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The issue of propofol administration by nonanesthesiologists for upper endoscopy and colonoscopy remains controversial. A recent study investigated the efficacy and safety of a novel computer-assisted personalized sedation device. Patients sedated using the device experienced fewer serious cardiorespiratory events than patients undergoing standard sedation by bolus administration using a hand-held syringe.
An international consortium (the Colon Cancer Family Registry) has recently published interesting data on the risk of developing metachronous colorectal cancer (CRC) after treatment of primary CRC in patients with Lynch syndrome. The findings are clinically important as they might justify more extensive surgery to treat primary CRC in these patients.
Both stepwise radical endoscopic resection (SRER) and radiofrequency ablation (RFA) are effective endoscopic strategies for the treatment of patients with flat, dysplastic Barrett esophagus. Findings from a randomized, controlled trial indicate that the two treatments have similar efficacy, but considerably more complications are associated with SRER compared with RFA.
Liver transplantation is a rare occurrence in patients with cystic fibrosis, and there are limited data on the benefits of such intervention. A recent study examined the outcomes of this procedure in children and adults with cystic fibrosis, reporting that a significant survival benefit can be achieved despite extrahepatic factors.
Cholangiocarcinomas are often difficult to diagnose, their pathogenesis is poorly understood, and their dismal prognosis has resulted in a nihilistic approach to their management. This Review outlines some of the current challenges, discusses the types of cholangiocarcinoma and offers recommendations for the management of patients with cholangiocarcinomas.
The mechanisms of drug-induced liver injury (DILI) are not well understood. In this Review, the authors propose that a bedside to bench approach involving the study of clinicopathological features of patients with DILI can provide insight into the mechanisms underlying this condition. The authors also discuss the potential role of several factors, including mitochondrial toxicity and the host immune system, in the etiopathogenesis of DILI.
A major barrier to hepatitis C treatment uptake and delivery is the association of this therapy with frequent, and at times serious, adverse effects. This Review article provides a comprehensive literature review that systematically describes the adverse effects of Peg-IFN-α and ribavirin on various organ systems and, more importantly, recommends consensus approaches to managing those effects.
Prashant Kant and Mark Hull discuss the association between excess body weight and cancer risk in the gastrointestinal and hepatobiliary tract. Current understanding of the pathophysiological mechanisms is summarized, as well as the impact that weight loss has on future cancer risk. Finally, the authors describe the relationship between excess body weight and gastrointestinal cancer outcomes.
