Volume 6 Issue 2, February 2009

The use of nutritional therapy for Crohn's disease is controversial. The author of this Viewpoint article discusses the available evidence for this type of therapy, including data on therapeutic efficacy, possible mechanisms of action and groups of patients for whom this approach might be particularly beneficial. He also highlights directions for future research.

To practice evidence-based medicine, clinicians need to apply the findings of scientific research to the circumstances of individual patients as part of the process of clinical decision-making. This Review article presents a 10-step guide to the critical appraisal of research literature to assist clinicians with the task of identifying the most relevant, high-quality studies available to guide their practice.

A considerable proportion of patients with Crohn's disease are affected by the formation of fistulas, and appropriate fistula treatment requires knowledge of the available medical therapies. This Review discusses the pharmacological and surgical approaches available for the treatment of fistulas in patients with Crohn's disease, including novel therapeutic approaches. Discussion of the epidemiology and pathology of fistulizing Crohn's disease is also provided.

This Review article outlines the evolution of non-surgical treatment for colorectal cancer, in particular chemotherapy, its integration with radiotherapy, and the evolving use of biologic therapies. The authors also discuss new advances in patient selection for specific anti-cancer agents and regimens.

In this Case Study, Schnitzbauer et al. describe the case of a 30-year-old male who suffered multiple fractures and extensive internal injuries, including liver rupture with formation of a hematoma, because of a motorcycle accident. While in intensive care, the hepatic hematoma became infected with antibiotic-resistant bacteria and serum levels of cholestatic parameters started to increase, until retrograde cholangiography supported a diagnosis of cholangitis in a critically ill patient. Acute liver failure ensued, and liver transplantation carried out. In spite of a number of intervening complications, 50 months after transplantation the patient was in good health; therefore, the authors conclude that post-traumatic sclerosing cholangitis should probably become an indication for liver transplantation.