In the News
Person-to-person transmission now more common source of hepatitis A in U.S. than food
An analysis of hepatitis outbreaks in 2016 to 2020, comprising 37,553 cases, found that 56% of patients reported drug use, 14% reported homelessness, 12% reported recent incarceration, and 3% reported recent international travel.
Patient beliefs associated with successful antibiotic treatment of appendicitis
A secondary analysis of a randomized clinical trial found lower risk for appendectomy and higher likelihood of 30-day resolution of signs and symptoms among those who believed that antibiotics could be completely successful versus those who thought they would be unsuccessful or were unsure.
Single sigmoidoscopy significantly reduced long-term CRC incidence
A pooled analysis of four large randomized trials of sigmoidoscopy screening found a significant and sustained effect of a single performance of the test on colorectal cancer (CRC) incidence and mortality over 15 years of follow-up.
MKSAP Quiz: Gastroparesis symptoms in a patient with diabetes
This month's quiz asks readers to determine the most appropriate next step in management of a 60-year-old patient with a history of type 2 diabetes and daily nausea, fullness, and other symptoms suggestive of gastroparesis.
Spotlight on surgical management of IBD
One recent study found that Black patients are at increased risk of morbidity after surgery for inflammatory bowel disease (IBD), while another found benefit of early surgery after diagnosis in certain patients.
Guideline suggests prescription medications when lifestyle change ineffective for weight loss
For adults with obesity or overweight with weight-related complications, the American Gastroenterological Association found moderate certainty of benefit for four medications: semaglutide, liraglutide, phentermine-topiramate ER, or naltrexone-bupropion.
European trial finds reduction in cancers but not deaths with invitation to colonoscopy screening
Healthy patients in Poland, Norway, and Sweden were randomized to usual care or an invitation to screening colonoscopy; only 42% of invited patients responded. The invited group had an 18% lower risk of colorectal cancer at 10 years compared to the usual care group.
Continuing anti-TNF therapy in pregnancy appears beneficial for patients with IBD
A French target trial emulation, which refers to the use of observational data to mimic a randomized controlled trial, found that maternal relapse of inflammatory bowel disease (IBD) and premature births were less common when patients continued anti-tumor necrosis factor (anti-TNF) therapy after 24 weeks of pregnancy than when the drugs were discontinued.
Adenoma detection rate after positive FIT associated with interval cancer risk
A Dutch study of fecal immunochemical testing (FIT)-based colonoscopies found that for every 1,000 patients, the expected number of cancers after five years would be about 2 for endoscopists with adenoma detection rates (ADRs) of 70%, compared with more than 4.5 with an ADR of 55%.
In active Crohn disease, risankizumab increased clinical remission and endoscopic response at 12 wk
While the FDA has now approved risankizumab for adults with moderate to severe Crohn disease, understanding of the drug's role in relation to other biologic therapies is limited by broad exclusion criteria in randomized controlled trials, an ACP Journal Club commentary noted.
In active UC, upadacitinib induced and maintained remission
JAK inhibitors, such as upadacitinib, represent an advance in the management of patients with ulcerative colitis (UC); however, it remains unclear whether the balance of efficacy versus risk favors one drug over the others, according to an ACP Journal Club commentary.
Case reports published on gastroenterology, hepatology topics
Reports on iatrogenic hyperkalemia in a patient with gastroparesis, hepatosplenic abscesses in a patient with acute promyelocytic leukemia, superior mesenteric artery dissection in a patient with celiacomesenteric trunk anomaly, and more were published in the past month.