Dec. 2005 Briefing - Gastroenterology

Here are what the editors at HealthDay consider to be the most important developments in gastroenterology for December 2005. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Computerized Polyp Detection Rivals Optical Colonoscopy

FRIDAY, Dec. 30 (HealthDay News) -- A computer-aided polyp detection (CAD) program is as good as optical colonoscopy for detecting polyps that are at least 8 millimeters in size, according to a comparison study in the December issue of Gastroenterology.

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OTC High-Dose NANSAID Use Has Fivefold Risk for GI Bleed

FRIDAY, Dec. 30 (HealthDay News) -- Nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) that are purchased over-the-counter (OTC) can be taken safely without the risk of gastrointestinal bleeding if the proper dosage recommendations are followed, according to a report in the December issue of Gastroenterology.

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H. pylori Screening May Cut Long-Term Dyspepsia Costs

FRIDAY, Dec. 30 (HealthDay News) -- Screening and treatment for Helicobacter pylori infection may be a long-term, cost-effective method for reducing health care burden from infection-associated dyspepsia, according to a report in the December issue of Gastroenterology.

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Study Sheds Light on Gene Variations in Crohn's Disease

FRIDAY, Dec. 30 (HealthDay News) -- Two gene polymorphisms in a region of chromosome 5 previously linked to inflammatory bowel disease may be important for Crohn's disease susceptibility, according to a report in the December issue of Gastroenterology. The genetic variations are not independently linked to the disease, however, suggesting other mutations are lurking in this region of the genome.

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About 2% Of Adults Have Barrett's Esophagus

FRIDAY, Dec. 30 (HealthDay News) -- A random screen of the adult Swedish population has found that the incidence of Barrett's esophagus (BE) is 1.6% -- data that may provide a target number for BE intervention strategies, according to the December issue of Gastroenterology.

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FDA to Allow Health Claims for Barley-Containing Foods

THURSDAY, Dec. 29 (HealthDay News) -- The U.S. Food and Drug Administration has announced that whole-grain barley and barley-containing products can include claims of cardiovascular benefits on the product labeling.

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E. Coli Outbreaks Traced To Petting Zoos

THURSDAY, Dec. 29 (HealthDay News) -- Three outbreaks of Escherichia coli O157:H7 infection occurred in the United States in 2004 and 2005 that were linked to petting zoos, according to a report in the Dec. 23 issue of the Morbidity and Mortality Weekly Report.

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Wernicke Encephalopathy A Risk After Bariatric Surgery

THURSDAY, Dec. 29 (HealthDay News) -- Bariatric surgery for obesity can result in Wernicke encephalopathy, which may have an atypical clinical presentation, according to a case study published in the Dec. 27 issue of Neurology.

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Eosinophils Activated During Ulcerative Colitis Remission

WEDNESDAY, Dec. 28 (HealthDay News) -- High eosinophil activation during inactive ulcerative colitis (UC) suggests that eosinophils may help repair the injured epithelium, according to research in the December issue of Gut.

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Smaller Instruments Lead to Better Outcomes After Surgery

WEDNESDAY, Dec. 28 (HealthDay News) -- In laparoscopic cholecystectomy (LC), the use of 10-mm umbilical, 5-mm epigastric, 2-mm subcostal and 2-mm lateral ports is safe and can result in decreased postoperative pain, do away with late incisional discomfort and yield better cosmetic results, according to a study in the December issue of the Archives of Surgery.

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Childhood Diarrhea Prevalent in Industrialized Nations

TUESDAY, Dec. 27 (HealthDay News) -- Childhood diarrhea is still an important cause of morbidity in developed, industrialized countries where the risk factors include child-to-child transmission in daycare centers, foreign travel and lower socioeconomic status, according to a study in the January issue of Epidemiology.

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Obesity, Inactivity Reduce Colorectal Cancer Survival

TUESDAY, Dec. 27 (HealthDay News) -- Patients with colorectal cancer (CRC) who carry excess fat around the midriff and who do not engage in regular physical activity are less likely than other patients to survive the disease, according to a study in the January issue of Gut.

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Arterial Ammonia Can Predict Outcome of Liver Failure

TUESDAY, Dec. 27 (HealthDay News) -- In patients with acute liver failure, the level of arterial ammonia is predictive of outcome and useful as a means of risk stratification, according to a study in the January issue of Gut.

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Ghrelin Increases Gastric Emptying in Diabetics

MONDAY, Dec. 26 (HealthDay News) -- Ghrelin enhances gastric emptying in diabetics with gastroparesis, a condition with no consistently effective treatment, according to a study in the December issue of Gut.

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Short Drinks May Have More Kick Than Tall Ones

MONDAY, Dec. 26 (HealthDay News) -- Because of human perceptual bias, alcoholic beverages mixed in short, wide tumblers may be more potent than those mixed in taller and more slender highball glasses, according to a study published in the Dec. 24 issue of the British Medical Journal.

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Capsule Endoscopy Helps in Crohn's Disease Diagnosis

FRIDAY, Dec. 23 (HealthDay News) -- Capsule endoscopy and magnetic resonance imaging are complementary ways of diagnosing small bowel Crohn's disease, according to a study in the December issue of Gut.

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Wireless Systems May Improve Acid Reflux Detection

THURSDAY, Dec. 22 (HealthDay News) -- A new wireless pH monitoring capsule developed for the diagnosis of gastroesophageal reflux disease offers significant advantages over traditional ambulatory, catheter-based monitoring, according to an editorial in the December issue of Gut. However, two new studies in the same issue of the journal suggest more work is needed to determine the details and normal values for recordings from the capsule, which adheres to the esophageal wall.

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Immune Cells in Tumor Good Sign in Colorectal Cancer

WEDNESDAY, Dec. 21 (HealthDay News) -- Colorectal cancer patients who have immune cells infiltrating their tumors have fewer signs of metastasis and longer survival than patients who do not, according to a study in the Dec. 22 issue of the New England Journal of Medicine.

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CXCR4 Sign of Poor Prognosis in Esophageal Cancer

WEDNESDAY, Dec. 21 (HealthDay News) -- Expression of the chemokine and bone marrow-homing receptor CXCR4 is associated with lymph node and bone marrow micrometastasis and thus carries a poor prognosis in esophageal cancer, according to a study in the Dec. 21 issue of the Journal of the National Cancer Institute.

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Primary Anastomosis Valid for Infants with Enterocolitis

WEDNESDAY, Dec. 21 (HealthDay News) -- Infants who weigh less than 1,000 grams and have necrotizing enterocolitis (NEC) have similar outcomes whether they are treated with resection and primary anastomosis or with stoma formation, according to a study in the December issue of the Archives of Surgery. However, mortality in these patients is high, regardless of treatment, the authors say.

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NSAIDs Can Result in Small Bowel Disease, Resection

WEDNESDAY, Dec. 21 (HealthDay News) -- Small-bowel diaphragm disease caused by the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be more common than thought, and can lead to difficult-to-diagnose gastrointestinal tract bleeding and obstruction, according to a study published in the December issue of the Archives of Surgery. In some cases, the condition may require laparotomy and small-bowel resection, the authors say.

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Pyloromyotomy Success Linked to Hospital, Surgeon Volume

WEDNESDAY, Dec. 21 (HealthDay News) -- Surgeons and hospitals with higher volumes generate better results when treating infants with pyloric stenosis, according to a study published in the December issue of the Archives of Surgery.

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Hospital 'Handoffs' Common Source of Medical Errors

TUESDAY, Dec. 20 (HealthDay News) -- Poor communication during hospital "handoffs," when patient care transitions from one physician or team of physicians to the next, may be responsible for many of the estimated 44,000 to 98,000 deaths that occur each year in U.S. hospitals due to medical errors, according to a study published in the December issue of Academic Medicine.

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Acid-Suppresssing Drugs May Increase Risk for Clostridium

TUESDAY, Dec. 20 (HealthDay News) -- Use of gastric-acid suppressing agents, and possibly nonsteroidal anti-inflammatory drugs (NSAIDs), is associated with an increased risk of community-acquired Clostridium difficile infection, according to a study in the Dec. 21 issue of the Journal of the American Medical Association.

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Carbon Monoxide Relieves Chronic Colitis in Mice

TUESDAY, Dec. 20 (HealthDay News) -- Inhaled carbon monoxide (CO) relieves symptoms of chronic colitis in mice, which may explain why cigarette smoking protects against ulcerative colitis in humans, according to a study published online Dec. 19 in the Journal of Experimental Medicine.

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Company Recalls NeutroSpec Imaging Agent After Deaths

MONDAY, Dec. 19 (HealthDay News) -- Acting at the request of the U.S. Food and Drug Administration, the makers of NeutroSpec (Technetium 99m Tc fanolesomab), an imaging agent approved to diagnose appendicitis, are voluntarily withdrawing the product from the market.

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Bariatric Surgeries Jump 450% in U.S. in Five Years

MONDAY, Dec. 19 (HealthDay News) -- A 450% increase in bariatric surgeries in the United States between 1998 and 2002 could be tied to the growth of laparoscopic bariatric surgery, according to a study in the December issue of the Archives of Surgery.

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Drugs Can Match Surgery for Acid Reflux Disease

MONDAY, Dec. 19 (HealthDay News) -- Medication, including proton pump inhibitors, can work as well as surgery to manage gastroesophageal reflux disease (GERD), according to a report from the Agency for Healthcare Research and Quality (AHRQ).

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Cholera Grows, Diversifies on Crustacean Shell Compound

MONDAY, Dec. 19 (HealthDay News) -- Vibrio cholera was previously thought to mutate and diversify only through conjugation or by naturally induced DNA mutations. Now a study in Science suggests that the bacteria can take up exogenous DNA through "natural competence" while growing on chitin, the carbohydrate that makes up the shell of crustaceans and is found in the natural habitat of cholera.

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Wheat and Maize Allergies More Complex Than Expected

THURSDAY, Dec. 15 (HealthDay News) -- Wheat- and maize-related food allergy is far more complex than has been understood to date, due to the heterogeneity of genetic sequences and the biochemical nature of new allergens, according to a study published in the January issue of Allergy.

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U.S. Hospitals Lag in Adopting Safety Recommendations

TUESDAY, Dec. 13 (HealthDay News) -- Despite some improvements in hospital patient safety systems, many hospitals have made slow progress in adopting 1998 recommendations from the Institute of Medicine National Roundtable on Health Care Quality or from subsequent reports, according to a study published in the Dec. 14 issue of the Journal of the American Medical Association.

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No Link Found Between Fiber and Colorectal Cancer Risk

TUESDAY, Dec. 13 (HealthDay News) -- The combined data from 13 prospective studies aimed at measuring dietary cancer risks suggests there is no link between fiber intake and reduced incidence of colon cancer. The results are published in the Dec. 14 issue of the Journal of the American Medical Association.

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Iron Absorption Controlled by Liver Gene

THURSDAY, Dec. 8 (HealthDay News) -- Mice with a liver-specific deletion of the tumor suppressor gene SMAD4 develop symptoms of iron-overload similar to the human disease hemochromatosis, according to a report in the December issue of Cell Metabolism.

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Febuxostat More Effective Than Allopurinol for Gout

WEDNESDAY, Dec. 7 (HealthDay News) -- Febuxostat is more effective than allopurinol in the treatment of gout, researchers report in the Dec. 8 issue of the New England Journal of Medicine.

Michael A. Becker, M.D., of the University of Chicago Pritzker School of Medicine in Illinois, and colleagues randomly assigned 762 patients with gout to receive either 300 mg of allopurinol or either 80 mg or 120 mg of febuxostat once a day for 52 weeks. All patients had serum urate concentrations of at least 8 mg per deciliter.

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Policy Targets Disordered Eating in Youth Athletes

WEDNESDAY, Dec. 7 (HealthDay News) -- Alarmed by unhealthy weight-control practices among youths, the American Academy of Pediatrics (AAP) has issued a new policy statement promoting healthy weight control for young athletes. The policy is published in the December issue of Pediatrics.

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Infliximab Effective in Treating Ulcerative Colitis

WEDNESDAY, Dec. 7 (HealthDay News) -- Infliximab, a monoclonal antibody against tumor necrosis factor-alpha, is effective in treating ulcerative colitis, according to a report in the Dec. 8 issue of the New England Journal of Medicine.

Paul Rutgeerts, M.D., Ph.D., of University Hospital Gasthuisberg in Leuven, Belgium, and colleagues conducted two randomized, double-blind, placebo-controlled studies -- the Active Ulcerative Colitis Trials 1 and 2 (ACT 1 and ACT 2) -- to evaluate the efficacy of infliximab for induction and maintenance therapy in adults with ulcerative colitis.

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Paneth Cell Deficiencies Found in Crohn's Disease of Ileum

WEDNESDAY, Dec. 7 (HealthDay News) -- Reduced expression of Paneth cell (PC) alpha-defensins, such as HD5 and HD6, may compromise mucosal host defenses and cause Crohn's disease of the ileum, according to a study published online Dec. 5 in the Proceedings of the National Academy of Sciences.

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Adjuvant Chemo Improves Colon Cancer Treatment

TUESDAY, Dec. 6 (HealthDay News) -- The use of adjuvant chemotherapy for colon cancer and subsequent survival rates have increased since the treatment was recommended in a 1990 National Institutes of Health Consensus Conference, according to a report in the Dec. 7 issue of the Journal of the American Medical Association.

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FDA Issues Warning on Radiodiagnostic Agent

MONDAY, Dec. 5 (HealthDay News) -- The U.S. Food and Drug Administration announced that a radiodiagnostic agent, NeutroSpec (Technetium [99m Tc] fanolesomab), has been linked to two deaths due to cardiopulmonary failure and other cases of life-threatening cardiopulmonary events.

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Toxic Strain of Clostridium Difficile Linked to Death

FRIDAY, Dec. 2 (HealthDay News) -- A new, more toxic strain of Clostridium difficile may be causing severe diarrhea and other symptoms in relatively young patients, and is linked to the death of a pregnant woman, according to the Dec. 2 issue of the Morbidity and Mortality Weekly Report. Physicians should be alert to Clostridium difficile-associated disease (CDAD) in patients previously thought to be at low risk, according to the U.S. Centers for Disease Control and Prevention.

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COX-2 Inhibitors Don't Provide Added Stomach Protection

FRIDAY, Dec. 2 (HealthDay News) -- COX-2 inhibitors aren't any less harmful to the stomach lining than conventional nonsteroidal anti-inflammatory drugs (NSAIDs), according to a study published in the Dec. 3 issue of the British Medical Journal.

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