Prophylactic Treatment for Depression with Interferon Therapy for Chronic Hepatitis C
Among HCV-infected adults without previous psychiatric disease, prophylactic antidepressant use significantly decreased the incidence and severity of interferon-associated depression.Body-mass index was positively correlated with prevalence of colorectal adenoma.
Weekend Admission and Mortality from Upper Gastrointestinal Bleeding
Mortality was higher with weekend versus weekday admissions, but patient factors might play a larger role than time or day of admission in determining outcomes.
Multiple studies have suggested that hospital admissions on weekends, holidays, or at night might be associated with poor outcomes for a variety of conditions. However, studies of outcomes for patients admitted with upper gastrointestinal bleeding (UGIB) during these times have provided varying results (JW Gastroenterol Apr 6 2012 and JW Gastroenterol May 29 2009).Nephrotoxicity was similar with tenofovir or entecavir.
Both tenofovir and entecavir are considered first-line oral antiviral agents for chronic hepatitis B virus (HBV) infection. In previous studies, nephrotoxicity has been observed with tenofovir therapy in patients coinfected with HBV and HIV. However, whether similar renal toxicity is present during tenofovir therapy in patients with HBV monoinfection is unclear.Aspirin and PPIs Might Prevent Cancer in Barrett Esophagus
In the largest randomized U.S. trial to date, a combination regimen reduced levels of a biomarker for increased production of the COX-2 enzyme, which is implicated in carcinogenesis.
Preclinical data suggest that nonsteroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, may protect against the development of esophageal adenocarcinoma (EAC) by inhibiting the cyclooxygenase 1 and 2 (COX-1 and COX-2) enzymes, which regulate prostaglandin E2 (PGE2) production. A proposed mechanism for Barrett esophagus (BE) carcinogenesis is induced up-regulation of COX-2 (with high levels of PGE2 production) from acid, bile salt, or both. If this biological premise is correct, treatment with a proton-pump inhibitor (PPI) combined with aspirin might be chemopreventive.Hormonal and histologic changes observed with long-term use of proton-pump inhibitors do not seem to translate into an elevated risk for mucosal gland atrophy or cancer.
Prolonged use of proton-pump inhibitors (PPIs) has been associated with an increase in serum gastrin levels, which could drive proliferation of enterochromaffin-like (ECL) cells in the gastric mucosa and contribute to mucosal gland atrophy in the presence of Helicobacter pylori infection. Two recent studies evaluated the long-term effects of PPI use on gastric mucosa.Colonoscopic Tattooing May Improve Lymph Node Detection and Mapping
Lymph node detection was higher in patients whose lymph nodes were stained black during tattooing for tumor localization.
Colonoscopic tattooing is now commonly performed to mark colorectal cancer (CRC) and endoscopically unresectable polyps for laparoscopic or open surgical resection. Now, investigators evaluate whether colonic tattooing with carbon black could also mark lymph nodes and thus increase their detectability during surgical resection.
