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Bowel
Non-operative management of uncomplicated appendicitis in children:
An initial non-operative management of uncomplicated appendicitis with antibiotics alone had a success rate of 67,1% in an American trial involving approx. 1000 children and was associated with statistically significant fewer disability days compared to laparoscopic appendectomy.
Diet and risk of inflammatory bowel disease:
Results of 2 prospective cohort trials from Sweden with more than 86.000 patients reveal that adherence to a Mediterranean diet is associated with a reduced risk of primary manifestation of Crohn’s disease at an age over 45 years. Mediterranean diet was not associated with the risk to develop ulcerative colitis.
Prognosis of Crohn’s disease:
An analysis of follow-up data from the CALM study, induction of deep remission in early, moderate to severe Crohn’s disease was associated with decreased risk of disease progression over a median time of 3 years, irrespective of disease management by tight control or conventional therapy within the CALM trial.
Liver
Acute liver injury in COVID-19:
Acute liver injury is common in patients who test positive for SARS-CoV-2, but is most often mild. However, 6.4% of patients develop severe liver injury (alanine aminotransferase > 5 times the upper limit of normal); in these patients, severe disease course and high mortality should be anticipated.
Primary sclerosing cholangitis (PSC):
In a 10-year, nationwide study, patients with PSC and inflammatory bowel disease (IBD) had increased risks of colorectal cancer (CRC), hepatopancreatobiliary cancers, and death compared to patients with IBD alone. In the PSC-IBD group, diagnosis of IBD at age < 40 years was associated with greater risks of CRC and all-cause mortality.
Hepatitis B virus (HBV) and hepatic steatosis:
In patients with virologically quiescent chronic HBV infection, presence of hepatic steatosis is associated with a higher risk of fibrosis progression but, paradoxically, a 3-fold increase in HBsAg seroclearance rate (“functional cure”). Steatosis measurements by transient elastography thus have predictive value in patients with virologically quiescent chronic HBV infection.
Oesophagus Stomach Duodenum
Medical therapy for advanced gastrointestinal stromal tumors resistant to approved treatments:
Ripretinib, a tyrosine kinase inhibitor with broad activity even in the presence of mutations, significantly improved median progression-free survival compared with placebo.
Psychiatric comorbidities in patients with eosinophilic esophagitis (EoE):
Analysis of a cohort of approx. 800 EoE patients revealed that psychiatric comorbidities (mainly anxiety or depression) affect nearly one third of adults with EoE. These patients have a longer duration of symptoms preceding diagnosis of EoE.
Treatment of adolescents with obesity:
The use of liraglutide (3 mg) plus lifestyle therapy led to a significantly greater reduction in the body mass index than placebo plus lifestyle therapy.
Pancreas
Real-world practice of prophylaxis against post-ERCP-pancreatitis (PEP):
Despite its low cost and widespread availability, the adoption of rectal indomethacin for prophylaxis against PEP between 2009 and 2018 has been slow, while usage of prophylactic stents within the pancreatic duct has declined dramatically. However, the PEP rates remained unchanged over time and amounted to 8.6%.
Current Falk literature:
Download: Celiac Disease
Authors: K. Farrag, A. Wächtershäuser, S. Ulrich-Rückert, J. Stein (35 pages) BU86e
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