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The improvement of symptoms alone is no longer a satisfactory outcome for patients with Crohn's disease. The authors of this Viewpoint article argue that modification of the clinical course of Crohn's disease should be the major goal of medical therapy. Preliminary data suggest that the early use of biologics could achieve this aim in a subset of patients.
Gastrointestinal symptoms are extremely common during pregnancy. If symptoms do not respond adequately to lifestyle and dietary changes, drug therapy is often warranted to improve quality of life and prevent complications. Moreover, chronic gastrointestinal diseases can deteriorate during pregnancy and diagnostic and therapeutic approaches need to be adapted. This Review provides an overview of the spectrum and therapy of motility disturbances during pregnancy, and discusses specific aspects of IBD and liver disease.
The authors of this Review present what is known about the pathophysiology of increased coagulation in patients with cancer and how it applies to pancreatic carcinoma. The relationship between the activation of coagulation or symptomatic thromboembolic disease and the development of pancreatic carcinoma is explored. In addition, the relationship between thromboembolic disease and prognosis, and the rationale and evidence for the use of anticoagulants in patients with pancreatic carcinoma are considered.
Inborn errors of bile acid synthesis can present as neonatal cholestasis, neurologic disease or fat-soluble-vitamin deficiencies. In this Review, the authors discuss what we now know about the mechanisms underlying these disorders thanks to the application of modern biochemical and molecular techniques, the importance of early diagnosis, and the treatment options currently available.
This article considers the case of a 62-year-old white woman who presented with a 2-month history of progressive, painless, left supraclavicular and axillary lymph node enlargement. Her history was significant for chronic HCV infection, for which she had just completed a 48-week course of treatment with pegylated interferon [alpha] plus ribavirin. Granulomatous lymphadenitis with sarcoid and tuberculoid granulomas was diagnosed and anti-tuberculosis treatment initiated with a successful outcome.
