A study in the current issue of the New England Journal of Medicine shows a serious complication of ERCP, a procedure commonly used to diagnose and treat problems of the bile and pancreatic ducts, may be eliminated with a single dose medication. The finding is significant in helping patients avoid a condition known as post-ERCP pancreatitis, a disabling complication that affects up to 1 in 4 high-risk patients who undergo the gastrointestinal procedure. Despite decades of research, this clinical trial is the first to clearly demonstrate effective prevention of post-ERCP pancreatitis. The trial ended early after an interim analysis showed clear safety and benefit for the first 600 patients enrolled. The findings are already changing clinical practice. "ERCP is a very important procedure that can provide life-saving interventions for people who need it, although it is considered the most invasive of all the endoscopic procedures and it does have risks associated with it, " says lead study author and gastroenterologist B.
An international team of scientists, led by researchers from the Duke-NUS Graduate Medical School (Duke-NUS) in Singapore and National Cancer Centre of Singapore, has identified hundreds of novel genes that are mutated in stomach cancer, the second-most lethal cancer worldwide. The study, which appears online in Nature Genetics, paves the way for treatments tailored to the genetic make-up of individual stomach tumors. Stomach cancer is the second leading cause of cancer death globally with more than 700, 000 deaths each year, and is particularly common in East Asia. Treatment of this deadly disease is often difficult and unsuccessful because of late detection of tumors and a poor understanding of the causes. In the United States, less than a quarter of patients survive more than five years after diagnosis, even after treatment.
The incidence of pancreatitis after ERCP was considerably reduced if patients were administered rectal indomethacin after their procedure, researchers from the University of Michigan Health System and Indiana University Medical Center reported in NEJM (New England Journal of Medicine. ERCP (endoscopic retrograde cholangiopancreatography) is a procedure that is commonly utilized to treat or diagnose problems of the bile and pancreatic ducts. The authors explained that their findings may lead to a simple treatment that could prevent a condition called post-ERCP pancreatitis, a complication that can affect up to one quarter of all patients who undergo ERCP. Even though this complication has been studied for years, this clinical trial is the first to compellingly show how effectively post-ERCP pancreatitis can be avoided.
Scientists from the Monell Center report that blood glucose levels following starch ingestion are influenced by genetically-determined differences in salivary amylase, an enzyme that breaks down dietary starches. Specifically, higher salivary amylase activity is related to lower blood glucose. The findings are the first to demonstrate a significant metabolic role for salivary amylase in starch digestion, suggesting that this oral enzyme may contribute significantly to overall metabolic status. Other implications relate to calculating the glycemic index of starch-rich foods and ultimately the risk of developing diabetes. "Two individuals may have very different glycemic responses to the same starchy food, depending on their amylase levels, " said lead author Abigail Mandel, Ph.D., a nutritional scientist at Monell.
Researchers at the Sahlgrenska Academy at the University of Gothenburg, Sweden, have discovered a previously unknown mechanism which helps intestinal bacteria to affect the formation of blood vessels. The results, which are presented in Nature, may provide future treatments of intestinal diseases and obesity. There are ten times more bacteria in our intestines than cells in the human body. However, we know relatively little about how the normal gut microbiota functions and the resulting effects on our physiology. Previously unknown mechanism In a study of mice, researchers at the University of Gothenburg's Sahlgrenska Academy have discovered a previously unknown mechanism by which gut microbiota influences intestinal physiology and blood vasculature remodelling. The results, which are published in the online version of the highly respected scientific journal Nature, open up future opportunities to control the intestine's absorption of nutrients, which in turn may be used to treat conditions such as intestinal diseases and obesity.