Falk Gastro Info 2/2020

Dr. Falk Video report

Examination of the kidneys:
Right kidney, different levels

Author: Prof. Dr. Christoph F. Dietrich, Caritas Krankenhaus Bad Mergentheim.
©2019 Falk Foundation e.V., Freiburg. All rights reserved.

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Latest research in brief:

Bowel

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Frei R, J Crohns Colitis. 2019;13(10):1292–301

Anti-TNF therapy for Crohn’s disease: Results from the Swiss IBD cohort indicate that early initiation of anti-TNF therapy within 24 months after disease diagnosis results in favorable disease outcome including reduced rates of stenosis, medical consultations, work disability, osteoporosis and anemia).

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Zhang J, Gut. 2019;68(11):1971–8

Oral antibiotic use and risk of colorectal cancer: A large English cohort study suggests that oral antibiotic use is associated with a significantly increased risk to develop colon carcinoma, but reduced risk for rectal cancer. These results may suggest different functions of the gut microbiota in tumor pathogenesis along the large intestine.

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Pohl H, Gastroenterology. 2019;157(4):977–84.e3

Prophylactic clipping after endoscopic resection of large polyps: A randomized trial indicates that endoscopic clip closure of the mucosal defect following resection of large colon polyps reduces risk of postprocedure bleeding. The protective effect appeared to be restricted to large polyps located in the proximal colon.

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Liver Biliary Tracts

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Wong GLH, J Hepatol. 2020;72(1):57–66

Hepatitis B virus (HBV) reactivation with corticosteroids: A current study from Hong Kong analyzed the risk of HBV reactivation and hepatitis flares after steroid treatment. HBV reactivation occurred in 1.8% of patients with “resolved” hepatitis B within 1 year; within 10 years, the risk was 5.5% in patients with anti-HBc only. More common, however, was the occurrence of HBV-independent hepatitis flares (11.9% within 1 year), with a dose > 20 mg prednisolone equivalents and treatment duration > 7 days as risk factors.

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Younossi ZM, Lancet. 2019;394(10215):2184–96

Obeticholic acid in non-alcoholic steatohepatitis (NASH): A current phase 3 trial demonstrates the efficacy of obeticholic acid, especially in improving fibrosis. This effect was most prominent, however, at a higher dose (25 mg daily) that was associated with mostly mild to moderate pruritus in approx. 50% of patients.

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Gaspersz MP, J Hepatol. 2020;72(1):119–24

Hepatocellular adenoma (HCA) during pregnancy: A current prospective cohort study in 51 pregnancies of women with HCA < 5 cm showed that HCA increased in size during a quarter of pregnancies with a median increase of 14 mm. Clinically relevant complications such as bleeding, however, occurred in none of the pregnancies. Thus, HCA < 5 cm confer minimal risk to a pregnant woman and her child.

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Oesophagus Stomach Duodenum

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Luo H, Lancet Oncol. 2019;20(12):1645–54

Artificial intelligence for the endoscopic diagnosis of upper gastrointestinal cancer: A real-time artificial intelligence system achieved high diagnostic accuracy in detecting upper gastrointestinal cancers with sensitivity similar to expert endoscopists and superior to that of competent endoscopists or trainees.

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Werner YB, N Engl J Med. 2019;381(23):2219–29

Treatment of idiopathic achalasia: In a randomized trial, peroral endoscopic myotomy (POEM) was non-inferior to laparoscopic myotomy and fundoplication in controlling symptoms of achalasia, but gastrointestinal reflux was more common following POEM.

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Chinthrajah RS, Lancet. 2019;394(10207):1437–49

Oral immunotherapy for peanut allergy: Results of a phase 2 trial suggest that oral immunotherapy with 4000 mg peanut protein can effectively desensitize individuals with peanut allergy, but discontinuation or dose reduction could increase the risk of regaining clinical reactivity to peanut. Moreover, allergological lab test results at baseline predicted response to desensitization and could be useful for selecting the appropriate patient population.

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Pancreas

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Karjula H, Endoscopy. 2019;51(11):1027–34

Prophylactic pancreatic duct stenting in severe necrotizing pancreatitis: A small trial indicates that pancreatic duct stenting is technically difficult, associated with an unacceptably high risk of pancreatic necrosis infection and should be avoided.

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International Symposia and Workshops

Workshop

Primary Liver Cancer – Emerging Concepts and Novel Treatments

February 13–14, 2020, Mainz, Germany
Philosophicum, Johannes Gutenberg-Universität, Jakob-Welder-Weg 18, 55128 Mainz, Germany

Program

Registration

Online registration

Symposium 218

Current Challenges of Inflammatory Bowel Disease

6.–7. März, 2020, Mexico City, Mexico
Hyatt Regency Hotel, Campos Elíseos 204, Polanco Chapultepec, 11560 Mexico City, Mexico

Program