Gastrointestinal disorders (Basel, Switzerland)最新文献_第2页

Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review 内镜下挽救胃肠道吻合口渗漏——过去、现在和未来——述评

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-09-15 DOI: 10.3390/gidisord5030032

Alexandra Menni, George Stavrou, Georgios Tzikos, Anne D. Shrewsbury, Katerina Kotzampassi

{"title":"Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review","authors":"Alexandra Menni, George Stavrou, Georgios Tzikos, Anne D. Shrewsbury, Katerina Kotzampassi","doi":"10.3390/gidisord5030032","DOIUrl":"https://doi.org/10.3390/gidisord5030032","url":null,"abstract":"Background: Anastomotic leakage, which is defined as a defect in the integrity of a surgical join between two hollow viscera leading to communication between the intraluminal and extraluminal compartments, continues to be of high incidence and one of the most feared complications following gastrointestinal surgery, with a significant potential for a fatal outcome. Surgical options for management are limited and carry a high risk of morbidity and mortality; thus, surgeons are urged to look for alternative options which are minimally invasive, repeatable, non-operative, and do not require general anesthesia. Methods: A narrative review of the international literature took place, including PubMed, Scopus, and Google Scholar, utilizing specific search terms such as “Digestive Surgery AND Anastomotic Leakage OR leak OR dehiscence”. Results: In the present review, we try to describe and analyze the pros and cons of the various endoscopic techniques: from the very first (and still available), fibrin gluing, to endoclip and over-the-scope clip positioning, stent insertion, and the latest suturing and endoluminal vacuum devices. Finally, alongside efforts to improve the existing techniques, we consider stem cell application as well as non-endoscopic, and even endoscopic, attempts at intraluminal microbiome modification, which should ultimately intervene pre-emptively, rather than therapeutically, to prevent leaks. Conclusions: In the last three decades, this search for an ideal device for closure, which must be safe, easy to deploy, inexpensive, robust, effect rapid and stable closure of even large defects, and have a low complication rate, has led to the proposal and application of a number of different endoscopic devices and techniques. However, to date, there is no consensus as to the best. The literature contains reports of only small studies and no randomized trials, failing to take into account both the heterogeneity of leaks and their different anatomical sites.","PeriodicalId":73131,"journal":{"name":"Gastrointestinal disorders (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135436774","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}

引用次数: 0

Inflammatory Bowel Disease in Turkish Populations Served by English NHS Trusts 炎症性肠病在土耳其人口服务于英国NHS信托

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-09-13 DOI: 10.3390/gidisord5030031

Affifa Farrukh, John Francis Mayberry

{"title":"Inflammatory Bowel Disease in Turkish Populations Served by English NHS Trusts","authors":"Affifa Farrukh, John Francis Mayberry","doi":"10.3390/gidisord5030031","DOIUrl":"https://doi.org/10.3390/gidisord5030031","url":null,"abstract":"It is estimated that there are about 500,000 Turkish people living in the UK, of whom about 300,000 are of Cypriot origin. A Freedom of Information request was sent to the four NHS Trusts in London which served areas with significant Turkish communities. The request sought information on the total number of patients admitted between 2016 and 2020 with inflammatory bowel disease. Between 2016 and 2020, 1936 patients with inflammatory bowel disease were admitted to North Middlesex University Hospital NHS Trust. Some of these patients will have been readmitted in different years, leading to an inflation of the overall number. The average number of cases admitted each year was approximately 387. The proportion of White British patients with ulcerative colitis was 0.4; for Turkish Cypriots, it was 0.43 and for Turkish patients, 0.45. A z test comparison of these proportions showed that there was no difference between the Turkish communities (z = 0.52 ns) and no overall difference between White British and all Turkish patients (z = −1.5, ns). Between 2016 and 2020, the Homerton Healthcare Foundation Trust admitted 215 English patients with inflammatory bowel disease, of whom 113 had ulcerative colitis. Of the 26 Turkish patients, 4 had ulcerative colitis. The proportion of Turkish patients with Crohn’s disease was significantly greater than that amongst English patients (z = 3.58, p < 0.0003). In the context of the relatively large number of Turkish people with inflammatory bowel disease in both trusts, the absence of published work on the impact of these chronic diseases is of concern. The results from this investigation should prompt specific qualitative research into the Turkish experience in the UK following a diagnosis of inflammatory bowel disease with the intention of developing better patient-centred care.","PeriodicalId":73131,"journal":{"name":"Gastrointestinal disorders (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135783064","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}

引用次数: 0

Vedolizumab as Rescue Therapy in Carboplatin-Gemcitabine-Induced Triggered Acute Severe Ulcerative Colitis Flare-Up Vedolizumab作为卡铂-吉西他滨诱发的急性严重溃疡性结肠炎发作的拯救疗法

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-09-01 DOI: 10.3390/gidisord5030030

R. Pellegrino, M. Fasano, F. Morgillo, Giovanna Palladino, Isabella Vassallo, M. Pirozzi, G. Imperio, Salvatore Auletta, Andrea Ventura, I. Panarese, Alessandro Federico, A. Gravina

{"title":"Vedolizumab as Rescue Therapy in Carboplatin-Gemcitabine-Induced Triggered Acute Severe Ulcerative Colitis Flare-Up","authors":"R. Pellegrino, M. Fasano, F. Morgillo, Giovanna Palladino, Isabella Vassallo, M. Pirozzi, G. Imperio, Salvatore Auletta, Andrea Ventura, I. Panarese, Alessandro Federico, A. Gravina","doi":"10.3390/gidisord5030030","DOIUrl":"https://doi.org/10.3390/gidisord5030030","url":null,"abstract":"Approximately 20% of patients with ulcerative colitis (UC) develop acute severe UC (ASUC), for which intravenous systemic steroid therapy and possibly infliximab-based rescue therapy are generally imposed. However, there are no significant guideline recommendations on ASUC regarding vedolizumab as an alternative in this setting. A case report was presented where a patient with steroid-dependent UC developed ASUC induced by second-line chemotherapy. Treatment with intravenous methylprednisolone was imposed, but there was no reduction in bowel movements in the days following admission. Rescue therapy with infliximab was contraindicated because of the oncologic history. Surgical consultation, contraindicated colectomy, and administration of vedolizumab 300 mg were initiated. After infusion with vedolizumab, there was a significant reduction in bowel movements starting the day after infusion until normalisation of bowel movements within three days and the concomitant normalisation of inflammatory indices. The patient is currently in clinical remission, on therapy with vedolizumab 108 mg subcutaneously every two weeks, and is in oncologic follow-up for pulmonary neoplasm. This case highlights the novel potential of vedolizumab as a possible rescue therapy in ASUC, especially in special populations, where it may offer a better safety profile. Although cyclosporine and infliximab still represent the mainstays of salvage therapy for steroid-refractory ASUC, new therapeutic agents may also be effective, such as vedolizumab, ustekinumab, and anti-Janus kinase agents.","PeriodicalId":73131,"journal":{"name":"Gastrointestinal disorders (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41548993","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}

引用次数: 0

Training in Pediatric Gastrointestinal Endoscopy during Surgery Residency: Can Training Programs Currently Educate Proficient Pediatric Endoscopists? A Nationwide Assessment 外科住院医师期间的儿科胃肠内镜培训:目前的培训计划能否培养出熟练的儿科内镜医师?全国评估

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-08-29 DOI: 10.3390/gidisord5030029

Giovanni Parente, Marco Di Mitri, T. Gargano, Mario Lima

{"title":"Training in Pediatric Gastrointestinal Endoscopy during Surgery Residency: Can Training Programs Currently Educate Proficient Pediatric Endoscopists? A Nationwide Assessment","authors":"Giovanni Parente, Marco Di Mitri, T. Gargano, Mario Lima","doi":"10.3390/gidisord5030029","DOIUrl":"https://doi.org/10.3390/gidisord5030029","url":null,"abstract":"Background: Technological advances in pediatric gastrointestinal (GI) endoscopy require highly specialized physicians. Therefore, proper training is fundamental. The aim of this study was to assess the level of competence of pediatric surgery residents to determine areas that should be addressed to design better training programs focused on pediatric GI endoscopy. Methods: An observational study was performed on all Italian pediatric surgery trainees that concluded the training program by the end of 2021, who were asked to answer a questionnaire about the quality of the GI endoscopy education received during their 5 years of residency. Results: 12 out 14 (86%) pediatric surgery trainees answered the questionnaire. A total of 50% (6/12) of the trainees declared they were interested in pediatric GI endoscopy, and 42% (5/12) said that they would be interested in dedicating themselves to this discipline in the future. Only 33% (4/12) of them were in a center equipped with endoscopy simulators. Among them, 17% (2/12) never took part in GI endoscopic procedures while working in centers in which GI endoscopy is performed exclusively by pediatric gastroenterologists, 25% (3/12) had never performed GI endoscopic procedures as a first operator and 17% (2/12) not even as assistant. Overall, 50% (6/12) were not satisfied with the level of education received and only 17% (2/12) declared that they felt confident enough to perform routine endoscopies alone. Conclusions: Our study highlights great inhomogeneity between different schools and some important failings. Better programs should be designed to educate proficient pediatric GI endoscopists.","PeriodicalId":73131,"journal":{"name":"Gastrointestinal disorders (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46681915","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}

引用次数: 0

The Effect of COVID-19 on Gut Microbiota: Exploring the Complex Interplay and Implications for Human Health COVID-19对肠道微生物群的影响:探索复杂的相互作用及其对人类健康的影响

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-08-18 DOI: 10.3390/gidisord5030028

Shamima Akter, Sa’dia Tasnim, Rashu Barua, Mayank Choubey, Shahida Arbee, Mohammad Mohabbulla Mohib, Naofel Minhaz, Ajanta Choudhury, Pallab Sarker, Mohammad Sarif Mohiuddin

引用次数: 0

The Effect of COVID-19 on Gut Microbiota: Exploring the Complex Interplay and Implications for Human Health 新冠肺炎对肠道微生物群的影响：探索复杂的相互作用及其对人类健康的影响

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-08-18 DOI: 10.20944/preprints202307.1326.v1

Shamima Akter, Sadia Tasnim, R. Barua, M. Choubey, Shahida Arbee, M. M. Mohib, Naofel Minhaz, Ajanta Choudhury, P. Sarker, Mohammad Sarif Mohiuddin

引用次数: 1

Chronic Kidney Disease Linked to Higher Incidence of Gastric Diseases 慢性肾脏病与胃病发病率高有关

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-08-17 DOI: 10.3390/gidisord5030027

Xiaoliang Wang, Zachary Wright, Jiayan Wang, Wesam M Frandah, G. Song

引用次数: 0

Metoclopramide in Gastroparesis: Its Mechanism of Action and Safety Profile 胃复安治疗胃轻瘫的作用机制及安全性

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-08-01 DOI: 10.3390/gidisord5030026

M. Kalas, B. Trivedi, Mutaz Kalas, Luis Chavez, R. McCallum

{"title":"Metoclopramide in Gastroparesis: Its Mechanism of Action and Safety Profile","authors":"M. Kalas, B. Trivedi, Mutaz Kalas, Luis Chavez, R. McCallum","doi":"10.3390/gidisord5030026","DOIUrl":"https://doi.org/10.3390/gidisord5030026","url":null,"abstract":"Metoclopramide has been the cornerstone of gastroparesis management for the past 40 years as it is the only FDA-approved medication for gastroparesis. Other medications such as erythromycin and domperidone have been used off-label with variable efficacy. Historically, metoclopramide has been used in oral, intravenous, and subcutaneous formulations. It is an antiemetic and prokinetic medication that acts through the inhibition of central (chemoreceptor trigger zone) and peripheral dopaminergic and serotogenic receptors. Due to its antidopaminergic effects, extrapyramidal symptoms have been reported, with the most feared adverse event being tardive dyskinesia. Subsequently, the FDA issued a metoclopramide black box warning label in February 2009 due to its risk of causing tardive dyskinesia, which can be irreversible. The incidence and prevalence of tardive dyskinesia among metoclopramide users have been variable in different studies. However, upon review of the current literature, the true prevalence of tardive dyskinesia seems to be lower than previously thought. This review will focus on metoclopramide and the extrapyramidal symptoms associated with its use.","PeriodicalId":73131,"journal":{"name":"Gastrointestinal disorders (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47612212","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}

引用次数: 0

Nocturnal Pain Is Not an Alarm Symptom for Upper Gastrointestinal Inflammation but May Be an Indicator of Sleep Disturbance or Psychological Dysfunction 夜间疼痛不是上消化道炎症的警报症状，但可能是睡眠障碍或心理功能障碍的指标

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-07-31 DOI: 10.3390/gidisord5030025

J. Cindrich, Chance S. Friesen, J. Schurman, J. Colombo, C. Friesen

{"title":"Nocturnal Pain Is Not an Alarm Symptom for Upper Gastrointestinal Inflammation but May Be an Indicator of Sleep Disturbance or Psychological Dysfunction","authors":"J. Cindrich, Chance S. Friesen, J. Schurman, J. Colombo, C. Friesen","doi":"10.3390/gidisord5030025","DOIUrl":"https://doi.org/10.3390/gidisord5030025","url":null,"abstract":"Alarm symptoms are widely used in pediatric gastroenterology to discern when abdominal pain needs further workup. Despite wide use, the data supporting the validity of these symptoms are not well established. This study explored one alarm symptom—nighttime waking with pain—and its associations with histologic inflammation of the upper gastrointestinal tract, psychological dysfunction, and disordered sleep. This retrospective study evaluated 240 patients with abdominal pain-related disorders of the gut–brain axis (AP-DGBI). Patients underwent questionnaires related to sleep disturbance, behavioral assessment, and gastrointestinal symptoms, including Rome IV criteria for AP-DGBI. Routine upper endoscopy with standardized biopsies was performed in 205 patients. Endoscopy results showed no association between esophageal, gastric, or duodenal histologic inflammation and nighttime waking with pain. Nocturnal pain was associated with increased scores for both psychological and sleep disorders, including social stress, depression, disorders of initiation and maintenance of sleep (DIMS), disorders of daytime somnolence (DOES), and sleep hyperhidrosis (SHY). This study concluded that nocturnal pain is not a reliable predictor of upper gastrointestinal inflammation but may be a prognosticator for psychological distress and sleep disturbances.","PeriodicalId":73131,"journal":{"name":"Gastrointestinal disorders (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47639988","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}

引用次数: 0

Structure and Metabolic Activity of the Gut Microbiota in Diarrhea-Predominant Irritable Bowel Syndrome Combined with Functional Dyspepsia 腹泻型肠易激综合征合并功能性消化不良患者肠道微生物群的结构和代谢活性

Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-07-31 DOI: 10.3390/gidisord5030024

Aleksandra Kovaleva, E. Poluektova, R. Maslennikov, O. Zolnikova, O. Shifrin, A. Kudryavtseva, G. Krasnov, M. Fedorova, A. Karchevskaya, V. Ivashkin

{"title":"Structure and Metabolic Activity of the Gut Microbiota in Diarrhea-Predominant Irritable Bowel Syndrome Combined with Functional Dyspepsia","authors":"Aleksandra Kovaleva, E. Poluektova, R. Maslennikov, O. Zolnikova, O. Shifrin, A. Kudryavtseva, G. Krasnov, M. Fedorova, A. Karchevskaya, V. Ivashkin","doi":"10.3390/gidisord5030024","DOIUrl":"https://doi.org/10.3390/gidisord5030024","url":null,"abstract":"Gut dysbiosis presents in many digestive diseases. The aim of this study is to investigate the composition of the gut microbiota and its metabolic activity in patients with diarrhea-predominant irritable bowel syndrome combined with functional dyspepsia (I + D). This study included 60 patients with I + D and 20 healthy controls. Gut microbiota composition was studied using 16S rRNA gene sequencing. The short-chain fatty acids (SCFAs) spectrum was determined via gas–liquid chromatography. Patients with I + D had an increase in the abundance of Holdemanella, Erysipelotrichaceae, Erysipelotrichales, Prevotellaceae, Agathobacter, Slackia, Lactococcus, Pseudomonadaceae, Stenotrophomonas, Xanthomonadaceae, Rhizobiaceae, Erysipelatoclostridiaceae, Lachnospiraceae, and other taxa in addition to a decrease in the abundance of Frisingicoccus, Ralstonia, Burkholderiaceae, Hungatella, Eisenbergiella, Parabacteroides, Peptostreptococcaceae, Merdibacter, Bilophila, Rikenellaceae, Tannerellaceae, Bacteroidaceae, and Flavonifractor in comparison to controls. Patients with I + D showed significantly higher total SCFA content in feces; increased absolute content of acetic acid, propionic acid, butyric acid, and isoacids; and a significant negative shift in the anaerobic index. The relative levels of the main SCFAs and isoacids in the patient group did not differ significantly from those in the control group. The fecal acetate and isoacid levels correlated with the severity of diarrhea. The fecal butyrate level correlated with the severity of flatulence.","PeriodicalId":73131,"journal":{"name":"Gastrointestinal disorders (Basel, Switzerland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49644199","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}

引用次数: 0