Gastroent Hepat Barc
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The SARS-CoV-2 pandemic is leading to high mortality and a global health crisis. The primary involvement is respiratory; however, the virus can also affect other organs, such as the gastrointestinal tract and liver. The most common symptoms are anorexia and diarrhea. ⋯ Digestive endoscopies may give rise to aerosols, which make them techniques with a high risk of infection. Experts and scientific organizations worldwide have developed guidelines for preventive measures. The available evidence on gastrointestinal and hepatic involvement, the impact on patients with previous digestive diseases and operating guidelines for Endoscopy Units during the pandemic are reviewed.
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Gastroent Hepat Barc · Aug 2020
Review Practice GuidelineAEG-SEED position paper for the resumption of endoscopic activity after the peak phase of the COVID-19 pandemic.
The COVID-19 pandemic has led to the suspension of programmed activity in most of the Endoscopy Units in our environment. The aim of this document is to facilitate the resumption of elective endoscopic activity in an efficient and safe manner. ⋯ The AEG and SEED recommend restarting endoscopic activity in a phased, safe manner, adapted to local resources and the epidemiological situation of SARS-CoV-2 infection.
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Tofacitinib is an oral synthetic small-molecule inhibitor of Janus kinases, which are involved in the pathogenesis of various inflammatory diseases, representing a new therapeutic option for ulcerative colitis. The efficacy and safety of tofacitinib have been demonstrated in clinical trials in patients with moderate to severe ulcerative colitis, and it has recently been approved by the European Medicines Agency to treat this disease. This article reviews the most relevant characteristics of tofacitinib, its main differences from biological agents, the studies which demonstrate its efficacy in patients with ulcerative colitis, and its optimal use in different clinical situations.
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Gastroent Hepat Barc · Jun 2017
ReviewReview of the role of probiotics in gastrointestinal diseases in adults.
Probiotics may act as biological agents that modify the intestinal microbiota and certain cytokine profiles, which can lead to an improvement in certain gastrointestinal diseases. ⋯ Although some probiotics have not demonstrated any benefit, there are certain gastrointestinal diseases in which the use of probiotics, true biological agents, can be recommended.
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Gastroent Hepat Barc · Nov 2016
Review Practice Guideline[Evaluation and treatment of the critically ill cirrhotic patient].
Cirrhotic patients often develop severe complications requiring ICU admission. Grade III-IV hepatic encephalopathy, septic shock, acute-on-chronic liver failure and variceal bleeding are clinical decompensations that need a specific therapeutic approach in cirrhosis. The increased effectiveness of the treatments currently used in this setting and the spread of liver transplantation programs have substantially improved the prognosis of critically ill cirrhotic patients, which has facilitated their admission to critical care units. ⋯ These differential characteristics have important diagnostic and therapeutic implications that must be known by general intensivists. In this context, the Catalan Society of Gastroenterology and Hepatology requested a group of experts to draft a position paper on the assessment and treatment of critically ill cirrhotic patients. This article describes the recommendations agreed upon at the consensus meetings and their main conclusions.