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.
A Novel, Noninvasive Marker for Portal Hypertension in Cirrhosis?
The von Willebrand factor antigen performed well in diagnosing portal hypertension and predicting decompensation outcomes and mortality in patients with cirrhosis.
Portal hypertension (hepatic venous pressure gradient [HVPG] 10 mm Hg) in patients with cirrhosis is associated with increased morbidity and mortality. Measurement of HVPG is expensive, invasive, and typically available only in specialized centers. Now, researchers have explored whether von Willebrand factor antigen (vWF-Ag) is a useful alternative indicator of portal hypertension.
Generally no, except for certain high-risk patients — and even then, not within 7 days of the initial test
The recent increase in incidence and severity of Clostridium difficile infection has prompted a progressive switch from enzyme immunoassays (EIAs) to polymerase chain reaction (PCR) assays, because the latter is more sensitive and therefore more reliable when negative. But what about patients with suspected C. difficile infection whose symptoms persist despite negative PCR results? In a recent retrospective study, researchers at the Mayo Clinic evaluated the utility of repeat PCR testing for such patients. All testing was done using a real-time PCR assay developed in the Mayo Clinic's microbiology laboratory.
In a meta-analysis of 20 randomized, controlled trials, probiotics reduced risk by 66%.
Clostridium difficile–associated diarrhea (CDAD) is increasing in incidence and severity in North America and Europe. Some studies have suggested that probiotics taken in combination with antibiotics can reduce the risk for antibiotic-induced CDAD.
Does Red Blood Cell Transfusion Increase the Risk for Rebleeding in UGIB?
A large observational study shows a positive association, but prospective trials are needed to address causality.
