MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinical Gastroenterology and Hepatology' source. Wed, 08 Feb 2012 16:28:11 +0100 http://www.medworm.com/index.php?rid=5629663&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511013437%2Fabstract%3Frss%3Dyes In consideration of the American Gastroenterological Association (AGA) Institute (the “AGA Institute”) taking action to review and credit the below-identified submission (the “Manuscript”), and for other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned authors and/or creators (the “Authors”), jointly and severally, hereby transfer, convey, and assign to the AGA Institute, free and clear of any liens, licenses or encumbrances, the entire right, title, and interest in and to the Manuscript throughout the world, including without limitation in and to any and all copyrights for the Manuscript (including but not limited to rights to copy, publish, excerpt, collect royalties and make derivative works) in print, electronic, Internet,... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629663 Thu, 26 Jan 2012 21:26:19 +0100 5629663 http://www.medworm.com/index.php?rid=5629662&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511013425%2Fabstract%3Frss%3Dyes Clinical Gastroenterology and Hepatology is the go-to resource on a broad spectrum of themes in clinical gastroenterology and hepatology. The official clinical practice journal of the AGA Institute brings you the best original research in the field with a unique combination of reviews, editorials, podcasts, video abstracts, and outcomes research—all supporting clinical practice. Articles on education, policy, and practice management highlight issues pertinent to clinicians. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629662 Thu, 26 Jan 2012 21:26:19 +0100 5629662 http://www.medworm.com/index.php?rid=5629661&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511013413%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629661 Thu, 26 Jan 2012 21:26:19 +0100 5629661 http://www.medworm.com/index.php?rid=5629660&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511013401%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629660 Thu, 26 Jan 2012 21:26:19 +0100 5629660 http://www.medworm.com/index.php?rid=5629655&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511013383%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629655 Thu, 26 Jan 2012 21:26:19 +0100 5629655 http://www.medworm.com/index.php?rid=5538568&cid=s_38476_17_f&fid=38476&url=http%3A%2F%2Fdigitalstash.net%2Fpodcasts%2FAGA%2FCGH%2Fmedia%2F2011-12-22_cgh_podcast_january_2012.mp3 . Dr. Kuemmerle speaks to the first author of this study in the January issue of CGH, Dr. Corey Siegel. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology podcasts http://www.medworm.com/rss/comments.php?id=5538568 Thu, 22 Dec 2011 21:52:58 +0100 5538568 http://www.medworm.com/index.php?rid=5525940&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011803%2Fabstract%3Frss%3Dyes Copyright Assignment. In consideration of the American Gastroenterological Association (AGA) Institute (the “AGA Institute”) taking action to review and credit the below-identified submission (the “Manuscript”), and for other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned authors and/or creators (the “Authors”), jointly and severally, hereby transfer, convey, and assign to the AGA Institute, free and clear of any liens, licenses or encumbrances, the entire right, title, and interest in and to the Manuscript throughout the world, including without limitation in and to any and all copyrights for the Manuscript (including but not limited to rights to copy, publish, excerpt, collect royalties and make derivative works) in print,... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525940 Thu, 22 Dec 2011 09:31:58 +0100 5525940 http://www.medworm.com/index.php?rid=5525939&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011815%2Fabstract%3Frss%3Dyes Clinical Gastroenterology and Hepatology publishes clinical articles on all aspects of the digestive system, including the liver and pancreas. The types of articles Clinical Gastroenterology and Hepatology publishes include original papers, review articles, brief communications, and special category manuscripts. Manuscripts must be prepared in accordance with the “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” developed by the International Committee of Medical Journal Editors (ICMJE) (http://www.icmje.org). Clinical Gastroenterology and Hepatology is a member of the Committee on Publication Ethics (COPE) (http://www.publicationethics.org.uk). (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525939 Thu, 22 Dec 2011 09:31:58 +0100 5525939 http://www.medworm.com/index.php?rid=5525938&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011797%2Fabstract%3Frss%3Dyes Clinical Gastroenterology and Hepatology is the go-to resource on a broad spectrum of themes in clinical gastroenterology and hepatology. The official clinical practice journal of the AGA Institute brings you the best original research in the field with a unique combination of reviews, editorials, podcasts, video abstracts, and outcomes research—all supporting clinical practice. Articles on education, policy, and practice management highlight issues pertinent to clinicians. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525938 Thu, 22 Dec 2011 09:31:58 +0100 5525938 http://www.medworm.com/index.php?rid=5525937&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011785%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525937 Thu, 22 Dec 2011 09:31:58 +0100 5525937 http://www.medworm.com/index.php?rid=5525936&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011773%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525936 Thu, 22 Dec 2011 09:31:58 +0100 5525936 http://www.medworm.com/index.php?rid=5525932&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651101175X%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525932 Thu, 22 Dec 2011 09:31:58 +0100 5525932 http://www.medworm.com/index.php?rid=5525917&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651101038X%2Fabstract%3Frss%3Dyes Over the past several decades, advances in science and technology have yielded great strides in our ability to treat major medical conditions such as heart disease and cancer. The genesis of many of these technologies has been innovative biopharmaceutical, medical device, and diagnostic start-up companies often formed by physicians and researchers within academic medical institutions and hospitals. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525917 Thu, 22 Dec 2011 09:31:58 +0100 5525917 http://www.medworm.com/index.php?rid=5629630&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511013292%2Fabstract%3Frss%3Dyes Recurrent bleeding from gastrointestinal vascular malformations remains a significant challenge, especially when endoscopic therapy is either ineffective or the full extent of the lesions cannot be reliably assessed or treated. Recent evidence has shown that vascular ectasias express vascular endothelial growth factor. Because several case reports suggest thalidomide—which alters this growth factor—may be effective in these patients, this open-label, randomized trial was performed. Consecutive patients with refractory bleeding from vascular ectasias over a 4-year period were randomized to thalidomide 100 mg daily (n = 28) or 400 mg of iron (n = 27, controls) daily for 4 months. Bleeding was defined as a positive result from an immunoassay fecal occult blood test. A number of secondary ... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629630 Wed, 14 Dec 2011 05:00:00 +0100 5629630 http://www.medworm.com/index.php?rid=5629629&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511012870%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629629 Fri, 09 Dec 2011 05:00:00 +0100 5629629 http://www.medworm.com/index.php?rid=5629628&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511012869%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629628 Fri, 09 Dec 2011 05:00:00 +0100 5629628 http://www.medworm.com/index.php?rid=5469642&cid=s_38476_17_f&fid=38476&url=http%3A%2F%2Fdigitalstash.net%2Fpodcasts%2FAGA%2FCGH%2Fmedia%2F2011-12-01_cgh_podcast_december_2011.mp3 A “Perspective” article in the December issue of CGH looks at the rationale, methods, and use of fecal microbiota transplantation as treatment for Clostridium difficile infection. Dr. Kuemmerle speaks to co-author Dr. Christina Surawicz. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology podcasts http://www.medworm.com/rss/comments.php?id=5469642 Thu, 01 Dec 2011 22:48:58 +0100 5469642 http://www.medworm.com/index.php?rid=5495392&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511012894%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5495392 Thu, 01 Dec 2011 05:00:00 +0100 5495392 http://www.medworm.com/index.php?rid=5441871&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010925%2Fabstract%3Frss%3Dyes Copyright Assignment. In consideration of the American Gastroenterological Association (AGA) Institute (the “AGA Institute”) taking action to review and credit the below-identified submission (the “Manuscript”), and for other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned authors and/or creators (the “Authors”), jointly and severally, hereby transfer, convey, and assign to the AGA Institute, free and clear of any liens, licenses or encumbrances, the entire right, title, and interest in and to the Manuscript throughout the world, including without limitation in and to any and all copyrights for the Manuscript (including but not limited to rights to copy, publish, excerpt, collect royalties and make derivative works) in print,... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441871 Fri, 25 Nov 2011 09:23:44 +0100 5441871 http://www.medworm.com/index.php?rid=5441870&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010913%2Fabstract%3Frss%3Dyes Clinical Gastroenterology and Hepatology is the go-to resource on a broad spectrum of themes in clinical gastroenterology and hepatology. The official clinical practice journal of the AGA Institute brings you the best original research in the field with a unique combination of reviews, editorials, podcasts, video abstracts, and outcomes research–all supporting clinical practice. Articles on education, policy, and practice management highlight issues pertinent to clinicians. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441870 Fri, 25 Nov 2011 09:23:44 +0100 5441870 http://www.medworm.com/index.php?rid=5441869&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010901%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441869 Fri, 25 Nov 2011 09:23:44 +0100 5441869 http://www.medworm.com/index.php?rid=5441868&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010895%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441868 Fri, 25 Nov 2011 09:23:44 +0100 5441868 http://www.medworm.com/index.php?rid=5441864&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010871%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441864 Fri, 25 Nov 2011 09:23:44 +0100 5441864 http://www.medworm.com/index.php?rid=5441863&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011578%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441863 Fri, 25 Nov 2011 09:23:44 +0100 5441863 http://www.medworm.com/index.php?rid=5525911&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511012213%2Fabstract%3Frss%3Dyes Hvid-Jensen F, Pedersen L, Drewes AM, et al. Incidence of adenocarcinoma among patients with Barrett's esophagus. N Engl J Med 2011;365:1375–1383. There remains an intense interest in defining the risk of adenocarcinoma on long-term follow-up in patients with Barrett's esophagus (BE). Numerous papers have been written on the topic, and the current thought is that the risk of progression to cancer is higher in those with dysplasia, and the overall rate of progression is approximately 0.5% yearly. Wani and colleagues assessed the rate of progression from low-grade dysplasia to high-grade dysplasia and adenocarcinoma in a cohort of 210 patients with Barrett's esophagus and low-grade dysplasia. Patients were followed up for an average of 6 years. Of the cohort, only 6 patients developed ade... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525911 Thu, 17 Nov 2011 05:00:00 +0100 5525911 http://www.medworm.com/index.php?rid=5629638&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511012250%2Fabstract%3Frss%3Dyes Podcast interview: www.gastro.org/cghpodcast. Also available on iTunes. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629638 Wed, 16 Nov 2011 05:00:00 +0100 5629638 http://www.medworm.com/index.php?rid=5525910&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651101216X%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525910 Mon, 14 Nov 2011 05:00:00 +0100 5525910 http://www.medworm.com/index.php?rid=5525909&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511012158%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525909 Mon, 14 Nov 2011 05:00:00 +0100 5525909 http://www.medworm.com/index.php?rid=5629631&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011694%2Fabstract%3Frss%3Dyes Skeletal muscle wasting, accompanied by weakness and poor functional capacity, is a frequent finding in advanced liver disease. Many factors contribute to cachexia in cirrhosis. Loss of appetite is common and might be related to metabolic and hormonal alterations, medications, hepatic encephalopathy, or inflammatory cytokines. Poor diet is frequent in cirrhotic patients with active alcoholism and substance abuse and might be aggravated by poverty, poor social support, and iatrogenic restrictions. Postprandial discomfort associated with tense ascites might limit oral intake. Impaired gut motility with small intestinal bacterial overgrowth might contribute to altered digestion and nutrient malabsorption. Cirrhosis is a hypermetabolic state, increasing demand for calories and protein. The cir... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629631 Fri, 11 Nov 2011 05:00:00 +0100 5629631 http://www.medworm.com/index.php?rid=5629633&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011700%2Fabstract%3Frss%3Dyes Abdominal pain caused by chronic pancreatitis can be severe and incapacitating, difficult to control, and not surprisingly results in significant morbidity impacting quality of life and employment. Oral analgesia remains the mainstay of therapy, but when the pain is more severe, invasive treatments are often considered. Such invasive therapy is guided by the pancreatic ductal and parenchymal anatomy as assessed by cross-sectional abdominal imaging. If ductal dilatation and/or obstruction are present, then endoscopic or surgical treatment is preferred. The more difficult patients are those who have not responded to such therapy or who have unfavorable anatomy for such interventions. In this setting, direct attack on the nociceptive pathways might be considered; currently, celiac plexus bloc... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629633 Thu, 10 Nov 2011 05:00:00 +0100 5629633 http://www.medworm.com/index.php?rid=5629639&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651101161X%2Fabstract%3Frss%3Dyes Conclusions: Age >65 years is a significant risk factor for esophageal perforation after PD. Nonsurgical management of transmural esophageal tears is feasible, with favorable short-term and long-term outcomes, but is not devoid of complications. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629639 Mon, 07 Nov 2011 05:00:00 +0100 5629639 http://www.medworm.com/index.php?rid=5629632&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011657%2Fabstract%3Frss%3Dyes Fatigue is a complex symptom that encompasses a range of complaints including malaise, exhaustion, lethargy, and loss of motivation and social interest. Chronic fatigue is common in the general population, affecting up to 20%. Many chronic diseases are associated with fatigue including rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis. Fatigue is often a major factor in the reduction of quality of life associated with chronic disease. Furthermore, the symptom of fatigue does not typically correlate with traditional markers of disease activity, severity, disability, or clinical disease subtype. The exact frequency of fatigue in patients with chronic liver disease is variable; however it does constitute the most common complaint. Any physician who manages patients wi... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629632 Mon, 07 Nov 2011 05:00:00 +0100 5629632 http://www.medworm.com/index.php?rid=5629642&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011505%2Fabstract%3Frss%3Dyes Conclusions: Patients with IBD have a higher rate of illness compared with controls during trips to industrialized countries, but not to developing or tropical regions. These findings indicate that most travel-associated illnesses stem from sporadic IBD flares rather than increased susceptibility to enteric infections. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629642 Thu, 03 Nov 2011 04:00:00 +0100 5629642 http://www.medworm.com/index.php?rid=5629641&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011517%2Fabstract%3Frss%3Dyes Conclusions: The latest generation of wide-angle, high-definition colonoscopes improves rates of adenoma detection by 22%, compared with mixed, older technology endoscopes used in routine private practice. These findings might affect definitions of quality control parameters for colonoscopy screening for colorectal cancer. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629641 Thu, 03 Nov 2011 04:00:00 +0100 5629641 http://www.medworm.com/index.php?rid=5629640&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011554%2Fabstract%3Frss%3Dyes Conclusions: Stricture rates among patients who receive only RFA are comparable to those of patients who had prior EMR. EMR appears safe to perform prior to RFA. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629640 Thu, 03 Nov 2011 04:00:00 +0100 5629640 http://www.medworm.com/index.php?rid=5629637&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011542%2Fabstract%3Frss%3Dyes Background & Aims: Diverticular bleeding is the most common cause of acute severe lower gastrointestinal bleeding (LGIB) in Western countries. Diagnostic and therapeutic approaches, including endoscopy, radiology, or surgery, have not been standardized. We investigated colonoscopy as a first-line modality to diagnose and manage patients with LGIB. Methods: We performed a retrospective study of data collected from 2 tertiary Veterans hospitals of 64 patients (61 men, 76 ± 11 years) with acute severe diverticular bleeding, based on colonoscopy examination. We assessed primary hemostasis using endoscopic clipping for diverticular bleeding and described the bleeding stigmata. We measured early ( (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629637 Thu, 03 Nov 2011 04:00:00 +0100 5629637 http://www.medworm.com/index.php?rid=5388535&cid=s_38476_17_f&fid=38476&url=http%3A%2F%2Fdigitalstash.net%2Fpodcasts%2FAGA%2FCGH%2Fmedia%2F2011-11-01_cgh_podcast_november_2011.mp3 A look at new information in the November issue of CGH concerning Transjugular Intrahepatic Portosystemic Shunts (TIPS) for complications of cirrhosis. Dr. Kuemmerle speaks to Dr. Arun Sanyal of Virginia Commonwealth University (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology podcasts http://www.medworm.com/rss/comments.php?id=5388535 Wed, 02 Nov 2011 00:39:40 +0100 5388535 http://www.medworm.com/index.php?rid=5629650&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511011451%2Fabstract%3Frss%3Dyes In their letter, Dr Alavian and colleagues commented on our article regarding the effects of education by a nurse on the adherence to therapy in chronic hepatitis C patients. They raised questions about the role of several potential factors that are not indicated in our paper and that might have affected our results: 1) There was no effect of literacy. Indeed, all patients were required to be able to write, to read, and to understand the informed written consent to participate in the study; 2) All patients were also required to have an adequate socioeconomic status so they would have a reasonable chance to achieve a correct treatment. In addition, all patients had complete social security coverage; 3) There was no significant difference in the occurrence of adverse events, though patients ... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629650 Mon, 31 Oct 2011 04:00:00 +0100 5629650 http://www.medworm.com/index.php?rid=5348738&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009657%2Fabstract%3Frss%3Dyes In consideration of the American Gastroenterological Association (AGA) Institute (the “AGA Institute”) taking action to review and credit the below-identified submission (the “Manuscript”), and for other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned authors and/or creators (the “Authors”), jointly and severally, hereby transfer, convey, and assign to the AGA Institute, free and clear of any liens, licenses or encumbrances, the entire right, title, and interest in and to the Manuscript throughout the world, including without limitation in and to any and all copyrights for the Manuscript (including but not limited to rights to copy, publish, excerpt, collect royalties and make derivative works) in print, electronic, Internet,... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348738 Wed, 26 Oct 2011 20:45:41 +0100 5348738 http://www.medworm.com/index.php?rid=5348737&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009645%2Fabstract%3Frss%3Dyes Clinical Gastroenterology and Hepatology is the go-to resource on a broad spectrum of themes in clinical gastroenterology and hepatology. The official clinical practice journal of the AGA Institute brings you the best original research in the field with a unique combination of reviews, editorials, podcasts, video abstracts, and outcomes research—all supporting clinical practice. Articles on education, policy, and practice management highlight issues pertinent to clinicians. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348737 Wed, 26 Oct 2011 20:45:41 +0100 5348737 http://www.medworm.com/index.php?rid=5348736&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009633%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348736 Wed, 26 Oct 2011 20:45:41 +0100 5348736 http://www.medworm.com/index.php?rid=5348735&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009621%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348735 Wed, 26 Oct 2011 20:45:41 +0100 5348735 http://www.medworm.com/index.php?rid=5348732&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009608%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348732 Wed, 26 Oct 2011 20:45:41 +0100 5348732 http://www.medworm.com/index.php?rid=5348721&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008871%2Fabstract%3Frss%3Dyes Over the last 2 decades, a number of attempts have been made to slow the rise in healthcare costs. Among them were Health Maintenance Organizations, which lowered costs through capitation. In most cases, this resulted in quality being sacrificed for cost and ultimately, many patients rejected the Health Maintenance Organization concept due to the lack of choice and access. The economic downturn and the passage of the Affordable Care Act have again focused scrutiny on rising healthcare costs. In the next several years, the healthcare industry will be challenged to provide more care to more people with fewer resources. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348721 Wed, 26 Oct 2011 20:45:41 +0100 5348721 http://www.medworm.com/index.php?rid=5629627&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010822%2Fabstract%3Frss%3Dyes A 44-year-old woman was referred to our department with an incidental liver nodule found during an abdominal ultrasound for the investigation of unspecific dyspeptic symptoms. Clinical examination was unremarkable, and laboratory tests were within normal limits. Colonoscopy and upper gastrointestinal endoscopy did not reveal any pathologic findings. A magnetic resonance imaging scan was performed, which showed a solitary 2.5-cm lesion located at segment 2 of the liver. This subcapsular nodule (arrows) showed concentric alteration in signal intensity, corresponding to the regions of different histology, seen both on axial T1-weighted ( A and B) and axial T2-weighted ( C) images. Magnetic resonance imaging suggested the diagnosis of epithelioid hemangioendothelioma (EHE) on the basis of the ... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629627 Mon, 24 Oct 2011 04:00:00 +0100 5629627 http://www.medworm.com/index.php?rid=5525916&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010469%2Fabstract%3Frss%3Dyes Conclusions: CEMR might provide acceptable clinical outcomes for patients with large colorectal neoplasms. It results in a low incidence of incomplete treatments and low risk of complications. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525916 Wed, 19 Oct 2011 04:00:00 +0100 5525916 http://www.medworm.com/index.php?rid=5441841&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010421%2Fabstract%3Frss%3Dyes There have been rapid developments in capsule endoscopy from small bowel imaging to recently the colon. Colon capsule endoscopy (CCE) is actually now in its second generation, with the hopes of improved accuracy. This prospective multicenter trial from 8 European sites evaluated 109 patients and compared CCI to conventional colonoscopy. These were patients both at average and increased risk for colorectal neoplasia. Colonoscopy was performed in most cases on the same day or at least 10–12 hours following capsule ingestion, and the physician performing colonoscopy was blinded to the results of CCE. Colonoscopy was considered the gold standard. The per patient sensitivity of CCE for polyps >6 mm and 10 mm was 84% and 88%, respectively with specificities of 64% and 95%, respectively. All 3 ... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441841 Wed, 19 Oct 2011 04:00:00 +0100 5441841 http://www.medworm.com/index.php?rid=5441840&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010445%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441840 Wed, 19 Oct 2011 04:00:00 +0100 5441840 http://www.medworm.com/index.php?rid=5441839&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010433%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441839 Wed, 19 Oct 2011 04:00:00 +0100 5441839 http://www.medworm.com/index.php?rid=5441862&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010366%2Fabstract%3Frss%3Dyes Domínguez-Muñoz JE, Iglesias-García J, Vilariño-Insua M, et al. 13C-Mixed Triglyceride Breath Test to Assess Oral Enzyme Substitution Therapy in Patients With Chronic Pancreatitis. Clin Gastroenterol Hepatol 2007;5:484–488. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441862 Wed, 12 Oct 2011 04:00:00 +0100 5441862 http://www.medworm.com/index.php?rid=5629659&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010317%2Fabstract%3Frss%3Dyes A 56-year-old woman with a 35-year history of ulcerative colitis (UC) and recurrent kidney stones that had been in remission since 1995 on sulfasalazine 1000 mg every other day was diagnosed in July 2010 with a new kidney stone. Her pain was controlled with ketorolac in the acute setting and ibuprofen on discharge. She subsequently started having 10 bloody bowel movements per day associated with abdominal pain. The patient's gastroenterologist increased her sulfasalazine to 1000 mg 3 times per day with little therapeutic benefit. The patient was admitted to our hospital in acute anuric renal failure requiring dialysis. She was found to have extensive bilateral nephrolithiasis on a computed tomography scan. Urinalysis with microscopy revealed crystals resembling needle-like sheaths that wer... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629659 Wed, 05 Oct 2011 04:00:00 +0100 5629659 http://www.medworm.com/index.php?rid=5629654&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651101024X%2Fabstract%3Frss%3Dyes We thank Dr Braillon for his important comments on smoking as an etiology of hepatocellular carcinoma (HCC) and surveillance. We agree that most studies identify smoking as an independent risk factor for HCC. However, because the magnitude of the association between smoking and HCC is smaller than it is with viral hepatitis, alcohol, or nonalcoholic steatohepatitis (NASH), we did not report smoking as a separate risk factor for HCC. Nevertheless, we strongly agree with Dr Braillon on the importance of efforts to reduce smoking for prevention of HCC. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629654 Wed, 05 Oct 2011 04:00:00 +0100 5629654 http://www.medworm.com/index.php?rid=5629647&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010330%2Fabstract%3Frss%3Dyes Conclusions: Malignancy is associated with epithelial nodules in BD-IPMNs and MCNs, but most echogenic lesions detected in cysts by EUS are mucus. Knowledge of features that discriminate mucus from mural nodules improves the diagnostic accuracy of EUS. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629647 Wed, 05 Oct 2011 04:00:00 +0100 5629647 http://www.medworm.com/index.php?rid=5629626&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010263%2Fabstract%3Frss%3Dyes A 74-year-old man presented to the emergency department with complaints of chest discomfort and frothy white emesis 90 minutes after ingesting 2 to 3 oz of 35% hydrogen peroxide solution. The patient's daughter stored the hydrogen peroxide solution in a bottle in her refrigerator and had been using it in diluted form as a naturopathic therapy. The patient's wife poured him a cup of the solution to drink, thinking it was water. On initial evaluation, the patient appeared diaphoretic and uncomfortable. His posterior oropharynx was hyperemic without ulceration. His lungs were clear to auscultation. No subcutaneous crepitus was palpable. His abdomen was obese with normal bowel sounds, and without tenderness, rebound, guarding, or tympany. An esophagram and upper gastrointestinal series reveale... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629626 Wed, 05 Oct 2011 04:00:00 +0100 5629626 http://www.medworm.com/index.php?rid=5525912&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010329%2Fabstract%3Frss%3Dyes The risk of developing cancer or lymphoma is a major concern for individuals with celiac disease, and fear of malignancy is one factor that encourages gluten-free diet adherence. This concern appears well-founded because multiple previous studies have confirmed an elevated risk of lymphoid and certain non-lymphoid gastrointestinal malignancies in patients with clinically detected celiac disease. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525912 Wed, 05 Oct 2011 04:00:00 +0100 5525912 http://www.medworm.com/index.php?rid=5441844&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010287%2Fabstract%3Frss%3Dyes High-resolution manometry (HRM) incorporates 2 major advances in pressure measurement within hollow viscus: increased numbers of sensing units on manometry catheters and computerized data management that fills points in between pressure recordings with best-fit data. The final image is a color-coded pressure topograph, now universally termed Clouse plot in honor of Ray Clouse, who pioneered HRM. Several gains are evident over previously used conventional manometry; anatomic landmarks are easier to identify, data acquisition is shorter for both patient and operator, assessment of esophageal sphincter function is more accurate and specific, and motor patterns are overall easier to recognize. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441844 Wed, 05 Oct 2011 04:00:00 +0100 5441844 http://www.medworm.com/index.php?rid=5629645&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010172%2Fabstract%3Frss%3Dyes Conclusions: Five- and 10-year survival times for patients with PBC who developed HCC were 49.4% and 31.7%, respectively. Patients who meet the Milan criteria receive liver transplantation as often as those who do not; we did not observe a difference in survival time between groups. Patients with PBC who develop HCC appear to benefit from aggressive therapies. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629645 Mon, 03 Oct 2011 04:00:00 +0100 5629645 http://www.medworm.com/index.php?rid=5525931&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010238%2Fabstract%3Frss%3Dyes We appreciate the comments by Dr de-Madaria and colleagues and thank them for their thoughtful letter. They raise an important issue that we have also commented on in our discussion section—the role of reverse causation or “effect-cause” bias in our findings. In any retrospective cohort or case-control study, a potential does exist for an effect-cause explanation—ie, the observed association is real, but the causal pathway is reversed. Dr de-Madaria and colleagues have suggested that patients who develop complications from acute pancreatitis in the first day received more fluids in the second and third day, thereby being identified as being in the “late resuscitation” group. The question then becomes, “Did patients develop a worse outcome because of limited early resuscitatio... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525931 Mon, 03 Oct 2011 04:00:00 +0100 5525931 http://www.medworm.com/index.php?rid=5525926&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010184%2Fabstract%3Frss%3Dyes Conclusions: Use of the artificial intelligence methodology via artificial neural networks supports the medical decision process, providing fast and accurate diagnoses. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525926 Mon, 03 Oct 2011 04:00:00 +0100 5525926 http://www.medworm.com/index.php?rid=5525925&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010196%2Fabstract%3Frss%3Dyes Conclusions: High serum levels of IgE often are observed in older patients with PSC and are associated with a reduced incidence of biliary carcinoma. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525925 Mon, 03 Oct 2011 04:00:00 +0100 5525925 http://www.medworm.com/index.php?rid=5525920&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010214%2Fabstract%3Frss%3Dyes Conclusions: On the basis of data from 1 year of SONIC, the combination of IFX/AZA was more effective than IFX alone in patients with Crohn's disease who are naïve to either drug. For the risks of combination therapy to outweigh the benefits in this time frame, the incidence of serious adverse events would have to be higher than seems clinically realistic. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525920 Mon, 03 Oct 2011 04:00:00 +0100 5525920 http://www.medworm.com/index.php?rid=5274671&cid=s_38476_17_f&fid=38476&url=http%3A%2F%2Fdigitalstash.net%2Fpodcasts%2FAGA%2FCGH%2Fmedia%2F2011-10-01_cgh_podcast_october_2011.mp3 Upper abdominal pain in patients with gallstones is often treated by cholecystectomy but frequently persists. A study in the October issue of CGH found factors that determine patients' odds for relief. Dr. Kummerle speaks to author Dr. Johnson L. Thistle (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology podcasts http://www.medworm.com/rss/comments.php?id=5274671 Sat, 01 Oct 2011 19:40:27 +0100 5274671 http://www.medworm.com/index.php?rid=5261613&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008603%2Fabstract%3Frss%3Dyes In consideration of the American Gastroenterological Association (AGA) Institute (the “AGA Institute”) taking action to review and credit the below-identified submission (the “Manuscript”), and for other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned authors and/or creators (the “Authors”), jointly and severally, hereby transfer, convey, and assign to the AGA Institute, free and clear of any liens, licenses or encumbrances, the entire right, title, and interest in and to the Manuscript throughout the world, including without limitation in and to any and all copyrights for the Manuscript (including but not limited to rights to copy, publish, excerpt, collect royalties and make derivative works) in print, electronic, Internet,... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261613 Thu, 29 Sep 2011 08:28:53 +0100 5261613 http://www.medworm.com/index.php?rid=5261612&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008597%2Fabstract%3Frss%3Dyes Clinical Gastroenterology and Hepatology is the go-to resource on a broad spectrum of themes in clinical gastroenterology and hepatology. The official clinical practice journal of the AGA Institute brings you the best original research in the field with a unique combination of reviews, editorials, podcasts, video abstracts, and outcomes research—all supporting clinical practice. Articles on education, policy, and practice management highlight issues pertinent to clinicians. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261612 Thu, 29 Sep 2011 08:28:53 +0100 5261612 http://www.medworm.com/index.php?rid=5261611&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008585%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261611 Thu, 29 Sep 2011 08:28:53 +0100 5261611 http://www.medworm.com/index.php?rid=5261610&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008573%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261610 Thu, 29 Sep 2011 08:28:53 +0100 5261610 http://www.medworm.com/index.php?rid=5261606&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651100855X%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261606 Thu, 29 Sep 2011 08:28:53 +0100 5261606 http://www.medworm.com/index.php?rid=5261596&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511006100%2Fabstract%3Frss%3Dyes It is well documented that African Americans suffer disproportionately higher incidence (68 vs 55 [men], 53 vs 41 [women] per 100,000) and mortality (31 vs 21 [men], 21 vs 14 [women] per 100,000) rates for colorectal cancer (CRC) in comparison with non-Hispanic whites. Younger African Americans (aged 40–49) are more likely than those aged 50–59 to develop high-grade dysplasia, have 10.7 more cases of CRC per 100,000 people than Caucasians, have the youngest age of onset, and the most advanced stage of presentation. African Americans older than age 75 are at increased risk of adenomas, and the detection rate is even higher among those with a history of advanced adenomas. In addition, African Americans have an increased incidence of proximal colon lesions. (Source: Clinical Gastroenterol... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261596 Thu, 29 Sep 2011 08:28:53 +0100 5261596 http://www.medworm.com/index.php?rid=5629646&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009955%2Fabstract%3Frss%3Dyes Conclusions: Triamcinolone does not increase pain relief or lengthen the effects of EUS-CPB. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629646 Mon, 26 Sep 2011 04:00:00 +0100 5629646 http://www.medworm.com/index.php?rid=5525927&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009979%2Fabstract%3Frss%3Dyes Conclusions: IgG4-positive plasma cells are not more numerous in the digestive mucosa of AIP patients than in controls, but they are more abundant in the colon of IBD patients than in AIP patients. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525927 Mon, 26 Sep 2011 04:00:00 +0100 5525927 http://www.medworm.com/index.php?rid=5525924&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009992%2Fabstract%3Frss%3Dyes Conclusions: Patients with NC-PVT have hypercoagulability that is independent of the underlying etiology, based on in vitro analyses of thrombin-generation capacity and increased levels of biomarkers in blood samples. Further studies are required to determine if activation of hemostasis increases the risk for thrombotic events. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525924 Mon, 26 Sep 2011 04:00:00 +0100 5525924 http://www.medworm.com/index.php?rid=5525923&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010007%2Fabstract%3Frss%3Dyes Conclusions: Development of AKI reduces survival of patients with AH, in the short term. The AKIN criteria are useful and more accurate than traditional criteria in predicting mortality. Strategies to prevent AKI therefore should be considered in the management of patients with AH. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525923 Mon, 26 Sep 2011 04:00:00 +0100 5525923 http://www.medworm.com/index.php?rid=5525921&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009943%2Fabstract%3Frss%3Dyes Conclusions: Despite the increased use of APCT by emergency departments for patients with CD, there were no significant changes in admission rates between the periods of 2001–2003 and 2007–2009. The proportion of APCTs that detected intestinal perforation, obstruction, abscess, or other urgent conditions not related to CD remained high. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525921 Mon, 26 Sep 2011 04:00:00 +0100 5525921 http://www.medworm.com/index.php?rid=5525913&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009980%2Fabstract%3Frss%3Dyes In this issue of Clinical Gastroenterology Hepatology, Khiani et al provide an important glimpse into the evolution of the practice of procedural sedation for gastrointestinal endoscopy in the United States. By using the Surveillance Epidemiology and End Results Medicare database, the authors found that anesthesiologist involvement in screening colonoscopies among Medicare beneficiaries increased substantially over a 5-year period from 11% to 23.4%. Given the fact that the screening colonoscopy rate more than doubled over the interval examined, there is actually a potent multiplicative effect in the absolute numbers of patients undergoing anesthesia-assisted colonoscopy. Is this a welcome development in the effort to provide safe and effective endoscopic procedures for this, or is this a p... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525913 Mon, 26 Sep 2011 04:00:00 +0100 5525913 http://www.medworm.com/index.php?rid=5441861&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511010019%2Fabstract%3Frss%3Dyes We agree that the problem raised by Dr Matuchansky is potentially relevant. Several reports in the recent literature have emphasized the patchiness of the celiac lesion and the possibility that early lesions affect only the bulb, with the distal duodenum being normal. These data have been considered by European Society for Gastroenterology and Nutrition, and in the recently revised diagnostic criteria a biopsy from the bulb is always requested. However, the difficulties in the interpretation of bulb findings must also be considered. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441861 Mon, 26 Sep 2011 04:00:00 +0100 5441861 http://www.medworm.com/index.php?rid=5441843&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009967%2Fabstract%3Frss%3Dyes Pain during insertion and missed proximal lesions during withdrawal are 2 important modern challenges of screening colonoscopy. Trends toward embracing moderate to deep sedation testify to the need to manage pain to make screening more attractive. Loop reduction, external compression, and position change are effective in reducing pain but require time. Sedation can help make careful pushing through loops more tolerable to patients. Added costs and adverse events are inevitable. Poor bowel cleansing and suboptimal withdrawal techniques may contribute to missed proximal lesions. Split-dose or same-day purge can produce improved proximal colon bowel preparation quality scores evaluated by unbiased observers. Interventions targeting colonoscopist performance can modify withdrawal techniques. N... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441843 Mon, 26 Sep 2011 04:00:00 +0100 5441843 http://www.medworm.com/index.php?rid=5348713&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009530%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348713 Mon, 26 Sep 2011 04:00:00 +0100 5348713 http://www.medworm.com/index.php?rid=5348714&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009542%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348714 Thu, 22 Sep 2011 04:00:00 +0100 5348714 http://www.medworm.com/index.php?rid=5348715&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009529%2Fabstract%3Frss%3Dyes This study examined malpractice data from 1991 through 2005 with a client base of over 40,000 physicians with over 233,000 years of physician coverage by a large professional liability insurer. They found that across specialties, 7.4% of physicians had a malpractice claim annually, with 1.6% having a claim leading to a payment. The number of physicians with yearly claims was disproportionately represented by neurosurgery (19%), thoracic and cardiovascular surgery (18.9%), and general surgery (15.3%). For our specialty of gastroenterology—we were the 6th highest and the highest of medical specialties—over 10% of physicians had a malpractice claim annually, with an approximate 2%–3% rate of payment to a plaintiff. The median payment to plaintiffs was over $200,000, and for gastroentero... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348715 Wed, 21 Sep 2011 04:00:00 +0100 5348715 http://www.medworm.com/index.php?rid=5629656&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009128%2Fabstract%3Frss%3Dyes A 33-year-old woman with a history of systemic lupus erythematosus was admitted to the hospital with melena, hematochezia, and syncope. Upper endoscopy did not demonstrate any bleeding source. Colonoscopy revealed varices between mid and distal ascending colon and blood clots at colonic mucosa ( A). Therefore, variceal hemorrhage in ascending colon was suspected. To find a cause of ascending colonic varices, abdominal computed tomography (CT) angiography ( B and C) was performed. CT angiogram demonstrated development of collateral vessels at retroperitoneum (black arrow, B and C), abdominal wall (white arrow, B), and drainage of both renal veins to the mentioned collateral vessels (4 white lightning arrows, C), but liver cirrhosis, portal vein obstruction, and splenomegaly were not found. ... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629656 Mon, 05 Sep 2011 04:00:00 +0100 5629656 http://www.medworm.com/index.php?rid=5629643&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009165%2Fabstract%3Frss%3Dyes Conclusions: Sarcopenia is associated with mortality in patients with cirrhosis. It does not correlate with the degree of liver dysfunction evaluated by using conventional scoring systems. Scoring systems should include evaluation of sarcopenia to better assess mortality among patients with cirrhosis. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629643 Mon, 05 Sep 2011 04:00:00 +0100 5629643 http://www.medworm.com/index.php?rid=5629635&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009049%2Fabstract%3Frss%3Dyes Malnutrition is prevalent among cirrhotic patients and is an important prognostic factor. Etiologic factors include hypermetabolism, malabsorption, altered nutrient metabolism, and anorexia. It is a challenge to manage nutrition in cirrhotic patients because of alterations to metabolic and storage functions of the liver; use of traditional assessment tools, such as anthropometric and biometric measures, is difficult because of complications such as ascites and inflammation. In addition to meeting macro- and micronutrient requirements, the composition and timing of supplements have been proposed to affect efficacy of nutrition support. Studies have indicated that branched chain aromatic acid can be given as therapeutic nutrients, and that probiotics and nocturnal feeding improve patient out... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629635 Mon, 05 Sep 2011 04:00:00 +0100 5629635 http://www.medworm.com/index.php?rid=5525908&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009050%2Fabstract%3Frss%3Dyes A 71-year-old man with hypertension, coronary artery disease, and heavy alcohol use presented with abdominal pain, confusion, and rectal bleeding. Laboratory testing revealed hepatitis C infection, severe lactic acidosis, and abnormal liver function tests: arterial pH, 7.10; lactic acid, 16.8 mmol/L (reference range, 0.7–2.1); total bilirubin, 4.50 mg/dL (0.10–1.2); conjugated bilirubin, 3.37 mg/dL (0.0–0.3); unconjugated bilirubin, 1.13 mg/dL (0.1–1.0); alanine aminotransferase, 561 U/L (0–40); aspartate aminotransferase, 2273 U/L (0–39). Hepatitis C viral antibodies were present. He also had thrombocytopenia, hyperglycemia, and a coagulopathy. Contrast computed tomography showed a large heterogeneous liver mass extending into the inferior vena cava (IVC) and right atrium ( A)... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525908 Mon, 05 Sep 2011 04:00:00 +0100 5525908 http://www.medworm.com/index.php?rid=5525907&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009062%2Fabstract%3Frss%3Dyes A69-year-old man with an unremarkable medical history presented with a 3-month history of initially unilateral but subsequently bilateral lower limb pitting edema in the absence of dyspnea or chest discomfort. An abdominal ultrasound was suggestive of a retroperitoneal mass. A subsequent contrast-enhanced computed tomography of the abdomen revealed a 7.0 × 3.8 × 8.4 cm septated cystic lesion in the pancreatic head that extended toward the hepatic hilum with an unobstructed main pancreatic duct (). In contrast, endoscopic ultrasonography with fine-needle aspiration revealed a solid, well-defined mass confined to the pancreatic head, establishing an endocrine neoplasm immunoreactive with synaptophysin, chromogranin, keratin, and CAM 5.2 ( A–D). A preoperative 24-hour urinary collection r... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525907 Mon, 05 Sep 2011 04:00:00 +0100 5525907 http://www.medworm.com/index.php?rid=5441858&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009141%2Fabstract%3Frss%3Dyes Conclusions: IP is severe in only 1% to 3% of patients; mortality of IP is associated strongly with comorbidity. EXPN is more frequently severe than IP; EXPN must be distinguished from IP in clinical studies. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441858 Mon, 05 Sep 2011 04:00:00 +0100 5441858 http://www.medworm.com/index.php?rid=5441857&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009153%2Fabstract%3Frss%3Dyes Conclusions: In a population-based epidemiology study of PSC in Canterbury, New Zealand, we observed large differences between PSC patients with or without concurrent IBD in age at diagnosis, development of cancer, mortality, and requirement for liver transplantation. IBD therefore affects outcomes of patients with PSC, an important observation that requires further study. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441857 Mon, 05 Sep 2011 04:00:00 +0100 5441857 http://www.medworm.com/index.php?rid=5441845&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651100913X%2Fabstract%3Frss%3Dyes Clostridium difficile is a spore-forming, anaerobic, and gram-positive bacterium that causes gastrointestinal infection resulting in diarrhea and colitis. There has been a dramatic increase in both the incidence and the severity of C difficile infection (CDI) during the past decade. Recent studies demonstrate that nosocomial CDI prolongs hospital stay, even after controlling for confounding variables such as admission diagnosis, age, and burden of comorbidities, amounting to $1–3 billion per year in extra hospital costs alone in the United States. The increased severity of CDI is reflected in markedly increased death rates (from 5.7 deaths per million population in 1999 to 23.7 deaths per million population in 2004), making it a leading cause of death from nosocomial infection. Recurrenc... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441845 Mon, 05 Sep 2011 04:00:00 +0100 5441845 http://www.medworm.com/index.php?rid=5184810&cid=s_38476_17_f&fid=38476&url=http%3A%2F%2Fdigitalstash.net%2Fpodcasts%2FAGA%2FCGH%2Fmedia%2F2011-09-01_cgh_podcast_september_2011.mp3 A review article in the September issue of CGH looks at the pathogenesis of infections and immune dysfunction in patients with cirrhosis. Dr. Kuemmerle speaks to author K. Rajender Reddy of the University of Pennsylvania Health System (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology podcasts http://www.medworm.com/rss/comments.php?id=5184810 Thu, 01 Sep 2011 20:31:21 +0100 5184810 http://www.medworm.com/index.php?rid=5525935&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009116%2Fabstract%3Frss%3Dyes A 31-year-old man with portal hypertension caused by extrahepatic portal venous obstruction had recurrent episodes of hematemesis. He underwent a proximal lienorenal shunt 20 years ago and remained well for 15 years. Five years ago, he had 2 episodes of hematemesis, an endoscopy showed grade 2 esophageal varices and endoscopic variceal ligation was performed. He presented now with dull aching right upper abdominal pain and jaundice for 3 months without any associated symptoms. On examination, he was found to be icteric. His total (direct) serum bilirubin level was 10 mg/dL (7.4 mg/dL) with a markedly increased alkaline phosphatase level (2695 IU/L; normal range, 80–280 IU). An abdominal Doppler ultrasound examination showed dilatation of the intrahepatic biliary radicles and proximal com... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525935 Thu, 01 Sep 2011 04:00:00 +0100 5525935 http://www.medworm.com/index.php?rid=5525930&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009086%2Fabstract%3Frss%3Dyes In a recent study by Warndorf et al, it is concluded that those patients with acute pancreatitis receiving one-third or more of the total 72-hour fluid volume within 24 hours of presentation have reduced incidence of systemic inflammatory response syndrome and organ failure, so an early aggressive fluid therapy is recommended. The benefits of this approach have not been confirmed in prospective studies. Furthermore, it has been suggested that it might be associated with increased incidence of complications (particularly respiratory failure). (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525930 Thu, 01 Sep 2011 04:00:00 +0100 5525930 http://www.medworm.com/index.php?rid=5525928&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009104%2Fabstract%3Frss%3Dyes We read the article by Triantos and colleagues with great interest. The authors prospectively assessed adrenal function in 20 patients with variceal bleeding and 60 nonbleeding cirrhotic patients with a low-dose short synacthen test (LD-SST; 1 μg) and/or a standard-dose (250 μg) short synacthen test. Their crude conclusion was that adrenal insufficiency in bleeding patients using well-defined serum total cortisol thresholds was common, mainly using the low-dose short synacthen test (60% vs 48% in nonbleeding patients). The authors also found no significant difference in albumin concentrations between bleeding patients with and without adrenal insufficiency. These interesting results deserve comment because nearly 80% of circulating cortisol in serum is bound to corticosteroid-binding glo... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525928 Thu, 01 Sep 2011 04:00:00 +0100 5525928 http://www.medworm.com/index.php?rid=5525906&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009074%2Fabstract%3Frss%3Dyes A 53-year-old male patient was admitted to our hospital because of abdominal epigastric pain, melena, asthenia, and orthostatic hypotension. During the last 2 years he had presented with 2 previous similar episodes. Upper and lower gastrointestinal endoscopy were performed 5 months before and showed a small cardial peptic ulcer and sigmoid diverticulosis. He had a history of renal transplantation 20 years ago as a result of chronic pyelonephritis and has been on hemodialysis for the last year. Physical examination was unremarkable. Blood analysis showed iron deficiency anemia (hemoglobin, 7.7 g/dL; ferritin, 47.9 ng/mL), and normal coagulation parameters and liver function test results. An abdominal computed tomography and gastroscopy showed no abnormalities. A capsule endoscopy (CE) was p... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525906 Thu, 01 Sep 2011 04:00:00 +0100 5525906 http://www.medworm.com/index.php?rid=5441867&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511009098%2Fabstract%3Frss%3Dyes A 73-year-old woman presented with melena 4 days before admission, weight loss, and inappetence. She had peripheral arterial disease of the abdominal aorta and lower extremities and had undergone aortobifemoral bypass surgery 3 years previously. On presentation, she was hemodynamically stable (heart rate, 106/min; blood pressure, 100/60 mm Hg) and had blood hemoglobin of 12.5 g/100 mL (normal range, 12.0–16.0 g/100 mL). Laboratory data were notable for serum C-reactive protein of 36.34 mg/100 mL (normal range, 0.01–0.82 g/100 mL) and white blood cell count of 13,500/μL (normal range, 4000–10,000/μL), which were unexplained at first. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441867 Thu, 01 Sep 2011 04:00:00 +0100 5441867 http://www.medworm.com/index.php?rid=5163175&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007452%2Fabstract%3Frss%3Dyes In consideration of the American Gastroenterological Association (AGA) Institute (the “AGA Institute”) taking action to review and credit the below-identified submission (the “Manuscript”), and for other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned authors and/or creators (the “Authors”), jointly and severally, hereby transfer, convey, and assign to the AGA Institute, free and clear of any liens, licenses or encumbrances, the entire right, title, and interest in and to the Manuscript throughout the world, including without limitation in and to any and all copyrights for the Manuscript (including but not limited to rights to copy, publish, excerpt, collect royalties and make derivative works) in print, electronic, Internet,... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163175 Sat, 27 Aug 2011 16:09:51 +0100 5163175 http://www.medworm.com/index.php?rid=5163174&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007440%2Fabstract%3Frss%3Dyes Clinical Gastroenterology and Hepatology is the go-to resource on a broad spectrum of themes in clinical gastroenterology and hepatology. The official clinical practice journal of the AGA Institute brings you the best original research in the field with a unique combination of reviews, editorials, podcasts, video abstracts, and outcomes research—all supporting clinical practice. Articles on education, policy, and practice management highlight issues pertinent to clinicians. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163174 Sat, 27 Aug 2011 16:09:51 +0100 5163174 http://www.medworm.com/index.php?rid=5163173&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007439%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163173 Sat, 27 Aug 2011 16:09:51 +0100 5163173 http://www.medworm.com/index.php?rid=5163172&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007427%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163172 Sat, 27 Aug 2011 16:09:51 +0100 5163172 http://www.medworm.com/index.php?rid=5163168&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007403%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163168 Sat, 27 Aug 2011 16:09:49 +0100 5163168 http://www.medworm.com/index.php?rid=5163154&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511005702%2Fabstract%3Frss%3Dyes Soaring health care costs. Waning confidence in medicine's effectiveness. Limited access to care. Sound familiar? These present-day concerns are actually not so new; by 1970 an American health care crisis had already been declared. Since then, government and private payers have attempted to use legislation, regulation, and market forces to reshape how health care is financed and delivered. At each step, the health care industry has countered with efforts to preserve its autonomy and slice of the economic pie. The end result? A health care system that is consistently far more expensive, yet objectively less effective than those of other industrialized nations. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163154 Sat, 27 Aug 2011 16:09:47 +0100 5163154 http://www.medworm.com/index.php?rid=5629648&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008895%2Fabstract%3Frss%3Dyes Conclusions: PPI treatment interruption has dangerous consequences, and PPI therapy always should be maintained in patients known or suspected of ZES. Diagnostic evaluations should be performed under PPI protection. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629648 Thu, 25 Aug 2011 04:00:00 +0100 5629648 http://www.medworm.com/index.php?rid=5525919&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008925%2Fabstract%3Frss%3Dyes Conclusions: In a large, managed care cohort, most diagnoses of IBS were made by generalists, often without endoscopic evaluation. Patients with IBS had consistently higher rates of testing, chronic pain syndromes, psychiatric comorbidity, and operations than controls. Most patients with IBS were treated with psychiatric medications. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525919 Thu, 25 Aug 2011 04:00:00 +0100 5525919 http://www.medworm.com/index.php?rid=5441852&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008901%2Fabstract%3Frss%3Dyes Conclusions: There are similarities and differences in clinical characteristics of DG and IG. Gastroparesis is a heterogeneous disorder; its etiology affects symptoms and severity. Long-term studies are needed to determine whether the differences in symptoms and gastric emptying affect progression and treatment responses. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441852 Thu, 25 Aug 2011 04:00:00 +0100 5441852 http://www.medworm.com/index.php?rid=5441850&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008913%2Fabstract%3Frss%3Dyes Clostridium difficile infection is increasing in incidence, severity, and mortality. Treatment options are limited and appear to be losing efficacy. Recurrent disease is especially challenging; extended treatment with oral vancomycin is becoming increasingly common but is expensive. Fecal microbiota transplantation is safe, inexpensive, and effective; according to case and small series reports, about 90% of patients are cured. We discuss the rationale, methods, and use of fecal microbiota transplantation. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441850 Thu, 25 Aug 2011 04:00:00 +0100 5441850 http://www.medworm.com/index.php?rid=5348731&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008883%2Fabstract%3Frss%3Dyes I would like to thank Giannini and coworkers for their thoughtful comments on the potential improved sustained virologic response (SVR) rates that can possibly be obtained also in end-stage renal disease (ESRD) patients on hemodialysis with combination antiviral therapy, including ribavirin. When we were initially planning the “Hemodialysis patients: Efficacy with low-dose Pegasys” (HELPS) trial, none of the data on combination therapy in ESRD patients referred to by Giannini had been published. Neither was there a dose-ranging study of peginterferon alfa-2a, nor any larger prospective study on peginterferon alfa-2a in hepatitis C virus (HCV)-infected ESRD patients at all. So the decision was made to take one step at a time and conduct a solid study to evaluate the efficacy and safety ... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348731 Wed, 24 Aug 2011 04:00:00 +0100 5348731 http://www.medworm.com/index.php?rid=5629658&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008512%2Fabstract%3Frss%3Dyes A 46-year-old woman presented with complaints of loose stools for 2 months and unintentional weight loss of 20 lbs. She had a medical history of irritable bowel syndrome, endometriosis, and fibromyalgia. Her medications included hyoscyamine, calcium carbonate, and norethindrone acetate. Physical examination, vital signs, and complete blood count were all within normal limits. To further evaluate her symptoms, we performed esophagogastroduodenoscopy and colonoscopy studies. Esophagogastroduodenoscopy showed that she had a normal duodenum, that her stomach had mild diffuse erythema, and that she had a normal esophagus. Random biopsy samples were taken from the duodenum and stomach. Histologically, the duodenum was unremarkable and showed no duodenitis, eosinophilia, or celiac-related changes... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629658 Fri, 19 Aug 2011 04:00:00 +0100 5629658 http://www.medworm.com/index.php?rid=5441855&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008536%2Fabstract%3Frss%3Dyes Conclusions: From 1997 to 2008 opioid prescriptions for chronic abdominal pain more than doubled. Further studies are needed to better understand the reasons for and consequences of this trend. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441855 Fri, 19 Aug 2011 04:00:00 +0100 5441855 http://www.medworm.com/index.php?rid=5441853&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008548%2Fabstract%3Frss%3Dyes Conclusions: The IBS-SAT is a validated measure of patient satisfaction with IBS care. As a new, condition-specific instrument, it is likely to be a useful tool for quality measurement, health services research, and clinical trials. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441853 Fri, 19 Aug 2011 04:00:00 +0100 5441853 http://www.medworm.com/index.php?rid=5441851&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008524%2Fabstract%3Frss%3Dyes Conclusions: Technically imperfect EPT studies are common in a tertiary care center; large hiatal hernia and achalasia were the most frequent causes. However, despite the technical limitations, the data still could be interpreted, especially in the context of associated endoscopic and radiographic data. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441851 Fri, 19 Aug 2011 04:00:00 +0100 5441851 http://www.medworm.com/index.php?rid=5261586&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008202%2Fabstract%3Frss%3Dyes Previous studies have convincingly demonstrated that proton pump inhibitors (PPIs) reduce the rate of aspirin and nonsteroidal anti-inflammatory drug (NSAID)-related upper gastrointestinal bleeding (UGIB). Emerging evidence suggests that such therapy may also be beneficial for patients receiving dual antiplatelet therapy. This large study not only examined the utility of PPIs in preventing UGIB in the general population, but those on antithrombotic or anti-inflammatory therapy as well. Over a 7-year period, using a primary care database, 2049 cases of UGIB and 20,000 controls were examined. The risk reduction of UGIB associated with the current use of PPIs for more than a month was 0.58 (95% CI, 0.42–0.79) among patients who received low-dose aspirin; 0.18 (95% CI, 0.04–0.79) for clopi... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261586 Wed, 17 Aug 2011 04:00:00 +0100 5261586 http://www.medworm.com/index.php?rid=5629657&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008081%2Fabstract%3Frss%3Dyes A 61-year-old man with deep vein thromboses, pulmonary emboli, and heavy alcohol and tobacco use presented with a month's history of hematochezia. Physical examination was noncontributory. Laboratory data at admission were remarkable for anemia, with hemoglobin of 8.6 g/dL and a supratherapeutic international normalized ratio of 4.9. Upper endoscopy was unremarkable, with no hemorrhage or mass lesions. Colonoscopy demonstrated a 3- to 4-mm cecal polyp, a 1.5-cm pedunculated sigmoid polyp with 2-mm surface ulcerations ( A), and a 6- to 7-cm ulcerated rectal mass. The rest of the colon appeared normal. Histopathologic evaluation revealed an unusual histiocytic proliferation within the lamina propria and submucosa of the cecal polyp. The histiocytes contained lamellated intracytoplasmic inclu... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629657 Fri, 12 Aug 2011 04:00:00 +0100 5629657 http://www.medworm.com/index.php?rid=5629653&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008123%2Fabstract%3Frss%3Dyes Dear Editor: Yang and colleagues reported a retrospective series of 406 patients to review the causes of hepatocellular carcinoma (HCC) and the effect of screening. This deserves several comments. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629653 Fri, 12 Aug 2011 04:00:00 +0100 5629653 http://www.medworm.com/index.php?rid=5629649&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008135%2Fabstract%3Frss%3Dyes Dear Editor: We read with interest the published article by Larrey et al in your journal recently. Adherence is a reason for more sustained virologic response (SVR) in group A with more genotype-1 patients. Patients with genotype-1 profit more than others because of longer duration (48 weeks) of treatment and more risk of drop-out among them. We believe the education by a nurse did not affect the SVR in genotype 2 and 3 groups because of their good compliance with shorter treatment duration (24 weeks). (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629649 Fri, 12 Aug 2011 04:00:00 +0100 5629649 http://www.medworm.com/index.php?rid=5629644&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008111%2Fabstract%3Frss%3Dyes Conclusions: Fatigue is common among patients with cirrhosis and associated with impaired quality of life. Psychological distress, severity of cirrhosis, and low levels of cortisol determine general fatigue, whereas anemia and impaired renal function also contribute to physical fatigue. Physical fatigue remains of concern for patients who have received liver transplants for cirrhosis. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629644 Fri, 12 Aug 2011 04:00:00 +0100 5629644 http://www.medworm.com/index.php?rid=5525905&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008093%2Fabstract%3Frss%3Dyes We describe a patient in whom a partially covered SEMS was placed for benign disease prior to the commercial availability of fully covered SEMS and SEPS. Subsequent removal was complicated by stent avulsion. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525905 Fri, 12 Aug 2011 04:00:00 +0100 5525905 http://www.medworm.com/index.php?rid=5441859&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651100810X%2Fabstract%3Frss%3Dyes A patient presented with chronic substernal discomfort and intermittent dysphagia for solids. High-resolution impedance manometry (HRIM) of the esophagus showed that there was no peristalsis in the esophageal body but incomplete relaxation of the lower esophageal sphincter and incomplete bolus transit, so the patient was diagnosed with achalasia. Moreover, probably because of esophageal stasis, eosinophilic infiltration that mimicked a pattern of eosinophilic esophagitis was observed, on the basis of multiple biopsies of the esophagus. The patient was given 50 mg prednisolone once daily; the symptoms improved dramatically, and HRIM showed complete recovery of esophageal peristalsis, deeper relaxation of the lower esophageal sphincter, and complete bolus transit profile. HRIM can therefore ... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441859 Fri, 12 Aug 2011 04:00:00 +0100 5441859 http://www.medworm.com/index.php?rid=5348724&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008147%2Fabstract%3Frss%3Dyes Conclusions: Twenty-five percent of patients with IBS have FH. These patients had increased levels of fecal ECP and tryptase, indicating that they might cause inflammation in patients with IBS. Fecal assays for ECP could be used to identify FH in patients with IBS. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348724 Fri, 12 Aug 2011 04:00:00 +0100 5348724 http://www.medworm.com/index.php?rid=5261605&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651100807X%2Fabstract%3Frss%3Dyes Calabrese C, Liguori G. Acute esophageal necrosis. Clin Gastroenterol Hepatol 2011;9:A30. In the above article, the following text was not properly cited from another published work (Gurvits GE, Shapsis A, Lau N, et al. Acute esophageal necrosis: a rare syndrome. J Gastroenterol 2007;42:29–38). Any future citations based on the following sentences should cite the Gurvits et al article instead of the Calabrese et al article: (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261605 Mon, 08 Aug 2011 04:00:00 +0100 5261605 http://www.medworm.com/index.php?rid=5441856&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008019%2Fabstract%3Frss%3Dyes Conclusions: More than 25% of patients with biliary atresia survive at least 20 years without liver transplantation in The Netherlands. Women with biliary atresia have a reduced perception of their health, compared with control patients. Twenty percent of long-term survivors are symptom-free, without clinical or ultrasonographic signs of cirrhosis or portal hypertension. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5441856 Fri, 05 Aug 2011 04:00:00 +0100 5441856 http://www.medworm.com/index.php?rid=5348727&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008032%2Fabstract%3Frss%3Dyes Background & Aims: Hepatocellular carcinoma (HCC) can result from hepatitis C virus (HCV)-related liver disease and is the fastest-growing cause of cancer-related death in the United States. α-fetoprotein (AFP) has been used as a prognostic factor for HCC, but the value of AFP as a prognostic factor for HCV-related HCC in the United States is unknown. We investigated whether higher levels of AFP at the time of diagnosis are associated with increased mortality of patients with HCV-related HCC.Methods: In a retrospective study, we collected data from a cohort of HCV-infected veterans, identifying incident HCC cases from October 1, 1998, to January 1, 2007 (n = 1480 patients). The mean serum levels of AFP, obtained within 60 days before to 30 days after HCC diagnosis, were determined for 106... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348727 Fri, 05 Aug 2011 04:00:00 +0100 5348727 http://www.medworm.com/index.php?rid=5261584&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007968%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261584 Fri, 05 Aug 2011 04:00:00 +0100 5261584 http://www.medworm.com/index.php?rid=5348717&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007993%2Fabstract%3Frss%3Dyes “The presence or absence, the severity or rate of progress of the pancreatic lesion does not appear to vary with the quantity of alcohol ingested. Apparently, it may attack an individual who has had little or no previous indulgence … while it may completely spare a chronic and severe alcoholic. Alcohol alone is not enough.”“The … first attack usually occurred against a background of a heavy alcoholic intake of about 5–15 years' duration …. Relationship of the attack to an alcoholic binge or a night's over-indulgence was of paramount importance, but in many the amount of alcohol consumed was not necessarily greater than, or indeed as much as, that taken with impunity on previous occasions.” (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348717 Thu, 04 Aug 2011 04:00:00 +0100 5348717 http://www.medworm.com/index.php?rid=5348716&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511008007%2Fabstract%3Frss%3Dyes The concept of severity in irritable bowel syndrome (IBS) is clinically recognized and operative in making management decisions yet is poorly understood. Thus, the Rome Foundation Working Team Committee recently developed a consensus on this concept and made recommendations for its use in research and clinical care. The working team based the need and importance of a clearer understanding of IBS severity on several factors: (1) severity in IBS is determined by symptom reports and behaviors rather than by objective data; (2) categories of severity can influence diagnostic decisions and treatment planning; (3) there is no formalized way of categorizing IBS patients into clinically meaningful subgroups of severity; (4) severity needs to be understood within a psychosocial context; and (5) a b... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348716 Thu, 04 Aug 2011 04:00:00 +0100 5348716 http://www.medworm.com/index.php?rid=5261585&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651100797X%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261585 Thu, 04 Aug 2011 04:00:00 +0100 5261585 http://www.medworm.com/index.php?rid=5089091&cid=s_38476_17_f&fid=38476&url=http%3A%2F%2Fdigitalstash.net%2Fpodcasts%2FAGA%2FCGH%2Fmedia%2F2011-08-02_cgh_podcast_august_2011.mp3 Early Fluid Resuscitation Reduces Morbidity Among Patients With Acute Pancreatitis; Lactated Ringer's Solution Reduces Systemic Inflammation Compared With Saline in Patients With Acute Pancreatitis. Dr. Kuemmerle interviews author Dr. Timothy B. Gardner (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology podcasts http://www.medworm.com/rss/comments.php?id=5089091 Tue, 02 Aug 2011 15:36:14 +0100 5089091 http://www.medworm.com/index.php?rid=5629651&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007907%2Fabstract%3Frss%3Dyes Dear Editor: We read with great interest a recent article published in the journal Clinical Gastroenterology and Hepatology. Yang et al showed partial results obtained from a multiregional longitudinal cohort study on global hepatocellular carcinoma (HCC) surveillance. The authors showed that in descending order of importance, hepatitis C virus infection, alcohol use (>20 g/d), and nonalcoholic fatty liver disease (NAFLD) represent the predominant HCC etiologies. Interestingly, another recent study reported that patients affected by NAFLD- or alcohol-related HCC displayed a larger pattern of other metabolic syndrome–related features than patients presenting with HCCs from other etiologies. All these findings suggest that metabolic syndrome could be a promoting factor of hepatocarcinogen... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629651 Mon, 01 Aug 2011 04:00:00 +0100 5629651 http://www.medworm.com/index.php?rid=5629636&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007890%2Fabstract%3Frss%3Dyes See related article, Poitras P et al on page 199, in this issue of CGH. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629636 Mon, 01 Aug 2011 04:00:00 +0100 5629636 http://www.medworm.com/index.php?rid=5629625&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007919%2Fabstract%3Frss%3Dyes An 86-year-old man was admitted to our emergency department (ED) with massive lower gastrointestinal (GI) bleeding. His past history included pancreatoduodenectomy more than 5 years previously. Physical examination revealed a Glasgow Coma Scale score of E3V4M6 (total of 13), blood pressure 94/60 mm Hg, and heart rate 72 beats per minute. Hemoglobin concentration, hematocrit, and platelet count were 6.5 g/dL (normal, 11.0–17.0 g/dL), 20.0% (normal, 34%–49%), and 7.4 × 104/μL (normal, 14–34 × 104/μL), respectively. Enhanced computed tomography (CT) of the abdomen revealed extravasation of contrast medium at the hepatic flexure of the colon ( Ai). Multiplanar reconstruction (MPR) and volume-rendered 3-D reconstruction of arterial-phase CT images revealed arterial bleeding from the p... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629625 Mon, 01 Aug 2011 04:00:00 +0100 5629625 http://www.medworm.com/index.php?rid=5348729&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007920%2Fabstract%3Frss%3Dyes Conclusions: Treating portal hypertension by TIPS in patients with advanced cirrhosis and without HE had no effect on their CBF and seemed not to entail a risk of cerebral hypoperfusion. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348729 Mon, 01 Aug 2011 04:00:00 +0100 5348729 http://www.medworm.com/index.php?rid=5348726&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007956%2Fabstract%3Frss%3Dyes Conclusions: Ileal inflammation is not a contraindication for restorative proctocolectomy with ileal pouch construction in patients with UC or idiopathic inflammatory bowel disease of indeterminate type. Ileal inflammation with pancolitis is not a useful criterion for classifying otherwise typical UC as colitis of indeterminate type, because pouch outcomes are not affected. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348726 Mon, 01 Aug 2011 04:00:00 +0100 5348726 http://www.medworm.com/index.php?rid=5348725&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007932%2Fabstract%3Frss%3Dyes Conclusions: Postoperative complications frequently occur after colectomy for UC, predominantly among elderly patients with multiple comorbidities. Patients who were admitted to the hospital under emergency conditions and did not respond to medical treatment had worse outcomes when surgery was performed 14 or more days after admission. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348725 Mon, 01 Aug 2011 04:00:00 +0100 5348725 http://www.medworm.com/index.php?rid=5348722&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007944%2Fabstract%3Frss%3Dyes Conclusions: The clinical presentation of EGE is heterogeneous and varies in histologic pattern; about 40% of patients resolve the disease spontaneously, without relapse. Approximately 50% have a more complex disease, which is characterized by unpredictable relapses and a chronic course. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5348722 Mon, 01 Aug 2011 04:00:00 +0100 5348722 http://www.medworm.com/index.php?rid=5525934&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007397%2Fabstract%3Frss%3Dyes A 58-year-old man was admitted with a 2-month history of severe, sharp epigastric pain radiating to the flank and back, nonbilious emesis, and a 7-kg weight-loss. He had a 20-pack-per-year smoking history as well as significant chronic alcohol abuse. Electrolytes and liver function tests were normal. Contrast-enhanced computed tomography (CT) identified a 6-cm complex pancreatic head mass showing both solid and cystic components with extrinsic compression of the duodenum ( A). The common bile duct was dilated at 8 mm. CT-guided biopsy cores of the pancreatic head mass revealed acutely inflamed glands and normal duodenal mucosa. There was no definitive evidence of malignancy. The patient then underwent pancreaticoduodenectomy with curative intent. Gross examination revealed a poorly defined... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525934 Thu, 28 Jul 2011 04:00:00 +0100 5525934 http://www.medworm.com/index.php?rid=5261589&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007385%2Fabstract%3Frss%3Dyes Thus far, what constitutes refractory gastroesophageal reflux disease (GERD) remains an area of intense controversy. Many investigators believe that only GERD patients who exhibit partial or lack of symptomatic response to proton pump inhibitors (PPI) twice daily should be considered as refractory to PPI therapy. Others suggest that lack of satisfactory symptomatic response to PPI once a day is sufficient to consider GERD patients as refractory to PPI therapy. Furthermore, it is unclear what residual symptom burden during PPI consumption fulfills the definition of refractory GERD. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261589 Tue, 26 Jul 2011 04:00:00 +0100 5261589 http://www.medworm.com/index.php?rid=5053587&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511006318%2Fabstract%3Frss%3Dyes In consideration of the American Gastroenterological Association (AGA) Institute (the “AGA Institute”) taking action to review and credit the below-identified submission (the “Manuscript”), and for other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned authors and/or creators (the “Authors”), jointly and severally, hereby transfer, convey, and assign to the AGA Institute, free and clear of any liens, licenses or encumbrances, the entire right, title, and interest in and to the Manuscript throughout the world, including without limitation in and to any and all copyrights for the Manuscript (including but not limited to rights to copy, publish, excerpt, collect royalties and make derivative works) in print, electronic, Internet,... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5053587 Sat, 23 Jul 2011 17:08:00 +0100 5053587 http://www.medworm.com/index.php?rid=5053586&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511006306%2Fabstract%3Frss%3Dyes Clinical Gastroenterology and Hepatology is the go-to resource on a broad spectrum of themes in clinical gastroenterology and hepatology. The official clinical practice journal of the AGA Institute brings you the best original research in the field with a unique combination of reviews, editorials, podcasts, video abstracts, and outcomes research—all supporting clinical practice. Articles on education, policy, and practice management highlight issues pertinent to clinicians. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5053586 Sat, 23 Jul 2011 17:08:00 +0100 5053586 http://www.medworm.com/index.php?rid=5053585&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651100629X%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5053585 Sat, 23 Jul 2011 17:08:00 +0100 5053585 http://www.medworm.com/index.php?rid=5053584&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511006288%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5053584 Sat, 23 Jul 2011 17:08:00 +0100 5053584 http://www.medworm.com/index.php?rid=5053580&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511006264%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5053580 Sat, 23 Jul 2011 17:07:59 +0100 5053580 http://www.medworm.com/index.php?rid=5053570&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511005076%2Fabstract%3Frss%3Dyes Today, gastroenterologists and the organizations within which they work are increasingly being held accountable for the quality and cost of the care they provide. The first part of this series defined quality and cost, and discussed the theoretical bases of how these complex concepts can be measured. In this part, the attention shifts to the practical aspects of performance measurement, specifically how measures are developed and implemented in everyday practice, and whether a business case supports routine performance measurement in gastroenterology. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5053570 Sat, 23 Jul 2011 17:07:57 +0100 5053570 http://www.medworm.com/index.php?rid=5629634&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007361%2Fabstract%3Frss%3Dyes Conclusions: The results of this systematic review suggest that the majority of patients with GERD are relatively adherent to their PPI, although substantially different estimates were obtained using MPR data compared with surveys. Severe symptoms and the presence of Barrett's esophagus may increase PPI adherence, and other GERD medication is frequently taken in addition to a PPI. Limitations of studies in this area include inferring adherence from indirect MPR data, and recall bias associated with patient surveys. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629634 Fri, 22 Jul 2011 04:00:00 +0100 5629634 http://www.medworm.com/index.php?rid=5525922&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007336%2Fabstract%3Frss%3Dyes Conclusions: An increase in the involvement of anesthesiologists has significantly increased the cost of screening colonoscopies. Studies are needed to assess the effects of anesthesiologists on risks and benefits of colonoscopy, to determine the most safe and cost-effective approaches. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5525922 Fri, 22 Jul 2011 04:00:00 +0100 5525922 http://www.medworm.com/index.php?rid=5261603&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007348%2Fabstract%3Frss%3Dyes Conclusions: The presence of MDBs in liver biopsy samples from patients with CHC is associated independently with fibrosis progression. Gain of MDBs over time is associated with decompensation and progression to cirrhosis; and occurs most frequently among diabetic patients. MDBs might be used as prognostic factors for patients with CHC. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261603 Fri, 22 Jul 2011 04:00:00 +0100 5261603 http://www.medworm.com/index.php?rid=5261602&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS154235651100735X%2Fabstract%3Frss%3Dyes Conclusions: Bariatric surgery in patients with cirrhosis should be performed while liver disease is well compensated. Patients with cirrhosis should undergo surgery at centers that perform large numbers of these procedures. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261602 Fri, 22 Jul 2011 04:00:00 +0100 5261602 http://www.medworm.com/index.php?rid=5261598&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007373%2Fabstract%3Frss%3Dyes Conclusions: SI or SAP indexes can be overinterpreted, unless patients with gastroesophageal reflux disease who are refractory to PPI therapy have high rates of reflux. (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5261598 Fri, 22 Jul 2011 04:00:00 +0100 5261598 http://www.medworm.com/index.php?rid=5163147&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007300%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163147 Wed, 20 Jul 2011 23:00:00 +0100 5163147 http://www.medworm.com/index.php?rid=5163146&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007294%2Fabstract%3Frss%3Dyes (Source: Clinical Gastroenterology and Hepatology) Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163146 Wed, 20 Jul 2011 23:00:00 +0100 5163146 http://www.medworm.com/index.php?rid=5163148&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511007324%2Fabstract%3Frss%3Dyes This study updates in a larger cohort the use of multidetector CT scanning. At a single center, radiology records were retrospectively reviewed over a 9-year period using the search terms appendicitis, right lower quadrant pain, or appendix. Two thousand eight hundred seventy-one adults with suspected appendicitis were referred for CT. The final surgical pathology report was used as the gold standard for acute appendicitis supplemented by the intraoperative findings and clinical follow-up. After final review, acute appendicitis was confirmed in 675 (23.5%) patients. Acute appendicitis was confirmed in 662 and excluded in 54 of the 760 patients who had an appendectomy for a rate of negative findings of 7.5%. Other patients with acute appendicitis were managed nonoperatively and were include... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5163148 Tue, 19 Jul 2011 23:00:00 +0100 5163148 http://www.medworm.com/index.php?rid=5629624&cid=s_38476_17_f&fid=35401&url=http%3A%2F%2Fwww.cghjournal.org%2Farticle%2FPIIS1542356511006902%2Fabstract%3Frss%3Dyes A 67-year-old man was admitted to our hospital for 2-month constipation, nausea, and abdominal pain. Abdominal distention had been added to his list of complaints for about 2 weeks. He was not able to pass stool but did have discharge of gas. The patient had no history of serious illness, hospitalization, or major surgery, but he had been smoking cigarettes and cannabis and using various kinds of laxatives for many years. On initial evaluation, he had a temperature of 37.8°C, a heart rate of 106 beats per minute, respiratory rate of 16 breaths per minute, and blood pressure of 95/60 mm Hg. He was found to be in an agitated condition; on physical examination, his skin was wet and the patient seemed anxious. Bowel sounds were hypoactive, especially in the left quadrant. Palpation revealed a... Clinical Gastroenterology and Hepatology journals http://www.medworm.com/rss/comments.php?id=5629624 Mon, 11 Jul 2011 04:00:00 +0100 5629624