Table of contents
November 2004 Volume 1 No 1
Editorial
Viewpoints
Gallstones: how do we translate an old story into future therapy?
2Gallstone disease continues to be a significant problem. The recent identification of mouse genes may help determine susceptibility to the disease. An infectious etiology hypothesis has also been proposed to explain the development of gallstones. Could these discoveries lead to more effective strategies for the prevention and treatment of gallstones?
Treatment endpoints for advanced cholangiocarcinoma
4At present, there is no standard treatment for cholangiocarcinoma, a fatal cancer of the biliary tree. New therapies for cholangiocarcinoma are difficult to evaluate because treatment endpoints are ill-defined. This viewpoint explains why the current endpoints are problematic and proposes a new quantitative system for assessing disease progression.
Research Highlights
Safe administration of propofol by the endoscopist
8Albumin dialysis for acute-on-chronic liver failure
9
-blockers delay variceal growth and bleedingUpper gastrointestinal endoscopy in pediatric IBD
10Practice Points
What is the long-term effect of high-dose versus standard-dose omeprazole in patients with dyspepsia?
12Can paroxetine improve well-being in patients with irritable bowel syndrome who do not respond to a high-fiber diet?
14Does Helicobacter pylori infection and its eradication have any effect on heartburn and gastroesophageal reflux?
16What is the most accurate test to differentiate pancreatic cystic neoplasms?
18Are covered stents superior to uncovered stents in the management of malignant biliary obstruction?
20Is mortality from liver disease associated with normal serum aminotransferase concentrations?
22Reviews
Update on the etiology, pathogenesis and diagnosis of ulcerative colitis
26The etiology and pathogenesis of ulcerative colitis remain unclear, but evidence is accumulating that both genetics and the environment are important. Although diagnosis remains based on well-established clinical, endoscopic and histologic criteria, recent advances in the detection of fecal and serologic markers and the use of wireless capsule endoscopy promise to aid diagnosis.
Treatment of recurrent Clostridium difficile-associated disease
32At present, there is no uniformly effective treatment for recurrent Clostridium difficile-associated disease. Tapering and pulsing antibiotics after a 10-day standard course can decrease the recurrence of disease, as can adjunct use of the probiotic Saccharomyces boulardii. Restoration of normal colonic flora might be another treatment option, and new treatment approaches being developed include a vaccine.
doi:10.1038/ncpgasthep0018 | Full Text | PDF (266K)
Mechanisms of Disease: the role of hepcidin in iron homeostasis—implications for hemochromatosis and other disorders
39Hepcidin is the iron-regulatory hormone that links innate immunity and iron metabolism. Normally, a regulatory feedback loop with circulatory iron controls hepatic hepcidin production. Inflammatory stimuli upregulate hepcidin production, which can lead to anemia. Anemia downregulates hepcidin production. Human disorders associated with inappropriate hepcidin levels include anemia of inflammation and hereditary hemochromatosis.
doi:10.1038/ncpgasthep0019 | Full Text | PDF (128K)
Mechanisms of Disease: advances in understanding the mechanisms leading to chronic pancreatitis
46At present there is no cure for chronic pancreatitis—a progressive condition that culminates in the destruction of the pancreas. Recent advances in genetic and immunologic research have spawned new insights into the mechanisms underlying chronic pancreatitis, and new models are helping us understand associated risk factors and etiologies.
doi:10.1038/ncpgasthep0025 | Full Text | PDF (213K)
Case Study
Cholestatic jaundice and bone lesions in an elderly woman
53This article highlights the case of a 74-year-old Caucasian female who presented with jaundice, clay-colored stools, diarrhea, and fatigue of 3 months' duration, accompanied by a weight loss of 6.8 kg. The results of initial investigations were interpreted as primary sclerosing cholangitis, but futher investigation revealed lytic and and blastic bone lesions. A sacral bone biopsy established the diagnosis of systemic mastocytosis.
doi:10.1038/ncpgasthep0026 | Full Text | PDF (256K)
