Falk Gastro Info 8 i 9/2018

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Examination of the hepatobiliary system: Examination of the gallbladder in standing position

Author: Prof. Dr. Christoph F. Dietrich, Caritas Krankenhaus Bad Mergentheim.
©2017 Falk Foundation e.V., Freiburg. All rights reserved.

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Latest research in brief:

Bowel

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Taha AS et al, Lancet Gastroenterol Hepatol. 2018;3(7):469–76

Pharmacological therapy for patients with obscure intestinal bleeding from small bowel ulcers taking aspirin and non-steroidal anti-inflammatory drugs: The prostaglandin analogue mistoprostol is effective for the treatment of small bowel ulcers and may represent a novel therapeutic approach for patients with obscure gastrointestinal bleeding.

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Friedman AB et al, Aliment Pharmacol Ther. 2018;47(8):1092–1102

Therapy optimization in patients with inflammatory bowel disease not responding to azathioprine/mercaptopurine: A clinical trial reveals that approx. half of patients achieve steroid-free remission following adjunctive therapy of allopurinol and subsequent optimization of 6 thioguanine nucleotide concentrations.

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Panés J et al, Gastroenterology. 2018;154(5):1334–42.e4

Stem cell therapy for complex perianal fistulas in patients with Crohn’s disease: A single injection of allogeneic adipose-derived mesenchymal stem cells is safe and more effective in closing external fistula openings after 1 year in comparison to placebo.

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Liver Biliary Tracts

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Corpechot C et al, N Engl J Med. 2018;378(23):2171–81

Primary biliary cholangitis (PBC): Some patients with PBC display an inadequate response to ursodeoxycholic acid. In this patient group, a recent placebo-controlled trial demonstrates that a combination of bezafibrate (400 mg/day) and ursodeoxycholic acid results in a normalization of alkaline phosphatase in 67% of patients and complete biochemical response (normalization of alkaline phosphatase, aminotransferases, bilirubin, albumin, and prothrombin time) in 31% of patients.

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Faber M et al, J Viral Hepat. 2018;25(6):752–8

Hepatitis E: A population-based study reveals that the seroprevalence in Germany significantly declined from 18.6% in 1998 to 15.3% in 2010. Continuously rising numbers of hepatitis E diagnoses in Europe are likely due to an increased awareness of clinicians. The estimated seroincidence, however, remains high with approx. 420,000 cases per year in Germany.

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Caraceni P et al, Lancet. 2018;391(10138):2417–29

Decompensated cirrhosis: A potential benefit of long-term human albumin administration in patients with hydropic decompensated liver cirrhosis is so far controversial. A current randomized study demonstrates a substantial survival benefit for long-term human albumin administration (40 g twice weekly for 2 weeks, followed by 40 g weekly for up to 18 months) in patients with uncomplicated ascites and diuretic treatment with aldosterone antagonist and furosemide.

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Oesophagus Stomach Duodenum

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Sharma A et al, Clin Gastroenterol Hepatol. 2018;16(6):877–83.

GFeatures of adult autoimmune enteropathy (AIE): A retrospective study suggests that AIE has distinct clinical, demographic and histologic characteristics compared to refractory celiac disease type 1. Most patients respond to open-capsule budesonide.

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Mera RM et al, Gut. 2018;67(7):1239–46

Long-term exposure to Helicobacter pylori is associated with progression of gastric precancerous lesions: A trial with 16-year follow-up suggests that patients with precancerous lesions benefit from eradication therapy, in particular those with atrophic gastritis without intestinal metaplasia and those with incomplete intestinal metaplasia.

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Barroso M et al, Gastroenterology. 2018;154(8):2087–96.e7

Pathogenesis of celiac disease: Dietary patterns during early childhood after weaning are associated with the development of celiac disease autoimmunity. A dietary pattern characterized by high consumption of vegetables, vegetable oils and grains and low consumption of refined cereals and sweetened beverages appears to be protective.

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Pancreas

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Buxbaum J et al, Am J Gastroenterol. 2018;113(5):755–64

Novel scoring sytems for acute pancreatitis (PASS): The PASS score is associated with important clinical outcomes in acute pancreatitis. The ability of the score to forecast important clinical events at different time points in the disease course suggests that it is a valid measure of pancreatitis activity.

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International Symposia and Workshops

Symposium 212

IBD and Liver: East Meets West

September 7-8, 2018, Kyoto, Japan
Kyoto Hotel Okura, Kawaramachi-Oike, Nakagyo-ku, Kyoto 604-8558, Japan

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Registration

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Symposium 213

Tailored Therapies for IBD: A Look into the Future

October 5-6, 2018, Milan, Italy
Milan Marriott Hotel, Via Washington 66, 20146 Milan, Italy

Program