Journal of gastroenterology and hepatology
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J. Gastroenterol. Hepatol. · Apr 2017
ReviewUnderstanding the complications of anti-tumor necrosis factor therapy in East Asian patients with inflammatory bowel disease.
Remarkable advances have been made in the treatment of inflammatory bowel disease since the introduction of anti-tumor necrosis factor-α agents, especially for patients who are refractory to or cannot tolerate conventional therapies. Currently, infliximab, adalimumab, and golimumab are available in the East Asian medical market, and these agents have been shown to be effective for inducing and maintaining long-term remission of inflammatory bowel disease. ⋯ To further improve treatment efficacy and safety, close monitoring of inflammation, regular surveillance for malignancy, and regularly scheduled vaccinations are needed. Treatment strategies for biologics should be customized to meet the needs of different patients.
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J. Gastroenterol. Hepatol. · Apr 2017
Early transjugular intrahepatic portosystemic shunt in US patients hospitalized with acute esophageal variceal bleeding.
Early transjugular intrahepatic portosystemic shunt (TIPS) used as preventive therapy prior to recurrent bleeding has been recommended in patients presenting with acute esophageal variceal bleeding (EVB) who are at high risk of further bleeding and death. We investigated the impact of early TIPS on outcomes of US patients hospitalized with EVB from 2000 to 2010. ⋯ Early preventive TIPS in patients with EVB and decompensated cirrhosis was associated with significant in-hospital reductions in rebleeding and mortality without a significant increase in encephalopathy in "real-world" US clinical practice.
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J. Gastroenterol. Hepatol. · Apr 2017
Presence of non-hypervascular hypointense nodules on Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in patients with hepatocellular carcinoma.
Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) performed before curative therapy for hepatocellular carcinoma (HCC) can distinguish between intrahepatic distant recurrence and hypervascularization. This study aimed to retrospectively evaluate the presence of non-hypervascular hypointense nodules on hepatobiliary phase images from Gd-EOB-DTPA-enhanced MRI as a risk factor of the intrahepatic distant recurrence of early stage HCC following radiofrequency ablation (RFA). ⋯ The presence of non-hypervascular hypointense nodules on hepatobiliary phase images from Gd-EOB-DTPA-enhanced MRI obtained prior to RFA is an important predictive factor of intrahepatic distant recurrence following RFA of HCC.
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It has long been known that many short-chain carbohydrates can induce abdominal symptoms that are similar to those in patients with irritable bowel syndrome (IBS). It was hypothesized that restricting the intake of all short-chain carbohydrates that are either slowly absorbed or not digested in the small intestine should be considered together because they all have similar effects on the intestine by distending the lumen. ⋯ Over the last 12 years, the mechanisms of action, food content of FODMAPs and efficacy of the diet, among other aspects have been intensively studied. In many parts of the world, the low FODMAP diet is now considered a front-line therapy for IBS.
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J. Gastroenterol. Hepatol. · Feb 2017
Development and validation of a prognostic nomogram for acute-on-chronic hepatitis B liver failure.
Determining individual risk of short-term mortality in patients with acute-on-chronic hepatitis B liver failure (ACHBLF) is a difficult task. We aimed to develop and externally validate a prognostic nomogram for ACHBLF patients. ⋯ The prognostic nomogram provided an individualized risk estimate of short-term survival in patients with ACHBLF, offering to clinicians to improve their abilities to assess patient prognosis.