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Amyloidosis for the Gastroenterologist: A Comprehensive Systematic Review of Diagnosis and Management of Gastrointestinal Manifestations.

BackgroundAmyloidosis is a rare, multisystem disorder characterized by extracellular deposition of misfolded protein fibrils. Gastrointestinal (GI) amyloidosis is uncommon but under-recognized due to nonspecific symptoms, but early diagnosis is critical to improve quality of life and prognosis. This comprehensive systematic review aimed to summarize current literature on GI and hepatic manifestations of amyloidosis, highlighting diagnostic and management strategies across the major subtypes of amyloidosis, in particular AL (immunoglobulin light chain), ATTR (transthyretin), and AA (serum amylo

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… In the esophagus, dysmotility may manifest as heartburn, dysphagia, or chest pain. … For those with heartburn, proton pump inhibitors in standard doses are recommended [ 25 ]. Diarrhea Diarrhea is a common but difficult‐to‐treat symptom due to its multiple potential etiologies. …

Changes of bone turnover markers and bone mineral density among postmenopausal Thai women with osteoporosis receiving generic risedronate.

BackgroundOsteoporosis has been recognized as a significant health issue in Thailand. Pharmacological interventions are important way to prevent fracture. However, one of the main challenges in selecting a medication is high cost, particularly for brand-name drugs. Data on generic bisphosphonate use in Thai are still lacking. Therefore, our study aimed to assess the efficacy and safety of generic risedronate in postmenopausal Thai women with osteoporosis.MethodsThis prospective study was conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from December 2022 to January 2024. S

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… Four participants (5.00%) experienced new-onset dyspepsia and heartburn. None of the participants required endoscopic or surgical interventions. Three participants (3.75%) experienced back pain, and two participants (2.50%) reported pyrexia with myalgia. … In terms of safety and adverse effects, the most prevalent adverse effect reported in our study was new-onset dyspepsia and heartburn. However, the prevalence rates of dyspepsia and heartburn were lower in our study than those reported in the pooled analysis [ 32 ]. …

Editorial foreword.

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… Gastroesophageal reflux disease (GERD) is a highly prevalent, unpleasant and debilitating condition characterized by heartburn and regurgitation of food, the latter being association with Barrett's esophagus and adenocarcinoma of the esophagus and gastric cardia. …

Drug repurposing for breast cancer therapy: Old weapon for new battle.

Despite tremendous resources being invested in prevention and treatment, breast cancer remains a leading cause of cancer deaths in women globally. The available treatment modalities are very costly and produces severe side effects. Drug repurposing that relate to new uses for old drugs has emerged as a novel approach for drug development. Repositioning of old, clinically approved, off patent non-cancer drugs with known targets, into newer indication is like using old weapons for new battle. The advances in genomics, proteomics and information computational biology has facilitated the process o

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… appetite, stomach pain, diarrhea, difficulty swallowing, hair changes, skin sensitivity, rash, nail changes, irregular periods Denosumab Xgeva RANKL inhibitor Advanced stage Limits osteoclasts activity Bone pain, nausea, vomiting, fever, fatigue, constipation, diarrhea, loss of appetite, teary eyes, heartburn … building blocks Diarrhea, hair changes, irregular periods, rash, joint pain, loss of appetite, nausea, mouth sores, swelling in the feet and legs, vomiting Mitoxantrone Novantrone Anthracycline Advanced stage Damages genetic material Back pain, constipation, diarrhea, fatigue, hair loss, headache, heartburn …

Treating chronic atrophic gastritis: identifying sub-population based on real-world TCM electronic medical records.

BACKGROUND AND OBJECTIVE: Chronic atrophic gastritis (CAG) is a complex chronic disease caused by multiple factors that frequently occurs di … ymptom improvement in all three subgroups were stomach pain, bloating, insomnia, poor appetite, and heartburn. However, the three groups were different. The M29 subgroup was more likely to have stomach distention, anorexia, and palpitations. Citrus medica, Solanum nigrum, Jiangcan, Shan ci mushrooms, and Dillon were the most popular botanical drugs. The M3 …

Atypical Scleroderma-like Chronic GVHD in a Liver Transplant Patient, Clinical and MRI Correlations.

Dear Editor, cutaneous chronic graft versus host disease (cGVHD) is a pathological process consisting of donor-derived T-cells aimed at the … plish plaque associated with a progressive increase in pain. Patient denied dysphagia, retrosternal heartburn, Raynaud's phenomenon, arthralgia, and dyspnea. A previous MRI (Figure 2, a,b) showed subcutaneous and muscle edema. Blood tests showed abnormal liver function indexes due to extrahepatic cholestasis, while C-reactive protein, erythrocyte sedimentat …

Effects of D-003, a mixture of high-molecular-weight sugar cane wax acids, on lipid peroxidation markers in older individuals: A randomized, double-blind, placebo-controlled study.

BACKGROUND: Aging is associated with increased lipid peroxidation (LP). D-003, a mixture of long-chain aliphatic primary acids purified from … dy. There were a total of 3 AEs reported: insomnia and acidity in 2 patients receiving placebo; and heartburn in 1 patient receiving D-003 5 mg. CONCLUSIONS: D-003 5 and 10 mg/d administered to these older individuals (aged ≥60 years) for 8 weeks inhibited LP of LDL and increased TAS in a dose-dependent manner, while plasma MDA concentration decreased in t …

Effects of policosanol on borderline to mildly elevated serum total cholesterol levels: a prospective, double-blind, placebo-controlled, parallel-group, comparative study.

BACKGROUND: Hypercholesterolemia is a major risk factor for coronary heart disease. Clinical studies have shown that lowering elevated serum … d AEs; all were mild. Of the patients who received placebo and reported AEs, all 3 (6%) experienced heartburn, and 1 (2%) also experienced dry skin, while the policosanol-treated patient (2%) who reported an AE experienced headache. CONCLUSIONS: In this study of patients with borderline to mildly elevated serum TC levels, based on the criterion that ≥70% o …

Unusual case of amyloidosis presenting as a jejunal mass.

Amyloidosis constitutes a heterogeneous group of disorders of protein misfolding that can involve different organ systems. The disease can occur either in a systemic or localised manner that is well known to involve the gastrointestinal (GI) tract. GI amyloidosis can present with a wide range of symptoms including diarrhoea, bleeding and obstruction. This case illustrates a patient with localised jejunal amyloid light chain disease that was diagnosed serendipitously during a workup for haematuria. Our patient was otherwise asymptomatic, but this case underscores the importance of considering a

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… A retrospective review of 2300 patients identified only 16 with localised amyloidosis of the GI tract. 4 Symptoms included GI bleeding in eight (50%), heartburn in eight (50%) and constipation in three patients (19%). 4 Biopsy sites included the stomach in 8 (50%), colon in 7 (44%) and small bowel in …

Colesevelam for lenalidomide associated diarrhea in patients with multiple myeloma.

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… In the PRO-CTCAE questionnaires, patients reported fewer watery stools, better control of their bowel movements, improvements in abdominal pain, heartburn, bloating, and better appetite over the course of the study (Fig. 2 , Supplementary Figure S1 ). … Five patients reported adverse events with an increase in constipation, flatulence, heartburn, or nausea after starting colesevelam. Nevertheless, patients graded the effect of the gastrointestinal symptoms on their daily life and activities as less severe after starting colesevelam. …

Lower esophageal sphincter injections for the treatment of gastroesophageal reflux disease.

Endoscopic therapies for the control of GERD offer the potential for significant symptomatic improvement while obviating many of the potenti … efluxers. Study subjects, by and large, have had uncomplicated GERD with typical reflux symptoms of heartburn or regurgitation that have responded to PPIs. Patients who have severe anatomic derangements, such as esophageal strictures, persistent esophagitis, Barrett's esophagus, or sizeable hiatal hernias, are excluded from clinical trials, as are patients …

A patient survey indicates quality of life and progression-free survival as equally important outcome measures in multiple myeloma clinical trials.

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… is not significant at p < 0.05 Number of patients | 90 | 78 | 21 | 189 Hair loss Yes | 20 (11%) | 20 (11%) | 6 (3%) | 46 (24%) No | 70 (37%) | 58 (31%) | 15 (8%) | 143 (76%) Fisher exact test statistic value = 0.72 | The result is not significant at p < 0.05 Number of patients | 91 | 81 | 21 | 193 Heartburn …

Endoscopic and pathological characteristics of gastrointestinal amyloidosis: a retrospective analysis.

BackgroundGastrointestinal amyloidosis (GIA) is a rare manifestation of amyloidosis, characterized by amyloid fibril deposition in the gastrointestinal tract, leading to a range of clinical symptoms. Early diagnosis is challenging due to the nonspecific nature of endoscopic and clinical findings.ObjectiveTo analyze the clinical, endoscopic, and pathological characteristics of GIA and identify potential diagnostic markers for earlier detection.MethodsA retrospective study was conducted on 36 patients diagnosed with GIA based on histopathological findings, including Congo Red staining. Clinical,

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… Heartburn and acid reflux are the most common symptoms in patients with depressed lesions. Abdominal distension (37.5%) was most common in patients with multiple lesion types (Table 2 ). … ) 2 (6.9) 8 (27.6) Digestive Symptoms Abdominal pain 4 (36.4) 3 (37.5) 0 (0.0) 1 (12.5) Abdominal Distension 1 (9.1) 3 (37.5) 0 (0.0) 3 (37.5) Abdominal Discomfort 1 (9.1) 4 (50.0) 0 (0.0) 2 (25.0) Decreased Appetite 3 (27.3) 1 (12.5) 0 (0.0) 0 (0.0) Acid Reflux 3 (27.3) 3 (37.5) 2 (100.0) 1 (12.5) Heartburn …

AGA Clinical Practice Update on Esophageal Dysfunction Due to Disordered Immunity and Infection: Expert Review.

METHODS: This expert review was commissioned and approved by the American Gastroenterological Association (AGA) Institute Clinical Practice … s of immune-mediated disorders that should be considered when encountering patients with dysphagia, heartburn, and odynophagia. Best Practice Advice Statements: BEST PRACTICE ADVICE 1: Gastroenterologists should be aware of the esophageal manifestations of systemic immunologic and infectious diseases to reduce diagnostic delay. Clinicians should identify if …

Exenatide added to insulin therapy: a retrospective review of clinical practice over two years in an academic endocrinology outpatient setting.

BACKGROUND: Exenatide is an antidiabctic agent currently indicated as adjunctive therapy with oral agents for the treatment of type 2 diabet … ld and included nausea (n = 51 [22.6% of patients]), vomiting (22 [9.7%]), hypoglycemia (9 [4.0%]), heartburn (2 [0.9%]), diarrhea (1 [0.4%]), constipation (1 [0.4%]), malaise (1 [0.4%]), and generalized edema (1 [0.4%]). Two serious adverse events occurred during the study period: acute renal failure not attributed to exenatide (1 [0.4%]); and pancreatitis …

Intravenous pamidronate versus oral and intravenous clodronate in bone metastatic breast cancer: a randomized, open-label, non-inferiority Phase III trial.

PurposePatients with metastasized breast cancer often suffer from discomfort caused by metastatic bone disease. Thus, osteoprotection is an important part of therapy in breast cancer metastasized to bone, and bisphosphonates (BPs) are a major therapeutic option. In this study, our objectives were to compare the side effects of oral versus intravenous BP treatment and to assess their clinical effectiveness.Patients and methodsIn this prospective randomized, open-label, non-inferiority trial, we enrolled breast cancer patients with at least one bone metastasis and an Eastern Cooperative Oncology

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… GI tract-associated side effects, including nausea, vomiting, heartburn, abdominal cramps/pain, and diarrhea, were the most common adverse effects experienced by participants in this study. …

The 2024 Saudi Pharmacotherapy Didactic Curriculum Toolkit: A Modified Delphi Study.

BACKGROUND: Several pharmacy schools in Saudi Arabia (S.A.) refer to the American College of Clinical Pharmacy (ACCP) pharmacotherapy toolkit in developing their pharmacotherapy curriculum. However, the ACCP toolkit does not specifically address the healthcare needs of the Saudi population. A tailored pharmacotherapy curriculum that offers graduates the essential competencies to better serve the nation's needs is warranted. This study aims to develop a population-centered didactic pharmacotherapy toolkit for the Saudi population to assist pharmacy schools in designing pharmacotherapy course co

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… Pituitary gland disorders 3 Adrenal gland disorders 3 Diabetes secondary , e.g., monogenic diabetes syndromes , cystic fibrosis , pancreatitis , organ transplantation) Gastrointestinal Conditions 1 Constipation 1 Diarrhea 1 Drug dosing in hepatic dysfunction 1 Gastroesophageal reflux disease (including heartburn … disorders 3 | Adrenal gland disorders 3 | Diabetes secondary , e.g., monogenic diabetes syndromes , cystic fibrosis , pancreatitis , organ transplantation) | Gastrointestinal Conditions 1 | Constipation 1 | Diarrhea 1 | Drug dosing in hepatic dysfunction 1 | Gastroesophageal reflux disease (including heartburn …

Effects of short-term combined treatment with alendronate and elcatonin on bone mineral density and bone turnover in postmenopausal women with osteoporosis.

The antiresorptive drug elcatonin (ECT) is known to relieve pain in postmenopausal women with osteoporosis. A prospective open-labeled trial was conducted to compare the effects of short-term combined treatment with alendronate (ALN) and ECT on bone mineral density (BMD) and bone turnover with those of single treatment with ALN in postmenopausal women with osteoporosis. Two hundred and five postmenopausal osteoporotic women (mean age: 70 years) were recruited in our outpatient clinic. Forty-six women with back pain were treated with ALN and ECT (intramuscular, 20 units a week), and 159 women w

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… The main reasons for the dropout from the trial were difficulty in compliance, epigastric pain, gastric ulcers, heartburn, and tooth treatment (extraction) concerning osteonecrosis of the jaw in the ALN group, and difficulty in compliance, epigastric pain and loss to follow-up in the ALN+ECT group ( … ALN group (n = 20) | ALN+ECT group (n = 8) Difficulty in compliance (n =15) | Difficulty in compliance (n= 6) Epigastric pain (n = 2) | Epigastric pain (n = 1) Gastric ulcer (n = 1) | Loss to follow-up (n = 1) Heartburn (n = 1) | Treatment (extraction) of tooth (n = 1) | Characteristics of the study …

Case Report: Gastrointestinal cancer initially presenting as postmenopausal osteoporosis.

BACKGROUND: Gastric cancer usually presents late with nonspecific symptoms such as epigastric discomfort, anorexia, weight loss, nausea, anemia, or gastrointestinal bleeding. Initial presentation with osteoporosis-like manifestations and multiple bone metastases in the absence of gastrointestinal symptoms is rare. CASE PRESENTATION: We report a 59-year-old postmenopausal woman who presented with thoracolumbar back pain after routine activity. Bone mineral density assessment showed osteoporosis, but laboratory evaluation revealed markedly increased bone turnover markers, including alkaline pho

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… The patient denied recent weight loss, nausea, heartburn, abdominal pain, or hematochezia. …

Back pain as an initial feature of advanced gastric cancer mimicking multiple myeloma: A case report and literature review.

BackgroundBack pain is a rare initial presentation of gastric cancer. Isolated back pain with red flags in middle-aged patients might indicate multiple myeloma. However, it is rarely present in advanced gastric adenocarcinoma; hence, data are limited to case reports only. For a timely diagnosis of the underlying malignancy, endoscopy should be considered if the initial workup for this backache is unrevealing.Case presentationWe present a 34-year-old previously healthy gentleman with severe unremitting backache. He was ultimately diagnosed with gastric adenocarcinoma stage IV and received palli

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… Alive Fujita, I., 2020 (13) | 63, Male | Not mentioned | Signet-ring cell carcinoma Gastric biopsy demonstrated a signet-ring cell carcinoma Bone biopsy revealed cell aggregation, indicating signet-ring cell carcinoma | Thoracic and lumbar | Active | Died Additionally, abdominal pain, bloating, heartburn …