Articles related to Hepatology

Data on patients with mismatch repair deficiency (MMRD) CRC, the majority of whom could not undergo surgery due to various health conditions unrelated to cancer, were presented at the 2023 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO GI). Instead of radiation therapy or chemotherapy, the patients received immunotherapy with checkpoint inhibitors. It should be noted that the patients were treated outside of clinical trials. The overall response rate in this patient group was 74%, with 57% of those who responded experiencing complete tumor regression. Some of the patients have been in complete remission for a year or more after their diagnoses. The data indicate that immunotherapy is an effective treatment for patients who are unable to undergo surgery for a variety of reasons, including advanced age or a variety of health issues.

The assessment of response to radiation-based therapies can be complicated by persistent or changing imaging features, and this field of study is still in active development even though imaging-based response assessment systems have been validated for the evaluation of response to ablative locoregional therapies. Research is still needed to address the shortcomings of current imaging criteria for evaluating tumor response to these novel techniques, despite the increased application of radiation-based local-regional therapies for the treatment of HCC following technological advancements and a better understanding of tumor biology.

The adenoviral vector–based gene therapy contains the gene for interferon alfa-2b. It is administered by catheter into the bladder once every three months. The virus penetrates the bladder endothelial cells and releases the gene, which is incorporated by the cells. As a result, the cells begin secreting high levels of the cancer-fighting interferon.

In an analysis of 19 studies across 12 countries involving more than 25,000 participants, individuals in highest 20% bracket for omega 3 levels had 13% less risk for developing CKD compared with participants in the lowest 20% bracket. Results were consistent and independent of subgroup variables of age, GFR, hypertension, CAD, and diabetes.

Updated recommendations include EGD with multiple duodenal biopsies, setting intestinal healing as the goal for gluten-free diet, and use of gluten-free oats in some populations. There wasn’t evidence to support routine use of probiotics or use of gluten detection devices.

On exam, this 19-year-old woman has malar rash characterized by pink-violet papules and plaques with no other physical finding. ANA is positive and urinalysis is remarkable for 3+ blood and protein. What test is the most appropriate next step?