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July 2008 Briefing - Gastroenterology

Here are what the editors at HealthDay consider to be the most important developments in Gastroenterology for July 2008. 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.

PAND Doesn't Add to Survival with Gastric Cancer

WEDNESDAY, July 30 (HealthDay News) -- In patients undergoing gastrectomy for curable gastric cancer, the addition of para-aortic nodal dissection (PAND) to D2 lymphadenectomy isn't advisable, according to research in the July 31 New England Journal of Medicine.

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FDA Approves First Generic Divalproex Sodium

WEDNESDAY, July 30 (HealthDay News) -- The U.S. Food and Drug Administration has approved generic versions of Depakote delayed-release tablets (divalproex sodium) for the first time, according to a press release issued by the FDA this week.

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Hepatitis C Doesn't Impair CD4 Recovery in HIV Context

TUESDAY, July 29 (HealthDay News) -- Coinfection with hepatitis C virus does not reduce CD4 recovery in subjects with HIV who are receiving highly active anti-retroviral therapy, according to research published in the July AIDS Research and Human Retroviruses.

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Use of Antibiotic Prophylaxis for Endocarditis Discouraged

TUESDAY, July 29 (HealthDay News) -- Antibiotic prophylaxis should no longer routinely be given to prevent infective endocarditis in patients undergoing dental and other medical procedures, according to updated guidelines published online July 28 in the Journal of the American College of Cardiology. The guidelines were jointly developed by the American College of Cardiology and the American Heart Association.

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Fecal Occult Blood Tests Offer Different Results

MONDAY, July 28 (HealthDay News) -- The use of an immunochemical fecal occult blood test (I-FOBT) resulted in higher participation and detection rates for advanced adenomas and cancer than use of a guaiac-based fecal occult blood test (G-FOBT), according to research published in the July Gastroenterology.

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Postmenopausal Estrogen May Increase Reflux Symptoms

THURSDAY, July 24 (HealthDay News) -- Estrogen therapy in postmenopausal women may slightly increase the incidence of gastroesophageal reflux, according to research published in the July issue of Gastroenterology.

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'Tier 4' Drugs Raise Questions About Affordability

WEDNESDAY, July 23 (HealthDay News) -- The emergence of a fourth tier of copayment for expensive drugs calls into question how Americans are going to handle the rising costs of health care, according to a perspective article in the July 24 issue of the New England Journal of Medicine.

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Sorafenib Beneficial in Advanced Liver Cancer

WEDNESDAY, July 23 (HealthDay News) -- Treatment with sorafenib -- an oral multikinase inhibitor -- may benefit patients with advanced hepatocellular carcinoma, according to research published in the July 24 issue of the New England Journal of Medicine.

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Consequences of Genetic Non-Discrimination Act Examined

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

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Adjuvant Treatment Improves Pancreatic Cancer Survival

WEDNESDAY, July 23 (HealthDay News) -- Four new studies show that the addition of chemotherapy and radiation before or after surgery for pancreatic cancer can improve survival, according to an editorial in the July 20 issue of the Journal of Clinical Oncology.

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Physicians to Get Bonus for Electronic Prescribing

WEDNESDAY, July 23 (HealthDay News) -- Doctors using an electronic prescriptions system will be eligible for a bonus from Medicare from 2009 onwards for four years, according to U.S. health officials.

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Using Older Liver Donors May Help Reduce Waiting Lists

TUESDAY, July 22 (HealthDay News) -- Using livers donated by marginal donors may reduce the waiting time for liver transplant patients without having a negative impact on outcomes, even for patients with hepatitis C virus, according to research published in the July issue of the Archives of Surgery.

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Lymph Node Evaluation Varies by Hospital Type and Volume

MONDAY, July 21 (HealthDay News) -- In patients with gastric or pancreatic cancer, lymph node evaluation is significantly more comprehensive at National Comprehensive Cancer Network (NCCN), National Cancer Institute (NCI)-designated institutions and at high-volume hospitals, according to a report published in the July issue of the Archives of Surgery.

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Breast-Feeding Lowers Infant Risk of Stomach Infection

MONDAY, July 21 (HealthDay News) -- Infants of low-income women who are predominantly breast-fed have a lower risk of gastrointestinal infection but a higher risk of iron deficiency than infants who are partially or entirely formula-fed, according to the results of a study published in the August issue of the Journal of Nutrition.

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Only Modest Proof for Diabetic Gastroparesis Drug

FRIDAY, July 18 (HealthDay News) -- Although the majority of trials of domperidone to treat diabetic gastroparesis yield results in favor of using the drug, the findings should be treated with caution because of the lack of control arms in positive studies, according to a review article published in the July issue of Clinical Gastroenterology and Hepatology.

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Exception Reporting Improves Pay-for-Performance Benefits

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

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Medical Education Must Adapt to Changing Times

THURSDAY, July 17 (HealthDay News) -- Medical schools must adapt their admission requirements and curricula to changes in scientific theory, and are also facing a challenge to the traditional definition of who is suited to the study of medicine, according to two articles published in the July 17 issue of the New England Journal of Medicine.

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Therapy-Suspected Link Reported in Lung Cancer Patient

WEDNESDAY, July 16 (HealthDay News) -- A case of lung cancer in an individual using anti-tumor necrosis factor (TNF) therapies -- which regressed upon withdrawal of the drugs -- raises concerns about the use of anti-TNF therapy in older patients with a history of smoking, according to correspondence in the July 17 issue of the New England Journal of Medicine.

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AMA Actions Fostered U.S. Medical Racial Divide

TUESDAY, July 15 (HealthDay News) -- From the post-Civil War years to the civil rights era a century later, the American Medical Association (AMA) made decisions that helped support a division between white and black Americans in the field of medicine in the United States, according to an article in the July 16 issue of the Journal of the American Medical Association.

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Non-Invasive Biomarker May Help Screen for Liver Fibrosis

MONDAY, July 14 (HealthDay News) -- Type 2 diabetes patients who are at high risk for liver fibrosis may benefit from a screening test using a non-invasive biomarker, according to a report published in the July issue of Clinical Gastroenterology and Hepatology.

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Oral Hormone Therapy Raises Risk of Gallbladder Disease

FRIDAY, July 11 (HealthDay News) -- Postmenopausal women using hormone replacement therapy (HRT) are at higher risk of gallbladder disease if they use oral rather than transdermal drugs, according to study findings published July 10 in BMJ Online First.

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Health Cash Incentives for Poor People Debated

WEDNESDAY, July 9 (HealthDay News) -- Should disadvantaged people be paid to take care of their health? That's the question of a "Head to Head" debate published online July 8 in BMJ.

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Antidepressants Increase Risk of Gastrointestinal Bleeding

TUESDAY, July 8 (HealthDay News) -- Antidepressant drugs that block the serotonin reuptake mechanism -- notably selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors -- increase the risk of gastrointestinal bleeding, especially when used in conjunction with non-steroidal anti-inflammatory drugs, researchers report in the July issue of the Archives of General Psychiatry.

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New Strategies Needed for Crohn's Disease

MONDAY, July 7 (HealthDay News) -- Although anti-tumor necrosis factor agents have benefited patients with Crohn's disease, their variable effects demonstrate that new strategies are needed, according to a review article published in the July 5 issue of The Lancet.

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Liver Cancer Less Common with More Coffee Drinking

FRIDAY, July 4 (HealthDay News) -- High levels of coffee consumption demonstrated an inverse association with primary liver cancer, while elevated levels of gamma-glutamyltransferase (GGT) increased risk in a large prospective population-based study, according to an article published in the July issue of Hepatology.

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Combo Therapy Improves Survival in Hepatitis B

THURSDAY, July 3 (HealthDay News) -- Combining hepatitis B immunoglobulin (HBIG) and lamivudine significantly improves prevention of hepatitis B virus (HBV) recurrence, HBV-related death and all-cause mortality in the post-liver transplantation setting, according to an article published in the June issue of Clinical Gastroenterology and Hepatology.

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Drug Demonstrates Efficacy in Chronic Hepatitis B Patients

WEDNESDAY, July 2 (HealthDay News) -- Entecavir improved multiple efficacy endpoints compared to continued lamivudine in patients with chronic hepatitis B with resistance to lamivudine, according to an article published in the July issue of Hepatology.

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Liver Disease in Overweight Children Linked to More Risks

TUESDAY, July 1 (HealthDay News) -- Overweight children with non-alcoholic fatty liver disease (NAFLD) are more likely to have metabolic syndrome and cardiovascular risk factors than overweight children without NAFLD, according to research published online June 30 in Circulation: Journal of the American Heart Association.

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Physician's Briefing