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By Jeff Bank Internal Medicine R2 at the University of Utah
Barbara J Turner, Chen-Pin Wang, Trisha V Melhado, Raudel Bobadilla, Mamta K Jain, Amit G Singal
BACKGROUND & AIMS: Advanced liver disease, which includes fibrosis and cirrhosis, has been reported to be more prevalent in Hispanics patients at the time of diagnosis of chronic hepatitis C virus (HCV) infection than non-Hispanic black or non-Hispanic white patients. We performed a propensity score-matched analysis to determine whether metabolic risk factors contribute to this disparity. METHODS: We collected data from persons with 748 HCV infection (22% Hispanic, 53% non-Hispanic black, and 26% non-Hispanic while; 23% with advanced liver disease), born from 1945 through 1965, diagnosed at 6 healthcare systems in Texas...
December 6, 2018: Clinical Gastroenterology and Hepatology
Tarek Sawas, Mouaz Alsawas, Fateh Bazerbachi, Prasad G Iyer, Kenneth K Wang, M Hassan Murad, David A Katzka
BACKGROUND AND AIMS: Endoscopic eradication therapy (EET) is the main treatment for dysplastic Barrett's esophagus and intramucosal adenocarcinoma. Although the goal of EET is to achieve complete remission of intestinal metaplasia (CRIM), treatment might achieve complete remission of dysplasia (CR-D) only, without achieving CRIM. Persistent intestinal metaplasia after eradication of dysplasia might carry a higher risk for progression into advanced neoplasia. METHODS: We performed a systematic review and meta-analysis after searching multiple databases to identify studies, which evaluated dysplasia recurrence risk after successful eradication of neoplasia with EET...
December 7, 2018: Gastrointestinal Endoscopy
Vinod Kumar, Heather Broadley, Douglas K Rex
BACKGROUND: Excision of all visible neoplastic tissue is the goal of endoscopic mucosal resection (EMR) of colorectal laterally spreading tumors (LSTs). Flat and fibrotic tissue can resist snaring. Ablation of visible polyps is associated with high recurrence rates. Avulsion is a technique to continue resection when snaring fails. METHODS: We retrospectively analyzed colonic EMRs of 564 consecutive referred polyps between 2015 and 2017. Hot avulsion was used when snaring was unsuccessful...
December 5, 2018: Gastrointestinal Endoscopy
Roy Soetikno, Jennifer M Kolb, Tiffany Nguyen-Vu, Channa R Jayasekera, Roel Bogie, Jessica Yu, Ravishankar Asokkumar, Silvia Sanduleanu, Tonya Kaltenbach
No abstract text is available yet for this article.
November 29, 2018: Gastrointestinal Endoscopy
Dominik Bettenworth, Marcus M Mücke, Rocio Lopez, Amandeep Singh, Weiming Zhu, Feilong Guo, Toshiyuki Matsui, Theodore W James, Hans Herfarth, Martin Goetz, Ren Mao, Satya Kurada, Jochen Hampe, Katja Matthes, John Gásdal Karstensen, Piero V Valli, Marjolijn Duijvestein, Geert D'Haens, Vipul Jairath, Tian Bai Qiu, Nik Sheng Ding, Gerhard Rogler, Florian Rieder
BACKGROUND & AIMS: Little is know about the effects of endoscopic balloon dilation (EBD) for strictures of the upper gastrointestinal (UGI) tract in patients with Crohn's disease (CD). We performed a pooled analysis of the efficacy and safety of EBD for UGI CD-associated strictures. METHODS: We searched the EMBASE, Medline and Cochrane library, as well as bibliographies of relevant articles, for cohort studies of adults with CD and strictures of the stomach, or duodenum (up to the ligament of Treitz) who underwent EBD through December 2016...
November 29, 2018: Clinical Gastroenterology and Hepatology
Prudence R Carr, Barbara Banbury, Sonja I Berndt, Peter T Campbell, Jenny Chang-Claude, Richard B Hayes, Barbara V Howard, Lina Jansen, Eric Jacobs, Dorothy S Lane, Reiko Nishihara, Shuji Ogino, Amanda I Phipps, Martha L Slattery, Marcia L Stefanick, Robert Wallace, Viola Walter, Emily White, Kana Wu, Ulrike Peters, Andrew T Chan, Polly A Newcomb, Hermann Brenner, Michael Hoffmeister
BACKGROUND & AIMS: Red and processed meat intake is associated with colorectal cancer (CRC) incidence, but it is not clear if intake is associated with patient survival after diagnosis METHODS: We pooled data from 7627 patients with stage I-IV CRC from 10 studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of intake of red and processed meat before diagnosis with overall and CRC-specific survival...
November 23, 2018: Clinical Gastroenterology and Hepatology
Phillip R Chisholm, Arpan H Patel, Ryan J Law, Allison R Schulman, Arti O Bedi, Richard S Kwon, Erik J Wamsteker, Michelle A Anderson, Grace H Elta, Shail M Govani, Anoop Prabhu
BACKGROUND AND AIMS: Markedly elevated liver chemistries in patients presenting with acute calculous cholecystitis (AC) often prompt an evaluation for concomitant choledocholithiasis (CDL). However, current guidelines directing the workup for CDL fail to address this unique population. The aims of this study are to define the range of presenting lab values and imaging findings in AC, develop a model to predict the presence of concurrent CDL, and develop a management algorithm that can be easily applied on presentation...
November 19, 2018: Gastrointestinal Endoscopy
Hannes Hagström, Patrik Nasr, Mattias Ekstedt, Per Stål, Rolf Hultcrantz, Stergios Kechagias
BACKGROUND AND AIMS: Several non-invasive scoring systems have been developed to determine risk of advanced fibrosis in non-alcoholic fatty liver disease (NAFLD). We examined the association between 4 scoring systems and incident severe liver disease and overall mortality in a large cohort of patients with biopsy-proven NAFLD. METHODS: We performed a retrospective analysis of data from 646 patients with biopsy-proven NAFLD, recruited from 2 hospitals in Sweden, from 1971 through 2009...
November 21, 2018: Clinical Gastroenterology and Hepatology
Jeffrey M Lackner, James Jaccard, Christopher D Radziwon, Rebecca S Firth, Gregory D Gudleski, Frank Hamilton, Leonard A Katz, Laurie Keefer, Susan S Krasner, Chang-Xing Ma, Michael D Sitrin, Darren M Brenner
BACKGROUND: There is a need for safe and effective IBS treatments that provide immediate and sustained improvement of IBS symptoms, particularly among more severe patients. The aim was to assess long-term clinical response of cognitive behavioral therapy (CBT) with reference to IBS education. METHODS: A total of 436 Rome III-diagnosed IBS patients (80% F, M age = 41 years) were randomized to: 4 session home-based CBT (minimal contact (MC-CBT)), 10 session clinic-based CBT (standard (S-CBT)), or 4 session IBS education (EDU)...
November 14, 2018: American Journal of Gastroenterology
Knut Stokkeland, Jonas Höijer, Matteo Bottai, Karin Söderberg-Löfdal, Annika Bergquist
BACKGROUND & AIMS: There is increasing evidence that statins can benefit patients with chronic liver diseases, but their effects have not been studied in patients with primary sclerosing cholangitis (PSC). We performed a nationwide study in Sweden to determine the effects of exposure to drugs, including statins, in patients with PSC. METHODS: We studied a population-based cohort of patients in Sweden with PSC and concomitant ulcerative colitis or Crohn´s disease from 2005 through 2014 (n=2914), followed through 2016...
November 15, 2018: Clinical Gastroenterology and Hepatology
Zobair M Younossi, David Bernstein, Mitchell L Shiffman, Paul Kwo, W Ray Kim, Kris V Kowdley, Ira M Jacobson
Primary biliary cholangitis (PBC) is a chronic, cholestatic, autoimmune disease with a variable progressive course. PBC can cause debilitating symptoms including fatigue and pruritus and, if left untreated, is associated with a high risk of cirrhosis and related complications, liver failure, and death. Recent changes to the PBC landscape include a name change, updated guidelines for diagnosis and treatment as well as new treatment options that have recently become available. Practicing clinicians face many unanswered questions when managing PBC...
November 14, 2018: American Journal of Gastroenterology
Grace Burns, Georgia Carroll, Andrea Mathe, Jay Horvat, Paul Foster, Marjorie M Walker, Nicholas J Talley, Simon Keely
BACKGROUND: Subtle histopathologic features such as eosinophilia and increased mast cells have been observed in functional gastrointestinal disorders (FGIDs), including functional dyspepsia (FD) and the irritable bowel syndrome (IBS). The mechanisms that drive recruitment of these cells to the gastrointestinal tract remain unexplained, largely due to the heterogeneity in phenotypes among patients diagnosed with such conditions. We aimed to systematically review the literature and collate the evidence for immune activation in FD and IBS, and where possible, detail the nature of activation...
November 14, 2018: American Journal of Gastroenterology
Kimberly Zibert, Manish Singla, Patrick E Young
No abstract text is available yet for this article.
November 12, 2018: American Journal of Gastroenterology
Audrey H Calderwood, Joseph C Anderson, Christina M Robinson, Lynn F Butterly
OBJECTIVES: Although the 2008 US Preventive Services Task Force guidelines recommend against routine colorectal cancer (CRC) screening for adults aged 76-85, it is unclear what endoscopists recommend in practice. Our goal was to examine current practice around cessation of CRC screening in older adults. METHODS: We included normal screening colonoscopy exams in adults ≥ 50 years old within the New Hampshire Colonoscopy Registry between 2009 and 2014. The primary outcome was endoscopists' recommendation against further screening...
November 2, 2018: American Journal of Gastroenterology
Bo Shen, Gursimran Kochhar, Udayakumar Navaneethan, Xiuli Liu, Francis A Farraye, Yago Gonzalez Lama, David Bruining, Darrell S Pardi, Martin Lukas, Martin Bortlik, Kaicun Wu, Ajit Sood, David A Schwartz, William J Sandborn
Interventional (or therapeutic) inflammatory bowel disease (IBD) endoscopy has an expanding role in the treatment of disease and surgical adverse events. Endoscopic therapy has been explored and used in the management of strictures, fistulas/abscesses, colitis-associated neoplasia, post-surgical acute or chronic leaks, and obstructions. The endoscopic therapeutic modalities include balloon dilation, stricturotomy, stent placement, fistulotomy, fistula injection and clipping, sinusotomy, endoscopic mucosal resection, and endoscopic submucosal dissection...
October 23, 2018: Gastrointestinal Endoscopy
J López-Vicente, D Rodríguez-Alcalde, L Hernández, F Riu Pons, P Vega, J M Herrero Rivas, J Santiago García, I Salces Franco, M Bustamante Balén, M López-Cerón Pinilla, M Pellisé
BACKGROUND & AIMS: Serrated polyposis syndrome (SPS), characterized by multiple and/or large proximal serrated lesions, increases risk of colorectal cancer. Serrated lesions are often missed during colonoscopy but panchromoendoscopy can increase their detection in an average-risk population. We performed a randomized controlled study to determine the efficacy of panchromoendoscopy in detection of polyps in patients with SPS. METHODS: Patients with SPS (n=86 patients) underwent tandem high-definition (HD) colonoscopies February 2015 through July 2016 at 7 centers in Spain...
October 23, 2018: Clinical Gastroenterology and Hepatology
Diego Llovet, Mardie Serenity, Lesley Gotlib Conn, Caroline A Bravo, Bronwen R McCurdy, Catherine Dubé, Nancy N Baxter, Lawrence Paszat, Linda Rabeneck, Amanda Peters, Jill Tinmouth
OBJECTIVES: Follow-up colonoscopy rates among persons with positive fecal occult blood test results (FOBT + ) remain suboptimal in many jurisdictions. In Ontario, Canada, primary care providers (PCPs) are responsible for arranging follow-up colonoscopies. The objectives were to understand the reasons for a lack of follow-up colonoscopy and any action plans to address follow-up. METHODS: Semi-structured interviews were conducted with 30 FOBT+ persons and 30 PCPs in Ontario...
October 25, 2018: American Journal of Gastroenterology
Joseph C Anderson, Charles J Kahi, Andrew Sullivan, Margaret MacPhail, Jonathan Garcia, Douglas K Rex
BACKGROUND AND AIMS: Although water exchange may improve adenoma detection when compared to CO2 , it is unclear whether water is a better medium to fill the lumen during withdrawal and visualize the mucosa. Total underwater (TUC) involves the use of water exchange with the air valve off during insertion followed by the inspection of the mucosa under water. Our goal was to use a tandem colonoscopy design to compare miss rates for TUC to standard CO2 for polyps and adenomas. METHODS: We randomized participants (NCT03231917; clinicaltrials...
October 24, 2018: Gastrointestinal Endoscopy
Peter Klare, Christoph Sander, Martin Prinzen, Bernhard Haller, Sebastian Nowack, Mohamed Abdelhafez, Alexander Poszler, Hayley Brown, Dirk Wilhelm, Roland M Schmid, Stefan von Delius, Thomas Wittenberg
BACKGROUND AND AIMS: Adenoma detection is a highly personalized task that differs markedly between endoscopists. Technical advances are therefore desirable for the improvement of the adenoma detection rate (ADR). An automated computer driven technology would offer the chance to objectively assess the presence of colorectal polyps during colonoscopy. We present here the application of a real-time automatic polyp detection software (APDS) under routine colonoscopy conditions. METHODS: This was a prospective study at a university hospital in Germany...
October 17, 2018: Gastrointestinal Endoscopy
Rapat Pittayanon, Yuhong Yuan, Natasha P Bollegala, Reena Khanna, Brian E Lacy, Christopher N Andrews, Grigorios I Leontiadis, Paul Moayyedi
OBJECTIVE: Prokinetics are recommended for the treatment of functional dyspepsia (FD) but systematic reviews give conflicting results on the efficacy of these agents. We have therefore conducted an updated systematic review to support the 2017 joint ACG/CAG dyspepsia guidelines. METHOD: Electronic databases, including MEDLINE, EMBASE, and CENTRAL, were searched until September 2017 for randomized controlled trials (RCTs) comparing either prokinetics and placebo or two types of prokinetics to improve FD symptoms...
October 18, 2018: American Journal of Gastroenterology
2018-10-23 01:42:02
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