- Dimethyl fumarate for relapsing MS. [Journal Article]
- NCNeurol Clin Pract 2013; 3(3):249-253
- Dimethyl fumarate (DMF) is the latest oral therapy approved for relapsing-remitting multiple sclerosis (RRMS). In 2 placebo-controlled phase III trials, twice daily DMF demonstrated a 44%-53% reducti...
Dimethyl fumarate (DMF) is the latest oral therapy approved for relapsing-remitting multiple sclerosis (RRMS). In 2 placebo-controlled phase III trials, twice daily DMF demonstrated a 44%-53% reduction in annualized relapse rate and 71%-90% reduction in new MRI lesions. In one trial, DMF slowed the accumulation of disability, but not in the other trial. The main side effects of DMF include gastrointestinal symptoms (nausea, abdominal pain, vomiting, and diarrhea) and skin flushing, which peak at treatment initiation. There was no increased risk of opportunistic infections. Recommended safety monitoring includes complete blood count prior to treatment and annually while on treatment. Appealing aspects of DMF include potent efficacy, oral administration, and good safety and tolerability profiles. Altogether, DMF is an attractive option for first-line treatment, breakthrough disease activity, intolerance to other therapies, and possibly natalizumab-treated patients with positive JC virus serology.
- Spontaneous mesenteric hematoma of the sigmoid colon associated with rivaroxaban: A case report. [Journal Article]
- IJInt J Surg Case Rep 2018 Feb 10; 44:33-37
- CONCLUSIONS: Previous reports of mesenteric hematoma with anticoagulant were associated with warfarin. Since rivaroxaban is not affect to the value of prothrombin time (PT) and activated partial thromboplastin time (APTT) and mesenteric hematoma presents non-specific symptoms, it is difficult to diagnose mesenteric hematoma in the patients taking rivaroxaban.It is important to keep in mind that mesenteric hematoma is one of the critical complications in patients taking rivaroxaban.
- Increased Incidence of Pseudoaneurysm Bleeding With Lumen-apposing Metal Stents Compared to Double Pigtail Plastic Stents in Patients With Peripancreatic Fluid Collections. [Journal Article]
- CGClin Gastroenterol Hepatol 2018 Feb 20
- CONCLUSIONS: In a retrospective study of patients undergoing drainage of pancreatic pseudocysts or walled-off necrosis, we found LAMS and DPS to have comparable rates of technical and clinical success and adverse events. Drainage of walled-off necrosis or pancreatic pseudocysts using DPS was associated with fewer bleeding events overall, including pseudoaneurysm bleeding, but bleeding risk with LAMS should be weighed against the trend of higher actionable perforation and infection rates with DPS.
- Use of fibers in childhood constipation treatment: systematic review with meta-analysis. [Review]
- JPJ Pediatr (Rio J) 2018 Feb 20
- CONCLUSIONS: There is a scarcity of qualified studies to evaluate fiber supplementation in the treatment of childhood constipation, generating a low degree of confidence in estimating the real effect of this intervention on this population. Today, according to the current literature, adequate fiber intake should only be recommended for functional constipation, and fiber supplementation should not be prescribed in the diet of constipated children and adolescents.
- A systematic review of the evidence and analysis of the consequences. [Review]
- JIJ Intern Med 2018 Feb 23
- Senior people constitute the fastest growing segment of the population. The elderly are at risk for malnutrition, thought to be caused by reduced food intake or involution of the physiological capaci...
Senior people constitute the fastest growing segment of the population. The elderly are at risk for malnutrition, thought to be caused by reduced food intake or involution of the physiological capacity of the GI tract. Age-related changes are well known in other secretory organs such as liver, kidney, and intestine. The pancreas, representing a metabolically active organ with uptake and breakdown of essential nutritional components, changes its morphology and function with age. During childhood, the volume of the pancreas increases, reaching a plateau between 20-60 years, and declines thereafter. This decline involves the pancreatic parenchyma and is associated with decreased perfusion, fibrosis and atrophy. As a consequence of these changes, pancreatic exocrine function is impaired in healthy older individuals without any gastrointestinal disease. Five percent of people older than 70 years and ten percent older than 80 years have pancreatic exocrine insufficiency (PEI) with a faecal elastase-1 below 200 μg/g stool, and 5% have severe PEI with fecal elastase-1 below 100 μg/g stool. This may lead to maldigestion and malnutrition. Patients may have few symptoms, e.g. steatorrhoea, diarrhoea, abdominal pain and weight loss. Malnutrition consists of deficits of fat-soluble vitamins, and is affecting both patients with PEI and the elderly. Secondary consequences may include decreased bone mineral density and results from impaired absorption of fat-soluble vitamin D due to impaired pancreatic exocrine function. The unanswered question is whether this age-related decrease in pancreatic function warrants therapy. Therapeutic intervention, which may consist of supplementation of pancreatic enzymes and/or vitamins in aged individuals with proven exocrine pancreas insufficiency, could contribute to healthy ageing. This article is protected by copyright. All rights reserved.
- NK-cell enteropathy: a case report with ten years of indolent clinical behavior. [Case Reports]
- HHistopathology 2018 Feb 23
- NK-cell enteropathy is a recently described clinically indolent condition characterized by atypical NK-cell infiltrates in the gastrointestinal mucosa that mimics malignant lymphoma. We report the ca...
NK-cell enteropathy is a recently described clinically indolent condition characterized by atypical NK-cell infiltrates in the gastrointestinal mucosa that mimics malignant lymphoma. We report the case of a 69-year-old female who clinically had long-standing abdominal pain and recurrent mucosal ulcerations associated with atypical NK-cell infiltrates. The clinical, morphologic, and immunophenotypic findings in this case were diagnostic of NK-cell enteropathy. Review of the patient's prior biopsies demonstrated that this persisted without clinical progression for ten years-confirming the clinical indolent course. Recognition of NK-cell enteropathy is important to avoid over-diagnosing this benign condition as an aggressive lymphoma. This article is protected by copyright. All rights reserved.
- [Clinical observation on severe acute pancreatitis treated with electroacupuncture at Dachangshu (BL 25) and Shangjuxu (ST 37) combined with ulinastatin]. [Journal Article]
- ZZZhongguo Zhen Jiu 2018 Feb 12; 38(2):132-6
- CONCLUSIONS: EA at Dachangshu (BL 25) and Shangjuxu (ST 37) displays the satisfactory accessory therapeutic effects on SAP treated with ulinastatin.
- Bile Salt Hydrolase Activities: A Novel Target to Screen Anti-GiardiaLactobacilli? [Journal Article]
- FMFront Microbiol 2018; 9:89
- Giardia duodenalisis a protozoan parasite responsible for giardiasis, a disease characterized by intestinal malabsorption, diarrhea and abdominal pain in a large number of mammal ...
Giardia duodenalisis a protozoan parasite responsible for giardiasis, a disease characterized by intestinal malabsorption, diarrhea and abdominal pain in a large number of mammal species. Giardiasis is one of the most common intestinal parasitic diseases in the world and thus a high veterinary, and public health concern. It is well-established that some probiotic bacteria may confer protection against this parasitein vitroandin vivoand we recently documented the implication of bile-salt hydrolase (BSH)-like activities from strain La1 ofLactobacillus johnsoniias mediators of these effectsin vitro. We showed that these activities were able to generate deconjugated bile salts that were toxic to the parasite. In the present study, a wide collection of lactobacilli strains from different ecological origins was screened to assay their anti-giardial effects. Our results revealed that the anti-parasitic effects of some of the strains tested were well-correlated with the expression of BSH-like activities. The two most active strainsin vitro, La1 andLactobacillus gasseriCNCM I-4884, were then tested for their capacity to influenceG. duodenalisinfection in a suckling mice model. Strikingly, onlyL. gasseriCNCM I-4884 strain was able to significantly antagonize parasite growth with a dramatic reduction of the trophozoites load in the small intestine. Moreover, this strain also significantly reduced the fecal excretion ofGiardiacysts after 5 days of treatment, which could contribute to blocking the transmission of the parasite, in contrast of La1 where no effect was observed. This study represents a step toward the development of new prophylactic strategies to combatG. duodenalisinfection in both humans and animals.
- The Relationship Between Intradialytic Nutrition and Gastrointestinal Symptoms Using a Modified Version of the Gastrointestinal Symptom Rating Scale. [Journal Article]
- JRJ Ren Nutr 2018; 28(2):129-134
- CONCLUSIONS: In this sample, the modified version of the Gastrointestinal Symptom Rating Scale was a generally valid tool for measuring GI symptoms associated with a single HD treatment. Patients who ate during treatment did not experience greater GI symptoms than those who did not; however, high amounts of fat and fiber may be associated with greater GI symptoms. Prospective trials should examine the relationship between GI symptoms and dietary intake during treatment in HD patients.
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- Post-surgical recurrence of HCC along resection margin treated by percutaneous US-guided ablation. [Journal Article]
- MCMinerva Chir 2018 Feb 21
- CONCLUSIONS: HCC recurrence along the surgical margin can be safely and effectively treated by percutaneous therapy, despite the misconception of the surgical margin as a hostile location. Percutaneous treatment may bridge the patient for additional therapy.