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Background and Aim: Early endoscopic intervention reduces morbidity and mortality for patients with high-risk gastrointestinal hemorrhage and gallstones causing pancreatitis or ascending cholangitis. For low-risk bleeds ‘after-hours’ endoscopy services allow risk stratification and early, safe discharge leading to reduced length of stay. Recognized standards for these services include availability of endoscopically trained medical and nursing staff, access to a specialized endoscopy unit and full availability of the service. The aim of the present study was to assess ‘after-hours’ endoscopy services at Australian teaching hospitals using the British Society of Gastroenterology (BSG) criteria. Methods: A standardized questionnaire based on the BSG guidelines was developed. The Gastroenterology Society of Australia provided a list of accredited sites for gastroenterology training. An advanced gastroenterology trainee at each hospital was interviewed by telephone. Results: Thirty-four centers (100%) provided complete data. Gastroscopy, colonoscopy and endoscopic retrograde cholangiopancreatography were provided in 100, 58 and 84% of centers, respectively. The operation suite followed by endoscopy unit was the most frequently used site. However, one-third of centers performed procedures at the bedside, including the emergency department or ward. Support staff were not consistently trained endoscopically and, in 15 centers (44%), the advanced trainees participated in the ‘on call’ roster with a consultant present for the procedure, although this was not consistently the case. Conclusions: Most Australian hospitals offer comprehensive emergency endoscopy services. However, few centers fulfill all BSG recommendations. The registrar training and patient safety implications of emergency endoscopic services need to be considered in the light of these findings. [ABSTRACT FROM AUTHOR]

The authors talk about a study of coeliac disease undertaken in Australia. The screening strategy used in the study involved immunoglobulin A (IgA) and IgG anti-tissue transglutaminase (anti-tTG) antibody assays. According to the authors, genetic and environmental factors are important in the origin of the disease. Factors that should raise suspicion of the presence of CD and prompt testing are mentioned. The authors cite the most appropriate strategy for general practitioners.

The article discusses the role of general practitioners in the management of hepatitis C virus (HCV) and in informing patients on the role of alcohol in the progression of the disease. It explains that general practitioners can help patients with HCV in making cost-effective approach to the disease's management.