International Journal of Digestive Diseases最新文献

{"title":"Critical Analysis of ALPPS Procedure:A Single Centre Experience","authors":"M. Peteja, P. Vávra, A. Pelikán, M. Lerch, P. Ihnát, P. ZonÄa, Janout, A. El-Gendi","doi":"10.4172/2472-1891.100032","DOIUrl":"https://doi.org/10.4172/2472-1891.100032","url":null,"abstract":"The ALPPS (Associating Liver Partition and Portal vein Ligation for Staged Hepatectomy) method was presented to the expert public with the intention of providing a chance to patients with metastatic or primary liver cancer and a lack of residual parenchyma excluding resection therapy which is considered to be the only curative treatment. This method has been regarded as controversial due to its high mortality and morbidity on the one hand and high resection success rate on the second hand. The article presents the initial experience from one workplace. Materials and Methods: From August 2013 to June 2014 eight patients were selected for ALPPS method of hepatic resection at the Surgery of the University Hospital Ostrava Czech republic. For all patients the initial FLR (future liver remnant) volume was less than 25% and they have exhausted other treatment options for the disease. Results: The group consisted of two men and six women, aged 40 to 70. Four patients had CRC (colorectal cancer) liver metastases and two patients were diagnosed with gallbladder cancer metastatic to the liver. The first female patient suffered from hilar cholangiocarcinoma and the last female patient had leiomyosarcoma. Altogether six patients were subject to both phases of the therapy (75% of cases). From the entire patient group one female patient died after the first phase due to haemorrhagic shock, and one was assessed by the multidisciplinary team as unsustainable for the second phase. Remaining all six patients who underwent both phases of surgery had R0 resection but three of them had severe liver failure and they ended fatally. Conclusion: ALPPS is a new method for inducing rapid hypertrophy of the liver parenchyma based on the ligation the portal vein branch and in-situ splitting. However this therapy is still burdened by a relatively high rate of morbidity and mortality which are directly related to the tumour’s histological character to the age of the patient and to the functional state of their hepatic parenchyma","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122953246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celiac Disease in Children: A Review","authors":"C. Mantegazza, G. Zuccotti, D. Dilillo, J. Köglmeier","doi":"10.4172/2472-1891.100009","DOIUrl":"https://doi.org/10.4172/2472-1891.100009","url":null,"abstract":"Celiac disease is a lifelong immune-mediated systemic disorder that may develop in genetically predisposed individuals when exposed to dietary gluten. Its prevalence is estimated to be 1-3% in the European Community; in particular in children studies report a prevalence ranging from 1/500 to 1/93. Awareness of its wide clinical spectrum is mandatory and relevant to all physicians, and in particular pediatricians, to allow a prompt diagnosis and therapy. While the first european guidelines recommended the need of 3 consecutive duodenal biopsies to establish a diagnosis, from 2012 an histological assessment is not considered necessary in certain circumstances in children. Gluten free diet is still the only therapy available in celiac disease disease but dietary adherence allows control of symptoms and reduces the risk of malignancy. However this diet is challenging due to its costs, quality of life implications, and health consequences such as obesity. Therefore alternative therapies are currently being developed. This review will focus on the current knowledge on celiac disease in children.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129731101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Treatment of Gastric Cancer, Results in Ten Year Experience of a Brazilian Center: Southern Trial","authors":"Weston Ac, D. Giordani, C. Cereser, R. Menguer, G. Laporte, A. Roth, B. Albrecht, J. Assumpção, R. Weschenfelder","doi":"10.4172/2472-1891.100020","DOIUrl":"https://doi.org/10.4172/2472-1891.100020","url":null,"abstract":"Gastric Adenocarcinoma remains one of the leading worldwide causes of cancer. Despite the improvement in the surgical techniques the results of a surgery as a single treatment remains poor. Since 2001 the multidisciplinary and oncological approach has been indicated to gastric adenocarcinomas showing better results. A total of 422 patients were divided in two arms, 245 were treated with surgery plus adjuvant or neodajuvant therapy and 147 with surgery alone. In conclusion the result was a significant better overall survive in 5 year in the arm of the multidisciplinary approach.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"160 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116139322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori seropositivity in England, 2001-2007: time trends and the effect of ethnicity","authors":"Kalliopi Alex, ropoulou, F. Reid, R. Holliman, H. Al-Ghusein, A. Poullis, Jin-Yong Kang","doi":"10.4172/2472-1891.100006","DOIUrl":"https://doi.org/10.4172/2472-1891.100006","url":null,"abstract":"Background: Helicobacter pylori (HP) prevalence is decreasing in developed countries. Widespread adoption of the 'test and treat' strategy for dyspepsia (2002) may have contributed to this decline. \u0000Methods: Time trends in the proportion of positive HP serology results in our institution, covering an ethnically diverse area in London, were analysed between 2001 and 2007. The effect of age, gender and ethnicity was assessed. \u0000Results: 12307 tests were carried out between 2001 and 2007 in 11484 consecutive patients. There was a statistically significant reduction in the proportion of positive tests over the study period from 42.8% to 37.6% (p<0.001). HP seroprevalence was higher in older individuals (p<0.001), in men (p=0.001) and in patients of Indian subcontinent descent (p<0.001). There was a fall in the proportion of positive tests to HP over time for both genders and ethnic groups and among patients over age 30. The proportion of positive tests to HP remained unchanged for younger individuals. \u0000Conclusion: The proportion of positive HP serology in our institution decreased over a seven-year period. HP infection was more prevalent in older patients. A significant proportion of younger subjects had positive HP serology but the seroprevalence of HP infection amongst subjects aged under 30 remained unchanged.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"303 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122731084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Index of Rajma Bean (Phaseolus vulgaris) and Guar (Cyamopsis tetragonoloba) Incorporated Noodles: A Volunteers Study","authors":"P. Prabhasankar, S. Kumar","doi":"10.4172/2472-1891.100001","DOIUrl":"https://doi.org/10.4172/2472-1891.100001","url":null,"abstract":"Context: Diabetes mellitus is one of the non-communicable disorders, affecting over 2.8% of the World’s population. As noodles are becoming popular diets now-a-days and is categorized as high glycemic index (GI) product this is not recommended for diabetics. Objective: Current study focuses on the influence of low-GI ingredients on noodle GI. \u0000Methods: On basis of preliminary studies, rajma flour, whole guar and guar seed powder incorporated noodles were selected for the study. Noodles were prepared, dried and cooked just before the test. 15 healthy and 10 diabetic subjects were chosen for the study. All the subjects were healthy except for diabetes. All the subjects were given a test food after an overnight fasting. Fasting blood glucose was measured before the test. Blood glucose levels were measured at different time intervals. \u0000Results: Results of the study indicated that with different ingredients incorporation there was significant difference in the GI of the noodles. Noodles with added ingredients showed significant reduction of GI value of 49, 32 and 25 with rajma, whole guar and guar seed powder respectively compared to control noodles. \u0000Conclusions: Study spotlights on the use of these health’s beneficial ingredients in the noodle processing and its effect on health. The developed noodles may be included in the diet of diabetic patients.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122967424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Probiotics among Patients Receiving Antibiotics with a High Risk of Acquiring Clostridium difficile Infection","authors":"J. Dickson, W. Hung, Tai-Tsang Chen","doi":"10.4172/2472-1891.100018","DOIUrl":"https://doi.org/10.4172/2472-1891.100018","url":null,"abstract":"Importance: Despite recommendations not to routinely use probiotics for primary prevention of Clostridium difficile infection (CDI) from Updated Practice Guidelines for CDI in 2010 by the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America, the use of probiotics remains common among prescribers and patients. To our knowledge, there has been no analysis conducted to evaluate the impact of probiotics on the primary prevention of CDI among patients receiving antibiotics known to be associated with an increased risk of CDI. \u0000Objective: To determine whether patients who receive “high-risk” antibiotics along with probiotics are at a decreased risk of developing CDI. \u0000Design, setting, and participants: This was a retrospective cohort study including adult patients admitted to Yale New Haven Hospital, Saint Raphael Campus, between July 1, 2010 and December 31, 2010. Patients were excluded if they did not receive high-risk antibiotic(s) for more than 5 days nor had a history of CDI. \u0000Interventions: Eligible patients were then analyzed based on whether they had received concomitant use of probiotics or antibiotics alone. \u0000Main outcome(s) and measure(s): The primary outcome of the study was the development of CDI within 90 days of high-risk antibiotic use. \u0000Results: A total of 389 patients were included in the study. CDI occurred in 8.4% (12/143) of patients who received concomitant probiotics as opposed to 3.3% (8/246) that had CDI and received antibiotics alone with relative risk (RR) of 2.58 (95% CI: 1.08, 6.16; p=0.033). A chi-square analysis identified statistically significant differences in age (p<0.0001) and proton-pump inhibitor (PPI) utilization (p=0.0088), but the imbalance between patients with and without probiotics was removed after adjusting for the propensity score (p=0.1141). \u0000 Conclusion and relevance: We found that use of antibiotics along with probiotics had a significantly higher incidence of CDI than those who did not receive probiotics. Our findings based on adjusted odds ratio do not support the recommendation of the routine use of probiotics for the prevention of CDI. Other strategies such as eliminating the unnecessary use of PPI should be applied to prevent CDI.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114178510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Alcoholic Fatty Liver Disease in Patients with Diabetes Mellitus: A Clinician's Perspective","authors":"Sarah M. Kashanian, M. Fuchs","doi":"10.4172/2472-1891.100010","DOIUrl":"https://doi.org/10.4172/2472-1891.100010","url":null,"abstract":"Nonalcoholic fatty liver disease with its phenotypes fatty liver and steatohepatitis, is the most common cause of chronic liver disease worldwide and linked to the epidemic of diabetes mellitus and obesity. It is characterized by a high cardiovascular and liver-related mortality and expected to soon become the leading cause for liver transplantation. This concise review summarizes recent progress in the clinical management of patients with diabetes mellitus and nonalcoholic fatty liver disease and evaluates strategies to manage diabetes mellitus in terms of their effectiveness towards this epidemic liver disease.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127969903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Resistance as a Key Factor in the Development of Metabolic and Inflammatory Biomarkers in Obese Children","authors":"Y. Elitsur, Deborah L. Preston, Alex, R. Nichols, M. Getty, K. Sodhi","doi":"10.4172/2472-1891.100024","DOIUrl":"https://doi.org/10.4172/2472-1891.100024","url":null,"abstract":"Introduction: Pediatric obesity is a major health problem. Insulin resistance (IR), is one of the early complications related to obesity but its role along that process has not been well investigated in children. \u0000Aim: To investigate the role of insulin resistance in the development of obesity related complications (dyslipidemia, inflammatory markers, adipocyte hormones). \u0000Method: Children who attended the gastroenterology clinic were prospectively recruited. Exclusion criteria included diseases that may affect obesity and metabolic complications. Fasting blood levels for glucose, liver enzymes, insulin, adiponectin, leptin, IL-6, and TNF were measured. Children were divided into groups: obese children with IR (A), obese children without IR (B), and normal weight children without IR (C). The indices were compared among the groups. Results: A total of 69 children were recruited. 26 were in group A, 15 in group B, and 28 in group C. Group A was significantly different in lipid profiles (TG, HDL), liver enzyme (ALT), leptin, adiponectin, and IL-6 compared to the control groups (C). No significant difference was found between groups B and C but for HDL and adipocyte hormones (leptin, adiponectin). \u0000Conclusion: Insulin resistance is crucial in the development of obesity related complications. We suggest that in order to detect early signs of obesity related complications insulin resistance should be measured in every obese child seen by the primary care physician.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132625135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Post-Cholecystectomy on Small Intestinal Bacterial Overgrowth and Orocecal Transit Time in Gallstone Patients","authors":"S. Rana, J. Kaur, Rajesh Gupta, Vikas Gupta, Sanjay Sharma, A. Malik, S. Sinha","doi":"10.4172/2472-1891.100023","DOIUrl":"https://doi.org/10.4172/2472-1891.100023","url":null,"abstract":"Background: Effect of duration of cholecystectomy on orocecal transit time and small intestinal bacterial overgrowth in gallstone patients is poorly understood. \u0000Method: 128 gallstone patients of either sex, aged between 25-68 years were enrolled. 79/128 followed after 4-6 months of cholecystectomy. 49 patients had undergone cholecystectomy 2 - 15years before study and reported gastrointestinal symptoms, classified as late post-cholecystectomy. Orocecal transit time (OCTT) and small intestinal bacterial overgrowth (SIBO) were measured by non-invasive lactulose and glucose breath tests respectively. \u0000Results: OCTT increased significantly (p < 0.01) from 125.9 ± 28.6 to 145.8 ± 30.5 minutes after 4-6 months of cholecystectomy. Among late post-cholecystectomy patients, OCTT was observed to be 159.2 ± 37.8 minutes, which was significantly higher when compared with OCTT in pre-cholecystectomy patients. SIBO was present in 10/79 (12.7%) gallstone patients pre-cholecystectomy and 11/79 (13.9%) in gallstone patients post-cholecystectomy. Presence of SIBO after 4-6 months of cholecystectomy was not significantly different compared to pre-cholecystectomy in gallstone patients. However, SIBO was present in 13 / 49 (26.5%) late post-cholecystectomy patients with duration of 2-15years, which was significantly (p < 0.05) higher compared to pre-cholecystectomy and 4-6months post-cholecystectomy patients. \u0000Conclusion: The study signifies that longer duration of post-cholecystectomy can lead to delayed OCTT and cause SIBO in gallstone patients. This can be mitigated by giving pro-kinetics to post-cholecystectomy patients.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114269885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leukocytapheresis Changes Functional Characteristics of Circulating Neutrophils in Humans: Mechanistic Implications","authors":"Koji Tanaka, T. Araki, S. Yoshiyama, Y. Okita, S. Kondo, Y. Toiyama, M. Inoue, M. Ohi, Minako Kobayashi, Y. Inoue, K. Uchida, Y. Mohri, C. Miki, M. Kusunoki","doi":"10.4172/2472-1891.100017","DOIUrl":"https://doi.org/10.4172/2472-1891.100017","url":null,"abstract":"Background and aim: Postoperative leukocytapheresis (LCAP) reduces surgical site infection (SSI) in ulcerative colitis (UC) patients undergoing proctocolectomy with ileal pouch–anal anastomosis (IPAA). To clarify the effect of postoperative LCAP on circulating neutrophils, we investigated neutrophil function before and after LCAP in UC patients undergoing proctocolectomy with IPAA. \u0000Method: Circulating neutrophils were obtained from 29 UC patients undergoing IPAA before and after postoperative LCAP. The phagocytic activity was measured using Escherichia coli BioParticles. Neutrophil viability after co-culture with E. coli was measured by flow cytometry. Inflammatory cytokines in patient serum and supernatants after co-culture of neutrophils with E. coli were measured by enzyme-linked immunosorbent assay. \u0000Results: No difference in phagocytic activity was found between preand post-LCAP neutrophils. The percentage of necrotic neutrophils was significantly decreased in post-LCAP neutrophils cocultured with E. coli. Serum neutrophil elastase (NE) after LCAP was significantly increased. No difference in cytokine production was found between pre- and post-LCAP neutrophils cocultured with E. coli. NE and tumor necrosis factor (TNF)-α levels in supernatants of post-LCAP neutrophils cocultured with E. coli were higher in patients with longer operating time and higher postoperative neutrophil count, respectively. Phagocytic activity of post-LCAP neutrophils was lower in the longer operating time group. Serum TNF-α level after LCAP was higher in the SSI group. \u0000Conclusion: Postoperative LCAP decreases the subset of circulating neutrophils, which induces necrosis against bacterial infection. This suggests a possible mechanism of prevention of SSI.","PeriodicalId":355284,"journal":{"name":"International Journal of Digestive Diseases","volume":"259 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132124428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}