Showing papers in "The Lancet Gastroenterology & Hepatology in 2019"

TL;DR: NAFLD prevalence in Asia is increasing and is associated with poor outcomes including hepatocellular carcinoma and death, especially in high-risk groups, such as older obese men, and targeted public health strategies must be developed in Asia.

TL;DR: Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age- standardised incidence rate in most countries poses a major public health challenge across the world.

TL;DR: Clinical and pharmacokinetic factors that predict primary non-response at week 14 after starting treatment, non-remission at week 54, and adverse events leading to drug withdrawal are identified.

TL;DR: Key recommendations include a greater focus on national progress towards elimination with support given, if necessary, through innovative financing measures to ensure elimination programmes are fully funded by 2020.

TL;DR: This multicentre, patient-blinded, parallel-group, randomised controlled phase 2/3 trial was performed in four centres in the Netherlands to assess whether laparoscopic pancreatoduodenectomy could reduce time to functional recovery compared with open pancreatic fistula.

TL;DR: The International Coalition to Eliminate HBV (ICE-HBV) as mentioned in this paper is a coalition of experts dedicated to accelerating the discovery of a cure for chronic hepatitis B. Following extensive consultation with more than 50 scientists from across the globe, as well as key stakeholders including people affected by HBV, they have identified gaps in our current knowledge and new strategies and tools that are required to achieve HBV cure.

TL;DR: A substantial increase in the incidence of colorectal cancer in people younger than 50 years in some of the countries in this study is noted, and non-linear cohort effects were more pronounced for rectal than for colon cancer.

TL;DR: Nivolumab had a manageable safety profile and signs of clinical activity in patients with unresectable or recurrent biliary tract cancer and provides supportive evidence for future larger randomised studies of nivolumsab in this difficult to treat cancer.

TL;DR: In patients with T4 or perforated colon cancer, treatment with adjuvant HIPEC with oxaliplatin did not improve peritoneal metastasis-free survival at 18 months, and there was no difference in peritonealan metastasis free-survival in the intention-to-treat population.

TL;DR: Observational data suggest that the effect of disordered brain-gut axis activity in IBD is substantial, and scope remains for further well designed trials of psychological therapies and antidepressants, particularly in the subset of patients who have coexistent psychological disorders, or in those who report IBS-type symptoms.

TL;DR: Ivosidenib is an oral, targeted inhibitor of mutant IDH1 approved for the treatment of mIDH1 acute myeloid leukaemia in newly diagnosed patients ineligible for intensive chemotherapy and patients with relapsed or refractory disease.

TL;DR: The evidence for clinical applications of computer-aided diagnosis and artificial intelligence in colonoscopy is summarised.

TL;DR: In this paper, the authors developed a dynamic deterministic hepatitis C virus transmission model to simulate country-level HCV epidemics among people who inject drugs and the general population and estimated the contribution of injection drug use to risk for HCV outbreaks globally, regionally, and at country level.

TL;DR: The primary outcome was transplantation-free survival, analysed in the intention-to-treat population, excluding individuals subsequently found to be ineligible for enrolment.

TL;DR: Key actions to address current policy gaps include validation of non-invasive tests for liver disease staging; additional immunopathogenesis studies in children with HBV infection; long-term follow-up of children on nucleoside or nucleotide analogue regimens; evaluation of different treatment strategies for children with high rates of HBV replication; and establishment of paediatric treatment registries and international consortia to promote collaborative research.

TL;DR: The evidence suggests that increasing dietary fibre intake to 50 g/day is likely to increase lifespan, improve the quality of life during the added years, and substantially reduce health-care costs.

TL;DR: Interim analyses suggest long-term efficacy and safety of obeticholic acid in patients with primary biliary cholangitis who are intolerant to or inadequately responsive to ursodeoxycholic acid.

TL;DR: The diagnosis of porto-sinusoidal vascular disease is based on liver biopsy and might include signs specific for portal hypertension with normal or mildly elevated liver stiffness values and no complete portal vein thrombosis.

TL;DR: In haemodynamically stable, immunocompetent patients younger than 85 years, primary anastomosis is preferable to Hartmann's procedure as a treatment for perforated diverticulitis (Hinchey III or Hinchey IV disease).

TL;DR: Current knowledge regarding classic and emerging comorbidities related to IBD is explored, including cardiovascular disease, neuropsychological disorders, and metabolic syndrome.

TL;DR: FMT was safe, but did not induce symptom relief at 12 weeks compared with placebo, and additional studies are needed to determine the efficacy of FMT for IBS-D.

TL;DR: It is concluded that a personalised, data-driven approach to care with active management from a multidisciplinary team, as well as increased communication and collaboration between clinicians and researchers based in east and the west, could help to reduce the differences in management and optimise treatment strategies.

TL;DR: The latest evidence on epidemiology, pathogenesis, and risk factors are summarized, established and novel therapeutic options for clinical remission are discussed, and an updated treatment algorithm is proposed.

TL;DR: Key actions to address the current policy gaps and achieve treatment scale-up that is comparable to that in adults include: establishment of a campaign on access to testing and treatment that is targeted at children and adolescents; fast-track evaluation of pan-genotypic regimens; and accelerated approval of paediatric formulations.

TL;DR: Consistent with data from other phase 3 studies, single-tablet sofosbuvir-velpatasvir for 12 weeks is an efficacious and safe treatment for Asian patients with chronic HCV infection, but might have lower efficacy in those infected with HCV genotype 3b and with cirrhosis.

TL;DR: In this article, the authors discuss potential targets and direct-acting antiviral approaches in development for chronic hepatitis B virus (HBV) infection, including entry inhibitors, capsid assembly modulators, and drugs targeting cccDNA or HBV RNA, and secretion inhibitors.

TL;DR: The addition of docetaxel to cis platin and S-1 did not improve overall survival in chemotherapy-naive Japanese patients with advanced gastric cancer, and cisplatin andS-1 remains the standard first-line chemotherapy.

TL;DR: A network meta-analysis to compare the efficacy of drugs in patients with chronic idiopathic constipation found almost all drugs studied were superior to placebo, according to either failure to achieve three or more complete spontaneous bowel movements per week or to achieve an increase of one or more CSBM per week over baseline.

TL;DR: S-1 for 1 year should remain as standard adjuvant chemotherapy for stage II gastric cancer, and Predictive probability for showing non-inferiority at the final analysis was calculated to be 2·9%, and the study was stopped for futility.

TL;DR: Pre-emptive administration of glecaprevir-pibrentasvir therapy results in expedited organ transplantation, rapid HCV suppression, prevention of chronic HCV infection, and excellent early allograft function in patients receiving HCV-infected donor hearts.