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A new study has found undetectable serum levels of HBV DNA at week 24 of treatment to be the strongest predictor of optimal outcomes for patients with chronic HBV infection. Although this finding is not surprising, it has important implications for those patients on antiviral therapy who do not achieve a favorable response.
Among the challenges of studying the contribution of individual dietary factors to cancer risk is the interwoven nature of diet—dietary factors are often correlated and eating patterns are complex. A large, prospective epidemiological study of diet patterns used cluster analyses to demonstrate the benefit of a fruit and vegetable diet to colorectal cancer risk.
A recent survey of patients, primary physicians and gastroenterologists found that an overwhelming majority prefer endoscopic polypectomy for small polyps detected by screening CT colonography. These hypothetical results, however, strongly contradict results in actual clinical practice.
The current re-treatment options available to patients with chronic hepatitis C who fail to respond to treatment with pegylated interferon plus ribavirin are limited. Findings from a large, multicenter study suggest that re-treatment with consensus interferon plus ribavirin should now be considered for compliant, motivated nonresponders.
Whether a midline or transverse incision is used in abdominal surgery depends mainly on the disease, anatomy and potential effects on wound healing, pain and postoperative complications. Decisions can, however, be based on a surgeon's experience and preference, as the procedures' respective benefits remain to be clearly delineated.
Hepatic venous pressure gradient (HVPG) is the most useful parameter for the assessment of patients with cirrhosis. HVPG provides diagnostic and prognostic information in several clinical scenarios: treatment of portal hypertension, surgery for hepatocellular carcinoma, treatment of HCV-related or HBV-related cirrhosis, and outcome of recurrent HCV infection after liver transplantation.
The signs and symptoms of dumping syndrome, a well-established complication of gastric and esophageal surgery, result from rapid gastric emptying and the delivery of large particles of poorly digested food to the small bowel. These symptoms, which can be classed as early or late, their pathophysiological basis, and the treatment options available to patients with dumping syndrome are outlined in this article.
The gastrointestinal mucosa is an important target of many sexually transmitted infections—it is a site for HIV entry, replication and destruction of CD4+T cells, and provides a niche for other sexually transmitted pathogens. This Review discusses the pathogenesis and gastrointestinal complications of HIV infection and summarizes advances in our understanding of other sexually transmitted infections of the gastrointestinal system.
Systemic amyloidosis is characterized by the extracellular deposition of protein in an abnormal and insoluble form. Involvement of the gastrointestinal tract is very common but is often subclinical. This Review describes the gastrointestinal manifestations of systemic amyloidosis and discusses available methods for the diagnosis and treatment of systemic amyloidosis and its gastrointestinal consequences.
This article considers the case of a 49-year-old woman with a history of hepatitis C and peptic ulcer disease who presented with massive hematemesis. She was diagnosed with gastric variceal hemorrhage and splenic vein thrombosis. The patient underwent splenic artery embolization and balloon-occluded retrograde transvenous obliteration of gastric varices. By 30 months post-treatment no evidence of gastric varices or splenic vein thrombosis remained.
