Gastroenterology
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The surface of the intestinal mucosa is particularly prone to hypoxia-induced inflammation. Previous studies implicated signaling via extracellular adenosine in endogenous attenuation of intestinal inflammation; we investigated whether epithelial adenosine transport could reduce hypoxia-induced inflammation of the mucosa. ⋯ HIF-1alpha-dependent repression of ENT2 increases mucosal adenosine signaling and attenuates hypoxia-associated inflammation of the intestine.
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Randomized Controlled Trial
A randomized controlled trial of antioxidant supplementation for pain relief in patients with chronic pancreatitis.
Oxidative stress has been implicated in the pathophysiology of chronic pancreatitis (CP). We evaluated the effects of antioxidant supplementation on pain relief, oxidative stress, and antioxidant status in patients with CP. ⋯ Antioxidant supplementation was effective in relieving pain and reducing levels of oxidative stress in patients with CP.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized, double-blinded, placebo-controlled multicenter trial of etanercept in the treatment of alcoholic hepatitis.
Alcoholic hepatitis is a cause of major morbidity and mortality that lacks effective therapies. Both experimental and clinical evidence indicate that the multifunctional cytokine tumor necrosis factor-alpha (TNF-alpha) contributes to pathogenesis and clinical sequelae of alcoholic hepatitis. A pilot study demonstrated that the TNF-alpha-neutralizing molecule etanercept could be an effective treatment for patients with alcoholic hepatitis. ⋯ In patients with moderate to severe alcoholic hepatitis, etanercept was associated with a significantly higher mortality rate after 6 months, indicating that etanercept is not effective for the treatment of patients with alcoholic hepatitis.
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Multicenter Study Comparative Study
Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice.
The most widely quoted complication rates for colonoscopy are from case series performed by expert endoscopists. Our objectives were to evaluate the rates of bleeding, perforation, and death associated with outpatient colonoscopy and their risk factors in a population-based study. ⋯ Although colonoscopy has established benefits for the detection of colorectal cancer and adenomatous polyps, the procedure is associated with risks of serious complications, including death. Older age, male sex, having a polypectomy, and having the procedure done by a low-volume endoscopist were independently associated with colonoscopy-related bleeding and perforation.