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Les derniers abstracts de la revue Gastroenterology :

    Date de mise en ligne : Dimanche 26 février 2017
    Sofia M.E. Weiler, Federico Pinna, Thomas Wolf, Teresa Lutz, Aman Geldiyev, Carsten Sticht, Maria Knaub, Stefan Thomann, Michaela Bissinger, Shan Wan, Stephanie Rössler, Diana Becker, Norbert Gretz, Hauke Lang, Frank Bergmann, Vladimir Ustiyan, Tatiana V. Kalin, Stephan Singer, Ju-Seog Lee, Jens U. Marquardt, Peter Schirmacher, Vladimir V. Kalinichenko, Kai Breuhahn
    Induction of Chromosome Instability by Activation of Yes Associated Protein and Forkhead box M1 in Liver Cancer
    Many different types of cancer cells have chromosome instability. The hippo pathway leads to phosphorylation of the transcriptional activator yes associated protein 1 (YAP1, YAP), which regulates proliferation and has been associated with development of liver cancer. We investigated the effects of hippo signaling via YAP on chromosome stability and hepatocarcinogenesis in humans and mice.

    Date de mise en ligne : Dimanche 26 février 2017
    Raaj S. Mehta, Mingyang Song, Reiko Nishihara, David A. Drew, Kana Wu, Zhi Rong Qian, Teresa T. Fung, Tsuyoshi Hamada, Yohei Masugi, Annacarolina da Silva, Yan Shi, Wanwan Li, Mancang Gu, Walter C. Willett, Charles S. Fuchs, Edward L. Giovannucci, Shuji Ogino, Andrew T. Chan
    Dietary Patterns and Risk of Colorectal Cancer: Analysis by Tumor Location and Molecular Subtypes
    Western and prudent dietary patterns have been associated with higher and lower risks of colorectal cancer (CRC), respectively. However, little is known about associations between dietary patterns and specific anatomic subsite or molecular subtypes of CRC.

    Date de mise en ligne : Samedi 25 février 2017
    Meng Zhu, Caiwang Yan, Chuanli Ren, Xiaodan Huang, Xun Zhu, Haiyong Gu, Meilin Wang, Shouyu Wang, Yong Gao, Yong Ji, Xiaoping Miao, Ming Yang, Jinfei Chen, Jiangbo Du, Tongtong Huang, Yue Jiang, Juncheng Dai, Hongxia Ma, Jianwei Zhou, Zhaoming Wang, Zhibin Hu, Guozhong Ji, Zhengdong Zhang, Hongbing Shen, Yongyong Shi, Guangfu Jin
    Exome Array Analysis Identifies Variants in SPOCD1 and BTN3A2 That Affect Risk for Gastric Cancer
    Several genetic variants have been associated with gastric cancer risk, although these account for only a fraction of gastric cancer cases. We aimed to identify low-frequency and other genetic variants that determine gastric cancer susceptibility.

    Date de mise en ligne : Samedi 25 février 2017
    Chun-Pyo Hong, Areum Park, Bo-Gie Yang, Chang Ho Yun, Min-Jung Kwak, Gil-Woo Lee, Jung-Hwan Kim, Min Seong Jang, Eun-Jung Lee, Eun-Ji Jeun, Gihoon You, Kwang Soon Kim, Youngwoo Choi, Ji-Hwan Park, Daehee Hwang, Sin-Hyeog Im, Jihyun F. Kim, Yoon-Keun Kim, Ju-Young Seoh, Charles D. Surh, You-Me Kim, Myoung Ho Jang
    Gut-specific Delivery of T-helper 17 Cells Reduces Obesity and Insulin Resistance in Mice
    Obesity and metabolic syndrome have been associated with alterations to the intestinal microbiota. However, few studies examined the effects of obesity on the intestinal immune system. We investigated changes in subsets of intestinal CD4+ T-helper (Th) cells with obesity and the effects of gut-tropic Th17 cells in mice on a high-fat diet (HFD).

    Date de mise en ligne : Vendredi 24 février 2017
    S. Lieberman, T. Walsh, M. Schechter, T. Adar, E. Goldin, R. Beeri, N. Sharon, H. Baris, L. Ben Avi, E. Half, I. Lerer, B.H. Shirts, C.C. Pritchard, I. Tomlinson, M.C. King, E. Levy-Lahad, T. Peretz, Y. Goldberg
    Features of Patients With Hereditary Mixed Polyposis Syndrome Caused by Duplication of GREM1 and Implications for Screening and Surveillance
    Hereditary mixed polyposis syndrome is a rare colon cancer predisposition syndrome caused by a duplication of a non-coding sequence near the gremlin 1, DAN family BMP antagonist gene (GREM1) originally described in Ashkenazi Jews. Few families with GREM1 duplications have been described, so there are many questions about detection and management. We report 4 extended families with the duplication near GREM1 previously found in Ashkenazi Jews; 3 families were identified at cancer genetic clinics in Israel and 1 family was identified in a cohort of patients with familial colorectal cancer.

    Date de mise en ligne : Vendredi 24 février 2017
    Zhang-Hui Chen, Yan P. Yu, Junyan Tao, Silvia Liu, George Tseng, Michael Nalesnik, Ronald Hamilton, Rohit Bhargava, Joel B. Nelson, Arjun Pennathur, Satdarshan P. Monga, James D. Luketich, George K. Michalopoulos, Jian-Hua Luo
    MAN2A1–FER Fusion Gene Is Expressed by Human Liver and Other Tumor Types and Has Oncogenic Activity in Mice
    Human tumors and liver cancer cell lines express the product of a fusion between the first 13 exons in the mannosidase α class 2A member 1 gene (MAN2A1) and the last 6 exons in the FER tyrosine kinase gene (FER), called MAN2A1−FER. We investigated whether MAN2A1−FER is expressed by human liver tumors and its role in liver carcinogenesis.

    Date de mise en ligne : Jeudi 23 février 2017
    Daniel Mønsted Shabanzadeh, Lars Tue Sørensen, Torben Jørgensen
    Association Between Screen-detected Gallstone Disease and Cancer in a Cohort Study
    In a general population screened for gallstones through ultrasound examination, gallstones were associated with the development of pooled gastrointestinal cancers and, in particular, right-side colon cancer.

    Date de mise en ligne : Jeudi 23 février 2017
    Aynur Unalp-Arida, Constance E. Ruhl, Rok Seon Choung, Tricia L. Brantner, Joseph A. Murray
    Lower Prevalence of Celiac Disease and Gluten-Related Disorders in Persons Living in Southern vs Northern Latitudes of the United States
    The association between prevalence of celiac disease and geographic region is incompletely understood, but the occurrence of several autoimmune disorders has been found to vary along a North–South gradient. We examined geographic, demographic, and clinical factors associated with prevalence of celiac disease and gluten-free diet (GFD) in the United States (US).

    Date de mise en ligne : Vendredi 17 février 2017
    Joseph C. Anderson, John A. Baron, Dennis J. Ahnen, Elizabeth L. Barry, Roberd M. Bostick, Carol A. Burke, Robert S. Bresalier, Timothy R. Church, Bernard F. Cole, Marcia Cruz-Correa, Adam S. Kim, Leila A. Mott, Robert S. Sandler, Douglas J. Robertson
    Factors Associated With Shorter Colonoscopy Surveillance Intervals for Patients With Low-risk Colorectal Adenomas and Effects on Outcome
    Endoscopists do not routinely follow guidelines to survey individuals with low-risk adenomas (LRAs, 1–2 small tubular adenomas, less than 1 cm) every 5–10 years for colorectal cancer (CRC)—many endoscopists recommend shorter surveillance intervals for these individuals. We aimed to identify reasons that endoscopists recommend shorter surveillance intervals for some individuals with LRAs and determine whether timing affects outcomes at follow-up examinations.

    Date de mise en ligne : Vendredi 17 février 2017
    Rohit Loomba, T. Jake Liang
    Hepatitis B reactivation associated with immune suppressive and biological modifier therapies: current concepts, management strategies and future directions
    Hepatitis B reactivation associated with immune suppressive and biological therapies is emerging to be an important cause of morbidity and mortality in patients with current or prior exposure to hepatitis B virus infection. The population at risk for HBV reactivation includes those who are either currently infected with HBV or have past exposure to HBV. Since curative and eradicative therapy for HBV is not currently available, there is a large reservoir of individuals at risk for HBV reactivation in the general population.

    Date de mise en ligne : Mercredi 15 février 2017
    George Thom, Mike Lean
    "Is there an optimal diet for weight management and metabolic health?”
    Individuals can lose body weight and improve health status on a wide range of energy (calorie) restricted dietary interventions. In this paper, we have reviewed the effectiveness of the most commonly utilized diets, including low-fat, low-carbohydrate and Mediterranean approaches in addition to commercial slimming programmes, meal replacements and newly-popularized intermittent fasting diets. We also consider the role of artificial sweeteners in weight management. Low-fat diets tend to improve LDL-cholesterol most, whilst lower-carbohydrate diets may preferentially improve triglycerides and HDL-cholesterol, however differences between diets are marginal.

    Date de mise en ligne : Mercredi 15 février 2017
    Oscar Chávez-Talavera, Anne Tailleux, Philippe Lefebvre, Bart Staels
    Bile acid control of metabolism and inflammation in obesity, type 2 diabetes, dyslipidemia and NAFLD
    Bile acids are signaling molecules, which coordinately regulate metabolism and inflammation via the nuclear farnesoid X receptor (FXR) and the Takeda G protein-coupled receptor 5 (TGR5). These receptors activate transcriptional networks and signaling cascades controlling the expression and activity of genes involved in bile acid, lipid and carbohydrate metabolism, energy expenditure, and inflammation by acting predominantly in entero-hepatic tissues, but also in peripheral organs. In this review, we discuss the most recent findings on the inter-organ signaling and interplay with the gut microbiota of bile acids and their receptors in meta-inflammation, with a focus on their pathophysiological roles in obesity, type 2 diabetes, dyslipidemia and non-alcoholic steatohepatitis and their potential therapeutic applications.

    Date de mise en ligne : Mercredi 15 février 2017
    Tove Fall, Michael Mendelson, Elizabeth K. Speliotes
    Recent advances in human genetics and epigenetics of adiposity: pathway to precision medicine?
    Obesity is a heritable trait that contributes to substantial global morbidity and mortality. Here, we summarize findings from the last decade of genetic and epigenetic research focused on unravelling the underpinnings of adiposity. More than 140 genetic regions are now known to influence adiposity traits. The genetics of general adiposity, as measured by body mass index, and that of abdominal obesity, as measured by waist to hip ratio, have distinct biological backgrounds. Expression of genes associated with general adiposity are enriched in the nervous system.

    Date de mise en ligne : Lundi 13 février 2017
    Xinxin Cheng, Lixuan Wei, Xudong Huang, Jian Zheng, Mingming Shao, Ting Feng, Jun Li, Yaling Han, Wenle Tan, Wen Tan, Dongxin Lin, Chen Wu
    SLC39A6 Promotes Aggressiveness of Esophageal Carcinoma Cells by Increasing Intracellular Levels of Zinc, Activating Phosphatidylinositol 3-kinase Signaling, and Upregulating Genes That Regulate Metastasis
    A common variant in the solute carrier family 39 member 6 gene (SLC39A6) has been associated with survival times of patients with esophageal squamous-cell carcinoma (ESCC). We investigated the function of SLC39A6 and ways in which this variant affects tumor progression by studying ESCC samples and cell lines.

    Date de mise en ligne : Lundi 13 février 2017
    Kyle Staller, Mary K. Townsend, Hamed Khalili, Raaj Mehta, Francine Grodstein, William E. Whitehead, Catherine A. Matthews, Braden Kuo, Andrew T. Chan.
    Menopausal Hormone Therapy is Associated With Increased Risk of Fecal Incontinence in Women After Menopause
    Low estrogen levels could contribute to development of fecal incontinence (FI) in women after menopause by altering neuromuscular continence mechanisms. However, studies have produced conflicting results on the association between menopausal hormone therapy (MHT) and risk of FI.

    Date de mise en ligne : Vendredi 10 février 2017
    M.P. Monteiro, R.L. Batterham
    The Importance of the Gastrointestinal Tract in Controlling Food Intake and Regulating Energy Balance
    The gastrointestinal (GI) tract, the key interface between ingested nutrients and the body, plays a critical role in regulating energy homeostasis. Gut-derived signals convey information regarding incoming nutrients to the brain, initiating changes in eating behavior and energy expenditure, to maintain energy balance. Here we review hormonal, neural and nutrient signals emanating from the GI tract and evidence for their role in controlling feeding behavior. Mechanistic studies that have utilized pharmacological and/or transgenic approaches targeting an individual hormone/mediator have yielded somewhat disappointing bodyweight changes, often leading to the hormone/mediator in question being dismissed as a potential obesity therapy.

    Date de mise en ligne : Vendredi 10 février 2017
    Kevin D. Hall, Juen Guo
    Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition
    Weight changes are accompanied by imbalances between calorie intake and expenditure. This fact is often misinterpreted to suggest that obesity is caused by gluttony and sloth and can be treated by simply advising people to eat less and move more. However, various components of energy balance are dynamically interrelated and weight loss is resisted by counterbalancing physiological processes. While low carbohydrate diets have been suggested to partially subvert these processes by increasing energy expenditure and promoting fat loss, our meta-analysis of 32 controlled feeding studies with isocaloric substitution of carbohydrate for fat found that both energy expenditure (26 kcal/d; p<0.0001) and fat loss (16g/d; p<0.0001) were greater with lower fat diets.

    Date de mise en ligne : Vendredi 10 février 2017
    Josep Vidal, Ricard Corcelles, Amanda Jiménez, Lílliam Flores, Antonio M. Lacy
    Metabolic and Bariatric Surgery for Obesity
    Metabolic and bariatric surgery (MBS) leads to weight loss in obese individuals and reduces comorbidities such as type 2 diabetes. MBS is superior to medical therapy in reducing hyperglycemia in persons with type 2 diabetes, and has been associated with reduced mortality and incidences of cardiovascular events and cancer in obese individuals. New guidelines have been proposed for the use of MBS in persons with type 2 diabetes. We review the use of MBS as a treatment for obesity and obesity-related conditions and, based on recent evidence, propose health care systems make the appropriate changes to increase accessibility for eligible patients.

    Date de mise en ligne : Vendredi 10 février 2017
    Ira M. Jacobson, Eric Lawitz, Paul Y. Kwo, Christophe Hézode, Cheng-Yuan Peng, Anita Y.M. Howe, Peggy Hwang, Janice Wahl, Michael Robertson, Eliav Barr, Barbara A. Haber
    Safety and Efficacy of Elbasvir/Grazoprevir in Patients with Hepatitis C Virus Infection and Compensated Cirrhosis: an Integrated Analysis
    Persons with hepatitis C virus (HCV) infection are at risk of progressive liver disease, cirrhosis, and decompensation. We analyzed the effects of the direct-acting antiviral agents elbasvir and grazoprevir in patients with HCV infection and compensated cirrhosis, combining data from 6 clinical trials.

    Date de mise en ligne : Vendredi 10 février 2017
    Chong He, Tianming Yu, Yan Shi, Caiyun Ma, Wenjing Yang, Leilei Fang, Mingming Sun, Wei Wu, Fei Xiao, Feifan Guo, Minhu Chen, Hong Yang, Jiaming Qian, Yingzi Cong, Zhanju Liu
    MicroRNA 301A Promotes Intestinal Inflammation and Colitis-Associated Cancer Development by Inhibiting BTG1
    Intestinal tissues from patients with inflammatory bowel disease (IBD) and colorectal cancer have increased expression of microRNA-301a (MIR301A), compared to tissues from patients without IBD. We studied the mechanisms of MIR301A in progression of IBD in human tissues and mice.

    Date de mise en ligne : Vendredi 10 février 2017
    Jeffrey S. Hyams, Marla C. Dubinsky, Robert N. Baldassano, Richard B. Colletti, Salvatore Cucchiara, Johanna Escher, William Faubion, John Fell, Benjamin D. Gold, Anne Griffiths, Sibylle Koletzko, Subra Kugathasan, James Markowitz, Frank M. Ruemmele, Gigi Veereman, Harland Winter, Nicholas Masel, Chu Ri Shin, Kezhen L. Tang, Meena Thayu
    Infliximab not Associated With Increased Risk of Malignancy or Hemophagocytic Lymphohistiocytosis in Pediatric Patients With Inflammatory Bowel Disease
    Immunosuppressive therapy for inflammatory bowel disease (IBD) in pediatric patients is thought to increase risk of malignancy and lymphoproliferative disorders, including hemophagocytic lymphohistiocytosis (HLH). We compared unadjusted incidence rates and of malignancy and HLH in pediatric patients with IBD exposed to infliximab compared with patients not exposed to biologics and calculated standardized incidence ratios (SIRs).

    Date de mise en ligne : Vendredi 10 février 2017
    Corey A. Siegel
    Transforming Gastroenterology Care With Telemedicine
    Healthcare is changing rapidly, so we must change with the times to develop more efficient, practical, cost-effective and, importantly, high-quality methods to care for patients. We teach medial students that optimal patient care requires face to face interactions, to collect information on patients’ history, and the physical examination. However, management of many patients—especially those with chronic diseases—does not always require physical examination. Telemedicine offers an opportunity to take advantage of technology while leveraging the progressive push towards efficiency and value, but also requires the belief that excellent patient care is not always provided in person.

    Date de mise en ligne : Vendredi 10 février 2017
    Michael Camilleri, Harmeet Malhi, Andres Acosta
    Gastrointestinal Complications of Obesity
    Obesity is usually associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause [e.g. non-alcoholic fatty liver diseases (NAFLD)] or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease (GERD), erosive esophagitis, Barrett’s esophagus, esophageal adenocarcinoma, erosive gastritis, gastric cancer, diarrhea, colonic diverticular disease, polyps, cancer, liver disease including NAFLD, cirrhosis, hepatocellular carcinoma, gallstones, acute pancreatitis, and pancreatic cancer.

    Date de mise en ligne : Vendredi 10 février 2017
    Sonia Caprio, Rachel Perry, Romy Kursawe
    Adolescent Obesity and Insulin Resistance: Roles of Ectopic Fat Accumulation and Adipose Inflammation
    As a consequence of the global rise in the prevalence of Adolescent Obesity, an unprecedented phenomenon of Type 2 Diabetes (T2D) has emerged in pediatrics. At the heart of T2D development lies a key metabolic derangement: Insulin Resistance (IR) . Despite the widespread occurrence of IR affecting an unmeasurable number of youths worldwide, its pathogenesis remains elusive. IR in obese youth is a complex phenomenon that defies explanation by a single pathway. In this review we first describe recent data on the prevalence, severity, and racial/ethnic differences in Pediatric Obesity.

    Date de mise en ligne : Vendredi 10 février 2017
    Hans-Rudolf Berthoud, Heike Münzberg, Christopher D. Morrison
    Blaming the brain for obesity: Integration of hedonic and homeostatic mechanisms
    The brain plays a key role in the controls of energy intake and expenditure and many genes associated with obesity are expressed in the central nervous system. Technological and conceptual advances in both basic and clinical neurosciences have expanded the traditional view of homeostatic regulation of body weight by mainly the hypothalamus to include hedonic controls of appetite by cortical and subcortical brain areas processing external sensory information, reward, cognition, and executive functions.

    Date de mise en ligne : Vendredi 10 février 2017
    Leon I. Igel, Rekha B. Kumar, Katherine H. Saunders, Louis J. Aronne
    Practical Use of Pharmacotherapy for Obesity
    Obesity management requires a multidisciplinary approach, as there are many factors that contribute to the development of obesity as well as the preservation of excess weight once it has been gained. Diet, exercise and behavior modification are key components of treatment. In addition to lifestyle changes, weight gain secondary to medications is an important modifiable risk factor. Even after appropriate lifestyle modification, and medication adjustments (where possible) to avoid agents that can contribute to weight gain, many patients are still unable to achieve clinically meaningful weight loss.

    Date de mise en ligne : Vendredi 10 février 2017
    Kristien E. Bouter, Daniël H. van Raalte, Albert K. Groen, Max Nieuwdorp
    Role of the Gut Microbiome in the Pathogenesis of Obesity and Obesity-Related Metabolic Dysfunction
    The potential role of intestinal microbiota in the etiology of various human diseases has attracted massive attention in the last decade. As such, the intestinal microbiota has been advanced as an important partaker in the development of obesity and obesity-related metabolic dysfunctions, amongst others. Experiments in animal models have produced evidence for a causal role of intestinal microbiota in the etiology of obesity and insulin resistance. However, with a few exceptions such causal relation is lacking for humans.

    Date de mise en ligne : Vendredi 10 février 2017
    N. Abate, M. Chandalia
    Risk of obesity-related cardiometabolic complications in special populations: a crisis in Asians
    The prospect of significant increase in global health-related costs associated with high cardiometabolic complications of obesity in Asians has encouraged more attention to the problem of growing obesity prevalence in these populations. While these studies have shown that cardiometabolic complications occur more frequently and at lower body mass index (BMI) in Asians than in European populations, the mechanisms involved are yet to be discovered. Ethnic/racial differences in body composition and fat distribution have been extensively studied.

    Date de mise en ligne : Vendredi 10 février 2017
    Victoria L. Webb, Thomas A. Wadden
    Intensive Lifestyle Intervention for Obesity: Principles, Practices, and Results
    Using the Guidelines for the Management of Overweight and Obesity in Adults as a framework, this article reviews intensive lifestyle interventions for weight loss. The Guidelines recommend a minimum of 6 months of high-intensity, comprehensive lifestyle intervention, consisting of a reduced-calorie diet, increased physical activity, and behavior therapy. Persons with obesity typically lose about 8 kg (approximately 8% of initial weight) with this approach, accompanied by improvements in health and quality of life.

    Date de mise en ligne : Vendredi 10 février 2017
    Shelby Sullivan, Steven A. Edmundowicz, Christopher C. Thompson
    Endoscopic Bariatric and Metabolic Therapies: New and Emerging Technologies
    Endoscopic Bariatric and Metabolic Therapies (EBMT) are a new addition to the treatment arsenal for obesity. These include devices which are placed or removed via flexible endoscopy, and procedures which utilize instruments that require flexible endoscopy for the indications of weight loss or treatment of glucose intolerance (from pre-diabetes to diabetes). The EBMTs are generally divided into gastric and small bowel categories, and although individual EBMTs may have unique mechanisms of action, similar themes in proposed mechanism of action are seen in the gastric and small bowel EBMTs respectively.

    Date de mise en ligne : Vendredi 10 février 2017
    Nicole T. Shen, Anna Maw, Lyubov L. Tmanova, Alejandro Pino, Kayley Ancy, Carl V. Crawford, Matthew S. Simon, Arthur T. Evans
    Timely use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: a Systematic Review with Meta-Regression Analysis
    Systematic reviews have provided evidence for the efficacy of probiotics in preventing Clostridium difficile infection (CDI), but guidelines do not recommend probiotic use for prevention of CDI. We performed an updated systematic review to help guide clinical practice.

    Date de mise en ligne : Mercredi 08 février 2017
    Nai-Ming Chen, Albrecht Neesse, Moritz Lino Dyck, Benjamin Steuber, Alexander O. Koenig, Clara Lubeseder-Martellato, Thore Winter, Teresa Forster, Hanibal Bohnenberger, Julia Kitz, Kirsten-Reuter Jessen, Heidi Griesmann, Jochen Gaedcke, Marian Grade, Jin-San Zhang, Wan-Chi Tsai, Jens Siveke, Hans-Ulrich Schildhaus, Philipp Ströbel, Steven A. Johnsen, Volker Ellenrieder, Elisabeth Hessmann
    Context-dependent Epigenetic Regulation of Nuclear Factor of Activated T Cells 1 in Pancreatic Plasticity
    The ability of exocrine pancreatic cells to change the cellular phenotype is required for tissue regeneration upon injury but also contributes to their malignant transformation and tumor progression. We investigated context-dependent signaling and transcription mechanisms that determine pancreatic cell fate decisions toward regeneration and malignancy. In particular, we studied the function and regulation of the inflammatory transcription factor nuclear factor of activated T cells 1 (NFATC1) in pancreatic cell plasticity and tissue adaptation.

    Date de mise en ligne : Mardi 07 février 2017
    Edwin Liu, Fran Dong, Anna E. Barón, Iman Taki, Jill M. Norris, Brigitte I. Frohnert, Edward J. Hoffenberg, Marian Rewers
    High incidence of Celiac Disease in a Long-term Study of Adolescents With Susceptibility Genotypes
    Little is known about the incidence of celiac disease in the general population of children in the United States. We aimed to estimate the cumulative incidence of celiac disease in adolescents born in the Denver metropolitan area.

    Date de mise en ligne : Mardi 07 février 2017
    Hidetoshi Nakagawa, Eishiro Mizukoshi, Eiji Kobayashi, Toshikatsu Tamai, Hiroshi Hamana, Tatsuhiko Ozawa, Hiroyuki Kishi, Masaaki Kitahara, Tatsuya Yamashita, Kuniaki Arai, Takeshi Terashima, Noriho Iida, Kazumi Fushimi, Atsushi Muraguchi, Shuichi Kaneko
    Association Between High-avidity T-cell Receptors, Induced by Alpha Fetoprotein-derived Peptides, and Anti-tumor Effects in Patients with Hepatocellular Carcinoma
    Levels of alpha fetoprotein (AFP) are measured for surveillance and diagnosis of hepatocellular carcinoma (HCC). We performed a phase 1 trial to evaluate the safety and efficacy of AFP-derived peptides as an anti-tumor vaccine for patients with advanced HCC, and characterized induction of AFP-specific T-cell receptors (TCRs).

    Date de mise en ligne : Vendredi 03 février 2017
    Dennis M. Jensen, Thomas OG. Kovacs, Gordon V. Ohning, Kevin Ghassemi, Gustavo A. Machicado, Gareth S. Dulai, Alireza Sedarat, Rome Jutabha, Jeffrey Gornbein
    Doppler Endoscopic Probe Monitoring of Blood Flow Improves Risk Stratification and Outcomes of Patients with Severe Non-Variceal Upper Gastrointestinal Hemorrhage
    For 4 decades, stigmata of recent hemorrhages in patients with non-variceal lesions have been used for risk stratification and endoscopic hemostasis. The arterial blood flow that underlies the stigmata is rarely monitored, but can be used to determine risk for rebleeding. We performed a randomized controlled trial to determine whether Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes in patients with severe non-variceal upper gastrointestinal hemorrhage.

    Date de mise en ligne : Vendredi 03 février 2017
    Kentaro Matsuura, Hiromi Sawai, Kazuho Ikeo, Shintaro Ogawa, Etsuko Iio, Masanori Isogawa, Noritomo Shimada, Atsumasa Komori, Hidenori Toyoda, Takashi Kumada, Tadashi Namisaki, Hitoshi Yoshiji, Naoya Sakamoto, Mina Nakagawa, Yasuhiro Asahina, Masayuki Kurosaki, Namiki Izumi, Nobuyuki Enomoto, Atsunori Kusakabe, Eiji Kajiwara, Yoshito Itoh, Tatsuya Ide, Akihiro Tamori, Misako Matsubara, Norifumi Kawada, Ken Shirabe, Eiichi Tomita, Masao Honda, Shuichi Kaneko, Sohji Nishina, Atsushi Suetsugu, Yoichi Hiasa, Hisayoshi Watanabe, Takuya Genda, Isao Sakaida, Shuhei Nishiguchi, Koichi Takaguchi, Eiji Tanaka, Junichi Sugihara, Mitsuo Shimada, Yasuteru Kondo, Yusuke Kawai, Kaname Kojima, Masao Nagasaki, Katsushi Tokunaga, Yasuhito Tanaka, Japanese Genome-Wide Association Study Group for Viral Hepatitis
    Genome-wide Association Study Identifies TLL1 Variant Associated With Development of Hepatocellular Carcinoma After Eradication of Hepatitis C Virus Infection
    There is still a risk for hepatocellular carcinoma (HCC) development after eradication of hepatitis C virus (HCV) infection with anti-viral agents. We investigated genetic factors associated with the development of HCC in patients with a sustained virologic response (SVR) to treatment for chronic HCV infection.

    Date de mise en ligne : Jeudi 02 février 2017
    Janneke van Grinsven, Sandra van Brunschot, Hjalmar C. van Santvoort, Dutch Pancreatitis Study Group
    The Value of a 24/7 Online Nationwide Multidisciplinary Expert Panel for Acute Necrotizing Pancreatitis
    Acute pancreatitis is the most common gastrointestinal reason for acute hospitalization.1 Approximately 20% of patients with acute pancreatitis develop necrotizing pancreatitis.2,3 In approximately 30% of these patients, secondary infection of the necrosis occurs, which almost always requires an invasive intervention.4,5 Diagnosing infected necrosis on clinical grounds can be difficult. Furthermore, even if infected necrosis is proven, international guidelines advise to postpone invasive intervention to around 4 weeks after disease onset.

    Date de mise en ligne : Mercredi 01 février 2017
    Sujan Ravi, Page Axley, DeAnn Jones, Sudha Kodali, Heather Simpson, Brendan M. McGuire, Ashwani Singal
    Unusually High Rates of Hepatocellular Carcinoma After Treatment With Direct-Acting Antiviral Therapy for Hepatitis C Related Cirrhosis
    Direct-acting antiviral (DAA) therapy has revolutionized the treatment of hepatitis C virus (HCV) infection, with very high rates of sustained virologic response (SVR) and an excellent safety profile.1,2 Interferon-based therapies in the past have shown improved outcomes, including reduced risk for occurrence and recurrence of hepatocellular carcinoma (HCC) with the achievement of SVR.3 However, data on the impact of DAA therapy on the natural history and development of HCC are limited. Recently, studies have shown unexpected high HCC recurrence rate of 27%-29% among patients treated with resection or ablation, who received DAA therapy.

    Date de mise en ligne : Mercredi 01 février 2017
    Hsuan-An Su, Hui-Ting Hsu, Hsu-Heng Yen
    Unusual Cause of Small Intestinal Bleeding in a Renal Transplant Recipient
    Question: A 63-year-old man was admitted to our hospital because of hematochezia for days. He underwent renal transplantation 1 year before admission, with immunosuppressant mycophenolate mofetil (MMF) 360 mg bid. Upper endoscopy and colonoscopy revealed several ulcers in the terminal ileum (Figure A). The patient had persistent intermittent bleeding with required daily blood transfusion. A capsule endoscopy revealed active bleeding in the middle ileum (Figure B, Video 1). The bleeding persisted despite supportive medical therapy.

    Date de mise en ligne : Mercredi 01 février 2017
    Thomas C. Winter, Andy J. Taylor
    Back to the Basics: High-Tech Imaging Is Not Always Necessary or Indicated
    Question: A 43-year-old woman with a clinical diagnosis of Crohn disease presented to her physician with severe rectal pain and increasing abdominal distension. An immediate supine abdominal radiograph was obtained.

    Date de mise en ligne : Mardi 31 janvier 2017
    Exam 1: Prevalence and Morbidity of Undiagnosed Celiac Disease From a Community-Based Study

    Date de mise en ligne : Mardi 31 janvier 2017
    Andrew T. Chan, Christopher S. Williams
    Covering the Cover
    In a multicenter, randomized, double-blind, placebo-controlled, parallel group trial, budesonide oral suspension improved symptomatic, endoscopic, and histologic outcomes in patients with symptomatic eosinophilic esophagitis.

    Date de mise en ligne : Mardi 31 janvier 2017
    Nynke Simons, Aaron Isaacs, Martijn C.G.J. Brouwers
    PNPLA3, TM6SF2 and MBOAT7 Genotypes and Coronary Artery Disease
    Nonalcoholic fatty liver disease (NAFLD) is projected to be the most common cause of end-stage liver disease requiring transplantation by 2025.1 The principal cause of death, however, is cardiovascular disease. In a recent meta-analysis, NAFLD—as diagnosed by either imaging or histology—was associated with an increased risk to develop cardiovascular disease, independent of all classical cardiovascular risk factors (odds ratio odds ratio, 1.69; 95% CI, 1.11-2.58).2

    Date de mise en ligne : Mardi 31 janvier 2017
    Tarek Debs, Imed Ben Amor, Jean Gugenheim
    Multirevisional Bariatric Surgery: What Is the Diagnosis?
    Question: A 63-year-old man presented for management of his morbid obesity. The history goes back to September 2005 when the patient presented with a body mass index (BMI) of 40 kg/m2 (123 kilograms to 175 cm). An adjustable gastric band (AGB) was placed. The AGB failed at long term, the patient regained weight and reached a BMI of 41 kg/m2. Removal of the AGB and conversion to Roux en Y gastric bypass (RYGB) was performed in May 2009. Two years after the RYGB, the patient regained weight. A 3-dimensional computed tomography (CT) volumetry of the gastric pouch was done that showed a dilation of the gastric pouch.

    Date de mise en ligne : Mardi 31 janvier 2017
    Feng Li, Lindsay Sobotka, Sean T. McCarthy
    An Unusual Finding During Evaluation for Dysphagia
    Question: A 27-year-old man with a past medical history notable for asthma, food allergies, and congenital pectus excavatum presented with worsening dysphagia. He reported a 5-year history of intermittent solid food dysphagia but denied any history of food impaction. A computed tomography scan of the chest showed an elongated mediastinal mass with associated mass effect on the left atrium and esophageal lumen and esophageal wall thickening without mediastinal lymphadenopathy. On upper endoscopy, a large fistulous opening in the lower third of the esophagus was found corresponding to the ‘mass’ seen on computed tomography (Figure A).

    Date de mise en ligne : Mardi 31 janvier 2017
    Chenguang Dai, Lili Zhao, Zhining Fan
    An Unusual Esophageal Dysphagia Under Gastroscopy and Endoscopic Ultrasonography
    Question: A 51-year-old man was referred to our hospital, presenting with a history of dysphagia for 3 months. Besides a history of smoking for 30 years, no abnormal symptoms or medical history were recorded, such as hypertension or weight loss. Laboratory examinations were also normal. Under gastroscopy, a 1.2 × 0.6-cm submucosal tumor (SMT) was found (Figure A, arrow). Interestingly, another horseshoe-shaped apophysis was located just near the lesion, occupying almost two-thirds of the circle of the esophagus (Figure A, arrowhead).

    Date de mise en ligne : Mardi 31 janvier 2017
    Zixi Huang, Fapeng Zhang, Zhiqiang Luo
    Intrahepatic Biliary Duct Dilatation With an Unusual Choledochoscope Image
    Question: A 52-year-old man presented with recurrent upper abdominal pain on the right side and fever. On physical examination, there was only mild right side upper quadrant tenderness. Blood tests revealed leukocytosis, mild elevation of direct bilirubin, alkaline phosphatase, glutamic-pyruvic transaminase, and serum carbohydrate antigen 19-9. The serology for hepatitis B virus infection was positive, but alpha fetoprotein levels were normal. Abdominal magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) demonstrated multiple obvious intrahepatic biliary duct cystic and columnar dilatations in the right lobe (Figure A, B).

    Date de mise en ligne : Mardi 31 janvier 2017
    Matthew Stier, Jessica Stoll, Sonia S. Kupfer
    A Diagnosis of Small Bowel Polyposis
    Question: A 19-year-old Hispanic man presented to the emergency department with nausea and vomiting. He was treated initially for viral gastroenteritis but returned several days later with intussusception and small bowel obstruction that was managed conservatively. Two months later, symptoms recurred with a 30-pound weight loss and intermittent hematochezia. An intussusception was again noted on imaging. An exploratory laparotomy was performed and a segment of the jejunum from the Ligament of Treitz to 25 cm with carpeting polyps was resected (Figure A).

    Date de mise en ligne : Mardi 31 janvier 2017
    Manoop S. Bhutani
    An Odd Colonic Mass in an Asymptomatic Woman
    Question: A 53-year-old woman with history of colon polyps came in for a routine surveillance colonoscopy. She had no GI symptoms and preprocedure vital signs were stable. The examination was complete up to the cecum with an excellent preparation. The only finding was a centrally depressed mass in the distal transverse colon with raised erythematous enlarged folds surrounding it (Figure A). A few cold biopsies were taken from the edge of the mass. A tattoo and a clip were placed on the normal mucosa just distal to the mass.

    Date de mise en ligne : Mardi 31 janvier 2017
    Seung Han Kim, Bora Keum, Yoon Tae Jeen
    Hemorrhagic Anal Mass
    Question: A 40-year-old man was admitted to the emergency room owing to a hemorrhagic anal mass that occurred while straining during defecation. The hemorrhagic anal mass was observable on initial examination, because it extended beyond the anus (Figure A). It was not painful and could not be reduced manually. Upon physical examination, the patient’s abdomen was soft and nontender. Past history revealed that 4 years ago, the patient underwent a small bowel segmental resection for intestinal obstruction at another hospital.

    Date de mise en ligne : Mardi 31 janvier 2017
    Angela Dolganiuc, Xiuli Liu, Anil Sharma
    Dysphagia With Unusual Esophageal Plaques
    Question: A 49-year-old Caucasian woman presents with complaints of fatigue and dysphagia for 3 months and nausea, abdominal pain, and diarrhea for 3 weeks. Her dysphagia is mostly to solids and not accompanied with odynophagia. Her abdominal pain is located in the epigastric area and “feels like a deep ache.” Her diarrhea is watery, occurring 5–6 times per day, occasionally with fecal urgency. She could not identify factors that would make her symptoms worse or better. She denies fever or chills, bloating, cramps or tenesmus, and states no overt gastrointestinal (GI) bleeding.

    Date de mise en ligne : Lundi 30 janvier 2017
    Helen M. Shields
    How to Create an Unfunded Teaching Fellowship During the Gastroenterology Fellowship that Positively Impacts Subsequent Teaching Activities and Career Path
    The gastrointestinal (GI) pathophysiology course is a 2.5-week required preclinical course at the end of medical school’s second-year pathophysiology organ system blocks. In 1993, I was appointed co-course director of this course. One year later, I was appointed sole course director and continued in that position for the next 22 years. In 2000, after 6 years of directing the course, I was confident that I was an excellent teacher, but the anonymous medical student evaluations of my teaching and the overall course ratings did not agree.

    Date de mise en ligne : Lundi 30 janvier 2017
    Michelle Kang Kim
    Neuroendocrine Tumors: A Multidisciplinary Approach
    The incidence of neuroendocrine tumors (NETs) has increased multiple fold in the last 4 decades, providing more impetus for clinicians to understand the heterogeneity of NETs and to be able to recognize and treat these tumors effectively. For this reason, the editors of this book sought to provide a resource to those clinicians interested in this field. In this book, a diverse group of authors provides a multidisciplinary approach to the management of NETs, an understudied group of tumors. This book addresses the more commonly encountered scenarios as well as unusual challenges that may arise in the clinical course.

    Date de mise en ligne : Lundi 30 janvier 2017
    Eóin N. McNamee, Rivera-Nieves
    Defective Lymphatics in Crohn’s Disease: Tertiary Lymphoid Follicles Plug the Gap
    Randolph GJ Bala S, Rahier JF, et al. Lymphoid aggregates remodel lymphatic collecting vessels that serve mesenteric lymph nodes in Crohn disease. Am J Pathol 2016;186:3066-3077.

    Date de mise en ligne : Dimanche 29 janvier 2017
    Barham K. Abu Dayyeh, Steven Edmundowicz, Chris C. Thompson
    Clinical Practice Update: Expert Review on Endoscopic Bariatric Therapies
    Multiple endoscopic bariatric therapies (EBTs) currently are being evaluated or are in clinical use in the United States. EBTs are well positioned to fill an important gap in the management of obesity and metabolic disease. The purpose of this expert review is to update gastroenterologists on these therapies and provide practice advice on how to incorporate them into clinical practice.

    Date de mise en ligne : Dimanche 29 janvier 2017
    Colin W. Howden, Nimish B. Vakil
    Current Challenges and Emerging Solutions in Upper GI Disorders: A Brief Report of the 2016 AGA Drug Development Conference
    In October 2016, the Center for Diagnostics and Therapeutics (CDT) of the American Gastroenterological Association (AGA) held its first Drug Development Conference. Over a 2-day period, researchers, clinicians, Food and Drug Administration (FDA) personnel, and representatives of the pharmaceutical industry and patient advocacy groups convened in Washington, DC, to discuss current unmet needs and future strategies in 4 disorders of the upper gastrointestinal (GI) tract. The 4 disorders discussed were gastroesophageal reflux disease (GERD), eosinophilic esophagitis, gastroparesis, and functional dyspepsia.

    Date de mise en ligne : Dimanche 29 janvier 2017
    Jae Kwan Jun, Kui Son Choi, Hoo-Yeon Lee, Mina Suh, Boyoung Park, Seung Hoon Song, Kyu Won Jung, Chan Wha Lee, Il Ju Choi, Eun-Cheol Park, Dukhyoung Lee
    Effectiveness of the Korean National Cancer Screening Program in reducing gastric cancer mortality
    It is not clear whether screening for gastric cancer by upper endoscopy or upper gastrointestinal (UGI) series examinations (looking at the upper and middle sections of the gastrointestinal tract by imaging techniques) reduces mortality. Nevertheless, the Korean National Cancer Screening Program for gastric cancer was launched in 1999 to screen individuals 40 years and older for gastric cancer using these techniques. We evaluated the effectiveness of these techniques in gastric cancer detection and compared their effects on mortality in the Korean population.

    Date de mise en ligne : Dimanche 29 janvier 2017
    John S. Fordtran, Alan F. Hofmann
    Seventy Years of Polyethylene Glycols in Gastroenterology: The Journey of PEG 4000 and 3350 From Nonabsorbable Marker to Colonoscopy Preparation to Osmotic Laxative
    The history of polyethylene glycols (PEGs) began in 1859 when Laurenco heated ethylene glycol and 1,2-dibromoethane and isolated oligo(ethylene glycol)s by fractional distillation.1 PEGs are synthetic, uncharged, nonbranched, hydrophilic polymers made by joining units of ethylene glycol by an ether linkage. PEGs thus have the formula of H(OCH2CH2)nOH, where n denotes the number of individual ethylene oxide units. Molecular weights vary by time of the polymerization process. When the process is stopped, the result is a relatively narrow range of ethylene oxide units, and the molecular weight given for a particular PEG is a weighted average of the individual PEG molecules.

    Date de mise en ligne : Samedi 28 janvier 2017
    Colleen R. Kelly, Alison M. Kim, Loren A. Laine, Gary D. Wu
    The AGA’s Fecal Microbiota Transplantation National Registry: An Important Step Toward Understanding Risks and Benefits of Microbiota Therapeutics
    Fecal microbiota transplantation (FMT) is the delivery of stool from a healthy donor to a recipient with the goal of mitigating disease by modifying the structure and/or function of the gut microbiome. This shotgun approach has proven to be a highly effective therapeutic modality for recurrent Clostridium difficile infection (CDI).1,2 The availability of the therapeutic substrate (ie, stool), together with its ease of administration, has advanced the practice of gut microbiota manipulation in patients more rapidly than our scientific understanding.

    Date de mise en ligne : Samedi 28 janvier 2017
    Theodore R. Levin
    The Best Laid Plans: Adaptation is an Essential Part of Going From Efficacy Research to Program Implementation
    Colorectal cancer (CRC) screening is widely recommended, but underused. The US Preventive Services Task Force (USPSTF) has given CRC screening an A grade, its highest possible recommendation. Owing to a lack of clear evidence of superiority, the list of recommended tests included 7 different strategies, without identification of a preferred strategy or set of strategies.1 The USPSTF recommendation is based on randomized, controlled trial (RCT) evidence of efficacy of guaiac fecal occult blood tests and flexible sigmoidoscopy for reducing the incidence and mortality of CRC.

    Date de mise en ligne : Samedi 28 janvier 2017
    Robert A. Holt, Kyla Cochrane
    Tumor Potentiating Mechanisms of Fusobacterium nucleatum, A Multifaceted Microbe
    Fusobacterium nucleatum is an unlikely candidate for a cancer-instigating microbe. For years, F nucleatum has been regarded as a common constituent of the commensal oral microbiome and recognized as one of many different microbes associated with gingivitis and periodontitis. What has set F nucleatum apart is extreme strain-to-strain variation in its genotype, fusiform morphology, and adhesive and invasive properties.1,2 The increasingly frequent reports of associations of F nucleatum nonoral pathologies, ranging from gastrointestinal abscesses and acute appendicitis to intra-amniotic infection, and most recently colorectal,3–6 pancreatic,7 and oral cancers,8 have raised the alert level of F nucleatum to that of an emerging pathogen.

    Date de mise en ligne : Samedi 28 janvier 2017
    Keane K.Y. Lai, Soo-Mi Kweon, Feng Chi, Edward Hwang, Yasuaki Kabe, Reiichi Higashiyama, Lan Qin, Rui Yan, Raymond P. Wu, Naoaki Fujii, Samuel French, Jun Xu, Jian-Ying Wang, Ramanchadran Murali, Lopa Mishra, Ju-Seog Lee, James M. Ntambi, Hidekazu Tsukamoto
    Stearoyl-CoA Desaturase Promotes Liver Fibrosis and Tumor Development in Mice via a Wnt Positive-signaling Loop by Stabilization of Low-density Lipoprotein Receptor-related Proteins 5 and 6
    Stearoyl-CoA desaturase (SCD) synthesizes monounsaturated fatty acids (MUFAs) and has been associated with development of metabolic syndrome, tumorigenesis, and stem cell characteristics. We investigated whether and how SCD promotes liver fibrosis and tumor development in mice.

    Date de mise en ligne : Vendredi 27 janvier 2017
    Edward J. Gane, Robert H. Hyland, Yin Yang, Evguenia Svarovskaia, Luisa M. Stamm, Diana M. Brainard, John G. McHutchison, Catherine A.M. Stedman
    Efficacy of Ledipasvir Plus Sofosbuvir for 8 or 12 Weeks in Patients With Hepatitis C Virus Genotype 2 Infection
    Patients with chronic hepatitis C virus (HCV) genotype 2 have high rates of response to treatment with sofosbuvir and ribavirin. However, ribavirin is associated with hemolytic events and is poorly tolerated by some patients. We evaluated the effectiveness of sofosbuvir and ledipasvir in treatment-naïve and treatment-experienced patients with HCV genotype 2, comparing 12 versus 8 weeks of treatment.

    Date de mise en ligne : Jeudi 26 janvier 2017
    Michael J. Rosen, Rebekah Karns, Jefferson E. Vallance, Ramona Bezold, Amanda Waddell, Margaret H. Collins, Yael Haberman, Phillip Minar, Robert N. Baldassano, Jeffrey S. Hyams, Susan S. Baker, Richard Kellermayer, Joshua D. Noe, Anne M. Griffiths, Joel R. Rosh, Wallace V. Crandall, Melvin B. Heyman, David R. Mack, Michael D. Kappelman, James Markowitz, Dedrick E. Moulton, Neal S. Leleiko, Thomas D. Walters, Subra Kugathasan, Keith T. Wilson, Simon P. Hogan, Lee A. Denson
    Mucosal Expression of Type 2 and Type 17 Immune Response Genes Distinguishes Ulcerative Colitis From Colon-only Crohn’s Disease in Treatment-naïve Pediatric Patients
    There is controversy over the role of the type 2 immune response in pathogenesis of ulcerative colitis (UC)—few data are available from treatment-naïve patients. We investigated whether genes associated with a type 2 immune response in the intestinal mucosa are upregulated in treatment-naïve pediatric patients with UC, compared to patients with Crohn’s disease (CD)-associated colitis or without inflammatory bowel disease (IBD), and whether expression levels associate with clinical outcomes.

    Date de mise en ligne : Jeudi 26 janvier 2017
    Cristina Alonso, David Fernández-Ramos, Marta Varela-Rey, Ibon Martínez-Arranz, Nicolás Navasa, Sebastiaan M. Van Liempd, José L. Lavin, Rebeca Mayo, Concetta P. Ilisso, Virginia G. de Juan, Marta Iruarrizaga-Lejarreta, Laura delaCruz-Villar, Itziar Mincholé, Aaron Robinson, Javier Crespo, Antonio Martín-Duce, Manuel Romero-Gomez, Holger Sann, Julian Platon, Jennifer Van Eyk, Patricia Aspichueta, Mazen Noureddin, Juan M. Falcón-Pérez, Juan Anguita, Ana M. Aransay, María Luz Martínez-Chantar, Shelly C. Lu, José M. Mato
    Metabolomic Identification of Subtypes of Nonalcoholic Steatohepatitis
    Nonalcoholic fatty liver disease (NAFLD) is a consequence of defects in diverse metabolic pathways that involve hepatic accumulation of triglycerides. Features of these aberrations might determine whether NAFLD progresses to nonalcoholic steatohepatitis (NASH). We investigated whether the diverse defects observed in patients with NAFLD are due to different NAFLD subtypes with specific serum metabolomic profiles, and whether these can distinguish patients with NASH from patients with simple steatosis.

    Date de mise en ligne : Mardi 24 janvier 2017
    Vittoria Massafra, Alexandra Milona, Harmjan R. Vos, Rúben J.J. Ramos, Johan Gerrits, Ellen C.L. Willemsen, José M. Ramos Pittol, Noortje Ijssennagger, Martin Houweling, Hubertus C.M.T. Prinsen, Nanda M. Verhoeven-Duif, Boudewijn M. Burgering, Saskia W.C. van Mil
    Farnesoid X Receptor Activation Promotes Hepatic Amino Acid Catabolism and Ammonium Clearance in Mice
    The nuclear receptor subfamily 1 group H member 4 (NR1H4 or farnesoid X receptor, FXR) regulates bile acid synthesis, transport, and catabolism. FXR also regulates post-prandial lipid and glucose metabolism. We performed quantitative proteomic analyses of liver tissues from mice to evaluate these functions and investigate whether FXR regulates amino acid metabolism.

    Date de mise en ligne : Mardi 24 janvier 2017
    Gilberto Silva-Junior, Fanny Turon, Anna Baiges, Eira Cerda, Ángeles García-Criado, Annabel Blasi, Ferran Torres, Virginia Hernandez-Gea, Jaume Bosch, Juan Carlos Garcia-Pagan
    Timing Affects Measurement of Portal Pressure Gradient After Placement of Transjugular Intrahepatic Porto-systemic Shunts in Patients With Portal Hypertension
    A reduction in portal pressure gradient (PPG) to below 12 mmHg after placement of a transjugular intrahepatic porto-systemic shunt (TIPS) correlates with the absence of further bleeding or ascites at follow-up examinations of patients with cirrhosis. The PPG is usually measured immediately after placement of the TIPS, when different circumstances can affect PPG values - this could affect determination of risk for decompensation. We investigated variations in PPG measurements collected at different time points after TIPS, aiming to identify a time point after which PPG values were best maintained.

    Date de mise en ligne : Lundi 23 janvier 2017
    Exam 5: American Gastroenterological Association Institute Technical Review on Initial Testing and Management of Acute Liver Disease

    Date de mise en ligne : Lundi 23 janvier 2017
    Exam 4: American Gastroenterological Association Institute Guidelines for the Diagnosis and Management of Acute Liver Failure

    Date de mise en ligne : Lundi 23 janvier 2017
    Sho Endo, Kohei Nakata, Kenoki Ohuchida, Shin Takesue, Hiromichi Nakayama, Toshiya Abe, Kazuhiro Koikawa, Takashi Okumura, Masafumi Sada, Kohei Horioka, Biao Zheng, Yusuke Mizuuchi, Chika Iwamoto, Masaharu Murata, Taiki Moriyama, Yoshihiro Miyasaka, Takao Ohtsuka, Kazuhiro Mizumoto, Yoshinao Oda, Makoto Hashizume, Masafumi Nakamura
    Autophagy is Required for Activation of Pancreatic Stellate Cells, Associated With Pancreatic Cancer Progression and Promotes Growth of Pancreatic Tumors in Mice
    Pancreatic stellate cells (PSCs) change from a quiescent to activated state in the tumor environment and secrete extracellular matrix (ECM) molecules and cytokines to increase the aggressiveness of tumors. However, it is not clear how PSCs are activated to produce these factors, or whether this process can be inhibited. PSCs have morphological and functional similarities to hepatic stellate cells, which undergo autophagy to promote fibrosis and tumor growth. We investigated whether autophagy activates PSCs, which promotes development of the tumor stroma and growth of pancreatic tumors in mice.

    Date de mise en ligne : Lundi 23 janvier 2017
    Ho Tsoi, Eagle SH. Chu, Xiang Zhang, Jianqiu Sheng, Daniel Nakatsu, Siew C. Ng, Anthony WH. Chan, Francis KL. Chan, Joseph JY. Sung, Jun Yu
    Peptostreptococcus anaerobius Induces Intracellular Cholesterol Biosynthesis in Colon Cells to Induce Proliferation and Causes Dysplasia in Mice
    Stool samples from patients with colorectal cancer (CRC) have a higher abundance of Peptostreptococcus anaerobius than stool from individuals without CRC, based on metagenome sequencing. We investigated whether P anaerobius contributes to colon tumor formation in mice and its possible mechanisms of carcinogenesis.

    Date de mise en ligne : Lundi 23 janvier 2017
    Rupert W. Leong, Marie Ooi, Crispin Corte, Yunki Yau, Melissa Kermeen, Peter H. Katelaris, Charles McDonald, Meng Ngu
    Full-spectrum Endoscopy Improves Surveillance for Dysplasia in Patients With Inflammatory Bowel Diseases
    Inflammatory bowel diseases (IBD) increase the risk of colorectal cancer. Surveillance colonoscopy with chromoendoscopy is recommended, but conventional forward-viewing colonoscopy (FVC) detects dysplasia with low levels of sensitivity. Full-spectrum endoscopy (FUSE) incorporates 2 additional lateral cameras to the forward camera of thecolonoscope, allowing endoscopists to view behind folds and in blind spots, which might increase dysplasia detection. We compared FUSE vs FVC in the detection of dysplasia in patients with IBD.

    Date de mise en ligne : Vendredi 20 janvier 2017
    Lincon A. Stamp, Rachel M. Gwynne, Jaime P.P. Foong, Alan E. Lomax, Marlene M. Hao, David I. Kaplan, Christopher A. Reid, Steven Petrou, Andrew M. Allen, Joel C. Bornstein, Heather M. Young
    Optogenetic demonstration of functional innervation of mouse colon by neurons derived from transplanted neural cells
    Cell therapy offers the potential to treat gastrointestinal motility disorders caused by diseased or absent enteric neurons. We examined whether neurons generated from transplanted enteric neural cells provide a functional innervation of bowel smooth muscle in mice.

    Date de mise en ligne : Jeudi 19 janvier 2017
    Vasiliki Koliaraki, Charles K. Pallangyo, Florian R. Greten, George Kollias
    Mesenchymal Cells in Colon Cancer
    Mesenchymal cells in the intestine comprise a variety of cell types, of diverse origins, functions, and molecular markers. They provide mechanical and structural support and have important functions during intestinal organogenesis, morphogenesis, and homeostasis. Recent studies of the human transcriptome have revealed their importance in development of colorectal cancer (CRC), and studies from animal models have provided evidence for their roles in pathogenesis of colitis-associated cancer and sporadic CRC.

    Date de mise en ligne : Samedi 14 janvier 2017
    Amber M. Moreland, Carol A. Santa Ana, John R. Asplin, Joseph A. Kuhn, Ross P. Holmes, Jason A. Cole, Elizabeth A. Odstrcil, Thomas G. Van Dinter, Juan G. Martinez, John S. Fordtran
    Steatorrhea and Hyperoxaluria in Severely Obese Patients Before and After Roux-en-Y Gastric Bypass
    Hyperoxaluria after Roux-en-Y gastric bypass (RYGB) is generally attributed to fat malabsorption. If hyperoxaluria is indeed caused by fat malabsorption, magnitudes of hyperoxaluria and steatorrhea should correlate. Severely obese patients, prior to bypass, ingest excess dietary fat, which can produce hyperphagic steatorrhea. The primary objective of the study was to determine whether urine oxalate excretion correlates with elements of fat balance in severely obese patients before and after RYGB.

    Date de mise en ligne : Vendredi 13 janvier 2017
    David Goldberg, Ivo C. Ditah, Kia Saeian, Mona Lalehzari, Andrew Aronsohn, Emmanuel C. Gorospe, Michael Charlton
    Changes in the Prevalence of Hepatitis C Virus Infection, Non-alcoholic Steatohepatitis, and Alcoholic Liver Disease Among Patients with Cirrhosis or Liver Failure on the Waitlist for Liver Transplantation
    Concurrent to development of more effective drugs for treatment of hepatitis C virus (HCV), infection, there has been an increase in the incidence of non-alcoholic fatty liver disease (NAFLD). Data indicate that liver transplantation prolongs survival times of patient with acute hepatitis associated with alcoholic liver disease (ALD). We compared data on disease prevalence in the population with data from liver transplantation waitlists to evaluate changes in the burden of liver disease in the United States.

    Date de mise en ligne : Vendredi 13 janvier 2017
    Carl M. Schoellhammer, Gregory Y. Lauwers, Jeremy A. Goettel, Matthias A. Oberli, Cody Cleveland, June Y. Park, Daniel Minahan, Yiyun Chen, Daniel G. Anderson, Ana Jaklenec, Scott B. Snapper, Robert Langer, Giovanni Traverso
    Ultrasound-Mediated Delivery of RNA to Colonic Mucosa of Live Mice
    It is a challenge to deliver nucleic acids to gastrointestinal (GI) tissues due to their size and need for intracellular delivery. They are also extremely susceptible to degradation by nucleases, which are ubiquitous in the GI tract. We investigated whether ultrasound, which can permeabilize tissue through a phenomenon known as transient cavitation, can be used to deliver RNA to the colonic mucosa of living mice.

    Date de mise en ligne : Vendredi 13 janvier 2017
    Yoichiro Asai, Tetsuya Yamada, Sohei Tsukita, Kei Takahashi, Masamitsu Maekawa, Midori Honma, Masanori Ikeda, Keigo Murakami, Yuichiro Munakata, Yuta Shirai, Shinjiro Kodama, Takashi Sugisawa, Yumiko Chiba, Yasuteru Kondo, Keizo Kaneko, Kenji Uno, Shojiro Sawada, Junta Imai, Yasuhiro Nakamura, Hiroaki Yamaguchi, Kozo Tanaka, Hironobu Sasano, Nariyasu Mano, Yoshiyuki Ueno, Tooru Shimosegawa, Hideki Katagiri
    Activation of the Hypoxia Inducible Factor 1 Alpha Subunit Pathway in Steatotic Liver Contributes to Formation of Cholesterol Gallstones
    Hypoxia inducible factor 1 alpha subunit (HIF1A) is a transcription factor that controls the cellular response to hypoxia and is activated in hepatocytes of patients with non-alcoholic fatty liver disease (NAFLD). NAFLD increases risk for cholesterol gallstone disease by unclear mechanisms. We studied the relationship between HIF1A and gallstone formation associated with liver steatosis.

    Date de mise en ligne : Lundi 09 janvier 2017
    Josepmaria Argemí, Theresia R. Kress, Haisul CY. Chang, Cristina Bértolo, Roberto Ferrero, Haritz Moreno, Manuela González-Aparicio, Rubén Hernández-Alcoceba, Victor Segura, Iker Uriarte, Laura Guembe, Matias A. Avila, Bruno Amati, Jesús Prieto, Tomás Aragón
    X-box Binding Protein 1 Regulates Unfolded Protein, Acute-phase, and DNA Damage Responses During Regeneration of Mouse Liver
    Liver regeneration after partial hepatectomy increases the protein folding burden at the endoplasmic reticulum (ER) of remnant hepatocytes, resulting in induction of the unfolded protein response (UPR). We investigated the role of the core UPR transcription factor X-box binding protein 1 (XBP1) in liver regeneration using genome-wide chromatin immunoprecipitation analysis.

    Date de mise en ligne : Vendredi 06 janvier 2017
    Fabiane Klem, Akhilesh Wadhwa, Larry Prokop, Wendy Sundt, Gianrico Farrugia, Michael Camilleri, Siddharth Singh, Madhusudan Grover
    Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis
    Foodborne illness affects 15% of the US population each year, and is a risk factor for irritable bowel syndrome (IBS). We evaluated risk of, risk factors for, and outcomes of IBS after infectious enteritis.

    Date de mise en ligne : Jeudi 05 janvier 2017
    Lisa L. Strate, Brieze R. Keeley, Yin Cao, Kana Wu, Edward L. Giovannucci, Andrew T. Chan
    Western Dietary Pattern Increases, and Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study
    Dietary fiber is implicated as a risk factor for diverticulitis. Analyses of dietary patterns may provide information on risk beyond those of individual foods or nutrients. We examined whether major dietary patterns are associated with risk of incident diverticulitis.

    Date de mise en ligne : Jeudi 05 janvier 2017
    Jan Freark de Boer, Marleen Schonewille, Marije Boesjes, Henk Wolters, Vincent W. Bloks, Trijnie Bos, Theo H. van Dijk, Angelika Jurdzinski, Renze Boverhof, Justina C. Wolters, Jan A. Kuivenhoven, Jan M. van Deursen, Ronald P.J. Oude Elferink, Antonio Moschetta, Claus Kremoser, Henkjan J. Verkade, Folkert Kuipers, Albert K. Groen
    Intestinal Farnesoid X Receptor Controls Transintestinal Cholesterol Excretion in Mice
    The role of the intestine in the maintenance of cholesterol homeostasis is increasingly recognized. Fecal excretion of cholesterol is the last step in the atheroprotective reverse cholesterol transport pathway, to which biliary and transintestinal cholesterol excretion (TICE) contribute. The mechanisms controlling the flux of cholesterol through the TICE pathway are, however, poorly understood. We aimed to identify mechanisms that regulate and stimulate TICE.

    Date de mise en ligne : Jeudi 05 janvier 2017
    Xi-Meng Lin, Liang Hu, Jin Gu, Ruo-Yu Wang, Liang Li, Jing Tang, Bao-Hua Zhang, Xing-Zhou Yan, Yan-Jing Zhu, Cong-Li Hu, Wei-Ping Zhou, Shao Li, Jing-Feng Liu, Frank J. Gonzalez, Meng-Chao Wu, Hong-Yang Wang, Lei Chen
    Choline Kinase α Mediates Interactions Between the Epidermal Growth Factor Receptor and Mechanistic Target of Rapamycin Complex 2 in Hepatocellular Carcinoma Cells to Promote Drug Resistance and Xenograft Tumor Progression
    Choline kinase α (CHKA) catalyzes conversion of choline to phosphocholine and can contribute to carcinogenesis. Little is known about the role of CHKA in the pathogenesis of hepatocellular carcinoma (HCC).

    Date de mise en ligne : Jeudi 05 janvier 2017
    Bradley Anderson, Seth Sweetser
    A Rare Endoscopic Clue to a Common Clinical Condition
    Question: A 64-year-old woman presented to a local emergency department after noting large-volume passage of bright red blood from her colostomy site over several days. She denied any associated abdominal pain, recent changes in bowel pattern, nausea, vomiting, orthostatic symptoms, abdominal trauma, NSAID use, or recent manipulation of the ostomy concurrent with her symptoms. Her past medical history was significant for hypertension and remote stage 1B cervical cancer complicated by radiation-induced enteritis, proctitis, and terminal ileal stricture.

    Date de mise en ligne : Mercredi 04 janvier 2017
    Thomas Blixt, Kim Oren Gradel, Christian Homann, Jakob Benedict Seidelin, Kristian Schønning, Anne Lester, Jette Houlind, Marie Stangerup, Magnus Gottlieb, Jenny Dahl Knudsen
    Asymptomatic carriers contribute to nosocomial Clostridium difficile infection: a cohort study of 4508 patients
    Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects of of asymptomatic carriers on nosocomial C difficile infections.

    Date de mise en ligne : Mercredi 04 janvier 2017
    Yuli Watanabe, Laure Stanchina, Laure Lecerf, Nadjet Gacem, Andrea Conidi, Viviane Baral, Veronique Pingault, Danny Huylebroeck, Nadege Bondurand
    Differentiation of Mouse Enteric Nervous System Progenitor Cells is Controlled by Endothelin 3 and Requires Regulation of Ednrb by SOX10 and ZEB2
    Maintenance and differentiation of progenitor cells in the developing enteric nervous system (ENS) are controlled by molecules such as the signaling protein endothelin 3 (EDN3), its receptor (the endothelin receptor type B, EDNRB), and the transcription factors SRY-box 10 (SOX10) and zinc finger E-box binding homeobox 2 (ZEB2). We used enteric progenitor cell (EPC) cultures and mice to study the roles of these proteins in enteric neurogenesis and their cross regulation.

    Date de mise en ligne : Mercredi 04 janvier 2017
    Robert A. Enns, Lawrence Hookey, David Armstrong, Charles N. Bernstein, Steven J. Heitman, Christopher Teshima, Grigorios I. Leontiadis, Frances Tse, Daniel Sadowski
    Clinical Practice Guidelines for the Use of Video Capsule Endoscopy
    Video capsule endoscopy (CE) provides a noninvasive option to assess the small intestine, but its use with respect to endoscopic procedures and cross-sectional imaging varies widely. The aim of this consensus was to provide guidance on the appropriate use of CE in clinical practice.

    Date de mise en ligne : Mercredi 04 janvier 2017
    Vu Q. Nguyen, Douglas J. Grider, Paul Yeaton
    A Rare Cause of Colonic Stricture
    Question: A 57-year-old man presented to our hospital with a week of generalized weakness and abdominal pain. Relevant medications included diclofenac 75 mg twice daily, aspirin 81 mg, and clopidogrel 75 mg/d. Vital signs were normal. Physical examination showed mild diffuse abdominal tenderness. Admission blood work revealed a hemoglobin of 8.8 g/dL, decreased from a baseline hemoglobin of 12 g/dL. The patient did not have overt gastrointestinal bleeding, but tested positive for fecal occult blood.

    Date de mise en ligne : Mercredi 04 janvier 2017
    Kherru Sarah Sim, Chung Yip Chan, Ser Yee Lee
    Spontaneous Self-Expulsion of a Large Stone From the Abdomen
    Question: A 70-year-old man presented to the outpatient clinic with a 4-cm stone that he described to have been expelled from a wound in his abdomen, after experiencing a bout of colicky abdominal pain. The stone was ovoid-shaped, hyperpigmented, solid, and measured approximately 4 cm in length (Figure A). He was afebrile and on physical examination, he was alert and comfortable. There was an 0.5-cm wound in the right hypochondrium (Figure B). It was clean, with no signs of infection, and no pus was expressed.

    Date de mise en ligne : Mardi 03 janvier 2017
    Susan M. Hutfless, Anthony N. Kalloo
    Commentary on the 2016 Multi-Society Task Force Endoscope Reprocessing Guidelines
    “Mrs. Joe was a very clean housekeeper, but had an exquisite art of making her cleanliness more uncomfortable and unacceptable than dirt itself.”— Charles Dickens, Great Expectations

    Date de mise en ligne : Mardi 03 janvier 2017
    Amir Klein, Michael J. Bourke
    How to Perform High-Quality Endoscopic Mucosal Resection During Colonoscopy
    Colonoscopy with polypectomy reduces mortality from colorectal cancer.1,2 A small fraction of polyps are >2 cm and termed lateral spreading lesions (LSLs) of the colon.3 These polyps require advanced resection techniques such as endoscopic mucosal resection (EMR) for safe and effective removal. However, colonic EMR is not routinely part of the general endoscopic curriculum available to gastroenterologists upon completion of their training. It requires dedicated training in advanced endoscopic resection techniques, the acquisition of clinical and interpretive skills, and the knowledge and ability to manage complications.

    Date de mise en ligne : Mardi 03 janvier 2017
    Andrew T. Chan, Christopher S. Williams
    Covering the Cover
    In a nationwide, population-based study, exposure to endoscopy during pregnancy was associated with a minor increased risk of preterm birth or small for gestational age, but not congenital malformations or stillbirth.

    Date de mise en ligne : Mardi 03 janvier 2017
    Steven K. Herrine, Paul Moayyedi, Robert S. Brown, Yngve T. Falck-Ytter
    American Gastroenterological Association Institute Technical Review on Initial Testing and Management of Acute Liver Disease
    Acute liver failure (ALF) is an uncommon but dramatic clinical syndrome characterized by rapid loss of hepatocyte function in an individual without pre-existing liver disease. The syndrome is rare in the United States, with an estimated incidence of 2000 cases each year.1 Acute liver failure should be suspected in any patient with new-onset liver disease associated with an increase of prothrombin time. A frequently used definition of ALF is the development of encephalopathy within a short interval after the initial onset of liver disease.

    Date de mise en ligne : Mardi 03 janvier 2017
    Steven L. Flamm, Yu-Xiao Yang, Siddharth Singh, Yngve T. Falck-Ytter, AGA Institute Clinical Guidelines Committee
    American Gastroenterological Association Institute Guidelines for the Diagnosis and Management of Acute Liver Failure
    This guideline was developed using a process outlined elsewhere.1 Briefly, the American Gastroenterological Association Institute (AGA) process for developing clinical practice guidelines incorporates Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology2 and best practices as outlined by the Institute of Medicine.3 GRADE methodology was used to prepare the background information for the guideline and the technical review that accompanies it.4 Optimal understanding of this guideline will be enhanced by reading applicable portions of the technical review.

    Date de mise en ligne : Mardi 03 janvier 2017
    L.G. Draijer, J.M. van den Berg, B.G.P. Koot
    An Unusual Cause of a Recurrent Liver Abscess in a Young Boy
    Question: A boy, 6 months of age and previously healthy, was evaluated for unexplained fever of 2 weeks’ duration. He was ill appearing and had a high white blood cell count (19.5 × 109/L) and C-reactive protein (CRP) of 265 mg/L. The diagnosis of a liver abscess supposedly by a bacterial pathogen was made based on abdominal ultrasound (US) examination, which showed an abscess in the left lobe (segments 2 and 3). The abscess was drained and amoxicillin/clavulanic acid, which had been initiated before drainage, was continued for 5 weeks.

    Date de mise en ligne : Mardi 03 janvier 2017
    Derek J. Erstad, Leandra S. Krowsoski, Haytham M.A. Kaafarani
    Abdominal Pain After Colonoscopy
    Question: A 56-year-old woman with no prior medical history presented to the emergency department with abdominal pain 12 hours after a screening colonoscopy. The procedure was uneventful with no suspicious masses or lesions detected and no biopsies performed. The patient was discharged to home after recovery from anesthesia, where she slept for several hours. She was awoken with right-sided abdominal pain, nausea, vomiting, and abdominal distension. Her nausea, distension, and abdominal pain worsened as the evening progressed, prompting the patient to seek evaluation at the emergency department.

    Date de mise en ligne : Mardi 03 janvier 2017
    Sarah Melloul, Mostafa El Hajjam, Catherine Julié
    A Subhepatic Calcified Cyst
    Question: A 68-year-old woman, asymptomatic, with no medical history, underwent an abdominal computed tomography scan in a traumatic context. An enhanced series (Figure A) revealed a 4-cm cystic mass with tissue and calcified rim components located under the left liver (Figure A, arrow) inside the ligamentum teres. The lesion was supplied by a left hepatic artery branch. The frontal view showed the mass drainage into the left external iliac vein through a long pedicle (the umbilicus vein connected to the left inferior epigastric vein) (v).

    Date de mise en ligne : Mardi 03 janvier 2017
    Malav P. Parikh, Niyati M. Gupta, Madhusudhan R. Sanaka
    A Congenital Gastric Anomaly That Appears as a Tumor of the Gastrointestinal Stroma
    Question: A 25-year-old man was admitted to the hospital with complaints of nausea, vomiting and abdominal pain of 2-3 months’ duration. He reported early satiety, poor appetite and weight loss of 20 lbs over 3 months. On examination, he was noted to be hypotensive (blood pressure, 96/60 mm Hg) and tachycardic (heart rate, 116/min). Complete blood count, serum electrolytes, liver function tests, and lipase levels were within normal limits.

    Date de mise en ligne : Mardi 03 janvier 2017
    Niccolo’ Petrucciani, Tarek Debs, Jean Gugenheim
    Painful Perineal Mass: What Is the Diagnosis?
    Question: A 69-year-old woman presented to the emergency department of our hospital for a painful perineal mass, which had appeared 6 hours before. Her past medical history included chronic constipation, Waldestrom disease, hypothyroidism, and coronary artery disease. The perineal examination showed a nonreducible, edematous, and partially necrotic mass, exteriorized from the anus (Figure A). Abdominal examination was normal. Vital signs were normal. Blood tests showed an inflammatory syndrome with 11 × 109/L leucocytes and C-reactive protein at 73.9 mg/L.

    Date de mise en ligne : Mardi 03 janvier 2017
    Chung-Liang Chiang, Zheng-Yi Huang, Bao-Chung Chen
    An Unusual Painless Groin Mass in an Elderly Man
    Question: An 89-year-old man had a painless mass in the right inguinal area for >6 months. Anorexia and unintentional weight loss occurred over the past month. His medical history was unremarkable. Physical examination revealed a fixed, hard, nonpulsatile, nontender, and irreducible lesion in the right groin (Figure A). The abdomen was soft, with no pain, and normal bowel sounds. The supine abdominal radiograph showed a normal bowel gas pattern. Sonogram of right inguinal region disclosed a 62 × 25 × 23-mm, well-circumscribed, heterogeneous, hypoechoic, and vascularized tumor (Figure B, white arrowheads).

    Date de mise en ligne : Mardi 03 janvier 2017
    Rafael Noronha Cavalcante, Fernanda Uchiyama, Francisco Cesar Carnevale
    A Rare Cause of Massive Gastrointestinal Bleeding
    Question: A 50-year-old male patient with squamous cell carcinoma and a previous esophagogastroduodenoscopy revealing a stenotic and infiltrative lesion at 21 to 30 cm from the incisors was admitted with history of intermittent upper gastrointestinal bleeding for the last 6 days, presenting as hematemesis and melena (Figure A). A computed tomography scan demonstrated a luminal narrowing of the esophagus at the middle third, with air and fluid in the proximal esophagus, which was mildly dilated (Figure B).

    Date de mise en ligne : Mardi 03 janvier 2017
    Ming-Chang Ku, Pei-Yu Lee, Victor C. Kok
    An Unusual Case of Cholangitis
    Question: A 52-year-old woman without any significant medical history presented to the emergency department with a 2-day history of poor appetite, chills, and abdominal pain. The patient was alert at the emergency room. The initial temperature was 98.6°F (37°C), pulse 132 beats/min, respiratory rate 18 breaths/min, and blood pressure 97/57 mm Hg. The patient exhibited scleral icterus and yellowish skin color. Physical examination revealed a distended abdomen with muscle guarding and right upper quadrant tenderness.

    Date de mise en ligne : Samedi 31 décembre 2016
    Nikhil Vergis, Stephen R. Atkinson, Suzanne Knapp, James Maurice, Michael Allison, Andrew Austin, Ewan H. Forrest, Steven Masson, Anne McCune, David Patch, Stephen Ryder, Mark Wright, Mark R. Thursz
    Patients With Severe Alcoholic Hepatitis Given Prednisolone Therapy Who Have High Circulating Levels Of Bacterial DNA are at Increased Risk for Developing Infections
    Infections are common in patients with severe alcoholic hepatitis (SAH), but little information is available on how to predict their development or their effects on patients. Prednisolone is advocated for treatment of SAH, but may increase susceptibility to infection. We compared the effects of infection on clinical outcomes of patients treated with and without prednisolone, and identified risk factors for development of infection in SAH.

    Date de mise en ligne : Samedi 31 décembre 2016
    Neena S. Abraham, Peter A. Noseworthy, Xiaoxi Yao, Lindsey R. Sangaralingham, Nilay D. Shah
    Gastrointestinal Safety of Direct Oral Anticoagulants: A Large Population-Based Study
    Direct oral anticoagulant (DOAC) agents increase the risk of gastrointestinal (GI) bleeding. We investigated which DOAC had the most favorable GI safety profile and compared differences among these drugs in age-related risk of GI bleeding.

    Date de mise en ligne : Samedi 31 décembre 2016
    Xiaoteng Qin, Shangming Liu, Qiulun Lu, Meng Zhang, Xiuxin Jiang, Sanyuan Hu, Jingxin Li, Cheng Zhang, Jiangang Gao, Min-Sheng Zhu, Yun Zhang, Wencheng Zhang
    Heterotrimeric G Stimulatory Protein α Subunit Is Required for Intestinal Smooth Muscle Contraction in Mice
    The α subunit of the heterotrimeric G stimulatory protein (Gsa), encoded by the guanine nucleotide binding protein, α-stimulating gene (Gnas, in mice), is expressed ubiquitously and mediates receptor-stimulated production of cyclic adenosine monophosphate and activation of the protein kinase A signaling pathway. We investigated the roles of Gsa in vivo in smooth muscle cells of mice.

    Date de mise en ligne : Samedi 31 décembre 2016
    Paola Nicoletti, Guruprasad P. Aithal, Einar S. Bjornsson, Raul J. Andrade, Ashley Sawle, Marco Arrese, Huiman X. Barnhart, Emmanuelle Bondon-Guitton, Paul H. Hayashi, Fernando Bessone, Alfonso Carvajal, Ingolf Cascorbi, Elizabeth T. Cirulli, Naga Chalasani, Anita Conforti, Sally A. Coulthard, Mark J. Daly, Christopher P. Day, John F. Dillon, Robert J. Fontana, Jane I. Grove, Pär Hallberg, Nelia Hernández, Luisa Ibáñez, Gerd A. Kullak-Ublick, Tarja Laitinen, Dominique Larrey, M. Isabel Lucena, Anke H. Maitland-van der Zee, Jennifer H. Martin, Mariam Molokhia, Munir Pirmohamed, Elizabeth E. Powell, Shengying Qin, Jose Serrano, Camilla Stephens, Andrew Stolz, Mia Wadelius, Paul B. Watkins, Aris Floratos, Yufeng Shen, Matthew R. Nelson, Thomas J. Urban, Ann K. Daly, International DILI consortium (iDILIC), Drug-induced liver injury network (DILIN) investigators and International Serious Adverse Events Consortium (iSAEC)
    Association of Liver Injury From Specific Drugs, or Groups of Drugs, With Polymorphisms in HLA and Other Genes in a Genome-wide Association Study
    We performed a genome-wide association study (GWAS) to identify genetic risk factors for drug-induced liver injury (DILI) from licensed drugs without previously reported genetic risk factors.

    Date de mise en ligne : Samedi 31 décembre 2016
    Daniela Sia, Augusto Villanueva, Scott L. Friedman, Josep M. Llovet
    Liver Cancer Cell of Origin, Molecular Class, and Effects on Patient Prognosis
    Primary liver cancer is the second leading cause of cancer-related death worldwide and therefore a major public health challenge. We review hypotheses of the cell of origin of liver tumorigenesis and clarify the classes of liver cancer based on molecular features and how they affect patient prognosis. Primary liver cancer comprises hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (iCCA), and other rare tumors, notably fibrolamellar carcinoma and hepatoblastoma. The molecular and clinical features of HCC versus iCCA are distinct, but these conditions have overlapping risk factors and pathways of oncogenesis.

    Date de mise en ligne : Vendredi 30 décembre 2016
    Exam 3: Isocaloric Diets High in Animal or Plant Protein Reduce Liver Fat and Inflammation in Individuals With Type 2 Diabetes

    Date de mise en ligne : Vendredi 30 décembre 2016
    Exam 2: A Rare Endoscopic Clue to a Common Clinical Condition

    Date de mise en ligne : Vendredi 30 décembre 2016
    Exam 1: SLC25A22 Promotes Proliferation and Survival of Colorectal Cancer Cells With KRAS Mutations and Xenograft Tumor Progression in Mice via Intracellular Synthesis of Aspartate

    Date de mise en ligne : Mercredi 28 décembre 2016
    Haleh Vaziri, Joseph C. Anderson
    Is Chromoendoscopy Superior to Standard Colonoscopy for Long-term Surveillance of Patients With Inflammatory Bowel Disease?
    Marion JF, Waye JD, Israel Y, et al; Chromoendoscopy Study Group at Mount Sinai School of Medicine. Chromoendoscopy is more effective than standard colonoscopy in detecting dysplasia during long-term surveillance of patients with colitis. Clin Gastroenterol Hepatol 2016;14:713–719.

    Date de mise en ligne : Mercredi 28 décembre 2016
    Douglas G. Adler

    When I was a first year GI fellow at the Mayo Clinic in Rochester, Minnesota, I quickly discovered that the world of gastroenterology was divided into 2 camps: people who relied on Yamada’s “Textbook of Gastroenterology” and those who leaned toward Sleisinger and Fordtran’s “Gastrointestinal and Liver Disease.” I distinctly recall one of my attending physicians impressing on me the gravity of the decision I would be making when selecting one over the other. Both are considered definitive textbooks of gastroenterology and hepatology, and both are exhaustive, 2-volume sets that cover, essentially, everything one could need to know as a practicing GI physician, yet these texts each have a distinctly different tone and tenor.

    Date de mise en ligne : Mardi 27 décembre 2016
    George Koutsoudakis, Sofía Pérez-del-Pulgar, Xavier Forns
    Occult Hepatitis C Virus Infection: Are We Digging Too Deep?
    Occult hepatitis C virus (HCV) infection (OCI) is the detection of HCV RNA in either liver tissue or peripheral blood mononuclear cells (PBMC) despite repeatedly undetectable levels of HCV RNA in serum.1 From a clinical perspective, OCI has been linked to liver disease of unknown origin (anti-HCV negative, serum HCV RNA negative), as well as to persistence of abnormal liver tests in some patients who achieve spontaneous or treatment-induced HCV RNA clearance from serum (anti-HCV positive, serum HCV RNA negative).

    Date de mise en ligne : Mardi 27 décembre 2016
    Mitchell S. Cappell
    Evaluating the Safety of Endoscopy During Pregnancy: The Robust Statistical Power vs Limitations of a National Registry Study
    From 1957 to 1962, an epidemic of about 4000 cases of phocomelia, a severe, congenital malformation of deformed or rudimentary limbs, occurred from in utero fetal exposure to thalidomide1 after its administration to pregnant mothers to treat nausea and vomiting or anxiety during the first trimester of pregnancy, even though thalidomide had been shown to be safe and efficacious in both nonpregnant laboratory animals and nonpregnant subjects enrolled in clinical trials.2 The medical community therefore codified through the United States Food and Drug Administration Drug Regulation Act of 1962 that the safety of drugs during pregnancy cannot be extrapolated from clinical studies in nonpregnant patients, but must be demonstrated directly by clinical studies in pregnant patients.

    Date de mise en ligne : Mardi 27 décembre 2016
    Thomas Karlas, David Petroff, Johannes Wiegand
    Collaboration, Not Competition: The Role of Magnetic Resonance, Transient Elastography, and Liver Biopsy in the Diagnosis of Nonalcoholic Fatty Liver Disease
    The global obesity pandemic necessitates characterization of nonalcoholic fatty liver disease (NAFLD) in an extremely large and growing number of patients. This disease subsumes hepatic fat, inflammation, and fibrosis. Fibrosis is of particular interest, being the strongest predictor of mortality,1,2 and noninvasive techniques for assessing its severity are becoming part of routine care, at least in Asia and Europe.3 As we endeavor to understand NAFLD more fully, steatosis quantification has become increasingly successful, although we are still struggling to understand its clinical implications.

    Date de mise en ligne : Vendredi 23 décembre 2016
    Ruta Sahasrabudhe, Paul Lott, Mabel Bohorquez, Ted Toal, Ana P. Estrada, John J. Suarez, Alejandro Brea-Fernández, José Cameselle-Teijeiro, Carla Pinto, Irma Ramos, Alejandra Mantilla, Rodrigo Prieto, Alejandro Corvalan, Enrique Norero, Carolina Alvarez, Teresa Tapia, Pilar Carvallo, Luz M. Gonzalez, Alicia Cock-Rada, Angela Solano, Florencia Neffa, Adriana Della Valle, Chris Yau, Gabriela Soares, Alexander Borowsky, Nan Hu, Li-Ji He, Xiao-You Han, Latin American Gastric Cancer Genetics Collaborative Group, Philip R. Taylor, Alisa M. Goldstein, Javier Torres, Magdalena Echeverry, Clara Ruiz-Ponte, Manuel R. Teixeira, Luis G. Carvajal-Carmona
    Germline Mutations in PALB2, BRCA1, and RAD51C, Which Regulate DNA Recombination Repair, in Patients With Gastric Cancer
    Up to 10% of cases of gastric cancer are familial, but so far, only mutations in CDH1 have been associated with gastric cancer risk. To identify genetic variants that affect risk for gastric cancer, we collected blood samples from 28 patients with hereditary diffuse gastric cancer (HDGC) not associated with mutations in CDH1 and performed whole-exome sequence analysis. We then analyzed sequences of candidate genes in 333 independent HDGC and non-HDGC cases. We identified 11 cases with mutations in PALB2, BRCA1, or RAD51C genes, which regulate homologous DNA recombination.

    Date de mise en ligne : Jeudi 22 décembre 2016
    Bishnu P. Joshi, Zhenzhen Dai, Zhenghong Gao, Jeong Hoon Lee, Navin Ghimire, Jing Chen, Anoop Prabhu, Erik J. Wamsteker, Richard S. Kwon, Grace H. Elta, Elena M. Stoffel, Asha Pant, Tonya Kaltenbach, Roy M. Soetikno, Henry D. Appelman, Rork Kuick, D. Kim Turgeon, Thomas D. Wang
    Detection of Sessile Serrated Adenomas in Proximal Colon Using Wide-Field Fluorescence Endoscopy
    Many cancers in the proximal colon develop via from sessile serrated adenomas (SSAs), which have flat, subtle features that are difficult to detect with conventional white-light colonoscopy. Many SSA cells have the V600E mutation in BRAF. We investigated whether this feature could be used with imaging methods to detect SSAs in patients.

    Date de mise en ligne : Jeudi 22 décembre 2016
    Lucas C. Duits, M.J. van der Wel, Cary C. Cotton, K. Nadine Phoa, Fiebo J.W. ten Kate, Cees A. Seldenrijk, G. Johan A. Offerhaus, Mike Visser, Sybren L. Meijer, Rosalie C. Mallant-Hent, Kausilia K. Krishnadath, Roos E. Pouw, Jan G.P. Tijssen, Nicholas J. Shaheen, Jacques J.G.H.M. Bergman
    Patients With Barrett’s Esophagus and Confirmed Persistent Low-Grade Dysplasia Are at Increased Risk for Progression to Neoplasia
    For patients with Barrett’s esophagus, the diagnosis of low-grade dysplasia (LGD) is subjective, and reported outcomes vary. We analyzed data from a multicenter study of endoscopic therapy to identify factors associated with progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in patients with LGD of the esophagus.

    Date de mise en ligne : Lundi 19 décembre 2016
    Carmelo Scarpignato, Werner Dolak, Angel Lanas, Peter Matzneller, Cecilia Renzulli, Maria Grimaldi, Markus Zeitlinger, Ingvar Bjarnason
    Rifaximin Reduces Number and Severity of Intestinal Lesions Associated With Use of Nonsteroidal Anti-Inflammatory Drugs in Humans
    The intestinal microbiota might contribute to enteropathy associated with use of nonsteroidal anti-inflammatory drugs (NSAIDs), but there have been few human studies of this association. We performed a placebo-controlled study to determine whether a delayed-release antibiotic formulation (rifaximin-EIR) prevented the development of intestinal lesions in subjects taking daily NSAIDs. Sixty healthy volunteers (median age, 26 y; 42% female) were given the NSAID diclofenac (75 mg twice daily) plus omeprazole (20 mg once daily), and either rifaximin-EIR (400 mg) or placebo, twice daily for 14 days.

    Date de mise en ligne : Dimanche 18 décembre 2016
    Sachin H. Patel, Fernando D. Camargo, Dean Yimlamai
    Hippo Signaling in the Liver Regulates Organ Size, Cell Fate, and Carcinogenesis
    The Hippo signaling pathway, also known as the Salvador−Warts−Hippo pathway, is a regulator of organ size. The pathway takes its name from the Drosophila protein kinase, Hippo (STK4/MST1 and STK3/MST2 in mammals), which, when inactivated, leads to considerable tissue overgrowth. In mammals, MST1 and MST2 negatively regulate the transcriptional co-activators yes-associated protein 1 and WW domain containing transcription regulator 1 (WWTR1/TAZ), which together regulate expression of genes that control proliferation, survival, and differentiation.

    Date de mise en ligne : Vendredi 16 décembre 2016
    Victor F. Zevallos, Verena Raker, Stefan Tenzer, Carolina Jimenez-Calvente, Muhammad Ashfaq-Khan, Nina Rüssel, Geethanjali Pickert, Hansjörg Schild, Kerstin Steinbrink, Detlef Schuppan
    Nutritional Wheat Amylase-Trypsin Inhibitors Promote Intestinal Inflammation via Activation of Myeloid Cells
    Wheat amylase-trypsin inhibitors (ATIs) are nutritional activators of innate immunity, via activation of the toll-like receptor 4 (TLR4) on myeloid cells. We aimed to characterize the biologic activity of ATIs in various foods and their effect on intestinal inflammation.

    Date de mise en ligne : Jeudi 15 décembre 2016
    Kirsteen N. Browning, Simon Verheijden, Guy E. Boeckxstaens
    The Vagus Nerve in Appetite Regulation, Mood, and Intestinal Inflammation
    Although the gastrointestinal tract contains intrinsic neural plexuses that allow a significant degree of independent control over gastrointestinal functions, the central nervous system provides extrinsic neural inputs that modulate, regulate, and integrate these functions. In particular, the vagus nerve provides the parasympathetic innervation to the gastrointestinal tract, coordinating the complex interactions between central and peripheral neural control mechanisms. This review discusses the physiological roles of the afferent (sensory) and motor (efferent) vagus in regulation of appetite, mood, and the immune system, as well as the pathophysiological outcomes of vagus nerve dysfunction resulting in obesity, mood disorders, and inflammation.

    Date de mise en ligne : Mercredi 14 décembre 2016
    Prashanthi N. Thota, Prashanth Vennalaganti, Sreekar Vennelaganti, Patrick Young, Srinivas Gaddam, Neil Gupta, David Lieberman, Richard Sampliner, Gary W. Falk, Sharad Mathur, Kevin Kennedy, Brooks D. Cash, Fouad Moawad, Ajay Bansal, Manon C. Spaander, Marco J. Bruno, John Vargo, Prateek Sharma
    Low Risk of High-Grade Dysplasia or Esophageal Adenocarcinoma Among Patients With Barrett's Esophagus Less Than 1 cm (Irregular Z Line) Within 5 Years of Index Endoscopy
    Many patients with a < 1 cm segment of columnar metaplasia in the distal esophagus, also called an irregular Z line, are encountered. These patients, often referred to as patients with Barrett’s esophagus (BE), are enrolled in surveillance programs. However, little is known about their risk of high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC). We aimed to determine the incidence of HGD and EAC in patients with irregular Z line with intestinal metaplasia.

    Date de mise en ligne : Vendredi 09 décembre 2016
    Su Yeon An, Yu Jin Jang, Hee-Joung Lim, Jiyou Han, Jaehun Lee, Gyunggyu Lee, Ji Young Park, Seo-Young Park, Ji Hyang Kim, Byung-Rok Do, Chugseong Han, Hee-Kyung Park, Ok-Hee Kim, Myeong Jun Song, Say-June Kim, Jong-Hoon Kim
    Milk Fat Globule-EGF Factor 8, Secreted by Mesenchymal Stem Cells, Protects Against Liver Fibrosis in Mice
    Mesenchymal stem cells (MSCs) mediate tissue repair and might be used to prevent or reduce liver fibrosis. However, little is known about the anti-fibrotic factors secreted from MSCs or their mechanisms.

    Date de mise en ligne : Vendredi 09 décembre 2016
    Chun-Qing Song, Yingxiang Li, Haiwei Mou, Jill Moore, Angela Park, Yotsawat Pomyen, Soren Hough, Zachary Kennedy, Andrew Fischer, Hao Yin, Daniel G. Anderson, Darryl Conte, Lars Zender, Xin Wei Wang, Snorri Thorgeirsson, Zhiping Weng, Wen Xue
    Genome-Wide CRISPR Screen Identifies Regulators of Mitogen-Activated Protein Kinase as Suppressors of Liver Tumors in Mice
    It has been a challenge to identify liver tumor suppressors or oncogenes due to the genetic heterogeneity of these tumors. We performed a genome-wide screen to identify suppressors of liver tumor formation in mice, using CRISPR-mediated genome editing.

    Date de mise en ligne : Mercredi 07 décembre 2016
    Jean Charles Nault, Gabrielle Couchy, Charles Balabaud, Guillaume Morcrette, Stefano Caruso, Jean-Frederic Blanc, Yannick Bacq, Julien Calderaro, Valérie Paradis, Jeanne Ramos, Jean-Yves Scoazec, Viviane Gnemmi, Nathalie Sturm, Catherine Guettier, Monique Fabre, Eric Savier, Laurence Chiche, Philippe Labrune, Janick Selves, Dominique Wendum, Camilla Pilati, Alexis Laurent, Anne De Muret, Brigitte Le Bail, Sandra Rebouissou, Sandrine Imbeaud, GENTHEP Investigators, Paulette Bioulac-Sage, Eric Letouzé, Jessica Zucman-Rossi
    Molecular Classification of Hepatocellular Adenoma Associates With Risk Factors, Bleeding, and Malignant Transformation
    Hepatocellular adenomas (HCAs) are benign liver tumors that can be assigned to molecular subtypes based on inactivating mutations in hepatocyte nuclear factor 1A, activating mutations in β-catenin, or activation of inflammatory signaling pathways. We aimed to update the classification system for HCA and associate the subtypes with disease risk factors and complications.

    Date de mise en ligne : Lundi 05 décembre 2016
    Bertrand Boson, Solène Denolly, Fanny Turlure, Christophe Chamot, Marlène Dreux, François-Loïc Cosset
    Daclatasvir Prevents Hepatitis C Virus by Blocking Transfer of Viral Genome to Assembly Sites
    Daclatasvir is a direct-acting antiviral agent and potent inhibitor of NS5A, which is involved in replication of the hepatitis C virus (HCV) genome, presumably via membranous web shaping, and assembly of new virions, likely via transfer of the HCV RNA genome to viral particle assembly sites. Daclatasvir inhibits the formation of new membranous web structures and, ultimately, of replication complex vesicles, but also inhibits an early assembly step. We investigated the relationship between daclatasvir-induced clustering of HCV proteins, intracellular localization of viral RNAs, and inhibition of viral particle assembly.

    Date de mise en ligne : Lundi 05 décembre 2016
    Joseph Burclaff, Luciana H. Osaki, Dengqun Liu, James R. Goldenring, Jason C. Mills
    Targeted Apoptosis of Parietal Cells Is Insufficient to Induce Metaplasia in Stomach
    Parietal cell atrophy is considered to cause metaplasia in the stomach. We developed mice that express the diphtheria toxin receptor specifically in parietal cells to induce their death, and found this to increase proliferation in the normal stem cell zone and neck but not to cause metaplastic reprogramming of chief cells. Furthermore, the metaplasia-inducing agents tamoxifen or DMP-777 still induced metaplasia even after previous destruction of parietal cells by diphtheria toxin. Atrophy of parietal cells alone therefore is not sufficient to induce metaplasia: completion of metaplastic reprogramming of chief cells requires mechanisms beyond parietal cell injury or death.

    Date de mise en ligne : Samedi 03 décembre 2016
    Ben Boursi, Brian Finkelman, Bruce J. Giantonio, Kevin Haynes, Anil K. Rustgi, Andrew D. Rhim, Ronac Mamtani, Yu-Xiao Yang
    A Clinical Prediction Model to Assess Risk for Pancreatic Cancer Among Patients With New-Onset Diabetes
    Approximately 50% of all patients with pancreatic ductal adenocarcinoma (PDA) develop diabetes mellitus before their cancer diagnosis. Screening individuals with new-onset diabetes might allow earlier diagnosis of PDA. We sought to develop and validate a PDA risk prediction model to identify high-risk individuals among those with new-onset diabetes.

    Date de mise en ligne : Samedi 03 décembre 2016
    Nikhil A. Kumta, Monica Saumoy, Amy Tyberg, Michel Kahaleh
    Submucosal Tunneling Endoscopic Resection for En Bloc Removal of Large Esophageal Gastrointestinal Stromal Tumors
    Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal subepithelial tumors of the gastrointestinal tract. GISTs have malignant potential, with size (>5 cm) and mitotic count (>5/50 high-power fields) the most useful predictors of malignant behavior.1 The management of localized GISTs has traditionally been surgical resection with avoidance of tumor rupture. In the era of modern medicine, we are encountering older patients with a higher proportion of comorbidities that have significant perioperative surgical risk.

    Date de mise en ligne : Vendredi 02 décembre 2016
    Rok Seon Choung, Scott A. Larson, Shahryar Khaleghi, Alberto Rubio-Tapia, Inna G. Ovsyannikova, Katherine S. King, Joseph J. Larson, Brian D. Lahr, Gregory A. Poland, Michael J. Camilleri, Joseph A. Murray
    Prevalence and Morbidity of Undiagnosed Celiac Disease From a Community-Based Study
    Little is known about the prevalence and burden of undiagnosed celiac disease in individuals younger than age 50. We determined the prevalence and morbidity of undiagnosed celiac disease in individuals younger than age 50 in a community.

    Date de mise en ligne : Jeudi 24 novembre 2016
    Jameson R. Lam, Jennifer L. Schneider, Charles P. Quesenberry, Douglas A. Corley
    Proton Pump Inhibitor and Histamine-2 Receptor Antagonist Use and Iron Deficiency
    Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) suppress gastric acid production, which can inhibit iron absorption. However, few data exist regarding whether these medications increase the risk of clinical iron deficiency.

    Date de mise en ligne : Jeudi 24 novembre 2016
    Esther Toes-Zoutendijk, Monique E. van Leerdam, Evelien Dekker, Frank van Hees, Corine Penning, Iris Nagtegaal, Miriam P. van der Meulen, Anneke J. van Vuuren, Ernst J. Kuipers, Johannes M.G. Bonfrer, Katharina Biermann, Maarten G.J. Thomeer, Harriët van Veldhuizen, Sonja Kroep, Marjolein van Ballegooijen, Gerrit A. Meijer, Harry J. de Koning, Manon C.W. Spaander, Iris Lansdorp-Vogelaar, Dutch National Colorectal Cancer Screening Working Group
    Real-Time Monitoring of Results During First Year of Dutch Colorectal Cancer Screening Program and Optimization by Altering Fecal Immunochemical Test Cut-Off Levels
    After careful pilot studies and planning, the national screening program for colorectal cancer (CRC), with biennial fecal immunochemical tests (FITs), was initiated in The Netherlands in 2014. A national information system for real-time monitoring was developed to allow for timely evaluation. Data were collected from the first year of this screening program to determine the importance of planning and monitoring for optimal screening program performance.

    Date de mise en ligne : Mercredi 23 novembre 2016
    Evan S. Dellon, David A. Katzka, Margaret H. Collins, Mohamed Hamdani, Sandeep K. Gupta, Ikuo Hirano
    Budesonide Oral Suspension Improves Symptomatic, Endoscopic, and Histologic Parameters Compared With Placebo in Patients With Eosinophilic Esophagitis
    Pharmacologic treatment of eosinophilic esophagitis (EoE) is limited to off-label use of corticosteroids not optimized for esophageal delivery. We performed a randomized, controlled phase 2 trial to assess the ability of budesonide oral suspension (BOS), a novel muco-adherent topical steroid formulation, to reduce symptoms and esophageal eosinophilia in adolescents and adults with EoE.

    Date de mise en ligne : Mercredi 23 novembre 2016
    Donna L. White, Aaron P. Thrift, Fasiha Kanwal, Jessica Davila, Hashem B. El-Serag
    Incidence of Hepatocellular Carcinoma in All 50 United States, From 2000 Through 2012
    The incidence and mortality of hepatocellular carcinoma (HCC) have been reported to be plateauing in the United States. The United States has large racial, ethnic, and regional variation; we collected data from all 50 states to better analyze changes in HCC incidence in the entire United States.

    Date de mise en ligne : Mercredi 23 novembre 2016
    Thomas Grabinger, Konstantin J. Bode, Janine Demgenski, Carina Seitz, M. Eugenia Delgado, Feodora Kostadinova, Cindy Reinhold, Nima Etemadi, Sabine Wilhelm, Matthias Schweinlin, Kay Hänggi, Janin Knop, Christof Hauck, Heike Walles, John Silke, Harald Wajant, Ueli Nachbur, Wong W. Wei-Lynn, Thomas Brunner
    Inhibitor of Apoptosis Protein-1 Regulates Tumor Necrosis Factor−Mediated Destruction of Intestinal Epithelial Cells
    Tumor necrosis factor (TNF) is a cytokine that promotes inflammation and contributes to pathogenesis of inflammatory bowel diseases. Unlike other cells and tissues, intestinal epithelial cells undergo rapid cell death upon exposure to TNF, by unclear mechanisms. We investigated the roles of inhibitor of apoptosis proteins (IAPs) in the regulation of TNF-induced cell death in the intestinal epithelium of mice and intestinal organoids.

    Date de mise en ligne : Samedi 19 novembre 2016
    Yongzhi Yang, Wenhao Weng, Junjie Peng, Leiming Hong, Lei Yang, Yuji Toiyama, Renyuan Gao, Minfeng Liu, Mingming Yin, Cheng Pan, Hao Li, Bomin Guo, Qingchao Zhu, Qing Wei, Mary-Pat Moyer, Ping Wang, Sanjun Cai, Ajay Goel, Huanlong Qin, Yanlei Ma
    Fusobacterium nucleatum Increases Proliferation of Colorectal Cancer Cells and Tumor Development in Mice by Activating Toll-Like Receptor 4 Signaling to Nuclear Factor−κ, Up-Regulating Expression of MicroRNA-21
    Nearly 20% of the global cancer burden can be linked to infectious agents. Fusobacterium nucleatum promotes tumor formation by epithelial cells via unclear mechanisms. We aimed to identify microRNAs (miRNAs) induced by F nucleatum and evaluate their ability to promote colorectal carcinogenesis in mice.

    Date de mise en ligne : Jeudi 17 novembre 2016
    Stephan J. Ott, Georg H. Waetzig, Ateequr Rehman, Jacqueline Moltzau-Anderson, Richa Bharti, Juris A. Grasis, Liam Cassidy, Andreas Tholey, Helmut Fickenscher, Dirk Seegert, Philip Rosenstiel, Stefan Schreiber
    Efficacy of Sterile Fecal Filtrate Transfer for Treating Patients With Clostridium Difficile Infection
    Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridium difficile infection (CDI). However, transferring undefined living bacteria entails uncontrollable risks for infectious and metabolic or malignant diseases, particularly in immunocompromised patients. We investigated whether sterile fecal filtrates (containing bacterial debris, proteins, antimicrobial compounds, metabolic products, and oligonucleotides/DNA), rather than intact microorganisms, are effective in patients with CDI.

    Date de mise en ligne : Mardi 15 novembre 2016
    Han-Byul Kim, Minchul Kim, Young-Soo Park, Intae Park, Tackhoon Kim, Sung-Yeun Yang, Charles J. Cho, DaeHee Hwang, Jin-Hak Jung, Sanford D. Markowitz, Sung Wook Hwang, Suk-Kyun Yang, Dae-Sik Lim, Seung-Jae Myung
    Prostaglandin E2 Activates YAP and a Positive-Signaling Loop to Promote Colon Regeneration After Colitis but Also Carcinogenesis in Mice
    Prostaglandin E2 (PGE2) is mediator of inflammation that regulates tissue regeneration, but its continual activation has been associated with carcinogenesis. Little is known about factors in the PGE2 signaling pathway that contribute to tumor formation. We investigated whether yes-associated protein 1 (YAP1), a transcriptional co-activator in the Hippo signaling pathway, mediates PGE2 function.

    Date de mise en ligne : Mardi 15 novembre 2016
    Joseph A. Murray, Ciarán P. Kelly, Peter H.R. Green, Annette Marcantonio, Tsung-Teh Wu, Markku Mäki, Daniel C. Adelman, CeliAction Study Group of Investigators
    No Difference Between Latiglutenase and Placebo in Reducing Villous Atrophy or Improving Symptoms in Patients With Symptomatic Celiac Disease
    Gluten ingestion leads to symptoms and small intestinal mucosal injury in patients with celiac disease. The only option is the strict lifelong exclusion of dietary gluten, which is difficult to accomplish. Many patients following a gluten-free diet continue to have symptoms and have small intestinal mucosal injury. Nondietary therapies are needed. We performed a phase 2 study of the ability of latiglutenase, an orally administered mixture of 2 recombinant gluten-targeting proteases, to reduce mucosal morphometric measures in biopsy specimens from patients with celiac disease.

    Date de mise en ligne : Mercredi 09 novembre 2016
    Sandra Elmasry, Sanya Wadhwa, Bo-Ram Bang, Linda Cook, Shefali Chopra, Gary Kanel, Brian Kim, Tammy Harper, Zongdi Feng, Keith R. Jerome, Jeffrey A. Kahn, Takeshi Saito
    Detection of Occult Hepatitis C Virus Infection in Patients Who Achieved a Sustained Virologic Response to Direct-Acting Antiviral Agents for Recurrent Infection After Liver Transplantation
    Occult infection with hepatitis C virus (HCV) is defined as the presence of the HCV genome in either liver tissue or peripheral blood monocytes, despite constant negative results from tests for HCV RNA in serum. We investigated whether patients who maintained a sustained virologic response 12 weeks after therapy (SVR12) with direct-acting antiviral (DAA) agents for recurrent HCV infection after liver transplantation had occult HCV infections. We performed a prospective study of 134 patients with recurrent HCV infection after liver transplantation who were treated with DAAs, with or without ribavirin, from 2014 through 2016 (129 patients achieved an SVR12).

    Date de mise en ligne : Samedi 05 novembre 2016
    Takeshi Yoshikawa, Jianfeng Wu, Motoyuki Otsuka, Takahiro Kishikawa, Nobumi Suzuki, Akemi Takata, Motoko Ohno, Rei Ishibashi, Mari Yamagami, Ryo Nakagawa, Naoya Kato, Masaaki Miyazawa, Jiahuai Han, Kazuhiko Koike
    Repression of MicroRNA Function Mediates Inflammation-associated Colon Tumorigenesis
    Little is known about the mechanisms by which chronic inflammation contributes to carcinogenesis, such as the development of colon tumors in patients with inflammatory bowel diseases. Specific microRNA (miRNAs) can function as suppressors or oncogenes, and widespread alterations in miRNA expression have been associated with tumorigenesis. We studied whether alterations in miRNA function contribute to inflammation-associated colon carcinogenesis.

    Date de mise en ligne : Samedi 05 novembre 2016
    Amit G. Singal, Jasmin A. Tiro, Jorge A. Marrero, Katharine McCallister, Caroline Mejias, Brian Adamson, Wendy Pechero Bishop, Noel O. Santini, Ethan A. Halm
    Mailed Outreach Program Increases Ultrasound Screening of Patients With Cirrhosis for Hepatocellular Carcinoma
    Surveillance of patients with cirrhosis increases early detection of hepatocellular carcinoma (HCC) and prolongs survival. However, its effectiveness is limited by underuse, particularly among racial/ethnic minorities and individuals of low socioeconomic status. We compared the effectiveness of mailed outreach strategies, with and without patient navigation, in increasing the numbers of patients with cirrhosis undergoing surveillance for HCC in a racially diverse and socioeconomically disadvantaged cohort.

    Date de mise en ligne : Jeudi 03 novembre 2016
    Prashanth Vennalaganti, Vijay Kanakadandi, John R. Goldblum, Sharad C. Mathur, Deepa T. Patil, G. Johan Offerhaus, Sybren L. Meijer, Michael Vieth, Robert D. Odze, Saligram Shreyas, Sravanthi Parasa, Neil Gupta, Alessandro Repici, Ajay Bansal, Titi Mohammad, Prateek Sharma
    Discordance Among Pathologists in the United States and Europe in Diagnosis of Low-Grade Dysplasia for Patients With Barrett's Esophagus
    There is suboptimal inter-observer agreement, even among expert gastrointestinal pathologists, in the diagnosis of low-grade dysplasia (LGD) in patients with Barrett’s esophagus (BE). We analyzed histopathologic criteria required for a diagnosis of LGD using the new subcategories of LGD with inflammatory and dysplastic features. We categorized each diagnosis based on the level of confidence and assessed inter-observer agreement among gastrointestinal pathologists from 5 tertiary centers in the United States and Europe.

    Date de mise en ligne : Mercredi 02 novembre 2016
    Anne M.L. Jansen, Stijn Crobach, Willemina R.R. Geurts-Giele, Brendy E.W.M. van den Akker, Marina Ventayol Garcia, Dina Ruano, Maartje Nielsen, Carli M.J. Tops, Juul T. Wijnen, Frederik J. Hes, Tom van Wezel, Winand N.M. Dinjens, Hans Morreau
    Distinct Patterns of Somatic Mosaicism in the APC Gene in Neoplasms From Patients With Unexplained Adenomatous Polyposis
    We investigated the presence and patterns of mosaicism in the APC gene in patients with colon neoplasms not associated with any other genetic variants; we performed deep sequence analysis of APC in at least 2 adenomas or carcinomas per patient. We identified mosaic variants in APC in adenomas from 9 of the 18 patients with 21 to approximately 100 adenomas. Mosaic variants of APC were variably detected in leukocyte DNA and/or non-neoplastic intestinal mucosa of these patients. In a comprehensive sequence analysis of 1 patient, we found no evidence for mosaicism in APC in non-neoplastic intestinal mucosa.

    Date de mise en ligne : Jeudi 27 octobre 2016
    Charlie C. Park, Phirum Nguyen, Carolyn Hernandez, Ricki Bettencourt, Kimberly Ramirez, Lynda Fortney, Jonathan Hooker, Ethan Sy, Michael T. Savides, Mosab H. Alquiraish, Mark A. Valasek, Emily Rizo, Lisa Richards, David Brenner, Claude B. Sirlin, Rohit Loomba
    Magnetic Resonance Elastography vs Transient Elastography in Detection of Fibrosis and Noninvasive Measurement of Steatosis in Patients With Biopsy-Proven Nonalcoholic Fatty Liver Disease
    Magnetic resonance imaging (MRI) techniques and ultrasound-based transient elastography (TE) can be used in noninvasive diagnosis of fibrosis and steatosis in patients with nonalcoholic fatty liver disease (NAFLD). We performed a prospective study to compare the performance of magnetic resonance elastography (MRE) vs TE for diagnosis of fibrosis, and MRI-based proton density fat fraction (MRI-PDFF) analysis vs TE-based controlled attenuation parameter (CAP) for diagnosis of steatosis in patients undergoing biopsy to assess NAFLD.

    Date de mise en ligne : Jeudi 20 octobre 2016
    Takashi E. Komatsu, Sarita Boyd, Adam Sherwat, LaRee Tracy, Lisa K. Naeger, Julian J. O’Rear, Patrick R. Harrington
    Regulatory Analysis of Effects of Hepatitis C Virus NS5A Polymorphisms on Efficacy of Elbasvir and Grazoprevir
    Elbasvir (an NS5A inhibitor) and grazoprevir (an NS3/4A protease inhibitor) are direct-acting antiviral agents recently approved in the United States for treatment of chronic hepatitis C virus (HCV) genotype 1 and 4 infections, as a fixed-dose combination. Trials of elbasvir and grazoprevir, with or without ribavirin, demonstrated high rates of sustained virologic response 12 weeks after treatment ended (SVR12). However, 12 weeks of treatment with elbasvir and grazoprevir failed in a small proportion of patients with HCV genotype 1 infection.

    Date de mise en ligne : Jeudi 20 octobre 2016
    Jonas F. Ludvigsson, Benjamin Lebwohl, Anders Ekbom, Ravi Pokala Kiran, Peter H.R. Green, Jonas Höijer, Olof Stephansson
    Outcomes of Pregnancies for Women Undergoing Endoscopy While They Were Pregnant: A Nationwide Cohort Study
    Endoscopy is an integral part of the investigation and management of gastrointestinal disease. We aimed to examine outcomes of pregnancies for women who underwent endoscopy during their pregnancy.

    Date de mise en ligne : Jeudi 20 octobre 2016
    Michael Camilleri, Joseph H. Sellin, Kim E. Barrett
    Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea
    Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (>4 weeks in duration) are more elusive. We review the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties.

    Date de mise en ligne : Mardi 18 octobre 2016
    Douglas J. Robertson, Jeffrey K. Lee, C. Richard Boland, Jason A. Dominitz, Francis M. Giardiello, David A. Johnson, Tonya Kaltenbach, David Lieberman, Theodore R. Levin, Douglas K. Rex
    Recommendations on Fecal Immunochemical Testing to Screen for Colorectal Neoplasia: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer
    The use of the fecal occult blood test (FOBT) for colorectal cancer (CRC) screening is supported by randomized trials demonstrating effectiveness in cancer prevention and widely recommended by guidelines for this purpose. The fecal immunochemical test (FIT), as a direct measure of human hemoglobin in stool has a number of advantages relative to conventional FOBT and is increasingly used relative to that test. This review summarizes current evidence for FIT in colorectal neoplasia detection and the comparative effectiveness of FIT relative to other commonly used CRC screening modalities.

    Date de mise en ligne : Lundi 17 octobre 2016
    Mariya Markova, Olga Pivovarova, Silke Hornemann, Stephanie Sucher, Turid Frahnow, Katrin Wegner, Jürgen Machann, Klaus Jürgen Petzke, Johannes Hierholzer, Ralf Lichtinghagen, Christian Herder, Maren Carstensen-Kirberg, Michael Roden, Natalia Rudovich, Susanne Klaus, Ralph Thomann, Rosemarie Schneeweiss, Sascha Rohn, Andreas F.H. Pfeiffer
    Isocaloric Diets High in Animal or Plant Protein Reduce Liver Fat and Inflammation in Individuals With Type 2 Diabetes
    Nonalcoholic fatty liver disease (NAFLD) is associated with increased risk of hepatic, cardiovascular, and metabolic diseases. High-protein diets, rich in methionine and branched chain amino acids (BCAAs), apparently reduce liver fat, but can induce insulin resistance. We investigated the effects of diets high in animal protein (AP) vs plant protein (PP), which differ in levels of methionine and BCAAs, in patients with type 2 diabetes and NAFLD. We examined levels of liver fat, lipogenic indices, markers of inflammation, serum levels of fibroblast growth factor 21 (FGF21), and activation of signaling pathways in adipose tissue.

    Date de mise en ligne : Mercredi 04 février 2015
    David T. Rubin
    The Rationale and Growth of Advanced Training in Inflammatory Bowel Disease

    Date de mise en ligne : Lundi 17 novembre 2014
    Steven F. Moss
    The Great Ulcer War: How It All Happened
    All gastroenterologists, most physicians, and many members of the general public are familiar with the discovery of gastric spiral bacteria in Western Australia in the early 1980s and the struggle to convince us that these bacteria, which we now call Helicobacter pylori, were a significant clinical issue. The eventual acceptance of Marshall and Warrren’s ideas resulted in their receiving the Nobel Prize for Medicine or Physiology in 2005. In contrast with the success story of triumph over adversity of these Antipodean pioneers that has been well-disseminated in the medical and lay media, little has been written about why the United States was particularly slow to accept the infectious theory of peptic ulcers.

    Date de mise en ligne : Lundi 19 novembre 2012
    Continuing Medical Education Answers: January 2013

    Date de mise en ligne : Lundi 15 octobre 2012
    Continuing Medical Education Answers: December 2012

    Date de mise en ligne : Mercredi 19 septembre 2012
    Ilaria Russo, Alessandro Luciani, Edoardo Troncone, Carolina Ciacci
    WITHDRAWN: The Endoplasmic Reticulum Stress Response Activates Tissue Transglutaminase and Intestinal Inflammation by Reducing Levels of IκBα
    This article has been withdrawn at the request of the authors. The Publisher apologizes for any inconvenience this may cause.The full Elsevier Policy on Article Withdrawal can be found at (http://www.elsevier.com/locate/withdrawalpolicy.

    Date de mise en ligne : Mercredi 22 août 2012
    Continuing Medical Education Answers: October 2012

    Date de mise en ligne : Jeudi 01 janvier 1970
    Information for Authors and Readers
    Gastroenterology is the premiere journal in the field of gastrointestinal disease and is led by an internationally renowned board of editors. As the official journal of the AGA Institute, Gastroenterology delivers up-to-date and authoritative coverage of both basic and clinical gastroenterology and hepatology. Regular features include research and perspectives by leading authorities, reports on the latest technologies for diagnosing and treating digestive diseases, images illustrating important clinical findings, reviews of scholarly media, medical news, meeting summaries, video abstracts, and monthly podcasts.

    Date de mise en ligne : Jeudi 01 janvier 1970
    Table of Contents

    Date de mise en ligne : Jeudi 01 janvier 1970
    Editorial Board

    Date de mise en ligne : Jeudi 01 janvier 1970
    Cover 1

    Date de mise en ligne : Jeudi 01 janvier 1970
    Francis K.L. Chan
    Because our study was a retrospective cohort study, the diagnosis of lower gastrointestinal (GI) bleeding was largely by exclusion rather than by direct confirmation of the source of bleeding. A lower GI investigation was not performed on every patient because some patients were too frail to undergo further endoscopic examination. Accordingly, presumed small bowel bleeding was a diagnosis of exclusion with no source of bleeding identified in the upper GI tract and the colon. Nevertheless, any misclassification of recurrent lower GI bleeding should be equally distributed between aspirin users and nonusers with the use of blinded adjudication.

    Date de mise en ligne : Jeudi 01 janvier 1970
    Antonios Wehbeh, Don C. Rockey, Kassem Barada
    RE: Risks of Bleeding Recurrence and Cardiovascular Events With Continued Aspirin Use After Lower Gastrointestinal Hemorrhage
    We read with interest the paper by Chan et al1 on the effects of resuming aspirin on clinical outcomes in patients with lower gastrointestinal bleeding (LGIB).1 In a retrospective study on patients who had LGIB on aspirin, the authors found that patients who resumed aspirin had a higher risk of recurrent bleeding, but a lower risk of serious cardiovascular events, cardiovascular mortality and, interestingly, mortality owing to sepsis, renal failure, or cancer.