Neutrophils interact with cholangiocytes to cause cholestatic changes in alcoholic hepatitis

Alcoholic hepatitis (AH) is a common but life-threatening disease with limited treatment options. Neutrophils in contact with bile ducts were quantified in liver biopsies from patients with AH and controls and correlated with clinical and pathological findings. Cholangiocytes co-cultured with neutrophils lost ITPR3, an apical intracellular calcium channel necessary for cholang iocytes' secretion. This previously unrecognised role alters our understanding of the disease and identifies new therape

Randomized Trial of Focused Ultrasound Subthalamotomy for Parkinson's Disease

Focused ultrasound subthalamotomy in one hemisphere improved motor features of Parkinson's disease in selected patients. Adverse events included speech and gait disturbances, weakness on the treated side, and dyskinesia. In 6 patients in the active-treatment group, some deficits were still present at 12 months after treatment. The MDS-UPDRS motor score for the more affected side decreased from 19.9 at baseline to 9. 9 at 4 months in theActive Treatment Group and 17.1 in the Control Group. The su

Dipeptidyl Peptidase 4 Inhibition for Prophylaxis of Acute Graft-versus-Host Disease

Dipeptidyl peptidase 4 (DPP-4; also known as CD26), a transmembrane receptor expressed on T cells, has a costimulatory function in activating T cells.In this nonrandomized trial, sitagliptin in combination with tacrolimus and sirolimus resulted in a low incidence of grade II to IV acute GVHD by day 100 after myeloablative allogeneic hematopoietic stem-cell transplantation.

Urgent endoscopic retrograde cholangiopancreatography with sphincterotomy versus conservative treatment in predicted severe acute gallstone pancreatitis (APEC): a multicentre randomised controlled trial

Randomised trial compared urgent ERCP with sphincterotomy versus conservative treatment. The primary endpoint was a composite of mortality or major complications within 6 months of randomisation. No relevant differences in the individual components of the primary endpoint were recorded between groups, apart from the occurrence of cholangitis. Findings support a conservative strategy in patients with predicted severe acute gallstone pancreatitis with an E RCP indicated only in patients who have c

A systematic review of symptomatic small bowel lipomas of the jejunum and ileum

Small bowel lipomas are rarely encountered benign adipose growths found within the small intestine wall or mesentery. We aim to aid clinical decision-making and improve patient outcomes. 124/137 (90.5%) required definitive surgical management. 9 patients were successfully managed endoscopically. Open surgery remains the primary management. Endoscopic and laparoscopic techniques may reduce utilising invasive surgery in the future as skillset and availability improve. 4 complications, 0 mortality.

Endoscopic Ultrasound-Guided, Percutaneous, and Transjugular Liver Biopsy: A Comparative Systematic Review and Meta-Analysis

Endoscopic ultrasound-guided liver biopsy (EUSLB) has become an attractive alternative. EUSLB appears to be a safe, minimally invasive procedure that is comparable to PCLB and TJLB regarding biopsy specimens obtained and rate of adverse events associated with each method. Compared to TJLB, EUS LB showed no difference in LLP( length of longest piece) (p=0.351), fewer CPT( complete portal triads), and longer TSL( total specimen length).

Systematic review with meta-analysis: age-related malignancy detection rates at upper gastrointestinal endoscopy

Age is an important and objective risk factor for upper gastrointestinal (GI) malignancy. The accuracy of various age limits to detect upper GI malignancies is unclear. Aim of this analysis was to synthesize data on upper GI malignancy detection rates. To detect >80% of malignant cases all symptomatic patients over 40 years of age should be investigated in Africa,over 50 years of age in South America and Asia, and over 55 years of age in North America and Europe.

Faecal microbiota transplantation for recurrent Clostridioides difficile infection: An updated systematic review and meta-analysis

Faecal microbiota transplantation (FMT) is effective for recurrent Clostridioides difficile infection (CDI) However, inconsistent effect rates and uncertain evidence levels have warranted caution. We aimed to establish the evidence of FMT for recurrent CDI across different delivery methods, treatment regimens, and in comparison with standard antibiotics. The overall clinical effect week 8 following repeat FMT (24 studies, 1855 patients) was 91% (95% CI: 89-94%, I 2=53%) and 84% (80-88%) followin