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Favipiravir-induced liver Injury in Patients with Coronavirus Disease 2019

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Journal of Clinical and Translational Hepatology 2021年第2期9卷 276-278页

作者： Pramod Kumar Anand Kulkarni Mithun Sharma Padaki Nagaraja Rao Duvvuru Nageshwar Reddy department of Hepatology and liver Transplantation Asian Institute of Gastroenterology HospitalsHyderabadIndia department of gastroenterology Asian Institute of Gastroenterology HospitalsHyderabadIndia

Favipiravir,an antiviral,was given restricted emergency use approval to treat coronavirus disease 2019(COVID-19)in many *** the clinical efficacy of favipiravir in COVID-19 remains uncertain,the approval was based on findings from in vitro studies and a clinical trial.1 Limited data from studies of the Ebola virus and influenza disease showed a favorable safety profile.2 Herein,we provide the first report of drug-induced liver injury(DILI)due to favipiravir in patients treated for COVID-19.

关键词： clinical approval liver

Efficacy of saccharomyces boulardii with antibiotics in acute amoebiasis

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World Journal of gastroenterology 2003年第8期9卷 1832-1833页

作者： Fariborz Mansour-Ghanaei Najaf Dehbashi Kamyar Yazdanparast Afshin Shafaghi Gastrointestinal and liver diseases Research Center Guilan University of Medical SciencesRashtIran department of gastroenterology Shiraz University of Medical SciencesShirazIran department of Microbiology Shiraz University of Medical SciencesShirazIran

AIM: To compare the efficacy of antibiotics therapy alone with antibiotics and saccharomyces boulardii in treatment of acute ***: In a double blind, random clinical trial on patients with acute intestinal amoebiasis, 57 adult patients with acute amoebiasis, diagnosed with clinical manifestations (acute mucous bloody diarrhea) and amebic trophozoites engulfing RBCs found in stool were enrolled in the *** 1 induded metronidazole (750 mg Tid) and iodoquinol (630 mg Tid) for 10 days. Regimen 2 contained capsules of lyophilized saccharomyces boulardii (250 mg Tid) orally in addition to regimen 1. Patients were re-examined at two and four weeks after the treatment, and stool examination was performed at the end of week 4. Student′s t-test, χ2and McNemar′s tests were used for statistical ***: Three patients refused to participate. The other 54 patients were randomized to receive either regimen 1 or regimen 2 (Groups 1 and 2 respectively, each with 27patients). The two groups were similar regarding their age,sex and clinical manifestations. In Group 1, diarrhea lasted 48.0±18.5 hours and in Group 2,12.0±3.7 hours (P＜0.0001).In Group 1, the durations of fever and abdominal pain were 24.0±8.8 and 24.0±7.3 hours and in Group 2 they were 12.0±5.3 and 12.0±3.2 hours, respectively (P＜0.001).Duration of headache was similar in both groups. At week 4, amebic cysts were detected in 5 cases (18.5 %) of Group 1 but in none of the Group 2 (P＜0.02).CONCLUSION: Adding saccharomyces boulardii to antibiotics in the treatment of acute amebiasis seems to decrease the duration of clinical symptoms and cyst passage.

关键词：抗生素阿米巴病酵母临床疗效

Distinct colonoscopy findings of microscopic colitis:Not so microscopic after all?

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World Journal of gastroenterology 2011年第37期17卷 4157-4165页

作者： Anastasios Koulaouzidis Athar A Saeed Endoscopy Unit Centre for Liver and Digestive DisordersThe Royal Infirmary of Edinburgh gastroenterology department Queen Elizabeth Hospital

Microscopic colitis(MC) is considered an "umbrella term",comprising two subtypes,i.e.,collagenous colitis(CC) and lymphocytic colitis(LC).They are classically associated with normal or unremarkable *** the last few years,reports have been published revealing findings that are thought to be characteristic or pathognomonic of MC,especially CC.A systematic electronic and manual search of PubMed and EMBASE(to December 2010),for publications on distinct endoscopic findings in MC,resulted in 42 relevant reports for inclusion in this *** eight patients with collagenous colitis were *** one publication describing a distinct endoscopic pattern in LC was *** findings in CC are alteration of the vascular mucosal pattern,mucosal nodularity,a sequence of change from mucosal defects to mucosal cicatricial lesions,and perhaps(although of doubtful relevance) mucosal pseudomembranes.A causal connection of mucosal defects with the use of lansoprazole seems to *** of the proposed lesion description herein is recommended in order to improve homogeneity of future reports.

关键词： Collagenous colitis Microscopic colitis Endoscopy Mucosa Lesion

MicroRNAs as non-invasive diagnostic biomarkers for gastric cancer:Current insights and future perspectives

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World Journal of gastroenterology 2018年第30期24卷 3313-3329页

作者： Alexander Link Juozas Kupcinskas department of gastroenterology Hepatology and Infectious DiseasesOtto-von-Guericke University Institute for Digestive Research and department of gastroenterology Lithuanian University of Health Sciences

Non-invasive diagnostic biomarkers may contribute to an early identification of gastric cancer(GC) and improve the clinical ***,no sensitive and specific screening biomarkers are available yet and the currently available approaches are limited by the nature of the *** is a heterogenic disease with various distinct genetic and epigenetic events that occur during the multifactorial cascade of *** RNAs(mi RNAs) are commonly deregulated in gastric mucosa during the Helicobacter pylori infection and in stepwise manner from chronic gastritis,through preneoplastic conditions such as atrophic gastritis and intestinal metaplasia,to early dysplasia and invasive *** of mi RNAs in blood in 2008 led to a great interest on mi RNA-based diagnostic,prognostic biomarkers in *** this review,we provide the most recent systematic review on the existing studies related to mi RNAs as diagnostic biomarkers for ***,we systematically evaluate 75 studies related to differential expression of circulating mi RNAs in GC patients and provide novel view on various heterogenic aspects of the existing data and summarize the methodological ***,we highlight several important aspects crucial to improve the future translational and clinical research in the field.

关键词： microRNA biomarkers screening stomach gastric cancer systematic review blood serum plasma

Biliary cholesterol secretion: More than a simple ABC

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World Journal of gastroenterology 2010年第47期16卷 5936-5945页

作者： Arne Dikkers Uwe JF Tietge department of Pediatrics Center for Liver Digestive and Metabolic DiseasesUniversity Medical Center Groningen University of Groningen

Biliary cholesterol secretion is a process important for 2 major disease complexes, atherosclerotic cardiovascular disease and cholesterol gallstone disease. With respect to cardiovascular disease, biliary cholesterol secretion is regarded as the f inal step for the elimination of cholesterol originating from cholesterol-laden macrophage foam cells in the vessel wall in a pathway named reverse cholesterol transport. On the other hand, cholesterol hypersecretion into the bile is considered the main pathophysiological determinant of cholesterol gallstone formation. This review summarizes current knowledge on the origins of cholesterol secreted into the bile as well as the relevant processes and transporters involved. Next to the established ATP-binding cassette (ABC) transporters mediating the biliary secretion of bile acids (ABCB11), phospholipids (ABCB4) and cholesterol (ABCG5/G8), special attention is given to emerging proteins that modulate or mediate biliary cholesterol secretion. In this regard, the potential impact of the phosphatidylserine flippase ATPase class Ⅰ type 8B member 1, the Niemann Pick C1-like protein 1 that mediatescholesterol absorption and the high density lipoprotein cholesterol uptake receptor, scavenger receptor class B type Ⅰ, is discussed.

关键词： Cholesterol Bile Gallstone Atherosclerosis Reverse cholesterol transport Lipoproteins High density lipoprotein Scavenger receptor class B type Ⅰ

Acute mesenteric ischemia and small bowel imaging findings in COVID-19:A comprehensive review of the literature

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World Journal of Gastrointestinal Surgery 2021年第7期13卷 702-716页

作者： Lorena Pirola Andrea Palermo Giacomo Mulinacci Laura Ratti Maria Fichera Pietro Invernizzi Chiara Viganò Sara Massironi Division of gastroenterology and Center for Autoimmune liver diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy European Reference Network on Hepatological diseases San Gerardo HospitalMonza 20900Italy

BACKGROUND Coronavirus disease 2019(COVID-19),an infectious condition caused by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2),has rapidly spread worldwide since its first description in Wuhan in December *** though respiratory manifestations are the most prevalent and responsible for disease morbidity and mortality,extrapulmonary involvement has progressively gained *** particular,gastrointestinal(GI)signs and symptoms,reported in up to two-thirds of patients with COVID-19,might represent the first and,in some cases,the only disease *** presence has been associated in some studies with an increased risk of a severe disease *** pathogenic mechanisms explaining GI tract involvement are either direct viral access to intestinal cells via angiotensin-converting enzyme 2 or indirect damage of the intestinal wall through mesenteric ischemia induced by the hypercoagulable state associated with COVID-19 *** not typical of SARS-Co V-2 infection,several small bowel manifestations have been described in infected patients who underwent any form of abdominal *** radiological findings were mainly reported in patients with abdominal symptoms,among which abdominal pain was the most *** To discuss small bowel radiological manifestations of SARS-Co V-2 infection in abdominal imaging *** Bibliographical searches were performed in Pub Med,using the following keywords:"COVID-19"AND"imaging"AND"gastrointestinal"OR"abdominal"OR"small bowel".RESULTS Of 62 patients with described radiologic small bowel alterations,mesenteric ischemia was diagnosed in 31 cases(50%),small bowel wall thickening in 10 cases(16%),pneumatosis in nine cases(15%),intussusception in eight cases(13%),pneumoperitoneum in two cases(3%)and paralytic ileus in two cases(3%).We also reported mesenteric adipose tissue hypertrophy and lymph nodes enlargement in a young *** So far it is difficult to establish whether

关键词： COVID-19 SARS-CoV-2 Radiology Small intestine Abdomen

Nonselective beta-blockers in cirrhotic patients with no or small varices:A meta-analysis

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World Journal of gastroenterology 2015年第10期21卷 3100-3108页

作者： Xing-Shun Qi Yong-Xin Bao Ming Bai Wen-Da Xu Jun-Na Dai Xiao-Zhong Guo liver cirrhosis group Department of GastroenterologyGeneral Hospital of Shenyang Military Area Xijing Hospital of Digestive diseases Fourth Military Medical University department of Traditional Medicine General Hospital of Shenyang Military Area

AIM:To explore effects of nonselective beta-blockers(NSBBs) in cirrhotic patients with no or small ***:The Pub Med,EMBASE,Science Direct,and Cochrane library databases were searched for relevant papers.A meta-analysis was performed using ORs with 95%CI as the effect *** analysis was conducted according to the studies including patients without varices and those with small ***:Overall,784 papers were initially retrieved from the database searches,of which six randomized controlled trials were included in the *** incidences of large varices development(OR = 1.05,95%CI:0.25-4.36;P = 0.95),first upper gastrointestinal bleeding(OR = 0.59,95%CI:0.24-1.47;P = 0.26),and death(OR = 0.70,95%CI:0.45-1.10;P = 0.12) were similar between NSBB and placebo ***,the incidence of adverse events was significantly higher in the NSBB group compared with the placebo group(OR = 3.47,95%CI:1.45-8.33;P = 0.005).The results of subgroup analyses were similar to those of overall ***:The results of this meta-analysis indicate that NSBBs should not be recommended for cirrhotic patients with no or small varices.

关键词： Beta-blocker liver cirrhosis Portal hyper-tension

Clinical management of acute liver failure: Results of an international multi-center survey

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World Journal of gastroenterology 2016年第33期22卷 7595-7603页

作者： Liane Rabinowich Julia Wendon William Bernal Oren Shibolet liver Unit Department of GastroenterologyTel-Aviv Medical Center and Tel-Aviv University liver Intensive Therapy Unit Institute of Liver StudiesKing’s College Hospital

AIM To assess the practice of caring for acute liver failure(ALF) patients in varying geographic locations and medical *** Members of the European Acute liver Failure Consortium completed an 88-item questionnaire detailing management of ALF. Responses from 22 transplantation centers in 11 countries were analyzed,treating between 300 and 500 ALF cases and performing over 100 liver transplants(LT) for ALF annually. The questions pertained to details of the institution and their clinical activity,standards of care,referral and admission,wardbased care versus intensive care unit(ICU) as well as questions regarding liver transplantation- including criteria,limitations,and perceived performance. Clinical data was also collected from 13 centres over a 3 mo period. RESULTS The interval between referral and admission of ALF patients to specialized units was usually less than 24 h and once admitted,treatment was provided by a multidisciplinary team. Principles of care of patients with ALF were similar among centers,particularly in relation to recognition of severity and care of the more critically ill. Centers exhibited similarities in thresholds for ICU admission and management of severe hepatic encephalopathy. Over 80% of centers administered n-acetyl-cysteine to ICU patients for non-paracetamolrelated ALF. There was significant divergence in the use of prophylactic antibiotics and anti-fungals,lactulose,nutritional support and imaging investigations in admitted patients and in the monitoring and treatment of intra-cranial pressure(ICP). ICP monitoring was employed in 12 centers,with the most common indications being papilledema and renal failure. Most patients listed for transplantation underwent surgery within an average waiting time of 1-2 d. Over a period of 3 mo clinical data from 85 ALF patients was collected. Overall patient survival at 90-d was 76%. Thirty six percent of patients underwent emergency LT,with a 90% post transplant survival to hospital disc

关键词： Acute liver failure liver transplantation Intra-cranial pressure Hepatic encephalopathy

Current and Future Treatment of Hepatocellular Carcinoma:An Updated Comprehensive Review

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Journal of Clinical and Translational Hepatology 2018年第1期6卷 69-78页

作者： Saleh Daher Muhammad Massarwa Ariel A. Benson Tawfik Khoury gastroenterology and liver Units Department of MedicineHadassah-Hebrew University Medical CenterJerusalemIsrael

Hepatocellular carcinoma(HCC)is among the leading causes of cancer-related *** principal treatment is surgical resection or liver transplantation,depending on whether the patient is a suitable transplant ***,in most patients with HCC the diagnosis is often late,thereby excluding the patients from definitive surgical *** treatment includes sorafenib,which is the most commonly used systemic therapy;although,it has been shown to only minimally impact patient survival by several *** and radiotherapy are generally *** to the poor prognosis of patients with HCC,newer treatments are needed with several being in development,either in preclinical or clinical *** this review article,we provide an update on the current and future medical and surgical management of HCC.

关键词： HCC Treatments Sorafenib Mortality