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Background/Aims: Sedation rates may vary among countries, depending on patients’ and endoscopists’ preferences. The aim of this survey was to investigate the rate of using premedication for routine diagnostic upper gastrointestinal (UGI) endoscopy in endoscopy societies, members of the European Society of Gastrointestinal Endoscopy (ESGE). Methods: We evaluated a multiple-choice questionnaire which was e-mailed to representatives of national endoscopy societies, which are members of the ESGE. The questionnaire had 14 items referring to endoscopy practices in each country and the representatives’ endoscopy units. Results: The response rate was 76% (34/45). In 47% of the countries, less than 25% of patients undergo routine diagnostic UGI endoscopy with conscious sedation. In 62% of the responders’ endoscopy units, patients are not asked their preference for sedation and do not sign a consent form (59%). Common sedatives in use are midazolam (82%), diazepam (38%) or propofol (47%). Monitoring equipment is not available ‘in most of the endoscopy units’ in 46% (13/28) of the countries. Though they were available in 91% of the national representatives’ endoscopy units, they are rarely (21%) used to monitor unsedated routine diagnostic UGI endoscopy. Conclusions: In about 50% of ESGE-related countries, less than 25% of patients are sedated for routine diagnostic UGI endoscopy. Major issues to improve include availability of monitoring equipment and the use of a consent form.

A significant decrease in hepatitis B virus infection and an increase in hepatitis A virus infection have occurred since the earlier study was performed in 1983. The decrease in hepatitis B virus infection is attributable to the steep decrease in hepatitis B virus infection among children that resulted from the universal hepatitis B virus immunization of infants that was initiated in 1991. The increase in clinical hepatitis A virus infection occurred in older patients and could be attributed to improved sanitation that delayed individuals' initial exposures to the virus.

Reduced expression of MMR genes seems to play an important role in HCV-associated HCC. hPMS2 is likely involved at an early stage of hepatocarcinogenesis since it was detected in normal adjacent tissues. Reduced expression of hPMS2 provides a growth advantage and stimulates proliferation which encourages malignant transformation in non-cirrhotic HCV-infected patients via acquisition of more genetic damages.