September 2009 Vol XXXIII Issue 9

Previous MonthNext Month


Enteral Feeding and Vasoactive Agents: Suggested Guidelines for Clinicians

Kristin C. Turza, Joe Krenitsky, Robert G. Sawyer

Many patients may benefit from enteral nutrition. It may be undertaken with relative safety using a four-phase process with subsequent monitoring.


Protective Role of Helicobacter pylori Against Inflammatory Bowel Disease: A Hypothesis

Amnon Sonnenberg

The decline in the occurrence of peptic ulcer disease during the 20th century occurred simultaneously with the rise in the occurrence of inflammatory bowel disease. This article pursues the hypothesis that H. pylori infection may have protected its carriers against developing inflammatory bowel disease and that the increase of inflammatory bowel disease was in part caused by the loss of this protective influence.

Hepatitis D Virus

S. Bennett Hooks, C. Julian Billings, Jorge L. Herrera

The hepatitis D virus (HDV) requires HBV's presence for complete virus assembly and secretion. Parenteral and sexual transmission are routes of infection for this virulent virus that is an important public health concern.

A Review of Colonic Volvulus

Adam Spiegel, Tarun Chugh, Edward Lebovics

Departments Section

From the Pediatric Gastroenterology Literature

Outcome of Kasai Procedure and Patient Age

Biliary atresia (BA) is defined as progressive obliteration of the intra-and extrahepatic bile ducts during infancy and is caused by an unknown insult that may include an infectious, autoimmune, or genetic etiology. The Kasai procedure (hepatic portoenterostomy) can alleviate the end effect of BA (portal hypertension and liver failure), and studies have demonstrated that if the Kasai procedure is performed early in infancy, liver transplantation can be postponed for several years.

Is Eosinophilic Esophagitis Dependent on Where You Live?

Eosinophilic esophagitis (EE) has become a commonly diagnosed disease in children. Its etiology is unknown, and genetic and environmental factors likely are involved in its development. This study was performed in the Philadelphia area and consisted of a case control design. EE cases were obtained from an eosinophilic disorders database and were included in the study if esophageal biopsies demonstrated greater than 20 eosinophils per high- power field.

Book Reviews

Textbook of Gastroenterology, Fifth Edition

This is the fifth edition of one of the most comprehensive reference textbooks in the field of gastroenterology. Thoroughly updated, this classic two- volume set provides encyclopedic coverage of the scientific basis of gastroenterology along with detailed analyses of virtually every disease state encountered in practice.

Atlas of Gastroenterology, Fourth Edition

The practice of gastroenterology, perhaps more than any other in the field of medicine, has been enhanced by the rapid advancement in imaging technologies. Our practice, as gastroenterologists, is a visual one that has been enriched by many advances in recent years. Along with these technologies come new frontiers in understanding the pathophysiological processes that define and contribute to specific disease states.
Atlas of Gastroenterology in its fourth edition provides the clinician with an outstanding assortment of images, tables and charts in an attempt to encompass all disciplines in the field with over 1,700 full color images.

Complicated Cases in GI

Complicated Cases in GI, edited by Anthony Kalloo and Jonathan Buscaglia, is a collection of cases inspired by the Gastrointestinal (GI) Grand Rounds at Johns Hopkins Hospital. The book is a collection of 59 different cases which were presented at the grand rounds and written up by fellows at John Hopkins Hospital. The proceeds from the sale of the book go to the Johns Hopkins Hospital Division of Gastroenterology and Hepatology Fellowship Fund, which supports the growth and development of the fellowship program.

From the Literature

BMI and Pancreatic Carcinoma

Obesity has been implicated as a risk factor for pancreatic cancer. To demonstrate the association of excess body weight across an age cohort and the risk, age of onset and overall survival of patients with pancreatic cancer, a case-controlled study of 841 patients with pancreatic adenocarcinoma and 754 healthy individuals was carried out with frequency matched by age, race and sex. The study was conducted at a university cancer center in the United States from 2/2004 to 2/2008. Height and body weight histories were collected by personal interview, started at ages 14 to 19 years, and over 10 year intervals, progressing to the year prior to recruitment in the study.

Budesonide in Lymphocytic Colitis

It has been well identified that Budesonide is effective in treating collagenous colitis, but no treatment has been established for lymphocytic colitis.
A randomized, double-blind, placebo-controlled study was performed to evaluate the effects of Budesonide in patients with that disorder. Forty-two patients with lymphocytic colitis and chronic diarrhea were randomly assigned to groups that were given oral doses of Budesonide (9 mg per day), or placebo for six weeks.

Cigarette Smoking and Colorectal Cancer

To evaluate the relationship between smoking and the incidence of CRC in a meta-analysis of cohort studies, full publications of prospective studies were identified in MEDLINE and EMBASE from 1950 to 2008. Subjects were classified as current smokers, former smokers or never smokers. The quantity of smoking was assessed by the number of cigarettes per day, years of smoking and pack/years. The reported relative risks of CRC were pooled by random-effects model. Sensitivity analysis was conducted and publication bias was evaluated.

SVR for HBVe Antigen-Negative Patients Treated With PEG Interferon

It has been identified that patients with hepatitis Be antigen (HBeAg) negative chronic hepatitis B treated with PEG Interferon Alfa-2A, with or without Lamivudine achieved significantly higher six month post treatment rates of response, compared with those who are treated with Lamivudine alone. The durability of three year or greater post treatment response was investigated in this study in which patients received PEG Interferon Alfa-2A only (180 mcg once weekly— N = 177), in combination with Lamivudine (100 mg daily – N = 179), or Lamivudine alone (N = 181) for 48 weeks.

Medical Bulletin Board

Vectibix® Significantly Improved Progression-free Survival in Second-line Treatment of KRAS Wild-type Metastatic Colorectal Cancer

Second Prospective Phase 3 Vectibix Combination Chemotherapy Trial to Show Progression-Free Survival Advantage in KRAS Wild-Type Population

New Robot-Assisted Surgical Method Found Successful for Treatment of Thyroid Cancer

Journal Of The American College Of Surgeons Study Cites Safer And Easier Operation With Less Scarring

Endoscopy Intervention Within 24 Hours Associated With Better Outcomes in Older Patients With Peptic Ulcer Bleeding

A new study shows that elderly patients who underwent endoscopy within one day of presentation for peptic ulcer bleeding had a two-day shorter hospital stay and were less likely to require upper gastrointestinal surgery than patients who did not receive endoscopy within the first day of presentation. Researchers from University Hospitals Case Medical Center in Cleveland, Ohio, note that unless specific contraindications exist, the data supports the routine use of early endoscopy for upper gastrointestinal bleeding.

New Study Shows Quality Focus Reduces Surgical Complications and Disparities of Care in U.S. Hospitals

Hospitals Participating in the American College of Surgeons' NSQIP Program Prevent 250–500 Complications Annually, per Hospital; Health Reform Measures Focused on Quality Can Improve Care, Reduce Disparities and Reduce Costs