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Journal of Clinical Gastroenterology

José Tawil, Ronnie Fass
Globus is an area of interest for many medical specialists including otorhinolaryngologists, gastroenterologist, allergists, and psychiatrists. It may be caused by an organic disease, but it is not uncommon that an underlying etiology remains unidentified even after a full workup has been performed. Patients who suffer from globus usually visit several physicians from different specialties without finding a solution for their symptoms. Identifying the underlying cause of globus is not always a simple task; therefore, structural or functional abnormalities of the thyroid, larynx, pharynx, and esophagus should be investigated...
September 15, 2018: Journal of Clinical Gastroenterology
Daryl Ramai, Denzil Etienne, Gloria Ayide, Paul J Fields, Madhavi Reddy
PURPOSE: Initiatives by the Centers for Disease Control and Prevention as well as the National Colorectal Cancer Roundtable aim to increase the rate of colorectal cancer (CRC) screening. We assess individual and geographic characteristics associated fecal immunochemical test (FIT) CRC screening over 3 years. METHODS: This is a retrospective study of 1500 FIT kits which were mailed or opportunistically handed to eligible participants in Brooklyn, New York from January 2014 to December 2016...
September 15, 2018: Journal of Clinical Gastroenterology
Frank Lenze, Tobias Nowacki, Sabine Schöppner, Hansjörg Ullerich, Dominik Bettenworth, Paola Soriani, Tommaso Gabbani, Vincenzo G Mirante, Dirk Domagk, Mauro Manno, Philipp Lenz
BACKGROUND: Although bowel preparation before colonoscopy and capsule endoscopy is widely evaluated and usually follows established guidelines, a standard preparation regime for peroral small bowel enteroscopy is yet to be defined.The aim of the present study was to compare small bowel preparation with polyethylene glycol (PEG) and "fasting only" (FO) before peroral single-balloon enteroscopy (SBE). STUDY: We compared small bowel preparation with PEG versus "FO" for peroral SBE in a randomized European multicenter trial...
September 15, 2018: Journal of Clinical Gastroenterology
Elizabeth Danial, Shannon Fleck-Derderian, Philip Rosenthal
OBJECTIVES: Biliary atresia (BA) is a rare neonatal liver disease that causes cholestasis and is the leading indication for pediatric liver transplantation. Although the exact etiology of BA remains unknown, evidence from murine models supports the role of rotavirus infection in the development of BA. In 2006, universal rotavirus vaccination was implemented in the United States. The goal of this study was to determine if the prevalence of BA correlated with the number of annual rotavirus infections...
September 14, 2018: Journal of Clinical Gastroenterology
Elizabeth S Aby, Edward Lee, Satvir S Saggi, Matthew R Viramontes, Jonathan F Grotts, Vatche G Agopian, Ronald W Busuttil, Sammy Saab
BACKGROUND: Malnutrition and muscle wasting are common in patients with end-stage liver disease (ESLD), yet go underdiagnosed. Frequently used indices of nutritional status, such as body mass index, are inflated in patients with ESLD due to a fluid overloaded state. Previous work has demonstrated a strong association between psoas muscle area, a surrogate for sarcopenia, and worse survival following liver transplantation; however, the impact of sarcopenia on post liver transplant outcomes in patients with nonalcoholic steatohepatitis (NASH) cirrhosis has not been evaluated...
September 1, 2018: Journal of Clinical Gastroenterology
Joel H Rubenstein, Daniel McConnell, David G Beer, Amitabh Chak, Valbona Metko, Gregory Clines
BACKGROUND: Esophageal adenocarcinoma has been inversely associated with exposure to ultraviolet radiation. This could be because of vitamin D deficiency or hyperparathyroidism promoting gastroesophageal reflux disease (GERD) and Barrett's esophagus. AIM: The aim of this study is to determine the association between parathyroid hormone (PTH) and vitamin D deficiency with GERD symptoms, erosive esophagitis, and Barrett's esophagus. METHODS: We assayed banked serum for PTH and total 25-hydroxy vitamin D from a cross-sectional cohort...
September 1, 2018: Journal of Clinical Gastroenterology
Kishan Patel, Feng Li, Anjuli Luthra, Alice Hinton, Luis Lara, Royce Groce, Amy Hosmer, Sean T McCarthy, Sebastian Strobel, Darwin L Conwell, Somashekar G Krishna
GOALS AND BACKGROUND: In the elderly (age, 65 y or older), acute pancreatitis is most frequently because of gallstones; however, there is a paucity of national estimates evaluating outcomes of acute biliary pancreatitis (ABP). Hence, we utilized a representative population database to evaluate the outcomes of ABP among the elderly. STUDY: The National Readmission Database provides longitudinal follow-up of inpatients for 1 calendar-year. All adult inpatients (18 y or older) with an index primary admission for ABP between 2011 and 2014 were evaluated for clinical outcomes of mortality, severe acute pancreatitis (SAP), and 30-day readmission...
August 28, 2018: Journal of Clinical Gastroenterology
Zobair M Younossi, Maria Stepanova, Pegah Golabi, Robert S Epstein, Marcie E Strauss, Fatema Nader, Andrei Racila
BACKGROUND AND AIMS: Although relatively, primary biliary cholangitis (PBC) is an important cause of nonalcoholic chronic liver disease which may lead to liver transplantation. PBC patients with alkaline phosphatase (ALP) ≥1.5× the upper limit of normal (ULN) tend to have a more aggressive course. The study was designed to identify factors associated with ALP≥1.5×ULN or cirrhosis in PBC and to evaluate concomitant health care resource utilization. METHODS: We used a large real-world database that contained comprehensive and continuous electronic medical recored/claims data from over 500 health care practices or systems from the United States...
August 24, 2018: Journal of Clinical Gastroenterology
Emily B Hollister, Kevin C Cain, Robert J Shulman, Monica E Jarrett, Robert L Burr, Cynthia Ko, Jasmine Zia, Claire J Han, Margaret M Heitkemper
INTRODUCTION: Altered microbial diversity has been associated with gastrointestinal (GI) symptoms in persons with irritable bowel syndrome (IBS). Less is known about the relationship of microbiome with extraintestinal pain and psychological distress symptoms and quality of life (QOL) in persons with IBS. We aimed to evaluate the relationship of fecal microbiota to GI symptoms, stool consistency, psychological distress, extraintestinal pain, and QOL in participants meeting Rome III criteria for IBS...
August 24, 2018: Journal of Clinical Gastroenterology
Matthew S Chang, J Frank Wharam, Fang Zhang, Robert F LeCates, Emma Morton-Eggleston, Ruth E Tuomala, Anna E Rutherford, Muthoka L Mutinga, Karin L Andersson, Robert S Brown, Chinweike Ukomadu, Emily Oken
BACKGROUND: Hepatitis B virus (HBV) screening during pregnancy is standard of care to prevent vertical transmission to infants, yet the mothers themselves may not receive appropriate follow-up. GOALS: Using a national database, we sought to determine rates of maternal peripartum follow-up with a HBV specialist and identify factors associated with a lack of follow-up. MATERIALS AND METHODS: We identified women who delivered in 2000 to 2012 and were diagnosed with HBV according to International Classification of Diseases-9 codes using a national database (Optum) derived from commercial insurance claims with ∼46 million members ages 0 to 64 in all 50 states...
August 24, 2018: Journal of Clinical Gastroenterology
Lina Liu, Dongxia Hao, Wei Liu, Lianfu Wang, Xudong Wang
BACKGROUND: Compared with weekday admissions, weekend admissions are consistently associated with worse patient outcomes, known as the "weekend effect." The weekend effect may have adverse health consequences, including death. To determine the potential impact of the weekend effect on primary (ie, mortality) and secondary outcomes of patients with upper gastrointestinal hemorrhage (UGIH). MATERIALS AND METHODS: This was a network meta-analysis based on cohort studies...
August 16, 2018: Journal of Clinical Gastroenterology
Eugenia N Uche-Anya, Nicole DeCuir, Benjamin Lebwohl
BACKGROUND: Colonoscopy is effective for colorectal cancer (CRC) prevention, yet patients may develop CRC despite adhering to screening/surveillance intervals. There are limited data on predictive factors associated with these postcolonoscopy CRCs (PCCRCs). We aimed to measure PCCRC rates and identify risk factors for PCCRC. METHODS: We performed a case-control study, comparing patients with PCCRCs to spontaneous CRCs diagnosed during a 12.5-year period at an academic medical center...
August 16, 2018: Journal of Clinical Gastroenterology
Heba Ahmed Osman, Sanaa S Aly, Hasan S Mahmoud, Eman H Ahmed, Eman M Salah Eldin, Eman A Abdelrahim, Muhammad A El Masry, Rania A Herdan, Mohammed H Hassan
BACKGROUND AND AIMS: Gastroesophageal reflux disease (GERD) is a common prevalent disease. We aimed to assess the dynamic changes in the peripheral T lymphocytes and lymphocytes infiltrating the esophageal mucosa after treatment with proton-pump inhibitor (PPI) in patients with GERD. PATIENTS AND METHODS: A total of 200 patients who presented with upper GIT symptoms were included in this prospective study. All patients were subjected to full history taking, clinical examination, and complete blood count...
August 16, 2018: Journal of Clinical Gastroenterology
Maurizio Koch
The methods used to discern the structure (anatomy) and function (physiology) of the indigenous microbiota can be divided according to which aspect of the microbiota they can interrogate and are positioned accordingly. At the most basic level, methods can simply describe the community structure of the microbiota, that is, which taxa are present and in what relative amounts. Methods that investigate functional potential generally catalog the coding potential of individual members of the microbiota or the entire community (the metagenome)...
August 16, 2018: Journal of Clinical Gastroenterology
Min Kim, James Paik, Pegah Golabi, Thomas Jeffers, Alita Mishra, Zobair M Younossi
GOALS: To assess the outcomes and resource utilization of chronic hepatitis B (CH-B) among Medicare beneficiaries. BACKGROUND: CH-B is highly prevalent among immigrants from endemic areas. Although incidence of CH-B is stable in the United States, CH-B patients have become Medicare eligible. STUDY: We used the inpatient and outpatient Medicare database (2005 to 2014). Adult patients with CH-B diagnosis were included. One-year mortality and resource utilization were assessed...
August 13, 2018: Journal of Clinical Gastroenterology
Zhouxiang Jin, Zhaohong Wang, Jisheng Wang
GOALS: The aim of this study was to determine a potential strategy to prevent acute pancreatitis (AP) from deteriorating in obese patients. BACKGROUND: Nutritional support plays a critical role in the treatment of AP. Early enteral nutrition (EEN) is considered to be able to protect mucosa of AP patients and alleviate inflammatory reactions. Obesity worsen AP prognosis. However, little is known about the effects of EEN in obese patients. STUDY: Prospective randomized control trial...
August 13, 2018: Journal of Clinical Gastroenterology
Lynn F Butterly, Marion R Nadel, Joseph C Anderson, Christina M Robinson, Julia E Weiss, David Lieberman, Jean A Shapiro
BACKGROUND AND AIMS: National guidelines for colonoscopy screening and surveillance assume adequate bowel preparation. We used New Hampshire Colonoscopy Registry (NHCR) data to investigate the influence of bowel preparation quality on endoscopist recommendations for follow-up intervals in average-risk patients following normal screening colonoscopies. METHODS: The analysis included 9170 normal screening colonoscopies performed on average risk individuals aged 50 and above between February 2005 and September 2013...
August 13, 2018: Journal of Clinical Gastroenterology
Melissa Salavrakos, Hubert Piessevaux, Mina Komuta, Nicolas Lanthier, Peter Stärkel
BACKGROUND/GOALS: To date, there is no consensus on optimal cut-off values and timing of transient elastography (TE, Fibroscan) for fibrosis staging and prediction of portal hypertension in alcoholic liver disease. We evaluated the accuracy of Fibroscan for the diagnosis of fibrosis and clinically significant portal hypertension in alcoholic patients. STUDY: Heavy drinkers admitted to our standardized alcohol withdrawal program were evaluated by Fibroscan, by transjugular hepatic venous pressure gradient (HVPG) measurement and liver biopsy if significant fibrosis was suspected and by upper gastrointestinal endoscopy...
August 13, 2018: Journal of Clinical Gastroenterology
Vladimir M Kushnir, Daniel K Mullady, Koushik Das, Gabriel Lang, Thomas G Hollander, Faris M Murad, Sara A Jackson, Nicole A Toney, Sydney D Finkelstein, Steven A Edmundowicz
BACKGROUND: Routine cytology of biliary stricture brushings obtained during endoscopic retrograde cholangiopancreatography (ERCP) has suboptimal sensitivity for malignancy. We compared the individual and combined ability of cytology, fluorescence in situ hybridization (FISH) analysis and PCR-based mutation profiling (MP) to detect malignancy in standard biliary brushings. METHODS: We performed a prospective study of patients undergoing ERCP using histology or 1 year follow-up to determine patient outcomes...
August 13, 2018: Journal of Clinical Gastroenterology
Xiu-He Lv, Bo-Ling Wang, Guo-Wu Cao
BACKGROUND: The role of narrow band imaging (NBI) for surveillance colonoscopy in patients with inflammatory bowel disease (IBD) is debatable. We aim to compare NBI versus other endoscopic techniques in surveillance of IBD basing on current evidences. METHODS: A systematic search of PubMed, Embase, and the Cochrane Library databases was conducted for relevant studies. To assess the detection efficacy, we estimated risk ratios (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes...
August 9, 2018: Journal of Clinical Gastroenterology
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