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June 2010 Briefing - Gastroenterology

Here are what the editors at HealthDay consider to be the most important developments in Gastroenterology for June 2010. 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.

Cyclosporine After Transplant Tied to De Novo Cancer Risk

WEDNESDAY, June 30 (HealthDay News) -- Immunosuppressive treatment with cyclosporine A (CsA), rather than tacrolimus (TAC), with dose level monitoring two hours post-dosing (C2 monitoring) or in patients age 50 or younger appears to have a significant association with the development of de novo cancer after liver transplantation, according to research published in the July issue of Liver Transplantation.

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Doctors Agree Malpractice Fears Drive Overuse of Tests

MONDAY, June 28 (HealthDay News) -- A large majority of physicians agree that the practice of defensive medicine -- stemming from malpractice concerns -- is responsible for an overuse of medical tests and procedures, according to a research letter in the June 28 issue of the Archives of Internal Medicine.

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Phone Reminders Up Colorectal Cancer Screening Rate

THURSDAY, June 22 (HealthDay News) -- An automated telephone intervention appears to increase the completion of fecal occult blood testing (FOBT) for colorectal cancer screening, according to a study published in the July issue of Medical Care.

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Early Shunting Controls Bleeding in Cirrhotic Patients

WEDNESDAY, June 23 (HealthDay News) -- Typically reserved as a rescue therapy, the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) soon after hospital admittance for acute variceal bleeding in cirrhosis patients may reduce the likelihood of treatment failure and death, according to research published in the June 24 issue of the New England Journal of Medicine.

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Surveillance Colonoscopy Can Be Cost-Effective

TUESDAY, June 22 (HealthDay News) -- Surveillance colonoscopy is cost-effective for patients at high risk of colorectal cancer, but aggressive surveillance may be expensive or harmful, according to research published in the June issue of Gastroenterology.

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Severe Colitis Reported in Child After Rituximab Treatment

MONDAY, June 21 (HealthDay News) -- Children treated with rituximab for nephrotic syndrome (NS) may be at risk for severe T-cell mediated ulcerative colitis, as demonstrated by a case study published online June 21 in Pediatrics.

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Colon Capsule Endoscopy Detects Polyps Effectively

MONDAY, June 21 (HealthDay News) -- Colon capsule endoscopy (CCE) appears to be an effective noninvasive colorectal cancer (CRC) screening technique, as its sensitivity for polyps and significant findings compares favorably with other noninvasive CRC screening approaches, according to research published in the June issue of Clinical Gastroenterology and Hepatology.

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Hepatic Encephalopathy Linked to Chronic Cognitive Effects

FRIDAY, June 18 (HealthDay News) -- Among patients with cirrhosis, episodes of overt hepatic encephalopathy (OHE) may be associated with lingering and cumulative problems with learning, working memory, and response inhibition, according to research published in the June issue of Gastroenterology.

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Low Proportion of Cirrhosis Patients Screened for HCC

FRIDAY, June 18 (HealthDay News) -- Fewer than 20 percent of patients with hepatocellular carcinoma (HCC) who have previously had cirrhosis receive regular screening in the three years before being diagnosed with HCC, and those seeing only primary care doctors are least likely to be screened, according to research published in the July issue of Hepatology.

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Laparoscopy May Be Safest Option for Diverticular Disease

FRIDAY, June 18 (HealthDay News) -- Laparoscopic colon resection for diverticular disease results in fewer complications, lower postoperative mortality, and shorter hospital stays than open surgery for the condition, according to research published in the June issue of Gastroenterology.

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Smoking Linked to Higher Risk of Flat Colorectal Adenomas

FRIDAY, June 18 (HealthDay News) -- Smoking appears to be an important risk factor for flat colorectal adenomas, which may explain the earlier onset and advanced stage at presentation of colorectal cancer in smokers, according to research published in the June issue of Gastrointestinal Endoscopy.

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Colonoscopies Every 1-2 Years Urged for Those at Genetic Risk

THURSDAY, June 17 (HealthDay News) -- Getting surveillance colonoscopies every one to two years instead of every two to three years is associated with a reduced risk of colorectal cancer (CRC) for members of families with Lynch syndrome, according to a study in the June issue of Gastroenterology.

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Celecoxib Linked to Lower Rate of Gastrointestinal Events

THURSDAY, June 17 (HealthDay News) -- The cyclooxygenase (COX)-2 selective nonsteroidal anti-inflammatory drug (NSAID) celecoxib is associated with a lower risk of gastrointestinal adverse events than the NSAID diclofenac plus the proton pump inhibitor (PPI) omeprazole in patients with osteoarthritis or rheumatoid arthritis, according to a study published online June 17 in The Lancet.

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Adding Ligation to Nadolol Not Beneficial in Variceal Bleeding

THURSDAY, June 17 (HealthDay News) -- Combining band ligation with the beta blocker nadolol may increase the odds of adverse events and may not be the most effective prophylaxis for first variceal bleeding from cirrhosis, according to research published in the July issue of Hepatology.

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Functional Dyspepsia Tied to Higher Costs for Employees

THURSDAY, June 17 (HealthDay News) -- Individuals with functional dyspepsia are absent from work more often and incur higher direct and indirect medical costs than employees without the condition, according to research published in the June issue of Clinical Gastroenterology and Hepatology.

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Pyloric Stenosis Has Strong Familial Aggregation

TUESDAY, June 15 (HealthDay News) -- Pyloric stenosis, which is the most common condition requiring surgery in an infant's first months of life, has strong familial aggregation and high heritability, according to a study in the June 16 issue of the Journal of the American Medical Association.

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Treatments Found Effective for Chronic Hepatitis E Infection

TUESDAY, June 15 (HealthDay News) -- Ribavirin and pegylated interferon-α may be effective in treating chronic hepatitis E virus (HEV) infection, according to two reports published online June 14 in the Annals of Internal Medicine.

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Modifiable Factors Tied to Mortality Hike in Rectal Cancer

MONDAY, June 14 (HealthDay News) -- Disparities in cancer stage and treatment account for most of the excess mortality in rectal cancer patients who are uninsured or on Medicaid, compared with privately insured patients, according to research published online June 14 in Cancer.

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Delaying Gallbladder Removal Ups Complications, Costs

WEDNESDAY, June 9 (HealthDay News) -- Delaying cholecystectomy in elderly adults hospitalized due to acute cholecystitis often results in hospital readmissions within two years and increased patient morbidity, mortality and costs, according to research published in the May issue of the Journal of the American College of Surgeons.

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Fatal Medication Errors Rise in July at Teaching Hospitals

TUESDAY, June 8 (HealthDay News) -- In July there is a significant increase in fatal medication errors at medical institutions, and this spike is at least partly due to the arrival of new medical residents, according to a study published online May 29 in the Journal of General Internal Medicine.

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Constipation in Children Often Continues in Adulthood

MONDAY, June 7 (HealthDay News) -- Many children with functional constipation continue to experience symptoms into adulthood; those who don't respond to first-line treatment should be considered for referral to a specialized clinic, according to research published online June 7 in Pediatrics.

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Antivirals in Compensated Cirrhosis Found Cost-Effective

FRIDAY, June 4 (HealthDay News) -- The antiviral treatment of patients with compensated cirrhosis may be the most cost-effective treatment option for patients with advanced liver disease caused by hepatitis C virus (HCV) infection, according to research published in the June issue of Liver Transplantation.

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Risk of GI Bleeding Varies by NSAID Type, Dosage

WEDNESDAY, June 2 (HealthDay News) -- The risk of gastrointestinal (GI) complications due to nonsteroidal anti-inflammatory drug (NSAID) use varies by the specific drug used and by dosage, and those with a slow-release formulation or long half-life are associated with a greater risk, according to research published in the June issue of Arthritis & Rheumatism.

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FDA: Claris IV Medications Recalled Due to Contamination

TUESDAY, June 1 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals not to use intravenous medications including metronidazole, ciprofloxacin and ondansetron manufactured by Claris Lifesciences, as the products may be contaminated.

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