L Fisher, Jessica L Krok-Schoen, Ryan D Baltic, Holly L Sobotka, Electra D Paskett
Objective: The incidence of esophageal adenocarcinoma, one of the most lethal gastroenterological diseases, has been increasing since the 1960s. Prevention of esophageal adenocarcinoma is important because no early detection screening programs have been shown to reduce mortality. Obesity, gastroesophageal reflux disease, and tobacco smoking are risk factors for esophageal adenocarcinoma. Due to the high prevalence in Ohio of obesity (32.6%) and cigarette smoking (21.0%), this study sought to identify trends and patterns of these risk factors and esophageal adenocarcinoma in Ohio as compared with the United States...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30083063/gastroduodenal-tuberculosis-a-case-series-and-review-of-literature
#9
Suhas Udgirkar, Ravindra Surude, Vinay Zanwar, Sanjay Chandnani, Qais Contractor, Pravin Rathi
Gastroduodenal tuberculosis is infrequently seen in day-to-day clinical practice with few cases reported in the literature. It is usually associated with features of gastric outlet obstruction. This is a case series of 4 patients with 2 of them having associated lower gastrointestinal involvement. One of them resembled a growth in the cardia of the stomach which responded to antitubercular drugs. Another had duodenal erosions with portal lymph node enlargement which responded to antitubercular drug treatment...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30057447/a-case-of-acute-severe-hepatotoxicity-and-mild-constriction-of-common-bile-duct-associated-with-ingestion-of-green-tea-extract-a-clinical-challenge
#10
Balarama Krishna Surapaneni, Michelle Le, Julian Jakobovits, Rakesh Vinayek, Sudhir Dutta
Consumption of herbal and dietary supplements (HDS) has increased worldwide as potential treatment for weight reduction and metabolic enhancement. However, it has been reported that HDS can cause liver injury which accounts for 20% of hepatotoxicity in the United States. Prevention of HDS induced liver injury remains a challenge due to difficulties in identifying the hepatotoxins in these preparations and lack of federal regulations for dietary supplements. We report a case of acute severe hepatic necrosis presumably due to consumption of nutritional supplement advertised to boost vitality and stem cells in human body...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30013416/an-evidence-based-review-of-statin-use-in-patients-with-nonalcoholic-fatty-liver-disease
#11
REVIEW
Meredith A Sigler, Lee Congdon, Krystal L Edwards
Background: Nonalcoholic fatty liver disease (NAFLD) is a common complication in patients with metabolic syndrome. The role of statin therapy specifically for the treatment of NAFLD remains unknown. The aim of this review is to discuss outcomes of recent articles analyzing statin therapy in patients with NAFLD. Findings: A total of 12 trials met the inclusion criteria. Statins were not found to increase the prevalence of NAFLD once confounding variables were considered...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/30013415/successful-endoscopic-treatment-of-post-esophagectomy-refractory-reflux-using-overstitch-the-first-clinical-case
#12
Hirotsugu Nagase, Makoto Yamasaki, Yoshitomo Yanagimoto, Takashi Kanemura, Shigeyoshi Higashi, Kota Momose, Ryo Kato, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hiroshi Miyata, Shuji Takiguchi, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima
Aims: The reflux of duodeno-gastric contents into the remnant esophagus (gastric tube-esophageal reflux: GTER) is a significant issues in long-term esophageal cancer survivors after radical esophagectomy. We attempted endoscopic valve (funnel) creation for prevention for GTER using OverStitch endoscopic suturing system. Methods: The OverStitch was mounted onto a standard double-channel endoscope. Under general anesthesia, the funnel creation was attempted by placing semi-full thickness sutures on the gastric wall, at 3 cm distal to the primary esophago-gastric anastomosis...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/29795991/gastrointestinal-lesions-in-african-american-patients-with-iron-deficiency-anemia
#13
Hassan Brim, Anahita Shahnazi, Mehdi Nouraie, Dilhana Badurdeen, Adeyinka O Laiyemo, Tahmineh Haidary, Ali Afsari, Hassan Ashktorab
Background: Iron deficiency anemia (IDA) is a frequent disorder that is associated with many serious diseases. However, the findings of an evaluation of IDA-associated gastrointestinal disorders are lacking among African American patients. Aim: To determine the most prevalent gastrointestinal lesions among African American patients with IDA especially in young men. Methods: We reviewed medical records (n = 422) of patients referred for evaluation of IDA from 2008 to 2012...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/29686488/the-morbidity-and-mortality-of-laparoscopic-appendectomy-in-patients-with-cirrhosis
#14
Yasir Al-Azzawi, Yasir Al-Abboodi, Matthew Fasullo, Tarek Najuib
Introduction: The perioperative mortality is significantly higher in patients with cirrhosis undergoing certain surgical procedures. In this study, we examined the inpatient perioperative mortality and morbidities in cirrhotic people who underwent laparoscopic appendectomy. Methods: We performed a retrospective analysis using the National Inpatient Sample database for 2010. Inclusion criteria were all race and sex who are 18 years or older. Those who have laparoscopic appendectomy and have a history of liver cirrhosis were assigned to case group...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/29497344/orbital-inflammatory-complications-of-crohn-s-disease-a-rare-case-series
#15
Tanya M Monaghan, Giorgio Albanese, Philip Kaye, James D Thomas, Lorraine C Abercrombie, Gordon W Moran
Orbital inflammatory disease is a rare ophthalmic manifestation of Crohn's disease. Inflammation is characteristically nonspecific, involving one or multiple structures of the orbit. Mechanisms of disease and optimal methods of treatment are poorly understood. The aim of this report is to present 3 cases of orbital involvement in Crohn's disease. A retrospective case note review of patients with orbital inflammatory disease and Crohn's disease was performed at our academic center to determine the clinical, imaging, and histopathologic features of this condition and its relationship to intestinal Crohn's disease...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/29449779/-saccharomyces-boulardii-cncm-i-745-improves-intestinal-enzyme-function-a-trophic-effects-review
#16
REVIEW
Margret I Moré, Yvan Vandenplas
Several properties of the probiotic medicinal yeast Saccharomyces boulardii CNCM I-745 contribute to its efficacy to prevent or treat diarrhoea. Besides immunologic effects, pathogen-binding and anti-toxin effects, as well as positive effects on the microbiota, S boulardii CNCM I-745 also has pronounced effects on digestive enzymes of the brush border membrane, known as trophic effects. The latter are the focus of this review. Literature has been reviewed after searching Medline and PMC databases. All relevant non-clinical and clinical studies are summarized...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/29398926/a-randomized-controlled-trial-comparing-the-depth-of-maximal-insertion-between-anterograde-single-balloon-versus-spiral-enteroscopy
#17
Robert A Moran, Sindhu Barola, Joanna K Law, Stuart K Amateau, Daniil Rolshud, Erin Corless, Vandhana Kiswani, Vikesh K Singh, Anthony N Kalloo, Mouen A Khashab, Anne Marie Lennon, Patrick I Okolo, Vivek Kumbhari
Background: Three device-assisted deep endoscopic platforms presently exist and are available for clinical use: double-balloon enteroscopy, single-balloon enteroscopy (SBE), and spiral enteroscopy (SE). In a retrospective study, SE was associated with a greater depth of maximal insertion (DMI) with similar diagnostic yields and procedure time as compared with SBE. Aims: This was a prospective, randomized comparison of SE and SBE with respect to DMI, diagnostic yield, procedure time, and rate of adverse events...
2018: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/29662332/corrigendum
#18
(no author information available yet)
[This corrects the article DOI: 10.1177/1179552217711430.].
2017: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/29308020/a-case-of-gastric-ulcer-with-mucosal-bridge
#19
Tomoyuki Kitagawa, Ryo Masaoka, Yasumi Katayama, Masaya Tamano
Endoscopic images of the mucosal bridge with gastric ulcer are unusual. The mucosal bridge is presumed to have changed to a special form based on repeated development of gastric ulcer. The clinical course of mucosal bridge is unclear.
2017: Clinical Medicine Insights. Gastroenterology
https://read.qxmd.com/read/29276421/adaptive-returns-of-deficient-systemic-plasma-immunoglobulin-g-levels-as-rehabilitation-biomarker-after-emergency-colectomy-for-fulminant-ulcerative-colitis
#20
Alexander T Hawkins, Jun W Um, Amosy E M'Koma
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). Emergency colectomies are performed for fulminant colitis (ie, toxic megacolon, profuse bleeding, perforation, or sepsis). The RPC and IPAA involve manipulation of the proximal ileum, which may influence the essential physiological function of gut-associated lymphoid tissues. Circulating plasma immunoglobulin G (p-IgG) deficiency is observed in patients with fulminant UC...
2017: Clinical Medicine Insights. Gastroenterology
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