Volume 6 Issue 11, November 2009

Volume 6 Issue 11

Image supplied by Robert M. Genta, University of Texas Southwestern Medical Center, TX, USA. A biopsy specimen showing the gastric mucosa. Cover art by Nicola Hawes.

Editorial

Research Highlights

News and Views

  • News & Views |

    Autoimmune hepatitis is an inflammatory liver disease of unknown etiology that predominantly affects females, and requires immunosuppressive treatment. A new study investigates the role of mycophenolate mofetil as a rescue treatment for children with the disease.

    • Ugur Halac
    •  & Fernando Alvarez
  • News & Views |

    When all state-of-the-art reflux monitoring technologies are available, which should be used for patients who have persistent reflux symptoms despite acid suppressive therapy? A single-center study has investigated this clinical dilemma and provides guidance on the best diagnostic strategy.

    • Radu Tutuian
  • News & Views |

    Advances in gastroenterology, including the introduction of PPIs, effective therapies for Helicobacter pylori infection, and endoscopic intervention, have promised to improve the incidence and outcomes of gastrointestinal bleeding and perforation. However, have these improvements been borne out in clinical practice?

    • Venkataraman Subramanian
    •  & Krish Ragunath
  • News & Views |

    IFN-α therapy for hepatitis C is associated with a high prevalence of thyroid dysfunction, which is often irreversible. Two studies have recently investigated the role of HCV, PEG-IFN-α and ribavirin in the development of autoimmune thyroid disorders in patients with hepatitis C on antiviral treatment.

    • Alessandro Antonelli
    • , Clodoveo Ferri
    •  & Poupak Fallahi

Reviews

  • Review Article |

    The etiologies of lower gastrointestinal bleeding (LGIB), defined as bleeding from a colonic or anorectal source, are numerous and varied. LGIB can be acute or chronic; for both types, colonoscopy is the diagnostic and therapeutic procedure of choice. Hemostasis, if not occurring spontaneously, can usually be promoted by embolization or modern endoscopy techniques, and surgery is only undertaken as a last resort.

    • Jürgen Barnert
    •  & Helmut Messmann
  • Review Article |

    Patients with end-stage liver disease often experience disease progression and develop complications while waiting for a liver transplant. Prevention and management of these complications is, therefore, paramount to ensure that the patients can remain on the waiting list and have the greatest chance of a successful outcome following transplantation.

    • Ka-Kit Li
    •  & James Neuberger
  • Review Article |

    Osteoporosis is a common complication of chronic liver disease. This Review describes the prevalence and risk factors associated with bone loss in patients with chronic liver disease. New insights into the role of mediators that are involved in orchestrating bone loss in these patients are also discussed.

    • Inaam A. Nakchbandi
    •  & Schalk W. van der Merwe
  • Review Article |

    Identification and classification of dysplasia in patients with ulcerative colitis or Crohn's disease in the large intestine is a challenge. Surveillance programs in these patients aim to detect colitis-associated dysplasia at an early stage, as the risk of these patients developing colorectal cancer is considerable. Good communication and discussion between pathologists and endoscopists is essential to help reach unequivocal diagnoses and to improve the management of colitis-associated dysplasia.

    • Fiona D. M. van Schaik
    • , G. Johan A. Offerhaus
    • , Marguerite E. I. Schipper
    • , Peter D. Siersema
    • , Frank P. Vleggaar
    •  & Bas Oldenburg

Case Study

  • Case Study |

    This article considers the case of a 58-year-old man with a history of type II diabetes, obesity and hypertension who presented with non-alcoholic steatohepatitis-related liver cirrhosis and hepatocellular carcinoma (HCC), and self-referred for a second opinion. He was diagnosed with unresectable HCC. The patient underwent radioembolization with Yttrium-90 glass microspheres, which substantially decreased the tumor mass. 1 year after initial diagnosis with HCC the patient underwent orthotopic liver transplantation (OLT). He remains negative for recurrence of HCC 2.5 years post-OLT.

    • Laura E. Moreno Luna
    • , Paul Y. Kwo
    • , Lewis R. Roberts
    • , Teresa A. Mettler
    • , Denise N. Gansen
    • , James C. Andrews
    • , Gregory A. Wiseman
    •  & Vijay Laxmi Misra