A Real-World Comparison of Drug Trough Levels between Patients Experiencing a Secondary Nonimmune Loss of Response and Those Maintaining a Response to Infliximab on Long-Term Maintenance Therapy for Inflammatory Bowel Disease.

Introduction: A secondary loss of response (LOR) to infliximab (IFX) therapy for inflammatory bowel disease (IBD) is typically associated with low IFX trough levels, often with high levels of neutralizing antibodies to IFX (ATI). A small subset of patients on long-term therapy experience a "nonimmune" LOR, without ATI and with desired IFX trough levels ≥5 μg/mL, regarded as a LOR to the mechanism of action of IFX. However, this currently accepted IFX goal level is largely derived from observations of patients within the first year of therapy and may not apply to those on treatment beyond 1 year.

Early-life fecal microbiome and metabolome dynamics in response to an intervention with infant formula containing specific prebiotics and postbiotics.

This study examined fecal metabolome dynamics to gain greater functional insights into the interactions between nutrition and the activity of the developing gut microbiota in healthy term-born infants. The fecal samples used here originate from a randomized, controlled, double-blind clinical study that assessed the efficacy of infant formula with prebiotics and postbiotics (experimental arm) compared with a standard infant formula (control arm). A group of exclusively breast-fed term infants was used as a reference arm.

A Novel Culprit in a Patient with Budd-Chiari Syndrome.

Budd-Chiari syndrome (BCS) is an uncommon illness that is characterized by obstruction of hepatic venous outflow. Patients typically present with nausea, vomiting, and abdominal pain, which can further progress into signs associated with liver failure, including jaundice, encephalopathy, and coagulopathy. The most common causes of BCS include pathologies that induce portal vein thrombosis, such as myeloproliferative disorders, malignancy, and acquired hypercoagulable states.

An Unexpected Complication of Endoscopic Retrograde Cholangiopancreatography with a Novel Treatment Approach.

Splenic injury after endoscopic retrograde cholangiopancreatography (ERCP) has been documented in less than 30 cases. Here, we present a case that involves a 52-year-old male with choledocholithiasis who developed a splenic injury and major hemorrhage immediately after ERCP. The patient ultimately required splenic artery embolization without splenectomy, a novel treatment approach.

An uncommon presentation of a rare disease: A case of anti-glomerular basement membrane disease without renal involvement.

Anti-glomerular basement membrane disease (anti-GBM) is a well-documented, small vessel vasculitis that is classically associated with glomerulonephritis and alveolitis [1]. However, regardless of clinical process, not every patient will present with a constellation of classically associated symptoms. Literature review demonstrates that early anti-GBM disease can present as glomerulonephritis without alveolitis [2,3].