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Journal of Clinical Gastroenterology

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https://www.readbyqxmd.com/read/29112048/results-of-a-community-based-randomized-study-comparing-a-clear-liquid-diet-with-a-low-residue-diet-using-a-magnesium-citrate-preparation-for-screening-and-surveillance-colonoscopies
#1
Chandrashekhar Thukral, Sumeet K Tewani, Adam J Lake, Aaron J Shiels, Kathy Geissler, Sara Popejoy, Megan Stafford, Joseph J Vicari
BACKGROUND: Current bowel preparations for colonoscopy include a clear liquid diet (CLD) along with consumption of a laxative. This dietary restriction along with large volume bowel preparations are barriers to compliance and willingness among patients in scheduling screening examinations. The aim of our study was to compare the efficacy and tolerability of a low-volume split dose magnesium citrate bowel preparation in patients on a low-residue diet (LRD) with those on a CLD. METHODS: In this single center, single blinded, randomized controlled trial, patients scheduled for outpatient colonoscopies were assigned to either a CLD or a LRD 1 day before the examination...
November 3, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29099467/genotype-phenotype-associations-of-apc-mutations-with-pouch-adenoma-in-patients-with-familial-adenomatous-polyposis
#2
Revital Kariv, Guy Rosner, Naomi Fliss-Isakov, Nathan Gluck, Adam Goldstein, Hagit Tulchinsky, Shira Zelber-Sagi
BACKGROUND: Patients with familial adenomatous polyposis (FAP) may carry various adenomatous polyposis coli (APC) mutations. However, genotype-phenotype correlation for APC mutations is still debated and is yet to be evaluated with regard to pouch polyp formation. OBJECTIVE: To evaluate the association between APC mutation type and exon location and the outcome of pouch adenoma. DESIGN SETTING AND PATIENTS: Forty-five FAP patients with defined pathogenic APC mutations, who underwent total proctocolectomy and ileal pouch anal anastomosis were classified by mutation type and location...
November 3, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29099466/association-of-proton-pump-inhibitor-use-with-serum-biomarkers-of-inflammation-insulin-resistance-cardiovascular-risk-and-renal-function
#3
Gregory L Austin, Jennifer R Weiskopf, Jennifer L Czwornog
BACKGROUND AND GOALS: Proton pump inhibitor (PPI) use has been associated with cardiovascular disease, chronic kidney disease, and dementia. Prior studies did not account for key confounders and little is known about the association of PPIs with serum biomarkers of inflammation, insulin resistance, cardiovascular risk, and renal function. Our aims were to investigate differences in these biomarkers between PPI users and nonusers. METHODS: Our data are from the National Health and Nutrition Examination Survey (NHANES), a complex cross-sectional multistage probability sample of the US civilian population...
November 3, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29099464/physical-activity-protects-against-the-risk-of-erosive-esophagitis-on-the-basis-of-body-mass-index
#4
Jeung Hui Pyo, Ji Won Kim, Tae Jun Kim, Hyuk Lee, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Sin-Ho Jung, Kyeong Min Cha, Mira Kang, Jee Eun Kim, Yoon-Ho Choi, Jae J Kim
GOAL: To determine whether physical activity lowers the risk for erosive esophagitis on the basis of body mass index (BMI). BACKGROUND: Although previous studies have shown that physical activity is closely associated with erosive esophagitis, these data may be confounded by obesity. STUDY: In this retrospective study, we included 182,409 patients who underwent an upper endoscopy and were diagnosed with erosive esophagitis. The impact of the amount and intensity of physical activity on the risk for erosive esophagitis was analyzed based on BMI groups...
November 3, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29099463/associations-of-insulin-resistance-and-glycemia-with-liver-enzymes-in-hispanic-latino-youths-results-from-the-hispanic-community-children-s-health-study-study-of-latino-youth-sol-youth
#5
Christina M Parrinello, Bryan J Rudolph, Mariana Lazo, Linda C Gallo, Bharat Thyagarajan, Scott J Cotler, Qibin Qi, Tossaporn Seeherunvong, Denise C Vidot, Howard D Strickler, Robert C Kaplan, Carmen R Isasi
BACKGROUND: Associations of insulin resistance and hyperglycemia with a panel of liver enzymes have not been well studied in a young, heterogenous Hispanic/Latino population. We aimed to assess the associations of insulin resistance and glycemia with nonalcoholic fatty liver disease (NAFLD), as measured by liver enzymes and the pediatric NAFLD fibrosis index (PNFI), and whether these associations are modified by body mass index and mediated by inflammation or endothelial dysfunction. MATERIALS AND METHODS: We conducted a cross-sectional study of 1317 boys and girls aged 8 to 16 years from the Hispanic Community Children's Health Study/Study of Latino Youth...
November 3, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29099465/management-of-chronic-hepatitis-c-in-end-stage-renal-disease
#6
Veronica Angulo-Diaz, Joseph K Lim, Paul Martin, AnnMarie Liapakis
Treatment for chronic viral hepatitis C has advanced dramatically to current standard of care all-oral direct-acting antiviral regimens with relatively short treatment duration and high efficacy. Patients with comorbid end-stage renal disease have constituted a "special patient population" with data and treatment options lagging behind that of the broader population of patients with chronic hepatitis C until recently. Herein we review the current evidence base for direct-acting antiviral therapy in this population...
November 2, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095426/eus-guided-choledochoduodenostomy-versus-hepaticogastrostomy-a-systematic-review-and-meta-analysis
#7
Ricardo S Uemura, Muhammad Ali Khan, José P Otoch, Michel Kahaleh, Edna F Montero, Everson L A Artifon
BACKGROUND AND AIMS: Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as an alternative in cases of endoscopic retrograde cholangiopancreatography (ERCP) failure. Two types of EUS-BD methods for achieving biliary drainage when ERCP fails are choledochoduodenostomy (CDS) or hepaticogastrostomy (HGS). However, there is no consensus if one approach is better than the other. Therefore, we conducted a systematic review and meta-analysis to evaluate these 2 main EUS-BD methods...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095425/are-triglycerides-the-cause-or-simply-the-effect-of-worsening-acute-pancreatitis-severity
#8
(no author information available yet)
No abstract text is available yet for this article.
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095424/preventing-hospitalization-in-mild-acute-pancreatitis-using-a-clinical-pathway-in-the-emergency-department
#9
Darshan Kothari, Matthew Babineau, Matthew Hall, Steven D Freedman, Nathan I Shapiro, Sunil G Sheth
GOALS: We created an observation pathway with close outpatient follow-up for patients with mild acute pancreatitis (AP) to determine its effect on admission rates, length of stay (LOS), and costs. BACKGROUND: AP is a common reason for hospitalization costing $2.6 billion annually. Majority have mild disease and improve quickly but have unnecessarily long hospital stays. STUDY: We performed a pilot prospective cohort study in patients with AP at a tertiary-care center...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095423/association-of-statins-with-decreased-acute-pancreatitis-severity-a-propensity-score-analysis
#10
Peter J Lee, Kunjam Modha, Tiffany Chua, Amitabh Chak, Daniel Jang, Rocio Lopez, Amir Gougol, Georgios I Papachristou, Tyler Stevens
BACKGROUND: Statins possess anti-inflammatory properties and have a protective effect in certain inflammatory conditions; however, their effect on the natural history of pancreatitis is unknown. AIM: The aim of this study is to assess the effect of statin exposure on the severity of pancreatitis and incidence of organ failure using a propensity-matched approach. METHODS: A historical cohort study was conducted of adult patients with acute pancreatitis (AP) admitted in the Cleveland Clinic Health System between 2007 and 2014...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095422/roles-of-high-resolution-manometry-in-predicting-incomplete-bolus-transit-in-patients-with-dysphagia
#11
Zhaohong Shi, Jie Guo, John Clarke, Haifeng Jin, Xinjun Wang, Nina Zhang, Ellen Stein, Sameer Dhalla, Pankaj J Pasricha, Jiande D Z Chen
BACKGROUND: High-resolution manometry (HRM) is used to assess esophageal motility diseases. Abnormalities in a number of HRM parameters have been reported in patients with dysphagia. However, it is unclear whether some of abnormal HRM parameters are predictive of dysphagia. The aim of this retrospective study was to investigate the roles of HRM parameters in predicting incomplete bolus clearance (IBC) in patients with dysphagia using high-resolution impedance manometry. METHODS: A total of 644 wet swallows were reviewed and analyzed in 63 patients with symptoms of dysphagia or reflux who underwent a clinical high-resolution impedance manometry test...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095421/modern-management-of-pancreatic-fluid-collections
#12
Iman Andalib, Enad Dawod, Michel Kahaleh
The last decade has seen dramatic shift in paradigm in the management of pancreatic fluid collections with the rise of endoscopic therapy over radiologic or surgical management. Endosonographic drainage is now considered the gold standard therapy for pancreatic pseudocyst. Infected pancreatic necroses are being offered endoscopic necrosectomy that has been facilitated by the arrival on the market of large diameter lumen-apposing metal stent. Severe pancreatitis or failure to thrive should receive enteral nutrition while pancreatic ductal disruption or strictures are best treated by pancreatic stenting...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095420/rates-of-duodenal-biopsy-during-upper-endoscopy-differ-widely-between-providers-implications-for-diagnosis-of-celiac-disease
#13
Max Pitman, David S Sanders, Peter H R Green, Benjamin Lebwohl
GOAL: The goal of this study is to determine factors associated with performance of duodenal biopsy during upper endoscopy. BACKGROUND: Celiac disease (CD) prevalence approaches 1% in the United States and Europe, yet CD remains underdiagnosed, in part because of low rates of duodenal biopsy during upper endoscopy. We aimed to identify patient and provider factors associated with performance of duodenal biopsy during upper endoscopy. STUDY: In our hospital-based endoscopy suite, we identified all patients not previously diagnosed with CD who underwent upper endoscopy during a 5-year period for one of the following indications: abdominal pain/dyspepsia, gastroesophageal reflux (GERD), anemia/iron deficiency, diarrhea, and weight loss...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095419/emergency-department-burden-of-nausea-and-vomiting-associated-with-cannabis-use-disorder-us-trends-from-2006-to-2013
#14
Andrea Bollom, Jasmine Austrie, William Hirsch, Judy Nee, Daniel Friedlander, Johanna Iturrino, Sarah Ballou, Anthony Lembo
BACKGROUND AND AIMS: Chronic cannabis use is associated with nausea and vomiting that may lead to emergency department (ED) visits, multiple diagnostic tests, and procedures. The aim of this study was to analyze recent trends in ED visits for vomiting associated with cannabis use disorder between 2006 and 2013. METHODS: Data were obtained from the National Emergency Department Sample records in which vomiting (ICD-9-CM codes 787.01, 787.03, and 536.2) was a primary diagnosis in combination with cannabis abuse or dependence (304...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095418/racial-disparities-in-the-presentation-and-treatment-of-colorectal-cancer-a-statewide-cross-sectional-study
#15
Eduardo A Rodriguez, Leonardo Tamariz, Ana Palacio, Hua Li, Daniel A Sussman
BACKGROUND: Non-Hispanic blacks (NHB) and Hispanics often present with advanced colorectal cancer (CRC). The aim of the study was to characterize CRC differences among Hispanics, NHB, and non-Hispanic whites (NHW). METHODS: A cross-sectional analysis and logistic regression of 2009 Florida Agency for Healthcare Administration Hospital Admission Database data for CRC using the International Classification of Diseases, 9th Revision, Clinical Modification codes was performed...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095417/a-web-based-multimedia-program-before-colonoscopy-increased-knowledge-and-decreased-anxiety-sedation-requirement-and-procedure-time
#16
Siddhartha Parker, Jonathan Zipursky, Helen Ma, Geri-Lynn Baumblatt, Corey A Siegel
GOALS: Assess the impact of a web-based multimedia patient engagement program on patient anxiety, perception and knowledge about the colonoscopy in addition to procedure outcomes. BACKGROUND: The success of patients coming for a colonoscopy for colorectal cancer screening is dependent in part on patients' understanding of the preparation and of the procedure. Patients were randomized to use either our institution's standard preprocedure colonoscopy packet or a web-based multimedia patient engagement program (Emmi Solutions) before their scheduled procedure...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29095416/rolling-out-screening-volume-affecting-compliance-rate-and-waiting-time-of-fit-based-colonoscopy
#17
Hsiao-Hsuan Jen, Chen-Yang Hsu, Sam Li-Sheng Chen, Amy Ming-Fang Yen, Sherry Yueh-Hsia Chiu, Jean Ching-Yuan Fann, Yi-Chia Lee, Ming-Shiang Wu, Wen-Feng Hsu, Szu-Min Peng, Hsiu-Hsi Chen, Han-Mo Chiu
BACKGROUND AND STUDY AIMS: The population-based colorectal cancer screening program with fecal immunochemical test (FIT) from the inaugural period to the rolling-out period may create a higher demand for colonoscopies, but such a change has not been quantified. We intended to assess the change in the compliance rate and the waiting time (WT) for a colonoscopy and the associated geographic and institutional variations across the 2 periods. MATERIALS AND METHODS: Data from the Taiwanese nationwide colorectal cancer screening program were analyzed...
October 31, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29087991/pancreatic-cystic-lesions-new-endoscopic-trends-in-diagnosis
#18
Filipe Vilas-Boas, Guilherme Macedo
The diagnosis of incidental pancreatic cystic lesions is increasing in the general population because of the routine use of cross-sectional imaging modalities. Not all cysts are neoplastic, and the majority of cystic neoplasms have a low overall likelihood of progression to malignancy. Current management is based on imaging and cyst fluid analysis, but we are not able to diagnose the specific type of cyst and its malignant potential in a significant number of patients. Better diagnostic tools are required to avoid unnecessary surgical resections that carry an important risk of morbidity and mortality...
October 30, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29076882/the-gastric-acid-pocket-or-coat-and-its-attenuation-in-helicobacter-pylori-infected-subjects
#19
Kenneth E L McColl
In 2001, it was observed that the cardia region of the lumen of the stomach remained highly acidic after a meal and escaped the buffering effect of the food. This phenomenon was termed the acid pocket and is thought to explain why reflux symptoms occur after meals despite the buffering effect of food. This review describes the discovery of the acid pocket and our progress in understanding the intragastric physiology producing it, its exaggeration in hiatus hernia and role in reflux disease. The recent discovery that the acid pocket is attenuated in the Helicobacter pylori-infected population and the significance of this to the negative association between H...
October 25, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29035976/the-impact-of-obesity-on-mortality-and-other-outcomes-in-patients-with-nonvariceal-upper-gastrointestinal-hemorrhage-in-the-united-states
#20
Marwan S Abougergi, Heather Peluso, Chebli Mrad, John R Saltzman
GOALS: To quantify in patients with nonvariceal upper gastrointestinal hemorrhage (NVUGIH) the relationship between obesity and mortality, disease severity, treatment modalities, and resource utilization. BACKGROUND: NVUGIH is the most common gastrointestinal emergency. STUDY: Adults with a principal diagnosis of NVUGIH were selected from the 2014 National Inpatient Sample. The primary outcome was in-hospital mortality. Secondary outcomes were hemorrhagic shock, prolonged mechanical ventilation (PMV), upper endoscopy [esophagogastroduodenoscopy (EGD)], radiologic treatment, surgery, length of hospital stay (LOS), and total hospitalization costs and charges...
October 13, 2017: Journal of Clinical Gastroenterology
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