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Bowel
Antibiotic use and the development of inflammatory bowel disease (IBD)
A national case-control study in Sweden suggests that higher cumulative exposure to systemic antibiotic therapy, particularly with broad spectrum antibiotics, may be associated with an approx. 2-fold increased risk of new-onset IBD. This association did not appear to differ when predisposed siblings were used as control group.
Checkpoint inhibition for microsatellite instability-high (MSI-H) advanced colorectal cancer
Pembrolizumab as first-line therapy led to significantly longer progression-free survival in MSI-H or mismatch-repair-deficient metastatic colorectal cancer than chemotherapy with fewer treatment-related adverse events.
Epidemiologic trends for microscopic colitis
According to a nationwide cohort study from Denmark, the incidence of microscopic colitis has increased 10-fold between 2001 and 2016 and has surpassed that of Crohn’s disease and ulcerative colitis. However, incidence has stabilized since 2012, suggesting that a plateau has been reached.
Bowel
Antibiotic therapy versus operation for appendicitis
In a randomized trial including 1552 patients,antibiotics were non-inferior to appendectomy on the basis of results of a standard health-status measure. In the antibiotics group, nearly 3 in 10 participants had undergone appendectomy by 90 days. Participants with an appendicolith were at a higher risk for appendectomy and for complications than those without an appendicolith.
Liver
Endoscopic interventions in cirrhosis
A current database analysis shows that serious anesthesia complications associated with endoscopic interventions in cirrhosis are rare (0.4%). Serious complications were predominantly cardiac and associated with sicker patients undergoing general anesthesia. The complexity of end-stage liver disease may thus warrant anesthesia monitoring during endoscopic interventions.
Alcohol-related liver disease (ALD)
A current Swedish cohort study underlines the high mortality of this disease: In patients with alcohol-related cirrhosis, mortality is almost 5-fold increased, however, in patients with ALD without cirrhosis, mortality is also increased by a factor of 2.7. Specific programs for diagnosis and treatment of ALD should thus be established.
Hepatitis C virus and COVID-19:
A current modeling study demonstrates that COVID-19 could lead to almost 45,000 additional cases of hepatocellular carcinoma (HCC) and 72,000 liver-associated deaths worldwide by delaying screening, diagnosis and treatment. Thus, programs to eliminate hepatitis should be stepped up as soon as it becomes appropriate to do so.
Oesophagus Stomach Duodenum
Patterns and trends in first-line empirical eradication of Helicobacter pylori in Europe:
A prospective registry with more than 20.000 patients revealed that management of H. pylori eradication by European gastroenterologists is heterogeneous, suboptimal and discrepant with current recommendations. Only quadruple therapies lasting at least 10 days are able to achieve eradication rates above 90%.
Checkpoint inhibitor therapy for advanced esophageal cancer
Pembrolizumab significantly prolonged overall survival in patients with advanced/metastatic squamous cell carcinoma or adenocarcinoma and high PD-1L immunoscore as compared to chemotherapy with fewer treatment-related adverse events.
Effects of proton-pump inhibitor (PPI) therapy on clinical outcomes of COVID-19
A Korean nationwide cohort study involving 132.316 patients older than 18 years revealed that PPI therapy was not associated with increased susceptibility to Sars-CoV-2 infection. However, current PPI use conferred a 79% greater risk of severe clinical outcomes of COVID-19.
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Conocemos su compromiso con su actualización médica y nos sumamos a este invitándolo a descargar el Libro Coloproctología, en el...
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