Types of Achalasia

🔥 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

Early infliximab (IFX) levels and clearance predict outcomes after IFX rescue in acute severe ulcerative colitis:
Results from PREDICT-UC

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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.

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Springer Nature 19 September 2025

✳️ #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.

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.

✳️ 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)

Interpreting abnormal liver blood test results.

BMJ November 2025

Primary Biliary Cholangitis

JAMA November 2025

Potassium-competitive acid
blockers ( PCABs ) for the management of Gastroesophageal reflux disease

Acute Management of Non Variceal Gastrointestinal Bleeding in Children

Estimates of global and regional prevalence of Helicobacter pylori
infection among individuals with obesity: a systematic review
and meta‑analysis

Non-­ invasive tests of fibrosis in the management of MASLD: revolutionising diagnosis, progression and regression monitoring.

BMJ 2025

Primary Biliary Cholangitis ( PBC )

Performance measures for endoscopic ultrasound: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative– Update 2025

ACG Guidelines: Management of Irritable bowel syndrome (IBS)

Interpretation of abnormal liver blood tests.

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