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Despite major advances in understanding its prevention and treatment, diarrhea remains a leading cause of global child deaths and a potentially important cause of lifelong morbidity. A new study asks the question: how many lives would be saved by universal scaling up of best practices for diarrhea prevention and control?
A recent position paper by the American Gastroenterological Association has made a range of excellent recommendations for the management of patients with Barrett esophagus. However, the guidelines have several important limitations, including the omission of endoscopic therapy for patients who have T1 Barrett adenocarcinoma.
The failure of antiviral therapy for chronic hepatitis B can involve both virological breakthrough and genotypic resistance. A study of the failure of nucleoside analogue therapy suggests that drug-resistant mutants are not solely responsible for treatment failure. Suboptimal treatment adherence might also have an important role.
Owing to the shortage of donor organs, improved selection criteria are needed for allocating patients with hepatocellular carcinoma (HCC) to receive orthotopic liver transplantation (OLT). A study has found that the neutrophil:lymphocyte ratio independently predicts tumor recurrence after OLT for HCC and, therefore, might constitute a simple entry criterion that measures host inflammation status.
Despite some advances, the search for effective treatment modalities for advanced gastric and gastro-esophageal junction cancer (GEJC) is far from over. However, using biologic agents to target key molecular pathways, such as those regulated by human epidermal growth factor receptor (HER) family members, may be an effective approach. This Review briefly describes HER biology, summarizes available data regarding the clinical activity of anti-HER agents and their use in gastric cancer and GEJC, and provides insight into treatment personalization strategies.
Aspirin is one of the most prescribed drugs worldwide, as it can prevent cardiovascular morbidity and mortality. However, aspirin can cause gastrointestinal complications. In this Review, Angel Lanas and Carlos Sostres discuss the gastrointestinal effects of aspirin and suggest that physicians need to consider the advantages and risks for individual patients to maximize the benefits of aspirin.
The early identification of patients with ulcerative colitis who have an increased risk of colorectal cancer would be useful for clinicians. In this Review, the authors discuss the most promising preneoplastic biomarkers, including p53 mutations, chromosomal instability and senescence, in ulcerative colitis. They also present the available knowledge regarding the pathogenesis of ulcerative colitis-associated colorectal cancer.
Exocrine pancreatic disease is thought to be uncommon; however, several conditions are associated with exocrine pancreatic insufficiency and it perhaps occurs more frequently than is conventionally expected. A reliable, patient-friendly, cheap and easy to use test for exocrine pancreatic disease is yet to be established. This Review examines the role of fecal-elastase 1 testing in detecting exocrine pancreatic insufficiency in a number of conditions and determines the value of pancreatic enzyme supplementation in these settings.
