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Endocannabinoid system and cannabis hyperemesis syndrome: a narrative update
Perisetti, Abhilasha; Goyal, Hemantb
doi : 10.1097/MEG.0000000000001992
January 2022 - Volume 34 - Issue 1 - p 1-8
Cannabis use has been increasing in the United States and throughout the world. It is derived from one of the earliest plants cultivated by humans – Cannabis sativa. Cannabis (also called marijuana) is the most commonly used psychoactive substance worldwide. The cannabis plant has more than 400 chemicals, of which more than 100 cannabinoids (such as cannabigerol, cannabidiol, and cannabinol) have been identified. The endocannabinoid system (ECS) plays an essential role in the effects of cannabis on end organs. Although cannabis use has been reported for many decades, some of its unique adverse effects of nausea, vomiting, and abdominal pain, termed as cannabis hyperemesis syndrome (CHS), were noted recently. The legal status of cannabis in the United States has been rapidly changing from state to state. The incidence of CHS is expected to rise with rising access to cannabis in the United States. Furthermore, CHS is frequently underdiagnosed due to a lack of uniform criteria, subjective nature of symptoms, and overlap with cyclical vomiting syndrome (CVS). Understanding the ECS and its role in biphasic response (proemetic and antiemetic) of CHS is critical to explain its pathophysiology. As the use of cannabis increases globally, awareness of CHS is warranted for early recognition and prompt treatment to avoid complications. We describe the putative mechanism of CHS with an overview of the clinical features in these patients. Furthermore, we highlight the differences between CHS and CVS with important differentials to consider. We provide a narrative update on the current evidence on CHS pathophysiology, diagnosis, treatment, and identifying research gaps.
Response to: Malignancy associated to perianal Chrohn´s fistula – a challenge for more clinical research
Kruis, Wolfganga; Leifeld, Ludgerb
doi : 10.1097/MEG.0000000000002221
January 2022 - Volume 34 - Issue 1 - p 9-10
Thirty-day readmission rates, reasons, and costs for gastrointestinal angiodysplasia-related bleeding in the USA
Khan, Ahmada; Gupta, Kameshb; Chowdry, Monicaa; Sharma, Sachitc; Maheshwari, Sanjayd; Patel, Chiraga; Naseem, Khadijaa; Pervez, Hirae; Bilal, Mohammadf; Ali Khan, Muhammadg; Singh, Shailendrah
doi : 10.1097/MEG.0000000000002027
January 2022 - Volume 34 - Issue 1 - p 11-17
Patients with gastrointestinal angiodysplasia (GIA)-related bleeding are at high risk for readmissions, resulting in significant morbidity and an economic burden on the healthcare system.
Lack of anti-TNF drugs levels in fistula tissue – a reason for nonresponse in Crohn’s perianal fistulating disease?
Adegbola, Samuel O.a,b; Sarafian, Magalic; Sahnan, Kapila,b; Pechlivanis, Alexandrosc; Phillips, Robin K.S.a,b; Warusavitarne, Janindraa,b; Faiz, Omara,b; Haddow, Jamesd; Knowles, Charlesd; Tozer, Phila,b; Holmes, Elainec; Hart, Ailsaa,b
doi : 10.1097/MEG.0000000000002032
January 2022 - Volume 34 - Issue 1 - p 18-26
Anti-TNF therapy is recommended as treatment for patients with Crohn´s perianal fistulas. However, a significant proportion of patients have a sub-optimal response to anti-TNF therapy. Higher serum levels of anti-TNF agents have been associated with improved outcomes in perianal Crohn’s disease. Currently, it is unknown whether anti-TNF agent levels can be detected in tissue from fistula tracts themselves and whether this is associated with response.
Management of coeliac disease patients after the confirmation of diagnosis in Central Europe
Riznik, Petraa; De Leo, Luiginab; Dolinsek, Jasminac; Gyimesi, Juditd; Klemenak, Martinaa; Koletzko, Bertholde,f; Koletzko, Sibyllef,g; Koltai, Tundeh; Korponay-Szabó, Ilma Ritad,i; Krencnik, Tomaza; Milinovic, Marinaj; Not, Tarcisiob; Palcevski, Gorank; Sblattero, Danielel; Werkstetter, Katharina Juliaf; Dolinsek, Jerneja,m
doi : 10.1097/MEG.0000000000002039
January 2022 - Volume 34 - Issue 1 - p 27-32
Recently published paediatric guidelines for diagnosing coeliac disease do not include recommendations on the follow-up of coeliac disease patients.
A clinical prediction model to assess risk for pancreatic cancer among patients with prediabetes
Boursi, Bena,b,c; Finkelman, Briand; Giantonio, Bruce J.e; Haynes, Kevina; Rustgi, Anil K.a,f; Rhim, Andrew D.g; Mamtani, Ronaca,b,*; Yang, Yu-Xiaoa,*
doi : 10.1097/MEG.0000000000002052
January 2022 - Volume 34 - Issue 1 - p 33-38
Early detection of pancreatic ductal adenocarcinoma (PDA) may improve survival. We previously developed a clinical prediction model among patients with new-onset diabetes to help identify PDAs 6?months prior to the clinical diagnosis of the cancer. We developed and internally validated a new model to predict PDA risk among those newly diagnosed with impaired fasting glucose (IFG).
Structural validation and dyadic child–parent measurement invariance of the celiac disease quality of life questionnaire
Meyer, Sonyaa,b; Shani, Maorc
doi : 10.1097/MEG.0000000000002051
January 2022 - Volume 34 - Issue 1 - p 39-47
The celiac disease quality of life questionnaire (CDDUX) is used widely in numerous languages worldwide. However, it's structural and construct validity and child–parent invariance had not been thoroughly examined. The objective of this study was to examine the psychometric properties of the 12-item CDDUX and the extent to which it meets the acceptable requirements of reliability and structural and convergent validity, as well as its child–parent invariance.
Design and verification of individualized follow-up strategy of colonoscopy for postoperative patients with colorectal cancer
Guo, Chunmeia; Wu, Jinga,b,*; Jiao, Yueb; Zhang, Qianb; Wang, Canghaia; Wang, Yadana; Liu, Honga,*; Zhang, Shutianb,*; Wei, Nana; Lin, Wua; Liu, Kuilianga; Shi, Haiyunb
doi : 10.1097/MEG.0000000000002073
January 2022 - Volume 34 - Issue 1 - p 48-55
Current guidelines do not establish an individual scheme for surveillance colonoscopy in postoperative colorectal cancer (CRC) patients.
Increased prevalence of irritable bowel syndrome in migraine patients: a systematic review and meta-analysis
Wongtrakul, Wasita; Charoenngam, Nipithb; Ungprasert, Patompongc
doi : 10.1097/MEG.0000000000002065
January 2022 - Volume 34 - Issue 1 - p 56-63
Even though evidence showing increased prevalence of irritable bowel syndrome (IBS) among migraine patients exists, it has not been well-established and the magnitude of association varies substantially across the studies. This study aimed to comprehensively compare the prevalence of IBS among migraineurs versus nonmigraineurs using the systematic review and the meta-analysis technique.
Fluoroquinolone-resistant strains in cirrhotic patients with spontaneous bacterial peritonitis: microbiological and molecular aspects
Ghweil, Ali A.a; Bazeed, Shamardan Ezzeldin S.a; Al Rawy, M.H.b; Khodeary, Ashrafb; El-Amir, Mostafa I.c
doi : 10.1097/MEG.0000000000001908
January 2022 - Volume 34 - Issue 1 - p 64-68
This study aimed to determine the causative bacterial agents of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and to define antibiotic-resistance patterns in addition to identifying the genetic mutations in the quinolone resistance determining regions (QRDRs).
Age and fibrosis index for the prediction of hepatocellular carcinoma risk in patients with high hepatitis B virus DNA but normal alanine aminotransferase
Seong, Gyeol,*; Sinn, Dong Hyun,*; Kang, Wonseok; Gwak, Geum-Youn; Choi, Moon Seok; Lee, Joon Hyeok; Koh, Kwang Cheol; Woon Paik, Seung; Paik, Yong-Han
doi : 10.1097/MEG.0000000000001915
January 2022 - Volume 34 - Issue 1 - p 69-75
Chronic hepatitis B patients positive for hepatitis B e antigen (HBeAg) with high serum hepatitis B virus (HBV) DNA levels but normal alanine aminotransferase (ALT) levels may develop hepatocellular carcinoma (HCC). However, ways to risk stratify are limited.
Hepatitis C therapy with grazoprevir/elbasvir and glecaprevir/pibrentasvir in patients with advanced chronic kidney disease: data from the German Hepatitis C-Registry (DHC-R)
Stein, Kerstina; Stoehr, Albrechtb; Klinker, Hartwigc; Teuber, Gerlinded; Naumann, Uwee; John, Christinef; Heyne, Renateg; Serfert, Yvonneh; Niederau, Clausi; Zeuzem, Stefanj; Berg, Thomask; Wiegand, Johannesk; German Hepatitis C-Registry
doi : 10.1097/MEG.0000000000001923
January 2022 - Volume 34 - Issue 1 - p 76-83
Grazoprevir/elbasvir and glecaprevir/pibrentasvir (G/P) are the two preferred treatment options for patients with chronic hepatitis C virus (HCV) infection and a glomerular filtration rate (GFR) <30?mL/min. Both therapies have been separately analyzed in different real-life cohorts; however, a direct comparison has not been performed so far. We, therefore, analyzed safety and effectiveness of both regimens in a concerted real-life population.
Estimation of glomerular filtration rate in patients with cirrhosis: evaluation of equations currently used in clinical practice and validation of Royal Free Hospital cirrhosis glomerular filtration rate
Estimation of glomerular filtration rate in patients with cirrhosis: evaluation of equations currently used in clinical practice and validation of Royal Free Hospital cirrhosis glomerular filtration rate
doi : 10.1097/MEG.0000000000001935
January 2022 - Volume 34 - Issue 1 - p 84-91
Conventional creatinine-based glomerular filtration rate (GFR) equations have been reported to overestimate renal function in patients with cirrhosis. The Royal Free Hospital (RFH) cirrhosis GFR equation was developed to accurately estimate GFR in this population. The aim of this study was to evaluate the ability of widely available equations [Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI), Modification of Diet in Renal Disease equations (MDRD-4, MDRD-6)] and the RFH equation to correctly estimate the GFR of patients with cirrhosis.
Efficiency of azathioprine monotherapy for maintenance treatment of autoimmune hepatitis in children
Aksoy, Betula; Baran, Masallahb; Cagan Appak, Yelizb; Sag, Elifc; Cakir, Muratc; Guven, Burcuc; Yavuz, Sibeld; Emir, Busrae; Tumgor, Gokhand
doi : 10.1097/MEG.0000000000001930
January 2022 - Volume 34 - Issue 1 - p 92-97
Autoimmune hepatitis (AIH) is a common pediatric liver disease and long-term remission is usually maintained with low dose prednisolone and azathioprine (AZA). The aim of this study is to evaluate the efficiency of AZA monotherapy for maintenance treatment of children with AIH.
Accuracy of Fibrosis-4 index and non-alcoholic fatty liver disease fibrosis scores in metabolic (dysfunction) associated fatty liver disease according to body mass index: failure in the prediction of advanced fibrosis in lean and morbidly obese individuals
Eren, Fatiha,b; Kaya, Edac; Yilmaz, Yusufa,d
doi : 10.1097/MEG.0000000000001946
January 2022 - Volume 34 - Issue 1 - p 98-103
While non-invasive scores are increasingly being used to screen for advanced fibrosis in metabolic (dysfunction) associated fatty liver disease (MAFLD), the effect of BMI on their clinical utility remains uncertain. This study assessed the usefulness of the Fibrosis-4 index (FIB-4) and the non-alcoholic fatty liver disease fibrosis score (NFS) in lean, overweight, obese, severely obese, and morbidly obese patients with biopsy-proven MAFLD.
The role of nursing care in the type 2 diabetes treatment associated with chronic liver diseases
Fu, Bai Yua; Wang, Xue Jiaob
doi : 10.1097/MEG.0000000000002150
January 2022 - Volume 34 - Issue 1 - p 104-111
Diabetes is the fifth leading cause of death in the People’s Republic of China. The aim of the article is to compare the effects of nursing care on the laboratory findings and ultrasound results of diabetic patients with chronic liver diseases (CLD) who were treated with antiglycemic drugs.
Transjugular intrahepatic portosystemic shunt with transhepatic portal vein puncture guided by ultrasound: a technical alternative
Rêgo, Heloísa M.C.a; Medronha, Eduardo F.b; Junior, Enio Ziemieckib; Tovo, Cristiane V.a; de Mattos, Angelo A.a
doi : 10.1097/MEG.0000000000002174
January 2022 - Volume 34 - Issue 1 - p 112-116
Evaluation of an alternative technique to perform transjugular intrahepatic portosystemic shunt (TIPS), using abdominal ultrasound to guide portal puncture.
Chronic constipation and acute urinary retention
Chiba, Toshimia; Kikuchi, Satoshib; Omori, Soc; Seino, Kojic
doi : 10.1097/MEG.0000000000001970
January 2022 - Volume 34 - Issue 1 - p e1-e2
High level of defensin alpha 5 in intestine may explain the low incidence of diarrhoea in COVID-19 patients
Luan, Junwen; Ren, Yongwen; Gao, Shan; Zhang, Leiliang
doi : 10.1097/MEG.0000000000001941
January 2022 - Volume 34 - Issue 1 - p e3-e4
