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Gastroenterology

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543 papers 1000+ followers
By Jeff Bank Internal Medicine R2 at the University of Utah
https://www.readbyqxmd.com/read/29775794/rebleeding-vs-thromboembolism-after-hospitalization-for-gastrointestinal-bleeding-in-patients-on-direct-oral-anticoagulants
#1
Neil Sengupta, Ariela L Marshall, Blake A Jones, Sandra Ham, Elliot B Tapper
BACKGROUND AND AIMS: Little is known about outcomes of patients hospitalized for gastrointestinal bleeding (GIB) while they are taking direct oral anticoagulants (DOAC). We aimed to determine the frequency at which patients resume DOAC therapy following hospitalization for GIB in a real-world setting, and the risks and benefits. METHODS: We conducted a retrospective analysis of medical claims data from the Truven Health Marketscan Commercial Claims and Encounters Database, from January 1, 2010 through December 31, 2014...
May 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29755125/clinical-narrative-autoimmune-hepatitis
#2
REVIEW
Paul A Schmeltzer, Mark W Russo
Autoimmune hepatitis (AIH) is an inflammatory liver disease that is characterized by circulating autoantibodies, hypergammaglobulinemia, and a lymphoplasmocytic infiltration with interface hepatitis on liver biopsy. Treatment with corticosteroids and other immunosuppressive agents is effective and early diagnosis can result in near-normal life expectancy. Untreated patients, however, can progress to cirrhosis and liver failure. The clinical presentation is heterogeneous and may pose diagnostic and therapeutic dilemmas...
May 14, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29748562/managing-chronic-pancreatitis-the-view-from-medical-pancreatology
#3
Dhiraj Yadav, Adam Slivka
No abstract text is available yet for this article.
May 11, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29748563/assessing-the-feasibility-of-targeted-screening-for-esophageal-adenocarcinoma-based-on-individual-risk-assessment-in-a-population-based-cohort-study-in-norway-the-hunt-study
#4
Shao-Hua Xie, Eivind Ness-Jensen, Nils Medefelt, Jesper Lagergren
OBJECTIVES: Unselected screening for oesophageal adenocarcinoma (OAC) is not justified due to the low absolute risk in the general population. This study aimed to evaluate a risk prediction model in identifying high-risk individuals who might be considered for targeted screening. METHODS: A population-based cohort of 62,576 participants was recruited in 1995-1997 in Nord-Trøndelag County, Norway (HUNT) and followed up until 31 December 2015. A model for predicting individuals' absolute risk of OAC was developed using competing-risk regression...
May 11, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29730438/model-to-determine-the-optimal-dietary-elimination-strategy-for-treatment-of-eosinophilic-esophagitis
#5
Tiannan Zhan, Ayman Ali, Jin G Choi, Minyi Lee, John Leung, Evan S Dellon, John J Garber, Chin Hur
BACKGROUND & AIMS: Elimination diets are effective treatments for eosinophilic esophagitis (EoE), but foods that activate esophagitis are identified empirically, via a process that involves multiple esophagogastroduodenoscopies (EGDs). No optimized approach has been developed to identify foods that activate EoE. We aimed to compare clinical strategies to provide data to guide treatment. METHODS: We developed a computer-based simulation model to determine the optimal empiric elimination strategy based on reported prevalence values for foods that activate EoE...
May 3, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29730227/trends-in-the-timing-of-inpatient-ercp-relative-to-cholecystectomy-a-nationwide-database-studied-longitudinally
#6
Alejandro L Suarez, Huiping Xu, Peter B Cotton, B Joseph Elmunzer, David Adams, Katherine A Morgan, Douglas Sheafor, Gregory A Coté
BACKGROUND AND AIMS: ERCP has largely replaced common bile duct exploration for therapy of common bile duct pathology, yet its use as a purely diagnostic test has declined. Among inpatients, we hypothesized that timing between ERCP and cholecystectomy (CCY) have changed. The objectives were to measure temporal trends in the timing between inpatient ERCP and CCY, and to examine factors associated with delays. METHODS: We used the National Inpatient Sample between 1998 and 2013 to classify admissions for gallstone-related diagnoses who underwent inpatient CCY and ERCP by timing relative to CCY: within (±) 1 day, >2 days before, and >2 days after...
May 3, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29605975/advantages-and-disadvantages-of-long-term-proton-pump-inhibitor-use
#7
REVIEW
Yoshikazu Kinoshita, Norihisa Ishimura, Shunji Ishihara
Proton pump inhibitors (PPIs) potently inhibit gastric acid secretion and are widely used for treatment of acid-related diseases including gastroesophageal reflux disease and secondary prevention of aspirin/NSAID-induced ulcers. Although clinically important adverse effects of PPIs can occur, just as with other drugs, those are not frequently observed during or after administration. Thus, PPIs are regarded as relatively safe and considered to be clinically beneficial. Recently, PPIs have become frequently administered to patients with functional gastrointestinal diseases or primary prevention of drug-related gastroduodenal damage, even though their beneficial effects for those conditions have not been fully confirmed...
April 30, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29713027/evaluation-of-chronic-diarrhea-and-irritable-bowel-syndrome-with-diarrhea-in-adults-in-the-era-of-precision-medicine
#8
REVIEW
Lawrence R Schiller
Chronic diarrhea is a common clinical problem, affecting roughly 5% of the population in any given year. Evaluation and management of these patients can be difficult due to the extensive differential diagnosis of this symptom. Many patients with chronic diarrhea have structural problems, such as inflammatory bowel disease or celiac disease, that can be readily identified. Others do not, and often are given a diagnosis of irritable bowel syndrome with diarrhea (IBS-D). When based on generally accepted clinical criteria, a diagnosis of IBS-D identifies a group of patients who are unlikely to have disorders producing anatomical changes in the gut...
May 1, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29709540/implications-of-pharmacogenomics-to-the-management-of-ibs
#9
REVIEW
Michael Camilleri
The objectives are to review the role of pharmacogenomics in drug metabolism of medications typically used in patients with irritable bowel syndrome (IBS) focusing predominantly on cytochrome P450 metabolism. Other aims are to provide examples of genetic variation of receptors or intermediary pathways that are targets for IBS drugs and to critically appraise the situations where precision medicine is impacting health in IBS. Pharmacogenomics impacts both pharmacokinetics and pharmacodynamics. Although large clinical trials have not incorporated testing for genetic variations that could impact the efficacy of medications in IBS, there are therapeutic advantages to inclusion of pharmacogenomics testing for individual patients, as has been demonstrated particularly in the treatment with central neuromodulators in psychiatry practice...
April 27, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29702300/budesonide-suppositories-are-effective-and-safe-for-treating-acute-ulcerative-proctitis
#10
Wolfgang Kruis, Viacheslav Neshta, Marina Pesegova, Olga Alekseeva, Pavel Andreev, Oleksii Datsenko, Olena Levchenko, Sayar Abdulkhakov, Yuriy Lozynskyy, Yuriy Mostovoy, Konstatin Soloviev, Andrey E Dorofeyev, Michael Vieth, Michael Stiess, Roland Greinwald, Ralf Mohrbacher, Britta Siegmund
BACKGROUND & AIMS: Though proctitis is the most limited form of ulcerative colitis, it causes unpleasant symptoms. Topical mesalamine, the standard treatment, is not always effective. We conducted a randomized phase 2 trial to determine the efficacy and safety of 2 doses of a budesonide suppository vs mesalamine suppositories vs combined budesonide and mesalamine suppositories for proctitis. METHODS: We performed a prospective, double-blind, double-dummy, multicenter trial in 337 patients with active proctitis to compare the efficacies of 4 different suppository treatments...
April 24, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29700480/long-term-effects-of-omitting-antibiotics-in-uncomplicated-acute-diverticulitis
#11
S T van Dijk, L Daniels, Ç Ünlü, N de Korte, S van Dieren, H B Stockmann, B C Vrouenraets, E C Consten, J A van der Hoeven, Q A Eijsbouts, I F Faneyte, W A Bemelman, M G Dijkgraaf, M A Boermeester
BACKGROUND: Traditionally uncomplicated acute diverticulitis was routinely treated with antibiotics, although evidence for this strategy was lacking. Recently, two randomized clinical trials (AVOD trial and DIABOLO trial) published short-term results of omitting antibiotics compared to routine antibiotic treatment. Both showed no significant differences regarding recovery from the initial episode, as well as rates of complicated or recurrent diverticulitis and sigmoid resection. However, both studies showed a trend of higher rates of sigmoid resection in the observational groups...
April 27, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29700481/the-natural-course-of-eosinophilic-esophagitis-and-long-term-consequences-of-undiagnosed-disease-in-a-large-cohort
#12
Marijn J Warners, Renske A B Oude Nijhuis, Laetitia R H de Wijkerslooth, Andreas J P M Smout, Albert J Bredenoord
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic esophageal inflammation that may lead to stricture formation. This narrowing can cause major complications including food impactions. Despite increasing interest in EoE accurate data on its natural course is scarce. Therefore, we aimed to investigate the natural course of EoE and to evaluate the association between undiagnosed disease and the occurrence of complications over two decades in a large cohort. METHODS: We retrospectively analyzed charts of patients diagnosed with EoE between 1996 and 2015, collected from 15 hospitals throughout the Netherlands...
April 27, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29628281/easl-clinical-practice-guidelines-management-of-hepatocellular-carcinoma
#13
(no author information available yet)
No abstract text is available yet for this article.
April 5, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29653941/guidelines-for-the-investigation-of-chronic-diarrhoea-in-adults-british-society-of-gastroenterology-3rd-edition
#14
Ramesh P Arasaradnam, Steven Brown, Alastair Forbes, Mark R Fox, Pali Hungin, Lawrence Kelman, Giles Major, Michelle O'Connor, Dave S Sanders, Rakesh Sinha, Stephen Charles Smith, Paul Thomas, Julian R F Walters
Chronic diarrhoea is a common problem, hence clear guidance on investigations is required. This is an updated guideline from 2003 for the investigations of chronic diarrhoea commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). This document has undergone significant revision in content through input by 13 members of the Guideline Development Group (GDG) representing various institutions. The GRADE system was used to appraise the quality of evidence and grading of recommendations...
April 13, 2018: Gut
https://www.readbyqxmd.com/read/29686276/management-options-for-patients-with-gerd-and-persistent-symptoms-on-proton-pump-inhibitors-recommendations-from-an-expert-panel
#15
Rena Yadlapati, Michael F Vaezi, Marcelo F Vela, Stuart J Spechler, Nicholas J Shaheen, Joel Richter, Brian E Lacy, David Katzka, Philip O Katz, Peter J Kahrilas, C Prakash Gyawali, Lauren Gerson, Ronnie Fass, Donald O Castell, Jenna Craft, Luke Hillman, John E Pandolfino
BACKGROUND: The aim of this study was to assess expert gastroenterologists' opinion on treatment for distinct gastroesophageal reflux disease (GERD) profiles characterized by proton pump inhibitor (PPI) unresponsive symptoms. METHODS: Fourteen esophagologists applied the RAND/UCLA Appropriateness Method to hypothetical scenarios with previously demonstrated GERD (positive pH-metry or endoscopy) and persistent symptoms despite double-dose PPI therapy undergoing pH-impedance monitoring on therapy...
April 24, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29684461/when-should-we-stop-treatment-with-terlipressin-and-albumin-for-patients-with-hepatorenal-syndrome
#16
EDITORIAL
Thomas Reiberger
No abstract text is available yet for this article.
April 20, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29628280/easl-clinical-practice-guidelines-management-of-alcohol-related-liver-disease
#17
(no author information available yet)
No abstract text is available yet for this article.
April 5, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29679692/impact-of-fellowship-training-level-on-colonoscopy-quality-and-efficiency-metrics
#18
Hussein Bitar, Hassaan Zia, Muhammad Bashir, Pratyusha Parava, Muhammad Hanafi, William Tierney, Mohammad Madhoun
BACKGROUND & AIMS: Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by level of training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of level of training on moderate sedation use. METHODS: We performed a retrospective review of 2024 patients (mean age 60...
April 18, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29660528/yield-of-colonoscopy-after-a-positive-result-from-a-fecal-immunochemical-test-oc-light
#19
Muhammad Alsayid, Maneesh H Singh, Rachel Issaka, Victoria Laleau, Lukejohn Day, Jeffrey Lee, James Allison, Ma Somsouk
BACKGROUND & AIMS: The fecal immunochemical test (FIT) is widely used in colorectal cancer (CRC) screening. The OC-Light FIT is 1 of 2 FITs recommended for CRC screening by the Preventive Services Task Force guidelines. However, little is known about its ability to detect CRC in large average-risk populations. METHODS: We performed a retrospective cohort study of patients (50-75 years old) in the San Francisco Health Network who were screened for CRC by OC-Light FIT from August 2010 through June 2015...
April 13, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29610513/effects-of-saline-irrigation-of-the-bile-duct-to-reduce-the-rate-of-residual-common-bile-duct-stones-a-multicenter-prospective-randomized-study
#20
Dong-Won Ahn, Sang Hyub Lee, Woo Hyun Paik, Byeong Jun Song, Jin Myung Park, Jaihwan Kim, Ji Bong Jeong, Jin-Hyeok Hwang, Ji Kon Ryu, Yong-Tae Kim
OBJECTIVES: In clinical practice, recurrent cholangitis due to residual common bile duct (CBD) stone occurs frequently even after endoscopic stone removal. This study aimed to determine whether preventive saline irrigation of the bile duct (PSIB) after endoscopic removal of CBD stones would decrease the residual CBD stones. METHODS: In this multicenter, prospective, randomized study, patients who received endoscopic retrograde cholangiopancreatography for removal of CBD stone were randomized to either receiving PSIB after stone removal (PSIB group) or not receiving PSIB (non-PSIB group)...
April 2018: American Journal of Gastroenterology
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