November 2018 Vol XLII Issue 11
FRONTIERS IN ENDOSCOPY, SERIES #47
Current Management of Ascending CholangitisIf not recognized and treated appropriately, ascending cholangitis can pose significant morbidity to affected patients. Accurate diagnosis and assessment of disease severity is essential to guide selection of antimicrobials, timing of biliary decompression, and selection of a decompression technique. This article reviews the current literature related to ascending cholangitis management, in conjunction with current international guidelines.
DISPATCHES FROM THE GUILD CONFERENCE, SERIES #18
Novel Therapies for Primary Sclerosing CholangitisPrimary sclerosing cholangitis (PSC) is chronic, cholestatic liver disease that progresses to advanced liver disease and cirrhosis. PSC is strongly associated with inflammatory bowel disease (IBD). In this article we present new studies, clinical trials and novel therapies for the treatment PSC.
NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #181
Pancreatic Exocrine Insufficiency and Enteral Feeding: A Practical Guide with Case StudiesPatients with pancreatic disease can develop severe malnutrition. Pancreatic enzyme replacement therapies (PERT) are predominantly designed for oral administration, but this can be challenging in patients requiring enteral nutrition (EN). This review explores the use of PERT in complex patients who are on EN. Case studies will be utilized to demonstrate different methods available in order to provide practical guidance on administration, both in the United States (U.S.) and the United Kingdom (U.K.).
LIVER DISORDERS, SERIES #9
Analysis and Interpretation of Classic Liver EnzymesSymptoms and signs of liver disease are often seen late in the disease. As a result laboratory testing helps in identifying and characterizing liver disease. For the purposes of this article, the liver chemistries that will be focused on will be bilirubin, alkaline phosphatase, aminotransferases and gamma-glutamyl transferase. In addition, albumin and prothrombin time will be discussed briefly. Following discussion of these tests, this article will focus on different patterns of abnormalities that relate to different disease processes.
A CASE REPORT
Spontaneous Pancreaticoduodenal Fistula:An Uncommon Case of Severe GI BleedingDepartments Section
Over-the-Scope Clips for Recurrent Bleeding Peptic Ulcer
A prospective, randomized trial to determine whether over-the-scope clips (OTSCs) were more effective than the standard treatment of severe recurrent upper gastrointestinal bleeding, the study was carried out at 9 academic referral centers (Germany, Switzerland, and Hong Kong), from March 2013 through September 2016.
Effect of Treatment of HCV without Advanced Liver Disease
The impact of SVR on mortality after DAA treatment was studied to evaluate the impact with Interferonfree DAA treatment in all-cause mortality with HCV-infected patients without advanced liver disease. The study was an observational cohort analysis comprising 103,346 genotype 1, 2 and 3 HCV mono-infected patients without advanced liver disease, defined by FIB-4 less than 3.25 and no diagnosis of cirrhosis, hepatic decompensation or hepatocellular carcinoma and no history of liver transplantation, identified from the VA Hepatitis C Clinical Case Registry
Prediction of Bleeding in Cirrhosis with Low Platelet Counts
Thrombocytopenia is perceived as a risk factor for bleeding events in patients with cirrhosis. To determine a relationship between the platelet count and bleeding, investigation of relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of 4 years was carried out.
Corticosteroid Therapy vs. TN Therapy in Inflammatory Bowel Disease
To compare the mortality risk with prolonged corticosteroid use versus antitumor necrosis factor-a (anti-TNF) drugs in IBD, a retrospective cohort study was conducted among Medicaid and Medicare beneficiaries from 2001 to 2013 with IBD prescribed either greater than 3000 mg of prednisone or equivalent within a 12 month period, or new initiation of anti-TNF therapy, each treated as time-updating exposures.
Diabetes, Metabolic Comorbidities and the Risk of Hepatocellular Carcinoma
Type 2 diabetes (T2D), is a risk factor for hepatocellular carcinoma (HCC). To determine whether T2D duration or additional metabolic comorbidities further contribute to HCC risk, data from the Nurses' Health Study (NHS) with 120,826 women enrolled in 1980 and the Health Professionals Follow-Up Study (HPS), with 250,284 men enrolled in 1986 and followed through 2012. Physician-diagnosed T2D was ascertained at baseline and updated by biennially.
Stents vs. Balloon Dilation for PSC
Dominant strictures occur in approximately 50% of patients with primary sclerosing cholangitis (PSC). A prospective study to compare the efficacy and safety of balloon dilatation vs. short-term stents in patients with non-end-stage PSC was carried out as an open-label trial in patients with PSC undergoing therapeutic ERCP.
Prediction of Fibrosis Regression After SVR in HCV Treatment
To investigate the degree of fibrosis regression (decrease greater than 1 METAVIR stage) after SVR and its associated factors in recurrent hepatitis C, as well as the diagnostic capacity of noninvasive methods in the assessment of liver fibrosis and portal hypertension (PH) after viral clearance, 112 hepatitis C virus-infected liver transplant (LT) recipients who achieved SVR between 2001 and 2015 were evaluated. A liver biopsy was performed before treatment and 12 months post-SVR.
Adherence to Therapy in Pediatric Constipation
Functional constipation (FC) in children is a common cause of office visits in both the primary care and pediatric gastroenterology clinic setting. Osmotic laxatives typically are the first-line of therapy in this setting, but it is unclear why many patients with FC report treatment failure. Lack of adherence to therapy is a possible issue, and the authors of this study looked at factors involved with lack of treatment adherence in pediatric patients with FC.
New Technique to Treat Upper Gastrointestinal Bleeding in Children
Treatment of upper GI bleeding (UGIB) in children can be difficult if a pediatric gastroenterologist does not have much experience in endoscopic management of such disorders. A hemostatic spray (Hemospray®) has been developed to treat UGIB for adults although the FDA has not approved this medication for patients in the pediatric age range.
FDA APPROVES NEW MANUFACTURING FACILITY IN CLEARWATER, FLORIDA FOR SACROSIDASE, ACTIVE INGREDIENT OF SUCRAID® (SACROSIDASE) ORAL SOLUTION, FOR THE TREATMENT OF CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY
October, 2018, Vero Beach, FL - QOL Medical, LLC announced that the U.S. Food and Drug Administration (FDA) has approved the company's wholly owned manufacturing facility in Clearwater, Florida to manufacture sacrosidase, the drug substance used to make Sucraid® (sacrosidase) Oral Solution.
NEW REAL-WORLD DATA ANALYSES SUPPORT THE LONG-TERM USE OF ENTYVIO® (VEDOLIZUMAB) IN BIO-NAIVE PATIENTS FOR THE TREATMENT OF MODERATE TO SEVERE ULCERATIVE COLITIS OR CROHN'S DISEASE
Deerfield, IL, October, 2018 - Takeda Pharmaceuticals U.S.A., Inc., (Takeda) announced the presentation of new long-term efficacy real-world data analyses for Entyvio® (vedolizumab) at ACG 2018 in Philadelphia, PA. Studies of note include a retrospective multicentre cohort study of biologic-naive adults with ulcerative colitis (UC) and Crohn's disease (CD), two systematic reviews and meta-analyses of realworld treatment persistence and mucosal healing, and a time-trend analysis of Entyvio utilization and outcomes across the United States (U.S.). A total of 10 Entyvio abstracts were accepted for presentation at the meeting.
MAUNA KEA TECHNOLOGIES ANNOUNCES THE PUBLICATION IN SURGICAL ENDOSCOPY OF POSITIVE RESULTS FROM LARGE U.S. PROSPECTIVE MULTI-CENTER CLINICAL TRIAL ON DETECTION OF BARRETT'S ESOPHAGUS WITH CELLVIZIO®
Paris and Boston, September, 2018 - Mauna Kea Technologies (Euronext: MKEA), inventor of Cellvizio®, the multidisciplinary probe and needlebased confocal laser endomicroscopy (pCLE/ nCLE) platform, announced a new peer-reviewed publication in Surgical Endoscopy highlighting positive results of utilizing Cellvizio to aid in the screening and surveillance of Barrett's Esophagus.
December 13-15, 2018 Advances in Inflammatory Bowel Diseases - Multidisciplinary Approaches to IBD Patient-Centered Care
February 17-20, 2019 GUILD Conference 2019
April 5-7, 2019 Interdisciplinary Autoimmune Summit 2019
