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Topic review
Updated time: 21 Apr 2021
Submitted by: Berardino Vaira
Definition: H. pylori is a “fastidious” microorganism; culture methods are time-consuming and technically challenging. The advent of molecular biology techniques has enabled the identification of molecular mechanisms underlying the observed phenotypic resistance to antibiotics in H. pylori.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 18 Feb 2021
Submitted by: Tsvetelina Velikova
Definition: The interplay between drugs and microbiota is critical for successful treatment. An accumulating amount of evidence has identified the significant impact of intestinal microbiota composition on cancer treatment response, particularly immunotherapy. The possible molecular pathways of the interaction between immune checkpoint inhibitors (ICIs) and the microbiome can be used to reverse immunotherapy tolerance in cancer by using various kinds of interventions on the intestinal bacteria. This paper aimed to review the data available on how the antibiotic-related changes in human microbiota during colorectal cancer (CRC) treatment can affect and determine ICI treatment outcomes. We also covered the data that support the potential intimate mechanisms of both local and systemic immune responses induced by changes in the intestinal microbiota. However, further better-powered studies are needed to thoroughly assess the clinical significance of antibiotic-induced alteration of the gut microbiota and its impact on CRC treatment by direct observations of patients receiving antibiotic treatment.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 19 May 2021
Submitted by: Evette Hillman
Definition: Bile acid diarrhoea (BAD) is a widespread gastrointestinal disease that presents as chronic watery diarrhoea as well as bloating and abdominal pain. This condition is often misdiagnosed as irritable bowel syndrome and is estimated to affect 1% of the United Kingdom population alone. BAD is associated with excessive bile acid synthesis secondary to a gastrointestinal or idiopathic disorder (also known as primary BAD). Current treatment includes diet changes and bile acid sequestrant medication.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 17 Jun 2021
Submitted by: Mark Gray
Definition: Intestinal resection and anastomosis is a commonly performed abdominal procedure used in the treatment of colorectal cancers. Unfortunately, ~7% of all patients will develop an anastomotic leak (AL) following surgery. This situation occurs when the anastomotic site fails to heal correctly leading to contamination of the abdominal cavity with intestinal contents and the development of septic peritonitis. Patients often require revision surgery and intensive care, both of which are associated with significantly longer hospitalisation stays and increased economic costs. Patients also have higher morbidity and mortality rates and poorer oncological prognosis. Predicting which patients are at high-risk of developing an AL or diagnosing an AL early in the post-operative period is essential to optimise patient care and improve outcome. Unfortunately, predicting and diagnosing an AL following surgery for colorectal cancers is extremely difficult. Patients can present with a range of clinical symptoms and have non-specific findings on routine bloodwork. Diagnosis currently relies heavily on abdominal imaging with CT scans and contrast studies. Unfortunately, these techniques suffer from variable sensitivity and specificity and may delay diagnosis. To overcome these issues, pre-clinical and clinical research is continuing to identify diagnostic and predictive AL biomarkers.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 18 Mar 2021
Submitted by: Tuan Tran
Definition: Cirrhotic cardiomyopathy (CCM), cardiac dysfunction in end-stage liver disease in the absence of prior heart disease, is an important clinical entity that contributes significantly to morbidity and mortality. The original definition for CCM, established in 2005 at the World Congress of Gastroenterology (WCG), was based upon known echocardiographic parameters to identify subclinical cardiac dysfunction in the absence of overt structural abnormalities. Subsequent advances in cardiovascular imaging and in particular myocardial deformation imaging have rendered the WCG criteria outdated. A number of investigations have explored other factors relevant to CCM, including serum markers, electrocardiography, and magnetic resonance imaging. CCM characteristics include a hyperdynamic circulatory state, impaired contractility, altered diastolic relaxation, and electrophysiological abnormalities, particularly QT interval prolongation. It is now known that cardiac dysfunction worsens with the progression of cirrhosis. Treatment for CCM has traditionally been limited to supportive efforts, but new pharmacological studies appear promising. Left ventricular diastolic dysfunction in CCM can be improved by targeted heart rate reduction. Ivabradine combined with carvedilol improves left ventricular diastolic dysfunction through targeted heart rate reduction, and this regimen can improve survival in patients with cirrhosis. Orthotopic liver transplantation also appears to improve CCM.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 03 Feb 2021
Submitted by: Benoit Guery
Definition: Clostridioides difficile is an increasingly common pathogen both within and outside the hospital and is responsible for a large clinical spectrum from asymptomatic carriage to complicated infection associated with a high mortality. While diagnostic methods have considerably progressed over the years, the optimal diagnostic algorithm is still debated and there is no single diagnostic test that can be used as a standalone test. More importantly, the heterogeneity in diagnostic practices between centers along with the lack of robust surveillance systems in all countries and an important degree of underdiagnosis due to lack of clinical suspicion in the community, hinder a more accurate evaluation of the burden of disease. Our improved understanding of the physiopathology of CDI has allowed some significant progress in the treatment of CDI, including a broader use of fidaxomicine, the use of fecal microbiota transplantation for multiples recurrences and newer approaches including antibodies, vaccines and new molecules, already developed or in the pipeline.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 04 Jun 2021
Submitted by: Hiroki Kuniyasu
Definition: Advanced glycation end products (AGEs) are produced in response to a high-glucose environment and oxidative stress and exacerbate various diseases. Nε-(Carboxymethyl)lysine (CML) is an AGE that is produced by the glycation of lysine residues of proteins.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 14 Jan 2021
Submitted by: Duaa Elhag
Definition: Type 1 diabetes (T1D) is an auto-immune disorder characterized by a complex interaction between the host immune system and various environmental factors in genetically susceptible individuals. Genome-wide association studies (GWAS) identified different T1D risk and protection alleles, however, little is known about the environmental factors that can be linked to these alleles. Recent evidence indicated that, among those environmental factors, dysbiosis (imbalance) in the gut microbiota may play a role in the pathogenesis of T1D, affecting the integrity of the gut and leading to systemic inflammation and auto-destruction of the pancreatic β cells.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 21 Jul 2021
Submitted by: Heather Francis
Definition: cAMP was first discovered in 1958 and introduced the concept of a “second messenger” system. In fact, this molecule, together with cyclic guanosine monophosphate (cGMP), has been identified as an important intracellular translator of membrane signaling originating from hormones, growth factors, cytokines and other molecules. In the general transduction mechanism, the stimulated receptor activates the corresponding G-coupled protein, leading to increased adenylyl cyclase-mediated cAMP synthesis.
Entry Collection : Gastrointestinal Disease
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Topic review
Updated time: 18 Jan 2021
Submitted by: Young Park
Definition: Helminthiasis is an expensive management problem in sheep and goat industry, because the gastrointestinal parasites develop resistance against all anthelmintic chemical products which are discovered and produced by the pharmaceutical industry. The use of natural tannin containing forages such as Sericea Lespedeza is highly promising. Helminthiasis is the invasion of internal parasites into the GI tract of domestic animals, even in humans, causing serious deadly consequences. Sheep and goats are more seriously afflicted than other farm animals. Helminthiasis results in high mortality rate, and poor growth rates, low reproductive performances and low quality products produced from infected animals, which increase high production costs. Anthelmintic drug has been used as the most common control method against gastrointestinal nematodes (GIN) infection. Overuse and misuse of these drugs caused significant GIN resistance against the drugs, especially in sheep and goat production.
Entry Collection : Gastrointestinal Disease
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