Tight control for Crohn's disease with adalimumab-based treatment is cost-effective: an economic assessment of the CALM trial.

Objective: To evaluate the cost-effectiveness of an inflammatory biomarker and clinical symptom directed tight control strategy (TC) compared with symptom-based clinical management (CM) in patients with Crohn's disease (CD) naïve to immunosuppressants and biologics using a UK public payer perspective.

Design: A regression model estimated weekly CD Activity Index (CDAI)-based transition matrices (remission: CDAI <150, moderate: CDAI ≥150 to <300, severe: CDAI ≥300 to <450, very severe: CDAI ≥450) based on the Effect of Tight Control Management on Crohn's Disease (CALM) trial. A regression predicted hospitalisations.

Predictive Value of Mean Platelet Volume in Variceal Bleeding due to Cirrhotic Portal Hypertension.

Aim: To investigate whether mean platelet volume (MPV) is a predictor of variceal bleeding in patients with cirrhotic portal hypertension.

Materials And Methods: This prospective cohort was performed in the internal medicine department of our tertiary care center. Cirrhotic patients were allocated into two groups: Group I consisted of 31 cases without a history of variceal bleeding, whereas group II was made up of 31 patients with a history of variceal bleeding.

Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial.

Background: Biomarkers of intestinal inflammation, such as faecal calprotectin and C-reactive protein, have been recommended for monitoring patients with Crohn's disease, but whether their use in treatment decisions improves outcomes is unknown. We aimed to compare endoscopic and clinical outcomes in patients with moderate to severe Crohn's disease who were managed with a tight control algorithm, using clinical symptoms and biomarkers, versus patients managed with a clinical management algorithm.

Methods: CALM was an open-label, randomised, controlled phase 3 study, done in 22 countries at 74 hospitals and outpatient centres, which evaluated adult patients (aged 18-75 years) with active endoscopic Crohn's disease (Crohn's Disease Endoscopic Index of Severity [CDEIS] >6; sum of CDEIS subscores of >6 in one or more segments with ulcers), a Crohn's Disease Activity Index (CDAI) of 150-450 depending on dose of prednisone at baseline, and no previous use of immunomodulators or biologics.

Gastric myoelectrical activity abnormalities of electrogastrography in patients with functional dyspepsia.

Background/aims: Pathogenesis of functional dyspepsia (FD) is unclear and not well documented. Some gastric motility abnormalities have been reported to be important factors. Transcutaneous electrogastrography (EGG) is an experimental method that is used to assess FD.

Does CPAP treatment lead to gastroesophageal reflux in patients with moderate and severe OSA?

Obstructive sleep apnea (OSA) leads to upper respiratory tract obstruction, causing increased abdominal-gastric pressure and decreased lower esophageal sphincter (LES) pressure and thus gastroesophageal reflux (GER). Continuous positive airway pressure (CPAP) is known to be an effective method for OSA treatment, but its effect on GER is still controversial. There are a very few studies investigating CPAP and GER relationship and performed based on pre- and post-treatment objective parameters of GER in patients with OSA.

Eltrombopag: How secure in triple therapy of HCV?

Triple therapy of hepatitis C usually leads to some hematological and dermatological side effects. Thrombocytopenia is one of the most common side effects that are encountered during triple therapy. Eltrombopag was approved for the treatment of patients with chronic hepatitis C and thrombocytopenia to allow the initiation and maintenance of interferon based therapies.

Acute pancreatitis following adult liver transplantation: A systematic review.

Although uncommon, acute pancreatitis is a well-recognized, but generally serious, complication following liver transplantation. In addition to being more prevalent in patients who underwent liver transplantation than in the general population, it has a more aggressive course and can be responsible for significant morbidity and mortality. The post-liver transplant population has altered anatomy, increased comorbidities, and requires a myriad of drugs.

EUS-guided FNA of a portal vein thrombus in hepatocellular carcinoma.

Portal vein thrombosis is a relatively rare but well-known complication of cirrhosis that has a prevalence of between 1% and 5.7%. On the contrary, in case of hepatocellular carcinoma (HCC), it is a much more frequent complication.

Concurrent acute pancreatitis and pericardial effusion.

While pleural effusion and ascites secondary to acute pancreatitis are common, clinically relevant pericardial effusion and cardiac tamponade are observed rarely. In a study by Pezzilli et al., pleural effusion was noted in 7 of the 21 patients with acute pancreatitis whereas the authors detected pericardial effusion development in only three.

Acromegaly can be associated with impairment of LES relaxation in the oesophagus.

Introduction: Although prolonged small intestine and colonic transit time has been demonstrated in acromegaly patients, the influence of acromegaly on oesophagus motility and the pathological mechanisms involved are still not clarified. We aimed to investigate manometric measurements to ascertain whether oesophagus motility is affected in active acromegaly patients.

Material And Methods: The study was performed in an institutional referral centre at a tertiary care hospital.

The importance of upper gastrointestinal endoscopy in morbidly obese patients.

Background/aims: Obesity is an epidemic and its prevalence and number of patients underwent bariatric surgery continue to increase worldwide. This study aimed to evaluate endoscopic findings and co-morbidities, to investigate the prevalence of Helicobacter pylori (H. pylori) infection and the relationship between body mass index (BMI) and gastroesophageal sphincter incompetency in obese patients.

Staging of rectal carcinoma: MDCT, MRI or EUS. Single center experience.

Background/aims: To retrospectively compare the efficacy of multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and endosonography (EUS) in the staging of rectal carcinoma.

Materials And Methods: A total of 50 patients (36 male, 14 female) were included in the study. The data from surgical staging were used as reference for comparing the yield of EUS, MRI, and MDCT in preoperative T and N staging of rectal carcinoma.

Role of serum myeloperoxidase, CPK, CK-MB, and cTnI tests in early diagnosis of myocardial ischemia during ERCP.

Background/aims: Some patients may experience retrosternal pain during ERCP, which may be a pioneer of a serious myocardial problem, and early diagnosis is very important for the prognosis and management. In the study, we aimed to investigate the role of serum cardiac biomarkers, such as myeloperoxidase (MPO), creatine phospokinase (CPK), creatine kinase- myocardial band (CK-MB), and cTnI, on early diagnosis of myocardial ischemia during endoscopic retrograde cholangio pancreaticograpy (ERCP) procedures.

Materials And Methods: In this prospective observational study, ERCP patients were separated into ischemic cardiac (n:48) and non-ischemic (n:76) groups.

Roles of serum and biliary CEA, CA19-9, VEGFR3, and TAC in differentiating between malignant and benign biliary obstructions.

Background/aims: Despite the presence of many diagnostic methods, the differential diagnosis between benign and malignant biliary obstructions is still not easy. We aimed to evaluate the role of serum/biliary carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), vascular endothelial growth factor receptor-3(VEGFR-3), and total antioxidant capacity (TAC) tests in this differential diagnosis.

Materials And Methods: Patients (n:225; 110♂, 115♀) with diagnosis of malignant (n:96) or benign (n:129) biliary obstruction were included in this cross-sectional study.

Endoscopic repair of duodenal perforation with over-the-scope clipping system and endoclips: a case report.

Herein, we present an endoscopic repair of iatrogenic duodenal perforation by over-the-scope clipping system (OTSC) and endoclips in an 84-year-old woman that occurred during linear endosonography (EUS) examination. One OTSC and 8 clips were used for repairing the perforation hole. After 3 days in the intensive care unit (ICU) by chest tube and without oral feeding, she was discharged from the hospital at 6.

A randomized controlled trial of home monitoring versus hospitalization for mild non-alcoholic acute interstitial pancreatitis: a pilot study.

Background/objectives: Acute pancreatitis (AP) is a disease typically requiring in-hospital treatment. We conducted a trial to assess the feasibility of early discharge from the hospital for patients with mild non-alcoholic acute pancreatitis (NAAP).

Methods: Eighty-four patients with mild NAAP were randomized to home or hospital groups after a short hospital stay (≤24 h).

Esophagus motility in overt hypothyroidism.

Purpose: Gastrointestinal tract is one of the most affected systems in hypothyroidism. Despite decreased esophageal emptying, prolonged esophageal and gastric transit time have been indicated in previous reports, the mechanism of thyroid hormones activity and antibodies on the esophagus motility is not yet fully understood. This study was conducted to evaluate the esophagus motility by manometry in hypothyroid patients.

Gastroenterology cases of cutaneous leukocytoclastic vasculitis.

Rarely, leukocytoclastic vasculitis can result from ischemic colitis, inflammatory bowel disease, and cryoglobulinemia. There is no established standard for the treatment of leukocytoclastic vasculitis associated with gastroenterologic diseases. This paper presents three cases of leukoytoclastic vasculitis, each of which is associated with a different gastroenterologic condition: ischemic colitis, Crohn's disease, and chronic hepatitis C.

Durability of sustained virologic response in chronic hepatitis C.

Background/aims: The aim of this study is to investigate the rate of sustained virologic response (SVR) in chronic hepatitis C patients receiving antiviral treatment.

Methods: The files of patients with chronic hepatitis C treated with interferon±ribavirin between 1995 and 2009 were reviewed retrospectively. Six months after the end of treatment, patients with negative hepatitis C virus (HCV)-RNA (<50 IU/mL, as determined by the polymerase chain reaction method) were enrolled in the study.