Journals Clinical Gastroenterology and ...

Clinical Gastroenterology and Hepatology
Megan Lutz, Mary S Hayney, Francis A Farraye, Freddy Caldera
No abstract text is available yet for this article.
September 23, 2020: Clinical Gastroenterology and Hepatology
Allen A Lee, Krishna Rao, Henry P Parkman, Richard W McCallum, Irene Sarosiek, Linda A Nguyen, John M Wo, Michael I Schulman, Baharak Moshiree, Satish Rao, Braden Kuo, William L Hasler
BACKGROUND AND AIMS: Whether gastric emptying tests predict longitudinal outcomes in patients with symptoms of gastroparesis is unclear. We aimed to determine whether baseline gastric emptying tests and gut motility parameters could impact longitudinal symptom(s) and quality of life (QOL) in a prospective, observational cohort study of patients with symptoms of gastroparesis. METHODS: One hundred fifty patients with gastroparesis symptoms underwent simultaneous scintigraphy (GES) and wireless motility capsule (WMC) measurement of gastric emptying and other motility parameters...
September 21, 2020: Clinical Gastroenterology and Hepatology
Therese Bittermann, K Rajender Reddy
BACKGROUND / AIMS: Studies have suggested marked increases in transplant delisting due to clinical improvement for patients with hepatitis C virus (HCV) associated cirrhosis in the era of direct acting antivirals (DAAs). This study provides a 'real world' assessment of waitlist dynamics for HCV transplant candidates in the current era. METHODS: This was a retrospective cohort study of adults waitlisted for liver transplant (LT) alone between 1/1/2005-12/31/2018 using national US data...
September 21, 2020: Clinical Gastroenterology and Hepatology
Robert J Shulman, Sridevi Devaraj, Margaret Heitkemper
BACKGROUND & AIMS: The role of the innate immune system in functional gastrointestinal pain disorders is unclear. We investigated the role of β-defensin-2 and gut permeability in childhood irritable bowel syndrome (IBS) and functional abdominal pain (FAP) symptom generation. METHODS: Fecal β-defensin-2 (and in a subset, gut permeability) was measured in children with IBS (n=116), FAP (n=33) and healthy control (HC) children (n=72). IBS and FAP patients were recruited from tertiary and primary care and HC from primary care...
September 19, 2020: Clinical Gastroenterology and Hepatology
Wade Billings, Karan Mathur, Hannah J Craven, Huiping Xu, Andrea Shin
BACKGROUND AND AIMS: Patients with irritable bowel syndrome (IBS) may pursue complementary and alternative medicine (CAM). We conducted a comprehensive systematic review and meta-analysis examining efficacy of CAM vs. placebo or sham in adults with IBS. METHODS: Publication databases were searched for randomized controlled trials of CAM therapies (herbal therapy, dietary supplements, mind-body based, body-based, and energy-healing) in adults with IBS. Data were extracted to obtain pooled estimates of mean improvement in abdominal pain (standardized mean difference [SMD]) and relative risk (RR) of overall response using random effects models...
September 19, 2020: Clinical Gastroenterology and Hepatology
Douglas K Rex, John M DeWitt, Mohammad A Al-Haddad
No abstract text is available yet for this article.
September 19, 2020: Clinical Gastroenterology and Hepatology
Amit G Singal, Anna S Lok, Ziding Feng, Fasiha Kanwal, Neehar D Parikh
Hepatocellular carcinoma (HCC) continues to have a dismal prognosis, with 5-year survival below 20%. This poor prognosis can be in part attributed to failures along the cancer screening process continuum such as underuse of screening in at risk patients and appropriate treatments for patients with HCC. Better understanding these process failures, and how they compare to those seen in other cancer types, can help inform potential intervention targets and strategies to reduce HCC-related mortality. Herein, we outline a conceptual model with several discrete steps in the HCC screening process continuum including risk assessment, screening initiation, follow-up of screening results, diagnostic evaluation, and treatment evaluation...
September 19, 2020: Clinical Gastroenterology and Hepatology
Donghee Kim, Nia Adeniji, Nyann Latt, Sonal Kumar, Patricia P Bloom, Elizabeth S Aby, Ponni Perumalswami, Marina Roytman, Michael Li, Alexander S Vogel, Andreea M Catana, Kara Wegermann, Rotonya M Carr, Costica Aloman, Vincent Chen, Atoosa Rabiee, Brett Sadowski, Veronica Nguyen, Winston Dunn, Kenneth Chavin, Kali Zhou, Blanca Lizaola-Mayo, Akshata Moghe, José Debes, Tzu-Hao Lee, Andrea Branch, Kathleen Viveiros, Walter Chan, David Chascsa, Paul Kwo, Renumathy Dhanasekaran
BACKGROUND: Chronic liver disease (CLD) represents a major global health burden. We undertook this study to identify the factors associated with adverse outcomes in patients with CLD who acquire the novel coronavirus-2019 (COVID-19). METHODS: We conducted a multi-center, observational cohort study across 21 institutions in the United States (US) of adult patients with CLD and laboratory-confirmed diagnosis of COVID-19 between March 1, 2020 and May 30, 2020. We performed survival analysis to identify independent predictors of all-cause mortality and COVID-19 related mortality, and multivariate logistic regression to determine the risk of severe COVID-19 in patients with CLD...
September 17, 2020: Clinical Gastroenterology and Hepatology
William J Sandborn, Marc Ferrante, Bal R Bhandari, Elina Berliba, Toshifumi Hibi, Geert R D'Haens, Jay L Tuttle, Kathryn Krueger, Stuart Friedrich, Michael Durante, Vipin Arora, April N Naegeli, Jochen Schmitz, Brian G Feagan
BACKGROUND & AIMS: Mirikizumab is an antibody against the p19 subunit of interleukin 23 that has demonstrated clinical efficacy and was well tolerated following 12 weeks of induction treatment in a phase 2 trial of patients with moderate to severe ulcerative colitis. We present results of the open-label extended induction period in patients who did not initially respond to treatment with mirikizumab. METHODS: This study was a continuation of I6T-MC-AMAC, a double-blind trial, performed at 75 sites in 14 countries, in which patients with moderate to severe ulcerative colitis were randomly assigned to 12 weeks induction therapy with 50 mg, 200 mg, or 600 mg mirikizumab or placebo...
September 17, 2020: Clinical Gastroenterology and Hepatology
John M DeWitt, Mustafa Arain, Kenneth J Chang, Reem Sharaiha, Sri Komanduri, V Raman Muthusamy, Joo Ha Hwang
The evolution of endoscopic ultrasound (EUS) from a diagnostic to a therapeutic procedure has resulted in a paradigm shift towards endoscopic management of disease states that have previously required percutaneous or surgical approaches. The last few years have seen additional techniques and devices that have enabled endoscopists to expand its diagnostic and therapeutic capabilities. Some of these techniques were initially reported over a decade ago; however, with further device development and refinement in techniques there is potential for expanding the application of these techniques and new technologies to a broader group of interventional gastroenterologists...
September 17, 2020: Clinical Gastroenterology and Hepatology
Giorgos Bamias, Fabio Cominelli
The development of Crohn's disease is characterized by a breakdown of homeostatic immune-bacterial communication, which takes place at the intestinal mucosa when environmental triggers impact genetically predisposed individuals. Converging lines of evidence support the hypothesis that this pathogenetic model develops through sequential, although interrelated, steps that indicate failure of mucosal defense mechanisms at various stages. In this context, immunological phenomena that mediate the initial appearance of inflammatory lesions across the intestinal tissue may substantially differ from those that mediate and perpetuate chronic inflammatory responses...
September 16, 2020: Clinical Gastroenterology and Hepatology
Shazia Mehmood Siddique, Shivan J Mehta
No abstract text is available yet for this article.
September 14, 2020: Clinical Gastroenterology and Hepatology
Hyun Seok Lee, Navroop Nagra, Danielle La Selva, Richard A Kozarek, Andrew Ross, Wade Weigel, Ryan Beecher, Michael Chiorean, Michael Gluck, Elisa Boden, Nanda Venu, Rajesh Krishnamoorthi, Michael Larsen, Otto S Lin
BACKGROUND & AIMS: Patients who chronically use alcohol, marijuana or opioids, or suffer from post-traumatic stress disorder (PTSD), can be difficult to sedate with midazolam and fentanyl, and are often referred for monitored anesthesia care during endoscopy. Nurse-administered propofol continuous infusion sedation (NAPCIS), which confers the benefit of propofol-based sedation without the added expense of anesthesia, is effective and safe for sedation of healthy patients. We investigated whether NAPCIS is also effective for patients who are difficult to sedate...
September 12, 2020: Clinical Gastroenterology and Hepatology
Ole Haagen Nielsen, John Mark Gubatan, Carsten Bogh Juhl, Sarah Elizabeth Streett, Cynthia Maxwell
BACKGROUND & AIMS: Biologics are routinely used in pregnant women with inflammatory bowel disease (IBD) but large-scale data reporting adverse pregnancy outcomes among biologic users are lacking. We sought to estimate the prevalence of adverse pregnancy outcomes in women with IBD on biologic therapies. METHODS: We searched major databases from inception to June 2020 for studies estimating the prevalence of adverse pregnancy outcomes in IBD when using biologics (anti-TNF, anti-integrins, and anti-cytokines)...
September 12, 2020: Clinical Gastroenterology and Hepatology
Amanda J Cross, Emma C Robbins, Brian P Saunders, Stephen W Duffy, Kate Wooldrage
BACKGROUND AND AIMS: Detection and removal of adenomas reduces colorectal cancer (CRC) risk. The impact of adenoma detection rates (ADRs) on long-term CRC incidence and mortality is unknown. We investigated this using data from the UK Flexible Sigmoidoscopy Screening Trial (UKFSST). METHODS: Of 167,882 UKFSST participants, 40,085 were in the intervention arm and underwent flexible sigmoidoscopy screening at 13 trial centres. Median follow-up was 17 years. At each centre, one endoscopist performed most flexible sigmoidoscopies...
September 12, 2020: Clinical Gastroenterology and Hepatology
Wei Jiang, Bing Yee Suen, Hiu Tung Ho, Jessica Y L Ching, Francis K L Chan, Joyce W Y Mak
BACKGROUND: Although there are international guidelines on the management of anti-thrombotic therapy in patients undergoing colonoscopic polypectomy, whether clinicians and patients follow these recommendations are largely unknown. AIMS: We aimed to evaluate clinicians' adherence and patients' compliance to peri-endoscopic management of antithrombotic therapy and their impact on clinical outcomes. METHODS: Consecutive patients on anti-thrombotic therapy scheduled for elective colonoscopy in a tertiary referral center were prospectively recruited...
September 12, 2020: Clinical Gastroenterology and Hepatology
Nicole J Kim, Karine Rozenberg-Ben-Dror, David A Jacob, Nicole Rich, Amit G Singal, Elizabeth S Aby, Ju Dong Yang, Veronica Nguyen, Anjana Pillai, Michael Fuchs, Andrew M Moon, Hersh Shroff, Parul D Agarwal, Ponni Perumalswami, Shaun Chandna, Kali Zhou, Yuval A Patel, Nyan L Latt, Robert Wong, Andres Duarte-Rojo, Christina C Lindenmeyer, Catherine Frenette, Jin Ge, Neil Mehta, Francis Yao, Jihane N Benhammou, Patricia P Bloom, Michael Leise, Hyun-Seok Kim, Cynthia Levy, Abbey Barnard, Mandana Khalili, George N Ioannou
BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) surveillance rates are suboptimal in clinical practice. We aimed to elicit providers' opinions on the following aspects of HCC surveillance: preferred strategies, barriers and facilitators, and the impact of a patient's HCC risk on the choice of surveillance modality. METHODS: We conducted a web-based survey among gastroenterology and hepatology providers (40% faculty physicians, 21% advanced practice providers, 39% fellow-trainees) from 26 U...
September 11, 2020: Clinical Gastroenterology and Hepatology
Andrew J MacDonald, Jaime L Speiser, Daniel R Ganger, Kathleen M Nilles, Babak J Orandi, Anne M Larson, William M Lee, Constantine J Karvellas
BACKGROUND & AIMS: Acetaminophen (APAP)-induced acute liver failure (ALF) is a rare disease associated with high mortality. This study aimed to evaluate changes in interventions, psychosocial profile and clinical outcomes over a 21-year period using data from the ALF Study Group registry. METHODS: A retrospective review of this prospective, multicenter cohort study of all APAP-ALF patients enrolled during the study period (1998-2018) was completed. Primary outcomes evaluated were 21-day transplant-free survival (TFS) and neurological complications...
September 10, 2020: Clinical Gastroenterology and Hepatology
Fernando Magro, Catarina Alves, Joanne Lopes, Susana Lopes, Helena Tavares de Sousa, José Cotter, Vitor Macedo da Silva, Paula Lago, Ana Vieira, Mariana Brito, Maria Am Duarte, Francisco Portela, João P Silva, Paula Ministro, Bruno Arroja, Liliana Carvalho, Joana Torres, Mafalda Santiago, Manuela Estevinho, Silvio Danese, Laurent Peyrin-Biroulet, Cláudia Camila Dias, Paula Borralho, Roger M Feakins, Fátima Carneiro
BACKGROUND & AIMS: In addition to findings from endoscopy, histologic features of colon biopsies have been associated with outcomes of patients with ulcerative colitis (UC). We investigated associations between Geboes scores (a system to quantify structural changes and inflammatory activity in colon biopsies) and UC progression, and the time period over which this association is valid. METHODS: We analyzed data from 399 asymptomatic patients with UC enrolled in the ACERTIVE study, followed at 13 inflammatory bowel disease (IBD) centers in Portugal through 31 December 2019...
September 10, 2020: Clinical Gastroenterology and Hepatology
Amit G Singal, Sruthi Patibandla, Joseph Obi, Hannah Fullington, Neehar D Parikh, Adam C Yopp, Jorge A Marrero
BACKGROUND: The value of a cancer screening programs is defined by its balance of benefits and harms; however, there are few data evaluating both attributes for hepatocellular carcinoma (HCC) surveillance. We aimed to characterize benefits and harms of HCC surveillance in a large prospective cohort of patients with cirrhosis. METHODS: We conducted a secondary analysis of a clinical trial evaluating HCC surveillance among patients with cirrhosis at a safety-net health system enrolled between December 2014 and July 2015...
September 10, 2020: Clinical Gastroenterology and Hepatology
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