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Journal of Clinical Gastroenterology

David J Cangemi, Braden Kuo
Nausea and vomiting result from complex interactions between afferent and efferent pathways of the gastrointestinal tract, central nervous system, and autonomic nervous system. Afferent pathways from the vagus nerve, vestibular system, and chemoreceptor trigger zone project to nucleus tractus solitarius, which in turn relays signals to the central pattern generator to initiate multiple downstream pathways resulting in symptoms of nausea and vomiting. There is increasing evidence that the central pathway of chronic nausea is different from that of acute nausea and vomiting-and closely resembles that of neuropathic pain...
January 4, 2019: Journal of Clinical Gastroenterology
Amir Gilad, Zachary P Fricker, Adam Hsieh, Dylan D Thomas, Toni Zahorian, David P Nunes
GOALS: To determine whether diabetic patients with hepatitis C virus (HCV) treated with direct-acting antiviral agents have improved diabetes, accounting for change in both hemoglobin A1c (HbA1c) and diabetes medications, and whether any improvement was sustained. BACKGROUND: HCV infection is associated with an increased risk of diabetes, with improvement in glycemic control after eradication. There remains uncertainty about the durability and magnitude of this effect...
January 4, 2019: Journal of Clinical Gastroenterology
Marianna G Mavilia, Richa Bhardwaj, Dorothy Wakefield, Raffi Karagozian
INTRODUCTION: Cirrhotic patients are at a higher risk for sustaining orthopedic fractures with a reported prevalence of 5% to 20%. Cirrhosis also affects wound healing and bleeding risk, and hence, impacts the postoperative outcomes after fracture repair. However, there is limited data available on the postoperative risk factors and clinical outcomes of fractures in patients with chronic liver disease (CLD). METHODS: Data from the National Inpatient Sample for the years 2012 to 2015 were analyzed...
January 4, 2019: Journal of Clinical Gastroenterology
Nauman Siddiqui, Zubair Khan, Mohammad S Khan, Zarmina Khan, Khwaja F Haq, Shantanu D Solanki, Satish Munigala, Muhammad A Khan, Wasif M Saif, Ali Nawras
INTRODUCTION: Clostridium difficile infection (CDI) has been attracting attention lately as the most common hospital acquired infection. Patients with neutropenia because of malignancy seem to be at an increased risk for developing CDI. There is currently limited data that assesses the national burden and outcomes of CDI in Febrile Neutropenia (FN). METHODS: We analyzed the National Inpatient Sample (NIS) database for all subjects with discharge diagnosis of FN with or without CDI (ICD-9 codes 288...
January 4, 2019: Journal of Clinical Gastroenterology
Yi-Hua Zhou
No abstract text is available yet for this article.
January 4, 2019: Journal of Clinical Gastroenterology
Simon Weidlich, Simon Nennstiel, Moritz Jesinghaus, Knut Brockow, Julia Slotta-Huspenina, Monther Bajbouj, Roland M Schmid, Christoph Schlag
BACKGROUND: For eosinophilic esophagitis (EoE) recently an association with immunoglobulin (Ig)G4 rather than IgE has been reported. Gastroesophageal reflux disease (GERD) is the most important differential diagnosis of EoE. We compared esophageal IgG4 plasma cell infiltration and serum IgG4 levels of EoE patients (before and after budesonide therapy) with GERD patients. METHODS: Prospectively collected serum samples of 17 EoE patients before and after 8 weeks of therapy with budesonide (1 mg BID) were analyzed for total and antigen-specific IgG4 and IgE levels...
January 4, 2019: Journal of Clinical Gastroenterology
Prashanthi N Thota, Tanmayee Benjamin, Madhusudhan R Sanaka, John R Goldblum, John Vargo, Sunguk Jang, Rocio Lopez
BACKGROUND AND GOALS: Visible lesions (VLs) in Barrett's esophagus (BE) are seen in 70% to 90% of patients presenting for endoscopic eradication therapy (EET). It is not known if there are any differences in outcomes of patients with flat dysplasia versus patients with VL. Our aim was to assess outcomes of EET in BE patients with VL and BE patients with flat dysplasia. STUDY: This is a single center study with data drawn from a prospective registry of patients referred for EET of BE between 2011 and 2015...
January 4, 2019: Journal of Clinical Gastroenterology
Bubu A Banini, Sophie C Cazanave, Katherine P Yates, Amon Asgharpour, Robert Vincent, Faridoddin Mirshahi, Peter Le, Melissa J Contos, James Tonascia, Naga P Chalasani, Kris V Kowdley, Arthur J McCullough, Cynthia A Behling, Jeffrey B Schwimmer, Joel E Lavine, Arun J Sanyal
BACKGROUND: Haptoglobin (Hp) genotype has been linked to oxidative stress and cardiovascular outcomes in response to vitamin E (VitE) among patients with diabetes mellitus. Its effect on histologic response to VitE in nonalcoholic steatohepatitis (NASH) is unknown. GOALS: Our objective was to determine if Hp genotype associates with response to VitE in patients with NASH. STUDY: A post hoc analysis of 228 patients receiving VitE or placebo in 2 clinical trials was performed...
December 21, 2018: Journal of Clinical Gastroenterology
Michael Doulberis, Georgios Kotronis, Dimitra Gialamprinou, Onur Özgüler, Aristomenis K Exadaktylos, Vasileios Oikonomou, Panagiotis Katsinelos, Iordanis Romiopoulos, Stergios A Polyzos, Dimitri Tzivras, Georgia Deretzi, Efthimios Dardiotis, Jannis Kountouras
Acute liver failure is a rare hepatic emergent situation that affects primarily young people and has often a catastrophic or even fatal outcome. Definition of acute liver failure has not reached a universal consensus and the interval between the appearance of jaundice and hepatic encephalopathy for the establishment of the acute failure is a matter of debate. Among the wide variety of causes, acetaminophen intoxication in western societies and viral hepatitis in the developing countries rank at the top of the etiology list...
December 19, 2018: Journal of Clinical Gastroenterology
Stephanie Garbarino, Megan von Isenburg, Deborah A Fisher, David A Leiman
GOALS: Awareness of functional esophagogastric junction outflow obstruction (fEGJOO) has increased, but because there is no consensus on its management, we performed a systematic review of the literature to explore treatment strategies and outcomes. BACKGROUND: EGJOO is a heterogenous disorder defined by high-resolution manometry parameters of elevated integrated relaxation pressure with preserved esophageal peristalsis. The etiology may be mechanical obstruction or idiopathic, the latter being fEGJOO...
December 19, 2018: Journal of Clinical Gastroenterology
Matthew Bohm, Andrea Shin, Sean Teagarden, Huiping Xu, Anita Gupta, Robert Siwiec, David Nelson, John M Wo
INTRODUCTION: The clinical relevance of bacterial types identified in small bowel aspirate cultures during diagnostic evaluation of small intestinal bacterial overgrowth (SIBO) is unclear. AIM: The main purpose of this study was to assess associations between risk factors for upper aerodigestive tract (UAT) or coliform SIBO and SIBO diagnosis by culture. MATERIALS AND METHODS: Small bowel aspirates were cultured in patients with suspected SIBO, defined as ≥10 colony-forming units/mL coliform or ≥10 colony-forming units/mL UAT bacteria...
December 19, 2018: Journal of Clinical Gastroenterology
Tiffany Ju, Bruce D Naliboff, Wendy Shih, Angela P Presson, Cathy Liu, Arpana Gupta, Emeran A Mayer, Lin Chang
BACKGROUND: Irritable bowel syndrome (IBS) is a stress-sensitive disorder of brain-gut interactions associated with a higher prevalence of early adverse life events (EALs). However, it is incompletely understood how trauma severity or disclosure influence the risk of developing IBS or symptom severity. AIMS: To determine whether (1) IBS patients report a greater number of EALs compared with healthy controls; (2) trauma severity and first age of EAL increase the odds of IBS; (3) confiding in others reduces the odds of IBS; (4) the number, trauma severity, and first age of EAL are associated with symptom severity; (5) sex differences exist...
December 19, 2018: Journal of Clinical Gastroenterology
Magnus Halland, Karthik Ravi, Holly A Nelson, David A Katzka, Nicholas J Talley, Michael D Crowell
GOALS AND BACKGROUND: Baseline impedance measured during high-resolution impedance manometry (HRIM) can distinguish patients with gastroesophageal reflux disease (GERD) from controls, presumably due to differences in esophageal acid exposure. The characteristics of regurgitation and reflux in rumination syndrome and GERD are very different, and thus we investigated whether baseline esophageal impedance would differ in these 2 patient groups compared with controls. STUDY: We compared 20 patients with rumination syndrome with 20 patients who had GERD and 40 controls...
December 19, 2018: Journal of Clinical Gastroenterology
Ziad Bakouny, Tarek Assi, Elie El Rassy, Fadi Nasr
BACKGROUND: Advanced hepatocellular carcinoma (HCC) constitutes the second leading cause of cancer-related deaths. First-line therapy is either sorafenib or lenvatinib. Several treatment options have been recently added to the second-line treatment of advanced HCC. The aim of this network meta-analysis of randomized controlled trials was to compare the second-line treatments of advanced HCC. METHODS: Network meta-analyses were computed for overall survival (OS), progression-free survival, rates of grade 3 to 5 adverse events, and for treatment discontinuation due to adverse events...
December 19, 2018: Journal of Clinical Gastroenterology
Songxu Peng, Zhihua Wan, Tingting Liu, Yanni Wang, Hongyan Chen, Xiu Li, Yukai Du
GOALS: This study aimed to explore whether quantitative surface antigen [hepatitis B surface antigen (HBsAg)] can be used as a surrogate marker of hepatitis B virus (HBV) DNA to predict hepatitis B transmission before the first hepatitis vaccine dose in infants born to hepatitis B e antigen (HBeAg)-positive pregnant women. BACKGROUND: Currently, HBV transmission persistently occurs worldwide, especially in infants born to e antigen (HBeAg)-positive highly viremic mothers...
December 19, 2018: Journal of Clinical Gastroenterology
Sayali A Pendharkar, Ruma G Singh, Sakina H Bharmal, Marie Drury, Maxim S Petrov
AIM: To investigate the pancreatic hormone responses to mixed meal test, in particular changes in insulin secretion, insulin sensitivity, and their interrelationship, in individuals with new-onset prediabetes or diabetes after non-necrotizing acute pancreatitis (NODAP) compared with healthy controls. METHODS: Twenty-nine individuals with NODAP and 29 age-and sex-matched healthy controls were recruited. All participants (after fasting for at least 8 h) were given 12 oz...
November 21, 2018: Journal of Clinical Gastroenterology
Yi-Hua Zhou
No abstract text is available yet for this article.
November 14, 2018: Journal of Clinical Gastroenterology
Young Youn Cho, Su Jong Yu, Jung-Ju Yoo, Minjong Lee, Dong Hyeon Lee, Yuri Cho, Kyoung Wan Yoon, Eun Ju Cho, Jeong-Hoon Lee, Yoon Jun Kim, Jung-Hwan Yoon
BACKGROUND/AIMS: Transarterial chemoembolization (TACE) is a major therapeutic modality for patients with unresectable hepatocellular carcinoma, which needs repeated treatments. Model to Estimate Survival in Ambulatory Hepatocellular carcinoma patients (MESIAH) was recently developed as a model for predicting survival. We aimed to develop a novel index for TACE retreatment using MESIAH scores. PATIENTS AND METHODS: From 2005 to 2008, 783 patients with hepatocellular carcinoma who had undergone 1 previous TACE procedure were enrolled...
November 14, 2018: Journal of Clinical Gastroenterology
Valerie Gausman, Giulio Quarta, Michelle H Lee, Natalia Chtourmine, Carmelita Ganotisi, Frances Nanton-Gonzalez, Chui Ling Ng, Jungwon Jun, Leslie Perez, Jason A Dominitz, Scott E Sherman, Michael A Poles, Peter S Liang
GOALS/BACKGROUND: Patients who "no-show" for colonoscopy or present with poor bowel preparation waste endoscopic resources and do not receive adequate examinations for colorectal cancer (CRC) screening. Using the Health Belief Model, we modified an existing patient education pamphlet and evaluated its effect on nonattendance rates and bowel preparation quality. STUDY: We implemented a color patient education pamphlet to target individual perceptions about CRC and changed bowel preparation instructions to include a low-residue diet instead of the previous clear liquid diet...
November 14, 2018: Journal of Clinical Gastroenterology
Christian Labenz, Gerrit Toenges, Jörn M Schattenberg, Michael Nagel, Martin F Sprinzl, Marc Nguyen-Tat, Tim Zimmermann, Yvonne Huber, Jens U Marquardt, Peter R Galle, Marcus-Alexander Wörns
BACKGROUND: Current EASL/AASLD guidelines recommend treatment of covert hepatic encephalopathy (HE) only in symptomatic patients, for example, in those with impaired quality of life or with affected driving abilities. GOALS: Because testing for impaired quality of life is time consuming, the aim of the present study was to identify simple clinical predictors for poor quality of life in patients with covert HE (CHE). STUDY: In total, 139 cirrhotic in- and outpatients without a history of overt hepatic encephalopathy were enrolled...
November 14, 2018: Journal of Clinical Gastroenterology
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