Esophageal Adenocarcinoma in Populations with Gastroesophageal Reflux Disease

Incidence of EAC in patients with GERD was very low overall, especially among men younger than 50 and women at any age.

The incidence of esophageal adenocarcinoma (EAC) has increased rapidly during the past few decades. National society guidelines recommend endoscopic screening for Barrett esophagus in patients with long-standing gastroesophageal reflux disease (GERD). However, the incidence for EAC in demographic subpopulations with GERD is unknown.

Colorectal Tumor Development and Lynch Syndrome

Progression from adenoma to carcinoma occurred rapidly in patients with Lynch syndrome.

Because mutations responsible for Lynch syndrome can cause colorectal adenomas to pass rapidly through the polyp–cancer sequence, interval cancers are common in patients with Lynch syndrome. As such, current U.S. screening guidelines recommend that adults with Lynch syndrome undergo colonoscopy every 2 years until age 40 and then annually thereafter (JW Gastroenterol Jul 9 2010).

Predicting Poor Outcomes in Nonvariceal Upper Gastrointestinal Bleeding

Comorbidity, age >65 years, history of bleeding ulcers, and source and setting of bleeding contributed to risk for continued or recurrent bleeding, or death within 30 days.

Advances in endoscopic and pharmacologic therapy have reduced the risk for rebleeding in patients with nonvariceal upper gastrointestinal bleeding (UGIB); however, mortality remains relatively unchanged.

Fecal Occult Blood Tests Can Do More Harm Than Good in the Elderly

Among elderly men, 87% with the worst life expectancy and 65% with the best life expectancy experienced more burden than benefit from fecal occult blood testing.

Thiopurines Reduce Colorectal Cancer Risk in Patients with IBD

But, does this benefit outweigh the risks of these drugs?

Telaprevir Markedly Improves HCV Genotype 1 Cure Rates

Final results of phase III trials show that telaprevir plus standard therapy with peginterferon alfa-2a and ribavirin was more effective than standard therapy alone.

Recently, telaprevir-based triple therapy (i.e., in combination with peginterferon alfa-2a and ribavirin) was approved for the treatment of chronic hepatitis C virus (HCV) infection. The final results of the international phase III trials for both treatment-naive and treatment-experienced patients with HCV genotype 1 infection are now available.

GlideScope Matches Flexible Fiber-Optic Scope for Intubation in Obese Patients

In this small study, time to intubation, number of attempts, success rate, and incidence of complications were comparable.

Which Scoring System Best Predicts Outcomes of Upper Gastrointestinal Bleeding?

Glasgow-Blatchford and Rockall scores were similarly effective, but comparing systems is less important than using some method to identify which patients need early and vigorous therapy.

Multiple studies have evaluated various scoring systems to predict the outcome of patients with nonvariceal upper gastrointestinal bleeding (UGIB). Recent comparisons between Rockall scores — including both pre-endoscopy scores and postendoscopy (complete) scores — and the Glasgow-Blatchford score (GBS), which does not require endoscopy, have suggested that these three scores all have predictive value.

To further compare the ability of these scores to predict outcomes, investigators prospectively collected data from patients who presented with UGIB at four hospitals in the U.K. Some data were collected retrospectively from one hospital. Therapy was provided according to existing guidelines but varied somewhat when different protocols were used at some hospitals.

Efficacy of rabeprazole in treating ulcers was high with either aspirin or clopidogrel.

Aspirin and clopidogrel are antiplatelet drugs used to prevent thrombotic vascular events. However, both are associated with increased risk for bleeding from peptic ulcer disease (PUD). Aspirin induces peptic ulcers, and both drugs prevent their healing — aspirin through inhibiting mucosal prostaglandin generation and clopidogrel by decreasing platelet-related growth factors. Proton-pump inhibitor (PPI) treatment is effective for healing aspirin-associated PUD, but for patients requiring continued antiplatelet therapy, it is unclear whether the outcomes are different in patients taking clopidogrel versus aspirin.

Vegetarians Have Lower Risk for Symptomatic Diverticular Disease

Results support earlier findings on the protective effects of dietary fiber intake and vegetarianism on diverticular disease.