291 results match your criteria: "Digestive Diseases Institute[Affiliation]"

Background: Herein, we present a proof-of-concept study of three-dimensional [3D] pouchography using virtual and printed 3D models of ileal pouch-anal anastomosis [IPAA] in patients with normal pouches and in cases of mechanical pouch complications.

Methods: We performed a retrospective, descriptive case series of a convenience sample of 10 pouch patients with or without pouch dysfunction, who had CT scans appropriate for segmentation who were identified from our pouch registry. The steps involved in clinician-driven automated 3D reconstruction are presented.

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Introduction: Endoscopic eradication therapy (EET) combining endoscopic resection (ER) with endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) followed by ablation is the standard of care for the treatment of dysplastic Barrett's esophagus (BE). We have previously shown comparable rates of complete remission of intestinal metaplasia (CRIM) with both approaches. However, data comparing recurrence after CRIM are lacking.

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Article Synopsis
  • * Acute kidney injury (AKI) is common in ACLF patients, affecting 22.8-34%, and is often severe, particularly in stage 3, which shows a low response rate to treatments.
  • * The study aims to review existing data on AKI in ACLF and create a consensus with recommendations for its diagnosis, management, and areas for future research, targeting hepatologists and intensivists globally.
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Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Masters Program designated bariatric surgery as a clinical pathway. Among the tiers of the Masters Program, revisional bariatric surgery is the highest tier of "mastery" within the pathway. This article presents the top 10 seminal studies representing the current landscape of revisional bariatrics.

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Rediversion of the Failing Ileoanal Pouch: First Step in Pouch Salvage?

Inflamm Bowel Dis

March 2024

Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA.

Background: Ileal pouch-anal anastomosis is a technically demanding procedure with many potential complications. Rediversion with an ileostomy is often the first step in pouch salvage; however, it may not be clear if an individual patient will undergo subsequent pouch salvage surgery. We aimed to describe the indications and short- and long-term outcomes of rediversion in our pouch registry.

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Preventing fibrosis in IBD: update on immune pathways and clinical strategies.

Expert Rev Clin Immunol

July 2024

Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.

Introduction: Intestinal fibrosis is a common and serious complication of inflammatory bowel diseases (IBD) driving stricture formation in Crohn's disease patients and leading to submucosal damage in ulcerative colitis. Recent studies provided novel insights into the role of immune and nonimmune components in the pathogenesis of intestinal fibrosis. Those new findings may accelerate the development of anti-fibrotic treatment in IBD patients.

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Thoracoabdominal Wall Motion-Guided Biofeedback Treatment of Abdominal Distention: A Randomized Placebo-Controlled Trial.

Gastroenterology

August 2024

Digestive System Research Unit, University Hospital Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Instituto de Salud Carlos III, Madrid, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. Electronic address:

Background & Aims: Abdominal distention results from abdominophrenic dyssynergia (ie, diaphragmatic contraction and abdominal wall relaxation) in patients with disorders of gut-brain interaction. This study aimed to validate a simple biofeedback procedure, guided by abdominothoracic wall motion, for treating abdominal distention.

Methods: In this randomized, parallel, placebo-controlled trial, 42 consecutive patients (36 women and 6 men; ages 17-64 years) with meal-triggered visible abdominal distention were recruited.

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Background: Roux-en-Y gastric bypass (RYGB) effectively treats severe obesity, but some patients may require revisional surgery like limb lengthening (LL) for postoperative weight gain.

Objectives: This study aims to compare 30-day serious complications and mortality rates between LL and primary RYGB, given limited safety data on LL.

Methods: Patients who underwent LL and RYGB were identified from the 2020 and 2021 MBSAQIP databases, the only years in which LL data were available.

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Objectives: The study aimed to compare the risk of gastrointestinal infections among patients with and without metabolic dysfunction-associated fatty liver disease (MAFLD).

Methods: This was a population-based, retrospective, observational study using data from the National Inpatient Sample (NIS), the largest all-payer US inpatient care database.

Setting: Hospitalisation of adults aged ≥18 years old admitted in 2020 was identified using the NIS.

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Article Synopsis
  • Pouchitis is a common issue after surgery for ulcerative colitis, and the AGA has developed guidelines to help doctors manage this condition effectively.
  • A panel assessed clinical questions and outcomes to create 9 recommendations for treating pouchitis, Crohn's-like disease, and cuffitis.
  • Key recommendations include using antibiotics for intermittent pouchitis, considering probiotics for prevention, and exploring advanced immunosuppressive therapies for chronic cases or those resistant to antibiotics.
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Hepatocellular carcinoma (HCC) presents significant treatment challenges despite considerable advancements in its management. The Indian National Association for the Study of the Liver (INASL) first published its guidelines to aid healthcare professionals in the diagnosis and treatment of HCC in 2014. These guidelines were subsequently updated in 2019.

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Donor Evaluation Protocol for Live and Deceased Donors.

J Clin Exp Hepatol

July 2023

Department of Liver Transplantation, Minimal Access & GI Surgery, Fortis Escorts Hospital, New Delhi-110025, India.

Donor evaluation is a critical step before proceeding with liver transplantation (LT) in both deceased donor LT (DDLT) and living donor LT (LDLT). A good, healthy graft is necessary for the success of the transplantation. Other issues in selecting a donor include the transmission of infections and malignancies from the donor.

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Article Synopsis
  • Aversive conditioning can diminish the pleasure associated with comfort meals, and this study aimed to see if cognitive interventions could restore that pleasure.
  • The research involved 12 healthy women, measuring their responses to a comfort meal before, after conditioning (which made the meal less enjoyable), and after a cognitive intervention that provided an explanation of the conditioning.
  • Results showed that the cognitive intervention significantly improved participants' enjoyment and digestive well-being after eating the meal, while the control group saw no such improvements, indicating that the negative effects of aversive conditioning can be reversed.
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Liver Transplantation: Contraindication and Ineligibility.

J Clin Exp Hepatol

April 2023

Department of Gastroenterology, Manipal Hospital, Dwarka, New Delhi 110075, India.

Liver transplantation (LT) is a life-saving therapeutic modality for patients with various advanced liver diseases. It is crucial to identify that the patient's illness is sufficiently advanced and unlikely to improve with medical management to justify the need for transplantation. At the same time, it is crucial to identify patients with comorbidities and far advanced disease that would result in an unacceptable outcome after LT.

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Background: The mesentery has recently been implicated in the pathophysiology of Crohn's disease (CD), and several techniques have been developed to target the mesentery to reduce its influence on recurrence. We aimed to describe short-term safety and feasibility after these approaches.

Methods: This is a comparative, retrospective, single-center cohort study of consecutive CD patients undergoing primary or redo ileocolic resection from 2015 to 2022 with Kono-S anastomosis (KSA), extended mesenteric excision (EME) only, or both: mesenteric excision and exclusion (MEE).

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Impact of surgery after endoscopically resected high-risk T1 colorectal cancer: results of an emulated target trial.

Gastrointest Endosc

March 2024

Department of Gastroenterology, Digestive Oncology and Endoscopy, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Cité University, Paris, France.

Article Synopsis
  • The study aimed to compare long-term outcomes for patients with high-risk T1 colorectal cancer who underwent endoscopic resection, assessing the effectiveness of additional surgery versus surveillance alone.
  • Data was collected from patients treated at 14 centers between 2012 and 2019, with the primary outcome focusing on cancer recurrence or death within 48 months.
  • Results showed no significant difference in the rates of death or cancer recurrence between the two groups, suggesting that additional surgery may not provide benefits for these patients.
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Background And Aims: Tofacitinib (TFB) appears to be effective in the treatment of ulcerative colitis (UC); however, available real-world studies are limited by cohort size. TFB could be an option in the treatment of acute severe ulcerative colitis (ASUC). We aimed to investigate efficacy and safety of TFB in moderate-to-severe colitis and ASUC.

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Article Synopsis
  • Vaccines play a crucial role in controlling the COVID-19 pandemic, but patients with inflammatory bowel diseases (IBDs) on anti-TNF-α treatments show weaker immune responses after vaccinations.
  • A study involving 319 participants found that while a third dose of the Pfizer/BioNTech vaccine led to significant antibody levels in all groups, those on anti-TNF-α therapies experienced a drop in these levels three months later.
  • Despite no significant adverse effects or disease flare-ups, the lower antibody response after the third dose indicates a potential risk for infections, suggesting that a fourth dose might be necessary for this population.
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INTRODUCTION : Residual colorectal neoplasia (RCN) after previous endoscopic mucosal resection is a frequent challenge. Different management techniques are feasible including endoscopic full-thickness resection using the full-thickness resection device (FTRD) system and endoscopic submucosal dissection (ESD). We aimed to compare the efficacy and safety of these two techniques for the treatment of such lesions.

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Article Synopsis
  • * A study of 165 patients showed a rising incidence of pouch adenomas over time, with 28.5% of patients diagnosed, but none progressed to cancer throughout the follow-up period.
  • * The research created a classification system for polyposis severity based on the size, number, and histology of the adenomas, indicating that progressive monitoring is important for managing patient outcomes.
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Background: The presentation of the patient with acute cholangitis (AC) ranges from mild illness to life-threatening shock. Therefore, prompt diagnosis and treatment are critical. Abdominal ultrasound (US) is the imaging of choice to locate bile duct dilatation.

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Introduction: Recent pilot trials in acute pancreatitis (AP) found that lactated ringers (LR) usage may result in decreased risk of moderately severe/severe AP compared with normal saline, but their small sample sizes limit statistical power. We investigated whether LR usage is associated with improved outcomes in AP in an international multicenter prospective study.

Methods: Patients directly admitted with the diagnosis of AP were prospectively enrolled at 22 international sites between 2015 and 2018.

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Background: Autoimmune pancreatitis [AIP] is rarely associated with inflammatory bowel disease [IBD]. The long-term outcomes of AIP and IBD in patients with coexisting AIP-IBD and predictors of complicated AIP course have rarely been reported.

Methods: An ECCO COllaborative Network For Exceptionally Rare case reports project [ECCO-CONFER] collected cases of AIP diagnosed in patients with IBD.

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Background: Meal ingestion induces a postprandial experience that involves homeostatic and hedonic sensations. Our aim was to determine the effect of aversive conditioning on the postprandial reward of a comfort meal.

Methods: A sham-controlled, randomised, parallel, single-blind study was performed on 12 healthy women (6 per group).

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