Journal of gastroenterology and hepatology research 

About: Journal of gastroenterology and hepatology research is an academic journal. The journal publishes majorly in the area(s): Cancer & Cirrhosis. It has an ISSN identifier of 2224-3992. It is also open access. Over the lifetime, 555 publications have been published receiving 1396 citations.

Evaluation of histologic cutpoints for treatment response in eosinophilic esophagitis

Abstract: Aim: No consensus exists on the definition of successful treatment in eosinophilic esophagitis (EoE). The aim of this study was to identify the optimal histologic cutpoint to define successful treatment of EoE by assessing rates of symptomatic and endoscopic improvement. Materials and Methods: We performed a retrospective cohort study utilizing the University of North Carolina EoE Clinicopathologic Database between 2006 and 2013. Rates of symptomatic and endoscopic improvement were determined, as were post-treatment eosinophil counts. The area under the receiver operator characteristic curve (AUC) was calculated for symptomatic and endoscopic response at several possible eosinophil count cutpoints (eos/hpf). Predictors of response were also assessed. Results: Of 224 treatments in 199 patients, 76% were associated with symptomatic improvement, 68% with endoscopic improvement, and 60% with both. Of treatments that resulted in a post-treatment count of <15 eos/hpf, 90% were associated with an endoscopic response, 88% with a symptomatic response, and 81% with both symptomatic and endoscopic responses. Using a <15 eos/hpf threshold, the area under the curves (AUCs) were 0.70, 0.78, and 0.75 for symptomatic, endoscopic, and symptomatic/endoscopic responses, respectively. Lower histologic cut-points did not result in a substantial gain in response, but decreased the AUC. Conclusion: In this large cohort of EoE patients, rates of symptomatic and endoscopic improvement were generally associated with histologic improvement. A histologic cutoff for treatment response of <15 eos/hpf may balance clinical outcomes and test performance.

The Effects of Sensory Stimulation on Neurogenic Oropharyngeal Dysphagia

Abstract: Sensory input is crucial for the initiation and modulation of the swallow response. Patients with neurogenic oropharyngeal dysphagia present severe impairments in oropharyngeal sensitivity associated with impaired motor responses. Several strategies have been used with the aim to modulate the swallow response by modifying the sensorial properties of the bolus (either chemically or physically) or by directly stimulating the sensory and motor neurons of the pharynx and larynx. Most of the stimuli described as swallow sensory stimulants (such as acid, capsaicin or piperine) are integrated by receptors of the multimodal transient receptor potential (TRP) channel family, mostly expressed in sensory nerves. Enhancing the sensorial stimuli may increase the sensorial input to the swallowing centre of the brain stem, thus triggering the swallow response earlier and protecting the respiratory airway. Moreover, sensorial stimuli may promote brain plasticity, facilitating the recovery of deglutition. The aim of this review is to briefly summarize the effects of swallow therapies focused on sensory stimulation and discuss their effects, rationality, action mechanism and perspectives in patients with neurogenic oropharyngeal dysphagia.

Evaluation of L-Carnitine Efficacy in the Treatment of Non-Alcoholic Fatty Liver Disease among Diabetic Patients: A Randomized Double Blind Pilot Study

Abstract: AIM: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases worldwide and while its pathophysiology is still unverified, most of the present theories are based on Insulin resistance and oxidative stress as key factors According to role of L-Carnitine in the process of fatty acid oxidation and glucose metabolism, it seems that this drug could be potentially effective in the treatment of diabetic patients suffering from NAFLD This study has been designed to evaluate this potential therapeutic effect METHOD: 60 type 2 diabetic patients with NAFLD based on sonographic findings and elevated serum transaminases randomly divided into 2 groups The intervention group (A) treated with L-Carnitine 750mg TDS while the control group (B) received placebo After 3 months intervention the level of liver transaminases and sonographic degree of fatty liver compared between 2 groups RESULT: After three months of intervention, in group A the level of AST decreased from 1227 ± 136 to 963 ± 7 while in group B raised from 125 ± 14 to 126 ± 11 (p 005) and also the sonographic degree of fatty liver didn't change among 2 groups CONCLUSION: It seems that L-Carnitine is effective in treatment of NAFLD among diabetic patients and could be a potential therapeutic approach in such patients We recommend these findings to further be verified in future studies (wwwirctir: IRCT2014020316348N2)

Sedative and Analgesic Drugs for Gastrointestinal Endoscopic Procedure

Abstract: Gastrointestinal endoscopy has become an essential modality for evaluation and treatment of gastrointestinal tract abnormalities. This procedure is complex and may be unsafe if special concerns are not considered. The goal of procedural sedation in endoscopic procedure is the safe and effective control of pain and anxiety, to provide an appropriate degree of memory loss or decreased awareness and to improve endoscopic performance especially in therapeutic procedures. Regardless of regimen used, the safe administration of sedative and analgesic drugs requires an awareness of the particular needs of the patients. The most commonly used sedation regimen for sedation in gastrointestinal endoscopic procedure is still the combination of benzodiazepines and opioids. In addition, the use of propofol has increased enormously in the past decade. New sedative agents are currently used and studied. Although sedation in this endoscopic procedure is considered safe, the sedation has a potential for complications. Sedation-related complications can more easily occur even in healthy populations. Risk evaluation before the procedure and monitoring during and after the procedure as well as increased awareness of the sedation-related complications must be performed. Furthermore, properly trained staff and emergency equipment should be available. This article reviews pharmacokinetics and pharmacodynamics of sedative and analgesic drugs and discusses the clinical use in gastrointestinal endoscopic procedure.

Compounded Oral Viscous Budesonide is Effective and Provides a Durable Response in Eosinophilic Esophagitis.

Abstract: Aim Because no approved medications exist for eosinophilic esophagitis (EoE), patients must use off-label drugs or create their own formulations. We assessed the efficacy of a standardized compounded budesonide suspension for treatment of EoE.