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current gastroenterology

Dominique Ryan, Fiona Pelly, Elizabeth Purcell
BACKGROUND: Extending the scope of practice of allied health professionals has been a strategy adopted in the United Kingdom to address issues within the health system. Australia's health system is currently undermined by similar issues, heightening government interest in adopting the extended scope health care model. The aim of the current study was to describe the activities and outcomes of a dietitian-led gastroenterology clinic which operated under an extended scope of practice model in an outpatient gastroenterology department at a tertiary hospital in regional Queensland, Australia, and to assess patient satisfaction with the initiative...
October 21, 2016: BMC Health Services Research
Marta Martin-Richard, Angels Ginès, Juan Ramón Ayuso, Luis Sabater, Joan Fabregat, Ramiro Mendez, Glòria Fernández-Esparrach, Xavier Molero, Eva C Vaquero, Miriam Cuatrecasas, Antonio Ferrández, Joan Maurel
BACKGROUND AND OBJECTIVE: Clinical management of adenocarcinoma of the pancreas is complex, and requires a multidisciplinary approach. The same applies for the premalignant lesions that are increasingly being diagnosed. The current document is an update on the diagnosis and management of premalignant lesions and adenocarcinoma of the pancreas. PATIENTS AND METHODS: A conference to establish the basis of the literature review and manuscript redaction was organized by the Grupo Español Multidisciplinar en Cáncer Digestivo...
October 7, 2016: Medicina Clínica
Daniela Golger, Andreas Probst, Helmut Messmann
Data from recent studies cast doubt on former recommendations on diagnosis and management of Barrett's esophagus. Based on latest research findings several Gastroenterological Associations actualized their guidelines and international experts compiled consensus statements as practical help for clinicians. In this review we discuss recent trials and their impact on clinical practice, current recommendations and persisting controversies in Barrett's esophagus.
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Vahid Basirat, Zahra Azizi, Sanam Javid Anbardan, Mina Taghizadeh Asl, Yasaman Farbod, Azam Teimouri, Nasser Ebrahimi Daryani
INTRODUCTION Due to limitation of colonoscopy in assessing the entire bowel and patients' intolerance in inflammatory bowel disease (IBD), in the current study, we aimed to prospectively compare the accuracy of (99m)Tc(V)-dimercaptosuccinic acid (DMSA) and fecal calprotectin with ileocolonoscopy as new methods for localizing inflammations. METHODS Current prospective study conducted between 2012 and 2014 on 30 patients with IBD attending Gastroenterology Clinic of Tehran University of Medical Sciences. Fecal calprotectin and disease activity were measured for all participants and all of them underwent (99m)Tc (V)-DMSA scintigraphy and colonoscopy...
July 2016: Middle East Journal of Digestive Diseases
Selma J Lekkerkerker, Marc G Besselink, Olivier R Busch, Joanne Verheij, Marc R Engelbrecht, Erik A Rauws, Paul Fockens, Jeanin E van Hooft
BACKGROUND AND AIMS: Currently, 3 guidelines are available for the management of pancreatic cysts. These guidelines vary in their indication for resection of high-risk cysts. We retrospectively compared the final pathological outcome of surgically removed pancreatic cysts with the indications for resection according to 3 different guidelines. METHODS: Patients who underwent pancreatic resection were extracted from our prospective pancreatic cyst database (2006-present)...
September 29, 2016: Gastrointestinal Endoscopy
Linda N Nilsson, Margaret G Keane, Awad Shamali, Judith Millastre Bocos, Monica Marijinissen van Zanten, Anne Antila, Cristina Verdejo Gil, Marco Del Chiaro, Johanna Laukkarinen
BACKGROUND: The current management of pancreatic mucinous cystic neoplasms (MCN) is defined by the consensus European, International Association of Pancreatology and American College of Gastroenterology guidelines. However, the criterion for surgical resection remains uncertain and differs between these guidelines. Therefore through this systematic review of the existing literature we aimed to better define the natural history and prognosis of these lesions, in order to clarify recommendations for future management...
September 20, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
R J Wong, M T Nguyen, H N Trinh, A Huynh, M T Ly, H A Nguyen, K K Nguyen, J Yang, R T Garcia, B Levitt, E da Silveira, R G Gish
Sofosbuvir/ledipasvir (SOF/LDV) is the first all-oral ribavirin-free treatment approved for chronic hepatitis C virus (HCV) genotype 6, offering a safe and highly efficacious treatment option. Large studies evaluating real-world outcomes of this regimen are lacking. We aim to evaluate real-world treatment outcomes for HCV genotype 6. A retrospective cohort study evaluated 65 adults (age ≥18) with chronic HCV genotype 6 treated with SOF/LDV without ribavirin at a community gastroenterology clinic in the United States from November 2014 to May 2016...
September 27, 2016: Journal of Viral Hepatitis
Joel A Friedlander, Quin Y Liu, Benjamin Sahn, Koorosh Kooros, Catharine M Walsh, Robert E Kramer, Jenifer R Lightdale, Julie Khlevner, Mark McOmber, Jacob Kurowski, Matthew J Giefer, Harpreet Pall, David M Troendle, Elizabeth C Utterson, Herbert Brill, George M Zacur, Richard A Lirio, Diana G Lerner, Carrie Reynolds, Troy E Gibbons, Michael Wilsey, Chris A Liacouras, Douglas S Fishman
Wireless capsule endoscopy (CE) was introduced in 2000 as a less invasive method to visualize the distal small bowel in adults. As this technology has advanced it has been adapted for use in pediatric gastroenterology. Several studies have described its clinical use, utility, and various training methods but pediatric literature regarding capsule endoscopy is limited. This clinical report developed by the Endoscopic and Procedures Committee of the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition outlines the current literature, and describes the recommended current role, use, training, and future areas of research for CE in pediatrics...
September 16, 2016: Journal of Pediatric Gastroenterology and Nutrition
Mark W Russo, Ayman Koteish, Michael Fuchs, Gautham Reddy, Oren Fix
The field of hepatology has experienced dramatic changes since the last workforce study in hepatology over 15 years ago. Hepatology practice has been dominated by hepatitis C but is now being overtaken by patients with nonalcoholic fatty liver disease. Expertise once attainable only through informal training, hepatology now has an accredited fellowship pathway and is recognized as a distinct discipline from gastroenterology with its own board certification. These changes that have occurred since the last workforce study in the prevalence and therapy of liver diseases and training may impact workforce needs...
September 15, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
J Rüddel, B T Schleenvoigt, E Schüler, C Schmidt, M W Pletz, A Stallmach
We report the case of a 59-year-old patient who accidentally underwent live vaccination against yellow fever during continuous treatment with the TNF-α-antibody (AB) infliximab for ulcerative colitis. The clinical course showed fever of short duration and elevation of liver enzymes without further clinical complications. Yellow fever viremia was not detectable and protective antibodies were developed. A primary vaccination against yellow fever under infliximab has not been reported in the literature before, although vaccination is an important topic in IBD...
September 2016: Zeitschrift Für Gastroenterologie
Morris Gordon, Sahira Isaji, Fiona Tyacke
AIM: To ascertain United Kingdom adherence to European society of Paediatric Gastroenterology, Hepatology and Nutrition guidance (ESPGHAN). METHODS: A national cross sectional questionnaire study of neonatal units across England was completed between January and March 2014. All 174 units in the country were attempted to be contacted to complete a telephone survey. This included all level 1, 2 and 3 units. They were initially contacted by phone and asking any senior member of the team about their current practice and procedures...
August 8, 2016: World Journal of Clinical Pediatrics
Pengfei Liu, Yuanyu Qiu, Yuting Qian, Xiao Chen, Yiran Wang, Jin Cui, Xiao Zhai
BACKGROUND AND AIM: To appraise the current reporting methodological quality of meta-analyses in five leading gastroenterology and hepatology journals, and to identify the variables associated with the reporting quality. METHODS: We systematically searched the literature of meta-analyses in Gastroenterology, Gut, Hepatology, Journal of Hepatology (J HEPATOL) and American Journal of Gastroenterology (AM J GASTROENTEROL) from 2006 to 2008 and from 2012 to 2014. Characteristics were extracted based on the PRISMA statement and the AMSTAR tool...
September 6, 2016: Journal of Gastroenterology and Hepatology
Gary L Freed, Erin Turbitt, Amy Allen
Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia.Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields...
September 5, 2016: Australian Health Review: a Publication of the Australian Hospital Association
Ulrike W Denzer
BACKGROUND: The verbalisation of quality standards and parameters by medical societies are relevant for qualitative improvement but may also be an instrument to demand more resources for health care or be a unique characteristic. Within the health care system 3 different quality levels can be defined: structure, process and result quality. METHODS: The current S2k guideline of the German Society for Gastroenterology (quality requirements for gastrointestinal endoscopy) AWMF registry no...
February 2016: Visc Med
Christina Y Ha, Asher Kornbluth
On February 9, 2016, the Food and Drug Administration Arthritis Advisory Committee recommended by a vote of 21 to 3, that the biosimilar to infliximab, CT-P13, be approved for rheumatoid arthritis and ankylosing spondylitis and, by extrapolation, for all the indications for which infliximab is currently approved, including adult and pediatric ulcerative colitis and Crohn's disease. On April 5, 2016, the Food and Drug Administration concurred with this recommendation and approved CT-P13 (Inflectra; Pfizer Inc...
October 2016: Inflammatory Bowel Diseases
Rebecca Riddell, Anthony Lewis, David Tuthill
AIM: To produce a leaflet for parents and carers of children receiving parenteral nutrition (PN) explaining:▸ What PN is▸ Why it is given▸ How it will be given▸ Risks & Complications▸ Other useful information▸ Nutrition team contact informationCurrent practice is for the nutrition team pharmacist to give a verbal account of the above information to parents/carers. It was felt that providing this information in a written format would introduce consisitency and allow parents/carers more time to take information on board...
September 2016: Archives of Disease in Childhood
R Monina Klevens, Lauren Canary, Xiaohua Huang, Maxine M Denniston, Anthony E Yeo, Rick L Pesano, John W Ward, Scott Holmberg
BACKGROUND: Knowledge of the estimated proportion of hepatitis C virus (HCV)-infected persons with advanced fibrosis or cirrhosis is critical to estimating healthcare needs. METHODS: We analyzed HCV-related testing conducted by Quest Diagnostics from January 2010 through December 2013. Tests included hepatitis C antibody, HCV RNA, HCV genotype (nucleic acid tests [NAT]), liver function tests, and platelet counts; patient age was also determined. Aspartate aminotransferase (AST)-to-platelet ratio (APRI) was calculated as = 100*(aspartate aminotransferase [AST]/upper limit of AST)/platelet...
October 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Reena Khanna, Sigrid A Nelson, Brian G Feagan, Geert D'Haens, William J Sandborn, G Y Zou, John K MacDonald, Claire E Parker, Vipul Jairath, Barrett G Levesque
BACKGROUND: Endoscopic assessment of mucosal disease activity is widely used to determine eligibility and response to therapy in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently available endoscopic indices remain unclear. OBJECTIVES: A systematic review was undertaken to evaluate the development and operating characteristics of the Crohn's Disease Endoscopic Index of Severity (CDEIS) and Simple Endoscopic Scale for Crohn's Disease (SES-CD)...
2016: Cochrane Database of Systematic Reviews
Matthew J Wolf-Meyer
In 1987, Nancy Scheper-Hughes and Margaret Lock proposed "three bodies" to think through biomedicine and the kinds of subjects it produces. In the current article, I revise their theory of three bodies in two ways: first, I suggest that the three bodies are a scaling process, which allows medical governance to manage bodies across scales, from the individual to the group; second, I add two new levels of scalar analysis, the molecular and the microbial, in an attempt to flesh out the three bodies based on contemporary medical practice, including pharmaceuticalization and therapeutic to the microbiome...
July 30, 2016: Medical Anthropology Quarterly
Rena Yadlapati, Rajesh N Keswani, Jody D Ciolino, David P Grande, Zoe I Listernick, Dustin A Carlson, Donald O Castell, Kerry B Dunbar, Andrew J Gawron, C Prakash Gyawali, Philip O Katz, David Katzka, Brian E Lacy, Stuart J Spechler, Roger Tatum, Marcelo F Vela, John E Pandolfino
BACKGROUND & AIMS: Quality esophageal high-resolution manometry (HRM) studies require competent interpretation of data. However, there is little understanding of learning curves, training requirements, or measures of competency for HRM. We aimed to develop and use a competency assessment system to examine learning curves for interpretation of HRM data. METHODS: We conducted a prospective multicenter study of 20 gastroenterology trainees with no experience in HRM, from 8 centers, over an 8-month period (May through December 2015)...
July 27, 2016: Clinical Gastroenterology and Hepatology
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