Death Rate Falls with Anti-TNF’s

Reduced mortality was seen in Crohn’s patients with comorbidities who have been treated with anti-TNF’s, but primarily compared to those treated with prolonged steroids. There was a trend to positive outcomes for UC patients, but it did not meet statistical significance. Among 1,879 Crohn’s patients initiating anti-TNF therapy, there was a significantly lower risk of

Robotic Surgery in Esophageal Cancer

Robot-assisted surgeries are becoming more commonplace, and having greater success. They have become state of the art for prostatic and pelvic surgeries and have a widespread recognition for being superior in the right hands. A recent randomized trial showed robotic laparoscopic esophagectomy led to significantly fewer complications while achieving similar cancer control, compared with open

Esophageal allergy testing via prick test

An esophageal prick test similar to the skin testing commonly used by Allergists, appears promising in a new article. The process, in which allergens are injected directly into the esophageal mucosa, appears to identify individuals with esophageal sensitization, researchers report in the January issue of Gastroenterology. The tests provide a meaningful alternative in the evaluation of

Promising Hepatitis B Therapies

A number of promising drugs in the pipeline can lower hepatitis B virus (HBV) DNA and antigen levels. Some may offer a functional cure for selected individuals, but agents that offer a reliable cure for most patients are not yet on the horizon. This would be expected to substantially reduce the likelihood of liver disease progression

Common Food Additive May promote C. diff

An article appearing in Nature suggested that a common food additive known as trehalose might be responsible for the current Clostridium difficile epidemic. The Nature paper shows us that two of the most virulent strains of C. diff, including the “hypervirulent” ribotype 027, can metabolize even trace amounts of trehalose. They go on to show that when strains are mixed together, low

Cross-Epidemic of Hepatitis C with Diabetes, Obesity, and Kidney Disease

A cross-sectional and prospective analyses of 13,726 participants in the third National Health and Nutrition Examination Survey found that individuals with chronic hepatitis C have a high burden of major cardiometabolic comorbidities. Diabetes and chronic kidney disease, in particular, are associated with substantial excess mortality in persons with chronic hepatitis C.   See the article

Anesthesia Hand Off Mid-Surgery Increases Risk

Having an anesthesiologist hand off care and leave during the middle of a surgery was associated with worse outcomes for the patient on the operating table. Combined mortality, hospital readmission, and major complications within 30 days after the operation reached a rate of 44% when a handover between anesthesiologists occurred during surgery versus 29% when

MR Enterography and Small-Bowel Healing in Crohn’s

A Japanese study published in The American Journal of Gastroenterology showed magnetic resonance enterography (MRE) may effectively evaluate small-bowel endoscopic healing in Crohn’s disease and predict patient outcomes similar to balloon-assisted small bowel enteroscopy (BAE). Researchers found patients who did not show small-bowel healing on MRE or BAE had a higher risk of relapse, hospitalization

Evidence for risks of PPI is weak

Experts say even though studies have linked proton pump inhibitor use to multiple health problems, the scientific evidence overall is weak, which should help providers reassure concerned patients and avoid unnecessary discontinuation of PPI use. The attention on PPI safety, however, does offer an opportunity for practitioners to discuss limiting use of the drugs because

GERD linked to head and neck cancer risk

According to a study published online Dec. 21 in JAMA Otolaryngology-Head & Neck Surgery, data for 13,805 patients aged 66 and older found that gastroesophageal reflux disease was linked to an increased risk of malignancy of the larynx, oropharynx, hypopharynx, tonsil, nasopharynx and paranasal sinuses. “GERD is associated with the presence of malignancy of the (upper aerodigestive