✳️ The most appropriate management step for a patient who is found to have a gastric residual of 100 mL after starting on enteral feeding through a percutaneous gastrostomy tube is to elevate the head of the bed and continue the tube feeding.
The combination of fever, diabetes, abnormal liver function tests, and a hypoechoic hepatic lesion on ultrasound is consistent with pyogenic liver abscess. Broad-spectrum IV antibiotics should be initiated immediately to provide coverage for anaerobes, gram-negative bacteria, and gram-positive cocci.
For large abscesses, percutaneous drainage is indicated, which requires interventional radiology consult for image-guided catheter placement.
For large abscesses, percutaneous drainage is indicated, which requires interventional radiology consult for image-guided catheter placement.
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One_vs_Five_Days_of_Octreotide_Infusion_for_Acute_Esophageal_Variceal.pdf
1.1 MB
One vs Five Days of Octreotide Infusion for Acute Esophageal Variceal Bleeding: A Randomized Controlled Trial
AJG 25 December 2025
Correlation_between_virological_response_and_portal_vein_thrombosis.pdf
2.4 MB
Correlation between virological response and portal vein thrombosis in patients with chronic hepatitis B
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🔥 Hot From the Press | Clinical Pearl
Acute Severe UC: Early infliximab exposure matters.
🔹 Day-3 infliximab ≤57.9 µg/mL predicts:
🤜 Day-14 failure
🤜3-month colectomy
🔹 High infliximab clearance drives non-response — but can be overcome with intensified dosing (10 mg/kg).
⚠️ Limitations:
• Real-world TDM turnaround may be delayed
• Clearance not easily calculated at bedside
• Observational PK analysis
Acute Severe UC: Early infliximab exposure matters.
🔹 Day-3 infliximab ≤57.9 µg/mL predicts:
🤜 Day-14 failure
🤜3-month colectomy
🔹 High infliximab clearance drives non-response — but can be overcome with intensified dosing (10 mg/kg).
⚠️ Limitations:
• Real-world TDM turnaround may be delayed
• Clearance not easily calculated at bedside
• Observational PK analysis
PIIS0016508525057774.pdf
2.2 MB
Early infliximab (IFX) levels and clearance predict outcomes after IFX rescue in acute severe ulcerative colitis:
Results from PREDICT-UC
Results from PREDICT-UC
AGA Gastroenterology 2026
Propranolol versus endoscopic variceal ligation for primary prophylaxis of esophageal varices in cirrhosis: a systematic review
and meta‑analysis of randomized controlled trials
🔥Conclusion: EVL was superior in preventing esophageal variceal bleeding. Such results suggest that not all NSBBs provide equivalent efficacy in primary prophylaxis, reinforcing the need for further studies to confirm these findings.
PDF 👇
and meta‑analysis of randomized controlled trials
🔥Conclusion: EVL was superior in preventing esophageal variceal bleeding. Such results suggest that not all NSBBs provide equivalent efficacy in primary prophylaxis, reinforcing the need for further studies to confirm these findings.
PDF 👇
Springer Nature 19 September 2025
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✳️ #Pearls: HIV-negative wife should receive daily oral TDF/FTC PrEP starting at least 7 days before exposure and continued until the HIV-positive partner has sustained viral suppression for 6 months, then stopped 28 days after last exposure. Neonatal prophylaxis with zidovudine should be initiated within 6–12 hours of birth and continued for 4–6 weeks if the mother is HIV-positive.
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Real-World Indirect Treatment Comparison of Terlipressin vs Midodrine Plus Octreotide in Hepatorenal Syndrome-Acute Kidney Injury. (PDF 👇)
✳️ Conclusion: HRS-AKI treatment and outcomes differ between the United Kingdom and the United States, attributed to the historical standard of care MO in the United States. In adjusted analyses, real-world use of terlipressin was more effective than MO at improving kidney function and achieving HRS-AKI reversal.
✳️ Conclusion: HRS-AKI treatment and outcomes differ between the United Kingdom and the United States, attributed to the historical standard of care MO in the United States. In adjusted analyses, real-world use of terlipressin was more effective than MO at improving kidney function and achieving HRS-AKI reversal.
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✳️ Extra-hepatic Manifestations of Chronic HCV Infection
1. Mixed Cryoglobulinemia / Vasculitis
2. Non-Hodgkin B-cell Lymphoma
3. Insulin resistance / Type 2 Diabetes Mellitus
4. Membranoproliferative Glomerulonephritis
5. Sjӧgren’s syndrome and Sicca symptoms
6. Autoimmune thyroid disease
7. Porphyria cutanea tarda
8.Lichen planus / skin disorders
9. Hematologic disorders (e.g., thrombocytopenia)
10. Neuropathy / neurological disorders
11. Cardiovascular disease associations
12. Other autoimmune or rheumatologic conditions
13. Metabolic alterations (lipid abnormalities)
✳️ Extra-hepatic Manifestations of HBV Infection
1. Serum-sickness–like syndrome
2. Polyarteritis nodosa (PAN)
3. Membranous Glomerulonephritis/nephropathy
4. Cryoglobulinemic vasculitis (less consistent)
5. Non-rheumatoid arthritis / polyarthritis
6. Non-Hodgkin lymphoma (less common)
7. Aplastic anemia / hematologic abnormalities
8. Papular acrodermatitis (Gianotti-Crosti syndrome)
1. Mixed Cryoglobulinemia / Vasculitis
2. Non-Hodgkin B-cell Lymphoma
3. Insulin resistance / Type 2 Diabetes Mellitus
4. Membranoproliferative Glomerulonephritis
5. Sjӧgren’s syndrome and Sicca symptoms
6. Autoimmune thyroid disease
7. Porphyria cutanea tarda
8.Lichen planus / skin disorders
9. Hematologic disorders (e.g., thrombocytopenia)
10. Neuropathy / neurological disorders
11. Cardiovascular disease associations
12. Other autoimmune or rheumatologic conditions
13. Metabolic alterations (lipid abnormalities)
✳️ Extra-hepatic Manifestations of HBV Infection
1. Serum-sickness–like syndrome
2. Polyarteritis nodosa (PAN)
3. Membranous Glomerulonephritis/nephropathy
4. Cryoglobulinemic vasculitis (less consistent)
5. Non-rheumatoid arthritis / polyarthritis
6. Non-Hodgkin lymphoma (less common)
7. Aplastic anemia / hematologic abnormalities
8. Papular acrodermatitis (Gianotti-Crosti syndrome)
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ACLF__NatRevGastroHep__Jan2026.pdf
3 MB
Acute-on-chronic liver failure (ACLF): pathophysiological mechanisms and clinical management.
Nature Gastro&Hep Jan 2026