Volume 2, Issue 3
There is a growing demand for increased transparency, openness and reproducibility of research. Data sharing is an integral aspect of this. Therefore we are introducing guidelines across all Elsevier journals, encouraging sharing and citing of data. Data can be shared as supplementary material, but other ways exist; e.g. by linking to a domain-specific data repository. Where there is no such repository available, sharing through Mendeley Data is a great option. Elsevier also publishes the journal Data in Brief, where data can be properly described and made easy to find. We trust that with increased sharing, research globally will benefit.
Acute-on-chronic liver failure (ACLF) is a newly defined entity that complicates the course of relatively well patients with chronic liver disease. Louvet et al. report the results of a multicenter study assessing the outcomes of patients transplanted for severe ACLF (Grade 3). Their remarkable study shows for the first time that the 1-year survival of patients with ACLF Grade 3 is like those with no ACLF (84% vs. 90%). The 1-year survival of ACLF Grade 3 patients who were not transplanted was only 8%. These data are extremely provocative and likely to change clinical practice.
Clinical Practice Update: Expert Review - Opioids in Gastroenterology: Treating Adverse Effects and Creating Therapeutic Benefits
Opioid medications are commonly used in clinical practice and have acute or chronic effects on diverse parts of the gastrointestinal tract. Because of their widespread use, it is imperative to consider whether any presentation with gastrointestinal symptoms may be related to the intake of opioids.
Bowel preparation for colonoscopy should not cause significant shifts in systemic electrolyte concentrations. Ankie Reumkens and colleagues explored the magnitude of and risk factors for hypokalemia associated with bowel preparation, paying specific attention to higher-risk subgroups, especially diuretic users, hospitalized patients, and patients estimated to be at high risk by the gastroenterologist. In total, 5515 colonoscopies were performed, including 1822 procedures in diuretic users or hospitalized patients.
Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children with Obesity
Short-term (9 days) isocaloric fructose restriction decreased liver fat, visceral fat (VAT), and de novo lipogenesis (DNL), and improved insulin kinetics in children with obesity. These findings support efforts to reduce sugar consumption. ClinicalTrials.gov Number: NCT01200043.
The management of intraductal papillary mucinous neoplasm (IPMN) continues to evolve. Based on a consensus symposium held during the meeting of the International Association of Pancreatology in Sendai, Japan, in 2016, the working group has revised the guidelines regarding prediction of invasive carcinoma and high-grade dysplasia, surveillance, and postoperative follow-up of IPMN. The present guidelines include updated information and recommendations based on our current understanding, and highlight issues that remain controversial or where further research is required.
Fewer than 30% of patients with advanced hepatocellular carcinoma (HCC) are eligible for curative treatments like liver transplantation or surgical resection. For other patients treatment with the tyrosine kinase inhibitor sorafinib is the standard of care. Patients whose disease is confined to the liver also benefit from transarterial chemoembolisation (TACE); whether combining sorafinib and TACE improves outcomes was unclear. In the TACE 2 trial, published in The Lancet Gastroenterology & Hepatology, patients received either sorafinib or placebo, combined with TACE. The primary outcome of progression-free survival suggested that the combination of sorafinib and TACE provided no additional benefit to patients.
We previously reported that, in multiple murine models of low-grade intestinal inflammation, development of metabolic syndrome correlates with encroachment of bacteria into the normally sterile inner colonic mucus layer. Here, we report that microbiota encroachment is also a feature of metabolic disease, particularly insulin resistance–associated dysglycemia, in humans.
Probiotics are used all over the world as their beneficial effects have been widely demonstrated. Hundreds of different microorganisms are used in numerous probiotic products. As a result it is very difficult to choose the best probiotic product for specific or more general needs. Digestive and Liver Disease seeks to create clarity about the main characteristics that probiotic microorganisms and products should possess in order to have a positive impact on the host's health. This review suggests "10 golden rules" that clinicians can follow to select the optimal probiotic product and avoid the "pie in the sky" stories.
Ammonia-induced oxidative stress in liver and brain is thought to have a key role in the pathophysiology of hepatic encephalopathy (HE). Carnosine (b-alanyl-L-histidine; CA) is a dipeptide found to have antioxidant properties and reactive species scavenging ability. Although several investigations indicated hepatoprotective properties of CA, there is no study on its effect in cirrhosis and its associated complications. In the current investigation, it was found that CA (250, 500, and 1000 mg/kg) drastically reduced liver fibrosis and hyperammonemia, and improved locomotor activity in cirrhotic animals. CA administration might be considered as a new therapeutic approach for liver failure and HE.
As Niels Bohr, the Danish physicist, put it, "prediction is very difficult, especially about the future". In this December edition of HPB, Beal and colleagues aim to validate the American College of Surgeons National Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator (SRC) using data from 854 gallbladder cancer and extrahepatic cholangiocarcinoma patients from the US Extrahepatic Biliary Malignancy Consortium.
Best Practice & Research Clinical Gastroenterology focuses its latest special issue on Gastrointestinal Polyps. Guest Editors Cesare Hassan and Alessandro Repici deal with the natural history of the GI-polyps and GI-neoplasia. Furthermore they survey the most recent advances that have revolutionized the field of GI-endoscopy, including our comprehension on its role as preventive, diagnostic and therapeutic procedure.
Meet the Masters: Each month, VideoGIE will highlight a professional recognized for their endoscopic accomplishments. These video interviews and accompanying biographies will offer insight and advice from the greatest minds in the field and give the younger generation an opportunity to learn about those who made significant contributions to endoscopy. View the latest installment at http://www.videogie.org/current.
VideoGIE Quiz: Think you can outsmart VideoGIE? Try your luck with our new Quiz series. Using cases published in VideoGIE, we will be posting questions designed to improve the education of our fellows. Go to http://www.videogie.org to submit your answer, and keep checking back for more quizzes!