[Surveillance of patients with Barrett's esophagus].

Barret's esophagus (BE) is defined as a situation in which the distal esophageal squamous epithelium was replaced by columnar epithelium, with or without goblet cells. BE is considered a significant risk factor for the development of esophageal cancer, however, screening is recommended only for high risk patients. The new guidelines determine the proper terminology of the endoscopic appearance of BE and the way that biopsies should be taken.

[Management of hereditary non-polyposis syndrome (Lynch syndrome)].

Genetic background is suspected in about 20% of colorectal cancer (CRC) cases, in which either genetic polymorphisms or Mendelian heritable factors are involved. Currently known CRC syndromes include various polyposis syndromes (<1% of total CRC cases) and Lynch syndrome (LS), previously termed hereditary nonpolyposis colorectal cancer (HNPCC, comprises 3-5% of all CRC cases). LS is caused by dominantly inherited mutations in the mismatch repair genes MLH1, MSH2, MSH6 or PMS2, and results in a very high lifetime risk (approximately 80%) for CRC and significantly increased risk for extracolonic tumors in regions such as the endometrium, ovary, urinary tract, lymphoma, stomach, pancreas small bowel and brain.

[Surveillance of patients with inflammatory bowel diseases].

This position paper of the Section of Gastrointestinal Oncology of the Israeli Gastroenterological Association recommends specific guidelines for colorectal cancer surveillance in patients with inflammatory bowel disease. Colorectal cancer (CRC) is a severe complication of inflammatory bowel disease (IBD), generally developing into a longstanding disease. The Lifetime prevalence of CRC in ulcerative colitis (UC) patients is estimated to be 2% after 10 years, 8% after 20 years, and even 18% after 30 years of extensive disease.

Comparison of clinical characteristics of patients with gastroesophageal reflux disease who failed proton pump inhibitor therapy versus those who fully responded.

Background/aims: Refractory gastroesophageal reflux disease (GERD) is very common, affecting up to 40% of the patients receiving proton pump inhibitor (PPI) therapy. However, there is not much information about the clinical characteristics of these patients. The aim of the study is to compare the clinical characteristics of PPI responders vs non-responders.

Validation of the Capsule Endoscopy Crohn's Disease Activity Index (CECDAI or Niv score): a multicenter prospective study.

Background And Study Aims: The Capsule Endoscopy Crohn's Disease Activity Index (CECDAI or Niv score) was devised to measure mucosal disease activity using video capsule endoscopy (VCE). The aim of the current study was to prospectively validate the use of the scoring system in daily practice.

Methods: This was a multicenter, double-blind, prospective, controlled study of VCE videos from 62 consecutive patients with isolated small-bowel Crohn's disease.

The role of mucin in GERD and its complications.

Acid, pepsin and other noxious material reach the esophageal mucosa and interact with the luminal aspect of the squamous epithelium. The first protective barrier to these potentially injurious substances is the mucus buffer layer that covers the mucosa. In healthy people, the esophagus has a protective surface adherent mucus gel barrier.

Measured body mass index in adolescence and the incidence of colorectal cancer in a cohort of 1.1 million males.

Background And Aims: The increasing prevalence of adolescent obesity affects adult health. We investigated the association of adolescent overweight with colorectal cancer incidence in a large cohort of males.

Methods: Body mass index (BMI) was measured in 1.

MicroRNAs as a potential prognostic factor in gastric cancer.

Aim: To compare the microRNA (miR) profiles in the primary tumor of patients with recurrent and non-recurrent gastric cancer.

Methods: The study group included 45 patients who underwent curative gastrectomies from 1995 to 2005 without adjuvant or neoadjuvant therapy and for whom adequate tumor content was available. Total RNA was extracted from formalin-fixed paraffin-embedded tumor samples, preserving the small RNA fraction.

Factors affecting compliance in faecal occult blood testing: a cluster randomized study of the faecal immunochemical test versus the guaiac faecal occult test.

Objective: To compare the uptake of faecal immunochemical occult blood test (FIT) with guaiac faecal occult blood test (gFOBT) in a screening programme, with specific attention to the demographic and socioeconomic factors that might affect test uptake.

Setting: The Clalit Health Service screening programme, Israel.

Methods: Average-risk individuals aged 50-75 years were randomized into a FIT arm or gFOBT arm using a programme based on the socioeconomic status (SES) of their primary care clinics.

Expectancy-related changes in firing of dopamine neurons depend on orbitofrontal cortex.

The orbitofrontal cortex has been hypothesized to carry information regarding the value of expected rewards. Such information is essential for associative learning, which relies on comparisons between expected and obtained reward for generating instructive error signals. These error signals are thought to be conveyed by dopamine neurons.

Fecal immunochemical test and small bowel lesions detected on capsule endoscopy: results of a prospective study in patients with obscure occult gastrointestinal bleeding.

Background: Fecal immunochemical test (FIT) is gaining popularity as a screening tool for colorectal cancer. The introduction of capsule endoscopy (CE) enables an assessment of the relationship between small bowel (SB) lesions and FIT results.

Aim: To determine whether SB lesions found by CE are associated with an increased rate of positive FIT.

[Guidelines for diagnosis, treatment, surveillance and prevention of cancer in patients with familial non-adenomatous polyposis].

Approximately 30% of colorectal cancers exhibit familial clustering. Currently, we recognize a number of different types of polyps and polyposis syndromes that are classified according to the histology of the typical polyp. We differentiate between adenomas, hyperplastic, and hamartomatous polyps as well as between syndromes that are manifested by 10-100 or above 100 polyps.

[The Israeli recommendations for diagnosis, management, follow-up and prevention of colorectal cancer (CRC) in familial adenomatous polyposis].

Approximately 30% of colorectal cancers exhibit familial clustering. We recognize different types of polyps and polyposis syndromes that are classified according to the histological diagnosis. We differentiate between adenomas, hyperplastic, and hamartomatous polyps as well as between syndromes that are manifested by 10-100 or above 100 polyps.

Presence of JC virus DNA in the tumor tissue and normal mucosa of patients with sporadic colorectal cancer (CRC) or with positive family history and Bethesda criteria.

Introduction: JC virus (JCV) may infect the gastrointestinal tract in childhood, and, by encoding a gene for T-antigen (T Ag), can initiate chromosomal instability in epithelial cells.

Aim: We looked for JCV DNA in the cancer tissue of patients with sporadic colorectal cancer (CRC, Group A) and with positive family history and Bethesda criteria (Group B). We hypothesized that the role of JCV may be different between these two groups.

A neural signature of hierarchical reinforcement learning.

Human behavior displays hierarchical structure: simple actions cohere into subtask sequences, which work together to accomplish overall task goals. Although the neural substrates of such hierarchy have been the target of increasing research, they remain poorly understood. We propose that the computations supporting hierarchical behavior may relate to those in hierarchical reinforcement learning (HRL), a machine-learning framework that extends reinforcement-learning mechanisms into hierarchical domains.

The effects of motivation on response rate: a hidden semi-Markov model analysis of behavioral dynamics.

A central goal of neuroscience is to understand how neural dynamics bring about the dynamics of behavior. However, neural and behavioral measures are noisy, requiring averaging over trials and subjects. Unfortunately, averaging can obscure the very dynamics that we are interested in, masking abrupt changes and artificially creating gradual processes.

Complications in endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS): analysis of 7-year physician-reported adverse events.

Introduction: The number of malpractice claims against physicians and health institutes is increasing continuously in Israel as in the rest of the Western world, and has become a serious financial burden.

Aim: In this study we analyzed the reports of gastroenterologists on endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) adverse events to the risk management authority between January 1, 2000 and December 31, 2006.

Methods: All the reported adverse events associated with ERCP and EUS of health institutes and covered by Madanes Insurance Agency were summarized and analyzed.

Gradual cessation of proton pump inhibitor (PPI) treatment may prevent rebound acid secretion, measured by the alkaline tide method, in dyspepsia and reflux patients.

Gastro esophageal reflux disease and ulcer related or non-ulcer dyspepsia, attacks 20% of the Western population. These millions of patients are treated continuously with PPI for different periods, many for many years. Recently, rebound acid hypersecretion was recognized as a major clinical event after cessation of PPI therapy.

Perceptions of gastroenterologists and nurses regarding irritable bowel syndrome and inflammatory bowel disease.

Objective: Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) have similar symptoms, and both adversely affect patients' quality of life. The objective of this study was to compare the perceptions of physicians and nurses regarding IBS and IBD.

Methods: The Illness Perception Questionnaire Revised, adapted for medical staff, was sent at random to 300 physicians and nurses of gastroenterology departments and outpatient clinics nationwide to assess perceptions of IBS or IBD.

Gender medicine in gastroenterology.

The cause for gender differences in the epidemiology, natural history and response to therapy in many diseases is unknown and has seldom been investigated in depth. Sex hormones are blamed for many of these changes, mostly without any scientific evidence. In this review I will describe some of the evidence for gender differences in gastrointestinal diseases.

High eradication rates of Helicobacter pylori infection following sequential therapy: the Israeli experience treating naïve patients.

Background: Helicobacter pylori eradication rates following triple therapy are decreasing. Cure rates as low as 57%, mainly to claritromycin resistance, have been reported in Israel. Studies performed in Italy have shown eradication rates of 93%, following sequential therapy.

[Surveillance of patients after colonoscopic polypectomy and curative resection of colorectal cancer].

The position paper of the GastrointestinaL Oncology Section of the Israeli Gastroenterological Association recommends specific guidelines for surveillance after polypectomy and curative resection of colorectal cancer. Periodic colonoscopy is necessary for early detection of metachronous lesions or cancer recurrence. After polypectomy of a simple hyperplasic polyp, colonoscopy is repeated in 10 years.

Complications in colonoscopy: analysis of 7-year physician-reported adverse events.

Introduction: The number of malpractice claims against physicians and health institutes in Israel is increasing continuously, as in the rest of the Western world. This trend became a serious financial burden.

Aim: In this study we analyzed reports of gastroenterologists on colonoscopy adverse events to the medical malpractice insurer, as well as complaint/demand for compensation from patients represented by lawyers, between 1 January 2000 and 31 December 2006.