Falk Gastro Info 2/2021

Video course abdominal ultrasound

Examination of abdominal vessels – Aorta transversal, topography

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

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Latest research in brief:

Bowel

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Weimers P et al, J Crohns Colitis. 2020;14(12):1717–23
Epidemiologic trends for microscopic colitis: According to a nationwide cohort study from Denmark, the incidence of microscopic colitis has increased 10-fold between 2001 and 2016 and has surpassed that of Crohn’s disease and ulcerative colitis. However, incidence has stabilized since 2012, suggesting that a plateau has been reached.

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André T et al, N Engl J Med. 2020;383(23):2207–18
Checkpoint inhibition for microsatellite instability-high (MSI-H) advanced colorectal cancer:): Pembrolizumab as first-line therapy led to significantly longer progression-free survival in MSI-H or mismatch-repair-deficient metastatic colorectal cancer than chemotherapy with fewer treatment-related adverse events.

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Nguyen LH et al, Lancet Gastroenterol Hepatol. 2020;5(11):986–95
Antibiotic use and the development of inflammatory bowel disease (IBD): A national case-control study in Sweden suggests that higher cumulative exposure to systemic antibiotic therapy, particularly with broad spectrum antibiotics, may be associated with an approx. 2-fold increased risk of new-onset IBD. This association did not appear to differ when predisposed siblings were used as control group.

Link to text Liver Biliary Tracts

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Blach S et al, J Hepatol. 2021;74(1):31–6
NoHepatitis C virus and COVID-19: A current modeling study demonstrates that COVID-19 could lead to almost 45,000 additional cases of hepatocellular carcinoma (HCC) and 72,000 liver-associated deaths worldwide by delaying screening, diagnosis and treatment. Thus, programs to eliminate hepatitis should be stepped up as soon as it becomes appropriate to do so.

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Hagström H et al, Gut. 2021;70(1):170–9
AcuAlcohol-related liver disease (ALD): A current Swedish cohort study underlines the high mortality of this disease: In patients with alcohol-related cirrhosis, mortality is almost 5-fold increased, however, in patients with ALD without cirrhosis, mortality is also increased by a factor of 2.7. Specific programs for diagnosis and treatment of ALD should thus be established.

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Lieber SR et al, Hepatology. 2020;72(6):2109–18
Endoscopic interventions in cirrhosis: A current database analysis shows that serious anesthesia complications associated with endoscopic interventions in cirrhosis are rare (0.4%). Serious complications were predominantly cardiac and associated with sicker patients undergoing general anesthesia. The complexity of end-stage liver disease may thus warrant anesthesia monitoring during endoscopic interventions.

Link to text Oesophagus Stomach Duodenum

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Lee SW et al, Gut. 2021;70(1):76–84
Effects of proton-pump inhibitor (PPI) therapy on clinical outcomes of COVID-19: A Korean nationwide cohort study involving 132.316 patients older than 18 years revealed that PPI therapy was not associated with increased susceptibility to SARS-CoV-2 infection. However, current PPI use conferred a 79% greater risk of severe clinical outcomes of COVID-19.

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Kojima T et al, J Clin Oncol. 2020;38(35):4138–48
Checkpoint inhibitor therapy for advanced esophageal cancer: Pembrolizumab significantly prolonged overall survival in patients with advanced/metastatic squamous cell carcinoma or adenocarcinoma and high PD-1L immunoscore as compared to chemotherapy with fewer treatment-related adverse events.

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Nyssen OP et al, Gut. 2021;70(1):40–54
Patterns and trends in first-line empirical eradication of Helicobacter pylori in Europe: A prospective registry with more than 20.000 patients revealed that management of H. pylori eradication by European gastroenterologists is heterogeneous, suboptimal and discrepant with current recommendations. Only quadruple therapies lasting at least 10 days are able to achieve eradication rates above 90%.

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