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Helicobacter pylori infection and small intestinal bacterial overgrowth–more than what meets the eye

World Journal of Clinical Cases 2022年第21期10卷 7209-7214页

作者： murali dharan David Wozny Department of Gastroenterology and Hepatology University of Connecticut Health CenterFarmingtonCT 06030United States Department of Primary Care and Internal Medicine University of ConnecticutFarmingtonCT 06030United States

Helicobacter pylori(***)infection is very common and affects a significant proportion of the world *** contrast,the prevalence of small intestinal bacterial overgrowth(SIBO)in the general population is not well *** can be coexistence of both disease states in a given patient and their clinical symptoms may also overlap with one and *** is no clear clinical guidelines for testing for and treating SIBO in patients with *** *** review article explores the available evidence on the relationship between *** infection and SIBO,diagnosis and treatment of these entities and also comments on associated non-gastrointestinal conditions.

关键词： Helicobacter pylori infection Small intestinal bacterial overgrowth Overlap Diagnosis Treatment

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Breast cancer metastasizing to the upper gastrointestinal tract(the esophagus and the stomach):A comprehensive review of the literature

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World Journal of Gastrointestinal Oncology 2023年第8期15卷 1332-1341页

作者： Teresa Da Cunha David Restrepo Simon Abi-Saleh murali dharan Department of Gastroenterology and Hepatology University of Connecticut Health CenterFarmingtonCT 06030United States Department of Internal Medicine University of Connecticut Health CenterFarmingtonCT 06030United States

Breast cancer can infrequently metastasize to the upper gastrointestinal(GI)tract but the exact incidence is not well established-there is considerable variation between incidence reported from clinical studies and incidence noted in autopsy *** presentation can be very non-specific and often mimics primary gastrointestinal *** alone may not be sufficient to make a diagnosis and misdiagnosis is also common.A high degree of awareness and clinical suspicion is required to establish metastases to the upper GI *** undertook a comprehensive review of the available literature on breast cancer metastases to the esophagus and stomach including the clinical symptoms and presentation,endoscopic features,additional diagnostic imaging modalities,treatment and outcomes.

关键词： Metastatic breast cancer Esophagus Stomach Endoscopy

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Impact of Helicobacter pylori Infection on the Pathogenesis and Management of Nonalcoholic Fatty Liver Disease

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Journal of Clinical and Translational Hepatology 2023年第3期11卷 670-674,F0003页

作者： Marianna G.Mavilia-Scranton George Y.Wu murali dharan Department of Medicine Division of Gastroenterology and HepatologyUniversity of ConnecticutFarmington CTUSA

Helicobacter pylori(***)infection is widely prevalent *** infection has been reported to be a risk factor for the development of insulin resistance,nonalco-holic fatty liver disease(NAFLD),nonalcoholic steatohepatitis(NASH),liver fibrosis,and *** treatment for NAFLD,other than weight loss is limited,the treatment for *** infection is well *** is important to determine whether screening and treatment for *** infection should be considered in patients with no gastrointestinal *** aim of this mini-review is to evaluate the association be-tween *** infection and NAFLD including epidemiology,pathogenesis,and the evidence for *** infection as a modifiable risk factor for preventing or treating NAFLD.

关键词： Helicobacter pylori Hepatic fibrosis Hepatic steatosis Nonalco-holic fatty liver disease Nonalcoholic steatohepatitis

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Comparison of trans-gastric vs trans-enteric(trans-duodenal or trans-jejunal)endoscopic ultrasound guided gallbladder drainage using lumen apposing metal stents

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世界胃肠内镜杂志:英文版(电子版) 2023年第9期15卷 574-583页

作者： Dheera Grover Ifrah Fatima murali dharan Department of Internal Medicine University of ConnecticutFarmingtonCT 06030United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64110United States Department of Gastroenterology and Hepatology University of Connecticut Health CenterFarmingtonCT 06030United States

BACKGROUND Endoscopic ultrasound guided gallbladder drainage(EUS-GBD)is being increasingly used in practice(either as a bridge to cholecystectomy in high-risk patients or as destination therapy in non-surgical patients).Stents are used to create a conduit between the lumen of the gallbladder(GB)and the intestinal lumen through the gastric or enteric *** the various types of stents used,cautery-enhanced lumen apposing metallic stents(LAMS)may be associated with fewer adverse events(AEs).AIM To compare the clinical success,technical success,and rate of AEs between transgastric(TG)and trans-enteric[transduodenal(TD)/transjejunal(TJ)]approach to GB ***,we analyzed whether using cautery enhanced stents during EUS-GBD impacts the above *** Study was registered in PROSPERO(CRD42022319019)and comprehensive literature review was *** were reviewed for the data collection:Rate of AEs,clinical success,and technical *** effects model was utilized for the *** No statistically significant difference in clinical and technical success between the TD/TJ and TG approaches(P>0.05)were *** was no statistically significant difference in the rate of AEs when comparing two-arm studies ***,when all studies were included in the analysis difference was almost significant favoring the TD/TJ *** comparing cautery-enhanced LAMS with non-cautery enhanced LAMS,a statistically significant difference in the rate of AEs was observed when all the studies were included,with the rate being higher in non-cautery enhanced stents(14.0%vs 37.8%;P<0.01).CONCLUSION As per our study results,TD/TJ approach appears to be associated with lower rate of adverse events and comparable efficacy when compared to the TG approach for the ***,use of cautery-enhanced LAMS for EUS-GBD is associated with a more favorable adverse event profile compared to cold *** the approach chosen depends on se

关键词： Transduodenal Transgastric Cautery Endoscopic ultrasound guided gallbladder drainage AXIOS

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