Les derniers abstracts de la revue Gastroenterology : |
Date de mise en ligne : Jeudi 19 mars 2015
John I. Allen
AGA Strategic Plan 2015-2020: Something that Matters
Date de mise en ligne : Jeudi 19 mars 2015
Jittima Weerachayaphorn, Maria Jimena Amaya, Carlo Spirli, Piyachat Chansela, Kisha A. Mitchell, Meenakshisundaram Ananthanarayanan, Michael H. Nathanson
Nuclear Factor Erythroid 2-like 2 Regulates Expression of Inositol 1,4,5-trisphosphate Receptor, Type 3 and Calcium Signaling in Cholangiocytes
Most cholestatic disorders are caused by defects in cholangiocytes. The type 3 isoform of the inositol 1,4,5-trisphosphate receptor (ITPR3) is the intracellular calcium release channel detected most frequently in cholangiocytes. ITPR3 is required for bicarbonate secretion by bile ducts, and its expression is reduced in intrahepatic bile ducts of patients with cholestatic disorders. We investigated whether the nuclear factor, erythroid 2-like 2 (NFE2L2 or NRF2), which is sensitive to oxidative stress, regulates expression of ITPR3.
Date de mise en ligne : Jeudi 19 mars 2015
Steve Halligan, Katherine Wooldrage, Edward Dadswell, Urvi Shah, Ines Kralj-Hans, Christian von Wagner, Omar Faiz, Julian Teare, Rob Edwards, Clive Kay, Guiqing Yao, Richard J. Lilford, Dion Morton, Jane Wardle, Wendy Atkin, SIGGAR investigators
Identification of Extra-colonic Pathologies by Computed Tomographic Colonography in Symptomatic Patients
& Aims: Symptoms suggestive of colorectal cancer may originate outside the colorectum. Computed tomographic colonography (CTC) is used to simultaneously examine the colorectum and abdomino-pelvic organs. We performed a prospective, randomized controlled trial to quantify the frequency, nature, and consequences of extra-colonic findings.
Date de mise en ligne : Mardi 17 mars 2015
Emanuela Sala, Marco Genua, Luciana Petti, Achille Anselmo, Vincenzo Arena, Javier Cibella, Lucia Zanotti, Silvia D’Alessio, Franco Scaldaferri, Giovanni Luca, Iva Arato, Riccardo Calafiore, Alessandro Sgambato, Sergio Rutella, Massimo Locati, Silvio Danese, Stefania Vetrano
Mesenchymal Stem Cells Reduce Colitis in Mice via Release of TSG6, Independently of Their Localization to the Intestine
& Aims: Mesenchymal stem cells (MSCs) are pluripotent cells that can promote expansion of immune regulatory cells and might be developed for treatment of immune disorders, including inflammatory bowel diseases. MSCs were reported to reduce colitis in mice; we investigated whether MSC localization to the intestine and production of paracrine factors, including tumor necrosis factor-induced protein 6 (TSG6), were required for these effects.
Date de mise en ligne : Mardi 17 mars 2015
Daisy Walter, Petra G.A. van Boeckel, Marcel J. Groenen, Bas L.A.M. Weusten, Ben J. Witteman, Gi Tan, Menno A. Brink, Jan Nicolai, Adriaan C. Tan, Joyce Alderliesten, Niels G. Venneman, Wim Laleman, Jeroen M. Jansen, Alexander Bodelier, Frank L. Wolters, Laurens A. van der Waaij, Ronald Breumelhof, Frank T.M. Peters, Robbert C.H. Scheffer, Max Leenders, Meike M.C. Hirdes, E.W. Steyerberg, Frank P. Vleggaar, Peter D. Siersema
Cost Efficacy of Metal Stents for Palliation of Extrahepatic Bile Duct Obstruction in a Randomized Controlled Trial
& Aims: Endoscopic stents are placed for palliation of extra-hepatic bile duct obstruction. Although self-expandable metals stents (SEMS) remain patent longer than plastic stents, they are more expensive. We aimed to evaluate which type of stent (plastic, uncovered [uSEMS], or partially covered [pcSEMS]), is most effective and assessed costs.
Date de mise en ligne : Samedi 14 mars 2015
Alessio Fasano, Anna Sapone, Victor Zevallos, Detlef Schuppan
Nonceliac Gluten Sensitivity
During the past decade there has been an impressive increase in popularity of the gluten-free diet (GFD)—now the most trendy alimentary habit in the United States and other countries. According to recent surveys, as many as 100 million Americans will consume gluten-free products within a year. Operating under the concept that the GFD benefits only individuals with celiac disease, health care professionals have struggled to separate the wheat from the chaff; there are claims that eliminating gluten from the diet increases health and helps with weight loss, or even that gluten can be harmful to every human being.
Date de mise en ligne : Mercredi 11 mars 2015
Phil A. Hart, Yoh Zen, Suresh T. Chari
Recent Advances in Autoimmune Pancreatitis
Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis that is characterized clinically by frequent presentation with obstructive jaundice, histologically by a dense lymphoplasmacytic infiltrate with fibrosis, and therapeutically by a dramatic response to steroids. Two distinct diseases, called type 1 and type 2 AIP, share these features. However, the two diseases have unique pancreatic histopathological patterns and differ significantly in their demographic profiles, clinical presentation, and natural history.
Date de mise en ligne : Mercredi 11 mars 2015
Michael J. Grey, Stephen P. James, Griffin P. Rodgers
NIDDK Programs and Emerging Opportunities for Digestive Diseases Research
Date de mise en ligne : Mercredi 11 mars 2015
Ryan Law, Sara Wobker, Ian S. Grimm, Todd H. Baron
EUS-Guided Fine Needle Aspiration of Kidney Masses
Date de mise en ligne : Samedi 07 mars 2015
Takeshi Ogura, Saori Onda, Tatsushi Sano, Wataru Takagi, Masayuki Kitano, Daisuke Masuda, Akira Imoto, Shinya Fukunishi, Kazuhide Higuchi
EUS-guided antegrade balloon dilation from right hepatic duct combined with retrograde rendezvous stent placement
Date de mise en ligne : Vendredi 06 mars 2015
N. Chalasani, H.L. Bonkovsky, R. Fontana, W. Lee, A. Stolz, J. Talwalkar, K.R. Reddy, P.B. Watkins, V. Navarro, H. Barnhart, J. Gu, J. Serrano, United States Drug Induced Liver Injury Network
Features and Outcomes of 889 Patients with Drug-induced Liver Injury: The DILIN Prospective Study
The drug-induced liver injury network (DILIN) is conducting a prospective study of patients with DILI in the United States. We present characteristics and subgroup analyses from the first 1257 patients enrolled in the study.
Date de mise en ligne : Vendredi 06 mars 2015
Carlotta Tacconi, Carmen Correale, Alessandro Gandelli, Antonino Spinelli, Elisabetta Dejana, Silvia D’Alessio, Silvio Danese
Vascular Endothelial Growth Factor C Disrupts the Endothelial Lymphatic Barrier to Promote Colorectal Cancer Invasion
Colorectal cancer (CRC) is highly metastatic. Metastases spread directly into local tissue or invade distant organs via blood and lymphatic vessels, but the role of lymphangiogenesis in CRC progression has not been determined. Lymphangiogenesis is induced via vascular endothelial growth factor C (VEGFC) activation of its receptor, VEGFR3; high levels of VEGFC have been measured in colorectal tumors undergoing lymphangiogenesis, and correlated with metastasis. We investigated VEGFC signaling and lymphatic barriers in human tumor tissues and mice with orthotopic colorectal tumors.
Date de mise en ligne : Vendredi 06 mars 2015
Elisavet Serti, Xenia Chepa-Lotrea, Yun Ju Kim, Meghan Keane, Nancy Fryzek, T. Jake Liang, Marc Ghany, Barbara Rehermann
Successful Interferon-Free Therapy of Chronic Hepatitis C Virus Infection Normalizes Natural Killer Cell Function
Chronic hepatitis C virus infection activates an intrahepatic immune response, leading to increased expression of interferon (IFN)-stimulated genes and activation of natural killer (NK) cells—the most prevalent innate immune cell in the liver. We investigated whether the elimination of HCV with direct-acting antiviral agents normalizes expression of IFN-stimulated genes and NK cell function.
Date de mise en ligne : Vendredi 06 mars 2015
Satdarshan Pal Singh Monga
β-Catenin Signaling and Roles in Liver Homeostasis, Injury And Tumorigenesis
β-catenin (encoded by CTNNB1) is a subunit of the cell surface cadherin protein complex that acts as an intracellular signal transducer in the WNT signaling pathway; alterations in its activity have been associated with development of hepatocellular carcinoma and other liver diseases. Other than WNT, additional signaling pathways can also converge at β-catenin. β-catenin also interacts with transcription factors such as T-cell factor, forkhead box protein O, and HIF1α to regulate expression of target genes.
Date de mise en ligne : Vendredi 06 mars 2015
Kazuya Takahashi, Hiroki Sato, Yuichi Sato
An Unusual Case of an Esophageal Functional Disorder
Question: A 31-year-old man was referred to our hospital for chest pain and dysphagia that had lasted for 3 months. He had no allergies and was not receiving any medication. Physical examination and laboratory tests did not show any specific findings. Although endoscopy showed no remarkable findings in the esophageal mucosa, the lumen was not extended enough even with adequate air supply (FigureA). Six biopsy samples were obtained at different regions of the esophagus, and no characteristic findings were noted in the epithelium.
Date de mise en ligne : Mercredi 04 mars 2015
Joon Hyeok Lee, Jeong-Hoon Lee, Young-Suk Lim, Jong Eun Yeon, Tae-Jin Song, Su Jong Yu, Geum-Youn Gwak, Kang Mo Kim, Yoon Jun Kim, Jae Won Lee, Jung-Hwan Yoon
Adjuvant Immunotherapy with Autologous Cytokine-induced Killer Cells for Hepatocellular Carcinoma
No adjuvant therapy has been shown to extend survival of patients with hepatocellular carcinoma (HCC) receiving curative treatment. We investigated whether injections of activated cytokine-induced killer (CIK) cells (CD3+/CD56+ and CD3+/CD56– T cells and CD3–/CD56+ natural killer cells) prolongs recurrence-free survival of patients following curative therapy for HCC.
Date de mise en ligne : Mercredi 04 mars 2015
Chandan Kumar Kedarisetty, Lovkesh Anand, Ankit Bhardwaj, Ajeet Singh Bhadoria, Guresh Kumar, Ashish Kumar Vyas, Paul David, Nirupama Trehanpati, Archana Rastogi, Chhagan Bihari, Rakhi Maiwall, Hitendra Kumar Garg, Chitranshu Vashishtha, Manoj Kumar, Vikram Bhatia, Shiv Kumar Sarin
Combination of Granulocyte Colony-Stimulating Factor and Erythropoietin Improves Outcomes of Patients with Decompensated Cirrhosis
Patients with decompensated cirrhosis have significantly reduced survival without liver transplantation. Granulocyte colony stimulating factor (G-CSF) has been shown to increase survival in patients with acute-on-chronic liver failure (ACLF), and erythropoietin promoted hepatic regeneration in animal studies. We performed a double blind, randomized, placebo-controlled trial to determine whether co-administration of these growth factors improved outcomes of patients with advanced cirrhosis.
Date de mise en ligne : Mercredi 04 mars 2015
Brian Bressler, John K. Marshall, Charles N. Bernstein, Alain Bitton, Jennifer Jones, Grigorios I. Leontiadis, Remo Panaccione, A. Hillary Steinhart, Francis Tse, Brian Feagan, Toronto Ulcerative Colitis Consensus Group
Clinical Practice Guidelines for the Medical Management of Non-Hospitalized Ulcerative Colitis: The Toronto Consensus
The medical management of ulcerative colitis (UC) has improved through the development of new therapies and novel approaches that optimize existing drugs. Previous Canadian consensus guidelines addressed the management of severe UC in the hospitalized patient. We now present consensus guidelines for the treatment of ambulatory patients with mild-to-severe active UC.
Date de mise en ligne : Mercredi 04 mars 2015
Karen L. Edelblum, Gurminder Singh, Matthew A. Odenwald, Amulya Lingaraju, Kamal El Bissati, Rima McLeod, Anne I. Sperling, Jerrold R. Turner
γδ Intraepithelial Lymphocyte Migration Limits Transepithelial Pathogen Invasion and Systemic Disease in Mice
Intraepithelial lymphocytes that express the γδ T cell receptor (γδ IELs) limit pathogen translocation across the intestinal epithelium by unknown mechanisms. We investigated whether γδ IEL migration and interaction with epithelial cells promote mucosal barrier maintenance during enteric infection.
Date de mise en ligne : Samedi 28 février 2015
Noel FCC. de Miranda, Maarten van Dinther, Brendy EWM. van den Akker, Tom van Wezel, Peter ten Dijke, Hans Morreau
Transforming Growth Factor β Signaling in Colorectal Cancer Cells with Microsatellite Instability Despite Biallelic Mutations in
Most colorectal cancer (CRC) cells with high levels of microsatellite instability (MSI-H) accumulate mutations at a microsatellite sequence in the gene encoding transforming growth factor β receptor II (TGFBR2). TGFβ signaling is therefore believed to be defective in these tumors, although CRC cells with TGFBR2 mutations have been reported to remain sensitive to TGFβ. We investigated how TGFβ signaling might continue in MSI-H CRC cells.
Date de mise en ligne : Samedi 28 février 2015
Hyung-Don Kim, Young-Suk Lim, Seungbong Han, Jihyun An, Gi-Ae Kim, So Yeon Kim, So Jung Lee, Hyung Jin Won, Jae Ho Byun
Evaluation of Early-stage Hepatocellular Carcinoma by Magnetic Resonance Imaging with Gadoxetic Acid Detects Additional Lesions and Increases Overall Survival
Hepatocellular carcinoma (HCC) has a high rate of intrahepatic recurrence after curative treatment, possibly because metastases are not always identified before treatment. Magnetic resonance (MR) imaging with a liver-specific contrast agent, gadoxetic acid, can detect small HCCs with high levels of sensitivity. We investigated whether MR imaging with gadoxetic acid increases overall and recurrence-free survival of patients initially assessed by computed tomography (CT).
Date de mise en ligne : Samedi 28 février 2015
David S. Goldberg, Kimberly A. Forde, Dena M. Carbonari, James D. Lewis, Kimberly B.F. Leidl, K. Rajender Reddy, Kevin Haynes, Jason Roy, Daohang Sha, Amy R. Marks, Jennifer L. Schneider, Brian L. Strom, Douglas A. Corley, Vincent Lo Re
Population-representative Incidence of Drug-induced Acute Liver Failure Based on an Analysis of an Integrated Healthcare System
Medications are a major cause of acute liver failure (ALF) in the US, but no population-based studies have evaluated the incidence of ALF from drug-induced liver injury. We aimed to determine the incidence and outcomes of drug-induced ALF in an integrated healthcare system that approximates a population-based cohort.
Date de mise en ligne : Samedi 28 février 2015
Abdol Rahim Masjedizadeh, Pezhman Alavinejad, Ahmad Hormati
A Senile Man With Cystic Lesion of Liver and Biliary Obstruction
Question: An 83-year-old man presented with fever, biliary pain, and eosinophilia for 2 weeks. During admission in our hospital, the vital signs included: temperature 38.5°C, pulse 90 beats/min, respiratory rate 20 breaths/min, and blood pressure 140/85 mm Hg. On physical examination, the patient had tenderness in right upper quadrant and mild jaundice.
Date de mise en ligne : Samedi 28 février 2015
Mitsuhito Koizumi, Teru Kumagi, Yoichi Hiasa
An Unusual Cause of Abdominal Pain
Question: An 88-year-old woman was admitted to our hospital complaining of upper abdominal and back pain. She had a history of hypertension. On admission, she was febrile with a temperature of 38.4°C, blood pressure was 122/54 mmHg, and her pulse rate was 84 beats per minute. Her abdomen was soft, nondistended, and nontender. Admission blood work revealed a white blood cell count of 7,800/mm3. Her liver panel showed a total bilirubin of 1.1 mg/dL (normal, 0.1-1.1); alanine aminotransferase, 62 IU/L (normal, 3-49); aspartate aminotransferase, 47 IU/L, (normal, 9-37); alkaline phosphatase, 438 IU/L, (normal, 104-338); and r-glutamyl transpeptidase, 168 IU/L (normal, 6-71).
Date de mise en ligne : Jeudi 26 février 2015
Willem J. Lammers, Henk R. van Buuren, Gideon M. Hirschfield, Bettina E. Hansen, Global PBC Study Group
Reply
The comments of Giljaca, Stimac, and Gluud regarding our study are very much appreciated and timely. Patients with primary biliary cirrhosis (PBC) presently have only 1 therapy, ursodeoxycholic acid (UDCA), that is recommended universally for use globally; however, it fails to benefit all patients equally.
Date de mise en ligne : Jeudi 26 février 2015
Prashant Kedia, Reem Z. Sharaiha, Michel Kahaleh
Reply
We thank the authors for taking interest in our publication and appreciate their time to raise some insightful arguments regarding the internal endoscopic ultrasonography (EUS)-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE) procedure as a novel method for performing endoscopic retrograde cholangiopancreatography (ERCP) in Roux-n-Y gastric bypass (RYGB) patients.
Date de mise en ligne : Jeudi 26 février 2015
Jeffrey B. Raskin, Michael A. Kamm, Paul Streck
Reply
We thank Dr Floch for his interest in our study. The potential role of mesalamine for the prevention of recurrent diverticulitis and symptoms in diverticulosis was covered by the Tursi and Danese editorial1 that originally accompanied the PREVENT paper.2 While Floch questions the conclusion of the PREVENT paper (ie, “mesalamine is not superior to placebo in preventing recurrent diverticulitisâ€), he presents evidence that speaks to the potential effect of mesalamine on symptoms arising from diverticulosis rather than on the recurrence of diverticulitis.
Date de mise en ligne : Jeudi 26 février 2015
Vincent Wai-Sun Wong, Grace Lai-Hung Wong, Francis Ka-Leung Chan
Is Obeticholic Acid the Solution to Nonalcoholic Steatohepatitis?
Neuschwander-Tetri B, Loomba R, Sanyal AJ, et al. Farnesoid X nuclear receptor ligand obeticholic acid for non-cirrhotic, non-alcoholic steatohepatitis (FLINT): a multicenter, randomized, placebo-controlled trial. Lancet 2014 Nov 7 [Epub ahead of print].
Date de mise en ligne : Jeudi 26 février 2015
Deborah C. Rubin
Translational Gastroenterology: Organogenesis to Disease
Translational Gastroenterology: Organogenesis to Disease addresses the timely topic of bench-to-bedside “translational gastroenterology†by bringing together succinct yet comprehensive review of the basic science of gut organogenesis with paired chapters that summarize selected, relevant clinical disorders. Recognizing that the molecular pathways that regulate ontogeny of the gastrointestinal organs have relevance to congenital as well as acquired gastrointestinal diseases, the editors crafted this textbook to bring these 2 seemingly disparate subjects together.
Date de mise en ligne : Jeudi 26 février 2015
Michael J. Stamos
Anus: Surgical Treatment and Pathology
The editors of Anus: Surgical Treatment and Pathology are to be congratulated on their work. They assembled a truly world-class, international collection of authors who are all experts in the field, with the aim of producing a volume dedicated solely to the conditions and diseases affecting the anus. Most, if not all, prior books have covered the entire anorectum, with the diseases affecting the anus typically getting less attention than the ones affecting the rectum, because the typical practitioner with expertise or interest in proctologic problems prefers to treat these.
Date de mise en ligne : Jeudi 26 février 2015
Eamonn M.M. Quigley
Intestinal Microbiota in Health and Disease
One has only to peruse the tables of contents of Nature, Science, and Cell (and their various offspring) and read the leading gastroenterology journals to immediately realize that the gut microbiome is among the hottest (if not the hottest) topic in biomedical research today. Each week sees a new revelation on the composition and diverse functions of the “forgotten organ†and bears witness to new and exciting insights into what factors modify the microbiome, as well as how it interacts with the host, not just along the mucosal surface of the gastrointestinal tract, but at sites as distant and diverse as the brain and the liver.
Date de mise en ligne : Jeudi 26 février 2015
Martin H. Floch
Preventing Diverticulitis: Mesalamine May Still Be Indicated in the Decision
I read with great interest the excellent editorial written by Drs Tursi and Danese concerning the prevention of diverticulitis recurrence.1 The article was obviously stimulated by the publication by Raskin et al, also in this issue, reporting that mesalamine did not prevent recurrent diverticulitis in phase 3 controlled trials.2 The history of recent interest in diverticulitis was focused in our Yale University Workshop Report published on Diverticulitis: New Concepts and New Therapies in 2006.3 That workshop was attended by the National Diverticulitis Study Group, including Drs.
Date de mise en ligne : Jeudi 26 février 2015
David L. Diehl, Jon D. Gabrielsen, William E. Strodel
The Challenges of Endoscopic Retrograde Cholangiopancreatography in Gastric Bypass Patients: The Game Is Not Yet Over
We read with interest the video case report from Kedia et al1 regarding a new approach to facilitate ERCP in patients who have had Roux-en-Y gastric bypass (RYGB) surgery. Device-assisted enteroscopy has an unacceptable failure rate for successfully accomplishing ERCP when there is a long Roux limb,2 and as a result several approaches have been described in recent years to allow access to the remnant stomach through which a “regular†ERCP can be done. Although this well-documented presentation does provide a proof of concept, we feel that it is premature to declare “game over†from a single case report.
Date de mise en ligne : Jeudi 26 février 2015
Barham K. Abu Dayyeh, Christopher C. Thompson, Christopher Gostout
Re: Internal EUS-Directed Transgastric ERCP (EDGE): Game Over
We read with interest the article by Kedia et al1 demonstrating the feasibility of using a lumen-apposing metal stent to create a gastrogastric fistula (GGF) in a post-Roux-en-Y gastric bypass (RYGB) surgery patient to allow access to the excluded stomach for performance of an endoscopic retrograde cholangiopancreatography (ERCP) using a side-viewing duodenoscope. Although the technique is certainly novel and illustrates the progress made in the field of interventional endoscopy, the game is “not over†as stated in the article and caution should be used before using or adopting this technique in clinical practice.
Date de mise en ligne : Jeudi 26 février 2015
Vanja Giljaca, Davor Stimac, Christian Gluud
Levels of Alkaline Phosphatase and Bilirubin Are Surrogate Endpoints of Outcomes of Patients With Primary Biliary Cirrhosis: An International Follow-up Study
We read with interest the article by Lammers et al in Gastroenterology.1 The authors conclude that lower levels of alkaline phosphatases (ALP) and bilirubin are associated with lower risk for death or liver transplantation in patients with primary biliary cirrhosis (PBC) and that this information is independent of use of ursodeoxycholic acid and follow-up time (C statistic for ALP, 0.71; 95% CI, 0.69–0.73 at 2 times upper limit of normal; for bilirubin, 0.79; 95% CI, 0.77–0.80 at 1 times upper limit of normal).
Date de mise en ligne : Jeudi 26 février 2015
Jieun Koh, Chansik An, Yong Eun Chung
A Liver Mass Found After Subtotal Gastrectomy
Question: A 37-year-old woman underwent routine postoperative follow-up imaging study. Two months prior, she had undergone radical subtotal gastrectomy for advanced gastric cancer and a hysterectomy with bilateral salpingo-oophorectomy for Krukenberg tumor from gastric cancer. After surgery, she had no particular symptoms or abnormal findings on physical examination. Preoperative serum carcinoembryonic antigen (CEA) was 0.84 ng/mL (normal range, 0-5), CA 72-4 was 19.26 U/mL (normal range, 0-8.2), and CA 19-9 was 94.2 U/mL (normal range, 0-37).
Date de mise en ligne : Jeudi 26 février 2015
Tsutomu Namikawa, Michiya Kobayashi, Kazuhiro Hanazaki
Esophageal Tumor After Radical Surgery for Gastric Cancer
Question: A 63-year-old man underwent total gastrectomy and regional lymphadenectomy with Roux-en-Y reconstruction for gastric cancer in the anterior wall of upper third of the stomach. Pathologic examination revealed signet-ring cell carcinoma that had invaded the muscularis propria, measuring 7.0 × 6.5 cm, with metastasis to 1 lymph node and no lymphatic or venous invasion. The margins of the resected specimen including proximal, distal, and vertical sides were all free of cancer cells, and the proximal margin was 5.2 cm.
Date de mise en ligne : Jeudi 26 février 2015
Carlos Fernandes, LuÃsa Proença, João Carvalho
Recurrent Regurgitation of a Spongy Mass Into the Mouth
Question: A 55-year-old woman was referred to our gastroenterology outpatient clinic because of recurrent externalization through the mouth of an elastic, spongy mass that the patient could hold with her fingers and returned spontaneously to the digestive tract. This strange clinical picture had already motivated a psychiatry referral. Upper gastrointestinal endoscopy revealed a large pedunculated polypoid mass in the proximal esophagus (FigureA). Endoscopic ultrasonography was proposed and revealed the polyp insertion immediately distal to the upper esophageal sphincter, extending distally for about 15 cm.
Date de mise en ligne : Mercredi 25 février 2015
Michael Sigal, Michael E. Rothenberg, Catriona Y. Logan, Josephine Y. Lee, Ryan W. Honaker, Rachel L. Cooper, Ben Passarelli, Margarita Camorlinga, Donna M. Bouley, Guillermo Alvarez, Roeland Nusse, Javier Torres, Manuel R. Amieva
Activate and Expand Lgr5 Stem Cells Through Direct Colonization of the Gastric Glands
Helicobacter pylori infection is the main risk factor for gastric cancer. We characterized the interactions of H pylori with gastric epithelial progenitor and stem cells in humans and mice and investigated how these interactions contribute to H pylori-induced pathology.
Date de mise en ligne : Mercredi 25 février 2015
American Gastroenterological Association
Management of Asymptomatic Neoplastic Pancreatic Cysts: Clinical Decision Support Tool
Date de mise en ligne : Mercredi 25 février 2015
Anson W. Lowe, Richard H. Moseley
Covering the Cover
Current approaches to the treatment of ulcerative proctitis or proctosigmoiditis have largely consisted of the topical application of antiinflammatory compounds such as corticosteroids or mesalamine. These agents are administered usually as suppositories or liquid enemas. Budesonide is a corticosteroid that is applied topically to affected areas. Its major advantage is that 90% is metabolized on its first pass through the liver, which significantly lowers the incidence and severity of systemic adverse effects often associated with corticosteroids.
Date de mise en ligne : Mercredi 25 février 2015
Exam 2: Asymptomatic Neoplastic Pancreatic Cysts Guidelines
Date de mise en ligne : Mercredi 25 février 2015
Exam 1: The Combination of Simeprevir and Sofosbuvir Is More Effective Than That of Peginterferon, Ribavirin, and Sofosbuvir for Patients with Hepatitis C-related Child's Class A Cirrhosis
Date de mise en ligne : Mardi 24 février 2015
Fieke E.M. Froeling, Hemant M. Kocher
Homeostatic Restoration of Desmoplastic Stroma Rather Than Its Ablation Slows Pancreatic Cancer Progression
Sherman MH, Yu RT, Engle DD, et al. Vitamin D receptor-mediated stromal reprogramming suppresses pancreatitis and enhances pancreatic cancer therapy. Cell 2014;159:80–93.
Date de mise en ligne : Mardi 24 février 2015
Jesper B. Andersen
Fibrolamellar Hepatocellular Carcinoma: A Rare But Distinct Type of Liver Cancer
Primary liver cancers—hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA)—are a serious global health problem with >1 million cases diagnosed annually.1 Hepatocarcinogenesis resembles a branched, multistage process that develops through sequential acquisition of molecular alterations2 and several recognized histopathologic stages (low-/high-grade dysplastic nodules, early HCC, and advanced or progressed HCC). Depending on the cellular target of malignant transformation, a large spectrum of molecular3–5 and morphologic patterns may be observed.
Date de mise en ligne : Mardi 24 février 2015
Subrata Ghosh, Marco Daperno
Topical Therapy in Ulcerative Colitis: Always a Bridesmaid But Never a Bride?
Proctitis, proctosigmoiditis, and left-sided ulcerative colitis define the anatomic extent in 70% of patients at inception in the population-based IBSEN (Inflammatory Bowel South-Eastern Norway) cohort from Scandinavia.1 Despite rather limited affected area of the colon, these patients suffer from significant morbidity and poor quality of life, because active distal disease elicits symptoms such as urgency, tenesmus, blood loss per anum, and a feeling of incomplete evacuation. Limited extent of disease makes topical anti-inflammatory therapy appealing owing to safety and efficacy.
Date de mise en ligne : Mardi 24 février 2015
Brent A. Neuschwander-Tetri
Targeting the FXR Nuclear Receptor to Treat Liver Disease
To survive and function appropriately, cells respond to diverse signaling molecules and nutrients. Although the response to polar hydrophilic molecules is usually transmitted through membrane-bound receptors whether the ligand is small (eg, acetylcholine, epinephrine, dopamine) or large (eg, insulin, cholecystokinin, vasopressin), cells must also respond to a diverse array of small lipophilic molecules and for this a different strategy is used. Perhaps because lipophilic molecules can traverse cell membranes to reach the intracellular space, cells sense the presence of these molecules with a collection of intracellular nuclear receptor proteins that can modulate gene expression directly.
Date de mise en ligne : Mardi 24 février 2015
David T. Rubin
The Rationale and Growth of Advanced Training in Inflammatory Bowel Disease
In recent years, there have been tremendous scientific and medical advances in the understanding and management of the inflammatory bowel diseases (IBDs), Crohn’s disease and ulcerative colitis. Accompanying these rapid and paradigm-shifting advances has been the challenge to disseminate efficiently new information and to translate effectively such research discoveries to the bedside of patients. One approach to this challenge has been the development of advanced training programs in IBD, allowing for additional years of focused training in high-volume academic centers.
Date de mise en ligne : Mardi 24 février 2015
Paul Moayyedi, David S. Weinberg, Holger Schünemann, Amitabh Chak
Management of Pancreatic Cysts in an Evidence-Based World
Pancreatic cysts are common, incidental findings on cross-sectional imaging. Some of these cysts, either at identification or over time, can be malignant. Although the cancer risk of a cyst is very low, the morbidity of pancreatic cancer is high. To further complicate matters, management and treatment of pancreatic cysts carry substantial costs, financial and otherwise, to individual patients and to society. As clinicians, we always want to do the best for our patients, usually in the face of imperfect information.
Date de mise en ligne : Mardi 24 février 2015
Carlos Fernández-del Castillo, Masao Tanaka
Management of Pancreatic Cysts: The Evidence Is Not Here Yet
This issue of Gastroenterology contains a technical review commissioned by the American Gastroenterological Association (AGA) on the diagnosis and management of pancreatic cysts,1 as well as guidelines for the management of neoplastic pancreatic cysts derived from this review and developed by the AGA’s Clinical Practice Guideline Committee.2 The authors are to be commended for performing a titanic review of the literature. They identified >1,500 papers on the subject, and ultimately cited >250. Using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework and the PICO (Patient problem or population, Intervention, Comparison and Outcome) format they attempted to answer very relevant questions, and reach conclusions that are interesting, because in several aspects they differ substantially from what is currently accepted practice in the field.
Date de mise en ligne : Mardi 24 février 2015
Marcia Irene Canto, Ralph H. Hruban
Managing Pancreatic Cysts: Less Is More?
The management of patients with an incidentally detected pancreatic cyst is a significant clinical challenge. The US Centers for Disease Control and Prevention reported a rising trend from 1996 to 2007 in the number of advanced imaging tests (MRI, CT, and positron emission tomography [PET]) ordered or provided in American hospital outpatient departments from <10 to >30 per 100 persons per year (Figure 1). Indeed, 15.8% of ambulatory visits in the United States were associated with an MRI or CT, compared with 4.4% 10 years before.
Date de mise en ligne : Mardi 24 février 2015
Niels Vande Casteele, Marc Ferrante, Gert Van Assche, Vera Ballet, Griet Compernolle, Kristel Van Steen, Steven Simoens, Paul Rutgeerts, Ann Gils, Séverine Vermeire
Trough Concentrations of Infliximab Guide Dosing for Patients with Inflammatory Bowel Disease
Infliximab, a tumor necrosis factor antagonist, is effective for treating patients with Crohn’s disease (CD) and ulcerative colitis (UC). We aimed to determine whether dosing based on therapeutic drug monitoring increases rate of remission and whether continued concentration-based dosing is superior to clinically based dosing of infliximab for maintaining remission in patients with CD and UC.
Date de mise en ligne : Lundi 23 février 2015
Alexander Lemmer, Leila Kia, Greg Cohen
A Rare Esophageal Complication After Autologous Stem Cell Transplantation
Question: A 58-year-old white man with refractory stage IIIA immunoglobulin G kappa multiple myeloma (MM) developed severe nausea, vomiting, and coffee-ground emesis during an extended hospitalization after salvage stem cell transplantation (SCT). The patient was initially diagnosed with MM 5 years before presentation, and had been treated with multiple antineoplastic therapies, including bortezomib/dexamethasone, lenalidomide, cyclophosphamide, pomalidomide, daratumumab, carfilzomib, and a failed autologous SCT.
Date de mise en ligne : Lundi 23 février 2015
Magnus Halland, Jeffrey A. Alexander
A Case of Esophageal “Double Jeopardyâ€
Question: A 66-year-old male outpatient was evaluated for progressive dysphagia to liquids and solids, which had slowly developed over 6 years. He also described a background of longstanding heartburn treated with proton pump inhibitor therapy for more than 10 years. In the last few years, his heartburn had resolved largely. His past medical history was significant for rheumatoid arthritis and hypercholesterolemia. Physical examination revealed no palpable lymphadenopathy, no cranial nerve deficits, and no significant cardiorespiratory or abdominal findings.
Date de mise en ligne : Lundi 23 février 2015
Sarah Derhy, Najat Mourra, Lionel Arrivé
Splenic Lesions in a Patient With Crohn’s Disease
Question: A 35-year-old woman with severe Crohn’s disease presented for evaluation of a persistent continuous low-grade fever and asthenia for few days. She was treated at that time with thalidomide (100 mg/d) and oral prednisone (20 mg/d) Physical examination was unremarkable. Her past medical history was significant for a colonic and perianal Crohn’s disease refractory to medical therapy including corticoids, azathioprine, infliximab, and adalimumab. She underwent total proctocolectomy with definitive ileostomy.
Date de mise en ligne : Lundi 23 février 2015
Edan Zitenly, Roy Lacey, Roberto Bergamaschi
Rare Case of a Giant Cystic Pararectal Mass
Question: A 47-year-old woman with a history of a known pararectal mass, first diagnosed in 2004, presented to the emergency room with acute pain and a subjective increase in size of the mass, as well as new-onset constipation. Previous biopsy of the mass was negative for malignancy, and the patient had opted for observation and follow-up. On physical examination, there was a clinically visible mass and palpable fluctuance in the right buttock. MRI (FigureA) showed a 6 × 7 × 16 cm tubular mass parallel to the anorectum.
Date de mise en ligne : Vendredi 20 février 2015
Erin C. Dubnansky, Christopher B. Lowe, Thoba K. Petrovic, Lindsey M. Brounstein, Hashem B. El-Serag, Jerrold R. Turner, M. Bishr Omary
Why Send Your Paper to : Global Outreach and Partnerships With Sister Journals, and , Among a Menu of Offerings
First published in 1943, Gastroenterology remains the premiere journal in the field of digestive diseases. The original mission of Gastroenterology, as envisioned by its founding editors, was to disseminate advances in the field to a thriving community of gastroenterology and hepatology practitioners and researchers.1 Moreover, the first editors and American Gastroenterological Association (AGA) leaders wanted Gastroenterology to be a home for translating state-of-the-art basic, translational, and clinical research findings and concepts for readers so that such findings could be of practical use and advance the science of gastroenterology at large.
Date de mise en ligne : Jeudi 19 février 2015
Andrew T. Schuster, Craig R. Homer, Jacqueline R. Kemp, Kourtney P. Nickerson, Emily Deutschman, Yeojung Kim, Gail West, Tammy Sadler, Eleni Stylianou, Dawid Krokowski, Maria Hatzoglou, Carol de la Motte, Brian P. Rubin, Claudio Fiocchi, Christine McDonald, Michelle S. Longworth
CAP-D3 Promotes Bacterial Clearance in Human Intestinal Epithelial Cells by Repressing Expression of Amino Acid Transporters
Defects in colonic epithelial barrier defenses are associated with ulcerative colitis (UC). The proteins that regulate bacterial clearance in the colonic epithelium have not been completely identified. The chromosome-associated protein D3 (dCAP-D3), regulates responses to bacterial infection. We examined whether CAP-D3 promotes bacterial clearance in human colonic epithelium.
Date de mise en ligne : Jeudi 19 février 2015
Hiroyuki Tsuchiya, Kerry-Ann da Costa, Sangmin Lee, Barbara Renga, Hartmut Jaeschke, Zhihong Yang, Stephen J. Orena, Michael J. Goedken, Yuxia Zhang, Kong B, Margitta Lebofsky, Swetha Rudraiah, Rana Smalling, Grace Guo, Stefano Fiorucci, Steven H. Zeisel, Li Wang
Interactions Between Nuclear Receptor SHP and FOXA1 Maintain Oscillatory Homocysteine Homeostasis in Mice
Hyperhomocysteinemia is often associated with liver and metabolic diseases. We studied nuclear receptors that mediate oscillatory control of homocysteine homeostasis in mice.
Date de mise en ligne : Mardi 17 février 2015
Massimiliano di Pietro, Daniel Chang, Rebecca C. Fitzgerald, Kenneth K. Wang
Screening for Barrett’s Esophagus
The large increase in the incidence of esophageal adenocarcinoma in the West during the last 30 years has stimulated interest in screening for Barrett’s esophagus (BE), a precursor to esophageal cancer. Effective endoscopic treatments for dysplasia and intramucosal cancer, coupled with screening programs to detect BE, could help reverse the increase in esophageal cancer. However, there are no accurate, cost-effective, minimally invasive techniques available to screen for BE, reducing the enthusiasm of gastroenterologists.
Date de mise en ligne : Jeudi 12 février 2015
Li Hsu, Jihyoun Jeon, Hermann Brenner, Stephen B. Gruber, Robert E. Schoen, Sonja I. Berndt, Andrew T. Chan, Jenny Chang-Claude, Mengmeng Du, Jian Gong, Tabitha A. Harrison, Richard B. Hayes, Michael Hoffmeister, Carolyn M. Hutter, Yi Lin, Reiko Nishihara, Shuji Ogino, Ross L. Prentice, Fredrick R. Schumacher, Daniela Seminara, Martha L. Slattery, Duncan C. Thomas, Mark Thornquist, Polly A. Newcomb, John D. Potter, Yingye Zheng, Emily White, Ulrike Peters, Colorectal Transdisciplinary (CORECT) Study and Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO)
A Model to Determine Colorectal Cancer Risk Using Common Genetic Susceptibility Loci
& Aims: Risk for colorectal cancer (CRC) can be greatly reduced through screening. To aid in development of screening strategies, we refined models designed to determine risk of CRC by incorporating information from common genetic susceptibility loci.
Date de mise en ligne : Jeudi 12 février 2015
Mounira Chalabi-Dchar, Stéphanie Cassant-Sourdy, Camille Duluc, Marjorie Fanjul, Hubert Lulka, Rémi Samain, Catherine Roche, Florence Breibach, Marie-Bernadette Delisle, Mary Poupot, Marlène Dufresne, Takeshi Shimaoka, Shin Yonehara, Muriel Mathonnet, Stéphane Pyronnet, Corinne Bousquet
Loss of Somatostatin Receptor Subtype 2 Promotes Growth of KRAS-induced Pancreatic Tumors in Mice by Activating PI3K Signaling and Overexpression of CXCL16
The KRAS gene is mutated in most pancreatic ductal adenocarcinomas (PDACs). Expression of this KRAS oncoprotein in mice is sufficient to initiate carcinogenesis but tumor progression. Activation of phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) is required for KRAS for induction and maintenance of PDACs in mice. The somatostatin receptor (SSTR2) inhibits PI3K, but SSTR2 expression is lost during development of human PDAC. We investigated the effects of SSTR2 loss during KRAS-induced PDAC development in mice.
Date de mise en ligne : Jeudi 12 février 2015
Daniel A. Leffler, Ciaran P. Kelly, Peter H.R. Green, Richard N. Fedorak, Anthony DiMarino, Wendy Perrow, Henrik Rasmussen, Chao Wang, Premysl Bercik, Natalie M. Bachir, Joseph A. Murray
Larazotide Acetate for Persistent Symptoms of Celiac Disease Despite a Gluten-Free Diet: A Randomized Controlled Trial
& Aims: Celiac disease (CeD) is a prevalent autoimmune condition. Recurrent signs and symptoms are common despite treatment with a gluten free diet (GFD), yet no approved or proven non-dietary treatment is available.
Date de mise en ligne : Mardi 10 février 2015
Christian C. Abnet, Douglas A. Corley, Neal D. Freedman, Farin Kamangar
Diet and Upper Gastrointestinal Malignancies
Diet is believed to modulate cancer risk and this relationship has been widely studied in the gastrointestinal tract. Observational epidemiologic studies have provided most of the evidence for the effects of diet on cancer risk, because clinical trials to determine nutritional exposures are often impossible, impractical, or unaffordable. Although a few foods or nutrients are thought to protect against specific types of cancer, it seems clear that the strength and even direction of dietary associations (increasing or decreasing risk) is organ site- and even histology-specific, along the gastrointestinal tract.
Date de mise en ligne : Mardi 10 février 2015
Rudolf Valenta, Heidrun Hochwallner, Birgit Linhart, Sandra Pahr
Food allergies—the Basics
Immunoglobulin (Ig)E-associated food allergy affects approximately 3% of the population and has severe effects on the daily life of patients—manifestations occur not only in the gastrointestinal tract but affect also other organ systems. Birth cohort studies have demonstrated that allergic sensitization to food allergens develops early in childhood. Mechanisms of pathogenesis include cross-linking of mast cell- and basophil-bound IgE and immediate release of inflammatory mediators, as well as late-phase and chronic allergic inflammation, due to T cell, basophil, and eosinophil activation.
Date de mise en ligne : Mardi 10 février 2015
Peter R. Gibson, Jane Varney, Sreepurna Malakar, Jane G. Muir
Food Components and Irritable Bowel Syndrome
Ingestion of food has long been linked with gut symptoms, and there is increasing interest in using diet in the management of patients with irritable bowel syndrome (IBS). The West has developed an intense interest in specialized, restrictive diets, such as those that target multiple food groups, avoid gluten, or reduce fermentable oligo-, di-, and mono-saccharides and polyols. However, most gastroenterologists are not well educated about diets or their effects on the gut. It is important to understand the various dietary approaches, their putative mechanisms, the evidence that supports their use, and the benefits or harm they might produce.
Date de mise en ligne : Mardi 10 février 2015
Tom C. Russ, Mika Kivimäki, Joanne R. Morling, John M. Starr, Emmanuel Stamatakis, G. David Batty
Association Between Psychological Distress and Liver Disease Mortality: A Meta-Analysis of Individual Study Participants
Risk factors for cardiovascular disease, such as obesity and hypertension, have been associated with nonalcoholic fatty liver disease. Psychological distress (symptoms of anxiety and depression) is a risk factor for cardiovascular disease, so it might also be associated, directly or indirectly, with liver disease. We investigated the relationship between psychological distress (measured by the 12-item General Health Questionnaire [GHQ]) and liver disease mortality.
Date de mise en ligne : Lundi 09 février 2015
Michael S. O’Keeffe, Joo-Hye Song, Gongxian Liao, Jaime De Calisto, Peter J. Halibozek, J. Rodrigo Mora, Atul K. Bhan, Ninghai Wang, Hans-Christian Reinecker, Cox Terhorst
SLAMF4 Is a Negative Regulator of Expansion of Cytotoxic Intraepithelial CD8 T Cells That Maintains Homeostasis in the Small Intestine
Intraepithelial T lymphocyte cells (IEL) are the first immune cells to respond to pathogens; they help maintain the integrity of the epithelial barrier. We studied the function of the glycoprotein signaling lymphocyte activation molecule family receptor (SLAMF) 4 (encoded by CD244) on the surface of CD8αβ αβ T-cell receptor (TCR)+ IELs, and the roles of these cells in homeostasis of the small intestine in mice.
Date de mise en ligne : Vendredi 06 février 2015
Marc E. Rothenberg
Molecular, Genetic, and Cellular Bases for Treating Eosinophilic Esophagitis
Eosinophilic esophagitis (EoE) was historically distinguished from gastroesophageal reflux disease on the basis of histology and lack of responsiveness to acid suppressive therapy, but it is now appreciated that esophageal eosinophilia can respond to proton pump inhibitors. Genetic and environmental factors contribute to risk for EoE—particularly early-life events. Disease pathogenesis involves activation of epithelial inflammatory pathways (production of eotaxin-3 [encoded by CCL26]), impaired barrier function (mediated by loss of desmoglein-1), increased production and/or activity of transforming growth factor-β, and induction of allergic inflammation by eosinophils and mast cells.
Date de mise en ligne : Mercredi 04 février 2015
David T. Rubin
The Rationale and Growth of Advanced Training in Inflammatory Bowel Disease
Date de mise en ligne : Mardi 03 février 2015
Ciarán P. Kelly, Julio C. Bai, Edwin Liu, Daniel A. Leffler
Advances in Diagnosis and Management of Celiac Disease
Celiac disease is an autoimmune disorder induced by dietary gluten in genetically predisposed individuals. It has a prevalence of ∼1% in many populations worldwide. New diagnoses have increased substantially, due to increased awareness, better diagnostic tools, and probable, real increases in incidence. The breadth of recognized clinical presentations continues to expand, making the disorder highly relevant to all physicians. Newer diagnostic tools, including serologic tests for antibodies against tissue transglutaminase (tTG) and deamidated gliadin peptide, greatly facilitate diagnosis.
Date de mise en ligne : Mardi 03 février 2015
Annette Fritscher-Ravens
Reply
We thank Carroccio et al for their comments on our study1 and their thoughts about nonceliac wheat sensitivity. Recently, there has been increased interest in food intolerances (defined as a lack of enzymes to digest the incriminated food) and sensitivities (involving an immune reaction to the food) that may trigger symptoms in patients with irritable bowel syndrome (IBS).1 Although intolerances to lactose or FODMAPs (fermentable oligo- and disaccharides, monosaccharides and polyols) are dose dependent and can be defined and treated relatively easily, identification of food sensitivities is more difficult, especially in case of food allergy.
Date de mise en ligne : Mardi 03 février 2015
Gerald Kircheis, Norbert Hilger, Dieter Häussinger
Reply
We respectfully disagree with the reproaches of Weissenborn et al that we made several fundamental methodologic mistakes. As stated frequently, the definition of minimal hepatic encephalopathy (MHE) remains a matter of scholarly debate and remains controversial, whereas the prevalence of MHE depends on the definition1 and the diagnostic test used.2
Date de mise en ligne : Lundi 02 février 2015
Giovanni Dothel, Maria Raffaella Barbaro, Hélène Boudin, Valentina Vasina, Cesare Cremon, Luciana Gargano, Lara Bellacosa, Roberto De Giorgio, Catherine Le Berre-Scoul, Philippe Aubert, Michel Neunlist, Fabrizio De Ponti, Vincenzo Stanghellini, Giovanni Barbara
Nerve Fiber Outgrowth Is Increased in the Intestinal Mucosa of Patients With Irritable Bowel Syndrome
Mediators released by the intestinal mucosa of patients with irritable bowel syndrome (IBS) affect the function of enteric and extrinsic sensory nerves, which can contribute to the development of symptoms. Little is known about the effects of mucosal mediators on intestinal neuroplasticity. We investigated how these mediators affect the phenotypes of colonic mucosa nerve fibers, neuron differentiation, and fiber outgrowth.
Date de mise en ligne : Lundi 02 février 2015
Natalie L. Berntsen, Olav Klingenberg, Brian D. Juran, Maria Benito de Valle, Björn Lindkvist, Konstantinos N. Lazaridis, Kirsten Muri Boberg, Tom H. Karlsen, Johannes Roksund Hov
Association Between HLA Haplotypes and Increased Serum Levels of IgG4 in Patients With Primary Sclerosing Cholangitis
Increased serum levels of IgG4 have been reported in 9%–15% of patients with primary sclerosing cholangitis (PSC); it is not clear whether this increase contributes to pathogenesis. We performed genetic analyses of the HLA complex in patients with PSC from Norway, Sweden, and from the United States. We found an association between levels of IgG4 above the upper reference limit and specific HLA haplotypes. These patients had a significantly lower frequency of the strongest PSC risk factor, HLA-B*08, than patients without increased IgG4, and significantly higher frequencies of HLA-B*07 and DRB1*15.
Date de mise en ligne : Lundi 02 février 2015
David Y. Graham
Update: Gastric Cancer, Reliable Therapy, and Possible Benefits
Helicobacter pylori infection contributes to the development of diverse gastric and extragastric diseases. The infection is necessary but not sufficient for the development of gastric adenocarcinoma. Its eradication would eliminate a major worldwide cause of cancer death, therefore there is much interest in identifying how, if, and when this can be accomplished. There are several mechanisms by which H pylori contributes to the development of gastric cancer. Gastric adenocarcinoma is one of many cancers associated with inflammation, which is induced by H pylori infection, yet the bacteria also cause genetic and epigenetic changes that lead to genetic instability in gastric epithelial cells.
Date de mise en ligne : Vendredi 30 janvier 2015
Pertti Aro, Nicholas J. Talley, Sven-Erik Johansson, Lars Agréus, Jukka Ronkainen
Anxiety Is Linked to New-Onset Dyspepsia in the Swedish Population: A 10-Year Follow-Up Study
Functional dyspepsia (FD) is associated with anxiety but it is not clear if one causes the other. We investigated whether anxiety and depression precede the onset of FD (based on the modified Rome III criteria) and gastroesophageal reflux symptoms (GERS) in a population-based follow-up study.
Date de mise en ligne : Vendredi 30 janvier 2015
William J. Sandborn, Brian Bosworth, Salam Zakko, Glenn L. Gordon, David R. Clemmons, Pamela L. Golden, Robert L. Rolleri, Jing Yu, Andrew C. Barrett, Enoch Bortey, Craig Paterson, William P. Forbes
Budesonide Foam Induces Remission in Patients With Mild to Moderate Ulcerative Proctitis and Ulcerative Proctosigmoiditis
Budesonide is a high-potency, second-generation corticosteroid designed to minimize systemic adverse consequences of conventional corticosteroids. We performed 2 randomized, phase 3 trials to evaluate the ability of budesonide rectal foam, formulated to optimize retention and provide uniform delivery of budesonide to the rectum and distal colon, to induce remission in patients with ulcerative proctitis or ulcerative proctosigmoiditis.
Date de mise en ligne : Vendredi 30 janvier 2015
Alastair J. Tulloch, Susan Murray, Regina Vaicekonyte, Nicole M. Avena
Neural Responses to Macronutrients—Hedonic and Homeostatic Mechanisms
The brain responds to macronutrients via intricate mechanisms. We review how the brain’s neural systems implicated in homeostatic control of feeding and hedonic responses are influenced bythe ingestion of specific types of food. We discuss how these neural systems are dysregulated in preclinical models of obesity. Findings from these studies can increase our understanding of overeating and perhaps, in some cases, the development of obesity. Furthermore, a greater understanding of the neural circuitsaffected by the consumption of specific macronutrients, and by obesity, may lead to new treatments and strategies forpreventing unhealthy weight gain.
Date de mise en ligne : Jeudi 29 janvier 2015
Bratati Kahali, Yang-Lin Liu, Ann K. Daly, Christopher P. Day, Quentin M. Anstee, Elizabeth K. Speliotes
TM6SF2: Catch-22 in the Fight Against Nonalcoholic Fatty Liver Disease and Cardiovascular Disease?
Nonalcoholic fatty liver disease (NAFLD) is rapidly becoming the most common cause of chronic liver disease worldwide.1,2 NAFLD includes a spectrum of disease ranging from the accumulation of fat in the liver (steatosis) to histologic evidence of necroinflammation (nonalcoholic steatohepatitis [NASH]), then fibrosis and cirrhosis, in the absence of excessive alcohol ingestion.2,3 Approximately one-third of the US population has radiologic evidence of NAFLD. Although the majority (70%–90%) will have relatively benign simple steatosis,4–6 NAFLD may progress to cirrhosis or hepatocellular carcinoma, and can lead to liver failure in the absence of lifestyle change or effective pharmacological treatments.
Date de mise en ligne : Mercredi 28 janvier 2015
Maneesh Dave, Yujiro Hayashi, Gabriella B. Gajdos, Thomas C. Smyrk, Phyllis A. Svingen, Sergiy M. Kvasha, Andrea Lorincz, Haidong Dong, William A. Faubion, Tamas Ordog
Stem Cells for Murine Interstitial Cells of Cajal Suppress Cellular Immunity and Colitis Via Prostaglandin E Secretion
After allogeneic transplantation, murine stem cells (SCs) for interstitial cells of Cajal (ICCs), electrical pacemaker, and neuromodulator cells of the gut, were incorporated into gastric ICC networks, indicating in vivo immunosuppression. Immunosuppression is characteristic of bone marrow− and other non-gut–derived mesenchymal stem cells (MSCs), which are emerging as potential therapeutic agents against autoimmune diseases, including inflammatory bowel disease. Therefore, we investigated whether gut-derived ICC-SCs could also mitigate experimental colitis and studied the mechanisms of ICC-SC–mediated immunosuppression in relation to MSC-induced pathways.
Date de mise en ligne : Mercredi 28 janvier 2015
MarÃa José de Castro López, José MarÃa Fraga Bermúdez, Maria Luz Couce Pico
A Rare Cause of Neonatal Obstructive Jaundice
Question: A 10-day-old, full-term male infant born by vaginal delivery after an uneventful pregnancy presents to the Pediatric Emergency Department with irritability, poor feeding, and jaundice. Complete blood count, chemistry profile, and coagulation tests showed direct hyperbilirubinemia (total bilirubin, 4.1 mg/dL; direct bilirubin, 2.9 mg/ dL), gamma-glutamyl transpeptidase of 459 UI/L and alkaline phosphatase of 440 UI/L, without other alterations. Abdominal ultrasounds (US; Figure A) examination revealed a cystic duct dilated by biliary sludge (pink asterisk) with a normal gallbladder (green arrow head) and the newborn was hospitalized.
Date de mise en ligne : Mercredi 28 janvier 2015
Dominik Schramm, Andreas Gunter Bach, Alexey Surov
An Unusual Incidental Finding in a Patient With Colon Perforation
Question: A 74-year old man presented to our emergency department with acute abdominal pain and rectal bleeding. One week before admission, he underwent endoscopic laser therapy because of colonic angiodysplasia and polyposis. On clinical examination, his abdomen was painful in the right paraumbiblical region. CT was performed (Figure, transverse [A], coronal [B, C], and sagittal [D] reconstruction).
Date de mise en ligne : Mercredi 28 janvier 2015
Pao-Ying Lin, Jia-Ruey Tsai, Chun-Chao Chang
A Rare Cause of Intermittent Epigastric Pain and Melena in a 38-Year-Old Man
Question: A 38-year-old man presented with a 1-month history of intermittent epigastric pain and melena. He denied hematemesis, fever, and body weight loss. The only significant past medical history were hypertension and gallstones. Physical examination showed epigastric tenderness without Murphy’s sign. His initial blood tests including hemoglobin level and lactate dehydrogenase were unremarkable. Upper gastrointestinal (UGI) endoscopy illustrated some ulcerated, doughnut-shaped tumors involving gastric body and fundus (Figure A).
Date de mise en ligne : Mercredi 28 janvier 2015
Edward L. Barnes, Linda S. Lee
Got Milk? An Unusual Cause of Abdominal Pain
Question: A 43-year-old woman with a history of abdominal trauma from a motor vehicle accident 3 years before admission presented with increasing severe abdominal pain located in the epigastrium and left upper quadrant with radiation to the back, significant nausea, and intermittent vomiting. The pain was exacerbated by both eating and drinking. On physical examination, she was afebrile with a soft abdomen that was tender to minimal palpation in the epigastric and left upper quadrant regions. Laboratory data were notable for normal amylase, lipase, liver function tests, white blood cell count, and hematocrit.
Date de mise en ligne : Mercredi 28 janvier 2015
Ananta Addala, Brittany N. Middleton, Cynthia H. Ho
A 14-Year-Old Boy With a Painful Abdominal Mass
Question: A 14-year-old boy presented with abdominal pain for 3 weeks. On examination, a bulging, tender mass was palpated in the right lower abdomen and flank (Figure A). Laboratory values showed white blood cell count of 28.2 K/cumm with 92.8% neutrophils, 2% lymphocytes, 4% monocytes and 0.5% eosinophils, hemoglobin 8.9 g/dL, and platelet count 590 K/cumm. Magnetic resonance imaging showed a peri-appendiceal abscess overlying the right iliac fossa and extending into the adjacent subcutaneous tissues (Figure B).
Date de mise en ligne : Mercredi 28 janvier 2015
Kati Glockenberg, Ethan M. Weinberg, David W. Wan
A Sinister Cause of Hematemesis
Question: A 52-year-old man with myelofibrosis presented to the emergency room with hematemesis. Earlier that day, he had experienced cough, rhinorrhea, and pharyngitis. On the evening of admission, he vomited blood, prompting him to seek medical attention. He denied fevers, chills, chest pain, abdominal pain, melena, hematochezia, prior history of upper gastrointestinal bleeding, nonsteroidal anti-inflammatory drug ingestion, or alcohol abuse. He was afebrile and hemodynamically stable. Physical examination was significant for splenomegaly and brown, guaiac-positive stool.
Date de mise en ligne : Lundi 26 janvier 2015
Mike Kulis, Benjamin L. Wright, Stacie M. Jones, A. Wesley Burks
Diagnosis, Management, and Investigational Therapies for Food Allergies
Food allergies have increased in prevalence over the past 20 years, now becoming an important public health concern. Although there are no therapies currently available for routine clinical care, recent reports indicate that immunotherapies targeting the mucosal immune system may be effective. Oral immunotherapy is conducted by administering small, increasing amounts of food allergen; it has shown promise for desensitizing individuals with peanut, egg, or milk allergies. Sublingual immunotherapy also desensitizes allergic patients to foods—2 major studies have examined the effects of sublingual immunotherapy in subjects with peanut allergies.
Date de mise en ligne : Samedi 24 janvier 2015
Sameer D. Saini
Website Review: Review of Patient-Oriented Websites for Colorectal Cancer Screening
Screening for colorectal cancer (CRC) is a widely recommended preventive service that has been underused traditionally. Recent data suggest that only two-thirds of eligible individuals have been screened for CRC (www.cdc.gov/media/releases/2013/p1105-colorectal-cancer-screening.html). Thus, continued efforts to increase screening are needed. In some health care systems, however, efforts to promote screening have resulted in overuse. This is particularly true in older and less healthy patients, for whom screening may provide limited benefit.
Date de mise en ligne : Samedi 24 janvier 2015
Gerard E. Mullin
How Gut and Brain Control Metabolism
The gut is no longer recognized as merely a conduit for the processing of food and passage of waste products. There is a large body of growing evidence that the gut has a controlling influence on bodily functions. This renaissance of interest in gut health began with the $173 million Human Microbiome project, which was funded by the National Institutes of Health, leading to the explosion of research in how the gut microbiota impacts health and disease. How Gut and Brain Control Metabolism is a 1st edition book, the 42nd volume of the Frontiers of Hormone Research series edited by Ezio Ghigo of Turin, Italy.
Date de mise en ligne : Samedi 24 janvier 2015
Arjun R. Sondhi, Jacob E. Kurlander, Akbar K. Waljee, Sameer D. Saini
A Telephone-Based Education Program Improves Bowel Preparation Quality in Patients Undergoing Outpatient Colonoscopy
Liu X, Luo H, Zhang L, et al. Telephone-based re-education on the day before colonoscopy improves the quality of bowel preparation and the polyp detection rate: a prospective, colonoscopist-blinded, randomised, controlled study. Gut 2014;63:125–130.
Date de mise en ligne : Samedi 24 janvier 2015
Nabeel S. Koro, B. Joseph Elmunzer, Gregory A. Coté
“FISHing†for an Accurate Diagnostic Test for Cholangiocarcinoma
Navaneethan U, Njei B, Venkatesh PG, et al. Fluorescence in situ hybridization for diagnosis of cholangiocarcinoma in primary sclerosing cholangitis: a systematic review and meta-analysis. Gastrointest Endosc 2014;79:943–950.
Date de mise en ligne : Samedi 24 janvier 2015
Anson W. Lowe, Richard H. Moseley
Covering the Cover
Achalasia is an esophageal disorder in which peristalsis is absent and the lower esophageal sphincter fails to relax with swallowing. Patients exhibit difficulties with oral intake that are often associated with dysphagia, regurgitation, aspiration, and weight loss. The diagnosis is best established with esophageal manometry, a technology that now provides sufficient resolution such that achalasia patients can be stratified into clinical subtypes.
Date de mise en ligne : Samedi 24 janvier 2015
Karin Weissenborn, Hartmut Hecker, Norbert Rückert
Pitfalls in Psychometric Testing
In their paper, Kircheis et al1 make several fundamental methodologic mistakes that need to be commented on. First, in their paper “Test results were considered abnormal when they were outside 1 SD from the mean of a large age-matched control population . . . A psychometric test result was considered abnormal when 1 or more of its test parameters were abnormal.â€1 Minimal hepatic encephalopathy (MHE) was defined as presence of ≥2 abnormal test results in a battery of 5 computerized psychometric tests applied.
Date de mise en ligne : Samedi 24 janvier 2015
Antonio Carroccio, Alberto D’Alcamo, Pasquale Mansueto
Nonceliac Wheat Sensitivity in the Context of Multiple Food Hypersensitivity: New Data From Confocal Endomicroscopy
We enjoyed reading the article by Fritscher-Ravens et al who showed, by confocal endomicroscopy, that candidate food antigens caused immediate duodenal mucosa damage in irritable bowel syndrome (IBS) patients with a prolonged clinical history of symptoms after meals.1 Their in vivo data add evidence to the relationship between IBS and food allergy and seem to reinforce our hypothesis that a percentage of “nonceliac wheat sensitive†(NCWS)–patients with an IBS-like clinical presentation could suffer from non–immunoglobulin E-mediated wheat allergy.
Date de mise en ligne : Vendredi 23 janvier 2015
Nai-Ming Chen, Garima Singh, Alexander Koenig, Geou-Yarh Liou, Peter Storz, Jin-San Zhang, Lisanne Regul, Sankari Nagarajan, Benjamin Kühnemuth, Steven A. Johnsen, Matthias Hebrok, Jens Siveke, Daniel D. Billadeau, Volker Ellenrieder, Elisabeth Hessmann
NFATc1 Links EGFR Signaling to Induction of Transcription and Acinar–Ductal Transdifferentiation in the Pancreas
Oncogenic mutations in KRAS contribute to the development of pancreatic ductal adenocarcinoma, but are not sufficient to initiate carcinogenesis. Secondary events, such as inflammation-induced signaling via the epidermal growth factor receptor (EGFR) and expression of the SOX9 gene, are required for tumor formation. We investigated mechanisms that link EGFR signaling with activation of SOX9 during acinar–ductal metaplasia, a transdifferentiation process that precedes pancreatic carcinogenesis.
Date de mise en ligne : Vendredi 23 janvier 2015
Monica Schmidt, A. Sidney Barritt, Eric S. Orman, Paul H. Hayashi
Decreasing Mortality Among Patients Hospitalized With Cirrhosis in the United States From 2002 Through 2010
It is not clear whether evidence-based recommendations for inpatient care of patients with cirrhosis are implemented widely or are effective in the community. We investigated changes in inpatient outcomes and associated features over time.
Date de mise en ligne : Vendredi 23 janvier 2015
Jeroen van Bergen, Chris J. Mulder, M. Luisa Mearin, Frits Koning
Local Communication Among Mucosal Immune Cells in Patients with Celiac Disease
In patients with celiac disease, gluten consumption causes inflammation of the duodenum, and, to a lesser extent, the proximal jejunum. Immune-dominant gluten peptides are modified by the enzyme TG2, leading to their high-affinity binding to HLA-DQ2 or HLA-DQ8 molecules (present in people with a predisposition to celiac disease). Gluten peptide-loaded HLA-DQ2 or HLA-DQ8 molecules are recognized by highly conserved receptors on CD4+ T cells in the lamina propria. B cells specific for TG2 and modified gluten peptides are also abundant in the lamina propria of patients with celiac disease.
Date de mise en ligne : Vendredi 23 janvier 2015
David Whitcomb
The Gastrointestinal System: Gastrointestinal, Nutritional and Hepatobiliary Physiology
The Gastrointestinal System: Gastrointestinal, Nutritional and Hepatobiliary Physiology is a concise, comprehensive, readable textbook of gastrointestinal physiology. The authors must be congratulated for accomplishing these goals in a single, very well-organized and structured volume.
Date de mise en ligne : Vendredi 23 janvier 2015
Exam 2: Prevalence of Germline Mutations in Cancer Predisposition Genes in Patients With Pancreatic Cancer
Date de mise en ligne : Vendredi 23 janvier 2015
Exam 1: Nonalcoholic Steatohepatitis Is the Second Leading Etiology of Liver Disease Among Adults Awaiting Liver Transplantation in the United States
Date de mise en ligne : Vendredi 23 janvier 2015
Michele Barone
Neurophysiologic and Psychometric Tests in the Diagnosis of Low-Grade Encephalopathy
I read with interest the paper on the value of Critical Flicker Frequency (CFF) and Psychometric Hepatic Encephalopathy Score (PHES) in diagnosis of low-grade encephalopathy, recently published by Kircheis et al.1 Using a computerized psychometric testing and the evaluation of mental state, they conclude that CFF and PHES are not optimal to identify minimal hepatic encephalopathy (MHE). Although accurate, this study presents some aspects that require some comments.
Date de mise en ligne : Vendredi 23 janvier 2015
Korosh Sharain, Pratik Patel, Amy S. Oxentenko
A Challenging Case of Progressive Enteritis
Question: A 21-year-old man was transferred to our institution from an outside hospital for a 4-week history of worsening diffuse colicky abdominal pain, nausea, vomiting, and nonbloody loose stools. His symptoms began several days after starting ciprofloxacin for scrotal pain and swelling, diagnosed as epididymitis. He described a 15-pound weight loss during this time period.
Date de mise en ligne : Vendredi 23 janvier 2015
Koushik K. Das, Erica F. Clayton, Michael L. Kochman
An Unusual Case of Nausea and Vomiting
Question: A 51-year-old man, a retired physician, presented with several admissions over the preceding 2 months with progressive, intractable nausea and vomiting and a 25-pound weight loss.
Date de mise en ligne : Vendredi 23 janvier 2015
David O. Rahni, Jeanette Smith, Kenneth Friedman
A Problem Within
Question: A 19-year-old woman with no significant past medical history presented with hematochezia and abdominal pain for 1 month. Physical examination was significant for a well-looking woman in no acute distress with hyperactive bowel sounds in all quadrants, periumbilical tenderness with no guarding or rebound tenderness, no skin rashes or joint swelling, and otherwise unremarkable findings. Laboratory tests were notable for hemoglobin of 8 and hematocrit of 24, but otherwise were normal.
Date de mise en ligne : Vendredi 23 janvier 2015
Mohamed Kaif, Paul Fitzmorris, Frederick Weber
A Rare Case of Chronic Diarrhea
Question: A 58-year-old African-American man with well-controlled hypertension and diabetes presented with 18 months of 6–8 watery loose brown stools per day, nocturnal stools, and 40-pound weight loss. He denied steatorrhea and stool frequency was unaffected by fasting. He denied any abdominal pain, nausea, vomiting, melena, hematochezia, fevers, or chills. He did not have any history of abdominal surgery. Medications included irbesartan and sitagliptin, both of which had been started well after the onset of diarrhea.
Date de mise en ligne : Jeudi 22 janvier 2015
Lars Eckmann, Kim E. Barrett, John M. Carethers
Martin F. Kagnoff, MD, January 19, 1941—November 16, 2014
Martin F. Kagnoff, gastroenterologist and mucosal immunologist, passed away from pancreatic cancer on November 16, 2014 at the age of 73. Known to family and friends as Marty, he had been a faculty member in the Division of Gastroenterology at the University of California, San Diego (UCSD) for more than 40 years. Marty was a native of Vancouver, British Columbia, and later became a US citizen. After attending college in Vancouver, he matriculated at Harvard Medical School, and received his medical degree in 1965.
Date de mise en ligne : Jeudi 22 janvier 2015
Zbigniew Mikulski, Rebecca Johnson, Iftach Shaked, Gisen Kim, Heba Nowyhed, Wendy Goodman, Grzegorz Chodaczek, Theresa T. Pizarro, Fabio Cominelli, Klaus Ley
SAMP1/YitFc Mice Develop Ileitis via Loss of CCL21 and Defects in Dendritic Cell Migration
The lymphatic chemokine CCL21 is required for dendritic cell (DC) migration from tissues to lymph nodes, which helps establish tolerance to foreign yet harmless antigens. We demonstrate that CCL21 is almost completely absent from SAMP1/YitFc (SAMP) mice, which spontaneously develop chronic ileitis that resembles Crohn’s disease, and that DC migration is severely impaired in these mice compared with AKR mice (controls). Toll-like receptor agonists like the Toll-like receptor 7 agonist R848 induce DC maturation and mobilization.
Date de mise en ligne : Jeudi 22 janvier 2015
Emily K. Wright, Peter De Cruz, Amy L. Hamilton, Kathryn J. Ritchie, Efrosinia O. Krejany, Steven Leach, Alexandra Gorelik, Danny Liew, Lani Prideaux, Ian C. Lawrance, Jane M. Andrews, Peter A. Bampton, Simon L. Jakobovits, Timothy H. Florin, Peter R. Gibson, Henry Debinski, Finlay A. Macrae, Douglas Samuel, Ian Kronborg, Graeme Radford-Smith, Warwick Selby, Michael J. Johnston, Rodney Woods, P. Ross Elliott, Sally J. Bell, Steven J. Brown, William R. Connell, Andrew S. Day, Paul V. Desmond, Richard B. Gearry, Michael A. Kamm
Measurement of Fecal Calprotectin Improves Monitoring and Detection of Recurrence of Crohn's Disease After Surgery
Crohn’s disease (CD) usually recurs after intestinal resection; postoperative endoscopic monitoring and tailored treatment can reduce the chance of recurrence. We investigated whether monitoring levels of fecal calprotectin (FC) can substitute for endoscopic analysis of the mucosa.
Date de mise en ligne : Jeudi 22 janvier 2015
Douglas K. Rex, Samuel N. Adler, James Aisenberg, Wilmot C. Burch, Cristina Carretero, Yehuda Chowers, Steven A. Fein, Steven E. Fern, Ignacio Fernandez-Urien Sainz, Alexander Fich, Eyal Gal, John C. Horlander, Kim L. Isaacs, Revital Kariv, Adi Lahat, Wai-Keung Leung, Pramod R. Malik, Doug Morgan, Neofytos Papageorgiou, David P. Romeo, Smita S. Shah, Matti Waterman
Accuracy of Capsule Colonoscopy in Detecting Colorectal Polyps in a Screening Population
Capsule colonoscopy is a minimally invasive imaging method. We measured the accuracy of this technology in detecting polyps 6 mm or larger in an average-risk screening population.
Date de mise en ligne : Lundi 19 janvier 2015
Ramon Bataller, Pranoti Mandrekar
Identifying Molecular Targets to Improve Immune Function in Alcoholic Hepatitis
Alcoholic liver disease (ALD) is a major cause of liver-related morbidity and mortality worldwide. ALD encompasses a range of disorders including steatosis, steatohepatitis, progressive fibrosis, cirrhosis, and hepatocellular carcinoma.1 In addition, patients with underlying ALD (in most cases cirrhosis) and active drinking can develop an episode of acute-on-chronic liver failure named “alcoholic hepatitis†(AH).2 AH in its severe forms bears a high short-term mortality. In these patients, liver homeostatic function is impaired profoundly and portal pressure is particularly high, leading to life-threating complications such as variceal bleeding, encephalopathy, and hepatorenal syndrome.
Date de mise en ligne : Lundi 19 janvier 2015
Ilya Gukovsky, Anna S. Gukovskaya
Impaired Autophagy Triggers Chronic Pancreatitis: Lessons From Pancreas-Specific Knockout Mice
A few years ago, autophagy would require a detailed background introduction, but more and more, this fundamental cell biology mechanism of lysosome-driven degradation and recycling of cellular organelles, long-lived proteins, and lipids is becoming a common knowledge. Its main pathway, macroautophagy (herein referred to as autophagy), sequesters material destined for degradation into autophagosomes, which then fuse with lysosomes, forming the autolysosomes where cargo is degraded. The degradation products are recycled for the cell’s energy and biogenesis needs.
Date de mise en ligne : Lundi 19 janvier 2015
Sumeet K. Asrani, Jacqueline G. O’Leary
The Changing Liver Transplant Waitlist: An Emerging Liver Purgatory?
A palpable change has occurred over the last decade in the type of patients listed for liver transplantation (LT): we are listing and transplanting sicker patients at higher Model for End-Stage Liver Disease (MELD) scores with more comorbid conditions.1,2 In this issue of Gastroenterology, Wong et al3 used the United Network for Organ Sharing/ Organ Procurement and Transplantation Network (UNOS/OPTN) registry data to describe these dynamic changes occurring on the liver transplant waiting list from 2004 to 2013.
Date de mise en ligne : Lundi 19 janvier 2015
Pankaj Jay Pasricha
Hunger Games: Is Your Stomach Making You Fat?
As a digestive organ, the stomach often gets no respect. Its powerful enzymes are treated as physiologic curiosities, serving no obvious purpose and its acid is regarded as the bane of human existence, to be neutralized by any means. Its apparent irrelevance is embodied in the name of a popular bariatric procedure, where almost all of the stomach can be bypassed and made dormant for years. With increasing clarity about the role of the hypothalamus and peripherally derived peptides (largely from the small intestine),1 gastric factors in the pathogenesis of obesity were largely dismissed.
Date de mise en ligne : Lundi 19 janvier 2015
Jeremy Humphris, David K. Chang, Andrew V. Biankin
Inherited Susceptibility to Pancreatic Cancer in the Era of Next-Generation Sequencing
This issue of Gastroenterology presents a manuscript from Ontario, Canada by Grant et al.1 The study provides early insights into the prevalence of point mutations and small insertions and deletions for a set of 13 well-characterized cancer predisposition genes. The genes they tested using a multigene panel include APC, ATM, BRCA1, BRCA2, CDKN2A, MLH1, MSH2, MSH6, PALB2, PMS2, PRSS1, STK11, and TP53. They sampled 290 patients from a population-based cohort of patients with histopathologically confirmed pancreatic ductal adenocarcinoma (PC), who were further grouped based on family history.
Date de mise en ligne : Vendredi 16 janvier 2015
Dawn L. Francis
Winning the Colonoscopy Revaluation Delay
Over recent years, we have warned American Gastroenterological Association (AGA) members that physician reimbursement is in turbulent times. While this remains the case, we scored a point for fairness and transparency in the 2015 Medicare Physician Fee Schedule Final Rule. The AGA Governing Board asked reimbursement expert Dr Dawn Francis to reflect on policy issues in the 2015 rule and outline the challenges we face in the future.
Date de mise en ligne : Vendredi 16 janvier 2015
Dale Lee, Lindsey Albenberg, Charlene Compher, Robert Baldassano, David Piccoli, James D. Lewis, Gary D. Wu
Diet in the Pathogenesis and Treatment of Inflammatory Bowel Diseases
Some of the most common symptoms of the inflammatory bowel diseases (IBD, which include ulcerative colitis and Crohn’s disease) are abdominal pain, diarrhea, and weight loss. It is therefore not surprising that clinicians and patients have wondered whether dietary patterns influence the onset or course of IBD. The question of what to eat is among the most commonly asked by patients and among the most difficult to answer by clinicians. There are therefore substantial variations in dietary behaviors of patients and recommendations for them, although clinicians do not routinely endorse specific diets for patients with IBD.
Date de mise en ligne : Jeudi 08 janvier 2015
Raj Vuppalanchi, Victor Navarro, Maricruz Vega, Herbert L. Bonkovsky, Leonard Seeff, Jose Serrano, Drug-Induced Liver Injury Network (DILIN)
Herbal Dietary Supplement Associated Hepatotoxicity: An Upcoming Workshop and Need for Research
Use of herbal dietary supplements (HDS) in the United States is increasing as evidenced by consumer spending that has increased annually between 1999 and 2010, with the exception of 2002 and 2003. Indeed, the amount spent on HDS in 1999 was $4 billion, increasing to $5 billion in 2010 and $5.6 billion in 2012.1–4 The actual safety and benefit of HDS, however, are questionable.5,6 Conventional drugs are required to undergo careful clinical trials and receive approval from the US Food and Drug Administration (FDA) before being marketed in the United States.
Date de mise en ligne : Mercredi 07 janvier 2015
Michael Camilleri
Guanylate Cyclase C Agonists: Emerging Gastrointestinal Therapies and Actions
The bacterial enterotoxin ST of Escherichia coli, which is responsible for travelers’ diarrhea, is a guanylate cyclase C (GC-C) receptor agonist that results in water and electrolyte secretion and diarrhea. The GC-C receptor is a membrane-spanning protein containing an extracellular binding domain and intracellular protein kinase and catalytic domains. Based on the structure and function of this naturally occurring intestinal secretagogue, the medication linaclotide was developed (see section on Chemistry) as a treatment for chronic constipation and constipation-predominant irritable bowel syndrome (IBS-C).
Date de mise en ligne : Mercredi 07 janvier 2015
Jean-Michel Pawlotsky
Hepatitis C Treatment: The Data Flood Goes on—An Update From the Liver Meeting 2014
The recent review article entitled “New hepatitis C therapies: the toolbox, strategies, and challengesâ€1 listed several treatment challenges in the treatment of hepatitis C virus (HCV) infection with direct-acting antiviral (DAA) drugs that were unsolved, including: (i) treatment of patients with advanced liver disease, including compensated and decompensated cirrhosis and patients in the pre- and post-liver transplant setting, who might need higher doses or longer durations of treatment and for whom little is known about the safety of many DAA combinations; (ii) treatment of patients with impaired renal function, such as those with an estimated glomerular filtration rate (eGFR) of <50 mL/min; (iii) treatment of special populations including patients with acute hepatitis C, elderly patients, hemodialysis patients, patients with mixed cryoglobulinemias and associated vasculitis, pregnant women, and children; (iv) understanding of the role of ribavirin, a drug known to efficiently reduce the time needed to cure HCV infection, in interferon (IFN)-free DAA-based regimens; (v) understanding of the role of HCV resistance in DAA-based treatment failures, measurement of its actual incidence, characterization of its posttreatment dynamics, and assessment of its influence on virologic outcomes upon retreatment with alternative regimens; and (vi) identification of retreatment options that produce high rates of sustained virologic response (SVR) in patients who failed on a DAA-based regimen.
Date de mise en ligne : Mardi 06 janvier 2015
Grace H. Elta, Jennifer Jorgensen, Walter J. Coyle
Training in Interventional Endoscopy: Current and Future State
Advanced or interventional endoscopy is not an Accreditation Council for Graduate Medical Education (ACGME) recognized fellowship. Historically, training for endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) occurred during the traditional 3-year fellowship, usually in small numbers as “exposure†for all trainees, or as more dedicated training for a subset of a program’s trainees. Clearly this training model was inadequate; a survey of GI fellows in 2003 showed that the majority believed the amount of ERCP training they received was inadequate and yet 90% planned to perform the procedure in their practices.
Date de mise en ligne : Mardi 06 janvier 2015
Herbert Tilg, Alexander R. Moschen
Food, Immunity, and the Microbiome
There is increasing evidence that ingested diet-borne components are involved in the pathogenesis of disorders such as inflammatory bowel diseases, atherosclerosis, and type 2 diabetes. Nutrients can have short- and long-term effects in shaping the composition of the microbiota. Western diets (enriched in fat, phosphatidylcholine, and L-carnitine) promote inflammation and atherosclerosis through specific fatty acids and degradation products such as trimethylamine N-oxide. Other dietary factors such as carbazoles or tryptophan-enriched proteins have anti-inflammatory properties—partly via activation of aryl hydrocarbon receptors.
Date de mise en ligne : Mardi 06 janvier 2015
Mingyang Song, Wendy S. Garrett, Andrew T. Chan
Nutrients, Foods, and Colorectal Cancer Prevention
Diet has an important role in the development of colorectal cancer. In the past few decades, findings from extensive epidemiologic and experimental investigations have linked consumption of several foods and nutrients to the risk of colorectal neoplasia. Calcium, fiber, milk, and whole grains have been associated with a lower risk of colorectal cancer, and red meat and processed meat have been associated with an increased risk. There is substantial evidence for the potential chemopreventive effects of vitamin D, folate, fruits, and vegetables.
Date de mise en ligne : Mardi 06 janvier 2015
Elena Bonora, Francesca Bianco, Lina Cordeddu, Michael Bamshad, Ludmila Francescatto, Dustin Dowless, Vincenzo Stanghellini, Rosanna F. Cogliandro, Greger Lindberg, Zeynel Mungan, Kivanc Cefle, Tayfun Ozcelik, Sukru Palanduz, Sukru Ozturk, Asuman Gedikbasi, Alessandra Gori, Tommaso Pippucci, Claudio Graziano, Umberto Volta, Giacomo Caio, Giovanni Barbara, Mauro D'Amato, Marco Seri, Nicholas Katsanis, Giovanni Romeo, Roberto De Giorgio
Mutations in Disrupt Regulation of APOB in Patients With Chronic Intestinal Pseudo-Obstruction
Chronic intestinal pseudo-obstruction (CIPO) is characterized by severe intestinal dysmotility that mimics a mechanical subocclusion with no evidence of gut obstruction. We searched for genetic variants associated with CIPO to increase our understanding of its pathogenesis and to identify potential biomarkers.
Date de mise en ligne : Mercredi 31 décembre 2014
Arnald Alonso, Eugeni Domènech, Antonio Julià , Julián Panés, Valle GarcÃa-Sánchez, Pilar Nos Mateu, Ana Gutiérrez, Fernando Gomollón, Juan L. Mendoza, Esther Garcia-Planella, Manuel Barreiro-de Acosta, Fernando Muñoz, Maribel Vera, Cristina Saro, Maria Esteve, Montserrat Andreu, Maria Chaparro, Josep Manyé, Eduard Cabré, MarÃa López-Lasanta, Raül Tortosa, Josep LluÃs GelpÃ, Andrés C. GarcÃa-Montero, Jaume Bertranpetit, Devin Absher, Richard M. Myers, Sara Marsal, Javier P. Gisbert
Identification of Risk Loci for Crohn’s Disease Phenotypes Using a Genome-Wide Association Study
Crohn’s disease is a highly heterogeneous inflammatory bowel disease comprising multiple clinical phenotypes. Genome-wide association studies (GWASs) have associated a large number of loci with disease risk but have not associated any specific genetic variants with clinical phenotypes. We performed a GWAS of clinical phenotypes in Crohn’s disease.
Date de mise en ligne : Mercredi 31 décembre 2014
Amy Tyberg, Kunal Karia, Steven Zerbo, Reem Z. Sharaiha, Michel Kahaleh
Endoscopic Ultrasonography-Guided Jejunojejunostomy to Facilitate Endoscopic Retrograde Cholangiopancreatography: A Minimally Invasive Option
Managing patients with altered gastrointestinal anatomy and concomitant pancreatobiliary disease poses a challenge to gastroenterologists. The technical success rate of endoscopic retrograde cholangiopancreatography (ERCP) in long-limb surgical bypass patients is reported to be as low as 63%, with nearly one-half of all failures being due to an inability to reach the pancreatobiliary anastomosis and/or papilla.1 Endoscopic ultrasonography (EUS)-guided creation of a stable conduit or fistula between two lumens using a fully covered, lumen-apposing metal stent (LAMS) to facilitate biliary access without the risk of leak is a novel technique that can be used in patients with altered anatomy.
Date de mise en ligne : Mercredi 31 décembre 2014
Helena Cornella, Clara Alsinet, Sergi Sayols, Zhongyang Zhang, Ke Hao, Laia Cabellos, Yujin Hoshida, Augusto Villanueva, Swan Thung, Stephen C. Ward, Leonardo Rodriguez-Carunchio, Maria Vila-Casadesús, Sandrine Imbeaud, Anja Lachenmayer, Alberto Quaglia, David M. Nagorney, Beatriz Minguez, Flair Carrilho, Lewis R. Roberts, Samuel Waxman, Vincenzo Mazzaferro, Myron Schwartz, Manel Esteller, Nigel D. Heaton, Jessica Zucman-Rossi, Josep M. Llovet
Unique genomic profile of fibrolamellar hepatocellular carcinoma
Fibrolamellar hepatocellular carcinoma (FLC) is a rare primary hepatic cancer that develops in children and young adults without cirrhosis. Little is known about its pathogenesis, and it can only be treated with surgery. We performed an integrative genomic analysis of a large series of patients with FLC to identify associated genetic factors.
Date de mise en ligne : Mercredi 31 décembre 2014
Brian L. Pearlman, Carole Ehleben, Michael Perrys
The Combination of Simeprevir and Sofosbuvir Is More Effective Than That of Peginterferon, Ribavirin, and Sofosbuvir for Patients With Hepatitis C–Related Child's Class A Cirrhosis
The efficacy and safety of interferon-free regimens for the treatment of chronic hepatitis C virus (HCV) infections require further evaluation and comparison with those of interferon-containing regimens. We compared a regimen of peginterferon, ribavirin, and sofosbuvir with a regimen of simeprevir and sofosbuvir in patients with HCV infection and unfavorable treatment features.
Date de mise en ligne : Jeudi 11 décembre 2014
Elizabeth Barba, Emanuel Burri, Anna Accarino, Daniel Cisternas, Sergi Quiroga, Eva Monclus, Isabel Navazo, Juan-R. Malagelada, Fernando Azpiroz
Abdominothoracic Mechanisms of Functional Abdominal Distension and Correction by Biofeedback
In patients with functional gut disorders, abdominal distension has been associated with descent of the diaphragm and protrusion of the anterior abdominal wall. We investigated mechanisms of abdominal distension in these patients.
Date de mise en ligne : Jeudi 11 décembre 2014
Gideon M. Hirschfield, Andrew Mason, Velimir Luketic, Keith Lindor, Stuart C. Gordon, Marlyn Mayo, Kris V. Kowdley, Catherine Vincent, Henry C. Bodhenheimer, Albert Parés, Michael Trauner, Hanns-Ulrich Marschall, Luciano Adorini, Cathi Sciacca, Tessa Beecher-Jones, Erin Castelloe, Olaf Böhm, David Shapiro
Efficacy of Obeticholic Acid in Patients With Primary Biliary Cirrhosis and Inadequate Response to Ursodeoxycholic Acid
We evaluated the efficacy and safety of obeticholic acid (OCA, α-ethylchenodeoxycholic acid) in a randomized controlled trial of patients with primary biliary cirrhosis who had an inadequate response to ursodeoxycholic acid therapy.
Date de mise en ligne : Jeudi 11 décembre 2014
Leonard B. Seeff, Herbert L. Bonkovsky, Victor J. Navarro, Guqi Wang
Herbal Products and the Liver: A Review of Adverse Effects and Mechanisms
Herbal products have been used for centuries among indigenous people to treat symptoms and illnesses. Recently, their use in Western countries has grown significantly, rivaling that of prescription medications. Currently, herbal products are used mainly for weight loss and bodybuilding purposes but also to improve well-being and symptoms of chronic diseases. Many people believe that because they are natural, they must be effective and safe; however, these beliefs are erroneous. Few herbal products have been studied in well-designed controlled trials of patients with liver or other diseases, despite testimony to the contrary.
Date de mise en ligne : Jeudi 11 décembre 2014
Kalliope N. Diakopoulos, Marina Lesina, Sonja Wörmann, Liang Song, Michaela Aichler, Lorenz Schild, Anna Artati, Werner Römisch-Margl, Thomas Wartmann, Robert Fischer, Yashar Kabiri, Hans Zischka, Walter Halangk, Ihsan Ekin Demir, Claudia Pilsak, Axel Walch, Christos S. Mantzoros, Jörg M. Steiner, Mert Erkan, Roland M. Schmid, Heiko Witt, Jerzy Adamski, Hana Algül
Impaired Autophagy Induces Chronic Atrophic Pancreatitis in Mice via Sex- and Nutrition-Dependent Processes
Little is known about the mechanisms of the progressive tissue destruction, inflammation, and fibrosis that occur during development of chronic pancreatitis. Autophagy is involved in multiple degenerative and inflammatory diseases, including pancreatitis, and requires the protein autophagy related 5 (ATG5). We created mice with defects in autophagy to determine its role in pancreatitis.
Date de mise en ligne : Samedi 06 décembre 2014
Shinya Munakata, Yoshihiko Tashiro, Chiemi Nishida, Aki Sato, Hiromitsu Komiyama, Hiroshi Shimazu, Douaa Dhahri, Yousef Salama, Salita Eiamboonsert, Kazuyoshi Takeda, Hideo Yagita, Yuko Tsuda, Yoshio Okada, Hiromitsu Nakauchi, Kazuhiro Sakamoto, Beate Heissig, Koichi Hattori
Inhibition of Plasmin Protects Against Colitis in Mice by Suppressing Matrix Metalloproteinase 9–Mediated Cytokine Release From Myeloid Cells
Activated proteases such as plasmin and matrix metalloproteinases (MMPs) are activated in intestinal tissues of patients with active inflammatory bowel diseases. We investigated the effect of plasmin on the progression of acute colitis.
Date de mise en ligne : Vendredi 05 décembre 2014
Andres Acosta, Michael Camilleri, Andrea Shin, Maria I. Vazquez-Roque, Johanna Iturrino, Duane Burton, Jessica O’Neill, Deborah Eckert, Alan R. Zinsmeister
Quantitative Gastrointestinal and Psychological Traits Associated With Obesity and Response to Weight-Loss Therapy
Weight loss after pharmacotherapy varies greatly. We aimed to examine associations of quantitative gastrointestinal and psychological traits with obesity, and to validate the ability of these traits to predict responses of obese individuals to pharmacotherapy.
Date de mise en ligne : Mardi 02 décembre 2014
Christine Bernsmeier, Oltin T. Pop, Arjuna Singanayagam, Evangelos Triantafyllou, Vishal C. Patel, Christopher J. Weston, Stuart Curbishley, Fouzia Sadiq, Nikhil Vergis, Wafa Khamri, William Bernal, Georg Auzinger, Michael Heneghan, Yun Ma, Wayel Jassem, Nigel D. Heaton, David H. Adams, Alberto Quaglia, Mark R. Thursz, Julia Wendon, Charalambos G. Antoniades
Patients With Acute-on-Chronic Liver Failure Have Increased Numbers of Regulatory Immune Cells Expressing the Receptor Tyrosine Kinase MERTK
Characteristics of decompensated cirrhosis and acute-on-chronic liver failure (ACLF) include susceptibility to infection, immuneparesis, and monocyte dysfunction. MER receptor tyrosine kinase (MERTK) is expressed by monocytes and macrophages and contributes to down-regulation of innate immune responses. We investigated whether MERTK expression is altered on monocytes from patients with liver failure.
Date de mise en ligne : Mardi 02 décembre 2014
Eyal Shteyer, Simon Edvardson, Sarah L. Wynia-Smith, Ciro Leonardo Pierri, Tzili Zangen, Saar Hashavya, Michal Begin, Barak Yaacov, Yuval Cinamon, Benjamin Z. Koplewitz, Amos Vromen, Orly Elpeleg, Brian C. Smith
Truncating Mutation in the Nitric Oxide Synthase 1 Gene Is Associated With Infantile Achalasia
Nitric oxide is thought to have a role in the pathogenesis of achalasia. We performed a genetic analysis of 2 siblings with infant-onset achalasia. Exome analysis revealed that they were homozygous for a premature stop codon in the gene encoding nitric oxide synthase 1. Kinetic analyses and molecular modeling showed that the truncated protein product has defects in folding, nitric oxide production, and binding of cofactors. Heller myotomy had no effect in these patients, but sildenafil therapy increased their ability to drink.
Date de mise en ligne : Mardi 02 décembre 2014
Nam-Joon Cho, Choongho Lee, Phillip S. Pang, Edward A. Pham, Benjamin Fram, Khanh Nguyen, Anming Xiong, Ella H. Sklan, Menashe Elazar, Elif S. Koytak, Caroline Kersten, Kay K. Kanazawa, Curtis W. Frank, Jeffrey S. Glenn
Phosphatidylinositol 4,5-Bisphosphate Is an HCV NS5A Ligand and Mediates Replication of the Viral Genome
Phosphoinositides (PIs) bind and regulate localization of proteins via a variety of structural motifs. PI 4,5-bisphosphate (PI[4,5]P2) interacts with and modulates the function of several proteins involved in intracellular vesicular membrane trafficking. We investigated interactions between PI(4,5)P2 and hepatitis C virus (HCV) nonstructural protein 5A (NS5A) and effects on the viral life cycle.
Date de mise en ligne : Mardi 02 décembre 2014
Robert C. Grant, Iris Selander, Ashton A. Connor, Shamini Selvarajah, Ayelet Borgida, Laurent Briollais, Gloria M. Petersen, Jordan Lerner-Ellis, Spring Holter, Steven Gallinger
Prevalence of Germline Mutations in Cancer Predisposition Genes in Patients With Pancreatic Cancer
We investigated the prevalence of germline mutations in APC, ATM, BRCA1, BRCA2, CDKN2A, MLH1, MSH2, MSH6, PALB2, PMS2, PRSS1, STK11, and TP53 in patients with pancreatic cancer.
Date de mise en ligne : Mardi 02 décembre 2014
Lee J.L. Markwick, Antonio Riva, Jennifer M. Ryan, Helen Cooksley, Elena Palma, Tom H. Tranah, Godhev K. Manakkat Vijay, Nikhil Vergis, Mark Thursz, Alex Evans, Gavin Wright, Sarah Tarff, John O’Grady, Roger Williams, Debbie L. Shawcross, Shilpa Chokshi
Blockade of PD1 and TIM3 Restores Innate and Adaptive Immunity in Patients With Acute Alcoholic Hepatitis
Susceptibility to bacterial infection is a feature of alcohol-related liver disease. Programmed cell death 1 (PD1), the T-cell immunoglobulin and mucin domain–containing protein 3 (TIM3, also known as hepatitis A virus cellular receptor 2), and their respective ligands—CD274 (also known as PD ligand 1 [PDL1]) and galectin-9—are inhibitory receptors that regulate the balance between protective immunity and host immune-mediated damage. However, their sustained hyperexpression promotes immune exhaustion and paralysis.
Date de mise en ligne : Lundi 24 novembre 2014
Robert J. Wong, Maria Aguilar, Ramsey Cheung, Ryan B. Perumpail, Stephen A. Harrison, Zobair M. Younossi, Aijaz Ahmed
Nonalcoholic Steatohepatitis Is the Second Leading Etiology of Liver Disease Among Adults Awaiting Liver Transplantation in the United States
Nonalcoholic steatohepatitis (NASH) has been predicted to become the leading indication for liver transplantation (LT) in the United States. However, few studies have evaluated changes in the etiology of liver diseases among patients awaiting LT, and none have focused on the effects of NASH on liver transplant waitlists in the United States.
Date de mise en ligne : Jeudi 20 novembre 2014
Stephanie S. Tseng-Rogenski, Yasushi Hamaya, Daniel Y. Choi, John M. Carethers
Interleukin 6 Alters Localization of hMSH3, Leading to DNA Mismatch Repair Defects in Colorectal Cancer Cells
Elevated microsatellite alterations at selected tetranucleotide repeats (EMAST) is the most common DNA mismatch repair defect in colorectal cancers, observed in approximately 60% of specimens. This acquired genotype correlates with metastasis and poor outcomes for patients, and is associated with intra-epithelial inflammation and heterogeneous nuclear levels of the mismatch repair protein hMSH3. Inflammation and accompanying oxidative stress can cause hMSH3 to change its intracellular location, but little is known about the source of oxidative stress in cancer cells.
Date de mise en ligne : Lundi 17 novembre 2014
Steven F. Moss
The Great Ulcer War: How It All Happened
All gastroenterologists, most physicians, and many members of the general public are familiar with the discovery of gastric spiral bacteria in Western Australia in the early 1980s and the struggle to convince us that these bacteria, which we now call Helicobacter pylori, were a significant clinical issue. The eventual acceptance of Marshall and Warrren’s ideas resulted in their receiving the Nobel Prize for Medicine or Physiology in 2005. In contrast with the success story of triumph over adversity of these Antipodean pioneers that has been well-disseminated in the medical and lay media, little has been written about why the United States was particularly slow to accept the infectious theory of peptic ulcers.
Date de mise en ligne : Jeudi 18 septembre 2014
Michael Camilleri
Peripheral Mechanisms in Appetite Regulation
Peripheral mechanisms in appetite regulation include the motor functions of the stomach, such as the rate of emptying and accommodation, which convey symptoms of satiation to the brain. The rich repertoire of peripherally released peptides and hormones provides feedback from the arrival of nutrients in different regions of the gut from where they are released to exert effects on satiation, or regulate metabolism through their incretin effects. Ultimately, these peripheral factors provide input to the highly organized hypothalamic circuitry and vagal complex of nuclei to determine cessation of energy intake during meal ingestion, and the return of appetite and hunger after fasting.
Date de mise en ligne : Lundi 19 novembre 2012
Continuing Medical Education Answers: January 2013
Date de mise en ligne : Lundi 15 octobre 2012
Continuing Medical Education Answers: December 2012
Date de mise en ligne : Mercredi 19 septembre 2012
Ilaria Russo, Alessandro Luciani, Edoardo Troncone, Carolina Ciacci
WITHDRAWN: The Endoplasmic Reticulum Stress Response Activates Tissue Transglutaminase and Intestinal Inflammation by Reducing Levels of IκBα
This article has been withdrawn at the request of the authors. The Publisher apologizes for any inconvenience this may cause.The full Elsevier Policy on Article Withdrawal can be found at (http://www.elsevier.com/locate/withdrawalpolicy.
Date de mise en ligne : Mercredi 22 août 2012
Continuing Medical Education Answers: October 2012
Date de mise en ligne : Mercredi 31 décembre 1969
Information for Authors and Readers
Gastroenterology is the premiere journal in the field of gastrointestinal disease and is led by an internationally renowned board of editors. As the official journal of the AGA Institute, Gastroenterology delivers up-to-date and authoritative coverage of both basic and clinical gastroenterology and hepatology. Regular features include research and perspectives by leading authorities, reports on the latest technologies for diagnosing and treating digestive diseases, images illustrating important clinical findings, reviews of scholarly media, medical news, meeting summaries, video abstracts, and monthly podcasts.
Date de mise en ligne : Mercredi 31 décembre 1969
Table of Contents
Date de mise en ligne : Mercredi 31 décembre 1969
Editorial Board
Date de mise en ligne : Mercredi 31 décembre 1969
Cover 1
Date de mise en ligne : Mercredi 31 décembre 1969
Loren Laine, Tonya Kaltenbach, Alan Barkun, Kenneth R. McQuaid, Venkataraman Subramanian, Roy Soetikno, SCENIC Guideline Development Panel
SCENIC International Consensus Statement on Surveillance and Management of Dysplasia in Inflammatory Bowel Disease
Patients with ulcerative colitis or Crohn’s colitis have an increased risk of colorectal cancer (CRC). Most cases are believed to arise from dysplasia, and surveillance colonoscopy therefore is recommended to detect dysplasia. Detection of dysplasia traditionally has relied on both examination of the mucosa with targeted biopsies of visible lesions and extensive random biopsies to identify invisible dysplasia. Current U.S. guidelines recommend obtaining at least 32 random biopsy specimens from all segments of the colon as the foundation of endoscopic surveillance.
Date de mise en ligne : Mercredi 31 décembre 1969
James F. Marion, Bruce E. Sands
The SCENIC Consensus Statement on Surveillance and Management of Dysplasia in Inflammatory Bowel Disease: Praise and Words of Caution
Nearly a century after Rosenberg and Crohn recognized the occurrence of colorectal cancer (CRC) in ulcerative colitis,1 our understanding of how best to prevent this lethal complication of inflammatory bowel disease (IBD) continues to confound practitioners and disconcert patients. A profusion of recommendations about the best means to perform surveillance for dysplasia, and how best to manage it once found, has led to considerable discord and confusion. Published simultaneously in this month’s issues of Gastroenterology2 and Gastrointestinal Endoscopy,3 the SCENIC consensus statement (Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations) hopes to bring some order to this chaotic scene.
Michiko Iwamoto, Paolo L. Peghini, Stephan U. Goebel, Jose Serrano, Robert T. Jensen
Epidermal growth factor receptor (EGFR) is overexpressed in a subset of gastrinomas and correlates with advanced disease
Antoine Cortot, Jean-Frederic Colombel, Paul Rutgeerts, Karsten Lauritsen, Helmuth Malchow, Jens Hamling, Krankenhaus Tabea, Trevor Winter, Andre Van Gossum, Tore Persson, Eva Pettersson
Effect of switching to budesonide on the quality of life of patients with steroid-dependent Crohn's disease
Shirin Haim, Hanina Hibshoosh, Yuichi Kawabata, I.B. Weinstein, Steven F. Moss
p16 is overexpressed in -associated gastritis and is correlated with increased epithelial apoptosis
Akira Mizuki, Hiromi Nishiya, Kazuto Fukui, Tatsuhiko Hayashi, Nobuhiro Tsukada, Hirosi Nagata, Hiromasa Ishii
Is it possible to treat acute mild to moderate colonic diverticulitis by oral antibiotic and carbonated beverage in outpatient clinic?
D. Trapp, W. Dieterich, H. Wieser, M. Leidenberger, D. Seilmeier, E.G. Hahn, D. Schuppan
Tissue transglutaminase, the celiac disease autoantigen, preferentially generates antigenic neoepitopes in and but not in gliadins
Karel J. Erpecum, Mehmet H. Dolu, Piero Portincasa, Gerard P. Vanberge-Henegouwen, Dieter Jungst
Cholesterol and pigment gallstones: relation with apolipoprotein E genotype, pronucleating proteins and lipids in bile
Joe West, Alison Lloyd, Rosemary Reader, Peter G. Hill, Geoffrey Kt Holmes, Kay-Tee Khaw, Richard Fa Logan
Prevalence of undiagnosed celiac disease in the general population of England
M. Alison Stalls, Jiaren Sun, Katherine L. Thompson, Nancy Van Houten
Tolerance to mucosally encountered antigen is linked to cell cycle control
Matthew D. Perry, Kate A. Bowley, Geoffrey I. Sandle
Somatostatin inhibits high conductance colonic apical potassium channels via G protein-dependent tyrosine dephosphorylation
Richard W. McCallum, Thomas F. Jones, Zhiyue Lin, Irene Sarosiek, Michael Moncure
Assessment of gastric emptying and myoelectric activity in the morbidly obese patient
David M. Parry, Carol Green, Donald R. Duerksen
Gum chewing is a potential confounding factor in assessing intestinal permeability
Hannu Paimela, Leena Paimela, Riitta Myllykangas-Luosujarvi, Eero Kivilaakso
Peptic ulcer disease in Finland-incidence of surgery, mortality and hospital admissions for the disease during the past 25 years
Tom G. Moreels, Rogier J. Nieuwendijk, Joris G. De Man, Benedicte Y. de Winter, Gunther Vrolix, Arnold G. Herman, Eric A. Van Marck, Paul A. Pelckmans
infection accelerates healing of TNBS-induced colitis in the rat
Ioan Puscas, Ludovic Gilau, Marcela Coltau, Adrian Maghiar, Gabriela Domuta, Teodor Maghiar, Carmen Puscas, Otillia Micle, Sorina Magheru, Liana Micle, Calin Magheru
Proton pump inhibitors are gastric mucosa carbonic anhydrase inhibitors as well
Lenard M. Lichtenberger, Rebecca Darling, Jimmy J. Romero, Robert Langenbach
Effect of luminal damaging agents on the gastric mucosal barrier and prostaglandin (PG) metabolism in cyclooxygenase (COX) knockout (KO) mice
A. Hillary Steinhart, Brian G. Feagan, Gordon R. Greenberg, Cindy J. Wong, Margaret Vandervoort, Shelley Mikolainis, Kenneth Croitoru, Emest G. Seidman, Desmond J. Leddin, Eric Drouin, Alain Bitton, Albert Cohen
Combined budesonide and antibiotic therapy for active Crohn's disease: A randomized controlled trial
Mary F. Otterson, Shawn C. Leming, Xiaoqu Liu, John E. Moulder, Winnie Ho, Keith A. Sharkey
Longterm neurochemical and motility adaptations associated with irradiation
L Daniel Howell, Melissa E. Danko, Roy Borchardt, Christoph Randak, Jonathan A. Cohn
Domain-domain interactions regulate ATP hydrolysis during CFTR activation
Song-Ze Ding, Sankar Mitra, Tadahide Izumi, Bernadette Dirden-Kramer, Randy C. Miffin, Sheila E. Crowe
Antioxidants inhibit nuclear translocation of apurinic/apyrimidinic endonuclease-1 induced by and oxidative stress in human gastric epithelial cells
Harinder S. Garewal, Lois Ramsey, Richard E. Sampliner, Claire Payne, Harris Bernstein, Carol Bernstein, Ronnie Fass
Post-ablation biomarker abnormalities in Barrett's esophagus (BE): Are we increasing the cancer risk?
Sunil G. Sheth, Michele D. Bishop, Julie C. Shea, Isabel K. Hopper, Lynda Ellis, Emily Malmberg, Julian Zielenski, Lap-Chee Tsui, Sanjiv Chopra, Peter R. Durie, Steven D. Freedman
Association of primary sclerosing cholangifis (PSC) with the cystic fibrosis (CF) carrier state: Results 01 extensive genotypic and phenotypic analysis
Jeanne M. Clark, Frederick L. Brancati, Anna Mae E. Diehl
Nonalcoholic fatty liver disease: The most common cause of abnormal liver enzymes in the U.S. population
Stephen B. Hanauer, Gary R. Lichtenstein, J-F. Columbel, Lloyd Mayer, Stephan Schreiber, Daniel Rachmilewicz, Doug Wolf, Helmut Malchow, Michael Safdi, Brian Feagan, Allan Olson, Paul Rutgeerts
Maintenance infliximab (Remicade) is safe, effective and steroid-sparing in Crohn's disease: Preliminary results from the accent i trial
William J. Sandborn, Stephen B. Hanauer, Seymour Katz, Michael Safdi, Daouglas C. Wolf, Richard D. Baerg, William J. Tremaine, Therese Johnson, Nancy Diehl, Alan R. Zinsmeister
A randomized, double-blind, placebo-controlied trial of subcutaneous etanercept (p75 souble tumor necrosis factor: FC fusion protein) in the treatment of moderate to severe Crohns' disease
Gianfranco Alpini, Shannon Glaser, Jo Lynne Phinizy, Noriatsu Kanno, Heather Francis, Mikel Ludvik, Gene Lesage
Bile acid stimulation of small bile duct proliferation requires de novo expression of the apical bile acid transporter (ABAT)