Gastroenterology Richter JE, Kumar A et. al.
Jan 6th, 2018 - The effects of transoral incisionless fundoplication (TIF) and laparoscopic Nissen fundoplication (LNF) have been compared with those of proton pump inhibitors (PPIs) or a sham procedure in patients with gastroesophageal reflux disease (GERD), but there has been no direct comparison of TIF vs LNF. We performed a systematic review and network meta-analysis of randomized controlled trials to comp...
Gastroenterology Hadjiliadis D, Khoruts A et. al.
Dec 31st, 2017 - Improved therapy has substantially increased survival of persons with cystic fibrosis (CF). But the risk of colorectal cancer (CRC) in adults with CF is 5-10 times greater compared to the general population, and 25-30 times greater in CF patients after an organ transplantation. To address this risk, the CF Foundation convened a multi-stakeholder task force to develop CRC screening recommendatio...
JAMA Lemaitre M, Kirchgesner J et. al.
Nov 8th, 2017 - An increased risk of lymphoma has been reported among patients receiving thiopurines for inflammatory bowel disease (IBD). The risk of lymphoma associated with anti-tumor necrosis factor (TNF) agents either alone or in combination with thiopurines is uncertain. To assess the risk of lymphoma associated with thiopurines and anti-TNF agents, used alone or in combination, for the management of IBD...
The Lancet. Oncology; Thuss-Patience PC, Shah MA et. al.
Mar 27th, 2017 - Although trastuzumab plus chemotherapy is the standard of care for first-line treatment of HER2-positive advanced gastric cancer, there is no established therapy in the second-line setting. In GATSBY, we examined the efficacy and tolerability of trastuzumab emtansine in patients previously treated for HER2-positive advanced gastric cancer (unresectable, locally advanced, or metastatic gastric c...
Arthritis Care & Research; George MD, Baker JF et. al.
Jan 27th, 2017 - The optimal timing of tumor necrosis factor antagonists before elective surgery is unknown. This study evaluated the association between infliximab timing and serious infection after elective hip or knee arthroplasty. A retrospective cohort study evaluated US Medicare patients with rheumatoid arthritis, inflammatory bowel disease, psoriasis, psoriatic arthritis, or ankylosing spondylitis who re...
Obstetrics & Gynecology; ACOG
Nov 30th, 2019 - A hereditary cancer syndrome is a genetic predisposition to certain types of cancer, often with onset at an early age, caused by inherited pathogenic variants in one or more genes. Most hereditary cancer syndromes exhibit autosomal dominant inheritance. The most common hereditary cancer syndromes related to women’s cancer include hereditary breast and ovarian cancer syndrome, Lynch syndrome, Li...
Nov 26th, 2019 - Maintenance Therapy for RAS Wild-Type Metastatic Colorectal Cancer
JAMA Wald A
Nov 16th, 2019 - Chronic constipation is very common. The most recent estimate of clinician visits attributable to constipation were from 2001 to 2004 and reported more than 8 million clinician visits in the United States, with most occurring in adult primary care settings (33%) followed by pediatric (21%) and gastroenterologist (14%) offices.1 These encounters result in large expenditures for nonprescription l...
Nov 11th, 2019 - Results from a preliminary research study showed the majority of patients aged 85 years and older were still alive in the short-term after undergoing segmental colectomy for stage II and III colon cancer. Kaur et al presented these findings at the American College of Surgeons Clinical Congress 2019.
Nov 10th, 2019 - This week, we’ll review an interim analysis of the CASPIAN trial, which evaluated the addition of durvalumab to etoposide plus platinum chemotherapy for extensive-stage small cell lung cancer. Then, we’ll talk about two recently issued guidelines on screening for colorectal cancer. Lastly, we’ll summarize some recent FDA approvals and announcements.
Annals of Internal Medicine;
Nov 5th, 2019 - The goal of this American College of Physicians (ACP) guidance statement is to guide clinicians on age to start and stop CRC screening, frequency of screening, and optimal screening test in asymptomatic, average-risk adults, based on a critical review of existing guidelines and their evidence reviews.
Lancet Gastroenterology Hepatology; Schiller LR
Oct 31st, 2019 - Constipation is a symptom that affects around 11-20% of the adult population yearly. Most physicians consider infrequency of defecation as a hallmark of constipation. However, most patients view excessive straining as the biggest component of constipation and only a minority of patients with constipation have infrequent bowel movements.
The New England Journal of Medicine; Kopetz, S. et. al.
Oct 23rd, 2019 - BACKGROUND Patients with metastatic colorectal cancer with the BRAF V600E mutation have a poor prognosis, with a median overall survival of 4 to 6 months after failure of initial therapy. Inhibition of BRAF alone has limited activity because of pathway reactivation through epidermal growth factor receptor signaling. METHODS In this open-label, phase 3 trial, we enrolled 665 patients with B...
Oct 22nd, 2019 - On October 23, 2019,the Food and Drug Administration approved niraparib (ZEJULA, Tesaro, Inc.) for patients with advanced ovarian, fallopian tube, or primary peritoneal cancer treated with three or more prior chemotherapy regimens and whose cancer is associated with homologous recombination deficiency (HRD)-positive status. HRD is defined by either a deleterious or suspected deleterious BRCA mu...
Annals of Internal Medicine; Barkun, A. et. al.
Oct 21st, 2019 - Description: This update of the 2010 International Consensus Recommendations on the Management of Patients With Nonvariceal Upper Gastrointestinal Bleeding (UGIB) refines previous important statements and presents new clinically relevant recommendations. Methods: An international multidisciplinary group of experts developed the recommendations. Data sources included evidence summarized in ...
Oct 20th, 2019 - The Janssen Pharmaceutical Companies of Johnson & Johnson announced today the U.S. Food and Drug Administration's (FDA) approval of STELARA® (ustekinumab) for the treatment of adult patients with moderately to severely active ulcerative colitis. The approval for this new indication is based on the pivotal Phase 3 UNIFI clinical trial which achieved its primary endpoint of clinical remission. Re...
Oct 10th, 2019 - Gastric cancer treatment options depend on extent of disease and may include radical surgery, chemotherapy, radiation, and immunotherapy. Get detailed information about the diagnosis, treatment, and prognosis of newly diagnosed and recurrent gastric cancer in this clinician summary.
Journal of Emergency Medicine; Anderson J, et al
Oct 4th, 2019 - Children presenting to pediatric emergency departments (EDs) are frequently given enemas for relief of constipation symptoms; there is very little literature guiding solution selection.
American Family Physician; Coffa, D. et. al.
Sep 30th, 2019 - Opioid use disorder is highly prevalent and can be fatal. At least 2.1 million Americans 12 years and older had opioid use disorder in 2016, and approximately 47,000 Americans died from opioid overdoses in 2017. Opioid use disorder is a chronic relapsing condition, the treatment of which falls within the scope of practice of family physicians. With appropriate medication-assisted treatment, pat...
The New England Journal of Medicine; Sands, B. et. al.
Sep 25th, 2019 - BACKGROUND Biologic therapies are widely used in patients with ulcerative colitis. Head-to-head trials of these therapies in patients with inflammatory bowel disease are lacking. METHODS In a phase 3b, double-blind, double-dummy, randomized trial conducted at 245 centers in 34 countries, we compared vedolizumab with adalimumab in adults with moderately to severely active ulcerative colitis...
The New England Journal of Medicine; Sands. B., et al
Sep 25th, 2019 - he efficacy of ustekinumab, an antagonist of the p40 subunit of interleukin-12 and interleukin-23, as induction and maintenance therapy in patients with ulcerative colitis is unknown. METHODS We evaluated ustekinumab as 8-week induction therapy and 44-week maintenance therapy in patients with moderate-to-severe ulcerative colitis. A total of 961 patients were randomly assigned to receive an...
Sep 23rd, 2019 - Description: The Kidney Disease: Improving Global Outcomes (KDIGO) 2018 clinical practice guideline for the prevention, diagnosis, evaluation, and treatment of hepatitis C virus (HCV) infection in chronic kidney disease (CKD) is an extensive update of KDIGO's 2008 guideline on HCV infection in CKD. This update reflects the major advances since the introduction of direct-acting antivirals (DAAs...
Sep 17th, 2019 - An alarming number of people nationwide are developing infections of either the heart’s inner lining or valves, known as infective endocarditis, in large part, due to the current opioid epidemic. This new trend predominantly affects young, white, poor men who also have higher rates of HIV, hepatitis C and alcohol abuse, according to new research published in the Journal of the American Heart As...
Sep 10th, 2019 - Objective To assess the effects of Helicobacter pylori treatment, vitamin supplementation, and garlic supplementation in the prevention of gastric cancer. Design Blinded randomized placebo controlled trial. Setting Linqu County, Shandong province, China. Participants 3365 residents of a high risk region for gastric cancer. 2258 participants seropositive for antibodies to H pylori were ...
Annals of Internal Medicine;
Sep 9th, 2019 - Background: Whether health outcomes of menopausal estrogen therapy differ between women with and without bilateral salpingo-oophorectomy (BSO) is unknown. Objective: To examine estrogen therapy outcomes by BSO status, with additional stratification by 10-year age groups. Design: Subgroup analyses of the randomized Women's Health Initiative Estrogen-Alone Trial. (ClinicalTrials.gov: NCT...
Annals of Family Medicine;
Sep 9th, 2019 - PURPOSE An optimal diagnostic process in primary care is pivotal for reducing cancer-related disease burden. This study aims to explore reasons for long times to referral for Dutch colorectal cancer (CRC) patients in primary care. METHODS A retrospective cohort study of anonymized free-text primary care records from the Julius General Practitioners’ Network database, linked to the Netherland...
Annals of The Royal College of Surgeons of England; Hay D, et al
Sep 5th, 2019 - Intragastric balloons have been used as an invasive non-surgical treatment for obesity for over 30 years. Within the last 37 years, we have found only 27 cases reported in the literature of intestinal obstruction caused by a migrated intragastric balloon. We report the laparoscopic management of such a case and make observations from similar case presentations published in the literature. A ...
Gut Siegel, R. et. al.
Sep 4th, 2019 - Objective Early-onset colorectal cancer (CRC) is increasing in the USA despite rapid declines in older ages. Similar patterns are reported in Australia and Canada, but a comprehensive global analysis of contemporary data is lacking. Design We extracted long-term data from Cancer Incidence in Five Continents and supplemental sources to report on worldwide CRC incidence rates and trends by age...
The Lancet Gastroenterology & Hepatology; Luthra P, et al
Aug 28th, 2019 - There are several drugs available for the treatment of chronic idiopathic constipation, but their relative efficacy is unclear because there have been no head-to-head randomised controlled trials. We did a network meta-analysis to compare the efficacy of these therapies in patients with chronic idiopathic constipation.
Aug 27th, 2019 - The Food and Drug Administration (FDA) has received reports that the use of Mavyret, Zepatier, or Vosevi to treat chronic hepatitis C in patients with moderate to severe liver impairment has resulted in rare cases of worsening liver function or liver failure. All these medicines contain a hepatitis C virus (HCV) protease inhibitor and are not indicated for use in patients with moderate to sever...
Aug 20th, 2019 - The USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations with an appropriate brief familial risk assessment tool. Women with a positive result on the risk assessment tool should receive genetic counseling a...
Aug 19th, 2019 - Importance Potentially harmful mutations of the breast cancer susceptibility 1 and 2 genes (BRCA1/2) are associated with increased risk for breast, ovarian, fallopian tube, and peritoneal cancer. For women in the United States, breast cancer is the most common cancer after nonmelanoma skin cancer and the second leading cause of cancer death. In the general population, BRCA1/2 mutations occur i...
American Family Physician;
Aug 14th, 2019 - Patient story about being diagnosed with hepatitis C and successful treatment by family doctor.
Aug 12th, 2019 - If you shudder at the thought of having a colonoscopy to check for hidden colon cancer, chances are it's the "prep" that's stoking your apprehension. It's certainly a major inconvenience: getting ready for the procedure takes much longer — an average of 16 hours, according to one study — than the three hours or so you'll spend at a medical center the day of your colonoscopy. But what's most off...
Aug 5th, 2019 - Importance Pancreatic adenocarcinoma is the third most common cause of cancer death among men and women in the United States. Objective To systematically review benefits and harms of screening for pancreatic adenocarcinoma to inform the US Preventive Services Task Force. Data Sources MEDLINE, PubMed, and the Cochrane Collaboration Registry of Controlled Trials, from January 2002 throug...
Aug 5th, 2019 - The USPSTF recommends against screening for pancreatic cancer in asymptomatic adults.
Aug 4th, 2019 - Importance Pancreatic cancer is an uncommon cancer with an age-adjusted annual incidence of 12.9 cases per 100 000 person-years. However, the death rate is 11.0 deaths per 100 000 person-years because the prognosis of pancreatic cancer is poor. Although its incidence is low, pancreatic cancer is the third most common cause of cancer death in the United States. Because of the increasing inciden...
Aug 4th, 2019 - Knowledge of genetic susceptibility to gastrointestinal cancers is constantly evolving with identification of new genes. Similarly, a better understanding of the genotype/phenotype relationship in patients with Lynch syndrome (LS) or familial adenomatous polyposis (FAP) is leading to more individualised surveillance recommendations. In addition, molecular profiling of patients with cancer h...
Kowdley, K. et. al.
Aug 1st, 2019 - Hereditary hemochromatosis (HH) is one of the most common genetic disorders among persons of northern European descent. There have been recent advances in the diagnosis, management, and treatment of HH. The availability of molecular diagnostic testing for HH has made possible confirmation of the diagnosis for most patients. Several genotype-phenotype correlation studies have clarified the diffe...
Cancers Petrelli, F. et. al.
Jul 30th, 2019 - The association between antibiotic use and risk of cancer development is unclear, and clinical trials are lacking. We performed a systematic review and meta-analysis of observational studies to assess the association between antibiotic use and risk of cancer. PubMed, the Cochrane Library and EMBASE were searched from inception to 24 February 2019 for studies reporting antibiotic use and subsequ...
Jul 25th, 2019 - The U.S. Food and Drug Administration has approved new warnings about an increased risk of blood clots and of death with the 10 mg twice daily dose of tofacitinib (Xeljanz, Xeljanz XR), which is used in patients with ulcerative colitis. In addition, the approved use of tofacitinib for ulcerative colitis will be limited to certain patients who are not treated effectively or who experience severe...
Jul 25th, 2019 - AUDIENCE: Patient, Health Professional, Pharmacy, Gastroenterology, Rheumatology ISSUE: FDA has approved new warnings about an increased risk of blood clots and of death with the 10 mg twice daily dose of Xeljanz, Xeljanz XR (tofacitinib), which is used in patients with ulcerative colitis. In addition, the approved use of tofacitinib for ulcerative colitis will be limited to certain patients...
Jul 23rd, 2019 - Samsung Bioepis Co., Ltd. today announced that the US Food and Drug Administration (FDA) has approved HADLIMA™ (adalimumab-bwwd), a biosimilar referencing HUMIRA® i (adalimumab), for the treatment of rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, adult Crohn’s disease, ulcerative colitis and plaque psoriasis. Please see below the full indicatio...
Jul 22nd, 2019 - Screening for hepatitis B virus (HBV) infection during pregnancy identifies women whose infants are at risk of perinatal transmission. Data from a nationally representative sample showed a prevalence of maternal HBV infection of 85.8 cases per 100 000 deliveries from 1998 to 2011 (0.09% of live-born singleton deliveries in the United States). Although there are guidelines for universal infant H...
Jul 22nd, 2019 - Contemporary clinicians who provide obstetric care acknowledge screening of pregnant women for perinatally transmissible infectious diseases as a routine component of prenatal care,1 although this has not always been the case. For example, prenatal screening for hepatitis B virus (HBV) infection only began to be discussed after rigorous trials conducted in the 1970s and 1980s in high-endemic ar...
Jul 10th, 2019 - This document presents the official recommendations of the American Gastroenterological Association (AGA) on the Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D) in Adults. The guideline was developed by the AGA’s Clinical Practice Guideline Committee and approved by the AGA Governing Board. These Guidelines should expire in 5 years. The ...
Jun 26th, 2019 - People with HIV infection are affected disproportionally by viral hepatitis. Nearly 75% of people with HIV who report a history of injection drug use also are infected with hepatitis C virus (HCV).
Jun 26th, 2019 - Pfizer Inc. (NYSE:PFE) today announced the United States (U.S.) Food and Drug Administration(FDA) has approved ZIRABEV™ (bevacizumab-bvzr), a biosimilar to Avastin® (bevacizumab),1 for the treatment of five types of cancer: metastatic colorectal cancer; unresectable, locally advanced, recurrent or metastatic non-squamous non-small cell lung cancer (NSCLC); recurrent glioblastoma; metastatic ren...
Current Opinion in Clinical Nutrition & Metabolic Care; Contaldo, F. et. al.
Jun 17th, 2019 - Purpose of review To review the healthy protective effects of coffee against several metabolic diseases and some types of cancer. In this short review, the possible preventive and/or therapeutic actions of coffee on liver function is focused. Recent findings The protective mechanisms of coffee are various and because of several components with anti-inflammatory and antioxidant properties in ...
American Family Physician; Raetz, J. et. al.
May 31st, 2019 - Varicose veins are twisted, dilated veins most commonly located on the lower extremities. The exact pathophysiology is debated, but it involves a genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure. Risk factors include family history of venous disease; female sex; older age; chronically increased intra-abdominal pressure due to obesity, pregn...