August 2017 Vol XLI Issue 8

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INFLAMMATORY BOWEL DISEASE: A PRACTICAL APPROACH, SERIES #102

Fecal Microbiota Transplantation in the Elderly - A Need for Early Consideration in Select Cases of Clostridium difficile Infection

Yao-Wen Cheng, Monika Fischer

Fecal microbiota transplantation (FMT) is recommended treatment for recurrent Clostridium difficile infection (CDI). There is also increasing evidence that FMT is effective in severe and severe-complicated CDI and in averting CDI-related complications such as colectomy and mortality. In this article, we explore the role of FMT in elderly patients with CDI and other gastrointestinal diseases. It may be reasonable to offer FMT earlier in the CDI disease course in older individuals, possibly after just the second recurrence and/or for the first episode of severe CDI to halt disease progression and prevent development of associated complications.



DISPATCHES FROM THE GUILD CONFERENCE, SERIES #7

Hepatitis C Resistance Testing - When, Why and How to Do it

Jordan J. Feld

Hepatitis C virus (HCV) therapy has evolved dramatically in recent years with the development of highly effective and well-tolerated direct-acting antivirals (DAAs). Although it was initially felt that DAA resistance would be a challenge, the cure rates in most patient populations are extremely high. Fortunately, new therapies in development will likely make the need for resistance testing less and less relevant. In this review, the principles of resistance development are reviewed and the role of resistance testing in clinical practice is discussed, with specific recommendations on when to do testing, how to interpret the results and how to modify therapy appropriately based on the results.



NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #166

Parenteral Nutrition Lipid Emulsions and Potential Complications

Manpreet S. Mundi, Bradley R. Salonen, Sara L. Bonnes, Ryan T. Hurt

Intravenous lipid emulsions (ILE) have become a crucial component of parenteral nutrition providing a source of essential fatty acids as well as non-protein calories. However, their long-term use has been associated with significant complications. This has led to the quest to identify a lipid emulsion that decreases complications and provides beneficial physiologic effects. Multiple plant and fish based sources of ILE have been identified and are in use throughout the world. In this review, we focus on the benefits and adverse effects associated with soybean oil (SO) ILE and subsequent generations of ILE.



Departments Section


From the Pediatric Literature

Breast Milk and the Infant Microbiome

It is poorly understood how the infant microbiome develops over time. The authors of this study recruited mother-infant pairs from California and Florida for ve different age groups: 0 to 7 days (de ned as initial colonization), 8 to 30 days (full maternal milk usage), 31 to 90 days (before solid food introduction), 91 to 180 days (solid food utilization), and 181 to 365 days (after solid food introduction).



Does a Community Effort Lead to a Decline in Pediatric Obesity?

Childhood obesity is an epidemic in the United States, and little is known about effective large-scale preventative measures to effect change in populations at risk for obesity. The authors of this study evaluated the prevalence rates of children in Cincinnati, Ohio diagnosed with overweight (body mass index (BMI) greater or equal to the 85th percentile and less than the 95th percentile for age and sex); obesity



A Red Airway is Not Reflux!

Children with chronic cough, hoarseness, and other upper airway symptoms often undergo direct laryngoscopy by otolaryngologists. Abnormal laryngeal findings, such as a red airway, do not have good correlation with gastroesophageal reflux disease (GERD).



Esophageal Dilation in Children with Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is chronic allergen- mediated disease associated with esophageal inflammation, which can progress to esophageal fibrosis and stricture formation. Early clinical experience with EoE suggested that such patients were a high risk group for esophageal perforation. However, more recent studies evaluating the efficacy of dilation for adult patients with EoE have shown this intervention to be safe.



Medical Bulletin Board

NESTLE HEALTH SCIENCE DEVELOPS RECIPES FOR BLENDED DIETS USING COMPLEAT® FORMULAS AS A BASE

Homemade Blenderized Tube Feedings Allow Patients to Experience a Variety of Real Foods and Become Involved in Mealtime



ADLER MICROMED, INC. OF SAN DIEGO IS NOW THE U.S. DISTRIBUTOR FOR ALL SAPIMED SINGLE USE, DISPOSABLE, HEMORRHOID LIGATORS BANDING SYSTEMS, ANASCOPES, RECTOSCOPES, AND PROTOSCOPES

Hemorrhoid banding systems begin at $16.00. Pediatric Anascopes at $5.00 each.



COLON CANCER ALLIANCE CONNECTS CLINICAL TRIAL FINDER WITH ONLINE SUPPORT FOR PEOPLE WITH COLON CANCER AND THEIR FAMILIES

CCA partners with Smart Patients to link their Clinical Trial Finder to a new online community that will give patients and families access to support and learn from one another.



Meetings Calendar

September 9, 2017 - National Hepatitis B & C Training Program and Treatment Update
October 13-18, 2017 World Congress of Gastroenterology (WCOG) at ACG 2017
November 9-11, 2017 - Advances in Inflammatory Bowel Diseases - Multidisciplinary Approaches to IBD Patient - Centered Care