WikiJournalClub:List of landmark papers/Gastroenterology

Peptic Ulcer Disease

• FAMOUS Famotidine prevents ulcers in patients taking aspirin. [1]

Gastrointestinal Bleeding

• Erythromycin IV erythromycin before endoscopy improves stomach cleansing and quality of endoscopic examination in patients with UGIB, but clinical benefit is limited. [2]
• Antibiotics in cirrhosis and hemorrhage Ceftriaxone vs. norfloxacin in cirrhotics with GI bleeding [3]
• Omeprazole After endoscopic treatment of bleeding peptic ulcers, a high-dose infusion of omeprazole substantially reduces the risk of recurrent bleeding. [4]

Clostridium Diffiicile

• Vancomycin vs. Metronidazole in C. difficile Diarrhea: Vancomycin vs. metronidazole in C. difficile. [[5]]

Inflammatory Bowel Disease

• SONIC Patients with moderate-to-severe Crohn's disease who were treated with infliximab plus azathioprine or infliximab monotherapy were more likely to have a corticosteroid-free clinical remission than those receiving azathioprine monotherapy. [[6]]
• Combined immunosuppression was more effective than conventional management for induction of remission and reduction of corticosteroid use in patients who had been recently diagnosed with Crohn's disease. Initiation of more intensive treatment early in the course of the disease could result in better outcomes. [[7]]
• Infliximab in ulcerative colitis [[8]]
• Methotrexate for maintenance of remission in Crohn's disease [[9]]
• Adalimumab for Crohn's disease who cannot tolerate Infliximab [[10]]

Pancreatitis

• enteral feeding preferred over TPN [[11]]
• Antibiotic prophylaxis of Severe Acute pancreatitis does not reduce mortality or protect against infected necrosis, or frequency of surgical intervention. Am J Surg 2009;197:806
• No difference in conversion rates to open surgery, local or systemic complications between early (within 2 weeks after onset of disease) versus delayed cholecystectomy in patients with biliary AP, but greater rate of recurrent biliary pancreatitis found in the group undergoing CCY later [[12]]
• Surgery within 48 hours of hospital admission was associated with shorter length of stay. Ann Surg 2010;251:615
• Early ERCP does not reduce risk of pancreatitis complications [[13]]
• Dutch Pancreatitis Study A minimally invasive step-up approach, as compared with open necrosectomy, reduced rate of major complications or death among patients with necrotizing pancreatitis and infected necrotic tissue [[14]]
• BISAP 5-point scoring system on admission identifies pts at risk for increased mortality Am J Gastro 2009;104:966
• Ranson's criteria Etiological and prognostic factors in human acute pancreatitis Am J Gastro 1982;77:633
• value of CT in establishing prognosis Radiology 1990;174:331

Viral Hepatitis

• peginterferon-alpha2a plus ribavirin vs peginterferon-alpha2b plus ribavirin in chronic hepatitis C[[15]]
• PROVE1 Treatment with a telaprevir-based regimen significantly improved sustained virologic response rates in patients with genotype 1 HCV [[16]]
• PROVE2 Telaprevir and Peginterferon with or without Ribavirin for Chronic HCV Infection [[17]]
• PROVE3 Retreatment with Telaprevir in combination with peginterferon alfa-2a and ribavarin in patients in whom initial treatment failed. [[18]]
• REALIZE Telaprevir combined with peginterferon plus ribavirin significantly improved rates of sustained virologic response in patients with previously treated HCV infection [[19]]
• SPRINT-1 boceprevir in combination with peginterferon alfa-2b and ribavirin [[20]]
• SPRINT-2 addition of boceprevir to standard therapy with peginterferon-ribavarin
• RESPOND-2 The addition of boceprevir to peginterferon–ribavirin in previously treated patients with chronic HCV genotype 1 infection. [[

Alcoholic Hepatitis

• Prednisolone improves short-term survival [[21]]
• Pentoxifylline improves short-term survival in severe acute alcoholic hepatitis. [[22]]
• AAH-NAC Combination therapy with prednisolone plus N-acetylcysteine among patients with severe acute alcoholic hepatitis [[23]]

Nonalcoholic Fatty Liver Disease

• NASH CRN Vitamin E and pioglitazone [[24]]

Acute Liver Failure

• ALF IV NAC in all pts with early stage non-acetaminophen-related hepatic failure

Cirrhosis

• Therapeutic paracentesis with and without intravenous albumin in cirrhosis. Gastroenterology 1988; 94: 1493-1502
• Paracentesis and TIPS in Patients with Ascites increases transplant-free survival.[[25]]
• TIPs + medical therapy is superior to medical therapy alone for control of ascites but does not improve survival, affect hospitalization rates, or improve quality of life. Gastro 2003;124:634
• IV albumin in addition to antibiotics reduces incidence of renal impairment and death in comparison with treatment with antibiotics alone. [[26]]
• Abx ppx improved short-term survival in treated patients when compared with untreated control groups and reduced the overall risk of infections, including SBP, during follow-up. In summary, antibiotic prophylaxis should be considered for high-risk cirrhotic patients with ascites. [[27]]
• Nonselective beta-blockers ineffective in preventing varices in unselected patients with cirrhosis and portal hypertension; decrease risk of bleeding [[28]]
• Banding ligation and beta-blockers decrease bleeding and mortality Am J Gastro 2007;102:2842
• Combination of endoscopic and drug therapy reduces overall and variceal rebleeding in cirrhosis more than either therapy alone.

[[29]]

• Lactulose vs placebo as secondary prophylaxis of hepatic encephalopathy Gastro 2009;137:885
• Rifaximin versus placebo as secondary prophylaxis of hepatic encephalopathy [30]
• Midodrine + Octreotide vs. Dopamine in HRS-1 Hep 1999;29:1690
• Albumin + terlipressin versus albumin alone in HRS-1 Gastro 2008;134:1352
• Terlipressin versus placebo in HRS Gastro 2008;134:1360
• MELD used to stratify pts on liver transplant list & to predict 3-month survival in patients [[31]]
• MELD and serum sodium concentration are important predictors of survival among candidates for liver transplantation. [[32]]
• Ursodoxycholic Acid in PBC [33]

Ascites

• Serum-ascites albumin gradient versus exudate-transudate concept in the classification of ascites [[34]]
• if known cirrhosis and SAAG < 1.1 but no other readily identifiable cause, likely just cirrhosis [[35]]

Cholelithiasis

• Statin use > 1 year decreases risk of symptomatic gallstones and cholecystectomy [36]

Cholecystitis

• Early versus delayed cholecystectomy for acute cholecystitis [37]