January 2013 Briefing - Gastroenterology

Here are what the editors at HealthDay consider to be the most important developments in Gastroenterology for January 2013. 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.

Overuse of Surveillance Colonoscopy After Resection

THURSDAY, Jan. 31 (HealthDay News) -- Approximately one-third of patients with normal results on their first and second colonoscopies after undergoing curative resection for colorectal cancer undergo subsequent surveillance colonoscopies within two years, which is earlier than recommended by current guidelines, according to research published in the January issue of Clinical Gastroenterology and Hepatology.

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Peds Rotavirus Vaccine Offers Indirect Protection for Adults

THURSDAY, Jan. 31 (HealthDay News) -- Pediatric rotavirus vaccinations also decrease the prevalence of the disease in unvaccinated adults, according to a study published online Jan. 23 in Clinical Infectious Diseases.

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Physicians Commonly Report Unsafe Hospital Workloads

TUESDAY, Jan. 29 (HealthDay News) -- Physicians say they often face unsafe hospital workloads, according to a study published online Jan. 28 in JAMA Internal Medicine.

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Brain Scans Show Doctors Empathize With Patients

TUESDAY, Jan. 29 (HealthDay News) -- Physicians who empathize with a patient in pain and feel relief when the patient receives effective treatment show activity in brain regions associated with pain relief and reward, according to a study published online Jan. 29 in Molecular Psychiatry.

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FDA: Samsca May Cause Irreversible Liver Damage

FRIDAY, Jan. 25 (HealthDay News) -- Patients who take Samsca (tolvaptan) may be at elevated risk for significant liver injury, according to a Jan. 25 safety alert issued by the U.S. Food and Drug Administration.

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CDC: 1,527 Foodborne Disease Outbreaks in 2009 to 2010

FRIDAY, Jan. 25 (HealthDay News) -- In 2009 to 2010, there were 1,527 foodborne disease outbreaks reported, according to research published in the Jan. 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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ACPE Survey Finds Skepticism Relating to Online Doc Ratings

THURSDAY, Jan. 24 (HealthDay News) -- Physicians are skeptical of online ratings, and believe that few patients use them, according to a survey published by the American College of Physician Executives (ACPE).

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CDC: Novel Norovirus Replacing Former Dominant Strain

THURSDAY, Jan. 24 (HealthDay News) -- A novel strain of norovirus, GII.4 Sydney, which was first detected in Australia in March of last year, was responsible for the majority of norovirus outbreaks in the United States from September through December 2012, according to a report published in the Jan. 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Physician Education Ups Communication for New Meds

THURSDAY, Jan. 24 (HealthDay News) -- A physician-targeted education session improves physician communication about newly-prescribed medications, according to a study published in the January/February issue of the Annals of Family Medicine.

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Scoring System IDs Patients at Risk for Nosocomial GI Bleed

THURSDAY, Jan. 24 (HealthDay News) -- A scoring system based on several independent risk factors can identify non-critically ill hospitalized patients at risk for nosocomial gastrointestinal bleeding, according to a study published in the January issue of the Journal of General Internal Medicine.

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Surgeon Volume, Prognosis Post-Esophageal Cancer Op Linked

THURSDAY, Jan. 24 (HealthDay News) -- For patients with esophageal cancer undergoing resection, surgeon volume, but not hospital volume, is independently associated with prognosis, according to research published online Jan. 7 in the Journal of Clinical Oncology.

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Large Teaching Hospitals Face More Readmission Penalties

WEDNESDAY, Jan. 23 (HealthDay News) -- Large hospitals, teaching hospitals, and safety-net hospitals (SNHs) are more likely than other hospitals to be penalized under the Centers for Medicare & Medicaid Services' Hospital Readmissions Reduction Program (HRRP), according to a research letter published in the Jan. 23/30 issue of the Journal of the American Medical Association.

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Fatty Liver May Directly Mediate CAD in Metabolic Syndrome

WEDNESDAY, Jan. 23 (HealthDay News) -- Men and women with fatty liver are more likely to have metabolic syndrome (MetS) with type 2 diabetes, and women with fatty liver are more likely to have MetS with subclinical atherosclerosis, according to research published online Dec. 18 in Diabetes Care.

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Physical Activity Cuts Mortality in Colorectal Cancer Survivors

WEDNESDAY, Jan. 23 (HealthDay News) -- For patients with invasive, non-metastatic colorectal cancer, increased recreational physical activity is associated with reduced all-cause mortality, while prolonged sedentary time correlates with increased all-cause mortality, according to a study published online Jan. 22 in the Journal of Clinical Oncology.

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Care Transition Initiative Decreases Rehospitalizations

WEDNESDAY, Jan. 23 (HealthDay News) -- Communities instituting quality improvement initiatives for care transitions see significant declines in the rate of 30-day rehospitalizations and hospitalizations, according to a study published in the Jan. 23/30 issue of the Journal of the American Medical Association.

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Increase in Proportion of Livers Not Used for Transplantation

TUESDAY, Jan. 22 (HealthDay News) -- The proportion of livers not used for transplantation is increasing, with the primary causes being donation after cardiac death (DCD), older donor age, greater body mass index (BMI), and increasing diabetes prevalence, according to research published in the January issue of Liver Transplantation.

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Ulcerative Colitis, Not Crohn's, Deaths Down From 1982

MONDAY, Jan. 21 (HealthDay News) -- Over the past 30 years in Denmark, mortality from ulcerative colitis (UC) has decreased, but mortality from Crohn's disease (CD) has remained persistently higher than the general population, according to research published in the January issue of Clinical Gastroenterology and Hepatology.

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About 10 Percent of Neoplastic Polyps Incompletely Resected

FRIDAY, Jan. 18 (HealthDay News) -- About 10 percent of neoplastic polyps are incompletely resected, with considerable variation in the rate of incomplete resection between endoscopists, according to a study published in the January issue of Gastroenterology.

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Efforts Failed to Up Primary Care, Rural Resident Training

FRIDAY, Jan. 18 (HealthDay News) -- The 2005 redistribution of graduate medical education (GME) funds did little to train more residents in primary care and in rural areas, according to a study published in the January issue of Health Affairs.

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Donor Fecal Infusion Effective for C. difficile Infection

WEDNESDAY, Jan. 16 (HealthDay News) -- Duodenal infusions of donor feces are significantly more effective than vancomycin for treating recurrent Clostridium difficile infections, according to a study published online Jan. 16 in the New England Journal of Medicine.

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Family Docs Are Early Adopters of Electronic Health Records

WEDNESDAY, Jan. 16 (HealthDay News) -- Family practice physicians are adopting electronic health record (EHR) systems at a fast pace, with 68 percent using an EHR system by 2011, and 80 percent expected to be users by 2013, according to research published in the January/February issue of the Annals of Family Medicine.

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Depressive Symptoms Tied to Doubled Risk for Crohn's

WEDNESDAY, Jan. 16 (HealthDay News) -- Depressive symptoms are associated with a two-fold increase in risk of Crohn's disease (CD) but not ulcerative colitis (UC), according to research published in the January issue of Clinical Gastroenterology and Hepatology.

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Even Brief Interruptions Dramatically Increase Errors

WEDNESDAY, Jan. 16 (HealthDay News) -- Even momentary interruptions of two to four seconds can significantly affect a person's ability to accurately complete a task requiring considerable thought, according to research published online Jan. 7 in the Journal of Experimental Psychology: General.

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No Gastric Volume Monitoring Is Not Inferior Strategy

TUESDAY, Jan. 15 (HealthDay News) -- For adults requiring invasive mechanical ventilation, enteral nutrition management without residual gastric volume monitoring is not inferior to a similar protocol which includes monitoring for protection against ventilator-associated pneumonia (VAP), according to a study published in the Jan. 16 issue of the Journal of the American Medical Association.

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Certain Online Behaviors of Docs Warrant Investigation

MONDAY, Jan. 14 (HealthDay News) -- There is high consensus among state medical boards regarding the likelihood of probable investigations for certain online behaviors, according to a study published in the Jan. 15 issue of the Annals of Internal Medicine.

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Top Five Issues for Docs and Patients Identified for 2013

MONDAY, Jan. 14 (HealthDay News) -- The top five issues that will impact physicians and patients in 2013 have been identified, according to a report published Dec. 10 by The Physicians Foundation.

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National U.S. Health Care Spending Relatively Stable

FRIDAY, Jan. 11 (HealthDay News) -- The growth in national U.S. health care spending was relatively stable in 2011, but growth in personal health care spending accelerated, according to a study published in the January issue of Health Affairs.

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10-Year Lag in Survival Benefit After Cancer Screening

THURSDAY, Jan. 10 (HealthDay News) -- Breast and colorectal cancer screening have, on average, a 10-year time lag to survival benefit, according to a meta-analysis published online Jan. 8 in BMJ.

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Genetic CRC Risk Likely Mediated by Differential Adenoma Risk

THURSDAY, Jan. 10 (HealthDay News) -- Much of the genetic risk for colorectal cancer (CRC) in the general population is mediated by differential adenoma risk, according to research published in the January issue of Gastroenterology.

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SPIRIT 2013 Clinical Trial Protocol Guidelines Issued

THURSDAY, Jan. 10 (HealthDay News) -- A panel of experts, including trial investigators, trial coordinators, and representatives from ethics and regulatory agencies, has developed the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 guidelines for the minimum content of a clinical trial, according to a statement published online Jan. 8 in the Annals of Internal Medicine.

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Multiple Stressors Contribute to Readmission Within 30 Days

WEDNESDAY, Jan. 9 (HealthDay News) -- Nearly one-fifth of Medicare patients discharged from the hospital are readmitted within 30 days, which seems to arise from a combination of factors contributing to patient vulnerability, according to research published in the Jan. 9 issue of the New England Journal of Medicine.

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Health Care Use Dropped Among All During Recession

TUESDAY, Jan. 8 (HealthDay News) -- Health care use declined significantly among all races and ethnicities during the recession from 2007 to 2009, with the only ethnic disparity being fewer physician visits by Hispanics compared with whites, according to a study published online Jan. 7 in JAMA Internal Medicine.

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Shared Savings May Promote Care Coordination Entity Use

MONDAY, Jan. 7 (HealthDay News) -- Use of shared savings could encourage individuals who are dually eligible for Medicare and Medicaid to enroll in state-designed care coordination entities (CCEs), according to a perspective piece published online Jan. 2 in the New England Journal of Medicine.

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FDA Proposes New Food Safety Standards

FRIDAY, Jan. 4 (HealthDay News) -- The U.S. Food and Drug Administration is proposing two new food safety rules as part of the implementation of the FDA Food Safety Modernization Act in an effort to shift the focus of food safety from reactive to preventive measures, according to a Jan. 4 news release issued by the agency.

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Program Benefits Children With Functional Abdominal Pain

FRIDAY, Jan. 4 (HealthDay News) -- Both children with persistent abdominal pain and their parents still benefit from a short social learning and cognitive behavioral therapy intervention a year later, according to a study published online Dec. 31 in JAMA Pediatrics.

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Association Between Health Care Cost, Quality Inconsistent

THURSDAY, Jan. 3 (HealthDay News) -- The direction of the association between health care cost and quality is unclear, with inconsistent evidence indicating positive, negative, mixed, and indeterminate associations, according to a review published in the Jan. 1 issue of the Annals of Internal Medicine.

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Restrictive Transfusion Strategy Safe for Acute GI Bleeding

WEDNESDAY, Jan. 2 (HealthDay News) -- For patients with severe acute gastrointestinal bleeding, a restrictive transfusion approach is safe and effective compared with a liberal approach, according to a study published in the Jan. 2 issue of the New England Journal of Medicine.

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Interferon-Free Therapies for Hep C Virus Look Promising

WEDNESDAY, Jan. 2 (HealthDay News) -- For untreated patients with hepatitis C virus (HCV), treatment with an oral nucleotide inhibitor of HCV polymerase, sofosbuvir, plus ribavirin seems effective for genotypes 1, 2, and 3; and the HCV NS3 protease inhibitor ABT-450, combined with low-dose ritonavir (ABT-450/r) plus the nonnucleoside NS5B polymerase inhibitor ABT-333 and ribavirin, seems effective for genotype 1, according to two studies published in the Jan. 2 issue of the New England Journal of Medicine.

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Fulyzaq Approved for ART-Related Diarrhea in HIV/AIDS

WEDNESDAY, Jan. 2 (HealthDay News) -- The first medication to treat diarrhea in people with HIV/AIDS who take antiretroviral drugs has been approved by the U.S. Food and Drug Administration.

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House Joins Senate to Avert Medicare Cuts

WEDNESDAY, Jan. 2 (HealthDay News) -- The House of Representatives settled on an 11th-hour agreement late Tuesday night that has averted the widespread tax increases and spending cuts that would have gone into effect January 1. This agreement occurred 21 hours after the U.S. Senate did its part to steer the country clear of the "fiscal cliff."

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