August 2009 Volume 6 Number 8
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UCSD Clinical and Translational Research Institute and Nature Medicine
present:
Frontiers of Clinical Investigation Symposium
Metabolism 2009: From Bench to Bedside
October 8-10, 2009
La Jolla, California, USA
The theme for this year's symposium explores innovative approaches to
bridge laboratory investigation to clinical research in metabolism.
Abstract Submission: Deadline: August 21, 2009
Early Bird Deadline: September 8, 2009
For more information visit:
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EDITORIAL
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Quid pro quo and the pharmascolds
Stephen B. Hanauer
p437 | doi:10.1038/nrgastro.2009.129
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RESEARCH HIGHLIGHTS
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Motility: Stem cells-therapy for gut neuromuscular disease?
p439 | doi:10.1038/nrgastro.2009.117
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IBD: Treatment of steroid-refractory Crohn's disease
p440 | doi:10.1038/nrgastro.2009.112
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Cirrhosis: Hyponatremia may lead to hepatic encephalopathy
p440 | doi:10.1038/nrgastro.2009.118
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CORRECTION
Pancreatic cancer: molecular pathogenesis and new therapeutic targets
p440 | doi:10.1038/nrgastro.2009.123
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Motility: CRF-1 antagonists fail to improve bowel function in IBS
p441 | doi:10.1038/nrgastro.2009.113
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Crohn's disease: Statin therapy might reduce inflammation in Crohn's disease
p441 | doi:10.1038/nrgastro.2009.114
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HCV genotype and risk of HCC
p441 | doi:10.1038/nrgastro.2009.77
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Hepatocellular carcinoma: Visceral fat is a risk factor for nonviral,
nonalcoholic HCC recurrence
p442 | doi:10.1038/nrgastro.2009.115
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Barrett esophagus: Complete eradication of dysplasia
p442 | doi:10.1038/nrgastro.2009.116
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NEWS AND VIEWS
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Endoscopy: Insertion versus withdrawal phases for polyp detection
Douglas K. Rex
p443 | doi:10.1038/nrgastro.2009.119
Detection of polyps by colonoscopy is commonly performed during slow
withdrawal of the colonoscope, after its rapid insertion. The authors of
a new study found that considerably more polyps were identified during
endoscope insertion, rather than withdrawal, and suggest that further
investigation of polyp inspection during the insertion phase is warranted.
http://links.ealert.nature.com/ctt?kn=71&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
IBD: Incidence of HSV and HPV with azathioprine
Mario Cottone and Sara Renna
p444 | doi:10.1038/nrgastro.2009.110
Severe infections are an established risk of immunosuppressive therapy;
however, the risk of opportunistic infections in patients with IBD who
receive immunosuppressive therapy has so far only been studied
retrospectively. The increased incidence of herpes flares and development
or worsening of viral warts in patients with IBD who receive azathioprine
has now been demonstrated for the first time in a prospective study.
http://links.ealert.nature.com/ctt?kn=34&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Ulcers: Adjuvant PPIs to prevent major ulcer bleeds
Andreas Leodolter and Joachim Labenz
p446 | doi:10.1038/nrgastro.2009.120
Two very different studies have recently been published, which indicate
that use of intravenous PPIs as an adjunct to endoscopic hemostasis might
effectively prevent recurrent ulcer bleeding. What do these studies add
to our current knowledge, and what are their practical implications for
gastroenterologists?
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Celiac disease: Diagnosis criteria in young children
Lotta Hogberg and Lars Stenhammar
p447 | doi:10.1038/nrgastro.2009.111
Diagnosis of celiac disease in children under 2 years of age at first
biopsy currently requires a small-bowel biopsy to be taken after a gluten
challenge. The authors of a new study question these recommendations, and
suggest that gluten challenge and biopsy are not required in this group of
patients.
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Cirrhosis: Screening for esophageal varices
Roberto de Franchis
p449 | doi:10.1038/nrgastro.2009.122
Two multicenter trials have evaluated the potential of capsule endoscopy
as a diagnostic tool for screening and surveillance of esophageal varices
in cirrhotic patients. Their results are similar and show that capsule
endoscopy has good performance characteristics, although it is somewhat
inferior to esophagogastroduodenoscopy.
http://links.ealert.nature.com/ctt?kn=25&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Gastrointestinal bleeding: Adjuvant pharmacotherapy for peptic ulcer bleeding
Yao-Chun Hsu and Hwai-Jeng Lin
p450 | doi:10.1038/nrgastro.2009.121
Findings from a new, multinational, randomized, controlled trial suggest
that histamine receptor 2 antagonists and PPIs are equal in their ability
to control peptic ulcer rebleeding. However, several methodological issues
of this study limit the conclusions that can be drawn from it.
http://links.ealert.nature.com/ctt?kn=12&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
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REVIEWS
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Hepatitis B virus variants
Watcharasak Chotiyaputta and Anna S. F. Lok
Published online: 07 July 2009
p453 | doi:10.1038/nrgastro.2009.107
Replication of HBV occurs through reverse transcription, but inherent
lack of proofreading causes a high rate of mutations. The most common
naturally occurring HBV mutations are those in the precore and core promoter
regions that abolish or decrease the production of hepatitis B e antigen. In
this Review article, Chotiyaputta and Lok discuss these mutations and
those that confer resistance to antiviral agents and/or facilitate escape
from host immunity.
Abstract: http://links.ealert.nature.com/ctt?kn=7&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=10&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Endoscopy for upper gastrointestinal bleeding: how urgent is it?
Kelvin K. F. Tsoi, Terry K. W. Ma and Joseph J. Y. Sung
Published online: 14 July 2009
p463 | doi:10.1038/nrgastro.2009.108
The optimal timing of endoscopy after presentation with upper
gastrointestinal bleeding is a matter for debate. Tsoi and colleagues
examine the findings of randomized clinical trials and retrospective cohort
studies, and conclude that endoscopy within 24 h of admission to hospital
aids risk stratification of patients and reduces the need for
hospitalization. However, very early endoscopy shows no evidence of benefit
in terms of the risk of rebleeding or improved survival.
Abstract: http://links.ealert.nature.com/ctt?kn=42&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=55&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Acute pancreatitis: risk of recurrence and late consequences of the disease
Juhani Sand and Isto Nordback
Published online: 07 July 2009
p470 | doi:10.1038/nrgastro.2009.106
The late consequences of acute pancreatitis refer to the complications
that can arise after the convalescence period of acute pancreatitis, that
is, 3-6 months after the initial pancreatitis episode. The development of
late complications correlates with disease recurrence. This Review discusses
risk factors for the recurrence of acute pancreatitis and the late
consequences associated with this disease.
Abstract: http://links.ealert.nature.com/ctt?kn=50&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=72&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Barrett esophagus: histology and pathology for the clinician
Robert D. Odze
Published online: 07 July 2009
p478 | doi:10.1038/nrgastro.2009.103
Barrett esophagus involves the replacement of normal esophageal squamous
epithelium with metaplastic columnar epithelium and is a major precursor
to adenocarcinoma of the esophagus. Histological evaluation of biopsy
samples from the esophagus and gastroesophageal junction for the presence
of goblet cells and extent of dysplasia is the mainstay of surveillance
for Barrett esophagus. This Review discusses the histological features
of Barrett esophagus and its neoplastic complications.
Abstract: http://links.ealert.nature.com/ctt?kn=89&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=66&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
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CASE STUDY
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Fulminant Clostridium difficile-associated pouchitis with a fatal outcome
Bo Shen, Feza H. Remzi and Victor W. Fazio
p492 | doi:10.1038/nrgastro.2009.105
Clostridium difficile infection is increasingly recognized in patients
who have undergone restorative proctocolectomy with ileal-pouch-anal
anastomosis. The effect of this infection on patient outcomes is not clear.
In this Case Study, Shen and colleagues describe a case of fulminant
C. difficile-associated pouchitis with a fatal outcome that occurred after
ileostomy closure.
Abstract: http://links.ealert.nature.com/ctt?kn=47&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=76&m=33811131&r=MTc2OTYyOTQ2MwS2&b=2&j=NTUxNjY3NTYS1&mt=1&rt=0
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