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Journal of Clinical Gastroenterology

Brett E Fortune, Guadalupe Garcia-Tsao, Maria Ciarleglio, Yanhong Deng, Michael B Fallon, Samuel Sigal, Naga P Chalasani, Joseph K Lim, Adrian Reuben, Hugo E Vargas, Gary Abrams, Michele D Lewis, Tarek Hassanein, James F Trotter, Arun J Sanyal, Kimberly L Beavers, Daniel Ganger, Paul J Thuluvath, Norman D Grace, Roberto J Groszmann
GOALS/BACKGROUND: Data on acute variceal hemorrhage (AVH) in the United States is limited and the best method to stratify risk is not clear. Taking advantage of a prospective US cohort study, we aimed to (1) describe clinical outcomes of AVH and their predictors; (2) compare predictors of 6-week mortality. STUDY: Prospective 15-center US cohort of patients with cirrhosis presenting with endoscopically proven AVH, all of whom received antibiotics, vapreotide (a somatostain analog) infusion and endoscopic band ligation...
October 24, 2016: Journal of Clinical Gastroenterology
Adrianne Tsen, Yasmin Alishahi, Laura Rosenkranz
Autoimmune pancreatitis (AIP) occurring in association with inflammatory bowel disease (IBD) is rather rare and carries a worse prognosis and greater disease severity compared with IBD alone. Although it is an infrequently documented association, progress over the last 20 years has led to better understanding of the association between AIP and IBD. IBD has a stronger association with type 2 than with type 1 AIP. Clinical and histologic features of AIP-IBD more often reveal features of type 2 AIP. Imaging is not helpful in facilitating the diagnosis of AIP and IBD...
October 24, 2016: Journal of Clinical Gastroenterology
Hyungchul Park, Ji Yong Ahn, Hwoon-Yong Jung, Joo Hyun Chun, Kwangwoo Nam, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Jin-Ho Kim
BACKGROUND: Gastric bleeding is not rare and difficult to treat in gastric cancer patients. We investigated whether this affects survival and if successful bleeding control improves the prognosis. PATIENTS/MATERIAL AND METHODS: We retrospectively reviewed medical records for 64 subjects who underwent endoscopic therapy for gastric cancer bleeding at Asan Medical Center from January 2012 to December 2014 (bleeding group). Each subject was matched 1:2 by age, sex, and American Joint Committee on Cancer staging with 128 randomly selected patients treated for stomach cancer during the same period (control group)...
October 21, 2016: Journal of Clinical Gastroenterology
Jasper L A Vleugels, Joep E G IJspeert, Yark Hazewinkel, Manon van der Vlugt, Paul Fockens, Lianne Koens, Evelien Dekker
BACKGROUND: Optical diagnosis of diminutive (1 to 5 mm) polyps could result in a more cost-effective colonoscopy practice. Previous optical diagnosis studies did not incorporate the differentiation of sessile serrated polyps (SSPs). This study aimed to evaluate the impact of optical diagnosis of diminutive SSPs on the overall performance of endoscopic polyp differentiation in daily colonoscopy practice. METHODS: Endoscopy data were prospectively collected between 2011 and 2014 in a colonoscopy center...
October 21, 2016: Journal of Clinical Gastroenterology
Brian E Lacy, Michael D Crowell, Carole Mathis, David Bauer, Leslie J Heinberg
BACKGROUND AND AIMS: Gastroparesis (GP) patients suffer from recurrent symptoms of nausea, vomiting, early satiety, and abdominal pain. The impact of GP on quality of life (QoL), health care utilization and daily activities is not well understood. MATERIALS AND METHODS: Part 1: 398 adult patients (≥18 y) with documented GP (symptoms >6 mo) were surveyed to assess QoL and pain using the Short Form 36 and McGill pain questionnaires. Part 2: 491 adult GP patients were surveyed to evaluate employment status, work and daily activities, medication use, physician visits, diagnostic testing, emergency room visits, and hospitalizations related to their GP symptoms...
October 21, 2016: Journal of Clinical Gastroenterology
Jana G Hashash, Claudia Ramos-Rivers, Ada Youk, Wai Kan Chiu, Kyle Duff, Miguel Regueiro, David G Binion, Ioannis Koutroubakis, Ashley Vachon, David Benhayon, Michael A Dunn, Eva M Szigethy
BACKGROUND: Fatigue is common in inflammatory bowel disease (IBD) patients and is associated with factors such as psychopathology, sleep quality, and disease activity. GOAL: To investigate the combined role of all the above factors in the burden of fatigue among IBD patients. STUDY: We conducted an observational study of adult patients enrolled in an IBD clinical research registry at a tertiary care clinic. Fatigue burden was defined by Item 1 of the Short-form IBD Questionnaire (SIBDQ), which is scored on a 7-point Likert scale...
October 21, 2016: Journal of Clinical Gastroenterology
Marc Russo, Willem Volschenk, Alan Nazha, Danielle Santarelli
No abstract text is available yet for this article.
October 21, 2016: Journal of Clinical Gastroenterology
Erwin Santo, Anna Itshak, Liat Mlynarsky, Moshe Leshno, Nathan Gluck
BACKGROUND: Biliary strictures (BS) are a common complication of liver transplantation. The standard treatment is sequential insertion of increasing numbers of plastic stents by endoscopic retrograde cholangiopancreatography (ERCP). Despite high success rates, some strictures fail to resolve and require surgery as definitive treatment. GOALS: To identify predictors of response or failure of standard endoscopic treatment, allowing earlier referral to alternative modalities when needed and avoiding unnecessary procedures...
October 21, 2016: Journal of Clinical Gastroenterology
Alejo Mancebo, María Luisa González-Diéguez, Carmen A Navascués, Valle Cadahía, María Varela, Ramón Pérez, Luis Rodrigo, Manuel Rodríguez
BACKGROUND: Patient adherence to screening for hepatocellular carcinoma (HCC) is not well known. Our aims were to analyze the adherence to a surveillance program in a prospective cohort of cirrhotic patients and to examine its association with HCC stage at diagnosis. MATERIALS AND METHODS: A total of 770 patients with cirrhosis were examined semiannually by ultrasound and alpha-fetoprotein at a tertiary center. We collected data on 17 variables at baseline. Suboptimal adherence was defined as failure to complete 2 consecutive screening rounds...
October 21, 2016: Journal of Clinical Gastroenterology
Yaron Niv, Eyal Gal, Violeta Gabovitz, Marcela Hershkovitz, Lev Lichtenstein, Irit Avni
BACKGROUND AND THE STUDY AIM: Crohn's disease (CD) is a chronic inflammatory disorder defined as a transmural inflammation of the bowel wall, affecting the small and large intestine. The Capsule Endoscopy Crohn's Disease Activity Index (CECDAI or Niv score) was devised to measure mucosal disease activity. We extended the Niv score to the colon and have a comprehensive view of the whole intestine. METHODS: We evaluated 3 parameters of intestinal pathology: A, Inflammation; B, Extent of disease; C, Presence of strictures...
October 7, 2016: Journal of Clinical Gastroenterology
Yoon Suk Jung, Nam Hee Kim, Seungho Ryu, Jung Ho Park, Dong Il Park, Chong Il Sohn
GOALS: We aimed to ascertain whether low relative muscle mass is associated with colorectal neoplasm (CRN) risk. BACKGROUND: CRN and sarcopenia have common pathophysiological mechanisms such as insulin resistance, chronic inflammation, and physical inactivity. However, the direct relationship between the 2 diseases has not been investigated. STUDY: A cross-sectional study was performed on 81,885 examinees who underwent colonoscopy as part of a health check-up...
October 4, 2016: Journal of Clinical Gastroenterology
Shria Kumar, Frank Gress, Peter H Green, Benjamin Lebwohl
No abstract text is available yet for this article.
October 4, 2016: Journal of Clinical Gastroenterology
Deepanshu Jain, Ejaz Mahmood, Shashideep Singhal
Benign intestine strictures secondary to postoperative narrowing or inflammatory bowel disease can be managed surgically or conservatively. Some patients may not be suitable surgical candidates and some patients may choose not to have repeat surgery. Biodegradable (BD) stents offer a prolonged dilatory effect before gradual degradation and obviates the need of a second procedure for stent removal. BD stents have high technical success rates (mean, 94.4%; median, 100%; range, 86% to 100%) but widely variable clinical success rates (range, 45% to 100%)...
October 4, 2016: Journal of Clinical Gastroenterology
Michele Limoges-Gonzalez, Amar Al-Juburi
Anal squamous cell cancer (SCC) is a relatively uncommon cancer in the United States. Anal SCC has long been associated with human immunodeficiency virus (HIV) positivity and/or men who have sex with men. The incidence of anal SCC has been increasing in both genders regardless of HIV status. Few clinicians are aware that white women, when not controlling for gender and sexual preference together, have the highest incidence of anal SCC. Anal intraepithelial neoplasia (AIN), dysplastic cells of the anal canal due to human papilloma virus infection, is believed to be the precursor to anal SCC...
October 4, 2016: Journal of Clinical Gastroenterology
Alan N Barkun, Viviane Adam, Yidan Lu, Yen-I Chen, Myriam Martel
GOALS: We compared the cost-effectiveness of traditional recommended endoscopic hemostatic therapies and Hemospray alone or in combination when treating nonvariceal upper gastrointestinal bleeding (NVUGIB). BACKGROUND: Hemospray (TC-325) is a novel endoscopic hemostatic powder, achieving hemostasis through adherence to actively bleeding biological surfaces. STUDY: A decision tree of patients with NVUGIB assessed 4 possible treatment strategies: traditional therapy alone (T), Hemospray alone (H), traditional therapy completed by Hemospray if needed (T+H), or Hemospray completed by traditional therapy if needed (H+T)...
October 4, 2016: Journal of Clinical Gastroenterology
Thomas R McCarty, Mena Bakhit, Mayra Sanchez, Tarun Rustagi
No abstract text is available yet for this article.
September 28, 2016: Journal of Clinical Gastroenterology
Patrícia Andrade, Fernando Príncipe, Guilherme Macedo
No abstract text is available yet for this article.
September 28, 2016: Journal of Clinical Gastroenterology
Jonah Cohen, Douglas Grunwald, Laurie B Grossberg, Mandeep S Sawhney
BACKGROUND: Although colonoscopy with polypectomy can prevent up to 80% of colorectal cancers, a significant adenoma miss rate still exists, particularly in the right colon. Previous studies addressing right colon retroflexion have revealed discordant evidence regarding the benefit of this maneuver on adenoma detection with concomitant concerns about safety and rates of maneuver success. In this meta-analysis, we sought to determine the effect of right colon retroflexion on improving adenoma detection compared with conventional colonoscopy without retroflexion, as well as determine the rates of retroflexion maneuver success and adverse events...
September 28, 2016: Journal of Clinical Gastroenterology
Thomas M Runge, Swathi Eluri, Cary C Cotton, Caitlin M Burk, John T Woosley, Nicholas J Shaheen, Evan S Dellon
GOALS: To characterize patients who suffer perforation in the context of eosinophilic esophagitis (EoE) and to identify predictors of perforation. BACKGROUND: Esophageal perforation is a serious complication of EoE. MATERIALS AND METHODS: We conducted a retrospective cohort study of the University of North Carolina EoE clinicopathologic database from 2001 to 2014. Subjects were included if they had an incident diagnosis of EoE and met consensus guidelines, including nonresponse to a PPI trial...
September 27, 2016: Journal of Clinical Gastroenterology
Fernando Azpiroz, Laura Molne, Sara Mendez, Adoración Nieto, Chaysavanh Manichanh, Marianela Mego, Anna Accarino, Javier Santos, Manuela Sailer, Stephan Theis, Francisco Guarner
GOAL: To determine the effect of a prebiotic chicory-derived inulin-type fructan on the tolerance of intestinal gas. BACKGROUND: Subjects with gas-related complaints exhibit impaired handling of intestinal gas loads and we hypothesized that inulin would have a beneficial effect. STUDY: Placebo-controlled, parallel, randomized, double-blind trial. Subjects with abdominal symptoms and reduced tolerance of intestinal gas (selected by a pretest) received either inulin (8 g/d, n=18) or maltodextrin as a placebo (8 g/d, n=18) for 4 weeks...
September 27, 2016: Journal of Clinical Gastroenterology
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