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Endoscopic Ultrasound-Guided Rendezvous Technique for Failed Biliary Cannulation in Benign and Resectable Malignant Biliary Disorders
ConclusionsEUS-RV may be a safe and feasible salvage method for unsuccessful biliary cannulation for benign or resectable malignant biliary disorders. Use of a 4-Fr tapered tip catheter may improve the overall EUS-RV success rate. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 18, 2018 Category: Gastroenterology Source Type: research

Efficacy of Atopy Patch Testing in Directed Dietary Therapy of Eosinophilic Esophagitis: A Pilot Study
ConclusionsAPT does not reliably predict food triggers identified by food elimination diet in adult patients with EoE. As a result, APT does not have a clear role in the evaluation of patients with EoE. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 18, 2018 Category: Gastroenterology Source Type: research

Anti-Tumor Necrosis Factor- α-Induced Dermatological Complications in a Large Cohort of Inflammatory Bowel Disease Patients
AbstractBackground/AimsThe broader use of anti-tumor necrosis factor (TNF) agents in inflammatory bowel disease (IBD) has been associated with a high rate of adverse reactions. Dermatological complications are among the most common adverse events. We assessed the incidence, risk factors, management, and outcome of anti-TNF-induced dermatological complications in a large cohort of IBD patients.MethodsThis was an observational retrospective study at a single tertiary referral center. All consecutive adult IBD patients treated with anti-TNF agents between 2005 and 2015 were identified. Patients who developed at least one derm...
Source: Digestive Diseases and Sciences - January 18, 2018 Category: Gastroenterology Source Type: research

Ascites Due to Constrictive Pericardial Disease Not Appreciated on Echocardiogram: A Report of Three Cases
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 18, 2018 Category: Gastroenterology Source Type: research

Long-Term Outcome of Infliximab Optimization for Overcoming Immunogenicity in Patients with Inflammatory Bowel Disease
AbstractBackgroundPreliminary data suggest that treatment optimization can reverse immunogenicity and regain response in patients with IBD and secondary loss of response (SLR) to anti-TNF therapy due to antidrug antibodies. However, data regarding the long-term outcome of these patients are scarce.AimsWe aimed to investigate drug retention in IBD patients of whom infliximab was optimized to overcome immunogenicity and variables associated with drug retention.MethodsThis was a retrospective, multicenter study of consecutive IBD patients with antibodies to infliximab (ATI), based on either proactive or reactive therapeutic d...
Source: Digestive Diseases and Sciences - January 16, 2018 Category: Gastroenterology Source Type: research

Factors Associated with Anxiety About Colonoscopy: The Preparation, the Procedure, and the Anticipated Findings
ConclusionsFewer people had high anxiety about preparation than about the procedure and findings of the procedure. There are unique predictors of anxiety about each colonoscopy aspect. Understanding the nuanced differences in aspects of anxiety may help to design strategies to reduce anxiety, leading to improved acceptance of the procedure, compliance with preparation instructions, and less discomfort with the procedure. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 13, 2018 Category: Gastroenterology Source Type: research

Analysis of Plasma Tenascin-C in Post-HCV Cirrhosis: A Prospective Study
AbstractBackground and aimHepatitis C virus (HCV)-related cirrhosis, one of the most common etiologies of liver cirrhosis in the Western world, is a risk factor for hepatocellular carcinoma. To confirm and improve current effectiveness of screening and prognosis of patients with established cirrhosis, a credible, simple plasma biomarker is needed. Hepatic stellate cell activation, a pivotal event in cirrhosis development, results in increased secretion of extracellular matrix proteins, including tenascin-C (TnC). Herein, we tested TnC as a simple biomarker to identify cirrhotic patients with active HCV infection from those...
Source: Digestive Diseases and Sciences - January 12, 2018 Category: Gastroenterology Source Type: research

Revenge of the NERDs: Cadherin Fragments Differentiate Functional Heartburn from Non-erosive Reflux Disease
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 12, 2018 Category: Gastroenterology Source Type: research

Cytologic Diagnosis of Biliary Strictures: FISH or Cut the Sensitivity Rate?
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 12, 2018 Category: Gastroenterology Source Type: research

Gastroenterology Fellowship Match: An Inside Look
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 12, 2018 Category: Gastroenterology Source Type: research

Ultra-Deep Genomic Sequencing of HCV NS5A Resistance-Associated Substitutions in HCV/HIV Coinfected Patients
ConclusionWhile the clinical significance of this observation may be limited in highly drug adherent populations, some HCV/HIV coinfected persons may be at greater risk of viral resistance if suboptimal dosing occurs. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 12, 2018 Category: Gastroenterology Source Type: research

Chronic Rejection After Intestinal Transplant: Where Are We in Order to Avert It?
AbstractChronic rejection affects the long-term survival of all solid organ transplants and, among intestinal allografts, occurs in up to 10% of the recipients. The insidious clinical evolution of the chronic allograft enteropathy, the absence of noninvasive biomarkers, and the late endoscopic findings delay its diagnosis. No pharmacological approach has been proven effective, and allograft removal nowadays still represents the only available therapy. The inclusion of the liver in the visceral allograft appears to be the only intervention affecting the development of chronic rejection, as revealed by large-center studies a...
Source: Digestive Diseases and Sciences - January 11, 2018 Category: Gastroenterology Source Type: research

Risk of Neoplastic Progression Among Patients with an Irregular Z Line on Long-Term Follow-Up
ConclusionsPatients with irregular Z line do not develop major BE complication in more than 5  years of follow-up. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 11, 2018 Category: Gastroenterology Source Type: research

Proton Pump Inhibitors Increase the Susceptibility of Mice to Oral Infection with Enteropathogenic Bacteria
ConclusionsLaz raised susceptibility toC. rodentium as increased numbers of the pathogen reach the site of infection. Our results suggest that it was due to increased stomach pH which allowed more peroral enteropathogens to pass the stomach, but not because of changes of intestinal environment. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 11, 2018 Category: Gastroenterology Source Type: research

Effect of Post-Traumatic Stress Disorder on Cognitive Function and Covert Hepatic Encephalopathy Diagnosis in Cirrhotic Veterans
ConclusionsVeterans with cirrhosis and PTSD have a higher frequency of psychotropic drug use and alcoholic cirrhosis etiology. CHE diagnosis using PHES or ICT is not affected by concomitant PTSD. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 8, 2018 Category: Gastroenterology Source Type: research

Small Intestinal Bacterial Overgrowth and Coronary Artery Disease: What Is in the CArDs?
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 6, 2018 Category: Gastroenterology Source Type: research

Occurrence of Jaundice Following Simultaneous Ursodeoxycholic Acid Cessation and Obeticholic Acid Initiation
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 5, 2018 Category: Gastroenterology Source Type: research

Efficacy of 125 I Versus Non- 125 I Combined with Transcatheter Arterial Chemoembolization for the Treatment of Unresectable Hepatocellular Carcinoma with Obstructive Jaundice
ConclusionsThe combination of 125I with TACE was more effective than TACE without the radioactive seeds for treating patients with unresectable HCC with obstructive jaundice. Future prospective trials with larger samples will be required to validate these results. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 5, 2018 Category: Gastroenterology Source Type: research

When Lightning Strikes Twice
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 4, 2018 Category: Gastroenterology Source Type: research

Improving the Quality of Inpatient Bowel Preparation for Colonoscopies
AbstractBackgroundHospitalized patients completing bowel preparation for colonoscopy typically have preparations of poorer quality when compared to outpatient populations.AimsOur study aimed to evaluate the effectiveness of a performance improvement program in improving colonoscopy preparation for an inpatient population.MethodsWe identified a cohort of adult patients (n = 641) undergoing an inpatient colonoscopy during a 12-month period at an academic medical center and compared a multifactor intervention group to a historical baseline group. During this 12-month period, a performance improvement program includi...
Source: Digestive Diseases and Sciences - January 4, 2018 Category: Gastroenterology Source Type: research

Sham Feeding with Bacon Does Not Alter Transit Time or Complete Examination Rate During Small Bowel Capsule Endoscopy
ConclusionBacon sham feeding has no effect on GTT, SBTT or CER and cannot be recommended in clinical practice. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 4, 2018 Category: Gastroenterology Source Type: research

Exploring Gut Microbiota Composition as an Indicator of Clinical Response to Dietary FODMAP Restriction in Patients with Irritable Bowel Syndrome
ConclusionsGut microbial composition, assessed by using a new RI, may constitute a tool to identify patients that are likely to respond to dietary FODMAP restriction. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 4, 2018 Category: Gastroenterology Source Type: research

Causes of Infrequent Prevalence of Eosinophilic Esophagitis in Hispanics May Involve Social and Cultural Factors: Probable Role of Digestive Microbiota
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 3, 2018 Category: Gastroenterology Source Type: research

Pursuing a Medical Career Outside of the USA
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 3, 2018 Category: Gastroenterology Source Type: research

Vitamin D3 Versus Gliadin: A Battle to the Last Tight Junction
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 1, 2018 Category: Gastroenterology Source Type: research

Small Intestinal Bacterial Overgrowth: Should Screening Be Included in the Pre-fecal Microbiota Transplantation Evaluation?
ConclusionsFMT is effective and well tolerated for rCDI. Positive LBT in asymptomatic donors may have an effect on post-FMT GI symptoms. Larger studies are needed. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 1, 2018 Category: Gastroenterology Source Type: research

Correction to: Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data
AbstractThe articleEarly Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data, written by Mark C. Hornbrook, Ran Goshen, Eran Choman, Maureen O ’Keeffe-Rosetti, Yaron Kinar, Elizabeth G. Liles, and Kristal C. Rust, was originally published Online First without open access (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - January 1, 2018 Category: Gastroenterology Source Type: research

High Incidence of Recurrent Crohn ’s Disease Following Colectomy for Ulcerative Colitis Revealed with Long Follow-Up
ConclusionThe incidence of recurrent CD following colectomy for ulcerative colitis, when followed postoperatively for an average of 20  years, was 25%, considerably more than previously reported. Patients who come to colectomy for ulcerative colitis and are followed for at least 10 years show a high incidence of recurrent Crohn’s disease in the ileostomy or ileo-anal pouch. Extended follow-up should be included in patients comi ng to colectomy for ulcerative colitis before they should be considered cured of their disease. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 28, 2017 Category: Gastroenterology Source Type: research

Efficacy and Safety of Lumen-Apposing Metal Stents in Management of Pancreatic Fluid Collections: Are They Better Than Plastic Stents? A Systematic Review and Meta-Analysis
ConclusionsLAMS seem to have excellent efficacy and safety in the management of PFCs. They may be preferred over plastic stents as they are associated with better clinical success and lesser adverse events. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 27, 2017 Category: Gastroenterology Source Type: research

Estrogen-Dependent Nrf2 Expression Protects Against Reflux-Induced Esophagitis
ConclusionsEstrogen-dependent Nrf2 expression might contribute to protection against the development of gastroesophageal reflux disease in females. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 27, 2017 Category: Gastroenterology Source Type: research

Vonoprazan: A Novel and Potent Alternative in the  Treatment of Acid-Related Diseases
AbstractAlthough proton pump inhibitors (PPIs) have been used widely, acid-related diseases are still associated with a huge burden on the health care system. Recently, the efficacy and safety of a new acid suppressant named vonoprazan in the treatment of acid-related diseases have been evaluated by a series of studies. As a novel potassium-competitive acid blocker, vonoprazan may provide reversible acid suppression by preventing K+ from binding to gastric H+/K+-ATPase. It has been clinically used for the short-term treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease andHelicobacter pylori (H. pylori)...
Source: Digestive Diseases and Sciences - December 27, 2017 Category: Gastroenterology Source Type: research

Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis
AbstractBackgroundUpper gastrointestinal hemorrhage (UGIH) is common and carries substantial mortality requiring frequent hospitalizations.AimTo investigate trends in etiology and outcome of UGIH in hospitalized patients in the USA.MethodsRetrospective, observational cohort study of the Nationwide Inpatient Sample from 2002 to 2012 was carried out. UGIH was identified in hospitalizations with a principle ICD-9-CM diagnosis of UGIH or secondary diagnosis of UGIH with a principal diagnosis of hematemesis, blood in stool, or gastrointestinal bleeding. Age 18  years or older was required for inclusion, and elective admiss...
Source: Digestive Diseases and Sciences - December 27, 2017 Category: Gastroenterology Source Type: research

Endoscopic Submucosal Dissection of Early Gastric Cancer in Patients with Liver Cirrhosis
ConclusionsESD is feasible in patients with EGC and comorbid LC, even those with CP-class B cirrhosis. Their prognosis depends on LC-related diseases and not recurrent EGC. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 27, 2017 Category: Gastroenterology Source Type: research

Concise Commentary: Breathing New Life into Antisecretory Medications
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 27, 2017 Category: Gastroenterology Source Type: research

The Impact of Race on Survival After Hepatocellular Carcinoma in a Diverse American Population
AbstractBackground and AimsHepatocellular carcinoma (HCC) incidence is increasing at differential rates depending on race. We aimed to identify associations between race and survival after HCC diagnosis in a diverse American population.MethodsUsing the cancer registry from Sylvester Comprehensive Cancer Center, University of Miami and Jackson Memorial Hospitals, we performed retrospective analysis of 999 patients diagnosed with HCC between 9/24/2004 and 12/19/2014. We identified clinical characteristics by reviewing available electronic medical records. The association between race and survival was analyzed using Cox propo...
Source: Digestive Diseases and Sciences - December 23, 2017 Category: Gastroenterology Source Type: research

Old and New Lymphocyte Players in Inflammatory Bowel Disease
AbstractInflammatory bowel disease (IBD), encompassing Crohn ’s disease and ulcerative colitis, is a chronic intestinal inflammatory disorder characterized by diffuse accumulation of lymphocytes in the gut mucosa as a consequence of over-expression of endothelial adhesion molecules. The infiltrating lymphocytes have been identified as subsets of T cells, in cluding T helper (Th)1 cells, Th17 cells, and regulatory T cells. The function of these lymphocyte subpopulations in the development of IBD is well-known, since they produce a number of pro-inflammatory cytokines, such as interferon-γ and interleukin-17A, wh...
Source: Digestive Diseases and Sciences - December 23, 2017 Category: Gastroenterology Source Type: research

Distinct Expression of Phenotypic Markers in Placodes- and Neural Crest-Derived Afferent Neurons Innervating the Rat Stomach
ConclusionsThere are phenotypic distinctions between the neural crest-derived DRG and placodes-derived vagal nodose TRPV1-positive neurons innervating the rat stomach that are similar to those described in thoracic organs. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 23, 2017 Category: Gastroenterology Source Type: research

Redox Imbalance in Intestinal Fibrosis: Beware of the TGF β-1, ROS, and Nrf2 Connection
AbstractIntestinal fibrosis, a common complication of inflammatory bowel diseases, becomes clinically apparent in ~  40% of patients with Crohn’s disease and ~ 5% of those with ulcerative colitis. Fibrosis, a consequence of local chronic inflammation, is characterized by excessive deposition of extracellular matrix (ECM) proteins by activated myofibroblasts, which are modulated by pro-fibrotic and anti-fibrot ic factors. Fibrosis depends on the balance between production and degradation of ECM proteins. Although the transforming growth factor (TGF)-β1/Smad pathway is the major driving force of fibrosis...
Source: Digestive Diseases and Sciences - December 22, 2017 Category: Gastroenterology Source Type: research

Helicobacter pylori Antimicrobial Susceptibility Testing-Guided Salvage Therapy in the USA: A Real Life Experience
ConclusionsThe success rate of AST-guided salvage therapy in the USA is low particularly in those with high BMI. Bismuth-based therapy appears to be better than non-bismuth-based regimens. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 20, 2017 Category: Gastroenterology Source Type: research

Speckle-Type POZ Protein Down-Regulates Matrix Metalloproteinase 2 Expression via Sp1/PI3K/Akt Signaling Pathway in Colorectal Cancer
ConclusionsSPOP could down-regulate MMP2 expression in CRC, and this regulation is mediated by inhibiting SP1 phosphorylation and nuclear translocation through PI3K/Akt signaling pathway. Our findings in this study provide understanding of MMP2 regulation in CRC and may also shed lights on the development of anti-CRC treatments. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 19, 2017 Category: Gastroenterology Source Type: research

Concise Commentary: Is Nrf2 a Master Regulator of Intestinal Fibrosis?
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 19, 2017 Category: Gastroenterology Source Type: research

Esophageal Stents for Acute Variceal Bleeding: Expanding the Possibilities
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 18, 2017 Category: Gastroenterology Source Type: research

A 14-Year Study of 398 Esophageal Adenocarcinomas Diagnosed Among 156,256 EGDs Performed at Two Large Hospitals: An Inlet Patch Is Proposed as a Significant Risk Factor for Proximal Esophageal Adenocarcinoma
ConclusionsStudy supplements 39 previously reported cases of simultaneous disease, by adding three new cases, and by novel report of statistically significant association between these two entities, which has important implications in the pathophysiology of proximal esophageal adenocarcinoma. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 16, 2017 Category: Gastroenterology Source Type: research

Outcomes of Salvage Liver Transplantation and Re-resection/Radiofrequency Ablation for Intrahepatic Recurrent Hepatocellular Carcinoma: A New Surgical Strategy Based on Recurrence Pattern
AbstractBackgroundThe treatment of intrahepatic recurrent hepatocellular carcinoma (HCC) has been poorly investigated, and the optimal treatment strategy remains unclear.AimsThe aim of this study was to compare outcomes between salvage liver transplantation (SLT) and re-resection (RR)/radiofrequency ablation (RFA) for intrahepatic recurrent HCC according to recurrence pattern.MethodsBased on postoperative histopathological examination, 122 patients with intrahepatic recurrent HCC were divided into an intrahepatic metastasis (IM,n = 75) group and a multicentric occurrence (MO,n = 47) group. The demograph...
Source: Digestive Diseases and Sciences - December 14, 2017 Category: Gastroenterology Source Type: research

Endoscopic Treatment of Biliary Leaks After Laparoscopic Cholecystectomy: Cut or Plug?
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 14, 2017 Category: Gastroenterology Source Type: research

Split-Dose Bowel Preparation Reduces the Need for Early Repeat Colonoscopy Without Improving Adenoma Detection Rate
AbstractBackground and AimsSplit-dose bowel preparation is associated with improved mucosal visualization and patient tolerance, becoming a standard of care. However, quality measures data associated with this preparation are limited. At our academic tertiary-care facility, we aim to study the effect of changing from single- to split-dose preparation on colonoscopy quality measures.MethodsA retrospective cohort study with quality indicators was conducted using electronic medical record data. Cases were identified via ICD9 code V76.51, “Special screening for malignant neoplasms of colon.” Single-dose preparation...
Source: Digestive Diseases and Sciences - December 14, 2017 Category: Gastroenterology Source Type: research

Carbamazepine-Associated Hypersensitivity Colitis
(Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 14, 2017 Category: Gastroenterology Source Type: research

Comparative Effectiveness of Infliximab Versus Adalimumab in Patients with Biologic-Na ïve Crohn’s Disease
ConclusionsOur real-life experience in biologic-na ïve CD patients demonstrated that patients started on IFX were more likely to have a harder-to-treat phenotype. Despite that, efficacy end points were similar between both groups. Clinical remission was higher in patients with combination therapy for IFX, but not for those on ADA. This warrants fur ther investigation. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 14, 2017 Category: Gastroenterology Source Type: research

Skepticism Regarding Vaccine and Gluten-Free Food Safety Among Patients with Celiac Disease and Non-celiac Gluten Sensitivity
AbstractBackgroundThere has been a marked increase in the adoption of the gluten-free (GF) diet.AimsTo query individuals with celiac disease (CD) and non-celiac gluten sensitivity (NCGS) on their beliefs toward the health effects of gluten, and safety of vaccines and GF food products.MethodsWe distributed a Web-based survey to individuals with CD and NCGS on a CD center e-mail list. We used univariate and multivariate analysis to compare responses of respondents with CD and NCGS.ResultsThe overall response rate was 27% (NCGSn = 217, CDn = 1291). Subjects with NCGS were more likely than those with CD to ...
Source: Digestive Diseases and Sciences - December 14, 2017 Category: Gastroenterology Source Type: research

A Prospective Multicenter Study of a Fully Covered Metal Stent in Patients with Distal Malignant Biliary Obstruction: WATCH-2 Study
ConclusionsFCSEMSs appeared comparable to PCSEMSs in terms of RBO without a significant increase in stent migration rate in patients with unresectable distal MBO.Clinical Trial Registration NumberUMIN000007131. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - December 7, 2017 Category: Gastroenterology Source Type: research