Search Our Scientific Publications & Authors

J Crohns Colitis 2019 Apr 17. Epub 2019 Apr 17.

Department of Gastroenterology, Queen Alexandra Hospital, Southwick Hill Road, Portsmouth.

Background: Inflammatory bowel disease is associated with an increased risk of colorectal cancer, with estimates ranging from 2-18%, depending on the duration of colitis. The management of neoplasia in colitis remains controversial. Current guidelines recommend endoscopic resection if the lesion is clearly visible with distinct margins. Read More

Reg Anesth Pain Med 2019 Apr 16. Epub 2019 Apr 16.

Department of Anesthesiology - Division of Pediatric Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA.

Objective: Pediatric liver transplantation presents a number of anesthetic challenges, especially in providing adequate perioperative analgesia. In an effort to reduce opioid consumption and improve functional outcomes following pediatric liver transplantation, we have instituted a novel analgesia protocol centered on the provision of continuous regional analgesia with erector spinae plane (ESP) blockade.

Cases: We describe preincisional bilateral ESP catheter placement in two pediatric patients undergoing orthotopic liver transplantation. Read More

Clin Nutr 2019 Mar 25. Epub 2019 Mar 25.

Salford Royal NHS Foundation Trust, Salford, United Kingdom.

Background & Aims: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF).

Methods: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90. Read More

Minerva Endocrinol 2019 Apr 15. Epub 2019 Apr 15.

Endocrine Unit.

Neuroendocrine neoplams (NENs) of unknowm primary origin (UPO-NENs) are advanced neoplasms constituting 11%-22% of all NENs that by definition their primary tissue of origin has not been identified with standard diagnostic work-up. Delineating the primary site of origin of UPO-NENs has important implications for selecting the appropriate treatment and overall prognosis. The small bowel, followed by the lung and pancreas are the most prevalent primary sites of origin of UPO-NENs that are uncovered during an extensive and prolonged diagnostic work-up; however, a number of UPO-NENs may still remain occult even after prolonged follow-up. Read More

Nat Rev Gastroenterol Hepatol 2019 Apr 15. Epub 2019 Apr 15.

Endoscopy Unit, The Royal Infirmary of Edinburgh, Edinburgh, UK.

Capsule endoscopy (CE) has proved to be a powerful tool in the diagnosis and management of small bowel disorders since its introduction in 2001. However, white light imaging (WLI) is the principal technology used in clinical CE at present, and therefore, CE is limited to mucosal inspection, with diagnosis remaining reliant on visible manifestations of disease. The introduction of WLI CE has motivated a wide range of research to improve its diagnostic capabilities through integration with other sensing modalities. Read More

J Hosp Med 2019 Apr 8;14:E1-E7. Epub 2019 Apr 8.

Hospitalist Division, VA Greater Los Angeles Healthcare System, Los Angeles, California.

Malignant bowel obstruction (MBO) complicates 3%-15% of cancers and often necessitates inpatient admission. Hospitalists are increasingly involved in treating patients with MBO and coordinating their care across multiple subspecialties. Direct resolution of the obstruction via surgical or interventional means is always preferable. Read More

J Infus Nurs 2019 May/Jun;42(3):132-136

Boston Children's Hospital, Division of Gastroenterology, Hepatology and Nutrition, Boston, Massachusetts (Mss Gallotto, Rosa, Takvorian-Bené, McClelland, and Tascione); and Harvard Medical School, Boston, Massachusetts (Drs Carey and Raphael). Mary Gallotto, BSN, RN, CPN, is a level 2 staff nurse in the home parenteral nutrition (HPN) program at Boston Children's Hospital (BCH) with previous nursing experience working in hepatology and gastroenterology at Floating Hospital for Children in Boston, Massachusetts. A graduate of Northeastern University, she is currently enrolled in a certification program for nursing education at the University of Massachusetts at Amherst. Carolyn M. Rosa, BSN, RN, CPNP-BC, is a pediatric nurse practitioner in the HPN program at BCH. She was previously a nurse in inpatient liver and small bowel transplant and intestinal rehabilitation at Georgetown University Hospital in Washington, DC. She received a BSN at Villanova University in 2008. She also earned a certification as a pediatric nurse practitioner and a degree in public health nurse leadership as part of a dual degree program from the University of Virginia in 2012. Melissa Takvorian-Bené, BSN, RN, CPEN, is a level 2 staff nurse in the HPN program at BCH with previous nursing experience in the emergency department and inpatient nursing. She is a graduate of Salem State University in Salem, Massachusetts. Jennifer McClelland, MS, RN, FNP-BC, is a nurse practitioner in the HPN program at BCH. She was previously a nurse in inpatient liver and small bowel transplant and intestinal rehabilitation at Georgetown University Hospital in Washington, DC. She earned a BSN from Boston College and completed a graduate degree at Georgetown University. Christina Tascione, BA, is a level 2 program coordinator for the HPN program at BCH. She holds a bachelor's degree in health management and policy from the University of New Hampshire. Alexandra Carey, MD, is an attending gastroenterologist in BCH's Division of Gastroenterology, Hepatology and Nutrition, an instructor of pediatrics at Harvard Medical School, and the associate director of the Center for Advance Rehabilitation (CAIR). She is also the director of BCH's Nutrition Laboratory. Dr Carey earned a BS from the University of Florida and a medical degree from the University of South Florida College of Medicine. Bram P. Raphael, MD, is an instructor in pediatrics at Harvard Medical School and an attending physician in gastroenterology, hepatology, and nutrition at BCH. He is the director of the hospital's HPN program.

To maximize safety and the patient experience, caregivers require intensive training to administer home parenteral nutrition (HPN) before initial hospital discharge. This article provides the rationale, best practices, and a template for caregiver predischarge HPN education provided by nurses. The standardized HPN discharge curriculum is outlined over 5 didactic and hands-on sessions. Read More

J Pediatr Gastroenterol Nutr 2019 Apr 9. Epub 2019 Apr 9.

Rosalind Franklin University of Medicine and Science.

Objectives: Adolescents and young adults (AYAs) with chronic illnesses use substances at similar, if not greater, rates compared to healthy peers. The present study aimed to examine rates and patterns of tobacco use, marijuana use, and binge drinking in AYAs with inflammatory bowel diseases (IBD). We expected that substance use would be associated with poorer physical health, psychosocial functioning, and disease management. Read More

Gastroenterol Res Pract 2019 7;2019:6156581. Epub 2019 Mar 7.

Division of Gastroenterology and Hepatology, Scripps Clinic, La Jolla, CA, USA.

Human cytomegalovirus (CMV) is a ubiquitous virus with a wide spectrum of pathology in humans. Host immunity is a major determinant of the clinical manifestation of CMV and can vary widely in the gastroenterology and hepatology practice setting. Immunocompetent patients generally develop a benign, self-limited mononucleosis-like syndrome whereas gastrointestinal tissue-invasive disease is more frequently seen in immunocompromised and inflammatory bowel disease patients. Read More

Physiother Theory Pract 2019 Apr 15:1-10. Epub 2019 Apr 15.

b PhyWorld Physiotherapy Clinic, Arjun Marg , Defence Colony , New Delhi , India.

Background And Purpose: The purpose of this case report is to describe the benefits of manual therapy techniques, including mobilization and stretching, in the management of a patient with chronic constipation.

Case Description: A 17-year-old male with an 8-month history of constipation and complaint of incomplete evacuation after defecation was referred for therapy. The patient was diagnosed with a spastic perineal syndrome. Read More

Patient Educ Couns 2019 Apr 6. Epub 2019 Apr 6.

Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Objective: We assessed the information needs of persons with any of three immune-mediated inflammatory diseases (multiple sclerosis [MS], inflammatory bowel disease [IBD] and rheumatoid arthritis [RA]) regarding depression, as a first step toward developing patient-relevant information resources, ultimately to facilitate self-management and appropriate care. We also compared information needs across genders.

Methods: We surveyed participants with MS, IBD and RA regarding depression-related information needs including types of treatments, effectiveness, risks, benefits, and perceived helpfulness of treatments. Read More

J Neurogastroenterol Motil 2019 Apr;25(2):241-249

Division of Pediatric Allergy, Immunology, and Rheumatology, Department of Pediatrics, Children's Hospital, China Medical University Hospital, Taichung, Taiwan.

Background/aims: Recent studies suggest that air pollution may play a role in gastrointestinal disorders. However, the effect of long-term exposure to air pollution on childhood irritable bowel syndrome (IBS) is unclear. Hence, we conducted a nationwide cohort study to investigate the association between long-term air pollution exposure and the incidence and risk of IBS in Taiwanese children during 2000-2012. Read More

Ir J Med Sci 2019 Apr 13. Epub 2019 Apr 13.

Irish Surgical Research Collaborative, Royal College of Surgeons in Ireland, 123, St. Stephen's Green, Dublin 2, Ireland.

Background: There is contradictory evidence regarding the merits of restricted versus liberal perioperative intravenous (IV) fluid administration in bowel surgery. This study sought to audit perioperative fluid management in elective colectomy in Ireland and to analyse the impact of such on operative outcomes.

Methods: A national surgical trainee collaborative audit of perioperative fluid management was performed. Read More

Gastrointest Endosc 2019 Apr 10. Epub 2019 Apr 10.

Royal Free Unit for Endoscopy, The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health, Hampstead, London, United Kingdom.

Background And Aims: Small-bowel varices (SBV) are an uncommon consequence of portal hypertension. Radiological intervention (RI) is usually considered for first-line management. When RI is not possible, management options become very limited. Read More

Inflamm Bowel Dis 2019 Apr 13. Epub 2019 Apr 13.

Division of Gastroenterology, University of California, San Francisco, California, USA.

Background: Hospitalization for ulcerative colitis is a high-risk period associated with increased risk of Clostridium difficile infection, thromboembolism, and opiate use. The study aim was to develop and implement a quality-improvement intervention for inpatient ulcerative colitis management that standardizes gastroenterology consultant recommendations and improves delivery of evidence-based care.

Methods: All adult patients hospitalized for ulcerative colitis between July 1, 2014, and December 31, 2017, who received intravenous corticosteroids were included. Read More

Cochrane Database Syst Rev 2019 Apr 12;4:CD012680. Epub 2019 Apr 12.

School of Psychology, Deakin University Geelong, 221 Burwood Highway, Burwood, VIC, Victoria, Australia, 3025.

Background: Symptoms of anxiety and depression are common in inflammatory bowel disease (IBD). Antidepressants are taken by approximately 30% of people with IBD. However, there are no current guidelines on treating co-morbid anxiety and depression in people with IBD with antidepressants, nor are there clear data on the role of antidepressants in managing physical symptoms of IBD. Read More

N Z Med J 2019 Apr 12;132(1493):38-43. Epub 2019 Apr 12.

Head of Department in General Surgery, Consultant General Surgeon, Department of General Surgery, Taranaki Base Hospital, New Plymouth.

Aim: At our institution there has been a long-standing early operative approach to large bowel volvulus as well as initial decompression with rigid sigmoidoscopy. The primary aim of this study was to investigate the safety and efficacy of this approach on reducing readmissions and complications. Secondary aims were to investigate the safety and efficacy of bedside rigid sigmoidoscopy in decompression of sigmoid volvulus and investigate the sensitivity of abdominal x-ray in the diagnosis of acute large bowel volvulus. Read More

Holist Nurs Pract 2019 May/Jun;33(3):155-162

Ahmet Erdoğan Vocatıonal School of Health Services, Bulent Ecevit University, Zonguldak, Turkey (Dr Erdogan); and Faculty of Medicine, Public Health Department, Bulent Ecevit University, Zonguldak, Turkey (Dr Kurçer).

This study was conducted to determine the dietary supplement (DS) use in gastrointestinal symptom management, and its effect on hopelessness levels in patients with irritable bowel syndrome (IBS). The universe of this cross-sectional study consisted of 132 patients presenting at the polyclinic, while the sample consisted of 127 patients who meet the inclusion criteria to study. Data were collected using a patient identification form including sociodemographic characteristics and DS use, the Gastrointestinal Symptom Rating Scale, and the Beck Hopelessness Scale. Read More

Curr Opin Gastroenterol 2019 Apr 9. Epub 2019 Apr 9.

Division of Gastroenterology, Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Purpose Of Review: The current review provides an updated overview on the role of therapeutic drug monitoring (TDM) of biological therapies in inflammatory bowel disease (IBD). We examine the data behind TDM for the antitumor necrosis factor agents, vedolizumab and ustekinumab, in patients with IBD. In addition, we discuss reactive vs. Read More

Curr Opin Gastroenterol 2019 Apr 9. Epub 2019 Apr 9.

The Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Purpose Of Review: To describe the development of re-do pouch surgery, what it entails, its indications and role in the management of patients with inflammatory bowel disease.

Recent Findings: Re-do pouch surgery has very good outcomes and excellent patient satisfaction when performed on carefully selected patients in specialized centers.

Summary: The ileal pouch anal anastomosis (IPAA) procedure, which was developed 40 years ago, is a mainstay in the reconstruction of patients who undergo a proctoclectomy for ulcerative colitis and familial adenomatous polyposis (FAP). Read More

Digestion 2019 Apr 10:1-11. Epub 2019 Apr 10.

Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China,

Objectives: The aim of the study was to assess the quality of guidelines on irritable bowel syndrome (IBS) using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument and identify concordance of different commendations.

Materials And Methods: A systematic search was undertaken from inception to May 2018. Two reviewers independently selected the titles and abstracts. Read More

Acta Haematol 2019 Apr 10;142(1):30-36. Epub 2019 Apr 10.

Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,

Inflammatory bowel disease (IBD) is a group of chronic relapsing inflammatory disorders affecting the large and small intestine, with a rising worldwide incidence and prevalence. Anaemia is the most common extraintestinal manifestation of IBD, correlating with disease activity, and tending to relapse even after successful therapy. Iron deficiency is the most common cause; however, it often manifests in combination with anaemia of inflammation. Read More

Obes Surg 2019 Apr 10. Epub 2019 Apr 10.

Carolinas Bariatic/MIS Fellowship Program, Carolinas Weight Management, Carolinas Medical Center, Charlotte, NC, USA.

Introduction: Since it was first described in 2001, the one anastomosis gastric bypass (OAGB) has been gaining popularity in the Middle East region and worldwide. We designed a survey to evaluate the trends, techniques, and outcomes of OAGB in our region.

Methods: A questionnaire to study OAGB was sent to the members of the IFSO MENA chapter. Read More

J Dig Dis 2019 Apr 10. Epub 2019 Apr 10.

Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC, USA.

Background And Aims: There is significant data that support the efficacy and safety of Fecal Microbiota Transplant ( FMT) in Recurrent Clostridium Difficile Infection (RCDI). The objective of our study was to determine the success rate of FMT in patients diagnosed with severe and complicated CDI with impending colectomy in the ICU setting.

Methods: This was a 2 center study, which consisted of 9 patients who met criteria of severe and complicated CDI and had impending colectomy. Read More

SAGE Open Med Case Rep 2019 1;7:2050313X19839531. Epub 2019 Apr 1.

Department of Medicine, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY, USA.

In this clinical vignette, we present a case of a 59-year-old woman with catastrophic antiphospholipid syndrome likely triggered by polymicrobial sepsis. The diagnostic criteria and clinical manifestations of catastrophic antiphospholipid syndrome are reviewed. We also compare diagnostic criteria and clinical manifestations with other clinical entities in the differential diagnosis, including thrombotic thrombocytopenic purpura-hemolytic-uremic syndrome, disseminated intravascular coagulation, sepsis, and inflammatory bowel disease. Read More

J Health Popul Nutr 2019 Apr 9;38(1):11. Epub 2019 Apr 9.

School of Health Sciences, University of Management and Technology, Lahore, Pakistan.

Background: Bowel necrosis is a commonly observed condition in elderly patients with longstanding diabetes. In such condition, intestinal resection is usually performed for the removal of the gangrenous part. Post-surgical dietary management after bowel resection poses several challenges for the health care team. Read More

J Pediatr Gastroenterol Nutr 2019 Apr 1. Epub 2019 Apr 1.

Cincinnati Children's Hospital Medical Center, Schubert-Martin Pediatric IBD Center.

Objectives: Deficits in the preparation of patients with inflammatory bowel disease (IBD) who are transitioning to adult care are known yet studies presenting outcome data of transition interventions in IBD are lacking. We present data evaluating the impact of a transition coordinator on behavioral and clinical transition outcomes.

Methods: A retrospective chart review identified 135 patients who had met with our transition coordinator and completed the Transition Readiness Assessment Questionnaire before, and 1 year after, the intervention. Read More

Eur Rev Med Pharmacol Sci 2019 Mar;23(6):2532-2538

Digestive Surgery Unit of the Fondazione Policlinico "A. Gemelli" IRCCS, Catholic University of Sacred Heart, Rome, Italy.

Objective: Colonoscopy is recognized as the primary screening test for colorectal cancer. However, its inaccuracy in identifying the exact tumor localization is still high. As a consequence, repeated colonoscopies and changes in the surgical management have been reported. Read More

Clin J Gastroenterol 2019 Apr 8. Epub 2019 Apr 8.

Department of Medicine, University of Connecticut, 263 Farmington Ave, Farmington, CT, 06030, USA.

Distal intestinal obstructive syndrome (DIOS) is a gastrointestinal complication of cystic fibrosis caused by increased viscosity of intraluminal contents leading to partial or complete bowel obstruction. DIOS is often misdiagnosed or mistaken for surgical bowel obstruction or appendicitis. This can lead to unnecessary surgical intervention when DIOS should be treated medically with aggressive bowel regimen. Read More

Case Rep Surg 2019 6;2019:4036823. Epub 2019 Mar 6.

Intensive Care Department, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

Although Schistosoma infection in humans commonly involves the intestines, megacolon is a rare finding. We report a 47-year-old patient who was found to have chronic megacolon. After failing conservative management, he underwent extended hemicolectomy with colorectal anastomosis. Read More

Autoimmun Rev 2019 Apr 5. Epub 2019 Apr 5.

Rheumatology Unit, University of Messina, Messina, Italy.

The development of biologics and small oral molecules has recently changed the scenario of pharmacologic treatment of systemic rheumatic diseases and it has become a real revolution. These drugs have innovative mechanisms of action, based on the inhibition of specific molecular or cellular targets directly involved in disease pathogenesis. This new scenario has lead to a regular update of the management recommendations of several institututions, such as those for Rheumatoid Arthritis treatment that address the use of conventional and biologic therapies including TNFin (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab), abatacept, rituximab, IL-6 inhibitors (tocilizumab and sarilumab), biosimilars and small oral molecules (the JAK inhibitors tofacitinib and baricitinib). Read More

Neurosurgery 2019 Feb 14. Epub 2019 Feb 14.

Department of Anesthesiology, University of Virginia, Charlottesville, Virginia.

Background: Pain management following major spine surgery requires high doses of opioids and is associated with a risk of opioid-induced constipation. Peripheral mu-receptor antagonists decrease the gastrointestinal complications of perioperative systemic opioid administration without antagonizing the analgesic benefits of these drugs.

Objective: To investigate the impact of alvimopan in opioid-naive patients undergoing major spine surgery. Read More

BMJ Case Rep 2019 Apr 4;12(4). Epub 2019 Apr 4.

Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.

A 41-year-old woman with menorrhagia secondary to adenomyosis underwent an elective uncomplicated total laparoscopic hysterectomy after failed medical therapy. She developed fever, epigastric pain, nausea and diarrhoea on postoperative day (POD) 2. CT of abdomen and pelvis performed on POD 3 revealed an 8×3×3 cm fluid collection superior to the bladder. Read More

BMJ Case Rep 2019 Apr 3;12(4). Epub 2019 Apr 3.

Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Immune checkpoint inhibitors (ICPis) have revolutionised survival outcomes for cancer patients by bolstering anti-tumour immunity. However, immune activation also occurs in non-cancer tissue, and a significant proportion of patients develop immune-mediated colitis, which can be fatal if not promptly recognised and managed. Diagnosis is often made by inflammation observed during lower gastrointestinal endoscopy. Read More

Acta Med Port 2019 Mar 29;32(3):240-243. Epub 2019 Mar 29.

Departamento de Cirurgia. Centro Hospitalar Tondela-Viseu. Viseu. Portugal.

Internal hernias are a rare cause of bowel obstruction (1%) and can be caused by broad ligament defects in 4% to 7% of the cases. These defects may be congenital or acquired and are classified according to its anatomical location. This paper reports three cases of small bowel obstruction by broad ligament hernia. Read More

Medicine (Baltimore) 2019 Apr;98(14):e15044

Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain.

To assess inflammatory bowel disease (IBD) patients' experience of chronic illness care and the relationship with demographic and healthcare-related characteristics.This cross-sectional survey used the Instrument to Evaluate the EXperience of PAtients with Chronic diseases (IEXPAC) questionnaire to identify parameters associated with a better healthcare experience for IBD patients. IEXPAC questionnaire responses are grouped into 3 factors - productive interactions, new relational model, and patient self-management, scoring from 0 (worst) to 10 (best experience). Read More

J Gastroenterol Hepatol 2019 Mar 8. Epub 2019 Mar 8.

Department of Gastroenterology, The Alfred Hospital, Monash University, Melbourne, Victoria, Australia.

Since its first trial showing evidence of efficacy for managing symptoms of irritable bowel syndrome, the fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet has been gaining popularity but not without criticism. Application of the diet has changed from a rigid list of "allowed" and "not allowed" foods to a structured program of initial FODMAP restriction followed by food reintroduction and finally personalization so that patients are empowered to adjust their diet themselves to achieve good predictability of symptoms. Safety concerns of the diet have centered around its initial elimination leading to compromise of nutritional and psychological health, but careful patient assessment and management, preferably through a FODMAP-trained dietitian, will reduce the risk of such negative health outcomes. Read More

J Gastric Cancer 2019 Mar 12;19(1):72-82. Epub 2019 Feb 12.

Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.

Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea.

Materials And Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. Read More

Prz Gastroenterol 2019 12;14(1):19-25. Epub 2019 Mar 12.

Department of Gastroenterology, Allergology and Paediatrics, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.

Radiological examination occupies a significant role, complementary to endoscopic studies, in the diagnostic process of inflammatory bowel disease (IBD). Both ulcerative colitis and Crohn's disease, due to multiple remissions and relapses, require repetitive examinations to evaluate the disease extent, severity, and response to pharmacological treatment. Whereas the use of barium contrast studies is progressively reduced, plain radiography confirms its utility as a first-line imaging tool for acute abdomen. Read More

Prz Gastroenterol 2019 12;14(1):1-18. Epub 2019 Mar 12.

Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland.

These recommendations refer to the current management in pancreatic ductal adenocarcinoma (PDAC), a neoplasia characterised by an aggressive course and extremely poor prognosis. The recommendations regard diagnosis, surgical, adjuvant and palliative treatment, with consideration given to endoscopic and surgical methods. A vast majority of the statements are based on data obtained in clinical studies and experts' recommendations on PDAC management, including the following guidelines: International Association of Pancreatology/European Pancreatic Club (IAP/EPC), American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), National Comprehensive Cancer Network (NCCN) and Polish Society of Gastroenterology (PSG) and The National Institute for Health and Care Excellence (NICE) All recommendations were voted on by members of the Working Group of the Polish Pancreatic Club. Read More

Gut 2019 Apr 3. Epub 2019 Apr 3.

Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Patients with Crohn's disease commonly develop ileal and less commonly colonic strictures, containing various degrees of inflammation and fibrosis. While predominantly inflammatory strictures may benefit from a medical anti-inflammatory treatment, predominantly fibrotic strictures currently require endoscopic balloon dilation or surgery. Therefore, differentiation of the main components of a stricturing lesion is key for defining the therapeutic management. Read More

J BUON 2019 Jan-Feb;24(1):408-409

Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece.

MBio 2019 04 2;10(2). Epub 2019 Apr 2.

Center for Medical Mycology, Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA

Dysbiosis of the gut microbiome has been implicated in inflammatory bowel diseases. We have shown that levels of , along with those of and , are significantly elevated in Crohn's disease (CD) patients. Here, we evaluated the ability of a novel probiotic to prevent and treat polymicrobial biofilms (PMB) formed by with and Since has been reported to be elevated in CD patients, we investigated the interactions of with these bacterial species in biofilm formation. Read More

BMC Gastroenterol 2019 Apr 2;19(1):47. Epub 2019 Apr 2.

Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, USA.

Background: Few data are currently available on the initial presenting symptoms of patients with inflammatory bowel disease (IBD).

Methods: We evaluated the initial symptom presentation of patients with IBD in the Ocean State Crohn's and Colitis Area Registry (OSCCAR), a community-based inception cohort that enrolled Rhode Island IBD patients at time of diagnosis with longitudinal follow up. A 41-question symptom inventory was administered at time of enrollment to capture symptoms experienced during the 4 weeks preceding diagnosis of IBD. Read More

Cochrane Database Syst Rev 2019 Apr 2;4:CD011118. Epub 2019 Apr 2.

Cochrane Pain, Palliative and Supportive Care Group, Pain Research Unit, Churchill Hospital, Oxford, UK.

Background: This is the first update of a review published in 2015, Issue 1. Chronic pain is common during childhood and adolescence and is associated with negative outcomes, such as increased severity of pain, reduced function, and low mood. Psychological therapies, traditionally delivered face-to-face with a therapist, are efficacious at reducing pain intensity and disability. Read More

PLoS One 2019 2;14(4):e0214582. Epub 2019 Apr 2.

Interdisciplinary Research Center on Biotechnology-CIP-Biotec, Universidade Federal do Pampa, São Gabriel, Rio Grande do Sul, Brazil.

Introduction: The gut microbiome has been related to several features present in Glycogen Storage Diseases (GSD) patients including obesity, inflammatory bowel disease (IBD) and liver disease.

Objectives: The primary objective of this study was to investigate associations between GSD and the gut microbiota.

Methods: Twenty-four GSD patients on treatment with uncooked cornstarch (UCCS), and 16 healthy controls had their faecal microbiota evaluated through 16S rRNA gene sequencing. Read More

J Palliat Med 2019 Apr 2. Epub 2019 Apr 2.

12 Department of Community-based Medicine and Primary Care, University of the Ryukyus, Okinawa, Japan.

Background: Gastrointestinal symptoms, including nausea, vomiting, bowel obstruction, ascites, constipation, and anorexia, are common and often refractory in advanced cancer patients. The palliation of gastrointestinal symptoms is important in improving the quality of life of cancer patients, as well as that of their families and caregivers. Currently published clinical guidelines for the management of gastrointestinal symptoms in cancer patients do not comprehensively cover the topics or are not based on a formal process for the development of clinical guidelines. Read More

Ann Ital Chir 2019 Jan 10;8. Epub 2019 Jan 10.

Aim: Describtion of a rare case of intestinal obstruction due to peritoneal sarcoidosis mimicking peritoneal carcinomatosis, and of the literature review about its surgical management.

Material Of Study: A 69 year-old woman was referred to our emergency department with diffuse abdominal pain, enteric vomiting and constipation. Abdominal CT showed a dilatated small bowel loops extended to the jejunum with a mechanical obstruction. Read More

World Allergy Organ J 2019 22;12(3):100018. Epub 2019 Mar 22.

Division of Allergy Immunology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Background: X-linked agammaglobulinemia is an inherited immunodeficiency recognized since 1952. In spite of seven decades of experience, there is still a limited understanding of regional differences in presentation and complications. This study was designed by the Primary Immunodeficiencies Committee of the World Allergy Organization to better understand regional needs, challenges and unique patient features. Read More