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Hepatitis B virus (HBV) infection is the most common chronic viral infection in the world. Despite the availability of a preventative vaccine, more than 250 million people worldwide are chronically infected with HBV. The complications of chronic HBV infection—cirrhosis and hepatocellular cancer (HCC)—account for more than 850,000 deaths per year. HBV is transmitted haematogenously and sexually, with the majority of HBV infections being transmitted vertically (or perinatally) in high prevalence regions. HBV infection acquired at birth or in early childhood results in chronicity in >95% of cases, whereas only 5–10% of those who are infected in adulthood will progress to chronic infection. 

Mistakes in chronic hepatitis B management and how to avoid them

Mistakes in chronic hepatitis B management and how to avoid them

Patrick Kennedy, Upkar S. Gill

Topics

Hepatobiliary

Citation

Gill US and Kennedy PTF. Mistakes in chronic hepatitis B management and how to avoid them. UEG Education 2019; 19: 22–24 

Published

2019
UEG Mistakes In Articles
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Ulcerative colitis (UC) is a lifelong inflammatory bowel disease (IBD) of unknown origin characterized by alternating flare and remission periods. An acute severe episode, so-called acute severe UC (ASUC), may happen in approximately one-quarter of patients during their life.1 Notably, more than 25% of ASUC episodes correspond to the index presentation of the disease. Patients with ASUC should be promptly identified by the modified Truelove and Witts criteria recommended by the most recent international guidelines and admitted rapidly to a digestive unit. Indeed, ASUC is a life-threatening condition still leading to a 1% death rate in Western countries. In the current article, we will discuss the most frequent and/or relevant mistakes in managing patients admitted for an ASUC episode and how to avoid them. The manuscript is based on the available evidence and expert opinion when evidence is lacking.

Mistakes in acute severe ulcerative colitis and how to avoid them

Mistakes in acute severe ulcerative colitis and how to avoid them

David Laharie

Topics

IBD

Citation

David Laharie. Mistakes in acute severe ulcerative colitis and how to avoid them. UEG Education 2023; 23: 19-21.

Published

2023
UEG Standards and Guidelines
Clinical Practice Guideline
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Abstract

This Technical and Technology Review from the European Society of Gastrointestinal Endoscopy (ESGE) represents an update of the previous document on the technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including the available types of needle, technical aspects of tissue sampling, new devices, and specimen handling and processing. Among the most important new recommendations are:

ESGE recommends end-cutting fine-needle biopsy (FNB) needles over reverse-bevel FNB or fine-needle aspiration (FNA) needles for tissue sampling of solid pancreatic lesions; FNA may still have a role when rapid on-site evaluation (ROSE) is available.

ESGE recommends EUS-FNB or mucosal incision-assisted biopsy (MIAB) equally for tissue sampling of subepithelial lesions ≥20 mm in size. MIAB could represent the first choice for smaller lesions (<20 mm) if proper expertise is available.

ESGE does not recommend the use of antibiotic prophylaxis before EUS-guided tissue sampling of solid masses and EUS-FNA of pancreatic cystic lesions.

Endoscopic ultrasound-guided tissue sampling: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review

Endoscopic ultrasound-guided tissue sampling: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review

Antonio Facciorusso

Publisher

European Society of Gastrointestinal Endoscopy logo
European Society of Gastrointestinal Endoscopy

Guideline

Clinical Practice Guideline

Topics

Endoscopy

Citation

Endoscopy 2025; 57(04): 390-418

Published

2025
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The complexity of managing inflammatory bowel disease (IBD) stems from the heterogeneity of Crohn’s disease and ulcerative colitis. This leads to differences in disease course, complications, and treatment responses among patients. Current treatment strategies rely on a trial-and-error approach, but there's a need for personalized therapy. Efforts have been made to develop reliable prognostic and predictive biomarkers to overcome disease heterogeneity. This article discusses common mistakes in biomarker development, interpretation, and application in IBD, emphasizing evidence-based insights and lessons learned from other fields.

Mistakes in biomarkers for IBD and how to avoid them

Mistakes in biomarkers for IBD and how to avoid them

James C. Lee, Chris Palmer-Jones

Topics

IBD

Citation

: Palmer-Jones C. and Lee J. C. Mistakes in biomarkers for IBD and how to avoid them. UEG Education 2023; 23: 8-11.

Published

2023
UEG Mistakes In Articles
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Jaundice can be caused by abnormalities in any of the steps comprising the formation, metabolism and excretion of bilirubin. In addition, these processes may be functioning properly, but jaundice can be seen because of an obstruction of the biliary tree at any point, from its intrahepatic origins to its end at the ampulla of Vater. For this reason, it is clear that numerous conditions can result in jaundice. When faced with a patient presenting with jaundice a reasonable and careful diagnostic approach is, therefore, warranted to elucidate the underlying cause of this sign. Conventional wisdom may be that “jaundice by itself never killed anyone,” but it is imperative to find the cause as soon as possible, as prompt intervention saves lives in many cases.

Mistakes in acute jaundice and how to avoid them

Mistakes in acute jaundice and how to avoid them

Spyridon Siakavellas, Georgios Papatheodoridis

Topics

Hepatobiliary

Citation

Siakavellas S and Papatheodoridis G. Mistakes in acute jaundice and how to avoid them. UEG Education 2018; 18: 24–26.

Published

2025
UEG Standards and Guidelines
Clinical Practice Guideline
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Summary

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease (NAFLD), is defined as steatotic liver disease (SLD) in the presence of one or more cardiometabolic risk factor(s) and the absence of harmful alcohol intake. The spectrum of MASLD includes steatosis, metabolic dysfunction-associated steatohepatitis (MASH, previously NASH), fibrosis, cirrhosis and MASH-related hepatocellular carcinoma (HCC). This joint EASL-EASD-EASO guideline provides an update on definitions, prevention, screening, diagnosis and treatment for MASLD. Case-finding strategies for MASLD with liver fibrosis, using non-invasive tests, should be applied in individuals with cardiometabolic risk factors, abnormal liver enzymes, and/or radiological signs of hepatic steatosis, particularly in the presence of type 2 diabetes (T2D) or obesity with additional metabolic risk factor(s). A stepwise approach using blood-based scores (such as FIB-4) and, sequentially, imaging techniques (such as transient elastography) is suitable to rule-out/in advanced fibrosis, which is predictive of liver-related outcomes. In adults with MASLD, lifestyle modification – including weight loss, dietary changes, physical exercise and discouraging alcohol consumption – as well as optimal management of comorbidities – including use of incretin-based therapies (e.g. semaglutide, tirzepatide) for T2D or obesity, if indicated – is advised. Bariatric surgery is also an option in individuals with MASLD and obesity. If locally approved and dependent on the label, adults with non-cirrhotic MASH and significant liver fibrosis (stage ≥2) should be considered for a MASH-targeted treatment with resmetirom, which demonstrated histological effectiveness on steatohepatitis and fibrosis with an acceptable safety and tolerability profile. No MASH-targeted pharmacotherapy can currently be recommended for the cirrhotic stage. Management of MASH-related cirrhosis includes adaptations of metabolic drugs, nutritional counselling, surveillance for portal hypertension and HCC, as well as liver transplantation in decompensated cirrhosis.

Source file

https://doi.org/10.1016/j.jhep.2024.04.031

EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)

EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD)

Publisher

European Association for the Study of the Liver logo
European Association for the Study of the Liver

Guideline

Clinical Practice Guideline

Topics

Hepatobiliary

Citation

Journal of Hepatology, Volume 81, Issue 3, 492 - 542

Published

2024
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Children and adolescents with chronic diseases requiring lifelong care face unique challenges that affect their daily lives and those of their families. Initially, these patients receive specialized care in pediatric facilities, where parents play a key role in treatment decisions. However, transitioning to adult healthcare facilities is inevitable, and this process, recognized as crucial years ago, involves moving adolescents with chronic conditions from child-centered to adult-oriented care. This transition can be complicated by varying age limits for pediatric care and the scarcity of adult care centers with specific expertise. The transition often requires cooperation between different centers or even countries due to patient mobility. The transition phase is critical, as it can lead to loss of follow-up, treatment suspension, and increased risks of complications or disease relapse. Beyond medical management, various factors influence the long-term prognosis of chronic conditions, making a well-organized transition program essential. While many hospitals have implemented transition models with mixed results in satisfaction, disease control, and follow-up adherence, there are frequent shortcomings in the process. This Mistakes In article will outline eight common mistakes made during the transition from pediatric to adult care, supported by literature and professional experience.

Mistakes in transitional care for children and young adults and how  to avoid them

Mistakes in transitional care for children and young adults and how to avoid them

Patrizia Burra, Hans Törnblom, Jorge Amil Dias, Moriam Mustapha

Topics

Primary Care

Citation

Jorge Amil-Dias, Hans Törnblom, Moriam Mustapha and Patrizia Burra. Mistakes in transitional care for children and young adults and how to avoid them. UEG Education 2023; 23: 22-25.

Published

2023

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