Articles You Don’t Wanna Miss (August 2017 Issue)

Henry Chan - The Chinese University of Hong Kong, Hong Kong
Justin Wu - The Chinese University of Hong Kong, Hong Kong

If you're wondering what good articles to read while you're waiting to board the plane or for your phone to charge, you’re on the right spot! IDDF’s OC members who are themselves editors of prestigious journals have handpicked a list of recent articles that make a good read. 

 

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“Are Targeted Treatment Recommendations in Chronic Hepatitis C Tailored to Diagnostic Methods of Fibrosis?”

Sylvie Deuffic-Burban,  Jérôme Boursier, Vincent Leroy, Yazdan Yazdanpanah, Laurent Castera, Philippe Mathurin.  J Hepatol 2017;66:304-312

 

Recommended by HENRY CHAN, Associate Editor of Journal of Hepatology

 

With the development of pangenotypic direct antiviral agents for hepatitis C virus (HCV) infection, medical cure of HCV infection can easily be achieved with 8-12 weeks of very safe once daily oral therapy. The challenge becomes the national policy on reimbursement of these very expensive antiviral agents; how much a does a government have to invest to reduce liver cirrhosis complications and mortality related to HCV infection? In this collaborative study from France, Italy and the United Kingdom, a country-specific Markov model was used to predict clinical outcomes in patients with chronic HCV infection over 5 years. Three therapeutic strategies were tested: (1) no treatment, (2) targeted therapy based on stage of fibrosis (F2- or F3-scenario), and (3) treatment regardless of stage of fibrosis (universal analysis). If HCV treatment is prioritized to those with F2 or F3 fibrosis, the overall incidence of liver cirrhosis, cirrhotic complications and mortality would be reduced. But the most effective strategy to reduce 5-year morbidity and mortality would be to initiate HCV treatment to all HCV patients regardless of their liver fibrosis stage. Based on the analysis, universal therapy reduced the 5-year incidence of cirrhosis by 12.0–17.7, liver complications by 4.2–5.3 and liver deaths by 3.7–4.7 as compared to no treatment. These data are important for local governments to estimate the cost of antiviral drugs versus the cost of medical care for complication of HCV infection. Governments should take universal treatment of HCV as a case of investment to reduce healthcare cost for cirrhotic complications and mortality of their population.

 


 

 

“Novel 3D High-resolution Manometry Metrics for Quantifying Esophagogastric Junction Contractility.” 

Lin Z, Xiao Y, Li Y, Pandolfino JE, Chen M, Kahrilas PJ. Neurogastroenterology & Motility. 2017 Aug;29(8).

 

Recommended by JUSTIN WU, Editor of Neurogastroenterology and Motility

 

The esophagogastric junction is a complex sphincter composed of both the crural diaphragm (CD) and lower esophageal sphincter (LES). Three-dimensional high-resolution manometry (3D-HRM) provides a dynamic 360° representation of esophagogastric junction (EGJ) pressure in which the crural diaphragm (CD) has a distinct pressure signature.

 

This study devised novel 3D-HRM metrics to quantify the crural diaphragm and lower esophageal sphincter elements of EGJ contractility. Both measures correlated strongly with conventional high resolution manometry metrics of EGJ contractility. The new metrics are potentially useful in quantifying elements of the anti-reflux barrier in mechanistically defined subsets of patients with gastroesophageal reflux disease and esophageal motility disorder such as achalasia.