Current Opinion in Gastroenterology最新文献_第4页

Imaging abnormalities of the pancreas in diabetes: implications for diagnosis and treatment. 糖尿病患者的胰腺成像异常：对诊断和治疗的影响。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-09-01 Epub Date: 2024-06-28 DOI: 10.1097/MOG.0000000000001054

Benjamin Spilseth, Evan L Fogel, Frederico G S Toledo, Martha Campbell-Thompson

{"title":"Imaging abnormalities of the pancreas in diabetes: implications for diagnosis and treatment.","authors":"Benjamin Spilseth, Evan L Fogel, Frederico G S Toledo, Martha Campbell-Thompson","doi":"10.1097/MOG.0000000000001054","DOIUrl":"10.1097/MOG.0000000000001054","url":null,"abstract":"Purpose of review: Radiographic imaging of the pancreas has drawn recent interest as pancreas volume may serve as a biomarker in identifying the likelihood of diabetes development, subtyping diabetes, and identifying prognostic indicators of poor ultimate outcomes. In this review, the role of pancreas imaging is discussed in various forms of diabetes including type 1 diabetes (T1D), type 2 diabetes (T2D), and diabetes of the exocrine pancreas, particularly diabetes following acute or chronic pancreatitis.Recent findings: Recent literature of quantitative pancreatic imaging correlating with various forms of diabetes was reviewed. Imaging-derived pancreas volumes are lower in individuals with diabetes, in particular those with T1D. Additionally, morphologic changes, enhancement characteristics, fat content, and MRI signal changes have been observed in different diabetes subtypes. These characteristics, as well as potential confounding variables, are reviewed. Additionally, future areas of research in MRI, CT radiomics, and pancreatitis-related imaging predictors of diabetes are discussed.Summary: Increased understanding of pancreas imaging features which predict diabetes and gauge prognosis has the potential to identify at-risk individuals and will become increasingly important in diabetes care. This article reviews the current knowledge of common pancreas imaging features as well as future directions of ongoing research in diabetes imaging.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"381-388"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk and factors determining diabetes after mild, nonnecrotizing acute pancreatitis. 轻度非坏死性急性胰腺炎后患糖尿病的风险和决定因素。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-09-01 Epub Date: 2024-06-26 DOI: 10.1097/MOG.0000000000001055

Ariana Pichardo-Lowden, Mark O Goodarzi, Guru Trikudanathan, Jose Serrano, Kathleen M Dungan

{"title":"Risk and factors determining diabetes after mild, nonnecrotizing acute pancreatitis.","authors":"Ariana Pichardo-Lowden, Mark O Goodarzi, Guru Trikudanathan, Jose Serrano, Kathleen M Dungan","doi":"10.1097/MOG.0000000000001055","DOIUrl":"10.1097/MOG.0000000000001055","url":null,"abstract":"Purpose of review: Diabetes mellitus (DM) is relatively common following acute pancreatitis (AP), even after mild acute pancreatitis (MAP), the most frequent AP presentation, in which there is no overt beta cell injury. Post-AP related diabetes is widely misdiagnosed, resulting in potentially inappropriate treatment and worse outcomes than type 2 diabetes (T2D). Thus, it is important to understand risk across the spectrum of AP severity.Recent findings: Biological mechanisms are unclear and may include local and systemic inflammation leading to beta cell dysfunction and insulin resistance, altered gut barrier and/or gut peptides and possibly islet autoimmunity, though no studies have specifically focused on MAP. While studies examining clinical risk factors on MAP exclusively are lacking, there are studies which include MAP. These studies vary in scientific rigor, approaches to rule out preexisting diabetes, variable AP severity, diagnostic testing methods, and duration of follow-up. Overall, disease related factors, including AP severity, as well as established T2D risk factors are reported to contribute to the risk for DM following AP.Summary: Though numerous studies have explored risk factors for DM after AP, few studies specifically focused on MAP, highlighting a key knowledge gap that is relevant to the majority of patients with AP.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"396-403"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ideal strategy for nonvariceal upper gastrointestinal bleeding. 治疗非静脉性上消化道出血的理想策略。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-09-01 Epub Date: 2024-07-03 DOI: 10.1097/MOG.0000000000001043

Robert T Kavitt, Ian M Gralnek

引用次数: 0

Introduction to the issue: acute pancreatitis and related metabolic complications. 本期简介：急性胰腺炎及相关代谢并发症。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-09-01 Epub Date: 2024-08-08 DOI: 10.1097/MOG.0000000000001044

Dhiraj Yadav, Phil A Hart, Melena Bellin

引用次数: 0

Current and future microbiome-based therapies in inflammatory bowel disease. 基于微生物组的炎症性肠病疗法的现状与未来。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-07-01 Epub Date: 2024-04-10 DOI: 10.1097/MOG.0000000000001027

Jonathan A Montrose, Satya Kurada, Monika Fischer

{"title":"Current and future microbiome-based therapies in inflammatory bowel disease.","authors":"Jonathan A Montrose, Satya Kurada, Monika Fischer","doi":"10.1097/MOG.0000000000001027","DOIUrl":"10.1097/MOG.0000000000001027","url":null,"abstract":"Purpose of review: The role of the microbiome and dysbiosis is increasingly recognized in the pathogenesis of inflammatory bowel disease (IBD). Intestinal microbiota transplant (IMT), previously termed fecal microbiota transplant has demonstrated efficacy in restoring a healthy microbiome and promoting gut health in recurrent Clostridioides difficile infection. Several randomized trials (RCTs) highlighted IMT's potential in treating ulcerative colitis, while smaller studies reported on its application in managing Crohn's disease and pouchitis.Recent findings: This review delves into the current understanding of dysbiosis in IBD, highlighting the distinctions in the microbiota of patients with IBD compared to healthy controls. It explores the mechanisms by which IMT can restore a healthy microbiome and provides a focused analysis of recent RCTs using IMT for inducing and maintaining remission in IBD. Lastly, we discuss the current knowledge gaps that limit its widespread use.Summary: The body of evidence supporting the use of IMT in IBD is growing. The lack of a standardized protocol impedes its application beyond clinical trials. Further research is needed to identify patient profile and disease phenotypes that benefit from IMT, to delineate key donor characteristics, optimize the delivery route, dosage, and frequency.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"40 4","pages":"258-267"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inflammatory bowel diseases 2024. 2024 年炎症性肠病。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-07-01 Epub Date: 2024-06-06 DOI: 10.1097/MOG.0000000000001038

Matthew A Ciorba

引用次数: 0

Small bowel intussusception - aetiology & management. 小肠肠套叠--病因和治疗。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-05-01 Epub Date: 2024-02-28 DOI: 10.1097/MOG.0000000000000994

Nicole Sciberras, Stefania Chetcuti Zammit, Reena Sidhu

引用次数: 0

Terlipressin for hepatorenal syndrome. 治疗肝肾综合征的特利加压素

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-05-01 Epub Date: 2024-03-07 DOI: 10.1097/MOG.0000000000001016

Florence Wong

{"title":"Terlipressin for hepatorenal syndrome.","authors":"Florence Wong","doi":"10.1097/MOG.0000000000001016","DOIUrl":"10.1097/MOG.0000000000001016","url":null,"abstract":"Purpose of review: The definition and diagnostic criteria of hepatorenal syndrome-acute kidney injury (HRS-AKI) has undergone recent changes. A major vasoconstrictor, terlipressin, has recently been approved as pharmacotherapy for HRS-AKI in the United States. The purpose of this review is to familiarize the readers with these new diagnostic criteria of HRS-AKI, and how best to use terlipressin.Recent findings: Terlipressin is effective either as bolus dosing or continuous infusion and can achieve reversal of HRS-AKI in approximately 40% of patients. Continuous infusion allows lower daily dose with equal efficacy and less side effects but not an approved mode of administration in the United States. Response to terlipressin in the randomized controlled trials was defined as repeat reduction of serum creatinine to less than 1.5 mg/dl. Newer studies will likely require response to treatment to be defined as a repeat serum creatinine to be less than 0.3 mg/dl from baseline. Terlipressin use is associated with ischemic side effects and potential for respiratory failure development.Summary: Careful patient selection and close monitoring are necessary for its use. Response to terlipressin with HRS-AKI reversal is associated with improved outcomes with better survival and less requirement for renal replacement therapy.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"156-163"},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Postoperative small bowel Crohn's disease: how to diagnose, manage and treat. 术后小肠克罗恩病：如何诊断、管理和治疗。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-05-01 Epub Date: 2024-01-31 DOI: 10.1097/MOG.0000000000001007

Chak Lam Ip, Ray Boyapati, Rahul Kalla

{"title":"Postoperative small bowel Crohn's disease: how to diagnose, manage and treat.","authors":"Chak Lam Ip, Ray Boyapati, Rahul Kalla","doi":"10.1097/MOG.0000000000001007","DOIUrl":"10.1097/MOG.0000000000001007","url":null,"abstract":"Purpose of review: Crohn's disease is a relapsing inflammatory condition and disease recurrence after surgery is common. Significant variation in clinical practice remains despite progress in management of postoperative Crohn's disease. In this review, we summarise current management strategies and guidelines, unmet needs, and research progress in this field.Recent findings: There has been real progress in risk stratifying individuals' postsurgery and tailoring therapies based on their risk; this has been incorporated into current management guidelines in the USA, UK, and Europe. Furthermore, novel noninvasive monitoring tools such as intestinal ultrasound have shown high sensitivity and specificity at detecting disease recurrence and are an attractive point-of-care test. Recent studies are also investigating multiomic biomarkers to prognosticate postoperative Crohn's disease. However, given the heterogeneity within this condition, large multicentre clinical validation across all age groups is needed for clinical translation in the future.Summary: Ongoing progress in research and the development of novel prognostic and noninvasive disease monitoring tools offers hope for personalised therapy tailored to individual recurrence risk in postoperative Crohn's disease.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"209-216"},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Update on ischemic hepatitis. 缺血性肝炎的最新进展。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2024-05-01 Epub Date: 2024-03-15 DOI: 10.1097/MOG.0000000000001017

Jessica Elizabeth Smith, Don C Rockey

引用次数: 0