Specific Bacteria and Metabolites Associated With Response to Fecal Microbiota Transplantation in Patients With Ulcerative Colitis.

Background & Aims: Fecal microbiota transplantation (FMT) can induce remission in patients with ulcerative colitis (UC). In a randomized controlled trial of FMT in patients with active UC, we aimed to identify bacterial taxonomic and functional factors associated with response to therapy.

Methods: We performed a double-blind trial of 81 patients with active UC randomly assigned to groups that received an initial colonoscopic infusion and then intensive multidonor FMT or placebo enemas, 5 d/wk for 8 weeks.

The gut microbiota: cause and cure of gut diseases.

The gastrointestinal microbiota is emerging as a central factor in the pathogenesis of a range of gastrointestinal and hepatic disorders. Epidemiological studies, and experimental studies in animals and humans, have highlighted a likely causative role of this microbial community in the modern global epidemics of inflammatory bowel disease, non-alcoholic fatty liver disease, non-alcoholic steato-hepatitis, obesity and metabolic syndrome. New techniques for microbial culture and gene sequencing are enabling the identification of specific pathogens and protective organisms in these conditions.

Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: a randomised placebo-controlled trial.

Background: The intestinal microbiota is implicated in the pathogenesis of ulcerative colitis. Faecal microbiota transplantation is a novel form of therapeutic microbial manipulation, but its efficacy in ulcerative colitis is uncertain. We aimed to establish the efficacy of intensive-dosing, multidonor, faecal microbiota transplantation in active ulcerative colitis.

Gastroenterologist perceptions of faecal microbiota transplantation.

Aim: To explore gastroenterologist perceptions towards and experience with faecal microbiota transplantation (FMT).

Methods: A questionnaire survey consisting of 17 questions was created to assess gastroenterologists' attitude towards and experience with FMT. This was anonymously distributed in hard copy format amongst attendees at gastroenterology meetings in Australia between October 2013 and April 2014.

Donor Recruitment for Fecal Microbiota Transplantation.

Background: Increasing demand for fecal microbiota transplantation (FMT) has created a need for stool banks sourced from long-term healthy donors. Here, we describe our experience in recruiting and screening fecal donors.

Methods: Mailbox, newspaper, and online advertisements were used.

Stimulation of the superficial zone protein and lubrication in the articular cartilage by human platelet-rich plasma.

Background: Platelet-rich plasma (PRP) contains high concentrations of autologous growth factors that originate from platelets. Intra-articular injections of PRP have the potential to ameliorate the symptoms of osteoarthritis in the knee. Superficial zone protein (SZP) is a boundary lubricant in articular cartilage and plays an important role in reducing friction and wear and therefore is critical in cartilage homeostasis.

Posterior interosseous nerve incarceration with endobutton repair of distal biceps.

Distal biceps ruptures are uncommon injuries that comprise approximately 3% of all biceps pathology. This injury is most commonly seen in 40- to 60-year-old men, and the mechanism of injury involves a forceful extension movement to a flexed elbow. Without surgical intervention, patients are left with measurable weakness in elbow flexion and supination as well as a cosmetic deformity that often leaves them dissatisfied.

Translational research and efficacy of biologics in Crohn's disease: a cautionary tale.

In the last several years many biologic agents for Crohn's disease have been developed. Due to their unique molecular specificity biologics are de facto indicators of the ultimate significance of the molecule targeted by the biologic itself. Here, we have reviewed many clinical studies that have used biologics for Crohn's disease.

Surgery for Crohn's disease and anti-TNF agents: the changing scenario.

Surgery has been a mainstay of therapy for Crohn's disease for a long time, essentially as a consequence of the fairly modest efficacy of traditional medications such as immunomodulators, antibiotics and 5-ASA, especially in severe cases. However, in the past decade and half, the advent of anti-TNF agents has greatly changed the medical approach to this disease and may modify its general management as well. Here, we have reviewed the current literature on incidence of surgery, timing of surgery and postoperative recurrence of Crohn's disease before and after the advent of anti-TNF agents.

Bringing top-end endoscopy to regional australia: hurdles and benefits.

This paper focuses on recent experience in setting up an endoscopy unit in a large regional hospital. The mix of endoscopy in three smaller hospitals, draining into the large hospital endoscopy unit, has enabled the authors to comment on practical and achievable steps towards creating best practice endoscopy in the regional setting. The challenges of using what is available from an infrastructural equipment and personnel setting are discussed.

The race for mainstream gastrointestinal endoscopy: frontrunners.

In recent years, gastrointestinal endoscopy has evolved and branched out from a primary naked-eye diagnostic technique to a multitude of sophisticated investigative and therapeutic procedures. While many of the new endoscopic techniques are currently too complex or expensive to make it to mainstream clinical practice, others are already bringing major progress to the management of digestive diseases. In this review we will discuss a selected group of the emerging techniques and technologies used to increase the diagnostic yield in the colon and small intestine, including Third Eye® Retroscopes®, colon capsule endoscopy, spiral enteroscopy and confocal laser endomicroscopy.

The effect of drill trajectory on proximity to the posterior interosseous nerve during cortical button distal biceps repair.

Purpose: The aim of this study was to evaluate the effect that different drill trajectories across the radius have on the proximity of the drill tip to the posterior interosseous nerve (PIN).

Methods: In 10 cadaveric specimens, we drilled from the bicipital tuberosity across the radius using 4 different trajectories: (1) aiming across the radius at 90° to the longitudinal axis of the radius, (2) distally at 45°, (3) ulnarly, and (4) radially. We measured the distance between the tip of the drill as it exited the dorsal cortex of the radius and the PIN.

The superficial medial collateral ligament reconstruction of the knee: effect of altering graft length on knee kinematics and stability.

Purpose: The purpose of this study was to evaluate and compare the resulting knee kinematics and stability of an anatomic superficial MCL (sMCL) reconstruction and a non-anatomic sMCL reconstruction.

Methods: In a cadaveric model, normal knee stability and kinematics were compared with sMCL deficient knees and with two experimental sMCL reconstructions. The first reconstruction (AnatRecon) attempted to anatomically reconstruct the sMCL.

Preoperative esophageal manometry does not predict postoperative dysphagia following anti-reflux surgery.

This prospective study was undertaken to determine the value of manometric studies in predicting postoperative dysphagia in patients undergoing laparoscopic Toupet fundoplication. Two hundred and twenty-nine out of 401 patients (57%) had preoperative dysphagia, and 26 patients had late postoperative dysphagia (6.5%).

Distal embolization and local vessel wall ulceration after gastric variceal obliteration with N-butyl-2-cyanoacrylate: a case report and review of the literature.

Repeated endoscopic injections of N-butyl-2-cyanoacrylate mixtures into large gastric varices in a single patient led to two complications: initially, pulmonary embolism, and later local ulceration of the wall of a varix. The latter resulted in massive uncontrollable hemorrhage that ultimately led to a fatal outcome. This case report also analyzes complications reported in the literature during similar endoscopic procedures for gastric varices.

Hepatic osteodystrophy in rats results mainly from portasystemic shunting.

Background And Aims: In chronic liver disease, bone disease frequently develops. The contributions of the different features of liver disease such as parenchymal inflammation, portal hypertension, and portasystemic shunting on bone metabolism have not been systematically studied. The aim of this study was to identify the features of liver disease contributing to bone disease using rat models.

Gut mucosal response to food antigens in Crohn's disease.

Background: Food antigens may contribute to gut inflammation in Crohn's disease.

Aim: To assess in vivo sensitization to food antigens, ascertain whether sensitivity is gut specific, assess food sensitization in vitro, and correlate in vivo changes with histological and blood changes.

Methods: Skin testing and rectal exposure to six food antigens (cereal, cabbage, citrus, milk, yeast and peanut) and control saline were assessed double-blind by immediate and 3.

Immune sensitization to food, yeast and bacteria in Crohn's disease.

Background: Complex food proteins and enteric flora may act as antigenic stimuli in Crohn's disease. This study assessed the prevalence and magnitude of lymphocyte priming to these antigens in Crohn's disease.

Methods: A total of 31 Crohn's disease patients (median age 42 years, range 25-72 years) and 22 healthy controls (median 29 years, 23-43 years) were studied.

Hepatic osteodystrophy: the influence of liver disease and portal hypertension on cytokine activation.

Chronic liver disease is frequently complicated by bone disease. The mechanisms leading to bone-loss are unknown but are probably not related to abnormal vitamin D metabolism. The effects of portal hypertension and porto-systemic shunting on bone-loss have not been studied.

Solitary rectal ulcer syndrome.

Background: Solitary rectal ulcer syndrome is a rare disorder characterized by erythema or ulceration of the rectal wall, associated with typical histological features, and disturbed defaecatory behaviour with the passage of blood and mucus.

Methods: This is a review based on a literature search using a computer database (Medline) and manual cross-referencing.

Results: The pathogenesis is likely to vary in different patients; it includes trauma from straining, direct digital trauma and possibly primary neuromuscular pathology.

Serum proteins facilitate neutrophil induction of endothelial leukocyte adhesion molecule 1.

Background: Although the individual actions of neutrophils and serum proteins such as complement in acute inflammation are well characterized, less is known about their effects in combination. We investigated the combined effects of neutrophil contact and active serum proteins on the expression of endothelial leukocyte adhesion molecule 1 (ELAM-1).

Methods: Confluent monolayers of human umbilical vein endothelial cells were incubated with neutrophils in the presence and absence of fresh human serum.

Complement activation, its consequences, and blockade by gene transfer.

The success of xenotransplanting vascularized pig organs into humans is limited owing to the immediate immune reaction, termed hyperacute rejection (HAR). This reaction is primarily mediated by naturally occurring xenoreactive antibodies binding to the graft and activating the complement system, resulting in organ dysfunction. Pig membrane-bound complement regulatory proteins efficiently control autologous complement only and are unable to protect against human complement-mediated damage.

Xenogeneic transplantation.

Hyperacute rejection, the previously insurmountable obstacle to pig-to-human xenografts, has been overcome. There is reason to hope that concerted research will overcome the remaining obstacles. Pigs will be produced expressing other regulators of complement activation molecules in addition to decay accelerating factor.