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  1. Article ; Online: An update on the management of cholestatic liver diseases.

    Appanna, Gautham / Kallis, Yiannis

    Clinical medicine (London, England)

    2020  Volume 20, Issue 5, Page(s) 513–516

    Abstract: Cholestatic liver diseases are a challenging spectrum of conditions arising from damage to bile ducts, leading to build-up of bile acids and inflammatory processes that cause injury to cholangiocytes and hepatocytes. Primary biliary cholangitis (PBC) and ...

    Abstract Cholestatic liver diseases are a challenging spectrum of conditions arising from damage to bile ducts, leading to build-up of bile acids and inflammatory processes that cause injury to cholangiocytes and hepatocytes. Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are the two most common cholestatic disorders. In this review we detail the latest guidelines for the diagnosis and management of patients with these two conditions.
    MeSH term(s) Bile Acids and Salts ; Bile Ducts/pathology ; Cholangitis, Sclerosing/diagnosis ; Cholangitis, Sclerosing/pathology ; Cholangitis, Sclerosing/therapy ; Humans ; Liver Cirrhosis, Biliary/pathology
    Chemical Substances Bile Acids and Salts
    Language English
    Publishing date 2020-09-12
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2048646-7
    ISSN 1473-4893 ; 1470-2118
    ISSN (online) 1473-4893
    ISSN 1470-2118
    DOI 10.7861/clinmed.2020-0697
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5439: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Is it time for recommendations to reflect reality in PSC surveillance?

    Hawken, James / Appanna, Gautham / Portal, A J

    Frontline gastroenterology

    2021  Volume 13, Issue 1, Page(s) 88–89

    Language English
    Publishing date 2021-03-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2521857-8
    ISSN 2041-4137
    ISSN 2041-4137
    DOI 10.1136/flgastro-2021-101812
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6880: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: The Ussing chamber system for measuring intestinal permeability in health and disease.

    Thomson, Amanda / Smart, Kathryn / Somerville, Michelle S / Lauder, Sarah N / Appanna, Gautham / Horwood, James / Sunder Raj, Lawrence / Srivastava, Brijesh / Durai, Dharmaraj / Scurr, Martin J / Keita, Åsa V / Gallimore, Awen M / Godkin, Andrew

    BMC gastroenterology

    2019  Volume 19, Issue 1, Page(s) 98

    Abstract: Background: The relationship between intestinal epithelial integrity and the development of intestinal disease is of increasing interest. A reduction in mucosal integrity has been associated with ulcerative colitis, Crohn's disease and potentially could ...

    Abstract Background: The relationship between intestinal epithelial integrity and the development of intestinal disease is of increasing interest. A reduction in mucosal integrity has been associated with ulcerative colitis, Crohn's disease and potentially could have links with colorectal cancer development. The Ussing chamber system can be utilised as a valuable tool for measuring gut integrity. Here we describe step-by-step methodology required to measure intestinal permeability of both mouse and human colonic tissue samples ex vivo, using the latest equipment and software. This system can be modified to accommodate other tissues.
    Methods: An Ussing chamber was constructed and adapted to support both mouse and human tissue to measure intestinal permeability, using paracellular flux and electrical measurements. Two mouse models of intestinal inflammation (dextran sodium sulphate treatment and T regulatory cell depletion using C57BL/6-FoxP3
    Results: Distinct regional differences in permeability were consistently identified within mouse and healthy human colon. In particular, mice showed increased permeability in the mid colonic region. In humans the left colon is more permeable than the right. Furthermore, inflammatory conditions induced chemically or due to autoimmunity reduced intestinal integrity, validating the use of the system.
    Conclusions: The Ussing chamber has been used for many years to measure barrier function. However, a clear and informative methods paper describing the setup of modern equipment and step-by-step procedure to measure mouse and human intestinal permeability isn't available. The Ussing chamber system methodology we describe provides such detail to guide investigation of gut integrity.
    MeSH term(s) Animals ; Colitis/chemically induced ; Colitis/metabolism ; Colon/metabolism ; Dextran Sulfate ; Electrodiagnosis/instrumentation ; Electrodiagnosis/methods ; Fluorescence ; Humans ; Intestinal Mucosa/metabolism ; Mice ; Mice, Inbred C57BL ; Permeability
    Chemical Substances Dextran Sulfate (9042-14-2)
    Language English
    Publishing date 2019-06-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041351-8
    ISSN 1471-230X ; 1471-230X
    ISSN (online) 1471-230X
    ISSN 1471-230X
    DOI 10.1186/s12876-019-1002-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Efficacy of rituximab in difficult-to-manage autoimmune hepatitis: Results from the International Autoimmune Hepatitis Group.

    Than, Nwe Ni / Hodson, James / Schmidt-Martin, Daniel / Taubert, Richard / Wawman, Rebecca E / Botter, Meemee / Gautam, Nishant / Bock, Kilian / Jones, Rebecca / Appanna, Gautham D / Godkin, Andrew / Montano-Loza, Aldo J / Lammert, Frank / Schramm, Christoph / Manns, Michael P / Swain, Mark / Burak, Kelly W / Adams, David H / Hirschfield, Gideon M /
    Oo, Ye Htun

    JHEP reports : innovation in hepatology

    2019  Volume 1, Issue 6, Page(s) 437–445

    Abstract: Treatment options remain limited for patients with autoimmune hepatitis (AIH), while there are still concerns over the consequences of long-term corticosteroid use. A few studies have suggested a role for B cell-driven autoimmune liver injury in AIH. ... ...

    Abstract Treatment options remain limited for patients with autoimmune hepatitis (AIH), while there are still concerns over the consequences of long-term corticosteroid use. A few studies have suggested a role for B cell-driven autoimmune liver injury in AIH. This multicentre, international retrospective cohort study from the International Autoimmune Hepatitis Group aims to evaluate the clinical efficacy and safety of rituximab in difficult-to-manage AIH.
    Methods: Clinical data from 22 patients who received rituximab between 2007 and 2017 were collected from centres in the United Kingdom, Germany and Canada. Clinical response was assessed using changes in biochemical and immunological parameters up to 24 months post-rituximab infusion. In addition, we compared the doses of prednisolone used 3 months before and 12 months after treatment, and assessed freedom from AIH flares over the post-treatment period.
    Results: Twenty-two patients with type-1 AIH were included, with a median age of 40 years at diagnosis (range 19-79); 15/22 (68%) were female and 18/22 (82%) were Caucasian. The median period from diagnosis to the end of follow-up in these patients was 11 years (range 3-28). Values of alanine aminotransferase, aspartate aminotransferase and albumin improved significantly following rituximab therapy, and were sustained for up to 2 years (all
    Conclusion: In patients with difficult-to-manage AIH, rituximab appears to be clinically effective and well tolerated. Rituximab was associated with sustained improvements in serum liver tests, an absence of clinical disease flares, and a reduction in prednisolone dose. Controlled trials are warranted to further evaluate B cell-targeting therapies in patients with AIH.
    Lay summary: Autoimmune hepatitis is an autoimmune condition of the liver, usually treated with medications that suppress the immune system, such as steroids. However, some patients do not respond to this treatment. We analysed the safety and efficacy of rituximab in patients who were not responding to first- or second-line therapies. Rituximab was safe and improved liver blood tests in 70% of patients over a 2-year follow-up period, while enabling steroid doses to be reduced in two-thirds of patients, which is a very positive clinical outcome.
    Language English
    Publishing date 2019-11-05
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2589-5559
    ISSN (online) 2589-5559
    DOI 10.1016/j.jhepr.2019.10.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Efficacy of rituximab in difficult-to-manage autoimmune hepatitis

    Than, Nwe Ni / Hodson, James / Schmidt-Martin, Daniel / Taubert, Richard / Wawman, Rebecca E / Botter, Meemee / Gautam, Nishant / Bock, Kilian / Jones, Rebecca / Appanna, Gautham D / Godkin, Andrew / Montano-Loza, Aldo J / Lammert, Frank / Schramm, Christoph / Manns, Michael P / Swain, Mark / Burak, Kelly W / Adams, David H / Hirschfield, Gideon M /
    Oo, Ye Htun

    JHEP reports (Online)

    Results from the International Autoimmune Hepatitis Group.

    2019  

    Abstract: Twenty-two patients with type-1 AIH were included, with a median age of 40 years at diagnosis (range 19-79); 15/22 (68%) were female and 18/22 (82%) were Caucasian. The median period from diagnosis to the end of follow-up in these patients was 11 years ( ... ...

    Abstract Twenty-two patients with type-1 AIH were included, with a median age of 40 years at diagnosis (range 19-79); 15/22 (68%) were female and 18/22 (82%) were Caucasian. The median period from diagnosis to the end of follow-up in these patients was 11 years (range 3-28). Values of alanine aminotransferase, aspartate aminotransferase and albumin improved significantly following rituximab therapy, and were sustained for up to 2 years (all p ≪0.001). Prednisolone doses were significantly reduced by 12 months post-treatment (p = 0.003), with 13/21 (62%) patients having a dose reduction. Over a median post-treatment follow-up period of 6 years (range 1-10), 5 patients developed AIH flares at a median of 22 months post-treatment, giving an estimated 71% freedom from AIH flare at 2 years. Four of these patients received a second course of treatment, of whom 2 had subsequent further flares. No serious adverse events attributable to rituximab were recorded.
    Keywords Autoimmune hepatitis ; B cell depletion therapy ; Difficult-to-manage ; Prednisolone ; Rituximab
    Language English
    Publishing date 2019-12-01
    Publisher Elsevier
    Publishing country de
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Do traditional VT zones improve outcome in primary prevention ICD patients?

    Duncan, Edward / Thomas, Glyn / Johns, Neville / Pfeffer, Cameron / Appanna, Gautham / Shah, Nirav / Hunter, Ross / Finlay, Malcolm / Schilling, Richard J / Sporton, Simon

    Pacing and clinical electrophysiology : PACE

    2010  Volume 33, Issue 11, Page(s) 1353–1358

    Abstract: Aims: We reviewed outcomes in our primary prevention implantable cardioverter defibrillator (ICD) population according to whether the device was programmed with a single ventricular fibrillation (VF) zone or with two zones including a ventricular ... ...

    Abstract Aims: We reviewed outcomes in our primary prevention implantable cardioverter defibrillator (ICD) population according to whether the device was programmed with a single ventricular fibrillation (VF) zone or with two zones including a ventricular tachycardia (VT) zone in addition to a VF zone.
    Methods: This retrospective study examined 137 patients with primary prevention ICDs implanted at our institution between 2004 and 2006. Device programming and events during follow-up were reviewed. Outcomes included all-cause mortality, time to first shock, and incidence of shocks.
    Results: Eighty-seven ICDs were programmed with a single VF zone (mean >193 ± 1 beats per minute [bpm]) comprising shocks only. Fifty ICDs had two zones (mean VT zone >171 ± 2 bpm; VF zone >205 ± 2 bpm), comprising antitachycardia pacing (100%), shocks (96%), and supraventricular (SVT) discriminators (98%) . Discriminator "time out" functions were disabled. Mean follow-up was 30 ± 0.5 months and similar in both groups. All-cause mortality (12.6% and 12.0%) and time to first shock were similar. However, the two-zone group received more shocks (32.0% vs 13.8% P = 0.01). Five of 16 shocks in these patients were inappropriate for SVT rhythms. The single-zone group had no inappropriate shocks for SVTs. Eighteen of 21 appropriate shocks were for ventricular arrhythmias at rates >200 bpm (three VF, 15 VT). This suggests that primary prevention ICD patients infrequently suffer ventricular arrhythmias at rates <200 bpm and that ATP may play a role in terminating rapid VTs.
    Conclusions: Patients with two-zone devices received more shocks without any mortality benefit.
    MeSH term(s) Aged ; Cardiomyopathies/complications ; Cardiomyopathies/therapy ; Defibrillators, Implantable ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia/therapy ; Primary Prevention/instrumentation ; Retrospective Studies ; Stroke Volume ; Tachycardia, Supraventricular/diagnosis ; Tachycardia, Supraventricular/mortality ; Tachycardia, Supraventricular/prevention & control ; Tachycardia, Supraventricular/therapy ; Tachycardia, Ventricular/etiology ; Tachycardia, Ventricular/mortality ; Tachycardia, Ventricular/prevention & control ; Treatment Outcome ; Ventricular Fibrillation/prevention & control ; Ventricular Fibrillation/therapy
    Language English
    Publishing date 2010-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 424437-0
    ISSN 1540-8159 ; 0147-8389
    ISSN (online) 1540-8159
    ISSN 0147-8389
    DOI 10.1111/j.1540-8159.2010.02859.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1466: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
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    Zs.MO 399: Show issues

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