News & Views

Approximately 50% of patients with chronic hepatitis C fail to achieve a sustained virological response to standard therapy with pegylated interferon and ribavirin. Progression to advanced liver disease (which may lead to hepatic decompensation, hepatocellular carcinoma, and death) is common in these patients, but can low-dose pegylated interferon maintenance therapy improve outcomes?

Many patients with chronic constipation have a poor quality of life and are dissatisfied with laxative treatment. Findings from a multicenter, randomized, placebo-controlled, phase III study have demonstrated the beneficial effects of the 5-hydroxytryptamine 4 receptor agonist, prucalopride, for chronic constipation and associated symptoms. This drug represents the newest addition to the medical armamentarium for this disorder.

The benefit of preoperative combined chemotherapy and radiotherapy to perform sphincter-preserving surgery for patients with locally advanced distal rectal cancer is not supported by findings from randomized, controlled trials. These findings have, however, now been questioned by a study that supports the prospect of a tailored surgical approach to rectal-cancer treatment on the basis of tumor behavior after neoadjuvant treatment.

Despite advances in laparoscopic surgery for colorectal cancer, the role of laparoscopic approaches for rectal cancer remains controversial. A large, single-center study has now demonstrated the safety and feasibility of laparoscopy for rectal cancer, which provides new incentives for prospective clinical trials to rigorously test this surgical approach.

The management of alcoholic pancreatitis is mostly reactive; little is done to prevent disease progression. It is time for physicians to pay attention to the root cause of the condition—that is, alcohol—rather than just responding to its effects. This article discusses an important paper that describes the first prospective, randomized, controlled, clinical trial to investigate the effect of brief interventions for alcohol abuse on the progression of alcoholic pancreatitis.

Children and adolescents with untreated celiac disease display disease-related, histological alterations in the duodenal bulb, according to a new study. In 16 of the 665 patients enrolled in the study, lesions were confined to the duodenal bulb.

The selective, chloride channel 2 activator, lubiprostone, facilitates intestinal-fluid secretion and stimulates gastrointestinal motility. These effects increase stool frequency and improve abdominal discomfort for patients with constipation-predominant IBS, which makes lubiprostone the newest addition to the treatment armamentarium for these patients. Findings from a new, pivotal, phase III study by Drossman and colleagues support the use of lubiprostone in such patients.

In a study carried out in India, antioxidant therapy for chronic pancreatitis offered short-term benefits and was associated with few adverse events. Although the etiology and characteristics of this condition vary between countries, antioxidant therapy could be implemented as an adjunct treatment in the early inflammatory phase of chronic pancreatitis.

Extensive research has addressed the effectiveness of various endoscopic treatments for bleeding peptic ulcers. These studies are often heterogeneous in their methodology, definitions, end points and combinations of modalities used. Evidence-based recommendations that address clinically relevant questions are now available, and will be a valuable resource for practicing endoscopists.

A promising new scoring system has stratified mortality risk in a large group of patients with acute pancreatitis. This new model is more practical than APACHE II, but needs to be validated in patients in whom the diagnosis of acute pancreatitis can be verified from detailed clinical records.

The recent outbreak of Salmonella typhimurium, associated with peanut butter and products containing it in the US and Canada, highlights our ongoing susceptibility to food-borne infections despite advanced food production systems. As the globalization of food resources continues, how can we control outbreaks and minimize their effect on health?

The recurrence of hepatitis C in HCV-infected, orthotopic liver transplant recipients is a major problem that can influence the survival of both grafted tissue and patients. Yet the effects of immunosuppression strategies, in particular those of steroids, on disease recurrence remain unclear.

Adolescents with celiac disease who adhere to a gluten-free diet have a better quality of life than those who do not comply with the diet, according to a new study. Adolescents who are diagnosed as having this disease at a young age also have improved quality of life.

A retrospective, comparative study that focuses on patients with already impaired kidney function adds to the body of evidence that links administration of oral sodium phosphate bowel-preparation solutions for colonoscopy with a decrease in renal function. When possible, a polyethylene glycol solution should be used instead.

Antibodies against tumor necrosis factor are a highly effective treatment for Crohn's disease, as measured by disease-activity indices. But what influence does this type of therapy have on the health-related quality of life of patients with Crohn's disease?